6 Burst results for "Michelle Weber"
"michelle weber" Discussed on Future Tense
"Revive and restore is a us based organization that uses genetic tools to save endangered species. And if possible to try and bring back extinct ones talk to michelle. Weber is its director of conservation innovation. Now rationale is simple. It's that we need to use all the tools in the toolbox revival in stores making an effort to fill a gap in the conservation toolbox. We see a lot of incredible research coming out of academia out of industry. We've made huge progress in genetics. But it's been primarily applied so far to solve biomedical agricultural challenges. And it's very slow to trickle down into conservation and so what our organization is trying to do is speed up that knowledge transfer and bring those genetic tools to bear on conservation problems on biodiversity crisis tax on tax on and this is just another approach. This is another set of tools that will have to be combined with the existing well proven methods to improve outcomes and when we talk about genetic tools. What are we talking about. Exactly what sort of till's how do they work. So when we talk about the genetic rescue toolkit at revive restore we start with genomics basic. Dna sequencing on the genome scale will provide information about the diversity. In the history of that organism we also talk about bio banking so making sure that dna and that information is preserved out into the future we talk about synthetic and using molecular biology tools to actually create molecules in the lab that can replace the molecules derived from wild caught animals or wild harvested plants we use advanced reproductive to to restore genetic diversity and then we can use tools leg genetic engineering or gene. Editing to tackle problems like facilitated adaptation invasive species and even the extinction which brings us to elizabeth and a small ferry bundle of genetic potential elizabeth. Ann is a black footed ferret. So this is a small carnivore. That's native to the wild prairies of north america and we thought that these carnivores were extinct in the eighties. They hadn't been seen in a while and then they were rediscovered. Small population was brought into captivity in a captive breeding program was established. The captive breeding program has successfully produced hundreds maybe thousands of individuals but they're all descended from seven. Individuals seven founders. Luckily back in the eighties win. That first population was brought into captivity. Somebody was prescient enough to save cells and those cells refrozen at the san diego prison zoo and preserved until now and in twenty twenty one of those cell lines was cloned to produce elizabeth and the nucleus from those historic cells was injected into a donor. Xl and the resulting embryo was injected into a surrogate mother where it grew up into elizabeth cohen. Who was just born in december and so. This ferret carries a genome from the nineteen eighties. That has since been lost. And so this will be an eighth founder to the population and that audio of restoring genetic diversities enormously. Important isn't it. This is not just your works not just about bringing back more offspring safe from an endangered species. Yes absolutely so. There are thousands of black footed ferrets. That have been bred by that captive breeding program over the last several decades but all of the blackfoot ferrets. That are alive. Today are their siblings or cousins and they carry very closely related dna and so by introducing a new founder where actually adding new dna new genetic variation and that's a very different from just individual organisms. And so most of our work is about genetic rescuing it's about this genetic diversity available for natural selection to act on so the evolutionary process. He's don't stall that. These populations do not suffer inbreeding effects by you. Also adapting the genetic makeup of spacey's to try and make them more resistant to say disease. That kinda thing is that possible diseases. A real challenge pathogens are moving around more than ever. I think we've really seen this in the times of the coronavirus so there's multiple different ways that we can approach this challenge. Reviving restore has a cadillac science fund which supports portfolio of projects that tackle genetic rescue in different ways and several of them tackle disease so in one particular project sea stars are an example dated suffer from the wasting disease along the pacific coast of north america and we are using dna sequencing to infer which points in the genome may be responsible for survival in the stars. That are still alive today. With those answers we will be able to strategically breed. He starts to skew the population towards individuals with those same genome it components so that they will be more likely to survive when they were released. The black footed ferret for example suffers from somatic. Clegg this is an invasive pathogen and it's lethal so currently all black footed ferrets have to be vaccinated otherwise they die of sell vatican rag and so we can approach this infection challenge at least two different ways in the host weaken either directly engineer solutions to this particular pathogen engineering the immune system to adapt more readily so we are starting to think about both of these different approaches for the black footed ferret but as with any interaction it to consider it from both sides and so if we know how the pathogen works maybe we could actually engineer the pathogen to be less infectious or less virulent. And so that is another alternative that we're considering for the blackfoot In this elastic leg gret so genetic risk approach is showing considerable promise and revive and restore a male applying it to a range of animal species but it comes at a cost so genetic rescue is not cheap. I think from what. I've said so far you could see that coming very expensive than it. Costs us somewhere around forty thousand dollars for one round of cloning in the ferret so like anything. That costs will go down as technology improves but this is not meant to be an ongoing high maintenance solution. This is meant to jump start. The end goal is to eliminate conservation. Reliance so right now. We're spending much more than forty thousand dollars. Maintaining black footed ferret captive breeding programme paying all the people to take care of the ferrets. Paying for all of the reintroduction is paying for all of the vaccination programs et cetera. So if we can reintroduce enough genetic variation to where the ferrets can recover themselves out on the landscape and are no longer reliant on these types of programs then we will save money in the long run and the goal. Is that if you it strategically inject money in this type of genetic rescue at the right time in the right place. Then you can actually make things easier in the long term and bring cost way down.
