MD Monthly July 2017 - Austin

July 2017

mdmonthly.com

The Women’s

Hospital at Renaissance

THE ‘NEXT GENERATION’ OF SPINAL CARE

BRINGS HOPE TO PARENTS With a small, but powerful group of physicians, the Women’s Hospital at Renaissance Team are rewarded by the results of their profession.

Dr. Anthony Owusu Equips his Patients to Prevent and Care For Spinal Pain

CORPUS CHRISTI REHAB HOSPITAL An institution credited by a reputation for excellent patient care and outstanding a services

EMPOWERING

WOMEN of the Austin Community

Dr. Jennifer Walden of Walden Cosmetic Surgery Prides A Practice Built on Passion

BOERNE, TEXAS

NOW OPEN

Lounge on the broad, breezy wraparound porch, cocktail in hand. Step into a lovingly restored 19th century dining room to savor contemporary interpretations of Southern heritage foods and classic American dishes. Sit down to a familiar, casual, satisfying menu influenced by seasonal bounty from “As a kid growing up in Jourdanton, I watched my Mother and Grandma make everything from scratch every day. My Father and Grandfather were the Kings of Barbeque. I cooked some, too, but I did a lot more watching, tasting, and learning.”

area farms and the affinity of beef and mesquite smoke that is the soul of the Hill Country.

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Back to Normal S p i n e A s s o c i at e s

Comprehensive Spine Center Adult & Pediatric Orthopaedic Spine Specialists Spine Associates’ Comprehensive Spine Center creates a direct link between your primary care provider and the management of your spine injuries. Our Comprehensive Spine Center provides a full scope of spinal services including the evaluation, treatment of the cervical, thoracic and lumbar spine by a nationally recognized orthopedic spine specialist. Working together with referring physicians, our team ensures that each patient receives a personalized treatment plan specific to his or her circumstance and lifestyle. Spine Associates is equipped with the most state-of-the-art imaging and diagnostic technology which enables our spine specialists to effectively and accurately

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THE HUNT OF A LIFETIME If you are looking for the ultimate hunting experience, then look no further then DEA Ranch. The diverse selection of wildlife will create a lasting impression and make you the envy of your family and friends. For the discriminating whitetail, elk or exotic hunter, DEA Ranch is a paradise.

Skeet shooting, nature walks, bird watching or just relaxing under the 100-year-old oak trees, will make your trip a complete Texas retreat.

• Customized hunting packages for groups of all sizes.

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• Wedding and party packages including skeet shooting and quail hunting.

We look forward to helping you plan the hunt of a lifetime or a oneof-a-kind event. Contact us today for additional information.

311 CR 351, Mathis, TX 78368 361.249.1157 www.dearanch.com

Dr. Constance Barone is Honered to be Selected as

TOP DOCTOR IN AMERICA

by Castle Connolly

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Dr. Constance M. Barone

PLASTIC SURGERY

Stop the Pain Visit Us At AmericanSinus.com or SouthTexasSinusInstitute.com

Honrubia Technique™ for Balloon Sinuplasty

Patient Comfort and Safety Come First

The Honrubia Technique™ for Balloon Sinuplasty is a revolutionary, minimally invasive procedure for treating chronic sinusitis.

The primary symptoms of chronic sinusitis are headaches, trouble sleeping, snoring, fatigue, facial pressure, ear discomfort, and post nasal drip. The Honrubia Technique™ addresses many of the primary symptoms of chronic sinusitis while maximizing the comfort and safety of the patient. It is recommended by our team of board certified ENT Physicians. This technique involves less pain than a traditional sinus surgery and therefore contributes to a quicker recovery.

The Honrubia Technique™ for Balloon Sinuplasty is done under anesthesia. This ensures that patients have a more relaxing and positive experience than when the procedure is performed under a local anesthetic. It also allows us to address several other sinus related complaints. An anesthesia provider administers intravenous medications to keep patients lightly sedated and comfortable.

Our American Sinus Institute team of specialists have performed thousands of procedures using the Honrubia Technique™ for Balloon Sinuplasty. Come see us at the American Sinus Institute. We Solve Sinus Problems.

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July 2017 Production Media Digital Source Designer Meghan Goettl Project Manager Miranda Paredes Writers Rudy Arispe Edmond Ortiz Jody Joseph Marmel Contributing Writers Dr. Karen Hasty Dr. Amy Jackson.

Leticia Morales Fortino Gonzalez, PT, Dip MDT, FAAOMPT, OCS Fransico Arredondo Dr. Steven Cyr Eric Kala Contributing Photographers

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Paul Marshall

The 'Next Generation' Empowering Women of the Austin Community of Spinal Care

Jason Roberts

Dr. Anthony Owusu Equips his Patients to Prevent and Care For Spinal Pain

Rudy Ximenez

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Corpus Christi Rehab Hospital An institution credited by a reputation for excellent patient care and outstanding rehabilitation services

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Dr. Jennifer Walden of Walden Cosmetic Surgery Prides A Practice Built on Passion

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The Women's Hospital at Renaissance Brings Hope to Parents With a small, but powerful group of physicians, the Women's Hospital at Renaissance Team are rewarded by the results of their profession.

Marc Arevalo

Trinity Greer FOR ADVERTISING INFORMATION, PLEASE CALL 210.373.2599 OR EMAIL HELLO@MDMONTHLY.COM. FOR EDITORIAL COMMENTS AND SUGGESTIONS, EMAIL EDITOR@MDMONTHLY.COM.

MDMonthly.com Digit al Cover Photo Monica Brant: Trinit y Greer Digit al Cover Designed by: Michel Mancha Cover Photo Anthony Owusu: Jason Roberts Cover Photo CCRH: Paul Marshall Cover Photo Jennifer Walden: Rudy Ximenez Cover DHR - Women's Hospit al at Renaissance: Gerardo Garmendia

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Informed Patient

When is the right time to chill your eggs?

Dr. Francisco Arredondo gives hope to those who wish to delay motherhood

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Finance

The Precision of Attention Avid Wealth Partners Believes a Well-Guided Plan Provides Security for the future.

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Empowering others to 'live radiantly' through fitness, nutrition and faith.

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Informed Patient

Hormone Optimization - Is This What You Are Missing?

Dr. Karen Hasty Emphasizes the Importance of Overall Care for the aging woman

JULY - 2017

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Life and Fitness with Monica Brant

MD Monthly

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Feature Story

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Feature Story

North Park Lexus at Dominion Helps Keep Medical Professionals on the Road and on the Go This San Antonio dealership earns prestigious Elite of Lexus Award for the second consecutive year

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FINANCE/SAN ANTONIO

The Precision of

Attention By: Eric Kala CFP®, AEP®, CLU®, ChFC®, CRPS® Wealth Management Advisor | Estate & Business Planning Advisor Avid Wealth Partners Affiliated with Northwestern Mutual

I

t’s not a stretch to recognize that our thinking follows our attention. What we mull over, stew over, research or dwell on governs, or at least certainly influences, our thoughts, our attitudes, and ultimately our decisions. This can work for you or against you.

look in the future. That’s called a “vision.” It doesn’t have to be some benign statement on a plaque, but it’s important to have some sort of picture, idea, story or concept for what the future will be like. That is what a plan needs to address. If it doesn’t, your attention may not be quite right.

For example, if your attention is on the roller coaster ride of the markets, it won’t take long to experience the swings of emotion that come with up-markets and down-markets, and for your thoughts to be fixated on the ticker. It’s not a problem to be aware of it, but it usually doesn’t serve you to be checking it minute by minute.

But with a clear vision for the future, you can then start looking forward in a meaningful way. The next place to look is how you want things to happen. For example, we spend time with clients helping them not only articulate their vision, but to name the values, or rules, that need to be respected along the way. Ultimately, only by understanding someone’s vision and values can meaningful goals be created.

When you’re making financial plans, or managing your plan, attention becomes even more important.

Here’s a fundamental that needs to be understood: Planning is not about advice, it’s about decisions.

It’s tempting to put a lot of attention on advice; indeed, many financial advisors put a lot of attention there. But what we’ve found is that, while having good advice is critical, it’s secondary to clarity about the decisions that need to be made.

That means paying to have someone at the planning table who can objectively and supportively help you develop the plan you need.

Plans need to be based on one thing, and one thing only: how you want your life to

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Goals are the steps you take that move you closer to your vision in a way that respects your values. When those are clear, then advice can be brought into the mix. Trying to get advice without clarity might feel soothing, but it risks the development of a misguided financial plan.

Avid Wealth Partners is a marketing name for Eric Ilmari Kala in their capacity as a representative of Northwestern Mutual and is not a legal business name. Northwestern Mutual is the marketing name for The Northwestern Mutual Life Insurance Company, Milwaukee, WI (NM) (life and disability insurance, annuities and life insurance with long-term care benefits) and its subsidiaries. Eric Ilmari Kala is a Representative of Northwestern Mutual Wealth Management Company (NMWMC) Milwaukee, WI (fiduciary and fee-based financial planning services), a subsidiary of NM and a federal savings bank.

Certified Financial Planner Board of Standards Inc. owns the certification marks CFP®, CERTIFIED FINANCIAL PLANNER™ CFP® (with plaque design) and CFP® (with flame design) in the U.S., which it awards to individuals who successfully complete CFP Board's initial and ongoing certification requirements.

Eric Kala is a San Antonio based advisor that works extensively with physicians and business owners on their financial wellness and their specific needs around protecting and growing their assets.

17802 W Interstate 10, Ste. 114, San Antonio, TX 78257 | 210.445.5755 | avidwealthpartners.com

And how does this connect to attention?

It’s this simple: keep your attention on your vision, on the desired future state that matters to you. Work with an advisor who knows how to help you name it and articulate it, because then your attention will be well-placed, and your plans can be well-guided.

JULY - 2017

MDMONTHLY.COM

Welcome to the SOUTH TEXAS BRAIN AND SPINE CENTER.

Our surgeons provide neurosurgical care in many of the major hospitals in Corpus Christi, Texas. Our surgeons and staff provide individual and conservative treatment using the most effective and modern technologies available in the world.

