Best Docs Network Houston November 24 2013

It's a call that's telling me I'm here to serve. It's a need to make a difference in the world. 24 hours day or night these healing hands will make it right. Looking in their eyes I know that I'm changing lives, changing lives, changing lives for the better, for the better, changing lives. Hello everyone, IÄôm Grace Sells and today we have a great episode of Best Docs Network, the show featuring some of the best doctors in the Houston area that are changing lives. Up first we have vein specialist Dr. Peter Morgan. My legs were very, very tired. I couldÄôt sleep, toss and turn, couldÄôt get comfortable, they would just hurt all night for years. Restless legs is best described as a very strong sensation or urge to move your legs. It becomes disabling because it creates an anxious sensation, itÄôs hard to explain, yoÄôre not sure whaÄôs causing it, you just have this overwhelming urge to move your legs. It almost always occurs at night and because of that it creates severe insomnia and severe anxiety. I had varicose veins, I knew I could see them on the outside but I didÄôt know about the veins on the inside that were not allowing the blood flow to go past my knees. They would just go up so far and then just go back down to my feet. We mapped her veins very carefully using ultrasound. We again isolated all the bad things, the ones that were too large and the blood was running backwards because the valves had failed and we selectively ablated those using radiofrequency under ultrasound guidance. No pain, just a little stinging when they first go in with it but really not much even though they said iÄôs not gonna hurt, iÄôs not gonna hurt but it really didÄôt. The last treatment I had I didÄôt feel a thing. We do that without any incisions or anesthesia. Patients can walk in, sit down, have the procedures done, stand up, walk out, get in their car and drive themselves home. I would say donÄôt worry about it, just do it, just get it done because you need to have it taken care of. IÄôm sleeping now, I rest comfortably and it turned out good. In the past we used surgical procedures. The problems with that, 1 it required general anesthetic, 2 it required big cuts with potential side effects like infection, damage to nerves, arteries, muscle and they werenÄôt selective, we were almost randomly choosing veins to treat and they werenÄôt always the only or maybe even the correct veins to treat. Now we selectively treat only the veins that are running backwards so it works much better. Jack from Tomball has a question for Dr. Annie. How can airplane travel cause clots and death? Long travel can cause venous flow to decrease so therefore the flow in the legs can kind of pool and accumulate and not come back up to the heart. When that happens after patients are sitting for long periods on an airplane, a clot can form because the blood becomes stagnant. To prevent that we tell patients to walk the aisles of the plane, exercise the legs even while sitting and try to stand up intermittently throughout the flight. This will protect the patient from having clot formation. What happens when the clot forms is when the patient finally leaves the airplane and gets to their destination, the clot can move and go up to the lungs and cause sudden death from a pulmonary embolus. Very critical to know about clot formation, very critical to prevent it and easy to prevent by just moving, actually sometimes wearing hose will help. And knowing the risk factors of flying can prevent a problem when you get to your destination. My teeth needed to all be extracted, they were crumbling, they were breaking, I couldÄôt chew my food. HÄôs a professional, an accountant and hÄôs certainly concerned about finances and how to structure his budget and he was the guy that his lower teeth were worse off than the uppers. And so that was an area that he decided to focus on. I guess this started in 2009 and this really happened in kind of in two settings so that in 2009 we did the lower and in 2011 we did the upper. The bottom is all done and Äôm in the midst of having the prosthesis on the top done. And also with David his concern regarding his budget. We were able to do this without grafting. Previously in the upper jaw because of the maxillary sinuses we would have to graft those areas in the majority of cases that we were replacing a full jaw worth of implants. But with the advent of cone beam CT we are able to look at individuals from a 3 dimensional standpoint radio graphically ahead of time so as to know where the bone is so that we can position implants within that bone and avoid the need for sinus grafting and subsequently lower his overall cost significantly as well as increase the predictability. No longer do I have to make sure that everything is in place where iÄôs supposed to be in place. ItÄôs, I have, I have a new chance at a brand new set of teeth and they doÄôt hurt. IÄôs satisfying to see him come back smiling, see him walking down the hallway standing upright with their chin up, smiling and being much more confident so from a psychological standpoint outside of the health benefits that you see, the mental health benefits are significant. Äôm a CPA, I meet with clients and high net worth clients. Appearance is important to me, itÄôs certainly not of the utmost importance, but iÄôs important to me and I donÄôt want to be embarrassed by a crumbling smile. ItÄôs a wonderful, wonderful solution. To request an appointment with any of the great doctors youÄôve seen on our show today, head to our website, bestdocsnetwork.com. How many times have you heard, oh my aching feet? Well, when your feet art hurting your entire well being can suffer. HerÄôs someone who can help, Dr. Gabriel Maislos. Minnie presented in my office complaining of a painful bunion deformity. A bunion deformity is a deviation of the great toe where