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Men and Women Not Equal When It Comes to Alcohol Abuse

Thursday, May 15th, 2014

With media recently purporting the health benefits of moderate alcohol consumption (most popularly red wine, for the antioxidants), you may be wondering whether to add a daily glass (or two) of wine to your diet. Here are some reasons to think twice – or at least strictly moderate your intake.

Even though on average men drink alcohol in larger amounts than women, women’s bodies have a harder time metabolizing it. That means that if a woman matches her male companion drink for drink, she will be affected by the alcohol faster and more powerfully and will have more alcohol in her blood than him. She will also suffer more pronounced long-term health effects from overindulging.

Alcohol in Pregnancy

There is no justification for drinking any amount of alcohol at all when you’re pregnant, because there is no known safe amount. Drinking alcohol during pregnancy increases the risk of fetal alcohol spectrum disorders, which can cause birth defects and mental retardation. Because you may not know you’re pregnant for several weeks, you should also avoid alcohol if you are trying to become pregnant, and seriously consider whether drinking is wise if there is a chance you could get pregnant.

Other Health Concerns Related to Alcohol Abuse

Excessive alcohol consumption can cause reproductive health problems, such as disruption of the menstrual cycle, miscarriage, stillbirth, or premature delivery. In addition, excessive alcohol intake increases the likelihood of having multiple sexual partners, resulting in an elevated risk of sexually transmitted diseases and unintended pregnancy. Binge drinking is strongly linked to sexual assault, especially among college students.

Women also have a greater risk of cirrhosis of the liver and other liver diseases related to alcohol. Effects on the brain impact women more as well, and these can include brain shrinkage and memory loss. These effects tend to take place in women sooner and with shorter periods of alcohol abuse than in men.

Consuming too much alcohol also affects women’s hearts differently than men’s, and women have a greater risk of damage to the heart muscle. Alcohol consumption leads to a higher risk of cancers of the breast, colon, liver, esophagus, throat, and mouth.

What about the Benefits?

So what about those antioxidants in red wine? New studies show that they aren’t particularly effective at the low doses obtained from a daily glass of wine anyway. You’re better off getting your antioxidants from a balanced, healthy diet that includes lots of fresh fruits and veggies. You can get resveratrol, the specific compound found in red wine, from grapes and raisins (and, to a lesser extent, peanuts); a wide range of other antioxidants can be found in other natural foods such as berries, apples, beans, plums, and many, many more. So if it’s antioxidants you’re after, head to the farmers’ market or the produce department – not the beer and wine aisle.

– Yvonne S. Thornton, M. D., M. P. H

Menopausal Weight Gain NOT Inevitable

Thursday, May 8th, 2014

It may seem like weight gain is an inevitable effect of menopause. It is indeed common, and there are several reasons why, including:

  • Levels of estrogen, which appears to have a weight-regulating effect, drop significantly during menopause.
  • Older women are less likely to get enough exercise than younger women.
  • Muscle mass declines, and this has a slowing effect on your metabolism. This means that you may need fewer calories, but if you adjust your food intake accordingly, creeping weight gain will likely be the result.
  • Older women are more likely to have jobs that demand very little in the way of physical labor; they may also eat out more with the kids out of the house.

And weight gain isn’t just a cosmetic issue – it also increases your risk of many health problems, including diabetes, heart disease, high blood pressure, and several types of cancer.

However, you still have plenty of control over your weight during and after menopause, so don’t fall for the notion that weight gain is natural or that there’s nothing you can do about it. Even though weight control may be more of a challenge because of physiological and lifestyle changes that take place during menopause, it still boils down to taking in no more energy than you expend.

If you find the pounds adding up, your first line of defense is to eat less. In your fifties, you probably need a couple hundred calories a day less than you did when you were younger. Make your food choices more carefully. No one needs empty calories, but menopausal women should be especially careful to choose mostly vegetables, fruits, lean meats, whole grains, and low-fat or non-fat dairy products.

Exercise is another key step to beating menopause weight gain. Exercise gives you more energy and burns fat, while building muscle. And maintain or increasing your muscle mass is important because the more muscle you have, the faster you burn calories all day long. Adults up to 65 years old need at least 30 minutes of moderate-intensity exercise five days a week, such as brisk walking, and at least two muscle-strengthening workouts a week. You may need to add even more if your goal is to lose weight.

A good support system is also important. Enlist the support of your family and friends, or better yet, find a partner to work out with who can help encourage you and keep you motivated – and do the same for him or her.

