Imagine - Fall 2014 - University of Chicago Medicine

FALL 2014

TAKE HEART New technology is changing the game for patients with advanced heart failure

INSIDE THIS ISSUE Q&A with a Heart Failure Expert Robotic Bypass Leads to Quick Recovery Preserving a Young Ballplayer’s Hip Baby’s Lifesaving Liver Surgery

The University of Chicago Medicine & Biological Sciences has been at the forefront of medical care, research and teaching for more than 90 years. Located in historic Hyde Park on the South Side of Chicago, the University of Chicago

GREETINGS FROM THE FOREFRONT OF MEDICINE

Medicine & Biological Sciences includes: Patient Care » Bernard A. Mitchell Hospital » Center for Care and Discovery » Comer Children’s Hospital » Duchossois Center for Advanced Medicine » Numerous outpatient locations throughout the Chicago area Teaching Programs » Pritzker School of Medicine » Master’s and doctoral degree programs » Postdoctoral programs Research » Medical and basic science units Among our many honors and acknowledgments: 12 Nobel laureates; ranked 11th of all U.S. medical schools; one of only 41 National Cancer Institute–designated comprehensive cancer centers; ranked fifth in nation for National Institutes of Health grant

Our physicians provide innovative treatments and expert care for patients with complex heart and vascular conditions.

support per researcher.

University of Chicago Medicine & Biological Sciences Executive Leadership Kenneth S. Polonsky, MD, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago Sharon O’Keefe, president of the University of Chicago Medical Center Jeffrey Glassroth, MD, dean for clinical affairs, University of Chicago Medicine T. Conrad Gilliam, PhD, dean for basic science, Biological Sciences Division Holly J. Humphrey, MD, dean for medical

Many patients come

mother’s heart surgery when he felt ill.

Chicago Medicine

Our interventional cardiologists repaired

for our expertise in

a rare, life-threatening leakage in two

evaluating and treating

of his arteries, and he was at his mother’s

the most challenging

side for her recovery.

education, Pritzker School of Medicine

illnesses. In this issue of Imagine, we focus

IMAGINE IS PUBLISHED THREE TIMES

on the highly advanced care we offer

A YEAR BY THE UNIVERSITY OF CHICAGO MEDICINE & BIOLOGICAL SCIENCES. Editor: Anna Madrzyk Assistant Editor: Gretchen Rubin Email us at: imagineeditor@uchospitals.edu Design: TOKY Branding + Design Contributing writers

looking for an alternative to open heart

vascular conditions. You’ll meet several

surgery, a robotic heart surgeon and

patients who benefited from our innovative

an interventional cardiologist worked

treatments and expert care:

in tandem to perform two minimally invasive procedures in the same

» After his heart stopped three times, Roy Sammons was airlifted to UChicago

Kevin Jiang, Eileen Norris, Angela Pirisi,

Medicine to be treated by our advanced

and Matt Wood Contributing photographers David Christopher, Ashley Heher, Kevin Howe, Robert Kozloff, Jean Lachat, Andrew Nelles and David Proeber ADDRESS

» When Leroy Cooper came to us

for individuals with complex heart and

Thea Grendahl Christou, John Easton, Gretchen Rubin, Tiffani Washington

» Gerald Gill was in Chicago for his

to the University of

operating suite. Cooper was back on the golf course less than two weeks later.

heart failure experts. Thanks to a

To read more patient stories and to learn

permanent mechanical pump, he is able

about our state-of-the art treatments,

to enjoy life at home with his wife.

please visit us online at uchospitals.edu.

Thank you for your interest in the University of Chicago Medicine.

The University of Chicago Medicine 5841 S. Maryland Ave., Chicago, IL 60637 The University of Chicago Medicine Comer Children’s Hospital 5721 S. Maryland Ave., Chicago, IL 60637 Telephone 1-773-702-1000 Appointments 1-888-824-0200 Follow the University of Chicago Medicine

SHARON O’KEEFE President of the University of Chicago Medical Center

on Twitter at twitter.com/UChicagoMed or visit our Facebook page at facebook.com/ UChicagoMed. You can read more about our news and research at uchospitals.edu/news and at sciencelife.uchospitals.edu.

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 right away.

Read Imagine online at uchospitals.edu/imagine.

KENNETH S. POLONSKY, MD Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago

AT THE FOREFRONT OF

HEART AND VASCULAR CARE

CLINICAL TRIAL

CARDIAC IMAGING

Tiny Pacemaker Works without Wires

Looking into Your Heart

Nanostim is a single-chamber pacemaker, the simplest form of pacing. It was developed specifically for patients with bradycardia, a heart rate that is too slow. Approximately 10-15 percent of patients who require a pacemaker could be candidates for this device, according to the manufacturer.