you see that bump on the side or bump on the top. It has to do with a deviation of the first metatarsal and basically you know just became really painful for her to walk in her regular shoes. Yes, because I really had this bunion I think like probably about a year. And so it had got so bad I couldÄôt even wear a shoe so thaÄôs what really made me came in you know to have surgery on it. The next step was for us to take an x-ray to evaluate her foot and determine what kind of you know surgery would be appropriate. So after looking at her metatarsal angle we basically decided that a Austin Bunionectomy would be the best procedure and so thatÄôs what we ended up doing. After I had the surgery I felt much better. You know, no pain. It just felt better and I was so happy you know to get it done. I mean as long as you address the underlying ideology, the cause of it, then youÄôre not going to get a recurrence and iÄôs wonderful, I mean, you know people suffer from painful bunions all the time. It can be painful to the point that you can actually develop an ulcer at the side bump because first it gets red, the next thing you know you have a wound and that can be problematic because then you can get an infection to the bone. I mean itÄôs not sore or nothing. It just feels better and so he really do a good job and he makes me feel comfortable. I mean hÄôs a real good doctor. Bunion surgery has a bad knock to it you know. A lot of people are concerned that theyÄôve heard from their neighbor or they know someone at work whÄôs had the surgery and iÄôs extremely painful. I have some patients that have zero pain from bunion surgery but I can keep the area numb for three days with a pain pump, which is a device that just gives a continuous drip of local anesthetic and keeps it nice and numb. Because really inflammation is the first part of wound healing and thatÄôs in the first seventy two hours, so the first three days. IÄôs a great relief for patients, really two weeks of just not putting weight on it and you know itÄôs really come a long way with our surgeries. Stretching can help boost circulation and digestion and even ease back pain. Remember when stretching to hold each position for about 25 seconds and to breathe deeply. I am an athlete. I am a world series champion. IÄôm a hockey player. IÄôm a football player. I am strong. I am strong. I am strong. Fight colorectal cancer. Demand a cure for colon and *** cancer. I am strong because I have lost a frienÄôs mother. Because I lost both of my parents to this disease. I am strong because nobody should suffer. LetÄôs beat this cancer. One simple test and you can save your life or someone you love. Get screening. Be a part of one million strong. You know I just always felt like my body was out of proportion. When I would try on clothes I just, it was never when I looked into the mirror what I envisioned in my own mind. So I guess thaÄôs what prompted me to start researching and looking on line. I just, I never felt like my full potential. Karen came in just wanting to have bigger *** because she had always felt that her breast size was out of proportion to her hips. She had always wanted to be a little bigger. She just felt she needed it to kind of balance out her shape so she was, after discussing it with her, a really good candidate for that. As soon as I met his staff and him, I know he had that attention to detail just speaking to him. Something about him set him apart from the others. He just made me feel safe. I knew I could trust him and his work. So thereÄôs a lot of factors that go into it. By taking the measurements and using them carefully to that particular patient and matching it to the size of the implant, we can give them a good aesthetically pleasing size and shape that looks good and matches their body. It was an outpatient procedure so I came in that morning, the same day I was out and back at home. It was a really good experience. It really made a huge difference in her confidence and self esteem. It may seem like a small thing to someone who didnÄôt know her or just a casual observer but in her mind it made a world of difference. It just really changed her personality. It kind of brought her out of her shell, she just felt better in a bathing suit and photographs, just being out socially so it was a real blessing for her over all. Before my breast augmentation I was wearing a size A and after the augmentation I was a C. I had already decided I wanted a very natural look and thatÄôs something thaÄôs very important to me. That is what Dr. Altamira gave me, a very natural look and Äôm very happy with the results. A lot of people are on aspirin. Aspirin is good to prevent heart attacks and strokes because it inhibits the stickiness of the platelets in your blood. These platelets clump together when they get real sticky and then they can cause blood clots then you get a heart attack and stroke. Aspirin stops that stickiness. Now we used to say that anyone at high risk for a heart attack and stroke should be on aspirin to prevent those problems but now we think we should only use it for people who have had a heart attack or stroke. We found that people who took aspirin to prevent those things yet had never had one of those problems, a heart attack or stroke, those patients still had just the same number of heart attacks and strokes that had more bleeding from the aspirin because it can be *** your stomach and had more bruising because it can cause the blood not to clot in your arms and legs and then youÄôll get bruises all over the place. So if yoÄôve had a heart attack and stroke you should take aspirin, 81 milligrams, thaÄôs a baby aspirin, doÄôt get brand name just get generic stuff. If youÄôve had stomach problems like ulcers and gastritis use an enteric coated aspirin. But it is true in many cases an aspirin a day can keep the doctor away. For additional Medical