Dr. Nicholas J. Marsh, DO

Anesthesiologist

44045 Riverside Pkwy Anesthesiology Waterford Virginia, 20197 Show map

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About

Dr. Nicholas Marsh is an Anesthesiologist and Medical Cannabis Consultant in Sterling, VA where he has practiced for 30 years at Inova Loudoun Hospital Center. As an anesthesiologist, Dr. Marsh specializes in managing pain, stress and anxiety in the perioperation area and beyond. Dr. Marsh has additional interest in helping patients with medical cannabis therapy. His extensive clinical experience makes him uniquely qualified to evaluate the benefits and risks of therapies like medical marijuana. “The evidence is overwhelmingly supportive for cannabis helping in a wide variety of clinical applications, particularly in managing stress, anxiety, pain and immune disorders” he explains. As the founder of ReThink-RX, an online medical cannabis certification practice, he and his team deliver consultation, care and certifications to patients throughout the commonwealth of Virginia. Medical cannabis treats many ailments including anxiety, pain, sleep disorders, eating disorders, fibromyalgia, cancer, PMS and more.

Education and Training

Ny Coll Of Osteo Med Of Ny Inst Of Tech- Old Westbury Ny 1988

Board Certification

AnesthesiologyAmerican Board of AnesthesiologyABA

Provider Details

MaleEnglish

Dr. Nicholas J. Marsh, DO

Dr. Nicholas J. Marsh, DO's Expert Contributions

My Latest Posts
My Answers

Nature’s Balance: The Remarkable Science of the Endocannabinoid System
The endocannabinoid system (ECS) is a remarkable and intricate network of signaling molecules and receptors that play a crucial role in regulating various physiological processes in the human body. Discovered in the late 20th century, the ECS has since become the focus of extensive research,...
Medical Marijuana: Debunking Common Myths and Misconceptions
Medical marijuana has been a topic of significant debate and controversy over the past few decades. As an alternative form of medicine, it has garnered both staunch supporters and vehement opponents. The debates surrounding medical marijuana are often fueled by various myths and misconceptions that...
Cannabis: Nature's Sleep Aid
We've all heard the phrase, "Sleep is the best medicine." And while it might sound like a quaint adage, modern science is showing us that there's profound truth in those words. A good night's sleep is not just a luxury; it's a fundamental necessity for maintaining physical and mental well-being. As...
How to Get Approved for Medical Marijuana in Virginia
Marijuana is now legal in Virginia, but you still need a medical marijuana card to buy it. Luckily, the newest dispensary opens soon in Sterling. Learn how to get approved for medical marijuana by certified cannabis doctors, right on your phone or computer.Many Virginians may not be aware that they,...
Medical Marijuana and Lyme Disease
Lyme disease is prevalent in Virginia, especially in Northern Virginia. But people of any age and in any part of the state can get the disease. If you, or someone you know, has Lyme disease you know just how devastating it can be.Infections occur throughout the year but are more common during the...
Local Doctors Endorse Medical Marijuana
It may be new that medical marijuana is becoming more commonplace in this country, but the use of marijuana to treat pain, stress, anxiety as well as a variety of other medical conditions, is anything but new. Now legalized in Virginia, a new enthusiasm is developing in our local medical community...
COVID-19, Anxiety, and Cannabis
30 years as a practicing anesthesiologist comes with some benefits. I am considered by many of my medical colleagues as an “expert’ in managing stress, anxiety, and pain- together with being a master of critical care medicine practiced in the OR. But, inside, I feel my practice has been...

