A Day At The Doctor's Office

Do you ever wonder when you go to the doctor each time the receptionist ask you for your insurance card? I sure do. I went to the same doctor for 10 years seems they would know me by now or have made a copy of my insurance card. Have you ever read the sign that says payment due when services rendered, just to hear the lady ask you for your co-payment before you've even had the chance to sit down? Or how about after sitting for a long time in the waiting room, they call you back just to take your blood pressure than send you back out in the waiting room again. Or they call you back just to have you wait in another area.

I have always felt this was a tactic to make you feel like your getting somewhere when your really not. How about while waiting, your Doctor happens to see you, and he does all he can do not to make eye contact with you, or if you do they act like your a perfect stranger. How about that study I heard where the average time actually spent with the doctor is about three minutes. I then have to ask myself the question, why am I waiting so long in the waiting room. Or how about the one when the pharmaceutical rep just walks in asking for the Doctor and they tell them to come on back. I guess those free game tickets, or the free day at the spa is really more important than my health. These are just some of the mysteries I have never figured out when going to the doctor.

Those days are history. Knowing what medications I need each month, knowing already my diagnosis, obtaining prescription medications online is the wave of the future. If I need to get my pain medication, I have a consultation with a U.S Physician. I receive a 90 day supply of pain medication. You get the initial scipt filled, plus two refills which can be filled on the 25th day. Same goes for my treatment of my anxiety. All medications are written by U.S Physicians and filled by U.S. Pharmacies. Such medications as Hydrocodone, Vicodin, Lortab, Xanax are available. When receiving other non controlled medicatons for my migraine headaches, high cholestoral, ocassional depression, and a few other meds, I receive a free conslultation from a U.S. Physician and filled again by a U.S. Pharmacy.

These medications are shipped usually by overnight delivery. With this type of service available, more and more people are turning to the internet for their medication needs. Why wait hours in a doctors office, why pay the outrageous office visit fees, why feel treated like a number and not a person, when you can get the meds you need delivered to your door at a great low price. With so many people losing their healthcare benefits, losing their insurance, more people will be getting their medication online. So days at the doctors office to get your prescriptions are numbered. I hope this article has given you


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A Cure for Near Sightedness - Radial Keratotomy

Radial keratotomy (RK) is a refractive surgical procedure employed to correct myopia or nearsightedness. Radial Keratotomy came into existence by accident rather than through meticulous research. The procedure was discovered by Dr. Svyatoslav Fyodorov when he operated one of his patients who had met with a bicycle accident. The boy wore eyeglasses, which broke on impact, and the glass splinters lodged into his eyes. The doctor had to make several radial incisions in the corneal tissue in order to extract the glass. When the cornea healed, the doctor found that the boy’s eyesight was significantly improved.

In radial keratotomy (RK), a series of micro-fine incisions are made in the outer portion of the cornea with the aid of a high-precision calibrated diamond knife. The surgeon administers a local anesthetic, since the incisions are superficial and the procedure is fairly painless. The corneal thickness of the patient’s eye is measured prior to the surgery. Before the incisions are made, the diamond-edged cutting instrument is precisely set under the operating microscope. Thus by flattening the curvature of the cornea in such a manner, RK can easily correct myopia or nearsightedness.

Radial keratotomy was first introduced in the United States in the 1980s. Initially it was much of an investigational procedure, with doctors operating only one eye at a time and waiting for at least 3 months to observe the results, before operating on the other eye. But the surgeons gained experience over time and now they could well operate both eyes simultaneously. Now, radial keratotomy is a minor surgery that takes about 15 to 20 minutes for each eye.

Radial keratotomy is constantly improving, owing much to the rapid advances in technology, and the fact that a number of such procedures have already been performed successfully. However, RK is not as precise as LASIK and PRK. Since, RK is less predictable, only a few surgeons now perform this procedure.


