Barbara Bush is recovering from abdominal surgery this
morning. She had been experiencing abdominal pains for the last few days and went to the hospital Tuesday night for evaluation.
Initial reports from the White House claimed that she went for a routine checkup of a several month history of abdominal pain.
Her evaluation was said to be negative and she would be discharged from the hospital this morning. It is a little unusual
for someone to seek routine evaluation first at night, and secondly in a hospital as opposed to during the day at their physician's
office. The truth came out in a statement released by the hospital this morning which
said the former First Lady "underwent routine, laparoscopic surgery Tuesday night to correct a perforated ulcer. She
was resting comfortably Wednesday morning, and visiting with her family."
"During the procedure last
night, surgeons cleansed her abdominal area, then patched and closed a one-centimeter hole in Mrs. Bush's stomach, caused
by the ulcer," the statement said. "Mrs. Bush is expected to be discharged from the hospital next week." President
Bush in his annual Thanksgiving pardoning of a turkey stated that he was thankful his mother was doing well after surgery.
Barbara Bush is 83 years old and otherwise healthy. She revealed a diagnosis of Grave's Disease while her husband was
in the White House.
According to Sanjay
Gupta of CNN, an abdominal Xray was performed which revealed that air was seen on the xray. Air visible on an xray indicates
that it had escaped through a hole in the intestine A hole in the intestine is dangerous and must be treated with surgery
immediately. Stool, or intestinal contents, can exit this hole into the abdominal cavity causing a severe infection if untreated.
Patching, closes the hole, allowing the bowels to heal. She will likely be in the hospital for a week. She will not be allowed
to eat for several days requiring intravenous fluids for hydration. She will most certainly need antibiotics for a short time.
It is difficult to discern at this time her prognosis given the limited information we are receiving. Her recovery is dependent
on the time interval between her perforation and her treatment. In addition, since she was able to have minimally invasive
laparascopic surgery which uses multiple small incisions as opposed to one large one, she should have less pain. Since she
is a relatively healthy 83 year old, she will probably do just fine.
When most people make plans to purchase
a home, there are certain features they look for in their dream home: size of the kitchen, number of bedrooms, etc. But not
only should you focus on the physical characteristics of the home, you should also pay attention to aspects of the home you
cannot see. When purchasing a home, you are
offered the opportunity
to perform a number of inspections before you commit to buying. You realtor will toss you brochures on physical home inspection,
radon inspection, termite inspection, lead inspection, to name a few. Most new homeowners will go for a physical inspection
which tends to be the most comprehensive and expensive and forgo the others either because they don't see the need or
they do not want to be nickeled and dimed by various forms of testing. However, not having your home checked for radon can
be dangerous to your health. Why? Because, the Surgeon General of the United States has warned that radon is the second leading
cause of lung cancer in the United States today. Exposure to high radon levels in your home in combination with smoking increases
your risk of developing lung cancer significantly.
What is
Radon?
Radon is a radioactive gas that comes from the natural
breakdown of uranium in soil, rock and water. Cracks and holes in the foundation allow radon to move up into the air from
the ground. Radon is trapped in your home where levels can build up over time. A radon level of 4pCi/L is considered elevated.
How do I get my home tested for radon?
There are two tests that can be performed: a short and long version. Both involve placing
a monitor in the lowest level of your home for a certain number of days to keep track of radon levels. The tests can be performed
via a certified radon specialist or a home testing kit.
How
do I rid my home of radon?
There are a number of options. One
easy option is to have a qualified mitigator add a vent fan to an existing passive system for about $300; however some fixes
can run as high as $2500.
Make a commitment to
reduce your risk of developing lung cancer. Get your home inspected today. Learn more from the Citizen's Guide to Radon
published by the EPA, (environmental protection agency) at http://www.epa.gov/radon/pubs/citguide.html#howdoes
Several hours under the knife, a full week
of hospitalization, followed by weeks to months until full recovery seems daunting for just about anybody. Even more so, if
we are talking about Grandma or Grandpa having major surgery. Nevertheless, take heart. New studies show that the elderly,
specifically those in their 80’s, fared pretty well after open heart surgery. The data was presented at the American
Heart Conference in New Orleans last week. Dr.
