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.

My husband wants to think and talk about his diabetes all the time. How can I get him off the subject?

It's hard to find a middle of the road diabetic. Diabetics either try to ignore the disease totally or they become almost obsessed by it. Those who fall into the obsessive category are at least better than the ignorers. They'll probably live longer and eventually outgrow their obsession.

As a matter of fact, many diabetics are only obsessed for a while, right after they're diagnosed. It's not surprising that they should be preoccupied when they first confront a disease that demands the constant attention and thought that diabetes does. Much of the diabetic's talk about diabetes at this time is just musing out loud as he or she tries to figure out what to do; whether he or she needs another slice of bread to make up for that weeding before dinner, if those funny feelings indicate low blood sugar or if they're something totally unrelated to diabetes.

One way that might tone a diabetic down a little is to become more informed on diabetes yourself. By showing your husband that you know something about diabetes, he may begin to feel that he can let go of his desperate hammerlock on the subject and relax and let you do some of the thinking for him. If the two of you have workable, give and take exchanges on new solutions to his diabetic problems, perhaps he'll be able to cut his personal, lonely fretting time in half and start to think and talk about something else.

Your advantage in knowing something about diabetes is that when he does talk about it, you'll understand what he's saying. Then the talking will seem a lot less like a foreign language you don't understand and, consequently, it will be a lot less boring to you.

If this plan doesn't work or just seems to feed his obsession, then you may eventually have to get tough with him. Tell him in no uncertain terms that nobody loves a monomaniac and that he's going to alienate everybody if he can't talk or think about anything but his disease. This won't be easy to do, especially if you have sympathy and love for the diabetic. Unless somebody sets him straight, however, he's going to ruin his life by thinking of himself as a walking case of diabetes rather than a human being with infinite interests and infinite possibilities who just happens to have diabetes.


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