Royal Caribbean Cruisers -- How Are Things Where You Are? (was "Routine" ​ 😁 ​day in lockdown... how was yours?)

[Ozark_Kid]

8 hours ago, BonTexasNY said:

Any update on Kenzie's aunt?  Hopfully she's recovering well.

Kenzie’s mom (my daughter) texted her yesterday and she said she is in pain and may need to have the other lung drained.  The aunt’s mom said she is improving and getting more sleep.  Thanks for asking.  It"s amazing when you think that for the most part the people who post here have not met in person but we care for one another.  

[Sunshine3601]

I've been sitting in waiting room for over an 1 hr.   This place is packed.   Hope I get called soon.

[Ozark_Kid]

1 hour ago, Sunshine3601 said:

Sounds like Eric.  He loves his milkshakes!

Just a little after posting I made me one!  
Yesterday afternoon Sharon helped me put up cattle panels in the garden.  It was a lot of work but glad we were able to get the beds done.  

 

It was really nice out so after we were done we enjoyed sitting out on the deck for a few hours.  We our so happy with the deck.

 

[Ocean Boy]

12 hours ago, BonTexasNY said:

I was not going to post this 2 weeks ago when my 15 year old niece in Israel had a spinal stroke leaving her totally paralyzed. This thread is full of the most sympathetic and compassionate  folks, but I still hesitated bringing this into our thread .   BUT now I can mention it because Hila (pronounced Heela) has movement in her legs and arms.  She can now finally stay sitting up with help and the therapists are working with her to get her to slowly walk. We were sent a video of her lifting up both her legs high and twirling them around.  Yayyy! 

 

Doctors are optimistic she'll be able to walk again after lots of therapy.

 

This is a very rare stroke for a 15 year old.

So please keep sweet Hila in your prayers for a complete recovery.

 

Note to @dani negreanu: Dani, Hila is Jack's twin sister's granddaughter who lives in Modi'in in a high rise.  All 3 married children of Jack's sister live in Modi'in.

Did she have an MRI and do you know the results? Not that it is any of my business.

[Ozark_Kid]

8 minutes ago, Sunshine3601 said:

I've been sitting in waiting room for over an 1 hr.   This place is packed.   Hope I get called soon.

Well that sounds like crap…… oh wait, that was last night.   😉 Hope it all goes well for you.

[Sunshine3601]

13 minutes ago, Ozark_Kid said:

Well that sounds like crap…… oh wait, that was last night.   😉 Hope it all goes well for you.

In pre op area with gown and IV in.   Said another hr.

[bobmacliberty]

Harmony update: Per Concierge, they expected between 5200-5300 passengers this week. Ended up with a little less than 5000 (she didn’t have a final number). Lots of energy last night at all venues! Really wanted to watch the Temperatures Band in Dazzles late last night but they were very, VERY loud. Just as well that we went to bed and didn’t have anything more to drink. 

[bobmacliberty]

37 minutes ago, Sunshine3601 said:

In pre op area with gown and IV in.   Said another hr.

Hopefully you’re on the way in now or in just a few minutes. Then you’ll open your eyes and start thinking about Scrapple!

[Sea Dog]

3 hours ago, Sunshine3601 said:

I'm headed to my colonscopy in a couple minutes.   Was not a pleasant Sunday afternoon/evening with many bathroom trips but finally fell asleep around 1 or 2 am.  

I already gave Eric my breakfast order from local diner.   

I hope the give you propofal as opposed to conscious sedation. After propofal I was hungry and ready to eat. Conscious sedation made me out of it and I just wanted to go home and sleep.

good luck! 

[BonTexasNY]

7 hours ago, grapau27 said:

I'm sorry to hear about Hila.

Sending prayers 🙏 for her full recovery.

Thank you. Graham.

5 hours ago, aussielozzie18 said:

@BonTexasNY Sending all my positive thoughts  to your niece on her recovery journey.  

I appreciate it, thanks.

4 hours ago, sgmn said:

Bonnie, sorry to hear about your niece. Sending best wishes to Hila for a complete recovery 🙏 

Fingers crossed here too, Sue, thanks.

