1. science
2. medicine
3. surgery

March 2010 | Reading Time: 15 Minutes
leading edge
5950 University Avenue | West Des Moines 50266 515.875.9100 | iowaclinic.com
Laparoscopy for Gynecologic Cancers
By Steven Elg, M.D., Ph.D. – Gynecologic Oncologist
The Iowa Clinic Gynecologic Oncology Department
The Iowa Clinic’s Gynecologic Oncology Department
is pleased to offer the only Single Port Laparoscopic
Program in Iowa for suspected pelvic masses,
prophylactic salpingo-oophorectomies for patients with
BRCA1/2 mutations as well as early endometrial cancers.
The idea behind this innovative approach is to utilize a single small
incision in a natural orifice of the body such as the umbilicus. Unlike
robotic surgery which leaves the patient with four to five incisions up to
¾ of an inch in size or traditional laparoscopy which results in three to
four ½ inch incisions, single port laparoscopic surgery employs a single ¾
inch incision that is virtually “scar less”.
Since performing the first single port hysterectomy in Central Iowa last
year we have found that patient satisfaction has been extraordinarily
favorable. Technological advances that make the surgery possible include
a 5 mm laparoscope with an articulating head and exceptionally good
optics as well as articulating 5mm instruments. Sometimes multiple
complex procedures can be performed through the same small single
incision by a team of trained surgeons. Recently Dr. Fialkov, a Urologist
with The Iowa Clinic, performed a partial nephrectomy and I followed
to remove bilateral ovarian masses through the same tiny incision. This
surgery was reported to be the first of its kind in Iowa and resulted in a
very short hospitalization as well as a minimal scar for the patient.
Single port laparoscopy may not be suitable for all women requiring
surgery for a gynecologic malignancy, which is why we also perform
robotic and traditional laparoscopy. A decision on the surgical
approach should be made
after careful consultation
with a physician familiar
with all available techniques.
To contact Dr. Elg please
call 515-241-4161.
®2010 The Iowa Clinic, P.C.
2
3
•Essure – A n Office-based Permanent Birth Control Option for Your Patients
•Advances in
Hearing Technology
•Research News in Brief
innovation | communication | education
The Access Center at The Iowa Clinic
By John Matsuura, MD – Vascular Surgeon
The Iowa Clinic Cardiovascular Services Department
A patient who faces the prospect of hemodialysis for
renal failure has tremendous challenges that will alter
his or her lifestyle forever. They must commit a half
day to treatment an average of three times a week.
Unfortunately, the hemodialysis access fistulas and catheters are prone
to complications of thrombosis and infection. It takes a dedicated staff
to monitor and maintain dialysis access in these patients. As vascular
surgeons, we have often played a role in creating
hemodialysis access fistulas and grafts.
However, the role of maintenance was
not clearly defined and patients often
presented when their access had
already failed. Nephrologists and
dialysis centers had few options
beyond sending patients to
radiology, where they sat in a
crowded waiting room until their
name was called to undergo
treatment of their failed access.
As a group, we recognized the
growing problem. How would we
feel, if we were in their situation? Is
there a more efficient and cost effective
solution? Two months ago, we opened
the doors to the Access Center at The Iowa
Clinic. It is the first access center in Iowa and is designed with a clinic
approach to the problem of hemodialysis access. Jessica is our dedicated,
full time receptionist and scheduling secretary. She talks directly with
the dialysis centers and schedules the patients for appointments rather
than the traditional, come early and “pick a number and wait in line”.
Barb Thompson is our access nurse who has many years of experience
in both critical care and radiology nursing. Stephanie Steuben is our
certified radiology technician who comes with several years of experience
in endovascular therapy. Our vascular group covers the Access Center
full time to meet the needs of our patients. It is hoped, the patients
will recognize our center as their doctor’s office. No more hospital
registration and sitting in crowded waiting areas. The came walk in
and have immediate service. We are also providing ongoing monitoring
of their access. We place a high priority on education. Through word
of mouth from our patients, we now see referrals from over 15 dialysis
centers in the State of Iowa from places as far away as Ottumwa and
Fort Dodge.
continued on next page >
Essure – An Office-based Permanent Birth Control Option for Your Patients
By Steven Keller, M.D. – Obstetrician & Gynecologist
The Iowa Clinic Obstetrics & Gynecology Department
Introduction
Permanent contraception for women via a simple office
procedure has been available through our office for
nearly 3 years and has become the method of choice
for most women seeking permanent, non-hormonal birth control.
