Dr. Joe Galati's Blog

Dr. Galati's Blog Has Moved

Effective January 1, 2011, our blog has been relocated to this new site, providing a better platform for both readers and contributers.

My practice website for Liver Specialists of Texas has also been redesigned, with greater acces to social media, including their Facebook fan page, Flickr (photographs), and You Tube, where a number of health related videos are posted.

For patients of Liver Specialists of Texas, a web based "patient portal" is available, allowing access to your medical records. This feature requires a protected access code, provided by our staff.

I hope these updated changes improve your experience on the web.

 

Dr. Galati

Endoscopic Images from Liver Specialists of Texas

I spend a good part of my day doing endoscopic procedures, such as colonoscopies and upper endoscopies. While I am a Hepatologist and Liver Transplant Physician, I have been first trained as a Board Certified Gastroenterologist.

Attached in this photo album, there are several images seen during procedures. Many more will be added in the days to come, so come back often, and share.

New Hepatitis C Therapies Are Closer Than Ever

Telaprevir, Boceprevir Improve HCV Cure Rates. The new therapies for chronic hepatitis C are closer than ever. While we have been participating in conducting may of these trials, it has never been more exciting for both patients and physicians who care for hepatitis C patients. Here is an anaylsis from the recent AASLD meeting in Boston this month. Read more here.

Dr. Joe Galati and Lauren Thomas, R.N., NP-C, Discuss Hepatitis C Treatment

In this post, Lauren Thomas, our nurse practitioner in our office, discussed with me various aspects of anti-viral therapy for chronic hepatitis C. Lauren provides a common-sense approach to dealing with the side effects, and how we successfully manage them, allowing for better tolerance,and success with the therapy.

Listen to the audio podcast below.

 

 

Download Listen to HCV Therapy

 

 

Dr. Khaderi and Dr. Galati Discuss Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease, NAFLD, remains a large public health concern, and a common disorder we see in our practice. Dr. Khaderi and I sat down and reviewed some of the more common features and suggested guidelines for the care of these patients.

You can listen to the podcast below.

Non-Alcoholic Fatty Liver Disease Podcast

 

Teen Driving Safety Week: A Radio Interview with Three Teens

Tonight I held an interview on my weekly radio program,  Your Health First, with three Strake Jesuit High School juniors, Alex Trevino, Joseph Galati, and Blake Holbrooke. They discussed issues related to teen driving, and steps they take to reduce accidents.

This past week was Teen Drive Safety Week. Additional links and information can be reviewed at their website.

The audio file of the interview can be listened to here:

Listen to Teen Driving

 

Wall Street Journal Article on Hepatitis C

Melinda Beck from the Wall Street Journal wrote an excellent article on Hepatitis C that was published today. It features a number of our patients, and their experience with the new research studies we are performing. The article can be read here.

For additional information on becoming a candidate for these new research studies, contact us at 713- 634-5110. Visit our research staff page for more information.

Boceprevir Improved Hepatitis C Response in Genotype 1 Patients-Dr. Paul Kwo Interview

Dr. Paul Kwo was on Your Health First with Dr. Joe Galati this past Sunday evening, discussing the latest results published this past week in the medical journal Lancet, which discussed the new finding with the drug Boceprevir. The response rates in chronic hepatitis C, genotype 1, are significantly improved compared to standard of care therapy currently available.

Listen to the interview here.

Paul Kwo HCV Interview

 

New Obesity Regulation and Body Mass Index: A Podcast

New regulations for controlling obesity. Good idea, but there are better ways to solve the obesity epidemic. Read the full article here.

Listen here to my views.

 

 

 

Vertex Pharmaceuticals: Teleprevir Results Promising for Chronic Hepatitis C

Vertex Pharmaceuticals Inc. (VRTX) reported strong results from the first of three key late-stage studies of hepatitis-C treatment, telaprevir, showing success in three-quarters of patients using the drug for 12 weeks.

This is very good news for both patients and physicians involved with chronic hepatitis C. Hepatitis C infects well over 4 million Americans. Complications of hepatitis C include cirrhosis, hepatocellular carcinoma (liver cancer), and the potential need for a liver transplant. Currently available FDA approved therapies can attain a 45-55% sustained viral response to 48 weeks of combination therapy with Interferon and Ribavirin in genotype 1 individuals.

