Smoking…

Not only increases the risk of heart disease, stroke, lung cancer, lung disease and peripheral vascular disease, it specifically increases the risk of Covid19 infection, watch this video today to learn more.

“As the number of confirmed COVID-19 cases continues to rise, we have seen more severe symptoms among those with underlying health concerns,” explained Cardiovascular and Thoracic Surgeon Lawrence Schmetterer, M.D., FACS; member of Salem Regional Medical Center’s medical staff.

“COVID-19 affects the lungs, causing flu-like symptoms such as fever, cough and shortness of breath. Those who smoke or vape may be more susceptible to COVID-19 because they may already have lung disease or inflammation in their airways that can weaken their ability to defend against bacteria and viruses.”

“Smoking tobacco, marijuana or vaping paralyzes the cilia in the lungs. These tiny, hair-like structures help fight off infection and clear mucus and debris out of the lungs. When the cilia are damaged or destroyed, a person’s risk of developing pneumonia or other respiratory infections increases. The good news is that the cilia are one of the first parts of the lungs to heal when a person stops smoking.”

A recent study published by the New England Journal of Medicine found that people who smoke were over two times more likely to have severe symptoms from COVID-19 compared to those who did not smoke.

Dr. Schmetterer noted that even the act of smoking- by putting an object in your mouth with your hands- introduces virus particles into the mucus membranes of your mouth.

Smokers may also be more prone to severe COVID-19 infections, in part, because their lungs contain an abundance of entry points that the virus can exploit. COVID-19 infections begin at the ACE2 receptors, which are proteins found throughout the body on the surfaces of cells, including in the upper and lower respiratory tracts.

“In a healthy person, these proteins help with the regulation of blood pressure and other functions of the body,” Dr. Schmetterer added. “However, COVID-19 has the ability to plug into the ACE2 receptor in order to inject its genetic material into the cells, reproduce and then spread throughout the body.”

New research suggests that lungs exposed to cigarette smoke accumulate abnormally large numbers of ACE2 receptors, which may increase the ability of the COVID-19 virus to enter the lungs.

“Unlike more common respiratory viruses, COVID-19 can also cause extensive damage to the cells in the lung wall and lining of the air sacs,” Dr. Schmetterer advised. “As the body reacts to this infection, it releases an inflammatory response that causes the lungs to become even more inflamed and filled with fluid. This process can then lead to severe pneumonia or acute respiratory distress.”

“Quitting smoking or vaping may help lower the risk of developing more serious COVID-19 symptoms. People who vape of smoke may not be as aware of the damage they are doing to their lungs until their ability to fight off an infection is compromised. Stopping smoking and vaping may be the single best decision you can make right now to help fight off this disease.”

Dr. Schmetterer’s office is located at 790 Boardman-Canfield Road in Boardman, and he has a weekly clinic at Salem Regional Medical Center. For more information, call 330-743-3604.

Telemedicine with Dr. Lawrence Schmetterer

Dr. Lawrenece Schmetterer breaks down the impact that Covid 19 is having on healthcare and discusses telemedicine options that he's now offering as a result of needing to treat people that have ongoing health issues.Watch today to learn about…1. Covid 19's impact on day-to-day healthcare.2. Precautions for patients and healthcare workers.3. Telemedicine's role in delivering care in this current crisis.4. Eliminating office visits for people with health issues but still need the see the doctor.Call for an appointment – 330-743-3604https://www.schmetterermd.com/

Posted by Lawrence Schmetterer MD FACS Thoracic & Vascular Surgery on Monday, March 30, 2020

Dr. Lawrence Schmetterer MD FACS Thoracic & Vascular Surgery shares his perspective of life in a community hospital during this unprecedented time.

ABOUT SCHMETTERER M.D.

Lawrence Schmetterer, M.D., F.A.C.S. is one of the top and most trusted vascular surgeons in Youngstown and Warren, Ohio. He’s been practicing medicine for over 34-years and sees patients in Youngstown, Austintown, Boardman, and Salem, Ohio, with hospital privileges at all the area’s major hospitals including Mercy Boardman and Youngstown’s St. Elizabeth Hospital, The Surgical Hospital at Southwoods, Salem Community Hospital, and Steward – Trumbull Regional Medical Center. Dr. Schmetterer is known for treating Venous Disease, including varicose veins. Additionally specializing in Thoracic, Arterial, Venous, and Mediastinal Disease.

Got Poor Circulation? Leg pain? Leg Cramps? Cold Feet? | Tests For Peripheral Artery Disease

Got Poor Circulation? Leg pain? Leg Cramps? Cold Feet? Lawrence Schmetterer MD FACS Thoracic & Vascular Surgery shares the types of tests you can discuss with your doctor to determine if you have blocked arteries in your legs (Peripheral Artery Disease | PAD).

