Author Archives: ADC

About ADC

The Austin Diagnostic Clinic is a multi-specialty clinic in Central Texas providing quality primary and specialty health care since 1952. We have more than 120 doctors and providers that work hand in hand to coordinate your care at locations across the area. My health. My doctor. My ADC.

Kimberly’s Peacamole Recipe

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bowl of peas

Peacamole Ingredients

1lb bag frozen peas
¼ red onion
2 cloves garlic, crushed
1 serrano (less if you don’t want spicy)
juice of 1 lemon
2 tbs salsa fresca
salt or salt substitue to taste

Method

Cook peas for 3-4 minutes in lightly salted boiling water or until tender. Drain and allow to cool slightly. Put the peas into a food processor with all the remaining ingredients (apart from the salsa fresca). Pulse until mixture is crushed but not completely smooth.

Season with salt, freshly ground black pepper. Finally, mix in salsa fresca

Cooking tips

The less water you use when cooking peas, the less vitamin C is lost. Steaming helps to conserve this vitamin.

When boiling frozen peas, add enough water to cover, bring to the boil and then cover and simmer for 3 minutes. To microwave 227 grams (8oz) of frozen peas add 15ml (1 tablespoon) of water, place in a non metallic container and cover. Cook on full power for 4 minutes (750W) or 4 1/2 minutes (650W).

Bioidentical hormone options – Video

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There are a wide variety of bioidentical hormones options available through your physician’s office that are safe and effective.

Dr. Michele McDermott, Menopause and Osteoporosis Specialist at The Austin Diagnostic Clinic, explains what some of those options are in the second part of a three-part series on bioidentical hormones:

Video Transcription

I am going to explain all of the different options that you have for bioidentical hormones.

Like the compounded hormones, these bioidentical hormones come in many forms. They come in pills, patches, and gels.

I have in front of me just some examples of the bioidentical estrogen and progestin available by prescription from your physician.

When I see a patient, I show them many of these options.

We take them out and look at them so that they can decide what they think would work best for them.

Let’s start with a basic pill.

This is a tablet that has bioidentical estradiol.

Estradiol is just like the estrogen in your ovary. As you can see, it comes in a simple packet. There is nothing messy or difficult about it. It is covered by insurance. It can be taken once daily.

There are other types of bioidentical progesterone capsules.

Many women believe that progesterone has to be taken in a cream form. In fact, the cream is not proven to be effective to prevent uterine cancer.

This capsule – oral form – has been tested and found to prevent the uterus from being overly stimulated by the estrogen. This is the best type of progesterone to use for preventing uterine cancers. Oral progesterone or it could be in a patch.

We have oral, tablets. We have patches. We have gels of varying concentrations and delivery methods.

These types of gels that come in a bottle are very simple to use.

We simply pump this bottle and a very small amount of gel goes on the arm. Then it is spread on the arm. It evaporates within a few minutes Once it evaporates, the hormone is in your skin and the bloodstream picks it up and takes it throughout your circulation.

That is a very physiologic way of getting your hormones.

Another type of hormone that goes through the skin are the patches. These are very well-liked by women because they are easy to use. They come in a variety of doses.

It is very easy for us to regulate the dose so that it is just right for you. To do that, we talk about your symptoms. We don’t just rely on blood levels.

You may have heard that it is important to measure blood levels. Blood levels vary from day-to-day. They really don’t tell us how you are feeling.

Because we have many doses, we may start with an average dose. If you have a lot of symptoms we may start with a higher dose.

The patch is easy. As you can see the back just peels off. It is applied to the lower abdomen. It is changed twice a week. It withstands heat, showers, baths. Even here in Austin, Texas women find that it stays on perfectly well.

There are some patches that contain both hormones. Of course, that is a very convenient way of getting your hormone therapy.

These are gels that are applied on the thigh. They come in packets. There is even a bioidentical estrogen that comes in a spray.

This is a little spray device that is brand new so the top is a little hard to take off… But this goes on the forearm and just one pump delivers a low dose.

So this would be a very good starting hormone when you are just having symptoms at the very beginning of menopause but you don’t need a very high dose.

Here we have many options for you.

I would encourage you to speak with your physician. If they are not familiar with these choices then look for a menopause specialist like myself.

The way to find a menopause specialist is through the Menopause Society at menopause.org. On that site there is a tab that says find a doctor. There may be a menopause specialist in your area.

