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I think the 2nd look surgery is pretty much the norm. I found out

about it from this site after my daughter's 1st surgery to repair a

tear in her eardrum (ctoma was found unexpectedly during that

surgery so I wanted to learn more about ctomas). Her surgeon didn't

mention a 2nd look surgery until I started asking questions about

it. I do think that once the surgeon realized that I was informing

myself with information he was a lot more forthcoming with

information.

Candy

> I'm reading a lot of post of people mentioning a " second look "

> procedure. Does everyone have this or does it depend on where the

c-

> toma was before they removed it, how extensive it was, etc.? I go

> back back for my 2nd follow up on Monday so hopefully if they feel

> this is necessary they will tell me then but I'm curious now that

> I've been reading it so much, especially these past few days.

>

> Thanks.

>

>

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A second look can be as simple as a CT-Scan. Our ENT schedules our daughter for CT's every 6-8 months. Once we get to 2 consecutive scans without a c-toma, we'll have longer intervals between scans.-----Original Message-----From: luvnmomangela Sent: Sep 16, 2003 8:11 PMcholesteatoma Subject: QuestionI'm reading a lot of post of people mentioning a "second look" procedure. Does everyone have this or does it depend on where the c-toma was before they removed it, how extensive it was, etc.? I go back back for my 2nd follow up on Monday so hopefully if they feel this is necessary they will tell me then but I'm curious now that I've been reading it so much, especially these past few days.Thanks.

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Tim,

I hope all goes well with your surgery this friday. I have had a lap and an open procedure. The lap made my A worse...but i had a surgeon that didn't know exactly what he was doing. Thats the reason I had to have the open procedure done. I had that done an the Cleveland Clinic. I go this next Teusday for my one yr check up. I still have a little trouble with breads and tough meats...but thankfully my procedure has worked so far. It was a long recovery though...months of nothing but mushy stuff. My open procedure consisted of removing part of my E and part of my stomach....it was no picnic. But now that i'm healed and doing well....I would go through it all again...just for the last year that I've had with hardly any symptoms. I wish the procedures worked for everyone..but they don't. We are all different and heal in different ways. Good luck and take it slow.

In Indiana

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In a message dated 9/23/2003 4:53:41 PM Central America Standard Tim, nurikochan02@... writes:

what are some of things that you guyz ate after your myotomoys were

through and recovery was finished?

, you wrote the above. I interpreted this to mean

after you were completely healed from the Myotomy. Others

seem to interpret it to mean immediately after surgery.

Would you please clarify.

Maggie

Alabama

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, from what I've seen some people can eat everything, some people can't eat everything but can eat almost everything, and some people are still on soups and such. (I've not yet had surgery, so I'm only recounting what I've read on this site over the past year.)

Keep in mind that the surgery is just to open the LES muscle -- if you have abnormal peristalsis before the surgery, you're still going to have abnormal peristalsis after the surgery. Most people find that because of this lack of peristalsis, they still need to chew their food very very well, and then still use lots of water to "wash it down" when they eat.

Hope this helps!Debbi in Michigan

what are some of things that you guyz ate after your myotomoys were through and recovery was finished?

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My sincere apologies, . I re-read 's question and I don't know how I missed ... and recovery was finished. I'm terribly sorry.

Thank You, Maggie, for pointing this out.

All the best,

-- Re: QUESTION

In a message dated 9/23/2003 4:53:41 PM Central America Standard Tim, nurikochan02@... writes:

what are some of things that you guyz ate after your myotomoys were through and recovery was finished?, you wrote the above. I interpreted this to meanafter you were completely healed from the Myotomy. Othersseem to interpret it to mean immediately after surgery.Would you please clarify.MaggieAlabama

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  • 3 weeks later...

Diane, as I understand it, revision surgery often involves osteotomies, so yes,

this would be considered revision surgery. Revision is pretty much a general

term, and there are a variety of approaches, depending on the individual case

and the surgeon's preference.

I'm sorry to hear your first 7 back operations weren't sufficient and now you're

facing an eighth. I find even the prospect of a second one daunting.

I wish you the best for whatever you decide.

Sharon in Southern New Hampshire

Congenital scoliosis w/ spina bifida and other vertebral anomalies

1971 Harrington rod fusion, T5-L4, flatback, L5-S1 degeneration, etc.

QUESTION

I am fairly new to the group and have a question I need answered. I

have seen 2 drs who are Revision Specalists and was told by both that I

had FlatBack Syndrome with a Plumb Line of 10cm & that I needed an

Osteotomy from L1 to S1. Is an Osteotomy the same thing as Revision

Surgery???? I cannot find the answer to this question with all the

research I have done.

