Best Docs Network Houston July 21 2013

Best Docs Network Houston July 21 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, Äôm Dr. Annie Varughese
and welcome to another episode of Best Docs Network where
we feature some of the finest doctors in Houston. Today letÄôs meet bariatric
surgeon Dr. Robert Marvin. I weighed 236 pounds. It was just time, I needed to
do something to feel, better, healthier, I needed to feel
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. SheÄôs increased her exercise
in response to having the control to lose the weight more
easily so thereÄôs a positive reinforcement there. If they do the right thing in
terms of exercise if theyÄôre 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 sheÄôs running,
sheÄôs 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 sheÄôs 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 arenÄôt ideal for her but I think her
exercise takes care of that. ThaÄôs why sheÄôs 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 itÄôs difficult to tell sometimes ahead of time whoÄôs
going to do well and whÄôs not going to do well and we have
patients that do very well with it and thatÄôs great. The problem is the
predictability when it comes to the lap band. So shÄôs an example of someone
whoÄôs used it as a tool the way iÄôs supposed to be used. Unfortunately that isÄôt
the case with everybody. Dorothy, she had multiple teeth
that were decayed and she had failing restorations. So, she had a history of having
multiple dental procedures on her natural teeth and these
restorations had subsequently failed over time secondary
to wear as well as decay. I came to see Dr. Metz and I was
of course just knocked out, my heart went, he was so
nice and encouraging. He said yes I
think we can help you. At ninety years old she had
all her lower teeth removed and placement of four dental
implants and also placement of an immediate
prototype so to speak. So she had fixed teeth on the
day that her teeth were removed. I had no problem whatsoever. It worked. I could eat and chew and
I looked normal and I was perfectly happy with it. Her situation is not unique,
thereÄôs many people in her age group that just by virtue of
their age, their teeth are beginning to fail. Many of them are under the
misconception that theyÄôre too old to have oral surgery safely. Although by virtue of their age,
that age bracket, we do more implants in that age bracket
than any other age brackets. So they do tremendously well
with it just like somebody much younger and also their
health improves afterwards. And I just was thrilled. That first steak was
like out of heaven. It was paradise, you
know it was just wonderful. I was so thrilled and happy. You know with their fixed teeth,
theÄôre able to chew what they want and not foods that are
high in sugar and so theyÄôre healthier in the long run. For one theÄôre not fighting
infected teeth, they have a healthier state in their mouth
and theÄôre able to chew what they want and theÄôre able to
have a much more balanced diet. I would say donÄôt do
that, donÄôt tough it out. Go get something done. Go get some dental implants
and be comfortable like I am. We ask these individuals after
theÄôve had this procedure done, they say they feel
more energetic, they just feel better. And then we feel that
iÄôs their body not fighting a chronic infection, that
theÄôre in a healthier state overall. 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 heÄôs 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 thaÄôs 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. What is advanced lipid testing? Most of my patients say, well I
had my cholesterol checked with my doctor. I say well advanced
lipid testing is different. It evaluates different parts of
the cholesterol, different areas that we can
effectively make change. So, iÄôs important to do
an advanced lipid analysis. There are multiple companies
who provide that service. But ask your doctor to look at
your lipids in a more advanced way because there are things on
the lipid analysis that can tell us if you have early diabetes,
insulin resistance, if you have a high tendency towards
clotting, if yoÄôre genetically prone towards
having a heart attack or not. These are important
questions that you need to know. When weÄôre sitting out there
in the communities and we have physicians that may or may not
know about these things, I think iÄôs important that there are
informational shows like this out there that can teach you,
