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Monday, March 19, 2012
Where I Am
I have been "trying" so many different things/plans/ways and it is giving me a headache, literally. I woke up with a massive migraine complete with nausea, light sensitivity and one eye seeing things differently than the other eye this morning. It has taken me four hours, a breakfast, 2 cups of coffee, a Tylenol and an aspirin to be functional enough to write this but I am still about half headachey so bear with me here. I want to say some things because I feel like I am at a turning point. Yeah, I have felt like that before and ended up back in the pit a couple of days or weeks later, but enough is enough already with the plans and I just have to take this an hour at a time and turn this around. I need to build some momentum to get back to where I was in October 2010.
It's been almost a year and a half since I hit 175 pounds which was 103 pounds lost. I felt AMAZING. My quality of life was beyond anything I had hoped for. Looking back now on those blog entries, I see how my quality of life has crumbled by regaining 40 pounds since then. I want it back. I want that life back!! I got mad enough this weekend... mad at myself... to force myself into some uncomfortable changes. I struggle with Seasonal Affective Disorder and "forcing myself" to do things over the winter is practically impossible. But now, spring is coming and there is more daylight and sunshine and I think this is the best time for me to get going again.
Where I am today:
I weigh 215 pounds. I am down to ONE pair of jeans that *barely* fits; they are size 16 and they nearly cut me in half when freshly washed and buttoned. I have to wash them every couple of days and while they're washing I have to wear the ONE pair of fuzzy grey sweatpants that still fit me. I feel like a frump! Ugh. I really do.
Medical issues that had disappeared completely at 175 pounds are back. I have acid reflux, am back to taking Tums most nights so I can sleep and propping up on a pillow in bed. My joint pain returned (knees, hips, feet, hands, shoulders) and is bad enough that it prevents me from being as active as I'd like. I no longer swing on the swings with my daughter, and when I took her skating the last few times, I didn't skate. I just watched. It SUCKS!! I also have had some heart palpitations coming back. More headaches, more fatigue, worse mood, and far less energy and motivation. Frankly I do not want to do ANYTHING.
It hurts to carry groceries in to the house. It hurts to carry laundry baskets up and down the stairs. Heck, it even hurts to get dressed. The pain in my shoulders is horrible. And I have plantar fasciitis again.
I think I look like crap, too. Obviously very few of my clothes fit me right, as I got rid of all my fat clothes when I was 175 pounds. Ninety percent of my wardrobe is too small and too tight. I have nothing, ZERO, to wear when the weather gets warmer.
What I am doing about it:
I have to focus on action. Minute by minute, I am forcing myself to get up and move. I am not even worrying about formal exercise right now, because over the winter I have become SUCH a slug, very sedentary whenever I am not doing things I *have* to do. So now, I am simply MAKING myself get up and do stuff. Clean, do yard work, play with the dog, DO things. I am making myself get outside in the sunshine. This week I am also making myself do ALL of my physical therapy exercises on Monday-Wednesday-Friday. That will be happening from now on. I NEED to build my strength back to have the quality of life I desire. I am also walking the dog every day and want to build up to 2 miles a day... maybe more eventually. Right now my feet hurt SO BAD after a walk that I am almost limping. Yeah, it sucks.
As for the food, I am so SICK of measuring and counting and planning right now. This week my focus is to eat regular, healthy, real food meals for breakfast, lunch and dinner and knock it off with the grazing all day. If and ONLY if I am TRULY feeling hunger between meals, I will let myself have a Medifast meal. No other choices. All of them are around 100 calories and have plenty of protein in them, so they should fill that NEED if there is truly a need and not a *want to eat* thing going on. After all, I never crave Medifast meals, so if I am willing to have one between meals then it will be likely to be actual hunger. Sort of like this:
me: Wow it's been 2 hours since lunch and I am really hungry!
myself: Oh! Okay, have a Medifast bar.
me: uh, well, I was thinking more along the lines of a latte and a scone.
myself: No, if you're hungry have a Medifast bar.
me: um, hey! How about a handful of almonds and a few chocolate chips! that would be good!
myself: nah, if you're hungry, have a Medifast bar!
me: that doesn't really sound good.
myself: I guess you're not hungry then!
Reminds me of talking to a 4-year-old, actually...
Anyway, the rule is no eating between meals or after dinner except for a Medifast meal if I am really hungry. I think this is a good use of the meals I have remaining. I do plan to fix reasonably healthy meals for the family but right now I need to use up things we have in the freezer (like tonight's beef short ribs), so they may be higher fat or carb than ideal. I am going to always limit myself to one serving of *whatever* and then fill up the rest of the plate with salad or steamed vegetables.
We'll see how this goes and reassess at the end of the week.
*FTC-required disclosure: Medifast provided me with its products for my personal use for free. I am not paid or compensated in any other way for mentioning their products.*
35 comments:
Sounds like a good plan. I hope you find your way to get rid of the extra weight if that is what you want to. I am not wondering that you are sick of different diet plans etc. Sounds to me you have been doing them for years. I couln't have done it.
- March 19, 2012 at 11:12 AM
You said it yourself...hang in there, never never never give up. Take each day at a time, do what you can. Be blessed and at peace.
- March 19, 2012 at 11:54 AM
Hi Lyn:
I've been reading for years, commenting rarely, feeling sad with you the last few weeks. I know what it's like to feel you are failing; that things are spiraling back out of control and you don't know what to do. Been there myself, many times.
It's admirable that you won't give up. The "only medfast" for snacks sounds like it can work for you. Try to be kind to your four-year-old self.
- March 19, 2012 at 12:34 PM
Good for you Lyn!
- March 19, 2012 at 1:02 PM
- Greta @ Staying Lost said...
Lyn, I'm so glad to hear that you aren't giving up. I hope that what you are trying now will help you lose the weight, and will also give you the peace of mind you seem to be looking for.
- March 19, 2012 at 3:40 PM
- PaulaMP said...
I'm sorry you are in so much physical pain ... Hang in there
- March 19, 2012 at 3:43 PM
Hang in there! I'm at the same "sick of everything" level you are. I've tried every diet out there. My weight hasn't moved one pound in over 3 years.
Don't be too tough on yourself. Just do what you can.
Sending hugs!
- March 19, 2012 at 3:57 PM
- AprilA said...
I'm so glad to read you're taking time for yourself to enjoy the sun on your skin. Don't under-estimate the power of that! :)
Wishing you a happier Springtime Lyn, and, in due course... progress again on the weight-front.
Be kind to yourself #1.
- March 19, 2012 at 4:04 PM
I understand (partly) about being seing of all it takes to lose weight--all the numbers, planning aheard, frustrations, etc. However, if this is what TRULY HELPS YOU, then i think you have to stick it out and do it. No one really "likes" to study, especially for a subject that's not a favorite, but generally people do it anyways because it is necessary for success. I don't always love taking long walks in the summer when it's unbearably humid and sticky but I do it anyways because I know staying active helps me keep my weight down and is good for my well-being in general. We all have to do things we don't like.
I see trouble whenever you talk about how you are just "so sick" of things and want to simplify, do it your own way. To be blunt, if you could handle doing things "your own way" you wouldn't be in this boat to begin with, right?
I think once you master counting calories/finding a weight "zone" that you are happy and healthy in THEN maybe you can let it slide a little. After maintaining a weight loss for years and kind of finding your groove, then you just kind of know the amount of food you can handle. But you can't just stop when you are still in the midst of losing and feeling off.
- March 19, 2012 at 4:16 PM
Hi, Lyn, I really enjoy your blog. Your idea of getting up and doing things, being in the sunshine = GREAT. The food approach seems sensible, as well. Managing weight just DOES take planning, effort, cooking, exercise, etc. You aren't alone, many of us are out here doing the same things: self-care! We see the scale go up, recommit to monitoring ourselves, getting lots of fruit and veg, managing our thoughts, etc (I am a Weight Watcher!) -Lydia
- March 19, 2012 at 5:15 PM
- beerab said...
I feel your pain, but you did it once, and you CAN do it again- I know you can!
I am also frustrated with myself for getting all the way down to 196 and then today being at 200 after a bad week last week, why is it SO darn easy to gain?! GR!!!
- March 19, 2012 at 5:52 PM
- Princess Dieter said...
Lyn, please get at least 2 pair of "stretchier" pants that fit. Pants that will take you through 15+ pounds of loss. You need clothes that fit. Skirt or slacks or dress and jeans or yoga pants and skirt or whatever combo. THE REALITY is that your clothes do not fit and you feel horrible in them. At the very least, you can feel comfort while losing as you may need to (slowly, carefully, with balanced food intake).
Trying to wear pants that cut you "in half" is only going to make reflux WORSE.
You may think these tight clothes will be motivation. Um, no. They simply will make for new health issues (too tight pants can lead to neural damage in the groin and yeast infections).
So, please, while you figure out what you need to do to get a handle on food/calories/etc, get a couple of outfits that really fit WELL RIGHT NOW. K?
Hugs, babe...
- March 19, 2012 at 6:45 PM
*I understand (partly) about being SICK of all it takes.
- March 19, 2012 at 6:47 PM
- Tara said...
I just want you to know that I am rooting for you! You can do it!
- March 19, 2012 at 7:01 PM
I agree with Princess D -- those tight jeans probably aren't good for reflux! You deserve clothes that fit and feel comfortable, and you deserve them at your current weight. You don't need to buy a whole wardrobe or feel like you're giving up, but wearing clothes that just make you feel worse isn't helping. A couple of pairs of pants that don't make you feel awful can only put you in a better place mentally, right?
- March 19, 2012 at 7:25 PM
I've been (unsuccessfully) on the weight loss merry-go-round for years and I'm still churning away too. I read a blog post somewhere recently in which the author said (I paraphrase) that she didn't get fat overnight and she can't get fit overnight either. It's not easy, but it's so worth it.
