Top10MD Blog


 4 months ago    Leave a comments (0)

Urinary incontinence or stress incontinence is a common and often embarrassing issue that no one likes or wants to talk about; if you’re experiencing urinary incontinence, you are not alone. Nearly 25-million people in the United States have the same problem. Men don’t get off, either approximately 10% of men are susceptible to this condition. When urinary incontinence prevents you from going places, participating in sports activities, and enjoying that belly laugh it’s time to do something about it. Common among post-menopausal women it’s not limited to the older generation; urinary incontinence also affects young adults as well, especially new mothers. Many women neglect to inform their doctor, due to the embarrassment of the issue. Beforehand, it seemed as if there was no hope for you outside of surgery, but now, a new device InTone is a treatment that is changing the lives of people everywhere with no surgery.

What Is Urinary Incontinence?

Urinary incontinence is bladder leakage. It happens when we run, jump, and even laugh; this occurs when the muscles that hold urine weaken causing you to urinate when you’re not supposed to. That muscle is a voluntary muscle; which means, you have control over it. The problem occurs when that muscle becomes lack, or you lose total control over it. Your symptoms can be mild meaning you leak occasionally, or they can be severe meaning you are always leaking. It may feel as if you cannot make it to the bathroom in time and if you do, your bladder may never feel empty. If you are experiencing these symptoms, it’s time to get help.

Treatments for Urinary Incontinence

Treatments for urinary incontinence depend on several factors:

  • What type of incontinence you are suffering from
  • Your age
  • Your general health
  • Your mental health

By exercising your pelvic floor with Kegel exercises; these exercises help to strengthen the urinary sphincter and muscles that contribute to control urination; thereby, reducing your stress incontinence.

Bladder training is another method, and there is also medications along with botox or a sacral nerve stimulator. When all else fails, surgery is your best option. If you plan on having children or not through having children, you will need to discuss this with your doctor. If you are finished having children, or you have had a hysterectomy that eventually caused your bladder to drop you may be a candidate for the following non-surgical or surgical procedures:

Non-Surgical Treatment for Urinary Incontinence

Intone– a device developed to stop urinary leakage. Intone is the most effective, nonsurgical treatment available today to prevent urinary leakage. Intone takes you through 12-minutes of voice-guided pelvic floor exercises, visual biofeedback, and muscle stimulation.  Office visits will be required to customize your device to your specific needs. These exercises are completed once daily for six days a week for 90-days in the privacy of your home.

Surgical Procedure Options for Urinary Incontinence

  • Sling Procedure: There is a new mesh that is inserted below the neck of the bladder to support the urethra and stop urine from leaking out.
  • Colposuspension: This procedure lifts the bladder neck and has shown to help patients with stress incontinence.
  • Artificial Sphincter: This procedure involves inserting an artificial sphincter or valve to control the flow of urine from the bladder into the urethra.

What’s My Next Step?

If you’re struggling with incontinence, you don’t have to suffer in silence any longer. You don’t have to be afraid to talk to your doctor about it as there are options for you. Call today, and you will be off to a better quality of life including your ability to laugh without fear.

Dallas Gynecologist and Functional Medicine Specialist Maryann Prewitt, MD is Director and Founder of HealthWellnessMD. Dr. Prewitt is Fellow and Board Certified by the America College of Obstetricians and Gynecologists. Dr. Prewitt holds a Master’s Certification in the da Vinci Surgery System – this minimally invasive technology has revolutionized the way surgery is performed today. Dr. Prewitt has been named 2016 | 2017 Top10MD an honor only 1-in-3 doctors succeeds with this recognition in the United States. Call Dr. Prewitt’s office today and schedule an appointment at 469-619-1066.


 8 months ago    Leave a comments (0)

Last year alone, over 64,000 men and women were diagnosed with thyroid cancer in the U.S.  Women are two to three times more likely to develop cancerous nodules than men. In recent years, the advancement of new, highly sensitive diagnostic testing is leading to increased early detection and saving thousands of lives.

The thyroid is an endocrine gland in the neck that produces the thyroid hormone, a crucial hormone in your body, and helps regulate your metabolism. The gland can develop nodules and can grow into a thyroid goiter as well. When to operate on these nodules and how to evaluate them all depends on your situation, so it is important to have a doctor familiar with management to guide the workup and determine your next step.

