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August 2017 Production Media Digital Source Project Managers Miranda Paredes Jessie Moore Designer Meghan Goettl Cover Designer Michael Mancha Editor Morgan Grant Writers Rudy Arispe Jody Joseph Marmel Contributing Writers Christina Grenga Dr. Jose Pliego Dr. Michael Fuentes Dr. Jon Roberts
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Dr. Steven Cyr
From the Migrant Fields of Minnesota to Medical School:
A multitude of pediatric services offered through one practice:
Dr. Maria Palafox
The Corpus Christi Bay Area Medical Center Internal Residency Program led by Dr. Antonio Guzman.
Dr. Olutola Adetona and Omolola Adetona D.D.S. Share Their Compassion through Practical Approach Pediatrics, Pediatric Dentistry and Pediatric Urgent Care
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Inner and Outer Beauty Revealed: Cosmetic surgeon, Dr. Erika Sato, finds fulfillment in a satisfied patient.
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Sun Safety for Seniors As you age, you may become more adversely affected by heat as your body becomes less efficient at regulating temperature. Corpus Christi Rehabilitation Hospital suggests these tips to protect yourself from a heat-related illness: • Stay hydrated. Drink water often, even if you don’t feel thirsty. • Check your medicines. Some may make you more sensitive to the sun. Ask your doctor. • Wear sunscreen. Apply before you head outside, and reapply often. • Wear proper clothing. Wear light-weight, breathable clothing, long sleeves and a wide-brimmed hat. • Wear sunglasses. Look for those that protect from UVB and UVA rays. • Go indoors. Mid-day sun is the hottest. Plan indoor activities for those times.
If you experience a flushed face, high body temperature, headache, nausea, rapid pulse, dizziness or lack of sweating, it could be a heat-related illness. Get to a cooler spot, drink water, and seek help immediately.
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Q&A with Dr. Melissa Macias Dr. Melissa Macias talks about Her Patient-Centric Approach & Quality of Care
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Sarah Walls with Strength & Performance Training, Inc provides tips for exercising while pregnant
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Heat and Sun Safety for Seniors As we age, we are more susceptible to heat-related illnesses.
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HEALTHY LIVING/REGIONAL
TIPS FOR
EXERCISING THROUGH
Pregnancy By: Sarah Walls
A
common question that many women have when pregnant is whether or not they should continue with their exercise programs. According to the National Institutes of Health (NIH), almost all women can and should be physically active during pregnancy. They recommend that women aim for around 30 minutes of moderateintensity exercise, one that gets you breathing harder but not to the point of exhaustion, on most days of the week. Knowing the ins and outs of exercising through pregnancy can help keep moms-to-be safe and in better condition. “Maintaining an appropriate exercise program through pregnancy 10
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is important for both the mother and the baby,” explains Coach Sarah Walls, personal trainer and owner of SAPT Strength & Performance Training, Inc., who is also the strength and conditioning coach for WNBA’s Washington Mystics. “Many people are surprised to learn what they can and should be doing when it comes to exercising while pregnant. Maintaining an exercise program will not only bring you health benefits, but it will also help keep you feeling good emotionally.” Coach Walls has worked with many women through pregnancy to help them begin and maintain a healthy workout routine. The NIH reports that exercising during pregnancy helps reduce pregnancy discomfort, lowers
the risks of gestational diabetes, improves sleep, improves mood, helps with an easier labor, and helps provide a faster recovery after delivery. Here are some tips to keep in mind when it comes to exercising through pregnancy: • Research has shown that the mothers of infants who exercise generally have more desirable/ healthy body composition. In other words, if you keep up an exercise routine throughout pregnancy, you will have an easier time going back to your pre-pregnancy weight once the baby arrives. • Stay well hydrated while exercising, stop exercising if you feel exhausted or overheated,
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or if you feel dizzy. Also, avoid activities that could have a high injury risk, such as contact sports, like football, or that change direction quickly, such as basketball or tennis. Keep the weather in mind and if it’s hot outside, avoid exercising in the heat, so you don’t become overheated. Mothers who maintain an exercise program gain less weight during pregnancy and lose the gained weight faster after birth. For many active women, there is no reason to dramatically cut back on exercise during pregnancy. Most women can maintain the program and routine that they are accustomed to doing. Listen to the body and it will guide you. If you've never exercised, then you should take it easy on starting a plan, but if you're an avid exerciser or athlete, keep pushing on with some minor modifications. After pregnancy, it is important
to begin a training plan that is tailored to your body's unique needs. Keep in mind that C-sections require a different approach than a vaginal birth when it comes to your postpregnancy workout routine. • In the initial months after birth, the plan should be designed to help address any aches and pains and begin to recondition/strengthen the core musculature. Moderate to high intensity training designed to lose body fat can be started after this reconditioning phase. It should not be designed for high intensity with the goal to lose the baby weight. • Diet modification is the best way to focus on losing extra weight. • Once the basics of strengthening and reconditioning have been taken care of, a more challenging plan can be started as soon as the body indicates it is ready. “A woman's body is designed
for childbirth and can and should be expected to ‘come back’ stronger and fitter than ever,” added Coach Walls. “When you have the right program that has been designed for you, exercising through pregnancy is a pleasure. It will help you every step of the way, making pregnancy, delivery, and recovery easier.” Sarah Walls has over 15 years experience in coaching and personal training. Owner of SAPT Strength & Performance Training, Inc, founded in 2007, she offers coaching to develop athletes, adult programs, team training, online coaching, and more. She is also the strength and conditioning coach for the WNBA’s Washington Mystics, and has over eight years of experience working as an NCAA D1 strength and conditioning coach and personal trainer. To learn more, visit the site: www.saptstrength.com. SAPT Strength & Performance Training, Inc. Located in Fairfax, Virginia, SAPT Strength & Performance Training, Inc. is a high performance training club that specializes in helping to develop athletes of all ages. They offer athletic training programs for youth, college students, and amateurs. The company was founded in 2007 by Sarah Walls, a professional strength and conditioning coach and personal trainer with NCAA D1 experience, who is the strength and conditioning coach for the WNBA Washington Mystics team. To learn more, visit the site: www.saptstrength.com. Sources: National Institutes of Health. Should I exercise during pregnancy? https:// medlineplus.gov/magazine/issues/ winter08/articles/winter08pg26.html 2017 - AUGUST MD Monthly
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FOOD SWAPS FOR YOUR
Sugar, Dairy
& GLUTEN FREE DIET By: Christina Grenga
G
oing on a sugar, dairy or gluten-free diet and don’t want to substitute taste? The good news is, you don’t have to. Thankfully, God provided us with enough natural ingredients and foods on this earth to please our palate without compromising taste or texture. Eat your favorite foods…but learn the best substitutions for a diet that is free of gluten, sugar or dairy. Here are some healthy food swaps that taste like you haven’t changed a thing. Gluten Free Gluten Free Flour for Wheat Flour - For the pizza lover, this switch makes it possible for all of us to enjoy a rich baked good... even those of us who can't eat gluten. When you use gluten-free flour, you lose the stickiness, which helps bind the 12
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muffin, cake, or pizza together, so you'll need to throw in 1 teaspoon xanthan gum per cup of flour. Pasta Zoodles for Pasta Noodles - Thin strips or ribbons of zucchini are a great stand-in for carb-packed pastas. Sauté for a few minutes until soft and add your favorite pasta sauce. Spaghetti Squash for Pasta Roasted and pulled apart with a fork, spaghetti squash is a great low-carb substitute for pasta. One squash will make between two and three servings. Quinoa or Brown Rice Pasta This is about as close to the “real” thing as you’ll get, maybe even better! Just add Sauce! Bread Crumb Filling or Coatings Ground Flaxseeds for Bread
Crumbs - Crushing flaxseeds and mixing it with some herbs makes an easy, lower-sodium substitution for traditional bread crumbs and are so much healthier for you. Almond meal - Protein packed seeds and nuts make a hearty and crunchy alternative to bread crumbs. Use this to stuff your favorite artichoke or to bread fish or chicken. Wraps Lettuce Leaves for Tortilla Wraps - It's not a perfect swap, but forgoing the carbs for fresh lettuce is a fun (and easy) switch to lighten up any wrap or taco dish. Plus, it provides a nice little crunch that the wrap doesn't. Go green with your next burger too! Coconut Wraps for Tortilla Wraps This is a newer alternative and provides the healthy benefits of coconut!
