Choose Your Own Anesthetic

The trend in the Bay Area is to allow patrons to customize everything. We have make-your-own burgers, sundaes, pizzas, salads, even lattes. And what could be more empowering than being able to put locally foraged hipster quinoa into that green smoothie? One of my patients last week was an engineer entrepreneur who expects everything to be customizable in the near future. Already, you can build your own computer, choose the features of your Tesla, and build a trampoline room in your multimillion dollar home. We had a long conversation and concluded that this will soon move into medicine. Especially in the Bay Area with highly educated Type A personalities, patients want to take control of their health. Empowering patients is an important role for physicians, and we envision a role where doctors are patient advocates and patient consultants, guiding them through choosing their own treatments.

Here's a rough draft of the anesthetic protocol for a straightforward general anesthetic.

1. Pre-anesthesia consultation. Choose one:
[  ] Phone call the night before from my anesthesiologist.
[  ] Pre-operative clinic visit one week before surgery (extra charge may apply)
[  ] None

2. Day of Surgery: pre-operative orders.
[  ] Nothing to eat or drink after midnight. If an earlier surgical slot opens, we may be able to accommodate you.
[  ] Allowed to drink black coffee, clear tea, or fruit juices up until 2 hours before surgery. You cannot have your surgery earlier than your scheduled time.
[  ] Offered black coffee, clear tea, or fruit juices on check-in. ($5 donation suggested.)
[  ] Regular parking     [  ] Valet parking
[  ] Cloth gown: Mark size here: _____
[  ] Paper gown that allows attachment of heating system.
[  ] IV placement by RN
[  ] IV placement by nursing student. You will receive a thank-you note in the mail.
[  ] IV placement by anesthesiologist with lidocaine 1% (extra charge may apply)
[  ] IV perfered location: ____
[  ] iPad while waiting for your surgery.
[  ] Cable channels while waiting for your surgery.
[  ] Video game system while waiting for your surgery.
[  ] Wifi (24 hour access)
[  ] Operating room heated up before you are brought in.
[  ] Extra pillows
[  ] Extra blankets
[  ] Tempurpedic mattress
[  ] Compostable oxygen mask or nasal cannula requested

3. Anesthetic Choices
[  ] Anxiety treated with midazolam before you enter the operating room.
[  ] Volunteer to hold your hand as you are falling asleep
[  ] Oxygen mask can be scented: [  ] Bubble gum  [  ] Cherry  [  ] Watermelon  [  ] Mint
[  ] Awake intubation with a recorded video of your vocal cords (extra charge may apply)
[  ] Asleep intubation with a recorded video of your vocal cords (extra charge may apply)
[  ] Induction of anesthesia with ketamine to experience dissociative state (may have nightmares)
[  ] Smaller endotracheal tube (may decrease sore throat)
[  ] Lidocaine sprayed into trachea prior to intubation (may decrease sore throat)
[  ] Minimize opiates
[  ] Extra opiates please
[  ] Non-steroidal anti-inflammatory mediations (ie. ketorolac) (extra charge may apply).
[  ] Please use nitrous oxide
All our patients get complementary ondansetron to prevent nausea. Please check if you would in addition like [  ] metoclopramide  [  ] scopolamine
Please list music requests for the operating room (genre, songs, or artists): _______

4. Recovery Room
[  ] Window slot requested
[  ] Aisle slot requested
[  ] Soothing music played
Please give me [  ] ice chips, [  ] water, [  ] apple juice, [  ] cranberry juice, [  ] organic Blue Bottle coffee (extra charge may apply).
[  ] 35 minute massage (extra charge may apply)
All our patients get complementary sequential compression devices. Please check if you would also like a [  ] 15 minute foot rub (extra charge may apply)
All our patients get a complementary photograph. Please check if you would like [  ] High resolution emailed picture, [  ] Framed photo, [  ] Framed photo signed by your anesthesiologist.

Happy April 1!
Craig