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Activity after open or laparoscopic abdominal surgery

Every patient who visits my office with a surgical condition has several decisions to make and has a lot of information to absorb and understand.

I typically spend much of our time together describing the condition itself, why I recommend surgery, how I will perform the surgery and any risks involved in the procedure. While this is all critical to anyone’s understanding of their treatment plan, once the decision has been made to proceed with surgery, many patients’ concerns quickly turn to their recovery and what to expect after surgery. Most patients want to know when they can get back to walking, lifting, exercising, and their normal daily routine. While every patient and procedure is different, some generalizations can be made to help you know what to expect.

General abdominal surgery can broadly be separated into two categories: 1) open surgery where a large incision is made through the abdominal wall and 2) laparoscopic (or robotic) surgery where the procedure is preformed through multiple small incisions. Both types of surgery are used for a wide array of surgical problems.

The recovery from these two types can be different. Every patient should ask their surgeon wound care questions, dietary restrictions or signs of possible complications specifically related to their recommended procedure. There will be activity restrictions in the early postoperative period for all surgical procedures.

Many people wonder why we limit activity after ..

Why you should take sports concussions seriously

Concussions are serious injuries that should be treated by healthcare providers who are experienced with their management. Sports Medicine physicians diagnose and treat concussions with the goal of promoting a healthy recovery and returning athletes to sports and kids to school. Additionally, we work with parents, athletes, coaches, and other providers to identify the signs and symptoms of a concussion and help to proactively manage the effects.

What is a concussion?

A concussion, also referred to as a mild traumatic brain injury, is an injury to the brain caused by a blow to the head or from a whiplash effect due to a hit to the body. Concussions change the way the brain works and how a person thinks, acts, and feels. Most people do not lose consciousness. Even a "ding" or "bell ringer" can be serious.

What are the symptoms of a concussion?

Symptoms fall into four categories: physical, cognitive or thinking abilities, mood and behavior, and sleep. A person may have many symptoms or only a couple of symptoms. If a person reports one or more symptoms of concussion or if another person notices the symptoms, keep the person out of play and seek medical attention.

The symptoms of a concussion that fall into each category include:

Increasing Your Child’s Comfort with Nitrous Oxide

You may be familiar with “laughing gas” as something you find at the dentist’s office but did you know it can also be used when your child is a patient at Swedish? Laughing gas is a mix of nitrous oxide and oxygen, but you might hear your pediatric nurses just call it “nitrous.” In pediatrics, we use it to help a patient relax and feel more comfortable during certain procedures such as IV placement or urinary catheterization.

Once your doctor or nurse has determined that your child is a good candidate for nitrous (without any contraindications such as conditions where air may be trapped in the body, pregnancy, or impaired level of consciousness), your nurses and certified child life specialist (CCLS) will explain the process: Your child will choose a flavor for the inside of their mask used to administer the gas. They will be on a stretcher or bed and have a saturation probe attached to a finger to monitor their oxygenation. One nurse will administer oxygen, then the nitrous, gradually increasing the amount until your child is suitably relaxed for the procedure, while remaining responsive to directions. Another clinician will perform the procedure, e.g., place the IV. A doctor is also available.

As a parent ...

Eczema season

"It's eczema season" is an often repeated phrase for me lately.

This time of year, I always find myself seeing more patients with eczema. The common presenting complaint is a persistent rash that itches so much that it disturbs sleep. The dry, itchy patches of skin are commonly seen on the back, sides of the torso, arms and legs, but can happen almost anywhere. People with a history of allergies, asthma, or childhood eczema are even more likely to develop eczema in the fall or winter.

There are a number of contributing factors to the increased incidence of eczema in the winter:

Furnaces run more, drying out the air inside homes and buildings. We wear more clothing, increasing the friction on our skin. Hot water feels better, so we tend to spend more time in the shower or bath.

That last one sounds counter-intuitive, but ...

Picky Eaters - Tips for Establishing Healthy Eating Habits

Picky eaters. We all know at least one, have a child that’s proud to be one, or heck, might have a history of being one (gulp). Every child is unique, hence the approach to picky eating needs to be highly individualized, but here I will outline some general tips on how to establish healthy habits for picky eaters!

The Basic Rules...

Introducing solids to your infant

As your baby grows, you’ve probably started wondering when and how to start feeding your infant solid foods. Here are some general tips to consider:

Is there a safe age to start feeding solid foods to my infant?

Yes, most infants this is between four and six months of age.

Why is there a ‘safe’ age to start feeding solids?

There are a few reasons why this age is safest. The first reason is because prior to four months of age, an infant is not developmentally ready to safely eat from a spoon.

To be able to swallow solids safely, an infant needs good head control; to be able to sit well with support; and to have lost the “extrusion reflex” (the reflex which enables newborns to tightly latch and suck from a nipple, but makes them shove a spoon out of their mouth).

The second reason an infant should be fed solids between four and six months is something many families are not aware of: it is also a strategy to prevent common food allergies. This is one of the strongest reasons I passionately advocate for infants to be exposed to as many foods as possible during this crucial three-month window.

Starting solids and preventing food allergies:

In the past, healthcare providers have advised parents to avoid potential allergens such as peanuts, eggs, and milk. New evidence is now showing that this practice might have played a role in the increased incidence of childhood food allergies in the U.S

Why might this occur? The ...

Why you should have your hernia repaired

Do you have a groin bulge that seems to come and go, often absent upon waking in the morning? Or perhaps you already know you have a hernia? Hernias are very common and occur in approximately 1 in 4 males (less common in women), so chances are you or someone you know has or has had an inguinal hernia. The main question I always get asked is "should it be fixed?"  

As a general surgeon, I see 4-5 patients every week with a newly diagnosed inguinal hernia. Many are self-referred after discovering a lump in the groin, while many others are referred from their primary care provider after the hernia is discovered during the physical exam. After verifying that a hernia is the correct diagnosis (other possibilities are a groin strain, swollen lymph node, etc.), I have a discussion which addresses the aforementioned question. As an aside, these are very common and also found in the pediatric population (see a similar discussion by one of our pediatric surgeons)

To understand hernias...

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