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No Chip Dipping Snacks Veggies for Pita - Forget the pita. Fresh veggies work as killer dippers with hummus or guacamole and contain fewer carbs plus more nutrients per bite. Mary’s Gone Crackers – This is another that is gluten-free, packs a crunch, and is great for dipping or topping. Gluten Free Oats or Quinoa for Oatmeal – You won’t compromise the taste here; it is just as hearty and yummy. Add some cinnamon, please! Gluten Free Rolled Oats for Bread Crumbs - While bread crumbs can pack extra sodium, using rolled oats seasoned with thyme and rosemary means you won’t be skimping on flavor at all. Sans The Sugar but Not the Sweetness or Taste Cacao Nibs for Chocolate Chips - News flash: Chocolate chips start
out as cacao nibs—the roasted bits of cocoa beans that then get ground down and turned into chocolate. Opting for these unprocessed (or at least less-processed) morsels cuts out the additives and added sugar in chocolate while also delving out a healthy dose of antioxidants. Great for smoothies or to top yogurt, too! Vanilla Extract for Sugar - Cutting sugar in half and adding a teaspoon of vanilla as a replacement can give just as much flavor with significantly less sugar. You can't sub this one in equal ratios, but next time you're whipping up some cookies, try cutting 2 tablespoons of sugar and adding an extra 1/2 teaspoon of vanilla extract. Cinnamon for Cream and Sugar in Coffee - Cutting out the cream and sugar in favor of a sprinkle of cinnamon can cut the sugar out completely. Almond Milk Creamer for coffee - If you still need the creamy texture, try this great alternative. Ice Cream: Frozen Bananas -
These are the perfect alternative to that creamy treat. Add a little vanilla, coconut cream, cinnamon or cacao and you are on your way to heaven! Top with nuts and a cherry and Voila! Sugar and dairy free! Unsweetened Applesauce for Sugar - Using applesauce in place of sugar can give the necessary sweetness without all that sugar. Pro tip: You can sub sugar for applesauce in a 1:1 ratio, but for every cup of applesauce you use, reduce the amount of liquid in the recipe by 1/4 cup. Plain Yogurt with Fresh Fruit for Flavored Yogurt - Pre-flavored yogurts often come packed with extra sugar. To skip the sugar rush without sacrificing flavor, opt for plain yogurt (or better yet, plain Greek yogurt) and add fresh fruit and/or honey if you want that extra hint of sweetness. Fresh Fruit with Homemade granola cereal! This is soon to be your personal favorite. Try granola (gluten
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equal. Darker greens usually mean more nutrients like iron, vitamin C, and antioxidants. Sorry, iceberg lettuce is just not cutting it anymore, go out and get some grown-up greens. Try kale but massage it with a little lemon juice to make it softer. Greek Yogurt for Sour Cream Lighten up those taco toppings by opting for Greek yogurt instead of sour cream. You’ll never taste the difference. Plus, Greek yogurt offers an extra dose of lean protein.
& sugar free too) and top it with fresh fruit and a splash of almond milk, and enjoy sweet, crunchy delightfulness in one meal. Dairy Almond Milk for Dairy Milk Almond milk is so hot right now. Add it to your smoothie or froth it in your coffee. You’ll never miss that cow stuff. Banana Ice Cream for Ice Cream - No milk, no cream, no sugar… but the same, delicious consistency. It’s simple: Freeze bananas, then purée. (see above in Sugar Free too) Nutritional Yeast for Cheese - The taste is cheesy, and the texture is comparable to flakes of Parmesan. Instead of topping that taco with cheddar, try a sprinkle of nutritional yeast for a dairy-free cheesy flavor.
goods, prune purée makes for a perfect butter substitute. Yes, seriously. Combine 3/4 cup prunes with 1/4 cup boiling water, and puree to combine. Sub in equal amounts in most dark baked good recipes. Chia Seeds for Butter - These funny looking little seeds are good for more than just growing countertop pets. Combine 1 tablespoon chia seeds with 9 tablespoons water, let sit for 15 minutes, and you get a gel that's the perfect consistency to stand in for fat in baking recipes. One word of caution: Don't try to cut out all the fat with this substitute—it works best when subbing an equal amount of this mixture for half of the fat in a recipe. Make it Healthy
Coconut Milk for Cream Coconut milk is a great substitute for heavy cream in soups and stews. Don’t be turned off by the word “coconut”—it doesn’t taste like the sweetened shredded kind.
Kale Chips for Potato Chips Who would’ve guessed that a leafy green could make such delicious chips? When lightly tossed in olive oil and some seasoning (salt and pepper, paprika, or chili powder work great) and baked, these curly greens turn into a delightfully delicate, crunchy snack
Prune Purée for Butter - In brownies and other dark baked
Dark Leafy Greens for Iceberg Lettuce - All greens are not created
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Avocado Mash for Mayo - Half a mashed avocado is a great substitute for mayo on any sandwich. Both give some moisture, but avocado makes everything in life better and creamy. Oh, and it's full of healthy fats. Puréed Fruit for Syrup - Do it yourself with a masher and top those oat bran pancakes or whole-wheat waffles, but puréed fruit warmed on the stovetop first. It packs less sugar than store bought and you’ll be adding some whole foods to your diet. These swaps will have you eating better and feeling great without feeling deprived. You can also look for assistance from health coaches who will walk you through all you need to know. Christina Grenga is a faith-based Certified Holistic Health Coach who works with modern Christian women who are ready to quit dieting for good, lose weight naturally, and transform their lives. She graduated from the world renowned Institute for Integrative Nutrition in New York City. Christina uses a Christ-centered approach to guide women to create a balanced, thriving life. You can learn more about Christina at www. grengahealth.com. She also offers a faith-fill detox at www.grengahealth. com/detox/
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FEATURE/CORPUS CHRISTI
AN MD MONTHLY
Q & A with Dr. Macias WITH AN EMPHASIS ON HER PATIENT-CENTRIC APPROACH & QUALITY OF CARE By: Jody Joseph Marmel
T
alking with Dr. Melissa Macias was an enlightening experience because she not only taught me about her neurosurgical specialty, but she also made me aware of the fact that her primary concern is the patient, regardless of the diagnosis. Dr. Macias emphasized “quality of life” throughout our interview and she always wants her patients to have the best quality of life possible. Whether this means surgery, pain management, physical therapy or interventional techniques, Dr. Macias strives to bring positive energy to her patients and takes the time to explain in detail what the patient can expect with the recommendations given. “I want my patients to get back to their lives as quickly as possible whether
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this means going back to work, being able to partake in their hobbies and enjoying their time with family and friends”. It is crystal clear that she cares about her patients and makes sure she takes the time to help them every step of the way. As we got further into the Q and A session, Dr. Macias elaborated on all the facets involved in diagnosing the patient and helping them get back on their feet. Hearing her words and listening to her guidance through the process gave me hope for the medical community at large. I kept thinking that being a neurosurgeon is such a complex field, but Dr. Macias’ sympathy and kindness converts the complexities into solutions with a gentle touch that is respected and
appreciated by all of her patients. Her patient-centric approach can be seen and felt in her answers below. MD Monthly: Being a highly experienced Neurosurgeon, what do you find to be the most challenging aspect of your specialty? Dr. Macias: There is more than one challenging aspect. My response is that there are multi-facets to the challenges we face. There is the challenge of the pathology itself, the pathologies that we are seeing in the brain and spine, as well as helping the patients and their family members understand the problem or diagnosis and treatment options. I find the biggest challenge, as well as reward, is helping patients navigate through
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the entire process. This includes understanding their diagnosis and the options that are recommended to help them feel better and get back into their lives again. On a separate, but integrally related note, there are many challenges that lie within the health care system itself. There has been so much change and uncertainty that patients need help navigating through their health care options as well. As a physician, I want to help them get the best care possible, period. MD Monthly: What case or cases have been the most difficult to date? Dr. Macias: As a general neurosurgeon, I concentrate on both the brain and the spine. This ranges from brain tumors, spine tumors, and tumors of the nervous system to degenerative disease of the lower back. I can’t isolate a single case and say that was the most challenging of my life. I treat every patient’s problem in depth and detail and I concentrate my approach on that problem and share that with the patient. I want them to be equipped with the knowledge of knowing what they have and what has to be treated. I explain the surgery and the post-surgical care as well as the healing process in great detail. The most rewarding part is having patients understand what is causing their pain and difficulties and how we get to a better place, if we can. The most difficult times is when explaining to a patient that we are dealing with a condition such as a tumor or injury that cannot fully or completely cured or healed. For example, If there is a malignancy or severe
trauma, we can perform surgery and take pressure off of the brain. But, there are situations where even the best surgical technique does not cure a difficult malignancy or repair irreversible injury. Sometimes we just hope to minimize damage and optimize protection of brain tissue and therefore function. Knowing that we are dealing with the fear the patient has is difficult. I am fully transparent and honest with my patients no matter what their diagnosis, because I believe patients deserve that from their physician. It amazes me how many patients I see that don’t understand what is going on after seeing multiple providers. I take a different approach and that is another challenge. I want the patients to understand what they
are dealing with and what we can and cannot do. Patients appreciate that. I can actually see the moment when they understand what is happening and they are grateful for that explanation, knowledge and the discussion we had. MD Monthly: Can you please share with us the benefits of using adult stem cell technology in certain procedures. What are the benefits? Dr. Macias: I think stem cell therapy plays a tremendous role. Currently, I am using it in spine surgeries to help bones healing. Bone healing is a very important part of spine surgeries that require stabilization and fusion. But, not all spine surgeries require bone fusion. I think that using autologous stem cells (stem cells from the patient) is important because the patient can’t reject them. They are produced by your own body and when mixed with bone help to optimize bone healing. Stem cell technology augments the healing processes of the body. I also believe that stem cell technology can be used in degenerative disc disease before it progresses to a serious disease where surgery is required. It can retard or halt that process. There are studies that have been conducted and we see the results. I look forward to being a part of that in the very near future. MD Monthly: Where are these studies being conducted? Dr. Macias: There are a few institutions in this country and abroad that are doing studies. We need to really look at these studies and see what they can
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bring to people in real life fashion. For example, back pain is one of the major health problems in this country in terms of loss of time at work and overall productivity, lost wages and clearly carries a very serious socioeconomic burden in society. We need to get to the source of the problem and offer alternative treatments before the degenerative changes advance to the point where a more invasive surgery is required. There is a lot of potential for stem cell therapy, looking ahead. MD Monthly: On your website, you highlight “Walk Again, Think Clearly Again, and Regain Control of Your Life.” Can you please elaborate on this and how do you go about getting patients to regain control of their lives?
