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On this edition of the Best Docs Network featuring Forest Park Medical Center, neurosurgeon Jeffrey
Cattorini, bariatric surgeon David Kim, general surgeon Tom Roshek, family practice Richard
Berlando. Happy holidays 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 Forest Park Medical Center as you know Jim is one of the top medical centers
in all of Dallas, Fort Worth. And Forest Park Medical Center also has some of the top physicians
operating right here including our first physician. It is neurosurgeon Dr. Jeffrey Cattorini.
Trigeminal Neuralgia is a disorder where patients have lancinating pain in their face, typically
in one of three distributions, either super orbital infra orbital to the nasal region
or nose region or below the mouth to the chin region. I went to the neurologist for about
three months and I wouldn’t go the route of because I am a single mom and ran my own
business so I couldn’t be in the drug induced coma and I was asking really for a fix. I
was like I don’t want to bandaid the problem anymore, I want this fixed. Laura’s, case
she had trigeminal neuralgia for almost 17 years and it initially manifested itself in
her early twenties and she underwent the medication route for multiple years and became ineffective
to the medications intolerant to them. Well at first I thought it was just a toothache.
It felt kind of like having your teeth drilled without novacaine and then it moved into the
whole side of my face. Basically neuralgia is nerve pain and if you think that patient
has nerve pain you treat it typically with seizure medications. The actual nerve is about
the size of a wire to your headphones to your iPod. What he did is cushioned the trigeminal
nerve and then put me all back together again. Now my typical day is I go to work, I have
a full day of work because I have my energy back. I get to come home and I go to dinner
with my kids and we watch movies and we’re up until 10:00 at night after homework and
everything and it’s a real day back again. Laura had a good result from the surgery.
We weaned her off the majority of her medications by three months postoperatively. She had some
incisional numbness around her incision site but she’s much more functional and much
more happier than she was preoperatively. The pain is gone and it’s gone for good.
He recognized that it was something that needed to be taken care of right away and didn’t
make me go through a bunch of red tape, just took care of it. Infertility itself is tough
enough to experience alone. A lot of patients do feel like they have nowhere to turn to
but fortunately we’re here in the community. We’re luck that at Dallas IVF we have a
one stop shop type of center where the patient can come and receive a whole wide range of
treatments to help them get pregnant. Some couples come to us because there’s a male
factor, *** is poor. Some couples come to us because the woman has endometriosis or
does not ovulate well. There’s a whole range of reasons why couples come to us. About 15
per cent of the patients we see in the office have what’s called unexplained infertility.
They have a completely normal workup yet they’re still unable to conceive. Here at Dallas IVF
we offer a wider range of infertility treatments ranging from basic aggressive therapy like
taking medicines just pills to grow an extra one or two eggs combined with something called
insemination or IUI. That’s where we’ll take the partners *** and place it closer
to the eggs within the uterus. Another treatment that we offer is a very aggressive treatment
called IVF also called in vitro fertilization. What that is is where everything that occurs
in the tube which is particularly fertilization and embryo development and growth, all that
occurs in a glass dish in a lab. So in that way we can actually find the healthiest embryo
and place that back into the uterus. If there’s a structural reason why they can’t conceive,
the tubes are blocked, there’s fibroids, polyps in the uterus, endometriosis for these
people we often have to take them to the operating room and try and correct those abnormalities.
We’re fortunate we operate at Forest Park Medical Center at Frisco which provides the
full range of services that we need on all our surgical patients. Infertility and infertility
treatments is like an emotional roller coaster, hope and excitement followed by despair and
frustration followed by hope and excitement. But one day there will be a little baby at
the end of the road. It’s so rewarding. Especially when the families come back and
they are so excited to show us their little child. It really is the best part of what
I do. Ann was suffering from severe sinus problems and she credits Dr. Colin Pero for
helping change her life. To find out more about Ann’s story and other life changing
stories, logon to bestdocsnetwork.com. We’re here at Forest Park Medical Center of Dallas
where we are a bariatric center of excellence through the American Society of Metabolic
and Bariatric Surgery. What a bariatric center of excellence is is it’s a designation that
a facility has to actually apply for it. It covers ten very vigorous standards that are
set forth from the American Society of Metabolic and Bariatric Surgery and they actually come
and interview, they audit charts, they look at outcomes and they look at ten very vigorous
standards to make sure you meet those standards from the equipment you have to care for your
patients, the personnel that you have involved in taking care of the patient and it’s there
for patients to be able to select the facility that is above and beyond for their care of
bariatric patients. Part of being a bariatric center of excellence means that we are able
to handle any complications that occur with our patients so we have several physicians
that we can consult for whatever needs we may have, whether that be pulmonology, nephrology,
neurology, any of those things that we may need we have those here at our fingertips
and we have that for the ICU and the ER as well. I oversee all of the medical nutrition
therapy both before and after surgery with the bariatric patients. So up to 6 months
prior to bariatric surgery patients can come and see us and work on lifestyle changes and
then we also visit with the patients here in the hospital immediately after surgery
and we offer postop classes just to kind of keep everybody on track up to a year following
the procedure. I help teach the pre op in the seminar classes for our bariatric patients
or our prospective bariatric patients. We do in patient teaching after they’ve had
surgery as well as do the lab band adjustments once they’ve had surgery we do upper GI’s.
