Smart Living featuring Kyra Samuels

Winter 2019 $3.00 Value

Kyra Samuels is an emerging champion in a growing sport

Priming the Pump Advanced devices can help save patients during a heart attack and set the path for full recovery

L i v e smar t .

In Every Issue

Inside Cover

A Word from the President & CEO Paul P. Hinchey President/CEO

If you have a new goal in mind or

project in the works—or if you’re looking at a calendar with 365 blank days ahead—perhaps it all seems too much and you’re not sure you can handle it. I’d like you to meet Kyra Samuels, a young woman who fell in love with the sport of Brazilian jiu-jitsu. This relatively unknown sport pitted Samuels against male athletes that were stronger, taller, and 40-50 pounds heavier than her. Learn how Samuels took down these opponents, and won first place in her division in one of the sport’s most prestigious competitions, in this issue.

Our hearts work for us every moment of our lives, even while we sleep. We owe it to ourselves to take good care of our hearts, and thankfully, the pursuit of innovative technology to support us in that care shows no sign of stopping. In this issue, learn about advances in CT scanning, ventricular support, and extracorporeal life support that help us detect and treat some of the most severe heart conditions.

Please enjoy this edition of Smart Living, and also feel free to share any comments you have with us at SmartLiving@sjchs.org.

Back Cover

Ask A Magnet Nurse

Pullout Calendar

4 6 8

Live Life Smart Priming the Pump

Advanced devices can help save patients during a heart attack and set the path for full recovery

Return to Learn, Return to Play

With concussion-focused athletic trainers, student athletes can recover the smart way

The Butterfly Effect Our whole body is affected by the thyroid gland

Features

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Faster than the Beat

Advances in CT technology help radiologists get a clearer picture of the heart

Belting it Out

Kyra Samuels is an emerging champion in a growing sport

Smart Living Goes Green!

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5353 Reynolds Street, Savannah, Ga. 31405 912-819-8169 arkinsb@sjchs.org

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or computerized tomography, the imaging technique known as CT, the more still the patient is, the better. Patients are asked to lie as still as they can be, and may be asked to hold their breath for a few seconds.

Movement can cause images to blur.

Advances in CT technology help radiologists get a clearer picture of the heart

But no matter how still you are, your heart still beats. So how do you get a clear image when the heart is your subject? With the advanced technology in the GE Revolution CT scanner, recently installed in St. Joseph’s Hospital, you get the image of the whole heart within a single beat. The machine can scan just that fast, and it is a great help to physicians like Daniel M. O’Mara, MD, a radiologist with Savannah Chatham Imaging.

“Our goal is to use imaging to give our patients the most accurate picture of their health,” Dr. O’Mara says. “One challenge in achieving this goal, particularly when we are evaluating small and continuously moving structures like the coronary arteries, is to minimize motion as much as possible. The new scanner allows us to essentially freeze motion, which results in exceptionally crisp images that are easy to interpret.”

This advanced capability not only helps achieve high-definition images for heart patients, but also for trauma and stroke patients, as well as the very young, who aren’t typically inclined to stay still no matter where they are. Delivering clear, sharp images in seconds helps physicians with diagnosis and treatment planning, but it also provides more convenience to patients. To begin with, in many instances, the contrast dose is lower Daniel M. O’Mara, MD and the appointment is often shorter.

“Because we are able to obtain images very quickly, our patients spend less time in the scanner,” Dr. O’Mara says. “Because the images we obtain are high quality and motion free, fewer repeat scans are required.”

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Smart Living Winter 2019

Kyra Samuels is an emerging champion in a growing sport

W

hen Kyra Samuels found a sport she loved, she was driven to do it every day. And it was a long drive.

Growing up in Statesboro, the teen traveled an hour to follow her passion: Brazilian jiu-jitsu.

“My mom would pick me up from school and drive me to Savannah so that I could train, and then drive me back to Statesboro,” Samuels recalls. Once she got her driver’s license, she did the same daily trek by herself.

