Patient learns the hard way that colonoscopies are worth making time for
New “mesh” procedure improves outcomes for those with pelvic prolapse
Maintain an asthma action plan during cold and flu season
Work to prevent osteoporosis with a few guidelines
Study finds risk of diabetes is lowered with the right carbohydrate choices
Program helps seniors deal with everyday issues
More are surviving breast cancer but not among certain groups of women
Chesapeake Regional surgeon takes the next step in fighting reflux
New procedure provides an alternative to a hysterectomy
Patient learns the hard way that colonoscopies are worth making time for
Janis Mathews was enjoying the busy life of most Baby Boomers. The owner of her own company and the main caregiver of an ailing mother, Mathews didn’t make time to get a baseline colonoscopy at age 50, as her doctor suggested.
Before she knew it, 10 years had passed. Now, she wishes she had taken her doctor’s advice.
After undergoing a hysterectomy and surgery for pelvic prolapse in early January, Mathews began experiencing increased constipation. She’d had a problem with constipation for a year, but finally it became so severe and painful, she went to the Emergency Department at Chesapeake Regional Medical Center.
A CT scan showed complete intestinal blockage. She was referred to Dr. Pramod Malik, a Chesapeake Regional Gastroenterologist, who immediately scheduled an endoscopic procedure.
“We used a stent through a scope to help release the blockage from colon cancer and provide her with relief so as to avoid a colostomy and open operation,” said Malik. “After this, we did a colonoscopy at a more convenient time for her, during which we found additional polyps and removed them.” The next day, the cancer along with the lymph nodes and portions of her colon were removed in a surgery by Dr. Alireza Farpour. Mathews is now at home recovering from major surgery and facing the possibility of chemotherapy.
She now realizes that, if she’d gone for her colonoscopy 10 years ago, the polyp that eventually became the cancer, could have been removed during colonoscopy and without surgery. She wouldn’t be facing the ordeal she is now.
She is telling everyone she knows the lesson she learned the hard way. Get that baseline colonoscopy!
Dr. Michael Sperling, a Chesapeake Regional Gastroenterologist, concurs. “According to the American Cancer Society’s guidelines, anyone over age 50 should get a colonoscopy,” he said. “If you have a family history of colon cancer, gynecological cancers, inflammatory bowel disease, and colon polyps at a young age talk to your physician. You will need to get one sooner.”
New “mesh” procedure improves outcomes for those with pelvic prolapse
It’s a sinking feeling, many women say, that something isn’t right. Usually, they are correct.
Pelvic organ prolapse – or the descent of the pelvic organs – is common among women, especially those 45 and older. In fact, one in three women suffers
from the condition.
“I see this condition particularly in women who have experienced childbirth,” said Dr. Rebecca Ryder, a Chesapeake Regional gynecologist. “Patients typically experience symptoms of pelvic or low abdominal pressure, incontinence, constipation and sometimes vaginal protrusions.”
Traditionally, when organs such as the bladder, bowel or uterus became dislodged, a physician would reposition and fasten them in place using stitches. The recovery time would last about six weeks. However, up to 30 percent of those who have surgery have it again later in life.
But, now, a new procedure is making recovery faster and reoccurrence less common. Ryder is one of only a select few physicians nationally who is performing the surgery.
“I now do many of my pelvic reconstruction surgeries using a monofilament mesh,” said Ryder. The physician explained that the mesh works much like a hammock holding the organs in place.
Patients usually stay in the hospital a shorter time after the surgery and recover in about two to four weeks. Fewer women experience reoccurrences. According to Ryder, only about 5 to 10 percent need the surgery again.
For more information about the procedure, you can contact Ryder at 312-8221.
Maintain an asthma action plan during cold and flu season
After an allergy-filled fall season, during the winter many asthma sufferers are anxious to take a break from their asthma control measures during the winter. However, new asthma care guidelines from the U.S. National Heart, Lung and Blood Institute’s National Asthma Education and Prevention Program cautions against this risky behavior.
“Asthma is a chronic disease that needs to be managed over time,” said Dr. Dominic Johnson of Chesapeake Emergency Physicians. “We see far too many cases in our Emergency Department of patients not keeping up with their regimen and getting into a crisis situation. Often, this can be prevented.”
The new guidelines, the first the institute has issued in 10 years, stress that regular monitoring is crucial. Control of environmental factors, medication management and education are key. The routine use of inhaled corticosteroids as the standard for patients with persistent and chronic asthma is highlighted as well.
“The new guidelines stress what we have always stressed as emergency physicians,” said Johnson. “Visit your primary care doctor regularly and you may not have to come see us.”