Lamb Moore holding a miniature pacemaker

Imagine a miniature cardiac pacemaker, about the size of a AAA battery, that can be implanted directly into the heart without surgery.

University of Chicago Medicine patient Lamb Moore, 75, was the first person in Illinois to receive the device, currently being tested in a nationwide clinical trial.

Moore received the Nanostim pacemaker in July. In addition to an abnormally slow heart rate, he has a form of T-cell lymphoma that primarily affects the skin. It can weaken the immune system.

Moore’s doctors had previously implanted two standard pacemakers in a small pocket under his shoulder, with lead wires connecting the device to his heart. But both times, he quickly developed an infection surrounding the implant.

The Nanostim leadless pacemaker from St. Jude “Of the three pacemakers I’ve Medical does not require the had, this has been the best lead wires that connect most one,” Moore said. “I can tell conventional pacemakers to the it’s working. I don’t get so worn heart. It also leaves no visible out now. I can go all day, and I lump or scar on the chest. sleep better at night.”

“We think it could prove to be a good alternative, especially for patients who have had problems caused by a traditional pacemaker implant,” said UChicago Medicine electrophysiologist Hemal M. Nayak, MD.

The experimental pacemaker is currently available only as part of the LEADLESS II Clinical Trial, a multicenter study designed to evaluate its safety and effectiveness.

UChicago Medicine is one of two Illinois hospitals participating in the trial.

The physicians of the University of Chicago Medicine Cardiac Imaging Center use the most advanced noninvasive and minimally invasive approaches to see inside the heart, figure out what is wrong and determine the best way to fix it. Our specialists are not only expert interpreters of cardiac imaging studies, but they also train others to perform and read the studies.

chest pain. Some conditions that previously required invasive tests can now be diagnosed noninvasively with cardiac MRI. Cardiac Computed Tomography (CT) Angiography

A noninvasive imaging technology, CT angiography helps physicians identify blockages and narrowing of the arteries, and establish

WE USE THE NEWEST TECHNOLOGIES TO MINIMIZE RADIATION EXPOSURE AND CONTRAST USE FOR OUR PATIENTS.

Echocardiogram

A valuable tool for diagnosing many types of heart disease, echo uses sound waves to check the heart’s structure, movements and blood flow.

Our physicians pioneered three-dimensional echo as well as the use of safe contrast agents for improving image quality.

Cardiac Magnetic Resonance Imaging (Cardiac MRI)

Cardiac MRI produces detailed images of the beating heart.

This tool helps doctors evaluate blood flow abnormalities and heart muscle disease and can uncover the cause of a patient’s heart failure or

future heart attack risk. Our highly advanced 256-slice CT scanner provides sharp, 3D images while minimizing radiation exposure.

Positron Emission Tomography (PET) and Single-Photon Emission Computed Tomography (SPECT)

PET and SPECT are types of nuclear cardiac imaging tests using low-dose radioactive tracers to detect areas of inflammation and blood flow in the heart. Physicians use the tests to identify patients at high risk for coronary heart disease and to diagnose heart damage related to a heart attack or other heart illnesses.

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| B E L OW |

Jayant M. Pinto, MD, holds a Sniffin’ Stick.

Imagine that!

SNIFFING OUT TROUBLE

“Doesn’t pass the smell test” takes on a more ominous meaning in light of recent research findings: Thirtynine percent of subjects ages 57 to 85 who failed a simple smelling test had died five years later, compared to only 10 percent with a normal sense of smell.

UChicago Medicine researchers found that smell loss was better at predicting mortality than a diagnosis of heart failure, cancer or lung disease.

For those already at high risk, lacking a sense of smell more than tripled the probability of death. “Loss of the sense of smell doesn’t directly cause death, but we think it’s an early warning that something has gone badly wrong,” said ear, nose and throat surgeon Jayant M. Pinto, MD, lead author of the study published in the journal PLOS ONE.

CANCER’S FINANCIAL SIDE EFFECTS

Along with the distress and discomforts that accompany cancer treatment, many patients struggle with “financial toxicity” — anxiety over facing large, unpredictable expenses, often compounded by decreased ability to work.

After consulting more than 150 patients with advanced cancer, University of Chicago Medicine cancer specialists designed a novel tool to measure this burden. Named COST (for COmprehensive Score for financial Toxicity), it includes 11 short, easy-to-understand questions. The patient-reported measurement tool was described in the July issue of Cancer. “This is another important piece of information for the shared-decision-making process,” said study author Jonas de Souza, MD. “If we can identify which patients are most at risk, we can get them the assistance they need.”

