BMN Blog

Breast pain is one of the most common symptoms in patients undergoing breast imaging tests. Known clinically as breast mastalgia, breast pain is a frequent ailment in women regularly affecting their quality of life. In the mainstream, especially in the media and on the internet, breast pain is often associated as a symptom of cancer. However, breast pain can develop from a variety of different conditions.

Throughout training, physicians are taught how to prescribe medications. How does the medication work within the body? Which patients will benefit? What is the appropriate dose? What are the side effects? The cost? We spend years honing our expertise on how to prescribe medications safely and correctly. Great care is taken to prescribe the best medication for each situation in each patient. We become comfortable prescribing medications early in training. Over the course of a patient’s lifetime, the number of these medications can build, leading to polypharmacy.

September is Atrial Fibrillation (AF) Awareness Month, which reminds us that even in the midst of the pandemic, cardiovascular and other diseases progress unabated. As a result, we welcome this opportunity to review some of the important approved developments in AF therapeutics and assess their validity when subjected to scientific scrutiny.

Question:

What is the importance of taking extra care of your skin during our current pandemic?

September is National Childhood Cancer and Sickle Cell Awareness Month. This year’s observance comes as we continue to learn more about COVID-19 and its effects, and we are fortunate that our pediatric hematology-oncology patients have not been severely impacted. Two of our faculty members, Julie Wolfson, MD, MSHS and Emily Johnston, MD, MS are involved in a national research effort to collect information on pediatric cancer patients infected with the virus.

The COVID 19 pandemic has thrown a wrench into all of our day to day routines, including going to work, taking our children to school, running household errands, exercising, and even going to see our doctors or dentists.

Oral Immunotherapy (OIT) for food allergies is a life changing medical treatment that re-trains the immune system to become desensitized to food allergens through regular ingestion of food proteins at increasing doses. Alabama Allergy's Food Allergy Treatment Center provides OIT to patients who are at risk for anaphylactic reactions to peanut, tree nuts, milk, egg, soy, sesame seed, and wheat. This treatment is guided by Sunena Argo, MD Board Certified Allergist and Erin Cuzzort, CRNP.

When Children’s of Alabama performed its Community Needs Assessments in 2013, 2016 and 2019, mental and behavioral health were found to be among the top priorities for pediatric health.

Pediatric office visits have declined by half during the COVID-19 pandemic, according to the American Academy of Pediatrics (AAP). Not only are children missing well-child checks, but also the vaccines that are given during these visits. Manufacturers are reporting a decline in vaccine orders and vaccine doses distributed through the Vaccines for Children program.

In this day and age of advanced technology, physicians have access to abundant clinical information at their fingertips. Electronic medical record (EMR) systems can provide physicians with the data they need to care for their patients at virtually any time or place (whether or not these systems are user-friendly is another story).

Potential complications of both surgery (carotid endarterectomy or CEA) and conventional stenting (accessed from the groin) for stroke prevention in patients with carotid artery disease occur during or after the procedures. Studies have shown a higher risk of stroke during conventional stenting as compared to surgery and a higher risk of heart attack and wound complication with surgery as compared to conventional stenting.

Heart South Vascular Institute at Heart South Cardiovascular Group, has successfully performed its first radial to peripheral intervention, and is one of the earliest adopters of this new technology in the area.

Obesity is a growing disease both in the US and around the world. It is a major cause of many diseases including diabetes, hypertension, heart disease, cancer, cerebrovascular disease and stroke, gastroesophageal reflux disease, bone and joint damage and respiratory disorders. It also places individuals at increased risk of developing serious complications from COVID-19.

Approximately every 40 seconds someone in the United States has a stroke and roughly every four minutes someone dies of a stroke. It causes about one in 20 deaths annually – making it the fifth-leading cause of death – and the primary reason for long-term disability. Moreover, Alabama has the second-highest stroke mortality rate in the United States, behind Mississippi, according to the Centers for Disease Control and Prevention (CDC). This high incidence of stroke has earned Alabama a spot in the stroke belt, dubbed so by the medical community.

There is still a great deal of uncertainty regarding the coronavirus. Although researchers are studying several pharmaceuticals that may have positive effects on the virus, we still don’t have a definitive antidote. This is why it is important to do what we can to flatten the curve, and social distancing is one of the most effective remedies. This limits the spread of germs between people so that fewer people become sick and it buys our nation time to strengthen our healthcare forces.

The COVID-19 pandemic has challenged virtually every aspect of life, and for many of us, sleep has been severely affected.

The Brookwood Baptist system recently incorporated state-of-the art Cardiac Magnetic Resonance (CMR) imaging for diagnosis patients with complex cardiovascular conditions. The technique allows for the acquisition of three-dimensional multi-planar moving images of the heart, blood vessels and associated organs without the need for ionizing radiation in about one 15-minute session.

Observed annually on the fourth Tuesday in March, Diabetes Alert Day is a wake-up call to inform the American public about the seriousness of diabetes – an illness that affects millions of Americans of all ages, particularly when diabetes is left undiagnosed or untreated. This year, Diabetes Alert Day falls on March 24, and it’s especially imperative that the people of Alabama take note considering our state has among the highest prevalence of diabetes in the United States.

On Dec. 31, 2019, an outbreak of novel coronavirus (2019-nCoV) was first reported from Wuhan, China. Since then, the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and every major news outlet have kept us up to date on the outbreak and its impact across the world. 

In winter, the combination of colder temperatures, dry air, and turned-up thermostats can wreak havoc on your respiratory and immune system. One of the best ways to reduce your risk for infection is to start using a humidifier. Although humidifiers can help to relieve sinusitis, moisturize dry skin, protect vocal cords, and halt the spread of flu germs, they can also promote bacteria and mold growth if not cleaned properly. Clean your humidifier by doing the following:

Over the last four decades, there has been a tremendous reduction in mortality of patients with cardiovascular diseases. This applies to the entire spectrum of disease, including patients with acute myocardial infarction, heart failure, atrial fibrillation and arrhythmia.

We live in a three-dimensional world, where many physicians and surgeons diagnose, treat and operate on patients using flat images, but that is not the case at Children’s of Alabama. Seven years ago, I helped open Children’s first 3-D laboratory, which provides cutting-edge technology through advanced visualization. We help our medical staff provide a clearer, less invasive and more realistic view of joints and organs. With this type of information, doctors can also give patient families a clearer vision and understanding of their child’s condition.

I have a meniscus tear, now what?

Many patients who come to my clinic with an MRI that shows a meniscus tear are looking for advice on what to do next. Another physician may have told them that they need surgery because the MRI is abnormal. Some people just want another opinion. Not all meniscus tears need surgery.

