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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

Swift School

Swift School

Swift School

This week I sat down with two learning specialists and three students from The Swift School in Roswell, GA.  This private school is one that focuses on the learning needs of high-potential students that are challenged with dyslexia, dyscalculia (problems with math), working memory issues, and others.  Their learning environment is designed to help these children achieve their academic potential through smaller class sizes, teaching styles (such as Orton-Gillingham method) that take these various brain types and learning process needs into consideration.

As many as 1 in 5 children deal with some sort of learning challenge such as dyslexia, according to the learning specialists, Lisa Armorer and Carol Madden.  We now know that these aren’t so much learning “disabilities” as “Brain Types”.  As Carol explained, most kids dealing with dyslexia and some of these other challenges are “Right Brain” dominant.  This affects the style of learning that is most effective for them and can have an impact on their behavior patterns to some extent as well.  Many children are misdiagnosed as having behavioral “problems” when in fact they are actually exhibiting responses to frustration and/or anxiety because they are having trouble learning and they don’t understand why.

Lisa explained how Swift School’s learning approach differs from many “traditional” learning settings and how the strategies they employ take the child’s brain type and associated learning techniques into consideration.  This empowers them to achieve academically at a high level and advocate for themselves as students as they return to middle schools and high schools in traditional class environments/teaching approaches.

I got to talk to two 5th graders, Mackenzie Day and Olivia Hall, and 8th grader, Grant Meyer.  They shared their poignant stories about how it felt to be “different” from their peers as young students, watching them excel when certain (or all) concepts seemed so difficult for them.  They talked about their experiences going to visit Swift School and what it was like to become “veteran” students once they’d been there for a while.  Olivia, Mackenzie, and Grant also shared advice for peers in the community who might be considering Swift School as an option when a traditional setting is not helping them reach their academic potential.

Lisa Armorer shared this information with me:

Is your child bright but still struggling in school?  It might not be laziness.  It might be dyslexia.

Dyslexia affects 1 in 5 students today.  Dyslexia is not just seeing words backwards.  Dyslexia is a language-based learning difference and causes difficulty with reading, writing and spelling.

COMMON CHARACTERISTICS OF DYSLEXIA:

  • Delayed spoken language
  • Left/Right Confusion
  • Difficulty rhyming words and sounds
  • Poor sequencing of numbers and letters
  • Difficulty sounding out, identifying, and spelling words
  • Slow to memorize alphabet and math facts
  • Avoids reading aloud.
  • Difficulty with reading and comprehension.

For more information:

The International Dyslexia Association – www.interdys.org

Academy of Orton-Gillingham Practitioners and Educators – www.ortonacademy.org

 

Special Guests:

Lisa Armorer, Learning Specialist, Swift School  facebook_logo_small3  youtube logo

Armorer headshot 2

Carol Madden, Middle Division Director, Swift School

Armorer Madden

Grant Meyer, 8th Grade Swift Student, President, Student Counsil

Grant

Mackenzie Day, 5th Grade Swift Student

Mackenzie

Olivia Hall, 5th Grade Swift Student

Olivia Grant

 

AirWatch

 

IMG_0267

AirWatch by vmware

This week on TopDocsRADIO we sat down with Paul McRae of AirWatch by vmware. Healthcare is evolving. As information technology advances and our health laws change, greater importance is being placed on electronic health records.  Today, digital data is flowing between departments in a hospital, to physician offices, to practitioners in the patients’ homes.  The result is greater efficiency in coordination of care, easier collaboration across multi-specialty teams, and an increased risk of compromise of sensitive HIPAA-protected information.

AirWatch by vmware provides technology that allows healthcare organizations to protect sensitive data across their enterprise, including mobile devices and laptops that may be in use outside the confines of the building or campus of the health company.  With their solution, the enterprise can determine whether certain data elements can be accessed by a given device (including BYOD), attachments can be included in outbound emails, and more.

If your organization is working to take advantage of the benefits of digital platforms and mobile devices then get to know AirWatch by vmware.  You’ll give your company the strengths that come with digitized information coupled with the confidence your information will meet compliance requirements and stay safe in the hands of those its meant to be seen by.

Special Guests:

Paul McRae, Director of Business Development – Healthcare Solutions, AirWatch by vmware  twitter_logo_small  youtube logo  google-plus-logo-red-265px  linkedin_small1  facebook_logo_small3

AirWatch by vmware

  • BA Economics, Cornell University
  • Board Member, Warrick Dunn
  • Presenter, Georgia Healthcare Trade Faire & Regional Conference 2013
  • Former SCVP of Healthcare Emerging Technology, AT&T

 

 

International Medical Graduates

 TDR 12-9

International Medical Graduates

In our ongoing series with Medical Association of Georgia, we discussed International Medical Graduates on this episode.  Today, we continue to extend the age to which we humans live. This, coupled with the large post-war baby boomer population that is now entering the elderly population, compounds the effects of the period 2-3 decades ago where it was thought we possessed a surplus of physicians. During that time the creation of new medical colleges and expansion of residency programs was limited. These factors combined to bring us to the situation we find ourselves in today: an expanding shortage of physicians in the US.

