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Telemedicine in Neurology and Beyond

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telemedicine

Tanya Mack

Emory

Dr. Gregory Esper

Telemedicine in Neurology and Beyond

Womens Telehealth CEO, Tanya Mack sat down with Emory Healthcare’s Dr. Gregory Esper.  Gregory Esper, MD, MBA is currently Associate Professor and Vice Chairman of Clinical Affairs for the Department of Neurology, and he also is Director of General Neurology and Neuromuscular Diseases. He serves Emory Healthcare in the capacity as the Director of New Care Models.

Dr. Esper shared his perspective of the role of telemedicine in neurology, as well as how Emory Healthcare is evaluating other areas of need for access to care where telemedicine can be deployed to simultaneously provide greater efficiency for patient and care provider, as well as improving the health of the population served.

 

We talked about how patient information is protected while using this technology, as well as some of the current limitations that confound expansion of telemedicine to the patient’s home on a larger scale.

Throughout the world and US, there is a shortage of neurologists, which is expected to worse, not improve in the coming years. The access is outstripped by the demand, especially in rural areas, where
geographical disparities exist. Georgia has over 100 counties that have no neurologist.

Telemedicine improvements and patient and provider adoption, especially over recent years, has proven that in many cases, reliable remote diagnosis can be made, patient outcomes are positive and costs can be saved.

Treatment of stroke, multiple sclerosis, Parkinson’s, epilepsy and some urgent neuro problems can be
managed via telestroke medicine. In 2016, Emory University opened a remote telemedicine service.
Listen in as Dr. Greg Esper updates us on new developments in telestroke and Emory’s new program.

Dr. Scott Beach

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Heart & Vascular Care

Dr. Scott Beach talks vascular disease.

Dr. Scott Beach

On this week’s show I sat down with interventional cardiologist, Dr. Scott Beach, of Heart & Vascular Care, with offices in Johns Creek, Cumming, and Canton, GA.  I’ve known Dr. Beach for several years through the practice I was working for (Hyperbaric Physicians of Georgia).  Our physicians have worked with him on numerous patients’ cases, both sending him folks who needed to have their blood flow to their lower extremities evaluated, as well as providing specialized wound care for patients he and his colleagues occasionally see in their practice.

Dr. Beach share how he enjoys the fact that his relationship with his patients and their loved ones tends to extend over years rather than being short and limited to a procedure or two.  We talked about vascular disease and some things both patients and doctors need to think about to get problems identified and treated early.

Scott explained how often, symptoms of developing vascular disease are mild and gradually reduce the patient’s tolerance to activity.  In many instances, the patient and their family merely chalk the changes up to “getting older”.  That’s dangerous, because it means the blockage of blood flow that’s causing the symptoms continues to grow until a major event occurs such as a heart attack, stroke, or possibly a limb amputation.

We discussed the fact that there are simple, non-invasive studies that can reveal early vascular disease when it’s easier and more-likely-successful to treat with more options to choose from.  Additionally, we talked about the fact that having pulses that can be felt on a patient’s foot is NOT an accurate means of determining whether a patient has vascular disease that needs attention in many patients.

Additionally, when patients have a wound on their foot or leg that is healing slowly or not at all, it is very important to know whether blockage of blood flow is contributing to the inability to heal.  Too often, these patients go for amputation that could have been readily prevented with one of those non-invasive or minimally-invasive studies he described.  For patients with a wound that’s not healing, it is important for them to have a multiple-specialty team of doctors who help with different facets of the non-healing wound.  Scott and his colleagues certainly subscribe to this approach and get their patients with limb threatening wounds access to all available experts who can help save their foot/leg.

The value in this multi-specialty approach cannot be overstated when you consider that in diabetics (one of the largest groups who experience vascular disease), the 5 year mortality rate for patients undergoing a below-the-knee amputation is just under 50%.  Most patients and many doctors are not fully aware of this risk.

