Imagine - Summer 2017 - University of Chicago Medicine

SUMMER 2017

COVER STORY

Forward motion Elbow and shoulder specialist helps a high school pitcher stay in the game PAGE 9

Managing kids’ seasonal allergies PAGE 12

Timing is everything for a former Marine and an open-water swimmer PAGE 14

Minimally invasive procedure jump-starts weight loss

Imagine

SUMMER 2017 IN THIS ISSUE

3

ON THE COVER

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THE MICROBIOME, IMMUNITY AND YOU Harnessing the body’s natural defenses to foster wellness.

HEALTHY WEIGHT

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Spreading the word about the link between obesity and endometrial cancer.

MINUS 50 AND COUNTING Wine consultant Gregory Fulham

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is feeling and looking great after a new nonsurgical weight loss procedure.

For high school pitcher Brandon Kelly,

READ ONLINE Find these stories and more at SCIENCELIFE.UCHOSPITALS.EDU

THE NEXT IMMUNOTHERAPY CAR T-cell therapy rewires the immune system to attack cancer.

The emerging treatment is showing some remarkable results.

an elbow injury leads to a fresh start.

AND US

READY FOR ACTION

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We’re collaborating with Google to

How to use your arms

improve the quality of health care

to strengthen your

through data.tem TK

running stride.

Imagine magazine features stories

VISIT OUR WEBSITES FOR

Vice President, Chief Communications

about life-changing care and

MORE INFORMATION:

and Marketing Officer: William “Skip” Hidlay

breakthroughs in medical research at the University of Chicago Medicine and Biological Sciences.

Kenneth S. Polonsky, MD Dean of the University of Chicago

Adult care uchospitals.edu Children’s care uchicagokidshospital.org

Editor: Anna Madrzyk Associate Editor: Gretchen Rubin Design: SBDWorks, Inc. Contributing writers Kat Carlton, Thea Grendahl Christou, David

Biological Sciences Division and the

Main number

Dodd, John Easton, Cynthia Greenwood,

Pritzker School of Medicine and executive

1-773-702-1000

Ashley Heher, Jane Martinsons, Gretchen

vice president for Medical Affairs Sharon O’Keefe

Appointments 1-888-824-0200

Read Imagine online at uchospitals.edu/Imagine Email us at imagineeditor@uchospitals.edu Facebook.com/UChicagoMed Twitter.com/UChicagoMed This publication does not provide medical advice or treatment suggestions. If you have medical

Rubin, Lorna Wong

problems or concerns, contact a physician, who will

Contributing photographers

medical advice because of something you read

President of the University of Chicago

Pietro Brezzo, David Christopher, Bart Harris,

Medical Center

Jean Lachat, Eddie Quinones, David Travis, Nancy Wong

determine your treatment. Do not delay seeking here. For urgent needs, call 911 right away.

CANCER ALMOST STOPPED JENNIFER FROM COMPLETING HER FAMILY.

MEET ROCCO.

From the time she was young, Jennifer Mason Zinga knew she wanted three children. A wife and mother of two boys at 31, Jennifer was on her way to achieving her dream. Just six months after the birth of her second son, Jennifer was diagnosed with early-stage cervical cancer. The recommended treatment — a hysterectomy — would end her hopes of conceiving a third child. Then University of Chicago Medicine gynecologic oncologist Dr. Ernst Lengyel gave Jennifer encouraging news. By performing a rare procedure called radical trachelectomy, he could remove her cervix while leaving her uterus intact. This would enable Jennifer to conceive again. One year later, she did. Rocco makes three. To learn more or make an appointment, call 1-888-824-0200 or visit uchospitals.edu.

AT

T H E

F O R E F R O N T

O F

M E D I C I N E®

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OPERATION MEDICATION BRING BACK

Patients and community members can safely and legally discard unused medication at UChicago Medicine’s Hyde Park campus. A MedSafe disposal container, located in the outpatient pharmacy in the Duchossois Center for Advanced Medicine, is part of our ongoing effort to combat the nation’s burgeoning opioid crisis. Seventy percent of opioid abusers obtain pain medication from relatives and friends — often left over from earlier medical care. “Unfortunately, most patients don’t know what to do with their unused pills, and safe options are not easily available,” said surgeon Vivek Prachand, MD. The collection receptacle is available during pharmacy hours, 9 a.m. to 5:30 p.m. weekdays. The discarded prescriptions have multiple layers of security and are incinerated as medical waste. MedSafe disposal also is more environmentally friendly than flushing medication down the toilet or sink.

COUNTDOWN TO ADULT TRAUMA CARE

JANUARY 8, 2018

Our new, expanded emergency department is scheduled to open.

MAY 1, 2018

Level 1 trauma services are set to begin, pending state approval, providing care for adults with serious injuries from falls, motor vehicle crashes, violent crimes and other emergencies.

