I was in the hospital for sepsis and the patent in the next room was going in for a bilateral leg amputation due to diabetes, his friends came in about 30 minutes before his surgery and they all did shots together for about 10 minutes before the nurse saw what was going on . I have never seen a more angry nurse in my life . The surgery was cancelled for that day also .

Reminds me of the story of a lady checking in at surgery with her 10 year old son. Nurse asks if he has eaten anything in the last 8-10 hours. She says no, while the kid is eating a bag of Doritos. She gets mad when the surgeon cancels surgery.

"She was fussing because she was thirsty, so I gave her a little juice. I didn't think it was a big deal " the dad said to the surgeon, after his daughter almost died from aspirating fluid into her lungs while under anesthetic.

Several years ago I was going to have surgery and was told no food or drink, not anything, not even water. They made a point of that, repeating it 5 times. But when it came time to get my surgery, my blood pressure was high because I didn't take my blood pressure meds. They were all mad at me for not taking my meds. I pointed out that they made it absolutely 100% clear that I was absolutely not to eat or drink anything, not even water, so I didn't take my medicine. They all acted as if I was stupid for following their instructions to the letter and told me, "well, you can drink a little water to take your medication". They should have told me that before. How do you think I felt? I fasted for nothing. I was the one who was hungry, thirsty and had to reschedule and fast all over again.

I remember hearing a story about a dad who had to bring his young daughter in for surgery, he felt that the "no eating or drinking" rule was too strict so he let her have breakfast, she later died of pulmonary aspiration during surgery and that has scared me into listening to my doctor very closely

As somebody who spent nearly six weeks in the hospital with aspiration pneumonia and a related lung abscess after I aspirated my stomach contents during knee surgery, I can attest that this is a serious and pressing concern.

Trying to explain this to my cats before they have a dental cleaning under anesthesia is always an issue. We have to go around the house the night before and make sure that all the water bowls are taken up and all the toilets are closed. It's especially a point of argument if only one is going under anesthesia and the other has to whine and go hungry all day.

In outpatient surgery, we have many patients lie about not eating or drinking. Then we find out when we extubate , they aspirate , then we have to call an ambulance to transfer them to the hospital on a ventilator. Or they lie, and feel the pressure right before surgery and say, well, I did eat a jelly bean….but usually it’s much more than they admit to. I really wish the pre op instructions would tell patients this is actually a matter of life or death that they don’t eat and drink. I think they just tell them to not eat or drink but never say why

I was wondering how anesthesia was handled with emergencies, such as appendectomies, where the patient hasn’t had time to fast before the surgery. Thanks for posting.

I had an emergency appendectomy when I was 18, in 1980. A couple of hours before my symptoms became bad enough that we headed to the hospital, my mom got me to try eating a light lunch to see if it helped. The first thing I heard when I woke up in recovery was two orderlies speculating about whether it was half-digested chicken soup or chicken salad they had just cleaned up. I signaled my return to consciousness by croaking "Soup". 🙂

A friend of my dad's has a story related to this. He was set to do surgery on a little girl, about 7 or 8, and instructed her parents not to let her eat anything from the night before the procedure. While on the operating table, she started vomiting, and went into cardiac arrest. It turned out that, since the little girl had been complaining that she was hungry, her parents had decided some eggs for breakfast would surely be fine... right? In the end, they managed to bring the girl back, but that story has always stuck with me.

I think it's odd that people don't listen when they're told not to eat or drink anything before surgery. Why wouldn't you listen? They tell you that for a reason, even if you don't understand why.