The answer to menopause weight gain isn’t glamorous or easy, and there is no secret formula. But with concentrated effort to control your diet and exercise habits, you can absolutely maintain or even improve your weight at any stage of life. For more information on menopause, see my book, Inside Information for Women.

– Yvonne S. Thornton, M. D., M. P. H

Dealing with Springtime Allergies during Pregnancy

Monday, May 5th, 2014

Spring is here, and if you’re like many people, you’re dealing with the watering eyes, coughing, sneezing, and sniffling that pollen causes those sensitive to it. When you aren’t pregnant, you usually don’t need to think twice before popping a pill to relieve those symptoms, but once you are pregnant, you start to question everything you put into your body – and rightfully so. You want to do everything you can to keep your baby safe and healthy, but you also don’t need the continual stress of dealing with your allergy symptoms, whether they are caused by pollen, dust, pet dander, or whatever else triggers them. 

Many pregnant women deal with allergies. Some of these are women who have always had them and find that they don’t magically disappear just because they are now pregnant; some women find that they experience allergy symptoms during pregnancy that they have never had before. Sometimes swollen nasal passages, a common result of pregnancy hormones, can mimic the symptoms of allergy sufferers. This can occur alone or in conjunction with actual allergies, multiplying the misery of the affected woman.

What You Can Do

The best way to get relief, of course, is to avoid your triggers in the first place, whenever possible. Secondhand smoke (which is dangerous for you and your baby anyway), pollen, cat dander, and mold are all common triggers; so are paint thinner and other household chemicals. Use common sense and stay indoors when pollen is at its worst, invite your cat-loving friends to your house instead of going to theirs, and use natural cleaners that don’t make your symptoms flare.

If your best efforts to avoid symptoms are unsuccessful and you need to take a more proactive approach, the first step is to talk to your doctor to see what steps you can safely take. Even if you have been taking an allergy medicine for years, check with your doctor before continuing it now – and this includes prescription, over the counter, and homeopathic medicines.

There are some general guidelines for what drugs are safe in pregnancy. For example, over-the-counter antihistamines are usually considered safe for use by pregnant women, but they can make you sleepy. Pregnancy itself can also cause considerable fatigue, so this may not be ideal for you. Conversely, decongestants such as Sudafed or other decongestants containing vasoconstrictors like pseudoephedrine may constrict the vessels in your placenta and cause fetal compromise. The bottom line is that you should ask your doctor before taking any medication at all during your pregnancy to make sure the drug is safe for your individual situation.

Desensitization for allergies needs to be discussed with your obstetrician and your allergist in a mutual consultative meeting, understanding the risks and benefits. You can also try natural remedies such as using a neti pot (with sterilized water), as long as your doctor is aware of the treatment and gives you his/her approval.

– Yvonne S. Thornton, M. D., M. P. H

Making the Most of Your Annual OB-GYN Appointment

Monday, April 21st, 2014

Too often, women have a list of questions or concerns in their heads in the days leading up to an appointment with their doctors, only to forget most or all of them once in the exam room. Or, they leave the doctor’s office without feeling they received all of the information they needed. You don’t get a lot of time with your gynecologist, so it’s a good idea to be aware of some strategies for making sure you get as much as you can out of the visit. Here are some tips for making sure you and your doctor communicate well and that you get what you need out of your visit.

1. Know when your last period was. Mark it on a calendar and know the date – your gynecologist needs to know this. If you are experiencing irregular bleeding, a calendar tracking your periods as far back as possible is preferable.

2. For a couple of days before your visit, do not douche (which you should not be doing anyway) or have sex. Both of these things can interfere with the results of your pap test.

3. Bring a written list of all medications you are taking, including herbal supplements and vitamins. Know the doses and names of all of them.

4. Bring a list that you have prepared ahead of time of all questions you want to ask or concerns you want to bring up. Even if there are only a few items on the list, write them down – it’s too easy to forget them during the visit.

5. Ask for clarification. If the doctor says something you don’t fully understand, speak up. If you aren’t sure, repeat it back to the doctor in your own words to make sure you get it. Also ask if he or she can recommend any books or other resources for information on any condition you may have.

6. Be completely honest. Never lie about drug or alcohol use, your sexual history, or any other issues your doctor asks about, no matter how embarrassing the conversation may feel. Not being truthful can lead to a wrong diagnosis or the wrong advice.

7. If you need to discuss a specific problem you are having, take some time to make some notes before your appointment and know the answers to questions such as: When did the problem begin? What have you tried to improve your symptoms? What worked and what didn’t? Has any other doctor seen you for the condition; have any tests been done? What were the results? What makes the problem worse and what alleviates it? Include any information you can think of that might be relevant.

