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.

What am I likely to do that will irritate my diabetic girlfriend most?

Remember the Paul Simon song, "Fifty Ways to Leave Your Lover?" Well, there must be 150 ways to irritate your diabetic. In fact, if that diabetic takes insulin and you catch her when she has low blood sugar, anything you do, including trying to get her to eat something to raise her blood sugar, can irritate or even enrage her. (Some diabetics in that state have even been known to hurl food into the face of the person trying to help.) All diabetics, even when their blood sugar is normal and even if they don't take insulin, have their pet peeves. You'll just have to find out with experience what they are.

We can start you off with a few tips, though. A diabetic hates to hear the same phrase over and over from you. For example: "Is that on your diet?" "Did you remember to take your injection?" "Did you bring along a snack?" "Are you spilling sugar?" anything you keep repeating begins to grate after a while.

June, for some reason, gets furious when asked, "Do you have low blood sugar?" (She claims Barbara always asks this in an accusatory tone.) Her response is usually a garbled conglomeration of "How should I know?" "Do you see a blood sugar sensor sticking into me that I can read?" "Do you want me to stop what I'm doing and take my blood sugar; is that what you're saying?" Rant. Rant. Rant. She actually prefers to be told "You're acting weird" or asked "Why are you being so obnoxious?" probably because it's not the oft repeated phrase that she's come to loathe.

Nagging, which one psychologist defined as "trying to control with criticism," is also near the top of the diabetic irritation scale. Nagging is not only irritating to a diabetic but it's also a futile endeavor on your part. Changes are going to be made only when the diabetic wants to make them. The best that you can do is to help her climb Maslow's hierarchy of needs to the point that change is possible.

Another thing that will bother your diabetic girlfriend is if you cadge snacks off her. Insulin taking diabetics need to carry sweets at all times in case of an insulin reaction. If friends who are aware of this storehouse of goodies persist, like Goldilocks, in eating them all up, the diabetic can be in trouble in an emergency.

A far, far better thing to do is to find out what your girlfriend likes for diabetic snacks and carry something at all times for her emergencies (and your own snacking).

Probably the number one irritant for diabetics is if you don't make an effort to understand diabetes. Among her close friends June has some she's known for years and in whose homes she has frequent meals. All of them have supposedly read most of our books, and yet they still have only a vague idea of what she can or cannot eat. They understand little about how her meals must be scheduled or what to give her when she has low blood sugar. Since these friends are not stupid, she can only infer that they don't really care. A feelin that your friends don't care goes deeper than irritation. It goes into the hurtful wound area.


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