PERSPECTIVE A quarterly journal with the latest news, stories and updates
Winter 2017
Advanced Surgical Technique Gives Options for Breast Cancer Patients
Deadly Super Bugs— How You Can Help Avert a Crisis Don’t Neglect Your Neck! Why Thyroid Cancer is on the Rise
Network Experts: Why Artery and Vein Conditions Demand a Specialist
PALOS HEALTH WELCOMES NEW PHYSICIANS Amina Ahmed, M.D.
Syed Bokhari, M.D.
Julia Espel, M.D.
Board certified and specializing in Gynecologic Oncology, completed her residency and fellowship at University of Iowa Hospitals & Clinics, Iowa City, IA. She received her medical degree from Rush Medical College, Chicago. Dr. Ahmed is affiliated with Rush University Medical Center, 1725 W. Harrison Street, Chicago.
Board certified and specializing in General Surgery, completed his residency at Easton Hospital, affiliated with Hahnemann University School of Medicine, Easton, PA. He received his medical degree from King Edward Medical College, Pakistan. Dr. Bokhari’s office is located at Cardinal Surgical Associates S.C., 1051 Essington Road, Suite 230A, Joliet.
Fouad Al-Qawasmi, M.D.
Mircea Coca, M.D.
Board certified and specializing in Obstetrics & Gynecology and Pediatrics, completed his Obstetrics residency at the University of Illinois at Chicago and Pediatrics residency at Wake Forest University, Winston-Salem, NC. He received his medical degree from University of Jordan Faculty of Medicine, Amman, Jordan. Dr. Al-Qawasmi is affiliated with Midwest Women’s Family Healthcare Center, 7714 West 159th Street, Orland Park.
Specializing in Retina, completed his residency at the University of Texas Main Branch, Galveston and fellowship at Chicagoland Retinal Consultants, LLC. He received his medical degree from the University of Rochester School of Medicine, Rochester, NY. Dr. Coca is affiliated with Chicagoland Retinal Consultants, LLC, 7808 West College Drive, Palos Heights.
Board certified and specializing in Pulmonary & Critical Care Medicine, completed her residency at the University of Chicago Medical Center and fellowship at Northwestern Memorial Hospital, McGaw Medical Center. She received her medical degree from the University of Minnesota Medical School, Minneapolis. Dr. Espel is affiliated with Pulmonary & Critical Care Consultants, S.C., 11900 Southwest Highway, Palos Heights.
Jessica Dy-Johnson, M.D. Wassim Ballany, M.D. Board certified and specializing in Cardiac Electrophysiology, completed his residency at Wayne State University, Detroit and fellowships in Cardiovascular Disease at John Stroger-Hospital of Cook County and Clinical Cardiac Electrophysiology and Advanced Electrophysiology at Aurora Health Care, Milwaukee. He received his medical degree from the University of Aleppo School of Medicine, Aleppo, Syria. Dr. Ballany is affiliated with Consultants in Cardiology & Electrophysiology, LLC, 5151 West 95th Street, Oak Lawn.
Specializing in Obstetrics & Gynecology, completed her residency at Rush University Medical Center, Chicago. She received her medical degree from the University of Chicago Pritzker School of Medicine, Chicago. Dr. Dy-Johnson is affiliated with Western Hills Medical Center, 4700 West 95th Street, Oak Lawn. The physicians listed or quoted, while having privileges, are not employees or agents of Palos Health unless they are specifically identified as such.
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Ganapathi Gottumukkala, M.D. Board certified and specializing in Family Medicine, completed his residency at Jackson Park Hospital, Chicago. He received his medical degree from Rangaraya Medical School, Kakinada, India. Dr. Gottumukkala is affiliated with Ingalls Health System, 6701 West 159th Street, Suite B, Tinley Park.
Veeral Oza, M.D. Board certified and specializing in Gastroenterology, completed his residency at George Washington University, Washington, D.C. and fellowships in Gastroenterology at Ohio State University and Advanced Endoscopy at Yale University, New Haven, CT. He received his medical degree from Rush Medical College, Chicago. Dr. Oza is affiliated with Midwest Center for Digestive Health, 9921 Southwest Highway, Oak Lawn.
PALOS HEALTH PERSPECTIVE
Vivek Patel, D.P.M.
Samer Rajjoub, M.D.
Srinath Sriram, M.D.
Specializing in Podiatry, completed his residency at Beaumont Hospital in Wayne, MI. He received his medical degree from Temple University School of Podiatric Medicine, Philadelphia, PA. Dr. Patel is affiliated with Performance Foot and Ankle Center, 15300 West Avenue, Orland Park.
Board certified and specializing in General Surgery and Endocrine Surgery, completed his residency at Pinnacle Health System, Harrisburg, PA, and fellowship at the University of Chicago/North Shore University Health System. He received his medical degree from George Washington University School of Medicine & Health Sciences, Washington D.C. Dr. Rajjoub is affiliated with Palos Medical Group, 12251 South 80th Avenue, Palos Heights.