  • About 30-40% of all adults have at least one thyroid nodule. Typically, nodules are found after an ultrasound.
  • Roughly 90-95% of thyroid nodules are benign.
  • Most thyroid cancers occur between 20 and 50 years of age.
  • A history of radiation exposure is a risk factor for thyroid cancer.
  • A solitary nodule is more likely to be cancer than a thyroid full of nodules.
  • A nodule in a normal thyroid gland is more likely cancer than a nodule in a hyperfunctioning gland, or hyperthyroid.

When Should I Be Concerned?

Every thyroid nodule needs to be evaluated with imaging – usually a neck ultrasound. An evaluation of a thyroid nodule by a doctor will determine if a biopsy needs to be done.

Benign thyroid nodules can be monitored over time to assess the size and growth.  If a nodule is easily felt on the physical exam, then a thyroid surgeon can biopsy the nodule with a very fine needle in the office setting. Following thyroid nodules is done with serial ultrasound exams of the thyroid to assess the nodule.  Ultrasound is the most common X-ray modality to evaluate nodules. All nodules found on physical exam and all goiters in the neck should be evaluated with ultrasound.

Surgery is only necessary for thyroid nodules for the following reasons:

  • Cancer – If there is cancer in the nodule then surgical removal is needed. The good thing is that most thyroid nodules are benign. A biopsy is done with a very fine needle which is used to extract cells from the nodule and then examined under a microscope. Removal of the thyroid may involve a lobectomy (partial removal) or require total thyroidectomy (complete removal).
  • Obstruction – Thyroid nodules or thyroid goiters can cause obstruction or blockage in the neck of the esophagus or trachea.  The gland may compress the trachea (breathing tube) or esophagus where it can cause difficulty breathing, swallowing or a choking feeling in the neck.  If there is hoarseness associated with a thyroid nodule that could mean a higher risk for malignancy.
  • Hyperthyroid Nodule – If a nodule is producing high amounts of thyroid hormone and causing hyperthyroidism, medical or surgical treatment may be necessary.  This may involve RAI (Radio active Iodine) treatment or surgical excision of the nodule.
  • Pain – Pain or discomfort from a nodule may require surgery, but this case is rare. If the biopsy (FNA) is not normal, then surgery would be considered.

Most nodules are benign, so a simple checkup with your board-certified general surgeon should help you determine your next steps.

Dr. Rajesh Padmanabhan is board certified by the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Padmanabhan has practices in both the Dallas-Fort Worth and Arlington areas. He is named Top10MD – 1-in- 3 doctors succeeds with this recognition in the United States. To schedule a consultation with Dr. Padmanabhan link to his profile or call his office today at 817-466- 7400.


 11 months ago    Leave a comments (0)

Surgeries that some consider routine can still sometimes cause serious complications. No matter how straightforward you think your surgery might be, you still want to be in the absolute best surgical hands.

Today, your surgeon and hospital are especially important for procedures that are new or complex or even routine. You should be concerned and research but your surgeon and the hospital for that matter as most errors happen in a hospital setting according to John Hopkins report in May noting the third leading cause of death is medical errors. In your search for the best surgeon one indicator is how often your surgeon performs the procedure you’re seeking. For example, a study by researchers at New Hampshire’s Dartmouth-Hitchcock Medical Center of people undergoing surgery for pancreatic cancer found that annual death rates were nearly four times higher for those treated by surgeons who performed the fewest operations.

With that being said, how should you choose a surgeon, someone with whom you’ll be sharing some of your most personal information and entrusting with life-and-death decisions? Communication with your surgeon is essential.

Ask your prospective surgeon these questions before going under…

Are you board certified, and is your certification current?

  • Look for a surgeon who has the necessary board certification(s), necessary training, and has maintained their certification(s) in the specialty they are practicing.

Is this surgery necessary?

  • Avoiding surgery entirely is the only sure way to avoid a surgical complication; understanding the effectiveness of the surgery and having exhausted alternatives you then need to compare the results of your alternatives with the possible risks of the surgery. 

What are your success, failure, and complication rates?

  • Not all surgeons are willing to be upfront with this information, but a good surgeon will.

