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Michael Jackson family: What justice for his death? Propofol expert answers.
The most meaningful justice for Michael Jackson’s family will to have his death serve as a wake up to all Americans about the critical need for brain monitoring to avoid anesthesia over medication.
FOR IMMEDIATE RELEASE
Newport Beach, California, United States of America (Free-Press-Release.com) April 29, 2011 — No amount of legal defense attorney posturing can relieve Conrad Murray of his responsibility to have watched & monitored his patient,” says propofol expert, renowned anesthesiologist, Barry Friedberg, M.D.
Unlikely the Jackson family will get meaningful justice from the criminal justice system. Even if convicted of involuntary manslaughter, accused Conrad Murray only faces a maximum of 4 years time. Hardly justice for killing Michael Jackson.
Jackson’s death is the sad (and preventable) tale of anesthesia over medication. Yet the vast majority of Americans are routinely over medicated every day when going under anesthesia for surgery. Why? Their anesthesiologist is not measuring their brain.
“Brain monitors are found in 75% of US hospitals, yet only used 25% of the time, mostly because patients simply do not know to ask for one,” says Friedberg.
Anesthesia over medication is especially perilous for people over 50. Nearly 40% of people leave the hospital in a ‘brain fog,’ clinically called Post Operative Cognitive Dysfunction (POCD).
One person dies daily from anesthesia over medication. But death is not the worst result of the nefarious practice of routine anesthesia over medication.
The movie ‘Awake’ terrorized Americans about being awake during surgery. However, waking up in the middle of surgery is a very slight risk that’s 82% reduced when a brain monitor is used.
The most serious risk faced from routine anesthesia over medication is waking up with dementia after anesthesia (DAA) & never again being the same person who went under anesthesia for surgery.
“Going under anesthesia without a brain monitor is like playing Russian roulette with your brain,” says Dr. Friedberg. “You have to live with the long term effects of your short term care.”
The most meaningful justice for Michael Jackson’s family will to have his death serve as a wake up to all Americans about the critical need for brain monitoring to avoid anesthesia over medication.
Goldilocks anesthesia is not too much or too little but always just the right amount.
Over- and under- anesthesia is 2 sides of the same coin: failure to measure your brain!
Download three free letters to help you get Goldilocks anesthesia @ www.drbarryfriedberg.com
19 years & counting…
Today is the 19th anniversary of my first propofol ketamine anesthetic that was given at a Newport Beach plastic surgeon’s office!
Propofol ketamine is the ‘lemonade’ I made from Martha’s ‘lemon’ or avoidable demise.
Had it not been for this plastic surgeon’s refusing to allow me to use narcotics or smelly gases, I would have never been motivated to find an alternative anesthetic paradigm.
Little did I know, 19 years ago, how dramatically for the better that motivation would change the lives of my patients as well as my professional life.
Louis Pasteur said, ‘Luck favors only the prepared mind.’
So when I heard Charles Vinnik talk about Valium-ketamine anesthesia @ the Hyatt Newporter in December 1991, I was ‘prepared’ to seek an alternative.
My first insight was finding that sleep doses of propofol blocked ketamine hallucinations every bit as well as Vinnik’s Valium.
Later, once I saw that giving 50 mg ketamine (aka the ‘nifty fifty’) before injecting the patient would prevent surgeons from inflicting pain on their unconscious, helpless patients, it became a matter of conscience to no longer give narcotics or smelly gases for cosmetic surgery.
Incorporating the brain monitor in December 1997 allowed others to reproducibly create my paradigm as well as giving every patient a custom tailored experience as opposed to ‘one size fits most’ anesthesia.
However, it was not until I experienced the absence of pain for 4 days after my own total hip replacement in May 2008 that I realized the ‘nifty fifty’ was applicable to any time the skin is breached for surgery.
While writing ‘Getting Over Going Under’ to help the general public deal with anesthesia fears, Michael Jackson died from unsafe propofol administration. I knew that I needed to add comment about his avoidable death to my book.