Tags: lasik, laser eye surgery, eye surgery, lasek, eye, vision

A Brief Ovierview Of Lasik Eye Surgery

LASIK, an acronym for Laser-assisted In Situ Keratomileusis, is a form of refractive laser eye surgery procedure performed by ophthalmologists intended for correcting vision. The procedure is usually a preferred alternative to photorefractive keratectomy, PRK, as it requires less time for full recovery, and the patient experiences less pain overall.

The LASIK technique was made possible by Dr Jose Barraquer (Colombia), who around 1960 developed the first microkeratome, used to cut thin flaps in the cornea and alter its shape, in a procedure called keratomileusis. This procedure was developed and pioneered by the world leading Barraquer Clinic, based in Bogota, Colombia.

LASIK surgery was developed in 1990 by Dr. Lucio Buratto (Italy) and Dr. Ioannis Pallikaris (Greece) as a melding of two prior techniques, keratomileusis and photorefractive keratectomy. It quickly became popular because of its greater precision and lower frequency of complications in comparison with these former two techniques.

In 1991, LASIK was performed for the first time in the United States by Drs. Stephen Brint and Stephen Slade. The same year, Drs. Thomas and Tobias Neuhann successfully treated the first German LASIK patients with an automated microkeratome.

Patients wearing soft contact lenses typically are instructed to stop wearing them approximately 7 to 10 days before surgery. One industry body recommends that patients wearing hard contact lenses should stop wearing them for a minimum of six weeks plus another six weeks for every three years the hard contacts had been worn.

Before the surgery, the surfaces of the patient's corneas are examined with a computer-controlled scanning device to determine their exact shape. Using low-power lasers, it creates a topographic map of the cornea.

This process also detects astigmatism and other irregularities in the shape of the cornea. Using this information, the surgeon calculates the amount and locations of corneal tissue to be removed during the operation. The patient typically is prescribed an antibiotic to start taking beforehand, to minimize the risk of infection after the procedure.

The operation is performed with the patient awake and mobile; however, the patient typically is given a mild sedative (such as Valium or diazepam) and anesthetic eye drops.

Lasik is performed in two steps. The initial step is to create a flap of corneal tissue. This process is achieved with a mechanical microkeratome using a metal blade, or a femtosecond laser microkeratome that creates a series of tiny closely arranged bubbles within the cornea. A hinge is left at one end of this flap. The flap is folded back, revealing the stroma, the middle section of the cornea. The process of lifting and folding back the flap can be uncomfortable.

The second step of the procedure is to use an excimer laser (193 nm) to remodel the corneal stroma. The laser vaporizes tissue in a finely controlled manner without damaging adjacent stroma by releasing the molecular bonds that hold the cells together. No burning with heat or actual cutting is required to ablate the tissue. The layers of tissue removed are tens of micrometers thick.

During the second step, the patient's vision will become very blurry once the flap is lifted. He or she will be able to see only white light surrounding the orange light of the laser. This can be disorienting.

Currently manufactured excimer lasers use a computer system that tracks the patient's eye position up to 4,000 times per second, redirecting laser pulses for precise placement. After the laser has reshaped the cornea, the Lasik flap is repositioned over the treatment area by the surgeon. The flap remains in position by natural adhesion until healing is completed.

Performing the laser ablation in the deeper corneal stroma typically provides for more rapid visual recovery and less pain.


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A Brief History Of Hip Replacement Surgery

Hip replacement is a medical procedure in which the hip joint is replaced by a synthetic implant. It is the most successful, cheapest and safest form of joint replacement surgery. The earliest recorded attempts at hip replacement, which were carried out in Germany, used ivory to replace the femoral head.
Use of artificial hips became more widespread in the 1930s; the artificial joints were made of steel or chrome. They were considered to be better than arthritis but had a number of drawbacks. The main problem was that the articulating surfaces could not be lubricated by the body, leading to wear and loosening and hence the need to replace the joint again (known as revision operations).

