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I Was Just Diagnosed with Hepatitis C: What Can I Expect?

Dr. Joseph Galati Galati — Sat, 31 Jul 2010 18:00:00 GMT

Part I: What do I do now that I have been diagnosed with chronic hepatitis C.

31-Jul-10 1:00 PM

Liver Specialists of Texas Newsletter Volume 9 No 5

Dr. Joseph Galati Galati — Wed, 12 May 2010 04:00:00 GMT

Welcome to the Liver Specialists of Texas newsletter of upcoming events, articles, jobs and more from our membership. Keep up to date with the latest in liver disease news, as well as general health and wellness information. We all look forward to feed back, and topics in the future you would like to learn about.

March was Colon Cancer Awareness Month: Podcast

March was colon cancer awareness month. Listen to Dr. Galati's podcast here. Among cancers that affect both men and women, colorectal cancer—cancer of the colon or rectum—is the second leading cause of cancer-related deaths in the United States. Colorectal cancer also is one of the most commonly diagnosed cancers in the United States. The risk of developing colorectal cancer increases with advancing age. More than 90% of cases occur in people aged 50 or older. Colorectal cancer... [More Info]

Too Much Dietary Salt: A Conversation with a Nutrition Expert

An interview from Your Health First, this is an informative discussion with a dietitian, explaining the problems of too much salt in the American diet.

Salt Overload: Podcast

More on the excess salt (aka sodium) we all consume.

Alcohol Awareness Month

For addition health and wellness information, tune into Talk Radio 740 KTRH every Sunday evening at 7:00 p.m. for Your Health First, hosted by Dr. Galati. Go to www.yourhealthfirst.com for more details and program information.

11-May-10 11:00 PM

March is Colon Cancer Awareness Month: Podcast

Joseph S. Galati, M.D. — Sun, 07 Mar 2010 21:00:00 GMT

March is colon cancer awareness month. Listen to Dr. Galati's podcast here.

Among cancers that affect both men and women, colorectal cancer—cancer of the colon or rectum—is the second leading cause of cancer-related deaths in the United States. Colorectal cancer also is one of the most commonly diagnosed cancers in the United States.

The risk of developing colorectal cancer increases with advancing age. More than 90% of cases occur in people aged 50 or older.

Colorectal cancer screening saves lives. However, many people who are at risk for the disease are not being screened according to national guidelines.

It is estimated that as many as 60% of colorectal cancer deaths could be prevented if all men and women aged 50 years or older were screened routinely. In most cases, colorectal cancer develops from precancerous polyps in the colon or rectum. Screening tests can find precancerous polyps, so that they can be removed before they turn into cancer. Screening tests also can find colorectal cancer early, when treatment works best.

Keep in mind that you do not have to have symptoms to be screened. Colon cancer can still develop early without any symptoms.

There’s no doubt that increased physical activity and maintaining a healthy weight may decrease the risk for colorectal cancer.

The role of diet is a bit unclear though most of us recommend a diet low in animal fats and high in fruits, vegetables, and whole grain products to reduce the risk of other chronic diseases, such as coronary artery disease and diabetes.

This month make it a point to speak with your physician and ask to be screened for colon cancer. Colonoscopy, in addition to other testing strategies, may save your life.

7-Mar-10 3:00 PM

Mice Helping Unlock Hepatitis B and Hepatitis C Treatments

Joseph Galati, M.D. — Sat, 27 Feb 2010 20:00:00 GMT

The full blog report is posted here. The full articles are also available for those wanting more detail.

Enjoy.

Dr. Joseph S. Galati

27-Feb-10 2:00 PM

Job Opportunity: Internist Needed

Dr. Joseph Galati Galati — Fri, 29 Jan 2010 03:35:23 GMT

Dear Internal Medicine Program Directors and Administrators:

We are pleased to announce a career track Internal Medicine positions that will be available in April, July, and December 2010 for your graduating physicians. Kindly post the job offer and forward this opportunity to them. We are available for those with interest in the position to discuss the positions further.

