I thought it might be helpful to describe what to expect, from an Anesthesiologist point of view, on the day of your surgery.  It’s a big day for you.  A day you have probably been thinking about for a long time.  It is completely normal to be nervous, excited, anxious, and even calm.  Different people react differently to unknown situations.   My hope is to arm you with knowledge about what to expect.  It should help to ease some of the anxiety you may have.  I am going to walk you through a day in the life of a patient at Wayzata Plastic Surgery.

Typically we ask patients to arrive an hour before their scheduled operation.    You will meet with one of our nurses who will do your intake.  This is similar to being admitted at a hospital except it doesn’t take hours to accomplish or require loads of paperwork.  Next, you will meet with me, your Anesthesiologist.  I will take a short history, explain what type of anesthetic you will be having and answer any questions you have about the sleeping portion of your day.  No questions are “dumb questions” and I am happy to spend as much time as needed to help you feel comfortable with the process.  Being a bit of a control freak myself, I know how difficult it is to give up that sense of control and let someone who was a complete stranger only minutes ago, take care of you in your most vulnerable state.  I have been on the other side as a patient and it is not an easy thing.   After we are done talking, your surgeon will visit with you and answer any remaining questions you have about the surgery.

During your time in the preoperative room we ask that you stay nice and warm by using blankets and a space heater.  When the nurse brings you into the operating room you will understand why this is so important.  The operating room is kept very cold!  This is not done intentionally to make you feel uncomfortable.  There are a couple of good reasons for it.  The first is for infection control.  Infectious organisms cannot live in a cold environment so it is protective against postoperative infections.  The other reason is your plastic surgeon and his assistants will be standing under hot lights in a large sterile robe for a long period of time and it keeps them comfortable.

Once you are in the room we will ask you to lie down on the operating room table.  We will place warm blankets on you and introduce you to the any of the operating room staff you haven’t met yet.  There will seem to be a flurry of activity as there are usually at least four people in the room and each of us has a job to do.  I will work on getting a line placed in your arm to give you fluids and medications.   I have a few tricks to help make the line placement less traumatic.  If this is something you are worried about, please let me know when we meet.  The nurses will put on several monitors.  Booties will be placed on your feet to give you a massage during the surgery and to help to prevent blood clots.

Once I have taken your baseline vital signs, and everyone in the OR is ready, we will place a mask on your face that contains oxygen and ask you to take some nice big breaths.  It’s time to go to sleep! I will give you medications thru the IV line to accomplish this and it typically takes about five to ten seconds for you to fall asleep.  During the entire duration of your surgery I will be continuously monitoring your vital signs and giving you medications to keep you asleep, reduce your pain, and  prevent postoperative nausea.

Once your surgery is complete I will gradually wake you.  It is common to feel as if no time has passed because patients don’t typically dream.  It will seem as if you were asleep for a second or two, regardless of the length of the surgery.  You may also be surprised by how good you feel upon waking.  We are lucky here at Wayzata Plastic Surgery that we are not obligated to give the cheapest anesthetic.  We give the best anesthetic, using the best medications, and that usually means quite a different experience upon waking than you may have had with previous surgeries performed at a hospital.  In fact, most patients with a history of nausea and vomiting postoperatively are amazed that they can go to sleep here and wake up feeling great.  A recovery nurse will stay with you until you feel ready to sit up, get in a wheelchair, and head for home.

That’s all there is to it!  Hopefully having some “inside information” will help ease your nerves when your surgery day finally arrives! Until then, I’ll look forward to meeting you in person.  Annie Burton, MD (Your Anesthesiologist) September, 2010

Some practices use nurse anesthetists or RNs who have completed additional training to provide anesthesia.  I am a Board Certified Anesthesiologist and a medical doctor.  It took 4 years of college, 4 years of medical school, 4 years of residency, and a couple of years at a level I trauma center for me to land at my dream job here at Wayzata Plastic Surgery.  I work in an AAAASF certified operating room and both of our surgeons are Board Certified.

I have heard the practice of Anesthesiology described as, “years of boredom intermixed with seconds of sheer terror”.  I don’t agree with the saying.  I have encountered my fare share of “seconds” and during those “seconds” I have surprised myself over and over by how I am able to calmly take charge of the situation and resolve the problem.  “Sheer terror” may have been part of the equation 20 years ago.  However, with the advances that have been made in the field over recent years it has become incredibly safe to have a general anesthetic.  In fact, if you are relatively young (<70 in my book) it is probably safer to have an anesthetic than it is to get in your car and drive to the surgery center.  Of course, unexpected problems do, and will, happen.  The laws of nature, and statistics, demand it.  Being prepared to deal with those problems is the difference between “sheer terror” and a having an action plan.    If something out of the ordinary should happen during an anesthetic, we are more than prepared to take care of it.  Ultimately we want to get you home in better condition than you arrived that morning…..in that dangerous car of yours!