AT THE FOREFRONT

LIKE US! FOLLOW US! The University of Chicago Medicine is on NurseJournal.org’s list of the Top 100 Social Media Friendly Hospitals in the country.

FACEBOOK

Facebook.com/ UChicagoMed TWITTER

@UChicagoMed

READ MORE AT ScienceLife. uchospitals. edu @ScienceLife

DEPRESSION AND PROSTATE CANCER

Men diagnosed with both prostate cancer and depression have worse survival rates and are less likely to undergo proactive treatment such as surgery or radiation therapy, more often choosing to simply monitor the cancer’s progression. Scott Eggener, MD, co-director of the prostate cancer program at the University of Chicago Medicine, was among a team of researchers who studied Medicare data and found clear differences in outcomes for prostate cancer patients who also have depression.

“Our study points to the need for greater awareness of the effects of depression in these patients,” Eggener said. “We focus on the specifics of the cancer and probably underappreciate the effects of medical conditions like depression.” The analysis was reported in the Journal of Clinical Oncology.

PROMISING PROBIOTICS

Food allergies affect 15 million Americans, and the number continues to rise. In a major breakthrough toward prevention and treatment, University of Chicago scientists have identified a potentially promising novel probiotic therapy. A team led by Cathryn Nagler, PhD, the Bunning Food Allergy Professor of Pathology, investigated food allergies in laboratory models. The researchers found that common gut bacteria known as Clostridia seem to prevent allergens from entering the bloodstream. They announced their discovery in Proceedings of the National Academy of Sciences. “It’s exciting because we have a way to intervene,” Nagler said. “This is absolutely testable as a probiotic therapy against a disease for which there’s nothing. As a mom, I can imagine how frightening it must be to worry every time your child takes a bite of food.”

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AT THE FOREFRONT

PRESERVING A YOUNG ATHLETE’S GAME “We see FAI in young athletes because they perform extreme pivoting maneuvers while playing rigorous sports,” said Kang, noting that Payne also plays golf and basketball. FAI can lead to early arthritis and hip replacement.

Just a few hours after Chase Payne got his surgeon’s clearance to play baseball on a limited basis, he batted the game-winning hit.

“I muscled it into right field and brought the guy on second base in,” said Payne, 17, a pitcher and center fielder for the Lexington High School Minutemen in Lexington, Ill. Following the game, Payne quickly emailed University of Chicago Medicine orthopaedic surgeon Richard W. Kang, MD, MS, to share the news. “He was very excited for me,” Payne said. A month later, Kang approved a full release for the rest of the season.

Payne’s hip trouble started in 2013, while he was attending a summer baseball camp at Florida State University. He dove into base and felt “something weird in my back,” he recalled. “I was confined to bed for the rest of camp.”

Physicians in Florida and in Illinois thought it was a back injury. But when a spine surgeon in Peoria, Ill., determined the problem was in Payne’s left hip, he referred him to Kang, an expert in hip preservation.

In January 2014, Kang performed arthroscopic surgery on Payne’s hip.

Using minimally invasive tools, he removed loose bone and repaired the labral tear. He then reshaped the ball and socket. “The goal of the surgery is to relieve pain while preserving the hip joint and its function,” Kang said.

Anxious to get back on the field, Payne followed Kang’s strict protocol for recovery, returning to his team in three months.

A local sportswriter credited him with breathing new life into the Minutemen.

“My hip feels amazing,” said Payne, who dreams of playing baseball for the Division I Florida State Seminoles. “I have more range of motion and I am not afraid to do any type of movement.

I think the hip is actually better power-wise.”

| A B O V E | University of Chicago

Medicine orthopaedic surgeon Rex Haydon, MD, PhD, talks with runners at a recent CARA-certified race.

We’re excited to be the official hospital of the Chicago Area Runners Association (CARA), serving on the medical team at races and providing education and advice for runners.

Read the UCM Medical Minute on the CARA website at bit.ly/1i1dXUM.

Our sports medicine experts care for all ages and skill levels, from young competitors and weekend athletes to seasoned pros.

Call 888-824-0200.

Where to find us:

“The first time I saw Chase, he could barely walk,” Kang said.

“He couldn’t take a step without debilitating pain.”

IN CHICAGO

Kang diagnosed Payne with femoroacetabular impingement (FAI), an injury of the hip joint. Because the bones in Payne’s hip had structural abnormalities, the ball of the thighbone was striking the edge of the hip socket. The resulting friction had damaged the joint and torn the labrum (a ring of cartilage in the hip socket).