"michelle weber" Discussed on Future Tense
"It's twenty twenty and we just made a mammoth discovery literally on the edge of a beach above the arctic circle scientists so busy exhuming the bones of a tin thousand-year-old adult mammal. I will namath found by any means but this time the bones contain soft tissue. Hello antony fennell here. Welcome to feature tents and to a program about the maturing of a once controversial conservation approach called rewarding. There is a lot of things that i really like about the term reviled and so i know that there's been a lot of focus on reintroducing large charismatic mega fauna but the term has really evolved to incorporate many more different axa and the entire ecosystem and all of the downstream cascades that come as a result of those introductions and it's that illusion. We're going to focus on today. We'll come back to the woolly. Mammoth a little later in the program a promise but as evolutionary biologists michelle weber just indicated. The game has changed significantly since the last time future tense took the field roundabout eight years ago back then re wilding was all about attempts to bring back extinct. Giants like the mammoth or to reintroduce apex predators like wolves and bays to rural areas that they've been driven out of in the past. It had a largely nostalgic. Feel to it but today it's much more future focused using the reintroduction of species to strengthen habitats and promote biodiversity it's really an ecosystem perspective at a landscape scale. And i like the fact that we are talking about the health of the interactions that bill be entire ecosystem and that we're talking about it at big enough scales that will actually start to incorporate all sorts of things that weren't necessarily part of the original plan there is i guess a great nayed full success stories and conservation. I'm sure most of its media. We often say environmental stories conservation stories reporting juryman glaring because we are amidst nor the well six mass extinction event and we donate to have harp and bringing back. Spacey's is a positive thing that we can jury and it can have really great outcomes for the environment so that we want to actually support you. Enriching an associate professor in wildlife ecology and conservation at deakin university. Unfortunately have tatis. We can't go back in time and right. The wrongs that we've done but we can think about what future we might have a ham on our environments. Look if we could bring back some of these species including species that are not extinct species at monaco in one area but have gone extinct elsewhere. I mean market. Bring them back. So we really wanna be focusing on that. The australian context according to dr ritchie. That could start. With the strategic reintroduction of dingoes across large parts of the continent we know as an example the between gary came particularly can control kangaroo numbers and in some parts of southern and eastern that can getting quite high numbers. Now because we've changed. The landscape is a lot more water that's available. Kangaroos is a lot more. Ross it's available to kangaroos and dingoes. Which one of their main predators have been killed off so if we could bring him back that can help regulate their numbers which has flow benefits for whole range of other spacey's dingoes also a nine to kill feral goats so that can help us manage the invasive species there's also of course talk about bringing something wipe it has manian devil back to the mainland which was probably in australia. Roughly three thousand or so us ago so ecologically speaking. It's not actually a long time and we could think about whether the tasmanian devil might help us potentially to control things like feral cats. So there's some evidence that they deter that behavior of cats cats motto void particular areas or times die devils mice active so bringing back some of these predators to atlanta in an experiment. Saint as as a really positive thing you might be edited. The conservation and disease transmission is also an issue that you believe the reintroduction of can also help with one of the problems that we have is where we have spaces that become over abundant whether we're talking about ninety of animals like kangaroos particularly osa feral animals. We had problems in australia. With things. like dea feral pigs and sensei fourth if rates really