Saturday, August 20, 2011

Unhappy Camper

ARD Validation Be your own best doctor!

Offering Hope and Help to the Victims of ARD Worldwide



Be your own best doctor!

ARD Validation
for
"Social Security" & "Medical Appoints"
OUR voice DOES make a difference in getting ARD recognized!!!!
THIS report is a MUST to take to your "Medical Appoints"
and to add to your file for applying for "Social Security"
as it validate that "ADHESIONS"
are recognized at the natinal level as the
eitiology (cause) of chronic adominal/pelvic pain!


BIG NEWS!!!
National Institute of Health

World J Surg.2006 Mar 13;
Laparoscopic Lysis of Adhesions.
Szomstein S, Menzo EL, Simpfendorfer C, Zundel N, Rosenthal RJ.
Bariatric Institute, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, Florida, 33331, USA, szomsts@ccf.org.
BACKGROUND: Intra-abdominal adhesions constitute between 49% and 74% of the causes of small bowel obstruction. Traditionally, laparotomy and open adhesiolysis have been the treatment for patients who have failed conservative measures or when clinical and physiologic derangements suggest toxemia and/or ischemia. With the increased popularity of laparoscopy, recent promising reports indicate the feasibility and potential superiority of the minimally invasive approach to the adhesion-encased abdomen. METHODS: The purpose of this study was to assess the outcome of laparoscopic adhesiolysis and to provide technical tips that help in the success of this technique. RESULTS: The most important predictive factor of adhesion formation is a history of previous abdominal surgery ranging from 67%-93% in the literature. Conversely, 31% of scars from previous surgery have been free of adhesions, whereas up to 10% of patients without any prior surgical scars will have spontaneous adhesions of the bowel or omentum. Most intestinal obstructions follow open lower abdominopelvic surgeries such as colectomy, appendectomy, and hysterectomy. The most common complications associated with adhesions are small bowel obstruction (SBO) and chronic pain syndrome. The treatment of uncomplicated SBO is generally conservative, especially with incomplete obstruction and the absence of systemic toxemia, ischemia, or strangulation. When conservative treatment fails, surgical options include conventional open or minimally invasive approaches; the latter have become increasing more popular for lysis of adhesions and the treatment of SBO. Generally, 63% of the length of a laparotomy incision is involved in adhesion formation to the abdominal wall. Furthermore, the incidence of ventral hernia after a laparotomy ranges between 11% and 20% versus the 0.02%-2.4% incidence of port site herniation. Additional benefits of the minimally invasive approaches include a decreased incidence of wound infection and postoperative pneumonia and a more rapid return of bowel function resulting in a shorter hospital stay. In long-term follow up, the success rate of laparoscopic lysis of adhesions remains between 46% and 87%. Operative times for laparoscopy range from 58 to 108 minutes; conversion rates range from 6.7% to 43%; and the incidence of intraoperative enterotomy ranges from 3% to 17.6%. The length of hospitalization is 4-6 days in most series. CONCLUSIONS: Laparoscopic lysis of adhesions seems to be safe in the hands of well-trained laparoscopic surgeons. This technique should be mastered by the advanced laparoscopic surgeon not only for its usefulness in the pathologies discussed here but also for adhesions commonly encountered during other laparoscopic procedures.
PMID: 16555020 [PubMed - as supplied by publisher]
Copyright Status
Government information available from this site is within the public domain. Public domain information on the National Library of Medicine (NLM) Web pages
may be freely distributed and copied. However, it is requested that in any subsequent use of this work, NLM be given appropriate acknowledgment.



Find out about ARD before you have any surgery!

Is “Adhesion Related Disorder” A Chronic Disease?


Is “Adhesion Related Disorder” A Chronic Disease?
Q. > Is “Adhesion Related Disorder” A Chronic Disease?
A. > Yes it is!
(Based on the “Centers for Disease Control and Prevention” & The National Digestive Diseases Information Clearinghouse (NDDIC) "Adhesion Related Disorder” IS considered a

“Disease.”

The following information is important to take with you when you see your “Medical Appointments” or to appointments associated with applying for “Social Security Benefits” as this information correlates directly with the “debilitating and often untreatable” symptoms experienced by those afflicted with “Adhesion Related Disorder.”

Chronic Disease Overview

The profile of diseases contributing most heavily to death, illness, and disability among Americans changed dramatically during the last century. Today, chronic diseases—such as cardiovascular disease (primarily heart disease and stroke), cancer, and diabetes—are among the most prevalent, costly, and preventable of all health problems. Seven of every 10 Americans who die each year, or more than 1.7 million people, die of a chronic disease. The prolonged course of illness and disability from such chronic diseases as diabetes and arthritis results in extended pain and suffering and decreased quality of life for millions of Americans. Chronic, disabling conditions cause major limitations in activity for more than one of every 10 Americans, or 25 million people

Costs of Chronic Disease

The United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases:

More than 90 million Americans live with chronic illnesses.