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Dr. Macias: Spine disease in its degenerative form causes pain, discomfort, weakness, numbness and decreased mobility. One of the key questions I ask a patient is how much does this pain affect the quality of your life. The answers range from I can’t do anything; I can’t garden anymore, I used to walk my dog, to I used to be active in community sports. The patients simply can’t do any of these activities anymore. Then I have patients that say that it does not impact their life very much at all. They can do everything that they want to do. This is the key question when we are talking about spine disease. It helps me understand and the patient understand how it is impacting their lives and whether
or not intervention is an appropriate measure or if it’s not. I am very conservative. I believe that physical therapy and pain management are helpful to those patients that need that type of treatment. I look at everything that helps the patient feel better and we work together so we can get back to that quality of life desired. This question gives the patient time to reflect-I am in a really bad place or I am not in a bad place at all. We then go on from there and discuss what treatment options are available to optimize their well-being and regain control of their lives. MD Monthly: What are the different metrics that you use when deciding
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what treatment is best for the patient?
the Coastal Bend?
Dr. Macias: Pain is definitely one metric that we use. But, I have had patients come to me with absolutely no pain at all. There can be loss of coordination or dexterity, inability or increasing difficulty with fine motor skills such as buttoning a shirt to increasing gait difficulties and imbalance. It is an astounding situation where you can have critical pressure on the nerves, weakness, numbness, bladder problems and actually not have a pain component. If I only used one metric to understand what treatment is best, that would be terrible. I have to look at the whole picture because we treat the whole spectrum in order to get the best outcome for each and every patient.
Dr. Macias: it is a pleasure and a privilege to participate in a patient’s care and in the Coastal Bend I do feel like I am returning home after a long absence. The physician community is tightly knit and very supportive of each other.
MD Monthly: Returning back to the South Texas Brain and Spine Center in Corpus Christi after all of your studies, various practices and programs that you have been involved with including extensive research, travels, writings and lectures must be a big change for you. Besides being back “home”, what do you enjoy most about practicing on
I’m incredibly fortunate to be working with a team of people of the South Texas Brain and Spine Center that genuinely care for patients’ and each other’s well-being. The heart and soul of the Coastal Bend makes me be the best that I can be. MD Monthly: What are your long term goals? Dr. Macias: First of all, I want to continue to build and maintain a successful presence in the Coastal Bend. I would also like to make the time to reach out to the community at large with educational opportunities on a vast array of topics. I love engaging with others on an individual basis, listening and learning about their lives, experiences and concerns. I learn and receive much inspiration by just taking time and really listening to my patients.
My focus would be to make learning about the brain and spine fun with ways apply it to everyday life. For example, after learning about the brain perhaps emphasizing the importance of wearing helmets when riding bicycles and the dangers involved in not taking these precautions. I look at it this way; One child at a time and then one class at a time - this is how you can make a difference! After talking with Dr. Macias, I can tell that she has already made that difference and there is no stopping her now. The Coastal Bend is in excellent hands and looking ahead, there is a lot of promising areas of medicine that will be explored and prevention of certain medical problems may be uncovered in the near future. For More Information visit http:// www.drmelissamacias.com/ 1227 3rd Street Corpus Christi, TX. 78404 (361) 883-4323 Twitter @DrMelissaMacias Visit https://www.facebook.com/ drmelissamacias
I am also interested in teaching and enjoy giving resident lectures on neurosurgical issues throughout the year. Working with residents is a true opportunity to interact with young physicians and I enjoy the educational component of these talks. At a different level, I would like to have an anatomy class on the brain and spine for elementary kids. I’ve had this idea that I am trying to implement in the school systems.
2017 - AUGUST MD Monthly
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F E A R to
P: 210.504.5053 www.MariaPalafoxMD.com " @PC? Q A?LACP BG?ELM G A?L QFPC?QCL LMQ MLJV ? TMK?L| JGDC @RQ FCP CJD AMLDGBCLAC 6GQF LCT RPEGA?J QCAFLGORC RPECML ?Q ?PC LMT ?@JC QM ?AFGCSC MNQGK?J AM KCQGA PC RJQ ?LB GKNPMSCB OR?JGQV MD JGDC DMP @PC? Q A?LACP N?QGCLQ #V NCPDMPKGLE )GBBCL A?P #PC? Q $?LACP RPECPV MRP RPECML CDDCAQGSCJV QPC?Q A?LACP TFGJC NPC CPSGLE QFC L?QRP?J F?NC MD QFC @PC? Q JC?SGLE LM SG G@JC PCKGLBCP @CFGLB
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DOCTOR’S CHOICE:
SUNDAY BRUNCH AT
Peggy’s On the Green By: Jessie Moore
BUSINESS/SAN ANTONIO
S
unday Brunch is probably the most important meal of the week! This is the meal that sets the tone for the rest of the week, or helps you shake off the previous week. We spent one Sunday out in Boerne, Texas visiting a Doctor’s Choice for Sunday Brunch at, Peggy’s On the Green. When you walk into Peggy’s On the Green, you’ll find yourself in a comforting home atmosphere. From the staff to the interior design, you’ll feel right at home. Arrive wearing “Sunday Best” and bring the whole family for some quality time with the
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ones you love. And, of course, you’ll leave Peggy’s with your stomach satisfied and a hankering for a nap. Doctor’s Choice recommends you try the “Cast Iron Shrimp & Grits” it’ll leave you feeling warm and tingly inside. Their menu describes it as: Stone-Ground Pimento Cheese Grits, Baked Andouille Sausage, and Gulf Shrimp topped with Green Onions Doesn’t that just make your mouth water?! It’ll be the best shrimp and grits you’ve ever had. Following that, we had the
“Peggy’s Standard!” Who doesn’t love eggs, bacon, and potatoes? Two Eggs, your way, Sausage or Thick-cut Tender Belly Bacon, Hash Browns and a House-made Biscuit Um, yes, please. The eggs are so light and fluffy, and have such a unique flavor. The chef wouldn’t tell us their secret, but maybe you can figure it out. If that’s not enough, try their “Short Ribs Benedict”. Braised Short Rib on House-made Biscuits, with Poached Eggs and Green Chili Hollandaise
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The biscuit is so doughy and moist that it just melts in your mouth. Along with the short rib and poached egg to top it off. It doesn’t get any better than that. Now, if you’re the omelet lover of the group, you’ll love their Crab Omelet. Lump Crab Omelet with Scrambled Eggs and Fresh Herbs Crab inside an omelet, (WOW) with a side of potatoes, will fill you right up. Of course, it’s not a Sunday Brunch without a mimosa. They offer a grapefruit and orange juice version. We highly recommend the grapefruit mimosa! On the weekends Peggy’s On The Green will host live music, adding to their beautiful outdoor area. Makes for a perfect date night! Spend your Sunday in Boerne at Peggy’s On the Green and share your photos with us on Facebook! Facebook.com/mdmonthly Peggy's on the Green is located on 128 W. Blanco Rd., Boerne, TX 78006
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From the Migrant Fields of Minnesota To Medical School:
Dr. Antonio Guzman to Lead Corpus Christi Bay Area Medical Center Internal Residency Program By Rudy Arispe
A
s they say, father knows best. And it was wise of Dr. Antonio Guzman to heed his dad’s words of advice while toiling in the fields up north beginning at age 7. Until high school graduation, he was picking sugar beets, onions and tomatoes alongside his parents and five siblings. “We had no summer break. It was school, working in the fields and then back to school again,” he recalled. “Through all of this, my father kept saying, ‘If you want to do this for the rest of your life, then do nothing in school. If you want a different life, then hit the books and study hard.’ ” Dr. Guzman, 51, chose the latter path, and for more than two decades, he has been doing inpatient and outpatient medicine. Moreover, his professional career has come full circle. More than 20 years ago, the Crystal City native was a resident at the University of Texas Health Science Center at San Antonio. Now, he oversees residents at Corpus Christi Bay Area Medical Center, where on July 1, he was named program director for the Internal Medicine Residency Program. In his role as program director, Dr. Guzman is also responsible for making sure the program is compliant with regulations and national standards, as well as hiring faculty to teach residents. “It’s an administrative role, but you have a lot of interaction with doctors in training,”
“As educators, we do this for the love of teaching and to share our knowledge.” - Dr. Antonio Guzman 2017 - AUGUST MD Monthly
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he said. “As educators, we do this for the love of teaching and to share our knowledge. I want to encourage and help elevate residents in being the best doctors they can be.” Dr. Guzman has proven to be an effective educator. Since joining the Corpus Christi Bay Area Medical Center Internal Medicine/Family Residency Program in 2005, he has been awarded Educator of the Year eight times. “Each year, during graduation ceremonies, residents select a person who they think was instrumental to them in teaching,” he said.
