The Forefront - Summer 2023

At the University of Chicago Medicine, your convenience is a top priority. We’re bringing new facilities, services and access to clinical trials closer to home for thousands of our patients. In January, four hospitals joined our system. New UChicago Medicine Advent Health locations are available in Bolingbrook, Glendale Heights, Hinsdale and La Grange, along with a network of nearly 50 physician offices and outpatient locations.

Our new $121 million multispecialty care center and micro-hospital in Northwest Indiana is on schedule for completion in spring of 2024. This facility will include an emergency department, short-stay inpatient unit, Comprehensive Cancer Center, imaging center, outpatient surgery center and medical offices with access to UChicago Medicine’s physicians and specialists.

Our new $815 million cancer center will be the first free-standing cancer center in Chicago and will play a key role in addressing inequities on the South Side, where cancer death rates are twice the national average. Other initiatives include expanded behavioral health services at our UChicago Medicine Ingalls Memorial campus; urgent care facilities in Homewood, Dearborn Station and River East; imaging services in Orland Park and River East; and many new primary care physicians.

Executive Director, Communications and Content Strategy: Lorna Wong

Executive Director, Marketing and Provider

Communications: Gerry O’Keefe

Editor: Ken Rickard

We are also pleased to announce that four prominent urogynecologists have joined UChicago Medicine. They are practicing in Glenview and will open permanent offices in Northbrook in the coming months.

Through our partnership with the South Side Community Health Organization — a coalition of 13 safety-net hospitals, health systems and federally qualified health centers — UChicago Medicine is helping to hire primary care physicians and hundreds of community health workers, increase access to specialists and build community partnerships. In fiscal 2022, UChicago Medicine provided $686.2 million in community benefits, which is a 13.1% increase over fiscal 2021.

With convenience top of mind for you and us, UChicago Medicine is working hard to ensure that accessing services to stay healthy isn’t harder than it should be. We’ll never stop searching for new opportunities to bring the very best of academic medicine closer to your community.

This publication does not provide medical advice or treatment suggestions. If you have medical problems or concerns, contact a physician, who will determine your treatment. Do not delay seeking medical advice because of something you read here. For urgent needs, call 911.

Mark

Anderson, MD, PhD Dean of the University of Chicago Biological Sciences Division and

Pritzker School of Medicine and Executive Vice President for Medical Affairs

Thomas E. Jackiewicz President, University of Chicago Health System

Assistant Editors: Angela Wells O’Connor and Jack Wang

Contributing editors and writers: Jamie Bartosch, Cassandra Belek, Alexis Hayes, Ashley Heher, Chelsea Johnson, Danielle Narcisse, Sarah Sargent, Angela Wells O’Connor and Jack Wang

Contributing photographers: Mark Black, Andrew Nelles, Jordan PorterWoodruff, Jason Smith and Nancy Wong

UChicago Medicine Medical Group is comprised of UCM Care Network Medical Group, Inc., and Primary Healthcare Associates, S.C. UChicago Medicine Medical Group providers are not employees or agents of The University of Chicago Medical Center, The University of Chicago, UChicago Medicine Ingalls

The Forefront magazine features stories about life-changing care and breakthroughs in medical research at the University of Chicago Medicine and Biological Sciences.

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The summer months are finally here. Whether that means a slower pace for you, your family and loved ones or a busy travel schedule, we know that convenient access to healthcare is more important than ever. In fact, research shows that convenience is the top driver

A NEW PROBLEM / Could you have fatty liver disease? It wasn’t on patient Kerry Sivia’s mind when she ended up in the emergency room and got the diagnosis. 3

LOOKING FOR SOME HOT STUFF / Is eating spicy foods good for you? Edwin K. McDonald IV, MD, cools down the drama with facts about kicking it up a notch.

ON THE COVER

Barry Rapport was healthy and active when he received a lymphoma diagnosis. He came to UChicago Medicine and saw expert Sonali Smith, MD, who suggested a clinical trial.

FIVE YEARS / Looking at the impact of UChicago Medicine’s Level 1 trauma center on the community.

PUT ME IN, COACH / Make sure your young athlete is ready for their season with a sports physical examination. 13 10 14

YOU DOWN WITH IBD? / Intestinal ultrasound offers in-clinic visualization of the bowel for Crohn’s disease and ulcerative colitis patients.

RACIAL JUSTICE IN MATERNAL HEALTH / Black women and babies have been the most affected by adverse health outcomes in the U.S.

ONLINE

PAST ISSUES / Read our archive of The Forefront and Imagine magazines at UChicagoMedicine.org/Forefront-Magazine.

MORE FROM THE FOREFRONT / Sign up for our Health & Science e-newsletter at UChicagoMedicine.org/enewsletter.

Cover photo by Mark Black

An update on Chicago’s first free-standing cancer center

The University of Chicago Medicine has updated its original proposal to build the city’s first freestanding cancer hospital with an enhanced design that incorporates feedback from patients and residents of the South Side. The new cost and size of the project is $815 million for a 575,000-square-foot facility, with the ability for future expansion. The changes include a redesign of the groundfloor space to be a community hub for cancer prevention, screening and diagnosis, as well as private infusion bays, a dedicated breast center,

and shell space for future growth and technologies that have yet to be developed. Pending state approval, the facility will be constructed on East 57th Street between South Maryland and Drexel avenues, with a planned opening in 2027.

Expanding our services in the western suburbs

A new joint venture between UChicago Medicine and AdventHealth combines the expertise and resources of both organizations to bring academic medicine to Chicago’s western suburbs. UChicago Medicine acquired a controlling interest in AdventHealth’s Great Lakes Region, which includes hospitals in Bolingbrook, Glendale Heights, Hinsdale and La Grange. Co-branded as UChicago Medicine AdventHealth, the joint venture allows physicians of UChicago Medicine and AdventHealth Great Lakes to partner and coordinate care.

Growing our pediatric care team

Eric M. Thompson, MD, has been named the new Director of Pediatric Neurosurgery and Chief of Pediatric Neurosurgery for the Chicagoland Children’s Health Alliance. He previously worked at Duke University, where he specialized in the care of children with brain and spine tumors, epilepsy, craniosynostosis, vascular disease, congenital spine disease, trauma and hydrocephalus. Thompson also conducts basic science and clinical research, focusing on pediatric brain tumors.

