Vitals & Voices
Welcome to Vitals and Voices, brought to you by Lexington Regional Health Center — your community, your health, your care. This is your trusted source for health-related content that matters to you.
Each episode, we bring you real conversations with the voices behind the care — from medical experts and wellness champions to community leaders and patients — sharing insights, stories, and tips to help you live your healthiest life.
Whether you're tuning in from Lexington or beyond, we're here to inform, inspire, and connect. Because at LRHC, your health is our priority — and your voice matters.
Vitals & Voices
“Do I Really Have to Do All This Before Surgery?”
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In this episode of Vitals & Voices, we sit down with Ben Huls, Certified Registered Nurse Anesthetist (CRNA) at Lexington Regional Health Center, to answer a question many patients ask before surgery: “Why do I have to do so much before my procedure?” Ben breaks down the purpose behind fasting, medication adjustments, lab work, and other pre‑surgery instructions and why each step plays a critical role in keeping patients safe before, during, and after anesthesia.
From explaining the commonly referenced “8‑6‑4‑2” fasting rule to addressing questions about chewing gum, smoking, and newer diabetes or weight‑loss medications, this conversation offers clear, practical insight into how anesthesia teams prepare for surgery. Whether you’re facing an upcoming procedure or supporting a loved one through surgery, this episode helps remove confusion and empowers you to feel confident going into surgery day.
What You’ll Learn in This Episode:
- Why pre‑surgery instructions are essential for anesthesia safety
- What the 8‑6‑4‑2 fasting rule really means
- How eating, drinking, gum, tobacco, and smoking affect anesthesia
- Why certain medications may need to be adjusted or paused
- The importance of lab work and pre‑surgery physicals
- How following instructions can prevent delays or cancellations
Why This Episode Matters:
Surgery isn’t just about the procedure—it’s about anesthesia, breathing, circulation, and recovery. Many surgical complications are preventable, and careful pre‑operative preparation helps reduce risks, improve outcomes, and ensure surgeries happen safely and on time.
If you’ve ever felt overwhelmed by pre‑surgery instructions or wondered why they matter so much, this episode offers reassurance, clarity, and a deeper understanding of how your care team is working behind the scenes to support your health—every step of the way.
Vitals & Voices is a podcast powered by Lexington Regional Health Center, offering meaningful health conversations that matter to you. Each episode features authentic stories and expert insights from the people behind the care — including healthcare professionals, wellness advocates, community leaders, and patients — all aimed at helping you live your healthiest, most informed life.
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Welcome to Vitals and Voices, brought to you by Lexington Regional Health Center. Your community, your health, your care. This is your trusted source for health-related content that matters to you. Each episode, we will bring you real conversations with the voices behind the care, from medical experts and wellness champions to community leaders and patients, sharing insights, stories, and tips to help you live your healthiest life. Whether you're tuning in from Lexington or beyond, we're here to inform, inspire, and connect. Because at LRHC, your health is our priority and your voice matters. Hello, everyone, and welcome to today's episode of Vitals and Voices. Well, if you've ever had surgery, you probably remember being told to fast, stop taking certain medications, get your lab work done, maybe even quit smoking. And you might have thought, does all of this really matter? Why am I doing this? So today we are joined by Ben Holes. He is one of our CRNAs here at Lexington Regional. And he's going to walk us through those pre-surgery steps that are so, so important and will help you set up success for the safest possible surgery experience, no matter where you're having surgery, if it's Lexington or beyond. So Ben, thanks for being here.
SPEAKER_02No problem. Thank you for having me.
SPEAKER_00What is a CRNA? Our listeners need to know.
SPEAKER_02CRNA, uh, I'm a certified registered nurse anesthetist. So um after graduation from college, um, I actually got a nursing degree. So I have a couple of bachelor's degrees and uh went into a master's program. They're now PhD programs uh to get my anesthesia training. So that's basically how I became a CRNA. There was some intensive care experience uh after nursing school, before going into anesthesia school, um, which we have to go through. So that was done as well. But that's what a CRNA is. I do anesthesia.
