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On this edition of the Best Docs Network Featuring Forest Park Medical Center, Dr. Garner Newton,
Dr. Jonathan Oh, Dr. Thomas Hung, Dr. Jeff Angobaldo. Hi again everyone, I’m Kandace
Krueger along with Jim Knox. 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 premier medical centers in all of the Dallas, Fort Worth area. No doubt about
it Kandace. Also out of Forest Park Medical Center, some outstanding physicians operate
right here including our first physician, one of the top plastic surgeons in the entire
Dallas, Fort Worth area, it’s Dr. Richard Ha who helped one little girl, it’s one
of my favorite stories, helped one little girl with a bilateral cleft lip and palate.
Babies with cleft lip and palate are born every year. The incidence is about one in
seven hundred. So while it’s not very common, most people probably know somebody who may
know somebody who had a cleft. When we got our referral approved from the Chinese government
it said that we were going to get a child with a bilateral cleft lip and palate. We
took a referral picture to Dr. Ha and asked him if he could fix her and he said I’d
be happy to and I was thrilled and it was a huge sigh of relief that he was going to
be there for us. Andrea is a delightful child. She came to me after being adopted from China.
She had a bilateral cleft lip and palate so there was a little more severe deformity than
you might find with a one sided lip or just an isolated cleft palate. But she had some
work done and an initial repair in China clearly a very rudimentary repair had been done and
she didn’t have the full treatment plan completed. I’ve heard that the average cleft
child has eight surgeries and she will be average. She’s had seven so far. The treatment
plan for these patients starts at a very early age. A lot of specialists are required to
help take care of these babies in the proper way. It’s not just the plastic surgeon who’s
going to be doing the repair but you need speech pathologists, orthodontists, dentists
as well as ENT surgeons. Together you come up with a comprehensive approach and a treatment
plan. I performed a lip and nasal revision as well as fix the remaining hole in her palate
as well as did the procedure for her to improve her speech. Her next procedure will be when
she’s around sixteen where they’ll move the upper jaw forward and do maybe a rhinoplasty
as well. She initially had some language transitional issues but quickly learned English and she
is very well integrated and just a happy child at school. She looks fabulous and she’s
a resilient child, she’s always happy and she loves the way she looks and Dr. Ha has
really changed her life. I love Dr. Ha. One of the things that is important in nursing
or any type of career is making sure that everyone is well educated on what the expectation
is of the facility. When I became the CNO here at Forest Park I wanted to be able to
focus on clinical education to make sure that we were always providing safe care to our
patients and that all of our clinical staff were able to be educated on doing the same
thing every single time to make sure that there was no room for any type of errors to
occur. With that thought we developed an educational program and hired a clinical educator that
is master’s degreed, prepared to be able to provide that type of education to our staff.
My role as clinical educator here at Forest Park is just to make sure all clinical staff
are up to date on all evidence based practices and current literature and making sure that
we provide our patients with top notch care that is contingent on what research is backing
these days. I teach anything from American Heart Association classes to ventilator classes
to classes on hemodynamics to classes on basic needle sticks, blood draws, anything in the
health care arena. Clinical education is very important to both of my areas because as everybody
knows health care is always changing. We are updating our processes, we are finding new
and better ways to take care of patients and I want to ensure that my staff is doing everything
they can to provide the best care they can to our patients and so here at Forest Park
we have our clinical educator Dan Cloud who is very active with the staff, finding out
what areas they feel like they need education on and finding out what is the newest research
and articles that are out so that we can make sure that we are staying abreast of all the
newest research and practices. Just seeing some of the nursing staff or clinical staff
when you’re teaching them something when it finally clicks or they can take it back
to the bedside with them in their interaction with the patients, that is most rewarding
for my job. I can talk and tell somebody how to do stuff all day long but if it doesn’t
get taken back to the bedside then it’s not doing any good, especially in the healthcare
setting. Best Docs Network featuring Forest Park Medical Center. Forest Park Medical Center,
extraordinary in every way. I was experiencing pain in the right shoulder up into my neck.