Imagine that!

KIDS’ BRAINS AND APNEA

Children suffering from a common, treatable sleep disturbance also risk losing brain cells that affect movement, memory, emotions, speech, perception, decision-making and self-control. Compared with youngsters who sleep normally, children with obstructive sleep apnea had significantly less gray matter in several parts of the brain, according to brain scans studied by UChicago Medicine researchers.

“The changes are striking,” said Leila Kheirandish-Gozal, MD, director of pediatric clinical sleep research and a senior author of the study, published in Scientific Reports. This extensive reduction of gray matter provides more reason for parents of children with symptoms of sleep apnea, such as snoring, to consider early detection and therapy. Future study aims to pinpoint the exact effects of the losses and whether they are reversible.

READ MORE AT

sciencelife.uchospitals.edu THYROID SURGERY LEAVES NO SCAR

TRANS FATS OFF THE MENU

Outlawing trans fats in restaurant food has proven to be a healthy move. People living in places with the restriction, such as New York City, had fewer hospitalizations for heart attacks and strokes compared with residents of areas with no trans fat restrictions, University of Chicago and Yale University researchers found. Eating even a small amount of trans fats — commonly found in fried foods, chips, crackers and baked goods — increases the risk of cardiovascular disease, the leading cause of death worldwide. “The results are impressive, especially since we focused on restaurant bans, as opposed to bans covering food bought in stores,” said Tamar Polonsky, MD, a general cardiologist at UChicago Medicine and senior author of the study published in JAMA Cardiology. A nationwide ban eliminating trans fats in all foods in 2018 should yield even more long-term benefits, Polonsky said.

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Standard surgery to remove the thyroid gland leaves an obvious, 2-inch scar on the front of the neck. UChicago Medicine surgeons were the first in the Midwest — and fourth in the U.S. — to remove a patient’s thyroid using a new approach that leaves no visible scar. In the trans-oral endoscopic thyroidectomy vestibular approach (TOETVA), three small incisions are made inside the mouth where the lower lip meets the gums. Using endoscopic surgical instruments and a miniature video camera, the surgeon tunnels under the skin past the chin into the neck to reach the thyroid and remove it through one of the incisions. “Two weeks after the operation, most patients look as if they never had surgery,” said endocrine surgeon Raymon Grogan, MD. Patients may eat the next day, and complications are rare and comparable to those of open surgery.

Watch a video: uchospitals.edu/ scarless-thyroidectomy

The micro microbiome, o immunity and you yo Imagine a world where peanuts could safely return to school menus.

Or probiotics and prebiotics make drugs to treat cancer and depression more effective.

Or careful use of antibiotics reduces the impact of Alzheimer’s disease.

That future is getting closer to reality, thanks to a $100 million gift to the University of Chicago Medicine from Janet and Craig Duchossois and The Duchossois Family Foundation. The Foundation’s gift was made possible in part by the thoughtfulness of the late Bruce Duchossois.

The gift establishes The Duchossois Family Institute: Harnessing the Microbiome and Immunity for Human Health. The microbiome is the collection of organisms that live in and on us. Microbes in our guts, for example, play a role in allergies, metabolism and even responses to medical treatment. The Institute aims to develop a new science of wellness based on how the immune system, microbiome and genetics interact with each other to harness the body’s natural defenses and maintain health.

This new area of study will be tackled by a team of scientists, physicians, data analysts and commercialization specialists

who will help bring breakthrough treatments to market.

“The goal is for the knowledge we generate here to enable people to foster health and wellness within their own bodies, instead of responding to a diagnosis of illness,” said Jessica Swoyer Green, vice president of The Duchossois Family Foundation, “echoing our family’s dedication to wellness and education.”

Learn more about The Duchossois Family Institute and this exciting research uchospitals.edu/ microbiome-immunity

A generous gift establishes a new institute focused on using the body’s own defenses to promote wellness. | L E F T | Members of The Duchossois

Family Foundation are, from left, standing: Craig J. Duchossois, Janet Duchossois, Ilaria Woodward, Jessica Swoyer Green, Dayle Duchossois Fortino. Seated: Ashley Duchossois Joyce, left, Richard L. Duchossois, Kimberly Duchossois.

FROM ONE OF OUR MICROBIOME RESEARCHERS:

“Health begins in infancy. It’s when we have the greatest opportunity to establish or compromise beneficial microbial patterns for a lifetime.”

ERIKA CLAUD, MD, neonatologist at Comer Children’s Hospital, studies the gut microbiome of premature babies.

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Survival Plan Soon after undergoing surgery for endometrial cancer, Mary Zirino listened as her gynecologic oncologist, S. Diane Yamada, MD, cautioned her to lose weight.