University of Chicago Medicine » 150 E. Huron » 5758 S. Maryland IN MATTESON, ILL.

4749 Lincoln Mall Drive Suite 500 IN RIVER FOREST, ILL. | RIGHT |

Chase Payne

7411 W. Lake St. Suite L180 Visit uchospitals.edu/ortho

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People need to know there is help out there and not to give up.

CAROL SAMMONS, ROY’S WIFE

A NEW LIFE, A GOOD LIFE Roy Sammons, 74, went into cardiac arrest three times after being hospitalized for complications from heart failure in early June. His wife and children thought it was the end.

“The doctors told us that it was time to let him go,” said Carol Sammons, Roy’s wife of 54 years and his high school sweetheart.

“I responded with, ‘Well, I can’t do that.’”

Roy was airlifted to the University of Chicago Medicine, one of just a few hospitals in the Chicago area offering a heart failure, mechanical circulatory support and heart transplant program. Nir Uriel, MD, an expert in the treatment of advanced heart failure, leads the multidisciplinary team.

When to See an Advanced Heart Failure Specialist If you have heart failure and any of the following: CAN’T WALK ONE BLOCK WITHOUT SHORTNESS OF BREATH SIGNS OF KIDNEY FAILURE

“When Roy arrived, his heart was not pumping enough blood to meet the needs of the body,” Uriel said. “He was near death.”

CAN’T TOLERATE HEART FAILURE MEDICATIONS DUE TO LOW BLOOD PRESSURE

Due to his age and condition, Roy was not a candidate for heart transplant. But Uriel and Valluvan Jeevanandam, MD, chief of cardiac and thoracic surgery, offered the family an alternative: a surgically implanted portable pump, called a left ventricular assist device, or LVAD (pronounced el-vad), to support Roy’s heart and restore its function.

NEED A HIGH DOSE OF DIURETICS

The mechanical pump of an LVAD rests inside the chest or in the abdomen and is connected directly to the heart. The device

HOSPITALIZED DUE TO HEART FAILURE IN THE PAST SIX MONTHS

pumps blood from the left side of the heart into the aorta, the large vessel that circulates blood to the rest of the body. A small external computer, or controller, runs the pump. Batteries or electricity from an outlet powers the device.

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When LVADs were first introduced, they were designed to keep critically ill patients alive until they could get new hearts. But today’s more advanced and smaller devices are increasingly used as a long-term alternative to transplant.

“Today we are in a different time with this disease,” Uriel said. “Many more advanced heart failure patients are now benefiting from mechanical circulatory support.”

But, he cautioned, the technology has limitations and requires care, attention and commitment from the patient and the family. “Life on an LVAD is a life on batteries, gadgets and alarms. There is no going back.”

Roy’s family didn’t hesitate to choose the LVAD surgery. “The kids and I looked at this as a lifesaving choice for their dad, my husband,” Carol said. “Dr. Uriel and the surgical team were like knights in shining armor to us.”

On June 10, 2014, Jeevenandam implanted Roy’s mechanical device. Roy spent two weeks recovering in the hospital, followed by three weeks in a rehabilitation facility.

Now back in his Braidwood, Ill., home, he is improving every day.

“It is not the life we had, but it is a good life,” Carol said. “It’s a new direction for us, thanks to Dr. Uriel and the University of Chicago Medicine. People need to know there is help out there and not to give up.”

For more information about care for advanced heart failure, visit uchospitals.edu/heart-failure.

Courtesy of HeartWare, Inc.

AT THE FOREFRONT

Left ventricular assist devices (LVADs) pump blood in a continuous flow from a weakened left ventricle into the aorta. The pump is connected to an external controller through a cable that exits through the patient’s skin.

The controller is powered by lithium ion batteries or electricity from a wall or car outlet.

The University of Chicago Medicine Heart Failure Program CARDIOLOGY NIR URIEL, MD

Director, Heart Failure, Transplant and Mechanical Circulatory Support SAVITRI E. FEDSON, MD GENE H. KIM, MD

Ask the Expert NIR URIEL, MD Nir Uriel, MD, is director of the heart failure, transplant and mechanical circulatory support program at the University of Chicago Medicine.

therapy. LVADs represent a new horizon for the many patients who are ineligible for heart transplant or who cannot get a donor organ.

WHAT ARE THE TREATMENT OPTIONS FOR ADVANCED

HOW DOES YOUR TEAM DECIDE WHAT TREATMENT

HEART FAILURE?

