#general anaesthesia

[ipscindia]

Vertebroplasty and Kyphoplasty for Osteoporotic spine fracture and spine metastasis

Advanced age, asthma, diabetes, emphysema, menopause, chronic steroid use and rheumatoid arthritis are all risk factors for osteoporosis. The resultant weakening of bones can lead to compression fractures of the spine causing severe pain, deformity, loss of height, immobilization, and in some cases, failure to thrive.

Historically, vertebral compression fractures have been treated either with conservative methods of cast or brace immobilization with long term bed resting or with major surgery. This surgery requires a long incision, screws and rods for fixation and is done under general Anaesthesia. These treatments are limited by long recovery times and disruption of daily life.

Now, these painful spine fractures can be treated with a Minimally Invasive, Non Surgical procedure known as VERTEBROPLASTY, an innovative alternative to traditional treatments which stabilizes fractures of the spine safely and effectively, often providing immediate pain relief.

Q. Do we have any non-surgical procedure to fix spine fracture?

Vertebroplasty or targeted cementoplasty is one of the most advanced procedure for immediate and significant pain relief in patients with spine fracture or compression fracture due to osteoporosis. Osteoporosis is a condition where the bones becomes porous and fragile and leads to fracture with even minor trauma or jerk.

Q. How complicated is this vertebroplasty procedure for compression fracture of spine?

The procedure is very safe in experienced hands. There are costly options available but they have not proved to be more safer than vertebroplasty.

This procedure is done in Local anaesthesia, so we can even avoid the effects of general anaesthesia and patient can be discharged same day.

IPSC India is pioneer in performing this procedure.

Q. Is vertebroplasty a major surgery?

The goal of a vertebroplasty procedure is to stabilize the vertebral compression fracture to stop its painful movements. Vertebroplasty is considered a minimally invasive surgery because it is done through a small puncture in the skin instead of an open incision.

Q. Which procedure is better for spine fracture, Vertebroplasty or kyphoplasty.

Vertebroplasty and Kyphoplasty, both the procedures are done to fix the compression fracture of spine vertebrae. In Kyphoplasty, we use balloon to create some space inside the vertebrae and then fill that space with cement. But this makes kyphoplasty a difficult procedure as compared to Vertebroplasty and requires general anesthesia. Most of the recent studies have shown that there is no difference in outcome between the two procedures. Cost of the procedure is also less as compared to Kyphoplasty which is done under general anesthesia and may require hospital admission.

Q. What are the advantages compared to Surgical Fixation?

 Vertebroplasty has several advantages:

Do not require general anaesthesia.

No need to open spine.

No need to put rods and screws.

No need of prolonged hospitalization.

All these reduces the risk of complications.

Q. How long does it take to recover from vertebroplasty?

Most people are able to walk after the procedure, but you may need to restrict yourself to home for 24 hours afterward to rest. Then you can slowly resume normal activity. Some patients, but not all, feel pain relief soon after vertebroplasty. These patients report that their pain is gone or is much better within 48 hours.

At times, due to involvement of other nearby structures, pain relief is not complete after the procedures. In such cases, your pain specialist may advise another procedure like facet joint block or facet denervation, or myofascial trigger point injection.

Q. Can we use vertebroplasty for old age and osteoporotic spine?

Yes! percutaneous vertebroplasty can be performed in spinal vertebrae that are not suitable for surgical fixation, for instance because of osteoporosis or because general anaesthesia may not be advised in patients who are very sick.

This procedure can also be performed in spine fractures due to spinal metastasis. Some cancers at some stages of cancer, spread to other areas like spine.  These spinal pathologies are very painful and at times lead to fracture of spine.

Q. How this procedure is performed?

The beauty of this procedure is its simplicity. “A small needle is advanced into the fracture using only local anaesthetic followed by the placement of bone cement into the fractured area. The cement hardens in about 10-15 minutes and remarkably the pain is gone.”

“After performing good number of vertebroplasties, I can confirm that this is one of the most significant procedures for the treatment for vertebral compression fractures,”

Q. How long does bone cement take to set?

The calcium phosphate cement flows into the spongy inside portion of the bone, filling in microfractures and other damaged areas, and it hardens in about 10 minutes' time.

Dr (Maj) Pankaj N Surange

Interventional Spine and Pain Specialist

Spine Endoscopist and Vertebral Augmentation Specialist Director, IPSC India, New Delhi Director, IPSC India training institute. Hon. Secretary, Indian society for study of pain

[luna-lovegreat]

I love Legend sick fics because they all boil down to: "no amount of emotional stress will make him crack so let's give him a fever and see how that works"

[melit0n]

Off to surgery today, wish me luck lads 🫡

[cowardstiel]

well. i’ll be spending lazarus rising day getting all 4 of my wisdom teeth out. peace and love on planet general anaesthesia

[bee-whistler]

Too awake to sleep, too sleepy to wake. Too early to get up, too late to go back to bed.