Research continues with many new agents targeting the hepatitis C virus. With FDA approval in the near future, the tools we will have to treat our patients will vastly change the practice of medicine for those with hepatitis C, achievingsignificantly greater viral clearance. Good time lie ahead.

Olive Garden Food Is A Hazard To Your Health

You can eat where every you'd like to. Eat as much as you want. I cannot control that behavior. What I try and do, both with my own patients, and listeners of Your Health First, is to enlighten them to the hazards we all face regarding our health and wellness.

As a country, we eat out far too much. The portions are enormous. The salt (sodium) content is excessive, and the fat and calories of these meals is a leading cause of both adult and childhood obesity. Hypertension, cardiovascular disease, stroke, diabetes, kidney failure, and cancer are all complications of obesity. The cost to care for all of these people with make us all go broke. Obesity related care is expensive.

The Olive Garden has their nutritional information posted on their website. My family recently had the opportunity to dine there. They were all impressed with the lack of nutritious meals, and the contributions to the obesity problem this kind of a menu has. Reading it will both raise your blood pressure and make you sick. There is nothing healthy on the menu. As consumers, be aware of the salt, fat, and calorie content of the food you eat. Only then can we begin to put the brakes on obesity which is killing us all.

My podcast commentary from Your Health First is posted below.

Podcast: Olive Garden Commentary-Listen Here

 

Have a Safe Summer at the Pool: Avoiding Waterborne Illnesses

Listen to the podcast of this article.

Summer Pool Safety

 

New Low Salt Heinz Ketchup

We talk about excessive salt in the American dail all the time. Heinz has decided to cut 15% of the salt ouot of their world famous ketchup. This amounts to a 30 mg drop per serving. While this is a start, the few miligram difference is a drop in the water compared to the thousands of excessive miligrams we consume weekly.

Listen to the podcast for more details.

New Low Salt Ketchup Podcast

 

More on Salt Overload in the American Diet

TThe Institute of Medicine this past week came out with a report - once again - stating we are all taking in too much salt in our diet. Listen to this audio file for more details. Let me know what you think.

Sodium overload

Everything You Wanted To Know About Liver Biopsy

 

Our practice, Liver Specialists of Texas, recently produced a video outlining what is involved with a liver biopsy.

Send us your comments.

 

 

Too Much Dietary Sodium: Interview with Jolene Vanderzyl, R.D.

Jolene Vanderzyl, a Registered  Dietitian with Sugar Lakes Family Practice, will join Dr. Galati tonight to discuss the problem of excessive dietary sodium (salt) in the American diet. For the past five years, we have been discussing the salt problem in our food, and while there have been some strides in changing our behavior, educating the general public is still priority number one.

 

Salt is everywhere in the food we eat. A day does not pass where I am instructing my own patients, as well as their family, on how to maintain a low sodium diet.  For patients with advanced liver disease and cirrhosis, we strive for a diet with no more than 2000 mg of sodium daily. In some cases, we need to go even lower. There is always great confusion regarding salt and sodium, and the foods to stay away from. Many times, patients will state "I haven't used salt in years", yet on a quick scan of their diet history, they are well over 2000 mg. How does this happen, you ask? I do not doubt the patient is telling the truth and retired their salt shaker years ago, yet the sodium content of prepared foods is huge, and this is what throws most everyone over the limit. Eating out regularly, or consuming prepared foods that you nuke, are all loaded with sodium. In addition, both of these activities will lead to obesity.

 

Links related to dietary sodium are listed here. Let us know what you think on this subject by commenting below.

 

Dangers of Dietary Sodium

 

More Bad New on Sodium

 

American Heart Association and Salt

Listen to the interview here

Colon Cancer Awareness Month: Harry Smith Has His Colonoscopy LIVE on TV

I had the pleasure, though brief opportunity to meet Harry Smith several years ago at CBS Headquarters in New York City - we shared a video editing room while I waited for Dan Rather to show up for a photo shoot I was conducting (that story later). Harry was a great conversationalist, and seemed to be an alla round good guy.

Now we get to see him getting his colonoscopy. The take away point is that he is comfortable during the procedure. Rumors of barbaric screems and torture during the procedure are unfounded.

