Surgery Medicine & Health Pages
Unexpected Consequences of Joint Replacement Surgery
By Dr. Gifford Jones
An English proverb cautions that “It is the unexpected that always happens”. No doubt people looking back on their life can recall several of those unexpected and unpleasant events. But how often do unexpected events happen in surgery?
Today an increasing number of people face hip and knee replacement operations.
They’re often concerned about the pain following surgery and long sessions of physiotherapy to recover joint mobility. But how many think of coronary attack after the operation?
How To Prevent Unusual Hazards in 2007By Dr. Gifford Jones
Of course you all know how to keep healthy this year. Keep active, eat healthy foods, don’t smoke, drink alcohol moderately, have regular medical, dental and eye checkups, buy a bathroom scale so there’s no burying your head in the sand about obesity, etc, etc, etc. But here are some precautions you may not have considered.
Are you scheduled for surgery in 2007? If so, there’s a sure way to circumvent a horrendous surgical error. We’ve all heard stories about surgeons amputating the wrong leg. Or fixing a hernia on the side that didn’t need it and neglecting the one that did. If you think this is past history, you had better think again.
Unfortunately, I Cannot Guarantee Your SurvivalBy Dr. Gifford Jones
“What’s the worst thing that can happen if I agree to surgery?” a patient recently asked me. Unfortunately, the only honest answer was that “some patients die”. It’s hardly the positive way to discuss surgical complications, but it does get quickly to the heart of the issue. Today, patients have every right to be informed about risk, but to do so effectively is easier said than done.
For instance, it could be cynically said that the only truly informed patient would be a brain surgeon informing another brain surgeon about potential complications. There are no ifs, ands or buts in this case.
Is It Losing an Ear or Using Bloodsuckers?By Dr. Gifford Jones
It was August 16, 1985 and the day started in horrendous fashion for Guy Condelli. A five-year old boy in Medford, Massachusetts, he had his right ear bitten off by a dog. Dr. Joseph Upton, a reconstructive surgeon at Children’s Hospital, Boston, reattached the ear during a tedious 12-hour operation.
But three days later an ominous sign of impending disaster appeared. The ear had turned blue-black due to venous congestion. Blood thinners and lancing failed to restore normal blood supply. In desperation Upton telephoned Biopharm, an English company. It sent 30 leeches by air to Boston.
If It’s Partly Broken Should You Fix It?By Dr. Gifford Jones
Do you want to have a body free of imperfections? In an ideal world we would all say “Yes”. But how important is it to be perfect?” A recent report shows that in some surgical operations it’s prudent to live with a slight imperfection.
Several months ago I watched one hernia after another being repaired at Shouldice Hospital in Toronto. This clinic has developed an international reputation for doing one thing very well. It’s the old story that practice makes perfect whether you’re a surgeon or a plumber.
Why Surgeons Need Cockpit TrainingBy Dr. Gifford Jones
Would you buy an airplane ticket if the pilot refused to check his instrument panel before taking off? You’d probably run for the woods, choose another airline or decide it’s safer to go by train. But a recent study shows that surgeons are not following proven surgical guidelines for a potentially fatal operation. What’s needed? A big dose of pilot discipline.
Dr. Thomas Feasby, neurologist at The University of Alberta, reviewed carotid endarterectomies done in four western provinces. His study revealed that one in 10 of these procedures should not have been performed and 47 percent were done for dubious reasons. His conclusion; surgeons needed “cockpit management”.
A Surgical Assembly Line to Repair HerniasBy Dr. Gifford Jones
To ask what goes on at The Shouldice Hospital is like asking, “Is the Pope Catholic?” This hospital situated in Thornhill, near Toronto, is a world-famous center for the repair of hernias. But is its reputation as good as they say? If so, why? And why is it possible for surgeons to repair an obvious hernia and miss another one? To find the answers I observed Dr Casim Degani, chief of surgery at Shouldice, perform one hernia operation after another.
Reduction Surgery to Treat EmphysemaBy Dr. Gifford Jones
“Damn those cigarettes”, an angry Johnny Carson repeated over and over as he slowly died from emphysema. Unfortunately, Carson should have said “Damn those cigarettes” years ago. The former star of the Tonight Show could have stopped destroying his lungs. But Carson, like so many others, failed to realize that once damage has occurred nothing can restore lung tissue. However, a new surgical operation, lung volume reduction surgery (LVRS), can help to improve the quality of life for some patients suffering from emphysema.
