Baylor Scott & White
B a p aylo art r H e of Ba alth ylo Ca r S re cot Sys t & tem Wh is ite now He alt h
BaylorHealth.com/Dallas
MARCH 2015
‘‘I can
eat my favorite foods again.
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Josh ned found the solution he needed for chronic heartburn PAGE 6
Master of One Focused surgical specialties means expert care for you page 4
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QUICK HITS
The Benefits of Being a Teaching Hospital
Conquering Cancer with Quality Care When fighting cancer, you want the best and the brightest experts on your side. That’s why we’re excited about our cancer care report card: Accreditation with Commendation, Gold Level. That was the result of the recent evaluation of the Baylor Charles A. Sammons Cancer Center at Dallas by the Commission on Cancer (CoC) of the American College of Surgeons. To measure the quality of cancer care programs, the CoC does a rigorous evaluation every three years, looking at how well a program meets 34 quality care standards. “Receiving accreditation with commendation says that we are meeting and exceeding standards in
all areas,” explains Alan Miller, MD, PhD, medical director of the Baylor Sammons Cancer Center. The CoC has continuously accredited the cancer program since 1962. However, 2014 marks the first time the program received commendation in all seven possible commendation categories, earning the program’s Gold Level status.
Local Cancer Care Visit BaylorHealth.com/ DallasCancer to learn more about the cancer care services available at Baylor Dallas.
As a teaching hospital, Baylor University Medical Center at Dallas serves as a major patient care, teaching and research center for the Southwest. Physicians who have completed medical school serve as interns, residents and fellows, pursuing increasingly advanced training in their chosen specialties and subspecialties. After their residency programs end, “between 25 to 30 percent of our residents stay in the area and become future doctors for our health system and community,” says William Sutker, MD, director of medical education at Baylor Dallas. A teaching hospital also tends to attract highly skilled physicians who enjoy training the next generation of doctors. “It’s rewarding to be able to teach, and it keeps the staff on their toes,” Dr. Sutker says. “You have to stay current in order to be the best teachers.” In fact, having a teaching program enhances the reputation of a hospital, Dr. Sutker says. Baylor Dallas was voted to the U.S.News & World Report’s “America’s Best Hospitals” list in 2014.
Learn More
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Go to BaylorHealth.edu for more information on medical education.
Baylor University Medical Center at Dallas, 3500 Gaston Ave., Dallas, TX 75246. Patient Information: 214.820.0111. Volunteer Opportunities: 214.820.2441. Giving Opportunities/Baylor Health Care System Foundation: 214.820.3136. Visit BaylorHealth.com or call 1.800.4BAYLOR for information about Baylor University Medical Center at Dallas services, upcoming events, physician referrals, career opportunities and more. Baylor Health Care System Mission: Founded as a Christian ministry of healing, Baylor Health Care System exists to serve all people through exemplary health care, education, research and community service. CEO, Baylor Health Care System: Joel Allison. President, Baylor Health Care System: Gary Brock. President, Baylor University Medical Center at Dallas: John B. McWhorter III. Marketing/Public Relations Director: Jana Pope. Editor: Breck Yakulis. Baylor University Medical Center at Dallas Board of Directors: Timothy Owens, Chair; Dighton Packard, MD, Vice Chair; CT (Sparkey) Beckham; Judge Oswin Chrisman; Shelly Conroy; Gary Cook; Michael L. Graham; James H. Gray, MD; Charles Ku; Robert Mennel, MD; Ronald D. Murff; J. Kent Newsom; Michael Ramsay, MD; Gretchen Williams; Donald H. Wills; John B. McWhorter III. The material in Baylor Scott & White Health is not intended for diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines. Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor University Medical Center at Dallas or Baylor Health Care System. Photographs may include models or actors and may not represent actual patients. Baylor Scott & White Health is published by McMURRY/TMG, LLC six times a year for friends and supporters of Baylor University Medical Center at Dallas. © 2015 Baylor Health Care System. If you are receiving multiple copies, need to change your mailing address or do not wish to receive this publication, please send your mailing label(s) and the updated information to Robin Vogel, Baylor Health Care System, 2001 Bryan St., Suite 750, Dallas, TX 75201, or email the information to robinv@BaylorHealth.edu.
