Thank you for this video. Outpatient elective procedures are not cancelled or delayed for marijuana use on day of surgery in my area. I enjoy the excellent content on this channel! Cheers!
Great presentation! I work in a state that has legalized marijuana and I can tell you that anecdotally the anesthesia requirements are much greater. I’m also amazed how it seemed like overnight the marijuana using population grew exponentially. Before legalization, very few patients admitted to using. After legalization people have been very honest about using. I don’t think they became users overnight. Makes me wonder if all the patients I had pre legalization that had unexpected high requirements were closet users 🤔? Anyway, I agree with a lot of your assessments and recommendations (especially the one about the marijuana naïve practitioner not being qualified to discuss post op recommendations for use with patient). Keep up the great work!
Hi Sally. Indeed. What the hell do we know? Being a musician, I have been around a lot of folks who consumed marijuana. Many of them benefited from the inspirational and creative side, which made me try a few times. Each time, even with a small puff, I ended up instantly sick, nauseous, and vomiting. Case in point - it is beneficial for some people, and it does not agree with others. But if your patient is used to rolling a joint for relaxation - that is how you want them to come to their anesthesia and surgery - relaxed, not edgy. Likewise, as they are recovering from their surgery, instead of detoxing using non-approved Dronabinol and risking withdrawal, let them smoke a joint or consume what they need to get back to their life as usual. I do not think that our task is to make them stop preoperatively. As for smoking side effects and dangers - it is no different than cigarettes - I do not think too many smokers abstain from smoking before surgery. And I totally agree with you in that there were many closet smokers before the legalization. Greetings!
Thanks for sharing! Legalization does push us forward a long way in terms of precautionary measures we can take now and overall openness. A big step for safety! Greetings from our team!
Thank you for the video! My sister was treated terribly for consuming marijuana (just in general not beforehand) and she was treated as if she was gross or a bad kid. Very unprofessional
Very helpful info. I have to undergo rotator cuff surgery soon. When asked what medicines or supplements I took I explained I recently got a bag of CBD Gummies specifically for post-surgery. In Japan cannabis is still very illegal but CBD is not illegal. Doctors and nurses know next to nothing about it. The nurse told me I had to absolutely stop taking CBD gummies 2 weeks before surgery and now it is likely they will not allow me to use the medicine after surgery. I underwent the same procedure 10 years ago and suffered sleep deprivation for my 10 day hospital stay. The night nurse hated me as I was awake all night regularly begging for ice packs. Morphine is not allowed at all and Japanese pain-killers have no noticeable effect for many foreigners. CBD was new to me. I found that taking 2 gummies at bedtime significantly helped me sleep. Maybe I should have kept my mouth shut but on the other hand if no patients come out of the closet regarding CBD or THC the medical community in Japan will remain ignorant.
Keep in mind that the half life of CBD is usually 1 to 2 days, but can be as long as 5 days (per Epocrates ap). If true then patients using CBD can accumulate large amounts of it if they use it daily. Because its metabolism inhabits multiple enzyme pathways that the liver also uses for clearing other medications, I would indeed test, looking specifically for unusually high levels. Surely we must know what liver enzymes take up propofol, fentanyl, versed and the other medications used by anesthesiologists.
Thank you! I have been stressing, I have a colonoscopy on Friday. The rules they gave us were disturbing, no alcohol, no recreational drugs. Wow 14 days, what do I do?? I have cut way back, I will stop 4 days before prep day. That’s. I’m not a hard user. I have had them from him in the past, but he never gave me rules. I will be glad when this is over and pray I’m okay. 😊
Great video! The lack of science for cbd and thc is a myth. My grandpa got his pharmacy license in 1922. At that time, 30% of all medicines in US Pharmacopeia had cannabis as an ingredient. Medical students get very little info on the ECS, according to a survey published from the Univ of Mich, 85% of fibromyalgia pts try cannabis and dont trust their PMD on cannabis. And 85% of MD’s weren’t comfortable talking to pts about it. It’s perfect for ERAS standards .
