By Dr. Manpreet Grewal 

A hernia occurs when an internal organ or other body part protrudes through a weak spot in the surrounding muscle or tissue. Most hernias occur between the chest and the hips.  

A hernia may produce a prominent lump or bulge that can be pushed back in, or that may disappear when lying down. Laughing, crying, coughing, straining, or other physical activity may make the lump reappear after it has been pushed in.  

Different types of hernias include: 

  • Inguinal hernia: fatty tissue or a part of the intestine pokes into the groin at the top of the inner thigh. This is the most common type of hernia, and affects men more than women. 
  • Femoral hernia: Fatty tissue or part of the intestine protrudes into the groin at the top of the inner thigh. Femoral hernias are much less common than inguinal hernias and primarily affect older women. However, both inguinal and femoral hernias are the result of weakened muscles, whether they have been present since birth or are associated with aging and repeated strain from physical exertion, obesity, pregnancy, frequent coughing, or straining on the toilet due to constipation. 
  • Umbilical hernia: Fatty tissue or part of the intestine pushes through the abdomen near the belly button. 
  • Hiatal hernia: Part of the stomach pushes up into the chest cavity through an opening in the diaphragm. 
  • Incisional hernia: Tissue protrudes through the site of an abdominal scar from a remote abdominal or pelvic operation. 
  • Epigastric hernia: Fatty tissue protrudes between the navel and lower part of the sternum . 
  • Spigelian hernia: The intestine pushes through the abdomen at the side of the abdominal muscle, below the belly button. 
  • Diaphragmatic hernia: Organs in the abdomen move into the chest through an opening in the diaphragm. 

If left untreated, hernias will not improve. Doctors generally recommend surgery to repair a hernia. 


By Dr. Manpreet Grewal 

The thyroid is a small gland located just below your Adam’s apple. Hormones produced by the thyroid gland — triiodothyronine (T3) and thyroxine (T4) — control the metabolism, or how your body’s cells use energy from food. These hormones also regulate vital functions including body temperature and heart rate. 

You should consult your doctor if you feel unusually tired and experience symptoms such as dry skin, increased sensitivity to cold, aching muscles, irregular menstrual periods, bloating, constipation, memory loss, or losing your voice. Together, these symptoms could indicate hypothyroidism. Your doctor will conduct a blood test to measure the levels of thyroid hormones present, which indicates if your thyroid is underactive. 

If the tests indicate you are experiencing hypothyroidism, they will also help your doctor determine the right dosage of medicine to prescribe. Treatment is generally daily injections of synthetic thyroid hormones, and your doctor may repeat these tests at least annually to ensure you continue to receive the right levels of hormones. 

You are at increased risk for hypothyroidism if you are a woman, older than 60, have a family history of thyroid disease, have an autoimmune disease such as type 1 diabetes or celiac disease, have been treated with radioactive iodine or anti-thyroid medications, received radiation to your neck or upper chest, have had thyroid surgery, or have been pregnant or delivered a baby within the past six months. Some medications, such as lithium, can also contribute to thyroid disorders. 

If left untreated, hypothyroidism may result in complications such as goiters, neuropathy, infertility, and birth defects to babies born to women with hypothyroidism.  

Eye Health and Screen Time

By Dr. Manpreet Grewal 

Many of us spend much of our day looking at a computer, tablet, or phone screen, whether for work or entertainment.  

More than nine in 10 American adults surveyed — 93 percent — spend two hours or more per day in front of some sort of screen, from televisions to computers to smartphones to e-readers, according to a report by The Vision Council, an advocacy group for optical manufacturers and distributors. Sixty-one percent said they spend five or more hours and 30 percent said they look at screens more than nine hours per day. The group surveyed more than 9,700 U.S. adults. 

How does this affect our eyes? 

When we are focused on screens, our eyes blink less—half their normal rate–which means they dry out faster. When your eyes are dry, you may experience blurry vision, burning, or irritation. Your eyes may feel especially tired, heavy, or strained. These symptoms are occasionally referred to as “computer vision syndrome”.  

An abundance of screen time is not likely to cause permanent damage to your eyes, but there are some steps you can take to reduce the strain. One good rule of thumb is to practice the “20-20-20” rule. Every 20 minutes, take a break from the screen to look at an object at least 20 feet away for 20 seconds. Consider purchasing a matte screen filter to place over your computer screen. Use a humidifier or artificial tears if your eyes are dry.  

A study published in the American Academy of Opthamology’s journal last year points out that incidents of nearsightedness in the U.S. have increased by 42 percent since 1971. However, there is no conclusive evidence to show whether this increase is due to an increased exposure to screens, to light interacting with our circadian rhythms to influence our eye growth, or neither of these possibilities. 


