Who treats appendicitis?

A general surgeon can diagnose and remove the appendix if necessary.

Is appendicitis preventable?

There is no known way to prevent appendicitis. However, if you are able to recognize appendicitis symptoms, you can prevent serious appendicitis complications from occurring.

Removing the appendix is the only sure cut way of preventing appendicitis. This may be done if intrabdominal surgery is being performed for other reasons and the appendix is removed incidentally but it is not practiced as a routine.

What are the symptoms of peritonitis?

When the appendix ruptures, the patient may suddenly feel better. But soon after, the entire abdomen may become distended with gas and fluid and will likely feel tight, hard and tender to the touch. Patient may also have pain throughout the abdomen, but may not have the severe, localized pain of appendicitis. In addition, patient may not be able to pass gas or have a bowel movement because of the inflammation. Other signs and symptoms may include a fever, thirst and a low urine output.

Is appendicitis dangerous?

The great danger in appendicitis is rupture or perforation of the appendix. All the inflammatory agents and bacteria in the appendix spill out into the abdominal cavity, causing severe peritonitis. Sometimes there's mild peritonitis even before the appendix ruptures.

Early symptoms of acute appendicitis may include:

• Constipation, diarrhea, or gas
• Dull pain beginning around the navel, turning to sharp pain in the lower right portion of the abdomen - this takes place over about 2 hours
• Loss of appetite
• Low fever (98.6F-102.2F)
• Nausea and vomiting
• Tenderness when pressure is applied in the lower right abdomen; a good indicator of appendicitis is rebound tenderness (this means it hurts less when the fingers press over the tender area than it does when the pressure is suddenly released)
• Symptoms of more advanced appendicitis include:
• Abdominal swelling and rigidity
• Pain on the right side of the abdomen when pressed on the left sid

I'm worried I might have breast cancer. What are the signs?

The most common signs of breast abnormality include a lump, an area of thickening, or a dimple in the breast. Less common signs include breast swelling and redness or an enlarged underarm lymph node.

These signs by themselves do not mean you have breast cancer. However, they require that you SEE YOUR DOCTOR RIGHT AWAY.

How often should I do a breast self exam (BSE)?

Give yourself a breast self-exam once a month. Look for any changes in breast tissue, such as changes in size, feeling a palpable lump, dimpling or puckering of the breast, inversion of the nipple, redness or scaliness of the breast skin, redness or scaliness of the nipple/areola area, or discharge of secretions from the nipple.

Does a family history of breast cancer put someone at a higher risk?

Although women who have a family history of breast cancer are in a higher risk group, most women who have breast cancer have no family history. Statistically only 5-10% of individuals diagnosed with breast cancer have a family history of this disease.

What is a Mammotome Biopsy?

A Mammotome, or vacuum-assisted biopsy, is performed with the coordination of stereotactic mammography, which involves using computers to pinpoint the exact location of a breast mass based on mammograms (x-rays) taken from two different angles. The computer helps the physician to guide the needle to the correct area in the breast. Mammotome biopsy is a minimally invasive procedure that allows for the removal of multiple tissue samples. The special biopsy probe used during mammotome biopsy is inserted only once into the breast through a small skin nick made in the skin of the patient’s breast.

Who is at risk of colon cancer?

Age is the No. 1 risk factor – more than 90% of colon cancer cases occur in people (men and women equally) at age 50 and older. Other risk factors include:

• Family history of colorectal cancer or adenomas (polyps)
• Cigarette smoking – it can increase the risk of colon cancer death by 30% - 40%, possibly accounting for up to 12% of colon cancer fatalities
• Obesity
• Sedentary lifestyle
• High-fat diet, especially one from mostly animal sources
• Heavy alcohol intake
• Ulcerative colitis or Crohn's colitis
• Cancer of the uterus or ovaries before age 50
• Past removal of the gall bladder
• Past radiation therapy of the abdomen
• Diabetes – it can increase the risk of developing colorectal cancer 30% - 40%

Who should be screened and when?

The American Cancer Society recommends that adults be screened for colon cancer beginning at age 50 – or even earlier if there is a family history of the disease.

What is colonoscopy?

Colonoscopy allows a doctor to have a close look at the inside of the entire colon and rectum. The doctor is looking for polyps, which could be early signs of cancer. Polyps are small growths that over time can become cancer. The doctor uses a thin (about the thickness of a finger), flexible, hollow, lighted tube that has a tiny video camera on the end. This tube is called a colonoscope. The colonoscope is gently eased inside the colon and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and let the doctor see clearly.

