Surgery Archives - Health Beat

What is a hernia ?

Posted on April 11, 2019 by Andrew Rubin

A hernia occurs when an organ or body part pushes through a weak spot in muscle or connective tissue into a part of the body that it isn’t supposed to be in. While some hernias can occur at birth, others may form later in life. These types of hernias may occur as a result of heavy lifting, straining, pregnancy and obesity.

There are several types of hernias that include:

Inguinal hernias – Occurs when a part of the intestine pushes into the inguinal canal. Most commonly seen in males.
Femoral hernia -Occurs when the femoral artery and vein pass through the canal between the abdomen and the groin. Most often seen in females.
Epigastric hernia – Occurs when a small piece of fat protrudes through a weak spot in the abdominal muscles located between the belly button and the breastbone
Umbilical hernia – Occurs when a portion of the intestine pushes through the abdominal wall next to the belly button
Hiatal hernia – Occurs when the stomach pushes through the diaphragm into the chest and causes heartburn
Incisional hernia – Occurs when a portion of the intestine pushes through the abdominal wall where surgery had been performed previously

The symptoms of a hernia often depend on where it is located. Some hernias will cause pain while there are others that only have physical signs, such as a bulging out of the skin, but aren’t painful. When a portion of the intestine pushes through a muscle and becomes trapped it can be very painful block the intestinal blood supply. These hernias require urgent surgical attention. A hernia can be prevented by avoiding lifting heavy objects improperly, maintaining proper weigh, care when coughing, having a diet that contains adequate fiber, and avoiding excessive straining during a bowel movement.

Treatment for a hernia depends on its location, size and the amount of discomfort. In some cases surgery isn’t necessary and the hernia can be pushed into place and held there by a device called a truss. Surgical options include closing the weak spot in the muscle with stitches, , using a mesh to reinforce the weak muscle that the hernia is pushing through, and laparoscopic surgery to repair the defect that is causing the hernia.

If you are experiencing any discomfort from a hernia, it is important to seek professional help to learn what the options are to repair it. You can schedule an appointment with a surgeon at Jamaica Hospital by calling 718-206-7001.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Heel Spur

Posted on July 5, 2018 by Andrew Rubin

A heel spur is the term used when a bony growth appears on the underside of the calcaneous ( heel bone). It may not be painful when it is first being formed but as time progresses it can become painful.
Heel spurs typically form when there is long term, excessive pulling on the part of the heel where the plantar fascia (a band of fibrous connective tissue that runs from the heel to the toes) attaches to the bone. When the plantar fascia loses its elasticity due to age or injury, it exerts tension on the heel. Over time this will cause a heel spur to develop.
Risk factors and other causes of heel spurs include:
• Poorly fitting shoes
• Weight gain
• Exercising on hard surfaces
• Natural aging
• Shoes with little or no arch support
• Long periods of time spent standing
• Diabetes
The symptoms of a heel spur are described as sharp pains in the bottom of the heel when putting your feet on the ground, especially after prolonged periods of rest. This pain usually diminishes when walking for a while, but doesn’t go away completely. It will return again when walking is resumed.
A heel spur is diagnosed definitively by performing a physical exam and an x-ray. Treatment options include stretching exercises, cold compresses to the area, using custom molded orthotics, physical therapy, localized injections of anti-inflammatory and pain medication, and taping the foot to give the muscles and tendons a rest. In severe cases, surgical intervention may be required.
If you would like to schedule an appointment with a podiatrist at Jamaica Hospital Medical Center please call 718-206-7001.

Preparing for Your Outpatient Visit

Posted on June 20, 2016 by Zakiya Hazel-Jemmott

Outpatient surgery also known as day surgery eliminates the need for an overnight hospital stay. This procedure is minimally invasive surgical techniques. Being told that you need surgery is a pretty terrifying feeling especially if it is your first one and you do not know what to expect. Here are a few notes to follow to make sure you are prepared for your outpatient surgical procedure.

Prior to your surgery you will receive instruction from your doctor or nurse about pre-operative precautions. Please follow all pre-operative instructions such as what medications to take or hold, when to stop eating and drinking and what time to be at the registration desk to register for your surgery or procedure. It is advisable to bring someone from your family to interpret or sign for you if necessary. As expected for outpatient surgery you will go home the same day, you will not be allowed to drive yourself home from your surgery or procedure if you have received any sedation. Please have your ride home arranged before the day of surgery.

People with medical problems, such as prior heart attacks or strokes, high blood pressure, diabetes, asthma, or chronic obstructive pulmonary disease, should visit with their doctor or anesthesiologist before the day of their surgery. At this visit, the doctor may also require the following information:

Copies of medical records, especially ECGs and results of heart and lung testing and recent lab tests
A list of medical problems and past surgical procedures, including any problems that occurred during prior surgeries
A complete list of medications (both prescription and over-the-counter), including vitamins, herbs, or other supplements, and their dosages
A clearly identified list of medications that cause allergic reactions or other problems

The day of your surgery it is strongly advised that you do not wear contacts, makeup or dentures. Contacts may dry out or get lost over the duration of the procedure. Makeup interferes with tape and surgical tools depending on the area you are having operated. A representative from the surgery department will come to the waiting room to escort you to the area where you will change into a surgical gown. You will be asked to empty your bladder and change into the gown. Some female patients may be asked for a urine sample to provide pregnancy status.