I’d seen Dr. Newton before for some hip issues and thought he was the man to see.
Dr. Newton took several x-rays, subsequently an MRI and announced that I had a torn rotator
cuff. The most common way to tear a rotator cuff is really as we age because of the blood
supply in part of the rotator cuff is not very good then it tends to tear. I was concerned
about my athletic endeavors with golf and swimming and the activities that I like to
take part in caused me not to sleep very well or be comfortable in any one position for
a period of time. It’s a very common complaint of a rotator cuff tear is basically having
pain at night that tends to wake them up and or they can’t sleep on that side. The first
thing you do is get a good physical exam. It’s very important to get a good physical
exam and history to see how they may have injured it because you want to pick out if
they injured it in a specific trauma or a lifting type episode because it matters a
lot on what you decide to do as an orthopedic surgeon. Dr. Newton suggested that surgery
was in fact the solution. That it would not heal itself and the pain would not subside,
the discomfort would not subside, it was a very easy election. The rotator cuff surgery
is something that can be done either arthroscopically or through a mini open type procedure. The
way I decide to do it has a lot to do with the type of tear, how big the tear is in the
patient. If we decide to do it through the scope, the incisions are obviously much smaller
but that would require in my opinion a smaller type tear that wouldn’t require multiple
anchors, multiple sutures like in a large to massive tear. Dr. Newton made it very clear
that with each patient needs surgery it could be slightly different. He was very optimistic
that it was a routine procedure and that I would be pleased with the outcome, which I
was. It’s been eight months. I feel fairly unlimited at this moment in time. I feel that
I’m on my way to being 100 percent. Did you know that in 2011 Forest Park Medical
Center was voted as one of the top twenty most beautiful hospitals in the United States?
Also Forest Park Medical Centers were the only hospital in Texas to make this prestigious
list. For more information on Forest Park Medical Center or any of the fine doctors
that operate right here, just visit our website bestdocsnetwork.com and click on the Forest
Park Medical Center tab. Next up let’s check in with Dr. Jonathan Oh. When you hear stages
of cancer, basically stages are just a way of classifying how far the cancer has spread.
Every disease type has their own way of staging things so staging for breast cancer is not
going to be the same as staging for ovarian cancer obviously because it’s completely
different diseases. But that’s generally what we’re trying to do Is trying to get
an idea of how advanced the cancer is and once we know how advanced the cancer is we
can generally give people an idea of what the prognosis is. That’s ultimately what’s
important. You’re not so much worried about stage you’re more worried about are you
going to be able to cure this. So stage kind of gives us an idea of what the cure rate
would be. For a gynecologic cancer after surgery and what we call adjuvant therapy and adjuvant
therapy will just be either chemotherapy or radiation. After the surgery patients undergo
what we call surveillance. Surveillance is just a fancy term for keeping a close eye
on things. Typically the patients come back in to the office anywhere from every three
to every six months for an exam and blood work. We want to keep an eye on things to
make sure that the disease doesn’t come back. Chemotherapy is just a fancy term for
medical therapy. Traditional chemotherapy is an IV infusion so just like if you were
to go to a hospital you get an IV placed and these are medications designed to help kill
cancer cells and for the most part the way I describe it, it’s a very expensive, very
well thought out poison and it’s poison that's designed to help kill cancer cells
before it causes too much damage to normal cells. Length of treatment depends on the
type of cancer the person has and the treatment option that they decided for. But usually
it’s about a eighteen week treatment course. There’s a number of trials that are ongoing
through our research division that’s based out of Mary Crowley here in Dallas. We have
a number of clinical trials open for not just gynecologic tumors but also breast cancers
and multiple other disease sites. We have targeted therapies. We also have tumor specific
options such as vaccines so a lot of these tumor vaccines are created at the time of
surgery where samples of a person’s tumor is sent to a lab and this lab creates a vaccine
targeted specifically against that person’s tumor. That’s something that’s under clinical
trials here in Dallas that I’m very actively participating in. Today’s ask the doctor
comes from Mary. Mary has a question for Dr. Lowell Ku. My husband and I are trying to
get pregnant. When is it time to seek a fertility specialist? Many couples may wonder, well
