Q: What if I am experiencing dense breast tissue?
A: Dense breast tissue is a common concern to many women. While dense breast tissue is most often normal glandular tissue, it can hide small breast cancers, making detection difficult or impossible by routine screening mammograms. Starting at age 40, high quality digital screening mammogram yearly is incredibly important. Even with no suspicious findings on routine screening, it may be appropriate for women with dense breast tissue, especially those with other risk factors, to consider evaluation with the newer techniques of either high resolution Whole Breast Ultrasound or 3-D Mammography (Digital Tomosynthesis). If you have been told you have very dense breast tissue, then ask your doctor if one of these new tests to detect subtle breast cancers may be appropriate for you.
Tommy Cupples, MD
Q: I have heard bad things about spine surgery, but I am in pain. How can I feel confident proceeding with a surgical procedure?
A: While the success rate of spine surgery is approximately 80 to 85 percent, particularly if you’re a good candidate and you have a straight-forward problem, it should be a last resort. Your doctor will likely pursue other options first such as rest, medications, physical therapy, and possibly injections, before discussing surgery. If surgery is necessary, ask your doctor if it’s possible to perform minimally invasive spine surgery, which utilizes smaller incisions that can speed recovery while accomplishing the same goals as traditional surgery. Since MRI scans never show pain, it is important that your surgeon works to correlate your pain with what is found in the scans. It’s also critical that you and your surgeon have realistic goals and expectations, so make sure you fully understand what to expect from the surgery. If you are uneasy at all with your surgeon’s recommendations, you should ask the surgeon to recommend someone he or she trusts for a second opinion.
P. Douglas deHoll, MD
Moore Center for Orthopedics
Q: What are the main risk factors for heart disease? Can I do anything to improve my chances?
A: Six main factors tend to mark you as being at risk to develop heart disease:
- Hypertension (high blood pressure)
- High cholesterol
- Family history
- Sedentary lifestyle/obesity
The good news here is that you have the power to control five out of the six. All but family history are firmly in your hands. Heart disease is far too prevalent in South Carolina. In fact, it was the number-one killer of women here in 2008. Our traditional Southern diet is not our friend. However, everyone has the ability to lower risk. Eat healthier. Exercise. If you smoke, quit. You can beat the odds.
Dr. Edward “Mac” Leppard, MD
Q: What is Coolsculpting and who should consider it?
A: Coolsculpting is an FDA-cleared non-surgical body contouring treatment that freezes and eliminates fat. A good candidate for Coolsculpting is someone who is physically active and has good eating habits, but still has stubborn fat that won’t go away. All treatments take one hour, except for the outer thighs, which take two hours per side. One Coolsculpting treatment is usually all that is needed. Two treatments per area are approved by the FDA, although you must wait at least 90 days before having a second treatment. Some individuals are not candidates for Coolsculpting, including those with cold urticaria, neuropathic disorders, impaired skin sensation, open or infected wounds, hernias or a history of hernias, recent surgery or scar tissue in the area to be treated, or who are pregnant. With Coolsculpting, there is no downtime and no restrictions post-treatment; however, slight swelling, bruising, numbness and discomfort are common, which could last up to four weeks. Results begin to take effect within one month, with maximum results visible by the third or fourth month.
Peter Haines, MD, FACS
Healing Waters at Palmetto Health
Q: What is CyberKnife?
A: CyberKnife is a leading edge radiation therapy technology, targeting many types of tumors without cutting. It is a robotic radiation machine that allows doctors to treat cancer with extreme precision using very high radiation doses to target small regions anywhere in the body. CyberKnife treatments are painless and, on average, one hour per session. Radiation oncologists can treat patients in one to five days with CyberKnife compared to months of daily radiation treatments.
Daniel Fried, MD
Spartanburg Regional Healthcare System
Q: Can a chiropractic doctor adjust a woman while she is pregnant?
A: Typically, a woman’s spine is under the most stress during pregnancy and delivery. The ligaments of her uterus attach to her sacrum and pelvis. As the uterus enlarges and stress occurs to the pelvis, these ligaments may become torqued, unevenly pulling on the uterus and spine. Not only does this cause back pain or discomfort to the mother, but it may also restrict the baby’s movement, preventing the baby from optimal positioning or moving into the best presentation for delivery. Consult a Certified Webster Technique Chiropractor who specializes in maternity and pediatric chiropractic to adjust the mother’s sacral ligaments and pelvis. Published studies have indicated that chiropractic adjustments may even reduce labor time, as well as reduce maternal discomfort, and help reduce ligament torsion, optimizing baby positioning for better birth outcomes that provide a potentially safer and easier delivery for mother and baby.
Shelly Jones, DC
Chiropractic Wellness Center, Inc.
Q: Why are Urinary Tract Infections misdiagnosed in senior adults?
A: Urinary Tract Infections (UTIs) are frequently used to explain changes in mental status, neurologic changes and chest pain. A new Choosing Wisely® campaign highlights the dangers of over diagnosing UTIs and incorrectly prescribing antibiotics. While UTIs are common, treatment should be used for those with symptoms related to the bladder, most often, pain with urination and a positive urine culture. Many physicians mistakenly prescribe antibiotics for UTIs without running proper tests. When antibiotics are over-prescribed, they lose their efficacy and can actually kill the “good” bacteria our bodies need. Antibiotics do not help bladder control, memory issues or balance. Furthermore, antibiotics have side effects like diarrhea, vomiting, nausea and headache, which can cause future problems. The best ways to avoid a UTI include drinking lots of water, voiding frequently and practicing good hygiene.
David Greenhouse, MD
Laurel Crest Continuing Care Retirement Community
Q: Will I need to wear glasses after cataract surgery?
A: During cataract surgery, an ophthalmologist removes the cloudy natural lens inside the eye. The natural lens is replaced with an artificial intraocular lens (IOL) that can reduce the need for glasses, but some patients may still need to wear glasses after surgery for some activities. One option is to have the IOL for one eye set for distance vision, and the other set for near vision, which can reduce the need for reading glasses. Multifocal or accommodative lenses are another IOL option and are designed with a series of focal zones or rings allowing for both clear near and distance vision. An ophthalmologist who offers the most advanced surgical technology and all lens options can help you make the best decision for your vision needs and lifestyle.
Derrick A. Huey, MD
Columbia Eye Clinic
Q: Why is hip resurfacing a better option than hip replacement for athletic patients?
A: Hip resurfacing is an alternative to traditional hip replacement that is particularly suited to athletic patients. This procedure replaces a thin layer of bone from both sides of the hip joint with metal surfaces, which is biomechanically much more similar to the natural hip than a traditional hip replacement. Resurfacing preserves more of the natural bone and facilitates natural movement of the hip joint without fear of dislocation. As a result, these patients are able to achieve a much higher activity level after surgery to include running and full athletic participation, which is not typically possible after a traditional hip replacement. Less bone loss, increased stability of the hip joint and avoidance of thigh pain are key benefits of hip resurfacing that make it the preferred option for athletic individuals.
Coleman D. Fowble, MD
Midlands Orthopaedics, P.A.