IMFW retro-post is sneaky. Yes, that's right. I am writing this Interesting Medical Fact of the Week on Wednesday because I'm rubbish,* but I am retroposting it so it looks like it was posted on Monday, because I'm cunning. But I'm telling you about it because I'm honest. Damnit!
Anyway, last week's interesting medical look at face transplants proved pretty popular - let's be honest, face transplants are both amazing and intriguing. And everyone wants to see the pictures. So I figured that I would carry on in the same vein/paranasal sinus, because I am too unimaginative to come up with another good topic at this late hour.
But here is a link to a pretty amazing film clip of Dallas Wiens, the first American man to undergo a full face transplant, one year after surgery. He suffered serious burns from a high-voltage wire when he was just 23 years old, to the point where his entire face was effectively destroyed; he was blind, with no lips or nose, and he had to be placed in a medically induced come for three months while surgeons attempted to reconstruct what they could. Since the transplant, he has regained some facial sensation, is able to smell, speak and breathe through his new nose. When you see how severely disfigured he was before the transplant, you can appreciate just how incredible the effects of the surgery were.
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*And because I was in the office for ten hours straight on Monday and so busy I only just managed to take a ten minute lunch break.
Showing posts with label facial expression. Show all posts
Showing posts with label facial expression. Show all posts
Monday, 16 April 2012
Monday, 2 April 2012
IMFW: Face Transplants
Today's Interesting Medical Fact of the Week is all about face transplants! Recently an American man named Richard Lee Norris received what is allegedly the most extensive face transplant ever carried out, in which he received a new jaw, teeth, tongue and nose. The pictures are pretty incredible. After being severely disfigured by a gun accident, Mr Norris had been living as a recluse for fifteen years, wearing a mask whenever he had to leave home - and he had lost his sense of smell completely. That's all changed.
Only the 23rd facial transplant ever carried out, the operation was a gruelling 36 hours long; all Mr Norris' facial tissue from the scalp to the back of the neck was completely replaced. As with every transplant, there is a risk of rejection; recipients of face transplants have to take immunosuppressant drugs for the rest of their life, which increase their risk of cancer and infection. The first Chinese recipient of a partial facial transplant, Li Guoxing, died in 2008 just two years after his transplant, when he either stopped taking his immunosuppressant drugs or failed to take them correctly. There is also the potential psychological issue of patients finding it difficult to adjust to their new face; although such transplants don't give the recipient the face of the donor, nevertheless even after the most successful operation they will never regain their appearance from before their injury.
The world's first face transplant came in 2005 in France, on Isabelle Dinoire, whose face was so badly mauled in a dog attack that she was left unable to speak or eat. Dinoire has had problems with her transplant, including kidney failure and two episodes in which her body tried to reject the transplant. But from the interviews she's given, it seems that she has been happy with the results. The first full facial transplant came in March 2010, when a Spanish man who had accidentally shot himself in the face received a completely new jaw, nose, teeth, cheekbones and skin.
Face transplants can be controversial because some people see them as being done for "cosmetic", rather than purely medical reasons. Yet if you look at the people who have received facial transplants, it's clear that in every case their disfigurement affects their lives in much more than a purely "cosmetic" way. These are people so badly injured that they can no longer eat, drink, or - in some cases - breathe independently. For them, the risk of rejection and of a shortened lifespan due to the immunosuppressant drugs is worth taking in order to have the chance to live a more normal life.
Equally, as the story of Richard Lee Norris shows, even for those who remain independent after injury, the effects of severe facial disfigurement are much more wide-reaching than the purely medical, affecting employment, relationships and simply the ability to leave the house without feeling the need to cover your face. It's difficult for those of us who haven't experienced disfigurement to understand just how significant an impact it can have on people's lives. Obviously, face transplantation is an extreme step and certainly not one which is suitable for most people with serious disfigurement - but it should be available as a last option for those who cannot be treated by other means.
