院長親自示範 #鳳凰電波 心得分享😆
我當全職麻醫已經超過半年
有一陣子沒做醫美微整了！
前幾天來莎斐爾跟謝醫師互打鳳凰電波
謝醫師說我是「電波神手」
施打能量一度調到6.0
痛覺只有輕微而已但還仍能忍受
實在是太強了！👍

但超怕痛的我，還是想在麻醉下做電波…
身為麻醉專科醫師，當然要請專業的來幫我麻醉才安心啦！
所以，我先幫謝醫師打完後
請另一位麻醉專科醫師立刻幫我麻醉
然後換謝醫師幫我打😂
（可以去謝醫師的粉專 整形外科醫師 謝宇豪 Dr.195 看鳳凰電波的完整心得～）

最後還是推廣，麻醉不分大小
例如醫美、腸胃鏡檢等的全身麻醉、鎮靜麻醉等等，
我認為都是需要麻醉專科醫師在場
才能更安全無虞的完成手術唷！

📍莎斐爾整形外科診所
歡迎預約醫美諮詢及指定我麻醉唷！

李佳霖醫師 - 麻醉專科女醫師

#李佳霖醫師 #drjennielee #麻醉專科醫師 #專科醫師執照 #診所 #doctor #醫師 #麻醉女醫 #醫學美容 #醫美 #微整形 #微整 #麻醉 #電波 #anesthesia #propofol #anesthesiology #anesthesiologist #anesthesialife

Finally Vaccinated on 3rd August ! I've been trying very hard to avoid #CucukMyAZ as I was afraid of the 3 day downtime 🥲 but I guess God knows better 😝 I know of some who had it easy and some who had it bad. I would say my 3 day downtime was bearable. Thanks to my parents, all I had to do was eat & sleep 💤  without needing to worry about the kids 🤭  or meals
.
Jabbed at 9am, I was #001, yea I'm #Kiasu like that 🥲 feeling lightheaded after the jab which I was enjoying. You know the feeling you get after waking up from Anesthesia? Yes, that. Very mild tho. Day 1, 6pm my temperature started to rise... as soon as it hit 38°c I gave in and took 2 Panadol Actifast 🤭 and went to bed. I sleep well thru the night
.
Day 2, I woke up feeling as though a truck ran over me, everywhere was aching except my hair & nails 😅 Temperature was still up & down, when it goes up i took Panadol Actifast. My head was pounding, Panadol did help a lil tho I wished I could take my Migraine Pain Killers instead. I spent the whole day in bed, I couldn't watch Netflix even if I wanted to cos my eyes won't let me. I couldn't even focus on something long enough,  replying whatsapp was hard and I get agitated so easily.  I also got hungry every 2 hours, I didn't know doing nothing also can hungry 😅 guess the body is working really hard
.
Day 3, which is today. Most aches are gone and whats left is bearable, even the headaches are bearable without medication, tho my arm now hurts and lifting them makes the pain worse. Temperature seems to be ok up till now, looks like I'll be able to finally get some work done since I'm able to type this 🤭
.
Second dose on 5th October, I'm hoping that the side effects would be much lesser...anyone done your second dose of #CucukMyAZ ? Can share with me if there's any side effects?

[關於反芻動物全身麻醉的風險，反芻動物中，全身麻醉的弊大於利。] 有興趣的朋友可以多了解一下喔! (中文翻譯的部分為Google翻譯的，能夠閱讀英文的朋友建議看原文會比較清楚喔)
還有很多很多相關的學術發表，就不貼那麼多出來啦!