“It becomes a lifestyle,” Samuels says. “I got really into it, and I found I had a self-confidence that I’d never had before.”

Size Doesn’t Matter

Samuel’s father was among a few practitioners of Brazilian jiu-jitsu in Statesboro, and when he tried to share it with his daughter and her siblings, he originally got no takers. But later on, Samuels opted to try it for a few months.

Brazilian jiu-jitsu is both a martial art and a sport, developed from the Japanese martial art of judo in the early 1900’s. It became a little more known in America when its master practitioners won several Ultimate Fighting Championships in the 1990’s. Instead of punches or kicks, Brazilian jiu-jitsu is based on ground fighting and grappling. Fighters win by forcing their opponent to submit, or tap out, after being overpowered with moves such as a joint lock or chokehold. With proper technique, a smaller or weaker person can still defeat a bigger opponent. When Samuels realized this, she quickly fell in love with the sport.

“Most of my training partners are men who are 40 to 50 pounds heavier than me,” she says. “But if you have good technique, those size and strength differences aren’t much of a factor anymore. You can outdo their strength with technique. It makes it so much fun.”

Up The Ranks

Samuels quit her high school cross country, track, and soccer teams to focus solely on Brazilian jiu-jitsu. She continued those daily trips to SERG Brazilian Jiu Jitsu and Fitness in Savannah. As her skill and experience increased, she entered competitions hosted by the

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International Brazilian Jiu-Jitsu Federation (IBJJF). The IBJJF tournaments are the biggest in the world, and Samuels has traveled to cities across the country to compete.

In 2017, as a blue belt (the second adult rank) in the female light featherweight division, Samuels took first place in the Pan-American Championship, the second most prestigious tournament in the IBJJF. She did the same in the Pan No-Gi Championship that year. A gi is the practitioner’s traditional uniform; in a No-Gi tournament, fighters typically wear shorts and a rash guard instead. Though the difference may seem small to spectators, the changes in rules and strategy are significant enough to warrant their own competition.

Samuels was then promoted to purple belt, the intermediate adult ranking. With even more formidable opponents, she was able to take third place at the Pan-American Championship and second place at the Pan No-Gi this year.

Samuels is matter-of-fact about her ultimate goal, mostly because she knows how much she’ll enjoy the journey to get there.

“I want to be a black belt world champion,” she says. “That may be far in the future, but in between then and now I want to do well at each competition. For me it’s about putting all of my training on the mats in the best way possible. Smaller goals help me to keep that drive. Even just saying, ‘Tonight I want to hit this one move,’ and then I hit it, that’s what keeps me going.”

Hold Yourself Higher

Samuels understands that, although knowledge of the sport is growing, not many people in coastal Georgia are that familiar with Brazilian jiu-jitsu. But she would encourage anyone—male or female, young or old, big or small—to give it a try.

“I used to be scared of just walking down the street by myself,” she says. “There was an insecurity. Now I know that I would be able to defend myself. I think everyone can benefit from having that kind of understanding. It helps you to be confident in life and hold yourself higher. And Brazilian jiu-jitsu gave that to me more than anything else—more than punching or kicking or anything like that—and I think it can give that to others.”

Do We Need His And Her Workouts?

Kyra Samuels will admit to being “really small” in comparison to her Brazilian jiu-jitsu training partners. But she also says that “when we’re on the mats, I feel like we are all the same.”

Still, it is a common misconception that females need to train differently from men to get the most out of their workout. Kristen Maynard, an exercise physiologist in St. Joseph’s/Candler’s Wellness Center, often gets this question from her clients. The short answer is no.

“Men and women do not need to train differently,” Maynard says. “Daily energy requirements are based on fat mass, fat-free mass, and activity level. Now, men do tend to be leaner, due to needing less essential fat for metabolic functioning, and they tend to have larger hearts, leading to more blood being able to move through the body per beat. Lastly, men tend to have higher hematocrit levels due to the higher testosterone levels—this means easier oxygen carrying capacity to working tissue. But basically, what are seen as sex differences are really just differences in body composition and size.”

