Best Practices 3rd Quarter 2015

Medical Community News and Information

Third Quarter 2015 www.BestPracticesMD.com

FADING AWAY As more Americans enjoy longer life expectancy, the incidence of Alzheimer’s is increasing steadily.

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Protect yourself against the Chikungunya Virus and Mosquito Bites ‘Surgical Saturday’ Program to Offer Free Surgeries Twice a Year Sun Safety Crucial in Preventing Melanoma

CONTENTS

Third Quarter 2015

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PUBLISHER/CHAIRMAN Rick Clapp

EDITORIAL Editor Mary Alys Cherry Medical Director Victor Kumar-Misir, M.D.

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Contributing Writers Mary Alys Cherry Rod Evans Kelly Groce Victor Kumar-Misir, M.D.

ART Creative Director Brandon A. Rowan Graphic Designer Kelly Groce Photography/Editing Mary Alys Cherry Patty Kane Brian Stewart

Letter From the Medical Director 7 In Praise of Women in Medicine Features 8 STEMI and An Unlikely Father-Son Adventure 11 Fading Away: A Closer Look at Alzheimer’s Disease 14 Childhood Obesity: Teacher Challenges Students to Healthy Summer 15 Students Take First Step Towards Nursing Career 16 Medistar Completed Construction of Rehab Hospital 17 Clear Lake City Elementary Celebrates 50th Anniversary 18 Houston Methodist St. John Hospital Welcomes New Surgeons 19 UTMB Named Regional Ebola Treatment Center 20 Sun Safety: Protect Yourself Against Melanoma 22 Chikungunya Virus May Be Coming to a City Near You 4 |www.BestPracticesMD.com |Third Quarter 2015

ADVERTISING Director of Advertising Patty Kane Account Executives Shannon Alexander Debbie Salisbury

PHONE: 281.474.5875 FAX: 281.474.1443 www.BestPracticesMD.com Best Practices Quarterly is trademarked and produced by Medical Best Practices Group, LLC. Best Practices Quarterly is not responsible for facts as presented by authors and advertisers. All rights reserved. Material may not be reproduced in part or whole by any means whatsoever without written permission from the publisher. Advertising rates are available upon request.

Best Practices Quarterly P.O. Box 1032 Seabrook, TX 77586 R.Clapp@Baygroupmedia.com

By Victor Kumar-Misir, M.D. | imeddrs.vm@gmail.com

From the Medical Director

LETTER

In Praise of Women in Medicine

D

OCTORS are always

in awe whenever I present my 1898 original copy of Sir William Osler’s “The Principles and Practice of Medicine,” which became the bible of medicine. Vastly utilized and acclaimed globally, this monumental work inspired so many of the giants in medicine, that it had an historic impact on the geo-medical landscape of the planet.

At a pivotal moment in medical history, in 1867, Baltimore’s millionaire merchant and financier, Johns Hopkins, created a University and Hospital trust with $3.5 million. The Johns Hopkins University he created opened in 1876, and Daniel Gilman, a Yale-trained professional educator, became its founding president.

An Army bureaucrat in Washington, John Billings, who later became the founder of what eventually became the National Library of Medicine and Index Medicus, convinced the Board of Trustees that research and teaching, with an elite of first-class teachers, would aspire to the ideal of “benefiting the sick and afflicted of all countries and of all future time.”

In 1888, hospital chief William Welch, MD, an 1850 Yale graduate, along with Billings, recruited and appointed William Osler, MD, as Physician in Chief and professor of the Theory and Practice of Medicine.

The hospital formally opened in 1889, and its first patient was admitted with a thoracic aneurysm.

However, fiscal problems prompted President Gilman to appeal for financial help, in order to open a Johns Hopkins

Joyce M. Lyon M.D.

School of Medicine. As nobody responded, a group of women, Mary Garrett, Carey Thomas, Mary Gwinn and Elizabeth King – all unmarried daughters of Hopkins’ trustees – formed a Women’s Fund Committee that elicited funds from all over the United States, including the First Lady, and eventually collected the $500,000 necessary for starting the school, but with the provision that women would be admitted. In 1893, in its first year, the Johns Hopkins School of Medicine registered 18 students – three of them women.

In 1890, Dr. Osler thought of writing a book for the medical school but fell in love, with Boston beauty Grace Revere Gross, who refused to marry him, unless and until he had finished writing the book.

He then worked tirelessly on it, and in March 1892, he published “The Principles and Practice of Medicine” – and the rest is history.

Osler did not keep his first copy of the book. Instead he took it to Philadelphia, threw it on Grace’s lap, and demanded marriage, which she granted with relief.

At a momentous event in history, in 1901, the reverend

Frederick Taylor Gates had a conversation with the richest man in the world at the time – John D. Rockefeller, Sr., who was looking for some major ideas in which to invest his wealth. Reverend Gates had read Osler’s Practice of Medicine, and with unbounded admiration and enthusiasm, he rushed it to Mr. Rockefeller, and said: “I have the idea! The world isn’t getting its full share of benefit from scientific discoveries. This knowledge must be distributed in a practical way, to relieve the ills of the world.”

Mr. Rockefeller immediately founded the Rockefeller Institute for Medical Research, which provided grants and aid to investigators and institutions.

Dr. Simon Flexner, Professor of Pathology, became its leader. Among the recipients of this largesse was Dr. William H. Welch, who, endowed with a million dollars, became the director of the first modern school of hygiene in the United States, and along with others, took part in the organization of the China Medical Board, and later the Peking Union Medical College, exporting medical innovativeness worldwide. Interestingly, Dr. Flexner himself was dispatched to California, to stem the westward spread of bubonic plague that had intermittently affected residents of California.

Dr. Victor Heiser, who, while a medical student, had met Dr. Welch, with whom he became lifelong friends, was responsible for pioneering public health programs to prevent and eradicate a variety of endemic and epidemic communicable diseases in

over 45 countries. Other great innovators at the time included Dr. Milton J. Rosenau of Harvard, whose volume on preventive medicine was a classic on the subject.

These are just a few of the leading innovators in the practice of medicine, inspired

by Sir William Osler’s 1898 publication.

This early momentum spawned a plurality of foundations, universities, private companies, entrepreneurs, businessmen, politicians and individuals to support and spur medical ingenuity innovativeness.

Today, as a result, modern medicine is capable of incredible feats of human preservation and health promotion.

