All About Positive Health

The man was very much worried.” A bone was growing over the wrist since a few months” was his complain. The swelling was nearly circular, painless, almost defined boarders, does not move in any direction, hard to feel, almost fixed in the depth and was very slowly growing in size. So, he thought it to be a bony growth and must be dangerous.

I examined the swelling. It sits over the wrist with the characteristics as described above. Frequently I encounter this sort of complain. Mostly ladies are affected. This is also a beauty concern for them. Though most commonly seen near the wrist, it is also seen over the back of hand, forearm and near the tendons. That was diagnosed to be a ganglion.

A ganglion forms because of degenerative changes in the tissue covering of a tendon or that of a joint called synovial capsule. This may be termed as pseudoganglion or ganglion. When originates from the tendon sheath it is called pseudoganglion and when comes from the joint capsule is called a ganglion. A thick gelatinous material is found enclosed in a capsule. Many times the capsule is thin and sometimes it is thick. Diagnosed is based on clinical findings. Sometimes an x-rays examination is ordered to eliminate a bony growth.

The ganglion or the pseudoganglion is pressed hard so that it bursts and that gives a dramatic cure evidenced by sudden disappearance of the swelling. If thick walled it may not burst under pressure. In that case a wide bore needle is inserted into it and the gelatinous material is aspirated. Sometimes about 1 ml. of steroid is injected to the cavity. These procedures cure majority of patients. Sometimes larger ones require surgery by removing as much of capsule as possible. Ganglion is notorious for its recurrence. But it is an innocent disease.

Some times some people do not avail a chance and let that go. A folk tale in Orissa,India describes how people ignore the opportunities.Once “Lord Shiva and His wife Goddess Parbati“were in the sky to observe the people of earth.They saw a poor man in skeletons begging for food but was not getting anything.Parbati became felt pity for him and asked Shiva to see this and also asked why people created by them should suffer like this.God replied to it with a smile that some do not like a grab an opportunity and are lazy ,consequently suffer.And He wanted to show that to Goddess Parbati then and there.The god put a pot full of gold coins on the road of the beggar .But the beggar at that moment wanted to mimick a blind man and walked closing his eyes.He gave a kick to the pot and walked past to open his eyes later .Consequently he missed the gold filled pot.Then the god asked his wife to interpret it and they went on the voyage.

Something of the sort happened to-day in our hospital.A person injuring his Achilles tendon came to me.Since ours is a private hospital only for port trust employees ,other people have to pay for the service with a token price only.I inspected the injury and asked him to deposit the required fees to get the tendon repaired .But the person expressed his inability to pay.I suggested him if he does not have the money he can pay it later also.He was not willing for that also.But on humanitarian ground I offered him to repaired it free of cost using material we get as physician’s sample but he has to get admitted to the hospital for some time.And to my utter surprise he declined for that and went away. Instantly my staffs reminded me of the story I just narrated.
The thick tendon through which the calf muscles get anchored to the heel bone is called Achilles tendon named after the Greek mythological hero Achilles.This is a tough tendon in the body.This tedon lifts the body weight off the ground while walking.

This tendon gets severed mainly by accidents,assault or in collagen diseases.When partially torn the person can walk limping and disability is more severe if completely torn.The person can not stand on toes of the affected foot.And if completely severed a distinct gap can be felt over an intact skin or the end can be seen if skin is cut.The upper end of severed tendon usually is dragged by the calf muscles to an upper level and may not be seen.Tendon repair is a special procedure and done under aseptic conditions .It can be performed under local.regional or general anaesthesia.The repair is done using a non-absorbable suture material.After repair a plaster of paris cast is given to immobilise the foot for 6 weeks.After that period a gentle physiotherapy makes the patient fit for duty.The results are good.