“Fortunately, Mary had a very early stage of the disease, so I didn’t recommend additional medical treatment beyond the surgery,” Yamada said. “But her weight almost certainly contributed to development of the endometrial cancer and it put her at risk for other types of cancer in the future.”

bike and weights. She began working out for an hour most mornings before she left for her job as director of talent acquisition for a staffing agency.

“I thought changing my diet was going to be impossible,” she said, “but I started sleeping better and feeling better. And I had so much more energy.”

Zirino gave up her daily diet sodas and starting drinking only water. A self-described creature of habit, she designed a new healthy meal plan — oatmeal and fruit for breakfast, a simple sandwich or salad for lunch and grilled chicken or “reasonable” take-out food for weeknight dinners.

This past spring, Zirino sent Yamada a before-and-after photo. She had shed 56 pounds in six months.

“I was thrilled she lost weight and did so in a healthy way,” Yamada said. “She is an inspiration for others.”

continued on page 5

Zirino dutifully lost a few pounds but returned to her old eating habits within a few months. “Cancer can mess with your head,” she said. “On one hand, your doctor is telling you to lose weight, so no more cake.

On the other hand, I just survived cancer, and life is short — eat the cake.’’

Two and a half years after her endometrial cancer surgery, a routine mammogram showed something irregular. Follow-up scans were normal, but for Zirino, this second scare was all it took to put her on a healthier path.

Like many people, she had gym equipment at home that went unused. Her husband, Charlie, set up their cross trainer, exercise

| A B O V E | Gynecologic oncologist S. Diane Yamada, MD, left, calls patient Mary Zirino

“an inspiration for others.” The 49-year-old southwest suburban woman lost 56 pounds in six months following treatment for endometrial cancer, which is linked to obesity.

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continued from page 4

Most of the endometrial cancer patients seen by Yamada and other University of Chicago Medicine gynecologic oncologists are overweight. And most, Yamada said, are surprised to hear that obesity is a risk factor not only for diabetes and heart disease but also for uterine, breast and colon cancer.

Her colleague, Nita Karnik Lee, MD, MPH, has conducted focus groups with endometrial cancer survivors to examine barriers to weight loss. “Our findings highlighted the importance of a supportive social network in helping survivors modify their lifestyle,” Lee said.

“Endometrial cancer often can be just the tip of the iceberg,” Yamada said.

Zirino has had the support of friends, work colleagues and family. Charlie joined her on

the quest to get healthy and lost 20 pounds.

“We are in it together,” she said, “because we have so much more to see and do together.

“I have a new purpose. I never want to go back to being tired and sluggish. And I don’t want to go to another appointment and hear a doctor say, “you have cancer.”

Ask the Expert NITA KAR N I K L E E , MD, MPH are also risk factors for developing endometrial cancer.

HOW DOES LIFESTYLE MODIFICATION HELP?

Nita Karnik Lee, MD, MPH, specializes in the care of women with gynecologic cancers. An expert on cancer survivorship and disparities, Lee has a special clinical and research interest in endometrial cancer and the importance of a healthy lifestyle after diagnosis and treatment.

WHY IS OBESITY A RISK FACTOR FOR DEVELOPING ENDOMETRIAL CANCER?

Extra stored fat in our bodies is not passive. It increases estrogen levels, causes inflammation and can promote cancer development.

And most common endometrial cancers are estrogen dependent.

Women who are 50 pounds overweight are 10 times more likely to get endometrial cancer.

Diabetes and physical inactivity

A cancer diagnosis can be a wake-up call. Lifestyle changes that include a healthier diet and more physical activity can protect patients against cancer recurrence as well as the development of other obesity-linked cancers, including breast and colon cancer, diabetes and cardiovascular disease. And of course, losing weight is good for overall health.

WHAT ADVICE DO YOU GIVE CANCER SURVIVORS TRYING TO LOSE WEIGHT?

I encourage them to start with small changes in their everyday habits — such as tracking meals and daily steps — and to find support in their network of friends and family. Ask a friend to go for a walk. Encourage healthy eating at family gatherings.

Make yourself a priority while also being an advocate for those around you. Share your story about weight, lifestyle changes and cancer — spread the word and you can make an impact on others.

Nita Karnik Lee, MD, MPH, left, and S. Diane Yamada, MD

WHERE TO FIND OUR EXPERTS IN GYNECOLOGIC CANCER University of Chicago Medicine Comprehensive Cancer Center HYDE PARK CAMPUS

University of Chicago Medicine Comprehensive Cancer Center at Silver Cross Hospital NEW LENOX

University of Chicago Health Specialists SCHERERVILLE, IND.

uchospitals.edu/specialties/cancer/gynecologic

Obese women who intentionally lost weight showed a 56 percent reduction in endometrial cancer risk, according to a recent analysis of the Women’s Health Initiative study involving more than 50,000 women in the United States.

