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Mitochondrial Diseases and Hyperbaric Medicine

Mito TDR

Mitochondrial Diseases and Hyperbaric Medicine

This week I sat down with experts in the fields of mitochondrial diseases and hyperbaric medicine.  Each cell in our body has an “engine” where the nutrition we consume through eating is converted to the energy we need to function and survive.  These engines are known as “Mitochondria”.  These cellular components use genetic code to function and on occasion there will be problems with the genetic code or with how it is decoded.  In these cases, a variety of health problems can reveal themselves, depending on what sort of tissue is made up by these cells in question.  These can range from challenges with learning, developmental problems, or disease states such as Alzheimer’s, Parkinson’s, Muscular Dystrophy, and others.  Dr. John Shoffner, neurologist and geneticist of Medical Neurogenetics came by with Laura Stanley of the Foundation for Mitochondrial Medicine.

 

We talked about the research Dr. Shoffner is doing in an effort to find medical therapies that could help patients who are dealing with the variety of disorders caused by mitochondrial dysfunction.  We talked about how challenging it can be to identify a health problem(s) that are caused by mitochondrial disease unless a patient’s family is fortunate enough to be seen by a physician familiar with the genetic tests that can be utilized to diagnose them.

As described by the Foundation for Mitochondrial Medicine, “Every aspect of our beings – seeing, breathing, thinking, moving – requires energy. Mitochondria, often called the cells’ “powerhouses,” supply that energy by turning raw materials found in the food we eat and in the air we breathe into a substance called ATP (adenosine triphosphate), which our cells can use as fuel. ATP is, quite simply, vital to life.  Without enough ATP, children cannot appropriately develop, grow, learn, move, or even sleep. Adults without enough ATP are unable to sustain brain, muscle, and other vital organ function. A deficit of ATP can also cause invisible damage in some disease states, leading to early failure or dysfunction of organs, or just a chronic state of inefficiency leading to pain, fatigue, changes or limitations in thinking and learning, and increased susceptibility to acquired diseases.

Laura and Dr. Shoffner shared how they are working to improve awareness of mitochondrial diseases and through research, uncover treatments to halt or at  least slow the effects of these diseases.  The ultimate goal is to find a way to prevent or reverse these problems.
Dr. Helen Gelly joined us to talk about a recent article she co-authored with Dr. Caroline Fife in Today’s Wound Clinic, called, “Hyperbaric Oxygen Therapy in Wound Care: A Service Under True Pressure“.  In the article, Dr. Gelly and Dr. Fife talked about how numerous Medicare Administrative Contractors and Commercial insurers are making changes to indications they are willing to reimburse hyperbaric oxygen therapy for.  That means that patients with wounds that place them at risk for amputation or for degraded quality of life due to previous radiation therapy may not be able to receive this evidence-based, effective treatment.  We talked about how in some cases where the providers in a given MAC were asked for clinical documentation of their HBO treatments provided, as many as 30% failed to respond.  Dr. Gelly shared how this lack of response leads to suspicions of fraud.

It was clear from the Today’s Wound Clinic article and from our conversation that hyperbaric medicine specialists must begin to activate and collaborate to protect this evidence-proven treatment modality.  HBO providers need to not only be responsive to requests for data but ACTIVE as it relates to advocating on behalf of educated decisions being made as it relates to the availability of the modality for tomorrow’s patients in need.

Special Guests:

Dr. John Shoffer, MD, CEO of  Medical Neurogenics 

Shoffner

  • Former Associate professor of neurology and molecular medicine at Emory University
  • Former Director of the molecular diagnostics program at Children’s Healthcare of Atlanta
  • Discovered some of the first gene mutations causing mitochondrial diseases and one of the first genes causing epilepsy
  • Finalist, 2012 Atlanta Business Chronicle’s Health-Care Heroes Awards

Laura Stanley, of Foundation for Mitochondrial Medicine  feed logo  facebook_logo_small3  twitter_logo_small  youtube logo

Laura

  • IMBA, University of South Carolina Darla Moore School of Business
  • Former Senior Associate, Korn Ferry
  • Former Vice President, EzGov
  • Parent of a child with mitochondrial disease

Dr. Helen Gelly, MD of HyperbaRXs  twitter_logo_small  google-plus-logo-red-265px  facebook_logo_small3  linkedin_small1

helen

  • Doctor of Medicine, Emory University School of Medicine
  • Internship/Residency: Pediatrics/Emergency Medicine at Emory University Affiliated Hospitals
  • Board Certified in Emergency Medicine
  • Fellow of the American College of Emergency Physicians
  • Fellow of the American College of Certified Wound Specialists
  • Subspecialty Certified Undersea and Hyperbaric Medicine

Sleep Disorders

North Atlanta Pulmonary and Sleep Specialists

Sleep Disorders

It is estimated that as many as 35-40% of Americans experience poor quality of sleep secondary to a variety of sleep disorders.  We continued our series with Northside Hospital this week as I sat down with Sleep Medicine specialist, Dr. Robert Albin.  We talked about the statistics around sleep disorders and Dr. Albin discussed the serious accidents that have occurred that are thought to be related to sleep deprivation.  Some of those include:  Three Mile Island, the Exxon Valdez oil spill, Chernobyl, a recent ferry accident in NYC, and more.

