Best Docs Network Houston December 8 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, I'm Grace Sells and welcome back to another edition of Best Docs Network, the show featuring some of the best doctors in the Houston area that are changing lives. Up first we're going to introduce you to plastic surgeon, Dr. David Altamira. 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 that's 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 there's 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 didn't 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 that's something that's very important to me. That is what Dr. Altamira gave me, a very natural look and I'm very happy with the results. I had, the 4 front teeth were very crooked. Two were going forward, two were going backward. I found I had to wear braces for quite a few years and that just wasn't a good alternative for me so I did some research. I don't know if there's cosmetic dentists up there, I'm sure there are but I just didn't investigate it but I did investigate this one and thought well this is as good as any. So I did some research, checked into it and here we are. Well Ken had come from Cleveland, Ohio. So he sent me a lot of pictures and stuff before he came and I knew I could help him out. And so he came in one night and got here late and we stayed and took care of him, prepared his teeth, made him some temporaries that looked fabulous, let him go home and then came in and we put them on him. He's just been really happy with them and it made a big improvement on his smile. I spoke with Christine quite a bit, more of a consultation type of format because obviously I kind of skipped a couple of steps in the process because I live so far away, but very helpful. Christine kind of explained the process, what was done, what's going to be done, how it works, I mean getting the quotes and pricing and everything so it was very consultive, very helpful. We did prep veneers on him but it was not extensive. I mean just because you have to prep the tooth doesn't mean you have to take it down. A lot of people think oh you're going to have to take my tooth down to a little nub or something like that. No, sometimes it's just a matter of a little smoothing that is very, very minimal. I was getting pretty self-conscience of when I would laugh or smile of putting my hand over my face because I would just you know that's funny something like that and what I found it's a, it's somewhat liberating to the point where I find myself not doing that any more which is nice, I mean I actually when I smile for a picture with my family, my kids I actually smile instead of you know kind of half smile it. They're always making fun of me for that, so. Very happy with the results, the staff is very professional, they obviously know what they're doing. The results are fantastic, really are. It doesn't have to be a trip to the dungeon. It doesn't have to be uncomfortable. I would just say you know come in and experience it, see for yourself. It really, it really can be very pleasant. All of the great doctors that you've seen on our show today have profiles on our website complete with bios, photos, videos and you even have the ability to request an appointment. That includes our next doctor, interventional cardiologist, Dr. Annie Varughese. I came to see Dr. Vaughese on the advice of my primary care physician because my blood pressure was a little elevated and my EKG reading was a little off. She suggested that I take a stress test and have some other procedures done just to determine the causes of that and it was determined that I did have blockage in one of my arteries and a stent had to be implanted and then reality sunk and Dr. Varughese talked to me during the recovery time and I asked her in tears I asked her what was going on? I asked her was I about to have a heart attack? And she said yes. Yolanda Garcia to this day, she's so thankful that her primary care was cognizant enough to send her for evaluation because many times primary doctors or nurse practitioners who see all of these patients they may not recognize because the patient's not complaining much so I think this is a wakeup call for all of us as physicians and healthcare providers to really focus on prevention, evaluating the patient early, getting them to the right specialist on time. Because of her, I'm able to take care of my clients, because of her I have a better life so I really am appreciative of all she has done for me. Well coronary disease in women especially is the number one killer of women in this country and pretty soon will be the number one killer of women all over the world. And in Hispanic women especially there is a high prevalence of diabetes so therefore diabetes lends towards cardiovascular disease and coronary disease especially. It's just so important to educate our Hispanic population, our Indian population because Indians die 4 times the rate of any other population from diabetes and cardiovascular disease. People are hungry for knowledge. It's just for the lack of knowledge we perish. Find out more about your family history. Finding out what your grandparents died of can provide useful and lifesaving information. A bunion deformity is a deviation of the first