A PUBLICATION OF THE METHODIST HOSPITAL SYSTEM • VOLUME 4, NUMBER 1, 2006
For stroke patients, Time is Brain THE ORGANIC FOOD MAZE HOW MUCH ANESTHESIA IS ENOUGH? BREAST CANCER TREATMENT IN FIVE DAYS
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LEADING MEDICINE LEADING MEDICINE Volume 4, Number 1, 2006
R.G. GIROTTO President & CEO
Contents
MARC L. BOOM, MD Executive Vice President & Chief Operating Officer
JOHN E. HAGALE, CPA
THE NOR S
R AMON “MICK” CANTU, JD Senior Vice President & Chief Legal Officer
MARK E. KIMBELL
Contributing Writers
BRIDGETT AKIN / BRI DESIGN, INC. Design
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DENNY ANGELLE STEFANIE ASIN ERIN FAIRCHILD AMI FELKER SHESHE GIDDENS MELANIE MCFARLANE GALE SMITH SHELBY STRUDLER JOHN T YLER
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Leading Medicine is published by The Methodist Hospital System Corporate Communications Department for patients, physicians, employees and supporters. ©2006 The Methodist Hospital System All rights reserved. Materials may be reproduced with acknowledgement for noncommercial and educational purposes. Permission from the editor required for any other purpose. Send address corrections and letters to Leading Medicine The Methodist Hospital System Corporate Communications 8060 El Rio Houston, Texas 77054 Tel: 713-790-3333 or esource@tmh.tmc.edu If you wish to cancel your free subscription to Leading Medicine magazine, contact us at 713-790-3333 or esource@tmh.tmc.edu.
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CEO MESSAGE A great place to work ...............................................2
FOUNDATION OF SUPPORT.....................................18
MEDICAL TOOLBOX Improving heart disease diagnosis............................................3
JOB SATISFACTION Nurse receives highest honor...............19
RICARDO MERENDONI Photography
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Managing Editor
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EMMA V. CHAMBERS
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Executive Editor & Senior Vice President
THY LEGA OR W
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Executive Vice President, CFO & Chief Administrative Officer
PLANTING SEEDS Breast cancer radiation therapy reduced to five days.......................5 TURNING RESEARCH INTO REALITY Acclaimed physician returns to Houston .........................8 BIS MONITORS Keeping patients sedated during surgery ............................................10 TIME IS BRAIN Technology and drug therapies help stroke victims..............................................12
FOCUSED ON THE FUTURE Orthopedic conference paves way for better patient care........21 METHODIST IN THE COMMUNITY ............................22 HEALTHY LIVING Organic foods ...............................24 COMMUNITY HOSPITALS Women’s services at Methodist Willowbrook Hospital ...............26 ACCOLADES ...........................28
BLANK CANVAS Renowned thyroid cancer researcher builds new Department of Medicine ............16
VOLUME 4, NUMBER 1 䡲 1
A MESSAGE FROM THE CEO Dear friends, Leading Medicine magazine spotlights the latest research and medical treatments we provide our patients. We share with you our commitment to
OFFICERS OF THE METHODIST HOSPITAL SYSTEM BOARD OF DIRECTORS JOHN F. BOOKOUT JR. Chair
HON. EWING WERLEIN JR. Vice Chair
deliver world-class clinical care with unmatched
ERNEST H. COCKRELL
compassion. It begins with the people who work at
RONALD G. GIROTTO
Methodist — the physicians and staff who care for
Vice Chair President & CEO
you. We recently were recognized nationally for our
DAVID M. UNDERWOOD
work environment, which attracts and retains the
EMILY A. CROSSWELL
best employees. FORTUNE magazine named us as one of its “100 Best Companies to Work For” in 2006. It is a prestigious honor that speaks volumes about what we strive to do every day. Methodist is the only health care system in Texas to win this distinction this year. We also were recognized as one of the top 10 employers for women and minorities. This acknowledgement tells the rest of the country what we have known all along — that our dedicated employees and values make Methodist one of the top health care organizations in the nation.
Secretary Asst. Secretary
CHARLES W. DUNCAN JR. Treasurer
JACK S. BLANTON Asst. Treasurer
ROBERT K. MOSES Asst. Treasurer
BOARD OF DIRECTORS MORRIE K. ABRAMSON CARLTON E. BAUCUM
We are more than a workplace; we are a community that is proud to serve
W. EARL BLEDSOE, DD
Houston, and we thank you for the opportunity.
MARY DAFFIN
In this edition, you will read about advancements in stroke and heart care, with a focus on healing patients with the latest in technology and drug therapy. And you will meet one of our newest physician leaders Dr. Rich Robbins, who came to us from Memorial Sloan-Kettering Cancer Center in New York. As you will see, we are moving rapidly toward our goal of being one of the country’s best academic medical centers. I hope you continue to enjoy our magazine! 䡲
CONNIE DYER GARY EDWARDS JAMES A. ELKINS III BISHOP JANICE RIGGLE-HUIE SANDRA SMITH JACKSON, ND VIDAL MARTINEZ JAMES W. MOORE, DD GREGORY V. NELSON MICHAEL J. REARDON, MD PLINY C. SMITH, MD JOSEPH C. WALTER III D. GIBSON WALTON STEPHEN P. WENDE, DD
R. G. Girotto President Chief Executive Officer The Methodist Hospital System
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ADVISORY MEMBERS REV. JAMES W. FOSTER ROBERT E. JACKSON, MD
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The SPECT/CT system creates moving, 3-D views of a patient’s heart that can be rotated and examined in a way never before possible. Dr. John Mahmarian
Fusion of technologies
improves diagnosis of heart disease Today’s newest and most advanced medical imaging technologies are greatly improving the ability of physicians to make accurate diagnoses and determine the best form of treatment for patients with heart disease. Single photon emission computed tomography/
computed tomography (SPECT/CT) elevates imaging diagnostics to a new level by merging leading-edge SPECT with the anatomical precision of diagnostic multi-slice CT. The Methodist DeBakey Heart Center is currently using this fusion of technology in the diagnosis B Y
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of coronary heart disease. “SPECT/CT is an innovative approach to streamlining patient care by providing three tests in one (SPECT, CT angiography and calcium scoring), resulting in more accurate diagnosis. It is a totally noninvasive way of looking at the heart,” said
Dr. John Mahmarian, medical director of the nuclear diagnostic lab at the Methodist DeBakey Heart Center. SPECT analyzes blood flow and CT angiography visualizes the anatomy of the heart. The two studies allow physicians to observe how a patient’s
F A I R C H I L D
VOLUME 4, NUMBER 1 䡲 3
Fusion of technologies
coronary arteries are feeding the heart tissue and see abnormalities in the heart structure. A calcium score, derived from the CT, helps them better predict a patient’s risk for future heart disease. With the advent of high-speed, highresolution CT angiography, excellent images can be taken of the heart while it’s beating. The SPECT/ CT system takes this information and creates moving, 3-D views of a patient’s heart that can be rotated and examined in a way never before possible. While cardiac catheterization is the current gold standard for detection of significant blockage in the coronary arteries, high-speed CT angiography has the potential — in the future — to reduce the need for diagnostic catheterization. “If we can acquire the same information without the need to use the catheter, we will be able to eliminate some of the risks associated with the more invasive catheterization procedure,” heart center cardiologist Dr. David Samuels said.
