Rehabilitation after radiation therapy

Withdrawal syndrome after a long binge is more similar to drug withdrawal than a hangover. A hangover syndrome can occur in a non-drinker due to yesterday's binge drinking. However, abstinence occurs only in alcoholics with prolonged use of alcoholic beverages from the second stage of addiction. Against the background of regular drinking, the liver does not have time to process the diseased volume of alcohol, and highly toxic substances - acetaldehydes - accumulate in the body.
This leads to a whole range of consequences, including somatic and vegetative symptoms:
  • weakness;
  • increased sweating;
  • dyspnea;
  • tremor of the limbs;
  • nausea;
  • rapid pulse;
  • high blood pressure;
  • exacerbation of concomitant diseases.

However, the most common complaint of alcohol addicts is pain after a long binge. At the same time, painful sensations do not always have a clear localization. Addicts complain that everything hurts after drinking and they don’t know what to do. In some cases, with chronic intoxication, the whole body actually hurts after binge drinking, and sometimes the pain is localized in a specific organ or limb.

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Why can't you ignore pain?

Most often, after drinking, the head, throat, stomach, abdomen, liver, kidneys, lower back, back, right side, heart, neck, legs below the knees, etc. hurt. In the article you will find out what this may be connected with. Most often, unpleasant sensations in the internal organs are the result of alcohol intoxication.

It is important to pay attention to the existing symptoms in time and consult a doctor, since, for example, chest pain after heavy drinking can signal an impending heart attack; a headache after heavy drinking can indicate not only the death of neurons and connections between brain cells, but also the risk of stroke and subsequent mental disorders. Painful sensations should not be ignored, as they can signal the development of severe chronic diseases, for example, cirrhosis of the liver.

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Patients and methods

Functional-saving operations were performed in 71 patients from 2006 to 2014: for RG - in 66 people, cancer of the tongue with spread to the vestibular part of the larynx - in 1, thyroid cancer with spread to the trachea and larynx - in 1, papillomatosis - in 3. Primary R.G. was in 66 people: of them T2 - in 53, T3 - in 9, T1 - in 3, cancer recurrence after a full dose of radiation therapy - in 1. The average age of the patients was 59.2±9.6 years. There were 65 men (91.5%), 6 women (8.5%). Resections of the larynx in the vertical plane were performed in 62 people, in the horizontal plane - in 9. The following types of operations were performed in the vertical plane: frontolateral resections of the larynx - in 51 people, extended frontolateral - in 10, combined - in 1.

An important part of the intraoperative stage is the reconstruction of the remaining elements of the larynx, depending on the type of intervention performed.

When performing frontolateral resection, plastic surgery of the remaining elements of the larynx was performed with the formation of vocal, vestibular folds and organ walls using the external perichondrium and thin flaps of the anterior neck muscles. During resection of the arytenoid cartilage, the mucous membrane of the arytenoid region and pyriform sinus was used for its reconstruction. Reconstruction of the upper parts of the larynx in order to create sufficient lumen of the organ is carried out by strengthening the fixed part of the epiglottis and creating the posterior wall of the organ.

A patient diagnosed with thyroid cancer with invasion into the trachea and larynx underwent thyroidectomy with resection of the cricoid cartilage and 4 tracheal rings. To eliminate the resulting defect in the trachea and larynx, mobilized muscle flaps from the sternocleidomastoid muscles were used and sutured to the upper and posterolateral parts of the defect in the form of a duplicate. The lumen of the larynx and trachea is formed on a silicone endoprosthesis.

In the horizontal plane, combined horizontal resections of the larynx were performed in 4 patients, the lower version of horizontal resection was performed in 5. When performing a horizontal resection of the larynx, after isolating the thyroid cartilage and cutting off the neck muscles from the hyoid bone, the hyoid bone was dissected, the preepiglottic tissue was isolated, the upper parts of the thyroid cartilage were removed, vestibular folds, epiglottis, and with combined resection, additional resection of the root of the tongue and oropharynx was performed. The most important aspect of this operation was the preservation of the arytenoid cartilages. Reconstruction of the larynx was carried out by suturing the mucous membrane of the vocal folds to the perichondrium, creating a lumen for the organ (on a silicone endoprosthesis), the anterior wall of the pharynx and larynx was formed using a flap from the root of the tongue, which was sutured to the thyroid cricoid membrane, perichondrium. The flap from the root of the tongue was covered with the anterior muscles of the neck. A tracheostomy was formed.