The Essure micro-insert tubal occlusive devise allows the patient to
obtain permanent sterilization in the office setting without the need for
general anesthesia and with no incisions. Compared to the traditional
laparoscopic tubal ligation, this procedure offers a much quicker recovery,
less risk of operative or anesthetic complications and is considerably less
expensive. Some patients will pay only the cost of a simple office co-pay.
Like many procedures, the devise was initially placed in an outpatient
surgical setting when first introduced in 2002, but has quickly become
a popular office procedure. Since FDA approval, tens of thousands of
women worldwide have had the procedure and studies confirm 99.8%
effectiveness at 4 years follow-up.
Patient Selection
First and foremost, this procedure is considered to be 100% permanent
and not to be considered reversible. Since there are no hormones
involved, the procedure will have no effect on cycle length, flow,
premenstrual symptoms or menopause. Patients should therefore be
counseled that their menses will likely return to “normal” but should
be reminded that this may be heavier than expected if recently on
oral contraceptives.
The ideal office candidate should demonstrate normal pelvic anatomy
and be able to tolerate up to 30 minutes in dorsal lithotomy position.
This can be assessed at the pre-operative consultation visit.
There are very few contraindications but the procedure should not be
performed in individuals with a known nickel hypersensitivity, known
allergy to contrast media, active pelvic infection or any pregnancy event
within the last 6 weeks.
This procedure can also be performed in situations in which laparoscopic
tubal ligation would not typically be advised such as severe pelvic
adhesive disease or multiple prior abdominal/pelvic surgeries. Those
with cardiovascular or respiratory conditions that may make general
anesthesia undesirable may also be candidates for the Essure in an
office setting.
Mechanism of Action
The small, flexible micro-inserts consist of polyethylene fibers tightly
wrapped around a stainless steel inner core. An expandable nickel
alloy coil surrounds the device and when deployed anchors the device
within the junction of the uterus and fallopian tube. Once placed,
the polyethylene fibers cause reactive in-growth of tissue, which both
permanently blocks the tubes and permanently holds the device in
place. This process is generally completed in 3 months and a follow-up
low-pressure office radiographic hysterosalpingogram (HSG) is performed
to confirm tubal occlusion. Occasionally, an additional 3 months may be
required for complete occlusion.
Procedure
The patient typically is instructed to take an over the counter NSAID,
such as Ibuprofen, prior to arriving. Consent is obtained and a negative
pregnancy test verified. Toradol IM and a paracervical block are
administered for patient comfort and to reduce the chance of tubal
spasm. A small 5.5 mm hysteroscope with saline is introduced into the
uterus, typically with no dilation required. Once both internal ostia are
identified, the micro-inserts are placed under direct visualization. The
patient is also able to watch the procedure herself as the micro-inserts
are placed. She is observed shortly following the procedure, and then
discharged to home. She may resume normal activities immediately if
desired. The entire procedure takes 35 minutes on average.
Follow up
Patients may experience some mild cramping or spotting for 24 – 48
hours, but symptoms typically respond well to Ibuprofen and rest if
needed. She should continue to use an alternative birth control method
until the HSG is performed 3 months later.
Conclusion
The Essure procedure is a minimally invasive, non-incisional office
procedure which can provide permanent birth control with less risk,
less discomfort, quicker recovery, greater efficacy and less cost than
laparoscopic tubal ligation, and may even be an option for some patients
that would not be laparoscopic tubal ligation candidates.
If and when you have a patient who is a candidate for Essure, we hope you’ll
consider The Iowa Clinic Obstetrics & Gynecology Department. Call 875-9290.
