Bariatric Surgery Related Conditions

Fats, or lipids, in the blood are an important part of processing energy. But too much of these blood fats can build up in your arteries and cause a number of cardiovascular problems like heart attack and stroke. Patients with high cholesterol usually show no symptoms, so regular testing is the only way to monitor this crucial health indicator.

There are two different types of cholesterol: LDL, which are low-density lipids, and HDL, high-density lipids. Total cholesterol levels should be less than 200, with LDL (also known as the “bad” cholesterol) less than 130. HDL cholesterol can actually help reduce LDL cholesterol by transporting it to the liver so the body can excrete it.

Most of the body’s necessary cholesterol is produced by the liver, with only about a quarter of cholesterol needed from food. So if your diet is high in fats, your body may have too much LDL cholesterol, and deposit the extra as a waxy substance in the arteries.

There are a number of things your Palm Beach Health Network Physician Group doctor can do to help with high cholesterol. These include recommending a healthier diet, planning an exercise program, and prescribing cholesterol-lowing medications.

The term “arthritis” covers about 100 different joint inflammation diseases which affect children, adults and seniors of every race. There are three types of arthritis that are most common: osteoarthritis, rheumatoid arthritis, and juvenile arthritis. Osteoarthritis comes on when cartilage breaks down, causing pain and stiffness. Rheumatoid arthritis involves the body’s immune system and how it reacts with the thin membrane that lines the joints.

Juvenile arthritis refers to a host of inflammatory and autoimmune problems that affect children under 16. The onset and severity of arthritis often determine treatment programs. Medications or supplements have been shown to improve arthritis symptoms in many. In some instances, light to moderate exercise or resistance training is recommended. Arthritis brought on by injury can sometimes be eased with physical therapy.

There are times when more medical intervention is needed. Joint replacements can provide relief for many patients. Other surgical options like cartilage and bone repair, bone fusion and arthroscopy are also surgical options. Palm Beach Health Network Physician Group believe that each arthritis patient’s treatment should be tailored to their individual needs and abilities. An action plan that addresses everything from diet and exercise to environmental factors, medication, or surgery will help you live more comfortably with your condition.

Any number of injuries and conditions can contribute to back pain. Strain, injury and illness can all cause muscle and ligament damage that result in pain. Disk and spine issues can also cause intense discomfort.

The intensity of back pain cannot, on its own, indicate the cause of the pain. Sometimes muscle spasms can cause debilitation pain that you might associate with a more serious spine condition. Only a doctor can diagnose the cause of your pain and help you on the road to recovery.

Most cases of back pain will resolve with over-the-counter anti-inflammatories and rest. But sometimes, medical intervention is needed for relief. The first step is diagnosis of the underlying reason for the pain. Often this requires some kind of testing like an X-ray or an MRI (magnetic resonance imaging) study. Your Palm Beach Health Network Physician Group doctor will also perform a thorough physical exam and detailed patient history.

Treatment for back pain can range from rest to physical therapy and medication to surgical intervention. In many cases of repeated or prolonged muscle pain in the back, steps are taken to strengthen the abdominal and surrounding muscles to help support the upper body. Other approaches like monitoring weight, examining environmental factors like work stations can ease back discomfort.

The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand where the median nerve and tendons run. When the median nerve is compressed by injured or swollen tissues, you feel pain, tingling, weakness or numbness in the hand and wrist, and sometimes up the arm. Symptoms especially affect the thumb, index and middle fingers. Early diagnosis and treatment can help avoid permanent damage to the median nerve.

A Palm Beach Health Network Physician Groups doctor first makes sure carpal tunnel is not related to an underlying condition like diabetes. As the physical exam progresses, the doctor will check for swelling, sensation, weakness, and tenderness. Sometimes an X-ray or MRI (magnetic resonance imaging) study is used to help diagnosis.

