A Visit to the Doctor
The family physician seemed delighted. He manipulated my crotch a little more vigorously than I thought necessary. This was not, you realize, a situation in which I felt comfortable. The man was conducting an annual physical after all, which I arrange at five-year intervals, whether I need one or not.
"Oh yes, that"s a hernia all right," he beamed, as if announcing a lottery win. "No big deal nowadays, of course. They can do it laparoscopically. No stitches and you"re back to work in a couple of days."
I began to wonder about his bedside manner. What happens when he comes across something really serious? "Oh yes, Mr. Thomson," he"d say, squinting his eyes and sucking air noisily through clenched teeth, "we"re going to have to do a ream job on that prostate of yours. It"ll only take a couple of days in hospital. When you"re in there, we may as well take a roto-rooter to your colon. Guys over fifty need it, you know. Your sex life will be over and you won"t be able to shit for a week but, hey, you hafta be philosophical at your age... So, when can we schedule another appointment?"
Now, Dr. X was not convincing in his knowledge of hernia repair. There appeared to be more to it than the latest technique he"d heard about. I determined to conduct some basic research in the Web. This threw up a bewildering array of surgical fads and remedies at ritzy websites, many of which trumpeted the advantages of a local anesthetic. The conventional "tension" method, which has been practiced by general surgeons for eons, received short shrift, being delegated to the "general information" category on basic surgical methods. There is apparently no real money or reputation to be made, as no special high tech materials or surgical techniques are needed. And it required a general anesthetic. This was definitely not on.
My aversion to being knocked out, you have to understand, stems from the time when I was seven years old and experienced primitive dentistry at the hands of an elderly gentleman with equally ancient equipment. This included a large mask reminiscent of those used in trench warfare. It smelled nauseous and definitely received its gas from the pipe feeding the heating system, before being filtered through rubber. I knew I was going to die. What did die, in fact, was my confidence in the medical fraternity"s ability to administer anesthetics. Besides, who wants to lose consciousness? God knows what they get up to when you"ve got your pants down and they know you"re not looking.
It became clear that the proponents of the various techniques, as practiced by different organizations and clinics, were selling their solutions to a robust and competitive marketplace. Advocates of one method tended to put down the apparent virtues of the others. Very confusing. They all seemed to take pride in the low incidence of failure, which begs the question as to how accurate these figures really are. If the thing doesn"t work out, you can"t expect the same surgeon to get the job of fixing it again. So who puts the statistics together?
It became obvious that male inguinal hernia repair is one of the most common of operations, up to 700,000 being performed in the U.S. each year. That works out at a pretty good chance that a guy will have a problem at some point in his life. I recalled seeing hernia trusses in the drug store, displayed alongside aluminum walkers and elastic stockings, and wondering what they were for. It now became clear. Allow this thing to get worse and I might need one...
The traditional method pulls muscles together under tension, laced like a football to keep its inflated bladder from bursting out. No wonder it can hurt. It leaves you gripped with pain every time you move, for days and sometimes weeks on end. Our next-door neighbor, a dentist who should have known better, had that one done last year. Poor guy. I ended up cutting his lawn. He walked bent-over for weeks. I look at him closely sometimes. I swear he walks with a limp. He was definitely laced up too tight on the one side.
Then there"s the "improved" tension method, pioneered by Shouldice in Canada in the 1940"s, which would qualify the surgeon to receive advanced awards in quilt making. The needlework design and rearrangement of muscle tissue is supposed to be better than the standard method. Then there is the modified Shouldice method, utilizing mesh, which strengthens the job.
The "tension-free" methods, all of which incorporate various types of foreign objects, come under a variety of types. I liked the idea of not having my groin muscles stretched and stitched. Far better to insert some kind of painless reinforcement.
Dr. X"s suggestion of the hi-tech laparoscopic solution is understandable, if he believes the claims made for it in some quarters. Others warn against it, claiming it to be too new, and responsible for major problems. The description of internal organs and other body parts being stapled in error, and the need to inflate one"s insides with carbon dioxide to permit the surgeons to see what they"re doing, was enough for me. I could imagine the compressor going haywire, followed by a large bang. "Ms. Thomson," the surgeon would have to say, "I"m afraid that you"ll have to come back for your husband tomorrow. The janitorial staff would like to work with him this evening".