The ECFMG (Education Commission for Foreign Medical Graduates) reports that since its inception in the 1950’s it has examined and certified over 320,000 foreign-trained physicians for acceptance to train in US medical colleges and residency programs.  Recent statistics show as many as 25% of practicing physicians in the US are foreign-trained graduates.  And they play a vital role in the delivery of healthcare in our country.  I sat down with Kate Boyenga, Director of Membership and Marketing with Medical Association of Georgia and current MAG president, Dr. Manoj Shah, himself a foreign medical graduate.

We learned about some of the reasons why Medical Association of Georgia is experiencing its largest membership with over 7500 members statewide.  And Dr. Shah shared excellent information about the steps required to study in medical school abroad with the ultimate goal of practicing medicine in the US.  He talked about the tests one can expect to take, challenges they may face while making application to schools/residencies in the US, and possible solutions for them.

Special Guests:

Kate Boyenga, Director of Membership and Marketing for Medical Association of Georgia 

twitter_logo_small  facebook_logo_small3  linkedin_small1

boyenga

  • BA Communication, College of Charleston
  • Under her leadership MAG Membership is at an all-time high
  • 14 years with MAG

Dr. Manoj Shah, MD, of Physicians for Women and president of MAG  linkedin_small1

  shah

  • MAG’s first President from Warner Robins
  • MAG’s first president of East Indian descent
  • Doctor of Medicine, Baroda, India
  • Residency, Henry Ford Hospital in Detroit
  • Has delivered more than 7,000 babies

Dr. Khusrow Niazi

Emory Healthcare

Dr. Khusrow Niazi

This week I sat down with Emory School of Medicine’s Dr. Khusrow Niazi, Interventional Cardiologist and Director of Peripheral Vascular Interventions.  Dr. Niazi is a cardiologist but is different from many other cardiologists as he treats disease from the head to toes. He specializes in blockages of the artery which may involve coronary arteries around the heart which may cause chest pain or heart attack, carotid arteries which may cause TIA or strokes, arteries to the leg which may cause leg discomfort or slow wound healing. In addition he is one of the few cardiologists who also treat veins of the legs which may cause leg cramps, swelling, heaviness or varicose veins. He has lectured nationally and internationally and has helped many patients from getting their legs amputated.

Dr. Niazi appeared with the goal of providing the folks in the community with a cardiologist’s perspective on what they need to know about vascular disease which can affect the arteries that supply the brain, heart, and limbs.  We talked about things we can do to reduce our risk of disease in the vascular system.  He also shared recommendations on the types of tests and studies that folks who are at greater risk for vascular disease should consider having conducted.  Many of these tests are quite basic and can be performed at their local primary care physician’s office.  Persons who should consider regular monitoring for the presence of vascular disease include those who are over-weight, have diabetes, high cholesterol levels, hypertension, as well as those who have close relatives with a history of vascular problems.

Dr. Niazi advised our listeners to not ignore symptoms that might indicate a vascular problem exists such as chest tightness/pain, dizzy spells or changes in vision, speech, or ability to walk, pain in the lower legs when walking, shortness of breath at rest or with mild activity, etc.  These can be signs that vascular problems exist that could potentially be corrected with early intervention.  He also spoke about the fact that persons who have a wound on their lower leg or foot need to be evaluated for the presence of correctable vascular disease.  Many of these people go on to have amputations when they may have been prevented by intervention by a vascular specialist.

Special Guest:

Dr. Khusrow Niazi, MD, of Emory University School of Medicine facebook_logo_small3  twitter_logo_small  youtube logo  linkedin_small1

 

Emory Healthcare

  • Doctor of Medicine, King Edward Medical College, Lahore, Pakistan
  • Residency, Cardiology, Kettering Medical Center
  • Fellowship William Beaumont Hospital
  • Multiple published research articles

 

Dr. Jon Minter of Northside Total Joint Specialists

Northside Total Joint Specialists

Dr. Jon Minter of Northside Total Joint Specialists

This week I sat down with Dr. Jon Minter of Northside Total Joint Specialists.  In our ongoing monthly series with Northside Hospital we learned about the various conditions that could lead to a total joint replacement.  Dr. Minter shared some great information about some of the techniques he uses now to perform the surgery, including using robotic assistance with portions of the procedure.  Having robotic assistance helps the surgeon minimize surgical trauma to the tissue in the surgical field, making the recovery process proceed more quickly and with less pain.

Dr. Minter talked about the fact that he is able to perform joint replacement for a wide variety of joints from knees, to hips, shoulders, wrists, ankles and even digits.  He is able to repair joint damage from disease processes such as arthritis as well as traumatic injuries.  I was surprised to learn that patients undergoing total hip replacement and total knee replacement can often go home to recover the same day as their surgery rather than staying for several days in the hospital.