Board certified and specializing in Pulmonary & Critical Care Medicine, completed his residency at the University of Wisconsin Hospital & Clinics and fellowship at Loyola University Medical Center, Maywood, IL. He received his medical degree from Drexel University, Philadelphia, PA. Dr. Sriram is affiliated with Pulmonary & Critical Care Consultants, S.C., 11900 Southwest Highway, Palos Heights.
Discrimination is Against the Law Palos Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Palos Health does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Perspective is a publication of Palos Health 12251 South 80th Avenue Palos Heights, IL 60463 708.923.4000 paloshealth.com Terrence Moisan, M.D. Palos Health President and CEO Heather Mascarello Public Relations Specialist and Editor of Perspective Osborn & DeLong Graphic Design
Palos Health focuses on ‌
Creating a better everyday life for our community
Supporting healthy living while calming the anxiety of serious illness
Providing compassionate health care
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PALOS HEALTH PERSPECTIVE
Network Experts: Why Artery and Vein Conditions Demand a Specialist When a medical problem occurs, it’s important to seek out an expert in order to know all your options and receive the best treatment. Yet in the case of artery and vein issues, many people pass up the opportunity for optimal care by not seeing a vascular specialist. These doctors—specialists in the treatment of blood vessels—are trained in medical management, complicated surgeries and less invasive procedures, ensuring patients receive quality care for serious issues, including arterial aneurysms, diseases of the arteries and even access for dialysis. The U.S. Department of Health and Human Services estimates that millions of people are affected by vascular conditions each year. Seeing a specialist can mean a better overall outcome for many.
blood transportation system that sends life-giving oxygen and nutrients throughout your body. When this system breaks down and blood no longer flows freely—either from the narrowing, enlargement, twisting or blockage of arteries or veins—serious health problems can occur. Symptoms such as leg pain when walking, leg numbness or weakness or lower extremity sores that won’t heal mean it’s time to consult a vascular surgeon.
Some of the more common vascular conditions include: Abdominal Aortic Aneurysm (AAA) – The abdominal aorta is an essential blood vessel that supplies blood to the legs. When the wall of this vessel weakens, a balloon-like enlargement called an aneurysm sometimes develops. In most cases, abdominal aortic aneurysms cause no symptoms. However, patients with AAA may experience sudden, severe pain in the abdomen or back. According to the Society for Vascular Surgery, a ruptured AAA is the 15th leading
Why See a Vascular Specialist? You might not give much thought to your veins and arteries, but this interior highway comprises an unbelievable 12,000 miles of vessels, creating a WINTER 2017
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geons at Palos can determine what type of treatment is best for PAD, whether that be medical management, less invasive procedures, more complicated open surgery or even a combination of all of the above.
cause of death in the U.S., and the 10th leading cause of death in men older than 55. Palos offers an entire range or treatment options for aneurysm repair, including traditional open surgery as well as minimally invasive options. See the patient stories below for two different examples of AAA treatment at Palos.
Specialized Care Close to Home No matter what treatment patients undergo, it’s important to have a vascular surgeon that can be trusted, since certain conditions may mean regular follow up visits for decades. Patients who must think long term about their care should have a doctor they can rely on when considering all health care options.
Carotid Artery Disease/Stroke – Carotid stenosis occurs when the main blood vessels to the brain develop a buildup of plaque. When the buildup becomes very severe, it can cause a stroke. Strokes are the third leading cause of death in the United States according to the National Center for Health Statistics. Carotid endarterectomy (CEA) can reduce the risk of stroke by removing plaque on the inside of arteries, allowing for greater blood flow.
Peter McDonnell, M.D., a Palos Medical Group vascular surgeon with 27 years of experience, sees first-hand the benefits to patients of meeting with him early in their diagnosis. “Patients with artery and vein issues should be evaluated by a specialist who can offer all current treatment options,” says Dr. McDonnell. “Many patients can be managed medically and do not necessarily need invasive treatment. However, despite all of our technical innovations, some patients are still better treated with open surgical reconstruction.”
Peripheral Arterial Disease – The Centers for Disease Control (CDC) estimates that 8.5 million people in the U.S. have Peripheral Arterial Disease (PAD) or Peripheral Vascular Disease (PVD), including 12-20 percent of individuals older than age 60. PAD occurs when plaque builds up in the blood vessels that carry oxygen and nutrients to all the tissues of the body, causing blood flow to limbs to be reduced or blocked. PAD may cause difficulty walking, painful foot ulcers and infections, and even gangrene if left untreated, which could require amputation. Vascular sur-
The board certified vascular surgeons that see patients at Palos Hospital work with each patient’s unique situation to decide on the best treatment option. In addition to access to skilled vascular
Open AAA Surgery
Minimally Invasive AAA Surgery
Edward Popow of Orland Park recently had open AAA surgery at Palos Hospital. Like most patients, he wasn’t expecting an aneurysm diagnosis when he went to see his family doctor for abdominal pain. He was shocked when his doctor, Jorge Balandrin, M.D., told him he had significant coronary artery disease and would need a coronary bypass as well as an AAA repair.