But for the influence of brave, farsighted women at a different socio-cultural time, the world may not have benefited from Sir William Osler’s history-changing work.

Drs. Joyce M. Lyon, M.D. and Victor Kumar-Misir, M.D., who have been married for 50 years, are international physicians, who have spent the past 40 years integrating trans-lingual, cross-cultural healthcare delivery with emerging informationmanagement tele-technologies, with the goal of delivering healthcare to all individuals, regardless of language, literacy, location or level of income.

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M E D I C A L

T R I V I A

A. Morning

2. What is the most common blood type?

3. The number one cause of blindness is what?

B. Afternoon

A. A

A. Glaucoma

C. Night

B. O

B. Stroke

D. All of the above

C. B

C. Diabetes

D. A-H

D. None of the above

4. Which of the following condiments was sold in the 1830’s as medicine?

5. If the human eye was a digital camera, how many pixels would it have?

6. ____ are the only body part that can’t repair themselves.

A. Mustard

A. 212

B. Eyes

B. Mayonnaise

B. 576

C. Lips

C. Ketchup

C. 833

D. None of the above

D. All of the above

D. 1,015

1. Your brain is most active when?

A. Teeth

1. C, 2. B, 3. C, 4. C, 5. B, 6. A

Survey spotlights local hospitals

By Mary Alys Cherry

S

EVERAL AREA MEDICAL FACILITIES came in for

national honors with the release of U.S. News & World Report’s 2015 “Best Hospital” survey.

The University of Texas MD Anderson Cancer Center, which has a location in Nassau Bay, was ranked the No. 1 hospital for cancer care in the nation in the survey.

Since the annual survey launched in 1990, MD Anderson has been named one of the top two cancer hospitals in the United States. It has ranked first 11 times in the past 14 years.

Houston Methodist, of which Houston Methodist St. John Hospital in Nassau Bay is a part, had national rankings in 11 specialities – cancer, cardiology and heart surgery, diabetes, gastroenterology, geriatrics, gynecology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology -- and was named the Best Hospital in Texas for the

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fourth consecutive year.

And, the Memorial Hermann System, which has Memorial Hermann Southeast here in the Bay Area, is also celebrating. Its TIRR Memorial Hermann was ranked the best rehabilitation hospital in Texas and the second best in the United States -- marking the 26th consecutive year TIRR Memorial Hermann has been included in the rankings.

Memorial Hermann-Texas Medical Center was ranked No. 4 in Texas and also listed in the rankings in the specialty areas of gynecology, nephrology and urology.

Clear Lake Regional Medical Center was ranked No. 13 in Texas and No. 6 in the Houston metro area.

U.S. News evaluated hospitals in 16 adult specialties and ranked the top 50 in most of the specialties. Less than 3 percent of the nearly 5,000 hospitals that were analyzed for Best Hospitals 2015-16 were nationally ranked in even one specialty.

DOCTORAL

DIGITS MD Anderson named No. 1 U.S hospital for cancer care

T

he University of Texas MD Anderson Cancer Center, which has a location in the Clear Lake area, has been ranked the No. 1 hospital for cancer care in the nation by U.S. News & World Report’s “Best Hospital” survey.

Since the annual survey launched in 1990, MD Anderson has been named one of the top two cancer hospitals in the United States. It has ranked first 11 times in the past 14 years.

“We’re honored by this tremendous national recognition, but the true measure of our success is the number of lives we’ve impacted with our care, research and support,” said Ronald A. DePinho, M.D., president of MD Anderson. “We owe our gratitude to the more than 20,000 cancer fighters, including world-class faculty and nurses, and 1,000-plus volunteers working every day to end cancer for our patients and others around the world. Our culture of exceptional care and genuine caring is second to none.”

Specialty rankings Two subspecialties also were ranked highly in this year’s survey. In the Ear, Nose and Throat specialty, MD Anderson’s Head and Neck Surgery service was ranked No. 5, the same ranking as last year. In Gynecology, MD Anderson’s Gynecologic Oncology and Reproductive Medicine service moved forward one ranking, coming in at No. 7.

These specialty rankings are particularly notable, officials say, because they include care provided at general hospitals across the nation, not just cancer centers. Both of these specialties have been consistently ranked high for the past two decades.

The survey also named MD Anderson as “high performing” in Urology, meeting the survey’s standards for excellence.

“We’re particularly proud of the efforts of our clinical team which contributed so much to MD Anderson achieving this,” said Thomas Buchholz, M.D., executive vice president and physician in

“The survey also named MD Anderson as ‘high performing’ in Urology, meeting the survey’s standards for excellence.” chief. “This recognition is a direct result of their constant dedication to the patients and families who come through our doors every day.”

Events of Fiscal Year 2015 Last year, more than 127,000 people went to MD Anderson for innovative care, prevention services, clinical trials, diagnostics, second opinions and consults at survivorship clinics.

More than 8,000 participants were enrolled in clinical trials available through MD Anderson’s Texas Medical Center campus and many of the locations and affiliations in its network.

MD Anderson’s reach continues to expand, with the additions of partner member hospital Baptist MD Anderson Cancer Center in Jacksonville, Fla. and international associate member Hospital Israelita Albert Einstein in Sao Paulo, Brazil.

16,000,000 Around 16 million Americans practice yoga and for good reason too. Yoga reduces stress and back pain, gives you a stronger heart, and increases weight loss.

5 The human brain can hold 5 times as much information as an Encyclopedia.

200 When you take one step, the human body uses 200 muscles.

On average we take 10,000 steps a day.

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you that, you know, your life flashes in front of your eyes and your adrenaline starts pumping. I’ve got a 9-year-old …

There’s nobody else who lives down here with me. I’ve got nobody for him.”

Jesse rode along in the front seat of the ambulance as his father was attended to in the back. When they arrived at Houston Methodist St. John Hospital, Jesse waited with the ER staff as the doctors saved his dad’s life.

WHAT HAPPENED?

Jerry had suffered a STEMI, or ST segment elevation myocardial infarction.

This potentially lethal type of heart attack occurs when a blood clot cuts all or part

“Smoking, lack of exercise and even stress can also precipitate a STEMI.” of the heart off from its blood supply.

The lack of oxygen in the heart can cause muscle injury or death. STEMIs strike a quarter-million people every year.