TO RECOMMEND?

We can help patients who have damaged or weakened hearts with medication, pacemakers/defibrillators, rehabilitation therapy and lifestyle changes. But the disease eventually progresses and the heart can no longer pump enough blood to meet the needs of the body. Heart replacement therapies, including heart transplant and left ventricular assist devices (LVADs), are the current treatments for advanced heart failure. Heart transplant still offers the best quality of life. But with improvements in mechanical circulatory support technology, this may change.

We work together across multidisciplinary lines — cardiology, cardiac surgery, interventional cardiology, imaging, nursing, social work and psychiatry.

We have the experience to identify which patients will do well with an LVAD or a transplant based on medical need, readiness and the patient’s support system.

WHAT ARE LVADS?

LVADs are heart pumps that push the blood from the heart into the main artery (aorta). These mechanical pumps were initially devised as a bridge to transplant, but we now offer them as a long-term

WHAT IS REWARDING ABOUT TAKING CARE OF HEART FAILURE PATIENTS?

Heart failure is not similar to other conditions. We see sicker patients, and we care for them for a long time. We become part of their lives and vice versa.

Sometimes we have ups and downs. It’s like a marriage; we are in it together. The joy of seeing my patients enjoy life with their families drives my work.

GABRIEL SAYER, MD

CARDIOTHORACIC SURGERY VALLUVAN JEEVANANDAM, MD

Chief, Cardiac and Thoracic Surgery DAVID ONSAGER, MD TAKEYOSHI OTA, MD, PHD

MONTHLY SUPPORT GROUP

The University of Chicago Medicine offers a monthly support group for patients with advanced heart failure who require heart replacement therapy. For more information, contact Diane White at 773-702-9396.

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ALL IN THE FAMILY

Atman P. Shah, MD, co-director of the cardiac catheterization laboratory.

Gerald Gill flew to Chicago to be with his mother for her heart surgery. As it turned out, he was in the right place at the right time.

Within the next 18 hours, the hospital would coordinate Gerald Gill’s out-ofstate insurance coverage, complete an echocardiogram and other imaging tests, and schedule him for a procedure the next day.

Gill, 60, of Madeira Beach, Fla., previously had a coronary bypass and also had been diagnosed with aortic stenosis, a narrowing of the heart’s aortic valve. Lately, he’d been feeling tired and short-winded.

“He actually didn’t have aortic stenosis,” Shah said. “The angiogram showed he had two branches off of his bypass graft that were uncharacteristically stealing blood from his heart.” It was a unique problem, and Shah opted for an innovative approach. “We used vascular plugs to stop the leakage so the blood could flow to the heart.” Because of the large size of the arteries involved, the team had to use a type of plug that hadn’t been used for this purpose before. It worked.

His 78-year-old mother, Betty Gill, was scheduled to have an aortic valve replacement and bypass surgery at the University of Chicago Medicine. Betty, who is a Jehovah’s Witness, chose the medical center because of its expertise in bloodless heart surgery.

JEEVANANDAM

While they were meeting with her surgeon, Valluvan Jeevanandam, MD, chief of cardiac and thoracic surgery, Betty looked at her son and got worried.

“I thought to myself, he’s in worse shape than me,” she recalled. “I was even ready to give up my surgical date if he needed it.”

That’s when she asked if someone could examine her son. Jeevanandam sent him to interventional cardiologist

Symptom-free immediately after the procedure, Gerald was back at his mother’s side by the time she woke up in recovery.

“I was at the best place I could ever be — we both were,” she said. “The best of care, the best of advice — what they did is absolutely beyond words. I have nothing but praise for the doctors, surgeons and staff at the University of Chicago Medicine.”

For more information on the University of Chicago Medicine Cardiac Center, visit uchospitals.edu/cardiac-center.

The fact that we were able to treat Gerald’s unusual problem, as well as his mother’s complex surgery, really highlights our unique capabilities.

VALLUVAN JEEVANANDAM, MD

| O P P O S I T E PA G E |

Gerald Gill and Buddy, Betty Gill

Interventional cardiologist ATMAN P. SHAH, MD,

BETTY GILL

specializes in minimally invasive treatments for patients with complex structural heart disease.

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ABOVE PAR Cooper had significant blockages in two of his major arteries. Because of their location, a robotic approach by itself wouldn’t work, Balkhy said. Instead, he recommended a hybrid solution for clearing Cooper’s blockages without opening his chest.

Leroy “Rocky” Cooper

Although it would mean missing his weekly golf game, Leroy “Rocky” Cooper, 61, knew his heart problem had to be fixed.

