Your Health Today
Your guide to healthy lving from Georgia Health Sciences System.
health [ Your guide to Healthy Living from Georgia Health Sciences Health System ] your 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 INSIDE THIS ISSUE 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. PAGE 3 ips for a safe and healthy winter T 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 ©2013 Intuitive Surgical, Inc. Rheumatoid arthritis vs. osteoarthritis Depend on the area’s highest level NICU 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). Expanding robotic surgery 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). [ 2 ] georgiahealth.org 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. Copyright © 2013 Georgia Health Sciences Tips for a safe and healthy winter Three ways to avoid winter weight gain [ S] few tips: hort days and cold nights bears, not people. Keep moving, regardless of the temperature. Dress in layers and head to the park or walk the dog around the block. Join a gym, or buy a jump rope and hand weights and work out at home. Try to limit screen time and sitting. Even simple chores such as folding laundry, vacuuming or raking leaves burn calories. better options because they are lower in fat and calories. If you drink alcohol, limit it to one drink a day for women or two for men. Alcohol is high in calories. Drinking in excess also increases your risk of many diseases. can lead to lethargy, over eating and winter weight gain. But with a little caution, you can hold the line or even lose weight. Here are a like macaroni and cheese, mashed potatoes and gravy, and hot apple pie are all great on cold evenings, when you feel isolated at home. But they are loaded with fat and calories. Instead, build menus around vegetables, whole grains and lean meats. Try vegetable soups, black Images on any of these pages may be from one or more of these sources: © 2013 Thinkstock and © 2013 istockphoto.com.  Don’t treat your mood with food. Comfort foods  Think before you drink. Hot chocolate and creamy coffee drinks are great in chilly weather, but don’t drink them too often. Black coffee, tea or warm cider are beans and brown rice, skinless grilled chicken or whole grain pastas with tomato sauce.  Don’t “cave” in. Hibernation is for 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 Robotic salvage prostatectomy prostate cancer Madi, MD, a urologic oncologist at Georgia Health Sciences Center for “Robotic technology increases surgical accuracy and minimizes the morbidity of these complex procedures,” Dr. Madi says. [A] pproximately 30 percent of men who have radiation therapy for prostate cancer experience Advanced Robotic Surgery. a recurrence of the cancer. They may now benefit from a surgery known as salvage prostatectomy. This has traditionally been a challenging procedure due to the scarring and tissue changes caused by radiation. But a few specially trained physicians across the country are performing robotic salvage prostatectomy. That includes Rabii 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. How is the procedure performed? “The robotic system is just a tool. The surgeon is in control at all times,” says Dr. Madi. The surgeon inserts small instruments and a camera into the patient’s abdomen through keyhole-size incisions. Sitting at a console with a clear three-dimensional image of the surgical area, he maneuvers the instruments and camera. The technology seamlessly translates the surgeon’s hand movements If you need surgery To learn more or to schedule an appointment with Dr. Madi, please call 706-721-3042 or visit georgiahealth.org/robotics. Rabii Madi, MD, a urologic oncologist, is one of only a few surgeons in the country who perform robotic salvage prostatectomies. into real-time movements of the instruments. “This allows for the careful and precise removal of Smaller incisions, faster recoveries Robotic surgery offers the following benefits over traditional open surgery: the prostate, adjoining seminal vesicles and surrounding lymph nodes,” says Dr. Madi. • shorter hospital stays •l ess scarring, pain and blood loss • less risk of infection •q uicker return to normal activities [ 4 ] georgiahealth.org cervical cancer New Pap screening guidelines [ J] anuary is national cervical • women who have received the HPV vaccine still need to follow the screening guidelines “Talk to your gynecologist about Dr. Rungruang. Cancer Awareness Month and a good time to review the Pap screening guidelines for this disease. According to Bunja Rungruang, MD, your screening schedule,” says a gyn oncologist at Georgia Health 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: 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. • 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 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 beyond age 65 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. georgiahealth.org [ 5 ] Heart-Healthy living therapy The heart of the matter but afraid that hormone therapy (HT) will increase your risk of heart disease? Pascha E. Schafer, MD, a cardiologist with the Georgia Health Sciences Cardiovascular Center, addresses those concerns. “Although all women should take heart disease seriously, the risk of HT on heart health varies depending on your overall health,” she says. hormone [A] re you bothered by says. “If you’ve already had a heart attack or have heart disease or a history of blood clots, the risks of taking HT generally outweigh the benefits.” menopausal symptoms 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). Easy does it If you are a candidate for HT, Dr. Schafer suggests you speak to your gynecologist about: • using a form of therapy that minimizes absorption, such as vaginal preparations or skin patches • finding the lowest effective dose and taking it for the shortest possible time • making lifestyle changes, such as losing weight and giving up cigarettes, to reduce your overall risk of heart disease. “And be sure to have regular blood pressure and cholesterol screenings,” she says. • discussing other possible risks of HT Is hormone