Eideard

A man has praised surgeons after his missing thumb was replaced with one of his toes.

Fisherman Donald Gunn lost his right thumb while at sea when his hand got caught in rope. Surgeons at Aberdeen Royal Infirmary used the second toe from the Caithness man’s left foot.

He said: “The difference it has made to me already is unbelievable. I am delighted with the result and cannot thank the team enough.”

Consultant plastic surgeon Amir Tadros had believed the toe transplant was a viable option. Mr Tadros said: “This is a very complex procedure but the difference it could make to Mr Gunn’s life convinced me it was worth trying.

“By using the second toe from his left foot we ensured that the patient’s balance wasn’t affected and the cosmetic appearance was almost the same as a normal foot…

He explained: “It’s a rare operation, it’s been around since the 60s, but is not very often done…

Mr Gunn added: “It’s hard to explain the impact of losing my thumb had on my life. “It might only be a small part of the body but it’s only when you lose it that you realise how important it is.

Folks don’t need to study evolution and the progress brought by the opposable thumb to realize the value of that little bit of structure. Bravo to the physicians and surgeon involved in aiding Donald Gunn.

Daylife/Getty Images used by permission

Two doctors who performed breast enlargement surgery on a German porn actress have been charged with negligent manslaughter after the woman’s death, a prosecutor’s spokesman said.

The 23-year-old woman, identified only as “Sexy Cora,” fell into a coma during the surgery at the Alster Clinic in Hamburg on January 11, according to Wilhelm Moellers, the spokesman for the Hamburg state prosecutor. She died Thursday.

Doctors who responded to an emergency call to the clinic called police and filed charges that started the investigation of the clinic, Moellers said.

A statement from the clinic said the doctors were “extremely upset and deeply regret the death of patient C.W.” and that they are giving “full and complete support” to investigators.

“As matters stand currently a defect in the anesthetizing device can be ruled out,” the clinic statement said. “The claim that the monitoring could have given readings other than the actual vital functions of the patient has nothing to do with the facts and has no connection to reality…”

“Erroneous behavior by the doctors is unproven and at this point just an ‘assessment’ by one of the emergency medical personnel who’d brought Ms. W to the University Clinic Hamburg,” the clinic said…

Everyone’s standing in line, jostling each other to be certain the world knows they’re not to blame.

Ila with her parents – in November

A nine-year-old East Timorese girl, Ila Amaral, has died because no Australian hospital would give her a life-saving operation.

For more than 12 months Dan Murphy, a doctor who runs a clinic for the poor in Dili, tried to convince Australian hospitals to accept her for surgery to correct her defective mitral heart valve.

“I blame myself first – I was unable to find the words to make things move for her,” Dr Murphy told the Herald by telephone from the Bairo Pite Clinic, where Ila died last week.

A Victorian cardiologist, Noel Bayley, examined Ila in Dili in November. He said she needed open heart surgery. A cardiac team from Sydney had offered to travel to East Timor to perform the operation but permission to use local facilities was refused by Timorese authorities.

Dr Murphy appealed to the US Navy to be allowed to use one of the 12 operating rooms on the hospital ship USN Mercy when it was in Dili late last year but that was also refused.

“The navy people didn’t want to allow the operation … because of the negative publicity if it didn’t go well and she died,” he said.

After failing to get a hospital in Australia to accept Ila, Dr Murphy appealed to others in the US and then a small cardiac hospital that is opening in Vietnam.

“All in all. a massive effort for something ridiculously simple as correcting a small girl’s problem failed,” he said…

Thousands of Australians donated to a fund to pay for the surgery; but, no hospital in Oz could – or would – shortcut the red tape standing in the way of her operation. The government was no help. Hospital administrators were no help.

Ila Amarai has died.

Efforts to make hospitals safer for patients are falling short, researchers report in the first large study in a decade to analyze harm from medical care and to track it over time.

The study, conducted from 2002 to 2007 in 10 North Carolina hospitals, found that harm to patients was common and that the number of incidents did not decrease over time. The most common problems were complications from procedures or drugs and hospital-acquired infections.

“It is unlikely that other regions of the country have fared better,” said Dr. Christopher P. Landrigan, the lead author of the study and an assistant professor at Harvard Medical School. The study is being published on Thursday in The New England Journal of Medicine.