Chronic diseases account for 70% of all deaths in the United States.

The medical care costs of people with chronic diseases account for more than 75% of the nation’s $1.4 trillion medical care costs.

Chronic diseases account for one-third of the years of potential life lost before age 65.

Hospitalizations for pregnancy-related complications occurring before delivery account for more than $1 billion annually.

The direct and indirect costs of diabetes are nearly $132 billion a year.

Each year, arthritis results in estimated medical care costs of more than $22 billion, and estimated total costs (medical care and lost productivity) of almost $82 billion.

The estimated direct and indirect costs associated with smoking exceed $75 billion annually.

In 2001, approximately $300 billion was spent on all cardiovascular diseases. Over $129 in lost productivity was due to cardiovascular disease.

The direct medical costs associated with physical inactivity was nearly $76.6 billion in 2000.

Nearly $68 billion is spent on dental services each year.

Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, U.S.A
Tel: (404) 639-3311 / Public Inquiries: (404) 639-3534 / (800) 311-3435

The National Digestive Diseases Information Clearinghouse (NDDIC) "Adhesion Related Disorder"

National Institutes of Health | Department of Health & Human Services

Intestinal Adhesions

Treatment

Some adhesions will cause no symptoms and go away by themselves. For people whose intestines are only partially blocked, a diet low in fiber, called a low-residue diet, allows food to move more easily through the affected area. In some cases, surgery may be necessary to remove the adhesions, reposition the intestine, and relieve symptoms. But the risk of developing more adhesions increases with each additional surgery.

Prevention

Methods to prevent adhesions include using biodegradable membranes or gels to separate organs at the end of surgery or performing laparoscopic (keyhole) surgery, which reduces the size of the incision and the handling of the organs. More......http://www.adhesionrelateddisorder.com/ardnews9.html

DISEASE.,

Definitions of:


an impairment of health or a condition of abnormal functioning wordnet.princeton.edu/perl/webwn
A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. Sometimes the term is used broadly to include injuries, disabilities, syndromes, symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts these may be considered distinguishable categories. en.wikipedia.org/wiki/Disease
a term of health status; when something is wrong with a bodily function
www.jhsph.edu/publichealthexperts/Glossary.htm
Disease can be defined in three ways: www.med.uwo.ca/ecosystemhealth/education/glossary.htm
Process injurious to health and/or longevity www.weightlosssurgery.com.au/index.php
A condition of an organic being or of one of its parts that impairs normal living functioning.
www.iffgd.org/GIDisorders/glossary.html
A condition of being sick from a particular cause. Different plants and animals often suffer from certain diseases. Some animals are known to carry diseases that effect other organisms. For example, a beetle carries a fungus which causes Dutch Elm Disease in elm trees.
www.fcps.k12.va.us/StratfordLandingES/Ecology/mpages/glossary.htm
An abnormal condition of a plant in which its physiology, morphology, and/or development is altered under the continuous influence of a pathogen. (3)
ppathw3.cals.cornell.edu/glossary/Defs_D.htm
an abnormal bodily condition of a living plant or animal that interferes with functioning and can usually be recognized by signs, symptoms, and illness. whyfiles.larc.nasa.gov/text/kids/Problem_Board/problems/biosphere/glossary.html
stress condition produced by the effects of a pathogen on a susceptible host.
scarab.msu.montana.edu/historybug/glossary.htm
Any condition that prevents the body from working as it should other that direct injury.
ricegenomics.plbr.cornell.edu/glossary.htm
A condition of an organism that impairs normal physiological function. Also see Infectious Disease.
fightaidsathome.scripps.edu/glossary.html
Any abnormality of bodily structure or function, other than those arising directly from injury. www.canadapharma.org/Patient_Pathways/Glossary_Terms/
A deleterious change in the body's condition in response to destabilizing factors, such as nutrition, chemicals, or biological agents.
highered.mcgraw-hill.com/sites/0070294267/student_view0/glossary_a-d.html
Diseases may be caused by microorganisms or by environmental factors such as a lack of available iron in the soil or excess water.
www.ottawa.ca/residents/healthy_lawns/lawns/links/glossary_en.shtml
Illness, sickness. An interruption, cessation, or disorder of body functions, systems, or organs. Top of page
www.rationaltherapeutics.com/reference/glossary.htm
can be defined as a derangement in the function of the whole body of the host or any of its parts. www.fao.org/Wairdocs/ILRI/x5436E/x5436e04.htm
A condition of the body in which there is incorrect function due to heredity, infection, diet, or environment.
www.mdk12.org/instruction/curriculum/science/glossary.shtml
a pathological condition that is cross-culturally defined and recognized.
oregonstate.edu/instruct/anth370/gloss.html
a condition, caused by living organisms or environmental changes, that impairs the normal functions of a living organism.
www.ipmalmanac.com/glossary/index.asp
a state in which a function or part of the body is no longer in a healthy condition
lib1.store.vip.sc5.yahoo.com/lib/allergybegone/glossary.html
A medical concept, which serves for communication between doctors. Disease does not exist as such in nature. What medicine conceives as disease is a tolerance decline accompanied by WOB complaints www.what-is-cancer.com/papers/newmedicine/glossary.html
a medically definable process, in terms of pathophysiology and pathology. Illness is what the patient experiences.
www.therubins.com/geninfo/Definit.htm
Presence of some pathology or abnormality in a part of the body. Bacteria and viruses cause many such diseases Tolerance – In pharmacology, the ability to tolerate larger and larger doses of a drug after each exposure to it.
www.uwic.ac.uk/shss/dom/newweb/General/Glossary.htm
Disorder or pathology that affects health.
www.moh.govt.nz/moh.nsf/0/15f5c5045e7a1dd4cc256b6b0002b038
Any departure from health; a particular destructive process in an organ or organism with a specific cause and symptoms.
www.michigan.gov/dnr/0,1607,7-153-10364_10950-27394--,00.html
Sickness, illness or loss of health.
www.sabin.org/vaccine_science_GlossaryB_D.htm