Dr. Minter discussed how he takes a conservative approach to joint replacement, exploring non-surgical options where feasible to attempt to give the patient relief of pain while avoiding surgery if possible.  If you or a loved one is experiencing a decrease in activity in an effort to avoid pain you should seek a consultation with this specialist.  You will be pleased to experience his pleasant, personable demeanor.  We talked about the fact that when patients begin to avoid activity in an effort to prevent experiencing pain, they can see their heart health decrease over time, potentially shortening their lives.  Dr. Jon Minton of Northside Total Joint Specialists can help you or your loved ones get your life back through his expert, conservative approach to joint replacement.

Special Guest:

Dr. Jon Minter, DO, of Northside Total Joint Specialists  linkedin_small1 

Northside Total Joint Specialists

  • Doctor of Osteopathy, Kirksville Osteopathic Medicine
  • Residency, Orthopedic Surgery, Parkview Hospital
  • Adult Reconstructive and Arthritis Fellowship, Florida Orthopaedic Institute/Tampa General Hospital
  • Published Study Author and Frequent Lecturer on the subject of Joint Replacement

“Think About It”

MAG LOGO

Think About It

 

“Think About It” Campaign to End Prescription Drug Abuse

Prescription medication abuse and subsequent addiction is a serious problem that needs our immediate attention as a community and as healthcare providers.  According to the National Institute on Drug Abuse, “Although most people take prescription medications responsibly, an estimated 52 million people (20 percent of those aged 12 and older) have used prescription drugs for nonmedical reasons at least once in their lifetimes.”  And, National Council for Alcoholism and Drug Abuse states, “Taking prescription drugs not prescribed for you by a doctor or in a way that hasn’t been recommended by a doctor, can be more dangerous than you think.  In fact, it can be fatal.  Prescription drugs are the third most commonly abused category of drugs, behind alcohol and marijuana and ahead of cocaine, heroin, and methamphetamine.  Some prescription drugs can become addictive, especially when used in a manner inconsistent with their labeling by someone other than the patient for whom they were prescribed, or when taken in a manner or dosage other than prescribed.  Overall, an estimated 48 million people have abused prescription drugs, representing nearly 20% of the U.S. population.”  

This week I sat down with Dallas Gay and Dr. Tennant Slack along with Lori Cassidy Murphy from the Medical Association of Georgia to talk about their recently-launched campaign to fight prescription medication abuse and addiction.  Dallas and Dr. Slack co-chair the campaign and they’re working hard to bring community focus to the problem.  The campaign is being funded by the Medical Association of Georgia Foundation and is working to raise awareness of this issue among Georgia’s residents as well as healthcare providers who prescribe controlled medications.  Their team has developed colorful handout materials that give key recommendations for persons who have prescriptions for controlled pain or anti-anxiety medications with regard to how they take it, how they store it, and how to dispose of it when they no longer need the medication.  Additionally, they’re involved with numerous events around the community to get people talking and thinking about how this problem can be prevented.

Think About It is a program conducted by the Medical Association of Georgia Foundation for the purpose of reducing the incidence of prescription drug abuse and resulting deaths. The concept for the program originated at NGMC in 2010 and is presently co-chaired by Dr. Jack Chapman, Dr. Tennent Slack and Dallas Gay. Hall County has served as the incubator of the program since its inception. The “Help Stop Rx Drug Abuse in Georgia” leaflets encourage Georgians to 1) only take their medicine as prescribed and 2) not share their medicine and 3) store their medicine in a safe and secure place and 4) properly dispose of any unused medicine.

The ‘Think About It’ campaign involves a wide array of organizations, including medical societies, the Georgia Composite Medical Board, the Georgia Board of Pharmacy, the Georgia Pharmacy Association, the Council on Alcohol and Drugs, and the Georgia Bureau of Investigation – as well as other law enforcement agencies, schools, and business and religious and other community organizations.

Thank you for listening and PLEASE SHARE! this podcast with your networks.  You may just help someone you care about.

Special Guests

Dr. Tennant Slack, MD, of Northeast Georgia Physician’s Group

Slack_Tennent_MD2_small (3)

  • Doctorate of Medicine, Emory University School of Medicine
  • Residency, Anesthesia, Emory University School of Medicine
  • Fellowship, Pain Medicine, Medical College of Georgia
  • Board Certified, American Board of Anesthesiology: – Anesthesiology – Pain Medicine

Dallas Gay, Co-Chair, “Think About It” Campaign

Dallas Gay

  • Board Member, Northeast Georgia Medical Center
  • MBA, Georgia State University
  • Member, Drug Free Coalition of Hall County
  • Former President, Protein Products, Inc
  • Former President, American Proteins, Inc.