Dr Kelsey Jordan

19 December 2014

Q & A with The Montefiore Hospital’s Consultants

Dr Kelsey Jordan, Consultant Rheumatologist answers some questions on gout.

What is gout and who gets it?

Gout is a condition that is much lampooned, bringing to mind images of Henry VIII and other similarly well-fed gentlemen! For sufferers however it is no laughing matter, as an attack of gout is excruciatingly painful and can result in permanent joint damage and disability if left untreated.

Gout is an inflammatory arthritic condition and is the only curable type, but sadly is commonly undertreated or not taken seriously. It’s all to do with how the body metabolises uric acid – usually an excess of the substance is got rid of naturally, but in some people it is deposited in needle-like crystals in the joints.

According to statistics on NHS.uk, one in 70 adults is thought to be affected.  While it is true that the typical gout sufferer is middle-aged and male, this is not always the case and women, especially after the menopause, are prone to it too”.

What are the symptoms?

Symptoms start with pain and swelling in the joint – usually the big toe, but some people get it their ankles, knees, elbows, fingers and wrists. The joint reddens, gets hot and extremely painful, often unbearable to touch. Sometimes the skin becomes shiny and starts to peel.  You may have a temperature and feel very tired.

How can I avoid it?

Whether you have gout or not you should aim to eat a balanced diet and try to maintain a healthy weight. While you don’t need to be completely teetotal, bear in mind that alcohol is not a great friend of gout, as it stimulates the production of uric acid. The worst offender is beer as it contains purine-rich yeasts, so best to have a glass of wine instead. If you opt for soft drinks, make sure these do not contain high fructose corn syrup.

If you suffer frequent attacks of gout, do consult your GP as it is a condition that can be cured with the correct medication and lifestyle changes. Have a happy and healthy Christmas!

Dr Kelsey Jordan specialises in the treatment of rheumatic disorders including rheumatoid arthritis and gout and is a trustee of the UK Gout Society. Dr Jordan has regular clinics at the Spire Montefiore Hospital in Hove.

For further information please call 01273 828148

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.


10 December 2014

Weight Loss Surgery at The Montefiore Hospital

Brighton BariatricsNewly opened in 2012, The Montefiore Hospital offers a wide range of diagnostic and surgical services for medical conditions and also cosmetic procedures. This state-of-the-art facility, located in a landmark building in central Hove, forms part of the Spire Healthcare Group, a leading provider of private healthcare.

The hospital has recently introduced a weight loss surgery (bariatric) service for the treatment of patients with obesity. This service is led by consultant bariatric surgeons Mr Goldie Khera and Mr Khaled Hamdan.

Based at The Montefiore Hospital, Brighton Bariatrics is a multi-disciplinary team which includes experienced bariatric surgeons, anaesthetists, nurse specialists, psychologist and dietician.

Mr Goldie Khera describes the service: “Obesity is a serious disease which interferes with basic physical functions such as breathing or walking. In addition, obesity can lead to long term health conditions, ultimately reducing quality of life and lowering life expectancy.

“There are several different procedures that can be highly effective in helping people to lose excess body weight. These include gastric balloons, gastric banding, gastric bypass and sleeve gastrectomy. Our surgeons will discuss all available options with each patient, creating a bespoke weight loss plan. This will include an initial consultation with the surgeon, followed by a consultation with our dietician and psychologist."

Mr Khaled Hamdan adds: "At Brighton Bariatrics our team will be there to provide support at every stage of the journey, from pre-surgery to post-surgery. The high quality care is provided locally, at The Montefiore Hospital, placing the whole pathway underone roof.”

At The Montefiore Hospital we want you to feel completely happy before you make any firm decisions about having bariatric surgery and having access to expert advice is an important part of this. We offer regular bariatric surgery open evenings. You will have the opportunity to listen to a presentation from an experienced consultant bariatric surgeon and dietician. Here you will be able to learn about the latest treatments available, ask any questions you may have and discuss your options.

For further information or to book an appointment please contact The Montefiore Hospital on 01273 828 148 or email montefioreinfo@spirehealthcare.com.