I first want to understand the patient’s symptoms, and I look to see if the knee is locking, catching, or if it feels unstable. Meniscus tears that are unstable create these problems, which may indicate that more damage is being done to the articular cartilage in the rest of the knee. An additional concern here is that the knee could give way at a bad time, causing a fall or buckle leading to another injury. Be careful.

Varicose veins appear as bulging, enlarged, bumpy, purple veins. Symptoms can include restless legs, swelling, aches, and cramps. Varicose veins occur more frequently with age but anyone can get them at any time. The American Academy of Dermatology estimates that about 80 million people in the United States have leg vein problems.

I am an Associate Professor of Pathology at UAB, and was surprised when, shortly after moving to the Birmingham are in 2013, I was diagnosed with leukemia. As a researcher of diabetes and cardiovascular diseases, I had no idea how many advances had been made in the world of oncology. However, owing to the discovery of tyrosine kinase inhibitors, like Gleevec and Sprycel, and the outstanding medical care I received at the O’Neal Comprehensive Cancer Center and Kirklin Clinics, I was quickly cured. However, not all have been so lucky, and that is why I have now put my love of running to help put an end to blood cancer for others.

As 2020 approaches and people begin to contemplate their New Year’s resolutions, weight loss is often at the top of the list. There are two excellent options available for dramatic weight loss: the gastric bypass procedure and gastric sleeve procedure.

Breaking a bone is often the first sign of osteoporosis. Approximately one in two women, and up to one in four men age 50 and older will break a bone due to osteoporosis. Osteoporosis causes bone to become brittle and weak, which allows them to fracture with relatively low impact. We typically refer to an osteoporotic fracture as a fragility fracture.

Saliva is produced by three paired “major” salivary glands in the head and neck – Parotid, Submandibular, and Sublingual as well as ~400 “minor” salivary glands throughout your oral cavity and oropharynx. Saliva is usually plentiful (your mouth makes between one pint and one liter per day) and is important in the enzymatic digestion of food, providing an immunologic barrier for dental protection, and to foster ideal oral mucosal health. Salivary glands may be affected by several different disorders that disrupt their important normal function:

The holidays are a season of joy, gratitude, and family. However, for people with allergies it can be a difficult time. Class parties and homemade treats make it hard to check food labels and ingredients. Christmas trees and decorations can cause their own problems with those who are environmental or dust mite allergic. Having to say “no” to a thoughtful treat given by a neighbor due to your child’s nut allergy, but still remaining grateful for the gesture can be awkward.

The effects of a stroke are unique to each patient and everyone’s path to recovery will look different. However, there are inherent truths to stroke treatment that should guide clinical decisions on the best care for patients.

During your first visit as a new patient to our fertility clinic, the American Institute for Reproductive Medicine, you will undergo a series of lab tests. These tests are critical in determining the right treatment plan. We focus on eight common lab tests.

As the new division director of the Pediatric Hematology-Oncology and Blood Marrow Transplantation program in the University of Alabama at Birmingham (UAB) Department of Pediatrics and Children’s of Alabama, my top priority is to build a well-rounded program; a program that is not only strong in its clinical mission – to provide the best treatment possible for children with cancer and blood diseases – but one that also has a strong research base, which includes clinical, basic and translational research.

Seasonal affective disorder (SAD), which as its name implies, is a disorder related to the change in seasons. The earlier sunsets cause less daylight exposure which can impact mood and, subsequently, cause depression for many people. Further, SAD occurs like clockwork as the seasons change with certain people exhibiting the first warning signs in the fall which, consequently, worsen in the winter. During this time people with the disorder feel depressed, lethargic and irritable to the point that it interferes with their daily functioning.

Managing medical waste is not for the faint of heart - and neither is managing a medical office. Your facility’s staff must adhere to strict, sometimes time-consuming medical waste guidelines and regulations while providing the highest level of patient care. You must protect the health of your patients, your employees, and the environment. Following best practices in health care delivery, medical waste management, and medical office management can streamline processes and help ensure the best delivery of service in each area.

Most people associate allergy season with the Spring, but just because the pollen isn’t present doesn’t mean the sniffles aren’t.

Hay fever, despite its name, actually has nothing to do with hay. Ragweed is a common cause of hay fever/allergic rhinitis. Ragweed begins to pollinate in mid-August and will continue provoking allergy symptoms through the fall until a hard freeze. Allergy shots, sublingual allergy drops or dissolvable ragweed tablet are beneficial for patients who struggle with ragweed, helping to build immunologic tolerance to pollen.

Transcatheter aortic valve replacement, or TAVR, is a minimally invasive alternative to open heart surgery for patients who require replacement of their aortic valve due to severe aortic stenosis. Although previously available only to patients at high or intermediate surgical risk, in August the Food and Drug Administration approved both of the latest-generation TAVR valves for use in patients at low surgical risk. This is a large group of patients who are typically younger and/or more active than those at higher risk. Until now these patients' only option was open heart surgery.

Influenza, commonly known as flu, is a virus that can be spread by droplets. It can occur anytime of the year, but the majority of cases occur in December through March. Flu vaccines are the single best way to protect yourself from getting the flu. It is best to be vaccinated in early fall, as it takes two to four weeks to build up immunity. You can still develop the flu after being vaccinated, but cases are generally milder than for those that have not been vaccinated.

You are likely aware of the outbreak of measles that has received a lot of attention in 2019. The CDC reports that over 1,000 cases of measles have been reported this year, which is the greatest number of cases reported in the U.S. since 1992.

Obstructive Sleep Apnea (OSA) is a common problem affecting nearly one-third of the adult population. The long-term health effects of untreated OSA are beginning to become established and are frightening: increased risk of cardiovascular disease, stroke, dementia, pulmonary hypertension.

Cataracts are the number one cause of reversible vision loss in the world. While cataracts can cloud your vision, they don’t have to cloud your life. I was drawn to this Ophthalmology medical specialty because of the profound life change I could make with his patients. Surgical treatment of cataracts can completely restore a patient’s vision. There are very few other types of conditions where complete recovery can be achieved by a very simple outpatient surgery.

The Psychiatric Intake Response Center (PIRC) at Children’s of Alabama has completed its inaugural year of operations, assisting more than 5,000 patients and callers seeking mental health expertise for children, adolescents and their families in central Alabama. The PIRC, established in March 2018 as a collaboration between Children’s and the Anne B. LaRussa Foundation of Hope, is one of only three centers of its kind in the U.S. We are dedicated to identifying the right care at the right time and at the right place.