metatarsal and the second metatarsal so basically you know what people see of their big toe is this. So the big toe is pointing this way and this bone is going out this way. When it's not matching up well you get bone growth. And so bone starts to build up right here and it also starts to build up top. I spend about 85% of my time traveling so I'm in and out of the airports. As a training manager I do a lot of facilitation so I'm on my feet a lot walking and it got to the point where even flat shoes what most people would think is comfortable shoes became painful. Her surgery was an Austin Bunionectomy but it was a little bit different because on the x-ray I discovered that she had severely arthritic joint. She had fracture fragments. So these fracture fragments never healed and because they were constantly moving it was severe pain. It caused an enormous amount of bone growth on the top and on the side. So I was really excited to do her surgery because I knew it would provide immediate relief. I'll be wearing a boot for at least another 4 weeks and then I'll come back for another reassessment and then he'll determine then whether I can take the boot off and then just start walking in normal shoes. People always ask you know why do I have this problem and the biggest component, genetics. So, if you look at your parent's feet or your grandparent's feet, it's basically telling you that if you see a bunion forming that chances are your feet are going to develop these structural deformities. And then obviously for the females, it's wearing the high heels. You know, there's a price to pay for high fashion. You wear the high heel it puts your foot in a position which predisposes you to a bunion forming. I would love to be able to get back out there and be pain free. A lot of times, I couldn't wait for the day to end because I would be in so much pain. So I'm looking forward to being able to be on my feet for longer period of times pain free. The look on the patients face when they come in and they see the results and they're happy with the results and they see that instead of having a crooked toe that it's actually straight and that the pain that they had before is gone so that's the rewarding part to me. We all get leg cramps, usually it happens at night and they can be severe. I get horrible leg cramps after I play racquetball, they're bad enough they make me cry. What causes leg cramps and what can you do to prevent them? Well there are three or four causes. Number one, dehydration, if you're not drinking enough fluids especially after exercise. If you don't have enough fluids when you lie down, you become horizontal, the blood flow doesn't increase as it should to your legs because you're horizontal and you're a little dried out from dehydration, if you don't get blood to your muscles in your legs, they cramp up and they hurt. Also low potassium, if you're on diuretics for your high blood pressure or swollen ankles your potassium may be low and this too is a very common cause of leg cramps, that can be fixed with potassium tablets. Magnesium may be a problem too. You can have that checked with your doctor but the first thing to do is try over the counter magnesium, 400 milligrams might do the trick. Stretching will help also but the main thing is you want to stay well hydrated especially after exercise. 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're going to introduce you to gynecologist, Dr. Meredith Morgan. Osteoporosis is a disease, it's a disease of bones. It manifests as either a fracture or the realization that the bones are very, very thin with a high risk of fracture. It's important, it's common. It happens in over 50 percent of women post menopausal. That is to say over half of women over the age of 50 are going to have a fracture in their lifetime and it's serious because some people that have hip fractures will die very quickly and some people will go into a nursing home and not get out. Since it's a function of time and duration of estrogen deficiency, the time since estrogen deficiency with a thinning of the bone is predictable. It may be needed sooner if there are other risk factors for thinning of the bone sooner, smoking, extreme thinness, sedentary lifestyle, parent's history or a previous low trauma fracture. Most objective way to quantitate the status of the bone health, thickness or thinness is to measure the areas of interest to the spine and the hip since those carry the most risk of morbidity and mortality. It's done on an x-ray type device called a bone density unit. It's painless, it's easy, it's safe. It involves lying on a table and being positioned as you're able. It's not exactly the same as doing x-rays for fractures. Although it may be more sensitive for certain kinds of painless fractures, it's not for diagnosis of various diseases or fractures in general. The ultimate goal of screening is to prevent death and disability from fractures. We're trying to predict fractures based on age and the thickness of the bone. If someone has very thin bone then they have a very high risk for fracture. We recommend that all women have bone density testing at age 65 and sooner if they have risk factors that would indicate that they would have high or increased risk for