Best Docs Network Forest Park Medical Center April 7 2013

On this edition of the Best Docs Network featuring Forest Park Medical Center, Dr. Garner Newton, Dr. Jorge Casas, Dr. Robert Wyatt, Dr. James Davidson. Hi again everyone, I’m Kandace Krueger along with Jim Knox and we’re back again with another edition of the Best Docs Network featuring Forest Park Medical Center. Of course Jim Forest Park Medical Center is one of the top medical centers in all of the Dallas, Fort Worth area. And they continue to gain recognition from a number of areas like Forest Park Medical Center Dallas has recently been known as the bariatric center of excellence. We’re here at Forest Park Medical Center of Dallas where we are a Bariatric Center of Excellence through the American Society of Metabolic and Bariatric Surgery. What a Bariatric Center of Excellence is, it’s a designation that a facility has to actually apply for. It covers ten very vigorous standards that are set forth from the American Society for Metabolic and Bariatric Surgery and they actually come and interview, they audit charts, they look at outcomes and they look at ten very vigorous standards to make sure you meet the standards from the equipment you have to care for you patients, the personnel that you have involved taking care of the patients and it’s there for patients to be able to select a facility that is above and beyond for their care of bariatric patients. Part of being a Bariatric Center of Excellence means that we are able to handle any complications that occur with our patient, so we have several physicians that we can consult for whatever needs we may have. Whether that be pulmonology, nephrology, neurology, any of those things that we may need we have those here at our fingertips and we have that for the ICU and the ER as well. I oversee all of the medical nutrition therapy both before and after surgery with the bariatric patients so up to six months prior to bariatric surgery patients can come and see us and work on lifestyle changes and then we also visit with the patients here in the hospital immediately after surgery and we offer post-op classes just to kind of keep everybody on track up to a year following the procedure. I help teach the pre-op in the seminar classes for our bariatric patients or our prospective bariatric patients. We do inpatient teaching after they’ve had surgery as well as do the lap band adjustments. Once they’ve had surgery we do upper GI’s. We do see them from prospective patients and postop wise we see them throughout the whole course of their procedure as well as two years out, three years out so we continue to follow up with them and see how they’re doing, continue their education. The pre-op procedures that we do in radiology are the upper GI’s and they like to do that to be able to see the intestinal tract before they have surgery so the doctor knows what they’re working with and then postop we bring the patients down and we do upper GI’s so the doctor can make sure that all the suture lines look good and there’s no leaks and everybody’s good to go home. We do around three percent of the cases nationally for bariatric surgery. That means that out of all the thousands of bariatric surgeries nationwide this specific hospital does three percent of them. We have a great multi-disciplinary team and we do have a great team of our dieticians, our nurses, our surgical staff, our respiratory therapists, physical therapists, radiology techs, everyone and it takes every one of those members of the team to provide great patient care. And without any one member of the team we couldn’t be as effective as we are. After five years of general surgery, I did a fellowship to learn how to do bariatric surgery for one year and then I did a second fellowship in cosmetic plastic surgery. And that allows me not only to take my patients through the weight loss surgery, help them lose the excess weight, but in addition to that, after they lose the weight, I can do the reconstructive surgery that addresses the excess skin that they’re going to have or that they may have after they lose the weight. When I started seeing Dr. Frenzel for my follow-ups, I had lost about 100 pounds and I ended up losing about 115. And after her gastric sleeve, she had significant excess skin in multiple areas of the body. After 115 pounds you have a lot of skin that is sagging and I needed a total reconstruction. Not every bariatric patient is going to need this type of surgery, but if you lose over 100 pounds, most patients will have some skin issues. The four areas that are the biggest concerns are the abdomen, back, the ***, arms and thighs. When he saw that I was pretty much down to where I was going to be, and wasn’t going to lose any more, then we started talking about the reconstruction. And I wanted it all done at once and he said no it doesn’t work that way so we did it in stages. My number one goal is to get the patient to a healthy weight, okay. This is about getting the