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Ask Dr. Gott 12/21
Weighing the risks of surgery
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    DEAR DR. GOTT: I hope you can help me. I'm 89 years old and in good health. Lately, I've been passing out without any warning at all.
    My doctor can't give me an answer, nor can anyone at the hospital where they take me fairly regularly. I sure would like to know the cause. This has happened four times in the past six months. Do you have an answer?
    DEAR READER: In my experience, age-related fainting (syncope) is frequently the result of a cardiac problem, such as a rapid pulse, a slow heartbeat or some abnormality in the brain.
    You are at significant risk of harming yourself if you faint in the street or on the stairs in your home. I urge you to persist in your efforts to find a diagnosis. You need a diagnostic specialist (internist) who will check you thoroughly, order appropriate testing, such as a 24-hour Holter monitor, and refer you to a specialist if needed.
    Frankly, I'm surprised that your current doctors and hospital have failed to be more aggressive.
    Also, I would involve family members who can monitor the situation. This involvement requires a legal form known as a health care proxy. In this way, the medical staff can follow along with them in a time of emergency and keep you informed, as well.
    To give you related information, I am sending you a copy of my Health Report "Coronary Artery Disease." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

    DEAR DR. GOTT: Have you ever heard of a calcified, benign, fibroid tumor attached to the outside of the uterus? I have one the size of a grapefruit. Because I am 91 years old, my doctors do not want to do surgery. Please let me know your opinion.
    DEAR READER: A fibroid is a noncancerous tumor of the lining of the uterus. Those that grow outward are referred to as subperitoneal. As a general rule, a fibroid is harmless and can be left alone unless abdominal pain, discomfort or other symptoms are experienced.
    I agree with your doctors. Major surgery in a 91-year-old carries definite risks that should be avoided if possible. First, exhaust all your options. A gynecologist can help you. Next, hold off the surgery unless your quality of life becomes compromised. At that point, you will have to accept the risks of an operation. Perhaps the surgeon would consider laparoscopy — removal of the uterine tumor through a tube inserted into the pelvic area.

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