Posts Tagged ‘surgery’

Is there a threat of antibiotic resistance for surgical and chemotherapy patients.

Wednesday, October 21st, 2015

logo1267406_mdA new study published in the Lancet Infectious Disease Journal concluded that the rising antibiotic resistance could have disastrous consequences for patients receiving surgery or cancer chemotherapy.  New estimates show that up to half of infections following surgery and over a quarter of those following chemotherapy are caused by organisms already resistant to standard prophylactic antibiotics in the United States. They further say that just a 30% reduction to the efficacy of preventive antibiotics that are given routinely before, during, and after these procedures could result in 120,000 more infections and 6300 infection-related deaths every year in the United States.  Although bacterial resistance was known, it extent was unknown previously.

Researchers conducted a review of all meta-analyses of randomized control trials conducted between 1968 and 2011. They examined the efficacy of antibiotic prophylaxis in preventing infection-related deaths after 10 of the most common surgical procedures and blood cancer chemotherapy and calculated the additional number of infections and infection0related deaths under different scenerious of reduction in the efficacy of antibiotic prophylaxis. In addition, they use data and existing studies from the National Health Safety network they estimated the proportion of infections caused by bacteria that are resistant to currently used standard prophylactic antibiotics., They found that between 39% (after caesarean section)and 50-90% (after trans-rectal prostate biopsy) of surgical site infections are caused by organisms that are  resistant to recommended antibiotic prophylactic regimes. Also, just over a quarter of the infections after blood cancer chemotherapy are resistant to standard antibiotics. Using additional modelling they estimated that a 10% drop in the efficacy of antibiotic prophylaxis could result in 40,000 additional infections every year in the United States at best. or 280,000 infections in a pessimistic scenerio –a 70% drop in efficacy.  They also concluded the infection-related deaths could increase by 2100in an optimistic scenerio. or even a 15,000 deaths in a pessimistic scenerio. They concluded that clinicians have a responsibility to prevent this from happening by clinician education, guideline development, and formulary restrictions to optimize antibiotic use.

Colorectal Patients have Speeded Recovery Time with New Care Approach.

Friday, May 15th, 2015

Colorectal Surgery Patients in Enhanced Recovery

A new research study published online as an “article in press” on the Journal of the American College of Surgeons website in advance of print publication concluded that patients who participated in an enhanced recovery program following colorectal surgery left the hospital sooner and had a significantly lower hospital costs than those following a traditional pattern of care. The focus of the enhanced recovery program is to speed patient’s recovery by reducing the body’s stress responses to a surgical procedure and promoting earlier return of bodily functions. In this study patient stays were trimmed by nearly two days, on average, compared to patients receiving traditional care and there was no increase in readmission’s in the first month following surgery. In addition, the rate of surgical site infections dropped by nearly 10 percent.

Enhanced recovery includes but goes beyond “fast tract surgery” in which there is minimal invasive techniques and encouragement of early mobilization and eating by patients.  Enhanced  recovery does away with traditional preoperative fasting and bowel-emptying preparation  whenever possible and instead allows clear fluids   up to two hours before surgery.  To prevent fluid retention, anesthesiologists reduce the amount of intravenous  fluids given during the procedure. Patients also receive fewer narcotic painkillers during and after surgery. By using alternative types of pain medications the length of hospital stay is shortened because the side effects of narcotics such as vomiting and constipation are reduced.

Researchers say the U.,S, hospitals have been slow to accept components of this pattern of care. For example, “The scientific evidence that it is safe for patients to drink clear fluids up to a few hours before anesthesia is more than 25 years old. It just took us that long to adopt.”

In this study data was used from patients undergoing elective major colorectal resection  at Duke between September 2006 and March 2013. Seven hundred eighty seven patients met study criteria and were divided into 3 groups based upon surgical care provided. Three hundred were in group one who received traditional care, 165 were in group 2 receiving the enhanced recovery program but did not receive the SSI (surgical site infection) bundle, and the third group that had both enhanced recovery program and SSI bundle.