fracture. If you have asthma do not let it stop you from playing sports. Swimming, canoeing, fishing, sailing and walking are all asthma friendly options. My symptoms were like I would always wake up in the middle of the night having short breath and then on the baseball field like I would just, I'd be the one bending over all the time. I was the only kid on the team that would always be slouched over trying to gasp for breath. And I would say that that was my major, major symptom right there, my major problem. Aryn is a young athletic teen whose mom brought him to see me because he was not, never been able to breathe through his nose. He feels tired all the time and he complains that he doesn't have enough oxygen. He feels like he's short of breath. I've been to several different doctors around Houston and they've always like thought it was asthma or something else but Dr. Nguyen has taken his time to actually look into my nose and like go further into seeing what was wrong with me. When I examined Aryn I noticed that he has a severe deviated nasal septum combined with enlarged turbinate. The turbinate at the swelling part on the sidewall of the nose which contributes to more than 75 percent of his nasal obstruction. We discussed those findings with his mom and him and decided upon a line of treatment that consists first of correcting is septum and using energy radiofrequency coblation to reduce the swelling on the sidewall of his nose therefore increasing his nasal passage and increasing his oxygen intake. Two months out of my surgery I feel like I can breathe a lot better. I feel like my performance in baseball has improved, it feels like I'm getting a really good night's rest every night. It just seems really amazing to finally get that breath of air that I've always needed. Aryn's surgery was performed in an outpatient surgery center. The procedure took around 45 minutes and Aryn goes home the same day. Dr. Nguyen has forever changed my life. From when I was born to now I could not breathe and now I can. We just appreciate what Dr. Nguyen has done for my life. For more information and to check out hundreds of videos, head to our website, bestdocsnetwork.com. And up next we have oral surgeon, Dr. Paul Metz. The ideal patients for dental implants are ones that have been through lots of restorative procedures and where these procedures just aren't predictable and so we're able to give them their third set of teeth with the use of dental implants. I had an accident when I was 10 years old and I fell down on my face and I dislocated my jaw. And I didn't know that then, but started looking for the oldest doctor or the one with 35 years or more of experience so I went to the facility on Gessner and I saw Dr. Metz and they said this is the guy who's going to have to be working on you. I had to decide if I wanted to go through with it and I did research. He graduated top in the class. So in Teco we were able to move his upper jaw forward and set his lower jaw back so as to help line up his skeleton so that his teeth meshed together well. We as specialists in oral surgery are uniquely qualified to provide these procedures. I just figured out this is the best facility, this is the best doctor and I truly believe that you know. Dr. Metz and his team they know what they're doing. With these patients, we know when they come down the hallway, when we see them after this procedure, we see their level of confidence has gone up tremendously. We can tell by the smile on their face as well as their dress. They're dressed sharply and they're holding their chin up. You can certainly tell that they are happier individuals afterwards. Technology today you know has really revolutionized how we practice implant dentistry. We have comb beam CT's which allow us to take a CT of the patient in the office and in about 20 seconds we have 360 degrees of bone around the implant. So we know ahead of time whether we need to graft and also the type of grafting that we need to do ahead of time. So patients are better prepared for the experience and know more of what to expect afterwards. We are able to do this in a safer fashion. It's much more rapid. The procedures are much more rapid and the recovery is much easier as well. After a workout don't eat carbohydrates for at least an hour. Your body will be forced to breakdown body fat rather than use the food that you have ingested. Welcome. Today we're joined by Dr. Denton Cooley, a native Houstonian and the actual founder of the Texas Heart Institute. What a pleasure to be with you today Dr. Cooley. Thank you for joining us. You're welcome and thank you for visiting our institution. Can you tell us a little background about how the Texas Heart Institute became an entity? Well it I think began in the mid 1950's when open heart surgery was first introduced in our Texas Medical Center and before long my program here at St. Luke's and Children's Hospital was probably the most prolific of all institutions in the country including the Mayo Clinic and Cleveland Clinic and everything. We had a simplified technique of open heart surgery and soon began a leadership position in this new field of cardiac surgery. Well then I decided to create this institute in 1962 so it's been a little over 50 