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Robotic
Surgery in Gynecology |
 Laparoscopy
has altered gynecologic surgery for the better and
opened the door for many new technologic
advances. It has been shown that
minimally invasive surgical techniques through
laparoscopy allow for a faster recovery, shorter
hospitalization stay, decreased blood loss as well
as significantly less postoperative pain when
compared to traditional abdominal surgery.
In gynecology, laparoscopy has become a
valuable tool for performing multiple surgeries
including: hysterectomy, ovarian surgery,
myomectomy (uterine fibroid removal),
endometriosis, and pelvic floor procedures for
vaginal prolapse. It has additionally become
an adjunct for many surgeries in reproductive
endocrinology and infertility as well as in
gynecologic oncology. However, while
laparoscopy has revolutionized gynecologic
surgery, there are several limitations which
include restraints with instrument motion or
dexterity as well as the use of 2 dimensional
visualization. In an attempt to address some
of these limitations, the da Vinci robotic
surgical system was approved in 2005 by the Food
and Drug Administration.
The
da Vinci robotic system is comprised of three
components. The first component is the
surgeon's console which is located near the
patient bedside. The surgeon is seated at
the console and controls the robot assisted tools
which include the camera and all surgical
instruments. The second component is the
called the patient-side robot. The surgical
instruments are attached to the patient side-robot
which are then placed carefully within the
operative field. Third, the vision cart
allows for 3-dimensional imaging. Finally, a
surgical assistant is at the patient's side
throughout the procedure for additional
aid. In order for all components of
the da Vinci robotic system to orchestrate, a
well-trained surgical team is
required.
As with any surgical
advancement and technique, it is crucial to
balance available technology with its indications
for use and potential advantages. The da
Vinci robotic system offers instruments which have
full dexterity and range of motion. As a
result, the robotic instruments are advantageous
for delicate tissue manipulation and surgical
dissection. This may be of particular use in
patients who have had scarring from multiple
previous surgeries, endometriosis, malignancy,
uterine fibroids or similar situations. This
potentially would allow for a laparoscopic surgery
which in any other circumstance would require an
open laparotomy and large abdominal
incision. As mentioned previously, the
3 dimensional visualization and the ability to
quickly zoom into small areas allows for precise
tissue manipulation in challenging surgical
spaces.
From the surgeon's
perspective, the da Vinci robotic system also
allows the operator to sit comfortably at a
console. This helps to avoid physician
fatigue due to standing for long hours in
uncomfortable positions. Furthermore, the
capabilities of the robotic system are astounding
with regards to medical communication and
teaching! The robotic system allows for imaging,
such as a recent CT scan or MRI, to be seen on the
surgeon's console. This may be helpful when
trying to precisely locate an abnormal
finding. Additionally, the system
allows specialists who are long distances away
from the actual surgery to watch the procedure and
communicate with the operating surgeon throughout.
This aids in providing up-to-date techniques and
improved patient care.
As with any
technology, there are advantages and
disadvantages. One of the largest
disadvantages of robotic surgery is the added time
needed to set up the system. As mentioned
previously, this requires a specialized robotic
surgical team. Additionally, the technology
is expensive and not available in all hospital
facilities. As the technology advances, further
refinements in surgical instruments, operational
systems, and timing will become available.
This will result in even less invasive surgical
options and improved patient outcomes.
It is important that patients
consult with their physician regarding the best
surgical method to deal with their medical
concerns. While laparoscopic robotic surgery
has many advantages, it may not be the most
appropriate surgical option for everyone. However,
one thing is for sure.....robotic surgery is here
to stay!
- Rachel Spieldoch,
MD
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Insurance:
HSA or HRA ? |
 Ok...back
to those acronyms...HSA or HRA. Let's start by
defining each of
them.
HSA
is a Health Savings Account which is paired with a
qualifying high dollar deductible insurance plan,
either employee or employer can contribute to the
HSA and any monies left in at the end of the year
stay in the account and earn
interest.
HSA's
are portable, meaning that if you leave an
employer you can take it with you and continue to
fund.
Anyone can have an HSA, whether you
are employed by someone or
self-employed.
HRA
is a Health Reimbursement Account this type of
account can only be funded by the employer and any
monies left in at the end of the year go back to
the employer. HRA's are not portable and remain
with the employer if an employee
leaves.
