X's Q & A

Q&A: At 42, could I be a candidate for a tubal ligation reversal?

The simple answer to your question is “Yes”.  You could elect to do a reversal of your tubal ligation.  The longer answer, though, is that conceiving a pregnancy at the age of 42, by whatever means, is not an easy task and has some risks.  Most importantly, the risk of conceiving a baby is potentially risky at your age.  The risk of having a baby with aneuploidy (abnormal number of chromosomes as in Down syndrome) is significantly higher at age 42 (1 in 30 vs. 1 in 400 at age 30).  Secondly, the chance of conceiving is very low, perhaps at less than 5% per cycle, and if you should conceive, the risk of miscarriage is 60% or higher.   Those numbers increase as you get older and time is of the essence if you’re going to try to conceive with your own eggs.
With regard to your choices for conceiving, one other option for someone with a tubal ligation is in vitro fertilization (IVF), a procedure that bypasses the fallopian tubes.  The obvious advantage for you would be the shorter time to conception (assuming it was successful) but the risks, as outlined above, would still apply.  With IVF, one can test embryos for aneuploidy prior to transferring them into the uterus and that could be of great benefit for older patients. 
A third option is IVF with donor eggs.  This option would not allow you to contribute to the genetics of the child but would significantly decrease the risk of aneuploidy (relative to the age of the egg donor) and thus increase the chance for a healthy liveborn.  Donors are also prescreened for genetic and infectious diseases and are often the best option for success (healthy liveborn) in women who are in their 40’s.
These decisions are never easy and I would encourage you to see your physician to discuss these options further.
--Dr. John Gililland, Reproductive Endocrinologist

Q&A: Can I go to a primary care physician for anxiety or do I have to see a therapist?

Whether it's for anxiety or depression, if you go to a primary care physician you'll usually get a prescription for medication.  Unfortunately, primary care physicians don't usually have their first response be to refer you to a therapist, like a psychologist.  Most of the time, you can get help for anxiety or depression with therapy alone.  When the therapy alone isn't helping soon enough or strongly enough, your therapist can then refer you to a medical doctor for medication evaluation, and your therapist should be trained to know when to do that, as psychologists are trained in that way.  If you could feel better by talking with someone or by taking pills, which would you prefer?  Remember, talking with a professional is not the same as talking with a friend or family member.

Q&A: Is LASIK surgery covered under any medical insurances?

Only your insurance company knows what is covered under your particular plan.  Your best bet is to contact your benefits representative to check on your coverage.

Q&A: Does bipolar cause memory loss?

No, bipolar does not cause memory loss.

Q&A: What is the cost of the Obagi Blue Peel service?

The Obagi Blue Peel is a medium to deep depth chemical peel, designed to safely restore a smooth and healthy appearance to the skin.  The Blue Peel is unique in that the provider can control the depth of the peel to match the specific needs of an individual patient. An Obagi Peel will decrease fine lines and wrinkles, acne scarring, sun damage, and freckles; while softening and smoothing the skin.  The Obagi Blue Peel with anesthesia will cost about $1000.00, depending on the area being treated and the level of correction required.  There are other types of chemical peels available such as a Radiance Peel: light depth, VI Peel: light to medium depth, Phenol Peel: deep depth. 
Call Plastic Surgery Services of Fredericksburg for a complimentary consultation.

Q&A: Will an abdominoplasty help me lose half of my 350 lbs?

  Having an Abdominoplasty will not get you where you want to be. You should consider having Bariatric Surgery first and you will lose over 100 lbs. then it will be better to have the Abdominoplasty after and you will lose even more. 
  Right now your weight is all over your body. Bariatric surgery will affect your weight over every part of your body. You are too heavy now to have a safe Abdominoplasty. 
  The best operation for you to lose the most weight is the gastric bypass. A Sleeve Gastrectomy will not get you enough weight off. You have to lose 100 lbs minimum to qualify for Abdominoplasty. Depends also on your insurance.
 Thanks. Best of luck.

Q&A: Would a cannulation procedure be an option in place of a tubal ligation reversal?

I will be more than happy to help.We have good results with our methods you have to be very patient because it takes time.There is no overnight results.

Q&A: What type of doctor do I see to get on HRT MTF?

I would assume this type of treatment would be through an endocrinologist specializing in HRT MtF

Q&A: Can Vaginal Rejuvenation be done for vaginal atrophy and does it require anesthesia?

Vaginal rejuvenation may include several procedures ranging from labia reduction (labiaplasty), fat augmentation, and vaginal tightening.  A private consultation with a Cosmetic Surgeon who performs these procedures will determine what procedure(s) are appropriate for you and if this may be accomplished with local anesthesia or whether additional sedation is required.

Q&A: Will Stomaphyx procedure help after gaining weight following a gastric sleeve procedure?

Hi.  As you have discovered, sleeve patients can also be subject to late weight regain—a problem that was rumored to be limited to bypass patients only.  While only a minority of patients will experience substantial weight regain after either kind (sleeve or bypass surgery), it happens sometimes. 
The Stomaphyx is not, in fact, new; it has been around for close to a decade.  It is possible that you might benefit from an endoscopic (nonsurgical) procedure to restore the function of your sleeve, but it needs to be evaluated first.  We don’t yet know if anything is wrong with it.

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