Genitourinary, Lifestyle, Medicine, Surgery
Kidney Disease Has No Good Ending
Will humans ever learn to care for their kidneys? Or will they live to count mixed blessings – staying alive but reliant on a machine to clean the blood. This, or a kidney transplant, is the result of end-stage kidney failure. Over 40 million North Americans are living with the precursor, chronic kidney disease. Astonishingly, nine in ten sufferers are unaware they have the problem. But the body knows, and as the disease progresses, other health problems including stroke and heart attack can result. A dialysis machine can remove waste products and excess fluid from the blood when kidneys stop working. Dialysis patients require treatment 3 to 7 times a week, for three or more hours per session, in a hospital, clinic,...Read More
Surgery
Some Advice Never Ages
After 10 books, over 2,500 columns, and nearly 50 years of writing it, some things bear repeating. This week revisits a column from three decades ago about how to prepare for surgery. Has anything changed? From that old column, “What would God do if He were a surgeon? If it is true God helps those who help themselves, He would refuse to operate on many, telling us, ‘Respect your own God-given body and then I’ll do what I can.’” Next came a case. “A 45-year-old woman underwent an operation for extensive vaginal repair. For this type of surgery, her surgeon warned her repeatedly about the hazards of smoking and her persistent smoker’s hack. Ten days later she was rushed to hospital because...Read More
Alternate Treatments, Infection, Neurology, Orthopedics, Pain, Psychiatry, Surgery
Alternative Medicine Makes a Good Gift
What’s the gift we’d like to have in stock for our readers this holiday season? It would be a healthy dose of common sense, and a reminder that not every health problem needs a medical solution. Unfortunately, few people open their minds when confronted with a swollen joint, an injury to the skin, back pain, broken bones, or even brain injuries. Yet, instead of costly, dangerous drugs that come with side effects, or surgical treatments that involve other risks, these are examples of problems that respond well to alternative forms of therapy. We have written in the past about low-intensity laser therapy (LILT). It’s now known as photobiomodulation (PBM), which involves the application of light to instigate a natural healing process....Read More
Alternate Treatments, Medicine, Philosophy, Surgery
Have Faith in the Doctor, with Limitations
Is it wise to believe what the doctor tells you? Or are there misleading types, not entirely honest with their patients? Does the medical system place the patient’s best interests first, as commonly stated on health center posters? Or do other factors, like pressure to ease wait times for a high-demand treatments, mean that some people aren’t informed of their best options. The truth is, having implicit faith in the medical profession is risky business. There are ample reasons to place your faith in doctors and medicines. Antibiotics save people from dying of pneumonia and a host of other diseases. Cortisone enables people to be free of wheelchairs. Cardiac pacemakers add years to the lives of heart patients. Surgeons (and organ...Read More
Pain, Surgery
The Pros and Cons of Surgery for Osteoarthritis
When osteoarthritis in the knee is causing you pain, how do you know whether to hang in there and take it or to accept the risks of going under the knife in hopes of bouncing back stronger? It’s not an easy question. Many factors need to be part of the decision. Osteoarthritis (OA) is the most common form of arthritis, often described as a “wear and tear” problem, and usually found in the knees, hips and hands. Symptoms are usually mild initially – stiff joints and reduced flexibility. It gradually progresses to more noticeable swelling and aching caused by the breakdown of joint cartilage and the underlying bone. According to the Centres of Disease Control and Prevention, over 32 million Americans have...Read More
Philosophy, Surgery
Total Family Doctor Prevents Needless Surgery
How important is what I like to call the “Total Family Doctor” (TFD)? For years, I’ve praised the hardworking family doctor for the role he or she plays in medical care. Now, many North Americans say it’s impossible to find a family doctor. What has happened to them? Prior to becoming a surgeon, I had the good fortune to spend time as a family doctor. And I nearly decided to follow this path. Why? Because I also watched Specialists performing the same task every day. It could become boring, I thought. So, surgery finally won. But I’ve never forgotten the challenges of being a family physician. I even experienced the roles of hotel doctor and ship’s surgeon during medical training. I believe...Read More