As
you can see the big difference in these two types
of Accounts is
control.
HSA's
allow you to pay for co-pays, co-insurances and a
large variety of non covered services as well as
over the counter medications and/or
supplies. You can usually fund these plans
to a maximum of two times the deductible amount,
which will vary depending on your deductible and
whether or not it is single or family
coverage. HSA's are a trust of sorts
and you will receive interest on the monies in the
account as well as receiving a list of
services that you can utilize through the bank
that holds the HSA, such as Stock & Mutual
Fund options. The monies remain in an
interest bearing account until you use
them.
HRA's
allow to pay for medical expenses not covered in
another manner. This type of fund is set up for
each employee through the employer and all
monies are contributed by the employer and at the
end of the year all monies remaining in the
account go back to the
employer.
As
you can see the HSA's have a great advantage over
the HRA's and as more people realize the potential
for the HSA's, HRA's will become
obsolete.
If
you think that an HSA maybe the right product for
you, please make sure that you check with your
accountant for all possible tax
implications. |
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Skintique
MD
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 Hi
from Lori at Skintique MD- Dr. Wilson and
Associates very own skin care dept!
I
wanted to thank those of you who have recently
come to us from the newsletter! It was such a
pleasure meeting you, and introducing you to what
we offer at Dr. Wilson's skin care dept. Since
summer is right around the corner I wanted to talk
about sun-damage. Living in beautiful Arizona we
are all susceptible to the sun's rays; however the
after effects are not always welcome. Dark spots
(known as hyperpigmentation) and broken
capillaries are just some of these unwanted
visitors that hang around after summer has gone.
The most effective defense we have against these
rays is Sun Screen, at least a 15 SPF on a daily
basis. However, the damage we now see is from
summers past, and although SPF will help prevent
further damage, it will not lessen the effects we
see today.
Some of you may have heard of
the IPL or Photo Facial. This is a treatment
designed to specifically target and eliminate sun
damage. It works on reducing the
hyperpigmentation, broken capillaries, rosacea and
also helps to stimulate collagen beneath the
surface, re-building the fibroblasts and creating
stronger skin. When done in a series this offers
the most amazing results in overall skin texture
and tone. Some clients are so happy with the
initial results they stop at one, but most prefer
to see continuous improvement within 3-4
treatments.
If you would like to try this
treatment, or find out more about it I encourage
you to have a free consultation, or book a
consultation along with an IPL treatment. During
the consultation I will determine your eligibility
for this procedure ensuring you will receive the
best results and that you and I will be able to
reach your skin care goals. I want to offer this
treatment to our newsletter readers for the price
of $150.00 for your initial treatment (normally
$200.00 per treatment). This offer will be valid
through the end of March (so even if I am booked
up this price will be honored as long as you call
before March 31st). I look forward to meeting you
or welcoming back the clients I have already had
the pleasure of meeting!
Please feel free
to call if you have any questions, or to set up
your consultation at (480) 860-4791 or (480)
860-9383.
I am excited to share with you
the success of our first Laser Hair Removal Party
that we held 4 weeks ago in our office for Karen
Brey and friends! The next newsletter will have
pictures and a re-cap of the party, as well as our
Open House and Peel Party that we held on Feb.
11th. We are also in the process of launching our
new skin care line MyChelle Dermaceutics with a
special event, which will be announced in our next
newsletter. Please look at the Skintique display
in Dr. Wilson's office for details regarding the
time and date the next time you visit.
Take
care and stay as beautiful as you are-inside and
out!
NEW SPA HOURS- 1ST SATURDAY OF EACH
MONTH- CALL FOR A WEEKEND APPOINTMENT WITH
LORI
Lori Gordon from Skintique MD -
located right around from Dr. Wilson &
Associates main office at 10752 N. 89th Place
#102, Scottsdale AZ
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Nurse
Practitioner |
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What
is a Nurse Practitioner?
NPs are
advance practice nurses who provide high-quality
healthcare services similar to those of a
doctor. They practice in a variety of
settings and are licensed and independent.
NPs practice autonomously and in collaboration
with health care professionals, including
physicians. This autonomy requires a high
level of accountability for health care
outcomes. NPs are Registered Nurses who
return to school to obtain additional education
and medical training that prepare them to diagnose
and treat a wide range of health problems.