Cooper結紮的日期是4月26日，他現在很健康很調皮。

(德叔真的超級超級愛看這些學術發表的文章，但是我還是相信醫生的專業。)

https://www.researchgate.net/publication/334673867_The_Use_of_Epidural_Anaesthesia_over_General_Anaesthesia_in_Ruminants
全身麻醉是現代醫學的重要組成部分。它是一種藥物誘導的可逆病症，包括特定的行為和生理特徵，包括無意識、健忘症、鎮痛和運動不能——伴隨自主神經、心血管、呼吸和體溫調節系統的穩定性。
[反芻動物全身麻醉具有內在風險，如瘤胃內容物反流、唾液分泌過多和肺部誤吸的可能性；因此並不總是推薦使用本地或區域技術。硬膜外麻醉是一種中樞神經阻滯技術，經常用於獸醫實踐中，用於治療家畜會陰、骶骨、腰椎和尾椎部位的不同產科和外科手術干擾。關於在反芻動物和其他物種的各種外科和實驗室程序中使用硬膜外麻醉的科學研究已經有幾項。總之，全身麻醉的弊大於利，特別是在反芻動物中。因此，硬膜外麻醉是首選。

General anaesthesia is an essential component of modern medicine. It is a drug induced reversible condition that includes specific behavioral and physiological traits unconsciousness, amnesia, analgesia, and akinesia- with concomitant stability of the autonomic, cardiovascular, respiratory, and thermoregulatory systems.
[General anesthesia in ruminants has inherent risks such as regurgitation of ruminal contents, excessive salivation and the possibility of pulmonary aspiration; therefore it is not always recommended and local or regional techniques may be used instead. Epidural anaesthesia is a central neuraxial block technique which is used regularly in veterinary practice for treatment of different obstetrical and surgical interferences in the perineal, sacral, lumbar, and caudal parts of the thoracic region of domestic animals. There have been several scientific researches on the use of epidural anesthesia in ruminants and other species for various surgical and laboratory procedures. In conclusion, the disadvantages of general anaesthesia outweigh the advantages especially in ruminant specie. Therefore, epidural anaesthesia is the most preferred.

https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118886700.ch1
瘤胃鼓脹、腹脹、反流和吸入性肺炎是與家畜全身麻醉相關的常見問題，應通過適當的預防措施和必要的麻醉前考慮來預見和解決。家畜在麻醉期間可能會出現胃內容物反流和誤吸，尤其是未禁食的動物。反芻動物在麻醉期間通常會大量分泌唾液。惡性高熱的觸發因素包括壓力（例如興奮、運輸或麻醉前處理）、鹵化吸入麻醉劑（例如氟烷、異氟烷、七氟烷和地氟烷）和去極化神經肌肉阻滯藥物（例如琥珀膽鹼）。同樣，氟烷似乎是豬惡性高熱的最有效和最常見的觸發因素。麻醉前禁食可能不能完全防止反流，但會減少瘤胃內容物中的固體物質數量。獸醫應將這些知識與適當的麻醉前準備和適當的圍手術期管理相結合，以確保這些動物的麻醉成功。
Ruminal tympany, bloat, regurgitation, and aspiration pneumonia are common problems associated with general anesthesia in farm animal species that should be anticipated and addressed with proper precautions and the necessary preanesthetic considerations. Regurgitation and aspiration of stomach content can occur in farm animal species during anesthesia, especially in nonfasted animals. Ruminants normally salivate profusely during anesthesia. The triggering agents of malignant hyperthermia include stress (e.g., excitement, transportation, or preanesthetic handling), halogenated inhalation anesthetics (e.g., halothane, isoflurane, sevoflurane, and desflurane), and depolarizing neuro-muscular blocking drugs (e.g., succinylcholine). Similarly, halothane appears to be the most potent and most frequently reported trigger of malignant hyperthermia in pigs. Preanesthetic fasting may not completely prevent regurgitation, but it will decrease the amount of solid matter in the rumen content. Veterinarians should incorporate the knowledge with proper preanesthetic preparations and appropriate perioperative management to ensure successful outcome of anesthesia in these animals.

