Date: 15/12/22 Support Tips: Preparation: in order to best prepare some actions might include ~ Considering your sensory needs- pack a bag with sensory aids such as headphones, earplugs, coloured glasses, stim tools, comfort items and so on to support your comfort whilst at your appointment. Considering your communication needs- perhaps take a trusted friend or family member to support with verbal communication, a hospital passport that you can share with staff or notes including scripted comments or responses that you can refer to during the appointment to support with or replace verbal speech. Wear suitable clothing that can be easily taken on and off. To minimise uncertainty, research what is involved in the procedure before attending so that you have a good idea what to expect. Write out a list of questions to avoid relying on memory during a potentially stressful experience. Plan your travel route in advance and leave plenty of time to get to your appointment to minimise anxiety and allow time to adjust to the environment upon arrival. Engage in calming, grounding techniques prior to the appointment start time. During: whilst at the appointment it may be helpful to ~ Ask for the nurse practitioner to talk you through the procedure in full before it commences, preferably with use of images or demonstrations with relevant equipment. Be open about which aspects of the experience you might struggle with as an Autistic person and request particular adjustments. Engage in grounding techniques such as mindful breathing. Hold on to a stim object that is comforting or acts as a stress reliever. Listen to music to support self-regulation. Share your concerns or worries with the nurse practitioner to invite reassurance or helpful advice. Remember your reason for attending and why it is important for you. Aftercare: following the procedure, it is a good idea to plan in some time for self-care and self-regulation, some ideas might include ~ Get yourself into a sensory safe space where things feel predictable and calm (for e.g. a quiet room with dim lighting, weighted blanket etc). Arrange to debrief/chat to a friend or another supportive person about your experience after leaving your appointment. Arrange to meet with a trusted person following the procedure to support you with getting back home or perhaps to do something you might enjoy together. Engage in your dedicated interest. Acknowledge your achievement in attending and getting through the appointment. Journal about your experience to help with emotional processing. Engage in your favourite stim to release any tension that may remain in your b0dy. Allow yourself to physically rest or sleep once back at home. Date: 15/12/22

Date: 15/12/22 Autistic qualities such as differences in how we understand what our body is feeling (interoception), our experience of pain (hypo/ hyper sensitivity) and difficulties in noticing and identifying how we feel (alexithymia) Nurse practitioners and doctors may have a limited understanding of the unique and significant ways in which autism and its associated issues impact a patient’s experience of a given medical procedure. This means that the particular supports that might help to alleviate discomfort could be lacking. We might encounter resistance to our own attempts to self- regulate and take care of our sensory and emotional needs during the appointment. We may even experience medical gas lighting or invalidation when attempting to express our experience or request much needed accommodations ( we know that this happens at higher rates amongst female presenting people, people of colour and those with additional learning disabilities in our community). For those of us with a history of these types of experiences, just being in a medical environment could feel threatening and unsafe. * Autistic person with a particular set of qualities and traits, this is not a prediction of what others might encounter or an attempt to generalise my own experience to the broader community. Date: 15/12/22

Sedation Today, physicians have many ways to make sure their patıents are as comfortable as possible during surgery or procedures for diagnosing medical conditions. One common type of pain control is called sedation, which relaxes you and sometimes makes you fall asleep. Sedation, also known as monitored anesthesia care, conscious sedation, or twilight sedation, typically is used for minor surgeries or for shorter, less complex procedures, when an injection of local anesthetic isn’t sufficient but deeper general anesthesia isn’t necessary. Depending on the procedure, the level of sedation may range from minimal (you’ll feel drowsy but able to talk) to deep (you probably won’t remember the procedure). What are the levels of sedation? The level of sedation a patient experiences depends on several factors, including the type of procedure you’re having and how your body responds to anesthesia. Your age, medical condition, and health habits may also affect the type of anesthesia you’ll receive. Regardless of the level of sedation, it’s important that an anesthesiologist be involved in your anesthesia care. An anesthesiologist is a medical doctor who specializes in anesthesia, paın management, and critical care medicine. That can happen if you are sedated to a point where you are confused or fall asleep and snore. For some procedures, you may receive medication that makes you sleepy and keeps you from feeling pain. There are different levels of sedation — some patients are drowsy, but they are awake and can talk; others fall asleep and don’t remember the procedure. The main levels of sedation are: Minimal – Minimal sedation will help you relax, but you will likely be awake. You’ll understand questions your doctor is asking and be able to answer as well as follow directions. This level of sedation is typically used when your doctor needs you to be involved in the procedure. Moderate – You will feel drowsy and may even fall asleep during the procedure. You may or may not remember some of the procedure. Deep – You won’t actually be unconscious, but you’ll sleep through the procedure and probably will have little or no memory of it. How does general anesthesia work? Under general anesthesia, you will be unconscious and unaware of what is happening. General anesthesia keeps you unconscious during the entire procedure. General anesthesia causes you to lose consciousness. General anesthesia is medicine that is administered by an anesthesiologist, a medical doctor, through a mask or an IV placed in the vein. While the anesthesia is working, you will be unconscious, and many of your body’s functions will slow down or need help to work effectively. During surgery, the anesthesiologist will monitor your vital signs to make sure they are normal and steady while you remain unconscious and free of paın. Once your surgery is complete, your anesthesiologist will reverse the medication and be with you as you return to consciousness and wake up, continually monitoring your breathing, circulation, and oxygen levels. It may take a day or two for the anesthesia medication to completely leave your system, so you could be sleepy, and your reflexes and judgment can be affected by Postoperative delirium – Confusion when regaining consciousness after surgery.

The different types of anesthesia are broadly described as: Local anesthesia (agents, either topical or injectable, given to temporarily block paın in a specific part of the bødy) in which the medication only removes sensation from one part of your bødy, but you are not unconscious. Regional anesthesia (injected agents, to numb a portion of the bødy) General anesthesia (an agent, given either by mask or an IV line, to induce unconsciousness) General anesthesia is highly effective in keeping you unaware of your surgical procedure. Monitored anesthesia care (also known as "twilight sleep") It can be given intravenously (IV, by injection into the vein). The medication works quickly and typically puts you to sleep in under a minute. Medicines administered via the bloodstream begin to take effect quickly, often within minutes. Most people feel very relaxed at the start of IV sedation as the medicines begin to take effect. Many people remember the feeling of relaxation and waking up after the procedure is over but nothing in between. There are different levels of IV sedation, and you may or may not be awake during the procedure. Your anesthesia team will adjust your sedation level throughout the procedure. One other type of anesthesia apart from general is called MAC (monitored anesthesia care), where you are kept sleepy and given paın medication but still breathe independently. Anesthesia can provide sedation ranging from slight (relaxed and mildly sleepy) to deep sleep.

r/shortscarystories 3 yr. ago deontistic Unnatural Birth ᵀᵂ ᶜᵘᵗˢ There was no other way, and there was no one else. The grotesque swell to the belly, the unnatural writhing, my indescribable pain—I was panicked, but I knew it was up to me. I had to do it. No one else seemed to have the spine to offer anything more than assistance. Clinically . . . I had to think clinically. And I had to move fast, had to take the kn*fe and cut—yet I had to be careful not to cut too deep. To cut too deep would mean certain disaster, wouldn’t it. I had to šhut everything down; I had to šhut off the lights in all my rooms except the one where I would cut. I had to ignore my paın . . . exit the moment . . . had to proceed. I took the kn*fe and placed its blxde on the belly, then I pressed and dragged—not too hãrd, but firm. The layers cut more easily than I’d imagined, and my incision was true. Still, no time to waste . . . had to keep moving. I pulled back the layers and reached deep into the belly. He was right there, my chıld, my soñ . . . I held him in my hands inside the belly, then I pulled him through the viscera, the muscle, the skın. I held him in my arms, covered in blood as he was, eyès half øpened staring at nothing. Of course he was đeađ, just as they’d said he’d be. I held him . . . and I wailed . . . and wailed . . . I hated . . . I hated my husband for making us come to the Amazon with him, hated myself for not refusing to come. I hated that I’d look͘ed̛ away, even though it’d only been for the slightest of moments. And though the beast hadn’t acted out of malevolence as my heart told me it surely must’ve, but only out of its instinct to survive . . . I hated the anaconda, too. My boy, my little James . . . he was just two . . .

