your
health [ Your guide to Healthy Living from Georgia Regents Medical Center ]
Spring 2013 | gru.edu/health
today Obesity and infertility
Get the facts Adolescent medicine: Bridging the gap Fight cancer the smart way with coordinated, one-stop care
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INSIDE THIS ISSUE
What’s new and noteworthy at
Georgia Regents Medical Center? As part of an academic health center, we are continuously upgrading our services, technology and outreach. Here are a few of our latest initiatives, achievements and honors.
PAGE 3 Tips for a safe and healthy spring
PAGEs 4–5 Cancer Prevention A lifeline for breast cancer patients One-stop cancer care
PAGE 6 Heart Healthy Living Heart failure on the rise
PAGE 7 Focus on Women Obesity and infertility
PAGE 8 Neuroscience From wheelchair to walking miracle Beat the clock on stroke The Georgia Regents Comprehensive Stroke Center has recently earned two national honors. The center was named to the Target: Stroke Honor Roll by the American Heart Association/American Stroke Association for excellence in emergency stroke care. It is currently one of only about a dozen centers in Georgia to earn that distinction, identifying it as one of the fastest, most responsive stroke centers in the nation. The Comprehensive Stroke Center also earned the American Heart Association/ American Stroke Association’s Get with the Guidelines® Stroke Gold Plus Quality Achievement Award for the second consecutive year, indicating excellent compliance with stroke care guidelines. By delivering fast, effective care, the center is saving lives and preventing disabilities.
ECMO: Keeping critically ill children alive during healing The Children’s Hospital of Georgia’s extracorporeal membrane oxygenation (ECMO) team recently earned its fourth consecutive Award of Excellence in Life Support from the Extracorporeal Life Support Organization. This award is recognized by U.S. News and World Report and Parents magazine as critical for being named a top children’s hospital. ECMO channels blood into a roller pump that serves as the patient’s heart, then through an oxygenator, which serves as an artificial lung. The system delivers life support until patients’ hearts or lungs improve.
PAGE 9 Digestive Health Irritable bowel syndrome and fructose intolerance
PAGES 10–11 Family Health Heart disease starts early Adolescent medicine
PAGE 12 In the News Children’s Medical Center becomes Children’s Hospital of Georgia
The material in Your Health Today is not intended for diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment. For more information, please call 800-736-CARE (2273) or visit our website at gru.edu/health.
[ 2 ]
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Copyright © 2013 Georgia Regents Health System
Tips for a safe and healthy spring SCHOOL OF
hard knocks
Tim McLane, manager of athletic training services
Concussion Assessment Program helps protect student athletes
[ A]
lthough concussions
prevent, recognize and treat sports
have always been a problem
injuries, including concussions.
The trainers also attend practice
for athletes, the public has become
sessions and games to monitor play
National Football League and other
Baseline neurocognitive measurements
sports organizations acknowledged
Using a 25-minute computer-based
always the health and well-being of the
the issue.
neurocognitive test administered at
athlete when deciding what to do after
the schools, trainers determine each
a potential injury,” says McLane.
increasingly aware of them since the
“Concussions can be serious, and the
damage can be cumulative if athletes are athlete’s baseline ability to react,
Images on any of these pages may be from one or more of these sources: © 2013 Thinkstock and © 2013 istockphoto.com.
Evaluating injuries, caring for athletes
and evaluate injuries. “Our priority is
“If medical care is needed, it is
not given the proper time to recover,”
recall, recognize and differentiate.
available through our Concussion
says Tim McLane, manager of athletic
If players suffer injuries, they are
Center,” McLane adds. The center’s
training services at Georgia Regents
reevaluated after medical care. “By
sports medicine physicians, neurologist
Sports Medicine Center.
comparing the two scores, we pick up
and athletic trainers deliver multi-
changes in neurocognitive function
disciplinary care, monitor patients’
personnel who are trained to evaluate
Even so, schools don’t always staff
and determine the next steps to take,”
progress and follow a strict return-to-
injuries and make informed decisions.
McLane says.
play protocol.