Just remember when you feel stressed, worried and overwhelmed with all of the information you see on the internet and hear from your friends, take pause.

Remember that there are many choices and specialists there to help you.

Meet Dr. Mary Gasal, Menopause and Osteoporosis Specialist

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Mary Gasal

Mary Gasal, MD, CCD, NCMP, FACOG is a board certified Obstetrics  and Gynecology specialist. Her areas of interest include the diagnosis and treatment of menopause, osteoporosis and gynecologic needs for the mature woman.  She is a physician practicing in ADC’s Menopause and Osteoporosis Center in Austin, TX.

Dr. Gasal  received her medical degree from the University of Oklahoma Medical School, Oklahoma City and Tulsa, OK .  She completed her internship and residency at the University of Oklahoma,Tulsa Medical College.  Dr. Gasal is board certified in Obstetrics and Gynecology by the American College of Obstetrics and Gynecology.  She is also a Certified Menopause Specialist (NCMP) by the North American Menopause Society, Certified Clinical Densitometrist (CCD) and Fellow of the American College of Obstetrics and Gynecology (FACOG).

She has been recognized by her patients for health care excellence with the Patient’s Choice Award.  Dr. Gasal is a member of the American Medical Association,  North American Menopause Society,  American Board of Obstetrics and Gynecology, International Bone and Mineral Society, Texas Medical Association and Travis County Medical Society.

Meet Dr. Michele McDermott, Menopause and Osteoporosis Specialist

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michele-mcdermott-Apr12Michele McDermott, MD, CCD, NMCP is an Endocrinologist specializing in the care of mid-life women. She is the founder and director of the Menopause & Osteoporosis Center in Austin, Texas.

Dr. McDermott received her medical degree from Eastern Virginia Medical School. She completed her Residency in Internal Medicine and Fellowship in Endocrinology and Metabolism from the University of Texas Health Science Center in Houston, Texas. She has been a Certified Clinical Densitometrist since 1998 and a Certified Menopause Clinician Specialist since 2000.

After practicing Endocrinology in Houston, Dr. McDermott established The Women’s Center at the Austin Diagnostic Clinic 1990, creating the first program in Austin, Texas to provide comprehensive women’s health services including osteoporosis and breast cancer screening.

Dr. McDermott has been principal investigator in dozens of clinical trials of drugs for osteoporosis, hormone therapy regimens, and treatments for female sexual dysfunction. She lectures regularly on osteoporosis, menopause management, hormone therapy and other topics related to mid life women’s health. She has made numerous appearances on television as an advocate for osteoporosis and menopause awareness. She has been providing health education to women in the Austin community for almost two decades. The national organization “Speaking For Women’s Health” selected Dr. McDermott a “Women of the Year” in recognition of her dedication to empowering women with health education. She received the “Vision to Action Award”, has been recognized as a “Texas Monthly Super Doctor” from 2004-2010, the Patients’ Choice Award in 2009 and most recently as Distinguished Physician of the Year by ADC in 2011.

 

Pregnancy and High Blood Pressure

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Here are important facts all people should know about pregnancy and high blood pressure.

mother's hand on pregnant belly

Image source: Thinkstock

Expectant mothers may often spend a lot of time worrying about potential health problems like down syndrome and other genetic disorders in their unborn children. Yet a serious and more common health condition can harm both mother and child if left untreated or undiagnosed: high blood pressure.

Dr. Allison Devine, ADC OB/GYN, says high blood pressure — hypertension — is a health risk that can be present in women before, during, or after pregnancy.

“Expectant mothers should make sure they fully understand the type of high blood pressure they have to help ensure their own health and safety, as well as their child’s safety,” Dr. Devine said.

Understanding high blood pressure

Blood pressure is defined as the amount of force exerted by the blood against the walls of the arteries. If the blood pressure in a pregnant women becomes too high, it can lead to very serious health risks for both the mother and child, according to Dr. Devine.

“The main health risks of high blood pressure during pregnancy include a decreased flow of blood to the placenta, which can slow the development of the baby and increase the risk of a low birth weight,” Dr. Devine said. “High blood pressure can also cause dangerous internal bleeding in the mother and result in stillbirth.”

High blood pressure problems happen in about 6 percent to 8 percent of all pregnancies — most of them in first-time pregnancies, according to the National Institutes of Health.

