Dr. Graeme Browne, MD, DDS, MSC

Thank you for your question. The answer to your question regarding side effects from colon resection surgery is not simple. Multiple factors influence the side effects or one's clinical course after colon resection depending on why surgery is indicated, extent of colon resection, the need for radiation, chemotherapy, possible associated perforation pre- operatively & soiling of the abdominal cavity, your underlying pre-operative physiological condition, need for exteriorization of the residual colon to the outside of the abdominal cavity, how anesthesia might affect you in the immediate post-operative period, and many additional factors. Your surgeon will provide his opinion regarding what you specifically should anticipate from the effects of colon resection to be performed. Please ask this question directly to your surgeon, he best can provide you with answers that might emerge following your resection, he will augment with additional issues once he has successfully concluded your surgical procedure. My experience has been, that asking your internist or family physician on this matter will possibly create differences in opinions divergent from what your surgeon will provide. My firm opinion is the surgeon BEST knows what may evolve for you since the surgeon knows these matters intimately and has performed many similar procedures on many other patients. Best wishes for an uncomplicated & swift recovery.

Thank you for your question. Understandably, obtaining prompt resolution to diarrhea is important for personal comfort, as well as the need to understand what might be the underlying causation for this disorder. Many causes for exist for diarrhea. Just trying to suppress the intestinal tract, may in fact be ill advised. Therefore, the causes become very important to consider, rather than to simply reach for a remedy to achieve fast relief. The following are some of the many possible reasons why the bowels dump volume and possibly result in dehydration or even malnutrition should the process be an extended one: viral infection, medication side effects, use of antibiotics, underlying bowel motility disorder, inflammatory bowel lining disorders, bowel polyps or cancers, intestinal parasites, stress and anxiety, endocrine gland disorders, use of bowel stimulants/laxatives, food intolerances and food allergies, food poisoning from eating contaminated potato salad amongst several possible causes for diarrhea. Age of the affected individual becomes a marker for beginning the process for determining the underlying cause, as might occupation, personal eating or drinking habits. This question is a tough one to give a simple solution for. I recommend, discussing this matter with your healthcare team for diagnostic evaluation, before assuming this condition is one of little potential consequence. Thank you for asking this question. GA Browne MD.MSc.FAAEP.FAADM.FAAFP

Thank you for your question. Overweight & obese individuals deserve a comprehensive evaluation to determine why an individual might be overweight or be classified as obese. Consequently, management of either condition is best determined individually without defaulting to a fix such as taking medication. Please have your daughter evaluated by her medical provider. Resolving excess weight conditions will in the long run be beneficial for her.

Thank you for your question. First, I wish to congratulate you on this pregnancy. Hopefully you may be beyond the morning sickness often associated with early stages of pregnancy. Regarding advice for what to take & what not to take during one's pregnancy is best discussed with your prenatal care provider. Such matters can be associated with your underlying health factors & that of your baby. Best wishes to you for a happy & healthy pregnancy. With your next prenatal visit, or ask this question of your provider with a call to the office whichever is sooner. GABrowne MD. FRC

Thank you for your question. Your orthopedic surgeon will advise you on this matter. It is not possible for me to offer an opinion since I know nothing of the ankle condition that required a surgical procedure. Additionally, many other factors contribute to the rate & to the degree of healing your ankle is capable of & for me to interpret the extent of daily activities you expect to accomplish. I encourage you to achieve your prior level of daily activities but to do so under the direction of your orthopedic surgeon who will offer rehabilitation strategies that meet your anticipated recovery needs. Best wishes for your recovery. GA Browne MD. FRC Get Outlook for iOS<https://aka.ms/o0ukef>

Thank you for your question, Pancreatic cancer will very often express its presence with a combination of clinical signs & symptoms in addition to showing abnormalities in certain blood test results. You state your physician has determined that your concern is not a shared concern. Unless specific red flags are present that will alert your physician for the need to proceed with advanced imaging i.e. CT scan or MRI, screening for pancreatic cancer is not performed, unlike screening that is advised for breast cancer deploying mammograms. If you believe you have not been heard by your physician regarding your belief you need further evaluation to exclude the presence of pancreatic cancer, then I strongly suggest you ask your physician to reconsider your concern regarding an undetected underlying pancreatic cancer, or to obtain a second opinion on this troubling matter from another physician. My recommendation to you is to not delay in obtaining further medical advice on this matter. GA Browne MD.FRC.FAAEP.

