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### Question: What to expect before the procedure?
### Response: When your amputation is planned, you will be asked to do certain things to prepare for it. Always tell your doctor or nurse:
What drugs you are taking, even drugs or herbs you bought without a prescription If you have been drinking a lot of alcohol
During the days before your surgery, you may be asked to stop taking aspirin, ibuprofen (such as Advil or Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
Ask your doctor which drugs you should still take on the day of your surgery. If you smoke, stop.
If you have diabetes, follow your diet and take your medicines as usual until the day of surgery.
On the day of the surgery, most times you will be asked not to drink or eat anything for 8 to 12 hours before your surgery.
Take your drugs your doctor told you to take with a small sip of water. If you have diabetes, follow the directions your doctor gave you.
Prepare your home before surgery:
What help will you need when you come home from the hospital? Do you have a family member, friend, or neighbor who can help you? If not, ask your doctor or nurse for help planning for someone to come into your home. Is your bathroom and the rest of your house safe for you to move around in? Will you be able to get in and out of your home safely? |
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### Question: What to expect after the procedure?
### Response: The end of your leg, or stump, will have a dressing and bandage that will remain on for 3 or more days. You may have pain for the first few days. You will be able to take pain medicine as you need them.
You may have a tube that drains fluid from the wound. This will be taken out after a few days.
Before leaving the hospital, you will begin learning how to:
Use a wheelchair or a walker Stretch your muscles to make them stronger Strengthen your arms and legs Begin walking with a walking aid and parallel bars Start moving around the bed and into the chair in your hospital room Keep your joints mobile Sit or lay in different positions to keep your joints from becoming stiff Control swelling in the area around your amputation Properly put weight on your leg. You'll be told how much weight to put on your leg. You may not be allowed to put weight on your leg until the stump is fully healed.
Fitting for prosthesis, a manmade part to replace your limb, may occur when:
Your amputation wound is mostly healed Your stump is no longer tender to the touch |
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### Question: How is Appendectomy done?
### Response: The appendix is a small, finger-shaped organ that comes out from the first part of the large intestine. It is removed when it becomes swollen (inflamed) or infected. An appendix that has a hole in it (perforated) can leak and infect the entire abdomen area, which can be life-threatening.
If appendicitis is suspected, a doctor will often suggest surgery without conducting extensive diagnostic testing. Prompt surgery decreases the likelihood the appendix will burst. Surgery to remove the appendix is called appendectomy and can be done two ways.
The older method, called laparotomy, removes the appendix through a single incision in the lower right area of the abdomen. The newer method, called laparoscopic surgery, uses several smaller incisions and special surgical tools fed through the incisions to remove the appendix. Laparoscopic surgery leads to fewer complications, such as hospital-related infections, and has a shorter recovery time.
Surgery occasionally reveals a normal appendix. In such cases, many surgeons will remove the healthy appendix to eliminate the future possibility of appendicitis. Occasionally, surgery reveals a different problem, which may also be corrected during surgery. It is not clear if the appendix has an important role in the body. There are no major, long-term health problems resulting from removing the appendix although a slight increase in some diseases has been noted, for example, Crohn's disease.
Sometimes an abscess forms around a burst appendix鈥攃alled an appendiceal abscess. An abscess is a pus-filled mass that results from the body's attempt to keep an infection from spreading. An abscess may be addressed during surgery or, more commonly, drained before surgery. To drain an abscess, a tube is placed in the abscess through the abdominal wall. CT is used to help find the abscess. The drainage tube is left in place for about 2 weeks while antibiotics are given to treat infection. Six to 8 weeks later, when infection and inflammation are under control, surgery is performed to remove what remains of the burst appendix.
An appendectomy is done using either:
Spinal anesthesia. Medicine is put into your back to make you numb below your waist. You will also get medicine to make you sleepy. General anesthesia. You will be asleep and not feel any pain during the surgery. |
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### Question: Who needs Appendectomy?
### Response: An appendectomy is done for appendicitis. The condition can be hard to diagnose, especially in children, older people, and women of childbearing age.
