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Anesthesiology/Questions Answered by Expert JM Starkman, MD

SubjectDate Asked
Anesthesiology for TURBT with NSVT arrhythmia2/5/2012
  Q: I am a 65 yr old male currently on dialysis (since June '11) and in the process of getting listed ...
  A: The risks with a spinal vs general are about the same. A bigger question is the nature of your ...
Side Effects of General Anesthesia1/18/2012
  Q: I am an otherwise healthy 23 year old female. In the past 6 months, I've had 3 surgeries. The first ...
  A: Not knowing every detail of the anesthetic, surgery and your medical history will keep me from ...
Surgery1/13/2012
  Q: My wife is having breast implant surgery in three weeks and smoked marijuana yesterday. She is very ...
  A: Marijuana around the time of surgery has been studied as a possible way to reduce post-operative ...
poison1/12/2012
  Q: im researching poisonous plants for my adventure tourism course, and im currently looking up ...
  A: Since it's an adventure tourism course for which you're doing research, I'd say your best bet is to ...
poison1/11/2012
  Q: im researching poisonous plants for my adventure tourism course, and im currently looking up ...
  A: As I'm NOT a toxicologist, I would say your question is better directed at someone who is! While ...
Anesthesia Reaction8/19/2011
  Q: Starkman, First may I say "thank you" for providing this service. Second, I want to say that the ...
  A: Not knowing anything else about the particulars of your experience, off hand, it sounds like the ...
Duration of general anesthesia8/17/2011
  Q: i am about to undergo a cosmetic surgery that is scheduled to last 8.5 hours. A friend ...
  A: I believe you and your friend should preoperatively speak with the anesthesiologist who is scheduled ...
Hernia repair8/12/2011
  Q: I had a hernia repair in 1986, I must have been about two weeks pregnant (if that) since I had ...
  A: Anesthetics have been accused of many things, but as an etiology of major mental illness I have ...
Pre-emptive analgesia8/9/2011
  Q: Doctor, What are your thoughts on pre-emptive analgesia with NSAIDs for surgical pain? Thanks in ...
  A: Pre-emptive analgesia has worked out well for the researchers getting mileage out of publishing ...
Compazine reaction8/2/2011
  Q: I know that compazine is oftern used pos- operatively, preoperatively or intraoperatively to ...
  A: This is an interesting question and can only be answered with a "logical" answer, not a studied one ...
preop sedation question7/26/2011
  Q: It is to my understanding that often prior to surgery chloral hydrate will be used for preoperative ...
  A: You didn't mention what country you're from. In the US, Europe and Australia chloral hydrate is not ...
slow heart rate drop after anesthetic7/23/2011
  Q: After a recent eye surgery and having anesthetic,my heart rate dropped and anestheologist ...
  A: The heart rate changes you have noted are part of the abnormal physiology and depressant nature of ...
Bad response to Versed / Better plan for future procedures7/16/2011
  Q: Starkman, I will apologize in advance for my lengthy post; my question really isn't that ...
  A: Read them. Bottom line: If you want a properly administered anesthetic, then an anesthesiologist is ...
project1/20/2011
  Q: I am doing a project for boy scouts where i need to contact a person currently working a job and ...
  A: and please accept my apologies for the response delay, as I was out of town & on vacation. Most ...
PTSD but facing an upcoming surgery1/17/2011
  Q: I know in the world of anesthesia, this may look like a pretty small deal, but as a professional, I ...
  A: If your wife is "the rock" and she is the one having the surgery, then why do YOU have to be at her ...
myasthenia gravis and anesthesia12/8/2010
  Q: I have had MG for 20 years. I initially got the symptoms when I underwent surgery for laperscopy ...
  A: Yes, I have and the problem and its options for anesthesia are well-worked-out and have been for ...
Typical Day of Anesthesiologist12/2/2010
  Q: What would the typical day be for an anesthesiologist (besides the obvious answer). I am looking ...
  A: You're doing the right thing!........but the best answer to this question comes not from a written ...
Propofol -induced "mania"11/29/2010
  Q: I've had three past experiences with propofol during the past 5 years. On two occasions it was used ...
  A: Don't be hesitant to raise concerns with your anesthesia "provider"...maybe he or she could help ...
use of crna during transforaminal steroid injection11/21/2010
  Q: I'm having trouble getting worker's comp to approve use of crna when anesthesiologist is doing ...
  A: Here's a great article about the pros and cons and politics of EBM: ...
low blood pressure way after surgery11/17/2010
  Q: I have blood pressure of 64/42 after surgery and had to be re-admitted. During surgery my pressure ...
  A: I hope by "no one" you have included the anesthesiologist who provided the anesthesia service for ...
Flying shortly after surgery11/14/2010
  Q: I will be having a second procedure to unblock a tear duct at a prestigious eye clinic in a distant ...
