neither the el paso medical society its members nor pbs el paso shall be responsible for the views opinions or facts expressed by the panelists on this television program please consult your doctor [Music] in order to prevent the spread of the virus we all need to do our part one of the easiest ways to prevent that is by wearing a mask in order for a mask to do its job it needs to cover your nose your mouth and your chin first you should wash your hands with either sanitizer or soap and water before putting on a mask then pick up your mask by one of the ear loops to make sure that there's no tears or stains on the mask if it is dirty throw it away immediately if it's intact take both loops and put it over your ears like this and then press down on the bridge of the nose to make sure that it fits and there are no uh gaps once you're done with the mask please take it off the same way both ear loops pull it away and put it either in a ziploc bag or throw it away if it's a surgical mask if it's a cloth mask make sure to wash it with soap and water and keep it dry for the next use do not put your mask down at your chin or above on your forehead when you're starting to remove it as that just contaminates the mask thank you so much for doing your part to prevent the spread throughout the scene one in four people die of heart disease in the united states those numbers are pre-coveted but we are here today to let you know that if you are having some kind of a cardiac situation that you absolutely should indeed go to the hospital even in this time of covid it's very very important we are also here today to make sure that you know how to take care of yourself at home as well the title of the show is called advance heart care at home during the next hour we have experts answering your questions about advanced treatment and heart disease including detection intervention and beyond as you know this is a live show so if you have any questions ask us this evening call us at 880-1313 this evening's program is underwritten by the hospitals of providence and we also want to thank the texas tech pauliel foster school of medicine for providing medical students to man our phones today with us we have myra perkins who is helping us out with the phones and do give her a ring which she does as she interprets what you are asking writes it down and texts the questions over my way so she's competent and wonderful about that i also want to say thank you very much to the el paso county medical society who has been bringing this show to you for 23 years good evening i'm catherine berg and you are watching the el paso physician thanks again for joining us we have two experts here today and uh there's a lot that we're going to be talking about specifically in the world of cardiology we have an interventional cardiologist and that's dr edward aussie thank you for coming here and this is his third time here but i feel like it's your 20th time here you know he's really good about explaining things so again if there's questions you have give us a call at 880-1313 we also have rob anderson with us who is the ceo of hospitals of providence at the sierra campus and rob is going to talk to us about policies procedures a little bit but also the ranking of what's going on with certain uh heart care and we this is your first time here so you're the rookie it is pleasure to be here well i'm i'm glad that you're here very glad that you're here um i'm going to start off with dr aussie and dr aussie we have we have a heart and i'd actually you know what i'm going to do interventional quality let's do that the second question so let's talk about when i said cardiologists i had that on my paper and i said oh yeah remember interventional cardiology explain what does that mean versus just cardiologists well whether you're an interventional cardiologist or not we basically do a whole gamut of things but being interventional i am a cardiologist who has to go to the emergency room take care of someone coming in with a heart attack to be able to take them to our heart lab where in our heart lab we use balloons and stents to open up clogged heart arteries that basically that and there's many other facets now that have become interventional cardiology such as dealing with structural heart disease which we'll touch on today as an interventional cardiologist we are all partaking in that aspect of cardiology but on a day-to-day basis i'm also seeing patients in my office taking care of you know general heart complaints not always just the patient having a heart attack exactly and i love and i don't know if uh some of the audience can see what you we have all kinds of toys today and i'm super excited uh dr aussie came with this this beautiful thing in a big box he's like should i take this out or would it be scary and i'm like we're all about showing what this is about so i thank you wholeheartedly for that rob as you uh so you're talking about you've been here nine years now and i thought it was longer too um when we are looking at the sierra campus of hospitals of providence what do you do all day every day and i would love for you to kind of integrate what it used to be like prior to like february of last year and kind of what it's been like over the last 12 months so kind of talk about before and then just oh my goodness over the last 12 months yeah absolutely and again i'm you know excited to be here first of all i want to say thank you to all the healthcare providers and the frontline workers it's been it's been a tremendous struggle in 2020 um in 2021 i think started off kind of rough um but again a sincere thank you to everybody it's been tough for everybody whether it's a it's a evs it's a nurse um it's those individuals working in restaurants um it's been tough so thank you to everybody but as a ceo you know my my main goal is to really focus on you know the patient satisfaction physician satisfaction and patient care and it's overseeing all of that at sierra campus we have about 435 employees that includes nurses first assist or techs evs are our you know food workers too so you know my job is really oversee all of that but let the nurses let the physicians such as dr ossie do what they do best you know take care of those patients um during covid um you know again my hat's off to all the hospital systems here um i think we we work really good together to you know function is one a function is an el paso community to uh you know ensure icu bed capacity ensure beds are available ensure we had nurses ensure we had ppe and so you know during 2020 i think most folks were focused on on you know the cobit safety for patients safety for staff and just getting us through this pandemic and i do want to uh since we're talking about covid and i'm going to do this several times throughout the program um vaccines and i and i have to give a shout out to hospitals