Geraldine Jacoby of Palos Park was able to undergo a minimally invasive EVAR procedure for her AAA, which was discovered during a CAT scan for diverticulitis by Palos Medical Group’s Zulfiqar Rizvi, M.D. Dr. McDonnell met with Geraldine to discuss the seriousness of her condition, but other more pressing health problems forced her to delay surgery. After almost a full year of medical treatments for conditions unrelated to the aneurysm, Geraldine decided not to treat her aneurysm. “But my kids encouraged me to see Dr. McDonnell again,” said Geraldine. “When I finally did, I changed my mind after hearing how simple the surgery sounded—just a small incision in my groin area to insert a stent into the aneurysm. I was out of the hospital in three days and felt fine afterward. Dr. McDonnell was wonderful and professional throughout my time at Palos. I can’t imagine anyone would have been better.”
After bypass surgery, Edward followed up with Dr. McDonnell, who told him the aneurysm was serious and would need to be addressed. Four weeks after heart surgery, Edward underwent an open AAA procedure, which involved opening his abdomen to access the aneurysm, then using an artificial graft to repair it. Although both procedures kept Edward off work longer than he would have liked, he was able to return to his job as a truck driver within four months.
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surgeons, Palos offers one of the few hybrid operating rooms in the southwest suburbs. This unique dual-procedure operating suite is equipped to accommodate either open or closed surgeries, or a combination of the two. “The hybrid OR at Palos offers state-of-the-art imaging equipment along with advanced operating room capabilities for open surgical procedures,” explains Dr. McDonnell. The highest quality imaging technology available means surgical risks to the patient are lowered, especially when complicated cases are involved.
Vascular Profile Testing Palos Health offers vascular profile testing through ultrasound, also known as a duplex study, to check for signs of stroke, aortic aneurysm or sources of leg pain. This procedure involves no discomfort and is performed by a registered technologist. Screening may include an examination of the carotid (neck) artery, the abdomen and the legs. Results are reviewed by a vascular surgeon and follow up treatment is discussed, if needed. Talk to your doctor to determine if this test may be appropriate for you.
Peter McDonnell, M.D. “Patients with vein and artery issues should be evaluated by a specialist who can offer all treatment options.”
Know All Your Options Vascular conditions can be managed if you see a physician early. Advances in technology mean vascular surgery and procedures are constantly improving, and sometimes a particular condition can be treated without surgery. “I can’t emphasize enough how important it is to have a physician who can perform both surgical and less invasive procedures, along with medical management,” says Dr. McDonnell. “When it comes to vascular health, no other specialty outside of vascular surgery can offer all of these options with the goal of determining what is best for the patient.”
Are You a Candidate for Vascular Testing?
Over age 60
Have a family history of vascular disease, aortic aneurysm or stroke
Smoke or have a history of smoking
Surgeons on Staff at Palos
Have high blood pressure, heart disease,
To find a vascular specialist, call Palos Health at 708.226.2300.
hardening of the arteries, high cholesterol Peter J. McDonnell, MD
Sarhan Mohammad, MD
Martin Ellenby, MD
Sanjeev K. Pradhan, MD
Are older than 50 and have two or more
Robert Gasior, MD
Eugene Tanquilut, DO
of these risk factors
Dean Govostis, MD
or diabetes.
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Hidden ScarTM Surgery Brings New Options to Breast Cancer Patients Area women now have another option when it comes to breast surgery. Palos Hospital recently became the first hospital in Illinois to be recognized as a Center of Excellence for Hidden ScarTM Breast Cancer Surgery. This advanced approach to breast cancer surgery effectively treats cancer while minimizing the physical reminder of a breast cancer diagnosis. Palos Medical Group breast surgeons Kanesha Bryant, M.D., and Jennifer Gambla, M.D., brought Hidden ScarTM Breast Cancer Surgery to Palos Health to further
expand healthcare options for women throughout the Chicagoland area. The procedure allows surgeons to remove cancerous tissue through a single incision made in an inconspicuous area, preserving the natural shape of the breast while reducing visible scarring. The procedure is appropriate for patients undergoing breast-conserving surgery (lumpectomy) as well as mastectomy. Qualification for each approach depends on a patient’s tumor size and location, breast shape, size and personal choice.
“Not only does the Hidden Scar™ technique eff f ectively remove the tumor, r it also helps patients to recover psychologically from their treatment by minimizing the concerns of disfigurement of their breast,” explains Dr. Gambla. “Dr. Bryant and I feel that this is a huge step forward for women in having a choice in their surgical and cosmetic outcome.”
Dr. Bryant came to Palos from Mayo Clinic in Rochester, Minnesota, where she trained under a multi-disciplinary team of breast specialists that included breast surgeons, radiologists, plastic surgeons, pathologists, and medical and radiological oncologists.
Dr. Gambla joined Palos Medical Group in 2010 from Riverside Methodist Hospital in Columbus, Ohio. She has dedicated her practice exclusively to the diagnosis and treatment of breast disease since 2004.
