surgery
oracknows | April 2, 2007In the course of a few days last week, two prominent political personalities from different parties, White House Press Secretary Tony Snow and Elizabeth Edwards, wife of Democratic Presidential candidate John Edwards, announced that their cancers (breast cancer in the case of Edwards and colon cancer in the case of Snow), after having apparently been successfully treated two years ago had recurred and were now metastatic. One of the issues that comes up whenever famous people announce that they have cancer is the question of early detection and why we don't detect tumors earlier. Indeed, Amy…
oracknows | March 29, 2007I was going to try to be a good boy. Really, I was. I had been planning on answering a question about the early detection of tumors. It was an opportune time to do so, given the recent news of cancer recurrence in Elizabeth Edwards and Tony Snow, coupled with a couple of papers I saw just yesterday and the announcement of new screening guidelines for breast MRI. However, I was finding that writing the piece would be fairly complex (because it's a complex topic) and that it might even require a multi-post approach. There was no way to do it justice today; doing it over the weekend would make a…
oracknows | March 28, 2007It's been a bad few days.
A mere four days after Elizabeth Edwards announced that her breast cancer had recurred in her rib, with an update the other day saying that the apparently was also another lesion in in her hip, I learn from a commenter and multiple other sources that White House Press Secretary Tony Snow has suffered a recurrence of his colon cancer. Apparently, it has spread to the liver:
CBS/AP) Presidential spokesman Tony Snow's cancer has returned and spread to his liver and elsewhere in his body, shaken White House colleagues announced Tuesday. They said he told them he planned…
oracknows | March 27, 2007I realize that being in academic medicine at a tertiary care center often produces the "ivory tower" syndrome, but occasionally it is brought home to me that the way we practice surgery here often differs considerably from how surgery is practiced "in the trenches." This time around, it was a study about how often surgeons referred women whose breast cancers are large enough to require a mastectomy to treat to plastic surgeons for a discussion of reconstruction options prior to the mastectomy. The answer was: Not nearly often enough. See for yourself:
ANN ARBOR, Mich. -- Forty-four percent of…
oracknows | March 22, 2007[Note: The following is based on an aggregation of multiple patients. It does not represent any single patient's case.]
It was a little case.
I know, I know, I've said in the past that there's no such thing as a little operation, at least not when it's happening to you, and that's true. Nonetheless this case was as close to "minor surgery" as you could get while still actually having to wield a scalpel to cut through skin. As I spoke to her before the operation to get informed consent, the patient ran her fingers across her short hair, only now starting to grow back after her having completed…
oracknows | March 21, 2007...like this (explanation here):
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oracknows | March 18, 2007Yesterday, at the end of a post about the fallacious statements about evolution that Dr. Mike Egnor, a Professor of Neurosurgery, has been routinely serving up at the Discovery Institute, I made a challenge. I think I'll repeat it daily for a while until we see if he's up to answering it. It should be a very easy challenge for him to meet, given the number of times that he has made the two assertions that I plan to challenge him about.
Here are the two assertions that Dr. Egnor has made on more than one occasion, but most recently on Friday, and I'll quote him directly:
In fact, most research…
oracknows | March 17, 2007Agh!
I say: Agh! Again.
Remember how it was just a mere three days ago that I administered some Respectful Insolence⢠to Dr. Michael Egnor, the Energizer Bunny of jaw-droppingly, appallingly ignorant anti-evolution posturing based on his apparently nonexistent understanding of what the theory of evolution actually says? Remember how I said how much I sincerely hoped that I could ignore him for a while? I really did mean it at the time.
Really, I did.
And then Afarensis and Mike Dunford had to and let me know that Dr. Egnor's at it yet again.
Dr. Egnor just won't stop, and as a fellow surgeon…
oracknows | March 14, 2007I need some β-blockers STAT.
I say that not because I'm hypertensive or because I'm having heart palpitations--at least not at the moment. I'm saying it because, after reading the latest brave foray into antievolutionary ignorance by--as much as I hate to admit it--a fellow surgeon named Dr. Michael Egnor, I need to do something for prophylaxis against such problems. Yes, Dr. Egnor is back again, hot on the heels of taking massive and much-deserved abuse from the science blogosphere (including a heapin' helpin' of Respectful Insolence⢠from me) over his spreading of misinformation and…
oracknows | March 12, 2007It figures.
After my having written repeated debunkings of various physicians who are creationists (mostly of the "intelligent design" variety), in retrospect I should have seen this one coming. I should have seen that the Discovery Institute, eager to use anyone they can find whom they can represent to the public as having scientific credentials (never mind whether those credentials have anything to do with evolutionary biology) and thus dupe the public into seeing them as having authority when they start laying down ignorant brain farts about how they "doubt Darwinism," would settle on…
oracknows | March 8, 2007...That all around evolution-ignorant but nonetheless eager lapdog of the Discovery Institute, SUNY Stonybrook Professor of Neurosurgery Dr. Michael Egnor, is back.
