Health News Blog provides coverage of current health news.

posted by admin on Apr 22

Although the medical treatment you receive in a private hospital will be similar to that available at any NHS hospital, there are some basic differences between the two systems.

As with the NHS, you will have to be referred to see a consultant privately by your GP. Most GPs have contacts with particular consultants (and private hospitals) to whom they tend to refer patients. If there is a private hospital you particularly want to go to, or a consultant you have some reason to prefer, you can ask your GP to make an appointment for you.

After your visit to your GP, you are unlikely to have to wait longer than a week or two before you see the consultant at an out-patient appointment. Your appointment may be at the private hospital where your operation is to be carried out, at an NHS hospital which has private wards, or at the consultant’s private consulting rooms. Once the decision has been made to go ahead with surgery, you will probably be able to enter hospital at your convenience within another week or two.

You will receive confirmation of the date of your operation from the Bookings Manager of the hospital you are to attend. You will also probably be sent leaflets and any further relevant details of how to prepare for your admission to hospital. Do read these carefully, as knowing how your particular hospital organizes things will help you to be prepared when you arrive for your operation. You will also be sent a pre-admission form to fill in and take with you when you are admitted.

If your operation is being paid for by insurance, you will be asked to take a completed insurance form with you when you are admitted to hospital. You should have been given some of these forms when you first took out your policy, but your insurance company will be able to supply the correct form if you have any problems. If you are covered by company insurance, the form will probably be filled in and given to you by your Company Secretary.

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posted by admin on Apr 22

Laser laparoscopy for endometriosis is surgery which attempts to remove and destroy endometrial implants, cysts and adhesions using a laser beam.

Lasers are fine, highly concentrated beams of light that can be precisely aimed and controlled. They have been used in some branches of medicine for many years. Ophthalmologists use lasers to treat a variety of eye diseases and dermatologists use them to remove skin cancers and other skin growths.

There are several different types of lasers used in laser laparoscopy and each one has its own particular characteristics and uses. The three types of lasers that are most commonly used in the treatment of endometriosis are the carbon dioxide laser, the argon laser and the Nd: YAG laser. The type of laser used by your gynecologist will usually depend on which type is available.

Who is suitable for laser laparoscopy?

Laser laparoscopy is most suitable for women with minimal to moderate endometriosis. It is not usually suitable for women with severe endometriosis.

Things to discuss before laser laparoscopy

At some stage before the operation you and your gynecologist should discuss what procedures are proposed and what should be done if a laparotomy is needed.

What happens with laser laparoscopy?

A laser laparoscopy involves the same basic routine as that which is used for a diagnostic laparoscopy except that a laser instrument is inserted through a channel in the laparoscope. The laser beam then travels through special fibres known as fibre-optics before being directed onto the relevant tissue in the pelvic cavity.

The laser beam can be used to remove or destroy superficial endometrial implants and endometriomas, and to remove adhesions. The implants, endometriomas and adhesions are removed or destroyed by directing and focusing the laser on to them and using the intense energy of the laser beam to ‘vaporize’ or break up their cells.

Effectiveness of laser laparoscopy

Laser laparoscopy has several advantages over other surgery. It involves less risk of accidentally damaging underlying organs because the gynecologist is able to precisely control the depth and amount of tissue being destroyed. Similarly, because the laser destroys only the target tissue and leaves the surrounding tissue undamaged, there is likely to be less pain and discomfort and faster healing of the affected area. It is thought that the main advantage of laser laparoscopy is that it may produce less scarring and fewer adhesions than other types of surgery. In addition, because laser surgery usually involves a laparoscopy it has all the advantages associated with having laparoscopic surgery rather than a laparotomy.

The main disadvantage of laser laparoscopy as opposed to conventional laparoscopic surgery is that some women have taken significantly longer to recover from the operation because they were under the general anaesthetic for a greater period of time as laser laparoscopy takes longer to perform.

So far, there are few statistics on the effectiveness of laser laparoscopy. At present there is no evidence to suggest that laser laparoscopy is any more effective than other surgeries in terms of eradicating the disease or relieving the symptoms. Rather, in the hands of an experienced operator, the results of laser laparoscopy appear to be similar to those of other surgical treatments.

Risks and complications of laser laparoscopy

The risks and complications of laser laparoscopy are the same as those associated with a diagnostic laparoscopy.

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posted by admin on Apr 22

In the first stage the patient’s main goal is to return to a pattern of regular eating. We want to establish a routine whereby she plans to eat three or four meals per day and possiblyó two planned snacks. .

The key here is planning. A patient should know w due to eat next. She shouldn’t skip meals, nor should she re ó on her appetite to tell her when to eat. If her plan calls for her to eat lunch at one o’clock, then she should do so, eating everything she planned to eat whether she feels hungry or not. She shouldn’t snack unless the snack is part of the plan. Of course, the woman should not go for long periods without food. She shouldn’t skip breakfast, for example.

Sticking to the plan takes priority over other activities. It’s okay to accept dates, for example, but the patient must structure her social life around her meal plan. Her schedule may change on weekends, but she needs to plan those changes carefully.

The content of meals is less important than the regular pattern of meals during this phase. I urge the patient not to count calories, for instance. Instead she should eat average-size portions. She should wear loose clothing when she eats, since feeling constricted can lead to feelings of fullness. Here are some other helpful hints on controlling eating:

Tips for controlling eating

• Don’t engage in other activities while eating: Don’t watch TV, read, talk on the phone, do

homework and so on

• Restrict eating to one room of the house

• Limit food available when eating. Discard leftovers. Practice leaving some food on the plate.