Thank you,
Joseph S. Galati, M.D., FACG
and the Liver Specialists of Texas Team

Job Opportunity: Internist Needed

Author: Dr. Joseph S. Galati

Release Date: Monday 25-Jan-10 8:00 AM

Houston Based Liver Specialists of Texas is Seeking Internists for Their Growing Hepatology and Liver Transplant Program Internists are... [More Info]
Posted by: Dr. Joseph Galati

Stay up to date with our RSS feeds.

28-Jan-10 9:35 PM

Job Opportunity: Internist Needed

Dr. Joseph Galati Galati — Mon, 25 Jan 2010 14:00:00 GMT

Internists are needed to expand within a busy clinical Hepatology and Liver Transplant practice, caring for the Internal Medicine needs of patients with all facets of liver disease. Disease management of hypertension, renal disease, hyperlipidemia, obesity, metabolic syndrome, and endocrine disorders in a supportive environment, located in the world’s largest medical center, has openings for April, July, and December 2010.

PODCAST: Liver Transplant Evaluation

Joseph Galati, M.D. — Fri, 25 Sep 2009 02:00:00 GMT

In this podcast, Dr. Joe Galati discusses the liver transplant evaluation process that is used at The Methodist Hospital Center for Liver Disease and Transplantation. Individuals with end-stage liver disease, who have experienced various complication of cirrhosis, are considered for transplantation. Diseases that lead to cirrhosis include the following: chronic hepatitis C, chronic hepatitis B, alcoholic liver disease, non-alcoholic fatty liver, autoimmune disorders, and other genetic disorders of the liver.

The evaluation process usually takes place as an out-patient, where you are seen by one of our liver transplant surgeons, as well as specialized nurse coordinators, social worker, dietitian, financial counselors, and other medical specialists such as cardiology, psychiatry, and lung specialists as needed.

Once evaluated and approved, patients are listed for transplant. Priority for transplant is based on the MELD score. The higher the MELD score, the more ill the patient is, and the highr priority for transplant.

Listen here to Dr. Galati's Podcast on Liver Transplant Evaluation

Websites of Interest

United Network for Organ Sharing

All about MELD

The Methodist Hospital Center for Liver Disease and Transplantation

24-Sep-09 9:00 PM

PODCAST: Dr. Joe Galati Talks About Food and Diets

Dr. Joseph Galati — Fri, 03 Jul 2009 02:00:00 GMT

Food is very important to health and wellness, both if you have a liver problem, or do not. For those with liver disease, we ask that you be put on a low sodium (salt) diet, consuming less than 2000 mg per day. This is a very restricted diet, considering the highly processed foods that are available.

Over the years, I have posted numerous links to cover the following topics of nutrition and health:

Sodium restricted diets
Portion control
Daily intake of fruits
Daily intake of veggies
Dietary fiber (remember: 40 grams of fiber daily)

Click here to listen to the latest podcast by Dr. Galati.

Share and enjoy.

2-Jul-09 9:00 PM

Update on Hepatitis C: AASLD Guidelines 2009

Dr. Joseph Galati Galati — Wed, 22 Apr 2009 17:00:00 GMT

In the April issue of Hepatology, the AASLD published updated guidelines on the Diagnosis, Management, and Treatment of Hepatitis C. This is a comprehensive article, incorporating all of the new research on best practice standards for chronic hepatitis C. The full article can be downloaded here.

A video of Dr. Galati explaining some of the recommendations is available here.

22-Apr-09 12:00 PM

Colonoscopy Bowel Prep Instruction (with Podcast)

Dr. Joseph Galati Galati — Tue, 16 Dec 2008 18:00:00 GMT

HALFLYTELY BOWEL PREP INSTRUCTIONS

NOTE: Before beginning the following steps, have your prescription for Halflytely® filled.

THE DAY BEFORE YOUR PROCEDURE:

*Make sure to take the Bisacodyl tablets at 10a.m. then wait 6 hours to start Halflytely®

*CLEAR LIQUIDS ONLY, ALL DAY BEFORE PROCEDURE.

Clear liquids include black coffee or tea, clear fruit juices (apple or white grape), broth or bouillon, non-red gelatin dessert, Sprite, Gatorade and Ginger ale.