Results showed each intervention improved surgical outcomes in different ways. Those receiving enhanced recovery stayed in the hospital 1.7 days less than those receiving traditional care.  In addition, the average cost for colorectal surgical admissions fell from $31,926 before the enhanced recovery program was initiated to an inflation-adjusted $22,044 three years after it started.  The group having both enhanced recovery and the SSI bundle had a decreased rate of superficial wound infections: 6.3 percent vs 16.1 percent in the enhanced recovery only group. The rates of sepsis, a life-threatening infection, also were lower, 1.8 vs 11.2 percent. The SSI bundle included among other measures, keeping the patients temperature normal during the post op period, removing the bandages within 2 days of the operation, and washing the incision daily for one week with antiseptic solution.  Researchers concluded ” The enhanced recovery program and the SST bundle together have profoundly altered the practice of colorectal surgery at our institution and improved the quality of care.”

Dr David Hanscom (Non-Invasive Back Pain Relief) and Joyce O’Brien (Late Stage Cancer survivor)

Sunday, July 13th, 2014

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Dr. David Hanscom is a board certified orthopedic surgeon specializing in complex spine problems in all areas of the spine. He has expertise in adult and pediatric spinal deformities such as scoliosis and kyphosis. A significant part of his practice is devoted to performing surgery on patients who have had multiple prior spine surgeries. He works for Swedish Neuroscience Specialists in Seattle, WA with eight neurosurgeons and a physiatrist.

Dr Hanscom completed his medical degree from Loma Linda University in 1979, .a residency with internal medicine in Spokane, WA from 1979-1981, an Orthopedic surgery residency was at the University of Hawaii from 1981-1984, .a six-month orthopedic trauma fellowship in 1984 at UC Davis in Sacramento, CA. and completed his spinal deformity fellowship in Minneapolis, MN at Twin Cities Scoliosis Center in 1986.

He is the founder of the “DOCC” project. It stands for “Defined, Organized, Comprehensive, Care.” This is a structured rehabilitation protocol for chronic pain, which involves improving sleep, managing stress, engaging in long-term conditioning, obtaining adequate pain control with aggressive medication management, re-setting goals, and educating the patient so as to regain control of their decision making.

He is the founder of the Puget Sound Spine Interest group, which was formed in 1987. It is a non-profit educational group, which provides a regional forum for physicians to share ideas regarding optimum spine care.  “Awake at the Wound” is a process, which brings athletic performance principles into the operating room. He co-founded the program with his golf-instructor, David Elaimy, in 2006. David Elaimy is also a performance coach who has been giving golf-based performance seminars in the financial sector for over fifteen years.

He had written many articles and his latest book Back in Control: A spine surgeon’s roadmap out of chronic pain, publish in 2012 is still a top seller on Amazon.

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Within a 5-year period, Joyce OBrien’s husband, Kevin, was paralyzed after a brain hemorrhage and both Joyce and Kevin were diagnosed with late stage cancers.

Faced with their devastating diagnoses, and fearing leaving their baby girl an orphan, Joyce, an Executive Vice President on Wall Street, left a successful 18 year career to begin her healing journey.

Ten years ago, Joyce and Kevin were blessed with healing stage 3b and stage 4 cancers, chronic fatigue, depression and more. Joyce’s life mission became clear and she invested years in training, research and studying with top doctors and experts in holistic health to discover many of the secrets of what makes us sick and how to heal.

Joyce, trained in Biological Medicine and Microscopy, is a national speaker empowering, inspiring and educating her audiences with the tools to improve their health – body, mind and spirit.

 

Does Surgery or Radiation Benefit Older Men w/Early-Stage Prostate Cancer and Other Health Problems?

