Tag Archives: Surgery

Studies: What Makes For Successful Recoveries

Inflammation is the body’s first line of defense, occurring as droves of immune cells rush to the site of injury or acute illness to make repairs and stem further damage.

When successful, inflammation helps the body survive and heal after trauma. However, when recovery following an inflammatory response goes awry, it signals that damage is still occurring — and the inflammation itself can cause further injury, leading to more-severe illness or even death.

But what differentiates a good inflammatory recovery from a bad one?

A new study, led by researchers at Harvard Medical School and Massachusetts General Hospital, published Aug. 22 in Nature Communications, yields critical clues.

The scientists identified universal features of the inflammatory responses of patients who successfully recovered after surgery or acute illnesses such as COVID-19, heart attack, and sepsis. These features, they discovered, include precise paths that white blood cell and platelet counts follow as they return to normal.

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Aging: Degenerative Disk Disease Surgical Options

#DegenerativeDiskDisease is a common disorder linked to aging and years of wear and tear on the spine. Long-term therapies have so far eluded medical science.

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LAMINECTOMY

Lumbar laminectomy

Laminectomy is surgery that creates space by removing the lamina — the back part of a vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.

This pressure most commonly is caused by bony overgrowths within the spinal canal, which can occur if you have arthritis in your spine. These overgrowths sometimes are referred to as bone spurs, but they’re a normal side effect of the aging process in some people.

Some patients are able to have a same-day laminectomy, which means they do not need to stay in the hospital following surgery and are able to go home to recover. The procedure is performed using minimally invasive techniques resulting in smaller incisions, lower risk of infection and, for many people, a quicker recovery.

SPINAL FUSION

Spinal Fusion, Lower Back

Spinal fusion is surgery to permanently connect two or more vertebrae in your spine, eliminating motion between them. Spinal fusion involves techniques designed to mimic the normal healing process of broken bones. During spinal fusion, your surgeon places bone or a bone-like material within the space between two spinal vertebrae. Metal plates, screws and rods may be used to hold the vertebrae together, so they can heal into one solid unit.

Because spinal fusion surgery immobilizes parts of your spine, it changes the way your spine can move. This places additional stress and strain on the vertebrae above and below the fused portion, and may increase the rate at which those areas of your spine degenerate.

Read more at Mayo Clinic

Women’s Health: What Is An Oophorectomy?

An oophorectomy is a surgical procedure where one or both of the ovaries are removed. This procedure can be done through a laparoscopic approach, a vaginal approach, or a laparotomy. Removing both ovaries will cause menopause to begin immediately.

There are many reasons why you may need an oophorectomy. This video provides a brief look at what the procedure is, how it’s done and important things to know.

Chapters: 0:00 What are ovaries? 0:17 What is an oophorectomy? 0:45 Why would you need an oophorectomy. 1:10 How is an oophorectomy performed? 2:13 Can you still get pregnant after an oophorectomy? 2:46 What is the recovery process after an oophorectomy? 3:38 Speak with your healthcare provider openly to discuss all of your options.

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Skin Cancer Removal: The Benefits Of Mohs Surgery

Mohs surgery is a highly effective skin cancer removal procedure that takes just a few hours. It is most often used to treat basal cell and squamous cell carcinomas, the two most common skin cancers.

Chapters: 0:00 How effective is Mohs Surgery? 0:23 When is Mohs Surgery used? 0:50 How does Mohs Surgery work? 1:55 Does Mohs Surgery cure skin cancer? 2:06 How long is the recovery period after Mohs Surgery?

Knee Injuries: Options For ACL Surgery (Mayo Clinic)

DR. C’S JOURNAL: PAIN FOLLOWING TOTAL KNEE REPLACEMENT SURGERY


Total knee replacement(arthroplasty) is one of the most successful orthopedic operations. Satisfaction rate varies between 75 and 90%. Even so, almost 10% of operated individuals will have anterior knee pain, the most common complication, 1 year after TKR.

I had an even greater appreciation of the knee after reading the following article, which explain the causes of knee pain more adequately than I can, and would be good to read.

