First Posting: An Anesthesiologist's Day on Call
I want to thank Dr. Tyson and Mrs. Abrams for inviting me to participate in this project. I hope to share some aspects of my work with you and answer your questions about anesthesia and medicine. I'm looking forward to a good year working with you. ajb
I am an anesthesiologist working at Emory University Hospital. An anesthesiologist is a physician who has received specialized training to care for patients having surgery or painful diagnostic or treatment procedures. Anesthesiologists use medications and other techniques to make patients comfortable during surgery, unaware of what is going on, and insensible to pain. Anesthesia is temporary so that at the end of the procedure, the patient recovers back to their preoperative state.
(Physicians have their own vocabulary of words to allow them to precisely communicate with each other. I will sometimes use these scientific terms in my postings and will try to explain them as I go along. If there are terms that you don't understand, let me know.)
I was on call over the weekend and took care of seven patients. Two of them received renal (kidney) transplants. Patients whose kidneys have stopped working (renal failure) can live for many years but they must undergo dialysis three times a week. This involves having their blood flow through a machine that filters out the impurities. Dialysis takes about 4 hours and often causes the patient to feel bad the rest of the day. By getting a transplanted kidney, the patient no longer would require dialysis and can pursue a more normal life.
The first successful kidney transplant was performed in Boston in 1954. A kidney was transplanted from one identical twin to the other. The body normally would reject tissue or an organ, in this case the kidney, from another individual. This immune process keeps bacteria and other foreign tissue (sometimes cancer) from taking over the body, but since the genetics of the identical twins was the same, the recipient twin did not reject the new kidney from the brother.
Now we know more about the genetics of transplantation and can better match organs with recipient patients. Now there are also drugs to suppress the immune system (turn it off) to allow the transplanted organs to survive. (What might be the bad side effects of the drugs that stop the body's immune system from functioning?)
One of the kidneys that was transplanted over the weekend was flown in all the way from Florida because it was a perfect match to the patient in Atlanta. Kidneys and other organs for transplant are very limited in number so there has been a system devised to allocate (decide who will get it) organs as they become available. (What do you think would be the factors involved in deciding who gets an organ for transplant? How could you make it fair for all patients waiting?) An organ can only survive for a few hours outside of the body, even with preservation techniques, so this limits the distance that the organs can be transported.
Both kidney transplant patients were doing well after surgery. They will remain in the hospital for about a week, but they will have to continue taking medication forever to prevent their body from rejecting the transplanted kidney. If all goes well, they will not need dialysis again and their lives can become more normal.
Till next time.
Dr. Berry