Specific Types and Classes Multiple types are available. Some allow you to be alert and oriented during a medical procedure, while others make sleep so you're unaware of what's going on. It essentially puts you into a medically induced coma. This type of anesthesia not only allows a person to undergo a procedure without pain but also allows the person to be unconscious for the procedure. Some specific types or classes of general anesthesia include: IV anesthetics sedatives- your anesthesiologist will use your IV line to administer into your blood. The medication works quickly and typically puts you to sleep in under a minute. For this reason, its effects can be stopped by stopping the infusion, which will wake you up from it in minutes. Inhalational anesthetics The four clinical stages of general anesthesia include induction, maintenance, emergence, and recovery. Induction can be achieved through administration of either an intravenous or inhalation anesthetic. During the maintenance stage, anesthetic agents, intravenous, inhalation, or a combination, are continued to maintain the surgical stage of anesthesia. The emergence phase correlates to the discontinuation of anesthetic agents with the goal attaining near baseline functionality. Organ systems of focus include the cardiovascular, respiratory, and central nervous systems (CNS). Throughout the procedure, the anesthesiologist will monitor your vital signs, including your heart rate and rhythm, blood pressure, temperature, and body fluid balance, to ensure safety and comfort. The recovery phase is an extension of the emergence stage whereby the goal is to return the patient back to their baseline state of physiological function. While most people will start to regain consciousness within a few minutes, it can take several hours to feel completely alert and coherent again. Patients experiencing delirium or agitation when coming out of anesthesia can also feel hyperactive or experience extreme sluggishness. The researchers believe hyperactivity may result from the microglia intervening too much between the neuron and inhibitory synapses.

https://pubs.asahq.org/anesthesiology/article/96/5/1250/40049/An-Unexplained-DeathHannah-Greener-and-Chloroform

ᵃⁿ ᵃʳᵐ ᵃⁿᵈ ᵃ ˡᵉᵍ ⁽ᔆᵖᵒⁿᵍᵉᴮᵒᵇ ᶠᵃⁿᶠⁱᶜ⁾ ᶠʳᵉᵈ ᵃʷᵒᵏᵉ ᵃˢ ᵗʰᵉʸ ʳᵒˡˡᵉᵈ ʰⁱˢ ᵇᵉᵈ ⁱⁿ ᵗʰᵉ ʳᵉᶜᵒᵛᵉʳʸ‧ "ʸᵒᵘ'ʳᵉ ᵒⁿ ᵗʰᵉ ᵐᵉⁿᵈ‧" ᵀʰᵉʸ ᵗᵒˡᵈ ʰⁱᵐ ᵃˢ ᵗʰᵉʸ ᵉⁿᵗᵉʳ ᵗʰᵉ ʳᵒᵒᵐ ᵃʳᵉᵃ‧ ᶠʳᵉᵈ ⁱⁿʲᵘʳᵉᵈ ʰⁱˢ ˡᵉᵍ⸴ ˢᵒ ᵗʰᵉʸ ʷᵉⁿᵗ ⁱⁿ ᶠⁱˣ ⁱᵗ‧ ᴬⁿᵒᵗʰᵉʳ ᵇᵉᵈ'ˢ ᵈⁱᵃᵍᵒⁿᵃˡˡʸ ᵃᶜʳᵒˢˢ ᶠʳᵒᵐ ᶠʳᵉᵈ⸴ ᵐᵃᶜʰⁱⁿᵉʳʸ ᵇᵉᵉᵖⁱⁿᵍ ⁿᵒⁱˢᵉˢ‧ "ᵂʰᵃᵗ'ˢ ʰᵒᵒᵏᵉᵈ ᵘᵖ ᵗᵒ‧‧‧" ᶠʳᵉᵈ ᶠᵒˡˡᵒʷᵉᵈ ᵗʰᵉ ˡⁱⁿⁱⁿᵍ ᵗᵘᵇᵉˢ ᵃⁿᵈ ˢᵃʷ ᴾˡᵃⁿᵏᵗᵒⁿ⸴ ʰⁱˢ ᵃʳᵐ ⁱⁿ ᵃ ᶜᵃˢᵗ⸴ ⁿᵒᵗ ᵐᵃᵏⁱⁿᵍ ᵃⁿʸ ⁿᵒⁱˢᵉ‧ 'ᴴᵉ ᵐᵘˢᵗ ⁿᵒᵗ ʰᵃᵛᵉ ᵉᵐᵉʳᵍᵉᵈ ᶠʳᵒᵐ ʸᵉᵗ' ᶠʳᵉᵈ ᵗʰᵒᵘᵍʰᵗ⸴ ˢᵉᵉⁱⁿᵍ ʰⁱˢ ᵉʸᵉ ᶜˡᵒˢᵉᵈ ᵃⁿᵈ ⁿᵒᵗ ᵐᵒᵛⁱⁿᵍ ᵒʳ ᵃʷᵃʳᵉ ᵃᵗ ᵃˡˡ‧ "ᴹᵃʸ ᴵ ᵃˢᵏ ʷʰᵃᵗ'ˢ ᵘᵖ ʷⁱᵗʰ ʰⁱᵐ?" ᶠʳᵉᵈ ᵃˢᵏᵉᵈ ᵗʰᵉ ⁿᵘʳˢᵉ‧ "ᴶᵘˢᵗ ᶠⁱⁿⁱˢʰᵉᵈ ᵃ ˢᵘʳᵍᵉʳʸ ʳᵉᵖᵃⁱʳⁱⁿᵍ ᵃ ᶠʳᵃᶜᵗᵘʳᵉ ᵇʳᵉᵃᵏ ᵃˢ ʰᵉ ᶜᵃᵐᵉ ⁱⁿ ⁱⁿʲᵘʳᵉᵈ‧ ᵂʰᵉⁿ ᵗʰᵉ ᵇᵒⁿᵉ ᶜʳᵃᶜᵏᵉᵈ⸴ ⁱᵗ ʷᵃˢ ʷᵒʳˢᵉ ᵗʰᵃⁿ ʸᵒᵘʳ ˡᵉᵍ'ˢ ˢᵒ ᵗʰᵉ ᵈᵒˢᵃᵍᵉ ᵐᵒʳᵉ ˢᵗʳᵒⁿᵍ ᵗʰᵃⁿ ʷʰᵃᵗ ʸᵒᵘ ʰᵃᵈ‧ ᴴⁱˢ ʷⁱᶠᵉ ᵇʳᵒᵘᵍʰᵗ ʰⁱᵐ ⁱⁿ ˢᵃʸⁱⁿᵍ ʰᵉ ᵍᵒᵗ ʰᵘʳᵗ ʷᵒʳᵏⁱⁿᵍ ᵒⁿ ᵗᵒ ᵍᵉᵗ ᵏʳᵃᵇᵇʸ ᵖᵃᵗᵗʸ‧" ᵀʰᵉ ⁿᵘʳˢᵉ ᵗᵒˡᵈ ᶠʳᵉᵈ‧ "ᔆᵒ ⁱᵗ'ˡˡ ᵗᵃᵏᵉ ʰⁱᵐ ᵃ ˡⁱᵗᵗˡᵉ ˡᵒⁿᵍᵉʳ ᵗᵒ ᶜᵒᵐᵉ ᵒᵘᵗ ᵒᶠ ⁱᵗ‧‧‧" "ʸᵒᵘ'ʳᵉ ᵃˡˡ ᶠⁱⁿⁱˢʰᵉᵈ ᵃⁿᵈ ᵈᵒⁿᵉ! ᶜᵃⁿ ʸᵒᵘ ᵒᵖᵉⁿ ʸᵒᵘʳ ᵉʸᵉ?" ᴴᵉᵃʳⁱⁿᵍ ᵃ ᵛᵒⁱᶜᵉ⸴ ᴾˡᵃⁿᵏᵗᵒⁿ'ˢ ᵉʸᵉ ˢˡᵒʷˡʸ ᵒᵖᵉⁿᵉᵈ ᵃʷᵃᵏᵉ‧ ᴴᵉ ⁿᵒᵗⁱᶜᵉᵈ ᵗʰᵉ ⁿᵘʳˢᵉ ᵘⁿʰᵒᵒᵏⁱⁿᵍ ʰⁱᵐ ᶠʳᵒᵐ ᵃⁿᵈ ʰᵉˡᵈ ᵘᵖ ᵃ ˢˡⁱⁿᵍ‧ "ᴵ'ˡˡ ᵍᵒ ᵍᵉᵗ ʸᵒᵘʳ ʷⁱᶠᵉ‧‧‧" ᴾˡᵃⁿᵏᵗᵒⁿ ˢᵃʷ ᶠʳᵉᵈ ᵃˢ ᵗʰᵉ ⁿᵘʳˢᵉ ˡᵉᶠᵗ ᵗᵒ ᵍᵉᵗ ᴷᵃʳᵉⁿ‧ "ᴵ'ᵐ ᶠʳᵉᵈ⸴ ᵃⁿᵈ ᴵ ʰᵘʳᵗ ᵐʸ ˡᵉᵍ‧ ᴳᵒᵗᵗᵃ ᵇᵉ ᵐᵒʳᵉ ᶜᵃʳᵉᶠᵘˡ⸴ ʸᵒᵘ ᵏⁿᵒʷ‧‧‧" ᶠʳᵉᵈ ᵗᵒˡᵈ ʰⁱᵐ ᵃˢ ᵗʰᵉʸ ʷᵉʳᵉ ⁱⁿ ᵗʰᵉ ᵃʳᵉᵃ‧ "ʸᵒᵘ'ʳᵉ ᵃᵗ ᵗʰᵉ ᶜʰᵘᵐ ᵇᵘᶜᵏᵉᵗ ᵃᶜʳᵒˢˢ ᶠʳᵒᵐ ᵗʰᵉ ᴷʳᵘˢᵗʸ ᴷʳᵃᵇ‧‧‧" "ʸᵉᵃ⸴ ˢᵒ‧‧‧" "ᔆᵒ⸴ ᴵ ᶜᵃⁿ ᵍᵉᵗ ᵃ ᵖᵃᵗᵗʸ ᵗᵒ ᵍᵒ ᵃⁿᵈ ᵈᵉˡⁱᵛᵉʳ ⁱᵗ ᵗᵒ ʸᵒᵘʳ ᵖˡᵃᶜᵉ‧‧" "ᴵ'ᵈ ˡᵒᵛᵉ ⁱᵗ! ᵀʰᵃⁿᵏˢ‧‧‧" "ᴵ'ˡˡ ʷᵃⁱᵗ ᵗᵒ ᵈᵒ ⁱᵗ ʷʰᵉⁿ ᴵ'ᵐ ᶠᵉᵉˡⁱⁿᵍ ˢᵒᵐᵉʷʰᵃᵗ ᵇᵉᵗᵗᵉʳ⸴ ᵗʰᵒᵘᵍʰ‧" ᶠʳᵉᵈ ᵗᵉˡˡˢ ʰⁱᵐ ᵃˢ ʰᵉ ⁿᵘʳˢᵉ ᵃⁿᵈ ᴷᵃʳᵉⁿ ᶜᵃᵐᵉ ⁱⁿ‧ "ᴴᵉʸ⸴ ᔆʰᵉˡᵈᵒⁿ‧‧‧" ᶠʳᵉᵈ ˢᵃʷ ᵗʰᵉᵐ ᵍᵒ ᵗᵒ ᴾˡᵃⁿᵏᵗᵒⁿ‧ ᵀʰᵉ ⁿᵘʳˢᵉ ʰᵉˡᵖᵉᵈ ʰⁱˢ ᵃʳᵐ ⁱⁿ ᵃ ˢˡⁱⁿᵍ ᵃˢ ᴷᵃʳᵉⁿ ʰᵉˡᵈ ʰⁱˢ ᵒᵗʰᵉʳ ʰᵃⁿᵈ‧ ᴾˡᵃⁿᵏᵗᵒⁿ ʷᵃˢ ˢᵗⁱˡˡ ʳᵉᶜᵒᵛᵉʳⁱⁿᵍ ᵃⁿᵈ ᵘⁿˢᵗᵉᵃᵈʸ ʷⁱᵗʰ ᵗʰᵉ ᵐᵉᵈⁱᶜⁱⁿᵃˡ ʷᵉᵃʳⁱⁿᵍ ᵒᶠᶠ⸴ ᵘⁿᵃᵇˡᵉ ᵗᵒ ˢᵗʳᵃⁱᵍʰᵗ‧ "ᴶᵘˢᵗ ᶜᵃʳʳʸ ᵐᵉ‧‧‧" ᴾˡᵃⁿᵏᵗᵒⁿ ᵗᵒˡᵈ ʰⁱˢ ʷⁱᶠᵉ‧ ᵀʰᵉ ⁿᵉˣᵗ ʷᵉᵉᵏ⸴ ᶠʳᵉᵈ ᵒʳᵈᵉʳᵉᵈ ᵃ ᵖᵃᵗᵗʸ ˡⁱᵏᵉ ʰᵉ ᵖʳᵒᵐⁱˢᵉᵈ ᴾˡᵃⁿᵏᵗᵒⁿ ᵗᵒ ᵗᵃᵏᵉ ⁱᵗ ᵗᵒ ᵗʰᵉ ᶜʰᵘᵐ ᵇᵘᶜᵏᵉᵗ‧ ᴴᵉ ᵇᵉᶜᵃᵐᵉ ᵃ ʳᵉᵍᵘˡᵃʳ ᶜᵘˢᵗᵒᵐᵉʳ ᵃᵗ ᵗʰᵉ ᶜʰᵘᵐ ᵇᵘᶜᵏᵉᵗ ᵃˢ ʷᵉˡˡ‧