[voormaligskischansspringer]

I don't know if I can watch the competition tomorrow, because I will have a small surgery tomorrow morning and I don't know how long it will take and how I well I'm gonna be afterwards 🙈

[ourbastardofsorrows]

the ramones had the right idea. i wanna be sedated

[gay-jewish-bucky]

wild that the best my student insurance can offer for dental care is a maximum of $800 per policy year and will give you a maximum of $480 for individual features (aesthetic by itself, root canal by itself ect) of basic dental restoration, which can cost several thousands of dollars total (like close to what i pay annually for part-time tuition)

like genuinely what the fuck is the point then?

[artemisbarnowl]

Feel like I'm physically incapable of wearing my uggs to the hospital and that really is the biggest stressor of the day

[theforesteldritch]

I’m not going under general anaesthesia for my wisdom teeth because when I had surgery it was supposed to take about 2 hours for the surgery drugs to wear off enough so I could go home. It actually took 5 hours, and apparently when I was being wheeled in the bed thing down the hall from the postsurgical ward to the extended postsurgical ward because I was taking forever the nurse who checked me in for surgery saw me and was surprised I was still here, I still remember that his name was Leif for some reason lol. He was nice. And then I also don’t get any of the strong painkillers for my wisdom teeth removal because when I got hydromorphone after my surgery it made my breathing slow a lot and my oxygen dropped so I had to wear one of the nose oxygen things. I remember it tickled a lot. I was also very out of it from surgery drugs so I don’t remember at least half of it and what I do remember is weird details.

[choirgirlhotel]

that was a reach honestly if most people are afraid of something i’m probably afraid of it too

[salamancers]

guess whos just had surgeryyy~~~

technically it was, like, this morning, but i only now came home to my parents place after spending hours in the car so! still counts even if it took around 13 hours from after the surgery was done until i came home heh

i have four brand new holes in my stomach and one less internal organ and for some reason i feel like this is something to *brag about* lmao

[grendel-sceadugenga]

My dog is getting xrayed today and I’m so nervous…

[worldwake]

To me the crop/dock thing is really simple. It's not necessarily right (I think docking is especially unethical, I have less of an issue with cropping), but people ARE going to do it whether or not it's legal. The best we can do is ensure that it is professionals performing these procedures and offering education to owners, especially when it comes to cropping where risk of complications varies depending upon the length of the ear. This helps prevent people who aren't professionals from inhumanely performing the procedures themselves, which obviously still happens, but making these procedures more accessible and spreading information on them (including the cons!) will help dogs. I'd also like to see more breeders and fanciers being HONEST about cropping and docking - it's fine to bring up historical reasons for the procedures, but I'd like to see more people admit that it's purely for aesthetics. I think that honesty would go a long way.

[luveline]

I'd love a wisdom tooth with Hotch; I got mine removed last Saturday and I'm in pain 🥲

You should’ve had your wisdom teeth out years ago, but you couldn’t afford it. When Aaron suggested you get them removed after a particularly embarrassing bout of pain, you’d been honest with him: you still couldn’t afford it. Stuff kept going wrong, your car would break down, or your landlord would hike the rent, and you didn’t have enough saved up to do it without worry. 

So he pays for it. You don’t ask him to, you fight him on it, but he hates seeing you in pain. 

“You’re my hero,” you say, mumbling through gauze. “Generous hero.”

“It’s not generosity,” he says, reaching across the console of the car to catch your hand, “try not to touch your mouth.” 

“I feel dizzy.” 

“I know, honey. Can take some more deep breaths for me?” 

He suspects you’re not only dizzy, but overstimulated. You take a few deep breaths, and then you say, “That’s so nice.” 

“What is?” he asks, regretful as he takes the steering wheel into both hands and turns the car onto the next road. 

You’re his sweetheart, he means that firmly, and he’d do much more than pay for your dental surgery. You’ve been very honest with him about how grateful you are. It’s uncomfortable —you shouldn’t have needed his assistance, how unfair it is that you couldn’t afford it alone— but it’s sweet, too, to see your thankfulness manifesting itself while you aren’t entirely yourself. 

“You calling me honey.” 

“You think it’s old-fashioned.” 

“You’re super old-fashioned.”

“That’s not very nice,” he teases. “I remember when we first met, you were so nice and polite. Now you’re abrasive.” 

“I am not!”

“You’re cruel to me. What should I do about it?” 

“Nothing.” 

