DID YOU KNOW ?
There are an estimated 65,000 web sites on the internet pertaining to hernias. One of the sites includes a "guest book" which asks for hernia patients to recount their own hernia surgery experience. It is designed to help hernia patients who don't know what to do. You can find it by simply typing in the words "hernia surgery experiences" in the search window of your search engine. There are over 300 letters to read. Your personal comments may be valuable to others.
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QUOTE
"Hernia repairs done at Shouldice Hospital are Y2K compliant!"
Steve Dixon,
(computer expert)
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Shouldice Fact Sheet
1. Shouldice Hospital was founded in 1945 by Dr. Edward Earle Shouldice.
2. 10 Full time surgeons perform over 7,000 herniorrhaphies each year.
3. The hospital is fully licensed and inspected by the Ontario Ministry of Health. The Doctors are licensed by the College of Physicians and Surgeons. U.S. Board Approval.
4. The average chance of hernia recurrence after repair at Shouldice is less that 1%.
5. North American average inguinal hernia recurrence rates are reported at more than 10%.
6. Hernia patients from over 80 countries have been treated at Shouldice.
7. Local anaesthetic & pre-op sedation are all that's needed in most Shouldice operations.
8. Patients return to work in an average of 8 days after an operation at Shouldice. Many start work right away.
9. Direct and indirect inguinal, femoral, incisional, umbilical, epigastric and spigelian hernias are repaired at Shouldice.
10. The largest annual Shouldice patient reunion to date included 1,500 patients.
11. Shouldice Hernia Centre employs 170 people. The average length of employment is 12.5 years.
12. The hospital is equipped with 5 operating theatres and 89 hospital beds dedicated exclusively to the repair of abdominal wall hernias.
13. Shouldice Hospital has been featured as an example of excellence in a Harvard Business School case study as part of the MBA curriculum there since 1983.
14. The Shouldice property consists of 30 landscaped acres: 23 acres for the Shouldice Hospital and 7 acres for Glynnwood retirement community.
15. "The patient's welfare is our responsibility".
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Shouldice Hernia Centre
Phone: 1-800-29l-775O
Fax: 1-905-889-4216
Internet Web Site:
www.shouldice.com
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Music in the Operating Rooms
Over the years many patients have requested music in the operating room. Some refer to the use of music in the dentists' offices to help them relax. Studies show that certain types of music can help people to relax while stimulating mental capacity. So we decided to investigate the possibilites. The test started with a CD/tape player in one room. The music was specially selected to be soothing and appropriate to the environment of the OR. After a positive response we now offer music in all operating theatres. So if you have a favourite CD that fits the bill, bring it along ... Oh, just one more thing. The surgical staff has to like it too!
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Word of Mouth Reference
Over the last fifty-three years, patients of Shouldice Hospital have referred their freinds and relatives to Shouldice for hernia examinations and repair. "Word of mouth" is the main process through which our name and service has spread. One study shows that over 80% of our patients come to us because of these comments. Recently during the Ontario, provincial pre-election debate the Honourable Mike Harris, Premier of Ontario, also mentioned Shouldice in a supportive manner. We take this time to thank our patients for the comments shared with others about the "Shouldice Experience".
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"Snack Time" - Linda & Tamara's "Asparagus Quiche"
12 asparagus tips cooked
3 eggs
1 1/3 cups milk
salt & pepper to taste
½ cup grated Gruyere
cheese
To cut down on calories, no pastry has been added. If pastry is desired then simply add your favourite crust and follow the instructions below.
Place asparagus in the bottom of an 8" pie plate. Beat eggs, milk, salt & pepper. Add cheese and pour mixture into pie plate. Bake at 350 until firm, approx 15-20 mins.
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The Nurses' Cap
It is a symbol of professionalism, of authority and achievement. The nurses' cap has a long history dating back to pre-first world war. They vary in design. Some are adorned with badges or emblems identifying the hospital (pre 1970s) or college from which a nurse attained certification or a degree. On some you may see a stripe, the meaning of which dates back to the days of Florence Nightingale, the founder of the nursing profession. Upon her death it was added as a symbol of mourning. Some schools continued its use, connecting the modern day nurse with the origins of a noble practice.
Today this icon of professionalism is rare. Shouldice patients often comment on how much they like the caps and are impressed that Shouldice nurses still wear them in a time when traditions like this seem to be disappearing. "In most hospitals you can't tell a nurse from an orderly or a clerk. Here I know in an instant." says one patient. The cap is part of a uniform which helps patients identify who is in charge and who to go to for assistance. Caps are a valued characteristic of the nurses of Shouldice Hospital.
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Missed Hernias
"The Hidden Threat!"
A missed hernia is a second defect which the surgeon has failed to discover during surgical repair of a hernia on the same side of the groin. There are four different types of groin hernias; indirect inguinal, direct inguinal, femoral and interstitial. Any of these can be a dominant or secondary hernia. If the area is not carefully examined, the surgeon may miss any of the above secondary hernias as they can be well hidden and totally without symptom at the time of surgery.
A recent review of 7,281 hernia operations done at Shouldice Hospital, revealed that our surgeons had found 1,158 secondary hernias in the study group. Secondary diagnoses were made during the operations and repairs were completed accordingly. This number indicates that 16% of patients diagnosed with a hernia are likely to have secondary hernias in the same area.
This raises two key points for discussions in the surgical community. Surgical technique of choice and redundant surgery.
The technique of choice is important because unless a meticulous exploration of the groin anatomy is carried out, secondary hernias can become "missed hernias". Missed hernias can become symptomatic sometimes years after the primary surgery, requiring additional surgical attention. Surgery that should have been avoided. Some "plug" or mesh techniques which are designed to be "minimally invasive" or to save time, do not go beyond treating the dominant hernia. This can result in a missed hernia and more surgery in the future. Any surgical procedure which does not address this issue properly, falls short of a cure and presents the patient with risk.
Redundant hernia surgery is also pertinent. Estimated recurrence rates in the general surgical profession are reported in surgical journals to be greater than 10%. Add the cases with missed secondary hernias, which may take years to develop and the outlook on redundant hernia surgery becomes a compelling concern. The next time the patient has a hernia, will it be considered a missed hernia, a new hernia or a recurrent hernia?
Since 1945 when Dr. Edward Earle Shouldice started his hospital, it has been a fundamental requirement of the Shouldice procedure to fully explore the anatomy of the groin during hernia repair to insure that all secondary hernias are found and repaired. It demands experience and is time consuming but essential if the best interests of the patient are to be met. This standard Shouldice Hospital practise is part of curing hernias permanently. Having 10 competent hernia specialists on hand at any time for consultation and assistance in these matters is a unique Shouldice resource which we are proud to provide.
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