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

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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 do I find a doctor who specializes in diabetes? What kind of doctor is best for diabetes?

Call your local diabetes association and ask them for the names of diabetologists who are closest to your home (and closeness is important).

If your town has no local association, call your state affiliate of the American Diabetes Association and ask them for a recommendation.

If you still have no luck, call your local hospital and ask who on their staff handles most of the diabetes cases. Another good thing to do is go to your public library and check the Directory of Medical Specialists. This way you can find out the doctor's training, what hospitals he or she has worked in, age, and special experience.

We realize, however, that in some small towns there simply isn't a diabetologist. In that case, find (or keep) a doctor with whom you feel you can have a good relationship. Look for one who is willing to explore solutions to problems you present. Be sure she or he is willing to investigate new developments in diabetes that you may learn about in your reading or from discussions at meetings and seminars.

Incidentally, if you have a beloved family doctor, there's no reason to desert him or her for a diabetologist. You can keep the beloved one as your general physician and go to your diabetologist for specific diabetes care.

When your diabetes is in its early stages or if you start developing problems at any time, you may want to go to one of the major diabetes clinics in the country where you stay a week or so and they give you examinations and lab tests. You attend classes and learn what you need to do to get your diabetes in good control.

After all this talk about what your doctor should do for you, we mustn't forget your responsibilities to your doctor and what your doctor should expect from you.

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