It is that time of year again - pool parties, camping, hiking, yard work, and picnics. Along with increased time outdoors comes the risk of an insect sting. While insect stings occur regularly, only about two to three percent of patients will experience an anaphylactic reaction. These anaphylactic reactions occur more commonly in adults than in children. A majority of these patients do not seek medical care. 

The “just right” theme repeated in the classic fairy tale of Goldilocks and the Three Bears hits close to home at Children’s of Alabama’s Pediatric Imaging Center (PIC), where services are tailored especially for kids. Every inch of the PIC, located at Children’s South Pediatric Outpatient Center in Birmingham, is designed with children in mind to ensure their experience is “just right.”

One of the most common operations in orthopaedics and sports medicine is surgery for a torn meniscus. I get a lot of questions about what this surgery involves, how long it takes to recover, and when it should be done.

Many of the patients I see at the American Institute for Reproductive Medicine have endometriosis.

Recently, a friend in the pharmaceuticals business asked me about SGLT-2 Inhibitors. He wanted to know what a nephrologist thought of the drugs, and I expressed strong misgivings about potential complications.  

Arrhythmias are abnormal heart rhythms that are often under recognized cardiac problems and can lead to dangerous consequences if ignored or not treated appropriately. Typical symptoms can mimic those of other cardiac conditions like a heart attack, and often include palpitations (abnormal sensation in the chest, feeling like your heart is racing or beating abnormal). Sometimes symptoms may be associated with chest discomfort, shortness of breath at rest or with exertion, dizziness, near passing out or passing out, and/or fatigue.

As the temperatures spike this summer, the risk of heat-related injury such as heat stroke and heat exhaustion also rise. While the temperatures are hard to avoid, there are ways to recognize symptoms and prevent heat-injury. People who tend to be more at risk are young children and infants, people over the age of 65 and those who are overweight or have a preexisting illness. It is important to note that some medications can also make you more sensitive to sun exposure and heat.

Physical health, mental health, and substance abuse problems often are more apparent in prisons than in the community, and many incarcerated men and women are often only diagnosed with these problems after receiving care from a correctional health provider. Correctional health care is also tasked with providing experienced management, technologically advanced services, and programs that control costs while ensuring quality of patient care.

Millions of patients around the world wear contact lenses to correct their vision.¹In fact, research suggests that contact lenses provide patients with benefits such as better perceived cosmetic appearance, better social acceptance, and a better ability to play sports compared to glasses.^2-4While most contact lens wearers use soft contact lenses for cosmetic reasons, some patients wear specialty hard contact lenses because they are the only way that they can achieve functional vision without undergoing surgery to correct a visually debilitating eye disease like keratoconus (a degenerative disease that results in an irregularly shaped cornea).⁵In other cases, patients who suffer from moderate to severe dry eyes wear specialty contact lenses because they have the ability to make their eyes comfortable enough to effectively function.⁶While there is more than one type of specialty contact lens that can help patients with these conditions, scleral lenses have emerged over the past few years as the contact lens treatment of choice for these difficult-to-treat patients.⁷

Teen Health Week, a global campaign to raise awareness of the unique health issues adolescents and young adults face, is observed every year during the first week of April. However, raising awareness is an everyday reality for the University of Alabama at Birmingham (UAB) Division of Adolescent Medicine at Children’s of Alabama, where our team of specialists provides a comprehensive array of services to help patients transition into a healthy adulthood.

What if a microscopic amount of food protein you accidentally ingested quickly resulted in life threatening symptoms such as hives, swelling, vomiting, diarrhea, coughing, wheezing, or difficulty breathing? This is a serious reality for patients with food allergies and results in a constant anxiety and fear of accidental ingestion. Many are never able to eat out at restaurants, go to baseball games, fly on planes, attend movies, or simply have the option to eat at any table in a cafeteria without fear. This not only affects the patients, but their families as well.

The field of oncodermatology has emerged as a result of remarkable advances in cancer treatment. Unlike traditional chemotherapy, targeted anticancer agents such as epidermal growth factor receptor (EGFR) inhibitors are associated with decreased systemic toxicities.

The Apple Watch and other wearables are now able to monitor your heart rhythm. The Apple watch can detect irregular heart rhythms, and if it does so five times, it will prompt you to record your rhythm. In that way, it can also be used to diagnose atrial fibrillation.

One of the more common complaints evaluated by health care providers on a daily basis is Sciatica which is described generally as pain in the lower back or buttock that radiates into the leg and the foot along the path of the sciatic nerve. Patients will sometimes complain of associated numbness, tingling and even weakness in their lower leg with difficulty sitting. Symptoms can appear suddenly or gradually, and with or without a preceding precipitating event such as lifting or other back straining activities.

While there are seemingly countless spinal surgical approaches and techniques, all spinal surgeries fall into one of two categories: decompression or stabilization. Decompression involves taking pressure off neurologic structures including the spinal cord and, more commonly, nerve roots to improve function and relieve pain. Stabilization involves restoring structure to one or more spinal segments, i.e. two adjacent vertebra and the intervening disc, by creating an environment for bone to grow from one vertebra to the next. This may be performed to treat gross instability from a traumatic fracture or chronic instability from a degenerative spondylolisthesis.

The numbers tell the story.

• 176 pediatric heart transplants since 1981
• 59 pediatric heart transplants since 2012
• Zero deaths since 2014
• A 97 percent one-year survival rate over the last decade; considerably higher than the national rate of 90.2 percent

Atrial fibrillation (AFIB), a condition in which the heart fires so rapidly that the upper chambers quiver instead of beating in a normal rhythmic pattern, is the now most common arrhythmia condition worldwide and is recognized as a global health problem with its burden of morbidity and mortality resulting from embolic stroke. AFIB is expected to double by 2030.

Vince Lombardi once said football is not a contact sport. Dancing is a contact sport. Football is a collision sport. He was right. And when you or your family members are involved in collision sports like football (or soccer, wrestling, basketball, mountain biking, etc.) your shoulders may pay the price. Contact injuries to the shoulder are a common cause of down-time and occasionally result in surgery. What is the best management for these injuries?

Peripheral arterial disease, or PAD, is a disease process in which plaque buildup causes the arteries to narrow, resulting in reduced blood flow to the limbs. This can lead to a variety of medical emergencies: Claudication, stroke, uncontrolled hypertension, and possibly amputation.

In 2012, Transcatheter Aortic Valve Replacement (TAVR) became commercially available in the US to treat high-risk patients with severe aortic stenosis. It offered effective, minimally invasive, and often lifesaving treatment to tens of thousands of patients who previously had no option for aortic valve replacement surgery.

