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.

Should I give my brother his insulin injections?

Yes and no. Yes, you should give them to him sometimes. You can reach injection sites he can't reach himself, unless he's a contortionist. This is a big help. Since a diabetic isn't supposed to inject within one inch of the same spot for a month, you can see how easily he can run out of accessible areas, especially if he has to shoot more than once a day.

Another reason for giving him his insulin is that you'll know how to give an injection. Should he ever pass out in insulin shock, you'll know how to give him glucagon which is injected in the same way as insulin, and bring him out of it.

But no, you shouldn't always give him his injection. He's got to be mainly responsible for his own insulin shooting. No one should be that dependent on another person. It's almost like being dependent on another person for your breathing. It's not good for him or for you, either.

We know a nurse whose husband is a diabetic. At first, he tried to wheedle her into giving him his shot every day. He got nowhere with her. She was as firm as Senator Inouye's nurse after he had had his arm amputated in Italy during the war.

The senator's nurse handed him a pack of cigarettes and matches but refused to either open the pack or light the match. She explained, "I'm not always going to be around to do things for you. You're going to have to learn to do for yourself."


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