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First of all, congratulations for asking. One of the best ways to prepare for any surgical procedure is to have some basic knowledge about it.

An abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen. Your uterus (or womb) is where a baby grows if you're pregnant.

A hysterectomy can be performed through an incision in the vagina (vaginal hysterectomy) or by a laparoscopic approach, which uses laparoscopic instruments passed through small abdominal incisions. Abdominal hysterectomy may be recommended over other surgical approaches if you have a large uterus or if your doctor wants to check other pelvic organs for signs of disease. A partial hysterectomy removes just the uterus, and a total hysterectomy removes the uterus and cervix. A total hysterectomy can also include removal of the uterus, cervix, ovaries and fallopian tubes.

I recommend that my patients spend a little bit of time writing their questions before they come to my surgery. In that way the consultation is productive, informative and provides peace of mind. Try doing the same next time with your own doctor. Best wishes

Dear Dr. De La Flor,

I’ve been using several over-the-counter medications for my ear but I don’t seem to be getting better and sometimes I feel dizzy. Why is that?

John

Dear John,

The scenario you described sounds typical of a problem with the Eustachian tube, which connects the middle ear with the throat. The ear feeling clogged and the clicking during a cold or sinus infection are a result of the Eustachian tube, the ear’s natural drainage tube, getting swollen shut or, more commonly, partly shut.

That swelling can create a clicking or popping noise, a feeling of ear fullness, a mild earache or even a sense of disequilibrium (being off balance, dizzy). The swelling can commonly last a couple of weeks. If the tube stays completely swollen for more than a couple of days, you could even begin to build up fluid behind the eardrum. In addition to colds, nasal allergies, sinus infections and even stomach acid reflux can cause the Eustachian tube swelling.

A middle ear infection from infected fluid behind the eardrum will cause muffled hearing and usually severe pain. This is usually the end result of the Eustachian tube being swollen completely shut for several days. Usually, antibiotics are not needed for the sensation of fullness, clicking and mild pressure. In fact, for just plain Eustachian tube dysfunction (or ETD) without infection or allergies, we do not really have a proven medical treatment that is any better than just 'waiting it out.'

If there are other signs of a lingering sinus infection or the beginnings of an ear infection, antibiotics may be helpful. Other medications such as prescription nasal sprays can at times help treat Eustachian tube dysfunction as well, especially if there is a lot of swelling in the nose from the remnants of a cold or allergies.

Finally, try not to worry about the popping and clicking when you blow your nose, that is just the Eustachian tube trying to open up to get the ear aired out again. These symptoms will go away once the Eustachian tube is working properly. If your ear congestion is not clearing in about 2 weeks, then getting evaluated by your GP or an otolaryngologist may be helpful. Hope you get well soon.

Dr. De La Flor, licensed G.P./Family Doctor, holds certificates in coaching, nutrition and medical exercise from Berkeley University and the American Council on Exercise. His medical approach is highly influenced by Positive Psychology; an empowering, encompassing way of approaching patients through the study of their strengths and virtues to enable them to thrive and lead fulfilling lives, accept the past, find happiness in the present, and hope for the future. You can reach the doctor at 00-34-697.888.666 to schedule a consultation in his surgery or in your home/business.

Dear Dr. De La Flor,

Can I get dehydrated if I exercise regularly in the heat and don’t drink a sports electrolyte drink?

Gill

Dear Gill

Inevitably, as the temperature increases, so do the constant reminders to replace electrolytes after exercising in the heat. For most people, all you really need to do is to eat a few salted nuts. The only mineral that you need to take during prolonged exercise is sodium. And even this is only true if you exercise regularly at a fairly decent intensity for more than an hour, particularly in hot weather. If this is true, you probably need extra salt.

I run an average of 5-10 km daily and honestly, I never need any fancy sports drinks, electrolyte gels or tablets…not that there’s anything wrong with them if you enjoy them, but performance wise, for most of us it is not going to make any difference. Truthfully, you do not need extra potassium, magnesium or calcium during exercise. Athletes do lose minerals through increased sweating, but compared to blood loss, sweat is very diluted when it comes to minerals, so they can get all the minerals they need from food before or after a workout. I hope you enjoy your exercise time as much as I do!

This article appears in the print edition 650 of Island Connections

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