Your Health Today by Augusta University

your

health [ Your guide to Healthy Living from Georgia Health Sciences Health System ]

Winter 2013 | georgiahealth.org

today

NEW HOPE FOR RECURRING

prostate cancer Heart health and hormones: Get the facts A new therapy for Barrettâ&#x20AC;&#x2122;s esophagus Scan this code with a QR code reader to visit our website!

What’s new and noteworthy at

Georgia Health Sciences 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.

INSIDE THIS ISSUE

PAGE 3 T ips for a safe and healthy winter Avoid winter weight gain

PAGEs 4–5 Cancer Prevention When prostate cancer recurs: Robotic salvage prostatectomy Pap tests: Who and when?

PAGE 6 Heart Healthy Living Heart health and hormones: Get the facts

PAGE 7 Focus on Women Rheumatoid arthritis vs. osteoarthritis

Expanding robotic surgery

Depend on the area’s highest level NICU

Robotic surgery is fast becoming the standard of care in many specialties. Therefore, Georgia Health Sciences has recently opened a Center for Advanced Robotic Surgery that centralizes robotic surgery across a range of specialties, including: • gynecology and urogynecology • gynecologic oncology • urology and urologic oncology • thyroid surgery • otolaryngology (for tumors of the mouth and throat) Many hospitals offer robotic surgery, but statistics show that outcomes are better if the surgery is performed by experienced surgeons like those at Georgia Health Sciences. The center staffs the largest, most experienced team of robotic surgeons in the region and offers procedures not available at other area hospitals. To learn more, visit georgiahealth.org/ robotics or call 706-721-CARE (2273).

The Georgia Health Sciences Neonatal Intensive Care Unit (NICU) has recently been recognized as a Level IV unit, the highest possible designation. This means that premature infants who need even the most specialized care can receive treatment right here in Augusta. What’s more, the unit serves as a regional referral center. The unit offers: • the area’s largest team of neonatologists • extracorporeal membrane oxygenation (ECMO) technology and team, used to keep the hearts and lungs of critically ill infants working • dedicated neonatal dietitians, pharmacists and respiratory therapists • a neonatal air and ground transport team For more information, call 706-721-KIDS (5437).

PAGE 8 Neuroscience Epilepsy and seniors

PAGE 9 Digestive Health HALO ablation therapy for Barrett’s esophagus

PAGES 10-11 Family Health Sleep apnea in kids New i-book calms fears at Children’s Medical Center

PAGE 12 In the News Georgia Regents University powers local economy

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 georgiahealth.org.

[ 2 ]

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Tips for a safe and healthy winter Three ways to avoid winter weight gain

[ S]

hort days and cold nights

bears, not people. Keep moving,

better options because they are

can lead to lethargy, over

regardless of the temperature.

lower in fat and calories. If you

eating and winter weight gain. But

Dress in layers and head to the

drink alcohol, limit it to one drink

with a little caution, you can hold the

park or walk the dog around the

a day for women or two for men.

line or even lose weight. Here are a

block. Join a gym, or buy a jump

Alcohol is high in calories. Drinking

few tips:

[1]

rope and hand weights and work

in excess also increases your risk of

Don’t treat your mood

out at home. Try to limit screen

many diseases.

with food. Comfort foods

time and sitting. Even simple

like macaroni and cheese, mashed

chores such as folding laundry,

potatoes and gravy, and hot apple

vacuuming or raking leaves

pie are all great on cold evenings,

burn calories.

when you feel isolated at home. But they are loaded with fat and

calories. Instead, build menus around

[3]

Think before you drink.