The Essure®®®® Procedure for Permanent Birth Control
The
The Essure
Essure Procedure
Procedure for
for Permanent
Permanent Birth
Birth Control
Control
The Essure® Procedure for Permanent Birth Control
The
The Essure
Essure micro-inserts
micro-inserts are
are inserted
inserted through
through the
the vagina
vagina
The into
Essure
micro-inserts
are without
insertedincisions.
through the vagina
and
the
Fallopian
and into
themicro-inserts
Fallopian tubes
tubes
The
Essure
are without
insertedincisions.
through the vagina
and into the Fallopian tubes without incisions.
and into the Fallopian tubes without incisions.
The Essure micro-inserts are inserted through
the vagina and into the Fallopian tubes
without incisions.
Upon
Upon placement,
placement, the
the Essure
Essure micro-inserts
micro-inserts expand
expand to
to fit
fit each
each
Upon placement,
the
Essure
micro-inserts
expand to
fit
each
Fallopian
tube.
helps
to
the
in
place
Fallopian
tube. This
This
helps
to hold
hold
the micro-inserts
micro-inserts
in fit
place
Upon
placement,
the
Essure
micro-inserts
expand to
each
Fallopian
tube.barrier
This helps
to hold the micro-inserts in place
while
forms.
while aa tissue
tissue
forms.
Fallopian
tube.barrier
This helps
to hold the micro-inserts in place
while a tissue barrier forms.
while a tissue barrier forms.
Upon placement, the Essure micro-inserts expand
to fit each Fallopian tube. This helps to hold the
micro-inserts in place while a tissue barrier forms.
During
During the
the 3
3 months
months after
after the
the Essure
Essure procedure,
procedure, tissue
tissue grows
grows
During
the
3 months
after the
Essure
procedure,
tissue grows
into
Essure
micro-inserts
to
form
natural,
barrier.
into the
thethe
Essure
micro-inserts
to Essure
form aaprocedure,
natural, permanent
permanent
barrier.
During
3 months
after the
tissue grows
into the Essure micro-inserts to form a natural, permanent barrier.
into the Essure micro-inserts to form a natural, permanent barrier.
During the 3 months after the Essure procedure,
tissue grows into the Essure micro-inserts to form a
natural, permanent barrier.
The Essure Confirmation Test is performed after 3 months. Dye
is inserted into the uterus and an x-ray is taken to confirm that
the tubes are blocked and that reliance on Essure for permanent
birth control can begin.
The
The Essure
Essure Confirmation
Confirmation Test
Test is
is performed
performed after
after 3
3 months.
months.
The Essure
Confirmation
Test isand
performed
after
3 months.
Dye
is
into
an
is
to
Dye Essure
is inserted
inserted
into the
the uterus
uterus
an x-ray
x-ray after
is taken
taken
to confirm
confirm
The
Confirmation
Test isand
performed
3 months.
Dye the
is inserted
intoblocked
the uterus
and
an
x-ray on
is taken
to confirm
that
tubes
and
that
reliance
Essure
that the
tubes are
are
and and
that an
reliance
ontaken
Essure
Dye
is inserted
intoblocked
the uterus
x-ray is
to confirm
thatpermanent
the tubes are
blocked
and
that
reliance on Essure
for
birth
control
can
begin.
for permanent
birth
controland
canthat
begin.
that
the tubes are
blocked
reliance on Essure
for permanent birth control can begin.
for permanent birth control can begin.
Copyright © 2007 Conceptus Incorporated. All Rights Reserved. CC-0304 09Nov07F
Copyright © 2007 Conceptus Incorporated. All Rights Reserved. CC-0304 09Nov07F
Copyright © 2007 Conceptus Incorporated. All Rights Reserved. CC-0304 09Nov07F
Copyright © 2007 Conceptus Incorporated. All Rights Reserved. CC-0304 09Nov07F
The Access Center. . . continued from previous page
Renal failure will continue to become a major health care problem with
an average growth rate of 7% per year. In the U.S. alone, this is a 75
billion dollar problem. World wide, there are over 2 million patients
on chronic hemodialysis and it is estimated that the cost of dialysis will
reach one trillion dollars in the next decade. To put it in perspective, that
amounts to six times the value of all the gold in Fort Knox. It is our hope,
that the Access Center at the Iowa Clinic will become recognized as a
quality leader in this area.