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The offices of Dr. Bryant and Dr. Gambla are located at the Palos Women’s Center 17333 S. LaGrange Rd. Suite 102, in Tinley Park. For more information about Hidden Scar™ Breast Cancer Surgery, or to make an appointment, please call 708.590.5520.
PALOS HEALTH PERSPECTIVE
FIGHT DEADLY SUPER BUGS! USE ANTIBIOTICS WISELY
Imagine hearing your health care provider say there is nothing he or she can do for your infection because the bacteria are resistant to all antibiotics available. Can this happen? According to Palos Medical Group’s infectious disease expert B. Ramakrishna, M.D., most scientists agree that we are moving closer toward a day when the answer is yes. Palos Health’s Antibiotic Stewardship Program, led by a team that includes Dr. Ramakrishna, as well as a pharmacist trained in infectious disease/antibiotics and an infection control nurse, was recently created to combat
antibiotic resistance and decrease the incidence of the deadly intestinal bacteria Clostridium difficile (C. diff). “Our goal at Palos will improve patient care and also make it more likely that antibiotics will be available for future generations,” explains Dr. Ramakrishna. “However, it’s important that everyone be informed and involved in this important issue to help avert a crisis.” The introduction of penicillin in 1941 was a health care game changer. Patients could now be cured from infections that were once considered deadly. However, shortly after penicillin’s introduction, some bacteria started to become resistant to this new agent. Over the years, despite the addition of many new antibiotics, bacteria continued to change and develop resistance. In recent years, the media have reported on ‘super-bugs’ or bacteria that are difficult to treat with the current antibiotics available. These bacteria are even resistant to the ‘strong antibiotics’ requiring
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hospital admission. According to the Centers for Disease Control and Prevention (CDC), each year at least 2 million people in the U.S. become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die as a direct result of these infections. To add to this problem, there has been a lack of development of new antibiotics during the past 25 years. According to Dr. Ramakrishna, pharmaceutical companies are reluctant to spend money on research, as there is no long-term profit. There simply is more incentive to create new medications for lifelong conditions, rather than those that are used in the short term. The growing resistance of bacteria to antibiotics is not just a United States problem, it is a worldwide concern. The United Nations and government bodies across the globe are developing strategies to address the rise of antibiotic resistance. In the U.S., the CDC has recently launched a ‘Get Smart about Antibiotics’ campaign.
PALOS HEALTH PERSPECTIVE
What You Can Do Everyone has a role to play in preventing antibiotic resistance! Below are a few steps you can take to ensure antibiotics are effective for a long time and will be available to protect your and your loved ones' health. Wash your hands! Handwashing is the number one protection against infection.
Keep up with vaccinations. Vaccinations help prevent infections that may require antibiotic treatment and help prevent disease from spreading.
Ask your health care provider about symptom relief. Talk with your health care provider about the best treatment for your illness. Ask your clinician or pharmacist what you can use to best relieve your symptoms.
Only take antibiotics for infections caused by bacteria. Antibiotics do not help illnesses caused by cold virus or the flu.
Ask your health care provider if watchful waiting is best for you. Some bacterial infections can get better without antibiotics, so your health care provider may recommend waiting to see if you feel better in a few days before prescribing antibiotics. Ask about side effects. Antibiotics can cause diarrhea, including C. diff, nausea or other side effects. Take the antibiotics exactly as directed. Even if you feel better, unless directed by your health care provider, take all of the prescribed doses.
Antibiotic Stewardship at Palos Health Palos Health has long been aware of antibiotic resistance and has worked to make wise use of antibiotics among patients. These efforts have recently been formalized through the creation of the Palos Health Antibiotic Stewardship Program. Chaired by Dr. B. Ramakrishna and cochaired by Amanda Ries, Director of Pharmacy and Andrea Quinn, Clinical Coordinator of Pharmacy, the program strives to provide the tools, education and information needed to help health care providers make decisions about antibiotic therapy that are best for each and every patient. By working together and being attentive to each patient’s needs—including the benefits and risks of antibiotic therapy—Palos Heath is able to provide quality care and hopefully decrease the spread of antibiotic resistance. For additional information on antibiotic use, refer to the CDC and its “Get Smart about Antibiotics” campaign, available at http://www.cdc.gov/getsmart.
Dispose of left over antibiotics properly. Never save antibiotics for future use or share with others. Talk to your pharmacist about how best to dispose of them—never flush down the toilet.
B. Ramakrishna, M.D. Palos Medical Group
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February is Heart Month
THINK IT MIGHT BE A HEART ATTACK? DIAL 9-1-1! Minutes matter when you’re experiencing a heart attack. Time is muscle, and every second counts toward a better overall outcome for you and your heart.
Many people delay treatment out of fear, embarrassment, or even denial. Make the decision to call 9-1-1 if you experience any of the following symptoms:
Making the decision to call 9-1-1 when symptoms first occur can significantly reduce hospital arrival and treatment times. Paramedics can transmit electrocardiogram readings directly from ambulances to the Palos Hospital Emergency Department, and if needed, initiate immediate measures, including activation of our leading-edge cardiac catheterization lab prior to your arrival.
