2015-06-01 - HealthCare Quarterly (Vol. 8) - Top Doctors 2015 - Spring 2015

VEGAS INC HEALTH CARE QUARTERLY 2015 | VOLUME 8

2015 | VOL. 8 PRESENTED BY:

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SPONSORED BY:

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HONORING MEDICAL PROFESSIONALS IN SOUTHERN NEVADA

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WHEN YOU’RE IN THE FIGHT OF YOUR LIFE, IT HELPS TO HAVE AN ARMY ON YOUR SIDE.

UNITED TO REDEFINE CANCER CARE Comprehensive Cancer Centers of Nevada treats more patients than all other Nevada treatment centers combined. We are also affiliated with The US Oncology Network – one of the nation’s largest networks of community-based oncology practices.

UNITED WE HEAL • Through our affiliation with The US Oncology Network, you can put the knowledge and experience of nearly 1,000 physicians nationwide on your side.

• Your individual treatment plan will draw on nearly 1,400 clinical research trials involving more than 60,000 patients.

RIGHT HERE IN NEVADA • Comprehensive is now conducting more than 170 Phase I, Phase II and Phase III clinical research studies in Nevada.

• More than 4,000 out-of-state patients come to Comprehensive to secure the strongest possible allies in their fight against cancer.

• Comprehensive has helped develop 54 FDA approved cancer therapies.

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Susan Hilburger

Diagnosis: Brain Tumor

This means no matter what you face, chances are we’ve faced it before. Comprehensive possesses the absolute latest medical research to support your own unique course of individual treatment. And if your participation in a research study could benefit you, we can give you opportunities that simply don’t exist elsewhere.

Ask your doctor about Comprehensive. Visit cccnevada.com for more information or call 702.952.3350 to schedule an appointment today.

United in Healing

The US Oncology Network is supported by McKesson Specialty Health. © 2015 McKesson Specialty Health. All rights reserved.

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CONTENTS

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28 COVER FEATURE Top Doctors 2015

WHAT TO ASK A DOCTOR

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Get the most out of your visit by being prepared.

WHAT TO ASK A PHARMACIST

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A little extra knowledge can go a long way to improving your health.

TREATING ADDICTION

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Different trends show up in different age groups.

Patient Joe Mosier pauses with Paula Lane, left, R.N. supervisor, Pam Hetterscheidt, R.N. manager, and his daughter Kathy Hamilton, far right, at a Southwest Medical Associates Urgent Care facility.

MENTAL ILLNESS

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Intervention and education are key.

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OVER 55 Treating older patients with cancer.

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HEART FAILURE A new way to treat congestive heart failure

COLUMNS 16

Don Evans, C.S.H.M., Safety Consultation and Training Section

105 Lia Yulianti, proprietor of Belia, helps cancer patients feel beautiful.

SAFETY

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FERTILITY Eva Littman, M.D., Red Rock Fertility Center

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WELLNESS Eva Liang, M.D., Center for Sight

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INSURANCE Rebecca Edgework, M.D., Volunteers in Medicine of Southern Nevada

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HOSPICE Maureen Kelleher, R.N., Las Vegas Solari Hospice Care

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TECHNOLOGY Linda Rittenburg, R.N., Southwest Medical Associates

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CHILDREN’S HEALTH Health care milestones from newborns to teens

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SENIOR HEALTH Helping senior citizens get the most out of life

Dr. George Alexander is a local plastic surgeon whose career was influenced by his love of the study of anatomy.

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VOLUNTEER PROFILE Lia Yulianti, Proprietor of Belia

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CONSUMER TIP Radiology 101: What you need to know before your next visit

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HEALTH TIP Staying skin smart this summer

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PATIENT SUCCESS PROFILE Joseph Mosier, Southwest Medical Associates

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PATIENT SUCCESS PROFILE Ruth Peoples, Desert Institute of Spine Care

COMMUNITY 110

CALENDAR Upcoming events and classes

2015 | VOL. 8 PRESENTED BY:

Dr. Alexander photo by PROTO Images

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SPONSORED BY:

COVER DESIGN Michele Hamrick

SPRING 2015

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Cong ra

ns o i t la u t

PUBLISHER DONN JERSEY (donn.jersey@gmgvegas.com)

EDITORIAL EDITOR OF SPECIAL PUBLICATIONS CRAIG PETERSON RESEARCH LIBRARIAN REBECCA CLIFFORD-CRUZ RESEARCHER PASHTANA USUFZY

ART ART DIRECTOR MICHELE HAMRICK STAFF PHOTOGRAPHERS L.E. BASKOW, CHRISTOPHER DEVARGAS, STEVE MARCUS, SAM MORRIS PHOTO COORDINATOR MIKAYLA WHITMORE

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ADVERTISING ASSOCIATE PUBLISHER, ONLINE MEDIA KATIE HORTON ASSOCIATE PUBLISHER, LAS VEGAS MAGAZINE AND VEGAS2GO JAMAL PARKER ASSOCIATE PUBLISHER, LAS VEGAS WEEKLY MARK DE POOTER ADVERTISING DIRECTOR JEFF JACOBS

Positively Kids provides comprehensive health care services for Clark County children, including medically fragile and/or developmentally delayed children.

On any given day Positively Kids provides health care services for over 600 children and their families. ♥ Home Health Care ♥ Skilled Respite ♥ Medical Daycare ♥ Early Intervention Services ♥ Family Healthcare Clinic at Child Haven Campus and School-Based Health Centers ♥ Positively Kids’ Health Insurance Enrollment Program ♥ Medical Case Management ♥ High Risk & Premature Baby Clinic including Certified Breastfeeding and Lactation Specialist

ACCOUNT MANAGERS KATIE HARRISON, DAWN MANGUM, BREEN NOLAN, SUE SRAN ADVERTISING MANAGERS JIM BRAUN, BRIANNA ECK, FRANK FEDER, KELLY GAJEWSKI, JUSTIN GANNON, TRASIE MASON, DONNA ROBERTS GROUP DIRECTOR OF SALES OPERATIONS STEPHANIE REVIEA PUBLICATION COORDINATOR KAREN PARISI EXTERNAL CONTENT MANAGER EMMA CAUTHORN

PRODUCTION VICE PRESIDENT OF MANUFACTURING MARIA BLONDEAUX ASSISTANT PRODUCTION DIRECTOR PAUL HUNTSBERRY PRODUCTION MANAGER BLUE UYEDA PRODUCTION ARTISTS MARISSA MAHERAS, DARA RICCI TRAFFIC SUPERVISOR ESTEE WRIGHT ART DIRECTOR OF ADVERTISING AND MARKETING SERVICES SEAN RADEMACHER GRAPHIC DESIGNER CARLOS HERRERA TRAFFIC COORDINATORS MEAGAN HODSON, KIM SMITH

DISTRIBUTION DIRECTOR OF CIRCULATION RON GANNON ROUTE MANAGER RANDY CARLSON, JOEL SEGLER FULFILLMENT MANAGER DORIS HOLLIFIELD CIRCULATION RESEARCH SPECIALIST CHAD HARWOOD

MARKETING AND EVENTS DIRECTOR OF EVENTS KRISTIN WILSON EVENT COORDINATOR JORDAN NEWSOM

GREENSPUN MEDIA GROUP CEO, PUBLISHER & EDITOR BRIAN GREENSPUN CHIEF OPERATING OFFICER ROBERT CAUTHORN GROUP PUBLISHER TRAVIS KEYS EXECUTIVE EDITOR TOM GORMAN MANAGING EDITOR RIC ANDERSON ASSISTANT MANAGING EDITOR/BUSINESS DELEN GOLDBERG

702-262-0037 positivelykids.org

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/positivelykids

CREATIVE DIRECTOR ERIK STEIN VEGAS INC 2360 CORPORATE CIRCLE, THIRD FLOOR HENDERSON, NEVADA 89074 | 702.990.2550

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FROM THE EDITOR

FROM THE SPONSOR

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here’s no question that making the correct health-care decisions isn’t easy. Even defining what “healthy” is can change depending on what study you read or which website you visit. That’s why it’s so important to have access to multiple sources; your family physician is a good start. If your doctor gave you a recommendation that would benefit your health, you’d trust her judgment, right?

Now imagine if you could ask more than 4,000 doctors for their opinions. That changes the game a bit (although perhaps the thought of sitting in 4,000 waiting rooms doesn’t sound especially appealing). That’s why our “Top Doctors” issue of Health Care Quarterly is so useful.

This is the fifth consecutive year that Greenspun Media Group has published such a list. For 2015, we reached out to a broad section of medical professionals in Southern Nevada, mailing them directly and visiting their offices to ask them one question: Who do you recommend?

What we have is a list of quality professionals from dozens of specialties cross-referenced with state and county boards, including the State Board of Medical Examiners.

We’re very excited to honor these professionals not only in these pages but at an event on June 3. Contact events@gmgvegas.com for information and to RSVP for you and your guests.

You’ll also find articles and columns that will prepare you to be a better-informed patient. Learn what you need for a trip to the doctor and the pharmacist. If you’ve got a family, we’ve got information for you about every age group in your home that will help you make informed decisions regarding your care.

We hope you find this special issue of Health Care Quarterly useful in the coming year. Save a spot for it on your desk or coffee table, where it can be of service to the entire family.

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he College of Medicine at Roseman University of Health Sciences is honored to sponsor and recognize the VEGAS INC Health Care Quarterly 2015 Top Doctors. We congratulate the outstanding physician honorees for their dedication to providing high quality care to Southern Nevadans.

Roseman University, as a private nonprofit health professions university, aspires to transform health care education, advance care and touch lives. Since our founding in Henderson in 1999, Roseman University has been committed to educating a new generation of health care leaders, in the areas of pharmacy, nursing, dental medicine and health care business.

Roseman University is expanding our commitment to Southern Nevada through the development of our MD-granting College of Medicine. Housed at our 327,000 square-foot Summerlin campus, the College of Medicine is progressing through the accreditation process with the goal of enrolling its first class of 60 medical students in 2017. The university and College of Medicine are also working in collaboration with education and health care partners and physicians in the community to expand graduate medical education opportunities in the region with the goal of retaining more doctors to meet health care needs of our communities.

We look forward to the future when our medical school graduates join Southern Nevada’s highly skilled and compassionate community of physicians and other health care providers who strive to enhance the quality of life in our state.

Stay safe and healthy!

Sincerely,

Craig Peterson Editor of Special Publications craig.peterson@gmgvegas.com

Dr. Mark A. Penn Chancellor, Summerlin Roseman University of Health Sciences

SPRING 2015

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FROM THE SPONSOR

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omprehensive Cancer Centers of Nevada (CCCN) is proud to sponsor VEGAS INC’s 2015 Health Care Quarterly Top Doctors publication and event, recognizing the physicians making a positive impact on patients throughout Southern Nevada. CCCN would like to congratulate all of the honorees for their unique contributions to the medical industry and commitment to making Southern Nevada an even better place to call home. We’d also like to recognize our own physicians for their contributions to health care in our community.

For more than 35 years, CCCN has been a steadfast advocate for quality cancer care. Today, we offer 11 treatment centers and offices throughout Southern Nevada focused on medical oncology, hematology, radiation oncology, breast surgery and clinical research. The practice has developed an extensive clinical research program and participates in more than 170 Phase I, Phase II and Phase III research studies each year. Over the years, our doctors have helped develop 54 FDA-approved cancer therapies, providing patients with access to world-class treatment options right here in Nevada.

CCCN is always exploring new ways to expand its expertise and strengthen the seamless flow of care for its patients. In June, the practice will add a pulmonary division, expanding CCCN’s multidisciplinary approach by offering more services to patients with lung and bronchus cancer — the leading cause of cancer deaths in Nevada. The new division will provide treatment for pulmonary diseases as well as offer low-dose CT scans for annual screenings for patients at high risk of developing lung cancer.

Like CCCN, more local medical groups, practices and hospitals are participating in research and expanding their diverse offerings than ever before — all committed to bringing new treatments, technologies and services to our city. This year’s impressive list of Top Doctors, including our own, are directly tied to many of the impactful health care initiatives making headlines throughout the valley, including prospective new medical schools, growing research programs, expanding graduate medical education and the steady growth of medical tourism.

To all of the Top Doctors: congratulations and thank you. Your outstanding service and unwavering dedication to your patients, our community and our industry are admired.

Sincerely,

James Kilber, MBA Executive Director Comprehensive Cancer Centers of Nevada

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FROM THE SPONSOR

RED ROCK COUNTRY CLUB OFFERS THE BEST OF LAS VEGAS, YET A WORLD AWAY.

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ou will notice the difference when you arrive at our palm tree-lined driveway, reaching our flagstone and brick clubhouse overlooking the Las Vegas Valley. With the organic architecture of our clubhouse, sweeping views of the Las Vegas Strip, mountains and golf courses, our facility will provide the perfect backdrop to corporate and social events and is unlike other venues. Our indoor and outdoor fireplaces and two terraces invite your guests into a familiar yet stunning atmosphere.

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Red Rock Country Club strives to exceed your expectations by delivering service that is tailored to each bride and groom.

Our wedding packages are designed with four- or five-hour receptions that include the hors d’oeuvres hour, buffet or plated meal, and full open bar as well as wedding linens including chameleon chairs and more.

We excel at birthday parties, engagement parties, graduations, anniversaries, baby showers and other social events leaving your guests talking about the party long after the last glass of champagne has been finished.

SPRING 2015

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SAFETY

STATISTICS ON WORKPLACE SAFETY CAN BE DECEIVING UPON FIRST GLANCE

By Don Evans

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he most enthusiastic workers might say, “I’m dying to go to work!” But they mean it figuratively. Almost no one would say “I’m going to work to die.”

But it happens.

The Bureau of Labor Statistics reports that a little more than 4,000 people died on the job in 2014, but this number can be deceiving. The Occupational Safety and Health Administration has guidelines for counting the number of fatalities each year, but the parameters for making this count are quite restrictive. A person may suffer a serious injury, but may not die for some time; OSHA only counts those fatalities that occur within 30 days of the incident.

You may wonder, “What about those cases that exceed this reporting limitation?” If we were to look at the OSHA Injury and Illness 300 Log, and expand the period between on-the-job incident and subsequent deaths to five years, the number of deaths tracing back to workplace incidents would climb.

OSHA acknowledges that a huge number of cases slip through the cracks because of reporting requirements. Let’s say you contract some form of cancer because of chemical exposures on the job, but you are able to keep working.

Some time after your diagnosis, you become terminally ill and die. Because the case was never recorded, this fatality is overlooked and never becomes a work-related statistic.

OSHA has agreed with researchers who estimate that there are around 50,000 work-related deaths each year in the United States, and that most of these go unreported. The difference between 4,000 and 50,000 is a chasm.

This means that approximately 92 percent of all workplace deaths go unreported. No one is trying to cover anything up, it is just how the parameters for reporting events are used.

Millions of workers go to their jobs daily, but few if any expect not to return home after their shifts. If we use OSHA’s reporting rules, approximately 12 people die every day because of a workplace event. If we include those deaths that don’t make the 300 Log, the number rises to around 137 people per day. Statistics only tell a part of the story and don’t include human suffering or how a death affects friends and family members.

Safety professionals seem to fight a never-ending battle to raise awareness of hazards so dangerous or potentially deadly workplace incidents can be avoided or minimized.

Many of us become complacent and think that bad things won’t happen to us and we become lazy and ignore the hazards around us.

For a parallel, consider unsafe driving behaviors. None of us expect to get involved in a crash when we drive our vehicles, yet a little more than 37,000 Americans died in traffic collisions in 2014, and millions more suffered serious injuries.

Safety isn’t an afterthought; it must be an integral part of everyday life. Just as we teach children not to stick their fingers in electrical outlets, we must train ourselves to notice our surroundings and deal with hazards.

We have enough bad things happening in our world without creating more because of our own ignorance or lack of attention. Remember, safety means preventing unwanted and undesired events from occurring.

“

Safety isn’t an afterthought; it must be an integral part of everyday life.

Just as we teach children not to stick their fingers in electrical outlets, we must train ourselves to notice our surroundings and deal with hazards.

Don Evans, C.S.H.M., is a safety and health trainer for Safety Consultation and Training Section, which offers on-site consultation services designed to help employers recognize and control potential safety and health hazards at their workplaces, improve their safety and health programs and assist in training employees.

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FERTILITY

FIVE THINGS TO KNOW ABOUT FERTILITY TREATMENTS

By Eva Littman, M.D.

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he decision to start or expand a family is a significant and exciting step, but when fertility issues arise, it can often become complex. The most common mistake people make is waiting too long to explore their options.

If you’re facing complications with achieving pregnancy, here are five things you should know as you work toward building a family.

Testing is essential One question patients often ask is whether the testing process differs depending on age. The initial testing processes are the same whether a patient is 22 or 42, but age plays a role in determining what service best suits an individual or couple. During the initial fertility consultation, certain ailments such as drug-induced infertility and timing-induced infertility must be ruled out. If the problem cannot be pinpointed, comprehensive laboratory and diagnostic tests are given to patients. Men have their semen analyzed, while women have their follicle-stimulating hormone and antimullerian hormone levels measured, along with radiologic studies on their reproductive anatomy. This allows fertility experts to determine the most prudent course of action.

Intrauterine insemination A procedure that combines cost effectiveness with a high success rate is intrauterine insemination (IUI), which is when a woman takes medication to stimulate the ovaries in order to develop her eggs. Then, the woman is injected with a trigger shot, releasing the egg. The sperm is then cleaned and concentrated before being inserted into the uterine cavity. IUI is two to three times more effective than natural conception. Unlike IVF, the entire IUI process has to be repeated each time a couple wants to have a child.

Age is often a factor While the testing process does not change as women age, time is of the essence when determining specific treatments and the probable success of treatments. As women age, IUI is not as effective. Some patients elect to undergo IVF because there is a large drop-off in success rates from age 37 to the 38-to-40 age range. Age is not as much of a factor for those who use egg donors, but for individuals who would like to use their own genetics, it is beneficial to start the fertility process earlier. This is why egg freezing at a younger age can give women a much higher likelihood of success.

In vitro fertilization

Egg and sperm freezing

While many factors, such as a woman’s age and health, will affect her chances of success, in vitro fertilization (IVF) is often a great way for couples to achieve pregnancy. IVF is a multistep process that begins with the woman taking medication before having her eggs removed and fertilized outside of the body. After the eggs are removed and fertilized, the most promising embryos are transferred into the uterus. IVF cycles are especially beneficial for women who are starting a family in their mid-to-late 30s and those who would like to have multiple children, as the process allows fertility doctors to freeze additional, healthy embryos, giving women and couples the ability to schedule additional pregnancies later. IVF is also utilized for gestational carriers, when fertilized eggs from another woman are implanted into a carrier’s uterus. This can be the best option for women whose infertility is due to uterine quality rather than egg quality.

Egg and sperm freezing are viable options for individuals diagnosed with cancer, but they can also be used as a safety net for women and couples who know they want to have children later in life. This has become more common in recent years. I often see women who opt to hold off on starting a family in order focus on their careers and finances. Freezing your eggs at a younger age can be a preemptive measure against the fertility challenges many women eventually face.

The rate of success using the frozen egg of a 28-year-old is much greater than the natural egg of a 42-year-old.

Red Rock Fertility Center offers a full suite of services for individuals and couples seeking to start families. Additional information about the types of fertility services offered can be found online at www.lasvegasfertility.com. Red Rock Fertility Center is committed to guiding patients through the fertility process with sensitivity and personalized care.

Dr. Eva Littman is the founder and practice director of Red Rock Fertility Center.

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At Center for Sight, it’s about far more than just 20/20.

We’re about 20/Happy.

On behalf of all the doctors at Center for Sight, we want to thank the best employees in Las Vegas. Without such a world-class collection of professionals, we would never be able to offer beyond 20/20, 20/Happy.

At Center for Sight we specialize in laser-based cataract surgery, LASIK, minimally invasive glaucoma surgery and other procedures that help reduce patients’ dependence on glasses and contact lenses. For more information about how our procedures could benefit you, call one of our world-class professionals!

2015 Top Ophthalmologists

Jeffrey Hart, M.D.

Eva Liang, M.D.

Board-certified ophthalmologist

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WELLNESS

EYE CARE THROUGH THE SPECTRUM OF LIFE

By Eva Liang, M.D.

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hat a fantastic gift we, as human beings, have in our eyesight. The complexity and performance of the human eye is a marvel even to evolutionary biologists. The eye is precious, and vulnerable — an intricate organ, exposed to the elements, delicate and in need of protection and professional care for optimal lifelong function.

From infancy to the senior years, good ophthalmological care is essential. Delayed or neglected screening for disorders of the eye, at any stage of life, can have permanent consequences. It’s unfortunate and sad when children miss the opportunity for visual corrective treatment only to suffer impaired vision for a lifetime, or when older people fail, for example, to have a simple test for glaucoma, only to have the condition progress unnecessarily because it was not treated early. These cases occur not only among populations without easy access to eye care, but among the well-to-do.

Annual vision screenings are inexpensive, painless and easily accessible; and one need not necessarily see an ophthalmologist to receive them. Here in Las Vegas, we have many excellent licensed optometrists.

Optometrists are uniquely positioned as the primary care providers for eye care. Just as you need a family physician or internist for routine physical examinations, so ought you have an optometrist for routine eye exams. Should you need an ophthalmologist for specialty care, your trusted optometrist can recommend one. Some people may never need to see an ophthalmologist; however, as we age, the chances are with you that you will.

••• Because of the problems associated with the aging eye, most ophthalmology patients are seniors. Fortunately, with recent technological advances in ophthalmology, good eye health and visual acuity is attainable for many people well into old age. In the case of cataract surgery, for example, state-of-the-art procedures offered by some practices have reduced patients’ dependency on glasses and occasionally eliminate the need for glasses altogether. Common eye diseases among seniors are glaucoma and diabetic retinopathy.

These and other conditions, like dry eye need ongoing treatment once diagnosed.

Diagnostic advances through new technologies offered by ophthalmology practices have recently made objective comprehensive evaluation of the eye more accurate. For example, the HD Analyzer enables eye care specialists to know the limits of vision by evaluating the optics of the entire eye by measuring the retina directly. This new objective method can allow ophthalmologists with access to this technology to better understand your visual performance, especially if you have cataract, dry eye syndrome or certain other conditions.