Does anyone know?

Yoli, I have been praying for your daughter & was very glad to read that

she was doing well, I envy her that she had the courage to go through

it. I am 56 now & after 9 major surgeries, 7 for my back, I am really

hesitant about having the surgery they tell me I need.

Beth, hope you are doing ok & thanks again for the information.

Love To All,

Diane B.

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Osteotomies are the areas where bone is removed from the old fusion mass

(usually in wedges) in order to regain motion at certain levels. Once there is

motion, the surgeon can re-align the spine; in simpliest terms (which was how it

was explained to me and made the most sense!), by creating areas of motion where

there was only fusion mass before they can pull the spinal column backwards to

created a more balanced sagital plane; then by bending rods to create either

lordosis (in the case of a thoracolumbar or lumbar fusion) or kyphosis (where

there was a thoracic fusion) they can eliminate the appearance of a flattened

spine. Once everything looks good on an x-rays taken during surgery, they use

pedicle screws at the levels to be re-fused and usually use cadaver bone to

create a new fusion. The main reason cadaver bone is used is because in the case

of Flatback due to previous scoliosis fusion, either one or both posterior

illiac crests have already been used as donor bone sites.

Best to all,

Beth

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Of course sometimes they also go in through the front or side (in order to fuse

the anterior portion of the spine), and then they remove a rib and use that for

the needed bone grafts. Sounds like great fun, eh?!

Re: QUESTION

Osteotomies are the areas where bone is removed from the old fusion mass

(usually in wedges) in order to regain motion at certain levels. Once there is

motion, the surgeon can re-align the spine; in simpliest terms (which was how it

was explained to me and made the most sense!), by creating areas of motion where

there was only fusion mass before they can pull the spinal column backwards to

created a more balanced sagital plane; then by bending rods to create either

lordosis (in the case of a thoracolumbar or lumbar fusion) or kyphosis (where

there was a thoracic fusion) they can eliminate the appearance of a flattened

spine. Once everything looks good on an x-rays taken during surgery, they use

pedicle screws at the levels to be re-fused and usually use cadaver bone to

create a new fusion. The main reason cadaver bone is used is because in the case

of Flatback due to previous scoliosis fusion, either one or both posterior

illiac crests have already been used as donor bone sites.

Best to all,

Beth

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I don't know, but I have an acne problem anyway. I have noticed

some extra breaking out, but I'm also on Depo and that causes me to

break out too. So I can't really say for sure.

> Does Lexapro cause break outs?

>

>

>

>

>

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  • 3 weeks later...
  • 3 weeks later...

Dear Has 2,

1. First we need to kne the total Rx in strength(mg) then convert to

volume of liquid (ml).

2. Then 1 tab of 250mg x 4 times a day x 10 days = 40 tabs of 250mg

for a total of 10,000 mg.

3. Now solve for the total volume of suspension:

Av = Rx

250mg/5ml = 10000mg/X ml

or

250mg ……………10,000 mg

------- = ----------

5ml…………………………Xml

Cross multiply:

5 x 10,000 / 250 = 200ml

Another way of looking at it is this:

1. Because 1 tab = 250 mg you need 40 tabs (see step 2 above).

2. And since 5 ml = 250mg, then 1 tab is equal to 5ml.

So 40 x 5 = 200ml.

FYI: By the way 5ml = 1 teaspoonsful.

So instead of the pt taking 40 tablets over a period of 10 days the

patient will take 40 teaspoonsful over a period of ten days.

I think you had your ration and proportion upside down. But I am

sure you will figure out what you did wrong after seeing the correct

way.

Hope that this helops you out,

Respectfully,

Jeanetta Mastron CPhT BSChem

Pharm Tech Educator

Founder/Owner of this site

> Hi I'm studying for the cert test in march 04. I need help

setting

> up a math problem. Here it is. A prescription is written for

> penicilin vk 250mg tabs po qid for 10 days. if the patient cannot

> swallow tablets and requests a liquid dosage form, what volume of

> 250mg/5ml suspension should be dispensed for a 10 day supply.

>

> I come up with 500 but the answer is 200ml. what am i doing

wrong.

> I divide 5/250 then x's by 10.

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Hi All-

Karin brings up a really good point---we all learn/process info in

different ways. What may seem like a simple method of calculating a

problem for one person, can be a nightmare for another. If you are

stuggling with a particilar problem or process (either learning it or

teaching it) take a step back and try another way.

