The most popular girls’ names from the 1990s in Massachusetts, masslive.com/living
Better Health D
|
MUSIC: Ukraine orchestra comes to UMass, D7 LIFESTYLE: A nightclub for those 65 and older, D7 HEALTH: Here’s what to eat or drink to handle a cold, D7
| SUNDAY, JANUARY 29, 2023
“ ... the word ‘doctor’ means ‘teacher,’ and that we should be teaching our patients how to make healthy choices to prevent illness whenever possible.” - Martin Walko, MS FACS
Weight Management By Cori Urban
its own. Over time, with increased tion also be addressed or the hernia first. “However, sometimes repair intra-abdominal pressure, many will return,” Walko emphasized. before weight loss is fraught with hernias will get larger and more “This is where addressing obesity greater risks, including recurrence.” At Holyoke Medical Center, medical staff empower patients who symptomatic. “They can even cause becomes important. Technically, Obese patients have a greater both open and minimally-invasive chance for complications during herare having weight-loss surgery with life-threatening problems if the tiseducation and guidance and become sue gets stuck out or twists and loses (laparoscopic) repairs are options nia surgery depending on whether partners in their care. its blood supply, which is known as a and tailed to patient needs.” it’s emergent or elective surgery and strangulated hernia,” he said. He also is trained in robotic the specific problem. “In general, Clomaris Velazquez, of Holyoke, had successful bariatric surgery with How obesity creates a hernia is repairs, which is another aspect of emergency surgery is usually accomminimally-invasive surgery. panied by a patient who has poorDr. Yannis Raftopoulos in 2017 and a complex and “we don’t understand complex recurrent incisional hernia all the reasons,” the doctor continThere are risks to hernia repair. ly-controlled or uncontrolled health repair by Dr. Martin Walko last year ued. Some issues that are agreed “As with any operation, there are issues, like diabetes, smoking, lung always risk of bleeding, infection problems, so yes, the risk of comat Holyoke Medical Center; she lost upon include increased intra-abdominal pressure that stretches and and anesthesia risks, which are unplications are greater,” Walko said. 123 pounds over the course of five years and recently said she feels applies pressure on any weakness. common,” Walko said. “In the case “However, when an obese patient great. “I feel more energetic, and I Also, “obese patients tend to be of hernia repair, the hernia mesh/ follows a care plan to minimize other more sedentary, so their fascia, patch can become infected or pinch, health issues, like smoking/nicotine am looking forward to going back to work,” as a medical assistant, she in theory, will be weaker than an causing pain or even more serious use, weight loss, better control of hopes. athlete’s.” issues. But the hernia repair-specific diabetes, better control of breathing The doctors and staff “were there for anything I needed,” she said, awarding them five out of five stars, meaning she received top-notch care. Patients like Velazquez are taught about healthier food choices, eating fewer processed food with empty calories and the importance of some activity to help burn calories. “We help them and monitor their progress as well as recommend modifications for what works and what isn’t working,” said Walko, a Valley Health Systems Inc. bariatric and Martin Walko, MD FACS at Holyoke Medical Center general surgeon. He helps persons who are obese to lose weight and enjoy a higher Many obese patients also have risk is that the hernia can return, es- problems, the risks are minimized, quality of life. type 2 diabetes, which impairs heal- pecially in the setting of weight-gain which is why following a health care or not following activity restrictions plan is always important.” Obesity is defined as having a body ing, as well as other health issues, such as sleep apnea, restrictive lung around the time of surgery.” Symptoms of hernia depend on mass index greater than 30; in the disease and other health issues Ideally, the best data show barthe type of hernia. Sometimes, there United States, two thirds of adults are overweight or obese. which makes a “one -size-fits-all” iatric surgery first and weight-loss are no symptoms, which is common increase options for the patient in with umbilical hernias; hiatal herniOne of the obesity related comor- repair complicated. Valley Health Systems/Holyoke abdominal wall hernia repairs, but as cause heartburn and sour tastes bidities is hernia. “Simply stated, a hiatal hernias are repaired during in one’s mouth; incisional, abdomihernia is a hole that allows an organ Hospital treats umbilical, incisional, inguinal and other abdominal bariatric surgery. “But, patients nal and groin hernias tend to cause to protrude into an area where it’s wall hernias as well as hiatal and don’t always present in a manner local pain/pressure and affect some not supposed to be,” Walko expara-esophageal hernias that cause that allows it, so a symptomatic activities. plained. The most common hernia are and contribute to GERD/heartburn. hernia will need to be repaired Hernias usually are diagnosed “Hernias, in general, require rebefore bariatric surgery, at times,” during a physical exam, but someholes in the fascia, which is the times a CT scan is required due to gristle that holds muscles and bodies turning the organ to its proper body he added. If the hernia is causing together. In the case of abdominal space and closing of the hole; it’s debilitating symptoms, is incarcerpatient’s build and the need to look wall hernias, once there’s hole in paramount that any medical probated (stuck out) or is causing bowel for other, smaller hernias. lems that contributed to its formablockage, then it’s usually repaired Obesity carries with it increased the fascia, the hole won’t close on Special To The Republican
“Bariatric surgery begins with patient education for healthier lifestyle choices, better nutrition, weight loss and, as these changes occur, the related health problems like type 2 diabetes, lipid problems and unhealthy lifestyle choices like substance abuse or nicotine abuse are improved by the patient and healthier choices.”
intra-abdominal pressure, type 2 diabetes, pulmonary problems like sleep apnea, vascular problems and can also be accompanied by other health issues like cigarette smoking which increase the risk of complications and additional hernias, explained Walko, who attended Robert Wood Johnson Medical School Camden Campus which is now known as Rutgers Medical School and whose general surgery residency program was five years at Abington Memorial Hospital outside of Philadelphia. “Bariatric surgery begins with patient education for healthier lifestyle choices, better nutrition, weight loss and, as these changes occur, the related health problems like type 2 diabetes, lipid problems and unhealthy lifestyle choices like substance abuse or nicotine abuse are improved by the patient and healthier choices.” In the Holyoke Medical Center program, he has performed at least 100 hernia operations, not including emergencies and several hundred bariatric surgery operations including emergencies. He suggested persons who think they are a candidate for bariatric surgery contact the team at Holyoke Medical Center. “Everyone should bear in mind that your surgeon will meet with the patient, review your health history and formulate the best plan as well as other options,” he said. “When I was a resident, one of my surgical instructors told me … the word ‘doctor’ means ‘teacher,’ and that we should be teaching our patients how to make healthy choices to prevent illness whenever possible. Some illnesses not preventable, but education is still paramount in helping a patient make the best choice in their care.”
For more information, call Holyoke Medical Center at 413-534-2500.