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  Phone : 610.375.0500

All Posts in Category: Dr. Joseph R. Levan

Stereotactic Breast Biopsy: Minimally Invasive Cancer Screening Care

In the fight against breast cancer, it may be reassuring to know that they are many effective screening tests in regular use today. When a routine mammogram detects an abnormality, including calcifications within the breast, your doctor may order a biopsy to further aid in diagnosis.

Which Biopsy For My Situation?

There are different types of breast biopsies, and your doctor will choose the biopsy best suited for your care. Generally the type of biopsy used depends on whether a lump can be felt, or if a previous mammogram showed a change within the breast. In many cases, however, a minimally invasive stereotactic breast biopsy may be utilized for its many benefits.

A stereotactic biopsy is an x-ray based, image-guided process that assists the doctor in pinpointing the area of concern, from which a small tissue sample is collected for examination and final diagnosis.

What Can I Expect?

When making your appointment for a biopsy, it’s always a good idea to ask how long the procedure is expected to take. As with any procedure, it may be comforting to have a friend or family member accompany you to the appointment and wait for you until the procedure is completed. For the procedure you’ll either lie down or sit upright, depending on the imaging equipment used.

Just like a mammogram, on the day of the biopsy don’t wear perfume, deodorant, lotion, or put anything else on your skin. This is so the imaging equipment will be able to accurately view the area of concern. A numbing agent will be used on the breast area so you won’t feel any pain. Again just like a mammogram, the breast is compressed between two plates to x-ray the targeted area. A small tissue sample is then taken for examination.

How Soon Can I Go Home?

A stereotactic breast biopsy is a minimally invasive procedure, so unlike surgical biopsies that require an overnight stay, you are able to go home shortly after the procedure is finished. Once home, you may want to take it easy for 24 hours. Your doctor will provide additional self-care instructions as needed, as well as provide biopsy results once they are available. At all times, you are encouraged to ask as many questions as needed to fully understand the procedure, as well as what to expect both during and after.

Providing complete breast cancer screening, surgery and treatment services, Dr. Joseph Levan, Dr. Robert Howard and Dr. Thomas Beetel of Spring Ridge Surgical Specialists perform stereotactic breast biopsies at Reading Health System, and Penn State Health St. Joseph. Each of our surgeons take pride in making certain patients fully understand their care, and options available to them. If you have any questions pertaining to breast cancer care, please contact Spring Ridge Surgical Specialists at 610.375.0500.

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Woman drinking water from a glass to help prepare for a colonoscopy

Getting Ready for Colonoscopy: What’s New about the “P” Word

No doubt, the dreaded “P” word can conjure up mild apprehension. We are talking, of course, about “prep”, the oh-so necessary process prior to a colonoscopy. Everyone has heard stories about it, maybe even experienced it with a prior procedure. It’s OK if you’re beginning to get a nervous knot in your stomach at the mere thought of “prep”, but we’re here to tell you times have changed, and that usually means things get better, more informed. Such is the case with “prep”.

You made the appointment. You’ve completed the hardest part.

Of course, the benefit of having a colonoscopy to check for polyps or any other potentially cancerous abnormalities within the digestive tract far outweighs the very temporary inconvenience of its “prep”. Fortunately, ongoing advancements of “prep” methods over the past few years have provided more patient-friendly approaches that make “prep” – excuse the pun – easier to swallow.

One example is the evolution away from the high volume (upwards of 12 liters) liquid solutions that had to be consumed, to the more current method of combining liquids and laxatives in a timed regimen. Another common approach is the “split” prep, where half of the regimen is consumed the day before the colonoscopy and the second half on the day of the colonoscopy. Your doctor will discuss what approach is best for you, as well as provide detailed, easy to follow written instructions for the “prep” itself.

An easier process with better results.

As we shared before, welcome side effects from “prep” advancements are an easier process for patients, as well as a higher success rate in achieving a total cleanse of the colon to ensure best screening during the procedure. Many of our patients report the “prep” was much easier than they expected, especially if they experienced their first colonoscopy.

It’s all down hill from here.  

