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S P E C IA L A DVE R T ISING SE C T I O N Ask the Health Professionals Ask the Doctor Adult Attention Deficit Disorder (ADD).............................................S37 Chad Brock, M.D., Savannah Psychiatry Balloon Sinuplasty.......................................................................................S39 David S. Oliver, M.D., F.A.C.S., Coastal ENT Bio-Identical Hormone Therapy.............................................................S29 Mary Kay Ross, M.D., FACEP, Live Well MD Breast Augmentation..................................................................................S47 Joel Shanklin, M.D., Coastal Empire Plastic Surgery Breast Reconstruction . ............................................................................ S46 Cliff Cannon III, M.D., Coastal Empire Plastic Surgery Corrective Breast Surgery.........................................................................S38 Thomas W. Horn, M.D., Finger and Associates Enlarged Prostate/BPH..............................................................................S31 Michael Funderburk, M.D., Urological Associates of Savannah Erectile Dysfunction....................................................................................S33 Stephen Michigan, M.D., Urological Associates of Savannah Eyelid Lifts..................................................................................................... S44 Angela Rowden, M.D., F.A.C.S., Georgia Skin and Cancer Clinic Facial Rejuvenation......................................................................................S47 Meghan McGovern, M.D., Coastal Empire Plastic Surgery Female Urology.............................................................................................S33 Ruth Ann Miles, M.D., Urological Associates of Savannah Flat Feet...........................................................................................................S43 Steven Shapiro, M.D., Savannah Orthopaedic Foot & Ankle Foot & Ankle Joint Replacement ............................................................ S41 Mark A. Jenkins, D.O., Chatham Orthopaedic Associates, P.A. Hip/Joint Replacement ............................................................................ S40 James F. Holtzclaw, M.D., Chatham Orthopaedic Associates, P.A Hospice Care..................................................................................................S45 Kelly Erola, M.D., Hospice Savannah Kidney Cancer.............................................................................................. S30 Buffi Boyd, M.D., Urological Associates of Savannah Knee Arthritis . .............................................................................................S42 Greer E. Noonburg, M.D., Chatham Orthopaedic Associates, P.A. Knee Ligaments ...........................................................................................S43 Spencer M. Wheeler, M.D., Chatham Orthopaedic Associates, P.A “Mommy Makeovers” .............................................................................. S46 Luke Curtsinger, M.D., Coastal Empire Plastic Surgery Neuromas........................................................................................................S45 Frederic Spector, D.P.M., Coastal Foot & Ankle Center Pediatric Urology..........................................................................................S32 Richard Mazo, M.D., Urological Associates of Savannah Preventing Skin Cancer............................................................................. S44 Sidney Smith, M.D., Georgia Skin and Cancer Clinic Prostate Cancer........................................................................................... S30 David Cheng, M.D., Urological Associates of Savannah Robotic Surgery............................................................................................S34 Samuel Torres, M.D., Urological Associates of Savannah S28 savannahmagazine.COM Compiled by Judy Bean Photography by Bunny Ware, Lyn Bonham, Christine Hall and Allie Morris Rotator Cuff . ................................................................................................ S40 Robert Dow Hoffman M.D., Chatham Orthopaedic Associates, P.A. The Spine .......................................................................................................S42 Raphael R. Roybal, M.D., Chatham Orthopaedic Associates, P.A. Spine Surgery................................................................................................S35 James Gunn Lindley Jr., M.D., FACS, Neurological Institute of Savannah & Center for Spine Stone Disease.................................................................................................S31 Michael Cox, M.D., Urological Associates of Savannah Thyroid Problems.........................................................................................S34 William Moretz, M.D., ENT Associates of Savannah Treatment-resistant Depression........................................................... S48 William G. Ellien, M.D., TMS Neuroscience Center of Savannah Upper Extremity/Hand ............................................................................. S41 Ronald H. Levit, M.D., Chatham Orthopaedic Associates, P.A. Vasectomy......................................................................................................S32 James Judy, M.D., Urological Associates of Savannah Weight Loss....................................................................................................S36 Kyrin Dunston, M.D., FACOG, True Balance MD Ask the Health Professional Assisted Living..............................................................................................S53 Rita Slatus, Executive Director, Buckingham South Outsourced Medical Billing......................................................................S52 Gary Nesbit, B.B.A. & Will Ronning, M.B.A., J.D., Coastal Medical Billing Physical Therapy for Back