Types of high blood pressure

Dr. Devine says there are three different types of high blood pressure than can occur during pregnancy.

One type is called chronic hypertension. If women had high blood pressure before becoming pregnant, developed it during the first 20 weeks of pregnancy, or have high blood pressure lasting more than 12 weeks after delivery, it’s considered chronic hypertension.

“Another type is gestational hypertension, when high blood pressure develops after 20 weeks of pregnancy,” Dr. Devine said. “But usually this type of hypertension goes away after delivery.”

She says preeclampsia is the third and most dangerous form of high blood pressure during pregnancy.

Preeclampsia happens when women with chronic or gestational hypertension develop high blood pressure and a protein in the urine after 20 weeks of pregnancy. It can also take place in women with no prior history of high blood pressure.

Preeclampsia can lead to serious and even fatal complications for mother and baby if left undiagnosed, says Dr. Devine.

“Preeclampsia affects the placenta and it can affect the mother’s kidney, liver, and brain,” Dr. Devine said. “It may cause seizures in the mother — called eclampsia — which is the second leading cause of maternal death, and may lead to other complications such as low birth weight, premature birth, and stillbirth.”

Keeping mother and baby healthy

If you do develop hypertension during pregnancy, you may need to take blood pressure medication and have more frequent prenatal doctor visits.

“Some blood pressure medication can’t be prescribed during pregnancy,” said Dr. Devine, “but we do have alternatives that are safe for mother and baby.”

Women with chronic or gestational hypertension can also help control their blood pressure through exercise and reducing sodium, she said.

For preeclampsia, however, there is no proven means of prevention. Most women who develop preeclampsia will be closely monitored to lessen or avoid health problems, said Dr. Devine.

“If you experience persistent headaches, experience blurred vision or other changes in vision, or have upper abdominal pain, these could be indications of preeclampsia and you should check with your physician or call 911 immediately,” she said.

In some cases, your doctor may prescribe bed rest if you have preeclampsia. In other cases, early delivery of the baby may be required to protect the health of the mother and child.

“The most important thing you can do for you and your baby is to get early and regular prenatal care,” Dr. Devine said. “It’s the best way to help ensure a safe, happy, and healthy delivery.”

 

Family Practice medication refill request policy

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Effective August 1, 2013, the ADC Family Practice Department will no longer refill maintenance medications by phone or fax.

If you or your pharmacy call to request a refill on your maintenance medications, you will receive a 2-week supply of medicine.  This should allow enough time to schedule your next appointment.

At your office visit, your doctor will give you enough medication to last until your next scheduled appointment.  Remember to schedule your appointments in a timely manner so that you receive your full prescription refill.

The purpose of this new refill policy is to allow our nurses to respond and focus on your clinical questions and needs quickly and efficiently.

By working together to improve our processes we will create a successful health partnership and medical home.

Dr. David Joseph named Chief Medical Officer

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Dr. Ghassan Salman, Chief Medical Officer, Monday announced that David Joseph, MD, will serve as ADC’s Chief Medical Officer.

Dr. Joseph was selected for for position because of his depth of knowledge and experience, Dr. Salman said.

Dr. Joseph, a family practitioner, served on ADC’s Board of Directors for 10 years and held several officer positions, including Chairman of the Board from 2004 to 2009. He will continue to see patients in his new position at the clinic.

“Dr. Joseph brings a wealth of experience and great dedication to our executive team,” said Dr. Salman. “Dr. Joseph is committed to our vision of compassionate care and excellent service.”

In his new role, Dr. Joseph is responsible for overseeing the clinic’s commitment to quality care and the highest medical standards.

Dr. Joseph replaces Dr. Salman, who was appointed CEO in January 2013.

Dr. Joseph was named ADC’s Physician of the Year in 2009. He also won the Frist Humanitarian Award from North Austin Medical Center in 2011 for his outstanding humanitarian and volunteer activities.

“It’s an honor to be named Chief Medical Officer,” said Dr. Joseph. “I look forward to meeting our patients’ and physicians’ expectations for a superior level of medical care.”

 

ADC appoints Salman as Chief Executive Officer

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 Dr. Ghassan Salman selected for proven leadership, impressive credentials

Ghassan Salman
Members of the board of directors for The Austin Diagnostic Clinic have selected Ghassan Salman, M.D., to be the multi-specialty clinic’s new Chief Executive Officer.

