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Healthcare
In the
1960’s |
Healthcare
Today |
Average Length of Stay |
9 days or sometimes more than 2 weeks for those 65+ years of age |
5.2 days |
Average Length of Stay for all Births
OB/GYN’s on the Active Medical Staff include:
Dr. Beverly Alten
Dr. Mack Barnes
Dr. Jodie Benton
Dr. James Brock
Dr. Heather Christie
Dr. John Foster
Dr. Rupa Goolsby
Dr. William Johnson, III
Dr. William Lemons
Dr. Jennifer Maddox
Dr. Lewis Schulman
Dr. Michael Steinkampf
Dr. Randy Yarbrough |
4 days |
2.6 days |
Leading Causes of Death
Trinity Medical Center’s Cancer Program received Three-Year Approval with Commendation from the American College of Surgeons Commission on Cancer. |
Heart disease, cancer, and stroke accounted for well over two thirds of all deaths in the mid-1960’s. |
Heart disease, cancer, and stroke remain the leading causes of death. However, the death rate from all causes of death combined decreased by 32% between 1970 and 2002, with the largest decreases for heart disease and stroke, but with an increase in death rates for diabetes and COPD. The decline in overall death rate is attributed to advances in technology and lifestyle changes, while the increase in diabetes and COPD could be attributed to the growing number of elderly and obese populations. |
% of Hospital-Affiliated Outpatient Surgeries Performed
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Less than 1% |
60% |
Gallbladder Surgery
General Surgeons on the Active Medical Staff performing laparoscopic gallbladder surgery include:
Dr. Timothy Bullock
Dr. E. S. Frey
Dr. Scott Pennington
Dr. Derek Robinson
Dr. William Tapscott
Dr. William Thompson, III
Dr. John Touliatos |
Gallbladder is removed through a single, large incision in the abdomen. This surgery leaves a moderately large scar [4 in. (10.2 cm) to 8 in. (20.3 cm) long]. Hospital stay is 6 or more days. Most people can return to their normal activities within 4 to 6 weeks. |
Normally performed as a laparoscopic procedure in which the surgeon inserts a lighted scope attached to a video camera (laparoscope) into one incision near the belly button. The surgeon then uses a video monitor as a guide while inserting surgical instruments into the other incisions to remove your gallbladder. Normally an outpatient surgery, but sometimes a 1-2 day hospital stay. Most people can return to their normal activities within a week to 10 days. |
Advances in Cardiology
Cardiologists on the Active Medical Staff include:
Dr. Raashid Ashraf
Dr. Stephen Bakir
Dr. James Boogaerts
Dr. Elizabeth Branscomb
Dr. Robert Brock
Dr. Jerry Chandler
Dr. J. T. Eagan, Jr.
Dr. Donald Gordon
Dr. William Harrison
Dr. James Jones
Dr. Luiz Pinheiro
Dr. Russell Reeves
Dr. Richard Russell, Jr.
Dr. William Stetler
Dr. Paul Troup
Dr. W.H. Watford, Jr.
Dr. Phillip Watkins
Dr. Peter Scalise, III
Cardiovascular Surgeons on the Active Medical Staff include:
Dr. Richard Gitter
Dr. Lev Khitin
Dr. Duane Randleman, Jr.
Dr. Sanjay Tripathi
Dr. John Casterline
Cardiothoracic Surgeon on the Active Staff:
Dr. Parvez Sultan
Dr. Duane Randleman, a member of the Trinity Medical Center Active Medical Staff and a cardiovascular surgeon, is the only physician in the State of Alabama performing this procedure with da Vinci Robotics.
Dr. John Eagan, Jr. is one of the few cardiovascular interventionalists in Alabama with the skill and knowledge to perform the AAA Stent Graft procedure.
Drs. John Eagan, Jr. and Jerry Chandler are the top producing peripheral vascular interventionalists in the Southeast. They teach a monthly course to visiting physicians on carotids and other peripheral interventions.
Dr. Russell Reeves is one of the few cardiologists in Alabama and the Southeast with the skill and knowledge to perform the Pacemaker and AICD Lead Extraction procedure.