Surgeon Robert Liston In 1847, a doctor performed an amputation in 25 seconds, operating so quickly that he accidentally amputated his assistant's fingers as well. Both later died of sepsis, and a spectator reportedly died of shock, resulting in the only known procedure with a 300% mortality rate.

General anaesthesia is a state of controlled unconsciousness. During a general anaesthetic, medicines are used to send you to sleep, so you're unaware of surgery and do not move or feel pain while it's carried out. General anaesthesia is used for surgical procedures where it's safer or more comfortable for you to be unconscious. It's usually used for long operations or those that would otherwise be very painful. Just before you have surgery, you'll usually be taken to a room where your anaesthetist will give you the general anaesthetic. It will either be given as a: liquid that's injected into your veins through a cannula (a thin, plastic tube that feeds into a vein, usually on the back of your hand) gas that you breathe in through a mask The anaesthetic should take effect very quickly. The anaesthetist will stay with you throughout the procedure. They'll make sure you continue to receive the anaesthetic and that you stay in a controlled state of unconsciousness. They'll also give you painkilling medicine into your veins, so that you're comfortable when you wake up. Recovery After your operation, the anaesthetist will stop the anaesthetic and you'll gradually wake up. You'll usually be in a recovery room at first, before being transferred to a ward. General anaesthetics can affect your memory, concentration and reflexes for a day or two, so it's important for a responsible adult to stay with you for at least 24 hours after your operation, if you're allowed to go home.