The Iowa Clinic Vascular Access Center can be reached at 515-875-9750.
Advances in Hearing Technology
By Jennifer Brown, MA, CCC-A – Audiologist
The Iowa Clinic Audiology & Hearing Aid Department
Hearing aids have come a long way since our
grandparents’ times. Gone are the days of the clunky,
cumbersome, whistling monstrosity jutting out of the ears
of those with hearing impairment. Today’s hearing aids
are more sleek and streamlined than ever. Not only have the cosmetic
aspects of hearing instruments been greatly enhanced, the internal
features and fidelity of these new instruments has skyrocketed over
the past 5 years.
According to the
Sergi Kochin, Ph.D.,
at The Better
Hearing Institute,
about 31million
people in America
have hearing loss,
while there are 22
million people in
the US who have
never tried hearing
aids. We hope to
change this.
With these advancements in technology we are now able to help patients
that we might not have been able to help in the recent past. Not only
has the criteria for hearing aid candidacy been expanded, but the new
range of features within the instruments themselves allow exceptional
customization to fit the even the most outgoing lifestyles our
patients lead.
Active learning processes within the hearing instruments analyze the
wearers preferences in actual listening environments and customize
the settings accordingly. The need for manual adjustments is ultimately
reduced, as is the need for numerous return appointments for the
audiologist to adjust the hearing aid. After all, who is more capable
of making decisions regarding their own listening preferences than
the patients themselves?
The most exciting advancement in recent years has been connectivity.
Hearing aids can now be synched wirelessly to cell phones, televisions,
MP3 players and computers. This allows the patient to listen to these
devices directly through the prescription tuned hearing instruments,
providing exceptional signal-to-noise ratios and clarity. The hearing
aid wearer simply carries a small, discreet interface that links the hearing
instrument to a number of selected devices and transmits the sound
wirelessly to the ear.
In a nutshell…out with the old and in with the new. Hearing aids have
indeed come a long way. We are excited to offer this new technology to
customize prescription tuned hearing instruments to the high-tech,
active lifestyles with which our patients have challenged us.
The Iowa Clinic Audiology/Hearing Technology Department is supported by
five board certified otolaryngologists. Please call 515-875-9450 to schedule
an appointment.
Research News in Brief
The Iowa Clinic Department of Urology has a long history of providing
the finest care for patients in Central Iowa. The department has
participated in clinical research for over 13 years, including phase II
through phase IV studies, as well as device studies. They have worked
with most major pharmaceutical companies and sponsors. Conducting
clinical research allows the specialty physicians access to leading edge
medicine and treatment, and provides patients with the most current
aspects of medical science.
Studies have been completed in nearly every urologic condition,
including BPH, prostate cancer, erectile dysfunction, bladder cancer,
overactive bladder, stress urinary incontinence, prostatitis, and
hypogonadism. The research department has been a research center
for pivotal new drug applications to the FDA for the following
medications, Cialis, Avodart, Uroxatral, Enablex, Vesciare, Toviaz
and Zometa to name a few.
Right now a multi-center study is underway using High Intensity
Focused Ultrasound (HIFU) for prostate cancer. It gives the patient
an opportunity to undergo therapy that offers minimally invasive
treatment for recurrent localized prostate cancer that has not spread
or metastasized outside the prostate. It is considered investigational in
the United States and The Iowa Clinic is one of 20 centers undergoing
clinical trials for FDA approval. (HIFU is already approved and used
outside the US. Precision focused ultrasound waves are used to ablate
diseased prostate tissue via the Sonablate 500 system. The treatment can
be repeated if necessary, and having HIFU does not preclude patients
from having further treatment).
Urologists at TIC have also begun an international multi-center clinical
trial to explore treatment for patients with overactive bladder symptoms
that could offer improvement over traditional drug therapy. Patients
that are refractive to medical therapy are invited to participate in a
double blind, randomized, placebo-controlled study using Botox
(Botulinum Toxin Type A) for patients with Idiopathic OAB with
urinary incontinence.
For more information about the clinical research conducted at TIC or about the
above studies, please contact the research nurses at 515-875-9815, you can also
reach Mary Lepic at [email protected].
