Introduction of Surgery

I. Introduction of Surgery

Surgery, branch of medicine concerned with treatment of diseases, deformities, and injuries through manual procedures called operations. Surgery can be used to repair broken bones, stop uncontrolled bleeding, remove injured or diseased tissue and organs, and reattach severed limbs. Exploratory surgery helps physicians diagnose conditions that cannot be detected by traditional tests. It allows for examination of internal organs for signs of disease.

People have practiced surgery since ancient times, but it did not become a respected science until the 19th century. Increasing knowledge of the human body, the discovery of anesthesia (a loss of physical sensation that can be induced with drugs), and the use of germ-free, or sterile, operating procedures combined to make surgery a safe and effective method of medical treatment. In the 20th century advances in technology have helped the field of surgery grow at a rapid pace.

Use of the Operating Microscope in Surgery

The use of operating microscopes for surgical procedures has greatly assisted surgeons with seemingly impossible types of surgery such as limb reattachment and eye and ear surgery. Operating microscopes are especially useful when individual nerve fibers and blood vessels must be realigned for attachment or repair.

Photo Researchers, Inc./Hans Halberstadt/Science Source

II. Division of Surgery

Surgery is performed by specially trained medical physicians known as surgeons. General surgery training and training in some surgical specialties, such as neurosurgery, which concerns the brain, spinal cord, and peripheral nerves, and orthopedic surgery, which repairs the bones and joints, is conducted in association with a hospital and usually lasts from five to seven years. At the end of this period, known as a residency, the general surgeon may receive further training to learn the skills of a particular specialty, or subdivision, of surgery. Surgical subdivisions include, for example, thoracic surgery, which is concerned with diseases of the chest; vascular surgery, which corrects diseases of blood vessels; plastic surgery, which reconstructs or cosmetically improves features of the body; and pediatric surgery, which is concerned with operations on children.

General surgery is the broadest surgical division, focusing on surgery of the abdomen, the breast, and the endocrine organs—the glands and tissues of the body that secrete hormones for controlling growth, development, and other bodily functions. General surgeons operate on the appendix, colon, small intestine, gallbladder, stomach, pancreas, spleen, and liver. Pediatric surgery is a subdivision of general surgery that focuses on the unique conditions of operating on infants and children—their organ systems are not fully developed, and anesthetics and medications must be adjusted for their smaller bodies. The most common pediatric procedures include correction of birth defects and removal of abnormal growths that are potentially cancerous.

Colon and rectal surgery procedures are performed on the anus, rectum, and intestines. These include operations to treat hemorrhoids (enlarged veins around the anus), polyps (usually benign growths), and cancer. In a colostomy, surgeons remove all or part of the large intestine. An opening called a stoma is then made in the abdomen, which allows the colon to empty waste into a specially designed plastic bag located outside of the body. An ileostomy is a similar operation in which the lower part of the small intestine is routed to the stoma.

Neurological surgery involves operations on the brain and spinal column. These procedures include excising, or cutting out, brain tumors and removing ruptured discs in the spine, an operation known as a laminectomy. The use of specialized imaging equipment, such as computed tomography (CT) and magnetic resonance imaging (MRI), permits surgeons to identify the exact location of some tumors, making surgery to remove these growths more precise and less harmful to surrounding healthy tissue.

Gynecology encompasses a variety of procedures, including surgery to remove diseased reproductive organs such as the uterus (see Hysterectomy); surgery to remove tumors of the breast; and procedures to correct female infertility or facilitate permanent contraception (see Tubal Sterilization). Obstetrics is a division that focuses on all aspects of a woman’s pregnancy and may involve procedures such as a cesarean section, the surgical delivery of a newborn infant, or an episiotomy, a surgical enlargement of the vaginal opening.

Ophthalmic surgery involves operations on the eye and often requires the use of microsurgical techniques performed under a microscope. Such procedures include the removal of a cataract (a clouding of the lens of the eye) and implantation of an artificial lens to restore vision; reconnection of a detached retina to the back of the eyeball; and radial keratotomy (RK), an operation on the cornea to correct nearsightedness.

Cataract Surgery

Surgery is usually required to restore full sight to individuals afflicted by cataract, a loss of transparency in the eye’s lens. The surgeon cuts into the cornea and snips off a piece of the iris, the round membrane that covers the lens and gives the eye its individual color. After this procedure, called an iridectomy, the natural lens is removed with a small pair of forceps and replaced by a new plastic lens. A fine suture is then used to close the incision in the cornea.

Orthopedic surgery entails operations on bones, muscles, and joints. Orthopedic surgery allows for the replacement of hip and knee joints with artificial joints made of special metals and plastics. Fractures in bones are repaired with the implantation of pins, metal plates, and screws. These techniques greatly reduce the time needed for healing and recuperation. A subdivision of orthopedic surgery is sports medicine, which treats injuries and coordinates physical rehabilitation of amateur and professional athletes.