Everyone's different, but one of my major problems has been lack of satiety. I never used to feel full. I've been following the primal lifestyle lately and incorporating much more healthy fat (avocado oil, avocados, some nuts, coconut) and I finally feel full before I've finished my meal. It's such a motivating discovery! While you're focusing on those minute by minute actions, I encourage you to find those daily successes too.
I also wanted to ask if you're sure that the soy in the Medifast meals are ok for you. After a months with Nutrisystem and then trying Weight Watchers (supplemented by soy to make my points go further), I found that my body does not handle soy well AT ALL. I felt more depressed, lethargic, and achy than ever before. Eliminating soy was a blessing for me, but I know everyone's different.
- March 19, 2012 at 7:31 PM
- Megan said...
Hi Lyn, I like your idea of limiting yourself to a Medifast snack if you're hungry. I'm doing a similar thing myself, but with boiled eggs. I keep them in the fridge all the time and if I'm hungry between meals, that's my snack. I like boiled eggs, but I don't *love* them, so I'll only eat it if I'm truly hungry, not just in the mood for eating.
Good luck with the new plan, I'm sure you'll find your mojo again soon :)
- March 19, 2012 at 8:18 PM
- Ron from NJ said...
So many others have said it but I want to echo things. It is great that you aren't giving up. It is great that you are trying something...anything to try to get things going for yourself. Keep going. We are all behind you and hoping for you.
- March 19, 2012 at 8:37 PM
- Diana said...
As usual, we're on the same page again. I could have written several of your recent posts.
I'm so tired of the battle. It never seems to end. I'm tired of being tired. I too am on an upward spiral with the weight. Every day I wake up and think "what happened?!". How, why did I let this happen to me.
I sure don't have the answer. I can only tell you I understand 100% what you're going through. I'm going through it too.
I'm like you though, Spring is my season. I'm hoping for a turnaround soon, for both of us. :)
- March 19, 2012 at 9:06 PM
Hi Lyn.
I've read your blog everyday for the past 2.5 years. I feel a connection to your journey. I don't have a struggle with my weight, but I do struggle everyday with food and numbers. I have been a type one diabetic since I was eight years old. I know what it feels like to have to account for everything you eat. I know what it feels like to feel like your success hinges on a number. (For me its my HbA1c.) I know what it feels like to feel guilty when you eat something you shouldn't. So even though, looking at me, you would never know all the "food" issues I have, I get it.
I think sometimes "having" to think about everything you put in your mouth is just to much. It's exhausting. It creates this relationship with food that is just overwhelming. It takes all the joy out of eating. And we need to eat! I know your exhausated too. Hang in there!
I wish you the best. Thanks for "being there" for all of us!
- March 19, 2012 at 9:42 PM
- Kristi said...
Your plan sounds great. It sounds a lot like Intuitive or Mindful Eating. Wait until you are hungry, eat until you're satisfied. I hope you can start feeling better soon.
- March 19, 2012 at 10:02 PM
Sounds like a good plan! Be careful not weighing, but i mean you know yourself what a reasonable portion of carbs / protein is, and its not as important with veggies.
I was once told that if i felt like having a snack - have 2 glasses of water and an apple / orange / banana and see if you want anything else. Normally i dont even bother with the fruit as i've basically just been thirsty.
I'm glad to see you are back on track this week :)
- March 20, 2012 at 1:07 AM
- Diandra said...
This sounds like a good enough plan to me. And once you are done with your Medfast meals, there are lots of 100kcal options for snacking... my favorite: 100g mixed berries and 100g low-fat yogurt. ^^ I am sure now that the weather is improving, your mood will as well, and your energy will return.
- March 20, 2012 at 1:15 AM
- Claire said...
Stop beating yourself up Lyn. It's not good for you and won't help you lose weight. You'll punish yourself by overeating. Love your body, cherish it and you'll find both diet and exercise much easier. Like you, your body deserves some love x
- March 20, 2012 at 2:20 AM
- Julia Stambor said...
So, you´re back up forty pounds. That´s the bad news. The good news is that you have managed to lose these before, so you definitely can do it again. It has happened to me, too, and from my experience I can give one simple advice: remember what you were doing when you first lost those pounds. It was obviously working for you. Resolve to do it again. At first, for a specified amount of time, say, one month. Do it one day at a time. You know you can. And- as annoying as that may be- record what you eat. Every bite. It´s all too easy to slip back to eating things that aren´t good for us and not notice because hey, it´s just a bite, or one slice. If you want to wean yourself off the medifast products in the long run, you have to know how your body reacts to the "real" foods you put into it, and that will mean experimenting, which translates to weighing (yourself and your food), note-taking and measuring. Having setbacks during that kind of experimentation is something one must expect. The important thing is identifying what went wrong, and stop doing/eating it. The sooner the better. (Look who´s talking- it has taken me two periods of massive regains and as many plateaus to find out I shouldn´t eat bread and potatoes).
You´re right about not really trusting other people´s diet plans- every body is unique, and everybody who wants to lose weight and keep it off must find out what his or her unique body can or cannot tolerate food-wise.
I wish you the best of luck getting re-started! And yes, it´s better to accept What Is and do it in fitting pants:).
- March 20, 2012 at 5:31 AM
- Susannah said...
Hi Lyn,
I am positive you will find your own unique path to wellness and health. You are very smart, very strong and very focused.
One thought I have had about Medifast since you started it. I had not known anything about the program before and, as we all do, processed your posts with my own perspective in mind.
As a sugar addict myself (and as a former nicotine addict I know exactly what addiction feels like physically and mentally! "Cutting down on smoking" (which never ever worked) felt 100% like "cutting down in sugar". And it never worked either.) Sugar free is good for me. I do not "moderate" sugar.
Anyway, one of the first thoughts I had about Medifast and the brownies, shakes, crisps etc. was that these "foods", although sugar free and perhaps high in protein, would only feed my beast.
And I have learned that eating throughout the day also feeds my beast.
Just my two cents, but perhaps this is one of the reasons it has been so challenging for you to move away from the Medifast plan.
Good luck with all aspects, Lyn. You have many supporters!
- March 20, 2012 at 8:05 AM
- Kimberly said...
I think I could have written part of your post! I reached my lowest in a long time with you in Oct. 2010 - 185. I felt GREAT! Then... medical issues, gained weight, and it got out of control again.
Feb. 22nd the scale said 215 for me. I felt AWFUL. I am now at 204. It is going slowly, but I am committed and the weather is helping me also! Got out and rode my bike with my 6 year old daughter last night and it felt great! We CAN do this!
Thanks for sharing with all of us - you have a lot of people that relate all too well with your struggle.
- March 20, 2012 at 8:11 AM
My personal opinion is that the weight loss and your happiness was a warm blanket to cover over other things that have never gone away or been dealt with. When you're thin you are happy.... When you're not thin you don't have that positive thing to focus on and the deeper issues are closer to the surface. Feel free to say " not even close!" I still think therapy is a very good option...... Are you single with your children or are you married? It might make a difference to assess your relationship if you are married. Best of luck to you Lyn.
- March 20, 2012 at 8:23 AM
I have nothing today, Lyn, except that as always, I hope you find something that will work for you and one of my favorite quotes,
by William Blake:"You never know what is enough until you know what is more than enough."
- March 20, 2012 at 8:38 AM
I so know where you are coming from! I just read a book that is full of info. It really made sense to me. I know you love to learn new things. Maybe this book will help. "Food Addiction, The Body Knows" by Kay Sheppard. It is an old book. I got it on amazon for a penny plus shipping. I wish you the best.
- March 20, 2012 at 8:39 AM
- Becca said...
Leave the Medifast bars alone! How about when your body says it's hungry you give it some water and a good protein/complex carb snack. Like an apple and natural peanut butter. I'm tellin' ya, you need to let the free diet food go! (I know, I've been there), and the artificial sweetners... sugar free oreos are just as bad for your body as the real deal. Don't kid yourself.
I've struggled this year too by gaining back almost all of the weight I lost last fall on Medifast. It doesn't work long term!...leave that junk alone!
How did you lose your weight in the very beginning??...
I wish you luck Lyn...we all want to see each other succeed in this fight. I hope you are able to gain control again soon, and find a healthy way to lose the weight again. And I agree with the others...you do need a couple pair of pants that fit you now, though don't get so comfortable in them you give up.
- March 20, 2012 at 8:54 AM
i have been reading for a while now. i would like to encourage you to check out the following website. you may not think it applies to you, but since you were basically starving your body, i believe in some ways it does, and why you always find yourself weighing so much more after eating "off-plan." the link i am leaving has some useful info on it for anyone that has been trying to lose weight, but you might want to check out the whole website.
even if you feel it doesn't apply to you, it is an interesting read.
good luck, i know how it feels to have a difficult relationship with food.
- March 20, 2012 at 10:23 AM
- Redfizz said...
Wow. Thank you for being so honest. I know exactly how you feel. :(
You are such an inspiration! Stay well and keep going!
- March 21, 2012 at 11:56 AM
- Steelers6 said...
Hi, friend. My son is eating very few carbs right now, & no longer seems to have the heartburn/reflux thing. Seems it was caused by carbs. ? Just thought I would pass that on, since you were eating low carb/high protein and did not have that problem then. Maybe too many carbs have found their way into your menu?? I don't know, it was just a thought.
Wishing you the best,
- March 21, 2012 at 6:39 PM
- Another Step Forward said...
I just came across your blog today. I am a SAHM of four kiddos under 10 years old. I have been sturggling with obesity most of my married life, especially since having children. I lost a lot of weight - from about 250 to 180 - after baby# 2, but added it all and more while pregnant with baby# 3.
I have been trying recently to unzip this fat suit and step into the life I want, be the mom I want my children to remember.
I was inspired when I first found your blog to see your before and after pictures. Thank you for being open about the struggle to maintain it! Thank you for not disappearing! Your openess reminds me that it isn't just about taking the pounds off, that I need to be restructuring my life to aid myself in being able to keep it off once I get there. Thank you!