In middle age, most of us will be confronted by presbyopia, more commonly known as near-sightedness. At around the age of 40, reading and viewing objects up close becomes progressively more difficult and will require reading glasses for correction. In coming years, exciting new elective surgical solutions will be available to address this problem.

Proper eye care begins in childhood. For teens in particular, good eyesight is important for academics, sports and safety. Novice drivers should be checked for visual acuity, and certain athletes need to be fitted for safety eyewear. It is in the teenage years that education on eye health may be most beneficial, not only to prevent injury but to establish good habits of prevention for a lifetime.

In younger children, vision problems are often not so obvious. Vision problems tend to emerge between 18 months and 4 years old. Two of the more common issues are a crossed or wandering eye and uneven focus, where one eye is more farsighted than the other.

Amblyopia is the medical term used when the vision in one of the eyes is reduced because the eye and the brain are not working together properly. The eye itself looks normal, but it is not being used normally because the brain is favoring the other eye. This condition is sometimes called lazy eye. The compromised vision in the weaker eye, which is amblyopia, can be reversed, provided it is caught early.

As a wife, mother, and child of a senior parent, all of the concerns and many of the conditions referenced here — whether my son’s amblyopia, my husband’s presbyopia, my mother’s cataracts, or my own desert climate dry eye — are part and parcel of my at-home eye care responsibilities.

With the blessing of modern ophthalmology, and prevention, we all enjoy good eyesight. We wish the same for you!

Eva Liang, M.D. is an ophthalmologist and medical director of Center for Sight in Las Vegas and Henderson.

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INSURANCE

HEALTH INSURANCE IS NOT A ONE-SIZE-FITS-ALL DEAL

By Rebecca Edgeworth, M.D.

W There’s more: Know what to Ask Your Doctor. See Page 66.

hile it is now mandatory for all U.S. citizens to have health insurance under federal law, that doesn’t mean obtaining health care coverage is simple. There are many different private and governmental sources of coverage and qualifying parameters vary. Even with the available options, there are still many people who fall through eligibility gaps and find themselves without coverage. Fortunately, local organizations are available to help families determine their insurance options and provide care if coverage isn’t possible.

The young For individuals 26 years old and younger who have parents with health care insurance, coverage is simple. Under the Affordable Care Act, they can be included under their parents’ coverage.

For young people whose parents do not have insurance, they might be eligible for Medicaid, a federal program providing free or low-cost health care coverage for low-income Americans. Medicaid eligibility is determined by overall household income, which must be below 138 percent of the federal poverty level in Nevada. Children whose parents are not insured and earn more than the federal poverty level can qualify for Nevada Check Up, the state’s Children’s Health Insurance Program. This program provides low-cost health care coverage for children who aren’t covered by private insurance or Medicaid.

Working adults older than 26 Many people choose to obtain health insurance coverage through their employer or their spouse or partner’s employer.

Under federal mandate, most businesses with 50 or more full-time equivalent employees must provide a minimum level of health insurance coverage for most of their full-time employees and dependents, or pay a fee. The extent of coverage required varies based on a company’s number of employees.

Companies with staff numbers below the federal coverage mandate might not provide insurance for employees, and some larger employers might find it more affordable to pay a fine than provide insurance for workers. In these cases, employees must seek coverage elsewhere. Working adults older than 26 can qualify for Medicaid if their household

meets the income requirement. If Nevada residents earn between 138 and 400 percent of the federal poverty level, they can qualify for subsidized insurance under the Affordable Care Act. Those who earn above 400 percent of the poverty level are not eligible for subsidies.

Nevadans seeking to obtain health insurance coverage outside of an employer can visit www.nevadahealthlink.com, the online portal for Nevada’s state health insurance exchange, during specific open enrollment periods. People can also obtain insurance anytime as a result of special circumstances such as marriage. In Nevada, off-exchange carriers are required to offer year-round enrollment.

Adults 65 and older Most U.S. citizens 65 and older qualify for Medicare, a federal health insurance program for senior citizens and certain people with disabilities. Seniors qualify for Medicare at the age of 65 if they are citizens or legal residents, if they have lived in the U.S. for at least five years and if they have worked for at least 10 years in the U.S. while paying into Medicare through payroll deductions. Individuals who meet these requirements automatically receive Medicare Part A, which provides hospital coverage, and most seniors are also eligible for Medicare Part B, providing medical coverage. Those who qualify for Medicare parts A and B can elect to enroll in Medicare Part D, which offers prescription drug coverage.

The uninsured Unfortunately, many people still do not qualify for health care coverage, even after the implementation of the Affordable Care Act. Approximately 325,000 Nevada residents are still uninsured. There are many resources available to help, however, including Volunteers in Medicine of Southern Nevada (VMSN), a nonprofit organization that provides free health care for uninsured Nevada residents. In addition to providing a wide variety of health care services, VMSN also offers staff members who can help local residents determine their eligibility for health insurance coverage.

VMSN currently operates at 4770 Harrison Drive and is in the process of constructing a new clinic in downtown Las Vegas. For information about VMSN, visit www.vmsn.org or call 702-967-0530.

Dr. Rebecca Edgeworth is the medical director of Volunteers in Medicine of Southern Nevada.

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FOCUS ON LEO GERMIN, M.D. AND CLINICAL NEUROLOGY SPECIALISTS One of the Leading Neurology Practices in Nevada

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5/4/15 12:45 2:01 5/20/15 2:35 5/20/15 4:43 AM PM

HOSPICE

KNOWING WHEN TO TURN TO HOSPICE CARE CAN BE A DIFFICULT DECISION

By Maureen Kelleher, R.N.

M

any people make it a top priority to ensure their loved ones receive the most effective care for significant health issues, but these efforts can culminate in a difficult decision when an individual has exhausted all treatment options. If a condition is terminal, the question arises of whether a patient’s remaining days or months are best spent with hospice care. Needing hospice services can be difficult for some people to accept and there are numerous factors to consider when determining how an individual will experience the best quality of life in the limited time remaining. This isn’t a decision to be taken lightly, and it is important for families to weigh important details such as whether hospice care can be provided at a person’s residence, who will be the primary caregiver, if there is a need to hire a caregiver, and more.

In order to make the best decisions about hospice care, the following details should be considered:

Advancing symptoms A key indicator that hospice care might be the next step is if a patient’s condition has begun to deteriorate considerably despite treatment. Signs can include worsening symptoms such as a significant increase in pain and distressed breathing, repeated hospitalizations and a growing dependency on others for help with basic activities such as walking, bathing and dressing.

If the condition is terminal Hospices provide services for individuals who are expected to live less than six months, making an individual’s diagnosis an important component of choosing hospice care.

If there are no options for recovery, hospices can provide valuable supportive services that will help manage a person’s symptoms instead of aiming to treat them, allowing for more peace and comfort.

Impact on the caregiver Many individuals and families strive to provide sole support for their loves ones, but serving as a caretaker can sometimes be overwhelming. When considering hospice care, it is helpful to assess not only how the patient can benefit, but

how the caretakers can, as well. Caretakers might find that they cannot handle the physical requirements of providing the necessary care or that they are in need of more emotional support to cope with their loved ones’ condition.

The extent of care needed It is important to identify the extent of a patient’s daily needs to determine if professional hospice care is needed to provide the necessary treatment. This can include the extent of medications a patient takes, whether routine visits for pain management are necessary, and the kinds of medical equipment and supplies required for personal care.

Inpatient versus in-home care Receiving hospice care doesn’t necessarily mean a patient must move into a hospice facility. In most cases, the best setting for patients is their own home. Hospice care can often be arranged at a patient’s home, a family member’s home, a nursing facility or an assisted living facility. Patients and their loved ones might find it easier to pursue hospice care if the services are provided in a familiar environment.

Seek an expert opinion If families and patients are uncertain about hospice care, it can often be valuable to seek input from a health care professional. Primary care providers can provide helpful input about the status of their patients’ condition and whether any alternatives might still be available. They can also provide feedback on patients’ overall goals for their quality of life. If inpatient services are a possibility, it can be useful to call a hospice facility to discuss services offered and schedule a tour.

Las Vegas Solari Hospice Care provides comprehensive services for individuals with life-limiting illnesses, including addressing patients’ physical, emotional and psychological needs. Staff members understand the highly emotional process of determining whether end-of-life care is necessary, and our staff members are always happy to answer questions about the services associated with hospice care. For more information about Las Vegas Solari Hospice Care, call 702-870-0000 or visit www.lvsolarihospice.com.

Maureen Kelleher, R.N., is executive director of hospice and palliative care services at Las Vegas Solari Hospice Care.

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I hold water to a higher standard.

The All-Star Standard.

My name is Corey, and my job at the Southern Nevada Water Authority is to make sure water delivered to your home meets or surpasses all state and federal drinking-water standards.

At home, my job is to make sure my family drinks plenty of clean, healthy water.

At the SNWA, we keep a very close eye on water quality, conducting hundreds of thousands of analyses every year to verify the quality of our drinking water. And that makes both of my jobs a lot easier.

We know that some customers use additional home water treatment devices and want to help you make informed decisions. If you have questions or would like objective information about supplemental water treatment systems, visit snwa.com or call 702-258-3930.

Visit your local water provider online or go to snwa.com to view your 2015 Water Quality Report.

The SNWA is a not-for-profit public utility.

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4/24/15 4:45 3:02 PM 5/20/15

TECHNOLOGY

THE ABILITY TO SAVE A LIFE IS WITHIN YOUR GRASP

By Linda Rittenburg, R.N.

A

ccording to the American Heart Association, sudden cardiac arrest strikes approximately 365,000 people in North America every year and is the leading cause of death in the United States.

Many lives could be saved if more members of the community were trained to respond using cardiopulmonary resuscitation (CPR) and automated external defibrillators (AED).

The most common cause of sudden cardiac arrest is an arrhythmia called ventricular fibrillation, or “v-fib.” In v-fib, the heart’s lower chambers don’t beat normally. Instead, they quiver rapidly and irregularly. Another type of arrhythmia that can lead to sudden cardiac arrest is ventricular tachycardia, which is a fast, regular beating of the heart’s chambers that may last for a few seconds or much longer.

An AED can restore the heart’s normal rhythm if used as soon as possible from the onset of cardiac arrest.

What are the signs of sudden cardiac arrest?

If someone is having sudden cardiac arrest, he or she may collapse and lose consciousness. He or she may not be breathing, or may have an abnormal breathing pattern. If you check, you usually can’t find a pulse. The person’s skin also may become dark or blue from lack of oxygen. Also, the person may not move, or his or her movements may look like a seizure (spasms). An AED can check the person’s heart rhythm and determine whether an electric shock is needed to try to restore a normal rhythm.

How to use an automated external defibrillator Your first action should be to call 911, or have someone else call 911.

Before using an AED, check the person in need of help. If it’s an adult, shout at and shake the person to make sure he or she isn’t sleeping. Never shake an infant or young child.

Instead, you can pinch the child to try to wake him or her up. If breathing and pulse are absent, start CPR immediately and prepare to use the AED as soon as possible.

Using an Automated External Defibrillator. Depending on the model of the AED you may have to pull a handle or push the “on” button. Follow the AED’s voice prompts. Remove clothing from the chest.

Peel the pads off and place them exactly as shown on the package. Accuracy is more important than speed.

Usually the AED will start to immediately analyze the patient’s heart rhythm. If it does not, you might have to push the analyze button. Do not touch the patient during this or any other part of the defibrillation process.

If the AED has a “shock advised” prompt, push the button. Some AEDs will shock automatically without requiring the responder to push any buttons. When you shock, make sure no one is touching the patient. Also, the patient must not be touching metal and there must not be large amounts of water on the chest. Sweat is OK. Remove any medication patches that interfere with placement of the AED pads. If the patient has a pacemaker, try not to place the pads directly on the unit.

The AED will shock up to three times. Usually only one shock is needed. Newer AEDs will shock only once on the highest energy setting, after which they should prompt you to immediately perform two minutes of CPR. Some pulse-less heart rhythms cannot be treated by defibrillation. If the AED does not advise a shock, check the pulse, and if there is none, continue CPR. If an AED is not available, determine what is needed.

If there is no breathing and no pulse, start chest compressions. If there is a pulse but no breathing, just give ventilation. If no one knows how long the person has been unconscious, or if an AED isn’t readily available, continue CPR until emergency medical help arrives or until the person begins to move.

Preparedness saves lives Nevada Project Heartbeat is an advocacy organization dedicated to saving lives by raising awareness of sudden cardiac arrest, increasing access to AEDs and promoting training in CPR and the use of AEDs throughout the state.

Southwest Medical is the only Southern Nevada provider organization partnering with Nevada Project Heart Beat to fulfill this mission.

As a result, the number of AED devices increased from nine to over 135 among our centers and offices, creating a heart-safe environment for patients, employees and guests.

Linda Rittenburg is the R.N. director of specialty care and imaging services at Southwest Medical Associates and serves on the board of directors for Nevada Project Heartbeat.

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Thank You Red Rock Fertility.

Thank you, Red Rock Fertility! As older parents with kids who have kids of their own, we love having a big family, and we weren’t ready to stop growing it. However, due to Mom’s age of 51, our options were slim.

Fertility treatments were our only option and we chose Red Rock Fertility because of its excellent reputation and experience. Their nurse practitioner, Shannon McGrath made us feel like family. Dr. Littman is extremely professional and our experience with the embryologists was wonderful! We absolutely recommend Red Rock Fertility to others and are excited to begin another round of treatment to expand our family even further.

Thank you, again, Red Rock Fertility for our beautiful twins, Ashton and Anastasia, and the joy they bring to our entire family!

Photographer: Meghan Poort

To learn more about Ashton and Anastasia, visit lasvegasfertility.com/babyofthemonth/ashtonandanastasia /redrockfertilitycenter

@FertilityLV

Schedule an appointment today, at 702-789-6568 or visit us online at RedRockFertility.com.

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Eva Littman,

Shannon L. McGrath,

M.D., F.A.C.O.G.

M.S.N., W.H.N.P.-C.

6410 Medical Center Street, Suite A • Las Vegas, NV 89148 870 Seven Hills Drive, Suite 103 • Henderson, NV 89052

4/21/15 12:16 10:41 PM AM 5/22/15

The Experts You Should Know

A

ny time you have the chance to make more educated decisions about the health and wellness of you and your family, you should take advantage of it.

Welcome to Health Care Quarterly’s 2015 Top Doctors

list. We reached out to more than 4,000 physicians and medical professionals in Southern Nevada. We asked them who they recommend in a variety of specialties and are proud to share with you the top names — those doctors who were recommended over and over again:

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Photo Credit

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FAQ What is a “Top Doctor”?

We hope that being named a Top Doctor is a source of pride for the doctors on this list. These are the physicians who come to mind when their peers are asked “Who do you recommend?”

We will be celebrating them at an event on June 3. Contact events@gmgvegas.com for information.

What was the survey?

We invited doctors to fill out a confidential survey, asking us to give us one name for the specialties we listed. It was not necessary to offer a name in each specialty. Our logic: Local doctors are the most qualified to suggest other medical professionals in Southern Nevada.

So is this a list of every doctor who was nominated?

No. Not every doctor responded and not every doctor who was nominated was listed. This is a list of doctors who were nominated multiple times.

The list was then checked against records with the state medical board, to ensure that all are in good standing.

Why isn’t my doctor listed?

This list is by no means a complete one; there are many excellent doctors in Southern Nevada.

If you like your doctor, you should probably continue seeing him. Doctors who have been in the community longer and who have more established practices may have received more nominations because they have better name recognition, but that

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should not imply that your doctor isn’t imminently qualified. This list — and this entire magazine — is merely one tool that you can use to help guide your health-care decisions.

The doctors named each other?

Sounds like a popularity contest to me.

We encourage the doctors to give some thought to their answers, but we have no way of enforcing that. Your doctor gives out referrals all the time; the criteria she uses to refer you to another doctor are up to her. We spent months reaching out to thousands of doctors asking for their referrals; we believe that the volume of responses helps cancel out the politics that might influence any one doctor’s individual answers.

Tell the truth: Did the doctors pay to be included in the list?

Nope. Doctors did not pay to be mentioned.

After the list is compiled by the editorial team, sales begins its job. Doctors may choose to advertise, but if or when they do has no bearing on the list itself.

What about the profiles in the section?

How were those doctors chosen?

In the ensuing pages, you’ll see Q&As with a few doctors. Their names were chosen randomly.

At the end of the Top Doctors section you’ll find some Medical Profiles. Those profiles are paid for and are a standing element in Health Care Quarterly.

SPRING 2015

5/20/15 5:18 PM

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EXPERIENCE. RESULTS. Congratulations to all the Nominees and Winners of the “HealthCare Quarterly Top Doctors 2015” honor! Thank you all for delivering superior health care to Southern Nevada!

*MoDEL

Face. Breast. Body.

Botox / Juvederm. Coolsculpting. Mommy Makeovers.

Jeffrey J. Roth, M.D., F.A.C.S. Double Board Certified.

Multiple Local and National “Top Doc” Award Winner.

Noted author and speaker.

Plastic Surgeon to the Champions.

702.450.0777 | www.jjrothmd.com 9280 W. Sunset Rd. #236 | Las Vegas NV 89148

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10:22 5/20/15 AM 5/20/15 11:30 5:18 PM

TOP DOCTORS

ALLERGY / IMMUNOLOGY Jim Christensen 4 Sunset Way, Ste. A3 Henderson 89014 702-434-9690

Berge Dadourian

4445 S. Eastern Ave., Ste. A Las Vegas 89119 702-735-1556

William Evans 3006 S. Maryland Parkway, Ste. 690 Las Vegas 89109 702-732-1290

Joel Katz 2625 Box Canyon Drive Las Vegas 89128 702-360-6100

Carlos Fonte

Sean McKnight 2485 W. Horizon Ridge Parkway, Ste. 100 Henderson 89052 702-212-5889

7500 W. Lake Mead Blvd., # C9-292 Las Vegas 89128 702-822-2444

David Tottori 4000 E. Charleston Blvd., Ste. 100 Las Vegas 89104 702-432-8250

BARIATRICS Erik Evensen 607 S. Decatur Blvd.

Las Vegas 89107 702-822-7400

Dana Trippi 607 S. Decatur Blvd.

Las Vegas 89107 702-822-7400

CARDIOLOGY Sean Ameli

Kenneth Shah 2465 W. Horizon Ridge Parkway, Ste. 100 Henderson 89052 702-616-0500

400 S. Rampart Blvd., Ste. 240 Las Vegas 89145 702-906-1100

Victor Cohen

Joram Seggev

Keith Bowman 601 S. Rancho Drive Las Vegas 89106 702-383-0677

3201 S. Maryland Parkway, Ste. 502 Las Vegas 89109 702-733-8600

Vanessa Gastwirth 3121 S. Maryland Parkway, Ste. 512 Las Vegas 89109 702-233-1000

Sam Green 3121 S. Maryland Parkway, Ste. 512 Las Vegas 89109 702-233-1000

Patrick Hsu 3121 S. Maryland Parkway, Ste. 512 Las Vegas 89109 702-233-1000

Sunil Kalla 2779 W. Horizon Ridge Parkway, Ste. 200 Henderson 89052 702-433-2777

Cres Miranda 700 E. Silverado Ranch Blvd., Ste. 170 Las Vegas 89183 702-240-6482

Dhiraj Narula

400 S. Rampart Blvd., Ste. 240 Las Vegas 89145 702-906-1100

10105 Banburry Cross Drive, Ste. 250 Las Vegas 89144 702-360-7600

Jose Aquino

Stephen Portz

700 E. Silverado Ranch Blvd., Ste. 170 Las Vegas 89183 702-240-6482

9280 W. Sunset Road Las Vegas 89148 702-534-5464

Muhammad Bhatti

William Resh

700 Shadow Lane, Ste. 240 Las Vegas 89106 702-3840022

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700 E. Silverado Ranch Blvd., Ste. 170 Las Vegas 89183 702-240-6482

Adel Shehata 4275 Burnham Ave., Ste. 220 Las Vegas 89119 702-796-4278

Robert Wesley 700 E. Silverado Ranch Blvd., Ste. 170 Las Vegas 89183 702-240-6482

CARDIOVASCULAR SURGERY Neel Dhudshia 5320 S. Rainbow Blvd., Ste. 282 Las Vegas 89118 702-737-3808

Nancy Donahoe 5320 S. Rainbow Blvd., Ste. 282 Las Vegas 89118 702-737-3808

Joseph Randall Feikes 5320 S. Rainbow Blvd., Ste. 282 Las Vegas 89118 702-737-3808

Demetrios Mavroides 5320 S. Rainbow Blvd., Ste. 282 Las Vegas 89118 702-737-3808

Robert Wiencek 3059 S. Maryland Parkway, Ste. 202 Las Vegas 89109 702-735-1454

Michael Wood 3150 N. Tenaya Way, Ste. 140 Las Vegas 89128 702-735-1454

DERMATOLOGY Candace Spann 2615 Box Canyon Drive Las Vegas 89128 702-998-9001

Robert Strimling 10105 Banburry Cross Drive, Ste. 350 Las Vegas 89144 702-243-6400

SPRING 2015

5/22/15 12:29 PM

TOP DOCTOR Dr. Gregory Hsu SPECIALTY Ophthalmology IN PRACTICE 20 years

What colleges have you attended and where did you earn your medical degree(s)?

University of California, Irvine — Undergraduate

Western University, College of Osteopathic Medicine — Medical school Ohio University, Grandview — Residency in ophthalmology United States Air Force School of Aerospace Medicine — Flight surgeon Board certified in ophthalmology UNLV — Master’s degree (crisis and emergency management)

Why did you choose this particular specialty and when did you know this was what you wanted to do?

I was very lucky to know that I wanted to be a physician during grade school years.

I did not know that I needed glasses until I saw the ophthalmologist at 8 years of age. The ride home with my new glasses was life altering.

I could see! I remember it vividly to this day.

It made was such an impression; I could see for the first time the definition of leaves on trees. It was then that I knew what type of physician I wanted to be, so that I could help others to see well, too.

What are some of the things in this field that have captured your attention?

How fast technology is changing the diagnosis and treatment options for sight.

The research is digging ever deeper to discovering new treatments. It gives me great hope of things to come for people who may currently suffer with eye disease. As a surgeon, I also enjoy many of the advances made recently in cataract surgery. It is still awesome to me to restore vision with surgery every week!

What is the most rewarding part of your job as a medical professional?

