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.

How can I tell if a diabetic has low blood sugar?

It helps if you know the diabetic well enough to recognize behavior that isn't normal. If a generally easygoing person starts snapping and snarling, it may be low blood sugar. If a decisive person becomes vague, that can be a clue. Fumbling hands, glassy eyes, slurred speech, perspiration on the forehead or upper lip, a dopey smile, an odd, taut look about the face all can be symptoms of hypoglycemia. Just about all diabetics have some signs peculiar to themselves that you'll grow to recognize, if you're around them a lot and are observant.

Even if you know the person well, though, it's not always easy to recognize low blood sugar. We still remember the time we were talking to the Glendale chapter of the Diabetes Association of Southern California and told about one of our editors who said she could always recognize when June had low blood sugar "because she starts being mean to Barbara." We noticed a woman in the audience frowning. During the question and answer period she said, "My little boy has diabetes and takes insulin. Often, in fact, very often before dinner he's a holy terror. I can't do a thing with him. Could that be low blood sugar?" "Oh boy, could it!" we chorused.

She was really shaken, because she had been punishing him for the misbehavior of his chemicals. When you ascertain that a diabetic does have low blood sugar, take action immediately.

Above all, don't follow the example of the sister of a diabetic friend of ours, who, when she saw he was starting to act funny, looked terrified and announced, "You've got low blood sugar! I'm getting out of here!" And she fled.


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