Evening star. [volume] (Washington, D.C.) 1854-1972, 1956-06-14
FEATURE Rcz
How to
STOP KILLING
YOURSELF
GoIIstones and Heart Patients
By DR.. PETER J. sTEINcRoHN

0UUSIOH6S ana Tie
Dear DR.. Steincrohn: My hus-
band has gallstones. I suppose
that isn't unusual, but he has
another condition that poses a
problem. He had an attack of
coronary thrombosis about two
years ago.
He was doing nicely until the
last three months, when he be-
gan to complain of indigestion.
He has had nausea after eating.
He has been unable to finish the
simplest meal and has been los
ing weight and strength. His
doctor ordered X-rays of his gall
bladder and these showed it
was filled with stones. Ordinarily,
there wouldn't be any problem
at all. He'd go into the hospital,
have his gallbladder out and that
would take care of the matter.
But what I am concerned
about is an operation on a man
who had a severe coronary at
tack only a few years ago. How
dangerous is it? Would it be
better to treat his condition med
ically in the hope that he will
feel better? Can't he put of
operation until he has an acute
attack of gallbladder pain and
jaundice? I'd never forgive my
self if l let him be operated on
and something happened. This
is an awfully difficult and worri-
some decision to make. You don't
know how greatly l shall ap-
preciate your advice in this mat
ter. Sincerely, Mrs. j. j. N.
Decision Is Difficult
Answer: I have been faced
with such decision many times
And it hasn't been easy to make
Every case is a problem unto
itself.
For example. consider the man
who has no indigestion. He has
a gallbladder workup as part oil
a routine investigation. We find
stones. He is As and had a
coronary thrombosis at Al. What
to do?
My advice to such patient i;
to let well enough alone. l ad-
wise against operation and tel
him to keep his fingers crossed
He may go through life without
a gallbladder attack. If he does
have one. the problem will have
TO be met at that time.
l realize there is a group who
suggest operation as soon as X
rays indicate the presence OF
stones. I do not go along with
that. Many people with a small
handful of stones in their gall
bladder go through to old age
without symptom referable tc
gallstones. If this is true fol-
people who have never had any
trouble with their heart, / be.
lieve it is good judgment not to
subject a coronary patient tt
what may be an unnecessary
operation.
But there are cases and cases
In some I have argued for ar
operation as hard as l have
against one in others. For in.
stance. take the problem that
faces the husband of Mrs. j. J
N. Here is a man who not only
has gallstones ION a picture" but
has stones that are producing
symptoms that are running him
down. He is losing weight, suf-
fering daily discomforts and be-
coming weaker.
Would Review Condition
I would review his coronary
condition. Has there been ans
recent change in his electrocar-
diogram? Is his sedimentation
rate behaving? Is there any in
creaSing cardiac enlargement?
Are there any symptoms OF heart
failure like cough, ankle swelling
or increased frequency OF an.
ginal pains?
II a careful examination re-
veals no activity Of the coro.
nary process. l would advise
operation. Those gallstones-anc
the gallbladders - had better
come out while her husband 1,
in good condition and able tc
Withstand surgery.
Unlike people with stones anc
without symptoms, unless op.
Grated on he is likely to have
complications that may come
suddenly. That is what we wan
to guard against. Coronary pa.
;ieftts do not do as we'll in emer.
gency operations. But they d.