Health Watch April 26, 2015 by The Times

HealthWatch April 2015

IN THIS ISSUE

is better: Mapping out cancer: A matter of the heart: More NGMC Braselton Gainesville location is one of the 1st to use new, less-invasive, heart valve procedure...PAGE 2

uses a big screen to view patient info...

PAGE 10

A new diagnostic tool helps doctors quickly detect cervical cancer...PAGE 4

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Sunday, April 26, 2015

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New procedure provides heart surgery alternative by alana swain

aswain@gainesvilletimes.com

he Heart Center of Northeast Georgia Medical Center in Gainesville is constantly advancing when it comes to treatments for their patients, with the newest technology-driven procedure providing a possible alternative to surgery. The procedure, known as MitraClip, is a less invasive option to correct or repair the mitral heart valve, and Gainesville’s heart center is the first in the region to perform it. “It’s relatively new in the U.S. and was just FDA approved in the fall of 2014, so there aren’t very many centers that are doing this yet,” said Allison Dupont, an interventional cardiologist with the Heart Center. “We’re the first in the region to bring this therapy to our patients, so I’m really excited about it,” she continued. MitraClip has been performed in Europe for more than five years, so with FDA approval and research studies of

the results, centers in the U.S. are now in the process of having it as an option for patients. “We are trying to build kind of an allencompassing valve therapy program here so that our patients who are not candidates for surgical valve repair or replacement can still undergo some kind of therapy to reduce symptoms, or in some cases, lengthen life,” Dupont said. “There are a fair number of patients that are not surgical candidates either because of their age or other pre-existing medical conditions and we’re able to do less invasive therapies on these patients without opening up their chest,” she continued. MitraClip is intended for patients who have a leaky heart valve, known as mitral valve regurgitation. Patients with this condition have ■■Please see HEART, 3

Photo: The Northeast Georgia Medical Center is now using the MitraClip percutaneous mitral valve repair. The device is world’s first percutaneous mitral valve repair therapy available and allows improvement in patient symptoms, reduction in hospitalizations for heart failure and a reduction in mitral regurgitation.

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Heart ■■ Continued from 2

symptoms such as shortness of breath, dizziness, swelling, decrease in exercise tolerance and an inability to perform normal daily activities due to shortness of breath. Previously, a surgical repair or replacement of the valve was the only option for treatment, but the catheter-based MitraClip offers an alternative for those unable to undergo surgery. “The way we go about doing this procedure is we have to have careful patient selection — and that goes with any procedure in cardiology — but we use a catheter that’s inserted through the groin and goes up into the heart and we can direct the clip device toward the valve and position it to clip the valve shut to prevent the severe leakiness that happens in these patients,” Dupont said. According to Dupont, the pro-

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SCOTT ROGERS | The Times

Pradyumna Tammala and Allison Dupont of the Northeast Georgia Medical Center hold the hospital’s new MitraClip percutaneous mitral valve repair system. The device is a treatment option for patients suffering from the debilitating symptoms of mitral regurgitation.

cedure usually takes anywhere from one to four hours and recovery time is typically short, with patients having the clip implanted one day and being discharged from the hospital the next in some cases.

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“That’s the goal, from the standpoint of recovery. Heartwise, we’ll probably recommend most patients go through a cardiac rehab program if they haven’t already done that,” Dupont said. “There really is not any kind of

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healing time at all. We stitch up the hole that we made in the groin to get into their heart, the stitches are removed the following day and the patients can walk around and resume normal activities, for the most part,” she continued. MitraClip also poses fewer risks than traditional cardiac surgeries in that patients are not under as deep of anesthesia, and are usually awake and talking within 1015 minutes of procedure completion. “It’s pretty neat. It’s an amazing technology. We’re ramping up our program very quickly so we’re excited about it. We’re trying to stay on the cutting edge here,” Dupont said. The center had three of the MitraClip procedures performed by April 13, with more scheduled for the following weeks. Several patients were also in the process of evaluation for MitraClip. “There’s definitely a need in the area,” Dupont said. “We are educating. The first step was to educate all of the cardiologists,

so everybody that’s at Northeast Georgia has been educated about it. I’m also going to be going around and speaking with referring physicians about it.” Patients can refer themselves in most cases, if they feel they may be a candidate. “It depends on insurance, of course, but in most cases patients can make a self-referral to come be evaluated and see one of the cardiologists at the Heart Center who will then, if they feel it is appropriate, refer them to either myself, or to Dr. Tummala, who is also implanting these,” Dupont said. According to Dupont, in studies that have been done so far on the MitraClip both in the U.S. and Europe, patients that underwent placement of the clip were shown to have significantly reduced symptoms. To learn more about MitraClip and the Heart Center of Northeast Georgia Medical Center, visit theheartcenterngmc.org or contact 770-534-2020.

