If you are sounding a little hoarse and have a sore throat, you may be bracing for a cold or a bout of the flu. But if you've had these symptoms for a while, they might be caused not by a virus but by a valve—your lower esophageal sphincter. That's the muscle that controls the passage between the esophagus and stomach, and when it doesn't close completely, stomach acid and food flow back into the esophagus. The medical term for this process is gastroesophageal reflux; the backward flow of acid is called acid reflux.
Acid reflux can cause sore throats and hoarseness and may literally leave a bad taste in your mouth. When acid reflux produces chronic symptoms, it is known as gastroesophageal reflux disorder, or GERD.
The most common symptom of GERD is heartburn —pain in the upper abdomen and chest. Three conditions—poor clearance of food or acid from the esophagus, too much acid in the stomach, and delayed stomach emptying—contribute to acid reflux, says Dr.
In this case, your surgeon may use a nerve graft. Nerve graft is a piece of nerve, either from another part of your body or from a cadaver. This piece of nerve serves as a bridge between the two ends of the nerve. Nerve fibers grow slowly, about one millimeter per day or one inch per month.
It may take many months for a nerve to grow from where it is injured all the way to its target. You may need therapy to help keep your joints moving and your pain controlled while your nerve is growing. If it has been a long time since your nerve damage, nerve repair may not be possible.
If a muscle does not receive a signal from a nerve for a long time, it can stop responding altogether. This usually happens after 18 months without a signal but depends on the kind of nerve damage, the age of the patient, and other factors. If the nerve is not repairable, your doctor may discuss other options such as nerve or tendon transfers to help you regain function.
Figure 1. Pressure sores affect between 1 to 5 in every people admitted to hospital. They are more likely it you are seriously ill, have had a spinal cord injury, or have had a poor diet. They are more common in people who smoke, in those with diabetes or heart failure and in those with neurological diseases. Pressure sores are prevented by good nursing care - in particular helping you change your position as much as possible and the use of pressure-relieving devices such as cushions and mattresses.
They are treated with antibiotics and painkillers, dressings and surgery. See separate leaflet called Pressure Ulcers. This is very common and involves a blockage and then a collapse atelectasis of a part of one of your lungs, usually at the bottom, so that it no longer fills with air when you inhale.
It is particularly common after surgery to the tummy abdomen or the chest. Lung collapse occurs when the finer airways get blocked with trapped mucus. Once air can't get in or out, the air that is already behind the blockage is absorbed by the body and the fine tubes collapse. These collapsed sections of lung easily become infected due to trapping of germs bacteria. Atelectasis is more likely if you are overweight, are a smoker, are in a lot of pain and can't cough, or if you are having a very high level of painkillers which tends to suppress coughing.
The condition makes you breathless and you may develop a painful cough and start to become hot. Treatment is usually with physiotherapy, including breathing exercises to help you clear the blockage, together with antibiotics for any infection. You may be given extra oxygen through nasal prongs or a mask for a day or two to compensate for the area of lung that isn't working.
Infection in the lungs pneumonia can occur after surgery. It is fairly common, although much less common than atelectasis. You may have a cough or abdominal pain and you are likely to be hot and running a high temperature feverish , and possibly be short of breath. Pneumonia often follows atelectasis and is treated with antibiotics.
Sometimes additional oxygen is needed. It is more likely to happen if you are a smoker, if you are older, or if you have had surgery to your lungs.
Deep vein thrombosis DVT occurs when clots form in the large veins in your legs and pelvis, and pulmonary embolism PE occurs when bits of those clots come loose, enter the circulation and end up in your lungs. PE is very serious and can be fatal. There is an increased risk of PE and DVT any time from surgery until you are fully mobilised again; however, the risk is highest in the first two to three days after your operation.
Clots in veins are more likely to form after surgery because you are not moving around, and because the body's response to the intentional injury of surgery is to increase its tendency to form blood clots. The risk is greatest for surgery affecting the pelvis. The risk of clotting is increased by long periods of being immobile, by being on hormones, if you are overweight, by certain medicines including hormone replacement therapy HRT and the combined oral contraceptive COC pill , by pregnancy and, particularly, by being a smoker.