1227 3rd Street | Corpus Christi, TX 78404 361.883.4323 | SouthTexasBrainAndSpineCenter.com

INFORMED PATIENT/CORPUS CHRISTI

After a Stroke

FINDING THE RIGHT WORDS By: Leticia Morales

I

t’s common to struggle at times to find the right words during a conversation. But for an individual who has had a stroke, finding the right words may be much more difficult.

Aphasia can be a side effect of a stroke, which can affect a person’s ability to communicate by impairing the ability to speak, read, listen or write. It doesn’t affect intelligence, however. When a person with aphasia has word-finding difficulty, it’s called anomia. Anomia is a common symptom of aphasia that makes it difficult to find the words or ideas that a person may wish to share.

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Anomia can be really frustrating for individuals because they know what they want to say, but they just can’t find the words. It can make a conversation difficult because sometimes the word will come and sometimes it won’t.

There are various causes to word-finding problems in patients with aphasia, and they may present differently. For example, one person may not be clear on the meaning of a word so he or she may not be able to complete an errand that requires knowing what the word means.

Another person may not be able to identify a family member or name an

item in a photo. Another may know a word and recognize it in print, but may not be able to pronounce the sounds to say it, or an individual may say a word that’s a little bit off from the right word (i.e. poon versus spoon).

When these types of things happen in a conversation, the person who is speaking to the stroke survivor may want to jump in quickly to supply the word. But in reality, that can be more of a hindrance than a help. It would be more beneficial to help the person find the word they are looking for rather than supplying it.

To best communicate with

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INFORMED PATIENT/CORPUS CHRISTI

someone under these circumstances, consider these following suggestions:

• •

•

•

•

•

Be patient. Allow plenty of time for a response. Talk with the individual, not for him or her.

Give the person time to respond and don’t rush him or her.

Ask “yes” or “no” questions that can be answered simply and without a lot of explanation.

Ask questions that can help zone in on what the individual wants to say. For example, if you were talking about flowers, ask “Is it in our yard?”

•

•

Use photographs or pictures to help provide cues.

Write your cues – such as a letter or a drawing – on a piece of paper to share.

Confirm and repeat back what the person has said. Use paraphrases or keywords to be sure that you’re understanding properly.

Use gestures as you ask questions.

The most important thing is to not “talk down” to an individual. Be respectful and provide emotional support showing that you recognize that the person knows what he or

she wants to say. And remember that every word doesn’t have to be perfect, so downplay errors. Not all words need to be said perfectly to communicate.

Leticia Morales is a speech pathologist at 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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DR. ANTHONY OWUSU Provides

‘NEXT GENERATION’ OF Spinal Care By: Edmond Ortiz

Owusu did his fellowship training at the famed Texas Back Institute in Dallas. He grew to embrace Texas and all that it had to offer. Later, Owusu returned to the Dallas area and interviewed at multiple practices.

After accumulating some more experience, Owusu was eager to have his own practice, seeing it as the best way to apply his growing skill set, especially in spine surgery.

He arrived in San Antonio, to start anew and to launch Next Generation in the late summer of 2014.

“I just jumped out there on a limb,” he said. “I fell in love with the city and the people.”

Over the years, Owusu has carried out hundreds of spinal procedures, and has published and presented research on the topic. Owusu also continues to be enthralled with evolving technologies and methods to address various afflictions of the spine.

“It’s not just one technique. You get to consider different things for different ages, backgrounds and conditions,” he said.

D

r. Anthony Owusu offers orthopedic spine surgery from his own practice, Next Generation Orthopedic and Spine Institute.

The New Jersey native remembers when he first became attracted to the medical profession. He was 13 and he had broken his right ankle. Sitting in the hospital, Owusu simply observed the doctors and nurses do their thing.

“I liked how everyone interacted with each other. I fell in love with it,”

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he said. Owusu went on to become the first person in his family to graduate from college, earning a medical degree from the Howard University College of Medicine.

Initially, Owusu thought he would be a dermatologist. But following a rotation in orthopedics, he found the study and treatment of afflictions of the spine fascinating.

“The spine is still a discoverable specialty,” he explained. “There are many ways, many pathologies, to approach the spine.”

Owusu said a major part of his treatment plan is to talk with each patient as if he or she were a friend or loved one. Getting as much critical information as possible from the patient is vital.

“The most important thing to me is to sit down and listen to the patient and get their complete story,” he said.

“My training gives (the patient) some guidance. The more conversation, the more the patient understands, and the better their outcome.”

Complete disclosure, including the risks, is key in consulting with the patient, Owusu noted.

PHOTOGRAPHS BY Jason Roberts

MDMONTHLY.COM

“It’s all about educating and empowering the person and making sure their expectations are appropriate,” he added.

“For example, if someone’s had three back surgeries and they’re facing a fourth surgery, I tell them it’s not going to be like your first,” Owusu said.

He added that he would tell such patients about scar tissue, and about the possible need for an extra day of bed rest.

muscle-sparing techniques, with less loss of blood and smaller incisions being among the results.

“You can approach the spine from the oblique or lateral position, or from the front,” he said. “Threelevel fusions are now averaging two to three day (stays) in the hospital.”

Still, there may be additional factors to consider in most other afflictions and procedures, such as body mass and the patient’s range of mobility.

ONE OF MY MENTORS OFTEN TOLD ME TO HELP PATIENTS KEEP SOMETHING IN MIND: YOU CAN MAINTAIN YOUR SPINE IF YOU MAINTAIN YOUR FLEXIBILITY AND AGILITY. -Dr. Anthony Owusu few years ago, when owning and operating a practice seemed like a daunting task.

Owusu’s practice specializes in a variety of fusion surgeries and decompression, in addition to the usual minimally invasive spine surgery and other conservative treatments. Fusion often is the last resort when all other viable treatments are exhausted.

“Your mobility prior to surgery dictates your mobility after surgery,” Owusu said.

Owusu said technology has changed and has moved toward

“One of my mentors often told me to help patients keep something in mind: You can maintain your spine if you maintain your flexibility and agility,” he said.

“She came to me, and I listened to her. I felt she had legitimate pain issues, and I also felt like I could help her,” he recalled.

By maintaining your flexibility and agility through regular exercise, Owusu said, you decrease your risk of injury, so long as you also keep up the use of Vitamin D and calcium. This is especially true for women, and is vital in staving off the onset of osteoporosis.

In addition to needing to figure out the best course of treatment for his new patient, Owusu had trouble finding an available operating room and time to accommodate the surgery. Ultimately, the hours-long surgery went off without a hitch. The patient did well in the operating room and in recovery.

But when preventative measures are not enough, disc replacement has been one solid method of addressing degeneration of the spine.

“I was still trying to find my niche at the time. It was a humbling experience,” he said.

Owusu keeps adding to his surgical experiences and number of patients at Next Generation.

However, Owusu said he is thankful to be able to use his talents to help alleviate the pain of spinal patients.

“It’s a growing practice. We’re good at getting patients in to be seen pretty quickly,” Owusu added.

“It’s rewarding to see someone feel better. It’s instant gratification,” he added.

Owusu emphasizes that he does his best to offer suggestions in the way of prevention and maintenance of the spine.

Owusu recalls one patient – one of the very first at Next Generation, not long after the practice opened. The patient previously had endured four spinal surgeries but without much luck in alleviating her pain.

But Owusu remembers, just a

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INFORMED PATIENT/SAN ANTONIO

Cervical Headaches

FROM HERNIATED NUCLEUS PULPOSUS

By: Steven J. Cyr, M.D., FAAOS

M

ost people at some point in their life have had a headache.

Unfortunately for some, this unpleasant event occurs far too often. There are many different types of headaches. This is because there are many different sources of headaches. The term headache is a good descriptive umbrella term but it does not specifically differentiate the subtle differences between the various headache types and sources.

For example, according to the American Migraine Foundation, there are 23 different types of headaches.

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A few of the more common types include Cervicogenic headache, Tension-type headache, and cluster headaches. Headaches can be also described by the location of manifestation on the head. Some headaches only occur toward the back of the scalp whereas other headaches involve the entire head or are more toward the forehead. The tension-type headache is a common headache which relates directly to the neck. Occipital headache also relates to the neck. When the neck vertebrae are poorly aligned or the discs are degenerated, a headache

can be part of the constellation of symptoms that ensue.

The neck vertebrae are referred to as cervical vertebrae and poor posture of the cervical vertebrae can result in pain and headache. Many people have poor posture due to their workplace requirements. Of course this is only one source of poor neck posture.

However, prolonged exposure to poor posture can strain the soft tissue discs within the neck. This can result in herniation of those discs. The discs are a primary source of stabilization between spinal vertebrae, and any compromise or degeneration of

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those discs can cause pain. Pain can come from the disc itself, from the surrounding joints in the neck, muscle fatigue, nerve compression, or other soft tissue sources. Figuring out the source of that pain is not a straightforward process.

Pain from a disc in the neck is unlikely to respond positively to any conservative measures. Pain from the joints in the cervical spine has been documented in the literature to display both up and down the neck.

If a painful joint is located higher in the neck, that pain may extend up into the scalp. This pain can feel like a headache. So, if a disc has degenerated, causing joint pain in the neck, the pain can be primarily perceived as a headache. This is true but not straightforward and this is why clinical professionals are carefully trained to differentiate between these different sources of pain. Most of the time, joint pain from the neck only affects the posterior scalp. However, pain from the neck can extend beyond the neck.

Another source of headache from the neck can be from nerve compression due to muscle spasm. A muscle in spasm may be attempting to hold the spine in place but in turn causes nerve compression. The spine is highly mobile and muscles greatly affect the posture of our spine.

Anywhere in the spine, if a muscle is in spasm, there can be nerve compression from that spasm. In the neck, at the base of the skull, there is a large nerve called the Greater Occipital Nerve which supplies the posterior scalp with sensation. The

anatomy of the Greater Occipital Nerve describes it actually emerging through a muscle called the Trapezius.

Another muscle in close proximity to the Trapezius is the Obliquus Capitis Inferior. Any spasm of either of these two muscles can pinch the Greater Occipital Nerve, causing pain. The posterior scalp difficulties can be painful but this can be treated with a nerve block injection procedure.