of providence uh we had nico on several months ago and it's just el paso is just rocking it when it comes to the dissemination of vaccines now i get that there's frustration because there's not enough vaccines to disseminate right but once we really start getting the vaccines the way that it's been put together is great and everyone that i've spoken to that has been able to get their vaccine just because of their you know what position they are online so to speak it's been a smooth process and that's due to el paso that's due to the hospital systems all working together it's due to the county it's due to the city on that note though if you have not registered for your vaccine yet here are two ways you can do it you can do one online and it's actually easier than you might think so the website is ep just el paso the website's ep covid vaccine dot com ep covidvacine.com on the opening page there is a top button that says register for the vaccine it says it right there right when you get to this website so it's nice and easy easy to find if you are a person who'd rather telephone the telephone number is 915 it's on your screen i want to say thank you to gracie for putting that up there so again the telephone number two one two one zero three two we're gonna flash that up several times uh throughout the show and you know when it comes your turn definitely get the vaccine again that hurt humidity or herd humidity herd immunity immunity thank you very much sir um everybody watches the show no i misspeak all the time um dr ossie i want to talk about just heart complications just for a second just to touch base on heart complications when it comes to covid i know it's not really on here but some of the complications that we are hearing at least in the very beginning one of the first ones we're hearing are what uh different complications can happen to the heart with people who have had covid you know then there's the long haulers too let's touch base on that i don't want to focus too much on that sure but what you're what you're seeing or experiencing or reading yeah i mean we have seen patients come in with covid and they develop basically they can develop a heart attack they can develop shock from a condition called myocarditis which is inflammation of the heart muscle where the heart muscle stops working as efficiently as it should and those are you know covet is an inflammatory state right so the immune right the vessels in the heart become inflamed the heart muscle can become inflamed and those conditions can create a dire situation for a patient yeah i think i think one thing that that you know dr aussie you know kind of touched on the challenge we've had during during the cold pandemic is individuals did not seek emergency care right and so they felt chest pain they thought oh it's okay i'm more worried about getting covered than i am you know making sure i'm all right so across the market across you know nationally including el paso our burns room visits down uh 20 the first quarter and then year over year down 42 for most room visits right and so you know a lot of that time um it was it was you know heart pain it was chest pain that they just thought it's okay i'm not going to seek you know care and the challenge we had is that they come in later on right and their disease is is more severe than it was and poses a challenge for the patient and for the physician so i i love that you're bringing that up on that note uh so bottom line is if you're having a cardiac situation and you would or if it wasn't coveted time if you would call the hospital called the ambulance still do that because there is no safer place right now for you to go then to the hospital all the protocols are in place and on that note i'd like for you to talk about what protocols you have in place like if someone's going into the emergency room if you can maybe walk us through what what they're going to be seeing who's you know what are they checking etc just to make people feel comfortable that they can't do that yeah you know again it is a challenging time right and i think everybody is coming through the emergency room is going to be screened they're going to be screaming for the temperature um you know asking the questions have you had covid have you been around covid do you have symptoms um that's the front line right and and you know i'm going to encourage people to be honest with us you know with the screeners that if you've got those issues say yes i do have those symptoms and then if they are coveted they're going to be sent on a separate pathway than those that are non-coveted okay um so they will go the emergency room they'll be treated they're it's dividers that's up um the ventilation is proper so the safety precautions are there everybody has ppe everybody's covered um and so you know you're right that you know i feel that the hospitals are more safer now than they were two years ago just because of these extra precautions that we put in place and so you know for individuals especially in the emergency room that are having these emergencies you need to call 1-9-1-1 right exactly the e-ms are following that same two or if you can drive yourself an emergency room but you'll be safe there yeah you know it's okay to go and i think you know our challenge from the hospital side is getting the education out that it is safe to be at a hospital and if you you know if you're having symptoms please come in please come in please come in and it's again that is a place that has it down absolutely has it down employees are screened i just want to say that out loud too employees are screened all the time so if they're thinking what is somebody that works at the hospital's got it they're around it all the time it's definitely the place i mean the employees are screened on a daily basis right and we have two different shifts employees come in and they're screened all the time um you know it doesn't get a little redundant it does but it's the right thing to do it's the right thing to do for the patients and so you know we're wearing masks we're wearing gowns we're wearing you know face masks and you know shields when appropriate too so the hospital is a safe place to be um and again if you know if you're having those issues you need to come to the hospital absolutely i'm so glad that we talked about that um now dr aussie it's time to break out the toys so we're talking about cardiology we're talking about the heart and we're talking about structural heart issues today you've got a great model of the heart and what i'd like for you to do is point at this camera here and just i know it seems like you know cardiology 101 to you but it's nice for the people at home to see what we're looking at and talking about this evening of course so of course everyone focuses when we talk about the heart about having a heart attack and and that is related