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