Another part of the intraoperative stage is the immediate restoration of the lumen of the larynx. We have developed a silicone endoprosthesis of an original design, which is a hollow tube. The upper end of the tube is presented in the form of a tent with two side holes for breathing. The roof is positioned so that it completely covers the lumen of the tube (Fig. 2). Endolaryngeal prosthetics was carried out at the final stages of the operation. The silicone endoprosthesis was installed into the lumen of the larynx and fixed with three transdermal interrupted sutures (Fig. 3). After suturing the surgical wound, a tracheostomy tube No. 5 was installed in the patient.


Rice. 2. Silicone endoprosthesis.


Rice. 3. Intraoperative endoprosthetics (explanations in the text).

The second stage of rehabilitation is postoperative. It can be divided into early (inpatient) and late (outpatient). At the inpatient stage, conservative therapy was carried out: antibacterial (cephalosporins of the first and third generations, macrolides, etc.), hormonal, antihistamines, non-steroidal anti-inflammatory drugs. To exclude the development of complications of the tracheobronchial tree, inhalation therapy was carried out. The duration of the stationary stage is 7-14 days. The silicone endoprosthesis (Fig. 4) was removed on days 14–21, endolaryngeal or through a tracheostomy.


Rice. 4. Endoprosthesis in the lumen of the larynx.

An important task in the postoperative period is to prevent tracheal complications due to the presence of a tracheostomy tube. At this stage, the most important aspect was the gradual replacement of a larger diameter cannula with a smaller one in order to prevent the development of granulations and tracheomalacia. We also recommend breathing through natural pathways by temporarily or permanently closing the tracheostomy tube with an obturator, and conducting speech training.

After performing horizontal resections, one of the most important tasks is to restore the protective function. In the early postoperative period, patients are fed through a nasogastric tube with gradual training in order to restore the natural act of swallowing. At this stage, the patient chooses a position in which the act of swallowing is least difficult. To prevent aspiration, it is necessary to have a tracheostomy tube with an inflatable cuff and obstruct the tracheal lumen only during natural feeding. After swallowing occurred without choking, the nasogastric tube was removed. The protective function in patients was restored 4-6 weeks after surgery.

Most patients with RG received remote gamma therapy in the postoperative period. During this period, to prevent radiation epitheliitis, inhalation, desensitizing therapy and therapeutic laser exposure to the surgical area were carried out.

In order to increase the effectiveness of rehabilitation of patients after laryngeal resections, endolaryngeal surgery was used in the postoperative period. Endolaryngeal correction of the lumen of the larynx using endoscopic techniques and laser was performed in 32 people. These patients underwent step-by-step removal of ligatures, laser ablation of granulations and scar tissue. The use of this technique made it possible to restore adequate lumen of the larynx in 30 (93.8%) of 32 patients.

When planning decannulation, the lumen of the operated larynx was assessed using fibrolaryngoscopy and ultrasound of the organ. In the absence of contraindications, the tracheostomy hole was sutured. After decannulation, patients were referred to a speech therapist for training in sonorous speech. At each stage of rehabilitation, we conducted an acoustic analysis of the voice.

In the first year after performing organ-preserving operations, an important aspect is clinical observation of this group of patients. In order to detect early recurrence of RG and non-palpable metastases, it is necessary to perform ultrasound of the neck, indirect laryngoscopy, fibrolaryngoscopy in the first year after surgery, 1.5-2 months later, and in subsequent years - after 3-6 months.

Binge drinking - its dangers and consequences

At the first stage of addiction, a person realizes that drinking is bad and understands that alcohol causes absenteeism at work and quarrels with loved ones. However, alcoholics tend to justify their addiction, so every time they look for a reason to drink, even if there is no holiday, the addict will come up with a reason to drink alcohol again, as he develops an irresistible craving.

However, for alcohol addicts, drinking alcohol is not limited to one or two glasses. Binge drinking characterizes the presence of a person in the second stage of addiction. Alcoholics drink for several days in a row, but they can still stop drinking on their own. However, interruption of a false binge, as a rule, is due to some external factors: the person has to go to work, his wife is scandalous, he has run out of money for booze.

However, a disease such as alcoholism tends to progress; soon a person loses control over both the quantity and quality of what he drinks, binge drinking develops into true, and addiction into chronic. A person no longer needs company to drink; he can drink at any time and anywhere, including at work, disregarding generally accepted social boundaries and norms of morality and behavior. Over time, the addict loses interest in family, loved ones, work, hobbies, cognitive and intellectual abilities decrease, aggression, egocentrism, and lack of critical thinking arise.

