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Venous Reflux Disease

October 24, 2013 by angishields

The Doctors Roundtable

Venous Reflux Disease

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Veins have valves to promote sufficient blood return from the lower extremities to the heart. However, when veins in the lower extremities don’t function properly, the blood flows backwards (reflux) and can pool in our legs, ankles and feet. Over time and left untreated, this condition (also called chronic venous insufficiency) can cause spider and varicose veins, swelling, aching, leg cramps, discoloration, restlessness and can lead to venous hypertention. On the mild side, this condition causes veins on the surface that are cosmetic but harmless. On the serious side, it can lead to disability and venous hypertension. Both sexes can be affected by this condition, but women appear to more affected than men. It can also have genetic implications. Gravity, standing on your feet for long periods of time and sedentary lifestyles can exacerbate the conditions. It is a global problem with serious health and economic implications. Approx. 10% of the population or roughly 40 million Americans are reported to have some form of venous reflux disease.

Old treatment of venous reflux disease often involved surgery and saphenous vein “stripping.” With the advent of lasers and imaging technology to measure valve function, newer treatments are often non-invasive and employ thermal energy or injections. Conservative treatments involve compression stockings and lifestyle changes (weight loss, feet elevation, increasing movement). Newer and promising treatments on the horizon include genetic links (Restless Leg Syndrome) and nutraceuticals.

In this segment, Dr. Darelll Caudill, a board certified cardiovascular surgeon and Medical Director of VeinInnovations and his team will discuss the venous reflux disease spectrum, diagnosis, signs and symptoms and treatments. Listeners can visit: www.veininnovations.com, www.rls.org and www.phlebology.com for more information.

Darrell Caudill, MD, FACS

David Martin, CRNFA

Frank Ferrier, MD, FACS

Alexander Park, MD, FACS

David Park, MD, FACS

Pediatric Food Allergies

October 17, 2013 by angishields

The Doctors Roundtable

Pediatric Food Allergies

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Approximately 15 million people have food allergies and about 6 million of them are children. Food allergy occurs when the body’s immune system identifies a specific food as a foreign substance and produces an allergy antibody (IgE) to respond to the substance. Compounding this response is the fact that the most common foods people are allergic to, such as peanut, wheat, soy, eggs are frequently in our diet! Food allergies can be mild to severe and in rare cases, life threatening if they stimulate an anaphylactic reaction.

There are two types of food allergies: fixed (immediate response) and cyclic (delayed). Signs and symptoms of food allergies include: itching in mouth, swelling, GI symptoms (vomiting and diarrhea), hives, tightness in the throat and difficulty breathing. Food allergies should be distinguished from intolerances and sensitivities to food (non immune reactions). Diagnosis may involve: extensive history, nutrition evaluation, lab testing, food challenges, elimination diets and skin testing. Food allergies can also be connected to other allergies. There is no known curative treatment for food allergies at present but treatment involves: strict elimination, education (food labels, meal prep, high risk situation avoidance), emergency planning and availability of emergency medications. There is promising new research in this field- sublingual immunotherapy.

In this segment, Dr. Lakshmi Reddy, a local Atlanta physician that is board certified in adult and pediatric allergy, immunology and asthma will discuss the basics of pediatric food allergy signs/symptoms, diagnosis and treatment. Listeners can visit: www.reddyallergy.com and www.aaaai.org for more information.

Dr. Lakshmi Reddy

Medical School at Meharry Medical College
Residency completed at Washington University in St. Louis
Fellowship in Allergy and Immunology at Medical College of GA
Board certified in allergy, immunology and asthma
In private practice in Johns Creek, GA

Obstructive Sleep Apnea

October 10, 2013 by angishields

The Doctors Roundtable

Obstructive Sleep Apnea

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A great night’s sleep not only makes us feel great and rested, it improves our health. For some, this is easier said than done! Over 18 million Americans suffer from Obstructive Sleep Apnea (OSA). This is a serious condition in which the the airway collapses or becomes obstructed during sleep causing shallow breathing or breathing pauses which can last from a few seconds to a over a minute. These episodes can be severe , occurring several times per hour. Blood oxygen levels drop can drop during these episodes. Over time, OSA has been linked to high blood pressure, heart disease, stroke, depression and accidents while driving. What used to be considered a nuisance can sometimes be not only a quality of life but quantity of life issue.

