Gallstones and gallbladder disease

By Dr. Manpreet Grewal

Gallstones are treated very differently than kidney stones. Kidney stones must be broken down so they can pass through the system.

Gallstones can be hereditary, or caused by diet or pregnancy. There are some disorders which cause red blood cells to recycle more quickly, causing gallstones to form at a very young age.

Symptoms include pain, a burning sensation, and bloating in the upper abdomen. Your doctor will use an ultrasound or CT scan to confirm the diagnosis. You can manage your symptoms medically by staying on a low-fat diet, or you may consider having your gallbladder surgically removed. That procedure is done laparoscopically, as an outpatient procedure under anesthesia. Patients generally take two to seven days to recover.

Vitamin B12 Deficiency

By Dr. Manpreet Grewal

Vitamin B12, also called cobalamin, helps your body produce red blood cells and plays an important role in the functions of the nervous system. It is a common vitamin deficiency, especially among the elderly and people who eat a vegetarian diet, since B12 is most commonly found in animal products such as meat, eggs, poultry, and dairy products.

If you have recently undergone bariatric surgery, you may also be at risk of a B12 deficiency, since those procedures can interfere with the body’s ability to process B12. Other people commonly at risk of B12 deficiency are those with Crohn’s disease or colitis, and those who frequently take heartburn drugs, because stomach acid is needed to absorb B12.

If you have any of the following symptoms, ask your doctor for a blood test to determine if you are B12 deficient:

  • pale or jaundiced scale
  • numbness or tingling in your extremities
  • difficulty walking, including staggering or balance problems
  • anemia
  • a inflamed tongue or mouth ulcers
  • cognitive difficulties or memory loss
  • weakness or fatigue

Many breads, cereals, and other grains are fortified with B12, so look for those options when grocery shopping if you would like to increase your intake. Otherwise, standard multivitamins can help you increase your B12 levels, and specific B12 supplements are commonly available in pill or liquid form. Your physician may also recommend a B12 injection.

Managing Asthma in the Summer

By Dr. Manpreet Grewal

If your asthma symptoms flare up when the weather gets hotter, take these steps to protect your health:

  • Check the weather. Air quality, including the pollen count, is an important factor to consider when planning your day if you are managing asthma symptoms. If the pollen count is high or the air quality is poor, consider planning to stay indoors for most of the day. The American Lung Association has created a new “State of the Air” app that may be useful to you.
  • Plan your day. It is vital that people who are managing asthma symptoms seek shelter during the hottest parts of the day. Plan outdoor activities for early in the morning or late in the evening when the sun is less harsh.
  • Consult with your doctor. There may be a way to adapt your medication, whether it’s the dose or regimen, to fight the heat-induced symptoms you are experiencing.
  • Popular summer activities may aggravate your condition. If you enjoy camping in the summer, recognize that smoke from the campfire may increase your asthma symptoms. Fireworks also release smoke and particles that can cause asthma symptoms. Consider these alternatives: sit at a distance from the fire, make sure you stay upwind of smoke, make sure your inhaler is nearby in case you need it.

Alzheimer’s Disease

By Dr. Manpreet Grewal

Alzheimer’s disease ranks among the top 10 causes of death in the United States, but unlike other leading causes of death such as heart disease and cancer, death rates for Alzheimer’s are increasing, according to the Centers for Disease Control and Prevention. Because dementia-related conditions, including Alzheimer’s disease, are underreported on death certificates, the actual proportion of older people who die from Alzheimer’s may be higher than statistics indicate.

Scientists have not yet determined a cause for Alzheimer’s disease, but they have identified a number of risk factors. The most significant risk factor is, of course, age. Family history may also be an indicator that you are at risk for Alzheimer’s. Patients may experience imperceptible changes in the brain years before their first symptoms appear.

Researchers are also working to determine whether other factors such as education, diet, and environment play a role in developing Alzheimer’s disease. They have found evidence that staying physically, mentally, and socially active may reduce the risk of Alzheimer’s.

