What is the best option for HOCM (Hyper Obstructive Cardio Myopathy) treatment? Chemical Ablation or an open heart surgery? Will it be possible to avoid operation with medicine?

I'm not an expert in HOCM but we did learn about it whilst in medical school.It's a genetic condition that causes increased thickening but not proliferation of heart muscle. This causes obstruction of blood to leave the heart as there is too strong of contraction and sometimes even physical obstruction.This is a type of heart failure, could be systolic failure from obstruction, but also diastolic from over contraction. Since it's a type of heart failure, the drug treatment would be similar, using beta blockers mainly.But for definitive resolve, removal of muscle would be best. Not all patients would need such drastic treatment. Some would fair well on pharmacological alone. Also keep in mind that there is increased risk of arrhythmia and heart attacks to happen.Should discuss with either a cardiologist, cardiothoracic surgeon and maybe a medical geneticist for further details of management. I hope I helped, and hope you get better.

How difficult is it for a doctor or surgeon right out of medical school to get a bank loan to open his own clinic or surgery center?

Opening your own clinic/office? Probably not difficult at all. Depends on what you have in the bank, debt, credit rating, whether the bank thinks your location is likely to yield a successful (monetarily speaking) practice. If you are in an underserved area, or small town, and it's a local bank, the bankers may take into consideration the need of the area for the services you will be adding to the community. Will your being there help the town prosper and grow for example.Opening a surgery center is a whole different, and much, much more complicated and expensive ball of wax. Are you partnering with a local hospital? Are there other ASCs that provide similar services close by? Have you done a feasibility study? How many surgical suites are you opening? Do you have adequate parking? Arrangements for Anesthesia/ ER services? Will you be the only surgeon using, or owning the facility? Is it single speciality or multi speciality? Are you violating any Stark Laws? Are insurers going to pay your facility? Are you going to be in-network or out-of-network? Does your location require a CON (certificate of need)? Are you prepared for annual inspections, bookkeeping, regulatory, quality reporting requirements, etc., etc., etc,?It's complicated. And those are just a few questions I thought of while I was writing this while sitting on the john. It's probably much more complicated than that. Really. Not the part about where I wrote this, but the rest of it is. Really.

What are the chances of not waking up from getting open heart surgery for ASD? How safe is the surgery to repair a hole in the heart and fix an artery?

The chances of not surviving the surgery are small. The chances of dying from hemodynamically signNow ASD plus a bum artery (coronary?) are very high. Take your pick.

Is surgery the best treatment for fibroids and how do I prevent it or to shrink it?

Treatment for fibroidsSince most fibroids stop growing or may even shrink as a woman approaches menopause, the health care provider may simply suggest watchful waiting. With this approach, the health care provider monitors the woman's symptoms carefully to ensure that there are no signNow changes or developments and that the fibroids are not growing.In women whose fibroids are large or are causing signNow symptoms, treatment may be necessary. Treatment will be determined by your health care provider(s) based on:Your overall health and medical historyExtent of the diseaseYour tolerance for specific medications, procedures, or therapiesExpectations for the course of the diseaseYour opinion or preferenceYour desire for pregnancyIn general, treatment for fibroids may include:Hysterectomy. Hysterectomies involve the surgical removal of the entire uterus. Fibroids remain the number one reason for hysterectomies in the United States.Conservative surgical therapy. Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy.-releasing hormone agonists (GnRH agonists). This approach lowers levels of estrogen and triggers a medical menopause. Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.Anti-hormonal agents. Certain drugs oppose estrogen (such as progestin and ), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used.Uterine artery embolization. Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort.

How does one decide between medicine or surgery as a speciality when you want to do both write medicines and do procedures?

I would say go into Cardiology. Procedures like cardiac cath, pacemaker implantation, angioplasty, stenting, and such. Small incisions, or puncture wounds only, but skilled manipulation of catheters and devices once inserted. You could take extra medicine work while preparing to be a surgeon, also. A med school classmate of mine took one year of internal medicine internship before starting his 4-year orthopedics residency and a one-year fellowship in hand surgery. But, you can write plenty of meds as a full-time surgeon, such as antibiotics, analgesics, and other products. The practice of medicine is not about writing medicine prescriptions. It is about diagnosing and treating medical problems without surgery. As far as Dr. Gunsul’s pathway, those were the good days. These days, you could not get malpractice insurance or staff privileges without being at least board eligible in each of those fields. And, even if so trained, you have to do a certain number of procedures and have a peer review history that is strong before accreditation groups like the Joint Commission would allow it to continue. The medical field in the USA is the most regulated industry in the country. More so that nuclear energy.

How can you know if your body will respond better in terms of pain and discomfort to a laparascopic or open surgery procedure when you've never had either before?

Short answer: You cannot, though laparoscopic is usually less painful and an easier heal.Long answer: All the research I did on the surgical procedure called a Whipple (open surgery, not laparoscopic in my case, for pancreatic cancer) told me to expect a long recovery period with a lot of pain, and flares of pain after the healing period.My recovery period was relatively short, started chemo at 6 weeks out and went back to work, with limitations, in a home improvement warehouse store at 9 weeks out. I was given 30 Oxycodones for pain in the middle of June 2015 with a script for 2 refills. I have 4 of the original 30 left and the script has expired. At least half of what I have taken was for flares of the chronic tendinitis in my shoulders and elbows I had for decades. One of only 3 times I used the pump at the hospital was likewise for a shoulder flare (had an epidural with over ride button if I needed extra for 5 of the 8 days I was in the hospital). Most of my pain has been controlled by Tylenol, Motrin or Advil, in over the counter strength.My pain tolerance is higher than usual. My 10’s have been when I had an abscessed tooth and passed kidney stones. My shoulders can get to 8. The surgery averaged 6. I have not had any of the so-called Whipple Attacks. The surgeon told me the pancreas was scarred, like one gets from having had pancreatitis. I may have had it, but the aches in my abdomen before the diagnosis and treatment flared to maybe 5…There’s the rub, each human reacts differently to the same stimuli. If we were all the same, the only pain reliever we’d need would be willow bark tea.

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Music over the next hour live from Children's Hospital Boston's cardiac oh are see cardiac surgeons repair a complex congenital cardiac defect each year the pediatric cardiac surgery program provides surgical care to approximately 1,100 patients including more than 700 cases of open heart surgery that require cardiopulmonary bypass and 400 closed cases that do not require bypass with extraordinary success rates in just moments the cardiac team will present this complex congenital cardiac case and answer your email questions Oh our live makes it easy for you to learn more just click on the request information button on your web cast screen and open the door to informed medical care now let's join the doctors hello I would like to welcome you to this live webcast my name is Amit Basha I'm one of the characters at Children's Hospital Boston and associate professor of surgery at Harvard Medical School the theme today is LV rehabilitation and bordered on the ventricles something we have ext

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