Beginning treatment for carpal tunnel syndrome as early as possible will help avoid more serious nerve damage. Usually doctors first recommend rest, anti-inflammatory medications, immobilization through a splint or other device, and simple hand exercises.

Sometimes more intervention is needed to relieve carpal tunnel syndrome that persists longer than six months. Carpal tunnel release, one of the most common surgical procedures in the United States, may be performed to ease the strain on the hand and wrist. Your Tenet doctor can discuss if this procedure is right for you.

Depression is a common condition that has a number of manifestations. It could appear as one major depressive episode, persistent chronic depression (which lasts more than two years), psychotic depression, postpartum depression, bipolar disorder, and seasonal affective disorder.

Symptoms vary widely depending on the kind of depression you may experience. In general, you may have persistent sad, anxious, or “empty” feelings; feelings of hopelessness or pessimism; feelings of guilt, worthlessness or helplessness; unexplained irritability or restlessness; loss of interest in activities or hobbies once enjoyed; low sex drive; fatigue and decreased energy; difficulty concentrating, remembering details, and making decisions; insomnia, early-morning wakefulness, or excessive sleeping; overeating, or appetite loss; thoughts of suicide or suicide attempts; aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

Illnesses associated with depression include anxiety, post traumatic stress disorder, obsessive-compulsive disorder, panic disorder and social phobia.

Doctors are trained to recognize and treat various kinds of depression. Because each patient has specific needs, treatment for depressive illnesses may include any number of approaches like medication therapy, psychotherapy, and diet and exercise changes.

When bile stored in the gallbladder hardens into a stone-like material, we call it gallstones. A number of factors contribute to gallstones, including too much blood cholesterol or an imbalance of bile salts. Bilirubin can sometimes cause gallstones in people with liver cirrhosis, biliary tract infections, and heredity blood disorders.

At first, most gallstones do not cause symptoms. As gallstones become larger, or if they obstruct bile ducts, “attacks” may begin, often occurring after a fatty meal and at night. Symptoms usually, but not always, include: steady, severe pain in the upper abdomen that increases rapidly and may last several hours; pain in the back between the shoulder blades or in the right shoulder; nausea and vomiting; fever; chills; and other gastro-intestinal distress. People who experience sweating, chills, yellowing of the skin or eyes, or clay-colored stools should contact their doctor immediately.

Diagnosis of gallstones requires a full physical exam and usually an imaging test like an X-ray or ultrasound. Some other tests, like an endoscopic retrograde cholangiopancreatography (ERCP), give a better view of the biliary ducts.

Once your Palm Beach Health Network Physician Group doctor has reached a diagnosis, treatments will vary for each patient’s specific needs, overall health and medical history. Some patients need gallbladder removal, while others respond to medications that can dissolve the gallstones, or shock wave therapy (using sound waves to destroy gallstones).

Gout refers to inflamed, painful joints due to the formation of monosodium urate crystal deposits from an excess of uric acid. The increased uric acid may be caused by an overproduction in the body, inefficient elimination of the uric acid by the kidneys, or increased intake of certain foods that metabolize into uric acid in the body (like game meats, kidney, brains, liver, some seafood, some dried beans, and dried peas). Alcoholic beverages and drinks high in sugar may also increase levels of uric acid in the body.

Attacks of gout can be triggered by consumption of alcohol or protein-rich foods, fatigue, emotional stress, minor surgery, or illness. Symptoms can include: severe and sudden pain in one or more joints (most often the joint in the big toe), swelling in one or more joints, discolored (red or purple) and tight skin on joint, warmth in joint area, fever, chills, and hard lumps under the skin.

To make a diagnosis, your Palm Beach Health Network Physician Group doctor will make a complete physical exam and may collect a sample of the fluid in the affected joint. The fluid can then be analyzed for signs of monosodium urate crystal deposits. If you are diagnosed with gout, your Tenet doctor will talk with you about a treatment plan that may include steroid oral medication or injections, diet and behavioral changes, and some surgical procedures.

