November 11th, 2011 by BruceCampbellMD in True Stories
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Traveling makes one modest – you see what a tiny place you occupy in the world.
-Gustave Flaubert
We have come to Kenya, expecting to work outside of our “comfort zones.”
Our patient has arrived from miles away, riding on the back of her husband’s bicycle. She has an enlarging, bleeding mass growing off of the side of her neck. There are no pathologists available, so we are uncertain what kind of tumor it is, although it appears to be a cancer. She has been wearing a scarf to hide the mass for the past year; her head covering is speckled with blood.
We are anxious. Unexpected things can happen in an operating room this far from home. We expect Read more »
November 10th, 2011 by CodeBlog in True Stories
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So, Megen wrote this post recently about “Therapeutic Presence.” The following passage really caught my attention:
Question is: are there more things in nursing, Horatio, than science can explain? Can we touch patients and zap them with calmness or take away their pain? Can we, by our mindset during our provision of care, substantially affect our patients’ outcomes? Can any of this be taught? Can we do it on purpose? I don’t know. That situation has captured my attention, though, because the flip side must also be true—if I despise my patient, she can probably tell that too, regardless of how tightly I’m controlling my behavior.
Little backstory: A few weeks ago I had a laparoscopic cholecystectomy. Basically, a very nice surgeon made a few incisions into my abdomen, inserted a camera and some wrenches or something, and took my gall bladder out. I had never had surgery before. Never been intubated. I have been on “the bed side” quite a few times, but never for surgery.
A week elapsed between the time we decided to do surgery and the time the surgery actually happened. It was a really hard week for me as I was very anxious about the whole thing. I’m not even sure what exactly it was that I was nervous about. I Read more »
*This blog post was originally published at code blog - tales of a nurse*
November 6th, 2011 by ChristopherChangMD in Health Tips
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Though most people like the professional nose whistler shown here require an instrument to enable the nose to whistle, in others it occurs naturally due to unique anatomic features within the nose.
Why might someone’s nose whistle?
Septal Perforation
The most common reason it may occur constantly is due to a hole in the septum (septal perforation). The septum is a wall that divides the right nasal cavity from the left side. Normally, it should be straight and without any openings.
However, when a hole is present in the septum and it is in just the right size and place, whenever air is breathed in and out of the nose, it will whistle. In this situation, the hole is the “window” of the whistle and the nose itself is the mouthpiece.
Correction of this problem is by Read more »
*This blog post was originally published at Fauquier ENT Blog*
November 6th, 2011 by Toni Brayer, M.D. in Health Tips
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Immediately Post-op Carpal Tunnel release
Carpal Tunnel Syndrome (CTS) is common and is the result of the median nerve becoming squeezed or “entrapped” as it passes through the wrist down into the palm of the hand. Because this is a sensory nerve, the compression causes tingling, burning and itching numbness in the palm of the hand and fingers. A different nerve goes to the little finger and the lateral half of the 4th finger so the sensation there would feel normal. There is often a sensation of swelling even though there is rarely any true edema that can be seen in CTS.
The symptoms of Carpal Tunnel Syndrome usually start at night when people sleep with flexed wrists. As it progresses, the tingling and numbness can be felt on and off during the day. It can cause decreased grip strength and weakness in the hands.
CTS can be worsened by medical conditions like rheumatoid arthritis, diabetes, pregnancy or wrist trauma. Women are three times more likely to develop CTS than men, and it is rare in children. Most of the time no cause is found. The space that the median nerve traverses is very tiny and it doesn’t take much to compress the nerve. Even small amounts of tissue swelling such as occurs in pregnancy can cause severe symptoms.
The treatment for Carpal Tunnel Syndrome starts with Read more »
*This blog post was originally published at EverythingHealth*
October 16th, 2011 by ChristopherChangMD in Opinion
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Over the years, I have found that patients can be loosely grouped into 4 different types. Nothing particularly wrong with any type, but it does help me to approach patients appropriately if I can get a sense of what type they are.
The four types are:
Type A: If a surgery can “fix” or “cure” me such that I won’t have to take medications every day of my life, than let’s do it.
Type B: I will never consider surgery unless it is a life-threatening situation. If a medicine can help, why do it???
Type C: I will consider surgery only as a last resort when all else fails.
Type D: Read more »
*This blog post was originally published at Fauquier ENT Blog*