Our 23rd consecutive ‘A’ Safety Grade

The University of Chicago Medical Center was awarded its 23rd consecutive “A” Safety Grade from The Leapfrog Group, a national industry watchdog. The Medical Center is the only hospital in Chicago — and one of only 20 nationwide — to have earned the top grade in every edition of the semiannual report card, which began in June 2012. To determine their grades, Leapfrog reviewed more than 30 national metrics reflecting errors, accidents, injuries and infections, as well as systems hospitals have in place to prevent harm. For more information, visit HospitalSafetyGrade.org.

Pritzker to redesign curriculum, boost tuition support

In an increased effort to attract top applicants from a range of backgrounds and reduce student debt, the Pritzker School of Medicine will provide fulltuition scholarships to up to half of each incoming class of medical students and modernize its curriculum starting in fall of 2023. The new Pritzker Phoenix curriculum focuses on empowering students to serve as patient advocates and enhance small-group learning and community engagement.

Through this initiative, the Pritzker School is furthering its goal of inspiring a more diverse generation of leaders and innovators in medicine and science, including those who choose to teach future generations or work in underserved communities. Pritzker was ranked No. 18 in research in the latest U.S. News & World Report survey of the nation’s medical schools.

What’s the skinny on spicing up your meals?

Spicy foods — some people swear by them and some swear they are dangerous. So, which is it?

“Patients often tell me they’re giving up spicy foods to get healthy,” said Edwin K. McDonald IV, MD, a University of Chicago Medicine gastroenterologist and trained chef.

“Last time I checked, having a little Tabasco sauce won’t ruin your life.”

Here, McDonald sheds some evidencebased light on eating spicy foods to separate fact from fiction.

ARE SPICY FOODS GOOD FOR YOU?

Of course they are! Capsaicinoids, which include the compound capsaicin, are the chemical components of peppers that create their spicy taste. Research over the past couple of decades has demonstrated that capsaicinoids — and thus, spicy foods — also possess several health benefits.

WHAT ARE THE HEALTH BENEFITS OF SPICY FOODS?

Eating spicy foods may help you live longer. According to an extensive population-based study published in The BMJ journal in 2015, “Compared with those who ate spicy foods less than once a week, those who consumed spicy foods 6 or 7 days a week showed a 14% relative risk reduction in total mortality.” The association between spicy food consumption and total mortality “was stronger in those who did not consume alcohol than those who did.”

It’s OK to eat your heat-enhanced meals, but cut down on the margaritas with your spicy tacos.

CAN EATING THIS WAY CAUSE ULCERS?

Spicy foods don’t cause ulcers — they may actually help ulcers.

As a gastroenterologist, I diagnose people with ulcers all the time. When I tell someone they have an ulcer after a procedure, almost everyone is quick to blame spicy foods. People frequently ignore the fact they are taking ibuprofen around the clock or that they may have a bacteria called H. pylori (one of the world’s most common causes of ulcers).

Contrary to popular belief, multiple studies show that capsaicin actually inhibits acid production in the stomach. If you’re worried about an ulcer, you can

visit a gastrointestinal doctor. When seeing your doc, make sure you have a conversation about any anti-inflammatory medications you are using.

DO SPICY FOODS CAUSE HEMORRHOIDS?

No, but they may irritate anal fissures.

CAN THEY HELP YOU LOSE WEIGHT?

They can, according to a meta-analysis of 90 different studies that looked at the role of capsaicin in weight management. The analysis found spicy foods reduce appetite and that they increase energy expenditure. So, yes! Spicy foods can help with weight loss.

ARE SPICY FOODS DANGEROUS?

It depends on how spicy. You’ve heard of pepper spray, right?

CAN SPICY FOODS CAUSE STOMACH PAIN?

Although they don’t cause ulcers, spicy foods can trigger abdominal pain in some people. One study specifically highlighted that frequent consumption of spicy foods can trigger upper gastrointestinal symptoms in some people with dyspepsia (or, indigestion). For people with irritable bowel syndrome (IBS), spicy foods can also trigger symptoms.

WHAT’S THE BOTTOM LINE?

Spicy foods are healthy.

They don’t cause ulcers, but be careful if you have irritable bowel syndrome, dyspepsia, or inflammatory bowel disease. Basically, if spicy foods give you stomach pain, think before you eat.

Regarding ridiculously spicy foods with warning labels, eat them at your own risk.

Edwin K. McDonald IV, MD

This story was adapted from a post on McDonald’s blog TheDocsKitchen.com

UChicago Medicine marks anniversary of trauma center and Violence Recovery Program

The University of Chicago Medicine treated nearly 19,000 adult trauma patients in the first five years following the launch of a Level 1 adult trauma center and Violence Recovery Program on May 1, 2018.

Through April 2023, more than 21,000 trauma patients were treated at UChicago Medicine’s main campus on the city’s South Side. In the same five-year time frame, the Violence Recovery team worked with 7,761 trauma patients to help them transition back into the community.

About half of trauma patients come from the 12 ZIP codes surrounding the Medical Center.

“Through the thousands of adult and pediatric patients our hospital has treated, our trauma program, like a rising tide, has lifted many boats within our health system and in the community,” said Selwyn O. Rogers Jr., Section Chief of Trauma and Acute Care Surgery. “We’ve saved lives and brought compassion to the work that we do with integrity. Providing adult trauma care has promoted collaboration within UChicago Medicine and made our health system a stronger 24/7 operation. And our proficiency at trauma care is leading to others seeking our partnership.”

Prior to 2018, the South Side had not had a hospital with an adult trauma center for 27 years. In December 2015, UChicago Medicine announced plans to establish a Level 1 adult trauma center, building upon the existing Level 1 pediatric trauma center and burn center programs.

“This is a true victory for the community,” Candace Henley, a local health activist who would become a volunteer member of

UChicago Medicine’s Community Advisory Council, said at the time of the center’s 2018 opening. “Community voices played a vital role shaping the hospital’s plan to increase access to critical services and meet the growing needs of its neighbors and patients.”