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A patient might be sent for a SPECT/CT because of symptoms such as chest pain at the onset of exercise or risk factors including a family history of heart disease, high blood pressure, diabetes, obesity or smoking. Prior to the scan, contrast material, which enhances the view of the arteries and heart tissue, is injected into a vein in the patient’s arm. The patient may also be given a medication that slows the heart rate, which also enables clearer images of the heart. The patient then lies down on a table, which moves slowly into the scanner. X-rays rotate very quickly around the body, capturing hundreds of images of the heart and arteries. These images are then analyzed by the SPECT/ CT software to determine the patient’s heart function, blood flow and anatomy. They also can help identify normal and abnormal structures, giving physicians an added edge in determining a patient’s medical treatment. “Accurate, clear images of the arteries supplying blood to the heart can
help determine the need for a stent,” said Dr. Al Raizner, interventional cardiologist at the heart center. “If we can see the anatomy of the patient’s artery with the CT and also judge the degree of deficiency in blood flow to the heart tissue with the SPECT technology, we can provide our patients with much better care. “With the information gleaned from a SPECT/ CT, our ability to plan the interventional procedure is greatly enhanced. We should be able to see whether a patient is likely to need and benefit from a stent, and get an idea of the difficulties or problems that might be encountered doing such a procedure, even before inserting the catheter in the first place,” Raizner said. 䡲
Front
Side
Rear SPECT/CT scans showing the front, side and rear views of the heart.
“Spect/CT is a totally noninvasive way of looking at the heart.”
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itting in an exam room
after her mammogram, Virginia Purdy was unable to hear or speak. She could only recall the words: “You have a suspicious mass that we need to biopsy right away.”
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The resulting biopsy revealed that Purdy, 59, had a malignant tumor in her left breast. Seeking out the best possible treatments, she discovered a minimally invasive method of delivering radiation therapy called MammoSite® offered at The Methodist Hospital. Developed for patients with earlystage breast cancer who have had lumpectomies (the removal of a cancerous lump and a portion of the
surrounding tissue), MammoSite delivers high-dose radiation directly to the site where the tumor was removed. It targets the spot where cancer would most likely recur and spares surrounding healthy tissue. Purdy was referred to Methodist radiation oncologist Dr. Hsin Lu after her lumpectomy. Lu, whose practice is comprised almost entirely of breast cancer patients, said traditional whole breast radiation is considered the current standard of care, with high energy X-rays delivered to the skin, breast and other tissue.
Breast cancer radiation therapy reduced to five days
Dr. Hsin Lu WWW.METHODISTHEALTH.COM
VOLUME 4, NUMBER 1 䡲 5
Breast cancer
Dr. Michael Coselli
“It was previously believed that irradiating the whole breast would decrease the chances of the cancer recurring. In fact, research shows that MammoSite, which minimizes exposure to the rest of the breast and surrounding organs by targeting radiation only to the area where tumors are most likely to recur, has a low risk of recurrence. More importantly, it has fewer side effects for patients,” she said. MammoSite uses a balloon catheter to deliver the radiation source or “seed.” The catheter is placed inside the cavity created after the tumor is removed. Next, the seed is inserted into the balloon and left there for five to 10 minutes twice daily, with six hours between doses. After five days the balloon is deflated, the catheter is removed and a
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small amount of antibiotic and gauze are placed over the site. Lu said the benefits of MammoSite are numerous. The radiation source is placed inside the lumpectomy cavity, delivering radiation to only the area where cancer is most likely to recur. Therefore, the amount of radiation to healthy tissue is limited, reducing the potential for side effects and overwhelmingly increasing patient satisfaction. “With only two treatments per day for five days, MammoSite radiation therapy is a convenient option for patients who work. It’s also suitable for those traveling from another city to receive treatment,” she said. When Purdy finished the MammoSite treatment early this year, she marveled at how easy it was. “I work downtown, and every morning
and every afternoon, I simply rode the light rail into the Medical Center, received my treatment and went back to work.” She learned about MammoSite at Fayez Sarofim & Co. where she works. The company’s owner, Fayez Sarofim, is a strong philanthropic supporter of the medical community and makes health information available to his employees. “I’m fortunate my employer was so supportive of my need for treatment. Many women do not have careers that can accommodate six weeks of therapy,” Purdy said. Lu says that in spite of this less invasive and decreased treatment time, 40 percent of women still opt for a mastectomy. “The combination of lumpectomy and MammoSite appears to be an effective and more
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convenient option, but this treatment has only seven or eight years of followup results, whereas a mastectomy has 20 to 30 years of results.” The recurrence rates paint a more detailed picture for patients considering both treatments: lumpectomy alone results in a 20 to 30 percent recurrence of breast cancer. Lumpectomy combined with whole breast radiation has a five to 10 percent recurrence. When lumpectomy is combined with partial breast radiation, there is only a zero to five percent chance of recurrence.
Early detection is key Breast cancer is the leading cancer in women, and it is estimated that one in eight women in the United States will develop breast cancer in her lifetime. With these statistics, early detection is critical for women wishing to undergo breast conservation therapy. Dr. Michael Coselli, a surgeon at
The Methodist Hospital, performed Purdy’s lumpectomy to effectively treat the cancer while avoiding complete removal of the breast (mastectomy). “Lumpectomies are the standard treatment for early detected localized cancer with survival rates equal to mastectomies,” Coselli said. “This surgical approach is optimal for patients with malignant tumors — usually less than four centimeters that can be removed with clear margins (no cancer cells in the tissue surrounding the tumor).” The earlier a tumor is detected, the smaller the lumpectomy and chances are better for a successful treatment if the tumor is malignant. “The key message here is that early detection saves lives and also provides more options for less invasive therapies like MammoSite,” said Dr. Luz Venta, director of imaging at the Methodist Breast Care Center. Venta performs diagnostic imaging, primarily mammograms and ultrasounds. “Annual mammograms
for women 40 and older are essential for improving the rate of early detection,” she said. “Yes, there are risk factors that make some women more susceptible to breast cancer, but more than 90 percent of women diagnosed never have one of those risk factors.” It is expected that in five to 10 years MammoSite will replace traditional whole breast radiation as the standard of care for early detected breast cancer. “With patient word of mouth, more and more patients are discovering the benefits of MammoSite,” Venta said. Purdy is a strong advocate for MammoSite. “I have recommended it to many others. The time between my diagnosis and completed treatment was less than two months. Not only am I now a cancer survivor, but I survived with hardly any interruption in my life.” 䡲
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How MammoSite Radiation Therapy System works
The MammoSite balloon is placed into the center of the surgical cavity. The balloon is then inflated to optimally position the breast tissue to receive the radiation dose. During the radiation treatment, the catheter is attached to a machine that houses the radiation source. A thin wire with a tiny radioactive seed on the end moves up the catheter under precise computer control into the center of the balloon. The seed irradiates the tumor site and the area immediately surrounding the cavity where tumors are most likely to recur.