Most often, the first symptom is pain around your belly button.
The pain may be mild at first, but it becomes sharp and severe. The pain often moves into your right lower abdomen and becomes more focused in this area.
Other symptoms include:
Diarrhea or constipation. Fever (usually not very high). Nausea and vomiting. Reduced appetite. |
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### Question: Where to find centers that perform Appendectomy?
### Response: Directions to Hospitals Performing Appendicectomy |
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### Question: What are the risks of Appendectomy?
### Response: Risks from any anesthesia include the following:
Reactions to medications. Problems breathing.
Risks from any surgery include the following:
Bleeding. infection of the wound.
Other risks with an appendectomy after a ruptured appendix include the following:
Buildup of pus (abscess), which may need draining and antibiotics. Longer hospital stays. Side effects from medications. |
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### Question: What to expect before the procedure?
### Response: If you have symptoms of appendicitis, seek medical help right away. Do not use heating pads, enemas, laxatives, or other home treatments to try and relieve symptoms.
Your health care provider will examine your abdomen and rectum. Other tests may be done.
Laboratory tests
Blood tests are used to check for signs of infection, such as a high white blood cell count. Blood tests may also show dehydration or fluid and electrolyte imbalances. Urinalysis is used to rule out a urinary tract infection. Doctors may also order a pregnancy test for women.
Imaging tests
Computerized tomography (CT) scans, which create cross-sectional images of the body, can help diagnose appendicitis and other sources of abdominal pain. Ultrasound is sometimes used to look for signs of appendicitis, especially in people who are thin or young. An abdominal x-ray is rarely helpful in diagnosing appendicitis but can be used to look for other sources of abdominal pain. Women of childbearing age should have a pregnancy test before undergoing x-rays or CT scanning. Both use radiation and can be harmful to a developing fetus. Ultrasound does not use radiation and is not harmful to a fetus.
There are no actual tests to confirm that you have appendicitis. Other illnesses can cause the same or similar symptoms.
The goal is to remove an infected appendix before it breaks open (ruptures). After reviewing your symptoms and the results of the physical exam and medical tests, your surgeon will decide whether you need surgery. |
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### Question: What to expect after the procedure?
### Response: With adequate care, most people recover from appendicitis and do not need to make changes to diet, exercise, or lifestyle. Full recovery from surgery takes about 4 to 6 weeks. Limiting physical activity during this time allows tissues to heal.
After an uncomplicated appendectomy, your surgeon will usually advise you to:
Get up and walk around the day of the surgery. Keep the incision clean and dry. Avoid lifting. Avoid constipation and straining during bowel movements by drinking plenty of fluids and eating high-fiber foods such as fruits, vegetables, beans, and whole grains; move your bowels as soon as you feel the urge.
The same advice often applies in the case of a ruptured appendix, but over a longer time period. Be sure to call your doctor immediately if you notice:
Signs of infection, such as fever and chills, redness, swelling, increased pain, excessive bleeding, or discharge from the incision sites. Difficulty urinating, nausea or vomiting, constipation, pain that isn't relieved by available medication, cough, shortness of breath, or chest pain. |
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### Question: How is a bone graft made?
### Response: A bone graft can be taken from the patient's own healthy bone. This is called an autograft. Autograft bone often comes from your ribs, hips or a leg.
A bone graft can also be made from frozen, donated bone (allograft). Most allograft bone comes from donors who have died. Tissue banks screen these donors and disinfect and test the donated bone to make sure it is safe to use.
In some cases, a man-made (synthetic) bone substitute is used.
No matter where the bone graft comes from, the surgery will be the same. A surgeon makes a cut over the bone defect. The bone graft is shaped and inserted into and around the area. It is held in place with pins, plates, or screws. Stitches are used to close the wound.
A splint or cast is usually used to prevent injury or movement while healing. |
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### Question: Why is a bone graft performed?
### Response: Bone grafts are used to:
Fuse joints to prevent movement Repair bone loss from broken bones (fractures) or cancers Repair injured bone that has not healed |
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### Question: What to expect if I have Bone grafting (Outlook/Prognosis)?
