Flourish

Perimenopause is the four to ten years on average that lead up to menopause for a woman. And this can start anywhere in a woman's mid-30s to anywhere in her 40s. One of the first things that we hear is, I just don't feel like myself. That's because perimenopause starts in the brain. We do hear women having problems with anxiety, depression, memory changes, fatigue, mood swings, sleep changes, weight gain, and an increase in belly fat, menstrual changes, hot flashes, as well as joint pain, palpitations, vaginal and bladder changes.

I would like women to realize that there are treatments out there, that they do not have to be suffering through perimenopause. I will meet with women and we will discuss their past medical history, their risk factors, and their goals of treatment. Often we do start with menopause hormone therapy. This does include estrogen in the form of estradiol, sometimes progesterone, and sometimes testosterone.

I understand how you're feeling. I am in perimenopause myself. I am on hormone replacement myself. There is a light at the end of the tunnel and I'm seeing women daily in discussing these therapies and these treatments and it does give me such joy when they come back in to say, Hey doc, I'm feeling a lot better.

Obstructive sleep apnea is a serious medical condition because it involves periods of time during your sleep where you're not breathing, and that puts an extra strain on your heart and lungs, which can be very, adverse in terms of the consequences to your overall health.

It doesn't always manifest as big health issues initially but over time can really cause, issues with our heart and our lungs especially.

Most patients who suffer from obstructive sleep apnea are able to tolerate a CPAP mask. For patients who aren't able to tolerate a mask, then the Inspire may be an option for them.

It's a surgery where we make an incision in your neck and we hook a cuff around the nerve that controls your tongue and it helps protrude your tongue out and keep your throat wall intact and open whenever you're breathing in and out and sleeping at night.

Six weeks after the surgery they activate it. I would say within ten to twelve days of, you know, it's the difference, major difference of just sleeping better, just deeper sleep, REM sleep, you know. I would never go back to a CPAP after having Aspire. It's the difference between daylight and dark.

The goal of treating these patients is to make people healthier, to get people to be in a spot where they feel like they can do everyday living without feeling tired and run down, and to get them feeling back to themselves.

Family medicine means to me, first and foremost, relationships. Know, I think one of the hallmarks of our specialty in what we do is really building relationships within communities. And those relationships are what really allow us to provide that bread and butter medicine that we like to provide, is primary care and preventive care. So what we're doing with this is we're really looking long term. What are the preventive medicine things that we need to do for you to set you up for a long and healthy life? Other things that we do, we do manage chronic conditions, everything from diabetes to thyroid disorder, as well as heart disease, kidney disease, anything that falls in those categories.

After I had my thyroid up, it's just been a rollercoaster with emotions. So Doctor. Bushclaw picked up on my medications, seen what I was taking, and seen that one of my medications that I was taking needs to be taken a certain way. We fixed that and it has definitely shown a big improvement.

We really try to take an approach to the individual patient. So if you come in and you're coming to see me for a well child visit and you're a two year old, I'm going have a different approach than if you're coming to see me for that twenty year old visit.

And that's all based on evidence based medicines, the things that we're being recommended to do for those preventive care Being a patient of his, it truly makes you feel heard.

He really digs through to find what's going on. He wants to figure out the cause so that way we're just not masking the symptoms. He's truly figuring out what's causing those symptoms. So I trust him fully with my care.

Patients who've been having ongoing knee arthritis and mostly those who have tried conservative therapies and are at the point where those just don't work for them anymore are patients who really do benefit from total knee joint replacement. At Baptist Louisville, we are an orthopedic center of excellence, which means the surgeons and staff are experienced and well trained. You know, from when somebody walks into the door to when they walk out, they are receiving care that is second to none. With anybody, I want to treat them like I'd want to be treated. I like to explain all the options that are available to my patients and just let them know that we're a team.

