Wednesday, October 28, 2015

Well, at least I can help you with #1!

Talking about private health issues is part of going to the doctor. Some health concerns, however, feel a lot more personal than others. But whether it’s a sexual problem, hidden rash or body odor, or a debilitating emotional issue, don’t let embarrassment keep you from seeking relief.
Here, in no particular order, are 10 sensitive health problems you can discuss with a health care provider, who won’t be shocked – just ready to help.
1. You have an object stuck in a bodily orifice. It’s probably not a patient’s proudest moment, but hospital emergency rooms routinely deal with sex toys or household objects that become embedded in the body.
While any opening can be involved, “a lot of the objects are inserted into the rectum and get lost there,” says Kate Patrizzi, a clinical nurse specialist in emergency services. “Other objects – a dildo, an ice cream scooper – are really inserted for the intention of pleasure but [patients] can’t get it back out once they’ve put it in.”
If this happens to you, don’t be shy – head to the ER. The staff can medicate you for pain, and they’ll order an X-ray or CT scan to find out just how far the object has gone. They may be able to remove the item then and there, while surgery might be required in other cases.

Wednesday, April 29, 2015

Hemorrhoid Treatment Options

Hemorrhoids – Treatment Options

Medications can help relieve symptoms associated with hemorrhoids. Ointments which protect the skin like zinc oxide can prevent injury and reduce itching by forming a barrier over the hemorrhoids. Suppositories used for 7 – 10 days soothes irritation and lubricates the anal canal during bowel movements. Some of these products contain chemicals that can harm the anal tissues if they are used for a long period of time.
Ointments containing hydrocortisone 1% have the effect of reducing inflammation and itching. These products should not be used more than 2 weeks as they can cause atrophy (thinning) of the skin. If  inflammation, thrombosis and irritation  occurs treatment that is generally recommended is local application of ointments containing anti-inflammatory substances, painkillers or anesthetic substance, suppositories with similar content, and in cases associated with constipation laxatives.

Minimally invasive surgery techniques

  • Ligation with elastic bands. This process consists of applying a rubber band to the hemorrhoid. Circulation is interrupted and hemorrhoidal mucosa will necrosis (dies). Hemorrhoid is drawn into a tube, then strangled with a lever at the base to be mounted two rubber rings, so that the hemorrhoid dries, because it is not irrigated with blood anymore. After 7-10 days the hemorrhoid falls, leaving a small wound that scars quickly. This procedure is repeated every 2-3 weeks for the other hemorrhoids. This procedure requires no anesthesia.
  • Sclerotherapy. In this procedure the doctor injects a chemical solution inside hemorrhoids. This method is useful only for small hemorrhoids and is less effective than ligation with elastic bands. The results are often short-lived and require repeated treatment.
  • Laser photocoagulation. Clots the hemorrhoids and transforms them into fibrous scars. The method is very effective in small hemorrhoids but scar tissue can lead to stenosis or contrary to anal incontinence.
  • Infrared coagulation. This technique uses a probe that emits infrared radiation and thus produces heat. The probe is applied to the hemorrhoid causing clotting and scar tissue transformation. The method is used alone or in combination with ligation with elastic bands and is considered more effective than laser therapy for treatment of hemorrhoids.
  • Bipolar coagulation. Electrotherapy bipolar coagulation has a direct effect on the mucous membrane near the hemorrhoid. Bipolar probes are used to treat internal hemorrhoids that bleed.
  • Galvanic current therapy. Galvanic current therapy is defined as hemorrhoids dissolution (destruction) by chemical means and electrical power supplies using a chemical reaction on the hemorrhoidal mass. The procedure takes around 10 minutes. Galvanic current, completely painless, is applied directly into veins: the current, positive or negative, causes a thermal or a chemical reaction in the tissues, which either destroys or obliterates the hemorrhoidal mass. It is a simple and safe procedure and requires no anesthesia or hospitalization, no sequelae, and does not cause severe complications.
  • Cryotherapy (extreme freezing). A cryogenic device uses liquid nitrogen to freeze the hemorrhoid. This causes the affected tissue to die, so new tissue can grow in place. This technique has an increased effect when used to treat external hemorrhoids.
  • Hemorrhoidal artery ligation of branches of internal hemorrhoidal artery with hemorrhoids atrophy as consequence.
  • Hemorrhoidectomy. Hemorrhoidectomy is surgical resection of hemorrhoids. Hemorrhoidectomy is indicated in case of complications of hemorrhoids like (bleeding, pain, formation of a clot, inflammation of the anus) or while other treatments (sclerosis, cryotherapy, ligation) failed. It is performed under general anesthesia or spinal anesthesia. Hemorrhoidectomy may be performed as a day procedure, but due to inadequate outpatient care and increased levels of pain after this procedure hospitalization is often required (3 days). Hemorrhoidectomy is the most effective and complete way to remove hemorrhoids, but is associated with the highest complication rate (ano-rectal region pain, temporary difficulty in emptying the bladder, urinary tract infections, etc.).
  • Hemorrhoidopexy. This procedure aims to reduce blood flow to hemorrhoidal tissue. Patients have less pain compared to those who experienced conventional techniques. Patients can return quickly to normal activities. Hemoroidopexia was associated with a higher risk of recurrence of hemorrhoids and rectal prolapse.
Hemorrhoids Treatment
Hemorrhoids Treatment

