Our interlocutor - an experienced honored surgeon Jaroslav Susak, MD and professor, successfully performs operations on the liver and pancreas, which require virtuosic professionalism.
Jaroslav Mikhailovich , what are the most difficult states, and how do you deal with them?
Very severe pathology - acute pancreatitis. Untimely treatment of a doctor can lead to irreversible changes and death. The pathologies of the liver, bile ducts and pancreas always pose a serious threat to the life of the patient, and operations on these organs require experience and special skills. Honored surgeon Jaroslav Susak works on the methodology of Professor Zemskov, a talented scientist and surgeon, whom he was lucky to learn. Also he was very useful experience in the European Center for Surgery of the liver. Earlier in the hospital of first aid, where I work for the third year, there were four universal surgical departments. Later, thanks to the reorganization, it became possible to improve the experience gained and introduce progressive methods. For example, we can perform hemo-and lymphosorption (purification of blood and lymph) around the clock, for free, to serious patients. Such a complex procedure is often salutary for the patient and literally brings him back to life.
Honored surgeon Jaroslav Susak, you said that with acute pancreatitis there is a threat to the life of the patient. How often do you deal with this pathology?
Alas, quite often. In most cases, the ambulance delivers patients to us, because we have gained a considerable experience of surgical care in this pathology, and its level is very high. A year to the hospital receives up to a thousand of these patients, of which 130-150 are extremely severe. Acute pancreatitis can occur as a complication of cholelithiasis, its second cause is poisoning with alcohol surrogates, which cause a powerful toxic damage to the liver and pancreas, in the third place of the injury. Of the common causes of acute pancreatitis can also be called a violation of the hormonal sphere, parathyroid disease, metabolic disorders, diabetes mellitus.
Yaroslav, probably, can not be considered as dangerous other conditions of patients who are brought by an ambulance?
With simple cases can calmly cope in other hospitals. In general, we accept patients with all surgical pathologies: acute appendicitis, cholecystitis, perforated stomach ulcer, surgical jaundice, with peritonitis as their complication, as well as emergency conditions in pancreatic cancer.
Yaroslav, from the waiting room, patients immediately get into the operating room?
Not always. Everything depends on the diagnosis and condition of the patient. It happens that the patient needs to be prepared for the operation, to hold supportive therapy. If a person has a trauma or acute bleeding, when everyone decides the minutes, we immediately take him to the operating table. Very dangerous cases when we are dealing with the consequences of cholelithiasis. Moving along the bile ducts, the stone traumatizes them, which leads to spasms, stenosis, increased pressure in the pancreas and its inflammation. In this case, the patient experiences severe pain, his condition deteriorates sharply. To save the sick, we remove the stone. If you have found stones, do not use questionable methods and wait for the development of pancreatitis, because sooner or later it will begin. I believe that stones are always an indication for surgery.
Honored surgeon Jaroslav Susak, and in fact some people believe that the operation will not save them from the re-emergence of stones?
Well, why? Removing the gallbladder (reservoir, in which the formation of stones), we thereby solve the problem: bile immediately enters the intestine and the conditions for the formation of stones do not arise. After the operation, if it is done correctly, the patient must adhere to certain restrictions for four months, and then he lives without taking medications. It is much more dangerous when the gallbladder is in place, but it does not work. Due to stagnation of the bile, a chronic infection develops, which leads to inflammation of the bile ducts, and then to billiard pancreatitis.
Jaroslav, and what happens after removal of the pancreas?
The gland is removed from a malignant tumor. After the operation (but not instead of it!) We use a drug that significantly increases the life expectancy of patients.
There are legends about this drug. Are they not exaggerated? I apply "Ukraina", which was invented in Austria by the Ukrainian Novitsky in 1972, for many years. His analogue, our domestic drug "Amitazin", authored by Dr. Potopalsky, appeared much earlier - in 1959. "Ukraina" is effective for various tumors, especially those that do not respond to chemotherapy (these include pancreatic tumors, melanoma, and ovarian tumors). This remedy is noteworthy in that it treats not only local manifestations, but oncological disease as a whole. It affects only malignant cells and normalizes the antitumor immunity. It would be an exaggeration to say that "Ukraina" is able to cure every oncological patient, but it significantly increases his chances of surviving. This is an effective drug therapy, which improves the quality and life expectancy of the patient after surgery.
Honored surgeon Jaroslav Susak, you want to say that the removal of the tumor - not yet recovery?
Quite right. Operation is not an occasion to forget about the problem once and for all. In my practice there was a case when we operated a woman, and then treated with "Ukraine". After a while our patient safely endured and gave birth to a healthy child. It must be remembered that cancer does not occur without a cause: there are always factors that led to the development of cancer. The operation can not completely rid the person of this peculiarity of his organism. Not too optimistic ... To solve such a complex problem with the help of only a scalpel is unrealistic.
