General Practitioners

• Osteoporosis
• Medical Weight Loss
  The thyroid is a butterfly-shaped gland in the neck that consists of two lobes with a narrow isthmus between them. It lays over the trachea, or windpipe. The gland makes thyroid hormone, an important regulator of metabolism. Overproduction of thyroid hormone is called hyperthyroidism. Symptoms of hyperthyroidism include nervousness, irritability, heat intolerance, rapid heartbeat, muscle weakness, fatigue, frequent bowel movements, light menstrual periods, weight loss, and hair loss. Under production is called hypothyroidism. Symptoms of hypothyroidism include decreased energy level, feeling cold, muscle pain, slowed thinking, constipation, long menstrual periods, weight gain, brittle nails and hair, and depression.
• Primary Care
  If your insurance requires a referral from your primary care physician (PCP), it is your responsibility to assure that your PCP sends the referral to our office prior to your appointment. If we do not have a required referral, payment in full will be due at the time of service.
• Emergency Care
  If you have seen your surgeon only through the Emergency room or as an inpatient consult in the hospital, please contact our staff at
• Colonoscopy
  Diagnostic tests may be used to pinpoint the problem or rule out other colon disorders. A CT scan can evaluate for diverticulitis. A barium enema is an x-ray that allows visualization of the colon after filling it with barium. It can show narrowing of the colon, growths, or pouches in the colon wall. A colonoscopy involves the use of lighted
tube to look directly into the colon.
• Constipation
• Bronchitis
• Pneumonia

Internists

• Kidney Cancer
  Cancer that spreads from another organ is considered a “metastasis†to the adrenal gland, and most often originates from a lung or kidney cancer.
• Kidney Stones
  Primary hyperparathyroidism occurs when there is excessive or inappropriate secretion of PTH by one or more of the parathyroid glands leading to higher than normal calcium levels (both PTH and calcium levels high). This is the most common reason patients are referred to our practice. In approximately 85% of patients, one of the four parathyroid glands is overactive, due to benign enlargement of a single gland called an adenoma. Some patients have more than one abnormal gland, termed hyperplasia. The elevated PTH in hyperparathyroidism causes resorption of calcium from bone thereby weakening the bones, a condition known as osteoporosis or osteopenia. Additionally, elevated levels of calcium in the urine and can result in kidney stones and, over time, permanent kidney damage. Patients with elevated blood calcium levels also often suffer from fatigue/lack of energy, muscle weakness, memory or concentration lapses, irritability, insomnia, depression, excessive thirst and urination, reflux/indigestion, and risk of cardiac and pancreatic problems. About a third of patients with this condition are minimally or non-symptomatic.
• Colon Cancer
  A cancer is made up of abnormal cells that are growing out of control. They can grow into the colon lining and spread, or metastasize, to other parts of the body. The earlier cancers are removed, the greater the chance of preventing cancer spread. Colon cancer usually spreads first to nearby lymph nodes, and then to the liver, lungs, or other organs.
• Endoscopy
  Endoscopy: This test allows the doctor to examine the inside of the patient's oesophagus, stomach, and portions of the intestine, with an instrument, called an endoscope, a thin, flexible, lighted tube.
• Cancer Care
  Skin Sparing and nipple sparing mastectomies are variations of a simple mastectomy that may be combined with plastic surgery reconstruction of the breast to provide improved cosmetic outcomes while maintaining the standard of cancer care.

