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Doctor Q&A for Dr. Barry Rosen

A 48-year-old female asked:
Dr. Barry Rosen
General Surgery 34 years experience
2 Different Issues: Mastectomy or Lump-x + Radiation RX are LOCAL treatments of breast cancer, with EQUAL survival rates. One or the other is necessary for all breast CA pt's. CHEMOTHERAPY ("drugs") are SYSTEMIC (whole body) RX's for certain breast cancers. Her2Neu (+) cancers are particularly sensitive to Herceptin (trastuzumab). Please meet with your oncologist to understand the different options you have. Good luck.
A 62-year-old female asked:
Dr. Barry Rosen
General Surgery 34 years experience
Scar Tissue is...: ...An inevitable and expected outcome after every operation. Your oncoplastic procedure likely "rearranged" the breast tissue, creating scarring in the area of the lumpectomy and below the areola, along the "inverted t". If you had radiation therapy, this will increase the scarring further. Best bet: ask your surgeon--depending on the timing, breast massage may help.
A 28-year-old female asked:
Dr. Barry Rosen
General Surgery 34 years experience
Nope: Congrats on the benign results! we have been performing core biopsies for over 30 years and have not found any association between benign biopsies and cancer development. Moreover, surgical biopsies are more "traumatic"--we've been doing those for 100+ years without any increased cancer risk.
A 37-year-old male asked:
Dr. Barry Rosen
General Surgery 34 years experience
Cremaster Muscle: The vas and blood vessels to the testicle are covered by a muscle layer that has to be divided when performing an open inguinal hernia repair, called the cremaster muscle. Depending how extensive the dissection, your testicle may not raise up any more. While i can understand your concern, this should have no major effect on your testicle function. Please discuss with your surgeon.
A 59-year-old female asked:
Dr. Barry Rosen
General Surgery 34 years experience
Plz See GI Doctor: Postcholecystectomy syndrome is the persistence or return of RUQ abd pain following gallbladder removal. This is due to non-biliary causes (irritable bowel, ulcer dz, gerd, etc), organic biliary dz (common duct stones/stricture/cancer), or functional biliary disease (sphincter of oddi dysfunction). I advise GI work up to include labs, ultrasound+/-ercp, depending on above results.
A 39-year-old male asked:
Dr. Barry Rosen
General Surgery 34 years experience
No--depends on...: ...What is "stuck" within the hernia. The most common tissue "incarcerated" is fat from just beneath the muscles; this is often painless. If it is internal fat from the omentum, this can be painful. If it is a loop of intestine, this causes a bowel obstruction or even compromise of the blood supply to the intestine ("strangulated" hernia)--this is usually very painful.
A 27-year-old female asked:
Dr. Barry Rosen
General Surgery 34 years experience
Possibly: Spigelian hernias are notoriously difficult to diagnose since the hernia is in the inner muscle layer of the abdominal wall; since there is intact fascia above the hernia, one often cannot see or feel a bulge. Therefore, your pain certainly may be due to the hernia. Diarrhea is rarely due to hernias, but it's possible. More importantly, if you have a spigelian hernia, you should have it repaired.
A 28-year-old male asked:
Dr. Barry Rosen
General Surgery 34 years experience
Expected: Unfortunately, testicular pain is the norm after inguinal hernia repair, especially in the first week. Did your surgeon give you any instructions for treatment of postoperative pain? If so, follow these. If not, you may want to call your surgeon's office for recommendations.
A 34-year-old female asked:
Dr. Barry Rosen
General Surgery 34 years experience
Apples ; Oranges: Mammograms can see things which cannot be felt; breast (self) exam can sometimes find lumps that cannot be seen--these modalities complement one another. That said, we usually do not recommend mamms until age 40. If one has a suspicious lump by either modality, (nonsurgical) needle biopsy is the only means for definitive diagnosis.
A 25-year-old male asked:
Dr. Barry Rosen
General Surgery 34 years experience
SurgeryOnlyOption: Umbilical hernias may be easily repaired under general anesthesia as an out-patient. Depending on the size of the hernia and other patient-factors, we often advise using mesh to close the hole (like patching a tire). I advise hernia repair if it is causing symptoms that are interfering with one's quality of life, or if the hole is so large that there is the potential for intestine to get stuck.
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