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One out of every seven Americans will face a substance addiction. Here are some resources to help you help a loved one, and notice…
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Like some of the others have alluded to, Dr. Figert also performed my inguinal hernia repair a few months ago. I too found out, after the fact, that she had ordered a bladder catheter placed after I was anesthesized. So I go online to research the entire procedure and also Figerts backround, what I found was enlightening and surprising. Laprascopic hernia repair is relatively new, only gaining popularity since the mid 1990's. Early on Dr. Figert realized the many benefits of the new procedure over the old 'open' style where mesh was simply placed on 'top' of defect. So Dr. Figert honed her skills with special training and undertook the exceptionally long learning curve (100 plus surgeries) to become an expert using the superior Laprascopic TEP approach. (Totally Extraperitoneal) considered more difficult but better than the more invasive TAPP method (Transabdominal). Dr. Figert also wisely chose the best polypropylene mesh and the highly regarded titanium helical devices for securing the mesh. So where am I going with all of this? With all of the very wise decisions made by Dr. Figert (my surgeon) why would she cling to the outdated bladder catheterization protocol developed in the 1990's when this laprascopic surgery was in it's infancy? The assumption then was that surgeons were slow and clumsy with these new fangled, long instruments operated while viewing a monitor. And during these early, rather protracted laprascopic hernia repairs, the bladder would become distended (full) with urine and become more vunerable to injury by the surgeon. But that was 20 years ago and many thousands of hernia repairs ago. Now most experienced general surgeons perform the laprascopic procedure in 45 minutes to one hour. And simply having the patient to empty their bladders completely during the hour or two in the pre-op area will suffice. Thus a patient with a nearly empty bladder undergoing a laprascopic hernia repair by an experienced surgeon has no medical reason to receive a bladder catheter. This is where the paradox comes into play. Why would a surgeon like Dr. Figert who was very progressive on techique (TEP) and materials (correct mesh and fixation) still INSIST on ordering a relic from the past ( Foley indwelling baldder catheters) ? A Foley catheter is a foot long and about 6mm in diameter (1/4" or about the size of a pencil) and is forced into the urethra by the nurses hand using some lubricant. They always carry urethra bacteria back into the bladder (even while using sterile method) and usually cause trauma to the urethra, especially in males. On some occasions the urethra tears or is punctured or the inflatable balloon causes permanent damage to the urinary tract. Those events could affect a persons ability to self-urinate forever. So while Dr. Figert is unquestionably a qualified surgeon for the reasons mentioned, her absolute insistence on ordering painful and risky bladder catheters before ANY surgery may be enough of a reason to seek out a surgeon who does not expose patients to such archaic methods. Most general surgeons do NOT order bladder catheters for surgery's lasting under three hours. So just check with other surgeons and you'll find others who are confident and skilled and don't intentionally expose patients to unnecessary cath's. Good Luck to you.
One would like to believe that an experienced (20 plus years) general surgeon would know the medical indications (reasons) to order bladder catheterization. And they are; Acute urinary retention, need for uncontaminated urine for tests, patient immobility and urine blockage, and finally bladder catheters are medically indicated before urinary tract & prostate surgery. Also any long duration surgery (more than 3 hours) to prevent bladder filling. So it is very surprising that this surgeon, Dr. Patricia Figert MD, would order bladder cath's for her surgery patients NOT in any of those catagories. And even for 45min. to 1 hour routine surgeries. For those who don't know, a bladder catheter, also known as an indwelling Foley catheter, is a large ( 6mm or 1/4" diameter, pencil-sized ) 15" long plastic tube that a nurse forces into the patients urethra with her hand. Its implied that it's a 'sterile' procedure, but actually the bacteria within the urethra naturally is carried back into the bladder contaminating it and sometimes causing urinary tract infections. After the plastic tip of the tube is pushed in all of the way to the bladder, the nurse uses a syringe of water to fill a balloon to secure the catheter tubing from slipping out on its own. Even after removal, these catheters have nearly always caused trauma to the urethra from extreme 'stretching' of the lining. Due to this urethra damage the ammonia in the urine causes days of urinary burning. But first you may experience many hours of induced urinary retention, another very common side effect of bladder catheterization. Occasionally severe urethra damage results from the catheterization and then surgery must then be performed for that repair (hopefully by a more caring surgeon).Dr. Figert attempts to justify 'cath' orders by claiming that she might inadvertantly puncture a slightly distended bladder during surgery (statistically an extremely low occurance). And only intern (novice) and inexperienced general surgeons can claim that excuse. For any routine surgery of less than 3 hours, simply having the patient to empty their own bladder pre-op will suffice. The surgeon could also use a bladder scanner (ultra-sound) to confirm the bladders empty status before surgery. But Dr. Figert (and some other old-school surgeons) just have old, bad habits and willingly expose their patients to the many serious risks of bladder catheters. It may be easier to find another surgeon who does not 'cath 'em all' . Good Luck, Chris T. May, 2015