Hot chocolate and

vegetables, whole grains and lean

creamy coffee drinks

meats. Try vegetable soups, black

are great in chilly

beans and brown rice, skinless grilled

weather, but don’t

chicken or whole grain pastas with

drink them too

tomato sauce.

often. Black

[2]

Don’t “cave” in.

coffee, tea or

Hibernation is for

warm cider are

A new year. A new you. If you are morbidly obese, you may be a candidate for bariatric surgery, a proven treatment for diabetes and other obesityrelated conditions. There are many misconceptions about weight-loss surgery, but you can get the facts at a free informational seminar sponsored by Georgia Health Sciences Weight Loss Center. Seminars are held on the second and fourth Tuesdays of each month at 6:30 p.m. For more information

or to register, visit georgiahealth. org/weightloss or

call our Bariatric Nurse Coordinator at 706-7212609. Visit georgiahealth. org/weightloss to sign up for the Weight Loss Center monthly electronic newsletter, featuring the latest weight-loss information, tips and upcoming events.

georgiahealth.org

[ 3 ]

cancer prevention

new hope for recurring

prostate cancer

Robotic salvage prostatectomy

[A]

pproximately 30 percent

Madi, MD, a urologic oncologist at

of men who have radiation

Georgia Health Sciences Center for

therapy for prostate cancer experience Advanced Robotic Surgery. a recurrence of the cancer.

“Robotic technology increases

They may now benefit from

surgical accuracy and minimizes

a surgery known as salvage

the morbidity of these complex

prostatectomy. This has traditionally

procedures,” Dr. Madi says.

been a challenging procedure due to the scarring and tissue changes caused by radiation.

How is the procedure performed? “The robotic system is just a tool.

But a few specially trained physicians across the country

The surgeon is in control at all

are performing robotic salvage

times,” says Dr. Madi. The surgeon

prostatectomy. That includes Rabii

inserts small instruments and a camera into the patient’s abdomen through keyhole-size incisions. Sitting at a console with a clear

World-class physicians, worldclass care As an academic health center, Georgia Health Sciences staffs specialists not found at other area hospitals. That includes Rabii Madi, MD, a prominent urologic oncologist who has performed more than 400 robotic surgeries. Renowned in the surgical treatment of prostate, kidney and bladder cancers, Dr. Madi pioneered single-setting robotic surgery for patients with both prostate and kidney cancer. He also performs single-incision kidney removals. Preeminent physicians like Dr. Madi are a hallmark of Georgia Health Sciences Cancer Center.

three-dimensional image of the surgical area, he maneuvers the instruments and camera. The technology seamlessly translates the surgeon’s hand movements Rabii Madi, MD, a urologic oncologist, is one of only a few surgeons in the country who perform robotic salvage prostatectomies.

the instruments.

Smaller incisions, faster recoveries

“This allows for

Robotic surgery offers the following

movements of

the careful and

benefits over traditional open surgery:

precise removal of

• shorter hospital stays • l ess scarring, pain and blood loss • less risk of infection • q uicker return to

seminal vesicles and surrounding lymph nodes,” says Dr. Madi.

georgiahealth.org

To learn more or to schedule an appointment with Dr. Madi, please call 706-721-3042 or visit georgiahealth.org/robotics.

into real-time

the prostate, adjoining

[ 4 ]

If you need surgery

normal activities

cervical cancer New Pap screening guidelines

[ J]

anuary is national cervical

Cancer Awareness Month

and a good time to review the Pap screening guidelines for this disease.

• women who have received the HPV vaccine still need to follow the screening guidelines “Talk to your gynecologist about

According to Bunja Rungruang, MD, your screening schedule,” says a gyn oncologist at Georgia Health

Dr. Rungruang.

Sciences Cancer Center, those guidelines were updated in March 2012 by the U.S. Preventive Task Force with the support of the American Cancer Society. “The new guidelines reduce the number of Pap tests women should have over their lifetimes. They preserve the benefits of testing while minimizing risks,” says Dr. Rungruang.