Posted by Lawrence Schmetterer MD FACS Thoracic & Vascular Surgery on Monday, February 24, 2020

Dr. Lawrence Schmetterer MD FACS Thoracic & Vascular Surgery discusses a procedure used to restore blood flow to the lower leg called a “FemPop” bypass. He talks about when a doctor may decide this is the next best option when all endovascular techniques are exhausted. He also shares what questions to ask your doctor before getting on the table for surgery.

ABOUT SCHMETTERER M.D.

Lawrence Schmetterer, M.D., F.A.C.S. is one of the top and most trusted vascular surgeons in Youngstown and Warren, Ohio. He’s been practicing medicine for over 34-years and sees patients in Youngstown, Austintown, Boardman, and Salem, Ohio, with hospital privileges at all the area’s major hospitals including Mercy Boardman and Youngstown’s St. Elizabeth Hospital, The Surgical Hospital at Southwoods, Salem Community Hospital, and Steward – Trumbull Regional Medical Center. Dr. Schmetterer is known for treating Venous Disease, including varicose veins. Additionally specializing in Thoracic, Arterial, Venous, and Mediastinal Disease.

Got sore legs?

Leg cramps?

Cold feet?

Thoracic and Vascular Surgeon, Dr. Lawrence Schmetterer from Ohio, describes the different imaging options to discuss with your doctor to determine if you have blocked arteries in your legs (Peripheral Artery Disease | PAD) and have a productive discussion on the locations of those lesions restricting blood flow BEFORE you schedule an angiogram. Disclaimer: The advice and views in this interview are that of The Way To My Heart and Dr. Lawrence Schmetter. The information offered is for educational purposes only. ALWAYS check with your healthcare provider before acting upon any advice offered in this interview or in any other videos shared by The Way To My Heart. Got Poor Circulation? Leg pain? Leg Cramps? Cold Feet? Lawrence Schmetterer MD FACS Thoracic & Vascular Surgery shares the types of tests you can discuss with your doctor to determine if you have blocked arteries in your legs (Peripheral Artery Disease | PAD).

ABOUT SCHMETTERER M.D.

Lawrence Schmetterer, M.D., F.A.C.S. is one of the top and most trusted vascular surgeons in Youngstown and Warren, Ohio. He’s been practicing medicine for over 34-years and sees patients in Youngstown, Austintown, Boardman, and Salem, Ohio, with hospital privileges at all the area’s major hospitals including Mercy Boardman and Youngstown’s St. Elizabeth Hospital, The Surgical Hospital at Southwoods, Salem Community Hospital, and Steward – Trumbull Regional Medical Center. Dr. Schmetterer is known for treating Venous Disease, including varicose veins. Additionally specializing in Thoracic, Arterial, Venous, and Mediastinal Disease.

Dr. Lawrence Schmetterer: New Information for Patients

Our patients are very important to us!

Many have serious health concerns that require expeditious evaluation and management, in many cases requiring outpatient or inpatient surgical procedures.

In the best interests of our patients, and in consideration of the current public health concerns and advisories regarding the COVID19 viral pandemic, the following are instituted effective Monday, March 16, 2020.

Outpatient Clinic Protocol

Patients who have appointments for routine follow up of testing, or long-term surgical follow ups, and are otherwise doing well, will be rescheduled for 4 weeks in the future. Any testing results such as ultrasound or CT scans will be reviewed once completed to confirm that no significant interval findings are present.

You will be asked to email or text a photo of the front and back of your updated insurance card and identification card if needed, in order to minimize handling.

If a patient has a need for an outpatient follow up visit, prescreening by phone will be completed by our staff. You will be asked if you have experienced fever, cough, cold, flu-like aches, or respiratory symptoms that are not a stable chronic condition. You will be asked if you have traveled abroad, or been on a cruise ship within the past four weeks, or if you have been exposed to anyone with the above potential exposures or conditions.

If any of the above are present, you may be asked to follow up immediately with your primary care physician for further evaluation and possible testing. If an outpatient visit is deemed urgent, provisions will be made for an expedited full evaluation of any vascular or thoracic problem with Dr. Schmetterer regardless of above exposures. This will be conducted in such a fashion as to ensure safety of staff and other patients.

At the time of a patient’s office visit, you can expect the following:

The waiting room will not contain magazines or books for general use. You are welcome to bring your own reading materials and of course, a smart phone.

Patients should self-seat a minimum distance of six feet from other patients, not including family members. In the event of crowding, you may wait in your car and receive a text when an exam room opens for you.

There will not be a “clipboard & pen” sign in process. You will register for the visit verbally with staff, who will also take your temperature with a sterilized forehead swipe device. Staff will wear gloves and masks. If you have a fever or outward symptoms of an active respiratory infection, you will be asked to follow up with your primary care physician.