Most women don’t look forward to their annual gynecologic checkup, but it is one of the most important things you will do all year. Following these tips for making the most of your visit can ensure you get the highest quality care possible.

– Yvonne S. Thornton, M. D., M. P. H

Understanding Group B-Streptococcus in Pregnancy

Monday, April 14th, 2014

Group B β-Streptococcus (GBS or GBBS ) is a bacterium commonly found in the rectum, and vagina. Group B Β Streptococcus  should not be confused with the bacteria that causes strep throat (Group A); these are two different types of bacteria. Group B β-Streptococcus  infection is not generally serious for women and can usually be treated easily with antibiotics. But things change when a woman becomes pregnant.

There isn’t a surefire way to keep from passing Group B β-Streptococcus  from mother to baby during delivery. Group B β-Streptococcus  infection can be fatal to a newborn, and although this is rare, it does happen. That’s why it’s so important to do everything possible to minimize the risk.

Group B β-Streptococcus is one of those bacteria that a woman can carry without realizing it. Although it is transmitted sexually, it is not considered to be a sexually transmitted disease, like gonorrhea or syphilis. The chances of passing the bacteria on to the baby during delivery are high, but most babies are not affected. However, a small number will develop a Group B β-Streptococcus  infection, which can cause problems ranging from the mild to the severe, perhaps death.

Screening for Group B β-STREPTOCOCCUS

Some doctors choose to routinely test every pregnant patient for Group B β-Streptococcus between 35-37 weeks of gestation and treat the ones who test positive for the bacteria with antibiotics at the beginning of labor. This is the method that has been shown to be the most effective at catching Group B β-Streptococcus  colonization and preventing infection in newborns.  Because the urine in the bladder is sterile, any Group B β-streptococcal infection found on a urine culture indicates that the mother is a “colonizer” and she will need antibiotics during her labor.

Some doctors, however, choose to treat only mothers who are at high risk for passing Group B β-Streptococcus on to their babies. These women include those who go into labor prematurely, those whose membranes rupture early and labor looks like it will be long, those with unexplained fever, those who have had a baby with Group B β-Streptococcus  infection before, and those who have or have had a kidney or bladder infection caused by Group B β-Streptococcus.

The test itself is simple and painless, and involves inserting a special cotton swab into the woman’s vagina and rectum. The swab is then placed in a solution in which the bacteria will grow if present. This is called a culture.

Treatment for Group B β-STREPTOCOCCUS

When an expectant mother tests positive for Group B β-Streptococcus , or is at high risk for passing it on to her baby, she is given antibiotics when she goes into labor. Giving the antibiotics earlier on, during pregnancy, is not as effective, as this allows the bacteria time to re-grow before delivery.

As for babies, they can develop one of two types of infections. The most common (and most dangerous) is early-onset disease, wherein the baby is infected while moving down the birth canal. Symptoms of this type of infection appear during the first week of the baby’s life, and the infection can be severe and difficult to treat. Antibiotic treatment during labor is designed to prevent this type of Group B  β-Streptococcus  infection in the baby.

The other type of Group B β-Streptococcus  infection is late-onset disease, and babies do not show symptoms of this until after their first week. These babies may have contracted the disease from their mothers during delivery or from contact with her or someone else carrying the disease after birth. This type of infection is not prevented by antibiotic use during labor, but can be treated with antibiotics after the baby is born.

However, whether early- or late-onset, Group B β-streptococcus is an infection not to be taken lightly and could result in disastrous results for your newborn.  So, make sure you keep your prenatal visits during the last weeks of your pregnancy in order to be tested for Group B β-streptococcus.

– Yvonne S. Thornton, M. D., M. P. H

Getting the Facts on Genital Herpes

Monday, April 7th, 2014

Herpes is a common sexually transmitted infection (STI) caused by one of two types of viruses, herpes simplex type 1 and herpes simplex type 2, and that anyone who is sexually active can get. Most of the time, individuals with the virus have no symptoms, and it’s important to understand that even those with no symptoms can still spread it to sexual partners.

Of people in the United States between the ages of 14 and 49, about one out of six has genital herpes. It is spread through vaginal, anal, or oral sex with an infected individual. The fluid in herpes sores carries the virus, and infection can be the result of contact with those fluids. However, the virus can also be released through the skin, so you can even get herpes from someone who is not showing symptoms, or may not even be aware that he or she is infected. The flip side of this, of course, is that if you are the infected partner, keep in mind that you can still spread the virus to your sexual partner(s) even when you have no symptoms.

