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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.
Good morning everyone, Äôm Grace Sells and welcome back to
another edition of Best Docs Network, the show thaÄôs
featuring some of the best doctors in the Houston area that
are really changing peoplÄôs lives.
LetÄôs go ahead and get todayÄôs show started with
interventional cardiologist Dr. Annie Varughese.
As you get older sometimes you have trouble finding words, so
my daughter got all worried and she made me go to a neurologist.
So he does his thing, go back later and he said, it looks like
you had a couple of small strokes.
They're small, they're not going to bother you but he says, you
need to go to a cardiologist to check out your heart just to be
on the safe side.
Valvular heart disease encompasses many different
entities.
The heart has four different valves and Gary had actually
infection and rupture of his mitral valve which is a very
important valve separating the top and bottom chamber of the
left side of the heart.
So she sent me to Houston Northwest Hospital where she
ordered ultrasound for me.
You know I feel fine, can I go home now?
So my wife and I are sitting there and she comes in with this
film of the ultrasound and she says, can you see the mitral
valve there?
I said no I'm not trained for that.
So she points to it with her pen and she said it's right there
hanging down in the ventricle.
It's been ruined with bacteria and it's not doing anything.
And so she says within a month you're going to have a massive
heart failure and I heard my wife gasp you know and I got
rocked and said wait a minute, I feel fine.
She said, I'll check you into the hospital right now.
Gary had mitral valve prolapse, therefore the valve was not
closing properly, was redundant and thick and therefore it was
easy for bacteria to stick to that valve and cause infection.
And this happened before I met him and his story is quite
interesting, how he came to me.
He immediately needed surgery because his valve was infected
and ruptured and not working at all.
But he's very thankful that he came because we were able to
save him.
Obviously I lived but the point is I may not have if Dr.
Vaughese had not caught that ruined mitral valve and so I owe
her.
Yeah, I lost a couple and the rest of them started getting
loose and it was something that took about five or six years to
happen.
It just suddenly came on though.
Yeah, George, his teeth were in an end stage in that they were
decayed and he also had periodontal disease, bone loss
around his teeth.
His teeth were chronically infected, they had become loose.
Also, there was a cosmetic problem with his teeth and
George is a very outgoing person and likes to smile and has a
great smile and so his smile just didnÄôt suit his character
not to mention the health of his teeth.
It was really driving him down.
I was kind of getting to the point where things that required
real chewing particularly in the back of my mouth was getting
more and more difficult.
With George what we did was removed his teeth.
Now in him we focused on his lower jaw and from a financial
standpoint many individuals decide to maybe focus in one jaw
versus the other.
Now granted with him we could have done both of them
simultaneously but for whatever reason and oftentimes iÄôs
schedules, their busy work schedule, also finances that
theÄôll sometimes stagger the case to suit them better and
with George we focused on his lower jaw and we removed all of
his teeth upper and lower but we put the implants immediately in
his lower jaw.
IÄôm feeling fine now.
IÄôm back to the point of eating anything, thatÄôs no
problem.
WÄôll continue on.
IÄôm not quite through with all the procedure but just about.
And that is a misconception that wÄôre seeing right now with
the advertising where it talks about get this all done,
completed in one day.
Reality is the final is usually done later down the road once
the body has fused to the implants and the textbook answer
for that is at least three months.
But it can be as long as anywhere from three to six
months but standard of care is to keep the patient in a
provisional, a prototype if you will, for a period of at least
three months.
According to my experience no question about it, doÄôt be
waiting on it.
The earlier you start some treatment, clearly the better.
We all get cuts and may need stitches.
How can you tell when a cut that you have somewhere on your body
needs a stitch and when it doesnÄôt?
Well, there are several ways.
One way is if iÄôs gaping open, thaÄôs going to be
obvious to you, skin is gaping open, things look like they have
to come together, then you need to go to the emergency room or
to your doctoÄôs office.
If yoÄôre having arterial bleeding, thaÄôs spurting
blood, pulsates out as opposed to vein bleeding where it just
sort of leaks out, spurting is obviously not so goodÄì that
probably needs a stitch or two.
If you see that yellow fatty tissue then youÄôre deep enough
that yoÄôre going to need stitches to make this wound heal
right.
Also if the wound is over a stretched area on your body, for
example a wound on your forearm like right here wouldÄôt be a
big deal to keep together with a bandaid but over your elbow
where it bends and opens up with each bend, yoÄôre going to
need stitches for that.
So those are the things to look for.
Also just use your common sense.
If it looks like it needs stitches, it probably does.
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 videos,
head to our website, iÄôs bestdocsnetwork.com.
