Your Health Today
Your guide to healthy lving from Georgia Health Sciences System.
your health [ Your guide to Healthy Living from Georgia Health Sciences Health System ] Winter 2013 | georgiahealth.org today NEW HOPE FOR RECURRING prostate cancer Heart health and hormones: Get the facts A new therapy for Barrettâ€™s esophagus Scan this code with a QR code reader to visit our website! What’s new and noteworthy at Georgia Health Sciences Medical Center? As part of an academic health center, we are continuously upgrading our services, technology and outreach. Here are a few of our latest initiatives, achievements and honors. INSIDE THIS ISSUE PAGE 3 T ips for a safe and healthy winter Avoid winter weight gain PAGEs 4–5 Cancer Prevention When prostate cancer recurs: Robotic salvage prostatectomy Pap tests: Who and when? PAGE 6 Heart Healthy Living Heart health and hormones: Get the facts PAGE 7 Focus on Women Rheumatoid arthritis vs. osteoarthritis ©2013 Intuitive Surgical, Inc. Expanding robotic surgery Depend on the area’s highest level NICU Robotic surgery is fast becoming the standard of care in many specialties. Therefore, Georgia Health Sciences has recently opened a Center for Advanced Robotic Surgery that centralizes robotic surgery across a range of specialties, including: • gynecology and urogynecology • gynecologic oncology • urology and urologic oncology • thyroid surgery • otolaryngology (for tumors of the mouth and throat) Many hospitals offer robotic surgery, but statistics show that outcomes are better if the surgery is performed by experienced surgeons like those at Georgia Health Sciences. The center staffs the largest, most experienced team of robotic surgeons in the region and offers procedures not available at other area hospitals. To learn more, visit georgiahealth.org/ robotics or call 706-721-CARE (2273). The Georgia Health Sciences Neonatal Intensive Care Unit (NICU) has recently been recognized as a Level IV unit, the highest possible designation. This means that premature infants who need even the most specialized care can receive treatment right here in Augusta. What’s more, the unit serves as a regional referral center. The unit offers: • the area’s largest team of neonatologists • extracorporeal membrane oxygenation (ECMO) technology and team, used to keep the hearts and lungs of critically ill infants working • dedicated neonatal dietitians, pharmacists and respiratory therapists • a neonatal air and ground transport team For more information, call 706-721-KIDS (5437). PAGE 8 Neuroscience Epilepsy and seniors PAGE 9 Digestive Health HALO ablation therapy for Barrett’s esophagus PAGES 10-11 Family Health Sleep apnea in kids New i-book calms fears at Children’s Medical Center PAGE 12 In the News Georgia Regents University powers local economy The material in Your Health Today is not intended for diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment. For more information, please call 800-736-CARE (2273) or visit our website at georgiahealth.org. [ 2 ] georgiahealth.org Copyright © 2013 Georgia Health Sciences Tips for a safe and healthy winter Three ways to avoid winter weight gain [ S] hort days and cold nights bears, not people. Keep moving, better options because they are can lead to lethargy, over regardless of the temperature. lower in fat and calories. If you eating and winter weight gain. But Dress in layers and head to the drink alcohol, limit it to one drink with a little caution, you can hold the park or walk the dog around the a day for women or two for men. line or even lose weight. Here are a block. Join a gym, or buy a jump Alcohol is high in calories. Drinking few tips:  rope and hand weights and work in excess also increases your risk of Don’t treat your mood out at home. Try to limit screen many diseases. with food. Comfort foods time and sitting. Even simple like macaroni and cheese, mashed chores such as folding laundry, potatoes and gravy, and hot apple vacuuming or raking leaves pie are all great on cold evenings, burn calories. when you feel isolated at home. But they are loaded with fat and Images on any of these pages may be from one or more of these sources: © 2013 Thinkstock and © 2013 istockphoto.com. calories. Instead, build menus around  Think before you drink. Hot chocolate and vegetables, whole grains and lean creamy coffee drinks meats. Try vegetable soups, black are great in chilly beans and brown rice, skinless grilled weather, but don’t chicken or whole