Monday, March 30, 2015


Dr. Craig Amshel, M.D. of Absolute Surgical Specialists, is happy to spread the word about FDA approval of Botox  for the treatment of migraine headaches.  Botox isn’t just about looking better, it’s about feeling better, and to those that get migraines, feeling better is paramount. Dr. Amshel looks forward to helping people improve their lives with Botox, whether it’s for wrinkle removal, or finding some relief from the crushing pain of migraine headaches.

There are about 3.2 million Americans that suffer from migraine headaches. A migraine is a headache that persists for four to 72 hours and involves sensitivity to noise, odors, and lights. Chronic migraines can be severely disabling to the sufferer and have an adverse impact on work, family, and social functioning. Sadly, many migraine suffers don’t respond well to traditional treatments and medications.

Research on this particular subject has been going on for quite a long time. The FDA has confirmed that Botox shots administered to the head and neck can alleviate and possibly prevent future chronic migraine headaches. To confirm this, the FDA undertook two experiments for 24 weeks each. After the first trial, people who received Botox for migraine were noticed to experience 7.8 fewer headache days and people who received just plain salt water, reported 6.4 fewer days of headache. At the end of second trial, people who received Botox for migraine reported 9.2 fewer days of headache as compared to 6.9 fewer days of the ones who received salt water.

According to the largest study performed to date, presented at the 45th Annual Scientific Meeting of the American Headache Society (AHS), eighty
percent of patients in the study said that after treatment with Botox, their head pain was less frequent, less intense, or both. Compared to standard medications, which can cause a number of side effects, such
as upset stomach, drowsiness and weight gain, side effects from Botox treatment are relatively rare. About 95% of patients in the study reported no side effects.
Researchers are unsure as of yet why Botox relieves head pain. For its other uses -- including alleviating wrinkles and treating certain medical conditions – the purified protein relaxes the overactive muscle by blocking nerve impulses that trigger contractions. For migraines, there is no muscle component. Scientists believe Botox works by blocking the protein that carries the message of pain to the brain.

Relief typically takes effect two to three weeks after Botox  injections. The longer the treatments continue, the better the pain relief. Study doctors said some patients who had previously overused oral medications were able to stop taking those medications entirely after being treated with Botox.
For more information on Botox for its many uses, or any other way to help you put your best face forward, visit Dr. Craig Amshel at 139 S. Pebble Beach Blvd., Suite 200, Sun City Center, 33573, 813.633.0081 or in Brandon.

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Monday, February 16, 2015

African Americans need to have their Colonoscopy starting at age 45- NOT 50!