With other surgical procedures, things can sometimes get more difficult as each step progresses. With colonoscopy, it’s the opposite. Making the appointment, doing the “prep”; that’s the heavy lifting. By the time your colonoscopy is finished, you will probably have a feeling of “is that it?” Regardless of what your screening reveals, from a practical standpoint, yes, that’s it.

Dr. Joseph Levan, Dr. Robert Howard and Dr. Thomas Beetel of Spring Ridge Surgical Specialists all perform colonoscopy at Surgical Institute of Reading, right next to the offices of Spring Ridge Surgical Specialists in Wyomissing. If you have questions about screening for colon cancer and colonoscopy, please call our offices at 610.375.0500.

– Spring Ridge Surgical Specialists

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Colorectal Cancer Screenings: Take Time to Put Yourself First

Possibly the biggest gift we can give ourselves is time. Time to smell the flowers, go for a long walk or just enjoy a laugh with friends. In our hectic lives, it’s easy to put ourselves last and not take the time we need to check in on our personal health. Even easier is to avoid taking a first step to what we know will help us in the long run. “I can do it tomorrow”, “I feel fine”, “I don’t have the time right now” are common roadblocks we might use to convince ourselves that routine health screenings just don’t fit into our busy lives right now.

Why and When to get Screened for Colorectal Cancer

At Spring Ridge Surgical Specialists, we consult with many patients who come to us hesitant to take the first step in screening for colorectal cancer, one of the most prevalent cancer types in the United States today. It’s important to point out that colorectal cancer often does not produce any symptoms until the disease is in the advanced stage. Whether referred by a family doctor, a family history of colorectal cancer, or having reached the suggested age of 50 to begin screenings, it’s natural to have many questions – some perhaps difficult or embarrassing to ask – but so important as you take an active role in your colorectal care. In this article, we’ll share basic information on the types of screenings and what you might expect with each.

What You Can Expect

The goal of any screening is to detect polyps within the gastrointestinal tract. Your doctor will discuss the screening method best for your individual health needs. If detected, the majority of polyps is usually non-cancerous and not cause for concern if promptly removed. Lab testing of the removed polyps will confirm if cancer is present or not.

  • Colonoscopy is the best test available today that doctors can utilize to detect the presence of polyps and remove them during this minimally invasive procedure.  A day before your procedure, bowel prep will need to be performed at home. During the painless procedure, you will be sedated, asleep and completely comfortable. A long, flexible tube will be inserted and guided throughout the entire colon, producing images the doctor will see on a video monitor to determine if polyps are present.
  • Digital Rectum Exam (DRE) is a painless exam your doctor performs in the office to detect polyps in the rectum or anus.
  • Fecal Occult Blood Test tests for blood in the stool that can’t be seen, but if present may indicate polyps or cancer.

Regardless of the screening method your doctor recommends for you, it’s important to ask as many questions as necessary so you fully understand the procedure. Dr. Robert Howard, Dr. Joseph Levan, and Dr. Thomas Beetel each take pride in educating patients on the benefits of colorectal cancer screenings, and what to expect during a screening procedure.

Most importantly, as an informed patient you have the power to take time for yourself and maintain your best health!

– Spring Ridge Surgical Specialists

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Computer tablet with the words "Acid Reflux" appearing on screen

Barrett’s Esophagitis: A Condition Caused by GERD

GERD and its Impact on the Esophagus

As we shared in other posts, GERD (short for “gastroesophageal reflux disease”) is the culprit in creating heartburn, the painful burning sensation felt in the throat and chest after eating certain foods.  It is estimated that approximately seven million people in the United States, from adults to infants, suffer from the symptoms of GERD at some point in their lives. For many people, the affects of GERD are felt only occasionally such as after a very large meal (think Thanksgiving). But for some who suffer from heartburn on a regular basis, GERD can cause other conditions if left untreated. One such condition this post will discuss is Barrett’s Esophagitis.

When GERD occurs, acidic fluids from the stomach flow backwards, or reflux, up into the esophagus. These caustic fluids irritate the lining of the esophagus, creating the burning sensation commonly referred to as heartburn. Repeated bouts of GERD over an extended period of time can damage the lining of the esophagus, creating a condition called Barrett’s Esophagitis. Although not cancerous itself, the presence of Barrett’s Esophagitis indicates the lining of the esophagus has been changed enough that cancerous cells could develop.