The guidelines recommend that every patient work with a physician or nurse to develop a written asthma action plan. The plan should include daily treatment details and ways to proceed if symptoms get worse.
“Many asthma patients who visit us give up on their daily medications once allergy season has gone away,” said Johnson. “They shouldn’t do that if they want to stay healthy, especially during cold and flu season.”
Work to prevent osteoporosis with a few guidelines
We are all at risk of fracturing a bone in our lifetime. But, for the 44 million Americans at risk for osteoporosis, this threat is elevated.
Osteoporosis is responsible for more than 1 million painful fractures per year.
According to the National Institute of Arthritis and Muskuloskeletal Disease, one out of every two women and one in four men older than 50 will have an osteoporosis-related fracture in their lifetimes. Many older adults experience fractures due to bone loss.
For the 34 million Americans with low bone mass, such risk factors as gender, age, body size and family history cannot be changed. However, some factors can be managed, according to the NIAMD:
- Sex hormones - Abnormal absence of menstrual periods and low estrogen or testosterone levels can bring on osteoporosis.
- Anorexia nervosa - This eating disorder increases the risk for osteoporosis.
- Calcium and vitamin D intake - A lifetime diet deficient in calcium and vitamin D makes you more prone to bone loss.
- Medication use - Long-term use of glucocorticoids and some anticonvulsants can lead to loss of bone density and fractures.
- Lifestyle - An inactive lifestyle tends to weaken bones, as does extended bed rest.
- Cigarette smoking - Cigarettes are bad for bones as well as the heart and lungs.
- Alcohol intake - Excessive consumption increases the risk of bone loss and fractures.
Bone density tests can be done in several ways but the most accurate is a bone densitometry, a test similar to an X-ray that quickly and accurately measures bone density. It is used primarily to detect osteopenia or osteoporosis, diseases in which the bone's mineral content and density are low and the risk of fractures is high. Bone mineral density measures the amount of calcium in a specific region of the bones. From this information, an estimate of bone strength can be made. Unlike the densitometer, ordinary X-rays cannot detect mild bone loss.
Bone density testing is recommended for women over the age of 65 or those who have other risk factors.
Study finds risk of diabetes is lowered with the right carbohydrate choices
Diabetes has become an American epidemic, with nearly 21 million Americans living with the more common Type 2 diabetes. And as obesity continues to climb about children, the numbers continue to grow.
Now, new studies suggest what many have suspected all along, that diet plays a large role in developing Type 2 diabetes. Two new studies published in the Archives of Internal Medicine suggest that eating simple and refined grains, such as white rice and white bread, raises the risk of Type 2 diabetes.
“We have known for some time that food with a high glycemic index, like white bread, has some correlation to Type 2 diabetes,” said Babs Carlson, Ph.D., a certified registered dietitian who serves as Chesapeake Regional’s coordinator of Nutrition and Diabetes Services. “It is important for people to increase their intake of whole grains, and vegetables as this appears to help reduce the risk of Type 2 diabetes.”
One study looked at 40,000 African American women for eight years. In that time, 2,000 of them developed Type 2 diabetes. The women who consumed whole grains, particularly cereal fibers, were the least likely to be diagnosed with diabetes.
The second study looked at the eating habits of more than 65,000 Chinese women over five years. More than 1,600 of those women were diagnosed with Type 2 diabetes during that time. These women were consumed large amounts of carbohydrates. According to the study, the women who consumed the most carbohydrates were 28 percent more likely to get diabetes than those who consumed the least.
The dietitians at Chesapeake Regional work to help patients with diabetes stay healthy. Patients are also referred to the program to learn healthful eating habits in avoiding the disease. For more information about scheduling an appointment with a Chesapeake Regional dietitian, call 312.6132.
Program helps seniors deal with everyday issues
Mary Waldo never took the time to think about how alone she felt, not until her daughter made her take a time out.
“My husband has dementia and I was getting depressed,” she recalled.
At her daughter’s suggestion, Waldo turned to Chesapeake Regional’s Partial Hospitalization Program. She thought she would be getting support as a caregiver. She got a whole lot more.
After an examination and assessment to determine her eligibility, Waldo began meeting with other older adults, ages 55 and older, from 10 a.m. until 2 p.m. daily to develop tools to help her cope with the psychological issues of aging.
It was a godsend. She completed the program in seven weeks and has regained her vitality of old. “It was really helpful to know what others are going through,” she said. “I have learned to not sweat the small stuff.”
Like Waldo, other seniors turn to the program to help them with acute behavioral and psychiatric issues without having to be hospitalized.