@@DRBLUESNYC If you could, would you make alcohol illegal for the same reason? I ask because we know the risk for abuse and side effects is more significant than with cannabis yet no one seems to suggest that it shouldn't have mass legalization.
@@jeremywallin-sanchez8366 DRBLUESNYC is the official dissenter here. The one person that would rain on a kitten parade. It’s like your parent has entered the room. ‘’Ok kiddos, but what if it’s legalized and people abuse it?” Uh-oh for them. You’re right Jeremy. Alcohol has destroyed more lives than can ever be measured. Had a friend that worked as a police officer. They were never ever called to a domestic dispute involving weed only. Always booze fueled. Cannabis has applicable medical benefits. Alcohol? It’s a great fire accelerant. It kills bacteria and us if we drink enough of it.
Have a surgery tomorrow and I just smoked a little blunt but I smoke every day and my blood pressure is usually low so if it does increase that a little I think I’ll be OK and I definitely told them when I had to do the Pre Surgical Testing they said I should be OK
All good points. But difficult to postpone/cancel the case based on Canabinoids screening, unless acutely intoxicated. I think this would be problematic in many centers. Greetings.
i have a colonoscopy today at 10am, its 6am right now, i havent smoked since yesterday night but thanks to the information in this video i wont smoke this morning im gonna wait til after the procedure lol
@@danieflamme8725hey did your surgeon recommend you stop smoking cannabis because they will test for it? I have a breast reduction in 10 days and I’m really struggling with quitting but don’t want my surgery to be cancelled because of it
@@seven594how did it go? Did they test you for thc? I’m having weight loss surgery and I’m stopping 2 weeks before surgery but of course it will still be in my system and they drug test the day of. Smh
If someone smokes a joint before surgery we can’t legally confirm consent as it impedes the patients ability to understand as they are under the influence. If the surgeon needs to change or modify the surgery on the day they cannot legally until the patient is not under the influence.
That is one of the concerns expressed in the video - what do you do with the information. Keep in mind that these folks walk around, work, transact businesses, bank transactions while smoking. That is how they live they-by-they. Where do you draw a line when they are competent to sign the consent? I think that it would be a very sticky situation if we, anesthesiologists who are naive to the effects of marijuana were to judge from patient-to-patient their cognitive and comprehension competence. Unless they are overtly intoxicated, I'd say - go with the flow may be the most sensible approach. Or don't ask don't tell. After all, there does not appear to do anything much we can do differently preoperatively. And if they require 20% more propofol to go to sleep or analgesic postoperatively, I do not see a big deal. Greetings
@@DRBLUESNYC Try and argue that with the hospital legal team when they hang you out when the family sues. Anaesthetics has cancelled patients that have had a joint prior to surgery. If it’s an issues it needs to be raised and discussed prior to admission.
thats why look at your patient, every smoker will not present the same way, if you notice they are highly intoxicated or not in the right state of mind when consenting ... erm yes back to the line they go ( i know there are some silly people out there ...but does this situation really happen that often ? )
@@trentsteel4421 these days they have you sign release forms for surgery in your pre-surgical appointment. That cuts out being too inebriated to make an informed medical decision on the day of the procedure.
Dam I’m scared now I’m getting a esophagogastroduodenoscopy procedure tomorrow at 11AM is it safe to sill do it I smoke at like 5PM EST cannabis now I’m panicking scared out my life help
i was gonna stop smoking a few days before my surgery and i wanted to ask, is consuming marijuana via vape pen before ur surgery any different from a joint?
Ya bro I think all is a no go I’m in the same situation I have it in June and I’m addicted to those pens and I’m stressin especially after seeing video of 4 wisdom teeth getting ripped out
I think he is confused about the recommendations to screen all patient for marijuana use. They are not recommending to do urine drug screens, rather the recommendations are to ask patients if they use marijuana. That's not an unreasonable recommendation.