Realize that condoms may not fully protect you from herpes infection. That’s because outbreaks can occur in areas that aren’t covered by a condom. You should still use a condom every time you have sex, of course, unless you are in a long-term monogamous relationship and you and your partner have both had negative STI test results. The only other way to fully protect yourself from genital herpes is to avoid having sex.

Genital Herpes Symptoms

Herpes often causes no symptoms, or symptoms that are very mild. Mild symptoms may not even be noticed, or they may be mistaken for a skin condition such as an ingrown hair. This is why so many people have herpes and don’t know it.

When there is an outbreak, herpes causes sores that appear as blister(s) in the genital area. When the blisters break, they form painful sores that can take weeks to heal. The first time an infected individual experiences an outbreak, the sores may be accompanied by flu-like symptoms such as fever or swollen glands.

Genital Herpes and Pregnancy

Prenatal care is even more important for pregnant women with genital herpes. Be sure to tell your doctor if you have herpes or if there is any chance you may have it. Because herpes can cause pregnancy complications and is dangerous to your baby, it is important to avoid being exposed to it during pregnancy. At 36 weeks of pregnancy, women with a history of herpes are given an antiviral oral medication in order to decrease their likelihood of having a recurrence.  However, if any symptoms at all or evidence of a lesion are present when it is time for you to deliver, a cesarean delivery will most likely be performed.

If You Have Herpes

Herpes cannot be cured, but there are medications that can shorten outbreaks or help prevent them in the first place. Certain medications are also available that are taken daily and lower the likelihood that you will spread the infection to any sexual partner(s) you may have.

It is very important to inform any potential sexual partners of the fact that you have genital herpes and discuss the involved risks. Not having symptoms and using condoms are two things that can lower the risk of infection, but again, not remove it.

It is possible to spread a genital herpes infection to other parts of your body, such as your eyes, so you should not touch the sores or the fluid from the sores. If you do, you should immediately wash your hands.

Talk to your doctor about how herpes may affect your relationships and overall health, if these are concerns. Realize that while herpes isn’t curable, it is manageable. Talk to a doctor, take the medications he or she recommends, and be cautious about spreading the infection to others. You can find more information on this and other topics in my book, Inside Information for Women.

– Yvonne S. Thornton, M. D., M. P. H

Dropping Preschool Obesity Rates an Encouraging Sign

Thursday, April 3rd, 2014

The news is mixed when it comes to obesity rates in the United States. The good news is that the obesity rates in preschool-age children appears to be dropping. The latest data shows a decline in preschool obesity, from 14% to 8% since 2003. However, at the same time, obesity rates in women over 60 seems to be going in the opposite direction. The overall obesity rate hasn’t changed in the last ten years.

By analyzing data from the CDC’s National Health and Nutrition Examination Survey (NHANES), researchers determined that there has been a significant drop in obesity rates in two- to four-year-old children, particularly those from low income families who participate in federal nutrition programs. The news is encouraging because it means that there is hope for affording even more widespread and long-term changes.

One piece of information the new data does not provide is the precise reasons for the changes. However, in recent years, there has been an increasing initiative at both local and regional levels to provide enhanced opportunities for increased physical activity and improved nutrition in child care centers and schools, probably playing a role in the positive changes that are occurring. For example, consumption of sodas and other sugary drinks has declined, which is most likely one major factor.

The CDC also reported last year that only one in five adults gets enough exercise, something that could certainly contribute to the rising obesity rates in older women. Healthy adults over 65 should strive for the equivalent of 30 minutes of brisk walking five days a week plus strength exercises twice a week. Children need much more; those under 18 should be getting around an hour a day of aerobic exercise, plus muscle and bone strengthening activities.

However, it’s important to recognize that adding more exercise into your daily routine alone will most likely not be enough to achieve significant weight loss. If you have extra weight to lose, and you are ready to get started, realize that while exercise plays an important role, nutrition plays a much more important one. This is partly because many people overestimate the number of calories they burn exercising, or they are hungrier after they exercise and eat more to compensate.

Sometimes creating small changes in your diet may be all you need; others will need to make more dramatic changes. Either way, making the changes gradually will probably help you develop more lasting habits and ultimately see better results. Focus on natural, healthy foods, and try some helpful tricks such as eating more slowly, planning meals ahead of time, and getting more sleep, if you don’t tend to get enough. Lots of helpful information can be found here.

