Borland-Groover Clinic: News & Events

Code Blue: Holiday Overeating & Digestive Health

2011-12-04T19:16:26+00:00

As part of the Code Blue Campaign, Dr. Nieto spoke with Action News about some simple steps you can take to make sure you’re treating your body right this Holiday Season.

Dr. Moulis discusses a procedure that can detect cancerous polyps

2011-11-25T04:49:42+00:00

This article appeared online at news-journalonline.com Procedure can detect cancerous polyps by Harry Moulis, M.D. What are colon polyps and colonoscopies? Colorectal cancer is the second most common cause of cancer death in this country. But it’s a preventable cancer that tends to start as a benign growth called a polyp. Polyps cause no symptoms; you’ll never know they’re there. However, if not removed, some types of polyps may become colon cancer over time. A polyp can be described as a mass of tissue that projects upward from the normal surface level. Some polyps are flat, some are raised, and some are on stalks, appearing like mushrooms. Colonoscopy is the most-common and accurate technique available to find and remove these potentially pre-cancerous growths. Colonoscopy is an outpatient procedure during which a long, flexible, tube with video is inserted into the colon to view the inside surface. The main inconvenience for this procedure is the preparation involved to cleanse the colon lining beforehand. The procedure is done under sedation to make it as comfortable as possible. During the exam, polyps can be removed, assuming they aren’t too big to remove safely. The specimens are sent to a pathologist for microscopic evaluation. There are two basic types of colon polyps: adenomatous polyp (adenoma) is the type that may become a cancer over time, if not removed. A hyperplastic polyp is, essentially, overgrowth of normal colon lining; this type of polyp is believed to be not pre-cancerous. In general, if you’ve had one or a few hyperplastic polyps removed, a colonoscopy should be repeated in 10 years if no immediate family member (parents, brothers, sisters, children) have had adenomas or colon cancer. If there is such a family history, you should have a follow-up colonoscopy in five years. If adenomas are removed, the number, size and shape, plus your family history all play a role in determining timing for a repeat colonoscopy. This may be one to five years. Possibly the most important thing about a colonoscopy is the quality of preparation before the exam. It’s important to follow the directions you’re given to flush out the colon so the lining can be seen well. Poor preparation on the patient’s part may mean repeating a colonoscopy sooner than would otherwise be necessary. Are there alternatives to colonoscopy? Yes. An air-contrast barium enema is a radiologic study in which a liquid, then air, is passed into the colon through a tube, and X-ray images of the colon are taken. A virtual colonoscopy or CT colography is another radiologic study in which air is pumped into the colon and a CT scan is performed. With both of these techniques, preparation is extremely important, as residual fecal matter on the colon surface may look like a polyp. These two procedures are performed without any sedation and may be uncomfortable. Additionally, if polyps are detected, a colonoscopy would then be recommended to remove them.

