Physician Spotlight on Neil Alan Fenske, MD

25Jul

PHYSICIAN SPOTLIGHT: Neil A. Fenske, MD Chairman, Department of Dermatology & Cutaneous Surgery, USFCOM, Tampa

Some might think that growing up “dirt poor” on a farm in Blue Earth, Minn. would be a liability. But Neil Fenske treasures it as a character-building experience that allows him to appreciate how far he has come in life.

“I’m a guy who came up the hard way,” said Fenske, chairman of the Department of Dermatology & Cutaneous Surgery at the University of South Florida College of Medicine in Tampa. “I had to carve, scratch, dig and cajole. That’s not a complaint. It has made me stronger, Fenske said.

How poor was his family? Fenske, the eldest of five children, wore only used clothes and one winter his only jacket was a girl’s. “I had to wear it to school because that was all (his parents) could afford for $1.50,” he remembered.

Fenske was driving a tractor and plowing fields at 10 years of age. His parents eventually purchased a small grocery store in nearby Winnebago, where he and his siblings worked at night and weekends. Fenske credits the long hours and hard work to forging his work ethic. “It was working behind the cash register where I learned to interact and communicate will people of all ages and personalities, which has served me well as a physician,” he said.

The family’s diet was low-budget and high-cholesterol. “SPAM® was a staple … and hot dogs and hamburgers were served on thin white bread because buns were ‘too expensive,’” he said, adding that an experience with a hamburger at age 12 was a turning point in his young life. “A friend’s mom took him and me for my first restaurant experience – a hamburger on a bun, French fries and a Coke. What a treat! It was at that point that I decided I was not going to be poor when I grew up. I committed myself to academic and athletic excellence throughout my high school years,” Fenske recalled.

He earned a basketball scholarship to Gustavus Adolphus College, becoming the first Fenske to attend college. He already knew he wanted to study medicine because of his teenage admiration for two family physicians. After college he enrolled in medical school at St. Louis University, where he took an elective course in dermatology and “fell in love with it,” Fenske said. He completed his internship at St. Mary’s Hospital in Duluth, and residency at the University of Wisconsin, where he met and married his wife Robyn, and soon realized “an academic career was my calling,” he said. Fenske was recruited to USF to start a residency training program in dermatology and he has been there since 1977.

But in many ways that is just the beginning of a career in which he has influenced the lives of countless patients, students and the institution he has served for 34 years. Along the way Fenske has left his mark in many ways, including being president of seven dermatologic organizations and being named the 1999 practitioner of the year by the Florida Society of Dermatology. In addition, he was chosen by his peers in the Castle Connolly Medical Ltd., directory as one of America’s top cancer doctors for five of the past seven years.

But the professional accomplishments that Fenske treasures most are his relationships with students and patients.

“I have had the privilege to educate and mentor many bright young men and women, many of whom practice in the greater Tampa Bay area,” he said. “All our grads are reputable and very highly sought-after. (Tampa-area) docs scoop up my residents all the time. I’m proud of all of them.”

Fenske said he still spends about 50 to 60 percent of his time seeing patients, which is unusual for a department chair, and that he still thrives on that interaction. “I have not lost my zeal,” he said. “I have as much enthusiasm today as when I started here 35 years ago. … I’m very motivated and high-energy.”

Others confirm Fenske’s self-evaluation. Stephen Klasko, MD, MBA, is senior vice president of USF Health and dean of the College of Medicine. “He is very well thought of by me and others,” Klasko said, pointing out his work with Fenske to transform the Dermatology Division into a full-fledged department. Klasko also noted that Fenske was instrumental in securing the endowment of the Dermatology Department Chair. It was Fenske’s relationship with a patient that made it possible.

Tampa resident Chris Sullivan is co-founder and CEO of Outback Steakhouse, and a patient of Fenske’s for about 15 years. “I’ve dealt with a lot of skin cancer issues personally and in my family. Over time I observed how he was teaching young doctors and how innovative he was in his practice and teaching,” said Sullivan. “They did not have a dermatology chair at USF and I knew he had done a fantastic job of building that department. The idea of endowing that chair became available to me and I thought it was the right thing to do because Neil had earned that opportunity. Personally, he has impacted me very positively and I like the way he goes about his business. He’s an outstanding educator and an outstanding doctor,” Sullivan said.