Maynard emphasizes the essential principals that work for one and all.

“Train the heart and lungs with cardio, muscle and bone with strength training,” Maynard says. “Maintain a proper diet and ensure proper rest to prevent overtraining. Everyone should be active at least 30 minutes a day on most days of the week. This is true for men and women alike.”

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Smart Living Winter 2019

Advanced devices can help save patients during a heart attack and set the path for full recovery

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ne of the miracles of our body that we take for granted is that our hearts pump without us thinking about it. But a severe heart attack can take that power away when we need it the most.

Cardiogenic shock occurs when the heart cannot pump enough blood to meet a patient’s needs. If not treated immediately, cardiogenic shock can be fatal.

Physicians in The Heart Hospital at St. Joseph’s Hospital use the Impella, a left ventricular assist device that augments the heart’s cardiac output, on patients suffering from a severe myocardial infarction (commonly known as a heart attack). In short, the Impella does the pumping when the heart cannot. With the device performing the heart’s role, it gives interventional cardiologists like William F. Wallace, MD, the chance to focus on opening blocked arteries and saving the patient’s life.

William F. Wallace, MD

Now the Impella has been upgraded, and St. Joseph’s Hospital is the only one in the region that offers this advanced technology. This is great news for heart patients, but one fact remains the same—survivors have an important role to play in getting their heart strong again and preventing another heart attack in the future.

Impella RP

“The Impella is typically used as a small pump for the left ventricle of the heart,” Dr. Wallace explains. “But in very severe cases, the right side of the heart can also fail. So the blood is not being pushed out to the lungs and becoming oxygenated. Medications can help support pumping, but the pump is not being primed, so to speak.”

Dysfunction in the right ventricle is common in heart attack patients who have gone into cardiogenic shock. The new Impella RP has been specifically designed to provide support to the right ventricle. Dr. Wallace places a thin catheter through the patient’s leg, implanting the tiny pump so that it can take blood from a vessel outside the heart and push it through the heart and into the lungs.

“Within a few minutes or less, the blood pressure starts going up, and we can dial back the medications that we use to support the heart rate, blood pressure, and cardiac output in a shock setting,” Dr. Wallace says.

This capability has long-term implications for the patient, in that those medications—while life-saving in the emergency of a heart attack—can have an adverse effect on the heart’s pumping function.

“The Impella RP helps put the heart into more of a total rest state, which allows it to recover better,” Dr. Wallace says.

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Smart Living Winter 2019

Get Out And Stay Out

The fullest, most optimal recovery is the goal for physicians and staff at The Heart Hospital.

“Once we get you out of the hospital, we want to keep you from ever having to come back again,” Dr. Wallace says. He typically follows up with patients a week or two later, and he strongly encourages patients to implement better lifestyle choices—including new dietary and exercise routines—and to maintain compliance with their medications.

He also refers patients to St. Joseph’s/Candler Cardiopulmonary Rehab, where they will receive that education and support, usually over a few months.

“During this critical window of time, we want to get your risk back down to where it was before the myocardial infarction, if not even lower,” Dr. Wallace says. “What you learn in cardiac rehab is very important to success in that regard, because if you do the right things, the odds of something happening again become exceedingly low.”

Your Heart’s Future Dr. Wallace says that the staff at St. Joseph’s/Candler Cardiopulmonary Rehab does “great work.” So what exactly do they do?

In short, they help you regain control of your health. Through multiple sessions, patients begin with cardio exercises, and then add resistance training. Patients gain strength while losing weight and receive guidance and monitoring from rehab staff.

Mark Berry came to rehab after he had open-heart surgery to replace a mitral valve. At first he was so weak in recovery that he needed a cane to walk. But he was determined to see it through.

“Whatever it is that I need to do to get better, I am going to do it,” he says. Within the first week, Berry didn’t need the cane anymore. Over the following weeks, Berry was able to expand his 12-minute sessions into hour-long ones.