1 September 2014

Challenging Persistent Pain

Living with constant pain is a struggle, both physically and emotionally. If you have pain that just refuses to go away, it may be time to see a pain specialist, says The Montefiore Hospital's Dr Simon Thorp.

"Pain is something we all experience from time to time - we fall ill, hurt ourselves and sometimes have aches and pains for no apparent reason. It's an indication that something is not quite right in our body and can protect us from doing further damage. In most cases, the painful symptoms either go away by themselves or can be resolved quickly and easily by your GP. But occasionally, the pain just won't go away no matter what you do. This type of pain is often associated with back and joint conditions; neuralgia - a sharp shocking pain that follows the path of a nerve; and pain that persists after having surgery.

"A pain specialist will be able to recommend the best approach to managing your pain. In recent years there have been many advances in drugs that provide pain relief. A pain specialist will review any drugs that you are currently taking and identify the most effective ones for your type of pain.

"Living with persistent pain can take its toll emotionally as well as physically and it is quite common for patients to suffer from depression and feelings of isolation. In many cases the pain specialist will call upon a psychologist trained in pain to help treat the emotional component of the patient's symptoms.

For further information, or to book an appointment with Dr Thorp, please call 01273 828 148 or submit an enquiry.



23 July 2014

First UK hospital deploys new wearable, vital signs monitor – a "game-changer" for patient care and safety

A BRIGHTON HOSPITAL is the first in the UK to start using a new wireless vital signs monitoring device to provide early warnings to medical staff when patients' health is suffering.

Spire Healthcare's Montefiore Hospital introduced the SensiumVitals® system at the end of May and feedback from clinicians has been strongly positive. By taking vital signs measurements every two minutes, the system allows medical staff to react swiftly to signs of patient deterioration.

SensiumVitals® is a lightweight, wireless patch which is attached to the patient's chest with sensors taking readings of heart rate, respiration and temperature. The data is then sent wirelessly to nurse stations and handheld devices. If readings exceed pre-set levels, alerts are sent to nurses who are then able to intervene immediately.

The system is designed for use in general wards and Accident & Emergency waiting areas and since The Montefiore Hospital introduced the British-designed wireless patches, they have been worn by more than 50 patients. Based on results so far, Matron Lynette Awdry believes the patch could be used as standard across all healthcare providers including the NHS.

Mrs Awdry said:

"As a nurse with 30 years' experience, I know nothing can replace the 'eyes on' assessment of a patient and direct communication about their condition. For us, the SensiumVitals® patch is a new tool which provides an extra layer of monitoring and support for patients and nurses.

"The key advantage of the system is the frequency of the data sent automatically from the patch - it keeps nurses up to date with all their patients, so they can manage their workload more effectively. As a result, they can spend time with patients who might need more immediate attention, safe in the knowledge that if there is a sudden change with another patient, they can respond immediately.

"We decided to implement the SensiumVitals® patch here at The Montefiore because exploring innovations in patient care is a key part of Spire Healthcare's culture. I would expect to see other hospitals, both private and NHS, using the patches in the near-future in a variety of clinical settings."

Oxford-based Sensium Healthcare, which designs and supplies the patches and the wireless network on which they operate, confirmed it is currently liaising with a number of NHS hospitals looking to deploy the system over the next 12 months.

Anthony Sethill, CEO of Toumaz Group, parent company of Sensium Healthcare, said:

"Our goal with SensiumVitals® is to help improve patient safety and deliver health economic benefits to hospitals.

"By taking vital signs measurements every two minutes, the system allows clinicians to react swiftly to signs of patient deterioration. This provides reassurance to both patients and staff and offers the firm prospect of improving patient outcomes and reducing the length of hospital stays.

"The system has already been described as a "game-changer" and we are very encouraged by the feedback we have received from The Montefiore Hospital in Brighton. In the coming months, we expect to introduce the system into a significant number of hospitals both in the private sector and across the NHS."

About SensiumVitals®

SensiumVitals® is a wearable, wireless system which provides continuous monitoring of heart rate, respiration and temperature for patients in general wards and Accident & Emergency waiting areas.

