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Great options for gallstones.

You will observe with concern how long a useful truth may be known and exist, before it is generally received and practiced on. -Benjamin Franklin

Great Options for Gallstones

About 500,000 gallstone surgeries are done every year in the United States. Changing from surgery to lithotripsy or ether drip for removing gallstones will make a tremendous difference in the number of hospital beds being used for this common-nuisance surgery. More important, new options are alleviating a great deal of pain as well as the risks of surgery and general anesthesia for patients with stones.

Following recent gallstone surgery, Gloria Kindy told us, "I'll be off work six weeks. I was in a great deal of pain immediately postoperatively. I was on a morphine drip for two to three days and then took narcotic pills for about the next week. I still have occasional pain with movement, with climbing steps, or with walking."

Contrast her case history with that of Doyne Marks, whose stones were removed by lithotripsy. She told us, "The procedure was not painful at all. You could feel a sensation, but there was no pain during or afterwards. If necessary, I could have gone back to work that afternoon.

"I learned about the gallstone lithotripsy through The Saturday Evening Post. I called Methodist Hospital in Indianapolis, and they kept in touch with me until the machine was up."

Since Doyne Marks' procedure, the total of hospitals that have their gallstone lithotripsy equipment up and running has risen to ten. To date, 600 patients in the United States have had their gallstones removed without incident with the lithotripsy equipment.

Dr. Johnson Thistle at Mayo Clinic has been using another alternative to gallstone surgery for a number of years. Ether is injected into the gallbladder to dissolve the stones. Mayo Clinic has relieved about 90 patients of their stones by this method, which has recently been adopted at the Indiana University Medical Center by Dr. Robert Hawes.

Jo Ann Hamilton, who faced the prospect of gallstone surgery, said"I really didn't want surgery. I have a sister and a mother who had the operation, and I knew what they went through. They both had hard times with it." Offered the option of ether therapy, she jumped at it. After several days in the hospital, all but a fraction of her 12 gallstones had been dissolved. A remaining fragment was treated with lithotripsy.

"I feel really good now," she told us.

Gallstone fatalities can't be ignored. Gallstones account for 5,000 to 8,000 deaths and a cost of more than $1 billion annually in medical costs and recuperation time in the United States. For this reason we hope the clinical trials at the ten hospitals will soon satisfy the FDA and that they will make as quick work of approving lithotripsy for gallstones as they did for kidney stones.

Health insurance companies would do well to pay for the less expensive lithotripsy for their patients even though some policies do not require them to pay for procedures still in clinical trials. This will no longer be a roadblock when the FDA approves the procedure. Many insurance companies already pay for lithotripsy when they discover the savings.

Readers and their physicians may request further information about lithotripsy and other alternatives to surgery by writing to the Post. A list of the hospitals now doing gallstone lithotripsy appeared in the October '88 Post. A surgery technique developed by Dr. Patrick Walsh avoids cutting the nerves that control erection. With this improvement, men who lose their prostates to cancer surgery are more likely to maintain their potency, as well as urinary and bladder control.

Life Goes On

Dear Dr. Ser Vaas:

Another letter! I feel fortunate that we were given a subscription to The Saturday Evening Post for Christmas so I know about your column!

I have a close friend whose 81-year-old father just had prostate surgery for cancer removal. He is a lawyer and very active, manly, etc. Now he feels life is over for him, even though they tell him they got all the cancer. But he is depressed and will not accept that he is just as much "man" as he ever was and that his wife, children, and grandchildren love him just the same. But he feels robbed of his "manhood," etc. He won't respond to therapy, etc.

Is there a book or an article(s) in your magazine or an other that might help him-inspire him, etc.? If so, please write and let me know. Thanks.

Dottie Vandagriff Fort Worth, Texas

There is life after prostate surgery just as there is life after breast surgery. Surgery for prostate cancer can now be done in a way that retains the nerve supply so that the man can continue to have an erection and not lose his ability to hold urine. This is a blessing for all men who will undergo prostate surgery. The technique was developed by Dr. Patrick Walsh at Johns Hopkins.

There are a number of good people who work with depression in ways that have been most promising. I like particularly the work that's been done by Dr. John Greist at the University of Wisconsin, where he has even senior citizens running and doing exercise. Working aerobically and getting out of breath seem to stimulate the release of endorphins, which give one a feeling of well-being. In this way, physical exercise fights depression.

If running might be traumatic for the joints of your friend's father at his age, swimming would be a very good way to work to exhaustion. He would, of course, want to check with his physician to make sure that his heart is O.K. for aerobic workouts. Dr. Ken Cooper, at the Cooper Clinic, in Dallas, Texas, will outline a diet and exercise program for people of all ages and all physical conditions.

Dear Dr. SerVaas:

You must inform your readers about this prostate operation. 1 have three friends who had prostate cancer and had the operation at Johns Hopkins Hospital in Baltimorethis is a new operation-and they can have sex 12 to 18 months later. (Dr. Patrick Walsh is doing the operation.) I'm sure they are doing the operation at several big hospitals across the country.