As for the “years of boredom” portion of the saying………  I believe people are naturally called to, or drawn to, what they love and what they are good at.  Anesthesiologists in general, tend to be type A, organized, meticulous, and, without skirting around the bush……………..control freaks.  I love my job.  I love what I do and I don’t find any of what I do to be “boring”.  I am excited every morning to come in and meet my patients of the day.  I love talking to my patients and learning about both their medical and personal histories.  It is nice to be able to make someone feel comfortable in an unfamiliar situation.  Does this sound boring to you?  I certainly don’t think so.  Annie Burton, MD, June, 2010

We are in the business of keeping secrets.  Plastic surgery has always been that way.  We understand that surgery is a very private matter for many of our patients.  The Federal government made it more real with strict laws that protect private health information.  So not only do we want to keep patient information confidential – we are legally bound to secrecy.  I frequently see patients who are in a “gathering information” mode and haven’t even discussed the plan with their spouse.  On the other hand – we have patients who are happy to tell their family, friends, neighbors and even recent acquaintances about their plastic surgery experience.  We love to share their stories.   I have not discovered any reliable way to predict who is or isn’t willing to share their story – other than to ask.  So we do ask – we ask for written permission before we share photos or stories with anyone else.  I have even had some patients who, although they had beautiful results,  are a little disappointed that we have not yet posted their results on our internet site.  Confidentially – I love doing what I do.  I love that I can be a part of the story – and I like to share the stories when I get permission to do so.  I think it helps people to understand that they are not the only ones undergoing or considering plastic surgery.   JNESS, MD May,2010

One of the continued surprises at this point in life is that I thought I would have more of my life’s direction figured out by now.  Alas, not quite true.  My family knows that I tend to have horrible directional sense.  So in this instance, I have been heard to say that, “I just put one polished shoe in front of the other and keep moving forward.”  It is true that I often get lost when I’m looking for a new place, but I do have a knack for finding my way home.  We have called St. Cloud, MN our home for the past 12 years.  We have raised our sons there and our eldest is due to graduate from high school in May.  So it is with some relief that I can now say I found my way back home and that Wayzata Plastic Surgery has opened a new Plastic Surgery Clinic in St. Cloud, Minnesota.  My non-compete expired last week, the first ad went into the St. Cloud Times on Sunday and I already have several patients scheduled for my first day on Friday, April 16th, 2010.  We are planning an open house in the future for anyone interested in visiting this new facility, but for now you will be able to find me – on most Fridays – at 1900 Connecticut Ave S, Suite 100, Sartell, MN  56377.  It is true…there is no place like home.   JNessMD April, 2010

The 2010 Winter Olympics have just concluded and I am both a little happy and a little sad. Happy because the United States did so well and NBC captured so many amazing athletes in action. I am also a little relieved because I can’t afford to watch the Olympics every night – no matter how good they are. I was also left feeling a little sad for all of the Olympic competitors that had invested so much time, effort and energy – and went home without a medal or worse – fell at the wrong time and then had to have it recorded in slow motion and have a failure watched over and over. So it was quite a coincidence (at least to me) that today I received an award for “being honored a ‘Patients’ Choice’ doctor for the second year in a row” – hmm. There isn’t any such thing as the Plastic Surgery Olympics – and even if there were an “Iron Chef” competition or equivalent – I’m not sure I would want to compete. I spent years in training and I continue – everyday – to work at improving my technique and craft. I love the rush of getting a perfect score and nailing the landing – but sometimes it just isn’t all up to me. I am in a field where every result needs to be great and I deal with so many variables because each patient’s concern or condition is unique in their own way. I can’t risk falling or wiping out – especially when there is so much expectation riding on the results. So – getting an award is nice – (although – honestly – I’m not even sure what it means) – but I prefer the rewards that I get every day working with patients and helping them achieve their goals and dreams. I have also never been a fan of my own publicity – real or imagined. So back to the slopes of my every-day Olympics to focus, improve, and push for better outcomes. I don’t expect to end up on a podium (where falling off would seem all too easy) with a ribbon around my neck. My rewards are the kind notes and words from the people I have the privilege of caring for. Our new tag line pretty much sums it up – “Improving You. Every Day.” Medal worthy or not – we will keep at it.