“I, 100 percent of the time, feel better the rest of the day because of this,” he says.

With supervised exercise therapy, patients not only receive monitoring of their heart’s rhythm for abnormal rates, they also get educated about healthy behaviors from a dedicated staff.

“Cardiac rehab doesn’t change your past, but it can help you improve your heart’s future,” says Cardiopulmonary Rehab Manager Emily Parks. “It is also how you can lower your risk of a second cardiac event. It’s the path to feeling better than before, and we’re by your side the whole way.”

Patients in cardiac rehab stand to benefit in several ways. You will: • Lower your risk of a future cardiac event • Eat better • Lose weight • Return to work • Engage in daily activities you might have missed Read more about Mark’s 12 weeks in rehab and how it helped him on our Living Smart blog at www.sjchs.org/heartrehab.

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Smart Living Winter 2019

With concussion-focused athletic trainers, student athletes can recover the smart way

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ootball season may be over, but concussion risk for high school athletes in any sport is year-round. There are still chances for player-to-player (or is some cases, player-to-ground) hits in basketball, soccer, softball, lacrosse, cheerleading, and wrestling.

St. Joseph’s/Candler’s Sport Medicine program, which has been setting the standard for athletic health care in several of SouthCaroline Brif, Certified Athletic Trainer east Georgia’s high schools and colleges for decades, is continuously developing its policies to address the needs of the students it serves. Since the risk is always there, the program added a second athletic trainer—specific to concussions—to always be there too.

“Anytime there is a concussion, I come out to do a reevaluation of the student and help with the treatment process,” explains certified athletic trainer Caroline Brif. “The athletic trainer at each of our schools will do an initial evaluation, but they are responsible for all of the students each day, and concussions are often time-consuming cases.”

A Matter Of Time

A concussion is a brain injury caused by some kind of trauma or blow to the head. Any athlete—male or female—could possibly suffer from one in a game or during practice. While the moment of injury may be clear, what happens next can be different for every person. Symptoms such as headache, dizziness, confusion, or nausea may not even appear until the next day. One student may recover in a few days, another may take weeks. Brif checks in with these students routinely to make sure they are on the right track to recovery.

“Communication with our team physicians is great, and that’s part of what I do,” Brif says. “I talk with the athletic trainer, the patient and the parents, and the physician, making sure everyone is on the same page. We have a lot of athletes in our schools, and this makes sure that people are getting better and not falling through the cracks over time.”

Having An ImPACT

Part of getting a student back to where they were before their injury is establishing their pre-concussion baseline. During a player’s clinical exam, athletic trainers also use the Immediate Post-Concussion Assessment and Cognitive Testing, or ImPACT program, to measure cognitive functions such as verbal and visual memory and reaction times.

“If a student suffers a concussion, we’ll have them retake the test,” Brif says. “Then we have objective data to compare their normal brain function to where they fall after the injury.”

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Smart Living Winter 2019

The team physician and athletic trainer develop a concussion management plan based on the patient’s individual needs. Brif can use the player’s ImPACT score, along with her own observations, to make sure the student is progressing safely and at the right pace.

“If I know a student is having a really hard time with verbal memory scores, it tells me they may have a really hard time in the classroom as well,” Brif says. “For a kid with a concussion, just being in school can be challenging.”

Learn, Then Play

Students may be surprised to find that their athletic trainer’s primary goal is having the student back, and succeeding, in school.

This is known as Return to Learn. Once that has been achieved, then they can work on Return to Play.

“We want to make sure step-by-step that these athletes are okay,” Brif says. “And we’ve seen that when our initial goal is to get kids back to being a normal student, then the Return to Play part becomes much easier. When I see that they are back to where they were academically, I know it’s okay for them to start stressing their body a little more. The athletic trainers then supervise the student through a stepwise progression of exercise over several days to make sure no symptoms return.”