Attempts to use teflon produced joints that caused osteolysis and wore out within two years. Another significant problem was infection. Before the advent of antibiotics, surgery on the joints carried a high risk of infection. Even with antibiotic treatments, infection is still a cause for some revision operations. Such infections are not necessarily caused at surgery; they can also be the result of bacteria entering the bloodstream during dental treatment.

The modern artificial joint owes much to the work of John Charnley at the Manchester Royal Infirmary; his work in the field of tribology resulted in a design that completely replaced the other designs by the 1970s. Charnley's design consisted of 3 parts – (1) a metal (originally Stainless Steel) femoral component, (2) an Ultra high molecular weight polyethylene acetabular component, both of which were fixed to the bone using (3) special bone cement. The replacement joint, which was known as the Low Friction Arthroplasty, was lubricated with synovial fluid.

The small femoral head (22.25mm) produced wear issues which made it suitable only for sedentary patients, but - on the plus side - a huge reduction in resulting friction led to excellent clinical results. For over two decades, the Charnley Low Friction Arthroplasty design was the most used system in the world, far surpassing the other available options (like McKee and Ring).

In 1960 a Burmese orthopaedic surgeon, Dr. San Baw (29 June 1922 – 7 December 1984), pioneered the use of ivory hip prostheses to replace ununited fractures of the neck of femur ('hip bones'), when he first used an ivory prosthesis to replace the fractured hip bone of an 83 year old Burmese Buddhist nun, Daw Punya. This was done while Dr San Baw was the chief of orthopeadic surgery at Mandalay General Hospital in Manadalay, Burma. Dr San Baw used over 300 ivory hip replacements from the 1960s to 1980s.

He presented a paper entitled 'Ivory hip replacements for ununited fractures of the neck of femur' at the conference of the British Orthopeadic Association held in London in September 1969. An 88% success rate was discerned in that Dr San Baw's patients ranging from the ages of 24 to 87 were able to walk, squat, ride the bicycle and play football a few weeks after their fractured hip bones were replaced with ivory prostheses. Dr San Baw's use of ivory was, at least in Burma during the 1960s, 1970s and 1980s (before the illicit ivory trade became rampant starting around the early 1990s) cheaper than metal. Moreover, due to the physical, mechanical, chemical, and biological qualities of ivory, it was found that there was a better 'biological bonding' of ivory with the human tissues nearby the ivory prostheses. An extract from Dr San Baw's paper, which he presented at the British Orthopeadic Association's Conference in 1969, is published in Journal of Bone and Joint Surgery (British edition), February 1970.

In the last decade, several evolutionary improvements have been made in the total hip replacement procedure and prosthesis. Many hip implants are made of a ceramic material rather than polyethylene, which some research indicates dramatically reduces joint wear. Metal-on-metal implants are also gaining popularity. Some implants are joined without cement; the prosthesis is given a porous texture into which bone grows. This has been shown to reduce the need for revision of the acetabular component. Surgeons still frequently use bone cement for the femoral component, however, which has proven very successful after 35 years of clinical experience.

The latest developments are several competing Minimally Invasive Surgery (MIS) approaches, which may result in far less soft tissue damage and a quicker recovery. C.A.O.S (Computer assisted orthopedic surgery) is also being marketed heavily by the implant manufacturers, though its value remains largely unproven.. Computer assisted surgery is said to better navigate prosthetic implantation.

