"Only a little over a month. She's 35 yo."
"Please, tell your friend not to put it off. I know she is afraid, but the sooner it's diagnosed the better."
I am a plastic surgeon in Little Rock, AR. I used to "suture for a living", I continue "to live to sew". These days most of my sewing is piecing quilts. I love the patterns and interplay of the fabric color. I would like to explore writing about medical/surgical topics as well as sewing/quilting topics. I will do my best to make sure both are represented accurately as I share with both colleagues and the general public.
It will have a loose theme of “Doing better”.
Why? I am currently reading Atul Gawande’s 2nd book called “Better: a surgeon’s notes on performance“.So get that literary genius in you start typing. How you have gone that extra mile for a patient to “do better”, or what have you done to ensure others, e.g. the OR staff, to do a little more to ensure better patient outcome, etc. All submissions outside of this theme are still welcome. Please submit your posts to me via this form.
This information is from the Lahey Magazine Summer 2008 Edition, pp 6-7. Only part of it is reprinted here. The entire article can be read here (pdf file).
Led by David J. Bryan, MD—an MIT-Harvard lecturer and specialist in hand surgery and microsurgery in Lahey’s Department of Plastic and Reconstructive Surgery—the team recently presented results from original research on the use of tissue-engineered conduits in peripheral nerve (sciatic nerve) models. The study, funded by a grant from longtime Lahey benefactor Leisa V. Clayton, demonstrated that artificially engineered nerve tissue can perform as well as, and possibly better than, standard live-tissue nerve grafts in restoring lost peripheral nerve function.
The current standard of care calls for using live nerve tissue taken from other parts of the body. According to Bryan, autologous (self-donated) nerve grafts have limitations in terms of availability, side effects—mainly loss of sensation in the donor site—and clinical effectiveness. To overcome these challenges, the Lahey team collaborated with an outside engineering group to create a custom-made, bioengineered blend of synthetic polymers and proteins using sophisticated spinning equipment.Electrospinning—an application of the emerging field of nanotechnology—allows researchers to create minute quantities of a desired cellular fiber for use in peripheral nerve tissue grafts. The artificial material created at Lahey has all the desired qualities needed for the ideal nerve graft: biocompatibility, porosity, biodegradability and the ability to promote growth of new blood vessels in damaged nerve tissue. Bryan reports that nanotechnology has allowed his research team to make great strides in understanding how nerve cells communicate, grow and regain function. Proteins—organic compounds that play a vital role in all basic cell processes—are the key to understanding the inner working of nerve tissue, he explains. Looking to the future, Bryan is extremely excited about the emerging field of proteomics, the study of proteins in living cell tissue.
Welcome to Grand Rounds, Volume 4, #40 (see future GR schedule). If you missed our first Grand Rounds last year, with our amazing Clicky Brain, then feel free to pause and enjoy. This year, since the anticipated release of the Apple iPhone 3G is just around the corner (July 11), we asked for submissions to have some connection to the iPhone, no matter how twisted the logic is to make the connection. The bloggers obliged. So we are including, free of charge, our Clicky iPhone, which will let you visually navigate this week's Grand Rounds submissions. Of course, below that is the regular text for you old-schoolers. And if you have low vision or prefer to LISTEN to your Grand Rounds, you can get our PODCAST of it HERE.
A former patient presents with general malaise and reports having had low-grade fever. The examination is unremarkable, but laboratory tests indicate an infection not isolated to an organ system. Groin and blood cultures are positive for MRSA.A while ago you diagnosed an abdominal aortic aneurysm in this patient, but she went to India for aortic endograft placement. You are considered an authority on graft infection. What should you do?A. Tell her to return from whence she cometh.
B. Alert the media to the problem of cheap international medical care.
C. Advise the patient to sue in International Court.
D. Care for her as you would any patient.
E. Tell her that once a patient leaves your care, she leaves permanently.
The loose theme for the collection was "Secrets and Surprises" - what season finale would be complete without a few of those?Yet there's another ingredient that no real season finale would be complete without. It's The Unanswered Question. The Unsolved Mystery. Unfinished Business. Arguably it's why any of us keeps returning to any realm of inquiry or learning.The world of medicine abounds with unanswered questions. While they might not show up here in the form of a conventional "cliffhanger ending," they're here all right...lurking behind the answers to other questions, the often-untidy "resolutions" to stories, and in situations that remain unresolved altogether and that keep us wondering about doctors, nurses, patients, the O.R., the characters in the vast series of episodes that comprise life in medicine today.