“Non-classic” symptoms (especially for women)
Mild chest discomfort, pressure, squeezing, tightness or fullness
“Classic” symptoms:
Weakness
Sudden, intense chest pain
Unusual fatigue
Pain or discomfort in the stomach, one or both arms, back, shoulder, neck or jaw
Sleep disturbances
Indigestion, nausea or vomiting
Anxiety
Shortness of breath
Sweating (often a cold, clammy sweat), nausea or lightheadedness
Credit: WomenHeart: The National Coalition for Women with Heart Disease.
Check out our February Heart Health classes on the back page!
The Palos Health Heart & Lung Wellness Clinic now offers care to adults with mild to severe asthma complimenting the care already provided by primary care physicians. The clinic provides standardized education for meter-dose inhalers, spacer use, irritant avoidance, home treatment and written action plans for mild to severe asthmatics. With an order from a physician, the Asthma Clinic may administer Xolair to qualified patients with moderate to severe asthma. Patients who may benefit from the adult asthma clinic include those with increased risk of hospitalization and frequent emergency room visits and those with hard-to-control asthma.
Getting Started Ask your doctor if the Asthma Clinic is a fit for you or call 708.923.5300 to schedule an appointment.
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PALOS HEALTH PERSPECTIVE
Palos Health is committed to providing patients with the highest quality, least invasive options for identifying and monitoring internal diseases and injuries. Our new Imaging and Diagnostic facility offers state-of-the-art equipment that includes:
Magnetom Skyra 3.0T MRI
Magnetom Espree Skyra 3.0T MRI MRI 1.5T
SOMATOM Definition AS 128 Slice CT
Siemens Biograph PET
·
Industry standard Strongest commer1.5T magnet field cially available magnet strength in aoffering wide on the market, bore quality designimages highest
Largest PET field of view in the industry
High definition lesion detection
·
Quicker scan times and up to 60% lower radiation dose
Enables a fast diagnosis for patients with acute chest pain, abdominal pain or stroke symptoms
Used in oncology, surgical planning, radiation therapy and cancer staging
Strongest commercially available magnet on the market, offering highest quality images Faster scan times and accommodating design help patients feel more relaxed Exceptional image quality for: brain, pituitary gland, orbits, inner ear, wrists, ankles, elbows, knees Superior image quality aids diagnostic confidence of meniscal and tendon injuries
Exceptionally Faster scan times andcomfortable accommodating for designpatients help patients feel of all sizes more relaxed Most exams can · be Exceptional image done with head quality for: brain, pituoutside system; itaryperfect gland, for orbits, inner claustroear,phobic wrists,orankles, elanxious bows, knees patients
·
Superior image qualIdeal for MRI exams ity aids diagnostic confiof the abdomen, chest dence meniscal and andofbreast, renals, tendon injuries adrenals and liver
Currently the first 128 slice CT in an outpatient setting in the immediate area
Detects diseases and injuries to the brain, spine, chest, abdomen and pelvis
Palos offers competitive pricing and an experienced staff, all at a convenient location. Evening and weekend hours available.
Palos Imaging & Diagnostics Palos Health South Campus 15300 West Avenue, Suite 100 –East Building Orland Park, IL 60462 palosimaging.com
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Call 708.226.2500 to schedule your exam.
PALOS HEALTH PERSPECTIVE
Don’t Neglect Your Neck! January is thyroid awareness month What organ is the size of a lime and sits on the front of your windpipe? If you guessed the thyroid, you would be correct. This butterfly-shaped gland is responsible for sending hormones throughout the body to do the important work of regulating metabolism, growth and development and body temperature. Most likely, you will never notice your thyroid—that is, until there’s a problem. Fortunately, thyroid conditions, including most cancers, are very treatable when caught early. The expert staff at Palos Health is equipped to treat patients with thyroid, parathyroid and other endocrine system disorders using the latest technology and resources.
First Signs of Trouble In many cases, patients don’t realize their thyroid isn’t functioning properly until they undergo testing for a different, often unrelated, medical issue. That
According to the American Cancer Society, thyroid cancer is the fastest rising cancer in the United States. Palos Health has experts on staff equipped with advanced technology ready to provide optimal treatment. was the case with busy customer service representative and Chicago Ridge resident Linda Ronkowski, who mentioned to her primary doctor that she was feeling “more tired than usual.” When someone notices unusual changes in energy levels, the first step is usually a simple blood test, which can help to shed light on any contributing medical issues. In the case of the thyroid, a blood test can determine
whether the gland is hypo(underactive) or hyperthyroid (overactive). Linda went on to have a thyroid ultrasound at an outside facility, which indicated that she had one large thyroid nodule as well as several smaller ones. “I was immediately worried, especially since my dad was diagnosed with thyroid cancer, and had his thyroid removed,” she said. Linda was referred to Palos Health Endocrine Surgeon Samer Rajjoub, M.D., for further evaluation. Dr. Rajjoub reviewed and reinterpreted the findings of Linda’s ultrasound and sent her for a repeat ultrasound at Palos with specific instructions. Linda remembers this attention to detail very well during the procedure, including how the technician told her that she had received a “very detailed diagram” of where Dr. Rajjoub wanted her to focus the ultrasound.