Fenske said that when he and Klasko met with Sullivan to discuss a fundraising effort, Sullivan volunteered not only to endow the chair for $2 million, but he insisted on putting it in Fenske’s name. “I was caught off guard” by Sullivan’s generosity,” Fenske said. “I literally had tears welling in my eyes. Most people (who make a donation of that size) would want their name on the chair.”

But Sullivan saw it differently. “Neil’s the one who did all the work. It should be named after him,” he said.

And, Fenske said, his work is nowhere near done. Several area dermatologists and philanthropists have contributed, and one of his goals before retirement is to endow the entire Dermatology Department, which will require raising several million dollars. “It would be a great legacy for this great university,” he said.

But that doesn’t mean Fenske is eyeing retirement. “I still love going to work on Monday mornings. … Other than my grandkids and my immediate family, my work is my life and it’s a labor of love. God willing, and my health holds up, I’m here several more years,” he said.

Fenske has three children and four grandchildren and he savors the time he and Robyn spend together with them, especially during autumn at “our mountain house in the Smokies,” he said.

Reflecting on his humble beginnings, Fenske takes heart in the fact that “in America, you can still overcome it. … You’ll have to work harder than the average bear,” he said, but adhering to a simple set of principles has served him well: “Always work hard, do your best, and always do what’s right.”

BroTox: Botox for Men

20Jan

In this new economy we all need to be looking our best so we can get the perfect job, or meet a significant other, or just to make ourselves feel better. This outlook on life does not discriminate. Men need to look their best just as women do. Wrinkles on men use to mean experience or that they are distinguish, now it just equates to being old. Therefore, more and more men are looking to Botox to help keep them young like their women counterparts. Women have done such a great job turning the clock back that men have been left behind. Men are wanting to catch-up and look just as youthful and rested. Last year more than 300,000 men received Botox according to the American Society of Plastic Surgeons, which is a 10% increase from 2010. Botox injections are the most commonly performed nonsurgical cosmetic procedure in North America. And now men are getting on the Botox bandwagon.

The most common area of concern for men is the wrinkles between their eyes and on their forehead. This is the result of repetitive use of the upper face muscles. This repeated use leads to dynamic wrinkles in which Botox can help. Botox cannot be used for static wrinkles that are present all the time, even when the face is not moving. Also, Botox will not eliminate creases or etched in lines in the skin from many years of repeated movement. This is an excellent reason to start Botox injections sooner, rather than later.  By relaxing these areas men will look more relaxed, less confused and not as angry. Botox has a wonderful safety profile and is used to soften wrinkles, not erase them. Botox works by weakening the muscles, therefore improving facial expression lines.  Onset usually occurs 3 to 12 days after injection, and usually lasts somewhere between 3-6 months.  Thus, repeat injections are required to maintain the effects. The most common side effects but unlikely is redness and minor swelling to the injection site. Some individuals may experience little discomfort or bruising, but most do not. I recommend that Botox be purchased by the unit, not by the area. Keep in mind that cost alone should not drive your selection of a provider but experience and skill should. Botox for men or women is a great procedure to remain young and refreshed.

By: Robin McClain, ARNP-C, Cosmetic Practitioner at the USF Health Cosmetic and Laser Center on Davis Islands

The Winter Itch of Dry Skin, What to DO…..

11Jan

Winter weather comes with dry, itchy skin that may start to crack and possibly become painful. Several factors contribute to dry compromised skin including but not limited to cold weather, low humidity, overuse of soap, and genetics. Some of these factors we can control and others we cannot control, like genetics. However, there are things we can do, avoid, and apply to aid in minimizing dry itchy skin.

#1 Drink Plenty of Water. Drink at least 8 glasses of water a day to stay hydrated to keep your skin soft and less dehydrated from the environmental changes.

