FWD: from jennifer smith / pd poorly managed perioperatively / webMD

[janet paterson <janet313@xxxxxxxxxxx>]

hi all

jennifer sent this to me
so i'm sending it to you

"perioperatively" - hmmm, that's a new one for me!

janet

>Date: Mon, 02 Aug 1999 19:50:54 -0400
>From: Jennifer Smith <artworks@xxxxxxx>
>Organization: Smoky Mountain Artworks
>To: janet313@xxxxxxxxxxx
>Subject: Hi Janet...
>
>Hi Janet,
>I sent the following to the list but I guess I can't do that as I am
>still temporarily off list.  I do check the list online once a day but I
>am sure I am missing out on some of the posts so if this is a repeat, I
>apologize for taking your time.  I thought the following might be of
>interest to the list and since I am unable to post it myself, I wonder
>if you would do it for me.  Hope all is well with you and I look forward
>to returning to the list.  Unfortunately I will be spending the month of
>september in california helping with the care of my elderly mother who
>is slated for some rather hairy surgery.  they are not computer savy and
>I dont habe a portabnle one so I hadnt figured on rejoining the list
>until I get bavck.  I miss you all vbery much.  thaks for your help.
>Jennifer Smith
>
>
>I noticed that WebMD is having a chat called
>"Understanding the Americans with Disability Act in Light of Recent
>Supreme Court Decisions" on Tuesday August 3 at 6:00 pm Pacific Time.
>The address is my.webmd.com.
>Also found this interesting article on the same site:
>Jennifer Smith
>
>-----------------------------------------------------
>Parkinson's disease poorly managed
>perioperatively
>
>VANCOUVER, Aug 02 (Reuters Health) -
>Patients with Parkinson's disease (PD) say that their disease is
>poorly managed in-hospital when they undergo surgery for other
>conditions, investigators reported here at the 13th International
>Congress on Parkinson's Disease.
>
>Dr. David Stewart and colleagues at the Victoria Infirmary in Glasgow,
>Scotland, analyzed the results of questionnaires completed by patients
>with PD who underwent operations for unrelated conditions. Patients'
>caregivers also filled out questionnaires.
>
>The investigators obtained data from 125 procedures (neurologic,
>ophthalmologic, orthopedic, urologic, and general surgery) undergone
>by 92 patients. Patients' mean age was 70.7 years, and the mean duration
>of PD was 8.6 years.
>
>Overall, patients and their caregivers said that they were unhappy with
>the way PD was managed after 31% of the operations. Problems with
>medication timing or omission after the operation were reported in 37
>(30%) of the operations.
>
>"A possible reason for the problems with medication timing or omission
>is that patients' overall functioning can vary greatly throughout the
>day, and a number of patients felt that the nurses could see that they
>were capable of doing things for themselves at some point in the day,"
>Dr. Stewart suggested. "What happens is that later on in the day when
>patients were perhaps incapable of doing things for themselves and asked
>the nurses for help, the nurses were sometimes suspicious and hesitant
>to assist."
>
>Of the 37 operations in which patients and caregivers cited problems with
>drug timing or omission, 31 cases (84%) resulted in PD complications
>compared with 32 of the 88 (36%) procedures in which no problems were
>reported with drug administration.
>
>Dr. Stewart said he is currently working on guidelines that will help
>surgeons, anesthesiologists, and nurses on the perioperative management
>of PD.
>
>Elsewhere at the meeting, a group from the University of British Columbia,
>in Vancouver, reported the results of a study of patients with PD who were
>selected for unilateral pallidotomy based on their motor symptoms. The
>study showed that the procedure significantly decreases PD-related pain.
>
>Overall, 42% of 50 patients described pain related to PD prior to
>pallidotomy. Preoperative scores for pain were significantly reduced at
>both 6 weeks and 1 year following pallidotomy.
>
>The investigators identified four primary types of PD-related pain: somatic
>pain exacerbated by the disease, musculoskeletal pain, pain associated
>with dystonic movements, and dysesthetic pain. A few patients had more
>than one type of pain. Exacerbations of somatic pain and musculoskeletal
>pain responded to treatment more than dystonic and dysesthetic pain.
>
>Study leader Dr. C. R. Honey said that 15% to 46% of PD patients have
>pain attributable to their disease.
>
>-Westport Newsroom 203 319 2700

janet paterson
52 now / 41 dx / 37 onset
snail-mail: PO Box 171  Almonte  Ontario  K0A 1A0  Canada
website: a new voice <>
e-mail: <janet313@xxxxxxxxxxx>