LetÄôs go ahead and take a look at our next physician, ear, nose
and throat specialist, Dr. C.
T.
Nguyen.
I was experiencing a sinus, like an ongoing sinus infection for
like the past two years.
I was feeling congestion in my nose and ears and throat, fever,
body aches, headache.
Alondra canÄôt breathe through her nose, she feels pressure in
her face, her ears, and most importantly she had this
constant post nasal drip that makes her cough all the time.
Constant feeling like youÄôre tired, you know youÄôre feeling
like you gotta go to work but you feel not 100 percent.
And it would also affect my social life because I was always
so tired out of feeling sick that I would just decide to just
stay in and not really go out.
Upon examination I noticed that her nasal cavity and sinus are
completely blocked, she canÄôt breathe through her nose and
decided upon a plan of treatment that consists obviously of
allergy avoidance and allergy control combined with a
turbinate coblation.
IÄôs a technology using radiofrequency to reduce the
swelling of the sidewall of her nose, increasing the capacity to
breathe through her nose and improving her nasal allergy
symptoms.
After the procedure I no longer experienced the symptoms that I
was experiencing before.
I noticed that I could breathe a lot better, a lot better, like I
just want to say I could breathe.
Alondra was very happy with the results of the treatment.
We actually found the cause of the problem and targeted her
treatment.
Alondra breathes better, she feels better, iÄôs a new
person.
Medicine has advanced so much that therÄôs always a solution
to breathe well and live well.
Patient doesnÄôt have to suffer anymore.
I no longer felt congestion, I wasÄôt getting sick every
month because I no longer had that infection inside of like my
sinus passage, my sinus passages.
So I want to say I feel great now.
Over 90 percent of diseases are caused or complicated by stress.
Some ways to heal deal with the stress in your life are
exercising, listening to music, writing in a journal or going
for a walk.
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 certainly
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.
Prevention and therapy of osteoporosis is one of Dr.
Meredith Morgan's specialties.
Dr. Morgan offers some suggestions that can help
prevent this disease.
If a womaÄôs normal, a healthy lifestyle should be adequate.
The question about diet and nutrition and exercise, iÄôs
part of life, would be an active lifestyle.
Weight bearing exercise say five times a week for 30 minutes is
good for cardiovascular and iÄôs good for the bones, so
walking is great.
So if a person can do that, thaÄôs the ideal for the bone
health.
Therapy is indicated on a risk factor.
If therÄôs been a fracture, iÄôs obvious the disease
exists.
If there has not been a fracture but the absolute risk projects
to over 20 percent for a major fracture of the spine, arm,
wrist or a 3 percent ten year risk of the hip, then drug
therapy is indicated.
Dr. Morgan can adjust his treatment depending on his
patient's lifestyle.
There are basically two groups of first line therapy.
The bisphosphonates to use a big chemical phrase and denosumab
which is a type of immune therapy, these have been proven
to be effective and significantly reduce the risk of
fracture.
Highly, highly preferred to obtain our calcium in the diet,
just make it really short and easy, about 1200 milligrams of
calcium a day.
In terms of nutrition, this is very serious, there is
controversy but thereÄôs enough evidence to indicate that a
person who tries to treat osteoporosis only with calcium
supplements or calcium and vitamin D supplements may have
an associated 30 percent higher risk of having a coronary event,
a heart attack.
IÄôs mainly theory as to why this would happen and thereÄôs
some people that doÄôt believe it would happen but in terms of
the alternative managements of the disease or the high risk
wÄôre talking about nutrition, supplements and a reasonable
dosage and the lifestyle of exercise and fall prevention.
All of the doctors that youÄôve seen on our show today have
profile pages on our website complete with bios, photos,
videos and you even have the ability to request an
appointment.
And that includes our next doctor, plastic surgeon, Dr.
David Altamira.
I had a double mastectomy and they needed to round out one of
the *** with more tissue so they took it from my stomach.
She had always been bothered by her stomach.
Her stomach was kind of bulging and out of proportion to the
rest of her body and she thought you know I went through this
trauma with the breast cancer now iÄôs time to do something
nice for myself and so she elected to go ahead and have the
tummy tuck to improve the shape of her stomach.
I have had four children, 2 naturally and then 2 cesarean
and you start to get a, what would you say, a pouch and scar
tissue build up so you know I want to look sexy again, feel
sexy.
A tummy tuck can really benefit a wide variety of people.
Usually what we see is women who just have extra loose, saggy
skin in the abdominal area.
Oftentimes itÄôs from either from pregnancy or from weight
gain.