At the third stage of alcohol addiction, true binge drinking occurs, which occurs completely spontaneously. The intervals between binges are short and painful, accompanied by tremors, chills, anxiety, nervousness, insomnia, and aggressive behavior. Withdrawal syndrome occurs in a binge alcoholic quite quickly, within a couple of hours after the last drink. Therefore, he has to “take a bottle” quite often so that the condition does not worsen.

A person no longer gets pleasure from alcohol. Alcohol is integrated into metabolic processes and disrupts them; without ethanol, the body can no longer fully function, since a number of necessary substances are not released; they are obtained from the outside. Binges at the third stage of alcoholism end only when the body can no longer cope with the incoming volume of alcohol, and alcohol intoxication occurs.

Why does pain occur after drinking?

Most often, alcoholics experience pain in the abdomen, legs, heart, chest, stomach, muscles, lower back, joints after drinking, and often the pancreas hurts. What are the causes of discomfort? You must understand that alcohol is a poison that has a very detrimental effect on the cells of internal organs and the brain.

Some of the consequences of binge drinking include:

  1. Diseases of the cardiovascular system. Heart attacks and strokes are already in first place among the causes of mortality in Russia and the world. Regular consumption of alcohol increases the risk of developing dangerous diseases significantly. Ethanol disrupts the functioning of the circulatory system, due to which red blood cells cannot deliver sufficient nutrients and oxygen to the cells. Oxygen starvation occurs, which has a negative effect on the human brain.
  2. Mental abnormalities, dysfunction of the central nervous system, neurological complications. Alcohol irreversibly destroys brain cells and neural connections, which affects the thinking and intelligence of the addict, leading to mental disorders and chronic hypoxia of the nervous system. Severe headaches after heavy drinking are not uncommon; they are a consequence of chronic intoxication and neuronal death. Don't ignore your body's signals. Is it possible to take pills for headaches after binge drinking? It is important to understand that taking painkillers on a regular basis leads not only to dehydration, but also to addiction, which is difficult to get rid of even for doctors.
  3. Liver diseases. It is in the liver that the main metabolic processes take place; ethanol is broken down into water and carbon dioxide. Due to the disruption of natural processes, lipid deposition occurs, which leads to the occurrence of foci of necrosis and the formation of connective tissue. Simply put, toxins destroy the liver, causing cells in the organ to die and break down, leading to cirrhosis or liver failure.
  4. Diseases of the gastrointestinal tract. Alcoholics often have stomach and intestinal pain, problems with stool and appetite, and they often feel sick. The consequence of alcoholism is fibrosis or pancreatic necrosis of the pancreas, gastritis, cysts in the digestive tract, stomach and bowel ulcers, etc. The so-called “alcoholic gastritis” is nothing more than an inflammatory destructive disease of the stomach that arose against the background of alcohol abuse and is difficult to treat.

Symptoms of alcohol poisoning

Experts divide body intoxication into three categories:

– mild alcohol poisoning;

– average degree;

– severe intoxication.

If a person has experienced a mild degree of poisoning from alcohol-containing drinks, then he may experience the following symptoms:

– hyperpigmentation of the skin;

– increased excitability, and sometimes aggressiveness;

– being in a euphoric state;

– the appearance of hypertrophied character traits (increased level of conflict, stinginess, generosity, etc.);

– a significant decrease in self-control and the appearance of inflated self-esteem;

– loss of coordination of movements.

If you stop drinking alcoholic beverages at this stage, you may only experience a hangover. In cases where drinking continues, a moderate degree of poisoning may occur, which is accompanied by the following symptoms:

– slowdown of intellectual processes;

– unintelligible speech;

– violation of orientation in space and time;

– the occurrence of dyspeptic disorders (nausea, pain in the stomach area, diarrhea, vomiting);

- appearance of drowsiness.

Having stopped consuming products harmful to the body at this stage, the drinker falls into deep sleep. In some cases, immediate first aid may be required, which will allow the person’s condition to normalize after 12 hours.

Severe alcohol poisoning is accompanied by more pronounced symptoms:

  1. Being in an unconscious state.
  2. Lack of response to painful and tactile stimuli.
  3. Disturbances in the functioning of the cardiac, vascular, and respiratory systems (rare pulse, shortness of breath, drop in blood pressure, etc.).
  4. Decreased body temperature.