Limit supplies of binge foods in the house; keep “safe” foods around instead

• Plan food-shopping expeditions. Make a shopping list and stick to it. Don’t shop when hungry.

Carry just a little money when shopping, especially if you feel you aren’t in good control

• Buy foods that need a lot of preparation, rather than those that can be eaten immediately

• Get rid of laxatives and diuretics

• Discard clothes that are too small

• Make adequate plans for your time – too much or too little unstructured time increases the

possibility of bingeing

If a patient eats too rapidly, she needs to slow down. Satiety signals need a little time to take effect. One tip: Put the fork down between mouthfuls and swallow before taking the next bite. It helps to savor food, pausing once in a while to decide whether or not to keep eating. I ask patients not to drink a lot of fluids during the meal, since doing so can exaggerate the feeling of fullness.

At first a patient may feel full after eating very little. Such feelings may trigger the urge to vomit. We work together to create a list of alternative activities so that she can distract herself and counteract these urges. One such list might include the following:

• Make a list of friends’ names and telephone numbers and call them when urges strike

• Visit friends

• Exercise (moderately)

• Go to a movie

• Take a bath or shower

• Write a letter

• Garden

• Knit or sew

• Read

• Listen to music

During this first stage the patient needs to keep checking on her progress. She should evaluate her eating daily. If she is successful, she needs to praise herself. On the other hand, she shouldn’t overreact to failure. She needs to avoid turning a small slipup into a major catastrophe.

Once regular eating patterns return, her binge frequency should drop. The patient can then begin to examine the causes of her bingeing. Does she eat to relieve anxiety or depression? Is she bored? Does eating bring on sleep? Is she trying to compensate for something (perhaps even a monotonous diet)? Is purging self-punishment, or a way of expressing anger that she should direct at other people?

We also talk about situations that may contribute to the problem. Does she keep too much food in the house? Does her home environment interfere-is there too much stress or chaos?

One way of keeping track of these elements is through the food diary. The patient uses these sheets to record her feelings and actions connected with food. The food diary is a crucial element in therapy, offering a window on the patient’s behavior. The vital information on these sheets becomes the raw material for our therapy sessions.

During the first stage of therapy, we work out a plan for keeping track of the patient’s weight. Weighing too often can lead to anxiety and obsessions about weight. As I mentioned, everyone has day-to-day fluctuations in weight. For a patient, a slight rise can trigger panic and a sense of failure. These feelings may cause her to give up, leading her back down the path of bingeing and purging. On the other hand, if she never weighs herself, she just continues to feed her phobia about doing so. We have to strike the right balance-usually about once a week is enough.

I encourage the patient to discuss her disorder openly with friends and family. Removing some of the secrecy helps alleviate guilt and shame. It also lets other people take a more active role. Knowing that a family member is having trouble helps others to understand her behavior and offer emotional support.

By the end of this first stage we usually see a lot of improvement. The patient’s mood is better, and the frequency of her bingeing drops. If not, though, I will consider adding medication or admitting her to the hospital.

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posted by admin on Apr 22

Jill Scoggins was on her way to weight-loss success. Then, a new job, a new home, and a family wedding nearly derailed her efforts. But she managed to get back on track, eventually losing 37 stubborn pounds.

Her secret? She concentrated on her accomplishments rather than dwelled on her defeats.

Jill, age 41, says that she never worried much about her weight, not even as her dress size got bigger. “I suppose that I was in denial,” she explains. “It was a very gradual gain, so it was easy for me to ignore.” But when her size-14 clothes—what she calls her fat clothes—started feeling tight, she decided that she had to slim down. And as a health-care communications professional, she knew exactly what to do: Eat better, drink lots of water, and, for the first time in her life, exercise.

Jill launched her weight-loss program in September 1998. She concentrated on making healthier food choices while phasing out late-night snacking. She also joined a gym and consulted a personal trainer, who helped her develop an exercise program that included aerobic workouts and strength training.

Jill’s plan worked perfectly. Within 1 month, she lost 8 pounds. “That convinced me that I could lose even more,” she says. “So I kept at it, and the more I lost, the more I wanted to stick with it.”

She managed to stick with it for 4 months, taking off another27 pounds. Then, her life turned upside down. Both she and her husband landed new jobs farther away from home. When they weren’t commuting, they were house hunting, hoping to find a home closer to their respective workplaces. In what little spare time she had left, Jill was helping her stepdaughter plan her wedding.

With her schedule crammed, Jill’s weight-loss program stalled. “I didn’t have time to go to the gym or even to pack my lunch,” she says. “I found myself in the drive-thru at Jack in the Box more often than I care to admit.”

Jill could feel herself getting discouraged. “I was still losing weight, but at a much slower rate,” she explains. But then, she remembered how faithfully she had followed her program and how easily the pounds had been coming off. “I told myself, ‘You’ve proven that you can lose weight. Just do what you have to do,’ she says.

Her personal pep talk paid off. Within a year of starting her weight-loss program, Jill dropped 37 pounds and four dress sizes. She has maintained her weight at 120 pounds ever since. She and her husband eventually found a new home, and her stepdaughter’s wedding went off without a hitch. “Many of the guests commented on my weight loss,” she says. “That made me feel great!”

WINNING A C T I O N

Remember your victories. Revel in your successes, no matter how small they may seem. Today, you may be only I pound lighter. In 6 months, that 1 pound could be 50! Acknowledge every step that you make toward weight-loss success. Knowing that you can slim down will keep you motivated when your determination starts to wane.

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