Fewer, less frequent screenings Since it can take more than a decade for cervical cancer to develop, the guidelines recommend:

• women ages 21 to 29 have a Pap test every three years; women under age 21 do not need screenings

• women ages 30 to 65 should have a Pap test every three years or a Pap test with HPV screening, known as cotesting, every five years

• screening is not recommended

Robotic GYN cancer surgeries: Smaller incisions, shorter recoveries When gyn cancers strike, women deserve the latest, least invasive surgical solutions. That is often robotic surgery. Robotic technology offers surgeons clearer 3-D visualization and superior tools that allow for more precise, tremor-free surgeries. Georgia Health Sciences Cancer Center’s renowned gyn oncologists perform the area’s widest range of robotic procedures for gyn cancers in our Center for Advanced Robotic Surgery.

Robotic surgeries: • shorten hospital stays and speed recovery • reduce blood loss, scarring and pain • reduce the risk of infection • help prevent the need for further surgeries For more information, visit georgiahealth.org/robotics. To schedule an appointment, call 706-721-6744.

for women over age 65 who have had regular screenings with normal results

• women with certain risk factors may need to have more frequent screenings or to continue screening

Get screened! For more information or to schedule an appointment with a gynecologist, please call the Georgia Health Sciences Women’s Center at 706-721-4959 or visit georgiahealth.org/appointment.

beyond age 65

georgiahealth.org

[ 5 ]

Heart-Healthy living

hormone

therapy The heart of the matter

[A]

re you bothered by

says. “If

menopausal symptoms

you’ve

but afraid that hormone therapy

already

(HT) will increase your risk of heart

had a heart

disease? Pascha E. Schafer, MD, a

attack or have

cardiologist with the Georgia Health

heart disease

Sciences Cardiovascular Center,

or a history of

addresses those concerns.

blood clots, the risks

“Although all women should take

of taking HT generally

heart disease seriously, the risk of HT

outweigh the benefits.”

on heart health varies depending on your overall health,” she says.

Easy does it If you are a candidate for HT,

Is hormone therapy right for you?

Dr. Schafer suggests you speak to

“Most healthy women can safely

• using a form of therapy that

your gynecologist about:

take short-term HT for menopausal

minimizes absorption, such as

symptoms without significantly

vaginal preparations or skin

increasing their risk of heart disease,”

patches

Dr. Schafer says. “But that’s a

• finding the lowest effective dose

decision you’ll need to make with

and taking it for the shortest

your gynecologist.”

possible time

If you stopped having periods or

• making lifestyle changes, such

How is your heart health? A coronary calcium scan can help answer that question and guide treatment planning. These painless, noninvasive scans take only five minutes. Most insurance plans do not yet cover this valuable test, but the scan and physician interpretation cost only $100. To schedule a scan, call 706-721-XRAY (9729).

Specialized care for women To schedule an appointment with a gynecologist or a cardiologist, call 706-721-CARE (2273) or visit georgiahealth.org/appointment.

lost the normal function of your

as losing weight and giving up

ovaries before age 40, you may need

cigarettes, to reduce your overall

estrogen for a longer time to protect

risk of heart disease. “And be sure

against the health effects of estrogen

to have regular blood pressure and

your overall risks, determine if

deficiency. “However, long-term HT is

cholesterol screenings,” she says.

HT is right for you and prescribe

no longer recommended just to reduce

• discussing other possible risks of

the risk of heart disease,” Dr. Schafer

[ 6 ]

georgiahealth.org

“Your gynecologist can evaluate

the appropriate type and dosage,” Dr. Schafer says.

focus on women

rheumatoid arthritis

vs. osteoarthritis

What’s the difference?