Cervical herniated disc is diagnosed through a detailed history, clinical examination, and a combination of images including radiographs and MRI. While it is not possible to diagnose a muscle spasm from either of these studies, a medical professional can identify the root cause of the spasm which is likely contributing to the pain and headache. There are many nonoperative treatment options for a cervical herniated disc. Physical therapy, exercises, massage, medication, activity modification, injection, postural training, ice, and rest are all effective conservative treatment avenues. Often, a therapeutic injection can both serve to diagnose and treat a source of pain. While this injection does not reverse a herniation, it can help greatly reverse the symptoms of neck pain and headache from a herniated disc. Ultimately, the goal of treatment is eradication of the source of pain. Conservative means of this is ideal. There are however, cases where conservative treatment is not able to provide acceptable relief. In this case, a surgical procedure is discussed. There are different surgical procedures for

the different cervical issues in the neck and an appropriate plan can be determined through a thorough workup and diagnostic process.

At The Orthopaedic & Spine Institute, Dr Cyr and our uniquely trained team of medical professionals have experience in treating all symptoms and conditions of the spine, from the cervical spine to the sacrum. If you suffer from neck or back pain, contact us to schedule a consultation.

Dr. Steven Cyr is one of the nation’s few Mayo Clinic trained spine surgeons. His training included both orthopaedic and neurosurgical techniques of the spine. The Mayo clinic is one of the world’s leading medical institutions and has ranked number one for orthopedic and neurosurgical training programs in America for more than 20 years. Dr. Cyr is the President and Founder of The Orthopaedic and Spine Institute in the South Texas Medical Center located at 8401 Datapoint Drive, Suite 700, San Antonio, Texas 78229.

(210) 487-7463 or (844) 896-7846 www.saspine.com

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FEATURE STORY/SAN ANTONIO

Life and Fitness WITH MONICA BRANT

By: Jody Joseph Marmel

B

eing a country girl from Texas, Monica Brant’s adventurous spirit led her to California, where the fitness movement was happening back in 1995. Her love for fitness was ignited during her first year of college. Brant found the old weight machines in the school gym and figured out how to use them. To her surprise, other students started asking her how to exercise. “It was in this stage of my life that I started to discover how much I enjoyed helping others.”

When ‘Fitness’ gained popularity in the 90s, Brant was hired to travel worldwide, spreading the good news about health and fitness while 24

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demonstrating the differences of a ‘fitness’ athlete from a female ‘bodybuilder’. Brant explains, “Men and women were hungry for something other than bodybuilding and so they looked to my lead. I really enjoyed interacting with people from all over the world.”

Throughout the course of her profession, Brant has been featured on the cover of both international and national publications, over one hundred times to date. She has won some amazing titles including the IFBB Fitness Olympia 1998, which is the same title Arnold Schwarzenegger was known for in Bodybuilding. Brant also won the WBFF World’s Figure Pro both in 2010 and in 2013. She

was 40 and 42 while on the stage for those titles.

As Brant’s talent on the stage grew, her life was becoming more of an adventure. Looking back on her move to California, her resources were limited and she barely had five acquaintances in the entire state. “I discovered that facing our fears is one of the most empowering moments a woman can have.” The bold move she made was instrumental in securing her place as one of the ‘pioneers’ of the industry. She explains, “I was in the right place at the right time with the right attitude and work ethic.”

In Gold’s Gym (Venice, CA.), Brant refers to this as the mecca of fitness PHOTOGRAPHS BY Trinity Greer

MDMONTHLY.COM

FEATURE STORY/SAN ANTONIO

and bodybuilding, she connected with an amazing choreographer who took her routines to the next level. She also met all of the top fitness photographers at that time.

Back then, most photoshoots for the fitness publications were taken either in Gold’s Gym or in the surrounding areas of Santa Monica and Venice. “Learning to stay photo shoot ready was a must and this is where I learned how to balance life and fitness.”

Most recently, in the fall of 2016 at the age of 46, Brant was invited to represent the USA in two shows that were both held in the United Kingdom. “Obviously winning 1 Overall Title and taking 2nd in these two shows gave me a great sense of accomplishment while proving that women in their 40’s can still be very competitive.”

Through the years, Brant discovered and proved that women can accomplish what they truly desire. “The difference is believing in ourselves and to dream big.” In 2013, she decided to return to her love of sprinting and competed in the Women’s 40-44 age group in the USATF Master’s Track meets (100, 200 and 400m races). During the 2013 World’s Master’s Track meet held in Brazil, she earned top 3 placings representing the USA in the events.

Once again, this provided more opportunities to encounter people from all over the world and prove a healthy lifestyle pays off. Although fitness has become an integral focus in her life, she discovered how to have consistent success balancing fitness and living life. “My passion is to share this message of ‘Lifestyle’ balance with women and men all

over the world through the various ventures I am working on.”

Being in a constant state of personal development is crucial for everyone. “I never had a problem asking for guidance and I believe it’s important for others to get out

of their comfort zone and ask for help when necessary. Throughout the years, I have been privileged to pay it forward by giving my time to listen and provide sound advice for other fitness professionals as they walk through situations. If we want to grow, we must have mentors and 2017 - JULY MD Monthly

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FEATURE STORY/SAN ANTONIO

coaches to help get to the next level.”

Even now, Brant has a business coach who challenges her to dream big and grow. And that is exactly what she is doing.

Over the last 27 years, Brant discovered that having a healthy balance of emotional and spiritual strengthening is more important to the overall mind, body and soul than just the physical component. “I’ve met more super fit people that feel they are missing something or they have low self-esteem due to only focusing on the physical. Therefore, I decided to focus not only on the fitness side of a person, but also on their entire life and that’s why I coin myself a ‘Lifestyle’ Coach as opposed to a ‘Life’ Coach.”

Lifestyle Coaching encompasses both fitness and life lessons.

Learning to balance attitudes, emotions, situations and schedules while also pursuing a change in your physique can be quite demanding.

When Brant works with a client as their Lifestyle Coach, she partners with them in a thought provoking and creative process that inspires the client to maximize their personal potential. Brant explains, “It brings me great joy to feel I can guide my clients through their desired personal changes to experience fuller and more meaningful lives in every area.”

Brant remembers her father sharing a story about an example of life focusing on a 4-legged table and how the table can’t support the weight from two or three legs only. “I believe our lives are like this table; we are a 4-legged or 4-part being that requires a balance of spiritual, physical, emotional/ relational and career/ dreams.” These four parts summed together equally make for a fuller, healthier life. If someone only focuses on one or two of these “legs”, the table or body (inside and outside) can’t survive the pressures of life.

Lifestyle Coaching is unique and Brant emphasizes that we have to step out of the comfort zone and challenge ourselves in different activities and training types. Here are a few tips to follow. . Physical People should keep in mind that weights are your ‘friends’ and will help you shape your body because we

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can’t ‘tone bone’. Don’t be afraid to lift heavier and push the intensity in all of your exercise endeavors.

After 20 plus years of lifting heavier weights, Brant has reaped the rewards of heavier lifting as opposed to extended cardio or light-high reps.

Allowing your body to undergo the taxation of weights will allow you to open the energy receptors in your muscles to absorb and utilize the nutrients you eat. It is imperative to have the proper fuel (food) for muscle growth and recovery. Plus, hire an experienced coach if you are unsure of the exercise you want to engage in. . Emotional Take time to De-Stress more often and allow yourself to relax. Move on from hurts and disappointments from others or yourself. Just let it go. If you can relieve emotional baggage, everything else becomes lighter and easier. . Nutritional 2 words - Manage Insulin. Insulin can be your best friend or worst enemy when it comes to fat loss and retaining muscle. Learning how to manage it correctly by making it work for you and not against you will extend your efforts. Eat lower glycemic index (GI) foods such as lean protein, healthy fats, fibrous carbs as a rule, and combine higher GI foods such as sweet potatoes and yams with lower ones (lean protein, fibrous carbs) to lower their net impact on your body.

The secret is knowing when to eat your starchy foods. Timing meals according to your exercise will help you receive the benefits of insulin.

PHOTOGRAPHS BY Trinity Greer

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FEATURE STORY/SAN ANTONIO

San Antonio in 2018 and she is doing a lot of writing including a book she is working on. “I’m loving this time of my life when I get to take my three decades of experience and share with people what I’ve discovered about fitness and life.” She owns and hosts a women’s retreat, The Body & Soul, that takes place in San Antonio. The event is to empower women physically, mentally and emotionally. For more details and to review the sessions and dates of the upcoming events, please visit www. monicabrant.com/bodysoulretreat .

After a weight training or a sprint type interval session, adding a small amount of starchy foods in the mix along with your post training meal can work well. This is your golden opportunity to have insulin direct the correct starches you eat to your muscles and not your fat cells. For most of the other meals, focus on protein, healthy fat, and carbs mainly in the form of non-starchy vegetables.

Green is Good! . Spiritual Take some time to pray, meditate and refuel your spirit! Many times you may find yourself looking to eat because you think you feel hungryor you simply just want to snack. In reality, your body is in need of some spiritual fuel. Next time you have a craving for something that might set you back from all of your hard work, take a mental examination of when the last time you stopped to pray, give thanks and then “listen” to what God may be saying to you.

The motivational ‘muscle’ exists

in all of us, just like we all have abs.

Brant describes this in detail. “Some people choose a lifestyle that allows the abs to be seen clearly because of their daily habits of healthier eating practices and exercise routines. If the motivational muscle becomes accustomed to lounging and not being used consistently, it will become covered with self-doubt and low self-esteem, just like the abs of someone who chooses to eat poorly and lacks discipline. In that case, the person must find an external motivational tool that will start the motivational internal muscle firing once again.”

If people could stop settling for less than what their hearts desire, and successfully follow through with their goals, the motivational muscle will remain strong and capable of handling all of life’s curve balls.

Currently, Brant and her business coach are developing new programs, expanding her speaking platform, hosting her own competition show in

As I was interviewing this talented and well versed woman, I took note of how she signed all of her emails. “Stay Fit, Love Life & God Bless You!” Brant then ends her email with “Live Radiantly”. I knew immediately that I was going to be a fan of hers for life. Just those few words empowered me to reach my full potential. At the end of the day, it’s about putting others first and taking care of one another to the best of our abilities. Brant concludes, “If we live radiantly, we can shine the pathway for others to follow in the glow of our example.”