to these red pipes that lay on top the red arteries are the ones that become clogged with cholesterol and can develop uh into a heart attack but in addition to that there's multiple other areas of the heart that have um that as we've had an increase in interest in and basically when you start opening up the heart and start looking at the chambers within the heart there's four major chambers the two upper chambers are the atrium and the atrium basically pump blood down into the two main ventricles the left ventricle and the right ventricle now the way i kind of look at this is blood has to travel through each of these chambers and in order to do that they have to get through these valves which i basically call one-way doors they open and they close in order to allow blood to circulate through the chambers of the heart go to the lungs and then come back down to the main pumping chamber that pumps blood through another door called the aortic valve which you can see right there goes up through the aorta this big pipe right here which then delivers blood to our brain and all of our organs and so not only now do we focus in on the heart arteries and heart attacks but we're starting to deal with structural problems with the heart when it comes to heart valve problems and take for instance the two most common heart valve problems that occur in adulthood are one that is related to the mitral valve and then the other one is related to the aortic valve which is this three cusp valve right up and here so um at this point you know we start to develop problems as we get into adulthood with these valves and these valves then can be treated through other ways other than the traditional way which has been open heart surgery right i mean and it's not that open-heart surgery has gone away we are still an avid surgical program we have a great surgical team and surgery is still an option and a good option for many patients but this new technology that we're using to treat heart valve problems has come about uh recently within the last 10 years and has progressed and grown exponentially right um you were talking about surgery you were talking about teams rob i'm going to throw your way for a second um sierra campus of hospitals of providence was recently named a heart care center tell us what that means so it's you know what it means to be accredited it's the american college of cardiology et cetera et cetera it's a big deal yeah and i'd love for the audience to understand when they're looking for credentials in different cardiology situations what that kind of stuff means yeah you know so the american cardiology is really it's the place to be right it's it's the place to know it's the experts it's the resource for anything cardiology and so one of their designations is the heart care center designation what that means is that a hospital hospital system is really they're dedicated to cardiology get you know dedicated to heart programs they have the outcomes they have the length of stay they have the education and they're treating patients in the right way and so really essentially what this is is there's their stamp of approval to say this program provides the best patient care what's what's good about the heart care program especially in el paso is we are one in uh 34 designated hospitals across the country oh my goodness that has this there's only five in texas and of course there's only one in el paso so this just shows the dedication of sierra campus or really what you know what we are and who we are and it's a true testament to the physicians the cardiologists our nursing staff and the dedication we have to el paso nice and it's all about the teams and and again we've been on shows before when we actually had three people we're social distance we're willing to do two but it's all about who does what in the teams and that team effort um let's talk about structural heart disease um i'm a mitral valve gal i you know i was one of those people that grew like four inches in a year and so structurally a lot of people that do that you know the soft tissues don't go along um but in general just some structural heart issues diseases i think diseases sometimes might be a misleading word but just some heart issues for me it's chronic but it's pretty benign at the end of the day you know we checked out all that out but talk about some some structural issues yeah i mean two of the most common structural issues that we're dealing with today is dealing with the aortic valve which is basically the main door that allows blood to exit the heart and go out go out the aorta that valve in adulthood is probably the most common valve condition that we deal with along with mitral valve disease those two are really the main valve issues that we see in adulthood aortic valve disease is one in which there is degeneration of the valve over time this valve that main valve takes i always say the max intensity stress it's the one that is basically getting beat on the most because that's the main pumping chamber of the heart is pushing blood out through that valve and then that valve starts to get inflamed get a little cholesterol build up on it and then in later life calcium deposits really take over and then prevent the valve from no longer opening so the door becomes very stiff and resistant and that is one of the main structural heart problems that we are dealing with in our day-to-day society today and with at the sierra campus there's structural disease that can occur to the mitral valve more commonly it causes the valve to leak right instead of becomes stiff right there's other potential problems that can occur with the heart such as a condition of atrial fibrillation where we are predisposed to stroke and there's a little pouch right here that's called the appendage that sits on this top chamber of the heart and this pouch houses the majority of thrombus or clot that causes stroke really okay show me that again because that that that makes me curious so here's the left atrium right which is the top chamber that delivers blood down to the bottom chamber gotcha this appendage has been there all our lives and it really has no real need for us at this point it has become a nuisance to us because that is the area that ninety percent of the time if you're going to form a clot from atrial fibrillation it's going to be housed in that little unit how nice that you know that though seriously you know that you can figure it out and find it there okay my apologies so we typically that's the mainstay the standard of care of treating people with atrial fibrillation to prevent clot is to put people on blood thinners but there's a small subset of patients that can't take blood thinners they have bleeding problems and so there's a structural technique that can be done to basically close off this appendage in order to prevent patients from having a stroke