A blog by Baptist Health


Image of Jeremy Kalma, MD - Evaluating and Treating an Ankle Injury

Lexington Common Ankle Injuries

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♪ Ankle injuries are among the most common reasons patients seek medical care after a trauma, such as a car accident or a fall. Although many of these injuries are sprains, I continue to see more and more ankle fractures with time. The ankle joint is formed by two bones of the leg and one bone in the foot. These bones are held together by the ligaments of the ankle to form what is called the ankle mortise.

Ankle injuries typically occur due to a common combination of bending and rotational forces placed across the ankle joint at the time of injury. The number of injured structures of the ankle mortise as well as the extent of those injuries determines whether or not the injury is stable or unstable. Most ankle sprains and many ankle fractures are stable injuries that can be treated successfully with non-operative management. Unstable ankle fracture patterns, however, are often best treated with surgery.

Surgery frequently involves the use of orthopedic hardware such as plates and screws. However, the technology is always changing and continues to improve with time. Flexible fixation devices to stabilize the ankle and fibular intramedullary nails are some of the newer implants available and can really offer added benefits for some patients. One of the reasons I became a foot and ankle surgeon is because I enjoy treating ankle injuries.

I would say my goal when treating any patient with an ankle injury is to get them back to doing the things they enjoy. And getting people back to doing the things they enjoy is why I do what I do.
Image of William Bickers, MD

Floyd Back Pain Treatment

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♪ - [Dr. Bickers]

The HFX IQ implant is a new device that we have from one of our vendors which helps to treat chronic low back pain. There are actually quite a few patients that will benefit from this device. These patients are going to be ones that have had back surgery in the past. These patients are oftentimes difficult to treat as they've already had surgery and unfortunately still develop pain.

- [Trina]

I've had injections, epidurals, nerve injections, and then I had surgeries, still having problems. And so I was referred to Dr. Bickers to find out why I'm constantly having lower back pain.

- So the implant is approximately the size of a pacemaker. It uses electrodes that we put inside the epidural space, and then we put them at specific levels to target specific nerves or nerve roots. One of the great things about this device is that it allows the patients to continually adjust based upon survey questions that are asked through a smartphone-type interface, and then knowing the type of pain that the patient has is able to adjust the therapy. It is able to make sure that the patient is being treated as a whole patient.

- The improvement, overall improvement of the pain has just been incredible. I'm off medication. I occasionally take an ibuprofen, but no pain medication. I was on hydrocodone and I no longer need it.

It really has made a difference in my life.
Image of Robert J. Farrell, MD - Benefits of Weight-Loss Surgery

Louisville Weight Loss Management Plan

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♪ Obesity is a head-to-toe disease. There's not an organ system or body part that's not affected. There are common comorbid diagnoses that we see from diabetes to high blood pressure and heart disease, sleep apnea, these are the things we think about, but also joint pain, liver disease, and then we see increased risk of cancer. Weight loss surgery is a tool.

I always tell patients it's a very powerful tool. It's something that, when used in combination with increasing their exercise and improving their lifestyle that they can see tremendous results using the surgery as an adjunct to their weight loss. When a patient comes to us, there is a thorough workup that we want to do, and then we have a number of classes that we have for patients where we do education and we're teaching them everything from what to eat but then also we're instructing them how to exercise and how to get movement back in their life so that when the surgery happens, patients have good fundamental footing to start off on so that they can have the most success possible.

Patients often don't realize the things that they give up as they're gaining weight. It's only after that they lose 50, 75, 100, or 100-plus pounds that they can come back in and say, "You know, I can get down on the floor and I can play with my kids." You know, their confidence level comes back. They'll just enjoy life more.

For myself, as a physician, it's one of the great joys that I get.
Image of Polly West, RN - Support for Patients with AFib

Lexington Atrial Fibrillation treatment

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♪ As the electrophysiology nurse navigator, I help guide patients and families on the journey of atrial fibrillation, from diagnosis to pre-procedural workups to treatment options and ongoing support and resources. Patients are referred to the cardiology office, and once they meet with the physician and figure out options and how they want to move forward, I will be introduced to journey with them and be a resource and someone they can call. When they're scheduled for surgery, I do a pre-procedural workup and talk about the surgery itself, what to expect. And I talk to them about how many people are going to be in the room, that there's a lot of equipment, that that's normal.

When patients come in with atrial fibrillation, especially if it's a new diagnosis, they are unsure, what do I do? They feel overwhelmed because they don't understand it. So I can help them talk about modifiable risk factors, some things they can do to make their health journey better, and then treatment options, just to give them peace of mind and give them some control over a situation that feels a little out of control. Every day that I come to work, I want to provide hope and show them love and support.