Final medical clearance is given by a physician. If cognitive function or symptoms are unusually prolonged, the student may be referred to a neurologist, though Brif says this doesn’t happen often.

Speaking Of Education…

Brif tries to do a little teaching herself during the initial baseline exam with the athletes.

“The ImPACT test is a good time for some education,” Brif says. “I ask the students to please let us know if they notice anything off about how they feel, and I emphasize that playing through injuries is never a good idea. It could make things worse if you get a second hit before recovering from the first. And that it will only take you out of your sport even longer.”

Parents also appreciate the guidance and communication Brif provides. Though the concept of concussion risk is more familiar now than in the past, many parents still aren’t sure what to do or what not to do for their child.

“Sometimes a concussion is dramatic and sometimes it’s more subtle,” Brif says. “I try to help parents understand whether something is emergent or not, and also let them know that symptoms may not show up immediately, or they may evolve over the next day or two. But the most important thing I want them to know is that we are trained to evaluate, diagnose, and treat concussions, and we will be there every step of the way.”

Is It A Concussion?

Every person is different, but there are some common signs and symptoms that can occur after a person has suffered a blow, bump, or jolt to the head. Concussion symptoms include: • Headache • Confusion • Concentration or memory problems • Dizziness/Balance problems • Nausea/Vomiting • Blurry vision • Fatigue, drowsiness, or feeling slowed down If you think it might be a concussion, don’t wait. Children should report it to their coach, teacher, or parent as soon as possible. You should be seen by a health care provider for evaluation.

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Smart Living Winter 2019

Our whole body is affected by the thyroid gland

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t the base of your neck, there is a butterfly-shaped organ that is only about two inches long, but it makes a difference from head to toe. This is the thyroid gland, and it releases hormones that travel through your bloodstream, entering tissues and regulating their use of energy.

Thyroid hormones work to

ensure the proper function of your: • Brain

• Intestines

• Eyes

• Hair

• Heart

• Skin

Consequently, too much or too little of hormones released by the thyroid can lead to symptoms of dysfunction.

With hyperthyroidism (an overactive thyroid), you may experience: • Irritability, nervousness • Sleeping problems • Bulging eyes • Sensitivity to light • Fast heartbeat • High blood pressure • Weight loss • Increased bowel movements • Brittle hair • Sweating

With hypothyroidism (an underactive thyroid) you may experience: • Trouble concentrating • Face swelling • Fatigue • Slow heart rate • Weight gain • Constipation • Dry skin • Joint pain or muscle cramps • Sensitivity to cold • Irregular menstrual periods

These symptoms can be a sign of a variety of different diseases, but if you are experiencing a combination of the above, talk with your primary care physician. After a physical examination of your thyroid, your doctor may recommend blood tests to help determine a diagnosis.

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Smart Living Winter 2019

Back on Track If you’re back hurts but you’re not sure why, you’re not alone. Along with being

one of the most common conditions that bring people to their doctor, it is also one in which the cause is not readily identifiable with tests or even imaging. Learn more by taking our quiz:

1. Back and neck pain can have several different causes, and often the exact cause is difficult to determine.

4. Back problems will give you either a dull or sharp pain, but not a burning or tingly sensation.

A. True B. False

A. True B. False

B. False. Back pain can vary not only in type but in size. It could cover a large area or be confined to one spot. Leg tingling or numbness can be another

A. True. Some of the most common causes are repetitive heavy lifting, trauma, and degeneration of the spine’s vertebrae. But a variety of other factors—such as obesity, abdominal problems, or infection—could also be a cause.

symptom.

2. Managing back pain requires a rehabilitation program.

5. Which of the following makes no difference to whether someone is at risk for back pain?

A. True B. False C. It depends C. It depends. Acute pain lasts from a few days to a few weeks and doesn’t often require rehab, unless it is severe or disabling. Pain that remains for several weeks or months, however, is classified as chronic, and a rehab program is a common treatment option.