The bottom line is that the unchanging overall obesity rate means that there is an ongoing need for education and initiative. However, the decline in preschool obesity is an encouraging sign that the scales may be starting to tip in the right direction.

– Yvonne S. Thornton, M. D., M. P. H.

What Is a Pap Test Used For?

Thursday, March 20th, 2014

The term  “Pap test” or “Pap smear” is known by almost every woman in the United States.  However, over the past few years, its annual frequency has been questioned and the actual manner in which it is performed has been enhanced in many gynecologists’ offices. One of the components of a gynecologic exam that you have undoubtedly undergone is the Pap test (or Pap smear).  As stated in my health book for women and many times before on this blog, A Pap smear is NOT a pelvic exam.  The purpose of a pelvic (gynecologic exam) is to check all of your reproductive organs, which includes uterus, ovaries, vagina and vulva.  The Pap test is only to check for cellular changes in your cervix (the mouth of the womb) that may signal cancer or precancer. This is why regular appointments with your gynecologist are so important – because a precancerous condition can be treated before it becomes invasive cervical cancer, but the only way to detect a condition like this is with a Pap test.

Make no mistake – a Pap test can save your life. The chances of treating cervical cancer successfully are far, far higher when it is caught in its early stages. In most cases, precancerous cell changes can be treated before they ever become cancer at all. If you are wondering why you need a Pap test, or have been putting off making an appointment for your annual visit to the gynecologist, remember: a Pap smear is the absolute best way to prevent cervical cancer.

With that said, a Pap test is not recommended for women less than 21 years of age.  However, between the ages of 21 and 65, most women need an annual Pap test. Even though the American Cancer Society recommends Pap tests every three years, the American College of Obstetricians and Gynecologists recommends this screening test every year, because three years is a long time for cancer to grow and spread. Why wait three years when your cervical cancer could have been caught in its precancerous stage two years earlier?

Even if a woman has had a hysterectomy, she still needs a Pap test if her cervix is still in place, which is the case with certain types of hysterectomies (known as subtotal or supracervical hysterectomies). Either way, she still needs an annual pelvic exam; you can find more information on this in my book, Inside Information for Women.

To help ensure accurate Pap test results, you should not douche for a couple of days beforehand. That was a trick question, you should not be douching in the first place!!). Also avoid sex, vaginal creams or suppositories, deodorant sprays or powders in the vaginal area before a pelvic exam and Pap test.  Although some gynecologists prefer that the patient is not menstruating, a Pap test can be performed during your menses and they are not mutually exclusive.  If there are cancer cells present, they will be present whether you are menstruating or not.

What Does a Pap Test Involve?

The Pap test is done as part of the pelvic exam, and is very quick. The doctor places a bi-valved instrument called a speculum (hopefully warmed) in the patient’s vagina, which allows the cervix to be visualized.  The word “speculum” comes from the Latin “to see”. The doctor then uses a special brush (cytobrush) or swab (similar to a Q-tip) to collect cells from the cervix. These cells are placed on a slide and examined in the lab under a microscope. That is the traditional Pap smear.  Recently, liquid-based Pap tests have essentially replaced the conventional Pap smear.  In this test, after the cytobrush or the Q-tip has collected the cells from the cervix, it is submerged into a small vial of liquid preservative for transport to the laboratory, where it is then processed and smeared on the slide.  The presence of Human Papilloma Virus (HPV) can also be tested with this technology.  Some spotting is not unusual after a Pap test, but the test does not hurt. If the test shows a potential problem, your doctor will let you know that further testing is needed. Although this can be scary, remember that abnormal test results do not necessarily mean you have cancer.

Most insurance plans cover Pap tests as part of the gynecologic visit. However, if you are uninsured and not participating in the coverage afforded by the Patient Protection and Affordable Care Act, there are facilities that offer free or low-cost Pap tests

– Yvonne S. Thornton, M. D., M. P. H.

Supplements No Substitute for Healthy Diet

Thursday, March 13th, 2014

Bad news for vitamin-lovers: it appears they are not helping you prevent cardiovascular disease (CVD). A study carried out by the American Heart Association concluded that “the scientific data [does] not justify the use of antioxidant vitamin supplements for CVD risk reduction,” and that there is no consistent evidence which suggests that consuming micronutrients in higher amounts than those found in a balanced, healthy diet is beneficial in regards to CVD risk reduction.

What’s more, your vitamin supplements aren’t helping you prevent cancer, either, as outlined here by the American Cancer Society. Other organizations such as the Academy of Nutrition and Dietetics and the American Academy of Family Physicians have reported similar findings. 