  A: Perhaps your surgeon would be willing to have your anesthesia "provider" (I note the word or concept ...
Nursing to Medicine esp.Anaesthesiology11/10/2010
  Q: I am currently studying a Nursing Science degree in Zimbabwe and i have always wanted to become an ...
  A: No, you will not be too old at 30 to start your residency or even a primary care practice, for that ...
RN vs CRNA vs MD10/4/2010
  Q: Is this standard procedure? To have an RN, not even a CRNA, administer conscious sedation? I ...
  A: It sounds like the people running this endoscopy center are gargantuan morons.....geez!.....y.ou've ...
a question about blood loss9/29/2010
  Q: I thought you might be able to help me with a question not related specifically to anesthesiology ...
  A: Certainly, it would have been preferable to diagnose the problem sooner, but I don't have at hand ...
Making the administration of a spinal block less painful9/28/2010
  Q: I am scheduled to have a c-section in March of the coming year, and I am terrified at the prospect ...
  A: Anything administered to you insofar as 'taking the edge of' [sic] affects the fetus as well as the ...
What report is used9/26/2010
  Q: Which of the following anesthesia reports would be used to document an unusual event or complication ...
  A: Either one, or many times a hospital or physician's organization will have a separate documentation ...
avoiding CRNA9/24/2010
  Q: Five years ago I had ortho surgery to repair a torn meniscus in my knee; before the surgery I met ...
  A: Yes, this is the state of affairs today, as I've discussed in this forum previously. You and your ...
work9/21/2010
  Q: while you are going through all of this college, do you work as part of your schooling as like an ...
  A: Working as a paid assistant or apprentice or has become nearly impossible in health care today even ...
Anesthesiology Practice9/20/2010
  Q: I've heard of private practice anesthesiologists. Can they actually do that, contract to hospitals? ...
  A: [I thought I answered this question already, so pardon me if this is a duplicate] Yes, of course ...
PONV9/14/2010
  Q: I got an operative hysteroscopy under conscious sedation and I've been sick after. They used 750ug ...
  A: So many good questions.................. ALL narcotics (e.g. Alfentanil) cause nausea and vomitting ...
elective surgery9/6/2010
  Q: I am a 51 yr old female and I smoke 7-10 cigarettes a day. I know they are bad %26 I've "quit" a ...
  A: [pls excuse my delay in answering as I've been on vacation] 1. Is there a board-certified ...
Should I be afraid?9/2/2010
  Q: I am having surgery next Tuesday. I am very afraid of anesthesia! I try to educate myself on every ...
  A: Anesthesia for otherwise healthy people is pretty darn safe--provided you really are "otherwise ...
Anesthesia options9/1/2010
  Q: I am scheduled to have a minor outpatient gynecological procedure (approx 20 minutes) and the doctor ...
  A: [Pls excuse my delay in replying as I've been on vacation] Yes, there are alternatives. If your ...
Post-Anesthesia Coma8/24/2010
  Q: My grandfather (79 year old diabetic with COPD) went in to have a valve replaced on Tuesday morning ...
  A: "Cognitive Impairment" or "cognitive dysfunction" are the terms used for neurological disturbances ...
surgery8/23/2010
  Q: I quit smoking 2 weeks ago. Soon after i stop smoking i end up with a cough and nasal congestion. ...
  A: Since the 1980's it has been well-known to anesthesiologists that the first few weeks after the ...
tremors post anesthesia8/15/2010
  Q: Dr. Starkman I am beyond thrilled to have connected with you a week prior to surgery. I am to have ...
  A: You don't want to wake up?......maybe you should hire Michael Jackson's doctor!**.....OK, all bad ...
Anesthesiology8/12/2010
  Q: I want to become an Anesthesiologist. I wanted to know what are some good schools here in New ...
  A: Here are the steps: 1. Decide what it is about becoming a physician and anesthesiologist that ...
Anesthesia after pregnancy8/11/2010
  Q: Dr. Starkman, My wife will be having gall bladder surgery after she gives birth to our first child ...
  A: Today's anesthetics are so rapidly metabolized that the amounts that make it into mother's milk AND ...
Anesthesia8/8/2010
  Q: I am 54 years old and obese and need nasal/sinus surgery for some growths in my nasal and sinus ...
  A: Yes, lose all the weight you need to lose prior to surgery--that weight loss alone may fix your ...
allergic reaction to anaesthesia8/5/2010
  Q: My mother had a knee replacement four days ago she is overweight diabetic Since she has gotten out ...
  A: This is not a forum for the treatment of individual patient medical problems! Since it's not ...
anesthesia question8/1/2010
  Q: Starkman: I just returned from a deployment in the Middle East and I need to have some shell ...
  A: I'm sorry this has taken me so long to answer, but I copied your message and let a few colleagues ...
Questions about being an anesthesiologist4/27/2010
  Q: I'm Brianti and I'm doing a research project on becoming an anesthesiologist. I am also interested ...