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TAKE THIS QUIZ If you have diabetes, it’s essential that you understand hemoglobin A1c, a test that measures your average blood glucose. Visit BaylorHealth.com/ HemoglobinA1c to see what you know.
Exercise is a vital component of good health for young and old. Yet the way to prevent injuries changes as we age. Here are two tips to keep you in the game.
Beat Blood Sugar Spikes Although managing diabetes might seem daunting, a big part of your plan boils down to this: Avoid blood sugar spikes. The good news is, it really can be as easy as 1-2-3.
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Add exercise to your life—ideally, right after a meal. Eating raises blood sugar. Exercise lowers it.
Fill up on fiber. Beans, whole grains and some high-fiber vegetables can actually squash blood sugar spikes. Added bonus: These foods are filling, so they help with portion control, too.
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Find your whey. Recent research suggests that consuming whey protein prior to a high-carb meal helps reduce post-meal blood sugar spikes in well-controlled type 2 diabetes patients.
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Kids, avoid overtraining. Many experts recommend taking off at least one season a year to reduce the risk of injury. According to one research study, young athletes should not spend more hours training per week than their age. Those who exceeded the limit were 70 percent more likely to suffer an overuse injury. Adults, avoid undertraining. Build up your exercise level gradually, and avoid the “weekend warrior” temptation to fit a week’s worth of activity into a day or two.
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Get Help for What Hurts Visit FindDrRight.com to locate a sports medicine physician near you—and make an appointment today!
Six out of 10 adults in Texas got colorectal screenings as recommended in 2010. That’s up from 35 percent in 2000—but it’s just below the 2010 national average of 65 percent. Screenings help find polyps before they have a chance to become cancerous. BaylorHealth.com/Dallas
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Who Does What? Understanding surgical specialties
Call in the Specialists By sharpening their skills in particular disciplines, surgeons offer expert care for patients Two or three decades ago,
cardiothoracic and vascular surgery was considered one specialty. “The same surgeon might operate on a blood vessel in the neck and then on a child’s heart the next day,” says David Mason, MD, chief of thoracic surgery and lung transplantation for Baylor Scott & White Health. With an explosion of knowledge, technology and techniques, “there’s no way that an individual surgeon can really be an expert in all the nuances of these vastly varied specialties,” Dr. Mason says. Over time, surgeons have begun to subspecialize in a particular aspect of cardiothoracic and vascular surgery. “It’s by keeping up with the advances in their specific fields that surgeons can provide patients with the best care,” Dr. Mason says. In simplified terms, cardiac surgeons treat the heart, thoracic surgeons treat everything else in the chest, and vascular surgeons treat noncardiac blood vessel problems.
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Taking It to the Next Level To be an expert means knowing more than just how to do certain procedures—it also means knowing whether and when a surgery is needed. “In addition to the technical aspects of the operation, one needs to have knowledge about the patient’s disease, the other potential treatment options and the patient’s overall medical condition,” Dr. Mason says. “This can only happen with close collaboration among treating physicians and should occur before any patient goes to the operating room.” In line with national trends of narrowly focused surgical specialization, Baylor University Medical Center at Dallas added a dedicated thoracic surgery department in September. “We’re completely committed to noncardiac surgery of the chest,” Dr. Mason says. “Our mission is to advance the field of thoracic surgery and provide expert, compassionate care to our patients.”
A cardiac surgeon can treat: F Coronary artery disease or blockages of the arteries in the heart F Blocked or leaking heart valves F Abnormal enlargement or aneurysms of the large arteries in the chest F Heart failure F Atrial fibrillation A thoracic surgeon can treat: F Lung or esophageal cancer F Severe emphysema F Gastroesophageal reflux disease F Hiatal hernias F Swallowing disorders A vascular surgeon can treat: F Blocked blood vessels in the upper and lower limbs F Aneurysms in the abdomen and elsewhere F Vascular trauma F Varicose veins
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Your Neighborhood Surgical Specialists Visit BaylorHealth.com/ DallasHeart to learn more about the specialty care available at Baylor Dallas.
