Q&A with the Docs

Breast cancer is the most common malignancy affecting women in the United States. There are approximately 200,000 new cases of breast cancer diagnosed a year. It is the second leading cause of cancer death in women behind lung cancer.

Mammography is the best tool available to screen for breast cancer. A baseline mammogram should be obtained at age 40, and every other year until age 50. After age 50, a mammogram should be done yearly. Individuals who have a family history of breast cancer or certain symptoms should perhaps have a mammogram at an earlier age. The treatment of breast cancer has changed significantly over the last 20 years.

Most cancers can now be treated with breast conserving therapy. Women who have breast-conserving therapy will also undergo radiation treatment. Early detection is very important in treating any cancer and is especially important in breast cancer.

We are all Board Certified General Surgeons and well trained and experienced in the treatment of breast cancer.

Colonoscopy is a procedure that is recommended for anyone who is over the age of 50. It should be done sooner if there is a family history of colon cancer, polyps, a change in bowel habit, or rectal bleeding. Colonoscopy is the best procedure to diagnose colon cancer or problems that could turn into colon cancer. Most colon cancers begin as benign polyps. If found at colonoscopy, benign polyps can be removed and prevent colon cancer. It is generally felt that if all adults over the age of 50 were screened with a colonoscopy, 25,000 deaths from colon cancer could be prevented. It is felt now that about 50,000 people die each year from colon cancer. It is the second leading cause of cancer deaths in men and women combined. More lives are lost each year to colorectal cancer than to breast cancer and AIDS combined. It is important for every adult to discuss the need for a colonoscopy with your health care provider.

The colon is a flexible tube lined with muscles. These muscles help move stool through the colon. When stool stays soft, it passes smoothly. Without enough fiber and water in the digestive system, stool becomes harder. The colon's muscles have to squeeze more to move the harder stools through the colon. The extra pressure can cause the lining of the colon wall to bulge out into pouches called diverticula. The majority of people will have diverticula once they reach their 70s and 80s. There are often no noticeable symptoms. Diverticulitis occurs when the diverticuli become infected by stool lodging in the opening of the diverticuli. Symptoms often include pain in the abdomen, fever and chills. In severe cases, infection of the abdominal cavity may result. A diet high in fiber is generally felt to be the best way to avoid the development of diverticuli. It was once thought that seeds and nuts should be avoided in anyone who has diverticuli, but recent studies have shown that this is not the case. A diet that includes seeds and nuts, does not result in increased risk of complication from diverticuli. We are trained in the medical and surgical management of diverticular disease.

A hernia is a condition in which part of the intestine bulges through a weak area in the abdominal muscles. The most common sites for abdominal hernias are at the umbilicus (belly button), the groin area, and at the site of old incisions. A hernia should be repaired when the hernia becomes painful or continues to get larger. Hernia repairs are one of the most common general surgical operations. The majority of hernia repairs can be done using a laparoscopic technique. The laparoscopic technique decreases post-operative pain and allows a quicker return to work. We are all trained in the surgical treatment of hernias and would be happy to visit with you about the proper treatment, risks, and recovery expectations after surgery.

Approximately 97 million adults in the United States are overweight or obese. Morbid obesity is a serious disease affecting more than 6 million Americans. A person diagnosed with this condition generally weighs at least 100 pounds more than his or her ideal body weight (BMI > 40). A few of the health implications of obesity include increased risk for coronary artery disease, hypertension, hyperlipidemia, type 2 diabetes mellitus, sleep apnea, reflux, arthritis of the weight-bearing joints, and increased prevalence of selected types of cancer. Surgery is currently the best-established and most successful method for sustained weight loss in the morbidly obese. Roux-en-Y gastric bypass is currently the most commonly performed operation for treating morbid obesity. Patients can lose an average of 75% of excess weight and most will see improvement or remission of many associated health conditions. This surgery can be performed laparoscopically, which reduces post-operative pain and enables a quicker return to work.

We have been performing this operation in Grand Island for the last six years. Please contact our office to receive more information or to join our surgical weight loss program.

Lap-Band is a surgical weight loss procedure in which an adjustable band is placed around the upper stomach to help control a person's hunger. This band is placed laparoscopically so there is minimal discomfort with this procedure. A few weeks after surgery, the band is filled with fluid through a port under the patient's skin. This tightens the band around the stomach causing the patient to eat less and subsequently lose weight.

Lap-Band is for patient's that are 100 pounds over their ideal body weight or that have significant medical problems caused by obesity. Examples of these illnesses include diabetes, arthritis, sleep apnea, and hypertension. Many times these illnesses can be cured or improved significantly with weight loss.

If you would like to learn more about Lap-Band, please contact us.

Gastroesophageal Reflux Disease or GERD is a problem that affects at least 60% of the population, at least intermittently. Most symptoms can be controlled by avoiding foods that trigger reflux or with various medications available to control gastric acid.

Those whose symptoms are not adequately controlled with medication may require further investigation and treatment. Various studies such as endoscopy, barium swallow, and esophageal acid monitoring can be performed to evaluate the severity of GERD and to determine the best treatment option. Some patients with severe GERD symptoms or damage to the esophagus from GERD may benefit from a laparoscopic anti-reflux surgery. This surgery allows GERD to be controlled without medications and can reverse the damage done by GERD. If GERD is a problem for you, please call us for a complete evaluation and the surgical treatment of GERD.

Laparoscopy is the use of a small camera that is inserted into the abdomen to allow operations to be performed with small incisions. A variety of surgeries can be performed laparoscopically including gallbladder removal, colon resection, anti-reflux surgery, hernia surgery, and others. Since only small incisions are made during laparoscopic surgery, pain is reduced as well as recovery time and patients are able to get back to normal activities faster. If you or someone you know needs surgery, please contact us to see if it can be done laparoscopically.

Carotid artery stenosis, or blockage of the carotid artery, is one of the leading causes of stroke. Approximately 750,000 people a year experience a new or recurrent stroke. Stroke is the third leading cause of death in the United States.

Risk factors for stroke include high blood pressure, high cholesterol, and smoking. The majority of strokes are caused by blockage of the carotid arteries in the neck, the main vessels that supply blood to the brain. Your doctor may hear a high-pitched noise called a bruit by listening to your neck with a stethoscope. This should then be evaluated by an ultrasound of the arteries to see how much blockage there is. People with blockages of less than 70% can routinely be watched and treated with aggressive medical therapy. Those with blockages of 70% or greater should be referred to a surgeon to determine if they are a candidate for a carotid endarterectomy. This is a surgical procedure to remove the blockage in the artery and prevent a stroke from happening. We can evaluate you and perform this surgery if it is determined that you are an appropriate candidate.

Gallstones are a fairly common medical condition affecting many people in the U.S. While 20% of the population may have gallstones, less than 50% will develop symptoms.

Symptoms from gallstones include pain in the right upper side under the ribs; pain can also radiate into the back around the right shoulder blade. This pain usually occurs after meals but may awaken a patient from sleep. Gallstones that have no symptoms do not require medical attention.

However, if you do have symptoms, you should visit with your physician.

You will most likely be referred to a general surgeon for surgical removal of the gallbladder. The majority of cases can be done using the laparoscopic technique. We are all trained in surgical treatment of the gallbladder and would be happy to visit with you about the proper treatment, risks, and recovery involving gallbladder surgery.