That's the wonderful thing about this site---I have found so many new

ways to tackle old problems in just about every area of my job. I am

constantly learning from all of you---that includes all you PTCB

candidates as well. Thank you all.

Sincerely,

Dora

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thanks for explaining the question for me!

> > Hi I'm studying for the cert test in march 04. I need help

> setting

> > up a math problem. Here it is. A prescription is written for

> > penicilin vk 250mg tabs po qid for 10 days. if the patient

cannot

> > swallow tablets and requests a liquid dosage form, what volume

of

> > 250mg/5ml suspension should be dispensed for a 10 day supply.

> >

> > I come up with 500 but the answer is 200ml. what am i doing

> wrong.

> > I divide 5/250 then x's by 10.

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Dear Has,

You are Most Welcome!

Jeanetta

> >

> > Dear Has 2,

> >

> > 1. First we need to kne the total Rx in strength(mg) then convert

> to

> > volume of liquid (ml).

> > 2. Then 1 tab of 250mg x 4 times a day x 10 days = 40 tabs of

> 250mg

> > for a total of 10,000 mg.

> > 3. Now solve for the total volume of suspension:

> >

> > This message was trunkated by Jeanetta as a courtesy

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Has2B,

Let me see if I can lay this out in type so that you can see it better (you

are really almost there) -

1/150 gramin = X mcg (microgram)

1 grain = 65 mg

you layed out the problem:

1/150 gr = 1 gr

x (mg) 65 mg

which gives you x = 0.433 mg (milligrams)

note: always leave the zero in front of a decimal - it will help avoid errors

0.433 mg x 1000 mcg/mg = 433 mcg (or move the decimal point 3 places to the

right)

Ususally dosing is rounded to the closest whole number

So - partial answer to your question - your conversion to mcg was off by a

factor of 10 (you multiplied by 100 not 1000. (or moved the decimal point 2

places instead of 3).

Hope this helps,

Anne P LaVance, BS, CPhT

Instructor

Pharmacy Technician Program

Delgado Community College

New Orleans, LA

TEXTPERT

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Call me a geek but I get kind of excited looking at these problems

and how you guys solve them. I have no clue what they mean or how to

do them. I can't wait to learn about all this. Maybe one day I'll be

helping someone solve a problem here! :)

> Has2B,

>

> Let me see if I can lay this out in type so that you can see it

better (you

> are really almost there) -

>

> 1/150 gramin = X mcg (microgram)

> 1 grain = 65 mg

>

> you layed out the problem:

> 1/150 gr = 1 gr

> x (mg) 65 mg

>

> which gives you x = 0.433 mg (milligrams)

> note: always leave the zero in front of a decimal - it will help

avoid errors

> 0.433 mg x 1000 mcg/mg = 433 mcg (or move the decimal point 3

places to the

> right)

> Ususally dosing is rounded to the closest whole number

>

> So - partial answer to your question - your conversion to mcg was

off by a

> factor of 10 (you multiplied by 100 not 1000. (or moved the decimal

point 2

> places instead of 3).

>

> Hope this helps,

>

> Anne P LaVance, BS, CPhT

> Instructor

> Pharmacy Technician Program

> Delgado Community College

> New Orleans, LA

>

> TEXTPERT

>

>

>

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  • 3 weeks later...

Janet,

I get the same answer you do. Occasionally there is a typo in the answer

keys. Which means they may have hit the " 7 " instead of the " 9 " .

Anne P LaVance, BS, CPhT

Instructor

Pharmacy Technician Program

Delgado Community College

New Orleans, LA

TEXTPERT

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That would probably be best answered by a doctor. below is a site

where you can read a little about each and various patient reactions

to each.

http://www.remedyfind.com/hc-Depression.asp

I will tell you that each of us will react differently to different

drugs/doses....unfortunately the only way is to try and listen to

your doctor!

regards

jeff

> What the differance between lexapro and effexor? I have not

started a Anti Depressent yet but will soon. I was on wellbutrin

but didnt work. Mike http://www.nacps.us

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Lexapro has been GREAT for me!!! I had barely any sides at all. It's

really been a major help. I've heard Effexor is a rough AD.

Crystal

What the differance between lexapro and effexor? I have not started a Anti

Depressent yet but will soon. I was on wellbutrin but didnt work. Mike

http://www.nacps.us

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Dear Janet,

This problem can be solved by an equation or by an allegation. I

will show you the equation now on post, but I suggest that you use

the Tutorials on allegations to get the answer also. Allegations

can be used whenever in doubt for dilution of a strong solution with

water OR dilution of a stronger soluition with a weaker one. They

are easy and you do not have to differentiate bewtween the two

typesof problems. The equation can oNLY be used if you are diluting

with water.