STEMIs typically present initially as heartburn, and the pain may radiate outward from there. Other symptoms include shortness of breath, lightheadedness, nausea, weakness and palpitations.

WHAT CAUSES STEMIS?

An Unlikely Father-Son Adventure A heart attack was the last thing on their list of family fun

J

ERRY BRAWNER woke up at 3 a.m. on a Monday with what felt like severe indigestion. By the time 4 o’clock rolled around, it had only gotten worse, and he knew something was wrong. A single father, he woke his 9-year-old son, Jesse, and told him to pack

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a backpack while he called an ambulance “Come on, buddy, we’re going on an adventure,” he said.

Once the paramedics arrived, Jerry explained, “They hooked me up and said, ‘yeah, you’re having a heart attack.’” At 45, Jerry didn’t expect anything like this on what should have been just another normal Monday morning. “What’s scary,” he continued, “is that as soon as they tell

Dr. Palur Balakrishnan, who treated Jerry, said, “Myocardial infarctions can result as complications from other infirmities, including diabetes, high blood pressure and obesity. Smoking, lack of exercise and even stress can also precipitate a STEMI.” He continued, “Due to the nature of these causes, many STEMIs can be prevented with a healthy diet and exercise.”

WHERE ARE THEY NOW?

Jerry has been making an effort to adopt a healthier lifestyle and has been back to Houston Methodist St. John as he gets healthier. Jesse said, “I feel like my dad is a new person now. He eats a lot healthier, and he doesn’t eat as much, and he’s losing weight.”

With the help of the team at Houston Methodist, Jerry is on the road to recovery and a healthier lifestyle.

care without luck,” said Dr. Ngo, who has traveled to Guatemala several times on medical missions. “I’m really grateful that I have the opportunity to help them and give back to my community.

GREAT OPPORTUNITY

Free surgeries offered ‘Surgical Saturday’ program aims to provide free surgeries twice a year

F

OR MANY UNINSURED RESIDENTS

in the Houston area, it’s a challenge to pay for a much-needed surgery and to take a day off from work to have it performed. The result is a life with daily pain or frequent emergency room visits because they can’t bear it anymore.

Neither option is good, so the Texas Gulf Coast Project Access (TGCPA) “Surgical Saturday” initiative was recently launched to help make a difference in the lives of many.

The TGCPA is a pilot project partnership between Memorial Hermann and Gateway to Care that unites healthcare providers such as Southwest Surgical Associates, Memorial Pathology Consultants, United Surgical Partners International, Greater Houston Anesthesiology in partnership with USAP and a host of neighborhood primary care clinics in a collaborative effort to provide free surgeries and medical procedures to uninsured residents in the Houston community.

The inaugural Surgical Saturday event kicked off April 25 with Dr. Rick Ngo, a general surgeon with Southwest Surgical Associates, providing three, pre-selected patients with pro bono surgeries at their office on the campus of Memorial Hermann Southwest hospital.

“The impetus for the project is to demonstrate that the Houston healthcare community can join together to measurably and profoundly impact the lives of residents who do not have access to the care they desperately need,”

said Carol Paret, senior vice president and chief community health officer, Memorial Hermann Community Benefit Corporation.

“This project encourages local surgeons, nurses, anesthesiologists and other medical professionals to volunteer to perform – at no charge – procedures that patients have sometimes waited months or years to have, but were unable to afford,” Paret said.

A CALL-TO-ACTION

One of the goals of the TGCPA initiative is to serve as a call-to-action to highlight the “medical missions at home” opportunities available to medical professionals. While many travel abroad to lend a hand, there are thousands of people in their own backyard who also need their expertise and care.

“We are honored to contribute to this year’s Surgical Saturday Event in partnership with the surgeons and facilities we serve,” said Brandon May with U.S. Anesthesia Partners. “We’re happy this year’s event was a great success for our community and for those who need access to high quality surgical care.”

Dr. Ngo volunteered his services for the inaugural Surgical Saturday and performed two laparoscopic gallbladder and cyst removals. Although not life threatening, such conditions can hinder a person’s ability to live a pain-free and productive life.

“I have been blessed personally in many ways and Surgical Saturday is my chance to help others who have tried to navigate the normal avenues and resources to attain surgical

“I believe that many physicians do want to volunteer,” Dr. Ngo continued.

“Often it’s just a matter of the opportunity presenting itself. I think Surgical Saturday is a great opportunity for physicians in the area to be able to provide their skills and resources to help others without having to travel internationally on a medical mission trip. They can do it in their own backyard.”

Idonia L. Gardner, executive director of Gateway to Care, said Surgical Saturday is important because it enables patients to have a surgery performed without missing work during the week. But the project also has another benefit.

“This type of program, with partners coming together for the public good, helps the community,” Gardner said.

“When you talk about individuals who are sick and experiencing pain, this type of surgery is able to relieve that pain and reduce sick time off. It also helps curtail visits to the emergency room, which we all know is the most costly kind of care.

So, Surgical Saturday is really beneficial to both the patient and the community at large.”

Gardner added that the goal is to have Surgical Saturday twice a year and urged health professionals to volunteer their services for future events.

The importance of Surgical Saturday was not lost on Gabriela Arellano, one of three patients pre-selected from neighborhood primary care clinics to receive free surgery. Arellano, 40, was suffering with chronic cholecystitis, an inflammation that can result in the gallbladder becoming gangrenous if left untreated.

“I am really grateful for this surgery,” Arellano said.

“I was living in pain because I could not afford to pay for surgery. Now, I will be able to do things normally without pain. I appreciate what was done for me. It will make my life better.”

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FADING AWAY Alzheimer’s disease slowly robs patients of vitality and function

By Rod Evans

I

T’S THE WORST case health scenario for many Americans, and for good reason. Alzheimer ’s disease is a condition that generally creeps up on its victims before eventually robbing them of their functionality, vitality and, eventually, their lives.

(Continued on page 12)

According to the Alzheimer’s Foundation, the disease is the sixth leading cause of death in the U.S. and an estimated five million people across the country currently have the condition, most of them over the age of 65. Death usually occurs due to malnutrition, pneumonia or some other type of infection. According to statistics provided by the National Center for Health Statistics of the Centers for Disease Control, over 83,000 people in the U.S. died due to Alzheimer’s in 2010. What makes the disease especially insidious is the fact that the cause of it is unknown and there is currently no cure. And as the average life expectancy for Americans increases, the incidence of Alzheimer’s is rising accordingly.