Dr. Stephen Bakir is one of the few cardiovascular interventionalists in Alabama with the skill and knowledge to perform PFO Closure. He teaches a course to visiting physicians on PFO Closures every 2-3 months. |
Conventional open heart surgery was performed. The surgeon made an incision down the center of the sternum (breastbone) to get direct access to the heart. The surgeon would then repair or replace the abnormal heart valve or valves. Recovery from heart valve surgery usually involved several days in an intensive care unit (ICU). Full recovery from heart valve surgery could take several months. Recovery includes healing of the surgical incision, gradual building of physical endurance, and exercise.
The first human implant of a totally implantable pacemaker was in 1960. Its battery life was approximately 12-18 months. In the mid-1960s, "transvenous leads," leads that could be inserted through a vein leading to the heart, replaced earlier leads that were attached to the outer surface of the heart. Pacemaker and lead implants could now be done without opening the chest cavity or using general anesthesia. "Demand" pacemakers, introduced in the mid-1960s, sense when the heart is beating on its own and provide pacing only when necessary. Earlier pacemakers continuously paced the heart at a set "fixed" rate. All new pacemakers today are "demand" models.
The first coronary artery bypass operation was performed in the 1960's. The conventional CABG surgery is done by opening the patient's chest with an incision over the sternum (breast bone) and dividing it to expose the heart. During the operation the patient's heart is connected to a heart-lung machine which is used to provide circulation and oxygenate the blood while the heart is stopped by the surgeon to work on it. Depending on the number and location of the blockages, the surgeon might perform between one and seven bypasses. Typically, recovery was required in intensive care unit (ICU) for several days. Barring any complications, a total hospital stay of ten or more days could be expected with this type of surgery. |
da Vinci Robotics System for mitral valve repair: An alternative to conventional open heart surgery. Using the precision of robotic arms, the surgeon operates through a few small incisions. In addition to avoiding the pain and trauma of sternotomy and rib spreading, da Vinci Mitral Valve Repair may provide patients with the following benefits over open surgery: less risk of infection, less blood loss and need for blood transfusions, shorter hospital stay, significantly less pain and scarring, faster recovery, quicker return to normal activities, and a potentially better clinical outcome.
AAA Stent Graft: A stent covered with graft material is placed via a catheter to cover the aneurysm. Patients do not have to go through major abdominal surgery and recovery of surgery which would usually last 6-8 weeks. Patients are able to go home within a couple of days with limitations from the procedure that will only last a few days.
Carotid Artery Stenting: Stents are placed in the carotid artery. Patients do not have to go through surgery and the recovery of surgery. Also, the patients are able to go home the next day with limitations from the procedure for a couple of days.
Pacemaker and AICD Lead Extraction: Pacemaker and AICD leads sometimes get infected and require removal. Removal of the lead can be difficult if the lead has been implanted for a while. This laser technique helps with the removal of such leads. Patients can have the lead removed without surgery and be placed on antibiotics to fight the infection. The patient is able to go home within a couple of days with limitations from the procedure for a few days. Also, the patient can have the device reinserted later or during the same admission.
TMR (Transmyocardial Revascularization): TMR surgery is an open heart surgery in which a special heart laser is used to create very small channels (1 mm in diameter) in the heart muscle. TMR can be performed with or without Coronary Bypass Surgery (CABG), depending upon the nature of the disease in the arteries. When performed alone, TMR is completed through an incision on the left side of the chest, between the fourth and fifth ribs, without using the heart-lung machine (cardiopulmonary or bypass support).
PFO Closure: PFO (Patent Foramen Ovale) is a hole in the heart that should close shortly after birth. In some people, it never closes and as patients age, clots pass through the hole and can cause strokes or TIA’s. This is a patch that can be placed over the hole via a catheter similar to a heart cath. The patient does not have to go through open heart surgery and the recovery of surgery and is able to go home the next day.
Echocardiogram: This is a test in which ultrasound is used to examine the heart. It allows accurate measurement of the heart chambers and offers far more sophisticated and advanced imaging. Also, this allows the physician to determine the size of the heart chambers, pumping function of the heart, valve function, and volume of blood pumped by the heart. Echocardiogram is noninvasive, generally quick, safe and painless. It does not require hospitalization and is a good screening test for heart disease in certain groups of patients.
Microwave ablation therapy for atrial fibrillation: New minimally invasive treatment used for the management of atrial fibrillation. It involves smaller surgical incisions, shorter recovery time, and quicker results. Also, this eliminates the need for lifelong anti-coagulation therapy.