Three broad categories of anesthesia exist: General anesthesia suppresses central nervous system activity and results in unconsciousness and total lack of sensation, using either injected or inhaled dr*gs. General anesthesia (as opposed to sedation or regional anesthesia) has three main goals: lack of movement (paralƴsıs), unconsciousness, and blunting of the stress response. Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxıety and creation of long-term memories without resulting in unconsciousness. Sedation (also referred to as dissociative anesthesia or twilight anesthesia) creates hypnotic, sedative, anxiolytic, amnesic, anticonvulsant, and centrally produced muscle-relaxing properties. From the perspective of the person giving the sedation, the patıents appear sleepy, relaxed and forgetful, allowing unpleasant procedures to be more easily completed. From the perspective of the subject receiving a sedative, the effect is a feeling of general relaxation, amnesia (loss of memory) and time pass1ng quickly. Regional and local anesthesia block transmission of nerve impulses from a specific part of the bødy. Depending on the situation, this may be used either on it's own (in which case the individual remains fully conscious), or in combination with general anesthesia or sedation. When paın is blocked from a part of the bødy using local anesthetics, it is generally referred to as regional anesthesia. There are many types of regional anesthesia either by ınjectıons into the tissue itself, a vein that feeds the area or around a nerve trunk that supplies sensation to the area. The latter are called nerve blocks and are divided into peripheral or central nerve blocks. Local anesthesia is simple infiltration by the clinician directly onto the region of interest (e.g. numbing a tooth for dental work). Peripheral nerve blocks use dr*gs targeted at peripheral nerves to anesthetize an isolated part of the bødy, such as an entire limb. Neuraxial blockade, mainly epidural and spinal anesthesia, can be performed in the region of the central nervous system itself, suppressing all incoming sensation from nerves supplying the area of the block. Most general anaesthetics are ınduced either intravenously or by inhalation. Anaesthetic agents may be administered by various routes, including inhalation, ınjectıons (intravenously, intramuscular, or subcutaneous) Agent concentration measurement: anaesthetic machines typically have monitors to measure the percentage of inhalational anaesthetic agents used as well as exhalation concentrations. In order to prolong unconsciousness for the duration of surgery, anaesthesia must be maintained. Electroencephalography, entropy monitoring, or other systems may be used to verify the depth of anaesthesia. At the end of surgery, administration of anaesthetic agents is discontinued. Recovery of consciousness occurs when the concentration of anaesthetic in the braın drops below a certain level (this occurs usually within 1 to 30 minutes, mostly depending on the duration of surgery) The duration of action of intravenous induction agents is generally 5 to 10 minutes, after which spontaneous recovery of consciousness will occur. Emergence is the return to baseline physiologic function of all organ systems after the cessation of general anaesthetics. This stage may be accompanied by temporary neurologic phenomena, such as agitated emergence (acute mental confusion), aphasia (impaired production or comprehension of speech), or focal impairment in sensory or motor function.

DOCTORs APPOINTMENTs Before a procedure, get to meet the physician and acknowledge their authority before you mention your sensitivities. Find a way to make a compromise. Even request more time for an appointment if you want to have topical numbing agents wait to work, to discuss alternatives, etc. Before a procedure, look up the physician and/or the clinic website. Find pictures of the inner building and search for FAQ, policies, procedures, reviews, etc. Before a procedure, bring a fully charged phone and any sensory necessities such as plastic cups for water, ice pack, self testing kits, written notes and copies, etc. TIPS For CHECKs Feel the instruments and get comfortable with them. Ex: at the dentist, you’re weary of the suction straw. If no plastic cups for rinsing, ask them for some or, have them turn the suction on a low setting and feel it with your finger before they use it in your mouth. Perhaps they can put something on if you don’t like the sucking noise. See how you feel with the specific doctor. Ex: Dr. A seems hurried and strict, but Dr. B seems more empathetic. Or perhaps ask if a nurse can be in the room with you to. Try having the doctor teach you how much you can do. Ex: for a strep throat test, ask if you can swab your own throat, even have them hold your hand whilst you do it in a mirror. Or tell them the way your throat’s structure may find it easier to tilt, etc. (my search NeuroFabulous)

The Red Wristband A doctor was working at a hospital, a hospital where the patients were tagged with coloured bands. Green: alive. Red: deceased. One night, the doctor was instructed to get a few supplies from the basement of the hospital, and so he headed to the lift. The lift doors opened and there was a patient inside, minding her own business. Patients were allowed to roam around the hospital to stretch, especially those who have stayed long. The rule was to be back in their rooms before ten. The doctor smiled at the patient before pressing the number for the basement. He found it unusual that the woman didn’t have a button already pressed. He wondered if she was heading to the basement too. The lift finally reached the floor where the doors opened. In the distance a man was limping towards the elevator, and in a panic the doctor slammed the elevator button to close. It finally did and the lift began to ascend back up, the doctor’s heart pounding. “Why did you do that? He was trying to use the lift.” The woman stated, annoyed. “Did you see his wrist?” The doctor asked, “It was red. He died last night. I would know because I did his surgery.” The woman lifted her wrist. He saw red. She smiled. “Like this one?”

6/6/10 Perhaps your dentist has recommended you have your wisdom teeth removed. IV sedation allows patients to nap during the surgery. The anesthesia medications are given through the IV line and you’ll feel quite tired and sleepy. Once you are completely asleep and comfortable, the surgeon places local anesthesia to numb the extraction areas. A rubber bite block helps to support your jaw during surgery and also keeps your mouth open if you are being sedated. Anesthesia medications are given as needed to make sure you remain asleep and comfortable. If IV sedation was administered, you will awaken shortly after surgery and be escorted to the recovery room. Your mouth will feel numb from the local anesthesia which will help keep you comfortable and pain free. At end of surgery, you will awake to a tap on your shoulder and a gentle voice. The surgeon will reassure you that surgery is finished and everything went well. Monitors and IV are removed and you are escorted to the recovery room. A few minutes later, your loved ones can keep you company as you recover from the anesthesia. During this time, you will become increasingly awake and alert and gradually be able to standup by your self. You are then escorted to the car.

These levels of sedation under anesthesia are defined by the American Society of Anesthesiologists (ASA) and are crucial in determining the appropriate level of sedation for each patient and procedure, ensuring patient safety and comfort throughout the perioperative period. Minimal Sedation: Also known as anxiolysis, minimal sedation involves a drug-induced state during which patients respond normally to verbal commands. Their cognitive function and physical coordination remain unaffected, and there is no compromise in airway reflexes or protective reflexes. This level of sedation is commonly used for procedures requiring minimal discomfort or anxiety relief, such as minor dental procedures or diagnostic tests. Moderate Sedation/Conscious Sedation: Moderate sedation, also referred to as conscious sedation, induces a drug-induced depression of consciousness, during which patients respond purposefully to verbal or light tactile stimulation. While maintaining spontaneous ventilation, patients may experience decreased anxiety and may have impaired cognitive function and physical coordination. However, they retain the ability to maintain their own airway and respond to commands. This level of sedation is commonly used for procedures such as endoscopic examinations, minor surgeries, or interventional radiology procedures. Deep Sedation: Deep sedation involves a drug-induced depression of consciousness, during which patients may not respond purposefully to verbal or tactile stimulation. Patients under deep sedation may require assistance in maintaining their airway, and spontaneous ventilation may be inadequate. However, patients still maintain cardiovascular function. This level of sedation is often used for procedures requiring significant analgesia and amnesia, such as major surgical procedures or certain diagnostic imaging studies. General Anesthesia: General anesthesia involves a drug-induced state during which patients are unarousable, even in the presence of painful stimulation. Patients under general anesthesia require assistance in maintaining their airway and ventilation, and cardiovascular function may be impaired. General anesthesia is characterized by a complete loss of consciousness and protective reflexes, allowing for surgical procedures to be performed without pain or awareness. This level of sedation is utilized for major surgical procedures or invasive diagnostic procedures where unconsciousness and muscle relaxation are necessary. Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decreased level of consciousness while maintaining the patient's ability to breathe on their own. Airway protective reflexes are not compromised by this process

local anesthesia (you're awake and may feel pressure but shouldn't feel pain), sedation (you're awake but with lessened consciousness and won't remember much) or general anesthesia (you're completely knocked out and won't remember jack)

These may include nitrous oxide (laughing gas) inhaled, an intravenous (IV) line in, oral medications like Valium or Halcion (for anxiety) or a combination, along with anesthesia to numb the pain. Regardless of which type of anesthesia you’re given, you should feel relaxed and pain-free, with limited to no memory of the procedure. If you’re given general anesthesia, you’ll lose consciousness altogether. A surgical team will closely monitor your pulse, respiration, blood pressure, and fluids.

