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 much does diabetes cost per month?

How do I cut the high cost ofbeing a diabetic?

You're right to worry about costs. Being a diabetic can be an expensive proposition and the expenses rise every year with inflation and new discoveries in diabetes care.

The number one way to keep costs down is to practice preventive maintenance, just as you do with a car. If you keep your diabetes in control and keep yourself healthy, you'll keep yourself out of the hospital. Hospitalization is the most horrendous expense of all.

If you have a choice of health insurance plans where you work, be sure to investigate them to see which one pays for the most diabetes expenses. Some now pay for blood sugar testing materials and meters and some even reimburse you for insulin and syringes.

Often insurance companies initially refuse to pay for something like Chemstrips or Dextrometers and Dextrostix but if you keep haranguing them and submitting letters from your doctor (or lawyer!) and evidence of other plans that pay, they sometimes will eventually (and reluctantly) come around. It's worth the fight, because not only will you save money yourself, but you'll make it easier for diabetics who come after you to get reimbursement for their basic needs.

When you're working on health insurance claims, be sure to keep pointing out to them how much money they'll save in the long run if they pay for, say, home blood sugar testing materials, and you use them to keep yourself well and out of the hospital.

Incidentally, we've heard from health professionals that the best time to ask insurance companies to pay for home blood sugar testing equipment and supplies is right after a patient has been hospitalized with some diabetes problem. While the high hospital bills are fresh in its computerized memory, the insurance company is much more likely to pay for those things that will keep a diabetic healthy and out of the hospital. Of course, this is the hard way of getting the insurance companies to cough up and is hardly recommended.

When it comes to buying diabetes supplies, do a lot of comparison shopping. Prices vary tremendously from pharmacy to pharmacy. Sometimes you can even bargain with them for a discount if you buy in quantity.

Watch for sales on such things as Tes Tape and disposable syringes and stock up. Watch for discount coupon offers from the manufacturers. You sometimes find these in Diabetes Forecast or at diabetes association meetings. Talk to other diabetics and see how they find ways of cutting costs.

Often you can save money by mail order. The American Association of Retired Persons pharmacies have very competitive prices on insulin, urine testing materials, and disposable syringes. You can join the association if you're fifty five years old or older for a cost of $40 a year. If you're too young, we can't see anything wrong with having an older relative join and order your supplies for you. In Diabetes Forecast, mail order "discount pharmacies" surface from time to time. Some of these require that you pay an annual membership fee of $12-$24, so you have to make sure you'll be ordering enough each year to make the investment worthwhile. Others may offer a special super low price good for one order only. This is a way of getting you on their mailing list, but if you don't mind being on another mailing list, you do save a lot on the one order and in spending for diabetes supplies, every penny counts.

We started the Sugarfree Center to try both to keep prices down and to discover and make available new products that improve diabetes care. We publish a bulletin that describes the products and includes any thrift tips we discover.

If you really put your mind to it, you can come up with a lot of ways to cut down on the costs of diabetes. For example, many people use their disposable syringes and needles several times until they grow too dull to be comfortable. (One fellow who dropped by the Sugarfree Center told us he used his fifteen or twenty times! In fact, he said he liked them better when they weren't so sharp!) After using the needle you should carefully recap it, very carefully because you don't want to hit the needle with the plastic cap and further dull it or bend it. Then place it in the refrigerator until the next use. (This prevents the growth of bacteria in case some got on it.)

When it comes to home blood sugar testing an admittedly expensive proposition there are many ways to save. Using Chemstrips bG or Dextrostix alone rather than buying a meter is, of course, a big saving, but if you need the accuracy of a meter, sometimes you can buy a used model secondhand.

With the Autolet you can cut costs a good bit over the years by ignoring the printed instructions that tell you to throw away the lancet and platform after each use. You can, in fact, keep using the same lancet until it gets dull. June usually uses hers around five times.

As for the platform, there is no need to ever change it unless it gets bent or broken. June has been using the same one for over two years. The ten platforms that come with the Autolet will probably be enough to last you through your next four or five incarnations.

While using the Autolet is admittedly the easiest and most painless way to get a blood sample for the test, you don't have to have one to do home blood sugar testing. You can prick your finger with a lancet or even more of a saving with an old insulin needle. This is how June did it in her early days of home blood sugar testing.

Now here's the Really Big Saving. We heard the rumor that some clever rascals were cutting their Chemstrip bG testing strips in half (lengthwise, of course) and thereby getting two tests for the price of one. This sounded like a great idea but we were afraid that cutting them might break some sort of seal and make the test inaccurate, so we conducted a little experiment. We took two Chemstrips bG from the same vial, cut one in half and left the other one whole. We then put a drop of 130 glucose testing solution on each and followed the standard procedure. At the end of the test they looked identical and the half strip was just as easy to read as the whole one. Since we feared the cut might make the color unstable and cause it to fade out, we set the strips aside and checked them every week. Now it's three months later and the two strips still look identical. Needless to say, June has cut all her Chemstrips bG in half. Additional benefit: It takes a smaller drop of blood to make the test with a half strip. Unfortunately, if you're using a machine, you can't cut your testing stick in half.

Another way for a diabetic to save money and to be healthier as well is to stop using a lot of expensive processed foods. Cook from scratch whenever time allows. You eliminate all kinds of chemical nasties and overgenerous sugaring and salting, and you gain more vitamins and minerals when you use fresh vegetables and fruits and bake your own bread products from whole grains.
Now, from the foregoing, you can see that we have the utmost empathy for people who have trouble paying for their diabetes necessities and we try to figure out ways to cut costs. There are people, however, who have plenty of money yet who clamp their wallets and purses shut when it comes to spending for supplies that will help improve their health.

At the Sugarfree Center we've had people drive up in Cadillacs and Lincoln Continentals who would sit and orate about their annual Caribbean cruises and European tours, and their winter homes in Palm Springs, and their summer hideaways at the beach, and then anguish over their doctor requiring them to buy "all this expensive stuff" (an Autolet and Chemstrips bG totaling out at around $40.00). They would mutter that they hoped they wouldn't have to "keep spending all this money" on testing their blood sugar for very long. Some would even decide to go home and think about it before springing for the supplies.

As Diane Victor, the Diabetes Teaching Nurse at Valley Presbyterian Hospital in Van Nuys, California, says, "Some diabetics have to get their priorities in order."

Ron Brown, the young diabetic who works with us, agrees, "You can't enjoy any of your other activities if you don't take care of your health." Since he's a normal human being, Ron would certainly prefer not to have diabetes and to buy a one day ski lift ticket at Mammoth Mountain (currently $17) rather than a bottle of Chemstrips bG (currently under $17), or take his girl friend out to dinner (in all probability a $25 jaunt these days) rather than buy an Autolet for the same price. But he has his priorities and his testing materials and his health.

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