Diprivan has to be a step too far, even for Hollywood doctor with cash loaded MJ and no medical aid authority to justify choice of drugs, compounded by dog eat dog capitalistic mentality feeding trough. Who zaps induction media, diprivan to be specific, the worst as far as respiratory depression is concerned, and turns his back on the patient. A line needs to be drawn, in red I have to add. If one has no theatre, no ventilator and no surgeon to operate no doctor ought to use no diprivan, period.
Any doctor who has ever used diprivan knows it stops people breathing for few minutes after induction. I have used it more than a thousand times and you get the same result, but because the ventilator is connected and ready or you have a bag, you think very little about it. It happens so frequently it cannot be called a side effect no more. If the patient had opiates as a pre medication, the respiratory depression is even worse. The idea I hope was to get MJ to sleep, not stop him breathing, but if the doctor called a student in my 4th year medical class for advice, MJ should still be alive bar further complications. He just had to be assisted respiration wise, which means he had to be there, assisting his breathing until its used up, not balancing his cheque book.
Insomnia is a very common disorder that every doctor should be familiar with. Sleep has two main cycles, REM and nonREM sleep. The quality is in the ratio of the two. Probably just as important as the quantity, therefore justifying naps at work or in narcolepsy. Short and so refreshing compared to all night sleep of an alcoholic that one wakes up from feeling like a dead dog, warmed to pass as alive. Just as bad and not refreshing is the anaesthetic sleep induced by Diprivan.
The aim of the treatment should be to tip the patient into sleep and leave the melatonin to do the rest, and keep sleep cycles as natural as possible. This will hopefully correct the circadian rhythm and set one ready for the following days sleep without need to have another Zolpidem.
Sleep dependent on benzodiazepines is not as fulfilling and addiction will render them ineffective in the long run, not to mention the whacked sleep cycle ratios.
Melatonin as the starting point will at the very least be as natural and ideal as one can get. We have no practical experience other than the studies packaged by the drug companies as part of their licensing. Trusting such as the baseline is like asking the Mercedes car salesman what car is best and taking his advice as the bible?
I have always slept in class. I have recently found American you tubers to be as sleep inducing as Diprivan, without side effects. The tendency to faff around without getting to the point is very effective sleep induction product and will only cost you energy to hold a cell phone to your face for 3 minutes. If only MJ knew this, he might still be moonwalking.
Being isolated as a doctor could make one decay into bad habits in part defense of the guilty doctor. Being capitalistic may even be blamed for patient satisfaction at all costs, but this is not ignorance anymore. It is criminal, black or not.
If biochemistry and physiology of health are the elements of every mix, then results are assured
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