grain pastas with drink them too tomato sauce. often. Black  Don’t “cave” in. coffee, tea or Hibernation is for warm cider are A new year. A new you. If you are morbidly obese, you may be a candidate for bariatric surgery, a proven treatment for diabetes and other obesityrelated conditions. There are many misconceptions about weight-loss surgery, but you can get the facts at a free informational seminar sponsored by Georgia Health Sciences Weight Loss Center. Seminars are held on the second and fourth Tuesdays of each month at 6:30 p.m. For more information or to register, visit georgiahealth. org/weightloss or call our Bariatric Nurse Coordinator at 706-7212609. Visit georgiahealth. org/weightloss to sign up for the Weight Loss Center monthly electronic newsletter, featuring the latest weight-loss information, tips and upcoming events. georgiahealth.org [ 3 ] cancer prevention new hope for recurring prostate cancer Robotic salvage prostatectomy [A] pproximately 30 percent Madi, MD, a urologic oncologist at of men who have radiation Georgia Health Sciences Center for therapy for prostate cancer experience Advanced Robotic Surgery. a recurrence of the cancer. “Robotic technology increases They may now benefit from surgical accuracy and minimizes a surgery known as salvage the morbidity of these complex prostatectomy. This has traditionally procedures,” Dr. Madi says. been a challenging procedure due to the scarring and tissue changes caused by radiation. How is the procedure performed? “The robotic system is just a tool. But a few specially trained physicians across the country The surgeon is in control at all are performing robotic salvage times,” says Dr. Madi. The surgeon prostatectomy. That includes Rabii inserts small instruments and a camera into the patient’s abdomen through keyhole-size incisions. Sitting at a console with a clear World-class physicians, worldclass care As an academic health center, Georgia Health Sciences staffs specialists not found at other area hospitals. That includes Rabii Madi, MD, a prominent urologic oncologist who has performed more than 400 robotic surgeries. Renowned in the surgical treatment of prostate, kidney and bladder cancers, Dr. Madi pioneered single-setting robotic surgery for patients with both prostate and kidney cancer. He also performs single-incision kidney removals. Preeminent physicians like Dr. Madi are a hallmark of Georgia Health Sciences Cancer Center. three-dimensional image of the surgical area, he maneuvers the instruments and camera. The technology seamlessly translates the surgeon’s hand movements Rabii Madi, MD, a urologic oncologist, is one of only a few surgeons in the country who perform robotic salvage prostatectomies. the instruments. Smaller incisions, faster recoveries “This allows for Robotic surgery offers the following movements of the careful and benefits over traditional open surgery: precise removal of • shorter hospital stays • less scarring, pain and blood loss • less risk of infection • q uicker return to seminal vesicles and surrounding lymph nodes,” says Dr. Madi. georgiahealth.org To learn more or to schedule an appointment with Dr. Madi, please call 706-721-3042 or visit georgiahealth.org/robotics. into real-time the prostate, adjoining [ 4 ] If you need surgery normal activities cervical cancer New Pap screening guidelines [ J] anuary is national cervical Cancer Awareness Month and a good time to review the Pap screening guidelines for this disease. • women who have received the HPV vaccine still need to follow the screening guidelines “Talk to your gynecologist about According to Bunja Rungruang, MD, your screening schedule,” says a gyn oncologist at Georgia Health Dr. Rungruang. Sciences Cancer Center, those guidelines were updated in March 2012 by the U.S. Preventive Task Force with the support of the American Cancer Society. “The new guidelines reduce the number of Pap tests women should have over their lifetimes. They preserve the benefits of testing while minimizing risks,” says Dr. Rungruang. Fewer, less frequent screenings Since it can take more than a decade for cervical cancer to develop, the guidelines recommend: • women ages 21 to 29 have a Pap test every three years; women under age 21 do not need screenings • women ages 30 to 65 should have a Pap test every three years or a Pap test with HPV screening, known as cotesting, every five years • screening is not recommended Robotic GYN cancer surgeries: Smaller incisions, shorter