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Hello everyone, IÄôm your host, Karla Macias of Best Docs
Network featuring Forest Park Medical Center, San Antonio.
In the next 30 minutes weÄôre going to take a look at some of
the best doctors from all specialties talking about
todayÄôs medical issues.
LetÄôs start today off with urologist Dr. Michael White.
So Richard came to me with a rather common problem that a lot
of older men face and thaÄôs just simple enlargement of the
prostate.
And so therÄôs a certain sub type of men whose prostates grow
much more rapidly than others and that can lead to things such
as bladder infections, stones in the bladder, blood in the urine
and then the worst case scenario which is inability to urinate
and possibly damage to the kidneys.
Richard came and he couldÄôt urinate.
Being 63 years old I had not had anything to do with the prostate
exam since the age of 43, so it was a 20 year span.
And so definitely I was avoiding the exams that I should have
been having.
And in his case it was a difficult situation because his
prostate was about 8 times the size of normal.
And he frankly told me that yours is the largest that I have
ever seen.
And when prostates are very, very large the traditional
treatment which is to typically carve out the prostate from the
inside was not possible because his prostate gland was just too
big.
So RicharÄôs specific treatment options would have
been a catheter for life that he would change every month to self
catheterize himself three times a day for the rest of his life,
to have an open simple prostatectomy which involves a
rather large incision from his belly button all the way down to
his *** bone or to have 5 small incisions and then use a
robot to perform the same procedure as the open procedure
but with a lot less morbidity short of hospital stay and less
blood loss.
He said IÄôm going to try to do it robotically but if I have any
problems weÄôre going to have to do open and so I went ahead
and said Dr. White I have all the faith and confidence in you.
You do whatever it is that you have to do.
So Richard was actually the first person in South Texas to
have a robotic simple prostatectomy.
RichardÄô recovery has been fantastic.
He is urinating without difficulty, hÄôs urinating
better than he has in many, many years and hÄôs extremely happy
and healed quite fast.
He was only in the hospital two days.
The recovery has been tremendous.
I couldÄôt imagine going another week, another day in the
situation that I was in.
The quality of life is 100 percent better.
Forest Park San Antonio is at an exciting stage right now.
IÄôs really starting to take form, youÄôre starting to get
an element of scale and size.
WÄôre at the top of a beautiful hill so we have 360
views of the whole area.
The project is currently set to complete construction completion
at the end of May.
The exterior of the building is largely complete, itÄôs not
final completion but whenever you drive by itÄôs really
starting to look like a building that is near its completion
stage.
IÄôs fully enclosed, fully dry, the roof is on, the glass
is installed.
When you first walk into the lobby, I think one of the things
that yoÄôll see is just this grand staircase.
It acts as kind of a wayfinding piece where the patients will
know exactly where they are at any given time.
YouÄôll see double volume glass, yoÄôll see a two story
water feature.
Every floor within the building has interior trades working
right now from drywall to tape and bed, flooring going down in
some locations, millwork beginning to move in, the
ceilings are beginning to get installed so every floor in that
hospital, every inch of that hospital has some level of
interior finish going on right now.
One thing that we effort to do is to connect dots, you know,
wÄôre connecting dots between the doctor and the patient and
the facility and the community so it feels like one uniform
expression.
Forest Park San Antonio is perched on top of a hill and I
donÄôt think thereÄôs anybody in town from any location that
canÄôt see it, thaÄôs how prominent it is.
So itÄôs really going to be literally a pillar of the
community but what itÄôs also going to bring besides just
sticks and bricks, itÄôs going to bring a higher level of care
to the community.
IÄôs going to bring another option to patients and how they
get healthcare, the type of healthcare that they get and
really the quality of healthcare they get and itÄôs going to be
in a warm, soothing, calming environment with the best in
class physicians.
Smartphones and on the go technology are on the rise
causing Americans to use headphones more than ever.
But did you know that wearing headphones for just an hour
could increase the bacteria in your ear by 700 times?
Did you know Forest Park Medical Center was the first hospital in
the state of Texas to utilize the Acessa Technology and
procedure to treat uterine fibroids as a way to continue
their exceptional care in womeÄôs health.
The great thing about the doctors at Forest Park Medical
Center is that they take the time to educate their patients.
Now letÄôs take a look at otolaryngologist and facial
plastic surgeon Dr. Jose Barrera as he educates us on sinuses.
Patients who have sinus problems usually present with congestion
and nasal obstruction.
They caÄôt breathe through their nose.
Sometimes patients say to me that they wake up in the morning
and their teeth hurt, maybe their cheeks hurt and they
donÄôt know whether itÄôs a cold or allergies or another
sinus infection.