- March 26, 2012 at 3:24 PM


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JONESBORO, Ark. (AP) Ryan Aplin threw a 70-yard touchdown pass to Taylor Stockemer to break a tie early in the third quarter, David Oku ran for 131 yards and three scores, and Arkansas State held off Louisiana-Monroe 45-23 on Thursday night to take the Sun Belt Conference lead.
Aplin was 26 of 34 for 334 yards and two touchdowns, and also ran for 44 yards and a touchdown to help Arkansas State (7-3, 5-1) run its winning streak to five games. The Red Wolves began the night tied for the conference lead with ULM (6-4, 4-2) and Middle Tennessee, which is idle this week.
Oku added 1- and 6-yard touchdown runs in the third quarter and a 4-yarder in the fourth. He finished with 22 carries, and J.D. McKissic led the Red Wolves in receiving with 12 catches for 102 yards.
ULM's Cody Wells was 37 of 53 for 357 yards and two TDs, Bryant Leonard had 14 catches for 134 yards, and Je'Ron Hamm added nine receptions for 102 yards. The Warhawks have lost two straight after winning five in a row.
After ULM opened the scoring on Wells' 27-yard pass to Monterrell Washington, Arkansas State took a 14-7 lead on Aplin's 35-yard TD pass to Julian Jones, and Aplin's 38-yard scoring run in the first quarter.
The teams traded 37-yard field goals in the second quarter, with Justin Manton connecting for ULM and Brain Davis countering for Arkansas State, and the Warhawks tied it early in the third quarter on Wells' 37-yard touchdown pass to Rashon Ceasar.


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When you speak of my treating my first fans as "a hilarious joke," I'm afraid that it may convey the impression that I thought their support for me was a joke. I was delighted and touched that these girls I had never met were sincerely interested in my career and personal happiness. I was simply amazed that anybody at that time would want to start a fan club for me.
Grace Kelly, NEW YORK CITY


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Current Law Students / Re: Florida Stand-Your-Ground Law isn't that controversial, is it?« on: April 28, 2012, 01:44:12 PM »
Please note that the stand your ground law would not apply in the Martin case, as Zimmerman pursued Martin. Everyone is entitled to a defense, but the primary tenet of self-defense is unprovoked attack, thus the defense would not be available to Zimmerman. The law itself does need to be revised, however, especially the "reasonable belief" standard that shifts the burden to prosecutors to disprove reasonableness, as usually the only person able to dispute what defendant says is dead. It allows for the perfect murder. Also applying the law to "any place you have a right to be" is horribly vague as the public has the right to be many places. It removes the responsibly of every person to exercise caution, and caters to those who actually go looking for trouble. Legislators also need to specify that immunity from criminal prosecution does not kick in without evidence to back up what you say.


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GS23 wrote:I thought it was disrespectful to Mullin, but Lacob had it coming. This is a team that was "guaranteed" to make the playoffs and was only 3 games out when he gave up on them.
Wait... He had it coming for making a guarantee that 90% of owners make in their first season? The smart fans understood when the Warriors failed to obtain a center that the playoffs were probably out of reach... And even the less smart ones got the picture when Curry couldn't stay healthy. What kind of dimwits seriously still had playoff hopes before they traded Monta? Btw, regarding the "3 games under" remark, Riley addressed it: they don't wanna be a middle ground, too good for the lottery, too poor for the playoffs team. We've had ENOUGH of that crap. It's time to make a bold move and they did it.
GS23 wrote:It might work out great but right now we have team built around 2 guys who can't stay on the court and a joke of a coach who isn't going to lead them anywhere.
Have you ever seen a video of Andrew Bogut's injuries? I know the Bay is jaded cause they've seen Steph roll his ankle seemingly over and over this year, but Andrew Bogut has hurt himself in some freak accidents. It's a dull correlation trying to blur the line between injury history and injury prone. Bogut has the former. He has no chronic injuries to date. Just cause he's hurt NOW does not mean he'll always be hurt, show some foresight.
GS23 wrote:The initial boos were well deserved and from there he pretty much egged on the crowd with the "now that we got that over with" comment. Just watching it on tv made me angry because I felt like Lacob and Barry had arrogant attitudes about him like they were talking down to children. I especially lost respect for Barry after he said "this man is spending his money..." We're the ones spending our money and Lacob is the one making the profit. I don't know how many thousands of dollars I have spent on tickets and merchandise supporting this team only to see them fail year in and year out. Talking about accolades, look up in the rafters nothing has happened for this franchise in 20 years. Heck we haven't even had an all star since Sprewell. Yeah the crowd might have been a little out of control, but after everything we've been through as a fan base it was bound to happen.
#1, Rick Barry is a blow hard, always has been, and sounded a lot like Triple H riling up a crowd, as Pawno pointed out.
But Lacob was genuinely surprised and sure maybe the remark fueled the fire, but get back to me after you get booed by 20 thousand people and lets see how gracious you are about it... Especially considering RICK BARRY WAS RIGHT. It IS Joe Lacob's money! He HAS shown a willingness to spend that Cohan NEVER did! As I said in my first, embarrassed, post: would you rather he sold the team back to Cohan??? He JUST traded for a top 5 center. Is everyone so near-sighted that they can't recognize what Bogut is because he's wearing a boot brace?? This is the fix EVERYONE has asked for... For THIRTY YEARS... And Lacob made it happen.
For him to be booed because a bunch of drunk assh*les felt like sucking Monta's balls for 5 minutes... It's embarrassing to be grouped into a fan base with morons like that.
For clarification, GS23, I'm bad-mouthing the punks in the arena and not trying to personally attack you. I'm just frustrated at how this whole thing was handled and the seemingly booming pride these people have for "exercising their right AS FANS to boo."


text: OldGreyEagle 4 Posted July 21, 2004 The intent of this sub section is for Scouts and Scouters to exchange posts and thoughts about their own disabilities or that of others to put together a resource of strength My son was born with epispadias, thats an imcomplete formation of the urinary system. There are many forms, anywhere from not having the lower half of the abdomen closed to tiny imperfections. Well, my son was born without a penis. Male yes, but just an opning and some tissue that looked like a split hot dog. After tests to determine sex, (yes, he is a male) an operation was done to surgically construct a penis when he was 6 months old. The problem was without the necessary muscles in the penis, he could never control his bladder, he just leaked urine all the time which was alright as a baby and toddler, but as he got older, it wasnt as accpetable. He was also diagnosed as dyslexic and ADD. Around ages 7-8 he had his ureters transplanted from his bladder to his colon so he would urinate/defecate stool at the same time. This gave him much better control, but if he laughed or was startled, he would have an "Accident". When we first joined the troop, he would also tent with me, I carried all the necessary supplies as well as a portable toilet that he would use. I had it so if it were to be discovered, it would be mine. Well he caught some heck because he was always with daddy. Eventually at age 13 he had a (this is for boleta)appendicovesicostomy (hope I got this right) The surgeons took his ureters off his colon and put them back on the bladder, augmented it with colon tissue and then took his appendix and connected it to the new bladder and the outside abdomen wall. He now urinates by passing a catheter (10 french Doc) through the stoma into the bladder. He sleeps at night with a catheter in his bladder attached to a drainage bag. He tented with me a few times before he said, " I am who I am" and joined the troop. Showing them the bag. He never had a problem, or none that I heard about. He is Add, Dyslexic and has disfluencies, but he was elected SPL as well. HE was patrol leader to the 2001 Naitonal Jamboree, on staff at council JLTC for two years and an Eagle scout with a second bronze palm. In the early days, I and he were ready to quit more than a few times, while his peers came to accept him, the older scouts werent to sure. But I am an old Eagle and I wanted him to see all the benefits of the program. We stuck it out, and both are glad we did. We attended a Naitonal Jamboree together, even if he did need two footlockers, one full of supplies, we have been white water rafting in Maine, been to Gettysburg, Antietam and a whole bunch of other places. Do not quit, move around if you have to. You can find accptance, you may have to be his advocate as I am sure you are now. In the end, the scouts will mirror the behavior of the adults (that adult association thing, its pretty powerful stuff). You will find a troop that accepts people for who they are, it can be done. Share this post Link to post Share on other sites


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Professor Rafid Al-Khaddar, Head of Construction and Civil Engineering Department at John Moores University, Liverpool, and Key Associate and Fellow of FSTC, presented a lecture on "Science and Research in the Arab World".
Professor Rafid Alkhaddar*
Note of the editor
Professor Rafid Al-Khaddar, Head of Construction and Civil Engineering Department at John Moores University, Liverpool, and Key Associate and Fellow of FSTC on Environment in Muslim Heritage, presented a lecture in the symposium hosted by the Cambridge University Arab Society (CUAS) on Science and Research in the Arab World: Obstacles, Challenges and Future Perspectives on 14th March 2009. Hereafter, we publish the abstract of Professor Al Khaddar's lecture, a short biography, a notice on the Cambridge University Arab Society and some resources for further reading.
Figure 1: Professor Rafid Al-Khaddar.
The Symposium was well attended by a young generation of Arab scholars studying at Cambridge. It was also attended by some Professors and Academics from Cambridge who are interested in the history of the Arab World and its policy, education and development. Also in attendance were representatives of Arab universities, members of non-governmental organizations, diplomats, and participants from businesses and charitable organizations. The presenters were from different parts of the Middle East and informed the conference of their different activities with regards to the development of science and technology within their own fields of work. This included a presentation of the activities of the Kuwaiti Institute for Scientific Research, the Arab Science and Technology Foundation and an insight of scientific research in Syria. The audience was very well informed and contributed to the conference with a number of testing questions to the presenters. A workshop followed the presentation and this was focused on discussing the proposed formation of the Arab Scientific League where the experiences of the attendees were shared and discussed in order to formulate and agree a mission statement for the proposal. A memorandum of understanding was signed by all the attendees committing themselves to helping the organising committee in their work for developing the proposal and the formation of the Arab Scientific League.
