You were offered an operation.
I am an interventional radiologist. I treat fibroids, an enlarged prostate, varicocele, liver tumours and pelvic pain from inside the blood vessel that feeds them, through a needle rather than a cut.
A question costs you a message. Nothing is decided today.
The same idea, every time.
Almost everything I do works the same way. One vessel is the one that matters. I reach it from inside, and I leave every other one alone.
01Usually one artery feeds the problem. Sometimes it is a vein that is not draining. Either way, one vessel is the one that matters.
02A fine tube goes in through a small puncture in the skin. I watch it on a screen the whole way and steer it into that one branch.
03Then I work from inside it. Usually I close it. For a tumour in the liver I send the treatment down it. Everything else carries on.
Find the one that is yours.
Most people who write to me are dealing with one of these five.
Fibroids and bleedingYou plan your week around the bleeding, and you have been told your uterus has to come out.
What I do
A fibroid feeds off one artery. I block that artery, and the fibroid shrinks. You will see it written as uterine fibroid embolization.
The day itself. You are awake. I numb the spot and give you something to keep you calm. You stay one day in hospital.
What it spares you, and what it costs you
Your uterus stays where it is. In the largest study that followed women that long, two in three had still never needed it taken out ten years later.
It comes back more often than it does after surgery, and then I do it again. If you want to be pregnant, this is probably not your operation, and I will send you to the right surgeon.
Ask me about fibroids on WhatsAppAn enlarged prostateYou are up again at night, and an operation is the only thing anyone has offered you.
What I do
I block the small arteries feeding the prostate, through a needle. Nothing is cut, and nothing goes up the tube you pee through. The usual operation does both. You will see it written as prostatic artery embolization.
The day itself. You are awake. I numb the spot and give you something to keep you calm. Home the same day, and the prostate shrinks over the weeks after.
What it spares you, and what it costs you
I will say the thing most men are too polite to ask. After the usual operation, semen often goes backwards into the bladder instead of out. After mine, far less often.
You are more likely to need it done again, and the usual operation does more about the getting up at night than mine does.
Ask me about the prostate on WhatsAppVaricoceleAn ache by evening that was not there at breakfast. Or a fertility test came back low.
What I do
I close the vein that is not draining, from the inside, through a needle. You will see it written as varicocele embolization.
The day itself. You are awake. You go home the same day.
What it spares you, and what it costs you
A cut in the groin. Being put to sleep.
It comes back more often than it would after surgery. And if you came about fertility, anyone who promises you a number is ahead of the evidence, me included.
Ask me about varicocele on WhatsAppLiver tumoursA scan found something, and everyone is asking you what happens now.
What I do
I send tiny radioactive beads down the artery that feeds the tumour. They stay there and leave most of your liver alone. You will see it written as radioembolization.
What it spares you, and what it costs you
The worst of what chemotherapy does to you.
It does not make you live longer. Anyone who promises your family more time is not telling you the truth.
Ask me about the liver on WhatsAppPelvic painWorse by the end of the day, and worse on your feet.
What I do
Sometimes it comes from veins in your pelvis that do not drain. I look for those veins with a scan. I close them from the inside, and you will see it written as pelvic vein embolization. If they are not the cause, I tell you.
What it spares you, and what it costs you
Mostly, being disbelieved.
Of everything I treat, this is the one I am least sure of.
Ask me about pelvic pain on WhatsAppThe room you would be in.
Clemenceau Medical Center, Beirut. The screens on the wall are what I watch while I work.
What I have done, and where.
A journal, a hospital, and a television station.
2020 Selective internal radiation therapy for tumours in the liver My own twenty three patients at Clemenceau, written up with my name first, in a journal any doctor anywhere can open for free and check against what I have told you. Clemenceau
2015 First in Lebanon to treat inoperable liver tumours this way My hospital's own announcement, 26 January 2015, crediting me with the first three cases in the country. I did not write that sentence. Their page has since come down, so this is the archived copy. Archived MTV
Santé Fifteen minutes of live questions about fibroids, on national television Lebanese television asked me on to take viewers' own calls, unscripted, on their daily medical programme. Clemenceau
film My hospital filmed me explaining how I work On their premises, on their own channel, in their own words. I did not write the script and I do not control the page.
Beirut, by way of Washington.
I studied medicine at the American University of Beirut. I went to Georgetown University in Washington, DC, to train in interventional radiology. I worked in the United States for a while, and then I came home.
Today I practise at Clemenceau Medical Center and at Saint George Hospital University Medical Center, both in Beirut, in the Department of Diagnostic and Interventional Radiology.
In 2023 a medical magazine asked me, on the record, what a newer treatment for an enlarged prostate could and could not do. I answered the second half first.
هذا الخيار لعلاج تضخم البروستات ليس بديلاً عن الجراحة او العلاجات الأخرى المعتمدة
This option for treating an enlarged prostate is not a replacement for surgery, or for the other treatments that are already established.
Arab Hospital Magazine, 19 June 2023
That is the answer I give in the room, too. If a specialist has already told you something that still holds, I will tell you that, and where to go instead.
Tell me what is happening, in your own words.
I will tell you whether this is even a problem to solve my way, and where to go if it is not. If you are abroad, or you are asking on behalf of a parent, send me the scan report in the same message and I will read it before we speak.
A question costs you a message. Nothing is decided today.
Lebanese Order of Physicians, Beirut · ي/225
Clemenceau Medical Center
Department of Diagnostic and Interventional Radiology, Beirut
Saint George Hospital University Medical Center
Achrafieh, Beirut
Send the imaging and the question on the same number and I will come back to you, not to your patient.