Images courtesy of Cytyc Corporation and its affiliates
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After the patient receives the prescribed dose of radiation over a five-to-10-minute period, the seed is removed from the balloon. After five days of treatment, the balloon is deflated and easily removed from the breast.
VOLUME 4, NUMBER 1 䡲 7
Dr. James Musser
Turning resea
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urn on the TV, or flip to the Health section of the daily newspaper, and you are liable to find news of a potentially groundbreaking medical cure or treatment. But way below the headline is the inevitable disclaimer that research is still ongoing and this breakthrough is years — or decades — away, if it ever comes at all. Turning research into reality is a top priority for clinicians and researchers at The Methodist Hospital Research Institute (TMHRI). Dr. James Musser, executive vice president and codirector of TMHRI, says the first step in accomplishing this is to make clinical trials and new treatments available to all Methodist patients. “Our top priority is to bring more clinician-scientists, and with them more clinical trials, to patients in Houston,” Musser said. “Patients will have increased access to cutting-edge therapies and new treatment options, particularly when all of their other options aren’t successful.” Musser is casting his net across America to attract other top-flight
Dr. James Musser WWW.METHODISTHEALTH.COM
arch into reality researchers to Methodist. “We are extremely fortunate to have one of the best hospitals in the country. When we increase the amount of patient-oriented clinical research performed in the Research Institute, I believe we can offer our patients even more outstanding patient care that is available in only a few places in the world,” he said. An acclaimed clinical investigator in his own right, Musser served as professor of pathology, microbiology and immunology at Baylor College of Medicine until 1998. He then was recruited by the National Institute of Allergy and Infectious Diseases, a division of the National Institutes of Health, (NIH), to be the founding chief of the Laboratory of Human Bacterial Pathogenesis. He has received many national honors and awards including the Warner-Lambert/Parke-Davis Award sponsored by the American Society for Investigative Pathology (1999). Musser has published approximately 300 academic papers and book chapters in the field of bacterial infectious diseases. Musser, who also serves as the director of TMHRI’s Center for Human Molecular and Translational Infectious Diseases Research, joined Methodist in late 2005. He holds the Fondren Distinguished Endowed Chair, funded by the Fondren Foundation. This philanthropic support enables him to continue his work in studying the genetics of group A streptococcus, a bacteria that causes strep throat, as well as the “flesheating” disease, an infection that killed Jim Henson of the Muppets fame. “My group is focusing on understanding how toxins made by the pathogen help the germ to grow in the body during infections,” Musser said. “By understanding this process, we seek to identify new strategies to treat life-threatening infections and perhaps develop a vaccine to prevent them.” This vaccine would not only protect against the “flesh-eating” disease, but also against the more common strep throat, an infection that can affect a child many times. “The goal would be to provide this vaccine to every child worldwide…group A streptococcus is also the cause of acute rheumatic fever and rheumatic heart disease, an affliction that can permanently damage the WWW.METHODISTHEALTH.COM
heart, and is most often found in developing countries,” Musser said. And of course, the question is — when? “In a couple of years, we believe we can begin Phase 1 human trials,” Musser said. “The trials are generally done in specialized units that are determined by the NIH. They determine where these types of trials take place.” One thing that helps improve the odds considerably is Methodist’s alliance with New York-Presbyterian Hospital and Weill Medical College of Cornell University. Through this partnership, a number of joint research projects are ongoing.
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nother plus is a willingness to work with the private sector — in this case, the pharmaceutical industry — to conduct research and bring about new treatments. “Every year promising research comes out of private industry. Our job is to be savvy and pick and choose the best science available,” he said. “The NIH is devoting more of its budget to funding patient-oriented research, including much done in partnership with industry, so the possibilities are there to have research at Methodist funded not only by the NIH and other federal agencies but by the private sector.” Researchers at TMHRI have recently submitted grants to the NIH in areas including cardiology, infectious diseases, pathology and interventional radiology. These applications are just the latest projects to join more than 600 existing clinical studies in Methodist’s research portfolio. “We are well on our way to building an institute for biomedical research that puts the patient at the forefront,” Musser said. “Methodist has a long-standing reputation for quality patient care, and now we will distinguish ourselves with additional outstanding patient-oriented and translational research — all designed to enhance discovery of new drugs, new preventive treatments and new diagnostics.” With some of the best minds working in medicine today, keep an eye out for Methodist in the news. One day soon, that headline may read: “Medical breakthrough offered to patients today.” 䡲
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How much is enough? B Y
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In the operating room, anesthesiologists must walk a fine line between administering enough drugs to anesthetize the patient without causing harm and keeping a patient sufficiently sedated during the operation or procedure.
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Imagine waking up and hearing voices, feeling pressure or pain and not being able to speak or move. Imagine this happening in the operating room. There has been a lot of media attention given to the phenomenon commonly referred to as anesthesia awareness or intraoperative awareness. This phenomenon occurs when a patient under general anesthesia becomes aware of events during surgery or a procedure and is able to later recall that experience. Although this occurrence is rare, anesthesiologists at The Methodist Hospital are using the latest technology to decrease the risk of this happening.
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For the past several years, bispectral index monitors, also known as BIS monitors, have been available in Methodist’s operating rooms. Traditionally, clinicians have relied on monitoring vital and autonomic signs to assess the effects of the anesthetic drugs on the patient and used standardized dosages to ensure an adequate amount of anesthesia. The BIS monitor measures brain waves through a sensor placed on the patient’s forehead. The information from the raw electroencephalogram or EEG is interpreted and converted into a single number — bispectral index or BIS value — that represents each patient’s level of consciousness on a scale ranging from zero (indicating the absence of brain activity) to 100 (indicating an
awake patient). “When we apply a BIS monitor and induce patient sleep, the numbers start going down. At a range of 90 to 100, the patient is awake. At 80, the patient is sedated. The desired level for general anesthesia is a range of 40 to 60,” said Methodist cardiovascular anesthesiologist Dr. Zbigniew Wojciechowski. Determining the right dose of general anesthesia for a patient can be complicated. An anesthesiologist considers numerous factors including age, weight and medical history in determining the right amount for each patient. In the operating room, anesthesiologists must walk a fine line between administering enough drugs to anesthetize the patient without causing harm and keeping a
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BIS monitoring provides direct information about the effects of anesthetics and sedatives on the brain. The technology works by placing a BIS sensor on a patient’s forehead to obtain information from electrical brain activity or EEG. The monitor then translates this information into a single number from 100 (indicating a patient who is awake) to zero (indicating the absence of brain electrical activity) that objectively represents each patient’s level of consciousness.
