Health News and Information

Laparoscopic surgery for endometriosis is any surgery that attempts to remove or destroy endometrial implants, cysts and adhesions during a laparoscopy.

Laparoscopy was originally only used as a means of diagnosing endometriosis but over the years it has been used increasingly as a way of surgically treating the condition. It is now common for some laparoscopic surgery to be performed at the time of a diagnostic laparoscopy – assuming the woman agrees and laparoscopic treatment is appropriate.

In the early days of laparoscopic surgery only simple procedures were performed but as experience with the technique has increased surgeons have treated increasingly severe cases and performed more complex procedures. The complexity of the procedures that your gynecologist will attempt will depend on his or her level of training and experience.

Who is suitable for laparoscopic surgery?

Laparoscopic surgery is generally only suitable for women with minimal or mild endometriosis, though in some cases it may also be appropriate for women with moderate disease.

Things to discuss before laparoscopic surgery

Before your operation you should discuss with your gynecologist what he intends to do during the operation and what should be done if more extensive surgery is necessary.

What happens with laparoscopic surgery?

The basic routine for laparoscopic surgery is the same as that described for a diagnostic laparoscopy except that in addition to inspecting the pelvic organs, one or more of the treatment procedures outlined below will be performed.

Procedures that may be performed include the removal or destruction of superficial implants and small cysts, the removal of adhesions, the removal or destruction of endometriomas and the removal of an ovary. Few gynecologists are able to perform the latter two procedures but it is possible that in the future more surgeons will be able to do so.

Any superficial implants and small cysts on the peritoneum and ovary will usually be destroyed by cauterization. Cauterization involves the use of a heat source or electrical current to destroy or ‘burn’ the implants or cysts. As the depth of the burn cannot be precisely controlled cauterization is not used if there is any danger of damaging any important underlying organs, such as the fallopian tubes, bowel or bladder. It is not always possible to destroy all the implants and cysts present. Larger cysts may be removed by cutting them out.

Adhesions can be removed by cutting or cauterization but again it may not be possible to remove all the adhesions present.

Effectiveness of laparoscopic surgery

Laparoscopic surgery has several advantages over conservative laparotomy because being minor surgery as opposed to major surgery it is associated with fewer risks and complications, causes less discomfort and has a shorter recovery period. It can also readily be done at the time of diagnosis which means that only one bout of surgery, one hospital stay and one recovery period are needed.

It is not possible to compare the results of laparoscopic surgery with other forms of treatment as there are no reliable figures available at present. The impression of many gynecologists is that laparoscopic surgery relieves the symptoms in many cases and it restores fertility in some cases.

Risks and complications of laparoscopic surgery

The risks and complications of laparoscopic surgery are the same as those associated with a diagnostic laparoscopy except that there is the additional risk of damaging organs during cauterization.

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Educational therapy, sometimes known as psycho-educational therapy, involves teaching people the facts they need to overcome their disorder. It is not always a substitute for psychotherapy but can be a very helpful adjunct to it.

Some of the best work in this field has come from eating disorder specialists at the University of Toronto. They recently conducted an important piece of research comparing the effectiveness of different treatments in reducing the symptoms of bulimia. Amazingly enough, they found that for the healthiest 40 percent of the bulimia patients, educational therapy-in the form of a short lecture course-was as effective as a much longer treatment involving individual cognitive-behavioral therapy. The lecture course gave information about bulimia as well as self-care strategies to help the patients learn how to return to normal eating habits. The findings of this research suggest that it makes sense to begin treating bulimia patients with educational therapy and reserve costly, time-consuming individual therapy for those who don’t get better after learning the facts about their disease.

I can think of few other illnesses in which there can be such a dramatic therapeutic response after taking the simple step of learning the facts. In the next few pages, let’s review some of these facts as they might be covered in a course of educational therapy.

Our society keeps turning up the pressure to be thin. As a result many women resort to severe dieting. Our bodies, however, operate under biological rules. Each of us has a certain predetermined weight range-the set point range-that our bodies fight to maintain. For many people, this range is higher than what society says is the “ideal standard” for beauty.