Here you can see some of the shirt labels and one of the pockets.
The fabric used for the back of this one features Route 66. The man who is being remembered with these quilts had planned to drive Route 66. He never got to take that trip.
Mr. Zink was the coolest teacher in my middle school. Everyone liked him: nerd, jock, cheerleader alike. He taught science, and if you were lucky you got him two years in a row. In those few minutes after the lesson finished, but before the bell rang, he would tell us the grossest stories that he knew.
I still remember them. The one about the kid playing basketball with his class ring on, who left his ring and its attached finger on the rim after a dunk, connected by all the tendons from his finger to his shoulder. (Can that really happen?)
She had avulsed the skin off her ring finger of her right (dominant) hand whilst attempting to jump over a spiked fence, catching her ring on the spike.
The first 1998 study conducted under Dr. David M. Kupfer, Department of Plastic and Orthopaedic Surgery, University of San Diego in California, involved dropping a 30-pound weight attached to a ring bearing finger hanging from a hook, from a 9-inch height.Results showed that in more than 90% of cases, the injuries caused by rings and wedding bands are Class II (29%) and Class IV (61%). On the tested sample (41 fingers), Class I injuries (10%) occurred at less than 80 N and the first ring avulsions at 111 N. Maximum finger resistance is 346 N with average resistance at 154 N. Film records also show that the skin is the finger’s strongest part. Once the skin tears, the remaining finger degloves or quickly avulses. Accordingly, although thin and narrow or tight rings are less resistant to traction and cause the skin to shear under traction, they are more dangerous than wide, thick rings.
I say he did a great job! Hope you will check it out.I’ve always wanted to be a newspaper editor, not because I want to edit, but because I want to write headlines. And not for a respectable paper like the New York Times. Maybe for a newspaper, like the Enquirer -- you know, where an editor can have some creative freedom with the facts. So, finally, I get my chance with this week's Grand Rounds. Sometimes the headlines I’ve written relate to the post, sometimes, they are just a whacked out free associations. Like all headlines, their purpose is to get you to read the posts. I hope I can entice you. There are some really great writers out there. Great job everyone.
For first time Blog Talk Radio listeners:
*Although it is not required to listen to the show, I encourage you to register on the BlogTalkRadio site prior to the show. I think it will make the process easier.
*To get to my show site, click here. As show time gets closer, keep hitting "refresh" on your browser until you see the "Click to Listen" button. Then, of course, press the "Click to Listen" button.
*You can also participate in the live chat room before, during, and after the show. Look for the "Chat Available" button in the upper right hand corner of the page. If you are registered with the BTR site, your registered name and picture will appear in the chat room.
*You can also call into the show. The number is on my show site. I'll be taking calls beginning at around the bottom of the hour. There is also a "Click To Talk" feature where you do not need a phone to call into the show - only a microphone headset. Hope these tips are helpful!
Please submit your posts here or email her directly at email@example.com with a link to your post.Tonight I was honored once again to be invited to host the SurgExperiences blog carnival for its final edition of the season, SurgExperiences 124, to be posted on June 22. I am considering the theme "Secrets and Surprises," but the last time I thought I might have a theme, the collected works morphed into something else - so again, the "theme" isn't written in stone!
Tonight I was honored once again to be invited to host the SurgExperiences blog carnival for its final edition of the season, SurgExperiences 124, to be posted on June 22. I am considering the theme "Secrets and Surprises," but the last time I thought I might have a theme, the collected works morphed into something else - so again, the "theme" isn't written in stone!
The Scheck house will be hosting our very own Alex's Lemonade Stand on the 4th of July.I hope you will help them surpass their goal. I have sent my e-mail to Bryan already.
