Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In most situations the surgery is performed as an outpatient
at either
a hospital or a surgery center. In both facilities, quality
care is
provided without the expense and inconvenience of an overnight
stay. An
anesthesiologist will monitor the patient throughout the
procedure. Usually, the anesthesiologist (or surgery staff) will call the night
before
surgery to review the medical history. If they are unable to
reach the patient the
night before surgery, they will talk with the patient the morning of the
surgery. If
the doctor
has ordered preoperative laboratory studies, the patient should arrange
to have
these done several days in advance. The patient should arrange for someone to take
them to the surgical facility, back home, and to spend the first night after
surgery with
the patient.
The patient should not take aspirin, or any product
containing
aspirin, within 10 days of the date of the surgery.
Nonsteroidal
antiinflammatory medications (such as
ibuprofen, Advil, and
others)
should not be taken within 7 days of the date of surgery. Many
over-the-counter products contain aspirin or ibuprofen-related
drugs so it
is important to check all medications carefully. If there is
any question
please call the office or consult a pharmacist.
Acetaminophen (Tylenol)
is an acceptable pain reliever. Usually the doctor will give
the patient several prescriptions at the preoperative visit. It is best to
have these filled prior to the date of surgery so they are available when
you return home.
If it is a child who is having the surgery, it is advised
that you be
honest and up front with them as you explain their upcoming
surgery.
Encourage the child to think of this as something the doctor
will do to
make them healthier. Let them know that they will be safe and
that you
will be close by. A calming and reassuring attitude will
greatly ease the
child's anxiety. Let them know that if they have pain it will
only be for
a short time period, and that they can take medicines which
will greatly
reduce it. You may want to consider a visit to the surgical
facility or
hospital several days in advance to that the child can become
familiar with the
setting. Contact the surgical facility or hospital to arrange
for a tour.
The patient must not eat or drink anything 6 hours
prior to the
time of surgery. This includes even water, candy, or chewing
gum. Anything
in the stomach increases the chances of an anesthetic
complication.
If the patient is ill or has a fever the day before
surgery,
call the surgeon's office. If the patient wakes up sick the day
of surgery,
still proceed to the surgical facility as planned. The doctor
will decide
if it's safe to proceed with surgery. However, if your child has
chickenpox, do not bring your child to the office or to the
surgical
facility.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Strep throat is a sore throat caused by a bacterium called streptococcus (strep) that can be treated through antibiotics. Common symptoms of strep throat include pinkeye, runny nose, skin rash, cough, hoarseness, diarrhea and more. Complications of untreated strep throat include middle ear infections, meningitis, pneumonia, rheumatic fever, and more.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
It is thought that the tonsils and adenoids assist the body in fighting incoming bacteria and viruses by helping the body form antibodies. This is thought to be important only during the first year of life. Acute tonsillitis, strep throat, mononucleosis (mono), chronic tonsillitis, peritonsillar abscess, and hypertrophic tonsils and adenoids are all common problems involving the tonsils and adenoids. Treatment of tonsillitis and adenoids include antibiotics and other medications depending on the cause. In some cases, a tonsillectomy or adenoidectomy (the removal of the tonsils or adenoids) may be necessary.
Nausea and vomiting are symptoms that may be caused by many conditions. Antiemetics are drugs that treat nausea and vomiting. Though some antiemetics for motion sickness and mild nausea are available over the counter (OTC), most require a medical evaluation and prescription.
Bad breath can result from poor oral hygien habits and may be a sign of other health problems. Bad breath, also called halitosis, can be made worse by the types of food you eat and other unhealthy lifestyle habits.
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