  A: I've answered most of these questions already----check out my answers. As to the health benefits ...
questions about anesthetics.4/26/2010
  Q: What is the average cost of schooling for anesthesioligy.? Do you need to take state boards? Is ...
  A: Advanced training in many fields is expensive depending on the college and medical school you ...
Anesthesiologists or Nurse Anesthetist4/24/2010
  Q: I am in high school right now, but I really want to be an anesthesiologist I know that it requires a ...
  A: Since I don't know you, I recommend you review the "downside" of each choice and see which fits ...
Residency program4/22/2010
  Q: I'm doing a school project on Anesthesiologists, and i need to find out what a Residency Program is. ...
  A: A residency in anesthesiology (as in any medical , or perhaps other field) is a paid period of ...
What type of anesthesia did I receive for my foot surgery?4/20/2010
  Q: During May of 2009, I received foot surgery on my right foot to remove a medium-large sized bone ...
  A: There is no need for conjecture on my part here---call the hospital or surgery center where you had ...
Becoming a Anesthesiologist4/19/2010
  Q: i was wondering what college classes did you have to take before becoming an anesthesiologist ...
  A: All anesthesiologists are physicians--in college you will have to meet the entrance requirements of ...
Anesthesiology as a Career4/18/2010
  Q: I am a 3rd year medical student considering anesthesia as a career. My question is what do you think ...
  A: Greetings, and thanks for the provocative questions. As patients get less and less 'attached' to ...
general info4/15/2010
  Q: I am a high school senior working on a career research paper, and if you could answer any of the ...
  A: An anesthesiologist's working hours typically start about 6 AM (early surgeries need prep time, plus ...
possible POCD?4/14/2010
  Q: Starkman, Just yesterday morning I underwent a minor procedure (transurethral botox injections) ...
  A: POCD is marginally defined and is usually considered to be a long term complication of longer and ...
mac sedation problems?4/9/2010
  Q: Two months ago, I underwent a upper endoscopy for evaluation of intestinal inflammation. I am a ...
  A: This is pretty common stuff during an upper endoscopy done under sedation and should certainly not ...
Phentermine Use4/1/2010
  Q: I am supposed to have Functional Endoscopic Sinus Surgery on April 8th (7 days from now.) The ...
  A: Yes, the cancellation is necessary. The back-up research is retrospective and supports your ...
wpw and anesthesia3/31/2010
  Q: my daughter has wpw syndrome. she also has cysts in her ovaries. i would like to know appox what ...
  A: The risk is quite low (though I do not have a 'number', formally published as a studied established ...
pre op pregnany test3/29/2010
  Q: Is it necessary to perform a morning HCG prior pain procedures like an epidural injection or ...
  A: This is usually a matter of protocol which varies from facility to facility. As such, common sense ...
memory loss after surgery3/27/2010
  Q: My friend had knee replacement surgery a week ago--she is still on lots of pain meds--she has had ...
  A: There are too many variables to make an accurate diagnosis here, on the internet. Matters that are ...
College Requirements3/26/2010
  Q: What math classes will you need to take in college in order to become an Anesthesiologist ?
  A: All anesthesiologists are physicians and will therefore need to meet the minimum requirements for ...
Program demands3/22/2010
  Q: I would like to know how much time during the actual program is required. I understand that it is ...
  A: I'd write to the program director of the "program" (WHAT program?????) you are considering to get ...
epidurals3/20/2010
  Q: i have since had another baby 8 months ago and now am suffering from back pain in the same place as ...
  A: I hope you've made an appointment with the anesthesiologist who did your last epidural such that he ...
question help for information2/5/2010
  Q: ok, hi, im a student here at cal state monterey bay im going to get my b.a. for psychology. Ok well ...
  A: Yes. And here's what you can do: Review the down-side of becoming a doctor in 2010 by going to ...
Anesthesia and Bronchitis before outpatient surgery2/3/2010
  Q: I am due to have a short proceedure (D & C) for uterine lining build up (post menopausal) Next week ...
  A: Given your chronic history of bronchitis, morbid obesity and (?contolled or uncontrolled) ...
Sedation appropriate or not?2/2/2010
  Q: I have read many of your comments and find your candor refreshing. I'm a hospital pharmacist who is ...
  A: Your anesthesiologist sounds a little 'holier-than-thou' ("Im not letting you suffer..") that's YOUR ...
Disc herniation and Delivery2/1/2010
  Q: I had disc herniationL5-S1 after the normal birth of my first child.Its been 7 yrs.Now I am daring ...
  A: An epidural anesthetic itself is not contraindicated in the presence of a herniated disc. i.e. there ...
Seizures while under anesthesia12/5/2009
  Q: I'm a night nurse on a med-surg floor (I'm a new grad). Recently, I had an epileptic patient with a ...
  A: Anesthetics, by definition, depress CNS activity and so, raise the seizure threshold. However, that ...
