tag:blogger.com,1999:blog-30499448.post8070798350173723219..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: One Spleen...Sid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger33125tag:blogger.com,1999:blog-30499448.post-23200777117002216822019-08-12T18:20:37.400-07:002019-08-12T18:20:37.400-07:00Yes they have.Yes they have.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-11665375282507504092019-08-12T18:06:51.754-07:002019-08-12T18:06:51.754-07:00hello, have doctors ever considered the psycholog...hello, have doctors ever considered the psychological ramifications, the daily anxiety, the hypervigilance patients endure and what life is like after losing a spleen. It is a life altering event that impacts you the rest of your life. Vaccines ate great but without a spleen, you do not mount the same immunity as a person with a spleen and serology results to ascertain whether the vaccines cover you is not considered the norm because doctors do not know what to do with the results- give booster shots before they are recommended may be counterproductive. There is mot enough information out there for doctors on how to keep patients with no spleen healthy and I find specialists do not know when you do need antibiotics for procedures. Get sepsis and over half the hospitals have appalling positive outcomes. More research, more specific vaccines and recommendations are needed for this at risk population. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-2924814592417891202018-02-22T19:27:39.586-08:002018-02-22T19:27:39.586-08:00The tail of the pancreas is nearly always in close...The tail of the pancreas is nearly always in close proximity to the spleen, so it's common to need to separate them and unusual not to be able to. Similarly, removing the tail of the pancreas for, say a tumor there, can be expected to have little or no effect on pancreatic function; and because of the anatomic relationship between blood supply to the spleen, and the pancreas, removing parts or all of the pancreas not rarely requires removing the spleen.<br /><br />Which is to say removing the tail of the pancreas along with the spleen is done for a variety of reasons and the techniques for doing so have been around for longer than six years. I can't comment on whether, with your diagnosis, splenectomy is indicated at this point; but if it's felt to be, I'd think an experienced surgeon could do it.<br /><br /><br />Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-45900508485301643972018-02-22T19:15:52.453-08:002018-02-22T19:15:52.453-08:00Hi there, I am 71 years old and had a lesion diagn...Hi there, I am 71 years old and had a lesion diagnosed on the spleen 6 years ago (Diffuse Large B cell lymphoma) which was treated with chemo and now in recession but still being monitored for possible new "uptake". At the time a splenectomy was attempted but not completed as spleen was attached to the "tail" of the pancreas. Given the 6 years in the interim is there a newer technique for removal of spleen (now enlarged) and part of pancreas tail that would still leave me with normal functionality of the pancreas?Anonymoushttps://www.blogger.com/profile/07484568147651456302noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-43207014230186401972018-01-29T17:32:05.359-08:002018-01-29T17:32:05.359-08:00Four weeks after surgery, there's still lots o...Four weeks after surgery, there's still lots of healing taking place, and changes happening. Too soon, in other words, for the process to be resolved. But, especially early in the process, it's best to let your surgeon know what's going on and what your concerns are. He/she is in a far better position to offer meaningful input, and, if indicated, to look into it further.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-63713077622413245782018-01-29T15:44:44.510-08:002018-01-29T15:44:44.510-08:00Hi there. I love your writing and appreciate it. I...Hi there. I love your writing and appreciate it. I am 32 yrs old and just had an open splenectomy due to Sarcoidosis 4 weeks ago. My spleen was 4lbs and about the size of a football. HUGE. So, my question is, what could be causing this pain I have in the area where my spleen used to be. It's a new pain that just started but is getting pretty severe. I've been reading online and wasn't sure how likely an "adhesion" would be after open surgery. I've only read about it with laparoscopic. Any insight is greatly appreciated. Anonymoushttps://www.blogger.com/profile/07631502814134946782noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-39274674654168007072015-08-07T06:27:22.148-07:002015-08-07T06:27:22.148-07:00I can't think of any reason why a person witho...I can't think of any reason why a person without a spleen would be more prone to dehydration, Lisa. It has no role in fluid balance that I know of.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-50698964645160072112015-08-06T22:27:45.125-07:002015-08-06T22:27:45.125-07:00I had my spleen removed due to an aneurysm on the ...I had my spleen removed due to an aneurysm on the main artery leading to the spleen. I've also had all of the recommended immunizations. My question is, could I be more likely to be dehydrated quicker than before it was removed?Anonymoushttps://www.blogger.com/profile/12944614516993323159noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-11163120797218284682013-07-20T19:08:59.526-07:002013-07-20T19:08:59.526-07:00Good story. Thanks!
