Dr. Gary Roach
Anesthesiology
San Francisco, CA
44 years experience male
Locations
The Permanente Medical Group
About
SpecialtiesDoctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.
Doctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.
Anesthesiology
Languages spoken
English
Doctor Q&A
123 Answers
50 Agrees
The number of answers this doctor has agreed with.
A 33-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Multiple ways: The are multiple causes for leaky heart valves. Some of the most common causes are: congenital (born that way), rheumatic disease, deterioration over... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 41-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Performs the exam: The echocardiogram technician actually performs the echocardiographic exam. Most centers have a routine "complete" examination, but sometimes very sp... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsAnswered >2 years ago
A 33-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
You should not: Drugs llike oxycodone should only be used when you have pain, not in anticipation of a procedure.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 40-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Yes: No steroidal anti inflammatory agents such as toradol can be used. Intravenous Acetaminophen is also an option. Either of these types of drugs can b... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 44-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Lots of variation: Everyone reacts to anesthesia differently, although we tend to rely on "normal response" which is really just an average. There are a number of facto... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsAnswered >2 years ago
A 45-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Very rare: True Lidocaine allergy has been reported in less than 0.3% of people who get skin tested. Most people who report Lidocaine allergy experienced sympto... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsAnswered >2 years ago
A 30-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Not technically: Hydrocodone is derived from codeine, but does not actually contain codeine. Both are narcotics, but hydrocodone is more potent.
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsAnswered >2 years ago
A 46-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
2 different things: "normal heart) likely refers to the function of your left ventricle (the main pumping chamber of the heart). Leaking aortic valve means some of the b... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 33-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Relatively painless: Spinal anesthesia is normally relatively painless. You should only feel a mild stinging when they numb the skin prior to insertion of the spinal need... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
No: Increased platelet count is a normal reaction following surgery. It is not related to anesthesia.
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 37-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
No: Mild valvular insufficiency is common and does not cause problems. It may be worth periodic echocardiographic follow up to ensure the valves do not g... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 50-year-old male asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Yes: These drugs work by different mechanisms, have different side effects, and can be complementary.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 70-year-old male asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Probably: Rate control drugs are often prescribed for atrial fibrillation. If it is recurrent and/or lasts >24 hours you may need blood thinners as well. D... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.6k viewsReviewed >2 years ago
A 30-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Not really: They can help alleviate the discomfort, but will do nothing to improve the swelling or underlying condition.
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 33-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
You should not: Obviously this depends on the integrity of the person receiving the mistaken prescription. The person should return the drug.
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 43-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Depends: Cataract surgery is usually done with local anesthesia and sometimes intravenous sedation. An anesthesiologist is not necessary, but many facilities ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 50-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
See cardiologist: A new myocardial infarction (heart attack) on ekg is a serious finding that warrants a cardiology consultation. Likely you will be advised to undergo... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 22-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Probably not: Unless you have additional valve pathology such as significant stenosis or regurgitation, it is unlikely. Many people have some mitral valve prolapse... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.8k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Possibly.: Both are potential side effects of Norco (hydrocodone and acetaminophen). You shouldn't drive or operate heavy machinery while taking the drug. If y... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.1k viewsReviewed >2 years ago
A 48-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Like a pinch: There is usually a very brief stinging sensation such as being pinched.
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 47-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
As high as necessary: The dose of spinal anesthesia is adjusted depending on the height of numbness needed for the procedure. It typically is somewhere between the lower a... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 37-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Discuss with doctor: The best advice is probably to discuss your concerns in detail with your anesthesiologist. The vast majority of anesthetics are extremely safe and ha... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 32-year-old member asked:
Why are you not supposed to eat or drink anything for 6 hours prior to having a general anaesthetic?
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Prevent aspiration: During anesthesia you might regurgitate stomach contents. Since the airway reflexes are also anesthetized, this might enter the trachea and lungs whe... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Yes but not safe: It is possible to withdraw from opiates cold turkey, but not advise able. There can be serious and sometimes life-threatening physical side effects f... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 23-year-old male asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Probably not : It would be highly unusual for a 24 year old to have significant atherosclerosis.
Other tests would include vascular ultrasound and stress tests.
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 23-year-old male asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Structural problems: A number of structural problems with the heart can cause irregular heartbeats and can be detected with echocardiography. A normal echocardiogram mean... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 47-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Depends: Different opiates are metabolized differently. It takes about 4 half-lives to be 95%excreted.
Created for people with ongoing healthcare needs but benefits everyone.
4.7k viewsReviewed >2 years ago
A 39-year-old male asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
It varies: That will depend on what medications you are taking, their dosages, and baseline blood pressure previously. You should continue monitoring your blood... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.5k viewsReviewed >2 years ago
A 31-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Probably not: Mild aortic insufficiency (leakage) is not uncommon and usually does not progress to a problematic stage. Her doctors should be informed of this and ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.6k viewsAnswered >2 years ago
A 39-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Gas is general anest: Gas is general anesthesia. The exception would be nitrous oxide which can only be used alone for minor surgery.