#2 Use a Small Amount of a Gentle Soap. Use a gentle soap with minimal ingredients and a small amount. The more soap you use and the more ingredients the soap has the drier you are more likely to be. Very dry people may consider only using soap on the really dirty or stinky parts. Our office recommends for the face SkinMedica® Sensitive Skin Cleanser and for the body Cetaphil® Skin Restoring Body Wash.

 #3 Avoid Long Hot Showers or Baths. The hotter the water and the longer you are exposed the more dry your skin will become.

#4 Use a Moisturizer. After bathing pat dry with a towel and while your skin is still moist apply a moisturizer. Our office recommends a facial moisturizer specifically tailored for your skin type. And for those with really dry compromised skin we suggest a moisturizer that contains ceramides and other lipids to aid in restoring and protecting the skin barrier. We recommend SkinMedica® TNS Ceramide Cream for the face and Ceratopic Replenishing Cream for the body.  For really dry, red, painful cracked skin one should use a healing ointment, such as SkinMedica® Restorative Ointment.  

#5 Wear Gloves and other Protective Clothing. Wearing gloves and other protective clothing protects your skin from the environmental conditions that cause compromised skin. When washing dishes, preparing food or cleaning bathrooms we recommend you keep your hands as dry as possible. One technique you can use is the double glove technique. First, put on thin cotton gloves and then put rubber gloves over the cotton gloves. Also, wear hats, gloves, jackets, etc to protect your skin when going outside during the cold months.

#6 Hand Washing and Antibacterial Gels. Washing your hands is a must. Just make sure that you thoroughly and completely dry your hands and then immediately apply a moisturizer to help lock in the moisture from washing your hands. If this is not feasible consider using a barrier type moisturizer. Remember lotions in soaps do not moisturize, they rinse away like the soap. Also, antibacterial gels are good at getting rid of bacteria, but they have a very high percentage of alcohol that tends to dry the skin.

If you continue to have dry compromised skin after trying the suggestions above see the dermatologist for more intensive treatment and detailed education for your unique skin.

By: Robin McClain, ARNP-C, Cosmetic Practitioner at the USF Health Cosmetic and Laser Center.

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Thinking about Botox? How many units of Botox will you need and what is the cost?

26Jul

Many providers sell Botox by the unit. Most new Botox consumers do not understand what this means. I am going to explain, to help you determine the average cost of Botox per area. First, you must determine what constitutes a unit in the practice you are receiving Botox from. In my practice I dilute my Botox by a 1:1 ratio. Therefore, I am delivering the strongest Botox to my patients. Next the provider must assess the area of concern and determine how many units will be needed to give the desired effect. The following is the ranges of Botox per unit my practice uses per area. In the glabella, which is the area between the eyes usually in women takes between 16-28units and in males takes between 18-30units, for correction of crows feet bilaterally 18-24units, horizontal forehead lines 8-16units, bunny lines on the nose 4-6units. Botox can also be used in the lower face but should be used with caution. Usually, for upper vertical lip lines 4-8units are needed, for a gummy smile bilaterally 2-4units, Marionette lines bilaterally 2-8units, and for chin dimpling 4-8units. Now to calculate how much Botox will cost you, first select the area of concern. Take the number of units and multiple by the cost per unit to determine your cost. For example if Botox was 10 per unit and the area of concern will take 10 units to correct then 10 per unit X 10units = $100 cost for the area to be treated. Most providers charge between $10-16 per unit of Botox with the average being $13 per unit. I hope this helps consumers like you to determine the cost of Botox for you, so you can budget appropriately prior to seeing your provider.

Botox $10 per unit

13Jul

USF Health Cosmetic and Laser Center is offering Botox for $10 per unit with Robin McClain, MSN, ARNP-C.  This offer expires August 31, 2010

How can I rejuvenate my skin without surgery?

17May

http://health.usf.edu/nocms/medicine/dermatology/pdfs/Fenske_TT%20Column_Skin%20Rejuvenation_4%2025%2009.pdf

Making Sense of Botox and Fillers

12Apr

Published: April 10, 2010

Many of my patients have expressed confusion regarding the role of Botox and fillers for treatment of skin wrinkles.