How to Do a Neck Check 1
Hold the mirror in your hand, focusing on the lower front area of your neck, above the collarbones and below the voice box (larynx). Your thyroid gland is located in this area of your neck.
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While focusing on this area in the mirror, tip your head back.
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Take a drink of water and swallow.
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As you swallow, look at your neck. Check for any bulges or protrusions in this area when you swallow. Reminder: Don’t confuse the Adam’s apple with the thyroid gland. The thyroid gland is located further down on your neck, closer to the collarbone. You may want to repeat this process several times.
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If you do see any bulges or protrusions in this area, see your physician. You may have an enlarged thyroid gland or a thyroid nodule that should be checked to determine whether further evaluation is needed.
Credit: The American Association of Clinical Endocrinologists and the American College of Endocrinology.
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After Linda’s ultrasound, Dr. Rajjoub joined the technician to help interpret the results. To Linda’s relief, the concerning nodule referred to on the previous ultrasound could not be confirmed. “I still have a few small nodules that we will watch over the next year,” said Linda. “If they remain stable, I will only need to come in for an annual ultrasound. If there are any concerning changes, I may need to have a biopsy in the future.”
Check Your Neck It’s important to recognize common symptoms that could be related to thyroid nodules. According to Dr. Rajjoub, concerning signs could include a lump in the neck, voice hoarseness and difficulty swallowing. Your health care provider can perform a neck check if you suspect an issue, but you can also do an easy self-exam at any time (see graphic on opposite page). If your health care provider confirms a lump, the next step is to see an endocrinologist or
endocrine surgeon—doctors specifically trained to treat diseases of the endocrine glands. Dr. Rajjoub regularly evaluates patients with thyroid nodules using an ultrasound machine. Although many people are concerned when nodules are discovered, he notes that, “the large majority of thyroid nodules are benign. And of those that are not, most are well-differentiated (low-risk) cancers.” With thyroid cancer on the rise, Palos Health is equipped to perform accurate and rapid thyroid biopsies, intraoperative nerve monitoring and post-operative surveillance. When it comes to the treatment of parathyroid disease, Palos offers localization with ultrasound, sestamibi and 4D computerized tomography (CT) scans, along with intraoperative parathyroid hormone monitoring to aid in a minimally invasive approach. Dr. Rajjoub is one of the few fellowship-trained endocrine surgeons in the Chicago area, bringing experience and expertise in order to achieve better patient outcomes.
“Sometimes surveillance is preferred over surgery,” explains Dr. Rajjoub. “As with Linda, when a thyroid nodule is discovered, I work closely with patients to discuss treatment options and provide personalized attention. At Palos, we use a multidisciplinary approach that includes endocrinologists, pathologists, radiologists and oncologists to offer coordinated care.”
Back on Track With early detection, thyroid cancer is often very treatable and in most instances results in little to no disruption of normal activities. In the case of thyroid surgery, patients are typically home within a day and generally can expect to resume their regular routine. “I’m so glad I was referred to Dr. Rajjoub,” said Linda, “he went above and beyond for me. Hopefully my nodules don’t change, but if they do I know I will receive excellent care from everyone at Palos.”
Signs and symptoms of thyroid cancer
A lump in the neck
Swelling in the neck
Pain in the front of the neck, sometimes radiating up to the ears
Hoarseness or other voice changes that are persistent
Difficulty swallowing
Difficulty breathing
A chronic cough that is not due to a cold If you have any of these signs or symptoms, talk to your doctor right away.
Samer Rajjoub, M.D. Palos Medical Group
Need a doctor? Go to paloshealth.com/doctor.
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CLASSES EVENTS & GROUPS
WELLNESS Freedom from Fibroids Are you a woman who struggles with heavy menstrual bleeding, pelvic pressure or pain, frequent urination, backache or leg pain? The problem could be caused by uterine fibroids. Fortunately, there is relief from these noncancerous tumors through Interventional Radiology at Palos Hospital. Learn about minimally invasive procedures to remove tumors with significantly improved or resolved symptoms. Presented by Interventional Radiologist Michael Ginsburg, M.D. TIME/DATE: 7 to 8 p.m. Tuesday, March 21 LOCATION: Palos Hospital Auditorium, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free
Learn how posture, body mechanics and other forms of physical therapy can be used to prevent or manage back pain. This workshop is led by a Palos physical therapist. Registration is required.
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COST: Free
Don’t get sidelined by diabetes! Our nationally recognized Diabetes Program gives you the tools you need to manage the physical and emotional aspects of this disease. Get information about nutrition and physical activity, instructions on blood glucose monitoring and a customized eating plan. Note: A physician referral is required to join the program.
REGISTRATION: 708.226.2300
INFORMATION: For additional information, including meeting times, call 708. 923.4330. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights
TIME/DATE: 10 a.m. to noon, Tuesdays, March 7 to April 25
Nutrition for Your Heart
LOCATION: Palos Hospital ACC1/ACC2, 12251 S. 80th Ave., Palos Heights
Eat healthy for your heart’s sake! Understand how to control fat and saturated fat intake, avoid trans fats, cholesterol and sodium, increase fiber and read food labels. Taught by a Palos registered dietitian.