His goal as program director is to impact each resident. “I have been working with residents for 20 years,” he said. Over time, you realize these residents are so varied in personality and in backgrounds, and in order to help elevate them, you begin to paint a picture of how you’re going to help each one, or one graduate at a time.” In addition to overseeing the resident program, Dr. Guzman will continue to treat patients as a doctor of internal medicine. He chose this specialty, he said, because it allows him to see patients suffering from
“As educators, we do this for the love of teaching and to share our knowledge. I want to encourage and help elevate residents in being the best doctors they can be.” -Dr. Antonio Guzman both acute and chronic illnesses. “I like the idea of adult medicine,” he said. “I have some patients who have been with me for 20 years, but I also have the luxury of treating patients with acute illnesses that I follow at the hospital.” He recalls growing up in Crystal City and traveling to the border town of Piedras Negras whenever he or a family member needed health care. There was one particular physician, who inspired him to pursue medicine.
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PHOTOGRAPHS BY Paul Marshall
MDMONTHLY.COM
“As I looked into careers, he was someone I wanted to emulate,” Dr. Guzman said. “After high school, I moved to San Antonio, so I never got to see him again. But the idea of becoming a physician just like him is what led me to medicine.” Dr. Guzman, meanwhile, looks back on those summers as a young migrant worker in the fields of Minnesota, North Dakota and Wisconsin with fond memories. “My
family and I were together every single day,” he said. “We had to be in the fields by 7 a.m., and it was hard work. But our reward each year was $100, so that we could buy our school clothes.” Antonio Guzman, M.D., P.A. CCMC Bay Area Graduate Medical Education 3240 Fort Worth Street, Suite 120 Corpus Christi, Texas 78411 (361) 989-1115
“I have been working with residents for 20 years, Over time, you realize these residents are so varied in personality and in backgrounds, and in order to help elevate them, you begin to paint a picture of how you’re going to help each one, or one graduate at a time.”
-Dr. Antonio Guzman
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INFORMED PATIENT/AUSTIN
POLYCYSTIC OVARY SYNDROME:
THE BASICS
Identify and control the condition to manage your symptoms and help with infertility Special to MD Monthly
W
hile no one knows the exact cause of polycystic ovary syndrome (PCOS), an estimated 5 to 10 percent of women of childbearing age have it. In women with PCOS, the ovary doesn’t make all of the hormones it needs for any of the eggs produced to fully mature. They may start to grow and accumulate fluid, but no one egg becomes dominant. Instead, some may remain as cysts. Since no egg matures or is released, ovulation does not occur
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and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent. Also, the cysts produce male hormones, which continue to prevent ovulation and can lead to acne, excessive hair growth and weight gain. Cause of PCOS The cause of PCOS is not completely understood. It is likely that a genetics tendency is involved. Women with PCOS can have a wide spectrum of signs
and symptoms from very mild to severe. They may include: • Irregular or absent menstrual periods • Heavy vaginal bleeding • Oily skin and acne • Acanthosis nigricans (darkening and thickening of certain areas of the skin, especially in skin folds) • Excessive hair growth on the face, chest, abdomen or thighs • Thinning of hair on the crown of the head • Type 2 diabetes • Obesity
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• Cardiovascular problems, including high cholesterol • Multiple tiny ovarian cysts; some women with PCOS have a large number of tiny follicle cysts (visible by ultrasound) on their ovaries
pregnant, treatment is aimed at establishing regular ovulation. • For women with PCOS and insulin resistance, medication to improve insulin sensitivity may be useful. Treatment
Diagnosis The diagnosis of PCOS is made based on physical signs and symptoms. Blood tests can be used to confirm the diagnosis and direct management. Treatment depends on the particular patient's signs and symptoms, as well as her goals. Treatment options include: • For women who are not ready to become pregnant, birth control pills are an excellent way to replace progesterone, establish regular periods and lower androgen levels. • If a woman wants to become
Because there is no cure for PCOS, it needs to be properly managed by a physician. Treatments are based on the symptoms each patient has and whether she wants to conceive or needs contraception. Some of these treatments are as follows: • Birth control pills can help regulate the menstrual cycle and prevent endometrial problems. • Diabetes medications can decrease the testosterone production, causing abnormal hair growth to slow down and ovulation to return. • Medicine for increased hair
growth or extra male hormones. If a woman is not trying to get pregnant, there are some other medicines that may reduce hair growth. Spironolactone is a blood pressure medicine that has been shown to decrease the male hormone’s effect on hair. Propecia, a medicine taken by men for hair loss, is another medication that blocks this effect. Both of these medicines can affect the development of a male fetus and should not be taken if pregnancy is possible. Other non-medical treatments such as electrolysis or laser hair removal are effective at getting rid of hair. A woman with PCOS can also take hormonal treatment to keep new hair from growing. • Surgery. Although it is not recommended as the first course of treatment, surgery called ovarian drilling is available to induce ovulation. This surgery can temporarily lower male hormone levels and help with ovulation. • A healthy weight will help the body lower glucose levels and use insulin more efficiently, and it may help restore a normal period. While PCOS cannot be prevented or cured, it can be controlled with varying degrees of success and healthy lifestyle choices. Jose Pliego, M.D., is a reproductive endocrinologist at Scott & White Hospital – Round Rock. For more information, call 512-509-0200.
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INFORMED PATIENT/SAN ANTONIO
SYMPTOMS AND TREATMENT FOR
Scoliosis By: Steven J. Cyr, M.D., F.A.A.O.S., Dominion Resident
hen looking at the body from the side, the spine has three normal curves. These curves are described by two terms: lordosis and kyphosis. Lordosis describes an inward curvature of the spine when viewed from the side. Kyphosis describes the opposite, or an outward curve. The curve of the spine at the neck and lower back, is the same with regard to the descriptive term applied: lordosis. The mid back, or thoracic spine is kyphotic. An extreme example of a kyphotic thoracic curvature can also be described as a “hunchback”. Scoliosis is a sideways curvature of the spine. It describes the appearance of a spine in which there are curves to the right and
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left. A scoliotic spine may have both side-to-side curves and front-toback curves, but usually one set of these curves is more predominant. This is due to a rotation of the spine which occurs in scoliosis. In fact, a common medical term for scoliosis is “rotoscoliosis” because the spine rotates as it curves to the side. Just as there are varying degrees of scoliosis, there are varying degrees of involvement with respect to the body’s internal organs, neuromuscular and musculoskeletal system. Some patients with scoliosis have no symptoms, while other patients may have muscle spasms, nerve pain, and unstable joints. In Orthopaedics, scoliosis is described or diagnosed by the
cause and age of onset. There are three main types of scoliosis: (1) Congenital and Infantile Idiopathic Early Onset Scoliosis, (2) Juvenile and Adolescent Scoliosis, and (3) Neuromuscular Scoliosis. Congenital scoliosis occurs mostly before the age of 2, and can occur from insufficient development or partial fusion of the vertebral column during early development. The spinal column develops simultaneously with other organ systems and in early onset scoliosis, lung development may be compromised. Early onset scoliosis is very rare, with an incidence of 1 or 2 in 10,000 people. Juvenile and adolescent scoliosis is much more common and has an incidence of up to 520 in 10,000 (5.2%). It is categorized by
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INFORMED PATIENT/SAN ANTONIO
age of onset and can be identified in patients aged 3 to 17. In the condition of Neuromuscular Scoliosis, the muscle is unable to counteract the forces across the spinal column from conditions such as Cerebral Palsy, muscular dystrophy, poliomyelitis, or spinal cord injury.
to only at night. If a brace does not work and if the patient is of acceptable age and finished growing, surgical intervention may be considered to correct the spinal curvature. There are also surgical procedures for patients who will continue growing.
In a visit to the doctor’s office, x-rays are needed to measure the amount of curve and establish a baseline for future comparison. The x-ray will also help determine the remaining potential for growth of the patient, if adolescent or younger. The remaining growth may contribute to progression of the curve. Based on the measurements taken from x-rays, the doctor will determine the best course of treatment which may include a brace. Time requirements for wearing the different corrective braces can range from full-time,
Long term, over the course of the lifespan, patients with scoliosis are treated based on their symptoms and diagnostic imaging studies. If the scoliosis is balanced,(head centered over the tailbone) patients may have little physical impairment and some can manage the symptoms with activity modification and exercise. This treatment approach is most desirable. In any patient with scoliosis, routine checkups are recommended on 6-12 month intervals in order to check on symptoms and any progression of the curve.
