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Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain. You may initially experience short, mild attacks. But trigeminal neuralgia can progress and cause longer, more-frequent bouts of searing pain. Trigeminal neuralgia affects women more often than men, and it's more likely to occur in people who are older than 50. Because of the variety of treatment options available, having trigeminal neuralgia doesn't necessarily mean you're doomed to a life of pain. Doctors usually can effectively manage trigeminal neuralgia with medications, injections or surgery.
Dr. Eric Janssen of SportsMED Orthopaedic Surgery & Spine Center in Huntsville, Alabama demonstrates a total knee replacement using dry bones model. In this demonstration he uses the Wright Medical Evolution Knee implant. This demonstrations does not include soft tissue.
There is a strong association with obesity. In children younger than 10 years, it is associated with metabolic endocrine disorders {hypothyroidism, panhypopituitarism, hypogonadism, renal osteodystrophy, growth hormone abnormalities). SCFE is considered chronic if it has been present more than 3 weeks and acute if it has been present for 3 weeks or less. It is called "stable" if the patient can bear weight and "unstable" if the patient cannot ambulate. Unstable SCFE is associated with more complications, including avascular necrosis of the femoral head (AVN). SCFE is diagnosed by x-ray of the pelvis and bilateral hips. The underlying cause is a widened epiphyseal growth plate, due to abnormal cartilage maturation and endochondral ossification. The treatment is surgical, requiring immediate internal fixation with a single screw. Delay in treatment {> 24 hours) leads to increased AVN, SCFE progression from stable to unstable, and high risk of future degenerative arthritis. Prophylactic contralateral fixation of the unaffected hip is not routinely done in the U.S., except in patients with endocrine abnormalities.
It used to be when a woman needed a hysterectomy she could expect full abdominal surgery with a long recovery time. Dr. Melissa Lee uses less invasive methods that can cut the patients downtime in half.
"We were trained in more laparoscopic and minimally invasive cases so of course that's what I'm more comfortable with doing right now."
She sees a new generation of patients opting for laparoscopic surgery.
"Laparoscopy is the use of small cameras with small incisions and instruments that are guided by the hand, and you're able to see directly into the abdomen without actually fully opening the abdomen," says Dr. Lee, an obstetrician-gynecologist with Lee Memorial Health System.
Nowadays, even a large mass or uterus can be removed using the slender tools.
"There are multiple different laparoscopic instruments that you can use. Whether they're blunt dissections or just dissectors that hold and retract back or actual scissors or cutting instruments, there are multiple different options," says Dr. Lee.
While a standard abdominal hysterectomy requires a four to eight inch incision, the laparoscope needs only a quarter to half inch. It's enough to make a big difference in terms of recovery.
"They're able to get up and move around faster. They're able to recover faster, their pain level and their need for pain medicine is much lower," says Dr. Lee.
The laparoscopic procedure also cuts down on scarring and more importantly, shortens the hospital stay. The trend now is home within 24 hours.
"Where the patient is done early in the morning, they're doing well they're tolerating oral intake they're able to getup and move around. And those patients a lot of times will feel comfortable to go home that same nigh after a major surgery," says Dr. Lee.
New studies show women who've had a laparoscopic hysterectomy viewed their quality of life as better than those who had an open abdominal procedure, making this a good option for the right patient.
View More Health Matters video segments at leememorial.org/healthmatters/
Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we've been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries.
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BioDigital Systems created this 3D animation of a knee replacement surgery.
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ThermiVa is a non-surgical vaginal tightening treatment for women who want to reclaim what childbirth or aging may have taken away. Using the same technology that’s used in ThermiTight and ThermiSmooth, radiofrequency energy is sent to the desired area (internally or externally), heating the tissue and stimulating the body’s own collagen. ThermiVa is performed in three treatments over the course of three months.