I've read with interest these patient reviews of the general surgeon Dr. Patricia Figert. It seems that Dr. Figert has a personal preference to order bladder catheters on virtually all of her patients. Years ago bladder catheters were considered a normal and routine pre-operative practice. Much has changed but Dr. Figert has not. Research and disturbing statistics now reveal that Foley indwelling cathetization (Dr. Figerts choice) is responsible for urethra damage, bladder and kidney infections and worse. They are supposedly inserted a 'sterile' fashion. BUT, bacteria already residing in the urethra gets pushed back into the bladder initiating infections in many patients. The catheter is a large tube (nearly 1/4" diameter) and is so long (14 to 16") that it curls up inside the bladder because the nurses are told to keep pushing it till it will go no farther.But here's the thing. Patients who simply empty on their own need no catheter. The only reason bladder catheters are ever needed before surgery is if the patient can not self-void beforehand or it the surgery will be extended (several hours or more). This should not be just the patients opinion against the surgeons opinion or personal prefernce. This should be about the best and safest course of action for the patient! Here are the federal (National Institute of Helath) guidelines for laparoscopic hernia repair (TEP/TAPP). But the cautions given about limiting bladder catheterization apply to most surgerys.See Chapters 2 & 11 - see 'Statements and Recommendation' boxes, copy and paste into your browser-www.ncbi.nlm.nih.gov/pmc/articles/PMC3160575/#Sec6titleand also more of the same from the very respected site, emedicinehttp://emedicine.medscape.com/article/1534321-periprocedure#aw2aab6b3b2Congrats to you on researching your surgeon before just blindly choosing one. You deserve a general surgeon who will provide you with the best care. And NOT subject you the many risks of bladder catheteriztion simply because she (or he) has developed bad habits which exposes patients to those complications unnecessarily.S.M. June, 2015
My doctor advised me to go to Baptist Health, Louisville, Ky Emergency. i was of the impressionthat my doctor would be attending me but he stopped seeing patients in hospital about a month earlier. After seeing numerous doctors and lack of communication there was an error in my treatment plan that cost me dearly. I was assigned a the hospital Dr Alan Jackson. This is the worst MD I have ever encountered. He tried to dismiss me when I was having Pulmonary Embolisms. When I asked him if he was concerned about the PE ,he answered NO.Some one from Cardio had to order an MRI todetermine the PE and and extend my stay in hospital. This doctor ha little experience and does not listen to the patient. If you go to Baptist Health and is assigned this doctor RUN.I asked to be assigned another doctor and was told NO. I am not by any means an indigent patient.I asked to file a complaint with the hospital and was put off until I asked again the day of my dismissal. A nurse was sent to take the complaint and didn't even bring paper and pen or accept the notes I written down.She seemed very unconcerned and disinterested.
I am writing in response to all the critical reviews of Dr. Figert and her preference to order bladder catheters for most all of her surgical patients. You should know that she is of the generation of surgeons coming out of med school when laparoscopic procedures were very new (1990's) and at a time when catheters were thought to be harmless and were routine (we now know better). And as a female she couldn't possibly appreciate a male patients perspective and his aversion to the procedure. Much like male gynocologists falling out of favor by women who now nearly universally prefer a woman ob-gyn. Although she may not really have an excuse for her stubborness to skip the cath (for patients able to fully void before surgery) at least her history provides us with an explanation. This can serve as a notice to male patients (who are able to fully self void) to seek out a male surgeon who is able to appreciate that aversion and act accordingly (by NOT catheterizing before surgeries). Jim
I was looking for a doctor closer to my home and also within my network. I was little worried about choosing another doctor so I stopped by the office to check it out first. The office staff was really nice and helpful. When I did meet the doctor I will have to say that Dr. Stuart made my visit very comfortable. The transition was great and I feel very through. I felt like he covered my history very well and that I left there feeling like I would be in good hands. The office was clean and liked having blood work done in the same area. I did have to wait a bit but it only meant that he was taking time with others needs as well. charolette w.