A hernia is a weakened area of the abdomen where organs push into other areas. There are several different types of hernias. A femoral hernia is a bulge in the upper thigh, just below the groin. A hiatal hernia occurs in the upper part of the stomach. An incisional hernia can occur through a scar if you have had abdominal surgery in the past. An umbilical hernia appears as a bulge around the belly button. An inguinal hernia is a bulge in the groin.

In most cases, there is no obvious cause for a hernia to develop. Heredity, birth defects (sometimes not known at birth), straining or heavy lifting, or an underlying medical condition may bring about a hernia.

Most hernias begin with mild pain and discomfort that may get worse while sitting, standing or lifting. Patients then may feel a lump that is sore and getting bigger. If a hernia gets too large and stuck in the abdominal wall opening, it may start losing blood supply (a process called strangulation). If this happens, immediate medical attention is needed.

Hernias need surgery for repair, but with the advances in laparoscopic surgery, these procedures are usually easy on the patient. In laparoscopic surgery, small incisions allow a tiny camera and thin, long handled instruments to be inserted into the abdomen to patch or close the hernia.

Blood pressure is the natural force of blood pushing against the artery walls when your heart beats. The pressure as the heart contracts is called the systolic pressure, while the pressure when the heart relaxes is called the diastolic pressure. That’s why a blood pressure measurement includes two numbers.

Normal blood pressure is around 120 systolic/80 diastolic, or 120/80. Prehypertension is 120 to 139 systolic or 80 to 89 diastolic. Stage 1 of hypertension (high blood pressure) is 140 to 159 systolic or 90 to 99 diastolic. Stage 2 of hypertension is 160 or higher systolic or 100 or higher diastolic. If systolic pressure is higher than 180 or diastolic pressure is above 110, the patient is in crises and needs immediate medical attention.

Regular blood pressure measurements help track blood pressure and reveal upward trends that may need intervention. Since high blood pressure rarely has noticeable symptoms, blood pressure testing is often the only way to discover hypertension.

After your Palm Beach Health Network Physician Group doctor diagnoses high blood pressure, he or she will outline a number of actions to bring blood pressure back to normal. These actions may include medication, increased exercise, weight loss, smoking cessation, diet changes, limiting alcohol, and managing stress.

Fats, or lipids, in the blood are an important part of processing energy. But too much of these blood fats can build up in your arteries and cause a number of cardiovascular problems like heart attack and stroke. Patients with high cholesterol usually show no symptoms, so regular testing is the only way to monitor this crucial health indicator.

There are two different types of cholesterol: LDL, which are low-density lipids, and HDL, high-density lipids. Total cholesterol levels should be less than 200, with LDL (also known as the “bad” cholesterol) less than 130. HDL cholesterol can actually help reduce LDL cholesterol by transporting it to the liver so the body can excrete it.

Most of the body’s necessary cholesterol is produced by the liver, with only about a quarter of cholesterol needed from food. So if your diet is high in fats, your body may have too much LDL cholesterol, and deposit the extra as a waxy substance in the arteries.

There are a number of things your Palm Beach Health Network Physician Group doctor can do to help with high cholesterol. These include recommending a healthier diet, planning an exercise program, and prescribing cholesterol-lowing medications.

Different causes of joint pain include (but are not limited to): arthritis, which covers about 100 different joint inflammation diseases the most common of which are osteoarthritis, rheumatoid arthritis, and juvenile arthritis; tendonitis, which is inflammation of a tendon which is the thick fibrous cord that attaches muscle to bone; sprains, which are an injury to a ligament; and bursitis, when the fluid-filled sacs around joints, called bursae, are irritated and inflamed.

Joint pain frequently responds to rest, ice, compression and elevation (RICE). Severe pain, visual misalignment, or inability to put pressure on the joint means it needs a doctor’s attention. Usually an imaging study, like an X-ray or MRI (magnetic resonance imaging), is needed to understand the scope of the problem. Sometimes other tests may be needed if the doctor suspects an underlying condition.