Hint: in this problem it askds for the volume of D50W to be used,

yet it gives you the amount or volume that you have on hand or in

stock as 1000ml. A) Most pharmacies would not be limited to 1000ml

(1 liter)of D50W on hand B) You are calculating the volume of or

amount of D50W you will need so it may or may not be 1000ml

Therefore the 1000ml is NOT part of the equation or allegation set

up.

Try the equation first:

C = concentration in percent or %

V = Volume in ml

it is understood that C1 is multiplied by V2

C1V1= C2V2

OR

C1 x V1 = C2 x V2

Desired Medication = Med on Hand

Rx = Stock

25% x 500ml = 50% x V2

25% x 500ml......50% x V2

-----------.. =..--------

50%..............50%

250ml = V2

Add 250ml of a 50% Dextrose solution and QSAD to 500ml .

Want to know the exact amount of water?

500ml of D25W - 250ml D50W = X ml of Water

250 ml of Water

Answer: Use 250ml D50W and 250ml of H20

Lets Try another one

If a MD orders 15% Dextrose 500ml and you have 70% dextrose 5L, how

much 70% dextrose and how much water do you need?

C1 x V1 = C2 x V2

15% x 500ml = 70% x V2

15% x 500ml.....70% x V2

-----------..=..----------

70%.............70%

107.14 ml = V2

500ml D15W - 107.14ml of D70W = 392.86 ml Water

Answer: Use 107.14ml of D70W and 392.86ml of H20

May also be written as: Use 107 ml of D70W and 393ml of H20

May also be written as: Use 107 ml of D70W and QSAD 500ml H20

I hope this helps you.

Allegation for your problem:

50...........25/50 x 500ml use 250 ml D50W

...................

........25

...................

0............25/50 x 500ml use 250 ml Water

Allegation for my problem:

70...........15/70 x 500ml use 107.14 ml D50W

...................

........15

...................

0............55/70 x 500ml use 392.86 ml Water

Above is copyrighted by Jeanetta Mastron 12-28-03

I hope that this helps you out Janet.

If you still have any questions regarding solving this problem,

anything else feel free to post/ask again. If you have a question

about these allegations, please try the tutorials first and then

post further questions.

Let me know if this helped you,

Jeanetta Mastron CPhT BSChem

Pharm Tech Educator

Founder/Owner

> Hello all,

> I understand this problem by sight but actually setting up this

problem is more challenging to me. The problem comes from APHA

Pharmacy Technician Workbook and Certification Review.

>

> If a MD orders 25% Dextrose 500ml and you have 50% dextrose

1000ml, how much 50% dextrose and how much water do you need?

>

> Thanks,

> Janet

>

>

>

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  • 3 weeks later...

~ ~ I honestly don't know, I have been on the South Beach

Diet now for 2 months and have tried to eliminate all sugar and fruit

and it is really hard. I just got a report back from my

endocrinologist that I have Hashimoto's thyroiditis and that may also

be contributing to my slowed metabolism. It could be a combination

of the two.

Dana Rose

> Oh that's encouraging. LOL Is it because of the Lexapro though?

>

>

>

> ~ ~ I am on Lexapro and trying to stick to the South Beach

> diet and failing, LOL.

>

> Dana Rose

>

>

>

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  • 2 months later...
Guest guest

Karolyn --

There are personal attacks and there are personal attacks. The comment about

Danny Black did not use any personal invective, and Danny did what I thought

was a fine job of defending himself. Bill Bradford and I have no intention

of coming down like assassins on every single poster who makes a slightly

negative reference to someone else. We've got better things to do. I realize

that viciousness is in the eye of the beholder, but this just didn't seem

that bad.

Personally, I was more offended by the desire for people who are " strong

healthy proportionate. "

So, no, I wouldn't recommend that you hold your breath.

Dan Kennedy

Co-administrator

The Dwarfism List

<dwarfism>

On 4/13/04 4:47 PM, " Karolyn " <Pugluv@...> wrote:

> To the Moderators of the list:

>

> Are personal attack " punishments " only reserved for those who personally

> attack only " popular " members of the list or is there a consequence for all

> equally? Danny Black was maligned in a rather cavalier and back handed manner

> fashion.

>

> I am awaiting indignation and fair treatment for everyone. Should I hold my

> breath or will I only fall off my chair with a purple face gasping for air?

>

> Bill, Dan?

>

> Karolyn

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