But he was reluctant to have open heart surgery.

“I thought there must be a better way,” said the Frankfort, Ill., resident.

His research led him to Husam H. Balkhy, MD, director of minimally invasive and robotic cardiac surgery at the University of Chicago Medicine. Balkhy is one of a handful of surgeons in the country doing a large volume of robotic coronary procedures.

First, Balkhy would perform a robotic coronary bypass. Then interventional cardiologist Sandeep Nathan, MD, MS, would perform an angiogram to check the status of the new bypass graft, followed by angioplasty and stent placement using catheter-based techniques.

Although each physician has done hundreds of these cases, the duo had never performed the two procedures together on the same day in the same operating room. Cooper would be the first.

Getting a Leg Up on Varicose Veins Why come to the University of Chicago Medicine for varicose vein treatment?

room,” said vascular surgeon Robert Steppacher, MD.

“We’re board-certified vascular surgeons with state-of-the-art tools who have cared for a lot of patients with varicose veins, and we offer a full spectrum of care,” said vascular surgeon Ross Milner, MD.

Venous ablation begins with the insertion of a tiny catheter to deliver radiofrequency energy inside the vein, heating the vein wall. The enlarged vein shrinks and closes, and the blood flows to other, healthy veins. The procedure results in little or no pain and minimal bruising, and patients typically are able to return to normal activities within a day.

Treatment at the University of Chicago Medicine Vein Clinic starts with a comprehensive evaluation by a vascular specialist and simple, noninvasive testing. Specially fitted stockings can help relieve painful symptoms while advanced treatment is being planned.

“The good news for patients is that this common condition can now be treated with same-day, minimally invasive procedures that do not require general anesthesia or a trip to the operating

He was all for it. “I liked that it was all being done at once,” he said.

“The approach is quite novel,” Nathan said. “I don’t know of another place that combines a totally endoscopic surgical approach with leading-edge interventional techniques in quite the same way. But it makes perfect clinical sense and benefits the patient greatly.”

Cooper had the surgery on July 10. That evening, he was pleased that despite having had two teams unclog and reroute the arteries that delivered blood to his heart, he had little or no pain.

Twelve days after his pioneering operation, Cooper played 12 holes on the golf course. “I got tired, but it was fine,” he said.

“It was good just to be out there.”

Varicose veins can be unsightly and cause leg fatigue, aching and swelling. Although they’re hereditary, there are things you can to do to stave off venous disease.

MAINTAIN A HEALTHY BODY WEIGHT. IF YOU’RE PREGNANT, WEAR COMPRESSION STOCKINGS

Other options include sclerotherapy (injection of a fluid to collapse the vein) and microphlebectomy (removal of surface veins).

in the second and third trimester.

Added weight and pressure on the blood volume in the legs during pregnancy can contribute to the development of varicose veins.

For more information about varicose veins, visit uchospitals.edu/ vein-clinic.

HIGH HEELS CAN AGGRAVATE

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if you already have venous disease, so consider wearing flats most of the time.

SYMPTOMS

Baby Elizabeth’s Lifesaving Liver Surgery A biopsy confirmed the suspected diagnosis: biliary atresia, a progressive liver disease that is the most common indication for liver transplantation in children.

Azzam and Lo recommended the Kasai procedure — an operation in which the damaged bile ducts are removed and a segment of the small intestine is sewn directly to the liver, recreating the bile drainage system.

“Time was of the essence,” said Azzam. For 20 to 25 percent of infants who undergo the surgery in the first two months of life, the procedure delays the need for transplantation. In some, it may completely eliminate the need for transplant.

Lo performed the Kasai surgery in July 2013.

Elizabeth recovered quickly.

“Her color improved right away,” said Leah, “and her bilirubin levels were back to normal by our follow-up hospital visit.”

Elizabeth Woodcock

Many busy young families rely on a to-do list. But for Leah and Matthew Woodcock of Montgomery, Ill., checking off items on their dry erase board was a matter of life and death.

Their lengthy list detailed medication reminders as well as their infant daughter Elizabeth’s ever-changing tube and bottle feedings. “Looking back, I’m not sure how we did it,” Leah said. “But, thanks to prayer and the medical team at Comer Children’s Hospital, she is now healthy.”

Soon after Elizabeth was born in May 2013, a blood test showed abnormally high bilirubin levels. Elevated bilirubin causes jaundice and indicates inflammation of the liver or blockage of bile ducts.

At first, the bilirubin numbers trended down.

“But she was jaundiced,” said Leah, “and getting her enough nutrition was a struggle.”