Readings are taken every two minutes, with the results sent wirelessly to nurse stations or web-enabled portable devices. Notifications are issued to nurses if measurements exceed pre-set thresholds. The key benefit of the system is that it allows clinicians to identify patient deterioration more quickly than with standard observation rounds - the classical model is every four to eight hours.

The system is based on a lightweight, wireless patch which is attached to the patient's chest. Each patch is disposable - to avoid cross-infection; and has a battery life of five days - long enough to cover most hospital stays. The patch weighs only 15 grams and is therefore unobtrusive to patients. The system's wireless capability allows patients to move around whilst still being monitored – hence aiding faster recovery times.

The system addresses concerns about patient safety which have been highlighted in a number of recent reports. In a US study of SensiumVitals® in 2013, patients who received early intervention on average saw hospital stays reduced by four days.

Read more about wireless patient monitoring on the BBC.



4 July 2014

A keen cyclist back in the saddle

With the Tour de France nearly upon us, we take a look at a cycling enthusiast's partial knee replacement which put him on the road to recovery.

The knee is one of the most commonly affected joints of osteoarthritis and can hinder both young and old.1

Mr Sandeep Chauhan, Consultant Orthopaedic Knee Specialist at The Montefiore Hospital, Hove says: "Around 35,000 people in the United Kingdom suffer with debilitating arthritis within their knees and often this requires a total or partial knee replacement".

David Butler, a very active patient in his early 50's, suffered ongoing pain for around 12 years before finally undergoing Unicompartmental (partial) Knee Replacement surgery in November 2013 at The Montefiore Hospital, under the care of Mr Chauhan. For Mr Butler, a keen cyclist as well as a fitness coach, it was felt that surgery was the best option available to reduce pain and improve mobility to fit his active lifestyle.

Mr Chauhan advises: "Unicompartmental Knee Replacement surgery allows surgeons to work with very small incisions, which enables patients to return to activities much more quickly than patients who have had total knee replacement surgery".

Mr Chauhan utilises advanced technology during surgery to accurately position the implants specifically to the individual patient, ensuring consistency and reproducibility. The results reported in a major combined British/European orthopaedic meeting in June 2014 showed that not only do patients gain the expected rapid short-term recovery, but the five-year results do show superior outcomes over conventional techniques.2

Mr Butler, who owns his own cycling and fitness coach business; 48PTC, says: "I had been living with increasing amounts of pain and discomfort that had begun to affect my passion for cycling, not to mention impacting my professional life as a fitness coach.

"Following my consultation, Mr Chauhan recommended Unicompartmental Knee Replacement surgery. It was good to know that there was an alternative to a total knee replacement procedure. I felt all options were discussed thoroughly ensuring I was offered the right solution to fit me personally.

"The operation itself was absolutely fine. The hospital is excellent with fantastic facilities and is very comfortable.

"The staff were extremely caring and informative and I felt supported from start to finish. I'd like to especially thank the nurses and physiotherapists who aided me post-surgery.

"Of course some pain is to be expected following an operation, but once I was home I ditched the crutches, did the exercises as recommended by the physiotherapist and within one week I was back to work.

"Within five weeks I was increasing my activity levels and was even able to ski. I was back on the road cycling again after two months and within five months had climbed the Pyrenees as part of 300km cycling tour. I am now no longer in pain, have improved movement, am cycling more efficiently and comfortably and have no need for inflammatories.

"My advice for anyone considering similar surgery is to find the surgeon you feel comfortable with, even if it takes several referrals. Be positive and embrace the rehabilitation exercises, be fit and strong before surgery and set goals to work towards with your recovery".

Mr Chauhan has regular clinics at the Spire Montefiore Hospital in Hove. For further information on the hospital or this procedure, please visit: www.spiremontefiore.com or call 01273 828148

1 arthritisresearchuk.org

2 Efortnet, Unicompartmental Prosthesis, Amin Kheiran, 5th June 2014



27 June 2014

Local hospital part of newly awarded Hospital Group of the Year

The Montefiore Hospital is one of the newest additions to Spire Healthcare who have recently been named Hospital Group of the Year at the HealthInvestor Awards

On Wednesday 11 June 2014 in London, Spire Healthcare, which is the parent company for The Montefiore Hospital, was named Hospital Group of the Year at the 2014 HealthInvestor Awards.