recoveries When gyn cancers strike, women deserve the latest, least invasive surgical solutions. That is often robotic surgery. Robotic technology offers surgeons clearer 3-D visualization and superior tools that allow for more precise, tremor-free surgeries. Georgia Health Sciences Cancer Center’s renowned gyn oncologists perform the area’s widest range of robotic procedures for gyn cancers in our Center for Advanced Robotic Surgery. Robotic surgeries: • shorten hospital stays and speed recovery • reduce blood loss, scarring and pain • reduce the risk of infection • help prevent the need for further surgeries For more information, visit georgiahealth.org/robotics. To schedule an appointment, call 706-721-6744. for women over age 65 who have had regular screenings with normal results • women with certain risk factors may need to have more frequent screenings or to continue screening Get screened! For more information or to schedule an appointment with a gynecologist, please call the Georgia Health Sciences Women’s Center at 706-721-4959 or visit georgiahealth.org/appointment. beyond age 65 georgiahealth.org [ 5 ] Heart-Healthy living hormone therapy The heart of the matter [A] re you bothered by says. “If menopausal symptoms you’ve but afraid that hormone therapy already (HT) will increase your risk of heart had a heart disease? Pascha E. Schafer, MD, a attack or have cardiologist with the Georgia Health heart disease Sciences Cardiovascular Center, or a history of addresses those concerns. blood clots, the risks “Although all women should take of taking HT generally heart disease seriously, the risk of HT outweigh the benefits.” on heart health varies depending on your overall health,” she says. Easy does it If you are a candidate for HT, Is hormone therapy right for you? Dr. Schafer suggests you speak to “Most healthy women can safely • using a form of therapy that your gynecologist about: take short-term HT for menopausal minimizes absorption, such as symptoms without significantly vaginal preparations or skin increasing their risk of heart disease,” patches Dr. Schafer says. “But that’s a • finding the lowest effective dose decision you’ll need to make with and taking it for the shortest your gynecologist.” possible time If you stopped having periods or • making lifestyle changes, such How is your heart health? A coronary calcium scan can help answer that question and guide treatment planning. These painless, noninvasive scans take only five minutes. Most insurance plans do not yet cover this valuable test, but the scan and physician interpretation cost only $100. To schedule a scan, call 706-721-XRAY (9729). Specialized care for women To schedule an appointment with a gynecologist or a cardiologist, call 706-721-CARE (2273) or visit georgiahealth.org/appointment. lost the normal function of your as losing weight and giving up ovaries before age 40, you may need cigarettes, to reduce your overall estrogen for a longer time to protect risk of heart disease. “And be sure against the health effects of estrogen to have regular blood pressure and your overall risks, determine if deficiency. “However, long-term HT is cholesterol screenings,” she says. HT is right for you and prescribe no longer recommended just to reduce • discussing other possible risks of the risk of heart disease,” Dr. Schafer [ 6 ] georgiahealth.org HT “Your gynecologist can evaluate the appropriate type and dosage,” Dr. Schafer says. focus on women rheumatoid arthritis vs. osteoarthritis What’s the difference? [A] bout 1.3 million “This affects the tissue that lines Complications of RA American adults— the joints, causing stiffness, pain and The inflammation that causes mostly women—live with the pain swelling. RA tends to impact the small RA also increases the risks for of rheumatoid arthritis (RA), a joints in the hands and feet first but osteoporosis, heart attack, stroke and chronic autoimmune disease that actually affects the entire body,” says other diseases. generally begins between ages 40 Alyce Oliver, MD, a rheumatologist and 60. at Georgia Health Sciences Medical tant to see a rheumatologist. “RA can Center who specializes in RA. be difficult to diagnose in the initial If you think you have RA, it’s impor- How does RA differ from osteoarthritis? is a degenerative disease caused ized care can reduce these risks and Rheumatoid arthritis is caused by by thinning in the cartilage that delay or even prevent joint damage,” inflammation