The relationships that are built between myself and patients. I have been taking care of families for 20 years and I have seen their children grow up. It is always a pleasure to meet a new patient for the first time and begin to build that relationship of trust. I feel very blessed and special to have the patients come to me for their care.

What is the biggest problem you see in the health care industry?

I do not want our society to ever give up on making things better. Once we stop trying to make things better, then we have a true problem. The problems in health care are always going to be present. Once we fix a problem, then the lesser problem becomes the main problem and so forth. I am concerned with our ability to maintain the vast number of quality physicians that our country has presented in the past as we go forward. Needed health care seems like a basic human right.

Every person wants that for their mother or grandfather. How do we as a great nation balance cost and care?

SPRING 2015

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TOP DOCTORS Douglas Thomas 9097 W. Post Road, Ste. 100 Las Vegas 89148 702-430-5333

Johnnie Woodson

Randall Weingarten 10410 S. Eastern Ave., Ste. 110 Henderson 89052 702-617-9599

Larry Yu

229 N. Pecos Road, Ste. 100 Henderson 89074 702-485-5300

8530 W. Sunset Road, Ste. 230 Las Vegas 89113 702-792-6700

EAR, NOSE, THROAT

ENDOCRINOLOGY

Fred Gol III 7040 Smoke Ranch Road Las Vegas 89128 702-792-6700

Paul Johnson 3150 N. Tenaya, Ste. 112 Las Vegas 89128 702-562-1777

Randy Lomax 6850 N. Durango Drive, Ste. 314 Las Vegas 89149 702-834-5886

Scott Manthei 3692 E. Sunset Road Las Vegas 89120 702-735-7668

Sina Nasri 3101 S. Maryland Parkway, Ste. 102 Las Vegas 89109 702-732-4491

Matthew Ng 5380 S. Rainbow Blvd., Ste. 112 Las Vegas 89118 702-671-2298

T.J. O’Lee 5380 S. Rainbow Blvd., Ste. 112 Las Vegas 89118 702-671-2298

Walter Schroeder 3195 Saint Rose Parkway, Ste. 210 Henderson 89052 702-792-6700

Ashley Sikand 7040 Smoke Ranch Road Las Vegas 89128 702-792-6700

Bob Wang 2040 W. Charleston Blvd., Ste. 601 Las Vegas 89102 702-562-1777

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Shadi Abdelnour

FAMILY PRACTICE Kimberly Adams 9640 W. Tropicana Ave., Ste. 116 Las Vegas 89147 702-253-9355

Tony Alamo 56 N. Pecos Road, Ste. A Henderson 89074 702-456-4011

Ralph Carullo

1707 W. Charleston Blvd., Ste. 200 Las Vegas 89102 702-671-6469

2901 N. Tenaya Way, Ste. 210 Las Vegas 89128 702-852-2000

Brian Berelowitz

56 N. Pecos Road, Ste. A Henderson 89074 702-456-9100

653 Town Center Drive, Ste. 315 Las Vegas 89144 702-804-9486

Chard Bubb 2285 E. Flamingo Road Las Vegas 89119 702-862-8226

Asheesh Dewan 5235 S. Durango Drive, Ste. 103 Las Vegas 89113 702-851-7287

W. Reid Litchfield 2415 W. Horizon Ridge Parkway Henderson 89052 702-434-8400

M. Fariba Rahnema

Mark Day

Greg Fihn 7455 W. Azure Drive, Ste. 140 Las Vegas 89130 702-434-3446

Michael Gunter 7455 W. Washington Ave., Ste. 445 Las Vegas 89128 702-804-5138

Jenny Ha 2789 Sunridge Heights Parkway, Ste. 100 Henderson 89052 702-614-0850

Lisa Haworth

653 N. Town Center Drive, Ste. 504 Las Vegas 89144 702-701-8400

2482 W. Horizon Ridge Parkway, Ste. 110 Henderson 89052 702-719-6003

Rola Saad

Jeff Ng

6850 N. Durango Drive, Ste. 301 Las Vegas 89149 702-641-8500

Fred Toffel 2700 E. Sunset Road, Ste. D34 Las Vegas 89120 702-736-2021

Claudia Vogel 100 N. Green Valley Parkway, Ste. 340 Henderson 89074 702-990-4530

2870 S. Maryland Parkway, Ste. 300 Las Vegas 89109 702-735-0258

Elissa Palmer 2410 Fire Mesa St., Ste. 180 Las Vegas 89128 702-992-6888

Mario Tarquino 3111 S. Maryland Parkway Las Vegas 89109 702-968-6259

SPRING 2015

5/22/15 12:31 PM

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I SURVIV ED

BECAUSE OF UMC Eddie, a high school coach and athlete, was used to being in peak condition. So when he wasn’t feeling well and went to the doctor, he was shocked that a spot on his leg was actually a deadly flesh-eating bacteria. He was transported to the UMC Lions Burn and Wound Care Center at UMC, where high doses of blood pressure medication kept his heart and brain alive while doctors amputated his arms and legs in order to save his life. Today, Eddie has new prosthetics, he’s back with his family and coaching once again. And none of it would be possible at any other Nevada hospital, making UMC one of our most vital resources.

TOGETHER, WE SHINE. umcsn.com

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4/24/15 5:19 2:54 PM 5/20/15

TOP DOCTOR Dr. Robert Chapman Wesley, Jr. SPECIALTY Cardiology IN PRACTICE Nevada Heart & Vascular Center, 2002–present

What colleges have you attended and where did you earn your medical degree(s)?

I attended Yale College, graduating with highest honors, then Yale University College of Medicine.

I interned at Philadelphia General Hospital and completed residency and chief residency at the Graduate Hospital of Philadelphia. My cardiology clinical and research fellowships were performed at the University of Virginia under the auspices of an NHBLI Physician-Scientist Award.

Why did you choose this particular specialty and when did you know this was what you wanted to do?

I found electrocardiography fascinating as a first-year medical student and was hooked after observing the chief of cardiology at Yale-New Haven Hospital successfully managing an impromptu VF (ventricular fibrillation) arrest.

What are some of the things in this field that have captured your attention?

What is the most rewarding part of your job as a medical professional?

Aside from the nurturing of patients — which always comes first — my greatest professional reward is the teaching of young medical students, residents, and now cardiology fellows.

What is the biggest problem you see in the health care industry?

The biggest problem facing medicine is, without question, an unbridled litigation regime that has totally distorted and undermined clinical practice. How can there be meaningful health care reform without wholesale tort reform? I see disheartening abuses of this every day and a political class that is either uncaring and indifferent or, even worse, totally ignorant of the problem. This has led to innumerable inefficiencies and, in my opinion, the single most significant driver of uncontrollable health care costs.

But even more tragic is the increasing number of poor individual patient outcomes based on such distortions.

When is this madness going to stop?

It is absolutely amazing in the field of cardiology how quickly basic science observations are translated from evidence-based clinical research to wide-based clinical practice.

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SPRING 2015

5/20/15 5:19 PM

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4/28/15 5:19 2:04 PM 5/20/15

TOP DOCTORS

GASTROENTEROLOGY Howard Baron 3196 S. Maryland Parkway, Ste. 309 Las Vegas 89109 702-791-0477

Brent Burnette 3820 S. Hualapai Way, Ste. 200 Las Vegas 89147 702-796-0231

Frank Faris 3150 N. Tenaya Way, Ste. 580 Las Vegas 89128 702-483-5515

Homayon Iraninezhad 620 Shadow Lane Las Vegas 89106 702-388-4000

Greg Kwok 3820 S. Hualipai, Ste. 200 Las Vegas 89147 702-796-0231

Frank Nemec 3820 S. Hualapai Way, Ste. 200 Las Vegas 89147 702-750-7221

Mohammed Shafi 1647 E. Windmill Lane, Ste. 100 Las Vegas 89123 702-914-6555

Shahid Wahid 2031 McDaniel St., Ste. 210 North Las Vegas 89030 702-633-0207

Michael Zimmerman 2700 Crimson Canyon Drive, Ste. 180 Las Vegas 89128 702-562-2420

GENERAL SURGERY Jennifer Baynosa 2040 W. Charleston Blvd., Ste. 302 Las Vegas 89102 702-671-2369

Tim Browder 1707 W. Charleston Blvd., Ste. 160 Las Vegas 89102 702-671-5150

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Peter Caravella 8930 W. Sunset Road, Ste. 300 Las Vegas 89148 702-258-7788

Dennis Chong 10001 S. Eastern Ave., Ste. 206 Henderson 89052 702-617-1981

Sean Dort 10001 S. Eastern Ave., Ste. 200 Henderson 89052 702-914-2420

Wael Eid 653 N. Town Center Drive, Ste. 202 Las Vegas 89144 702-233-6694

Nick Fiore 653 N. Town Center Drive, Ste. 412 Las Vegas 89144 702-233-8101

Bernadine Hanna 6140 S. Fort Apache Road, Ste. 100 Las Vegas 89148 702-384-1160

Ronald Hofflander 3201 S. Maryland Parkway, Ste. 601 Las Vegas 89109 702-894-4440

Craig Iwamoto 1111 Shadow Lane Las Vegas 89102 702-383-4040

Elijah Johnson 1111 Shadow Lane Las Vegas 89102 702-383-4040

Barry Rives

INFECTIOUS DISEASE Alireza Farabi 6276 S. Rainbow Blvd., Ste. 100 Las Vegas 89106 702-845-2841

Alan Greenberg 1800 W. Charleston Blvd., Ste. 409 Las Vegas 89102 702-383-7815

Jerome Hruska 3006 S. Maryland Parkway, Ste. 780 Las Vegas 89109 702-737-0740

Brian Lipman 10001 S. Eastern Ave., Ste. 307 Henderson 89052 702-776-8300

Ron Shockley 3121 S. Maryland Parkway, Ste. 412 Las Vegas 89109 702-309-2311

Gary Skankey 3006 S. Maryland Parkway, Ste. 780 Las Vegas 89109 702-737-0740

Eugene Speck 3006 S. Maryland Parkway, Ste. 780 Las Vegas 89109 702-737-0740

Chukwudum Uche 6088 S. Durango Drive, Ste. 100 Las Vegas 89113 702-380-4242

Kathleen Waimaru

8285 W. Arby Ave., Ste. 165 Las Vegas 89113 702-263-9644

1700 Bearden Drive Las Vegas 89106 702-343-7610

Francis Teng

INFERTILITY

3150 N. Tenaya Way, Ste. 508 Las Vegas 89128 702-838-5888

Said T. Daneshmand

GERIATRICS Alvin Lin 2410 Fire Mesa St., Ste. 180 Las Vegas 89128 702-992-6888

8851 W. Sahara Ave., # 100 Las Vegas 89117 702-254-1777

Eva Littman 6410 Medical Center St. Las Vegas 89148 702-948-7778

SPRING 2015

5/22/15 12:32 PM

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4/24/15 5:19 3:00 PM 5/20/15

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4/21/15 5:19 3:22 PM 5/20/15

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5/7/15 11:59 AM 5/20/15 5:20 PM

TOP DOCTORS

LASIK

Bruce Shapiro 8851 W. Sahara Ave., # 100 Las Vegas 89117 702-254-1777

Eva Liang 5871 W. Craig Road Las Vegas 89130 702-724-2020

INTERNAL MEDICINE

Matt Swanic

Thomas Alfreda, Jr.

9555 S. Eastern Ave., Ste. 260 Las Vegas 89123 702-816-2525

201 N. Buffalo Drive Las Vegas 89145 702-242-2737

Bashab Banerji

Kent Wellish

5731 S. Fort Apache Road, Ste. 100 Las Vegas 89148 702-740-5311

2110 E. Flamingo Road Las Vegas 89119 702-733-2020

Fauzia Carullo

NEPHROLOGY

2901 N. Tenaya Way, Ste. 210 Las Vegas 89128 702-852-2000

Samuel Kantor 5701 W. Charleston Blvd., Ste. 100 Las Vegas 89146 702-877-9514

Michael Coy 1341 S. Rainbow Blvd., Ste. 101 Las Vegas 89146 702-255-4200

Bindu Khanna

Nouhad Damaj 6850 N. Durango Drive, Ste. 301 Las Vegas 89149 702-641-8500

9280 W. Sunset Road, Ste. 426 Las Vegas 89148 702-262-0124

Robert Gong

Steve Miller 653 N. Town Center Drive, Ste. 306 Las Vegas 89144 702-243-7483

Mohammed Najmi 2440 Professional Court, Ste. 110 Las Vegas 89128 702-240-8155

Misti Song 2040 W. Charleston Blvd., Ste. 300 Las Vegas 89102 702-671-5060

Bradley Thompson 3650 S. Eastern Ave., Ste. 300 Las Vegas 89169 702-796-8036

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Shankar Dixit PO Box 33340 Las Vegas 89133 702-405-3015

Leo Germin 1691 W. Horizon Ridge Parkway, Ste. 120 Henderson 89012 702-804-1212

David Ginsburg 1707 W. Charleston Blvd., Ste. 220 Las Vegas 89102 702-671-5070

Christopher Milford 2575 Montessouri St., Ste. 110 Las Vegas 89117 702-272-0694

Lawrence Lehner

Aurangzeb Nagy

Marc Leiserowitz

2789 Sunridge Heights Parkway, Ste. 100 Henderson 89052 702-614-0850

Luis Diaz 3150 N. Tenaya Way, Ste. 520 Las Vegas 89128 702-233-0755

500 S. Rancho Drive, Ste. 12 Las Vegas 89106 702-877-1887

500 S. Rancho Drive, Ste. 12 Las Vegas 89106 702-877-1887

Judy Ford

Bess Chang 8530 W. Sunset Road, Ste. 350 Las Vegas 89113 702-851-1065

500 S. Rancho Drive, Ste. 12 Las Vegas 89106 702-877-1887

Chidi Okafor

8285 W. Arby Ave., Ste. 220 Las Vegas 89113 702-901-4233

Roshan Raja 2847 St. Rose Parkway, Ste. 130 Henderson 89052 702-920-0290

Dylan Wint

500 S. Rancho Drive, Ste. 12 Las Vegas 89106 702-877-1887

888 W. Bonneville Ave. Las Vegas 89106 702-483-6000

Zvi Sela

NEUROSURGERY

500 S. Rancho Drive, Ste. 12 Las Vegas 89106 702-877-1887

Raj Singh 500 S. Rancho Drive, Ste. 12 Las Vegas 89106 702-877-1887

NEUROLOGY

John Anson 8530 W. Sunset Road Las Vegas 89113 702-471-7779

Gregory Douds 3061 S. Maryland Parkway, Ste. 200 Las Vegas 89109 702-737-1948

Tamer Ammar

Derek Duke

1800 W. Charleston Blvd.

Las Vegas 89102 702-765-7914

861 Coronado Center Drive, Ste. 200 Henderson 89052 702-896-0940

SPRING 2015

5/22/15 12:33 PM

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Congratulations to all of the physicians in the region for the outstanding care you provide to residents and visitors of Las Vegas and Southern Nevada.

We are proud to work with you.

www.valleyhealthsystemlv.com Physicians are independent practitioners who are not employees or agents of The Valley Health System. The system shall not be liable for actions or treatments provided by physicians.

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4/21/15 AM 5/20/15 10:44 5:20 PM

TOP DOCTOR Dr. George Alexander SPECIALTY Plastic Surgery IN PRACTICE 20 years

What colleges have you attended and where did you earn your medical degree(s)?

I attended Rutgers University and obtained a bachelors of science degree in biology with emphasis in physiology. I then moved to Washington, D.C., where I studied at Georgetown University’s School of Dentistry. Although I enjoyed it and did well in the dental school, I decided a medical career was best for me. I applied and was accepted to Georgetown University’s School of Medicine where I obtained my MD. I love that place!

Why did you choose this particular specialty and when did you know this was what you wanted to do?

I always knew I would go into surgery.

As a young medical student, I performed open-heart surgery in a research lab.

I thought I would be a heart surgeon.

A great career, but I became more enamored by the profession of plastic surgery. Of all surgical specialties, plastic surgery has more variety, with different operations, in virtually all parts of the body. My favorite course in medical school was anatomy, and plastic surgery is really surgical applications to all of human anatomy. When I graduated from Georgetown University I knew I would go into plastic surgery.

What are some of the things in this field that have captured your attention?

What has caught my attention in the field of plastic surgery is the continual advancement in surgical techniques and materials, with its attendant improvement in patient outcomes and higher degrees of patient safety.

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SPRING 2015

In the subspecialty of aesthetic (cosmetic) plastic surgery there has been an explosion of nonsurgical and minimally invasive procedures over the last one to two decades. One obvious example is the injectable medicine Botox, now a household word.

What is the most rewarding part of your job as a medical professional?

Appreciation. The most rewarding part of my profession is happy patients expressing thanks for the care I provide, and the expression of trust and confidence from my respected colleagues.

What is the biggest problem you see in the health care industry?

I had the pleasure of serving as past president of Clark County Medical Society, which broadens my response beyond just plastic surgery. The biggest problem I see in the health care industry today is the delivery of the highest quality health care to the many patients who need and deserve it. Over the 20 years of practicing in Las Vegas, I am happy to see more and more high quality physicians and surgeons in our community. We need to continue to foster retaining and attracting the best doctors and nurses, to our community.

We need to continually improve our infrastructure, which includes medical schools, residencies, and hospitals.

There are many moving parts to this solution, but the “good news” is that we have a lot of intelligent and dedicated people who are tirelessly working to make this happen.

Photo by PROTO Images

5/20/15 5:20 PM

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VISIT OUR WEBSITE AND LEARN WHY OUR DOCTORS ARE SOME OF OUR BEST-KEPT SECRETS *U.S. News & World Report. **For a limited time only. Certain restrictions apply. Not to be combined with any additional offers.

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TOP DOCTORS James Forage 861 Coronado Center Drive, Ste. 200 Henderson 89052 702-896-0940

Jason Garber 3061 S. Maryland Parkway, Ste. 200 Las Vegas 89109 702-737-1948

Jaswinder Grover 7140 Smoke Ranch Road Las Vegas 89128 702-320-8111

OBSTETRICS & GYNECOLOGY

Saovaros Michaels 7160 Smoke Ranch Road Las Vegas 89128 702-254-8900

Joseph Adashek 5761 S. Fort Apache Road, Ste. 236 Las Vegas 89148 702-341-6610

Donna Miller 2821 W. Horizon Ridge Parkway, Ste. 100 Henderson 89052 702-862-8862

Robi Burns 2633 W. Horizon Ridge Parkway Henderson 89052 702-853-1400

Nicole Moss 2931 N. Tenaya Way, Ste. 204 Las Vegas 89128 702-233-2123

George Chambers 7220 S. Cimarron Road, Ste. 200 Las Vegas 89113 702-463-0800

Yevgeniy Khavkin 19 Meadowhawk Lane Las Vegas 89135 702-242-3223

Edward Spoon 401 N. Buffalo Drive, Ste. 110 Las Vegas 89145 702-778-4000

Anita Gondy

Kelly Schmidt 3006 S. Maryland Parkway, Ste. 765 Las Vegas 89109 702-948-8788

9811 W. Charleston Blvd., Ste. 2 Las Vegas 89117 702-254-8900

Darin Swainston 2050 Mariner Drive, Ste. 120 Las Vegas 89128 702-255-2022

Michelle Lewis

Michael Seiff 3006 S. Maryland Parkway, Ste. 765 Las Vegas 89169 702-948-8788

Paul Wilkes

1701 N. Green Valley Parkway Henderson 89074 702-566-3040

5761 S. Fort Apache Road Las Vegas 89148 702-341-6610

CONGRATULATIONS to the following

2015 HEALTHCARE QUARTERLY TOP DOCTORS We are proud to have you on our team and applaud you for delivering quality care to our patients each and every day.

DR. JUDITH FORD INTERNAL MEDICINE

DR. BLAIR DUDDY PEDIATRICS

DR. MICHAEL COY FAMILY MEDICINE

DR. CHARD BUBB ENDOCRINOLOGY

DR. STEPHEN PORTZ CARDIOLOGY

DR. THOMAS ALFREDA, INTERNAL MEDICINE (NOT PICTURED)

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TOP DOCTORS

ONCOLOGY Heather Allen 3730 S. Eastern Ave. Las Vegas 89169 702-952-3400

Jonathan Bernstein 3121 S. Maryland Parkway, Ste. 300 Las Vegas 89109 702-732-0971

Fadi Braiteh 3730 S. Eastern Ave. Las Vegas 89169 206-952-3400

Oscar Goodman

Clark Jean

Hamidreza Sanatinia

7445 Peak Drive Las Vegas 89128 702-952-2140

9280 W. Sunset Road, Ste. 100 Las Vegas 89148 702-952-1251

Edwin Kingsley 3730 S. Eastern Ave. Las Vegas 89169 702-952-3400

Nicholas Vogelzang 3730 S. Eastern Ave. Las Vegas 89169 702-952-3452

Brian Lawenda 3006 S. Maryland Parkway, Ste. 100 Las Vegas 89109 702-894-5100

Paul Michael

3150 N. Tenaya Way, Ste. 200 Las Vegas 89128 702-822-2000

9280 W. Sunset Road, Ste. 100 Las Vegas 89148 702-952-1251

OPHTHALMOLOGY

Gilbert Nyamuswa

Jack Abrams

9280 W. Sunset Road, Ste. 100 Las Vegas 89148 702-952-1251

2460 W. Horizon Ridge Parkway Henderson 89052 702-822-2000

Karen Jacks

Wolfram Samlowski

9280 W. Sunset Road, Ste. 100 Las Vegas 89148 702-952-1251

Ann Wierman

6450 Medical Center St., St. 100 Las Vegas 89148 702-304-9494

Emily Fant

9280 W. Sunset Road, Ste. 100 Las Vegas 89148 702-952-3403

3575 Pecos-McLeod Las Vegas 89121 702-731-2088

NOW OPEN IN HENDERSON

Jacobs Medical Associates Internal Medicine and Family Practice Specialists Jacobs Medical Associates is now accepting new patients and serving our long-time patients in our new office in Henderson. Located near the future Union Village project, Jacobs Medical Associates offers quality primary care for teenagers and adults.

Wellness Care • Preventive Care • Sick Visits Screenings • Laboratory and Ancillary Services

LEFT TO RIGHT, Jeffrey Ng*, M.D.; William R. Shoemaker*, M.D.; Leslie Caryl Jacobs*, M.D.; Loring Bradford Jacobs, M.D.; Laura Addis, D.O. * Past Las Vegas Life magazine Top Docs

Trust your family’s health to our family’s practice.