For More Information & to book Monica for Personal Appearances, Lifestyle Coaching/Speaking Opportunities and Online Health Coaching visit monicabrant.com LinkedIn: Monica Brant FB: Fan Page visit https://www. facebook.com/monicabrantfanpage Twitter: https://twitter.com/ MonicaBrant IG: https://www.instagram.com/ monicabrant/ YouTube: https://www.youtube. com/c/MonicaBrant1

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Hormone Optimization

IS THIS WHAT YOU ARE MISSING? By: Karen Hasty, M.D.

A

s a gynecologist, I spend many days in my office hearing women complain about hot flashes, night sweats, inability to sleep, and mental fogginess. They tell me they have no libido because they are in pain and their desire is gone. They can not build muscle, their joints hurt, and they are gaining weight in their midsection, but they have no energy to do anything about it. These are not just women who are in menopause.

These are women whose ages range from 30-70. They chalk it up to life, marriage, kids, stress, and age, but not a single one is happy with how they feel. Before my practice learned of BioTe, I thought the same as well.

Now I know differently, and I would like to share my knowledge with you.

Hormones are in every cell of our bodies. Men produce testosterone hormone, while women produce among many estrogen and testosterone hormones. Hormonal decline can affect all aspects of our 28

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lives. Levels begin tapering off in our 30s and can fall up to 10% annually.

It is not uncommon for 40 and 50 year olds to have hormone levels so low that they don’t even register in lab results. Most people think feeling the way they do is because of their age. They don’t think to ask their doctors about getting their hormone levels checked.

You can learn if your hormones need to be optimized by having blood drawn for a testosterone, estrogen and thyroid check. An appointment will then be made to discuss your lab results and decide if pellet therapy is right for you. The amount needed is calculated based on your age, weight and lab values.

See, the process is simple.

For low hormone levels, one of your options is pellet placement.

Pellet placement is a minimal office procedure where the side of the buttocks is numbed with local

anesthesia and the pellet is placed through a tiny incision. You’ll start feeling results within a few days, and the hormone lasts around 4 months for women and 5 months for men.

A lot of women are often frightened of getting testosterone as they view it as a male hormone. We, too, have testosterone in our bodies just at a much smaller amount. To compare the two, women receive 100-200 mg of testosterone and men 1800-2400 mg.

A big difference!

Aging may be a part of life, but feeling old does not have to be.

With such a simple solution to feeling great, aging healthier and living happier could start with a simple blood test at a certified BioTE® provider.

We would love to help you at our practice Four Seasons Ob/Gyn 7711 Louis Pasteur Drive Ste 907 San Antonio, TX 78229 fourseasonsobgyn. com 210-593-0700

JULY - 2017

MDMONTHLY.COM

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8401 Datapoint Drive Suite 700 | San Antonio, Texas 78229

CORPUS CHRISTI

REHABILITATION HOSPITAL Special to MD Monthly

Nicholas Nilest, CEO of Corpus Christi Rehabilitation Hospital.

Nilest knows what he’s talking about. He is a Neuro-IFRAH (NeuroIntegrative Functional Rehabilitation and Habilitation) certified doctor of physical therapy.

Maximo De La Paz

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fter two back-to-back, neck surgeries in April to treat a sudden condition with no known cause, Maximo De La Paz, 66, was immobile and unable to do anything for himself. He chose Corpus Christi Rehabilitation Hospital (CCRH) for his rehabilitation treatment, and after four weeks, he was back on his feet.

“They helped me get back to normal, and they’ve gone beyond what I was expecting,” De La Paz said, adding that because of the exercises and treatment he received, he is now able to dress, shower and walk on his own.

Its reputation for excellent patient care and outstanding rehabilitation services led De La Paz to choose Corpus Christi Rehabilitation Hospital, which specializes in inpatient rehabilitative services and treats patients from Corpus Christi and the Coastal Bend area who are recovering from disabilities caused by injuries or illnesses, or who are living with chronic medical conditions.

“Studies show that when inpatient rehabilitation is specifically part of your post-acute care, you have a better likelihood of going home sooner, you get better quicker, and there is a lower mortality rate,” said 32

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“It helps me understand all of the clinical things going on,” he said.

“I’m not just the financial person who sits behind the desk. I’m certified to treat people with strokes and brain injuries. I can walk into a patient’s room, and if they need help getting out of bed, getting to the bathroom, or anything clinical, for that matter, I feel comfortable doing that.”

He said that all directors, with the exception of just a few, are also clinicians, including his directors of nursing, patient outcomes, case management, therapy, marketing, and pharmacy, and the director of clinical compliance, among others. “We’ve worked on the front lines and have been involved in day-to-day care,” the chief executive officer said.

For the senior administrative staff, interaction with patients is a requirement, Nilest explained, which is why CCRH has established a Patient Advocacy Program in which the rehabilitation hospital’s 12 directors are assigned to meet with patients upon admission, and regularly check on them throughout their stay.

“When a patient arrives, the patient advocate is expected to introduce themselves and let the patient know if they have any concerns, whether it be about the food, cleanliness of the room, or treatment by staff, we want to hear what they have to say,” he said.

“We’re encouraged to stop in once a week, or even daily if time allows. If there is an issue, we bring in all of our directors to discuss it.”

Nilest is proud of the fact that CCRH is stroke certified, which he said took the commitment of his entire team to accomplish. It began when staff members met to discuss what they could do to better serve their stroke patients.

“We make sure a neurologist is involved in every stroke patient’s case. We developed a special Diner’s Club for patients who have trouble swallowing, and we require a family conference early in a patient’s stay to improve communication,” Nilest said. “We have a psychologist to help those patients with depression and offer them counseling. We have a survivors’ support group that meets twice a month, as well as special stroke education and an individualized plan of care for all stroke patients.”

Later, after staff had established a well-developed stroke program, CCRH invited The Joint Commission, a non-profit organization that accredits health care organizations in the United States, to evaluate their program. “Approximately two years ago they came and looked at our charts and talked to patients and staff,” the CEO said. “They said,

I’M NOT JUST THE FINANCIAL PERSON WHO SITS BEHIND THE DESK. I’M CERTIFIED TO TREAT PEOPLE WITH STROKES AND BRAIN INJURIES. I CAN WALK INTO A PATIENT’S ROOM, AND IF THEY NEED HELP GETTING OUT OF BED, GETTING TO THE BATHROOM, OR ANYTHING CLINICAL, FOR THAT MATTER, I FEEL COMFORTABLE DOING THAT.

-Nicholas Nilest, CEO

PHOTOGRAPHS BY Paul Marshall

MDMONTHLY.COM

“My words are hard to come by, and my hand and foot on the right side of my body don’t work, but my arms and legs and speech work now,” Trammell said. “The nurses were nice and accommodating, and the physical therapists, occupational therapists and speech therapists were all great.”

Laura Trammell ‘You have a good thing going here, and we can give you our stamp of approval as a center of excellence for stroke victims.’ ” One stroke patient, who has benefitted from rehabilitation at CCRH, is Laura Trammell. On her son’s birthday on November 26, 2012, she suffered a brain aneurysm and stroke, which left her unable to speak or walk. She then spent twoand-a-half months in rehabilitation.

Today, she can walk and is able to speak clearly.

In addition to being stroke certified, CCRH offers a range of rehabilitative services for those with brain and spinal cord injuries, motor vehicle accident injuries, trauma, cancer, hip fractures, wounds, and Parkinson’s disease, to name a few.

“We have the whole gamut of intervention,” Nilest said. “You get a rehab doctor who follows your care, an internal medicine doctor or pulmonologist if you need that, in addition to respiratory, occupational, physical and speech therapy. We provide 24-hour nursing care, a dietitian, a pharmacist, and case managers. Once you leave, we follow up to make sure that when you get home you are comfortable with the home services we set up for you.”

At age 62, Stephen Connell was working on his computer when he suddenly lost use of his left arm and left leg. At the ER he learned that he was suffering from a stroke. Upon discharge from the ER, his wife requested that they be sent to Corpus Christi Rehabilitation Hospital for his treatment. After just five weeks of treatment, Stephen regained mobility in his left arm. He has also regained strength and mobility in his left leg; however, a weak knee is affecting his ability to walk and he may need a knee replacement.

Stephen Connell

“The staff at Corpus Christi Rehabilitation Hospital not only took care of what I needed, but they explain what you’re doing and why you’re doing it,” he says. “They’re very informative and listen to what you have to say, and it’s the only place I would go for inpatient rehabilitation.”

Meanwhile, Maximo De La Paz and his wife, Rosa, will always be grateful to Corpus Christi Rehabilitation Hospital for helping Maximo on the road to recovery.

Even more so, they will never forget the kindness shown to them when they needed it most. While Maximo was going through rehab, his mother passed away.

“The staff at Corpus Christi went out of their way to enable him to go to the Rosary for her funeral, including having a nurse accompany him,” Rosa said. “We want to thank them from the bottom of our hearts for everything they did for our family.”

For more information, visit ccrh. ernesthealth.com or call (361) 906-3700.

Raymond Najera After suffering an anoxic brain injury in 2015 Raymond Najera was unable to walk, speak clearly or eat by mouth.

His personal goals were to improve his activities of daily living. The treatment he received at Corpus Christi Rehabilitation Hospital helped him tremendously. Mr. Najera says, " he will do anything for Corpus Christi Rehabilitation Hospital" he is extremely grateful. He is now able to speak, walk with assistance, and eat.

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Fertility:

40s IS NOT THE NEW 30s.

When is the right time to chill your eggs?

By: Francisco Arredondo, MD MPH Founder RMA of Texas and SMART IVF

W

omen are born with roughly one million (oocytes) eggs and will never produce more.

They will simply mature and ovulate the eggs they have in stock. By the time women have their first period, they are left with only 400 thousand eggs in reserve. On average, a woman ovulates 400 times in her entire life, meaning she loses an average of 1000 eggs per month.

Unfortunately, a lot of women are incorrectly reassured by widespread opinions that the advances in technology can compensate for age related infertility. Furthermore, media’s deceitful reporting coupled with celebrities’ conceiving in their late 40s and 50s (certainly with donor eggs or previously stored embryos) have reinforced the false notion that fertility with your own eggs is always possible with our current technology. Moreover, for worthy 34

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social, economic, and professional reasons the proportion of women who delay childbearing has increased.