Pain.............................................................. S49 Bryan W. Kist, P.T., D.P.T., O.C.S., Spine & Sport Recovery from Dependency on Alcohol and Prescription Pills......................................................................................... S50 Terry Bruce, President and CEO, Assisted Recovery Center of Georgia Speech Therapy for Children.....................................................................S51 Stephanie Auker, Speech & Language Pathologist, Live Oak Children’s Therapy Ask the Dentist CAD/CAM Dental Technology................................................................S55 Julie Ann Routhier, D.M.D., Paderewski & Routhier, L.L.C. Esthetic Dentistry....................................................................................... S54 Bradley Busbee, D.D.S., Morrison Dental Associates Non-surgical TMJ Treatment.................................................................. S54 Eric Gladden, D.M.D., Gladden Dental Restoring Missing Teeth............................................................................S53 Jessanna Smith, D.M.D., Tybee Teeth Snap-On Smile ©...........................................................................................S55 Scott Cohen, D.D.S., Cohen Dental Center I A L A DVE DV E R T ISING I S I N G SE SECTION S P E C IA What Every Savannahian Needs to Know About... Bio-Identical Hormone Therapy Mary Kay Ross, M.D., FACEP Live Well MD 337 Commercial Drive, Suite 100 912-352-1234 livewellmdsavannah.com What are bio-identical hormones? Bio-identical hormones are hormones that are bio-chemically identical to those produced by the human body. Bio-identical hormones contain no added molecules compared to synthetic hormones thus allowing our bodies receptors to bind perfectly with them. Why are bio-identicals better? Synthetic hormones such as Premarin® and Prempro® are derived from horse estrogen which is much stronger than human estrogen and thus doesn’t bind as well with hormone receptor cells. In turn, they are prescribed in unnaturally high doses causing multiple side effects and have been linked to cancer, heart disease and other health problems. Can I get by without hormone therapy? OCTOR ASK D Perhaps. But there is a serious argument that hormone therapy plays a large role in preventative medicine in addition to providing relief from sleeplessness, hot flashes, mood disorders and intimacy problems. How do you administer bio-identical hormones? STATS Medical Degree: University of Louisville (KY), advanced training in Anti-Aging Medicine and Hormone Replacement Therapy Board Certifications: American Board of Emergency Medicine, American Academy of Anti-Aging Medicine (Board-eligible) Affiliations: American Medical Association, American College of Emergency Physicians, American Academy of Cosmetic Surgeons, North American Menopause Society, American Society for Laser Medicine and Surgery We offer a wide range of treatment options from transdermal creams to injections for both our male and female patients. We also offer implantable pellets only once we’re certain the dose is right for the patient, so each one feels his or her very best. SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S29 S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Kidney Cancer Buffi Boyd, M.D. Urological Associates of Savannah 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com What is kidney cancer? Kidney cancer is abnormal kidney cells that grow out of control. They first grow locally but can spread to other areas such as lymph nodes, lung, bone, central nervous system, etc. How is it detected? Kidney cancers are most commonly diagnosed incidentally on X-rays obtained for other reasons. The classic presenting symptoms include blood in the urine, flank/back pain and a palpable mass (only present in about 10 percent of patients). Can kidney cancer be cured? OCTOR D K S A Kidney cancers can be cured (with surgical resection). Cure rates depend on stage at presentation (which is related to tumor size and whether it has spread). Primary treatment includes surgical resection (laparascopic and conventional open surgery) and thermal treatments (heating and freezing). STATS Board Certification: Urology Medical Degree: Medical College of Georgia Residency: Medical College of Georgia What Every Savannahian Needs to Know About... Prostate Cancer David Cheng, M.D. Urological Associates of Savannah 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com What is prostate cancer? The most commonly diagnosed cancer in men in the United States. The prostate is a male sex gland just below the urinary bladder and surrounds the upper part of the urethra. When cells in the prostate undergo malignant transformation, they can grow without limit and control, resulting in tissue damage and even death. The cause is unknown. Who is at risk for prostate cancer? The major risk factor is age. Men in their 50s have about a 10 percent chance of developing this cancer, but men in their 80s have nearly an 80 percent chance. How important is prostate cancer screening? Screening is recommended for men over the age of 50, younger men with strong family history and for African Americans. OCTOR ASK D S30 savannahmagazine.COM STATS Board Certification: Urology Medical Degree: Cornell University Residency: Mount Sinai Hospital S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Stone Disease Michael Cox, M.D. Urological Associates of Savannah 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com What is a kidney stone? A kidney stone is an accumulation of mineral salts and other chemical substances in the urine that crystallize to form a solid mass, or “stone,” in the kidney. Who is at risk for kidney stones? Gender (male), ethnicity (more common in Caucasians) and age (uncommon in children and adolescents) are important risk factors. Geography is also relevant with increasing prevalence in hot, arid and tropical regions. Georgia lies in the “Stone Belt” and has one of the