The Sports Medicine Center takes the field Fortunately, the Sports Medicine Center has a team of certified athletic trainers who have earned bachelor’s or master’s degrees, passed a national certification
Playing offense against concussions The Sports Medicine Center has placed certified athletic trainers at: • Augusta Prep • Westminster Schools of Augusta • Augusta State University • Williston Elko High School • Midland Valley High School • Silver Bluff High School • Paine College
exam and are licensed in Georgia and South Carolina. These trainers work to keep athletes at seven area schools safe and healthy. They will also be expanding into
Stay safe on the field For more information about the concussion assessment program, call Tim McLane at 706-721-0266. To schedule an appointment with a sports medicine physician, call 706-721-PLAY (7529).
other schools. They are trained to help
gru.edu/health
[ 3 ]
cancer prevention and coordinate care, to delivering patient education and support. “This is a wonderful patient population,” Nicole says. “As mothers, wives and daughters, the women we serve have lots of reasons to live, so they’re generally ready to fight.” Nicole makes their battles easier. “Having Nicole schedule appointments with my three physicians, answer my questions and deal with other details of care was a real godsend,” says patient Gail Wilkinson, an elementary school teacher in Aiken County.
A lifeline for
breast cancer patients Meet breast health navigator Nicole Aenchbacher, RN, BSN
[N]
Meetings, managing … and endless phone calls Nicole also directs the center’s 12 additional cancer navigators and two data coordinators, attends managers’ meetings and serves as a clearinghouse for physicians. She works about 50 hours a week and fields about 50 calls and 100 emails a day, even while lunching at her desk.
Making the most of time off After work, Nicole is earning a
icole aenchbacher, rn,
assuring them easy access to coordinated
master’s degree in nursing. She also
BSN, seems to have come
care, information and support.
exercises an hour a day and takes her
straight from central casting. She’s
“Most of our patients view her as
4-year-old daughter swimming two
trim and articulate, and rocks a stylish
the keystone of the care they receive,”
nights a week. On the weekends, she
no-frills haircut—traits that reflect
says Thomas Samuel, MD, a medical
recharges by cooking and spending
her energy and efficiency. But this
oncologist at the center.
time with her husband and daughter. multidisciplinary breast health
Georgia Regents University Cancer
Guiding patients through the continuum of care
Center, Nicole brings a unique
For Nicole, it’s all a labor of love,
Nicole,” says Dr. Samuel. “She is
sensitivity to breast cancer patients.
from the four half-day clinics she
a compassionate, knowledgeable
She serves as the central point of
attends each week, to meeting with
professional who brings so much to
contact for about 150 patients a year,
patients and physicians to plan
the patients we serve.”
dynamo is powered by a big heart. As the breast health navigator at
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gru.edu/health
“I can’t imagine how our program would function without
One-stop
the patient and family to the table to
cancer care
present and discuss the plan. This is all
Fight cancer, not the system
are RNs, serve as the single point of
[C ]
done in one day in the Cancer Center.
Nurse navigators Dedicated nurse navigators, who contact for patients, coordinating communications, providing support
ancer patients often have
one central location, streamlining
and helping with resources.
to visit several physicians’
the process.
Multidisciplinary care is available
offices, try to remember what each
“Our team works together to care
for the following cancers:
says and self-navigate their way
for the whole person, with the patient
• breast
through a baffling system.
at the center of the team,” says Samir
• gynecologic
N. Khleif, MD, director of the center.
• head and neck
But Georgia Regents University Cancer Center offers a better
• bone marrow transplants/leukemia
approach known as multidisciplinary
Personalized teams
• lymphoma
care. Available at the nation’s leading
Depending on the diagnosis, the team
• gastrointestinal/liver/pancreas
cancer centers, the model is based
may include:
• prostate
on teams of physicians from various
• a medical oncologist
• lung
specialties who treat patients in
• a radiation oncologist
• central nervous system
• a surgeon
• melanoma/sarcoma
• a dietitian
The center also offers the area’s
Benefits of multidisciplinary cancer care • Allows patients to meet with their treatment team in one place, at one time • Takes the burden of communication off the patient and improves information flow • Integrates physician consultations • Reduces misdiagnoses, errors and unnecessary procedures • Results in a unified, carefully sequenced treatment plan
• a nurse navigator
widest range of clinical trials and
• a pharmacist
robotic surgeries not available at
• a social worker
other area facilities, including bladder
• therapists and others
removal, salvage prostatectomy for recurring prostate cancer and the
One-stop, same-day appointments
“facelift” thyroidectomy.
