Microsoft word - anterior lumbar interbody fusion.doc

Anterior Lumbar Interbody Fusion is a surgical procedure where the spine is accessed through the abdomen and is typically combined with a posterior approach. The procedure begins with a 3 to 5 inch abdominal incision. The abdominal contents are enclosed in a large sack (peritoneum) which is moved to the side, allowing access to the spine. A portion of the degenerated disc is then removed and a bone graft, spacer, or cage is inserted into the disc space. The incision is then closed with sutures. Average length of the surgery is 2 hours to 4 hours depending on the Pre-operative testing and preparations
You will be advised, if possible, to donate at least 2 units of your own blood approximately 1 month prior to your surgery date. We will provide you with the information to schedule this appointment with the American Red Cross. Usually, only one unit is donated at a time, so it may take you two to three visits to the blood bank to acquire the necessary amount of blood. In some cases, family members with the same blood type may donate instead, which is called directed donor blood. If for some reason you or your family cannot donate blood, screened donor blood from the blood bank may be used. Prior to your surgery date, you will be required to undergo routine laboratory tests, EKG and a chest x-ray. If you are over 50 years of age or have any history of cardiac or pulmonary problems, you will also be required to have a clearance by a cardiologist or pulmonologist, respectively. You will also be given information on what medications, both prescription and over the counter, that need to be discontinued pre-operatively as many can interfere with wound healing and bleeding time. What to expect in the hospital post-operatively
You will wake up in the recovery room after the operation is over. During this time you may be disoriented and tired, which is the normal effects of the anesthesia wearing off. Once stable, you will be taken to your room where you may be greeted by friends and family. At this time your pain will be controlled by IV medications and have a catheter placed into your bladder to drain urine. Your incision will be covered by a sterile dressing which will stay in place for 2 to 3 days. It is important to begin moving as soon as possible to prevent blood clots and speed your recovery. The day after surgery you will be visited by a physical therapist that will assist you. It is important to use your brace while out of bed with any activities. Over the course of your hospital stay, you will gradually increase your activity as tolerated. Getting out of bed is also a very important step in helping your lung function return to normal. Areas of your lungs collapse during surgery and a couple of days post-operatively, which is known as “atelectasis”. Additionally, deep inspirations and the use of your “incentive spirometer” are essential. You may shower after day 2 in the hospital, but it is important to keep the incision dry for 5 days. The nurse will help you cover your wound to keep it dry or you may take a sponge bath. Patients typically stay in the hospital for 3 to 5 days. A nurse will provide a list of “do’s and don’ts” and arrange for home health or special accommodations if necessary. Before your discharge, you will be provided with a list of “do’s and don’ts” and arrangements will be Once you arrive home
Continue to walk with the use of aids and your brace. Slowly increase your activity level. Outpatient physical therapy will begin 6 to 8 weeks after surgery. You may shower, but do not soak in the bath or hot tub for 4 to 6 weeks. Once the dressing is removed and you are informed to keep it open to the air, make sure that you protect it from sun exposure. Once the incision is healed, sun screen should be on the incision for 6 months to one year. This will help decrease its appearance. Maintain a healthy diet, especially one that is high in dietary fiber to decrease constipation. Additionally, a diet rich in protein is ideal for the healing process. Drink plenty of fluids. Monitor your incision. It is common to have a small amount of blood and fluid leakage, however, if there is persistent drainage contact the office. Additionally, watch for opening of the incision, redness or warmth around the incision, or fever greater than 101ºF. No driving for 4 to 6 weeks or until advised. No heavy lifting (greater than 5 lbs) for 4-6 weeks. No bending at the waist or twisting the back. No jumping, running, or high-impact sports. After 2 months, appropriate exercises include: swimming, No golfing for a minimum of 3 to 4 months. Do not take anti-inflammatory medications (i.e. Ibuprofen, Voltaren, Aleve, Feldene, Lodine, Daypro, Naproxen, Naprosyn, Relafen, and Motrin) for 3 months after the surgery as this may inhibit bone fusion.
Smoking also interferes with bone fusion; therefore patients who smoke should make every attempt to stop smoking before surgery. If you need additional assistance, contact 1-800-NO-BUTTS for free information. 11190 Warner Avenue, Suite 310, Fountain Valley, CA 92708 | 714.979.2401


Microsoft word - laboratory exercise xiv micro.doc

Laboratory Exercise # 14: Antimicrobial Testing Purpose: The purpose of this exercise is to familiarize the student with the Kirby Bauer Disk Diffusion Method for testing antimicrobial sensitivities. Introduction: The testing of microbial sensitivity to antibiotics can be accomplished by several methods. In this exercise the Kirby Bauer Disk Diffusion method will be used. The

Microsoft word - cop med emerg final mar05.doc

New Zealand Code of Practice Medical Emergencies in Dental Practice Endorsed by DCNZ March 2005 CONTENTS CODE OF PRACTICE Introduction …………………………………………………………………… 3 Preparation for Emergencies ……………………………………………. 3-4 ……………………………………………………………

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