New patients are encouraged to fill out their medical questionnaire at home prior to the clinic visit. If that is not completed, there will be an opportunity to complete the questionnaire with a sanitized clipboard. Please provide your own pen.

In the exam room, your seating will be on an exam table, covered with disposable paper. The table will be sanitized between each patient visit. While we will not exclude family members from accompanying the patient into the exam room, there will be no additional seating.

Outpatient and Inpatient Surgeries

The Surgeon General of the United States, the Ohio Department of Health, and Mike Dewine, Governor of Ohio have advised the cancellation of elective surgeries in the interest of patient safety and preservation of medical resources. An example of an elective surgery would be the removal of a benign fatty growth. Procedures deemed necessary would include any procedures involving the vascular system or lung disease such as cancer. Postponing such procedures could result in stroke, loss of life or limb. These are not considered elective procedures.

Many of our patients require inpatient or outpatient surgical procedures that, while not emergent, are necessary and required in an expeditious manner for serious medical problems. Rest assured, that your planned procedure, if deemed necessary, will be given the full support of surgical and hospital staff, including safe intensive care as needed.

The above policies and procedures are not intended to cause fear or undue concern. Our patients’ best interests are most important, and that includes keeping them safe from potential illness and assuring that significant medical issues are identified and treated quickly before any complications develop.

The current social and medical landscape is changing on a daily basis. Please follow us on Facebook or our website as updates may occur.

https://m.facebook.com/ThoracicandVascularSurgery

Home

We will all get through this together.

Lawrence Schmetterer MD FACS

Leg Pain and Swelling

In my practice, the most common reasons for a patient referral are leg pain and swelling.  So many people have problems with their legs, but often these difficulties seem to take a back seat to high blood pressure, heart disease, diabetes and other serious health issues.  Many times patients hesitate to mention these problems to their primary care physician, or their symptoms just don’t seem to get as much attention as other problems. Leg pain and swelling are important signs of potentially serious medical problems and may be sorted out with a referral to a vascular surgeon.

Causes of Leg Pain

Patients may experience leg discomfort or swelling for a variety of reasons. Each patient is evaluated based upon what they are feeling and the findings on physical examination. Problems that may cause leg pain include, first and foremost, peripheral artery disease (PAD) caused by narrowing or blockage of arteries carrying blood to the legs. Patients with PAD often experience cramping of the thighs or calves after walking a distance (intermittent claudication). With more advanced disease, patients may experience burning pain of the lower legs and feet, sometimes with the development of leg ulcers which is called critical limb ischemia (CLI). These are serious signs and require urgent attention.

Other common causes of leg pain include peripheral neuropathy frequently caused by diabetes mellitus. Patients typically describe both a burning sensation and numbness, or a feeling of pins and needles. If is not uncommon to confuse the symptoms of diabetic neuropathy with critical limb ischemia. A thorough vascular exam is crucial.

Lower extremity pain may also be caused by venous insufficiency,  blood clots of the veins (deep venous thrombosis), or nerve compression at the spine (spinal stenosis) or a bulging intervertebral disk. Many patients suffer from pain related to arthritis of the hip or knee joints.  All of these possible causes and more are considered at the time of evaluation after which the appropriate testing is completed. Most problems can be treated with substantial or complete resolution of pain depending on the cause.

Causes of Leg Swelling

Leg swelling is a common problem with a variety of possible causes. Commonly, patients suffer from venous insufficiency, or venous backflow across incompetent valves within the legs’ veins. This can occur within the deep leg veins or the superficial veins and may also cause symptoms such as heaviness, aching, throbbing, burning, itching, or restlessness of the legs. Ultrasound testing reveals the cause of the swelling and treatment is very effective in solving this problem for most patients. Patients may also suffer from severe leg swelling caused by compression of the large veins (iliac veins) in the pelvis which can be identified and treated with dramatic improvement in symptoms.  Other causes of leg swelling include deep venous thrombosis, congestive heart failure, kidney disease or lymphedema. All of these problems can be treated once the underlying cause of swelling is identified.

Many patients suffer from a combination of conditions causing leg pain and swelling. It is important to seek proper consultation in order to work through these causes and improve your health and well being.

If you have either of these problems, please schedule an appointment for an evaluation. Typically, patients can be seen within the week at one of our two locations: in the outpatient clinic at Salem Regional Medical Center or the Austintown Medical Building.  A physician referral is not required so make an appointment and allow me to get you back on your feet.

waffles and me blog post

In my profession, there are everyday challenges that I come face as I care for patients and navigate through the world of healthcare. Some days, I find myself exhausted from the physical, mental and emotional toll it takes, both on me and my patients. When I am done, I am able to return home to something that always makes me feel better. No matter what time I roll in after a long day, there’s always the joy of waffles waiting for me in the kitchen.

