Awake Intubation

I wish i could describe this.

Because of the many interruptions and aggravations with noises, i deleted a long comment on fb i wrote about atelectasis and i got mad that turned into enough motivation to get on the blog and write it all again.

I slept 6 hours and awoke about 2 hours ago and ever since everything that i'm doing is being accompanied by an orchestra of noises. Only thing is they don't seem random but coordinated and synced to what i'm doing. It's like dozens if not hundreds of people use their daily activities guided by a director with the only purpose of interacting and influencing what i'm doing. I mean they do something that can be called daily routines, maybe only slightly exaggerated (most of cars by examples have modified exhausts and one starts every half hour and roars for 10 minutes), but with pauses and break points that can be slightly adjusted by a director or something. One of the effects is i can hardly concentrate. That is if i even am completely awake.

I was outside, could not find any open mole holes in the immediate vicinity of the building. In fact it smells like clean air. When i got back inside, the same old smell of rotten earthworms.

Atelectasis is a very common complication of general anesthesia. Few people, and even those who went through major surgeries know about.

You do not go to sleep. You are being sedated to the point you loose consciousnesses and get paralyzed.

Loosing all pain and feeling comes with a price. You cannot breath on your own anymore. After the sedative is injected in your IV, a skilled anesthesiologist is ready with a tube in his hand and introduce it in your trachea (windpipe) within seconds of you loosing consciousness and stop breathing. It's called intubation. The same second they start the ventilator which pumps rhythmically oxygen or a mixture into your lungs, mimicking breathing. From that moment on until you are weened of the sedative and wake up, your life from this point of view depends on the anesthesiologist. He has to figure how much sedative you are given, how much oxygen, how fast the ventilator should work taking in account lots of parameters.

Your diaphragm muscle is responsible for about half of the volume of air getting to your lungs (the other half is done by your rib cage). When all those muscles get paralyzed, both of the rib cage and diaphragm, any abdominal pressure due to gas (bloating) caused by the food you last ate before surgery may press on the diaphragm muscle during the breath out phase or when the ventilator let the air out of your lungs and tear that muscle to the point it presses against your lungs and collapses them. I bet this parameter is not monitored by the anesthesiologist in any way, because they can give you pure oxygen and you can breath during those hours with maybe half of your lungs capacity and he gets you out of there alive but then after you have to go for a treatment for that collapsed lung which usually is long and not always 100% successful.

About the awake intubation. How weird this is, in the medical world, you may read the results of this google search. I mean  theoretically it can be done, a doctor can insert a tube on your trachea without sedation. But aren't you going to want to throw up right away? With local anesthesia and even with light general sedation i bet not many people can take it for more than a few hours, not even thinking about days. You'd have to be fully sedated (induced comma) to take that for a week as i saw claims in media.

On the other hand. Can't do general anesthesia without an anesthesiologist on the spot. (Michael Jackson, remember). I believe it's a rule (at least common sense is telling me that). So who's gonna tell me that all the people that have been on a ventilator had an anesthesiologist next to them, 24/7?

One more reason not to believe every or anything is written these days like always in the media.