Excessive or constant dieting robs the body of the food it needs to maintain the weight it prefers. The body then turns up the volume on the “hunger” signals. The result: bingeing.

Some people then try to undo the damage by purging, which leads to a vicious cycle. The woman binges with less guilt, since she knows purging will protect her from gaining weight. And she binges because it’s easier to vomit with a full stomach. Purging also keeps the body in a constant state of semi-starvation and dehydration. The cycle leads to anxiety and depression, which the woman then attempts to relieve through further eating.

After prolonged disruption, a person’s body may lose its ability to control eating. A woman must then relearn what it means to feel hungry, how to eat properly, and when to stop eating. She also has to learn to feel comfortable and not feel anxious when her body returns to its natural set point weight range.

But how does she know what that range is? In other words, what should her “goal,” or target weight, be? That’s something educational therapy can show her. First, the weight should be such that she can maintain it easily. She should be able to stay at that weight without resorting to extreme dieting, which as we have seen promotes bingeing. Secondly, the goal should be an individualized weight, not one derived from statistical charts.

Actually, the best goal is really a “no-goal.” By that I mean the woman should stop thinking in terms of weights and numbers and concentrate instead on learning better habits. Through psycho-education, she learns how to eat reasonably, exercise regularly, and develop ways of coping with stressful feelings without using food as self-medication.

Reaching this no-goal, however, usually occurs at the end of therapy. There are lots of steps in between, some of which involve setting up concrete objectives and working to achieve them. For example, an anorexic needs to know how much weight she has to regain. Her target should be neither too high nor too low, and should be a range rather than a precise number. As a rule, I ask patients to reach roughly 90 percent of the stable highest weight they had prior to the onset of their disorder. Each patient is different, but many find they can reverse starvation and maintain a reasonable weight without subsequently feeling the urge to binge and purge.

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Jeanann Pock isn’t what you’d call a morning person. But with a little help from legendary football coach Vince Lombardi, the Zionsville, Indiana, woman found a way to resist the snooze alarm. She ended up losing 85 pounds as a result.

In 1992, Jeanann was a 22-year-old college graduate about to embark on a career in university public affairs. At 5 foot 2 and 200 pounds—she gained about 20 pounds in each of her last 3 years of college—she wondered whether she would be able to meet the demands of her new job. “Being overweight made everyday activities so much more tiring than they used to be,” she explains. “I made up my mind to slim down.”

Armed with information from the university library, Jeanann began trimming the fat from her diet and walking on a daily basis. She planned her walks for first thing in the morning so she’d be certain to fit them into her schedule. The trouble was that she had a hard time getting up early. At 4:45 A.M., all she wanted to do was snooze.

At about that time, Jeanann happened to be reading What It Takes to Be Number One, a book by legendary football coach Vince Lombardi. She was struck by one particular passage, in which Lom-bardi wrote, “Winning is not a sometime thing; it’s an all-the-time thing.”

His words provided the motivation that Jeanann needed. “I understood that to succeed at weight loss, I had to win every little battle along the way—including my morning skirmishes with my alarm clock,” she says. “I had to think like a winner to be a winner.”

From that point on, Jeanann had a new morning ritual. Rather than hiding her head under her pillow to block out her alarm clock’s ring, she repeated to herself Lombardi’s words. And then she asked herself, “Do I really want to be fat?” That got her out of bed and into her running shoes.

It also kept her weight-loss program on track. “After all, a winner doesn’t give up when she’s halfway to the finish line,” Jeanann says. Within a year, she got rid of all 85 unwanted pounds. She has maintained her weight at a healthy 115 pounds ever since.

WINNING ACTION

Give yourself a pep talk. All of us have moments when we need a little extra push to help us stick with our weight-loss programs. At times like these, having some sort of personal slogan can help. Think of a quotation, a song lyric, or a prayer that gives you inspiration and strength. If you can’t come up with one, create your own affirmation. For example, “My body is getting stronger, slimmer, and healthier every day.” You can repeat your slogan to yourself whenever you need to, or you can make it part of a daily ritual, as Jeanann did. It can help you get over the bumps on the road to weight-loss success.