Thank you for your question. What bowel movements constitute 'idiarrhea'requires defining. Frequency, consistency, fluidity & volume are variables that your surgeon will determine to be acceptable in the context of the extent to which your colon has been resected. You will be asked on your post operative visit, questions that will include your bowel movements. This question is one that is best answered by your surgeon given the reasons for undergoing your surgery, the length of colon resected & if you had used antibiotics either before, during & after your surgery. Thank you for your question. I wish you well on your recovery. GABrowne MD. Get Outlook for iOS<https://aka.ms/o0ukef>

Thank you for your question. Without knowledge of her history, pertinent physical examination findings & metabolic profile this question becomes difficult to concisely provide you with a solid answer. Your daughter's physician or endocrinologist can best provide answers to your very important question. I wish you & your daughter well as you both enter this phase of your lives. GABrowne MD. FAAEP Get Outlook for iOS<https://aka.ms/o0ukef>

Your question is very important to fully appreciate that those individuals who are tobacco users, who wish to terminate their use of tobacco, do have several options to use under a physician's, or nurse practitioner's care available to them. First the individual must be ready to follow the steps provided by the medical team. Nicotine patches of different strengths might be deployed in conjunction with a medication to attenuate the craving for nicotine as the individual decreases their use of tobacco. Transition from high to low strength nicotine patches occurs as the physical symptoms decrease in intensity and use of a medication can be extended to sustain the absence of physical symptoms tobacco abstinence. To 'cure' someone of tobacco addiction is a continued work in progress for those afflicted with this condition. It might require several attempts to remain tobacco free, given that tobacco and its compounded substances do have a significant stimulating effect on specific brain sensory areas. It is unreasonable to expect a cure for tobacco misuse & overuse given the numerous factors that are believed to be associated with personality type & societal pressures influencing tobacco addiction, in addition to brain chemistry changes induced by tobacco. Thank you for your question. Please consult your physician on this matter, as extended health related conditions are caused by tobacco use. GABrowne MD. FAAEP

Thank you for your question. Seasonal allergies can be managed to variable degrees depending on individual sensitivities to a particular allergen (agent), or to a family of similar agents. Your medical practitioner can best advise you on specific management. I recommend that simple approaches be undertaken before commencing medications. Examples of simplistic approaches include ensuring that potential cofactors are eliminated, or at least decreased to the extent possible by decreasing exposure to suspected agents ie. pollens, by closing windows, using air conditioning where practical, or choosing the time of day you go outdoors and under what conditions. Medications often used belong to the antihistamine family of medications. These should be selected with the assistance of your physician or nurse practitioner. Earlier formulations of antihistamines possessed substantial side effects that caused drowsiness, dry mouth, adverse effects upon ability to urinate and importantly degrading learning skills in children, or fact or operational retention skills in adults. Other classes of medications can be deployed to supplement antihistamine control of seasonal allergies. When seasonal allergies affect lung function, it is important to ask your medical advisors for their advice. Given that our society invokes freedom of choice with options for over the counter purchase, you may become bogged down with selection of agents. I strongly advise against taking multiple agents simultaneously, or not allowing sufficient time to elapse for wash out of antihistamine byproducts, some of which remain pharmacologically active and will therefore potentially cause more adverse side effects in the presence of other medications used for symptom control. Please ask you physician or nurse practitioner for their recommendations on how to proceed with your management of seasonal allergies. Thank you for your very practical question on seasonal allergy treatment or management.

Thank you for your question. Your physician will determine the class of antibiotic & duration of treatment with antibiotics if that is indicated for your condition after completing his/ her examination to verify the presence of a prostatectomy infection. On occasions, a specialist ie. Urologist might be consulted to offer a course of action to treat your prostate. Differentiating between infection , inflammation, pelvic floor or rectal conditions must be considered, in addition to the possibility of prostrate cancer. It is best to not assume that an infection is present in the prostrate gland but to verify that you are being managed for the necessary cause of your discomfort. Thank you for your question. Please contact your physician to assist you further. GA Browne. MD Get Outlook for iOS<https://aka.ms/o0ukef>