What is your experience with this surgery?

  • Ask your surgeon how many of these procedures he or she has performed and compare that number with other surgeons performing the same procedure. The best surgeon is not necessarily the busiest surgeon; it’s about avoiding the surgeon who has not performed the procedure as much or as often or as well.

What’s the hospital’s infection rate?

  • Seventeen states now make that information public, and many hospitals report their rates voluntarily. Kudos to them! After asking these questions and others relating to your needs, likes, and dislikes, do your homework and make your choice. Your final decision could be one of the most important you’ll make for you and your family.

To locate a Top10MD Surgeon you can trust visit and schedule your appointment today.


 12 months ago    Leave a comments (0)

The gallbladder is a tiny pear-shaped organ that sits just beneath the liver on the upper right side of your abdomen. Your gallbladder collects and stores bile- a chemical produced by the liver that helps in the digestion of fats. Gallbladder removal surgery might be necessary for some people who experience pain or other conditions. Dr. Rajesh Padmanabhan explains, “Gallbladder removal surgery is a common surgery with very little risk of complications. For some of my patients, they are able to go home the same day.”

A very common ailment is gallstones. Gallstones cause pain by blocking the flow of bile. If you’re having gallbladder symptoms caused by gallstones or other conditions, your doctor may recommend surgery as part of your treatment. You don’t need to worry too much about losing that little organ, the human digestive system can work without a gallbladder. It may not function as accurately, but its absence won’t make much difference. To confirm the diagnosis before surgery an ultrasound or scan is performed.

The recommendation for removal may come if you have:

  • Gallstones in the gallbladder
  • Gallstones in the bile duct
  • Gallbladder infection
  • Gallbladder pain
  • Gallbladder inflammation
  • Pancreas inflammation

The most common symptoms of gallstones are:

  • Nausea and vomiting
  • Gallbladder pain in the upper right abdomen, usually after eating
  • Indigestion

In most cases, the gallbladder is removed, not repaired. Open surgery can be used for removal, however, this requires a large cut on the right abdomen. More than 90% of cases are treated with laparoscopic surgery. With laparoscopic surgery, small cuts are made and it is removed with the help of a laparoscope.

Dr. Rajesh Padmanabhan is board certified by the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Padmanabhan has practices in Dallas Fort Worth and Arlington. He is named Top10MD – 1-in- 3 doctors succeeds with this recognition in the United States. To schedule a consultation with Dr. Padmanabhan link to his profile or call his office today, 817-466- 7400.


 1 year ago    Leave a comments (0)

There are approximately 600,000 hernia repair operations performed yearly in the United States. Hernias can happen to both men and women, and some people are born with hernias. Others have hernias develop over time. Board certified surgeon Dr. Rajesh Padmanabhan shares that if you have a hernia, surgery is necessary, saying, “A hernia does not get better over time, or go away by itself. There are no exercises or physical therapy regimens that can make a hernia disappear.”

What is a Hernia?

A hernia is a gap in the strong tissue that holds your muscles in place. Hernias occur when the inside layers of the abdominal muscle have weakened resulting in a bulge or tear. If you can imagine an inner tube pushing through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a small balloon-like sac. This gap allows abdominal tissue or a loop of intestine to push into the sac. Hernias can cause severe pain or other potentially serious problems that could require emergency surgery.

How Do I know If I Have a Hernia?

Hernias are usually found in the groin area, belly button, or the site of a previous operation. If you have a hernia, it is usually easy to recognize by the bulge under the skin. Pain, when coughing, or lifting heavy objects, or strain during bowel movements or urination, are all signs that may point to a hernia.

The pain you feel may be sharp and or a dull ache that worsens. Severe pain and redness are signs a hernia is entrapped. If this condition presents itself, or the bulge that used to come and go is now stuck out, then immediately contact your surgeon.

What Causes a Hernia?

Hernias can develop in weakened areas of the abdominal muscle or other areas due to heavy strain on the abdominal wall, aging, injury, an old incision or a weakness present from birth. Men or women can develop hernias. Most hernias in children are congenital, but hernias can develop at any age. In adults, a natural weakness or strain from heavy lifting, persistent coughing, and difficulty with bowel movements or urination can cause the abdominal wall to weaken and separate.