Otolaryngology involves the medical and surgical treatment of diseases of the ears, nose, tongue, larynx (vocal cords), and neck, which includes the esophagus, trachea, and blood vessels. Treated diseases include cancers of the head and neck. Radiation therapy and chemotherapy regimens have reduced the need for radical operative removal of these cancers. Significant advances have also been made in restoring the ability to swallow and speak following operations of the neck.

Plastic surgery encompasses cosmetic procedures to improve appearance and reconstruct damaged parts of the body such as skin and underlying muscle. Cosmetic procedures include enlarging or reducing the size of the breasts; rhinoplasty (cosmetic surgery on the nose); face lift (cosmetic surgery to tighten facial tissues); and blepharoplasty (cosmetic surgery on the eyelids). Reconstructive procedures include modifying tissues and scars to minimize deformities due to birth defects, prior operations, or traumatic events like car accidents. New developments in three-dimensional computer software imaging help plastic surgeons simulate the results of a particular procedure to show a patient the visual results possible before surgery is performed.

Thoracic surgery deals with surgery of the lungs, chest wall, heart, and large blood vessels of the chest. Typical procedures include the removal of malignant cancers and correction of structural birth defects in the lungs and chest. Cardiac surgery is a subdivision of thoracic surgery. Cardiac surgeons perform over 400,000 heart operations annually in the United States. These include coronary artery bypass graft (CABG) surgery, which restores blood flow through vessels blocked by atherosclerosis (a buildup of plaque on the inner walls of the arteries); heart valve replacement surgery, which replaces damaged or worn heart valves with artificial valves; and heart transplants, in which a patient’s diseased heart is replaced by the healthy heart of a donor.

Vascular surgery involves replacing or repairing blood vessels, particularly arteries that deliver oxygenated blood to the body tissues. Operations on major abdominal arteries that carry blood to the legs or brain are performed to restore blood flow diminished by atherosclerosis. A procedure known as carotid artery endarterectomy—removal of blockages in the carotid artery in the neck—reduces the incidence of stroke in some patients. Weakness in a blood vessel wall can result in the development of an aneurysm, a dangerous widening of the blood vessel. Large aneurysms, which can rupture and cause death, are removed surgically and the blood vessel is reconstructed using a synthetic substitute.

Urology deals with kidney disorders, including malignancies, bladder and ureter problems, kidney stones, male infertility and reproductive disorders, and diseases and malignancies of the prostate gland in males. One of the most common operations is transurethral resection of the prostate (TURP), which removes portions of an enlarged prostate.

III. Surgical Procedures

Surgical procedures are classified as optional, required, elective, urgent, and emergent based on the patient’s medical condition. Optional surgery consists of operations that are not required but which the patient chooses to undergo as with some types of cosmetic surgery. Required surgery is performed when only surgery will correct a problem—such as cataracts—but the surgery can be delayed for a period of weeks or months. Elective surgical procedures usually involve conditions that may not require surgery but in which surgery will have a favorable effect—such as the removal of a small cyst. Urgent surgical procedures are performed when a patient’s condition is not immediately life-threatening, but failure to treat it may result in death. Patients with some form of cancer are often considered urgent surgical cases. Emergency procedures must be performed within a few hours of a patient’s arrival at a hospital to prevent death. These surgeries correct serious life-threatening conditions such as major wounds, blockages of the intestines, or appendicitis—inflammation of the appendix.

For any surgical procedure, medical care is provided before (preoperative), during (intraoperative), and after (postoperative) the operation. Preoperative care includes routine checks of vital signs including temperature, pulse, and blood pressure; analysis of blood and urine; and physical examination to evaluate organ function. An anesthesiologist (a physician trained to provide anesthesia) looks for signs that might make the administration of anesthetics dangerous such as chest infections or low blood pressure. A history of the patient’s use of medications is acquired to prevent possible adverse interactions with anesthetics. A surgeon will generally counsel the patient and his or her family about the surgery and what to expect after the operation is performed. Preoperative care reduces the risk of complications during and after surgery.

Intraoperative care involves several members of the surgical team. The surgeon determines the timing of the operation, the techniques, and the instruments and supplies to be used. The anesthesiologist controls the patient’s pain and, if necessary, the level of unconsciousness to make surgery more tolerable and ensure that the patient regains consciousness safely and quickly following the operation. The scrub nurse readies all instruments, ensures the sterility of the surgical field, and anticipates when instruments will be needed by the surgeon. The circulating nurse makes sure the operating room is adequately supplied and provides any additional supplies to the scrub nurse during the operation. Depending upon the hospital, surgical assistants, physician assistants, surgical residents, medical students, and nursing students may also attend an operation.

Postoperative care begins in a recovery room or intensive care unit (ICU). Both areas are equipped to monitor blood pressure and heart rate and provide supplemental oxygen, mechanical ventilation for the lungs, and physical support under critical circumstances. Drugs are often prescribed to control postoperative pain.