therapy right for you? “Most healthy women can safely take short-term HT for menopausal symptoms without significantly increasing their risk of heart disease,” Dr. Schafer says. “But that’s a decision you’ll need to make with your gynecologist.” If you stopped having periods or lost the normal function of your ovaries before age 40, you may need estrogen for a longer time to protect against the health effects of estrogen deficiency. “However, long-term HT is no longer recommended just to reduce the risk of heart disease,” Dr. Schafer Specialized care for women To schedule an appointment with a gynecologist or a cardiologist, call 706-721-CARE (2273) or visit georgiahealth.org/appointment. “Your gynecologist can evaluate your overall risks, determine if HT is right for you and prescribe the appropriate type and dosage,” Dr. Schafer says. [ 6 ] georgiahealth.org focus on women rheumatoid arthritis What’s the difference? vs. osteoarthritis “This affects the tissue that lines the joints, causing stiffness, pain and swelling. RA tends to impact the small joints in the hands and feet first but actually affects the entire body,” says Alyce Oliver, MD, a rheumatologist at Georgia Health Sciences Medical Center who specializes in RA. Osteoarthritis, on the other hand, is a degenerative disease caused by thinning in the cartilage that lines the joints. As cartilage wears, changes in the bone around the joint limit function and cause joint pain. This disease affects the joints only. mostly women—live with the pain of rheumatoid arthritis (RA), a chronic autoimmune disease that generally begins between ages 40 and 60. [A] bout 1.3 million Complications of RA The inflammation that causes RA also increases the risks for osteoporosis, heart attack, stroke and other diseases. If you think you have RA, it’s important to see a rheumatologist. “RA can be difficult to diagnose in the initial stages, yet early diagnosis and specialized care can reduce these risks and delay or even prevent joint damage,” says Dr. Oliver. “We treat the disease aggressively to achieve clinical remission, prevent underlying joint damage and disease, and help patients maintain an active lifestyle.” American adults— How does RA differ from osteoarthritis? Rheumatoid arthritis is caused by inflammation throughout the body. 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. What are the signs of RA? 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 • 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. Get back to doing what you love To schedule an appointment, call 706-721-1400 or visit georgiahealth.org/appointment. georgiahealth.org [ 7 ] neuroscience confusion, or something else? Epilepsy rates rising among seniors “These include stroke, Alzheimer’s disease, head injuries, brain tumors, brain surgery and infections affecting the brain. High blood pressure, heart disease and chronic alcoholism are also risk factors in seniors,” says Dr. Murro. Fortunately, the disorder can generally be controlled with medications or surgery. • uncontrollable jerking movements of the arms or legs •l oss of consciousness or awareness The symptoms usually last only hen seniors experience mistakenly label it a “senior moment” or think that their symptoms are caused by aging. That’s because epilepsy has traditionally been considered a disorder that begins in youth. “Physicians now know that people in their 60s, 70s and 80s are as likely to begin having seizures as children. In fact, epilepsy rates among older Americans are increasing faster than rates in any other age group,” says Anthony Murro, MD, a neurologist and epileptologist at Georgia Health Sciences Neuroscience Center. [W] a minute or two, but it often takes older people longer to recover. “Although having these symptoms certainly does not mean you have epilepsy, you should see your physician if you experience them,” says Dr. Murro. “Undiagnosed epilepsy can increase the risk of falls and broken bones in seniors.” a sign of epilepsy, they may Expert epilepsy care, right here in Augusta Georgia Health Sciences operates the only Epilepsy Center in the area. This regional referral center offers: • the area’s only epileptologists • an Epilepsy Monitoring Unit to diagnose epilepsy and pinpoint its site of origin • the full range of epilepsy treatments including vagal nerve stimulation and epilepsy surgeries • pharmacists who specialize in antiepileptic medications • nurse clinicians who educate patients and answer questions What causes epilepsy in seniors? Epilepsy is caused by a glitch in the brain’s electrical system. In seniors, the causes are often directly related to physical changes associated with aging. A range of symptoms Epilepsy symptoms can vary considerably and may include: • temporary confusion • a staring spell Help for epilepsy For more information or to schedule an appointment, call 706-721-4581 or visit georgiahealth.org/appointment. [ 8 ] georgiahealth.org digestive health preventing esophageal cancer A new treatment for Barrett’s esophagus [ I] f you think chronic esophagus and increases the risk of esophageal cancer,” says Sherman Chamberlain, MD, a gastroenterologist at Georgia Health Sciences Digestive Health Center. heartburn is nothing to worry about, think again. “People who suffer from long-term heartburn may develop Barrett’s esophagus. This serious condition changes the lining of the 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. A treatment breakthrough Physicians at the Digestive Health Center are offering a new treatment for Barrett’s esophagus known as HALO ablation therapy. It may be right for people with Barrett’s esophagus who show worrisome pathologic changes in an upper endoscopy screening. During the ablation procedure, skilled physicians deliver targeted heat energy to remove the damaged tissue without harming the normal structures of the throat. 