MilkmanAl

Awesome question! It seems like I'd mostly be hidden in the operating room with sleeping patients, right? It turns out that I manage anxiety and other mental health issues all day, every day. I frequently see people - both patients and patients' families - at their worst and most downtrodden. They are often scared, uncertain of how or when they'll recover. Many are desperate, trying to understand what is happening to them and why. When unexpected complications arise, I am typically present to break the news to the family. Sometimes people have simply had bad experiences with surgery in general or anesthesia in particular and are understandably apprehensive about undergoing that process again. It's common to have a fairly lengthy discussion with people about what to expect from their care, essentially managing expectations when bad outcomes are likely.

I rarely, if ever, have to deal with mental health longitudinally, but that's a challenge in its own right. I have to go earn someone's trust - usually in 15 minutes or less - and assure them that I'm staunchly on their side when they're mired in all of the above issues. When they've been through multiple surgeries and/or in and out of the hospital frequently, as a large percentage of the people I see have been, that's not always easy. Depression and anxiety are rampant in the chronically and severely ill, and making them feel better is part of the gig. My job is primarily safety with comfort as sort of a distant second, but if I'm looking to treat the whole person, mental health is a big part of physical recovery. Without hope or motivation, few people would make it out of the hospital and stay out.

Last but not least, I deal with a lot of chronic pain patients. Chronic pain, anxiety, and depression are generally densely interwoven, so there's not going to be much treating that pain without addressing the mental aspects of pain patients' issues as well. Certainly, I'm not the one to be doing deep-dive therapy sessions, but addressing their concerns and taking the time to validate their experiences is extremely important. If people feel heard and appreciated, they are much more likely to do the difficult things you ask them to do, which for pain patients often means doing some physical therapy that causes more discomfort in the short term for long term improvement or - this is the big one - weaning off narcotics they've been on for years. Addiction and dependence are a big part of the anesthesia game, and we're unfortunately usually the ones who have to be hardasses and develop and enforce plans to scale them back on their narcs.

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Wow, that was really long-winded. Hopefully I answered your question!

The redhead thing is actually true! It does, indeed take a whole lot more anesthesia to keep someone with red hair down. Y'all have a mutation in your melanocortin-1 receptor that makes anesthesia less effective. I've seen estimates as high as 50% more anesthesia required. If you're looking for some really dry reading, here's a study that shows a 19% increase in "volatile anesthetic" (read: anesthesia gas) necessary to anesthetize people with red hair. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1362956/

Yeah, I'd definitely mention it. I mean, it kind of becomes obvious that you need more juice during surgery when you're physiologically responding to whatever's going on - usually meaning a pain response like increased blood pressure and/or heart rate with faster breathing - but if they know ahead of time to expect you to facetank a bunch of meds, that's helpful for both sides.

Definitely a bad question to ask after I was up all night doing orthopedic surgeries. LOLZ

Laziest way? Buy one of these: https://www.compressionmanagement.com/our-products/sequential-compression-devices/

Never move again, and be clot-free!

If you're looking for a serious answer, most recs I've seen are you should do some calf extensions and flexion for about a minute every half hour if you're sitting. If you're up and walking around intermittently, you're probably fine, assuming no weird clotting issues.