Friday, August 19, 2011

September is Adhesion Related Disorder Awareness Month


September is Adhesion Related Disorder Awareness Month.
 Find out about ARD
before you have any surgery.

(PRWEB) September 2, 2005 -- Adhesions are internal scars that bind organs and tissues
that are not normally connected. Adhesions form as a result of trauma due to surgery,
infection, disease or other injury. Adhesions can distort and disturb body functions and
cause pain, intestinal obstruction and infertility, giving rise to a complex of problems,
collectively termed "Adhesion Related Disorder (ARD)" - Dr. David Wiseman, founder
International Adhesion Society.....


  Adhesions are internal scars that bind organs and tissues that are not normally connected. Adhesions form as a result of trauma due to surgery, infection, disease or other injury. Adhesions can distort and disturb body  functions and cause pain, intestinal obstruction and infertility, giving rise to a complex of problems, collectively  termed "Adhesion Related Disorder (ARD)" - Dr. David Wiseman, founder International Adhesion Society
The rate of adhesion formation after surgery is surprising given the relative lack of knowledge about ADHESIONS among doctors and patients alike.  From autopsies on victims of traffic accidents, Weibel and Majno (1973) found that 67% of patients who had undergone surgery had adhesions.  This number increased to 81% and 93% for patients with major and multiple procedures respectively.  Similarly, Menzies and Ellis (1990) found that 93% of patients who had undergone at least one previous abdominal operation had adhesions, compared with only 10.4% of patients who had never had a previous abdominal operation.  Furthermore, 1% of all laparoscopies developed obstruction due to adhesions within one year of surgery with 3% leading to obstruction at some time after surgery.  Of all cases of small bowel obstruction, 60-70% of cases involve adhesions (Ellis, 1997). 
 
Lastly, following surgical treatment of adhesions causing intestinal obstruction, obstruction due to adhesionreformation occurred in 11 to 21% of cases (Menzies, 1993).
        Between 55 and 100% of patients undergoing pelvic reconstructive surgery will form adhesions.
Recent analysis of the latest US health statisticsby the International Adhesions Society (IAS) 
(http://www.adhesions.org/) reveals that over 2200 people died in 2001 with a diagnosis of intestinal obstruction due to adhesions. This number has been consistent for five consecutive years with between 2100 and almost 2500 deaths per annum. Women account for a 60% majority of these deaths. 

In 2001 there were over in-patient 67,000 discharges with a primary diagnosis of adhesion-related
obstruction, with an average length of hospitalization of 9.8 days. With an average charge of some $32,000, this represents a cost to the economy of $2.15 Billion.
About two-thirds of these costs were borne by Medicare and Medicaid. 


  But this is just the tip of the iceberg. When other inpatient diagnoses of peritoneal and pelvic adhesions are added, the cost easily exceeds $5 billion, and that is before out-patient costs and loss of work are considered.  Nearly 30% of the hospital discharges for adhesion-related obstruction occurred in the 45-64 age range, and 53% occurred in the 65+ age range. The most deaths (1196) occurred in the 45-64 age range, but as a percentage of the hospitalizations, the greatest risk of death (10%) occurred after age 85. 