These are great achievements of women’s rights, yet paradoxically they have taken a toll in their ability to fulfill their dreams of starting a family.

The average age of the mother when

she has her first born has significantly increased in the last fifteen years.

In 2014, twenty-eight percent more women between 30-34 years of age had their first newborn compared to 2010. This number was twenty-three percent higher in women 35 years and more (figure 1). This has had

Figure 1 – Average age of mother at first birth

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INFORMED PATIENT/SAN ANTONIO

some reproductive consequences and unfulfilled desires. Several studies have pointed out the discrepancy between the desired number of children and the actual number of children achieved by couples. In summary, the investments that society and women have made in human capital have had an impact on their intended fertility. Women have had to face a very difficult and unfair choice: invest in developing their career or in building a family. That is, until now.

Since 2012, cryopreservation of oocytes (egg freezing) is no longer an experimental procedure. The rate of success for In vitro fertilization (IVF) is as good using freshly extracted eggs as it is for frozen eggs. While this is an astounding achievement, it is also important to remember that the success rate is not 100%. Therefore, egg freezing should not be seen as an insurance policy, but rather as a great way to maximize the possibilities of becoming a parent when the time is right for the woman and/or the couple.

How is egg freezing done?

In simple terms, IVF and egg freezing are the same procedures with the only difference being that in egg freezing the scheduling of conception and pregnancy is postponed to when the woman and/ or couple are ready. The method involves women taking fertility medications to enhance their oocyte (egg) production since naturally women produce only one egg per month. The eggs are then retrieved under sedation. In IVF the freshly obtained eggs go on a “date” with the sperm in a petri dish and typically 5 days later some of them become pre-embryos or blastocysts (see figure #3). At this point usually

Figure 2 – In Vitro Fertilization

one of them is placed in the womb so pregnancy can develop.

In the egg freezing method, the oocytes (eggs) are cryopreserved or “frozen” with a technique called vitrification without fertilizing them, and are kept in storage for a future date. Multiple research studies have found similar pregnancy rates in women less than 35 years of age when the egg is frozen. This rate is roughly 50 percent. The younger the woman is at egg freezing, the more successful the pregnancy rates will be. These technique can be performed in a 2-5 week span and currently the price is roughly around $10,000.00 USD (See figure 3 image of calendar). While several fertility and IVF centers offer these services, it is extremely important you choose one where the quality control and external monitoring

of the program performance is continuously evaluated.

Who should consider freezing their eggs?

•

•

•

•

Women who desire children and foresee delaying motherhood in order to pursue educational, professional or personal goals.

Women who desire motherhood and given social circumstances are unable to do it immediately (i.e. lack of the right partner) Women diagnosed with cancer that may undergo chemotherapy or radiation Women with moral, ethical or religious reasons against freezing whole embryos

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What is the best time to cryopreserve your eggs?

The two most common mistakes associated with the decision-making of when to freeze your eggs are related to timing: freezing too early and freezing too late. On the one hand, the consequences of freezing too early are wasting money and the inconvenience of the procedure. So the younger a woman freezes her eggs, the less likely she will need them and use them in the future. On the other hand, the risk of freezing eggs too late is that she has a higher risk of never conceiving a child with her own genetic material. Determined through a mathematical model based on probabilities, the maximum cost effectiveness for women to put a snooze in their biological clock and freeze their eggs is between 31-37 years of age.

rather inefficient. The survival rate of warming frozen eggs is 85% at RMA of Texas.

A study at New York University Fertility Center by Dr. Nicole Noyes revealed that the number of eggs needed to have one live birth is age dependent: • Women Age 25-34 years young: 8 eggs/live birth • Women Age 35-37 years young: 10 eggs/live birth • Women Age 38-40 years young 15 eggs/ live birth • Women Age 41-41 years young 50 eggs/live birth As a simplified rule, you will require anywhere between 8 to 10 eggs if you are younger than 37 years, and about 15 eggs per baby if you are 38 to 40 years of age.

How many eggs should I freeze?

How long can eggs stay frozen?

It is important to realize that not every egg frozen will give life to a newborn. The reproduction system is

If eggs behave just like embryos, and there is reason to believe they would, there is evidence that they can

last at least 20 years, if not more.

Corollary: Notwithstanding all the scientific advances of reproductive technology, there is indisputable evidence that the biological timer cannot be stopped and that the great majority of women in their forties who wish to have their own biological offspring will probably be disenchanted. Egg freezing can be a great alternative for women that are not ready, or able to start a family. It maximizes their chances of having their own biological child in the future. It is important to understand that egg freezing is a way to amplify hope rather than a guaranteed baby in the future.

Call to action: If you are 30 years or more and do not foresee to conceive a baby in the near future, consider egg freezing. (www.RMATX.com)

Figure 3 – Average age of mother at first birth

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ST CE R RT OK IFI E E D

Dive Safely Into Summer Summer is a great time for warm-weather activities like swimming, but it’s also the time for a little extra precaution. Diving is one of the most preventable causes of spinal cord injuries there is. Yet more than 1,800 spinal-cord accidents occur every year from diving.

When swimming this summer, think before you dive. Here are a few tips: • Always enter water feet first.

• Never dive head first into shallow water. More than 90 percent of diving accidents occur each year in 6 feet of water or less.

• Never dive into water that doesn’t have a clear bottom.

• Don’t dive into an above-ground pool.

• Carefully inspect home pools and hotel pools. Many – even those fitted with diving boards – are unsafe for diving.

• Obey “No Diving” signs.

• Don’t drink alcohol before or during swimming or diving.

It affects balance, coordination, and judgment.

CCRH.ERNESTHEALTH.COM

Follow Us

5726 Esplanade Drive • Corpus Christi, TX 78414 • ph: 361.906.3700

O

nce in a while, you encounter talented physicians who also happen to be extraordinary people who give back to the community in so many ways. After meeting with Austin, Texasbased plastic surgeon Dr. Jennifer Walden, it was easy to relate to her philosophies in the medical field as well as her outlook on life.

When I first learned about Dr. Walden two months ago, she was a finalist for the Woman’s Way Business Award in the Health and Wellness category. This year, finalists were chosen from over 150 nominees across the city.

Ultimately, only 3 finalists in each category proceeded to the next round of evaluation.

She told me, “It was particularly gratifying for me, as I have built my practice with an all-female team and my client base is mostly women. I love running a company built on the passion and can-do attitude of women helping other women look and feel their best,” explains Dr. Walden.

“It is also great to live and work in Austin since the city has traditionally been supportive of female-owned business. It is growing by leaps and bounds with active (and aging) people in the workforce who want cosmetic services, so the practice is economically sound as well.”

Dr. Walden is an aesthetic plastic surgeon and she recently expanded the nonsurgical part of her practice, The MedSpa at Walden Cosmetic Surgery

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Dr. Jennifer Walden EMPOWERING WOMEN ON PERSONAL AND PROFESSIONAL LEVELS By: Jody Joseph Marmel

and Laser Center, into a new physical location adjacent to the office that houses her surgical practice. She performs surgery of the face, breast, nose, genitals, and entire body within the privacy of her fully-accredited office operating room. Some cosmetic surgery is improving upon the results of previously performed reconstructive surgery of the breast and cosmetic surgery of the body, nose and face. “I often perform secondary or revisional cosmetic surgery. I also pay homage to culture, race, ethnicity, and genes when I perform a procedure on someone.

Being one of only a handful of female board certified plastic surgeons who is formally trained in aesthetic plastic surgery in Texas makes for an interesting career. Although around 92 percent of all cosmetic surgery patients are women, the field of plastic surgery is heavily male dominated. Dr. Walden adds, “My patients often tell me that they appreciate that I help them look like they themselves want to look. I listen to them in the process so that they’re a partner in the decision-making. I think this can be validating to them, and in a sense empower us both.”

Strong Women Supporting Strong Women While it is quite unique to have an all-female team in the practice of surgery, Dr. Walden and her staff of 16 women are able to provide a comfortable, supportive, nonjudgmental environment and years of experience in helping patients achieve the look they desire. “Each one of my staff members is a vital part of the team, which is necessary to function smoothly and effectively, just as in a soccer or basketball team. Without them, I couldn’t do what I do inside and outside of the operating room.

They provide me with support when I am facing personal and professional challenges that I have to deal with and get through. And they will also just point me in the right direction at my office when five people all want me at the same time.” Dr. Walden’s MedSpa practice manager and lead injector/

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aesthetician Kristin Gunn describes the team as “Strong women supporting strong women.” It is apparent that the team philosophy extends to the patients as well.

When I asked Dr. Walden what inspires her, she told me, “I can relate to much of what was written in Sheryl Sandberg’s 2013 book, “Lean In: Women, Work and the Will to Lead.” A couple of things that really hit home for me were: Don’t take “no” for an answer. Women can, and should, have everything they want in life—personally and professionally.

They deserve a rewarding career and a loving family. They shouldn’t sacrifice one for the other. If you face

I STRIVE TO OFFER A COMFORTABLE, SUPPORTIVE ENVIRONMENT, COUPLED WITH YEARS OF TRAINING WITH THE BEST, AS WELL AS EXPERIENTIAL LEARNING THAT ALLOWS ME TO HELP PATIENTS ACHIEVE THE LOOK THEY ARE SEEKING.

an obstacle, try a little harder—or find another way to make it happen.

She added, “I remember reading a review of the book in The New York Times, and the writer’s description stuck with me. She wrote, ‘Leaning in can promote a virtuous circle: you assume you can juggle work and family, you step forward, you succeed professionally, and then you’re in a better position to ask for what you need and to make changes that could benefit others.’ Isn’t that the truth?”

Dr. Walden has been fortunate to have mentors throughout her life and career who encouraged her to

step up to the plate and become a leader. “Without them,” Dr. Walden emphasizes, “I wouldn’t be where I am today, and I feel it’s important to do the same for others.” While Dr. Walden is the boss and very handson in the company as the surgeon, the visionary, and a consistent driving force of the business over the years, she encourages a collaborative and communicative approach when it comes to maintaining and improving the operations of the practice.