patient healthy. However, during that time in this massive weight loss, they can form this excess skin. At that point the skin usually needs to be addressed. And I said, I just want to look normal, I don’t want to look fake. And he said, I can do that and I said okay I’m trusting you then, do it. And he just did a fabulous job. I look normal again. And it’s not until they take the skin off that they say you know what now I feel like my transformation is complete. Now when I look in the mirror, I see the person that I know that I am. Cindy did very well, had excellent results. She recovered nicely. He gave me back me because I’ve always been a very outgoing person. I love to be around people. We have a great life you know and I have my life back because I get to do anything I want to do. Best Docs Network featuring Forest Park Medical Center. Forest Park Medical Center, extraordinary in every way. Well this is the fourth anniversary of the Dallas hospital. We opened in March 2009 and what we’re doing now is we’re treating our folks to custom cupcakes, ice cream, cold drinks. And really they’re being served by the leadership team themselves, the directors, the managers, the people who really appreciate what our staff have done. We started off as 24 beds and we’re up to 84 and now we have two hospitals and the third one to open June 10 and so we’ve grown a lot from where we started. Never thought it would grow so quickly in four years. I have a lot of pride in what we’ve done here and what we’ve done in the other two facilities. It’s very rewarding to see what you can do and what you can bring to the community. It was obviously a niche that was missing. Being able to open in an economically challenged time, to be able to grow from that and to sustain this level is something that, well the model has worked. Our staff, the people who take care of our patients, the people who take care of the ancillary functions such as facilities, lab, pharmacy, all the different functions that really make the hospital go, we really want to honor those people today and the commitment that they’ve had over the last four years. The meniscus is a structure inside the knee that acts like a shock absorber. It’s commonly injured with any twisting type motion. There are different signs and symptoms that occur when somebody tears the meniscus. The most common one is pain. It’s usually on the inside or outside of the knee depending on which meniscus is torn. I was bicycling and experiencing a lot of knee pain. Activities were limited because of the knee pain. I finally decided I had to go see Dr. Newton when the pain just became too much and I felt like even with rehab anything I did the pain wasn’t improving. This is a model of the knee and what it shows here are the two meniscus. This meniscus here is the lateral meniscus, it’s on the outside of the knee where you see the small bone here, the fibula. The medial meniscus is right here, that’s on the inside of the knee. The way these structures are torn usually is a sudden twisting type motion when the femur twists on the tibia and causes a tear. Once a patient is diagnosed with a meniscus tear and they’ve proven to fail nonsurgical treatment, then the treatment for meniscus here would be arthroscopy. That’s simply making three, maybe four but even sometimes two small incisions to go in there and trim that tear out. It’s an outpatient procedure. It usually only takes about twenty to thirty minutes to do and the patient for the most part is walking right away. I think the most important thing after somebody’s undergone meniscus surgery is to try to prevent future injury to their knee in general. The way to do that is to keep up the therapy exercises that they’ve worked so hard with in those three to four weeks after surgery on their own so that they’re conditioned, they’re dynamically stable and they are basically at less risk of reinjuring that knee. My husband and I live about four hours from Dallas and it is every bit worth the drive to come and see a doctor such as him. You get great care with him, he cares about you. Like I say he truly cares whether you recover and I think as a patient you have to believe that. For more information on Forest Park Medical Center or any of the amazing doctors that operate right here, just visit our website, bestdocsnetwork.com and click on the Forest Park Medical Center tab. Now let’s check in with our next Forest Park Medical Center doctor, it’s Dr. James Davidson who’s working at the Bariatric Center of Excellence helping a lot of people lose a lot of weight. For the last about ten years my life had been slowly getting smaller and smaller. I was unable to walk. My weight had ballooned up during that last year that I was unable to walk and I had been wanting to look into the weight loss surgery for several years. Obesity has been told to cause approximately in one article about 86 diseases but it also appears to be a risk factor for at least a dozen cancers, particularly