The exam itself takes about 30 minutes. Patients are usually given medicine to help them relax and sleep while the procedure is performed.

What are the symptoms of colon cancer?

Often, the early stages of colon cancer do not have symptoms. That is why preventive screening is very important. Every year, millions of adults protect themselves from the development of colon cancer by having a routine colonoscopy. During a colonoscopy, when doctors find pre-cancerous growths called “polyps,” they can easily remove the polyps – greatly lowering risk of developing colon cancer. Other signs and symptoms to watch for are: rectal bleeding, anemia, a change in bowel habit, abdominal pain and weight loss, but these symptoms are common for other illnesses as well. When the symptoms are caused by cancer, the disease may be in a late stage.

What is Laparoscopic Cholecystectomy? (Lap Chole)

Laparoscopic cholecystectomy, commonly referred to as a lap chole, involves the removal of the gallbladder through a laparoscopic approach. The gallbladder normally stores bile produced in the liver until it is needed for digestion. Unfortunately, the gallbladder often forms gallstones.

What are the symptoms of gallstones?

Common symptoms may include:

• Upper abdominal pain, occurring after meals rich in fat
• Nausea and vomiting
• Pain between the shoulder blades, and beneath the right shoulder
• Chills and fever

Symptoms usually last for short periods of time and often occur after fatty meals which stimulate the gallbladder to contract.

What are the benefits of having my gallbladder removed laparoscopically?

Laparoscopic gallbladder surgery requires a shorter hospital stay; usually the patient is home within 24 hours. In some cases you may need to stay overnight. In contrast, patients undergoing open cholecystectomy are often in the hospital three to seven days. Other advantages include a shorter recovery time, less scarring and less pain after surgery.

How is laparoscopic cholecystectomy (gallbladder removal) performed?

During a laparoscopic cholecystectomy, surgeons make several small incisions in the abdomen near the navel and pass surgical instruments and a light source with a tiny camera through them. Surgeons then locate the gallbladder and separate and close off the vessels and tubes from it. They then remove the gallbladder and close the incisions.

What is reflux disease?

Reflux occurs when stomach contents and acid flow back up into the esophagus causing irritation in the throat. Usually stomach acid is confined to the stomach. But in some cases when a small valve called the lower esophageal sphincter (LES) malfunctions, it allows acid to seep back up into the esophagus.

Is it true that some over-the-counter antacids can cause more harm than good?

Yes and no. The antacids can help your heartburn temporarily but it can mask a more serious problem. Remember, if you are having heartburn every day or every week, go to your physician who can refer you to a surgeon who specializes in GERD management. You do not want to be treating yourself for something that is serious

Can acid reflux be cured with surgery?

Yes. You no longer have to avoid certain foods or reach for a pill, this procedure makes it easier than ever, to swallow.

If I've been taking Nexium, or any other pill to help with acid reflux, for 3-4 years now for GERD can I still have the surgery?

Absolutely. In fact please reflect on your life with GERD. Do you have frequent bouts of pneumonia & bronchitis, anemia, hip fractures, diarrhea, unexplained chest pain, hoarseness of voice, and you do not know why? It all could be caused by the medications

Will I always have to take medication for GERD?

Not if you undergo GERD surgery. Your surgeon will create a new valve at the lower esophagus to keep the acid from rising up in to the esophagus. With proper evaluation, your surgeon can decide if you would benefit from such surgery.

Stopping the stomach from making acid is not the solution for GERD.

How common are hernias?

With more than 500,000 procedures done in the United States each year, hernia repair is one of the most frequently performed operations. Hernias can affect anyone of any age.

Although inguinal hernias occur in both men and women, they are found far more frequently in men. They are also found in approximately two percent of all newborn babies.

How are hernias diagnosed?

If you have a bulge in your side — even one that does not cause pain or discomfort or that seems to go away when you lie down — you should consult a physician. This is especially true if you cannot push it back into place.

A hernia that is incarcerated may not be a medical emergency, but it represents a potential of becoming one and needs to be dealt with in a timely manner. A hernia that is strangulated — and with symptoms of severe pain, cramps and nausea — is an urgent, life-threatening emergency and needs to be dealt with immediately.

How is surgery for hernias done?