Unexpected Consequences of Joint Replacement SurgeryBy Dr. Gifford Jones
An English proverb cautions that “It is the unexpected that always happens”. No doubt people looking back on their life can recall several of those unexpected and unpleasant events. But how often do these unexpected events happen in surgery?
Today an increasing number of ppeople face hip and knee replacement operations.
They’re often concerned about the pain following surgery and long sessions of physiotherapy to recover joint mobility. But how many consider a coronary attack after the operation?
Urinary Incontinence, A Little Tape Can Cure ItBy Dr. Gifford Jones
A woman recently complained to me, “I’d give all I own to be rid of the continual loss of urine. I’m embarrassed and I’ve become a social outcast. It’s ruined my life.” Today, with an aging population, 12 million North American women suffer from this disabling problem. And for years the ingenuity of surgeons has been taxed in the effort to ease their suffering. Now, a new technique is curing thousands of incontinent women. All it takes is a small piece of Tension-Free Vaginal Tape (TVT).
Think Twice Before Agreeing to These OperationsBy Dr. Gifford Jones
Is it better sometimes to run for the woods rather than submit to surgery? The decision is easy when the diagnosis is acute appendicitis or a strangulated hernia. But there are times when a sojourn in the woods makes sense. Time is often the best healer.
Several weeks ago the gods were unkind to me during the night. When arising from bed I suddenly experienced a pain from hell. Like a tire that blows out, two inter-vertebral disks had suddenly exploded with a vengeance, and I was on my hands and knees in agony.
Appendicitis Strikes More Than KidsBy Dr. Gifford Jones
I’ll never forget one Christmas. I had been in training at The Harvard Medical School only a few months and arrived home to find my father desperately ill. During a trip to Scotland he had developed abdominal pain and the doctor had mistakenly diagnosed “an intestinal cold”. The decision to fly home nearly ended my father’s life. An acute appendicitis had ruptured causing .
The diagnosis of acute appendicitis is sometimes as easy as falling off a log. Pain starts in the mid©abdomen and gradually shifts to the lower right side. Often the pain is worse on moving, coughing or when the abdomen is prodded. And frequently abdominal discomfort is accompanied by low grade fever, nausea or vomiting.
A Scotch-and-Soda And an Alarming Surgical DilemmaBy Dr. Gifford Jones
“Stick out your tongue”, my dentist invariably requests during my regular dental checkup. I know that shortly he’ll examine my teeth. But for the moment he’s looking for any sign of cancer of either the tongue or the rest of the oral cavity. But what happens if your dentist or doctor detects a malignancy? What I learned over a scotch-and-soda should alarm all of us.
Cancer of the tongue is one of the more common and serious types of mouth cancer. Every year 30,000 North Americans are diagnosed with this malignancy and it’s curable in about 80 per cent of cases when diagnosed early.
Sacrifice Part of Your Stomach To Lose Weight?By Dr. Gifford Jones
“Desperate diseases require desperate cures”, wrote the immortal bard, William Shakespeare. For grossly obese patients this means putting part of the stomach and small intestine out of commission (bariatric surgery). But this is not minor surgery and patients should know the risks before making this desperate decision.
This year 150,000 bariatric operations will be done in North America. These patients usually weigh 300 or more pounds and the surgery seems like the answer to a maiden’s prayer.
The Benefits and Risk of Laparoscopic CholecystectomyBy Dr. Gifford Jones
In 1991 Dr. Joacques Perissat at the University of Bordeau, in France, announced to the World Congress of Surgeons that he had removed a gallbladder (cholecystectomy), using optical instruments inserted through a few small incisions. Now, 90 percent of gallbladder operations are done by fiber-optics. What are the advantages and what is its most devastating complication? And the crematorium is the cure for some gallstones.
An emergency cholecystectomy is required when a stone blocks the common bile duct (CBD) resulting in an acute inflammation of the gallbladder. To prevent this from happening, patients are often advised to have a cholecystectomy before this complication occurs. It’s technically easier and safer to remove a gallbladder when the organ isn’t inflamed.
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