Brain monitoring would have enabled Conrad Murray to tell the difference between the benzodiazepine and propofol effect in Michael Jackson’s body. Jackson would still be alive today had this monitoring been used on him.
Brain monitoring is the 21st century standard for anesthesia care & propofol ketamine is the safest anesthetic.
Why do doctors play Russian roulette with patients’ brains – OpEd
OPINION, March 22, 2011 /Christian Newswire/ — The following is submitted by Barry Friedberg, M.D.:
Every time a patient has anesthesia for surgery or a medical procedure there are the dual risks of under-medication with waking up too soon or over-medication and having your brains scrambled. The anesthesiologist can get close to determining the correct dose using traditional protocol that involves an elaborate piece of guesswork no more reliable than the comical huckster who guesses your weight at the carnival.
Of the two risks, over-medication is the greatest because it can trigger Alzheimer’s-like dementia that does not go away. Patients always need to remember that they have to live with the long-term consequences of their short-term anesthesia care. Today patients must absolutely insist on waking up the same person they were before going under.
Unfortunately, almost all anesthesiologists gauge anesthesia response using the classical but, notoriously unreliable, signs of heart rate and blood pressure changes. Most do not rely upon a brain monitor, the best available technology to avoid either over-medication or under-medication.
The first practical brain monitor received FDA approval in 1996 and has been validated in more than 3,500 published scientific studies. The brain monitor can be found in 75 percent of American hospitals but yet is used only 25 percent of the time. Without direct brain response measurement, anesthesiologists are obliged to over-mediate for fear of under medicating (anesthesia awareness).
The dire consequences of anesthesia over-medication include one death every day and up to 40 percent of patients leaving the hospital in a brain fog (technically called Postoperative Cognitive Dysfunction or POCD) that can last as long as a full year after surgery.
Even worse than death or POCD is the major tragedy of patients condemned to the living death of dementia after anesthesia (DAA). Until brain monitoring becomes the 21st century standard of care, we will never know the true incidence of DAA.
Going under anesthesia without a brain monitor is like letting someone play Russian roulette with your brain. Measuring is always better than guessing. The next time you or a loved one goes under for surgery, it is your undeniable right to demand a brain monitor.
In fact, in the April 11, 2011 issue of “Current Opinion in Anesthesiology,” they conclude: “Given the trivial cost of the BIS (brain monitor) and the proven benefits demonstrated in prospective randomized studies, we consider its use justified in every general anesthetic.”
About Dr. Barry Friedberg
Dr. Barry Friedberg, author of Getting Over Going Under, is the #1 authority in the nation on anesthesia for cosmetic surgery. A board certified anesthesiologist for more than three decades, Dr. Friedberg is a propofol expert and has been interviewed by FOX, CNN, True TV, and People Magazine about the misuse of propofol in the death of Michael Jackson. Dr. Friedberg has been published and cited in numerous medical journals and textbooks. He was awarded a U.S. Congressional award for applying his methods on wounded soldiers in Afghanistan and Iraq. www.drbarryfriedberg.com, Getting Over Going Under: 5 Things You Must Know Before Anesthesia (ISBN 978-0-9829169-0-2, 2010, Goldilocks Press, 116 pages, $18.95).
Photo Available
Media Contact: For a review copy of Getting Over Going Under, or to schedule an interview with Dr. Barry Friedberg, please contact Scott Lorenz, President of Westwind Communications Book Marketing, Cell: 248-705-2214 or scottlorenz@westwindcos.com or www.westwindcos.com/book.