A phone call to Dr. Walsh will verify this.

P.S. Dr. Walsh offered to show one of our local urologists how to do the operation, but he refused to make the trip to Baltimore.

Peggy Miller Williamsport, Pennsylvania

The Perfect Squelch

The speaker related an episode of a 101-year-old gentleman who was in excellent health except for a problem with his right knee. He went to the doctor, who told him, after asking his age, that this is the kind of thing you need to expect because it's a part of getting old. The patient stood up rather indignantly and said, "Doctor, I have two knees. My left knee is just as old as my right knee, and my left knee isn't suffering ftom being old. I'd like to know, if what you say is true, why isn't my left knee suffering from being old?"

Against the Grain Dear Dr. SerVaas:

I read in The Saturday Evening Post of the importance of having oats, wheat, barley, and rye in the diet. Some years ago a friend ordered a formula diet recommended through a magazine. She sent for it, and her digestive problem was taken care of.

My husband tried the same diet formula, but it didn't work. Last June, after three months of extensive tests, we found out he had to go on a gluten-free diet. He has celiac sprue disease, and he can eat no oats, wheat, barley, or rye. That eliminates your usual kinds of flour-he can have rice, buckwheat, potato, corn, soybean, tapioca, and arrowroot.

On October 21 he had emergency heart bypass surgery followed by a stroke. My husband has come a long way back with extensive therapy, but I could sure use recipes for his diet. We can have potatoes, vegetables, meat, and fruits. But we're limited in many store products.

Minnie Roorda Pefla, Iowa

We're printing your letter because it certainly brings out the point that the right diet for one person isn't necessarily right for another. It's very important to study the problem. We're glad your husband learned his correct diagnosis; the celiac sprue recipes are on the way.

We're sorry to hear of the stroke that followed his bypass surgery. Did your husband have blood transfusions during the surgery? The Presidential Commission on the HIV Epidemic recommended that everyone who received a blood transfusion after 1977 be tested for HIV. If your husband received blood and hasn't been tested, this may be done at public-health clinics in most states at no cost. You may have to go to Des Moines to find a free clinic. However, your Pella doctor can draw blood and mail the serum to a laboratory.

We have had numerous letters from persons who have contracted AIDS from blood transfusions. Tragically, these people have often had to suffer needless invasive tests, have sometimes been given drugs that could harm an AIDS patient, and have been deprived of early treatment for AIDS. The level of suspicion is less in states like Iowa, where there is a low incidence of AIDS, but donor blood ftom high-risk states has been known to be shipped into states with low risk. For this and other reasons, the President's AIDS Commission recommended that everyone who had a transfusion after 1977 be tested.

The Estrogen Question

Dear Dr. SerVaas:

I hope you can help me make the fight decision as to whether to take hormone replacements or not.

I am 64 year old. At age 43, I had a complete hysterectomy and took estrogen for eight years. Every female in my generation (plus one brother) and my mother's generation has died of cancer, mostly of the breast, but two had uterine cancer.

My gynecologist says recent studies show estrogen is very important inthe prevention of osteoporosis, is beneficial in maintaining a healthy cardiovascular system, and may even play a part in preventing cancer. He wants me to take estrogen.

My internist says he is very much aware of the benefits of estrogen, and that my body shows signs of estrogen deficiency, but he could never bring himself to prescribe them because of my family history of cancer.

I think I would feel better if I could take estrogen, but have a fear of doing anything that might contribute to breast cancer.

Where do I go for the answer?

Anice Ward Prescott, Arkansas

I would side with your internist and would be afraid to prescribe estrogen supplements because of your family history of breast, uterine, and other cancer.

At some time in the future, you might be interested in participating in an upcoming study of women at high risk of developing breast cancer. The study will provide prophylactic treatment with an estrogen-blocker called tamoxifen. This drug has been successful in treating women with estrogen-receptor-positive breast tumors. Some cancer researchers are thinking of doing studies to find out whether fewer women at high risk would develop breast cancer if they took tamoxifen while they were well and before the first lump appeared.

We're collecting names of high-risk persons like you so that if this study begins, we will be able to notify you and put you in touch with the research site looking for volunteers.

If you take adequate amounts of calcium and magnesium and do weight-bearing exercises every day, you will help prevent osteoporosis and maintain a healthy cardiovascular system. The body doesn't metabolize calcium properly if it is magnesium deficient. Avoiding nicotine and caffeine may help keep your bones from becoming porous too.

Spare the Babies

Dear Dr. SerVaas:

Recently, I have been reading editorials about public heat put on officials advocating repeal of the premarital AIDS testing law. An often-used argument is that too few infected (and infectious) people were discovered in 1988.

There are other testing programs mandated by state government which compare unfavorably with premarital HIV testing, but no cry arises for their repeal. I refer to four out of five of the tests performed on newborns.

Here are the incidences for the various tests done on newborns in Illinois in 1988.