And so patients that present with these types of symptoms
often have trouble.
And if yoÄôre having recurrent symptoms like these and
theÄôre five, six times a year then itÄôs likely that youÄôre
having a recurrent sinus infection or maybe you have
chronic sinus abnormalities so thereÄôs an obstruction in the
sinuses, you doÄôt have proper drainage and so iÄôs best to
have the evaluation.
The proper examination is one to be seen by your primary care
doctor and be referred to an ear, nose and throat specialist.
WÄôll evaluate the patient and during this evaluation weÄôll
take a look at the sinuses using a small little scope in the nose
and wÄôll look for evidence of inflammation, evidence of
obstruction, also for evidence of infection.
And so we put all this together with a CAT scan of the sinuses
and then we take a look at the anatomy and see if the anatomy
is abnormal, see where the obstructions lie and then
recommend medical therapy or surgical therapy.
What are the sinuses?
TheÄôre just air filled sacs within your skull.
The sacs are the frontal sinuses, the ethmoid sinuses,
the sphenoid sinuses and then the maxillary sinuses.
And so in order to keep the natural openings of these
sinuses patent or open we prescribe different medications
such as anti-allergy medicines as well as topical steroid
medicines.
So these topical steroid medicines help to decongest the
nose.
In addition the anti-allergy medicines help to decrease your
inflammatory response to the allergens that are around you.
Sometimes the medicines donÄôt do what theÄôre supposed to do
because the problem is too severe and thatÄôs where we
come in and recommend sinus surgery after a thorough
evaluation in order to open up the sinuses.
Cecilia has a question for Dr. Chou.
How do I know if the lump I have is cancerous?
The only way that you can tell if the lump is cancer or not is
by sampling it, which is a biopsy.
And you know in the old days if a doctor felt a lump they would
take you to the OR and they would cut it out and then you
would have a defect of the breast you know and have a scar.
Nowadays a biopsy is usually done by whaÄôs called an image
guided biopsy.
So itÄôs either by an ultrasound or an MRI but usually
if you feel a lump the first thing you should do is come to
the breast clinic instead of just worry about it.
You know, you come to the breast clinic, we do all the workup and
if we think iÄôs necessary to do the biopsy after we do the
workup then we will do it.
WhaÄôs been so rewarding for me to be involved with Forest
Park is that Äôve been in the business of helping physicians
manage hospitals for 25 years and I have seen all the various
models that have been associated over that period of time.
IÄôve been involved in many different kinds of models and
iÄôs been a pleasure for me to implement the model that I think
works the best in this business and that is the majority
physician owned model where the physicians are in control and
govern their own hospital and have business partners like me
who come in and help them run that business.
But we focus on running the hospital the way that the unique
aspects of that medical staff wants their hospital to be run.
With the help of the doctors here and at all of our
hospitals, we recruit the very best people in all different
lines of work from the OR technicians, the floor nurses,
quality directors, everyone who walks through this hospital has
been very carefully considered.
This basically gives our patients the best possible
experience.
They walk into this place and very quickly are eased of a lot
of the stresses of surgery that you get in a cold sterile
hospital environment.
The people are very friendly, the place is very welcoming all
around them and of course the quality of care is unsurpassed.
What Forest Park means to a physician is that it provides a
place for that physician to practice medicine where he or
she is much more in control of their destiny, much more in
control of the atmosphere that they practice medicine in.
We provide our physicians with dedicated teams of nurses in the
operating room who become familiar with the type of
surgery that the physician does that makes the surgery go much
quicker and enables us to get the room turned over quicker
between cases so that the physicians can get more cases
done.
All of the physicians that I talk to tell me that they are
able to get more cases done and in a more efficient manner than
any other hospital they practice medicine in.
As a physician, a surgeon actually, practicing here we
start your cases on time, our turnover is very efficient, we
have top quality staff to provide you with the people and
the equipment necessary to really be state of the art in
everything we do.
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
theÄôre 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 is prepared fresh right in front of your eyes and
we try to do that in a timely manner.
Forest Park Frisco Ca© services incorporate patient and
family members into our dining experience.
So if thereÄôs something available down in the caf© that
is not on our written menus that a patient can select from,
iÄôs still an option that a patient can receive those items
from the ca© directly on to a tray up to a patient room.
With Krista we you know follow a pretty strict menu that we put
out in the back but then thereÄôs also special people
with allergies or people that can only have certain things.
WÄôre a small enough hospital that you know they really get a
personal, a personal care touches to 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
wÄôre doing.
And I thought it was pretty unique to have people walk down
the street come into this facility, theÄôre not patients
and they doÄôt have any family members here at the hospital but
they just want to try us out because theÄôve 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 IÄôd say Texas twists to it.