SPEAKER_00Okay. So, Ben, kind of just to set the stage here, why are there so many steps before somebody goes under surgery? I know we we hear that, oh, do I really have to do this? But walk us through why are these steps important?
SPEAKER_02It's safety. Um, so there's studies that have gone out a long time ago about safety for anesthesia, safety for surgery preparation, and they liken them to actually flying an airplane. Um, and so studies are similar. These are the checkpoints that we have to have to go through uh a procedure, having anesthesia, having surgery. So there is a checklist that we go through um to make sure that we set up the patient for the safest experience possible so that we have great outcomes for our patients because everybody's truly important. Your lives matter, your health matters, uh, your experience matters. So um there's lots of things that go into it. But from the patient standpoint, we have some questions coming up that will kind of illustrate how we'll hit on a few of those things. But it's very important to have uh the most safest uh possible outcome for everyone involved.
SPEAKER_00So I know one of the biggest ones, you cannot eat or drink for X amount of time before.
SPEAKER_02Yes, yes. Um, so that is one of the biggest ones uh from a patient perspective of you know, preparing for surgery is is especially on something where it's an elective procedure where we can plan this procedure, put you on a schedule. Um to set the patient up for success, the the fasting guidelines are there for us to prevent aspiration, uh aspiration pneumonitis. Um so there's you know a number of different rules uh and and hours to go through and and wait um to make sure it's uh safe that your your your stomach is emptied prior to going to anesthesia.
SPEAKER_00And so if somebody doesn't listen to that, I mean what does that look like or what does aspirating mean?
SPEAKER_02Or so we have you know aspiration means gastric contents. When you go under anesthesia, you lose your protective reflexes, um uh i.e. coughing, if you will. So if you lose your protective reflexes under anesthesia, and if gastric contents uh while in the lying position, uh while you're lying down under supine position, uh can passively uh retrograde, uh have a retrograde uh path uh back into your oral cavity or your pharynx, get down into your lungs. Um, and then we have something known as Mendelssohn syndrome, actually. Um so Mendelssohn syndrome is basically a gastric acid uh with a pH of less than 2.5 or very acidic, um, and certain amount of contents over 25 cc's can cause some some pretty severe sequilae. Um so we want to make sure that a patient um is safe for going uh under anesthesia, whether that's sedation anesthesia or general anesthesia or even regional anesthesia. Okay. Because things can happen where we might have to convert over to a general anesthetic or take away uh the patient's consciousness even during uh sedation anesthesia or or or regional anesthetic.
SPEAKER_00So I know one of them, or at least in my experience, it was okay, you know, after you go to bed, you can't have you know liquids or food. But are there some things like that even closer, like morning of, like within two hours you can't do certain things?
SPEAKER_02Sure. Uh people might hear of uh the eight, six, four, two rule. So if you want to think about it, we can think about it at two hours first. So I'll work kind of in that way. But um, two hours is basically we consider that you know clear liquids. Um a clear liquid would be, you know, obviously water. Um we do some sports drinks that would be considered clear liquid. Um, they move through um the stomach in and in a fairly quick way. So, you know, if I was telling someone, you know, a per a person might call have a phone call about hey, what they can have, what they can't have, that's a very important phone call. But we anesthesia providers might be very specific so that there's no mistakes made by the patient and have any um, you know, degree of ambiguity of what can I have? What is this? What is it not? Yeah. So water, black coffee, or a sports drink is something that I would tell patients that they can have black coffee being specific, no milk.
SPEAKER_00No creamer.
