Varix- Where did the word come from?

I was just wondering about the origin of the word 'varices' and how it arose. Online search revealed that the word came from Latin 'wer' which means highland or high. As surgeons, we encounter them usually as esophageal varices or varicose veins. Esophageal varices look like this.

Bleeding from esophageal varices is a significant cause of mortality in patients with portal hypertension. Currently, esophageal variceal ligation remains the treatment of choice to treat patients with esophageal varices.
It is exciting to read about the history of treatment of a particular condition and the difficulties faced by the inventors of the methods that are currently in use.
The story of esophageal variceal banding is closely linked to that of portal hypertension. The idea of a banding device for varices originated from the device that was being used for hemorrhoids. Initial devices were single shot devices and had to be reloaded each time after application of the band. Currently, multi-band ligation has made the life of both the surgeon and patient far easier.

Uffs and butts- A tale of asstronauts!

As surgeons, we often encounter patients with anorectal problems. They can be a source of great discomfort and cause loss of work and expenditure to patients. Some common problems faced by patients include hemorrhoids or piles, fissures, fistulas and pilonidal sinuses.

Although hemorrhoids don't deserve a treat, they sometimes require treatment. Hemorrhoids are often referred to as piles. This word is derived from the Latin word 'pila' which means ball which might have referred to the globular form of external hemorrhoids.
Fissures are tears in the anal canal and cause a lot of pain. The word fissure is derived from the Latin word 'fissura' which means 'to split'.
Fistulas in the anal canal cause a lot of embarrassment to the patients because of the pus discharge and are difficult to treat if they are complex. The word fistula is derived from Latin which means 'pipe'.
Pilonidal sinus is a discharge from the gluteal cleft and the term was first used in 1880 and meant pilus (hair) + nidus (nest).

He fed fevers!

Robert James Graves was an Irish surgeon who described a case of exophthalmos with goiter in 1835. The disease was named after him and is commonly referred to as Graves' disease and is the commonest cause of hyperthyroidism. Less commonly it is also known as Begbie's disease, Parry's disease, Flajani's disease, Marsh's disease etc. Signs and symptoms of hyperthyroidism may include muscle weakness, weight loss, diarrhea, fast heartbeat, poor tolereance of heat etc.
Some interesting facts about Robert James Graves :

• He had a gift for languages. He was thought to be a German spy and arrested for travelling without a passport as the authorities could not believe that an Irishman could speak German so fluently.
• He introduced new methods of clinical teaching which are followed to this day.
• He introduced the timing of pulse by watch.
• He was the first to introduce the practice of giving food and liquids to patients with fever instead of withholding it. He jokingly suggested an epitaph for himself " He fed fevers"!
• He is the uncredited inventor of the second-hand on watches.

Some notable cases of Graves' disease include

• George H.W. Bush and Barbara Bush
• Gail Devers,American sprinter
• Marty Feldman, a British comedian, who used his bulging eyes as part of his act.

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Hashimoto- A town doctor

June 20 is known as Hashimoto's thyroiditis awareness day. I was able to do armchair research and glean out some information about Hashimoto from Wikipedia.
Hakaru Hashimoto was a Japanese medical scientist born in 1881. He studied in Japan, Germany and England and returned to his hometown, Imaguchi, where he practised as the town doctor till his death in 1934.
He published a report on lymphomatous goiter in 1912 which was evaluated years later by English and American researchers and the disaese that he described was recognized as an independent illness and named as ' Hashimoto's thyroiditis'.
Hashimoto's thyroiditis is an autoimmune disease in which the thyroid gland is gradually destroyed leading to hypothyroidism and in some cases, thyroid lymphoma. A relapsing encephalopathy occurring in association with Hashimoto's thyroiditis is known as Hashimoto's encephalopathy.

Lyrical incisions

Many surgeons, anesthetists and nurses like music to be played in the operation theater. It helps them relax and sooth their nerves. It improves the cognitive function of the listeners and creates a sense of well being. Their moods get better.It helps personnel approach surgeries in a thoughtful and relaxing manner.
However, there are contrasting views regarding the role of music in the operation theater. Some people might be sensitive to noise and not like the type of music being played.
What if :

• Some people liked classical music and hated heavy metal?
• The music caused distraction?
• Sudden changes in tempo led to sudden unwanted movements?
• The music affected communication between anesthetists, surgeons and nurses?

It would be a good idea if all the operating theater personnel discussed the type of music to be played while operating. It would save a lot of heartburn among all concerned.

Here is a typical scene from the popular American sitcom 'Scrubs'.

Surgeons' song:-)

Laparoscopy vs Arthroscopy

Laparoscopy and arthroscopy both involve the use of small instruments to look into cavities and perform surgeries. Laparoscopy uses Carbon dioxide to insufflate the abdomen so that the abdominal organs are examined better. Arthroscopy usually involves the use of sterile saline which is pumped into joints at the required pressure using a pump.
Laparoscopy is usually done by trained surgeons or gynecologists while arthroscopy is done by trained orthopaedic surgeons. Joints such as shoulder, elbow, wrist, hip, knee and ankle are most frequently examined and operated with arthroscopic techniques.
Arthritis is an informal way of referring to joint pain or disease and involves many related conditions.
With advances in fiber optics during the 1970s, arthroscopy advanced significantly. The first interventions are credited to the Japanese surgeon Masaki Watanabe. The first arthroscopies were reportedly done with a cystoscope and a thoracolaparoscope.  
The seed for this article came from a walkathon being organised at our hospital on May 21, 2017. Details are given below.

  

The gall of living without a gallbladder

Gallbladder removal or laparoscopic cholecystectomy is one of the most common operations being performed in the world. Usually, the operation is advised for patients with gallstones who develop symptoms of inflammation of the gallbladder. There are several advantages to laparoscopic removal of the gallbladder such as lesser pain, faster recovery and smaller scar.
Many patients ask their surgeons whether removing the gallbladder causes any adverse effects. Many animals do not have gallbladders. Gallbladder is the storage organ for bile which helps in digestion. In people without gallbladders, bile is directly delivered to the intestines. Theoretically, patients may not digest food well but it is found that the body adjusts and most patients are able to consume a normal diet.
Celebrities who have undergone gallbladder surgeries include the Dalai Lama, Eric Clapton and Jack Black.