Psychiatrists

• Depression
• Insomnia

Endocrinologist

• Hypothyroidism
  Thyroid Function Tests are blood tests that can help diagnose hyperthyroidism (excessive thyroid hormone production) or hypothyroidism (underproduction). The thyroid is also examined by physical exam. Ultrasound is a routine imaging study that can be performed in the office, but very commonly patients are referred to a surgeon after having one. The ultrasound can identify nodules and cysts, provide precise measurements of these lesions, and identify other features that may be suspicious for cancer. A thyroid scan is a nuclear medicine test that can identify whether nodules are “hot†(excessive thyroid production) or “cold†(not producing any hormone). Hot nodules can be associated with hyperthyroidism and are typically benign. Cold nodules are more likely to harbor malignancy in about 10- 20% of cases. Fine Needle Aspiration (FNA) biopsy can help determine if a thyroid nodule is malignant. The FNA may be performed in the office by the surgeon, or by an endocrinologist, primary care physician, or interventional radiologist. Any nodule over 10 mm meets size criteria for FNA. Austin Surgeons utilize the Afirma gene expression classifier system (AFIRMA). This FNA is performed with the patient comfortably reclined with their head tilted slightly back. Only a minimal amount of local anesthesia is required. The test requires 4 passes of a skinny needle into each nodule that needs biopsy. Ultrasound is used to guide and confirm precise placement of the needle within the nodule. The cells that are in the needle aspirate and are then prepared and sent to a group of physicians trained to evaluate thyroid cells (cytopathologists).
• Thyroid

Radiologist

• Ultrasound
  An elevated blood calcium coupled with an elevated PTH level establishes the diagnosis. Occasionally, a physician may request a 24-hour urine collection for calcium. Patients then typically undergo a radiologic study known as a parathyroid scan using a Sestamibi radioactive marker in conjunction with a special CT and/or ultrasound to locate the abnormal parathyroid gland.
• MRI
  Tumors that are found incidentally on radiology imaging for other reasons are termed "incidentalomas". These occur in about 4% of the population, increasing with age. Once found, they are usually tested for excessive hormone production. If they are nonfunctional and a size of less than 4cm (determine via CT or MRI imaging), they are considered benign and are observed rather than removed. Observation typically entails the need for repeat imaging and labs every 6 – 12 months (25% will grow and 20% will hypersecrete over a 10-year period).
• Radiology
  Austin Surgeons will only bill for and collect the surgeon’s fee for performing surgery. Any fees for the hospital or surgery center, the anesthesiologist, the pathology lab, radiology, etc. are separate and will be handled by those providers. Please contact the appropriate provider if you have questions related to their fees.
• X-Rays
• Nuclear Medicine
• Computed Tomography
  The diagnosis of appendicitis starts with an examination by an experienced physician. Usually, patients will have significant tenderness in the right lower abdomen. Blood work may show an elevated white blood cell count. CT scan of the abdomen is often used to help diagnose appendicitis and can indicate whether the appendix is ruptured. Other conditions can mimic appendicitis, so a careful evaluation is important.
• Chemotherapy
  Axillary dissection is the removal of lymph nodes from under the armpit. This is done to determine if cancer has spread to these lymph nodes and, if so, to remove it. The lymph nodes are removed from an area that has certain anatomic boundaries. Anywhere from 5 to 25 lymph nodes may be present in this area. A drain tube is placed at the time of surgery and will remain for one to two weeks. The lymph nodes are analyzed in the laboratory to determine if cancer is present and the oncologist uses this information to make decisions about chemotherapy. Axillary dissections are far less common today and can be associated with swelling of the arm (lymphedema). There is also the possibility of nerve damage leading to numbness or muscle weakness, fluid collections in the wound cavity, and limited mobility of the arm. These problems, however, are not common.
• Radiation Therapy
  Partial breast irradiation – administered via a catheter placed into the breast and usually completed in 7-10 days. A consultation with a radiation oncologist is recommended prior to initiating radiation therapy. For more information about this type of radiation, click here.