Dr. Albin shared how poor quality and low quantities of sleep can lead to heart disease, high blood pressure, poor mental function, depression, and others.  We talked about the process sleep specialists go through to determine the source of a person’s sleep disorder.  In many cases, the issue is borne out of mental or emotional stress rather than a physical/neurological  issue.  In those cases the sleep specialist will collaborate with a psychology/psychiatry specialist to help work through those causative issues.

For patients who have a sleep disorder related to brain chemistry/function or an obstructive process such as obstructive sleep apnea, the specialists have specialized tests they can conduct to determine the quality of sleep and determine the cause of the problem.  The sleep specialty team at Northside offers a variety of diagnostic studies/treatments and it was the first sleep center of its kind in the city.  For our listeners who are themselves or their loved ones are experiencing difficulty sleeping please take a listen to this week’s show and share it!  You might help someone you care about.

Special Guest:

Dr. Robert Albin, MD, of North Atlanta Pulmonary and Sleep Specialists

North Atlanta Pulmonary and Sleep Specialists

  • Board Certified, Pulmonology, Internal Medicine, and Sleep Medicine
  • Doctorate of Medicine, Cum Laude, Emory School of Medicine
  • Associate Medical Director of NAPS Center for Sleep disorders
  • Medical Director for Peachtree Road Race and Atlanta Marathon
  • Past President and current Board member of the Medical Association of Atlanta

Medical Association of Georgia’s 2015 Legislative Priorities

Medical Association of Georgia

Medical Association of Georgia’s 2015 Legislative Priorities

This week I sat down with Dr. Michael Green and Marcus downs of MAG to discuss Medical Association of Georgia’s 2015 legislative priorities.  We talked about several issues that have a serious impact on both patient outcomes as well as Georgia physicians’ ability to provide care.  Some key areas of focus this year include Physician Autonomy/Scope of Practice relating to physician-extending providers such as optometrists, nurse practitioners, and physician assistants, Third Party Payers, Tort Reform, and Patient Access to Care/Physician Shortage.

Dr. Greene and Marcus shared important information about how the year’s priorities are decided upon from how they’re raised as issues, to how they are elevated through committee to final discussion/determination.  They also talked about how valuable it is to have active participation in the process by the members of MAG.  We discussed the ways that MAG members are able to contribute input on the process and identification of issues for the association to consider.

Marcus and Dr. Greene also talked about some important legislative issues MAG has been able to provide input on that helped shape or revise laws affecting how physicians provide care within the state of Georgia.

Special Guests:

Dr. Michael Greene, Chairman, Council on Legislation, MAG   twitter_logo_small  linkedin_small1  facebook_logo_small3

Medical Association of Georgia

  • Doctorate of Medicine, Mercer University School of Medicine
  • Former President of MAG, 2003-’04
  • Board Member, Secure Health Plan of Georgia
  • Practicing Family Practice Physician, Macon, GA

 

Marcus Downs, Director of Government Relations, MAG  linkedin_small1  

Medical Association of Georgia

  • Recipient, 2012, Outstanding Advocate Award, National Association of School Psychologists
  • National Institutes of Health Research Fellow, 2000
  • Former Director, Government Relations/External Coalitions/Research, Georgia Association of Educators

Complex Patients

Infectious Disease Consultants

Complex Patients

This week I sat down with our colleague, Dr. Andrew Pugliese, Infectious Disease specialist of Infectious Disease Consultants in Johns Creek.  He stopped by to talk about complex patients.  He shared how medical studies focus on single illnesses, disqualifying certain age groups and patients with multiple disease states.  Dr. Pugliese talked about the fact that in the real world medical office, rare is it that a patient walks in to be treated for a problem who is only dealing with that single disease.  More commonly, patients present with obesity, and/or diabetes, heart disease, or any number of other health problems that can affect the way the body responds to a given disease state and treatments for them.  Dr. Pugliese shared how these “multi-morbid” (having more than one health issue) patients are very complex and often do not respond to therapies as studies suggest they will.  He offered advice for providers to help them be better able to manage patients when they need care for a given problem when other health issues are present.  Check out Dr. Pugliese’s blog at http://sinusitisblog.com/.

Special Guest:

Andrew Pugliese, MD, Infectious Disease Consultants twitter_logo_small  linkedin_small1  facebook_logo_small3  Blogger 2  

Infectious Disease Consultants

  • Doctorate in Medicine, St. George University School of Medicine
  • Fellowship, Infectious Disease, Winthrop University Hospital
  • Triple Board Certified in Internal Medicine and Infectious Disease
  • Pioneer in non-surgical treatment of acute and chronic sinusitis
  • President of Sinus Solutions