Good Care Anywhere

2011-11-25T04:38:40+00:00

The following article appeared in the December 2011 issue of Gastroenterology and Endoscopy News. Good Care Anywhere by Mark Fleisher, M.D. Vacations are supposed to be about relaxation and rejuvenation. Sometimes they’re even about education. I knew it was time for a vacation. I could use a euphemism, but in all honesty I was just becoming plain old crabby. It was time to take a trip. I contacted my friends at touringisrael.com, and off we went. As a graduate of the Sackler School of Medicine of Tel Aviv University, I can say that I’ve lived in Israel. However, that was 20 years ago, and even when I lived there I basically saw nothing. Immersed in school, I learned my subjects but only years later did I learn my lesson. Real lessons. Not whether this muscle inserts here or there, not what is a Golgi apparatus. Real lessons that come with the most important aspect of medicine: observation. We see a patient at one locus in time and we have no idea of his or her fate. But when we watch them and observe them, we start to plot a course. It is akin to sitting in the chair at the optometrist: better, worse or the same. My internal barometer told me to go on vacation so I could get better. The first five days were amazing. Ibex in the desert. Eating caper shrubs. Walking through dry wadis. Lunching on hummus stuffed in pita with Bedouins. I certainly never did this while in medical school, and yet this was quite an education. As Friday night cooled the region, our tour guide Joe took us to his home for Shabbat dinner. We met his wife and three children. Hosted by his in-laws, Sarah and Felix, we were the honored guests. From Tunisia, they spoke French and Hebrew. Being from Brooklyn, I barely speak English. Despite having gone to school in Tel Aviv, I never learned Hebrew. An opportunity lost. I may know an endoplasmic reticulum, but I can’t communicate with an entire nation despite having spent four years there. Perhaps I never lived in Israel; I merely sojourned there, like the Jews in Egypt in Exodus. As Felix doled out heaping portions of Sarah’s creations, I was able to learn about him. He came here penniless. He was given the name Willie, in honor of the Nazi soldier who spared his father’s life. The Nazi soldier who said he was sorry. He was awarded the highest honor from the president of France for helping French and Tunisian expatriates to resettle in Israel. He was a seemingly simple elderly man, ladling out Sarah’s couscous. Yet, he was teaching us important lessons: humility, charity, memory. That was quite a dinner. The next day about two miles south of Nazareth, I fell off my mountain bike. With a fractured clavicle and a few broken ribs, I was brought to the nearest hospital in Afula, a speck on the map. My arm dangling, my legs bleeding and my head covered in thorns, the triage nurse asked, “From Nazareth?” I sure looked the part. I was whisked right in. So there I was, a Manhattan-trained gastroenterologist in the middle of nowhere doing my best Humpty Dumpty imitation. One thing I knew: I knew I would get good care. I live in Jacksonville, and whenever someone from New York City or Los Angeles or Chicago is admitted, I can read their xenophobic fear: Will I get good care? As if only traffic jams and smog will allow good care to be rendered. I had no such fear. I know wherever I go, doctors and nurses and technicians and transporters are universally going to strive to give good care. Maybe the equipment is not the newest, maybe the floors aren’t the shiniest, but the people always do their best. Worldwide, people in medicine always do the best they can. By my definition, that’s good care. The waiting room was half Arab, half Jewish. So was the staff. All in the same boat, each tacitly agreeing who should go first based on how bad the other looked. As I lay quietly, the nurse wheeled my bed over to the nurses’ station. She handed me the phone. “For me? I don’t know anyone,” I thought. It was the head of the hospital who wanted to know if I was OK. He wanted to know if I was getting good care. He wanted me to know that he was available if I needed anything. He told me that he was a friend of Felix. Later, I was wheeled over for three more phone calls. An orthopedist came in to look at my films—on the Sabbath, during a doctors’ strike. I got good care. But I have a feeling that the orthopedist would come in because that’s what they do. I know that everyone else was getting the best care available. They just didn’t get wheeled to the nurses’ station to speak on the phone with people whose names tend to be on letterheads. After I was discharged, I spent the next few days in our hotel while our boys did more hiking and swimming and rappelling. With me out of the way, they probably had a better time. But you could see the concern in their eyes. Fear and relief is a strange brew. Little did I know that Joe, our tour guide, my friend, was calling every hour to check on me. So did his wife. So did Felix. My wife doted on me but that’s nothing new; she always does. As I got better, I learned a great lesson. The best part of life is the relationships you form. One thing I didn’t need to learn: I knew I got good care.

Dr. Alan Harmon discusses early testing for Colorectal Cancer

2011-11-25T04:28:29+00:00

The Borland-Groover Clinic’s Dr. Alan Harmon discusses Colorectal Cancer with First Coast News. Learn what you need to look for and how early testing could save your life. View the video on First Coast News

Borland-Groover Clinic’s physicians are among the nation’s Top Doctors

2011-10-25T03:59:10+00:00

U.S.News & World Report keeps an up-to-date list of the nation’s best doctors based on a peer nomination process. Several of Borland-Groover Clinic’s Gastroenterologists are part of this select group. Read about their peer nomination process and search for a gastroenterologist in your area.

Dr. Nieto speaks about the importance of Colon Cancer awareness

2011-07-11T18:54:13+00:00

Dr. Nieto speaks about the importance of Colon Cancer awareness with First Coast Living. Colon Cancer is a preventable disease with a colonoscopy and early detection.

Jan Pratt and Dr. Vikram Gopal spoke with Action News about the importance of colon cancer screening

2011-03-08T15:09:48+00:00

Jan Pratt, a cancer survivor, and Dr. Vikram Gopal sat down with Action News to talk about the importance of colon cancer screening and the 2nd Annual March To Get Screened to benefit research and awareness. watch the video at actionnewsjax.com

Dr. Di Teodoro warns of the greater risk baby boomers face for Hepatitis C exposure

2011-02-09T22:08:49+00:00

It’s becoming known as another silent killer - Hepatitis C. “About 3 to 4 million people are infected with Hepatitis C,” said Dr. Linda Di Teodoro, who practices at the Borland-Groover Clinic and Baptist Medical Center. Another 3 million Americans are unaware they have it, and Di Teodoro said the problem is there aren’t many symptoms, just a flu-like feeling or fatigue. read more at firstcoastnews.com

Dr. Hoogerwerf and Dr. Sack discuss the importance of good digestive health during the holidays

2010-12-16T15:40:12+00:00

Dr. Hoogerwerf and Dr. Sack recently appeared on Action News as part of the Code Blue initiative to discuss the importance of good digestive health during the holiday season. Dr. Hoogerwerf Dr. Sack

New TV spots to bring awareness to digestive health

2010-11-24T21:12:07+00:00

Borland-Groover Clinic has produced four new television spots to bring awareness to digestive health. These spots cover Irritable Bowel Syndrome, Digestive Health, Colon Cancer, and Inflammatory Bowel Disease. Irritable Bowel Syndrome Digestive Health Colon Cancer Inflammatory Bowel Disease