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Prostate Cancer Treatment
Urologists on the Active Medical Staff:
Dr. Charles Bugg
Dr. Mark DeGuenther
Dr. Douglas Modling, Jr.
Dr. Carl Sanfelippo
Members of Trinity Medical Center’s Active Medical Staff performing prostatectomy with the da Vinci Robotics system include:
Dr. Charles Bugg
Dr. Mark DeGuenther |
Brachytherapy, often referred to as "seed brachytherapy or simply "seed therapy" is a form of internal low dose radiation treatment in which tiny "seeds," about the size of a grain of rice and made of laser-welded titanium, are inserted into the body and permanently implanted in cancerous tissue. It was developed in the 1960's and a patient was first treated with the therapy in 1967. For years, brachytherapy was limited by a doctor's ability to see inside the patient's body in order to accurately position the seeds. Also, chemotherapy began to be more widely used for recurrent and advanced cases. |
Brachytherapy remains an extremely effective treatment for early stage prostate cancer. With the advancements in ultrasound and digital imagery, there are no longer any limitations with this treatment. Chemotherapy is widely used in more advanced cases that have not responded to hormone therapy. Also, a radical prostatectomy can be performed by utilizing da Vinci Robotics. This minimally invasive procedure involves the removal of the prostate gland and surrounding tissue through a few small incisions resulting in a shorter hospital stay, less pain, less risk of infection, less blood loss and transfusions, less scarring, faster recovery, and quicker return to normal activities. External radiation treatments are also performed utilizing Intensity Modulated Radiation Therapy (IMRT) and Stereotactic radiosurgery. |
Bariatric Surgery
Trinity Medical Center is one of only 2 Bariatric Centers of Excellence in the State of Alabama.
Surgeons participating in the Bariatric Center of Excellence are:
Dr. Scott Pennington
Dr. John Touliatos |
Roux en Y Gastric Bypass Surgery (RYGB) is considered the "gold standard" of all bariatric surgical procedures because the gastric bypass is a time-tested operation (dating back to the late 1960's). The Roux-en-Y operation provides a restrictive and malabsorptive method to weight loss because the stomach and small intestines are reconfigured through an open incision in the stomach. First, a "mini stomach" is created by permanently dividing the stomach, creating stomach pouch that can hold about 2-3 bites of food. The intestines are then cut approximately one and one half feet beyond the stomach and is attached to the pouch to provide an outlet for the food. |
Today, the RYGB can be performed via a laparoscope through 5-6 small keyhole incisions in the abdomen. The surgeon uses a camera and several small instruments to perform the surgery. Since it is minimally invasive and relatively gentle on the body, patients often return to their regular routine within 1-2 weeks. The LAP-BAND® System provides continuous, long-term treatment for severe obesity. An adjustable silicone elastic band is placed around the upper part of the stomach creating a small pouch and restricting the passage of food. The band can be placed in as little as 45 minutes and patients are typically hospitalized for less than 24 hours following surgery. Patients usually lose 40-70% of excess weight within 1-3 years. Vertical Band Gastroplasty (VBG) is a purely restrictive procedure in which the upper stomach is stapled and divided, forming a small pouch that reduces the size of the stomach and the amount of food the stomach can hold. The outlet from the pouch is restricted by a non-adjustable band that allows food to slowly empty, creating a feeling of fullness and decreasing appetite. The procedure takes about 90 minutes to perform and patients are usually discharged within days and back to normal activities in 1-3 weeks. Patients usually lose 50-70% of excess body weight. |
CT Scanner
Trinity Medical Center’s 64-slice CT is part of the comprehensive Radiology Department with six Active Staff Board Certified Radiologists:
Dr. Bibb Allen
Dr. T. C. Brightbill
Dr. Clinton Holladay
Dr. Arthur Jones, III
Dr. Ronald Lepke
Dr. Colin Stewart |
Digital imaging techniques were implemented in the 1970's with the first clinical use and acceptance of the Computed Tomography or CT scanner. Original CT scan took hours to acquire a single slice of image data and more than 24 hours to reconstruct this data into a single image. |
The introduction of 64-slice CT scanner allows nearly all patients to be scanned with very high resolution. Scan times are now on the order of several seconds (usually 5-13 seconds); this means that even patients with severe pulmonary disease and congestive heart failure can hold their breath for the required length of time. Reduced time translates to minimal or no motion artifacts. Furthermore, higher number of slices means higher resolution; today’s 64-slice scanners are capable of performing 64 slices per rotation at less than 0.4 – 0.7 mm resolution. Such high resolution allows visualization of the entire coronary tree with extremely high accuracy and detail. Individual atheromatous plaques can be detected and characterized. The scanner is also enabling some patients to avoid an invasive cardiac catheterization by aiding in diagnosis for blockage of the coronary artery. |
MRI Scanner
Trinity Medical Center’s MRI units are accredited by the American College of Radiology.