Treatments vary according to the cause of the joint pain. Over-the-counter anti-inflammatories are often enough to ease discomfort. Oral or injectable steroids may be used to reduce pain and inflammation as well. Physical therapy may be prescribed to strengthen surrounding tissues and increase flexibility. In some cases, surgery is needed.

Kidney stones are one of the most common disorders of the urinary tract, with about a million people in the United States treated for kidney stones each year. A kidney stone forms from the crystallization of excreted substances from urine. The stone may remain in the kidney or travel down the urinary tract. A small stone may pass out of the body, but a larger stone can get stuck in the ureter, bladder or the urethra in an attempt to pass. If the stone stops the flow of urine, it can cause great pain.

There are different kinds of stones based on the different substances that create them: calcium stones, (the most common kind of stones), struvite stones, uric acid stones, and cysteine stones (the rarest kind of stones).

Symptoms can include: extreme pain in the back or side, nausea and vomiting, cloudy or odiferous urine, frequent urination, burning feeling during urination, and fever and chills. If you suspect you have kidney stones, you need to see a doctor for diagnosis and treatment.

Blood tests, urinalysis, ultrasound and other tests may be used to diagnose the exact kind and location of the stones. Small stones that can pass on their own may only require pain medication. Other treatments include shock wave therapy (using sound waves to break up the stones), removal with a ureteroscope, or tunnel surgical removal.

When the liver doesn’t function correctly, your body can’t absorb nutrients or filter out toxins. That’s why liver disease can be a serious threat to health. Liver problems can be hereditary or brought on by illness or injury.

Since there are so many causes of liver disease, there are many different symptoms. They can include yellowish skin or eyes, abdominal pain and swelling, itchy skin that does not go away, dark urine, pale stool, bloody or tar-colored stool, chronic fatigue, loss of appetite, and nausea.

There are some risk factors for liver disease that you can control. Alcohol consumption, obesity and intravenous drug use can all expose you to liver disease.

Palm Beach Health Network Physician Group doctors will do a thorough physical exam and medical history review if you present symptoms of liver disease. Different blood and imaging tests will help zero in on a diagnosis. Sometimes a biopsy (taking a small amount of tissue) of the liver is needed for analysis.

Treatment for liver disease may include medication therapy, lifestyle changes or surgery. In extreme cases, a liver transplant may be needed.

There are dozens of reasons a woman may experience menstrual irregularity. The causes can range from slight hormonal changes to uncontrolled diabetes. It is important to find the underlying cause of irregular menstrual cycles to make sure there is not a dangerous or even life-threatening problem.

Not experiencing a reasonably consistent menses, or period, is usually a symptom of something else. That’s why continued irregular menstruation should be reviewed by a doctor. A full physical exam, including blood and other tests, will help a doctor find the cause.

Metabolic syndrome includes the presence of several risk factors that significantly raise the risk of developing diabetes, heart disease and stroke. The risk factors include: abdominal obesity, when the waist circumference measures more than 35 inches for women and more than 40 inches for men; high blood pressure; abnormal fasting glucose results; high triglycerides and high cholesterol. When three of these factors are present in one patient, he or she has metabolic syndrome.

The causes of metabolic syndrome are complex because of the number of factors that can influence each risk factor. In general, those with a BMI greater than 25, African-American and Mexican American heritage, stress, alcohol use, and a sedentary lifestyle are at a greater risk.

Metabolic syndrome increases the chances of developing more serious, chronic conditions, such as cardiovascular disease and type 2 diabetes. Other conditions that may develop as a result of metabolic syndrome include polycystic ovarian syndrome, fatty liver, cholesterol gallstones, asthma, sleep disturbances, and some forms of cancer.

Treatment for metabolic syndrome focuses on the predominant risk factors displayed in each patient. Medications can be used to control cholesterol and blood pressure. Important lifestyle changes like adopting a healthy diet and exercise program help as well. Palm Beach Health Network Physician Group doctors create a specific plan for each patient to address their specific health risks.