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GAME

ON Brandon Kelly

It was the second game of a double header and freshman Brandon Kelly was 15 pitches in. The left-handed pitcher got the sign from the catcher and delivered his most effective pitch — a sidearm slider.

“My elbow popped and my arm just fell,” said Brandon, 14, who was pitching for a Marian Catholic High School baseball game in April when he was injured. “I was in a lot of pain. I dropped to the ground.”

Although the diagnosis was a simple dislocation, Brandon continued to have pain after initial treatment. He’d have to sit on the bench for the remainder of the season. When his primary care physician suggested the young athlete consult a sports medicine physician, Brandon’s mother, Katie Kelly, brought him to the University of Chicago Medicine.

Megan Conti Mica, MD, an orthopaedic surgeon with expertise in hand, elbow and shoulder care, told Brandon there was a silver lining to his injury.

“The biomechanics of his sidearm throw would have led to a more serious problem and the need for surgery,” Conti Mica said.

“Brandon needed to switch to overhand pitching in order to protect the ligaments and muscles around his elbow and shoulder.”

Conti Mica prescribed physical therapy to assist with range of motion and strengthening. She recommended he work with a trainer who specializes in throwing techniques.

It wasn’t just about Brandon’s elbow, it was about his future.”

MEGAN CONTI MICA, MD

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Although Brandon says throwing overhand is difficult for a left-handed pitcher, he is working with the trainer to improve his form.

Later in the spring, he began practicing his new pitching style in a noncompetitive league in the south suburbs. He plans to play for a traveling baseball team this summer.

“Dr. Conti Mica gave me life lessons about my injury,” Brandon said. “She told me ‘let’s go forward from here.’ And she gave me the confidence to do so.

“I’m trying to make baseball a career. So it’s better that this happened in my freshman year than in my junior year. I have time for a fresh start.”

Megan Conti Mica, MD, sees patients in our Hyde Park, Tinley Park and South Loop locations.

Where to find our sports medicine specialists

OUR TEAM IS ON YOUR TEAM Our orthopaedic surgeons offer state-of-the-art sports medicine care designed to get you back on your game.

We provide nonsurgical, surgical and rehabilitative options for treatment of

Duchossois Center for Advanced Medicine Hyde Park campus University of Chicago Medicine Center for Advanced Care South Loop Orland Park University of Chicago Orthopaedics Center Ingalls Medical Building Tinley Park University of Chicago Rehabilitation and Sports Medicine at West Suburban Medical Center River Forest

the shoulder, elbow, hip

Comer Children’s at Edward-Elmhurst Health Naperville

and ankle.

uchospitals.edu/ortho

| A B O V E | Orthopaedic surgeon

Sherwin S. W. Ho, MD, sees patients in our Hyde Park, Orland Park and River Forest locations.

PROTECT YOUR BODY, NOT JUST YOUR LEGS It’s time to dispel the myth that running is all about your legs.

Running engages the entire body in one way or another.

Your arms and legs are connected in a closed link with your core. Arms are important for your stride. They provide the counterforce to your legs’ momentum. Simply put, your arms keep your legs moving in a meaningful

Megan Conti Mica, MD

forward motion that is stable and balanced.

If your arms are weak or stiff, this can affect the biomechanics of your stride, balance and overall run.

Try “listening” to your whole body on your next run. It’s easy to note stiff quads or fatigued calf muscles after a long run. But now take the time to notice a weak torso that isn’t holding its posture, an inability to truly rotate the shoulders to counteract pelvic rotation, or back pain related to poor upper body strength.

What are the two most valuable ways to improve your arm game? Stretching and strengthening.

Stretch your arms before and after runs and identify any immobility in your shoulders.

Hit up those yoga classes and Pilates sessions.

Strengthening can happen in a myriad of ways, but one of the easiest strategies can be found in the gym. Step away from the treadmill and hit the weights. And always diversify your workout. If you make these few changes, you will strengthen your overall body agility and you’ll have more satisfying runs.

— Megan Conti Mica, MD

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Getting set for school sports NASREEN ANSARI, MD School sports are a great way for kids to stay active and make new friends.

But before your child puts on a uniform, a physical exam can help determine if it is safe for him or her to participate.

Most states, including Illinois, require that young athletes have a sports physical before they start a new sport or begin a new competitive season.

Nasreen Ansari, MD, a family medicine physician at the Center for Advanced Care at Orland Park, answers parents’ questions about sports physicals.

WHEN SHOULD I BRING MY CHILD

WHAT HAPPENS IF MY CHILD

IN FOR THE EXAM?

DOESN’T PASS?

Your child should be seen by your physician or other medical professional at least six weeks prior to the start of the sport.