Test Approx. Incidence

Biotinidase deficiency None in about 180,000

Galactosemia 1 in 45,000

PKU 1 in 11,250

Congenital adrenal hyperplasis 1 in 10,588

Premarital HIV infection 1 in 6,000

Hypothyroidism 1 in 2,903

Who among the editors or public health officials of Illinois would call for repeal of any mandatory test with less frequent positive results than premarital HIV testing?

Logic is a dangerous tool to use in political arguments.

Cal Skinner, Jr. Member, Illinois AIDS Advisory Council Crystal Lake, Illinois

Your points are well-taken. We understand that 28 cases of AIDS have been discovered in the premarriage testing program in Illinois since the program began in 1988. Isn't it about time for other states to take a second look at the results in Illinois? If these tests could be done efficiently through blood banks or through commercial laboratories such as the military uses (Damon Laboratories, for example), they could be accomplished for $4-$5 per test. Surely preventing AIDS in the newborns of the 28 couples detected would warrant spending money to test marriagelicense applicants routinely (not to mention the future partners who would avoid infection).

In Indiana the public accepts routine premarriage rubella (German measles) testing of all female marriage-license applicants. This is to help prevent birth defects in babies born to women who didn't know their immune statuses. All women susceptible to rubella should be vaccinated three months before conceiving babies. Shouldn't we similarly try to prevent the birth of babies with AIDS?

This society worked hard to help our readers understand the mental retardation in undiagnosedbabies born with galactosemia. Identifying these infants at birth is a godsend for the parents who must suffer with a retarded child and its early demise. Without routine testing, some parents would have to lose one or more children to the disease before this rare affliction would be suspected as the problem.

Galactosemia is present in only one in 35,000 to 45,000 births, but we test all babies. AIDS is now being reported in 5 percent of mothers giving birth in Newark. Two to 3 percent of young people tested at clinics for treating sexually transmitted diseases in St. Louis and Kansas City are positive for the AIDS virus and are capable of transmitting it to future spouses or children. How long should we wait to take action to help prevent the spread of AIDS?

Herpes Weapon

Dear Dr. SerVaas:

My ophthalmologist told me that you had researched the use of lysine as a weapon against the cold-sore herpes virus and that you could possibly send me some information regarding the effectiveness of using lysine and any possible adverse effects that might occur ftom using lysine.

I have a very severe case of this herpes virus in my eye and would appreciate very much any information you might be able to send me about this condition.

Name withheld Montgomery, Alabama

I referred your letter to Dr. Stephen M. Johnson of the Midwest Eye Institute of Methodist Hospital, Indianapolis, Indiana. He responds:

"I am aware of four double-blind placebo-controlled trials of oral lysine in the treatment of recurrent herpes infection. Three of the studies demonstrate a beneficial effect in regard to decreasing the number of recurrences and lessening the symptoms of infection. The actual healing time does not seem to be shortened with lysine use.

"No significant side effects were reported in these groups with the dose ranging from 300 mg to 3 grams of lysine daily. A typical dosage regimen would be 500 mg three imes daily. No adverse effects were noticed. It is important to note that patients with oral or genital herpes were studied. There has been no study of the efficacy of lysine in ocular herpes.

"It would not be surprising to find that recurrent herpes-simplex infection in the eye would similarly respond to oral lysine. However, ocular herpes infection, specifically keratouveitis, is more complex than dermal or oral herpes. Often the most significant problems are the aftereffects of actual viral replications rather than viral replication itself. Inflammations of the iris and cornea are examples of this. In these situations lysine would probably not be of benefit. To be sure, there are patients who find true recurrent herpes a very significant problem."

Dear Dr. SerVaas:

After a lengthy stay in a hospital, I developed a severe outbreak of herpes around my nose and upper lip. In time it did heal, but I was having trouble with my left eye. The ophthalmologist I went to found herpes in the eye, and after extremely expensive medication and many frequent visits back to the doctor, he determined the staining was gone. When it was over he told me it could have blinded me, so I was grateful indeed that I was cured. I have had a second attack of the virus and understand that it can be arrested but can always recur. Stress seems to be a prime suspect in recurrence.

My question to you: do you feel L-lysine would help in keeping the virus at bay? In what form and where can I obtain L-lysine? I have read many times about the product in your articles but did not retain the information. Your answer win be appreciated.

Donna Campbell Whittier, California

Lysine is inexpensive and it is readily available at supermarkets and drugstores. Copies of previous articles are being forwarded to you. Also please note the preceding response by Dr. Johnson.

Apple Assurance

Dear Dr. SerVaas:

I know apples are a great source of vitamins, but all this talk about Alar has me worried. Any advice?

Jackie Browning Baltimore, Maryland

We posed your question to Mott's, and we were assured that that company has had an Alar ban since 1986. Mott's is calling for the establishment of federal pesticide tolerance levels that are safe for everyone. Gerber told us they haven't used apples with Alar for seven years.
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Author:SerVaas, Cory
Publication:Saturday Evening Post
Article Type:column
Date:May 1, 1989
Words:3042
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