It is one of the most rigorous efforts to collect data about patient safety since a landmark report in 1999 found that medical mistakes caused as many as 98,000 deaths and more than one million injuries a year in the United States. That report, by the Institute of Medicine, an independent group that advises the government on health matters, led to a national movement to reduce errors and make hospital stays less hazardous to patients’ health…

Dr. Landrigan’s team focused on North Carolina because its hospitals, compared with those in most states, have been more involved in programs to improve patient safety.

But instead of improvements, the researchers found a high rate of problems. About 18 percent of patients were harmed by medical care, some more than once, and 63.1 percent of the injuries were judged to be preventable. Most of the problems were temporary and treatable, but some were serious, and a few — 2.4 percent — caused or contributed to a patient’s death…

RTFA. Disappointing? Yes. Surprising? No. Liable to support further improvements in healthcare beyond the tentative steps taken by the Obama administration? Don’t hold your breath.

The ignoranuses who just voted in a flock of less-than-useless Republicans may yet have a chance to join folks who voted out the least competent Blue Dog papier-mache Democrats – in 2012.

A German woman who splashed out on breast implants with a loan from her then boyfriend now fears her assets could be re-possessed after she failed to fully reimburse him, the 20-year-old woman told Bild newspaper.

Her ex-boyfriend is demanding that she return the 4,379 euros he gave her to pay for her breast enlargement surgery in 2009 or he’ll call the police and get the repossessors involved, Bild reported on Wednesday.

“It’s true that Carsten signed a loan agreement shortly before the operation,” the woman named only as Anastasia is quoted saying. “The condition was that I wouldn’t have to pay him back if I stayed with him for a year.”

But the pair split shortly after she underwent the plastic surgery. The woman said she had transferred 3,000 euros into her ex-boyfriend’s account last week.

Does that mean he only gets to repossess one boob?

Eeoough! Half of one boob?

Teenage years have long been linked with a heightened concern with appearance. Some reality TV shows take full advantage and tout happiness as just a nip/tuck away. A Rutgers–Camden psychologist has found that teens fond of these kinds of programs are more likely to join the millions who go under the knife each year. For bodies – and minds – still in development, these drastic decisions could have implications way after prom…

“When we think of cosmetic surgery, we don’t think of it as a lifetime issue. There is lots of pressure to look a certain way and I don’t blame them for succumbing; we’re all guilty of feeling vulnerable. But what young men and women think of their bodies now will culminate over time and contribute to their overall health,” notes the Rutgers–Camden psychologist. “What troubles me is that there’s no conclusive data that cosmetic surgery even makes people happier, what has been documented is that it makes repeat customers…”

As the Rutgers–Camden researcher suspected, women were more likely to want cosmetic surgery than men and viewers of the cosmetic surgery show were more inclined to consider the procedure for themselves than those who didn’t tune in. What still shocks Markey are the handwritten responses to the cosmetic surgery show, including comments like “inspirational” and “I saw an unhappy girl get her dreams.”

This saddens Markey because outward appearance seems to be the sole avenue to self satisfaction and this road, she believes, is circular. “If plastic surgery makes you feel better about yourself, then why do you keep getting it done?” she asks. “This mindset is very similar to that of an anorexic wanting to lose just five more pounds…”

Conformity for the sake of “fitting in” is mind-numbing enough. Conformity to external lookalike socialbots with no sense of individual decision or understanding – only results in imitations of marionettes.

Golems made to look and act like cartoon characters. Not even real human beings.

Kenneth Crocker, 70 – most important part of the operation

Doctors at a British hospital have carried out the first heart rhythm operation using a remote -controlled robot and say its success means patients could be treated by doctors in other cities, or even other countries.

Andre Ng, who performed the procedure on Wednesday from outside the operating theater, told Reuters it went very well and the patient’s irregular heart rhythm was restored to normal within an hour.

“It exceeded our expectations and we achieved what we set out to in very good time,” said Ng, a consultant cardiologist and electrophysiologist at Leicester’s Glenfield Hospital…

Ng said he was the first doctor in the world to carry out this type of remote-controlled operation on a human patient using a system called a Remote Catheter Manipulation System…

The procedure carried out by Ng involved inserting thin wires called catheters into blood vessels at the top of the groin and then threading them up into the chambers of the heart…

Despite being outside the operating theater during the procedure, Ng said he felt in “complete control” and could see and speak to other medical staff who were beside the patient.