“Community voices continue to be crucial as we envision the future of trauma care and violence reduction,” said Brenda Battle, UChicago Medicine’s Chief Equity Officer. “We cannot address violence without addressing its root causes, including racism, poverty and failures of public policy. That means working with local partners to make sure our patients live in neighborhoods where they can find safety and opportunity.”

Violence Recovery Program staff members listen to and talk with patients, call their family and friends, and connect them with resources like food or mental health counseling. The program has strengthened ties with local organizations as well. Violence Recovery specialists have been attending the Metropolitan Peace Academy,

an 18-week program that helps hospital staff members work more effectively with street outreach organizations.

“Our partnership with UChicago Medicine’s trauma center and Violence Recovery Program reflects the realities and complexity of the crisis of gun violence,” said Steven Perkins, director of field instruction for Metropolitan Peace Initiatives and its Peace Academy. “Tackling the crisis requires multidisciplinary and multilayered approaches and engagement — throughout our neighborhoods, within our institutions, and down to the street level where meaningful change is already happening.”

“The work accomplished at our trauma center these past five years is the result of strong collaboration, both within our medical system and with our neighbors and community partners,” said Health System President Tom Jackiewicz. “While we’ve increased the level and types of care we provide, we will continue to find ways to improve access to our care in the South Side and beyond.”

Reducing trauma is still the goal

At the five-year anniversary of the opening of the University of Chicago Medicine’s Level 1 adult trauma center, we sat down with Selwyn O. Rogers Jr., MD, MPH, Professor of Surgery and founding director of UChicago Medicine’s trauma center, to discuss how the team is caring for the community, preventing violence and their hope of reducing trauma.

Q: THE NEED FOR A LEVEL 1 TRAUMA CENTER ON THE SOUTH SIDE WAS CLEAR. WHAT CHALLENGES DID YOU FACE IN THE BEGINNING?

The trauma center is not an emergency department. It is people, policies and programs working together to create a system of care to take care of the most severely injured. It was clear to me there were going to be many challenges — some logistical, some resource-related.

What I didn’t realize was the other side: building trust with the community in solidarity to stand up this Level 1 trauma center. When I was meeting people in the community, I was faced with extreme hostility. People felt the University had turned a blind eye to the needs of the community for so long that the relationship was damaged, tattered and broken.

Q: WHAT PROGRAMS HAVE BEEN CREATED TO PROMOTE A HOLISTIC VIEW OF RECOVERY?

UChicago Medicine developed a Violence Recovery Program to run parallel to the clinical care the trauma team delivers to patients and their families. The program addresses wraparound services like psychological safety and support for victims of violence (as well as their families).

But how do you create a sense of primary prevention so that people aren’t shot, stabbed and assaulted in the first place? That is really hard. You’re addressing poverty, racism, discrimination, historical injustices, redlining and governmental policies. Those are really tough things to solve. But just because they are tough doesn’t mean that we shouldn’t try to solve them.

Q: WHAT DOES THE FUTURE HOLD? HOW DO YOU HOPE THE CENTER’S EFFORTS WILL HELP PUT AN END TO AN EPIDEMIC OF VIOLENCE IN CHICAGO?

Building a trauma center is kind of like how we view firehouses today. At the start of the 1900s, fires were a common cause of death in America. Then we created public health measures to address safety features and added fire stations everywhere and in every city in America. Today, there aren’t that many fires and far fewer people die from them. But we want to keep our fire stations open.

What if trauma care was like that? You want to keep a trauma center open because you never know. But what if we, as society, really committed ourselves to reducing trauma? That would be a beautiful thing.

UChicago Medicine Trauma Patient Volume 21,387 May 2018-March 2023

Trauma Types

Violence Recovery Program

If you’ve ever wondered whether to go to an emergency room or an urgent care clinic, you’re not alone. Here are some things to consider.

EMERGENCY ROOM

You should call 911 or come right to the emergency room (ER) if you’re systemically sick. That’s when an illness affects your entire body and you have severe pain or sudden onset of severe symptoms, a fever that won’t break, or “something doesn’t work,” like you’re unable to move an arm or leg or breathe normally. This includes:

» If a person has a severe injury or allergic anaphylaxis reaction.

» If they pass out or experience any signs of a possible stroke or heart attack.

While you or the victim may have a hospital of choice, an emergency may warrant going to the nearest ER for immediate treatment. ERs are the best place for actual emergencies.

SHOULD YOU CALL 911?

The American College of Emergency Physicians has useful guidance on when to call 911, but common reasons include:

» The condition is life-threatening and requires attention as soon as possible.

» You are unable to move yourself or the victim without causing harm or further damage.

» You are physically or emotionally unable to drive or be transported to an ER.

URGENT CARE

Unless a condition is life-threatening, a trip to urgent care is generally a better use of a patient’s time and resources to treat injuries, fever, infections and other ailments. Urgent care often has a shorter wait time and costs less than a traditional hospital emergency room visit. And many, like our Dearborn Station, Homewood and River East urgent care locations, offer convenient benefits such as walk-in visits (no appointment needed) and on-site lab and X-ray.

UChicago Medicine urgent care locations are staffed by experienced physicians who treat both adult and pediatric patients and are available seven days a week, from 8 a.m. to 8 p.m. during weekdays and 8 a.m. to 4 p.m. on weekends and holidays.

If necessary, urgent care providers can also connect you with a higher level of care.

URGENT

URGENT AID FOR LOWER-LEVEL EMERGENCIES

If you’re in the south suburbs, UChicago Medicine Ingalls Memorial offers an additional option to consider before heading to the ER. In our south suburban urgent aid locations, physicians provide ER-level care for lower-level emergencies — injuries, viruses and other illnesses — 24 hours a day, every day, in an urgent care-like setting.

If a stable person needs higher-level imaging such as an ultrasound or CT scan, urgent aid clinics may be a better fit than an urgent care.

The cost of an urgent aid visit is the same as the emergency department of UChicago Medicine Ingalls Memorial for the same level of care. The co-pay for emergency services will apply to your urgent aid visit, which may be higher than the co-pay for services provided by urgent care centers that are not part of a hospital’s emergency department.