When I speak with a patient regarding knee replacement or hip replacement surgery, he/she often asks in detail about the post-surgical rehab. In my specialty of orthopaedics, rehabilitation is critical to the success of the surgery. However, one of the major risks, although uncommon, facing surgery patients is the formation of a blood clot within a deep vein. This complication is often overlooked, and can be fatal when symptoms are ignored. 

The dawn of a new year is often a time to reflect on what has been and what is to come. At the Alabama Center for Childhood Cancer and Blood Disorders, we are excited about the opportunities to improve patient care, and we never cease to be amazed by a community determined to change things for the better.

At this point, nearly every American has heard about the opioid crisis. With increasing scrutiny from governing bodies regarding opioids, pain physicians are tested in treating patients in the challenging chronic pain population. While non-opioid medications, therapy and procedures have their place in treating chronic pain, what are physicians to do when patients fail all of these options? One treatment to consider is spinal cord and peripheral nerve stimulation.

Two years ago, the Children’s of Alabama Community Healthcare Education Simulation Program, or COACHES, launched with a mission of improving pediatric care in community hospitals throughout Alabama.

Earlier sunsets and dropping temperatures can lull us all into the false sense that the sun isn’t as intense and therefore, not as damaging in the fall and winter months. Because of this, many choose to forgo the most important skincare product of all- sunscreen. In fact, the clouds only slightly lessen one of the two UV types that cause skin damage and skin cancers, UVB. UVB causes sunburn and damage that leads to cancers, but ironically, in the absence of this warning sign, people can be less aware that they’ve had too much sun.

I work with Chris Heck, MD an orthopaedic spine surgeon. We have developed an interest in treating osteoporosis, as a result of patients with have seen with broken bones.

Peripheral angioplasty is a minimally invasive procedure that can be performed now in an outpatient setting under local anesthesia for the treatment of peripheral artery disease (PAD). Medical technology has played a significant role in furthering this trend. PAD is a common circulatory problem in which the narrowed arteries reduce blood flow in the legs causing leg pain, numbness and/or discoloration.

With the Halloween season upon us, it is a good reminder to bring up the discussion on the dangers of cosmetic contact lens abuse. Today, nearly 41 million adults in the U.S. (16.7%) wear contact lenses as an option for their vision correction.  There are also options available for patients who, in addition to wishing to correct their refractive error, can change the look of their eyes with cosmetic contact lenses. 

On Sept. 6, representatives of Children’s of Alabama, the University of Alabama at Birmingham (UAB) Division of Pediatric Rehabilitation Medicine and the Lakeshore Foundation gathered to cut the ceremonial red ribbon for the grand opening of Children’s at Lakeshore – the latest chapter in a partnership among the institutions.

How often do you walk into a room and completely forget why you went into the room? Or do you struggle with remembering someone’s name a few seconds after they introduce themselves to you? It seems that these “senior moments” occur more frequently as we all get older. As a clinical neuropsychologist, I am often asked if this is normal aging or if it is a sign of a bigger problem such as Alzheimer’s disease. The field of neuropsychology is uniquely skilled to answer this very question. Clinical neuropsychology is a sub-field of psychology which examines the relationship between the brain and behavior. It uses neuroscience, neuroanatomy, cognitive psychology, cognitive science and clinical psychology to understand the structure and function of the brain in relation to behavior and the information processing aspects of the mind. Neuropsychologists help to assess, diagnosis and treat individuals with neurological, medical, developmental or psychiatric conditions across the lifespan. Neuropsychological testing can aid in understanding how different areas of the brain are working. Neuropsychologists use various standardized tests to objectively examine a person’s strengths and weaknesses in all areas of thinking or cognition. Tests may be paper-and-pencil, answering questions, computer-based or task oriented. Areas of cognitive impairment or deficit can be identified and placed within the context of the individual’s medical and psychological history in order to determine what condition may be impacting a person’s functioning and thinking. 

As the summer months are a time when many people take vacations, it is a good time to get veins treated. So, today, we are decoding the facts about one of the latest minimally invasive technology offerings at the Alabama Vein Center: VenaSeal™ closure system.

Benign Prostatic Hyperplasia, or BPH, is a common condition that a lot of men will experience as they age. The prostate, which is involved in male sexual function, sits at the neck of the bladder. I tell my patients that, as it enlarges, it’s like putting your thumb on the end of a water hose. It requires more force to push the urine out effectively. Symptoms can arise as early as our 30’s and perhaps 50% of us will have issues by our 60’s. It causes all sorts of symptoms including slowing of the urinary stream, incomplete bladder emptying, frequent or urgent urination, urinary retention and nocturia. Unfortunately, a large percentage of men will simply ignore these symptoms and just chalk it up to “old age.” Not only can these symptoms be bothersome but, in some cases, it can lead to significant bladder dysfunction, kidney issues, infections, etc

Venous ulcers of the lower extremities can be a frustrating disease process for clinicians. Do I send them to wound care center (WCC), do I need to order specific studies, are they venous or arterial? 

Atrial Fibrillation (AF) is the most common abnormal heart rhythm which can cause adverse clinical outcomes such as stroke and heart failure. An estimated 2.7 to 6.1 million people have AF in the United States. As the prevalence of AF increases with increasing age, with an aging population, prevalence of AF is expected to double in the next 2-3 decades. People above the age of 40 years have a 1 in 4 chance of developing AF in their lifetime. Patients with AF are 6-7 times more likely than general population to suffer from a stroke.

What is the importance of occupational and physical therapy rehabilitation? Each discipline has its own unique benefits for clients of all age ranges with varying diagnoses and various settings. A common misconception regarding therapy in general is that treatment will elicit pain and discomfort. However, one of the primary goals of both occupational and physical therapy is to control pain in order to increase daily function and skill.

Children’s of Alabama in collaboration with the Anne B. LaRussa Foundation of Hope launched a new service in March 2018 targeting patients, families and providers who seek better access to mental health care resources. The Psychiatric Intake Response Center, or PIRC, located in Children’s Emergency Department, is staffed by licensed mental health clinicians who, via telephone or in person, assess a child or adolescent’s mental, emotional and behavioral needs, and recommend the best treatment options.

Dr Beth Malizia and Alabama Fertility Specialists are thrilled to announce the first pregnancy in the state of Alabama from a new technology that allows for the intra-vaginal culture of embryos. This new technique using a device (INVOcell) cultures embryos within a patient’s vagina rather than utilizing the complex incubators of an IVF laboratory.