Anesthesia problem?12/1/2009
  Q: "Hi, I had a tonsilectomy. No problems but then I had another surgery a year later & something ...
  A: again! 1. Blood pressure fluctuations are typical for many reasons during both regional and general ...
getting an anesthesiologist not a CRNA11/29/2009
  Q: Please excuse my hostility, but I'm mad as hell. I had surgery on the west coast and had no problem ...
  A: I really have no standing to apologize for the lousy treatment you are getting from people who have ...
Diverticulitis and Anesthesia11/28/2009
  Q: My Mother has had this condition for many years - usually well managed by drugs and diet. She has ...
  A: Diverticulitis, an inflammation by definition, is controlled by "things" that minimize ...
Anesia after chemo and heart problems11/25/2009
  Q: My mom underwent chemo which ended about 5 months ago. During her second session she had some ...
  A: You are asking all the right questions and doing a better job of it than most cardiologists who are ...
blood patch11/24/2009
  Q: i had some fogginess in the head and light headed too. Two weeks later and it hasn't got better. ...
  A: The doctor who caused the problem by doing a spinal tap in the first place is responsible for ...
anesthesia and paxil11/23/2009
  Q: I had wrist surgery last week (Tuesday) a day later I experienced extreme agitation. Very anxious. ...
  A: Versed seems to be prolonged in its actions with some unexpected side effects (for a ...
blood patch11/22/2009
  Q: i had some fogginess in the head and light headed too. Two weeks later and it hasn't got better. ...
  A: Spinal taps resulting in the loss of too much spinal fluid cause the brain to get pulled downward a ...
Nardil and versed, fentalyn11/21/2009
  Q: I recently had a colonoscopy and my doctor told me it would be ok to have the abive drugs while on ...
  A: I'm sorry you had the problem that you did with this "doctor" (probably a gastroenterologist, not an ...
hasn't woke up after surgery11/14/2009
  Q: My granny went in and had a whipple surgery done which lasted 6 hours. Had some complications and ...
  A: Typical. You don't mention what "DR." doesn't know what the problem is....and you can bet he's NOT ...
old age11/9/2009
  Q: i am 37 years old. when i originally went to college 20 years ago, i was too immature and screwed up ...
  A: This really doesn't require the expertise of an anesthesiologist or physician---but more that of a ...
Epidural site pain11/8/2009
  Q: I had my son 4 months ago, and recently I have been getting sharp stabbing, nerve pain at the site ...
  A: Congratulations on the birth of your son! As far as this unusual pain goes, since so much time has ...
Advance directive regarding anesthesia11/7/2009
  Q: My girlfriend recently had surgery and everything went quite well, but it has caused me to think ...
  A: In the event of ELECTIVE surgery you'll have time to re-write or modify the consent for surgery and ...
anesthea & gallbladder surgery11/2/2009
  Q: my wife needs to have her gallbladder taken out and she has copd uses oxygen at night only. how are ...
  A: The outcomes are variable and they are based on the skills of the anesthesiologist who is adept at ...
GETTING SLEEPY10/30/2009
  Q: I was wondering would you please tell me: if a person get anesthetic to put them asleep for the ...
  A: No, one's body doesn't get used to or build-up a tolerance to anesthetics, so you should not be ...
Neurovascular Manifestation10/26/2009
  Q: Do you know what the definition of Neurovascular Manifestation is? What are the symptoms/effect of ...
  A: A neurovascular manifestation is any resultant issue that affects nerves and blood vessels. Since ...
Anesthesia10/23/2009
  Q: What are some side effects/risks of having anesthesia? What happens if a person is allergic to the ...
  A: This question is really so broad it is hard to answer briefly without being overly general and ...
Surgical complications.10/20/2009
  Q: I have a question about a surgery I had some 15 years ago, it was an oral surgery so I believe they ...
  A: It sounds like your airway was compromised at some point, and then diagnosis and treatment consisted ...
anesthesia complications10/2/2009
  Q: I will be undergoing a thyroidectomy soon, and I have terrible fear regarding the anesthesia ...
  A: I hope you and/or your surgeon will arrange IN ADVANCE to meet with the anesthesiologist WHO WILL DO ...
Upcoming surgery9/29/2009
  Q: I have a question RE: nausea and vomiting after surgery. I had a appendectomy in 2000 and after ...
  A: Ask them not to paralyze you and do your anesthesia "TIVA" (total intravenous anesthesia). When you ...
Two questions on becoming an Amesthisiologist9/27/2009
  Q: My first questin ia what is the estimated cost to becoming an Anesthesiologist? Also how long dose ...
  A: Once you are a physician and have completed an internship year to be eligible for licensure (to ...
Very interested..9/23/2009
  Q: i am a high school student and i'm stuck on what colleges to attend. There is a comunity college in ...