IV. History of Surgery

The first surgical procedures were performed in the Neolithic Age (about 10,000 to 6000 bc). Trepanning, a procedure in which a hole is drilled in the skull to relieve pressure on the brain, may have been performed as early as 8000 bc. In Egypt, carvings dating to 2500 bc describe surgical circumcision—the removal of foreskin from the penis and the clitoris from female genitalia. Operations such as castration (the removal of a male’s testicles); lithotomy (the removal of stones from the bladder); and amputation (the surgical removal of a limb or other body part) are also believed to have been performed by the Egyptians. Ancient Egyptian medical texts have been found that provide instructions for many surgical procedures including repairing a broken bone and mending a serious wound. In ancient India, the Hindus surgically treated bone fractures and removed bladder stones, tumors, and infected tonsils. They are also credited with having developed plastic surgery as early as 2000 bc in response to the punishment of cutting off a person’s nose or ears for certain criminal offenses. Using skin flaps from the forehead, Hindu surgeons shaped new noses and ears for the punished criminals. In the 4th century bc, the Greek physician Hippocrates published descriptions of various surgical procedures, such as the treatment of fractures and skull injuries, with directions for the proper placement of the surgeon’s hands during these operations.

During most of the Middle Ages (5th century to 14th century ad), the practice of surgery declined. It was viewed as inferior to medicine, and its practice was left to barbers who traveled from town to town cutting hair, removing tumors, pulling teeth, stitching wounds, and bloodletting, the practice of draining blood from the body, then thought to cure illness. The red-and-white striped pole that today identifies barbershops derived its design from this practice. The red stripes symbolize blood and the white stripes signify bandages.

In 1316 the French surgeon Guy de Chauliac published Chirurgia magna (Great Surgery). This massive text describes how to remove growths, repair hernias (protrusion of an organ through surrounding structures), and treat fractures using slings and weights. The text helped surgery gain respect as a serious science. At this time a new order of surgeons arose in France. They were called surgeons of the long robe, distinguished from the barber surgeons who were known as surgeons of the short robe. The barber surgeons had little medical training, while the surgeons of the long robe were studied physicians and considered such practices as bloodletting primitive. Corporations, or guilds, of surgeons of the long robe were formed in several countries.

Early Modern Surgery

This daguerreotype, circa 1850, shows a reenactment of the first operation performed under an ether anesthetic at Massachusetts General Hospital in 1846. The discovery of anesthesia removed one of the major obstacles to the progression of surgery.

Photo Researchers, Inc./Van Bucher

Microsoft ® Encarta ® 2006. © 1993-2005 Microsoft Corporation. All rights reserved.

During the 16th, 17th, and 18th centuries, many discoveries in surgical practice took place. Much credit belongs to the French surgeon Ambroise Paré, often called the father of modern surgery. Paré successfully employed the method of ligating, or tying off, arteries to control bleeding, thus eliminating the old method of cauterizing, or searing, the bleeding part with a red-hot iron or boiling oil. Discoveries about functions of the human body also helped make surgery a more accurate science during this period. For example, the English physician and anatomist William Harvey discovered the process of blood circulation and Italian anatomist Marcello Malpighi identified the existence of tiny blood vessels called capillaries that carry blood from the major blood vessels to the cells of the body. John Hunter, a British anatomist and surgeon, stressed the close relationship between medicine and surgery and performed many experimental operations that advanced the practice of surgery.

Most surgery, however, continued to be restricted to less critical areas of the body or to operations that did not penetrate the skin too deeply. Surgeons rarely opened the abdomen, chest, or skull because of the pain it caused the patient and the risk of infection. This changed in 1846 when anesthesia was used as a way to mask pain during surgery by American dentist William Morton. Although Morton is often credited with the discovery of surgical anesthesia, American surgeon Crawford W. Long used anesthesia in 1842 during the removal of tumors but did not publish his results until 1849.

Post-surgical infections remained a serious complication of surgery until the mid-19th century when the French chemist Louis Pasteur discovered that fermentation or putrefaction, the decay and death of body tissue, is caused by bacteria in the air. In 1865 the British surgeon Joseph Lister applied Pasteur’s work to surgery, developing antiseptic (germ-killing) techniques including the use of a carbolic acid spray to kill germs in the operating room before surgery. These antiseptic procedures helped eliminate postoperative infection. Other physicians, including Austrian Ignaz Semmelweiss and American Oliver Wendell Holmes, determined that bacteria are also carried on the hands and clothing and transferred from patient to patient as a physician attends one after another. These physicians pioneered techniques such as washing hands and changing into clean clothing before surgery that prevent wounds from being contaminated during surgery.

In the late 1800s, having solved the problems of pain and infection, surgeons began performing new types of surgery including procedures on the abdomen, brain, and spinal cord. At the turn of the 20th century, improved diagnostic abilities and methods of treatment helped surgery become even more effective. When the German physicist Wilhelm Conrad Roentgen invented X rays in 1895 to “photograph” the inside of the body he changed the way surgery was performed. The discovery of the blood groups A, B, and O by Austrian pathologist Karl Landsteiner enabled surgeons to give patients transfusions of their own blood type to ensure survival during surgery. The need for a readily available supply of blood for transfusions led to the creation of blood banks in 1937.

