Member

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Welcome to the latest edition of SurgeXperiences, the fortnightly carnival of blog posts related to surgery.

This happens to be the 50th edition. Ironically the number 50 has acquired an altogether unwelcome significance this week due to the unfortunate and untimely death of Michael Jackson aged 50. Mr. Jackson may very well be the King of Pop to fans and music lovers, but to most of us in healthcare he is probably better known as the worst example of celebrity plastic surgery on demand or as a prominent plastic surgeon describes him, the most famous “nasal cripple.”

Dr. Pamela Lipkin, a prominent plastic surgeon in New York City who has studied photographs taken of Jackson at a California court appearance in November — in which his apparently scarred nose was covered by a small transparent bandage — believes something went wrong. “What I think happened recently is that something in his nose — a graft, an implant, something — has now come out through the skin,” said Lipkin, a nasal specialist who is not Jackson’s doctor and has never examined him in person. “He’s really got a hole in his skin.” “Michael Jackson has what we call an end-stage nose, a crippled nose, a crucified nose — one that’s beyond the point of no return,” she said. People who have had so many surgeries on their nose that it becomes hard to breathe through are called “nasal cripples,” Lipkin said. Although Jackson’s face has been splashed across the tabloids in recent months, Brittan Stone, photo editor at the celebrity magazine Us, says the singer’s face is not being seen on magazines. “The one thing you can’t do with Michael is a beauty shot, because that shot simply just doesn’t exist anymore,” Stone said. “I don’t think you can put Michael Jackson’s face on the full-page of a magazine…. I think the flaws in his face become a little too evident, a little too frightening. It becomes like a medical study.”

GruntDoc nailed it when he wrote…

I’m willing to bet drugs (legal, clean, prescribed by a doctor) were involved, and that a review of the records will show some questionable prescribing. First Do No Harm, unless it’s a celebrity? Why are docs willing to engage in this kind of horrible, destructive prescribing? It’s reprehensible.

and

…somewhere in Beverly Hills there’s a Plastic Surgery group applying for TARP funds.

In other surgically related sad news this week, actress Farrah Fawcett lost the battle with anal cancer and a young Iranian woman was shot down in cold blood in the streets of Tehran as a doctor who happened to be nearby tried in vain to save her.

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bongi, who celebrated his birthday this week, shares an angry moment, a story that he isn’t very proud of; and this sad story of mindless violence in south africa that cost a man his leg.

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Ramona, the sewing surgeon, reviews an article on surgical glove perforation.

It is well known that the risk of getting a hole in one’s glove increases with the length of the surgery (especially when over 2 hours) or when dealing with spiked bone fragments.

Ramona also writes, in her usual scholarly way, about posture and how Poland’s syndrome came to be thus named.

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Buckeye uses a tale of rare successful surgical outcome in a patient with gangrene of the bowel to pose a difficult question…

So what do we do? We have the ability to truly save patients from insults that had previously killed human beings for thousands of years. How do we decide when it’s justified to throw everything in our armamentarium against a disease afflicting a patient? If 50% of patients are going to die no matter what you do, is it still defensible to aggressively treat all of them?

… also from Buckeye, we have an interesting short review of a journal article on seven American presidents who underwent surgical procedures during their lifetime. Buckeye covers trauma in a Level II centre and is of the opinion that CT scan ought to be the imaging modality of choice for cervical spine injury. I agree.

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TBTAM says she will choose colonoscopy over a CT anytime and shares some news about how when it comes to vitamins, more is not necessarily better.

The surgical blogosphere’s éminence grise Sid Schwab dreams of surgery.

Intraoperate thinks she ought not to get familiar with some patients or their families preoperatively.

Anesthesioboist T thinks it could happen to you so be prepared for the worst. Sometimes being prepared doesn’t help. But then, such is life, say I.

Bruce Campbell is eloquent as usual in this post titled transcience.

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Apple CEO Steve Jobs received a liver transplant and the medbloggers have differing opinions. Orac does a comprehensive, partly speculative medical review. Buckeye has a different take.

Surgeon and columnist at The New York Times Pauline Chen writes on Medicine in the age of Twitter.

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From Whitecoat we have this news story of a promising new test for Appendicitis that involves only a urine test.

The implications of this test are huge. Appendicitis is one of the more difficult diagnoses to make clinically and missed appendicitis is an often-litigated issue, prompting many physicians to order expensive CT scanning in anyone with right lower quadrant pain. As many as 30% of appendectomies end up showing no appendicitis. If LRG testing has a low false positive rate (i.e. test is positive when there is no appendicitis) and a low false negative rate (i.e. test is negative when appendicitis is really present), it would save a lot of unnecessary surgeries, would decrease the number of CT scans being performed, and would significantly reduce the transit times in ED patients who have lower abdominal pain.

Again from Whitecoat we have a picture quiz and a short write-up on wound dehiscence with evisceration. In case you haven’t been following (where have you been if you’re a medblogger?) here is the latest episode of the riveting Trial of a Whitecoat.

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Surgeon and inventor Catherine Mohr talks about surgical instruments and the evolution of surgical technology…

[h/t Sterileeye & GrrlScientist]

Talking of surgical robots, here is one that uses a “frighteningly large needle” to remove shrapnel.

Scientists at IIT-Kharagpur have developed an artificial heart inspired by the cockroach and built like an onion.

Liquorice gargles may help reduce post-intubation sore throats in surgical patients, say doctors in India.

Cardiothoracic surgeons in an Indian hospital performed a risky and complicated open heart procedure on a 14-year-old Ugandan girl to replace the mitral valve, repair a leaking tricuspid valve and maze procedure to correct her abnormal heart rhythm.

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Links from regulars:

Sterileeye shares a link to a list of the Top 50 Surgical Bloggers.

Jeffrey Leow points us to a video on Brain Surgery from the Doctors Channel and to this news story about James Maki, the second face transplant patient in the U.S., who is taking his incredible story to the public in an effort to encourage organ donation.

From Flickr, a macabre photo of a knee arthroscopy training lab.

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Ending with a bit of humour…

…from Mike Cadogan we have a comically macabre poem that tells the tale of the last moments of a dying surgeon, who fears he will not be allowed his eternal rest, and what happens after his death

…and from Close To Home gives us a new disease, that I personally think ought to be included in ICD 10.

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Acknowledgments:

I’ve included a few posts here without getting prior permission from the authors. I know it’s not wrong to do that in a blog carnival, but in case any of you feel that your post ought to be removed from this listing, let me know and I’ll remove it.

I apologize if I have missed any posts which were submitted or suggested.

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Image Credits:

All photos are from Flickr - Tagged - bharatanatyam except the third photo, the only one of a male dancer which would be tagged kathakali.

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There is no host yet for the next edition

SurgeXperiences 227

to be posted on July 12, 2009.

If you are interested in hosting, contact Jeffrey Leow

Deadline for submissions is on Friday, July 10.

Please send in your submissions early via this form.

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