OSA is the leading cause of daytime sleepiness. Although anyone at any age can exhibit symptoms and be diagnosed with OSA, men seem more likely than women to have this condition. Risk factors include obesity and a family history of OSA. Occasionally, other medical conditions can affect OSA as well, such as congestive heart failure and neuromuscular disorders. Symptoms include loud and chronic snoring, headaches, memory problems, depression, irritability, dry mouth and sore throat. Treatments include Continuous Positive Airway Pressure (CPAP) and other devices and at times, surgical intervention.

In this segment, Dr. Scott Leibowitz, a board certified internal medicine physician and current President of the GA Association of Sleep Professionals will discuss OSA, good sleep hygiene, diagnosis and treatments for OSA and what’s new in this sleep apnea field. Listeners can visit: www.laureatemed.com and www.aasmnet.org for more information.

Dr. Scott Leibowitz

Residency in Internal Medicine completed at Colorado Health Science Center
Clinical research and fellowship in Sleep Medicine at Stanford
Author and frequent lecturer on sleep medicine
Current President of GA Association of Sleep Professionals
Now board certified physician in private practice with Laureate Medical Group

Chiropractic Care: Not Just for Pain!

October 3, 2013 by angishields

The Doctors Roundtable

Chiropractic Care: Not Just for Pain!

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Over 20 million Americans will seek chiropractic care this year! Chiropractic care has been around for over 100 years and involves care of the musculoskeletal and nervous system through use of a hands on, drug free, non-invasive and natural approach. Chiropractors have broad diagnostic skills. This type of care has been increasingly covered by health insurance plans in the US and is appropriate for all ages. Typically, patients turn to chiropractic care seeking relief from back pain, neck pain, joint injuries and headaches. However, chiropractic care is appropriate for all ages and for many types of health conditions, both chronic and acute. Chiropractors use such modalities as heat, spinal manipulation (adjustments), nutrition, acupuncture, biofeedback, labs, imaging and exercise to achieve immediate relief and long lasting results.

This segment will discuss how this specialty can assist with many other types of health issues that the public may not associate chiropractic care with at first, such as: infant care (birth trauma recovery, growth promotion, colic, chronic ear infections), pre and post-natal pregnancy support (low back pain, pelvic support prior to delivery), carpal tunnel syndrome and acid reflux problems (hiatal hernia, GERD). Goals of this type of treatment include immediate and long term relief, decreased drug and surgical intervention and promotion of general health.

In this segment, Dr. Forrest Watts, a Doctor of Chiropractic in Cumming, GA will discuss how chiropractic can help many types of patients beyond neck and back pain. Dr. Watts has also received additional training in acupuncture and sports injuries. Listeners can visit: www.drforrestwatts.com and www.acatoday.org for more information.

Dr. Forrest Watts

Doctor of Chiropractic from Life University
Special training in sports injuries and acupunture
Certified to treat carpal tunnel problems
Private practice in Cumming, GA

Pituitary Disease

September 19, 2013 by angishields

The Doctors Roundtable

Pituitary Disease

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The pituitary gland is often referred to as the “master gland” in the body. This lima bean sized gland at the base of the brain is part of the endocrine system and produces and regulates many hormones that affect glands such as growth hormone (regulates body structures and weight), thyroid stimulating hormone, prolactin ( affects milk production), sex hormones,and adrenal gland production (regulates water and electrolyte balance). Disorders of the pituitary gland can cause big and little problems- and these often go undiagnosed because symptoms can be vague. These disorders include tumors that cause overproduction of hormones that affect the end-organ system or pituitary lesions that may results in underproduction of hormones. Acromegaly, Cushings Disease, Addison’s Disease can all be linked to pituitary disorders. However, the most common problem is pituitary tumors.

Pituitary tumors are usually benign (adenomas), although they can be invasive and they account for approx. 10% of all brain tumors. Pituitary carcinoma’s account for a very small percentage of pituitary tumors. However, even these benign tumors can cause problems in hormone function and can be invasive to the surrounding structures, such as the optic nerve. Treatments include surgery, radiation and a few medications. Symptoms may include: headaches, vision and behavior changes, nausea and vomiting, hormone imbalance and fatigue. Diagnosis almost always involves investigating the “why” behind presenting symptoms.