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Your Lungs: What Can Go Wrong?
Yes! You can have exercise if you asthma. Talk to out your doctor ab . creating a plan
The low-down on three chronic conditions that cause trouble for the lungs, and the treatments that are making a difference Every time you take a breath, it kick-starts a complex series of events that brings oxygen from the air into the blood that circulates through your entire body. It’s a fascinating process that can sometimes hit speed bumps. “At least 40 million Americans are currently diagnosed with a chronic lung condition,” says Mark Millard, MD, medical director of the Martha Foster Lung Center at Baylor University Medical Center at Dallas. Here, he brings us up to speed on three conditions that cause trouble for the lungs (and have nothing to do with smoking), as well as the latest treatments.
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aSTHMa AMERICANS AFFECTED: ABOUT 26 MILLION The most common chronic lung condition, asthma is characterized by inflammation and spasms of the airways, which causes wheezing and shortness of breath. Though asthma has a strong genetic component and usually develops in childhood, Dr. Millard says some cases do appear in adulthood. “Those are often more serious and difficult to treat.” HOW IT’S TREATED: Daily medications can help keep symptoms at bay, and the latest inhalant medications are very effective at reducing inflammation and spasms, Dr. Millard says. You can also reduce your risk of an attack by avoiding exposure to cigarette smoke, allergies and pollution.
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PUlMoNaRY fiBRoSiS AMERICANS AFFECTED: 140,000 This progressive disease causes scarring and stiffness in the lungs, making it difficult to breathe. “It stems from a defect in how the lungs repair themselves—they scar instead of heal,” Dr. Millard says. Causes may include autoimmune
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diseases, genetics and chemical Ready for Relief? exposure (such as The Advanced Lung Disease Center asbestos). at Baylor Dallas offers people with HOW IT’S TREATED: cystic fibrosis access to the latest Without therapeutic techniques to control medication, the symptoms and improve quality of prognosis is bleak. life. Visit BaylorHealth.com/ “Life expectancy DallasPulmonary to learn more. after diagnosis is just three to five years,” Dr. Millard says. “Thankfully, two newly FDA-approved medications may help slow its progression and turn back the clock on scarring.”
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CYSTiC fiBRoSiS AMERICANS AFFECTED: 30,000 This inherited condition is characterized by an inability of the lungs to effectively clear mucus from the bronchi, the main passageways of the lungs. “These individuals experience chronic lung infections, and many will require transplantation,” Dr. Millard explains. HOW IT’S TREATED: Individuals born with cystic fibrosis have a difficult road ahead, requiring treatment several times each day as well as frequent hospitalizations. “But exciting new medications for treating CF are on the horizon,” Dr. Millard says. “These treatments may be able to repair the basic genetic defects and allow these individuals to lead normal lives.”
BaylorHealth.com/Dallas
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REAL PATIENTS. REAL STORIES.
Burned Out
After a decade-long bout with heartburn, Josh Ned is pain-free and back to eating the foods he loves with occasional heartburn after a particularly greasy or spicy meal. But Josh Ned’s heartburn was anything but occasional. “I was taking over-the-counter medication for heartburn about 10 times a day,” says the 32-yearold McKinney resident. “I couldn’t eat anything spicy or sweet. Even apple juice and orange juice were off the list.” After nearly a decade of discomfort, Ned finally mentioned his heartburn to his doctor last spring, who sent him for an upper endoscopy, a procedure used to determine the cause of heartburn. It showed that Ned had gastroesophageal reflux MOST OF US ONLY DEAL
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disease, or GERD, a condition in which the valve between the esophagus and stomach doesn’t close properly, allowing stomach acid to back up into the esophagus, causing a burning sensation and severe damage. The fi x was medication— one that Ned would only have to take once a day. He was thrilled. “I haven’t had heartburn since starting the new medication,” Ned says. “I can eat my favorite foods again—Tex-Mex, barbecue, cranberry juice and smoothies. I just feel so much better.” Ned may have waited years to ask his doctor about heartburn, but you don’t have to. Here are the answers to some common questions about GERD.
