Dry eyes and surgery

Punctal plugs for dry eye

Dry eyes affect anywhere from 10-20 percent of the adult population in North America. Often dry eyes are associated with symptoms like itching, burning and a foreign body sensation in the eye. The vision can also become blurred. It is impossible to wear contact lenses with dry eyes.

It is known that tears drain down the lacrimal duct located on the nasal corner of the eyes. Some eye physicians recommend plugging the opening of the duct, so that the tears stay on the eye instead of draining away. The procedure is done as an outpatient and is of short duration. 

Unfortunately, despite inserting plugs to block the duct, very few people find this of any benefit. The reason is that in many people the dry eyes is caused by lack of tears and not due to excessive drainage. 

Plugging of the lacrimal duct is an expensive procedure and rarely helps people with dry eyes- definitely not recommended.

Qeutiapine for bipolar disorder

Quetiapine is frequently used to treat schizophrenia and bipolar disorder. It works well and is just as effective as another atypical antipsychotic drugs. However, unlike the other antipsychotics it has a slightly lower risk of movement disorders. Unfortunately, it can cause weight gain, dry mouth, sleepiness and there is a higher risk of dizziness. To avoid the weight gain, there is no magic bullet-work more and eat less

Back surgery and prolapsed disc

After low back surgery, what is the recurrence rate of a prolapsed disc?

This depends on whom you speak to. If you speak to surgeons, they claim they have no recurrence rates and that all patients are happy and gainfully employed. If you speak to patients who have had back surgery, then the majority will claim that they have not improved and feel like the prolapsed disc has recurred.

From MRI studies done in patients after back surgery, it appears that anywhere from 10-40% have some degree or residual stenosis or recurrent prolapse within a few months.

In simple, unless you have a life threatening problem with the back, avoid back surgery at all costs. Some orthopedic surgeons will simply butcher you- trust me, I have seen plenty of them in action.

Relaxation for Depression

Can relaxation help symptoms of depression?

Many people with depression do not want to take medications-chiefly because they are expensive and also have serious side effects. For this reason many people seek non-drug therapies.

One such therapy widely used to treat depressed patients is relaxation. This simple form of behavior therapy is not as effective as medications or cognitive behavior therapy, but does help people with mild forms of depression; Relaxation may involve yoga, tai chi or meditation. It is relatively cheap and complication free. If this fails, you can pursue other therapies. For people with moderate to severe depression, relaxation is often combined with drug therapy to get the maximum benefit.

Risperidone for Schizophrenia

Is risperidone effective for schizophrenia?

Schizophrenia is serious chronic mental health disorder which affects a high number of people. The first line of treatment is use of antipsychotic medications. Risperidone is a relatively old medication and works well in schizophrenia. Most people seem to respond to the high dose (6-10 mg per day) compared to the lower doses of 2-4 mg. Unfortunately when high doses are used, the drug does induce weight gain, causes hyperlipidemia and may also cause movement disorders. If it is working work you, I would not change it. Just eat less and walk more to avoid the weight gain.

Robotic surgery for gallbladder

I have gallstones and my surgeon says he will do the surgery with a robot. Is this helpful?

Another gimmick designed to rip-off patients. Robotic surgery has it uses, but not for removal of the gallbladder. Laparoscopic cholecystectomy is already done with 4 small skin incisions and is now the gold standard. With the use of a Robot, the only difference is the cost, which can range in the tens of thousands of dollars, instead of the few thousand done laparoscopically. 

Please change your surgeon as he/she simply wants to experiment on you. Robotic surgery to remove the gallbladder is a complete waste of money and  time, as it may take a whole day depending on the surgeon’s skill. There is no advantage of using a robot to performing most surgeries, especially not the gallbladder. However, hospitals and surgeons need to make money to pay for their luxurious lifestyles.