In such situations, it is impossible to do without qualified medical care, since severe poisoning can cause alcoholic coma. In the absence of proper procedures, which are carried out exclusively by professionals, everything will end in death.

Poisoning can occur not only due to the use of ethyl, but also other alcohols that are used in the creation of surrogates. As a rule, in such cases, wood or methyl alcohol is used. Poisoning with these substances is extremely dangerous and leads to human death. When they are consumed, pathological intoxication is observed, the level of which differs significantly from the dose consumed. The main manifestations of methanol intoxication are similar to those mentioned above, but the difference is that after 2-4 days after consuming the drinks, vision problems appear, leading to irreversible consequences (blindness, blurring, double vision).

What diseases does alcohol cause?

Alcoholics are often diagnosed with:

  • alcoholic polyneuropathy;
  • arrhythmia;
  • hypertension;
  • heart failure;
  • high risk of stroke, heart attack;
  • hepatitis;
  • cirrhosis;
  • fatty degeneration;
  • carcinoma;
  • pancreatitis;
  • alcoholic psychosis.

Violations affect all systems of the addict’s body, including the reproductive, urinary, and endocrine systems, provoking the development of serious complications in human health.

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How to get rid of pain after drinking?

If a person cannot get out of a binge on his own, this is a reason to call a doctor at home. There is no point in risking his life and health; you need to seek help from professionals in the field of addiction medicine and psychiatry. The patient needs emergency drug treatment at home, which can be easily, quickly and inexpensively, and also completely anonymously organized by our Center for Healthy Youth.

A narcologist will help eliminate the serious condition of an alcoholic, alcohol intoxication, and withdrawal symptoms. It is abstinence that most often results from the occurrence of painful sensations in the human body after heavy drinking.

What to do if everything hurts after a long binge?

A dropper will help against alcohol intoxication. Infusions will speed up metabolic processes in the body, and with them the removal of toxins, as well as the addict from binge drinking. The dropper will help relieve a person of all symptoms of withdrawal syndrome, stop the destruction of internal organs and promote their regeneration. What will help in treating pain after binge drinking? Drug therapy and infusion of drugs directly into the blood of the addict.

What is infused into the body:


  • nootropic drugs;
  • vitamin complexes;
  • analgesics;
  • non-steroidal anti-inflammatory drugs;
  • cleaning solutions;
  • restorative drugs;
  • antispasmodics, anticonvulsants, anticonvulsants;
  • sedatives, sedatives;
  • tranquilizers;
  • medications that normalize heart function;
  • drugs that normalize blood pressure;
  • hepatoprotectors;
  • enzymes;
  • antioxidants;
  • neuroprotectors.

Complications after radiation therapy

During radiotherapy, a general radiation reaction and local changes in the irradiated area may occur.

General radiation reaction

We are talking about the general radiation reaction to radiation. It occurs not only as a result of the damaging effects of radiation, but also as a result of intoxication of the body with tumor decay products. The severity of the reaction depends on the dose of radiation received and the technology used in treatment.

In most cases, the general radiation reaction is mild and does not require a break in radiation therapy or its cancellation. The main clinical manifestations may be:

  • Headache,
  • dizziness,
  • fatigue,
  • irritability,
  • slight nausea.

Symptoms of a general radiation reaction disappear on their own soon after irradiation - within 2-4 weeks.

However, in the Tomotherapy system, using patented beam shaping technology, negative side effects are much less common than with general radiation therapy.

Local radiation complications

Local reactions can be early (up to 3 months after irradiation) and late (after many months and even years). Their clinical picture is very diverse and depends primarily on what tissues were irradiated:

Irradiated organs Possible complications
Leather Redness, radiodermatitis, radiation ulcers, hair loss.
Mucous membranes Ulcerative changes, inflammation of the larynx, pharynx, impaired salivation.
Abdominal and pelvic organs Radiation damage with inflammation of the irradiated segments and corresponding symptoms: stool upset, false urge to defecate, abdominal discomfort.
Chest organs Radiation pneumonia (shortness of breath, cough), inflammation of the esophagus (discomfort and pain when passing food), pericardium.
Spinal cord and brain Inflammatory changes in nervous tissue.
Bone Delayed bone growth and osteoporosis.

The Tomotherapy system uses technology that minimizes the impact of radiation on healthy organs and tissues surrounding the tumor, making treatment comfortable and improving the patient’s quality of life.

The vast majority of the presented violations are temporary and can be corrected. To prevent many complications, it is enough to follow simple rules for recovery.

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