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Machine helps detect cervical cancer earlier by andi eckardt

aeckardt@gainesvilletimes.com

SCOTT ROGERS | The Times

Holt Harrison demonstrates a DySIS machine to Michele Owen at the Heritage OB/GYN offices in Gainesville. The high tech device allows doctors to get a closer look at the cervix and searches for cancerous and pre-cancerous spots.

At Northeast Georgia Physicians Group Heritage OB/GYN, doctor Holt Harrison is helping women catch the symptoms of cervical cancer early with a new machine called DySIS. DySIS features a new computerized diagnostic tool designed to assist in the early detection of cancerous and precancerous cervical lesions. “A colposcopy is a way we evaluate the cervix for cervical

dysplasia,” Harrison explained. The test would likely be recommended by a doctor if a woman received an abnormal Pap smear, one of the easiest ways to first detect any abnormalities, according to the Mayo Clinic website. Harrison and the DySIS manufacturer describe it as a “next generation colposcope.” The DySIS colposcopy is performed by scanning the cervix with a vinegar solution that turns ■■Please see DySIS, 5

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DySIS ■■ Continued from 4

abnormal blood vessels a bright white. According to Harrison, DySIS does two important things in the screening process. “(First), the patient can see exactly what we’re seeing so they can understand the problem and what needs to be biopsied,” Harrison said. “(Second), we are able, over time, to detect changes with the dysplasia. If it’s more severe than before, we can issue a biopsy.” The most unique thing about DySIS is that it uses a computer model to process highdefinition images onto the screen for a patient to see. The computer objectively projects the areas with the greatest amount of whitening to showcase abnormalities, giving another layer of certainty when scanning. “The DySIS system helps take the fear out of the process for patients. They see what we see on the screen, and that eases some of their fears,” Harrison said. Harrison also wants patients to know not all abnormalities have to be treated. It depends on the severity of the dysplasia. “In most cases, if it’s a mild case it goes away on its own,” Harrison said.

Holt Harrison and Michele Owen work with their new DySIS machine at the Northeast Georgia Physicians Group Heritage OB/ GYN offices on Lanier Park Drive. SCOTT ROGERS The Times

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Beach body got you down? Could be time for a little lift

BY Brandee A. Thomas For The Times

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s summer on the lake approaches, many ladies — and gentlemen — can hear the ominous tune from “Jaws” playing louder and louder in their ears as they think about shedding layers and laying out in swimsuits for all the world to see. If diet and exercise alone haven’t given you the summertime fine body that you’re after, a consultation with a cosmetic surgeon may give you the results you’re craving. “Now is the perfect time to get ready for summer,” says Puya Davoodi, a board certified plastic surgeon with the Aesthetic Center of Gainesville. “Most people consider the summer season starting with Memorial Day. If you had your procedure done now, depending on the type of surgery, you could potentially be ready way before then.” If a nip or tuck is on your radar, now is the time for surgery if you want to minimize potential scarring. “Scarring really depends on the

For the Times

Plastic surgeon Puya Davoodi warns patients to not treat plastic surgery as a “build-a-body workshop,” but said certain surgical interventions can enhance appearance just in time for summer.

quality of your skin and skin type, but if a scar gets (too much) sun, it can create a really dark line,” Davoodi said. ■■Please see beach, 7