1. In the morning, after a clear liquid breakfast, prepare your Halflytely® solution according to the instructions on the package and refrigerate.

2. Have a clear liquid lunch.

3. By 10 a.m. – Begin by taking the 2 time released Bisacodyl tablets provided in the prep kit box.

4. At 4 p.m. – begin drinking Halflytely® as instructed – 8 oz. every 10-15 minutes until the bottle is empty. (Rapidly drinking a glassful is better than sipping an ounce or two at a time).

•You will have consumed several glassfuls before having the first loose, watery bowel movement.

•Initially, you may feel slightly bloated, but will become more comfortable as you continue to have bowel movements.

5. You can drink clear liquids up until midnight.

6. Do not eat anything after midnight, until after your procedure.

THE DAY OF THE PROCEDURE:

1. Hold your morning medicines until after the procedure.

2. Please wear comfortable clothes, leave your valuables at home.

3. Remember to come to your appointment with a responsible adult who is able to drive you home after you are released from your procedure.

In order to have a good diagnostic result, it is very important to follow these instructions. If you fail to follow these instructions there may be a need to reschedule your colonoscopy.

LIVER SPECIALIST OF TEXAS

TEL (713) 794-0700 FAX (713) 794-0610

www.texasliver.com

16-Dec-08 12:00 PM

Job Opportunity: Internist Needed

noemail@texasliver.com — Mon, 25 Jan 2010 14:00:00 GMT

Houston Based Liver Specialists of Texas is Seeking Internists for Their Growing Hepatology and Liver Transplant Program Internists are needed to expand within a busy clinical Hepatology and Liver Transplant practice, caring for the Internal Medicine needs of patients with all facets of liver disease. Disease management of hypertension, renal disease, hyperlipidemia, obesity, metabolic syndrome, and endocrine disorders in a supportive environment, located in the world’s largest medical center, has openings for April, July, and December 2010. Houston, TX, January 25, 2010: Internist needed for Hepatology and Liver Transplant Program. Located in Houston’s world-famous Texas Medical Center, we are seeking an energetic BC/BE internist to join a well established and respected program. This physician will care for the internal medicine needs of patients with liver disease and recipients of liver transplants in an integrated fashion. Clinical support from hepatologists,...

New Hepatitis C Research Study to Begin: Update September 2009

noemail@texasliver.com — Thu, 25 Sep 2008 23:00:00 GMT

Dr. Joseph S. Galati and Liver Specialists of Texas are pleased to announce the start of a new investigational study for patients with hepatitis C. As of September 2009, we will be having additional investigational studies for patients with hepatitis C. The studies are classified for patients based on any prior treatment for HCV. Naive patients have never received any form of anti-viral therapy for hepatitis C. This would include Rebetron, Intron A, Ribavirin, PEG-Intron, Pegasys, or Infergen. Other classes of patients will include those previously treated with any of the above drugs. Further, patients will be classified as either responder-relapsers, or non-responders. Once we are able to screen your records, we can detwrmine if you could participate in any of the studies. There are several large companies sponsoring these studies, with a number of very exciting medications that will be used. The basic inclusion criteria for these study include: male or female...

Lauren Thomas, R.N. Nurse Practitioner

Fri, 03 Sep 2010 04:44:35 GMT

Lauren Thomas was born and raised in St. Martinville, Louisiana and has lived in Houston since 2004. She attended Louisiana State University from 1998- 2000 and transferred to the University of Louisiana at Lafayette for nursing school. Lauren graduated in 2003 with honors in a Bachelor’s of Science in Nursing.

Lauren has been a registered nurse for 6 years, first working as an ICU nurse at the Methodist Hospital from 2004 until 2007. She began graduate school at the University of Texas Health Science Center in 2006 and graduated in 2008 with an Masters in Science Nursing. She is holds a national certification as an Adult Nurse Practitioner from the American Academy of Nurse Practitioners.

Lauren began practicing as a nurse practitioner in 2008 in cardiology at Cardiology Center of Houston. In 2009 she joined Liver Specialists of Texas. Since joining Liver Specialists of Texas, Lauren has become dedicated to treating patients with liver disease, and believes strongly that educating the patient and their family members about liver disease is paramount.