I have type1 diabetes and recently had a short surgery under general anaesthesia. While I was waiting before surgery my blood glucose was falling gradually and eventually I could see I was going to have to do something about it. Normally I'd just eat something but obviously that was out. I let the nurses know about the situation, thinking it was all going to be pretty simple, since to me this is a completely normal kind of situation and I knew exactly what needed to be done. But I forgot that's not how things work in a hospital. Any time someone has Type 1 diabetes everyone seems to completely panic because it's just something they only have to deal with rarely. I know they just needed to give me some IV glucose but the nurses have to go and find a doctor to make the decisions. The doctor turns up, starts asking me questions about what symptoms I'm experiencing due to low blood glucose, I have no idea why! She decided they were going to start sliding scale treatment (IV glucose _and_ insulin) which is used when a patient can't manage their own diabetes for whatever reason. This was about a 2 hour surgery so definitely not required in this case. Anyway, the hospital had just got a new computer system so the nurses were trying to work out how to log the medications on the system, and whether to start the insulin or glucose first. When I heard that, I couldn't quite believe it! At this point I've been hypoglycaemic for an hour, getting worse and worse, and now I'm hearing they're going to start giving me insulin?! I'm normally a pretty chill person, but if you've ever experienced being "hangry" you can probably understand my getting a bit more assertive sitting there with a blood glucose of 2.5 (45 in american units) Doctor was long gone by that point so I just told them to start the glucose now and we can talk about the insulin when I'm not about to expire, which they did. Half an hour later I'm feeling much better, apologised for being short with them, and with my brain working again I was able to explain that I didn't need any insulin and the problem was sorted now. But what a rigmarole! honestly if they hadn't been watching me the whole time I think I would have just eaten 20g glucose and sipped a mouthful of water. I think really that would have been the best option too. The glucose would have been completely absorbed, leaving nothing in the stomach. But I appreciate there are procedures that are designed to cover the majority of situations and be simple enough not to leave open the possibility of confusion. Having Type 1 in a hospital situation is a nightmare because you're used to dealing with this complex condition all by yourself, and become an expert. But then you go into a hospital and suddenly somebody else is in charge of it all, and they don't actually know what they're doing. If you have type 1 and you're going into hospital for any amount of time, I recommend insisting on seeing the diabetes specialist so you can have a conversation with them, work out how the condition is going to be managed, and then they can advocate for you with the medical staff.

We had a patient come in for a tilt table test. I asked her when she ate last. Answer was, about two hours ago. What and how much did you eat? A plate of liver and onions with mashed potatoes and a coke. She got rescheduled! I had a chat with her about why it’s important to not eat prior to this test. There is a risk of aspiration should a patient lose consciousness. I have been in other situations where the patient says they’ve not ate but during a procedure the truth comes up….literally! All we have to go on is what the patient says.

My father had a quadruple bypass in 1990. He died from pna from aspirated stomach acid. Back then they didn’t have the cuff on the endotracheal tube, so it just flowed up. Ironically, his heart was fabulous, sepsis killed him😢

Thanks for the information. I'll start taking those no food or drink orders more seriously from now on. I've had quite a number of surgeries for a number of different medical issues. Usually I do refrain from eating well in advance, but I do occasionally sip some water before surgery. I always thought that no food or drink order was to prevent nausea. Never realized it was all about aspiration.

I had a really fun experience with anesthesia last month. I have a multitude of sleep disorders which always get the anesthesiologist’s interest. Anyway, I remember being taken to the OR, being given two syringes of stuff and being asked “are you getting tired yet?” I said no. Then we talked about Whitney Houston who was playing in the PR and how no one in the room seemed like the Whitney Houston type. Then another anesthesiologist showed up, told the original anesthesiologist to skip to the fourth syringe while he drew up some other stuff. Finally I was out. I was quite the topic of discussion in the PACU. Fun times. 🤘🏻

I know that when you're going to surgery, you're forbidden to eat or drink anything, but i never know that it can life threatening. Thank you for your video. When i was going for surgery to remove a metal pin on my broken arm, my surgery starts at 4pm, i was fasting from 8/9am i think, and on 3pm i'm feeling really thirsty that makes me really want to drink a mineral water, my thoughts at that moment was "it won't matter too much right? because it's just a regular water", but then for some miracle i didn't take it and endure the thirsty feeling. Thank God my surgery was successful.

The funny/sad thing is healthcare workers can explain exactly why ignoring directions can lead to death but people will still ignore them thinking they’re the exception.