Dr. Reyes is the only doc I have met, who will take the time to get to know you, and familiarize himself with your specific issues. You are not rushed. His bedside manner is impeccable. You will receive the most thorough work up. I can not say enough good stuff. The downside, expect to wait to see him. He gives everyone his time, so when it's your turn it's worth it. The staff is, 'relaxed', but kind. This is not your average uppity-money making office. I believe he cares about his patients. Bottom line. He is worth the wait time. If you go, block out at least 3.5 hours. Usually only takes 2.5 though.
Dr. Warren R. Kemper is a really great doctor. To me, he is what a physician should be. He doesn't rush in and out. He listens to you and spends an appropriate amount of time with you. He remembers things about you like to ask about your family and kids which you don't much these days. Sometimes his staff gets a little irked with him running over with his patients and to me that is a good thing. He has a good knowledge base and when I had whooping cough, he suggested to the NP that saw me that day to have me tested even though it was rare at the time-and I had it. He is spot on and I appreciate his thoroughness.
My mother was in Nazareth Home for rehab and we would never have her go anywhere else. Everyone in the facility treated my mother as if she were the only patient they had to care for. The food was excellent and mom never complained about anything. The facility is clean, bright and airy. The staff met with me, her caregiver, before they released her to make sure we were all on the same page as to her requirements. Thank you Nazareth Home for making a difficult situation more than bearable.
Dr Aronoff was wonderful with our little Trace. He explained things in full detail & there was a lot to explain to us. Our precious little one had too much wrong with him & fought a hard battle but his little body had to give finally give up. My daughter & I were on our way home when she received a call from Dr Aronoff giving her his sympathy in the the passing of her baby. We thought that was extremely kind of him & his office. We appreciate everything he did for my daughter's son.
Physicians and surgeons help to keep people - from infants to the elderly - as healthy as possible. These individuals provide diagnoses and treatments for a wide variety of ailments, and preventative care and early detection for more serious illnesses. Whether you love or hate going to the doctor, the fact is your physician is there to listen to your health concerns, take preventative measures against diseases and advise you on your options for staying in tip-top shape.
In 2013, there were more than 1 million doctors of medicine in the U.S., over 854,000 of which were active. Additionally, in 2012, there were about 18,000 active general surgeons in the country. It's important to know which type of physician or surgeon you need, how to choose the best one, and account for other considerations in order to stay healthy.
Patients can choose from a wide variety of physicians depending on doctor specialty and what problems they are experiencing. Here are a few of the most common types of physicians that you may see in your lifetime:
Your GP is the doctor that you go to for regular checkups, vaccines and to identify health issues. GPs can treat many different illnesses and injuries, from the common cold to a broken arm. If your health requires a second opinion or expert care, the GP will refer you to a specialist who has the skills to focus in on the issue.
Heart attacks and heart disease are some of the most common afflictions seen across the country, making cardiologists important to your long-term health. These physicians specialize in studying and treating the heart and related diseases.
Other than a GP, the dentist is likely the most common physician you'll ever see. These professionals work with the human mouth, ensuring that your teeth and gum health are up to par. Patients typically go to the dentist twice a year.
Dermatologists are focused on skin-related issues and diseases, from skin cancers, to acute acne, eczema, psoriasis, and general cosmetic concerns like aging and scars. Most will also perform annual or semi-annual mole checks to screen for any signs of melanoma, the most serious form of skin cancer.
If you have a number of sinus infections or have had your tonsils taken out, you've likely seen an ENT specialist. ENTs handle ailments related to the ear, nose and throat, often related to taking out tonsils and treating hearing issues.
For many women, their gynecologist and obstetrician are the same person. These professionals work with the female reproductive system to focus on reproductive health, fertility issues, prenatal care, options for new and expectant mothers, neonatal care and childbirth. OB/GYNs can also help in the early detection of breast or cervical cancer.
There are obviously a number of physicians that you can choose from, but how do you know if they're the best choice for you? Here are a few considerations to help you pick a physician:
Look at Your Insurance
Before you get down to the details, you need to verify which doctors are covered by your insurance and whether they are in or out of your carrier's network. Rates may be cheaper if the doc is in network – a doctor can be covered by your insurance but not necessarily in network. Out of network is typically more expensive. Doctors often add and drop plans, so it's important to ensure that your options are compatible with your insurance plan. Doing your homework will help you avoid unexpected expenses.
Check for Board Certification
Your physician should be certified through the American Board of Medical Specialties. Doctors must earn a medical degree from a qualified school, complete three to seven years of residency training, be licensed by a state medical board and pass one or more ABMS exams to be certified.
Examine the Reviews
Reviews of a doctor can reveal a lot about what your experience may be like. People may grade on staff friendliness, availability and effectiveness of treatment. Looking at these evaluations and getting recommendations from family and friends can direct you toward a physician for your needs.
