HealthyUMAGAZINE Apr-June 2010

INSIDE > University’s new Helipad is open for bUsiness> fleXibility Can be an indiCator of arterial HealtH> ClarifyinG tHe new pap test GUidelines

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Dr. Harper and Dr. Shah enjoy a tour of AirMed’s helicopter.

From left to right: Weems R. Pennington, M.D.; Ray E. Johnson, M.D.; Bimal R. Shah, M.D.; G. Leslie Walters, M.D.; William Callaghan, M.D.; Harry T. Harper III, M.D.; Alexander H. MacDonell III, M.D.; Janet L. Utz, M.D.; William C. Kitchens, M.D.; Doris Tummillo, M.D.; Michael S. Holman, M.D.; William R. Kitchens, M.D.; Mac A. Bowman, M.D.

TIME Is MusclE. It’s short, but to the point. When a person is having a heart attack, the faster they get help, the more likely they are to avoid death or severe disability.

That’s why University Hospital is continually working to shave minutes and even seconds off its cardiac response time, and two new projects are helping make that happen.

In mid-January, University launched its LifeNet program with Gold Cross ambulance service in Richmond, Columbia and Jefferson counties.

The system gives paramedics the ability to perform 12-lead electrocardiograms (ECGs) while on a call and transmit the information directly to University Hospital’s Emergency Department. From that transmission, a physician can deter-mine if a patient is suffering a heart attack and immediately launch preparations for receiving and treating the patient the moment they arrive at the hospital.

“If you have the ECG done before getting to the hospital, the physician can make a preliminary diag-nosis while the patient is enroute,” said Ward Rogers, M.D., a cardiologist who practices at University Hospital. “You can then immediately call the cath lab, expedite the patient’s treatment and open up the ar-tery quicker, which saves heart muscle.”

Peggy Bobo, University Hospital’s Emergency Department nurse manager, said the department is always looking for ways to more quickly diag-nose and treat cardiac patients.

The national standard for door-to-balloon times, or the time it takes a patient to receive cardiac intervention from the moment they enter the hospital, is 90 minutes. University – a nationally accredited Chest Pain Center – wants it done even faster.

“For the Emergency Department, we have a des-ignated nurse who drills down on every (STEMI, or severe heart attack) to ensure we get our times,” she said. “If it takes five minutes to get an ECG, we look at one-minute intervals to see what could have been done to improve that time.”

Another way University is working to save heart muscle is with its new helipad, which is situated directly in front of the entrance to the Emergency Department.

The helipad will primarily be used to trans-port cardiac patients from outlying hospitals to University for treatment.

Dan Gates, president of AirMed, said the new he-lipad will be a tremendous improvement over the old system, which included landing at Daniel Field and then transporting by ambulance.

“From Jefferson County Hospital, it’s a 45-min-ute to an hour drive with the ambulance,” he said. “In the helicopter, it’s a 12-minute flight. That piece of the puzzle is strengthened greatly.”

The AirMed fleet also has the advantage of being staffed by a dedicated registered nurse as well as an EMT.

“The level of care is higher on the helicopter than you would find on the ambulance,” Mr. Gates said. “We’re better staffed and have more medi-cations to help stabilize patients before they get to the hospital.” v

For more information, call university Hospital’s Heart line at 706/828-2828 or toll free at 866/601-2828. For symptoms of a heart attack, log on to www.universityhealth.org/heartsymptoms.

University Hospital shaves time off cardiac care

Health News

“If you have the ECG done before the patient gets to the hospital, the physician can make a diagno-sis while the patient is enroute.”- Ward Rogers, M.D., Cardiologist

The national standard for door-to-balloon times, or the time it takes a patient to receive cardiac intervention from the moment they enter the hospital, is 90 minutes. University – a nationally accredited Chest Pain Center – wants it done even faster.

FlExIbIlITy Is oFTEN usEd to gauge physical health, but now it’s gaining ground as a possible way to gauge your arterial health as well.