If you have symptoms or have been diagnosed with Scoliosis, contact our office to schedule a consultation for treatment options. Our uniquely trained team of medical professionals and our spine team has experience in treating all symptoms and conditions of orthopedic, neck, lumbar, thoracic, and sacral spine pain. Dr. Steven Cyr is a Mayo Clinic trained spine surgeon. The Mayo Clinic has ranked number one for orthopedic and neurosurgical training programs in America for the past 20 years. Dr. Cyr is the President and Founder of The Orthopaedic and Spine Institute Medical Centers in the South Texas Medical Center located at 8401 Datapoint Drive, Suite 700, San Antonio, Texas 78229 Phone: 210 487-7463 Fax: 210 487-7468 www.saspine.com
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Dr. Erika Sato HELPING HER PATIENTS FIND CONFIDE N C E BY RE V E AL IN G T H E IR
INNER AND OUTER BEAUTY By: Jody Joseph Marmel
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M
eeting with Dr. Erika Sato makes you realize that being a successful Cosmetic and Reconstructive Surgeon requires a lot of hard work, long hours and dedication. Sprinkle that with being a perfectionist and having an abundance of compassion, and that is who Dr. Sato is in her professional and personal life. She has so many wonderful attributes, but the one that makes her unique is that she is down to earth. She truly cares about her patients from the moment they step into her office. She says, “Patients probably don’t realize or understand that I put each and every one of them ahead of myself. When they are upset or unhappy, I am too. My day-to-day feelings works directly off of them.” She chose plastic surgery because it allows her to operate on the entire body, head to toe. There is a large artistic component to plastic surgery and Dr. Sato was an artist in her youth and won many awards throughout middle school and high school. But, she also chose plastic surgery for another reason. When she was a young girl, she looked “pretty normal”. She is a mix of Japanese from her father and Italian from her mother. In 6th grade, she began to look “funny”. Her mother just thought it was an awkward phase that she was going through. “I had a lot of dental abnormalities so my parents were kind enough to spend a small fortune on orthodontic treatment. To this day, I give kudos to my orthodontist as he was clearly extremely talented.” After her bite was corrected and all of her teeth were perfectly straight, she explains that she still looked funny. “I was made fun of constantly at school and was bullied. My mom started to worry that I wouldn’t have a normal childhood. My parents were middle class blue collar workers, but my mom was determined to make sure that I would be successful 2017 - AUGUST MD Monthly
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in life.” Her mother took the small amount of savings they had left after paying for her braces and took Dr. Sato to an ENT residency clinic where they practice surgery at a much more affordable cost. They were never given a diagnosis and Dr. Sato underwent a rhinoplasty where they used cartilage from her right ear to reconstruct her nose. Given the circumstances, the result was better than she could have hoped for. “Now that I am a plastic surgeon, I can easily say that my rhinoplasty is not great, but it is great to me. Compared to what I looked like before, I think it is beautiful. I do see the imperfections every day in the mirror-a down fall of my career-but I love them.” It wasn’t until Dr. Sato started her plastic surgery residency that she discovered she had a rare congenital abnormality - Binder’s Syndrome. It is so rare that no doctors including her pediatrician, orthodontist, or ENT surgeon realized she had this syndrome. It is a congenital disease affecting the face-undergrowth of the central face and may include elements of the nose or upper jaw. The primary physical characteristic of Binder’s Syndrome is a flat, underdeveloped midface and 40
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flattened nose associated with the absence of the anterior nasal spine. “I was/am essentially a textbook case. I had all of the symptoms.” Dr. Sato feels that her orthodontist and her ENT surgeon changed her life. “After I healed from surgery, I no longer was made fun of and I made friends, went on dates, and had a normal teenage experience.” She explains that before she even knew that she had this rare congenital abnormality, she wanted to be a plastic surgeon to just make people feel “prettier” and more confident. “I thought of how much I hated my nose and how it consumed me on a daily basis. I wanted to ‘fix’ other people’s imperfections so that they didn’t have to feel the way that I did. Some people think that only the reconstructive side of being a plastic surgeon is applaudable, but I don’t believe that. At the time that I got my rhinoplasty, I went to an ENT facial plastic surgeon that mainly did cosmetic surgery and he changed my life.” Most people that undergo plastic surgery do so because they have one or more “imperfections”. Just like Dr. Sato felt about her nose so many years ago, there are teenage girls who are consumed with the
fact that they have very small breasts. “Because we fixate on these things, we aren’t confident and sometimes we don’t let others see our ‘inner beauty’. I have found that just fixing or changing that one thing that bothers the patient, no matter how small it is, can literally change their lives.” Dr. Sato continues, “Their demeanor is so different when I see them in post-op versus how they were in pre-op or at their consultation appointment. I have done what I am supposed to do on earth if I can affect one person’s life like my ENT surgeon did for my life years ago.” Staying true to herself and her patients, Dr. Sato never talks anyone into plastic surgery. She explains, “I listen to them and help them figure out what they need to meet their goals and expectations. If I feel that patients are unreasonable, I will be the first one to tell them. When I get beautiful, young girls in my office wanting plastic surgery, I tell them that they don’t need it. I know that I am risking them going to another surgeon and still getting the surgery, but I hope that at least
PATIENTS PROBABLY DON’T REALIZE OR UNDERSTAND THAT I PUT EACH AND EVERY ONE OF THEM AHEAD OF MYSELF. WHEN THEY ARE UPSET OR UNHAPPY, I AM TOO. MY DAY TO DAY FEELINGS WORKS DIRECTLY OFF OF THEM.
-Dr. Erika Sato
PHOTOGRAPHS BY Paul Marshall
MDMONTHLY.COM
a few of them leave my office and don’t have anything done.”
talented at creating that hourglass figure that is so popular right now.”
Dr. Sato does a lot of body contouring in her practice. Currently, one of the most popular procedures is the Brazilian Butt Lift. This is a procedure where excess body fat is taken from unwanted areas such as the stomach, love handles or thighs through liposuction. The fat is then processed and injected into more desirable areas. With the Brazilian Butt Lift, the fat is injected into the buttocks and hips. “This fat can also be injected into the breasts. I love fat transfer. We are taking what God gave us and just moving it around.”
Dr. Sato is Board Certified by the American Board of Plastic Surgery and the American Board of Surgery. She went to the University of Missouri-Columbia for her undergraduate degree on an academic scholarship that covered her tuition and books. She worked three jobs during most of that time. She was a server at Applebee’s Neighborhood Bar and Grill where she worked for 10 years. “I always joke that I ‘grew up’ at Applebee’s and learned the strong work ethic that I have today.” She was also a phlebotomist at Boone Hospital and tutored science and math for the university. “I mainly tutored college athletes. This was back before the internet and online lectures.” She graduated Cum Laude from the Honor’s College with a Bachelor of Science in Biology with a pre-med emphasis. Dr. Sato kept her eye on the prize. “I kept telling myself that I wanted to be a doctor more than anything.”
She also does a lot of mommy makeovers. This includes surgery to the body and breasts at the same time. When women go through pregnancy, childbirth and breastfeeding, more often than not, the body changes. This can be very hard on women no matter how much they workout or diet. They just can’t get their pre-baby body back. “I help them get that body back! The tummy tuck is one of the most popular procedures included in a mommy makeover. In my hands, this entails liposuction to the upper abdomen, waistline and flanks; repair of the abdominal muscles (muscle diastasis) and excision of excess loose skin below the umbilicus.” Women may need or want more fullness in their breasts and can get either implants or implants with a lift. If they have a decent amount of breast tissue, they may just need a lift to get their breasts back to being perky. Sometimes the nipple areola complex increases in size and this tends to bother some women. This can be cut down to a smaller size as part of the lift. “I do all plastic surgery from head to toe, but the vast majority of my practice is cosmetic plastic surgery to the body. I must say that I am really
old fast for everyone involved.” Medical School turned out to be a fantastic experience for Dr. Sato. She knew right away that she was meant to be a surgeon and graduated in the top 25% of her class. Moving on to the University of Texas Health Science Center at Houston, Dr. Sato states, “I learned to be a badass – saving lives at the #1 trauma center in the country. When my five years of General Surgery residency were over, I continued my education with a 3 year residency in Plastic Surgery. At this point, all of my hard work had paid off. My dream of becoming a plastic surgeon was coming true. Plastic surgery at the time was the most competitive field of medicine and I had earned one of these coveted positions. I literally danced around my apartment in my white coat embroidered with Erika Sato MD Plastic Surgery crying tears of joy.”