SPEAKER_02No creamer, no dairy products. So black coffee, water, sports drink. If you can have one of those things two hours prior to your arrival time, um it might be further out than two hours from surgery, but from arrival time that gives you an even safer window. So that's what I'll tell patients most of the time is for clear liquids. Um and you have a four-hour rule, which is basically breast milk. So children who are breastfeeding, um, they can have breast milk up to four hours. So, I mean, you know, if you're still breastfeeding and your child is having a procedure that you're scheduling, breastfeeding up to four hours is fine. Um, six hours would be for like formula. Okay. Uh, and we call light meals. So it's one thing I I have a problem with is we have light meals or formula at six hours and then you know, full meals at or heavier meal at eight hours. Well, that heavier meal is going to be you know something very fatty. So fat uh fatty foods, um, you know, steaks, um, even chicken, even though it doesn't have much fat. But I would consider those things meats uh would be like out at eight hours. So whatever you have a meaty meal with, but a light meal would be something light, toast, maybe some eggs, things like that. Uh-huh. Maybe some soup, um, some cereal. So, you know, carbohydrates just kind of kind of move through our system just a little quicker. Okay. Um, so proteins and fats uh go through a little slower.
unknownOkay.
SPEAKER_02This makes us feel full. Um, that feeling that everybody doesn't, hey, I get fuller after a failure or a high protein meal. So um you know, and again, when you make your when you make your pre-up phone calls and you're getting that pre-up phone call from that person, they'll have those things set out for you. But I usually say from the time of arrival rather than time of surgery, and that makes that window even safer so that we can prevent Mendelssohn syndrome, which is basically aspiration of gastric content.
SPEAKER_00So that that is important. And like you said, that person scheduling it will walk you through what that looks like for you.
SPEAKER_02And facilities can be different too about how their anesthesia team and their surgeons uh feel about these guidelines and how which they are strict guidelines, but they might differ from from from place to place a little bit. They're universal guidelines, but how they're applied differ from facility to facility.
SPEAKER_00Aaron Powell Now tell me about chewing gum, hard candy, smoking tobacco, do those fit into that rule?
SPEAKER_02Aaron Powell So absolutely chewing gum and hard candies, you're still you know, two hours for chewing gum and a hard candy because you're still producing basically um enzymes that would stimulate your stomach to produce gastric acid. So even though you don't have a lot of uh food in your tummy at the time, if you're just sucking on a hard candy or chewing gum, you're still your body's still receiving a signal to produce an enzyme which would release gastric acid into your tummy and increase your chance of having aspiration. So hard candies and stuff like that. We get into smoking and chewing tobacco. Well, nicotine does something different.
SPEAKER_03Okay.
SPEAKER_02Um, chewing and swallowing would be the same thing. So if you're chewing tobacco and swallowing that, um, it's considered that's already not great for your stomach.
SPEAKER_00No, it's not anyway.
SPEAKER_02So you're gonna be producing that gastric acid as you're doing that. Um smoking and chewing have nicotine. Um, and when you have this nicotine in your bloodstream, smoking and chewing tobacco can do things like decrease wound healing. So your wound healing isn't as good. Um, you're not getting as much oxygen to the tissues because, especially with smoking, you get that carbon monoxide effect from having smoked, which deplaces oxygen. So your oxygen status is a little bit low. So, from a surgical standpoint, there's going to be you know wound healing. You want that wound to heal. Um from an anesthesia standpoint, what it does to your lungs, even the day of surgery, um, you can have greater oxygen um transported through the bloodstream to help with your healing, to help with your breathing. Um, so stopping those things is very important, especially if you can do it a week or two out, even better. You know, you'll you'll heal much quicker without without that being there for you. So um, without the nicotine being there for you, you'll heal, you'll heal better. And then from an anesthesia perspective, we want you to have the greatest chance of getting oxygen um while you're asleep to your blood cells while you're asleep. So um it's very important that we oxy, especially if you have coronary artery disease, you know, oxygen transport. Your heart is stressed during an anesthetic, your lungs are stressed during an anesthetic. So getting all that oxygen that you can and and have that capacity to carry that oxygen is very important for healing and for uh anesthesia as well.