  A: Your first challenge will be to attend and successfully complete college--either a large or small ...
phentermine9/22/2009
  Q: I have been taking Phentermine for 10 days and stopped taking it 4 days before I am scheduled to ...
  A: Phentermine is not one of those drugs that are studied by physician scientists or placed into random ...
TIVA for full absominoplasty9/18/2009
  Q: I lost 100lbs a few years ago (now I'm in excellent health), but now I need full abdominoplasty ...
  A: There are many more issues in avoiding PONV than solely the agents chosen for the anesthetic, and ...
what's the best degree?9/17/2009
  Q: I am currently a senior and I wanted to know what is the best degree to receive if you want to ...
  A: I assume you meant 'senior' in high school, but you did not state that. In the US to become an ...
meds so you dont aspirate during surgery9/14/2009
  Q: What medicine does anesthesiologist give to patients to ensure they don't aspirate during surgery?
  A: 'Medications' given during surgery that address the 'pulmonary aspiration of gastric contents' issue ...
Duration (half life?) of anesthetic Versed?9/11/2009
  Q: Starkman, > In 2007, I had a "disinhibition episode" 4 days after outpatient surgery. It points ...
  A: The time drugs remain in one's body is described as the "half-life" of that drug and it is an ...
Chronic pain since epidural9/10/2009
  Q: I had my son almost two years ago. Ever since I have had chronic pain in my spine and back. It is ...
  A: Yes, I have heard of anesthesiologists and other doctors not "knowing when to quit" or being given a ...
Anesthesiology9/9/2009
  Q: What would you suggest as the "first step" for a student coming out of high school going into their ...
  A: Read "Code Blue: Health Care In Crisis". Annis, Edward. Washington, DC. Regnery Press, 1993. He'll ...
2 epidurals didn't work-should I try a 3rd time?9/4/2009
  Q: a little background on me and my situation. I am the mother of 4 children. 33 years old, very good ...
  A: First, congratulations on your 'surprise #5'! Second, I don't think you'll ever know precisely ...
anesthesia/plastic surgery9/3/2009
  Q: Dr Starkman, I am anticipating having breast reduction/abdominoplasty within the next 6 months. In ...
  A: Your diskectomy surgery should not pose a problem. A regional block with sedation for both ...
bad procedure? did something go wrong?8/28/2009
  Q: I was in a car accident this past Feb and have 2 herniated discs and 1 bulging disc in my lumbar, my ...
  A: time since accident, etc.) necessary to adequately attempt to answer your question. What you left ...
pseudocholinesterase and benzodiazepines8/25/2009
  Q: What do you recommend for anesthesia (conscious sedation) for endoscopy screening procedure for a ...
  A: Propofol as the sole agent is reliable and quite safe in trained 'anesthesia' hands. Its only ...
Versed8/22/2009
  Q: This drug was given to me by an anesthesia nurse masquerading as a Doctor. I had specified that no ...
  A: I've addressed the Versed controversy in some previous postings. The good news is that this drug is ...
daughter not feeling well after anethesia8/20/2009
  Q: My daughter, 13, had a colonoscopy yesterday. She ran fever of 103.4 for several hours during the ...
  A: You did not mention why your daughter was having the colonoscopy in the first place--did she already ...
versed8/19/2009
  Q: I was given versed two years ago without my consent or knowledge. I only know this because I spent ...
  A: There seems to be a significant group of people who feel their exposure to Versed has left them with ...
"Coma" after anesthesia8/16/2009
  Q: I had a hysterectomy last week and asked that I use an ipod during surgery to calm me. I got the ...
  A: Given the miniscule amount of information provided, there really is not much I can do to determine ...
college8/11/2009
  Q: I'm a junior in high school and I'm very interested in anesthesiology. i play volleyball and i plan ...
  A: One's undergraduate school (college or university) need not have a medical school--you'll apply to ...
Arachnoid cyst and anesthesia8/10/2009
  Q: I am a healthy 34 year old man with only an occasional sinus headache. I learned from reviewing my ...
  A: There is no increased risk with the anesthetic given the information you've provided. One kidney ...
General Anesthetic8/9/2009
  Q: I've had quite a few surgeries in my young life. I've always wondered how general anesthetic ...
  A: The mechanism by which general anesthetics render one "anesthetized" is unknown! They simply "work" ...
Anesthesia Anaphylaxis8/8/2009
  Q: My daughter had an allergic reaction to anesthesia during a tonsillectomy. She went in anaphylaxis ...
  A: First, get a copy of the "anesthesia record" the anesthesiologist completed at the time of the ...
Waking up from general anesthesia and an ON-Q pain buster....8/7/2009
  Q: On Tuesday I had an outpatient surgical procedure; an umbilical hernia that unbeknownst to myself or ...
  A: It sounds like the On-Q system worked well for you after this type of surgery which is known for ...
