Our Services – Gastric Tube Changes

shutterstock_241844200

VCU Health at Baird Vascular Institute is a multi-disciplinary collaboration of interventional radiologists and vascular surgeons. By working in tandem, we can use the most advanced imaging technology to give us the fastest, clearest picture of a patient’s peripheral circulatory system and vascular problems and diseases, pointing us precisely to the right diagnosis and treatment plan and procedures.

It also allows us to provide services outside those of a traditional vascular practice. We can treat the pain of plantar fasciitis and other tendon injuries, place IV ports for long-term care or dialysis, or treat painful, sometimes debilitating, varicose veins. And as a division of VCU Health, we partner with our colleagues at VCU Health Medical Center to refer patients whose conditions require higher levels of care.

We also perform gastric tube changes here in our office – a service we haven’t written much about.

We spoke with Nancy Lang, a member of Baird Vascular Institute’s nursing team about gastric tube changes and what’s involved for the patient.

What is a gastric tube change? For patients that have a gastronomy tube (more commonly referred to as a feeding tube), about every 3 or 4 months they must come in to have the tube changed because it gets clogged or starts leaking. When the feedings become slower going in or the patient is seeing some leaking around the tube, that’s a sign that it’s time for the tube to be changed. Occasionally, a tube will get accidently pulled out and folks have to come in to get it reinserted.

Who needs this service? A feeding tube can be required for several medical conditions, some short term or others that are long term – depending on the patient’s medical needs. Some folks are undergoing radiation treatments and unable to eat solid food. Some people are unable to perform the function of swallowing. Sometimes patients are paralyzed and food doesn’t move through their system very well, so they also require a feeding tube for nutrition.

How long does it take? A gastric tube change is a very quick procedure. The patient comes in and the staff takes their vital signs, the doctor then explains the procedure, then the patient signs a consent form.  Next, the patient is taken back to a sterile procedure room, the staff cleans the area and drape the patient. The physician inserts a wire into the current tube and removes current tube. After the physician gets the tube out, that leaves the wire, and then they insert the new tube over the wire and inflate the tube. An X-ray machine is used during the procedure to guide the insertion process.

Is it painful? The process is not painful. Some people are irritated where the tube has been rubbing, so if the patient is irritated or sore, the physician will use a little numbing medication. Some patients that have had their tube for a long time don’t need to be numbed, it greatly depends on the patient and their tolerance for irritation or minor pain.

What should I know before coming in for a gastric tube change? We generally ask you to not eat for about 4 hours before procedure so that the stomach is empty before the tube is changed. After the tube is changed you can resume normal feeding and daily schedule.

Why is Baird Vascular Institute a good provider for this service? Here at Baird, we have the x-ray equipment right here in the office. Of course, the procedure can be done at the hospital, but it’s a lot more convenient for the patients to come here. We have free, convenient parking, and most of the time we are right on schedule because we’re a small facility. Here, the same nurse stays with the patient before during and after the procedure, so there’s very little waiting – and the patient gets a little more individualized care.

For more information regarding gastric tube changes or any of the other services that are offered at the VCU Baird Vascular Institute, feel free to call 804.828.2600 or visit us on the web at http://www.vcuvascular.com.

Physician Profile – Dr. Bailey

VCU Health’s medical staff at Baird Vascular Institute reflects fresh thinking about a collaborative approach to vascular care. VCU Health Medical Center’s Division of Vascular Surgery and Department of Radiology joined forces to create Central Virginia’s only academically based vascular center. We’ve brought together leading interventional radiologists and vascular surgeons to provide the Greater Richmond and Central Virginia region with the best in vascular diagnosis and treatment. Together, they offer area patients and referring physicians a level of medical expertise, experience and knowledge usually found only in a major academic medical center, as well as the most advanced technologies and facilities to support their work – all in a convenient outpatient setting.

Occasionally, we like to highlight some of our physicians on a more personal level. We recently sat down with Dr. Christopher Bailey.

Christopher Willam Bailey

Dr. Christopher Bailey

Where are you from? I was born and raised in Port Charlotte, Florida, a small sleepy fishing town on the Gulf coast.

Would you say you’re a city person or a country person? I’m a hybrid of both. I grew up in a small town, but have done much of my schooling in large metropolitan areas. Both areas have benefits.

What do you enjoy in your spare time? Spending time with my wife, hiking with my 2 dogs, sporting events, crossword puzzles, and golf.

