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.

Will i have to take insulin for diabetes?

That depends to a large extent on the kind of diabetes you have. Lately it's been recognized that diabetes is really more of a family of diseases than just one disease. If you get diabetes as a child or young person (this used to be called juvenile diabetes) you almost certainly will have to take insulin, because your pancreas is making little or no insulin. If, however, you get diabetes later in life say, after forty you're usually overweight, and often if you get your weight down you can be virtually symptom-free without insulin.

What if you're not overweight but you get diabetes after forty? Do you have to go on insulin or not? 

You may or you may not. You're a fence straddler. June was one of these. She was diagnosed at the age of forty five. She was not at all overweight (5 '5" and 116 lb.) and never had been. Her doctor put her on pills at first (Tolinase). They worked for her for several months. Then, although she followed her diet meticulously, she began running high blood sugar again. What's worse, her weight dropped to 108 and she started producing those calling cards of totally out of control diabetes, ketones. To get her blood sugar down, she had to start taking insulin and has been taking it ever since. The French divide their diabetics not into age groups but rather into the thins and the fats. They believe that if you're thin when you're diagnosed you'll probably have to take insulin and if you're fat, you won't. This certainly has held true for June.


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