How Barrett’s Esophagitis is Detected

In many cases, Barrett’s Esophagitis is detected during routine diagnostic evaluation for GERD via an upper endoscopy. During this minimally invasive procedure, a small flexible tube with a video camera is used so the surgeon can perform a visual analysis of the affected area.   In a healthy esophagus, the lining is pink and uniform in color. With an esophagus affected by Barrett’s Esophagitis, the lining appears uneven in color and pattern, as seen in this side by side comparison:

Barretts comparison

If Barrett’s Esophagitis is present, your surgeon may need to perform additional testing such as biopsies to detect the presence of pre-cancerous or cancerous cells within the esophagus.

Preventing Further Damage from Barrett’s Esophagitis

Your surgeon will keep track of any changes in your esophagus through regular testing. The good news is that controlling the symptoms and potential esophageal damage from GERD is often achievable with lifestyle changes your surgeon can suggest specifically for your condition. These can include losing weight, avoiding smoking and alcohol, and eliminating greasy and high-fat foods that create reflux.

Dr. Thomas Beetel, Dr. Robert Howard, and Dr. Joseph Levan of Spring Ridge Surgical Specialists each provide evaluation of GERD and Barrett’s Esophagitis. With offices located at 2758 Century Boulevard, Suite 1, Wyomissing, PA., many procedures are performed at the adjacent Surgical Institute of Reading. To make an appointment to see Dr. Beetel, Dr. Howard, or Dr. Levan, please call 610.375.0500.

– Spring Ridge Surgical Specialists

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Illustration of Reflux Aggravating Foods - pasta, citrus, chocolate and wine

Best Foods to Eliminate If Suffering From Reflux

Summertime Foods Often Aggravate Reflux

With summer cookouts in full swing, Spring Ridge Surgical Specialists would like to share some insight into what might cause that post-barbeque digestive discomfort.

As we shared in a previous post Evaluation of Reflux: Providing Best Treatment by Targeting the Cause, reflux occurs when digestive acids in the stomach flow backwards – or “reflux” – up into the esophagus. Unfortunately, some of the season’s favorite foods can cause that uncomfortable burning sensation in the chest that is hard to ignore.   The good news, however, is relieving the discomfort of reflux may be as easy as cutting back on or avoiding foods that aggravate the digestive tract.

Identifying and Eliminating Aggravating Foods a Great First Step

Generally, highly acidic or difficult to digest foods are the main offenders contributing to reflux. Tomato sauces, fatty or greasy foods, wine/liquor, chocolate and citrus juices are particularly prone to creating painful bouts of reflux.  Reducing the intake of these foods is a great way to proactively manage the discomfort of reflux without the use of medication.

If you still experience the pain of reflux even after eliminating certain foods, you may want to be evaluated for reflux by a physician. Dr. Thomas Beetel, Dr. Robert Howard and Dr. Joseph Levan of Spring Ridge Surgical Specialists each provide evaluation and surgical treatment for reflux disease. To contact our office, please call 610.375.0500.

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Picture of Dr. Robert Howard, Dr. Joseph Levan and Dr. Thomas Beetel of Spring Ridge Surgical Specialists

The Three Best Questions to Ask Your General Surgeon Before Surgery

Taking An Active Role in Planning For General Surgery

As consumers, it’s very much second nature for us to gather and sort through masses of information on countless products and services, choosing the one we think will work best.   When taking on the role of patient, however, sometimes there is a hesitancy to ask questions about concerns that could have a major impact on our health. If you can relate to the feeling of “I should’ve asked”, Spring Ridge Surgical Specialists would like to offer three of the best questions to ask your surgeon prior to general surgery.

Discussing General Surgery’s Surgical Methods

First, of course, is asking about the type of surgery and surgical method that will be utilized. Used to treat many conditions within the abdomen, including the colon and hiatal hernias, minimally invasive laparoscopic and robotic surgery uses keyhole-sized incisions to access and address areas of concern. As we shared in a previous post, What Is Minimally Invasive Surgery?, the advantage of minimally invasive laparoscopic and robotic surgery is a much quicker recovery period when compared to traditional open surgery with its large incision and lengthy recovery.