 To our knowledge this is the first report to document the number of deaths related to adhesions, and serves to highlight the extent of an under-appreciated problem. Others have previously reported that a patient undergoing pelvic or abdominal surgery will be readmitted twice in the next 10 years for a problem related to adhesions, or for a procedure that could become complicated by adhesions.  Given the extent and severity of ARD it is surprising that few people have heard of the condition. In a recent survey conducted by the IAS, patients reported that they were told about adhesions in only 25% of procedures they underwent. This number dropped to only
10% when procedures not known to involve adhesion surgery were considered. 
   The IAS strongly urges all patients to ask their doctors about ARD before undergoing surgery. The IAS also urges hospital and public health officials to ensure that adhesions are discussed as part of the informed consent procedures. By engaging in this discussion doctors will want to consider options for reducing the risks to the patient of post-operative adhesions. This will benefit not only patients, also the doctors who are faced with the sequelae of ARD. 
For more information please contact: 
                         Dr. David Wiseman, Founder, International Adhesions Society
6757 Arapaho Road, Suite 711-238, Dallas, TX 75248 
972- 931- 5596 
david.wiseman@adhesions.org

Adhesions are internal scars that bind organs and tissues that are not normally connected. Adhesions form as a result of trauma due to surgery, infection, disease or other injury. Adhesions can distort and disturb body functions and cause pain, intestinal obstruction and infertility, giving rise to a complex of problems, collectively termed "Adhesion Related Disorder (ARD)" - Dr. David Wiseman, founder International Adhesion Society

The rate of adhesion formation after surgery is surprising given the relative lack of knowledge about ADHESIONS among doctors and patients alike. From autopsies on victims of traffic accidents, Weibel and Majno (1973) found that 67% of patients who had undergone surgery had adhesions. This number increased to 81% and 93% for patients with major and multiple procedures respectively. Similarly, Menzies and Ellis (1990) found that 93% of patients who had undergone at least one previous abdominal operation had adhesions, compared with only 10.4% of patients who had never had a previous abdominal operation. Furthermore, 1% of all laparoscopies developed obstruction due to adhesions within one year of surgery with 3% leading to obstruction at some time after surgery. Of all cases of small bowel obstruction, 60-70% of cases involve adhesions (Ellis, 1997).


Lastly, following surgical treatment of adhesions causing intestinal obstruction, obstruction due to adhesionreformation occurred in 11 to 21% of cases (Menzies, 1993).

Between 55 and 100% of patients undergoing pelvic reconstructive surgery will form adhesions.

Recent analysis of the latest US health statisticsby the International Adhesions Society (IAS)
(www.adhesions.org) reveals that over 2200 people died in 2001 with a diagnosis of intestinal obstruction due to adhesions. This number has been consistent for five consecutive years with between 2100 and almost 2500 deaths per annum. Women account for a 60% majority of these deaths.

In 2001 there were over in-patient 67,000 discharges with a primary diagnosis of adhesion-related
obstruction, with an average length of hospitalization of 9.8 days. With an average charge of some $32,000, this represents a cost to the economy of $2.15 Billion.
About two-thirds of these costs were borne by Medicare and Medicaid.
But this is just the tip of the iceberg. When other inpatient diagnoses of peritoneal and pelvic adhesions are added, the cost easily exceeds $5 billion, and that is before out-patient costs and loss of work are considered.
Nearly 30% of the hospital discharges for adhesion-related obstruction occurred in the 45-64 age range, and 53% occurred in the 65+ age range. The most deaths (1196) occurred in the 45-64 age range, but as a percentage of the hospitalizations, the greatest risk of death (10%) occurred after age 85.

To our knowledge this is the first report to document the number of deaths related to adhesions, and serves to highlight the extent of an under-appreciated problem. Others have previously reported that a patient undergoing pelvic or abdominal surgery will be readmitted twice in the next 10 years for a problem related to adhesions, or for a procedure that could become complicated by adhesions.
Given the extent and severity of ARD it is surprising that few people have heard of the condition. In a recent survey conducted by the IAS, patients reported that they were told about adhesions in only 25% of procedures they underwent. This number dropped to only
10% when procedures not known to involve adhesion surgery were considered.

The IAS strongly urges all patients to ask their doctors about ARD before undergoing surgery. The IAS also urges hospital and public health officials to ensure that adhesions are discussed as part of the informed consent procedures. By engaging in this discussion doctors will want to consider options for reducing the risks to the patient of post-operative adhesions. This will benefit not only patients, also the doctors who are faced with the sequelae of ARD.

For more information please contact:
Dr. David Wiseman, Founder, International Adhesions Society
6757 Arapaho Road, Suite 711-238, Dallas, TX 75248
972- 931- 5596
david.wiseman@adhesions.org

Endoscopy Market to Reach $34 Billion by 2016

August 15, 2011 10:08 ET

Endoscopy Market to Reach $34 Billion by 2016


ROCKVILLE, MD--(Marketwire - Aug 15, 2011) - MarketResearch.com has announced the addition of the new report "Endoscopy Devices: Applications and Global Markets" to their collection of Medical Devices market reports. For more information, visit http://www.marketresearch.com/product/display.asp?ProductID=6481743

The overall medical device market is very large; endoscopy is a significant component of that market. For companies with an effective strategy, market opportunity awaits. However, the ability to develop an effective strategy begins where opportunity exists and ends with effective execution and capturing profit from the opportunity.