Some doctors have raised concerns over the way these transplants are followed up, suggesting that there should be greater emphasis on psychological analysis of patients, to gain deeper understanding of just how facial transplants affect recipients.
The Guardian has a short history of face transplants here.
Only the 23rd facial transplant ever carried out, the operation was a gruelling 36 hours long; all Mr Norris' facial tissue from the scalp to the back of the neck was completely replaced. As with every transplant, there is a risk of rejection; recipients of face transplants have to take immunosuppressant drugs for the rest of their life, which increase their risk of cancer and infection. The first Chinese recipient of a partial facial transplant, Li Guoxing, died in 2008 just two years after his transplant, when he either stopped taking his immunosuppressant drugs or failed to take them correctly. There is also the potential psychological issue of patients finding it difficult to adjust to their new face; although such transplants don't give the recipient the face of the donor, nevertheless even after the most successful operation they will never regain their appearance from before their injury.
The world's first face transplant came in 2005 in France, on Isabelle Dinoire, whose face was so badly mauled in a dog attack that she was left unable to speak or eat. Dinoire has had problems with her transplant, including kidney failure and two episodes in which her body tried to reject the transplant. But from the interviews she's given, it seems that she has been happy with the results. The first full facial transplant came in March 2010, when a Spanish man who had accidentally shot himself in the face received a completely new jaw, nose, teeth, cheekbones and skin.
Face transplants can be controversial because some people see them as being done for "cosmetic", rather than purely medical reasons. Yet if you look at the people who have received facial transplants, it's clear that in every case their disfigurement affects their lives in much more than a purely "cosmetic" way. These are people so badly injured that they can no longer eat, drink, or - in some cases - breathe independently. For them, the risk of rejection and of a shortened lifespan due to the immunosuppressant drugs is worth taking in order to have the chance to live a more normal life.
Equally, as the story of Richard Lee Norris shows, even for those who remain independent after injury, the effects of severe facial disfigurement are much more wide-reaching than the purely medical, affecting employment, relationships and simply the ability to leave the house without feeling the need to cover your face. It's difficult for those of us who haven't experienced disfigurement to understand just how significant an impact it can have on people's lives. Obviously, face transplantation is an extreme step and certainly not one which is suitable for most people with serious disfigurement - but it should be available as a last option for those who cannot be treated by other means.
Some doctors have raised concerns over the way these transplants are followed up, suggesting that there should be greater emphasis on psychological analysis of patients, to gain deeper understanding of just how facial transplants affect recipients.
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| Connie Culp, the first US recipient of a face transplant. |
Friday, 25 November 2011
The T-Word
Considering that it's only six letters long, and half of those are cuddly-looking vowels, 'tumour' is a surprisingly big word.* When you put the word 'brain' in front of it, it becomes positively enormous.
I may be biased, but I definitely feel that modern science should devote a little time and energy to investigating the phenomenon of the Brain Tumour Face, which in my experience is virtually universal. The phenomenon is this: when you tell someone that you have a brain tumour, their eyebrows shoot up violently and their mouth goes to a perfect o-shape. They say "oh!", quickly try to get their outlying facial features under control, and then warily ask "is it cancer?" If the answer is "no" (which for me, thankfully, it is) they slowly start to relax again. They may attempt a few further questions which you are ill-equipped to answer and/or they are ill-equipped to understand. This part seems to be optional.
Possibly the Brain Tumour Face is the seventh basic facial expression, common to all peoples and cultures across the earth. It certainly is the reason that it took me so long to mention the tumour to my friends - and even then I chickened out and told most of them over Facebook (I am grateful that no-one clicked 'like'). The problem is that it then becomes a self-fulfilling prophecy; people don't use the word 'tumour' face-to-face, which only serves to increase its fear factor. Even when referred to as a pituitary tumour rather than a brain tumour, the t-word creates quite a reaction; referring to it as a pituitary adenoma merely gets you a blank look, which personally I find preferable.