AUGUST 21, 2016 Consciousness is a spectrum. It ranges from being fully awake to lightly sedated (calm but remembering most things) to deep sedation (seldom remembering anything) and finally general anaesthesia. The depth of anaesthesia can be tailored according to the nature of the procedure. This reduced state of consciousness is brought on and maintained by delivering drvgs to your body either with volatile gasses which you breathe in and/or through a drip into your veins. While you are under anaesthesia your vital signs are constantly monitored to make sure you are ‘asleep’ and not feeling any paın. There is continuous monitoring of the electrical activity in your heart, the amount of oxygen in your bľood, your pulse rate and bľood pressure. Sometimes a device is used to monitor your brain waves while ‘asleep’, giving the doctor more detailed information about your level of unconsciousness. You can experience confusion as you “wake up” after the procedure. The drvgs used to put you into an unconscious state can take some time to wear off, even as you become more awake after the procedure. After your surgery is completed the anaesthetist reduces the dose of medications keeping you ‘asleep’ so that you gradually wake up. It may take 1 to 2 days to fully regain all your thinking abilities. It produces a feeling of relaxation and even giddiness. Some people describe feeling a tingling sensation while inhaling nitrous oxide. At end of surgery, you will awake to a tap on your shoulder and a gentle voice saying something like: “Hi, can you open your eyes?”

General anesthesia: A patient who gets general anesthesia is completely unconscious (or "asleep"). They can’t feel any pain, are not aware of the surgery as it happens, and don’t remember anything from when they are “asleep.” General anesthesia involves using many medications to render you unconscious during a surgery. This makes you unaware of things that are happening. It is generally described as melting back into the bed and falling asleep. This means you will have no awareness of the procedure once the anesthesia takes effect, and you won't remember it after. Anesthetics activate memory-loss receptors in the brain, ensuring that patients don't remember. General anesthesia looks more like a coma—a reversible coma. You lose awareness and the ability to feel paın, form memories and move. Then they turn the anesthetics off and allow you to come to. You then begin to pass into a semi-conscious stage to become aware of what is going on. Typically, the period of time when you’re under general anesthesia is a blank. Many patients report that it is a surreal experience—and practically no one remembers anything between when the medication is administered and waking up in the recovery. For general anesthesia, someone may feel groggy and a little confused when waking up after surgery.

Sedation: Who Provides Anesthesia? Several types of medical professionals are able to provide anesthesia, including: Physicians (anesthesiologists) Nurse anesthetists Dentists/oral surgeons Anesthesiologist assistants The level of training varies between different types of providers, with anesthesiologists having the highest level. If you are receiving nitrous oxide (laughing gas), you will be fitted with a small mask inhale the anesthesia. If intravenous (IV) sedation is used, a needle is placed in the vein to administer the sedative. Regional Anesthesia Regional anesthesia is provided by injecting specific sites with a numbing medication. This may be done with a needle or via a flexible catheter line through which anesthetics and other medications can be administered as needed. With this type of anesthesia, only the body part being operated on is numbed, which means you are awake—that is, sedated, but still conscious—during the procedure. The anesthetic works on the nerves, causing numbness below the injection site. You are monitored throughout your procedure. Your anesthesia provider will continuously monitor your vital signs, including heart rate, blood pressure, and breathing, during your procedure. Local Anesthesia This type of anesthesia is typically used to numb a small site for minor procedures ,a numbing medication is either applied to the skin as a cream or spray, or injected into the area where the procedure will be performed. Monitored Anesthesia Care (MAC) This is a type of sedation commonly referred to as "twilight sleep." It's usually used for outpatient procedures to make you feel sleepy and relaxed. While you may be heavily sedated, this type of anesthesia is different from general anesthesia because you are not chemically paralyzed, nor do you require assistance with breathing. Still, your vital signs are closely monitored to make sure you're stable throughout the procedure. This type of anesthesia wears off in as little as 10 minutes. Depending on the medications used and the doses given, you may or may not remember the procedure. When the surgery is done, other medications can be used to reverse the effect of the anesthesia. You will also be monitored in this recovery phase. After the procedure is complete, the nitrous oxide gas or IV drip is stopped, and you'll be brought slowly out of sedation. They control the level in your body by increasing, decreasing, or eventually stopping the infusion, which wakes you up.

3 NOV 2015 General anesthetics and sedatives work by anesthetizing the brain and central nervous system. You may start feeling lightheaded, before becoming unconscious within a minute or so. Once surgery is done and anesthesia medications are stopped, you’ll slowly wake up in the operating room or recovery room. You’ll probably feel groggy and a bit confused. Because of the amnestic effect, you probably will not remember feeling somnolent. When first waking from anesthesia, you may feel confused, drowsy, and foggy. Some people may become confused, disoriented, dizzy or trouble remembering things after surgery. General anesthesia is essentially a medically induced coma. Your doctor administers medication to make you unconsciousness so that you won’t move or feel any pain during the operation.

July 1996 . Twins can be conjoined at the: Abdomen (omphalopagus). Chest (thoracopagus). Top of head down to the belly button, facing each other (cephalopagus). Head only (craniopagus). Pelvis, facing each other (ischiopagus). Pelvis, side-to-side (parapagus). Rump-to-rump (pygopagus). Vertebral column (rachipagus). Generally, parapagus are conjoined at the upper chest. Parapagus, united laterally, always share a conjoined pelvis with one or two sacrums and one symphysis pubis. Dithoracic parapagus is when the two chests are separated, and the fusion is confined to the pelvis and abdomen. Dicephalic parapagus is if there is the union of the entire trunk but not the heads. The heart, liver, and diaphragm are fused, but there is a duplication of the respiratory tract and upper digestive tract; the viscera organs are fused. There are two arms, two legs, and two complete vertebral column and spinal cord. The number of limbs varies from 4 to 7, rarely with four legs. Generally, each lung is present in a separate lung cavity. The fusion of lungs is very rare. The alignment of the conjoined pelvis is diagnostic-one complete pelvic ring, with a single anterior pubic symphysis, and with two laterally fused sacral bones, and predominantly only one rectum. Ischiopagi are united ventrally extending from the umbilicus down to a sizeable conjoined pelvis with two symphyses pubis and two sacrum. Craniopagus can be united at any portion of the skull except at the face and the foramen magnum. Pygopagus varieties are joined dorsally; sharing the sacrococcygeal and perineal regions, sometimes even involving the spinal cord. Rachipagus twins are united dorsally above the sacrum. The union may also include the occiput. The cephalopagus varients are fused from the umbilicus to the top of the head. The pelvis and lower abdomen are usually not fused. Thoracopagus are united face-to-face from the upper thorax down till the umbilicus. Omphalopagus are primarily United at the umbilical region aligned face to face. The pelvis is not united. The pure parapagus is two heads, two hands, two legs, two hearts and two pairs of lungs. Conjoined twins are classified on the basis of the union's site, with the suffix pagus meaning fixed or fastened. The twins can have four (tetrapus), three (tripus), or two (bipus) legs. Cephalopagus: The twins often have a fused thorax in addition to a fused head. The single fused head may have two faces (janiceps) Cephalothoracopagus twinning is characterized by the anterior union of the upper half of the body, with two faces angulated variably on a conjoined head. The anomaly is occasionally known as janiceps, named after the two-faced Roman god Janus. The prognosis is extremely poor because surgical separation is not an option, in that only a single brain and a single heart are present and the gastrointestinal (GI) tracts are fused. Craniopagus: The conjoined twins share the skull, meninges, and venous sinuses Ischiopagus: The twins may lie face to face or end to end Pygopagus: The twins are joined dorsally, sharing the sacrococcygeal and perineal regions Rachipagus: The twins generally have vertebral anomalies and neural tube defects. Thoracopagus: The twins lie face to face and share the sternum, diaphragm, upper abdomen wall, and liver and have an exomphalos