high numbers that can be vectors for disease. But also even when i die if animals being eight and removed from the landscape that can be open source of disease and so we know that having predators in the landscape is a really healthy united states. Xm so we need them to sort of casings. Things imbalance and reducing disease. Transmission is a potential benefit as well. Now you'll researches stressed the importance of focusing on the ecological functions of spacey's rather than the individual identities and origins just explained that idea to why that important so the dingo is probably arguably one of strays controversial in a mighty spacey's was introduced riley. Roughly brain hoffa's news as a minimum but potentially much longer ago and say some people will classify as a native animal out of the people. Do but the fact of the matter is that we've lost the following tasmanian tiger from my land destroy leah. We did have a mainland version of the tasmanian devil. We had the my sapio line. Fi likely layer and a whole range of other predators in viral gone from australia. And and particularly the my land of course and sorry the dinger whether you call it. Ninety not has a really important role in the landscape agai in regulating things like hungary numbers of course getting rid of some feral animals and keeping things in balance Lock we say a guy. In in other parts of the world things like wolves which helped to regulate numbers. If dea in some parts of the us lodge cats in parts of africa in europe incite fourth inside the site on what because something but the end of the day. Ecosystems spacey's plying their role inside they functions are really important and the danger is the best that we have currently in australia for a land based animal. And how far can you go back in time before a species is no longer relevant to its original environment. Is there a rough cut off point. Look i think there's an ex got out of for that. It's a fascinating question to ponder. And that's spain discussed even in the context of the father. Saying which you know. It didn't go extinct very long at all. Nine thirty six is a lost animal and that was in captivity but people have discussed the fact that you know maybe it's habitat has been largely moved in many parts of tasmania. Sorry there are big questions that even if you could bring back an animal to the landscape at some point in the fuchsia would there be suitable environments for they space. He's i guess a really important point against it is that where experiencing rapid climate change and if we manage to have a the worst possible scenario which temperature increases above one and a half two degrees above that way. Really gonna say some pretty dramatic and diet challenges to environments. It may be that. Quite large areas become unsuitable for a whole range.
"michelle weber" Discussed on The JOY Effect
"Once they can if you enjoy the next Australia. O out also short from dramatic mood after the whole state of a certain push and shove my new need my pain Pina Michelle Weber Gardens and hold the focus of sort of a motor after it's over mate locked up to take anything saved and all have to unload I used from me. So there'd be no mo one who uses and the taken. This is it's like yourself. She come to pass does need McCulloch days concept is simple woman to do is a big market. So it's on the likes of Baylor's from The Joy affect me personally, daughter or me. Enjoy the game. And 24 Karat Dodge home and puts him to drive my heart panic. And they will be taking his wife. If they conform you can really learn to accept the item to Creator. The glass is in for my personal enjoy the image to stop all silk died and space for eight of them needs. It's the halacha and don't have my joy Dipa taking his diaper take a look at phone just like the energy we have been implemented and Creator rod and your staff is available that more than you would life but, shocked by how did my mental energy like helped by the technician? All. Caped don't move either need in supply for home is and on the prospective Molek. It's really a teaspoon our opening a trainer it help you to exactly nice holiday bolt goes for her on both, replacement gloss over and now she's deeper Wilcox still middle number a few teams and individual made it clear for me. Enjoy in Olathe Medical. Yeah from the day Collision. The film are energy saver off and enjoy your dog make.