3 hours ago, A&L_Ont said:

This is an incredible thing to read. I hope and pray that things continue to improve for Hila.  It sounds like she has a great spirit and an equally   Great medical team. 

Well said, Andrew, thanks.

3 hours ago, Sunshine3601 said:

I have never heard of a spinal stroke.   How very scary for Hila and her family.   Beautiful name.   She is in our thoughts and prayers for a full recovery.

Spinal strokes are very rare especially for a 15 year old.  Thank you for your thoughts and prayers.

1 hour ago, Ocean Boy said:

Did she have an MRI and do you know the results? Not that it is any of my business.

OB, anything posted in here becomes your business, especially medical issues.  Of course, I have to assume she had an MRI.  The cause was a blood clot found either in or near her spine which I hope was zapped out by now with meds.  She's in an excellent medical facility, Tel Hashomer.  By now I believe she was transferred to their rehab facility.

Edited April 11, 2022 by BonTexasNY

[Ozark_Kid]

3 minutes ago, Sea Dog said:

I hope the give you propofal as opposed to conscious sedation. After propofal I was hungry and ready to eat. Conscious sedation made me out of it and I just wanted to go home and sleep.

good luck! 

Conscious sedation, wasn’t sure what it was called but sounds like what I had.  To me it was the weirdest.  

[BonTexasNY]

2 hours ago, Ozark_Kid said:

Kenzie’s mom (my daughter) texted her yesterday and she said she is in pain and may need to have the other lung drained.  The aunt’s mom said she is improving and getting more sleep.  Thanks for asking.  It"s amazing when you think that for the most part the people who post here have not met in person but we care for one another.  

Continued prayers for improvement, of course.  

We really are a great bunch in here, aren't we??!!

Edited April 11, 2022 by BonTexasNY

[bobmacliberty]

13 minutes ago, Ozark_Kid said:

Conscious sedation, wasn’t sure what it was called but sounds like what I had.  To me it was the weirdest.  

I think they called it twilight sedation for me. Didn’t seem like twilight at all. I remember nothing between the doctor talking to me a couple of minutes before the procedure and waking up in the recovery room. 

[cruisingpeople]

15 hours ago, h20skibum said:

Sending prayers for a full and complete recovery. 

Also praying for Hila. 🙏

[Sunshine3601]

3 hours ago, Ozark_Kid said:

Just a little after posting I made me one!  
Yesterday afternoon Sharon helped me put up cattle panels in the garden.  It was a lot of work but glad we were able to get the beds done.  

 

It was really nice out so after we were done we enjoyed sitting out on the deck for a few hours.  We our so happy with the deck.

 

Nice!   Garden looks great!   Looks like the perfect place to hang out and watch the garden grow.    And BBQ!

[Sunshine3601]

1 hour ago, Sea Dog said:

I hope the give you propofal as opposed to conscious sedation. After propofal I was hungry and ready to eat. Conscious sedation made me out of it and I just wanted to go home and sleep.

good luck! 

I did not ask what they gave me, but I woke up while still in the OR.   They seemed a bit surprised when I woke up and asked if done as they were just finishing up.   So they kept me awake.   I was hoping for a nice long nap.   

 

All good, clean bill of health.   go back in 7 yrs.   

The nurses were all joking about how boring I am with no meds, no health concerns, no cavities, etc.   Then I told them I'm having a mohs procedure on small spot under my eye then they were happy (jokingly) that I had something wrong.

 

Went to diner and ate half of my breakfast order, saved rest for lunch/dinner.

[h20skibum]

2 minutes ago, Sunshine3601 said:

I did not ask what they gave me, but I woke up while still in the OR. 

I am not sure what they called mine, but I woke up during the procedure and told them they could back that truck out of there anytime.

 

I got a reminder card that I should schedule one.  Maybe later in the year, but I don’t want to wake up during another!

[Jimbo]

8 minutes ago, Sunshine3601 said:

I did not ask what they gave me, but I woke up while still in the OR.   They seemed a bit surprised when I woke up and asked if done as they were just finishing up.   So they kept me awake.   I was hoping for a nice long nap.   