Dr. Zbigniew Wojciechowski
patient sufficiently sedated during the operation or procedure. But some patients fall into a special category in which smaller doses of general anesthesia must be used in order to decrease the risk of significant side effects in high risk surgeries such as trauma, cardiac or emergency cesarean sections, or in patients with unstable conditions. It is in this group that anesthesia awareness is most likely to occur. “We walk a narrow line in order to make sure that we are not harming the patient with excess of anesthesia or giving it too light,” Wojciechowski said. “Awareness during surgery can be a very frightening experience causing sleep disorders, post-traumatic stress disorder and depression. Patients experiencing awareness may be traumatized because frequently they have no means of communicating this to us.” In October 2004, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) issued a sentinel event alert to health care organizations across the country recommending steps to prevent anesthesia awareness, which WWW.METHODISTHEALTH.COM
includes using devices such as the BIS monitor, that measure brain activity rather than physiological responses. JCAHO is an independent, nonprofit organization that evaluates and accredits more than 15,000 health care organizations and programs in the United States. According to the American Society of Anesthesiologists (ASA), the frequency of anesthesia awareness is rare, ranging between one to two patients out of 1,000 under general anesthesia. Generally, patients who have experienced this phenomenon have reported the ability to recall sound, a sensation of not being able to breathe and/or pain. Because of the paralyzing effects of neuromuscular blocking agents used during surgery, patients are unable to communicate his or her awareness of this experience as it occurs. The ASA’s house of delegates issued a practice advisory at its October 2005 annual meeting, which leaves use of the BIS monitor up to the discretion of anesthesiologists. The use of the BIS monitor may allow anesthesiologists to administer
minimal doses of anesthesia, which may result in patients awakening faster and feeling more alert sooner. According to cardiovascular surgeon Dr. Jon-Cecil Walkes, there are other benefits to using BIS monitors in the operating room. “The BIS monitor allows us to be more confident about how the patient is doing. It can be used to indicate how the brain function is doing after we have reestablished blood flow and removed a patient from the heart lung machine,” he said. Because no technology can replace the expertise of an experienced anesthesiology professional, a patient undergoing general anesthesia should discuss their concerns with their anesthesiologist. Be sure to share information about any previous problems with anesthesia as well as any other issues or concerns prior to surgery including allergic reaction to drugs, control of pain, delayed awakening, nausea or awareness. 䡲
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O TIME IS BRAIN B Y
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Dr. David Chiu
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On a Sunday morning in 2001, Clyde Morley went about his usual routine of getting ready for church when he noticed he couldn’t comb his hair very well, but he didn’t think much of it. Dropping his keys and difficulty writing weren’t clues either.
“I didn’t realize what was happening until it got worse,” Morley said.
Allen Rankin’s symptoms were not as noticeable, but numbness in his left hand caught his attention. Both men joined the ranks of the estimated 700,000 people affected each year by stroke. Both men found the care they needed at the Methodist Neurological Institute (NI) at The Methodist Hospital.
Morley, director of plant operations and security at an area hospital, suffered a stroke just when he was retiring to care for his wife of 47 years, who has Parkinson’s disease. He spent several years on medications, including muscle relaxers, but found it increasingly difficult to per-
Richard Simpson, a neurosurgeon at the NI, implanted an Intrathecal Baclofen (ITB) pump in Morley’s abdomen. The device is the size of a hockey puck and releases the medication, Baclofen, into the fluid surrounding the spinal cord to relax the muscles. Morley sees Fisher about
form tasks such as buttoning his shirt, walking or driving. The severe spasticity, or continuously contracted muscles, resulting from the stroke caused Morley’s right side to stiffen, causing pain and significantly limiting physical activity. When Morley’s doctor told him there was nothing more to do, the 68 year old turned to NI neurologist Dr. Stan Fisher, who offered help in the form of an innovative but proven neurorehabilitation treatment for stroke patients with spasticity. On Fisher’s recommendation, Dr.
every three months to refill the pump, using a catheter attached to a
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port in the center of the device. The Baclofen in the pump is the same medication Morley took orally but without negative side effects such as severe fatigue and weakness. “The pump allows us to deliver a small and precise amount of concentrated medication to a targeted area without the unwanted side effects of the oral medication,” said Fisher, who is codirector of the NI’s Movement Disorders and Neurorehabilitation Center. “I can monitor the pump’s activity with a handheld computer and, at any time, adjust the dose and delivery to what is best suited to the individual patient.” Rehabilitation alone has limited effects, but with new therapies like ITB, stroke survivors can have a second chance at rebuilding their strength and confidence to continue daily activities despite the effects of stroke. Morley felt the results almost immediately after receiving his first dose via the pump. Now fully retired and caring for his wife, Wanda, who is also being treated by Fisher for her Parkinson’s, Morley says he’s selfsufficient and feels like he has his life back. “I can do something as simple as open my right hand and lift my right arm. Wanda and I are able to garden together. It’s a miracle to be that receptive to medication,” he said.
Mini strokes
Intrathecal Baclofen Pump
Allen Rankin had two episodes within a month-and-a-half of each other in 2005. The 67-year-old retiree didn’t know if the numbness in his hand was a stroke warning sign, but it
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TIME IS BRAIN was enough of a concern for him to seek medical help, and he found it in Dr. David Chiu, medical director of the Eddy Scurlock Stroke Center at the NI. Tests confirmed that a blocked artery in Rankin’s brain led to the transient ischemic strokes (TIAs), or mini-strokes, which caused the numbness. With TIAs, the blood clot occurs for a short time and tends to resolve itself, but they are strong indicators of a possible major stroke. Rankin went to the NI just in time. Chiu introduced him to Dr. Richard Klucznik, medical director of the Texas Neurovascular Center at the NI. Klucznik had just received approval to use the first FDAapproved brain stent in ischemic stroke patients. Rankin was offered the opportunity to be the first NI patient to undergo this procedure. Without hesitation, he agreed. During an hour-long procedure, Klucznik inserted the Wingspan™ Stent into the leg, through the chest, and deep into Rankin’s brain. The mesh-like tube is smaller than a pencil and extremely flexible. “In the past, patients with atherosclerotic lesions or accumulated plaque in brain arteries due to a stroke were treated with anticoagulants or cholesterol-lowering drugs. We also used cardiac stents or angioplasty balloons, but these devices were not specifically approved for the brain and were less effective,” Klucznik said. “The Wingspan Stent is designed specifically for the brain’s fragile vessels and can handle the twists and turns we have to maneuver in order to place the stent in an artery and open the blockage.”
Wingspan™ Stent System with Gateway™ PTA Balloon Catheter (top). The deployed stent (bottom), which is smaller than a pencil and extremely flexible, is used to open a blocked artery in the brain.
