Lateral Incisions...

Many thanks for your post.  I understand the different approaches, my problem is in cutting my way through the varying reports of post op trauma vs a relatively smooth recovery, horror stories of what the surgeon does not inform his patient, etc.  It seem to imply that some surgeons are actually selling the surgery by telling patients that recovery is a piece of cake! 

I think any patient who believes the "sell" that it will be a piece of cake is seriously deluded. Even the most basic question (such as: How long will I be off work) will lead most people to understand that this is a major operation.

I was told that although the operation is straight forward and common, it is nevertheless a severe trauma to the body. I was also told that, under normal circumstances, I would be signed off work for three months. My employers told me that according to ATOS, I would need several weeks or "light duties" before full activity can be considered. And without getting political, anyone who has heard of ATOS, will know that they tend to err on the side of a swift return to work. 

And this is why I get so vexed when some say that they ignore all the traditional advice. Why would you? It is your body and surely a quck recovery is the best way forward. And that is why I ignored one physio who told me the 90 degree rule was old school and I should ignore it - and then he said the small print (there is a posibility of a dislocation, but it is very small). Sorry, got carried away.

Michael x

I is interesting how the body responds to trauma, no matter how minor.  

Reason I say this is that yesterday, I had a "routine" appointment with my dentist.  Over twenty years ago, when I first returned to the UK, I visited a dentist in Putney because on upper back molar had broken.  She did a root canal, and then capped it.  For  years, I was aware of a gap between the cap and the gum.  I was also aware that the area had become infected.  Previous dentist ignored the situation, and so did the hygienist.  No antibiotics prescribed, either.  Having said that, I am firmly opposed to the over prescribing of antibiotics.  Look at the situation we are in, now!  This awful outbreaks, AIDs, Ebola, and the latest in Brazil.

Yesterday, I advised the new dentist - have seen him twice - that I am having a THR relatively soon, and that for a long time, I had been aware that the molar was not only loose, but I suspected that it was also infected, and was cncerned about how that would impact on the surgery and my curent state of health, with bacteria wondering around my body,

Dentist asked if I wanted to hold onto the tooth, and I stated that as it was loose, it should come out.  He asked if I had a history of cardiac problems.  I advised him that I had recently had an ecg, and had heard nothing back, so assumed that I was OK.  So, the extraction went ahead, and while the anaesthetic was taking effect, he also removed some plaque that had formed since my last visit.  

Dentist said that he was going to give the tooth a "little wiggle."  Tooth out.  I felt rather wobbly getting iut of the chair, and his assistant helped me out through to reception, and said that I could sit in reception for a while.  It was full, so I sat in my car before driving off.  

The anaesthetic was administered at around 3:30 p.m., and I was still quite numb at 11:30 p.m.  No pain or discomfort, although I took a co cadomol first thing this morning.  Spending the day in bed as I feel listless and "washed out."  

Reason for this anecdote, is that this is a relatively straightforward procedure that thus far, has taken a day out of my week to recover.  Do not know what to  expect tomorrow.   THR is major surgery - so it does not take too much on my part, to figure out, how I am likely to react to THR!   In other words, a good means of gauging how individuals respond to trauma and anaesthesia! 

They gave me a light general and a spinal which allowed them to give stronger meds directly. The result what that my thigh was effectively frozen for a week and thus my leg was very uncooperative. But the surgeon thought this was "normal" and I was abl to accept it as such.

I very much hope tomorrow will be a smooth process and ceretainly look forward to hearing from you - if not before

Only a fool goes in with some of the facts. Guilty as charged, M'Lord.  

The problem with upper molars is that they have much larger and longer roots than the lower jaw, and there is also the possibility of taking out bone with the tooth and getting ito the sinus cavitiy!  The dentist, very oviously, gave me a fairly good dose of anaesthetic as he went into the gum three times.  I was suprised that no antibiotic was given, and when asked, he said that any bacteria would drain.

Main thing was that it was totally pain free, even throughout the day, today.  He did a very good job, and I was surprised how long the anaesthesia lasted.  Only after effects was the "wobbliness", which I put down to shock the kicked in as the tooth came out, and the washed out feeling today.

Last time, I had an extraction was a lower jaw molar, years ago.  Anaethesia, very clearly has made great inroads since then,.and this, I am sure, goes right across the board.  

So what I am really saying is that as far as any fears I may have had about "the science of anaesthesia," they have been very firmly laid to rest. 

Interesting that your thigh was effectively "frozen" for a week as this reinforces what I have said about anaesthesia regarding the "tooth!"    Essentially, keeping the patient pain free for a period of time, but not prolonging it, should there be symptoms of post op complications, I would think.  Although any infection would be fairly easy to spot numb or numb, not!

Many thanks for taking the time to write back to me.

So far as the surgeon himself is concerned, he is considered to be just about the best there is and to whom other surgeons refer.  I also know that he does a lot of revisions, but not of his own work.

My meeting with him was an initial meeting.  I do not have a date  yet for the surgery, and am due to see my GP on Monday, although I do ot expect her to give me the anwers that I require.  I have found a couple of sites that discuss the varius approaches, one of which discusses the the lateral approach itself, but is aimed at the medical profession, itself.  So when I get round to reading through what it has to say, I shall have to look up the medical terminology used if possible  The other site is geared more toward the patient, and goes throgh all three.  

I did find that the surgeon was somewhat arrogant, but finally managed to coax a smile from him.  I am sure that I will have another opportunity to get to grips with issues such as restrictions with him again.  A lot of so called "restrictions"  really do come down to using basic common sense, but obviously post op, there are certain things that one simply should not atempt to do. 

Would not wish to change surgeons as he comes very highly recommended, although as I have said, his bedside manner coud be better.  

When living and working in San Francisco I had surgery performed on my dominant hand, that had to be revised.  I later was told that surgeon one was more used to operating on feet!  He really did make a fine old mess of my hand!