Trinity MRI, located at 790 Montclair Road, also offers an Open MRI to better enhance the patient experience along with convenient access. |
In 1977, the first MRI exam was performed on a human being, and it took five hours to produce one image. The first MRI equipment in health was available at the beginning of the 1980s. |
Magnetic resonance imaging (MRI) uses radiofrequency waves and a strong magnetic field rather than x-rays to provide remarkably clear and detailed pictures of internal organs and tissues. The technique has proven very valuable for the diagnosis of a broad range of pathologic conditions in all parts of the body including cancer, heart and vascular disease, stroke, and joint and musculoskeletal disorders. In addition, MRI of the heart, aorta, coronary arteries and blood vessels is a fast, noninvasive tool for diagnosing coronary artery disease and heart problems. The conventional MRI unit is a closed cylindrical magnet in which the patient must lie totally still for several seconds at a time and consequently may feel "closed-in" or truly claustrophobic. However, new "patient-friendly" designs are rapidly coming into routine use such as open or upright units.
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Advances in Pulmonology
Pulmonologists on the Active Medical Staff:
Dr. Russell Beaty
Dr. Allan Goldstein
Dr. W. B. Kelley
Dr. Louis Pappas
Dr. Oksana Senyk
Drs. Oksana Senyk, Louis Pappas, Russell Beaty and W. B. Kelley are each certified to perform fiberoptic bronchoscopies. These physicians also manage patients on NIPPV (NonInvasive Positive Pressure Ventilation).
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Fiberoptic Bronchoscopy:This is diagnostic or therapeutic procedure in which a tube with a tiny camera on the end is inserted through the nose or mouth into the lungs. The procedure provides a view of the airways of the lungs and allows the physician to collect lung secretions or tissue specimens (biopsy).
NonInvasive Positive Pressure Ventilation (NIPPV): A ventilator support strategy which does not require intubation. By using NIPPV the length of stay in the ICU, length of stay on a mechanical ventilator, utilization of resources and related complications can all be reduced.
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Advances in Gastroenterology
Gastroenterologists on Active Medical Staff include:
Dr. Charles Bluhm
Dr. Joseph Cochran
Dr. Colin Helman
Dr. Jack Mauldin
Dr. Peter Miller
Dr. Leonard Ou-Tim
Dr. Harold Philpot
Dr. J. C. Shallcross, Jr.
Dr. Kenneth Sigman
Dr. Raymond Tobias
Dr. Kenneth Sigman specializes in ERCP(Endoscopic retrograde cholangiopancreatography) and teaches many courses on cannulation techniques.
Drs. Leonard Ou Tim and Raymond Tobias are the only physicians in Alabama and the surrounding area that perform the Double Balloon Enteroscopy procedure.
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ERCP (Endoscopic retrograde cholangiopancreatography): Dye is injected into the biliary or pancreatic duct then viewed under x-ray. By using special instruments, the physician can remove stones, brush for cytology, perform sphincterotomy, permanent or temporarily stent, etc. This is non-surgical means to remove stones, relieve strictures of the biliary or pancreatic duct, and to relieve pain.
Double Balloon Enteroscopy: This involves the passage of an endoscope through the entirety of the small bowel. It allows the ability to cauterize, inject, biopsy, remove polyps, etc, the full length of the small intestine. Until now, the only way to care for a small bowel bleed was abdominal surgery. This is a three hour procedure under moderate sedation. The patient is in and out in a matter of hours and able to return to work the next day.