The event is one of the main events for the health sector and is run by trade publication, HealthInvestor.

Andy Wood, Director for The Montefiore Hospital says: "We are delighted to be a part of the Hospital Group of the Year. We are pleased the judges recognised the investments made in the company and the hard work and dedication everyone at Spire Healthcare gives to providing high quality patient care. I hope this highlights to the local people of Brighton and Hove that they have access to a high quality, award-winning hospital, right on their door-step."

The judges said: "In a very tight category Spire just got the award due to their recent numerous and quantifiable measures underpinning their efforts to ensure service excellence."

Spire Healthcare won due to their strong performance during 2013. Highlights of the year included continued investments in hospitals, maintaining its high patient satisfaction rates and having exemplary clinical outcomes. In 2013 there were no cases of MRSA bacteraemia reported across Spire hospitals and according to data from the Department of Health, three Spire hospitals ranked in the top 25 providers for hip replacement, with four also ranking in the top 10 for knee replacement.

'The Times' columnist Matthew Parris presented the awards, which were judged by a panel of 21 independent judges.



25 April 2014

Q&A with The Montefiore Hospital's Consultants

Mr Michael O'Connell, ENT specialist, answers general Ear, Nose and Throat (ENT) questions.

What are the most common ENT complaints that you see?
"My practice covers all aspects of ear, nose and throat problems, but cosmetic nose and ear surgery, nose and sinus conditions, nasal polyps and allergic nose disease form a large part of my day-to-day work. Other common problems include ear infections, hearing loss, tonsillitis, lumps and bumps in the neck and throat, dizziness and tinnitus".

How do you approach treatment for these conditions?
"An important part of being a specialist is to recognise the unusual, or difficult cases by thoroughly assessing patients to diagnose their condition and then advise on the best treatment for that complaint. People may develop a lump in their neck or throat and worry that this may be sinister or serious, but that isn't necessarily the case. By methodically assessing the patient, their medical history and symptoms I am best able to identify their problem and commence the right treatment as quickly as possible".

Are ENT conditions easily treated?
"Most treatments are straightforward. When a patient comes for a consultation, questions are asked, recommendations are made and the benefits and potential side effects of treatment are discussed, so the patient can make an informed decision about what is best for them. Ongoing treatment will then be closely supervised.

What is your specialist interest?
"Cosmetic nose and ear surgery and nasal reconstruction are the most challenging and rewarding parts of my field. I like to continually develop my practice and introduce new techniques. Recently I have been at the forefront of a procedure using balloon technology, to effectively treat sinus disease and manage debilitating facial congestion, catarrh and headache. It has proved effective and popular and allows rapid return to daily life".

For further information please visit www.spiremontefiore.com or call 01273 828 120.

Read article in the Brighotn & Hove Independent.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.



26 March 2014

Varicose Veins

Varicose veins are a common problem which affect up to one third of people. Although they are rarely serious they may look unsightly and can cause discomfort. Karim El Sakka, a consultant vascular surgeon at The Montefiore Hospital in Hove, gives some advice on the options available for treatment of varicose veins.

"As spring moves into summer I always expect to see more patients with varicose veins. It's not that the warmer weather causes varicose veins, more that people decide to have them treated so they can go bare-legged without feeling self-conscious.

I normally begin my consultations by explaining how veins work in general. The muscles around veins continuously contract, increasing pressure and forcing blood towards the heart. Valves within each vein are designed to ensure that blood can only flow in one direction. It is thought that varicose veins occur when these valves become damaged. This means they cannot close properly which results in blood leaking backwards and pooling, causing the vein to swell.

This problem of varicose veins typically occurs in the superficial veins running near the surface of the legs. Most of the time they pose a cosmetic problem rather than a health issue, though there can be symptoms such as swollen ankles, aching legs and restless leg syndrome. Once damaged, the veins can swell to quite a large size and may appear blue or purple beneath the skin. Some people feel uncomfortable or self-conscious about them and avoid going bare legged. But, before you resign yourself to a life of wearing tights and trousers there are a number of surgical procedures which can help.