Thankyou for explaining! I am still baffled at people who don't take this seriously or feed their children before surgery. Like, we get it, its difficult to go hungry for 8 hours, especially for a cranky child who doesn't understand, but its only temporary and they will not die. When I was a teen, I was in the childrens surgery unit for day surgery and I was in a small cubicle waiting for anesthesiologist, another family was next door with parents and a 4 year old boy, the doctor asked them clearly, "has your son had anything to eat or drink in last 8 hours?", the father replies, "no, but 2 hours ago he had some toast and scrambled eggs"... the doctor went silent, um... genius man, scrambled eggs and toast is FOOD! In what world is toast and scrambled eggs not food?? The doctors cancelled their surgery, rightfully. It seems like many parents are okay with the serious risks than to hear their whiny brats cry and complain... anything to shut them up I guess.

OR nurse here. On more than one occasion, we found out a patient lied about their fasted state when they aspirated stomach contents on extubation (removing the endotracheal tube). They ended up in ICU. Play stupid games, win stupid prizes.

i had 2 major brain op's and they told me not to fast and all that stuff never gave me a real reason as to why, THANK YOU so much for doing this

I've had a number of procedures where I had only been allowed a sip of water the day of surgery in order to take medication. It isn't as bad as it sounds and much better than having serious issues as a result of eating a 4-course meal before an 8-hour surgery My surgeon used to not eat or drink anything when he had to do longer (6+ hours) surgeries like mine

I dropped my daughter off for oral surgery a few months ago and at the checkin was a man telling the nurse “by the way, I had a coffee this morning. I simply can’t function if I don’t have my coffee”. She told him he definitely wouldn’t function after the surgery if they went forward. Obviously the surgery was cancelled and he could not understand why. He just wasn’t understanding how serious it was.

Great to see the "X hours before surgery" advice and the "more hours for food than for water" advice. In the bad old days they would tell you no food or drink after midnight the day before. whether you were going under at 8AM or 6 PM.

I’m glad I followed the instructions well! I had my surgery at 12:30 in the afternoon, didn’t have anything to eat since 6 o’clock the night before, even very little or no water after midnight. All I really had the night before were a couple of cups of kava stress relief tea, and a melatonin. No caffeine since early morning, and certainly no alcohol in three days.

As someone who type 1 diabetes I was allowed to drink a small sugar drink 30 minutes before I had a big heart surgery it was more important to prevent a low blood sugar. As having a low blood glucose under general anaesthesia is more dangerous

I appreciate that you’re upfront about what you sometimes eat when on-call. Some medical YTers have you believe they’re Olympians of nutrition

Seen multiple surgeries cancelled because the meal service guys miss the NBM sign by the bed, give the patient food, the patient thinks "well if I've been given it it must be ok" and hey presto, they're off the list for the day. Doesn't matter what they've been told by the anaesthetist, or the nurse. I think it's because patients abdicate responsibility when they are in hospital, they have limited understanding of the more complex stuff, so they allow every decision to be made for them, and if they get food, no matter what they are told, they assume somebody who knows more than them has made that decision to feed them and it must be ok.

Great video. I've always gone extra time, for fasting, and I fast 2 days prior to surgery. That's 2 days prior, and day before, with only broth, jello, water until 10 hrs prior to surgery. Then only water on evening before, stopping water 8-10 hrs prior. Anesthesiologist and surgeons are always thrilled when I tell them I did this in the pre-op. Limits post surgery nausea, too. Some people, it takes a long time to completely digest. Some can't do this if they're diabetic. Otherwise, I swear by my fasting technique. Jello is good.

I enjoy your videos and anesthesiologists play an import role to the patient’s mood going into surgery. I’ve had 15 surgeries, 14 I remember. There were two with the same doc and the second surgery when I got to the operating room it was the same anesthesiologist. He was so nice and fun the first time, and this was so much more serious, complete bowel obstruction with sepsis, I was so glad to see him. You seem like a fun one to start off in the operating room with.

I've seen people claim that the reason people aren't allowed to eat or drink during labor is in case they need an emergency C-section with general anesthesia. But most C-sections aren't done under general anesthesia, so some people claim that the rule is outdated and that it's worse for people to not be allowed to eat or drink at all when labor is such a strenuous event. As long as they know the risks.