Take Better Care of Your Back
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Your Diabetes Game Plan
REGISTRATION: 708.226.2300 COST: $80
Gentle Yoga
TIME/DATE: 4:30 to 5:30 p.m., second and fourth Thursdays
TIME/DATE: 6:30 to 7:30 p.m. Wednesdays, beginning February 1 LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights
Thursday, March 2 – The Prepared Pantry
Sweet treats don’t have to be full of unhealthy calories and fat. Learn how to make desserts that satisfy cravings while keeping your heart healthy. Taught by Palos registered dietitian nutritionist Loretta Wojtan and featuring Palos Health pastry chef Stephanie Connelly.
Having a well-stocked cupboard is a great step on the way to healthier, more mindful eating. Learn what essentials you should always have on hand, as well as a few options you might not have considered! Basic recipes will be provided for easy meals or quick, companypleasing dishes. Led by Palos registered dietitian nutritionist Loretta Wojtan.
Register online for these events at paloshealth.com/classes or call 708.226.2300.
TIME/DATE: 10 a.m. to 12 p.m., Wednesdays, March 8 to April 26
Courage to Quit
Thursday, February 2 – Desserts from the Heart
CLASS TIMES: 6:30 -7:30 p.m. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights
LOCATION: Palos Hospital
Cancer patients and their loved ones can learn how to reduce stress and anxiety, regain strength and flexibility and minimize treatment side effects. Poses can be done on the floor or on a chair (your choice).
Back to Basics – Winter Nutrition Classes
To register for any of these FREE events, go to paloshealth.com/classes or call 708.226.2300.
Maintain your independence while reducing the risk of falling. Led by physical and occupational therapists at Palos, this program emphasizes practical strategies to manage falls. Gift certificates now available for purchase!
INFORMATION: For additional information, including meeting times, call 708. 226.2300. LOCATION: Palos Hospital, 12251 S. 80th Ave. Palos Heights
This eight-week program is designed for adults who are ready to quit smoking. Offered by the Respiratory Health Association.
TIME/DATE: 6 to 7 p.m., Wednesday, February 8 (Additional dates available.) LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free
A Matter of Balance
CLASS TIMES: 6:30 -7:30 p.m. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights
LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free
FAMILY-CENTERED CARE FAMILY-CENTERED CARE Birth, Babies and Beyond Get the most out your birthing experience. In a relaxed setting, expectant mothers and their support person learn about labor, birth, medical interventions, physical and emotional changes after birth, infant care and more. TIMES: Classes available in two formats: a four-week session, one evening/week on Wednesdays, from 7 to 9 p.m. ($85/couple), or a weekend marathon from 8 a.m. to 4 p.m. on Saturday ($85/couple, meals provided). Call for available dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708. 226.2300
Opiate Use: Hope and Help Heroin and prescription opiate use has skyrocketed in our area in recent years, and many struggle with addiction to these powerful drugs. Addiction Medicine specialist Leonard Spishakoff,
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M.D., explains how these drugs work, signs of opiate abuse and what treatments can help with addiction.
TIME: 7 – 8:30 p.m., Tuesday, January 31 LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights
Register online for this event at paloshealth.com/classes or call 708.226.2300.
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Baby Basics This three-hour class offers up-todate information on caring for a newborn. Topics include: feeding, diapering, bathing, infant stimulation, newborn characteristics and behavior, infant-soothing techniques, signs of illness, immunizations, car seat safety and general safety. TIME/DATE: 6:30 to 9:30 p.m. Wednesdays, February 1 and March 8. This class meets on the fourth week of the Birth, Babies & Beyond class. Call for additional times and dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: $20/couple
Breastfeeding Basics A Palos lactation specialist provides the basics for successfully nursing your baby. This class covers breastfeeding advantages, practical techniques, pumping, storing, returning to work, dad’s role and family support. TIME/DATE: 6:30 to 9 p.m. Thursday, February 16; or Thursday, March 16. Call for additional dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: $15/couple
Infant/Child/Adult CPR Be prepared to act in an emergency. This American Heart Association class is intended for parents, grandparents and and anyone 11 years and older interested in learning cardiopulmonary resuscitation techniques to assist infants, children
and adults in distress. Note: This is not a class for CPR certification. TIME/DATE: 6 to 9 p.m. Thursdays; February 9 and 23; or March 2 and 23. Call for additional dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708. 226.2300 COST: $30/person
Birthing Center Tour One of the most important decisions to make when expecting a baby is where to deliver your child. Learn how Palos is different from other hospitals through our single-room maternity care, where labor, delivery, recovery and postpartum all take place in newly remodeled private rooms. TIME/DATE: 6 to 6:45 p.m., select Wednesdays and Thursdays; 11 to 11:45 a.m., select Saturdays. Call for dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REISTRATION: 708.226.2300 COST: Free
Joy of Grandparenting Are you welcoming a grandchild? Explore the many facets of the grandparent role and learn about family adjustment as well as ways you can support the new parents. An update on childbirth practices, the latest in baby care and a tour of the Birthing Center are included. TIME/DATE: 7 to 9:30 p.m. Thursday, January 26 or March 9. Call for additional dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights
Diabetes Fair 2017 Diabetes & Diet: What Really Works! No Fads, Just Facts Take charge of your health at Palos Health’s annual Diabetes Fair! Open to anyone living with diabetes and their family members, this year’s Fair features practical strategies from Palos dietitians for eating to manage blood sugar levels, as well as help in sorting through the diet clutter to find weight loss programs that actually work.