Here’s how the system works: The patient has an initial appointment with the entire team of specialists in one clinic. After the patient is seen and examined,
Experience coordinated care
the team collectively
For more information, visit gru.edu/cancer or call our cancer information line at 888-365-0747. To schedule an appointment, call 706-721-6744.
situation and
discusses the clinical develops a plan of care that addresses the patient’s every need. They then bring
gru.edu/health [ 5 ]
Heart-Healthy living
Heart failure
on the rise Take these offensive moves
[T]
hanks to improved
blood to meet the body’s needs.
medications and advanced
This chronic, progressive disease
procedures, increasing numbers of
causes shortness of breath and
people are surviving heart attacks and
fluid retention.
coronary artery disease. Yet many of
“Heart failure is often caused by
these people are struggling with heart
other conditions that damage the
• persistent coughing or wheezing
failure, also known as congestive
heart muscle, such as coronary artery
• s welling in the abdomen, legs, ankles
heart failure.
disease, heart attacks, high blood
John Thornton III, MD, a
pressure or heart valve problems,”
cardiologist at Georgia Regents
says Dr. Thornton. Like coronary
Cardiovascular Center who directs the
artery disease, heart failure is
outpatient heart failure program, says
largely preventable.
the condition occurs when the heart becomes too weak to circulate enough
Heart failure by the numbers According to the Centers for Disease Control, heart failure: • affects 5.7 million Americans • is the primary cause of death of 55,000 Americans a year • contributes to the death of more than 280,000 Americans a year
Expert heart care close to home Call 706-721-CARE (2273) now to schedule an appointment with a cardiologist who specializes in heart failure.
gru.edu/health
• s hortness of breath and reduced ability to exercise • rapid or irregular heartbeat “Although most cases of heart disease can’t be cured, early diagnosis and good
What’s the best defense?
medical management can help patients
Dr. Thornton suggests you take these
live longer, more active lives,” says
steps to prevent heart failure:
Dr. Thornton.
• control your blood pressure • eat a low-fat, low-salt diet • exercise regularly and maintain a healthy weight
Comprehensive medical management The Georgia Regents Cardiovascular
• don’t smoke
Center Heart Failure Program offers a full
• drink alcohol only in moderation,
range of care for heart failure, including:
if at all • take medications as prescribed
• medications and medical management • heart failure education • investigational drugs and devices
Heed these warnings
• cardiac catheterization
Contact your doctor if you experience
• e lectrophysiology services, including
these signs of heart failure: • weight gain of 3 pounds or more in one day • fatigue and weakness
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or feet
biventricular pacemakers • a state-of-the-art Cardiac Rehabilitation Center • cardiac surgery
focus on women
Obesity and
infertility
Beat the clock with weight-loss surgery
[Y]
ou probably know that
obesity increases your
risks of diabetes, heart disease and certain types of cancer. But did you know that obesity also increases the risks of infertility in both men and women? In women, obesity may: • disrupt the body’s normal hormonal cycles • cause problems with ovulation and menstrual cycles • increase the risk of polycystic ovary syndrome (PCOS), or the growth of a large number of ovarian cysts—a major cause of infertility in obese women
Possible complications of pregnancy Obese women who do conceive
Get the facts on bariatric surgery at a free seminar If you are morbidly obese, you may be a candidate for bariatric surgery, a proven treatment for diabetes and other obesity-related conditions.
But there are many misconceptions about weight-loss surgery. Get the facts at a free informational seminar sponsored by the Georgia Regents Weight Loss Center. Seminars are held on the second and fourth Tuesdays of the month at the Columbia County Library at 7022 Evans Town Center Blvd. in Evans and at the GRU Alumni Center at 919 15th St. in Augusta. To register, please visit gru.edu/weightloss or call our bariatric nurse coordinator at 706-721-2609.
are more likely to experience complications, miscarriage or
The good news
partner, Brian Lane, MD, say women
Cesarean delivery. They also
Bariatric surgery can help restore
should wait at least 12–18 months
experience less success with fertility
fertility, if being overweight was part
after surgery before becoming
treatments like in vitro fertilization.
of the problem. And a growing body
pregnant, as the rapid, ongoing
“Yet it can be extremely difficult
of scientific data now suggests that
weight loss that occurs during
for the morbidly obese to lose
women who have had weight-loss
this period can deprive the baby
weight through diet and exercise
surgery have safer pregnancies and
of nutrients. “Women who’ve had
alone,” says Michael Edwards, MD,
fewer complications than women who
bariatric surgery should also work
a bariatric surgeon who directs the
are obese during pregnancy.
with an obstetrician on preconception
Georgia Regents Weight Loss Center.
Both Dr. Edwards and his bariatric
planning,” Dr. Edwards says.