SPEAKER_00So that's good to know. Um, medication instructions. I know sometimes those can be a little bit confusing, but are there certain medications? I know we're speaking about a lot of different surgery types, but generally speaking, that patients might have to stop before surgery.
SPEAKER_02Um, from a surgery standpoint and for some anesthetics, if you're on if a patient's on blood thinners, um aspirin or even something more like Plavics, um, cuminin, when we're on these medications, uh there's going to be instructions that we look at a risk and a benefit for staying on that medication for that individual or not, and the procedure itself. So you want to make sure that, you know, we want you to heal. We don't want we want there to be little blood loss during surgery. So we'll look at things like that. If you're having an anesthetic, an epidural, a spinal anesthetic for a total joint, we definitely want to make sure that um we don't want to have extra bleeding um and hematomas form from one, the surgery or two, the anesthetic. So blood thinners are very important. Um, and there'll be guidelines for those when you make that pre-op phone call. Um blood pressure medications are a big one. A lot of people want blood better, blood pressure medications. You know, studies have shown that taking a beta blocker medication and staying on that blood that blood pressure medication can reduce uh heart attacks during the perioperative process. Like I said before, your heart and your lungs are taxed during an anesthetic. So I want to make sure that we keep your blood pressure in a normal spot. Um, there's some blood blood pressure medications we recommend that the patient not take because we're doing a regional anesthetic or something like that, and the patient's blood pressures can drop during an anesthetic, they naturally will. Um so we want to make sure we set that patient up for success, uh, depending on what the anesthesia plan is. So oftentimes, you know, a pre-op scheduler will come to us and say, hey, what medications would you like this patient to stay off of? Are you planning a regional anesthetic? Something like that. So beyond the surgery and what the surgeon has for their expectations from an anesthetic guideline, you know, our patients' uh pre-op schedulers will be in contact with the anesthesia and say, Hey, this is important. What do you think? So we'll have those conversations before you even get that phone call about uh, especially like heart, heart medications or blood pressure medications. A big one out there today that kind of goes back with fasting is the uh GLP ones. So the Ozempics, the Wagovies, uh, those those medications um are fairly new to anesthesia. Um, and it's not to anesthesia, but how how we interpret how it affects your fasting. Sure. Um, because they become widely popular. They've been around to help with type two diabetics. Now that it's coming and entering in the weight loss field, we're seeing more and more of it. Well, they delay gastric emptying.
SPEAKER_03Okay.
SPEAKER_02So one thing that they do to make a patient feel fuller, uh, they regulate, i.e., our our our blood sugars, but they also make us feel fuller and they delay our gastric emptying. Um when they first came out, anesthesia was, you know, there wasn't even any research on how it affects aspiration. Right. Um, but that has come out over the last couple of years. And facilities are getting anesthesia is getting um newer and newer research all the time. So more and more research is coming out currently, like at Lexington, where we're off for about a week. Um and it's pretty important to us for an elective procedure that you're you're off for about a week. That can change and it might be different from facility to facility and procedure to procedure. Um some places might even be going to a 24 hour, if you're going to be on it, stay off of it for 24 hours and only clear liquids for 24 hours. So no solid flu, so solid food. Um, is you know, that's one thing that's coming out. We're not there yet at Lexington looking at that. Um we're looking at just stay off the medication if you can for for a week prior to your procedure. So that's that's kind of tying in NPO fasting guidelines and stuff like that. And you know, the research comes out, anesthesia providers, anesthesiologists, CRNAs are required to have continuing education. So when this continuing education gets to us, um, we then start to apply it, change guidelines uh in at each facility we're at.
SPEAKER_00So along these two, are part of these, I know a lot of times a pre-surgery physical is recommended, going to their provider, doing that. Are part of these conversations with their provider as well, too?
SPEAKER_02And you know, and you you can probably get it from providers as well. So providers, you know, they hear from their anesthesia teams and they're up to date on some of these things.