‘The goal of the program is to increase awareness in patients of what ‘triggers’ their symptoms,” said Carol Schultz, program coordinator. “They learn coping skills and are educated about health issues, medication and depression. Group psychotherapy sessions allow patients to discuss their feelings, if they wish, in a confidential setting with their peers.”
Participates attend sessions from two to six weeks depending on their individual needs and progress. In addition to education and psychotherapy, patients participate in art, music and pet therapy and learn tools to deal with depression and anxiety.
Patient’s families are also included in the process. They are also updated on the patient’s progress weekly.
Transportation is provided to the program, located at 667 Kingsborough Square in Chesapeake. Assessments are at no charge, and participation is covered by Medicare and most private insurances.
For more information about the Partial Hospitalization program, call 312.6143.
More are surviving breast cancer but not among certain groups of women
Thanks in part to new technologies and advances in cancer detection, more women are surviving breast cancer, according to a recent study by the American Cancer Society.
The study found breast cancer death rates in American women dropped 2.2 percent annually from1994 to 2004.
“The emphasis on mammograms and self breast exams has really changed the face of cancer treatment,” said Dr. Juliana Ballestero, a Chesapeake Regional radiologist. “Still, we are still nowhere near where we need to be.
Surviving breast cancer has a lot to do with a woman’s race and ethnicity, according to the study, as do diet and cultural acceptance of treatment and detection practices, according to the study. Women's breast cancer death rates didn't decrease among Asian-American/Pacific Islanders, American Indians and Alaska natives. And, the rates dropped by only 1.6 percent for African Americans during the study period.
All women, according to Ballestero, should eat a diet rich in grains and vegetables. They should also get a baseline mammogram at age 40. Women with family histories of breast cancer should consult their physician about cancer detection practices.
Eating right, not smoking tobacco and getting regular medical checkups will also help to prevent the other major causes of death for American women, such as lung cancer and heart disease, Ballestero pointed out.
According to the American Heart Association, heart disease kills more American women than all cancers combined.
For more tips about breast cancer prevention or questions about treatment, contact Chesapeake Regional’s Breast Center at 312.2232.
Chesapeake Regional surgeon takes the next step in fighting reflux
At breakfast, lunch and dinner many people live in fear that they’ll pay for what they eat with a burning sensation that just won’t go away. Over-the-counter remedies and lifestyle changes are often not enough to rid them of their heartburn.
Described as a harsh, burning sensation between the ribs or below the neck, in medical terms, heartburn is actually a symptom of gastroesophageal reflux disease or GERD.
“GERD is caused by stomach acids which back up or ‘reflux’ into the esophagus,” said Dr. Surya Challa, a Chesapeake Regional general surgeon. “The reflux can cause pain and even erode the lining of the esophagus.”
Now, for those who have tried everything from weight loss to medical remedies with no results, Challa offers a laporoscopic anti-reflux surgery.
“The surgery is minimally invasive,” said Challa. “Typically, we see the stomachs of these patients have lifted into their chest cavity. We use tools to bring the stomach back down.”
It may also be necessary, according to Challa, to remove any hernias that may have been causing the reflux and tighten the opening between the stomach and esophagus.
The surgery, which requires an overnight stay, provides 95 percent of patients with relief.
New procedure provides an alternative to a hysterectomy
Many women suffer monthly with heavy, painful periods, often lasting days to weeks. Now, a procedure available at Chesapeake Regional Medical Center can change all of that.
Dr. Khadijah Jordan, chief of obstetrics and gynecology at Chesapeake Regional, has instituted the use of Novasure Endometrial Ablation for women with heavy periods that negatively affect their quality of life. This can often serve as an alternative to a hysterectomy or long-term hormonal therapy.
In the procedure, Jordan uses a wand – equipped with a mesh shaped to fit into the uterus – to deliver precisely measured electrical energy to the uterine lining. The entire procedure lasts less than four and a half minutes.
“It uses a suction technique to gently remove the lining of the uterus so there is no more growth,” said Jordan. “It is not absolute because the mesh is not the exact shape of everyone’s uterus. But it makes a significant difference in heavy bleeding and is a viable option with no incision and no long hospital stay.”
The procedure may be performed by some physicians in their offices. However, Jordan uses general anesthesia or IV sedation at the hospital. Patients may experience brief cramping or vaginal discharge and can resume their normal activity the following day. Afterwards, according to Jordan, 75 percent of patients experience amenorrhea and 98 percent experience a reduction in menstrual flow.
For more information about the procedure, call Jordan’s office at 436.2424.
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