### Response: Outlook for a bone graft is very good. Most bone grafts help the bone defect to heal with little risk of graft rejection. |
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### Question: Why and when should a breast examination be performed?
### Response: The asymptomatic breast exam is generally performed only on women. This is because diseases of the breast, in particular cancer, occur far more commonly in women then men. Malignancies generally originate in either the glandular tissues that secrete milk or in the ductal structures that transport it to the nipple.
Examination can be done by the clinician (Clinical Breast Exam - CBE) or patient (Self Breast Exam - SBE). Those performed by the clinician are usually done on an annual basis, beginning at the age of 40, which coincides with time of increased risk for development of breast cancer. Other major breast cancer risk factors include: prior history of breast ca, family history in 1st degree relative (particularly if at a young age), increasing patient age and features that result in prolonged/uninterrupted exposure to estrogen (e.g. early age at onset menstruation, never having been pregnant, older age at first pregnancy, older age at menopause). SBE is often recommended on a monthly-to-every-few-months basis.
Interestingly, while both SBE and CBE are part of routine clinical care, there are no studies that demonstrate that either of these techniques, when performed as stand-alone examinations, actually improves clinical outcomes (i.e. detects cancer at an earlier stage, demonstrating positive impact on cancer related morbidity or mortality). In contrast, mammography (performed with or without CBE), has a strong body of evidence to support its routine use as a screening tool for early detection of malignancy.
The goal of the examination in the setting of symptoms is to better characterize the abnormality, identify underlying etiology, and direct additional evaluation and treatment. Breast related symptoms may include any of the following:
Discrete masses detected by the patient, often concerning for malignancy Pain, which can be associated with a number of processes including: cyclical in a menstruating women (reflecting transient hormone induced changes in the breast tissue), occasionally malignancies. Unusual nipple discharge, which may include:
Blood, concerning for malignancy Milk when not pregnant. Suggestive inappropriate Prolactin secretion from the pituitary - may also be induced by certain medications Other
Discoloration or change in the quality of the skin:
Redness suggests infection or inflammation - in the post partum patient, this is often due to mastitis, a diffuse inflammatory condition caused by congestion from inadequately expressed milk. "Peau d'orange" quality - an "Orange Peel" like texture that's caused by an uncommon, aggressive inflammatory malignancy
If a mass or other abnormality is identified, it's location can be described as being in one of 4 quadrants (left upper, left lower, right upper, right lower) of the breast. Alternatively, it can be described relative to it's position, imagining a clock face were superimposed on the breast.
It's worth noting that breast symptoms may be caused by diseases elsewhere in the body. For example, as mentioned above, inappropriate milk production may be due to a pituitary tumor secreting Prolactin. Or breast development in men may signify underlying liver disease. Given this, breast symptoms may merit careful history and evaluation of other organ systems. As symptoms can occur in male or female patients (though overall, female >>> male), evaluation is indicated in either sex patient who presents with breast concerns. |
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### Question: How is Cholecystectomy done?
### Response: Open gallbladder removal surgery
The surgeon makes a large incision (cut) in your belly to open it up and see the area. The surgeon then removes your gallbladder by reaching in through the incision and gently lifting it out. Surgery is done while you are under general anesthesia (unconscious and unable to feel pain). The surgeon will make a 5 to 7 inch incision in the upper right part of your belly, just below your ribs. The surgeon will cut the bile duct and blood vessels that lead to the gallbladder. Then your gallbladder will be removed. A special x-ray called a cholangiogram will be done during the surgery. This involves squirting some dye into your common bile duct. This duct will be left inside you after your gallbladder has been removed. The dye helps locate other stones that may be outside your gallbladder. If any are found, the surgeon may be able to remove these other stones with a special medical instrument. Open gallbladder removal surgery takes about an hour.