In the vast majority of cases it is not possible to repair the damaged valves so treatment means either closing the vein so that blood can no longer pass through it, or removing the varicose vein altogether.

There are a variety of methods for closing or removing varicose veins. We use minimally invasive techniques such as laser and ultrasound which can often be performed with a local anaesthetic. These procedures are far less painful than traditional methods and can usually be carried out as a day case. Many patients are concerned how their blood will flow back to their heart if the vein is removed, but rest assured it will naturally find another route without causing any harm.

If you don't want to undergo a surgical procedure, you could try wearing special compression stockings which will help to improve circulation in the legs. Stockings won't make your varicose veins go away but they may help to alleviate some of the discomfort. Other suggestions include putting your legs up, making sure you do not stand for prolonged periods of time and exercising. There is no proven method of prevention but keeping a healthy weight and doing lots of exercise are believed to make it less likely for varicose veins to occur.

If you have concerns about varicose veins contact your local GP or a vascular surgeon. The Montefiore Hospital offers the latest technologies, including Radio-Frequency Ablation (VNUS closure) and foam sclerotherapy.

Mr Karim El Sakka is a consultant vascular surgeon at The Montefiore Hospital in Hove. For further information, please contact The Montefiore Hospital on 01273 828120.



15 March 2014

Hospital pass for Brighton & Hove Business Lunch Club

Nearly 40 senior business leaders enjoyed a visit and tour of the city's newest private hospital, The Montefiore Hospital in Montefiore Road, Hove.

The tour provided an opportunity to learn about the services and treatments on offer at Spire Healthcare's 38th hospital and the amazing state-of-the-art technology that provides talented clinicians with a platform to practice innovative techniques.

Hospital Director Andy Wood greeted members of the Brighton & Hove Business Lunch Club on Friday February 21. He outlined the history of the building, which started life as a furniture storage depot, and its eventual transformation into a multi-disciplinary hospital, offering a comprehensive service for most medical conditions and cosmetic procedures.

He said: "The hospital sits at the heart of the community, so it's great to be able show it off to some of the city's top business leaders. We want everybody to be aware of this amazing facility on their doorstep and to consider us when making a lifechanging decision about their personal health."

Business club organiser Tim Cobb, of Cobb PR, thanked The Montefiore for a great event. He said: "It is more like a five star hotel than a hospital. It has a great atmosphere and I was hugely impressed by the professionalism of staff and the great testimonials from very satisfied patients."



28 January 2014

Are you thinking about having cosmetic surgery, but would like to find out more before booking a full consultation?

If so, come along to our cosmetic event on Tuesday 25 February 2014, 6-8pm where your can have a free 10-minute mini consultation with our experienced consultant plastic surgeon Mr John Pereira.

We want you to feel completely happy before you make any firm decisions about cosmetic surgery and having access to expert cosmetic surgeons is an important part of this. Book a free mini consultation and you will be able to learn about the latest treatments and ask any questions you may have.

Mr John Pereira is a hugely experienced surgeon who covers all aspects of aesthetic surgery including breast reshaping, facial surgery, body contouring, as well as hair/ eyebrow/ eyelash transplants.

Tea and coffee is available on arrival and there is the chance to view one of our beautiful boutique style bedrooms.

Mini consultation appointments are 10 minutes in length and are available between 6pm and 8pm. Numbers are limited, so to book your free appointment please contact us with your name, email and procedure that interests you.

montefioreinfo@spirehealthcare.com
01273 828 085

Medical loans available so you don't have to wait.
Spire Healthcare works with First Medical Loans to help you arrange affordable finance for private treatment in our hospitals quickly and easily.
Call First Medical Loans today on 0845 618 5375 for further information. Lines open 8.30am to 6.30pm Monday to Friday, 9am to 1pm Saturday.

Mini consultations are an opportunity to ask any questions you may have about cosmetic surgery, and are not a formal out-patient consultation. If you wish to proceed to surgery, a full out-patient consultation will be required.