Wednesday, May 21st, 2014

logo1267406_mdA new study in the early online edition of Cancer concluded that treating older men with early-stage prostate cancer who also had other serious health problems with aggressive therapies such as surgery or radiation therapy does not help them live longer and may be detrimental. The retrospective study followed more than 140,500 men ge 68 and older diagnosed with early stage prostate cancer between 1991 and 2007. Men were followed for 15 years after diagnosis and the Charison Index that can predict 10 year mortality for a patient who has a range of other health problems was used. A protstate cancer patient with diabetes may score 1 on the index, whereas a man with multiple or more severe health problems might score a 3 or higher. Findings showed that men with a Charison index score of 0,1, or 2 who were treated with surgery or radiation therapy had a lower risk of dying of prostate cancer compared to men receiving no treatment. However, men with scores of 3 or higher did not have a reduction in risk of death from cancer with aggressive treatment because they did not live long enough to benefit from it and were more likely to die from something else. They said that men who also had multiple medical conditions such as a history of heart attack, chronic obstructive pumonasry disease, and diabetes in combination did not live longer after agressive treatment compared with men receiving no treatment and were also at risk of side effects such as impotence, urinary incontinence and bosel problems that can result from surgery and radiation treatment. Researchers said “The guidelines suggest the men with life expectancies of less than 10 years shouldn’t be treated aggressively, but life expectancy is difficult to measure accurately. This data clearly defines a subset of patients who should avoid therapies that will only cause them problems they don’t already have.”

Saturday’s Show with Cancer Survivors Kathleen O’Keefe Karnavos, Margaret Bermel, and Claire Petretti

Sunday, December 23rd, 2012

Guests for the show on Saturday included cancer survivors Kathleen O’Keefe Kanavos (left) , Margaret Bermel (middle), and Claire Petretti (right) .

Kathleen  is an inspirational speaker, phone counselor at R.A. Bloch Cancer Foundation and author of Surviving Cancerland: The Psychic Aspects of Healing. More information was presented earlier on this site or can be found at http://www.Survivingcancerland.com

Margaret has co-authored management articles in scholarly journals, was the co-recipient of the Human Resource Management and Orgamizational Behavior Journal’s Distinguished Paper Award in 1985, and is author of The Cancer Odyssey: Discovering Truth and Inspiration on the Way to Wellness. More information was presented earlier on this site or can be found at: http://www.thecancerodyssey.com

Claire Petretti studies for law but decided it was not for her and has spent many years working with Yoga and Cancer Recover, completed a DVD on Yoga for Cancer Recovery and finishing a book based upon her self-written cancer journals. More information was presented earlier on this site and can also be found at: http://www.oceansoulyoga.com

Are Double Mastectomies Necessary for Women With Breast Cancer?

Friday, December 7th, 2012

A new study presented at the American Society of Clinical Oncology’s Quality Care Symposium last month concluded that about 70% of women who have both breasts removed following a breast cancer diagnosis do so despite a very low risk of having subsequent cancer in the healthy breast.

The study found that 90% of wom,en who had surgery to remove both breast reported being worried about cancer recurring., The researchers said “Women appear to be using worry over cancer recurrence to choose contralateral prophylactic mastectomy. This does not make sense, because having a non-affected breast removed will not reduce the risk of recurrence in the affected breast.  ”

One thousand four hundred forty six women who had been treated for breast cancer and who had not had recurrence were included in the study.  Of these, 7% had surgery to remove both breasts and among women who had a mastectomy, nearly 1 in 5 had a double mastectomy.

Researchers also collected data on clinical indications for double mastectomy, including patients family history of breast and ovarian cancer and the results of any genetic testing. “For women who do not have a strong family history or a genetic finding, we would argue it’s probably not appropriate to get the unaffected breast removed.” The researchers are developing a decision tool that will help guide women through breast cancer treatment choices. The researchers said “I believe surgeons are telling their patients that a contralateral mastectomy won’t reduce their risk of recurrence and that it is associated with higher mortality. But this procedure is still done and it’s done in women who donm;t need to have it done. A decision tool like ours will solicit common misconceptions about breast cancer treatment and give women feedback to help them fully understand the options and risks involved.”

Staging Lung Cancer Using Less Invasive Method Shows Promise

Wednesday, December 1st, 2010

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In a study reported in the November 24 issue of the Journal of the American Medical Association (see the reference below) researchers concluded that when using two interventions to determine the stage of suspected non-small cell lung cancer (NSCLC) the less invasive may be more effective and save the patient unnecessary surgery.

In the study the researchers compared the two recommended lung cancer staging strategies that are endosonography, untrasound using a fiberoptic endoscope, considered the less invasive and
surgery. Currently, endosonography may be followed by surgical staging if no nodal metastases are found. Surgical staging alone has limitations and mit is believed may result in unnecessary surgery.