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“So a person with very fair skin can have a thin scar turn into a big dark line because of sun exposure, so that would be very noticeable. “With all surgeries, we like to stay on the side of caution, so we encourage our patients to limit sun exposure for the first 2-3 months during the initial healing process, but then we also say it’s good to get into the habit of using plenty of sunblock for the first, full year after your procedure. Sunblock is especially important when you’re out on the lake.” If you’ve ever observed your bathing suit-clad body in a mirror and wished for the ability to reposition fat from one area of your body to another, your dream is a very tangible reality with liposuctionaided body contouring. “With lipo-contouring, you take a person’s own fat and use that to contour a variety of body parts. Most people are familiar with that (procedure to improve) the gluteal region, but you can also use some of that fat if there’s a little breast asymmetry if you don’t want to do full breast implants,” Davoodi said. “We use this a lot for breast reconstruction patients to create better symmetry and upper breast fullness.” Whether it’s liposuction or lipo-contouring, Davoodi warns against patients treating cosmetic surgery as an “abracadabra” body image cure-all or build-a-body workshop. “If someone is largely overweight, I always tell them to try to lose some weight first. We try to give (clients) realistic options, which is why it is so important to come into your consultation with an open mind,” Davoodi said. “I want to make sure we’re on the same page before we enter the operating room. Sometimes people will bring pictures and point out features they like on others. Pictures are great, but we can’t always recreate what they see because of differing bone structures and body shapes. “We don’t mind when you bring in pictures, but one of the best resources you have available to you is a consultation with a board certified surgeon to get a realistic idea of what can be done.” Realistic goals and a stable body weight is especially important when it comes to lipo-contouring because an increase in your weight could cause your re-deposited fat to disperse to undesired areas. Now is also the time to take care of those worrisome spider and varicose

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While varicose veins and spider veins require different treatments, both can typically be taken care in office-based procedures with minimal recovery time.

veins in your legs, Michael Lebow, a board certified vascular surgeon with of University Surgical Vascular in Gainesville said. “Varicose veins are the kinda bumpy ones and the spider veins are the blue lines you see in your legs,” Lebow said. “Both are easily treated with different techniques. Both are office-based treatments with no real recovery times, but spider veins are best treated in the winter or early spring. To get rid of those, we do a little injection into the vein and sometimes the blood in those clots. “Because the vein is so close to the surface of the skin, it can get a dark spot for a period of time and then get reabsorbed like a scab. If there is a lot of sun exposure to the area during this time, it can cause the skin to pigment, so it is best to not sunbathe during your recovery.” Unlike varicose veins, which are largely a cosmetic issue, it can take about a month for spider veins to heal following your procedure. “If you really want to be out on your boat in June and you have spider veins, take care of them now,” Lebow says. “If you wait until summer time, it’s not good for cosmetic reasons. The procedure would work fine, but it wouldn’t get you the (visual) results you want.”

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NE Georgia Medical Center Braselton

Combined screens improve efficiency, outcomes by carly sharec

csharec@gainesvilletimes.com

As technology advances, health care improves — as staff at Northeast Georgia Medical Center’s Braselton location have discovered. “We had to sort of think outside-the-box here in Braselton,” said Ivan Moore, cardiology manager at the South Hall hospital. “One of the things we did was, we took (similar) areas and combined them. “We brought multiple departments together into one to try to maximize our space but still give the services to the

community that we give in Gainesville.” Northeast Georgia Medical Center’s Braselton location opened its doors April 1, bringing a variety of medical services to South Hall along with the 100-bed hospital. Moore’s area brings together interventional radiology and a cardiac catheterization laboratory into one department. “With a 100-bed hospital, you have to make some decisions ... to have a room for

This laboratory combines interventional radiology and cardiac catheterization into one department, improving efficiency at Northeast Georgia Medical Center Braselton. For The Times

■■Please see SCREEN, 11

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SCREEN ■■ Continued from 10

SCOTT ROGERS | The Times

Northeast Georgia Medical Center’s 100-bed Braselton location opened April 1 to serve the South Hall community.

interventional radiology down in the radiology department, and a room for the cath lab in the cardiology area and then a room for the vascular surgeons in their world ... it’s very expensive to have three different rooms, three different staffs, three different areas to store supplies,” Moore said. These services in particular aren’t new; many formerly invasive procedures, short of full-blown surgery, can now be completed using a sheath, like pacemaker insertions or placing an inferior vena cava filter (which is placed around the kidneys to capture a blood clot). What is new in this combined department at Braselton’s location is something called FlexVision — a giant television screen with the ability to show multiple test results side-by-side. “It’s sort of like watching two channels at the same time when you’ve got a bar right down the middle of the screen,” Moore explained. “We’re able to configure that FlexVision in a whole bunch of (ways).

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“It gives the doctor a lot of flexibility to be able to use multiple tools at the same time, which really we haven’t had the capability to do without having to roll multiple screens in front of the doctor.” Beforehand, doctors would have to review various test and imaging results separately. Now, it can all be reviewed at the same time. According to Moore, this has helped doctors make faster, more informed diagnosis and treatment plan for patients. “It’s a great comparison tool,” Moore said. “Sometimes, the doctor will want to see what’s going on with the X-ray, but also correlate the X-ray against an ultrasound or against some invasive waveforms on a screen. And then we can manipulate it to fit however the doctor wants it. “You can do it with fewer people involved,” Moore continued. “... You would have to have lots of people rolling different pieces of equipment around the room. Things were bumping into each other. It’s just really nice to have all of that on one screen. “We have barely scratched the surface with this new tool. I’m sure it will prove to be very valuable.”