With knee replacement surgery, a great deal depends on the technical expertise and precision of the operating surgeon. A rotational error more than a degree or two can be critical, so important is proper tracking of the kneecap in the trochlea, or groove in the leg bone(femur). An imbalance in the pull  of muscles, or a knock knee, (Valgus) angulation of the knee, hip rotation, spinal problems, all can be important in generating pain as you get older.

There are psychological factors too. The knee pain after TKR average is only 1/3 of that suffered before the operation, on average. However if you expect that discomfort will disappear completely, or if your pain threshold is low, or if you have anxiety or depression, you may have more postoperative pain, and  be disappointed with the surgery.

My immediate reason to write this article was the anterior knee pain developing in a friend of mine, 15 years after surgery, at the age of 89. She had polio in childhood, and her right leg was severely affected. This caused her to overuse her left leg, resulting in a TKR 15 years ago. Just recently, she started developing anterior knee pain in the left knee. A thallium scan showed a lot of signal on the inside of the kneecap, most likely indicative of inflammation. She is not enthused about having another operation because of her age., and wondered about other things she might do.

An orthopedic friend of mine suggested that injections of a viscous lubricant might help, if the initial operation did not include resurfacing of the kneecap (patella). I would imagine that eventually the resurfacing of the patella with advanced materials, or perhaps stem cells might help.
I also thought of a special brace with a motor assist for her right leg, but the orthopedist said that this did not work very well in polio patients, who have a weak nerve signal.

Although my friends polio made her TKR almost inevitable, there are things that you can do, or avoid doing, that could help avoid TKR. Activities to reduce include squatting, deep lunging, running (particularly in deep sand), high impact sports, repetitive jumping, and running up stairs. Basketball, football, and volleyball come to mind as regular sports that are risky. Maintaining a healthy weight, controlling blood sugar, stoppage of smoking, avoidance of injury, and regular exercise, particularly walking and swimming ,are things that might help.

Remember that your knees are your wheels and are jewels to protect as you get older.

–Dr. C

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #45: SLEEP APNEA

Sleep apnea and obesity are bound together as Charles dickens observed in his Pickwick papers. The Pickwickian syndrome is obesity associated with alveolar hypoventilation(insufficient breathing) with an increase in CO2 in the bloodstream which causes narcosis, or SLEEPINESS, in the daytime.

When I went in for my sleep apnea study, I noticed a number of double wide chairs available for the usual clientele there. OBESITY is one of the major risk factors for sleep apnea. Depositions at the base of the tongue and throat interfere with breathing, and causes snoring to the point of tracheal blockage and apnea at night.

Some people with normal “ BMI”, have sleep apnea. Sleep apnea can run in families, occur when you are older, or have a thick neck. So no matter what your weight, if you have daytime sleepiness after an apparently full night of sleep, you should be considered for a sleep study.

A SLEEP STUDY requires that you go into a sleep center overnight, get hooked up to an electroencephalogram machine, oxygen monitor, chest straps, and the like. This is the gold standard for a diagnosis of sleep apnea, but a recording pulse oximeter will let you know a lot less expensively if you have the critical problem, a drop in oxygen saturation. The type of sleep apnea I have been discussing so far is obstructive sleep apnea. Of course there are other types such as central, or complex sleep apnea.

Most sleep apnea responds to nasal CPAP, if you can tolerate it.
My own sleep apnea was diagnosed as moderate, 15% central and 85%  obstructive in type.  I have a stuffy nose which I believe to be the main problem setting me up for sleep apnea, and I could not tolerate the positive nasal CPAP. There is also a dental apparatus that I tried unsuccessfully. I wound up sleeping on my side, and propping myself in that position with pillows .This seems to help me, but I still wake up several times a night, usually at the end of a 90 minute sleep cycle, and with a full bladder.

I sleep through better on days when I have had more physical or mental exercise. Avoiding a full stomach at bedtime is also helpful with both sleep apnea and GERD.

I do use Afrin on the left side of my nose, which is more obstructed. I restrict the use to every third day, although I have heard that you can use it every other day, alternating sides, if you have a stuffy nose that has resisted other treatments .I have also heard that using corticosteroid nasal sprays makes Afrin better tolerated. Be sure to get clearance with your doctor before trying this.

— Dr. C

Read more at Mayo Clinic