DVT is not always detected but it causes painful swelling of the leg particularly the calf. Smaller pulmonary emboli cause sudden breathlessness, chest pain and confusion, while large ones cause collapse and may be fatal. Doctors try to reduce the risk of DVT and PE by stopping drugs which increase your clotting risk well before high-risk surgery, by getting you to wear compression stockings to keep blood from pooling in the deep veins of the legs and by getting you up and mobile as soon as possible after surgery.
If you are particularly at risk you will be given blood-thinning medicines for the period of your surgery. Aspiration pneumonitis also called aspiration pneumonia is a rare complication of surgery. It is a chemical inflammation of the lungs which occurs because acidic stomach contents are inhaled, usually due to being sick vomiting or regurgitation followed by inhalation whilst you are under anaesthetic. Aspiration pneumonia is more likely in emergency surgery where you did not have a period of starvation to empty your stomach beforehand.
It is an extremely serious condition which needs treatment with antibiotics, ventilation and suction of the lung, and often steroids. Anaesthetists treating emergency surgery patients are very aware of the risk of vomiting and inhaling, and will use medicines and techniques to try to prevent it. This rare condition comes on hours after surgery, usually after multiple trauma, although it can also occur after near drownings.
It causes severe breathlessness and confusion due to low oxygen levels. It is sometimes called 'shock lung'. ARDS is a serious condition which requires intensive care.
It is more common if you have widespread, generalised infection sepsis , have inhaled harmful substances including smoke inhalation and near-drownings and after serious head injury and serious burns. It can also occur as a consequence of aspiration pneumonitis. Heart problems associated with surgery most often happen in the 48 hours following surgery, although they may occur in the first six days. They include heart attacks , abnormal heart rhythms , angina and heart failure.
They can sometimes go undetected, because you are on strong painkillers which mask pain and discomfort, or you are still sleepy or confused. Heart problems occur because the physical strain and challenge of surgery, including the anaesthetic, the surgery itself and the medicines and any fluids you have been given, are an extra load on your heart. A normal, healthy heart can cope with this extra work; however, if you were already at risk of or you already had heart disease or cardiovascular disease, surgery may be enough to trigger a heart problem.
Your surgeon and anaesthetist will assess you carefully prior to your operation, to determine whether you are at increased risk of heart problems. If your risk is thought to be high then you may be advised against all but essential surgery. If you do want or need to go ahead with surgery then the surgeon and anaesthetist will take every precaution they can to minimise the strain on your heart, including making your operation as short and small as possible, making sure you have enough pain relief and taking extra care with medicines and with fluid replacement.
This is very common after surgery, particularly to the tummy abdomen or pelvis. You are unable to pass urine despite a full bladder. Urinary retention is most often caused by pain and it will often settle with pain relief.
It is sometimes necessary to pass a catheter to allow the bladder to drain, particularly if it is so full that it is causing you discomfort. Urinary retention is common after surgery close to the bladder, including vaginal wall repair for prolapse which can cause bruising around the neck of the bladder.
See separate leaflet called Urinary Retention. Urinary tract infection UTI, or cystitis is very common after surgery, especially in women, and particularly if you had a catheter during your surgery. He has stopped thousands from getting unnecessary surgeries and resolved the pain of thousands of others who had surgery that did nothing to alter their pain.
Additionally, Dr. Tired of living in pain? Clearly having your finger or thumb stuck in a bent position can affect the ability to grasp objects and perform the most common daily activities.
One do-it-yourself approach is to simply use the other hand to assist in straightening the bent finger. Watch out if you seek medical attention for trigger finger. The most common mainstream treatment for trigger finger is a cortisone shot into the offending joint.
The thought here is that inflammation is preventing the tendon from gliding through the tunnel properly. In truth, cortisone rarely works long term. It may provide short term relief— but that is actually because the shot also contains lidocaine, an anesthetic pain reliever.
Cortisone shots rarely, if ever, have any lasting effect on trigger finger. Other types of treatments for trigger finger are splints and taping the joint. In every case of trigger finger I have treated, the person could either not straighten the finger back after it was bent or could do so but it was very painful.
Ultimately, the person was forced to use the other hand to straighten the finger every time it was bent. The ability to return it to the straightened position was easy under this circumstance—and with no pain. If there were a true structural limitation, the finger would not be able to be straightened at all!
This logical understanding explains why all the treatment in the world to the joint with the limited motion does not resolve the issue. Now I will provide the more logical explanation for trigger finger and the one that has allowed me to resolve this issue in every case I have treated.
The problem is not at the finger joint.
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