GAINESVILLE HEART AND VASCULAR GROUP At Gainesville Heart & Vascular Group, we believe that the patient is the center of our practice. We are committed to providing the best possible care through diligent clinical evaluation and appropriate use of state-of-the-art technology. Guided by compassion for each individual, we strive to provide convenience and peace of mind to our patients by providing most services under one roof. Our ultimate goal — help our patients achieve a better quality of life. S E RV I C E S O F F E R E D • Adult Consultative Cardiology • ECG, Holter and Event Monitoring • Exercise Treadmill Testing • Echocardiography • Transesophageal Echocardiography • Stress Echocardiography • Myocardial Perfusion Imaging (Nuclear Scans) • Peripheral Vascular (claudication) Testing • Cardiac Catheterization (leg and wrist access)

• Coronary Angioplasty and Stenting • Peripheral Vascular Angioplasty and Stenting • Renal Angioplasty and Stenting • Pacemaker Implants • Loop Recorder Implants • Pacemaker and ICD Management • Anticoagulation Management • Lipid Management • Pulmonary Hypertension Testing

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Cardiovascular disease affects over 80 million people in the United States. Risk factors associated with cardiovascular disease include age, diabetes, high blood pressure, high cholesterol, tobacco use and family history of cardiovascular disease. Symptoms associated with cardiovascular disease include chest pain, shortness of breath, arm/leg pain, loss of consciousness and fatigue. We at the Gainesville Heart and Vascular Group specialize in prevention, diagnosis and treatment of cardiovascular disease. Established in 1994, the Gainesville Heart & Vascular Group, formerly known as the Gainesville Heart Group, is recognized as the first cardiology practice dedicated to the care of heart patients in Gainesville and surrounding areas. Its founder, Dr. David P. Johnson is a Gainesville native who had a dream of providing full-time and full-service cardiac care to the community. He and his partners played an integral part in bringing the Open Heart Surgery Program to Gainesville in 2002. Our staff has a reputation of applying a personal touch to our care and cherishing the relationship we have with our patients. Our staff, including physicians, enjoys residing and being an active part of the Hall County community. Our office has a wide variety of services, including general cardiology consultation, electrocardiography, echocardiography / 2-D Doppler, stress echocardiography, nuclear stress testing and ankle brachial pressure index. Our physicians are staffed round the clock, 365 days a year, at the Northeast Georgia Medical Center. Cardiac catheterizations, including coronary and peripheral artery stenting, stress testing, transesophageal echocardiography and pacemaker devices are performed at the Northeast Georgia Medical Center.

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Vigilance, knowledge essential for water safety by caroline watts intern@gainesvilletimes.com As the weather heats up in Northeast Georgia, countless people will flock to Lake Lanier to cool off and have a good time. Though having fun may be your main priority this spring and coming summer, your safety and the safety of others shouldn’t be far behind. There are about 3,500 deaths from drowning annually in the United States, which is about 10 deaths a day, according to the National Safety Council. About 14 percent of those that die from drowning incidents are children under age 4. Despite the alarming facts, there are steps you and your family can take to ensure that you don’t become part of the statistics. “Safety on the water, as in other environments, is mostly a

Water safety resources

■■ redcross.org/watersafety ■■ cdc.gov ■■ nsc.org ■■ gainesville.org/ swim-lessons ■■ hallcountyymca.org

matter of awareness and good judgment,” said Michael J. Riemann, disaster program manager of American Red Cross of Northeast Georgia. “Adults supervising children have a particularly special obligation to be certain that conditions are safe.” Riemann also suggests paying attention to the water you and your family will be swimming in and making sure there are no submerged objects that could present a threat. The Red Cross recommends knowing the proper way to provide CPR and first aid, as well

as having an object that can be thrown to the person in danger and a cellphone on hand to quickly call 911, should something happen. Though children account for many drowning deaths in the United States, maturity doesn’t remove risk. The Center for Disease Control reported in 2014 that up to 70 percent of drowning deaths among teens and adults were the result of alcohol use. “Don’t mix alcohol, drugs and poor judgment with water recreation,” Riemann wrote via email. “Thoughtless behavior can turn a good day into a bad one in a heartbeat.” The Red Cross as well as the city of Gainesville and other businesses around Hall County provide water safety classes that just might save your life or the life of someone you love.

