drmarinakurian

So I got a dog. Ok, technically, my daughter wanted a dog, my husband caved , my son was all in, and i was leading a silent cheer for dogdom, trying to stop my face from splitting into two from sheer unadulterated happiness. After all, happiness is a puppy. We went to the ASPCA on 91st in NYC. This is a great place or at least, I think it is a great place. The trainers and workers care and are involved. Our dog was 5.5 months when we got him. He was underweight, and I kept wondering when he would start to forget where he came from and accept our house as home. I, of course, did not want him to get heavy. My dog is part lab and apparently, they are prone to being overweight. He gets no people food but I couldn’t resist the organic treats that are sold in every pet sotre. Seems good right? Organic, wheat -free (Hang on! is that important??), with fruit or honey or peanut butter. I had two dogs growing up, and I gave them Milk Bone dog biscuits after a walk. I figured, if organic is good for my kids, then I should get organic for my pooch.

But do you guys know what gets old real quick? Paying $8.99 for a bag of treats that lasts like two days. I happen to be a baker. Nothing fancy people! Cookies, brownies, pies, quick breads and sometimes a cake come out of the oven. But I have a singular talent to mass produce for school bake sales (well a talent other than my day job;) ), so I thought, I can bake his biscuits! Yup.. a little bit of research, and a biscuit was born. Our dog’s name is Sonny, so I called them Sonny Snax. He loves them. So do the other dogs in the building. I stand a fair chance of getting jumped by the large yellow lab in my building for one of these snax! Sonny has a sensitive stomach and dry skin, so the ensuing recipe is easy on the gi tract and good for the skin!

All products can be organic!

Set the oven for 385 F

1 ripe banana mashed

1/2 cup organic applesauce

2 tbs olive oil

2 tbs molasses

2 tbs organic honey

2 cups rolled oats (not quick cook)

1 1/2 cups organic ground brown rice flour

1/2 cup organic ground flaxseed

mix wet ingredients together, then add dry. I use a small spoon to shape the biscuits and plate them onto silpats and cookie sheets. Bake for ten minutes, flip and bake for 8 minutes more. Makes about 48 snax.
Cool and then refrigerate. I have left them out but they stay refrigerated forn two weeks. The honey and molasses act as a natural preservative. Hope your pooch enjoys.

I have used peanut butter instead of apple sauce or bananas but the this mix is i think a tasty biscuit. Yes I sample them!

Esophageal Sphincter Augmentation for the Treatment of GERD

There’s a new technique to fight GERD, heartburn or reflux. These symptoms occur because the lower end of the esophagus, the lower esophageal sphincter, is not tight and not creating a high pressure zone.

The esophageal sphincter, in patients without GERD, creates a high pressure zone so that food and fluid that is in the stomach doesn’t reflux back into the esophagus. When food refluxes from the stomach, so usually does acid. The reflux gives patients the sensation of burning which occurs behind the sternum- hence, heartburn. Patients also can feel the food reflux up into their chest and sometimes note a sour brash or acrid taste in their mouths. Some patients have a cough or throat pain.

Many people self medicate for these symptoms, including taking TUMS, Mylanta and over the counter acid reduction meds like Pepcid AC or Prilosec OTC. Other people will see their doctor and get a prescription for an acid reducing medication like full strength Prilosec or Nexium. Some patients may also need an upper endoscopy, where a surgeon or a gastroenterologist puts a long tube down the throat that is also a camera, known as an endoscope. This helps look at the inside of the Esophagus, Stomach and first part of the intestine, the Duodenum, and so the procedure is also known as EGD (Esophagogastroduodenoscopy). An EGD helps identify inflammation like esophagitis or gastritis as well as ulcers and hiatal hernia.

There is a naturally occurring hole in our diaphragm called the esophageal hiatus. This hiatus allows the esophagus to pass thru the chest and then into the abdomen. If that hiatus is wider than it should be, the lower esophagus and stomach can move through the diaphragm and into the chest. How much stomach goes into the chest determines the size of the hiatal hernia. But know this, when you have a hiatal hernia, there is no high pressure zone for your lower esophagus and you will have GERD.

There are several surgical treatments for GERD as well as endoscopic treatments. All of the treatments involve a fundoplication, meaning that a valve or flap is created to make a high pressure zone between the stomach and the esophagus. The endoscopic treatments work in patients that don’t have a hiatal hernia. There are times that I will do a hybrid procedure with a gastroenterologist where I fix a hiatal hernia, and the gastroenterologist does the endoscopic fundoplication. Other times, I will do a surgical fundoplication where I fix the hiatal hernia and wrap the stomach around the lower esophagus to create a flap valve. If the wrap goes all the way around the esophagus, then it is considered a Nissen, and if it goes only ¾ of the way, it is a Toupet.

This new technique to augment the lower esophageal sphincter involves magnets. Yes, you read correctly, Magnets! The idea is to create a bracelet on the lower esophagus that sits above the stomach that can open and close with each swallow creating a high pressure zone. As food or liquids come down the esophagus, the pressure generated by the esophagus as it squeezes the food down, opens the magnetic bracelet. As the food passes thru into the stomach, the magnets do what magnets do and attract each other back to recreate the high pressure zone.

The company that makes the device is called Torax, and the device is called LINX. The magnets are linked together in a way that they can open and close. The device has been tested and approved by the FDA in a rigorous process with over three years of study. The procedure is safe and the risks include potential for bleeding and infection as is the case for any fundoplication. The magnets are placed laparoscopically so the incisions are very small, and the procedure takes about an hour. Patients are discharged the same day, and unlike with fundoplication procedures, they can eat a normal diet immediately. 90% of patients who have had this procedure out to three years have improvement or resolution of their GERD symptoms.