March 2019 health matters

Robert Grossman, MD Joins NCH General Surgery Department NCH is proud to welcome Robert Grossman,

Robotic and laparoscopic benign and malignant stomach and esophagus procedures: • Achalasia General and specialized surgeries offered by Dr. Grossman include: Robotic and laparoscopic benign and malignant colon and rectal procedures: • Colon and rectal cancer • Diverticulitis • Rectal prolapse Robotic and laparoscopic Hernia Repair: • Inguinal hernia • Ventral and umbilical hernia • Incisional hernia • Abdominal wall reconstruction Robotic and laparoscopic spleen and adrenal surgery Bariatric and weight loss procedures Gastroparesis treatment General and emergency surgery (gallbladder, appendix, hernia, etc.) Median arcuate ligament syndrome treatment Sports hernia and athletic pubalgia • Hiatal hernia repair • Anti-reflux surgery • Gastroesophageal cancer

MD, to its general surgery physician staff. A highly trained and experienced surgeon, Dr. Grossman specializes in minimally invasive surgeries of the gastrointestinal tract and brings a wealth of training and expertise to the department. Born and raised as an only child in Miami, Dr. Grossman is the son of a retired plastic and reconstructive surgeon. He attended medical school at the University of Miami and completed his residency at Mount Sinai Medical Center in Miami Beach. “I received excellent training,” says Dr. Grossman, who exceeded the number of cases required to graduate three times over. He also completed a fellowship at George Washington University in Washington, DC, where he studied laparoscopic, robotic, and minimally invasive surgery. He was mentored by very highly regarded surgeons in the field, including Frederick Brody, MD and Vincent Obias, MD. “The things we can do now through tiny incisions are pretty incredible,” says Dr. Grossman. “The robot is a fantastic platform for the future of minimally invasive surgery, offering full-wristed movements that allows for more finesse.” That finesse of movement lends itself well to robotic and laparoscopic surgeries for the removal of benign and malignant lesions of the stomach, colon and rectum. Dr. Grossman also uses his surgical skills to repair hiatal hernias and to reconstruct abdominal walls, as well as to repair abnormalities that cause reflux disease. “And, I have an almost pain-free laparoscopic or robotic technique that has great outcomes for the repair of abdominal wall – or ventral – hernias called the Rives-Stoppa technique,” explains Dr. Grossman. Dr. Grossman also performs other surgeries including decompression of the celiac artery that causes median arcuate ligament syndrome,

otherwise known as celiac artery compression syndrome – a relatively rare abdominal disorder – as well as gastric electrical stimulation for gastroparesis. He also works with Dr. Wesley Dailey, NCH general surgeon, in performing bariatric sleeve and gastric bypass surgeries. Striving to be an excellent surgeon is not the only trait Dr. Grossman recognizes as being important. “Staying humble is important in all aspects of life,” states Dr. Grossman, “everyone deserves respect and everyone has a purpose.” Treating others with respect comes naturally to Dr. Grossman because he recognizes its importance in the treatment of disease. “We must treat the patient not only the patient’s disease,” he explains. “Doctors have to address the patient as a whole and communicate with him/her and the concerned family members.” When he is not seeing patients or performing surgery, Dr. Grossman enjoys working out and

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reading. He hopes to use his expertise and passion to better serve the southwest Florida community. For more information, or to schedule an appointment with Dr. Robert Grossman at NCH Physician Group General Surgery, call (239) 624-4650 Secret to Optimal Recovery After Joint Replacement Surgery Is Pre-Surgical Planning

Jennifer Miller

The numbers are staggering. It is projected that by 2023, 4 million total joint replacements will be performed annually nationwide. Taking the appropriate steps before and after elective joint replacement surgery will optimize recovery and decrease stress and anxiety. One step patients can take to maximize their recovery is to stop smoking before surgery. Smoking inhibits the healing process, and being smoke-free a minimum of six weeks prior to surgery will decrease the risk of complications. Additionally,

According to NCH physical therapist Sara Baldwin, patients should increase walking, do exercises in the pool, ride a bicycle, or perform physical exercises at a facility with a trainer or at home to increase endurance and flexibility before joint replacement surgery. Baldwin says that after surgery, pain medication will be prescribed and should be taken before post-surgery physical therapy visits. For swelling that may last up to six months, cold therapy using ice is effective, she explains. Suzanne Graziano, Nursing Director of Medical-Surgical Units at NCH Downtown Baker Hospital says it’s important to prepare your home environment too. “We will provide outstanding care while you are at NCH, but you need to plan for your first few days at home. Once you are discharged, have a support system in place - someone who is a phone call away or who can stay with you the first couple of days,” Graziano advises. “Prepare and freeze meals, stock up on nutritious, quick foods or use a food shopping service. Install a safety grab bar and a shower stool and use a raised commode if needed. Remove throw rugs when possible, and clear your living area of obstacles.”

even moderate amounts of alcohol can weaken the immune system, slow recovery, and can lead to surgical complications and bleeding. Refraining from alcohol use for 2 weeks prior to elective surgery is strongly recommended to decrease these risks, as well as the potential for alcohol withdrawal symptoms following surgery. “Do your best to maintain a healthy weight,” advises Jennifer Miller, RN, surgery, follow a diet that ensures you get the right balance of proteins and vegetables; a good balance of nutrients and controlled blood sugar levels aid the healing process and decreases complications,” she adds. Take care of dental issues before joint replacement surgery; bacteria from dental problems can enter the blood stream, leading to prosthetic joint infections. It is important to communicate about your new prosthetic joint to your dentist, as antibiotics will generally be required prior to any future dental procedures. Miller teaches a two-hour pre-surgery class that patients should attend before their surgery date. In the class, patients learn about preparations for surgery, expectations about the hospital stay and discharge information. Total Joint Coordinator at NCH. “Pre and post-

How to optimize recovery after joint replacement surgery After surgery: • Have a support system ready after discharge • Use ice as directed to reduce swelling

Before surgery: • Avoid smoking and alcohol use • Maintain a healthy weight • Eat nutritious and balanced meals • Attend the pre-surgery class • Increase walking, do water exercises, ride a bicycle • Prepare quick and easy meals to freeze • Clear your home of obstacles • Install safety devices in shower and bathroom

• Follow the prescribed physical therapy plan • Take prescribed pain medication,especially before physical therapy visits • Keep a positive outlook

“Before surgery, stay as active as you can without causing more discomfort to your joints,” advises Miller. “Upper body strength will also be important as all patients will use a walker after surgery and doing normal movements like getting in and out of bed may take more strength than usual. And, keeping a positive mind-set and focus will aid in the healing process.”

For more information, contact Jennifer Miller, NCH Total Joint Coordinator at (239) 624-3998 or email Jennifer.Miller3@nchmd.org

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