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La Prensa: Appointment with a Surgeon? Can you avoid it?

by Maria Palafox, MD

General surgeons like me do a wide variety of procedures, many of which now are done as outpatient, meaning you go home the same day. In general, we no longer do hysterectomies or bladder suspensions, and we don’t generally do heart, brain or lung surgery.

The most common patient I see is for a gallbladder evaluation. Most people have gallstones but some have malfunction of the gallbladder without gallstones. The gallbladder patient that we learned about in medical school is typically female, overweight, in her 50s and has had multiple children. More often, the patient is Hispanic or Native American.

We are plagued in San Antonio with gallbladder disease because much of our population is Mexican-American. We also tend to be younger when we start having gallbladder attacks. Let’s not forget, however, that gallstones are made mostly of cholesterol. Don’t kid yourself—what you eat has a lot to do with gallbladder disease.

Pain in the upper and right side of the belly going to the back which occurs after eating a heavy or greasy meal is the standard story that I hear from patients, and most of them winding up having their gallbladder removed. Eat healthier and try not to eat meat every day, and you have a chance of avoiding me.

The other very common surgery in the U.S. is weight loss surgery—it is almost as common as gallbladder surgery nowadays. People with a BMI (weight divided by height) over 35 with weight-related health problems are candidates for surgery; patient with a BMI over 40 are candidates just based on weight alone.

Weight-related health problems include Type II diabetes, high blood pressure, sleep apnea, fatty liver disease, arthritis, cholesterol problems or heart disease. More and more insurances are paying for the surgery, but it is not as straightforward as just having surgery.

Most bariatric surgeons have patients undergo nutritional counseling, physical evaluation by a trainer and even a psychological evaluation, all to make sure you are committed to the lifestyle change. Weight loss surgery can be very effective, but the bottom line is, you still have to change the way you eat and the way you stay active to keep the weight off.

The common theme to both of these surgeries is that with good health, they can both be avoided. Up to 85 percent of health problems can be reversed or minimized by eating right, exercising and avoiding unhealthy habits like drinking, smoking and drugging.

Eating a balanced diet with more vegetables and fruit than meat and carbs can lower your risk of developing gallstones, even if everyone else in your family has had their gallbladder out. Eating that same diet will help avoid extra weight; sprinkle in a little exercise and voila! You don’t need to think about weight loss surgery! None of this is easy, but there is nothing lost in trying. To good health!

Dr. Palafox is a general and breast surgeon and can be reached at 210-504-5087; Dr. Rene Jaso is a general and bariatric surgeon and can be reached at 210-226-5350. Both are located on San Antonio's South Side.

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