Schedule an appointment today!

Call 725-333-8400 Learn more at www.JacobsMedicalAssociates.com Open Monday through Friday 7 a.m. to 5 p.m.

1389 Galleria Drive, Suite 100 • Henderson, NV 89014

We accept most insurances, including Medicare.

SPRING 2015

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TOP DOCTORS Jeffrey Hart

Michael Monroe

Robert Bien

7121 W. Craig Road, Ste. 113 Las Vegas 89129 702-724-2020

3233 W. Charleston Blvd., Ste. 101 Las Vegas 89102 702-388-1008

7050 Smoke Ranch Road, Ste. 130 Las Vegas 89128 702-233-9911

Gregory Hsu

Gary Morris

299 N. Pecos Road Henderson 89074 702-450-6000

7455 W. Washington Ave., Ste. 160 Las Vegas 89128 702-258-3773

Marietta Nelson

Jason Nielson

2800 N. Tenaya Way, Ste. 102 Las Vegas 89128 702-384-2020

653 N. Town Center Drive, Ste. 208 Las Vegas 89144 702-434-6920

Neville Campbell 1150 Forum Veneto Drive Henderson 89052 702-912-4100

Ho Dzung 9920 W. Cheyenne Ave., Ste. 110 Las Vegas 89129 702-316-2281

Timothy Perozek

Bernie Ong

653 N. Town Center Drive, Ste. 212 Las Vegas 89144 702-982-1360

8551 W. Lake Mead Blvd., Ste. 251 Las Vegas 89128 702-796-7979

6070 S. Fort Apache Road, Ste. 100 Las Vegas 89148 702-307-7700

PEDIATRICS

Helga Pizio

Todd Swanson

501 S. Rancho Drive, Ste. G46 Las Vegas 89106 702-485-5000

2800 E. Desert Inn Road, Ste. 100 Las Vegas 89121 702-731-1616

Grace Shin

G. Mark Sylvain

6028 S. Fort Apache Road, Ste. 101 Las Vegas 89148 702-896-2020

3233 W. Charleston Blvd., Ste. 101 Las Vegas 89102 702-388-1008

Meher Yepremyan

Michael Thomas

653 N. Town Center Drive, Ste. 518 Las Vegas 89144 702-369-0200

7455 W. Washington Ave., Ste. 160 Las Vegas 89128 702-258-3773

ORTHOPEDICS Andrew Cash 9339 W. Sunset Road, Ste. 100 Las Vegas 89148 702-630-3472

Greg Bigler 9499 W. Charleston Blvd., Ste. 200 Las Vegas 89117 702-997-1782

Michael Crovetti 2779 W. Horizon Ridge Parkway Henderson 89052 702-990-2290

Steve Thomas 9499 W. Charleston Blvd., Ste. 200 Las Vegas 89117 702-997-1781

Tim Trainor 8420 W. Warm Springs Road, Ste. 100 Las Vegas 89113 702-740-5327

Richard Wulff 3233 W. Charleston Blvd., Ste. 101 Las Vegas 89102 702-388-1008

PAIN MANAGEMENT

Michael McKenna

Sonya Aikels 653 N. Town Center Drive, Ste. 600 Las Vegas 89144 702-765-5437

Blair Duddy 3150 No. Tenaya Way, Ste. 260 Las Vegas 89128 702-870-2099

Constantine George 6252 S. Rainbow Blvd., Ste. 110 Las Vegas 89118 702-253-5410

Atousa Ghaneian 3196 S. Maryland Parkway, Ste. 400 Las Vegas 89109 702-902-4060

Heath Hodapp 2350 W. Horizon Ridge Parkway Henderson 89052 702-564-8556

Rosemary Hyun 2350 W. Horizon Ridge Parkway Henderson 89052 702-564-8556

Ronald Hillock

Sanghamitra Basu

7455 W. Washington Ave., Ste. 160 Las Vegas 89128 702-878-0393

6955 N. Durango Drive, Ste. 1115-301 Las Vegas 89149 702-362-7246

10001 S. Eastern Ave., Ste. 310 Henderson 89052 702-566-2400

Michael Miao

Marjorie Belsky

2800 E. Desert Inn Road, Ste. 100 Las Vegas 89121 702-731-1616

9333 W. Sunset Road, Ste. A Las Vegas 89148 702-968-6259

John Lepore

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Kim Lamotte-Malone

10105 Banburry Cross Drive Las Vegas 89144 702-765-5437

SPRING 2015

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Humana is proud of its network of physicians including HealthCare Partners Medical Group Boulder Crossing Clinic 5230 Boulder Hwy. – Suite 110 Las Vegas, NV 89122 702-940-1560 Fort Apache Clinic Fort Apache Corporate Center – Suite 150 4730 S. Fort Apache Rd. Las Vegas, NV 89147 702-940-1570 Sun City Clinic 9454 Del Webb Blvd.

Las Vegas, NV 89134 702-940-1580 At Humana, we understand how important the patient-doctor connection is. We encourage our members to ask questions and take a collaborative approach with their doctors.

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Y0040_ GHHHZFWEN_15 Accepted

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5/7/15 2:27 5/21/15 2:55 PM

TOP DOCTOR Dr. Howard Baron SPECIALTY Pediatric Gastroenterology IN PRACTICE 22 years

What colleges have you attended and where did you earn your medical degree(s)?

University of Minnesota College of Liberal Arts — B.A. cum laude in physiology

University of Minnesota Medical School — M.D. degree University of Minnesota — Residency in pediatrics University of Minnesota — Chief residency in pediatrics UCLA Center for the Health Sciences — Fellowship in pediatric gastroenterology, hepatology and nutrition

Why did you choose this particular specialty and when did you know this was what you wanted to do?

Initially I chose pediatrics because I enjoyed working with children and families; Peds GI interested me as a student when I was allowed to follow around a Peds GI specialist in Minnesota, and later as a resident the subject matter interested me as it covered a broad array of medical problems, included hospital and office work and procedures.

ImproveCareNow. It focuses on measuring and improving outcomes for children with Crohn’s disease and ulcerative colitis, two types of inflammatory bowel disease that cause tremendous hardship in thousands of children and teenagers nationwide.

What is the most rewarding part of your job as a medical professional?

Being able to help children feel better and allay anxiety in their parents, and teaching students and residents to prepare them to work in our community.

What is the biggest problem you see in the health care industry?

The demand for services outpaces the supply of physicians available to provide them. This is especially true in Nevada where we have some of the lowest ratios of physician to patients in the country. The graduate medical education system has not kept pace with estimated national needs in the physician work force, and the cost of medical education has gotten to the point that only the very wealthy can afford it, or students carry lifelong debt that they can never hope to fully pay back during their work years.

What are some of the things in this field that have captured your attention?

The recent focus on improving quality of medical care has interested me, and our practice has participated in one of the leading learning health care networks in the world called

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“ Dr. Khorsandi was amazing and I am so happy that I went to him for my breast augmentation. From the consultation to the procedure, he was very professional and answered all of my questions, I mean ALL of my questions. I have been wanting to get this surgery for the longest time and I am so happy that I finally did it. “ - Kim H

“ Love This Doctor!! Just love Dr. Khorsandi!

He is a truly a skillful surgeon that takes great pride in all his work!”

- Henderson, NV - RealSelf

“ I have always wanted to have fuller lips. And, as I have gotten older I had noticed that my lips were becoming thinner. I went to VIP Plastic Surgery with Dr. Khorsandi and he looked at them and we discussed the procedure and Juvederm was the selection. I never felt any pain and the results after the procedure were amazing!!!”

- Keely S

702-608-1318 | vipplasticsurgery.com 2 779 Su n r i d ge H e i gh t s P kw y St e 1 00 | H en d e r s o n , NV 8 905 2

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TOP DOCTORS Goesel Anson

Mary Herte

2040 W. Charleston Blvd., Ste. 402 Las Vegas 89102 702-671-2231

Beverly Neyland

8530 W. Sunset Road, Ste. 130 Las Vegas 89113 702-822-2100

2555 Montessouri St., Ste. A Las Vegas 89117 702-732-9600

Ryan Nishihara

Hayley Brown

9030 W. Cheyenne Ave., Ste. 120 Las Vegas 89129 702-436-7337

Kirmani Shazia 2050 Mariner Drive, Ste. 150 Las Vegas 89128 702-228-9066

Laura Weidenfeld 653 N. Town Center Dr. Las Vegas 89144 702-363-3000

10001 S. Eastern Ave., Ste. 406 Henderson 89052 702-260-7707

Michael Edwards 8530 W. Sunset Road, Ste. 130 Las Vegas 89113 702-822-2100

Orna Fisher

Terry Higgins 8530 W. Sunset Road, Ste. 130 Las Vegas 89113 702-822-2100

Christopher Khorsandi 2779 Sunridge Heights Parkway, Ste. 100 Henderson 89052 702-608-1318

Brandon Reynolds 6460 Medical Center St., Ste. 350 Las Vegas 89148 702-410-9800

PLASTIC SURGERY

6539 S. Las Vegas Blvd., Ste. 111 Las Vegas 89119 702-362-5960

George Alexander

Julio Garcia

Bryson Richards

5320 S. Rainbow Blvd., Ste. 282 Las Vegas 89118 702-242-6776

6020 S. Rainbow Blvd., Ste. C Las Vegas 89118 702-870-0058

6020 S. Rainbow Blvd., Bldg C Las Vegas 89118 702-870-7070

38 Physicians at the Top of their Field.

14 Honored as Top Doctors.

One Vision.

Comprehensive Cancer Centers of Nevada congratulates our physicians who have been honored as VEGAS INC Health Care Quarterly Top Doctors.

The dedication shown by you, and the entire practice, is helping to make a future without cancer a reality.

Heather J. Allen, MD, FACP | Fadi Braiteh, MD | Oscar B. Goodman Jr., MD, PhD Karen S. Jacks, MD | Clark S. Jean MD | Edwin C. Kingsley, MD | Paul E. Michael, MD Wolfram Samlowski, MD, FACP | Hamidreza Sanantinia, MD | Nicholas J. Vogelzang, MD

We also congratulate the doctors from The Lung Center of Nevada who will make up our new Division of Pulmonary and Sleep Medicine starting June 1st: Jack Collier, MD, FCCP, DABSM | James Hsu, MD, FCCP, DABSM George Tu, MD, FCCP, DABSM | John Wojcik, MD, FCCP, DABSM

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702.952.3350 • cccnevada.com

SPRING 2015

5/20/15 5:22 PM

00001232

888.844.5665

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Abdominoplasty Liposuction Arm lift Labiaplasty

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Call for questions about any procedure not listed above.

When you mention Dr. Fisher in Top Docs issue

TOP DOCTOR ORNA FISHER, M.D. Board-Certified Plastic Surgeon

To schedule your private consultation or for information regarding any procedures, please email:

info@drfisherlasvegas.com 888.844.5665 | www.thefemaleplasticsurgeon.com Town Square Las Vegas | 6539 Las Vegas Blvd. South| Las Vegas, NV 89119 | Upstairs inside LOOK Style Society Bldg

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TOP DOCTORS Jeffrey Roth

Sean Duffy

James Hsu

9280 W. Sunset Road, Ste. 236 Las Vegas 89148 702-450-0777

1885 Village Center Circle, Ste. 150 Las Vegas 89134 702-360-2800

9280 W. Sunset Road, Ste. 312 Las Vegas 89148 702-737-5864

Marvin Spann

Peter Mansky

2615 Box Canyon Drive Las Vegas 89128 702-998-9001

9811 W. Charleston Blvd., Ste. 2-735 Las Vegas 89117 702-467-8118

Frank Stile 8954 Spanish Ridge Ave. Las Vegas 89148 702-243-9555

William Zamboni 2040 W. Charleston Blvd., Ste. 301 Las Vegas 89102 702-671-5110

Craig Nakamura 3820 Meadows Lane Las Vegas 89107 702-598-4411

Faisal Suba

Paul Stewart

2810 W. Charleston Blvd., Ste. 78 Las Vegas 89102 702-258-3415

2000 Goldring Ave. Las Vegas 89106 702-384-5101

PULMONARY

Joaquim Tavares

John Collier

PSYCHIATRY

3150 N. Tenaya Way, Ste. 125 Las Vegas 89128 702-869-0855

Debora Barney

Salvatore Guarnera

6284 S. Rainbow Blvd., Ste. 110 Las Vegas 89118 702-242-0485

3150 N. Tenaya Way, Ste. 425 Las Vegas 89128 702-255-5903

Request an appointment online at nevadaorthopedic.com or call 702 • 258 • 3773 Henderson Office 1505 Wigwam Parkway, Suite 330 Henderson, Nevada 89074

Congratulations to 2015 Top Doctors Gary D. Morris, M.D. and Michael D. Thomas, M.D.

6787 W. Tropicana Ave., Ste. 120 Las Vegas 89103 702-893-0020

George Tu 3150 N. Tenaya Way, Ste. 125 Las Vegas 89128 702-869-0855

Celebrating over 20 years of orthopedic excellence by providing quality healthcare you can trust!

Northwest Las Vegas Office 7455 W. Washington Avenue, Suite 160 Las Vegas, Nevada 89128

Edward S. Ashman, M.D. • Bradley S. Baker, M.D. • Michael S. Bradford, M.D. • Holman Chan, M.D. Ronald W. Hillock, M.D. • John J. Kastrup M.D. Thomas C. Kim, M.D. • Daniel D. Lee, M.D. Patrick S. McNulty, M.D. • Gary D. Morris, M.D. • Russell T. Nevins, M.D. • Reynold L. Rimoldi, M.D. Walter J. Song, M.D. • Arthur J. Taylor, M.D. • Michael D. Thomas, M.D. • Conrad O. Yu, M.D. Hand, Wrist & Elbow, Shoulder, Hip & Knee, Foot & Ankle, Spine, Scoliosis, Pediatric Orthopedics, Sports Medicine, Total Joint Replacement, Musculoskeletal Oncology Accepting Most Insurance Plans

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ANSON EDWARDS HIGGINS P L A S T I C

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S U R G E RY

A S S O C I AT E S

5/7/15 1:12 5/20/15 5:22 PM

TOP DOCTOR Dr. Greg Fihn SPECIALTY Family Practice IN PRACTICE 20 years

What colleges have you attended and where did you earn your medical degree(s)?

University of Nevada Reno — B.S.

Des Moines University — Doctor of Osteopathy

Why did you choose this particular specialty and when did you know this was what you wanted to do?

What is the most rewarding part of your job as a medical professional?

Empowering patients to make positive changes in their lives.

What is the biggest problem you see in the health care industry?

Lack of resources and education that lead people to a healthier lifestyle.

Family practice allows me the opportunity to care for all aspects of a person’s health, it allows me the opportunity to help people in a holistic manner and make a difference in their lives.

What are some of the things in this field that have captured your attention?

In most cases we all have the opportunity to improve our health by living the healthiest possible lifestyle.

Exercise, eat healthy, exercise , eat healthy, exercise…. Get the idea?

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SPRING 2015

Photo by Steve Marcus

5/20/15 5:22 PM

TOP DOCTORS Walter Willoughby 10105 Banburry Cross Drive, Ste. 355 Las Vegas 89144 702-998-1400

Dianne Mazzu

Mitch Forman

2020 Palomino Lane, Ste. 100 Las Vegas 89106 702-759-8606

874 American Pacific Drive Henderson 89014 702-777-4809

John Wojcik

Joshua Owen

Scott Harris

7130 Smoke Ranch Road Las Vegas 89128 702-731-2888

874 American Pacific Drive Henderson 89014 702-777-4809

9280 W. Sunset Road, Ste. 312 Las Vegas 89148 702-737-5864

RADIOLOGY Rajneesh Agrawal 2020 Palomino Lane, Ste. 100 Las Vegas 89106 702-759-8606

Paul Bandt

Lisa Wong

Timothy Kelly

2020 Palomino Lane, Ste. 100 Las Vegas 89106 702-990-5330

7200 Cathedral Rock Drive, Ste. 110 Las Vegas 89128 702-341-5444

RHEUMATOLOGY

Ewa Olech 1707 W. Charleston Blvd., Ste. 220 Las Vegas 89102 702-731-9110

Michael Clifford

2020 Palomino Lane, Ste. 100 Las Vegas 89106 702-759-8606

7151 Cascade Valley Court, Ste. 103 Las Vegas 89128 702-944-5444

Ash Gupta

Mike Colletti

2020 Palomino Lane, Ste. 100 Las Vegas 89106 702-759-8606

4580 S. Eastern Ave., Ste. 29 Las Vegas 89119 702-734-2242

Elham Taherian 2040 W. Charleston Blvd., Ste. 300 Las Vegas 89102 702-671-2231

More reasons to love your job.

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Find out more visit a Sprint store. storelocator.sprint.com or call 1-866-639-8354 Activ. Fee: $36/line. Credit approval required. Early Termination Fee (sprint.com/etf): After 14 days, up to $350/line. SDP Discount: Avail. for eligible company or org. employees (ongoing verification). Discount subject to change according to the company’s agreement with Sprint and is avail. upon request for monthly svc charges. Discount only applies to Talk 450 and primary line on Talk Share 700; and data service for Sprint Family Share Pack, Sprint $60 Unlimited Plan and Unlimited, My Way plans. Not avail. with no credit check offers or Mobile Hotspot add-on. Other Terms: Offers and coverage not available everywhere or for all phones/networks. Restrictions apply. See store or sprint.com for details. Š 2015 Sprint. All rights reserved.

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MV1234567

SPRING 2015

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TOP DOCTORS Andrew Hwang

Scott Slavis

2482 W. Horizon Ridge Parkway, Ste. 130 Henderson 89052 702-614-6868

653 N. Town Center Drive, Ste. 407 Las Vegas 89144 702-728-5686

3131 La Canada St., Ste. 217 Las Vegas 89169 702-796-8669

UROLOGY

7500 Smoke Ranch Road, Ste. 200 Las Vegas 89128 702-233-0727

Christianne Yung

Steven Kurtz

Scott Baranoff 9053 S. Pecos Road, Ste. 2900 Henderson 89074 702-735-8000

Dave Larsen 9053 S. Pecos Road, Ste. 2900 Henderson 89074 702-735-8000

Joseph Candela

Mark Leo

7500 Smoke Ranch Road, Ste. 200 Las Vegas 89128 702-233-0727

PO Box 35380 Las Vegas 89133 702-877-0814

Clare Close 2653 W. Horizon Ridge Parkway, Ste. 100 Henderson 89052 702-220-4006

Sheldon Freedman 9280 W. Sunset Road, Ste. 200 Las Vegas 89148 702-732-0282

Alex Lesani 7150 W. Sunset Road, Ste. 201A Las Vegas 89113 702-233-0727

Robert McBeath 5701 W. Charleston Blvd., Ste. 201 Las Vegas 89146 702-877-0814

Michael Verni 653 N. Town Center Drive, Ste. 302 Las Vegas 89144 702-212-3428

Jeffrey Zapinsky 7200 Cathedral Rock Drive, Ste. 180 Las Vegas 89128 702-341-9000

VASCULAR SURGERY Eric Chino 3150 N. Tenaya Way, Ste. 560 Las Vegas 89128 702-586-4913

Frank Jordan 7200 Cathedral Rock Drive, Ste. 130 Las Vegas 89128 702-228-8600

Proactive Accountants with Cloud Based Technology

Keeping up with the new technology and software Organizing and protecting accounting data Routine check up for accuracy by a CPA Real-time access to financial information For more information, Call 702-732-4302

www.summit-cpa.com 4730 S Fort Apache Rd #220 Las Vegas NV 89147

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MEDICAL ADVERTISING SECTION SP O N S O R ED BY:

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Thomas Umbach, M.D.,

David G. Stewart, Jr., M.D.

Christopher Khorsandi, M.D.

B A R I AT R I C S U R G E R Y

P E D I AT R I C O R T H O P E D I C S

COSMETIC SURGERY

MEDICAL ADVERTISING SECTION

F.A.C.S.

Dr. Thomas Umbach is a fellowship-trained Las Vegas bariatric surgery specialist devoted 100 percent to bariatrics with more than 15 years experience in laparoscopic and bariatric surgery.

After starting up the laparoscopic surgical weight loss program at Kaiser Permanente South San Francisco, Dr. Umbach then created a Center of Excellence program in Eugene, Ore., and rejuvenated the Bariatric Program at Desert Springs Hospital. His other achievements include being recognized as one of the Nation’s Leading Bariatric Surgeons by Newsweek, Best Healthcare Consultant and Best Medical Tourism Provider by the New Economy.

Board-Certified: American Board of Surgery Fellow: American College of Surgeons, American Society of Metabolic & Bariatric Surgeons Fellowship: Advanced Minimally Invasive Surgery, University of Southern California M.D.: Medical College of Virginia

David G. Stewart, Jr., M.D., practices pediatric orthopedic surgery with an emphasis on trauma, reconstruction, spinal deformity and cerebral palsy. Dr. Stewart received his medical degree at the University of Colorado School of Medicine with board scores in the top 1 percent and went on to complete a residency in orthopedic surgery at the University of Texas Medical Branch and fellowship in pediatric orthopedic and scoliosis surgery at Children’s Hospital Los Angeles. Dr. Stewart is board certified and is a member of the Pediatric Orthopedic Society of North America and the Alpha Omega Alpha medical honor society and is a fellow with the American Academy of Orthopedic Surgeons. He frequently travels to Kyiv, Ukraine, where he teaches surgeons and consults in research and patient care. Dr. Stewart speaks fluent English, Spanish and Russian. Since joining Children’s Bone and Spine Surgery in 2005, Dr. Stewart has been selected for numerous Top Doctor awards, including from Castle Connolly, Las Vegas Life, Desert Companion and Vegas Seven.

Children’s Bone & Spine Surgery 1525 E. Windmill Lane, Suite 201 Las Vegas, NV 89123

Blossom Bariatrics 3235 E. Warm Springs Road, Ste. 100, Bldg. 24 Las Vegas, NV 89120

(702) 463-3300

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9050 W. Cheyenne Avenue, Suite 110 Las Vegas, NV 89129

(702) 998-5200

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(702) 434-6920

cbsortho.com

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Dr. Christopher Khorsandi offers cosmetic, plastic and reconstructive procedures for the breast, body, face and skin as the chief plastic surgeon for VIP Plastic Surgery. Dr. Khorsandi attended Villanova University and Temple University School of Medicine.

