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Hernias: why are some watched while others are repaired?

September 17, 2012

The most common thing that I see as a pediatric surgeon is a child with a lump that is thought to be a hernia. A hernia is a bulging of tissue through an opening in the muscle layers that isn’t normally present. In children, these openings are usually the result of a developmental process that just didn’t quite reach completion. Some hernias need surgery emergently, while others are observed for years with the expectation that they will close on their own.

Here are some pointers to help understand this wide range of approaches to hernias:

Location is very important in considering how aggressive to be with hernias. Belly button (umbilical) hernias are...

Swedish Vascular: Chapter Published by Expert in Cerebrovascular Imaging

September 14, 2012

We are pleased to share that Colleen Douville, Director of Cerebrovascular Ultrasound at Swedish Medical Center, published a textbook chapter in Diagnostic Medical Sonography: The Vascular System. Douville’s chapter, “Intracranial Cerebrovascular Examination,” details cerebrovascular anatomy, transcranial Doppler & imaging ultrasound techniques, clinical applications and diagnostic criteria. The book was published this spring.

The Swedish Vascular Ultrasound Laboratory, located at the Swedish Cherry Hill campus, has the capabilities and expert staff that perform specialized exams to assist in the diagnosis and treatment of vascular disease. In addition to conventional examinations for peripheral arterial occlusive disease, abdominal aortic aneurysms, deep vein thrombosis, chronic venous disease, renal and mesenteric disease and dialysis access, this center performs cutting-edge studies to detect abnormalities of the cerebral circulation.

The physicians ...

Do self breast exams matter?

September 12, 2012

Self breast exams: to do or not to do?

Remember when there were monthly emails you could sign up for to remind you and your friends to do your self breast exams at home? Remember seeing the news anchors talking about their monthly self breast exams in an attempt to remind you to do your breast “due diligence?” What happened to self breast exams and are they still important?

Initially, self breast exams were recommended as a screening tool to help early detection of breast cancer. Unfortunately long-term studies have not confirmed that they actually live up to their hype. Two large studies looking at over 200,000 women in both Russia and China didn’t show any difference in breast cancer mortality after 15 years between the women who were ...

You've been diagnosed with prostate cancer - now what?

September 10, 2012

Almost daily there are new recommendations for how to treat prostate cancer and an equal number of controversies surrounding the recommendations. What is a man to do when faced with the words, “you have prostate cancer”?

The good news is that there are many proven options to consider; but how do you choose the best one for you? The decision can be daunting and the controversies swirling in the news only increase the confusion when wading through the information. You may be considering:

  • Active surveillance (watchful waiting) is an option for those who want to closely monitor their cancer over short intervals. Intervention is considered if the cancer grows quickly, PSA scores increase or other ...

Health Dot Com - Tips for Accessing Health Information Online

August 27, 2012

Copays and premiums and bills, oh my! Some health care services may be expensive but health information shouldn’t have a price tag. So what happens when  you just want the answer to a simple question? Whether there wasn’t enough time during an appointment, you forgot to ask your doctor, or your next check-up isn’t for a while, there are options to get the answers you need.

Many of us get a second—or first—opinion from Dr. Google, which may lead to incorrect or unreliable information. And while there’s nothing wrong with getting health information online, it’s important to make sure it is correct!

“But I don’t know the answer to begin with so how can I know if it’s correct?”

Here are some questions to ask yourself:

Rib Fractures: Essentials of Management and Treatment Options

August 22, 2012

Rib fractures are the most common chest injury accounting for 10 to 15 percent of all traumatic injuries in the U.S. Nearly 300,000 people are seen each year for rib fractures and 7 percent of this population will require hospitalization for medical, pain, and/ or surgical management.

Rib fractures can cause serious complications including: bleeding in the chest (hemothorax), collapse of the lung (pneumothorax), or result in a fluid accumulation in the chest (pleural effusion), just to name a few. As well, rib fractures may contribute to the development of a lung infection or pneumonia. These problems are important to diagnose following chest trauma and even more importantly, when present, they need to be followed closely in the early post-traumatic period.

The most common symptom that people experience with rib fractures is....

Eliminating your risk for stroke

August 20, 2012

In the clinic, we work with stroke patients and their families to help them understand the risk of having a second stroke and what they can do to reduce their risk. Lifestyle and medical conditions determine your risk for a first, or second, stroke.

  • Do you have high blood pressure and/or high cholesterol?
  • Do you have diabetes?
  • Have you been diagnosed with atrial fibrillation?
  • Do you smoke?
  • Are you overweight?
  • Do you avoid exercise?
  • Has a close relative had a stroke?

If you answered yes to any of those questions, you’re at greater risk for having a stroke. If you’ve already had a stroke, your “yes” answers mean you’re more likely to have another one.

Your lifestyle can help you avoid a first or second stroke. And, because family history is a stroke risk factor, your entire family can benefit from a healthy way of life. Pledge to help each other stick to a routi...

Constipation during infancy

August 17, 2012

As a pediatric surgeon with a special interest in intestinal issues, I am often contacted by worried parents regarding their baby's infrequent bowel movements. This can be caused by a variety of
problems such as blockages of the intestines or abnormal intestinal function (including a condition called Hirschsprung's disease); but most frequently babies are just efficiently absorbing and thus not needing to poop very often. This is especially true for breastfed babies. So, how can a parent tell the difference?

I would offer the following "red flags" as issues that may indicate a problem needing further medical evaluation:

What test is best for breast screening?

August 15, 2012

I often get asked why can’t a woman just get a breast MRI rather than a mammogram. The imaging tests that we do for breast cancer screening and evaluation of abnormalities have different strengths and weaknesses.

Mammograms are very useful as a screening tool. They can be done quickly and read efficiently by the breast radiologist. They have minimal radiation exposure. They can be done by a mobile coach in locations that are more convenient to patients. They are excellent for identifying abnormal calcium deposits within the breast tissue and for seeing disrupted tissue and masses. They may be less effective in women who have dense breast tissue but the digital techniques have he...

Pipeline: New Alternative Treatment for Brain Aneurysms Performed at Swedish

August 14, 2012

The interventional neuroradiologists at Swedish Neuroscience Institute in Seattle are rapidly building experience performing Pipeline® embolization on patients with certain types of brain aneurysms.

Dr. Joe Eskridge and Dr. Yince Loh are both performing this new ‘flow diversion’ technique, where the pipeline device is placed across the aneurysm neck to divert blood flow back to the normal vessel. This technique is a new treatment option for large, complex and wide-necked brain aneurysms, which can be challenging to treat with traditional methods.