Are You Missing Out on the Most Up-To-Date Procedures?

Don’t miss out on the latest state-of-the-art medical procedures.

by Meryl Davids Landau
Photograph: Illustrated by Bryan Christie

Midlife women suffer throat polyps at double the rate men the same age do, thanks to our more delicate (and thinning) vocal cords and higher occurrence of acid reflux disease. Typically, benign, precancerous and small cancerous polyps are removed in a surgical procedure that requires general anesthesia and sometimes an overnight hospital stay. But there’s an alternative: unsedated office-based laryngeal laser surgery (UOLS).

During this procedure, the doctor sprays a topical anesthetic on the vocal cords, places a small flexible scope down the patient’s nose, then activates a pulsed-dye laser to treat the polyp or other growth to be removed. “The laser destroys only the abnormal tissue, which is why the complication rate is very low,” says Jamie A. Koufman, MD, director of the Voice Institute of New York. Patients can go back to work, pain-free, the same day. “Our study of over 400 procedures found the results are superior to surgery that requires anesthesia, and patients overwhelmingly prefer it,” Koufman says.

The problem: Insurance companies haven’t yet created a UOLS code, so it’s a battle for doctors to be reimbursed (though they will get paid eventually). As a consequence, many stay away.

If your doctor recommends surgery to remove throat polyps, get a second opinion from an otolaryngologist who does UOLS. You’ll have to call around, but Koufman says these specialists practice in most major cities.

Endometrial Ablation: Stops excessive vaginal bleeding

Women in their forties and early fifties are increasingly prone to menorrhagia, a condition in which the uterine lining grows, causing heavy and painful bleeding. When hormone treatments don’t relieve the problem, women may undergo a hysterectomy, the surgical removal of the uterus (and sometimes the ovaries, too). Fortunately, there’s a much less drastic way to stanch the blood flow: endometrial ablation, a procedure that heats up and destroys much of the uterine lining.

“Over the last decade our options for how to treat the lining have multiplied—and now include a heated balloon, radio frequency waves and microwaves, among others. All reduce or eliminate the lining and thereby curtail the bleeding,” says Charles Cash, MD, chair of ob-gyn at Oakwood Hospital and Medical Center in Dearborn, Michigan. The procedure, which can usually be performed in the doctor’s office, is short (patients are in and out in a couple of hours), painless and has a quick recovery period; you’ll probably be back to work in a couple of days.

“Older doctors in particular don’t offer patients this option because they’re used to performing hysterectomies
to deal with bleeding problems,” Cash says. Some also worry that a woman will end up needing a hysterectomy later on, but a recent Kaiser Permanente study found that’s much less true for women 40 and older than their younger counterparts.

If your doctor recommends a hysterectomy for your bleeding, consult with a gynecologist who performs ablations to discuss whether that treatment might be right for you.

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