Morbid obesity includes those who are 50 percent to 100 percent, or 100 lbs, over their ideal weight. Excess weight takes a toll on general health by greatly increasing the risks of heart disease, high blood pressure, diabetes, stroke, osteoarthritis, and certain cancers.

Losing weight takes dedication to a new lifestyle. Decreasing caloric intake and increasing activity and exercise are the cornerstones of any weight loss program. Slow, steady weight loss works best for most people instead of rapid weight loss.

There are some medications that may help with weight loss. At Palm Beach Health Network Physician Group, your doctor can help you decide if medication may be a good option for you. Tenet also offers bariatric surgery, known as weight loss surgery.

The general idea for all bariatric procedures is the same: reduce or adjust the size of the stomach so the patient consumes less. This stomach manipulation can be done with a medical device (gastric banding), through removal of a portion of the stomach (sleeve gastrectomy), or by altering the small intestines into a small stomach pouch (gastric bypass surgery). Long-term studies show that patients who have these surgeries show significant long-term weight loss, and a host of health benefits like recovery from diabetes and improvement in blood pressure and reflux disease.

Obesity hypoventilation syndrome (OHS) is a condition where poor breathing leads to lower oxygen and higher carbon dioxide levels in the blood. Being obese is a major risk factor.

OHS is believed to result from misfiring of the brain’s signal to breathe combined with excessive weight against the chest wall. The combination of problems makes it difficult to take a deep breath, leaving the blood with too much carbon dioxide and not enough oxygen. People with OHS are often tired due to sleep loss, poor sleep quality, and chronic low blood oxygen levels.

Symptoms of OHS may include bluish color in the lips, fingers, toes, or skin; reddish colored skin; signs of heart failure like swollen legs or feet, shortness of breath, or fatigue after little exertion. Diagnosing OHS includes a physical exam for symptoms and some additional blood tests, lung function tests, imaging tests, and a sleep study.

Because obesity is a risk factor for so many dangerous conditions like heart disease and stroke, losing weight is an important part of treatment. Breathing assistance machines and medications may also help.

More and more research shows the important of sleep for overall good health. Sleep apnea not only affects the quality and quantity of sleep, but is also associated with irregular heartbeat, high blood pressure, heart attack, stroke, daytime sleepiness, and increased risk of motor vehicle and work accidents.

There are two types of sleep apnea. Central sleep apnea is when the brain fails to send the appropriate signals to the muscles to initiate breathing. Obstructive sleep apnea is when air cannot flow into or out of the person’s nose or mouth because of some kind of blockage.

Signs and symptoms of sleep apnea include loud snoring with repeated episodes of gasping or choking. Other signs may include: morning headaches; memory or learning problems; concentration problems; feeling irritable, depressed, or having mood swings or personality changes; or waking up frequently to urinate.

Type 2 diabetes is the most common form of diabetes. It means that the body can’t make or use insulin properly. Patients usually experience the onset of type 2 diabetes in middle age, but doctors are seeing more of it in severely overweight children. Some people have a hereditary predisposition for diabetes. Excess weight and physical inactivity are also risk factors.

Some people show no signs of diabetes, which is why annual blood sugar checks are important. Symptoms may include: frequent bladder and skin infections that don’t heal easily; high levels of sugar in the blood when tested; high levels of sugar in the urine when tested; unusual thirst; frequent urination; weight loss despite an increase in appetite; blurred vision; nausea and vomiting; extreme weakness and fatigue; irritability and mood changes; dry, itchy skin; and tingling or loss of feeling in the hands or feet.

The goal of diabetes treatment is to keep blood sugar levels as close to normal as possible. Often, type 2 diabetes can be controlled through weight loss, improved nutrition, and exercise alone. However, in some cases, other treatments like oral or injectable insulin or other medications may be needed.