This is funny cause I’m getting my wisdom teeth out in about 2 weeks. Currently having a panic attack because I didn’t tell my doctor I use and I’m hoping that 2 weeks is enough to not have to come clean 😅
I told mine exactly this. I've smoked weed, they gave me endone, morphine, fentanyl all in the last 6 hours.. should I really be having ketamine on-top? She said: I'm the anesthesiologist here. I just said: YEP, FAIR ENOUGH. She proceeded to put me into cardiac arrest.
I have relatives are blind but the smell bother them so bad they are haveing truoble with issues and made her sick and haveing truobles since this vote pass on on marijuana i too has well have issue i feel like i either put someone in the hospital or thier life be really short .
So you’re telling me for my upcoming septoplasty surgery…I can smoke the days before my operation if I’m already a chronic user just to make sure to stop at least 12 hours beforehand and be upfront with my anesthesiologist?
They already called me and I already told them I was an everyday user and they said as long as you are not hiding anything from us it’s best to let us know so that the anesthesiologist is aware that I might be more tolerable to the anesthesia but other then that it’s mostly to avoid situations with bleeding and scaring. My surgery is tomorrow and I smoked today. I’m assuming as long as you’re not intoxicated like they stated in this video you should be fine.
What an advertisement for marjiuana use!! Where is the medical ethical for quitting of smoking as we are teached in school !?? Nevertheless, pulmonary physiology change during smoke didn’t mention on this episode which impact our anesthesia practice during periooperative . Thank you from far east
HI Othman. Super vaulable counterpoint. Thank you. Do not know about the Far East - by the West is at the point beyond return. Marijuana is being legalized (against my position) and we will all have to deal with it. Patients WILL come with history of recent smoke. The question is - given the new guidelines - would you cancel the cases? In my opinion - we will need to live with it and go with the flow. THoughts? Greetings
Thank you for this objective analysis and honest presentation. This is yet another W for NYSORA!
Hi Jeremy! Glad to hear this! Thanks!
thankyou for this and all your videos! very good analysis
by far the best video about this topic!! thanks for sharing the info and ur experience!!!!
Hi Rocco, Thank you so much for your kind words; we really appreciate your feedback.
Thank you for this video. Outpatient elective procedures are not cancelled or delayed for marijuana use on day of surgery in my area. I enjoy the excellent content on this channel! Cheers!
Thank you so much for your kind words; we really appreciate your feedback. Greetings!
Facts with humour..perfect combination 👍
Always a great video! Tks
Hi Cristina! Thanks for watching! Greetings from NYSORA!
Love your videos!! Thank you!
Glad you like them!
Thank you for the video!!
Dear Ismar! Glad to hear this!
Great presentation! I work in a state that has legalized marijuana and I can tell you that anecdotally the anesthesia requirements are much greater. I’m also amazed how it seemed like overnight the marijuana using population grew exponentially. Before legalization, very few patients admitted to using. After legalization people have been very honest about using. I don’t think they became users overnight. Makes me wonder if all the patients I had pre legalization that had unexpected high requirements were closet users 🤔? Anyway, I agree with a lot of your assessments and recommendations (especially the one about the marijuana naïve practitioner not being qualified to discuss post op recommendations for use with patient). Keep up the great work!
So interesting to hear!
Hi Sally. Indeed. What the hell do we know? Being a musician, I have been around a lot of folks who consumed marijuana. Many of them benefited from the inspirational and creative side, which made me try a few times. Each time, even with a small puff, I ended up instantly sick, nauseous, and vomiting. Case in point - it is beneficial for some people, and it does not agree with others. But if your patient is used to rolling a joint for relaxation - that is how you want them to come to their anesthesia and surgery - relaxed, not edgy. Likewise, as they are recovering from their surgery, instead of detoxing using non-approved Dronabinol and risking withdrawal, let them smoke a joint or consume what they need to get back to their life as usual. I do not think that our task is to make them stop preoperatively. As for smoking side effects and dangers - it is no different than cigarettes - I do not think too many smokers abstain from smoking before surgery. And I totally agree with you in that there were many closet smokers before the legalization. Greetings!