“It is an ever-growing entity . . . a real living and breathing thing that requires constant attention and patience,” Walden states. “Wow— that sounds like having a baby,” she added laughingly.

For a long time, Dr. Walden’s practice was enough for her. Early on in her career, her priority was to become a plastic surgeon and marriage was low on her priority scale. At 38, once she established her practice, tests revealed conception would be difficult.

She then made what she feels is the best decision of her life “By choice, I gave birth as a single mother. This was probably the most challenging phase of my life.” After an extensive search for an anonymous sperm donor and failed attempts at conception through intrauterine inseminations, she eventually conceived through IVF and gave birth to twin boys, Houston and Rex. “They are my life’s greatest blessing.”

Getting a glimpse into Dr. Walden’s private life is important so that women can visualize a female who can run a practice and have a unique and fulfilling family life. She has a male au pair from Capetown, South Africa and he is in his second year with the family. He extended his stay since it was a good fit living with the family. “The boys love him,” Dr. Walden emphasizes, “He is a positive, fun, athletic and an intelligent man for them to be around.” He also helps with whatever chores in and out of the house need to be done. There are no strained PHOTOGRAPHS BY Rudy Ximenez

MDMONTHLY.COM

dynamics or issues of who does what, as there very likely may be when a woman with a highpowered career enlists her husband in taking on all of the domestic tasks that the woman usually does in a married relationship.

“It cuts through all of that quickly, and enables us to get our jobs done easily without any strained relations. It is crystal clear what each of our roles are, and there is no pressure for things to get done burdened by the typical American gender stereotypes of male and female household and childcare duties.”

Austin is renowned for its quality of life and its attractiveness as a place to live with a relatively low cost of living. “It’s a ‘green’ city,” Dr. Walden explains. “Its people are among the fittest in the nation. This makes recruiting for new employees relatively easy, and I get new patients from all over the country almost weekly.”

A Supportive and Comfortable Environment “I strive to offer a comfortable, supportive environment, coupled with years of training with the best, as well as experiential learning that allows me to help patients achieve the look they are seeking.” Dr. Walden adds, “I want my patients to make well-informed choices that are in their best interest and I won’t do surgery unless I can achieve the best results possible with informed consent regarding the potential risks and complications of a procedure.”

Born and Raised in Austin “A Rare Unicorn” Dr. Walden is a proud born-and-raised Austin native. The reason she moved her practice from New York City back home to Austin was to be close to family while raising her boys. But, there are a plethora of wonderful opportunities the Capitol City has to offer.

The Austin area is known for conditions that support great businesses. Our “creative class” culture is fed by our diversity, quality of life and focus on education. “Highly educated professionals from all over the world come to Austin to enjoy the Hill Country setting, innovative vibe and powerful job market. With Austin’s supportive and diverse community, businesses of all kinds can thrive here.”

Austin’s attractiveness as a place to live and work is a huge draw for companies looking to establish corporate and regional headquarters. The new medical school is a prestigious addition to the healthcare community.

Walden adds, “I recently flew home from a conference, and the

CEO of a major healthcare tech company that has many plastic surgeon and dermatologist clients, sat down and introduced himself to me. It was cool that he lives here in Austin and has grown his digital marketing company here as well, right down the road from me. He demonstrated his online services on his laptop as I told him he had me as a captive audience until we landed!”

Austin also has a strong technology infrastructure supported by a multitiered workforce. These conditions combine to create one of the strongest business environments in the United States. Dr. Walden’s alma mater, The University of Texas, and surrounding universities, as well as the high-tech industries, offer an innovative and largely educated workforce.

This is important since some cosmetic surgery patients think or hope that their plastic surgeon is a “magician.” “In fact, I am not. I can’t erase scars; I can’t make you look like a celebrity, and of course, I can’t create 100 percent symmetry or perfection.” She tells her patients that she wants them to look like themselves, and when all is said and done, just a refreshed or more rested version. For some patients, the best recommendation is to do nothing, and she is able to say and do that if a patient she consults with is not mentally or physically equipped for a surgical procedure.

Patient safety is also something Dr. Walden makes her priority. She does not want her patients to have any problems under her watch, or

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serves as a spokesperson and luminary (key opinion leader-KOL) to leading medical aesthetic companies such as Sciton Inc., Cynosure, Lumenis, SmartGraft, and Thermi Aesthetics. On a regular basis, Walden makes presentations at national conferences about laser techniques with facelifting, breast implant and fat grafting surgery, vaginal rejuvenation, and social media in the aesthetic industry.

complications that are preventable. She always thinks ‘how would I do things if this were my mother, my brother, or sister who was the patient on the operating room table?’

An Innovator in the Field Dr. Walden has a strong commitment to technology which in turn has helped her grow her MedSpa. She uses an industry-leading 3D imaging technology that can help a patient visualize their “look” after surgeries such as a breast lift, augmentation or rhinoplasty.

She is also the first medical professional within the Austin and Central Texas area to use both the diVa laser and ThermiVa radiofrequency for noninvasive vaginal rejuvenation, the SmartGraft device for single follicular unit hair transplantation, and she is the first plastic surgeon to use SculpSure for laser fat reduction. Dr. Walden

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Dr. Walden enjoys serving in leadership of The American Society for Aesthetic Plastic Surgery (ASAPS) and she is the Commissioner of Communications and a member of their Board of Directors. She spends much of her free time either with her twin boys or working on projects for this prestigious organization, that is the most respected group of board-certified aesthetic plastic surgeons in the world.

Dr. Walden is frequently asked to comment on health and beauty topics in print magazines and on local television. She is regularly asked to participate in local television network lifestyle segments such as “Beauty and Beyond” on KEYE TV-CBS Austin and says, “Another one that we are going to film more for this summer is KVUE TV-ABC’s ‘Looking Good and Living Well with Dr. Jennifer Walden.’ Austin is a big small town and it’s nice to know the people at each of the television networks here in town.”

Giving Back “I feel good when I give back to the community I was born and raised in. Austin is trying to keep up with its growth so I hope I can help in some small way,” Walden states.

In June of 2016, Dr. Walden was named runner-up for Austin’s Woman of the Year by the Austin Leukemia and Lymphoma Society. This campaign raised funds for research in blood cancers. “I raised the most money behind Amanda Bush, who fought in honor of Barbara Bush and raised a record-breaking amount on a national level. For the amount I raised, I was bestowed the honor of a research grant by the Leukemia and Lymphoma Society for advanced research into pediatric blood cancers.”

She is a member of the Guardian Angel Society, a philanthropic group of individuals who provide support to abused children served by Austin’s Center for Child Protection, and also supports the Junior League of Austin’s Food in Tummies (FIT) program, designed to provide weekend nourishment to elementary school children who qualify for free or reduced meals. She has also served on the local Executive Leadership Team of the American Heart Association’s Go Red for Women campaign in Austin to help bring awareness to female heart disease. With her twins entering first grade soon in a top Texas public school district, she has most recently became a sponsor for Forest Trails Elementary School and the Eanes Education Foundation to help fund teachers.

I learned, once I researched and interviewed her, that Dr. Jennifer Walden is quite a successful doctor and is known throughout the country for her expertise, skills and advice.

She is also a wonderful mother and juggles the two parts of her life on a daily basis. “I place my boys first and work hard so that they will be taken care of no matter what happens. Being a single mom who is by definition always ‘on call’ for my patients has at times meant staying at home instead of going out with friends or traveling.

But, I chose this and I wouldn’t trade it for anything else.”

Visit www.drjenniferwalden.com or call (512) 328-4100 to learn more.

PHOTOGRAPHS BY Rudy Ximenez

MDMONTHLY.COM

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INFORMED PATIENT/SAN ANTONIO

GIVE YOUR CHILD

THE ADVANTAGE

THEY DESERVE By: Amy B. Jackson D.D.S., M.S.

T

hink back to the last time you didn’t get a full night's sleep. How did it affect your concentration? Your reaction time? Your mood? Now imagine you are four to nine years of age, with that same lack of sleep only you’re expected to sit in a classroom, listen to your teacher, and retain information all day long. This is exactly what is happening to millions of children on a daily basis. Multiple studies show that a lack of quality sleep in children can lead to deficient growth, hyperactivity, low motivation, poor behavior, trouble following directions, inability to concentrate, delayed 44

MD Monthly

processing and altered brain function.

In my opinion, the best natural advantage you can give your child is good quality sleep with a maximum amount of oxygen flow and uptake.

The Problem: Sleep Disordered Breathing (SDB) is a condition characterized by repeated episodes of sleep related breathing abnormalities including but not limited to, hypopnea (underbreathing), apnea (not breathing), snoring, upper airway resistance, sleep apnea and obstructive sleep apnea. Most adults are familiar with snoring and cessation of breath in the

night, but did you know that the same conditions could be affecting the children in your family?

Did you know?

• A Preschooler (Ages 3-5 years) should be getting between ten and thirteen hours of sleep.

• Your child should sleep with their mouth closed and breath through their nose.

• Tooth Grinding is frequently related to SDB. • The slightest sound from your child in the night, often described as a purring can be considered pediatric snoring.

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INFORMED PATIENT/SAN ANTONIO

• A child with a lack of adequate sleep often has a forward head posture, and may have a long face with venous pooling under the eyes.

• A child with a lack of sleep may be overactive, act out and have difficulty following directions and is often confused with having an attention deficit disorder.

• Sleeping with the tongue on the roof of the mouth is critical for proper cranial and airway development.

• If a child’s father snores his children are prone to have sleep disordered breathing.

What can you do about it?

• Pay attention to your child’s sleeping patterns, watch and listen for abnormal sounds, snores or gasps for air.

• If you are suspicious of SDB,

take a video of your child sleeping at night and view it with a professional.

• Take a Sleep Questionnaire** and review the answers with a trusted dentist or physician.