Laparoscopic gallbladder removal
It is the most common way to remove the gallbladder. A laparoscope is a thin, lighted tube that lets the doctor see inside your belly. Gallbladder removal surgery is done while you are under general anesthesia (unconscious and not able to feel pain). The surgeon will make 3 to 4 small cuts in your belly. The laparoscope will be inserted through 1 of the cuts. Other medical instruments will be inserted through the other cuts. Gas will be pumped into your belly to expand it. This gives the surgeon more space to work. First, the surgeon cuts the bile duct and blood vessels that lead to the gallbladder. Then the surgeon removes the gallbladder, using the laparoscope. Sometimes the surgeon cannot safely take out the gallbladder using a laparoscope. In this case, the surgeon will instead do an open cholecystectomy. |
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### Question: Who needs Cholecystectomy?
### Response: Your doctor may recommend gallbladder removal surgery if you have gallstones or your gallbladder is not functioning normally (biliary dyskinesia). You may have some or all of these symptoms:
Pain after eating, usually in the upper right or upper middle area of your belly (epigastric pain) Nausea and vomiting Indigestion Infection |
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### Question: Where to find centers that perform Cholecystectomy?
### Response: Directions to Hospitals Performing Cholecystectomy |
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### Question: What are the risks of Cholecystectomy?
### Response: The risks for any anesthesia include:
Reactions to drugs you are given. Breathing problems. Pneumonia. Heart problems. Blood clots in the legs or lungs.
The risks for gallbladder surgery include:
Bleeding. Infection in your belly. Injury to the common bile duct. Injury to the small intestine. Pancreatitis (inflammation in the pancreas). |
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### Question: What to expect before the procedure?
### Response: Your doctor may ask you to have these medical tests done before you have surgery:
Blood tests (complete blood count, electrolytes, and kidney tests). Chest x-ray or electrocardiogram (EKG), for some people. Several x-rays of the gallbladder.
Always tell your doctor or nurse:
If you are or might be pregnant. What drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.
During the week before your surgery:
You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), and any other drugs that make it hard for your blood to clot. Your doctor may ask you to "clean out" your colon or intestines. Ask your doctor which drugs you should still take on the day of your surgery.
On the day of your surgery:
Do not eat or drink anything after midnight the night before your surgery. Take the drugs your doctor told you to take with a small sip of water. Shower the night before or the morning of your surgery. Your doctor or nurse will tell you when to arrive at the hospital.
Prepare your home for after the surgery. |
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### Question: What to expect after the procedure?
### Response: If you do not have any signs of problems, you will be able to go home when you are able to drink liquids easily. Most people go home on the same day or the day after this surgery. If there were problems during your surgery, or if you have bleeding, a lot of pain, or a fever, you may need to stay in the hospital longer. Some people may experience mild diarrhea after the procedure,this usually goes away with time. |
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### Question: How is the Episiotomy done?
### Response: Just before the baby is born, the obstetrician numbs the vaginal area opening and makes one of two cuts:
A mediolateral cut is angled down away from the vagina and into the muscle. A midline cut is made straight down between the vagina and anus. The cut makes the opening to the vagina bigger. The cut is stitched closed after the baby and placenta have been delivered. |
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### Question: Who needs Episiotomy?
### Response: Episiotomies were once routinely performed to prevent vaginal tears during delivery. Today, routine episiotomies are not recommended.
However, episiotomies may still be performed when there is a complicated delivery. An episiotomy may be needed if the baby's head or shoulders are too big for the mother's vaginal opening, or the baby is in a breech position (feet or buttocks coming first) and there is a problem during delivery.
It may also be needed to speed the delivery process if there is concern about the baby's heart rate. |
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### Question: Where to find centers that perform Episiotomy?
### Response: Directions to Hospitals Performing Episiotomy |
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### Question: What to expect if I have Episiotomy (Outlook/Prognosis)?
### Response: An episiotomy usually heals without problems and may be easier to repair than multiple tears.
You can resume normal activities shortly after the birth. The stitches are absorbed by the body and do not need to be removed. You can relieve pain and discomfort with medication and ice in the first 24 hours, followed by warm baths. |
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### Question: How is Nissen fundoplication done?