Researchers have found that, among people 40 and older, performance on a sit-and-reach flexibil-ity test could help determine arterial flexibility.

The study, which was published in the American Journal of Physiology, noted that because arterial stiffness often predicts cardiovascular disease, the simple flexibility test could quickly measure a per-son’s risk of heart attack or stroke.

Houman Tamaddon, M.D., a vascular surgeon and medical director of University’s Peripheral Vascular Lab, said the study makes some interest-ing correlations.

“Keeping your body flexible is actually more important than keeping your arteries flexible. The reason for that is that flexibility promotes

general cardiovascular health,” he said. “If you’re more flexible, it means you’re more active, and if you’re more active, then your cardiovascular sys-tem is working more efficiently.”

Dr. Tamaddon said inflexibility alone probably isn’t cause for concern, but there are those who might want to talk with their physician about their overall physical health.

“Certain patients with risk factors such as diabe-tes, hypertension or coronary artery disease may also have problems with the flexibility of their lower extremities, which has some correlation with stiff-ening of the arteries and peripheral artery disease (PAD),” he said. PAD occurs when plaque builds up in the artery walls, which can lead to a narrowing of the arteries, limiting the flow of oxygen-rich blood to organs and other parts of the body. People with PAD often suffer from leg pain when walking or wounds on their legs or feet that heal slowly.

To combat PAD, Dr. Tamaddon recommends a healthy, active lifestyle.

“We know that staying active throughout your life can keep your entire cardiovascular system healthy,” he said. “It decreases your risk of having a heart attack, decreases your risk of having a stroke and decreases your risk of developing PAD.”

And don’t think you have to necessarily engage in high-impact exercise to make a difference in your heart and vascular health.

Yoga, a low-impact activity that includes core strength and flexibility training, is an excellent way to promote cardiovascular health without putting undue stress on your joints. v

If you have questions about peripheral artery disease, call university Hospital’s Heart line at 706/828-2828 or toll free at 866/601-2828, or log on to www.universityhealth.org.

Health News

Reaching for your toes might help check out your arteries

According to the article in the American Journal of Physiology, researchers asked volunteers to sit on the floor, backs against the wall and their legs straight. They slowly reached their arms forward by bending at the waist. Based on how far they could reach, researchers classified the partici-pants as having either low or high flexibility.

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“Keeping your body flexible is actually more important than keeping your arteries flexible.”- Houman Tamaddon, M.D., Vascular Surgeon

Health News

THE HuMAN body Is AN ENGINEErING MArvEl, but even the sturdiest parts wear down over time.

Tony Tapley, of Evans, said his right knee was “bone on bone” when he had total knee replace-ment surgery in December 2008, meaning nearly all the cartilage in his knee had been worn away. He had to wait nearly a full year before he received the same surgery on his left knee, but in the interim, advancements were being made in the field that have been put into practice at University Hospital.

During his second knee replacement surgery, Mr. Tapley received a new pain-management therapy used for knee and hip replacement surgeries de-signed to increase a patient’s comfort level, making it easier for them to begin the rehabilitation process.

“We started a new protocol for post-operative pain for total knee replacement that has improved patient outcomes,” said Paul Herzwurm, M.D., an orthopaedic surgeon who practices at University Hospital. “It allows patients to get up and move faster and allows them to be discharged from the hospital faster.”

The surgery itself hasn’t changed, Dr. Herzwurm said. What has changed is that medicines given prior to surgery, injections during surgery and more medicines introduced after surgery all make patients more comfortable and ready to begin the rehabilitation process.

“Most patients initially will walk 5-7 feet their first day post-op and now we have patients walking 200 feet their first day post-op,” Dr. Herzwurm said.

Mr. Tapley could definitely tell the difference be-tween the procedures.

“There was just no comparison. I could just do more, be active much quicker as opposed to the other surgery,” he said. “It was less than a year later, but hands down it was a better procedure.”

Besides patient comfort, Dr. Herzwurm said the pain protocol also provides vital health benefits.