some of the female cancers. We know that some of the cancers that are particularly hormonally related such as breast or endometria or uterine cancer is exacerbated because of probably some of the extra hormones that people get from extra fat cells. I had many health issues that were going on in my life. I had diabetes, I had high blood pressure, I had what’s called metabolic syndrome. My waist was larger around than six feet and I was unable to walk due to osteoarthritis. I had discussed many options for the weight loss surgery with Dr. Davidson in his office and the gastric bypass turned out to be the best option for me. What I like about bariatric surgery is it allows to put diseases into remission so that people, their arteriosclerosis or their hardening of the arteries doesn’t progress because they don’t have their diabetes and all the inflammatory responses of the body that you get from the metabolic syndrome with being overweight. I also like bariatric surgery because it actually decreases people from getting cancer. My feeling is, is a weight reduction surgery should even be used as a means to both prevent and improve the prognosis of people that have cancer. I really enjoyed my time with Dr. Davidson. He is a straight shooter, he is a very intelligent but a very kind person. He lets you know exactly what you can be expecting and he is a perfect partner in the weight loss process with you. Raymond, a loving father of three had sleep apnea. At times he stopped breathing at night until he met Dr. Trone. To find out more about Raymond’s story and other life changing stories, logon to bestdocsnetwork.com. Chad has a question for Dr. Jorge Casas. If I’m having pain after joint replacement surgery, should I be concerned? Pain after joint replacement surgery is extremely common. Typically the further out you get from your surgery the less severe the pain is. However if you notice increasing swelling, increasing rather than decreasing pain or any fever or chills this is an indication that you could potentially have an infection and you should go in and see your doctor as soon as possible. Prior to coming to see Dr. Wyatt I was constantly clogged, my nose, constantly had to blow my nose. I was carrying toilet paper around with me constantly and was just miserable. I couldn’t smell at all, I had a hard time tasting and it really affected my lifestyle. Jenna has been a patient of mine for a long time now and she has very serious problems with sinus infections, sinus polyps, allergies and associated problems with asthma. I wanted to find out what was going on so I could breathe better and be functional. She has a lot of problems with chronic sinusitis with the formation of a lot of polyps. It’s driven by her allergic disease and underlying inflammation that she has all the time. One of the big problems she has is something I see very commonly where sinus problems are making asthma worse. He explained to me that I had a lot of polyp development in my nose and that he needed to remove them so that way I could breathe better and that way everything would flow more clearly and I would be able to smell as well. So one of the things that happens to her when her sinuses start causing trouble is her asthma gets a lot worse. I would never be able to cure her but I would be able to dramatically improve her quality of life by cutting down on the medicines she had to take all the time, improving her breathing through her nose, her sense of smell. Dr. Wyatt has changed my life in many ways. First of all being able to smell my own perfume. Yeah, he’s definitely changed my life. I can taste food again, I can make trips with my husband and I can have a normal life. I love being able to smell flowers. And she’s one of those people unfortunately that I have not been able to go in and cure with a single surgery but because of the minimally invasive techniques that I’m able to employ now, even though she requires surgery to clear out polyps every eighteen months to two years or so she’s able to get that done and tolerate that with very little down time. He is a great doctor. I love that he explains things to me well. He shows me things, he helps me out with new medications if I’m on them. He coordinates really well with other doctors. I just love Dr. Wyatt and his team. I would definitely recommend Dr. Wyatt. Forest Park Medical Center is not only known for some of the best physicians operating right here out of Forest Park Medical Center, Kandace, but also some of the best technology. It certainly is and their radiology department is second to none. Let’s take a closer look. Radiology Departments are very commonly in hospitals. The difference here is that this is primarily a surgical hospital and our primary purpose is to support our O.R. and we have 14 O.R. suites upstairs. We have both pre and post operative imaging. Here at Forest Park I work more closely with the staff members, kind of the segway between the director and the technologist. I’m here