Specifically, they often don’t realize that these very popular cosmetic procedures serve two very different purposes.

As we age, repetitive muscle movement results in dynamic wrinkles, such as those that occur around the eyes (crow’s feet) and between the eyes (frown lines). Botox, the brand name for OnabotulinumtoxinA, is injected into the muscles responsible for causing these wrinkles. By temporarily paralyzing these tiny facial muscles, the wrinkle is softened, making the face look younger and refreshed. It generally takes two to three weeks before the full benefit is seen. The effects of Botox only last three to four months.
Botox injections will not work for static wrinkles – wrinkles that are present all the time, even when the face is not animated. And Botox won’t eliminate the tiny creases already etched into the skin from many years of repeated movement – a good reason to commence with injections sooner, rather than later.
Botox injections are the most commonly performed nonsurgical cosmetic procedure performed in North America. They have an excellent safety profile. The only significant adverse events have been when large doses (many times that used for treating facial wrinkles) have been used “off label” in non-facial sites.

Newer varieties of botulinum toxins, such as Dysport, are becoming available. Whether these prove to be superior is yet to be determined.

I recommend that you purchase Botox by the unit, not by the area – it is the only way to accurately compare prices. Keep in mind that cost alone should not drive your selection of a provider. Experience and skill are necessary for a successful outcome!

Before Fillers

Before Fillers

Immediately Post Fillers

Immediately Post Fillers

Fillers, in contradistinction, are used primarily to restore volume to the aging face. As we age, our facial skin becomes thinner, fat diminishes, muscles atrophy and bone loss occurs, resulting in a face reminiscent of a deflated balloon. As the skin sags we develop unsightly furrows along the nose (naso-labial folds) and on the chin (marionette lines). These furrows can be safely filled with many different materials, and the results are immediate.

I generally prefer nonpermanent fillers, especially those containing hyaluronic acid (e.g. Restylane, Juvederm), a natural component of normal skin. These fillers last six to nine months, so if you don’t like the results, the skin will eventually return to baseline. Even better, if you hate the results, you can inject hyaluronidase and immediately reverse the effect.

Fillers are also used to enhance the lips, which also lose volume as we age. This is a case where less is more; if they end up being too big, it doesn’t look normal (restoration, not over-inflation, is the rule).

Remember, Botox and fillers are temporary “fixes” that have an excellent safety profile.

Injection is both a science and an art. It is foolhardy to just shop price – a lesson many have learned the hard way. Experience and an artistic eye are paramount to a successful outcome!

Dr. Fenske is professor and chair of the Department of Dermatology and Cutaneous Surgery at USF Health.

http://health.usf.edu/medicine/dermatology/bios/bio_fenske.htm

For appointments call 813-974-4744

Bald spots a problem for women too

26Mar

http://www.abcactionnews.com/mediacenter/local.aspx?videoid=22258@wfts.web.entriq.net&navCatId=3

Fade Your Sun Damage Away with IPL

16Mar

Intense Pulse Light (IPL) is a light therapy that minimizes brown spots and redness associated with sun damage. The IPL procedure evens out skin color giving you a more youthful appearance to your skin. IPL can be safely used on any area of the body, but most commonly done on the face, chest, and hands. IPL works by delivering visible light to the skin. The IPL light is then absorbed specifically by the pigmented cells and vasculature resulting in fading of brown spots and redness. Majority of people need approximately three treatments usually spaced out a month a part to achieve the best results. However, most people see a great improvement within two to three weeks of their first IPL treatment. There is no downtime with IPL treatments and minimal discomfort making this procedure a highly sought after treatment. Intense pulse light is a great treatment for the majority of people trying to improve their skins appearance and treat sun damaged skin.

Robin McClain ARNP-C

Hot Tips for Healthy Skin

05Jan

 

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http://archive.constantcontact.com/fs069/1102100181178/archive/1102908976191.html