SPEAKER_00Um Joint collaboration, right?
SPEAKER_02Yes, and we don't want to send mixed messages. Sometimes a mixed message can occur, um, just depending on how the research is getting out and things like that. So we don't mean to confuse patients, but at the end of the day, what you're getting in that pre-op phone call is what is what is the anesthesia team is looking for. You know, a PCP might be out there saying one thing and it might not quite jive with how the anesthesia team is looking at things, and and and that's okay. Um just whatever you're getting on that pre-op phone call is probably what you want to stick by the most.
SPEAKER_00So for patients to know too, maybe about that pre-surgery physical, are there things that providers are looking for to then kind of inform your team too of, oh, hey, you know, this, this, and this is maybe why I wouldn't recommend surgery.
SPEAKER_02Absolutely. So when when you go to get that pre-op physical, what we're looking for is to basically set this patient up for success during anesthesia. So, hey, within the last 30 days, we want you to have an HMP for most facilities. And that's just to make sure, hey, listen, is this patient up to date? Is their EKG current? Um, if they need any other additional studies done to make their anesthesia team and surgeons feel safer about the anesthetic, how I provide anesthetic to a patient who has congestive heart failure and the degree of that congestive heart failure might determine what anesthetics I will probably lay off the table for that particular particular patient.
SPEAKER_00So you're learning a lot from that too. Oh, absolutely. Oh, yeah.
SPEAKER_02Um, those, especially for, for anesthesia, we want to know how well your heart is working. And hey, I'm seeing a heart doctor because I have coronary arteries. What degree of our you know, coronary artery disease do you have? Do we want to make sure we tailor your anesthetic so that we decrease the effect that it has on your heart as best as we can? So we might say, well, the surgeon and the anesthesia team prefer this type of an anesthetic. Well, the patient might not do very well with that anesthetic. So let's make sure we tailor this to each patient specifically and give them the best possible outcome.
SPEAKER_00Aaron Powell And would you say that 30 days? I know sometimes patients are like, oh, I was just there a couple months ago. But I mean, that's important. A lot can change kind of in a body, and we want you the closest to surgery time as possible.
SPEAKER_02Yeah, that's that's a lot of it. I mean, we'll look at things and and um depending on the patient's health status, go, okay, I we we have to come up with a timeline. I mean, we have to go through our checkpoints, like starting the plane and flying the plane. And studies have shown that at 30 days is a is probably a pretty good catch-all. Um, but everybody's different, everybody's health is different. Um and that that that HP with that PCP might be a real quick visit for you because you know your health and your your your doctor knows their health or your your your provider knows your health and will just sign up for you. But if you're someone that needs a little bit more of an extensive amount of workup, um we want to make sure that happens for you so we give you the safest anesthetic that we possibly can.
SPEAKER_00It's important to do it. So we kind of touched on a little bit, but are there different lab work or other tests that might be recommended before surgery? And what does that tell you and your team?
SPEAKER_02Um so yeah, I mean, there's some basics for procedures and um, you know, for coming someone coming in for a total joint, they might have a lot of different things, the blood chemistry uh to tell us what your what your hemoglobin looks like and what your sodium and potassium look like. Those are very important to anesthesia providers and surgeons. Your platelet count is very important to us. Um, we want to make sure that we don't give you a regional anesthetic if your platelet count's too low. And that might be too low even for a surgeon to want to perform a procedure depending on the procedure. Um, sodium and potassium, what we give, what we give you in anesthesia, some medications might raise your potassium, some might have different effects with your sodium levels. So we want to make sure that um those things are within normal limits the best that we can. Okay. Some procedures don't require some some people's physical health doesn't require those things. So they're not always necessary. But for some procedures, we want to, and you know, insurance drives things a lot too. So these insurance carriers are going to make sure that you have all these things taken care of. So you before you give somebody a total knee or an elective procedure, it's a fairly big operation. It doesn't seem like that anymore because they're so routine. It doesn't mean it's not big. Right. Uh just because they're routine, it's because your surgeons have gone through training, have done many procedures, they're excellent at them. Your anesthesia team, extensive training. So they make it seem routine, but it doesn't mean it's not a big procedure. The procedures are big, so we want to make sure the patients are set up and the the lab work uh guidelines uh help us guide our anesthetics and our surgeries to help you do better as a patient.
