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The Doctors Roundtable

Health

Diabetes and Eye Disease

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November is Diabetes Awareness month. Did you know that diabetic retinopathy is the leading cause of new, irreversible blindness in adults from industrialized nations for people aged 20-74? Globally, 93 million people suffer from Diabetic Retinopathy alone. Four primary eye diseases are linked to diabetes: cataracts, glaucoma, macular edema and the most common- diabetic retinopathy. Duration of diabetes, poor glycemic control and hypertension are the highest risk factors for diabetic eye disease. Diabetes affects the eye in specific ways.

First, high blood sugar can cause swelling in the lens of the eye. This can be a temporary condition. Over time, diabetes damages the tiny blood vessels in the retina and can cause blind spots, blurred and double vision, “flashing lights”, floating spots and decreased vision. Visual acuity can also fluctuate. Decreased vision, however affects daily living. There are four stages of Diabetic Retinopathy and eye exams for diabetics include more specialized test than a routine annual comprehensive eye exam. There are no treatments available to restore lost vision. However, there are treatments that can minimize further damage and aid in coping with the damage including: lasers, medicine, surgery and vision-related rehabilitation.

In this segment and as part of Diabetes Awareness Month, Dr. Janelle Davison, a local optometrist that specializes in clinically complex eye care will provide a general overview of how diabetes affects the eye, diabetic eye diseases, treatments and preventive strategies for diabetic patients to maintain their vision. Listeners can visit: www.brillianteyesmarietta.com, www.visionaware.org or www.diabetes.org for more information.

 

Dr. Janelle Davison

  • BS in Biology from Xavier University in LA
  • Doctor of Optometry from Pennsylvania College of Optometry
  • Specialist in clinically complex eye disease
  • Currently in private practice at Brilliant Eye Vision Center in Marietta, GA

 

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Alzheimer’s Disease

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November is National Alzheimer’s Disease Awareness month and unfortunately, the US ranks first in the increasing number of deaths associated with neurological disease, including Alzheimer’s Disease (dementia). Today, over 5.4M Americans suffer from some degree of Alzheimer’s and this number is expected to double between now and 2030. Did you know that Alzheimer’s affects twice as many patients as heart disease and three times as many patients as cancer in the US? Estimated annual expenditures for 2010 for Alzheimer related treatments were $200B. Yet- this disease, for which there is no cure or proven treatments to delay or stop the disease is almost absent from mainstream media-perhaps because there are not many profitable remedies.

Alzheimer’s is a neurological disease that disrupts the way electricity passes through our brain and also affects the activity of neurotransmitters in the brain. Over time, the brain, quite literally, shrinks due to nerve cell death. Risk factors for Alzheimer’s include: age, family history, genetics, head trauma and some lifestyle factors. The primary symptoms for Alzheimer’s is memory loss that disrupts daily life (this is different than normal aging memory changes). Diagnosis is made through a complete medical assessment that may include a physical exam, neurological tests, mental status tests, blood work and brain imaging. There are several stages of Alzheimer’s and patients do not all progress at the same rate. There is no cure for Alzheimer’s Disease and no treatments that have proven to delay or stop the progression. Treatments focus on symptom management for sleep disturbances and memory loss.

Most distressing to families of patients with Alzheimer’s are behavior changes such as irritability, depression, anxiety, sleep changes, verbal outbursts and delusions. There are also many “myths” surrounding Alzheimer’s like- do flu shots, aluminum or Aspartame lead to the development of Alzheimer’s? Can only older people get Alzheimer’s?

In this segment, Dr. Monica Parker, a board certified family medicine physician and gerontology specialist and Ms. Suzette Binford, the Program Director of the Atlanta Chapter of the Alzheimer Foundation, will provide a general overview of Alzheimer’s Disease and some tips on “life after a diagnosis of Alzheimer’s Disease. Listeners can visit: www.emoryhealthcare.com and www.alzfdn.org for more information.

 

Dr. Monica Parker

  • MD obtained from University of Nebraska
  • Residency completed at University of Mississippi
  • Board-Certified in Family Medicine, Gerontologist
  • Assistant Professor, Dept. of Medicine, Div. of Geriatric Medicine at Emory University

 

Suzette Binford

  • Master’s Degree in Clinical Counseling from The Citadel
  • Program Director, Alzheimer’s Foundation, ATL Chapter

 

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An Overview of Male Infertility

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The male role in contraception has been thought of as relatively simple, when in fact, it is actually quite complicated. The Mayo Clinic estimates that 15% of couples are infertile (frequent , unprotected sex of childbearing age with no pregnancy in one year). Research estimates show that 7.5-10% of all males of reproductive age are infertile. Male infertility is a major cause of no conception in 50% of childless couples. Male infertility can be defined as abnormalities in sperm production, maturity or delivery that impedes the establishment of pregnancy.

