Our Services – Gastric Tube Changes

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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.

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.

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.

How we can help with your overall health

Baird overall health

There are 60,000 miles of blood vessels in the body.
Pointing us toward a lot of answers.

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.

Because of our advanced diagnostic imaging capabilities and convenient location, many physicians refer patients to see us for outpatient evaluations and preparation for various surgical procedures that must be conducted in the hospital, as well as for follow-up examinations. Seeing us as an outpatient saves you many trips to the hospital – and leads to a shorter hospital stay.

Whether you’re referred to us by your doctor or want to talk with us directly about your concerns and needs, our physicians are always available for consultation appointments to listen, learn and talk about your condition and what we can do to help. Open and clear communication with your doctor and you is a crucial aspect of providing proper treatment and care. We work as a team.

Before your appointment, take a few steps in advance to make sure we have the best background information. During your consultation, we’ll talk through your concerns, review your medical history and make an assessment of your current situation. Once we make our diagnosis, we discuss different options to develop a treatment plan tailored to your individual needs. We make sure you understand every aspect of your care.

Our capabilities also allow us to handle the primary treatment of a number of other conditions that once often required prolonged hospitalizations. Today, our image-guided expertise makes possible primarily outpatient care of these conditions. Depending on the condition, certain procedures are handled at the hospital; in other cases, however, these conditions can now be handled completely on an outpatient basis – without a single hospital visit.

Making an appointment at the VCU Health at Baird Vascular Institute is quick and easy. We try to accommodate patients and referring physicians as efficiently as possible.

To schedule an appointment call (804) 828-2600 to speak to one of our scheduling associates, or send us an email.

Why now is the perfect time to get rid of your spider & varicose veins

baird fall leg vein treatment

Most people start to think about their spider or varicose veins right about the late springtime when the weather gets warm and they go to put on shorts for the first time of the year. That’s a natural reaction, but truthfully – right now – in the fall, is the very best time to have a procedure done on your leg veins.

We talked to Dr. Malcolm Sydnor about why you should consider having your leg veins treated now, instead of in the spring. “if you have spider or reticular veins on your legs, we will use a tiny needle in a process called sclerotherapy to inject those things to get rid of them.” Sclerotherapy involves using a tiny needle to inject individual spider veins with a solution that makes them shrink. As they shrink, blood is channeled to deeper veins, making the spider veins on the surface almost invisible. “Afterward,” he continued, “we are going to need you to stay out of the sun until those veins have totally resolved – otherwise you’re going to see pigmentation changes on the skin where those veins were.”

Dr. Sydnor continued, “If the sun hits those locations before they fully resolve, the blood cells that remain will release a pigment that you can see on your skin. It’s because of that reason that we like to perform the vast majority of cosmetic treatments retail for spider veins in the fall.”

“Other treatments such as endovenous thermal ablation, are not as affected by sun exposure because the vein is much farther under the skin,” he continued. Endovenous thermal ablation (EVTA) is an alternative to surgically removing varicose veins. The team uses ultrasound to guide a small catheter tipped with a laser or radio frequency emitter into the vein. The catheter delivers just enough laser or radio wave heat to cause the vein to close, collapse and seal shut, without affecting nearby tissue. The treated vein is absorbed by the body and disappears within a few months. EVTA not only treats your large varicose veins, but also eliminates many smaller unsightly ones.

Although we welcome patients any time of the year, ideally our physicians recommend a fall time frame so that the legs have plenty of time to heal before exposure to the warm summer sun.

Call us at (804) 828-2600 to discuss your options. You may decide that beautiful legs are worth it.

Who are the best candidates for image guided tendon treatment?

baird image.guided candidate

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.

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.

We talked to Dr. Jeffrey Elbich, who said, “The majority of the time, tendon pain goes away on its own with time, rest and ice – and reducing the activities that brought the pain in the first place. However, if the pain lasts more than 3 months, medical research suggests that it is unlikely to go away on its own.”

“If you’ve had pain more than 3 months and you’ve tried all the home remedies with no relief, you may be a good candidate for image guided tendon treatment,” continued Dr. Elbich.

If you’re frustrated with chronic tendon pain or have tried multiple treatment options, our image-guided tendon treatment – also called percutaneous tenotomy or fasciotomy – could be the treatment you need for rapid pain relief. 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.

You may be asking if image-guided treatment is right for you.

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.