healthy u april-june 2011

www.universityhealth.org

HealthyUMAGAZINE April-June 2011

nUNIVERSITY TARGETS HEART ATTACKS, STROKEnNONPROFIT HOSPICE OFFERS COMFORT, COMPASSIONnEARLY DIAGNOSIS KEY FOR ALZHEIMER’S TREATMENT

University Health Care System

YOUR CHOLESTEROL NUMBERS are looking pretty good. Your fasting blood glucose has never been more than 100. Your blood pressure never seems to rise – even when the neighbor’s dog barks past 10 p.m.

So there’s no reason to be worried about your heart, right?

Well, you might have more to worry about than you thought. Traditional screening for heart attack and stroke uses a number of tests – like the ones men-tioned above – to determine your risk of developing the disease, but physicians are learning that those numbers are just the tip of the iceberg when it comes to your true heart and vascular health.

Even small amounts of plaque in the arteries are raising red flags for physicians who in the past might have given a patient a clean bill of health.

“Your physician might say the numbers are OK, but now we know that it’s that little bit of plaque that could rupture and kill you,” said Chris McElroy, M.D., a lipidologist and co-medical director of University’s new Heart Attack & Stroke Prevention Center,

The new center at University Hospital is designed to tailor treatment to a patient’s individual needs and medical history – because as everyone knows, health care is not a one-size-fits-all service.

“Early intervention is really key. The longer the disease progresses, the more likely you are to have a catastrophic heart attack or stroke,” said Allison Hillman, a heart and vascular educator at University Hospital. “So the earlier we catch it, the earlier we can get you started on the correct medications and lifestyle changes.”

When a patient comes to the Heart Attack & Stroke Prevention Center, clinicians go on a fact-finding mis-sion – researching their medical history as well as that of their immediate family. Everything is scrutinized, from how many cups of coffee they consume in a day to the date of their last dental exam.

“We want to look for risk factors,” Ms. Hillman said, “and they might not be the most obvious ones we all know. We believe that you can prevent heart attacks and strokes if you start treatment early and aggressively.”

Besides clinical screening tests, patients may opt for state-of-the-art genetic testing that can help pinpoint advanced heart and vascular risk in pa-tients that might never have presented with tradi-tional risk factors.

“It really opens people’s eyes. When you go over it with the patient, they might not understand all of it, but they know what red means,” Dr. McElroy said. “You have to end up telling them, ‘I know it was OK before, but we now know that what was OK in the past might kill you.’”

Once a comprehensive history is compiled at the Heart Attack & Stroke Prevention Center, clinicians go over the results with the patient and map out a plan of attack. They provide heart and vascular edu-cation and look at what tests and screening exams might help root out possible signs of heart or vas-cular disease.

They can include: nGenetic and Metabolic Testing These advanced genetic tests help physicians

map out appropriate lifestyle changes and choose the medications and therapies that are

We’d like to interrupt your regularly scheduled heart attackUniversity Hospital opens new Heart Attack & Stroke Prevention Center

Chris McElroy, M.D., shares genetic test results with a patient.

Health News


best for the patient’s specific genetic makeup. These cutting-edge tests are constantly updated as breakthroughs in genetic testing make more individualized health care a reality. Specific meta-bolic testing can help diagnose disease earlier and gauge response to therapies and lifestyle changes.

nAdvanced Cholesterol Screening University offers advanced blood tests to determine

the exact makeup of the cholesterol in your blood. These detailed exams along with other tests can help your physician more accurately determine your risk for heart and vascular disease and monitor the prog-ress of your drug therapies. Aggressive therapies can help lower your risk of having a heart attack or stroke.

nCarotid Intima Media Thickness Test This noninvasive test measures the combined

thickness of the intimal and medial layers of the ca-rotid artery walls by using an ultrasound to check for plaque buildup and arterial thickening.

nAbdominal Aortic Aneurysm (AAA) Screening Exam This noninvasive screening uses an ultrasound to

check for abdominal aneurysms – or a ballooning of the aorta, the largest blood vessel in the body. Many cases of ruptured AAA can be prevented with early diagnosis and medical treatment.

nAnkle Brachial Index (ABI) Screening Exam This noninvasive test compares the pressure measures

at the arm and the leg. A ratio below a certain number could indicate a decrease in blood flow due to periph-eral arterial disease, which can cause leg discomfort.

nCalcium Scoring Screening Exam This noninvasive test uses computed tomography

to check for buildup of calcium in plaque on the walls of the heart’s arteries, which can be used to check for early stage heart disease. u

If you would like a free consultation to review your risks, please call 706/774-5548.