3. You may be able to alleviate acute back pain at home with ____.

A. Rest B. Hot or cold packs C. Stretching and flexing D. Over-the-counter pain relief medication E. All of the above E. All of the above. You should still speak with your doctor about whether hot or cold packs may benefit you, and which specific stretching exercises are recommended for your pain.

A. Posture while standing or sitting B. Emotional stress C. Smoking D. None of the above D. None of the above.

All make a difference.

Unfortunately, correct posture is often neglected, especially at a computer. Emotional stress can cause muscle tension, which may lead to back pain. Smoking is actually a risk factor for back pain, and quitting is a great step in prevention.

Could your own daily habits be causing your back pain?

Our online Living Smart blog has a quick and simple self-assessment quiz for back pain risk. The blog also has lots of great tips and insights from physicians and other healthcare providers about many common ailments and their treatments. Go to www.sjchs.org/backpain to get started.

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Smart Living Winter 2019

Sunday

Monday

Tuesday

Wednesday

February

Thursday

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Silver Sneaker Classic 912-819-8800

Tea & Tour for expecting couples Mary Telfair Women’s Hospital 912-819-3360

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Greater Savannah Area Breast Cancer Support Group 912-819-5704

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Prepared Childbirth Class (The Weekender) for expecting couples 912-819-3360

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Tai Chi 912-819-8800

5

Core & More 912-819-8800

Hatha Yoga 912-819-8800

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Free Yoga for Cancer Patients 912-819-8800 Support Group for Families Affected

by Mental Illness 912-819-8498

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Mommy and Me Breastfeeding Support Group 912-819-3360

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Free Yoga for Cancer Patients 912-819-8800

Core & More 912-819-8800

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Circuit Training 912-819-8800 Hatha Yoga 912-819-8800

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Essential Tremor Support Group 912-819-2224

Cancer Transitions Survivorship

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Tai Chi (Beginner) 912-819-8800

Prostate Cancer Support Group Multiple Sclerosis 912-897-3933 Support Group 912-819-2224

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Mobile Mammography Richmond Hill 912-819-6800

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Mobile Mammography Savannah 912-819-6800

Mobile Mammography Islands 912-819-6800

Mobile Mammography Savannah 912-819-6800 Core & More 912-819-8800

Mobile Mammography Sylvania 912-819-6800

Mobile Mammography Garden City 912-819-6800 Cancer Transitions Survivorship Program 912-819-5704

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Silver Sneaker Classic 912-819-8800

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Mobile Mammography Savannah 912-819-6800 Candler Clays Reception and Auction 912-819-8683

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Circuit Training 912-819-8800

Cancer Transitions Survivorship Program 912-819-5704

Tai Chi 912-819-8800

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Breast Feeding Class 912-819-3360

Mobile Mammography Sylvania 912-819-6800

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Tai Chi 912-819-8800

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Tai Chi (Beginner) 912-819-8800

Saturday

Tai Chi 912-819-8800

St. Joseph’s/Candler Calendar

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Friday

Silver Sneaker Classic 912-819-8800

16 Prepared Childbirth Class (The Weekender) for expecting couples 912-819-3360 Candler Clays Tournament 912-819-8683

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Coastal Empire Polio Survivors Association Support Group 912-927-8332

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Skidaway Parkinson’s Disease Support Group 912-598-9845

Cancer Transitions Survivorship Program 912-819-5704

Cardio Sculpt 912-819-8800

Chair Yoga 912-819-8800

New events are added every day. Please visit www.sjchs.org and click on “Events” for additional information.

