JOHN Rophael is a city boy with a passion for the country.

The vascular and endovascular surgeon studied at Melbourne University before training as a junior doctor at St Vincent’s Hospital and rotating through a range of surgical specialties.

Mr Rophael decided to specialise in vascular surgery – medical treatment of diseases of the vascular system or arteries and veins – and split his training between Victoria and New South Wales.

“I trained at The Austin and The Alfred here in Victoria and at the Royal North Shore in Liverpool in Sydney,” he said.

“After I finished my training I decided to work regionally so I set up my practice in Wagga and also in Albury.

“I had quite a big practice there.

“I was essentially the sole surgeon covering about 400,000 people in the catchments and surrounding areas.

“It was good for a specialist who’d just finished to go and get that degree of exposure and also offer a regional service.”

Mr Rophael set up Albury’s first endovascular service and was also instrumental in establishing the first regional complex wound and ulcer multidisciplinary service. He also set up the region’s first endovenous laser treatment service.

“In Melbourne vascular surgery is very much city centric whereas in New South Wales I think they’ve tried the model of having vascular surgeons in regional areas like Lismore and Byron Bay,” Mr Rophael said.

“They proved it is possible, as long as you have a hospital that has the appropriate facilities.

“Wagga had already had some vascular surgery done there but the vascular surgeon who was there had left for a few years to go and set up in Tasmania.

“But in Albury there was very minimal vascular surgery, in fact no endovascular surgery was being done. So I set that up and we treated quite a number of patients.”

Mr Rophael provides a range of vascular diagnostic and interventional services including the management of peripheral arterial disease; venous disease; complex ulcers and wounds; cerebrovascular disease; aortic and peripheral aneurysms; and spinal access surgery.

“Traditionally vascular surgery was done as open surgery,” Mr Rophael said.
“Now about 60 per cent of vascular surgery workload is endovascular which is minimally invasive, done through the vessel rather than exposing the vessels. So if you have a blocked artery, traditionally you’d open the artery and clear it out with open surgery. Now you put a little wire and you balloon it.

“Our patient population is often patients who are in their 70s and 80s and so on for whom a minimally invasive approach is always better because it carries a lesser risk of anesthetic complications, wound infection and that sort of thing.”

Mr Rophael is based in Melbourne but has an appointment at St John of God Bendigo Hospital.

“I like working regionally,” he said.

“The message I would like to convey is it is possible to do complex surgery for vascular surgery in a regional centre and I’m offering that here in Bendigo.”

Article Source: http://www.bendigoadvertiser.com.au/story/2400309/serving-bendigo/

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Atherosclerosis can affect arteries all over the body. There are different names for atherosclerosis depending on which arteries it affects.

Carotid artery disease is a form of atherosclerosis that affects the carotid arteries, which bring blood to the brain. This form of atherosclerosis can lead to stroke.

Coronary heart disease is a form of atherosclerosis that affects the coronary arteries, which bring blood to the heart muscle. This form of atherosclerosis can cause chest pain and lead to heart attack.

Renal artery stenosis is a form of atherosclerosis that affects the renal arteries, which bring blood to the kidneys. This form of atherosclerosis can cause high blood pressure or lead to kidney disease.

Peripheral artery disease is a form of atherosclerosis that affects the arteries that bring blood to the arms and legs. People with this condition sometimes have pain, tingling, or numbness in their legs when they walk.

How does atherosclerosis cause heart attacks, strokes, and other problems? — Atherosclerosis-related plaques can cause problems in 2 ways:

Plaques can get too big and reduce blood flow to certain body parts. This can cause symptoms (such as pain) in the part of the body that is not getting enough blood.

Plaques can break open, or rupture. When that happens, blood clots form inside the artery and block the blood supply to tissues past the clot. This is what happens during a stroke or a heart attack.

Who is at risk for atherosclerosis? — A person has a higher chance of getting atherosclerosis if he or she:

• Has a high cholesterol or triglycerides (triglycerides are a type of fat found in blood)
• Has high blood pressure
• Has diabetes
• Smokes
• Has an unhealthy diet
• Is overweight or does very little physical activity
• Has a mother or father who got atherosclerosis before the age of 50 years

Will I need tests? — Maybe. Doctors do not typically order tests to check for atherosclerosis in general. Instead, they order tests if they think a patient might have a specific form of atherosclerosis, such as coronary heart disease or peripheral artery disease. The tests for each of these conditions are all very different.

A general test that is often done in people who might have atherosclerosis is called a “lipid profile.” This is a blood test that measures the amounts of different forms of fat and cholesterol.

Can the problems caused by atherosclerosis be prevented? — Yes. To reduce your chances of having a heart attack, stroke, or related problem, do the following:

• Take the medicines your doctor prescribes to treat high blood pressure, high cholesterol, and to prevent clots.
• Lose weight (if you are overweight).
• Choose a diet rich in fruits, vegetables, and low-fat dairy products. Don’t eat a lot of meats, sweets, or refined grains.
• Do something active for at least 30 minutes a day on most days of the week.
• Quit smoking (if you smoke). Ask your doctor for help.
• Limit the amount of alcohol you drink. Have no more than 2 drinks a day if you are a man. Have no more than 1 drink a day if you are a woman.

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