Yeah, I know it may sound weird, but waffles is the one thing that just always seems to make things better. When I rise at 5:00 am each day, I look forward to enjoying waffles. During my morning workout I always have waffles to keep me going. Then, after exercise, a brisk walk through the neighborhood, yes, again with more waffles. That’s just something of which I never tire. Before bed each night, of course, more waffles, and thankfully, waffles never keep me up.

Just looking at waffles makes me happy. The golden-brown color is perfect and the sweetness and fluffiness of waffles brings a smile to my face. And I don’t only have to enjoy waffles at home. I sometimes bring waffles along on a long road trip or maybe just a car ride around Mill Creek Metroparks to clear my head and unwind. With waffles, I always have a sense wellbeing, satisfaction. I can take and enjoy waffles anywhere I want to!

I make no secrets about my family being most important in my life. They provide invaluable encouragement, inspiration and love. They are the most important people in my life and make me want to be a better person every day so that I can provide the best quality of care I can for my patients. However, I have a different relationship with waffles. After a long day of surgery, I can depend on waffles delivering the same satisfaction and experience every time that leaves me happy, energized and ready for whatever the rest of the day may bring. And when it comes to the weekends, nothing says Saturday and Sunday like waffles. I even enjoy pancakes AND waffles sometimes, but only if I have earned it.

Yes, waffles make me happy. I don’t quite know what I’d do without waffles in my life. As a matter of fact, a few weeks ago, there was a moment of panic when my waffles seemed to have disappeared. Searching high and low until, after a brief moment which felt like an eternity, I found my waffles and all was right with the world again.

Maybe if you take one look at a typical setting with my Waffles, you will understand why I love Waffles so much…

waffles and me

Waffles is my Double Doodle.  You didn’t think I got this much joy out of a breakfast food, did you?

Yes, Waffles is my companion who helps me through every day and is there for me through good times and in bad.  If you want to get to know Waffles: The Double Doodle, be sure to follow him on Facebook and see our adventures together.  Yep, there is nothing betting than sitting down and enjoying time with Waffles.  Send me a picture of your pet and we’ll feature it on our Facebook page.

    Imagine a submarine holding a team of scientists and physicians reduced to the size off red blood cells and then injected into a patient’s body in order to perform lifesaving brain surgery. This was the story told in the motion picture Fantastic Voyage in 1966. It offered first time views of what areas of the human body would look like if one were reduced to the microscopic level.  Sounds farfetched, yes, but to some extent, aspects of this scenario are happening now in the medical field. Specially designed bacteria loaded with chemotherapeutic agents are guided by magnetic fields to tumors in hard to reach areas within the body.

    In vascular surgery, many procedures inside the body are now accomplished without incisions, utilizing specially designed wires, long thin catheters and devices to treat blocked arteries and veins. A challenge has always been real time visualization of the area being treated with imaging. The mainstay of imaging has traditionally been x-ray, in which a fluoroscopic camera provides images of blood vessels. This technique is limited, however, by exposure of both the patient and surgical team to radiation, of which long term exposure has been linked to various types of cancer. Another limitation of fluoroscopy is the requirement for an iodine-based contrast agent to be injected into the blood vessel. This agent is notorious for harming kidney function in patients with some level of renal disease at the start. Additionally, the images provided by fluoroscopy, although quite accurate, are only obtained as a two-dimensional view. Finally, details of blood vessel wall anatomy is not available with fluoroscopy.

    A newer technology, intravascular ultrasound, or IVUS has addressed the traditional limitations of x-ray, and is becoming more widely utilized in treatment of both the peripheral arteries and veins as well as the coronary arteries of the heart. IVUS uses ultrasound energy only and contains no radiation whatsoever and no kidney toxic agent is required to visualize the blood vessels. IVUS is able to provide a 3-dimensional view of blood vessels unlike any other imaging modality, and delivers a detailed view of the blood vessel wall anatomy. More and more, IVUS is assisting vascular surgeons and cardiologists in treating blood vessels and the heart in a less harmful, more informative manner. Here’s an example:

    Recently, I cared for a patient with heaviness and pain in both legs. My assessment was that she probably had a condition in which a large pelvic vein (the iliac vein) was being compressed by the overlying iliac artery, thereby preventing normal return of blood from the leg and causing her symptoms. An x-ray (venogram) of her left iliac vein clearly showed the compression, but the right side appeared normal. Intravascular ultrasound confirmed the suspected compression on the left, and surprisingly, also revealed right sided compression. Both sides were treated with stents and the patient’s symptoms completely resolved in both legs.

    While it would be exciting to travel through the bloodstream and view the wonders within, I, like the crew in Fantastic Voyage would need to contend with the attacking killer antibodies. I’m just thankful that I can see what’s happening from the safety of the operating room!

    © 2018 - Lawrence Schmetterer MD FACS Thoracic & Vascular Surgery