I really appreciated this video. Everything you spoke of made sense to me. Maybe because I have a lot of issues with choking currently (neuro and eds related so waiting to try and sort it) and also waking with choking thanks to mucous from mast cell reactions. It’s not all the same BUT has a similar issue and then having gastroparesis, very experienced in trying to keep stuff out of my lungs! Thanks for explaining so clearly and showing us with drawings etc. I also appreciate that you speak about what is done now especially considering prior literature but what current literature says and so why it might (and probably should) change in regards to RSI’s. I’ve always followed the rules and now I’m definitely glad I did! Thanks 😊

Just thank you for all of the time and effort you’ve put in these videos! I love all things health-related and particularly love how easily-digestible your content is.

The easiest answer is due to the anesthesia if you ate or drink anything, there's a high risk of you puking but because you're effectively placed in a deep sleep, it suppresses your gag reflex along with the numbness. So you would suffocate on your own vomit to death.

Good info as always Max, thanks. By coincidence, yesterday, I received my new bilateral ureter stents - the sixth set of them in 2 .5 years. Anyway, it's a relatively short (about 40 minute) simple procedure under general anesthesia with no incision required because it's done through the urethra. I followed all pre surg guidance: nothing to eat or drink after midnight except to drink 12 oz water 2 hours b4 arrival at hospital at 5AM. Procedure began at 8AM sharp with me "counting by 13's" just for fun. I made it to the 12 iteration (156) before succumbing to the anesthesia. There were no issues were the procedure and I was discharged at 9:45 AM.

Finaly, someone explained it! Thanks, Dr. Feinstein!

Not sure how or why this video was recommended by KZfaq but I enjoyed it. It's informative and it's something I never thought I'd want to know until now.

One fun fact: In WW2 it was recommended to go into battle on empty stomach because if you get wounded it had higher percentage to survive.

This was a really informative video. One thing I've always wondered is why a King tube is never used by default as it does a decent job preventing gastric inflation and aspiration while still maintaining a patent airway.

When they give the order to not eat or drink for twelve hours, it would help a lot if they included this video. The Dr/nurses have never explained why. They just expect blind obedience. Thank you for the explanation! 👍👍👍

As one who has neen NPO midnight !ore times than I like to think about, I want to thank you for this video. Now it all makes sense. You da man, Doc!

I had jaw and genioplastic surgery as well as forehead reconstruction a year ago and being already underweight I think the lack of food prior and difficulty eating post surgery has definitely made the side effects and drowsiness of anaesthetics a lot worse

I could watch a whole video on RSI in a variety of emergency situations. I'd love to hear you explain how intubation would proceed in a case of anaphylactic shock.

Truly a side note on this is gastric emptying. I had a gastric emptying study done several years back and the radiologist (with decades of experience) stated that she had never seen someone empty so fast. Every ounce of what I injested was completely clear of my stomach within an hour. As a physician I know it will not be TMI to you but to others I must warn... It is the reason that I have a BM within 30 minutes of eating any true meal (most times within 15 minutes). My wife had gastric bypass and was warned about (and if she eats the wrong thing she gets) "dumping syndrome." I naturally have "dumping syndrome" and have so all my life. So myself could go under within an hour of eating a full meal and not stand a chance of suffering any bad outcome. A normal person could wait a few hours, and on the other end someone that has delayed gastric emptying could have to wait 6, 8, or even more hours. So I agree, and the standard of care, is to err on the side of caution, and to say 8 hours fasting.

Thank you for making this video, I definitely need to show this to my dad before he gets his surgery

This is one of my favorite videos of yours yet, Max! It's super informative with the drawing (shoutout to Mitch!). When you started doing the ultrasound on yourself I was like, cool! Then you make this ghetto bed with a chair and put your feet up, I was giggling pretty good. I almost feel like 3-5 years from now you're going to start breaking the rooms down to teach us things if this keeps up! XD

This is very helpful. Wish that explanations were routine. I have a congenital dry throat and so not drinking is basically impossible. Have found that using a hiking trick (sucking on a small rock) makes it possible for me to not drink before surgery. The look on the face of the person asking if I have anything in my mouth (they're thinking dentures etc) ranges from baffled to "no, I didn't hear that" when I say that I'm suckling on a rock. By the way, this is a common thing to do in a desert climate but I now live in the east,

Excellent. Absolutely informative! Thank you!