The endoscopy market is positioned for significant growth in the next 5 years. The endoscopy market worldwide was $23.3 billion in 2010 and is projected to reach nearly $24.8 billion in 2011. This is further anticipated to increase to $33.7 billion by 2016 at a compound annual growth rate (CAGR) of 6.4%.

Laparoscopy accounts for more than 26% of the total market and is expected to reach $6.8 billion by end of 2011 and to increase up to $10.6 billion by 2016 at a compound annual growth rate (CAGR) of 9.2%.

Endoscopy of the GI track for tumors, adhesions, diverticulitis, etc. is projected to experience an increase from $3.7 billion in 2011 to more than $4.9 billion in 2016, a CAGR of 5.7%.

This is due, in part, to new applications for the technology, as well as new innovations in the technology itself. The other major factor that will contribute to this growth is the recognition of this technology in emerging markets like Japan and Vietnam. Continued worldwide growth is expected in other geographic areas due to a growing middle class in countries such as India, China, Brazil, and Russia.

This report addresses the critically important topics for analyzing a changing market dynamic, the emerging players and technologies, strategies for accessing these emerging markets, and specific disease segments and geographies in order to allow allocation of resources and make effective decisions.


Corboy & Demetrio Secures $2.5 Million Settlement for Illinois Patient Who Dies After Surgery

Chicago, IL (PRWEB) August 18, 2011

The family of a woman who went into the hospital for a one-day surgery has settled a wrongful death claim filed in the Circuit Court of Cook County on behalf of her estate for $2,500,000, according to Corboy & Demetrio partner Susan J. Schwartz, the lawyer for the family.

Laura Kraska, 40, legally blind since birth, worked out of her home in Downers Grove as a billings system consultant. On May 29, 2009, she had minimally invasive surgery at Loyola University Medical Center to remove a cyst on her ovary, believed to be the cause of unrelenting abdominal pain, according to the lawsuit. Dr. Katherine D. Matta, a hospital employee gynecologist, found dense adhesions requiring a difficult dissection of the bowel during surgery, according to medical records. No complications were noted or appreciated by her, said Schwartz.

As medical records show, Laura’s anticipated discharge within 23 hours did not occur when she complained of severe abdominal pain in spite of narcotic pain control. Late in the afternoon of May 30, 2009, her heart rate increased, and she had shortness of breath, according to medical records. An abdominal CT ordered by Dr. Freager Williams, another Loyola employee gynecologist, showed fluid and a possible bowel obstruction according to medical records. A lung study ruled out a pulmonary embolus. None of the ordered tests ruled out a perforation of the colon, a known complication of the surgery Laura had, according to those records.

According to medical records, nly after Laura’s blood pressure dropped very low to dangerous levels, early in the morning on May 31, 2009, a surgeon examined her. It was immediately determined that she needed more surgery. During that surgery, at 6:00 a.m. on May 31, 2009, two holes were found in the intestines, one in the large bowel and one in the small bowel, according to the lawsuit.

Unfortunately, on the operating room table, prior to induction of anesthesia, Laura went into cardiac arrest, according to the lawsuit. After surgery, Laura was ventilator dependent with fixed and dilated pupils. She had no meaningful brain function. After removal from the ventilator, she died on June 2, 2009, according to the lawsuit.

According to Susan J. Schwartz:

“Laura was very ill. She had what was described as a difficult surgery. A bowel perforation is a known complication. Patients should get better every hour after surgery. She did not. When her blood work showed severe leukopenia, a sharp decrease in her white blood count, a sign of sepsis or an infection in the blood, in this setting, the most likely explanation was a bowel perforation. To survive, she needed to be taken back to surgery before the infection destroyed her bowel and caused her brain to swell.”

Laura Kraska is survived by her mother, Carol Hofmann, her father, Thomas Kraska, her brother, Timothy Kraska, and her sister, Kristen Schneider.

Case Information: Thomas Kraska, Independent Administrator of the Estate of Laura Kraska, Deceased v. Loyola University Medical Center, 2010 L 2270, filed in Cook County.

Thursday, August 18, 2011

ARD Education and Awareness

ARD Education and Awareness from the best educational ARD website!