You can contact the Urology Department directly to speak to one of the
participating urologists at 515-875-9800.
Certifications
Amerlon Enriquez, M.D., is now board certified in sleep
medicine. Dr. Enriquez is the second board certified sleep
specialist at The Iowa Clinic and the West Lakes Sleep Center.
Amy McEntaffer, M.D., is now board certified in
Obstetrics & Gynecology.
John Houghton, D.O., is now board certified in
Obstetrics & Gynecology.
provider directory
CORPORATE OFFICE 515-875-9100 | WEST LAKES CAMPUS 515-875-9000
ALLERGY
Richard B. Merrick, MD
Richard J. Rinehart, MD
Mark K. Zlab, MD
5950 University Ave., #265, WDM
p: 875-9450 | f: 875-9457
Audiology/
Hearing Technology
Dawn A. Baldwin, AuD, CCC-A
Jennifer L. Brown, MA, CCC-A
Kimberly A. Krambeck, MA, CCC-A
Sheryl D. Neal, AuD, CCC-A
5950 University Ave., #265, WDM
p: 875-9450 | f: 875-9457
1212 Pleasant St., #410, DM
p: 875-9450 | f: 875-9457
Cardiovascular Services
Cardiology
Jonathan L. Fudge, MD
Frank N. Haugland, MD, PhD
David K. Lemon, MD
James P. Lovell, DO
Mohamed A. Morsy, MD
Pamela L. Nerheim, MD
Dirk A. Ver Steeg, MD
Jay Yans, MD
Steven L. Loveland, ARNP
Cynthia G. Marske, ARNP
5950 University Ave., #231, WDM
p: 875-9090 | f: 875-9312
1215 Pleasant St., #618, DM
p: 875-9090 | f: 875-9312
1810 SW White Birch Circle, #111,
Ankeny
p: 875-9090 | f: 875-9312
1005 Pennsylvania Ave.,
#102-A, Ottumwa
p: 641-684-2589
f: 641-684-2590
A. Nasser Khan, MD
1215 Pleasant St., #618, DM
p: 875-9090 | f: 241-8395
1005 Pennsylvania Ave., #102-A,
Ottumwa
p: 641-684-2589
f: 641-684-2590
Cardio-Thoracic Surgery
Ronald K. Grooters, MD
Robert F. Schneider, MD
Kent C. Thieman, MD
1215 Pleasant St., #618, DM
p: 875-9090 | f: 241-5930
Vascular Surgery
Dennis M. Fry, MD
Douglas W. Massop, MD
John H. Matsuura, MD
Eric C. Scott, MD
John A. Stern, MD
Anson A. Yeager, MD
5950 University Ave., #231, WDM
p: 875-9090 | f: 875-9077
Dennis M. Fry, MD
Douglas W. Massop, MD
John H. Matsuura, MD
Eric C. Scott, MD
Anson A. Yeager, MD
1215 Pleasant St., #618, DM
p: 875-9090 | f: 875-9077
John A. Stern, MD
411 Laurel St., #2380, DM
p: 288-8001 | f: 288-5890
John H. Matsuura, MD
John A. Stern, MD
Colorectal Surgery
P. Sue Beckwith, MD
5950 University Ave., #135, WDM
p: 875-9795 | f: 875-9796
P. Sue Beckwith, MD
Michael J. Page, MD
Kyle E. Rogers, MD
1212 Pleasant St., #211, DM
p: 283-1541 | f: 283-0473
Michael J. Page, MD
411 Laurel St., #2380, DM
p: 288-5858 | f: 288-5890
Kyle E. Rogers, MD
1301 Penn Ave., #115, DM
p: 262-3143 | f: 266-5116
DermAtology
J. William Holtze, MD
1221 Pleasant St., #500, DM
p: 241-8660 | f: 241-8662
Ear, Nose & Throat
Steven R. Herwig, DO, MBA
Richard B. Merrick, MD
Richard J. Rinehart, MD
Douglas L. Schulte, MD
Mark K. Zlab, MD
5950 University Ave., #265, WDM
