I'm a practicing anesthesiologist whose wife is also a physician. I'm sure I can drag up a boatload of references if you're genuinely curious, but the short version is that almost anything can be adjusted for if you do it every day. If you're on warfarin for anticoagulation, eating vitamin K-rich foods will affect that. So it's not that eating spinach is forbidden; it's that you have to eat the same amount every day or very, very little ever.
I mean, we do give drugs that have primarily renal excretion to people with nonfuctioning kidneys. After we consult a pharmacist, of course.
And I have no control over my patients' behaviors, because I don't meet them until the day of surgery. I already have to take them as they are. I might delay or cancel a case if someone isn't optimized, but sometimes "really bad" is as good as they will ever be.
No, it's okay. Coming from two people with your backgrounds, okay. What I really don't like is that sometimes people make assertions here and they really are not in a position to do so, and it looked like this was the case here until you clarified. Upvoted both.
The part where I acknowledged that some people are horrifically ill?
The American Society of Anesthesiologists has a Physical Status that is part of every pre-op examination we do.
ASA 1: a normal healthy patient. (You almost never see these.)
ASA 2: A patient with mild systemic disease.
ASA 3: A patient with severe systemic disease. Subtext of the definition of this class notes that it causes some impairment of function. This is our most common class.
ASA 4: A patient with severe systemic disease that is a constant threat to life.
ASA 5: A moribund patient who is not expected to survive without the operation.
ASA 6: A declared brain-dead patient whose organs are being removed for donor purposes.
There's a bit of personal style in there - my 4 might be someone else's 3 - but it's a shorthand way of saying "they're very sick". A 5 is someone who is actively trying to die.
I mean, we do give drugs that have primarily renal excretion to people with nonfuctioning kidneys. After we consult a pharmacist, of course.
And I have no control over my patients' behaviors, because I don't meet them until the day of surgery. I already have to take them as they are. I might delay or cancel a case if someone isn't optimized, but sometimes "really bad" is as good as they will ever be.