The most effective treatment is when the patient recovers and quickly forgets about the doctor. Doctors also quickly forget the good results of the treatment, and the bad ones they remember all their lives. This was said by neurosurgeon Andronik Qalayjyan during the interview with NEWS.am Medicine reporter. Let’s remember that the doctor left Armenia two years ago but now he is back and heads the neurosurgical clinic of “Astghik” MC.
Every Surgeon Has His Cemetery
“Every surgeon has his cemetery,” says Andronik Qalayjyan adding that if something fails, the doctor never forgets about it to avoid further repetition:” I always remember these cases, also the ones when I was unable to help.”And what does the doctor feel at that moment? “Compassion towards the patient, bitterness and anger for the failure. But there are cases when you do everything as it should be done but – in vain, because such is the disease nature.” To the request of describing a complicated case, the doctor answered that actually in neurosurgery all cases are complicated. “There are huge cancers when you hesitate whether the patient will live after the surgery or not.But there is no other way out, the operation should be performed,” he says.
What Does Neurosurgery Deal with?
“We treat people with brain and spinal cord diseases. These are injuries, inflammations, vascular diseases and also cancers,” he says highlighting that, for example in case of strokes the hematoma incurred from a hemorrhage is removed. “After a massive brain stroke in case of uncontrollable swells we have to remove a part of the skull to allow the patient bear the acute period, and then we restore that part. The surgery does not save from disability but it improves the life quality,” he explains.
But the most common disease which is dealt by neurosurgery and which is always a subject for discussion is the hernia of intraspinal discs.
Why Is the Spinal Hernia the Problem of Neurosurgery?
“Historically it has arranged in this way,” says Dr. Qalayjyan with an explanation that actually the disease is in the crossing point of orthopedics and neurosurgery. What concerns the intraspinal hernia diagnosis, the doctor says, now due to MRT this disease is diagnosed more easily and precisely than 20 years ago. ”MRT properly shows whether it is the very disease or not. And formerly, in order to perform a hernia diagnosis, it was necessary to puncture the backbone with a long needle, to inject a contrast material, to do X-ray pictures and estimate approximately if there is a hernia or not,” remembers the neurosurgeon.
Are the Nerve Disorders Incurred During the Injuries Restorable?
As to the doctor, the peripheral nerves regrow; the membrane allows them to grow but the nerves of spinal cord and brain do not. “The nerve-threads of brain and spinal cord are not possible to grow. If the spinal cord is damaged, it becomes a zone of irrevocable injuries which has been squeezed and its function has been disordered but it is possible to recover only in certain conditions: to help this zone get nutrition on time and the swelling disappear. But to what extent they will recover depends on Nature and God,” says the doctor.
The conversation comes to the severe neck injuries which a few participants of April war hadreceived: “These are very severe injuries as the spinal cord is injured in the upper part, the hands and legs are paralyzed. Both the esophagus and trachea are damaged; the risk of disability is very high,” says the doctor. What concerns the restoration of functional mobility of such patients, the doctor highlights that it is possible to restore the sector of the spinal cord which has not been injured completely:” There is always an area for change round the necrosed space where the function is disordered but the anatomy is not distorted. In case of favorable conditions, the function may be restored,” he says.
Further Programs in “Astghik” MC
“Now we are intended to import the endoscopic surgeries and we have lots of ideas. We have already implemented an endoscopic surgery and will promote this method,” says the doctor. As to him, neurosurgical operations are performed both on the spinal cord and the brain. This method is more preferable than the open operations for causing less traumas and postoperational complications. Particularly, as the doctor says, the endoscopic method considerably facilitates the operation of pituitary adenoma which is performed from nasal cavities. And there are all the conditions for the installation of new surgical equipment in “Astghik” MC.
“Astghik” MC stands out for its best surgical devices and work conditions. There is a splendid surgical microscope here, a high standard operation room, good tools. All the conditions for early diagnosis are created here; there is a tendency to adopt every innovation and skillful specialists of international standards have gathered here,” concludes the doctor.