“We’re all wearing our team colors, but colors don’t matter when it comes to concussion,” says Dr. Jimmy Robinson, University of Alabama lead team physician. This year, at the Children’s of Alabama Annual Concussion Summit, a special science, vision, and engineering breakout session featured the insight of Dr. Robinson and others in the trenches of Division I sidelines. Led by UAB’s director of medical athletics, Dr. Heath Hale, and UAB Team Eye Doctor, Dr. Kathy Weise, lead team physicians and scientists from Alabama, Auburn, Florida and Clemson joined forces to weigh in on UAB’s advancements in concussion expertise. What if a contact lens could determine how much the eye sloshes around in the orbit to predict how much the brain moves in the skull when exposed to impact? What if retinal blood flow could predict cerebral blood flow following concussion? What if an objective pupil test could help predict prolonged concussion recovery?

Unfortunately, yes! Diabetes is the leading cause of new cases of blindness in adults ages 20-74 in the U.S.  African Americans are two times more likely to have diabetic eye disease than Caucasian patients. Despite the risk of vision loss, only about half of people with diabetes follow the recommendation to receive a dilated eye exam every year.

Those of us who live in the South are pretty familiar with hot weather, but as we get into the dog days of summer, the heat can become excessive and oppressive. All the normal rules for heat and sun safety apply, but as temperatures soar, you may need to take more extreme measures to stay cool and safe.

Over 10 million people in the Unites States and over 200 million worldwide have peripheral arterial disease (PAD).¹ Critical limb ischemia (CLI), defined as ischemic rest pain or tissue loss resulting from arterial insufficiency, affects approximately 1% of the adult population, or 10% of patients with PAD.² Further increasing the impact of CLI is the poor prognosis it carries. Major amputation occurs in 33-67% of patients with ischemic tissue loss at 4 years.^3,4 Mortality at 2 years in CLI patients is as high as 40%, and appears to be even higher in those with tissue loss. The vast majority of these deaths are due to cardiac events, cardiovascular disease, and cancer, rather than PAD.^4,5

Where are the old (and not so good) days when a patient with myocardial infarction was staying in hospital bed for a week?

Other than skin cancer, prostate cancer is the most common cancer in American men. Although it is common, it is still one of the least well-known cancers and a diagnosis can cause confusion about treatment, symptoms, and potential side effects. In search of a minimally-invasive treatment for your prostate cancer? Through our partnership with Vituro Health, Urology Centers of Alabama is the first and only in the state to offer High Intensity Focused Ultrasound, or HIFU treatment.

Medical advancements through specialized programs and essential personnel are vital to the continued growth of the University of Alabama at Birmingham (UAB) Division of Pediatric Neurology at Children’s of Alabama. Expansion is underway while the unremitting needs of patients are met.

The CDC estimates that 1.2 million people in the United States have chronic Hepatitis B (HBV) but two-thirds do not know they are infected. These unaware patients can have clinically silent infections for decades until developing cirrhosis, end-stage liver disease, or hepatocellular carcinoma (HCC). HBV is transmitted by percutaneous or mucosal exposure to blood or body fluids of an infected person, such as from an infected mother to her newborn during childbirth, through close personal contact within households, through unscreened blood transfusion or unsafe injections in health- care settings, through injection drug use, and from sexual contact with an infected person.

"I believe it was divine intervention that I was sent to Aspire Physical Recovery Center at Cahaba River. The therapy team brought me back to myself."

The question is often asked, at what point should a patient and his or her physician begin to consider a total joint replacement?

 Mitral valve regurgitation has been described as a very common cardiac valvular abnormality which is under recognized and under treated even in industrialized countries

Pelvic organ prolapse (POP) is the descent of one or more parts of the vagina and/or uterus. Woman may experience displacement of the anterior, posterior or apex of the vagina, and often there is a combination. This is referred to as a cystocele, rectocele and enterocele.

More than 10 million people in the United States are affected by Peripheral Artery Disease (PAD). About one in every twenty Americans over the age of 50 has PAD. Smokers are four times more likely to develop the condition. Peripheral Artery Disease is a strong indicator for potential heart attack and stroke. Most people are aware of coronary artery disease but few know the symptoms of vascular disease. The most common symptom of PAD in the lower extremities is a painful muscle cramping in the hips, thighs and calves when walking or exercising.   Other symptoms to be aware of are leg numbness, skin discoloration of the legs or toes & loss of hair on the lower legs.                                                                                                                                    

Are you sleeping well? One in three Americans suffer from sleep-related issues. If you or someone you know suffers from a sleep disorder, there has never been a better time to find a solution. Lack of good sleep can be detrimental to one’s quality of life in many aspects. Untreated sleep disorders make it difficult to control other health conditions such as migraines, anxiety, depression, pain, and more. Poor sleep due to a disorder such as sleep apnea can also have negative effects on your social life, as you are too tired to participate in social activities. People who snore could also interrupt the sleep of their bed-partners!  Finally, sleep issues can lead to poor concentration, job performance, and lack of productivity.

Lipedema (Lip- fat, edema- swelling) is a disease of abnormal and disproportionate adipose tissue deposition almost exclusively occurring in women¹. While the disorder was originally described in 1940², lipedema remains under-recognized and underdiagnosed in the United States³. This article aims to elucidate the salient features of lipedema toward the goal of raising awareness among the medical community.

Almost everyone has seen the ads for the new anticoagulants at this point. However, many Americans still remain in the dark regarding what atrial fibrillation (Afib) is and it’s potentially devastating consequences. Despite increasing efforts to improve the awareness for atrial fibrillation, many still do not know it’s signs and symptoms or that it is a progressive disease. Afib is the most common arrhythmia in the world affecting 3-6 million Americans with projections of up to 16 million by the year 2050.

A rare cancer of the eye known as uveal melanoma has affected a specific demographic, mainly women, who attended Auburn University in the late 1980’s and early 1990’s. Uveal melanoma is the most common cancer in the eye, but overall its incidence is extremely low, known to affect only 4.3 per 1 million people in the US.  While these cancers are uncommon, they can lead to unfortunate outcomes including total removal of the eye, and even aggressive cancers spreading throughout the body, making it crucial to catch them early.

When most people think of Spring they think of flowers blooming, birds chirping and sunny day ahead, but for millions… their thoughts turn to congestion, runny noses, itchy eyes or endless sneezes. They have what are known as seasonal allergies. Allergy symptoms are caused by a hypersensitive response to an otherwise harmless substance and not all allergies are the same.