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“Within a few days of starting the medication, I saw a difference. It makes me wish I would’ve talked to my doctor a lot sooner.” —Josh Ned
HoW CAN I TeLL WHeTHer IT’S GerD? A doctor will need to diagnose GERD, but symptoms include: 3 Frequent heartburn 3 Regurgitation of food or a sour
taste in the back of your mouth
3 Chest pain 3 Difficulty swallowing 3 Cough 3 Hoarseness or sore throat 3 Feeling as if there’s a lump in
your throat
“Different people have different symptoms. More common than not, people will have heartburn or discomfort in their stomach or chest,” says Praveen Srungaram, MD, a gastroenterologist on the medical staff at Baylor Medical Center at McKinney. “But those symptoms overlap with heart and lung issues. Talk to your doctor to make sure it’s not your heart or lungs.” IS GerD DANGeroUS? GERD itself isn’t dangerous, but it can lead to other conditions. “When stomach acid is constantly coming back up into the esophagus, it starts to eat away at the esophageal lining,” Dr. Srungaram says. “That can lead to inflammation, bleeding and, in some cases, Barrett’s esophagus.” Barrett’s esophagus is a condition where the tissue of the esophagus, after repeated exposure to stomach acid, begins to resemble tissue found in the intestine. It’s an uncommon complication of GERD, but it can lead to esophageal cancer.
HoW IS GerD TreATeD? Your doctor may recommend trying over-the-counter antacids to curb the pain associated with heartburn. But if that doesn’t work, other medications are available to help reduce acid production and strengthen the esophageal valve. In some cases, surgery may be necessary to repair damage to the esophagus. “If you’re finding that you have to take medicine on a regular basis or you still have symptoms after eight to 12 months, it’s probably a good idea to see a specialist,” Dr. Srungaram says. WHAT CAN I Do To PreVeNT GerD? Although you can’t prevent GERD, there are steps you can take to reduce heartburn. Maintain a healthy weight. Excess belly fat directly contributes to heartburn because it puts pressure on your stomach and causes acid to back up into your esophagus. Aim for a waist circumference of no more than 35 inches for women or 40 inches for men. Loosen your belt—literally! Avoid tight-fitting clothing around your abdomen for the same reason as above—it puts unnecessary pressure on your stomach. Don’t lie down after eating. Wait at least three hours before going to bed. Don’t smoke. Smoking reduces the effectiveness of the esophageal valve. Avoid trigger foods. Different people have different heartburn triggers, but common culprits include spicy dishes, fatty foods, tomato sauce, onion, garlic, chocolate, peppermint, alcohol and caffeine. Large meals of any type can also trigger heartburn.
Have IBD? Read This Last September, the Baylor Center for Inflammatory Bowel Diseases opened to provide specialized care for people with IBD. What is IBD? Ulcerative colitis and Crohn’s disease are the two main types of IBD, not to be confused with irritable bowel syndrome, or IBS. “We all have some low-grade inflammation in our intestines to fend off dangerous microorganisms,” explains Themistocles Dassopoulos, MD, medical director of the center. “With IBD, this normal inflammation becomes unnecessarily exaggerated and causes damage to the intestine.” Although these lifelong diseases have no cure, the goal of medical management is to give people a better quality of life by controlling symptoms and preventing complications. “The vast majority of our patients lead normal lives. Our center brings an integrated, coordinated approach to patient care, with a close collaboration between medical and surgical doctors,” Dr. Dassopoulos says. “We emphasize the importance of the patient as an active participant in managing the disease.”
More
Let Us Help Visit BaylorHealth.com/ DallasDigestive to learn more about the Baylor Center for Inflammatory Bowel Diseases.
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How Bad Is It?
Talking on your cellphone all day. Saying yes to tanning and no to sunscreen. Skipping screenings. Find out how risky these actions really are when it comes to cancer NOBODY’S PERFECT. But with cancer prevention, it pays to be as close to impeccable as possible. Here, we rate your habits on a one-to-five scale based on advice from Baylor Scott & White Health experts.
RISK RATING
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Stop it right this minute!
