Dr. Arundathi Rao, M.D.

This is an excellent question. There is no “best surgery“. If there were a “best” surgery then we would only offer that one procedure. The decision to fix a hiatal hernia actually starts with what type of symptoms you’re actually experiencing and what the findings from your endoscopy showed. There is a work up required beyond the endoscopy in order to determine which procedure is best suited for you. These decisions aren’t just based on the fact that you have a hiatal hernia, but also on your Health status as well as the function of your esophagus, stomach, and even the medication as you might be on. I would highly recommend discussing this further with your primary care physician and to the surgeon that your primary care physician might refer you to. I hope this answers your question, but feel free to reach out and ask a follow-up question if this did not address your concerns. Good luck!

This is quite a complex issue. Surgery in any field boils down to risk to benefit ratio. It’s important to understand that hospice and DNR (Do not resuscitate) status does not mean do not treat. Hospice is all about preserving the quality of life of a patient as they take their final steps from life to death. If there is something in particular that is making him miserable or uncomfortable and it is straightforward, I suspect that surgical intervention is an option as long as the risk benefit ratio is in his favor. This is a very tricky topic, especially for surgeons because outsiders looking in may not understand the thought of going to surgery with somebody who might be terminal. With that being said, your family and those that are acting in the best interest of your grandfather as well as your grandfather Should have a say in what is done. Praying for peace for both your family as well as your grandfather.

Using an incentive spirometer (IS) and ambulating (walking) are probably the biggest things you can do. If you are using the IS appropriately, expect that it will make you cough. That is the equivalent of clearing those lungs. I recommend 10 times an hour while you are awake after surgery. Depending on the length of the surgery, you should continue to use your IS for 7-10 days. Good luck with your upcoming surgery.

I am a bariatric surgeon. Yes, you would be eligible. Insurance may or may not cover based on your coverage and the insurance companies pre-set requirements. The cut off is a BMI of 35, usually with 1-2 co-morbid conditions (hypertension, diabetes, sleep apnea, etc). At a BMI of 40 or greater, insurance may or may not require other co-morbid conditions. There are cash pay options if insurance does not cover as well. Make sure you look for an ASMBS designated surgeon. Remember that bariatric surgery isn't magic. It is a tool to help you in your pursuit of health. The surgeon is important, but an actual program with support in the form of dieticians and support groups is absolutely essential if you are to realize life-long success. Good luck on your journey!

Though this has happened, it is an extremely EXTREMELY rare event. Anesthesia protocols and technology provide for much better outcomes and well administered anesthetic. If, by chance, you were to wake up in the middle of the case, the anesthesiologist or CRNA would administer more anesthetic to ensure you proceed safely throughout your procedure.
Hope this helps,
Dr. Rao

There are many reasons patients may have sleep apnea. Issues such as obesity, enlarged tonsils/adenoids, and even enlarged tongues can cause severe sleep apnea. Since there was a certain amount of alteration to your upper airway as a result of surgery, you will need a titration of your CPAP in order to ensure you are getting the support you need while you sleep. Let me also congratulate you on using a CPAP machine. Sleep apnea is a serious issue and many people who have it won't even consider a study let alone treatment. Severe sleep apnea that goes untreated can increase your risk for heart attack, stroke, dementia and even cancer. Keep using that CPAP, but get the titration study done along with a thumbs up of your ENT. Good luck!

Please communicate with the surgeon who performed this procedure. Before leaving the hospital from any procedure, and in fact, during your pre-operative appointment you should know what the expectations are when the procedure is completed. Time can be of the essence when dealing with neurological deficits post surgery. If you cannot get in touch with your surgeon, a visit to the ER would be the next step. This is not something I would recommend waiting for until your receive a response unless otherwise instructed by the doctors office. Hope this helps you.

It is hard to give you a diagnosis without examining you and getting more of a history. The top three things I would suspect would include: Gallbladder issues, gastric ulcers or severe reflux, or kidney stones. This is by far and away not the only thing it could be and my recommendation would be to go to the hospital even though the wait time is ridiculous. The other option is to see your primary care physician. They can order tests and potentially treat you without having to admit you. What you don't want to happen is for this to get worse, turn into a real medical emergency, and then deal with trying to be seen in a busy ER. Delay in treatment in any situation can be a life or death concern. Prioritize your health. Your body is telling you something isn't quite right. Praying for healing.

I am unclear about the question you are asking. A bowel blockage from constipation should not routinely require a rectal examination. If this is something that you frequently deal with then I would recommend working on ways to prevent the constipation. Drink 80-100 ounces of water daily. Increase fruits and veggies. Consider taking a teaspoon to a tablespoon of coconut oil by mouth everyday (it is a natural laxative). Do your best to start having more frequent bowel movements. Additionally, you should consider having yearly physical exams (at your age, a rectal exam is not something that is routine during a yearly physical unless you have a significant family history of prostate cancer or there are other factors at play). Good luck

This could be normal, but it might not. Nerve impingement can cause this type of sensation. Likely the nerve that is causing this discomfort is a sensory nerve and not a motor nerve. In other words, this a nerve that is related to feeling and not moving your arm. I would notify your surgeon to ensure that he feels this is normal. If this sensation continues he may recommend a steroid pack or an evaluation with pain management. Good luck.

These symptoms could mean a whole host of things. Helpful information would include: any other symptoms? Associated with eating? What improves the pain and what makes it worse? When did it start? In essence, a full work up would be indicated in this situation. Don't ignore the symptoms and assume it will get better. As physicians, outcomes are commonly related to how quickly the patient presents. Don't wait. Get evaluated.

My recommendation would be to keep a food journal to see if you can identify if there is a food trigger. Along the same lines, I would recommend seeing an allergist and and a gastroenterologist. Upper and lower endoscopy (camera's used to look in your stomach and colon)may prove helpful. There are a number of GI conditions that can cause chronic abdominal pain including H.pylori, Celiac disease, SIBO and even ulcers/inflammation of the intestinal tract. I had similar issues at your age and these pains were directly related to stress.

I had irritable bowel syndrom (IBS) and I was also lactose intolerant. Your brain is the most powerful thing you have and it can cause all sorts of things to happen as a result of stress and worry. Don't neglect that aspect as you search for answers (and no, it's not all in your head). :)