The main advantage is that the doctor doesn’t have to wear heavy radiation shields such as lead aprons, which are normally required in the operating room because X-rays are used to show what is going on inside the patient.

Doctor Ng made the useful point already obvious to geeks in the crowd: “If there is a reliable enough link, then you could do it from any location in the world.”

Is that the Premier’s skiff?

With these words, Newfoundland Premier Danny Williams defended his decision to hop the border and go under the knife for heart surgery in Florida.

The minimally invasive mitral valve surgery he needed is not available in Newfoundland, he told his province’s NTV News channel in the first part of an interview aired last night…

But it is available in his home country, a point that cardiologists fervently made last night.

“It’s his body, it’s his money, hopefully, but don’t tell us the operation cannot be done here. It can be done,” said Arvind Koshal, director of cardiac surgery at the Mazankowski Alberta Heart Institute in Edmonton.

Some of the best mitral valve surgeons are in Toronto and Montreal, he said, noting that some even use robots, commonly employed in minimally invasive surgery. The wait times for cardiac surgery in Canada are relatively short, he added, saying such surgery could have been done within weeks…

While Mr. Williams was clear that surgery in his home province was advised against, he was more ambiguous about the Canadian options he explored.

Virtually all heart surgery can be done in Canada, a chorus of cardiologists said earlier this month when they heard about Mr. Williams’s cross-border surgery, a decision that launched a debate about private versus public health care…

From footage taken in the Premier’s sun-drenched condominium last week, Mr. Williams appeared to be the picture of health…

Another politician who’s a walking advertisement for healthcare reserved for those who can afford it. I think the sun-drenched condo had as much as anything else to do with his decision – or should we take Premier Williams at his word?

A team of researchers working at the MR-Center of the University Children’s Hospital in Zürich has completed a pilot study using transcranial MR-guided focused ultrasound to treat 10 patients with neuropathic pain.

The origin of chronic pain in these patients included post amputation phantom limb syndrome, nerve injury, stroke, trigeminal neuralgia and post herpetic neuralgia from shingles.

“This study showed that we can perform successful operations in the depth of the brain without opening the cranium or physically penetrating the brain with medical tools, something that appeared to be unimaginable only a few years ago,” says Daniel Jeanmonod M.D., a neurosurgeon at the University of Zurich. “By eliminating any physical penetration into the brain, we hope to duplicate the therapeutic effects of invasive deep brain ablation without the side effects, and for a wider group of patients…”

“This research demonstrates that transcranial MR-guided focused ultrasound can be used non-invasively to produce small thermal ablations with extreme precision and accuracy deep in the brain,” comments Neal Kassell, M.D., a neurosurgeon at the University of Virginia, and Chairman of the Focused Ultrasound Surgery Foundation. “It paves the way for further research into the treatment of a variety of other brain disorders, including Parkinson’s disease and essential tremor, epilepsy, brain tumors and stroke.”

Any time you don’t have to poke holes in this carcass of ours is a good time.

I have a bit more confidence in ultrasound used for this procedure rather than focussed radiation.

Via Telephone, Doctor Gets Instructions on Brain Surgery Using a Household Drill

A doctor in rural Australia used a handyman’s power drill to bore a hole into the skull of a boy with a severe head injury, saving his life.

Nicholas Rossi fell off his bike on Friday in the small Victoria state city of Maryborough, hitting his head on the pavement, his father, Michael, said Wednesday. By the time Rossi got to the hospital, he was slipping in and out of consciousness.

The doctor on duty, Rob Carson, quickly recognized the boy was experiencing potentially fatal bleeding on the brain and knew he had only minutes to make a hole in the boy’s skull to relieve the pressure.

But the small hospital was not equipped with neurological drills _ so Carson sent for a household drill from the maintenance room ….

Carson called a neurosurgeon in the state capital of Melbourne for help, who talked Carson through the procedure _ which he had never before attempted _ by telling him where to aim the drill and how deep to go….

“It was pretty scary. You obviously worry, (are) you pushing hard enough or pushing too hard, but then when some blood came out after we’d gone through the skull, we realized we’d made the right decision,” Tynan told Australian Broadcasting Corp.

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I also liked this quote from a BBC video:
“This is a once in a career thing that happens to very few people.”