By Dr. Manpreet Grewal

If you have been bitten by a snake, take the following steps until you receive medical help: 

  • Try to remain calm, and remove any jewelry or tight clothing before you experience swelling. 
  • Elevate the bite so it is at or below your heart. 
  • Clean the wound without flushing it with water, and cover it with clean, dry dressing. 
  • Do not cut the wound or attempt to remove the venom.  
  • Do not try to capture the snake, but remember its color and any other identifying details. This information will help your doctor treat you effectively. 

Venomous snakebites consist of four different kinds of toxins: 

  • Cardiotoxins, which damage the heart directly 
  • Cytotoxins, which cause tissue damage at the site of the bite 
  • Hemotoxins, which cause internal bleeding 
  • Neurotoxins, which damage the nervous system 

The effects of a snakebite vary, from just healing from the puncture wound inflicted by the snake’s fangs, to fatal injury. Snakebites can cause symptoms including swelling, numbness, blisters, tissue death, internal bleeding, vision problems, and difficulty breathing.  

Anyone bitten by a snake should seek emergency medical treatment unless an expert identifies the snake as nonvenomous. The wound will be examined and cleaned, and your doctor may send blood and/or urine samples to be tested. Patients who go into shock may require intravenous fluids and possibly other medicines to maintain blood flow to vital organs.  

Your doctor may administer an antivenom treatment, and/or antibiotics to prevent infection. You should also receive a tetanus shot if you have not had one within the past five years.   

Water Safety

By Dr. Manpreet Grewal 

Throughout summer, families flock to pools, the beach, lakes, and rivers to cool off. Remember to keep yourself and your loved ones safe around the water. 

Do not swim alone, and choose locations where a lifeguard is on duty. In addition to watching the people in the water, lifeguards are trained to watch the water and help swimmers avoid any safety issues or conditions. They are also trained to respond quickly when something happens. 

Don’t rely on toys like water wings, noodles, or inner tubes to keep children safe. Young children and inexperienced swimmers should always wear a Coast Guard-certified life jacket when they are around water.  

Never leave children unsupervised near a body of water. In a large group, make sure at least one adult is the designated watcher and isn’t distracted. 

Make sure your children learn how to swim. Swimming lessons can begin as early as one year old, depending on the child’s physical and emotional development. However, swimming lessons do not prevent drowning, and are not a substitute for diligent adult supervision. Vital swimming skills include: 

  • Swimming in water that is over your head, then returning to the surface. 
  • Floating or treading water for at least one minute. 
  • Turning over and turning around in the water. 
  • Swimming at least 25 yards. 
  • Exiting the water.  

Practice “reach, throw, don’t go” if a friend is in trouble in the water. Use a long object to pull the person to safety. This prevents the distressed swimmer from overpowering the friend trying to rescue them. 

Flesh-eating bacteria

By Dr. Manpreet Grewal 

Necrotizing fasciitis, popularly known as flesh-eating bacteria, is an infection which stops blood circulating, causing tissue death near the site of the infection. The bacteria enters the body during surgery or as the result of an injury, including minor cuts, insect bites, and abrasions. Once the infection begins, it destroys muscle, skin, and fat tissue. 

Patients will begin to experience symptoms during the first 24 hours after infection, including pain that is unusually severe for the appearance of the injury, flu-like symptoms, and dehydration. Over the next several days, the area will swell and/or develop a purplish rash. When tissue death begins to occur, you will notice discoloration, peeling, and flakiness, along with blisters filled with bad-smelling fluid. 

Because many of the early symptoms are so similar to other, more common conditions, doctors often diagnose the condition based on advanced symptoms, and will use lab analysis of fluid and tissue samples to identify the bacteria.  

Treatment for this condition includes antibiotics, surgery to remove the damaged tissue and prevent any further spread of infection. Hyperbaric oxygen therapy may be employed in order to preserve the healthy tissue. Your doctor may also recommend IV immunoglobulin, in order to help your body fight the infection. 

Infectious disease specialists suggest that we will see an increase in cases of flesh-eating bacteria due to climate change. The bacteria flourishes in warmer waters, and also thrives on organic material such as red tide.  


By Dr. Manpreet Grewal

Diverticular disease begins with the formation of small pockets, called diverticuli, in the wall of the colon, a condition known as diverticulosis. These areas of the colon are not as thick-walled as the rest of the colon, so if your colon is overworked because you are dehydrated, you are not getting enough fiber in your diet, or you experience a lot of stress, your colon can become spastic., that increased pressure causes areas of weakness in your colon walls to rupture, get inflamed, and release bacteria into otherwise sterile areas of our body. Complications from diverticulosis can include rectal bleeding, called diverticular bleeding, and diverticulitis, when these pockets become infected.

In order to prevent diverticulitis, drink plenty of fluids, ensure your diet contains the recommended amount of fiber, and minimize stress in your life.

A common misperception that many patients have is that nuts and seeds can get stuck in diverticuli and cause irritation and discomfort. However, studies show that diverticuli are not caused by nuts or seeds, so there is no need to avoid these foods.