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(Aortic Aneurysm Repair/Removal)
Aneurysmectomy – Definition
The aorta is the largest artery in the body. It begins at the heart and runs through the chest and abdomen. Sometimes the walls of the aorta weaken and bulge in one area. An aortic repair is a surgery to create a support for the weakened area.
Aneurysmectomy – Reasons for Procedure
- To prevent rupture (bursting) of an aneurysm, which causes severe, life-threatening bleeding
- To remove a ruptured aneurysm and repair the damaged aorta
Aneurysmectomy – Possible Complications
If you are planning to have an aortic aneurysm repair, your doctor will review a list of possible complications, which may include:
- Problems from general anesthesia (eg, light-headedness, low blood pressure, wheezing)
- Infection
- Bleeding
- Blood clot formation
- Damage to organs or tissue
- Death
Factors that may increase the risk of complications include:
- Smoking
- Emergency surgery due to a burst aneurysm
- Heart disease
- Previous episodes of transient ischemic attacks or strokes
- Lung disease
- Debilitation due to cancer
- Diabetes
- Obesity
Aneurysmectomy – What to Expect
Prior to Procedure
Your doctor will likely do some or all of the following:
- Physical exam
- Blood tests
- Your doctor may need detailed pictures of your body. These can be made with:
- X-rays
- Ultrasound
- CT scan
- MRI scan
- Cardiac catheterization
- Electrocardiogram
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
Leading up to your procedure:
- The night before, eat a light meal. Do not eat or drink anything after midnight.
- You may be given laxatives and/or an enema to empty your intestines.
- You may be asked to shower the morning of your procedure. You may be given special antibacterial soap to use.
- Arrange for help at home after returning from the hospital.
- Arrange for a ride to and from the procedure.
Aneurysmectomy – Anesthesia
General anesthesia will be used. You will be asleep.
Aneurysmectomy – Description of Procedure
Depending on the location of the aneurysm, blood flow may need to be passed to a heart-lung machine. The machine will temporarily do the jobs of the heart and lungs.
An incision will be made over the area of the aneurysm. This may be in the abdomen or chest. The aorta will be clamped off above and below the aneurysm. The doctor will open the aneurysm and clean out any debris. The graft will be sewn into place to reconnect the two ends of the aorta. The tissue of the aneurysm will then be wrapped around the outside of the graft.
When the graft is properly in place, the clamps will be released. This will allow blood flow to resume through the aorta. The incision will be closed, using either stitches or staples. The area will be covered with a sterile dressing.
Some aneurysms can be repaired without a large abdominal incision (percutaneously). Instead, punctures are made in the arteries in the groin. Not all patients are suited for this procedure. Your doctor will discuss your options with you.
Aneurysmectomy – Immediately After Procedure
You will be brought to a recovery room after surgery. You will be monitored there for any negative effects from the surgery or anesthesia.
Aneurysmectomy – How Long Will It Take?
One hour to a few hours
Aneurysmectomy – How Much Will It Hurt?
Anesthesia prevents pain during surgery. The incision will cause some pain after the surgery. Talk to your doctor about medicines to help you manage the pain.
Aneurysmectomy – Average Hospital Stay
The usual length of stay is 4-7 days. Your doctor may choose to keep you longer if complications happen.
Aneurysmectomy – Postoperative Care
At the Hospital
- You will need to stay in the intensive care unit for the first day or so after surgery. You will then be moved to a regular hospital room.
- For the first day or two, you will be hooked up to monitors to track your heart rate, breathing, blood pressure, and blood oxygen levels. Your doctor may also order blood tests, chest x-rays, EKG, and an ultrasound of the repaired area of the aorta.
- You may have some tubes in place, which may include the following:
- Urinary catheter — monitors urine output
- Arterial catheter — monitors blood pressure
- Central venous catheter — monitors pressure in the heart
- Epidural catheter — provides pain medicine
- Nasogastric tube — inserted through the nose and into the stomach to remove secretions and provide nutrition until your intestines regain normal function
- You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently. This will help improve lung function after general anesthesia.
- You may be given special compression stockings to wear after surgery. They may help decrease the possibility of blood clots forming in your legs.
At Home
When you return home, do the following to help ensure a smooth recovery:
- Follow any discharge instructions to care for the wound.
- Ask your doctor when it is safe to shower, bathe, or soak in water.
- Gradually return to your normal activities.
- To help prevent further problems, you and your doctor will need to work to increase your overall health. Atherosclerosis and high blood pressure should be managed carefully. This can be done with medicines and a healthy lifestyle. If you are a smoker, you should talk to your doctor about quitting.
Recovery takes about six weeks. If you had symptoms from your aneurysm before the surgery, you may notice some improvements in your health. You may find you have more strength and less swelling in your legs. You may also have lower blood pressure, improved energy, and absence of pain from the aneurysm.
Aneurysmectomy – Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Pain or swelling in your abdomen
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
- Pain that you cannot control with the medicines you have been given
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Cough, shortness of breath, or chest pain
- Pain or swelling in your feet, calves, or legs
- In case of an emergency, call for medical help right away.


