Half rate for children ?

Administering anesthesia to little tots is great challenge to a Anaesthsiologist.Many of the anesthisiologist refuse to give anesthesia to tiny tots,as the risk involved is ten foldsas compared to adults.Children demand a highest degree of competence from an anesthesiologists ,because of their small weight they need normally the least dose of drugs,moreever all the systems are not well developed to take on the potent drugs used in anesthesia.Chiledren easily go in for cynosis(turning blue)because of breathholding spells,suffer hypothermia (body temp goes down easily),and they do not tolerate the less oxygen supply at times complicating the anesthesia.One more problem is that few of the mothers would feed the child when it cries,with our understanding the gravity of the situation of feeding infants before anesthesia,incedently under anesthesia when the body reflexes are lost, the contents of the stomach will flood the lungs causing pnemonia and at times sudden deathve To name a few above are the problems we face in anesthetising the infants and childrenAt times we will be under lot of tension fearing about the outcome of surgery and anesthesia in paediatric age group.We sigh a relief when we see the child crying at the end of the surgery and anesthesia,exactly for the above reasons the anesthesiologists charge double charges of an adult.Once I managed anesthesia on a kid who had huge lump in the neck,the surgery took around two hours, i had to giveblood tranfusions for the baby to save her from the catastrope of blood loss and cardiac arrest.After handing over the baby to her mother after anesthesia I was really feeling on top of the world for I had managed sucessfully the anesthesia on a challenging case in that child,but I was brought to earth, when the owner of the hospital who happened to be non medico,casully commented that charges should be half rate as in KSRTC busfare !!!! for a kid.

Humour in anaesthesia

Surprised by the title !!
Anaesthesia is such a serious business with life and death,rarely one comes with a humour in it.
Once it so happened after the surgery, the patient came back to me complaining I had charged too much (Rs 1000/)to administer anaesthesia on him, he further accusesed me of charging so much for small injection to put him to sleep before surgery.I try to convince him in my way but he wouldnt agree at all, ultimately when i told him my charge to administer a inj to put him to sleep was only Rs 100/ but to put him back to LIFE was Rs 900/,then there was no sight of the patient

Near death experience: two lives

I was called for an emergency cessarian section to save the baby and mother from a catastrope.
The patient had no problem medically,except the present pregnency which itself is a high risk
when it comes to anesthtise the patient.
I went ahead with spinal anesthesia, after the cursory examination,which is the popular technique of choice for the Gynae and Anae.
After the spinal anaesthesia, the patient was put in supine position, I went ahead with the oxygen mask and monitoring,about to signal the surgeon to go ahead for the surgical assault.At that point of time I noticed the patient had turned blue with froth in the mouth,pulse was missing, so also the respiration had ceased,my GOD patient was ending up with what is described as Aorto Caval Compression Syndrome.The pregnant uterus after the spinal anaesthsia sits over the inferior vena cava and abdominal aorta,because of the tone of the abdominal musculature is lost after a spinal,thus there is no flow of blood incoming to heart,allowing it to stop for want of blood to be filled in its chambers.
I had to yell at the OT attender for help to put the heavy patient in to the left lateral position,which he did as per my advise and Iwent ahead with resuciation of the patient by giving
pure oxygen to breathe by artificial ventilation,and inj Atropine to increase the Heart rate,and Inj Mephentine to jack up the blood pressure to normal,By sheer GODs grace on the patient,and little extent on me, the patient showed signs of life again.surgery was allowed to go ahead.
its needless to say I had a chance of seeing a healthy live baby which I thought otherwise.
I had one more experience of saving a mother and child in her.