IÄôs anything from fine dining up in the doctoÄôs 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,
use some of the local produce, try to make it more of a resort
like setting.
Nutrition is a lot about lifestyle changes and lifestyle
behaviors and those things donÄôt 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 dieticians
as well so if they have questions postop therÄôs
always someone available or some kind of way to get the extra
information that they may need.
As we see it, advances in medicine have as much to do with
patient comfort as with medical technology.
Oh, at Forest Park Medical Center we invest in medical
technology as much as any hospital in north Texas, itÄô
just that we invest in other things as well.
See, Forest Park Medical Center was designed for warmth,
designed for comfort, designed for, dare we say it, our
patients.
Come see for yourself what medical care should be, Forest
Park Medical Center, your destination to better health.
In this organization we have a comprehensive disease management
that is assisted and managed by a registry.
So different to other family care facilities or different to
urgent care facilities, in this facility we donÄôt just manage
the acute care visit for the patient, we manage the reason
that the patient is getting sick.
So we identify the chronic diseases that the patient has
and we have created a team of providers that are responsible
for managing the diseases with the patient.
My blood pressure started giving me problems here.
My cholesterol, it started with that and then other problems,
you know, I became a borderline diabetic or so Dr. Reyes told
me.
And when a patient comes we try to help him in improving the
care for diabetes.
And the better we have proven in the United States that if you
manage chronic diseases the better you can, the better is
the outcome for the patient, the better is the health of the
patient, the less admissions you have, the less year visits you
have, the less complications you have.
And another important factor is you reduce cost, so in this
organization we have the power, every member of the team, to be
what we call a small business unit.
What Dr. Reyes did for me was basically to acknowledge the
problems that I had.
He really also focus and remembers the problems that we
discussed.
He gets to know you very, very well and your problems.
He is absolutely without any doubt one of the best doctors
that Äôve ever seen.
I consider him not only my doctor but a friend.
I think what makes Forest Park unique and different is truly
the culture that we have.
A lot of places present that they have the patient care and
the employee satisfaction in their culture, but when you walk
into Forest Park you feel the difference.
Our directors over our units are very passionate about what we do
and since wÄôre a physician owned facility, the physicians
that are here are very involved in the care and in the decisions
that we make down to the in-patient level.
One thing I really love about Forest Park and I tell everyone
that I talk with in my nursing career about Forest Park, I like
to talk about the camaraderie thaÄôs here.
I really enjoy just a positive, energetic setting with the
staff.
Everyone works quite well together.
Inter department, just you know pharmacy, ER, X-ray, the
doctors, the nurses, itÄôs just a really cohesive unit and I
really enjoy that.
And I fell like every day I come here I enjoy my day and that
says a lot because nursing can be really stressful.
To be able to come here and feel the support from my teammates
and to have a good day at the end of every day, iÄôs
something I really appreciate.
The best thing about working at Forest Park is that we are a
family here.
All the directors know each other.
We know each other inside and outside of the hospital.
We know how to work well with each other and our
administration here at Forest Park really appreciates and
shows us how much they appreciate us, not in big ways
but in small ways every day that really make a difference in the
place where you want to work.
One thing that really stood out about Forest Park was just the
quality of patient care and just the way the patients are
treated, the not only high level of patient care thaÄôs
delivered but also the entire experience that they receive
here.
The facility promotes patient satisfaction, patient care,
which are all things that are very important to me and itÄôs
a facility that I feel like are vey in line with their values
and what they view.
Unless you worked at a hospital like Forest Park yoÄôre going
to find that therÄôs a lot to learn, a lot to do and a lot of
rewarding experiences to be had here.
So counting calories, should I count calories, should I not,
should I do low fat, should I do low carb?
Well therÄôs reasoning behind each one of those theories, but
overall the goal is absolute caloric restriction.
Now thereÄôs a fine line there.
You know if youÄôve been taking in leÄôs say 2500 calories a
day on average throughout the last couple of years and the
weighÄôs been fairly steady, if you cut it back to 2000
calories you now create a caloric deficit which results in
weight loss.
There is a fine line though at that point because if you cut
back too far, if you go to an extreme and cut back to 800
calories a day, yeah yoÄôll lose a lot of weight up front
but the problem is that then your body becomes very efficient
at soaking up calories.
So on the back end when you resume your regular diet those
fat cells come roaring back.
So the goal is to create just a slight caloric deficit where
youÄôre burning a few more calories, taking in a few less
calories and that results in weight loss.
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.
If you or anyone that you know were looking for options for
breast reconstruction, then this segment is for you.
Up next we have breast reconstruction specialist Dr.
Gary Arishita.