Abdominal/Pelvic Pain Can Occur After Surgery.
Abdominal/Pelvic pain can occur after surgery. Post surgical pain can present shortly following your surgery, and usually resolves over the following days and weeks as you recover from that surgery. But some pain may linger for months or years following a surgical procedure. The question is, what is the source of this pain?
In some cases, the answer is Adhesions!
Adhesions are bands of scar tissue intra-abdominal and/or pelvic cavity that bind your internal organs together, causing them to stick to each other. The result of these bands of scar tissue can lead to:
Adhesion Related Disorder or ARD.
The symptoms of ARD include:
Chronic pain
Infertility
Bowel obstruction
Gastro-esophageal reflux disease, (GERD)
Urinary Bladder dysfunction
Pain and difficulty having a bowel movement
Pain on movement such as: Walking, sitting or laying in certain positions.
Loss of Nutrients due to poor eating habits or loss of appetite.
Loss of employment due to lost work days
Loss of family and social life
Emotional Disorders such as: Depression, Thoughts of Suicide, Hopelessness
If you are experiencing pelvic pain, it’s important to see your doctor. Pain in the pelvic or abdominal area can be caused by a variety of conditions, some of which may be serious. Your doctor will be able to perform tests to determine the cause of your pain. Do not assume all pelvic or abdominal is caused by adhesion even if your post adhesiolysis, as adhesions do reform following surgery.
It is important to ask for and allow diagnostic tests to rule out other sources of pathology as being the cause for your symptoms…while some adhesion do cause pain, not all adhesions cause pain and not all pain is caused by adhesions!
If all diagnostic tests result in negative findings, one cause of pain that your doctor might consider is adhesions, particularly if you have had abdominal or pelvic surgery. Adhesions are commonly associated with pelvic pain. In fact, an estimated 38 percent of women suffering from pelvic pain have adhesions.
The better news is that there are things that your doctor can do to reduce the incidence post-operative adhesions – and maybe even prevent them altogether. Educate yourself to “Adhesion Related Disorder” as the informed patient can make informed decisions when you discuss your symptoms and medical care needs with your doctor.
Always request and keep a personal file of all your medical interventions!




Adhesions Can Cause Pain:
Adhesions can cause pain by binding normally separate organs and tissues together - essentially “tying them down.” The stretching and pulling of everyday movements can irritate the nerves involved. Some adhesions can cause pain during intercourse. Ask your medical care provide to order an “ESR = Erythrocyte Sedimentation Rate” ‘ blood test for inflammatory reaction in your body. Inflammation at the adhesion attachment sites become agitated due to the pulling and tugging on the tissues of the attached organs. This inflammation creates pain and must be taken into consideration by the Doctor when treating the ARD sufferer for pain.
While pelvic pain can be an obvious symptom of adhesions, there are other serious complications of which you should be aware. Two of the more common complications of adhesions are infertility and bowel obstruction.


Adhesion can and do cause disabling pain and loss of productivity. You will want to resent substantiating information on this issue when you meet with your Doctor.
Be prepared, be your own best Doctor!


Bowel obstruction:
Adhesion formation involving the bowel (intestine) is particularly common following hysterectomy. These adhesions occasionally they can cause the bowel to kink and not allow the passage of digested food. This causes a “back-up.” Bowel obstruction can occur shortly after surgery or many years later. Symptoms of bowel obstruction may include pain, nausea, and vomiting. Bowel obstruction is a serious illness and requires immediate medical attention.
Even though the overall incidence of bowel obstruction is low, you should be aware of the possibility of its occurrence. If left untreated, obstruction can lead to serious complications, even death. Symptoms of bowel obstruction include:


Abdominal pain
Nausea
Vomiting
Diarrhea (early)
Constipation (late)
Fever
You should talk to your doctor if you have any of these symptoms.
Endometriosis.
One of the more common non-surgical causes of pelvic pain is endometriosis.
If you have been trying unsuccessfully to conceive, you are probably searching for the cause. Your search may have led you to this site. It’s important to understand that there are many conditions that can cause infertility, and you should talk to your doctor to determine whether your situation requires medical attention.


Adhesions that form as a result of certain types of gynecologic surgery, especially tubal surgeries and myomectomies (surgery to remove fibroids), are a common cause of infertility. Adhesions can form between the ovaries, fallopian tubes or pelvic walls.
These adhesions can block the passage of ovum (an egg) from the ovaries into and through the fallopian tubes.
Adhesions around the fallopian tubes can also interfere with sperm transport to the ovum.


Ovarian Surgery
Surgical Treatment of Endometriosis
Myomectomy
Reconstructive Tubal Surgery
The good news is that infertility due to pelvic adhesions can be successfully treated in approximately 40% to 60% of women. However, the surgical procedure, adhesiolysis, can often lead to more adhesions. The best way to reduce the chances of adhesions forming and/or reforming is for your surgeon to learn the best procedure used in the attempt to reduce adhesion formation. The more a surgeon practices the procedure, the more skilled he will become in performing it. As he develops his technique over time along with the use of an effective adhesion barrier, the better the results for improvement in the symptoms of the adhesion patient!
Talk to your doctor if you have pelvic pain of any kind.





Although adhesions often form after gynecologic surgery, they are not inevitable. And, even if adhesions do form, they usually don’t cause pain or other problems.
Although there is no way to eliminate the risk of adhesions completely, there are steps your surgeon can take to reduce the likelihood of adhesion formation. The most effective methods of adhesion prevention involve meticulous surgical technique and the use of a physical barrier to separate tissue surfaces while they heal.


Surgeons have developed minimally invasive techniques such as the laparoscopy, that are designed to minimize trauma, blood loss, infection, and the introduction of foreign bodies, all of which can lead to inflammation and adhesion formation. Good surgical technique involves minimizing tissue handling, using delicate instruments, and keeping the tissues moist when they are exposed to the air.