TheÄôve tried dieting, theÄôve tried all the gyms and
working out and they still have that just loose, sagging skin or
that little just pooch or bulge in the lower abdomen that they
just cannot get rid of.
The difference is looking at myself and not seeing a stomach
protruding, where I can put on clothes and I feel good, you
know I feel sexy.
You know, I can wear a bikini where I couldÄôt do that since
4 children ago, so you know, it just brings that sexiness back.
She had a dramatic improvement.
Before the surgery she had just a very thick layer of fat on her
stomach, she had stretch marks, loose bulging skin pretty much
all around her entire waistline.
After the surgery we were able to remove a great deal of skin
and fat, give her a nice, smooth flat contour, a great deal of
the stretch marks were removed.
Everything was nice and firm and tight once again.
Oh after having 4 kids I always wanted to have a tummy tuck, I
just you know wanted to get back to me, got my sexy back.
Another reason to stay hydrated throughout the day is because
your brain is composed of 75 percent water.
Your brain will also begin shrinking a quarter percent in
mass each year after the age of 30.
How do you know the difference between having a bad cold and
having allergies?
IÄôs important to know because sometimes that depends on
whether you go to the doctor or not or whether you stay home
from work or school.
Well a bad cold is caused by a virus so you generally have
fever, you generally feel bad, you feel achy.
The reason you feel achy is the viruses live in the tiny
capillaries in your muscles so in those capillaries they swell
up because the virus is there and then you hurt.
Also you generally get chills and have generally been exposed
to someone whÄôs had similar symptoms.
Allergies you generally tend to sneeze, you doÄôt have
achiness, you donÄôt have fever, you doÄôt have chills.
You may have itchy eyes, runny nose.
Also when you have a bad cold your mucous, the stuff that
comes out of your nose or your lungs, might be discolored,
thick, yellow, green whereas iÄôs going to be thin, clear
and watery when you have allergies.
Now thereÄôs different ways to treat these things especially if
thereÄôs a bacteria involved you might need antibiotics.
So basically just remember iÄôs fever, chills and just
feeling horrible all over.
That usually means a bad cold with a virus or a bacteria and
you need to see your doctor.
Otherwise iÄôs probably just allergies, just get some stuff
over the counter.
My symptoms are you know I donÄôt want to walk on the ball
of my foot.
It shoots sharp pains up my leg.
I mean it feels like a nerveÄôs being pinched off.
Wanda is a patient that presented to my office
complaining of shooting pain you know down her heel, up her leg
and so immediately I started thinking maybe therÄôs a
possibility of a nerve compression.
I told him my symptoms, he suspected what it was.
He wheeled in a little mini ultrasound machine, he did it
right there on the spot and you know diagnosed the problem and
we set up surgery because I had already tried other treatments
with other doctors and it didÄôt work and we were done.
This is your ankle joint and you have a major nerve that courses
through here, thereÄôs a natural tunnel, iÄôs called
your tarsal tunnel.
What happens is the tunnels getting real tight and the clamp
on the nerve or the protective covering which we call the
flexor retinaculum, the nerve tends to get stuck underneath
it, so what happens when the nerve gets compressed, itÄôs
extremely painful.
What heÄôs trying to do is avoid that numbness and for most
people it works.
You know you basically take whaÄôs pinching the nerve off
away.
You make room for it and life goes on.
And the advantage of this, iÄôs not a surgery where
youÄôre really held up for a while, where you have to you
know stay at home and you canÄôt put weight because I
want the patient walking as soon as they can because I donÄôt
want those tunnels to tighten up or to close up so I want to make
sure the nerves can glide.
Wanda had tarsal tunnel surgery, she comes back to the office 3
to 5 days later and just dressing changed, no need for
x-rays because weÄôre not doing any bone work which is great too
because if yoÄôre not doing bone work iÄôs not necessarily
as painful, thereÄôs less swelling and so two weeks later
sutures are out and sheÄôs walking on her own.
IÄôm very happy, IÄôve actually recommended him and all
my friends that have gone to him, theÄôve had more
extensive things done to them, where you know, youÄôre
reattaching muscles, putting in screws, you know, really crazy
stuff.
They also think hÄôs awesome.
The side effect that one has from nerve decompression is not
pain, iÄôs lack of sensation, iÄôs numbness and that's
temporary because with time they regain their sensation but
iÄôs a really easy recovery and it provides immediate
relief.
Requesting an appointment with any of our amazing physicians is
easy.
Just head to our website, bestdocsnetwork.com, go to the
doctors profile page and click on the request an appointment
tab.
And you can even request an appointment with our next
physician, bariatric surgeon Dr. Robert Marvin.
