The Academy Corner - Introduction

by

Dr. Michael Stark, MD

The physicians of the Academy of Medicine of Toledo and Lucas County are pleased to bring a new series of articles with timely health information to the people of our region. We hope that the information and perspectives are helpful and interesting.

As a general surgeon, I was evaluating a patient recently for gall bladder problems and recommended an operation. However, I had to consider all of the other medical problems she had. How will they effect her operation and her future?

Gall bladder surgery is usually straightforward. However, at times it can be very difficult. My patient’s medical problems can certainly affect her operation and her recovery.

My patient is very over weight. This definitely makes the operation more difficult since seeing what we need to see is harder. Not only does obesity make the operation more difficult, it makes the recovery more difficult. It is harder for patients to get up and move around. This increases the risk of pneumonias and blood clots. For her future, she is at risk of joint problems, blood pressure and heart disease, and diabetes. Losing weight would certainly lower these risks.

My patient also is a cigarette smoker. This makes the anesthesia more challenging because of the risk of lung complications. Congestion and pneumonias are more common. Patients who smoke always wake up harder from anesthesia. They always cough harder. This increases post operative pain and increases the risk that the incisions will not heal well. Smoking also causes lung cancer, emphysema, heart disease, strokes, and vascular problems.

My patient is of the age where breast cancers are common. I found out she has never had a mammogram. We know that mammograms can help detect breast cancers early. This makes treatment easier and more successful. My patient also is also of the age were colon cancers are common. She also has a family history of colon cancer. She has never had a colonoscopy. Screening colonoscopies not only can find cancers early but can also detect pre-cancerous polyps. These can often be removed during the colonoscopy. This can actually prevent colon cancers.

When we see someone for a specific problem, we consider many issues. We evaluate the patient for that specific problem. We make recommendations for treatment and follow-up. However, we also look at our patient as a whole and try to help his or her overall health. I did recommend gall bladder surgery. I also recommended she loose weight, quit smoking, get a mammogram, and consider colonoscopy. I recommended some programs to help with these tasks. By choosing healthy life styles, patients can help themselves and definitely help us care for them.

Michael E. Stark, MD

Academy of Medicine of Toledo and Lucas County