In her senior year of college, it was time to apply to medical school and she realized she did not have enough money. She made the decision that even though she had what is considered a very strong application for medical school, to take one year off and work to gather the necessary funds. Dr. Sato worked at Enterprise Rent-a-Car and saved money as well as made some of her best friends for life. The following year, she was accepted to the University of Missouri-Columbia for medical school. “Looking back at this ‘time off’, I believe it turned out to be the best decision that I have made so far. I got to stop and be a normal kid so to speak. I went out with friends, stayed up late and went shopping. It sounds crazy, but I didn’t get to do any of those things in college unless one of my friends was offering to pay for me, which gets 2017 - AUGUST MD Monthly
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Throughout her eight years in Houston, Dr. Sato grew to love the city. Houston was now her home. She interviewed for various plastic surgery jobs all around the country and she was offered a job opportunity that she could not resist. Dr. Sato joined Houston Plastic Craniofacial & Sinus Surgery with one partner-Dr. Sean Boutros. They have now grown into a multi-specialty practice with eight surgeons. In just three short years, Dr. Sato built a successful cosmetic practice. In November, 2016 Dr. Sato was a main cast member on Bravo’s ‘Married to Medicine Houston’. “What more can a girl ask for! Reality TV has always been a guilty pleasure of mine, so this was a once in a lifetime experience.” There were ten episodes and it was a fun escape. Her husband, Derek Moore, is also a doctor and is currently finishing his General Surgery Residency at Baystate Medical Center in Springfield, Massachusetts. They are turning their attention to their family and hope to have their first
child soon. “Unfortunately, this has not proven to be an easy feat for us and we have turned to IVF. We have a wonderful doctor at Houston IVF, Dr. McKnight and have two healthy frozen embryos-a boy and a girl.” Giving back in other ways is also an important part of Dr. Sato’s life. She went on her first mission trip to Guatemala City, Guatemala with Austin Smiles in her last year of plastic surgery residency. On that trip, they mainly did cleft lip and cleft palate surgery. “This is what I had always wished for. I saw an HBO special on ‘Operation Smile’ when I was 14 and I just knew that someday I would volunteer on a similar mission trip.” She went on her second mission trip in May of 2016 to Antigua, Guatemala with Faith in Practice. This time they did more complex cases such as microsurgical free flaps. She hopes to go in the future but right now Dr. Sato and her husband are going through fertility treatments and hope to get pregnant in the near future. “Because of the Zika virus, it is best for me not to travel to Guatemala until after we successfully have a baby.”
I LITERALLY DANCED AROUND MY APARTMENT IN MY WHITE COAT EMBROIDERED WITH ERIKA SATO MD PLASTIC SURGERY CRYING TEARS OF JOY.
-Dr. Erika Sato Dr. Sato has never lost sight of why she went into medicine. She treats each patient with equal importance because each and every one of her patients chose her to be their doctor. “If a patient needs one hour to talk to me, that is fine. Surgery is a serious decision and should not be taken lightly. I want each patient to feel 100% confident in choosing me as their surgeon. They may feel that way after an email or multiple one hour visits/consultations. I also need time talking to them to make sure that we are on the same page as far as realistic expectations.” Dr. Sato goes the extra mile to make sure that each of her patients get the quality of care they deserve and the end results are rewarding to her patients and herself. “If I don’t accomplish anything else in my life, my heart will be fulfilled as far as my career is concerned.” For more information visit http:// www.houstonbeautifulbody.com/ 9230 Katy Freeway Suite 600 Houston, TX 77057 (713)791-0700 drsato@houstonbeautifulbody.com Facebook: https://www.facebook. com/erikasatomd/ Instagram: dr.erikasato Twitter: @erikasatomd Snapchat: MyHouSurgeons
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INFORMED PATIENT/CORPUS CHRISTI
THE ADVANCEMENT OF
Cystic Fibrosis
TREATMENT
By: Jon Roberts, M.D., Driscoll Children’s Hospital
C
ystic fibrosis (CF) is a chronic, genetic disease that affects about 30,000 people in the United States, and 70,000 people worldwide. The defective gene found in CF patients causes the body to make thick mucus that can clog the lungs and lead to infection. It may also block the pancreas and keep natural enzymes from helping the body digest and absorb food. A child with CF may experience a number of signs and symptoms, including the following: • Wheezing or shortness of breath • Frequent cough and increased lung mucus • Multiple episodes of bronchitis and pneumonia • Nasal polyps and frequent sinus infections
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• Slow weight gain or weight loss, even with a healthy appetite • Abnormal or frequent bowel movements • Liver and gallbladder disease • Enlargement of the fingertips and toes (clubbing) • Rapid dehydration and heat stroke • Fertility issues The disease previously carried a life expectancy of less than 5 years of age, mainly due to malnutrition and failure to grow. With the advent of pancreatic enzyme replacement therapy in the early 1950s, patients were able to maintain good nutrition and growth, and the life expectancy jumped to about 10 - 15 years of age. With CF children surviving longer, it became apparent that the main issue would become chronic, worsening lung disease. Now able to live beyond the first few years, these children
were succumbing to overwhelming airway and lung infections. Thus, the care of CF was handed over to pulmonary specialists. Over the past 60 years or so, doctors and scientists have revolutionized the management of children with cystic fibrosis. Airway clearance techniques (using specialized vests and other devices) have allowed patients to loosen the thick mucus in the airways and improve lung function. Inhaled medications, such as hypertonic saline and dornase alpha) have functioned to thin the mucous and help clear it from the lungs. Inhaled antibiotics have made it possible to more-efficiently kill disease-causing bacteria, such as Pseudomonas aeruginosa and Staphylococcus aureus. These measures (giving digestive
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enzymes because the body cannot make its own, loosening and clearing thick mucus in sinuses and lungs) have pushed the life-expectancy of CF from less than 5 years of age in the 1950s, to just over 40 years of age today. In fact, 2015 marked the first year there were more adults living with cystic fibrosis than children - and the future is looking optimistic! In the last decade, new medications have been created to directly target the DNA and proteins that cause the disease in the first place. In 2012 the drug ivacaftor was approved for use in the United States, allowing the defective protein that causes the disease to work properly in about 5%
of CF patients. In 2015, a second medication (a combination of the same ivacaftor and another called lumacaftor) was approved to treat the most common genetic cause of CF known as delta F-508 mutation. It is the hope of CF specialists around the world that a cure for the disease is on the horizon. In 2015 the Driscoll Children’s Hospital Cystic Fibrosis Center became one of only 110 centers nationwide accredited as a Cystic Fibrosis Foundation Affiliate program. In doing so, it became the first cystic fibrosis center to serve the population of South
Texas. Children with CF are urged to visit an accredited care center four times a year for visits which include evaluations with a physician, respiratory therapist, nutritionist and social worker. Driscoll’s earned accreditation makes it possible for patients living in South Texas to make those visits. The Driscoll Center houses an experienced team of physicians, respiratory therapists, nurses, dieticians, social workers, physical therapists and pharmacists ready to give patients the highest quality care available. Jon Roberts is currently the medical director of pediatric pulmonology and respiratory therapy at Driscoll Children’s hospital. He graduated summa cum laude from the City College of New York, and afterwards attended New York Medical College in Valhalla, NY, graduating in 2000. He completed his pediatric residency in 2003 at Winthrop University Hospital in Mineola, NY, and his pediatric pulmonology fellowship in 2006 from the same institution. Since moving to Corpus Christi in 2011 and working at Driscoll Children’s Hospital, he has become focused on treating childhood asthma, and has most recently led the effort to create the first cystic fibrosis center in South Texas. For more information visit www. driscollchildrens.org/specialty/ pulmonology Driscoll Children's Hospital is located at 3533 S. Alameda St., Corpus Christi, TX 78411.
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INFORMED PATIENT/CORPUS CHRISTI
HEAT & SUN SAFETY for Seniors By: Dr. Michael Fuentes
A
s a child, you may have spent numerous hours outdoors during the summer. Now that you’re an adult, you may find the summer months to be far less enjoyable because of the heat. But don’t fret; this is normal. As you age, the body’s mechanisms that help regulate internal temperature become less efficient. This means that you lose some of your ability to adapt to heat, leaving you with a lower tolerance and making you more susceptible to heat-related illnesses. This is caused for a few different reasons, one being that an adult older than 65 doesn’t sweat as much as a 46
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younger individual. Sweating helps to cool the body. Also, an older adult may be more likely to have a chronic condition or be on medication that affects the body’s ability to respond to heat. Called hyperthermia, heat-related illnesses can include heat exhaustion, cramps, fatigue, and stroke (also called sun stroke). Symptoms can include a flushed face, high body temperature, headache, nausea, rapid pulse, dizziness, or lack of sweating. Hyperthermia is caused as blood rushes to the skin’s surface as the body tries to cool itself. As a result, less blood reaches the brain, muscles, and other organs, which can
interfere with muscle strength and mental capacity. In severe cases, this can be dangerous. According to the National Institute on Aging, if someone is suspected of suffering from a heat-related illness, you should: •
•
•
●Get the person out of the heat and into a shady, air-conditioned, or other cool place. Urge them to lie down. If the person can swallow safely, offer fluids such as water, fruit or vegetable juices. Avoid alcohol and caffeine. Encourage the individual to shower, bathe or sponge off with cool water
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•
•
Apply a cold, wet cloth to the wrists, neck, armpits, and/or groin area. These are places where blood passes close to the surface of the skin, and the cold cloths can help cool the blood. Call 911 if you suspect heat stroke.
The best defense with a heatrelated illness, however, is to prevent it from occurring. Arm yourself with heat-related knowledge and take sensible precautions to enjoy a warmer day, safely. Follow these tips: •
Stay hydrated. Drink water often,
•
• •
•
•
even if you don’t feel thirsty. Check your medicines. Some may make you more sensitive to the sun. Ask your doctor. Wear sunscreen. Apply before you head outside, and reapply often. Wear proper clothing. Wear lightweight, breathable clothing, long sleeves and a widebrimmed hat. Wear sunglasses. Look for those that protect from UVB and UVA rays. Go indoors. Mid-day sun is the hottest. Plan indoor activities for those times. Stay in air-conditioned
•
areas when it’s hot outside. Take cool showers or baths to cool down.