highest prevalence rates of stone disease. STATS OCTOR D K S A Board Certification: Urology Medical Degree: Jefferson Medical College Residency: Barnes-Jewish Hospital: Washington University in St. Louis Languages: English and Spanish What Every Savannahian Needs to Know About... Enlarged Prostate/BPH Michael Funderburk, M.D. Urological Associates of Savannah 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com What happens with an enlarged prostate? Also known as BPH (benign prostatic hyperplasia), an enlarged prostate restricts a man’s urine flow, causing a sense of urgency, a slow urine stream, dribbling or repeated nighttime bathroom visits. Is it dangerous? At its worst, BPH makes it impossible to urinate. If neglected too long, it can cause kidney and bladder damage. What are the treatment options? Medication helps most men. If that doesn’t work, there are minimally invasive outpatient solutions. STATS ASK DOCTOR Medical Degree: University of Missouri – Kansas City School of Medicine Residency: Massachusetts General Hospital Certifications: Urology Privileges: Memorial University Medical Center, St. Joseph’s/Candler Health System SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S31 S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Vasectomy James Judy, M.D. Urological Associates of Savannah 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com What is a vasectomy? It’s a method of contraception: a minor surgical procedure to prevent sperm produced by the testicles from reaching the ejaculation fluid. Does it work immediately as a contraceptive? No. Couples should continue to use their present form of birth control until specimens are checked to see whether sperm is present. Will my sex life be affected? Desire and performance are not affected. You should not notice any change in the fluid or volume of fluid because sperm only makes up about 10 percent of the ejaculation fluid. STATS OCTOR D K S A Board Certification: Urology Medical Degree: Medical College of Georgia Residency: Memorial Health University Medical Center What Every Savannahian Needs to Know About... Pediatric Urology Samuel Richard Mazo, M.D. Urological Associates of Savannah 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com What is a Pediatric Urologist? A urologist who specializes in taking care of children under the age of 18. When should my child see a pediatric urologist for bedwetting or urinary incontinence? If it is interfering with the social development of the child or if there are associated urinary tract infections. STATS ASK DOCTOR S32 savannahmagazine.COM Board Certification: Pediatric Urology, Urology Medical Degree: Medical College of Georgia Residency: University of Michigan Fellowship: Meath Hospital Professional Organizations: American Urological Association, Society for Pediatric Urology, American Academy of Pediatrics S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Erectile Dysfunction Stephen Michigan, M.D. Urological Associates of Savannah 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com Is Erectile Dysfunction a normal part of aging? Not entirely and the loss of sexual function is not inevitable. Changes in erectile function are the result of normal aging and specific medical conditions which occur more commonly in older individuals. These include, but are not limited to, diabetes, hypertension, heart disease, various cancers (and cancer treatments), hyperlipidemia and neurological disorders. Other contributing factors are lifestyle choices such as smoking and drinking. How is Erectile Dysfunction treated? There are a variety of medications (oral and injectable), mechanical aids and surgical procedures which, depending on the cause, can successfully treat sexual dysfunction in men. STATS OCTOR D K S A Board Certification: Urology Medical Degree: Johns Hopkins University Residency: Bellevue Hospital and Johns Hopkins Hospital What Every Savannahian Needs to Know About... Female Urology Ruth Ann Miles, M.D. Urological Associates of Savannah, P.C. 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com Why might a woman see a urologist? Women of all ages have issues with bladder control, frequent urination, strong urinary urges or urinary incontinence. Some also have pain from infection or chronic bladder inflammation. These conditions are best treated by a urologist. Can’t my “regular” doctor or OB/GYN treat those problems? These conditions typically are treated initially by a primary care physician or OB/GYN. If the condition persists, it’s time for referral to a specialist, who can provide nerve stimulation for overactive bladder and other advanced treatments. STATS OCTOR ASK D Medical Degree: University of Miami School of Medicine Residency: New Jersey Medical School Certifications: Urology Privileges: Memorial University Medical Center, St. Joseph’s/Candler Health System SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S33 S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Robotic Surgery Samuel Torres, M.D. Urological Associates of Savannah 230 E. DeRenne Ave. 912-790-4000 | urologysavannah.com What is a robotic prostatectomy? A minimally invasive surgical procedure done with a da Vinci robot to remove the cancerous prostate gland and related structures. The da Vinci is a remote-controlled robot that facilitates minimally invasive procedures with its enhanced range of motion and visibility, reducing patients’ blood loss and leading to faster recovery. Who is a candidate for a robotic prostatectomy? It is an advanced treatment option for the majority of patients with prostate cancer in need of surgery. Those who may not qualify for this type of surgery are obese patients and patients who’ve had multiple abdominal surgeries. STATS OCTOR D K S A Board Certification: Urology Medical Degree: University of the Philippines Residency: Upstate Medical Center Syracuse and Memorial Health University Medical Center Fellowship: Baylor What Every Savannahian Needs to Know About... Thyroid