昨年の年末に折れた犬歯の治療を行ったネコ吉。
歯にかぶせ物や歯内治療を行った場合は一定の期間が過ぎてから歯と顎の内部の検診が必要で、（昨年ボス吉も別の歯科治療を行っていますが、そちらは経過の診察は必要ありません。）今回ネコ吉は鎮静下で口腔内のレントゲンを撮り、その後の状態に異常がないかどうかを、専門医の先生に診察してもらいました。
先生曰く、同様の治療を行ったケースだと約3％の確率でその後のレントゲン検査で異常が見つかるそうですが、検査の結果、幸いネコ吉は大丈夫だったみたいで、今異常が見られなければ今後はもう検査の必要は無いとの事。

検査時に使った麻酔の影響で帰宅後もしばらくフラフラな状態が続き、そんなネコ吉の様子に大変心配してしまいましたが、数時間後には元の元気なネコ吉に戻ったのでほっとしました(^-^;

ネコ吉は近々目の定期検査も控えているので、そちらもまた追ってご報告します。

【ネコ吉の目の病気について】
ネコ吉の目の状態や現在の様子についてたまにご質問を頂きますが、ご心配を頂いてすみません。
ネコ吉の目は「虹彩メラノーシス」と言う、虹彩の色が徐々に変化していく病気で、年に2回、専門の病院で精密検査を行い、その都度詳しくご報告をさせていただいています。
個別に回答していく事が出来ない為、詳しくは過去動画をご覧いただければと思いますが、虹彩メラノーシスと言う病気はそれ自体、普段の生活に支障や制限が出る事はなく、痛みも全くありません。
ネコ吉の場合は眼圧もずっと正常で、虹彩のシミの状態も半年前の検査の時に比べてほとんど変化が無く、もちろん目を気にしたり、何か行動に変化が生じたりもしていません。
とりあえずそちらの件については検査が終わり次第、また詳しくご説明させて頂きますので、どうぞよろしくお願いします。

☆動画を見て頂き有難うございます☆
当チャンネルでは二匹の猫（ネコ吉＆ボス吉）の楽しい日常や、モノ作りが大好きな飼い主ドラ吉のDIY動画等を公開しています。基本的にお昼に公開しているのがショート動画で、夜に公開しているのがメイン動画です。
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Thank you for watching our videos. On this channel, we have uploaded happy daily life videos of the two cats and DIY for Cats videos. If you like the videos, please register this channel by all means.

【Pastel Cat World】メインチャンネル
https://www.youtube.com/channel/UCq_TsRds1PuHzPfLoSqGyZw

【Pastel Cat World Ⅱ】セカンドチャンネル
https://www.youtube.com/channel/UC7xW_s3Sk3WrNGDTn4_pEhA

【ネコ吉ワールド】（公式HP）
http://xn--tck8b540n.com/

【インスタグラム】
https://www.instagram.com/pastelcatworld/

【TopBuzz】https://www.topbuzz.com/user/6618771975987511302/publish

【ネコ吉LINEスタンプ】
https://store.line.me/stickershop/author/132599

【Eng CC】と言う表記について
一部の動画のタイトルやサムネイルに入っているEng CCと言う表記は、その動画が英語字幕に対応している事を表しています。
Eng CC対応の動画では、動画再生画面右下の字幕アイコンをクリックする事で、英語字幕のオンオフが出来ます。

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MusicMaterial http://musicmaterial.jpn.org/
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Premolar extraction is common in Orthodontic (Braces) treatment. ?
Wonder how long exactly does it take to take out your teeth? In simple & straightforward cases like this...less than a minute!

However, some tooth can be tricky to remove, especially when it has long, bulbous or curvy roots! Root canal treated tooth tend to be more brittle as well and that can increase the difficulty of extraction.

Now the question of the day...is it painful?
With proper anesthesia, you shouldn’t feel any pain apart from mild pressure! ?

Hope y’all learned something new today!

#dentalextraction #toothremoval #extraction #dentistry #premolar #toothless