I just called them "righ...Good story. Thanks!<br /><br />I just called them "right angle," and usually specified long or short. And, in honor of one of my favorite teachers, I referred to the really big honking ones as "giant noogerer."Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-60729486448291475892013-07-20T18:53:17.295-07:002013-07-20T18:53:17.295-07:00I'm an old retired scrub nurse. I used to work...I'm an old retired scrub nurse. I used to work with a surgeon who would scream for a mixter at various times that I was too busy sweating it out to see what was going on. He would get mad if I slapped a standard mixter into his hand and hollar out for a longer one. We finally had a friendly discussion after the procedure and agreed on a standard mixter length (long)and all was well. I really love your blog and whenever I hear splenectomy, I hear mixter screams in the background.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-4880701411259141722012-08-08T11:25:21.425-07:002012-08-08T11:25:21.425-07:00Thank you very much! I love hearing that. And good...Thank you very much! I love hearing that. And good luck in your career.<br /><br />P.S. When I was an intern, holding hooks on a big case, one of the vascular surgeons asked me, Can you see all right, Sid? I said yes, sir. He said, Then you're not pulling hard enough.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-23022525398911495592012-08-08T10:47:45.967-07:002012-08-08T10:47:45.967-07:00Was bopping around online looking at spleen/pancre...Was bopping around online looking at spleen/pancreas things because I was scrubbed on a distal pancreas/splenectomy a couple days ago. Couldn't see squat from my vantage point with surgeon and two residents , but got to peek here and there and feel-up the tumor. I loved your photo. I'm on the cusp of first assistant-ness ( even though the cusp is hard to get to - getting internship time with all the fellows and residents and PA students etc etc, is complicated .. ) , the attachments and anatomical locations are great to learn and memorize. P.S. I LOVE how you write. Very down to earth and funny. I've been in the O.R. 11 yrs. Wanna read all you have. THANKS !! Enjoyed this immensely. :))lorkavnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-86533669120981405092011-06-12T08:55:57.989-07:002011-06-12T08:55:57.989-07:00Like all the other images I've used, I just di...Like all the other images I've used, I just did an image search and downloaded it. Gray zone, I suppose.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-78809951344866250732011-06-12T08:42:26.767-07:002011-06-12T08:42:26.767-07:00Hello. That 3rd picture with the deudenum that say...Hello. That 3rd picture with the deudenum that says "technicalanimations.com" across it is very good and helped me study for anatomy. Did you create it yourself? Or where did you get it from? Do you have anymore pictures like it?Amyhttps://www.blogger.com/profile/02309847784095011971noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-76490704600565181532011-06-09T17:23:39.204-07:002011-06-09T17:23:39.204-07:00It shouldn't make a difference which incision ...It shouldn't make a difference which incision you choose: the spleen is gotten loose with the smaller incisions. Once it's free, the incision to remove it could be made anywhere.<br /><br />Since there are several ways to close the skin, and choosing is generally a matter of personal preference, I can't guess how your surgeon will do it. But it's certainly something you should feel free to ask; same with the question you asked about incision placement. <br /><br />Similarly, you should ask what possibilities are on the list after the studies you've had: a slow-growing lesion such as you describe could be any number of things, from infection to tumor. Anything I'd say, without the ability to see the results of the PET and MRI and CT scans would simply be a guess.<br /><br />All of your questions are reasonable ones, and you certainly have a right to have them answered before you have your operation: you shouldn't feel reluctant to ask your surgeon.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-52013766992654507872011-06-09T16:40:45.967-07:002011-06-09T16:40:45.967-07:00Hello doctor..