p: 875-9450 | f: 875-9457
1212 Pleasant St., #410, DM
p: 875-9450 | f: 875-9457
Endoscopy center
Gloria J. Dayton, RN, BS
5950 University Ave., #180, WDM
p: 875-9145 | f: 875-9146
foot & ankle
surgery/ Podiatry
Eric A. Barp, DPM
K. Linda Bratkiewicz, DPM
David L. Groen, DPM
5950 University Ave., #160, WDM
p: 875-9876 | f: 875-9877
Gastroenterology
Laura L. Dakovich, DO
Joel E. Hade, MD
John D. Hines, DO
Charles C. Larson, MD
Tamas Otrok, MD
James G. Piros, MD
Ramon S. Reyes, MD
Justin C. Rice, MD
Raneen E. Schulte, PA-C
5950 University Ave., #221, WDM
p: 875-9115 | f: 875-9117
General Surgery
Michael P. Mohan, MD
Frederick S. Nuss, MD
5950 University Ave., #135, WDM
p: 875-9795 | f: 875-9796
Gerald G. Baker, MD
Scott D. Hamling, MD
1212 Pleasant St., #211, DM
p: 283-1541 | f: 283-0473
Gynecologic
Oncology
Steven A. Elg, MD, PhD
1221 Pleasant St., #400, DM
p: 241-4161 | f: 241-4162
Hand Surgery
Konstantinos P. Lekkas, MD
Timothy M. Schurman, MD
Lester J. Yen, MD
5950 University Ave., #120, WDM
p: 875-9744 | f: 875-9765
Internal Medicine
Vimala V. Chandran, MD
Kevin J. Cunningham, MD
Jeffrey D. DeFrancisco, MD
Charles O. Lozier, MD
Thomas P. Luft, DO
Christina L. H. Taylor, MD
Rick L. Wilkens, MD
M. Michelle Masterson, ARNP
5950 University Ave., #151, WDM
p: 875-9192 | f: 875-9193
Sean D. Cunningham, MD
Richard B. Gloor, MD
Erin K. Herndon, MD
Lisa J. Jensen, MD
Laura Mirsky, DO
Ralph R. Pray, MD
Louis E. Schneider, DO
Julie A. Lehmann, ARNP
Shelley M. Schossow, ARNP
1215 Pleasant St., #206, DM
p: 241-5743 | f: 241-6474
Todd C. Jensen, MD
1223 Center St., #17, DM
p: 282-0441 | f: 282-0987
Kathleen R. Gannon, DO
1810 SW White Birch Circle, #111,
Ankeny
p: 964-7115 | f: 964-7899
mammography
5950 University Ave., #150, WDM
p: 875-9500 | f: 875-9696
1215 Pleasant St., #408, DM
p: 875-9500 | f: 241-8985
Medical Imaging
John D. Berger, MD
Christopher J. Ellerbroek, MD
Jon S. Hade, MD
Gary L. Haynes, DO
Rodion Herrera, DO
Kevin J. Koch, MD
Daniel J. Krejchi, MD
Susan B. Maurer, MD
5950 University Ave., #145, WDM
p: 244-5109 | f: 875-9676
1215 Pleasant St., #210, DM
p: 244-5109 | f: 241-4275
1215 Pleasant St., #408, DM
p: 244-5109 | f: 241-8985
1221 Pleasant St., #150, DM
p: 244-5109 | f: 241-3505
Neurology
Douglas W. Brenton, MD
5950 University Ave., #171, WDM
p: 875-9250 | f: 875-9251
Neurological &
Spinal Surgery
David J. Boarini, MD
Thomas A. Carlstrom, MD
Robert G. Kerr, MD, PhD
John G. Piper, MD
Jessica A. Benes, PA-C
1215 Pleasant St., #608, DM
p: 241-5760 | f: 241-8161
Nuclear medicine
John D. Berger, MD
1221 Pleasant St., #150, DM
p: 244-5109 | f: 244-9066
Obstetrics
& Gynecology
Robert J. Casper, MD
Eric G. Garner, MD
John D. Houghton, DO
Steven A. Keller, MD
Amy B. McEntaffer, MD
William H. Newland, MD
A. Perry Osborn, DO
Grant L. Paulsen, MD
