Damn it! Get it *BANG BANG* into *BANG* you *BANG* round *BANG* mother flippen hole you square shaped.....

"You're having what she's having."

I bloody well hope not, and I very much doubt it. They probably overdosed you, but doctors can't go by "I'm a lightweight" just on your say-so. The only thing worse than overdosed is being underdosed and insufficiently sedated.

But yes, the cookie cutter approach to medicine isn't really viable. People are willing to accept the occasional distorted cookie in a packet, not so much in health care. Totally different quality expectations are involved. This stuff is a trade-off, cut costs and you decrease quality. This doesn't apply when some sort of genuine innovation is involved (keyhole surgery, for instance, dramatically reduces recovery time and infection risk and hence cuts post-op care costs) but that doesn't seem to be Atul Gawande's point.

That's really interesting. I just posted on my blog about how I'm very weird regarding anesthesia. Apparently, when one is put under general anesthesia, they are supposed to forget what happened immediately before it. They designed the cocktail that way because people used to have nightmares of walking in to the OR based on their memories.

It does not work for me. At all. I actually said something to the anesthesiologist about my prior surgery experience (oh the table's lower - do they adjust height? etc.). She mentioned that I wouldn't remember her. I was surprised and told her I remembered the anesthesiologist from the last two times I was put under (ok, the ONLY two other times).

Well, needless to say I remember all this. I told my surgeon at the post-op to let her know I remembered our conversation where she said I wouldn't remember the conversation. He seemed sort of shocked once it was clear he believed me (about when I said my last thought was "why are they putting a little oxygen mask on me? How will he get to my sinuses with that in the way?")

He's the one who told me about patients getting nightmares. He said most patients report being shocked at how little they remember... like they don't remember going to the surgery center at all. Their only memories of it are post-op.

I told him about my other two full anesthesia experiences and he looked like he was in medical awe or something. He said it's really weird that I am immune to the retrograde amnesia effect.

So, I'm with you Amy. I actually think based on my comment, the anesthesiologist erred on the high side because my recovery time was extra-long and previously I was very fast. She probably thought I hadn't been fully sedated! Can't blame her, but I hope SOMEBODY puts this in a medical journal.

"Actually, listening to a patient is very important."

Period.

Whether it be anesthesia or something else; healthcare providers can only do their jobs correctly by getting feedback from their patients.

Redheads are rather notorious for their weird reactions to sedation. A little bit puts me clean out but I metabolize it faster and wake up earlier than expected. I'm a redhead, too.

I don't think it will inconvenience anyone to add more if they didn't give you enough. They had to give my husband more because he kept trying to get away when he was on the table. (They were scoping the other end.) He remembers almost nothing from that day.

didn't we try this already and wasn't it called an HMO?

They tried to standardize a lot of things, and it didn't help cost drivers.

IKEA furniture is pretty good, but ONLY if you glue it up as if it were normal furniture, and realize that it isn't meant to be heavy duty.

But you wouldn't mistake it for craftsmanship.

For this I recommend a line from a preposterous but amusing space shoot 'em up: Armageddon...
"Rockhound: You know we're sitting on four million pounds of fuel, one nuclear weapon and a thing that has 270,000 moving parts built by the lowest bidder. Makes you feel good, doesn't it?"

We have plenty of problems, but medical care by govt. lowest bidder? Yeesh, who would even trust that?

To be honest, I had never heard that anesthesia is supposed to cause retrograde amnesia. I'm pretty sure that it does not do that to me. I've had any number of sinus surgeries over the years, and I can recall for just about every one of them being wheeled into the OR, laying on the table under the lights, getting the IV started, watching the anesthesiologist inject the anesthetic into the IV line, and the feel of it moving through my veins. I've never had nightmares about being wheeled into an OR, so it doesn't bother me. It would bother me if I woke up and couldn't remember anything from that day.

Actually, the retrograde amnesia sounds a lot like what often happens in closed-head injuries. Long-term memory is not effected, but short-term memory is erased backwards in time from the time of the accident, and may return in spots later. NASCAR driver Bobby Allison (a personal hero of mine) suffered a near-fatal head injury in a race in June of 1988. To this day, his last memories of time before the accident are fragments from the Daytona 500 in February of that year, but he has great memories of things from before that time. I've also read of patients (such as one that Oliver Sacks described in The Man Who Mistook His Wife For a Hat of patients who are unable to form new short-term memories, but their long-term memories are intact up to a certain point. My maternal grandmother got to be that way in the last year of her life.