While good surgical technique is important, but it is often not sufficient to prevent adhesions. There are also other preventive steps that can be taken:
Surgical techniques that can help decrease adhesion formation


Not simply the surgical procedure used, but in combination with these techniques and the lesser of invasive surgery, a laporoscopy, one has the best chance of adhesion reduction when these are used together in a surgery!


Achieve meticulous hemostasis
Maintain vascularity
Moisten tissues
Avoid dry sponges
Minimize tissue handling
Use fine, non-reactive sutures
Avoid peritoneal grafts
Minimize foreign bodies
Heated and Humidified gas 


Even though the most meticulous surgical and microsurgical techniques cannot eliminate the formation of adhesions, the following steps can be taken to reduce adhesion formation:
Achieve meticulous hemostasis: Inadequate hemostasis and the resultant fibrin deposition promote adhesion formation.
Maintain vascularity: Limiting ischemia supports fibrinolysis.
Moisten tissues: Frequent irrigation and the use of moist sponges prevent desiccation of tissue. Ringer's lactate or other irrigating solutions also eliminate any residual talc, lint, or blood clots, which may provide a nidus for a foreign body reaction, inflammation, and adhesion formation.
Avoid dry sponges: Use of gauze and dry sponges should be avoided because they may damage the peritoneal surface and leave a foreign body behind.
Minimize tissue handling: Manipulating tissue increases the possibility of vascular and tissue damage. When direct manipulation of the peritoneum is necessary, use either atraumatic instruments or fingers. In addition, cutting and coagulating should be kept to a minimum to reduce the possibility of trauma and maintain vascularity.
Use fine, nonreactive sutures: To minimize foreign body reactions use the smallest size of suture composed of synthetic material.
Avoid peritoneal grafts: Grafting increases the risk of peritoneal trauma while decreasing vascularity.
Minimize foreign bodies: Foreign bodies may damage the peritoneal surface, lead to inflammation, and ultimately result in adhesion formation.
CONSIDERING SURGERY
If surgery is recommended for you, it's important to know what your options are and what questions to ask your primary-care physician and surgeon. If you learn all you can, you'll be sure that you're making the right decision.
Jason Bodzin, M.D., F.A.C.S., director of the Inflammatory Bowel Disease (IBD) Institute at Sinai Hospital in Detroit, advises you to follow a four-step process:


Examine your options.
Talk to your surgeon.
Talk to patients who have had the operation.
Weigh all the factors in making your decision.
Knowing What to Ask
Before consenting to surgery, the first question you should ask is: "Is this surgery necessary, or are there other medical options that I can try?" For instance, many people with IBD have avoided surgery by combining total parenteral nutrition (intravenous feeding) with medications. 6-MP, an immunomodulator drug, often successfully heals fistulas that once required surgery.
You'll also want to know:


Are there other surgical options?
What risks will I face by having the operation?
How will the operation improve my condition?
How long will my recovery take?
Will I require medications following surgery?
Whom do you recommend as a surgeon? As anesthesiologist?
Choosing a Surgeon
Many sources can help you find a surgeon:
Friends, relatives, neighbors
Your primary-care physician
American Board of Medical Specialties (ABMS): (800) 776-CERT. (The ABMS can tell you whether a surgeon is board-certified.)
American College of Surgeons: (312) 664-4050, Ext. 391
The American Society of Colon and Rectal Surgeons: (708) 290-9184
Your local CCFA chapter
Your health insurance carrier
Your local hospital, or your state or county medical association -- all can provide lists of board-certified surgeons.
Once you've compiled a list of two or three possible surgeons, ask the following questions about each one:
Is he experienced with the particular operation you need? (This is particularly important if you are undergoing a fairly new procedure, such as an ileoanal anastomosis.)
Does she treat many IBD patients?
Is he affliated with the hospital you want to be in?
Is she affiliated with a medical school or is she a member of its clinical faculty?
You'll also want to know:
Where the surgeon trained, what his specialization is, and whether he belongs to any professional organizations or has published any professional articles. (To get this information, ask the surgeon directly or go to the library.)
Whether the hospital frequently performs your kind of surgery and whether the staff is well-versed in IBD.
Getting a Second Opinion:
It is always wise to get a second opinion. In fact, many insurance companies require it. Before seeking a second opinion, you may want to get copies of all your medical records. However, any physician can request these for you.
If you receive conflicting opinions, visit a third surgeon or review the situation with your primary-care physician. Though this process can be frustrating and time-consuming, it will give you peace of mind

