QUESTION: A friend had a gallstone attack while traveling. They got him off a plane and into the hospital. He had the gallbladder taken out with "laparoscopic cholecystectomy." He said it's the way to go. He was out the next day. What is this? - A.Q.
ANSWER: Your friend had the very latest surgery has to offer in gallbladder removal.Laparoscopic cholecystectomy involves use of a tiny TV transmitter. It is inserted into the abdomen through an incision less than a half inch wide. At the same time, two or three other similar incisions are made, through which are inserted small grappling hook affairs with which the gallbladder is grasped and removed. You can see it on the TV and are left with relatively small incisions, which are sealed with adhesive bandages until they heal.
Laparoscopic cholecystectomy is not being done everywhere but is gaining adherents in more and more hospitals.
I haven't space to list other, more conventional or other new and sophisticated procedures for such removal. I am sending you the gallstone report, which other readers may order by writing: Dr. Donohue/No.40, Box 830, Gibbstown, NJ 08027. Enclose a long, stamped, self-addressed envelope and $2.
QUESTION: What's your opinion about mitral valve prolapse? Your previous references seem to downgrade its significance. That ain't the way I heard it - Mrs. H.G.
ANSWER: Let me describe this. The heart valve involved is the mitral, a one-way valve that prevents backflow of blood from the lower left chamber to the one above during contractions. When the valve balloons upward into the upper chamber, that is called prolapse.
MVP is common and mostly benign, the words I often use to describe it generally. As many as three of 10 people have it.
Now there are times when you have to do something about such prolapse, and one such time is when it results in actual leakage of blood into the upper chamber. And if a patient were to develop irregular heartbeats as a result of the prolapsed valve, he might need medicines to regulate things.
There's another point to be made, and I've made it many times. With MVP, the doctor may want the patient to take antibiotics prior to such events as dental surgery. Common mouth bacteria can get into the blood from dental wounds and travel to that valve, making it a haven for their growth. Otherwise, in the absence of any serious symptoms from MVP, you can scratch it from your worry list.
QUESTION: I am only 16, but I'm supposed to find out what it is my grandfather has. It's called polymyalgia rheumatica, PM for short. He was going down the tubes, but he takes medicine now and is fine. We just want to know more. - Ms. H. (Don't use my initials).
ANSWER: PM is an illness of older people. It causes muscle aches, especially in the hips, shoulders, upper arms and neck. It often is treated with cortisone drugs. Thanks to such drugs, PM is well treated today. We don't know what causes PM.
Let me introduce another term here - temporal arteritis. It is sometimes found with PM. Often scalp arteries are inflamed and this causes severe headaches. If your grandfather has any such symptoms, he should report that. It has to be treated, again with cortisone drugs, to ease the inflammation. Otherwise sight can be threatened.
Dr. Donohue welcomes reader mail but regrets that, due to the tremendous volume received daily, he is unable to answer individual letters. Readers' questions are incorporated in his column whenever possible.