UChicago Medicine Dearborn Station 47 W. Polk St.

UChicago Medicine River East 339 E. Grand Ave.

UChicago Medicine Medical Group — Homewood 17805 S. Halsted St.

See a list of reasons to visit urgent care and save your spot online at UChicagoMedicine.org/Urgent-Care or scan the code with your device.

*These locations include UChicago Medicine Medical Group providers and physician practice groups. UChicago Medicine Medical Group is comprised of UCM Care Network Medical Group, Inc., and Primary Healthcare Associates, S.C. UChicago Medicine Medical Group providers are not employees or agents of The University of Chicago Medical Center, The University of Chicago, UChicago Medicine Ingalls Memorial, UChicago Medicine Dearborn Station, UChicago Medicine Medical Group – Homewood or UChicago Medicine River East.

The facts about AFib and stroke Think F.A.S.T.

Atrial fibrillation (AFib) is the world’s most common type of heart arrhythmia, which is a condition where the heart beats irregularly — either too fast or too slow. AFib will affect an estimated 12 million people in the U.S. by 2030.

Despite being a heart condition, AFib can also affect the brain. People with untreated AFib are five times more likely to have a stroke than people without AFib.

Atman P. Shah, MD, is an interventional cardiologist at UChicago Medicine who specializes in minimally invasive, catheter-based techniques. This includes procedures to reduce the risk of stroke in patients with atrial fibrillation. Here, Shah answers patients’ most common questions about AFib and stroke.

WHY DOES AFIB PUT SOMEONE AT RISK FOR STROKE?

AFib is a disease that affects the electrical conduction of the heart and causes the heart to beat irregularly. The upper chambers of the heart (atria) beat out of sync with the lower chambers (ventricles). When the heart beats irregularly, clots can form in the part of the heart called the left atrial appendage (LAA). These clots can be ejected from the heart, and in some cases, they can block blood flow to the brain and cause a stroke.

FOR SOMEONE WITH AFIB, WHAT INCREASES THE RISK FOR HAVING A STROKE?

» Age 65 and over, with increased risk for age 75 and over

» Assigned female at birth

» Diabetes

» Heart failure

» High blood pressure

» History of stroke or heart attack

» Peripheral arterial disease

HOW CAN PEOPLE WITH AFIB PREVENT STROKE?

AFib is linked to obesity, high blood pressure and diabetes. Maintaining a healthy lifestyle with a balanced diet and regular exercise can reduce the likelihood of developing AFib.

For those with AFib, stroke can be prevented through oral anticoagulants (blood thinners) or through transcatheter closure of the LAA, a procedure that uses a device to seal the LAA and prevent future clots from escaping. This may be an option for patients who have bleeding risks and cannot be on anticoagulants.

DO PEOPLE WITH AFIB NEED A CARDIOLOGIST AND A NEUROLOGIST?

Having both is beneficial. At the University of Chicago Medicine Heart-Brain Clinic, every patient is seen by a neurologist and cardiologist at the same visit. This multidisciplinary approach saves patients time and improves coordination between physicians. UChicago Medicine is one of the few health systems in the country that offer this specialized and personalized care.

Learn about the UChicago Medicine Comprehensive Stroke Center online at UChicagoMedicine.org/Stroke-Center or call 1-888-824-0200

Use this acronym to recognize stroke symptoms and take action.

Atman P. Shah, MD

Life after lymphoma

Clinical trial helps Barry Rapport tackle treatment

Barry Rapport remembers the scene clearly. He was working in his office at a trust company when a doctor phoned. The physician asked if his family had a history of cancer.

It was October 2020.

“I remember dropping all of my files that I was holding and going a little numb,” said the Chicago resident, now 27.

One day earlier, Rapport had undergone a CT scan at an urgent care center to determine why his cough had lingered for months.

But he had neither COVID-19 nor allergies. He had lymphoma.

He lacked the telltale symptoms: night sweats, weight loss and fatigue. Yet the scan revealed swollen lymph nodes throughout his body, and fluid building up around his heart.

Rapport was stunned. He was 25 years old and felt healthy, working out five to six times a week.

The physician advised Rapport to go to an emergency room. He did.

A needle biopsy was inconclusive. That December, he underwent diagnostic surgery to remove a lymph node in his left armpit.

The results came back Dec. 16 and physicians’ suspicions were confirmed: Rapport had stage IV lymphocyte-depleted Hodgkin’s lymphoma.

“The roughly two months of waiting until you actually get the diagnosis is the absolute worst,” said Rapport. “There were a lot of sleepless nights. And you don’t think about anything else for those two months.”

Now it was time to focus on treatment. Through a friend of his aunt’s, Rapport learned about University of Chicago Medicine lymphoma expert Sonali Smith, MD. Smith immediately eased her patient’s anxieties about online claims he’d read about this particularly rare form of blood cancer.

Two weeks after receiving a diagnosis, Rapport received his first infusion as part of a six-month course of chemotherapy at UChicago Medicine. On Smith’s recommendation, he signed up for a clinical

trial that allowed him to avoid taking bleomycin, a common medication used to treat Hodgkin’s lymphoma that can be toxic to the lungs.

“From a medical perspective, he responded really well to the treatment,” said Smith. “The first scan we did after two months showed that he was already essentially in complete remission.”

Still, treatment was a grind. Rapport experienced heartburn and hiccups. A medical patch he wore to stimulate white blood cell growth resulted in aching bones. The steroids that alleviated his nausea led him to gain 40 pounds.

“There I was, at 25, taking as many pills as I remember my grandmother taking,” said Rapport, who worked throughout his treatment to distract himself. “I remember being a few months in and just not recognizing myself — losing the hair doesn’t help with that.”

However, gaining those extra pounds was a positive development.

“He started to gain weight, which I know he didn’t want to do, but that was a good sign,” said Smith. Most patients struggle with involuntary weight loss during chemotherapy treatments, she said.

Rapport is now approaching his two-year cancer-free anniversary. He speaks openly about his challenges of navigating survivorship at such a young age — handling relationships with friends who didn’t react as he expected toward his illness; pinpointing renewed purpose in his career; and braving the vagaries of a body he no longer trusts.