"michelle weber" Discussed on News Talk 1130 WISN
"Where the doctors and scientists from the Medical College of Wisconsin are making tomorrow better than yesterday for all of us in our final segment of this program, Dr Matt Goldblatt, and Michelle Weber will be joined by two of their patients. Joel Lee from Milwaukee, Wisconsin, and Nancy Baer from cedar Berg, Wisconsin. I think Joel, can we start with you? We're going to focus on, on inguinal groin hernias. I think your story covers virtually of, of challenges with groin or inguinal hernias. Maybe you can start with the first symptoms, you had before your first operation since I know you had a few surgeries. The first symptoms were on a golf course. Which you still frequent regularly, correct? Yes. Okay. Yeah. To the dismay of the pros. But that's okay. I was in two thousand six I walked off, of course, because I had intense pain them I left side, very low and Brian area. And with into the shower room where doctor was present and told me to take my pants on fight. Did he punched around a little bit? And says, I think you have a hernia sit come into my office went in a couple of days and prepared me for surgery. I had the surgery two thousand six and didn't have any adverse effects, but it did take me about three months after the surgery before I was able to start exercising and playing golf for tennis. And. Healing period. And the and the operation was performed open, right? And did they use a piece of mash or any other material? No probably not. And Matt, Dr Goldblatt, how frequently is our inguinal groin hernias repaired with or without mesh or some other material, I would say that the, the overwhelming majority of these days over paired with mesh there, you know, averages upwards of about ninety eight ninety nine percent, particularly in adults, so it's, it's unusual that, you know, especially today that we wouldn't use a piece of mesh that certainly is different than the past. I mean, this, this is a change that you would say occurred over the last decade or fifteen years or what would you say? Yeah, it's been evolving. Certainly over the last, you know, thirty years was when mash was, I really introduced as a as almost nice shouldn't say, the standard of care, but as a as a routine use, and its use has increased pretty much steadily ever since. That's correct. Michelle two months to recover is that kind of the long end of the spectrum. Would you think I mean so Joe? Dole was that the to get down to what's really important in life? Was that two months before you could golf knows too much before I could basically begin working out as to work out for five times week, everything from sit ups push so forth. And I just it took that long for me to feel able to do that. Because you had discomfort there. Yeah. Yeah. I think each patient's recovery is very individual based on other medical history, the type of repair that complexity of the repair, as well as the surgical approach. But typically, we say anywhere between four and eight weeks is pretty common in terms of recovery. Okay. So, so the first hernia is fixed, and after two months, all seems well, yes. And then then what happened? No further problems on the left side ever. Okay. In two thousand twelve I developed a similar type situation and I was on a golf trip. And we were getting in and out of the carton, playing thirty six holes a day for three days in a row and toward the end of it, it just got to the point where I couldn't get out of the car or sit down again I just had to stop went back in. Actually, Dr Gould, did the surgery out at freighter, and it was very quick. And I was actually up in around in less than four weeks. And so that was done. Laproscopy cly. No, that was done with an incision with incision also. Okay. And then over a period of the next couple of years, I would get occasions of tweaking in that area where it felt like a hernia. And I went and saw sports medicine doctor, and saw physical therapist, and nobody could feel anything and they just said, you know, leave it alone. See what happens in a little while. The end of the story was one day I was with a physical therapist. He he felt something popping out like from underneath where the mesh was a guess, and I don't know this medically but they tied it off on three sides, and whatever it was snuck underneath. And then it would go back and it would sneak out again. And one day he felt it I went back and again, Lapper Scott basically this time. So that was the let me before we get to the third operation, Matt. How if you if you have a hernia on one side, are you more likely to get a hernia on the other side? Yeah. It's, it's to have a bilateral hernia, which is what we would call that. It's, it's, it's more common than I think people realize it's somewhere between twenty to thirty percent patients will have a hernia on both sides. Usually one side is the one that's symptomatic and, and it's a pretty standard that when you go see a hernia surgeon. They'll check both sides because it's you know if you're going to be going, essentially. Under the knife. It's the best time to fix the other side would be while you're already in the operating room. So, yeah, it's pretty common. So you would fix both sides at the same time if if you notice that there was hurting on the other side, then I would fix it. It's not always evident. So I I'm not trying to insinuate that. There was a mistake made or anything like that. But just, you know it's not uncommon also to have a patient. Gotta hurry on one side. And then years later, one pops up on the other side. So the hernia on the right side now had was repaired with mesh, which, as you said, would be pretty typical and how do you secure? How do you secure the mesh, and whether you can describe, first of all, what is mesh? What are we talking about here? It's in a most of us envisioned like a little piece of the screen from our window. What is mesh? And then