GETTING YOUR BRONZE ON Sun-kissed, golden skin might look great, but melanoma does not. According to the International Agency for Research on Cancer (IARC), a working group of the World Health Organization, people who use tanning beds before age 30 increase their lifetime risk of melanoma (the deadliest form of skin cancer) by 75 percent. So if you want a tan, hit the bronzer bottle, not the bed—self-tanner options are inexpensive, easy to use and completely safe.
SKIPPING YOUR SCREENINGS Health screenings aren’t exactly fun, but their benefits are well worth the tedium, says James Fleshman, MD, a physician on the medical staff at Baylor University Medical Center at Dallas. For example, he says, “colonoscopy screening starting at age 50 and every 10 years thereafter in a patient with no risk factors can prevent cancer from ever occurring by detecting and removing precancerous polyps.” The same principle holds true for mammograms, says Michael Grant, MD, a physician on the medical staff at Baylor Dallas. “For women over age 50, studies show that screening mammograms can help reduce the number of deaths caused by breast cancer,” he says. In laymen’s terms? You can’t overcome cancer if you don’t even know it’s there. Talk to your doctor about setting up your screening schedule. ©Thinkstock
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Identify Cancer Early Organic or not— eat those veggies!
These four common cancers are easier to treat when detected early. But your doctor can’t find them if you don’t get screened. Here’s when to start. 3 Colorectal cancer: Men and women should get a colonoscopy at age 50, and every 10 years if no polyps are found. (African-Americans should start at 45.) 3 Breast cancer: Starting at age 40, women need to schedule annual mammograms.
oPTING oUT oF orGANIC If the pressure to buy all organic produce has you avoiding fruits and veggies entirely, take note: Whether organic foods translate to a lower risk of cancer because they are less likely to be contaminated by cancer-causing compounds is largely unknown, the American Cancer Society (ACS) says. So, while choosing organic produce certainly won’t hurt you (although it can be a bit pricier than conventional options), it may not be completely necessary. More important than organic versus nonorganic is fresh food versus junk food. Eat those veggies!
3 Cervical cancer: Pap tests are recommended every one to three years for women 21 to 65.
3 Prostate cancer: Starting at 50, men should have an annual DRE (digital rectal exam), along with counseling about the pros and cons of the prostatespecific antigen (PSA) blood test.
“If you have a family history or any other risk factors, talk to your primary care doctor about starting screening earlier,” says Michelle Ho, MD, an internal medicine physician on the medical staff at Baylor University Medical Center at Dallas.
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Need a Screening? Visit BaylorHealth.com/ Dallas to find a physician who can get you up to date.
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TALKING oN YoUr CeLLPHoNe ALL DAY Hold the phone—literally. A recent report by the IARC found limited evidence of a possible connection between cellphone use and brain tumors. One of the studies examined for the report, which looked at cellphone use in several countries prior to 2004, showed that the heaviest cellphone users had higher risks for malignant
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brain tumors. Heavy use was defined as 30 minutes per day for 10 years. Although the evidence is not conclusive, it is enough to warrant concern, the ACS says. What can you do? Use an earpiece or a landline (remember those?) to limit time spent with your cellphone to your ear. BaylorHealth.com/Dallas
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ADVANCING MEDICINE
Seek and Destroy A specialized immune receptor could hold the key for an HIV vaccine
ANY SOLDIER WHO HAS gone on a dangerous mission knows that being swift, strong and focused can make the difference between failure and success. Thanks to a recent study at the Baylor Institute for Immunology Research (BIIR), the lipoprotein ABOUT receptor LOX-1 could THE STUDY be that difference LOX-1 Receptor’s when it comes to Role in Mediating creating vaccines for Immune Responses viruses like HIV.
The cell-recognition lipoprotein receptor could boost immune response to infections like influenza, tuberculosis and HIV.
