Recently Published Articles
Dr. Wakily continues to research and study an array of health care topics. More recently, she's had the opportunity to publish some of her work in various medical journals and news sources. Her publications are very helpful to fellow doctors as well as medical students who are interested in learning more about surgery. Please feel free to read some of the publications below.
"I have a hernia, now what?"
June 17, 2019
Hernia Evaluation and Management
If you were just told that you have a hernia, then you probably have a few questions that need to be answered. First off, what exactly is a hernia? A hernia caused when there is a weakening in the abdominal wall creating a defect or “hole” that allows the intestines or other contents of your abdomen to protrude out, creating the bump that you feel. This sounds scary but there are many types of hernia and degrees of severity.
The biggest factor that will determine the next step is whether you have symptoms or not. If you have symptoms of pain, nausea, vomiting or if the bump will not go back in, then you need to see a general surgeon in the office or emergency room. If you occasionally have pain that comes and goes, you can be seen in the office. Most of my hernia patients are seen in the office for evaluation.
You are probably wondering what to expect at this upcoming visit. This is where you get to tell your surgeon how the symptoms present and how long you have had them. Sometimes they can be related to lifting something too heavy at one point, or chronic heavy lifting. There are many other causes which you and your surgeon will discuss. A physical exam will also take place to give the surgeon a chance to evaluate the size and type of hernia repair you will need. Sometimes the hernia best appears when you are standing up, so your exam may be standing or lying flat depending on location.
What are you options at this point? You will get the options of either surgery or no surgery. This depends on your surgeon’s evaluation of your existing risks. They will decide if surgery is safe for you or if a conservative route is more beneficial. The alternative to surgery would be nonoperative observational period. Observation allows you to better optimize your health or weight, if that is an option. Some people may not have any further issues with the hernia, but again this is different for everyone.
If you fall in the surgery option, then you will want to discuss with your surgeon the best repair for you. There are many options for repair including an open, laparoscopic or robotic repair, with or without a mesh. The type of repair you will have depends on your hernia and surgeon’s preference, comfort and experience. They will also talk to you about the post-operative expectations as well. It is very important that you ask all your questions at that time.
I have seen that patients do much better in the post-operative course when their expectations are addressed. Explaining the any type of discomfort, swelling, and even possible complications in detail allows patients to be mentally prepared and get through the healing phase much better and faster. So, if you are told you have a hernia this article should give you some guidelines of what to expect and possible questions to have addressed in your office visit.
Colon Cancer Awareness and Prevention
May 24, 2019
What is colon cancer?
Cancer of the colon and the rectum is a malignant growth/tumor arising from the colon or rectum. Colorectal cancer is the third leading cause of cancer for both sexes in the United States. It is a major cause of cancer-related deaths among men and women in the United States.
As a surgeon I want to make people aware of the fact that colorectal cancer can be both curable and preventable if it is detected early and completely removed before the cancerous cells spread. to other parts of the body. Colorectal cancer can be prevented by removing colorectal polyps before they grow and change into cancers.
Who is at risk?
Certain lifestyle factors are known to increase the risk of colorectal cancer which includes being overweight/obesity, excessive alcohol use, smoking cigarettes, a diet low in fiber, a diet high in red meat, as well as a sedentary (not physically active) lifestyle.
A family history of colon cancer, inflammatory bowel disease or certain colon polyps can increase the risk of colon cancer. Certain genetic syndromes like familial adenomatous polyposis or hereditary non-polyposis colorectal cancer.
What can help decrease my risk of colon cancer?
Fortunately, there are a few things that you can do to decrease you chances of colon cancer. Most colorectal cancers come from colorectal polyps. Even though colorectal polyps are initially benign, they can grow and change into colorectal cancers over a period of time ranging from five to twenty years. This is where early screening and identification are key to prevention or a better prognosis.
The best tools for both preventing and detecting early colorectal cancers are the Colonoscopy and flexible sigmoidoscopy, along with digital rectal examination and stool occult blood testing. New screening guidelines for those at average risk is 45 years old for a colonoscopy. Prior to this the age was 50 years old but new studies have shown that younger adults are getting colon cancer at earlier ages. The age was dropped to 45 years old with the goal of saving more lives with early detection.
For those with higher risk factors they need to be evaluated based on the risks and a discussion with their physician for the appropriate age to start screening.
Lifestyle changes can also contribute to decreasing risks of colorectal cancer. Increasing exercise, weight loss, diet high in fiber and lower in red meat, as well as stopping smoking and decrease alcohol intake. The key to prevention of colorectal cancer is screening and lifestyle modifications. For those with higher risk the goal is also early detection to improve prognosis.
In this increasingly busy world it is important to remember to take care of yourselves. Health is the greatest wealth you will have.