The male reproductive cycle involves testosterone secretion that is the common link between the pituitary gland and the testes. To achieve a pregnancy from the male component the following is needed: 1) healthy sperm 2) enough sperm is carried to the semen 3) the sperm is correctly shaped for motility and 4) no ejaculation problems. Causes for male infertility include varioceles (swelling of veins that drain the testes-42%), obstruction, infection, chromosome abnormalities, hormone imbalances, tumors, ejaculation problems, anti-sperm antibodies, sperm duct defects, some chronic diseases, environmental causes (exposures) and lifestyle causes (weight, stress, smoking and drug use). Male infertility evaluation often includes a semen analysis, an extensive medical history, a physical exam, lab testing and ultrasound examination.

Treatment of male infertility usually focuses on correction of the underlying problem or using treatments to help with the infertility. Possible treatments include: surgery, medications and assisted reproductive technologies such as sperm retrieval, sperm donation and cryopreservation. The process of identifying and treating male infertility can be stressful for the individual and couple. Costs can be high and this treatment is typically not covered by health insurance. The outcome is often unknown for some time period and stress can be high. There are many coping strategies and support groups for psychosocial support.

In this segment, Dr. Michael Witt, a board certified urologist and male infertility specialist (one of the few in the southeast) will discuss the a general overview of male infertility. Listeners can visit: www.rba-online.com and www.resolve.org for more information.

 

Dr. Michael Witt

  • MD obtained from Oregon Health Science University
  • Completed residency in urology at Boston University Hospital
  • Fellowship in male infertility completed at Baylor College of Medicine in TX
  • Board-certified in urology
  • Featured on CNN, The Learning Channel, named one of Atlanta’s Top Doctors
  • Now in private practice at Reproductive Biology Associates in Atlanta

 

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Pediatric Food Allergies

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Approximately 15 million people have food allergies and about 6 million of them are children. Food allergy occurs when the body’s immune system identifies a specific food as a foreign substance and produces an allergy antibody (IgE) to respond to the substance. Compounding this response is the fact that the most common foods people are allergic to, such as peanut, wheat, soy, eggs are frequently in our diet! Food allergies can be mild to severe and in rare cases, life threatening if they stimulate an anaphylactic reaction.

There are two types of food allergies: fixed (immediate response) and cyclic (delayed). Signs and symptoms of food allergies include: itching in mouth, swelling, GI symptoms (vomiting and diarrhea), hives, tightness in the throat and difficulty breathing. Food allergies should be distinguished from intolerances and sensitivities to food (non immune reactions). Diagnosis may involve: extensive history, nutrition evaluation, lab testing, food challenges, elimination diets and skin testing. Food allergies can also be connected to other allergies. There is no known curative treatment for food allergies at present but treatment involves: strict elimination, education (food labels, meal prep, high risk situation avoidance), emergency planning and availability of emergency medications. There is promising new research in this field- sublingual immunotherapy.

In this segment, Dr. Lakshmi Reddy, a local Atlanta physician that is board certified in adult and pediatric allergy, immunology and asthma will discuss the basics of pediatric food allergy signs/symptoms, diagnosis and treatment. Listeners can visit: www.reddyallergy.com and www.aaaai.org for more information.

Dr. Lakshmi Reddy

  • Medical School at Meharry Medical College
  • Residency completed at Washington University in St. Louis
  • Fellowship in Allergy and Immunology at Medical College of GA
  • Board certified in allergy, immunology and asthma
  • In private practice in Johns Creek, GA

 

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Obstructive Sleep Apnea

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A great night’s sleep not only makes us feel great and rested, it improves our health. For some, this is easier said than done! Over 18 million Americans suffer from Obstructive Sleep Apnea (OSA). This is a serious condition in which the the airway collapses or becomes obstructed during sleep causing shallow breathing or breathing pauses which can last from a few seconds to a over a minute. These episodes can be severe , occurring several times per hour. Blood oxygen levels drop can drop during these episodes. Over time, OSA has been linked to high blood pressure, heart disease, stroke, depression and accidents while driving. What used to be considered a nuisance can sometimes be not only a quality of life but quantity of life issue.

OSA is the leading cause of daytime sleepiness. Although anyone at any age can exhibit symptoms and be diagnosed with OSA, men seem more likely than women to have this condition. Risk factors include obesity and a family history of OSA. Occasionally, other medical conditions can affect OSA as well, such as congestive heart failure and neuromuscular disorders. Symptoms include loud and chronic snoring, headaches, memory problems, depression, irritability, dry mouth and sore throat. Treatments include Continuous Positive Airway Pressure (CPAP) and other devices and at times, surgical intervention.