In most cases, vitamin supplements are not harmful, and the results of the latest research do not mean that supplements offer no benefits whatsoever. But if you are taking them to lower your risk of CVD or cancer, the newest evidence suggests that you are wasting your money.

There is currently no official recommendation on either taking or avoiding vitamin supplements for healthy individuals, with a couple of exceptions. One such exception involves beta carotene, which studies such as this one show can actually increase a smoker’s risk of lung cancer when taken in the high doses found in many supplements. This is in direct opposition to the previously popular belief that high doses of beta carotene were beneficial in cancer prevention.

What has been shown to have a beneficial effect on CVD and cancer risk is nutrition – a diet consisting of mostly vegetables, fruits, whole grains, low-fat dairy, and lean meats, particularly seafood. A diet like this offers plenty of fiber, antioxidants, and Omega-3 fatty acids. These nutrients offer a number of health benefits, including weight control, blood pressure control, and heart disease and cancer prevention. What the new studies show is that if you are hoping that your vitamin supplements allow you a bit more leeway in your diet, you’re shortchanging yourself.

What about Prenatal Vitamins?

It’s important to note that these studies do not mean that women who are pregnant or planning to become pregnant should toss all of their supplements. Folic acid should be taken to help prevent neural tube defects; the prenatal multivitamins prescribed by a woman’s doctor should be taken as directed. Also make sure your doctor knows about any vitamin supplements you are taking, because some can be harmful. High levels of vitamin A, for example, may be linked to birth defects.

And again, just because you are taking a prenatal vitamin – which you should if you are pregnant – does not mean your diet is not important. Healthy, natural foods contain many compounds not found in supplements, so a combination of prenatal vitamins and a healthy diet will help protect your baby as he or she develops.

– Yvonne S. Thornton, M. D., M. P. H.

Pros and Cons of Robotic Surgery

Monday, March 3rd, 2014

If you need surgery, you are likely to be presented with the option of robotic surgery. This means that instead of the surgeon working on you directly with his hands, he or she will manipulate a set of robotic arms with surgical instruments attached from a console. Should you go along with this, or should you question the practice?

It would be understandable if you were hesitant. Thanks to the media’s love of a good horror story, most people have heard of instances where patients were accidentally injured – or worse – during robotic surgery. Even the American College of Obstetricians and Gynecologists maintains that robotic surgery is neither the best nor the most cost-effective approach to hysterectomy.

Does this mean that you should flatly reject robotic surgery? Not necessarily. Like any surgical instrument, a robot is as good as the surgeon using it. Furthermore, every patient profile is different. There are a number of considerations for anyone making a choice about robotic surgery.

In 2000, there were (worldwide) only 1,000 robotic surgeries. Last year, there were 450,000. Proponents of the practice say its benefits are responsible for its rising popularity. Less blood loss, less need for pain medication post-surgery, and shorter hospital stays are among these benefits, along with smaller scars (which is also a benefit of laparoscopic surgery). Robotic procedures are less taxing for surgeons, who don’t need to bend over an operating table, but instead, can sit at a console viewing the surgical field on a screen.

But some feel that robotic surgery does not offer significant benefits beyond those of laparoscopic or other types of surgery, and that the “wow” factor is one of the real reasons robotic surgery is catching on. In our love affair with new technology, it’s possible we have a tendency to move ahead too fast without enough standardized evaluation. To be sure, any new medical technology requires proper patient selection as well as a full explanation of all options and their risks and benefits for informed decision making.

What Does All of this Mean for You?

The wisest approach for a patient who needs surgery is to make sure to get an explanation from the surgeon about possible procedures, including what to expect in the postoperative period. The surgeon should also explain why he or she feels that a particular method is the best option in an individual patient’s case. There is no one-size-fits-all when it comes to surgery.

Another consideration is the cost of the surgery. Robotic procedures tend to cost more, but the patient may end up spending less overall. The need for longer hospital stays and pain medications is potentially lower with robotic surgery, and patients might have a lower chance of being readmitted for complications, all things which can lower a patient’s total costs.

For now, robotic surgery appears safe and effective, but it remains just one of the options available to patients. Ask your surgeon about his or her experience with any procedure he or she wants to use, and about complications that have arisen in the past. Remember that the right choice will be different for different people, so talk to your doctor, and let his or her expertise and experience guide you to make the right informed choice for your unique situation.

– Yvonne S. Thornton, M. D., M. P. H.