how do you actually secure it to the human body? So what you described. There's actually a pretty good description. It's it, it looks very similar to a window screen. It's made out. Of the, they're all made out of some sort of plastic. The two most common plastics are something called polypropylene, which is very similar to fishing line, and polyester, which most of us know is, is, is a fabric. It's not quite like the close fabric, but it's the same structure, and there are various ways to secure it. But most of the time you end up securing it to the patient's tissues, with suture typically a permanent suture that would hold the mesh in place. Now, the, the, the long-term fixation of the mesh is actually what the body does to it as it, basically encapsulates it, or it grows into the mesh, and that's what really holds in place. I use the analogy of it's like placing a lattice. In front of a rosebush and over time, the rose will grow into the lattice new can't pull the lattice away, because it's entangled with, with the tissues. So it's a similar type of process that happens. So Joel the so the, the physical therapist, actually helped you make the diagnosis of a little piece of intestine, or something, slipping underneath the mesh, which was giving you recurrent pain. And he for maybe the first three times I went to see him said, there's nothing they're nothing there. And then the third or fourth time he said, I feel something. Yeah. That's when I went to see doctors Goldblatt, and gold. So doctors, golden Goldblatt then reoprted on you. Yes. Okay. And Matt, what was the what was the operation that was done? That was done laproscopy. So essentially incision was made near the belly button. And we went in with a camera couple small little incisions for our instruments. The nice thing about doing that. Is that since his first operation was done open when we go in there? Lapper scott. We're really going into a separate surgical field. So we don't have to go through any of the scar tissue that was there. And it allows us to, to, as we mentioned earlier to get underneath the hernia reduce the hernia or pull. What's pushing through back in where it belongs. And then a piece of mesh there to stop it from pushing through again. So then Joel ended up with two pieces of mesh right one on the top one on the bottom. Correct. And how often the the complication that he experienced which it sounds like everything was fine for a couple couple years. Yes. For a couple years how, how common is that where where the mesh it sounds like the mesh dislodged a little bit of something? Yeah. Probably what happens is the, you know. The, the mesh didn't grow in as well as, as we hope it would on one of the corners, if in if it's a four, you know, it's, it's rectangle essentially, and you've got four sides to it. If it gives way on even on one side. There's a pretty good chance. It could slip away, or, or the hernia could push continue to push it away with what sounds like what was happening with Joel. Well, so happy ending to this Joel, not very happy with the doctors. My golf game has gotten any better. Well, we'll see. Doctor, Dr Goldblatt maybe you could help you with that. We'll see. We'll see what he has to say. Thank you very much, Nancy. Maybe I could ask Dr Goldblatt because your situation is, is, is, perhaps, even a little bit more more complicated to give a brief description of the first time that you met Nancy, and then we'll give have Nancy give her perspective on on everything that's gone on, so Nancy came to me with a complication related to hernia repairs, which is which is possible, but pretty on likely, and that is that there was an infection and anytime, there's an infection, particularly when there's this was a ventral hernias. This was this was a hernia repair from prior incision on the abdomen. Correct. Okay. And mesh was used which is very standard because without mesh the chance of the hernia coming back is, is very high. I would say unacceptably high particularly for eventual hernia. And so she had mesh place, which is. Very standard thing to do. And for whatever reason she got an infection and what usually happens is that because there's four and material in there. It's very difficult if not impossible for the patient's own body and own defenses to get rid of that infection. And so she had gone through a number of rounds of temps at trying to drain the infection and antibiotics. But the, the fact that there was permanent material in there just made it almost impossible for her body to get rid of that. Yeah. And Nancy, maybe you can enlighten us on the on what it was like from your perspective to have when you when you had that infection. It, it was just an open area that just wouldn't wouldn't hail. No wasn't necessarily eventually they became open..
"michelle weber" Discussed on News Talk 1130 WISN
"Or simply go to iheartradio I tunes pod being or Stitcher. Just look for the word on medicine channel in the first segment of this program, I am very lucky to be joined by Dr Matthew Goldblatt, and Michelle Weber, who will provide us an introduction primer of sorts on hernias, Dr gallbladders director of the Khandan hernia institute at the Medical College of Wisconsin. He has a graduate of both the university of Wisconsin, and the Medical College of Wisconsin, which I will abbreviate MC w for the remainder of the program. He also completed his surgical residency at MC w and fellowship in advanced laparoscopy at Ohio State. He has extensive experience in the military and retired from active duty in two thousand nine when he was recruited to our institution, medicine expert in all aspects of hernia surgery, laparoscopy and robotic surgery. Hopefully, we'll have time to cover the robot at some point during the show, Michelle Weber's nurse practitioner in the department of surgery at W. She is a graduate of Luther college into Cora, Iowa and received her masters degree in