Click here for the list of speakers and the timetable of the Symposium.
Figure 2: Rafid Al-Khaddar with members of the Cambridge University Arab Society during the symposium.
1. 1001 inventions v.1001 nights
The state of our education is such that it shows a gap summarising the Amnesia of 1000 years where it is termed as the 'Dark Ages'. During that period science and education was flourishing in the Muslim world. None of the 40 great scientist/ inventors during that gap can be found in the popular literature or school curricula nor in street names of laboratories. Each of these is as important as Newton. Take Al-Biruni for example who authored 200 books, theoretical predictions and verifications through field experiments on various subjects such as Astronomy, Mathematics, Geodesy, Observatories, Astrolabes, etc. The House of Wisdom in Baghdad (in activity the early 8th Century) was the first Institute of Learning and scholarly work. It had Muslims and non-Muslims as well male and female scholars working together.
Figure 3: Attendees of the lecture.
A large number of Scholars worked on Environmental aspects from the early days and contributed with a number of inventions. The preservation of the Environment and water is part of the belief of Muslims and it is referred to in many versus of the holy Quran.
Figure 4: Poster of an activity of the Cambridge University Arab Society: Arabic Music Night. (Source).
So what happened? The Arabs started to fight within themselves. The Crusaders used this weakness to defeat them and remove them from the Andalus (Muslim Spain). The Mongols and the Tatars invaded the Islamic World and drove it backwards. The Islamic World never recovered from this and got involved in many wars and struggles since. This resulted in centralised governments, diminished individuality and independence. All these factors significantly reduced and affected scholarship and innovation. It also increased dependence on the state. In this context, the state was blamed for everything and no one took responsibility.
What is the way forward then? Muslims need to stop looking backwards and instead of asking how did we get into the hole, they should start looking for ways to get out of it. We need to use the strong foundation that was built by our ancestors to rise and rebuild the glory. Muslims need to get involved in debates to highlight the role that they can play which is based on their background and heritage.
Many current scholars have attempted to form organisations and institutions for this very purpose. The author and a number of other colleagues formed ARABTECH. This is intended as a non profit organisation. One of the main objectives is to establish contacts with the Muslim world and Arab World to offer their services to ensure the correct transfer of technology to these countries. There is a high calibre Arab professionals in the West and they occupy senior positions in Industry and academia. They are also highly involved in the decision making process. These experts can be pooled together to produce a body of significant weight to serve the needs of the Arab World in order to advance its national industries.
It is believed that through such an organisation the Arab world will start to realise the potential of these people and use their knowledge and expertise to advance the way of thinking within these countries and creating a strong link between Arab professionals and Arab countries.
2. Professor Rafid Alkhaddar: A short biography
Professor Rafid Mustafa Alkhaddar is a Professor in Water and Environmental Engineering at Liverpool John Moores University. He is the Director of Studies for Construction and Civil Engineering Studies. He has over 20 years of experience in teaching research and consultancy in water and environmental related subjects.
His research interests are in water and wastewater treatment methods, where he published 70 scientific papers and reports in refereed journals and international conferences.
He managed to attract over £500,000 in research funding in the past four years to enable him to conduct his research activities.
He is a Chartered Engineer, a Chartered Environmentalist and a Fellow of the Chartered Institution of Water and Environmental Management (CIWEM) and a Fellow of the Higher Education Academy.
3. The Cambridge University Arab Society
The Cambridge University Arabic Society (CUAS) is a cultural, non-political university society aimed at bringing together Arab and non-Arab students at the university and to give an insight into Arab culture, traditions, and history. It is open to people of all backgrounds, ethnicities, races, and beliefs.
See the website of The Cambridge University Arabic Society and its 2008-09 Committee. The committee can be contacted at firstname.lastname@example.com.
4. Further resources
- Abbot, Alison, Islamic science: Rebuilding the past, Nature vol. 432, pp. 794-795 (16 December 2004) | doi:10.1038/432794a; Published online 15 December 2004.
- Al Khaddar, Rafid: A Biography, on the website of John Moores University in Liverpool.
- Al Khalili, Jim, It's Time to Herald the Arabic Science That Prefigured Darwin and Newton (published 3 January, 2009).
- Fazlun M Khalid, Islam and the Environment, Encyclopedia of global environmental change, editor-in-chief T. Munn, vol. 5: Social and economic dimensions of global environmental change, edited by Peter Timmerman, pp. 332–339. Chichester: John Wiley & Sons, 2002.
- FSTC, Remembering the Language of History and Science: When the World Spoke Arabic (published 1 January 2009).
- FSTC, The Emergence of Scientific Tradition in Islam (published 21 December 2006).
- FSTC, Islamic Science, the Scholar and Ethics (published 24 February 2006).
- FSTC, The fallacy of the 'Dark Ages' (published 01 November 2002).
- Khan, Yasmin, "Shining light upon light", Nature, vol. 458, 12 March 2009, pp. 149-150; doi:10.1038/458149a. Two online version are displayed at the website of Nature: Full Text and PDF version.
- Islam and Science special Nature vol. 444, 28 (2 November 2006), doi:10.1038/444028a; published online 1 November 2006.
- Khan, Yasmin, 1000 years of missing science (published 20.12. 2006).
- Maziak, Wasim, Science in the Arab World: Vision of Glories Beyond, Science vol. 308. no. 5727, 3 June 2005, pp. 1416-1418.
- Ozturk, Ruveyda, A Plea for the Recovery of the Forgotten History of Muslim Heritage (published 10 January, 2009).
- Science and technology education in the Arab world in the 21st century, Connect: Unesco International Science, Technology & Environmental Education Newsletter, vol. 28, No. 3-4, 2003.
- Science in the Arab world (Editorial), Nature vol. 441, 1027 (29 June 2006), doi:10.1038/4411027a; published online 28 June 2006.
*Head of Construction and Civil Engineering Department at John Moores University, Liverpool, UK.


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Surgical techniques
From SurgWiki
This chapter reviews techniques used in surgical practice and invasive procedures.
The operating room
The operating room is a dedicated area for surgical procedures and must be conducive to performing surgery to the highest standards of safety for patients and staff. The principal purpose of such a dedicated area is to reduce the risk of infection of patients. The operating room must be large enough for complex procedures to be undertaken, for storage of appropriate equipment, movement of staff, as well as the maintenance of a sterile area around the operative field. By changing the operating room air 20–25 times each hour at positive pressure relative to outside the room, low concentrations of airborne bacteria and particulate matter can be maintained. The number of people in the room and their movement should be minimised. Ambience should be calm and professional, and the air temperature such that inadvertent patient hypothermia does not occur. The operative field must be well illuminated by direct bright light, and surgeons sometimes wear a head light for procedures in body cavities which cannot be illuminated easily by standard operating room lights.
The surgeon's assistant has the important role of assisting and supporting the surgeon in the smooth conduct of operations. It is important to concentrate on the task at hand, to carry out the surgeon's instructions with speed and accuracy, to have a sense of anticipation, and to notify the surgeon of any potential hazard during the operation.
A face mask which covers the nose and mouth prevents droplet spread of bacteria, is worn for any invasive procedure and is changed after each case. Eye protection in the form of plain plastic glasses or a visor attached to the face mask must be worn to protect against droplet spray of infected body fluids. Gloves are worn if there is a possibility of coming into contact with patients' body fluids. Clean theatre attire, dedicated theatre shoes, and a disposable hair cover are worn while in the operating suite.
Aseptic techniques
Aseptic techniques are clinical practices which aim to prevent infection occuring in the patient as a result of the surgical procedure by:
- Preparation and cleaning the patient's skin with antiseptic fluid before it is cut or punctured.
- Use of sterilised instruments, equipment or surgical materials which might come into contact with the operative field and surgical wound.
Personnel involved directly in the operative procedure (surgeon, surgical assistant and 'scrub' nurse) wash their hands and forearms with antiseptic soap for 5 minutes before the first operation of the day and for 3 minutes before each subsequent case to reduce skin flora. Hands are dried with sterile towels, and a moisture-impermeable sterile gown is worn. One or two pairs of sterile gloves prevent transfer of bacteria from the surgeon's hands to the patient and also protect the surgeon from infected blood and body fluids from the patient.
The patient should shower or bathe with an antiseptic soap before going to the operating room. After induction of anaesthesia, hair is removed from the operative site by shaving with a razor or electric clippers. The skin is cleansed with an antiseptic solution starting at the site where the incision will be made and working away from the area, so that approximately 10–20 cm of skin around the incision site is prepared. The patient is covered with sterile linen or impermeable drapes, leaving exposed only the cleansed area around the incision site, which may be covered by a sterile adhesive plastic drape.
Surgical antiseptics
The commonest source of bacterial contamination in the operating room is from the patient. Therefore, topical antiseptic agents are used to reduce the number of skin organisms prior to any skin incision or puncture, and include:
- Aqueous chlorhexidine (0.5%) is used to disinfect mucous membranes and parts of the body adjacent to structures which would be adversely affected by more stringent antiseptics (e.g. the skin around the eyes). Aqueous chlorhexidine is bactericidal and has low tissue toxicity.
- Cetrimide (2%) is bactericidal.
- Iodine-based antiseptics (e.g. povidone iodine (10%) [Betadine], alcoholic iodine solution) destroy a wide range of bacteria, especially staphylococci, by iodisation of microbial proteins.
- Alcohol-based (70%) antiseptics kill bacteria by evaporation.
Anything that comes into contact with the surgical wound must be sterile. The method of sterilisation depends on the item being sterilised (Methods of sterilisation).
