Medical Techniques & Procedures
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Laparoscopic surgery, also referred to as minimally invasive surgery, is a type of surgical procedure that uses a video camera and several thin instruments to gain access to the inside of the patient. The surgeon makes small incisions through which the camera and the instruments can be inserted.
The camera transmits an image of the organs inside the abdomen onto a television monitor, allowing the surgeon to see directly into the patient without the traditional large incision. With laparoscopic surgery, there is less post-operative discomfort since the incisions are smaller, quicker recovery times, shorter hospital stays and less scarring.
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Because the radiation dose delivered by Synergy S is precisely targeted at the tumor or lesion, there is less damage to surrounding healthy tissue. As with the Gamma Knife, the benefits of non-invasive radiosurgery include no risk of blood loss, fewer complications, faster recovery and the ability to effectively treat patients who are no longer able to be treated by other methods of care.
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The Jobe's test is done to specifically test the supraspinatus muscle. Your doctor will ask you to place your arm in abduction/forward flexion with the thumb pointed towards the floor. He/she will then ask you to provide resistance as they push the arm down. With that forced loading of the supraspinatus muscle, your doctor can tell whether or not the supraspinatus is involved in your shoulder pain.
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Infraspinatus testing is performed to determine any issues with external rotation of your shoulder. Your doctor will ask you to push against him or her as they resist you during externally rotation. Any pain with that typically points to problems with the infraspinatus or teres minor muscles, which are two rotator cuff muscles at the back of the shoulder that are responsible for that motion.
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Surgeons benefit from the use of surgical simulators. Surgical simulators – computerized systems that enable surgeons to learn in a virtual environment – can help students train, and give practicing surgeons an opportunity to learn new or practice less common procedures, such as those for the carotid artery (in the neck) or renal artery (in the kidney).
"With the traditional teaching method in surgery, you learn only what you see in your own hospital during your residency," explained vascular surgeon Rajeev Dayal, MD. "So you may end up with limited knowledge of how to manage conditions that you don't see as frequently."
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Below are common culprits that are often missed by doctors in the initial exams and only caught in later follow-ups, many by a second-opinion doc. The maladies below have vague symptoms or hide behind other diseases:
- Chronic fatigue syndrome, which doesn't have any specific diagnostic test.
- Depression, which can cause of variety of physical and emotional symptoms.
- Fibromyalgia, which, like chronic fatigue syndrome, can cause of wide range of symptoms.
- Glaucoma, which can lead to blindness but doesn't cause symptoms early on.
- Hemochromotosis, a genetic disease that causes iron overload in some of the body's organs, which has no early symptoms.
- High blood pressure, or hypertension. High blood pressure may have no early symptoms.
- Impaired glucose tolerance and type 2 diabetes, which can produce mild symptoms that occur gradually over time.
- Kidney disease, which can be life-threatening and may have few early symptoms.
- Osteoporosis, which causes thinning bones, and often is only diagnosed after the person suffers from a bone fracture.
- Polycystic ovary syndrome, which causes hormonal and menstrual symptoms and can lead to infertility.
- Sexually-transmitted diseases like syphilis, chlamydia, trichomoniasis, bacterial vaginosis, gonorrhea and HPV. These diseases may have no major symptoms, or may take years for them to show up. Many masquerade as arthritis and dementia.
- Dementia can often be due to mercury or lead poisoning, though that cause is rarely diagnosed first.
- Thyroid disorders, such as hypothyroidism, which can cause vague symptoms like fatigue and weakness.
- Mental fogginess caused by medication overload, depression, or fluid in the brain, which many physician wrongly attribute to Alzheimer's disease.
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Misdiagnoses are more common than any patient or doctor likes to think. And it isn't always the mark of a shoddy medical work. Hundreds of diseases have almost exactly the same symptoms, and many others, maddeningly, have no symptoms at all (until they wreak havoc, that is).
Just how frequently do we get it wrong? It's impossible to know exactly, as records are difficult to keep, but different surveys have suggested that as many as 40% of all diagnoses may be wrong. Of course, doctors came up with this figure, so that could be wrong, too. In truth it's probably overblown, and the real percentage is far lower (that's my story and I'm sticking to it).
But one thing is certain: Misdiagnosis is an extremely common medical error. For example, a study of almost 2500 autopsies found that almost 40% had at least one significant undiagnosed disease. Another autopsy study found that doctors missed a problem in one out of every four patients; and in more than two-thirds of those cases, the patients would have likely received different treatment or lived longer had their overlooked disease been found. This is one reason why requesting an autopsy on a relative is a good idea.