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Advances in Anesthesiology
Board Certified anesthesiologists include:
Dr. Timothy Aiken
Dr. James Chaney
Dr. Charles Graham
Dr. Robert Henry
Dr. Joseph Houser
Dr. Jon Kentros
Dr. Stephen Klein
Dr. J. C. Spivak
Dr. William Uncapher |
During the 1960’s, it was rare to have Board Certified Anesthesiologists. There was no cardiac anesthesia, minimal post-operative pain management, minimal obstetric anesthesia, and no chronic pain management. |
Today, most anesthesiologists are Board Certified (including all members of the Trinity group). They are extensively involved in cardiac cases with the cardiologists and all other invasive procedures. Acute post-operative pain and chronic pain services are offered. Also, the anesthesiologists provide continuous coverage for obstetrics. |
Advances in Mammography
Trinity’s Diagnostic Center, located in the 880 building, provides digital mammography and a stereotactic breast biopsy system. The breast biopsy system provides an alternative to a needle localization performed in an outpatient surgery setting under anesthesia. |
Mammography was first introduced in the mid 1960's using regular x-ray machines. In 1967, the first commercially available dedicated mammography unit, the senograph, was released. In the 1960's, only 40 percent of the cancers in younger women could be found by X-ray screening, whereas now mammography can detect about 90 percent of cancers in such women. |
Digital Mammography is becoming readily available in diagnostic centers across the U.S. Digital spot view mammography allows faster and more accurate stereotactic biopsy. This results in shorter examination times and significantly improved patient comfort and convenience since the time the patient must remain still is much shorter. With digital spot-view mammography, images are acquired digitally and displayed immediately on the system monitor. In addition to spot-view digital mammography, the FDA has approved a "full-field" digital mammography system to screen for and diagnose breast cancer. With continued improvements, the "full-field" mammography systems may eventually replace traditional mammography.
Mobile mammography units are becoming increasingly popular and provide comparable results as the fixed units. These units can be taken out into community groups, etc to provide a service to women who might not otherwise visit a mammography center.
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Advances in Cancer Treatment
Trinity Medical Center’s Cancer Program is accredited by the American College of Surgeon’s Commission on Cancer.
The Cancer Center recently added a new Oncor Linear Accelerator and has been successfully performing IMRT Radiotherapy for approximately 3 years.
Board-certified radiation oncologists on active medical staff include:
Dr. James Kamplain
Dr. Brian Larson
Dr. John Pinkston
Board-certified medical oncologists on active medical staff include:
Dr. Jimmie Harvey
Dr. James Lasker
Dr. Kevin Windsor |
Radiation therapy and chemotherapy were in their early stages and were the most common treatments for all types of cancer. Surgery was also a popular treatment. Brachytherapy was developed in the 1960’s and was the most common treatment for prostate cancer. |
The Linear Accelerator (LINAC) is a device most commonly used for external beam radiation treatments for patients with cancer. It delivers a uniform dose of high-energy x-ray to the region of the patient’s tumor. These x-rays can destroy the cancer cells while sparing the surrounding normal tissue. Furthermore, it allows radiation oncologists and medical physicists to tailor treatment delivery depending on the patients’ particular situations.
Intensity Modulated Radiation Therapy (IMRT) allows the delivery of extremely precise doses of radiation that can destroy cancer cells while minimizing harm to surrounding normal and healthy tissues. IMRT is an aggressive therapy that requires multiple or fractionated treatment sessions. A medical linear accelerator generates the photons, or x-rays, used in IMRT. The machine is the size of a small room—approximately 10 feet high and 15 feet long. The patient lies on the treatment table, while the linear accelerator delivers beams of radiation to the tumor from various directions. The intensity of each beam’s radiation dose is dynamically varied according to treatment plan. Currently, IMRT is being used to treat cancers of the prostate, head and neck, breast, thyroid and lung, as well as in gynecologic, liver and brain tumors and lymphomas and sarcomas. IMRT is also beneficial for treating pediatric malignancies.
The GliaSite Radiation Therapy treats diagnosed metastatic and recurrent brain tumors by delivering radiation from within the cavity created by the surgical removal of the tumor. This places the radiation closest to the tissue most likely to still have cancer cells. It also reduces radiation exposure to healthy brain tissue. Typically radiation treatment lasts anywhere between 3 to 7 days, depending on your course of treatment and can be performed on an inpatient or outpatient basis. |