Rats. I thought that the utter drubbing he took at the hands of myself and my fellow ScienceBloggers (in particular PZ Myers) might have given him the message that he needs to lay low for a while. Apparently not. I guess he must have the monumental ego that more than a few neurosurgeons are famous for. (After all, it takes supreme confidence in one's own abilities to be able to cut into the human brain and believe that the patient…
oracknows | February 27, 2007I should know better. I really should. I'm referring, of course, to my having forgotten my usual avoidance of purely political posts yesterday. I'm beginning to remember why I so seldom blog about political matters in general and why I've never in two years discussed abortion on this blog in particular. I don't know what came over me. Given all that, I think it's high time for a straight science post, don't you? After all, I could beat up on Dr. Egnor again or do another dichloroacetate post, but what would be the point? Dr, Egnor's clearly an ideologue who is not likely to stop pushing "…
oracknows | February 26, 2007I'm getting really, really tired of this.
You've all read my rants at the propensity of surgeons who clearly don't have clue one about evolutionary theory spouting off ignorantly about the alleged shortcomings of evolution as a theory while either explicitly or implicitly promoting the pseudoscience of "intelligent design" creationism. I don't think I have to expound much on just how much this phenomenon irritates me other than to repeat my desire to find a more permanent solution to the question of hiding my face in shame over the antics of my fellow surgeons on this. Perhaps it truly is…
oracknows | February 22, 2007At least this time the surgeons aren't disgracing my profession by making ignorant statments about evolution. Well, actually, I almost wish they were, because puffed up idiots pontificating about evolution at least don't put patients in immediate danger like this:
A routine appendix operation in Belgrade went badly wrong when two surgeons started fighting and stormed from the operating theatre to settle their dispute outside, the daily Politika reported on Wednesday.
Surgeon Spasoje Radulovic was operating when his colleague Dragan Vukanic entered and made a remark that started a quarrel,…
oracknows | February 19, 2007You know, I'm really tired of this.
I'm tired of my fellow physicians with a penchant for spouting scientifically ignorant "attacks" on or "doubts" about evolution. It embarrasses the hell out of me around ScienceBlogs, and I really wish they would stop it. Sadly, it seems to be an increasingly long list. Although I first noticed it when former Senate Majority Leader Bill Frist (who is a cardiac surgeon) voiced support for "intelligent design" back in 2005, this tendency among my fellow physicians to pontificate on their distaste for evolution didn't start to irritate me really seriously…
oracknows | February 16, 2007It figures, it really does, that this would have to be one of the first clinical uses of stem cells that they'd come up with.
The really weird thing about this article is its schizophrenic nature. It starts out with a sensationalistic description of the new use of stem cells, and then it describes the discovery of a mutated allele of a gene that gives around a 10% decreased risk of breast cancer. It's like two entirely different articles pasted together in a haphazard fashion.
oracknows | February 11, 2007A couple of weeks ago, I posted about a bizarre complication of a central venous catheter placement. Now, on YouTube, I find a primer on how to place central venous catheters.
The remaining parts can be found here.
oracknows | February 8, 2007Well, here I am in sunny Phoenix, having spent pretty much all of yesterday at the conference, sneaking in alterations to and practicing of my talk in between sessions. All in all not a bad day, although I spent the entire day indoors and didn't get to partake of the bright and cheery warmth, which is sad, because it's particularly welcome given the weather at my present abode. The conference produced one other thing for me as well: A good blogging topic. Not only that, but it's a good blogging topic that fits in with the whole "Just Science" theme of this week. Don't worry, though, no…
oracknows | February 7, 2007I happen to be in Phoenix today, attending the Academic Surgical Congress, where I actually have to present one of my abstracts. That means, between flying to Phoenix last night and preparing for my talk, I didn't have time to serve up a heapin' helping of that Respectful Insolence⢠you know and (hopefully) love. Fortunately, there's still a lot of stuff in the vaults of the old blog begging to be moved over to the new blog; so that's what I'll do today. I'll probably be back tomorrow with new material, given that the conference will likely produce blog fodder. (Conferences usually do.) And…
oracknows | January 24, 2007Via Kevin, MD, a picture of a complication I hope I never have:
A description of the complication:
A 40-year-old man with Crohn's disease underwent an uncomplicated operation involving lysis of adhesions that were causing intestinal obstruction. After surgery, a cardiologist inserted a central venous catheter through the left subclavian vein. No problems with catheterization were noted. Three weeks later, after discharge, mild pain and edema developed in the patient's right lower leg. He was treated with antibiotics for 1 week, and his symptoms diminished. Six months after the operation, the…