nursing from Marquette university. She was certified as a nurse practitioner in two thousand eleven she has also been with the division of general surgery at MC w since two thousand eleven so Matt will start with you. What is the definition of her? Hernia. And what causes them. So a hernia is an abnormal protrusion of contents of a cavity that. Basically, the mobile protrusion is through a whole either normally exists, or is created by usually another surgeon and in the abdomen. That's typically in the groin or it's from prior incision. So that kind of touches what causes them with caused them is, is essentially either prior surgery or oftentimes, in the groin, these are just wear and tear type of defects that occur from from life. So as we get older, and we develop a kind of ripples and bumps and lumps all over our body that, that just kinda come with age. How do we know that, that we have a hernia in our, if we say, if we focus on the, on the groin area or the lower abdomen nail where the nail with a leg starts right? The the groin area. How do how do we know? We, we actually have a hernia there and it's just not a fact that I'm not twenty five years old anymore. So most of the time these things are, are symmetrical. So you'll you know, many people if they have hernia it's just on one side. And so that side will protrude out or that lump will be only on one side. The, the key thing that makes a hernia a hernia is that what's pushing through should be able to go back and forth. Forth, so you should be able to push it back in. And if it comes back out that pretty much by definition is a hernia. And what's the problem? Why why are they a big deal? Why not just leave them all alone? I mean I, I don't know if you can tell me how many hernias are actually surgically corrected in this country in a year, but it must be an astronomical amount. And what's the big deal? Why not? Why not just leave it alone? Yeah. So a few hundred thousand hernias are fixed every year in this country. So it's a very common ailment. The, the reason we fix them is because they can become problematic of the can cause pain. They can be unsightly and they can also in the worst case scenario. What's pushing through them, which is oftentimes some intestine you get stuck. And if it gets stuck that becomes a little bit more of an emergency situation. It's pretty rare. So you know you don't have. If you think you have a hernia, you don't have to call nine one one, but it is a, a concern when, when it's not as easy to push it back in as it once was what goes into your decision making when trying to decide whether hernia should be just watched all, whether you need to fix it. So it it, some of it just depends on patient per patient basis. So if, if you're someone who works really hard, and, and has to do a lot of lifting and their job and every time, you, you go to work, it pushes out causes pain makes it difficult to do your job. Well, that's probably something that needs to be fixed right away. Because most people don't have the luxury of just changing jobs, certainly, if, if a hernia that was at one point, just about symptom, free suddenly becomes more and more symptomatic more pain getting stuck, maybe even getting some digestive issues where you feel sick to your stomach, every time the hernias pushing out, then that's something that we should probably take a look at. And think about fixing a little bit sooner. Is it safe to say that pain is probably the most common symptom, that a patient would have a groin? Hernia. It's actually, you would think that, but ironically, a lot of these hernias are relatively pain-free a lot of patients. Don't even you know, certainly they can rarely tell you a time and date at which, and when they got the hernia, they many times patients notice them in the shower, significant other will notice it I and, and so many times, the, the pain is pretty minimal and since they occurred since they occur later in life. At least now we're talking about adult hernias would not talking about babies and kids. So if we focus just on a dull turn is, and they develop over time whether the whether the whether the patient is in their forties, fifties, sixties. Seventies, the obvious question. Is there anything is there anything anyone can do to prevent it? Not really. I mean, a lot of it has to do with proper lifting mechanics since there is pretty unusual to find a time. And like I said, when someone got their hernia, so usually, these are slow and sort of wear and tear type injuries. And so, you know, if this the stuff that you were taught in gym class, you know, make sure you don't hold your breath when you lift things, you know, lift with your legs, not with your back and all these types of things that are sort of common sense and proper lifting mechanics, probably help to decrease the abdominal pressure. But, but there is no so if I do. So if I do one hundred situps a day, and really focus on my ads. I can't prevent a hernia not that I'm aware of. Oh, boy, that's I'm sorry to hear that. So if and before I get to Michelle, Matt is there, any is there anything other than surgery that will fix an inguinal hernia? So like you mentioned you know you can't. You know, sort of cruncher way away from a hernia. I mean once the defect. Is there there's no real way to, to build the muscle around it to make the her new go away? So and nothing to do other than an operation. There's no other treatment. Well, it depends. It depends on how symptomatic it is. I mean, the, the basically the two treatments are you either watch it and wait and see if it becomes more symptomatic or surgically treat it, but yeah, there's, there's, you know, there there used to be a pretty popular thing called the trusts, which was something on the on the outside that you could use to help sort of push the hernia back in it helped reduce some of the symptoms. But it it doesn't fix the it doesn't cure will continue to get