An alternative to total hip replacement (THR) is hip surface replacement (HSR), also referred to as hip resurfacing. With both THR and HSR, a prosthetic socket is pressed into the pelvis. With THR, the end of the femur is amputated, a metal shank is inserted into the femur, and the shank holds a ball which mates with the socket. With resurfacing, the end of the femur is not amputated; the outer surface of the femoral ball is replaced with a cylindrical metal cap. Resurfacing eliminates the common THR problem of the metal shaft loosening from the femur. Resurfacing preserves bone stock if a revision is ever needed. A larger diameter ball and socket more closely mimic the natural joint structure, reducing the risk of dislocation and improving range of motion. There has been no published clinical evidence to show that today’s CoCr metal-on-metal articulating surfaces have the osteolytic effect on bone that earlier polyethylene devices had. Ten year success rates of hip resurfacing from studies in England report success equal to or greater than standard total hip replacement, in age-matched patients. In the United States, the first modern resurfacing device received FDA approval in May 2006, while some 90,000 resurfacings have been performed world-wide.

Patients need to be aware of all surgical options before hip replacement surgery. Hip surgeons have different surgical techniques and surgical outcomes. Currently, there are several different incisions used to access your hip joint. The posterior approach (widely used by the majority of orthopedic surgeons) separates the gluteus maximus muscle in line with the muscle fibers to access the hip joint. Other methods access the hip from the lateral side of the hip joint. In contrast to the posterior approach and lateral approach, the anterior approach uses a natural interval between soft tissue to gain access to the hip joint. Its main disadvantages are that it risks damage to the lateral femoral cutaneous nerve, and it is not widely available to the public because fewer surgeons have been trained in this technique.

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A Brief History of Anesthetics

Anesthetics have been used for thousands of years. In fact, the first recorded use of anesthetics was actually in the 'pre-history' era, an era of human history predating written text. Early Uses of Herbal Anesthetics In the pre-history era, anesthetics were herbal in nature. Opium poppies are known to have been harvested as early as 4200 BC, and these plants were farmed first in the Sumerian Empire. The first recorded uses of anesthetics containing opium preparations was in 1500 BC, and by 1100 BC, civilizations in Cyprus and other locations were farming and harvesting the plants. Opium poppies were introduced to India and China in 330 BC and 600 to 1200 AD, respectively. Other types of herbal anesthetics were in use in China during this era as well. In the second century, the Chinese physician Hua Tuo is known to have used an anesthetic derived from cannabis to perform abdominal surgery. In Europe, Asia, and the Americas, several other 'solanum' plant species were used as anesthetics, including mandrake, henbane, and several datura species. Each of these contains a potent tropane alkaloid. In the classical Greek and Roman eras, prominent figures such as Hippocrates and Pliny the Elder noted the uses of opium and solanum-containing plants. In the Americas, the leaves of the coca plant (from which cocaine is derived) were an often-used anesthetic. This was applied by Incan shamans who would chew coca leaves and then spit the leaves into wounds to administer a local anesthetic. Herbal anesthetics of these types were widely used for several centuries; however they were not without drawbacks. One of the main problems with the use of herbal anesthetics was in administering the right dosage-too little would have no effect, and too much often killed the patient. Standardization of anesthetics was difficult, but was achieved to a certain degree prior to the nineteenth century by categorizing anesthetics according to the location in which anesthetic plants were grown. The Discovery of Morphine In 1804, a German pharmacist named Friedrich Wilhelm extracted morphine from the opium poppy, and named the compound 'morphium', for the Greek god of sleep and dreams. However, morphine was not widely used for nearly fifty years. In 1853, the hypodermic needle was developed, and thanks to this new method of administration, the use of morphine increased substantially. Morphine was then widely used as an anesthetic. In 1874, a morphine derivative called diacetylmorphine-commonly known as heroin-was developed. Nearly twice as potent as morphine, heroin was marketed for a short time by Bayer, starting in 1898. However, it was just 16 years later in 1914 that the possession of morphine, heroin, and cocaine without a prescription was outlawed in the US due to the highly addictive nature of these substances. Development of Inhalant Anesthetics Oral and inhalant anesthetics were utilized historically by Muslim anesthesiologists, and the use of these preparations was well known in the Islamic Empire. Several hundred surgical operations were performed which used sponges soaked in narcotic preparations, placed over the face of the individual undergoing surgery. In the Western world, the development of inhalant anesthetics, along with the use of sterile surgical techniques developed by Joseph Lister, was one of the main keys to performing successful surgery in the nineteenth century. During the nineteenth century, both carbon dioxide and nitrous oxide were used in experimental surgical procedures. While the use of carbon dioxide as an anesthetic never became popular, nitrous oxide did in fact become very widely used. The anesthetic properties of nitrous oxide were first noted by Humphry Davy, a British chemist, in a paper published in 1800. However, it was not until several decades later in the 1840s that nitrous oxide became more widely used. One of the first successful uses of the gas for painless tooth extraction was carried out by American dentist William Thomas Green Morton, in 1846. During the same decade, an inhalant anesthetic called diethyl ether was also used for tooth extraction. Diethyl ether was originally synthesized by German physician Valerius Cordus in 1540; however it was not until the 1840s that the first public demonstration of the use of ether occurred. A decade earlier, in the 1830s, chloroform had also been developed. This became more popular in Britain, but even so the dangers of both ether and chloroform were well-noted. Modern Anesthetics Modern anesthetics are of two types: general and local anesthetics. Local anesthetics include substances such as lidocaine and procaine. These work by preventing transmission of nerve impulses in the area where the anesthetic is administered. General anesthetics, on the other hand, are more similar in nature to nitrous oxide in their method of delivery, and in fact this inhalant anesthetic is still in use. Inhalation anesthetics are usually fluorochemicals (isoflurane, sevoflurane and desflurane) that have much lower flammability than diethyl ether, thus they are much safer to use in the operating room.