I will be having a splenectomy in ...Hello doctor..<br /><br />I will be having a splenectomy in July and I'm very nervous and scared about it. I never have surgery in my life. I am 44 years old female and always keeping up my healthy life style but for some unknown reason. The CT scan shown that I have lesion growing inside my spleen from a spot to 3.1cm in 2 years. I have been having 7 CT, 1 PET/CT and 1 MRI in the past 2 years. After reveiwing the recent CT, my surgeon determined that he will have to make about 3-6" incision in additional of 3 holes for laporascopic procedure so that he can take the whole spleen out through that incision. He gave me 2 options, 1 is to make an incision above the belly or he can make it on the bikini area to hide the scar. My question is, from your surgeon point of view. would it be more difficult to remote the spleen from bikini area than from the above belly button? I just don't want to add a complication by having him removed the spleen from the bikini area. The second question is, what will be the closing method use to close the incision? would it be glue or staple? From your experience, have you ever encountered the similar situation that I have with my spleen? I don't drink or smoke. I just don't know how on earth I have this lesion growing inside my spleen. The only thing that I see bad for me is that I have been on birth control pill for 11 years but I stopped taking it last year. So it sounds like I will have a partial open splenectomy. Any advices would be greatly appreciated. Thank youNever be Sick againhttps://www.blogger.com/profile/06491759421675944145noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-44017278707088354292010-02-14T08:41:36.943-08:002010-02-14T08:41:36.943-08:00Well, that's a strange story; I can't imag...Well, that's a strange story; I can't imagine the physiology behind it. There are things that can cause spontaneous rupture, but I've never heard that one!!<br /><br />The most important vaccine would be pneumovax, for the pneumonia bug. H. flu is another, especially for kids.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-91250080205620982892010-02-13T23:51:24.863-08:002010-02-13T23:51:24.863-08:00So let me just ask, as somebody who had my spleen ...So let me just ask, as somebody who had my spleen removed about 20 years ago (had been robbed, and the doctors said my body pumped so much adrenaline into my system that somehow the blood vessle(s) pulled out of the spleen, ending it's useful function), and has never paid any mind to missing it since that time, what kinds of things (and vaccines) should I be making sure I have had, to keep myself a little safer?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-12064350669280536442009-08-05T19:03:12.100-07:002009-08-05T19:03:12.100-07:00Thanks, Dr S. Good to hear that I may in fact have...Thanks, Dr S. Good to hear that I may in fact have a bit of splenic function. I do have what I imagine are adhesions/ scar tissue in the area my deceased spleen once inhabited, but I can live with that. Pity the drs at the Cleveland would not listen to me when I asked if I could have sarcoidosis. They were hell - bent on a dx of lymphoma and insisted the spleen had to be removed.They refused to check out the lungs, which would have given them a definitive answer. Turned out it did not, any more than the sarc in my lungs, liver or kidneys were a cause for removal. So, I became a study case and can only hope others don't become asplenic for the same reason.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-24612782749278403122009-08-04T16:02:25.079-07:002009-08-04T16:02:25.079-07:00It is certainly possible; so it's good it was ...It is certainly possible; so it's good it was missed. How much function it will have is hard to say, but it's likely there'd at least be some.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-56453625015801801402009-08-04T15:53:16.404-07:002009-08-04T15:53:16.404-07:00I had a splenectomy in 2003 because lymphoma was f...I had a splenectomy in 2003 because lymphoma was feared. It turned out that I had sarcoidosis. The surgeon missed an accessory spleen hiding behind the kidney. Can this little splenule take over any splenic function? I have stayed very well re infections etc since my splenectomy and only have the pneumonia shot every 5 years.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-77315887035873750662007-07-03T19:48:00.000-07:002007-07-03T19:48:00.000-07:00Great post, Dr Sid. Sometimes I think I need a spl...Great post, Dr Sid. <BR/><BR/>Sometimes I think I need a splenectomy - I have vented mine one too many times....Margaret Polaneczky, MD (aka TBTAM)https://www.blogger.com/profile/16555722791007332247noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-89909299670367653342007-06-30T17:15:00.000-07:002007-06-30T17:15:00.000-07:00I am so happy to see the anatomy graphic. I scrub...I am so happy to see the anatomy graphic. I scrubbed (and assisted for lack of another willing soul or second scrub)one right nephrectomy, and assisted a couple of weeks later on a lap, hand assisted, right nephrectomy. I research (or try to, time permitting) my cases the night before and found it extremely frusting not to be able to find a plate in my anatomy books relaying the intimacy shared between the spleen and the doudenum. Thank you! <BR/><BR/>P.S. Removal of a ruptured spleen is one of my favorite procedures! Even though as an assist I don't get to see much, my main job is exposure, exposure, exposure...Can't wait to read your take on it.make mine traumahttps://www.blogger.com/profile/18149160428613740527noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-63623999334564658072007-06-24T20:56:00.000-07:002007-06-24T20:56:00.000-07:00lynn: it varies, and would depend in part on why a...lynn: it varies, and would depend in part on why and by what method the splenectomy was done. If for trauma, it was likely open, as opposed to laparoscopic. If the latter, the recovery would be less. And "recovery" is a sort of vague concept. Good as new, no fatigue, as if it never happened? For most any open abdominal operation it can be two or three months: healing work is going on for that long. To be able to do most anything, maybe feel a little tired, sore if over-doing it? Depending on the age and health of the person, three weeks would be possible. But most people would still feel less energy at that time, and if your character is running up and down mountains, or jumping around in buildings like the latest James Bond, after three weeks, she'd be beat. But flying on a plane ought to work out. I can accompany her if you like...Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-58972532483683039392007-06-24T18:50:00.001-07:002007-06-24T18:50:00.001-07:00I need to get her on a plane three weeks after the...I need to get her on a plane three weeks after the surgery. Sorry...didn't make that clear.Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.com