years ago. What is your most vivid memory about the Texas Heart Institute, about any type of incredible learning that has been occurring here, what's your greatest memory? Well of course our heart institute was created with two objectives, that is, research and education. So in each of those aspects of our history I think there are certain exciting things that have happened. And when the Texas Heart Institute first came into being cardio thoracic surgery was high on the list of available procedures to be done for patients. Now we have the artificial heart and the LVAD's and so would you tell the audience about that? Well I think that it shows the evolution of cardiac surgery. First we started off replacing just some of the components of the human heart, that is the valves and the great vessels and modifying the ventricles and that sort of thing. And then the big breakthrough came in 1968 when we did the first successful heart transplant to replace the entire organ and that was really an exciting period that followed that because it was such a new concept. Amazing, right? And we have actual volunteers here at the hospital who have been survivors from cardiac transplants for about 20 years now. Oh yes, our initial work in transplantation, we did I think about 15 or 20 heart transplants in that early era. But so many of these patients suffered from rejection of the tissues, but in the early 1980's a new breakthrough came with the development of a drug called cyclosporine which is still in use today and has made it possible for some patients to survive transplantation for 20 or 30 years so it's a really big change. Quite miraculous and you are such a part of that endeavor and we humbly thank you for everything you've done for the world population actually. Well, there's a great satisfaction to me to see how this institution and our whole medical center has grown during my lifetime. Thank you and now we're taking you again all over the world with Best Docs Network and we just wonder if you have something in these closing remarks that you can tell our public something about the Texas Heart Institute that you would like them to take to heart. Well I think that we have done a great deal to reach our objective, original objective of research and education and at the same time we have made many advances in just clinical medicines and surgery and have enjoyed a leadership position in this new development now that has sort of inspired the entire medical community around the world and you can find large cardiac programs going in Europe, in South America and elsewhere in North America. It's just amazing to see how rapidly it's expanded. Well for all of us who have trained under your great leadership, we humbly thank you and we give you great honor Dr. Cooley. Thank you for being with us today. Well, thank you. I weighed 236 pounds. It was just time, I needed to do something better, healthier, I needed more energy. I needed to do something. I had the lap band as opposed to the sleeve or gastric bypass because it was less invasive and it was really the right decision for me personally. She's increased her exercise in response to having the control to lose the weight more easily so there's a positive reinforcement there. If they do the right thing in terms of exercise if they're consistent then they see a bigger drop off then they had seen before they had the surgery. As time went on I started dropping the weight, you know eating you know slowly, you know liquids and then your soft foods, you know the way that you were told to do it. And things just started to work out for me. I started exercising more and eventually just started falling off. Right now she's running, she's trained for a half marathon. Those are great things in terms of the exercise side of taking care of the weight. When it comes to eating it sounds like she's doing a fairly good job switching to things that are lower calorie, less animal fat and lower glycemic index but it sounds like something, occasionally she eats things that aren't ideal for her but I think her exercise takes care of that. That's why she's at ideal body weight right now. Physically to be able to not huff and puff going up and down a flight of stairs you know. Mentally to work to you know educate yourself I think it makes it easier to feel confident about yourself. It just makes things that much easier. Before the surgery I was 236 pounds and 3 years later I am down 85 pounds. Unfortunately with the lap band it's difficult to tell sometimes ahead of time who's going to do well and who's not going to do well and we have patients that do very well with it and that's great. The problem is the predictability when it comes to the lap band. So she's an example of someone who's used it as a tool the way it's supposed to be used. Unfortunately that isn't the case with everybody. That's going to wrap up today's episode of the Best Docs Network, the show featuring some of the best doctors in the Houston area that are really changing people's lives. For more information and to check out hundreds of videos, head to our website, bestdocsnetwork.com. And if you have questions or comments we would love to hear from you. Send us an email at info@bestdocsnetwork.com. I'll see you next week.