May 8th, 2011 by John Di Saia, M.D. in Health Tips, True Stories
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It frequently amazes me how patients can be wowed by technology and advertising hype. The attraction of newer technology in particular helps part many people from their money at times. The SmartLipo system is one of the laser-assisted liposuction systems on the market. I have blogged on it before having used it quite a bit a few years ago.
The system is being marketed with phrases like “almost anyone can be a good candidate for SmartLipo.” That is simply BS.
I saw an attractive young woman in the office who had had Smartlipo on her lower back. It looked like the Geiko Gecko had done it. Her smooth contour had been made irregular and discolored despite the fact that the surgery had happened quite a while prior. Her ribs had been a bit exposed by the loss of some of the fat that would normally have laid over them. Early lipo results do change, but this wasn’t something that was going to improve over time. I have seen worse but this was so unnecessary.
SmartLipo Led to a Dent
Why did this happen? Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
February 11th, 2010 by Medgadget in Better Health Network, News, Research
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New cancer targeting nanoparticles seem like daily news here at Medgadget. Today we have gold nanoparticles developed jointly by researchers at Rice University and A.V. Lykov Heat and Mass Transfer Institute in Minsk, Belarus that create plasmonic nanobubbles when targeted with a laser. These particles can be guided to a tumor by antibodies and then activated to generate tiny explosions, so clinicians one day will be able to stay back and enjoy. Read more »
*This blog post was originally published at Medgadget*
December 27th, 2008 by Dr. Val Jones in True Stories
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Fortunately for me, my recent brush with the healthcare system was not as frightening as Dr. Dappen’s (he blogs here every Wednesday and recently had a mild heart attack). However, it was provided me with some amusing blog fodder.
Last week I was minding my own business, planning to purchase a new batch of contact lenses from a local optometrist, when I was required (under threat of withholding my lenses) to undergo a vision exam. Much to my disappointment, my right eye was not behaving itself, and refused to correct to 20/20 despite a good deal of lens fiddling on the part of the doctor. A slit lamp retinal evaluation followed, and the optometrist concluded that my right eye’s macula “looked like an 85-year-old’s.”
Well, that was not the most welcome of observations. I asked for the differential diagnosis (being that I’m quite a few years away from 85) and wondered how I’d developed macular degernation. He suggested that it could also be a “central serous” which is (apparently) a stress-related swelling of the macula that requires no treatment and usually resolves on its own.
“So basically you’re saying that my eye could be ‘bugging out’ because of stress.” I said. “And you’d like me to see an ophthalmologist just in case it’s something worse and equally untreatable?”
“Right.”
So I made an appointment with a local ophthalmologist – one of the few working on Christmas Eve – and was sorry to have him confirm that there was indeed something wrong with my retina. He even ordered an eye angiogram (I didn’t know those existed, but it makes perfect sense) and I was injected with a vegetable dye. Photographs were taken through my dilated pupils at regular intervals as the dye wound its way through my retinal vasculature.
“It’s not a central serous.” He said with a serious tone. “And you can see the macular defect here on this photograph.”
“So my right eye is like an 85-year-old’s?” I asked, wondering how I’d been so fortunate to have one part of my body on the aging fast-track.
“Well, not exactly. I think it’s unlikely to be age-related macular degeneration. You probably have retinal thinning caused by your nearsightedness.”
“You mean all that straining to see the chalk board wore out my retina?”
“No. What I mean is that your eye is supposed to be shaped like a baseball, but yours is an egg shape. So your retina is stretched thin and is starting to wear in your macula area.”
“Well can you suck out some of the vitreous gel and shape my egg back into a baseball?”
“No. Unfortunately that doesn’t work.”
“How do you know?”
“The Russians tried it in the 1960s.”
“Ok, well how do I take some of the tension off my stretched out retina?”
“You can’t.”
“Well if I lose weight or eat carrots or exercise, or stop wearing contacts, or get lasik… would any of that help?”
“No.”
“So there’s nothing I can do to prevent further damage, and nothing to repair or treat it.”
“Right.”
Pause.
“I don’t like this condition.”
“Well, you’ll have to come and see me once a year so I can monitor the progression. Sometimes the body responds to the retinal damage by growing blood vessels in the area, and that can cause further visual deficits. But we can zap those new vessels with a laser and decrease the damage.”
“So my eye might overgrow with blood vessels like weeds in a garden.”
“It might. But it also may stay exactly the same for the rest of your life.”
“Well, the uncertainty is anxiety-provoking.”
“I’ll see you in a year. You’ll probably be fine. Don’t worry. Oh, and if you see any ‘floaters’ or flashes of light, come in to see me immediately.”
“What would that indicate?”
“A retinal tear that would need laser therapy right away. People with thin retinas can have spontaneous tears. Just keep that in mind.”
“Um… ok.” I said, smiling feebly.
So here I am, with one wonky eye, not knowing if it will get worse or remain the same indefinitely. There’s nothing I can do but watch the progression once a year with an ophthalmologist. Like so many patients, I’m in a gray zone where prognostication is a challenge and reversal of disease is not possible. I have one 85- year-old eye. May it bring me wisdom, courage, and more empathy for patients.
October 30th, 2008 by Dr. Val Jones in Humor, True Stories
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True story: As a fourth-year medical student I spent a summer working with a dermatologist in Los Angeles. In addition to all the skin cancer removal, sun damage, and Mohs surgery patients, my preceptor had a thriving laser tattoo removal business.
One day a rock band electric guitarist came into the office requesting help for an incident he’d had the night before. Apparently he’d gotten terribly drunk (+/- stoned) and made an impulsive tattoo decision that he regretted deeply in the light of morning.
The gaunt, long-haired gentleman entered the dermatology suite with his head hung low. He sat down in the exam chair and explained that he was there for a tattoo removal consultation. “Man, I can’t believe I did this to myself,” he muttered as he unbuttoned his shirt.
I wondered what on earth could be so terrible…
And then I saw it.
It was an 8 inch by 4 inch, bright yellow and black tattoo…
On the left side of his neck…
An exact replica of…
The periodic table of the elements.
It frequently amazes me how patients can be wowed by technology and advertising hype. The attraction of newer technology in particular helps part many people from their money at times. The SmartLipo system is one of the laser-assisted liposuction systems on the market. I have blogged on it before having used it quite a bit a few years ago.