Near death experiences :one

I was called to anesthetise a patient of 80 yrs with the big wound on his leg,posted for debridement of the wound and skin grafting. A cursory examination did not reveal any major problem with the patient exeept his old age and age related problems.
I decided to offer him a spinal unilater anaesthesia blunting his senses on one of his leg.Which i thought would not alter his physiology, and the patient would tolerate the procedure well.
Well the procedure of debridement and grafing was over in no time, with the patient in a stable condition,I left the OR room to change over to my dress,leaving the patient under the care of the OR sister.
A loud shout of the sister brought me back to OR room.Patient had collapsed, turning blue,with no pulse,respiration,and BP. I thought I lost the patient once for all.My thoughts were how to answer the patients relatives,and surgical team about the disaster.
I pumped up all the courage,took the name of God ,prayed and went ahead with the resusciation. I immediately gave a thump on the chest to generate a heart impulse,pushed Inj.Adrenaline iv to improve the circulation,passed a ET tube in to the throat and started with the artificial ventilation.To my surprise and with Gods grace my prayers were answered.
Patient recovered in a matter of 10 minutes of resusciation,back to his conciousness and started to react to us,asking a usual dialogue in a filmy style,'muze kya huva tha ,mai kaha hun' reliving me of the tension i had so for!!
I left the scene leaving the patient under ICU care,thanking God, to anaesthetise the next patient !

Initial experience at B'lore.

I began my dream life at blore with a total chaos in mind "will I be a success at a new place,whether i will be accepted by my medical people,did i take correct decision to change the place,at a fag end of my carrier".In fact many people desisted from doing so .
Only thing I had in my mind was to succeed at any cost,come what may,i had three months leave
which came handy now. I could gamble for three months to see the results,before I take a decision
permanently.This idea was mooted by friend Dr Sangolli which i thought was very apt.I did not know the depth of water at blore.my trial period began on a high note.
I had to hire a small room for accommodation near to my working area.i could succeed in getting a room,on seeing it, my daughter exclaimed" pappa ye room to ate ate hi khatum ho gaya" in a circuit style. i had to endure all the hard ship that i faced in the beginning of my establishment at blore.

My days used to begin with a visit, to a Nursing home and meeting the owner of it,i had to wait like a medical rep waiting to see a doctor.I had to make several visits before i could meet the doctor.
literally i had to carry my all credentials,experience certificates to ingappraise them of my resume,begging to give me a chance to prove my worth as an anesthesiologist.
The is a hitch is that it is difficult to enter in to the vicious cycle of surgical team.Usually no surgeon
would like to change an anesthetist in whom he has confidence for the last couple of years.If this is the case then i thought i had no place in blore,where in so many stalwarts in anesthesia are established having a good practice and circle.My idea was to break this cycle and gain entry at least once in a nursing home,which i thought would pave way for the ;my smooth career.
What helped me was my experience behind me,when i quoted my experience,most of the surgeons were floored.moreover the work is so heavy that any no of unaesthetic would fall short.

At times i felt i was moving with a begging bowl,in a educated way,i too felt,why on earth i decided to come over to blore. but me patience i thought it would come to my rescue.

Freelancer after 25yrs of service in SAIL-VISL

Preamble:
I had a intense desire of moving to Bangalore after the retirement from VISLcbame ,this desi re became a reality, i still wonder who is behind my change.Ever since Manu took up his graduation at PES Bangalore,my visits frequented to my dream place.I enjoyed every bit of my trip to the place,driving down,stay at guest house,shopping at various malls along with company of Maya, sony and manu.I enjoyed driving onthe roads of Bangalore especialy under the navigational parter in manu, his left and right directions were amusing adding humour in our tour.
Since i stayed very close to Blore, i got few oppurtunity to own few sites around not in.so my desire intensified to many folds.
At visl i was denied the VRS,which i deserved most,i was told i was too good to be relieved under VRS scheme, my planned dream i thought was getting shattered for no fault of mine. i was getting disgusted and disillusioned to work at visl hospital, which was my KARMABHUMI.
At the same time ,as if adding insult to injury I was denied a richly deserved promotion.
At that point of time I felt the organisation, which I served with so much of sincerty,is not worth
for me to continue till my superanuation.
I made up my mind to change the guard and gear for better or worst circumstances.At that point of time i took a plunge as freelancer which i had no experience in the past,come what may.
Though i had a tailor made position at Bhadravati,i had enjoyed my stint as a anaesthsiologist,a leader by any standard.Every one of my well wishers asked me to continue at Bhadravati. But my mind was already in Bangalore!