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AMARILLO, Texas — A JetBlue Airways pilot who disrupted a cross-country flight by leaving the cockpit and yelling about religion and terrorists is free to go home rather than be committed to a mental health facility, a Texas judge ruled Friday.
Clayton Osbon of Richmond Hill was charged with interference with a flight crew for the March incident, but was found not guilty by reason of insanity in July. A forensic neuropsychologist testified in a short, unpublicized trial that Osbon had a "brief psychotic disorder" brought on by lack of sleep.
U.S. District Judge Mary Lou Robinson said Friday that Osbon would be allowed to go free, but set certain conditions for his release. He will not be allowed to fly or board any commercial or private planes without the permission of Robinson or his probation officer, and he will not be allowed to communicate with any passengers from the March 27 flight he disrupted, according to the judge's order.
"This is a bad situation for you and your family, but you are fortunate to have the type of immediate support that you have," Robinson said.
Passengers on the March 27 flight from New York to Las Vegas said the 49-year-old Osbon ran through the cabin yelling about Jesus and al-Qaida. The flight was diverted and safely landed in Amarillo, Texas.
At least 10 passengers have sued JetBlue over the episode.
Osbon appeared in a green jail jumpsuit and did not make an extended statement in court. His attorney, Dean Roper, said afterward that he didn't know if Osbon would fly again, but was relieved the months-long legal proceeding was at an end.
"It's been a long ordeal for everyone involved, especially Mr. Osbon," Roper said.
Osbon left the federal courthouse without commenting to reporters and was expected head back to his home in Georgia later in the day. Osbon and a friend who attended the hearing planned to make the 1,300-mile trip by car, Roper said.
JetBlue spokeswoman Sharon Jones said Friday that Osbon still was employed and listed on "inactive duty." Jones declined to say if Robinson's order would affect that status.
Osbon showed up unusually late for the March 27 flight. The plane was in midair when he told his first officer that they wouldn't make it to their destination, according to court documents.
Osbon began to ramble about religion, scolded air traffic controllers to quiet down, then turned off the radios altogether and dimmed the monitors in the cockpit. He said aloud that "things just don't matter" and encouraged his co-pilot to take a leap of faith.
When he left the cockpit, passengers moved to restrain him. A flight attendant's ribs were bruised in the scuffle, but no one was seriously injured.
Neuropsychologist Robert E.H. Johnson testified in July that Osbon's psychotic disorder at the time of flight lasted for about a week afterward, according to a hearing transcript. He determined Osbon suffered from a brief psychotic disorder and delusions "secondary to sleep deprivation." He didn't say how long Osbon had gone without sleeping before boarding the plane, and his psychiatric evaluation of Osbon has been sealed.
Those symptoms made Osbon incapable of understanding why his actions on the flight were wrong, Johnson testified.
After the July trial, Osbon was sent to a prison medical facility in North Carolina for evaluation. Robinson was to decide what happened next for Osbon in August, but instead extended his evaluation period into October after being notified that Osbon had suffered a psychotic episode in prison. She did not say what the nature of the episode was, if it was connected to his previous disorder or what prompted it.


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Radiator Repair in Etobicoke
Anyone who works in a busy working environment in Etobicoke will be aware of the benefits of letting off a little steam on a Friday evening with colleagues or friends. Unfortunately if your car is the one letting off the steam then there is a good chance that your weekend camping plans could be put in serious jeopardy.
If your vehicle is overheating then it is never a good sign and is an issue that needs to be addressed quickly. There are a number of common reasons for an overheating engine and at Kingsway Auto our skilled team of mechanics have the experience and equipment to diagnose the problem and have your car back to its best in no time at all. Don't take chances with something as important as an overheating engine, call the mechanics Etobicoke relies on today.
Don't be the guy on the side of the road covered in steam!
Chances are if you've driven in Etobicoke for any significant period of time you have more than likely seen someone's steaming car on the side of the road. At Kingsway Auto we always advise our customers not to be that person.
One of the most common ways of ensuring that you never have to deal with an overheating engine is to ensure that all aspects of your car's cooling system are properly maintained and, if needed, repaired. One of the most important things to consider is your vehicle's radiator.
Why is my car's radiator so important?
This is a commonly asked question among Etobicoke motorists and the answer is very simple. In essence, the radiator in your car or truck is responsible for ensuring that the coolant which is needed to keep your engine from over-heating is distributed and processed evenly. The radiator hoses are primarily responsible for this task and need to be strong and sturdy enough to be able to handle heat of an engine that can reach temperatures close to 200 degrees Celsius. By the same token, the radiator cap and tubes ensure that the radiator operates to an optimal level consistently.
Any repair or damage to your vehicle's radiator can have a series of consequences for your car and, as such, needs to be monitored very closely.
What does your radiator repair service look like?
The radiator is the most important part of your vehicle's cooling system. As such, we take the maintenance and repair of vehicle radiators very seriously. During a standard radiator repair service our mechanics will typically:
- Inspect the hoses and belts of the radiator for signs of leaks or fractures.
- Check the fluid level and assess if any blockages in the radiator tubes are causing the coolant not to reach the engine efficiently.
- Look for any signs of oxidation on the radiator.
- Search for fluid leaks which may indicate that the radiator is not performing optimally.