Problems William Moretz, M.D. ENT Associates of Savannah 5201 Fredrick St. 912-351-3030 | www.entsavannah.com What thyroid problems should we be aware of? There are several thyroid conditions your physician will be able to diagnose and treat. Typically, our office is involved when surgical management is indicated. Most of the surgery we perform is for thyroid nodularity and compressive multinodular thyroid glands. How can these conditions be treated? Surgery for the thyroid gland can be performed safely, with minimal risks. Many of the techniques for thyroid surgery have been refined with new technology, including endoscopic visualization and harmonic instruments. This technology allows for incisions as small as 1.5 centimeters. Typically, thyroid surgery can be performed safely on an outpatient basis without the need for drains. ASK DOCTOR S34 savannahmagazine.COM STATS Medical Degree: Medical College of Georgia Residency: Otolaryngology/Head and Neck Surgery from Medical College of Georgia Board Certified: Otolaryngology/Head and Neck Surgery Full Hospital Privileges: Candler/St Joseph’s Hospital, Memorial Hospital I A L A DVE DV E R T ISING I S I N G SE SECTION S P E C IA What Every Savannahian Needs to Know About... Spine Surgery James Gunn Lindley, M.D. Neurological Institute of Savannah and Center for Spine 4 Jackson Blvd. 912-355-1010 neurologicalinstitute.com What’s new in spine surgery? Two big stories about artificial disc replacement and minimally invasive spine surgery (MIS). What about artificial discs? Although they’ve been in use for years, the long term results are showing that artificial discs in the cervical and lumbar spine not only preserve motion but provide outcomes that are similar or better than fusion - once considered the gold standard. Also. artificial discs make it less likely that patients will need additional procedures. Is disc replacement an inpatient procedure? OCTOR ASK D Replacing neck discs has been an outpatient procedure for years, but replacing lower back discs requires a one or two day hospital stay. However, Savannah now has a disc replacement device – we are one of only four locations nationwide performing the procedure – that allows minimally invasive lower back disc replacement, reducing hospital time. What else can MIS do? STATS Medical Degree: Medical University of South Carolina Residency: Wake Forest University Medical Center Certifications: American Board of Neurological Surgery Affiliations: Congress of Neurological Surgeons, North American Spine Society, American College of Surgeons, Southern Neurological Society, Spine Arthroplasty Society, American Association of Spine Physicians, Georgia Neurological Society, Medical Association of Georgia, American Medical Association, American Association of Neurological Surgeons It targets small, precise areas to reduce muscle, tendon and ligament disruption to address nerve compression and degenerative conditions of the spine. MIS procedures minimize post-op pain, the likelihood of repeat surgery and time in the hospital. In fact, most MIS procedures can be performed on an outpatient basis. SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S35 S P E C IIA A L A DV DVE E R T IISING SING S SE ECTION What Every Savannahian Needs to Know About... Weight Loss Kyrin Dunston, M.D., FACOG True Balance MD 800 B E. 70th St. 912-401-0449 truebalancemd.com What is TRUE weight loss? True weight loss is when you lose weight easily, and it stays off. When you are overweight, imbalances occur that need to be addressed. The body needs to be rebalanced, resetting your system and allowing it to release weight naturally. Rebalancing also prevents weight from returning. How can I achieve TRUE weight loss? Natural supplements that rebalance the body’s systems are incorporated into the program. Your body is recalibrated to burn stored fat for fuel, thereby achieving the goal of weight loss. What should be included in a TRUE weight loss program? The true weight loss program includes an eating plan and supplements. The eating plan and supplements address the five key areas of dysfunction that occur from being overweight. The five areas include: s.ATURALHORMONEBALANCING — thyroid, insulin, estrogen, progesterone, testosterone, and the stress hormones, like cortisol. s$ETOXIlCATIONREMOVING undesirable chemicals from the body that hinder weight loss. CTOR O D K AS STATS Board Certification: American Board of Obstetricians & Gynecologists, Member of American Academy of Anti-Aging Medicine Fellowship Program Medical Degree: Jefferson Medical College Professional Organizations: American Academy of Anti-Aging Medicine, American College for Advancement in Medicine, Life Extension Foundation S36 savannahmagazine.COM s#ORRECTIONOFNUTRITIONAL deficiencies — most overweight people have deficiencies of specific vitamins, minerals and macronutrients. s)NmAMMATIONFOODSENSI tivities and chronic infections can be the cause of this. s"ARRIERSBREAKINGDOWNTHE barriers that keep you stuck in an unhealthy lifestyle. I A L A DVE DV E R T ISING I S I N G SE SECTION S P E C IA What Every Savannahian Needs to Know About... Adult Attention Deficit Disorder (ADD) Chad Brock, M.D. Savannah Psychiatry 635 Stephenson Ave. 912-352-2921 savannahpsychiatry.com Is there such thing as adult onset Attention Deficit Disorder (ADD)? ADD is a childhood disorder than can persist into adulthood. An adult may have always had the problem but was able to compensate for it. Major life changes can overwhelm their compensation measures and make focus issues more evident. For example, a young adult with untreated ADD may make it to college with the structure their parents provided only to falter in college because of the freedom and lack of structure. Are there non-medical treatments for ADD? OCTOR ASK D Yes! Exercise can have a tremendous benefit. I encourage my adult ADD patients to engage in vigorous cardiovascular exercise before their workday. Also, having someone help you establish structure