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 should I do if we're out dining in a restaurant and my friend,who is diabetic, orders all the wrong things for herself?

Diabetics sometimes perversely do this. Even June, who is the most careful and rational of diabetics, has occasionally suffered this restaurant aberration.

The best thing to do when you hear the diabetically inappropriate meal being ordered is not to screech and rant and embarrass your friend in front of the waiter, but rather to order a diabetic back-up meal for yourself. Usually when her meal is presented to her, the diabetic takes one look at it and comes to her senses. Then you just say casually, without any lectures or recriminations, "It looks as if my dinner might be better for you than yours. Would you like to trade?" The diabetic almost always will with gratitude, probably as much gratitude for the freedom from lectures and recriminations as for the food. Naturally, to perform this little sleight-of-plate act, you have to know what a diabetically appropriate meal is.


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