throughout the body. lines the joints. As cartilage wears, says Dr. Oliver. “We treat the disease changes in the bone around the joint aggressively to achieve clinical remis- limit function and cause joint pain. sion, prevent underlying joint This disease affects the joints only. damage and disease, and Get an accurate diagnosis and advanced care Georgia Health Sciences Rheumatology Department staffs physicians who specialize in RA and stay up to date on the latest research. These physicians offer one-stop diagnosis and care through musculoskeletal ultrasound, multidisciplinary medical management, and an infusion center for biologics that disrupt the immune response that occurs in RA. Osteoarthritis, on the other hand, stages, yet early diagnosis and special- help patients maintain What are the signs of RA? an active lifestyle.” People with RA experience symptoms in the joints and beyond, including: • tender, warm, swollen joints • morning stiffness that may last for hours • firm bumps of tissue under the skin on the arms Get back to doing what you love To schedule an appointment, call 706-721-1400 or visit georgiahealth.org/appointment. • fatigue, fever and weight loss “The symptoms vary in intensity and may come and go, but the pain and swelling generally occur in the same joints on both sides of the body,” Dr. Oliver says. georgiahealth.org [ 7 ] neuroscience confusion, or something else? Epilepsy rates rising among seniors • uncontrollable jerking [W] “These include stroke, movements of the arms Alzheimer’s disease, head injuries, or legs brain tumors, brain surgery and • l oss of consciousness or awareness infections affecting the brain. The symptoms usually last only High blood pressure, heart disease hen seniors experience a minute or two, but it often takes and chronic alcoholism are also a sign of epilepsy, they may older people longer to recover. risk factors in seniors,” says mistakenly label it a “senior moment” “Although having these symptoms Dr. Murro. Fortunately, the disorder or think that their symptoms are caused certainly does not mean you have can generally be controlled with by aging. That’s because epilepsy has epilepsy, you should see your medications or surgery. traditionally been considered a disorder physician if you experience them,” that begins in youth. says Dr. Murro. “Undiagnosed “Physicians now know that people in their 60s, 70s and 80s are as likely epilepsy can increase the risk of falls Expert epilepsy care, right here in Augusta and broken bones in seniors.” Georgia Health Sciences operates the only Epilepsy Center in the area. to begin having seizures as children. Americans are increasing faster than What causes epilepsy in seniors? rates in any other age group,” says Epilepsy is caused by a glitch in the Anthony Murro, MD, a neurologist brain’s electrical system. In seniors, diagnose epilepsy and pinpoint its and epileptologist at Georgia Health the causes are often directly related to site of origin Sciences Neuroscience Center. physical changes associated with aging. In fact, epilepsy rates among older This regional referral center offers: • the area’s only epileptologists • an Epilepsy Monitoring Unit to • the full range of epilepsy treatments including vagal nerve A range of symptoms Epilepsy symptoms can vary considerably and may include: • temporary confusion • a staring spell [ 8 ] georgiahealth.org Help for epilepsy For more information or to schedule an appointment, call 706-721-4581 or visit georgiahealth.org/appointment. stimulation and epilepsy surgeries • pharmacists who specialize in antiepileptic medications • nurse clinicians who educate patients and answer questions digestive health preventing esophageal cancer A new treatment for Barrett’s esophagus [ I] f you think chronic esophagus and increases the heartburn is nothing to worry risk of esophageal cancer,” about, think again. “People who suffer says Sherman Chamberlain, from long-term heartburn may develop MD, a gastroenterologist Barrett’s esophagus. This serious at Georgia Health Sciences condition changes the lining of the Digestive Health Center. Looking for a solution to your digestive problem? Our Digestive Health Center can help. It staffs the largest team of gastroenterologists and hepatologists in the area, offers the widest range of tests and treatments, and operates specialty clinics for: • motility disorders • pelvic floor disorders • lactose and fructose intolerance • swallowing problems • GERD/heartburn • irritable bowel syndrome • gastroparesis • constipation Don’t just live with digestive problems. Get an accurate diagnosis and competent care at the Digestive Health Center. Get tummy troubles under control A treatment breakthrough Center are offering a new treatment for What happens if Barrett’s esophagus goes untreated? Barrett’s esophagus known as HALO Untreated Barrett’s esophagus can ablation therapy. It may be right for result in the development of a type of people with Barrett’s esophagus who esophageal cancer with high mortality show worrisome pathologic changes in rates called adenocarcinoma. Most an upper endoscopy screening. people who develop this cancer are Physicians at the Digestive Health During the ablation procedure, skilled physicians deliver targeted heat energy unaware that they have Barrett’s esophagus. to remove the damaged tissue without harming the normal structures of the The next step throat. Dr. Chamberlain advises you to see your It is performed in conjunction with an upper endoscopy in an outpatient setting. No incision is required, and it takes only about 15 minutes. “HALO ablation is a major advance in Barrett's physician if: • you have heartburn several times a week • heartburn returns after your antacid wears off esophagus treatment. It is a safer, • heartburn wakes you up at night faster therapy that has been shown to Your physician can take a tissue sample remove diseased esophageal tissue,” during an upper endoscopy to determine Dr. Chamberlain says. if you have Barrett’s esophagus. To schedule an appointment at the Digestive Health Center, please call 706-721-1400 or visit georgiahealth.org/appointment. georgiahealth.org [ 9 ] Family health sleep apnea It’s not just an adult disorder [ M] ost people associate breathing becomes blocked during sleep apnea with sleep. Left untreated, sleep apnea overweight, middle-aged men, but it’s can lead to heart, behavior, learning not just an adult problem. An estimated and growth problems. two percent of children suffer from the disorder, and many are undiagnosed. Signs and symptoms Children who are overweight or have Frequent snoring is the classic Down syndrome, cerebral palsy or symptom, but also watch for: abnormalities of the skull or face are at increased risk. George F. Harris, MD, a pediatric • problems breathing during the night • sleepiness during the day otolaryngologist at Georgia Health • difficulty paying attention Sciences Children’s Medical Center, • behavioral problems says sleep apnea occurs when a child's “See your pediatrician if you notice these symptoms,” Dr. Harris says. Diagnosing the disorder Parents may report snoring or periods of blocked breathing that, The area’s largest team of pediatric specialists The physicians at the Children’s Medical Center treat everything from common childhood illnesses to life-threatening conditions like cancer and neurological disorders. The Center also staffs pediatric anesthesiologists and Child Life Specialists who help kids understand and cope with care. To schedule an appointment, call 706-721-KIDS (5437). Get a good night’s rest To schedule an appointment with a pediatric otolaryngologist or sleep medicine physician, call 706-721-KIDS (5437) or visit georgiahealth.org/appointment. along with a medical examination, indicate sleep apnea. In other cases, children may removing these tissues is generally a highly effective treatment,” says spend a night in a sleep lap where Dr. Harris. The surgery requires no their sleep is monitored, videoed incision but may require an overnight and analyzed by a physician. hospital stay, especially in very young The Children’s Medical Center operates a pediatric sleep studies lab staffed by specialized pediatric sleep medicine physicians. children. A nonsurgical therapy called nasal continuous positive airway pressure (CPAP) may be right for children who are struggling with weight loss, are not [ 10 ] georgiahealth.org Treatment options candidates for surgery or those who do “In children, sleep apnea is often not improve after surgery. This therapy caused by larger than normal involves wearing a mask that delivers tonsils and adenoids. In such cases, steady air pressure during sleep. calming children’s fears Children’s Medical Center develops i-book just for kids [ H] aving medical care can be frightening to Now, when a Child Life Specialist The show also discusses “sleepy” sits down with a child, the patient air and lets kids pick their favorite