Depending on the issue, your son or daughter may need to have a more advanced evaluation and/or diagnostic tests.

This could delay participation in the sport.

However, the goal is to always keep your child safe and healthy.

HOW DO I PREPARE FOR THE APPOINTMENT?

Parents should bring the school’s sports physical exam form completed with the child’s medical history, a list of the child’s medications (if any) and any other medical information that may be necessary.

WHAT ADVICE DO YOU HAVE FOR PARENTS OF YOUNG ATHLETES?

Plenty of rest and a well-balanced diet are key. In addition, look for ways to help your child manage stress. Participating in a sport, maintaining good grades and keeping up with household responsibilities can be a lot for any child to juggle.

Walk this way A 3.3 million-year-old fossil of a 2 1/2-year-old girl shows that our ability to walk and run on two feet was established millions of years earlier than previously thought.

University of Chicago paleoanthropologist Zeresenay (Zeray) Alemseged has been studying the nearly complete skeleton, named Selam, since he discovered her in Ethiopia in 2000. Recent advanced imaging analysis of Selam’s spine indicated an adaptation for walking upright, one of the hallmarks of human evolution.

Read more at sciencelife.uchospital.edu

The newly revealed spinal column and vertebrae of Selam, the “world’s oldest child.”

While Selam would have been able to walk, she wouldn’t have been a great runner.

That’s because the species didn’t have the fully formed anatomy that allows us to rotate our backs as we run or walk fast.

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Summer sneezes?

Seasonal allergies don’t have to spoil your child’s outdoor fun, even on high pollen count days.

“We rarely tell parents to keep their children inside and miss activities due to seasonal allergies,” said Comer Children’s Hospital pediatric allergist Nana Fenny, MD, MPH. “But you do need to give your child with allergies an antihistamine at least 30 minutes before shooing them out the door.”

Pollen — from trees in the spring, grasses in the summer, and ragweed and other weeds in the fall — is one of the most common causes of allergies. Symptoms may include nasal congestion, runny or itchy nose, sneezing, and itchy, watery eyes.

Fenny recommends a few simple lifestyle changes to help relieve a child’s allergy symptoms: | A B O V E | Pediatric allergist Nana Fenny, MD,

MPH, sees patients at Comer Children’s at Little Company of Mary Hospital and on our Hyde Park campus.

» Have your child shower, wash her hair and change clothes before going to bed.

» Vacuum your house, and replace your home air filters frequently. » Use a saline nasal spray before bedtime to help remove mucus and retained pollen. » If your child has eczema, have him take a shower after swimming in a chlorinated pool to reduce further irritation. » Add more fruits and veggies to your child’s diet to help fight inflammation. » Always carry your child’s epinephrine autoinjector. Put it in the shade if possible to minimize exposure to extreme heat.

If over-the-counter medications aren’t working for your child, it’s important to see an allergist. The physician will help you identify your child’s allergy triggers and create a treatment plan that may include prescription drugs or allergy shots.

To make an appointment with a pediatric allergist, please call 773-702-6169.

Exceptional care for kids, now in Orland Park Our pediatric specialists are coming to the University of Chicago Medicine Center for Advanced Care at Orland Park.

PEDIATRIC SERVICES AVAILABLE NOW IN ORLAND PARK

COMING IN FALL 2017

Dermatology

Hematology/oncology

Allergy Cardiology

Gastroenterology Neurology Pulmonology Surgery Urology To make an appointment for your child, please call 844-755-8267.

To learn more, visit uchicagokidshospital.org

Turn the page to see more of our pediatric locations.

| A B O V E | Pediatric neurologist James Tonsgard, MD, is

one of the Comer Children’s specialists now seeing young patients at our Orland Park clinic.

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HYDE PARK University of Chicago Medicine » Center for Care and Discovery » Comer Children’s Hospital » Duchossois Center for Advanced Medicine » Comprehensive Cancer Center STREETERVILLE 150 East Huron Primary and specialty care

NEW 900 N. Michigan Ave. Ophthalmology NEW University of Chicago Medicine Women’s Care at Streeterville 680 N. Lake Shore Drive

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SOUTH LOOP NEW Center for Advanced Care Primary and specialty care, women’s health, orthopaedics

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BRIDGEPORT NEW University of Chicago Medicine Care Network Physicians at Bridgeport 3529 S. Wells St. Family medicine

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NEW LENOX Comprehensive Cancer Center at Silver Cross Hospital

University of Chicago Medicine Obstetrics and Gynecology Specialty Services

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ORLAND PARK NEW Center for Advanced Care Adult primary and specialty care, women's and children's specialty care, orthopaedics

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HARVEY Ingalls Memorial Hospital

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CRESTWOOD Ingalls Care Center Immediate care, occupational medicine

