Link: https://pubmed.ncbi.nlm.nih.gov/34098004/ PMID: 34098004
DOI: 10.1016/j.jvs.2021.04.072

Really at my wits end here. My mother (53) has been recommended to get a knee replacement after a previous knee surgery failed. Her anxiety has gone through the roof, resulting in us ‘shopping around’ going to different professionals, who all have a different answer on what to do / go for the replacement or not. I know she needs the replacement, but she won’t go without reassurance from someone in the profession. She’s a sensitive person who can’t take the sometimes harsh facts surrounding the operation. We’re just going in circles. Does anyone have any advice? Sorry if I’m in the wrong place, just can’t find anything of substance online.

My injury was last June. Operation date is Dec. 9th. Due to depression, family and work changes, I didn't prepare properly. My prep included 10 PT sessions, occasional gym visits. I gained 10 lb since the injury since it stopped me from playing soccer, my only favorite sport.

I'm 38,M, BMI 28, not a smoker/drinker, diagnosed with ADHD, depression, chronic insomnia, healthy otherwise, going for allograft,

Is it too late to slavage my preoperative preparation for the next 9 days? Should I postpone the surgery?

I'm thinking of doing one hour of legs workouts everyday, not sure if that is going to be helpful at all.

Edit:

I can't thank you enough for this amazing support and valuable advice. What a wonderful community!

I am trying to find the manufacturers manual/specifications of the Alltech Econosil C18 (250 x 22 mm, 10um) preoperative column but haven't had any luck search google. Is anyone familiar with the columns or has a copy of its specifications from the manufacturer?

Hello. We have a few patients who had testing (92136 and 92025) done before a cataract surgery, however their eyes were too dry to get accurate results. Can we repeat the testing? Would it be covered by the insurance?

So I got all my documents in for bottom surgery. I got an email saying it could take up to 6 months to be completed. Does anyone have any recent experience with timelines? Once they contact me with a date, how far off is the surgery once I get a call?

Have you ever faced difficulties to make a visual reconstruction?

https://preview.redd.it/mmgz0qt44gf61.jpg?width=1280&format=pjpg&auto=webp&s=1e7a2e63b1319b6c8e45d76d109b7683006e34e8

https://doi.org/10.7150/ijms.52701

https://pubmed.ncbi.nlm.nih.gov/33526980

Abstract

Preoperative fasting aims to prevent pulmonary aspiration and improve bowel preparation, but it may induce profound systemic catabolic responses that lead to protein breakdown and insulin-resistant hyperglycemia after operation. However, the molecular mechanisms of catabolic reaction induced by prolonged preoperative fasting and surgical stress are undetermined. In this study, anesthetized rats were randomly assigned to receive a sham operation or laparotomy cecectomy. Fasting groups were restricted from food and water for 12 h before operation, while the feeding group had free access to food throughout the study period. Twenty-four hours after operation, the animals were sacrificed to collect blood samples and soleus muscles for analysis. Postoperative blood glucose level was significantly increased in the fasting group with elevated serum insulin and C-peptide. Continuous feeding reduced serum myoglobin and lactate dehydrogenase concentrations. Preoperative fasting activated inositol-requiring transmembrane kinase/endoribonuclease (IRE)-1α and c-Jun N-terminal kinase (JNK) mediated endoplasmic reticulum (ER)-stress, and reduced glucose transporter type 4 (Glut4) expression in the soleus muscle. Phospholamban phosphorylation was reduced and intracellular calcium levels were increased in the isolated skeletal muscle cells. Similar results were found in ER stress-induced C1C12 myoblasts. The expression of Glut4 was suppressed in the stressed C1C12, but was potentiated following inhibition of ER stress and chelation of intracellular free calcium. This study provides evidence demonstrating that prolonged preoperative fasting induces ER stress and generates insulin resistance in the skeletal muscle through suppression of Glut4 and inactivation of Ca^(2 ) -ATPase, leading to intracellular calcium homeostasis disruption and peripheral insulin resistance.

------------------------------------------ Info ------------------------------------------

Open Access: True

Authors: Ming-Wei Lin - Chih-I Chen - Tzu-Ting Cheng - Chien-Chi Huang - Jen-Wei Tsai - Guan-Ming Feng - Tzer-Zen Hwang - Chen-Fuh Lam -

Additional links:

https://www.medsci.org/v18p1189.pdf

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847634](https://www.ncbi.nlm.nih.gov

Article posted by TheBrainDriver tDCS Brain Stimulation Devices for Peak Performance

Link to Article

Hello everyone !

I was wondering how preop eval is done in your countries, especially in the US or Canada, where I know practices are different from mines. In France, we see the patients at least 48 hours before an elective surgery where we do the history taking, airway evaluation, exam or blood work ordering and preop medical optimization. This is mandatory by law (the preop eval but not the 48 hour delay) and a very important part in our work organization. The 48 hour delay obviously doesn't apply for urgent procedures.

I believe this preop consultation is a very important step in the management of patiebts from a medical point of view but also in the good organization of the operating ward where, at least in my country, surgical and anesthesia/cc doctors have (and should have, IMO) equal say.

How is it done in where you work? I don't believe a preop consultation is routinely done in the US? How so? How do MDs face difficult cases without seeing the patients first? Do surgeons order the preop eval themselves or address the patients to cardiologists for exemple on their own?