SPEAKER_00I'm jumping around, but just curious, Ben, do you have a pre-surgery meal within the time frame and things like that that you recommend to patients?
SPEAKER_02Nothing new.
SPEAKER_00Nothing new.
SPEAKER_02Nothing new. Um, you know, anesthesia has come a long way as far as nausea and vomiting goes. Um, but at the same time, you know, patients still get nauseous from the anesthetics. And you want to make sure that you like I wouldn't recommend a pizza if your tummy doesn't like pizza very well. Okay. Um if you tolerate pizza and pizza's a go-to for you or a burrito, whatever it is, um, if you if you handle it well um without needing, you know, if you don't feel gassy or anything like that from medications or foods, um, then you're you're you're you're safe if you're outside those guidelines. Um I always tell my friends and family, like, hey, have something high in carbohydrates that moves through your body because if you do get sick, um you want it to be for one for not very long and you don't want it to be very productive. You want you want your gut, you want everything cleaned up.
SPEAKER_00So Yeah, you want to you want to feel good. That's the thing. That's what I tell my friends and family.
SPEAKER_02Yeah, the lighter foods, like we said, the eggs, the toasts. If you never had sushi, maybe let's not try it. Yes, maybe not, yeah. And if you do well on sushi, it's you know, it's a fatty food. Um, it's got protein in it, so um it might stay in your system a little bit. Wow. But um, you know, I just recommend those toasts, those eggs, high carbohydrate foods um the night before if you can. It just will it'll just help you.
SPEAKER_00So, Ben, what is one of, would you say one of the most important things you want patients to understand no matter what surgery they're having?
SPEAKER_02Oh wow. Um, I think knowing that your team is going to take good care of you is very important. So being comfortable with your team um is and and your PCP will have their recommendations. So you know, I I think listening to your PCP uh is you know, this is how you get in get into to to see surgery. Um PCP notice, hey, if something hurts, uh, but being comfortable with your PCP and what they recommend is, you know, I have people come to me when their PCP tells them something and say, Hey, what do you think? I'm like, I'm gonna I'm gonna defer to your PCP. What I will say, but when I when I think about things, um I think about complaints. Okay. So um the biggest complaint no matter what facility I've ever been into, when I've been on on boards and we look at things, and you know, the usually the biggest complaint is usually my wait time. Okay. So I look at wait times, and I think if I was to be able to tell someone, no matter if you're at this facility, any facility you go to, um, it's pretty common practice for uh the day to be set up as efficient as possible for that work environment, which might mean patient wait times are up a little bit. So it might not seem efficient for the patient. Um for example, your surgeon has a block time. And within that block time, you know, based upon the surgeries that they do, they These things are not manipulated, but you can tell how long it takes this person to do a gallbladder. So, hey, your block time is you've got eight hours of block time. I can get this many gallbladders in. So, in order to do that, that the surgeon and the there might be uh two teams working for that one surgeon today to make things very efficient for that block time so that patients can get into that surgeon sooner. But that day of surgery might be a little bit longer. Um, if a patient has to wait for a couple of hours prior to surgery, it's not because things are moving slow, it's because you had to get ready for surgery that morning. You had to see your surgeon that morning. And that surgeon is working, working, working, seeing patients briefly postoperatively, seeing them pre-operatively. So one thing that surgeon has to do a risk and benefit and see that patient prior to them operating them on that day. So if that surgeon is in a two-hour procedure, that patient, that surgeon has just a couple of minutes to come out, say hi, any last-minute questions. This is where we're at. I'm prepared for you, and go back and keep operating on the next patient. So there's there's some delays there. And I guess what I tell my friends and family go, hey, this is going to be a long day for you. You've had your pain for a while. It's just one day. It's just one day. Um, so it might be frustrating. Now we all we have cell phones now. We didn't have these things, you know, 15 years ago. We have cell phones now that keep us occupied. There's going to be a TV in your room, but you might be waiting for a while in between procedures, no matter where you go. Because I've been to a lot of different places. Um, and I would just say that if you can just say, hey, this is one day. Right. It's one day I'm going to have my procedure. When the procedure's over, I'm going to be on convalescence and on my way to getting better. And it's one day. So I guess if I had to tell, and this is, you know, people ask me about guidelines, PPO guidelines. They ask me about this. Why is my wait so long?