Today’s hernia repair options include new techniques and materials that can make surgery less invasive, recovery faster and recurrence less likely. And the smaller your hernia (meaning, the earlier you fix it), the more options you’re likely to have.
Dr. Rajesh S Padmanabhan is board certified by the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Padmanabhan has practices in Dallas Fort Worth and Arlington. He is named Top10MD – 1-in- 3 doctors succeeds with this recognition in the United States. To schedule a consultation with Dr. Padmanabhan link to his profile or call his office today, 817-466- 7400.


 1 year ago    Leave a comments (0)



 1 year ago    Leave a comments (0)

Robotic surgery, or robot-assisted surgery, allows surgeons to perform many types of complicated procedures with more flexibility, dexterity, precision and control than is possible with conventional techniques. In robotic surgery, which is associated with minimally invasive surgery, surgeon’s use miniaturized surgical instruments that fit through a series of small incisions using a robotic system. It is also sometimes used in certain traditional open surgical procedures. Dallas-Fort Worth surgeon Dr. Rajesh S. Padmanabhan explains, “When compared to traditional surgery, robotic surgery guarantees faster recovery, less pain, and bleeding, lower risk of infection, shorter hospital stays, and smaller scars.”

Benefits of Robotic Surgery

Surgeons who use the robotic system find that it not only helps with precision and control but also allows them to see the site more clearly, compared with traditional techniques. With robotic surgery, surgeons can perform delicate and complex procedures that may have been difficult or impossible with other methods resulting in alleviated post-operative pain, a lower concentration of anesthesia, minimal blood loss, and smaller, less noticeable scars.

Robot-assisted surgery allows surgeons to take control over the surgical procedure and accepted for many types of procedures. These include:

  • Extracting Tumor Cells from Sensitive Body Organs
  • Removal of Gallbladder
  • Hip Replacement Surgery
  • Colorectal Cancer Surgery
  • Head & Neck Tumor Surgery
  • Hysterectomy & Tubal Ligation
  • Coronary Artery Bypass
  • Removal or Transplantation of Kidney
  • Mitral Valve Repair
  • Prostate Cancer Surgery

Although there are many advantages, robotic surgery isn’t an option for everyone. Talk with your board certified surgeon about the benefits and risks of robotic surgery and how it compares with other techniques, such as other types of minimally invasive surgery and conventional open surgery.

Dr. Rajesh S Padmanabhan is board certified by the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Padmanabhan has practices in Dallas Fort Worth and Arlington. He is named Top10MD – 1-in-3 doctors succeeds with this recognition in the United States. To schedule a consultation with Dr. Padmanabhan link to his profile or call his office today, 817-466-7400.


 1 year ago    Leave a comments (0)

Myth 1: The More Fiber, the Better.

Tired of having bran cereal for breakfast, lunch, and dinner? Maybe it’s time to ease up. Most experts agree that you need to get 25-30 grams of fiber per day. It is difficult for many to reach 25. However, some aim to go above and beyond the recommended amount. Should we? No! Not only is reaching 25 grams an accomplishment in itself but going above and beyond can be troublesome for your gut. For people with conditions such as irritable bowel syndrome (IBS), the increase in fiber isn’t as important as the type of fiber. Research shows that insoluble fiber, like bran, may aggravate IBS symptoms. What is more important is an intake of soluble fiber such as psyllium which can offer a reduction in IBS severity. Either way, it is critical to increase fiber intake gradually (2-5 grams per day) to avoid discomforts such as gas, bloating, constipation, or diarrhea.

Myth 2: Nuts Lead to Diverticulitis

Diverticulitis is a condition in which pockets in the intestine become inflamed and irritated. If you have diverticulitis, you may have been told to avoid nuts, corn, popcorn, and food with small seeds, which is a common myth. You may also have been told that these foods might worsen or even cause diverticulitis by lodging in pouches along your intestine. However, researchers have looked at the health records of more than 47,000 men and found no connection between these foods and diverticulitis. New studies suggest that people who eat a high-fiber diet have a lower risk of the disease, and the main culprit of diverticulitis is a low fiber diet.