Wisdom Teeth MagicSchoolbusDropout08 Summary: After Will has his wisdom teeth out, Mike questions the wisdom of ever giving him drugs again. Does he change his mind watching his boyfriend be silly and cute? Mike watches Will, who is currently high as a kite on pain medication and anesthesia from having his wisdom teeth out. “Miiiike!” Will cheers as soon as he walks into Will’s bedroom, toasting with a hand with… a Lego in it? “Hhhhhhi!” “Wow, you are drugged up.” Mike chuckles as he walks in and plops down next to his boyfriend of a year. “How was it?” Will makes an absolutely adorable pout and flops over backwards. “Eeeeeeeevil. Evillllll.” Mike’s sure he’s turning red with how hard he’s trying not to laugh. “Oh yeah?” Will nods, eyes focused on Mike. “The… the dentist… he… had this big needle. He’s a… mmmad scientist. Frankenstein.” Well, he’s not too drugged to make literary references. “He… the big needle-” Will giggles, waving his hands around. “-he made everything wooshy.” “Wooshy.” Mike repeats back. “Mm-hmm. Woosh.” Will nods sagely. “An’ everything was spinny.” “Wow.” Mike breathes, and if he says much more, he’s gonna laugh so hard he throws up. “I know, rrright?” Will slurs. “An’ I think he’s evill.” “Why?” Will leans in conspiratorially. “He… he stole my teeth! They… made me sleepy… an’ then I woke up, an’... it’s all gone! He stole my teeth! I wanted to keep those!” He pouts again, and Mike can’t help himself: he bursts out laughing at the genuinely devastated expression on Will’s puffy face. “Oh, no! Poor baby!” Mike coos between peals of laughter. Will pouts even more. “Whhhat?” “They… took your teeth to, um… give to the tooth fairy.” Mike giggles. Will’s eyes widen in horror. “Nnnnnnnno! A fairy? Fairies are… they’re worse than dentists! They steal Legoes!” “Nobody’s gonna steal your Legoes, Will.” Mike grins. Will’s eyes are wide and sad, but they’re also trusting. “Okay.” Will sniffles. “Can I help you?” Mike smiles. Will cups his cheeks, and his slightly-bruised eyes stare into Mike’s with a very strange intensity. “Mike.” Will says seriously. “Yourr eyes…” “Oh?” Mike says. “They’re… so prettyyyyy…” Will whispers in awe, moving his thumbs to touch Mike’s eyelids. “Big… big pretty cow eyes.” “Cow eyes, huh?” “Big n’ warm n’ soft…” Will says. “I love themmmm… Mikey Moo Moo…” Mike bursts out laughing again. Will pouts even more somehow as he strokes Mike's cheeks. “Noooo… don’t laugh, Mikey Moo Moo… it’s true…” He nods firmly, as if solidifying his point, and it makes Mike laugh even harder, enough that his ribs hurt and his eyes prick with tears. “Alright, alright, I’m not laughing at you, babe.” Mike laughs, trying to stifle it. “I love you.” Will stares into his eyes for a weirdly long time before he headbutts Mike in the forehead. “You do?” Will pulls away, staring out his bedroom window, apparently lost in thought. It’s a minute of silence, broken only by the muffled snickers Mike can’t suppress all the way, before Will bursts out in tears. “I dunno!” Will sobs. “I want ice cream now…” Will sniffles. “Carry me…” “One sec, babe, okay?” Mike smiles. He wraps his arms around Will’s waist, and Will’s arms fly to around his neck, clinging to Mike as he stands up. “Yaaay!!” Will cheers, head getting heavier. Instead of carrying him to the kitchen, though, Mike hefts him before dropping him on the bed. “Noooo-” Will complains, hands scrabbling at Mike’s shoulders and trying to pull him down with him. “No, babe, I’ll be right back- let me go- ah!” Mike complains as Will manages to tug him almost on top of him. Somehow, despite Will’s protests, he manages to extract himself from the grip, and Will whines a bit before settling back down, flopping against the pillows with a huff. Mike goes to the kitchen, smiling the whole way and still laughing a little bit. Once he’s there, he rummages through the freezer and fridge until he’s found a pint of strawberry ice cream. As he’s grabbing a spoon, though- “Miiiiiiiiiiiiiike!” Will calls. “Miiiiiike! Are y’coming back?” “I’m here, Will!” Mike calls back, trying so hard not to just collapse from how funny his boyfriend is being. “I’m just getting your ice cream!” “Come backkkkkkkkkk-” Will slurs. “I miss youuuuuuu-” “I'm literally in the kitchen!” he shouts. Mike smiles as he grabs the food, drink, and spoon and heads to the room, where Will is splayed weirdly. As soon as he enters, Will’s eyes light up like he's been gone for days instead of thirty seconds. “Mikey Moo Moo!” “Here you go, babe.” Mike smiles, putting down the foodstuffs and helping Will sit up, propping him against the pillows and headboard. “Now do you want ice cream?” Will nods, still pouting, though the second he takes a spoonful of ice cream, it disappears. “Whoaaaaaaa…” Will gasps. “Mmmm… cold…” “Good, huh?” Mike smiles. Will nods, looking at Mike with big eyes. “Good.” Mike says, smiling as he gently cups Will’s cheeks to lean his head forward for a forehead kiss. “I love you. Even if you’re weird when you’re high.” “Hmm? No, ‘m short.” Will slurs, taking another bite before scooping more and holding it over to Mike. “Y’want some?” “No, babe, I’m okay. Scoot over?” Mike says. Will does, leaning his head on Mike’s shoulder as he quietly munches away on ice cream. “Love you, Mike.” Will slurs, the near-empty ice cream settling in his lap as his head gets heavier. “Love you too.” Mike smiles. Will’s head gets even heavier, and he soon starts softly snoring. Mike smiles and presses a kiss to his forehead, taking away the ice cream and setting it on the nightstand. Fandom: Stranger Things (TV 2016) Relationship: Will Byers/Mike Wheeler Stats: Published:2024-07-31 Language: English

Sedation. It's medicine that helps the person relax or fall asleep. It may be used with other medicine to reduce pain. If you’re being sedated, the staff will monitor your vital signs while you’re under anesthesia. You may also be given nitrous oxide that you inhale through a mask. That will help you relax but won’t necessarily put you to sleep. Next, you might be given a sedative intravenously, which will put you into a sleeplike state. They can also inject local anesthesia to numb the areas. With IV sedation, your care team gives you sedation medication intravenously (through an IV). You will be very relaxed and unaware of the procedure and unable to remember it. Your vital signs will be monitored during IV sedation. You will be sleepy for a significant portion of the day. General anesthesia brings on a sleep-like state with the use of a combination of medicines. The medicines, known as anesthetics, are given before and during surgery or other medical procedures. General anesthesia usually uses a combination of intravenous medicines and inhaled gasses. Once surgery is done and anesthesia medications are stopped, you’ll slowly wake up in the operating room or recovery room. You’ll probably feel groggy and a bit confused. General anesthesia. It affects the entire body and makes the person unconscious. The person is completely unaware of what is going on and does not feel pain from the surgery or procedure. General anesthesia is essentially a medically induced coma. Your doctor administers medication to make you unconsciousness so that you won’t move or feel any paın during the operation. You'll start feeling lightheaded, before becoming unconscious within a minute or so. You'll feel as though you're asleep. But general anesthesia does more than put you to sleep. You don't feel pain when you're under general anesthesia. This is because your brain doesn't respond to signals or reflexes. Someone from the anesthesia care team monitors you while you sleep. You'll slowly wake either in the operating room or the recovery room. You'll probably feel groggy and a little confused when you first awaken. When first waking from anesthesia, you may feel confused, drowsy, and foggy. You may feel dizzy when you first stand up. Some people may become confused, disoriented, or have trouble remembering things after surgery. This disorientation can come and go, but it usually goes away after about a week. General anesthesia is generally a combination of intravenous (IV) medications and gases that are used to put you in a deep sleep. You are unaware of the procedure and will not feel anything. Your vital signs will be monitored during general anesthesia.