Projections indicate that as many as 16 million Americans will have the disease by 2050.

In Texas, the Alzheimer’s Association Houston and Southeast Texas Chapter reports that over 340,000 people in the state will be diagnosed with the disease in 2015, including 11 percent of

“The breaking point is usually when the family notices that it is interfering with their ability to function in life,” Burnet said.

WHAT IS ALZHEIMER’S?

The origin of the name of the disease dates to 1906 when German physician Dr. Alois Alzheimer presented a case history to a medical board meeting of a 51-year old woman who suffered from a rare brain disorder. An autopsy revealed the markers for what would eventually be called Alzheimer’s disease.

The Alzheimer’s Foundation says Alzheimer’s attacks the brain’s nerve cells, or neurons, resulting in memory loss, deterioration of thinking and language skills and behavioral changes. The neurons that produce the brain chemical, acetylcholine, break

“The incidence of Alzheimer’s in people 85 and older is about 25 to 40 percent.” the residents over the age of 65. It’s the sixth leading cause of death in Texas, with 5,293 people having succumbed to complications of the disease in 2012.

“Alzheimer’s is dementia characterized by memory loss, confusion, lack of insight and loss of judgment, and is a progressive degenerative neurologic condition,” said Leanne Burnett, director of neurological services at Methodist St. John Hospital in Clear Lake. “All of us are forgetful at one time or another, but when confusion and forgetfulness begin to interfere with everyday life, that’s when it could be a diagnosis of Alzheimer’s.”

Burnet says it is frequently family members and friends of Alzheimer’s sufferers who notice the decline in function, as patients typically have little insight into their declining condition and will usually offer up justification as to why they have forgotten something. In early onset dementia, the patient may lose track of paying bills or have a hard time remembering names of familiar people.

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connections with other nerve cells and ultimately die. Two types of abnormal lesions clog the brains of Alzheimer’s patients: beta-amyloid plaques—sticky clumps of protein fragments and cellular material that form outside and around the neurons; and neurofibrillary tangles, defined as insoluble twisted fibers composed of a specific type of protein that builds up inside nerve cells. But researchers don’t know what causes this process to occur.

Alzheimer’s Foundation research indicates that multiple factors could play a role in the development of the disease, including age, genetics, oxidative damage to the neurons from the over production of toxic particles called free radicals, serious head injuries and brain inflammation. And statistics indicate African-Americans

are two times more likely to be diagnosed, but the reason for that increased susceptibility is not known.

“Up to 25 percent of cases are familial (genetic) and that’s fairly provable,” Burnet said, “but beyond that, a lot of research is going on, but no real answers have been found regarding the cause. We still don’t completely understand the neuro pathology and arguments continue regarding the role of the amyloid plaques and neurofibrillary tangles in the onset of the disease.”

Because there is no definitive test for the disease, Burnet says the diagnosis is typically through examination by a physician who may then send a patient to have neuro psychological testing performed. While an MRI may be used to rule out other possible conditions, it cannot specifically diagnose Alzheimer’s.

“There is a test called an amyvid scan that is used to test some of the neuro pathologic changes in Alzheimer’s patients, but I rarely use it. Unfortunately, a small percentage of patients in older groups have an abnormal amyvid scan, but don’t have Alzheimer’s,” Burnet said.

annually, and the disease costs U.S. businesses more than $60 billion per year due to lost productivity and absenteeism by primary caregivers and insurance costs. It is estimated that the annual cost of caring for an individual with Alzheimer’s ranges from about $18,500 to $36,000.

AGING POPULATION

Because there is no cure and drugs have a limited capacity to treat the symptoms, the role of caregivers takes on even greater importance in the treatment of patients, but caring for someone with Alzheimer’s is extraordinarily difficult on both physical and emotional levels.

Fortunately, there is a vast support system for caregivers that includes online resources and local support groups.

Burnet says the first thing patients and their families should do following a diagnosis of the disease is gain as much information as they can about the condition and how it will impact their lives.

“I recommend the book titled, “The 36 Hour Day” by Nancy Mace and Peter Rabins to many of my patients,” Burnet said, “and the Alzheimer’s Association is a great source of information and resources.”

As more Americans enjoy longer life expectancy, the incidence of Alzheimer’s is increasing steadily. U.S. Census Bureau statistics indicate the number of people age 65 and older will double between now and 2050 to about 88 million people, and those 85 and older will total 19 million. The incidence of Alzheimer’s in people 85 and older is about 25 to 40 percent.

The increasing numbers of people diagnosed with Alzheimer’s also brings with it dire financial implications, as the Alzheimer’s Foundation reports that the estimated tab for caring for Alzheimer’s patients is about $100 billion

TREATMENT OPTIONS

While there is no cure for the disease, the U.S. Food and Drug Administration (FDA) has approved the use of several drugs that can help mitigate the symptoms in mild to moderate cases, including Aricept, Exelon and Razadyne, but Burnet says those medications have varying degrees of effectiveness, so most of the care for patients is supportive in nature.

CAREGIVERS CRUCIAL

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Pasadena teacher challenges students to a healthy summer

By Michelle Reed American Heart Association

O

VER THE PAST YEAR, the United States has seen a dramatic incline in childhood obesity. According to the American Heart Association, about one in three American kids and teens is overweight or obese, which is nearly triple the rate since 1963.

Childhood obesity has become the No.1 health concern among parents in the U.S. Kids today have health problems usually not seen until adulthood, such as high blood pressure, elevated cholesterol levels, and Type 2 Diabetes.

One of the primary culprits of childhood obesity is sugar-sweetened beverages, which includes soda, sports drinks, sweetened waters and teas.

According to the American Heart Association, consumption of sugary drinks has increased by 500 percent in the past fifty years and is now the single

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largest caloric intake in children.

Jacqueline Caver, a health advocate and physical education specialist at Turner Elementary in the Pasadena School District, said she wanted to get involved incorporating healthy living into her curriculum by raising awareness of the dangers of sugar-sweetened beverages.

“I use a bike as a comparison. If they leave their bike out in the rain, what happens to it? It gets rusty and eventually, it won’t work anymore,” Caver said. “I tell them that their bodies are just like that bike. If you don’t take care of it, it will not work properly.”

During the school year, Caver said she encourages healthy living exercises with her students to educate them on why it’s important to drink more water. It’s a lesson, she said, that the students try to keep up during the summer break.