after how long should I be worried that maybe something’s wrong and when should I see
a doctor? Well, the true definition of infertility is when a couple has been actively trying
for over a year without success as long as they’re under 35 years of age. If they’re
over 35 years of age and they’ve been trying for six months or greater, then they should
seek help and they would be considered to have infertility. So if you are under 35 and
you’ve been trying for over one year or if you are over 35 and you’ve been trying
for over six months it’s time to seek help. December the fourth woke up at a girls Christmas
party and couldn’t walk. Had to call my husband and say baby come and get me, I was
in tears. Come and get me, you’ve got to take me and get a cane. I said I’ve got
to do something, I’ve got to do something. Went to the doctor to get some medicine for
my knee and she goes you’re looking at knee replacement. I’m going to have the bariatric
surgery first and if I have to have the knee surgery after that I will. Why does a gastric
sleeve work? Well first thing it is a restrictive operation. You can’t eat as much because
you’re removing seventy, eighty percent of the stomach. The good news is is that you
can eat just about everything, certainly not as large a quantities because you’ll feel
full. Yeah, it really happened fast. I attended the seminar, very informative. I came right
to the office because I knew I wanted to do it. I came in and talked to the girls and
we started getting things set up. My first impression of Dr. Davidson was that he was
very easy to talk to, very easy to understand, very competent. I trusted him just almost
immediately. Wanda’s been, is a typical success story for somebody that has a sleeve
gastrectomy. She’s lost about 100 pounds, her BMI is now about 26. She can eat most
everything she could before, not in quite as large a quantities. Wanda does not have
reflux after the sleeve. Some people get reflux but she doesn’t. I had my surgery a year
ago and I’m right at 100 pounds down. I feel awesome. It is the most wonderful gift
I’ve ever given to myself. Wanda’s doing great. She’s one year postop this month.
She’s met all her goals, she does not have GERD, her knees don’t hurt as much and she’s
taking her vitamins. If she keeps doing these things of doing some exercise, taking her
vitamins, we anticipate she should do just great for many more years. Dr. Davidson changed
my life by offering this surgery to me. He wants you to take care of yourself. That’s
the awesome thing about Dr. Davidson. He wants you to be the best you can be. Dr. Davidson
gave me the confidence it took to proceed with vertical sleeve gastrectomy. You know
Kandace, March is National Nutrition Month and at Forest Park Medical Center, nutrition
as well as health care is basically around the clock. Absolutely, they take fine dining
to the next level and it’s just another way that they stand a step above the rest.
Let’s take a closer look. I assess patients based on their nutritional needs if they are
at nutritional risk if I need to do any kind of intervention as far as medical nutrition
therapy which is prescribing certain diets. For example, if a patient has diabetes then
we would order a diabetic, heart healthy diet so that it would fit into their meal pattern
to help control their blood sugars while they’re here at the hospital. Having a culinary team
in place definitely gives us an avenue to provide great, great meals. We feature anything
from gourmet pizzas to ready made salads to order. Everything’s prepared fresh right
in front of your eyes and we try to do that in a timely manner. Forest Park Frisco café
services incorporate patient and family members into our dining experience so if there’s
something available down in the café that is not on our written menus that a patient
can select from, it’s still an option that a patient can receive those items from the
café directly on to a tray up to a patient room. With Krista we you know follow a pretty
strict menu that we put out at the back but then there’s also special you know people
with allergies or people that can only have certain things. We’re a small enough hospital
that you know they really get a personal, a personal care touches for the patient every
day. She brings down the information to us and we take care of whatever culinary needs
they have. We have people from Frisco City Hall that come and frequent our dining establishment
quite often and they let us know how well we’re doing. And I thought it was pretty
neat to have people walking down the street come into this facility, they’re not patients,
they don’t have any family members here at the hospital but they just want to try
us out because they’ve heard from other staff members that work with them of how good
the food is. Our menu is not typical hospital fare. It has a lot of I’d say Texas twists
to it. It’s anything from fine dining up in the doctor’s lounge to some of the caterings
that we do for the doctors. And then down here we try to do things a little more regional.