In this segment, Dr. Joseph Pinzone, a double board-certified physician who is a national expert in pituitary diseases will provide a “master class” about this “master gland.”

Dr. Joseph Pinzone

Medical training at NYU, Columbia-Presbyterian and Mass General
Double board certified in Internal Medicine and Endrocrinology
Former NIH researcher on Pituitary Tumors
Current Clinical Professor at UCLA Geffen School of Medicine
Concierge private practice in Santa Monica, CA

Coronary Calcium Scoring

September 12, 2013 by angishields

The Doctors Roundtable

Coronary Calcium Scoring

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The statistics are sobering. Heart disease remains the nation’s leading killer for adults > 35 yrs. Consider these statistics: 1) every 29 seconds an American has a heart attack 2) every 60 seconds and American dies from a heart attack 3) for men and women, 50% or greater of those that have a heart attack had no prior symptoms and their first one was death. Heart disease comes about over years or even decades. There is now technology available that is 99% effective in either confirming or ruling out coronary heart disease with less radiation than one would get exposed to on an airplane flight! “Virtual exams” of our internal organs are now a reality due to advances in medical imaging technology. However, imaging does not provide direct outcomes for the patient- but the information these tests can provide can lead to changes that can decrease heart disease risk factors, potentially reverse damage, and save lives.

This segment will discuss a very specific screening test for coronary heart disease: the Coronary Calcium Scoring test or as some people have heard, “The Heart Scan.” Coronary arteries do not normally have calcium. Calcified plaque in coronary arteries is a leading indicator of heart disease. Using non-invasive, low dose radiation CT scan that takes about 15-20 minutes, patients and providers can now obtain critical cardiac information that can be used post test and in comparison’s over time, to minimize risk and take proactive steps in the maintenance of good heart health or the management of heart disease. The test is most beneficial as a screening tool for patients NOT yet diagnosed with heart disease. Scans are taken of the heart and the results are compared to a scoring system that is measured by a range of no cardiac disease, minimally present, moderately present, extensively present or high risk requiring medical intervention. Information is shared with the patient and their medical provider post test and the patient can return to normal activities when the scan is completed.

In this segment, board-certified preventive cardiologist, Jason Reingold and Dan McGeown, CEO of Virtual Imaging will educate the listeners on the testing methods, patients who benefit most, the scoring system and post test results and what do do about them. Listeners can visit: www.virtualimagingatl.com or www.drjasonreingold.com for more information.

Dr. Jason Reingold

Board-certified in Internal Medicine and Cardiology
MD from Emory University
Internal Medicine Residency program completed at UC San Francisco Med Ctr.
Cardiology fellowship completed at Mass General Hospital in Boston
Regular appearances on CNN’s Sanjay Gupta’s health program

Dan McGeown

CEO, Virtual Imaging Atlanta
Masters in Education and seasoned entrepreneur

Workers Comp: A Physician’s Primer

September 5, 2013 by angishields

The Doctors Roundtable

Workers Comp: A Physician's Primer

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No matter how safe the workplace is, injuries and illness occur. Georgia now has over 4 million workers >16 years of age and in the most recent statistics available, over 87,000 injuries were reported annually. In GA alone, over $1.5 billion in benefits were paid and this does not include the associated health care expenses! Medical costs now outweigh (60%) the indemnity costs. Also of note in GA, there is a shortage of qualified physicians that treat occupational injuries and illness as we have only one fifth of the recommended ratio of 1 MD/1000 employees. On July 1, 2013 GA enacted new law (GA House Bill 154)that increased slightly the weekly workers comp benefit, but capped the benefit for less serious work related injuries. Every employer with over 3 employees is mandated to have workers comp insurance.

Workers Compensation is an accident insurance program, paid for by employers, which may provide workers with medical, rehabilitation and income if an employee is injured or becomes ill on the job. Physicians are a key part of the workers compensation system as they are a pivotal point in getting the employee connected to appropriate treatment, focused on recovery, minimizing life disruption and assisting with developing a return to work plan. Providers often find themselves “the go-between” for the employer, carrier and injured employee. This program will not focus on the legalities or politics of the workers comp system, but on the provision of high quality occupational health by providers.

In this segment, Dr. Charles Cooley, a board-certified Family Practice physician who is an expert at treating occupational health patients through the workers comp system will discuss the basic concepts of the workers comp system, common types of workers comp injuries, special considerations when handling workers comp patient cases and tips for employers and patients in navigating through the medical aspects of the workers comp program.