In this segment, Dr. Scott Leibowitz, a board certified internal medicine physician and current President of the GA Association of Sleep Professionals will discuss OSA, good sleep hygiene, diagnosis and treatments for OSA and what’s new in this sleep apnea field. Listeners can visit: www.laureatemed.com and www.aasmnet.org for more information.

 

Dr. Scott Leibowitz

  • Residency in Internal Medicine completed at Colorado Health Science Center
  • Clinical research and fellowship in Sleep Medicine at Stanford
  • Author and frequent lecturer on sleep medicine
  • Current President of GA Association of Sleep Professionals
  • Now board certified physician in private practice with Laureate Medical Group

 

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Chiropractic Care: Not Just for Pain!

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Over 20 million Americans will seek chiropractic care this year! Chiropractic care has been around for over 100 years and involves care of the musculoskeletal and nervous system through use of a hands on, drug free, non-invasive and natural approach. Chiropractors have broad diagnostic skills. This type of care has been increasingly covered by health insurance plans in the US and is appropriate for all ages. Typically, patients turn to chiropractic care seeking relief from back pain, neck pain, joint injuries and headaches. However, chiropractic care is appropriate for all ages and for many types of health conditions, both chronic and acute. Chiropractors use such modalities as heat, spinal manipulation (adjustments), nutrition, acupuncture, biofeedback, labs, imaging and exercise to achieve immediate relief and long lasting results.

This segment will discuss how this specialty can assist with many other types of health issues that the public may not associate chiropractic care with at first, such as: infant care (birth trauma recovery, growth promotion, colic, chronic ear infections), pre and post-natal pregnancy support (low back pain, pelvic support prior to delivery), carpal tunnel syndrome and acid reflux problems (hiatal hernia, GERD). Goals of this type of treatment include immediate and long term relief, decreased drug and surgical intervention and promotion of general health.

In this segment, Dr. Forrest Watts, a Doctor of Chiropractic in Cumming, GA will discuss how chiropractic can help many types of patients beyond neck and back pain. Dr. Watts has also received additional training in acupuncture and sports injuries. Listeners can visit: www.drforrestwatts.com and www.acatoday.org for more information.

 

Dr. Forrest Watts

  • Doctor of Chiropractic from Life University
  • Special training in sports injuries and acupunture
  • Certified to treat carpal tunnel problems
  • Private practice in Cumming, GA

 

Dr. Forrest Watts

Common and Lifesaving Blood Tests

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Annual blood screening and testing a single, powerful and cost effective tool for preventing disease. Blood tests reveal a snapshot of our health and often detect health problems before symptoms or disease. Regular monitoring, especially over time, can help patients focus on early intervention strategies and good health maintenance. Blood tests are cost effective compared to the costs of disease related healthcare and medication expenses. Physicians often order “routine” blood tests during and annual physical, but often neglect age related or non-obvious blood testing and they often do not focus on risk factors. Blood tests provide information about the function of our cardiovascular status, hormone function, kidney and liver function, our body chemistry and our endocrine system. By obtaining blood samples and evaluating the results, patients can screen for cancers, learn about the degree of inflammation in their bodies, measure our risk factors for certain diseases and help us improve our health and longevity by catching critical changes and showing us where to focus for optimal health maintenance.

In this segment, board-certified urologist, certified medical review officer and owner of Any Lab Test Now, Dr. David Perlow will educate the listeners on top, common annual blood tests that can save lives and help us keep focused on disease prevention. Listeners can visit: www.anytest.com for more information.

 

Dr. David Perlow

  • Medical training at University of Michigan
  • Board-certified in Urology
  • Certified Medical Review Officer
  • Private practice at Georgia Regional Urology and owner Any Lab Test Now!
  • Affiliated with Wellstar Cobb, Kennestone and Windy Hill

 

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Pituitary Disease

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The pituitary gland is often referred to as the “master gland” in the body. This lima bean sized gland at the base of the brain is part of the endocrine system and produces and regulates many hormones that affect glands such as growth hormone (regulates body structures and weight), thyroid stimulating hormone, prolactin ( affects milk production), sex hormones,and adrenal gland production (regulates water and electrolyte balance). Disorders of the pituitary gland can cause big and little problems- and these often go undiagnosed because symptoms can be vague. These disorders include tumors that cause overproduction of hormones that affect the end-organ system or pituitary lesions that may results in underproduction of hormones. Acromegaly, Cushings Disease, Addison’s Disease can all be linked to pituitary disorders. However, the most common problem is pituitary tumors.

Pituitary tumors are usually benign (adenomas), although they can be invasive and they account for approx. 10% of all brain tumors. Pituitary carcinoma’s account for a very small percentage of pituitary tumors. However, even these benign tumors can cause problems in hormone function and can be invasive to the surrounding structures, such as the optic nerve. Treatments include surgery, radiation and a few medications. Symptoms may include: headaches, vision and behavior changes, nausea and vomiting, hormone imbalance and fatigue. Diagnosis almost always involves investigating the “why” behind presenting symptoms.