“It decreases their incidence of blood clots post-operatively, allows them to be mobile, and it allows them to go home and not have to go to a rehab facility,” he said.

Mr. Tapley, who has had multiple surgeries at University, said he wouldn’t consider going else-where when it comes to his health.

“It’s a tremendous facility,” he said. “It’s always been first class.” v

university Hospital offers a free Total Joint replacement class for those interested in the surgery. It is held from 1-3 p.m. every first and third Tuesday of the month in the levi W. Hill III Auditorium in the main hospital. registration is not required. For more information, call 706/774-2760.

Protocol offers patients less pain, more mobility

It allows patients to get up and move faster and allows them to be discharged from the hospital faster.”- Paul Herzwurm, M.D., Orthopaedic Surgeon

Health News

FuN IN THE suN is almost expected as the weath-er warms up, but too much of a good thing can be deadly down the road.

An estimated 68,720 cases of melanoma were diagnosed in 2009 and 8,650 people died from the cancer, which is the deadliest form of skin cancer.

Anna Katherine Duckworth, M.D., a dermatolo-gist who practices at University Hospital, said the number of U.S. deaths is even more startling when you consider the rate.

“That’s almost one death per hour,” she said. “It’s the sixth most common cancer in the U.S. and the No. 1 cancer in Americans age 25-29.”

The fact that skin cancer strikes younger people concerns Dr. Duckworth because at that age, most people aren’t thinking about sun damage.

“It’s really difficult to get the point across about skin cancer to teenagers and even those up to 30-35 years old,” Dr. Duckworth said. “They’re still in the immedi-ate gratification stage of life, and it’s not until later that it really starts to sink in that it’s a problem.”

Understanding the risks of sun damage is just one part of the problem with skin cancer; you also have to get people to recognize the warning signs and symp-toms of the disease. Dr. Duckworth said early detec-tion of melanoma is key to treating the disease.

“We know the risk of dying from melanoma is related to the depth of the cancer, which is directly related to the time it has gone untreated,” she said.

Research has come a long way to help physicians understand melanoma growth, but future studies might be able to help pinpoint just how the cancer grows in the individual.

“We’re pushing for more research into determin-ing how fast a cancer might grow,” Dr. Duckworth said. “We as a society are equally unwise about our risk for skin cancer. Most people don’t realize that you have a 6-8 fold risk of melanoma just by going to a tanning bed.”

That lackadaisical attitude toward skin cancer is what Dr. Duckworth said she tries to change once she has patients in her office, but it’s an uphill battle.

“When people come to me with skin concerns, it’s that they are getting brown spots; they’re get-ting wrinkles,” she said. “Melanoma is not even a consideration.” v

For more information about skin cancer, call university Hospital’s cancer Answer line at 706/828-2522 or toll free at 866/869-2522, or log on to www.universityhealth.org.

Play now, pay later when it comes to the sun

“We as a society are equally un-wise about our risk for skin cancer. Most people don’t realize that you have a 6-8 fold risk of melanoma just by going to a tanning bed.”- Anna Katherine Duckworth, M.D., Dermatologist

findinG MelanoMasThe ABCD rule can help you tell a normal mole from an abnormal mole. Moles that have any of these signs should be checked by your physician. ABCD stands for the following:

• asymmetry: One half of the mole does not match the other half.

• border irregularity: The edges of the mole are irregular or not smooth. They may look ragged, blurred or notched.

• Color: The mole’s color is not the same all over. There may be shades of tan, brown or black, and sometimes patches of pink, red, blue or white.

• diameter: The mole is larger than about 1/4 inch – about the size of a pencil eraser – although sometimes melanomas can be smaller.

Another important sign of melanoma is a mole that is growing or changing in shape or color. Still, some melanomas do not fit the “rules” above. It may be hard to tell if the mole is normal or not, so you should show your physician anything you are unsure of.

Source: American Cancer Society

cErvIcAl cANcEr rATEs HAvE FAllEN more than 50 percent over the past 30 years, and the Pap test is credited with much of that reduction.

