Archive for April, 2010
April 29th, 2010 | 
Author: I am going to try new version of pain control device from Empi that applies direct pain control thru application of a Tens unit easily apply to the skin.The goal is to lessen the need for drugs that can have so many side effects.We have tried to find best combination of products that may lower the need for surgery.
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Age is not an issue rather quality of life for decisions regarding surgery. I operated on 95 year old doctor’s father who actually was up and left hospital second day after laminectomy and fusion three levels. He was still living in his own home and driving to places. I believe there many elderly patients that do not realize withproper planning and cautious surgery they can be helped. These patients do poorly with medication for pain.
I do recommend a less complex procedure if patients have complex co-morbitities such as cardiac requiring blood thinners. However, sometimes this will require taking them back for a second procedures if the results are not adequate rather then having one 4 or 5 hour first surgery. Safety ranks number one in my planning.
Sciatica is a very common problem and one should not panic. Greater then 90 percent resolve without surgery. I usually give medication and complete therapy program that works for most patients. If symptoms are severe a nerve block is performed in the office. Acupuncture is also offered as well as decompression using special tables. Surgery only as a last resort after above fails.The first disc surgeries were in 1930’s so this treatment was not even offered years ago and patients did recover.
One of the most concerning complication of spinal surgery can be an infection. This reported problems can occur in 15 percent of elective surgeries requiring hardware such as rods and screws. I believe that if patients seek early contact with their surgeon the consequences can be minimized. Unfortunately, any delay can serious change the outcome. I give everyone of my patients my home and cell number for this very reason. Early detection can allow prompt initiation of antibiotics that can resolve the superficial wound infection from becoming a complex recovery.When a patient has redness or drainage that occurrs 1 vto 2 weeks after surgery they must become aggressive to let their surgeon know.
I have recently begun to ask patients to consider their diet and nutritional preparation prior to surgery. We ask all patients to take vitamins but review specifics if they are taking any herbal products. I also try to get them exercising within their pain limits two weeks prior to surgery as well. We all feel, as a team ,this has clearly improved patients outcomes and ability to handle pain in post- operative phase of their care.
Our team can now prevent 95 percent of need for sugery when patients are compliant. We now use acupuncture and added fitness training to the team. Surgery is now less invasive with rapid return to activity. So much progress in just a couple of years.I am still amazed that patients do not look at all their options and try our approach. Wellness is fundamental to a good team approach.