### Response: A procedure called fundoplication is the most common type of anti-reflux surgery. During this procedure, your surgeon will:
First repair the hiatal hernia with stitches. The surgeon will tighten the opening in your diaphragm to keep your stomach from bulging through.
Your surgeon will then use stitches to wrap the upper part of your stomach around the end of your esophagus. This creates pressure at the end of your esophagus and helps prevent stomach acid and food from flowing back up. Surgery is done while you are under general anesthesia (asleep and pain-free). Surgery usually takes 2 to 3 hours.
Ways your doctor may do this surgery are:
Open repair. Your surgeon will make an incision (cut) in your belly area (abdomen). Sometimes the surgeon will place a tube from your stomach through the abdominal wall to keep your stomach in place. This tube will be removed when you no longer need it. Laparoscopic repair: Your surgeon will make 3 to 5 small incisions in your belly. Your surgeon will insert a laparoscope (a thin, hollow tube with a tiny camera on the end) through one of these incisions and other tools through the other incisions. The laparoscope is connected to a video monitor in the operating room that allows your surgeon to see inside your belly and do the repair. The surgeon may need to switch to an open procedure if there is bleeding, a lot of scar tissue from earlier surgeries, or the patient is very overweight.
Endoluminal fundoplication is a new procedure that uses a special camera called an endoscope. The tube is passed down through your mouth and into your esophagus. Your doctor will place small clips on the inside where the esophagus meets the stomach. These clips help prevent food or stomach acid from coming back. An endoscope is similar to a laparoscope. This procedure is done to help prevent reflux. |
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### Question: Who needs Nissen fundoplication?
### Response: Your doctor may suggest surgery when:
You have symptoms of heartburn that get better when you use medicines, but you do not want to continue taking these medicines. Symptoms of heartburn are burning in the stomach that you may also feel in your throat or chest, burping or gas bubbles, or have trouble swallowing food or fluids. Part of your stomach is getting stuck in your chest or is twisting around itself. This is called a para-esophageal hernia. You have reflux disease and another related, serious problem. Some of these problems are strictures (a narrowing of your esophagus), ulcers in your esophagus, and bleeding in your esophagus. You have reflux disease and aspiration pneumonia (a lung infection caused by inhaling contents of the stomach into the lungs), a chronic cough, or hoarseness. |
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### Question: Where to find centers that perform Nissen fundoplication?
### Response: Directions to Hospitals Performing Nissen fundoplication |
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### Question: What are the risks of Nissen fundoplication?
### Response: Risks for any anesthesia are:
Reactions to medicines. Breathing problems, including pneumonia. Heart problems.
Risks for any surgery are:
Bleeding. Infection.
Risks for this surgery are:
Gas bloat, which makes it hard to burp or throw up. It also causes bloating after meals. These symptoms slowly get better for most people. Pain and difficulty when you swallow, for some people. This is called dysphagia. For most people, this goes away in the first 3 months after surgery. Damage to the stomach, esophagus, liver, or small intestine. This is very rare. Respiratory complications, such as a collapsed lung. This is also rare. Recurrence of the hiatal hernia. |
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### Question: What to expect before the procedure?
### Response: Your doctor may ask you to have these tests:
Blood tests (complete blood count, electrolytes, or liver tests). Upper endoscopy. Almost all people who have this procedure have already had this test. If you have not, you will need to. Other tests, such as manometry (to measure gases) or pH monitoring (to see how much stomach acid is in your esophagus).
Always tell your doctor or nurse if:
You could be pregnant. You are taking any drugs, supplements, or herbs you bought without a prescription.
During the week before your surgery:
You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and any other drugs or supplements that affect blood clotting several days to a week before surgery. Ask your doctor which drugs you should still take on the day of your surgery.
On the day of your surgery:
Do not eat or drink anything after midnight the night before your surgery. Take your drugs your doctor told you to take with a small sip of water. Shower the night before or the morning of your surgery. Your doctor or nurse will tell you when to arrive at the hospital. |
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### Question: What to expect after the procedure?