Plankton found himself in a sticky situation. In his haste, he collided with a submerged rock, and with a painful snap, one of his antennae broke dangling in half. His computer wife Karen took him to a clinic. The receptionist, a kind octopus named Tentacla, took his information and assured Dr. Dolittlefish would see him shortly. "Plankton?" Dr. Dolittlefish called out, his voice echoing through the room. Plankton walked in, Karen trailing behind. The doctor examined the fractured antenna. Plankton winced, feeling a sharp pain as the doctor prods it gently. Dr. Dolittlefish chuckled, "We'll need to perform a repair, and for that, you'll need a touch of anesthesia. It'll make you feel like you're floating on a cloud.." Plankton's one good antenna perked up with interest. "A magical elixir that will put you into a state of deep relaxation," Dr. Dolittlefish explained, his eyes twinkling behind his spectacles. "You'll be completely unaware of the surgery. We give you a little dose to make you drowsy. It's like sinking into a warm, bubble bath after a long day of plotting. Trust me, you'll wake up with a fixed antenna and no memories of the procedure. It's like a nap that'll keep you unconscious and pain-free throughout the operation. It's tailored for each patient, so you'll only get what you need." Turning to Karen, who had been quietly observing the exchange, the doctor said, "Karen, if you have any concerns, feel free to ask. Your husband's safety is my top priority. I'll be sure to take into account." Karen sighed, her circuits whirring as she searched for the right words. "Well, Plankton has always had trouble with deep sleep. He's a bit of a light sleeper, you see. Even the slightest disturbance and he's up for the day. It's hard for him to get to sleep." The doctor nodded, scribbling more notes. "I see," he said thoughtfully. "That does add a layer of complexity to the anesthesia. We'll need to be precise with the dosage to ensure he remains asleep throughout the surgery without any complications. We'll use the lightest touch possible and administer the anesthesia in a way that minimizes discomfort." Dr. Dolittlefish turned to Plankton. "Now, when you wake up, it'll be like coming out of a delightful dream. You'll feel a bit groggy, like you've just emerged from a particularly long nap. You might be a tad disoriented, but that's perfectly normal. Your body will be feeling the effects of the medication wearing off, so it's crucial that you rest for a while in our recovery area." Plankton's eye searched Karen', looking for reassurance. She nodded firmly, gripping his tiny hand. "You'll be okay, Plankton. I'll be right here." The doctor nodded. "Karen, you can accompany him into the surgery room. But remember, you'll have to go and stay outside once the actual procedure begins." The next day, Plankton and Karen returned to the clinic, feeling a mix of anxiety and hope. The lobby was filled with various sea creatures, all waiting for their appointments with their own assortment of woes and ailments. "Come on, Plankton," Karen urged, her voice steady. "You've got this." Dr. Dolittlefish took his place at the head of the operating table, a serious look on his face. "Alright, Plankton," he said, his voice steady, "It's time for the anesthesia. This might feel a bit strange, but remember, it's just like drifting off to sleep." With a flick of his fin, he administered the first dose through a small tube connected to a bubble filled with the sedative. The bubble popped, and Plankton felt a warm sensation spread through his body. It started in his toes and traveled up to his antennae, making them feel weightless. His eye grew heavier, and he couldn't help but let out a sigh. The room began to spin gently, the sounds around him becoming muffled, like the distant hum of a lullaby sung by the ocean currents. He felt himself sinking into the chair, the cushions seemingly made of the softest sea foam. "How do you feel?" Dr. Dolittlefish's voice was a comforting murmur. "Woozy," Plankton slurred, his eyelid fluttering. The room was a blur of lights and colors, like a kaleidoscope of bubbles. The pain in his antenna was fading, replaced by a pleasant numbness. Karen squeezed his hand tightly, her grip the only solid thing in his swirling world. She watched him closely, her LED eyes full of worry. "It's ok, Plankton," she murmured. "You're going to be fine." The doctor nodded to her encouragement. "I want you to count backwards from one hundred ok?" Plankton, already feeling the warm embrace of the anesthesia, began his count with a lazy sensation. "One hundred... ninety-nine... ninety-eight..." His voice grew softer with each number, the digits slipping away like grains of sand through his tiny fingers. The world around him grew fuzzy, like a TV show losing signal. The lights above looked like distant stars, their brightness dimming as he descended into the abyss of unconsciousness. "...eighty-four... eighty-three... eighty-two..." His eye now half-closed, the surgery room's noises melding into a symphony of comforting whispers. The gentle sway of the seaweed outside the clinic's windows seemed to be rocking him to sleep. His voice grew more faint, words slurring together. Karen watched him count, her gaze never leaving his face. She could feel his hand loosening in hers, his grip becoming as light as a feather. Each number he uttered was a step closer to the surgery that would hopefully restore his antenna to its former glory. The count grew slower, like a snail on a leisurely stroll across the ocean floor. His voice was a mere murmur, the words barely discernible. Karen could see his tiny chest rising and falling in a slow, rhythmic pattern, his breathing growing deeper and more relaxed with each passing moment. The colors around them bled into one another, creating a dreamlike landscape. The lights above danced like jellyfish in a moonlit lagoon, casting eerie shadows across the gleaming surgical instruments. Plankton's eye fully closed now, his count barely a whisper. Each word was a soft ripple in the vast ocean of sleep that was consuming him. The whirring of the machines and the occasional splash of water seemed to fade into the background, replaced by the steady rhythm of his breathing. Karen watched, her heart swelling with love and fear as she listened to the dwindling numbers. Plankton's voice was now a faint echo, his body going slack. The room was still, save for the hypnotic pulse of the anesthesia bubbles and Plankton's shallow breaths. Karen held her own breath, her screen never leaving his face. His count grew quieter still, each number a soft, barely perceptible sigh. Karen felt the tension in her limbs ease as she watched the lines of worry on Plankton's forehead smooth out. His sleep was finally deep and peaceful, the anesthesia working its magic. "Thirty-four... thirty-three..." His voice was a mere ripple in the vast sea of quiet that filled the room. The last number slipped away, and Plankton's count stopped, his breathing deep and even. Karen felt the weight of his hand in hers, a silent testament to his complete surrender to the anesthesia's embrace. She watched Plankton's chest rise and fall with each steady breath, his body utterly relaxed with his eye sealed shut slightly. The surgery room, once a cacophony of fear and doubt, was now a sanctuary of peace, the only sounds the rhythmic beep of the heart monitor and Plankton's soft snores. The doctor nodded, satisfied with the sedation's effect. "Alright, Karen, he finally fell asleep," he whispered, patting Plankton's shoulder. "Now, we'll proceed with the actual procedure." Karen swallowed hard, nodding her head. She had never seen Plankton so vulnerable, but she knew this was for the best. "I'll be right outside," she said, her voice wavering slightly. She leaned in and kissed Plankton's forehead before letting go. With a final squeeze of his hand, she reluctantly let go and went towards the door. The doctor nodded in understanding, his eyes focused on the delicate task ahead. As the door slid shut with a soft hiss, Karen found herself in the stark, sterile waiting room. The walls were lined with sea-themed art, an attempt to provide comfort in a place filled with uncertainty and anxiety. She hovered over to the plush sea sponge chair, the material reminding her of home. Her tentacles wrapped around the phone, her movements deliberate and precise as she dialed the numbers. The first call was to Spongebob, she knew he would want to know about the accident. The line rang, and she hoped he'd pick up. "Karen?" "Spongebob, it's about Plankton," she began, her voice trembling. "He's had an accident, and he's in surgery now." "Oh no!" Sponge Bob exclaimed, his bubbly enthusiasm dimming. "Can I talk to Plankton during the surgery?" "No, they put Plankton to sleep," Karen explained, her tentacles gripping the phone tightly. "But I'll let him know you called as soon as he wakes up." "Thank you, Karen," SpongeBob said, his voice filled with genuine concern. "Tell him I'm thinking of him." The receptionist, Tentacla, noticed her distress and swam over. "Is everything okay?" she asked, her tentacles poised to offer comfort or assistance. "It's just... I've never seen him like this," Karen admitted, her voice wavering. "So... vulnerable." Tentacla nodded sympathetically, her tentacles reaching out to pat Karen's arm. "It's tough, I know. But Dr. Dolittlefish is the best in the business. Plankton's in good fins."