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Comer Children’s Hospital Duchossois Center for Advanced Medicine Comprehensive Cancer Center

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SOUTH HOLLAND Ingalls Care Center Occupational medicine, rehabilitation services TINLEY PARK Ingalls Family Care Center

University of Chicago Orthopaedics Center at Ingalls Medical Building

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CROWN POINT, IND. University of Chicago Orthopaedics Adult and pediatric orthopaedic care

NEW Comprehensive Cancer Center at Little Company of Mary Hospital Adult radiation oncology

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SCHERERVILLE, IND. University of Chicago Health Specialists Specialty care

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MERRILLVILLE, IND. University of Chicago Pediatric Specialists

ELMHURST Comer Children’s at Edward-Elmhurst Health NAPERVILLE Comer Children’s at Edward-Elmhurst Health

JUST IN TIME Shawn Carter’s heart was beating out of control. And he had run out of options.

“There were no doctors left in California who would touch me,” Carter said, recalling the time last summer when his heart went into numerous bouts of ventricular tachycardia (VT), beating up to 180 times per minute.

The medical device engineer, a former Marine and now a Chief Warrant Officer 2 in the California State Military Department,

had undergone multiple procedures in the 28 years since he was diagnosed with Wolff-Parkinson-White syndrome. In this rare heart condition, patients have an extra electrical pathway between the heart’s upper and lower chambers, which can cause a rapid heartbeat.

Over three decades, Carter had two open-heart surgeries and several catheter ablations to treat arrhythmias. His heart had been shocked back into a safe rhythm numerous times, both externally and by an implantable cardioverter defibrillator. He took several anti-arrhythmic medications.

His most recent episodes were lifethreatening. Carter needed more ablation procedures to the endocardium (inner layer of the heart) as well as the epicardium (outer layer of the heart) to destroy the small areas of tissue triggering the abnormal rhythms.

Scar tissue made it impossible to reach the outside of his heart using an open heart or catheter approach.

Carter turned to University of Chicago Medicine cardiac electrophysiologist Roderick Tung, MD, an internationally known expert on advanced therapies for heart rhythm disorders.

Tung and cardiac surgeon Husam Balkhy, MD, had recently collaborated on the first totally endoscopic robotic epicardial ablation for a patient with a ventricular arrhythmia.

“Shawn’s situation was dire,” Tung said.

“But we told him we would find an innovative way to take care of him.”

Carter was airlifted from a hospital in San Francisco to UChicago Medicine.

Tung’s team planned for Carter’s two-part ablation treatment. Using a sophisticated mapping system, they created a 3D reconstruction of his heart detailing the patterns and points of abnormal electrical activity.

Shawn Carter

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In the first procedure, Tung and his team threaded a catheter through a large vein in Carter’s leg into his heart and delivered radiofrequency energy to destroy dysfunctional tissue.

Carter was treated with a hybrid approach pioneered by UChicago Medicine’s robotic cardiac surgery program, a referral center for patients from all over the country.

Roderick Tung, MD

Using the da Vinci surgical robot system, Balkhy then accessed the outer surface of Carter’s heart through three tiny incisions on the side of his chest.

“The robotic technology enabled us to dissect the scar tissue surrounding Shawn’s heart safely using this least invasive approach,” Balkhy said.

“Once the heart muscle was exposed, we were able to find and eliminate the sources of arrhythmias on the outside of his heart.”

The two minimally invasive procedures were successful, and the electrical systems in Carter’s heart were stabilized.

Today, Carter, 50, no longer takes cardiac medications. Although he feels an occasional palpitation, none has lasted long enough for his defibrillator to record or treat. He is back to his baseline fitness level, with a regimen of lifting weights and highintensity interval training five days a week.

“I work out for the cardiac benefits,” he said, “so my heart will be stronger.”

Husam Balkhy, MD

If Carter’s heart needs more treatment in the future, his UChicago Medicine care team will be ready. “Shawn is forever in our family,” Tung said.

Dr. Balkhy talks about his 500th cardiac robotic surgery uchospitals.edu/ cardiac-robotic

Pacesetter boosted by pacemaker Erikson was reluctant at first, though he was troubled about his loss of swim speed. Then he read an article explaining why swimmers often develop a slower heart rate. “That convinced him,” Hofmann-Bowman said.

In August 1961, at age 33, Ted Erikson set an open-water distance record.

He swam 43 miles, from Chicago to Michigan City, Indiana, in 36 hours.

Since then, Erikson has swum the English Channel, across and back. For almost 40 years, he held the record for swimming 26.4 nautical miles from California’s Farallon Islands to the Golden Gate Bridge.

The pacemaker, implanted by electrophysiologist Hemal Nayak, MD, helped immediately. “Ted feels his age,” Hofmann-Bowman said, “but he’s still a marvelous swimmer.”