Surgeons can literally hold your life in their hands, and it's important to find the best one that can put you at ease and treat you effectively
You need to feel comfortable with your surgeon. It's important to communicate your concerns and that your surgeon can respond adequately. Surgeons should be willing to go over the details of your procedure and answer any questions that you may have. They must take the time to discuss and address your worries.
If you're going in for surgery, you want someone that knows what they're doing and has a high success rate. Ask how often the surgeon performs this surgery and try to find one that regularly does it. This will give you peace of mind that you're in capable hands.
Your decision on a physician or surgeon can be majorly affected by the insurance plan you have. You may have insurance through employment, your spouse, your parents if you're under 26, or the marketplace if the previous options don't apply to you. It's important to understand how your insurance works to have the full picture of what you'll need to pay for.
Your insurance will have a deductible, which is the amount that you're responsible to pay for covered medical expenses. Some plans have coinsurances, where you must pay a certain percentage of the bill, and insurance will cover the rest. Co-pays state a flat rate for certain services, like paying $20 when you visit your GP or a $100 co-pay for an emergency room visit. Once you reach your out-of-pocket maximum, which will differ if you're an individual or within a family plan, your insurance may pay for 100 percent of covered medical expenses for the rest of the plan year.
If you plan to go to the doctor, need medication or have been recommended for surgery, call your insurance provider or go online to see what your plan covers. You can choose the best doctor for your needs, understand your options and prevent yourself from being blindsided by medical expenses.
Most doctors require a phone call for an appointment, although some may provide online scheduling as well. Be sure to have your insurance card with you when you set an appointment, and to bring it with you to the actual appointment. They need the ID numbers to verify your coverage, and will usually make a copy of the card for their files so you don't have to show it again unless your insurance changes.
When you call, let them know if you're a new patient, as this will require you to complete some paperwork for your first visit. Tell them the reason for your visit, such as your symptoms if you're feeling sick. It's also important to inform them if you have Medicaid and to find out if you need to bring anything to the visit, like current medications or medical records.
From here, the receptionist will likely ask what dates and times work best for you. During your call, it's important to be honest about your symptoms and the reason for your visit. This information will help the doctor treat you and give him or her an idea of what to expect. Your appointment may progress faster as a result, and the doctor can come prepared with a list of options to better care for you.
Doctors see a number of patients in a day, sometimes in 15-minute increments in areas where the physicians are in high demand. This can leave little time for doctors to perform thorough examinations, and they can end up missing certain problem indicators. While some problems, like a cold or flu, can be diagnosed in this time, more complex ailments require attention, which takes up time. Reviews can illuminate which doctors actively spend the necessary time with their patients and which ones are pressed against the clock to meet demand.
Surgery has some more dire risks attached to it, so be sure to talk to your surgeon about the potential issues that can come up as a result of your procedure. If a patient has a reaction to anesthesia, it can cause very serious complications, but this is an uncommon occurrence. Blood clots can be a significant problem after surgery, often caused by inactivity during recovery. Infections, numbness, scarring, swelling and death are all possible, but the likelihood of these issues will vary depending on the type of surgery you're undergoing. Talk to your doctor about your concerns and your risk potential.
Surgery affects people in different ways, but as you begin to emerge from anesthesia, you'll want to alert your nurse to any issues you may have. The nurse will tell you how the procedure went, what effect it will have on your condition, what to expect when you get home and how long it will take to get back to normal. If you start feeling pain, the nurse may give you medication to stop it from getting worse. When possible, it's also advised to move around to avoid blood clots from developing in your legs. This can be as simple as occasionally flexing your knee or rotating your foot.
Some surgeries are outpatient procedures, where people are released the same day. For major surgeries, patients may stay at the hospital for a few days to be monitored and address any concerns before being sent home. Discuss with your surgeon the projected length of the hospital stay and what you need to bring.
Your recovery time and follow-up expectations will vary depending on your procedure. For example, you can be expected to be on your feet within a few days of having your wisdom teeth taken out, but it may be weeks before you have fully recovered from a broken foot or heart-valve surgery. Your surgeon will give you a list of things that you'll need to do during this time, including what medications to take and when you'll be able to get back to work and other activities.
Every surgery will have a follow-up call or appointment to discuss your recovery and allow you to ask any questions about unusual symptoms or changes in your overall health. If you have a major operation, like heart surgery, it's important to make regular checkups with your doctor or a specialist to ensure that everything is normal. Visiting a doctor will help deter infection and verify that everything is healing as expected. These appointments will give you peace of mind about your state of health and ensure that any issues are caught early on.