I kind of came to a realization that I obviously was not healthy
and it got to the point where it was kind of borderline
embarrassing going shopping and I would shop for clothes and I
would cry in the dressing rooms and I realized at that point it
wasÄôt five pounds that I had put on, it wasnÄôt 10 pounds,
it was, I had gained about 100 pounds without really even, I
canÄôt say I didÄôt know it but I think I was kind of in a
state of, well, denial.
StephanieÄôs lost all of her extra weight, so thatÄôs ideal.
ThaÄôs not, we donÄôt expect that, we hope for that and
sheÄôs achieved that.
SheÄôs achieved it because the surgeryÄôs given her a lot more
control but sheÄôs exercised that control.
I got the surgery March 5 of 2012 and currently Äôve lost
about 115 pounds.
SheÄôs really changed how she eats and limited it to very
healthy things, natural things, local organic things all of
which have pretty much a low glycemic index.
SheÄôs cut out almost all the animal fat out of her diet and
thaÄôs ideal.
Everything has changed.
ThereÄôs a different joy.
My kids are proud of me and at work, working is easier.
I realize that it was absolutely the best thing that I ever did,
not only for my life right at this moment but for my life
forever.
Her whole approach to eating has changed and sheÄôs involved her
family and friends and co-workers in that and that will
produce an effect known as the halo effect which is the patient
having the weight loss surgery can actually transmit better
lifestyle to some of the people around them and those people
actually benefit from that.
And so everything has changed.
How I saw myself, how I see myself, how I see food, how I
cook, how I shop, everything totally, like, I feel like a
totally different person.
Sunscreen is unlikely to stop you from being sunburned or
reduce your risk of skin cancer if it is not applied properly.
Most people do not apply it correctly and stay out in the
sun too long.
Be sure to put plenty on and reapply often.
In todaÄôs ask the doctor, Mark from the Woodlands has a
question for Dr. Annie.
Why do I need to take so many medicines for high blood
pressure?
Blood pressure is regulated by multiple receptors on a cell.
So if you can visualize a cell having 20 different receptors
you can realize why one medication may affect one
receptor but not the other.
Therefore iÄôs better to have multiple medications affecting
many of the receptors rather than going high dose on any one
medication, because high dose usually can cause side effects.
So therefore the answer to your question is multiple medications
are necessary to affect multiple receptors on cardiac cells as
well as vascular cells to help regulate blood pressure.
Very important to take care of that blood pressure, keep it
low.
Protect your heart, protect your vessels, protect your life.
I found out about James through a local chiropractor who has
treated a lot of wounded warriors and has worked with
them and donated his time to help those guys.
On February 26, 2006 we were on a presence patrol and we got
some information that they were making IEÄôs in a mosque which
is a place that is the majority of time a place where canÄôt
go, mosques and schools.
But anyway, we went there.
We followed the information, detained some personnel and as
we were leaving there was an sv bit on site that detonated right
next to my striker.
A piece of shrapnel entered through my helmet over my left
ear and gave me a skull fracture.
He was at Walter Reed for a long time, coma, trauma and heÄôs
made a remarkable recovery.
HÄôs self-conscience about his teeth and iÄôs not that they
were broken up or damaged in the accident that he had, but hÄôs
studying to be a nurse practitioner and so hÄôs
seeing people in the clinic and so then hÄôs going in and
talking to patients and people.
I have a very stern and aggressive approach and iÄôs
just ingrained in my after 10 years of being a ranger,
thaÄôs just how you communicate.
IÄôm learning to smile and then I realized you know growing up I
was embarrassed about my smile and when I see my patients and I
donÄôt smile they just, itÄôs hard for them to, this guys too
serious for me to be treating me, heÄôs mean.
He just had a you know a self-consciousness about his
teeth and yes they definitely could use veneers.
He had some teeth that were real crooked and tucked in and stuff
so heÄôs a perfect candidate.
The whole team here theÄôve taken me in and IÄôm excited
about the change because I know my demeanors going to change as
I work on my patients.
You know I have so much respect for these guys who go and put it
on the line for our country and my dad was wounded in the South
Pacific in World War II and IÄôm just a big supporter of
our veterans and what they do.
So I wanted to help this guy, I just wanted to you know and I
think hÄôs going to get a fantastic result.
It is so great to see these doctors really making a
difference in peoplÄôs lives.
ThaÄôs going to wrap up todayÄôs episode of Best Docs
Network.
For more information head to our website, bestdocsnetwork.com and
if you have a question or comment or life changing story,
we would love to hear from you, send us an email at
info@bestdocsnetwork.com.
IÄôll see you next week.