Following medical school, he trained at the highly esteemed Ivy League surgery program at the University of Pennsylvania.

The advanced medical training Dr. Khorsandi completed took him to the Hospital of the University of Pennsylvania and the Children’s Hospital of Philadelphia. His hard work and academic achievements led him to be accepted into the plastic and reconstructive training program at the Cleveland Clinic in Weston. He spent two years refining his skills in plastic, reconstructive and hand surgery and became the program’s chief resident. He also co-authored a text chapter on wound healing and continued working on several research projects in the field of plastic surgery.

Looking to develop his skills further, Dr. Khorsandi went on to complete an advanced aesthetic fellowship in Beverly Hills before training in Houston, Texas, in minimally invasive hand surgery and peripheral nerve reconstruction.

VIP Plastic Surgery 2779 Sunridge Heights Parkway, Suite 100 Henderson, NV 89052

(702) 608-1318

vipplasticsurgery.com

Dr. Umbach photo by Bennie E. Palmore II

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MEDICAL ADVERTISING SECTION

Joseph P. Contino, M.D., F.A.C.S.

Karen S. Jacks, M.D.

Michael T. Sinopoli, M.D.

BREAST SURGERY

MEDICAL ONCOLOGY

R A D I AT I O N O N C O LO G Y

medicalprofiles

Joseph P. Contino, M.D., F.A.C.S., is a breast surgeon with Comprehensive Cancer Centers of Nevada (CCCN). He has treated patients with breast, colon and thyroid cancers for more than 20 years. He has a special interest in breast-related diseases using less invasive technologies such as breast ultrasound, stereotactic imaging, cryotherapy and other new modalities.

His dedication as a surgeon extends beyond his work in the operating room.

Dr. Contino has embraced all forms of social media into his practice by following health care industry organizations and news outlets. He believes in sharing timely information with his patients and other followers, who all appreciate his proactive approach to imparting knowledge and surgical expertise.

Dr. Contino’s patient philosophy is to treat breast cancer on an individualized basis. This requires staying up on the latest forms of breast cancer treatment and collaborating with other specialists who are like-minded. His goal is to spend time with his patients to inform them, and console if needed, as he would hope others would treat his own family.

Comprehensive Cancer Centers of Nevada 7445 Peak Drive Las Vegas, NV 89128

(702) 952-2140 CCCNevada.com

Karen S. Jacks, M.D., is a medical oncologist-hematologist at Comprehensive Cancer Centers of Nevada (CCCN), who treats patients with various cancer types and serious blood disorders.

Prior to joining CCCN, Dr. Jacks worked at UC San Diego Nevada Cancer Institute and Nevada Cancer Institute (NVCI) where she focused on breast cancer and other female cancers and served as assistant professor for medical oncology. Dr. Jacks also served as co-chair for the Cancer Control Committee and member of the Blood Utilization Committee. She previously served as an oncology fellowship preceptor, medical director of oncology services at University Medical Center, and as the oncology rotation residency coordinator at the University of Nevada School of Medicine.

Dr. Jacks has numerous peer-reviewed publications and presentations, and received the Eugene Furth, M.D. Award for Most Outstanding Senior Resident, and the Sir Williams Osler Award for Best Senior Resident in Cardiology. She has also been recognized as a “Medical Marvel” byNevada Business Magazine.

Comprehensive Cancer Centers of Nevada 9280 W. Sunset Road, Suite 100 Las Vegas, NV 89148

(702) 952-1251 CCCNevada.com

Michael T. Sinopoli, M.D. is a radiation oncologist at Comprehensive Cancer Centers of Nevada (CCCN), with special interest in treating patients with prostate cancer, lung cancer, and breast cancer using cuttingedge technologies such as CyberKnife® Stereotactic Radiosurgery and Image Guided Radiation Therapy.

Since joining CCCN in 2010, Dr. Sinopoli has become an active member in the Las Vegas community and serves on the Board for Family and Child Treatment of Southern Nevada. He has authored numerous scientific papers and has been a speaker at several national and international conferences for radiation oncology. With his years of experience, Dr. Sinopoli has been named a Top Doctor in Radiation Oncology by several local and national publications.

Growing up with six brothers and sisters, Dr. Sinopoli’s patient philosophy is to treat each patient with the same respect and personalized care that he would want for a member of his own family.

Comprehensive Cancer Centers of Nevada 7445 Peak Drive Las Vegas, NV 89128

(702) 952-2140 655 N. Town Center Drive Las Vegas, NV 89144

(702) 233-2200 CCCNevada.com

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Meher Yepremyan, M.D., M.S.

Michael Zimmerman, M.D.

Joe Willardsen, D.D.S.

OPTHALMOLOGY

GASTROENTEROLOGY

COSMETIC DENTISTRY

MEDICAL ADVERTISING SECTION

Dr. Meher Yepremyan was born in Armenia. His undergraduate training was in aerospace and mechanical engineering. He completed his graduate degree in biomedical engineering from the University of California, San Diego. Dr. Yepremyan received his M.D. degree from Yale University School of Medicine. He completed his internship in internal medicine at Yale-New Haven Hospital and residency training in general ophthalmology at the New England Eye Center in Boston. He completed his vitreoretinal surgery fellowship at McGill University.

After completing his training in 2005, Dr. Yepremyan moved to Las Vegas to join the Retina Consultants of Nevada (RCN), a practice limited to diseases and surgery of the retina and vitreous. RCN was established in 1980 and is one of the leading group subspecialty retinal practices in the country.

Dr. Yepremyan speaks several languages including Armenian and Russian. Dr. Yepremyan is a Diplomate of the American Board of Ophthalmology and an active fellow of the American Academy of Ophthalmology.

Dr. Yepremyan feels fortunate to live and raise his family in Las Vegas and work with the outstanding doctors in the community.

Retina Consultants of Nevada 2 Las Vegas locations and Green Valley

(702) 369-2000

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Digestive Disease Specialists 2700 Crimson Canyon Drive, Suite 180 Las Vegas, NV 89128

(702) 562-2420

RetinaNevada.com

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Dr. Michael Zimmerman received his undergraduate degree from Georgetown University. After completing his medical degree from the Rosalind Franklin University of Medicine in Chicago, he did his internship and residency at Norwalk Hospital / Yale University School of Medicine. Dr. Zimmerman then completed a three-year fellowship in gastroenterology and advanced therapeutic endoscopy at Baylor College of Medicine in Houston, Texas.

Dr. Zimmerman has been affiliated with Digestive Disease Specialists since completing his training and moving to Las Vegas in 1995. Dr. Zimmerman’s practice includes all aspects of gastrointestinal diseases, including liver and pancreatic disease. He is on the board of directors of the local chapter of the Crohn’s and Colitis Foundation, and has been involved for the past several years in many local clinical research protocols involving a variety of gastrointestinal disease states. He frequently lectures about a variety of topics to health care providers here in town.

SPRING 2015

Dr. Joe Willardsen is a cosmetic and neuromuscular dentist who has been practicing for more than 15 years.

Dr. Willardsen graduated from the Loma Linda University School of Dentistry. His continued education was completed at the Las Vegas Institute for Advanced Dental Studies, Arrowhead International and the Dr. Dick Barnes Group. He has also studied at Occlusion Connections, for which he sits on their board of directors. Dr. Willardsen’s office, True Dentistry, has a spa-like ambience and its own in-house dental laboratory. This way, Dr. Willardsen has more control of the results for creating beautiful smiles.

Dr. Willardsen has also built a lecture hall in his facility, where he often hosts courses about advances in cosmetic dentistry.

Dr. Willardsen is a member of the American Dental Association, Southern Nevada Dental Society, Nevada Dental Association, American Academy of Cosmetic Dentistry and the Occlusion Connections study group.

Dr. Willardsen’s expertise has been featured on “The Doctors,” an Emmy-winning daytime talk show.

True Dentistry has been featured in Vegas Rated magazine and is the official dentist of the Miss Nevada USA pageant. He is a certified Alleman-Deliperi Biomimetric instructor.

True Dentistry 9061 West Post Road Las Vegas, NV 89148

(702) 434-4800

TrueDentistry.com

Dr. Zimmerman photo by Wade Vandervort.

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medical profiles

COSMETIC SURGERY

Bryson Richards, M.D.

our first independent, national audited audience numbers for the sunday just came out! Look at the exceptional results!

Dr. Bryson Richards was trained in advanced cosmetic plastic surgery at the prestigious Cleveland Clinic. He is a graduate of Cornell Medical School in New York City and chief plastic surgery resident at Strong Memorial Hospital in Rochester, NY. His expertise in plastic surgery has been requested by numerous societies that have invited him to speak at multiple national meetings.

His recent peer-reviewed publications describe techniques that dramatically reduce pain after breast augmentation and facial cosmetic surgery.

Having a strong humanitarian commitment, Dr. Richards volunteered his time to perform cleft lip and palate procedures in Uganda, Africa. After 14 years of education and training in the nation’s best plastic surgery centers, Dr. Richards brought his family to the warm weather of Las Vegas. He is happily married for over 10 years and has four wonderful children.

He enjoys playing sports, skiing, boating, and mountain biking.

Richards Cosmetic Surgery 6020 S. Rainbow Blvd., Bldg. C Las Vegas, NV 89118

(702) 870-7070

RichardsCosmeticSurgery.com

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The Sunday readership is 142,000 (2.4 readers per issue)

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Average income is $98,000 ; the highest income of any general market publication in Southern Nevada

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SPRING 2015

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BEST PRIMARY CARE PHYSICIANS IN LAS VEGAS

Named a HealthCare Quarterly Top Doctor Seven Times 2000 | 2007 | 2011 | 2012 | 2013 | 2014 | 2015

Tony Alamo, M.D. • Graduate of the University of Southern California (USC) School of Medicine • Current Chairman of the Nevada Gaming Commission • Past Chairman of the Nevada Athletic Commission • Past Chief-of-Staff of two prominent hospitals • Current member of Search and Rescue and Tactical Physician for the Metro Police SWAT division • Aviation Medical Examiner • Commercial Rated Pilot Congratulations to Dr. Alamo on his 7th year as a “Top Doc” Dr. Alamo, born and raised in Nevada, established Alamo Medical Clinic in 1994.

Dr. Alamo is a Primary Care Physician with an emphasis in Internal and Aviation Medicine.

(702) 456-4011 www.AlamoClinic.com www.TonyAlamoMD.com 56 N Pecos Rd, Ste A • Henderson, NV 89074

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ALAMO MEDICAL CLINIC Tony Alamo, M.D. | Angela S. Miller, M.D.

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ASK A

DOCTOR T

he path to good health doesn’t end at the doctor’s door. The time you’ll spend with him or her is very

important, so maximize it by having some information at the ready. Afterward, take

advantage of your pharmacist’s expertise to get the most out of your medication.

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GETTING THE MOST OUT OF

A DOCTOR’S APPOINTMENT

By Tracy Wakefield, M.D.

R

egularly visiting a primary care doctor is an important component of staying healthy but many people might not be taking full advantage of their one-on-one time with providers. A doctor’s visit is useful not only for addressing current health issues, but also for checking in about important screenings, immunization updates and any other wellness services that might be needed. In addition, some patients might not be aware of how to fully use their health insurance coverage to achieve the best care at an affordable cost. With an increasing number of people obtaining health insurance as a result of the Affordable Care Act, many individuals have new options for taking control of their health care that they didn’t before. Fortunately, there are several helpful steps people can take to make the most out of each doctor’s appointment and to ensure their health insurance coverage is fully used.

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Provide family history

Health care providers are better equipped to offer thorough assessments when patients supply accurate information about common illnesses in their families. It’s helpful for patients to update their family histories before visiting their provider and to take note of any diseases or conditions that have occurred among immediate or extended family members. This information can help providers determine a person’s risk for many chronic diseases, such as cancer, heart disease and diabetes.

Be forthcoming about personal practices

It’s important for patients to be honest with physicians about their personal lifestyles, including their diet and exercise regimen, especially if their daily habits might put them at higher risk for any diseases. Providers can help design patients’ overall wellness plans based on this personal information, including recommending an improved meal plan or a more effective exercise regimen.

Compile a list of all current medications

Providers often request for patients to bring them a list of all current medications they are taking in order to ensure none of these prescriptions are counteracting each other or are dangerous to take at the same time. Some patients obtain prescriptions from multiple health care providers who aren’t aware of their other medications, making it important for the primary care provider to oversee all of their medications.

It could be useful for patients to look into pursuing coordinated care, where this is a high priority.

Ask about screenings

Health experts recommend a variety of wellness screenings for many patients who meet specific parameters. Some patients might also be due for vaccinations for certain illnesses, including shingles, tetanus and pneumonia. It is important for patients to ask their providers about which of these preventative measures they need to pursue based on their age, family health history and lifestyle.

Insurance coverage

There are also specific measures that can help people take full advantage of their health insurance benefits, including:

Learn about the discounts

Many health insurance plans offer free or discounted preventative health and wellness services, including gym memberships. Using these discounts can provide tools for people to improve their overall health and reduce the need for medical care down the road.

Pursue health screenings

Some plans also offer free screenings for blood pressure, cholesterol and body mass index. This information can be useful in working with health care providers to monitor patients’ overall health and also set target goals to improve these measurements.

Ensure your plan meets all your needs

It is useful for patients to select a health insurance plan that covers all treatments and preventative services necessary for themselves and their families. This should include choosing a plan with coverage for anticipated needs, especially if patients are expecting high-cost medical situations such as surgeries or pregnancies.

To learn more about HealthCare Partners, please visit www.hcpnv.com.

Dr. Tracy Wakefield is medical director for HealthCare Partners Nevada.

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DISPENSING

GOOD ADVICE FROM BEHIND THE COUNTER

By Kay-Lynn Bowman, PharmD, M.S.

A

s a neighborhood pharmacist, I see patients come in every day seeking advice for issues ranging from what to do for the common cold to situations much more complex that require a hospital visit. My fellow Smith’s pharmacists and I are frequently called upon to provide medication and health information to patients and other health care providers. We are very accessible and willing to assist in whatever way we can. Our goal is to have a healthy community.

To that end, here are some health care basics to understand: At various times throughout the year, for instance when it’s windy out, allergies kick in for many Southern Nevadans. We often recommend antihistamines or decongestants, but before we do ask questions about your health history to make sure what we’re recommending is safe. A person’s age, gender, pregnancy or breastfeeding status and other medications and medical conditions all can come into play. For example, in the elderly, certain conditions can be worsened by antihistamines. By discussing your history we can prevent problems and make the best recommendations.

For a cough or a cold, the same procedure is followed. We can help people determine if it’s an allergy or something beyond that.

As described previously for allergy treatment, for over-the-counter medications for cough and cold, many times it’s not about simply directing someone to the right aisle or product. Scenarios often can be more complicated than what a patient originally thought.

Kay-Lynn Bowman, PharmD, M.S., Med, is a team member of Smith’s Food & Drug Clinical Pharmacy.

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We’ll ask questions about how long you’ve had symptoms, what you’ve previously tried, and then recommend the next steps to a healthier you.

To prevent getting sick in the first place, wash your hands frequently and get your flu shot every year. Everyone 6 months and older should get a flu shot. There are very few reasons not to. Even for those allergic to eggs, there are certain flu vaccines that can be given without the risk of allergic reactions due to eggs.

If you are sick, stay away from others when you first become ill. Cover your mouth when you cough and stay home.

Most importantly, pay attention to simple signs if you don’t feel good. Things can go from bad to worse after a couple weeks and could require stronger medicine at that point if you haven’t treated the problem.

There are other things you can do to keep healthy, such as visiting a doctor for yearly checkups to catch any health problems early. If you do have health problems, make sure you’re taking your medications correctly so you get the most from them.

If you have questions, ask your pharmacist to review your regimen.

A healthy lifestyle is important for preventing or treating many health conditions.

Everyone should strive to be physically active. It is recommended to get at least 30 minutes of exercise on most days of the week. Start off with wearing a pedometer and log your daily steps to get an idea of what your baseline activity is. By the end of

two weeks you should set a goal of increasing steps by a reasonable amount. As you add more activity to your life, find what you like to do — gardening, swimming, biking or walking are all great options. Even small changes can help you be more active, like taking the stairs instead of escalator or elevator or parking at the far end of the parking lot. Stay positive and realize that small changes will add up and help you become more fit. Stay positive and realize that small changes will add up and help you become more fit.

Eating a healthy diet is important for any person, with or without existing medical conditions. Including plenty of fruits and vegetables, lean meats and whole grains is a recipe for success. Limiting fats and sugars is important, but depriving yourself completely isn’t realistic either. Most foods can be healthy in moderation. Portion size is key no matter the meal. Use a salad plate rather than a dinner plate when serving your meals. Try to fill half of the plate with vegetables. For extra help, check out www. chooseplate.gov, a great website that helps you track activity and has many printable health tips. Use supplements as just that — to supplement your diet. It’s often best to try to vary your diet to allow you to get vitamins and minerals you need from foods you eat.

Many people take more supplements than necessary. If you suspect you might have a nutritional deficiency, check with your doctor before adding too many supplements to your diet. Here’s to your health!

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Some kids think they’re a really big deal around here.

And we hope that never changes.

The Children’s Specialty Center of Nevada is the most comprehensive collection of board certified pediatric specialists in the state of Nevada, providing unequaled medical expertise when you need it most. Our board certified physicians and medical staff provide specialized treatments for children and young adults affected by cancer, blood disorders, rare and ultra rare diseases, rheumatology and genetic conditions.

As a member of the Children’s Oncology Group, the leading network of pediatric cancer physicians and treatment centers in the country, our patients have access to the latest pediatric cancer research and clinical trials. Our Long Term Follow Up Clinic for childhood cancer survivors is the only one of its kind in Nevada.

Our membership in the Pacific Sickle Cell Regional Collaborative ensures patients have access to the latest and most comprehensive treatments and clinical trials. This summer, we’ll add Nevada’s first (and only) pediatric neuro oncologist into our practice. We’ll also be adding a pediatric palliative program.

As a program of Cure 4 The Kids, a nonprofit organization, we understand the importance of providing care to all children, regardless if they have medical insurance or the ability to pay for treatment.

Actual Patient: Lillian, 4, diagnosed with Pre B Acute Lymphoblastic Leukemia in 2011 just celebrated her last treatment in February 2014.

HEMATOLOGY/ONCOLOGY | RHEUMATOLOGY | BLOOD DISORDERS | RARE AND ULTRA RARE DISEASES GENETIC CONDITIONS | LONG TERM FOLLOW UP FOR CHILDHOOD CANCER SURVIVORS

Jonathan Bernstein, M.D.

Katherine Marzan, M.D.

Founder and Medical Director Board Certified Pediatric Hematology/Oncology

Board Certified Pediatric Rheumatology

Alan Ikeda, M.D.

Board Certified Internal Medicine and Rheumatology

Director of Oncology Board Certified Pediatric Hematology/Oncology

Danielle T. Bello, Ph.D.

Waseem Alhushki, M.D.

Kanya Ayyanar, M.D. (Summer 2015)

Board Eligible Pediatric Hematology/Oncology

Alexandra Walsh, M.D., MSPH Board Certified Pediatric Hematology/Oncology

Nik Abdul-Rashid, M.D. Board Certified Pediatric Hematology/Oncology

Lisa Majlessi, M.D.

Clinical Psychology/Neuropsychology Board Certified Pediatric Neuro-Oncology

Nicolo Longo, M.D., Ph.D. Board Certified Clinical Biochemical Genetics and Clinical Genetics

Arlene Bayreder

3121 South Maryland Parkway Third Floor, Suite 300, Las Vegas, NV 89109 702.732.1493 | cure4thekids.org New Patient Coordinator: 702.732.3330

Nurse Practitioner

Diane E. Brown, M.D., Ph.D. Board Certified Pediatric Rheumatology

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TREATING ADDICTION R

By Jessica Kantor ecovery, like addiction, is a very personal journey. Individuals are not just taking themselves off of a drug their body is

physically dependent on. They are taking them-

selves out of a way of life and either learning or unlearning attributes that make them who they are.

In a rehabilitation center, clients are speaking with therapists and clinicians who are helping them grow into stronger people who can control their addiction. These sessions, and the way one receives treatment as a whole at a rehabilitation center, are not cookie cutter. One large area of difference in treatment has to do with age. Within different age groups there are different emotional skill sets and recovery methods that one must learn. On top of that, different age groups are usually addicted to different drugs.

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Mike Adams, vice president of clinical operations at Solutions Recovery Inc., said there are three main age groups to look at when treating addiction: 18 to 30 years old, 31 to 50 years old, and older than 51 years old.

There are some similarities between each; there will often be someone enabling the individual experiencing addiction, be it the parent, spouse or child. There will usually be a stressor that is causing or has caused the addiction, which must be dealt with in therapy.

There will also be coping problems and strategies to be identified.

There are also many differences between these groups. With different age groups come different ways the individuals have grown up. Whether they are baby boomers, Generation X, or millennials, there are different societal norms that are acknowledged and touched on during their treatment.

Ages 18 to 30

Chad’s mom said he’s learning how to deal with his problems now. Whether dealing with his relationship with his mother or addressing his personal needs, Chad now has new tools to use to help him steer clear of drugs.

Ages 31 to 50 People in their 30s and 40s can often experience problems with their spouse or job, Adams said, which can lead to substance issues. Sometimes individuals in this age group are identified as having a mid-life crisis, which can sometimes involve purchasing extravagant items. In some cases, however, they turn to substances to deal with their stress. As seen in the younger group, these situations often include enabling relationships, but among middle aged individuals this is usually with the spouse, rather than the parent.

“For individuals in this age group, we are usually looking at abuse of alcohol and prescription medications,” LaLuzerne said.

This age group often receives the same type of treatment as younger individuals, in regard to identifying negative consequences and learning better coping skills for specific issues.

According to Adams, 18 to 30-year-olds are usually not emancipated, which can impact their addiction and recovery.

“Their relationships are enabling, and they stop growing developmentally at the time of addiction,” Adams said.

“Usually the parents are inadvertently keeping their kids sick, and there’s more “Marijuana and prescripAges 51+ growth that needs to happen involving the family.”

The oldest age group experiences a tion pills are rampant in Angela LaLuzerne, clinical director set of problems all its own. The enablers at Solutions Recovery Inc., notes that are often the children, though somethe oldest age group.” there is a higher relapse rate with the times still the spouse. younger age group.

