Hernias, brain differences and hip resurfacing

April 25, 2013

Q. I understand that getting a hernia fixed today is a lot easier than it used to be. Is that true?

You get a hernia when a section of an internal organ bulges through weak abdominal muscle tissue. The protruding organ is usually the intestines. About 80 percent of hernias are located in the groin. The overwhelming majority of groin-hernia victims are men.

About 5 million Americans develop hernias annually, but only 700,000 get them fixed surgically. The common theory for this phenomenon among doctors is that most people fear having an operation. But hernia surgery today is not the ordeal it once was with a large incision and long recovery.

Today, patients requiring hernia surgery are in and out of the hospital the same day. The surgery takes about an hour. Most patients resume their normal lives within a few days after the surgery.

The operation can be done with a small incision or by minimally invasive laparoscopic surgery that employs a slender, tubular optical instrument with a surgical tool.

Q. Do men have different brains than women?

Here are some fascinating facts:

Dr. Gabrielle M. de Courten-Myers, a University of Cincinnati scientist, has determined men have about 2 billion more brain cells than women but the extra cells don’t make them smarter than women

Louann Brizendine, a San Francisco neuropsychiatrist and author of “The Female Brain,” asserts that the difference between male and female brains explains why women like to discuss their feelings, while men love to dwell upon sex.

“Women have an eight-lane superhighway for processing emotion, while men have a small country road,” Brizendine says. “Men, however, have O’Hare Airport as a hub for processing thoughts about sex, where women have the airfield nearby that lands small and private planes.”

A brain-scanning study suggests that when males watch a mild electric shock given to a cheater, they don’t feel his pain. Instead they enjoy it. Women’s brains empathize with the cheater’s pain and they get no pleasure from it.

Men tend to perform better than women at certain spatial tasks, target-directed motor skills, mathematical reasoning and navigating. (Is that why they don’t ask for directions?) Women tend to excel at word tests, identifying matching items and precision manual tasks.

Men and women with equal IQs achieve the same scores with different areas of the brain, Richard J. Haier, PhD, reported in NeuroImage. He also found that women have more white matter and fewer gray matter areas related to IQ than men do.

Q. What is hip resurfacing?

It is a surgical alternative to total hip replacement.

The hip is a ball-and-socket joint. The ball is at the top of the femur (thigh bone), and the socket is in the pelvis. In hip replacement surgery, the ball is replaced with a metal or ceramic substitute. The socket is fitted with a metal cup to hold the new ball.

The primary difference in hip resurfacing is that the surgeon doesn’t remove the femural ball. Instead, the damaged ball is reshaped, and then a metal cap is anchored over it.

A crucial issue in joint replacement is longevity. A substitute hip is good for about 20 years, and it is difficult to remove and replace one that’s shot. Hip resurfacing, unlike hip replacement, preserves enough bone to permit a total replacement if it is necessary later.

Surgeons estimate that 10 to 15 percent of people with bad hips can consider hip resurfacing instead of replacement. For example, resurfacing is not recommended for patients with osteoporosis, a disease that makes bones porous and vulnerable to fractures.

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