Fascinating stuff. I underwent a liver transplant in October of 2019. The anesthesiologist is the last person I remember speaking to before I woke up two days later. He must have done a good job because I did wake up and I'm doing fine.
I had a liver transplant at Mount Sinai Hospital in NY on March 16, 2016. There's a chance I had it done in the OR featured in this video. As I was being rolled into the OR I was very scared. I didn't know if I was going to die or not. The last thing I remember I told the anesthesiologist that I was very worried. He said to me in the kindest way possible, "Alan we're going to take good care of you. " Those words meant everything to me and they put me at ease. The next thing I know I woke up in the recovery room and I am ok 7 years later. Thank you to that anesthesiologist, the transplant surgeon Dr. Arvelakis and all those kind professionals that helped me at My Sinai.
I hope that you’re still doing well. I had had previous hernia surgery with Dr Hertl. I felt at ease with him and the team. I knew there was a chance that I may expire, but the waiting for the liver a nd cancer coming back a third time was my biggest concern. Now I’m approaching 11 years ❤
I’m a liver transplant recipient, 2018, so glad i found this video, gives me more insight into what happened that day. I had acute liver failure my liver died in 12 hours. I was listed right away with a meld score on 48, was put into a medically induced coma on sept 3, 2018 had my transplant sept 8th 2018 everything happened so fast i woke up and didn’t know what happened i just woke up with a new liver, talk about scary.
😮. I’m so glad you’re here. My situation took years (A massive GI bleed, liver cancer twice and then the transplant). The GI bleed was frightening. I came much closer to expiring then than the transplant. I’m so glad you made it ❤
Dr Feinstein, thank you for the tour. I underwent a liver transplant in March 2017, following an Alpha One diagnosis in 2012. My anesthesia team was awesome and I am forever grateful for how they talked me through the setup all the while reassuring me they had my back. While I don't remember their names, I do remember the face of the one as he placed the oxygen mask on me. My next memory was 3 days later. I am fully recovered now but I have required some subsequent incisional hernia repair surgeries and your videos have help me understand and appreciate your specialty. Thank you and all the best to you as you continue your career path.
I had my hernia surgery years before. So I got to know Dr Hertl before my transplant. When I found out that he was the lead, I got so relaxed about the whole thing. I’m approaching 11 years post op. He went to work at Rush Hospital and is back in Boston but at Tufts not Mass General Hospital.
Watching these videos presented by Dr Feinstein has given me an extremely heightened appreciation for Anesthesiologist. Its very rare to meet and greet an anesthesiologist let alone get to know them in the manner we would our surgeons. The last time I had surgery 10 years ago was for a 5.5 hr cochlear implant. Anesthesiologist are frick’n busy busy just prior to being taken in, so if you meet the anesthesiologist for 3 minutes, you’re lucky. I knew then that its pretty much a thankless profession. You never see them afterwards. In fact you never get to meet the surgical teams too. So on that day as the wheeled me into the OR, completely bombed out of my mind (good stuff) barely able to speak coherently, I fought to speak clearly and loud enough “in advance thank you everyone for your help today “. The last thing I remember was a few “you’re welcome(s)”. So when you first meet you anesthesiologist, thank them, its the last chance you’ll get. 👍
Thanks! Based on the stats RU-vid shows me, there are way more people who use subtitles than I would have imagined. RU-vid also makes it super easy to caption the videos because it can auto generate subtitles and is usually pretty accurate, so I just need to make a few tweaks and that’s it.
This was really cool 😎. I don’t remember my anesthesiologist for my liver transplant. I remember the room was large, in the Jackson building in Massachusetts General Hospital. The nurse was fun. We had a hard time getting my special earring out. I heard that things went smoothly during and after surgery. I remember my surgeons. Post op, for a couple of days, I got psychosis. I thought that I was dead and in hell being mistreated. Those meds were hard on my brain. I know that I was being taken care of by so many. I was off the pain medications by the time I made it to the transplant unit. I so appreciate everyone. ❤️❤️❤️❤️❤️❤️
I'm an IONM student and HOPE he sees this. Seriously my class was supposed to get to see our first live case back in July, but the patient got cold feet. I took my first "practice" CNIM exam today and A LOT of Max's information helped me. Eventually I will get into a place for my clinicals. Its nice to get a real run down of the OR and NOT be the one on the table. Love ya Max!
I'm waiting on a double lung and liver transplant. Very cool and informative to see what this room looks! Going in not knowing what all the machines are for can be overwhelming.