As stated in the article, the problem is that ObamaCare entrenches the government as the true consumer of medical care. You might be receiving it, but the government is paying for it.

Because it is the paying party, the government's arbitrary regulations carry more weight than the doctors' input, the patients' welfare, and medical guidelines combined when it comes to what procedure will be authorized to be performed.

And if the government mandates a brutal one-size-fits-all efficiency standard to save money, there is nothing anyone can do about it - since buying non-government insurance will be illegal.

Listen to the patients? Why? We went to med school; the patients didn't. All they do is complain hysterically anyhow. Most of them would get better if they would just shut up about it, or if they would just see their doctor first instead of reading some quackery about natural medicine, which they all do. And they are all fat. Why should we have to listen to somebody complaining about stuff when they got themselves fat? In my opinion, the practice of medicine is being ruined by all this listening to the patient nonsense.

Right now, the patient doesn't see the money being spent. The patient pays an insurance premium and demands service from the designated provider (or demands it from Medicare).

Let the patient watch his personal medical care reserve fund dwindling with every visit to the doctor for a condition the patient could have alleviated with exercise or a better diet and you might see patients taking better care of themselves.

Right now, it's all magic money to the patient. "I put a dime in as a premium and get a dollar's worth of medical care."

We sort of had this same discussion with Amy a while back.

The answers just don't seem any better now than then.

Cousin Dave,

If I'd known I wasn't supposed to remember, I would have piped up after the first surgery (wisdom teeth). If I hadn't made a comment to the anesthesiologist about "my last surgery" I would never have known.

I always knew there was something different about my brain - now as to what that means...

When my daughter was born, I had a very bad reaction to the medication they gave me to lower post partum high blood pressure. By morning the next day I was barely staying conscious. The nurse thought I may just need food, and I could barely feed myself. It was all I could do to keep focused. Then my sight went all wavery, and the edges getting dark, like right before you pass out. All I kept thinking was that if they didn't stop the meds I may not wake up.

It was a Sunday and the nurse said she needed to check with the doctor before stopping the med drip (was an I.V.). She came back and said that the doc did not recommend it. I said stop it or I am taking out the I.V. She did and about 20 mins later I felt normal. The doc came in later and said that if I wasn't going to take his advice I should just go home. He told me that the lady down the hall is on the same med and not giving him a hard time.

I had had a cesarean, so they kept me for another day and a half. Had to fight not to have pain meds. They made me loopy and I couldn't remember anything. The nurse argued when I said to stop that drip. I was still numb from the spinal so why were they giving me pain meds anyway? But I won that fight too. I was lucky, I never was in a lot of pain after the spinal wore off.

I am just glad I was looking out for myself, they aren't always right.

Melody,

I had almost forgotten. After my son was born, the nurses who came by every 12 hours or so would ask what I had been given for pain (presumably to double check the chart). I said nothing. They all freaked out and kept trying to give me stuff (I didn't need it unless I planned on running) - after 3 times, I finally gave up and took an ibuprofen. That seemed to get them to calm down. But really, I didn't need anything.

After my 2nd child, the midwife told me to take ibuprofen every 6 hours (for a specific reason that I no longer remember). She said she put it in the chart and the nurse would bring it to me. I had to track down the nurse and argue with her for the stupid ibuprofen! I was exhausted and kept having trouble keeping track of when I had it (versus when I last fed the baby, etc). Ugh!

My lady would go into the hospital with various issues. One painkiller -- morphine, Dilaudid, codeine she could handle. The nurses would come by and not do an assessment and ask her if she was in pain. She was high as a kite and would say sure to anything. They would then give her a second painkiller which would rip all of one mineral or vitamin out of her system and put her into simple dementia.

It may have been potassium or a vitamin B complex. Either way she was out in Lala-land with the yo-yo's. But since we weren't married, the day shift nursing staff didn't believe me when I said she should be lucid and this was not normal.

I never want to go to the hospital. That's where all the sick people are.