 

All good, clean bill of health.   go back in 7 yrs.   

The nurses were all joking about how boring I am with no meds, no health concerns, no cavities, etc.   Then I told them I'm having a mohs procedure on small spot under my eye then they were happy (jokingly) that I had something wrong.

 

Went to diner and ate half of my breakfast order, saved rest for lunch/dinner.

 

3 minutes ago, h20skibum said:

I am not sure what they called mine, but I woke up during the procedure and told them they could back that truck out of there anytime.

 

I got a reminder card that I should schedule one.  Maybe later in the year, but I don’t want to wake up during another!

What have to worry about is when you wake up and there is like a dozen people surrounded around you and you ask what's going on and one of them says, "Admiring a nice Ass" !!

[bobmacliberty]

@John&LaLa did a sort of live thread while on Harmony last week. Rather than post a lot of Harmony stuff here, I’ll just extend his thread for another week. If interested:

 

[Sea Dog]

1 hour ago, Ozark_Kid said:

Conscious sedation, wasn’t sure what it was called but sounds like what I had.  To me it was the weirdest.  

 

i didn’t remember anything even though they said I’d be awake. I hust remember being tired and out of it afterwards but with the Propofal I felt great and was ready to go to eat.

 

 

1 hour ago, bobmacliberty said:

I think they called it twilight sedation for me. Didn’t seem like twilight at all. I remember nothing between the doctor talking to me a couple of minutes before the procedure and waking up in the recovery room. 

 

me neither. It was weird. I did feel out of it and just wanted to go home to bed. The propofal was the best.

 

 

35 minutes ago, Sunshine3601 said:

I did not ask what they gave me, but I woke up while still in the OR.   They seemed a bit surprised when I woke up and asked if done as they were just finishing up.   So they kept me awake.   I was hoping for a nice long nap.   

 

All good, clean bill of health.   go back in 7 yrs.   

The nurses were all joking about how boring I am with no meds, no health concerns, no cavities, etc.   Then I told them I'm having a mohs procedure on small spot under my eye then they were happy (jokingly) that I had something wrong.

 

Went to diner and ate half of my breakfast order, saved rest for lunch/dinner.

I’m glad everything went well. You probably had the conscious sedation if you woke up in the OR. Enjoy the rest of your day!

[lenquixote66]

14 hours ago, Ozark_Kid said:

I’ll second the ice cream but I blend it into a milkshake about every other night!

I have not had a milkshake in many years.I am not supposed to eat dairy products but I cannot give up ice cream.

[lenquixote66]

Earlier today Toby was going to the post office.It was sunny and about 50 degrease so I went with her,a very short car ride and only a few feet to walk.

I sent something certified and the amount to pay was $4.33.I gave the woman behind the counter 4 one dollar bills,a quarter and a dime.

She looked at me and asked for 3 cents.I replied that I gave her 35 cents and she has to give me 2 cents back.She had no idea what I was talking about .She told me the amount was $4.33 and I had to give her 3 cents.

I could not believe it.I can just imagine if I had dollar coins or a two dollar bill.Finally after total silence on her part she gave me 2 cents.

[Lionesss]

Regarding different types of anesthesia.

 

It seems much of the current lingo of describing sedation is dependent on the facility, and their own interpretation.

 

Where I practiced for almost 40 years we kinda followed some basic guidelines.

 

I will just do the basic type of "Not a general anesthesia", with all the toots and bangles tubes and such.

 

OK.

 

1.  Local.  This is basically the injection a physician injects right into the area to be operated on.           ex. would be, getting a hang nail fixed, getting a mole or skin cancer removed.  You are completely 

awake, and have nothing to calm your nerves.    This is only if the doctor schedules you "Strait local"

 

2.  L.M.A.C.  or Local Monitored Anesthesia Care.  This is very little sedation given to just dull the senses, but be aware enough to assist the doctor by holding still, or moving when needed.

ex. would be having Cataract surgery and looking at the light and trying not to move or cough, or getting a carpal tunnel done or trigger finger, and moving your fingers when the surgeon asks to evaluate the repair work. (Low dose Versed, and Alfentanil) usually provide a happy experience.