Even doctors have succumbed to the power of the t-word. Unfortunately, some of the synonyms they end up employing are quite entertaining - my favourite is "lump", which always inexplicably reminds me of the slothful Onslow from Keeping Up Appearances. The first time I went to see my (very lovely) endocrinologist after an MRI found the tumour, he managed to say the t-word only once, right at the end of the appointment, although I did notice a couple of occasions where he started to say it and then quickly caught himself. Or maybe I misinterpreted him and the "tu- er- lump" really is a medical condition.
Personally, I prefer plain speaking. Admittedly, I don't call a spade a spade, but that's purely because I try to keep myself distanced from manual labour at all costs. There's a tumour in my head and frankly I am a lot more concerned about the thing itself than what it's called. It's good that doctors empathise with the fact that their patients are going through a scary time, but continually avoiding all mention of the t-word just makes the elephant in the room swell ever larger. And develop spontaneous tumours.
Naturally there are exceptions to the Brain Tumour Face rule, particularly amongst the medically inclined/drunk. One of my good friends, a medical student, tried to persuade me to go out clubbing one night with the immortal line "Your brain tumour wants you to go!"** Oddly enough, it worked.
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*Of course, if you're an American it's only five letters long, so the vowel quotient is significantly reduced. Does this correspond with a similar reduction in its bigness? Answers on a postcard, please.
** Hi, Havana.
I may be biased, but I definitely feel that modern science should devote a little time and energy to investigating the phenomenon of the Brain Tumour Face, which in my experience is virtually universal. The phenomenon is this: when you tell someone that you have a brain tumour, their eyebrows shoot up violently and their mouth goes to a perfect o-shape. They say "oh!", quickly try to get their outlying facial features under control, and then warily ask "is it cancer?" If the answer is "no" (which for me, thankfully, it is) they slowly start to relax again. They may attempt a few further questions which you are ill-equipped to answer and/or they are ill-equipped to understand. This part seems to be optional.
Possibly the Brain Tumour Face is the seventh basic facial expression, common to all peoples and cultures across the earth. It certainly is the reason that it took me so long to mention the tumour to my friends - and even then I chickened out and told most of them over Facebook (I am grateful that no-one clicked 'like'). The problem is that it then becomes a self-fulfilling prophecy; people don't use the word 'tumour' face-to-face, which only serves to increase its fear factor. Even when referred to as a pituitary tumour rather than a brain tumour, the t-word creates quite a reaction; referring to it as a pituitary adenoma merely gets you a blank look, which personally I find preferable.
Even doctors have succumbed to the power of the t-word. Unfortunately, some of the synonyms they end up employing are quite entertaining - my favourite is "lump", which always inexplicably reminds me of the slothful Onslow from Keeping Up Appearances. The first time I went to see my (very lovely) endocrinologist after an MRI found the tumour, he managed to say the t-word only once, right at the end of the appointment, although I did notice a couple of occasions where he started to say it and then quickly caught himself. Or maybe I misinterpreted him and the "tu- er- lump" really is a medical condition.
Personally, I prefer plain speaking. Admittedly, I don't call a spade a spade, but that's purely because I try to keep myself distanced from manual labour at all costs. There's a tumour in my head and frankly I am a lot more concerned about the thing itself than what it's called. It's good that doctors empathise with the fact that their patients are going through a scary time, but continually avoiding all mention of the t-word just makes the elephant in the room swell ever larger. And develop spontaneous tumours.
Naturally there are exceptions to the Brain Tumour Face rule, particularly amongst the medically inclined/drunk. One of my good friends, a medical student, tried to persuade me to go out clubbing one night with the immortal line "Your brain tumour wants you to go!"** Oddly enough, it worked.
_______________________________________
*Of course, if you're an American it's only five letters long, so the vowel quotient is significantly reduced. Does this correspond with a similar reduction in its bigness? Answers on a postcard, please.
** Hi, Havana.
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