What is a radical neck dissection? when is it done?

What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

Does a diabetic child disrupt a family?

A diabetic child can disrupt it or can merely change it, in some ways for the better. Disruptions occur when the parents are filled with guilt, anger, or both. We heard of a husband who blamed his wife for the child's diabetes and threatened to divorce her "if anything happens to that kid." Obviously, he hadn't heard of the new theory of the cause of juvenile diabetes, that a virus is responsible, just as for the measles or mumps.

Parents fraught with guilt can coddle and overindulge the diabetic child. This not only creates resentment and feelings of being unloved in any other children in the family but can be ruinous for the diabetic child as well. Diabetes can become for the child an excuse for dependence and manipulation of other family members instead of a stepping stone to strength.

This also holds true if one parent becomes diabetic. In American families these days we tend to be more than somewhat child centered. If a parent becomes diabetic and needs attention and care from the rest of the family, this develops in the children an increased responsibility and sensitivity to the needs of others.

In one family, the father, who had flexible business hours, spent much of his spare time chauffering the kids to their many and varied sporting activities and cheering them on from the sidelines. When he developed diabetes and had a need for exercise himself, the kids made it their business to see that dad got his jog every day and they took turns accompanying him on it. New responsibilities. New closeness.


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