larger probably correct. Yeah. So Michelle, Dr Goldblatt decides he's going to operate on someone. How do you make them as good as they can be in shape and ready for the operating room? So one of the things we like to consider is this idea of what we call prohibited. Tation or essentially could compare it to like training training for an athletic endeavors, something like that. So what we try to do is to maximize patients function prior to surgery, make certain that their heart and lungs are safer surgery. Make sure we can optimize their mobility if a patient is diabetic. We really want to work on blood sugar control. If a patient is a smoker, we often will ask them to quit smoking. Poor diabetes control and ongoing smoking are definitely two things that not only increase someone surgical risk, but also can increase the risk of a hernia coming back and are most of these operations performed as an outpatient, or does too many patients. Stay overnight, wh what is the normal situation for the inguinal? Hernia I would say a lot of patients do go home the same day. If a patient has an extensive medical history. A lot of heart issues lung issues. We may consider keeping them overnight just to observe. Okay. Matt, we may not have time to finish in this segment, the, the answer to this question, but options for surgery because I'm sure our listeners have who have had a hernia fixed or have a hernia in are seeing a surgeon get different opinions but options for repair open operation laproscopy robotic general, and, or re or local or regional anesthesia. How would you organize the answer to that? I think every surgeon should really think about what's best for the patient, and also what technique that they're best at there are two as you mentioned, two main approaches an open approach, and minimally invasive approach, and the minimally invasive is either laproscopy, or sort of a newer, robotic approach there to just about completely different approaches to the same. Problem. And so you can have a one open operation. And then if something were to happen, you could always have it done laproscopy, as well without getting into too much scar. So if we, if we think it about the, the England area or the groin grind hernia open would mean an incision on the skin and attacking it from the front. Correct Lapper Scott pick or robotic would attack it from the inside from pretty much from the inside. Correct. And, and how does that for our? It's, it's a little bit easier for us because we spend our lives in the operating room, but for those people who may never enter the operating room, other than if they're a patient, how would you explain laparoscopy or robotic surgery? So it's essentially using a camera using small incisions and small instruments to get done. What normally would be done with an a, a larger incision in the classic example is, is a gallbladder where it used to be a big incision. And now it's done through. Small little incisions. It's either used to be called laser surgery. We don't use lasers anymore or keyhole surgery. But it enables us to, to, to get into the tissue and do it. We need to do without having to make a large incision from the top to get there. So is it safe to say, then, for, for patients who are who have a groin or inguinal? Hernia and are seeing surgeons that really the operation could be done any of those three different ways as long as the surgeon is experienced in the technique that he or she recommends. And that's a great point. Yeah. So I would agree with that. And I would typically recommend that if you're a patient, and you're in the one question you should ask your, your surgeon is which approach are you best at because that's the really the one, you want them to. And just in way of reference in your practice, as someone who, who does a huge number of, of these operations, what percentage of your inguinal groin hernias done, open, laproscopy, and robotic, so about eighty percents are done. Done laproscopy cly about ten to fifteen percent or done robotically in about five percent or done open, right? Perfect way to end this segment. Thank you, both very much. We'll be back after a short break..
"michelle weber" Discussed on WZFG The Flag 1100AM
"Yeah. Well, I know that was kind of a question and a suggestion that was brought up. I guess I can't speak to that. I can tell you. What was in that podcast? But other than that. I don't know as far as maybe Mrs Weber. She's our next speaker. She is better. She's the principal at liberty middle school. She's probably more equipped to answer that question than I. But thank you for asking it. We'll make sure we get answered. Okay. Does that sound good? I feel like I need to intrude, social work fashion. Put one more plug, please make sure that you. Visit the resource table, right? On your way out there are some resources than to mental health, brochures, and those kinds of things for anyone that may need them. So make sure you stop there. All right. Thank you. Good evening. I'm Michelle Weber. I'm principle. I have the privilege of being principal at liberty middle school. I get to be the principal for those four lovely young ladies that grace the stage earlier this evening as well as Holly Eric in the back who provide those kinds of opportunities for our kiddos to explore what they're experiencing what's meaningful invaluable on their life. So thank you for this evening. Thanks, Beth and the whole community putting this together. So what I answer your question Bernie. I'm not one hundred percent. Sure. It's a new program. It's part of their. Yes. They've they've brainstorm different things to make their project real and meaningful. And this is a new direction that they're going. So I think we absolutely have to be listening to those podcasts. Find out what kids were thinking going through. And how we can provide them the services on the support that they they need. So good question. I oh they're going to.