In this segment, Dr. Joseph Pinzone, a double board-certified physician who is a national expert in pituitary diseases will provide a “master class” about this “master gland.”

 

Dr. Joseph Pinzone

  • Medical training at NYU, Columbia-Presbyterian and Mass General
  • Double board certified in Internal Medicine and Endrocrinology
  • Former NIH researcher on Pituitary Tumors
  • Current Clinical Professor at UCLA Geffen School of Medicine
  • Concierge private practice in Santa Monica, CA

 

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Coronary Calcium Scoring

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The statistics are sobering. Heart disease remains the nation’s leading killer for adults > 35 yrs. Consider these statistics: 1) every 29 seconds an American has a heart attack 2) every 60 seconds and American dies from a heart attack 3) for men and women, 50% or greater of those that have a heart attack had no prior symptoms and their first one was death. Heart disease comes about over years or even decades. There is now technology available that is 99% effective in either confirming or ruling out coronary heart disease with less radiation than one would get exposed to on an airplane flight! “Virtual exams” of our internal organs are now a reality due to advances in medical imaging technology. However, imaging does not provide direct outcomes for the patient- but the information these tests can provide can lead to changes that can decrease heart disease risk factors, potentially reverse damage, and save lives.

This segment will discuss a very specific screening test for coronary heart disease: the Coronary Calcium Scoring test or as some people have heard, “The Heart Scan.” Coronary arteries do not normally have calcium. Calcified plaque in coronary arteries is a leading indicator of heart disease. Using non-invasive, low dose radiation CT scan that takes about 15-20 minutes, patients and providers can now obtain critical cardiac information that can be used post test and in comparison’s over time, to minimize risk and take proactive steps in the maintenance of good heart health or the management of heart disease. The test is most beneficial as a screening tool for patients NOT yet diagnosed with heart disease. Scans are taken of the heart and the results are compared to a scoring system that is measured by a range of no cardiac disease, minimally present, moderately present, extensively present or high risk requiring medical intervention. Information is shared with the patient and their medical provider post test and the patient can return to normal activities when the scan is completed.

In this segment, board-certified preventive cardiologist, Jason Reingold and Dan McGeown, CEO of Virtual Imaging will educate the listeners on the testing methods, patients who benefit most, the scoring system and post test results and what do do about them. Listeners can visit: www.virtualimagingatl.com or www.drjasonreingold.com for more information.

 

Dr. Jason Reingold

  • Board-certified in Internal Medicine and Cardiology
  • MD from Emory University
  • Internal Medicine Residency program completed at UC San Francisco Med Ctr.
  • Cardiology fellowship completed at Mass General Hospital in Boston
  • Regular appearances on CNN’s Sanjay Gupta’s health program

 

Dan McGeown

  • CEO, Virtual Imaging Atlanta
  • Masters in Education and seasoned entrepreneur

 

Dr. Jason Reingold & Dan McGeown

Workers Comp: A Physician’s Primer

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No matter how safe the workplace is, injuries and illness occur. Georgia now has over 4 million workers >16 years of age and in the most recent statistics available, over 87,000 injuries were reported annually. In GA alone, over $1.5 billion in benefits were paid and this does not include the associated health care expenses! Medical costs now outweigh (60%) the indemnity costs. Also of note in GA, there is a shortage of qualified physicians that treat occupational injuries and illness as we have only one fifth of the recommended ratio of 1 MD/1000 employees. On July 1, 2013 GA enacted new law (GA House Bill 154)that increased slightly the weekly workers comp benefit, but capped the benefit for less serious work related injuries. Every employer with over 3 employees is mandated to have workers comp insurance.

Workers Compensation is an accident insurance program, paid for by employers, which may provide workers with medical, rehabilitation and income if an employee is injured or becomes ill on the job. Physicians are a key part of the workers compensation system as they are a pivotal point in getting the employee connected to appropriate treatment, focused on recovery, minimizing life disruption and assisting with developing a return to work plan. Providers often find themselves “the go-between” for the employer, carrier and injured employee. This program will not focus on the legalities or politics of the workers comp system, but on the provision of high quality occupational health by providers.

In this segment, Dr. Charles Cooley, a board-certified Family Practice physician who is an expert at treating occupational health patients through the workers comp system will discuss the basic concepts of the workers comp system, common types of workers comp injuries, special considerations when handling workers comp patient cases and tips for employers and patients in navigating through the medical aspects of the workers comp program.

 

Dr. Charles Cooley

  • MD from Medical College of GA in Augusta
  • Completed residency at Huntsville Hospital
  • Board certified in Family Practice
  • Affiliated with Northside Hospital, Cherokee Campus
  • In private practice with urgent care centers in Canton, Villa Rica

 

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