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What threatens your immunity? What is it your immune system protects you from? Antigens. Antigens are viruses, bacteria, cancer cells, fungi, protozoa (microscopic animals), particles, and anything else that challenges your immune system.

Antigens are the reason the immune system exists. If there were no antigens, to worry about, there would be no need for an immune system.

Not every antigen will excite the immune system into action. Some cancers for example, may disguise themselves in such a way that they remain in the body, undetected by the immune system, until it’s too late.

Of course, antigens don’t take being attacked lying down. They have their own weapons, strategies and tricks. Some antigens try to fool the immune system by changing their surface configuration, so they won’t be recognized. Others battle the immune system, hoping to overwhelm it. As the microscopic battle rages, millions of our immune soldiers die. The AIDS virus seems particularly adept at crippling the immune system’s ability to mount a defense.

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If you’re a stress seeker, it doesn’t take much to trigger your stress response. An angry thought, a glance at a clock, a look at the freeway traffic and the chemical fireworks begin. Highly charged chemicals get your heart beating faster and more vigorously, raise your blood pressure and increase the number of circulating blood cells. Muscle tension and strength increase; pupils dilate for better vision. Blood sugar rises, making more energy available.

These changes occur almost instantaneously as the stress seeker prepares to fight off threats to his or her life. But how do you fight off traffic? You can’t punch your boss when you’re told that your work is unsatisfactory. You can’t smash your watch because you’re late for an appointment. Are you going to take an ax to the car that backfired and woke you up?

So the high-voltage chemicals flooding your body are useless— worse than useless, in fact. With no outlet for their energy, they turn on you, jolting various parts of your “doctor within.” If that keeps up, you will eventually blow a fuse.

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Day 1

Lunch: Fruit salad

Whole-wheat bread

Cold, sliced, sweet potatoes

Dinner: Steamed fish

Steamed crucifers Side of kasha

Wedge of lettuce with sliced tomatoes

Day 2

Lunch: Sandwich-Bag Vegetables Whole-wheat tortilla Sprouts Plain yogurt Fruit

Dinner: Mama Fox’s Spaghetti Sauce Whole-wheat pasta

Romaine lettuce, cucumber, tomato, radishes

Day 3

Lunch: Dinner:

Day 4

Lunch: Dinner:

Day 5

Lunch: Dinner:

Day 6

Lunch: Dinner:

Day 7

Lunch: Dinner:

Mixed Sprouts and Raisins Whole-wheat pasta (leftover) 1/2 papaya or an apple

Simple Baked Chicken Vegetable and Barley Soup Dr. Fox’s Super Salad

Homemade Strawberry Yogurt Whole-wheat bread 1/2 melon or grapefruit

Flippers’s Choice Baked potato Eastern Salad

Pita Sandwich Fruit

Sandwich-Bag Vegetables

Pety’s Chili with bread

Zucchini Soup

Sliced tomato and cucumber

Fruit

Dr. Fox’s Favorite Sandwich-Bag Vegetables 1/2 melon or grapefruit

Spinach Lasagna L.A. Sprout Salad Fruit Salad

Fruit Salad Whole-wheat bread Sandwich-Bag Vegetables

Passyunk Fish Steamed Vegetables Dr. Fox’s Super Salad Cucumber and carrots

Day 8

Lunch: Tomato-Tuna Cottage Cheese Banana Whole-wheat bread

Dinner: Robin’s Pineapple Chicken and Rice Green Bean Cecy Sliced apple

Day 9

Lunch: Sandwich-Bag Vegetables Whole-wheat bread Fruit

Dinner: Kasha (Buckwheat) and Fish Steamed Vegetables Orange

Day 10

Lunch: Rodeo and Wilshire Yogurt

Whole-wheat bread

1/2 melon or grapefruit Dinner: Margarita’s Black Beans and Rice

Crucifer and Carrot Slaw Salad

Banana and/or orange

Day 11

Lunch: Vegetable Soup

Pita Sandwich Dinner: Chicken and Red Pepper Rice

Steamed Vegetables

Dr. Fox’s Super Salad

Day 12

Lunch: Cold sliced chicken breast in pita Fruit Salad

Dinner: Bean Lentil Supreme Steamed Vegetables

Day 13

Lunch: Sandwich-Bag Vegetables Crunchy Potato Salad Apple

Dinner: Tuna Sprouts

Brown rice or barley Shredded carrots and cabbage

Day 14

Lunch: Beverly Hills Coleslaw Salad Tuna Sprouts in pita

Dinner: Mixed beans

Steamed Vegetables

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Fibrous Super Foods are especially helpful in fighting cancer and intestinal disorders. Eating a lot of fiber makes your stool bulkier and softer, pushing it rapidly through the bowels. Getting the stool out faster reduces the amount of time your gut lining is exposed to potential carcinogens in the stool. In addition, fiber promotes the growth of aerobic bacteria (bacteria that requires oxygen to live) in the intestines, rather than the anaerobic bacteria encouraged by the low-fiber S.A.D. The S.A.D.’s anaerobic bacteria can break down bile acids into cancer-causing substances.

Thanks to the large amounts of fiber in my Super Food diet, straining and constipation are eliminated. This protects against hemorrhoids, appendicitis, varicose veins, diverticulosis (weak pockets in the large intestine caused by straining and constipation) and diverticulitis (an inflammation of those weak pockets). Gastroesophageal hiatal hernia, a condition that allows acid to pour onto the lining of the esophagus and cause the common “heartburn,” is also greatly ameliorated by the fibrous Super Food diet.

I’ve found fiber-rich diets to be useful in combating both insulin-dependent and noninsulin-dependent diabetes. Most of my diabetic patients, who have given up the S.A.D. in favor of a Super Food diet rich in fibrous foods have been able to reduce the amount of insulin they must take. Many can eventually do without insulin altogether.

High-fiber diets have another benefit: they can help you lose weight. Since we don’t digest and absorb fiber, it adds no calories to our diet. It also gives us a full feeling, so we don’t rush right back to the refrigerator after a meal.

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Every illness dealt with here can be caused in some other way as well, and it is important to remember this when thinking about your own problems. What makes food intolerance likely is if you have two, three or more of these symptoms, especially if your doctor has been unable to find any cause for them.

No-one with food intolerance will have all these symptoms – most patients have two or three major symptoms and several minor ones, but some people have just one symptom. No two patients with food intolerance are the same, and each one has a different collection of symptoms, acquired in a different order, and at a different time of life. Food intolerance can begin at any age, and it may disappear in a child as it grows up, only to reappear later, often in a different form.

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Every illness dealt with here can be caused in some other way as well, and it is important to remember this when thinking about your own problems. What makes food intolerance likely is if you have two, three or more of these symptoms, especially if your doctor has been unable to find any cause for them.

No-one with food intolerance will have all these symptoms – most patients have two or three major symptoms and several minor ones, but some people have just one symptom. No two patients with food intolerance are the same, and each one has a different collection of symptoms, acquired in a different order, and at a different time of life. Food intolerance can begin at any age, and it may disappear in a child as it grows up, only to reappear later, often in a different form.

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Although each kind of cell is different in structure from the others, they all have basic similarities. The cell’s most important part is the nucleus, just like the yolk of an egg. The nucleus is, as a rule, surrounded by a nutrient reserve, similar to the egg white that envelops the yolk. The cover holding everything together in the cell is the cell membrane. The cell itself is a small state within a state and enjoys a certain independence. There are even cells that circulate or wander for the purpose of being on hand wherever their help may be needed. That is why they are called ‘wandering cells’. We can say that every cell has it own internal regulations, and absorbs and releases certain substances. This process is called metabolism. The cell uses the absorbed nutrients and changes them into energy, or it converts them into a new substance that serves the body, especially in its growth.

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