Other technological advances permitted surgeons to perform increasingly complex and difficult operations. The introduction of antibiotics in the 1940s further minimized the risk of postoperative infection. The development of the heart-lung machine in 1953 by American surgeon John H. Gibbon allowed surgeons to more easily and successfully perform surgery on these organs. It also marked the beginning of modern clinical heart surgery. The operating microscope, developed in the 1950s, provided surgeons with a way to perform delicate operations on minute body structures like the inner ear and the eye, and more recently, enabled surgeons to reattach the tiny blood vessels from severed limbs to the body (see Microsurgery). The first kidney transplants were performed in the 1950s, and the first heart transplant, in 1967, was performed by South African physician Christiaan Barnard.

MEDICAL TRIUMPH

First Human Heart Transplanted

Los Angeles Times

December 4, 1967

This Los Angeles Times article reports on a medical breakthrough: the first successful human heart transplant. Dr. Christiaan Barnard led the South African medical team that performed the operation. His name is spelled differently here than in other reports.

CAPE TOWN, South Africa—A South African hospital Sunday made medical history with the world's first human heart transplant. Surgeons removed the heart of a young woman who died after an automobile crash and placed it in the chest of a 55-year-old man, dying of heart damage, a hospital announcement said.

When the transplanted heart was in place, it was started beating by an electric shock, said Dr. Jan H. Louw, hospital chief surgeon. He added: “It was like turning the ignition switch of a car.”

Groote Schuur Hospital said the man was in satisfactory condition late Sunday, but that the next few days would be a critical period.

Heart Removed From Body

The heart was removed from the body of Denise Ann Darvall, 25, an accounting machine operator at a bank, and transferred to Louis Washkansky, a wholesale grocer, the hospital said.

Washkansky was reported fully conscious and in very satisfactory condition after the five-hour operation that ended at 6 a.m. The announcement said his blood pressure was normal by Sunday afternoon.

In the first stage of the heart transplant operation, both Washkansky and the body of Miss Darvall were put on heart-lung machines, each manned by a team of technicians.

In the second stage, the donor's heart was removed and the circulation of her heart, once it was removed, was kept going by a pump.

The third stage was the removal of Washkansky's heart.

Most Intricate Stage

The fourth and most intricate stage of the operation was the placing of the donor's heart in Washkansky's body. When the transplant was completed, electrodes were placed against the heart walls, and a high current was switched on for a fraction of a second.

The heart started beating immediately, Louw said.

Hospital sources at Groote Schuur Hospital said the transplant for Washkansky nearly took place last Wednesday with another donor but was canceled at the last moment because the donor died too soon.

Miss Darvall's kidneys also were removed and taken to Cape Town's Karl Bremer Hospital for a successful kidney transplant to Jonathan Van Wyk, 10.

The announcement of the transplant to Washkansky came from Dr. Jacobus G. Burger, medical supervisor of the hospital.

“The operation was his only chance,” Dr. Burger said. “Washkansky was dying and wouldn't have lived longer than a few days otherwise.”

The doctor said the next two or three days would be the critical postoperative period.

“The longer Washkansky goes on, the better,” he said, “although that does not mean the heart will not be rejected later. The body could decide in 5 or 10 years that it doesn't want this heart.”

Washkansky had a tracheotomy—a tube inserted in his throat through which he is breathing—and is unable to speak, said Dr. Burger. He is being kept absolutely quiet in a special room.

“Even the nurses don't speak to him,” he added.

Dr. Burger said apart from the body's natural tendency to reject the heart, the main danger could come from blood clotting and resultant heart failure.

Washkansky is being fed anticlotting drugs to counter this possibility.

“We are also using steroids to prevent the heart being thrown out (rejected),” Dr. Burger said.

He said Washkansky had been kept alive by using pumps to assist his heart, but this could not have gone on indefinitely.

“The heart muscle was fibrosed, which means that all the muscle was gone and there was only fibrous tissue there,” the doctor said. “It wouldn't pump the blood any more, and his condition was deteriorating.”

Life Depended on Pumps

“We thought he was dying a week ago, and he would have died immediately if we had taken the pumps away.

“Washkansky knew what he was going into, but it was his only chance.”

Heading the team of five cardiac surgeons was Prof. Christian Barnard.

In addition to the cardiac surgeons, there were two neurosurgeons and two anesthetists. Altogether there were about 20 in the operating theater, including five or six nurses, said Burger. All the surgeons were South Africans.

The woman donor was injured fatally in an auto accident Saturday afternoon. Neurosurgeons, with an electroencephalogram to measure her brain waves, alerted the cardiac surgeons the instant she died—shortly before 1 a.m.—and the operation began immediately.

Consent earlier had been obtained from her father to use her heart.

“The operation had to begin within half an hour of her death,” Burger said.

The woman's mother was killed instantly in the same auto accident.

Mrs. Washkansky said that before the transplant her husband's life was “hanging by a thread.” She said he was approached three weeks ago by doctors who told him “in great detail what it would entail. He snapped up the chance, not even making use of the two days they gave him to think it over. He kept saying: ‘I'll pull through.’”