[A]

bout 1.3 million

“This affects the tissue that lines

Complications of RA

American adults—

the joints, causing stiffness, pain and

The inflammation that causes

mostly women—live with the pain

swelling. RA tends to impact the small

RA also increases the risks for

of rheumatoid arthritis (RA), a

joints in the hands and feet first but

osteoporosis, heart attack, stroke and

chronic autoimmune disease that

actually affects the entire body,” says

other diseases.

generally begins between ages 40

Alyce Oliver, MD, a rheumatologist

and 60.

at Georgia Health Sciences Medical

tant to see a rheumatologist. “RA can

Center who specializes in RA.

be difficult to diagnose in the initial

If you think you have RA, it’s impor-

How does RA differ from osteoarthritis?

is a degenerative disease caused

ized care can reduce these risks and

Rheumatoid arthritis is caused by

by thinning in the cartilage that

delay or even prevent joint damage,”

inflammation throughout the body.

lines the joints. As cartilage wears,

says Dr. Oliver. “We treat the disease

changes in the bone around the joint

aggressively to achieve clinical remis-

limit function and cause joint pain.

sion, prevent underlying joint

This disease affects the joints only.

damage and disease, and

Get an accurate diagnosis and advanced care Georgia Health Sciences Rheumatology Department staffs physicians who specialize in RA and stay up to date on the latest research. These physicians offer one-stop diagnosis and care through musculoskeletal ultrasound, multidisciplinary medical management, and an infusion center for biologics that disrupt the immune response that occurs in RA.

Osteoarthritis, on the other hand,

stages, yet early diagnosis and special-

help patients maintain

What are the signs of RA?

an active lifestyle.”

People with RA experience symptoms in the joints and beyond, including: • tender, warm, swollen joints • morning stiffness that may last for hours • firm bumps of tissue under the skin on the arms

Get back to doing what you love To schedule an appointment, call 706-721-1400 or visit georgiahealth.org/appointment.

• fatigue, fever and weight loss “The symptoms vary in intensity and may come and go, but the pain and swelling generally occur in the same joints on both sides of the body,” Dr. Oliver says.

georgiahealth.org

[ 7 ]

neuroscience

confusion, or

something else? Epilepsy rates rising among seniors

• uncontrollable jerking

[W]

“These include stroke,

movements of the arms

Alzheimer’s disease, head injuries,

or legs

brain tumors, brain surgery and

• l oss of consciousness or awareness

infections affecting the brain.

The symptoms usually last only

High blood pressure, heart disease

hen seniors experience

a minute or two, but it often takes

and chronic alcoholism are also

a sign of epilepsy, they may

older people longer to recover.

risk factors in seniors,” says

mistakenly label it a “senior moment”

“Although having these symptoms

Dr. Murro. Fortunately, the disorder

or think that their symptoms are caused

certainly does not mean you have

can generally be controlled with

by aging. That’s because epilepsy has

epilepsy, you should see your

medications or surgery.

traditionally been considered a disorder

physician if you experience them,”

that begins in youth.

says Dr. Murro. “Undiagnosed

“Physicians now know that people in their 60s, 70s and 80s are as likely

epilepsy can increase the risk of falls

Expert epilepsy care, right here in Augusta

and broken bones in seniors.”

Georgia Health Sciences operates the only Epilepsy Center in the area.

to begin having seizures as children. Americans are increasing faster than

What causes epilepsy in seniors?

rates in any other age group,” says

Epilepsy is caused by a glitch in the

Anthony Murro, MD, a neurologist

brain’s electrical system. In seniors,

diagnose epilepsy and pinpoint its

and epileptologist at Georgia Health

the causes are often directly related to

site of origin

Sciences Neuroscience Center.

physical changes associated with aging.

In fact, epilepsy rates among older

This regional referral center offers: • the area’s only epileptologists • an Epilepsy Monitoring Unit to

• the full range of epilepsy treatments including vagal nerve

A range of symptoms Epilepsy symptoms can vary considerably and may include: • temporary confusion • a staring spell

[ 8 ]

georgiahealth.org

Help for epilepsy For more information or to schedule an appointment, call 706-721-4581 or visit georgiahealth.org/appointment.

stimulation and epilepsy surgeries • pharmacists who specialize in antiepileptic medications • nurse clinicians who educate patients and answer questions

digestive health

preventing

esophageal cancer A new treatment for Barrett’s esophagus

[ I]

f you think chronic

esophagus and increases the

heartburn is nothing to worry

risk of esophageal cancer,”

about, think again. “People who suffer

says Sherman Chamberlain,

from long-term heartburn may develop

MD, a gastroenterologist

Barrett’s esophagus. This serious

at Georgia Health Sciences

condition changes the lining of the

Digestive Health Center.

