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Dr. Perry Soriano Discusses His Medical Training, Experience And Her Work At The Everett Clinic

Karen — Sat, 21 May 2011 16:01:19 +0000

Biography

Perry A. Soriano, MD, joined The Everett Clinic in 2008. He received his medical degree from the University of Chicago in 1999 and completed his residency at Caritas St. Elizabeth's Medical Center of Boston in 2004. Dr. Soriano is board certified in Surgery and completed fellowships in surgical oncology at the National Cancer Institute, National Institutes of Health in Bethesda, Maryland and at City of Hope in Duarte, California. In this interview, Dr. Soriano addresses surgery, The Everett Clinic, and communicating with patients.

Interview with Dr. Perry Soriano MD, The Everett Clinic

INTERVIEWER: Looking at the body of work that you've accomplished and the training you have, what would you say that you're the most proud of?

DR. SORIANO: In working with cancer patients, the most challenging aspect of the job is to be able to communicate the overall picture of what they have, coming into the office. So, to go through their pathology report, go through their diagnoses and talk about what steps are necessary, what steps are recommended; and, then on top of that, to go through what steps are most appropriate for that individual, is one of the largest challenges.

We have very clear guidelines for the majority of cases, though not all, but we have very clear guidelines for management for many of our cancers that we see. So, the challenge is to individualize that treatment for the particular person, and to communicate it in a way that makes sense. Certainly when people come in and have a diagnosis of cancer, their mind typically is racing. Usually people come in with their family, always a good idea, because you're only going to be able to absorb so much.

I think the thing that I am very proud of in going through the training, you know, medical school, surgery residency, fellowship training, etcetera, and then being out in practice, is being able to sit down and actually explain this scenario to people and their families, so that they have a sense of what is coming.

And luckily, I don't do that on my own. My colleagues have similar discussions. The gastroenterology specialists, the medical oncologists, the radiation oncologists… but it's a challenge to convey that to people, and to give them their options, and to allow them to see the scenario, and participate in the decision making. And I think that's what I'm most proud of in my practice.

The complex surgical procedures are long cases, they require stamina, so I'm proud of that as well. Being able to do complex pancreatic surgery takes additional training, and time, special interest in these cases. On the other hand, I think the thing that is even more important is being able to bring people through a big operation, so that they understand the course of surgery, recovery, so that they can prepare.

The Everett Clinic is Snohomish County's premier health care provider, with over 275 physicians. Specialty-trained physicians at the Everett Clinic practice in over 40 areas of expertise. Many are fellowship trained in advanced disciplines such as laparoscopic surgery, urological oncology, total joint replacement and more.

The Everett Clinic has many locations throughout Snohomish County, including Starwood, Marysville, Lake Stevens, Mill Creek and, of course, Everett. The Everett Clinic has four pharmacies, an advanced imagining center (offering MRI, CT, ultrasound and more), two outpatient surgery centers, vision and hearing aid centers and much more.

Dr. Elizabeth Neuger Discusses Her Medical Training, Experience And Her Work At The Everett Clinic

Karen — Sat, 21 May 2011 16:01:17 +0000

Biography

Elizabeth L. Neuger, MD joined The Everett Clinic in 1999. She received her medical degree from Boston University School of Medicine in 1993. She completed her residency at the University of Washington and earned a Fellowship at the Royal North Shore Hospital, Sydney, Australia. Dr. Neuger has a special interest in pediatric and general surgery. In her spare time she enjoys spending time with her family and attending Everett Silvertips games. In this interview, Dr. Neuger addresses surgery, The Everett Clinic, and her medical training.

Interview with Dr. Elizabeth L. Neuger, MD, The Everett Clinic

INTERVIEWER: Tell me about how you actually became surgeon and a little bit about your background and your training.

DR. NEUGER: I actually wanted to be a vet and I went to Cornell University undergrad because they have a great vet school. And I went there and I took all three small animal vet classes you could take as an undergraduate, and realized that I didn't particularly care for large animals, and so that would not be the best, suitable match for me. So, at that point in time, I considered studying biology and fell in love with medicine. It was, you know, much better.

INTERVIEWER: So tell me a little more about your training and the kind of procedures that you do here.

DR. NEUGER: I went to undergrad at Cornell, and I went to medical school at Boston University, and from Boston University, I actually came to the University of Washington for residency. I came out here, actually, during med school to do a rotation to see how I liked it, and just had a fantastic time at Harborview. So, of course, after having a fantastic time, I wanted to come out here. Got fantastic training at the University of Washington; it's one of the top ten surgical residency programs in the country. I fell in love with the area, and I didn't want to leave. A job opened up with Everett and I've been here ever since. So, I've been here the second longest of all the general surgeons. I'm the longest surviving surgeon at the Everett Clinic.

My practice is basically general surgery. I do a large amount of breast in my practice. I'm the only female in town who does breast surgery. So, for that reason, a lot of females come to me. And, I was actually thinking this morning that I'm seeing approximately 250 to 400 breast patients a year. That's in the office, not breast procedures. We treat various types of breast diseases.

On top of that, I want to be able to treat a lot of my patients other diseases: hernias, gall bladders. Two of us in the department do pediatric surgery: myself and Dr. Graves. We do that because you're really good at what you do a lot of. There's not enough pediatric surgery for all of us to be good at it. So, we've narrowed it down to the two of us.

INTERVIEWER: So, you could have decided to go anywhere, right?

DR. NEUGER: Yes.

INTERVIEWER: But you choose The Everett Clinic… Why?

DR. NEUGER: Well, you know, when I was a resident, like I said, we went to Wenatchee, and Wenatchee has a very similar clinic. And the one thing I really enjoyed about that is the camaraderie. Everybody's a team. You're not out there by yourself, it's a group effort.

