Episode 158: Keywords part 8-hepatic disease for the advanced exam and PACU for the basic exam with Gillian Isaac

In this 158th episode we return with another keywords episode with Dr. Gillian Isaac. We discuss hepatic disease for the advanced exam and PACU care for the basic exam.

Random recs:

Cloud Atlas: https://www.amazon.com/Cloud-Atlas-Novel-Liam-Callanan/dp/0385336950

Wolf Hall: https://www.amazon.com/s?k=wolf+hall+by+hilary+mantel&i=stripbooks&crid=2F978D2O2UCW&sprefix=wolf+hall%2Cstripbooks%2C135&ref=nb_sb_ss_i_1_9

Bottle of Lies: https://www.amazon.com/Bottle-Lies-Inside-Story-Generic-ebook/dp/B07JG49BQW/ref=sr_1_1?keywords=bottle+of+lies&qid=1581089047&s=books&sr=1-1

Thanks to Brian Robinson for pointing out: reversal of  rocuronium with Sugammadex can occasionally cause severe bronchospasm, especially in higher doses, and this was one of the reasons its release was delayed in the U.S.

Although most sugammadex hypersensitivity reactions cause mild symptoms such as sneezing, nausea, rash, and urticaria, there is a small but finite risk of anaphylaxis with potentially life-threatening symptoms such as airway edema, bronchospasm, and cardiovascular collapse.
www.apsf.org › article › sugammadex-the-anaphylactic-risk

Episode 157: Intermittent Fasting with Mark Mattson

In this 157th episode I welcome Dr. Mark Mattson to the show to discuss the science behind intermittent fasting including in the perioperative period.

Dr. Mattson’s review from NEJM: https://www.nejm.org/doi/full/10.1056/NEJMra1905136

Dr. Mattson’s Tedx Talk: https://www.youtube.com/watch?v=4UkZAwKoCP8

Episode 156: Personal Finance and Burnout with Jimmy Turner

In this 156th episode I welcome Dr. Jimmy Turner to the show to discuss the intersection of personal finance and physician burnout.


Dr. Turner’s about page: http://thephysicianphilosopher.com/about/

Dr. Turner’s website: https://thephysicianphilosopher.com/

Dr. Turner’s new podcast: http://moneymeetsmedicine.com/

Blogpost about burnout and finance: https://thephysicianphilosopher.com/what-causes-physician-burnout/

How to think about Money book: https://www.amazon.com/Think-About-Money-Jonathan-Clements/dp/1523770813

If You Can free PDF book: https://www.etf.com/docs/IfYouCan.pdf

Leaders Eat Last: https://www.amazon.com/Leaders-Eat-Last-Together-Others/dp/1543614620

Episode 155: Opioid-Free Anesthesia with Michael Manning

In this 155th episode I welcome Dr. Michael Manning to the show to discuss opioid-reduced and opioid-free anesthesia. We discuss the downsides of opioid usage and what we can do to reduce our use in our patients or even eliminate it completely.


1. Koepke EJ, Manning EL, Miller TE et al. The rising tide of opioid use and abuse: the role of the anesthesiologist. Perioper Med (Lond) 2018;7:16.

2. Brummett CM, Waljee JF, Goesling J et al. New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults. JAMA Surg 2017;152:–e170504.

3. Manchikanti L, Helm SI, Fellows B et al. Opioid Epidemic in the United States. Pain Physician 2012;15:ES9–ES38.

4. Gan TJ, Habib AS, Miller TE et al. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin 2014;30:149–60.

The Road Less Stupid: https://www.amazon.com/Road-Less-Stupid-Keith-Cunningham/dp/0984659269

Armchair Expert Interview with Ira Glass: https://armchairexpertpod.com/pods/ira-glass