Who is performing the anesthesia?8/6/2009
  Q: I recently had a colonoscopy to check on my FAP and the procedure was somewhat of a disaster because ...
  A: Your question brings up so many important issues that I hardly know where to start. (That's why it's ...
Versed8/4/2009
  Q: I have had to have numerous endoscopies and colonoscopies, and each time I get 5cc of Versed which ...
  A: If this is causing a dilemma for your "anesthesiologist" I suggest you find a new anesthesiologist. ...
cold symptoms/colonoscopy8/2/2009
  Q: I'm to have a colonoscopy Monday and now, Sat nite, have a runny nose. I have limited income, and ...
  A: A simple runny nose should not be much of an issue for an anesthesiologist to safely anesthetize you ...
becoming an Anesthesiologist8/1/2009
  Q: Starkman, I am 26 yrs old with 45 college credits that include ...
  A: If you're a surgical tech, you have access to anesthesiologists at work----talk to them to get their ...
Medical School vs. Nursing School...7/31/2009
  Q: After being in college for about a year without a direction, I had the opportunity to shadow an ...
  A: It's pretty rare that a nurse anesthetist moves to med school and then to training for ...
anesthesia consent-no sedation/no fent?7/30/2009
  Q: I recently ran into a problem with outpatient surgery anesthesia. A year ago I had elbow nerve ...
  A: No sense. There is no contraindication to small, conscienciously dosed amounts of fentanyl during ...
vomiting with anesthetic7/29/2009
  Q: Each time I have a general anesthetic I vomit for 12 to 24 hours, no matter how much gravol or ...
  A: Hopefully, when you expressed your concerns to your anesthesiologist they were able to formulate a ...
vomiting with anesthetic7/28/2009
  Q: Each time I have a general anesthetic I vomit for 12 to 24 hours, no matter how much gravol or ...
  A: Ask the anesthesiologist to provide a regional, instead of a general anesthetic for your hand ...
colonoscopy/no alcohol7/24/2009
  Q: how come they tell you not to have alcohol 24hrs after being under a mild anesthetic for ...
  A: 1. Alcohol dehydrates, and one who has undergone colonoscopy is already considerably dehydrated from ...
Spinal Anesthesiology7/24/2009
  Q: almost 9 years ago i had a spinal due to a c- section.sense that day i have had numbness and pain ...
  A: I can't make much sense out of the fact that your injection site was between your shoulders when I ...
best educational route to take (crna)7/23/2009
  Q: First of all thank you for taking the time to answer my question. I'm 26 years old and have ...
  A: Keep in mind that I'm a doctor answering a nursing-education question.......but here is what I'm ...
Versed for colonoscopy7/22/2009
  Q: I had my first colonoscopy on July 14, 2009. I am an extremely healthy, happy, drug-free ...
  A: I blame the Versed---many gastroenterologists-who act as anesthesiologists-during the colonoscopy ...
Recent Question7/21/2009
  Q: I recently posted a question to you & requested that it be "private" - For my own personal reasons, ...
  A: Because the question seemed "general to [me], and [my] answer would definitely benefit others". ...
anesthesia for colonoscopy7/19/2009
  Q: I have had 2 colonoscopies which were utterly horrible. I was assured I would be "out" for the ...
  A: I suspect, but do not know for certain, that your previous two colonoscopies were done by a ...
Becoming a CRNA7/17/2009
  Q: I'm not sure if you can answer my questions but I hope you can! I'm 20 years old & I have no nursing ...
  A: Quite the exhaustive question! You are doing the right thing now to line up your concerns and begin ...
Surgical Positioning with Hydrocephalus7/16/2009
  Q: Are you aware of any instances where placing a patient with Hydrocephalus/VP Shunt in the ...
  A: The brachial plexus is the complex grouping of nerve roots and their branches that subserve the ...
anesthesia consent7/16/2009
  Q: I recently ran into a problem with outpatient surgery anesthesia. A year ago I had elbow nerve ...
  A: Ask your surgeon to reschedule your case at another facility where he practices (he'll hate this if ...
cut under tongue after surgery7/15/2009
  Q: had knee surgery a few months ago. woke up with a large cut under my tongue(the skin that connects ...
  A: This is not a complication of knee surgery but one of anesthesia----see your anesthesiologist about ...
anesthesiology7/14/2009
  Q: I have a few questions... I plan on majoring in mass communications with a minor in french. But, I ...
  A: A Mass Comm major with a French minor is hardly a prerequisite for medical school and, eventually, ...
Surgical Positioning with Hydrocephalus7/13/2009
  Q: Are you aware of any instances where placing a patient with Hydrocephalus/VP Shunt in the ...
  A: The short answer is: "No, I'm not aware of a syndrome like the one you describe". However, there is ...
VCUG7/12/2009
  Q: My 14 months old is getting ready to have a VCUG done under sedation. They said they were using a ...
  A: If your daughter has had a problem with asthma, then the anesthesiologist sedating her for her VCUG ...