Our computer system, that we currently have, is fantastic. I mean, I can see any Everett Clinic doctor's note, at my fingertips immediately. We don't look around for charts… So, I like being able to treat the whole patient, even though I personally can't treat every medical disease.

INTERVIEWER: So, you could assure your patients that they have the best care, the latest care, the latest technologies… How would you state that in your own words?

DR. NEUGER: I see two different types of patients. I see the breast patients and I can say beyond a reasonable doubt that the care we give in Everett for breast cancer patients is equal to any other place. I have a number of patients who go down to Seattle for second opinions and I would say the majority of them come back and get their treatment here.

As far as the other general surgical treatments that I take care of: the gall bladder patients who need their gall bladder out, the hernia patients, the pediatric patients who have hernias, pediatric patients also have some lumps and bumps that need to be removed… Our communication ability, between the primary care doctors here at The Everett Clinic, our surgery centers, our operating rooms… they're just fantastic. I've never heard a patient complain about our outpatient surgery center, ever. Well, one complaint about the parking once. But that was about it.

INTERVIEWER: Based on everything we've talked about, based on where you are right now in your career, what are you the most proud of?

DR. NEUGER: I would say I'm the most proud of our department… In the general surgical department, when I first came, there were three of us… we were very stressed out, we were just trying to put out fires. We didn't have any ability at the time to anticipate problems, we were simply trying to plug the hole of the dam that was breaking… And, over the dozen or so years that I've been here, our department has grown, we have specialists, we have niches that are filled, all the holes are plugged. And now instead of trying to put out fires, or block the dam, we're actually building construction on the other side, and making it a world class, excellent general surgical department.

INTERVIEWER: Is there anything you'd like to say about specific procedures you do, like breast cancer or gall bladder surgery?

DR. NEUGER: I would say that we see a number of patients, as a surgeon, but not everybody needs surgery. So, some patients come in thinking that we are going to fix them with surgery and what they need to realize when they come for a consult is that we're going to evaluate them and really consider: "Am I able to fix them with surgery?" Because sometimes the answer is no. Some patients will be upset about that. But, really, if I'm not going to do you benefit, I'm not going to do surgery just to get paid.

Breast Cancer Symptoms Self Exam

admin — Wed, 19 May 2010 20:40:23 +0000

Signs of breast cancer, learn all about it! For Nguang Nguek-fluek

Recognizing the signs of breast cancer is very important and can save your life. If the disease is detected early, there is a high probability of success is to treat and even cure.
The main sign of breast cancer in both men and women is a mass. Without However, most lumps are not malignant. Often, these lumps are not painful. Other symptoms of breast cancer include:
? Unexpected blood or secretions clear nipple
? Inverted nipples
? A change in breast size or shape
? Bleeding or flattening of the breast skin
? Redness pitting of the skin, similar to an orange peel

Non-cancerous Breast Conditions
There are several factors that can cause these symptoms apart from breast cancer. In addition to the normal changes that occur during the menstrual cycle or pregnancy, there are other frequently noncancerous breast conditions, such as:
Fibrocystic changes
Fibrocystic changes can make your breasts feel granular or stringy. This condition of the breast is very common, affecting at least half of all women. Fibrocystic changes are not usually a sign of breast cancer and do not increase the risk of developing breast cancer either. When the chest feels very rounded, self-exam can be quite difficult. However, being familiar with what is normal and what is a concern may help to detect new packages easier.
CYSTS
Fluid-filled cysts are also common in women between the ages of 35 and 50. Their size varies from small for the size of an egg. These cysts are usually not a sign of breast cancer either. Sometimes increases in size until menstruation and disappear completely after. Are less common in women who no longer have a menstrual cycle.
Fibroadenomas
Fibroadenomas are benign tumors that are common in women during the reproductive years. They are smooth and elastic bundles with a clear and move under the skin when touched. The fibroadenomas are usually painless. They can change their size over time, becoming in small or larger and sometimes disappear completely. Although a doctor can usually detect fibroadenomas through a clinical examination, a tissue sample may also be necessary.

INFECTIONS
Mastitis or breast infections are also common in women who have just stopped breast-feeding, but may also occur in women who are breast-feeding. The breast skin may be red, swollen, warm and lymph nodes under the arm also may swell. Some women also feel sick and fever. Mastitis is not a sign of breast cancer either, but does require treatment.
TRAUMA
A Sometimes a bump or bruise on your breast also can cause a lump. However, this is not a sign of breast cancer and does not increase the risk of contracting the disease either.
Calcium deposits
Calcium deposits can develop anywhere on your chest and also appear on a mammogram. Most women have several deposits calcium in different sizes. These microcalcifications are often caused by cell debris, cell secretion, inflammation, radiation or trauma above. They are not caused by calcium supplements. Most calcium deposits are a sign of breast cancer. However, some of them are precancerous or even cancer. Your doctor will probably recommend further testing if any of them is suspect.
If you discover a lump through breast self-examination and its not gone through menopause, however, there is no need to panic. You can wait until the menstrual cycle to see a doctor, most will disappear as masses until then. However, if breast changes persist for more than a month, go to a doctor and get a breast exam as soon as possible.

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Breast Cancer Health » surgeon

Dr. Perry Soriano Discusses His Medical Training, Experience And Her Work At The Everett Clinic

Dr. Elizabeth Neuger Discusses Her Medical Training, Experience And Her Work At The Everett Clinic

Breast Cancer Symptoms Self Exam

Signs of breast cancer, learn all about it! For Nguang Nguek-fluek

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