Myth 3: You Will Know if You Have Cancer

There are usually no symptoms of colon cancer until its later stages, so early detection is important with routine colorectal checks. Those at risk of colon cancer should start getting tested at age 50 through a CT scan of the colon, a colonoscopy, or a colonoscopy. Talk to your board-certified practitioner about which one is right for you.

Myth 4: Bowel regularity means a bowel movement every day

The frequency of bowel movements varies from person to person. For some, three a day is regular and for some, it is three a week. Perfectly healthy people can fall outside both ends of this range. Nevertheless, even three bowel movements a day can be abnormal in someone who usually has one bowel movement a day. If you have had a change in your frequency, it is best to speak to a practitioner to make sure there are no underlying issues.

Myth 5: Spicy Foods Cause Ulcers

Bring on the tabasco sauce and Texas chili! Hot sauce lovers you may now rejoice! People used to believe that too much spicy food would give you an ulcer. But now we know the majority of stomach ulcers are caused either by infection with a bacteria called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen. Spicy food (and stress) may exacerbate ulcer symptoms in some people, but they do not cause ulcers.



There are hundreds of Gastroenterologists to choose from; however, not all doctors are created equal. Gastroenterology takes the skill and finesse of an experienced Gastroenterologist. That’s why we’ve selected your city’s finest Gastroenterologists – to make your decision process easier.

For your peace of mind Top10MD Gastroenterologists’ credentials are validated yearly to verify medical licenses have no serious patient care sanctions, current Board Certifications in their given Medical Specialty, current DEA & DPS licenses and malpractice insurance. Top10MD’s have at least 5+ years experience and/or performed 300+ procedures in their given specialty and current Patient Satisfaction Score of 8.5 or higher.


 3 years ago    Leave a comments (0)

General surgeon, Martin Salia, was working in Sierra Leone at the Kissy United Methodist Hospital when he contracted the Ebola virus and now is in a Nebraska hospital and is in severely critical condition.  Originally, from Maryland, Salia was first showing ebola symptoms on Nov.6, but originally tested negative.  Then, on Monday, November 11, he tested positive.

This time around, as reported by the Nebraska Medical Center, the doctors who are treating Marin Salia, are “using the maximum amount of supportive care possible in an effort to save his life.” It was further described as an “hour by hour situation” according to the head of the hospital’s biocontainment unit.

West Africa has had more than 5,000 individuals die from Ebola, and they were mostly from Guinea, Sierra Leone and Liberia.  Thankfully, for the 10 candidates treated for Ebola in the U.S., all but one have lived.

Salia’s wife reported that when she first spoke with him on the phone, he sounded weak and shaky, telling her he loved her. They prayed together and for their two children who are 12 and 20.  Salia’s wife referred to her husband as “my everything.”

Unfortunately, their have been 5 other doctors in Sierra Leone who have contracted Ebola, as Sierra Leone was hit very hard with the virus. None of these doctors have survived. Our thoughts, prayers, and support go out to Dr. Salia and his family.

*This report includes details from the Associated Press

* Photo Credit to NBC News


 3 years ago    Leave a comments (0)

Both Fire-Rescue paramedics, as well as Texas Health Presbyterian emergency room workers are under observation as they all had made contact with a patient who is carrying the Ebola virus.

Tuesday evening, September 29th, a whole crew of Ebola experts from The Center of Disease Control & Prevention, was flown in from Atlanta to help the Dallas staff.

One Dallas Fire-Rescue crew member commented that a paramedic who was treating the man, exhibiting possible symptoms of Ebola, then put on a mask and gloves, after this realization.  The patient’s symptoms were GI issues, nausea, and vomiting and high fever.

The observation period for the 3 Dallas paramedics, who may have been exposed, will be 3 weeks, which is the maximum amount of time it can take for Ebola symptoms to show up.

Assistant Chief Norman Seals commented that he spoke to all three paramedics who seemed relaxed and not nearly as concerned as all the hype coming along with this.

Meanwhile, the Dallas County Health department and CDC will be conducting a “contact investigation,” to interview everyone the patient has come in contact with, which is roughly a dozen people in all.

The patient, himself, was a traveller, but we are also hearing that he lived in Dallas, so the investigation continues to help bring more clarity to the situation.

On a positive note, Dallas County Health Director, Zachary Thompson, says this health situation is very manageable.


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