The Sleep Doctor Speaks: CDU Alum Dr. Tracy Charles Explains Anesthesiology from Local Numbing to Lights Out!
By Isidra Person-Lynn
CDU Communications Specialist
For many patients, anesthesia is the scariest part of surgery. But you can ease your fears and prevent the rare negative outcome with awareness and good communication with doctors.
Dr. Tracy Charles, veteran anesthesiologist, trained at Charles R. Drew University of Medicine and Science (CDU) calls herself “The Sleep Doctor.” She’s not the kind who studies why you can’t get to sleep or stay asleep. She’s the “Lights Out” anesthesiologist who puts you to sleep moments before surgeons fix whatever ails you.
Dr. Charles gives us a quick primer into her world of anesthesiology, which at the center is anesthesia: a temporary state consisting of unconsciousness, loss of memory, lack of pain, and muscle relaxation.
“First, you must understand that an anesthesiologist is a bona fide medical doctor,” said Dr. Charles. She recalls numerous times when she asked crucial questions of her patients and they say “Well, I’ll just wait until a doctor gets here.” Dr. Charles doesn’t take it personally but she will affirm “I am a doctor.”
Dr. Charles says there are three main types of anesthesia: local, regional and general. The type of anesthesia chosen depends upon the length of surgery, the patient’s health, and the patient or physician’s preference.
Local anesthesia blocks the nerves in a small specific area of the body and is used for minor surgeries.
Regional anesthesia is more for Cesarean section or a surgery on an arm or leg. The anesthesia is injected into clusters of nerves supplying the area that needs numbing. To numb the entire lower body the anesthetic agent is injected into the spinal space or into the epidural space. Of course, you can be sedated and sleep through the procedure.
And the real “lights out” generalanesthesia puts the patient into a deep unconscious state and provides a quiet operating field by reducing organ and muscle movement. To achieve the right balance of effect, the anesthesiologist often combines sleep inducing agents and analgesics.
While the person is unconscious, the anesthesiologist will maintain your airway or breath for you. They may place a breathing tube or laryngeal mask –airway—which is also introduced through the mouth all while you are asleep or unconscious and unaware.
Anesthesia is usually maintained with an inhaled anesthetic. There is usually no memory of the surgical procedure upon awakening.
So what does this Dr. Charles want patients to know?
1) It is critical for anesthesiologists to know what medicines the patient is taking, and even which herbs and vitamins being taken. Often, patients are asked to stop taking certain medicines, herbs, etc. two weeks before surgery, because even aspirin can cause excessive bleeding. This is why patients really need to schedule an appointment with anesthesiologists at least a month before the surgery. Emergency surgery, of course, requires a different approach.
2) Did you have a large meal yesterday? Did you eat anything today? Patients think they can cheat the instructions they should have been given, but the problem with eating a rack of ribs the day before surgery is if your body involuntarily vomits, the contents can get into your lungs, which can cause major complications. Anesthesia can stop reflexology from working and it can cause choking or aspiration pneumonia. “We see this sometimes in patients who recently ate just before getting shot,” Dr. Charles explains. No stomach contents, no problem! Dr. Charles recommends “NPO” which is a medical term which means “Nothing by mouth.”
3) Arrange for a caregiver. Do not take a taxi or get dropped off home alone. Sometimes complications from surgery arise and you may not be strong enough to call 911 on your own. Each person reacts differently from surgeries and medications.
4) CPAP Machine: Those suffering from Sleep Apnea may have CPAP machines. You may need to bring it for use in the recovery room while you are asleep.
5) Mark “Surgical Work Areas”: Make sure the area being amputated or operated on gets marked while you are still alert. This prevents costly surgical errors.
Questions you should ask your anesthesiologist:
· Ask about risk and prevention of blood clots, deep vein thrombosis and pulmonary embolism. These clots which can travel and lodge in veins can be life threatening.
· Discuss all allergies
· Ask if you should donate your own blood. Ask your surgeon if there is a chance you might need a transfusion
Dr. Charles has seen a lot since her time at Meharry Medical College, and her residency, a dual appointment at CDU and the former Martin Luther King Hospital where later she was Director of Obstetrics Anesthesia for 12 years in the 1990’s.
“There was nothing like it. There was so much pathology,” she reminisced. “I was well prepared when I left the former King/Drew because you saw so many traumas—gun shots, accidents, etc. — in so many different areas. And we had more deliveries in OB than all the other hospitals combined at that time.”
Follow her advice she says. “The risk of anesthesia is pretty low these days, but you must follow doctor’s orders!”
Los Angeles Sentinel
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Dr. Tracy Charles owns Mobility Medical Care, Inc., a professional mobile medical corporation which serves a number of hospitals. She may be reached at [email protected]. For more information about Charles R. Drew University of Medicine and Science, visit www.cdrewu.edu.