Paul Kurlansky, research director at the Florida Heart Research Institute led a study of 1,062 octogenarians who had heart
bypass surgery at Mount Sinai Medical Center in Miami Beach from 1989 through 2001. His goal was not only to see if they could
make it through the operation but how they did after. Survival was almost the same as their age-matched counterparts who did
not have heart disease – roughly six years. Overall, 90 percent survived their surgery to leave the hospital. This improved
dramatically as the study went on, from 85 percent in the early years to 98 percent by its end.Even more impressive: 65 percent survived without surgery-related
complications and even more without long-term complications , a "very, very remarkable" result, Kurlansky said.
Patients also reported a quality of life similar to others their age that did not have bypass surgery. Kurlansky points out
that the actual age really doesn’t matter. "What we are really dealing with is chronological age versus physical
age," he said. If Grandma is otherwise doing well and living independently then "there's no reason to deny them
that." The second study involved surgery for leaky aortic valves. This study led by Donald Likosky, a researcher at Dartmouth
College in New Hampshire looked at 8,796 elderly people in Maine, New Hampshire, and Vermont. Median survival was seven years
– again about the same as the general population of that age without leaky aortic valves. Those 85 and older in the
study actually outlived their general-population counterparts. In contrast, the condition untreated can kill within two or
three years, and "surgery is their best option" for treatment per Dr. Likosky.
So does that mean we should start shipping grandma or grandpa to the operating room? Not
necessarily. It’s important to gauge your loved ones functionality to assess their ability to tolerate surgery and then
recovery. For example, do they get out of the house to do shopping or other activities or are they essentially house-bound.
If they are house-bound, can they get up and down the stairs with minimal difficulty or are they relegated to just one floor.
If Grandpa gets short of breath after climbing a set of stairs he may have some difficulty taking the deep breaths needed
to prevent pneumonia after surgery. Also, he may find it more difficult to get up and walking after surgery to prevent blood
clots from forming in the legs.
One
other thing to consider is that since rising health care costs are prompting earlier discharges from the hospital, there is
a good chance that Grandma might not be quite ready to go home after leaving the hospital. Chances are that she will need
to go to a rehabilitation facility for several weeks before heading home. Before surgery is the best time to plan for this
possibility. Give your insurance company a call to see how many days at a rehabilitation facility they will pay for. Also,
make arrangements to have someone check in on Grandma’s house or apartment every few days to water the plants or feed
the pets. If you have time, check out some rehabs in the neighborhood to get a sense of how convenient they are for nearby
relatives to visit. Some other things you might want to take a look at: is the place clean, the staff friendly, and do they
have adequate parking. If emergency surgery is called for, don’t fret. Get in touch with the hospital’s social
work department or case management department soon after surgery to discuss your options after surgery so that when the doctor
gives the okay for Grandma to be discharged everything is in order. One last thing to remember, even if Grandpa doesn’t
need to go to an inpatient rehab facility, every patient after open heart surgery benefits from outpatient cardiac rehab.
This can take place at a center three times a week or sometimes in-home. A recent article from October 2007 in the journal,
Circulation, by Dr. Jose
A. Suaya of Brandeis University found that only 31% of patients who had bypass surgery in 1997 participated in a cardiac rehab
program despite its known beneficial effects of lowering mortality. What is disconcerting about is that since 1982, Medicare,
the primary health insurer for people in the United States aged 65 years and older, has provided coverage for up to 3 weekly
outpatient CR sessions for 3 months after a heart attack, bypass surgery, or those with a history of angina if these sessions
are prescribed and supervised by a physician. Coverage for outpatient cardiac rehab was expanded in March 2006 to include
those who have had percutaneous revascularization procedures, heart valve surgery, and heart or heart-lung transplant. So
make sure Grandpa or Grandma get what they need and deserve.
We can get some comfort from these new studies showing that the elderly, specifically those
in their 80’s, do well with open heart surgery, but as with everything, being prepared and informed makes the real
difference.