Looking for a solution to your digestive problem? Our Digestive Health Center can help. It staffs the largest team of gastroenterologists and hepatologists in the area, offers the widest range of tests and treatments, and operates specialty clinics for: • motility disorders • pelvic floor disorders • lactose and fructose intolerance • swallowing problems • GERD/heartburn • irritable bowel syndrome • gastroparesis • constipation Don’t just live with digestive problems. Get an accurate diagnosis and competent care at the Digestive Health Center.

Get tummy troubles under control

A treatment breakthrough Center are offering a new treatment for

What happens if Barrett’s esophagus goes untreated?

Barrett’s esophagus known as HALO

Untreated Barrett’s esophagus can

ablation therapy. It may be right for

result in the development of a type of

people with Barrett’s esophagus who

esophageal cancer with high mortality

show worrisome pathologic changes in

rates called adenocarcinoma. Most

an upper endoscopy screening.

people who develop this cancer are

Physicians at the Digestive Health

During the ablation procedure, skilled physicians deliver targeted heat energy

unaware that they have Barrett’s esophagus.

to remove the damaged tissue without harming the normal structures of the

The next step

throat.

Dr. Chamberlain advises you to see your

It is performed in conjunction with an upper endoscopy in an outpatient setting. No incision is required, and it takes only about 15 minutes. “HALO ablation is a major advance in Barrett's

physician if: • you have heartburn several times a week • heartburn returns after your antacid wears off

esophagus treatment. It is a safer,

• heartburn wakes you up at night

faster therapy that has been shown to

Your physician can take a tissue sample

remove diseased esophageal tissue,”

during an upper endoscopy to determine

Dr. Chamberlain says.

if you have Barrett’s esophagus.

To schedule an appointment at the Digestive Health Center, please call 706-721-1400 or visit georgiahealth.org/appointment.

georgiahealth.org

[ 9 ]

Family health

sleep

apnea

It’s not just an adult disorder

[ M]

ost people associate

breathing becomes blocked during

sleep apnea with

sleep. Left untreated, sleep apnea

overweight, middle-aged men, but it’s

can lead to heart, behavior, learning

not just an adult problem. An estimated and growth problems. two percent of children suffer from the disorder, and many are undiagnosed.

Signs and symptoms

Children who are overweight or have

Frequent snoring is the classic

Down syndrome, cerebral palsy or

symptom, but also watch for:

abnormalities of the skull or face are at increased risk. George F. Harris, MD, a pediatric

• problems breathing during the night • sleepiness during the day

otolaryngologist at Georgia Health

• difficulty paying attention

Sciences Children’s Medical Center,

• behavioral problems

says sleep apnea occurs when a child's

“See your pediatrician if you notice these symptoms,” Dr. Harris says.

Diagnosing the disorder Parents may report snoring or periods of blocked breathing that,

The area’s largest team of pediatric specialists The physicians at the Children’s Medical Center treat everything from common childhood illnesses to life-threatening conditions like cancer and neurological disorders. The Center also staffs pediatric anesthesiologists and Child Life Specialists who help kids understand and cope with care. To schedule an appointment, call 706-721-KIDS (5437).