Other "Tension-Free incorporating mesh" solutions looked interesting. But which technique is best? The Lichtenstein method? The Davol Perfix plug and mesh procedure? The Kugel expanding circular doohickey technique? The Outer Hebridean vulcanized tweed patch repair...? The list is endless. And quite confusing. And while many of the proponents trumpet the use of local anesthetics, others brush over the fact that they need to knock you out.
For me, the matter boiled down to whatever could be done with a local anesthetic and get me back to work fastest. It had to have a good track record and be carried out by an experienced surgeon, familiar with hernias. I didn"t want to deal with bossy administrative staff. And I wanted to get in and out in a couple of hours.
It seemed almost attractive to fly to either California, or London, to get attended to by the folks with the most convincing web sites and who would also accept my medical coverage. But I saw an ad. for the Jefferson University Hospital hernia clinic. I decided to give it a try and see what they had to offer.
Without embroidering the experience too much, I got what I was looking for. The surgeon, Stanton B. Miller, M.D., F.A.C.S., was chosen primarily because of his name. Now, I ask you, who on earth could lack confidence in a man with such a solid and resounding moniker? Not me. Anyway, my theory proved correct. Dr. Stan took pains to explain that, whereas disparate interest groups promote different techniques, his preference was to use the well-proven plug & mesh technique, finding it to be effective in most cases.
He cited the advantages and disadvantages of different methods and spent time to give me a mini-course on the anatomy of the inguinal area. He also cautioned that, until the patient was under the knife, he could not guarantee that he would not have to use the old tension method. And here"s the thing. He discussed the relative disadvantages and discomfort of a local anesthetic for this kind of procedure. He recommended the knock out technique. And I bought it. Actually agreed to have it done that way.
The Jefferson University Hospital "Surgical Unit" is in fact the physical home of the "Hernia Clinic" I saw advertised. Not exactly truth in advertising. Those who pass through its doors have a variety of ailments, apparently convinced that their physical outlook can be improved in short order by the deft use of knives and other sharp instruments. The place is, in fact, located in Center City Philadelphia, within the huge Jefferson University Hospital complex. Surgical complications and overnight stays can be addressed by a short ride in the elevator. I felt it prudent not to ask how many patients ended up having to take an unscheduled trip upstairs.
On arrival at the appointed hour, I was introduced to a lovely nurse who asked me in the confines of a private room to remove all of my clothes. I mean, everything. But she gave me prison garb, open at the rear for easy access, to wear in the meantime. Then acquaintance was made with the anesthetist, an inscrutable Chinese fellow from Beijing. And this was the centennial of the Boxer Rebellion. His parents were likely members of Mao"s Red Guard and pretty ticked off at Caucasians in general and Americans in particular. After a brief interrogation I emphasized my Canadian citizenship and determined that there were no hard feelings. He claimed to have been living here without incident for the last ten years, so I left it at that.
Then The Man arrived. The pleasant Dr. Stan, with his hearty professional manner and in his street clothes, I might add. After letting me check his fingernails and general lack of shakiness, he assured me that he would get out of his suit jacket before picking up the scalpel.
Let"s face it. The factory floor of the Jefferson Surgical Unit looks suspiciously like the Texas Death Chamber, although bereft of a conspicuous telephone for last-minute reprieves, or windows to frame the faces of interested observers. I furtively checked for the presence of anyone resembling Dr. Kevorkian as someone fiddled with the intravenous tube they had inserted in my hand. Dr. Beijing muttered something mysterious and all went dark. I was putty in their hands...
When I woke up, it seemed that the procedure had gone well. I did have a scar, as I later discovered, but somebody had shaved my pubic hair, for God"s sake.
The rest is history. Sure, it was a bit sore for a while. But not so uncomfortable that I could not go for a short walk that evening. I was back at work in three days. Well worth the effort. No one had to cut my lawn. And I don"t have a limp.
Great job, Dr. Stan. Glad to have made your acquaintance...
Ken Thomson is the president of Biz911, Inc., a business debt management firm based in Wilmington,
Source: http://ezinearticles.com/
How to Find the Right Law of Attraction Teacher - Corsavoo.com
Method with no madness - Irish Independent
Battle lines - The Age
The Age Battle lines The Age, Australia - Almost three years since the inquiry recommended that phonics should be the main method for teaching children to read, his frustration has turned to anger. ...