Many people have no recall of the procedure with these meds, when the procedure is done.

 

3.  Conscious sedation.  This is the one that gets a little bit tricky, and for our purposes we have to balance a fine line between comfort and sedation while avoiding heroic measures or placing breathing tubes.

  When providing anesthesia to the very ill, or very risky procedure and yet keep the patient safe at all times with complete monitoring.  

ex.  would be a patient that needs an xray procedure, and at times no movement is mandatory or if a patient has an MRI, and is claustrophobic, or any procedure where the patient is laying on their stomach and their airway could be compromised.  You would need to arouse them quick, so attention to detail is so very important.  ( we usually give low dose Versed, And Alfentanil) and then on a pump, titrate low dose Propofol (Diprivan) usually after one yawn, we let the doctor start.

 

There has been numerous concerns and complaints by the general public especially when having an MRI, (and claustrophobic) and we give sedation to calm them down.  It gets frustrating when the doctor ordering the test tells the patient you will be going to sleep for your MRI, but they are not the one giving the drugs.

We have to enlighten the patient that for safety our facility does not put you to sleep, but will do our best to  make you comfortable.  You will hear noises.  

If the patient is persistent and says they want to go to sleep we give them two options. Telling them since we do not provide that service of general......

a.  Go to a facility that gives a general anesthesia, because you will not get it here.

b.  Try an open MRI.

 

4.  Twilight Sleep.  The most famous and most provided type.  Usually for Gastroscopies, Colonoscopies, cystoscopies, breast biopsies, port insertions, major foot reconstruction.

This technique of anesthesia is practitioner dependent.

At our facility we use a combination of drugs dependent on patient history and surgical need.

Lets just say you had a  patient having a procedure done who just returned from a cruise and enjoyed the drink package, or you had someone who smoked cigarettes that are only legal in certain states, they would require much more of the happy stuff.  (Especially Marijuana, man, they require the big doses).

So we use what we are comfortable with, Versed, Alfentanil, Diprivan, Ketamine, Remifentanil, to name a few.

Our patients usually experience sleep, with no recall as long as the drugs are administered, and often tell us they had great dreams.  (When we ask them what they dreamt about, they cannot remember).

Some people are actually "aroused" but we wont go there.

 

Now in the news recently there have been stories about people not going to sleep or waking up during their surgery.  Unfortunately  that does happen.

 

But, the people that work in those think tanks came up with a monitoring device that monitors the depth of sleep.  The BIS monitor.

Its values are just like taking a test.

100% you are fully awake.Just like taking a test and scoring high.

75%, almost asleep

60% and below, your asleep, no memory, no recall.

 

The monitor updates your level of sedation every 15 seconds, from the preceding 15 seconds.

So if it is showing 60, than that is from 15 seconds ago, and you could be higher, and start to wake up.

 

Our facility places the BIS monitor on all patients foreheads (Except for cataracts) to evaluate and study our own effectiveness and provide reassurance to the patient.

We keep our depth by this monitor around 50, and yes patients still breath on their own.

 

We do not use it in the ENDO department because the best monitor is the patient, if they move, well push more stuff so they stop moving, and the combination of drugs we give they usually do not remember being well probed.

 

Thats my story and IT IS WHAT IT IS.

 

Take care and I hope I did not put you to sleep.

 

 

 

 

 

[Jimbo]

5 minutes ago, Lionesss said:

Regarding different types of anesthesia.

 

It seems much of the current lingo of describing sedation is dependent on the facility, and their own interpretation.

 

Where I practiced for almost 40 years we kinda followed some basic guidelines.

 

I will just do the basic type of "Not a general anesthesia", with all the toots and bangles tubes and such.

 

OK.