At Elizabeth’s two-month checkup, her bilirubin level was 7 (normal range is 0.1 to 1). She weighed a little less than 10 pounds, placing her in the 5th percentile for her age. She was admitted to the University of Chicago Medicine Comer Children’s Hospital under the care of pediatric liver specialist Ruba K. Azzam, MD, and pediatric surgeon Andrea Lo, MD.

But Elizabeth was still not feeding well.

Her growth was slow, and she had signs of progressive liver disease. Listed for liver transplantation in January 2014, she was started on comprehensive nutritional support. A nasogastric, or NG, tube was placed to bring nutrients directly into her stomach. Matt and Leah followed a strict feeding regimen for seven months.

By spring 2014, Elizabeth weighed 22 pounds, reaching the 67th percentile.

Her liver disease had subsided, and she no longer needed the NG tube. In July, the medical and transplant teams changed her transplant status to inactive.

Recently, Leah erased the family’s medical to-do list on their refrigerator for the last time. “It’s almost too good to be true,” she said.

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Stanley Liauw, MD Associate Professor of Radiation and Cellular Oncology

Everybody has a gift.

Stanley Liauw, MD, has a gift for changing patients’ lives. Take Pat Navin. Diagnosed with an aggressive form of prostate cancer, he underwent surgery followed by hormone therapy and radiation under Liauw’s supervision. After eight weeks of Monday-through-Friday radiation treatments—to which he bicycled 44 miles round-trip to UChicago from his home in Evanston, Illinois—Navin is now cancer-free. “One thing I’ve really come to appreciate about the medical center is the amount of effort that’s put into research, because that’s where the breakthroughs happen,” he says.

In gratitude, Navin turned his daily bike rides into a fundraiser to support Liauw’s research projects, including tracking outcomes for prostate cancer patients to identify factors associated with treatment success and quality of life. Liauw’s work also includes potentially life-changing clinical trials. One involves a new treatment regimen that could save the bladders of patients with bladder cancer; another is testing the delivery of large, precisely targeted amounts of radiation to pancreatic tumors—which are notoriously difficult to treat—while sparing surrounding tissue.

Pat Navin Donor to the University of Chicago Medicine

Imagine the impact yours can make.

When you make your gift to the University of Chicago Campaign: Inquiry and Impact, you support the work that results in better outcomes for patients in our hospitals, in our community and around the world.

With you, we will:

• Create game-changing computational resources and answer critical medical questions with data-driven discovery.

• Employ the transformative environment of the Center for Care and Discovery to set new standards for patient • Advance discovery and develop interventions to stop cancer. care, training and clinical research.

• Dramatically improve treatment for people with serious • Develop approaches to health care in our local South illnesses, including digestive disease, diabetes, heart and Side neighborhoods that can be the model for other vascular disease, and more. urban communities.

• Reveal how the human brain and our social and physical • Provide a unique and empowering education for the environments interact—and how this influences our most promising future physicians and scientists. health and behavior.

Together, we can:

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TARGETING PROSTATE CANCER Thanks to the prostatespecific antigen (PSA) screening test and early detection, prostate cancer is usually diagnosed when the disease is contained within the prostate.

Patients with low-risk prostate cancer typically have many options, including active surveillance, radiation therapy and surgery.

At the University of Chicago Medicine, a multidisciplinary

PROSTATE CANCER AFFECTS

1 IN 7 MEN IN THE U.S.

team of prostate cancer experts — urologists, medical oncologists, radiation oncologists, pathologists and radiologists — is available to collaborate on each patient’s care.

“We collect as much information as possible through blood tests, biopsies, genetic tests and EGGENER advanced imaging to determine the best strategy for our patients,” said Scott Eggener, MD, co-director of the prostate cancer program at UChicago Medicine.

Men at higher risk for the disease: » Men over 40 » African American men » Men with a family history of the disease

Prostate Cancer Program SURGERY

PATHOLOGY

Scott Eggener, MD Arieh L. Shalhav, MD Norm Smith, MD Gregory Zagaja, MD

Tatjana Antic, MD Gladell Paner, MD

MEDICAL ONCOLOGY

Chadi Nabhan, MD, FACP Peter H. O’Donnell, MD Walter M. Stadler, MD Russell Szmulewitz, MD David VanderWeele, MD, PhD

RADIATION ONCOLOGY

AT THE FOREFRONT

PROSTATE CANCER DIAGNOSIS AND TREATMENT PROSTATE MRI

We use state-of-the-art 3 Tesla MRI scanners.

Images are interpreted by dedicated prostate imaging experts.