Thanks for sharing! Legalization does push us forward a long way in terms of precautionary measures we can take now and overall openness. A big step for safety! Greetings from our team!
Thank you for the clear information.
Glad it was helpful!
Great video thank you...!
Glad you liked it!
Top video!
Hi Amar! Glad you enjoyed it
Thank you for the video! My sister was treated terribly for consuming marijuana (just in general not beforehand) and she was treated as if she was gross or a bad kid. Very unprofessional
I was confused if he was talking about the patient or doctor....🤣😆
Greetings! Both!
By the way i am an anesthesiologist.... Good to know this
Very helpful info. I have to undergo rotator cuff surgery soon. When asked what medicines or supplements I took I explained I recently got a bag of CBD Gummies specifically for post-surgery. In Japan cannabis is still very illegal but CBD is not illegal. Doctors and nurses know next to nothing about it. The nurse told me I had to absolutely stop taking CBD gummies 2 weeks before surgery and now it is likely they will not allow me to use the medicine after surgery. I underwent the same procedure 10 years ago and suffered sleep deprivation for my 10 day hospital stay. The night nurse hated me as I was awake all night regularly begging for ice packs. Morphine is not allowed at all and Japanese pain-killers have no noticeable effect for many foreigners. CBD was new to me. I found that taking 2 gummies at bedtime significantly helped me sleep. Maybe I should have kept my mouth shut but on the other hand if no patients come out of the closet regarding CBD or THC the medical community in Japan will remain ignorant.
@0:56 Who ever edited this video your the reason im Subscribing lol!!! What a legend putting the joint on him during OP hahahaha
Thank you for your comment!
Keep in mind that the half life of CBD is usually 1 to 2 days, but can be as long as 5 days (per Epocrates ap). If true then patients using CBD can accumulate large amounts of it if they use it daily. Because its metabolism inhabits multiple enzyme pathways that the liver also uses for clearing other medications, I would indeed test, looking specifically for unusually high levels. Surely we must know what liver enzymes take up propofol, fentanyl, versed and the other medications used by anesthesiologists.
Thumbs up all the way 👍
Thank you! I have been stressing, I have a colonoscopy on Friday. The rules they gave us were disturbing, no alcohol, no recreational drugs. Wow 14 days, what do I do?? I have cut way back, I will stop 4 days before prep day. That’s. I’m not a hard user. I have had them from him in the past, but he never gave me rules. I will be glad when this is over and pray I’m okay. 😊
Great video! The lack of science for cbd and thc is a myth. My grandpa got his pharmacy license in 1922. At that time, 30% of all medicines in US Pharmacopeia had cannabis as an ingredient. Medical students get very little info on the ECS, according to a survey published from the Univ of Mich, 85% of fibromyalgia pts try cannabis and dont trust their PMD on cannabis. And 85% of MD’s weren’t comfortable talking to pts about it. It’s perfect for ERAS standards .
Great comment. Indeed. I am not in favor of mass legalization with potential for abuse, otherwise...
@@DRBLUESNYC If you could, would you make alcohol illegal for the same reason? I ask because we know the risk for abuse and side effects is more significant than with cannabis yet no one seems to suggest that it shouldn't have mass legalization.
@@jeremywallin-sanchez8366 DRBLUESNYC is the official dissenter here. The one person that would rain on a kitten parade. It’s like your parent has entered the room. ‘’Ok kiddos, but what if it’s legalized and people abuse it?” Uh-oh for them. You’re right Jeremy. Alcohol has destroyed more lives than can ever be measured. Had a friend that worked as a police officer. They were never ever called to a domestic dispute involving weed only. Always booze fueled. Cannabis has applicable medical benefits. Alcohol? It’s a great fire accelerant. It kills bacteria and us if we drink enough of it.