Alternate Treatments, Genitourinary, Gynecology, Obesity, Surgery
What to Do When Things Fall Down
The law of gravity means our bodies are pulled down to Earth. This fact inevitably spells trouble over time. But for some women, it causes inconvenient and annoying issues, and sometimes surgery, to address what’s called vaginal prolapse. Not all women are born equal. Some inherit tougher pelvic tissues and do not experience prolapse, even after bearing several children. But the more pregnancies, the greater the risk in older age of weakened all pelvic structures leading to the sagging of the vagina, urinary bladder and often the rectum. The most common complaint is the loss of urine on coughing and sneezing. A large survey of women in North America revealed that four percent suffer from this annoying problem. Apart from pregnancy, what else...Read More
Miscellaneous, Surgery
The Promise of 3D Printing in Healthcare
In healthcare, it’s the elusive breakthrough to a cure for diseases like cancer that has us all hoping. But sometimes it’s the bit-by-bit advancements, rarely getting headings, that make for greater impact. An example is the field of 3D printing, not even a medical technology by inception, but now a major disruptive force in the healthcare industry. Also known as additive manufacturing, 3D printing allows the construction of physical objects based on three-dimensional digital models. A futuristic notion until recently, such printers are now commonly found in high schools, university libraries and labs, and also in a fabulous array of high-tech companies producing medical devices, and yes, body parts of all kinds. Hearing aid manufacturers were early adopters of 3D printing technology....Read More
Gynecology, Pediatrics, Philosophy, Surgery
The Changing Nature of Birth
We said goodbye to a beloved 17-year-old dog this week. She had rapidly lost quality of life. As sad as it was, few would have any qualms whatsoever with the vet’s provision of humane, painless, and sensible euthanasia. But what’s going on with medical interventions at the great miracle of birth? It’s no secret that humans commonly push the boundaries of scientific possibility – for better or for worse. Traditionally, interruptions in the natural birthing process have been overwhelmingly in the “for better” category. Caesarean sections may not have been a desirable option for women prior to the advent of modern surgical techniques – uterine suturing, for example – not to mention anesthesia. But in the modern era, there can be no...Read More
Cancer, Diabetes, Infection, Obesity, Surgery
COVID Means Double Trouble, and Worse
If ever a time to act on your health, this is it. Study after study in leading medical journals reports compounding troubles from COVID-19. What was described as a lung disease early in the pandemic is now better recognized as an attack on health systems – your own body’s systems involving multiple organs as well as societal systems of disease surveillance and care delivery. Whether you have been infected or not, chances are high your health is becoming worse. New research should raise alarm bells. In the journal, Nature, Dr. Ziyad Al-Aly, chief of research at Veterans Affairs St. Louis Health Care System, reported on deteriorated health of COVID-19 survivors. To his amazement, the disease was not just deadlier for people with...Read More
Cardiovascular, Surgery
Why Doctors Must Think Like Sherlock Holmes
A 57-year-old woman, receiving physiotherapy for an injured ankle, suddenly suffered a seizure, became unconscious, and was rushed to Emergency. The obvious diagnosis, a sudden stroke. But as Sir Arthur Conan Doyle, the English doctor and writer who created the fictional private detective, Sherlock Holmes, wrote, “There is nothing more deceptive than an obvious fact.” A report in the Canadian Medical Association Journal shows that Doyle was right. Doctors must sometimes think like Sherlock Holmes. The ultimate diagnosis was not a stroke. Rather, a complication from the triple A disease, abdominal aortic aneurysm (AAA). It’s a problem that doesn’t receive much press. But it killed Albert Einstein, the famous scientist, Lucille Ball, the TV star, and the actor George C Scott. Unless...Read More
Surgery
When Is the Right Time for Knee Replacement?