Mrs. Washkansky said, “I was petrified but my husband had such confidence in medical men he inspired me as well.” She said he had had heart trouble for seven years and in the last two years his condition became progressively worse.

The hospital said the operation “was his only chance.” The donor's father, Edward Darvall, said: “I gave the doctors permission to remove my daughter's heart and kidneys and donate them to other persons if it could save their lives—it was shortly before midnight after I was informed she was dying.”

Dr. Burger said heart transplant experiments on cats and dogs had been carried out over the last 10 years at Groote Schuur, which in Afrikaans means big barn.

“Prof. Barnard has two registrars—young doctors studying for postgraduate degrees—continually experimenting in his animal laboratory,” Dr. Burger said. “I know he has successfully transplanted hearts of dogs, but I don't know how long the animals lived afterwards.”

Source: Los Angeles Times, December 4, 1967

V. Surgery Today

New techniques continue to advance the field of surgery. High frequency sound waves, called ultrasound, are directed at kidney and gallbladder stones to break them apart so that they can be eliminated through the excretory system. Cryosurgery freezes and destroys abnormal tissue and is used to treat hemorrhoids and some cervical disorders, and to remove certain skin growths. Laser surgery, on the other hand, uses a beam of light to vaporize or destroy tissue, a procedure commonly employed in ophthalmology, neurosurgery, and thoracic surgery.

Endoscopic Surgery

An endoscope provides a surgeon with an illuminated and magnified view of internal organs and body cavities without making sizable incisions. Endoscopes are easily maneuverable to reach inaccessible areas and they can be equipped with a variety of instruments, from knives to lasers.

Encarta Encyclopedia BBC Worldwide Americas, Inc.

A variety of surgical procedures are performed using an endoscope, an instrument that permits doctors to view the inside of the body without making a large incision and through which special tools such as lasers or knives can be inserted to operate on a particular area of the body. Surgery using an endoscope, also called laparoscopy, is used to perform tubal sterilization, gall bladder removal, or lung removal. This technique is commonly used for biopsies, in which tissue is removed from an organ for evaluation under a microscope, or for removing patches of diseased tissue.

Transplantation surgery, in which organs or tissues are removed from one person and surgically implanted into another person, is now performed for the eye lens and cornea, blood, bones and bone marrow, heart, lung, liver, and pancreas. In severe burn cases, healthy skin from an uninjured site is transferred to an area that has been damaged. Patients typically receive transplants when their own organs fail. Donor organs come from recently deceased individuals who have indicated on organ donor cards a desire to donate organs or whose family members have authorized donation of the deceased’s organs. Donated organs must be transplanted within 24 to 48 hours after a donor’s death.

Ambulatory, or same-day surgery, is performed in a physician’s office or clinic. It involves operations that use minimally invasive techniques, require less extensive cutting, and use anesthesia that clears rapidly from the body. Some types of plastic surgery, implantation of permanent pacemakers, breast surgery, and biopsies are typically performed in ambulatory surgical clinics.

By: Norman S.Kato

Microsoft ® Encarta ® 2006. © 1993-2005 Microsoft Corporation. All rights reserved.

Hair Transplant Surgery - The Procedure

When considering hair transplant surgery, it is important to understand what is involved. Having a general understanding of the procedure can help you select the right doctor for you. It will also help you communicate with your doctor once you have chosen one.

Hair transplants are the most common form of hair restoration surgery. Complications from the surgery are relatively low, and it is not a difficult procedure for experienced doctors. The surgery is permanent, so it is important to do your due diligence.

The surgery will start with anesthetic injections, which is actually the most painful part of the operation. This is done to numb the scalp, and once it takes effect, you will more than likely not feel a thing.

A small incision is made in a portion of the scalp where you are donating hair. The piece is removed and the scalp is stitched up. The donor tissue is then divided into groups based on the areas of the scalp that need the new hair.

The hairs are then grafted into place onto the scalp. This is the most important part of the procedure, and the reason why you must select an experienced and recommended doctor. A talented doctor can graft the hairs so that they look natural, and nobody can tell you had hair transplant surgery. An inexperienced doctor may graft the hair so that the procedure is obvious.

Once the surgery is completed, the hairs that were grafted may fall out. This is natural and is a normal part of your hair growth process. Hair growth moves through cycles, and it make take up to six months to actually see new hair growth from the procedure.

If a doctor wants to use plugs, you should run. A competent doctor will perform micro or mini grafts that will leave you with a natural looking head of hair. Depending on the person, it may take several hair grafting sessions to get the desired look and feel of your new hair.

by Matt Adler

Exercising After Surgery

If you have ever had surgery, chances are exercise has been part of your recovery process. Depending on the type of surgery, exercise is typically used to help you return to pre-operative activities. If done properly, exercise will definitely improve your balance and make you more flexible. Exercise will strengthen the muscles that help stabilize your joints while keeping your cardiovascular and other bodily systems working properly.

How quickly you start exercise after major surgery will vary with the type of surgery you had. Simple outpatient surgery may only require a week or two whereas major surgery will likely sideline you for six to twelve weeks. Even if you begin to feel better prior to full recovery, you should not attempt any exercises without first consulting a physician.