To celebrate Black History Month, I want to make sure you know that despite the general population recommendation to start colorectal cancer screening at age 50, African Americans need to start at age 45. Yes, your insurance will cover it:

Wednesday, February 11, 2015

Botox treatment now offered in Sun City Center/Brandon

Absolute Surgical Specialists

Offices in Sun City Center and Brandon



Dr. Craig Amshel of Absolute Surgical Specialists has been approved to start treating patients with BOTOX® Cosmetic (onabotulinumtoxinA) for Temporary Improvement of Moderate to Severe Lateral Canthal Lines (Crow’s Feet Lines) in Adults.


Sun City Center, FL- January 2015 – Craig Edward Amshel, M. D., owner of Absolute Surgical Specialists ( announced he is now offering a new treatment option for patients with unwanted facial creases. I often see patients who are bothered by their crow’s feet and other facial lines, such as on their forehead, nose, and perioral areas, so I am very pleased that I can now provide my patients with an FDA-approved option to address the crow’s feet and frown lines that develop around the face.


BOTOX® Cosmetic is now the only pharmaceutical approved to treat both crow’s feet lines and frown lines between brows. This approval will enhance our ability to yield the best possible outcomes for patients.


The safety and efficacy of BOTOX® Cosmetic as a treatment for crow’s feet lines was demonstrated in two randomized, multi-center, placebo-controlled clinical trials. The studies enrolled more than 1,350 subjects with 833 subjects receiving treatment with BOTOX® Cosmetic. The trial demonstrated that BOTOX® Cosmetic was an effective treatment compared to the control group, which did not receive BOTOX® Cosmetic treatment.


“Crow’s feet lines are defined as the lines that extend around the corner of the eye area. They result from years of repetitive squinting and smiling,” said Dr. Steven Dayan, Founder of DeNova Research, Clinical Assistant Professor at the University of Illinois and a clinical investigator in the BOTOX® Cosmetic crow’s feet clinical trials.


BOTOX® Cosmetic is a prescription medication that is injected into the muscles around the eye area to temporarily improve the look of moderate to severe crow’s feet lines in adults. It is a quick procedure that generally requires no downtime or recovery. BOTOX® Cosmetic works by blocking nerve impulses and reducing movement to the muscles around the eye area. The decreased muscle activity helps lesson the appearance of moderate to severe crow’s feet lines for noticeable results that do not radically change facial appearance or make a patient look as if they have had “work done.”


BOTOX® Cosmetic should be administered by a licensed, trained healthcare professional. Since 2002, more than 11 million treatment sessions for glabellar lines have been performed with BOTOX® Cosmetic.


To learn more about BOTOX® Cosmetic, call Dr. Amshel at 813-633-0081


BOTOX® Cosmetic (onabotulinumtoxinA) Important Information


BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in adults for a short period of time (temporary).


BOTOX® Cosmetic is a prescription medicine that is injected into the area around the side of the eyes to improve the look of moderate to severe crow’s feet lines in adults for a short period of time (temporary).



BOTOX® Cosmetic may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX® Cosmetic:

Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months.


Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities.


The dose of BOTOX® Cosmetic is not the same as, or comparable to, any other botulinum toxin product.

There has not been a confirmed serious case of spread of toxin effect when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines or crow’s feet lines.

Serious and/or immediate allergic reactions have been reported. They include: itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you are wheezing or have asthma symptoms, or if you become dizzy or faint.

Do not take BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.

Tell your doctor about all your muscle or nerve conditions, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including severe dysphagia (difficulty swallowing) and respiratory compromise (difficulty breathing) from typical doses of BOTOX® Cosmetic.

Tell your doctor about all your medical conditions, including: plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to breast-feed (it is not known if BOTOX® Cosmetic passes into breast milk).

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® Cosmetic with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® Cosmetic in the past.

Especially tell your doctor if you: have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin, such as Myobloc®, Dysport®, or Xeomin® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; or take a sleep medicine.

Other side effects of BOTOX® Cosmetic include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.

For more information refer to the Medication Guide or talk with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

Please see BOTOX® Cosmetic full Product Information including Boxed Warning and Medication Guide.