the public, to check on your own health. So, ask your doctor for
advanced lipid therapy. IÄôs an amazing way to
take hold of your own health. A few years back I started
having ulcers show up on my lower ankles so these ulcers
would take 2 to 8 months to get rid of. Once those would heal over
another one would pop up. We did an ultrasound and
discovered that he had severe chronic venous insufficiency
with very large varicose veins and swelling. His biggest issues were that
he had open non-healing wounds. He had a very large one on the
right side and he had a much smaller one on the left side. He had been seen and treated
by a variety of people with a variety of
methods over the years. None of them had worked. He said well you know
thaÄôs not really a problem. We have surgeries that we
can do on an outpatient basis. We can get rid of
that for you in no time. We very carefully mapped out
which veins were bad in his legs, the ones that are running
backwards and then made sure we understood where the blood was
running correctly and we ablated selectively the bad veins to
restore the venous circulation out of his legs back to normal. And that improves the overall
health of the leg and improves healing and he actually
healed up very nicely. The procedures like I said
didÄôt take any time at all. Come in in the morning, go
to work in the afternoon. Not a problem. There was no pain
after the surgeries. It all went well,
went back to work. No problems. You can have wounds that
are unrelated to venous insufficiency but most chronic
non-healing wounds are related to problems with your veins. But if you have a non-healing
wound that is almost certain from venous insufficiency and we
can heal virtually all of those wounds here with
the procedures we do. Having the circulation back in
my lower legs allows me to work longer, it allows me to stay on
my feet longer, I donÄôt have the foot pain that I had prior. The procedures
helped dramatically. For more information about any
of our doctors on any of our shows, go to bestdocsnetwork.com
or email us at [email protected] Now letÄôs meet Dr. Guy Lewis
who specializes in cosmetic dentistry. 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. IÄôve 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. IÄôs 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 iÄôs 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 itÄôs not just a glaring oh what
did you do to your teeth? My family would say, okay
what did you do, somethinÄôs different, yoÄôre smile is
beautiful, did you get your hair cut? I just feel so good
about my smile now. Smiling is good. IÄôm 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. Your family history is very
important to your medical care. For example, therÄôs a lot of
cancers that run in families. These are what they are; colon
cancer, prostate cancer, breast cancer, melanoma, malignant
melanoma of the skin, also thyroid cancer and ovarian
cancer tend to run in families. So if you have a first degree
family member, that is children, brothers, sisters, parents with
those diseases, you need to tell your doctor so that he or she
can screen you more for those diseases. Also, thereÄôs a strong family
history for premature heart disease. For example if your mother or
father had a heart attack at age 70, thaÄôs not a big deal for
your particular risk factors, however if your father had heart
disease or stroke prior to the age of 55 or your mother prior
to the age of 65, thaÄôs an independent risk factor for
you to have heart disease. Glaucoma, osteoporosis, these
things tend to run in the family also, also
aneurisms, brain aneurisms. If you have more than one first
degree relative with an aneurism of the brain, that puts
you at risk for that. So anyway talk to your family
member, ask them what they had, tell your doctor and then you
can know what youÄôre at risk for. For additional Medical Minutes
from Dr. Honaker, logon to bestdocsnetwork.com, click on
Education and the Medical Minute tab. Colleen had a
robotic hysterectomy. She had abnormal bleeding after
menopause and that is always a very worrisome sign if
a woman experiences. My cervix was very thick
and above all my symptoms and because of my age you know Äôm
62 years old so it was time. Now Colleen was potentially a
case of uterine cancer so I decided to do a robotic
hysterectomy on her so that if we needed to we could continue
after the hysterectomy looking for cancer in other places. I was very impressed with Dr.