 

1.  Local.  This is basically the injection a physician injects right into the area to be operated on.           ex. would be, getting a hang nail fixed, getting a mole or skin cancer removed.  You are completely 

awake, and have nothing to calm your nerves.    This is only if the doctor schedules you "Strait local"

 

2.  L.M.A.C.  or Local Monitored Anesthesia Care.  This is very little sedation given to just dull the senses, but be aware enough to assist the doctor by holding still, or moving when needed.

ex. would be having Cataract surgery and looking at the light and trying not to move or cough, or getting a carpal tunnel done or trigger finger, and moving your fingers when the surgeon asks to evaluate the repair work. (Low dose Versed, and Alfentanil) usually provide a happy experience.

Many people have no recall of the procedure with these meds, when the procedure is done.

 

3.  Conscious sedation.  This is the one that gets a little bit tricky, and for our purposes we have to balance a fine line between comfort and sedation while avoiding heroic measures or placing breathing tubes.

  When providing anesthesia to the very ill, or very risky procedure and yet keep the patient safe at all times with complete monitoring.  

ex.  would be a patient that needs an xray procedure, and at times no movement is mandatory or if a patient has an MRI, and is claustrophobic, or any procedure where the patient is laying on their stomach and their airway could be compromised.  You would need to arouse them quick, so attention to detail is so very important.  ( we usually give low dose Versed, And Alfentanil) and then on a pump, titrate low dose Propofol (Diprivan) usually after one yawn, we let the doctor start.

 

There has been numerous concerns and complaints by the general public especially when having an MRI, (and claustrophobic) and we give sedation to calm them down.  It gets frustrating when the doctor ordering the test tells the patient you will be going to sleep for your MRI, but they are not the one giving the drugs.

We have to enlighten the patient that for safety our facility does not put you to sleep, but will do our best to  make you comfortable.  You will hear noises.  

If the patient is persistent and says they want to go to sleep we give them two options. Telling them since we do not provide that service of general......

a.  Go to a facility that gives a general anesthesia, because you will not get it here.

b.  Try an open MRI.

 

4.  Twilight Sleep.  The most famous and most provided type.  Usually for Gastroscopies, Colonoscopies, cystoscopies, breast biopsies, port insertions, major foot reconstruction.

This technique of anesthesia is practitioner dependent.

At our facility we use a combination of drugs dependent on patient history and surgical need.

Lets just say you had a  patient having a procedure done who just returned from a cruise and enjoyed the drink package, or you had someone who smoked cigarettes that are only legal in certain states, they would require much more of the happy stuff.  (Especially Marijuana, man, they require the big doses).

So we use what we are comfortable with, Versed, Alfentanil, Diprivan, Ketamine, Remifentanil, to name a few.

Our patients usually experience sleep, with no recall as long as the drugs are administered, and often tell us they had great dreams.  (When we ask them what they dreamt about, they cannot remember).

Some people are actually "aroused" but we wont go there.

 

Now in the news recently there have been stories about people not going to sleep or waking up during their surgery.  Unfortunately  that does happen.

 

But, the people that work in those think tanks came up with a monitoring device that monitors the depth of sleep.  The BIS monitor.

Its values are just like taking a test.

100% you are fully awake.Just like taking a test and scoring high.

75%, almost asleep

60% and below, your asleep, no memory, no recall.

 

The monitor updates your level of sedation every 15 seconds, from the preceding 15 seconds.

So if it is showing 60, than that is from 15 seconds ago, and you could be higher, and start to wake up.

 

Our facility places the BIS monitor on all patients foreheads (Except for cataracts) to evaluate and study our own effectiveness and provide reassurance to the patient.

We keep our depth by this monitor around 50, and yes patients still breath on their own.

 

We do not use it in the ENDO department because the best monitor is the patient, if they move, well push more stuff so they stop moving, and the combination of drugs we give they usually do not remember being well probed.

 

Thats my story and IT IS WHAT IT IS.

 

Take care and I hope I did not put you to sleep.

 

 

 

 

 

After all that, I think I need a sleeping pill. 😉

[Keksie]

22 minutes ago, Lionesss said:

Regarding different types of anesthesia.

 

It seems much of the current lingo of describing sedation is dependent on the facility, and their own interpretation.

 

Where I practiced for almost 40 years we kinda followed some basic guidelines.

 

I will just do the basic type of "Not a general anesthesia", with all the toots and bangles tubes and such.