• Use available resources to you such as: The Oxygen Advantage by Patrick McKeown, Johns Hopkins Pediatric Sleep Center website.

is the best natural advantage you can give your child mentally and physically. **Obtain a free Sleep Questionnaire at southtexasorthodontics.com

Conclusion Sleep disordered breathing afflicts a large number of children. The problem is often multifactorial and the most effective treatment involves cooperation between parents, physicians and dentists. An exam and sleep screening are complimentary in most Orthodontic Offices, and one the most effective and least invasive treatments is prevention through airway development. A healthy night's sleep, and a well-developed airway, 2017 - JULY MD Monthly

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FEATURE STORY/SAN ANTONIO

HELPS KEEP MEDICAL PROFESSIONALS

ON THE GO By: Rudy Arispe

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PHOTOGRAPHS BY Marc Arevalo

MDMONTHLY.COM

FEATURE STORY/SAN ANTONIO

O

n any given day, when you walk into North Park Lexus at Dominion, expect to see a number of medical professionals in their scrubs. That’s because they’re there to have their vehicles serviced in a timely manner that allows them to get back to their patients.

“We know how busy medical professionals are, and they don’t have a lot of time to wait to have their cars serviced, which is why we offer same day service,” said Jesus Rodriguez, General Manager of North Park Lexus at Dominion. “We keep people on the road with more than 100 loaner cars, as well as pickup and delivery service.”

When North Park Lexus at Dominion opened its doors in 2014, it did so with the intention of providing drivers with more than stunning luxury cars, but an exceptional shopping experience, as well. Early efforts to provide San Antonio drivers with a luxurious dealership experience have been successful, as North Park Lexus at Dominion has earned an Elite of Lexus award for its inaugural year, joining a select group of the county's most remarkable dealerships.

The San Antonio Lexus dealership took home this coveted national honor for its overall excellence in customer service throughout the 2016 calendar year. This is the second consecutive Elite of Lexus win for North Park Lexus at Dominion, which first opened its doors in 2014. By earning Elite of Lexus recognition for every full year that it has been in business, North Park Lexus at Dominion has proven its dedication to offering customers an exceptional experience.

To be named an Elite of Lexus winner, a Lexus dealership must earn stellar ratings and reviews 2017 - JULY MD Monthly

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FEATURE STORY/SAN ANTONIO

from its customers. The award only goes to those dealerships that have achieved the highest levels of customer satisfaction through every transaction. Customer feedback comes from surveys rating owner satisfaction, sales processes and service visits. Those who earn this coveted award are considered in a unique class all their own. North Park Lexus at Dominion remains the newest Lexus dealership in Texas to earn this accolade.

“To earn an award as prestigious as Elite of Lexus for the second year in a row is an incredible honor, and the fact that we've achieved this distinction for every full year we've been in business is simply outstanding," said John Kahlig, General Sales Manager. "Our resortstyle Lexus dealership prides itself on the unique experience it offers

local San Antonio clientele, all with the intention of building lasting relationships within the community.

We could never have earned this award again without our customers' relentless support.”

It’s customers like Hal and Sandra Shrewsbury, whose satisfaction helped North Park Lexus win the industry award. The couple recently purchased a new Lexus RX350 and wrote to Jesus Rodriguez about their experience.

“We were truly treated as welcome guests and enjoyed the easy and fast ‘bottom-line’ pricing we were given, especially since we hadn’t initially gone into the dealership to look at a new car,” Sandra said. “We still had six months remaining on our current Lexus lease.

Our entire experience was wonderful

and we found everyone at Lexus Dominion, from our sales consultant to the finance manager and service team, to have the most delightful demeanor, flexibility, good humor and product knowledge that made leasing a new Lexus easy and enjoyable.”

Customers of North Park Lexus at Dominion will engage in a one-ofa-kind luxury car-buying or servicing experience. The 72,000-square foot facility was custom-built to offer similar amenities to those found in a resort. The San Antonio Lexus dealership offers a cozy space with eight fireplaces, quiet areas for reading and meditation and a beverage and snack bar, as well as extra services including a private massage room and nail salon. This is all in addition to the dealership's comprehensive selection of new and L/Certified Lexus models, stateof-the-art service facility and fullystocked Lexus parts department.

Since opening its doors in 2014, the North Park Lexus at Dominion's goal has been to provide its customers a home away from home.

As a member of the prestigious Kahlig Auto Group, North Park Lexus at Dominion brings Texas drivers more than 15 years of customer service experience. The South Texas Lexus dealership combines a vast selection of the finest new and pre-owned Lexus models with a top-notch service center to ensure excellence throughout the ownership experience.

For more information, visit www. northparklexusatdominion.com or on Facebook at www.facebook.com/ NorthParkLexusatDominion. You can also call their sales team at (210) 8166000 or visit the dealership at 21531 Interstate 10 Frontage Road.

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PHOTOGRAPHS BY Marc Arevalo

MDMONTHLY.COM

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INFORMED PATIENT/RIO GRANDE VALLEY

The Naked Truth About Sciatica:

What’s really going on.

By: Fortino Gonzalez, PT, Dip MDT, FAAOMPT, OCS

E

veryone knows at least one person who is dealing with or has dealt with an episode of sciatica.

Sciatica is a medical condition characterized by pain, numbness, tingling and/ or weakness that may go down into one or both lower extremities below your knee that may or may not produce lower back or buttock pain. If you think this definition is confusing, try doing a Google search, or better yet, go and see a medical professional that treats sciatica. If you see 10 different clinicians, you may get 10 different opinions. Let’s strip it down to help make better sense of the condition that affects up to 40% of North Americans at least once in their lifetime. Most of these cases 50

MD Monthly

will resolve spontaneously over the course of six to eight weeks no matter what you do. However, the reoccurrence rate can be as high as 88 percent, and with each reoccurrence the episode is typically more debilitating, symptoms are more intense, and they travel further down into the leg and take longer to resolve.

Sciatica Defined: Sciatica is often referred to as a lumbar radiculopathy by many practitioners, which in essence implies that a nerve root from your lower spine is being compressed, causing symptoms into a specific nerve distribution pattern known as a dermatome. The most common analogy I use when explaining this

to patients is the “funny bone” experience. If you compress your “funny bone” which is actually your ulnar nerve with enough force, you will experience symptoms and/or pain along the path of that same nerve. Compress your “funny bone” with enough force, and your fourth and fifth digits will quickly let you know. So, put simply, sciatica is caused by abnormal compression of a nerve that runs into your lower extremity. That being said, the solution to this problem lies in finding a way to take the pressure off the nerve. Symptoms or pain will be influenced by position, posture, and/ or movement. If certain positions or movements increase your pain, then there should be certain positions or movements that will in turn decrease

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INFORMED PATIENT/RIO GRANDE VALLEY

or abolish your symptoms/pain.

About 90 to 95 percent of sciatica cases are caused by a disc pressing on one or more lumbar or sacral nerve roots. The remaining 5 to 10 percent of these cases can be caused by spinal stenosis (bone spurs, spondylolisthesis, or inflammation), “piriformis syndrome”, or pregnancy with less than one tenth of one percent of cases being attributed to spinal tumors. In a few cases if the nerve is compressed with enough force over a prolonged period of time, the patient may experience lower extremity weakness (foot drop) or bladder dysfunction (bladder retention) and/or loss of anal sphincter control causing bowel dysfunction (cauda equina syndrome); all of which require immediate medical care by your physician. About 66 percent of the time, patients report an insidious

onset, meaning that there was not a one-time incident that caused their symptoms/pain. In these cases, we must take a hard look at what that patient is doing throughout their day helping them identify potential sources, and contrary to popular belief, seldom is it the bed.

The Treatment: The vast majority of sciatica cases are influenced by position, posture, and/or movement; thus, it should be evaluated with this in mind. Simply put, if you treat the symptom, in this case the leg pain, you will be “chasing your tail” in hopes that the problem will resolve itself. The stretching of a compressed nerve root is highly discouraged as this can often make the nerve root more angry and irritated, which could lead to further problems. It is well

documented that sciatica needs movement; however, the question becomes do you want to be specific with your movement (Mechanical Diagnosis and Therapy Assessment guided by the evidence) or general (try the “sciatica exercises” that your well meaning friend or practitioner gave you)?

Fortino Gonzalez is a physical therapist, Diplomat of the McKenzie Institute, Certified in Mechanical Diagnosis and Therapy (Dip MDT), Fellow of The American Academy of Orthopedic Manual Physical Therapists (FAAOMPT), and a Board Certified Orthopedic Clinical Specialist in Physical Therapy (OCS) serving the Rio Grande Valley from his practice, McAllen Physical Therapy. To learn more, visit www.fortinogonzalezpt. com or call (956) 661-1964

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WOMEN’S HOSPITAL

AT RENAISSANCE BRINGS HOPE TO PREEMIES, PARENTS By: Edmond Ortiz

T

he Women’s Hospital at Renaissance in Edinburg, Texas, was established in 2007 as part of Doctors Hospital at Renaissance Health System.

Drs. Emil Milano, Dynio Honrubia, and Jyothi Swarup are partner physicians in the facility’s neonatal intensive care unit (NICU). Dr. Milano and Dr. Honrubia have been with the Women’s Hospital at Renaissance (WHR) since its inception. Dr. Honrubia is the medical director and director of the High-Risk Infant FollowUp Program.

Collectively, all three have overseen the delivery of tens of thousands of children, including those born prematurely.

The WHR NICU, a member of the Vermont Oxford Network quality improvement database, has tracked every baby admitted to its NICU over the last 10 years. Constant quality improvement measures have led to better outcomes and improved the odds of parents bringing home a healthy baby, especially a preemie, in the Rio Grande Valley.

Historically, all community NICU’s in the United States lacked subspecialists and comprehensive infrastructure that are critical for supporting particularly high-risk infants in the vital first few hours and days of their lives.

The Women’s Hospital at Renaissance has worked to solve that problem locally: providing state of the art technology and subspecialized neonatal nursing and medical care. Previously, many patients who had high risk pregnancies and threatened with extreme premature labor would leave the Valley to deliver in San Antonio or Houston.

The Women’s Hospital at Renaissance changed that, not only in the provision of compassionate, all-around care, but also changing the perception within the community that high acuity neonatal care was best provided outside of the Valley.

“I came to the Valley, in particular, to care for underserved families. Families who could not afford to travel far distances for their medical care,” Honrubia said of parents who may not have had the resources to transfer to another facility.

A Los Angeles native, Honrubia earned his medical degree from the David Geffen School of Medicine at UCLA, performed residency training at UCLA/Cedars-Sinai Medical Center, and completed his Neonatal-Perinatal Medicine fellowship at Harvard Medical School and Boston Children’s Hospital.