http://www.christiannewswire.com/news/2003716532.html
Increasing Safety in Anesthesia – Using a Brain Monitor
Posted on February 15th, 2011 February 15th, 2011
A special message from Amiya Prasad, M.D.:
I just returned from a conference in Charlotte, North Carolina run by Dr. Barry L. Friedberg. If you’ve been keeping up with the trial of Dr. Conrad Murray, who was the physician who administered propofol to Michael Jackson, you would recognize Dr. Friedberg as being a vocal advocate for patient safety through proper monitoring. Having met Dr. Friedberg at a Cosmetic Surgery Conference (The Annual meeting of the American Academy of Cosmetic Surgery), I was very impressed by his knowledge in providing anesthesia in a safer way using a brain monitor. During surgery, we routinely monitor the heart rate, blood pressure, oxygen levels in the blood and the EKG (electrocardiogram). Ironically, it’s not been routine to monitor the brain which is the organ that the sedation is working on. I incorporated the use of a brain monitor (also called a BIS Monitor), to monitor the level of sedation being given to our patients during surgery and have been absolutely delighted. Although this technology has been available for more than 10 years, very few operating facilities use BIS monitors. I’m very fortunate to have met Dr. Friedberg and my patients now benefit from his experience. To encourage people to advocate for themselves when it comes to proper and safe anesthesia during any surgery (not just Cosmetic), Dr. Friedberg created “The Goldilocks Foundation” [http://www.goldilocksanesthesiafoundation.org/] . Essentially it’s important in the modern era of health care for people to advocate for themselves. Dr. Friedberg advises to ask the question “Do you use a brain monitor when I will be under anesthesia?”
The practice of medicine requires a lifetime commitment to learning and flexibility to provide the best care for our patients. Unfortunately, the practice of plastic surgery tends to be inflexible and focused on the use of general anesthesia which in my opinion is more for the surgeon’s convenience rather than the patient’s in many cases. As it has been my focus to perform natural aesthetic procedures which are safe, under local anesthesia with light sedation and with a quicker recovery, Dr. Friedberg’s contribution to my practice through his experience is truly appreciated.
Do Your Brain a Favor… Book Review
Author: Bob Etier
Published: November 17, 2010 at 9:19 am
Every day you brings you closer to the day when you will undergo surgery. It’s just a matter of odds—the longer you live, the higher the chances you will need surgical intervention of some type. Or maybe you need to have that bump on your nose straightened out, your breasts enlarged, or your face lifted. Whatever the procedure, you will need to be anesthetized (you know, knocked out). Barry L. Friedberg’s latest book, Getting Over Going Under reveals what you need to know to improve your surgical experience.
“Your surgery will be May 13, and your anesthesiologist will be Dr. So-and-So (of the Chicago So-and-So’s)…” your surgeon—or more likely his nurse or scheduler—says. Most of us leave it at that. We are so concerned about our surgery and its outcome, that we’re not thinking about our poor little brains and what could happen when we’re in drug-induce dreamland. Most patients are aware—or should be, since they signed that little piece of paper—of the risks of anesthesia. They include nausea, dizziness, hallucinations, brain damage, dementia, and death. However, Dr. Friedberg assures us that none of those things will happen if we take a more active part in choosing who will knock us out and how.
In Getting Over Going Under, Friedberg describes the “Goldilocks” method of anesthesia, in which the dosage is not done by guesswork but by using a brain monitor, a specific anesthetic drug (propofol), and something to fool your brain into thinking it’s not experiencing pain (ketamine). He also devotes a chapter to Michael Jackson and propofol, the drug that precipitated his death (the drug is vindicated; Jackson’s doctor is not).
Using the Friedberg method, following surgery the patient will wake up and be the person he or she was before anesthesia. Nausea and vomiting, intense pain, dizziness and other undesirable side effects do not occur. Also, patients will not wake up during surgery.
If Goldilocks anesthesia is so effective and safe, why don’t all hospitals and anesthesiologists offer it? In presenting his case, Friedberg examines reasons that this method is not embraced by all. I know you’re not going to believe this, but pharmaceutical company profits figure in.