Beverages like energy drinks, an American Heart Association study reveals, can be deceiving because they advertise that they are healthy, but

usually are loaded with calories and sugar. Common forms of added sugars are sucrose, glucose, fructose, maltose, dextrose, corn syrups, concentrated fruit juice and honey.

“We did this activity where we used sugar cubes to demonstrate how much sugar is in a beverage,” Caver said. “I collected sugary drinks that were popular with my students, and then I had a visual with the sugar cubes so that they could compare sugar to the serving size. [My] students were blown away by the amount of sugar they found in beverages they drink just about every day.”

Using 27 sugar cubes as an example, Caver said she was able to show her students how much sugar was actually in a 20-ounce bottle of soda.

“I asked them if they would drink it and most of them said yes. Then I held both side-by-side [the sugar cubes and the soda] and turned the nutrition label around to show the amount of sugar that was in the bottle,” Caver said. “They could not believe it.”

If you have sugary drinks on a regular basis, the American Heart Association recommends cutting out one of those drinks a day. A week later, drink two less a day until those sugary drinks are cut out completely from your diet.

Even though the school year is over, Caver is still educating her students and their parents about staying active, healthy and away from sugary drinks.

“I will be doing several Facebook challenges over the summer…to encourage healthy lifestyle choices. If parents tag me with a picture of their family or the student drinking water, being active, eating fruits and veggies, then I give them special tickets at the beginning of the school year to participate in a before school open gym,” Caver said.

Staying active on Facebook throughout the summer, Caver said, helps her continue to educate her students about the importance of healthy living.

“Kids follow if they see you doing it. Make it fun! That’s why I do the challenges. It becomes fun for the kids and they have a reward to come back to school with,” Caver said. “I believe the elementary years are the years where students make life-long decisions on how the rest of their life will be. If I provide them with the tools to make a good choice, then the choice is theirs.”

For more information on the American Heart Association, and ways to stay healthy this summer visit www.heart.org

Nursing students wear big smiles as they await the CCISD pinning ceremony.

Clear Creek ISD Students Take First Step toward Nursing Career

T

HE DECISION OF WHAT TO DO

after graduation can be a difficult one, but one group of Clear Creek ISD students have already taken the first steps on the path to their future occupations. More than 40 students recently completed the Certified Nursing Assistant Program, which prepares them for a career in the healthcare industry.

Qualified students from all high schools in CCISD can enroll in the CNA Program, located at Clear View High School.

Participants begin by taking courses in ethical and legal responsibilities, client care, safety, first aid and CPR. Students then complete clinical rotations at Regency Village Nursing Home, where they provide hands-on care to the facility’s residents. This real-world experience is vital to the success of the students not only in their classes, but in their future endeavors as well.

“Students learn to communicate directly with residents who rely on their help and also professionally with their instructors and the healthcare staff,” said Wanda Herfarth, R.N., CNA program director.

“These skills are actual life lessons applicable to any future career.”

It’s not only the administrators that see the value of the program. “This class definitely helped me realize that this [healthcare] is what I want to do for the rest of my life and that there is nothing else I could possibly ever want to do besides help others,” said Rocquelle Mitchell, 2015 graduate of the CNA Program.

“I am truly grateful for everything this program has done for me both physically and emotionally and I know this experience will be with me for the rest of my life.”

Other students expressed similar sentiments. “This program has shaped

me into a person I am proud to be and I am confident in my decision to further my nursing education after I graduate,” said Lizzy Abrey, 2015 CNA Program graduate. CCISD’s Certified Nursing Program not only gives students realworld experience in their chosen field, it also equips them with the skills to be successful.

As family, friends and administrators watched the 2015 graduates of the CNA Program walk across the stage at the official pinning ceremony that marks the completion of the program, those involved reflected on the progress of the students. “The most rewarding part of working with CNA students is having the opportunity to witness their growth as healthcare providers and as compassionate human beings,” Herfarth said. “It is an exciting and rewarding experience as a teacher to be a part of their personal and professional development.”

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New Bay Area Rehabilitation Hospital in Webster.

Medistar Completes Construction of Rehabilitation Hospital in Webster

M

EDISTAR CORPORATION has

completed construction of the new Bay Area Rehabilitation Hospital in Webster. Located on the southeast corner of Medical Center Boulevard and Highway 3, this 53,514 square foot, 45-bed inpatient rehabilitation facility complements the full-service medical and surgery services provided by Bay Area Regional Medical Center.

Further enhancing the City of Webster as “the Medical Center of the South,” Bay Area Rehabilitation Hospital is operated

by Post Acute Medical, headquartered in Enola, Pa. Led by President and CEO Anthony F. Misitano, PAM is a leading provider nationwide of health and patient services for Long-Term Acute Care, Inpatient Rehabilitation, Outpatient Rehabilitation, Residential Brain Injury and Comprehensive Wound Care.

In addition to comprehensive inpatient and outpatient physical therapies, the new rehabilitation hospital features a specially designed unit for the treatment needs of individuals who have suffered traumatic

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brain injury, stroke or neurodegenerative disorders, such as Parkinson’s disease.

“Integral to all facets of our operations is strong physician leadership, which drives quality in all aspects of patient care,” Misitano said.

“Providing quality post-acute care for Bay Area seniors is the highest priority for Mr. Misitano and his organization.”

The completion of the rehabilitation hospital continues Medistar’s longstanding partnerships with operators of modern post-acute healthcare facilities, including the recently completed Heartland Rehabilitation Hospital (45-bed IRF in Overland Park, Kan.)

and Landmark Hospital of Savannah (50-bed long-term acute care hospital in Savannah, Ga.).

“Providing quality post-acute care for Bay Area seniors is the highest priority for Mr. Misitano and his organization. With the opening of Bay Area Rehabilitation Hospital, the best and most modern resources are available to PAM to deliver unparalleled levels of care and service,” said Medistar’s founder and CEO, Monzer Hourani.

Cobalt Medical Development codeveloped the real estate with Medistar and is co-owner of the operations with Post Acute Medical.

Medistar is a full-service medical real estate development company that primarily specializes in the design, development, financing, acquisition and construction of acute care hospitals, post-acute care hospitals, medical office buildings and related facilities for the healthcare industry nationwide. For more information, visit www.MedistarCorp. com

Clear Lake City Elementary -- still standing strong after 50 years of service to the Clear Lake City community.

