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.

Is diabetes high risk pregnancy? Can diabetes pregnancy harm baby?

Can i be pregnant with diabetes?

We assume from this question that you have already wrestled through the basic Everywoman life decision of whether or not to have children and have concluded that you want to, but you worry about the effect your diabetes will have on your baby and vice versa.

If that is the case, then the first step is to consult both your diabetologist (or internist or family doctor) and a gynecologist to see if there is any physical reason why pregnancy would be a poor risk for you.

If their reaction is positive, then you can be cheered by the news that the death rate of babies of diabetic mothers has been significantly reduced in the past ten years and is now closer to that of the general population. Both mother and child come through successfully more than 90 percent of the time.

To improve your odds even further you should heed the advice of Dr. Edith Miller of the Joslin Clinic who says that diabetic women who want to have children should be in the best possible control before becoming pregnant (have a hemoglobin Alc test to find out) and stay in good control from the time of conception on. This advice is backed up by a study of the pregnancies of twenty-five women that was reported in the British Medical Journal. These women had previously had fourteen pregnancies among them. Out of these fourteen pregnancies, six babies had been lost either during pregnancy or soon after birth. For this study the women were all put on home blood sugar monitoring. Result: the women were not only able to maintain good blood sugar level, but every one delivered a healthy baby. For a very brittle diabetic it may also be wise to go onto the pump during pregnancy.

We find it hard to conceive of the idea that health insurance, if you have it, would not pay for all the costs of blood sugar monitoring and, if necessary, the pump during pregnancy. It would be a sound investment on their part since the alternative could be astronomical hospital bills (in the $65,000 range).

We find it impossible to conceive of the idea that your doctor wouldn't want you to do home blood sugar monitoring, either alone or in conjunction with a pump, during your pregnancy.

If your main decision on whether or not to have a baby involves the ethics of producing a child with the possibility of diabetic heredity, than that's a decision only you can make. Since the pattern of inheritance of diabetes is unclear, each family must make a personal assessment of risks of having diabetic children. You can get counseling by requesting it through your diabetes educator or by contacting your nearest chapter of the National Foundation March of Dimes and asking for their list of genetic centers and genetic services.

While deciding, you might consider the fact that every human being carries many defective genes and having a baby involves playing genetic lottery. You might also ask yourself if you'd prefer to have been born programmed for diabetes or not to have been born at all.

On the other hand, many diabetic women and their mates ultimately decide to adopt a child. It occurred to us that since there's currently a shortage of "perfect" babies available for adoption, it would be a wonderful thing if a couple experienced with diabetes could find it in their hearts to adopt a diabetic baby or older child.


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