But new guidelines by The American College of Obstetricians and Gynecologists now recommend that women should have their first screening at 21 and can be rescreened less frequently after that.

Jolene Montano, M.D., an obstetrician and gynecolo-gist who practices at University Hospital, said those rec-ommendations don’t really look at the whole picture.

“They’re certainly not taking into consideration younger girls who are already sexually active,” she said. “If you’re sexually active, then you definitely need to be screened for the human papilloma virus and other sexually transmitted diseases.”

A Pap test is used to check the health of a wom-an’s cervix and tests for the presence of HPV. HPV is known to be the leading cause of cervical cancer and also can cause genital warts as well as oral and anal cancer.

Researchers suggest that screening at less fre-quent intervals does not increase the risk of devel-oping cervical cancer and it decreases the costs associated with unnecessary testing and interven-tions. One reason the recommendation for cervical screening has been postponed until after age 21 is that cervical cancer is a slow-growing cancer.

Despite that, Dr. Montano said the decision to screen should be discussed with your gynecologist.

“Also, you have to remember that a Pap test is just one reason to see your gynecologist every year,” she said. “Young women should still come in for an annual visit that includes a physician examination of the breast and a family planning discussion.” This is also a good time to talk with your physician about menstrual problems common in young women. v

For more information about the Pap test, call university’s AsK-A-NursE at 706/737-8423 or toll free at 800/476-7378.

Health News

“If you’re sexually active, then you definitely need to be screened.”- Jolene Montano, M.D., Obstetrician and Gynecologist

tHe aMeriCan ColleGe of obstetriCians and GyneColoGists CerviCal sCreeninG GUidelines

• Cervicalcancerscreeningshouldbeginatage 21 years (regardless of sexual history). Screening before age 21 should be avoided because women less than 21 years old are at very low risk of cancer. Screening these women may lead to unnecessary and harmful evaluation and treatment.

• A Pap test is recommended every twoyears for women between the ages of 21 years and 29 years. Evidence shows that screening women every year has little benefit over screening every other year.

Recommendations for Pap test can lead to confusion

FYI

Join University for the sixth annual Pops! Under the Stars

uNIvErsITy HosPITAl boArd oF TrusTEEs cHAIrMAN r. lEE sMITH Jr. received the Georgia Hospital Association’s Distinguished Service Award, its highest honor, at the group’s annual meeting held in February.

The award is given to a hospital board member who is a recognized leader in the community and in his or her own business or profession; has contributed time and talent to bettering the hospital and other health care services available to the community; has brought about specific and positive changes that have advanced health care services in the com-munity, and has increased public attention to the health care needs of the community and has created public concern for meeting those needs.

syMPHoNy orcHEsTrA AuGusTA ANd uNIvErsITy HEAlTH cArE sysTEM ArE PlEAsEd To PrEsENT the sixth annual POPS! Under the Stars concert Saturday, May 8, on University Health Care System’s Evans Campus, 447 North Belair Road.

This free concert features Symphony Orchestra Augusta under the direction of conductor Shizuo Z Kuwahara. Music begins at 6:30 p.m. with the orchestra taking the stage at 7:30 p.m.

Food and beverages will be available for purchase, and families are encouraged to bring blankets and chairs.

In case of rain, the concert will be held at West Acres Baptist Church, 555 Gibbs Road, Martinez.

www.universityhealth.org

University Health Care Foundation will hold the 25th annual Harry W. Jernigan Jr. Memorial Golf Tournament at noon, May 3 at the Woodside Plantation Country Club, 1000 Woodside Plantation Drive, in Aiken. Besides the golf round, raffle tickets will be sold and “closest-to-the-pin” contests will be held during play.

This annual tournament benefits the Jernigan Endowment, which helps provide free mammograms for women, treatment for underserved cancer patients, nursing education and support for University Hospital’s Mobile Mammography Unit.

To register for this exciting event, call the Foundation office at 706/667-0030.

Jernigan Memorial Golf Tournament