Universal precautions
The risk of transmission of infectious agents from patients to staff (and vice versa) is reduced by practising universal precautions. Thus, it is assumed that all patients harbour potentially dangerous pathogens (e.g. hepatitis C, HIV) no matter how innocuous they appear, because carrier status cannot definitely be excluded without repeated, expensive and time consuming investigations. The principle of universal precautions is to establish a physical barrier between the patient and the carer to prevent direct contact with any potentially infected body fluid or tissue in either direction (Universal precautions).
In addition to infection, there are many potential sources of hazard in the operating environment. Hazards, other than those intrinsic to the anaesthetic and surgical operation, are organisational, or related to operating room equipment or the transfer and positioning of the patient on the operating table.
Organisational hazards
Organisational hazards should be entirely preventable. A full history and examination of the patient must be made before surgery, including the past medical history, drug history and allergies, so that elementary errors are not made (e.g. unwittingly operating on a patient with a pacemaker or who is anticoagulated, or prescribing a drug to which the patient is allergic). Before surgery commences, the reason for and nature of the operation, together with its potential common and serious complications, and the reasonable expectations from the procedure, are discussed with the patient and family who are free to ask any questions. A consent or request for treatment form, which states the nature of the operation and the side on which the operation is to be performed if the operation is a unilateral procedure, is signed by the patient and the surgeon or deputy.
Once in the operating suite, a check is made that the patient is the correct one for that procedure, that the correct side or limb is identified and marked with an indelible pen, and that the lesion or lump is similarly marked to ensure that there is no confusion after the patient has been anaesthetised. All relevant case notes, investigation results and X-rays must be available in the operating room.
Diathermy is used universally in surgical practice. High frequency alternating current passes from a small point of contact (active electrode) through the patient to a large contact site (indifferent electrode or diathermy plate) to produce localised heat which coagulates protein. Diathermy produces either (a) coagulation - haemostasis with a small amount of adjacent tissue damage, (b) cutting - tissue cutting with minimal tissue damage, or (c) fulgaration - haemostatsis with considerable tissue necrosis. Potential hazards include electrocution, inadvertent burn to the patient at a remote site and to the surgeon, fire associated with pooled alcohol-based antiseptics, explosion of flammable anaesthetic gases, and interference with the function of cardiac pacemakers.
A variety of lasers with different wavelengths and effects on cells and tissues are used in surgical practice for highly accurate tissue destruction (e.g. mucosal surgery, CNS tumours, dermatological lesions, aerodigestive tumours), coagulating blood vessels (e.g. gastrointestinal tract, retinal photocoagulation), and for photo-activation of intra-tumour haematoporphyrin for malignant tumour destruction (photodynamic therapy). Hazards include eye damage, explosion of anaesthetic gases, and shattering and destruction of other equipment.
Limb torniquets are used to provide a blood-less field in which to operate. The limb is elevated and exsanguinated by a rubber bandage or compressive sleeve, and the proximal torniquet inflated to 50 mm Hg (upper limb) or 100 mm Hg (lower limb) above systolic blood pressure. A torniquet should not be kept inflated for more than 60-90 minutes. Hazards include arterial thrombosis, distal ischaemia, nerve compression and skin traction.
Positioning of the patient
The patient is positioned on the operating table in such a way that the procedure is facilitated and the airway can be protected. Pressure points are padded, and limbs are positioned so that peripheral nerves, major blood vessels, joints and ligaments are not stretched or compressed. The anaesthetised patient must be in a stable position on the operating table and may need to be strapped on with broad adhesive tape. There must be no contact between the skin and any metallic surface because of the risk of diathermy burn and pressure necrosis. Sections of the operating table can be angled so that the patient is optimally positioned for the particular procedure (e.g. flexed while lying supine or on one side, head-down, head-up).
Endoscopy is performed by inserting a fibre-optic telescope containing a light source and instrument channels into the gastrointestinal, respiratory and urinary tracts. The operator undertakes the procedure by manipulating the endoscope while viewing a video screen or looking down the eye piece of the instrument.
Gastrointestinal endoscopy
Endoscopy of the gastrointestinal tract allows the endoscopist to view the lumen of the oesophagus, stomach and proximal half of the duodenum (oesophagogastroduodenoscopy), colon (colonoscopy), and rectum and distal sigmod colon (sigmoidoscopy), and distal rectum and anal canal (proctoscopy). It is usually performed under sedation. Intestinal endoscopy can also be performed at laparotomy (enteroscopy) by making a small incision in the intestine and the surgeon passes the endoscope along the intestinal lumen. Procedures, such as dilatation of strictures, biospy and diathermy ablation of polyps, injection of adrenaline around bleeding gastric and duodenal ulcers, cholangio-pancreatography, removal of common bile duct calculi, injection of haemorrhoids, and tumour phototherapy can be performed using fibreoptic endoscopes.
The upper airway, trachea and proximal bronchi can be inspected by bronchoscopy, which may be performed under local or general anaesthesia. Bronchoscopy is used for diagnosis (e.g. inspection and biopsy of lung tumours) or therapy (e.g. removal of foreign bodies, aspiration of secretions). Anaesthetists ocassionally use the fibre-optic bronchoscope to facilitate difficult endotracheal intubation. (see also Common topics in thoracic surgery).
Urological endoscopy
The urethra (urethroscopy), bladder (cystoscopy), and ureters (ureteroscopy) can be inspected for diagnostic purposes. Extensive therapeutic procedures (e.g. resection of the prostate, diathermy and excision of bladder tumours, extraction of calculi) can be performed safely with far less morbidity than the equivalent open procedures.
Endoscopic surgery
Endoscopic surgery is performed by inserting a microchip video camera with a light source and specially crafted long-handled surgical instruments into a body cavity by way of small incisions. The surgeon undertakes the procedure by manipulating the instruments while viewing a video screen.
The advantages of endoscopic or 'closed' surgery are reduced post-operative pain and analgesic requirements, earlier discharge from hospital, and earlier return to normal function. However, many surgical procedures either cannot be undertaken endoscopically because of their very nature, or cannot be completed endoscopically because of difficulty or patient safety, in which case the operation is converted to an 'open' procedure. Some procedures use endoscopic techniques to assist with the procedure and an incision is made to either complete the operation or deliver the resected specimen (e.g. bowel resection, nephrectomy, splenectomy). The range of endoscopically performed operations in many surgical specialties has increased enormously over the last 10–15 years.
Abdominal surgery
Laparoscopy refers to the technique of insufflating the peritoneal cavity with gas, inserting a camera through a 10–15-mm sub-umbilical incision and inspecting the abdominal contents. Usually, three additional ports are inserted through 5–10-mm incisions in the abdominal wall and instruments (e.g. scissors, grasping devices, retractors, staplers, needle holders) are introduced and manipulated by the surgeon to perform the operation. Procedures such as cholecystectomy, gastric fundoplication, hiatus hernia repair, division of adhesions, appendicectomy, splenectomy, adrenalectomy, nephrectomy, oophorectomy, tubal ligation, and hernia repair can be undertaken laparoscopically with less morbidity than if undertaken as an open or conventional operation. Endoscopic surgery has allowed some procedures to be undertaken as day cases, whereas the same procedure performed as an open operation would require an inpatient stay of several days (e.g. cholecystectomy, hernia repair).
Thoracic surgery
Thorascopy involves inserting a camera with a light source and instruments into the thoracic cavity. The technique is used diagnostically and therapeutically for procedures such as drainage of the thoracic cavity (haemothorax, pleural effusion and empyema), lung biopsy, pleurodesis, and excision of lung bullae. The mediastinum can be inspected and mediastinal lymph nodes can be biopsied by mediastinoscopy, which may prevent the need for an exploratory thoracotomy.
Orthopaedic surgery
Large joints (e.g. knee, hip, ankle, shoulder, wrist) can be inspected by arthroscopy. Therapeutic procedures include removal of bone chips, cartilage excision and removal, and ligament repair. Arthroscopic surgery has been enormously beneficial for orthopaedic patients and has allowed far more rapid return to function.
Open surgery
Open surgery is the traditional or conventional method of operating. In general terms, open surgery involves making a surgical wound, dissecting tissues to gain access to and mobility of the structure or organ of interest, completing the therapeutic procedure, ensuring haemostasis is complete, and then closing the wound with sutures. Open surgey is performed more with the hands and direct touch than endoscopic procedures, and fingers may be used for 'blunt' dissection. The surgical wound accounts for much of the morbidity of open surgery, particularly the cutting of muscle. The range of open operations is extremely wide, as evidenced by the procedures described throughout this book.
Surgical methods
Surgical operations are performed by well worked out, standardised steps which progress in logical sequence. An operative plan is worked out by the surgeon for every operation.
Surgical instruments
There are literally thousands of surgical instruments, some simple and others extremely complex, but each designed for a specific function. The surgical incison is made with a scalpel which consists of a re-usable handle and a disposable blade. Scissors are used to cut other tissues and sutures, and for blunt dissection with the blades closed. Diathermy is used for haemostasis and to cut through tissue layers beneath the skin. Tissues are held with dissecting or tissue grasping forceps rather than the fingers. Hand-held forceps either have teeth which tend to dig into and damage tissues, or are non-toothed with poorer grasping ability. Needle holders are used to grasp needles for suturing and eliminate the need for hand-held needles, and are therefore safer. They have a ratchet so that the needle can be contained securely in the holder while not in the surgeon's hand. Retractors allow the surgeon to operate in an adequately exposed field. Self-retaining retractors keep the wound edges apart without the aid of an assistant. Retractors held by the assistant provide tissue retraction in awkward parts of the wound and in situations where retraction of specific tissues is required so that intricate parts of the operation can be performed. A sucker is used to aspirate blood and body fluids from the operative field and to remove smoke created by the diathermy. There are many instruments designed specifically for surgical specialties and procedures.
Surgical incisions are made so that:
- The operation can be undertaken with adequate exposure of the area or structure of interest.
