Everything Surgery

I have been told I have a slipped disc in my lower back. My doctor says I need surgery. I am 44 year old and have mild to moderate pain but can work. Should I go for it?

2011-05-08T14:21:00.001-07:00

Prolapsed discs are very common in our society; at least 5% of the population has prolapsed disc but not all of these people have symptoms. In some cases , prolapsed disc may cause pain which runs down the buttocks. In the majority of cases, this pain will settle down with non-surgical treatments. Surgery is only recommended in people who are in a hurry to recover and do not want to be bothered with exercise and/or a weight loss program. However, you should know that the results of surgery are not great. The majority of patients turn out to be worse. My advice is that you should exercise, lose weight and keep away from back surgeons- unless you want a life of intense pain and remain disabled for the rest of your life.

I am 32 and have had low back pain for 12 months. I am able to work and the pain is tolerable. Recently I underwent an MRI which revealed a small prolapsed disc. My doctor says I should undergo surgery. What do you think?

2011-03-08T18:13:00.001-08:00

Well I think your doctor is not an honest person or that he knows very little about prolapsed discs. Prolapsed discs are very common in people with low back pain; the majority resolve with non surgical methods. Surgery is the last resort for prolapsed discs or when there is acute nerve compression involving the balder or rectum. For most people conservative therapy, pain control, exercise or physical therapy is the key.

Even though surgery is needed sometimes, the results suck. Some orthopedic surgeons would make great butchers. Most people who undergo surgery for prolapse discs are worse off than what they started out with. So if you have any common sense, join a physical therapy program or better still, walk in a swimming pool regularly. Lower your weight and become active. Surgery when it fails can make you miserable for the rest of your life.

My doctor says I need surgery for my tennis elbow? Is this standard treatment?

2011-01-07T10:13:00.001-08:00

Surgery is very rarely done for tennis elbow. The treatment of tennis elbow is conservative therapy. Only when all these therapies fail after a period of 12 months or if you have a completely torn or ruptured ligament, is surgery a consideration. Surgery is sometimes undertaken if you are unable to move your arm, have developed adhesions or are in constant agonizing pain. Surgery for tennis elbow is done as an outpatient and utilizes a small camera. The surgery can help repair tendons, breakdown adhesion and clean any loose bone fragments. However, you had better get a second opinion because many surgeons tend to rush people for unnecessary surgery. While there are a few good surgeons, there are many bad surgeons who can also mess you up for good.

I just had an incidental ultrasound and a gallstone was discovered. My doctor says i need surgery. What should i do?

2011-01-02T06:41:00.000-08:00

Change your doctor because he is not interested in your welfare.

At least 20% of the population may have gallstones but that does not mean everyone needs surgery. IF you have no symptoms and only have a single gallstone, you do not need anything, except a change of doctor.

In the meantime, eat a low fat diet, exercise regularly and do not smoke. Sometimes it is not even your gallstone that encourages surgery; but the type of health insurance plan. Gallstones are frequently found at autopsy and do not cause any harm in the majority of people.

Outside of North America, millions of people live a healthy life with gallstones. Gallstone surgery itself is an American disease. Most gallstones are removed for no other indication other than to make money. However, if you have symptoms than perhaps you may require surgery.

I had coronary bypass 1 month go and now my doctor says the grafts are blocked. What should I do next?

2010-12-28T10:59:00.000-08:00

Well, the first thing you need is a damn good lawyer.

Coronary bypass surgery is a routine procedure but if the grafts blocks within the first 3 months, then the surgeon is almost always at fault. The problems are most likely technical.

You have to understand that there are many awful heart surgeons and this is evidenced by the number of patients who develop complications. The next thing you need to do is ask your doctor to perform an angiogram and determine which of the bypass grafts are blocked. In many cases, fresh bypass grafts may not be amenable to stenting or angioplasty because there is always a risk of a fresh clot breaking off.

If you have symptoms, you may need to continue your medications. In many cases, when the first surgery is screwed up, you need another one. If you have no symptoms, then you may have the option of taking medications, but if you have symptoms, then another surgery may be required. Speak to your doctor and do not go back to the same surgeon.

Can you explain me the surgery for droopy eyelids?

2010-12-26T19:25:00.000-08:00

Surgery for droopy eyelids is known as blepharoplasty. The procedure is usually done by eye surgeons and involves removing the excess fat and skin from the eyelid. With aging, most people develop droopy or saggy eyelids because the muscles lose their elasticity.

Over time, the skin starts to stretch and fat starts to accumulate causing sagginess or droopy eyelids. Droopy eyelids are not only aesthetically unpleasant but may also blur your vision.

Blepharoplasty can help restore the shape of your eyelids, make you look refreshed, young and can get rid of the blurry vision. The procedure is done as an outpatient under local anesthesia and does not take more than a few hours at most.