Health News

While comprehensive testing at the Heart Attack & Stroke Prevention Center will give you the most precise assessment of your level of risk, there are a number of red flags that may indicate an increased risk of heart attack, stroke or diabetes:

Any combination of these red flags may indicate increased risk for heart attack, stroke or diabetes.

npersonal or family history of heart or vascular disease

npersonal or family history of heart attack, stroke or Type 2 diabetes

ndiabetes (risk equivalent for heart attack) ngestational diabetes nelevated cholesterol nnicotine use in any form nsecondary exposure to nicotine use (such as

second-hand smoke) npsychosocial issues such as depression,

anxiety or stress nhigh blood pressure nabdominal obesity nsleep problems

nage (men older than 40 and women older than 50) ngum disease nerectile dysfunction nrheumatoid arthritis nlupus npsoriasis nmigraine headaches ngout npolycystic ovaries nhirsutism (facial hair growth in women) noligomenorrhea (changes in menstrual cycles) nHispanic or African-American descent nosteoporosis npre-eclampsia nbreast cancer treatment

RED FLAGS


Health News

EASING A PATIENT through the last stages of a ter-minal illness can be draining – mentally and physically – for everyone involved.

Patients often want to remain in the comfort and fa-miliarity of their own home. Caregivers, who are most often family members, must provide a level of care that is completely new and foreign for many. It’s a crash course in medical terminology and procedures that can leave them exhausted.

It is this circumstance that helped give rise to hos-pice, a concept of care that provides end-of-life com-fort and support to patients and their families either in their home or at inpatient hospice facilities.

Hospice does not prolong life, but rather staff and volunteers use medical care and pain management to improve a patient’s quality of life during their last days.

University Hospital will launch the Augusta area’s only nonprofit hospice program in June and Tara Kattine, M.D., an internist who is medical director of the program, said hospice could be considered an off-shoot of University’s current palliative care program.

“Hospice is a natural progression from palliative care, and it allows University to take care of people from birth to death,” she said. “So, patients have that whole continuum of care.”

When a patient enters into a hospice program, a number of professionals work together to create a stable, nurturing and comforting environment – to ease pain and anxiety in their last days. Dr. Kattine said that at its most basic level, hospice includes a nurse, social worker, a chaplain and a medical director. But it also involves nurse aides, volunteers, grief counselors, family members and anyone important to the patient.

“You don’t realize how out of control someone feels when they have a life-threatening illness and how out of control those who love them feel,” said Dr. Kattine, who is board certified in Hospice and Palliative Care. “So, when a patient is enrolled in hospice, the people who love them are just as important to hospice staff.”

Educating the public about hospice and the benefits of the program is the most daunting task, Dr. Kattine said, because people often don’t understand the program’s purpose for end-of-life care. While it is de-signed to be a six-month benefit, Dr. Kattine said most people don’t even get two months of care because they start or are referred to the program too late.

“The last time I looked, the figures were 80-90 per-cent of Americans want to have a peaceful, comfort-able death in their own home, but that’s not what the statistics bear out,” she said. “Most people are dying in institutions and not in a warm, loving and comfortable setting, surrounded by the people who love them.”

In addition to the home-based University Hospice program, University Hospital also will provide inpa-tient care in order to get symptoms under control as well as respite care – a limited inpatient option to provide a break for caregivers.

“It’s kind of like a bed and breakfast,” Dr. Kattine said with a smile. “Patients can go there when they’re stable but maybe their caregivers in the home need a break. It’s not only if they’re just exhausted, but maybe just to give them time to go grocery shopping without any worries and know that their loved one’s in good hands.” u

To learn more about University Hospice, the area’s only non-profit hospice program, log on to www.universityhealth.org/hospice.

Providing comfort through all stages of lifeUniversity opens Augusta’s only nonprofit hospice program

“You don’t realize how out of control someone feels when they have a life-threatening illness and how out of control those who love them feel.”Tara Kattine, M.D., Internal Medicine


Health News

FOR PATIENTS WITH LONG-TERM medical condi-tions, keeping the communication lines open be-tween family and friends can be a daunting task.

Luckily, computers have helped bring people to-gether while giving patients an outlet to discuss their condition, treatment and rehabilitation.

University Hospital is proud to offer its patients ac-cess to CaringBridge. This free computer service gives people undergoing medical treatment the ability to create their own personalized web page to help bridge the gap between them, their family and their friends.

Liz Price, director of Women’s, Children’s and Surgery Services at University Hospital, said the service is an important part of the overall health care experience.

“Having a health issue can be very isolating for many people,” she said. “CaringBridge is such a great tool because it brings people together and keeps everyone – the patient and their support system – in the loop.”