- The procedure can be performed and completed safely and expeditiously.
- The wound heals satisfactorily with a cosmetically acceptable scar.
Thus, incisions are to be of adequate but not excessive length and, if possible, placed in skin creases, particularly when operating on exposed areas of the body such as the face, neck and breast. Parallel skin incisions (tram tracking) and V- or T-shaped incisions are avoided because of ischaemia of intervening tissue and pointed flaps.
Tissue dissection
Ideally, surgical dissection should be performed along tissue planes which tend to be relatively avascular. The aim is to isolate (mobilise) the structure(s) of interest from surrounding connective tissue and other structures with the least amount of trauma and bleeding. Tissues should be handled with great care and respect and as little as possible. Dissection is undertaken by using a scalpel or scissor (sharp dissection), a finger, closed scissor, gauze pledget, or scalpel handle (blunt dissection), or the diathermy. Gentle counter traction on tissues by the assistant facilitates the dissection.
Surgical haemostasis refers to stopping bleeding which occurs with transection of blood vessels. The majority of cases of operative and post-operative bleeding are due to inadequate surgical haemostasis rather than disorders of clotting and coagulation. Haemostasis is essential in order to prevent blood loss during surgery and haematoma formation post-operatively. Methods of surgical haemostasis include:
- Application of a haemostatic clamp to a blood vessel and then ligation with a surgical ligature (see Care of the critically ill patient).
- Suture ligation of a vessel - under-running a bleeding vessel with a figure-of-8 suture which is tied firmly.
- Diathermy coagulation (see Anaesthesia and pain management).
- Localised pressure for several minutes to allow coagulation to occur naturally.
- Application of surgical materials (e.g. oxidised cellulose, Surgicell) which promote coagulation.
- Application of topical agents to promote vasoconstriction (e.g. adrenaline) or coagulation (e.g. thrombin).
- Packing of a bleeding cavity with gauze packs as a temporary measure until definitive haemostasis can be achieved.
Sutures have been used to close surgical wounds for thousands of years, and initially were made from human or animal hair, animal sinews, and plant material. Today, a wide variety of material is available for suturing and ligating tissues (Sutures).
Sutures are selected for use according to the required function. For example, arteries are sutured together with non-absorbable polypropylene or polytetrafluoroethylene (PTFE) sutures which are nonthrombogenic, cause virtually no tissue reaction, and maintain their instrinsic strength indefinitely so that the anastomotic scar (which is under constant arterial pressure) does not stretch and become aneurysmal. Skin wounds, for example, are sutured with either non-absorbable sutures, which are removed after several days (see Care of the critically ill patient), or absorbable sutures hidden within the skin (subcuticular sutures) and which are not removed surgically but are absorbed after several weeks.
Sutures are available in diameters ranging from 0.02–0.50 mm. The minimum calibre of suture should be used, compatible with its function. Non-absorbable sutures are avoided for suturing the luminal aspects of the gastrointestinal and urinary tracts because substances within the contained fluids (e.g. bile, urine) may precipitate on persisting sutures and produce calculi.
The requirements of suture material are:
- Tensile strength - the suture must be strong enough to hold tissues in apposition for as long as required.
- Durability - the suture must remain until either healing is advanced or indefinitely if the healed tissue is under constant pressure.
- Reactivity - tissue reaction (i.e. an inflammatory response) allows absorbable sutures to be removed by phagocytosis but results in chronic inflammation if non-absorbable sutures remain in situ.
- Handling characteristics - sutures must be easy to grasp, handle and tie.
- Knot security - sutures must be able to be tied effectively so that knots do not come undone or slip. Sutures are classified as:
- Absorbable or non-absorbable. The rate of absorption of absorbable sutures depends on what they are made of and their thickness. Disappearance of the suture occurs through inflammatory reaction, hydrolysis or enzymatic degradation.
- Synthetic or natural material. Sutures of natural (animal) origin are being phased out of surgical practice because of the very minimal risk of disease transmission. A wide variety of synthetic suture materials are available.
- Monofilament or multifilament. Monofilament sutures pass through tissues easily, are generally less reactive, and are more difficult to handle and knot securely. Multifilament sutures are braided or twisted thread, and are easier to handle and knot, but are more likely to harbour micro-organisms within the suture.
Surgical knots
Knots are tied to ensure that ligatures and sutures remain in place and do not slip or unravel. The ability to tie a secure knot is a fundamental technique in surgery, and patients' lives literally depend on knot security (e.g. the knot in a ligature used to tie off an artery). Knot security depends on friction between the throws of the ligature material, the number of throws used to tie the knot, the strength of the ligature material, and the tightness of the knot. Usually, multiple throws are used to secure the knot (e.g. two reef knots, one on the other).
The technique of suturing depends on the tissue and wound being sutured. Sutures may be either continuous (e.g. subcuticular skin sutures, abdominal closure, vascular anastomosis), or interrupted (e.g. skin sutures, sternal wires). The function of sutures is to hold the adjacent edges of sutured tissues in apposition and to immobilise them in that position so that wound healing (i.e. neovascularisation, connective tissue ingrowth and collagen formation) is facilitated. It is essential that sutures are not tied so tightly that the tissues encompassed by them become ischaemic. Skin sutures may be supported by adhesive paper tapes.
Retention sutures (incorrectly referred to as tension sutures) are used to close abdominal incisions which are thought to be at increased risk of dehiscence, and are inserted to encompass a large amount of fascial tissue and are placed 3–5 cm apart.
Within the last two decades, stainless steel staples have been used to close skin wounds and to perform gastrointestinal anastomoses. Staples are quicker to use than sutures, but are relatively expensive and produce a worse cosmetic result for skin closure than subcuticular absorbable sutures.
Suture removal
Sutures are removed as early as possible to minimise the risk of infection and scarring, so long as tissue healing is sufficently advanced that the wound will not open when the sutures are removed. Sutures are therefore removed at different times, depending on tissue and general patient factors (Timing of suture removal). for example, sutures are left in situ for a longer time in patients who are immunosuppressed, malnourished, jaundiced, or undergoing chemotherapy; who have renal failure, and in tissues judged to be relatively ischaemic, subject to increased stress and tension, and which have been irradiated.
Surgical drains
Drains are used widely in surgical practice to
- Remove blood or serous fluid, which would otherwise accumulate in the operative area (e.g. wound drain).
- Provide a track or line of minimal resistance so that potentially harmful fluids can drain away from a particular site (e.g. drain placed into an intra-abdominal abscess cavity).
Several different methods of drainage may be used depending on the required function.
- Open drainage - a drain tube or strip of soft flexible latex rubber is placed so secretions or pus can drain along the track of the drain into gauze or other dressing covering the external end of the drain tube (e.g. drain placed in an abscess cavity, drain placed prohylactically near a bowel anastomosis in case of subsequent anastomotic leak).
- Closed drainage - a tube is placed into an area or viscus to drain fluid contents into a collecting bag so that there is no contamination of the drained area from outside the system (e.g. chest drain, urinary catheter, cholecystostomy drain).
- Closed suction drain - the drain tube is connected to a bottle at negative atmospheric pressure so that fluid is sucked out of the area (e.g. wound drain, drain under skin flaps).
It is important to note both the amount and the type of fluid which drains. Large volumes of fluid drainage may need to be replaced as intravenous fluids (e.g. duo-denal fistula fluid). Depending on the particular situation, it may be necessary to culture drain fluid or send it for estimation of haemoglobin, creatinine, electrolytes, amylase or protein. A radiological contrast study may be performed along the drain tube, for example to estimate the size of a cavity being drained.
Drain tubes are removed when they are no longer required, for example when there is minimal fluid being drained, or when a cavity being drained has contracted and is small. Drains are removed simply by cutting the suture which anchors them to the skin and withdrawing the tube from the patient.
Venepuncture involves removing blood from a superficial vein, usually in the antecubital fossa or dorsum of the hand, by inserting a needle attached to a syringe or collection tube at negative pressure (vacutainer system). A venous torniquet is applied around the arm, which is hung in a dependent position; the patient vigorously opens and closes the hand, and the vein is gently patted to encourage venous dilatation. The skin is cleansed with antiseptic and the needle is inserted through the skin into the dilated vein at an angle of 30–45 degrees. Only the required volume is aspirated, the torniquet is released, the needle is withdrawn, the puncture site is immediately covered with a cotton wool swab, and light pressure is applied for 1–2 minutes. The site is covered with an adhesive dressing. Complications include bruising, haematoma, and rarely, infection and damage to deeper structures. Inadvertent needlestick injury to the venepuncturist is avoided by careful technique.
Intravenous cannulation
Intravenous (i.v.) cannulation is used commonly for administration of fluids and drugs. Superficial veins on the forearms and dorsum of the hands are used for i.v. cannulation. Antecubital fossa veins are best avoided for cannulation because the elbow has to be kept extended to avoid kinking of the cannula. Leg veins may have to be used in the absence of useable upper limb veins. Cannulas have a soft outer Teflon sheath attached to a hub, and a central hollow needle attached to a small chamber.
A suitable vein is identified as for venepuncture. Local anaesthetic cream is applied to the skin overlying the vein or local anaesthetic (1% lignocaine without adrenaline) is injected intradermally next to the vein after cleansing the skin with antiseptic. The cannula (needle and sheath) is inserted through the skin into the vein at an angle of 10–30 degrees and advanced into the vein in the same movement. The needle is removed from the sheath and a closed three-way tap or i.v. giving set is joined to the hub of the sheath. The cannula is secured to the skin with adhesive tape.
Intravenous infusion is painful when the infusate is cold or contains irritants (e.g. potassium, calcium, drugs of low or high pH), or if the cannula pierces the vein wall and fluid extravasates subcutaneously. Thrombophlebitis develops at the insertion site after about three days, and i.v. cannulas should be re-sited if infusions are required for longer periods.