Surgeons

• General Surgery
• Minimally Invasive Surgery
  The surgical removal of an adrenal gland is called adrenalectomy. Minimally invasive surgery performed either laparoscopically or robotically is the preferred technique. We have been performing minimally invasive adrenalectomy since the mid 1990s, when it was first confirmed a safe and effective procedure for adrenalectomy. The minimally invasive approach allows for small incisions and scars, less postoperative pain, shorter hospitalization, and faster recovery. Infrequently, a larger incision/open procedure is necessary to remove an exceptionally large tumor or one that is malignant.
• Cyst Removal
• Robotic Surgery
  Austin Surgeons is an independent group of board-certified general surgeons dedicated to providing the highest-level of patient-focused surgical care in Central Texas. Our physicians have over 100 years of collective experience and are committed to offering the most advanced surgical techniques including minimally invasive and robotic surgery. We are affiliated with area hospitals including Arise, Ascension Seton, Cedar Park Regional Medical Center and St. David’s Healthcare. Learn more about our surgeons below.
• Laparoscopy
  We perform many different types of surgery with laparoscopy. Examples include gallbladder removal (cholecystectomy), appendectomy, hernia repair, removal of part of the colon (colectomy) or small intestine, surgery for acid-reflux disease (fundoplication), removal of adrenal glands, and removal of the spleen.
• Reconstructive Surgery
  Treatment for breast cancer can include surgery, chemotherapy, radiation, and reconstructive surgery. The techniques in each of these fields have improved, leading to treatments that were not previously available. Consequently, breast cancer treatment has become more effective and the cosmetic results have improved.

Plastic Surgeons

• Botox
• Breast Reconstruction
  Lumpectomy is the removal of the tumor and a surrounding rim (margin) of normal breast tissue. Most the breast tissue is undisturbed. Radiation treatment is then necessary for the breast. In combination with radiation, lumpectomy is as successful as mastectomy in treating breast cancer and the cosmetic result is usually excellent. Depending on the location and size of the tumor, some women may not be candidates for this procedure and may need to have a mastectomy. Some women prefer a mastectomy, possibly with breast reconstruction, instead of lumpectomy and radiation. Occasionally, if microscopic analysis of the lump later reveals that the margins are not clear of cancer, a return to surgery for further removal of tissue or mastectomy may be necessary.
• Plastic Surgery
• Laparoscopic Surgery
  As with all surgeries, there are risks of complications associated with laparoscopic surgery. They include bleeding, infection, injury to organs or other structures, scar tissue formation, obstruction of the bowel, hernias, and complications related to anesthesia.

Dermatologists

• Skin Cancer
  Melanoma is an aggressive type of skin cancer. The tumor arises in pigmented cells in the skin called melanocytes. For reasons that we do not fully understand, these cells become cancerous, although sun exposure is thought to have a causative role. Melanoma usually forms at the site of a pre-existing mole; however, this is not always the case. Any mole that grows rapidly, bleeds, ulcerates, has an irregular margin, or an unusual color distribution should be considered suspect and a biopsy performed. Melanomas can form on any part of the body, but the sun-exposed areas are the most common. They may also form on the palms of the hands, on the soles of the feet, beneath finger and toe nails, and in the mouth, genital, or perianal areas. Melanomas are more common in Caucasians than in African-Americans, with a ratio of 20:1. The best treatment for melanoma is prevention through avoidance of prolonged sun exposure or use of strong sun blocking lotions if prolonged exposure is anticipated.
• Cyst
• Lesions
  The extent of the malignancy at the time of diagnosis is the most important prognostic factor. Patients with disease confined only to the skin have the best prognosis while those with disease confined to the skin and adjacent lymph nodes, but no distant spread, have an intermediate prognosis. Patients who have disease spread to distant organs, i.e. liver, or bone, have a poor prognosis. The depth of tumor invasion (the thickness of the original lesion) helps predict the likelihood of spread, as well as the surgical treatment. Tumors less than 1.0 mm. thick have a low risk of spread, those 1.0 – 4.0 mm in thickness (intermediate lesions) have at least a 20% chance of spread to the closest lymph nodes, even though no enlarged lymph nodes may be felt on exam. Tumors greater than 4.0 mm. in thickness (thick lesions) have greater than 50% chance of spread to local lymph nodes and beyond. A second method of measuring tumor thickness is called the Clark’s level, which determines the level of the dermis (a part of the skin) that has been penetrated. The Clark’s level is used in conjunction with the thickness measurement to determine treatment.

Physical Therapists

• Shoulder Pain