Become Familiar with Your Hospital

The second question to ask your general surgeon prior to surgery is equally important. Just as you select a surgeon based on comfort level and expertise, it’s best to become familiar with the surgical hospital where your surgeon will perform your procedure. Typically, surgeons are affiliated with specific surgical hospitals, so when you choose your surgeon, you are in effect also choosing the surgical hospital where your procedure will occur. Ask your surgeon what advantages the surgical hospital offers, compared to others in the area, so you have confidence in where your surgery will occur. In our practice, surgeons Dr. Thomas Beetel, Dr. Robert Howard, and Dr. Joseph Levan perform minimally invasive endoscopic, laparoscopic and robotic procedures at Surgical Institute of Reading, including laparoscopic treatment of incisional and inguinal hernias, reflux, as well as conditions of the colon and gallbladder.   Our practice is also affiliated with and performs procedures at Penn State Health St. Joseph and Reading Health, respectively.

For Your Health’s Sake, Ask Away!

Lastly, ask questions about what you can expect during your recovery period after surgery. How long will you stay in the hospital after surgery? Will you need to be driven home by a friend or family member after surgery? Will someone need to assist you with your personal care during recovery? How soon will you be able resume regular activities, including returning to work? Knowing the answer to these and other questions prior to surgery can make all the difference in having a positive surgical experience and outcome.

To Your Best Health,

Spring Ridge Surgical Specialists
2758 Century Boulevard, Suite 1
Wyomissing, PA 19610
610.375.0500

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Reflux as shown in healthy stomach, and stomach affected by GERD

Evaluation of Reflux: Providing Best Treatment by Targeting the Cause

Reflux, also referred to as GERD (gastroesophageal reflux disease), affects millions of people in the United States today. Its most widely known symptom is heartburn, a burning sensation in the throat or chest. But to clarify, “heartburn” has nothing to do with the heart. The problem, in fact, lies in the digestive tract.

Clearing Up the Confusion about Reflux 

As we’ve shared in a previous post Reflux Disease: Helpful Measures for a Common Condition, reflux indicates digestive acid has been allowed to escape through a weakened one-way valve at the top of the stomach and travel upwards through the esophagus and into the throat. Most people suffer from an occasional bout of reflux, particularly after a large meal or lying down right after eating. But when an occasional bout turns into a regular occurrence, it may indicate a larger – yet very common – condition requiring diagnosis.

Evaluation Key to Diagnosis 

A thorough discussion about your symptoms with your physician will aid in the best diagnosis and treatment. For the occasional “heartburn” sufferer, over-the-counter medications or lifestyle changes may be all that is needed. If suffering from regular, ongoing occurrences, however, your physician may suggest a physical exam and diagnostic testing to pinpoint the cause and provide diagnosis of reflux. Your physician will order testing most appropriate for your symptoms, but they can include any of the following:

  • An upper gastrointestinal (GI), which produces x-rays of the digestive tract. After swallowing a barium shake, the x-ray monitors the barium dye as it moves along the tract to the stomach, capturing images of any reflux as it occurs.
  • An esophageal endoscopy, which sends images of the esophagus and stomach to a video monitor enabling the surgeon to evaluate the esophagus for signs or acute or chronic damage caused by stomach acid.
  • An esophageal manometry, measuring the muscle tone of the one-way valve at the top of the stomach. This is performed if your physician believes you are a candidate for surgical correction of reflux.

Dr. Robert Howard, Dr. Thomas Beetel and Dr. Joseph Levan of Spring Ridge Surgical Specialists each provide thorough evaluation and surgical treatment of reflux disease. Surgical treatment is performed at Surgical Institute of Reading, conveniently located in the same complex as the Spring Ridge Surgical Specialists practice offices. To make an appointment to see Dr. Howard, Dr. Beetel or Dr. Levan at Spring Ridge Surgical Specialists, please call 610.375.0500.

