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Lewes, Delaware
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August 15, 1997     Cape Gazette
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August 15, 1997
 

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HEALTH & FITNESS Cardiologist joins Cape Region medical community By Kerry Kester If Beebe Medical Center is granted a certificate of need so it can develop diagnostic cardiac catheterization capability, it now has a physician who is already trained to perform the procedure. Budi Bahureksa, D.O., who is board certified in internal medi- cine, is now practicing his cardiol- ogy specialty in Lewes. Bahureksa provides full consul- tative, non-interventional cardiac care to his patients. His recently completed fel- lowship in car- diology provid- ed him with the skills to per- form proce- dures such as cardiac diag- nostic imaging, BAHUREKSA diagnostic heart catheterizations and pacemaker implantation. He is a member of Delaware Cardiovascular Associates of Wilmington, which is a practice comprised of seven cardiologists who work in Wilmington, New Castle, Dover and now Lewes. Members of the group include one cardiac electrophysiologist, two cardiac interventionists and four non-interventionists. Bahureksa is one of several family members who chose the art of healing for a career. Both of his parents were family practition- ers. Choosing cardiology as a specialty, Bahureksa said, was largely influenced by his family ties. His family, he sai has a strong history of cardiac disease, a dis- ease that robbed his father or" his life. One morning following a long night on call with the hospi- tal, Bahureksa heard from his mother that his father was in bed because he wasn't feeling well. Within a half hour, Bahureksa him and found that he had experi- enced sudden cardiac death while sleeping. "I wanted to help my dad," said Bahureksa, "but I didn't get a chance." What followed next was Bahureksa's desire to help other families avoid such heartbreak by committing himself to their car- diac care. "I'm determined from here on to help all cardiac patients. Every time I see patients with the same ailments, I can identify with them," he said. "It gives me a cer- tain kind of closeness with the pa- tients." Bahureksa believes strongly in getting to know his patients both on a physical and emotional level. "I see it as one big family," he said of his relationship with pa- tients. "I see them as my father, my mother, my brother, my sis- ter...getting to know them - I think that's very important. To spend time to talk, not just about the dis- ease but to talk to them as a per- son. "I always allow my patients to be their own boss," said Bahurek- sa. He believes that people should guard their heart health by avoid- ing fat, not smoking, limiting salt intake and exercising, but after being informed of what is best to maintain good health, lifestyle de- cisions are in the hands of the pa- tients. "The only thing you can't do anything about is your genes," said Bahureksa, "but people are in charge of their own life. Your time is not in your control, and it's not in your doctor's control either. I cannot force them to do some- thing. My job is to give them un- derstanding of causes and effects. "I don't want my patients to be afraid to come to me for help. I'm not here to judge them. I'm here to help them." Bahureksa is current on new de- velopments in cardiac care - treat- ment developments he shares with his patients. "Drugs are continu- ously upgraded and updated," he said. "The newest thing on the horizon is going to be anti-platelet and anti-clotting agents. They're especially useful for acute coro- nary care and cardiac interven- tion." Some of the newer drugs, he ex- plained, reduce the workload on the heart and help the heart func- tion at a more optimal rate. Other improvements in cardiac care, he said, include updated pacemakers. "We have tried to improve the pacemaker lead so it's thinner, more flexible, less easy to break," said Bahureksa. "And it's more lasting," The original models, he said, were visible through the chest, and sometimes people would ex- perience some embarrassment or even some slight discomfort be- cause there was a slight bulge on Continued on page 39 Much needed family practitioner joins Beebe, Hale in Lewes office By Kerry Kester In an area with a severe shortage of fami- ly practitioners, Elisa Montross-Lopez, M.D., is a welcome addition to the Cape Region medical community. Montross- Lopez is practicing with doctors Kirk Beebe and Eric Hale at Lewes Family Prac- tice. "I like to see the whole family," said Montross-Lopez. "By seeing the whole family, I see the dynamics of the family." Being involved with her patients - learning their family dynamics - she said, helpsher provide optimal care for her patients. "I am basically non-judgmental," she said. "I just take care of people. I'm actu- ally an advocate for my patients - to get them the best care whether from me or from a specialist." Also important to Montross-Lopez for providing the best care is offering her pa- tients education, which begins with educat- ing parents of newborns. "I try to give them booklets so they know what to ex- pect," she said, noting that new par- ents often have questions about things that are actually normal oc- currences. "I relate to the