DEAR DR. DONOHUE: I have been diagnosed with gallstones, which were seen on an ultrasound. My doctor told me I could go home and decide when to have my gallbladder removed. My question is what the dangers are of waiting awhile to have it done. I do have pain, but it is minor when I watch my diet. – C.D.

DEAR DR. DONOHUE: We have inquired about laparoscopic removal of the gallbladder but cannot find anyone in the United States who does it. Can you refer us to a physician? – S.T.

Some facts on gallstones and gallbladders will clear the air. More than 20 million North Americans are walking around with stones in their gallbladders. Yearly, about 2 percent to 3 percent of these people have their gallbladders removed. The rest remain pain-free and blissful.

One severe gallbladder attack all but assures a repeat attack in two to five years. A severe attack consists of intolerable pain in the upper right side of the abdomen, and the pain often spreads to the right shoulder or to the back. It comes on within 15 to 60 minutes of eating and can last for several hours. Nausea and vomiting often accompany the pain.

Because a severe attack pretty much guarantees a second attack, the suggestion is to have surgery soon. A delay does not hurt health, but it only postpones the inevitable.

If the stones have not caused pain or have brought only minor discomfort, the gallbladder and its stones can be left in place.

I cannot believe S.T. is having trouble finding a surgeon who performs laparoscopic surgery. Such surgery is performed via small abdominal incisions through which the scope and cutting instruments are passed. Recovery from such surgery is rapid.

S.T., call the surgical department of a nearby large hospital, and it will provide you with a list of surgeons who operate with a laparoscope.

DEAR DR. DONOHUE: I am a healthy man, age 80. I have never been sick until recently, when I was diagnosed with a lymphoma. What are the treatments for it, and what are the chances for a full recovery? – L.B.

Forgive me. I have to tap-dance around your question because lymphomas come in many varieties, each with its own treatment and prognosis.

A lymphoma is a cancer of lymph nodes, the body’s sanitation stations that filter out germs and foreign matter. Lymphomas are divided into two major classifications: Hodgkin’s disease and non-Hodgkin’s lymphoma.

Those two classes are further subdivided into categories that have their own treatments and prognoses. The division is made based on symptoms a patient has, the lymphoma’s spread or lack of spread, and the appearance of the cancer when viewed microscopically. Microscopic evaluation of lymphoma cells determines if the process is a felon or only a petty criminal.

Treatment for lymphomas consists of radiation, chemotherapy or a combination of radiation and chemotherapy. For people with lymphomas that deviate only slightly from normal appearance and are located in only a few lymph nodes, observation might be the treatment of choice.

For many lymphomas, a cure is anticipated.

DEAR DR. DONOHUE: In this morning’s paper, I think there is a little typo in your column. You have written that people need 0.136 grams of protein for every pound of body weight. The correct figure should be 0.36 grams. I am sure it was a miscue that crept in. – T.E.

T.E. is a New York state physician whose patients ought to be eternally happy they have him for their doctor. Not only is he a smart and supercompetent doctor, he also happens to be quite tactful.

Readers, T.E. is right. People should have 0.36 grams of protein for every pound of body weight. I don’t know how that “1” crept into my answer. I bear the full responsibility for the mistake.

DEAR DR. DONOHUE: I wonder if you can share my father’s experience with your readers. He was treated for the past 10 to 15 years for heartburn and gastric reflux. Recently he saw a program that stated that a large majority of heartburn cases are not caused by the stomach but by the heart and are often mislabeled as heartburn. He mentioned this to his doctor, and the doctor decided to do a stress test. It showed trouble. Cardiac catheterization showed a blockage to the main heart artery.

My father never told his doctor that his heartburn occurred only during times of stress and exertion. We are extremely lucky that this was discovered and rectified. Could you alert your readers to this dangerous situation? – D.W.

Readers will appreciate and learn from your father’s story. Thank you.

The topic of blocked heart arteries is discussed in the angina report. Readers can obtain a copy by writing: Dr. Donohue – No. 1, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 along with the printed name and address of the recipient. Please allow 4-6 weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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