Friedberg also explains patients’ rights and what a patient must do in order to get the anesthesia of his or her choice. Getting Over Going Under supplies the information patients need to improve the safety and success of their surgical experiences
Read more: http://technorati.com/lifestyle/article/do-your-brain-a-favor-read/#ixzz16VI9FMOM
Amazon.com book review for ‘Getting Over Going Under’
http://www.bookpleasures.com/websitepublisher/articles/2966/1/Getting-Over-Going-Under-5-Things-you-Must-Know-before-Anesthesia-Reviewed-By-Fran-Lewis-of-Bookpleasurescom/Page1.html
A Great Book About Anesthesia
Thursday, September 2, 2010
A Great Book About Anesthesia
I recently wrote about conquering your fear of anesthesia. Now there’s a book that covers this topic in great detail called Getting Over Going Under: 5 Things You Must Know Before Anesthesia by Barry L. Friedberg, MD.
I know Dr. Friedberg very well because he gives anesthesia for many of our cases. He is at the forefront of a trend to minimize the use of routine, full general anesthesia for cosmetic surgery cases where it is not necessary.
The technique that Dr. Friedberg has long championed, and with good reason, is called P-K anesthesia. “P” stands for propofol and “K” stands for ketamine.
Propofol is one of the great anesthesia advances of our time. The milky liquid, given intravenously, puts the patient asleep but does not render the patient unconscious. For that reason, it is a very safe and practical anesthetic. Another plus is it wears off very quickly. Now this medicine must be given in conjunction with the ketamine. Not only does the patient go to sleep, but is placed first into a state of “dissociation” where they are totally detached from the environment and have no awareness of going to sleep. Ketamine is also a very safe drug, but, of course, all drugs when given in an operating room need to be monitored by an anesthesia specialist.
Monitoring is a very important part of this technique. Dr. Friedberg uses a brain monitor, which tells the doctor at what level the brain is aware. It functions just as an electrocardiogram tells the cardiologist the status of the heart. The brain monitor is a very simple electronic device with a “lead” that attaches to the patient’s forehead and is merely held in place with some adhesive.
The wisdom and value of this technique is that the brain wave monitor tells the anesthesia specialist exactly what level the brain is receiving input and is “asleep.” At the same time, the brain wave monitor also monitors electrical contraction of the muscles which is another tip-off as to the level of anesthesia.
Understand that the technique is not a substitute for a full general anesthetic, but it is very appropriate for cosmetic surgery where the surgeons inject local anesthesia. Nearly every cosmetic procedure requires local anesthesia to numb the tissues and to shrink the blood vessels. For this reason, the wedding of a well-performed local anesthesia block by the surgeon and the intravenous P-K anesthetic technique is ideal.
Patients are amazed to find that they wake up very quickly with no grogginess nor any nausea and vomiting. During the operation, there is no tube placed in the nose or throat. Some patients have oxygen delivered through a very small tube in the nose but are totally unaware of this.
The technique is simple and elegant and I am very pleased that Dr. Friedberg now has a book to share his experience with the public.
- Robert Kotler, MD, FACS
Had a positive or negative experience with anesthesia? Post your comments about anesthesia and cosmetic surgery on the Skin and Beauty Community.
Posted by: Robert Kotler, MD, FACS at 9:47 am
Michael Jackson’s Doctor Murray’s recent hearing
LOS ANGELES, CA – AUGUST 23: Barry L. Friedberg, M. D. , signs a copy of his book in front of the courthouse during the preliminary hearing for Dr. Conrad Murrary at the Los Angeles courthouse on August 23, 2010 in Los Angeles, California.
FOX News’ Harris Falkner interviews Dr. Friedberg
Monday, August 23, 2010, via satellite, FOX News’ Harris Falkner interviewed Dr. Barry Friedberg about Goldilocks Press’ recently published Getting Over Going Under and the Conrad Murray/Michael Jackson story. One of the most serious risks of anesthesia without a brain monitor is a permanent, Alzheimer’s like dementia.