Although outpatient surgery does not require an overnight hospital stay, in some circumstances a patient intended for outpatient surgery may be admitted to the hospital for further care. If you require surgery, Jamaica Hospital Medical Center’s newly remodeled Ambulatory Surgery Unit provides patient centered care that focuses on relaxation and comfort. The ASU is open Monday through Friday, from 6:00 a.m. to 7:00 p.m. For more information, please call 718-206-6102.

History of Sutures

Posted on April 11, 2016 by Andrew Rubin

Sutures (also known as stitches) have been around for thousands of years and are used to hold wounds together until the healing process is complete. They were first described as far back 3000 BC in ancient Egyptian literature. For centuries they were made from plant materials like hemp, or cotton or animal material such as tendons, silk, and arteries. The material of choice for many centuries was catgut, a fine thread woven from sheep intestines.
In the 1800’s it became apparent that it was a good idea to sterilize the catgut before using it to suture wounds, In the 1860’s the physician Joseph Lister devised a technique for sterilizing catgut and it was perfected finally in 1906. Eventually, sterilization took place by exposing the suture material to radiation which was more effective than previous techniques. Each development helped to reduce the risk of infection.
Early in the 20th century synthetic materials were developed that could be used for suturing. These synthetic materials, still used today, were categorized as “absorbable” or ‘non-absorbable’ depending on their ability to be absorbed during the wound healing process.
Absorbable sutures usually dissolve anywhere from 10 days to eight weeks and are made from:
• Silk
• Catgut
• Polyglycolic acid
• Polylactic acid
• Monocryl
Non – absorbable sutures don’t dissolve naturally and are usually removed after the wound has closed. They are made from:
• Nylon
• Polyester
• Stainless steel
• PVDF
• Polypropelene
Additional new technology has added laser technology and surgical glue to the tools available to physicians for wound healing. These new materials help the process go quicker and also make the scars less visible. However, even with all the new modern techniques for suturing a wound, many of the basic concepts used today were first developed thousands of years ago.

Diabetes and Surgery

Posted on April 16, 2015 by Andrew Rubin

A surgical procedure for any patient requires a certain amount of preparation, both for the pre-operative phase and the post-operative phase. A patient with diabetes however has to be monitored very closely because they are at greater risk of developing complications than non-diabetic patients.

Your physician will tell you when you should eat before surgery and when you should take your last dose of diabetes medication prior to any surgical procedure. During the surgical procedure your blood glucose levels will be monitored to make sure that it stays with normal range (80-150 mg/dL).

Diabetic patients post operatively may experience:

Poor wound healing
Hyperglycemia or hypoglycemia
Infection at the wound site
Electrolyte imbalance
Diabetic ketoacidosis

After the surgical procedure is over, check your blood sugar level frequently because you may not be eating properly, may be less active, and are stressed. Diabetic patients may require a few days in the hospital post-op to have their glucose levels monitored carefully. If you are a diabetic patient and are scheduled for surgery, discuss pre and post-operative preparations with your surgeon.

Buyer Beware the Potential Dangers of Plastic Surgery Tourism

Posted on December 9, 2014 by Xavia Malcolm

Cosmetic surgery is chosen with the intent of enhancing a person’s appearance. Procedures could include breast augmentations, rhinoplasty and facelifts. The costs of plastic surgery can be expensive. Generally, most insurance plans consider cosmetic surgery as elective and will not cover the costs-leaving many patients to pay out of pocket and some exploring the option of plastic surgery tourism.

The costs of receiving surgery overseas can be relatively cheaper than in the United States and can be tempting; however, consumers should be aware of the dangerous and sometimes deadly situations they can encounter. It is highly important to keep in mind that many plastic surgery practices overseas do not uphold the rigid standards of qualified board-certified physicians in the U.S. There are no laws protecting patients who choose to do surgeries outside of the country, therefore if there is negligence it is unlikely the medical practice will be penalized.

Other complications that a consumer may encounter from plastic surgery tourism include:

Travel- Long flights can increase the risk of developing pulmonary embolisms and blood clots.
Lack of follow up care- Follow up care after surgery is extremely important. Physicians need to assess your recovery and ensure there are no abnormalities and infections. Many overseas facilities offer very limited or no follow up care.
Botched surgeries and revisions- If the procedure is botched, it may cost twice as much money to make revisions than the initial surgery would with a domestic surgeon.
Language barriers- A breakdown in comprehension and communication can be fatal.
Sub-standard equipment-The facility may be ill-equipped.Facilities overseas may not use the same safety checklist that is standard in the U.S. and medical records may not be properly documented.

Every surgery, including plastic surgery has risks. Boards and organizations such as the American Society of Plastic Surgeons are in existence to regulate practices, set safety standards and help reduce these risks. While you may be saving money by going abroad, you are being exposed to medical institutions that may not have the same standards of the U.S. and increasing your risks for complications and potentially death.