She is a member of the American Academy of Nurse Practitioners and the Houston Area Nurse Practitioners, and is licensed by the Texas Board of Nursing and the American Academy of Nurse Practitioners. Lauren’s non-work interests include traveling, cooking, and shopping. She enjoys spending time with family, friends, and her dog, Art.

Saira Khaderi, M.D.

Fri, 03 Sep 2010 04:42:05 GMT

Dr. Saira Khaderi has joined Liver Specialists of Texas.

Liver Specialists of Texas: Our Staff

Fri, 03 Sep 2010 04:28:45 GMT

Staff Members

Saira Khaderi, M.D.

Lauren Thomas, R.N. Nurse Practitioner

Aracelli Diaz: Medical Assistant

Diane Villareal: Medical Assistant

Herman Ortiz, LVN: Research Manager

Kim Walker: Research Coordinator

Lacie Ford: Research Coordinator

Racquel Celis: Front Desk/Reception

Bernadette Chapa: Patient Schedule/Insurance

Gil Gomila: Billing/Insurance Supervisor

Research Specialists of Texas 2010

TIEC Open House Photo Album

Out of town visitors

Wed, 01 Sep 2010 12:47:19 GMT

Continental Airlines: http://www.continental.com American Airlines: http://www.aa.com United Airlines: http://www.united.com/ Southwest Airlines: http://southwest.com/ Delta Airlines: http://www.delta.com/home/index.jsp Jet Blue: http://www.jetblue.com Aero Mexico: http://www.aeromexico.com British Airways: http://www.britishairways.com Emerites: http://www.emirates.com/ Kuwait Air: http://www.kuwait-airways.com Lufthansa: http://www.lufthansa.com Air Tahiti: http://www.airtahitinui-usa.com Houston Airport System: http://www.fly2houston.com/ ...

View Video Procedures

Wed, 01 Sep 2010 12:45:30 GMT

Dr. Galati discusses how a liver biopsy is performed. Dr. Galati Talks About Patient Expectation at Liver Specialists of Texas Colonoscopy Snare Polyp Removal Banding of Esophageal Varicies Gastric Antral Vascular Ectasia Diverticulosis

Patient Interviews

Wed, 01 Sep 2010 12:44:51 GMT

Patient interview videos are in production. Come back sooon and enjoy rest of our website.

Herman Ortiz, LVN Research Manager

Wed, 25 Aug 2010 20:14:01 GMT

Herman Ortiz is a native Houstonian and works as Manager of Research Specialists of Texas, a subsidiary of Liver Specialists of Texas. Herman joined RST in September 2008 and along with the help of his team has established RST as a very well known research center in the Hepatology industry.

Herman has spent 14 years as a nurse, first working as a floor nurse on an orthopedics / trauma unit in the Texas Medical Center. He then moved to medical offices in orthopedics and allergy where he was first trained in clinical research. In 2002, he was certified as a Clinical Research Coordinator (CCRC) and moved back to the medical center where being employed at St. Luke’s Hospital helped to start the liver research program. He was also a patient educator for the Texas Liver Coalition, conducting treatment training classes, town hall meetings, and occasionally part of the coalition’s radio program. He is a member of the Association of Clinical Research Professionals (ACRP), The American Association for the Study of Liver Diseases(AASLD) and is licensed by the Texas Board of Nursing.

Herman has great passion for educating patients about liver disease and treatment for liver disease. He has dedicated the past 8 years of his work in Hepatology and hopes to continue doing so. His other non-work interests are working out, running and golf. He enjoys spending time with family, laughing and watching movies.

Gil Gomilla: Billing Specialists

Wed, 25 Aug 2010 20:11:32 GMT

Billing, collection, and insurance issues are the responsibility of Gil, who has been with Liver Specialists of Texas since the practice began in 2001.

Gil is responsible for seeing that all of the claims are filed appropriately with the patient's insurance company, including charges for office visits and outpatient consultations, inpatient hospital charges, and charges that are related to procedures that have been performed.

