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Gall bladder stones, positive in treadmill test - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Thyroid Problem and Hormonal Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1381 Questions
User :   My mother is having GB Stones. She went for Laparoscopic surgery but doctors said there was a risk as she was tested positive in a tmt test. What do you suggest? What does a positive tmt test actually means? What are it's implications? What precautions do we need to take?
Doctor :   Hi
User :   hello ne 1 thr?
Doctor :   Iam.
User :   Hi
Doctor :   Let me read your post
User :   Sure
Doctor :   May i know her age?
User :   yup
User :   she is 48
Doctor :   ok
Doctor :   ECG treadmill testing is the first choice for patients with medium risk of coronary heart disease based on the risk factors of smoking, family history of coronary stenosis, hypertension, diabetes, and high cholesterol.
User :   Stone size is 24 mm
Doctor :   if it is positive she might have some blocks in her vessels in the heart
Doctor :   ok
User :   ya m aware of that
Doctor :   ok
User :   is %age of blockage determinable with these info.
Doctor :   nO
Doctor :   not exactly
Doctor :   for that you need an angiography test done
User :   I read somewhere if tmt test is negative that does not mean that there is no blockage
User :   instead it means that blockage is less than 70%
Doctor :   Biliary colic is the most common symptom of gallstones, but, fortunately, it is usually a self-limiting symptom.
Doctor :   yes
Doctor :   it tests whether the heart is vulnerable
User :   so does this mean that her blockage is > 70%
Doctor :   to heart attack
Doctor :   I cannot confirm
User :   hmmm
User :   what is biliary colic
User :   ?
Doctor :   It means pain caused by gall stones
Doctor :   If silent gallstones are discovered in an individual at age 65 (or older), the chance of developing symptoms from the gallstones is only 20% (or less) assuming a life span of 75 years. In this instance, it is reasonable not to treat the individual.
User :   i also want to tell u that she is not having ne pain apart from some on the right arm
Doctor :   ok
Doctor :   Was the surgery done?
User :   neither she is experiencing ne heart pain.problems
Doctor :   ok
User :   no the doctor asked us to write a note that we are aware of the risk... but he himself was not willing to take respons.
User :   so we decided to avoid surgery for the tym
Doctor :   If TMT is positive, it means there is a blockage in the coronary arteries/its branches and the patient needs further tests like the thalium stress test or coronary angiography. In such cases all investigations, as in the case of heart attack, should be carried out for the proper treatment.
User :   u r saying that tmt test alone is not sufficient to judge the ondition
Doctor :   yes
User :   ?
User :   condition*
Doctor :   it begins the investigations
User :   what risks are involved if we carry out operation at this tym
User :   ?
Doctor :   and then comes the angiogram,thallium tests etc

User :   kk
Doctor :   She might go for heart atatck

User :   and also if thr is no heart problems till now, gng for the surgery at this tym may trigger one?
Doctor :   yes
User :   okk
Doctor :   that is the important one here
Doctor :   Treadmill test (TMT) or exercise stress test is one of the commonest forms of stress tests used to induce provokable myocardial ischemia for diagnostic evaluation of coronary artery disease.
User :   so what do u suggest?
User :   ya doctor also told us this
Doctor :   You must consult a cardiologist and discuss
User :   but doctors do not present the clear picture
User :   we asked him several tym
Doctor :   ok
User :   about the remedial measures n all
User :   but he said thrs nothing u can do
Doctor :   the method is to avoid stress to her heart
User :   instead asked us to go for some more tests
Doctor :   and some times surgery might be avoided
Doctor :   yes you might need more to get a full picture of block in heart

User :   i did,nt understand the last lin
Doctor :   more investigations on heart might be needed
User :   hmm
User :   so u r suggesting to go for further checkups
Doctor :   yes it will clear the doubts
Doctor :   and help to develop
User :   nd what abt gall stones
User :   ?
Doctor :   an method that suits her
Doctor :   Cholecystectomy (removal of the gallbladder surgically) is the standard treatment for gallstones in the gallbladder. Surgery may be done through a large abdominal incision or laparoscopically through small punctures of the abdominal wall. Laparoscopic surgery results in less pain and a faster recovery
User :   is 24 mm a real big size
Doctor :   yes
Doctor :   Cholecystectomy has a low rate of complications, but serious complications such as damage to the bile ducts and leakage of bile occasionally occur.
User :   "laparoscopy is the best" i was told
Doctor :   Cholesterol gallstones are made primarily of cholesterol. They are the most common type of gallstone, comprising 80% of gallstones in individuals
Doctor :   yes
Doctor :   laparoscopy is less time consuming
Doctor :   assctd with less risks
User :   so what to do in this case
Doctor :   and easy recovery
User :   when we can't undergo surgery
User :   ?
Doctor :   no large incisions too
Doctor :   you can go for medical methods