CaringBridge, a non-profit organization that began with a single website in 1997, has grown to include more than 1 billion visits to CaringBridge pages and

500,000 daily connections. Ms. Price, who helped spearhead the effort to bring

CaringBridge to University Hospital, said the pro-gram is a great way to simplify communication for friends and family members as well as offer patients constant encouragement through message boards and the sites’ social media components.

Recent updates and improvements to the site include:nA mobile website for a streamlined experience

from any web-enabled smartphone.nA free iPhone app so authors can update their

journal and visitors can leave messages in the guestbook while on-the-go.

nThe ability to be notified via text message when a CaringBridge journal is updated.

nFacebook Connect so authors can easily notify their Facebook friends when they have a new jour-nal entry to share. u

To learn more about CaringBridge at University Hospital, log on to www.universityhealth.org/caringbridge.

Free CaringBridge web pages help patients connect with family, friendsService offers communication, encouragement for those with health issues


Health News

OVER THE COURSE OF YOUR LIFETIME, you’ll walk thousands of miles, stub your toes on dozens of doorframes and end up with multiple foot injuries where the first thing you say is, “Now, how did THAT happen?”

For most of us, those minor injuries stay that way – minor. But there are those people whose seemingly innocuous wounds can end up causing significant pain and disability, especially for those who suffer from diabetes.

According to the U.S. Centers for Disease Control and Prevention, more than 11 percent of the U.S. pop-ulation has diabetes, and left untreated the condition can lead to eye problems, nerve damage, kidney problems and heart attack and stroke.

A common complication of diabetes is one that can affect a part of the body that most people don’t give a second thought to – the foot.

Mickey Stapp, DPM, a podiatric surgeon who prac-tices at University Hospital, said people with diabetes have to be vigilant about foot care because they are at a much higher risk for health complications related to their feet.

“They could have problems with circulation and/or the nerves to their feet and legs, which can cause them to lose their normal protective sensations,” he said. “So something that might be bothersome to a healthy person, might not affect them the same way, and it can evolve into other problems.”

For most patients with diabetes, foot problems evolve from the wear and tear of daily life, and the

extent of the problem can vary greatly depending on how long a patient has been diagnosed with diabetes.

“A minor injury can turn into a major problem,” Dr. Stapp said. “It can be something as simple as a hang-nail or a callus that turns into a diabetic ulceration, which can turn into an infection.”

Dr. Stapp said about 25 percent of visits to his of-fice are from people with diabetes and they come to his office for a variety of reasons.

“If they don’t have current problems, we’re going to address preventive care with nail care, corns and cal-luses, education and examinations,” he said. “If they come in with problems such as diabetic ulcers, we have to treat those accordingly, whether it’s through wound care, surgery, hospitalization or antibiotics. It just depends on their situation.”

For those patients with problem wounds, University’s Wound & Hyperbaric Center offers a hospital-based treatment program. The center, which is located at the hospital, is open to patients through physician and self referral. u

For information about wound treatment, contact University’s Wound & Hyperbaric Center at 706-774-7242 or log on to www.universityhealth.org/woundcare.

Getting health care on the right foot Foot complications common for those diagnosed with diabetes

“It can be something as simple as a hangnail or a callus that turns into a diabetic ulceration, which can turn into an infection.”Mickey Stapp, D.P.M., Podiatric Surgery


Health News

ALZHEIMER’S DISEASE, an irreversible form of de-mentia that affects more than 5 million Americans, is the slow deterioration of memory and thinking skills.

The risk of having Alzheimer’s greatly increases as you age, but it is not, itself, a normal part of aging, and there can be a number of causes for the condition.

Grace Pilcher, M.D., a neurologist who practices at University Hospital, said physicians can’t be 100 per-cent sure of a diagnosis because certainty requires a PET scan or tissue diagnosis, which wouldn’t be performed on a live patient. But having Alzheimer’s disease doesn’t preclude people from having other forms of dementia, and vice versa.

“It’s not very common to have just Alzheimer’s,” Dr. Pilcher said. “As people get older, many develop vas-cular problems – the hardening of the small arteries that can cause different types of memory problems and dementia – and by the time they’re 85, 50 per-cent of the population may develop Alzheimer’s.”

It’s still unknown what starts the process of develop-ing Alzheimer’s, but it, like all types of dementia, results in the systematic death of the brain’s neurons, which send signals that aid in everyday activities such as memory, sensory perception and communication skills.

Alzheimer’s patients are frequently unaware of their mental deterioration, but for family members, watching the slow decline into dementia can be a devastating event – especially since they often miss the first warning signs of the condition.

“In their own environment, people can compensate for memory loss and short term memory problems,” Dr. Pilcher said. “And the smarter they were in the be-ginning, the better ideas they have to trick everybody into believing that nothing is wrong, like keeping the newspapers in the knitting basket to continuously reorient themselves to what day it is.”