*Thank you so much for this video!!!* I'm glad I saw it. I have a habit of listening very closely to my doctor and doing whatever she (or he) says. When they say Fast, I FAST! They say nothing after midnight, so I have nothing after 6pm to make sure I'm empty. It's wonderful to see this video and realize my OCD has been contributing to my making it through surgeries. 🤗🥰

Thanks for making these videos! As a pre-clerkship med student I appreciate these

I've become accustomed to surgeries done under local anesthesia. There's definitely some advantages. I've even asked for water and stuff and they accomodate to make me feel more comfortable.

Great information--very informative with explanations

Keep in mind this is true for your pets as well. Don’t disrespect your veterinarian, either!

It explains so perfectly, literally answered all of npmy questions.

I had an emergency surgery only 3 to 4 hours after I ate. But if I didn't have the surgery I had a very high risk of death so it was worth the risk.

I had oral surgery recently, and once I was awake and alert, I thought ‘I could eat’. I was given an Ensure, which was good enough to hold me over until I got home. But I was starving beforehand!

I'm glad you did the ultrasound. The internet told me the stomach empties in 3 hours, but you still had food in yours at 4 hours.

Thank you for explaining. I've been in anesthesia many times (22 I think) and knew roughly why I couldn't eat, but this clears things up a lot, Thank you :D

Great video man! Great info! I learned a lot!! That was amazing and awesome! I have had 14 surgeries because of my cerebral palsy! I don’t eat because surgery! I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy! I really wanted to be a anesthesiologist!! You rock man! I like your shoes

Ive had numerous surgeries in my life and I had one Anesthesiologist came into my room and said me O.K. What did we have for Breakfast this morning very sarcastically I told him nothing becauseI knew I was having surgery. I guess he deals with a lot of people that don’t understand you shouldn’t eat before going under for surgery.

Always great Max with this helpful information..

1:00 Thank you so much for saying this! Many medical youtubers tend to put emphasis on going to your doctor if you have any worries, or that it is always better to have your doctor diagnose you, but they miss stating that, at the end of the day, they cannot make a medical opinion because they are not seeing you! It might be a small thing, and many people might think it's not that big of a deal, but just as there are people that would rather have some snake oils because they saw it on youtube or facebook, there's also people that look at medical channels when they have any concerns, watch them, and get to the conclusions about their conditions instead of going to their physician.

This was VERY informative!! I was allowed to drink water and that was it. As always, Thanks Max.

last time i went in for a surgery (ovary cyst) the surgery team was pretty chill with the fact i did need some water to get the pills i needed to take down my throat

When I was 15 I had scoliosis surgery. Before I went back I went to use the restroom (mostly out of nervousness) and on the way out I took a small sip from the water fountain before I realized what I was doing. I actually did swallow a small amount. I didn't know the danger I was putting myself in by not telling anyone.

I knew you weren't supposed to eat before surgery but I didn't realize this was the reason why. That's so interesting

I clicked on this because I'm pregnant and planning a c-section, and I also have hyperemesis and I get severely nauseous if I wait too long to eat, basically if my stomach is empty at all. I can manage mornings now, but I dread going in for my surgery and I really hope they can schedule it for FIRST THING in the morning. My first baby, I went into labor spontaneously, but my baby was breech. I was informed when I checked in that I would have to wait 8 hours from when I had breakfast, or until I couldn't hold off any longer (if the baby came before then, for instance). When I was checking in, they asked what time I had eaten my cereal, and I couldn't quite remember. The nurses at the station kept trying to wink wink nudge nudge me to say it was later than I was guessing, for my sake because they didn't want me to have to wait so long in labor, but it actually really bothers me now knowing the risks of why that protocol was in place. If I had needed general for some reason and got to go into surgery sooner than the 8 hours because of a lie, I would have been at higher risk, without having had that risk explained to me. I'm a huge proponent of giving people INFORMED consent, and I think someone with that level of medical knowledge should've known better than to advise me in that way, despite whether they thought it was in my best interest.