Any type of surgery that causes you to suspend your daily activities or exercise routines, will reduce your metabolic level likely leading to weight gain. You would want to incorporate light weight training and cardio into your exercise program only after your physician has given you the okay. If you were an exerciser prior to surgery, slowly build up to the level you were prior to the surgery. Remember, always stay well hydrated no matter what your level of fitness. Water is helpful in keeping your joints lubricated and your synapse firing.

Again, take it slow and return to pre-operative exercise levels gradually. If you are not an exerciser, it would be beneficial to solicit the help of a physical therapist or personal trainer. Here are a couple of exercise routines you may consider with two types of surgery. Again, it is very important your physician says it is okay to begin exercising.

Breast Surgery

Typically, a week or two after surgery you will still be experiencing some type of discomfort. You can help your recovery along by performing a couple of simple arm exercises. It's always important to remember to breathe during any exercise you may perform.

It may seem a little silly so consider doing this in the bathroom if others are around, or, you may not care. Lift your arm which is on the same side the breast surgery was performed. Now simulate the eating motion, going from the bathroom counter up to your mouth. Perform 10 up-and-down motions before stopping. Next, lift your arm higher and simulate a hair brushing movement. Again, perform 10 repetitions prior to quitting. Repeat this cycle two or three times unless you feel discomfort, then discontinue immediately. While you're on the couch watching television, keep that same arm above heart level for an hour or two as this will help to reduce swelling. While your arm is elevated, slowly open and close your hand. As your discomfort decreases, gradually build up to the point where you can clinch a tennis ball. To avoid soreness in your elbow, occasionally straighten your arm and bring it back.

After a couple of weeks performing the above exercises, you should feel strong enough to do the following: You'll need a broom handle to complete this exercise, and you will also need to cut the broom portion off. With the handle in both hands, palms up and arms stretching outward, lift the broom handle above your head and hold for a count of five, then lower to your pelvis area and repeat up to 10 times unless you feel great discomfort.

Hysterectomy

Again, before starting any exercise program after surgery, be sure to consult your physician first. With these exercises, you will work your abdominal area, pelvic region and back muscles.

Lie on the floor with your knees bent and your hands behind your head. Start by pressing the small area of your back gently into the floor, then even more firmly. If pain increases don't continue, stop immediately. Do up to 10 repetitions, rest and repeat for as many sets as you feel comfortable doing.

For the abdominal area, a traditional crunch works very well. If you are not familiar with the crunch, lie on the floor with your knees bent and your hands behind your head. Slowly lift your head and shoulders off of the floor roughly 6 inches. While you're lifting, be sure not to talk your chin into your chest. Then slowly lower your head and shoulders back to the floor and to repeat up to 10 times, again for as many sets as you feel comfortable doing.

The third exercise is from the same position. Lift your hips off the floor a couple of inches, hold for a few seconds, and then lower them back to the ground repeating the same repetition recipe, up to 10 repitions and as many sets as you feel comfortable doing.

The fourth exercise is performed lying flat on the ground. Slowly raise your right arm and your left leg. Then alternate bringing down your right arm while raising your left arm. In the same motion, begin lowering your left leg while raising your right, much like a scissors movement. Again, 10 repetitions and as many sets as you feel comfortable performing.

In all of these exercises, I mentioned you should perform 10 repetitions and as many sets as you feel comfortable doing. Realistically, start with one set, then the next day if you are able, do two sets, third day three sets and so on. Again, never continue exercising if you feel pain.

by Mike Conley

Turning Back The Clock With Cosmetic Facelift Surgery

It seems that every time we turn on our televisions, open a magazine, or listen to the radio we are met with another reference, story, or advertisement for cosmetic facelift surgery. No longer are the masses content to just grow old gracefully; not when there are medical miracles happening that can prolong youth and sustain beauty. And while cosmetic facelift surgery is certainly not for everyone, in many it has transformed the way they feel about aging – putting their appearance back into their control.

Cosmetic facelift surgery works to erase common signs of aging – drooping eyelids, deep fold and wrinkles, loose skin, and loss of definition. It can be an incredibly successful surgery that – when healed – can restore ten years to your face. But, as with any surgery, cosmetic facelift surgery must be approached with caution and education.

First and foremost, you must decide if cosmetic facelift surgery is something that you want to do for yourself or something that you feel must be done to please others. Cosmetic surgery of any kind should be for person and one person only – you. Having cosmetic facelift surgery to help you feel better about yourself is absolutely valid; having surgery simply because someone tells you that you should look a certain way are not the right reason.

If you are confident that cosmetic facelift surgery is something that you want to explore then you should begin by doing your homework. Look into the details of the procedures you want done. Learn the requirements for surgery, and what to expect prior to, during, and after the surgery. Talk to other people who have undergone cosmetic facelift surgery so you can gage the recovery time and expected results. The Internet is a great place to find people who are in similar situations.