to your day can be beneficial. People with ADD often fail in their decision-making. You are less likely to go astray if you have set daily patterns. STATS Education: M.D., The University of Oklahoma College of Medicine Residency: Medical University of South Carolina Privileges: Memorial University Medical Center What are the current trends in treating ADD with medication? Stimulants used to have to be dosed several times a day. Now there are several extended release formulations that can be taken in the morning and will last throughout the day. SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S37 S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Corrective Breast Surgery Thomas Horn, M.D. Finger and Associates 5356 Reynolds St., Suite 505 912-354-4411 fingerandassociates.com What is corrective breast surgery? Corrective breast surgery is for prior breast augmentation and breast reconstruction patients who are unhappy with their results. This type of surgery restores the natural beauty of an individuals breast’s as well as her confidence. What problems do patients seek help with? Each patient has a unique set of problems that they wish to correct. These can range from saline implants with visible wrinkles to size mismatches to general displacement of an implant. Is this type of surgery a specialty for you? Corrective breast surgery has become about half of my practice. Addressing corrective concerns involves a great deal of time between myself and my patient to determine her individual priorities and best solution. How do you prevent future problems? OCTOR D K S A STATS Medical Degree: University of Florida, College of Medicine Residencies: Medical College of Georgia (General Surgey), University of Miami (Plastic surgery) Board Certifications: American Board of Surgery, American Board of Plastic Surgery S38 savannahmagazine.COM During the consultation I make sure my patients have realistic expectations of what she de desires to look like. I then make sure I can perform a corrective surgery to meet these expectations. Surgically, there are many challenges, such as maintaining nipple sensation, keeping the implant in the correct location and removing any asymmetries in the breast. My goal is to give my patients the breasts she always desired. I A L A DVE DV E R T ISING I S I N G SE SECTION S P E C IA What Every Savannahian Needs to Know About... Balloon Sinuplasty David S. Oliver, M.D., F.A.C.S. Coastal Ear, Nose and Throat, L.L.C. 322 Commercial Drive, Suite 2 912-355-2335 What is balloon sinuplasty? It’s a new, minimally invasive procedure for relieving sinusitis. Unlike past sinus surgery, balloon sinuplasty involves no scraping, no tissue removal, no excessive bleeding or bruising — and just a day or two of recovery time. How does it work? A small catheter is introduced into the nose. A balloon is then passed over a lighted wire into the sinus and inflated to a pressure strong enough to permanently dilate the bony openings of the affected sinuses. Who is a good candidate? OCTOR ASK D Balloon sinuplasty doesn’t relieve allergies or nasal polyps, and progressive diseases may require other treatments. It is ideal for people who have had several episodes of sinusitis and rounds of antibiotics within a year. Children who have chronic runny noses, snorting and mouthbreathing can also be good candidates. We have performed the surgery on patients of all ages, including children as young as 3. STATS Medical Degree: Medical University of South Carolina Residency: Medical College of Virginia Certifications: Fellow, American College of Surgeons, Academy of OtolaryngologyHead and Neck Surgery and American Academy of Procedural Coders Organizations: American Medical Association, Georgia Medical Society, Medical Association of Georgia Privileges: St. Joseph’s/Candler Health System, Memorial University Medical Center, Evans Memorial Hospital And the results? So far, results have been positive and lasting, much more so than adenoid surgery alone or the old-fashioned sinus-scraping surgery. SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S39 S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Rotator Cuff Robert Dow Hoffman, M.D. Chatham Orthopaedic Associates, P.A. 4425 Paulsen St. 912-355-6615 | chathamorthopaedics.com What exactly is the rotator cuff? The rotator cuff is a group of four muscles that cover the ball of the shoulder or the head of the humerus. These muscles allow you to rotate your shoulder and to reach overhead. They are important muscles for many everyday work and sports activities. Why is the rotator cuff so prone to injury? The rotator cuff can be injured in certain activities that place a great deal of stress on those muscles such as sporting activities, throwing motions and overhead lifting. The rotator cuff also becomes significantly more prone to injury as we age. How can patients avoid rotator cuff injury/strain in the future? OCTOR D K S A There is no way to completely eliminate the risk of injury. However, maintaining good rotator cuff strength is essential to avoiding injury, especially if you engage in heavy lifting, heavy overhead work and sporting activities. STATS Board Certification: American Board of Orthopaedic Surgery Medical Degree: Duke University School of Medicine Residency: University of Iowa Hospital and Clinics What Every Savannahian Needs to Know About... Hip/Joint Replacement James F. Holtzclaw, M.D. Chatham Orthopaedic Associates, P.A. 4425 Paulsen St. 912-355-6615 | chathamorthopaedics.com How does a patient know when it’s time for a hip/joint replacement? The answer to this question will be different for each individual. I tell patients that when their joint pain limits them from doing activities that make their life enjoyable, then it is time to consider surgery. The main indication to proceed with surgery is disabling pain. How long does it take to recover from hip/joint replacement? A patient is usually hospitalized for one to two days and is on crutches or a