Have a surgery tomorrow and I just smoked a little blunt but I smoke every day and my blood pressure is usually low so if it does increase that a little I think I’ll be OK and I definitely told them when I had to do the Pre Surgical Testing they said I should be OK
No, but I would say it is OK after you finish the list to have a joint to relax, "obviously not if you are on call"
what about smoking the day before an MRI and receiving sedation will there be any complications?
Watching this to see if I can smoke few days before my septoplasty surgery.
How'd it go??
Hilarious it is 😂 and really interesting too 👍
THanks KD. And greetings
How would this apply to someone like me who takes only Dronabinol twice daily every day for intractible nausea?
Sorry if I missed but what about pulmonary effects of smoking. CO, RAD etc. thx!
All good points. But difficult to postpone/cancel the case based on Canabinoids screening, unless acutely intoxicated. I think this would be problematic in many centers. Greetings.
i have a colonoscopy today at 10am, its 6am right now, i havent smoked since yesterday night but thanks to the information in this video i wont smoke this morning im gonna wait til after the procedure lol
Glad I could help!
Did your surgery go good ? Only asking because I have a breast reduction surgery in 3 days and I just stopped smoking
@@danieflamme8725 yeah it went great actually, i just stopped smoking the day before
@@danieflamme8725hey did your surgeon recommend you stop smoking cannabis because they will test for it? I have a breast reduction in 10 days and I’m really struggling with quitting but don’t want my surgery to be cancelled because of it
@@seven594how did it go? Did they test you for thc? I’m having weight loss surgery and I’m stopping 2 weeks before surgery but of course it will still be in my system and they drug test the day of. Smh
Probably best to stop all edibles and vaping cannabis 3 days before and on the day of surgery?
If someone smokes a joint before surgery we can’t legally confirm consent as it impedes the patients ability to understand as they are under the influence. If the surgeon needs to change or modify the surgery on the day they cannot legally until the patient is not under the influence.
That is one of the concerns expressed in the video - what do you do with the information. Keep in mind that these folks walk around, work, transact businesses, bank transactions while smoking. That is how they live they-by-they. Where do you draw a line when they are competent to sign the consent? I think that it would be a very sticky situation if we, anesthesiologists who are naive to the effects of marijuana were to judge from patient-to-patient their cognitive and comprehension competence. Unless they are overtly intoxicated, I'd say - go with the flow may be the most sensible approach. Or don't ask don't tell. After all, there does not appear to do anything much we can do differently preoperatively. And if they require 20% more propofol to go to sleep or analgesic postoperatively, I do not see a big deal. Greetings
Thanks for sharing and that definitely holds true. It's on us to take every possible precaution, even if that means pushing surgery off. Greetings!
@@DRBLUESNYC Try and argue that with the hospital legal team when they hang you out when the family sues. Anaesthetics has cancelled patients that have had a joint prior to surgery. If it’s an issues it needs to be raised and discussed prior to admission.
thats why look at your patient, every smoker will not present the same way, if you notice they are highly intoxicated or not in the right state of mind when consenting ... erm yes back to the line they go ( i know there are some silly people out there ...but does this situation really happen that often ? )
@@trentsteel4421 these days they have you sign release forms for surgery in your pre-surgical appointment. That cuts out being too inebriated to make an informed medical decision on the day of the procedure.
can you eat an edible the same day after the effects wear off?
Will I be ok if I just stop smoking weed a month before my surgery
NATIONAL TOSS A SEED DAY- May 15. Everyone toss seeds out your windows, in the woods, road sides, etc.
Отличный ролик. Особенно понравился бомж.
Dam I’m scared now I’m getting a esophagogastroduodenoscopy procedure tomorrow at 11AM is it safe to sill do it I smoke at like 5PM EST cannabis now I’m panicking scared out my life help
How did it go?
@@starkles2060Oh god
i was gonna stop smoking a few days before my surgery and i wanted to ask, is consuming marijuana via vape pen before ur surgery any different from a joint?