We do see them from prospective patients and postop wise we see them throughout the whole
course of their procedure as well as two years out, three years out we continue to follow
up with them and see how their doing and continue their education. The pre op procedures that
we do in radiology are the upper GI’s and they like to do that to be able to see the
intestinal tract before they have surgery so that the doctor knows what they’re working
with. And then postop we bring the patient down and we upper GI’s so the doctor can
make sure that all the suture lines look good and there’s no leaks and everybody’s good
to go home. We do around three per cent of the cases nationally for bariatric surgeries.
That means that out of all the thousands of bariatric surgeries nationwide this specific
hospital does three per cent of them. We have a great multi disciplinary team and we do
have a great team of our dieticians, our nurses, our surgical staff, our respiratory therapists,
physical therapists, radiology techs, everyone. And it takes everyone of those members of
the team to provide great patient care and without any one member of the team we couldn’t
be as effective as we are. Best Docs Network featuring Forest Park Medical Center. Forest
Park Medical Center, extraordinary in every way. Not only is Forest Park Medical Center
one of the top medical centers in all of Dallas, Fort Worth they also have some of the most
amazing physicians, like our next doctor, it’s Dr. David Kim. Erin’s a lovely 27
year old who struggled with her weight pretty much throughout her entire young adult life
and so after lots of different things like diets that exist and diet pills she was not
able to lose weight. Before I came to see Dr. Kim I was starting to have some health
issues. I had thyroid issues, I was border line diabetic and I was ready to do something
about that before they became major health issues. I was already starting to take medications
that I didn’t feel like I should really be on at my age. Erin and I sat down and chatted
about the different options that were available for her. She chose gastric sleeve surgery
and this was a great fit for her because she has a very active life. What really drew me
to the sleeve surgery was that there was no device that would be implanted into my stomach
and it was not as extreme as the gastric bypass. The operation allowed her to lose a tremendous
amount of weight. In a year she lost almost 100 pounds and she was able to then have a
life that everyone wants to have as a young person. Once I started seeing the results,
I was really motivated to keep going and to keep eating healthy and to keep going to the
gym every day and just mainly the results are what really keeps you going. Sleeve surgery,
though the operation does entail physically reconstructing someone’s stomach, what a
patient is required to do after surgery would be nothing different than what other people
are expected to do which is to practice portion control as well as wise nutrition choices
and try to get some exercise every day and when they do these practical steps, along
with good sleeve surgery, patients can do marvelously well. When I go shopping, you
know people are actually interested in helping me. The people in the stores now they’re
more willing to help me. They pull clothes for me and shopping is fun. I don’t have
to go to specialty stores anymore and I can wear heels. Before I could never wear high
heels and shopping is just a lot of fun for me now. Did you know that Forest Park Medical
Center Dallas has the accu vein vein finder. This allows the phlebotomist to actually see
the vein before drawing your blood eliminating multiple sticks. I lived on a farm my life
most of the time and I did hay work, we had cattle, we had hay fields, we had gardens,
we had truck patches and things like that. And I worked in the gardens and hoed and plowed
and ran a hay baler, run anything that’s strenuous to a lady. So, I think what happened
to my shoulders, I just wore the bones out. I couldn’t lift my arms, the pain was constant
day and night. She had had previous rotator cuff repair which because of the severity
of her care was not able to be completely repaired and the rotator cuff eventually completely
failed. It was no longer functioning. So I finally went to Dr. Aldrich and Dr. Aldrich
checked my arm and shoulders and bones out and he said I was eat up with arthritis and
Dr. Aldrich did a reversal shoulder surgery. Here is a standard shoulder replacement, ball,
socket, just like our natural shoulder is. The ball on the top, the socket here, they
go together. A reverse is just that, we have now reversed the relationship, so where there
used to be a socket, we have a ball. Where there used to be a ball, we have a socket.
What that’s done is it lowered the humorous bone down lower. It used to sit up higher.