Central venous catheterisation
Percutaneous catheterisation of a central vein is used for
- Short- or long-term venous access when peripheral veins are unsuitable or cannot be used (e.g. prolonged fluid infusion, total parenteral nutrition, ultrafiltration, haemodialysis, plasma exchange, chemotherapy).
- Short-term monitoring of central venous pressure A central venous catheter (CVC) may be inserted into the internal or external jugular vein or the subclavian vein. Temporary CVCs are made of semi-rigid Teflon, are approximately 25 cm in length and, depending on their function, are between 1 and 4 mm in diameter and have one, two or three lumens. Long-term CVCs are made of barium-impregnated silastic and are quite flexible. They have a Dacron cuff bonded to the part of the catheter which lies subcutaneously and becomes incorporated by fibrous tissue after several weeks so that organisms cannot track along the catheter from the skin into the circulation.
Some long-term single lumen CVCs are available with a small volume chamber attached to the extravenous end of the catheter (Portacath, Infusaport). The chamber is implanted subcutaneously after the vein is catheterised and can be accessed for chemotherapy or blood sampling by inserting a needle into it through the skin.
CVC insertion is best performed in an operating theatre, under local or general anaesthesia, and with ultrasound localisation of the central vein. The patient is placed in a supine, slightly head-down position, and the surface anatomy of the vein is marked. Aseptic technique is essential. A hollow wide-bore needle is inserted into the vein, a guidewire is passed down the needle and the needle is removed. The guidewire position is checked radiologically. A plastic dilator is passed over the guidewire to dilate a track for the catheter and is removed, and the CVC is passed over the guide wire which is removed after the CVC is in place. A chest X-ray is performed to check the final position of the CVC and also to ensure that a pneumo- or haemothorax has not occurred due to inadvertent puncture of the pleura or lung. The catheter is sutured to the skin to prevent dislodgement and the exit site is dressed with an adhesive dressing.
Further reading
Keen G, Farndon JR, eds. Operative Surgery and Management. 3rd ed. Oxford: Butterworth-Heinemann; 1994.
Select the single correct answer to each question.
- Universal precautions:
- protect operating theatre staff from electric shocks
- prevent polluted air from entering the operating theatre
- impose a physical barrier between patients and carers
- are only to be used when operating on patients
- protect only against bacterial pathogens
- Endoscopic surgery:
- has a very limited role in general surgical practice
- is inherently unsafe because the surgeon cannot touch the structures being operated on
- is associated with greater post-operative pain and immobility
- enables cholecystectomy to be performed as day case surgery in some patients
- can only be used for part of an operation
- Sutures:
- should be left in the skin for a minimum of 2 weeks
- often need to be removed with local anaesthetic
- must be tied tightly so that arterial inflow into tissues is not possible
- made of catgut lose tensile strength within 3 weeks
- of all types must eventually be removed
- Surgical drains:
- are removed when they are no longer necessary
- should always be removed the day after surgery
- are removed under general anaesthesia
- are not necessary with modern surgical techniques
- are required after the majority of general surgery procedures


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Mkay. So I just got a copy of Premise Medias SLAPP lawsuit against XVIVO.
It is quite possibly the dumbest thing I have ever read in my entire life. And I have read the Bible and Atlas Shrugged.
Its 16 pages.
The first 15 pages explain why they filed the suit in Texas instead of Canada (Premise) or Connecticut (XVIVO). 15 pages. Of this:
12. In addition, on information and belief based on the materials
displayed on the XVIVO Web Site, an Internet user in Texas and in this district can interact with XVIVO over the Internet in the following ways, among others:
a. view XVIVO promotions, offers for services, and solicitations;
b. hyperlink and download various items of sample work product including but not necessarily limited to the Inner Life Video;
c. provide information to, and otherwise communicate with XVIVO;
d. ask questions and receive answers about XVI VO's products and services, including ongoing projects
... etc etc etc etc etc...
Shorter first 15 pages:
YOU CAN GETZ TO XVIVO ON DEH INTRAWEBZ AND DEY HAS EMAILZ SO I CAN SUE THEM IN TIMBUCKTOO IF I WANTS BUT I DONT WANTS I WANTS TEXAZ!Yeah. Im sure it has *nothing* to do with the fact Texas has no anti-SLAPP laws. Premise is suing in Texas because "an Internet user in Texas and in this district can interact with XVIVO over the Internet".
So whats the last page about? Its a fucking ad for EXPELLED:
Premise Media's Expelled: No Intelligence Allowed is a provocative documentary film that examines the scientific community's academic suppression of those who dissent from the belief of the adequacy of Darwinian evolution to explain the origin of life.It goes on and on and on like that. But eventually they get to the meat of their claims. And they make no sense whatsoever:
The Documentary Film Expelled is narrated by Ben Stein, a well known actor, who is also a lawyer, economist, writer, and former presidential speech writer. Mr. Stein and the Expelled producers feel that Neo-Darwinism inappropriately dominates the classroom and academia and are interested in promoting free speech and debate regarding a diversity of views.
In preparing the Documentary Film, Premise Media commissioned computer animation of some of the natural processes inside a living cell (ERV-- Please note, even in the lawsuit, they dont say who made their animation. I will be taking bets in the comments if you have guesses).So, they knew what they were doing was morally and legally wrong, and have been working on a replacement for theatrical release. The animation on the DVD is not in the movie. But the reason they changed it was NOT because it was obviously stolen from 'Inner Life' and other resources.
Some time ago, as part of the pre-release activity relating to the Documentary Film, Premise Media commissioned a DVD highlighting some parts of the Documentary Film as then planned. The DVD was designed as an educational resource highlighting the theme of the Documentary Film and was distributed free of charge in all cases. The resource DVD included a short clip of an animation of the inside of a cell. The short clip showing the cell interior was independently created early in the production process, and was used in the resource DVD. At the time the short resource DVD was made, the Documentary Film was not complete. The final version of the film does not contain the segment from the DVD on which XVIVO appears to base its claims in its April 9 letter.
Even so, Defendant evidently obtained access to the resource DVD or its contents, as indicated in Exhibit 1, because, on information and belief, at the time it sent that letter, XVIVO could not have seen the Documentary Film (it had not been released).
The specific segment from the educational resource DVD is not even in the final version of the Documentary Film to remove.
Makes sense to me.
But this part is funny shit and worth reading 15 pages of "I CAN EMAILZ DEM SO I CAN HAS LAWSUIT IN TEZAS?":
Even if the resource DVD or Documentary Film had relied on the Inner Life Video in part (which it did not), any such use would be protected by the doctrine of fair use.
In addition, the fact that XVIVO makes available the Inner Life Video on its website with the "lead in" that "A full length version of 'The Inner Life of a Cell' is now available online for educational use" (emphasis added) creates an implied nonexclusive license for Premise Media to precisely do what XVIVO now complains Premise Media is doing, arguendo, i.e., make "educational use" of that video, via a Documentary Film.
Shorter version:
So, youve heard it here first, folks! All of you that saw previews of EXPELLED and saw a yellow 'Inner Life'-- you were hallucinating. All of you. Mass, country-wide, specific hallucinations. 'YELLOWZ INNER LIVES IS NUT IN EXPELLED! YELLOWZ INNER LIVES IS NUT IN EXPELLED! WHooooOOOO!'
Dont feel bad, hallucinating readers. Mark Mathis is even having trouble remembering what he has seen and which animation is in EXPELLED:
GW: I have compared the original Harvard footage with the promo DVD version that Myers has posted at Pharyngula, and though I've only seen the film once, as I recall, there are very, very substantial differences between the final cut of the animation and the version that appears on the promo DVD. Is that right?Poor poor Mark Mathis. All those lowly internet rats giving you trouble when all you want to do is steal other peoples hard work and make money. Must be so stressful. Explains you forgetting things.
MM: You know, I haven't made— I believe that's the case; but I haven't actually watched what Myers has posted. I haven't made my own comparison. I apologize; I should have done that, because I have the DVD version. I have the film on PC, too, so I can do that. My problem has been that I'm running so hard and fast doing twenty-seven other things that— I know that we've got Executive Producers who have dealt with this specifically, and this is kind of in the periphery of what I've been involved in. But I'm glad you brought that up, because I need to make that comparison myself, just for my own. But I know, because I've watched both, that certainly there are significant differences and improvements, and I believe that, because of those substantial differences, there isn't any merit to the charge. (H/T Quidam)
This might be what is in the final version of EXPELLED:
So, EXPELLites knew after Dembski got caught they couldnt leave the real 'Inner Life' in, so they created the Frankenstein 'Inner Life' as a place-holder until they could find some 5 year olds to create a shitty Las-Vegas-Meets-TeleTubbies 'Inner Life' for the actual theatrical release because they knew their Frankenstein wouldnt hold water in court. Prescreenings were tightly regulated so 'no one' could attend but stupid rubes who wouldnt be familiar with 'Inner Life' to squeal on Premise.
I gotta say, this lead up and animation detective work has been a hell of a lot more entertaining than the actual movie will be. Now that the 'real' animation is up, I have no reason to waste $10 to go see it myself. Save my money for quality films.
And XVIVO, Harvard, and Howard Hughes Medical Institute are vindicated-- Their hard work, though pilfered by these shameless half-wit Creationists for the past year, will NOT be in the final version of EXPELLED. WHOO!