Board-certified in physical medicine & rehabilitation, Dr. Michael Fuentes is the Medical Director of Corpus Christi Rehabilitation Hospital. The hospital provides specialized rehabilitative care to patients recovering from disabilities caused by injuries, illnesses, or chronic medical conditions. For more information, visit CCRH.ernesthealth. com, call 361-906-3700 or visit the hospital at 5726 Esplanade Drive, Corpus Christi, Texas.
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Christopher J. Busken, M.D. Dr. Christopher J Busken, is a Vascular Surgery specialist in San Antonio, Texas. He attended and graduated from University Of Missouri School Of Medicine in 2006, having over 11 years of diverse experience, especially in Vascular Surgery. He is affiliated with many hospitals including Methodist Hospital, Baptist Medical Center, Christus Santa Rosa Hospital, Southwest General Hospital. Dr. Christopher J Busken also cooperates with other doctors and physicians in medical groups including University Of Texas Health Science Center At San Antonio.
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DR. OLUTOLA ADETONA & OMOLOLA ADETONA D.D.S. Share Their Compassion Seven Days A Week at Practical Approach Pediatrics and Pediatric Dentistry and Practical Approach Pediatric Urgent Care By: Jody Joseph Marmel
H
aving the pleasure of meeting Dr. Adetona and his partner in life, Omolola Adetona D.D.S. was a delightful and refreshing experience on many levels. Their passion for quality care of children –newborn through 21 years old is a novel method in that they treat the patients’ needs all under one roof. Parents can bring their children to see Dr. Olutola Adetona for their pediatrician visitswell and sick visits-and then they can visit with Omolola Adetona D.D.S. for pediatric dentistry. “There is a convenience factor involved that our patients appreciate. They do not have to make two separate appointments and miss extra time from work or school. They can see both my wife and I with one appointment. We are here to make life easier and less stressful for both parents and the children,” explains Dr. Adetona. And that is exactly what they do-one patient at a time. Prior to opening Practical
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Approach Pediatrics and Pediatric Dentistry, Olutola Adetona graduated from the University of Ibadan Medical School in Nigeria. He then completed a one year internship at the Lagos University Teaching Hospital in Lagos, Nigeria. In 2004, Dr. Adetona was accepted to the University of Texas Health Science Center at San Antonio Pediatric Residency Program. He then finished his training at the Texas A&M Health Science Center in Corpus Christi. In 2008, Dr. Adetona became Assistant Professor and an Attending ER Physician at the Driscoll Children’s Hospital located on the Coastal Bend. His next move was back home to San Antonio where he was an accomplished Emergency Room Physician as well as a pediatrician. In 2012 Dr. Adetona received a Master of Public Health (MPH) from the School of Public Health University of Texas Health Science Center Houston. San Antonio has been home for the Adetona family since 2002 even though Dr. Adetona traveled between work and family life. His wife, Omolola Adetona D.D.S. has an equally remarkable past prior to her becoming a pediatric dentist. She graduated dental school at the University of Lagos, Nigeria. After earning her degree, she spent one year at the Lagos University Teaching Hospital in Lagos, Nigeria and completed an internship in general dentistry. In 2004, Dr. Omolola Adetona became a Pediatric Dentist at the University of Texas Health Science Center at San Antonio. She did not stop there though. She also became an Assistant Professor in the department. While at the UTHSCSA, Dr. Adetona went further and earned a certificate in Forensic Odontology and became a Diplomate of the American Board of Pediatric Dentistry. She practiced as an Associate Pediatric Dentist in San Antonio and
she was also a consultant in forensic dentistry with a special interest in child abuse and neglect.
We both have determination and a genuine commitment to pediatrics and we always go the full mile to make our business a success and most importantly, to make sure our patients are happy and healthy.
These two talented and well educated and experienced doctors got married in 1998 in Nigeria and three weeks later, they moved to Houston. Omolola Adetona was working as a Dental Assistant while
PHOTOGRAPHS BY Paul Marshall
MDMONTHLY.COM
studying for the Board Exams and Dr. Adetona was a Medical Assistant. “Once my wife passed her Dental Boards, she was accepted at the University of Texas Health Science Center at San Antonio and began practicing while I was studying for my Boards. We both have determination and a genuine commitment to pediatrics and we always go the full mile to make our business a success and most importantly, to make sure our patients are happy and healthy.”
doctors opened an Urgent Care Center in their office. “The patient can be seen in the same room for pediatric well and sick visits as well as dental care. We wanted to take this a step further and offer Urgent Care services because we want the community to know that we are there for them every single day. We understand and communicate well with the parents and the children. Our family grows a little bit more every day.”
In 2010, the beginning of their journey into private practice was coming to fruition. They started construction on what is now known as Practical Approach Pediatrics, Pediatric Dentistry and Pediatric Urgent Care. The doors opened in July of 2011 and the practice has been growing ever since then. “Our practice is the only one of its kind in San Antonio and with all of our research, we believe we are the only practice that offers all of our pediatric services under one roof in the entire state,” Dr. Adetona proudly adds and rightly so. To further offer additional care, in April of 2016, the
The Urgent Care was always a part of the Adetonas’ vision, but it took a while to get it started. The doctors focused on their practice and knew when it was time to expand their services. Looking back at their experiences with emergency room medicine and trauma, the Urgent Care service makes sense because Dr. Adetona practiced in the Emergency Room at hospitals for children. He wanted to share his knowledge and help children and their parents. “We are also the only pediatric urgent care that can truly do something about pediatric dental emergencies.” The Urgent Care is available from 10 a.m. to 8 p.m. Monday through Friday and on Saturday and Sunday, the Urgent Care is opened from 2 p.m. to 8 p.m. Dr. Adetona explains, “We see patients that range from fractures to dental emergencies to infections, hives, or insect bites. Mothers and fathers appreciate our services during these hours. It saves them from anxiety so they do not have to wait until the next business day and many times, we save them a trip to the Emergency Room. We try to be available so we can help families during their time of need.” And that is exactly what these two doctors accomplish; Practical Approach Pediatric Urgent Care offers the following services: Emergency Dental Care, Foreign Bodies, On-Site X-Rays, Stitches, Asthma, Diarrhea, Hives, Urinary Tract Infections,
Fractures, Minor Emergencies, TB Testing, Wound Care, Breathing Treatments, Dehydration, Pink Eye, Vomiting, Lacerations, Burns, Flu Shots, IV Therapy, Colds, Fever, Pneumonia, Sports Physicals, Sprains, Immunizations, Pain Relief, Allergic Reactions, Coughs, Ear Infections, Rashes, and Lab Tests. The Adetonas’ approach to pediatrics is with an emphasis on treating the whole child. If patients are not feeling well or need dental care, this is a “one stop” pediatric office that takes care of your child with a positive and caring approach. In addition to the aforementioned, the doctors perform routine physical exams, dental exams and of course, the Practical Approach Pediatric Urgent Care Center is a major convenience for those parents with children that get sick at times when most pediatricians are not available. “When we develop wonderful relationships with the parents over time, it easily translates into
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It is our Faith in God that stands out in everything we do. Our faith gives us the drive, mind-set and character to be who we are and what we want to give back to the community with our services.
wonderful and long term relationships with the children and in essence, the entire family. The kids are happier because they get to know both of us and they are more comfortable in our office setting because they are accustomed to our staff.” Keeping up with the times, the doctors also offer e-visits. This is a virtual visit and it works well for parents on the go that have questions or want to talk in the comfort of their home or wherever the case may be. “We make ourselves available when an e-appointment is confirmed and we can talk online and we can hear the parents’ concerns and take a closer look at the child. Often make a diagnosis and send a prescription to their pharmacy or home treatment and follow-up plan. If we feel that the child needs to be seen in the office, we waive the charges of the e-visit and make time to see the patient. We want all of our patients and their families to leave here without any anxieties and know that they are in the best of hands.”
smiles and says, “We now have established the model that we envisioned from the beginning. We want to keep on growing and taking care of the children in our community in San Antonio. Now that we built the model, we can duplicate it over time.” The doctors would like to have a few branches of the Practical Approach Pediatrics and Pediatric Dentistry with the Practical Approach Pediatric Urgent Care available throughout the ever growing Alamo city.
philosophies that sets them apart from the rest. Being a pediatrician and a pediatric dentist is a lifelong commitment to both the children and the parents. In essence, their patients are entire families and as Dr. Adetona says, “We wouldn’t have it any other way. We are one big family, from our warm staff to our patients and their families. That is what caring for children is about and we believe in taking care of all of the children’s needs with our practical approach seven days a week.”
Drs. Adetona have been married for over 19 years, have two precious children, Teniade (17yrs) and Adelani (12yrs) who are exemplary students, a joy to be around, and strive to become doctors too.