It’s down here and that’s put extra stretch on the deltoid and allows that deltoid to
substitute for the rotator cuff and to elevate the arm. And the rotator cuff used to hold
the humorous down lower, rotator cuff’s not there anymore so this relationship is
what’s holding it down lower, keeping the humoral or the humorous lower so that you
can do this. I had the surgery on November the 15th of 2010. I cooked my first full meals
on December the 19th, Christmas for 21 people. She has literally normal motion of her shoulder
as if she had never had anything wrong with it. I’ve done really well with it all and
I didn’t think I would ever touch my head or my back but I do. When it comes to developing
gynecologic cancer, Dr. Jonathan Oh has a few reasons how it develops. For most gynecologic
cancers the terms sporadic meaning there’s no familial disposition, there’s no genetic
link so 85 per cent will just be sporadic but a small percentage will be hereditary.
When dealing with gynecologic cancer there are signs and symptoms to watch for that are
associated with the three most common cancers. First ovarian cancer. For ovarian cancer the
signs and symptoms are very generalized. And when I say generalized I mean the symptoms
are not specific to what you would think would be gynecologic cancer so the most common complaint
that women will have for ovarian cancer is bloating and distention. So it’s not pain,
it’s not any problem with what they feel like is their female organs but it’s just
feeling bloated. Oftentimes people come in saying that they just can’t eat as much,
they feel full really early, they feel like their bellies are getting bloated, their clothes
are fitting more tightly and these are problems that just persist and progress over time.
Another form of gynecologic cancer is uterine cancer which is common in both older and younger
women. The most common sign for uterine cancer is post menopausal bleeding. So if a woman
generally over 50 who’s done having periods starts to have any bleeding then she should
seek medical attention because that’s a very, very worrisome sign and that’s the
most common sign for uterine cancer. The most common sign for uterine cancer in a young
patient would be heavy vaginal bleeding. So if you have bleeding that’s much heavier
than your typical period and this persists over several weeks or several months then
that warns of an evaluation and biopsy. Now to the third common gynecologic cancer which
is cervical cancer. The most common symptom for cervical cancer is abnormal bleeding and
oftentimes this will present as post *** spotting. And post *** spotting is just
a fancy term for spotting or abnormal bleeding after intercourse. What will happen is that
the cancer will develop on the *** with what we call trauma. Trauma could be intercourse,
it stirs the cancer up and causes it to bleed and women will present and complain of bleeding.
If you are having any of these signs and symptoms, please consult your physician. For more information
on Forest Park Medical Center and of course all the outstanding physicians that operate
right here out of Forest Park Medical Center head to the website bestdocsnetwork.com and
click on Forest Park. And up next our next best doctor, it’s general surgeon Dr. Tom
Roshek. A hernia basically is where your tissue will stretch out and it will allow other tissue
to bulge through that and it can actually get stuck to the tissue that it was bulging
through and that’s where you see a hernia. The hernia can happen in the groin, it can
happen in your abdominal wall so really anywhere the tissue stretches allowing something to
bulge through that basically is a hernia. Got back from a wonderful cruise where we
were very active, had a wonderful time, but I had a place in my belly button, near my
belly button that was bulging and I knew something was not right. Dr. Roshek discovered that
it was an incisional umbilical hernia and said I needed surgery to repair it. The most
common symptoms that we see from hernias are actually very non specific, so a lot of times
a patient will say I have a fullness or I have a feeling of discomfort in this general
area. The most common thing we actually see on the body is a bulge. Pain is actually a
symptom that you should watch out for. If you’re having sharp pains or pains that
are not getting better over time, that’s a sign that something may be caught inside
of the hernia and needs to be addressed immediately. It’s hard for us to say what actually causes
hernias, there are several factors. I think the main component of the tissue stretching
out is your venetics. Went in to see Dr. Roshek and I knew I was in a wonderful place when
he greeted me at the door and welcomed my husband in. One of the first questions I asked
Dr. Roshek, is this the treatment that you would give your own loved ones if they had
the exact diagnosis that I did. And he said absolutely. Once I see the patient in the
office and we diagnose the hernia then we have to decide how we’re going to fix the
hernia. And there are basically two different techniques, the open technique and the laparoscopic
technique. After surgery the recovery period for the patient is going to be determined
on how big the hernia was, how long the surgery took and the location of the hernia. Recovery
time, it wasn’t easy but it wasn’t too long before I was back to my active lifestyle,
busy preparing to enter nursing school, had lots to do. Dr. Roshek’s personality, his
calmness, his demeanor gave me great confidence in having surgery with him. Brothers Brock
and Brady experienced multiple injuries due to sports but they credit Dr. Steven Michelsen
who got them back in the game. To find out more about this story, logon to bestdocsnetwork.com.
Today’s ask the doctor comes from Eric. Eric has a question for Dr. James Davidson.