In a world of rapidly accelerating technology, our lives have become a 24hr sprint of endless tasks to be completed within a certain timeframe. Doctor offices are inundated with patients many young in age presenting symptoms such as high blood pressure, racing heartbeat, headaches, chest pain, random sweats, insomnia, and gastrointestinal problems. With the increased volume of patients and the demanding time constraints experienced in physician offices, these physical symptoms are often treated individually. The physician may prescribe medication, make recommendations on possible lifestyle changes, yet the symptoms remain. Effective treatment has to go deeper. These patients could be simply suffering from stress or they could be dealing with a more problematic subset of mood disorders: Anxiety Disorders.

Treatment for a pinched nerve in the neck (cervical radiculopathy) that has failed to improve with non-operative care has traditionally been treated with an anterior cervical discectomy and fusion (ACDF). Originally explained in 1958, this procedure achieves success by eliminating nerve root compression by removing the disc, replacing with bone graft via a fusion to prevent recurrent or pinched nerves and maintain stability. However, not only does this increase restricted motion to the spine (which is increased with multilevel fusions), but it also transfers force stresses to other levels or levels above and below the fusion which has been shown to increase symptoms/degeneration at other levels.

1. Control all of your “other” medical conditions.  Many chronic diseases negatively influence your intestinal tract: think poorly controlled diabetes, undertreated cardiovascular diseases, thyroid disorders, obesity, and so on.  There is a synergistic relationship between intestinal health and your other organ systems. 

Peripheral artery disease is a widespread and vastly underdiagnosed disease, affecting nearly 12 million Americans, mostly those over the age of 50, though the incidence increases with age. The most common symptom of peripheral arterial disease is claudication, which is pain, fatigue or aching in the legs when someone attempts to walk. This is due to the poor blood flow to the muscles in the legs. Beyond simply the discomfort in the legs, we know that having peripheral vascular disease makes one much more likely to have poor cardiovascular outcomes. Among patients with symptomatic peripheral arterial disease, more than 10% will have a stroke, heart attack, or die from a cardiovascular cause within two years. And when we look longer term, the statistics are even more sobering. For patients with symptomatic peripheral arterial disease, their mortality rate is 25% at 5 years and 50% at 10 years. When looking at patients with critical limb ischemia (those who have pain at rest or wounds on their feet), the numbers are even worse: they have a mortality rate of 50% at 5 years and 90% at 10 years.

Until recently, sufferers of chronic or recurrent sinusitis were limited to two treatment options: medication therapy or aggressive sinus surgery. Fortunately, advances in medical science have opened new doors.

If “Varithena” sounds like the latest Marvel or DC superhero, there’s good reason. When it comes to treating varicose veins, such an idea isn’t so far fetched!

Q: Could you tell us about Norwood Clinic Ophthalmology?

A: We’re a part of Norwood Clinic, which is the oldest and largest multi-specialty medical group in the Birmingham area. At the ophthalmology location, we offer comprehensive ophthalmology services. This includes routine adult and pediatric eye exams; medical and surgical treatment for diseases of the eye and eyelids; and screening for ocular manifestations of systemic diseases such as diabetes.

We also have certified ophthalmic technicians and an optician to assist with the dispensing of glasses and contact lenses.

 A couple should consider seeking help from a fertility specialist after attempting to conceive for three months, six months, a year—there really is no right answer. Infertility could be due to a single factor, or multiple factors, and fertility treatments vary in complexity. One factor in particular has become more prominent nowadays in couples who are trying to conceive: age, which effects both the husband and wife, has become a threat to fecundity as society pressures couples to start a family later in life.

Every year, new hearing aid technology is introduced to the market. New technology in hearing aids boasts updates and changes in directional microphones,  sound processing algorithms, noise reduction features, amplitude and frequency compression, and audio data transfer between hearing aids, just to mention a few.  What is often forgotten however, is that the primary objective of a traditional hearing aid fitting is to ensure that the patient is receiving the appropriate amount of amplification for their hearing loss at each frequency.

The Alabama Center for Childhood Cancer and Blood Disorders at Children’s of Alabama actively works toward the goal of a total cure through research and development of innovative therapies. More than a dozen prominent pediatric hematology, oncology and blood and bone marrow physician-scientists provide exceptional programs in patient care, education and research. Currently, the Center provides care or treatment for 90 percent of the pediatric hematology-oncology patients in the state.

Two million Americans suffer from plantar fasciitis every year and 10 percent of the population will experience it in their lifetime. It has become recognized as one of the most chronic and, often times, most difficult foot problems to treat.

Healthcare professionals are all well aware of what a clinical trial is, how they work, and the possibilities   that are provided to those who participate. However, the majority of Americans have not participated or heard about opportunities to participate in clinical research. According to a survey conducted by Research!America in partnership with Zogby Analytics (2017), fewer than 10% of Americans actually participate in clinical trials. Digging further into the reasons why, 55% of those surveyed stated that they were not aware or lacked information regarding clinical trials (Research!America, 2017).  

Dr. Sunshine arrives in her clinic at 8 am. Her lobby is full of patients. Mrs. Jane, a 45-year-old widower who has been Dr. Sunshine’s patient for 10 years. Mrs. Jane has recently been complaining about reoccurring back pain, the inability to fall asleep, and indigestion problems. Dr. Sunshine is aware of the sudden passing of Mrs. Jane’s husband a year ago and treats her physical symptoms as they present themselves with analgesics, sedatives and reflux medicine. Yet, Mrs. Jane’s complaints remain. Although compliant with her medications, Mrs. Jane’s symptoms are a result of Major Depressive Disorder. 

Just because you’re getting older doesn’t mean that it’s too late to get in shape. In fact, research shows that older people who have never exercised can still benefit from physical conditioning. By starting a regular exercise program, you can help prevent coronary artery disease, high blood pressure, stroke, diabetes, depression and some cancer. Physical fitness reduces the effects of osteoporosis and arthritis — two conditions which can severely limit an older person’s lifestyle. Being in good shape physically can help you remain independent as you age and improve the quality of your life.

Approximately 12 million Americans suffer from peripheral artery disease (PAD), yet general awareness of the disease is at 25%. Patients over the age of 50 with a history of smoking, high cholesterol, diabetes, hypertension, and heart disease are at the greatest risk.  A staggering 50% of PAD patients have unrecognized symptoms that may progress directly to severe disease.

An estimated 3.5 million people in the United States are infected with Chronic Hepatitis C Virus (HCV). Many of these people do not know they are infected and are not receiving care or treatment.  The CDC estimates that while Baby Boomers (born 1945-1965) comprise only 27% of the US population, they account for approximately three fourths of all HCV infections.  Therefore, they are at greatest risk for hepatocellular carcinoma and other HCV-related liver disease.  HCV is now the leading cause of liver transplantation and liver cancer in the US. 