We use some of the local produce, try to make it more of a resort like setting. Food and
nutrition is a lot about lifestyle changes and lifestyle behaviors and those things don’t
happen overnight so what little coaching that I do get to give patients here in the hospital
is mostly through a paper that they can take home with them and do some extra research
on it. We try to give contact information for the dietitian as well so if they have
questions postop there’s always someone available or some kind of way to get the extra
information that they may need. Did you know that Forest Park Medical Center Dallas has
the AccuVein vein finder. This allows the phlebotomist to actually see the vein before
drawing your blood eliminating multiple sticks. Adhesions are the normal healing process of
our body. If you get cut anywhere on your body you develop scar tissue. You develop
that same scar tissue on the inside of your abdomen but what can happen then is that scar
tissue then can cause organs to stick to each other. So the ovaries can be stuck to the
pelvic sidewall or stuck to the uterus. The bowel can be stuck to the back of the uterus.
So with all of this, this can contribute to some of the pain that women experience especially
with infections or endometriosis and until you get the endometriosis out that scar tissue
is going to continue to grow, it’s going to continue to interfere with their normal
functions. Sixty percent of bowel obstruction are from scar tissue and adhesions, so yes
this can be a bad problem. Usually start off slowly growing and then they get thicker,
they get their own blood supply, their own nerve system and they hurt as time goes on
as this disease progresses. So if endometriosis is the culprit that has initiated the growth
of these adhesions we have to go in and cut those adhesions because they cannot go away
on their own. The less blood loss that you have, then the less tissue damage. Any of
that can help prevent adhesion recurrence but it still can recurr in over eighty percent
of patients that have already had adhesions in the past. If left untreated the pain may
continue to get worse so the key is you cut them out. The problem is you’ve now cut
tissue, have raw surfaces, more adhesions. So there are things that we do to try and
prevent these adhesions from coming back. One is we use barriers. We put tissue down
or different types of material to try and keep those raw surfaces apart and unfortunately
other than maybe trying things like acupuncture or alternative methods to physical therapy,
anything to try and help relieve the symptoms, there’s really not many alternatives other
than surgery in trying to prevent the regrowth. Don’t’ forget, for more information on
any of the outstanding doctors or technology right here out of Forest Park Medical Center,
head to the website, bestdocsnetwork.com and click on the Forest Park Medical Center tab.
Now it is time to head to our next best doctor who operates right here out of Forest Park
Medical Center, it’s Dr. Thomas Hung. Before I had a chance to get with Dr. Hung I was
kind of suffering with allergies pretty severely whether it be sneezing or not being able to
breathe or not being able to breathe without opening my mouth. And all the time I would
sneeze or have an allergic reaction, anything, it would swell up so severely it just no air
could pass through and so I had gone to multiple allergists my whole life. Jennifer came to
me because she was primarily experiencing nasal obstruction. It had been going on for
most of her life. She did not have any clear history of any nasal injury or any accidents
in the past but she found that she was unable to breathe from both sides but it seemed like
her right side was more affected and after years of medication she still wasn’t getting
the relief and she still felt like she wasn’t breathing as well as she should. We talked
about if I wanted to do rhinoplasty as well which I ended up doing because I did have
a hump and then he straightened it out but I also wanted to not let it look like I had
had my nose fixed if you will and so he just took my bump out and then corrected my septum
which kind of straightened everything out. The surgery entailed straightening out her
septum and shrinking down the turbanist to create more room in both the right and left
sides of her nostrils. I also used some of that septum to create some grafts to help
support the nose because part of Jennifer’s problem was that the framework of the nose
was starting to shift and collapse contributing to her nasal obstruction. And so I used some
of her septum to help resupport the nose. You can make it as big a deal as you want
but for me personally my recovery time was nothing, there was only up sides for me. A
lot of people just go through most of their lives really not knowing sort of the potential
of how well they can breathe through their nose. It’s very hard to sort of be able
to mimic with medications or anything like that what it’s like to sort of optimally
breathe. It was literally one of the best things I’ve ever done. Best Docs Network
featuring Forest Park Medical Center, welcome to the twenty first century of cutting edge
medicine, Forest Park Medical Center. One of the main reasons why I came to see Dr.