User :   we can't undergo laparoscopy bcoz of positive tmt test
User :   medical methods?
Doctor :   like taking tablets that dissolve gall stones
User :   and what are they
User :   ?
User :   do they really exist.... the tablets
Doctor :   yes
User :   can u suggest nay
User :   any*
Doctor :   A device that generates shock waves is used to break gallstones up into tiny pieces.
Doctor :   called Extracorporeal shockwave lithotripsy
Doctor :   can be tried
Doctor :   Drugs made from bile acids are used to dissolve the gallstones.
User :   where can this be done
User :   ?
Doctor :   It may take months or even years for the gallstones to all dissolve.
Doctor :   discuss with an gastroenterologist
Doctor :   It may take months or even years for the gallstones to all dissolve.
Doctor :   The stones often come back after this treatment.
Doctor :   This treatment is usually offered only to people who are not able to have surgery.
Doctor :   medical treatments for gallstones are not as effective as surgery.
Doctor :   A low-fat, low-cholesterol diet can prevent symptoms of gallstones but cannot prevent formation of stones. It is not known why some people form stones and others do not.
Doctor :   A person who has had laparoscopic surgery to remove the gallbladder may leave the hospital 12-48 hours after surgery and return to full activities within three weeks.
Doctor :   If open surgery was required to remove the gallbladder, recovery takes a little longer. The person may leave the hospital within three to seven days and could resume normal activity after a six week recovery period.
Doctor :   The most common complication of surgery is damage to the biliary tract. If bile leaks out of the biliary system, it can cause an infection.
Doctor :   did you follow what i said?
User :   ya i did
User :   but we can't undergo laparoscopy now
Doctor :   so try home remedies too like
Doctor :   intake of only clear liquids to give the gallbladder a rest,

Doctor :   avoid fatty or greasy meals
User :   what is lever flush
User :   ?
User :   will that help in disolving the stones
Doctor :   it might help in removing smaller ones
User :   ne other way to treat gall stones
User :   ?
Doctor :   Liver cleansing cleanses both our livers and our gallbladders.
User :   is it effective
User :   ?
Doctor :   not fully
Doctor :   it is a type of naturopathy
Doctor :   Theoretically, the liver flush may be unsafe for people who have gallstones. The large amount of oil causes the gallbladder to contract, making it possible for a gallstone to become lodged in the narrow opening of the gallbladder and necessitate emergency gallbladder surgery.
User :   so u saying thr is no sure shot method to treat gall stones apart from surgery
Doctor :   This procedure should only be done under the supervision of a qualified health practitioner.
User :   ?
Doctor :   yes
Doctor :   surgery is the main treatment
Doctor :   all others are supportive
Doctor :   The usual treatment for symptomatic or complicated gallstones is surgical removal of the gallbladder. This is called cholecystectomy
User :   hello u thr
User :   ?
Doctor :   yes
User :   is this
Doctor :   yes
User :   ohh
User :   i have been trying to reach you but every time i was redirected to feedback page
Doctor :   ok
Doctor :   hope you understood what i said earlier?
Doctor :   the surgery depends on the other medical conditions too
User :   just like the tmt test
User :   ?
Doctor :   so you need an cardiology consultation too
Doctor :   yes
User :   hmm
Doctor :   Do an angiogram
User :   actually we consulted one
Doctor :   thallium test too
User :   he said nothing will happen
User :   but he was not ready to take responsibilty
User :   and that was creating doubt in our mind
Doctor :   ok
Doctor :   You can consult dr AAAAAAA
User :   what other day to day precautions do we need to take in respect to positive tmt test
Doctor :   WWW.WWWW.WW Doctor :   use the link
User :   i feel that is more serious than gall stone
Doctor :   ok
Doctor :   For that you need an cardiology consultation
Doctor :   they are experts on tmt tests
User :   is it?
Doctor :   consult dr AAAAAAA
Doctor :   he is renowned in south asia
Doctor :   you can get telephone call from him
Doctor :   if you want
Doctor :   i can help you
User :   whr can we visit him in person
Doctor :   he will call you
Doctor :   and discuss everything in detail
User :   ok
User :   how can i reach him
Doctor :   WWW.WWWW.WW Doctor :   use this link
Doctor :   you can consult him
Doctor :   he will call you back
Doctor :   or via email
Doctor :   as you prefer
Doctor :   WWW.WWWW.WW User :   ya i will get a call from him
Doctor :   all your details can be discussed
Doctor :   he has vast experience in cardiology
User :   i'll catch him
Doctor :   recognized world wide for his abilities
Doctor :   so do pay for him via our site link
Doctor :   and get an appointment
User :   ya i will
Doctor :   our customer executive will get back to you

User :   so u r suggesting to undergo further tests for heart
Doctor :   and arrange an convenient time for you
Doctor :   ys you might have to

User :   and then we shd go for treatment for gb stones
Doctor :   Only an cardiologist can say definitely..
Doctor :   yes
User :   hmm
User :   also i wanted to ask reasons for my thinning hairs
User :   some possible reasons
Doctor :   Do you have hair fall?
User :   ya
User :   i have very less hairs on my scalp
Doctor :   upto 100 hair fall is normal
User :   density is very low
User :   everyone who visits me
User :   notice that i am losing hairs
Doctor :   try using minoxidil solutions in consultation with an dermatologist
Doctor :   since the medicne has some side effects
User :   i used one
User :   aminoxil from Loreal
User :   i used it continously for 42 dayz
User :   as they suggested
Doctor :   yes
Doctor :   but it might cause hair loss when you stop it
Doctor :   so do discuss with an dermatologist
User :   so what shd i do
User :   ?
User :   i exper. hairfall while i do shampoo
User :   and conditioner
Doctor :   eat an balanced diet
Doctor :   take good proteins like eggs beans etc daily
Doctor :   it is very imp for hair growth
User :   hmm
User :   hey i got to go
User :   will resume later
Doctor :   ok
User :   thanx a lot for ur suggestions
Doctor :   Thanks for consulting..Bye for now...
Doctor :   Take care
Doctor :   Bye
User :   bye
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