Parkinson’s is recognized as the second most neurodegenerative disorder right behind Alzheimer’s. An estimated 7 to 10 million people have Parkinson’s disease worldwide, with 60,000 new cases of Parkinson’s being diagnosed just in the U.S. every year. Parkinson’s is known as a progressive condition and symptoms will affect patients differently. Typically, people diagnosed with Parkinson’s will portray some degree of difficulty with shaking or tremor, slowness of movement or bradykinesia, stiffness in movement or rigidity of the arms, legs and trunk and gait imbalance. Because of the loss of dopamine producing brain cells, patients will see their movements become slower and smaller, creating risk for falls and impairing their quality of life.

Robotic assisted surgery has seen an explosion since it was first introduced about 20 years ago with over 4 million procedures performed. Although minimally invasive laparoscopic surgery has been around longer, certain limitations existed within this field. Laparoscopic surgical instruments lack wristed movement, essentially forcing surgeons to operate with chop sticks. The effect was difficulty performing certain procedures and working at difficult angles. Robotic surgery allows wristed action of the instruments, better optics (depth perception), surgeon control of the camera, and better ergonomics. While there is not any significant change in long term outcomes, there are studies suggesting decreased pain and shorter hospital stays.

Full scale recruitment is under way for the Alabama Genomic Health Initiative (AGHI), a partnership of the University of Alabama at Birmingham (UAB), HudsonAlpha Institute for Biotechnology and Children’s of Alabama. Funded by a $2 million appropriation from the Alabama legislature to UAB, the AGHI is one of the nation’s first statewide efforts to use genomic analysis to identify those at high risk for genetic diseases.

The state’s first spine procedure using the Mazor Robotic System in conjunction with intraoperative imaging was performed by neurosurgeons with Neurosurgical Associates, PC at St. Vincent’s Birmingham.

Venous reflux in the lower extremity is when blood from the foot which should travel towards the heart reverses downwards due to gravity.

Sleep is a very important activity, that we often take for granted. It is especially important in children as it allows for proper neurological development. One disorder that is more and more common is sleep apnea, or interrupted sleep from breathing issues. We generally associate sleep apnea and distressed breathing while sleeping with adults, but it does occur with children - actually in 3-5% of children.

What is myopia?

Myopia is a condition that results in distant objects appearing blurry to a patient when not being corrected with glasses or contact lenses.¹ Myopic blur typically results from the eye being too long for its optical focusing components (cornea and crystalline lens), which causes distant objects to be in focus in front of the retina (back of the eye) instead on the retina, a requirement for the eye to be able to see clearly.¹ About one third of Americans have myopia, and its prevalence is likely increasing because of factors associated with living in a developed country (e.g., decreased time outdoors).^2-5 With that said, the scientific community only has a vague understanding of how genetics and the environment influence the development and progression of myopia.¹ While myopia’s visual affects can be a costly nuisance and strain on the health care system,⁶ myopia also places the affected individuals at a greater risk for developing vision-threatening conditions like cataracts, retinal detachments, and glaucoma.¹ Once present, myopia cannot be cured; therefore, preventing it or even reducing the amount of myopia that a patient develops is an upmost priority for the scientific community.⁷

For 2017, The American Cancer Society has estimated that around 252,710 new cases of invasive breast cancer will be diagnosed in women and 2,470 diagnosed in men, around 63,410 new cases of Carcinoma in situ(non-invasive and the earliest form of breast cancer) will be diagnosed, and approximately 40,610 cases will be fatal.

Over 36 million American adults have some degree of hearing loss.

That is over 4 times the amount of people who live in New York City.

Most people are aware that atherosclerosis can cause blockages in the coronary arteries, resulting in chest pain or heart attack, or in the carotid arteries, precipitating a stroke. But atherosclerosis can lead to another serious but often under-diagnosed condition: peripheral arterial disease (PAD). Defined as atherosclerotic obstruction of the arteries to the lower extremities, PAD causes leg pain and is associated with other cardiovascular disease. Although lower extremity PAD affects an estimated 12 to 20 million people in the United States, only four to five million of them are experiencing symptoms.

Did you know that prostate cancer is the second most common cancer among American men? In fact, an average of 480 American men are diagnosed with prostate cancer every day - that’s one every 3 minutes.

Treatment options for asthma and other atopic conditions continue to evolve. In regard to asthma treatment, we primarily use inhaled corticosteroids and bronchodilators, we treat flares with steroids, and we offer allergy shots to patients with allergy triggers. Yet a significant proportion of patients remain poorly controlled and susceptible to morbidity from their asthma and the toll steroids take upon them.

The prediction: 161,360 new diagnoses and 26,730 fatalities.

Every caregiver strives to expand the services they provide to their patients, while also improving quality of care and safety. These are certainly our goals at the Children’s of Alabama orthopedic clinic.

As a hand and upper extremity Orthopaedic surgeon, I see many patients that present to my office with pain in their elbow and forearm. For a certain subsets of these patients, I ultimately diagnose them with lateral epicondylitis, or tennis elbow. Oftentimes, their reaction is the same. They say, “Doc, I don’t even play tennis, how could I have tennis elbow?!” Unfortunately, many people assume that lateral epicondylitis will only affect those individuals that are active in racquet sports, when in reality; tennis elbow can affect both men and women regardless of their hobbies.

Bang, bang, bang! If you experience your heart banging against your chest or skipping beats you may be experiencing an arrhythmia. An arrhythmia is an irregular rate or rhythm of the heartbeat, where your heart can beat too fast or slow. Most commonly, this is caused by atrial fibrillation (AFib), when disorganized electrical signals cause the heart’s chambers not to beat in sync or fibrillate. Millions of Americans are affected by this disease and the number increases each year. AFib is the most common abnormal heart rhythm in America.

"Aspire Physical Recovery Center at Cahaba River is proud to offer its guest use of the OMNIVR system. The OMNI is a virtual reality augmented rehabilitation system that allows trained clinicians the opportunity to work with guests in novel, yet functional ways.

Tumor Treating Fields or TTF as it is more commonly known is a recently developed method by which malignant brain tumor cells are prevented from reproducing. Shelby Baptist Medical Center and Generations Radiotherapy & Oncology PC has begun therapy on its first patient using this entirely new approach in the treatment of malignant brain tumors with the Optune TTF system.

Prostate cancer is the second most common cancer diagnosed in American men and the second leading cause of cancer death. While a majority of men will be diagnosed after the age of 65, younger men do need to consider screening for prostate cancer, especially if risk factors are present such as African American heritage or a family history of prostate cancer.