Special Guest:

Dr. Scott Beach, MD, Heart & Vascular Care  facebook_logo_small3  linkedin_small1

Heart & Vascular Care

 

Cholesterol Isn’t The Bad Guy In Heart Disease

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Cholesterol Isn’t The Bad Guy In Heart Disease

I recently read an article by a former heart surgeon that talked about the fact that cholesterol isn’t the bad guy in heart disease.  Instead, he argued that inflammation of the lining of the blood vessels caused by sugars and even the “healthy” oils we eat such as corn, canola (Omega-6 oils) is the real cause of what is still the #1 cause of death in America today.

I sat down with Dr. Ellie Campbell of Campbell Family Medicine in Cumming, GA to talk about the article and she was eager to discuss it.  She completely agrees with the premise of the article and shared how the ratio of Omega-3 oils  to Omega-6 oils has grown from ~1:1 or 1:2 to as much as 25:1 Omega-6 to Omega-3.

She also talked about the fact that higher levels of cholesterol in the blood don’t necessarily equate to plaque and heart disease/stroke.  It’s when cholesterol molecules are oxidized and corrupted by inflammatory substances we eat that they become “sticky” and attach to the irritated walls of the blood vessels.

Dr. Campbell shared numerous suggestions for basic changes we can make that will not only serve to reduce our risk for heart disease but in some cases can actually reverse damage already done.

I also brought back Leana Kart, a chiropractor whose practice, Northwest Chiropractic and a member of the Georgia Chiropractic Association to talk about the fact that May is National Posture Awareness Month.  She shared several tips on how to avoid “tech neck”, damage to the spine and neck caused by long periods of chin-down angles to look at a device in our lap.  She also talked about why good posture contributes to keeping us healthy.

Special Guests:

Special Guests:

Dr. Ellie Campbell, DO, Family Practice & Integrative Medicine at Campbell Family Medicine

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Campbell Family Medicine

  • Doctor of Osteopathic Medicine, Kirksville College of Osteopathic Medicine
  • Family Medicine Residency, Medical College of Georgia
  • Board Certified Family Medicine

Dr. Leana Kart, DC, of NW Chiropractic  linkedin_small1

kart

  • Doctor of Chiropractic, Life University
  • Owner of NW Chiropractic for over 26 years
  • Board Member, Georgia Chiropractic Association

 

Dr. Khusrow Niazi

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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. Rheudasil of Emory Heart and Vascular Institute and Georgia Vascular Society

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Emory Heart and Vascular Institute and Georgia Vascular Society

Dr. Rheudasil talks about Emory Heart & Vascular Institute and GVS.

 

Emory Heart and Vascular Institute and Georgia Vascular Society

This week on Top Docs RADIO we sat down with Dr. Mark Rheudasil of Emory Heart and Vascular Institute.  We talked about the specialty of vascular surgery, new advances in minimally-invasive endovascular procedures, and upcoming events with Georgia Vascular Society.  Dr. Rheudasil shared some feelings about why he enjoys his chosen specialty as much as he does and when it’s advisable to be seen by the specialists of Emory Heart and Vascular Institute.

He talked about his membership with the Georgia Vascular Society and how it helps the vascular specialists across the state of Georgia stay in contact with each other to share best practices, new research, and other important information they provide through their educational conferences.  Our physician practice has worked with Emory Heart and Vascular Institute for many years, collaborating on countless patients with limb-threatening wounds.  Be sure to consider a consult with this practice should you or a loved one find themselves in need of evaluation for vascular disease of the extremities, aorta, carotids, and more.

Special Guest:

Dr. Mark Rheudasil, MD of Emory Heart and Vascular Institute and Georgia Vascular Society

Emory Heart and Vascular Institute and Georgia Vascular Society

Dr. Mark Rheudasil

  • Doctorate of Medicine, University of Texas Southwestern Medical School
  • Residency, Emory University Hospital
  • Fellow, American College of Surgeons
  • Board Certified in surgery and vascular surgery
  • Published articles in several medical journals including The Journal of Vascular Surgery, American Surgeon and The Journal of the Medical Association of Georgia