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Picture of Dr. Robert Howard, Dr. Joseph Levan and Dr. Thomas Beetel of Spring Ridge Surgical Specialists

Reflux Disease: Relief for a Common Condition

Reflux disease, also referred to as GERD (gastroesophageal reflux disease), is a common condition affecting millions of people regardless of age. As we shared in a previous post, A Burning Issue: Gastroesophageal Reflux Disease, reflux is caused by acid escaping from the top of the stomach and travelling as far up as the throat, creating a very uncomfortable burning sensation many refer to as heartburn.

Making Sense of Reflux Symptoms

Besides heartburn, many people suffering from reflux experience other painful symptoms that can sometimes be confused with other conditions. The symptoms can include belching, chronic cough and hoarseness, pain in the upper abdomen or worsening of symptoms when bending over or lying down. Left untreated, reflux can worsen and in some instances, develop into cancer. With all of these factors in mind, it is vitally important to seek physician evaluation to properly diagnose and treat reflux as early as possible.

Non-Surgical Treatment for Reflux Disease

Relieving the pain associated with reflux is of course a physician’s first priority. In doing so, your physician will work with you to find the right treatment appropriate for your symptoms. Lifestyle changes, use of over-the-counter medications or simply raising the head of the bed may be sufficient in providing relief. In some cases, your physician may recommend use of medication to reduce stomach acid or speed up digestion to alleviate symptoms.

When Reflux Persists

If still bothersome, your physician may recommend surgical treatment to ultimately correct reflux. With reflux, the one-way valve between the esophagus and stomach is weakened, allowing stomach acids to travel back up into the throat. To effectively treat the condition, the surgeons at Spring Ridge Surgical Specialists utilize minimally invasive surgery to perform laparoscopic fundoplication to correct the one-way valve as needed.

Dr. Robert Howard, Dr. Thomas Beetel and Dr. Joseph Levan of Spring Ridge Surgical Specialists each provides non-surgical and surgical treatment of reflux disease. Surgical treatment is performed at Surgical Institute of Reading, conveniently located in the same complex as the Spring Ridge Surgical Specialists practice offices. To make an appointment to see Dr. Howard, Dr. Beetel or Dr. Levan at Spring Ridge Surgical Specialists, please call 610.375.0500.

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Olga and Zuleica earn their CCMA!

A big congratulations to Olga Rivera (left) and Zuleica Gonzalez-Ortiz (right) of Spring Ridge Surgical Specialists, who recently completed intensive training and testing to earn their Certified Clinical Medical Assistant (CCMA) certification! Also pictured is Dr. Thomas Beetel (middle), who along with Dr. Robert Howard and Dr. Joseph Levan of Spring Ridge Surgical Specialists, fully sponsored Olga’s and Zuleica’s studies.

Having previously earned their Medical Assistant credential, Olga and Zuleica’s new CCMA certification qualifies them both to expand their patient care responsibilities.  As multi-skilled healthcare providers, Olga and Zuleica are now certified to perform patient interviews, measure and record vital signs, prepare exam rooms, clean and sterilize medical equipment, administer injections, perform venipuncture and assist with EKG’s, all under physician supervision.

Our thanks to Olga and Zuleica for all the hard work to earn the CCMA! Congratulations!

 

 

 

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Picture of Dr. Robert Howard, Dr. Joseph Levan and Dr. Thomas Beetel of Spring Ridge Surgical Specialists

Get In, Get Out: Spring Ridge Surgical Specialists Provides In-Office Treatments

It’s understandable to put off having minor surgical procedures done, especially when it can involve taking time off from work and rearranging family responsibilities to schedule your care.

In conditions requiring only minor treatment, however, the surgeons at Spring Ridge Surgical Specialists – Dr. Joseph Levan, Dr. Robert Howard and Dr. Thomas Beetel – often provide in-office procedures to fully manage certain conditions. After surgeon evaluation of the condition, treatment of very common issues such as hemorrhoids and cysts, as well as biopsies, can often be provided in our offices conveniently located in Wyomissing.

If you have a question about a condition you are trying to manage, click here to make an appointment in our office  or call 610.375.0500 today to schedule an appointment with one of our surgeons.

Spring Ridge Surgical Specialists. General Surgery. Compassionate Care.

 

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