Angobaldo was because I was not happy with the symmetry of my ***. I do body figure
competitions and when I lean out you could really, really see the symmetry of my ***
where my left one was a lot lower than my right one. The implant was very noticeable
and also wearing a bikini tube top you can see that the left breast was a lot lower than
the right one and so I always either had to pad it or tape it or do something so that
it wouldn’t be as noticeable and it was just very bothersome. So the initial consultation
with Claudette, she was unhappy with the asymmetry of her ***. She had previous breast implant
surgery by a different surgeon several years ago and she thought that one implant was lower
than the other which caused less fullness in one breast than the other. She was very
self-conscience of that. She competes in fitness competitions and she wanted also to switch
out from a saline to a silicone implant. As far as the procedure, a pre and post, the
pre was very comforting, the staff was wonderful. I never felt nervous. Everything from Dr.
A to the nurses and anesthesia was great. Post-surgical, probably 2 to 3 days is what
I took and then I was able to get back into my everyday life routine. Claudette is doing
fantastic. She is five weeks out from surgery, she’s had no complications, she’s perfectly
symmetrical, she looks fantastic and she’s, I’m going to free her up to start competing
again and working out within the next week or so. Now that I’ve had the surgery and
I’m symmetrical it’s definitely a boost of confidence. I don’t feel like you know
I’m being watched or you know I’m lopsided so I can’t wait for my next competition.
Dr. Angobaldo’s bedside manners for me and my experience were wonderful. He was very
positive throughout the entire process starting from the consultation to the pre-surgical
and post-surgical.
When we talk about reflux disease we actually have a list of the typical symptoms and the
list of atypical symptoms and sometimes we even have patients that come in and they didn’t
realize that they were having reflux disease. I had no symptoms whatsoever. The only reason
they found out that I had it was because I had entered my 50’s and it was time to get
a colonoscopy. At that time I decided to have both done, the endoscopy and the colonoscopy.
That’s how they found it and I was totally shocked because I had no idea that I even
had it. We have a lot of people that don’t realize that they have reflux disease and
it takes a little bit before they come to the realization that you know this is the
entity that they’re dealing with and that’s very important because having the right diagnosis
is going to lead to the right treatment. I had asked Dr. Ihde to explain it to me because
I couldn’t quite understand you know exactly what he was going to be doing. So now with
this surgery, I stand a great chance of living a normal life and eating what I want to eat.
First we went in with little incisions and we were able to free up the stomach, close
the diaphragm down to the right size and then we used the newer procedure to create the
valve to close off the esophagus so that she wouldn’t have reflux and that involves going
down through the mouth into the stomach. We attach to the end of the esophagus and then
we fold the top part of the stomach, what we call the fundus back on to the esophagus
and that creates sort of a flap valve. As the stomach expands, push the front wall of
the esophagus against the back wall closing it off so that the content in the stomach
doesn’t get into the esophagus which is what reflux is. Two weeks after surgery her
symptoms have been resolved, she’s off of her medications and is working towards getting
back to a normal diet. So, she’s very happy with the procedure and I think it’s a testament
to the way the procedure works. Just to know that he took care of that problem for me and
that my stomach will open and close you know when I eat my chances of living a longer life
are so much greater. That’ll do it everyone, that’ll wrap up another edition of the Best
Docs Network featuring Forest Park Medical Centers. Of course Forest Park Medical Centers
one of the premier medical centers in all of Dallas, Fort Worth. And for more information
about Forest Park Medical Center, all the outstanding doctors that operate right here
out of Forest Park Medical Center or the great technology, head to the website bestdocsnetwork.com
and click on the Forest Park Medical Center tab. Thanks for tuning in, we’ll see you
next week.