Get a good night’s rest To schedule an appointment with a pediatric otolaryngologist or sleep medicine physician, call 706-721-KIDS (5437) or visit georgiahealth.org/appointment.

along with a medical examination, indicate sleep apnea. In other cases, children may

removing these tissues is generally a highly effective treatment,” says

spend a night in a sleep lap where

Dr. Harris. The surgery requires no

their sleep is monitored, videoed

incision but may require an overnight

and analyzed by a physician.

hospital stay, especially in very young

The Children’s Medical Center operates a pediatric sleep studies lab staffed by specialized pediatric sleep medicine physicians.

children. A nonsurgical therapy called nasal continuous positive airway pressure (CPAP) may be right for children who are struggling with weight loss, are not

[ 10 ]

georgiahealth.org

Treatment options

candidates for surgery or those who do

“In children, sleep apnea is often

not improve after surgery. This therapy

caused by larger than normal

involves wearing a mask that delivers

tonsils and adenoids. In such cases,

steady air pressure during sleep.

calming

children’s fears Children’s Medical Center develops i-book just for kids

[ H]

aving medical care can

be frightening to

Now, when a Child Life Specialist

The show also discusses “sleepy”

sits down with a child, the patient

air and lets kids pick their favorite

children, especially if they require

can actually take part in an

flavor, if they need anesthesia. And

hospitalization. But Georgia Health

entertaining and informative slide

it lets them spin around in a three-

Sciences Child Life Specialists are

show. They can see the dinosaurs on

dimensional wheelchair.

trained to help kids understand and

the hospital walls, push the elevator

cope with care.

button, see their bed, talk about

new high-tech resource to prepare

their doctor, pick toys off a shelf

patients and families for surgery.

a book of photos to walk children

and color their own dressing gown.

With the iPad, I am able to make

through the facility and prepare

The show calms children’s fears by

it a more engaging process for the

them for hospitalization. But when

telling them what is going to happen

patients,” says Child Life Specialist

the hospital began using iPads,

in a way they can understand.

Jamie Wolfe.

Historically, these specialists used

“I love being able to use this

Kimberly Allen, director of child and adolescent life services, asked Jeff Mastromonico, associate director of educational and collaborative technology, to develop an electronic program to tell the story. Mastromonico and his team did much more. “We took their text and photos and added an interactive

Be a part of your child’s treatment team If your child needs medical care, you’ll want to be involved every step of the way. You can do that at the Children’s Medical Center. As a national leader in a concept known as Patient- and Family-Centered Care, Georgia Health Sciences builds collaborative partnerships between health care providers, patients and family members. To us, families are not an imposition but a part of the treatment team. That’s why we don’t have established visiting hours. You can stay with your child 24/7, even in intensive care. After all, no one knows your child like you do. To schedule an appointment, call 706-721-KIDS (5437) or visit georgiahealth.org/appointment.

element,” he says.

georgiahealth.org

[ 11 ]

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In the news

Opportunity knocks for

Georgia Regents University [ G]

eorgia regents university

Woodruff Foundation. Along with state

our community. Over the next eight

is moving into the future with

funding and philanthropy, the university

years, Georgia Regents University’s local

a new year, a new name and amazing

will build a 160,000-square-foot

economic impact is projected to increase

opportunities for the Augusta area.

Interprofessional Simulation Center.

from $2 billion to $3 billion a year. This

Here, students from different colleges

means more business, more jobs and

operates nine colleges in 150 buildings

within the system will coordinate and

more opportunity for the CSRA.

that span 650 acres. We are home to

integrate their skills.

The consolidated university currently

more than 9,000 students, 5,000 staff

What’s more, the state is considering

It also means Augusta will be home to a renowned university, health care

members and 1,000 faculty members.

$45 million in bond funding to

system, and research facility posi-

We also operate an integrated health

help finance a new $100-million

tioned for national and international

care system that delivers world-class

cancer research building, for which

recognition.

care to people throughout the area and

the university has also received a

beyond.

$20-million pledge. If approved, the building will be the cornerstone of

Extending our outreach through partnerships

a comprehensive complex that will

In the years ahead, the institution will

Cancer Institute-designated

increase its student population, faculty

cancer center.

become Georgia’s second National

and footprint. What’s more, we are forging partnerships that will enrich both the university and the community. Take, for example, the $8 million grant the university received from the

Fueling economic development Consolidation opens a world of exciting possibilities for

Working together, we can create a stronger, more vibrant city.