For more information visit https:// www.practicalapproachpediatrics.com/
Dr. Adetona emphasizes, “It is our Faith in God that stands out in everything we do. Our faith gives us the drive, mind-set and character to be who we are and what we want to give back to the community with our services.” While faith plays a big part in their lives, it is also their compassion and dedication that has been a part of both doctors’
Facebook: https://www.facebook. com/PracticalApproach/ Twitter @PractApproach A one stop shop for your child’s pediatric, pediatric dental and urgent care needs! Let’s partner together and ensure a healthier child! 9480 Huebner Road, Suite 400 San Antonio, TX. 78240 210-697-3900
papd3@practicalapproachpediatrics.com
This dynamic duo has plans for the future and just by meeting with them, it is easy to tell that their long term goals will be met. Dr. Adetona 54
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Experience with
Celltex By: Bob Lilly
D
o you know what it’s like to not be able to dress yourself? I do. I spent the better part of my life playing an extremely physical sport – football – and up until recently, I was not able to do everyday tasks such as comb my hair or even dress myself, due to the immense pain I was experiencing. Four years ago, I was diagnosed with an autoimmune disease, polymyalgia rheumatica. Prior to that, I was still a very active man. Whether it was rock climbing or playing a round of golf, I loved being
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outside. It felt like one day I woke up and my world came crumbling down. I was in so much pain that I could not even pull myself out of bed, and eventually I had to be rushed to the hospital. Doctors prescribed steroids which helped decrease the pain, but it was not a natural solution. Every day I felt weaker – I did not recognize the life I was living. I went from a completely active adult to being crippled with pain. My disease was eating away at my soft tissue and I lost 50 pounds at a rapid rate. I worried I would never be active again. There were
days I was completely immobile; I couldn’t even imagine swinging a golf club or picking up my camera. My family and friends said I looked like a ghost, and I really felt like one too. In addition to my pain, I was diagnosed with a heart murmur and atrial fibrillation. I was going every six months to have check-ups on my heart and discovered I also had a slight mitral valve prolapse. As the years progressed, my eyesight and hearing were becoming worse. Needless to say, I felt as if I was falling apart.
I watched my son suffer from psoriatic rheumatoid arthritis. His shoulders were down to a mere five percent of cartilage. He was in constant pain; so much in fact, he had to quit his job because everyday tasks were becoming too difficult. It is extremely hard to watch a loved one suffer and I felt helpless in offering a solution. My eldest son was the one who discovered stem cell therapy, which he told my younger son about. After the stem cell therapy, my son regained 98 percent cartilage back in his shoulders. It was absolutely
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amazing to watch his transformation.
murmur. I was astounded with this news.
After witnessing my son recover at a tremendous rate, and after speaking with my dear friend Jackie Sherrill about Houston-based biotechnology company, Celltex Therapeutics Corporation, I decided to visit their lab. I was blown away; David Eller, the CEO, was very passionate about stem cell therapy. The lab was extremely clean and modern. After seeing their work up close, I knew using my own stem cells was going to be the best route to recovery.
Now, one year later, I have full range of motion in my shoulders. I can wash my hair and pick up my camera. I never thought I would be able to take another photo, and anyone who knows me knows that photography is my passion. I am traveling again and taking road trips with my family. Overall, I am not suffering anymore.
My first therapy was in March 2016, where I received stem cells in my left shoulder. As with any new therapy, I felt some apprehension, but after checking into the hotel in Cancun, I was completely at ease. My wife and I marveled over how modern and clean the hospital was, and how hands-on the staff was with us. My second trip for therapy was even better. I received a thorough blood test and a visit from the cardiologist. I expected him to tell me I had a heart murmur and atrial fibrillation; he told me that I still have A-fib, but he could not detect a heart
And the good news continues. My ophthalmologist explained that my vision has improved to the point that surgery is no longer necessary. My vision went from 20/40 and 20/44 to an improved 20/30 in both eyes. In addition, my hearing has seemed to improve as well – in fact, I no longer have to use hearing aids. I have never felt better – I feel like a younger man! I cannot thank Celltex and the staff in Cancun enough. They gave me my life back. For more information visit celltexbank.com or call 713.590.1000. Celltex Therapeutics is located at 2401 Fountain View Dr., Suite 416 in Houston, TX 77057.
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ARE THEY DONATING
THE MONEY YOU SPEND ON
Pink Products? By: Dr. Maria Palafox
I
n honor of the breast cancer donation campaigns, I will offer an opposing view to all the “pinking” of groceries, office supplies, athletic gear and clothing. In the past, I, like many of you, would gravitate towards pink products because I believed that the company behind the product would make large donations to breast cancer research or to the American Cancer Society. When I became a follower of the Breast Cancer Research Foundation (BCRF), however, I thought about those purchases twice before buying. As it turns out, many companies promote supporting breast cancer
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research by slapping a pink label on their products, but not all of those companies donate any proceeds to breast cancer research. Many companies will dance around the question, by saying “a portion” of the proceeds go to breast cancer research—but what’s a portion? For example, American Express donated a penny from every transaction, no matter how large the transaction. Other companies, such as Clinique, will donate $10 from every Dramatically Different moisturizer purchased for $38—one of their most popular products. Yet other companies will advertise that they are making a donation in support
of breast cancer research, but fail to provide details. Yoplait donates 10 cents for every pink foil lid you collect and mail in, but it takes 6 lids just to cover the cost of the stamp. In their defense, they have donated over $40 million to breast cancer research over the years. Yoplait was criticized in 2008 for using dairy products stimulated with growth hormone, which is thought to contribute to an increased risk of breast cancer. In response, Yoplait and Dannon stopped using dairy products stimulated with this hormone. Forbes magazine named five companies that it felt went above
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and beyond in their donation efforts and four of those companies are featured below. Delta Airlines’ Pink Plane, affectionately known as Breast Cancer One, flew more than 140 employee breast cancer survivors from New York to an event in Los Angeles. The event included a discussion of breast cancer research and a meet-and-greet with Dr. Sofia Merajver, a world-renowned breast cancer researcher. Over the last 12 years, Delta employees and family members have donated over $11 million to the Breast Cancer Research Foundation. Ann Taylor Loft has four pieces of jewelry, all priced under $40, that are being sold to raise money for the Breast Cancer Research Foundation.
The company will donate 60% of the purchase price to BRCF, and they have been doing it for the last several years. The proceeds of up to 100% of Panera Bread’s Pink Ribbon Bagel sales in certain cities will go to local charities supporting breast cancer patients. Avon and its foundation provide grants and scholarships for breast cancer research—in fact, it was the Avon Foundation for Women that recently released a new study about the differences in breast cancer mortality among black and white women in the 50 largest cities in the United States. They also provide grants to smaller hospitals so they can update their mammography equipment.
So I encourage you to do your research and make sure those companies where you are doing your shopping are actually donating money. Better yet, if you want to help breast cancer patients and survivors, why not volunteer to drive a patient to their doctor appointment? Pitch in and pay for a mammogram for a friend or relative, or offer to mow a breast cancer patient’s lawn. Let the pink remind us all that we can do something to help all the mothers, sisters, wives and daughters living through breast cancer. For more information visit mariapalafoxmd.com or call 210.504.5053.
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Melissa Y. Macias, MD, PhD Neurosurgery Dr. Macias treats a spectrum of adult degernative spine and brain pathologies and conditions: • Complex Degenerative Spine Disease, Disc Herniations, Spinal Stenosis, Acquired Adult Scoliosis • Infections • Tumors • Stroke • Trauma Through compassionate and individualized care, Dr. Macias uses minimally destructive techniques, as well as stem cell technologies in her procedures. She also offers treatment of chronic pain and compressive peripheral nerve disorders.
A Healthy Spinal Axis is fundamental to an active and healthy lifestyle. SouthTexasBrainAndSpineCenter.com Corpus Christi Location: 361.883.4323 Fax: 361.883.4324
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Benefits of Weight Loss Surgery •
WLS may improve obesity related health conditions such as diabetes, heart disease, high blood pressure, and obstructive sleep apnea, among others.
•
Diabetes cured in 80% of patients and resolved or improved in 90% of patients.
•
Hypertension is cured in 62% of patients and resolved or improved in 78.5%
•
Obstructive sleep apnea is cured in 86% of patients
•
Risk of death is decreased by 89%
•
Weight Loss Surgery (WLS) can enhance fertility and lead to successful full term pregnancies
•
Average weight loss is 50-70% of excess body weight
•
Improvement in arthritis with reduction in pain and increased mobility.
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WLS is covered by 80% of insurances
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Texas Bariatric Specialists accepts most major insurances including Medicare.
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Richard M. Wupperman, MD Dr. Wupperman specializes in the treatment of a variety of spine conditions and performs several procedures including: • • • • •
Spinal Surgery: Cervical, Thoracic & Lumbar Minimally Invasive Surgery Scoliosis Spinal Deformities Disc Replacement
AustinSpineSurgery.com | P: 512.347.7463 | F: 737.202.2561 CENTRAL AUSTIN: 3000 N IH 35, Ste. 660, Austin, TX 78705 STEINER RANCH: 2900 N. Quinlan Park Rd., Ste. 430 Austin, TX 78732