Imtiaz when I came into her office and her staff. They lined all of my
appointments up for me. I just couldnÄôt have
been happier with her. I knew as soon as I met her that
I was going to be in good hands. She explained everything great. Robotic hysterectomy I usually
do for patients who may have other conditions that preclude
them from having a routine laparoscopic hysterectomy. Some of these conditions could
be a very large uterus or if we suspect cancer or if the patient
has had multiple abdominal surgeries and we are suspecting
adhesions or scar tissue inside the abdomen or in
patients who are overweight. When I get up in the morning I
think to myself I just have so much to look forward to because
I donÄôt have that pain, that misery and I have a lot
of ambition right now. I mean, IÄôm able to
do a lot more things. IÄôm not constantly thinking
about oh my God I donÄôt feel good today. You know as a gynecologist, as a
surgeon, it makes my day when I see a patient get up and walk
out shortly after her surgery. I think iÄôs silly to have
somebody bedbound for six weeks, not be able to walk around,
not be able to take care of her household when the
answer is simple. I know that I can get them up
and about moving and back to their life immediately. For addition health information,
be sure to check out our Healthy Living blog for the best tips,
latest medical procedures and up to date news for modern
medicine at our website at bestdocsnetwork.com. , Breast cancer is a
field of many specialties. I cannot do everything myself. ThereÄôs the imaging and the
diagnosis of cancer and then of course the surgical part. And so not one person can
take care of breast cancer by themselves. So here at Memorial Hermann
Breast Center at Southwest Campus we really try to approach
all aspects of patient care. We try to get the
patient through all different disciplines and we work as a
team to do a whole approach to cancer therapy. Dr. Rose and I met in 2000. I had been in practice for a
year and he was brought on here to develop a breast center
and up until then it was just a general radiologist
who was reading x-rays. And Dr. Rose was very different
because thaÄôs all he did was specialize in breast imaging and
as I was specialized in breast surgery, it was
an immediate fit. So it was a very awesome
opportunity to work to collaborate with people who
had tremendous experience, large experience in breast surgery
and breast cancer as well as in benign, handling benign breast
disease and iÄôs really very satisfying to work as a team. The surgeons , the radiologists
as well as the oncologists and radiation therapists working
closely together to give the patient the very best
care that they can get. Well breast cancer has always
been an important part of my life. My first experience was back
when I was very young and my mother had breast cancer. She died when I
was 13 years old. And so itÄôs always been a part
of my life, something that has been important to me. Just like Dr. Rose specializes
in mammography and breast imaging, I specialize in
surgery for the breast. IÄôm focused 100 percent on
taking care of breast cancer patients. And that dedication and that
focus really drives the quality of the surgery and it drives the
quality of the outcomes as well. Osteoporosis is a disease,
iÄôs 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. IÄôs important, itÄôs 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 itÄôs 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 iÄôs 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, parentÄôs
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. IÄôs done on an x-ray type
device called a bone density unit. IÄôs painless,
iÄôs easy, iÄôs safe. It involves lying on a table
and being positioned as youÄôre able. IÄôs not exactly the same
as doing x-rays for fractures. Although it may be more
sensitive for certain kinds of painless fractures, iÄôs
not for diagnosis of various diseases or
fractures in general. The ultimate goal of screening
is to prevent death and disability from fractures. WÄôre 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. 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,
sheÄôs 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
patientÄôs 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, IÄôm 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. IÄôs 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. IÄôs just for the lack
of knowledge we perish. This is such a fabulous event,
iÄôs called Go Red for Women and iÄôs putting together
women from the community, physicians, hospitals, everybody
supporting women and heart disease and the awareness for
women to protect and support. Even children can benefit from
this event so I think iÄôs so fabulous and thatÄôs why I
wanted Best Docs Network to really talk about it. My speech today is going to be
about how IÄôm dealing with heart disease and how to have an
optimistic and positive attitude while going through something or
anything difficult in your life. I keep laughing, I keep smiling,
try to stay positive about things. I could be stuck in the hospital
but instead IÄôm home with my family. The biggest way to prevent
these problems is education. So the main reason for this
type of event is to educate and through that we raise funds
and can get the word out. Number one, it educates people
on what has happened over the last several years and it brings
to the forefront with women in particular with Go Red for Women
to listen to your body and know your symptoms. The most important thing about
cardiovascular disease is iÄôs the number one killer of women
in this country and 50 percent of women or men with
cardiovascular disease die suddenly without any
symptoms, without any warning. I just believe getting the
word out to women especially, we always are tired and rundown and
raising kids and going here and there and we might just think
oh weÄôre just tired, my neck hurts for some reason and iÄôs
no big deal but it can be a sign of a heart attack or a stroke. Women you know and theyÄôre as
we know as men are different and they present differently. Fortunately stroke type symptoms
are about the same but again another large focus for us
is heart disease and they are completely different in the way
they present as a general rule than men. Cardiovascular disease and the
awareness for women is such a tremendous topic and thatÄôs
why Go Red for Women is such a marvelous cause and I just
want everybody to support it. Thank you for joining us for
another episode of Best Docs Network where we feature some of
the finest doctors in Houston. For more information about any
of our doctors on any of our shows, go to bestdocsnetwork.com
or email us at [email protected] For Best Docs Network, this is
Dr. Annie Varughese and IÄôll see you next time.

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