Minutes from Dr. Honaker, logon to bestdocsnetwork.com, click on Education and the Medical Minute tab. For more information and to check out hundreds of great videos, head to our website, bestdocsnetwork.com. Up next we have ear, nose and throat specialist Dr. C. T. Nguyen. Gosh I was young, maybe about 6 years old and was tagging along with my older brother playing golf and I just so happened to get too close to him when he was teeing off and got hit with a backswing right in the nose and from then on thatÄôs when the problem started. Joey came and see me because he canÄôt breathe through his nose so he has to breathe through his mouth. He doesnÄôt sleep well at night. He snores a lot and that makes him tired all the time. You know you would sleep through the night but wake up and not feel rested, you know even though you made it through a whole night and got a whole night of sleep, you just wake up and feel like gosh I really donÄôt even feel like I slept at all. When we examined Joey we noticed that the wall in the middle of his nose, what we call a septum that separates the left and the right side was crooked and in his case was crooked on the right side you know causing him problems to breathe through his nose. And we agreed upon a treatment plan that consists of first a surgery to correct his septum to straighten up his septum so to improve the nasal airway. Very simple outpatient, you know everything was explained to me. Go in in the morning. I actually took a little nap right before surgery because it was early in the morning, woke up and that was it. So it was real simple, real easy. JoeÄôs quality of life has improved tremendously. He breathes better, he sleeps better and he enjoys life more. Well you know, you just donÄôt realize because IÄôve had it for so many years, you just get used to it. YouÄôre thinking the way youÄôre breathing is normal and itÄôs not. And then once itÄôs changed the way it is, you know Äôm able to do things without getting winded, you know because Äôm not having to open my mouth to breathe now. I mean, I can breathe clear through my nose. The number one reason that patients come and see me is because they caÄôt breathe through their nose. In most of the cases, therÄôs a solution for that. As a center of excellence in nose and sinus disease, Äôm always in the forefront of medical research to improve my patient outcome. Medicine has advanced so much that therÄôs always a solution to breathe well and live well. Patients doÄôt have to suffer any more. Smart phones and on the go technology are on the rise causing Americans to use headphones more than ever, but did you know that wearing headphones for just an hour could increase the bacteria in your ear by 700 times. Welcome, today wÄôre here with Dr. David Fish who is the director of interventional cardiology at the Texas Heart Institute. Dr. Fish thank you so much for joining us today. My pleasure. So we know that you have done so many wonderful things in your career. Today we have just a few minutes to talk about one of your great interests is transcatheter aortic valve replacement. Could you tell the audience what is that? Well, for many patients especially those reaching older age, often the aortic valve which is the main outlet valve for the pumping chamber of the heart becomes narrowed or stenotic because of degenerative changes of the valve. Ordinarily this is a reason to do open heart surgery to surgically replace the valve but in some cases the risk for open heart surgery is very high for some patients. So for selected patients who have this problem and who are at high risk for surgical valve replacement, now we have techniques available and instruments available by which we can deliver a valve into the valve position through a catheter. Wow, that sounds very amazing. For years there was only surgical option for these patients. Is this happening in multiple centers? Yes, theyÄôre widespread now in the United States. There is as yet only a single commercial valve available and the delivery systems are large and require a lot of expertise and a great deal of teamwork in order to deliver successfully. We know that the great thing about the Texas Heart Institute is that iÄôs a huge team of cardiologists and surgeons and support services so we know that you are one of the great teachers here at Texas Heart Institute. Tell me what you feel about educating these students over the years. What has been your main feeling about this? Well, wÄôre fortunate here to have had over the years very highly qualified, very gifted students of medicine and doctors who come for their post graduate training in cardiology here and among these a number selected choose to go into interventional cardiology. That is of course the branch of cardiology involved with putting instruments in the body and opening arteries and correcting structural defects in the heart. IÄôs been my great privilege to have trained a great many of the operators whoÄôve gone on from the Texas Heart Institute into the community and to other places in the country and brought forth the skills theÄôve learned over there. I know that you have been my favorite teacher in all of my career and I thank you in front of the world for being such a fabulous teacher about cardiology and about life. YouÄôre very kind. Thank you. We just have a few more moments, what would you like to tell the public about the Texas Heart Institute and perhaps getting their evaluations done here? Well the Texas Heart Institute has a long tradition of research, patient care and of course teaching. And in this kind of environment I think patients get the best possible care and most astute kind of understanding of their problems and their specific needs. In addition of course with critical mass achieved here with all of the different researchers and the different clinical efforts and the different programs every patient has