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26 percent of Americans use the Web to search p. drugs

While 26 percent of Americans has used a Search Engine for finding drug information online, still only a few are venturing into the online prescription drug marketplace.

The prescription drug market is enormous and includes millions of Americans who go online to get information about the medicines they consume.

According to the new Pew Internet & American Life Project "Prescription Drugs Online" report, 64% of American households contain a regular user of prescription drugs, and one in four Americans (26%) has used the Internet to look for information about prescription drugs.

However, just 4% of Americans have purchased prescription drugs online, because, simply, most Americans do not fully trust the online prescription drug marketplace.

While 62% of Americans think purchasing prescription drugs online is less safe than purchasing them at a local pharmacy, only 20% think online purchases are as safe as local purchases. The remaining 18% responded that they did not know or that it depends on the situation.

In fact, even though one in five said online drug purchases are safe, only a fraction have ever bought prescription drugs online. The survey found a mere 4% of Americans have ever actually purchased prescription drugs on the Internet. To put that in actual numbers, of the 2,200 American adults surveyed just 93 people said they had purchased prescription drugs online.

When it comes to why people purchase drugs online, even though the sample size was small, Americans who have ordered prescription drugs online cited convenience and cost savings as the main reasons why they decided to take the leap. Privacy was the least likely factor of the choices offered in the survey.

When asked about the last time they purchased prescription drugs online, the majority of Rx purchasers said they visited a site that was based in the United States, and only a few visited a site based in another country. In addition:

-- Three-quarters of Rx purchasers said the last time they purchased prescription drugs online, they bought a drug for a chronic medical condition such as high blood pressure or arthritis.

-- One-quarter said their last purchase at an online pharmacy was to aid weight loss or sexual performance.

-- Most were satisfied with their last contact with an online pharmacy and plan to order prescription drugs online in the future.

All in all, the survey was upbeat about the future of the online drug market, stating that "Ignorance and mistrust of the online prescription drug market may be dispelled by further research and good experiences," and indicating that many Americans may soon change their minds about the safety of online prescription drug purchases.

Drawing an analogy to the growth in another large online category, the report stated: "[Prescription drug purchasers] who research a product online often become customers.

Convenience is the number one reason why banking became the fastest-growing activity between 2000 and 2002 — and it is the main reason why current Rx purchasers made the switch from offline to online ordering."


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