REGISTRATION: 708. 226.2300 COST: FREE
REGISTRATION: 708.226.2300 COST: Free
Nursing Moms Network
Caregiver Support Group
Get the support you need when it comes to breastfeeding. Meet and share experiences with other mothers and receive ongoing guidance and support from an experienced lactation consultant. TIME/DATE: 11 a.m. to 12:30 p.m., Tuesdays LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTATION: 708.226.2300 COST: Free
Offered by professionals from Palos Home Health Care, this group provides emotional and practical support for family members and friends caring for a loved one in the last years of life. REGISTRATION: Call for details, 630.257.1111 COST: Free
SUPPORT GROUPS SUPPORT GROUPS Look Good … Feel Better Look your best during cancer-fighting treatments with training from cosmetic industry professionals. Learn makeup, skin and nail care techniques as well as how to wear wigs, hats and scarves to enhance your appearance. This non-medical program is offered in partnership with the American Cancer Society. TIME/DATE: 3 to 5 p.m., Tuesday, February 7. Call for future dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights, Conference Room C REGISTRATION: 708. 226.2300 COST: Free
Lymphedema Support Network with others experiencing lymphedema while receiving updates on products, community resources and management strategies. TIME/DATE: 5:30 to 6:30 p.m., Wednesday, March 8 Call for additional dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights
To register for any of these FREE events, go to paloshealth.com/classes or call 708.226.2300.
Learn about the extensive support services at Palos, including nutrition counseling, our comprehensive diabetes program, home health care and physical therapy. Light refreshments available. Registration is required.
All cancer survivors are welcome to attend this group focusing on both supportive and educational care. Participants can network with other survivors facing similar struggles. This discussion group is brought to you by The Cancer Support Center. TIME/DATE: 6 to 7:30 p.m., second Wednesdays LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free
WEIGHT MANAGEMENT WT MGMT PROGRAMS WeightWise Discover a healthy approach to weight management for adults who prefer individual attention. Appointments scheduled at your convenience. LOCATION: Palos Hospital REGISTRATION: 708.923.4330
Shapedown (6 to 17 yrs) This ten session program is designed for overweight children and teens or as a preventative program for those at risk of obesity. The individualized format works to mold positive eating and exercise habits while addressing self-esteem. Education, family support and behavior modification also are addressed as keys to success. LOCATION: Palos Hospital REGISTRATION: 708.923.4330
Turning 40? Celebrate the milestone with a mammogram!
TIME/DATE: 9 a.m. - noon, Thursday, March 23 LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free
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Cancer Survivors Discussion Group
New to mammograms? Make your first screening mammogram a part of an evening of self-care at Palos. Bring a friend or two and enjoy light snacks and chair massages. Meet the radiologist and have your results explained to you. Appointments are required. Please call 708.923.5104
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TIME: 5 to 7 p.m., January 26 or February 23 LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights
PALOS HEALTH PERSPECTIVE
PALOS HEALTH
Non-profit Organization U.S. Postage
12251 South 80th Avenue Palos Heights, IL 60463
PAID Palos Health
Palos Hospital 12251 South 80th Avenue Palos Heights, IL 60463 708.923.4000
Palos Health South Campus 15300 West Avenue Orland Park, IL 60462 708.460.5550
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When It’s More Than Just a Pain in the Neck
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Don’t Skip a Beat! Understanding Atrial Fibrillation 6:30 – 7:30 p.m. Tuesday, February 21 People who experience an irregular and/or rapid heart rate are at an increased risk of stroke, heart failure and other heart-related complications. Learn how medications and other alterations can help manage this condition without skipping your daily activities. Presented by electrophysiologist M. Burke, M.D. Your Happy Heart 6:30 – 7:30 p.m. Tuesday, February 7 Did you know a positive and upbeat mood can directly affect the cardiovascular system? This free class, taught by Mike Azzaline, MA, CADC, MAC, LPC, gives practical, easy-to-implement strategies for lifting depression and experiencing a more confident and happy attitude toward life.
In the Thick of It: Life On Blood Thinners 6:30 – 7:30 p.m. Tuesday, February 28 Get all your medication questions answered, including how blood thinners work and how to take them effectively. Learn how to lead a healthy and active life on blood thinners! Presented by Palos Health pharmacists.
To register for any of these FREE events, go to paloshealth.com/classes or call 708.226.2300.