text:
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Few offbeat Honeymoon destinations in India June 29, 2016 07:41
Now you have all the major preparations underway for your big day, the next big thing to do on your list is to decide and plan for the most important and precious days post your…Read More
World's most famous Bachelorette Party destinations January 21, 2016 04:58
Are you getting married? Or your friends? Throw a Bachelorette Party on world's top most destinations. We are providing some suggestions to help you in choosing the best destination. Las Vegas: Las Vegas is the…Read More
Ideal winter destinations in India January 06, 2016 07:37
Finally, the winter season has begun. Snow and Cold breeze will appeal you to snuggle into a blanket, but if you love traveling and exploring different places, especially in Chilling weather , then it is…Read More
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Have you decided, Where to celebrate New Year.? If yes, refresh your list and if not, check out your favourite destination. To make easier for you, we have listed some of the new year destinations…Read More
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Modern IT city Bengaluru has more than 1,000 temples dated back as early as the 10th century. Visit to a temple in the heart of the modern IT city is worthwhile, even if you are…Read More
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Karnataka was originally known as princely state of Mysore. Definite places to visit in this South Indian state are lakes, forests, majestic palaces, temples, etc. Karnataka is a land with diverse culture and geography. These…Read More
Kodaikanal - "Princess of Hill Stations" June 25, 2015 12:40
Kodaikanal is a city in the hills of the Dindigul district in the state of Tamil Nadu, India. Kodaikanal is located on a plateau above the southern escarpment of the upper Palani Hills at 2,133…Read More
Houston, Texas: A Great Place to Be Yourself October 01, 2013 07:30
I'm known around the office as the guy who never goes anywhere outside New England -- my dream vacation is doing nothing at a bed & breakfast in Maine -- but when I got a…Read More
Bald Head Island, North Carolina: A Hopeful Vision of the Future October 01, 2013 07:23
Picture a place with no noisy automobiles, just golf carts and other quiet electric vehicles. A place with no chain stores or neon signs or urban sprawl, surrounded by pristine beaches and coastal forests, where…Read More
New Haven, Connecticut : A City for Every Palate October 01, 2013 07:00
New Haven may be known for the ivy-league college it houses, but it is far from being your quintessential college town. It is a big city, a little rough around the edges, but manages to…Read More
Cleveland, Ohio: A Great City to Visit October 01, 2013 06:40
In 1969, this Cleveland's Cuyahoga River caught fire. It was an event that inspired songwriter Randy Newman to write: "Burn On, Big River." No big news locally, however: "A strictly run of the mill fire,"…Read More
Destination Guide to Northampton, Massachusetts October 01, 2013 06:26
North-central Massachusetts. About 2 hours from Boston in the foothills of the Berkshires. Located on I-91, about 25 minutes north of Mass. Pike.WHY GO?A funky, small New England college town, named "The Best Small Arts…Read More


text:
The twenty-first-century minivan.
If you're considering a crossover on practical grounds, it's hard to do better than the Toyota Highlander. It squeezes three rows of seats into a manageable mid-size package. It outflanks competitors with three powertrain offerings — an in-line four-cylinder, a V-6, and a V-6 hybrid that achieves 28 mpg combined. The conventional six-cylinder likely would get better fuel economy if it, like the 2.7-liter four-cylinder, came with a six-speed automatic transmission rather than a five-speed. The interior, although lacking the pizazz of some newer offerings, remains a strong point, featuring large controls and all the technology buyers in this segment expect. The Highlander's styling borrows from Toyota's larger, tougher trucks, but the Highlander isn't fooling anyone: it's a minivan for those who don't want to be seen driving a minivan. There are some features that will please former minivan owners, such as second-row captain's chairs that can slide together to become a bench seat. A power liftgate is standard on all but base models. Driving dynamics aren't usually a top consideration in this segment, but we still think Toyota engineers could do better than the Highlander's limp, numb steering and "safe" handling. In fact, Toyota's own minivan, the Sienna, is more engaging to drive.
Chevrolet Equinox
Hyundai Santa Fe
Kia Sorento
Mazda CX-9
new for 2013
The four-cylinder is now available only in the base model. A touch-screen stereo display is now standard, and Toyota's Entune infotainment system is optional on the SE.
Front, side, side curtain, and driver's knee air bags; ABS; traction and stability control; a backup camera; and a tire-pressure monitoring system are standard.
Lots of powertrain options
Hybrid fuel economy
Versatile, user-friendly interior
Bland exterior
Numb driving experience
Base Price Range: $29,715–$47,015
DRIVE: Front-wheel, 4-wheel
TRIM LEVELS: Highlander, SE, Limited, Hybrid, Hybrid Limited
BODY STYLE: SUV/crossover, 7-passenger
ENGINES: 2.7L I-4, 187 hp, 186 lb-ft
3.5L V-6, 270 hp, 248 lb-ft
3.5L V-6/electric hybrid, 270 hp, 280 lb-ft
TRANSMISSIONS: 5- or 6-speed automatic, continuously variable
CAPACITIES: Towing 1500–5000 lb; cargo (behind third/middle/front seats) 10.3/42.3–42.4/94.1–95.4 cu ft


text:
January 9, 2019, 8:52 amDeMarcus Cousins - C - Golden State Warriors
Talking to reporters after Tuesday's game, Steve Kerr said that DeMarcus Cousins' return could be as early as January 16th or as late as January 21st.
This isn't a significant change to what was reported by Shams Charania earlier yesterday. Boogie should debut sometime next week and managers should absolutely grab him in case he is sitting on the waiver wire. It's very possible that the Warriors monitor his minutes but DMC still has top-15 potential as long as he proves he is healthy.
Source: Monte Poole on Twitter
Fantasy News
May 24, 2019, 9:48 pmMike DAntoni - Coach - Houston Rockets
Despite Rockets owner Tilman Fertitta stating his intention to bring back coach Mike D'Antoni, recent departures of key staff may indicate that the team is trying to nudge MDA out according to NYT's Marc Stein.
Large parts of D'Antoni's staff including assistant coach Roy Rogers, assistant Mitch Vanya, video coordinator John Cho and player development coach Irv Roland (noted for his work with James Harden) will not be returning next season for the Rockets. There's some speculation that despite Fertitta's comments, GM Daryl Morey isn't fully on board and might be the primary reason behind the recent firings. D'Antoni has one more season on his contract and it's looking increasingly likely that there will be another shoe to drop.
Source: Marc Stein on Twitter
May 24, 2019, 4:32 pmKevin Durant - F - Golden State Warriors
Kevin Durant (calf strain) still hasn't progressed to on-court work.
Durant has already been declared "unlikely" for Thursday's Game 1 of the Finals and considering DeMarcus Cousins has practiced in full and scrimmaged with the team, it's looking like he might return to action before Durant. There's almost a week until the Finals start so we'll have an update before then.
Source: Anthony Slater on Twitter
May 24, 2019, 4:10 pmDeMarcus Cousins - C - Golden State Warriors
DeMarcus Cousins (torn left quad) scrimmaged on Friday with coach Steve Kerr adding that he looked good.
It's still unclear what the timetable is for Cousins but he hasn't yet been ruled out for Game 1 of the Finals. We'll have an update as we draw closer to the start of the Finals next Thursday.
Source: Nick Friedell on Twitter
May 24, 2019, 3:52 pmAdam Silver - Commissioner - Free Agent
The NBA has moved the start time of free agency to 6 p.m. ET on June 30.
Previously, free agency officially kicked off at 12:01 a.m. on July 1 but the league is moving it up by six hours to accommodate an extra evening in the news cycle. Additionally, teams have permission to set up free agent meetings starting at 6 p.m. ET on June 29.
Source: Marc Stein on Twitter
May 24, 2019, 3:44 pmNeil Olshey - President - Trail Blazers
The Blazers have extended the contract of President of Basketball Operations Neil Olshey through 2024.
Olshey was being courted by the Wizards but will stay in Portland along with coach Terry Stotts. They'll look to run it back next season, hopefully with a full roster intact.
Source: Adrian Wojnarowski on Twitter
May 24, 2019, 3:41 pmPatrick McCaw - G - Toronto Raptors
Patrick McCaw (personal) has been ruled out for Saturday's Game 6 vs. the Bucks.
McCaw hasn't played all series and has pretty much been a non-factor all playoffs.
Source: NBA Injury Report
May 24, 2019, 3:37 pmAndre Iguodala - G/F - Golden State Warriors
Andre Iguodala (left calf tightness) did not participate in Friday's practice session.
Iguodala sat out Game 4 of the Conference Finals with the tight calf but the Warriors aren't worried about him missing Game 1 of the Finals.
Source: Connor Letourneau on Twitter
May 24, 2019, 11:45 amNeil Olshey - Team - Trail Blazers
According to Ben Standig of NBC Sports Washington, the Wizards have shown interest in Blazers' President Neil Olshey becoming the new President of Basketball Operations for the Wizards.
Ted Leonsis has yet to request permission to interview Olshey, who has spent the last seven years with the Blazers and is under contract through the 2020-21 season. Masai Ujiri's name has also been thrown around as a possible candidate and the Wizards would obviously be willing to wait until the end of playoffs before rushing to a decision.
May 24, 2019, 11:32 amNikola Jokic - C - Denver Nuggets
Nikola Jokic said he plans to play for his home country Serbia during the 2019 FIBA World Cup this Summer.
"I am very pleased with everything I did in the NBA this season, I had a great year in which I performed at the All-Star Game and was selected in the NBA All-Star Five. For me, the cherry on top of this whole season would be a medal with the national team. I am fully prepared to do my best to achieve this goal", said Jokic, confirming his participation. He will have a little bit of time to rest up, but Serbia is expected to compete against Angola, the Philippines and Italy starting on August 31. The miles will be a test for the big man, but one he has aced before.
Source: Eurohoops.net
May 23, 2019, 11:49 pmKhris Middleton - F - Milwaukee Bucks
Khris Middleton really struggled in Thursday's Game 5, scoring six points (2-of-9 shooting) and pulling down 10 boards as the Bucks fell 105-99 at home.
Middleton's disappearing act offensively was the difference for the Bucks who really need their second best offensive option to demand the ball and produce more. The airball late in the game was a microcosm of the outing for Middleton. He'll need to take more than nine shots (less than any other Bucks starter) for the team to have a good shot at a Game 6 win in Toronto.