MRI-GUIDED PROSTATE BIOPSIES

We are one of the few hospitals in the U.S. performing MRI-guided biopsies of suspected tumors in the prostate.

For eligible patients, targeted biopsies offer a minimally invasive, highly accurate diagnosis for prostate cancer.

RADIATION ONCOLOGY

We were one of the first to implement and report on the use of intensitymodulated radiation therapy (IMRT) for prostate cancer, which is now a standard method to optimize radiation dose to the tumor and minimize dose to the normal tissues. We also

offer innovative clinical trial options for men who are treated primarily or postoperatively.

ROBOTIC SURGERY

The robotic urologic surgery team is among the top programs in the world and has performed more than 4,000 robotic prostatectomies, the most in Illinois and among the most in the country. Our surgeons specialize in techniques that remove cancer tissue while preserving nerves for urinary and sexual function.

CARE FOR ADVANCED PROSTATE CANCER

Our medical oncologists have access to the latest FDA-approved therapeutics, are acknowledged national and international experts, and are testing the next generation of novel drugs for advanced and metastatic prostate cancer.

Stanley Liauw, MD RADIOLOGY

Aytekin Oto, MD

12 » THE UNIVERSITY OF CHICAGO MEDICINE IMAGINE MAGAZINE | FA L L 2 0 1 4

The University of Chicago Medicine received its sixth consecutive A grade in hospital safety, according to the latest Hospital Safety Score Survey released by The Leapfrog Group.

AT T H E F OR E F RON T OF

OUR COMMUNITY We are proud to call the South Side of Chicago our home. Working with neighborhood groups, residents and other health care providers, the University of Chicago Medicine is deeply committed to improving the health and well-being of our community.

SUPPORTING COMMUNITY GROUPS

Six nonprofit groups that provide services on Chicago’s South Side are sharing $253,475 in grants for programs to improve the health of area residents and communities.

The grants are the first to be awarded under the University of Chicago Medicine’s new Community Benefits Grant Program, a joint initiative between the Urban Health Initiative (UHI) and the Institute for Translational Medicine (ITM). The organizations receiving one-year grants are: » CommunityHealth — Take Action!

Diabetes Management Program » Asian Health Coalition — Diabetes Prevention Program for Asians in Chinatown » St. Bernard Hospital and Health Care Center — The Pediatric Asthma Clinic » Chicago Asthma Consortium — Comprehensive School-Based Approach to Improve Asthma Outcomes » Mobile CARE Foundation — Roseland Community Initiative » Respiratory Health Association — Southside Asthma Management Project

HEALTH PRIORITIES FOR CHICAGO’S SOUTH SIDE:

Access to Care | Diabetes | Cancer Childhood Obesity and Asthma COLLABORATING ON SOLUTIONS

UChicago Medicine has partnered with Northwestern Medicine and the United Way of Metropolitan Chicago to back a South Side community organization’s innovative approach to combat violence and avert behaviors that may lead to conflict.

Called the Bronzeville Dream Center, the program will be piloted in the Bright Star Church in Chicago’s Bronzeville neighborhood. The center draws on the model used by NATAL-Israel Trauma Center, which helps communities cope with and reverse the traumatic aftereffects of violence. Dream Center organizers also will be working with Communities That Care, an approach that seeks to strengthen the community and prevent youth delinquency, substance use and violence.

In addition to financial support, UChicago Medicine will provide program evaluation, access to psychiatric expertise, research and medical resources. “We are pleased to support this innovative model that draws from the cultural and spiritual strengths of communities to find solutions tailored to work for them,” said Kenneth S. Polonsky, MD, executive vice president for medical affairs at the University of Chicago.

Learn more in our recent Report to the Community: uchospitals.edu/community-needs | A B O V E | A student eats lunch at the Namaste Charter School. The school gets support from UChicago Medicine. | L E F T | UChicago Medicine resident Nikhil Narang, MD, treats a patient at a CommunityHealth clinic in Englewood.

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Learn More uchospitals.edu/dare-to-care

The University of Chicago Medicine is providing free vascular disease screenings for at-risk patients on Saturdays at our Hyde Park campus. Offered through a partnership with the Heart Health Foundation’s Dare to C.A.R.E. program, the screenings will test for four common vascular diseases: Carotid artery disease, Abdominal aortic aneurysms, Renal artery stenosis and Extremity artery disease.

THE SCREENING IS PAINLESS AND NONINVASIVE. YOU ARE ELIGIBLE IF YOU ARE:

Age 60 or older Age 50 or older with certain risk factors, such as smoking, diabetes or a family history Age 40 or older with diabetes Results will be shared with you and your physician.