SPEAKER_03Yeah.
SPEAKER_02Um, and that's why, because we're really working hard as a team, uh, and sometimes two teams to to really make sure that we're very efficient in the OR so that you can have your procedure that day and not two weeks from now or three weeks from now, because we're trying to make that day very efficient. When we get in the operating room, we're all very focused on our jobs and doing however long it takes to get that patient taken care of. Where we save time is in between surgeries, um, having what we call a flip room for people if they're available, having it if the team, hey, the surgeon's done, this team's available, great. We're gonna move patients from room to room, team to team with that surgeon to make sure that we can get through that day efficiently so that we can take care of our patients the way we need to.
SPEAKER_00I was just thinking about um like Dr. FootRay, who comes too. And I know we, you know, we set up the days for success for him and that team, surgeries in the morning and then patients in the afternoon. So maybe it's a uh sorry if your appointment was a little bit later, but we're making sure, you know, maybe that surgery regain. I'm sure I know we ran into that too.
SPEAKER_02But yep, especially the pla like Lexington where the visiting surgeons come in. Well, they come in from a ways out and they'll have surgery in the mornings and clinics in the afternoon. So sometimes that kind of spills over into a weighted clinic time. So it it does affect that. But we're lucky to have the surgeons that we have coming here, visiting here, taking care of the patients here. So you can have procedures right here in your hometown. We have some very good specialists that come in and do big procedures here. So um I feel lucky to do anesthesia here and continue to get to do, you know, bigger procedures that you can have done right here in Lexington, Nebraska.
SPEAKER_00So I'm sure you love all of the surgeries that you do, but if you could pick one or one anesthesia type, I know you talk about different blocks or things like that. What's what's one of your go-tos or what's something that's been fun lately for you?
SPEAKER_02You know, I I enjoy regional anesthesia. So when I can do regional anesthesia, what does that mean? So basically, regional anesthesia is that we're putting a we're putting a nerve to sleep. Okay. So it involves a needle, but um it's it's putting nerves to sleep. It's something I've always enjoyed doing. Um when I was training, we didn't have an ultrasound machine to kind of look at the nerves and find the nerves. We knew our anatomy. We used a nerve stimulator that kind of stimulated the nerve when we knew that we were there. We dumped a local anesthetic there. So numbing up that area for postoperative pain relief. Um that's something that I've really always enjoyed doing, even before the advent of ultrasound technology coming to help us here in the last 15 years. Um, so procedures that require regional anesthesia are something I really enjoy. Dr. Ray loves the pobleteal blocks, the adductor canal blocks for Dr. Shop. Um, you know, when we're working on shoulders, we'll do a block in the interscene or supracavicular area above your neck. So it sounds scary, but it's something that um I've always been able to I've been lucky as a CRNA to practice to the full extent of my scope. So um I like doing things that allow me personally to practice to the full scope uh that I'm trained to do.
SPEAKER_00So are there any hidden gems of surgery or different things that we're able to offer here at Lex that maybe questions that you've heard or oh, I didn't even know you offered that here.