with them daily supervising what rooms they’re in, what exams need to be done, what tech goes to what assignment. We’re a full service out patient facility. We have an MRI here that’s called a short bore. What that means is it’s not as coffin like for patients, it’s more open. We also have a CT scanner here, it’s a 64 slice that is capable of doing cardiac as well as any other CT imaging that you might need and it’s also an interventional radiology CT scanner meaning we can do procedures that normally would have had to been done in another room and then brought to CT for scanning. We can do both on the scanner at the same time. We have an onsite radiologist from RCA that read all our imaging. We have an onsite ultrasound unit fully capable of doing general ultrasound and vascular and I also have a staff member that can do both. Here at Forest Park Medical Center we work closely with some of the best surgeons in the area, they’re definitely top notch. We do what’s best for them and we make sure that we have all of the equipment necessary, all of the reps that they need to make sure that they get the job done well. Our surgery suite encompasses four C-Arms that can be used in a variety of times during the day and our primary O.R. tech who happens to be our lead tech here at this facility is Stefanie Woodlee and she has not only taken the bull by the horns here at this facility but she’s also trained each of the other staff members that work in O.R. and has done a phenomenal job in that capacity. If we’re doing spinal fusions, that screw placement is very important and we need to make sure that those screws go in exactly where they need to be and imaging has everything to do with that. If our image is wrong then those screws could be placed incorrectly so we work very closely with the surgeons to make sure that we have the right image that they need to make sure that they can place the screws correctly in the spine where they need to be. We’re actually imaging during the surgery and assisting the surgeon to make sure that he’s guiding his tools into the right proper anatomy to make sure that he’s doing it where he needs to be. I really firmly believe that we have state of the art equipment here and I’ve got a top notch staff that can really meet any of the referring physicians in the communities needs. Did you know that Forest Park Medical Center was voted as one of the top 100 places to work in the Dallas, Fort Worth area? Forest Park Medical Center received this honor for the second year in a row. A couple of years ago I decided that I needed to make some lifestyle changes and I lost about fifty pounds and just started to get healthier and I started feeling so much better and I decided that I really didn’t look as well as I felt. Donna is a very attractive woman. I think she has beautiful bone structure, she although she does not dye her hair and she has white hair she has a very elegant look, but I think she had very prominent jowls. She had an obtuse cervicomental angle which means that her neck went from her chin down straight which you can see in her preoperative photography. I didn’t want to look like a twenty five year old. I just wanted to look like my well self. He did my eyes, underneath my eyes the bags under my eyes which really made such a huge difference and you know pulled up the neck and you know so that this is really clean in here and I had with the weight loss I had a lot of hanging skin and he you know took that away so that was wonderful. Afterwards, she looks natural, she just looks a lot younger and a lot better. I mean people I don’t think would believe that she’s in her mid sixties. As of right now I’m about six months post op. I’m thrilled with it, I really am. It looks natural, it doesn’t look bold. I look now like I feel. So overall she has a very natural and refreshed look. You look like you’ve been vacationing or you’re well rested and people know you look a lot better they just can’t place it. You really have to be comfortable with the doctor that you’re going to. He answered every question that I had. Didn’t hesitate to say if you change your mind the morning of the surgery it’s no big deal, it’s up to you, you know, nobody’s pressuring you. So I just felt comfortable with him. Forest Park Medical Center, one of the top medical centers in the entire Dallas, Fort Worth area of course has some of the best physicians operating right here out of beautiful Forest Park Medical Center which includes bariatric surgeon Dr. Nick Nicholson. The main part that prompted me to call Dr. Nicholson to have the surgery is I was at a pool with my youngest daughter and she wanted to go down the water slide, just the fear of taking off my towel. Going swimming with my kids was a big downfall with my weight so I finally decided that the only way that I was going to make myself feel better physically and mentally was to look into having the surgery. Traci just got to the point where she’s basically a very happy fun loving