The question, how soon after bariatric surgery can I expect to see my diabetes go away? People
ask how fast is their diabetes going to be improved with either a bypass or a sleeve.
The answer is it’s going to be improved faster with a bypass and they may if they
don’t have real severe diabetes they may leave the hospital throwing away their med
for diabetic pills. With a sleeve it may take longer. It may take a few months to both have
a little weight loss and have accumulative effects of the metabolic changes from the
sleeve to resolve their diabetes so my recommendation is if somebody wants to resolve their diabetes
as fast as possible your probably better off to have a bypass. For more information on
Forest Park Medical Center and the outstanding doctors that operate right here out of Forest
Park Medical Center log on to bestdocsnetwork.com and click on Forest Park. Now it’s time
for our next best doctor, it’s Dr. Richard Berlando. Dr. Berlando’s been my physican
for probably 10 years. I just went to him originally to have a physician to go to and
I started have physicals on a yearly basis and about four and a half years ago at one
of my routine physicals, Dr. Berlando discovered that my PSA was high so he sent me to a urologist.
They did some tests including a biopsy and they discovered I had prostate cancer. In
Gene’s particular case there was a change in what’s called the PSA velocity, the prostate
specific antigen blood work. What we were able to identify there was a significant change
in that from the previous study and again that’s the importance of follow up so you
can kind of compare that every year to a year and a half to make sure that it’s not going
up too quickly. That was one of the key indicators that got him into the specialist to make the
early diagnosis of prostate cancer. Early detection is really the key. That way we’ll
have better outcomes, the patient has a wider variety of different treatment plans to choose
from that way and it just works all around much better. He’s a good doctor you can
tell he’s concerned, he spends time with you in the room. He doesn’t just rush in
and rush out. I believe he’s concerned about his patients, his well being, he’s just
generally a good guy, he’s knowledgeable, takes good care of me. He’s concerned about
my health. We’ve had people that are feeling well but you just come in for a routine exam
and didn’t realize it but they are a walking time bomb. And again explain to them how aggressively
this has to be dealt with from the get go, again we’re going to be with you every step
of the way making sure that whatever medication we use is not going to be harmful to you ensuring
the benefits of that. Again making sure that patient does follow up so we’ve got good
systems here in the office to make sure that we follow through with that. If I hadn’t
visited Dr. Berlando, he hadn’t been doing the physicals on a yearly basis, perform the
PSA’s I wouldn’t have known about it. Like I said I would probably find out about
it very late in the game and would have probably been too late to do anything for me. Best
Docs Network featuring Forest Park Medical Center, welcome to the twenty first century
of cutting edge medicine, Forest Park Medical Center. After Kimber was born he had a newborn
hearing test at the hospital so we were taken to several other doctors to find out more
about his hearing and hearing loss. We had heard about getting cochlear implants and
had done some research on them and that’s kind of the road we decided that we wanted
to take. A cochlear implant is truly a bionic ear. It is the only available full replacement
for a human special sensory function. When he was born we found out in the hospital before
we even left you know it kind of took the joy and excitement out of having a baby, you
know all of a sudden told that there may be a potential problem with your son, because
you know nobody wants to find out that something is you know wrong with their child especially
their first child. It’s a day surgery type procedure typically. Maybe small children
and babies would spend the night but this surgery takes no more than about an hour and
a half to two hours to do. That portion is allowed to heal and then a very specialized
computer is used on the outside called the processor and that processor takes all the
sound in the environment, digitizes it and sends it to the implant via an FM signal.
And when they first turned him on he had never ever heard sound so they started him off very
quietly and slow so not to scare him you know cause it’s a whole new world to him. And
the second that we had our first appointment with Dr. Peters he said okay you know my staff
will take care of everything and they did. In the case of Kimber who was identified early
and whose parents wanted to be very proactive, very aggressive in doing everything they could
for him, they presented early on so by the time I saw them and that we had completed
all of the evaluations at 9 months, not only was he ready for an implant, but I felt he
was old enough and he had grown enough that we could do both ears at the same time. It
really has changed his life. He turned into a different baby. He was just a lot happier
and it’s just like his whole world kind of opened up. We think very highly of Dr.
Peters. 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. I 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 side 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. Thanks for tuning in everyone, that’ll wrap up another edition
of the Best Docs Network featuring Forest Park Medical Center of course one of the premier
medical centers in all of Dallas, Fort Worth. For more information on Forest Park Medical
Center and of course their outstanding physicians that operate right here out of Forest Park
Medical Center head to the website bestdocsnetwork.com and click on Forest Park. And as always if
you have a question or comment for us we would sure like to hear from you, send us an email
at info@bestdocsnetwork.com. All right that’ll do it. Happy holidays again everyone, we will
see you next week.