that can't take blood thinners right right so there's all facets of structural heart disease the one that we see most commonly and that has developed significantly over the last year and a half at the sierra campus is the treatment of aortic valve stenosis okay stenosis being that the valve no longer opens properly becomes stiff and it causes the patient to develop common symptoms that's exactly what's going to how does one know if they're having issues you know i mean that's uh for example some we have some shows that are like okay heart pain that isn't your heart is it pain is it losing your breath is it a combination of the other so you're talking about structural issues and let's just say it's someone who doesn't go to the doctor like they should every year yeah um what are some of the symptoms that we're looking at with what you're describing right here so the early symptoms which are if you opened up a textbook and you said well give me the classic symptoms of aortic valve stenosis or a stiffened heart valve the classic one is that someone's going to develop heart failure they're going to pass out or they're going to get chest pain called angina but those typical symptoms those classic symptoms are typically at the very end of the disease way before because when you start to develop aortic valve stenosis there's a very long period where the patient may not have any symptoms because the valve doesn't become stiff overnight right it's a long progressive uh occurrence so when they start developing symptoms the most common are going to be exertional shortness of breath so if i'm you know carrying the groceries in and i have to stop and rest because i'm getting short of breath that can be a very common symptom of aortic stenosis exertional fatigue and dizziness so you know i've had patients that have come into my office and they're taking the trash out they're climbing up their driveway right and they almost feel like they're about to pass out they have to lay down on the floor so that they don't pass out and those are some of the you know cardinal signs that this is a major valvular problem of the heart so listen to your body and again as we were talking about before rob um if there's an issue definitely call if you have a physician and hopefully most people do if you have a physician call your physician go get it checked out if not you know if you are feeling dizzy over and over again you know i call it lightheadedness you know my fam my family it's just we surf the wave but it's very very important to do that and and the question i have for dr aussie that i get quite often too and i know i've asked you before is you know is this is this hereditary are you are you born with some of these issues or is it as you get older which i know a majority of of you know heart disease problems are 65 and older um how does that flow and you know as my six-year-old should i be concerned about his heart or is it something that he's going to get over time yeah well so aortic valve disease the most common cause of it is what we call senile calcific disease meaning that as we get older you can become you develop calcium on your valve in fact when you get into your 80s it affects near ten percent of the population and you're in this valve condition aortic valve disease interesting okay yep and now there are genetic predisposing factors that can cause your valve to degenerate earlier such as a bicuspid aortic valve so as i had mentioned earlier the aortic valve has three cusps uh let me see if i can point that out a little bit closer so as you can see right in there there's three leaflets three cusps of the valve yep one two three so that is a normal tricuspid valve but there are patients that are born with what we call a bicuspid valve where there's only one uh slit between and only two cusps and that can predispose someone to the development of aortic stenosis at a very young age in fact before the age of 50 sometimes they develop enough calcium on the valve and that's a genetic condition that can be transmitted that can predispose you to aortic stenosis so i always like to ask on cardiology shows you know with oncology shows there's screenings screening screenings i know that there's not technically screenings for heart issues but if if there was something that if you decide to go the doctor let's just say you're one of those and shame on you if you go once every five years you really should go try to go once a year once every other year what are internists looking for to see for example risk factors let's throw risk factors in there as well what are internists looking for to say i think you may have something going on with the heart yeah well that's it's a great question and as we know there are certain risk factors that predispose you to heart disease and we know them as diabetes high cholesterol high blood pressure smoking family history of premature disease so when you start having those risk factors your risk of developing heart disease starts to go up so as the primary care physician sees them and sees all those risk factors it starts to make them more aware and heighten their awareness of everything and the interesting thing is the risk factors for the development of coronary artery disease the blocked heart arteries also are risk factors for the development of aortic stenosis right it's almost the same pathology early on but with valve disease it becomes more of calcium rather than cholesterol burden later in life so as the internal sees the patient and starts to hear about all their risk factors that should raise a red flag that maybe you should be evaluated by a cardiologist bingo the other thing that's extremely important is a good physical exam because a lot of internists great primary care physicians will listen to the patient hear a murmur which a murmur is no more than turbulence of blood flow i'm glad that you explained that a lot of people was like well i've got a heart murmur i've got a heart what does that mean yeah it's it's turbulence of blood flow take take your garden hose and kink it and it makes a funny noise exactly so as blood moves through a stiff valve it creates turbulence of blood flow and we hear a murmur you know you know catherine kind of kind of you take a step back on from the screening events you know during 2020 was it was very difficult for us to do screening events so the hospitals of providence um we do those matter of fact on february 27th we're doing that from 7 a.m at our specialty campus to provide those those you know the community and opportunity that if they're not seeing their internist they're not seeing any cardiologists you know to come in and get their heart checked right that's important you know this is um february is heart month right which is why we're here and it's really to educate everybody on the severity uh you know to get your heart checked it's a