Please please please make more of these types of videos I love learning about the equipment in hospitals and especially operating rooms There’s so much weird and complex machinery and stuff it can seem overwhelming So these breakdowns are so awesome Everything from big transplant surgeries down to the most simple general surgery rooms are interesting to me and I love to learn about all the machinery and equipment in them it’s also really helpful since I’m building some different operating rooms in Lego including general surgery emergency surgery nero surgery and more So these types of videos are super super helpful in finding out what equipment and such needs to be in the different rooms
@@MaxFeinsteinMD of course mate Happy to help I am a huge anesthesia nerd/medical history nerd myself so I’m digging your content a lot Looking forward to that video that you got coming up sounds like it’s gonna be really useful to me
@@MaxFeinsteinMD just a quick question: why do you use those sort of volumetric pumps instead of 50ml syringe pumps (e.g. BD Alaris Guardrails) to administer vasopressors? Is the accuracy comparable? And if you place a CVC, is there a specific reason you don't use the different lumen for vasoactive medication instead of putting it all on the same line? Kind regards, Charles, BSN at an ICU in Belgium (Europe)
There are a LOT more medical staff involved in liver transplants than just the surgeons and anaesthetists. Think of the scrub nurse for instance, standing there for the length of the procedure. Keeping track of all the sutures used, the swabs and instruments etc. If something gets left in the patient it can be fatal. Also don’t forget all the backstage people. Those who maintain the filtered ventilation system, those who ensure that blood and blood products are available, Those who maintain the O.R. medical gas supply. The lab technicians who do all the tests the patient needs perioperatively. The team who procure the new liver. Etc. etc. etc. They are also smart and hardworking and vital to the liver transplant team.
Those machines are great. They used one on me during trauma surgery ( broken rib got my splenic artery...ouch!). I'd like to put in a thank you for all blood donors too. While I didn't need any outside blood, I'm grateful to the six people who donated a pint had there not been a machine.
Dr Max Feinstein, what a great video. I appreciate your dedication to educating people. I'll be having surgery again in November and these videos always help put my mind at ease!
I’ve watched this video a few times but this is my first since my transplant a week ago. Literally about this time a week ago I had just been stapled back up and was heading towards ICU for the standard ICU stay. The last things I remember before going under where the anesthesiologist saying I was getting a free shave with my transplant (I had a decent beard and that 1 dollar razor they gave me in my room prior to surgery both literally and figuratively wasn’t going to cut it), being slid onto the table by like 10 people as I’m kind of a bigger guy, getting strapped in and getting some oxygen. Last thing they said was the classic “Alright give us some deep breaths” and I drift off. My first memory post transplant is waking up in the ICU, not fully aware of where I was but basically knew, and I could see my wife and hear her voice. I don’t remember what she said but I could hear her and I knew it was her. Thank you for sharing this information. It helped calm me nerves before the transplant! You do excellent work!
What a gas, getting this info in this manner through the lens of technology. Anyone not in the profession would be awed by all this marvel yet clueless about what and how it's all used. Good stuff as usual.
As a physical therapist, who loves all things ICU and other complexities in a hospital setting, it was a real privilege to witness how the medical team works together in a complex operation. I myself got to witness a CABG x3.
Very intresting Dr.Feinstein! Keep it up, I'm sure thousands of people are very grateful for you and your sensitive work with these potentialy dealdy drugs. Your a very talented person! If i ever have a life saving surgery I would feel at ease with you in the operating room. Much love from Texas!
This was really interesting! I had a triple organ transplant, including liver, and the anesthesiologist had me out before I got to the OR so I didn’t see any of it!
Knowledge seems such a small word to use when, one becomes aware of how far we have come in healthcare provisions, that transform & Extends lives. In the1800's it was a Bottle of alcohol, a surgeon, & an amputation. Now Look! To those who truly Study & Love this work, Thank You is also a heartfelt, yet small word.🌷
I donated part of my liver to a friend and I only had about 45 seconds of consciousness in the OR before they put me under. I just remember how much stuff was in there and tried to take it all in, but this really helped me understand how deeply complicated things are even though the transplant team tried to keep it simple enough not to freak me out before surgery. Very cool!
@@asdasdasdqwe123 when i donated my liver, they made sure that i wasn’t being given any money for my donation. my guess is in different countries this becomes a problem - they don’t want people selling off their organs for whatever reason, so they have to legally limit it to family. here we can donate to friends or even be anonymous. american privilege is a factor
@@asdasdasdqwe123 it seems that they don’t want people for feel pressure to donate their organs for money in other countries. in the us they make sure you are not receiving money for your organ donation. limiting it to family would be one way to prevent this
I have biliary atresia (a liver disease in which I was born with a bad bile duct) and I underwent a Kasai surgery when I was 2 months old. I’m 19 almost 20 now and I am doing great, but it’s still possible I may have to get a liver transplant at some point in my life. Really interesting to see the equipment they use for the procedure. Hopefully none of it will ever have to be used on me fingers crossed 🤞
I miss doing my Liver Transplants at Houston Methodist Hospital In Houston. The fluid warmer and Bair hugger was not mentioned as it is two of the most important devices to have as patient's Temps are highly monitored. Great video. WOULD LOVE TO COME JOIN 😍
I play pipe organ. Then I worked for a a CDL. I thought that was complicated. Then I looked at a pilot's license later and perhaps will skip that. Then I see this. Keeping humans ALIVE is the most complicated thing ever and always will be! Those that take up the call and do this. WOW. Much respect.
