Victorians saw introductions to modern surgical advances like anesthetics and the concept of germs, surgery was a bleak and unforgiving practice before these developments. Unfortunately, many patients died from these "advancements."
-Many patients in surgery would bleed to death. Others would die of shock. Most had wounds which became infected, and subsequently died of fever.
-Due to the lack of anesthesia, surgeons had to work fast. Amputation procedures sometimes lasted as little as 30 seconds.
-Barbers often carried out basic surgical tasks, especially during war.
-Leeches were used as common practice to remove blood before surgery.
-Amputated limbs were placed in sawdust to soak up the blood.
-Only the poor stayed in hospitals. The wealthy would pay a doctor to attend to them at home.
-Beds in hospitals were often too close together, causing needless spread of disease.
-Surgery was not even considered medicine. Physicians were seen as high class. Surgeons were on par with butchers.
-If the patient had a wound that was bleeding profusely, it was cauterized with a hot iron or had boiling oil poured onto it.
Hundreds of cysts!!
A 37 years old female with end stage renal disease on dialysis since 10 years presented with abdominal distention and was referred for evaluation of large mass in liver.
It was diagnosed on imaging as liver hydatid cyst occupying the entire right lobe of liver. Daughter cysts of varying sizes were seen predominantly in the periphery of the giant mother cyst. The collapsed membranes were seen floating within the hydatid sand. Surgical excision of cyst was done which contained more than 100 daughter cysts!
The pathogen causing the disease, Echinococcus granulosus is commonly seen in the liver. It typically forms a spherical, fibrous-rimmed cyst with little, if any, surrounding host reaction. Classically it has a large parent cyst within which numerous peripheral daughter cysts are present. Satellite daughter cysts (outside the parent cyst) are seen frequently (~16% cases).
In these infections, humans are serving as the accidental intermediate host, white animals are serving as the definitive host.
Video by @lienoz
When Daisha Johnson asked for words of comfort and support for her new website alwaysinmyheart.com,
I wrote: “When counseling patients with recurrent pregnancy loss, I try to stay positive and remind patients of the facts. The most common cause of first trimester miscarriage is a genetic issue within the embryo, not something wrong with the people conceiving.
To me this means each pregnancy is a brand new opportunity!
Research shows that even with multiple miscarriages there is always a chance of a healthy baby with the next conception. Most women with recurrent miscarriage go on to have their “rainbow baby” (hope after the storm)!
In the middle of struggling with miscarriage (especially more than one), it’s normal to feel hopeless but be an advocate for yourself and find medical providers that will listen and offer supportive care. You are your own best advocate so educate yourself and take good care of yourself on the journey. Best wishes!” – Dr. Lora Shahine MD FACOG, Physician, Pacific NW Fertility and IVF Specialists
Daisha is a miscarriage and infertilty warrior who is not only sharing her story but creating a place of comfort and support for those who have experienced a pregnancy loss.
Thank you @alwaysinmyheart_charity .
I made it!!! After about 100 exams later, my 16 months of didactic year are finally over!! Now time to put the big girl pants on and use everything I’ve learned this far while I’m out on clinical rotations. It’s going to be uncomfortable at times, that I know...and I have so much more to learn. But that’s the awesome thing about medicine...it keeps you on your toes!
Thank you so much for supporting me on my journey. All of your words of encouragement help to motivate me each and everyday. I hope my road to becoming a PA-C inspires you to pursue your dreams and always believe in yourself. It may be challenging at times, but you can do anything you put your mind to! I’ll be heading home to Hawaii for a little break before I start rotations...shoot me with some questions!
Colon Cancer – A common and deadly disease that affects the large bowel (intestine). 🤒 Symptoms may include stomach pain, change in the number, texture or size of bowel movements, blood in your stool, feeling weak or tired. 🧐 Diagnosis usually involves a colonoscopy but may also be identified on a CAT scan. Sometimes it may cause an obstruction or even perforation of the intestine. 😷 Treatment – if found early enough it may be removed by colonoscopy alone but in more advanced cases it has to be removed surgically. If it has already metastasized (cancer spread to other areas) chemotherapy may be the only option. ⭐️⭐️⭐️ This is why it is so important to start your routine screening at the recommended age which is usually at the age of 50yo. If you have a family history of colon cancer screening usually starts sooner, discuss this with your family doctor. .