However, finding a reputable doctor to perform your cosmetic facelift surgery is the most important piece of the puzzle. Just because a surgeon is licensed to perform a cosmetic facelift surgery, doesn’t mean that he/she is the best person for the job. Extensively research the credentials of any surgeon you are considering. Better yet, ask for references of other patients that have had a cosmetic facelift surgery performed by this particular doctor. You’ll be able to see some examples of results up close and establish the doctor’s reputation.

Your meetings with the surgeon prior to your cosmetic facelift surgery should make you feel well informed, respected, and comfortable. Be sure to openly discuss any concerns that you have about the surgery and ask a lot of questions.

Be sure that you are clear on the risks associated with cosmetic facelift surgery. As with any cosmetic surgery there is the risk of fluid retention and infection. But using a reputable, experienced surgeon largely minimizes these risks.

You will, however, have some recovery time following the cosmetic facelift surgery. Expect some swelling, bruising, and possibly some minimal bleeding during the healing process. Be sure to follow-up with your doctor if you experience anything unusual; and follow all instructions for proper healing.

If done properly by a reputable and experienced surgeon, your cosmetic facelift surgery can be enormously successful and restore to you a youthful appearance.


by Michelle Bery

Secrets of Gastric Bypass Surgery: Lose Weight Without Surgery

There’s more to gastric bypass than surgery and rapid massive weight loss. Patients who undergo weight loss surgery (WLS) sign-up for a lifetime of rigid behaviors to guarantee their long-term success. Just imagine: If you knew what those behaviors were, could you lose the weight and keep it off without surgery? Take a look at the four rules WLS patients live by:










Rule 1: Protein First: The first rule for living after Weight Loss Surgery (WLS) is Protein First – that means eating protein for three daily meals, and protein must be 50 percent of food intake. Animal products are the most nutrient rich source of protein and include fish, poultry and meat. Dairy protein, including eggs, is another excellent source of protein. Nuts and legumes are also good sources of protein, but sometimes difficult for the bariatric patient to consume. Science is proving that a protein rich diet will prompt weight loss and increase energy. The body contains over fifty-thousand different active proteins all made out of the same building blocks: amino acids. Amino acids are made of carbon, hydrogen, oxygen and nitrogen as well as sulfur, phosphorus and iron. Many diseases – including obesity – indicate an amino acid deficiency. Weight loss surgery patients don’t have a choice, they must eat lean protein or they will get sick, anemic, and weary. Weight loss will cease if they eat processed carbohydrates instead of lean protein. Dumping or vomiting may also result if patients do not eat lean protein for the first half of every meal. The distinction must be made between high fat proteins and lean proteins. A gastric bypass patient cannot tolerate high fat proteins such as bacon, fatty beef or sausage products or greasy fried chicken: these foods cause nausea and vomiting. In addition, these high fat protein rich items are contributors to obesity and should be avoided by anyone wishing to control their weight.

Rule 2: Drink lots of water Dieters are often told – drink water. Drink a minimum of 64 ounces a day – eight glasses a day. Gastric-bypass patients don’t have a choice: they must drink lots water. Other beverages including coffee, tea, milk, soft drinks and alcohol are forbidden. Water is the essential fluid for living. Water is one of the most important nutrients the body needs to stay healthy, vibrant and energetic. A tell-tell sign of a gastric bypass patient is the ever-present water bottle. The human body is a magnificent vessel full of water. The brain is more than 75 percent water and 80 percent of blood is water. In fact, water plays a critical role in every system of the human body. Water regulates body temperature, removes wastes, carries nutrients and oxygen to the cells, cushions the joints, prevents constipation, flushes toxins from the kidneys and liver and dissolves vitamins, minerals and other nutrients for the body’s use. Nutritionists say a precise measure of the body’s need for water is to divide body weight (pounds) in half and drink that many ounces every day. That number could well exceed 200 ounces a day for morbidly obese people actively engaged in weight loss. The body will panic if actual water intake is significantly less than required. Blood cannot flow, waste processes are disrupted and the electrolytes become imbalanced. Proper hydration prevents inflammation, promotes osmosis and moistens lung surfaces for gas diffusion. It helps the body regulate temperature, irrigate the cells and organs and promotes all functions of elimination. Certainly by drinking plenty of water many people could resolve inflammation and elimination problems that result from insufficient water intake. Adequate water facilitates weight loss.

Rule 3: No Snacking Gastric bypass patients are instructed to avoid snacking. No exceptions. Snacking is the worst possible thing a WLS patient can do. If patients snack they cease to lose weight and could possibly regain weight. In addition gastric bypass snackers risk severe swings in blood sugar levels and glucose overdose, they fail to move forward to the healthy life that surgery makes possible. They feel like failures when the WLS does not result in weight loss. The nature of gastric bypass surgery gives patients an edge on beating the snacking habit. When a patient eats three protein-rich meals a day the body’s fuel requirements are met and satiation results. Hunger does not occur if water is sipped throughout the day. If a patient is taking vitamins they will not be nutritionally wanting. Given that, patients who snack are doing so out of the very habit that contributed to obesity. If a dieter must snack they must be mindful of their choices. Fruits, vegetables and lean proteins will contributed to wellness and weight loss. Processed carbohydrate convenience foods fail to meet nutritional needs or facilitate weight loss and should be avoided. Successful WLS patients understand that snacking is bariatric purgatory. When they begin to snack weight loss will cease and weight gain will certainly result. Successful weight loss patients – those who maintain their weight loss years after surgery – do not snack. The same is true for all successful dieters regardless of the means by which they initially lost weight.