In addition to clinical care, NPs also focus on
health promotion, disease preventions, health
education and counseling. They help patients
make wise health and lifestyle choices.
While many of our patients have been
seeing a nurse practitioner in our office
for years, those new to the practice may be
given an option to see a provider of their
choice. One of those choices is a Nurse
Practitioner.
Peggy
DeCarolis received both her baccalaureate and
masters of Science degree at ASU and is Nationally
Certified as a Woman's Health Care Nurse
Practitioner. Peggy has been involved in women's
health for 27 years. Prior to becoming an
NP, Peggy's career experience included Intensive
Care, Trauma, High Risk Obstetrics, and
Gynecology. She joined Dr. Wilson's practice in
1999.
Barbara Higgins is a Certified
Nurse Practitioner in Women's Health. Her job as a
Nurse Practitioner is the culmination of a rich
and rewarding career in Nursing. She has practiced
as an Advanced Practice Nurse since 1983. Most of
her advanced practice was as a Clinical Nurse
Specialist in Oncology. She previously worked in
university and community settings, specializing in
the care of women with breast and gynecological
cancers. She has been with the office since
2005.
Paula Mazzacano has been
involved in women's health for over 10 years. She
graduated with her Master in Science Degree and
became a Woman's Health Care Nurse Practitioner in
1999. She is skilled in many areas of gynecology,
such as hormone replacement therapy, contraceptive
management, breast exams, ultrasounds, and
colposcopy. She also has particular expertise in
the area of endocrinology and
infertility.
Robin Parry is a
Certified Family Nurse Practitioner. She
received both her baccalaureate and masters degree
from Arizona State University. Robin has
many years experience in women's health as labor
and delivery nurse. Her experience includes
general gynecologic examinations, menopausal
hormone evaluation and pellet management, and
colposcopic evaluation of abnormal pap
smears. She particularly enjoys gynecology
and focused her educational research on the
adolescent population. Robin joined the
practice in
2006.
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Hoof
Prints 2009
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You
are invited to the first annual Luv Shack Ranch
Fundraiser!
 We
are honoring Deborah Wilson MD, Director, Feathers
Foundation and Circle L Ranch for her work with
rescuing animals marked for euthanazia or
slaughter and finding them loving homes or
providing permanent sanctuary for the
un-adoptable.
March
26th, 7:00pm to 9:00pm
Ruby's
House at the Phoenix Zoo
455 North Galvin
Parkway
Phoenix, AZ
85008
click
here to view the full event
flyer |
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Testimonials:
Timed
Release Balance Hormone
Pellets |
The
following is a sampling of comments made by our
patients about the Balance Timed Release Hormone
Pellets. At this office, we offer bioidentical
estradiol and testosterone pellets.
For more information, please log
onto http://www.drwilsonobgyn.com/hormone_therapy/index.html
"Menopause
was so hard. I had hot flashes, night sweats, and
the rest of the typical menopausal symptoms for a
year. But the worst thing for me was the sense of
impending doom that I carried with me everywhere I
went, no matter what I did. The pellets took that
away immediately! I feel like a huge weight has
been lifted, and the other symptoms are gone too!"