pretty important part of your body um and you know to go get it checked what can it so repeat what you just said because i think sometimes everything's worth repeating because there are some people who are watching the show that don't have a family doctor don't have an internist repeat again what they can do if they are experiencing anything that dr aussie was talking about yeah well i mean you know first of all if they're having severe challenges call 9-1-1 yeah you know and you know we have to do that um and if you're not seeing an internist or cardiologist to go get checked go get screened we're offering a free event on february 27th from 7 00 am i actually have a question about that yeah did npm at our specialty campus there we'll have your advertisings out there too because you need to go out you need to get checked for that we're putting out a lot of educational events just to bring awareness to the heart because it is such a critical piece and it is you know for the else for the el paso community it is a it's a situation that we need to make sure we proactively get in front of so we're not getting to the point where we're having to you know see dr ossie right you know to be in a cath lab as much as we like about dr aussie so i'm going to repeat this february 27th you have an event is it the hospitals of providence sierra campus but it's at our specialty campus okay um which is about 250 yards from sierra campus it's on murchison drive okay on murchison and what exactly is going to be going on are there going to be people out there checking you out there's going to be nurses and physicians doing uh ekgs doing blood pressure checks just doing some of those initial screenings to see if you are at risk excellent um and then if you are at risk and you don't have a primary care you don't have a cardiologist we'll provide you with a list of those so you go you know so you can go seek care nice and do you know what time it starts by changing 7 a.m 7 a.m till people stop coming correct i like that okay we're going to repeat that make sure we repeat that at the end of the show as well i'm starting to get questions in uh from the audience maria and guillermo thank you very much i love that you're giving me names way to go there myra um dr ossie what i'd like to do before we get into the questions because uh one of the things we really wanted to talk about today was transcoyonia about t-a-v-r so um there's this procedure and let's let's start the conversation on that because i know we have a lot of cool things to show people sure well tavr transcutaneous transcutaneous through the skin approach aortic valve replacement but it's actually not a replacement it's a it's kind of taken on a new name of implant so tabby transcutaneous aortic valve implant is a way to treat someone with severe aortic stenosis with symptoms without doing open heart surgery now again that's a beautiful thing yes yeah but again open heart surgery and what we call saver surgical aortic valve replacement is still a very viable procedure done really well by our surgeons here but we're finding that there are sometimes certain age groups that would benefit more from surgical or transcutaneous without going through open heart surgery and so what we've been able to do is especially our elderly population you know especially our patients that are in their 70s and 80s right that we know that open heart surgery would be a more difficult procedure for them we are taking those patients and evaluating them for this procedure and one thing i really want to emphasize is that this procedure tavr has opened up the doors for all of us to become colleagues once again so it doesn't matter that i'm in one group or and then the physician is another group or the surgeons who have always you know it well it's cardiology and then it's surgery and there's a line in between us we are now a multi-disciplinary team that we are all working together we all sit at a table to discuss these patients and what is going to be the best approach for the patient nice and and we do it in a uh very collegial atmosphere we talk about it and get approval my background is oncology so i think of tumor board right the old days is a tomb award everybody comes together they look at this particular case study what's the best thing to do so it's it's in essence that kind of a strategy absolutely and this is what what you know dr ossie's talking about is what the you know the hospital sierra campus brought to el paso two years ago um and we're the only campus only hospital that is has the capabilities and abilities to do this this tavr procedure and there's there's five implanting surgeons that are doing it and again like dr aussie said that's what's unique um and great about this is that all of these you know these these these cardiologists and surgeons are coming together to do this and again it's another procedure that we the sierra campus has brought to el paso because historically either one you didn't get it right or two you had to go to phoenix to dallas san antonio you know to travel to get those procedures it's not only you going it's your entire family so now we're bringing this to here to el paso so you can do that right so you have these other options to take care of yourself and you have your support system that's such a big deal every time you talk about trying to keep whatever your treatment is at home you've got your support system you've got your own home you navigate mentally mental issues are are really really big when you're trying to recover that's super helpful as well um dr ossie what i'd like to do i'd like to talk about the scary thing [Laughter] because because it was so great because uh so what does this we were talking about this is how we deploy the valve right is that how you're saying or deploy the so the to implant the valve implant deploy the valve now you were joking about the word deploy but yes but yes so again i'm going to have you hold this because otherwise you won't be able to see so i just want to show that this is basically a device that we use to implant the valve it it basically when when the patient when the patient is in the room and typically the patient is asleep we access the right groin in order to deliver this system so the valve actually sits down here down on the very end and is deployed and this is what the valve looks like just so we can kind of yep there's two types of valves there's that one valve and then there's this other type of valve and there's differences between the valve and most of the patients do well with either one but we access the artery the femoral artery through the right groin and we take a delivery system this up through the major pipe called the aorta right here and cross in through that valve in order to deploy the valve and so we use this mechanism here to allow us to pull that up so they can kind of see