tag:blogger.com,1999:blog-4968787219619380438.post1961383664207413992..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: More on activity restrictions after surgerySkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-4968787219619380438.post-91456972017718960722016-02-29T07:37:33.298-05:002016-02-29T07:37:33.298-05:00Khim, thanks for the comment and the link to your ...Khim, thanks for the comment and the link to your post. I have written about restrictions that are impossible to follow too. See the link in my comment of 2/26/16 just above yours.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-63547371888022379772016-02-29T05:16:23.413-05:002016-02-29T05:16:23.413-05:00Hi Dr Skeptical Scalpel, I like and agree with you...Hi Dr Skeptical Scalpel, I like and agree with your post. I wrote a similarly themed post at my old blog about sternal precautions post-CABG: https://ebpinphysio.wordpress.com/2015/02/03/sternal-precautions-post-cabg-surgery-how-much-should-we-adhere-to-them/ <br /><br />More often than not, I find activity restrictions imposed by some surgeons to be impossible to live up to. That is why I don't adhere to them strictly... Khim Kwahhttps://twitter.com/KhimKwahnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-30001434855615273652016-02-26T17:22:48.073-05:002016-02-26T17:22:48.073-05:00William and Dr D, thanks for the comments. I agree...William and Dr D, thanks for the comments. I agree with the notion that prophylactic antibiotics should not be taken for more than 24 hours.<br /><br />We are all guilty of passing down dogma. I certainly did. I have more time to think about these things now. "Standard of care" is whatever a lawyer and his expert witnesses can convince a jury to find.<br /><br />I had forgotten about a post on this subject I wrote last year. Here's the link - http://skepticalscalpel.blogspot.com/2015/03/blame-patient.htmlSkeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-42274591107516762762016-02-26T16:27:43.601-05:002016-02-26T16:27:43.601-05:00I think most of our post op orders contain stuff b...I think most of our post op orders contain stuff based on simply passing them down from generation to generation. I questioned WAY back when, some of the details we had in our post op orders when in my residency. All I got was the typical "so DOCTOR you think your limited experience is sufficient to make changes?"<br />I realized that my requests were in deed at most at risk of altering "the standard of care" as well as potentially being in the dog house so why bother. To this day I use standardized boilerplate PO orders and haven't looked back to question them. I teach those same orders to all my generation of residents and fellows as well how pathetic! <br />A friend of mine a Dentist was sued a few decades back for not prescribing an antibiotic after extracting a "loose tooth." The jury determined he violated the SOC and to this day I can only find nothing on why it was a violation. It seems that just because they always do it seems to be enough to keep it going and violating it based on science is sufficient to get you in the hoosegow<br />Dr DAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-5865669508740376552016-02-26T15:25:18.238-05:002016-02-26T15:25:18.238-05:00My wife went to a dentist to have gum surgery on t...My wife went to a dentist to have gum surgery on the area under one tooth. The dentist told her she could not do "any" exercise<br />including long walks for three weeks after the surgery.I told her we needed a second opinion. SO she went to my dentist who thought the<br />proposed restrictions were hilarious. He did the surgery and she returned to normal activity right after and has done well.<br />After encounters with some surgeons I was told to take a long course of antibiotics to "prevent" infections.I searched the<br />literature and decided that the evidence for that was non existent and did not take them.I had no problems. A lot of medicine is of dubious value or worse. Buyer beware.<br /><br /><br />William Reicherthttps://www.blogger.com/profile/10062067819184876941noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-40919830660411956712016-02-26T10:53:06.905-05:002016-02-26T10:53:06.905-05:00I think fear of lawsuits is a very real reason why...I think fear of lawsuits is a very real reason why such restrictions exist. Add to that a lack of real evidence and you now see why surgeons say don't lift more than 10 lbs for X weeks.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-71020689222379111822016-02-25T22:12:18.397-05:002016-02-25T22:12:18.397-05:00The only thing I can think of that caused my forme...The only thing I can think of that caused my former surgeon to nix activity was fear of a lawsuit & being a wuss. I was in pretty good shape before and after my last 2 surgeries (ok, anesthesia issues on the last but that was it). <br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-52772858348903880862016-02-25T19:25:22.955-05:002016-02-25T19:25:22.955-05:00I am not aware of any evidence-based guidelines. T...I am not aware of any evidence-based guidelines. That's why I've written two posts about it. I'm hoping someone will chime in and enlighten us. We'll see. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-49793392863236578232016-02-25T18:35:01.553-05:002016-02-25T18:35:01.553-05:00Fascinating.
I have a post-operative incisional/v...Fascinating. <br />I have a post-operative incisional/ventral hernia and have found no studies to suggest what my weight-lifting or other isometric exercise limitations should be.<br />Are you aware of any evidence-based recommendations in this areaDrPhttps://www.blogger.com/profile/08426715469978567259noreply@blogger.com