Expert SBIP Medical Group

Patients who have excess skin and fat of the abdomen are candidates for a tummy tuck. Those who have laxity primarily below the umbilicus (belly button) are candidates for a mini-tummy tuck. Loose skin and fat above the belly button require a full tummy tuck to achieve optimal results.

After pregnancy or substantial weight gain, the abdominal muscles are frequently stretched beyond their ability to recoil. Stretch marks below the belly button may be removed when the skin in that area is excised. Above the belly button it is frequently impossible to remove stretch marks. When the skin of the abdomen is tightened however, the texture of the stretch marks usually improves and becomes less noticeable. Once the internal pressure distending the muscles is removed, as with weight loss, it is possible to tighten the muscles during the tummy tuck procedure. The combination of tightening muscles and excising skin and fat from the abdomen may result in dramatic improvements in abdominal contour.

David A Stoker, M.D.
Diplomate, American Board of Plastic Surgery
Member, South Bay Independent Physicians Medical Group, Inc.

"I'm a diabetic and I have tingling and numbness in my feet and I've heard about neuropathy. I wondered how is it treated and how serious is it?"

Diabetic neuropathy is one of the most common complications of diabetes. In fact, many adults already have some evidence of neuropathy at the time they are diagnosed with diabetes.

Neuropathy literally means "sick nerves," …translated to lay mans terms it means the nerves conduct abnormal signals when they shouldn't. This signal can be interpreted as an "unusual sensation, " to a feeling of "walking on pebbles" to numbness or to electric shocks. Diabetic neuropathy can be silent (in other words the feet are just numb) or extremely painful (a constant burning sensation). It is typical for the pain to be worse at night. It usually affects the toes first. It then can progress slowly to involve the entire foot and sometimes lower leg. Usually, only in more advanced stages does it affect the hands.

It is not life threatening, but can be a debilitating complication of diabetes. Often individuals will lose theirs sense of balance. In other words, their feet seem "drunk" all the time. This places an individual at greater risk for falls and makes typical activities more dangerous. It also makes them more susceptible to developing a foot ulcer.

Treatment depends on the symptoms. Doctors often prescribe a variety of medications for the painful type of neuropathy, and it is often a matter of trial and error to see what works best for any individual. Treatment is usually not given for the non-painful form, as there is no medicine to return the nerve function to normal. There have been some studies showing beneficial effects of the nutritional supplement alpha lipoic acid 100 to 200 mg daily.

To prevent the onset OR progression of diabetic neuropathy, meticulous attention should be paid to blood sugar control. Ultimately, to prevent progression, blood sugars should be as normal or "non-diabetic" as possible. Regular alcohol intake can significantly increase the risk of developing neuropathy. Other conditions such as B12 deficiency and thyroid disease need to be ruled out.

Cyntha L. Williams, M.D.
Diplomate, American Board of Endocrinology, Diabetes, and Metabolism
Member, South bay Independent Physicians Medical Group, Inc.

What Is The Most Accurate Test Available For Diagnosing A Possible Thyroid Disorder?

The single most reliable screening test to assess for either overactive or underactive thyroid function is a blood test called TSH (thyroid stimulating hormone). It measures the regulation of the thyroid hormone production by the pituitary gland. There are also other additional blood tests used. It is very important to have the appropriate tests correctly interpreted by the physician. Measuring body temperature is a very inadequate way to diagnose an underactive thyroid condition.

John M. Tsao, M.D.
Diplomate, American Board of Endocrinology and Metabolism
Member, South Bay Independent Physicians Medical Group, Inc.

My Wife Had a History Of Hay Fever and I Have Had Asthma Since Childhood. I Have a 7- year-old Son Who is Developing Hay Fever Symptoms. Is There Anything To Prevent Him From Developing Asthma?

Your family history strongly suggests that your child has allergies to some environmental particles. It is important to find out what these are by consulting your allergist.

There are some reports suggesting that reducing dust mites from the environment early in life may decrease the incidence of asthma later on. Studies also suggest that allergy shots during childhood may prevent the development of asthma.

Charles H. Song, M.D.
Diplomate, American Board of Allergy and Immunology
Member, South Bay Independent Physicians Medical Group, Inc.