He recently noticed a dark spot on his back and became concerned it might be an early sign of secondary skin cancer caused by his treatment. A dermatologist assured him it was only a bruise.

“They tell you if you can make it two years, three years, five years and you’re still clean that you’re considered cured, which is great,” said Rapport. “But I’m still going to hyperfixate on any little thing.”

He encourages people to see a physician if they’re worried about a health issue — and to avoid the internet if they have cancer.

“Your doctor knows best,” said Rapport. “Talk to people and talk to other patients. Don’t keep it to yourself. Try as much as you can to practice gratitude, because — thankfully — science has come a long way.”

Sonali Smith, MD

lymphoma

— Patient Barry Rapport, pictured with his dog Charlie

Improving comfort, convenience and outcomes for patients with IBD

For more than a decade, Sharon RosatiWilkie needed a yearly colonoscopy to help manage her Crohn’s disease.

Now she has something far better: the University of Chicago Medicine’s new, state-of-the-art intestinal ultrasound (IUS) program.

UChicago Medicine is the second hospital in the country to routinely offer IUS, prompting patients from across the U.S. to travel to Chicago for the procedure.

THE LATEST IN INFLAMMATORY BOWEL DISEASE TREATMENT

The 15-minute, noninvasive ultrasound is similar to the one a pregnant person would have: Gel is applied to the abdomen and a probe is rolled over the area. Then a detailed, live look at the small bowel and colon appears on the screen.

The gastroenterologist can see how the treatment is working, show the patient what is happening in real time, and immediately determine if there’s inflammation, active disease or other complications.

» No colonoscopy prep is required.

» No sedation is necessary.

» There is no internal probe or discomfort.

» It can be done as often as necessary.

NO MORE COLONOSCOPY PREP

Rosati-Wilkie used to spend an entire night to prep and take the next day off work for a colonoscopy. Now, she just goes in for her routine clinic visit, has the IUS in the office and heads back to work within the hour. The efficiency saves everyone time and money.

Another benefit, Rosati-Wilkie said, is that she gets to see what’s going on in her body — something she couldn’t do while under sedation during a colonoscopy.

“This procedure gives me a lot of comfort, and that’s important to someone who has a disease that never goes away. You’re so much more at ease with an intestinal ultrasound,” said Rosati-Wilkie, 63, of Oak Brook, Illinois. “It’s a huge breakthrough.”

“IUS is a game-changing tool for monitoring Crohn’s disease or ulcerative colitis,” said

Noa Krugliak Cleveland, MD, Director of UChicago Medicine’s Intestinal Ultrasound Program. “It has not only been shown to improve patient outcomes, but also improves our patients’ understanding of their disease and shared decision-making with their provider.

IMPROVING CARE FOR INFLAMMATORY BOWEL DISEASE PATIENTS

Aside from being convenient for patients — so they don’t have to return to the office for another CT scan or colonoscopy and everything that goes along with that — it’s cost-effective, immediately gratifying and enables rapid follow-up, said David T. Rubin, MD, Rosati-Wilkie’s doctor and UChicago Medicine’s Chief of Gastroenterology, Hepatology and Nutrition.

“That’s the reason Sharon has benefited from the intestinal ultrasound. And she’s one of

David T. Rubin, MD Sharon Rosati-Wilkie

Noa Krugliak Cleveland, MD

many. Every patient we’ve offered this to has felt similarly,” he said.

Rosati-Wilkie was one of the first UChicago Medicine patients to try IUS in August 2022. Krugliak Cleveland was able to show her on the screen how her resection surgery healed and that her disease was in remission.

The findings helped guide her disease management and address other symptoms, knowing they weren’t due to active inflammation.

“It put me very at ease,” Rosati-Wilkie said. “This procedure will give so many people the opportunity to feel this way.”

Until now, physicians lacked a tool that allowed real-time, in-office imaging to see if their patients’ IBD was active and if treatment was working, Krugliak Cleveland said.

“Intestinal ultrasound is improving our understanding of IBD and the care of our patients,” she said.

Many people with IBD have symptoms flare when their disease is active, but some do not. There could be a lag time of several months between the time their disease becomes active and the development of symptoms. So, it is possible to have a disease relapse and not realize it.

That’s why proactive disease monitoring is so important for those with IBD. Regular monitoring can help prevent IBD from becoming active. It enables patients and their doctors to adjust treatment before they experience pain, urgent bowel movements and other uncomfortable symptoms, halting the progression of the disease and other poor outcomes.

The latest IBD monitoring option is intestinal ultrasound, which does not require any preparation and is performed in clinic by placing an ultrasound probe on the abdomen. Intestinal ultrasound can detect IBD relapse weeks before symptoms occur.

The University of Chicago Medicine

Inflammatory Bowel Disease Center is one of only a few IBD centers in the country — and the only one in the Midwest — to offer intestinal ultrasound to IBD patients.

Noa Krugliak Cleveland, MD, specializes in gastroenterology and serves as Director of the Intestinal Ultrasound Program at UChicago Medicine. Here, she answers common questions about intestinal ultrasound and how it can benefit patients:

WHAT ARE THE BENEFITS OF INTESTINAL ULTRASOUND FOR PEOPLE WITH IBD?

Intestinal ultrasound is the latest in treatment for Crohn’s disease and ulcerative colitis. This accurate, reliable technology can detect disease relapse weeks — if not months — before symptoms occur.

An intestinal ultrasound can verify if you are experiencing a relapse by displaying in real time what is happening inside your bowel. Then, you and your doctor can

IBD symptoms?

talk about how to modify your treatment so you feel better faster.

Intestinal ultrasound is also convenient. It doesn’t require any advance preparation like fasting or “bowel prep.” It is also painless and does not involve any radiation. It takes about 20 minutes or less to complete.

HOW DO DOCTORS AT UCHICAGO MEDICINE USE INTESTINAL ULTRASOUND TO MONITOR IBD?

Your IBD specialist may recommend that you have intestinal ultrasounds regularly to monitor your disease. By providing highly accurate images of your bowel, an intestinal ultrasound can measure the degree of active inflammation. Your doctor can then use this information to assess changes since your last visit.