Clear Lake City Elementary Celebrates 50th Anniversary

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HUGE CROWD OF STUDENTS,

staff and alumni of Clear Lake City Elementary School gathered outside the front doors on Friday, May 22, 2015 to celebrate the campus’ 50th Anniversary. Principal Jepsey Kimble led the festivities with entertainment provided by the Clear Lake City Elementary 4th Grade Choir and Thunderbird Spirit Squad.

“Twenty-five years ago our school had a totem pole sculpted to celebrate our Silver Anniversary,” Kimble explained to the audience. “That totem pole still stands proudly today on the playground

used by our younger students, on the Fairwind Road side of our building. As we reached the half-century mark we commissioned another totem pole and a series of sculptures designed to reflect who we are: Our character, our history, and our future.”

Designed and made by Russell Ramirez, the new sculptures will serve as another daily reminder of the importance of the school’s Six Pillars of Character: Trustworthiness, Respect, Responsibility, Fairness, Caring and Citizenship. They are represented by the six schools in the Clear Lake City Elementary School’s Pre-K 12 Community: the elementary schools created from our area’s continued growth, and the two intermediate schools and the one high school to which the CLCE Thunderbirds will fly once they leave the CLCE nest.

Superintendent Dr. Greg Smith was on hand to help mark the golden anniversary and to announce that May 22, 2015 was proclaimed as Clear Lake City Elementary Day in Houston, Texas by Houston Mayor Annise Parker. Former Superintendent Dr.

Sandra Mossman also was in the crowd.

However, the school’s most famous alumna, Crown Princess Mary of Denmark, was absent from the celebration. Her schooling began at Clear Lake City Elementary in 1974 and 1975 when her father, John Dalgleish Donaldson, a professor of applied mathematics, worked at the Johnson Space Center. Today, she is busy raising four young children, while also attending to her royal duties.

CLCE is truly a school where, as their founding Principal Kenneth Royal said, “Children are Welcome, Wanted, and Worthwhile.” The campus is selling legacy bricks to fund an annual scholarship, the first of which was awarded to Kaitlyn Auger, Class of 2015 at Clear Lake High School.

CLCE is the second CCISD campus to celebrate its 50th anniversary. Earlier, Ed White Elementary in El Lago marked its 50th anniversary. Both campuses opened soon after the opening of NASA’s Manned Space Center to serve space agency employees and their families.

Students entertain the crowd with songs after unveiling of sculptures.

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Houston Methodist St. John Hospital welcomes new orthopedic surgeons Two new orthopedic surgeons have joined the staff at Houston Methodist St. John Hospital.

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R. EDWARD LEE, a fellowshiptrained orthopedic surgeon who specializes in minimally invasive arthroscopic shoulder procedures, and Dr. Jason Leaseburg, a fellowship-trained orthopedic surgeon who specializes in complex foot and ankle surgery have joined the hospital’s Orthopedics & Sports Medicine team at the Nassau Bay medical facility.

Dr. Lee is a highly trained orthopedic surgeon and has performed advanced shoulder surgery for more than 10 years in Arizona and California. He was previously a clinical instructor and assistant professor at the Albert Einstein College of Medicine in New York City.

His special interests include sportsrelated injuries, shoulder dislocations, labral tears, rotator cuff tears, arthritis (including shoulder replacement), tennis elbow, and fracture care of the shoulder, elbow, wrist, hip and knee.

“I’m thrilled to be joining the team at Houston Methodist St. John Hospital,” Lee said. “The physicians, physical therapists, athletic trainers and staff here have worked very hard to make this one of the top orthopedics programs in the nation.”

Dr. Leaseburg has been performing complex foot and ankle surgery since 2007 and will be the only board-certified, fellowship-trained foot and ankle surgeon in the Bay Area. Previously, Leaseburg was assistant professor and chief of the Foot and Ankle Division at the University of Colorado. His specialties include reconstructive foot surgery, deformity correction, diabetic foot disorders sport-related injuries and foot and ankle trauma.

Dr. Edward Lee

For more information about Orthopedics & Sports Medicine at Houston Methodist St. John Hospital, see www.houstonmethodist. org/st.john.

Dr. Jason Leaseburg

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“I’m honored to become a part of the Houston Methodist Orthopedics & Sports Medicine family and committed to providing the best quality care to the people in Bay Area communities,” Leaseburg said.

Dr. Lee and Dr. Leaseburg will join Dr. Kenneth First and see patients at 2020 NASA Parkway, Suite 230 in Nassau Bay. “Our skilled and experienced Orthopedics and Sports Medicine specialty physicians – Dr. First, Dr. Lee, and Dr. Leaseburg – bring the latest orthopedic techniques and treatments to Houston Methodist St. John Hospital,” said Dan Newman, CEO at Houston Methodist St. John Hospital. “They are the experts when it comes to caring for patients’ upper and lower extremity problems, including shoulders, elbows, hips, knees, ankles, and feet.”

To make an appointment with Dr. Edward Lee, Dr. Jason Leaseburg, or Dr. Kenneth First, call their office at Houston Methodist Orthopedics & Sports Medicine, 713.363.9090.

UTMB named regional Ebola treatment center

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he University of Texas Medical Branch at Galveston is one of only nine hospitals in the country selected by the U.S. Department of Health and Human Services to be a regional treatment center for patients with Ebola or other highly infectious disease.

UTMB will receive about $3.25 million over five years from the HHS’ Office of the Assistant Secretary for Preparedness and Response to pay for training for staff, plan development and purchase of personal protective equipment, UTMB officials said.

“This designation is recognition of the exceptional interface of research and clinical care available at UTMB Health,” said Donna Sollenberger, executive vice president and chief executive officer for UTMB’s Health System. “Our expertise in the research of emerging infectious diseases, including Ebola, at the Galveston National Laboratory, as well as our expertise in the care of patients with infectious diseases is nationally recognized.”

HHS selected health departments and partner hospitals across the country to serve as regional treatment centers that would strengthen the nation’s ability to respond to infectious diseases. To be eligible facilities had to be assessed by a Rapid Ebola Preparedness team led by the Centers for Disease Control prior to February.

With this designation UTMB, which is partnering with the Texas Department of State Health Services, will be expected to be continuously ready and available to care for patients with Ebola or other highly infectious diseases.