What’s on the horizon The ITB and Wingspan Stent are a glimpse of some of the options available to stroke patients, but the underlying question remains of how to effectively treat stroke patients beyond the three-hour window of opportunity. Physicians like Chiu are trying to answer that question through research and treatment at the Eddy Scurlock Stroke Center, designated a national primary stroke center by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). As medical director of the largest dedicated stroke unit in the Texas Medical Center, Chiu oversees nearly a dozen clinical trials ranging from treatment of acute ischemic stroke to prevention of secondary strokes. Preliminary results of one ongoing national study could be a step toward another treatment for acute ischemic stroke, which accounts for more than 80 percent of strokes in Americans each year. The clinical trial focuses on a neuroprotectant, which is a drug that protects neurons in the brain from injury or degeneration. The experimental drug appears to be well tolerated in acute ischemic stroke patients up to six hours after onset of
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troke is a medical emergency. Know these warning signs of stroke and teach them to others because every second counts:
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Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
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Sudden confusion, trouble speaking or understanding
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Sudden trouble seeing in one or both eyes
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Sudden trouble walking, dizziness, loss of balance or coordination
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Sudden, severe headache with no known cause 䡲
Dr. Stan Fisher symptoms, as opposed to the threehour window now used to administer tissue plasminogen activator (tPA), the only FDA-approved clotbusting drug on the market. Chiu is investigating whether this drug could be the first neuroprotectant that minimizes the brain damage caused by an ischemic stroke. Methodist’s stroke center is also the only location in Houston to offer cutting-edge research on possible new clot-busting drugs made from two unlikely sources: snake venom and vampire bat saliva. Desmoteplase is a genetically engineered version of a clot-busting agent found in the saliva of the vampire bat that can be given to stroke patients up to nine hours after the start of symptoms. Viprinex is an investigational drug derived from a compound found in Malaysian Pit Viper snake venom, called ancrod, which acts as an anti-coagulant in blood. This study may help determine if acute ischemic stroke patients treated with a one-time
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dose within six hours of the onset of stroke symptoms will have improved neurological function. Researchers believe both experimental drugs could reduce the amount of brain damage sustained during a stroke. “Stroke is the third leading cause of death in Americans, and there are still no FDA-approved drugs to dissolve or remove blood clots for ischemic stroke occurring more than three hours after onset of symptoms,” according to Chiu. “If we are
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to continue fighting this killer, we need more time and more options. “With every Clyde Morley and Allen Rankin success story, we are that much closer to winning the war against stroke,” he said. 䡲
䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲 䡲
JCAHO Stroke Certification With 18 beds, the Eddy Scurlock Stroke Center at the Methodist Neurological Institute (NI) is the largest dedicated stroke unit in the Texas Medical Center, and is designated as a primary stroke center by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The center, which received the JCAHO Gold Seal of Approval™ for stroke care in December 2005, is a leader in all areas of stroke research including diagnosis, innovative treatment, prevention, rehabilitation and recovery. Stroke can happen any time of the day or night, so a multidisciplinary team of physicians, nurses and other stroke specialists are on staff 24/7. In 2002, Jack S. Blanton Sr. and the Scurlock Foundation contributed $1 million to further the hospital’s recruitment, education and awareness initiatives. Their philanthropic investment has allowed Methodist to strengthen its comprehensive approach to stroke treatment and awareness. 䡲 VOLUME 4, NUMBER 1 䡲 15
“Here we have a
blank canvas upon which to design a department that reflects modern trends in patient care, clinical investigation and medical education.”
Renowned researcher builds new D B Y
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As Dr. Richard Robbins, renowned thyroid cancer researcher and clinician at New York’s Memorial Sloan-Kettering Cancer Center, began considering department chair positions around the country, he just couldn’t pass up the chance to build the new Department of Medicine at The Methodist Hospital in Houston. “I took this job because it is one of the most extraordinary opportunities in American medicine in the last 20 years,” he said. “There are no other institutions that have the context of Methodist — in the Texas Medical Center with a board of directors committed to adding academic excellence to established world-class patient care. “This is a 900-bed hospital seeking to develop an entirely new dimension, an academic Department 16 䡲 VOLUME 4, NUMBER 1
of Medicine,” he said. “That is extremely unique and exciting. Here we have a blank canvas upon which to design a department that reflects modern trends in patient care, clinical investigation and medical education.”
Building Blocks to Success Robbins envisions 11 divisions in the department. He said that by building the academic faculty from the ground up, he will be able to search around the country to find the most outstanding physicians and scientists in each one of the subspecialties of medicine. “This will provide an outstanding addition of new expertise to the Texas Medical Center and for the people of Houston,” he said. This building project is planned to
take place in three stages. The first two years will focus on recruiting clinician-educators. Then the department will shift its strategy slightly to bring in researchers. Finally, new basic and translational scientists will be recruited. This new team will focus on bringing research at Methodist directly to the bedside. “Right now our concentration is on recruiting subspecialists,” he said. “There are already about 450 highquality internal medicine specialists here at the hospital, and we want to support and enhance their options. I am meeting with each of the current subspecialties in medicine for guidance. I want to know what kind of additional specialists would help build the center and provide the best care for our patients.”
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Dr. Richard Robbins
epartment of Medicine Robbins, who holds the Charles and Anne Duncan Distinguished Endowed Chair, also is working quickly to establish a medical residency program and apply for accreditation through the Accreditation Council for Graduate Medical Education. This is an important step for the department he is currently fast-tracking. Methodist physicians and student researchers will pursue new knowledge in a proposed clinical research center (CRC) that will establish inpatient and outpatient clinical research protocols on everything from diabetes to cancer to heart disease. “This center will cover not only the Department of Medicine,” he said. “Physician-scientists in surgery, orthopedics or OB/GYN, for example, will all have equal access.” WWW.METHODISTHEALTH.COM
Additionally, the CRC will foster new relationships between Medical Center institutions. “We are open to collaboration with every Texas Medical Center institution,” he said. “I have found a very good sense of collaboration and integration here.
Achieving Excellence “We’re aiming for excellence in research, as well as to put on the best educational programs we can. We’re willing to collaborate with whoever can help us or whomever we can help do the same. We have no institutional barriers when it comes to achieving excellence.” Robbins surveyed what was already available in the Medical Center and what areas Methodist could make the biggest impact in the community. For starters, diabetes,
