is both real and perceived. Everyone's response is based on biophysics and emotion. Emotion can of course play a big or small role depending on our psychological state of mind. Nonetheless the majority of our pain is based on very real biophysical and biochemical events. To simplify this event lets pretend that out nerve endings that carry pain sensation to the brain are a gate. Some gates are very easy to swing open with just a light touch or push , and others require pushing with both hands to swing open. Our nerves (gates) vary from person to person; and so nerves require much (gate pushing) or very little (gate touching) stimulation to create the sensation of pain. This is known as the Gate Theory of Pain and explains the differences in reaction to the same pain stimulus from person to person. It is an over simplification to label people as "wimps" or "stoics" and also, many times, unfair.
Friday, December 26, 2008
Laser Treatment of Skin Texture
The best way to summarize the aging of the skin is to state that our skin texture worsens. Everyone wishes to improve the texture of their skin which includes fine wrinkles, scars, tone and the roughness that appears with time. The texture of our skin can start changing early; it can begin even in our thirties. Now with the advent of the fractional laser the skin can be improved upon in little to no downtime. The fractional component of the
laser uses microbeams to treat pinpoint areas of the skin. Instead of treating 100% of the skin surface area, only a fraction (6,8,10%) of the total skin receives a deep laser ablation, allowing for the surrounding non-ablated tissue to "cool down" the area. This technique provides little to no pain during the treatment. The healing process is also quick and the downtime is short. The process works because the treatment stimulates new collagen which plumps up the skin and smooths the texture. This laser can be used on the face, neck, chest and hands. No special preparation is needed other than clean skin that has a numbing cream applied. The procedure takes about half an hour depending on the size of the area. A person may need 1-4 treatments spaced 2-4,6 weeks apart. These treatments can be combined with other laser treatments at the same sitting. People experience mild redness that is treated with moisturizers. Healing occurs in 1-3 days. Most patients can wear make-up in 1-2 days. The laser treatment can be specifically tailored to a person's downtime schedule. If you are looking for smoother, younger skin and rejuvenation then you may be an
ideal candidate for this laser.
posted by Dr_Goldstein at 12:46 PM
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Thursday, December 11, 2008
Laser Treatment of Sun Damaged Skin
There is a new treatment available in the continued effort to rejuvenate skin. Broadband light is a new innovative technology that can be used to treat
sun damaged skin with resultant age spots (brown in color) and red spots of the face, arms, neck and chest. Using the appropriate wavelength filter a wide range of skin conditions can effectively treated. The
photothermal energy is directed on vessels that cause redness and on excessive melanin that causes the brown spots. The treatment is tailored to each individual and may require 2-5 sessions to achieve the desired result. The procedure is non-invasive enough so that there is minimal redness and some darkening that resolves in 1-3 days. There is minimal to no discomfort during the treatment and post procedure care involves only the use of a moisturizer and sun screen(which everyone should use anyways). This rejuvenation process is also easily
affordable.
posted by Dr_Goldstein at 8:24 AM
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Tuesday, November 18, 2008
Post-Op Domino Effect
People always wonder why areas of
injury or surgery hurt more so many hours after activity has stopped or when they are just plain resting at night and not moving at all. The reason for this all too true
phenomenon is the fact that the site of surgery has extra vessels (to provide the cells that will clean up the debris and provide the components of healing) as well as swelling (as a normal response to injury/surgery) in the tissues. As the activity level increases so does the flow of blood which increases swelling even more. Pain is directly proportional to swelling which proportional to activity. Each follows the other with a lag time of 2-4 hours, which explains why most of our pain occurs in the evening while we are resting. We pay for the sins we commit by day, at night.
posted by Dr_Goldstein at 8:07 PM
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Monday, November 10, 2008
Not Fade Away
Some words in our English language have taken on a meaning of their own, not reflecting the original intent, but rather a wish for quality that completely changes the communication . Such a word is "fade". As a
plastic surgeon, who cares for as well as creates scars, I explain to patients that their wounds re-model and mature over time and the end result is a scar that has transformed itself from a red, raised, hard appearance to a normal color, flat and soft presentation. This process in effect "fades" the scar, making it less visible, but certainly does not make the scar disappear! The scar is always present but less visible and therefore more acceptable." Fade" does not mean "gone".
posted by Dr_Goldstein at 6:32 PM
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Saturday, October 25, 2008
The Tom Brady Debacle
Apparently a great deal of space, ink and blame has been devoted by the media on Tom Brady's knee surgery and resultant complications. The fault finding is aimed at
physicians that did their best to help another person. Their well meaning intentions as well as expertise unfortunately did not produce the expected result. This is due to a well known complication: infection, which can occur in any operation under the best of circumstances and under the best of hands. What strikes me as peculiar is that the same type of publicity and public outrage has not been present in response to the unethical, self-serving, selfish behavior of banks, mortgage companies, and investing firms that have brought us to this present economic state. Their primary goals are not to help another person, but rather to help themselves... to our hard earned savings. Lets focus our attention on those who purposefully have hurt us.
posted by Dr_Goldstein at 12:51 PM
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