Your doctor may also suggest having an intestinal ultrasound after you start a new therapy to check how your body is responding. Research suggests that intestinal ultrasound can show how well a treatment is working for you as early as two weeks. So, if a treatment isn’t controlling your inflammation, your doctor can quickly adjust your care plan.

HOW DO I GET AN INTESTINAL ULTRASOUND?

Your UChicago Medicine IBD specialist can determine if intestinal ultrasound would be beneficial for you. If so, one of our specially trained gastroenterologists can perform an intestinal ultrasound during your regular clinic visit.

Your doctor will apply gel to your abdomen and use a small probe to view the interior of your intestines during the procedure. The results are immediate, so you and your doctor can discuss whether changing your treatment regimen would improve your symptoms.

How can intestinal ultrasound help patients get ahead of

Reversing nonalcoholic fatty liver disease

One out of every four Americans has fatty liver disease, a condition where excess fat builds up in the liver and can cause damage.

Most people don’t know they have fatty liver disease. There are no symptoms.

It wasn’t on Kerry Sivia’s mind when she landed in the emergency room with severely swollen ankles in 2021. The then-36-yearold was diagnosed with nonalcoholic fatty liver disease (NAFLD) — a version of the disease where alcohol isn’t a contributing factor — and cirrhosis of the liver.

Cirrhosis is rare for someone Sivia’s age, especially since she rarely drank alcohol and has no family history of liver disease. However, when she was diagnosed, she weighed 310 pounds. Obesity is one of the main causes of NAFLD.

Sivia’s fatty liver disease probably went undiagnosed for a decade or more and likely caused her cirrhosis, said University of Chicago Medicine hepatologist Mary E. Rinella, MD, Sivia’s physician and an expert on fatty liver disease.

People with obesity and Type 2 diabetes should be screened for fatty liver disease, according to new recommendations published in January 2023 by the American Association for the Study of Liver Diseases. Rinella said the screening involves a simple blood test called FIB-4.

“If you can catch fatty liver disease early, and you’re able to treat it, then you should be able to prevent the development of cirrhosis,” said Rinella, who runs UChicago Medicine’s Metabolic and Fatty Liver Disease Clinic.

The FIB-4 test estimates liver scarring based on age, platelet count and liver enzyme levels. If the results exceed certain

thresholds, the person should be assessed with a liver stiffness test called a FibroScan™ to determine if there’s evidence of serious liver disease.

While not everyone with obesity or Type 2 diabetes develops liver disease, the growing obesity epidemic means more people are at risk. According to Rinella, anyone who either has health issues, drinks three or more alcoholic beverages daily or has a family history of cirrhosis should ask their doctor about a FIB-4 screening.

Sivia, now 38, was able to reverse her NAFLD by revamping her diet and exercising regularly, with support from the Metabolic and Fatty Liver Disease Clinic. She’s lost 100 pounds and halted the progression of her cirrhosis.

“Kerry really took the bull by the horns and got it together. She’s very inspirational. And she extended her own life,” Rinella said. “She could have helped herself more if she’d been screened for fatty liver disease 10 years ago. She’s a perfect example of why diagnosing it in the early stages can be transformational.”

Sivia hopes her story will inspire others to get tested for fatty liver disease and realize they can reverse the disease with weight loss.

Today, Sivia works as an administrative assistant and just started an Instagram blog about healthy living. She looks and feels better than ever.

“As much success that I have with this, I still have liver cirrhosis. I still have things as a result of that to deal with,” said Sivia, who lives in Gurnee. “With the guidance and support of Dr. Rinella and her team, I’ve been able to reverse my NAFLD and slow, or maybe even stop, my cirrhosis. I’m not currently in need of a liver transplant. I hope to keep it that way.”

Fatty liver disease is about to overtake alcohol as the main reason for liver transplants. The number of liver transplants due to fatty liver disease has increased fivefold over the last 10 years, Rinella said. Fatty liver disease quadruples a person’s chances of getting diabetes (if they don’t have it already) and increases their risk of heart disease and cancer.

“Fatty liver disease is a silent condition that’s slowly taking over as a really big cause of death and disease. But, we can change the narrative if we, as a healthcare community and society, take decisive steps to increase awareness and implement simple methods to identify those at greatest risk of cirrhosis,” Rinella said.

Patient Kerry Sivia, left, and Mary E. Rinella, MD

A SPORTS PHYSICAL will ensure your young athlete is ready to play

Participating in competitive sports can be a way for children and teens to be active, learn new skills and make friends. Before your student athlete suits up, however, a pre-participation physical evaluation — or, sports physical — can help determine if they are ready to fully participate.

“A sports physical can give confidence to the clinician, as well as to the student athlete, that they are in top condition to start the sports season,” said Allison H. Foster, MD, FAAP, a pediatrician at the University of Chicago Medicine. “It can also help to identify health concerns that need further examination.”

HOW DOES A SPORTS PHYSICAL DIFFER FROM A SCHOOL PHYSICAL?

School physicals look at a patient’s overall health such as the condition of their body (weight, height, ears, eyes and throat), as well as their social and mental well-being. Students may also receive required vaccinations during school physicals. Sports physicals focus on cardiovascular and orthopaedic health.

HOW SOON BEFORE THE SPORTS SEASON SHOULD A STUDENT ATHLETE HAVE A SPORTS PHYSICAL?

Students should obtain a sports physical exam prior to starting any new sports activity. During an annual school physical, the care provider will ask the patient about plans to participate in sports. If needed, the school physical may be extended to include the sports physical criteria, which most schools will accept.

WHO SHOULD PERFORM THE SPORTS PHYSICAL?

The student athlete’s primary care provider is the best person to perform the sports physical, whether that is a nurse

practitioner, pediatrician or other provider. The primary care provider will have an established relationship with the patient and family, and will be familiar with the patient’s family history.

WHAT ARE CLINICIANS LOOKING FOR WHEN PERFORMING A SPORTS PHYSICAL?