obesity and lipids — areas of study related to the metabolic syndrome — will be the first area he concentrates on building. “I’d like to bring in 10 to 12 investigators on that section alone, both clinical people as well as researchers, to create one of the country’s largest centers on diabetes and obesity.” Secondly, he plans an emphasis on oncology research and patient care. Robbins is known nationally for his research with thyroid cancer. His most recent scientific efforts have focused on applying novel treatments, such as recombinant human hormones to help manage thyroid cancer, and innovative technologies that make it easier to detect residual thyroid cancer. Noting that an already strong cancer program exists at Methodist (the hospital sees the second largest number of cancer patients in Houston), he found several unique features to build upon. In medicine, specifically, it’s the latest in targeted cancer therapy and the patient-centered supportive treatments that help people get through their therapy. “We’re gaining on cancer,” he said. “We’re curing more and more every year, and the newer treatments are actually less toxic than the old ones were, making the patients’ quality of life better.” More cancer patients surviving longer or beating the disease altogether creates a new area in medicine that Robbins looks forward to pursuing. “It’s called cancer survivorship,” he said. “Survivors of cancer sometimes carry the consequences of their treatments. Often they must live with these for the rest of their life. It could be early menopause or cardiac dysfunction from certain drugs, lung problems or dry mouth from radiation treatment. We’re going to focus on all those issues.” 䡲
VOLUME 4, NUMBER 1 䡲 17
A Foundation of Support New recognition society honors planned giving donors
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he Methodist Hospital is an exemplary acaWhen Doris Hervey sought a way of continuing her demic medical center serving the health family’s commitment to Methodist, she estabcare needs of nearly three-quarters of lished the $1.6 million Robert W. Hervey a million people every year. More than 85 Endowed Chair for Parkinson’s Research THY LEGA R O years ago, it was little more than an idea and Treatment. Hervey choose W shared by a handful of Houstonians. Parkinson’s disease for the endowAmong them was Dr. Oscar L. ment because her husband suffered Norsworthy, a respected local physician. with the debilitating disease for In 1919, Norsworthy donated his small 17 years. private hospital to the Texas Conference The establishment of this endowed of what is now the United Methodist chair at the Methodist Neurological Church. Norsworthy’s simple act of charity Institute creates a legacy for the ET O was The Methodist Hospital’s first planned Hervey family that will last for generaHO H DIST gift — any charitable contribution promised tions to come and furthers Methodist’s in the future, such as a bequest. It can also be a vision of revolutionizing the treatment of gift made with assets other than cash, for example, neurological diseases such as Parkinson’s. property in Norsworthy’s case. The Norsworthy Legacy Society was created to What were once 32 beds in Norsworthy’s clinic on acknowledge visionary and generous individuals like Rosalie Street in downtown Houston have grown to Doris Hervey who will leave a legacy through their more than 1,300 beds in The Methodist Hospital planned gifts to The Methodist Hospital Foundation. System today. The impact of his generosity will be felt A decision to become a member of The Norsworthy forever in the community and around the world. Legacy Society reflects a donor’s vision and commitMethodist has the special privilege of naming its ment to the ideals of The Methodist Hospital. Funding new planned giving recognition society in his honor. for medical research plays a considerable role in the The Norsworthy Legacy Society recognizes all continued growth of the hospital’s goal of improving individuals who have made a planned gift to The patient care. “My husband Bob would be so pleased to Methodist Hospital Foundation or who have stated know we saw this dream through,” Hervey said. their intention to make a deferred gift to the founda“Wouldn’t it be wonderful if the Robert W. Hervey tion through their estate. Endowed Chair for Parkinson’s Research and The reality is that all planned gifts have the same Treatment led to a cure for Parkinson’s disease?” potential. And because The Methodist Hospital Foundation invests in endowments, facilities and Please contact The Methodist Hospital Foundation people, each gift increases in value with every at 832-667-5816 to speak to a representative about passing year. planned giving. Your legacy gift will help Methodist meet the ever changing needs of medicine far into the future. 䡲
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Gordon Walters, RN
Nursing award recipient
brings PASSION to the job B Y
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ordon Walters loves his job. And even though he works 12-hour shifts in an intense work environment with critically ill patients, he would not have it any other way. The coronary care unit (CCU) nurse was named the 2005 recipient of the Brown Foundation Outstanding Nurse Award — the highest honor for excellence in nursing at The Methodist Hospital. Since its inception in 1994, the award has been made possible with
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G I D D E N S
contributions from The Brown Foundation, Inc., which has a longstanding history of supporting public charity, primarily in the state of Texas. An interdisciplinary selection committee forms each year at Methodist to review nominations, interview finalists and select a winner. The award includes $15,000 in unrestricted funds for continuing education, professional development and other expenses. This was Walters’ fourth nomination for the award.
“When you say that you are a nurse at The Methodist Hospital – that turns people’s heads.”
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Nursing award “He is one of the hardest working people who you will ever meet. When he won, I was really excited for him,” said wife Karen Walters, a 1996 recipient of the award. Gordon and Karen Walters have the distinction of being the only husband and wife recipients of this award. “Everybody loves him. People come up to me all of the time and tell me how much he really deserves it,” said Karen, who has spent her entire 20-year nursing career working at Methodist. “It is quite an honor to be recognized as one of the outstanding nurses at Methodist,” said Gordon, stressing that Methodist has many outstanding nurses. “When you say that you are a nurse at The Methodist Hospital — that turns people’s heads.”
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fter Gordon put Karen through nursing school and she started working in the neurological intensive care unit, he really took notice of how excited she was when she talked about her job. One day he came home and announced that he was going to nursing school. At the time, the junior high history teacher and coach did not feel the same level of job satisfaction that Karen had in her job as a Methodist nurse. “One day he came home and said ‘I’m going to nursing school because you love it so much and I want to be happy,’” Karen recalled. Since graduating from nursing school with his RN degree in 1991, Gordon has followed in his wife’s footsteps by working in one of
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Methodist’s intensive care units, where he has found the job satisfaction he had been yearning for. “I will stay in the CCU until I retire. The most important part of critical care is the bedside nurse. We are the ones closest to patients and families. We are an important part of the healing process,” he said. Gordon finds many advantages in what he does. As a male nurse he finds it easier to get patients up and moving around. He also believes that male patients feel that they can relate to him. As nurses, he and Karen are the ones the neighbors look to whenever there is a medical
emergency in the neighborhood. As a coach, Gordon has remained involved in sports by coaching Little League and basketball. His philosophy is that “if you can’t have a passion for your job — quit.” Now after 15 years in nursing, he continues to bring that passion to work with him. 䡲
To learn about career opportunities at The Methodist Hospital System, visit www.methodisthealth.com.
UPCOMING EVENTS June 16 – 7:05 PM Astros vs Kansas City Royals
August 31 – 7:05 PM Astros vs Milwaukee Brewers
The Methodist Hospital Weight Management Center Night First 10,000 adults receive a water bottle
Methodist DeBakey Heart Center Heart Disease Awareness Night
July 7 – 7:05 PM Astros vs. St. Louis Cardinals
The Methodist Hospital System Cancer Survivor Day
The Methodist Hospital System Night First 10,000 women receive a pink Astros tote bag
August 12 – 6:05 PM Astros vs. San Diego Padres
September 17 – 1:05 PM Astros vs. Philadelphia Phillies
Game times subject to change.
The Methodist Hospital System is the official health care provider of the Houston Astros.
The Methodist Hospital System Night First 10,000 fans receive an Astrodome replica
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Nobuhiko Sugano, MD, an orthopedic surgeon from Japan, with Ken Mathis, MD. Sugano, lectured on computer-based planning for hip resurfacing.
International orthopedic conference advances physician education B Y
Philip Noble, PhD (right) and Joel Matta, MD, from Good Samaritan Hospital in Los Angeles, discuss Matta’s upcoming demonstration of the anterior single incision technique.