Created for people with ongoing healthcare needs but benefits everyone.
4.6k viewsAnswered >2 years ago
A 39-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
No: It's not a narcotic although the mechanism of action for analgesia is not known.
Created for people with ongoing healthcare needs but benefits everyone.
4.8k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Hopefully neither: Sedatives and tranquilizer a should be used for their calming effects. Occasionally sedatives might be used to induce sleep. An overdose would resul... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 33-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
No: This is a local anesthetic which has no therapeutic benefit for acne.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 45-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Local anesthetic: These patches contain lidocaine, a local anesthetic. It is absorbed directly into the skin causing a numbing effect.
Created for people with ongoing healthcare needs but benefits everyone.
4.8k viewsReviewed >2 years ago
A 71-year-old male asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Probably not: For most adults this is unnecessary and adds some potential risk. Some sedation is okay but unconsciousness is not desirable.
Created for people with ongoing healthcare needs but benefits everyone.
4.8k viewsReviewed >2 years ago
A 48-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Various types: General anesthesia is commonly used, but spinal and epidural anesthesia can be used also. There are some newer drugs, but the anesthetic techniques h... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 26-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Yes: An atrioventricular septal defect is a serious issue which should be detected by echocardiography. It would not necessarily be detected by an ekg.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 30-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Time: There is no reversal agent for lidocaine, so you must wait for it to wear off, usually in less than 60-90 minutes.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsReviewed >2 years ago
A 41-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
The next day: You should not take opiates and drink alcohol at the same time ever.
Created for people with ongoing healthcare needs but benefits everyone.
4.9k viewsAnswered >2 years ago
A 38-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Yes: It an be given safely with minimal risks as long as blood pressure and breathing are monitored as routinely done.
Created for people with ongoing healthcare needs but benefits everyone.
4.7k viewsAnswered >2 years ago
A 47-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Yes/no: While Novocaine allergies do occur occasionally, true allergies to lidocaine are extremely rare. If this has actually been documented by an allergist... Read More
Created for people with ongoing healthcare needs but benefits everyone.
3.8k viewsReviewed >2 years ago
A 26-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
It varies: It will depend on the practitioner and your level of anxiety. Typically, an anxiolytic such as midazolam will be used, perhaps in combination with a ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
909 viewsAnswered >2 years ago
A 49-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Yes: Yes, no problem.
Created for people with ongoing healthcare needs but benefits everyone.
3.8k viewsReviewed >2 years ago
A 21-year-old male asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
No interaction: Aleve (naproxen) does not alter the effects of drinking.
Created for people with ongoing healthcare needs but benefits everyone.
3.8k viewsAnswered >2 years ago
A 26-year-old female asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Not necessarily: This is routine in case genera l anesthesia or deep sedation becomes necessary, but not mean it is probable.
Created for people with ongoing healthcare needs but benefits everyone.
4.8k viewsReviewed >2 years ago
A 55-year-old male asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
More systemic effect: The Nitroglycerin ointment is applied for its local effects. Imdur taken orally would have more systemic effects such as lowering blood pressure and ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
4.7k viewsAnswered >2 years ago
A 35-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
It doesn't: Anesthesia does not cause hyperglycemia. Hyperglycemia can be caused by stress, and surgery can cause stress.
Created for people with ongoing healthcare needs but benefits everyone.
3.2k viewsReviewed >2 years ago
A 49-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
No: Topical an esthetics are not detected by standard drug testing.
Created for people with ongoing healthcare needs but benefits everyone.
4.1k viewsAnswered >2 years ago
A 46-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
Blood direction: Colors on echocardiography indicate blood direction. Red indicates flow towards the transducer, and blue indicates flow away from the transducer. Ye... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. Gary Roachanswered
Anesthesiology 44 years experience
It depends: Echocardiography is performed to provide information about the structure and function of the heart. It can provide information about structural abnor... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5k viewsReviewed >2 years ago
TestimonialsRecommendations and Thank you notes are endorsements given from patients or other doctors.
Recommendations and Thank you notes are endorsements given from patients or other doctors.
2
Recommendations
132
Thank you notes
HealthTap member
Mar 30, 2015
Dr. Roach is an amazing doctor! #nationaldoctorsday2015 #virtualflower1
HealthTap member
Mar 31, 2015
Dr. Roach is an amazing doctor! #nationaldoctorsday2015 #virtualflower1
HealthTap member
This saved my life. Thank You! Thanks doctor it help me out so much
HealthTap member
Thank you, your answer was very helpful! Thank you Doctor.
HealthTap member
Surgery is tomorrow. Atelectasis is chronic.
Education & Training
Medical/Graduate school
University of Texas Medical School at Houston, TX
Graduated 1979MD
Residency
Brigham and Women's Hospital
Completed 1982
Awards
Founding Knowledge Editor, First Place, San Francisco - Winter
2016
HealthTap Founding Doctor
Affiliations
Society of Cardiovascular Anesthesiologists
American Heart Association
American Society of Anesthesiologists
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