“There’s a post-retirement loss of “Does it have to do with age? Ideas identity.

The whole family is redefining — Mike Adams, of immortality? Impulse? We have to roles naturally,” LaLuzerne said of this vice president of address these issues and teach them age group. clinical operations at healthier and more productive ways to This is something that can have a Solutions Recovery Inc. deal with this stress,” LaLuzerne said. significant impact on people, because Adams and LaLuzerne mention that they often have to find a new sense of the most common type of drug used by purpose. Unfortunately, many indithe younger age group seeking recovery viduals find addiction instead of a new is usually prescription pills, or opiates, which can lead to heroin use. purpose or hobby.

Chad, 22, went through the Solutions Recovery program for Adams notes that since this generation is entering into retire30 days in-house and eight weeks Intensive Outpatient (IOP). ment and is no longer regularly drug tested, it can be easy to His drug of choice was heroin, but he said he started with alcohol return to drugs that they used to take when they were younger. and cocaine.

Some will pick up the drugs they previously put down when enter“I started drinking alcohol when I was 13, heroin when I was 17,” ing into the workforce, only to find addiction instead of social use.

Chad said. “I kept trying to quit and detox on my own, but I would “Marijuana and prescription pills are rampant in the oldest age always go back.” group,” Adams said.

Chad has a similar story to what both Adams and Laluzerne There are unique factors this age group faces with treatment, described in regards to an enabling relationship. according to LaLuzerne.

“My mom always tried to help me, but it was enabling me,” “With the older generation, medical issues become more of an he said. “She flew out to Las Vegas the second day I was in treatissue,” she said. ment here and said ‘OK honey, you ready to go home?’ I’m glad This needs to be kept in mind not only in the beginning during that I didn’t leave.” detox, as an older, frail body is going to take it harder than the Chad said that his mom was worried about him but didn’t think body of a 20-year-old, but after treatment, as well. Older individuanything was wrong with him. als are more likely to need prescription medication for various “‘You just need to stop using drugs,’” Chad remembers his health issues, which usually doesn’t bode well for the abstinencemother saying. style treatment that rehabilitation centers follow.

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Just what the doctor ordered.

Nevada Drug Card Preferred Pharmacy:

Free Statewide Prescription Assistance Program For more information or to order hard cards please contact: Suzanne Domoracki • suzanne@nevadadrugcard.com • 702-510-0100

Craig Weingrow, M.D. VALHALLA MEDICAL ASSO CIAT ES

Family Physician

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SPRING 2015

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Michael, 53, also went through Solutions Recovery’s in-patient program and IOP. He is currently going through chemotherapy treatment for cancer that was found while he was in treatment at Solutions Recovery. As LaLuzerne noted, Michael’s health is an issue he is dealing with alongside his addiction recovery. If doctors recommend for him to be on prescription medication, that is something he needs to discuss with his clinician, because his life could be at risk without it.

His sobriety, however, could also be at risk if he takes specific kinds of medication, which could also put his life at risk.

Michael has been struggling with alcoholism since the 1980s, but he began drinking far before that.

“I can remember I was 6 years old with a toothache, so my mom would put some whiskey on my tooth. When I was 12, there were always beers in the park with the boys,” said Michael, from Queens, New York. “My father was a bartender, I’ve been in a bar since I could walk.

We’re a big Irish family.”

In the ’80s, Michael started going in and out of rehabilitation centers when his drinking started to get out of control.

“My mother died, my two brothers died, my father died. My whole family was passing, there was a lot of death,” said Michael.

Although growing up with alcohol constantly around was something that Michael accepted in his youth, he is truly dealing with his addiction now. Identifying death and loss as a role in his drinking is something that has helped Michael in his recovery now.

“Therapy was very helpful,” Michael said.

Solutions Recovery Inc. is a Las Vegasbased drug and alcohol rehabilitation center that offers 24-hour care.

For more information about Solutions Recovery, visit www.solutions-recovery.com or call 702-228-8520.

Michael has successfully completed Solutions Recovery in-patient treatment program.

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Jessica Kantor is Solutions Recovery’s content developer.

Photo by L.E. Baskow

5/21/15 11:07 AM

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Founded by James E. and Beverly Rogers, the Foundation was established to provide innovative and exciting opportunities in arts and education for children and students throughout Southern Nevada.

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Top Doctors in Weight Loss …Once Again!

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5/8/15 5/22/15 12:46 PM 5/8/15 10:56 10:56 AM AM

THERE’S THIS VERY REAL FEAR OF BEING OSTRACIZED IF YOU HAVE A MENTAL ILLNESS. — KEVIN MORSS 82

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Photo Credit

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MENTAL ILLNESS

INTERVENTION AND EDUCATION ARE KEY

By Amanda Llewellyn

T

he stigma of mental illness is a paradox; it’s all around us but creates a blanket of ano-

nymity that keeps sufferers unseen

and often untreated for months, years, decades or sometimes a lifetime.

Although people suffering from mental illness are more likely to seek help today than they were 10 years ago, this stigma often shames many into silence.

Continued on page 84

Photo Credit

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THE MOST IMPORTANT THING I WOULD SAY TO A PARENT WHO IS WATCHING A CHILD SUFFER IS THAT YOU HAVE TO EXPECT THAT THE RIGHT KIND OF TREATMENT MAY NOT BE QUICKLY PINPOINTED, BUT DON’T GIVE UP. PUSH. PUSH THE DOCTORS, AND ADVOCATE FOR YOUR CHILD UNTIL THERE IS A BREAKTHROUGH THAT WILL LEAD TO HEALING. — ERIN KINARD

Continued from page 83

“There has been this tendency to just throw medication at an Kevin Morss, regional vice president of WestCare Nevada, has issue instead of doing investigative case management,” he said. worked with the mentally ill for years. During his time at WestCare, “Medication is a tool, but it won’t solve everything. Today, I think a community-based nonprofit that provides responsive human we are seeing a lot more psychiatrist referrals, and fewer doctors services and behavioral health care programs in 17 states and two U.S. are immediately assigning depression as the go-to cause when any territories, he’s spoken with hundreds of people who needed help, but before finding WestCare they weren’t sure where to start. Accord- number of symptoms emerge.”

Recent statistics estimate that 1/3 of the homeless populaing to Morss, the bias and challenges facing the mentally ill haven’t tion has some form of mental illness and do not have the ability changed much over the years but have been decades in the making. or presence of mind to seek out services designed to help their “There’s this very real fear of being ostracized if you have a mensituation. The solution? Resources dedicated to finding people on tal illness,” he said. “Of people thinking you are weak and don’t the street who need help but are unable to ask for it. According have it together. That has to stop. Seeking help for mental illness to Morss, society’s mental health woes will only dissipate when doesn’t make you weak. It makes you strong.” people collectively start to seek change.

Erin Kinard, area director for WestCare Nevada, said that the “Society as a whole should care about mental health because it evolution of treatment and awareness will be the key to changing affects everyone,” he said. “If we don’t treat those suffering with the problems within the health care system so that the mentally mental illness on the front end, many times those same patients ill have access to quality care in a timely manner. end up in prisons and hospitals. Treating the issues in the begin“Early intervention and education are all key components of a ning is more cost effective in the long run.” successful mental health care plan,” she said.

Kinard said that while there are a host of issues that contribute to Different types of conditions affect various demographics. mental illness, she believes that society as a whole has become more Depression and ADHD are common issues among teens and chilviolent in the past several decades, with wars and episodes of street dren, although in youths younger than 12, it can be difficult to have brutality. These exacerbate conditions that may have been managea definitive diagnosis. Even a decade ago, people were generally able or dormant before the volatile cocktail of an underlying condidiagnosed by their primary care doctors, who, according to Morss, tion is paired with something like post-traumatic stress disorder. aren’t always equipped to recognize and treat these conditions as “We see it in a lot in our veterans, some of whom had no mental are specialists and case workers who deal with it every day. Condihealth crises before being deployed, but many of whom had an untions such as anxiety and mood disorders are often treated before derlying anxiety, depression or similar condition to contend with,” a definitive diagnosis can be reached.

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she said. “When these heroes come home, their condition has been intensified by these issues that we know for a fact is in direct correlation with the person’s state of mental health wellness.”

While the perception of mental illness as something to be afraid or ashamed of is not as prominent as it was in years past, the stigma of admitting you need treatment for a condition still exists and prevents some from seeking assistance. One of the most prominent adult mental illnesses is schizophrenia, which, according to Kinard, is perceived as a disease that creates serial killers.

“Pop culture has had a lot to do with that,” she said. “It depicts folks with schizophrenia as ax-wielding murderers who hear voices and cannot function in society. That’s just not the case.

“Actually, with the right medications and treatment plan, people suffering from this disease can lead healthy, normal lives.”

It can be difficult to track patterns of mental health for children who are under the age of 13 because the brain is still developing, and concerns may not pop up until later. Children who are developmentally challenged may display behavioral problems, but true signs of emotional or mental instability may not manifest until they are older. Older children may suffer from depression, anxiety or bipolar disorder. Some of these issues can be situational while others may become chronic. Signs in early adolescence include: out of control or criminal behavior; drug or alcohol abuse; and attempted suicide.

“One of the first signs that something may be wrong is that your child is acting in a manner that is uncharacteristic for that child,” she said. “This is especially true with children who are in middle and high school. Perhaps there are things going on at school that

he or she doesn’t want to talk about. If that distress is being internalized, parents will see it in behavior changes.”

“The signs are many and varied,” Kinard said. “But no matter what the signs may be, I know that the system in general can be very frustrating. The most important thing I would say to a parent who is watching a child suffer is that you have to expect that the right kind of treatment may not be quickly pinpointed, but don’t give up. Push. Push the doctors, and advocate for your child until there is a breakthrough that will lead to healing.”

According to Kinard, the key is to get your child talking. If mental illness is allowed to fester then it can become a silent epidemic.

But the more these issues are discussed, the safer the child feels discussing their struggles, which makes them feel less alone.

“If a kid knows that a parent understands and can be an advocate, that same child is less likely to attempt suicide or engage in risky behavior,” she said. “Remember that it’s not the fault of your child, it’s the illness. Be caring and compassionate and don’t stop. Don’t give up.”

Amanda Llewellyn is an account executive with the Ferraro Group.

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Vegas Inc’s Top Doctor 2014 & 2015 for

PAIN M ANAGE ME N T

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University of Nevada School of Medicine

Congratulations to the physicians and surgeons honored as top doctors,

including those who practice and teach at the University of Nevada School of Medicine.

Shadi Abdelnour, M.D.

Alvin Lin, M.D.

Elissa J. Palmer, M.D.

Jennifer Baynosa, M.D.

Ewa Olech, M.D.

Misti Song, M.D.

Breast and Surgical Oncology

Rheumatology

David L. Ginsburg, M.D.

T.J. O-Lee, M.D.

Robert Wang, M.D.

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Neurology

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Family Medicine

William A. Zamboni, M.D. Plastic and Reconstructive Surgery

Internal Medicine

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medicine.nevada.edu

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TREATING

OLDER

PATIENTS WHO HAVE CANCER

By James Sanchez, M.D.

A

ge is just a number, as the adage goes. But is age really just a number in the realm of cancer diagnosis and care?

Specifically, are your risks of having cancer higher as an adult over 55 and are treatment regimens any different than younger demographics?

Statistically, yes. Men and women over the age of 55 are more at-risk for developing cancer. According to the American Cancer Society’s “Cancer Facts & Figures,” 78 percent of all cancer diagnoses occur when people are in the 55-plus age bracket.

And just how large is this demographic? There are nearly 100 million adults over the age of 55 living in the United States, per the 2010 U.S. census.

The most common cancers impacting this age group are breast, cervical, mouth and throat, prostate and skin cancer.

As you age, the likelihood of being diagnosed with cancer increases. But, this likelihood has much less to do with turning a particular age and pertains more to current routines as well as habits developed over a lifetime.

Staying one step ahead of cancer at any age Genes and unique genetic mutations, in some instances, can impact the likelihood of having cancer. For example, women who have a first-degree family member (such as a mother or sister) are approximately twice as likely to develop breast cancer as those without a family tie.

While genes can be an influential factor for many cancers, lifestyle choices and environmental components can also impact an older adult’s likelihood of cancer.

Some examples of healthy habits to reduce the risk of cancer include: Continued on page 92

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James Sanchez, M.D. serves as practice president for Comprehensive Cancer Centers of Nevada. He is also a hematology and oncology consultant for the practice, board-certified in internal medicine and medical oncology, and specializes in the areas of lymphoma and lung cancer.

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Continued from page 91

Eating right and exercising. It is a mantra that’s everywhere, but is important for staying one step ahead of cancer. People who are overweight are more likely to have the cancers that impact older Americans: prostate, colon and ovary, among others.

Staying sun smart. With such pleasant year-round weather, Nevada is an outdoor lover’s utopia. For each outdoor outing, it’s important to prioritize skin safety — wearing appropriate clothing and reapplying sunscreen as needed.

Approximately 500 Nevadans will be diagnosed with melanoma this year, many instances caused by excessive UV radiation from days in the sun or hours at the tanning beds.

Avoiding tobacco. Tobacco use causes cancer. Lung cancer accounts for more than any other cancer death in the United States each year. According to the American Cancer Society, 1,770 Nevadans will be diagnosed with lung cancer this year and 1,410 Nevadans will die from lung cancer.

Regularly checking in with your physician. The majority of health issues that impact the older population are typically discovered during routine physician visits.

Simple issues for a relatively healthy 30 year-old could be a precursor for a major issue with an older adult.

Not only can the aforementioned habits help those 55 and older (and any age, for that matter) help prevent cancer, but they contribute to an overall healthy lifestyle. Beyond age, genetics and habits, there is still one big factor that impacts cancer diagnoses, care and treatment: An individual’s unique health status.

The 55-plus treatment plan In the world of cancer, an individual’s health blueprint outweighs any other factor in determining treatment and care. This blueprint is primarily comprised of a person’s health status as well as what other medical conditions are present.

Older Americans are more prone to health conditions that, in many instances, can be more serious than their underlying cancer.

The same general approach to cancer care is typically used for all patients, no matter what the patient’s age. If there is a 75 year-old patient in excellent health, he/she will almost always be treated as aggressively as their younger counterparts.

Those patients nearing the age of 60 tend to have more medical problems, which can interfere with a treatment plan and lead to complications and/or an avoidance of certain therapies due to their underlying disease. These conditions — which regularly include heart attacks, stroke and kidney dialysis, among others — can impact the standard of care for a particular cancer or stage of cancer.

For example: A 60 year-old patient who simultaneously has lung cancer and a heart condition. The treatment of choice, normally, would be to conduct surgery to remove the lung. However, if the heart function is poor and there is a high risk for heart failure, it’s optimal to choose another form of therapy.

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Amid the various treatment regimens, there is also the underlying fact that aging brings us closer to inevitable death. For example, a 35 year-old with breast cancer will achieve significant benefit from adjuvant chemotherapy, treatment given after surgery to lower the risk of the cancer returning, whereas an 85 year-old with a life expectancy of 86 (on average) would receive minimal to no benefit from adjuvant chemotherapy in the long term, even though they might tolerate the treatment just fine.

Whenever a traditional form of cancer therapy is used, such as radiation therapy, chemotherapy and/or surgery, on older patients, there is a looming risk of stress to the patient’s immune systems. This stress on the immune system can make one more prone to infections and recovery can take a longer time. Such side effects as blood clots or pulmonary embolism can appear in older patients as a result of traditional therapies and the weakening of their respective immune systems.

Additionally, some testing that is standard for younger people is not recommended for some older demographics, due to the tests’ invasiveness. One example is a colonoscopy, which is typically complemented with an anesthesia. After the age of 75, there are significant health risks in using anesthesia and, with colonoscopies, perforation of the intestines is possible. Seeing as older patients’ intestines typically do not have the same integrity as they did when they were younger, this regular screening is not recommended.

In addition to customized treatment regimens and regular testing, one promising and effective option is often overlooked by many adult patients: clinical research trials.

The forefront of cancer treatment: clinical research Four out of every five children receiving cancer treatment are enrolled in a clinical research trial. Yet, the success rate of getting adults on a trial, nationally, is approximately only five percent.

There are several misconceptions and preconceived notions pertaining to adults and clinical trials. Some believe that they are receiving a lesser treatment regimen or that they are inherently less effective than traditional methods.

In reality, clinical trials are recommended for patients of any age — there is no age bias. When a physician signs up to take care of a patient, they want to use the most advanced and effective treatment possible, many of which exist in clinical research.

Locally, Comprehensive Cancer Centers of Nevada participates in more than 170 Phase I, Phase II and Phase III clinical research studies each year and has played a role in developing 54 FDA-approved cancer therapies. This robust research program has enabled CCCN, on various occasions, to be one of only a few research sites in the country to participate in certain trials. It has also allowed the practice to receive early access to administering specific treatments prior to FDA approval.

Therapies are currently being developed more rapidly than ever before, many of which can greatly benefit the 55-plus population.

Immuno-oncology is one particular realm that has produced incredibly effective treatments in recent times. Immuno-oncology is where newer drugs aim to re-establish the body’s immune system to recognize cancer cells and selectively destroy them through natural means.

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Erena Sedge, shown with Dr. Sanchez, is enrolled in a clinical trial designed to delay or block the growth of cancerous tumors.

Among recent trials, the CCCN research team recently worked on an anti-PD-L1 compound, designed to let the body’s own immune system break through the camouflage that deadly cancer cells can hide behind and populate. The compound is utilized to treat several types of cancer including, lung, melanoma, breast, bladder and throat and neck cancers, and is being administered to many older patients. CCCN was originally one of only six centers nationwide for “first in-human” testing and, in 2014, the FDA named the treatment a “breakthrough therapy” before subsequently fully approving it.

The advantages for older patients to participate in clinical trials typically outweigh the cons. For example, most immuno-oncology trials are well tolerated by patients, with minimal resulting side effects. Additionally, these therapies are easy to administer, typically given through an IV infusion.

There are no guarantees that a patient will be enrolled in a trial — prospective patients typically must meet certain criteria and/or have a specific gene mutation to qualify. But, for so many patients that have sought a low-risk alternative and exhausted all other options, clinical trials are a wonderful option.

Meet Erena Erena Sedge is a 71 year-old Las Vegas resident. Now retired, Sedge moved to Southern Nevada from Flint, Mich. in 1998. She enjoyed a fruitful career as a teacher, spending her latter teaching years in grades K-3 and, prior to that, working with junior high school students. She currently spends her free time watching sports, reading, visiting with friends and volunteering at a local elementary school where she helps children with reading.

Photo by L.E. Baskow

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In 2012, Sedge’s primary doctor discovered a lump in her breast during her annual mammogram. Sedge always prioritized this annual test and was surprised by the finding. She had a follow-up mammogram as well as biopsy and was subsequently connected with CCCN. She was diagnosed with Stage III breast cancer and decided to have a bilateral mastectomy.

During this timeframe, Sedge had chemo once every three weeks as well as 34 radiation treatments, administered daily. The cancer went away … but it ultimately spread to her liver, less than a year after it was eradicated from her breasts. Sedge then completed a chemotherapy regimen that spanned 16 weeks.

Currently, she has three tumors in her liver and is enrolled in a clinical trial with CCCN that is designed to delay or block the growth factors found in tumors. As part of the trial, Sedge takes oral chemotherapy daily and is seen at CCCN every two weeks. During her bi-weekly visits, she receives an assessment and physical exam to make sure she is tolerating the medication. Outside of her diagnosis, Sedge is generally healthy. She does have high blood pressure, however her physicians always work together to ensure her medication does not complicate her cancer treatment regimen.

As of her last check-up, the trial has proven incredibly effective for Sedge. All three tumors in her liver have shrunk, she is feeling zero pain and, to-date, has experienced no side effects whatsoever.

Clinical trials are working for patients, just like Sedge, in our community and throughout the country. While, regular checkups with your physician and maintaining a healthy lifestyle will contribute to the longevity of adults over the age of 55, it’s important to understand that there are still various treatment options available for those who might receive a cancer diagnosis later in life.

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A NEW WAY TO TREAT

HEART CONGESTIVE FAILURE

By Sylvia Song

T

echnology has provided more effective and efficient treatments for congestive heart failure. Historically, congestive heart failure is treated with lifestyle changes, medications and sometimes an implantation of a pacemaker or defibrillator. Pacemakers have been measuring cardiac impedance and used to direct therapy. Impedance change can alter medical therapy to make the patient feel better and ultimately stay out of the hospital.

A new device developed by St. Jude’s Medical is the CardioMEMS™ HF System. The device is implanted in the pulmonary artery (PA) during a nonsurgical procedure to directly measure internal cardiac pressures for patients with congestive heart failure.

The sensor will allow closer monitoring of a patient’s volume status and determine whether adjustments in the patient’s medications are necessary. In a small pilot study, the use of CardioMEMS™ significantly reduced heart-failure related hospital admissions and improved quality of life.

“There has been an evolution of knowledge with patients with congestive heart failure,” said Dr. Pamela Ivey, of Sunrise Hospital & Medical Center and Healthcare Partners Cardiology. “We have algorithms in place for medications and we are moving ahead with other available therapeutic options and now with CardioMEMS™, we hope that we will continue with technology that will be forthcoming to address congestive heart failure because it is so widespread in the United States and responsible for morbidity and mortality to a huge extent.”

The Heart Center at Sunrise was the first and only facility in Southern Nevada to implant a new miniaturized, wireless monitoring sensor to manage heart failure. The CardioMEMS™ HF System is the only FDA-approved heart failure monitoring device that has been proven to significantly reduce hospital admissions when used by physicians to manage heart failure.

Congestive heart failure can affect a person at any age and it does not discriminate by race or gender. Heart failure occurs when your heart muscle does not pump blood as well as it should and this can be a result from some form of insult to the heart. Certain conditions, such as narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to pump

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efficiently. This can be contributed by all risk factors that may cause a heart attack such as diabetes, smoking and obesity. Other causes that can weaken the heart can be thyroid dysfunction, alcoholism, viruses and in some rare cases — hereditary cardiac myopathy.

The device consists of an implantable PA sensor, delivery system and Patient Electronics System. Increased PA pressures appear before weight and blood pressure changes, which are often used as indirect measures of worsening heart failure. The new system allows patients to transmit daily sensor readings from their homes to their health care providers allowing for personalized and proactive management to reduce the likelihood of hospitalization. “CardioMEMS™ allows more optimal control of medications and in result, the patients feel better leading to an improved quality of life because they are more capable to do their daily activities,” said Dr. Ivey.

