Surgery & Complications

Amongst surgeons it is common to say "the only surgeons who do not get complications are those who do not operate". Obviously, just like in any other technical field there are gradations of skill amongst surgeons as there are amongst for example pianists. Excellent surgeons like excellent pianists are far less likely to be off key. However, the human body is also like a piano some are better than others, a finely tuned grand is going to perform better than an out of tune banged up old piano. Some patients because of genetics and environment and underlying medical conditions do not react to surgery as well as another patient might even if the surgery performance was identical. In other words, many surgical complications (intra-operative and post-operative) are just sheer bad luck for the patient and for the surgeon and are not due to surgical error.

I will talk a bit about refractive surgery complications here in this blog as I believe that many misconceptions exist regarding them. By nature I tend to be blunt and very frank, and I will say when a complication is more likely to be surgeon related than just simply bad luck.

In LASIK one common complication post-op is called DLK (diffuse lamellar keratitis) and it is essentially unrelated to the surgical performance or to the surgeon. It essentially is "like an allergy" to the surgery - some patients bodies react to surgery by mounting a stronger immune response than the norm. The immune system orders WBCs (white blood cells) to go to the eye and to the flap of the eye to eliminate the "insult". The only problem is there is no insult beyond the desired surgery and then the WBCs do more harm than good by attacking the flap. If left untreated the DLK response can result in flap scarring or melt and a permanent reduction in visual acuity. Fortunately, if caught immediately it is easy to handle by modulating the immune response using steroids either topically or orally, or both. The WBCs which have already arrived may also be washed out from under the flap speeding up the resolution and minimising the risks of further complications.

Blog Content

A short post regarding the content of this blog and its intent.

My personal mission statement in life follows directly after my first name. Mounir means the one who brings light into your life or the enlightening one. I grew into my name without realizing it when I found myself an Ophthalmologist in 1994 and finally a refractive surgeon (LASIK surgeon) in 1999. To this date I have done over 50,000 refractive procedures mostly LASIK but a few thousand PRK as well. I am not entirely sure but this may be the most of anyone in North America at present. I have been bringing light directly into people's lives 6 days a week for almost 10 years now, by opening their eyes to newfound vision.

Beyond this, however, my goal and the goal of any company or group that I associate myself with is to improve the lifestyle, health and fitness of my clients and /or patients. On a more personal level, I also strive to "awaken" people as much as I can.

Many "conscious" people who look around them in the world realize that most people are walking around in an unconscious fog, living each day relatively joylessly, and for most intents and purposes like sleepwalkers. If I can, I try and wake up these sleepwalkers to all the joy the world has to offer, in the here and now, not in the past or future.

No Original Thoughts

I acknowledge as I start this blog that there are no original thoughts - in all likelihood there are also no truly original expressions of an old thought. Every thought has been expressed in a variety of forms over the centuries, the differences largely as a result of the current language at the time as well as the audience the thought was being directed to at the time.

By current language I mean for example Chaucer's English, Shakespeare's English, or our 21st century American/Canadian/British/Australian English. In other words, language varies with time as well as in nature, French vs. Italian vs. Mandarin vs. Cantonese vs. Hindi vs. Arabic vs. English etc.

So to the current audience varies with time (e.g. a Shakespearean era physician from a current physician) as well as by nature (e.g. the common masses vs. the intellectual minority). Even though all thoughts have likely been presented to all audiences at one period or another in time. Not all thoughts have become realities to all audiences in all times. So re-presenting thoughts in current language to current audiences is I believe the function of those conscious of the thought (and its reality) to those as yet unconscious.

My goal in this blog is to present thoughts in my language to my audience and help them make those thoughts their realities. My goal is for that audience to be the world, hence the use of the "world wide web", let us see how far I get.