Laparoscopic surgery is the use of flexible fiber-optic instruments to allow surgery to be performed on internal organs without large, conventional incisions. Operating these thin instruments through several tiny incisions, an experienced surgeon can accomplish the repair with equally excellent outcomes, whether rejoining surrounding tissue or placing a mesh patch.

Surgical repair is the only effective treatment for hernias — Recurrence of hernias is likely in less than 10 percent of patients. Surgical techniques available range from traditional conventional approaches to laparoscopic procedures using flexible fiber-optic instruments and minimal incisions.

What is my recovery time from laparoscopic surgery?

Patients have soreness at the incision site for a few days but usually are able to resume routine activities within a week of surgery. However, patient may not be able to engage in vigorous activities or lift anything heavier than 10 pounds for six weeks following surgery.

What are hemorrhoids?

Hemorrhoids are swollen blood vessels in and around the anus and lower rectum that stretch under pressure, they are similar to varicose veins in the legs.

The increased pressure and swelling may result from straining to move the bowel. Other contributing factors include pregnancy, heredity, aging, and chronic constipation or diarrhea.

Hemorrhoids are either inside the anus (internal) or under the skin around the anus (external).

What are the symptoms of hemorrhoids?

Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid.

Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid.

In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.

How are hemorrhoids diagnosed?

A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool lasts more than a couple of days. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer. Sometimes your doctor may need to perform a colonoscopy to confirm presence of internal hernia.

what is the treatment for hemorrhoids?

Hemorrhoidectomy--Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy. This is the best method for permanent removal of hemorrhoids.

What is melanoma?

Melanoma is a very serious skin cancer characterized by the uncontrolled growth of cells that produce pigment, the substance in skin that produces color. Melanomas may appear suddenly and without warning. They are found most frequently on the face and neck, upper back and legs, but can occur anywhere on the body.

Is melanoma a serious disease?

Yes. In later stages, malignant melanoma spreads to other organs and may result in death. If detected in its early stages, melanoma can be treated successfully.

What causes melanoma?

Excessive exposure to ultraviolet radiation of the sun is the most common cause of melanoma. Other possible causes include genetic factors and immune system deficiencies. Malignant melanoma has been linked to childhood sunburns and sun exposure.

What does malignant melanoma look like?

Melanoma generally begins as a mottled, light brown to black flat blemish with irregular borders. Blemishes are usually at least a quarter of an inch in size and may turn shades of red, blue and white, crust on the surface and bleed. They frequently appear on the upper back, torso, lower legs, head and neck.

A mole that changes in appearance, a new mole or a mole that begins to grow should be examined by a doctor.

Can melanoma be cured?

When detected early, surgical removal can cure the disease in most cases. Early detection is essential. Patients with risk factors should have a complete skin examination annually. Anyone with a changing mole should be examined immediately.

What are thyroid problems and symptoms?

Some problems associated with thyroid gland can be harmless i.e. enlarged gland (goiter) but others can be serious and caused due to abnormal production of thyroid hormones e.g. hypothyroid (not enough production of hormone) or hyperthyroid (too much production of hormone). Both under and over production can lead to other metabolic problems and cancer.

Why do I need an operation?

The most common reason patients are referred for thyroid surgery is after an evaluation for a thyroid nodule. Surgery is also an option for the treatment of hyperthyroidism and for any goiter that may be causing symptoms.

How much of my thyroid gland needs to be removed?

Patients should discuss with the surgeon what operation on the thyroid is to be performed and how much of the thyroid should be removed.

Who suffers from varicose veins?

Varicose veins are actually quite common and affect up to 30% of the population. They are more often seen in women who have had children although there is also a strong genetic component as well. Most patients with varicose veins have either a mother or father with a history of varicose veins. Patients that are obese and have spent long hours standing can also have a higher incidence of varicose veins as well.

What symptoms do varicose veins cause?

Varicose veins can cause a whole spectrum of disease including pain, itching, swelling, heaviness and fatigue. In the most severe cases they can bleed or cause ulceration (skin tears), which can be quite difficult to heal.

What can be done to prevent the symptoms from varicose veins?

Aside from weight loss, there really is no way to prevent varicose veins.

When symptoms from varicose veins do not improve it is important that they see a physician who specializes in the treatment of varicose veins.

What happens when you see a vein doctor?

Most initial office evaluations begin with a careful history and physical exam. Photographs are often taken of the leg with the varicose veins. A painless ultrasound is then typically done which allows the doctor to identify the problem and decide if patient can benefit from surgery.

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