The research requires a dedicated team of practitioners to look at the daily data. In Dr. Ivey’s office, research nurses initially look at the data and when they see something suspicious, they have the physicians review the information to decide if medication adjustment is necessary. This is a real-time tool that is much more sensitive than taking a patient’s weight on a scale. By the time a patient has gained three pounds, he is already in trouble. Unfortunately, body weight and physical evaluation are not reliable tools. Heart failure does not manifest the same in every patient but it does if you are looking at internal pressures inside the heart.

“CardioMEMS allows us to individually treat our patients accord-

ingly to validate parameters that have historically proven to be accurate,” said Dr. Ivey.

CardioMEMS™ has a lithium battery that has no expiration or maintenance required and is designed to last the lifetime of the patient. The outpatient procedure can be done under general or local anesthesia and is not painful. The implantable sensor is permanently placed in the pulmonary artery, the blood vessel that moves blood from the heart to the lungs. The sensor is implanted during a right heart catheterization procedure and the device is about the size of a small paper clip. The patient is discharged on the same day and they can resume their regular activities.

Not all conditions that lead to heart failure can be reversed but treatments can improve the signs and symptoms of heart failure and help you live longer. Lifestyle changes — such as exercising, reducing salt in your diet, managing stress and losing weight — can improve your quality of life. If you think you may have a heart condition, please consult your primary care physician.

Sylvia Song is the director of marketing and communications for Sunrise Hospital and Medical Center.

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C H I L D R E N ’ S H E A LT H

HEALTH CARE MILESTONES FROM NEWBORNS TO TEENS

By Marissa Mussi

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s children grow from newborn into young adults, they cross several milestones along the way — both medically and developmentally. Each year, health care needs change and there are different milestones that should be met. Knowing what to look for allows parents to provide support and prepare children as they reach the milestones. In some cases, it allows parents to realize when something may need to be done.

During the first year, babies are busy with everything from cooing, crawling, and walking to everything in-between. To help the baby reach these milestones, there are many routine doctor visits within the first year.

“In the first year, checkups are frequent because during this time, there is a big transition from the newborn period with social, language, cognitive and motor development,” said Dr. Lesa Brookes, pediatrician at Healthy Kids Pediatrics.

Checkups typically begin within the first week of a child’s life and occur regularly throughout the first year. The baby will go for a second checkup around two weeks old to ensure there are no significant changes in weight, no ongoing signs of jaundice and to address any concerns the parents may have while in this transition. The remaining checkups needed within the first year occur at 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months of age. During these checkups, the physician is able to check the baby’s overall health, address any concerns the parents may have, administer vaccinations, and check on the developmental progress of the infant.

After the first year, other routine visits are: the 15-month, 18-month, 24-month, 30 month, and the 36-month checkups. Once the child turns 3, checkups are done on an annual basis. The annual visits are for the doctor to assess how the child is progressing on all levels.

As the child gets older and starts to enter into puberty, the visits also serve as a time for the physician

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to talk to the child about any questions or concerns they have that they may not be comfortable speaking to their parents about. Between the annual visits, if there are any questions or concerns regarding the child’s health or developmental progress, do not wait for the annual visit to bring these concerns to the physician, see a physician before.

The importance of vaccinations Within the first year, a baby receives its first series of vaccinations. The first shot, Hepatitis B, is typically given while the baby is still at the hospital. Brookes and her partner at Healthy Kids Pediatrics, Dr. Atousa Ghaneian, follow the American Academy of Pediatrics/Centers for Disease Control and Prevention vaccine schedule. According to the schedule, the remaining shots are then administered during checkups at 2 months, 4 months and 6 months. Shots are typically done in a combination vaccine to minimize the number of actual injections. At 9 months, this time is used to catch up on any vaccinations they may have missed. At 12 months, the child receives their next set of shots which consists of MMR (measles, mumps and rubella), Varicella (chicken pox), and Hepatitis A. “Vaccinations at this stage play an imperative role in the child’s overall health and development,” said Brookes. “They are especially important at this young age when children are highly susceptible to illnesses.”

After these shots are administered, the child will then receive their next series of injections around four years old. The shots administered at age four consist of vaccination boosters that are required to enter school.

As children enter into their adolescent years, additional vaccinations are needed, such as: DTaP (diphtheria, tetanus, and acellular pertussis) and Meningococcal. In addition, vaccinations to prevent against Human Papillomavirus (HPV) can be administered starting as young as age 9 up until the age of 26 years old. The HPV vaccination is

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part of a three-dose series which can be given to both males and females.

In terms of development, the developmental progress is different from one baby to the next, so there is a spectrum in which the milestones can occur; the following are just average ages. At 2 months, babies will start cooing; 4 to 6 months, babies start to sit up with some support. At 9 months, babies can sit up without the need for support and begin to crawl. Around 12 months, babies start to take their first few steps while holding onto things and by 15 months babies can walk on their own. If at 18 months, the child still isn’t walking at all, then Brookes recommends seeing a physician.

It’s all the talk Speech development starts as early as 2 months when the baby starts cooing. Around 6 months the baby starts making noises with more consonants. “At 9 months, babies will start to form simple words such as ‘mama’ or ‘dada,’ but these words are nonspecific. This means they do not actually associate the words to mom or dad.

However, by 12 months, babies are able to say mama and dada with specific relationship to mom and dad,” said Brookes.

As the child gets older, their vocabulary should gradually increase: 12 months: Mama and dada, plus two or three other words 15 months: Mama and dada, plus four to six other words 18 months: Mama and dada, plus 10 to 20 other words 2 years: 50 words and start to combine words to make two word sentences 3 years: Approximately 250 words and start to combine words to make three word sentences In addition to vocabulary progression, clarity is important as well. By 2 years old, a child’s speech should be clear enough for a stranger to

understand at least 50 percent of what is being said. By 3 years old, 75 percent clarity and by age 4, their speech should be 100 percent clear. If at 15 months old the child does not say any words, then check with a physician.

Parents and guardians play a huge role in childhood development. Brookes suggests several ways in which parents can aid in developmental progression: simple interactions such as talking to the child and explaining why and how; bonding or holding the child; reading to the child a few minutes every day helps with language skills and motor skills; and also listening to music.

When it comes to potty training, the average age is 2 1/2 years old for daytime dryness. By age 4, the child should be potty trained, but may experience occasional nighttime wetness. Potty training should be introduced at 18 months and then the topics should be revisited again at 2 years old. However, it is important that the child is ready to be potty trained and that it is not forced. If it is forced then it can create a power struggle. According to Brookes, some key indicators to determine if a child is ready for potty training are: dry periods for two hours, awareness of the difference between wet and dry, physically able to pull their pants up and down, and able to walk over to the toilet. Another important factor is that the child shows interest. If the child is capable of the above tasks and they show interest, then it is less likely there will be a power struggle. Once the child is potty trained, occasional bed wetting may still occur. If bedwetting is still constant after age 7, then Brookes recommends seeing a urologist.

Pre-kindergarten is a big transition for parents and children. This is a time to help prepare the child for elementary school and aids in the developmental progression of the child. The stimulation from being around other children assists with Continued on page 100 SPRING 2015

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language progression. Pre-K also helps see how the child interacts with other children and helps to ease the separation between child and parent.

The adolescent accent Puberty is different for both boys and girls. For girls, the early signs of puberty can start as early as age 8 but the average age is 9 years old. If puberty starts before the child reaches 8 years of age, see a physician. The early signs of puberty in a female consist of oily skin, widening of the hips, increase of body fat and muscle and signs of breast development. By age 13, if a female has not experienced any of these signs, then it is a sign of delayed puberty. Approximately two years after breast development starts, then girls will get their period. The average age at which girls start their period is 12 years old. It is not uncommon for their period to be irregular for the first year. Girls will experience their growth spurt or maximum growth rate roughly twelve months before they start their period. After a girl achieves her period, she is within about two inches of her adult height.

For boys, early signs of puberty start as early as 9 years old. Some of the noticeable early signs in boys are oily skin, body fat and muscle growth, a change in voice and testicular enlargement. If there are no signs of early puberty by age 14, then they are considered to have delayed puberty. Boys experience their growth spurts or reach maximum growth rate later than girls.

Puberty can be a sensitive time for both girls and boys as they experience several physical and emotional changes. It is recommended for parents to mention puberty to children around age 9. The first mention of puberty doesn’t need to be in-depth but just to introduce the topic and what they will experience. Even though the child may not be going through

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puberty themselves, it is important to address the topic because other children they may know may be experiencing it. When talking to a child about puberty, it is important to gauge the maturity of the child. This will help determine how to approach the topic or how in-depth to go in the discussion.

Parental involvement in the child’s life is important throughout all stages. This helps with the developmental progression and helps to create trust. Open lines of communication between a parent and a child are important as the child will be more willing to go to the parent with questions about their own health.

The time to switch from a pediatrician to a primary care physician on average is age 18 to 21 depending on the growth of the child but it is important to keep regular exams going to maintain your child’s health.

Sunrise Children’s Hospital is Nevada’s largest, most comprehensive children’s hospital that offers services for newborns to teens. They are here to treat the many milestones that occur throughout a child’s life as well as any serious bumps and bruises they may encounter along the way.

Marissa Mussi is the marketing manager for Sunrise Children’s Hospital.

Photo by Eric Jamison

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FROM LEFT TO RIGHT: Dr. Stephen Solomon, Dr. Mark Stradling, Dr. Douglas Lorenz, Dr. Surjeet Singh, Dr. Rajy Rouweyha, Dr. Rudy Manthei, Dr. Glen Hatcher, Dr. Darrick Neibaur, Dr. Shoib Myint, Dr. Douglas Orton, Dr. Vincent Gassen.

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Las Vegas, NV 89148

Henderson, NV 89074

Las Vegas Medical District 89106

Pahrump, NV 89048

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SENIOR MOMENTS TO REMEMBER

By Joyce Goedeke

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s time seems to pass more quickly each day, it is a continuous task to ensure that our individual health and the health of our loved ones remain a top priority. Yet, between school, work, activities and, life, in general, our existence can stream by faster than we realize and, sometimes, that means we do not think ahead to what health needs we may have in the future.

So, let’s stop and do just that: Think about our health, and, more specifically, the health of our aging population.

Southern Nevada is fortunate to have the warm, dry weather that attracts many to retire and live out their golden years in the golden sun.

This hopefully helps alleviate the potential aches and pains in our senior citizens, yet, this population needs to maintain their health awareness.

“The older adult population in our Las Vegas community continues to grow, and with it, comes specialized health care needs,” said Dr. Upinder Singh, internist and geriatrician at Southern Hills Hospital. “It is critical for all of us to understand and address those needs, as well as proactively find the necessary resources for their excellent care that they deserve.”

Along with our senior citizens maintaining their health care awareness, it is the responsibility of health care facilities to accommodate and exceed the needs of that age group.

Consider and remember the following to best serve senior patients: Seek a health care facility that proactively finds ways to improve service to seniors — look for senior citizen-reserved parking spaces in the ER parking lot, providing closer and easier access to hospital entrances.

Look for simple tools, such as the installation of larger, easier-to-read wall clocks and specialized furniture (chairs, couches) to adapt to the ease of senior patients getting in and out.

Oftentimes, seniors rely on their pets to provide love and comfort — consider a health care facility that offers animal-assisted therapy specifically in departments and units that typically host senior patients.

Dig even deeper into a facility’s certifications that target improving the treatment of senior citizens such as a NICHE-certified facility. NICHE

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stands for Nurses Improving Care for Healthsystem Elders, which is the leading nurse-driven program designed to help hospitals and health care organizations improve the care of older adults. This is a rare certification that enhances the care and education of their nursing staff specifically focused on special care for senior patients.

Additionally, check for certifications from the Joint Commission, the leading accreditor of health care organizations in America, that would best serve senior patients such as orthopedic certifications signifying the high priority focus on senior ailments and needs, as well as programs that treat Alzheimer’s disease.

It is reality that as our patients continue to age, their behaviors and mental state can change slowly or drastically. It is sometimes difficult to accept those behaviors as those that need and require clinical assistance.

Seek a health care facility that provides behavioral health resources for senior citizens, and one that can offer both in-house and outpatient care.

Find out if the health care facility that would treat senior patients has a geriatrician on staff — this is a medical doctor who is specially trained to meet the unique health care needs of older adults. Geriatricians prevent, manage and develop care plans that address the special health problems of the elderly.

By following these simple health care tips, treatment for and the health care of the older population can significantly improve for senior patients.

W d i c p s c t o t p w r d w A C s l a S c

Joyce Goedeke is vice president of marketing/public relations at Southern Hills Hospital and Medical Center.

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All of these therapies, as well as comprehensive digital imaging and lab services, are provided under one roof, while maximizing eciency and coordination of care and minimizing stress on patients. CTCA® is also the nation’s 1st all digital cancer hospital.

We believe in providing the Mother Standard® of care in the delivery of that treatment. Choosing the right treatment facility is one of the most important decisions a patient and their caregivers will make. At CTCA, our highly trained healthcare professionals utilize state of the art technology and scientically supported complementary medicines, resulting in optimal comprehensive cancer care. Each day, cancer patients travel to CTCA from across the nation to receive care from a team of highly-skilled clinicians and physicians with expertise in treating all forms and stages of cancer. The hospital’s travel program assists qualifying patients with expenses incurred while traveling for care. Upon arriving at CTCA, patients receive an individualized, comprehensive treatment plan developed by cancer experts across multiple disciplines who work together as a team.

Advocating for patient empowerment through health literacy, CTCA publishes on their website quality of life data and survival outcomes for the most common cancer types. To learn more about the unique, integrative treatment options available at CTCA, or to speak with an Oncology Information Specialist for more information, visit cancercenter.com or call 888-214-9488.

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www.fcidesign.com

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VOLUNTEER PROFILE

LIA YULIANTI, PROPRIETOR OF BELIA LookGoodFeelBetter.org

Operating since: 2014 Describe the services you offer: I offer esthetics services such as facials, eyelash extensions, chemical peels, microdermabrasion, waxing, makeup application, eyelash and brow tinting and oncology facials. I also offer eyelash extension certification to area spas and salons.

One of my favorite aspects of my business is something I do as a volunteer: “Look Good... Feel Better” classes for cancer patients through the American Cancer Society. I have taught classes at 21st Century Oncology, Comprehensive Cancer Centers (multiple locations) and the Caring Place (a nonprofit that helps cancer patients.). Through “Look Good Feel Better,” I share my knowledge about skin care regimens and makeup application as well as touching upon other aspects of self care during chemotherapy and radiation.

Every month is different, besides repeat clients. My services tend to have the most demand with women from 25–45 and men from 30–45.

But some of my regular clients are baby boomers. I volunteer my time and my knowledge for my “Look Good Feel Better” classes off site — and I also invite each patient/attendee in my classes to come in to see me and get a complimentary oncology facial at Belia. An oncology facial is a facial using organic products to hydrate and nourish the skin and a technique that is safe for cancer patients.

What makes your business unique?

right before she had surgery because she knew she would have family members in town in the room with her when she woke up from surgery and wanted to look her best. It makes me happy to be able to help people.

Belia means “youthful” in Indonesian (I was born in Indonesia). My business philosophy is to help our clients look as youthful on the outside as they feel on the inside.

What’s the most important part of your job?

To help my clients feel confident, beautiful and healthy.

What is the hardest part about doing business in Las Vegas?

Being new in town and not knowing anyone, as a sole proprietor, has been challenging. So has raising capital to expand and offer more services.

What is the best part about doing business in Las Vegas?

It’s the entertainment capital and there is a huge demand in the beauty industry for those who wish to maintain their appearance. I’ve also been lucky to have the opportunity to work with other small business owners around town. There are so many entrepreneurial individuals here willing to help others. I attribute a lot of Belia’s success to cross marketing with other businesses.

What obstacles has your business overcome?

I am one of three oncology estheticians in Nevada. Belia offers facials incorporating my “Indonesian touch” technique and LED light treatments.

I am developing new eyelash products.

Being new, I knew marketing is very important. I wanted the best marketing team available and there is a lot of talent in Las Vegas and had a difficult time reviewing all of the options and doing my own marketing.

Now I’ve assembled an outstanding marketing team.

What is your business philosophy?

What’s the most important part of your job?

I had skin problems growing up. Now that I am able to manage my own problem, I wanted to help others. I helped a client with eyelash extension

To help my clients feel confident and beautiful by having healthy skin.

As we all know skin is the biggest organ in our body.

Do you know a medical volunteer who we should know about?

Please contact Craig Peterson at craig.peterson@gmgvegas.com.

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CONSUMER TIP

RADIOLOGY 101: WHAT YOU NEED TO KNOW BEFORE YOUR NEXT VISIT

By Jerry Hartman

R

adiology (i.e. diagnostic imaging) is technology-driven, and thus is constantly evolving as advancements pave the way for more detailed and effective tests. From three-dimensional imaging to the fusion of images from multiple scan types, cutting-edge diagnostic services play an integral role in diagnosing a wide variety of ailments. As technology enhances the scope of radiology services, the focus should always remain on the patients, many of whom are unaware of the options available to them. Below are several key pieces of information patients should know before making their next radiology appointment.

Do your homework Most patients have options regarding medical imaging services.

While primary care providers write referrals, patients are not bound by the referral and should contact their insurance provider to see which imaging centers are covered by their plan. If multiple options are available, it is advisable to research each one to determine which facility best suits your needs. The first thing prospective patients should research is whether the facility has the proper accreditations, board-certified radiologists and up-to-date equipment. It is important to note that certain types of MRI and CT scanners are better suited for specific neurological or musculoskeletal exams.

Select a facility based on your needs, not just convenience Since many tests have become so complex and specialized, the exam that the referring doctor requests may not be available at the center closest to the patient’s residence. While convenience is a factor for many patients, it is essential to choose an imaging facility that is properly suited to provide the highest quality of service and technology. Accolades, such

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as whether an imaging facility is a Diagnostic Imaging Center of Excellence (DICOE), indicate a high level of imaging efficiency, patient safety and quality care. Be sure to examine the center’s website to check for information such as DICOE recognition and equipment inventory. The importance of finding the right imaging center cannot be overstated: In many cases, diagnostic imaging centers determine whether an individual has cancer or other life-threatening illnesses.

Understand radiation dose Steinberg Diagnostic Medical Imaging (SDMI) constantly monitors radiation levels to ensure patient safety. For most people, the amount of radiation exposure during a routine CT scan or X-ray is not worrisome.

As long as the correct test is performed, and the patient is delivered the proper dose, it should not be an issue. Radiation exposure is an issue for individuals undergoing chemotherapy or other radiation treatments, although recent technological advancements in the medical imaging industry have helped quell radiation concerns. Through SDMI’s research and development partnership with Toshiba Medical Systems, the center introduced the state’s first Ultra Low Dose CT and large bore PET/CT scanners, combining enhanced patient comfort with decreased radiation exposure. Later this year, SDMI will offer GE’s SenoClaire three-dimensional mammography technology at all seven of its locations. The machines will enhance mammography imaging and deliver no more radiation than the current two-dimensional technology.

Are you prepared?

Pre-test steps vary significantly depending on the scheduled exam.

When patients call SDMI to schedule a diagnostic exam, they speak with

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MEDICAL MEDICAL 2015 2015 2015 MEDICAL PROFILES PROFILES PROFILES

[ Special Advertising ] [ Special Advertising SectionSection ]

[ Special Advertising Section ]

Bernard Ong Dr.Dr. Bernard Ong Dr. Bernard Ong MD MD MD

members of the scheduling team, who walk through what is required prior to the test. Extensive preparation may be needed, including lab work, stopping medications for several days beforehand or utilizing a contrast agent such as barium before a CT scan to allow for clearer imaging. Depending on the procedure, the patient may have to fast for four hours prior to the test. However, not all exams require special preparation. To learn more about the procedure you’re having, visit www.sdmi-lv.com/exams.

SDMI has six Southern Nevada locations and will open its seventh at 800 Shadow Lane in Las Vegas in early July. In 2015, SDMI received DICOE recognition from the American College of Radiology and was the only outpatient practice in Nevada to achieve the highest level of accreditation, Level 3 Honor Roll, from Image Gently and Image Wisely, two national organizations focused on decreasing the amount of radiation used in medically necessary imaging studies. Additional information about the services offered by SDMI can be found at the clinic’s website, W. Lake Mead, 8551 8551 W. Lake Mead, SuiteSuite 251 251 www.sdmi-lv.com.

8551 W. Lake Mead, Suite 251 Las Vegas, NV 89128 Las Vegas, NV 89128 Las Vegas, NV 89128 702.796.7979 • www.bernardongmd.com 702.796.7979 • www.bernardongmd.com

702.796.7979 • www.bernardongmd.com

Jerry Hartman is the COO of Steinberg Diagnostic Medical Imaging.

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8551 W. Lake Mead, Suite 251 Las Vegas, NV 89128 702.796.7979 • www.bernardongmd.com SPRING 2015

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STAYING SKIN SMART THIS SUMMER

By Wolfram Samlowski, Ph.D.

T

he heat is on.

And with the heat can come extended amounts of fun in the sun — weekends lounging by the pool, family barbecues in the backyard, trips to the ballpark and daylong adventures at the water park.

Warmer weather and more daylight hours equate to people being outside longer. With increased time outside is an increased need for local residents to prioritize skin safety. By staying proactive, taking advantage of local skin safety resources and detecting prospective conditions early, Southern Nevadans can stay “skin smart” this summer.

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Staying ahead of skin cancer According to the American Cancer Society, more than 1 million skin cancers and melanomas caused by prolonged exposure to the sun are diagnosed each year in the United States. Skin cancer is the No. 1 form of cancer for men age 50 and older — ahead of prostate, colon and lung cancers. The three most common types of skin cancer are melanoma, basal-cell skin cancer and squamous cell skin cancer. Melanoma is the most dangerous form of skin cancer. In Nevada alone, nearly 500 residents will be diagnosed with melanoma this year.

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H E A LT H T I P

The majority of these staggering statistics can be prevented. There are five tips to follow this summer (and year-round) to protect your skin: • Limit direct sun exposure during midday — 10 a.m. to 4 p.m.

• Wear protective clothing, including wide-brimmed hats, that cover as much skin as possible.