Possible bad reaction to muscle relaxant?7/12/2009
  Q: I had 3 hours of dental work done on 7/1/09. I've been going to my dentist for years and having ...
  A: You more than likely had the reaction to succinlycholine that you describe. Your muscles were not ...
post anesthsia taste and lump in throat7/12/2009
  Q: On July 6 I had a Rectocele / Enterocele with sphincter repair. I very disturbed that I cannot eat ...
  A: Your anesthesiologist should be made aware of this potentially-related-to-anesthesia problem. Call ...
post-op concerns7/11/2009
  Q: 2 days ago, I went through tendon repair surgery on my right hand. I'm a 39 year old male. General ...
  A: 1. I've heard of patients who have hiccups after surgery--but they're usually children. It's fairly ...
procedure without sedation7/10/2009
  Q: I had a horrible experience with conscious sedation with Versed in the past (and this seems to be ...
  A: Deplorable. I read this more as a medical-legal issue than a medical/anesthesiology issue per se, ...
having generat anesthetic while suffering with a cough and sore throat safe or not7/8/2009
  Q: in 2 days time i am going into hospital for operation on my foot time of operation is 90 minutes , ...
  A: If you are not acutely ill at the time of surgery I imagine it would be safe to proceed with a ...
Pediatric Anesthesia7/6/2009
  Q: Is it true that is it safer to administer general anesthesia to a child after age 1? What are the ...
  A: I don't feel that the age of 1 is a particular cut-off point insofar as pediatric safety is ...
Time management7/3/2009
  Q: I have heard that anesthesiologists are not at the hospital the time and i have also heard that they ...
  A: The premise that you are a candidate, let alone a serious candidate, for anesthesiology or medical ...
Worsening reactions to anesthesia, will I wake up next time?7/3/2009
  Q: At the age of 13, I had routine oral surgery after which I was violently ill, and suffered from ...
  A: You sound like you are what is known s a "slow acetylator" (google that one!). Too bad you have a ...
Use of amnesics7/2/2009
  Q: I have had several surgeries in Baltimore. I remember waking up in the OR at the end of the ...
  A: Apparently, there are no limits to the pompousness of physicians (this time anesthesiologists) who ...
Toddler General Anesthesia Question7/1/2009
  Q: Good Morning My 3 year old daughter underwent surgery yesterday to remove her adenoids. Other than ...
  A: It is typical for anesthetics to cause a person to stop breathing---which is why it is ...
Local anesthesia administered by a doctor6/29/2009
  Q: Can a Doctor (Plastic Surgeon), administrate by himself the local anesthesia named Lorazepam and ...
  A: Lidocaine is a local anesthetic; lorazepam is a sedative-hypnotic. Your plastic surgeon is ...
Dental surgery6/28/2009
  Q: I am having a small dental procedure tomorrow ( bonding and exposure of a tooth) I have had the ...
  A: Twelve hours??? Probably not directly relating to the THC content of your blood that far out. There ...
Epidural anaesthetic6/27/2009
  Q: During my labour with epidural, I was taken for a caesarean and the anesthetist topped up my ...
  A: Epidurals, like all anesthetics, entail risks. It may happen again. Then again, it may not. ...
Anesthetic options6/26/2009
  Q: Dr.Starkman, I am a CHF & CAD patient who has been told by my cardiologist to avoid general ...
  A: Anesthesiologists fight this fight regularly--namely, that your cardiologist, irrespective of how ...
anesthesia in a patient with dysautonomia6/25/2009
  Q: My adult daughter has dysautonomia. As a result, the anesthesiologist used general anesthesia ...
  A: The nice thing about a general anesthetic is that if there is a major problem, it can be turned OFF ...
C-sections6/23/2009
  Q: I had an emergency c-section after 14 hours of labor with my first child my OB had to put me ...
  A: It's preferred to provide an epidural or spinal anesthetic for C-sections as opposed to general ...
Low blood pressure6/22/2009
  Q: My blood pressure has always been on the lower end, usually about 100/70. I had lipo under general ...
  A: Four days later your BP was not just low, but symptomatic. I'd guess that after four days, any ...
Dantrolene Sodium6/22/2009
  Q: Do outpatient surgery centers have to carry the drug Dantrolene Sodium in case something goes wrong ...
  A: The short answer is 'YES'. However, the statutes of various states, districts, provinces, etc ...
Pediatric Anestheic allergy???6/16/2009
  Q: My son had an elective plastic surgery on his scalp 3 days ago , surgery went well, after almost 3 ...
  A: It was not an allergy. Speak to the anesthesiologist as to why in this day and age it took 3 hours ...
effects of anethesia on your eye sight6/14/2009
  Q: Can you tell me if anethesia effects your eye sight?? I had surgery on thursday and since them my ...