a chance to get the very best of what cardiology has to offer. Well we thank you so much. YouÄôve been such a tremendous force here in the Texas Heart Institute and in my life and I want to thank you. Thank you. For more information, head to our website, bestdocsnetwork.com. And did you know that simply smiling more often can improve our overall health? LetÄôs check out smile specialist Dr. Guy Lewis. As I was aging I guess, my teeth werenÄôt as pretty as they used to be so I found that I wasÄôt smiling as much as I used to. You know SandÄôs a very beautiful lady. A lot of the patients I see, probably a majority of the patients I see are women you know over the age of 40, who a lot of times you know they take care of themselves, they stay in shape, they look great but thereÄôs just some things they want to do to try to look younger and for Sandy you know getting her teeth whiter, straightened up a little bit with the veneers was perfect for her. Äôve seen a lot of Dr. LewisÄôs work and have been so impressed so I came to see him and IÄôm so glad I did because now I smile all the time. It just really works great for a lot of people and she was a perfect candidate for that. IÄôs amazing to me that doing the veneers like we did for her which is a pretty simple two visit process two or three weeks apart, what a difference it can make in how someone looks. I mean literally 10 or 15 years younger. ItÄôs painless, it doesnÄôt take long. Dr. Lewis is very sensitive to your feelings and how you want to look. HÄôs a good listener. He listened to how I wanted my smile and my teeth to look and he did exactly what I wanted. It can be done so to where iÄôs not like people look at you and go wow where did you have your teeth done, but they look at you and go man you look great, what have you done? Have you been working out more or you just look, so itÄôs a for some people if their teeth are really bad yeah itÄôs going to be a noticeable change but for other people itÄôs just one of those things to where you just look good, you look more alive, you look more refreshed, you just look better but iÄôs not just a glaring oh what did you do to your teeth? My family would say, okay what did you do, somethingÄôs different, youÄôre smile is beautiful, did you get your hair cut? I just feel so good about my smile now. Smiling is good. Äôm not a big fan of going to the dentist so this was a big deal for me and I would do it again in a heartbeat. LeÄôs talk about grief and depression, thereÄôs a big difference. We all have grief, we lose a favorite animal, we lose a loved one, we lose a job. These are things you grieve over. Depression is a whole other thing, thatÄôs a chemical abnormality in the brain. It often needs medication to get well. Grief can lead into depression also so itÄôs important to know the difference and there are several ways to know the difference. Number one, grief tends to be more short lived. It may last a few weeks, a few months and in rare cases a few years and depression tends to last longer, more along the range of months and years. Also and this is the most important factor, grief tends to progressively improve. You get a little better every few weeks, every few months. You can look back and see that youÄôre improving. Depression doesnÄôt act that way, it tends to stay the same, stay bad and get worse. You feel anhedonia which means the lack of joy. If you have grief, you need time, you need help, you may need support groups. But if you have depression, you may need medication. Try to tell the difference and search for help. Coronary disease is a type of vascular disease where plaque coats the inside of the vessel to the point where therÄôs a growth and thatÄôs called stenosis. The number one problem with regard to formation of plaque is cholesterol. So we have different types of cholesterol, LDL cholesterol. We have HDL which is the good cholesterol, LDL being the bad. Triglycerides are another bad cholesterol. So iÄôs very important to do advanced testing of the lipids. Back in 2000 I was working, had some pains in my chest, went to my general practitioner, he examined me and said you need to go see the cardiologist today. Made an appointment for me with Dr. Varughese and when she examined me she said, stay right there, youÄôre going to the hospital. The case of Thomas is quite interesting. He came at the beginning of my practice years, IÄôve been practicing for 18 years now and Thomas came as a new patient and just complained of intermittent chest pain. We proceeded to take care of him and he proceeded to die on the table and had no heartbeat so we of course started resuscitative measures immediately and quickly transported him to the cardiac catheterization laboratory. Found a severe blockage in the right coronary artery and thaÄôs why he had become hypotensive, his blood pressure had dropped, his heart rate had slowed down to nothing and he had stopped. So in the office I pounded his chest and started CPR and then we took him to the cath lab. I was very lucky. I mean if youÄôre going to have it, If yoÄôre going to have that kind of thing happen, being in a cardiologists office is one of the better places to be. The thing thaÄôs most amazing I think about Dr. Varughese is her concern for her patients and her constant drive, her constant searching for things to help them, not only when theÄôve had the heart attack but helping prevention of the heart attack. Her personality of her patient care is phenomenal. It is so great to see these doctors really changing peoplÄôs lives. ThatÄôs going to wrap up todayÄôs episode of Best Docs Network, a show featuring some of the best doctors in the Houston area that are changing lives. For more information, head to our website, bestdocsnetwork.com. And if you have a question or comment we love hearing from you, send us an email at info@bestdocsnetwork.com. IÄôll see you next week.