Key Players Baylor Institute for Immunology Research National Institutes of Allergy and Infectious Diseases Tulane National Primate Center in Louisiana CEA (France)
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HOW VACCINES WORK To understand the importance of the research findings, you first have to understand how vaccines work. “Vaccines trigger an immune response by introducing a weakened version of a virus or bacteria to dendritic cells, which induce, regulate and orchestrate the immune response,”
says SangKon Oh, PhD, principal investigator of the study. But until now, researchers have had difficulty developing effective vaccines for certain viral infections, like influenza and HIV. “Th is is either because the virus can mutate, making it difficult to destroy, or because it remains latent, which makes it difficult to fi nd,” Dr. Oh says. HOW LOX-1 HELPS LOX-1 is a receptor on the surface of dendritic cells (immune system messengers) that senses inflammation caused by fungal, bacterial or viral infections and then activates the immune response, says co-investigator Gerard Zurawski, PhD. In this National Institutes of Health-sponsored study, BIIR researchers took existing vaccines and “aimed” them directly at LOX-1. “By fusing an antibody binding, LOX-1 and a virus protein, we were able to stimulate a much more effective, powerful immune response that was directed specifically at the body’s defense barriers, like the skin and mucous membranes,” Dr. Zurawski says.
HOW IT COULD CHANGE THE FUTURE Their findings could be the key to developing new vaccines against infections that have previously eluded scientists—and that’s created quite a buzz in the research community. In fact, the study made the cover of the journal Immunity in October 2014 and has garnered BIIR funding for future research from the Gates Foundation and others. “It’s our hope that we will see or even participate in the development of new vaccines for illnesses like HIV in the not-so-distant future,” Dr. Oh says. Now that’s a mission we can all get behind.
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More Research Like This
Visit BaylorHealth.com/ AdvancingMedicine and clinicaltrials.sw.org for more of our stories about groundbreaking discoveries in medicine.
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WHAT’S ONLINE BaylorHealth.com
VIDEO
“There was absolutely nothing wrong with me—or so I thought.”
TOOL
TRYING TO GET PREGNANT? ➜ Use our ovulation calculator at BaylorHealth.com/ OvulationCalculator to predict when you’re most fertile.
QUIZ
What’s Your Allergy IQ? Where are those dust mites most likely to be hiding? And what food is most likely to trigger an allergic response? ➜ Visit BaylorHealth.com/ AllergyQuiz to take the quiz and find out.
ONLINE
A New Place for People with IBD If you’ve been diagnosed with ulcerative colitis or Crohn’s disease, there’s a new resource you can turn to: the Baylor Center for Inflammatory Bowel Diseases. ➜ Visit BaylorHealth.com/DallasDigestive
to learn more.
RECIPE
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GRILLED PORK & PEACH SALAD
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If you’ve never tried adding fruit to your salad, now’s the time to start.
Bill Dippel didn’t know he had colon cancer until his physician suggested a routine colonoscopy screening.
➜ Visit BaylorHealth.com/Recipe to get this recipe, plus many more.
➜ Visit BaylorHealth.com/ MyStory to watch Bill’s story.
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Baylor Health Care System Marketing Department 2001 Bryan Street, Suite 750 Dallas, TX 75201
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BAYLOR SCOTT & WHITE HEALTH
THE MOST WELCOME WORDS YOU’LL EVER WANT TO HEAR:
Your heart transplant is 7 days away. Baylor University Medical Center at Dallas is first in Texas and second in the nation for heart transplant volumes. If you’re status 1A and waiting for a heart transplant at another hospital, you may wait months for a donor heart – but not at Baylor University Medical Center at Dallas. Our team of cardiac specialists aggressively pursues ways to save lives, with a remarkable median† wait time of 7 days. We are 1st in Texas for volume, with excellent survival rates. Baylor University Medical Center at Dallas is living proof that the more times a hospital performs a procedure, the better its success rate. Call 1.800.4BAYLOR now. Because if you can only be on one list, this is the one to be on.
To learn more, call 1.800.4BAYLOR or visit us online at BaylorHealth.com/HeartTransplant † Median time to transplant for heart patients listed 1A between 7/1/2013 and 3/24/2014. Source: TIMS, Transplant Referral Management System. Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor Health Care System or Baylor Scott & White Health. ©2015 Baylor Scott & White Health. All rights reserved. ACHC_430_ 2014 BHm CE 01.15
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