“Ted, like many distance swimmers, has had a slow heart rate for years,” said fellow lake swimmer Marion Hofmann-Bowman, MD, PhD. “We urged him to get tested.

It showed an irregular heartbeat. We suggested a pacemaker.”

©David Travis 2017

Now 89, he has slowed down a bit. He still swims in Lake Michigan most mornings, from May to October. But last fall, he noticed his pace was slowing, at a distressing rate. Luckily, one of his swimming pals is a UChicago Medicine cardiologist.

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When Gregory Fulham, 62, thinks of the extra weight he used to carry, he visualizes the heavy boxes of reds, whites and rosés he lifts in his job as a wine consultant.

A case of wine weighs about 45 pounds. Fulham has dropped more than 50 pounds and is still losing. “I feel better, I look better and it’s easier for me to move around,” he said.

In January 2017, Fulham became the first person in Chicago to undergo endoscopic sleeve gastroplasty (ESG), a new nonsurgical weight loss procedure offered at the University of Chicago Medicine.

“ESG is designed to help patients jump-start their weight loss,” said gastroenterologist Christopher Chapman, MD, who performed the minimally invasive endoscopic technique that reduced the size of Fulham’s stomach by 70 percent.

“I was particularly drawn to the idea of no incisions,” said Fulham, who was back at work five days after his procedure.

A dietitian worked with Fulham to plan well-balanced, lower calorie meals. “I eat my normal foods, even the spicy stuff, just not as much,” he said.

He lost nearly 15 percent of his body weight in the first three months after the procedure, and his body mass index (BMI) decreased from 39.7 to 33.9. His blood pressure went down. Customers and friends began commenting on how different he looks.

Gregory Fulham

Every day, someone tells me, ‘Wow, you look good.’”

GREGORY FULHAM

“I had never been successful at weight loss before,” Fulham said. “This procedure has been a miracle for me.

And it may have even saved my life.”

©Joe Ochoa 2017

1. An endoscope is placed through the mouth and into the stomach. 2. Using a device attached to the endoscope, the physician places about a dozen sutures. 3. Tightening these sutures decreases the stomach’s size and volume. 4. The stomach is reduced by 70 to 80 percent,

and the resulting “sleeve” is the size and shape of a banana.

Reducing the stomach without surgery A new alternative to traditional obesity surgery can help you jump-start your weight loss. The University of Chicago Medicine is the first hospital in Chicago offering the nonsurgical procedure to shrink the size and volume of the stomach.

Christopher Chapman, MD, is director of metabolic and bariatric endoscopy and a member of the Center for Endoscopic Research and Therapeutics at the University of Chicago. He answers your questions about endoscopic sleeve gastroplasty (ESG), which can help patients lose nearly 20 percent of their total body weight.

WHO IS A GOOD CANDIDATE FOR ESG?

ESG and other endoscopic therapies for weight loss are designed for patients with a body mass index (BMI) between 30 and 40. However, our multidisciplinary team evaluates patients on a case-by-case basis to determine their best option for achieving weight loss and will consider patients with higher BMIs. WHAT HAPPENS DURING THE PROCEDURE?

While the patient is asleep, we thread a flexible tube — called an endoscope — through the mouth, down the esophagus

Christopher Chapman, MD

and into the stomach. Using a device attached to the endoscope, we stitch and tighten sutures that constrict the stomach, reducing it to the size of a banana. The procedure takes about an hour and most patients go home the same day.

WHAT KIND OF RESULTS CAN PATIENTS EXPECT?

Changes in lifestyle and diet are always the most important factors in maximizing weight loss. In the first three to six months, patients can expect to lose 10 to 15 percent of their total body weight. Typical weight loss in the first two years after an ESG procedure ranges from 30 to 60 pounds.

Advantages of endoscopic sleeve gastroplasty » Outpatient » No incision » No scarring » Quick recovery » Reversible » Can be repeated

The Center for Endoscopic Treatment of Obesity SOUTH LOOP HYDE PARK CAMPUS

Make an appointment: 1-888-824-0200

Watch videos on endoscopic sleeve gastroplasty and the first patient in Chicago uchospitals.edu/gregory-story

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Primary care physician Paula Bey, MD, at our new Center for Advanced Care at South Loop.

I get to know my patients well because I believe in treating the whole person. Patients, many who live or work in the city, tell me they love coming to our central location in the South Loop for primary care while also having access to specialists here and at the University of Chicago Medicine’s main campus in Hyde Park.”