Ask a comedian, tennis player, or chef, what’s important in their work. They will tell you, it’s timing. Every year 1,200,000 knees are replaced in North America. And just as comedians need good timing, so too this elective surgery. If COVID-19 concerns have you delaying treatment, you may want to think again. Researchers at the Feinberg School of Medicine of Northwestern University report in the Journal of Bone and Joint Surgery that many people are getting it wrong. Their eight-year study involved 8002 patients aged 45 to 79 who were at risk of osteoarthritis. Assessing patients for knee replacement involves consideration of age, severity of symptoms, and what x-rays show of knee damage. Researchers found that 90% of people with knee osteoarthritis...Read More
Lifestyle, Miscellaneous, Philosophy, Surgery
The Greatest Gift to Give at Any Time of the Year
This holiday season there will be joy, intimacy, and affection around many family dinner tables. But for some families it will be a difficult time with little laughter. They know that next year a family member may be missing. They are waiting for the donation of a kidney, heart or other vital organ to keep a loved one alive. But it may not arrive in time. So here’s a story of compassion from a man who gave the ultimate gift to a perfect stranger. I recently came across an article written by Naazneen Karmali, Asia Wealth Editor and India Editor for Forbes Asia. She relates the story of a wealthy Indian tycoon, Kochouseph Chittilappilly. He acknowledged that, as his 60th birthday...Read More
Surgery
Appendicitis: To Operate or Not to Operate
This year about 700,000 appendectomies will be performed in North America. And although the lowly appendix does not get the attention associated with other problems, each year nearly 3,000 people will die of appendicitis. But do all cases require surgery? We’ve come a long way since the French surgeon Dupuytren ridiculed the idea that the appendix could be the cause of infection. Later, Henry Sands, a New York surgeon, simply stitched up a hole in an appendix! It’s also hard to believe that another surgeon, just straightened out the kinks in the appendix! If these patients survived, it was the Almighty who saved them. The appendix is a fingerlike tube about four inches long that’s situated in the lower right side of...Read More
Surgery
Gallstones: For Surgery or the Crematorium?
What should you do if you are diagnosed with gallstones? Today, 10% of North Americans share this medical problem. For some patients surgery is the prudent choice. But now, a report from the Canadian Medical Protective Association (CMPA), shows that, in some cases, leaving gallstones to the crematorium can prevent serious complications and even death. In 1991, Dr. Joacques Perissat at the University of Bordeau, in France, removed a gallbladder by laparoscopic (keyhole) surgery. This innovation provided a huge advantage for patients from a technical standpoint. But is it foolproof? The CMPA reports that during a four year period the most frequent complications of gallstone surgery were injury to the biliary duct that carries bile to the intestines, bowel injury, and hemorrhage....Read More
Alcohol, Alternate Treatments, Lifestyle, Medicine, Miscellaneous, Nutrition, Surgery
Dr. Gifford-Jones’ RX for a Long Life
One : Buy a Scale Obesity is a huge killer and it sets the stage for Type 2 diabetes, heart attack and hypertension. Be a smart consumer. Step on the scale each day so there are no surprises about weight gain. Count calories to live healthier and longer. Two : Buy a Pedometer To Count Steps Ships tied up at a dock too long get barnacles. To avoid medical barnacles, walk 10,000 steps a day. There’s no need to run the four minute mile. Remember, lions don’t buy Nike running shoes. Besides, studies show excessive exercise can cause medical problems. Three : Avoid Needless Radiation. A single CT scan delivers the same radiation as 500 chest X-rays or 1,000 dental ones. Always ask if an...Read More
Cardiovascular, Surgery
Surgery More Effective Than Drano for Stroke
How would you feel if you suffered a stroke and were left paralyzed? Then later discovered that if you had been aware of early signs of stroke, paralysis could have been avoided? This column might help to prevent this tragedy. Moreover, the good news is that surgery is superior to anti-clotting drugs for treatment of this devastating event. A report in the New England Journal of Medicine shows that surgery, rather than TPA, a clot dissolving drug that works like household Drano, produces a better outcome. There are two kinds of stroke. 80 percent of the time “blockage strokes” are caused by a clot that prevents oxygenated blood from reaching the brain. The other type of stroke happens when an artery ruptures...Read More
Surgery
The $1,000,000 Surgical Error
Many years ago I wrote, “The problem with laparoscopic (keyhole) surgery is it leaves the impression that tiny incisions mean a simple, uncomplicated way to perform an operation. Unfortunately, this is not always the case as catastrophic complications can happen.” Recently, a Canadian Medical Protective Association (CMPA) survey confirmed the potential dangers of keyhole surgery. So what went wrong to cause a $ 1,000,000 settlement? The CMPA reviewed 423 surgical cases involving keyhole surgery. It revealed that patients suffered a number of injuries to the bowel, blood vessels, nerves, and reproductive organs. There were 46 deaths. Operations that resulted in the most trouble were hysterectomy, other gynecological procedures, removal of the gallbladder, appendix and kidney. In one study of 613,706 gallbladder operations, 2,380...Read More
Surgery
Informed Consent: Are You Really Informed?