- MJ
"I
got married at age 47. My husband and I had a
great sexual relationship for about a year, and
then my periods stopped and I lost all interest in
sex. I was depressed, not sleeping, and generally
moody and sensitive. I tried a few types of
hormones, but when I finally discovered the
pellets, I felt like a new woman! My sex drive is
back and I feel great." -
BB
"Nothing
works as well as the pellets. Nothing. I was hit
hard with menopause at age 44 and this is the
only treatment that really took away the
symptoms." - RW
"I
have been recieving the pellets for 3 years. I
don't know what I would do without them. Last year
I moved to California, but I still fly in for the
pellets because I can't find any doctors who offer
pellets in my little town. The pellets are worth
the trip." -
PK
"Menopause
made me feel like I had hit a brick wall. I was
only 45, but I had no energy, no motivation,
and no sex drive. I can say honestly that with the
pellets I feel normal again. I had tried pills,
creams, and patches in the past, but nothing else
worked. I am very grateful that my Nurse
Practitioner suggested them." -
DL
"I
have a high-powered job and when I turned 50, I
could not sleep anymore, had hot flashes, night
sweats, and terrible mood swings. Worst of all, I
couldn't remember anything and my mind was not as
sharp. I had a hysterectomy 5 years ago, so I
wasn't sure this was menopause. My doctor
reassured me that this was menopause, and
suggested the pellets. I can honestly say that I
feel normal again. My thinking is clear, my memory
improved, and my moods steady." -
MG
"I
got the pellets and felt great, but I started to
bleed. It turned out that I had fibroids. I tried
going off of the pellets because I hated the
bleeding, but I felt terrible. Finally, my doctor
told me that I needed to choose between my pellets
and my uterus. That choice was easy. I had a
laparoscopic hysterectomy, got my pellets, and I
feel better than ever." -
RT
"When
my periods stopped at age 51, I changed. I gained
weight, felt despondent, could not make myself get
up in the morning, and could not get excited about
anything. I hated my body, but could not motivate
myself to exercise. A friend of mine suggested
hormone pellets, and I made an appointment. I have
been using pellets for a year now. I have lost all
of my weight, I am exercising daily and happily,
and I have a new boyfriend!" -
NB
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Consider
Adopting or Fostering |
Looking
for a pair of friends? Hiking buddies? Dogs to
curl up at your feet? Companions for your
children?
These
2 dogs would like to volunteer for
duty!
The
dalmatian is about 6 years old, neutered, and
extremely friendly. His buddy the shepherd mix is
a sweet 3 year old
female
Both
dogs are mellow, cooperative, and housebroken.
Please consider fostering or adopting these dogs.
They were saved from euthanasia at the 11th hour
at Maricopa County Animal Care and
Control.
Please
contact Susan Hopkins at 480-861-8144 or e-mail at
susanhopkins@cox.net to foster
or adopt. If you are interested in fostering,
Circle L will include the dogs in adoption events
and we will list on
line. |
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Volunteer
for Adoption Events |
Volunteers
are needed for PACC 911 adoption events and
Petsmart adoption Sundays around the valley.
Circle L Ranch saves dogs and cats from euthanasia
at Maricopa County Animal Care and Control. We
find homes for these animals through adoption days
at Petsmart and Petco as well as more formal
adoption events through PACC 911. We have events
over the next few weekends in Fountain Hills,
Greyhawk, and Mesa. Log onto http://www.pacc911.org/Adopt-A-Thons.html
for more information. We also need volunteers
every Sunday at Petsmart locations around the
valley. Volunteering at these events involves
walking dogs, talking to potential adopters, and
generally caring for the dogs at the adoption
event. It is fun
and very
satisfying.
  
MAKE
A DIFFERENCE FOR A NEEDY
ANIMAL
Participate
in an adoption event
E-mail Karen Duran at circlemountainrescue@gmail.com
for more information or to sign up to help.
Dogs
and cats are listed for adoption at www.circlemountainrescue.org
Please
adopt a needy pet- Don't buy from a
breeder. |
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Second
Home Pet Resort |
If
you need to board your pet, consider the Second
Home Pet Resort at 7th Ave and Thunderbird. The
resort is brand new and has been built with your
pet's comfort in mind. Many little extra features
are included such as large yards for pets to
exercise, a shallow pool for romping, webcams
for pet viewing, and much more.
Main
entrance
Shallow
Pool
Second
Home also offers doggy day care for those pets who
can't be left at home, grooming facilities, and a
cute little boutique.
The
Elite Suite
 The
pet resort is rescue friendly and has been
boarding one of our foster dogs for us free of
charge. Daytona is a small rottweiler who has a
fractured pelvis and needs cage rest. She has been
treated like a queen while at Second Home Pet
Resort! We are very appreciative of their
willingness to help with Daytona's recovery.
Second
Home plans on housing cats and dogs for adoption
to the public in addition
to boarding. They have included
condos for homeless cats that are multi-level
areas with little touches like "hiding places" and
tunnels- a cat palace! For homeless dogs, the
cages are large and comfortable.
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We
thank you for reading.
Dr.
Deborah Wilson
Dr. Rachel Spieldoch
Dr.
Debra
Wickman
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