 

March is Colon Cancer Awareness Month:Colonoscopy Bowel Prep Instructions

March is Colon Cancer Awarenessmonth. One of the methods for screening for colon cancer is a colonoscopy. For most patients, there is anxiety over the need to take the bowel preparation, which is a sometimes bad tasting solution that is consumed the day before the procedure.  Technology has improved, and the products we use at Liver Specialists of Texas are much improved, and most patients do not complain too much.

There is a podcast on the Liver Specialists of Texas website that outlines the specific directions for the bowel prep we use. In all cases, consult with your own physician regarding the bowel prep they request. Listen to the podcast posted below.

Schedule your colonoscopy this month.

PODCAST: Download Bowel Prep Instructions

March Is Colon Cancer Awareness Month Podcast: Part 1

March is Colon Cancer Awareness Month.

Listen below to an audio file from Dr. Galati regarding general issues related to colon cancer.

Colon Cancer Month

Low Salt Diets: More Education Needed

A delightful new patient was seen in the office today with the diagnosis of non-alcoholic fatty liver disease that unfortunately had progressed to cirrhosis.  She was accompanied by her sister. They we both obese, on the borderline of morbid obesity. The cornerstone of treatment is to get her weight under control, and I estimated that she would have to lose approximately 75 pounds to get anywhere near a reasonable, safe body weight.  We discussed several strategies, but the one point that stood out is that she was consuming massive amounts of dietary sodium (salt). Here diet was a parade of processed, nutrient stripped foods, loaded with enough salt for a week. These were the foods she regularly consumed:

   Sodium per serving

Frozen dinners:   800 mg
Commercial vegetable juice:    650 mg
Canned corn: 610 mg
Packaged deli meats:     605 mg
Canned soups:    1025 mg
Chinese food:    3500 mg

Adding it all up, she was consuming well over 7,000 mg of sodium daily. Remember, patients with cirrhosis should shoot for 1800-2000 mg/day. On physical examination, she had well over 30 pounds of fluid hanging on her body.

The lesson once again is to be aware of the foods that are high in sodium.  You must read labels on the food you consume. The public needs to be re-educated on low salt diets. Parents with children equally need to be aware of this fact. It is impossible to maintain a low salt diet if you eat out on a regular basis. If for health reasons (heart failure, liver disease, kidney disease) you must be on a low salt diet, eating out has to be a thing of the past. It will save you money, and the the grief of being scolded by your physician.

Remember: CUT THE SALT!

 

More on First Lady Michelle Obama and Let's Move

Today in the office, it was another hectic day seeing patients. I was struck by how often I had to discuss obesity with patients and their family. The educational need in this area is overwhelming. Basic facts on calorie, salt, sugar, and fat content of foods is lacking.  You can direct patients to web sites all day to seek out information on food, nutrition, and fitness - but in the end my feeling is that they will still fail to really grasp this issue at hand. It is not that these people are not smart-not at all-it is simply the fact they there is a very high level of intensity that is required in getting the real message across. In has to be face to face education.

We have a great staff in our office, Liver Specialists of Texas. I simply don't have the time to allow the staff to spend any more time with the patients. We could spend all day talking about obesity with them.

Enter Michelle Obama. One family brought up her name, and the Let's Move effort she has outlined. They seemed to have the basic facts on the program, and the issues at hand. Michelle Obama did seem to connect with them. The First Lady has limits to her time I would imagine. She would need to be pounding the pavement 12 hours a day for the next three years to even make a minor dent in the problem of obesity. So where do we all stand with this?

We have to reach the youth, their parents, educators, school administrators, and corporate leaders. One clear message needs to be in tune. Obesity is killing us. Obesity is killing our children. Obesity is going to bankrupt the economy. If we can fix this problem of obesity, healthcare reform (aka address obesity), and cost savings, would be a true victory.

Do the following starting tomorrow and everyday thereafter:

1. Reduce your salt (sodium) intake to 2,000 mg per day.
2. If you go out to eat, order one meal and split in two with you partner.
3. Weigh yourself daily and record it.
4. Start a food diary and record everything you put down the trap.
5. Exercise 5 days per week. Remember 3500 calories burned is a pound lost.
6. Don't eat anything out of a can, box, or bag. Fresh fruits and veggies are the only way to go.
7. Look in the mirror at yourself every morning.

Take responsibility for yourself, and your health.