Depending on the specific insurance company and policy, even after co-payments are paid by patients, there may still be additional charges that would come under "patient's responsibility" . Working with other staff members in the practice, Gil will review individual cases to see that insurance company required referrals are on file with us. These are referrals that need to come from your primary care physician.

Lacie Ford, Research Coordinator

Wed, 25 Aug 2010 20:11:10 GMT

Lacie Ford has two Associate’s degrees in Applied Science from Brazosport Community College in 1999 & 2000, where she was an active student in the co-op program for 2 1/2 years. After graduating with her associates degrees, she continued on to Texas A&M University.Lacie obtained a Bachelor’s Degree in Animal Science from Texas A&M in 2004, with a minor in Chemistry. At Texas A&M, Lacie was a part of the Sixth Man Foundation & the Pageant Association.

Following graduation from TAMU, Lacie found a job in clinical research and fell in love with this position.As a results, she now has 4 successful years of clinical research experience, and holds a CCRC certification through the Association of Clinical Research Professionals (ACRP) and is an active member of the Houston ACRP chapter.

Outside of research, Lacie is also a member of the Former Students Association for Texas A&M. She plans on getting a master’s degree part time or returning to school full time to get my BSN or PA license in the future.

I am an active member of New Hope Church in Pearland, and loves camping, working out, spending time with family, friends or my dogs. Lacie is a true giver, and loves helping people. Additionally, she is a true animal lover.

Kim Walker, Research Coordinator

Wed, 25 Aug 2010 20:10:39 GMT

Lorem ipsum survey

noemail@texasliver.com — Fri, 10 Aug 2007 18:51:28 GMT

Objectives:

Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diem nonummynibh euismod tincidunt ut lacreet dolore magna aliguam erat volutpat. Ut wisis enim ad minim veniam, quis nostrud exerci tution ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis te feugifacilisi.

Duis autem dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit au gue duis dolore te feugat nulla facilisi.

Ut wisi enim ad minim veniam, quis nostrud exerci taion ullamcorper suscipit lobortis nisl ut aliquip ex en commodo consequat. Duis te feugifacilisi per suscipit lobortis nisl ut aliquip ex en commodo consequat.Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diem nonummy nibh euismod tincidunt ut lacreet dolore magna aliguam erat volutpat.

Ut wisis enim ad minim veniam, quis nostrud exerci

Release Date: 10-Aug-07 1:51 PM
Expiration Date: 10-Nov-07 1:51 PM

Ut wisis enim ad minim veniam, quis nostrud exerci

Neutropenia (low white blood cells)

Tue, 18 Dec 2007 23:11:52 GMT

Similar to a drop in hemoglobin related to ribavirin, interferon caused a drop in white blood cells (WBC), manufactured in the bone marrow. Hite blood cells are used to fight infections in the body. If the WBC drops below an acceptable value, G-CSF (filgrastin) may be used. This stimulated the bone marrow to produce WBC, raising their value above acceptable limits. Similar to ribavirin, it seems beneficial to maintain the appropriate dose of interferon rather than dose reduce. If the WBC is below a critical level, therapy may be reduced or discontinued. G-CSF is associated with certain adverse reactions including skin rash, bone pain, muscle aches, and an exacerbation of psoriasis.

Anemia

Tue, 18 Dec 2007 23:11:34 GMT

Anemia is a very predictable complication of therapy, usually due to ribavirin. Ribavirin causes a hemolytic anemia, damaging red blood cells, which are later removed from the body resulting in the anemia. Symptoms of anemia include increasing fatigue, shortness of breath, lightheadedness, and dizziness. A significant complication of anemia is myocardial ischemia, which can lead to heart failure or a heart attack. For this reason, anemia is treated aggressively.

Reducing the dose of ribavirin usually results in a rise in hemoglobin and improvement in the anemia. This dose reduction in ribavirin may jeopardize the final result of therapy and a lack of viral clearance. It has been generally accepted to treat the anemia without reducing the dose of ribavirin. This is accomplished by making use of erythropoietin.

Erythropoietin is a protein naturally made in the body, which regulates red blood cell production in the bone marrow. It has been successfully manufactured nearly identical to the form in the human body and used in an assortment of conditions for the past 10 years. It is safe and well tolerated. It is very effective in treating the anemia seen with ribavirin use.