That delay in treatment can be detrimental as time

goes by because, while there is no cure for dementia or Alzheimer’s, there are medications that can help slow the disease’s progression.

“You don’t want to sit and wait because medica-tions don’t work when you don’t have neurons,” Dr. Pilcher said. “You still have to have your brain, and medications can keep you where you are, but they can’t restore what’s already been lost.” u

Early treatment can help slow down Alzheimer’s progressionIncurable disease affects more than 5 million Americans

“As people get older, many develop vascular problems and by the time they’re 85, 50 percent of the popula-tion may develop Alzheimer’s.”Grace Pilcher, M.D., Neurology

ninability to recognize oneself or family

n inability to communicate nweight loss nseizures nskin infections

ndifficulty swallowing ngroaning, moaning

or grunting nincreased sleeping nlack of control of

bowel and bladder

nincreased memory loss and confusion

nproblems recogniz-ing family and friends

ninability to learn new things

ndelusions and paranoia

nimpulsive behaviornproblems coping

with new situations ndifficulty carrying

out tasks that involve multiple steps (such as getting dressed)

ngetting lost ntrouble handling

money and paying bills

nrepeating questions nmood and personal-

ity changes

ntaking longer than before to complete normal daily tasks

npoor judgment nlosing things or mis-

placing them in odd places

SYMPTOMS OFALZHEIMER’S DISEASE

Mild Alzheimer’s disease

Moderate Alzheimer’s disease

Source: National Institute on Aging

Severe Alzheimer’s disease

JOAN WESSMAN, RN, MS, CENP, has joined University Health Care System as Vice President of Patient Care Services/Chief Nursing Officer.

Ms. Wessman fills the posi-tion of Marilyn Bowcutt, who advanced into the role of Senior Vice President/Chief Operating Officer.

Ms. Wessman has dedicated her career to nursing. She started as a staff nurse, and began early in her career to move into supervisory positions with the vi-sion of improving the continuum of care for patients, their families and the nurses who care for them.

She had been with the Greensboro, N.C., Moses Cone Health System since 2003 where she was Executive Vice President and Chief Nursing Officer. Among her many achievements there, she helped all five hospitals in the system achieve Magnet status simultaneously.

She revitalized and strengthened relationships with local schools and colleges of nursing; implemented a program to minimize staff injuries and developed programs to support graduate nurses into practice and staff nurses into leadership roles.

Prior to her leadership at Moses Cone, she was Senior Vice President at the Akron General Health System and Akron General Medical Center for 15 years. Prior to that, she rose through the ranks of multiple Ohio hospitals from staff and charge nursing positions, to director.

She has numerous professional affiliations related to nursing and management, and has been recog-nized with many honors, including the 2010 American Organization of Nurse Executives Mentor Award.

James Davis, University President/Chief Executive Officer, expressed delight in bringing Ms. Wessman aboard.

“You will not find anyone with a better knowledge and understanding of nursing from the perspective of the nurse and the patient,” Mr. Davis said. “She is a thinker, an encourager and an innovator, and some-one who can help ensure University is equipped to care for patients and our nurses into the future.” u

FYI

GREAT CARE. GREAT CAREERS.www.universityhealth.org/jobs

COMMUNITY ACTIVIST AND FORMER JOURNALIST LAURIE OTT joined University Health Care System as President of University Health Care Foundation, the system’s fundraising arm.

Ms. Ott succeeds Pete Brodie, who announced his

retirement last year. Mr. Brodie participated in the se-lection process, and will remain with the Foundation through May to assist in the transition.

“This is a wonderful opportunity to serve the re-gion’s leading health care system, while growing partnerships and relationships that will benefit the entire community,” Ms. Ott said. “I look forward to working with the management and staff of University Health Care System, supporting their efforts in de-livering state-of-the-art patient care to the entire Augusta region.”

Ms. Ott served since 2007 as Executive Director of the CSRA Wounded Warrior Care Project, a com-munity-based organization dedicated to developing best practices to maximize resources and provide world class support for our wounded warriors, veter-ans and their families.

Prior to that, she was with the local CBS affiliate WRDW from 1994 to 2007, where she was an award-winning anchor and reporter.

Her work with WRDW took her from war-torn Bosnia to the Super Bowl.

University President/CEO James Davis said Ms. Ott has the skills to move the Foundation forward during a new and challenging era in health care and fund-raising.

“I am very excited about having Laurie on our team,” Mr. Davis said. “She is a talented, dynamic individual with strong experience in education and consensus-building in the nonprofit sector. Her leadership skills, coupled with a passion and commitment for helping others, make her an ideal fit to lead University Health Care Foundation.” u

University Welcomes New Vice President of Patient Care Services

University Health System Names New Foundation Leader