Nicholas Sgaglione, MD, from North Shore University Hospital in Manhasset, NY (fourth from left) leads a hands-on bioskills demonstration of cartilage substitutes for defect grafting in the knee. WWW.METHODISTHEALTH.COM
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With advances in medicine continually paving the way for better patient care, orthopedic surgeons at The Methodist Hospital are leading the way in educating their colleagues around the world about the latest in technology and procedures. In September, The Institute of Orthopedic Research and Education hosted its second annual international orthopedic conference, with support from Methodist. “This part of the United States needed a conference that focused on the future of orthopedic surgery,” said Ken Mathis, MD, chair of the Department of Orthopedics at Methodist. “We established an event that introduces the latest cutting-edge technology, some of which is still in trial.” Mathis, along with Phillip Noble, PhD, Dunn Professor of Orthopedic Research at Methodist, initiated the conference, which includes lectures, live surgeries, open discussions and cadaver workshops, where attendees are encouraged to assist during procedures. The most recent conference VOLUME 4, NUMBER 1 䡲 21
ORTHOPEDICS CONFERENCE
covered such topics as computer navigation during surgery, minimally invasive partial knee replacements, joint replacement without cutting muscles and keeping as much of the original joint as possible during replacement surgery. The first conference, held in 2004, was broadcast live to Mexico City. In 2005, the conference extended its reach by broadcasting to Mexico, Honduras, Brazil and Saudi Arabia. Each year, Mathis and Noble contact leading orthopedic surgeons around the world to participate in the conferences and collaborate with colleagues at Baylor College of Medicine and the University of Texas Health Science Center-Houston. “We’re excited to work with other Texas Medical Center institutions,” Mathis said. “By coming together, we can produce something bigger and better than any of us can do alone.” Because the conference grew in popularity so quickly, Mathis and Noble have decided to take a step back this year to evaluate the needs for training and education across the globe. “In order to be successful and expand, we’re planning to create several conferences, more targeted to the various areas of orthopedic medicine,” Mathis said. He and Noble hope to hold conferences on topics such as cartilage regeneration, spine, foot and ankle, hand and shoulder care. “My vision is that The Methodist Hospital, a premier hospital in the world’s largest medical center, becomes the resource for orthopedic education, and in turn becomes a leader in training orthopedic physicians,” he said. 䡲
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eigh Ann is a vibrant wife, mother and active volunteer at her church and 10-year-old son’s school. She doesn’t take anything about her life for granted. At 18, her weight dropped to 88 pounds and she was diagnosed with Crohn’s disease. Living an active lifestyle has not come easy for her. Crohn’s disease, an inflammatory condition that affects the digestive tract, can become incapacitating when left untreated. In its active state, symptoms can vary from
extreme abdominal pain and fever to loss of appetite and sudden weight loss. Leigh Ann did not have health insurance and was accustomed to managing her health problems on her own. “I always tried to keep a good attitude when dealing with flare-ups of the disease. I focused on the positive things in my life and not on the impact of Crohn’s,” she said. “However, on this particular occasion, I was discouraged that I
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At The Methodist Hospital System, we consider it a responsibility and privilege to provide high quality health care to those in need, regardless of their circumstances. Our future is deeply intertwined with the future of those we serve. The health care needs of Houston area residents must be met to ensure our collective success for generations to come.
The Methodist Hospital System Charity Care Program was not experiencing any relief from the symptoms, and I didn’t have the financial resources I needed to move forward with an effective treatment.” Leigh Ann was referred to The Methodist Hospital for treatment, and the doctor who examined her recommended she be admitted to the hospital. “He was wonderful,” she said. “He did everything he could to speed up the process because he knew my condition was serious. Because of my financial situation, he referred me to Patient Access Services to see if I qualified for the hospital’s Charity Care Program. Their assistance and the benefits of that program have made a huge contribution to my life.”
Leigh Ann developed serious abscesses in her stomach, which required three surgeries in her first two weeks at Methodist. Once she recuperated, the hospital provided ongoing therapeutic treatment to keep the disease in remission. eigh Ann now receives regular outpatient treatments as part of her overall care. “The quality care that Methodist provides has completely changed my life. The treatments help me remain in remission and make it possible for me to actually have a life. I pay for my medications but I know I would never be able to afford this type of treatment without the assistance of Methodist’s Charity Care Program.”
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Leigh Ann also appreciates the consistency in caregivers. She has been able to see the same Methodist physician throughout her treatment. “Just having someone who knows me and my history has made a tremendous difference,” Leigh Ann said. “I no longer have to manage my own care and repeat my medical history every time I see a doctor.” 䡲
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The quality care that Methodist provides has completely changed my life. The treatments help me remain in remission and make it possible for me to actually have a life.
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Reprinted from 2004 Community Benefits Report.
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VOLUME 4, NUMBER 1 䡲 23
HEALTHY LIVING
Navigating the organic foods maze B Y
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Certified organic. Environmentally responsible. Chemical free. All natural. Traditionally produced. Hormone free. Walk into any grocery store or through one of the many local farmers’ markets or food co-ops, and you’ll find these terms bandied about freely. And while many believe that organic foods taste better, what does organic really mean and are organic foods really that much healthier for you? Buying organic foods isn’t just for the hippie, hempwearing, earthy types that they’ve formerly been associated with. Today, organic foods and products cross a multitude of racial and economic lines, making it the fastest growing category of all foods with more than $15 billion in sales in 2004 and sales projected to nearly double by 2009, according to Consumer Reports. While organic foods are undoubtedly more expensive,
S T R U D L E R
often costing 25 to 50 percent more than nonorganic foods, there are arguments on both sides of the proverbial nutrition fence. Some recent studies show that eating organic foods may limit one’s exposure to chemicals, which have been linked to cancer, immune system suppression, nervous system disorders, reproductive damage and hormone disruption. The Environmental Working Group, a nonprofit environmental research firm based in Washington, D.C., studied 46 popular fresh fruits and vegetables and found 192 different pesticides on the produce. They believe that those who eat the 12 most contaminated fruits and vegetables (see sidebar) may be exposed to approximately 20 pesticides a day on average, while eating the 12 least contaminated may expose those to only about two pesticides a day. Using this guideline, they
Most Contaminated vs Least Contaminated 12 Most
12 Least
Contaminated
Contaminated
Apples Bell peppers Celery Cherries Grapes Nectarines Peaches Pears Potatoes Raspberries Spinach Strawberries
Asparagus Avocados Bananas Broccoli Cauliflower Sweet Corn Kiwi Mangoes Onions Papayas Pineapples Sweet peas
Produce ranking provided by Environmental Working Group and based on a study of more than 100,000 tests for pesticides on produce collected by the U.S. Department of Agriculture and the U.S. Food and Drug Administration.
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claim, “can reduce the number of pesticides in produce a person eats by up to 90 percent.” But what about washing and peeling? The group says that while “washing and rinsing fresh produce may help reduce pesticide residues, it does not eliminate them.” In fact, a recent study funded by the U.S. Environmental Protection Agency found that children who switched to eating organic foods had “dramatic and immediate” reduced exposure to pesticides that were used on the crops. While Whole Foods Market, a leading national retailer of natural and organic foods, agrees that organic foods are spared “potentially harmful, long-lasting” exposure to insecticides, herbicides, fungicides and fertilizers, they do say, according to its Web site, “organic foods are not necessarily more nutritious.” Dr. Richard S. Rivlin, professor of medicine at Weill Medical College of Cornell University, which The Methodist Hospital is affiliated with, agrees. “The nutrient content of organic foods is virtually identical to that of traditional foods,” Rivlin said. “Organic harvesting doesn’t increase the amount of healthy nutrients so, the concentration is largely unaffected by whether it is organic. “I don’t think the pesticides are the cause of all the cancers we have now. It’s a difficult issue because everyone wants to eat healthy, but my personal opinion is, the widespread fears over pesticides and herbicides are really exaggerated and at most, they pose a very small risk.” But while many buy organic foods because they do believe they’re eating healthier, it doesn’t necessarily mean low fat. Gorging on organic foods won’t help anyone lose weight. “As in all things in life, moderation is the key,” said Karen Brewton, a clinical dietitian specialist with Methodist Wellness Services. “You would not want to eat half a jar of organic peanut butter or 10 organic apples because these are ‘healthy.’” In the end, Rivlin said that a more limited control of pesticides is best, but so too is “better control of one’s self,” and that “people should not be dissuaded from eating fruits and vegetables.” 䡲
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Reading the labels: What do they really mean 100% Organic – must contain only organically produced ingredients (except for water and salt)
Organic – must consist of at least 95 percent organically produced ingredients (except for water and salt) Made with Organic Ingredients – contains at least 70 percent organic ingredients; may list up to three of the organic ingredients or food groups on the display panel
Source: U.S. Department of Agriculture
“As in all things in life, moderation is the key.”