The picture depicts a mass in the right colon I removed from a patient the other day. You can also see the appendix as a small appendage that hangs off of the right colon. This is also the area in which the small bowel transitions to the large bowel. A large lymph node is also evident, lymph nodes serve a function in immunity and usually are not as large as in the picture. This procedure was done utilizing advanced minimally invasive techniques and the patient ended up with small incisions, once healed it will be hard to know they ever had such a major operation.
💮 I've replaced all my glad plug-ins with this one diffuser since joining the #zerowastelifestyle & tonight I've filled my room with the scent of lavender 💮
On an unrelated zero waste topic, this week I've been reflecting a lot about women who have been sharing their stories & the #metoo movement. Maybe it's bc one of the #humansofnewyork stories struck me recently, or that a blogger I've followed for ~10 years just recently shared her story (@wendyslookbook), or the fact that just this week I was treating a woman my age who was left paraplegic by an ex-boyfriend...maybe it was a combination of it all that left me feeling so sad & sorrowful for all the women who have suffered. I can't say I know what you're going through, but I can say that I stand by your side. These are my prayers for tonight...
New Q & A ~ Can we 3D bioprint a thyroid gland?~ New Q &A’s every Friday! ————————
References: •Bulanova, E. et al. (2017). Bioprinting of a functional vascularized mouse thyroid gland construct. BIofabrication, 9 (3). http://dx.doi.org10.1088/1758-5090/aa7fdd
•Davies, T. et al. (2013). Is thyroid transplantation on the distant horizon? Thyroid, 23 (2), 193- 141. http://dx.doi.org 10.1089/thy.2013.2302.ed2
HOCM = Hypertrophic cardiomyopathy; TR = tricuspid regurgitation; VSD = ventricular septal defect
Aortic stenosis: presents with a mid systolic ejection murmur that begins after S1 and ends before S2. Described as crescendo-decrescendo murmur. As a general rule, the more severe the obstruction, the louder and later-peaking the murmur. The murmur is classically heard loudest over the right 2nd intercostal space, with radiation into the carotid arteries.
Pulmonary stenosis: similar to aortic stenosis, it has a mid-systolic murmur, but is best heard over the second left intercostal space. *
HOCM: similar to AS, HOCM presents with a murmur secondary to obstruction and increased pressure gradient from the left ventricle to the aorta. However, unlike AS, the murmur is best heard between the lower left sternal border and the apex and maneuvers that decrease LV preload (Valsalva), will cause the murmur to intensify, whilst maneuvers that increase LV preload (passive leg raise, squatting), will cause the murmur to soften. *
Mitral regurgitation: chronic MR presents with a holosystolic murmur loudest over the apex. It reflects the wide pressure difference between the left ventricular and left atrium, such that the pressures in the left ventricle are greater than that of the left atrium throughout all of systole (pansystolic). The intensity of the murmur increases with maneuvers that increase LV afterload, such as sustained hand grip.
VSD: also presents with a holosystolic murmur, loudest at the mid-left sternal border.
TR is associated with a holosystolic murmur, but loudest at the lower left sternal border. The murmur is louder with inspiration (in contrast to MR) because there is increased blood flow in the R side of the heart during inspiration. *
MVP: mid-to-late systolic murmur, sometimes preceded by a click. The click represents the opening of the mitral valve as it prolapses, which is then followed by regurgitant blood flow from the left ventricle to the left atrium causing a systolic murmur. Similar to HOCM, the murmur is louder during Valsalva and softer with increased LV filling (such as expiration)
We ask our guests to draw a self portrait and we have seen reactions from delight to dread and everything in between.
Dr. Raymond Moody took another approach, he very quietly outsourced! Respect to you, Raymond!
And the result, as you can see is remarkable.
A big shout out to Kelli McConnell for her excellent drawing.
And thanks indeed to Raymond for being a guest on Figured Podcast. His episode will be released towards the end of 2018.