“UTMB Health System was the only organization within the region prepared and qualified to serve as the designated treatment center,” said Deborah McGrew, Chief Operating Officer at UTMB. UTMB will serve as the designated Ebola treatment center for Texas, Oklahoma, Arkansas, Louisiana and New Mexico, McGrew said.

The funds coming to UTMB as part of this designation will go toward paying for staff training as well as for the development of a response program, developing protocols for transferring a patient within the region and for the purchase of personal protection equipment.

Proper training for staff members is one of the most important and potentially costly aspects of preparing to treat patients with Ebola and other highly infectious diseases, said Dr. Scott Lea, the Infectious Diseases Clinic Director at UTMB. “You can have a biocontainment center but if you don’t have the right people that are trained properly you can’t use it appropriately,” Lea said.

Lea applauded the federal government for making the funds available to set up the regional centers. UTMB will be able to treat patients not just with Ebola but with other highly infectious diseases such as Lassa fever, Omsk Hemorrhagic Fever and Kyasanur Forest Disease, among others, Lea said.

“These are illnesses that are devastating to their local communities and in 2015 a person with a one of these diseases could step on a plane and be in the United States within hours,” Lea said.

Some of the requirements for being designated a treatment center include: • Accept patients within eight hours of being notified, • Have the capacity to simultaneously treat at least two Ebola patients, • Have respiratory infectious disease isolation capacity or negative pressure rooms for at least 10 patients, • Conduct quarterly trainings and exercises, • Be able to treat pediatric patients with Ebola or other infectious diseases or partner with a neighboring facility to do so, and, • Be able to safely handle Ebolacontaminated or other highly contaminated infectious waste.

Memorial Hermann opens Urgent Care in Friendswood A NEW LEVEL OF HEALTHCARE from Memorial Hermann is coming to Friendswood and the surrounding communities. Memorial Hermann opened its first Urgent Care there on June 24.

Memorial Hermann Urgent Care will provide walk-in care for nonlife-threatening health conditions.

No appointments are necessary.

Memorial Hermann Urgent Care will be staffed with board-certified family medicine physicians from the Memorial Hermann Medical Group.

“This will be the first of its kind for the Memorial Hermann system,” says Dr. David James, CEO, Memorial Hermann Medical Group.

“Our community is growing and our healthcare needs are changing.

We’re committed to meeting those changes by providing the appropriate level of high quality, convenient care to the communities we serve.”

Memorial Hermann is playing an active role in the growth of the Friendswood and Pearland areas.

Memorial Hermann’s Convenient Care Center, located in Pearland, opened in February of last year.

The CCC offers lab services, comprehensive radiology services and a 24-hour emergency room in one convenient location.

Meantime construction continues on the Memorial Hermann Pearland Hospital, set to open in early 2016.

The 64-bed acute care hospital will feature a number of services including an intensive care unit, cardiac catheterization labs, medical/surgical units and women’s and neonatology services.

The 4,711 square foot Memorial Hermann Urgent Care will offer Friendswood and the surrounding communities the ease and convenience of extended medical care and serves as an extension of a primary care physician’s office.

“We’re proud to be an active member of our growing community in Friendswood,” says Memorial Hermann Southeast Hospital CEO Kyle Price Sr. “Healthcare and healthcare needs are changing.

Memorial Hermann Urgent Care will provide one more choice and a new level of care for Friendswood and surrounding communities.”

Memorial Hermann Urgent Care is located at 1505 East Winding Way, Suite 112, in Friendswood and will treat patients as young as six months and older. Hours are from 9 a.m. to 9 p.m., seven days a week.

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SUN Safety

Protecting yourself and your family from too much sun helps prevent melanoma

By Rod Evans

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HE SUV IS PACKED and headed down I-45. You’ve got everything you and your family will need for a great day at the beach: ice cold drinks, Frisbee, volleyball net, a canopy, and plenty of food to throw on the grill. But just before you cross the Causeway Bridge you remember you forgot something you can’t do without— sunscreen. Time to hit the convenience store.

Because melanoma—better known as skin cancer—is the most common form of cancer, sunscreen is not only a must-have for the beach, it also should be a regular part of your daily preparation.

“I encourage people to use sunscreen regularly. We live in a part of the country where we should use it every day,” said Dr. Richard Ehlers, assistant professor of

“The incidence is growing quickly, especially in young women under 25.” surgical oncology at the M.D. Anderson Cancer Center and medical director for the Bay Area Regional Care Center.

“Even in wintertime and on overcast days, you’re still getting UV (ultra violet) exposure, so I encourage my patients to apply it every day when they get out of the shower.”

According to the American Cancer Society (ACS), about 73,870 new cases of

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melanoma are diagnosed each year in the U.S. It is responsible for over 9,400 deaths annually and the number of new cases has been increasing for at least the last 30 years.

In Texas, over 3,420 new cases of melanoma were reported in 2014 and the death rate is about nine (per 100,000 people), making it one of the more deadly forms of cancer in the state.

WHAT IS MELANOMA?

Melanoma is a cancer that begins in cells called melanocytes, which are responsible for giving skin its pigment or tan. Melanin protects the deeper layers of the skin from some of the most harmful effects of exposure.

Melanomas can develop anywhere on the skin, but are more likely to start on the trunk (chest and back) in men and on the legs in women. The neck and face are also common skin cancer sites. While the exact cause of melanoma is not clearly known, researchers have established a strong link to exposure to the sun’s rays as a likely culprit.

“We know there is a strong relationship with ultra violet radiation exposure from sunlight,” Ehlers explains, “but there are undoubtedly other related causes, some genetic or environmental or a combination of the two, and we know that fair skinned people have a slightly greater risk than darker skinned people.”

According to ACS statistics, about 10 percent of people diagnosed with melanoma have a family history of the disease and the lifetime risk of contracting melanoma is one in 40 for whites, one in 1,000 for African-Americans and one in 200 for Hispanics, and the overall risk increases with age.

WHAT ARE THE SYMPTOMS?

Melanoma is a disease that frequently creeps up on its victims because the symptoms can appear to be quite harmless. It is generally marked by a dark brown or black skin mole or lesion that wasn’t there before. Ehlers says people should keep in mind the “ABCDE” of melanoma symptoms: A: Asymmetry. If the lesion has an asymmetrical border that is not an even circle, it is suspicious.