Do you get general anesthesia during tonsillectomy?
Yes. Getting a tonsillectomy requires general anesthesia. Since the operation involves work in your throat, it is essential to secure the ability to breathe during the procedure safely. Once general anesthesia is induced, your anesthesia provider gently places a breathing tube to keep you safe while the surgeon does their work. READ MORE
Is colonoscopy done under local anesthesia?
No. Local anesthesia is not used for colonoscopies. Typically, colonoscopies are performed under sedation anesthesia. Since colonoscopies may feel crampy and uncomfortable, sedation allows for comfort to the patient while optimizing the conditions for the endoscopist. Usually, short-acting medicines like Propofol are used so the recovery time back to full consciousness is short. READ MORE
Can general anesthesia cause stomach issues?
Despite improvements in anesthesia, surgical techniques, and preventative medicines, post-operative nausea and vomiting may still sometimes occur, particularly following general anesthesia. Several things may contribute to this including surgical procedure and site, use of narcotic pain medicines, use of preventative nausea medicine, and the sensitivities of each patient. Younger, non-smoking females are most likely to develop this problem, especially if they have a history of motion sickness. While unpleasant, these symptoms will typically only last a short while. READ MORE
How soon after anesthesia can you drive?
That's a good question. In general, it is considered reasonable that anyone receiving anesthesia of any kind, even sedation, should wait at least 24 hours before getting behind the wheel of a car. The anesthesia medicines used for general anesthesia especially, can have a prolonged residual effect that may impact your reflexes enough to impair your ability to drive safely. Vapor (gas) type medicine, for example, will largely dissipate shortly after initially being turned off. This why you awaken quickly after surgery. But not all of the medicine leaves your system immediately. Some of this gas medicine will "redistribute" to tissues like fat or bone, from where they will continue to slowly leak until all of it has gone from your system. Because those tissues get a lower blood flow, this residual gas medicine may take a long time to leave, days in some cases. So, even though you feel awake, there may continue to be some residual impairment of your reflexes. Other factors may also impact on your ability to drive safely. Pain medicine after a surgery may impact your response times. Discomfort from the surgery itself may also impede your ability to respond quickly. Everyone's sensitivity to these factors is different. Bottom line: listen to the recommendations of your surgeon, anesthesiologist and nurses regarding when you can safely return to driving. READ MORE
Can anesthesia cause emotional problems?
Anesthesia involves the use of a variety of medicines with a variety of goals. Before going to sleep, calming medicines are often given to reduce situational anxiety. Going to sleep usually involves a “hypnotic,” or sleep-inducing medicine. Remaining asleep frequently involves a vaporous medicine. Before awakening, medicines for pain relief and nausea control are often provided. Awakening from anesthesia typically involves withdrawing the vapor medicine with a gradual emergence as you breath out the medicine. While in most people, the awakening phase is gradual and relaxed, in some a more vibrant or exaggerated awakening can occur. When emotions are exaggerated like this it is called “disinhibition” and can result in unpredictable elevated effect (happy drunk) or other escalated emotions like sadness or dysphoria. These emotional events almost always result from some level of confusion caused by awakening, so called emergence delirium. Once you have regained your bearings, prolonged emotionality is rare. What causes these emotional responses is not completely clear, but they are most often associated with the vaporous anesthesia medicines. Since the effects of anesthesia medicines are very short-lived once discontinued, any persistent emotional effects are usually the result of something else such as pain medicine. READ MORE
Does anxiety affect anesthesia?
Anxiety, whether short-lived situational anxiety or life-long generalized anxiety, is something commonly encountered by anesthesiologists. Anxiety calming medicines (anxiolytics) are commonly used to help patients manage with the stress of surgery. If you suffer from anxiety, it is helpful to let your anesthesia provider know so that they can anticipate your needs and help. Sometimes the medicine you take regularly for treating anxiety may increase the dose requirements in the OR. It is not uncommon that people with severe anxiety may need more anesthesia than others during surgery. It is a combination of normally heightened awareness coupled with chronic anxiolytics that usually results in these observed greater requirements. READ MORE
What happens if you stop breathing during anesthesia?
Anesthesia providers are highly trained and skilled providers who will be present and attentive to you the entire time you are asleep. The basic elements of safe anesthesia care start with A B C. Airway, breathing and circulation. Your provider will be paying close attention continuously to these. Anesthesia care frequently suppresses breathing drive, amongst other things. It is an anticipated event in many cases and it is one that every anesthesia provider is skilled at managing. Sometimes simple positioning maneuvers or placement of an artificial airway is what is needed. Sometimes more help by using a mask with positive pressure or a breathing tube may be indicated. Whatever measures are needed, the anesthesia provide will deliver. That’s their job. READ MORE
Are you unconscious during oral surgery?
Whether or not you are asleep for oral surgery depends on several factors. The surgeon, in conjunction with the anesthesiologist, will determine whether sedation or general anesthesia is indicated. Factors that influence this decision include patient factors (age, medical condition, preference, etc.), the extent and type of surgery and the availability of trained personnel and equipment to provide the anesthesia. Sometimes oral surgeons and dentists will administer their own sedation, including nitrous oxide. But that kind of sedation is usually aimed at provided a calm experience rather than an “asleep” experience. If you are planning to have oral surgery, be sure to ask your surgeon about sedation and anesthesia options. READ MORE
Is spinal anesthesia used for hemorrhoidectomy?
Spinal anesthesia is only rarely used for surgery on hemorrhoids. With new medicines and techniques, a brief general anesthesia is generally an excellent choice for a pleasant experience and prompt recovery with quick discharge. READ MORE
Is a bronchoscopy done under general anesthesia?
The actual technique used will vary depending on the preference of the pulmonologist and anesthesiologist, and the illness of the patient. But, for a lot of patients, general anesthesia can be used safely and comfortably. READ MORE
Do you get anesthesia for ankle surgery?
Definitely. Most ankle surgery is performed under general anesthesia. Post-op pain management for this kind of surgery may also include a nerve block performed by the anesthesiologist. Newer drugs and techniques can result in prolonged pain relief with these blocks. READ MORE
What kind of anesthesia is used for a colonoscopy?
Colonoscopies are usually performed under either conscious sedation (given by the endoscopist) or intravenous general anesthesia given by an anesthesia provider. The medicines for this kind of general anesthesia often produce a profound sleep but rapid emergence and recovery with few side effects. READ MORE
Do you need anesthesia for radiation therapy?
Most radiation therapy does not require anesthesia unless there is surgery involved. Some radiation therapy involved surgery to place radioactive materials in the body as therapy. READ MORE
What kind of anesthesia is used for kidney stone removal?
Kidney stone removal almost always involves general anesthesia. The ureters are the little tubes that connect the kidneys to the bladder. The urologist must pass an instrument up the ureter to extract the stones and these tubes are extremely sensitive. Without anesthesia this surgery is not possible. Rarely, regional anesthesia, like spinal anesthesia, may be used. READ MORE

Expert Publications

Data provided by the National Library of Medicine

Areas of expertise and specialization

AnesthesiologyMedical Cannabis Therapy.

Faculty Titles & Positions

Attending Anesthesiologist Inova Loudoun Hospital Center 1992 - Present

Professional Memberships

Society Cannabis Clinicians
American Society of Anesthesiologists
American Medical Association
American Medical Marijuana Physicians Association.
Loudoun Medical Society
Virginia State Society of Anesthesiologists

Internships

Long Beach Memorial Hospital, Long Beach New York

What do you attribute your success to?

Perseverance, compassion and involvement. The true rewards in medicine come with each and every patient interaction. I believe in science and objective data. Whether I am evaluating a new anesthesia medicine or technique, or evaluating the evidence regarding medical cannabis, objectivity is essential to guide responsible decision making. Other people can have their opinions, I need the facts.