Tell us about your family. My wife and I are inseparable. We enjoy being in each other’s company and have been doing so since 2003-ish.

What’s your favorite television show and why? Don’t have one. I do enjoy watching classic black and white films on TCM – a different time period with so much change in between then and now.

What’s your favorite sports team? Depends on the time of year. Tampa Bay Buc’s, West Virginia Mountaineers, Boston Celtics

What’s your favorite book? A Clockwork Orange

If you were stranded on a deserted island, what are 3 things you’d want to have with you? Ability to create fire, writing device, and Banyan trees

What’s one thing patients would be surprised to know about you? I’m an osteopathic physician (D.O). Many patients I encounter are unaware and ask me what that means.

What do you like most about working at Baird Vascular Institute at VCU Health? BVI is a relaxed atmosphere with great support staff.

How can Baird Vascular Institute at VCU Health help my heel pain?

baird heel pain

Tendons are the tough, flexible bands of tissue that connect your muscles to the bones in your joints, working together to allow all the twisting, gripping, grabbing, bending and lifting in your busy life. But repetitive pounding motions can cause microscopic tears every time you use your tendon. As you keep at it, these micro tears do not have time to heal properly and, unless treated, can get worse, making you suffer for months or years. This condition is often called simply tendinitis (tendon inflammation), but usually is actually tendinosis, tendon tissue that has simply broken down from the overuse and micro tears.

You know the feeling – it’s gotten a little worse with time. That little twinge you felt on your daily jog has now become a knife-sharp sting in the exact same spot with every step you take, every day. It’s impossible to ignore the pain…and you shouldn’t. Tendon injuries need attention. Sometimes, rest, therapy and a change in activities may ease the pain…but often the damage is permanent, and only gets worse.

Sometimes you can cope with tendon injuries with ice, rest, physical therapy and other treatments – particularly if you stop the repetitive activity and rest as soon as you feel the very first twinges. More often than not, people try coping with the growing pain, on the job or at play. However, if the damage doesn’t heal properly, or if you continue the activity and increase the damage, you risk long-term injury, constant pain – and giving up an activity you love.

We can help. Using precision ultrasound imaging guidance and a minimally invasive treatment, we can delicately remove the damaged tendon tissue and get you back to the activities you love in a matter of weeks – with little to no pain. Unlike other medical or physical therapies, this procedure safely removes the cause of the pain at the source, and unlike many traditional surgical procedures, it is far less invasive, requires far less recovery time – and has a much higher success rate. The treatment requires only a local anesthetic and a tiny incision, and is virtually pain-free. We use a targeted application of ultrasound energy to break down the damaged tendon tissue while leaving surrounding healthy tissue untouched.

We then use an FDA-cleared device to remove the damaged tendon tissue. You don’t even need stitches. The entire treatment takes about 20 minutes.

Most people won’t need any further treatment, such as physical therapy. You wear a walking boot for a week or two while the area heals. The most common post-procedure problem reported is some soreness, which can generally be treated with over-the-counter pain medication and typically lasts less than a week. In a recent study, doctors reported no other side effects. More than 25,000 people have had the treatment since 2012, with a high rate of satisfaction. In most cases, patients are back to the activities they love in six weeks or less.

Call us at (804) 828-2600 to discuss whether image-guided treatment is the right option for you.

Physician Profile – Dr. Levy

VCU Health’s medical staff at Baird Vascular Institute reflects fresh thinking about a collaborative approach to vascular care. VCU Health Medical Center’s Division of Vascular Surgery and Department of Radiology joined forces to create Central Virginia’s only academically based vascular center. We’ve brought together leading interventional radiologists and vascular surgeons to provide the Greater Richmond and Central Virginia region with the best in vascular diagnosis and treatment. Together, they offer area patients and referring physicians a level of medical expertise, experience and knowledge usually found only in a major academic medical center, as well as the most advanced technologies and facilities to support their work – all in a convenient outpatient setting.

Occasionally, we like to highlight some of our physicians on a more personal level. We recently sat down with Mark M. Levy, MD, our Chair of Vascular Surgery – to find out a little more about what he’s like outside of the office.

Where are you from?  I’m originally from Elberon, New Jersey – on the Jersey shore. The job at at VCU Health is what brought me to Richmond in the 1990’s.

Levy_1703

Mark M. Levy, MD

Would you say you’re a city person or a country person? I have no idea – I feel like I could be both. I feel comfortable in both an urban environment or a profoundly rural environment. But I would have to say, like most people, I can relax a little more in a rural environment.