SPEAKER_02Um, well, I mean, total joints, especially, you know, um Dr. Schop does a very good job. He's very busy with those things. We do the podiatry procedures as well, but being able to have your total knee done in Lexington. Um I've like I said, I've been to many different places and many, many people do a good job. And Dr. Shop is right there on on par with them. And you might not have as long as a wait time. Um I know he's he's busy, but um he does a fantastic job. Um so I think I think that's a that's a hidden gem here. So you can have a your total hip, your total knee, your total shoulder done right here in Lexington, Nebraska, if uh that's something you choose to do.
SPEAKER_00I'd say And you're not having to, I mean, if you yeah, live in Lexington or close, you're not having to drive hours with maybe right after surgery or those newer guidelines too of going home that you can be close to home.
SPEAKER_01Yeah, absolutely.
SPEAKER_00Which is nice. So, Ben, what didn't we hit on? What else do we want our audience to know? I know I've learned a lot.
SPEAKER_02Um, I I just say, you know, you come to a place like Lexington and you can have many different procedures done. Um the OR staff, the anesthesia team is very experienced. Um so you're getting quality care um in in Lexington. And uh I was I wouldn't have came here for my previous practice if I didn't feel that was something we were um able to offer here. Um I like being a part of part of a good team, and I think there's a good team here.
SPEAKER_00I completely agree. Well, Ben, I really appreciate, I mean, your knowledge for this. And I think it just echoes too, there's a lot of important things that are needed before surgery, and they're all, I mean, for the health of our patients. It's not, we're not trying to be stringent, we're not wouldn't make you jump through hoops, but it's for your safety.
SPEAKER_02Aaron Powell It truly is for your safety. So um and then you know, studies have shown what what creates success uh and and for a good surgery, good anesthetic is um following guidelines. So, like I said, it was like flying a plane. Go through these check checkpoints to make sure that we have a safe procedure and a safe flight.
SPEAKER_00Have you had to have patients that you've had a turn away for not following guidelines? Um Has it gotten better?
SPEAKER_02You know, yeah. So I I think what what you look at is maybe an abnormal lab works. So maybe they had the guidelines but didn't meet that abnormal lab is is rare, but but happens uh, you know, the NPO status is very important to us. And uh we want to make sure that when a patient NPO being the fasting guidelines are not eating. Um Yeah, it it depends sometimes, you know, what I'll do is hey, listen, you had food and we're gonna have to put you on at the end of the day, or you can reschedule.
SPEAKER_03Okay.
SPEAKER_02Um so we still look to try to get things done for we everybody's got a schedule. The the patient schedule is important to us. Physician, surgeon um is important too. So we don't try to fudge things at all. We want to be we want to be safe, but uh that's probably the biggest thing that happens is hey, you had something to eat. I I know you didn't mean to, it wasn't egregious. Exactly. Um thank you for being honest. Uh we we we don't want you to have aspiration um and end up in the hospital and intensive care unit um to take care of particulate in your lungs. So um that's that's the big one. Okay. So I might put you on at the end of the day. And if the surgeon still has time, we didn't lose any time, good.
SPEAKER_03Right.
SPEAKER_02Surgeon says, hey, I've got clinic and I've got to get out of here. Well, we might have to reschedule to another day.
SPEAKER_00Okay. Well, it's good to know just of how important these guidelines are. Well, Ben, thank you for coming here, breaking down in a way that I think really makes sense for our patients and community.
SPEAKER_02So my pleasure. Thank you for having me.
SPEAKER_00So, to our listeners, whether you're having surgery here at Lexington Regional or elsewhere, these steps are so important and a part of your care and really for your safety. And hopefully they'll set you up for the best success possible. Um, if you would please like, share, subscribe to our podcast. Hey, maybe a friend's having surgery, send this to them, have them remember these recommendations or save it and watch it for when you might have an upcoming surgery. But until next time, stay well.