Gregg B. Polzin, MD
Stephanie Powell Morgan, MD
Robert S. Sieman, DO
Therese H. Tran, DO
Jodi L. Aldrich, ARNP
Shawna M. Freeman, ARNP
Nicole L. Meyer, PA-C
Melissa J. Phillips, ARNP
5950 University Ave., #205, WDM
p: 875-9290 | f: 875-9291
1221 Pleasant St., #400, DM
p: 241-4161 | f: 241-4162
1810 SW White Birch Circle, #111,
Ankeny
p: 875-9290 | f: 875-9291
Kathleen M. Massop, MD
1221 Pleasant St., #400, DM
p: 241-4161 | f: 241-4162
Surgical Oncology
Daniel R. Kollmorgen, MD
1212 Pleasant St., #211, DM
p: 283-1541 | f: 283-0473
Trauma Surgery &
Surgical Critical Care
Sheryl M. Sahr, MD
Richard A. Sidwell, MD
James R. Swegle, MD
Peter M. Tonui, MD
1212 Pleasant St., #211, DM
p: 283-1541 | f: 283-0473
Urology
Markham J. Anderson, MD
John C. Bardole, MD
Jonathan M. Fialkov, MD
Brian L. Gallagher, MD
Richard L. Glowacki, MD
Mark A. Kellerman, MD
Michael W. Kent, MD
Carl A. Meyer, MD
Stephanie L. Pothoven, DO
Harlan K. Rosenberg, MD
Steven J. Rosenberg, MD
Ryan T. Schulte, MD
Joseph M. Sawhill, ARNP
Sheila A. Whyte, ARNP
5950 University Ave., #341, WDM
p: 875-9800 | f: 875-9802
OrthopAEdics
Des Moines
Orthopaedic Surgeons
Nicholas Honkamp, MD
Wesley Smidt, MD
Vascular access CENTER
Orthotics & Prosthetics
Mark A. McDonald, CPO
WEST LAKES
MEDICAL EQUIPMENT
Pain Management
Thomas D. Hansen, MD
WEST LAKES SLEEP CENTER
5950 University Ave., #175, WDM
p: 875-9908 | f: 875-9909
12655 University Ave., #160, Clive
p: 875-9425 | f: 875-9426
5950 University Ave., #280, WDM
p: 875-9902 | f: 875-9903
Pathology
Joy E. Trueblood, MD
5950 University Ave., #195, WDM
p: 875-9750 | f: 875-9751
VEIN THERAPY CENTER
5950 University Ave., #231, WDM
p: 875-9090 | f: 875-9077
5950 University Ave., #141, WDM
p: 875-9900 | f: 875-9899
5950 University Ave., #121, WDM
p: 875-9555 | f: 875-9556
WOMEN’S CENTER
5950 University Ave., #150, WDM
p: 875-9500 | f: 875-9501
5950 University Ave., #161,WDM
Physical Medicine
& Rehabilitation
Todd C. Troll, MD
5950 University Ave., #160, WDM
p: 875-9885 | f: 875-9886
Physical Therapy
Kelly M. Brown, MPT
Anna M. DeWaay, MSPT
William A. Fellows, PT
Katherine K. Hippler, OTR/L
5950 University Ave., #285, WDM
p: 875-9706 | f: 875-9707
Plastic Surgery
Konstantinos P. Lekkas, MD
Mark A. Reece, MD
Timothy M. Schurman, MD
Lester J. Yen, MD
5950 University Ave., #120, WDM
p: 875-9744 | f: 875-9765
Pulmonology, Critical care
& sleep medicine
Angela S. Collins, MD
Amerlon L. Enriquez, MD
A. John Glazier, MD
Katrina A. Guest, MD
Gregory A. Hicklin, MD
Linda C. McDanolds, ARNP
5950 University Ave., #131, WDM
p: 875-9550 | f: 875-9551
1005 Pennsylvania Ave., #102-A,
Ottumwa
p: 641-684-2589
f: 641-684-2590
DM = Des Moines
WDM = West Des Moines
Area code is 515 unless indicated
DEDICATING OUR LIVES TO TAKING CARE OF YOURS
www.iowaclinic.com