What do you enjoy in your spare time? I like to spend time with family on the river in Deltaville, Virginia – both sailing and fishing. My children have small racing sailboats, Optis and Lasers, and they’ve all learned to sail in Deltaville over the past 15 years.

Tell us about your family. My wife & I moved to Richmond in 1998, and we have 5 children, all of which are in school in Richmond or at the University of Virginia in Charlottesville.

What’s your favorite television show and why? That’s a hard one, that presumes I watch anything other than news and sports and increasingly, only sports. As many folks do, we watch more and more movies on Netflix and online.

What’s your favorite sports team? I love so many teams, but I do like the Richmond Flying Squirrels – since I’m a baseball fan, they would have to be my favorite.

What’s your favorite book? I enjoy reading stories from the Bible, but don’t happen to have a current favorite book.

If you were stranded on a deserted island, what are 3 things you’d want to have with you? Well, first, a large container of spring water for obvious reasons, a sailboat and mosquito repellent – I’m very susceptible to mosquitoes.

What’s one thing patients would be surprised to know about you? Most people don’t know that I have 5 children – ranging in age from 14 to 19.

What do you like most about working at Baird Vascular Institute at VCU Health? I love taking care of vascular patients with both venous and arterial occlusive disease. I enjoy getting to know them as well.

Why Baird Vascular Institute at VCU Health is unique

Baird Institute

With the expertise of a major medical center and the convenience of a neighborhood clinic, VCU Baird Vascular Institute is unique.

We are the only academically based vascular center in Central Virginia, combining the medical expertise, knowledge and advanced technologies of a prominent academic medical center with the ease and convenience of a neighborhood outpatient clinic.

The history of the VCU Baird Vascular Institute – and the inspiration for our work in advancing vascular medicine – is rooted on the work of a pioneering cardiologist, Charles L. Baird, Jr., M.D.

In 1972, Dr. Baird, a graduate of VCU School of Medicine and a member of the staff at the Medical Center, decided to take a bold step to completely transform the way vascular and heart disease was diagnosed and treated. He was convinced that early diagnosis and treatment could prevent needless suffering and save countless lives, and established the Virginia Heart Institute – now the VCU Baird Vascular Institute – to prove it. By bringing together the experience and expertise of leading interventional radiologists and vascular surgeons from VCU Health, we work to detect problems earlier and to develop and refine new, minimally invasive treatments and procedures that reduce risk, increase success rates and speed recovery for a wide range of vascular conditions, all on an outpatient basis. Because of this, you no longer have to travel to downtown Richmond to find advanced, comprehensive vascular care. We offer all our services under one roof, in one convenient location.

Advanced vascular care with the utmost convenience.

Our state-of-the-art facility offers customized vascular care tailored to the individual needs of each patient – set in a warm and friendly environment located conveniently just off Interstate 195 in the near West End at 205 N. Hamilton Street, Richmond.

Whether you are referred by your physician or wish a personal consultation, we have both the expertise and the latest technologies and techniques to diagnose and treat vascular disease and other problems. If we uncover signs of vascular disease, our experts can develop a custom treatment plan for you in close coordination with your doctor, and, as part of the VCU Health team, we can ensure the highest level of care for even the most serious of conditions.

If you are interested in a consultation for any of the services we provide, please contact us at (804) 828-2600 or send us an email.

 

 

Conscious Sedation

baird conscious sedation

One of the first questions that our patients ask us when they are scheduled for a procedure is, “Will I feel pain?” This is an understandable concern for someone getting ready to undergo a minimally invasive procedure, especially if it’s their first time having a medical procedure performed. Minimizing pain and discomfort is one of our primary concerns here at BVI. We want to do everything possible to ensure that our patients have a positive experience during their visit which is why we use conscious sedation during many of our procedures.

What is conscious sedation?

Conscious sedation is when a combination of medicines is administered to help you relax (a sedative) and to block pain (an anesthetic) during a medical procedure. Conscious sedation is safe and effective for people who need a minimally invasive procedure. Here at BVI, these medicines are given through an intravenous line (IV) by one of our nurses under the direct supervision of a physician. You will begin to feel drowsy and relaxed very quickly. You may fall asleep, but you will wake up easily to respond to people in the room. You may be able to respond to verbal cues. You will be monitored throughout the entire procedure by our medical team to make sure that your blood pressure, heart rate and oxygen levels stay within safe limits.