VOLUME 4, NUMBER 1 䡲 25
WOMEN’S SERVICES PROGRAM
M E T H O D I S T W I L L O W B R O O K H O S P I TA L
Virtual visit connects moms and babies B Y
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Lakeisha Clark was looking forward to the birth of her son, Jordan, in March, but he arrived seven weeks early when she underwent a cesarean section at Methodist Willowbrook Hospital. While hospital obstetricians delivered the baby, neonatologists with Texas Children’s Hospital stood close by, ready to take care of any special needs baby Jordan might have. Although physicians at Methodist Willowbrook handle most health issues common to premature babies, four-pound Jordan’s neonatologists decided to transfer him to Texas Children’s due to respiratory complications.
Patient education coordinator Diane Pearson explains virtual-visit technology to an expectant mother.
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While she recovered nearly 30 miles away, Clark was able to enjoy a “virtual visit” with her new son the very next day, thanks to state-of-the-art technology at Methodist Willowbrook. On her end, nurses set up a mobile monitor unit, equipped with speakers and a camera, while nurses at Texas Children’s set up a similar unit with a headset for baby Jordan’s doctor and nurse. “It was very comforting to see my son on the screen,” Clark said. “I was only able to hold Jordan for about 10 minutes before he was transferred, so it was wonderful to see him.” Methodist Willowbrook is the first Houston area hospital to offer this virtual visitation. Through a special pilot program with Texas Children’s, the monitor units are placed at each hospital so that as the mother recovers at Methodist Willowbrook, she is able to arrange a specific time to see her baby at Texas Children’s, with doctors and nurses at the baby’s side to explain treatment and answer questions. “It’s very hard to be without your child,” Clark said. “I felt reassured when I saw the doctor and nurse, and I could ask them questions. I knew they were taking good care of him.”
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Diane Pearson, RN, patient education coordinator at Methodist Willowbrook, said she is grateful for the chance to work with Texas Children’s on this project because it is in line with the hospital’s goal to provide a family-oriented environment. “It has been extremely heartwarming to watch new moms connect with their babies, even though they’re across town from one another,” Pearson said. “I think it also makes a difference for parents to be able to see their baby’s caretakers and ask questions. We’re very excited about what this technology brings to us.”
Family Education In an environment where all family members are important, nurses and staff at Methodist Willowbrook strive to provide as much education and support as possible during pregnancy and hospitalization. Long before babies are due, Methodist Willowbrook offers tours of the hospital, childbirth classes, breast feeding classes and refresher courses for moms and dads who have not had babies in awhile. Safe sitter classes and sibling classes for new big brothers and sisters are also available. “Our education does not stop once babies are born,” Pearson said. “While moms are in the hospital, nurses educate them, especially about postpartum depression. We
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hold discharge classes and encourage moms to call us any time they have questions or concerns once they’re home.” After discharge, a mom’s support group is available, where mothers can bring their babies and discuss their experiences
with their newborns. “These types of unique services in education and cutting-edge technologies such as the virtual visitation link to Texas Children’s set us apart in this growing community,” Pearson said. 䡲
Facilities and staff Women’s services at Methodist Willowbrook Hospital started out as a 22-bed unit just five years ago and rapidly expanded to a 34-bed unit. “We had no idea there would be such a demand,” patient education coordinator Diane Pearson, RN said. “Every year, our number of deliveries climbs, and this year we already expect to deliver around 2,500 babies.” Methodist Willowbrook Hospital has more than 20 physicians dedicated to women’s services, and Texas Children’s neonatologists provide the highly specialized care that premature babies need in the 10-bed Level 2 neonatal intensive care unit (NICU). The Level 2 NICU provides care for those babies who are premature or who require continuous monitoring, oxygen or intravenous medications. Newborns that require long-term ventilator assistance or surgery are transferred to Texas Children’s. “Offering this complete array of services allows us to provide family-friendly, personalized care,” said Dr. Gwynn Geddie, one of the neonatologists who oversees the nurseries at Methodist Willowbrook Hospital. Often, if babies are transferred to Texas Children’s for further care, they will return to Methodist Willowbrook Hospital until they’re ready to go home. “This helps us keep babies close to their families and in their own community,” Geddie said.
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Accolades ANN SCANLON MCGINITY, RN, chief nursing officer for The Methodist Hospital, has been selected by the Sigma Theta Tau International Honor Society of Nursing to be a member of an interdisciplinary nursing delegation to China in November 2006. This delegation will collaborate with colleagues in Shanghai, Beijing and Guilin regarding quality of care, financial issues and contemporary challenges facing health care organizations and strategies that have improved health care outcomes. DR. MIGUEL QUIÑONES, chairman of the Department of Cardiology at The Methodist Hospital and medical director of the Methodist DeBakey Heart Center, has been appointed vice president of the Inter-American Society of Cardiology. He will represent the American Heart Association and the American College of Cardiology in this new role to promote dialogue among cardiologists, cardiovascular surgeons and scientists and to maintain cooperation and promote the interchange of information with the international, regional and national societies of cardiology in the Americas. THE METHODIST HOSPITAL SYSTEM’S INTERNAL AUDIT DEPARTMENT has been awarded the Institute of Internal Auditor’s Recognition of Commitment Award. The award, an international achievement, acknowledges internal audit departments that demonstrate excellence in professional excellence, quality and outreach.
MARY SILAS LEMELLE, RN, a staff nurse and clinical mentor on the Dunn 9 cardiovascular care unit of The Methodist Hospital, has been named the recipient of the Methodist DeBakey Heart Center 2006 Cardiovascular Nursing Excellence Award. Lemelle was selected for her dedication to maintaining a high standard of clinical practice, being a positive role model for others, her commitment to the goals of the heart center, and her contribution to cardiovascular nursing in the hospital. ANN QUINN TODD, RN, nursing director of the Eddy Scurlock Stroke Center at the Methodist Neurological Institute, has been elected to the American Heart Association’s inaugural State Advocacy Committee. This is a voluntary, two-year term. Committee members will help craft the AHA’s legislative messages and work with elected state officials.
The Methodist Hospital Travel Health Program Travel health services from a name you trust While you’re planning for your international trip this summer, your health should be at the top of your list. The Methodist Hospital Wellness Services has established a Travel Health Program designed specifically for those traveling away from home. The Travel Health Program helps prepare you for the physical rigors of travel with pre-travel health planning, vaccinations, and travel health maintenance — especially for those with chronic health problems. Your pre-travel consultation with Methodist Wellness Services Travel Health professionals will include an overview of medical concerns and requirements for
your travel destination. They will review your current immunizations, the immunization regulations for your destination, and your current health including pre-existing medical conditions.
To learn more about our Travel Health Program or to schedule an appointment, please call us at 713-441-5978 or e-mail wellness@tmh.tmc.edu.
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