walker for approximately two weeks after the procedure. Patients usually require physical therapy for four to six weeks, which is significantly less than the 12 weeks usually required for knee replacement surgery. How can a hip/joint replacement help improve a patient’s quality of life? OCTOR ASK D Hip and knee replacement surgery have a long track record of providing excellent outcomes for patients. The main reason a patient’s quality of life is improved is due to the elimination of their joint pain. STATS Board Certification: American Board of Orthopaedic Surgery Medical Degree: Emory University School of Medicine Internship: Duke University Medical Center S40 savannahmagazine.COM S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Foot and Ankle Joint Replacement Mark A. Jenkins, D.O. Chatham Orthopaedic Associates, P.A. 4425 Paulsen St. 912-355-6615 | chathamorthopaedics.com Why is the foot/ankle so prone to injury? The foot and ankle have no inherent bone stability. This particular part of the body is mainly held together by ligaments and tendons, making it especially vulnerable to injury. What are some of the benefits of having joint replacement surgery on the ankle? With joint replacement surgery, patients can keep adequate ankle range of motion. This procedure can benefit patients by greatly improving their mobility and their quality of life. How long is the typical recovery time for foot or ankle replacement? The recovery time can take anywhere from four to six months. Physical therapy is an important part of the recovery process. OCTOR D K S A STATS Osteopathic Degree: Kirksville College of Osteopathic Medicine in Kirskville, Mo. Internship: Ohio University College of Osteopathic Medicine Residency: Grandview Hospital and Memorial Center in Dayton, Ohio What Every Savannahian Needs to Know About... Upper Extremity/ Hand Ronald H. Levit, M.D. Chatham Orthopaedic Associates, P.A. 4425 Paulsen St. 912-355-6615 | chathamorthopaedics.com What is the recommended treatment for carpal tunnel syndrome? Carpal tunnel syndrome may often be managed by non-surgical methods. Splinting, medications and steroid injections may be successful. If these measures do not provide significant relief, then surgery is recommended. I perform a minimally invasive endoscopic procedure that is very successful and allows my patients to return to activities earlier and is less painful than traditional surgery. Why is the hand such a difficult part of the body to operate upon? The hand is a complex structure with many small and intricate components. Multiple tendons, bones, muscles, ligaments and nerves must work in unison to perform even the simplest task. During surgery, I utilize advanced techniques I refined during additional fellowship training. ASK DOCTOR STATS Board Certification: American Board of Orthopaedic Surgery Medical Degree: University of Texas Health Science Center in San Antonio, Texas Residency: Henry Ford Hospital in Detroit, Mich. Fellowship: Curtis National Hand Center in Baltimore, Md. SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S41 S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Knee Arthritis Greer E. Noonburg, M.D. Chatham Orthopaedic Associates, P.A. 4425 Paulsen St. 912-355-6615 | chathamorthopaedics.com Is there any way to prevent arthritis in the knee? Despite some claims in the media, there is no “cure” for arthritis. There are several factors that can prevent or slow the development of arthritis including weight loss, low-impact exercise, physical therapy, braces and shoe inserts. What are the treatment options for patients with arthritis? Managing arthritis is a long-term commitment, and establishing a treatment plan with your doctor is an important first step. A combination of prevention and treatment is usually the most effective approach. Once arthritis is present, a number of different options are available including medications, dietary supplements, steroid injections and viscosupplementation injections. Individuals who have not gained lasting relief from nonsurgical management may be offered a variety of operations including knee arthroscopy, partial knee replacement or total knee replacement. OCTOR D K S A STATS Board Certification: American Board of Orthopaedic Surgery Medical Degree: Dartmouth University Residency (Affiliated): Madigan Army Medical Center in Tacoma, Wash. What Every Savannahian Needs to Know About... The Spine Raphael R. Roybal, M.D. Chatham Orthopaedic Associates, P.A. 4425 Paulsen St. 912-355-6615 | chathamorthopaedics.com Why is the spine so prone to injury/debilitation? The spine is a series of linked joints comprised of bone and cartilage tissue that perform the simultaneous function of providing both motion and stability while protecting the neurological structures. Because the spine is an erect series of joints in delicate balance, the paraspinal musculature is prone to fatigue as well as injury from over usage. When is surgery the right option for back pain? Surgery is appropriate when the correctible spinal pathology commonly referred to as a “pain generator” is accurately identified. In general, this is only after conservative treatment options have failed. Are there certain spinal conditions when early surgical intervention is advisable? Yes. Neurological deficits such as weakness, atrophy or bowel and bladder dysfunction and progressive deformity due to scoliosis and fracture can compromise the health of the cervical or thoracic spinal cord and require early intervention. OCTOR ASK D S42 savannahmagazine.COM STATS Board Certification: American Board of Orthopaedic Surgery Medical Degree: University of New Mexico School of Medicine in Albuquerque, N.M. Residency: University of Arizona, University Medical Center in Tucson, Ariz. Fellowship: Texas Back Institute in Plano, Texas S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Knee Ligaments Spencer M. Wheeler, M.D. Chatham Orthopaedic Associates, P.A. 4425 Paulsen St. 912-355-6615 | chathamorthopaedics.com