Since the interview took place for the FOXNews.com web cast, no video clips were possible to obtain for this site.
However, no sooner had the interview concluded than my LA camera man excitedly said, “Dementia? That’s exactly what happened to my mother. She fell down and broke her hip. After her surgery, she was demented for the last 13 months of her life which were spent at a nursing home at the cost of more than $80,000.”
Michael Jackson Physician, Dr. Conrad Murray Will Go to Jail
Expert Anesthesiologist Thinks Michael Jackson’s Physician, Dr. Conrad Murray Will Go to Jail
http://www.michaeljackson.com/us/node/917514
Albeit in a non-surgical setting, nevertheless Michael Jackson died from anesthetic overdose.
The message of the newly published ‘Getting Over Going Under’ book is to educate the general public of the need to demand a brain monitor when going under anesthesia precisely to avoid anesthetic overmedication – a routine, yet nefarious 20th century practice prior to the introduction of a simple device to directly measure patient’s brain response to anesthetic drugs.
If convicted, Murray only faces a maximum of 4 years in addition to the loss of his medical license. The Jackson family rightly wants justice for Michael.
The real justice for the grieving Jackson family will be seeing his death not being in vain but helping tens of millions of Americans from being over medicated.
Prevent Post-op Delirium
Preventing Post-op Delirium in May 2010 Outpatient Surgery Magazine
This month’s Outpatient Surgery Magazine features a neat little article on how to prevent post-op delilrium. http://www.outpatientsurgery.net/issues/2010/05/anesthesia-alert
Must have been written by an apologist for the American Society of Anesthesiologists. Never once in the differential diagnosis of post-op delirium was the issue of anesthetic over medication considered and the possibility of radically mitigating (or even eliminating) post-op delirium by measuring the organ our anesthetics measure – the brain!
Also neglected in the author’s analysis was that anesthesia over medication was responsible for nearly one death a day between 1999-2005. (Li G, Anesthesiol Apr. 2009) What part of ‘medicate the brain – measure’ it escaped the author’s analysis?
Patients over 50, beware of anesthesia without a brain monitor! The voice of Goldilocks Anesthesia Foundation (.org) has spoken.
Fatal Dangers of Going Under: What EVERY Patient Should Know
Anesthesiologist Warns of Fatal Dangers of Going Under: What EVERY Patient Should Know Before Surgery
My article was published by The National Health Federation on April 22, 2010.
Read it here:
http://www.thenhf.com/articles/articles_1120/articles_1120.htm
Happy days in warm Hawaii
While most of the country is freezing, my new bride and I made a return to the North Shore of Oahu for honeymoon 1.2 in balmy 80 degree weather.
We were here last month, but as luck would have it, Shelley was sick with that nasty coughing virus that’s been going around. She is feeling better this trip but still recovering.
While we were here in December for honeymoon 1.1, at the invitation of chairman Dr. Don Parsa, I gave a talk to the plastic surgeons at Queens Medical Center. He was so pleased by the content (& delivery) of the talk, ‘What killed Michael Jackson & how to make office anesthesia as safe as possible,’ that he invited me back this month to speak to the Biennial meeting of the Pan Pacific Surgery society on Tuesday, Jan. 12th.
I was also interviewed for Dr. Denise Davis’ radio show in Cincinnati for an hour long show this morning while watching the fabulous surf roll in at Turtle Bay Resort.
Instead of continuing to ‘bang my head against the wall’ of a largely indifferent anesthesia establishment, I am finding greater pleasure going where people are at least open to the idea of patient-centered ‘Goldilocks’ anesthesia – that which is not too much, not too little but always just right because it is driven by the individual patient’s brain response.
I am confident that ‘Goldilocks’ is no fairy tale.
The forces of reactionaryism can only prevail for so long in the face of a cost-effective, simpler, safer anesthetic that yields demonstrably better outcomes.
Measure the brain
Preempt the pain
‘Gag me’ drugs abstain
Aloha!