And it's very rewarding to have them say, "Thank you."
Image of Vedran Oruc, MD - Diagnosing and Treating an Irregular Heartbeat

Paducah Arrhythmia Treatment

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♪ - [Dr. Oruc]

Arrhythmias are abnormal heart rhythms. What we do in electrophysiology is we look for what types of abnormal heart rhythms they are. We then use specialized mapping techniques to find the source of the abnormal electricity and try to fix that abnormal electricity. Based on where those abnormalities are, we can oftentimes go into the heart, find the trouble spots, and doing procedures that we call either ablations, where we actually map and cauterize the problem area, or doing certain types of device implants like pacemakers or defibrillators can lessen someone's risk of having rhythm issues in the future.

- [Peter]

Before, I wasn't overly concerned and I would say, well, I'm fatigued, I'm tired, it's work. Well, after the procedure and after the recovery period, felt more energized, not feeling exhausted, not feeling tired. It's a very exciting feeling that I can check my heart because I do have a device where I can check it and it says that it's in sync. So it's a great feeling.

- There's lots of patients who have had years of rhythm issues that have been undertreated because of poor access to other sorts of institutions. So the ability to do that here locally for patients, I think that's an important step towards really providing the type of environment where we can deliver patients their best possible care.
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Corbin Personalized Heart Care

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- [Dr. Brandon]

Candidates for the Heart Failure Clinic at Baptist Health Corbin are patients that have a historical or new heart failure diagnosis, patients with known difficulties with either their pumping or filling functions of their heart. We provide a multitude of services for our patients. We have a nurse, pharmacist, and a provider that evaluate the patient and use a team-based approach to find the individual needs.

- [Marvin]

They knew what my story was. They knew what to do. They knew what to look at. They asked all the right questions to figure out what my situation really was.

- Here at the Heart Failure Clinic, we are able to individually titrate and adjust medications. The same combination of medications isn't appropriate for every patient, and we take those factors into consideration. We use their vital signs, their blood work, even factors such as weight loss to determine what adjustments we might need to make for the patient, and that requires sometimes frequent visits, and we utilize your visits to individualize your treatment.

- Apparently these heart drugs take time to work. You don't just start them and stop them. And they keep a check on them, they see how they're doing, do they need to be adjusted. Well, this is good, but that's not so good.

We need to change this. Who else is going to do that stuff? Nobody else. These are the people who have worked with me and who have saved my life.
Image of Juhee Mian, MD - A New Treatment for Sleep Apnea.jpg

Louisville Sleep Apnea Treatment

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♪ Sleep apnea is a condition where a patient stops breathing more often than they should during their sleep. So if you're noticing snoring, concerns for stopping breathing, and your sleep just isn't restorative or isn't refreshing, that would be a reason to get checked out for sleep apnea. In terms of treatment for sleep apnea, the gold standard is still a CPAP machine. One more option would be the Inspire therapy, which is newer, and for patients with more moderate to severe sleep apnea who cannot tolerate a CPAP machine.

So the Inspire therapy is essentially a nerve stimulator which is implanted in the chest wall of the patient through an outpatient procedure with only two incisions. The entire point of this device is that when the patient is sleeping, that device will stimulate the nerve which controls the movement of the tongue. Therefore, during sleep, the tongue will move forward in the patient's mouth as opposed to backwards and shutting the airway. In terms of the effectiveness of Inspire, the data is robust and it shows dramatic improvements in the events of stopping breathing, as well as improvements in how the patient feels the next day, in terms of how well-rested they feel.

So seeing a patient walk in after being treated for sleep apnea, I see them improving how they do at work. I see relationships improving. I see them functioning well in their communities and it's just a great feeling to be able to be a part of that.
Image of Kevin Croce, MD

Corbin Heart Imaging

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- [Dr. Croce]

A cardiac CTA or cardiac computed tomography angiography is a heart imaging test. It uses CT technology with IV contrast to visualize the coronary arteries or other heart structures in detail. The purpose is to look for blocked or narrowed arteries and to look at other abnormalities of the heart such as the valves or if there are congenital abnormalities involving the heart. It is a little bit different than a regular CT because it does involve the injection of dye into one of the veins, and it also uses computers to help reconstruct thin slices through your heart into a three-dimensional model so that we can visualize the structures more clearly.

Some of the benefits include a very short procedure time. Also, it's much less invasive than previously what we had done to look at the heart arteries, which involved threading catheters through the arteries. Cardiac CTA is not for everybody. People with irregular heart rates or heart rhythms, people who are severely obese, or people who may have already had stents placed in their heart vessels, that can affect the quality of the exam significantly and may not benefit from having the study done.

Cardiac CTA is a very advanced imaging tool, and it is a great benefit that our patients right here in Corbin have access to this imaging study without having to travel far distances to large cities.

"I’m just so appreciative for the life that I have and realize how many blessings I have and to not take any of it for granted."

Maddie Campbell had a hole in her heart and didn’t know it

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