### Response: Patients who have laparoscopic surgery usually spend 1 to 3 days in hospital. Those who have open surgery may spend 2 to 6 days in the hospital after the procedure.
Most patients go back to work 2 to 3 weeks after laparoscopic surgery and 4 to 6 weeks after open surgery. |
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### Question: Are there any diet restrictions before the procedure?
### Response: You should not eat or drink after midnight the night before the procedure. |
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### Question: Should I take my daily medications before the procedure?
### Response: If you usually take a medication in the morning, you may take this medication with a few amount of water (not a full glass).
please bring your medications along with the prescriptions (if available) with you on the day of surgery. If you are diabetic, a special instructions may be given to you. You should stop taking all aspirin, aspirin containing products, Vitamins and herbs two weeks prior to your surgery. Please inform your doctor If you are taking blood thinners medications. |
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### Question: Can I shower at the day of the procedure?
### Response: You need to shower at the morning of your procedure and the night before it. Also you need to use a special antiseptic soap called chlorhexidine gluconate, but make sure not to use this soap near your eyes, ears and mouth. Do not use the regular soap after you have used the antiseptic soap. Do not apply any powders or deodrants. |
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### Question: Should I shave in the area of the procedure?
### Response: Do not shave in the area of the procedure. |
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### Question: Who is at highest risk for Scrotal swelling ?
### Response: Scrotal swelling can occur in males at any age. |
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### Question: What are the symptoms of Scrotal swelling?
### Response: The swelling can be on one or both sides, and there may be pain. The testicles and penis may or may not be involved.
Testicular torsion is a serious emergency in which the testicle become twisted in the scrotum and loses its blood supply. If this twisting is not relieved quickly, the testicle may be lost permanently. This condition is extremely painful. Call 911 or see your health care provider immediately, because losing blood supply for just a few hours can cause tissue death and the loss of a testicle. |
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### Question: What causes Scrotal swelling?
### Response: Certain medical treatments Congestive heart failure Epididymitis Hernia Hydrocele Injury Orchitis Surgery in the genital area Testicular torsion Varicocele Testicular cancer |
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### Question: When to seek urgent medical care when I have Scrotal swelling ?
### Response: Call your health care provider if:
You notice any unexplained scrotal swelling The swelling is painful You have a testicle lump |
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### Question: What to expect if I have Scrotal swelling (Outlook/Prognosis)?
### Response: It depends on the underlying cause. |
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### Question: What are the symptoms of Varicose veins?
### Response: Fullness, heaviness, aching, and sometimes pain in the legs Visible, enlarged veins Mild swelling of ankles Brown discoloration of the skin at the ankles Skin ulcers near the ankle (this is more often seen in severe cases) |
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### Question: What causes Varicose veins?
### Response: In normal veins, valves in the vein keep blood moving forward toward the heart. With varicose veins, the valves do not function properly, allowing blood to remain in the vein. Pooling of blood in a vein causes it to enlarge.
This process usually occurs in the veins of the legs, although it may occur elsewhere. Varicose veins are common, affecting mostly women.
Causes include:
Defective valves from birth (congenitally defective valves) Pregnancy Thrombophlebitis
Primary varicose veins occur because of congenitally defective valves, or without a known cause. Secondary varicose veins occur because of another condition, such as when a pregnant woman develops varicose veins. |
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### Question: Who is at highest risk for Varicose veins ?
### Response: Standing for a long time and having increased pressure in the abdomen may make you more likely to develop varicose veins, or may make the condition worse. |
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### Question: When to seek urgent medical care when I have Varicose veins ?
### Response: Call for an appointment with your health care provider if:
Varicose veins are painful They get worse or do not improve with self-treatment, such as keeping the legs elevated or avoiding excessive standing Complications occur, including a sudden increase in pain or swelling, fever, redness of the leg, or leg ulcers |
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### Question: What to expect if I have Varicose veins (Outlook/Prognosis)?
### Response: Varicose veins tend to get worse over time. You can ease discomfort and slow varicose vein progression with self care. |