What are the most common knee ligament injuries? Although the knee is comprised of many ligaments, the two most commonly injured are the medial collateral ligament, commonly known as the MCL, and the anterior cruiciate ligament, commonly known as the ACL. MCL injuries occur when a valgus force is applied to the knee, causing it to strain. The ACL ligament is usually injured by pivoting or cutting maneuvers and is rarely caused by trauma. What is the best course of treatment for an ACL injury? For an ACL injury occurring in the young and active athletic population, the recommended treatment is an ACL reconstruction to provide stability of the knee. In patients who are older and not doing a lot of pivoting or cutting activities, other options such as bracing are certainly viable. OCTOR D K S A STATS Board Certification: American Board of Orthopaedic Surgery Medical Degree: Medical College of Georgia Internship: University of Florida, Jacksonville-General Surgery What Every Savannahian Needs to Know About... Flat Feet Steven Shapiro, M.D. Savannah Orthopaedic Foot & Ankle 6715 Forest Park Drive 912-352-FEET | savannahfoot.com Are flat feet ever serious? Actually, they can become very painful. Flat feet can lead to pain in the arch, ankle, knee and even the hips and lower back. How do you treat the pain? There are conservative, non-surgical treatments like orthotics and exercises. If those don’t work, we now have arch implants and other minimally invasive surgical procedures for both children and adults. These modern procedures have less down time than surgeries of the past. STATS OCTOR ASK D Medical Degree: George Washington University School of Medicine Residency: Harvard Orthopaedic Residency Program Fellowship: University of Texas at Southwestern, Foot and Ankle Board Certifications: Diplomat, American Board of Orthopaedic Surgery; Fellow, American Academy of Orthopaedic Surgeons; Member, American Orthopaedic Foot and Ankle Society SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S43 S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Eyelid Lifts Angela Rowden, M.D., F.A.C.S. Advanced Eye Care at Georgia Skin and Cancer Clinic 900 Mohawk St., Suite A 912-376-2591 What do you wish more people knew about eyelid lifts? That an eyelid lift, or blepharoplasty, is often covered by insurance. If you have to lift your eyebrows to keep your eyes open, or the sides of your lids droop and impede your side vision, a lift could be medically indicated and insurance-eligible. How can you tell if a lift is medically indicated? As an oculoplastic surgeon (an eye surgeon who specializes in surgery of the eyelids and orbit), I can perform the tests to determine if your lids are impeding your vision. OCTOR ASK D STATS Medical Degree: University of Kansas School of Medicine Residency: University of Missouri at Kansas City / University of Kansas, School of Medicine Board Certifications: American Board of Ophthalmology / Fellow: American Academy of Ophthalmology / Fellow: American College of Surgeons What Every Savannahian Needs to Know About... Preventing Skin Cancer Sidney Smith, M.D. Georgia Skin and Cancer Clinic 900 Mohawk St., Suite A 912-925-0067 georgiaskinandcancer.com When should I see a dermatologist about possible skin cancer? If you’ve ever had a sunburn with peeling or blisters, get a full-body check every year or two. More urgently, if a spot on your skin has changed in any way, come see us immediately! Why do people postpone coming in? Some are afraid of needles. The good news is we mix bicarbonate with our anesthesia so the initial injection doesn’t hurt. Most procedures are covered by insurance, but don’t be afraid to ask for a reduced fee if you are uninsured. ASK DOCTOR S44 savannahmagazine.COM STATS Medical Degree: Medical College of Georgia Residency: Dermatology: University of Alabama. Internal Medicine: Vanderbilt University Board Certifications: American Academy of Dermatology, American College of MOHS Physicians, American Board of Internal Medicine S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Neuromas Frederic Spector, D.P.M. Coastal Foot and Ankle Center 352 Commercial Drive 912-354-3668 What is a Neuroma? Neuromas are a common cause of pain to the ball of the foot. This problem is caused by compression of the interdigital nerve to the third and fourth toes. It occurs more frequently in women. What are the symptoms? Symptoms are severe pain and cramping to the ball of the foot and sometimes numbness to the toes. Are there surgical and non-surgical treatments available? Yes. Shoes should be wide, roomy and padded. If a cortisone injection does not help, then surgery may be necessary. STATS ASK DOCTOR Medical Degree: Ohio College of Podiatric Medicine Residency: Kaiser Permanente Medical Center, Hayward, Calif.; Southeastern Medical Center, North Miami Beach, Fla. Board Certification: Diplomate, American Board of Podiatric Surgery Hospital Affiliations: St. Joseph’s/Candler, Memorial Health University Medical Center Professional Organizations: Fellow, American College of Foot and Ankle Surgeons What Every Savannahian Needs to Know About... Hospice Care Kelly Erola, M.D. Chief Medical Director, Hospice Savannah, Inc. 1674 Chatham Parkway 912-355-2289 | HospiceSavannahHelps.com What happens when a patient goes to hospice? One doesn’t necessarily “go” to hospice. We happen to have a Hospice House, but most hospice care takes place at home. Hospice is a course of treatment a patient can choose while keeping their own doctor. It’s all about quality of life. How will we know when it’s time? So many people say “I wish we’d called sooner.” If you feel overwhelmed by dealing with a life-limiting illness, call us. We’ll assess your situation honestly and compassionately. If it’s too soon for hospice care, we’ll help you find the help you need now. ASK DOCTOR STATS Board Certification: Fellow, American Academy of Family Physicians; Fellow, American Academy of Hospice and Palliative Medicine Medical