As CEO,  Dr. Salman is responsible for the overall performance, strategic development, and long term success of ADC, which has over 115 physicians representing 21 medical specialties at more than seven locations in Central Texas.

Dr. Salman keeps his existing role as Chief Medical Officer. Dr. Salman replaces Robert Spurck, Jr., who resigned Wednesday as ADC’s Chief Executive Officer. He was commended for serving 27 years as ADC’s leader.

“The decision to select Dr. Salman to Chief Executive Officer was an easy one,” said Paul B. Moore, M.D., Chairman of ADC’s Board of Directors. “During his time as Chief Medical Officer, Dr. Salman was instrumental in our growth. We believe his expanded leadership will help ADC continue to grow and prosper in the coming years.”

Dr. Salman, an internal medicine physician, has received numerous accolades since joining ADC in 2003. He was named a “Top Doctor” by Austin Monthly magazine in 2012, and he received the ADC Distinguished Service Award — the clinic’s highest honor — in 2010.

His passion is providing patient-focused health care and improving overall quality and value of care.

“As anyone in health care knows, it’s an exciting and challenging time to be in this industry. I believe ADC is poised to achieve continued success for the patients we serve and our physicians who are committed to providing the highest quality care,” said Dr. Salman. “It’s an honor to be named Chief Executive Officer, and I look forward to my new responsibilities at ADC.”

Dr. Salman holds a Masters of Public Health from the University of Kansas School of Medicine and is pursuing his MBA.

He has served on numerous committees at ADC including chair of the Medical Continuous Quality Improvement Committee and the Peer Review Committee.

Dr. Salman’s professional affiliations include Fellow in the American College of Physicians, the American College of Physician Executives, and the Texas Medical Association’s Council of Science and Public Health.

Austin OB/GYNs certified to prescribe device to treat incontinence

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ADC’s OB/GYN doctors have been certified to prescribe Intone, a non-surgical device used to help women overcome incontinence or bladder leakage.

Intone Bladder device

Intone bladder device helps women overcome bladder leakage.

Yvette M. Schieffer, M.D., Wendy Cutler, M.D., Stephanie McNelis, M.D., Allison Devine, M.D., Angela Meyer, D.O., Kiranmayi Mechineni, M.D., can prescribe InTone for women with bladder leakage.

InTone, developed by InControl Medical, LLC, is a medical device available by prescription. It is indicated to treat stress incontinence, urge incontinence or mixed (stress and urge) incontinence. InTone combines a daily program of volitional exercises, voice-guided instruction, biofeedback and micro-current stimulation to strengthen muscle tone in the pelvic floor.

Stress incontinence can occur when lifting, sneezing, coughing, laughing or exercising. Urge incontinence is the unwanted and sudden need to urinate. Both can be caused or exacerbated by childbirth, obesity, excessive exercise, lack of exercise, age or trauma.

According to the National Association for Continence, up to 30 million women in America have experienced bladder leakage issues. About one in four new mothers experience “leaking” following normal delivery, and about one in six following cesarean section.

Up to two-thirds of women who “leak” have never mentioned it to their physicians, and up to two-thirds of women do not use any treatment or product to manage their bladder leakage.

Until now, available options had mixed results. Absorbent pads and diapers do nothing to treat the condition. Medications, if prescribed, can cause side effects and are not always effective. Surgery, if performed, is a more invasive option, and is not always effective. Research has shown that even when properly taught how to perform pelvic floor, or Kegel, exercises, about half of all women do them incorrectly.

After prescribing InTone, the physician customizes the settings for InTone and the patient is shown how to use it at home. A sensor in the unit measures pressure to determine if the patient is doing the exercises properly. The biofeedback unit uses voice-guided instruction to take her through the routine and reports her muscle isolation and strength. Each daily session takes about ten minutes, and data from each session is recorded. After two weeks or so, the physician analyzes the recorded data and adjusts InTone based on the patient’s progress, and at-home treatment sessions continue. Most patients should experience progress in a few weeks, and most patients should experience effective relief in 90 days.

Intone biofeedback form

Biofeedback from Intone device

InTone is available in the United States. InControl Medical provides specialty medical products for women’s health, and is sourced and manufactured entirely in the United States. More information on InTone can be found at www.incontrolmedical.com.

To make an appointment to see if Intone is right for you, contact ADC’s OB/GYN department at 512-901-4013.