Interventions in the study included either surgical staging or endosonography followed by surgical staging if no nodal metastases were found and thoracotomy (surgical procedure) with lymph node dissection when there was no evidence of mediastinal (space near the lungs in the thoracic cavity) spread of the tumor.

Two hundred forty one patients with suspected NSCLC in whom mediastinal staging was indicated were randomized into the two group during the period February 2007 to April 2009. Of these, 118 were in the surgical staging group, and 123 in the endosonography group. Of the later group 65 also underwent surgical staging. “Nodal metastases were found in 41 patients (35%) by surgical staging vs 56 patients by endosonography (46%) and in 62 patients (50%) by endosonography followed by surgical staging. This corresponded to sensitivity of 79% (41/52) vs 85% (56/66) and 94% (62/66).” Unnecessary thoracotomies were performed on 21 patients (18%) in the mediastinoscopy group vs 9 (7%) in the endosonography group.

The authors concluded that among suspect NSCLC patients a staging strategy combining endosonography and surgical staging resulted in greater sensitivity for mediastinal nodal metastases and fewer unnecessary thoracotomies than using surgical strategies alone.
See the full study below:
http://jama.ama-assn.org/cgi/content/full/304/20/2245

Back Pain and Seasonal Allergies to be Discussed on the Holistic Health Show

Sunday, June 20th, 2010

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On this show I will complete the series on back pain and start a new series on seasonal allergies.

My guests for Saturday, June 26 on the Holistic Health Show are Dr Steven Y. Park (left), Lou Paradise (right), and Kathi Casey (lower right).

Dr Park is an otolaryngologist, surgeon, and author of the book Sleep, Interrupted: A Physician Reveals The # 1 Reason Why So Many of Us Are Sick and Tired His book has been endorsed by the New York Times best-selling authors Christina Northrup,M.D., Dean Orish, M.D., Mark Liponis, M.D., and Mary Shomon. Dr Park is a Clinical Assistant Professor of otolaryngologist at the New York Medical College.
Steve practices integrative medicine and surgery, with a firm belief that other models of health and disease can complement traditional, western medicine. He provides monthly live tele-seminars with experts not only related to his field but also professionals in other areas-he has interviewed acupuncturist, dieticians, and neuro-linguistic programming and hypnosis experts in the past. He believes that treating the whole person including diet, lifestyle, stresses and emotional states, rather than focusing on one single symptom or area of the body is important. Dr Parks will talk about season allergies. More information is available at: www.sleepinterrupted.com

Mr Paradise is the Founder and Chief of Research of Topical Biomedics, a successful company producing natural solutions for pain management. Lou is a Marine Corp helicopter combat and rescue veteran serving two rotations in Viet Nahm. He is very modest about his combat service but his many decorations are for bravery in combat and rescue missions of wounded soldiers, and fellow Marines and for humanitarian rescues of Vietnamese civilians.
During these missions he developed carpal tunnel syndrome that caused severe pain. Using his knowledge of homeopathy, natural medicine, physiology, herbal medicine, and other natural healing modalities he self experimented for relief of his pain. Herbal medicine did not work and homeopathic medicine did slightly. Using his intuitive ability he decided to combine some homeopathic medications and began to see improvement. He refined the product that is now Topricin that treats a wide range of ailments including arthritis, lower back pain, and carpal tunnel syndrome.
Mr Paradise has a 25 year history of researching natural medicines, has developed pain management seminars for senior citizens, is considered an expert on rehabilitation and restorative medicine and has appeared as an expert on doctor hosted medical call in radio shows. He has been invited to participate on a committee that interfaces with both the FDA and FTC addressing the growing national interest in natural medicine.