PAULA BEY, MD

AT THE FOREFRONT OF PRIMARY CARE

Closer to you and your family Where to find us for primary care HYDE PARK CAMPUS

Duchossois Center for Advanced Medicine Comer Children’s Hospital 888-824-0200

BRIDGEPORT

University of Chicago Medicine Care Network Physicians at Bridgeport 3529 S. Wells St. 312-225-5785

SOUTH LOOP

University of Chicago Medicine Care Network Physicians at Flossmoor 19550 Governors Highway 773-834-4925

STREETERVILLE

Ingalls Family Care Centers

University of Chicago Medicine Center for Advanced Care at South Loop 1101 S. Canal St. (in Southgate Market) 877-336-5667 150 East Huron 773-834-4150

SOUTH SUBURBS

University of Chicago Medicine Center for Advanced Care at Orland Park 14290 S. LaGrange Road 844-755-8267

1600 Torrence Ave., Calumet City 708-730-1300 19550 Governors Highway, Flossmoor 708-799-8400 6701 W. 159th St., Tinley Park 708-429-3300

One-stop shopping, close to home Byron Thoren, 70, of Lemont had been getting his medical care in several suburban locations when he drove past our new Center for Advanced Care at Orland Park. “My wife and I had always heard good things about UChicago Medicine,” said Thoren, “so we decided to give it a try.” He made an appointment with one of our physicians, and quickly lined up two more specialists as well as a primary care doctor. “It’s one-stop shopping for me now,” he said. “And it’s just 20 minutes from my home.”

| A B O V E | Byron Thoren and his doctors at the Center for Advanced Care at Orland Park.

From left, cardiologist Ankur Shah, MD, endocrinologist Farah Hasan, MD, oncologist Murtuza Rampurwala, MD, MPH, and primary care physician Stephen Bennett, MD.

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CIRCLE OF

SUPPORT

Rob Gentile

A transplant patient helps fund the heart failure research of Nir Uriel, MD A massive heart attack in early 2016 put Rob Gentile into a coma for four days. When he awoke, he learned his heart was so severely damaged that he wouldn’t live long without a transplant.

He contacted several major transplant centers, but the options presented to him were bleak. Never could he imagine that in just a few months he would be up and fully functioning again with a new heart.

Yet he was, thanks to physicians at the University of Chicago Medicine and an innovative, lunchbox-size heart-pumping device that kept him mobile and able to exercise while he waited for a heart.

Today, a year after his transplant, the fit 57-year-old sales engineer is back home in North Carolina with his wife and daughter. His employer is suburban Chicago-based National Material Company, and its owner, Michael Tang, is a University of Chicago Medical Center trustee. When news of his longtime employee’s mounting health crisis reached him, Tang urged Gentile to consult Nir Uriel, MD, director of heart failure, transplant and mechanical circulatory support.

“Had Michael not reached out to help me, I would not be here today,” Gentile said. “And had Dr. Uriel and his team followed | B E L OW | Michael Tang and Nir Uriel, MD

the norm and not gone the extra mile, I would not have been transplanted.”

To enable him to meet pre-transplant qualifications, Gentile opted to participate in a clinical trial of a novel mechanical assist system, NuPulseCV iVAS. The device is implanted through a two-inch incision, and the external pump weighs only six pounds.

“Our hope is that this approach will improve life for patients with advanced heart failure,” said Valluvan Jeevanandam, MD, chief of cardiac and thoracic surgery. Although this initial trial is focused on hospitalized patients awaiting a heart transplant, “we designed the iVAS to help patients get out of the hospital and enjoy life at home,” Jeevanandam said.

Michael Tang taught me a great life lesson about the power of giving back.”

ROB GENTILE

Having fought to find quality health care for their daughter, who has a neurological disorder, Gentile said, “My wife and I can easily tell the difference between physicians who are simply performing duties and those who are purpose-driven, committed, passionate and determined to not only do their best for patients, but to see them as people with hopes, dreams, a life and family who depend on them. That’s what I found at UChicago Medicine.”

Learn about a milestone in our transplant program and the innovative device that kept Rob Gentile alive while he waited for a new heart uchospitals.edu/transplant-milestone

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TAKE CARE OF YOU We offer a full range of women’s health care services in seven convenient locations across Chicagoland and in Northwest Indiana. » General obstetrics and gynecology » High-risk pregnancy » Midwifery services » Minimally invasive gynecologic surgery » Infertility diagnosis and treatment » Gynecologic oncology » Urologic gynecology

Make an appointment

773-702-6118 | A B O V E | Neangela Dixon, right, and her 8-month-old daughter, Ryleigh, visit

This is the baby that we hoped for and Dr. Snow had confidence I would be able to have.”

NEANGELA DIXON

with Shari Snow, MD, at UChicago Medicine Women’s Care at Streeterville.

Snow, an expert in minimally invasive and robotic gynecologic surgery, specializes in alternatives to hysterectomy to preserve a patient’s fertility.

Watch Neangela’s story uchospitals.edu/neangela-story