I’ve been guilty of drinking a cup of coffee with milk or energy drinks the morning before surgeries/procedures. I’ve been fine but wow never again. Thank you

this video is truly so good. it’s everything

I'm from the UK and I've had surgery a few times, I never quesioned why I couldn't eat before surgery I just always trusted that the doctors knew best and followed any instruction.

can you do a video about anesthesia vs a medically induced coma? How do you put someone thats in a medically induced coma under general anesthesia for surgery?

Anesthesia scares me ever since my last time under. I have an issue with my right hand and last time I went under I had alot of dental work and when I woke up my hand was super purple and I couldn't move it otherwise I was fine. I will never forget to tell them about that if I ever need it again. Still freaks me out like two years later. I believe I have a collapsed vein in my hand that makes my thumb and pointer finger constantly a little swollen. Doctor said it was either a vein or lymph node issue but guessing how it reacted it's a vein issue.

I'm freestyling; let's just go for it....classic ! Thanks Max, really love....and learn from your videos. I'm a fan for sure now

about a year ago i had to undergo a pcnl surgery for my kidney stone,and i was not allowed to have anything before my surgery which left me with tons of questions. This video solved all of those questions 💫

I have nothing to do with the medical field but I find your video’s extremely interesting, almost addicting!!🙃

i've been under countless times, i have this information seared into my brain! so much so that when my cat needed a dental cleaning i made sure she fasted even though the vet hadn't told me to. she had a long wait once at the vet's office, so if i was wrong they could give her food and water if needed. when i got there they told me i didn't have to do that, which is still strange to me! ah well, it went smoothly either way.

I had to have emergency hernia surgery, and I woke up throwing up relentlessly. It was unpleasant but I was so grateful to be rid of the pain of the hernia.

Thank you so much. I broke my ankle 6/2020. I waited inpatient for three days while inflammation decreased. Food and water was not held. I went into surgery. Woke up from orif surgery feeling good ( on pain meds). I went to sleep and woke up five days later in icu with severe icu psychosis. It was terrifying. I learned (after being told by several people “wow it is a miracle you made it” I aspirated. Developed pneumonia, sepsis, had heart and lung failure. I was on a ventilator for five days. They didn’t know if I would make it; as I had trouble coming off the ventilator. Max thank you. I understand better because of this video. I became terrified when I have to go under general anesthesia. (I’ve needed further ankle surgeries.) For the love of God, thank you. My ptsd is relieved. Now I know no food or water. Not even a tiny bit. 🫶🏼🫶🏼

I’ve had 3 surgeries; 2 c sections and 4 wisdom teeth removed at the same time. If the doctor says don’t drink or eat anything 12 hrs before your appointment. Dont eat or drink at least 15 hrs before surgery. Don’t even eat a small ice cube. They tell you this for a reason.

Thanks for explaining! I have surgery today to get my collarbone fixed, haven't had anything to eat in like 14 hours and still have another 9 before the surgery. I hate this feeling but I'm sure I'd hate dying over a bowl of oatmeal more lol

For emergency surgeries, why can't an NG or OG tube be placed to remove the stomach contents? Seems like a logical way to avoid aspiration risk

My wife is currently in hospital (in the uk🇬🇧) due to an unrecorded hietes hernia that allowes aspiration during a lung and liver biopsy (key hole surgery) As a result she was intubated for 23 days (so induced coma and paralysis) then had a tracheotomy for 2 weeks, currently a feed tube into the lower intestine and and a stomach drain (small tubes in/out of the nose. Today she is scheduled for the hernial operation, and hopefully a final path to recovery. Was admitted on march 27th and still in, was on icu for 30 days. While she didnt eat before here key hole op, its a real life case study into what anesthetic and gas introduced in to the body for a routine procedure can do if there is a hidden weakness waiting for them.

Hello Dr. Feinstein - imo, this video is TRULY one of your best ones ever! The way you have explained why NOT to eat before surgery could very well save lives!! EXCELLENT video!! Should be used in classrooms in medical schools!