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[ 7 ]
neuroscience
FRom wheelchair to
walking miracle
After careful consideration, the team recommended deep brain stimulation, a procedure used to treat Parkinson’s disease but rarely used for dystonia. Nathan and his family agreed. During the procedure, Dr. Giller
Repairing the brain-muscle miscommunication
[W]
An innovative treatment
placed wires in carefully identified areas deep within Nathan’s brain, where muscle contractions originate. The wires are attached to a lead that
hen
8-year-old
Nathan Simmons of
Aiken began having trouble holding a pencil, his parents, Jeannie and Steve Simmons, consulted his pediatrician. Nathan then began experiencing
Advanced neurologic care To schedule an appointment at the Georgia Regents Neuroscience Center, call 706-721-4581.
trouble walking. Within a few months this once-
runs under the skin from the brain to the chest, where they connect with an implanted neurostimulator. Dr. Mehta programmed this pacemaker-like device, which stimulates the wires in the brain to jam the circuits that cause the contractions.
“Nathan was having constant
active child was confined to a
cramping in his legs, like he was
Up and running again
wheelchair and in pain, despite the
running a continuous marathon,”
Nathan was hospitalized for only
medication he was taking.
Mrs. Simmons says.
48 hours, but the physicians told the family that it might take six monthsto
Diagnosing Nathan’s problem
see results. It didn’t. “Nathan moved
The family turned to Children’s
from his wheelchair to the classroom
Hospital of Georgia and the Georgia
to the playground in just two short
Regents Neuroscience Center. Nathan
weeks,” Mrs. Simmons says.
was cared for by a comprehensive team that included Shyamal Mehta, MD, a neurologist and movement disorders specialist, and Cole A. Giller, MD, PhD, a neurosurgeon who has been listed among the Best Doctors in America several times. Dr. Mehta diagnosed Nathan with genetic dystonia, a disease that causes a disconnect between the brain and the muscles, resulting in painful involuntary muscle contractions.
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We are so fortunate to have an academic health center with worldrenowned specialists like Dr. Giller and Dr. Mehta in our area. Through a national association for dystonia, we’ve met people who have consulted various physicians and never even heard of deep brain stimulation.” — Jeannie Simmons, Nathan’s mom
digestive health
Irritable Bowel Syndrome and
fructose intolerance Common companions
[C]
ramping, abdominal pain,
high-fructose corn syrup in
gas, bloating, diarrhea and
processed foods.
constipation can make life miserable for the 58 million Americans who struggle
A poorly understood condition
with irritable bowel syndrome (IBS).
“There’s a lack of knowledge about
The disorder generally appears before
fructose intolerance, even among
10 percent of people with the condition
age 35 and is more common in females
many gastroenterologists,” Dr. Rao
are diagnosed.” If you are experiencing
and those with a family history. But it
says. “I suspect that only about
gastrointestinal problems, or have IBS, Dr. Rao suggests you ask your
can affect others as well. No one knows exactly what causes IBS. “But physicians think alterations in the interactions between the gut and the brain, as well as how food moves through the gut, may be responsible for this disorder,” says Satish Rao, MD, PhD, a neurogastroenterologist who specializes in this area of gastroenterology and directs the Georgia Regents Digestive Health Center.
Fructose intolerance: Double trouble People with IBS are more likely to suffer from fructose intolerance, a condition in which the body cannot break down and absorb fructose, a sugar found in fruits and vegetables. The disorder is spiking because of increasing amounts of
Solve GI problems at the area’s only Digestive Health Center
physician about fructose intolerance.
This regional referral center staffs gastroenterologists and hepatologists with training in virtually every area of gastroenterology, offers the state’s widest range of tests and treatments and operates specialty clinics for: • motility disorders • pelvic floor disorders • lactose and fructose intolerance • dysphagia (difficulty swallowing) • GERD/heartburn • irritable bowel syndrome • gastroparesis • constipation To schedule an appointment at the Digestive Health Center, call 706-721-9522.
Center offers a fructose intolerance
A diagnostic breath test Georgia Regents Digestive Health breath test that can accurately diagnose this disorder. “Both IBS and fructose intolerance can often be controlled by lifestyle changes,” Dr. Rao says.
New treatments for IBS There are several treatments available for IBS, including avoidance of foods that cause symptoms, new FDAapproved medications and biofeedback therapy. “But treatment should be tailored to each patient's needs,” says Dr. Rao.
gru.edu/health
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Family health
Heart disease
starts early Little hearts can be building big problems
[P]
arents, take note.
overweight and at risk, especially if
Lifestyle changes such as regular
Your children could be
obesity is a family problem.
exercise and healthy eating can
accumulating fat and plaque in their
often reverse the trend and ensure
arteries that will lead to heart disease
How to tell?
better health in the years to come,”
in the years to come. “This buildup
The following risk factors may
Dr. Murdison says.
often begins in childhood,” says
indicate that your child may be
Kenneth Murdison, MD, a pediatric
headed for heart disease:
cardiologist at Children’s Hospital of Georgia. That’s why it’s so important to monitor your children’s weight
• being overweight or obese, blood pressure, high cholesterol
much less likely to have a stroke or heart
and diabetes
attack by age 80 than their peers.
