What I wish I Could Tell my Patients: Confessions of a Vegan Nurse Anesthetist
For those who don't know, I am a passionate vegan (hence the site) and a nurse anesthetist.
We are the people that greet you before surgery, perform a pre-op assessment, wheel you back to the operating room, get you off to sleep, place a breathing tube, manage your anesthetic during surgery, wake you back up, write post-operative orders, and take you to recovery. Our scope of practice also includes placing epidurals, spinals, regional anesthetics, and central lines. Some of us work with anesthesiologists in a variety of ratios, and some of us practice independently; this is primarily determined by the state and facility in which we practice.
Basically, my entire job revolves around working very closely with people during one of the most terrifying, vulnerable, and stressful times of their lives.
Surgery is scary. Anesthesia is scary. And I would be lying if I didn't admit that there have been experiences in the operating room that I wish I could forget.
Do surgeons yell? Yes. Do they throw temper tantrums (and sharp things) at people? Sometimes.
But what I wish I could tell people about the stress of the operating room really has nothing to do with the occasional angry surgeon or unexpected difficult airway.
Surgery is extreme (but you're asleep for that part)
I fully understand the value of the modern world we live in, and that surgery is a necessary and life-saving miracle that we are fortunate to have as an option (especially in such a developed, Westernized country). What gets downplayed is the vast array of measures taken by anesthesia providers and surgeons to ensure that your body tolerates it. Think about it: organs get removed; chests get cut open so that coronary vessels can be cut, rearranged, and sewn in place; parts of the intracranial vault are exposed; video cameras go into deep dark places through your mouth and up your b*tt...the list goes on.
But as the patient, most of the time you simply go to sleep and wake back up. It seems like a matter of minutes, and the experience is made as comfortable for you as humanly possible: that's why anesthesia exists.
Our culture doesn't like to admit it, but we want everything to be quick and easy without having to bother ourselves with the gory details. I think if more patients had to watch and manage the things that could go wrong during surgery, they might do a little more to prevent themselves from getting to that point (if possible). Which brings me to another topic...
It's ok to take responsibility for your own health
Look, you aren't a doctor and neither am I, but you and I both know that there are certain health conditions that come about as a result of personal choice.
People often tell me that I must have so much will power to keep eating a whole-foods plant-based diet, but the truth is that I get more than enough motivation to keep eating this way just from the work I do.
I'm exposed to people who've chosen to smoke for their entire lives, and still balk at having a wedge resection due to lung cancer because it means they can't smoke while they're in the hospital. I've taken care of more Type 2 diabetic toe and foot amputations than I care to think about. Patients have hypertension, high cholesterol, and kidney problems simply because they think pills are enough to keep these problems at bay. Then, they come see me in pre-op the day that their dialysis catheter is to be placed.
And if that means I need lots of "will power" to eat delicious wholesome foods in order to prevent that in my own life, so be it.
I get scared when I see a high BMI
This is one that might stir up a lot of controversy, but everyone in anesthesia knows my pain.
A high BMI doesn't necessarily mean you have reached an unhealthy weight. Depending on your circumstances, your muscle and build may lend you to a BMI that is classified as "overweight" without actually experiencing the effects of a high percentage of body fat. But when you're 4'2'', weigh over 350 lbs, (aka a BMI of 98.4) and the surgeon wants me to give you sedation without a secure airway (just a quick colonoscopy, for instance), I get worried.
Why? Because quite frankly, the risk for complications increases significantly for morbidly obese people getting general anesthesia.
You're more likely to have OSA (obstructive sleep apnea), diabetes, hypertension, high cholesterol, kidney issues, and post-operative pulmonary complications if you're overweight.
I'm not saying anyone needs to lose weight simply because they don't feel perfect by the standards of society; I'm not saying anybody needs to stop loving how they look, even if they're large; and I'm definitely not pointing any fingers. Studies have shown that sugar, dairy products, and processed carbohydrates are highly addictive, lending to the large population of overweight and obese people we see in many developed countries today.
But we have to stop pretending that there aren't any consequences for being overweight. You may not have consequences in your daily life, but by the time you get to my world-- there could be significant risks.
Love yourself and choose health today
This is the whole point of this post. I wish people would get back to loving themselves. Your body is a temple. Your health is a gift.
As a person in anesthesia, I can say that most of the time I take care of people who at one point had a choice for health, and they let it slip away for other priorities.
The body is resilient, mysterious, and amazing in so many ways. You can improve your health in so many ways just through positive thoughts, exercise, and eating colorful foods that come from the ground.
Why not give it a shot?