person that was just always very carefree and her weight got to the point where she was no longer happy. I think one of the best parts about Dr. Nicholson’s clinic is that when I first thought about doing the surgery I didn’t know what to do. I have insurance but I don’t know what my insurance covers so when I called their office I told them you know gave them my insurance information and they took care of all that. They called the insurance, they told me what they covered, they told me what my copay was. I didn’t have to do anything. Traci ultimately decided on a gastric bypass and she’s worked very closely with us for a long time before deciding on that so I think she made a very well educated choice for her unique situation. The surgery was the easy part, I mean I really think that is the minimal amount that needs to be done, that’s the ten percent. The art if you will in the practice of this medicine is the other ninety percent. And that’s treating the issues for why people are overweight. Let’s face it, the reason people are overweight is going to remain after they have surgery. The surgery is only a certain part of the whole actual act of having weight loss. And then afterwards you have to worry about what you’re going to eat. The dietician you go to, they go through what you can have, what you can’t have, teach you how to go through the labels and it seems very daunting at first but once you really you know really get into it it’s very easy. So many people come in thinking well I’m going to have surgery on Monday and I’m going to lose weight on Tuesday and nowadays it doesn’t work that way. If I could just take Dr. Nicholson’s group and just put them in a little package with a little bow, I would say you know this is what you need to do because it’s everything, it’s the whole package deal and that’s what I loved about his office. Best Docs Network featuring Forest Park Medical Center. Forest Park Medical Center, extraordinary in every way. Steve has a question for Dr. Glenn Ihde. Why do I keep having to take medicine for reflux? Reflux is when acid in food and enzyme gets out of the stomach, past the valve at the end of the esophagus and then irritates the lining of the esophagus or really burns it. When you take an acid medication, it reduces the acid component but doesn’t take care of the digestive enzyme or the fluid that’s in the esophagus. The only way to treat the reflux itself is to fix the anatomy. If we reconstruct the valve at the end of the esophagus then we can stop fluids and food in the stomach from getting back into the esophagus. Hip replacement surgery and knee replacement surgery are two of the most commonly performed operations every year. In cases where patients develop an infection around an artificial hip or an artificial knee, a lot of times these cases have disastrous consequences. I had two knee replacements in 2011 and both times they got infected. I talked to the internist, I said what happens if I don’t do anymore surgeries because I was miserably sick of having my leg sliced open and having to go through the rehab and the pain and everything and the internist said well you’ll die. He had undergone a knee replacement for a worn out joint. He subsequently developed an infection of his artificial knee. When I went back to replace his knee, the defect was so large that I ended up having to reconstruct him with a design knee replacement that I typically will use for the cancer patients. Because he had already had a previous two stage exchange, he had a relatively large defect to reconstruct so he required reconstruction of a relatively large segment of his femur bone. I had to remove approximately four inches of his femur bone because it was completely eaten away by the infection. It’s 100 percent better than it was two years ago. All in all he probably saved my leg and he you know could have saved my life too. The good news is that there’s no sign of any infection coming back. He’s still having some pain and some episodes of swelling but he’s better now than he had been for several years. I’m able to do most everything I could do before and when I pitched the pain pills everything changed too. It makes you feel a whole lot better. Everybody says well bedside manner it doesn’t count, it’s got to be a good surgeon. Well he’s a good surgeon, he’s an excellent surgeon and he’s also a good communicator so there’s no surprises you know when you wake up from the surgery. You know what you’re up against and you know what you have to look forward to. That’ll wrap up another edition of the Best Docs Network featuring Forest Park Medical Center of course one of the top medical centers in the entire Dallas, Fort Worth area. For more information on Forest Park Medical Center, their fine facilities, or any of the amazing doctors that operate right here, just visit our website, bestdocsnetwork.com but be sure to click on that Forest Park Medical Center tab. There you go. So long everyone, we will see you next week.