In the meantime, check out our other guests' self-portraits, podcasts and stories at www.figuredpod.com
Happy Friday everyone! 💫 Hoping everyone has an amazing weekend ahead of them. I plan on spending it with my family and watching a hockey game or two.
I decided that every Friday, I will be posting a Fun Fact relating to medicine. 💉💊
Our first ever fun fact has to do with our teeth! Anyone ever notice that some toothaches are accompanied by a headache? In fact, this is because our teeth have nerve fibers that transmit sensations and discomfort/ pain to our brain 🧠
Let me know if you want me to continue posting fun facts every Friday! Your feedback is always appreciated 😃
Happy Friday Instagram family!
Our denial management program is getting alot of response from GA, TX, NC, CA, LA. Our mission is to help as many healthcare providers as we can with the knowledge we have and the knowledge we are gaining. Try us out. You can only gain!!!
Have you gotten your flu shot? An annual seasonal flu vaccine is the best way to help protect against influenza (the Flu). Influenza is a potentially very serious disease which may lead to hospitalization and even death. millions of people are infected with influenza annually and many die from flu related complications. Influenza strains change every season usually requiring a specific vaccine for that season vaccination has been shown to have benefits that include reducing the risk or the severity of a flu illness, hospitalizations, and the risk of flu related death. those most at risk are children and elderly individuals - Advisory Committee on Immunization Practices recommends with rare exception, vaccination for everyone six months and older. For many there is an option of nasal spray flu vaccine which is approved for people two years through 49 years of age you must be healthy and nonpregnant. when you immunize against influenza you not only protect yourself but indirectly protect those with whom you may contact like family members, coworkers, individuals gathering in public places and others. For more information check out the link in our bio.
I have been waiting for you, Friday! I’m glad you’re here. It’s been a long week of adulting and I can’t wait for it to be over.
I constantly struggle to utilize my time properly. I find myself zoning out while doing school stuff and distracted by all the other things going on in my life. I have this bad habit of doing something that takes way too much of my time when I’m in the midst of something that requires all my attention - I spread myself way too thin. This has been a problem when I was in nursing school, however I was was fortunate enough to just focus on school at that time and did not have to work. Now that I have to be an adult and do things for myself the struggle has been so real. I know that I’m not the only person in the world doing it and other people’s struggles are harder - I think what I’m trying to say is that my current situation gives me perspective. A perspective on how things could be worse and that I am very lucky to be able to to do the things I love despite the first world struggles I have.
And while we’re on the topic of first world problems, anyone struggling with costume ideas this Halloween? Any party you’re going to? Am I invited? How much alcohol are y’all planning to consume? Make sure you hydrate! Hangovers are not cute.
This past summer I started asking around for videos congratulating my dad on his retirement; I think 15 or 16 friends sent stories or memories, and from that I made a super cheesy video -
A version of which is now floating around YouTube (minus the Stones soundtrack ‘cause copyright laws)... here are a few of those lovely people. Thanks all
After Fox & Friends First, I headed over to the @Dr_Oz show to tape a couple health segments. 6 years and 20+ episodes later, everyone at the Dr. Oz show is family. Thank you all, it was SOOO good to see you, and I’m excited for an amazing Season 10!
Nothing but smiles shooting the #URWelcome campaign for @saxbys. Stay tuned, and check instastories for #bts photos👆🏾.
👗: @nicolemiller_philadelphia II ☕️: @saxbys II 📸: @bigrubeharley @freshflickzofficial
This week’s Q & A ~ What is 4D Bioprinting?~ New Q & A ‘s every Friday.
If you would like to learn more in depth about the methodology of 4D bioprinting, please let us know in the comments, it is a fascinating intersection between 3D bioprinting and homeostasis, that would be a pleasure to dedicate and address a publication on it!
McAlpine, K. (2016). “4D- printed structure changes shapes when placed in water”. Retrieved fromhttps://news.harvard.edu/gazette/story/2016/01/4d-printed-structure-changes-shape-when-placed-in-water/ ***
Morouço, P. et al (2017). “Four- dimensional bioprinting as a new era for tissue engineering and regenerative medicine”. Frontiers Journals. https://doi.org/10.3389/fbioe.2017.00061 —————————————