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KUALA LUMPUR, Malaysia (AP) — President Barack Obama said Sunday that comments reportedly made by the owner of a U.S. pro basketball team are "incredibly offensive racist statements," before casting them as part of a continuing legacy of slavery and segregation that Americans must confront.
"When ignorant folks want to advertise their ignorance, you don't really have to do anything, you just let them talk," Obama said when asked to respond to the reported comments from Los Angeles Clippers' owner Donald Sterling.
Obama's description of the controversy as part of a larger historical context is the latest example of his continuing willingness to expound on matters of race in his second term.
After avoiding much mention of race relations during his campaign to become the first Black president and in his first term, the president last summer offered a personal reflection in response to the shooting of Black teenager Trayvon Martin. And now Obama has spoken out against an audio recording of a man identified as Sterling telling his girlfriend not to bring Black people to games.
The firestorm over Sterling's comments has quickly engulfed the National Basketball Association.
Obama cast the comments through a broader prism of racism in America, adding that "we constantly have to be on guard on racial attitudes that divide us rather than embracing our diversity as a strength."
"The United States continues to wrestle with the legacy of race and slavery and segregation, that's still there, the vestiges of discrimination," Obama said during a news conference in Malaysia, where he was traveling.
"We've made enormous strides, but you're going to continue to see this percolate up every so often," he added. "And I think that we just have to be clear and steady in denouncing it, teaching our children differently, but also remaining hopeful that part of why statements like this stand out some much is because there has been this shift in how we view ourselves."
In the recording attributed to Sterling recording and posted on the website TMZ, a male voice questions his girlfriend's association with minorities. TMZ reported the woman, V. Stiviano, is of Black and Mexican descent.
The man asks Stiviano not to broadcast her association with Black people or bring Black people to games. The man specifically mentions Lakers Hall of Famer Magic Johnson on the recording, saying, "Don't bring him to my games, OK?"
Obama said he's confident NBA Commissioner Adam Silver will address the matter. He said the NBA has "an awful lot of African American players, it's steeped in African American culture. And I suspect that the NBA is going to be deeply concerned in resolving this."
Silver had said the NBA needs to confirm authenticity of the audio tape and interview both Sterling and the woman in the recording. He called the tape "disturbing and offensive" and promised to investigate quickly.


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Difference between Screen Printing and Heat Transfer
FAQ: Difference between Screen Printing and Heat Transfer
Creating design for your custom, original t-shirts, caps, hoodies or tote bags might be exhausting and difficult. Same is true for searching for printing method that works best for your design and chosen fabric.
There are free most common printing options: Direct-to-garment, screen printing (SP) and heat transfer (HT). We described DTG in detail earlier here, so this time we want to talk about SP and HT, their pros and cons, so you would understand both methods and choose which one is better for you.
The basic scheme of Screen printing is following:
1) once you created your design for t-shirt and sent it to our production site, the original image (text, logo, simple forms or pictures) uploads to special software that splits it to a different color elements\layers;
2) For each color\layer, we create a special 'screen' – stencil which will be used for spreading ink to the garment to the specific areas;
3) Color by color, screen after screen (actual number depends on complexity of your design) graphics being printed to the garment.
Heat Transfer
The Heat transfer is a printing method that can use two different technologies.
First (digital print heat transfer) combines ink printing with hot press transferring. On the first stage, the graphics your created is printed on a special printer using a solvent ink and heat transfer paper. After that image is being transferred from the paper to the garment using hot press.
Second way of the Heat transfer – Vinyl heat transfer – is more difficult and time consuming. First, special software splits desired graphics to a different color elements. Second, special computerized cutter cuts out separate elements of colored vinyl sheets. Finally, with a hot press each color vinyl elements is being printed onto garment.
So what should I choose?
Well, that depends on complexity of your design, type of garment and order's size. Due to the technical specifics Screen printing is an optimal solution for large order (from ____ units). Regarding the Heat transfer, cost-per-unit is basically the same for either small (just couple t-shirts) or large orders.


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As we head into the summer months we are seeing a healthy jump in inventory in our area. In May, we saw the biggest jump in new listings in a decade! Price appreciation has created this phenomenon, motivating many people to make big moves with their equity. In fact, prices are up 13% year-over-year. We currently sit at 1.4 months of inventory based on pending sales. This more-equal balance of homes for sale compared to the first quarter has created great opportunities for buyers, finally! While it is still a seller's market, it has eased up a bit. The average days on market in June was 15 days and the average list-to-sale price ratio was 101%.
South King County real estate has been an affordable option compared to "in-city" real estate. In fact, the median price in June was 75% higher in Seattle Metro. Sellers are enjoying great returns due to buyers choosing to lay down roots in our area, and buyers are securing mortgages with minor debt service due to low interest rates. The easing of inventory is a welcome change and is helping to temper price growth.
This is only a snapshot of the trends in south King County; please contact me if you would like further explanation of how the latest trends relate to you.