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CARLY SHAREC | The Times

YMCA swim instructor Miranda Elrod takes questions on Sept. 3 before letting third-grade students from Oakwood Elementary jump in the pool.

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Farmers markets provide trove of incredible edibles by jessika bouvier

jbouvier@gainesvilletimes.com

With summer months ahead on the calendar, local communities are once again hosting farmers markets featuring fresh, home-grown vegetables, fruits and other seasonal goodies. While some citizens jump for joy at the thought of markets returning for another season, others continue to wonder: What’s all the hoopla about street side produce stands? Farmers markets generally allow for local vendors to prop up a tent and sell their organic fruits and vegetables, homemade products or other handcrafted goods to nearby consumers. Certain people insist the combination of decent prices and fresh flavors are the two best-selling points for farmers market products, but for others the issue runs even deeper. Health has arguably become one of the hottest topics in the United States over the past decade. Numerous food documentaries like “Food, Inc.” and “Forks

Over Knives” have brought attention to unhealthy eating habits, as well as some unethical practices in food monopolies. Due to the increased rate of exposure to the connections between overall health and food produced in the United States, more people are asking questions about the food we eat: How is it made? Where does it come from? And, potentially the most popular, what is in it? “A genetically modified organism is simply a genetically engineered food,” said Leslie C. Davis, a nutritionist and registered dietitian with North Georgia Nutrition and Wellness. “‘Roundup ready’ crops ... are engineered to be sprayed with the herbicide Roundup (and suffer no ill effects).” GMOs occur when the DNA has been altered to contain one or more genes not found naturally. The herbicide Roundup was formulated by scientists in the 1970s, designed to destroy weeds surrounding crops in order to yield a more bountiful harvest.

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For the Times

The Flowery Branch Farmers Market will open in May, featuring non-genetically modified fruits and vegetables.

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Food ■■ Continued from 13

“The active ingredient in Roundup is glyphosate,” Davis wrote via email. “Glyphosate was invented to bind metals as a descaling agent to remove scales or deposits on boilers and pipes ... when the chemical was disposed of in nature it killed all plants in the area. The chemical was purchased and re-patented in 1969 as a herbicide.” Today almost all of the corn, soybean, canola, alfalfa and sugar-beets grown and sold in the United States come from Roundup-ready seeds. This also includes products that include these plants as active ingredients, such as canned soups, nonorganic baby formulas, carbonated soft drinks and much more. Some consumers choose to buy local foods because of this. While a large portion of research on GMOs is inconclusive,

the controversy alone is proof enough for some. Farmers markets offer the solution to the task of evading Roundup ready products. “Studies have shown a correlation between Roundup ready foods and diseases like celiac disease, autism, cancer, diabetes and infertility,” Davis wrote. “There is no regulation of Roundup in the U.S. and Canada but it is regulated in other countries and banned in some countries.” The Flowery Branch Farmers Market is one that has taken recent steps to make sure they are offering their customers the freshest organic foods. “Last year we asked these particular vendors about the type of seed that they used for their corn and they said that they used GMO seeds ... we are talking about not having them back this year. We need more organic, chemical and pesticide-free vendors at the market,” wrote Jimmy and Patty DePew, market managers.

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Area farmers markets Hall County Farmers Market

When: 2:30-6:30 p.m. Tuesdays and opening 7 a.m. Saturdays beginning May 5 Where: At the corner of Jesse Jewell Parkway and I-985, Hall County

Historic Downtown Gainesville Market on the Square

When: 2:30-6:30 p.m. Fridays from May 29 through Oct. 2 Where: Downtown Gainesville

Flowery Branch Farmers Market

When: 4-7 p.m. Thursdays from May through October Where: Railroad Avenue, Flowery Branch

Dahlonega Farmers Market

When: 3-6 p.m. Tuesdays and 8 a.m. to noon, Saturdays from May 2 through Oct. 10 Where: Hawkins Street, Dahlonega

Braselton Farmers Market

When: 4-7 p.m. Fridays from June 5 through Oct. 16 Where: Harrison Street, Braselton

Northeast Georgia Locally Grown

When: Order online, beginning 9 a.m. Fridays through 9 p.m. Mondays. Orders are picked up 5-7 p.m., Wednesdays Where: Northeast Georgia History Center, 322 Academy St., Gainesville More info: northeastgeorgia.locallygrown.net

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