I mean, I followed what the doctors told me before my surgery, but... how horrifying! I didn't know this would be the consequence if I hadn't! I would have liked to be told about such things, even if I followed their instructions anyways... if there's a risk of me dying in something I may do, I want to know. Truly a scary thought, that if I didn't listen to them, this could have happened.

I’ve got gastroparesis and im jej fed. I’ve had aspiration pneumonia (I have GORD too and i refluxed in my sleep one night, had my cat not gotten into my parents room my mum wouldn’t have heard my strange breathing and I’d probably be dead) and it had me in the ICU for a week. It’s both terrible and I felt absolutely awful. Also get hypos. So I just let the admission nurse know and they can have glucagon on hand. It really isn’t worth the risk!

i have surgery on april 12th! gonna be watching all your videos before :D

I though this was going to talk about why surgeons can’t eat before a surgery but it’s the why patients can’t eat before surgery

Cool, never saw a physician/KZfaqr perform ultrasound on themselves 😄

Great topic. Here’s a question. Can any of the general anesthetics given cause hiccups post op? Was in for a ureteral stone laser ablation on Tuesday and hiccups started last night on return home. Hopefully these are self limited. Enjoy Sinai. Did a preceptorship with Jerry Way back in 2005. Great GI Doc.

Fascinating information!! I’m an aircraft mechanic and sometimes wish I could’ve been a surgeon!

An excellent production and explanation.

I have gastroparesis and intestinal dysmotility. The last time I had a colonoscopy (with propofol anesthesia), I had to be intubated. This seems really unusual for this type of procedure. Even though I followed the directions for drinking the colonoscopy prep solution, a significant portion of it was retained in my stomach up to the time of the procedure, and there was concern for aspiration risk. It was really scary.

I remember the time my dad had to get a surgery. He's normally the type to quickly give into snacking, and doesn't like being hungry for any amount of time. We've been waiting for hours, and my dad is getting impatient. He keeps saying over an over "Just one bite," or "Something small, they won't notice." None of us know the exact reason why we fast for surgery, we just know to follow doctor's orders. My dad doesn't give a damn, and keeps insisting it'll be fine. He gives up and walks to a vending machine himself. Needless to say he faced the consequences of his actions, and we had to restart the clock and wait for the rescheduled surgery. It's been years since then, and I guarantee, if he had to get another surgery. He would repeat the exact same mistake

Excellent informative presentation. Good to know, having had ops under GA, including in emergencies.

I've had several operations, all in different countries (by some karma joke or something), but only before a broken ankle operation in Japan, I was pulled out of my room by an anesthesiologist, was explained everything I needed to know about being "put out", risks and all, asked if I had any concerns or conditions I wanted to report, and was finally asked to sign a paper that I understood what was going to happen to me (not a waiver). It was really reasuring, because someone took the time to come and tell me all details I needed to know, answer questions, and make sure I understand and feel secure (unlike other experiences that far). From my previous operations, I was already aware of the fasting prosedure, but that lady even made sure she was crossing language barriers. Still not recommended experience ;)

The worst part is when you get held “nil by mouth” for nearly 24hrs and only given one bag of fluids (as was my case waiting for emergency surgery to repair my badly busted ankle). When I came too hours later, I could have eaten anything!

Very good video. Much appreciated. Can you address what should be done for anesthesia on a patient that has severe dysphagia (small opening for swallowing food)? I had to be intubated for a sinus surgery, but after, I was in so much pain from my throat. I swallowed ice chips for 36 hours straight, and no sleep, because it hurt so much just to BREATH air down my throat. I mentioned my problem to the anesthesiologist before the surgery, but evidently he didn't listen to me. How do I handle this kind of procedure again without severe pain afterwards? I couldn't eat hard foods for 5-6 days afterwards. I was in more pain from my throat that I didn't give another thought to my sinuses. I get a dilation once a year from my GI doc, by the way.

I couldn’t even drink water 12 hrs before my surgery. Since I was having surgery involving skin, I couldn’t even use lotion, or Chapstick. It was unbearable, but I’m grateful I followed instructions.

I remember as a kid in the 90's being allowed a clear breakfast before surgery. Usually Jell-o and apple juice. I'm curious if this is still a common practice for pediatrics, and if so, why are the standards different?