The medicine will wear off quickly and recovery after the procedure is generally very fast. After conscious sedation, you may feel drowsy and not remember much about your procedure including any associated pain. Afterwards, you will feel sleepy and may have a headache or feel sick to your stomach. During recovery, your finger will be clipped to a special device (pulse oximeter) to check the oxygen levels in your blood and your blood pressure and heart rate will be monitored. You should be able to go home 1 to 2 hours after your procedure.

Is conscious sedation the same as general anesthesia?

No. General anesthesia (also known as deep sedation) is when you are administered drugs that put you in a totally unconscious state. Under general anesthesia, you have no awareness of the procedure or your surroundings at all. General anesthesia is usually reserved for more complex and lengthy procedures or when your provider deems in necessary. General anesthesia also comes with higher associated risks. Only licensed anesthesiologists or nurse anesthetists are able to administer general anesthesia. Recovery times are usually longer than conscious sedation and may present more unpleasant side-effects. BVI does NOT use general anesthesia.

Before the Procedure

Be sure to tell us if you are or could be pregnant. We also want to know what medicines you are taking, even drugs, supplements, or herbs you bought without a prescription. A day or two before the procedure, one of our nurses will contact you to go over pre-procedural instructions. This generally includes:

  • Not eating or drinking six hours prior to the procedure
  • Be sure to have someone accompany you to the procedure. You will not be in any shape to drive home
  • Discussion of any lab work that will be required prior to your procedure
  • Arrive at the time instructed

You will be given an instruction packet with more detailed information prior to your procedure. And as always, if you have any questions you can give us a call at (804) 828-2600 to talk with one of our providers. Conscious sedation is a safe and effective way to minimize pain and anxiety for our patients.

Image Guided Tendon Treatment for Tennis Elbow

Baird tennis elbow

“Excruciating.” That’s the word every active person uses to tell us about the pain of “runner’s heel” (plantar fasciitis), “tennis elbow” and other tendon injuries. That little twinge you felt on your daily jog or practicing your forehand has now become a knife-sharp sting in the exact same spot with every step or every swing you take, every day. It’s impossible to ignore the pain…and you shouldn’t. Tendon injuries need attention. Sometimes, rest, therapy and a change in activities may ease the pain…but often the damage is permanent, and only gets worse.

Until now. Using precision ultrasound imaging guidance and a minimally invasive treatment, we can delicately remove the damaged tendon tissue and get you back to the activities you love in a matter of weeks – with little to no pain.

We’ve talked several times about image guided tendon treatment for plantar fasciitis, but what about tennis elbow? We spoke with Dr. Jeffrey Elbich about the difference in the procedure.

Q. Tell us about the difference in the image guided tendon treatment procedure on the elbow vs. on the heel?

A. The procedure is quite similar; patient positioning is essentially upright in a chair as opposed to lying down. It seems to be a less sensitive area compared with plantar work, but I still give IV medicine (moderate sedation) to maximize comfort. The  procedure time a slight bit quicker because it’s usually smaller treatment zone.

Q. How big is the incision and where is it?

A. The incision is approximately 2-3mm over the lateral (outside) elbow.

Q. What’s the recovery time?

A. For the outpatient procedure, there will be some post-procedural discomfort and swelling expected for a few days, you’ll have some lifting restrictions for about 2 weeks. A patient can expect pain relief an average of 1-2 months after the procedure.

Q. What has the patient reaction been afterward?

A. We’ve had good results with the elbow treatment ~90% success.

Q. What does your ideal patient for this type of treatment look like?

 A. Any individual that has had pain localized to specific location on elbow (lateral epicondyle), going on for more than four months, despite conservative measures and at home remedies. An office visit will confirm the pain location, as well as ultrasound to see if there is targetable tissue.

The treatment requires only a local anesthetic and a tiny incision, and is virtually pain-free. We use a targeted application of ultrasound energy to break down the damaged tendon tissue while leaving surrounding healthy tissue untouched.

Is image-guided treatment right for me?

If you answer yes to these questions, it may be time to discuss our image-guided tendon treatment.

  • Have you given up any activities due to tendon pain?
  • Have you been suffering for three months or longer?
  • Have you taken multiple steps to get rid of your pain without lasting success?
  • Are you tired of masking the pain or enduring it rather than treating it at the source?

Call us at (804) 828-2600 to discuss whether image-guided treatment is the right option for you.