A tumor is a very serious reminder that a person should really take care of their health. More than once it happened that after a tumor was removed in one place, after a while it appeared in another. Why?
But this is what we need to work on. I always repeat to patients: "Remember that after the operation you need not only to continue treatment, but also radically change your lifestyle."
Yaroslav, but if a person does not change?
He always has a choice - and a way of treatment, and decisions, whether to fight him or not. But there are no standards that absolutely fit absolutely for everyone, and we can not guarantee that the means or method that came to one will also affect the other. All people are different: one patient perceives the process of treatment as work and strictly fulfills all the prescriptions of the doctor, and the other goes into his illness and does not fight. Of course, they will have different chances and forecasts.
How do you feel about prayers for health, visiting holy things? Can they bring healing? Faith always helps in getting rid of any disease. In some patients, tumor regression occurs spontaneously. But these are isolated cases. The psychological factor is very important, I do not argue. It is also known that patients, for whom they sincerely pray, are quickly recovering. However, a serious illness should be treated with serious methods. If I see a patient having a tumor or other serious problem, I will not call him to go to church and trust in God. But he can pray to be strengthened spiritually: it is always very supportive. It should be remembered: if you are shown an operation, then postponing it is simply dangerous.
Jaroslav Susak , did you notice that optimists recover faster?
The doctor should always take into account the personal moment. I teach my students to take into account the nature of the patient, his receptivity. Each person needs to talk in different ways, taking into account how he treats his illness.
Of course, if we have a simple problem, for example, appendicitis, then we can joke about this, which in most cases is perceived with understanding. Although I assure you: every normal person is afraid of the surgeon and surgical intervention. There may be no fear of people inadequate, unconscious, and also those who have nothing to lose. For example, if a person is to serve a sentence in places of deprivation of liberty, he perceives surgery and treatment, almost as a resort. Everyone has their own threshold of fear, but if you stay in the negative all the time, then this is fraught with aggravation of the problem. It is necessary to perceive surgery and treatment in the hospital as a natural process, and not as something extraordinary. Try to take it easy and work hard on yourself. So our organism is arranged, that it sometimes fails, like any mechanism. If you want to help him, you must confirm this with your actions - thereby you will extend your life. But falling into a depression, on the contrary, worsen the situation, only do yourself harm.
Probably every patient , getting to the deserved surgeon Yaroslav Susak, thinks: And why I do not ... "Everyone has his continuation of this phrase. Jaroslav, what "not" do you consider the most relevant?
In the first place - acute appendicitis. Often it occurs in people who eat wrong. But bleeding with cirrhosis of the liver can be triggered by alcoholism, viral hepatitis. A breakthrough ulcer of the stomach or duodenum is due to inaccuracies in the diet, an incorrect lifestyle, stress. Bile-stone disease is almost always immoderate food, fatty food, an abundance of spicy dishes. Heredity is very important. If someone in your family has suffered from this or that disease, there is a possibility that you have a tendency to it. This is a warning light, warning that you need to be on your guard and stick to moderation in everything.
Jaroslav, is it possible to avoid pressing conditions by following the rules?
It is difficult to say something new here. In Ukraine, no one is involved in prevention, as, for example, it was in Soviet times. The Soviet health system, with its preventive examinations, medical examination, district doctors, did a great job. It was destroyed, but at the same time they did not replace anything. I believe that the one who did this committed a grave sin. The system Semashko is still considered one of the best in the world. Today, preventive examinations are rare. As a result, the disease is detected already at the stage when surgical intervention is necessary. Well, if the ambulance manages to get the patient to us, and we can save him.
Today, a lot of people are actively engaged in self-medication, good, information about medicines can be found on the Internet, seen in commercials. Assuming that this is his case, a person begins to take drugs that he does not need! Even a doctor can not cure himself, because he can not be objective: an external view is absolutely essential. What can we say about the patient who is being treated at random!
Honored surgeon Jaroslav Susak, can you share a case from practice, which you remember most?
At that time I worked in a hospital. At night, a woman complained of a greatly enlarged abdomen. Three days she was troubled by pain, and compassionate relatives (in the family were doctors) gave her painkillers. Anaesthetized very well ... As it turned out already on the operating table, the patient had a perforating stomach ulcer. Peritonitis developed. The woman underwent three operations, was thrice in intensive care. We just dropped our hands.
Fortunately , the patient was saved. A year later, we operated on her hernia, putting a special net, and the retired teacher quietly lives on. Six years have passed, the woman periodically comes to us for advice, diligently follows all medical prescriptions. I think she is not self-medicated anymore.
The honored surgeon Yaroslav Susak has a daughter and children. He loves his work and is proud that his job is to help people.