Acid Reflux (GERD's; gastroesophageal reflux)

The main symptoms of acid reflux disease, which is also known as GERD (gastroesophageal reflux disease), are: Chest pain, Aspiration while sleeping (wake up coughing), Stomach pain, burning sensation, Prolonged medications (PPI's or H2 blockers), food sticking.

Dr. Thomae will conduct a complete assessment to determine the best method of treatment. There are several possible tests that would be performed:
• EGD esophagogastroduodenography)
• Esophageal ph monitoring with the Bravo pH System (computer chip in distal esophagus to check for GERD's for 48 hours [no tubes or tests through the nose]
• Bacterial testing for H. Pylori (by biopsy)
• Esophageal biopsies to rule out Barrett's esophagitis, a pre-malignant lesion caused by GERD's

There are also several treatment possibilities:
  •  EGD (esophagogastroduodenoscopy)
  •  Stomach wrap (Nissan Fundoplication)
  •  Stretta Procedure (endoluminal radio-frequency delivery to shrink distal esophagus)
  •  Gastro-esophageal plication (suture loose muscle sphincter)

Dr. Thomae can accurately diagnose many symptoms of breast tissue. You may come to our office for diagnosis of benign and malignant disease, breast lumps, mammographic abnormal findings or masses. treatment of infections and abscesses, treatment of Fibrocystic disease (benign disease).

In some cases surgery will be performed for:
• Ultrasound guided biopsies
• Fine needle aspiration biopsies
• Core needle biopsies
• Vacuum assisted rotational biopsies
• Ultrasound guided needle localization biopsies
• Open biopsies
• Lumpectomies
• Partial mastectomies
• Simple mastectomies
• Modified Radical Mastectomies
• Axillary node biopsies
• Sentinal node biopsies
• Cosmetic breast surgery:
      by liposculpture (liposuction)

Carpal Tunnel Syndrome is a problem that affects the wrist and hand. If you have CTS, tingling and numbness can make even simple tasks hard to do. Some people also have hand pain or even a weakened grip. Symptoms may be noticed while driving, or holding a newspaper.

Two types of surgery are used to treat CTS. Either one relieves the pressure on your median nerve. To do this, the carpal ligament is cut.

for:
  •  Cancer
  •  Bleeding
  •  Recurrent diverticuitis
  •  Perforation
  •  Volvulus (twisting)
  •  Obstruction
  •  Inlammatory bowel
  •  Toxic colon
Diagnosis by colonoscopy.

Esophago-gastro-duodenoscopy or EGD is a common way of diagnosing reflux, erosions, ulcers, and GERD. Biopsies also may be obtained. Dr. Thomae is then able to review the results to recommend a treatment plan for your condition.

Gallbladder disease is a very common problem. Most often, the symptoms are caused by stones that form in the gallbladder. Common symptoms of gallbladder attacks include severe pain or aching in the upper abdomen, a dull ache beneath the ribs or breastbone, back pain, or pain in the right shoulder blade, nausea, upset stomach, heartburn, or vomiting. To treat the problem, you will likely need to have your gallbladder removed. This eliminates pain and prevents future attacks.

This is most often done using a type of surgery called laparoscopy. Small incisions in the skin are made to allow Dr. Thomae to see and operate inside the abdomen.

A ganglion cyst is a firm, fluidfilled lump that can suddenly appear on the front or back of the wrist or at the base of a finger. These cysts grow from normal tissue in the wrist and fingers, and range in size from a pea to a peach pit. Although ganglion cysts are common, they don’t spread, and they don’t become cancerous.

Dr. Thomae may remove it surgically. A section of the tissue that lines the joint or tendon is removed along with the cyst.

Hemorrhoids are a very common problem that can be painful, or cause bleeding, but are not usually serious. They are a swelling of blood in the veins of the anal canal.

Veins can swell either internally or externally. For large external hemorrhoids, surgical excision is sometimes needed.  Our new technologies of pain management and lasers help this most dreaded procedure very tolerable.  Internal hemorrhoidal surgical options are even less invasive or painful.  Few surgical practices have the advanced technologies for state of the art hemorrhoidal treatments as does Metroeast Surgical. These include transanal stapling (PPH). If surgery or laser treatment is not needed,. adding fiber to your meals, drinking more water, and using over-the-counter ointments for a limited time can minimize the symptoms temporarily.

Men, women, and children of all ages can have hernias. A hernia is a weakness or tear in the wall of the abdomen. It is sometimes called a “rupture.” Acquired hernias are caused by wear and tear over the years. Congenital hernias result from a weakness in the abdominal wall that is present at birth. Hernias may get worse or grow larger with time or physical stress.

If you notice a bulge beneath your skin, you may have a hernia. You may experience pain when you lift, cough, or strain during urination or bowel movements. It can be a sharp pain, or a dull ache, and may get worse throughout the day.

There are several possible procedures for repairing hernias. The most appropriate option for you can only be determined through discussion with Dr. Thomae.

Regardless of the source of bleeding, a diagnosis should be made.  It is imperative that you seek evaluation at our center as soon as possible. Evaluation, diagnosis, and treatment of rectal bleeding will depend on the source or etiology.  A safe treatment plan will be initiated by Dr. Thomae so you can live a long healthy life free of intestinal cancer or bleeding sources.

Skin lesion removal employs a variety of techniques, from relatively simple biopsies to more complex surgical excisions, to remove lesions that range from benign growths to malignant melanoma.

Sometimes the purpose of skin lesion removal is to excise an unsightly mole or other cosmetically unattractive skin growth. Other times, Dr. Thomae will remove a skin lesion to make certain it is not cancerous, and, if it proves cancerous, to prevent its spread to other parts of the body.

Persistent and recurrent aches and sprains should be evaluated and severe soft tissue types of injuries should be treated and assessed. Pain that does not improve may be signs of fractures or “stress fractures” and should be assessed. Though the majority of injuries are often evaluated initially in an emergency room, patients can consult Dr. Thomae more often for these types of problems.

A venous skin ulcer, also called a stasis leg ulcer, is a shallow wound that develops when the leg veins do not move blood back toward the heart normally. Venous skin ulcers typically develop on either side of the lower leg, above the ankle and below the calf.

In a condition called venous insufficiency, the valves are damaged and allow some blood to back up in the vein. The slowed circulation causes fluid to seep out of the overfilled veins into surrounding tissues, causing tissue breakdown and ulcers.

The first sign of a venous skin ulcer is the appearance of dark red or purple skin over the affected area. Improving circulation is critical in the treatment of venous skin ulcers. You can accomplish this by elevating your legs above the level of your heart when you can and, during your waking hours, using specially fitted stockings called compression stockings, designed to help prevent blood from pooling in your legs. More aggressive medical treatments, such as vein surgery, are available for venous skin ulcers that take longer than 1 month of treatment to heal or that become infected.  Please come see an expert in this field like Dr. Thomae for evaluation and treatment.

Vasectomy is a simple, safe procedure that makes a man unable to father a child (sterile). During surgery, the two vas deferens are cut and sealed off. This prevents sperm from being able to travel from the testes to the penis. The testes still produce sperm, but since they have nowhere to go, they die and are absorbed by your body.

Dr. Thomae provides a safe, minimally invasive same-day procedure under sedation for sterilization by vasectomy.  Triple check standards guarantee effective lifetime sterilization.  Most men return to work in 2 days, and heavy lifting in 1 week.