Degree: McMaster University School of Medicine, Hamilton, Ontario Residency: Ottawa Hospital, Ottawa, Ontario SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S45 S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Breast Reconstruction Cliff Cannon III, M.D. Coastal Empire Plastic Surgery 900 Mohawk St., Suite A 912-920-2090 | coastalempireplasticsurgery.com What’s the latest in breast reconstruction? The latest technique in Savannah is the DIEP flap: Skin and fat — but not muscle — are taken from the patient’s lower abdomen to reconstruct the breast. The new breast is made of the patient’s own living tissue, and the abdominal contour is improved, much like a tummy tuck. What else should I know? Breast reconstruction surgery after mastectomy is extremely safe. It won’t interfere with ongoing treatment or increase the risk of the cancer coming back. OCTOR D K S A STATS Medical Degree: Mercer University School of Medicine Residency: Medical Center of Central Georgia, Macon Fellowship: Tulane University School of Medicine, New Orleans What Every Savannahian Needs to Know About... Mommy Makeovers Luke Curtsinger, M.D. Coastal Empire Plastic Surgery 900 Mohawk St., Suite A 912-920-2090 | coastalempireplasticsurgery.com What is a “Mommy Makeover”? A combination of procedures for women whose bodies have been changed by pregnancy, childbirth and lactation. It can include a breast lift, tummy tuck, liposuction and other options. When can I have a makeover? At least three months after you stop breastfeeding; once you are sure your family is complete. What results can I expect? Depending on your choices, you can flatten your tummy, remove stretch marks, lift the breasts, restore their volume or get your hourglass figure back. Our goal is to help you feel good about your body. OCTOR ASK D S46 savannahmagazine.COM STATS Board Certifications: American Board of Plastic Surgery Medical Degree: University of Louisville (KY) School of Medicine Residency: University of Texas Health Science Center (general surgery), University of Pittsburgh (plastic surgery) S P E C IA L A DVE R T ISING SE C T I O N What Every Savannahian Needs to Know About... Facial Rejuvenation Meghan K. McGovern, M.D. Coastal Empire Plastic Surgery 900 Mohawk St., Suite A 912-920-2090 | coastalempireplasticsurgery.com Does “facial rejuvenation” mean a facelift? Not necessarily. Although I’m trained in facial surgery, as I’ve matured in my practice, I’ve learned many techniques to restore the look of youth without surgery. There are some things that simply cannot be corrected without surgery, but there are some surprisingly subtle ways of restoring what we lose as we age and maintaining a natural, youthful look. This can be accomplished with minimal to no downtime for many patients. Will the results be as good as surgery? It really depends on your goals and desires. No matter what, the idea is for people to say “Gosh, you look great!” not “Gosh, who’s your surgeon?” OCTOR D K S A STATS Board Certifications: American Board of Plastic Surgery Medical Degree: University of Virginia Residency: LehighValley Hospital, Allentown, PA What Every Savannahian Needs to Know About... Breast Augmentation Joel Shanklin, M.D. Coastal Empire Plastic Surgery 900 Mohawk St., Suite A 912-920-2090 | coastalempireplasticsurgery.com Can breast implants look natural? Yes, especially with a gel implant placed under the chest muscle. But some women want more fullness or cleavage. What if I’m not sure what I want? I invite patients to come in with their favorite clothes, to try on different implants and see how they look. Some bring their friends or husbands along. Are implants safe? Very safe. Since the 1980s, when some had problems, implants are probably the most investigated medical devices. OCTOR ASK D STATS Board Certifications: American Board of Plastic Surgery Medical Degree: University of Louisville (KY) School of Medicine Residencies: University of Arizona (general surgery), University of California (plastic surgery) SAVANNAH HEA L T H 2 0 1 1 - 2 0 1 2 S47 I A L A DVE DV E R T ISING I S I N G SE SECTION S P E C IA What Every Savannahian Needs to Know About... Treatment-Resistant Depression William G. Ellien, M.D. TMS Neuroscience Center of Savannah 415 Eisenhower Drive, Suite 1 912-356-8300 TMSSavannahGA.com Is treatment-resistant depression widespread? Yes. Of the 14 million Americans suffering from Major Depression every year, only 30 percent of them achieve remission from their first anti-depressants. That percentage keeps dropping on subsequent tries. What can be done? If an antidepressant trial fails, noninvasive, non-drug Transcranial Magnetic Stimulation (TMS) may be prescribed. New to Savannah, it’s the first FDA-cleared treatment for recurrent major depression in many years. TMS directs ultra rapid, MRI-strength magnetic pulses to stimulate an area of the brain that helps to regulate mood. Is it affordable? Although few insurers cover TMS at present, we work with a case management company that has a 75 percent success rate in appealing reimbursement denials. Also, there are reputable treatment financing plans. OCTOR ASK D Is it really worth it? STATS Medical Degree: Jefferson Medical College of Thomas Jefferson University Residency: Dwight David Eisenhower Medical Center, Fort Gordon, Ga. Certifications: American Board of Psychiatry and Neurology Other: Chairman, Department of Psychiatry, and Medical Director, Behavioral Health Center at Memorial Health University Medical Center; Chairman, Department of Psychiatry and Behavioral Sciences at Mercer University School of Medicine, Savannah Campus; Physician of the Year in 2009 at Memorial S48 savannahmagazine.COM Absolutely! The brutal facts are major depression is a proven brain disease and the world’s leading cause of disability — at enormous economic costs. It significantly increases individual risks of stroke, heart attack and diabetes. It triples the risk of dying from a myocardial infarction. TMS is life saving!