Monday, August 01, 2011

MAST BIOSURGERY SurgiWrap

[PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________
No. 10-12578
________________________
D.C. Docket No. 7:08-cv-00114-HL
WANDA WILLIAMS,
Plaintiff-Appellant,
versus
MAST BIOSURGERY USA, INC.,
a wholly owned subsidiary of Mast
Biosurgery AG, the parent company,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Middle District of Georgia
________________________
(June 30, 2011)
Before TJOFLAT, WILSON and RIPPLE,* Circuit Judges.
* Honorable Kenneth F. Ripple, United States Circuit Judge for the Seventh Circuit,
sitting by designation.
RIPPLE, Circuit Judge:
Wanda Williams brought this diversity action in the United States District
Court for the Middle District of Georgia against Mast Biosurgery USA, Inc.
(“Mast”), a medical device manufacturer. She sought relief under Georgia
products liability law. After barring certain testimony that Ms. Williams had
attempted to offer in order to establish an element of her claim, the district court
entered summary judgment for Mast. We conclude that the district court did not
err in its evidentiary rulings and that Ms. Williams has failed to introduce
evidence sufficient to establish the manufacturing defect that she alleged.
Accordingly, we affirm the judgment of the district court.
I
BACKGROUND
A. Facts
In 2006, Ms. Williams sought treatment for a painful, undiagnosed
gynecological condition that was suspected to contribute to infertility. An
ultrasound revealed a large ovarian cyst. Ms. Williams underwent a laproscopic
procedure to drain the cyst. During the procedure, Dr. Adcock, her gynecologist,
observed within Ms. Williams’s abdomen significant dense adhesions that had
2
resulted from a prior surgery some years before. He further observed that these
adhesions “were suspicious for malignancy or something to that effect.” R.37,
Ex. 1 at 48.
To address further these observations, Dr. Adcock performed an exploratory
laparotomy on August 22, 2006. During this second procedure, he biopsied Ms.
Williams’s peritoneum and both ovaries and removed “extensive adhesions of
[the] sigmoid and rectum to the posterior uterine fundus.” Id. at 49 (internal
quotation marks omitted). To prevent new adhesions from forming, Dr. Adcock
placed four pieces of SurgiWrap in Ms. Williams’s abdomen. SurgiWrap is a
product designed and produced by Mast. It is marketed as a bioresorbable barrier
used to prevent post-surgical adhesions. Dr. Adcock believed that preventing
further adhesions between Ms. Williams’s organs could have a positive effect on
her fertility.
One month after the August 22 procedure, Ms. Williams returned to
Dr. Adcock’s office. She presented a number of symptoms, including persistent
diarrhea, fever and pain in the lower left quadrant of her abdomen. Observing that
she “looked really sick,” Dr. Adcock admitted her to the hospital and ordered tests
to ascertain the reason for her distress. Id. at 81. After ruling out various causes
of her symptoms, he referred her to Dr. George Yared, a gastroenterologist, for a
3
colonoscopy. During the colonoscopy, Dr. Yared observed what he described as
several stiff, hard and brittle pieces of plastic in Ms. Williams’s colon, some as
large as fourteen to eighteen millimeters. He removed two large pieces, but was
unable to remove other pieces embedded in the wall of the colon. He suspected
the material was the SurgiWrap used by Dr. Adcock during the August 22
procedure. The day following the colonoscopy, Ms. Williams underwent, at Dr.
Yared’s recommendation, a further exploratory procedure by Dr. Robert Brown, a
general surgeon. In addition to cleaning out the significant infection in her pelvis,
Dr. Brown performed a partial sigmoid colectomy to remove a damaged section of
her colon, an appendectomy and a colostomy formation. He found and removed
multiple small pieces that he believed were a foreign, clear, plastic-like substance.
A pathologist, Dr. Robert Nelms, Jr., examined the specimens and described the
material as stiff and thick.

Australian sues over forgotten surgical sponge

Sun Jul 31, 10:29 pm ET
SYDNEY (AFP) – An Australian woman who lived for more than 15 years with a grapefruit-sized surgical sponge sewn inside her after abdominal surgery was to sue her doctor for negligence, a report said Monday.

Helen O'Hagan claims the sponge was left in her abdominal cavity by surgeon Samuel Sakker during a 1992 colectomy, according to the Sydney Morning Herald.

She suffered cramps, fevers and loss of bowel control but attributed it to the long-running health issues that landed her in hospital to begin with, and did not discover the sponge until an October 2007 x-ray.

During that time the sponge "became encapsulated in dense fibrous adhesions within a sac of fluid", the Herald said. It was removed by a different surgeon on the same day that it was found.

O'Hagan won the right to sue Sakker for negligence or breach of contract over the incident, despite the now-retired doctor calling for the case to be dismissed because she had taken so long to start legal action.

Judge Leonard Levy accepted that O'Hagan was so preoccupied with her health woes, having been hospitalised 23 times since 1970, she did not initially seek answers about how the sponge had ended up inside her.

The delay was compounded by the fact that the surgeon who removed the sponge was posted interstate for the next three years and did not tell O'Hagan it could only have been left there by Sakker until last May.

The lawsuit begins this week.