I was diagnosed with cancer.
My options, I had already had a lumpectomy.
I had actually been through three surgeries before I found
Dr. Arishita.
I didÄôt realize that there was this type of opportunity out
there, that there was, that a woman had the ability to have
reconstruction directly after surgery and that a mastectomy
was an option.
For me a mastectomy was an option because of the type of
breast cancer I had.
IÄôs very aggressive and my thinking was I wanted to remove
all possibility of it coming back.
Karrie first came to see me for a consultation for breast
reconstruction.
Being very young she had decided to have a mastectomy to treat
the cancer as well as undergo a prophylactic mastectomy to
remove her other breast which didÄôt have cancer as a way to
reduce her risk of having another cancer in the future.
Ultimately she chose to have a DIEP flap.
ThaÄôs where we take skin and fat and blood vessels from the
abdomen and use that tissue to reconstruct the patienÄôs
breast.
When I first came in he talked to me a little bit more about my
options.
I even brought in pictures of what I was hoping to look like
afterwards after going through this and he was really sweet, he
sat through all my pictures and he was like okay, well this is
what I think we can do for you.
This is how I think it will come out and this is what you can
hope to achieve.
The option I chose was DIEP flap surgery.
One of the positive side effects of doing the surgery is that it
reduces the amount of skin and fat on the abdomen.
And iÄôs very much in appearance afterwards like a
tummy tuck.
Karrie recovered very well.
SheÄôs young and healthy and had a great attitude.
IÄôve yet to find another doctor out there that when I
came away from a surgery I felt like I had a person in my family
rather than just another medical advisor.
I feel amazing.
I can honestly say that if I had to do it over again I would do
it again in a heartbeat.
And I actually feel more comfortable with myself now
after the surgery than I did before.
It is important to cover your mouth when coughing and sneezing
since a cough can reach a speed of 60 miles per hour and a
sneeze can exceed the speed of 100 miles per hour.
The whole driving force for creating Forest Park Medical
Center was patient care and more efficiency.
I worked at hospitals and waiting hours between cases to
get the room cleaned, shutting down at 3:00 when they have
patients waiting to have surgery because thaÄôs not the typical
OR times and it just didÄôt make any sense to me.
And so we developed a hospital that is responsive to physicians
and the physicians are responsive to their patients.
And so thatÄôs what itÄôs all about is making the stay, making
the procedure as good as it can be.
Forest Park gives me the opportunity to have just a
wonderful, beautiful facility that my patients will really
enjoy or at least make their experience for unpleasant types
of problems a much better experience for them.
I also liked the camaraderie among the physicians, I like the
advantage of physicians being open to invest in the facility
and having more control over the management of the facility.
From a physicians standpoint it has been an extremely unique
experience.
IÄôve worked at 30 to 40 hospitals in my career and it is
the nicest in terms of the environment, the equipment and
the staff.
From my standpoint personally I love it because I do a lot of, a
lot of work in the orthopedic world that involves technology
and technology is expensive and most facilities require that you
operate there for a while and demonstrate a patient group that
you can bring there to offset the eventual cost of buying the
equipment without actually using it.
In Forest ParÄôs situation they said wÄôre from the very
beginning wÄôre going to buy this equipment and we will have
it available for our physicians as they need it.
And these are things that make our surgeries go more safely.
As physicians it allows us to continue to practice an
aggressive form of medicine where we feel like weÄôre
delivering state of the art care and itÄôs a facility that
really fosters that type of physician and that type of
mentality.
Best Docs Network featuring Forest Park Medical Center is
your destination to better health.
Vivian has a question for Dr. Rodriguez.
Do I need to get a flu shot?
Absolutely.
Currently the CDC recommends that all patients over the age
of 5 months get the flu vaccine annually.
It is especially important for those individuals who are
considered high risk.
So that includes patients that have chronic lung disease,
asthma, diabetes, pregnant women, children younger than 5
and adults over the age of 65.
Now, people caring for high risk patients should also get the
vaccine just because of the risk of contact exposure, so this
includes all healthcare workers.
There are some patients that should not get the vaccine and
that includes patients who have had a prior severe allergic
reaction to the vaccine or have an allergy to eggs or have a
history of Guillain-Barre syndrome.
Now typically flu season will peak in late December or early
January so the ideal situation would be to receive the vaccine
as soon as it becomes available which is usually September or
October.
And thaÄôll do it on this episode of Best Docs Network
featuring Forest Park Medical Center, San Antonio.
For more information on any of the doctors, head to
bestdocsnework.com.
We love to hear from our viewers so if you have any questions or
comments, please email us at info@bestdocsnetwork.com.
IÄôm Karla Macias and wÄôll see you next week.