Thank you for your very thoughtful question. Childhood allergies are prevalent and are a significant problem for children to cope with. Management of seasonal allergies may require medication. It is preferable to first determine that what is presumptively being treated is indeed, a seasonal allergy. Initially, a determination should be undertaken by your family doctor, pediatrician, or by consultation with your child's primary care allergist to differentiate between seasonal allergies, house dust allergy, sensitization to home cleaning agents, like the use of perfumed fresheners, or if nasal irritation and discharge is associated without allergen related agents ie. nasal blood vessel irritation (known as vasomotor rhinitis) might be considered as distinct from seasonal allergies. Finally, maxillary sinusitis might be cause for similar symptoms to that of seasonal allergies. These conditions often have associated overlapping symptoms that can be differentiated into their respective categories by obtaining a detailed clinical history. If this history suggests seasonality, periodicity, known, or suspected agents (allergens) that correlate with onset of symptoms, their timing and duration of symptoms which might include headache, fever, post nasal discharge, halitosis (bad breath), tender upper jaw teeth and even sore throat or cough, then a careful physical examination will permit findings obtained by your doctor's detailed history of events, that can point to a diagnosis of seasonal allergies. Skin testing and certain blood tests can be undertaken by a family doctor, pediatrician or allergist to obtain further evidence of a specific causative allergen. Once a reasonable risk assessment has been established for treating a seasonal allergy, then a discussion of options for its management can be undertaken. This is often a combined approach of avoiding exposure to the allergen by staying in doors on windy days, not riding bikes excessively during the pollen season, or perhaps not at all during the height of the pollen season, turning on the air conditioner, ensuring the air ducts have been cleaned are amongst other strategies to lower the exposure to allergens. With anticipation of spring, or fall seasons and before symptoms commence, then with advice from your doctor, it is common practice to commence medication known as anti-histamines to blunt the intensity of nasal and lung related symptoms related to allergen exposure. Other medications can be used in conjunction with anti-histamines for treatment of severe seasonal allergies. Medications can be used daily for extended periods and have been shown to have no significant adverse effects, but this does require your doctor to guide wise medication use. Everyone is a unique individual, each with our own pharmaco-genome, therefore, always obtain management directives and opinions from your doctor before proceeding with any medications whether for your child or yourself. A note of caution- the use of extended, or frequent intermittent use of Benadryl has been reported to interfere with daily activities, including learning acquisition and retention of educational factors. The newer second generation anti-histamine agents have beneficial effects on blunting seasonal allergies without side effects as stated above. Treating seasonal allergies is a wide spread need for many children and has proven value in allowing children to pursue normal behaviors during times of the year when being outdoors is generally important for their happiness and ongoing healthy development. Thank you for your question. GA Browne MD.

Thank you for your important question. CT scanning for lung, or other body parts are performed by Radiologists with the understanding that these investigations are performed only following a thorough determination for the necessity for performing such a diagnostic test. Exposure to radiation is required for this test to 'see' the lung tissue. Radiologists have the ability to modulate the exposure to radiation associated with CT scanning. This means that the minimum exposure to radiation is generated to obtain an image of sufficient quality to differentiate between healthy lung tissue and the possible presence of unhealthy lung tissue. The concern is discussed by ordering physicians and Radiologists with patients when multiple exposures to the same body region is necessary to track, or to follow a potential disease process over time. This can in susceptible individuals potentially induce an adverse reaction generating a 'tumor'. In such conditions when multiple imaging is required, alternative image techniques can be offered, such as magnetic resonance imaging, commonly known as MRI. This technique does not use radiation, but it senses molecular activity of tissue my magnetism. Healthy tissue cells 'vibrate' at a different frequency than does unhealthy tissue, hence a skilled Radiologist can interpret the image, or 'read' the MRI and provide an opinion to the ordering physician, or surgeon whether treatment is to be offered for that patient. The question of how much is too much radiation exposure is taken very seriously by physicians, surgeons and Radiologists. This becomes a significant matter when children require serial imaging. Children if exposed to medical radiation sources, have a life time of chance to develop radiation induced tumors. Fortunately, Radiologists have techniques to suppress exposure to imaging radiation and as with adult imaging, alternative imaging by MRI is also an option. I appreciate your question and why it is important for all of us to be aware of why imaging for diagnostic purposes is being performed and ask if serial images are to be anticipated during the course of our medical care. GA Browne MD. FAAEM.FAADM.FRC.

Thank you for your question. Constipation is widely prevalent across a broad spectrum of young & not so young individuals and not specific to gender. To answer your question, it is best to determine why constipation occurs. The cause for this condition has a spectrum of entities that are directly associated with what we eat & how much water we consume. For example, a diet that is low in fiber due to someone eating refined foods will take longer to move through the gastrointestinal tract. This slow passage in turn causes reabsorption of bowel water which then results in even slower progression of bowel contents through the large bowel. A sedentary life style contributes to slowing of bowel contents. A simple remedy for constipation related to dietary low fiber content, low fluid consumption or a low activity is to eat whole wheat bread, fruit containing high fiber eg. oranges and other fiber rich foods, and to engage in modest activity such as walking or low intensity jogging providing there are no medical reasons to avoid these latter activities. Other causes of constipation may be due to prescribed medications. These should not be stopped without your physicians approval. Use of anti constipation medications can be a cause for worsening constipation. It is best to avoid these agents unless your doctor advises only brief duration use. There are several important medical reasons for constipation and should be considered by consultation with your doctor, if the simple actions discussed above fail to result in regular, comfortable bowel movements. Regarding your daughter whose age is not stated, can be a cause for increased occurrence of bladder infections, making unresolved constipation a condition that is best discussed with your daughters physician. Your question is an important and practical one that affects many individuals. I hope my response will be of some value to improving your daughters comfort and lead to a healthy life style for her. Respectfully submitted. GA Browne MD.