so there's a mechanism that you're operating yep there's a mechanism that we're operating and it typically is a two-man team so the surgeon and myself or we have another maybe a possibly another interventional cardiologist but we are working together to deploy the valve under fluoroscopy or x-ray so that we see how the valve is getting implanted and if we need to maybe recapture it or bring it we have those abilities to do that with these systems and so much less invasive you know so much less invasive meaning most patients will go home the following day you're kidding me no they're really they're being discharged typically the following day okay on that note um when the operation's finished surgery is finished they're now in recovery the following day what what are they feeling what are they um and it's different with every patient and i get it are you waiting for them to get up and walk around for a while are they what is it that allows them to go home does that make sense all the little stair steps that you need to get well we you know the biggest issue is we want to make sure that their groin is okay because as you can see this is not a small needle that goes in to the artery it is a little bit bigger hole so we have to make sure that the artery is in good shape for the patient to sit up and start walking around and once that looks good the following morning we are getting the patient up moving around and allowing them to uh ambulate so that we can see how they feel but most of the time patients once they start moving around they start to notice a big difference that's what i want you to talk about because there are so many people and and rob you hit the what is it the the hammer on the nail then the nail on the head the nail on the head i always say the wrong thing um when you were talking about waiting you know we're in the time of kobe right now people are like i can wait i can wait i can wait i have heard through several shows too that people wait too long and this is prior to kovac this is not even at the time of code again talk to people why it is that they shouldn't wait and how quickly in so many different procedures so you're your entire hospital ceo so we're talking about orthopedic issues we're talking about cardiology issues we're talking about everything why again should people not wait to go in this time yeah and i just think you know it's a safe environment because you know healthcare can't wait right healthcare shouldn't wait um yes you know cove has been you know been a big frustration for everybody but we've got great nurses um great infection prevention controls we got great surgeons that are here um and to seek medical care as soon as you can and and you know for this instance in this case you're there maybe a day and a half right you're there overnight in your home in your home um and so it it's essentially an in and out procedure um and you're back home to where you should be you know with your with your family and it it's still it's the right thing to do and it is still a safe place to be exactly um question here maria called earlier today i was talking about that so questions from the audience really quick we have maria that's asking where can people find a cardiologist to help them with problems in el paso and do they speak spanish um do you have a telephone number equipped in your head by any chance rob i didn't ask you this ahead of time um if not you can call the hospitals of providence search engine the hospitals of providence and telephone the main number and just ask for the cardiology department so yeah and you can go to our website the hospitals of providence.com and you can search for a physician search you can search for cardiologists within your zip code and then you can also search in there that speaks spanish there you go and then you'll have a list of all the you know cardiologists that speak spanish um and so it it's a good resource and you could access it that way nice and again the use the word the hospitals at providence.com correct um question here from guillermo and dr assi what is a watchman procedure for the heart i do and again disclaimer if we don't know the answer we don't know the answer we'll do the best that we can but watchmen procedure for the heart no actually it's a good question i mean because you're where a lot of people are talking about it but it actually alludes to what i was talking about before it's the occlusive device that closes off the appendage of the heart to prevent stroke it's like a little umbrella that goes into the pouch and is delivered again transcutaneously through the skin the skin i love that yeah okay and it's deployed the watchman device is a occlusive device that closes off the appendage to help reduce the chances of stroke from atrial fibrillation in patients who are really felt to be not a good candidate for blood thinners right and such as such as the of the tavr the watchmen is is the procedure that is only done at sierra campus there are a handful of interventional cardiologists electrophysiologists that have the capabilities and abilities to do watchmen and so for uh i think you said his name was guillermo you can do that at sierra campus and dr ossie can you know find you the proper you know surgeon that could do that excellent um dr aussie you touched base on stroke and really we haven't talked about stroke too much tonight and i think that that's so important too because again we're in covid stroke has some pretty specific telltale signs let's talk about what those are and again the questions always is do i draw myself to the hospital do i call 9-1-1 what is the golden hour when it comes to cardiac issues and let's talk a little bit about stroke if people think that they may be having a stroke and sometimes the person who's with you is the one that's realizing you're having a stroke yeah of course and and time is brain and time is hard so any time you start to feel symptoms of a stroke you lose your vision you're having garbled speech your speech is incoherent whoever's with you feels that your face is drooping part of your body you're having numbness or you can't move it you you can't wait and see if it gets better you have to go in or if you're having chest discomfort pressure going to the jog going down your arms you start to have those symptoms it's never wrong to go in it's always better to be safe than sorry and the longer you wait whether you're having a stroke or having a heart attack you're damaging more organ and if you're alone call 911 it's not worth trying to drive yourself no that's something i would like because i and thank you for throwing in because the second part was heart attack so again if people think they're having a heart attack that's what you're talking about the pressure the yes numbness the dizziness like you said vomit or feeling nauseous um that's all i can think of what am