Ya bro I think all is a no go
I’m in the same situation I have it in June and I’m addicted to those pens and I’m stressin especially after seeing video of 4 wisdom teeth getting ripped out
@@Rw12323 bro im in same situation how did it go
@@jacobpoteete2152 I canceled the surgery but I still gotta try to quit
What about acute intoxication and consent, we do bedside surgical consents. Are they legally able to consent while acutely intoxicated?
Good question!
I have surgery early Monday morning and I’m a chronic user I just stopped last night would it be bad if I smoke up u til Saturday night
It would probably not make much difference. Greetings and good luck with your surgery!
@@nysoravideo thank you for the reply sir
@@nysoravideo and thank you!!
How was it? I’m in the same situations
🙏🙏
Thank you Rishi. I've got to admit - it is intense, but it is an honest information. Greetings
I think he is confused about the recommendations to screen all patient for marijuana use. They are not recommending to do urine drug screens, rather the recommendations are to ask patients if they use marijuana. That's not an unreasonable recommendation.
Seguís sin convencer me incluso vestirse de médico y poner informes por detrás.. lo puede hacer cualquiera.
Impacted wisdom tooth extraction surgery later today. Pissed o stopped smoking a week before 🤣😭
Been a stressful/ painful 7 days.
This is funny cause I’m getting my wisdom teeth out in about 2 weeks. Currently having a panic attack because I didn’t tell my doctor I use and I’m hoping that 2 weeks is enough to not have to come clean 😅
I’m going through the same thing. How’d it go??? Update???
I told mine exactly this.
I've smoked weed, they gave me endone, morphine, fentanyl all in the last 6 hours.. should I really be having ketamine on-top?
She said: I'm the anesthesiologist here.
I just said: YEP, FAIR ENOUGH.
She proceeded to put me into cardiac arrest.
I have relatives are blind but the smell bother them so bad they are haveing truoble with issues and made her sick and haveing truobles since this vote pass on on marijuana i too has well have issue i feel like i either put someone in the hospital or thier life be really short .
So you’re telling me for my upcoming septoplasty surgery…I can smoke the days before my operation if I’m already a chronic user just to make sure to stop at least 12 hours beforehand and be upfront with my anesthesiologist?
i’ve been searching for this answer omg. everywhere else i was looking said at least 4 weeks
They already called me and I already told them I was an everyday user and they said as long as you are not hiding anything from us it’s best to let us know so that the anesthesiologist is aware that I might be more tolerable to the anesthesia but other then that it’s mostly to avoid situations with bleeding and scaring. My surgery is tomorrow and I smoked today. I’m assuming as long as you’re not intoxicated like they stated in this video you should be fine.
@@joshmagana4563 yeah that’s what it sounds like! you’ll be okay. best of luck friend.
@@joshmagana4563 How did it go? I told my doctor I'm a daily user and they didn't seem to care & had nothing to say but "noted!"
@@joshmagana4563 are you fine? lol
watching this to see if i can smoke the night before my wisdom teeth surgery
How did that go btw?
I forgot I’ll have my wisdom teeth removed tomorrow and I’ve just smoked one…😮
I’ll let know what happens… lol
@@marcusbispo1681 just tell the doctor and ur chillin
The Problem in UK . its not legal ,,, so some people would be scared to say anything x julie from uk.
What an advertisement for marjiuana use!!
Where is the medical ethical for quitting of smoking as we are teached in school !??
Nevertheless, pulmonary physiology change during smoke didn’t mention on this episode which impact our anesthesia practice during periooperative .
Thank you from far east
HI Othman. Super vaulable counterpoint. Thank you. Do not know about the Far East - by the West is at the point beyond return. Marijuana is being legalized (against my position) and we will all have to deal with it. Patients WILL come with history of recent smoke. The question is - given the new guidelines - would you cancel the cases? In my opinion - we will need to live with it and go with the flow. THoughts? Greetings
As long as medicaid and Medicare takes care of the bill, our pts will continue what they will
Lol