Ms Casey is known as the “Healthy Boomer Body Expert.” She is an experienced registered Hatha Yoga Teacher, Certified Acu-Yogas Teacher, a certified Pilates Teacher, and Certified in Ayervedic Physical healing. She writes a monthly column for the South Shores Senior News, Life After 50, Boomers Forever, Boomer-Living, and other magazines, produces her own TV show called “To Your Health” and is founder of the Healthy Boomers Body Studio in Otis, Massachusetts. Her latest book is Get off the Couch, Potato. More information is available at: www.HealthyBoomerBody.com

***KATHI HAS A DVD TITLED GET RID OF SCIATICA PAIN FOR GOOD THE FIRST PERSON TO CONTACT ME AT THE END OF THE SHOW ON SATURDAY (12:55 PST/3:55 EST) WITH NAME AND ADDRESS WILL RECEIVE THE DVD. THEIR NAME WILL BE PUBLISHED IN THE NEXT MONTHLY ISSUE OF HEALTHY HOLISTIC AGING. GOOD LUCK.

A Nurse Hypnotherapist and Chronic Back Pain Sufferer to Be Interviewed on the Holistic Health Show

Sunday, May 23rd, 2010

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On Saturday, Dr Carl O Helvie, Host of the Holistic Health Show will interview Seth-Deborah Roth (left) and Karen Hummel, (right).

Seth-Deborah is a certified instructor and faculty member of the National Guild of Hypnosis and a Nurse Anesthetist. She is a member of the National Board of Certified Clinical Hypnotherapists, the International Hypnosis Federation, the American Board of Hypnosis, the International Medical and Dental Hypnosis Association, Imagery International and the American Association of Nurse Anesthetists.
She is an instructor of medical hypnosis at the Hypnotherapy Center in Oakland, California and received the 2005 “Award of Excellence” in the category of Health Care from the International Hypnosis Federation. She has been featured on the discovery Channel’s “Myth Busters” segment on hypnosis.
She has also presented to the National Guild of Hypnosis, the International Medical and Dental Hypnosis Association, the International Hypnosis Federation, the American Board of Hypnosis, the Institute for the Advanced Studies of Health World Conference, and the Dermatology Nurses Association on the many uses of hypnosis in the area of health. She lectures at hospitals on medical hypnosis including St Rose Hospital, Seton Hospital, and the Bay Area Cancer Forum at Sutter Hospital. Seth-Deborah teaches a teleseminar course on Medical Hypnotherapy Certification and often speaks on the San Francisco radio station KEST “Seeing Beyond” with Bonnie Colleen. She also writes a blog called “Hypnotic Health” at www.hypnotichealth.blogdpot.com

Karen Hummel is a wellness coach whose passion is helping others with pain. She holds a masters degree in Health Service Management and a baccalaureate degree in Nutrition and Exercise Physiology. Karen is a Certified Personal Trainer with eighteen years of training experience and has served as a Wellness Director for several large corporations.

In 1998, after years of perseverance to reach her own fitness goal she was seriously injured in an automobile accident and told prior to surgery that she would almost certainly be a paraplegic. Karen refused to believe this and after three surgeries her surgeon told her that had it not been for the muscles she had developed from years of exercise she would not have walked away.
Several years later after excruciating pain, doctor’s visits, and medical tests, a piece of hardware from her original surgery was found to be piercing the spinal canal. This had caused tremendous nerve pain throughout her spine and eventually the loss of feeling in her right leg. Another surgery was scheduled but the chronic pain continued. One year later, testing found that a second device in her back had broken and the area had not healed properly., Karen had her last back surgery to correct the problem in 2006.
Karen has made tremendous improvements since her last surgery and is happy to be back at the gym, but still lives with chronic pain daily. She is in the process of writing a book about her experiences and hopes it will be an inspiration to others battling pain. More information is available at: http://www.karenhummel.com

Natural Ways to Deal with Back Pain

Sunday, May 16th, 2010

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On the Holistic Health Show yesterday Dr Carl O Helvie interviewed Frank Titus (left) and Mitchell Yass (right) on natural ways to treat back pain.
Frank has a B.S. degree in Exercise {Physiology and is founder of Health Through Motion and uses Titus Motion Therapy with high profile entertainment and sports individuals. More information was presented earlier on this blog or can be found at www.titusmotiontherapy.com

Mitchell Yass is a physical therapist and is known as the “Miracle Man” on Long Island for his work with pain. His goal is to help others avoid surgery and drugs in the resolution of back pain. More information is available on an earlier blog and on www.mitchellyass.com

Both practitioners say they have achieved over a 90% success rate in resolving pain with natural methods.

Enjoy the interview below.