children, especially if they require can actually take part in an flavor, if they need anesthesia. And hospitalization. But Georgia Health entertaining and informative slide it lets them spin around in a three- Sciences Child Life Specialists are show. They can see the dinosaurs on dimensional wheelchair. trained to help kids understand and the hospital walls, push the elevator cope with care. button, see their bed, talk about new high-tech resource to prepare their doctor, pick toys off a shelf patients and families for surgery. a book of photos to walk children and color their own dressing gown. With the iPad, I am able to make through the facility and prepare The show calms children’s fears by it a more engaging process for the them for hospitalization. But when telling them what is going to happen patients,” says Child Life Specialist the hospital began using iPads, in a way they can understand. Jamie Wolfe. Historically, these specialists used “I love being able to use this Kimberly Allen, director of child and adolescent life services, asked Jeff Mastromonico, associate director of educational and collaborative technology, to develop an electronic program to tell the story. Mastromonico and his team did much more. “We took their text and photos and added an interactive Be a part of your child’s treatment team If your child needs medical care, you’ll want to be involved every step of the way. You can do that at the Children’s Medical Center. As a national leader in a concept known as Patient- and Family-Centered Care, Georgia Health Sciences builds collaborative partnerships between health care providers, patients and family members. To us, families are not an imposition but a part of the treatment team. That’s why we don’t have established visiting hours. You can stay with your child 24/7, even in intensive care. After all, no one knows your child like you do. To schedule an appointment, call 706-721-KIDS (5437) or visit georgiahealth.org/appointment. element,” he says. georgiahealth.org [ 11 ] Non-Profit Organization US POSTAGE 1120 15th Street, AD 1114 Augusta, GA 30912 PAID Lebanon Junction, KY Permit No. 115 Connect to Georgia Health Sciences recycle-logo_2options_v2.ai Printed With Soy Ink Printed With Soy Ink georgiahealth.org • facebook.com/GHSMedCenter Please Recycle This Publication twitter.com/GHSMedCenter Please Recycle This Publication Copyright © 2012 Georgia Health Sciences Printed With Soy Ink Please Recycle This Publication Printed With Soy Ink Please Recycle This Publication In the news Opportunity knocks for Georgia Regents University [ G] eorgia regents university Woodruff Foundation. Along with state our community. Over the next eight is moving into the future with funding and philanthropy, the university years, Georgia Regents University’s local a new year, a new name and amazing will build a 160,000-square-foot economic impact is projected to increase opportunities for the Augusta area. Interprofessional Simulation Center. from $2 billion to $3 billion a year. This Here, students from different colleges means more business, more jobs and operates nine colleges in 150 buildings within the system will coordinate and more opportunity for the CSRA. that span 650 acres. We are home to integrate their skills. The consolidated university currently more than 9,000 students, 5,000 staff What’s more, the state is considering It also means Augusta will be home to a renowned university, health care members and 1,000 faculty members. $45 million in bond funding to system, and research facility posi- We also operate an integrated health help finance a new $100-million tioned for national and international care system that delivers world-class cancer research building, for which recognition. care to people throughout the area and the university has also received a beyond. $20-million pledge. If approved, the building will be the cornerstone of Extending our outreach through partnerships a comprehensive complex that will In the years ahead, the institution will Cancer Institute-designated increase its student population, faculty cancer center. become Georgia’s second National and footprint. What’s more, we are forging partnerships that will enrich both the university and the community. Take, for example, the $8 million grant the university received from the Fueling economic development Consolidation opens a world of exciting possibilities for Working together, we can create a stronger, more vibrant city.