During the exam, the clinician listens to the patient’s heart to check for murmurs, extra heartbeats, skips or any other irregularities. The patient’s blood pressure and pulse will be taken while they are at rest and again after they exert themselves with an activity, such as by doing 25 jumping jacks. Next, the clinician will check for scoliosis and test the patient’s reflexes, noting mobility of joints and limbs. Finally, the clinician will perform a standard vision test to determine if there is a need to refer the patient to an optometrist or an ophthalmologist.

The clinician will also discuss family health history with the patient, particularly as it relates to cardiovascular health. This includes discussing family members that may have had arrhythmias, congenital heart disease and related issues.

HOW OFTEN SHOULD A STUDENT ATHLETE HAVE A SPORTS PHYSICAL?

In some instances, school districts will not accept a sports physical more than six months old. However, the longest interval that a student athlete should go without having a sports physical is one year.

WHAT HAPPENS IF THE STUDENT ATHLETE CAN’T PASS THEIR SPORTS PHYSICAL?

A student athlete would not pass their sports physical if they have an active, unresolved health issue and need a specialist for further evaluation. One example: The pediatrician could hear a new murmur and need to refer the patient to a cardiologist. Or, perhaps the patient had a recent concussion and was still experiencing symptoms. The primary care physician would not be able to clear the patient to participate in sports until those symptoms were resolved.

Allison H. Foster, MD, FAAP

Black maternal health: Tips for self-advocacy

In the United States, Black women are three to four times more likely to die from pregnancy-related causes than white women. Black patients are also 2.1 times more likely to experience severe maternal morbidity and 1.5 times more likely to have a preterm delivery when compared to white women.

Systemic racism is at the core of this disparity, according to the University of Chicago Medicine’s Jana J. Richards, MD, Assistant Professor of Obstetrics and Gynecology.

“There is nothing in a Black person’s genes or anything inherently wrong with their body that raises the risk for complications,” said Richards. “But treatable conditions can become life-or-death illnesses when implicit bias and systemic racism lead to delayed or missed diagnosis, delayed or withheld treatment, or disparities in access to health education.”

Efforts are underway on the national, state, local and community levels to address disparities in Black maternal health. Still, Richards urges those who are pregnant — and, in particular, Black women who may have elevated health risks — to become their own advocates during and after pregnancy, using these tips:

» Find a healthcare provider and inform them of anything that does not seem right. Ask questions about anything you

don’t understand. Do whatever you need to do to feel supported.

» Bring a support person with you to your appointments or have them present when talking to your provider.

» Review your visit notes and plan after your visit. Studies show that most patients retain only part of the information discussed during their visit. Now, with shared notes, you have an opportunity to review your electronic chart at any time.

» Try to find birth classes to learn about the basics of labor and delivery, including your options.

» Create a birth plan and discuss with your provider what options might be best for you. Understand that sometimes it’s necessary to adjust the plan based on what’s safest for you and your baby.

» Maintain social support systems during, before and after pregnancy. Support your mental and spiritual health by connecting with a therapist or a faith leader. Talk about the daily stressors and fears you may have about pregnancy.

Those who are pregnant with elevated health risks should recognize the signs of a medical emergency:

WARNING SIGNS AND SYMPTOMS OF A MEDICAL EMERGENCY DURING PREGNANCY

» Difficulty breathing

» Chest pain

» Racing heartbeat

» Persistent belly pain

» Persistent pain under the right breast

» Persistent headache

» Heavy vaginal bleeding

WORLD-CLASS CARE, CONVENIENT LOCATIONS

The University of Chicago Medicine’s multidisciplinary team cares for both birthing parents and babies through every phase of the pregnancy journey. We offer the full range of prenatal and postpartum care, from low-risk prenatal care with our midwives, obstetricians and gynecologists, to high-risk care with our highly skilled maternal-fetal medicine physicians and neonatologists. We also offer access to lactation consultants, community health workers, social workers and prenatal classes. Call 773-702-6118 to schedule an appointment.

» Feeling less movement from the baby

» Visual disturbances, such as flashes of light, dark spots or loss of vision

WARNING SIGNS AND SYMPTOMS OF AN EMERGENCY AFTER GIVING BIRTH

» Headaches that won’t go away with over-the-counter medicine

» Dizziness

» Blurred vision or blind spots

» Extreme swelling of the hands or feet

» Persistent temperature of 101 degrees Fahrenheit or higher

» Thoughts of hurting yourself or your baby

» Please call your provider and seek help even if the only thing you need is additional support with caring for your newborn baby.

Jana J. Richards, MD

Ingalls Memorial workshops address growing need for mental health services

South suburban Harvey, Illinois, has one of the highest rates of mental health-related emergency room visits in all of Cook County, according to the 2021-22 UChicago Medicine Ingalls Memorial Community Health Needs Assessment.

Through this assessment, Harvey-based UChicago Medicine Ingalls Memorial Hospital identified access to mental healthcare and services as a top health priority for those living in the 13 ZIP codes that make up the hospital’s community benefit service area. Major concerns around mental health include the stigma associated with mental illness, particularly in communities of color, and the need for mental health education among youth.

To help address mental health needs and disparities in the south suburbs, hospital leaders partnered with Felicia Houston, MA, LCPC, CWA, a licensed clinical professional counselor, to launch the Mental Wellbeing Spring Series. This free series of workshops, which Houston created and facilitates, is designed to empower participants to better

understand and manage their mental health and wellness.

The series ran from April to July, with workshops covering a different topic each month. The workshops were open to anyone interested in participating.

April’s workshop, titled “Stress Less, Live More,” held in Hazel Crest, Illinois, focused on women’s unique mental health concerns. The workshop explored the relationship between stress and mental health and identified practical coping and stress management skills. For example, Houston explained why prioritizing sleep, healthy eating habits and daily movement provides the foundation for managing stress and living a balanced life.

May’s hourlong virtual session focused on the impact of COVID-19 on mental health. Attendees learned about the stigma associated with talking about mental health and effective strategies for managing emotions.

Houston plans to offer additional virtual sessions in the future. “There are so many advantages to a virtual option. Not only is it convenient, but we can reach people who may never step foot on the hospital campus,” said Houston.

Some UChicago Medicine staff members have also participated. Suzanne Lino, MSW, Community Benefit Project Manager at UChicago Medicine, found the session valuable in addressing mental health concerns that can affect anyone.