B: Border irregularity, which refers to an irregular outline of the lesion.

C: Color variation. Most benign skin molds have a uniform dark color, while melanomas have a variegated pigmentation.

D: Diameter of the lesion. Those that are big are more suspicious. Ehlers said any lesion that is the size of a pencil eraser (about 6 millimeters) is suspicious.

E: Evolution, which refers to the changing nature of the lesion’s appearance.

ON THE RISE

“The incidence is growing quickly, especially in young women under 25.

Mike Snowden, 63, a Houston oil company executive and melanoma survivor, says his days as a youth when he spent hours outdoors with little regard for sun exposure probably contributed to his melanoma diagnosis in 2005.

“I lived in the sun as a kid. I mean, I’d come inside and I had these white blisters on my skin that would pop,” Snowden recalls. “That’s not good. The problem is that I’m a sun person, so it took a while for me to get wise to the danger.”

After several surgeries to remove melanomas on his leg, left arm and back, Snowden was declared cancer-free seven years ago. Now, he ventures outside much more cautiously.

“I definitely wear a hat that covers my neck and I don’t spend more than 20 minutes in direct sunlight,” Snowden said, “and my bare feet never see the sun. I wear long sleeves and always use a minimum of SPF 50 sunscreen.”

HOW IS IT TREATED?

“The mythology that you should get a sun burn at the beginning of the summer in order to get a good base tan is just that—a myth. Don’t do that, especially for children.”

The treatment options for melanoma patients varies according to its clinical stage, Ehlers said, and starts with a biopsy, which will determine the thickness of the melanoma. Early stage melanomas can often be treated with a simple incision, but thicker and more advanced lesions may require lymph node evaluation and advanced therapy, making early detection critical.

“When detected early, which is the overwhelming majority of melanomas, the long term survival rate exceeds 90 percent,” Ehlers said, “but once they are in a more advanced stage with nodal involvement, the rates begin to go down.”

PREVENTION Why? One of the strongest prevailing theories is use of tanning beds,” Ehlers said. “People should not use tanning beds at all. There is no safe exposure amount, particularly in children, because the dose intensity is greater.”

Ehlers explains that UV exposure is cumulative. If you get a big dose when you are a child, that doesn’t go away with time; it’s only additive with further sun exposure. He says that may explain why many women develop melanoma years after they stopped using tanning beds.

“The mythology that you should get a sun burn at the beginning of the summer in order to get a good base tan is just that—a myth. Don’t do that, especially for children,” Ehlers cautions.

While research is ongoing into the effectiveness of drugs that target specific cellular growth pathways unique to melanoma, along with advances in immunotherapy, in which the body’s immune system is used to fight the cancer, prevention remains the surest bet to avoiding melanoma.

“People should never use tanning beds and they should minimize their exposure to the sun and adopt routine application of sunscreen,” Ehlers said. “Avoid the sun if possible during the peak hours of 10 a.m. and 2 p.m. and wear protective clothing.”

Ehlers stresses that parents should be especially mindful of protecting their children from the sun at all times.

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Chikungunya virus may be coming to a city near you

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HE MOSQUITO-BORNE

chikungunya virus has been the subject of increasing attention as it spreads throughout South America, Central America, the Caribbean and Mexico. This painful and potentially debilitating disease is predicted to soon spread to the U.S. The University of Texas Medical Branch at Galveston’s Scott Weaver, globally recognized for his expertise in mosquitoborne diseases, has been studying chikungunya for more than 15 years.

Weaver and fellow infectious disease expert Marc Lecuit of the Institut Pasteur have summarized currently available information on this disease in the New England Journal of Medicine.

Since chikungunya was first identified in 1952 in present-day Tanzania, the virus has been confirmed in other African countries, Asia, The South Pacific and Europe. In Dec. 2013, the first locally acquired case of chikungunya in the Americas was reported in the Caribbean.

Since then, chikungunya has been identified in 44 countries or territories throughout the Americas with more than 1.3 million suspected cases reported to the Pan American Health Organization from affected areas.

Symptoms appear about three days after being bitten by an infected mosquito. The most common symptoms and signs are fever and severe

joint pain and may include headache, arthritis, muscle pain, weakness and rash.

Some patients will feel better within a week but others develop longer-term joint pain that can last weeks to years. Death is rare but can occur. People at increased risk for severe disease include young children, older adults and people with medical conditions such as diabetes or heart disease.

Other than anti-inflammatory drugs

“The most common symptoms and signs are fever and severe joint pain.” to control symptoms and joint swelling, there are no specific therapies to treat infected persons and no licensed vaccines to prevent chikungunya fever.

“Chikungunya continues to be a major threat to public health around the world,” said Weaver. “Until there is a treatment or vaccine, the control of chikungunya fever will rely on mosquito reduction and limiting the contact between humans and the two virus-carrying

PREVENTION •

No vaccine exists to prevent chikungunya virus infection or disease.

•

Prevent chikungunya virus infection by avoiding mosquito bites.

•

The mosquitoes that spread the chikungunya virus bite mostly during the daytime.

PROTECT YOURSELF FROM MOSQUITO BITES •

Use window/door screens to keep mosquitoes outside.

•

Empty standing water from containers such as flowerpots or buckets outside.

•

Wear long-sleeved shirts and long pants.

•

Use insect repellents. Those containing DEET, picaridin, IR3535, and oil of lemon eucalyptus and para-menthane-diol products provide long lasting protection.

•

If you use both sunscreen and insect repellent, apply the sunscreen first and then the repellent.

•

Always follow the label instructions when using insect repellent or sunscreen.

mosquitoes, Aedes aegypti and Aedes albopictus.”

These efforts generally focus on reducing or treating standing water and water storage containers where eggs are laid and larvae develop as well as wearing protective clothing and/or insect repellent.

Current research is focused on better understanding how exactly the virus enters and multiplies within the human and mosquito body. Researchers are also learning more about why some people develop long-term chronic joint pain after the initial chikungunya fever while others do not.

Several promising chikungunya vaccine candidates have reached late preclinical or phase one clinical testing, but final development will require major commercial investments. Another challenge to vaccine development lies in targeting locations where there will be many cases of chikungunya fever to set up and conduct clinical trials.

Weaver is the director of the UTMB Institute for Human Infections and Immunity, scientific director of the Galveston National Laboratory and leads the Global Virus Network’s Chikungunya Task Force.

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