Between 2000-2015 the number of Americans with hearing loss has doubled, bringing it close to 48 million. With the aging baby boomer population, that number will continue to climb in the coming years.  

Hard-to-heal wounds can be a problem for many people. One way that Medical West is offering treatment is through hyperbaric oxygen therapy at the Advanced Wound Center.

Hyperbaric oxygen therapy is the application of 100% oxygen that is applied to a patient under pressure. The therapy is used for decompression sickness, for infections, air pockets in blood vessels, and for diabetic wounds that won’t heal.

With the addition of two more physicians in the coming months, Children’s of Alabama will soon be able to expand the care we provide to pediatric patients with liver disease.

The AAOS (American Academy of Orthopaedic Surgeons) has recently sponsored some remarkable multimedia public service campaigns. You may remember the recent “Decide to Drive” initiative about distracted driving /texting. Well, their newest is “Painkillers are easy to get into. Hard to escape.”  Included in the AAOS statement, the U.S. Department of Health and Human Services reports on an average day in the U.S., more than 650,000 opioid prescriptions are dispensed and 78 people die from opioid-related overdose.  It is considered an “epidemic.”  We all have relatives, friends, and patients who have been caught up in and succumbed to the detrimental effects of drug addiction.

For years now, I have seen patient after patient frustrated with stubborn fat in areas that do not respond well (or quickly) to diet and exercise. Their concerns are very common, and certainly not something of which to be ashamed. Patients also frequently ask me for my recommendations on non-invasive cosmetic treatments designed to address these issues, like CoolSculpting®, Sculpsure®, Vanquish™ or Zerona™.

Birmingham Heart Clinic physicians are now utilizing a new approach to reduce atrial fibrillation stroke risk and eliminate the need for blood thinners over time.

Summer is quickly approaching, a season that usually comes with warmer weather and, for many of us, vacation time. Vacations come in a variety of forms. You may prefer a staycation where you simply stay at home and avoid emails for a week. You may favor an once-in-a-lifetime trip to a place like Iceland, or you might head to the southern Alabama coast to catch some sun at the beach. While the travel possibilities are nearly endless, a contact lens wearer needs to be prepared for every situation.   

Hearing loss is a common problem. 15% of American adults aged 18 and over report trouble hearing. Over the age of 65, one third of the population has significant hearing loss. Most people with Hearing Impairment suffer some social, psychological and physical problems. Social consequences of hearing loss include reduced social activity and problems communicating with family and at work.  Particularly in the elderly Hearing Loss can be isolating.

A family medicine doctor is someone you can always feel comfortable voicing your concerns to and leave an appointment feeling as though you were really listened to. They will help you to become an informed and active member of your healthcare decision-making process.
 

Most people don’t think tanning can cause fatal skin cancer. They just want to get a nice golden color to their skin. In our practice, we hear comments like, “I just wanted to get a base tan before my beach trip,” “I am only going a few times to look good in my prom (or wedding) dress” and “I already bought the package and don’t want to lose money.”

You may have thought that a sports orthopaedic center would be a place to go only after a catastrophic sports injury—something breaks or tears or starts hurting so badly you can’t physically use it.

“Most athletic injuries seen in sports clinics are indeed overuse injuries that have reached a point of taking the patient out of the game,” said Dr. Ricardo Colberg of Andrews Sports Medicine & Orthopaedic Center. “Although 85% of sports injuries do not require surgery, many patients wait until they are unable to compete to start correcting their issues.”

As pediatric medicine becomes more specialized, the demand for specialists grows. One need look no further than the Division of Pediatric Neurology at the University of Alabama at Birmingham (UAB) for evidence of this trend.

As we women age, we do not always know what is coming next. We think we do, but we may not. We all know the stereotypical changes that happen with menopause, and of course, chronic diseases such as diabetes, heart disease, etc. that can occur with age.  I can tell you that many women in their late 40s to late 70s are not expecting pain with intercourse, vaginal pain and discomfort, or both. It is honestly a surprise. And not a good one at that. It can make a healthy sexual relationship go sour very quickly, which not only hurts the woman’s quality of life, but her partner’s as well. This can affect the relationship as a whole, and both parties’ overall health, which can then lead to other medical issues. In our practice, we traditionally have treated men for erectile dysfunction and other sexual issues, but we understand that female sexual health is important as well. 

A colonoscopy is an endoscopic examination of your large intestine.  The primary indication for the procedure is colon cancer screening.  However, it is also an effective diagnostic tool for the evaluation of chronic intestinal symptoms including abdominal pain, diarrhea and rectal bleeding as well as unexplained anemia.

2 pounds asparagus  1 spring onion or scallion (thinly sliced) 1/4 cup extra virgin olive oil 4 hard boiled eggs (chopped) 1/4 cup toasted breadcrumbs 1/4 grated parmesan 

Early detection of coronary artery disease is a significant problem. One third of deaths after 35 are secondary to cardiovascular disease. One half of middle aged men and one third of middle aged women will develop coronary artery disease. Currently our ability to detect early disease is limited. By the time symptoms occur there is usually 70% obstruction of the coronary artery. Data from autopsies on Korean War casualties indicate initial signs of development of coronary plaque in the early 20’s of age. Theoretically it would seem appropriate to begin prevention therapy as soon as possible but who should get it? Obviously, the patients with known vascular disease and equivalents such as diabetes would need this therapy. Those without established disease need an estimate of their risk.

In the last 10-15 years, the use of mid-level providers has increased to expand the base of patients in many practices.  The Nurse Practitioner scope of practice is more flexible and there are specialty designations available to foster expertise in certain areas.  The insurance companies have expanded the number of plans covering a mid-level provider’s services.

Are you sleepy? We would like to introduce you to our Sleep Center here at Medical West!

Have you ever said?:

• I have been told that I snore

• I suddenly wake up gasping for air during the night

• I have been told that I stop breathing while sleeping

• I feel tired during the day even though I slept all night

• I have high blood pressure

A common diagnosis patients present at HealthSouth Lakeshore Rehabilitation Hospital is stroke. One of the many deficits a stroke patient may incur is aphasia, a speech and language disorder that causes difficulty using or comprehending words during listening, speaking, reading and writing. Although symptoms may vary from patient to patient, the difficulties and frustrations people with aphasia and their families encounter are consistent. 

Moving a medical practice can be a daunting task. A medical office move can be a result of needing a bigger space, physician retirement, or practice acquisition. While making patients aware of a major change is most certainly a priority, it is equally important to make sure their documents and all office data and service equipment survives the move as well.