Dear HealthSmart,

I visited an ear, nose, and throat doctor for problems with my aging voice. He told me I’m not a candidate for voice therapy but that surgery was an option. What would this procedure entail?

HealthSmart asked Dr. Clark Rosen, Professor of Otolaryngology at the University of Pittsburgh School of Medicine and Medical Director at University of Pittsburgh’s Voice Center. Here’s his response:

For patients who aren’t suited to voice therapy, surgery can be a great option. We inject a bulking substance such as collagen to add bulk to treat vocal cord weakness. This material fills the space next to one vocal cord, pushing it closer to the other. This procedure, which is relatively low risk, allows their vocal cords to vibrate more closely together. However, about 40 percent of patients say it doesn’t help them significantly. One approach is to use a temporary injection, which lasts about two months. If that helps, the patient can an go on to surgery—with lasting results.

Dear HealthSmart,

I find myself having discomfort in my legs during the night. Occasionally I feel the urge to move them. I thought I wasn’t stretching enough, but now I worry there may be something serious going on. I remember my grandmother complained of something similar. What’s happening?

HealthSmart asked Dr. John Winkelman, M.D./Ph.D., Chief of Sleep Disorders Clinical Research Program, Massachusetts General Hospital. Here’s his response:

It’s very possible you’re suffering from Restless Leg Syndrome (RLS), a condition characterized by a nearly irresistible urge to move the legs, typically in the evenings and while sleeping. There’s a large genetic component to RLS, so it’s no surprise that your grandmother suffered from it as well. Fortunately, we know much more about the disorder and approaches to treatment now than we have in years past. Consult your general practitioner and from there you may be referred to a neurologist specializing in sleep disorders. It’s possible you could be suffering from a RLS mimic such as neuropathy, arthritis, akathisia (a side effect of dopamine blockers), or simple having your legs fall asleep, but it’s best to have a consultation to be sure.

Dear HealthSmart,

I’ve considered having weight loss surgery for years and now that I’m getting serious about making the decision, I want to know the difference between the Sleeve Gastrectomy and Gastric Bypass. Is one better, or safer, than the other?

HealthSmart asked Dr. Amir Ghaferi, M.D., M.S., Assistant Professor of Bariatric Surgery at the University of Michigan Medical School. Here’s his response:

The two surgeries can be compared to cars. The Sleeve Gastrectomy is kind of like a reliable Toyota and Gastric Bypass is more like a Jaguar. The Toyota (Sleeve Gastrectomy) does the job and gets you from point A to point B with minimal maintenance. The Jaguar (Gastric Bypass) gets you from point A to point B much faster than the Toyota, but will likely require costly, long-term maintenance. With the Sleeve Gastrectomy, you miss risks such as internal hernias, narrowing of stomach/intestine connections, and vitamin deficiencies often associated with Gastric Bypass. However, Gastric Bypass provides slightly higher weight loss and there is good data that supports a higher resolution of diabetes with this procedure. Additionally, Gastric Bypass has been around longer and for this reason has been studied more long-term. All that being said, there are some proven and suggested benefits to one over the other and patients should discuss with their doctors to determine the best procedure for them.

Do you have questions on health or wellness you’d like answered by the nation’s leading medical researchers? If so, you can send to Editor@WashNews.com. HealthSmart is a national newspaper column from the Washington News Service in DC. Due to demand, we are unable to reply to all inquiries. Responses through the column are no substitute for care from physicians or other medical professionals.

Copyright Ellen James Martin 2021