Richard Anderson

A week should be fine. The data to support most of the herbal/natural medications impacting surgery and/or anesthesia are generally quite weak overall. I would not anticipate your ashwagandha use impacting anything about your surgical course.

Very good question. Having obstructive sleep apnea (OSA) does put you at risk for breathing problems after any surgery. Shoulder surgery can be a bit tricky with OSA; most anesthesiologists will place a nerve block before surgery to help with pain for 1-2 days after the procedure is done. Along with blocking the nerves that provide pain sensation to the shoulder, the nerve to the diaphragm (the phrenic nerve) is often blocked to some degree. This means your breathing may be slightly impaired. This makes the CPAP machine that is used to treat OSA even more important. You will also be prescribed pain medications that suppress your breathing to a degree. It would be best to have a diagnosis of OSA and get a CPAP prior to surgery.
That said, I take care of many patients with undiagnosed OSA and many more who simply refuse to wear the CPAP at night despite knowing they have OSA. If your shoulder is pretty bad it is reasonable to proceed with the surgery and handle the OSA issue afterward. You must still get tested for OSA in the future as it is dangerous in the long run

It is possible to do tonsil surgery under local anesthesia with sedation, but nearly all ENT doctors will ask for general anesthesia with a breathing tube. This means you will be completely asleep for the duration of the surgery.

In most cases, this is done under local anesthesia. This means your doctor will numb the area over the back of your hip bone so it is not painful. In some (fairly) rare cases, mild sedation can be given. Sedation is more common in children, most adults tolerate the procedure quite well without sedation.

You may stop breathing by design; many general anesthetics require us to give muscle relaxants (i.e., "paralytics") that take away the ability to breath. This is why we place breathing tubes and use a ventilator.

In the event that you stop breathing during a sedation-type case, the anesthesia provider can assist you with a mask or place a breathing device. This is actually quite common and typically managed very easily.

Typically we use general anesthesia; this would mean fully unconscious with a breathing tube in place. Some surgeons will do the procedure under spinal anesthesia or a type of nerve block (with some sedation), but the vast majority would use general anesthesia.

There are a handful of bad reactions that can be dangerous, but those are exceedingly rare. The bad reactions that are common enough to discuss include surgical pain, a sore throat from a breathing tube, or nausea/vomiting.

There is really no age that is "too old," and we commonly see ourselves taking care of the > 85 y/o crowd. At 65 years old, you are very far from being considered old and can proceed to surgery without concern for your age...your risk would be defined by the type of surgery and your medical history.

You will be sedated to some degree. There are really 3 options.

1) A light sedation administered by the doctor performing the bronchoscopy.
2) A sedation administered by Anesthesia; this is typically propofol and is similar to a colonoscopy-type sedation.
3) General anesthesia.

Most likely it will be option 1 or 2. As a general rule it is well-tolerated and most patients report the experience as being just fine.

Rarely. Most likely you will receive propofol in the IV and a mask/nasal prongs for oxygen. Few patients remember the procedure, most wake up feeling very good.

Generally speaking, it is not a painful procedure. Most patients have some mild discomfort when the skin and tissue just below the skin are injected with lidocaine to create numbness, but this is done with a very thin needle and it takes a matter of seconds. Once the skin is numbed up, most feel just pressure for the rest of the procedure.

The old view was to "pump-and-dump" for at least 24 hours following a procedure. This view has evolved over time as evidence has become available. It is now quite clear that the level of anesthetic drugs in Mom's blood are very low shortly after surgery, and the breast milk levels are nearly undetectable. Both the American College of Gynecology (ACOG) and American Pediatric Association (APA) recommend breast feeding as soon as the mother feels comfortable...this can start even in the recovery room.