February 2013
Blog

February 2013 posts

Activity after open or laparoscopic abdominal surgery

Every patient who visits my office with a surgical condition has several decisions to make and has a lot of information to absorb and understand.

I typically spend much of our time together describing the condition itself, why I recommend surgery, how I will perform the surgery and any risks involved in the procedure. While this is all critical to anyone’s understanding of their treatment plan, once the decision has been made to proceed with surgery, many patients’ concerns quickly turn to their recovery and what to expect after surgery. Most patients want to know when they can get back to walking, lifting, exercising, and their normal daily routine. While every patient and procedure is different, some generalizations can be made to help you know what to expect.

General abdominal surgery can broadly be separated into two categories: 1) open surgery where a large incision is made through the abdominal wall and 2) laparoscopic (or robotic) surgery where the procedure is preformed through multiple small incisions. Both types of surgery are used for a wide array of surgical problems.

The recovery from these two types can be different. Every patient should ask their surgeon wound care questions, dietary restrictions or signs of possible complications specifically related to their recommended procedure. There will be activity restrictions in the early postoperative period for all surgical procedures.

Many people wonder why we limit activity after ..

Why you should take sports concussions seriously

Concussions are serious injuries that should be treated by healthcare providers who are experienced with their management. Sports Medicine physicians diagnose and treat concussions with the goal of promoting a healthy recovery and returning athletes to sports and kids to school. Additionally, we work with parents, athletes, coaches, and other providers to identify the signs and symptoms of a concussion and help to proactively manage the effects.

What is a concussion?

A concussion, also referred to as a mild traumatic brain injury, is an injury to the brain caused by a blow to the head or from a whiplash effect due to a hit to the body. Concussions change the way the brain works and how a person thinks, acts, and feels. Most people do not lose consciousness. Even a "ding" or "bell ringer" can be serious.

What are the symptoms of a concussion?

Symptoms fall into four categories: physical, cognitive or thinking abilities, mood and behavior, and sleep. A person may have many symptoms or only a couple of symptoms. If a person reports one or more symptoms of concussion or if another person notices the symptoms, keep the person out of play and seek medical attention.

The symptoms of a concussion that fall into each category include:

Barrett’s Esophagus and Esophageal Cancer: The dark side of the acid reflux epidemic

Heartburn (which was once considered an annoying result of over-eating) has matured into a full-blown medical condition better known as gastro-esophageal reflux or GERD.

GERD, or the sensation of acid or other gastric fluids washing up into the chest or mouth, affects as many as 1 in 5 adults in the US on a monthly basis with up to 6% experiencing symptoms 2 or more times per week. Estimates suggest that about 5% of those who suffer from reflux will develop a potentially pre-malignant condition called Barrett’s esophagus (BE). Named after the British thoracic surgeon who erroneously suggested the condition resulted from a congenitally short esophagus, BE is characterized by “specialized intestinal lining” replacing normal squamous epithelium (ie, wet skin, like the lining of the mouth) in the lower esophagus in response to long-term, repetitive exposure to stomach acid.

While this may seem like a protective adaptation—Barrett’s tissue will not ulcerate and develop scarring the way squamous tissue does—it is inherently unstable and can progress to cancer. The risk for developing adenocarcinoma of the esophagus for people with BE is more than 30 times greater than for people without it.

Luckily, the absolute risk of progression from BE to cancer is relatively low. BE progresses to esophageal cancer at the rate of around 0.2% per year. Further, cancer doesn’t usually develop suddenly. Instead, it progresses through a series of stages termed “dysplasia” meaning bad or unfavorable changes that can be identified on biopsies collected at endoscopy. These changes progress from...

Swedish/Issaquah First Hospital in State to Offer Bavia Postnatal Massage Services

Bavia-provided-photo.jpgISSAQUAH, WASH., Feb. 1, 2013 – Childbirth is often painful and always unpredictable, but postpartum recovery doesn’t have to be. New mothers can now leave the hospital even happier with Postnatal Body Therapy™ by Bavia™. This postnatal massage service is now available at Swedish/Issaquah.

The Goal of DBS (Deep Brain Stimulation) Surgery

I met with several patients this week to discuss their personal journey to making the decision to pursue DBS surgery. Not surprisingly, they were well educated about their disease and treatment options.

Each patient reminded me that there is a lot of information and misinformation about surgery for movement disorders.

The most important advice I can give any patient or family is...

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