parents," she said with a smile as her pre-school-age daughter tugged at her neck. Issues she discusses with parents, she said, include simple things like toi- child restraints or wearing seat belts - bicycle safety, household safety and things children can do to prevent injuries while skateboard- ing, etc. When her patients reach their adolescent years, she speaks can- didly with them about factors that can greatly impact their health. "I let training, bed wetting and nutri- tion. Immunizations are also key to treating young children, and now, she explained, some older children need immunizations that may not have been available when they were infants and toddlers. Children born before 1992 would not likely have received a vaccine for hepatitis B, a disease that causes liver damage. "Now we're catching up all the kids in mid- dle school and high school," she said. As children grow older, she includes talks with parents and children about other health issues such as vehicle safety - using MOm'RO.t,OPZZ always give my teenagers talks about sex, drugs, alcohol and smoking," she said. Her technique, however, is not confronta- tional and is meant to put the teens at ease so they can ask questions comfortably. Par- ents often discuss health and safety issues with their children, she said, but often chil- dren listen more closely if they hear the same advice from other adults - particularly if the adult is perceived as an authority fig- ure. Education is a major part of prevention strategies, but Montross-Lopez also encour- ages her patients to undergo preventive screenings such as cholesterol checks, stress tests to check for heart disease, uri- nalyses to check for diabetes - especially those patients who have family history of the disease, and occult blood in the stool to check for colon cancer. "Colon cancer is such a big problem, and it's something that if caught early is some- thing that can be taken care of," said Mon- tross-Lopez. "I also have a big interest in doing Col- poscopy," she said. The procedure is used when women have abnormal pap s .mear re- sults, she said. The colposcope allows a physician to have magnified vision of the cervix and vagina. "It can see any area where abnormal cells are coming from," she explained. Using the scope, she can detect pre-cancerous or can- cerous cells. "There are a lot of patterns we can see in the cervix." Montross-Lopez also is trained to per- form cryosurgery, which is a procedure for Continued on page 38 Summer ear problems can be prevented Listen up! Ear problems are not on vacation just because it is sum- mer. There are two types of ear in- fections that are common during the summer months: swimmers ear and middle ear barotrauma. Experts at the duPont Hospital for Children encourage preven- tion of these painful aches, and of- fer ways to treat them if they oc- cur. Swimmers ear is caused as a re- sult of frequent exposure to water that continually moistens the outer ear canal skin, providing an ideal environment for bacteria and fun- gi to grow. First, there will be itching. Then the skin of the ear canal will swell and. drain. This is,acompaaie, xl by ;, severe pain, and the ear is tender to the touch. According to Steven Cook, M.D., of the Division of Otolaryn- gology at the duPont Hospital for Children, the most common treat- ment for swimmers ear is ear drops that contain antibiotics and/or possibly corticosteroids. Over-the-counter pain relievers will help until the antibiotics be- gin to work. While the infection is healing, it is crucial that the child not go swimming. It usually takes 10 to 14 days to heal. The doctor should decide when the child can swim again. Sometimes the child will be told to wear a shower cap or cotton balls coated with pe, tmleum jelly, "If children are prone to swim- mers ear, acid alcohol drops can be used at the end of the swim- ming day," Cook said. "Commercial drops can be pur- chased over-the-counter or made at home, using a few drops of vinegar in a pint of rubbing alco- hol. Be sure to keep them out of your child's reach," said Cook. The other common summer ear problem is middle ear barotrauma. This type of ear infection is relat- ed to abnormal pressure changes in the airspace behind the ear drum. While on an airplane, the air pressure increases and decreases as the plane ascends or descends. Children will most likely be af- fected when the airplane is de- scending because the air pressure in the cabin increases and the pressure in the middle of the ear must be equalized. If this does not happen, the in- creased cabin air pressure pushes on the eardrum and causes pain. To prevent this painful experi- ence, Cook recommends that the child drink a glass of noncaf- feinated beverage, preferably wa- ter, for every hour of travel. This prevents: the drying .effect of the Eustachian tube. Using a nasal decongestant spray just be- lore taking off and as the plane begins its descent will open the ear and nasal passages. The child should stay awake during these key moments in a plane. Older children should chew gum or suck on hard candy. Infants may find comfort in sucking from their bottle, as long as they are not lying down while drinking. All of these tips may be helpful. However, remember it is impor- uint to ask a doctor about anything that isn't understood, or for more ideas to help children who suffer from ear-related ailments.