  A: Yes, any number of anesthetic-related drugs can have an impact on vision; their effects should be ...
ect - cracked teeth/bite blocks?6/12/2009
  Q: Starkman, I'm 34. I've had ETC 55 times in the last 14 months. The first time I woke up before I ...
  A: I think it's a shame that you've had not one problem, but several, with respect to dental problems ...
Could the laryngeal mask cause severe sore throat for over a week ??6/11/2009
  Q: I'm 30yr Female I had knee surgery(Torn cartilage and meniscus) June 3 with great success, I might ...
  A: Yes, an LMA can cause a bad sore throat, though the cases that have been formally reported of which ...
Anesthesia in LBD6/6/2009
  Q: My mom is 81YO, with PD and moderate Lewy Body Dementia. No other significant health ...
  A: Your neurologist (the PD expert) probably has no experience anesthetizing PD patients--or ANY ...
Mid-term effect of anesthesia on fitness6/5/2009
  Q: Dr Starkman, Three weeks ago I underwent a laporoscopic appendectomy under general anesthetic. As a ...
  A: My guess--and it is a guess, as there is no accepted and/or recognized complication from general ...
anesthesiology6/4/2009
  Q: normally in patient undergoing TransUrethralResection of Prostrate,dose of 0.5%Bupivacaine(heavy)in ...
  A: I agree with your dose protocol for prostate resections using bupivacaine in SAB. T10 is more than ...
Socialized Anesthesiology6/4/2009
  Q: So I keep worrying about the socialization of medicine. What will this mean for someone who is ...
  A: Important question! I believe the increased socialization of medicine really asks all of us if we ...
breast reduction surgery6/2/2009
  Q: i have breast reduction surgery on June 16th. My problem is i know that i am suppose to stop smoking ...
  A: Smoking: Increases the risk of postoperative and intraoperative respiratory complications, ...
Preparing for surgery5/30/2009
  Q: I am a female, 56 yrs old and am scheduled to have arthoscopic surgery on the knee. I was set to go ...
  A: Ask the surgeon to have the anesthesiologist to do the "surgical clearance" (it is more properly ...
Upsetting induction5/28/2009
  Q: Last month I had Laparoscopic gallbladder surgery with general anesthetic. I expected to see ...
  A: No, I do not think your surprise and upset contributed to the poor recovery. You did not mention how ...
anesthesia5/27/2009
  Q: I am having surgery on june 10th and i have a few questions. I would like to know if flaxseed ...
  A: I believe any of the supplements/drugs you mentioned may cause issues during the time of your ...
woke up during suegery5/21/2009
  Q: I had a implant exchange,and small lypo procedure around the belly button.Aproximately 10cc's I ...
  A: I have to agree with you that this sounds like an [sic] "unproffesional mess". I do not know how ...
anaesthesia residency for IMGs5/21/2009
  Q: first of all i would like to thank you for the effort you do trying answering questions and helping ...
  A: 1-Not impossible at all.......since program directors are always looking for the best candidates(to ...
anesthesia question5/19/2009
  Q: I am wondering if you would answer a question for me. If not I will understand. I am having ...
  A: I am sorry I am just able to get to this question and provide a (late) answer. It would have been ...
Highschool Courses For Anestheisology5/19/2009
  Q: ..so I was wonderin what classes do I need to next semester if I want to be an anestheisologist?
  A: Spelling and English: One, so you'll know how we spell our specialty and, two, to be competitive ...
Central Nervous System and Anesthesia5/19/2009
  Q: Dr. Hi. My central nervous system is not well right now. I am a former user of Xanax and have ...
  A: I think it might have the effects you mentioned. Please ask your surgeon to arrange a ...
anesthesia and high blood pressure5/19/2009
  Q: my mother in law lives in mexico. she suffers from hbp. she had a stroke and has limited mobility on ...
  A: Anesthesiologists personally(as opposed to dentists, gynecologists and surgeons) regularly deal with ...
versed5/17/2009
  Q: I had a colonoscopy last Tues and I am upset at the amount of versed I was given. I have been sober ...
  A: No, there normally are no long-term effects from midazolam (the generic name of the drug known more ...
conscious and unconscious5/16/2009
  Q: When a person is asleep at night, are they unconscious?
  A: Although I am tempted to answer "yes", as an anesthesiologist I am probably not the best expert for ...

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JM Starkman, MD

Top Expert on this page

Experience

Over twenty-five years of adult and pediatric, inpatient and outpatient clinical anesthesia practice--some private, some group.

Organizations
American Association of Physicians and Surgeons. My county medical society.

Publications
[not a researcher]

Education/Credentials
American medical school graduate. Board Certified. Fellowship trained Cardiovascular and Pediatric anesthesia subspecialist.

Past/Present Clients
Over 20,000 anesthetics, the majority of which have been personally managed, with less than 5% consisting of supervising nurse anesthetists or in-training resident physicians.

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