“I think this workshop series is so important. Everyone’s mental wellness changed due to the pandemic. I know for me, as someone who works in a 100% remote capacity, it’s key to be intentional about taking mental health breaks throughout the day,” said Lino.

According to Houston, mental health breaks can lower one’s heart rate, center the mind and promote relaxation in the midst of a stressful situation. A mental health break can include taking a walk around the block, calling a friend for a 10-minute chat or listening to a favorite song.

Houston hopes to offer more mental health workshops in the future, especially for youth in the community.

“The positive response has been overwhelming. The community wants more sessions,” said Houston. “There is a huge need for additional mental health services in the south suburbs. These workshops are transforming communities one resident at a time.”

‘Transforming communities one resident at a time’

Felicia Houston, MA, LCPC, CWA, leads an April 2023 workshop as part of Ingalls Memorial’s Mental Wellbeing Spring Series.

Supporting trauma recovery programs

Grants awarded to organizations that aid youths, families

Southland RISE (Resilience Initiative to Strengthen and Empower), a collaboration between the trauma recovery programs of the University of Chicago Medicine and Advocate Health Care, awarded 19 South Side community organizations with a total of $150,000 for their summer youth programs. These programs will provide more than 5,000 community members with opportunities to participate in a variety of activities that include dance, gardening, video production and sports, while also building their skills around leadership, resiliency and conflict resolution, among others.

Over the past five years, Southland RISE has awarded $650,000 to support more than 50 community-based programs focused on violence prevention and trauma resiliency for youth and families on Chicago’s South Side. The Southland RISE grant awardees are all 501(c)(3) nonprofit organizations within the service areas of Advocate Health Care and UChicago Medicine.

“Young people in every community deserve access to spaces where they are not only safe, but where they can learn, laugh and become leaders,” said Brenda Battle, RN, BSN, MBA, and UChicago Medicine’s Senior Vice President for Community Health Transformation and Chief Equity Officer. “Through Southland RISE, UChicago Medicine can partner with more community-based organizations and engage youth and families in creative and diverse programming that emphasizes violence prevention, resiliency from trauma and mental health.”

The 2023 grant recipients will serve community members across 29 neighborhoods and 17 ZIP codes, primarily on Chicago’s South Side. This year, three Southland RISE grantees are in the south suburbs. One of the three, Disruptive INC,

Community investment increases

The University of Chicago Medicine provided $686.2 million in benefits and services to communities on Chicago’s South Side and in the south suburbs in fiscal year 2022, according to the annual Community Benefit Report. This includes $586.7 million through the University of Chicago Medical Center and $99.5 million through UChicago Medicine Ingalls Memorial. Total investment increased by 13.1% over fiscal 2021. Read the report online:

Community.UChicagoMedicine.org/2022

is serving residents in Harvey, providing STEM-related educational and career development resources to justice-impacted single mothers who participate in their “Mother’s Day Isn’t Just in May” program.

“Because of belief in our program, we’re able to fully sponsor many deserving women who are moving into the next phase of their life post-incarceration,” said Disruptive INC founder Catherine McNeil, MA.

Southland RISE was launched in 2019 by UChicago Medicine and Advocate Health Care to strengthen and integrate

the two health systems’ violence recovery and trauma programs. Southland RISE was inspired by U.S. Sen. Dick Durbin’s Chicago HEAL (Hospital Engagement, Action and Leadership) Initiative, which encourages the Chicago area’s healthcare providers to help reduce community violence and address healthcare needs associated with violence recovery.

Building trauma resiliency is one of the top three health priorities for the South Side service area, according to UChicago Medicine’s 2021-22 Community Health Needs Assessment.

Fathers, Families and Healthy Communities is a 2023 Southland RISE grant recipient. The group works with formerly incarcerated fathers.

Ullman family gift supports novel breast cancer research

In honor of family patriarch Don Ullman, who was diagnosed with cancer in 2009, the Ullman family has long supported cancer research at the University of Chicago Medicine. Last year, their gift supported novel research through an award that recognizes the power of many minds working together — “team science.”

The outstanding care Don received at UChicago Medicine prolonged his life for four years, after an initial prognosis of only four months. In gratitude, the family established the Ullman Family Scholars Fund in Cancer Immunology, the Ullman Family Fund in Cancer and the Ullman Family Team Science Award.

“One in two men and one out of three women will get cancer,” said Justin Ullman, president of the University of Chicago Cancer Research Foundation Board of Trustees. “I think about that when we gather as a family. Cancer has already taken too many loved ones from us.”

The power of team science lies in the collective work of researchers from an array of disciplines who tackle complex scientific challenges together. Ultimately, these teams can have a faster, larger impact than any one researcher working alone, shortening the timeline from laboratory research to clinical trials. In September 2022, seven researchers from diverse scientific backgrounds won the Ullman

Family Team Science Award for a proposal to investigate novel therapies for triple-negative breast cancer.

Triple-negative breast cancer is notoriously hard to treat since it does not respond to hormone therapy or the targeted anti-cancer drug Herceptin. Treatments are limited primarily to radiation and chemotherapy, which are hard on the patient.

The winning project will gather preliminary data on a novel therapy and drug delivery system to address these challenges. Chemists, cell biologists, cancer researchers, and cancer surgeons identified a type of protein, called a transcription factor, found in the cells of triplenegative breast cancer tumors as a potential target for therapy. They also proposed a cell-permeable drug delivery system, which could deliver the drug directly to a tumor and spare healthy tissue. The award provides seed money critical to starting the process of gathering data and testing theories, with the goal of bringing a new therapy to clinical trials.

Kunle Odunsi, MD, PhD, director of the Comprehensive Cancer Center, who announced the award, said the goal of the research is improved treatment for patients. “The ultimate yardstick of our work is to be able to help people.”

Justin Ullman, president of the University of Chicago Cancer Research Foundation Board of Trustees

From left: Xiaoyang Wu, PhD; Kunle Odunsi, MD, PhD; Suzanne Ullman; and Nan Chen, MD, at the presentation of the Ullman Family Team Science Award.