Memory loss is one symptom of Alzheimer’s, but not the only symptom. If you observe any of these changes in yourself or a loved one, it may be an indicator of Alzheimer’s disease:

  • Getting lost in a familiar place
  • Asking the same questions repeatedly
  • Trouble managing finances
  • Difficulty completing familiar tasks at home or at work
  • Misplacing things and being unable to retrace your steps to find them
  • Changes in mood, personality, or behavior

Preventing type 2 diabetes

By Dr. Manpreet Grewal

Having diabetes means the glucose, or sugar levels in your blood are too high. Type 2 diabetes is the most common form of the disease, and you are more likely to become a type 2 diabetic if you are overweight, have a family history of diabetes, have high blood pressure or high cholesterol, or are physically active fewer than three times a week.

Individuals who are at risk for type 2 diabetes should undertake diet and lifestyle changes in order to reduce their risk of the disease.

  • Eat a diet that is low in saturated fat, added sugar, and sodium.
  • Find physical activity that you enjoy, and get active for several hours each week. In addition to preventing diabetes, exercise offers a host of other benefits, including reduced risk of dementia, cardiovascular disease, various forms of cancer, and improved bone health. If you have a health condition which limits your mobility or ability to exercise, your health care provider can help identify some activities which are right for you.
  • Create a weight loss plan to maintain a healthy weight.
  • Get your blood pressure and cholesterol checked regularly.

The National Diabetes Prevention Program, led by the Centers for Disease Control and Prevention, offers classes to help people make the changes they need to prevent diabetes by eating healthy food, becoming physically active, and managing their stress effectively. More information about the program is available on their website.

Skin cancer prevention

By Dr. Manpreet Grewal

One in five Americans will develop skin cancer before they turn 70, and more people are diagnosed with skin cancer each year than all other cancers combined.  

Additionally, about 90 percent of nonmelanoma skin cancers and 86 percent of melanomas are associated with sun exposure, so we can take steps to lower our risk of skin cancer. Regular, daily use of sunscreen with SPF 15 or higher can reduce your risk of developing certain varieties of nonmelanoma skin cancer by 40 percent, and it reduces your risk of melanoma by 50 percent.

In order to make sure you have adequately applied sunscreen, apply one ounce, or two tablespoons, of sunscreen to your entire body 30 minutes before going outside. Make sure you reapply every two hours or after swimming.

On average, a person’s risk of developing melanomas doubles if they have had more than five sunburns, so preventing sunburn can reduce your risk of melanomas as well.

The International Agency for Research on Cancer, part of the World Health Organization (WHO), includes ultraviolet (UV) tanning devices in the same group of cancer-causing agents as plutonium, cigarettes and solar UV radiation. Additionally, it is estimated that more people develop skin cancer because of indoor tanning than develop lung cancer because of smoking.

You should examine your skin for any irregularities or changes that might indicate cancer at least once a month, and visit your dermatologist for an exam at least once a year.


By Dr. Manpreet Grewal

Shingles is a viral infection caused by the same virus as the chicken pox. Unlike chicken pox, however, it most commonly affects older adults and people with weakened immune systems.

If you contracted chicken pox as a child, the varicella zoster virus can lay dormant in your body but leave you symptomless. When the virus “wakes up,” it can travel along nerve fibers to your skin, causing shingles.

The painful rash commonly identified as shingles is most frequently found around the waist area. It is also commonly found on the forehead or near the eyes. However, they can be found anywhere on your body. These rashes will be accompanied by an itching or burning sensation. You may also experience a fever, chills, headache, or nausea.

Even if you think you have never had chicken pox and therefore are not susceptible to shingles, see your healthcare provider as soon as possible if you begin experiencing these symptoms. When you contracted the chicken pox, the symptoms may have been mild enough to go unnoticed. Starting treatment for shingles as soon as possible will help prevent complications.

The rashes should scab over in a week or two, and disappear within a month. However, people with weakened immune systems may take longer to heal.