EVERYTHING WE DO HERE IS DONE AS A TEAM AND WITH GREAT PRIDE. -Dr. Emil Milano

Dr. Honrubia’s decision to become a physician began after he volunteered at the Venice Family Clinic’s homeless pediatric clinic, providing care to homeless families. Honrubia was struck by the resiliency and strength of children who lacked a roof over their head.

“The free clinic experience was extraordinary. Homeless children and homeless moms were bright, caring, very underserved; absolutely 2017 - JULY MD Monthly

53

subspecialists moving here to work at Women’s Hospital at Renaissance,” Milano said.

The subspecialists focus on a variety of conditions and afflictions.

beautiful to help care for,” he said.

Honrubia practiced neonatology long before he arrived in South Texas to join his brother, Dr Vincent Honrubia, an Otorhinolaryngologist in McAllen.

Dr. Honrubia believed that, despite the area’s quite comprehensive and well ran NICUs, expectant parents were missing outcomes-driven clinical care. “A NICU that was technologically state of the art, outcomes-driven using networks like Vermont Oxford, and evidencedbased needed to be built for the Valley residents,” he stated.

“Families that needed higher levels of care prompted many transfers to another city,” added Milano, a Weslaco native who earned his medical degree from Universidad de Monterrey in Monterrey, Mexico.

Milano has practiced medicine for more than 20 years, with much time spent in the Corpus Christi area.

As physicians such as Honrubia and Milano arrived in Edinburg, there was an influx of subspecialists and other support staff who could give crucial, comprehensive neonatal care.

“I think that (public) trust was gained mostly because of the

WHEN YOU SEE BRIGHT, BEAUTIFUL KIDS, IT MAKES US FEEL LIKE WE’RE MAKING A BIG DIFFERENCE. -Dr. Jyothi Swarup

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Milano, Honrubia, Swarup and their colleagues have also developed a self-sustaining system of support for not only the subspecialists in the NICU but for the nurses, finetuning and expanding their neonatal care skill set.

“We came here to the NICU and built it from nothing,” Milano said of the opening of WHR. “Some of the NICU staff was trained up from ground zero.”

Swarup said. “It’s an extremely wonderful thing to see them stay together.”

In addition to an increase in skilled, experienced professionals and advanced technologies, research and collaboration have helped to make the NICU at the Women’s Hospital at Renaissance unique.

The Women’s Hospital at Renaissance is a member of the Vermont Oxford Network, a nonprofit health care exchange that administers one of the biggest neonatal databases in the world.

It contains outcomes for high-risk infants from more than 850 NICUs worldwide, with more than half of those in the United States.

“Each year we submit our morbidity and mortality data to the network,” Milano said. The data includes outcomes primarily of preterm infants admitted to the NICU.

“It’s an extraordinary place and it’s not just physicians. It’s the nurses, housekeepers, lab techs - everybody makes the place work,” said Honrubia. “The hospital deserves a lot of credit. They’ve been truly supportive of the mission.”

The Women’s Hospital at Renaissance NICU data is compared with that from other neonatal intensive care facilities of similar size and acuity classification. The outcomes at the WHR neonatal intensive care unit are at the top ten percent of Vermont Oxford’s Network for most of the indices reported, Milano said.

Ten years since the Women’s Hospital at Renaissance opened, neonatal care for Rio Grande Valley expectant mothers has “evolved into outstanding, comprehensive perinatal care,” added Milano. “And it’s something the community, over time, comes to appreciate what you’ve built.”

Milano explained that the shared data can show where the Women’s Hospital NICU can improve, or where the facility is highly successful and how that can be possibly applied to other facilities.

“It’s certainly a place where the outcomes speak for themselves. It’s certainly a safe place for any baby to be born,” Honrubia added.

A native of India, Swarup says the outcomes for mothers and newborns treated at the Women’s Hospital at Renaissance are as good as, if not better than, those at many university or children’s hospitals across the country.

The Women’s Hospital at Renaissance NICU is also able to provide key comprehensive treatment to expectant parents who would be unable to transfer to other medical facilities due to their lack of citizen documentation.

“The last thing you want to do is separate a newborn from their mother,” PHOTOGRAPHS BY Gerardo Garmendia, DHR

MDMONTHLY.COM

WE’RE NOT JUST PRACTICING MEDICINE, WE’RE PUSHING THE ENVELOPE OF MEDICINE. -Dr. Dynio Honrubia “Our outcomes are great. Mortality rate for low birthweight babies is 3 percent to 5 percent a year,” Honrubia said, adding that the same annual rate is higher at similar facilities in the network.

Honrubia said the morbidity rate is also low in several categories at the Women’s Hospital at Renaissance.

“We’ve had no deafness or blindness because of premature birth, for example,” he said.

The NICU is currently classified as Level IIIC, meaning it is able to care for the most complex and critically sick patients, thanks to immediate, on-site presence of pediatric medical subspecialty professionals.

The Women’s Hospital at Renaissance NICU, like a few other Level IIIC facilities nationwide, is working towards a Level IV designation and is awaiting formal certification.

Level IV facilities have a full gamut of pediatric medical and surgical subspecialities in addition to on-site pediatric anesthesiologists. Neurosurgery is available, but not open heart surgery.

Level IV NICUs can also provide transport and educational outreach.

According to Milano, being this prepared absolutely makes a difference in the care for a preemie.

“One of the most common problems seen in many premature infants can be some form of respiratory distress,” Milano said, adding that the NICU team of neonatal nurses, neonatal nurse practitioners, respiratory therapists and neonatologists is prepared to assess and manage this condition each and every day.

The high incidences of maternal diabetes and hypertension are two other health conditions prevalent in the Rio Grande Valley that pose a challenge when caring for the mother and also the subsequent provision of perinatal and neonatal care. Milano said he treated many infants born to diabetic and hypertensive mothers outside the Rio Grande Valley, but these health problems are much more prevalent and pronounced here. These maternal medical conditions can have a serious impact on not only the mother but also on the unborn fetus and thereafter the neonate.

to bond with the child in the hospital, and to foster neurodevelopment. The WHR NICU recently opened a 5,000 book library in honor of one of its former patients. The books were donated by community members at the behest of the child’s mother.

Out of the more than 8,000 to 10, 000 babies delivered each year at the Women’s Hospital at Renaissance, fewer than 50 are transferred out for conditions not yet treatable in the Valley. That’s how solid the hospital and the NICU have been performing.

The physicians leading the NICU at the Women’s Hospital at Renaissance said their hard work is worthwhile upon seeing their patients happy leaving for home.

The Women’s Hospital at Renaissance is the only facility in the region that carefully tracks its former NICU patients, and tracks their progress at specific times of their life up until four years of age (through a NICU High Risk Follow-Up Program).

The Women’s Hospital at Renaissance also furthers research. They are involved in ongoing studies, such as those related to maternal steroids and improving nutrition of low birthweight babies. WHR plans to participate in the development of a vaccine against RSV (Respiratory Syncytial Virus), an illness that impacts the respiratory tract of most children before their second birthday, which can be extremely harmful to an infant born prematurely.

Upon being discharged, the parents and their newborn(s) can take a book back home.

“Many of our mothers come from underserved areas. So, we’re now filling their homes with books,” said Honrubia.

“When you see bright, beautiful kids, it makes us feel like we’re making a big difference,” said Swarup.

Many of the children and mothers treated at the NICU return to the hospital for an annual celebration of life, reuniting with their doctors, nurses and multiple other staff members who did everything to make their stay a memorable one, with the best possible outcome. “Everything we do here is done as a team and with great pride,” Milano added.

The reunions, the feedback given by parents, and the young children going on to lead full lives is all rewarding to Milano, Honrubia, Swarup and their colleagues.

“Everything we do here is done as a team and our outcomes are shared with all the families.” Milano concluded.

The Women’s Hospital at Renaissance is taking part in a pilot project looking into how the drug Avastin could help treat retinopathy of prematurity.

“We’re not just practicing medicine, we’re pushing the envelope of medicine,” Honrubia said.

The Women’s Hospital at Renaissance gives back to the community in a different way, too. It has a neonatal reading program where new mothers read a book to their newborn 2017 - JULY MD Monthly

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9480 Huebner Road, Suite 400 | San Antonio, TX 78240 210.697.3900 | practicalapproachpediatrics.com

Pediatric Urgent Care San Antonio’s only Pediatric Medical and Pediatric Dental Urgent Care! Our practitioners at Practical Approach are fully trained to handle pediatric emergencies.

Your child’s safety is very important to us and we take great pride in ensuring the quality of our pediatric emergency services!

Specializing In:

Anthony Owusu M.D. Orthopedic Spine Surgeon

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Non-Surgical Intervention

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Artificial Disc

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Minimally Invasive Surgery

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Degenerative Disc Disease

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Sacroiliac Joint Fusion

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Spinal Stenosis

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Cervical and Lumbar Fusion • • Spinal Decompressions

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Robotic Surgery

Sciatica Back and Neck Pain

13409 NW Military Hwy | San Antonio, TX 78231 nxgosi.com | 210.251.2010

A BLEND OF AMERICAN, FRENCH & ITALIAN CUISINE

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THREE PRIVATE ROOMS

24116 IH-10 WEST SAN ANTONIO, TX 78257 LEONSPRINGSGRILL.COM | 210.698.8797

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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

LOSE WEIGHT, NOT HOPE GOOD-BYE DIABETES GOOD-BYE SLEEP APNEA HELLO WEIGHT LOSS

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.

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Diabetes cured in 80% of patients and resolved or improved in 90% of patients.

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Hypertension is cured in 62% of patients and resolved or improved in 78.5%

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Obstructive sleep apnea is cured in 86% of patients

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Risk of death is decreased by 89%

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Weight Loss Surgery (WLS) can enhance fertility and lead to successful full term pregnancies

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Average weight loss is 50-70% of excess body weight

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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.

Nilesh A. Patel, MD, FACS

Subhash Reddy, MD

Leah A. Dill, D.O.

BypassDoc.com | 877.459.7065 San Antonio | Austin | Corpus Christi | San Angelo Kileen | New Braunfels | Del Rio | Laredo

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