Alex's Lemonade Stand Foundation is a unique foundation that evolved from a young cancer patient's front yard lemonade stand to a nationwide fundraising movement to find a cure for pediatric cancer. What makes the foundation different is that it's model inspires people who would not be likely to donate to childhood cancer to make donations with the reassurance that "no donation is too small".The fourth of July is traditionally in our neighborhood an insanely huge community yard sale. Since it falls on a Friday this year we expect big crowds. Our garage is packed full of yard sale fodder, proceeds which also will be donated to the foundation.In addition to raising money from the lemonade sales, Anna is soliciting friends and family to pledge an amount of money for each cup of lemonade sold. This obviously greatly accelerates the earnings, and will hopefully motivate our "customers" to buy plenty of lemonade! If you're interested in sponsoring Anna, please email Bryan at mailto:firstname.lastname@example.org so we can sign you up. We have donations ranging from 25 cents to a dollar a cup (!), and we have set an ambitious goal of raising $1000. Additionally, some people have felt more comfortable giving a flat donation, which we are also very grateful to receive.There is a website designed to take the donated money here (link no longer active, 3/2017). Once the big day is over, we will call or email you to let you know what your donation is based on cups sold. You can then donate over the website.
Thank you for joining us in the fight against childhood cancer... one cup at a time!
I wanted to include a note about your little quilt. The first time I went to your blog was April 18. That picture stayed in my mind and this little quilt was the result.
Paula, I am thrilled with this quilt. Thank you so very much.O. And did you notice that I quilted it in the swirly type motion used for breast self exam? I certainly had fun making this. So glad you liked it.
Subcutaneous injections of carbon dioxide (CO2) can safely and successfully treat cosmetic concerns such as skin laxity and fatty deposits that may remain following liposuction, as well as psoriasis and hair loss, says an expert based here. Additional uses for this treatment — called carboxytherapy — include stretch marks, scars and cellulite, he says.
I've been using this technique for more than a year, and getting fantastic results," says Raphael Nach, M.D., a head and neck surgeon in private practice. He estimates that he has treated at least 40 patients for post-liposuction problems such as persistent islands of fatty tissue, skin irregularities and skin laxity. Dr. Nach explains that by adding CO2 gas to the subcutaneous tissues, localized post-operative accumulations of fat can be reduced or eliminated." Alternative forms of treatment have been advised to assist the general recuperate process," he says, "but none have been as successful in eliminating these localized fatty deposits."TECHNIQUE IN BRIEF The technique requires no anesthesia. First, one sterilizes the skin with Hibiclens (chlorhexidine topical antiseptic; Mölnlycke Health Care U.S., Norcross, Ga.) or its equivalent, he details. "Then a 30-gauge needle connected to the carboxytherapy machine is used to infiltrate the tissues with different volumes of carbon dioxide gas, depending on the condition that's being treated," Dr. Nach explains. A typical treatment site requires about 50 cc to 200 cc of gas, injected either once or twice a week, he says. Each session lasts 15 to 20 minutes. Depending on the treatment area, he says, four to six puncture sites with the 30-gauge needle may be necessary.
Injection of carbon dioxide for cosmetic purposes, namely to treat cellulite. Not U.S. FDA approved.
Dr Crippen was particularly addicted to ER as are a lot of British doctors. What would Mark do? we always asked when there was an emergency. Sadly, suddenly Mark was no longer with us. Medical life has not been the same since.
For more information on ovarian cancer:Lisette was born in Darby, PA and graduated from the University of Pennsylvania. She spent most of her career as a surgical nurse in Dallas and Little Rock. In Dallas she was active in charity work and was a past Chairman of the Multiple Sclerosis Society’s Yellow Rose Gala.She was an avid outdoors enthusiast, animal advocate, sporting clay shooter, traveler and mah-jongg player.She touched the lives of many and was an inspiration to us all. She will be dearly missed. In lieu of flowers, please make a donation to the Ovarian Cancer Research Fund or the ASPCA.
A riveting presentation today to our Board of Overseers. First was Diane Covert, freelance photographer and creator of "Inside Terrorism: The X-Ray Project". This is an exhibit which uses actual X-rays and CT scans from two large hospitals in Israel to explore the effects of terrorism on a civilian population.
In case you were wondering - "QuietusLeo" is latin for "sleeping lion" (I think). Obviously, I was born a leo. The connection seems to make sense.