 

OK.

 

1.  Local.  This is basically the injection a physician injects right into the area to be operated on.           ex. would be, getting a hang nail fixed, getting a mole or skin cancer removed.  You are completely 

awake, and have nothing to calm your nerves.    This is only if the doctor schedules you "Strait local"

 

2.  L.M.A.C.  or Local Monitored Anesthesia Care.  This is very little sedation given to just dull the senses, but be aware enough to assist the doctor by holding still, or moving when needed.

ex. would be having Cataract surgery and looking at the light and trying not to move or cough, or getting a carpal tunnel done or trigger finger, and moving your fingers when the surgeon asks to evaluate the repair work. (Low dose Versed, and Alfentanil) usually provide a happy experience.

Many people have no recall of the procedure with these meds, when the procedure is done.

 

3.  Conscious sedation.  This is the one that gets a little bit tricky, and for our purposes we have to balance a fine line between comfort and sedation while avoiding heroic measures or placing breathing tubes.

  When providing anesthesia to the very ill, or very risky procedure and yet keep the patient safe at all times with complete monitoring.  

ex.  would be a patient that needs an xray procedure, and at times no movement is mandatory or if a patient has an MRI, and is claustrophobic, or any procedure where the patient is laying on their stomach and their airway could be compromised.  You would need to arouse them quick, so attention to detail is so very important.  ( we usually give low dose Versed, And Alfentanil) and then on a pump, titrate low dose Propofol (Diprivan) usually after one yawn, we let the doctor start.

 

There has been numerous concerns and complaints by the general public especially when having an MRI, (and claustrophobic) and we give sedation to calm them down.  It gets frustrating when the doctor ordering the test tells the patient you will be going to sleep for your MRI, but they are not the one giving the drugs.

We have to enlighten the patient that for safety our facility does not put you to sleep, but will do our best to  make you comfortable.  You will hear noises.  

If the patient is persistent and says they want to go to sleep we give them two options. Telling them since we do not provide that service of general......

a.  Go to a facility that gives a general anesthesia, because you will not get it here.

b.  Try an open MRI.

 

4.  Twilight Sleep.  The most famous and most provided type.  Usually for Gastroscopies, Colonoscopies, cystoscopies, breast biopsies, port insertions, major foot reconstruction.

This technique of anesthesia is practitioner dependent.

At our facility we use a combination of drugs dependent on patient history and surgical need.

Lets just say you had a  patient having a procedure done who just returned from a cruise and enjoyed the drink package, or you had someone who smoked cigarettes that are only legal in certain states, they would require much more of the happy stuff.  (Especially Marijuana, man, they require the big doses).

So we use what we are comfortable with, Versed, Alfentanil, Diprivan, Ketamine, Remifentanil, to name a few.

Our patients usually experience sleep, with no recall as long as the drugs are administered, and often tell us they had great dreams.  (When we ask them what they dreamt about, they cannot remember).

Some people are actually "aroused" but we wont go there.

 

Now in the news recently there have been stories about people not going to sleep or waking up during their surgery.  Unfortunately  that does happen.

 

But, the people that work in those think tanks came up with a monitoring device that monitors the depth of sleep.  The BIS monitor.

Its values are just like taking a test.

100% you are fully awake.Just like taking a test and scoring high.

75%, almost asleep

60% and below, your asleep, no memory, no recall.

 

The monitor updates your level of sedation every 15 seconds, from the preceding 15 seconds.

So if it is showing 60, than that is from 15 seconds ago, and you could be higher, and start to wake up.

 

Our facility places the BIS monitor on all patients foreheads (Except for cataracts) to evaluate and study our own effectiveness and provide reassurance to the patient.

We keep our depth by this monitor around 50, and yes patients still breath on their own.

 

We do not use it in the ENDO department because the best monitor is the patient, if they move, well push more stuff so they stop moving, and the combination of drugs we give they usually do not remember being well probed.

 

Thats my story and IT IS WHAT IT IS.

 

Take care and I hope I did not put you to sleep.

 

 

 

 

 

Fascinating and very informative.