I'm a Competitive Basketball Player and Have a History of Spraining My Ankles. It Seems That My Ankles Are Getting Weaker and Weaker as I Age. Is There Something That Can Be Done?

One of the most common injuries in basketball is the ankle sprain. The most common areas of trauma are the lateral ligaments. Every time there is an injury the ligaments get stretched more and more, thus making the ankle unstable and more likely to produce sprains.

There are several surgical procedures available that repair these ligaments and stabilize the ankle. These surgical procedures have a good prognosis and have extended the playing life of many professional athletes.

Eric R. Hubbard, D.P.M.
Diplomate, American Board of Podiatric Surgery
Diplomate, American Board of Podiatric Orthopedics
Member, South Bay Independent Physicians Medical Group, Inc.

I Have Pain In My Heels That Prevents Me From Exercising. I Have Been Gaining Weight And The Increase Results In More Pain In Both Of My Heels. The Pain Is So Bad In The Morning That I Can Barely Limp To The Bathroom. It Gets Better After I Walk A Few Minutes But Returns Whenever I Get Up After Sitting. I Am Only 49 Years Old And I Feel Like An Old Man.

You are describing a classic case of "plantar fascitis". It is a common disorder caused by trauma to a fibrous band that runs along the bottom of the foot. Direct trauma, abnormal motion, bone spurs, and some systemic diseases can produce the symptoms you have mentioned. Conservative treatments include cortisone injections, physical therapy, and oral anti- inflammation medications, stretching exercises, functional orthotic supports, and night splints.

If heel spurs are the cause or conservative treatment is unsuccessful, then foot surgery may be necessary. A new treatment called "Low-Energy Extracorpearal Shock-Wave Therapy" is now available for chronic plantar fasciitis and can be discussed with your Podiatrist. Many articles report success with its use. It is also extremely important to be sure you are wearing the correct shoe. Your Podistrist will happy to measure your foot and discuss proper footwear with you.

Eric R. Hubbard, D.P.M.
Diplomate, American Board of Podiatric Surgery
Diplomate, American Board of Podiatric Orthopedics
Member, South Bay Independent Physicians Medical Group, Inc.

I Have Suffered With Chronic Low Back Pain For Several Years Now and My Doctor Has Suggested Something Called Radiofrequency to Correct the Problem. How Does it Really Work?

In a recent study, 70% of patients experienced pain relief following a radiofrequency procedure for low back pain with relief ranging from two weeks to two years in duration.

The basic principle of radiofrequency involves the placement of a needle with an insulated shaft next to the nerve. Then current is passed through the electrode generating heat in the tissue itself. A coagulative lesion is then formed adjacent the pain producing nerve. The procedure can be repeated without damage or harm to the body.

Patient selection is very important when considering this procedure so be sure to talk with your pain physician about other available options.

Ripu D. Arora, M.D., Q.M.E.
Diplomate, American Academy of Pain Management
Member, South Bay Independent Physicians Medical Group, Inc.

Fireworks are exciting, fun and spectacular, but decades of experience have taught us that they are dangerous and should be left to professional firework handlers.

Every Fourth of July period fireworks send approximately 11,000 individuals to the emergency room and 18 percent of these visits involve an injury to the eye.

Do not allow your children to play with fireworks. Young people, under age 25, suffer over two-thirds of all firework injuries. An estimated 10 percent of these young people injured suffer a permanent damage, such as the loss of an eye, finger or hand.

Although the illegal firecrackers, bottle rockets and Roman candles account for two-thirds of fireworks injuries, seemingly harmless sparklers also cause numerous injuries each year. For children under age five, sparklers account for three-quarters of all fireworks injuries. Fascinated by the bright sparks, young children find these sticks of fire-burning as hot as 1,200 degrees Fahrenheit, hot enough to melt hold - irresistible to touch.

The following steps can help you and your family celebrate safely this year at public fireworks displays:

" View displays from at least 500 feet (¼ mile) away
" Respect safety barriers set up by pyrotechnicians
" Let trained professionals light the fireworks
" Don't touch unexploded fireworks

Aarchan R. Joshi, M.D.
Diplomate, American Board of Ophthalmology
Member, South Bay Independent Physicians Medical Group, Inc.