• Use sunscreen with a Sun Protection Factor (SPF) of 30 or higher regularly. It should be sunscreen that blocks both UVA and UVB rays and will need to be reapplied after 3 to 4 hours in direct sunlight (waterproof sunscreens may last longer).

• Wear sunglasses that block UVA and UVB rays.

• Avoid tanning beds.

Protecting your skin from the sun is a full-time job. The sun’s UV rays can penetrate through light, loosely woven fabrics and wet clothing — that’s why it is important to wear proper sun protection regularly and correctly.

Skin safety and protecting the community More and more local businesses are prioritizing skin safety, offering up sunscreen and protective clothing on-site for purchase. However, some establishments that regularly attract sun-goers are taking skin safety a step further and developing collaborative programs to offer resources for guests.

One example of a local skin safety initiative is CCCN’s partnership with Wet ’n’ Wild Las Vegas. 2015 marks the second year of the partnership, which provides all water park attendees with sunscreen, via a three-pump kiosk at the park’s entrance. Two additional signs are located in the park and park-wide audio messages play periodically throughout the day, reminding guests to reapply sunscreen on a regular basis.

Building on the success of the Wet ’n’ Wild initiative, CCCN recently announced a new skin safety partnership with the Las Vegas 51s. During the 2015 season, fans and visitors to Cashman Field day games may visit two CCCN sunscreen kiosks on the main concourse for sunscreen. To complement the campaign, skin safety messages are broadcasted via the video board and public address system.

While Wet ’n’ Wild and the Las Vegas 51s are two local entities taking a proactive approach to skin safety during their 2015 seasons, it’s still important for the entire community to be knowledgeable about the effects of the sun’s harmful rays year-round.

vessels or lymph channels to distant sites within the body, long before a surgeon can remove the abnormal mole. Once melanoma spreads, it is almost always fatal.

For early detection and prevention you should check your skin monthly for any new or changing blemishes, moles or marks. Any abnormality that persists or continues to change over time is worth noting. If you find anything suspicious, make an appointment with your doctor no matter how minor you perceive the change to be. Also, be sure to consult an oncologist if the tests or a skin biopsy come back positive for cancer.

When you are examining yourself for melanoma, just remember ABCDE: • Asymmetry – One half of a mole doesn’t match the appearance of the other half • Border – Edges are ragged, notched or blurred • Color – Color is not uniform • Diameter – Changes in size, shape or color • Evolution – Change over time Other signs to look for during self-examination include: • Appearance of a new spot on your skin • Skin sores that don’t heal • Redness or new swelling beyond the existing border • Changes in sensation — itchiness, tenderness or pain • Changes in the surface of a mole — Scaliness, oozing, bleeding, or the appearance of a bump or nodule At Comprehensive Cancer Centers of Nevada (CCCN), we are on the frontlines of researching and administering innovative skin cancer and melanoma treatments, many of which are seeing promising results and FDA approvals. These skin cancer and melanoma studies are part of the more than 170 clinical trials CCCN conducts in Southern Nevada each year.

Through year-round prevention, protection and education and with groundbreaking research, we can effectively fight skin cancer and get that much closer to defeating the disease. There have been exciting new developments in research and new medicine to treat advanced forms of skin cancer, but the best plan is to prevent the disease so you never need to be treated. The best cure for skin cancer and melanoma is prevention and early detection.

Treating skin conditions and cancers Many people spend too much time in the sun before learning how dangerous it can be and before they start taking protective measures. In most cases, early detection is key for successfully treating skin cancer and melanoma. Redness of the skin and sunburns are signs of excessive exposure.

If a melanoma invades just three to four millimeters (less than 1/8inch) of skin, starts to bleed (ulcerate) or has many dividing cells, the risk for recurrence or metastasis is extremely high. Cells spread via blood

Dr. Wolfram Samlowski is a medical oncologist with Comprehensive Cancer Centers of Nevada. He focuses on the treatment of melanoma and kidney cancer.

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CALENDAR To include your calendar items in the next issue, contact Craig Peterson at craig.peterson@gmgvegas.com

BREAST CENTER AT SUNRISE HOSPITAL YOUNG SURVIVORS BREAST CANCER SUPPORT GROUP Offered to all women 40 years old and younger who have been diagnosed with breast cancer. Free.

June 10, July 8, Aug. 12, 6–7:30 p.m.

The Breast Center at Sunrise, 3006 S. Maryland Parkway, Suite 250 ONCOLOGY NUTRITION Led by Judy Reinhardt, registered dietitian. Cancer survivors and their loved ones are invited to learn about healthy eating after a diagnosis of cancer.

Register at 702-233-5454.

July 15, 6–7:30 p.m.

The Breast Center at Sunrise, 3006 S. Maryland Parkway, Suite 250 LOOK GOOD, FEEL BETTER American Cancer Society program to help cancer patients look good, improve self-esteem and manage treatment.

June 22, July 27, Aug. 24, 10 a.m.–noon The Breast Center at Sunrise, 3006 S. Maryland Parkway, Suite 250

SUNRISE HOSPITAL Registration is required for all events.

Call 702-233-5454 at least 48 hours in advance.

For information, visit SunriseHospital.com FETAL INCONTINENCE SEMINAR/ PATIENT SUPPORT GROUP June 2, July 7, Aug. 4, 10–11:30 a.m.

Sunrise Hospital Auditorium, 3186 S. Maryland Parkway PREPARING FOR CHILDBIRTH CLASS June 6, June 20, July 11, July 25, Aug. 8, Aug. 22, 8:30 a.m.–4:30 p.m. $55; Sunrise Hospital Auditorium, 3186 S. Maryland Parkway ADULT OUTPATIENT DIABETES CLASS — OVERVIEW AND MEDICATIONS June 9, June 16, July 7, July 14, Aug. 11, 2–4 p.m.

3121 S. Maryland Parkway, Suite 600

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ADULT OUTPATIENT DIABETES CLASS — NUTRITION June 10, June 17, July 8, July 15, Aug. 19, 2–4 p.m.

3121 S. Maryland Parkway, Suite 600

ST. ROSE DOMINICAN HOSPITALS For information, visit www.strosehospitals.org, or call 702-616-4900 for class reservations and to learn about other programs.

Location Abbreviations FTF Family to Family Connection, Henderson FTF WIC Family to Family Connection, Henderson HEND WomensCare Center, Henderson MAC Siena Campus - MacDonald Room, Henderson RAN Rose de Lima Campus - Annex, Henderson SAN San Martín Campus, Las Vegas SGR Siena Campus - Garden Room Henderson WEST WomensCare Center, Las Vegas WHAT IS PRE-DIABETES? LEARN HOW TO AVOID OR DELAY DIABETES June 25, 3:30–5:30 p.m.; July 7, 10 a.m.–noon GV: Free DIABETES AWARENESS TREATMENT & EDUCATION American Diabetes Association accredited diabetes education.

Tuesdays and Wednesdays, May 12–13, June 9–10, July 14–15, 9 a.m.–1:30 p.m.; June 23–24; 5–9:30 p.m.

GV: Call 702-616-4975.

STANFORD DIABETES SELF-MANAGEMENT PROGRAM Six-week program offers support, healthy eating tips and medication management.

June 18–July 23, 9–11:30 a.m.

HEND

DINNER WITH A DOC Do you suffer from unexplained leg pain?

It might not just be part of getting older; it could be a sign of peripheral arterial disease (PAD). Are you at risk? Find out with Dr. W. Tracey Jones, licensed vascular surgeon.

June 4, 6 p.m.

SAN: Seating limited HAPPY FEET SCREENINGS Have your feet examined to prevent diabetic-related problems and identify circulation issues.

June 27, 1–3 p.m.

GV: Free, appointment needed HEARTSAVER CPR/AED Learn American Heart Association adult, child and infant CPR and AED. Two-year certification.

May 26 and June 23, 5–9 p.m.; July 15, 5-9 p.m.

WEST: $30 CARDIAC NUTRITION Learn to eat for your heart’s health with Sharon Nasser, R.D. July 16, 10–11:30 a.m. GV: Free June 18, 3–4:30 p.m. WEST: Free FREEDOM FROM SMOKING Kick the habit with this supportive, seven-week American Lung Association program.

Tuesdays, June 2–July 14 and Thursday, June 25, 5:30-7 p.m.

SAN: Free CANCER THRIVING & SURVIVING Stanford School of Medicine’s six-week program can help you set personal goals and develop the skills you need to successfully regain control of your life. Enhances regular treatment with techniques to deal with poor sleep and living with uncertainty, exercise strategies, making decisions about treatment, healthy eating, and more.

May 25–June 29, 2:30–5 p.m.

GV: Free

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FIT COLON TEST Age 50 or better? Take home a Colorectal Cancer F.I.T. (fecal immunochemical test) Screening Kit, return your sample to a WomensCare Center and receive test results by mail.

GV; WEST: $15 MAMMOGRAMS Uninsured or underinsured? You may qualify for a free mammogram. Call the R.E.D. Rose Program at 702-492-8557 if under age 49 or call the Mammovan if over age 50 at 877-581-6266.

BREAST CANCER PROSTHESIS & BRA FITTINGS Uninsured? Receive a free fitted bra and prosthesis. Call 702-568-9595.

POWERFUL TOOLS FOR CAREGIVERS Feeling overwhelmed by the task of caring for a loved one? This six-week workshop will help you develop self-care tools to become a better caregiver and a happier, wiser, healthier you.

July 21–Aug. 25, 10 a.m.–12:30 p.m.

GV STEPPING ON: FALL PREVENTION PROGRAM Did you realize that one out of three people over 65 fall each year? Learn how to prevent serious injuries like hip fractures in this six-week class.

Wednesdays, May 13–June 17, 4–6 p.m.

GV: Free

EATING ON THE RUN Join registered dieticians Sherry Poinier and Samantha Louie for a cooking demo and tips for eating healthy on the go.

June 4, 11 a.m.–12:30 p.m.

GV: Free

INFANT AND CHILD CPR June 11, 5 p.m.; July 16, 2 p.m.; Aug. 15, 9 a.m.-noon $10 deposit (returned upon completion of class).

Family Resource Center, 901 Rancho Lane, Suite 180

HYPOGLYCEMIA AWARENESS What is hypoglycemia? Learn how to treat and avoid the symptoms from registered dietitician Sherry Poinier.

June 25, 9:30–11 a.m.

GV

CENTENNIAL HILLS HOSPITAL

SUPERFOODS FOR YOUR HEALTH Registered dieticians Sherry Poinier and Samantha Louie introduce foods with high contents of antioxidants and vitamins that can have health-promoting properties.

July 8, 10–11:30 a.m.

GV: Free GROCERY SHOPPING TOUR WITH A REGISTERED DIETITIAN Follow a virtual grocery store tour with a registered dietitian through the aisles to learn how to select healthy foods.

July 21, 1:30–3 p.m.

GV: Free LIVING GLUTEN FREE Find out if a gluten-free diet is right for you from registered dietician Sherry Poinier.

July 30, 10–11:30 a.m.

GV: Free

SOUTHERN HILLS HOSPITAL FIVE WISHES WITH NATHAN ADELSON HOSPICE Learn about the Hospice and the Five Wishes program. Breakfast included.

June 10, 9–10:30 a.m.

Call 702-880-2700.

STROKE SUPPORT GROUP Second Tues. of every month, 3–4 p.m.

Conference Room 1 & 2, 6900 N. Durango Drive TEDDY BEAR CLINIC Bring children and their favorite stuffed animals to explore what happens during a visit to the hospital.

Aug. 5, 10 a.m.–noon 6900 N. Durango Drive

DESERT SPRINGS HOSPITAL STROKE SUPPORT GROUP First Sat. of every month, 10 a.m.–noon South Magna Conference Center, 2075 E. Flamingo Road

SUMMERLIN HOSPITAL STROKE SUPPORT GROUP Fourth Thurs. of the month, 3–4 p.m.

Conference Room B, 657 N. Town Center Drive

VALLEY HOSPITAL STROKE SUPPORT GROUP Fourth floor, acute rehabilitation unit in the dining room, 620 Shadow Lane Fourth Wed. of every month, 10 a.m.–11:30 a.m.

GOT SNAP? SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM Three Square will help you complete and submit your SNAP application.

Call 702-616-4905 for an appointment.

Tuesday, 8 a.m.–noon GV WIC: Free

UNIVERSITY MEDICAL CENTER

WOUND CARE AWARENESS DAY Learn about wound care services and hyperbaric treatment.

June 3, 11 a.m.–1 p.m.

5400 S. Rainbow Blvd.

WEIGHT MANAGEMENT CLUB Free monthly weight management group with St. Rose registered dietitians.

June 24 and July 29, 5–6 p.m.

GV: Free

WATER SAFETY EVENT Free life jacket fitting and giveaway (while supplies last); part of Kohl Cares 4 U at Children’s Hospital of Nevada at UMC. June 13, noon–4 p.m.

Garside Pool, 300 S. Torrey Pines Drive

MINIMALLY INVASIVE SINUS SURGERY Learn about balloon sinusplasty, which can help sinusitis. Call 702-388-4888 to register.

June 23, noon–1 p.m.

SPRING VALLEY HOSPITAL

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PATIENT SUCCESS PROFILE

JOSEPH MOSIER

DIAGNOSIS: MYASTHENIA GRAVIS PATIENT OF: PAM HETTERSCHEIDT, R.N. MANAGER; PAULA LANE, R.N. TREATMENT CENTER SUPERVISOR, SOUTHWEST MEDICAL ASSOCIATES

J

oseph Mosier’s symptoms had progressed to a crisis level. He saw his neurologist on Dec. 26, with symptoms that included the inability to swallow or speak and trouble breathing, all typical symptoms of myesthenia gravis.

Myasthenia gravis is characterized by weakness and rapid fatigue of any of the muscles under voluntary control and is caused by a breakdown in the normal communication between nerves and muscles. There is no cure, but treatment can help relieve signs and symptoms such as weakness of arm or leg muscles, double vision, drooping eyelids and difficulties with speech, chewing, swallowing and breathing.

It had been weeks since Mosier had eaten solid food and he could only occasionally take a sip of water. When he did, it resulted in a blocking of his windpipe and an inability to take a breath for approximately 30 to 45 seconds at a time. He was in a danger zone.

His neurologist arranged for intravenous immunoglobulin treatments to begin on Dec. 31. IVIG is a blood product and a typical treatment for myasthenia gravis. His symptoms progressed over the weekend to a point that he called for an ambulance on that same Sunday night and was transported to an area hospital. There was no neurologist on staff there and the ER staff did not seem familiar with myasthenia gravis. The ER doctor said there was no medical reason to admit him and sent him home. Mosier held out until his scheduled IVIG treatment at the Southwest Medical Rancho Urgent Care health center that week.

That is when Southwest Medical registered nurses Pam Hetterscheidt and Paula Lane encountered Mosier and his daughter Kathy Hamilton.

“We recognized the seriousness of his crisis level symptoms,” said Lane.

“Since Joseph was now in a weakened and incoherent state due to his symptoms, I spoke with Kathy by phone,” said Hetterscheidt. “I explained the seriousness of her father’s condition and advised her to take him to the ER immediately after his IVIG treatment. I also insisted that a feeding tube be used, as Joseph had been unable to take nourishment in quite some time.”

“She guided me with some key phrases to use and particular points to make about his condition and what we should expect,” said Hamilton. “She obviously knew more about myasthenia gravis than any other medical professional we had dealt with so far. Everything she told me was spot on!”

Joseph Mosier with Pam Hetterscheidt, R.N.

Hamilton followed Hetterscheidt’s advice and got him to another area hospital with a staff neurologist who was familiar with his condition and admitted him right away.

Less than 24 hours after being admitted, his symptoms exploded and he began to suffer respiratory arrest. The hospital’s medical emergency response team transferred him to the intensive care unit where he was intubated and remained sedated and unconscious for seven days, but received proper treatment, including a feeding tube, hydration, and completion of additional finishing the IVIG as well as plasmapheresis. Plasmapheresis is a process in which the liquid in the blood, or plasma, is separated from the cells. In sick people, plasma can contain antibodies that attack the immune system.

Mosier remained in the hospital for another 9 days before being transferred to an area rehabilitation center.

“From the very first day that he got his treatment at the Rancho health center and throughout his stay in the hospital, Pam kept in contact with me to ask about my dad,” said Hamilton. “She comforted me when I was scared that he was going to die, and celebrated with me when he was extubated and began speak and swallow again! I am 100 percent certain that without the astute observation, knowledge and caring nature of Pam and her staff, my dad would have died at home from respiratory arrest rather than being in the hospital environment where they could save his life.

“I cannot express enough praise and gratitude for the quick thinking and willingness to take action on Pam’s part. My father’s life was saved because of it.”

Pam Hetterscheidt and Paula Lane work at Southwest Medical Associates, one of Nevada’s largest multi-specialty medical groups.

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PATIENT SUCCESS PROFILE

RUTH PEOPLES

DIAGNOSIS: SPINE PAIN PATIENT OF: DR. ANDREW CASH, DESERT INSTITUTE OF SPINE CARE

I

t started as a normal day for Ruth Peoples.

She enjoyed her cooking career on a military base, when one day, she lifted a big pot out of a deep sink, turned, and pain struck in her low back.

She visited a doctor in California, where she was living. He performed a procedure that was complicated by a staph infection in her spine and underwent no fewer than 14 spine surgeries. The pain increased after each surgery, eventually rendering her disabled, bedridden and isolated.

Peoples was referred to me when she moved to Nevada to be closer to her grandkids. By that time, nearly her entire low back was fused from L2 to S1. She had 10 screws, one of which was broken and two 10-inch rods.

She had four discs that had been removed and replaced with plastic polymer implants. She had multiple revision surgeries, fusions, bone grafts, cadaver bone — she had fused 80 percent of her lumbar spine, and probably 100 percent of her functional lumbar spine.

She was suffering from a psychological condition called “learned helplessness” that occurs in people with chronic pain. When there is no perceived escape from back pain, people learn not to even try. They become extremely depressed, anxious and completely hopeless that they will ever experience relief again.

What could we do to help alleviate Peoples’ pain that hadn’t already been done? Upon initial evaluation, I recommended a spinal cord stimulator — the last case scenario after surgery has failed. After 14 previous spine surgeries, how could the screws possibly be revised with a significantly better result?

Fortunately, Peoples opted against the spinal cord stimulator and held out for two years, as new technology surrounding the SI joint was in development.

The SI joint is the joint between the sacrum and ilium bones at the very bottom of the spine. The sacrum is a triangular bone, with is an iliac cone on each side — they wedge together like an arch-stone. The stresses for the entire body weight flow through the sacroiliac (SI) joints and down through the legs.

I was aware of the SI joint procedure, but the effectiveness was unproven and I didn’t want to experiment on anyone. So, I waited to review the two-year data of the procedure and then decided to become an early adapter. I had done so much research on the procedure with other doctors and centers that performed the surgery. It is among the most revolutionary breakthroughs in spine surgery today.

Peoples received diagnostic injections into the SI joint to confirm that the SI joint procedure would work for her. The pain relief she experienced

was the evidence that she needed to move forward with one last surgery.

The SI joint procedure is minimally invasive outpatient surgery that takes only about an hour. I’ve got the incision down to one inch, allowing me to provide a fusion with very little trauma and tissue damage. The instrumentation provides a surgical pathway between the muscles without cutting them, so after the procedure they can simply shift back to their normal, undamaged position.

Peoples told me that after surgery the nurses went in to change the bandage thinking it was going to look like any other back surgery, and they were shocked. “They couldn’t find a scar — (Peoples) just had a little bandage over it like it was a paper cut.”

The rehabilitation for this procedure is remarkably easy for patients. Postoperative stay lasts only an hour or two. Patients use a walker for three weeks so they don’t put too much weight on the surgical side while healing occurs, but in some cases this can be shortened. After the patient resumes full weight on the affected leg, three weeks of physical therapy begins, but some patients do not even need that, depending on the level of activity.

It is remarkable how SI conditions are so underdiagnosed in the medical community — and I was part of that group just three years ago. We didn’t have a procedure to actually adequately fix the SI joint. The only time an SI procedure would work is if somebody ripped their entire pelvis apart, called an open-book pelvis fracture, and we would open their pelvis in the front, like an OB/GYN approach to the pelvis, and put a 6-holed plate on the front pelvic bones and then do the SI joint procedure from the side. It worked for that specific condition, but it was incredibly rare because most people with an open-book pelvis fracture die before they hit the trauma bay.

There was not a good solution for people who either wear out their SI joint over time or have a less traumatic injury, as the procedures previously developed to treat those conditions had too low a success rate. The technology simply was not advanced enough for surgery. Physical therapists, chiropractors and pain management doctors can provide treatment in a three to six month window, but once it becomes a chronic condition, if the SI joint does not simply heal itself, they are extremely limited to repeat injections or life-long pain medications possibly facing addiction and internal organ damage.

Peoples’ pain is gone. She was excited to cook Thanksgiving dinner for her family last year, for the first time since her injury. She has plans to travel, and is re-learning to love life. I am working to educate the Las Vegas medical community about this innovation, hoping that Peoples’ success story will help other people with SI pain find the relief that they desperately crave.

Dr. Cash is a fellowship-trained and board-certified orthopedic spine surgeon, as well as the founder of the Desert Institute of Spine Care in Las Vegas and The Minimally Invasive Spine Institute, a surgery center especially for outpatient spinal surgeries.

Photo by Mikayla Whitmore

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From left to right: Mike Trainor, D.O., Eugene Libby, D.O., Nicole Dalessandro, D.P.M., Thomman Kuruvilla, D.P.M., Randall E. Yee, D.O., Timothy Trainor, M.D., Xin Nick Liu, D.O., Matthew H.C. Otten, D.O., Sep Bady, M.D.

The doctors of Advanced Orthopedics & Sports Medicine have been cited by US News & World Report, Las Vegas Life, Desert Companion, Seven Magazine and Castle Connelly as “Top Doctors.”

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OUR PRACTICE SPECIALITIES INCLUDE: KNEE & SHOULDER SURGERIES • SPINE SURGERY PODIATRY • PRP THERAPY

4 CONVENIENT LOCATIONS 2451 W. Horizon Ridge Pkwy, Ste. 130, Henderson, NV 89052 8420 W. Warm Springs Rd, Ste. 100, Las Vegas, NV 89113 6850 N. Durango Dr, Ste. 218, Las Vegas, NV 89149 921 S. Las Vegas Blvd., Las Vegas, NV 89101

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