Rule 4: Exercise The final rule, the one WLS despise the most, patients must exercise every day. Nothing is more disappointing than hearing a gastric bypass patient brag that they didn’t have to exercise to lose weight. It’s true; patients will lose weight without lifting a finger. But patients who do not use the time of rapid weight loss to incorporate exercise into their lifestyle are doing themselves a grave disservice. Obesity cripples the body. Bone tissues are compromised, joints are swollen, the vascular system is inadequate and the skeleton overburdened. As weight is lost, the burden on the bones, joints and vascular system is decreased. However, the body is a magnificent machine. Given proper nutrition and physical motion it will rebuild its broken framework. The systems can become strong and vital. The most effective way to heal the body from the ravages of obesity is to exercise. Exercise means moving the body: walking, stretching, bending, inhaling and exhaling. Exercise is the most effective, most enjoyable, most beneficial gift one can bestow on themselves in the recovery from life threatening, crippling morbid obesity. People who successfully maintain their weight exercise daily.

Conclusion: Successful weight loss surgery patients will tell you these are the four rules they live by, that the gastric bypass is only a tool to facilitate mindful behavior for better health. They will confirm that weight control, even with surgery, takes a lifetime of diligent attention to their bodies and behavior. They will assure you it isn’t easy, but the results are worth the effort. Kaye Bailey is a weight loss surgery success story having maintained her health and goal weight for 5+ years. An award winning journalist, she is the author of many articles about life after gastric bypass. Ms. Bailey is the webmaster of http://www.livingafterwls.com and http://www.livingafterwls.blogspot.com Fresh & insightful content is added daily, check in often.

By Kaye Bailey

Laser Eye Surgery: What Is Lasik

Lasik laser eye treatment - short for Laser In-Keratomileusis – is the surgery of the eye, through use of lasers, to correct vision. In most instances eyesight is restored sufficiently to negate the need for glasses or contact lenses.

Who is a suitable candidate for Lasik?

It is unsafe for surgery to be carried out on patients with eye disorders or diseases. The biggest factors, however, in whether an individual is suitable for Lasik surgery are the age of the patient and the severity of their long or shortsightedness.

Under the age of 21 the vision may still be experiencing changes which would render the results of Lasik surgery very short lived. After this age, vision becomes more stable and any deterioration or improvement in the sight should not be so marked. However, once a person is approaching the age of 60 the rate of degeneration increases again, making laser eye surgery less feasible.

Surgery can be markedly less effective on patients whose eyesight is extremely poor. When making initial enquiries about undergoing Lasik, a doctor may advise that you are an unsuitable candidate if you are highly longsighted (+2 or greater) or extremely shortsighted (which is considered to be in excess of -8).

How is Lasik surgery performed?

When undergoing Lasik the patient’s eyelid is taped back to allow full access to the eye and prevent blinking, which may cause some discomfort to the patient. Surgery is performed by slicing a small flap in the cornea (which can cause temporary vision loss, which should not last more than 30 seconds). A pre-programmed laser meticulously reshapes the eye before the flap is replaced. The surgery should not be painful, but there is a slight smell of burning during the use of the laser, which can make it an unpleasant experience for the patient.

Post operatively, Lasik surgery patients generally experience little or no discomfort. Vision will be a little hazy and distorted for the first 48 hours but will vastly improve after this time, with the final effects of surgery becoming apparent within a month of the procedure being carried out. Eye drops are a necessity for the first 6 months after surgery as dry eyes are a side effect of all forms of laser eye treatments.

How effective is Lasik?

The statistics available for successful laser eye surgery – where ‘perfect’ vision is restored – are inconsistent, but it is believed that between 80 and 98% of patients’ vision improves to the extent where contact lenses or glasses are no longer required.

The effects of Lasik are permanent, although laser eye surgery cannot prevent the natural degeneration of eye sight which is a normal part of the ageing process. The results generally are more long lived in short sighted patients, who may benefit from many years of good eye sight before requiring glasses again. The outcome of surgery is usually initially good for long sighted patients, but deterioration can occur much more rapidly and glasses are often required after two years.

Is Lasik safe?

If vision is improved but contact lenses re still required, the lenses may be very uncomfortable for the first few months after surgery. Dryness – a common side effect of surgery – can also cause the eye to become sore while wearing contact lenses.

The most worrying, but statistically unlikely, risk associated with Lasik is that the cornea can become detached. There is a small risk of a post operative infection developing in the corneal flap.

The best way to decide whether Lasik is a viable option for you is to book a consultation at a vision clinic or a hospital.

Leanne has had several articles published on the subject of laser eye treatment, including laser eye surgery risks. www.lasereyesurgery.about-beauty.net

By Leanne Williams