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 often should you test your blood sugar at home? What is the best time to check blood sugar?

Some doctors recommend blood sugar testing as few as four times a week; others advise doing it as often as four times a day (or more!). June usually does hers twice a day before breakfast and when she gets home from work in the late afternoon. She also does it when she's confused about what her blood sugar is because she's having trouble reading her body signals. This can be pretty often when she's under pressure or on a trip or doing an extra lot of exercising or is otherwise out of her regular routines. Many diabetics like to test two hours after eating to see how they handled the meal.

Richard K. Bernstein, who advocates very tight control for juvenile diabetics, has evolved a system called "Glucograf." In this system, diabetics test as frequently as six times a day in order to keep their blood sugar normal 90 percent of the time and thereby avoid the complications long term juvenile diabetics can be susceptible to.

Do you ever need to go to the doctor for tests if you do them yourself at home? 

Yes, you should go about every three months for a glycohemoglobin test (hemoglobin Alc ). This is a new test that reveals the amount of glucose clinging to individual cells. It tells you how your overall control has been over a 100-day period. The glycohemoglobin test is a great improvement over going to the doctor for a simple blood sugar test because it doesn't really allow you to fool yourself or your doctor. We are all only human and we want the doctor to think well of us. We want to be patted on the back for being the well-behaved patients we should be. Consequently, we tend to be much more meticulous about diabetes care immediately before visiting the doctor for a blood sugar. The hemoglobin Alc reveals whether you've been taking care of your diabetes all the time, rather than just the two or three hours prior to your visit to the doctor.

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