Dr. Charles Cooley

MD from Medical College of GA in Augusta
Completed residency at Huntsville Hospital
Board certified in Family Practice
Affiliated with Northside Hospital, Cherokee Campus
In private practice with urgent care centers in Canton, Villa Rica

Energy Healing: A Complement To Medicine

August 30, 2013 by angishields

The Doctors Roundtable

Energy Healing: A Complement To Medicine

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Energy fields in the body have long been recognized in Eastern cultures, including medicine. Subtle energy fields are now being more incorporated and used in Western medicine. “Chi, prana, and bioenergy fields” are all words used around the world to describe this lifeforce. The belief in a living force is ancient and widespread today. Energy healing one modality of complementary medicine. When we are injured, ill or under stress, the natural flow of energy is interrupted and may negatively impact our mind/body/emotional/ spiritual connections. We can use certain tools and modalities to clear, balance, energize and support the human energy system to maximize the body’s ability to heal.

The CDC’s National Health Statistics Report documented that 1:4 Americans have used some form of complementary medicine within the past 12 months. Multiple studies have shown that our thoughts can be measured and that thoughts affect our health in a significant way. Some physicians have estimated that one third of all “healings” come about not through surgery or medicine, but from our self-healing capacities. Matter is compressed energy and information is patterns of energy. The heart’s electromagnetic signals demonstrate energy flow throughout our bodies. Many practitioners and patients believe that it is time to bring the qualities of healing into the mainstream conversation- even Oprah and Dr. Oz have featured segments on this interesting topic.

Today, an Atlanta Energy Therapist and renowned author, shares her insights and experience on energy medicine, energy balancing and energy healing as a complement to traditional medicine in optimizing our own body’s ability to heal. She will discuss energy work modalities, what to expect when working with an energy healer and provide examples of working with people with chronic illnesses, such as cancer, as well as episodic dis-ease like stress management.

Robbie Houcek

Private Practice Energy Therapist for over 15 years
Healing Facilitator
National Speaker
Author featured in “Remarkable Women”, “Getting Things Done; Successful Women Speak” and “Freeing Godiva; A Woman’s Journey of Self-Empowerment”

Exciting New Drug Therapies for Hepatitis

August 16, 2013 by angishields

The Doctors Roundtable

Exciting New Drug Therapies for Hepatitis

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Hepatitis remains a global problem

Hot on the heals of World Hepatitis Day, which was July 28,2013, hepatitis remains a global problem. Viral hepatitis is a disease for both developed and developing countries that causes an estimated 1-3 million deaths globally and can often- well, be prevented! This disease can cause unnecessary suffering. Viral hepatitis is a group of five unrelated viruses (A, B, C, D and E) that can cause both acute and chronic infections, some of which do not cause symptoms and can lay dormant for decades before people learn they are infected. Like some heart diseases, viral hepatitis can be a “silent killer.” Symptoms can later show up and lead to chronic liver disease and even liver cancer long after exposure.

Vaccines are available for Hepatitis A and B. Hepatitis C and Hepatitis B is treatable. Common symptoms of hepatitis infections include nausea, loss of appetite, fatigue, jaundice, abdominal pain and dark urine. Transmission of the virus varies as to the virus type. Diagnosis is made through blood tests that can identify the virus. Many acute viral hepatitis infections resolve spontaneously. However, chronic hepatitis can lead to cirrhosis and death. Treatment involves symptom management, drug treatment and in extreme cases, liver transplant.

This segment of The Doctors Roundtable will feature Dr. Enrique Martinez, a highly acclaimed hepatologist based in Atlanta, who will discuss the basic information around Hepatitis A, B and C as well as at risk populations and exciting new drug therapies on the horizon. Listeners may also visit the following online websites for additional resources: www.atlantagastro.com, www.cdc.gov/hepatitis and www.hepatitisfoundation.org.

Dr. Enrique J. Martinez

MD training at University of So. FLA
Internship, residency and fellowship in IM at USF
Board-certified in IM and Gastro
Advanced training at University of Miami in Hepatology and Liver Transplantation
Widely published in text and peer review journals, a noted lecturer in liver disease
Now practicing with Atlanta Gastroenterology Associates and based at Emory in the midtown location of ATL