Aaron reaches over again to grab your thigh. “Nothing? That’s typical.” He pulls your leg toward him, and he gives the soft inside a squeeze you aren’t expecting. You laugh like a kid being tickled.

“You’re just bullying me while I’m defenceless.” 

“Is that what you are?” he asks, rubbing the length of leg he’d squeezed apologetically. “You can be mean to me for now, then, but when you’re feeling better we’re going to have to have a talk about where my nice girl went.” 

You make a sound that’s half excitement and half panic. “Do you mind?” 

He’s being a little much, sure, but you’d been swaying toward overwhelmed a few minutes ago. He figures some tough love will keep and hold your attention before you can remember the pain. “I don’t mind.” He pats your leg with his fingers, frowning when you shiver. “Are you cold?” he asks worriedly. 

“I’m freezing.” 

Luckily for you, you’re home. Aaron parks the car and gets out swiftly to retrieve you, fonder now that he can see up close. You aren’t as out of it as you’d been to begin with, recognition and light in your eyes as you unbuckle your seatbelt and he offers his hand. “Thanks,” you say, ducking out of the car with a little wobble, “I’m still dizzy, can you–”

“I’ve got you,” he says, hand braced more roughly than he means to at your elbow. 

It’s more of the same inside. You’re unsteady on your feet, he has to grab you to keep you standing, but he gets you into the kitchen at your request. His first port of call is a blanket for you. 

As he wraps it around your shoulders, he’s sure the anaesthesia is entirely worn off. You meet his gaze with an undeniable love. It’s in every line of your face. 

“Thank you,” you say. 

“You know I’m just kidding when I say you aren’t nice.” 

You nod. 

“Because you are,” he says. Looking after you isn’t generosity, it’s self-preservation. He’s found you, sweet and loving as you are, his match in teasing and seriousness alike. He has no intention of treating you with anything other than the utmost care. “Are you warm enough now? It’s a common side effect of sedation, the coldness. Your dizziness, too. It’ll feel better soon.” 

“Can I take this gauze out? I feel silly.” 

“If your gums aren’t bleeding anymore.” 

You haven’t had to spit, so you’ll be alright. Aaron washes his hands, has the honour of removing your gauze and witnessing your odd stitch, which he throws away to wash his hands again. Then he wets a cloth for you to wipe your face. It’s perhaps the uglier side of loving someone and looking after them, but he genuinely couldn’t care less. You’re just as lovely to him as you were yesterday, minus a few troublesome teeth. 

“Your cheek is swelling,” he says, stroking the line of your jaw carefully. 

“Well, you can’t stop liking me now. Then this surgery would be a total waste.” 

He laughs. “What do you mean?” he asks, tipping your chin up. 

“You pay for me to have no toothache and then we break up? It doesn’t make any sense.” 

“It makes zero sense. You’ve invented a scenario where I’d leave you,” he smiles like an idiot, “and that timeline doesn’t exist.” 

You close your eyes. He kisses your nose, weary of your soreness. 

“Timeline,” you mumble. 

“Oh, you have something to say? Let’s hear it.” 

You laugh and push him away. “I don’t have anything to say to you.” 

Unfortunately for you, Aaron has no intentions of being pushed away from you. He leans over to give you a hug and a kiss pressed to your temple, his hand feeling a path against the ridge of your shoulder. “Please tell me if I hurt you, I know your face is sensitive,” he says. 

You settle in his arms. “No, this is nice.” 

He presses another kiss atop the first one. 

[wisteriaiswriting]

General Dating Headcanons with Medic

Words: 273

Just because you two have started dating doesn’t stop him from being insane, but he’s become a romantic, kind of insane. (Just for you <3)

He really wants to swap your hearts with each other’s as some kind of ‘romantic gesture’ but trusts absolutely no one else with that job, especially with yours.

Would do it himself, but is aware that he couldn’t do it and keep you both alive during it without someone else’s help. It doesn’t stop him from trying at least once.

He will reluctantly settle for swapping any other organ he can ‘safely’ swap. (Safely for him means staying awake to complete the surgery.)

After every battle he’ll try to find someone’s heart and give it to you, as it ‘represents his love.’ (So far all of RED and around half of BLU have had their hearts stolen by Medic.)

Will have your combat outfit slightly modified, now it resembles his own just enough for everyone else to know you’re his.

Entering this relationship means you’ve become another bird parent to his little ones, and the birds show their gratitude to you.

His love languages are physical touch and quality time.

When he isn’t touching you he’ll just hang around you, menacingly (To everyone else) stand right behind you.

Gives you special permission to stay with him in his lab all day, which includes during surgeries.

After you two start dating he will expect all your free time is spent with him anywhere he goes.

When you go under, if you'd prefer he'll put you under so you don't feel anything. (He will order anaesthesia just for your surgeries.)