• having high blood pressure • having a family history of heart
problems early, before serious complications arise. Parents may not recognize that their children are
[ 10 ]
gru.edu/health
blood pressure, diabetes or other risk factors for cardiovascular disease are
with pediatricians who understand lets physicians identify and treat
reach age 45 without developing high
which increases the risk for high
through regular wellness visits the importance of this issue. This
In fact, studies show that people who
disease • smoking or being exposed to secondhand smoke “If your child has these risk factors, consult a pediatrician.
Keep your little ones healthy Call 706-721-CARE (2273) to schedule an appointment with a pediatrician who puts prevention first.
Adolescent
medicine Bridging the gap
[T]
Their goal is to help your children make it through adolescence safely and in good health, so they will be better prepared to take responsibility for their health in the future.
Support through the awkward years Adolescents often have concerns
he teen years were once a
important annual exams during
they don’t feel comfortable addressing
no-man’s-land of medicine,
these difficult years,” says Robert
with their parents. An adolescent
with adolescents caught between
Pendergrast, MD, an adolescent
medicine physician can provide your
pediatricians and adult physicians.
medicine physician and director of
child with accurate health-related
“But teens sometimes resist seeing a
the Adolescent Medicine Program at
information and guidance in a caring,
pediatrician, so parents may neglect
the Children’s Hospital of Georgia.
confidential manner.
Dr. Pendergrast leads a team of
A holistic approach to tween and teen care Adolescent medicine physicians at Children’s Hospital of Georgia address a full range of issues in people between ages 11 and 21, including: • general health checkups, immunizations and primary care • diagnoses and care of general medical problems • nutrition, exercise and eating disorders • smoking cessation • adolescent depression, stress and anxiety • puberty, menstruation and adolescent gynecology • school behavior and social problems
“It’s so important for people in this
pediatric specialists who understand
age group to develop a relationship
the unique health and social issues
with a physician they like and trust.
teens face and take the time to
During adolescence, people need
address them with patients and
to learn the importance of primary
their parents. As the only physician
care,” says Dr. Pendergrast.
at Georgia Regents Medical Center who has completed a fellowship in adolescent medicine, Dr. Pendergrast has additional training in caring for and communicating with tweens and teens and is responsible for educating and training other physicians in this area.
Making the transition “Teens face challenges that can affect their future health and development
Help them stay healthy at every age To schedule an appointment with an adolescent medicine physician, call 706-721-KIDS (5437) now.
during these formative years,” Dr. Pendergrast says. “That’s why we not only monitor our patients’ health but also address social, psychological and developmental issues with them and their families.”
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In the news
Children’s Medical Center becomes
[T]
he children’s medical
transport teams that make it easier
common childhood illnesses to life-
Center has recently been
for patients statewide to access
threatening conditions like cancer.
renamed the Children’s Hospital of Georgia. “The new name more
lifesaving care. “Since the initial thoughts more than
Special care units
accurately reflects our status as a
15 years ago of having a dedicated
The Children’s Hospital of Georgia
leading state and regional referral
hospital for children, many of us have
also operates:
center,” says Bernard L. Maria, MD,
felt that the ‘Children’s Hospital
pediatrician-in-chief and chairman of
of Georgia’ was a better and more
the Department of Pediatrics.
descriptive name for our facility. Now,
• a pediatric intensive care unit
it has finally happened,” says Charles
• a pediatric emergency department
in many ways. This includes novel
Howell, MD, surgeon-in-chief and
• a pediatric operating rooms
partnerships, a telemedicine program
chairman of the Department
that serves children in rural areas and
of Surgery.
The hospital reaches across the state
To schedule an appointment, call 706-721-KIDS (5437) or visit gru.edu/kids.
intensive care unit
Focusing on quality care Child Life Specialists help kids
pediatric and neonatal air and ground
Expert pediatric care
• a level IV (highest level) neonatal
Delivering a continuum of care
understand and cope with care, and
The 154-licensed-bed Children's
parents may stay with hospitalized
Hospital of Georgia is the second
children 24/7, even in intensive care.
largest in the state. The hospital offers
“Children’s Hospital of Georgia is a
the largest team of pediatric specialists
remarkable resource to Georgia’s children
in the area, who treat everything from
and their families,” Dr. Maria says.