However, success of blepharoplasty does vary and droopiness can recur. You have to be realistic about the procedure. While surgeons tend to brag about their results, the reality is that some patients end up with crappy results.

I had a ruptured appendix and had urgent surgery 3 days later. I remained in hospital for 6 more days, I am now having low grade fever and do not feel well, what should I do?

2010-12-20T05:20:00.001-08:00

Generally after a ruptured appendix, one of the biggest concerns afterwards is development of a pelvic abscess or pus collection deep in the lower abdomen. Most people develop a fever, have no appetite and feel like crap.

I think it would be wise to see the surgeon as soon as possible; A Ct scan will help make the diagnosis of a pelvic abscess. In general, the treatment for a small pelvic abscess is antibiotics. If the abscess is large, it may be drained via the rectum or with the use of CT scan. In some cases, you may need to be opened up again.

If the ruptured appendix was missed, no adequate tests were done, or if you were discharged prematurely and the surgery was delayed, go get yourself a good lawyer.

I recently had surgery on my left inguinal hernia and was later told that the surgeon has accidentally cut one of the nerves. Will this ever heal? It is now 3 weeks.

2010-12-20T05:12:00.000-08:00

If the surgeon did not put the nerve back with stitches, it is very unlikely that it will grow back. Moreover, for the nerve to grow back it must be put back as soon as possible. Stitching nerves back also requires expertise from a plastic or a neurosurgeon.

If you do not have any symptoms I would not worry about it. There are two nerves in the groin and if either is damaged during a hernia repair, you can develop pain, numbness or abnormal sensations around the groin, thigh and inguinal area.

If you are asymptomatic, just move on with your life. Some surgeons may recommend a second look but in most cases, the results are even worse than the first surgery.

If you are having pain, go see a lawyer. Winning some money back from a surgeon will take some of the pain away.

What are pros and cons about non-surgical treatment of Achilles tendon rupture?

2010-12-20T04:50:00.003-08:00

The chief advantage of a non-surgical approach is there is no incision, and thus, the risk of wound infection is zero. The skin remains intact and the nerve along the ankle is preserved intact. Other benefits of non-surgical approach include minimal costs and no risks of anesthesia.

The disadvantage of non-surgical approach is that the risk for re-rupture of the tendon is very high. Non-surgical approaches almost never result in 100% recovery of the tendon attachment. Further, non surgical approach also require much longer period of physical therapy with no guarantee of success

What are non-surgical methods of treating Achilles tendon rupture?

2010-12-20T04:50:00.001-08:00

First, herbs, lotions or potions are not part of non-surgical treatments for Achilles tendon rupture.

The non-surgical approach of managing Achilles tendon injury requires the application of a short leg cast with the ankle placed in a slightly plantar flexed position. This position reduces tension on the tendon and allows for better healing. The cast is usually left for 6-10 weeks and no movement of the ankle is allowed. During the first 4 weeks, crutches should be used and there should be no weight bearing.

After 4-6 weeks, walking is allowed. When the cast is removed, a small heel lift is placed in the shoe to allow ankle support for an additional 2-4 weeks. Following this, physical therapy for 2-3 months is recommended.

Can the Achilles tendon rupture be repaired non-surgically?

2010-12-20T04:49:00.001-08:00

Yes, but only in a few rare cases.

Surgery is still the gold standard for a ruptured Achilles tendon. However, sometimes a person may be too ill or may have an infection that prevents immediate surgery. Another group of patients who are not always candidates for Achilles tendon surgery are diabetics.

Diabetics tend to have very poor blood supply in their legs and surgery is fraught with complications. All diabetics with Achilles tendon rupture should always get a second opinion before rushing to surgery. Other individuals who also do not do well after surgery are those already have neuropathies. These individuals are unable to sense pain and do poor with rehabilitation

I am an otherwise healthy 65-year-old male and have been told that I have a 4.2 cm abdominal aortic aneurysm? My doctor says I need surgery.

2010-12-14T11:05:00.000-08:00

The first thing you need to do is dump your doctor. Abdominal aortic aneurysms are not rare and commonly occur in males in the 6-7 decade of life. In almost all cases, aneurysms which measure less than 4.5 cm are observed.

What you need is an ultrasound every 6 months to make sure it does not grow. In many cases, no other treatment is required. From previous studies, it is now apparent that many aneurysms that measure 4 cm do not grow and remain stable for decades.

Surgery for aneurysms is recommended when they are either 5 cm or larger, or suddenly increase in size.

In the meantime, stop smoking, eat healthy and make sure your blood pressure is under control. Ask your doctor about a beta-blocker. Walk everyday and refrain from exercises that increase pressure on your abdomen. If ever in doubt, always seek a second opinion. In your case, a change of surgeon is highly recommended.

In America, it can be hazardous to have health insurance because there are some doctors who are eager to cut you up- whether you need it or not.