If I were a patient, what would I want to know about the risk of treatment? Since I’ve been one a few times, let me tell you what I worried about before past medical procedures. And will there ever be truly informed patients? Let’s start with the major fear, death. Never forget that death lurks in the background, ready to strike. Surely, anyone who is scheduled for coronary bypass surgery realizes there’s a greater risk of dying in this case than when treated for an ingrown toenail. But never underestimate the hazard of even minor surgery. There’s always the possibility, though rare, of death from anesthesia. It’s usually what we call an “Act of God”, in which neither the surgeon nor anesthetist...Read More
Cancer, Surgery
Have you ever wanted To Say, “I Told You So”?
This week, a big thanks to Dr. Freddie Hamdy, Professor of surgery, Oxford University, England. Why? Because, for many years, I’ve advised readers, diagnosed with early prostate cancer, to take their time when deciding which treatment is best for them. Some authorities have disagreed with me. Now, I can legitimately say, “I told you so”. Does this mean I’m smart? No. I was just lucky years ago to interview Dr. Willet Whitmore, a world authority on prostate cancer at Memorial Hospital in New York City. At the time Whitmore remarked, “The survival rate of this cancer has little to do with the type of treatment. Rather, it’s related to the biological nature of the cancer.” In other words, how malignant is...Read More
Cardiovascular, Eyes, Ears, Nose & Throat, Miscellaneous, Surgery
A Miner Will Save Millions from Blindness
Would I, as a doctor, ever expect to meet a miner? As Mark Twain remarked, “A mine is a hole in the ground with a liar at the top”. Luckily, I accepted an invitation to do just that, and discovered there is something new under the sun. This week, how “DIAGNOS”, a Canadian company in Montreal, has developed what’s called “computer assisted retinal analysis (CARA)”. This computer software will save millions of people around the world from blindness due to Type 2 diabetes. So, did a miner become a retinal expert? The slogan of DIAGNOS is “Beat it in a blink”. Patients simply look into a camera and a photo is taken of their retina, the back part of...Read More
Surgery
Unexpected Complications of Joint Surgery
It’s been said that, “All would be well if there were no buts.” Unfortunately, life is full of “buts”. A prime example is joint surgery. Today, an increasing number of people are being relieved of chronic pain by hip and knee replacements. Others are being helped by lesser laparoscopic procedures. But patients should be aware that these are major operations sometimes associated with unintended consequences. For instance, several years ago Dr. Justin de Beer, an orthopedic surgeon at the Henderson site of Hamilton Health Services in Hamilton, Ontario, reported this unexpected finding. A worrying number of patients after hip and knee replacements had suffered heart attacks following the operation. The majority of these coronary attacks occurred within three to five days of...Read More
Surgery
The Perils of Being a Patient
What is one of the major health hazards today? It’s being a patient. Because there are so many pitfalls, and it’s easy to fall into them. Modern medicine has much more to offer today which makes life better for millions of people. But it can also create problems, unless you know where the traps are and how to avoid them. I’ve never forgotten an incident that happened years ago. I’d completed a successful surgical procedure and returned to the recovery room to check on my patient. But I noticed several doctors crowded around one bed, which is never a good sign. A male patient had undergone a gallbladder operation and was experiencing difficult, labored breathing. His surgeon and anesthetist were concerned. They...Read More
Surgery
Minor Surgery That Ends In Disaster
There is one fundamental rule in surgery, “If it ain’t broke, don’t fix it.” Why? Because as one of Harvard’s great neurosurgeons once remarked, “There is no such thing as minor surgery, but there are a lot of minor surgeons.” He could have added that minor surgery can also result in needless tragic deaths. And that one major operation can be avoided. The best adult example is Joan Rivers, the comedian, who allegedly had undergone several cosmetic facelifts and joked about it. But she had one too many and died of cardiac arrest during the operation. The youngest tragedy is the newborn baby who recently suffered a circumcision, apparently unwanted by his parents. He died from hemorrhage. For some families the decision for...Read More
Pain, Surgery
Wrong Site, Wrong Procedure, Wrong Patient Surgery
Are you scheduled for surgery? If so, there are ways to circumvent horrendous surgical errors. We’ve all heard stories about surgeons amputating the wrong leg. Or fixing a hernia on the side that didn’t need it. If you think this is past history, you had better think again as it happens every year in North America. During a 10 year period in Canada, wrong-site surgery happened 106 times. Each year, 6.3 cases involved a lower extremity and in 4.3 cases, an upper limb. The most common error was the use of arthroscopy (looking into the joint with an optical instrument) on the wrong joint. This misfortune happened to 24 patients. And in one case a total knee replacement was performed on...Read More