The use of erythropoietin not only increases hemoglobin, but also improves upon the fatigue reported in these patients. In most situations, the dose of ribavirin can be maintained, increasing the likelihood of clearing the virus. Blood transfusion is rarely required, but may be an option. Monitoring the effects of erythropoietin requires more frequent blood tests, usually on a weekly basis. Once erythropoietin is used, it is generally used the entire duration of therapy. It is given by weekly injection similar to the interferon.

Headaches

Tue, 18 Dec 2007 23:10:23 GMT

Minor headache complaints generally respond to remaining well hydrated and over the counter preparations such as acetaminophen and non-steroidal anti-inflammatory agents, such as ibuprofen. Patients that have a history of migraine headaches may find that there will be an exacerbation of these headaches once therapy with interferon and ribavirin begin. If they have been on prior therapy for these migraines it may be ineffective.

It will be recommended that in such situations, consultation from a neurologist or headache specialist will be required to continue on with anti-viral therapy. If such a specialist has already evaluated you, we will need to work closely with them to organize a specific plan of care for you.

Nasal Congestion

Tue, 18 Dec 2007 23:10:02 GMT

Nasal congestion is an uncommon complaint, but if present, can be annoying. Symptomatic relief can be obtained with over the counter medications, such as Claritin-D. Remain well hydrated, and avoid cigarette smoke and other nasal and sinus irritatants.

Nausea

Tue, 18 Dec 2007 23:09:45 GMT

Nausea on its own is difficult to treat. There are so many other causes for nausea that this complaint on its own may require a visit to the office. Results vary, but over the counter medications such as Zantac or Pepcid-AC may help. If not, we may recommend other prescription strength medications to reduce stomach acid. There are other classes of drugs that specifically address nausea, but as stated above, this may require a visit to the office for evaluation.

Mouth Ulcers

Tue, 18 Dec 2007 23:09:31 GMT

Some patients are prone to mouth ulcers, which can be rather painful. This may contribute to reduced calories and weight loss (see anorexia). My personal recommendation is to use Kenalog Orabase Dental Paste, which requires a prescription. There are other lesions that affect the mouth so it may require a quick visit to the office before we fill the prescription for you.

Heart Burn/Indigestion

Tue, 18 Dec 2007 23:09:14 GMT

Many patients develop an upset stomach during therapy. If they gave symptoms of gastroesophageal reflux (GERD), symptoms may get worse. Typically, over the counter agents work, such as Zantac or Pepcid-AC. Maalox or Mylanta may also alleviate symptoms. Prescription strength medications such as Nexium, Protonix, or Acifex may be needed. Avoid going to bed with a full stomach, and I recommend at least 4 hours after your last meal before going to bed.

Eye Complications

Tue, 18 Dec 2007 23:08:57 GMT

A baseline examination of your eyes is usually ordered prior to starting therapy with interferon, especially in patients with diabetes or hypertension. Be alert for changes in your vision and report them to the office. Changes may occur in the form of red eyes, blurred vision, eye fatigue, or the need for new prescriptions. It may be necessary to discontinue therapy.

Hair Loss

Tue, 18 Dec 2007 23:08:28 GMT

This is probably the most asked about side effect.

Hair loss is usually diffuse, but can be patchy. Thinning will resolve after therapy is completed.

Avoid excessive treatments to your hair, such as coloring, permanents, braiding, and ponytails. Reduce shampoo frequency where possible. Selsun Blue shampoo may reduce hair loss.

Shorter hairstyles may allow for more manageable hair. Satin pillowcases results in less pulling on the hair when you sleep and can contribute to less hair loss.

Diarrhea

Tue, 18 Dec 2007 23:08:10 GMT

Few patients complain of diarrhea. If present, it tends to be seen early in therapy.

Initial recommendations include increasing dietary fiber, with over the counter fiber supplements such as Metamucil or Citrucel twice daily. You can also try Kayopectate as directed. If diarrhea persists, or is associated with blood, fever, or abdominal pain, call the office immediately.

progressive fibrosis

Tue, 07 Sep 2010 13:45:58 GMT