Sunday

Monday

Tuesday

January

Wednesday

Thursday

Friday

Saturday

St. Joseph’s/Candler Calendar

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New Year’s Day

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Cancer Support Group 912-819-5704 Essential Tremor Support Group 912-819-2224

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Tea & Tour for expecting couples Mary Telfair Women’s Hospital 912-819-3360

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Prepared Childbirth Class (The Weekender) for expecting couples 912-819-3360

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Free Yoga for Cancer Patients 912-819-8800 Circuit Training 912-819-8800

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Mommy and Me Breastfeeding Support Group 912-819-3360 Multiple Sclerosis Support Group 912-819-2224

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Silver Sneaker Classic 912-819-8800

Core & More 912-819-8800

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Support Group for Families Affected

by Mental Illness 912-819-8498

Martin Luther King, Jr. Day

Mobile Mammography Rincon 912-819-6800

Mobile Mammography Islands 912-819-6800 Core & More 912-819-8800

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Free Yoga for Cancer Patients 912-819-8800 Hatha Yoga 912-819-8800

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Mobile Mammography Richmond Hill 912-819-6800 Core & More 912-819-8800

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Tai Chi (Beginner) 912-819-8800 Free Hearing Screening 912-352-4405

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Tai Chi (Beginner) 912-819-8800 Hatha Yoga 912-819-8800

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Skidaway Parkinson’s Disease Support Group 912-598-9845 Cardio Sculpt 912-819-8800

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Circuit Training 912-819-8800 Cardio Sculpt 912-819-8800

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4

Mobile Mammography Sylvania 912-819-6800

Silver Sneaker Classic 912-819-8800

Core & More 912-819-8800

Tai Chi 912-819-8800

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Core & More 912-819-8800 Chair Yoga 912-819-8800

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Mobile Mammography Sylvania 912-819-6800 Chair Yoga 912-819-8800

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Mobile Mammography Sun City 912-819-6800

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Silver Sneaker Classic 912-819-8800

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Tai Chi 912-819-8800

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Chair Yoga 912-819-8800

Tai Chi 912-819-8800

Cancer Transitions Survivorship Program 912-819-5704

12

Prepared Childbirth Class (The Weekender) for expecting couples 912-819-3360

Mobile Mammography Reidsville 912-819-6800

Mobile Mammography Sylvania 912-819-6800

Breast Feeding Class 912-819-3360

Silver Sneaker Classic 912-819-8800

Cancer Transitions Survivorship Program 912-819-5704

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New events are added every day. Please visit www.sjchs.org and click on “Events” for additional information.

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Life Support Procedure Can Give Very Sick Patients A Chance At Survival Amanda Norris, MSN, RN, FNP-C, CCRN Cardiovascular Navigator/ECMO Program Coordinator, St. Joseph’s/Candler

Smart Living: When more conventional forms of life support fail to help some of our sickest patients, we can provide extracorporeal membrane oxygenation, or ECMO. What is ECMO? Amanda Norris: ECMO is a very complex therapy, but basically it supports the heart and lungs when they are not functioning properly to sustain life. Two cannulas, or tubes, are inserted into a patient’s blood vessel. The patient’s blood is removed while simultaneously being reintroduced on a continuous basis during ECMO therapy. The machine we use at St. Joseph’s/Candler, the CardioHelp system, removes carbon dioxide and puts oxygen back into the patient’s blood. This is generally the function of the lungs, and is used when patients have very severe pneumonia or other types of acute respiratory distress. It can be thought of as giving the patient IV oxygen. ECMO can also function as the pump when the heart muscle is weak from heart failure. ECMO can support the patient until their organs have a chance to recover, which can be hours, days, weeks, or months if necessary.

SL: Is this a new development in life support?

AN: We have been using ECMO for patients here since at least 2014. But it is being used more frequently at St. Joseph’s/Candler as well as throughout the U.S. and internationally. We recently had a large training course for many of our critical care nurses and respiratory therapists so that we can continuously improve the care we provide to our patients on ECMO. SL: Why is the need for ECMO growing?

AN: One of the biggest reasons is adult patients who have contracted the influenza virus. We are still in flu season, so I’m asking everyone to please protect yourself and your loved ones by getting a flu shot every year.

Family members should know that ECMO is used for the very sickest of patients, and isn’t always successful, nor is it a treatment to any specific disease. But it does allow us to support our patients while giving their organs time to recover. With ECMO, patients who wouldn’t have survived on other forms of life support now have that chance.