i missing shortness of breath there you go breaking out into a sweat nausea chest discomfort i mean all those are signs of a potential heart attack okay we are yes rob i i heard you stutter start well yeah i was going to say that i think it's important to that you know that the enemies understand and dr ossie i'll ask you that you're the expert of this of a stroke versus a heart attack right and so two different you know two different issues there sierra campus is the conference of stroke center so um what we found though and in you know 2020 we saw the emergency room business go down um so a lot of individuals that had strokes thought it's okay saying they did with the heart attack that i didn't want to go i didn't want to go into the you know see care and as you mentioned before need to call 9-1-1 you need to call 9-1-1 to get them into the closest stroke center um depending on where they live and so i you know again i think yeah individuals understand the difference between those two absolutely but each one of them you cannot wait yeah just come just come into the hospital uh got another question here from the audience from bernie bernie says wow 30 years ago way to go bernie bernie got a mechanical valve 30 years ago and he is wondering he's been listening to tavr uh can i come in and get tavr if i need a replacement so again 30 years ago we don't know a lot about him obviously you'd have to do but this is a great question thanks for asking that bernie so bernie if you have a mechanical heart valve let's say of your aortic valve you cannot get tavr put into a mechanical valve now if you let's say have a mechanical valve in the mitral position you can get tavr done on your aortic valve okay but you cannot put tavr into a mechanical valve okay now there are two types of surgical heart valves there's mechanical that require lifelong blood thinners like coumadin but there are also tissue valves and the tissue valves if they degenerate over time you can get what we call valve in valve where we take a tavr valve and put it inside the bioprosthetic tissue valve that the surgeon may have put in 10 to 15 years ago and now it's become degenerated okay so this is me asking we've talked a lot about the aortic valve um again i'm eventually maybe i'll have to get that replaced because i do have a lot of leakage in my valve my mitral valve um can tavr also be used for that valve because that that's more of a loose leaf type thing so it's a whole different situation right i mean that's so mine would be a valid technology is expanding okay i just need to hang on for a while yeah okay on that note um we kind of are at a 15-ish minute uh point before the show ends and i want to kind of stop these questions for a second and make sure that we've talked about everything that you want to talk about and rob i feel like you've done less of the talking because this is like heart.guy i you have your ipad i do you have a laundry list of things you want to talk about i hope so no i i you know that's the time to do it you know i think the most important part is just you know for for the individuals to you know encourage them to get education on their heart um and i mentioned before this is this is a heart month and and you can go to our website and you can look at those opportunities there um but this is all about the doctors this is the you know the surgeons and so you know for us is it's a safe it's a safe environment um and again not to reiterate and you know you need to come in if you're feeling struggles if you're feeling pain call 911 come the emergency room um and you know take care of yourself it's stress related right you know everybody's having the same challenges you've got your children at home because of school you're stressful because you're all being coordinated and you know you're all in one location it's tough for everybody so seek help talk to individuals but if you're feeling those symptoms and feeling pain please come to the hospital i as you're saying that educate yourself about the heart and i want to make sure that when we say that when you do that go to peer-reviewed sites so easy for us to say to go to a real site but googling uh dr google does not exist he's not a doctor at all but again you can talk about the hospitals at providence that's a great website though thank you very much for the show this evening i do a lot of my personal research on md vip we know that what is on there the articles that are put on there there are questions there's a lot of q a that you can do on there i don't know if either one of you might have a generic website that you use for medical questions mdvip is the one that i go to all the time in fact when i prepare for these shows i just go to frequently asked questions on whatever the issue is so feel free to put in cardiology heart aortic valve mitral valve and there's also really cool videos youtube be careful there too to see if there is and dot org versus a dot com behind the website that you're going to why is that important usually.org are uh organizations you know dot com is different because it's a different hospital side i think with the hospital province but that's very helpful too um when it comes to just research because there's stuff out there that isn't real find a real website go to a real hospital that information at a real hospital would be correct information yeah and i think more importantly it is is talk to your doctor yeah and don't be afraid to ask them questions so yeah absolutely and if you don't have a doctor i encourage you to get one um you know there's a lot of of your health systems and shooting including the hospital province they're using telemedicine too so you can have those you know telemedicine visits that you can still get your questions answered right you know the google helps the webmd helps but nothing beats talking to your physician to ask he or she the proper questions absolutely and if you don't have a physician um as you said in the in the old days i would say you know showing up the emergency room sometimes may not have been the best thing but like you said emergency rooms are pretty scarce these days so this is actually kind of a good time to do that and figure out who you can get for your doctor if you don't yet have a doctor dr aussie what would you like to talk about we have again we have all kinds of stuff maybe maybe you can show this to the audience sure and i don't know if the camera will pick that up but that's an actual one and we have brenda behind the cameras who's jumping around and giving me the time so little kudos there too so these are the two different types of heart valves that are most commonly uh implanted so i see look at the camera so you can see there we go perfect that's that's a better way of looking at it there we go so they both have uh they both are good valves i mean they both have advantages uh