March 11: Lesson with Dr. J - surgical debridement

First, Common drug names of the day: 

Atacand: angiotan: Diovan (Valsartan) = ACE 2 (receptor antagonist) inhibitor for HTN
Nexium (Esomeprazole) = H+ pump inhibitor for GERD

Second, Common medical condition of the day:

*Hiatus hernia (protrusion of upper part of stomach through opening of the thorax due to weakening of the diaphragm --> exacerbate GERD (Gastroesophageal reflux disease)

Third, quick office surgery of the day:

Debridement: Unbridle (to free from restriction)

Second last patient of the day flinched a little bit when alcaine drop was applied.
Just below his right upper lid, there was a big brown scab with a groove.
In a minute he was given xylocaine - after pressure application the area (brown scabby) was excised out, cauterized and was sutured.

Debridement - Dr.J said, I muttered to myself.
I asked if the groove was too big for the skin to heal properly and he said yes, that's why he had to debride the area so that it will heal after the closure - otherwise you get the scar like those who have chicken pox.
Groove, brown and forever lasting.
Debridement he said again.
I really appreciate it when he repeats.

Fourth, word from letters today that caught my attention: 

Stevens-Johnson Syndrome: Cell death separates epidemis from dermis. Main cause is certain medications, infections and rarely cancers. It is a milder form of toxic epidermal necrolysis (TEN) - SJS and TEN can be mistaken for erythema multiforme (type 3 hypersensitivity and more benign). Dermatologic emergency.