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The Goal of DBS (Deep Brain Stimulation) Surgery

February 01, 2013

I met with several patients this week to discuss their personal journey to making the decision to pursue DBS surgery. Not surprisingly, they were well educated about their disease and treatment options.

Each patient reminded me that there is a lot of information and misinformation about surgery for movement disorders.

The most important advice I can give any patient or family is...

Why you should have your hernia repaired

December 31, 2012

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 (

Hernias: why are some watched while others are repaired?

September 17, 2012

The most common thing that I see as a pediatric surgeon is a child with a lump that is thought to be a hernia. A hernia is a bulging of tissue through an opening in the muscle layers that isn’t normally present. In children, these openings are usually the result of a developmental process that just didn’t quite reach completion. Some hernias need surgery emergently, while others are observed for years with the expectation that they will close on their own.

Here are some pointers to help understand this wide range of approaches to hernias:

Location is very important in considering how aggressive to be with hernias. Belly button (umbilical) hernias are...

Rib Fractures: Essentials of Management and Treatment Options

August 22, 2012

Rib fractures are the most common chest injury accounting for 10 to 15 percent of all traumatic injuries in the U.S. Nearly 300,000 people are seen each year for rib fractures and 7 percent of this population will require hospitalization for medical, pain, and/ or surgical management.

Rib fractures can cause serious complications including: bleeding in the chest (hemothorax), collapse of the lung (pneumothorax), or result in a fluid accumulation in the chest (pleural effusion), just to name a few. As well, rib fractures may contribute to the development of a lung infection or pneumonia. These problems are important to diagnose following chest trauma and even more importantly, when present, they need to be followed closely in the early post-traumatic period.

The most common symptom that people experience with rib fractures is....

Fixing Chest Wall Deformities: A Minimally Invasive Option

July 25, 2012

Pectus excavatum often referred to as either "sunken" or "funnel" chest is the most common congenital chest wall deformity affecting up to one in a thousand children. It results from excessive growth of the cartilage between the ribs and the breast bone (sternum) leading to a sunken (concave) appearance of the chest.

Although present at birth, this usually becomes much more obvious after a child undergoes a growth spurt in their early teens...

Pain after surgery

June 27, 2012

If you are scheduled to have surgery, it is normal to be concerned about pain you may experience after surgery.

The best time to talk about post-surgical pain is actually before your operation. Make sure you:

  • Talk to your surgeon about your experience with different methods of pain control.
  • Bring a current list of all your medicines and any drug allergies with you to your appointment.
  • Be honest about your alcohol and drug use. If you are abusing alcohol or drugs, you may experience withdrawal from these substances making your postoperative recovery difficult. If you are a recovering from alcohol or drug abuse we can design a pain management plan to reduce the chance for relapse.
  • Ask questions about the post-surgical pain: the severity, how long it will last, how it will be treated, what medications will be used, how they work, and their possible side effects.
  • Discuss any concerns you have about taking pain me...

Pectus excavatum � it looks like the chest is sinking inward

April 10, 2012

Have you ever noticed someone whose chest sinks inward in the front, kind of like a funnel? The first time I ever noticed this bony malformation was when I was in high school, and a friend of mine on the soccer team had one. It was called “pectus excavatum,” he told me.

In my thoracic surgery training, I was often called upon to evaluate patients with this chest wall abnormality. As a result, I began to delve deeper into some of the issues that may affect people with this type of defect.

Pectus excavatum is the most common chest wall deformity and results from abnormal development of the sternum and its attachments. Most patients are self conscious about the defect and usually focus on its appearance but because this is usually present for much of a person’s life, symptoms associated with it may not be totally obvious. Individuals affected generally get used to how they feel and try to overcome any limitations to the best of their abilities without even knowing that&...

Palmar hyperhidrosis

January 30, 2012

Everyone sweats – but what if you had a condition that caused uncontrollable sweating in your hands?

Palmar hyperhidrosis is a benign condition where individuals experience uncontrollable sweating of their hands, way beyond their physiological needs. Hand sweating in such a scenario is often described as being present 24/7, may be worsened in situations of stress but also occurs out of nowhere in times of total rest and serenity. From the constant dampness the hands are exposed to, ulcerations and other skin related changes may develop. Many patients with this condition adopt a line of work and a life style that minimizes public encounters and avoid hand contact such as having to shake hands.

It has been known since the 1920s that by dividing the sympathetic chain (nerve) high up inside the chest, a procedure called thoracic sympathectomy, we can make the hands stop sweating. To achieve this surgically was quite an undertaking back then. The surgical trauma was such that histori...

Let it snow

January 16, 2012

Have you been outside enjoying this weekend's snow fall?. Whether or not you were able to play outside, we thought we'd share some new videos in our robotic surgery series that don't require going out in the cold..and might give you inspiration of a craft project to do with your kids.

In Seattle, we can make a snowman:

And not only can our robots (driven by our robotic surgeons)
fold paper airplanes, but they can also make a snowflake:

It may be your first robotic knee surgery...

January 14, 2012

....but at Swedish, it's definitely not ours.

If you have advanced arthritis in part of your knee, robotic-assisted surgery is a great way to go. The incision is smaller. Recovery time is faster. And the surgery is more accurate for better knee function down the road.

So where should you go? Well, Swedish was the first in the Puget Sound area to perform MAKOplasty for partial knee replacements, and we’ve done more of them than any hospital in the region.

Come learn more from a Swedish orthopedic surgeon at one of our seminars, and take the first step toward a pain-free life. Or, watch the below video to see highlights from a partial knee replacement procedure:

 

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