over the other in certain situations um but what i really want to emphasize is that the hospitals are safe i i think that that is so key because i cannot tell you how many times a day that if i feel like i need to admit a patient they are so scared to go in because of coping yeah but these disease processes [Music] whether it's coronary disease or valve disease is more likely to affect you than covet will these are life-threatening diseases i'm not asking for numbers because i you know i didn't ask you to prepare for that but in general because i've been hearing a lot and reading a lot that there are so many people that because they are waiting and not going to the hospitals that there have been quite a few deaths and or like you were saying earlier there's a point of not no return there's a point of really difficult return because people are not going to the hospitals because of covid so talk a little bit about some of those case studies that you may have seen during this year yeah we've seen a lot of it we've seen a lot of people that have delayed their care that they were afraid to go in because of covet and came in with a heart attack that probably could have been aborted and a lot more heart muscle could have been saved if they had not hesitated but the the fear is there and i appreciate the fear i mean we see it every day but the hospitals are safe they have done a tremendous job of taking care of our patients and i i can't emphasize that enough the other thing i want to point out again is the heart team approach our heart team approach is outstanding at sierra we have a great group of physicians that are our physicians that are our ultrasonographers that help us get through the procedure we have the interventionalists we have the surgeons and when when one patient comes in to be evaluated by me for this they're not just going to end up being cared for by me but a whole team of physicians right and staff and in any given surgery say a surgery that we're doing a a replacement here or an insertion or a deployment how many people are in the operating room at any given time 20 20 and see sometimes because lay people like me we have the surgical staff we have our cath lab staff we have our sonographer our echo technician our anesthesia team phenomenal at sierra medical center i mean kudos to everything that the the hospitals of providence have done to help bring us all together right by building the room that we needed and going through all the motions to get set up to do procedures like this i like that and that's a great transition to rob really quick and i know we're running a little bit out of time but building the room that's kind of where someone like you would come in it's okay what what do my docs need what does my team need how do i now talk to the funding department to get the room built uh talk a little bit about your uh your role in that yeah well i mean again you know and it's not just the heart room um but there's other operating rooms too that's gotta it's gotta be big enough to fit the equipment to fit the beds in there some move up and down you got c arms that cover it you got lights coming in out and too and so you have to be able to move around and i think most people don't realize that in these cases like this there are 20 individuals literally 20 individuals in that room so you've got to have enough size where people can move around right um you have to do that so a lot of that comes in um to planning um understanding new types of technologies that that you know we consistently invest in it's costly but it's the right thing to do for the patients right thing to do for el paso but you know as a hospital we have to ensure that all of this is set in place so when we you know do cases like this everybody's involved and it's successful exactly and people and i'm just going to say this out loud because you were talking about it's costly and when people think about medical care yes it's costly but there are my gosh every time we do this show it's like something else is on the horizon even with mitral valve you're saying well there's some there's new things happening but the thing is that also means there are things you have to buy you know the different types of screening the different kinds of things that you use and procedures and surgeries and that's so very important um and i'm just kind of saying el paso his my gosh in the years that i've been doing this program where we have come in the last 20 some odd years i want to uh again before we start winding down i want to talk again about getting the covid vaccine at least registering for it i'm 53 years old i have no underlying condition so i'm in group like 99. i get it but i'm registered and to me that gives me peace of mind because when my turn comes i am at least in the book so to speak the places to go i'm going to give you a phone number and a website the website to go to is e p think of el paso covid vaccine.com it's on your screen and again if you're not too comfortable with websites etc if you type in exactly as you see this here if you want to put www.epcobidvaccine.com the window will come up and it will have on there pre-register pre-register or register for your vaccine for the coveted vaccine it's it's front and center and just click on that and it just walks you through it it actually is because i don't pride myself on technology i just don't when i got on there i thought oh this is easy um telephone number nine one five two one two one zero three two again if you're out of the el paso area nine one five area code two one two one zero three two um if there's another thing you want to throw away we've got a good well we have a minute so never mind um i want to say thank you very much to mariah you did an awesome job tonight and i think that uh mariah is going to start something new for us so with all the medical students that come mariah are you in first year second year third year she's a first year so everybody that you talk to i like including the names i love that if the person on the line is okay with that and also i want to say again hospitals of providence thank you so much for underwriting the show and again each and every month we've got the el paso county medical society for bringing this show to you thank you for that and again wear your masks if you want to double up i think that's a good idea when you're in public it's help is on the way but we're not there yet that's so important everybody in the county medical society want me to make sure to say that we're still social distancing i know that we had super bowl and a lot of people were together try to stay alone if you can or only go out when you need to double up on your masks and stay safe thank you so much i'm katherine berg and this is the el paso physician i love this stretch thank you because sometimes because i don't know sometimes [Music] [Music] you