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 esophagus treatment. It is a safer, faster therapy that has been shown to remove diseased esophageal tissue,” Dr. Chamberlain says. What happens if Barrett’s esophagus goes untreated? Untreated Barrett’s esophagus can result in the development of a type of esophageal cancer with high mortality rates called adenocarcinoma. Most people who develop this cancer are unaware that they have Barrett’s esophagus. The next step Dr. Chamberlain advises you to see your physician if: • you have heartburn several times a week • heartburn returns after your antacid wears off • heartburn wakes you up at night Your physician can take a tissue sample during an upper endoscopy to determine if you have Barrett’s esophagus. Get tummy troubles under control 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 overweight, middle-aged men, but it’s two percent of children suffer from the disorder, and many are undiagnosed. Children who are overweight or have Down syndrome, cerebral palsy or abnormalities of the skull or face are at increased risk. George F. Harris, MD, a pediatric otolaryngologist at Georgia Health Sciences Children’s Medical Center, says sleep apnea occurs when a child's apnea 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). It’s not just an adult disorder [ M] ost people associate breathing becomes blocked during sleep. Left untreated, sleep apnea can lead to heart, behavior, learning sleep apnea with not just an adult problem. An estimated and growth problems. Signs and symptoms Frequent snoring is the classic symptom, but also watch for: • problems breathing during the night • sleepiness during the day • difficulty paying attention • behavioral problems “See your pediatrician if you notice these symptoms,” Dr. Harris says. 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. Diagnosing the disorder Parents may report snoring or periods of blocked breathing that, along with a medical examination, indicate sleep apnea. In other cases, children may spend a night in a sleep lap where their sleep is monitored, videoed and analyzed by a physician. The Children’s Medical Center operates a pediatric sleep studies lab staffed by specialized pediatric sleep medicine physicians. removing these tissues is generally a highly effective treatment,” says Dr. Harris. The surgery requires no incision but may require an overnight hospital stay, especially in very young children. A nonsurgical therapy called nasal continuous positive airway pressure (CPAP) may be right for children who are struggling with weight loss, are not candidates for surgery or those who do not improve after surgery. This therapy involves wearing a mask that delivers steady air pressure during sleep. Treatment options “In children, sleep apnea is often caused by larger than normal tonsils and adenoids. In such cases, [ 10 ] georgiahealth.org children’s fears Children’s Medical Center develops i-book just for kids aving medical care can calming [ H] Now, when a Child Life Specialist sits down with a child, the patient can actually take part in an entertaining and informative slide show. They can see the dinosaurs on the hospital walls, push the elevator button, see their bed, talk about their doctor, pick toys off a shelf and color their own dressing gown. The show calms children’s fears by telling them what is going to happen in a way they can understand. The show also discusses “sleepy” air and lets kids pick their favorite flavor, if they need anesthesia. And it lets them spin around in a threedimensional wheelchair. “I love being able to use this new high-tech resource to prepare patients and families for surgery. With the iPad, I am able to make it a more engaging process for the patients,” says Child Life Specialist Jamie Wolfe. be frightening to children, especially if they require hospitalization. But Georgia Health Sciences Child Life Specialists are trained to help kids understand and cope with care. Historically, these specialists used a book of photos to walk children through the facility and prepare them for hospitalization. But when the hospital began using iPads, 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 element,” he says. 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. georgiahealth.org [ 11 ] Non-Profit Organization 1120 15th Street, AD 1114 Augusta, GA 30912 US POSTAGE 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 Copyright © 2012 Georgia Health Sciences Printed With Soy Ink Please Recycle This Publication Printed With Soy Ink Please Recycle This Publication Please Recycle This Publication In the news Georgia Regents University [ G] eorgia regents university Opportunity knocks for Woodruff Foundation. Along with state funding and philanthropy, the university will build a 160,000-square-foot Interprofessional Simulation Center. Here, students from different colleges within the system will coordinate and integrate their skills. What’s more, the state is considering $45 million in bond funding to help finance a new $100-million cancer research building, for which the university has also received a $20-million pledge. If approved, the building will be the cornerstone of a comprehensive complex that will become Georgia’s second National Cancer Institute-designated cancer center. our community. Over the next eight years, Georgia Regents University’s local economic impact is projected to increase from $2 billion to $3 billion a year. This means more business, more jobs and more opportunity for the CSRA. It also means Augusta will be home to a renowned university, health care system, and research facility positioned for national and international recognition. Working together, we can create a stronger, more vibrant city. is moving into the future with a new year, a new name and amazing opportunities for the Augusta area. The consolidated university currently operates nine colleges in 150 buildings that span 650 acres. We are home to more than 9,000 students, 5,000 staff members and 1,000 faculty members. We also operate an integrated health care system that delivers world-class care to people throughout the area and beyond. Extending our outreach through partnerships In the years ahead, the institution will increase its student population, faculty 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