This was so cool to see!! I am getting a liver transplant soon and am really glad I get to know more about the behind the scenes of it! - ps love the channel!!:)))
Love your videos! My interest in anesthesia is growing. How do you defibrillate when a patient is in active surgery? Where do you place the defib pads?
Great question! We try to anticipate when defibrillation may be necessary, so in those cases we place pads on the chest and back before a patient goes to sleep. Then if we need to defibrillate during surgery, we make sure nobody's touching the patient and then go ahead. If pads aren't already placed, we quickly try to get them on, but as you can imagine that's more difficult when the patient is already draped for surgery.
ABSOLUTELY AMAZING 👍🏻👍🏻. EVEN MORE IMPRESSIVE ARE PHYSICIANS LIKE MAX FEINSTEIN WHO WENT TO MEDICAL SCHOOL TO LEARN HOW TO OPERATE ALL THIS WHILE HAVING THE PATIENT IN A CONTROLLED INDUCED COMA ( if you will ) AND BRINGS THE PATIENT BACK FROM THAT STATE OF COMA TO AWAKE AND CONSCIOUSNESS, AMAZING !!
I'm an IONM student and HOPE he sees this. Seriously my class was supposed to get to see our first live case back in July, but the patient got cold feet. I took my first "practice" CNIM exam today and A LOT of Max's information helped me. In the mean time if your craving spine stuff. Dr. Scott Blumenthal our the Texas Back Institute has a GREAT Cervical ADR, Jack E Zigler Anterior Lumbar Fusion. I usually watch these for fun, but mostly pre op research.
isn’t there usually an “airlock” room in between the hallway and the surgical suite so the doctors can scrub in and to equalize the pressure since the or is kept at above ambient pressure?
Hi Max, love the channel! I didn’t see a video on anesthesia for trauma surgery and would be very interested in learning more! Also, I saw it discussed briefly when you were interviewing the Chief of Neuro Anesthesia, but would love to hear your thoughts on TIVA vs. Inhaled Anesthesia. And finally (sorry) would love to see a video on MAC Sedation vs. General Anesthesia for minor procedures (I realize it depends on the procedure and a host of other factors, however, I’m assuming the Anesthesiologist would make the final call if they believed it was in the best interest of the patient to convert to full GA even if MAC Sedation was planned for and even started…I think it would be an interesting topic for you to discuss anyway). Thanks!
Hello dear dr.Feinstein my brother has seizures post stroke. He is relatively well controlled with the drugs he takes but i wanted to know if he needed surgery can he undergo general Anesthisia safely?
Hello, I cannot give medical advice to people who are not my patients. Your brother will need to speak with his doctor. I can say that in general, patients with a history of seizures can safely be taken care of when receiving general anesthesia.
Hey! Maybe a little bit dumb question but how many sockets does this OR have and where is the coagulation machine? Because from shadowing surgeons in my home country at one of the best hospitals here in every OR where I’ve to they have special stand(bench) with maaany sockets, laparoscopic equipment and coagulation tools as well. This sockets are also being used by anaesthetists as well (its like 20 of them) and also there are multiple monitors. This construction can be easily moved and put aside, it can be adjusted for every hight and seems incredibly comfortable to use. How do you survive without this in your ORs? 😮
Between nurses, techs, doctors, and cleaning staff I’d say up to 20 people will have played some kind of important role in the direct or indirect care of the patient in a liver transplant surgery. Maybe 5-8 people in the OR at a given time during surgery.
This is a good idea for a video but I just don’t really know much about becoming a CRNA. Maybe at some point I could do a collaboration with a CRNA, we’ll see.
Your awesome..love your videos..3 yrs ago I was given succs ..anectine..it sent me into arrest..so ..im having surgery next week. I'm nervous. Bad..what is the next go to med for its place..thank u sir
Hi Randy, thanks for the nice feedback! Best thing you can do is talk with your anesthesiologist and let them know what medication you received and what reaction you had. They'll be able to pick out an appropriate medication to safely be able to take care of you. Best wishes for your surgery!
Liver biopsies are significantly less invasive than liver transplants. Those biopsies are often done by interventional radiologists with minimal amounts of anesthesia.
Just curious what the med with the brown cap in the upper left is- it looks like Omnipaque 300- I have never seen another medication in the same vial size with a brown cap before.
Wow. Always like your vid's .. but you totally glossed over the APC which is just as important in keeping the patient hemodynamically stable. Also I could not see your INR machine or setup for cutdown.
The surgeons use APCs and do cut downs, so I’ll leave coverage of that info to someone else! We use thromboelastography not INR for liver transplants, and that equipment isn’t located in the OR so I didn’t cover it.
Hiii sir I'm Basavaraj...from India banglore..I'm ct scan technician... I have 3 years experience in ct and x-ray also ..in liver transplant hospital banglore...is there any vecancy for me sir
Why do liver transplant patients need to be kept under general anesthesia for 2 hours before surgery begins? To my knowledge this isn't required in other surgeries.
Prior to surgery, patients only need to be kept under anesthesia for as long as it takes to insert the necessary lines which should take significantly less than 2 hours.