And whether we're doing conservative therapy or we're talking surgery, I'm here to support them in any way I can. And when it comes time to have a surgery, I really have the easy job in all this. The patient has the more difficult job in doing the rehab and putting the time in to get the results that we're wanting to get. With people undergoing a total joint replacement, the goal is to get you back doing normal daily activities and things you enjoy doing. We really want to restore you into living your life. And if we can't do that with conservative therapies, then that's when I tell all my patients, you need to have that honest conversation with yourself and consider having a total knee replacement with the end goal being getting back to living your life.

When you complete treatment in the Oncology Cancer Care Center, we work with patients on their survivorship care plan and that incorporates what they've been through as well as what surveillance we'll be doing. But we particularly want intentional self care. That's looking at your pillars of health. How are you sleeping?

What's your nutrition? How active are you? How socially active are you? What's going on with work?

There's all aspects. So we try to really build structure in which you can take your power and empower yourself to do your self care. Here at Baptist Health Cancer Care Center, we're here to help you through that. We have a bountiful source of resources for patients, whether it's the nurse navigator helping them through their cancer journey, dieticians, physical therapy, occupational therapy, genetic counseling, financial counseling.

We have social workers that can help with phase of life issues and of course behavioral health where we can help support your emotional strength. When we look at survivorship, what does that mean? That's a partnership. That's a partnership not only with your medical team, but your community, with your family, with your spiritual family.

All those components help strengthen you, and that's what the whole goal is.

I would describe reconstructive surgery as a field that restores function, form, and often psychological well-being for patients who have cancer diagnoses, prior trauma, or have had a successful weight loss journey. So a predominant portion of my practice is breast reconstruction after either partial mastectomy or a full mastectomy. And so that may involve reconstruction of the breast using your own tissue, or sometimes that may involve implant based breast reconstruction.

The process of breast cancer reconstruction is often performed at the same time as the mastectomy. I work with the breast surgeons to either reshape the breast after a partial mastectomy or to use an implant or a tissue expander to place that at the same day of the mastectomy for reconstruction. The goals of breast reconstruction are to recreate breasts that the patient is happy with. That may be reconstructing a breast that is smaller, perhaps larger, slightly shaped differently and lifted.

It's a discussion back and forth between the patient and I in terms of what their goals are and how I can best achieve those goals. I think our breast cancer care team is excellent. We work closely and in conjunction with each other to make sure that we're providing the optimal care for all of our patients. And then Baptist Health Louisville does a fantastic job of tightly coordinating and orchestrating your entire cancer care experience from the breast surgery team to the plastic surgery team to medical oncology to radiation oncology.

I think we provide excellent care across all of those specialties.

Pancreatic cysts are fluid filled structures that can show up in the pancreas. The pancreas being an organ that's right in the middle of the abdomen. It's in the back of the abdomen and hard to access. These cysts can range from benign cysts to potentially pre malignant or pre cancerous cysts.

If a is found on your imaging, the first step I would say is not to panic. Most of these cysts don't have any chance of progressing to cancer and many of them we can actually watch without the need to have surgery. But if a cyst is found, it is worthwhile to pursue and make sure it's not one of these cysts that can progress the cancer. So I'd recommend coming in to see one of us here at Baptist and we can propose a workup to make sure that if it is one of these cysts that we have to worry about cancer, we can get you in to get it taken care of with surgery.

If not, the majority of the time we will kind of watch this closely, make sure things don't change. Pancreatic cancer is not usually associated with cysts, we are finding out that about ten to twenty percent are associated with some type of mucinous cyst. Typically those patients actually do better. There's thought that that's because we're catching these cysts early.

They're showing up on these tests and we're taking them out. So it is a target for us that we can prevent pancreas cancer even though the majority of pancreas cancers are not necessarily associated with cysts. Pancreatic cancer is one of the more aggressive cancers and any opportunity that we have to prevent it, we want to take that opportunity. The more we know about these cysts, more we can restratify them and potentially do a surgery that would prevent pancreatic cancer.

Whenever we have the opportunity to do that, we would like to take it.