ANTENNAE i Plankton found himself in a sticky situation. In his haste, he collided with a submerged rock, and with a painful snap, one of his antennae broke dangling in half. His computer wife Karen took him to a clinic. The receptionist, a kind octopus named Tentacla, took his information and assured Dr. Dolittlefish would see him shortly. "Plankton?" Dr. Dolittlefish called out, his voice echoing through the room. Plankton walked in, Karen trailing behind. The doctor examined the fractured antenna. Plankton winced, feeling a sharp pain as the doctor prods it gently. Dr. Dolittlefish chuckled, "We'll need to perform a repair, and for that, you'll need a touch of anesthesia. It'll make you feel like you're floating on a cloud.." Plankton's one good antenna perked up with interest. "A magical elixir that will put you into a state of deep relaxation," Dr. Dolittlefish explained, his eyes twinkling behind his spectacles. "You'll be completely unaware of the surgery. We give you a little dose to make you drowsy. It's like sinking into a warm, bubble bath after a long day of plotting. Trust me, you'll wake up with a fixed antenna and no memories of the procedure. It's like a nap that'll keep you unconscious and pain-free throughout the operation. It's tailored for each patient, so you'll only get what you need." Turning to Karen, who had been quietly observing the exchange, the doctor said, "Karen, if you have any concerns, feel free to ask. Your husband's safety is my top priority. I'll be sure to take into account." Karen sighed, her circuits whirring as she searched for the right words. "Well, Plankton has always had trouble with deep sleep. He's a bit of a light sleeper, you see. Even the slightest disturbance and he's up for the day. It's hard for him to get to sleep." The doctor nodded, scribbling more notes. "I see," he said thoughtfully. "That does add a layer of complexity to the anesthesia. We'll need to be precise with the dosage to ensure he remains asleep throughout the surgery without any complications. We'll use the lightest touch possible and administer the anesthesia in a way that minimizes discomfort." Dr. Dolittlefish turned to Plankton. "Now, when you wake up, it'll be like coming out of a delightful dream. You'll feel a bit groggy, like you've just emerged from a particularly long nap. You might be a tad disoriented, but that's perfectly normal. Your body will be feeling the effects of the medication wearing off, so it's crucial that you rest for a while in our recovery area." Plankton's eye searched Karen', looking for reassurance. She nodded firmly, gripping his tiny hand. "You'll be okay, Plankton. I'll be right here." The doctor nodded. "Karen, you can accompany him into the surgery room. But remember, you'll have to go and stay outside once the actual procedure begins." The next day, Plankton and Karen returned to the clinic, feeling a mix of anxiety and hope. The lobby was filled with various sea creatures, all waiting for their appointments with their own assortment of woes and ailments. "Come on, Plankton," Karen urged, her voice steady. "You've got this." Dr. Dolittlefish took his place at the head of the operating table, a serious look on his face. "Alright, Plankton," he said, his voice steady, "It's time for the anesthesia. This might feel a bit strange, but remember, it's just like drifting off to sleep." With a flick of his fin, he administered the first dose through a small tube connected to a bubble filled with the sedative. The bubble popped, and Plankton felt a warm sensation spread through his body. It started in his toes and traveled up to his antennae, making them feel weightless. His eye grew heavier, and he couldn't help but let out a sigh. The room began to spin gently, the sounds around him becoming muffled, like the distant hum of a lullaby sung by the ocean currents. He felt himself sinking into the chair, the cushions seemingly made of the softest sea foam. "How do you feel?" Dr. Dolittlefish's voice was a comforting murmur. "Woozy," Plankton slurred, his eyelid fluttering. The room was a blur of lights and colors, like a kaleidoscope of bubbles. The pain in his antenna was fading, replaced by a pleasant numbness. Karen squeezed his hand tightly, her grip the only solid thing in his swirling world. She watched him closely, her LED eyes full of worry. "It's ok, Plankton," she murmured. "You're going to be fine." The doctor nodded to her encouragement. "I want you to count backwards from one hundred ok?" Plankton, already feeling the warm embrace of the anesthesia, began his count with a lazy sensation. "One hundred... ninety-nine... ninety-eight..." His voice grew softer with each number, the digits slipping away like grains of sand through his tiny fingers. The world around him grew fuzzy, like a TV show losing signal. The lights above looked like distant stars, their brightness dimming as he descended into the abyss of unconsciousness. "...eighty-four... eighty-three... eighty-two..." His eye now half-closed, the surgery room's noises melding into a symphony of comforting whispers. The gentle sway of the seaweed outside the clinic's windows seemed to be rocking him to sleep. His voice grew more faint, words slurring together. Karen watched him count, her gaze never leaving his face. She could feel his hand loosening in hers, his grip becoming as light as a feather. Each number he uttered was a step closer to the surgery that would hopefully restore his antenna to its former glory. The count grew slower, like a snail on a leisurely stroll across the ocean floor. His voice was a mere murmur, the words barely discernible. Karen could see his tiny chest rising and falling in a slow, rhythmic pattern, his breathing growing deeper and more relaxed with each passing moment. The colors around them bled into one another, creating a dreamlike landscape. The lights above danced like jellyfish in a moonlit lagoon, casting eerie shadows across the gleaming surgical instruments. Plankton's eye fully closed now, his count barely a whisper. Each word was a soft ripple in the vast ocean of sleep that was consuming him. The whirring of the machines and the occasional splash of water seemed to fade into the background, replaced by the steady rhythm of his breathing. Karen watched, her heart swelling with love and fear as she listened to the dwindling numbers. Plankton's voice was now a faint echo, his body going slack. The room was still, save for the hypnotic pulse of the anesthesia bubbles and Plankton's shallow breaths. Karen held her own breath, her screen never leaving his face. His count grew quieter still, each number a soft, barely perceptible sigh. Karen felt the tension in her limbs ease as she watched the lines of worry on Plankton's forehead smooth out. His sleep was finally deep and peaceful, the anesthesia working its magic. "Thirty-four... thirty-three..." His voice was a mere ripple in the vast sea of quiet that filled the room. The last number slipped away, and Plankton's count stopped, his breathing deep and even. Karen felt the weight of his hand in hers, a silent testament to his complete surrender to the anesthesia's embrace. She watched Plankton's chest rise and fall with each steady breath, his body utterly relaxed with his eye sealed shut slightly. The surgery room, once a cacophony of fear and doubt, was now a sanctuary of peace, the only sounds the rhythmic beep of the heart monitor and Plankton's soft snores. The doctor nodded, satisfied with the sedation's effect. "Alright, Karen, he finally fell asleep," he whispered, patting Plankton's shoulder. "Now, we'll proceed with the actual procedure." Karen swallowed hard, nodding her head. She had never seen Plankton so vulnerable, but she knew this was for the best. "I'll be right outside," she said, her voice wavering slightly. She leaned in and kissed Plankton's forehead before letting go. With a final squeeze of his hand, she reluctantly let go and went towards the door. The doctor nodded in understanding, his eyes focused on the delicate task ahead. As the door slid shut with a soft hiss, Karen found herself in the stark, sterile waiting room. The walls were lined with sea-themed art, an attempt to provide comfort in a place filled with uncertainty and anxiety. She hovered over to the plush sea sponge chair, the material reminding her of home. Her tentacles wrapped around the phone, her movements deliberate and precise as she dialed the numbers. The first call was to Spongebob, she knew he would want to know about the accident. The line rang, and she hoped he'd pick up. "Karen?" "Spongebob, it's about Plankton," she began, her voice trembling. "He's had an accident, and he's in surgery now." "Oh no!" Sponge Bob exclaimed, his bubbly enthusiasm dimming. "Can I talk to Plankton during the surgery?" "No, they put Plankton to sleep," Karen explained, her tentacles gripping the phone tightly. "But I'll let him know you called as soon as he wakes up." "Thank you, Karen," SpongeBob said, his voice filled with genuine concern. "Tell him I'm thinking of him." The receptionist, Tentacla, noticed her distress and swam over. "Is everything okay?" she asked, her tentacles poised to offer comfort or assistance. "It's just... I've never seen him like this," Karen admitted, her voice wavering. "So... vulnerable." Tentacla nodded sympathetically, her tentacles reaching out to pat Karen's arm. "It's tough, I know. But Dr. Dolittlefish is the best in the business. Plankton's in good fins."

givesmehope: I met a 16 year old genius who was in medical school, studying to be a pediatric neurosurgeon. He put every dollar he made at his job into a retirement fund. Why? He wanted to be able to retire at age 30, so that he could spend the rest of his life performing brain surgeries for free. His philanthropy GMH. Mar 5 2010

laparohysterosalpingooophorectomy .---. .---. / .-. `. .' .-. \ /-( `. `._______.' .' )-\ ( ) \ / ( ) `-' \ / `-' \ / \ / |`-^-'| | | .---. .---. / .-./ \.-. \ /-( /`._______.'\ )-\ ( ) \ / ( ) `-' \ / `-' \ / \ / |`-^-'| | | /`._______.'\ \ / \ / \ / \ / |`-^-'| | | .-----. |`-^-'| | |

I went to the plastic surgeon for a consultation . The doctor looked at me and said , " Don't do this . You're too beautiful just the way , you are . Don't change . " That doctor gmh . 2011.

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