Discover Rush Fall 2012 by rushmedicalcenter


									         IT’S HOW MEDICINE SHOULD BE
                                                 |   FALL 2012

                                                                                    THE UPS AND DOWNS ISSUE

                                                                                    • On the green roof of Rush’s new hospital, the Tower,
                                                                                      plants collect rainwater, helping to bring down roof
                                                                                      and atmospheric temperatures and lower green-
                                                                                      house gases.
                                                                                    • Medications and other time-sensitive patient materi-
                                                                                      als are sent up and down the Tower at high speeds
                                                                                      through pneumatic tubes — similar to those at the
                                                                                      drive-through windows of banks.
                                                                                    • In 1893, the first Ferris wheel carried passengers
                                                                                      264 feet up into the sky for a look down at the
                                                                                      Chicago World’s Fair.
                                                                                    • Chicagoan Whitcomb Judson invented the clasp-
                                                                                      locker — the garment closure eventually renamed for
                                                                                      its up-and-down sound: the zipper.
                                                                                    • Stroke survival rates have gone up due to advances in
                                                                                      medical treatments. From 1995 to 2005, the stroke
                                                                                      death rate went down by 29.7 percent.
                                                                                    • Inside the Willis Tower, 104 elevators whisk visitors up
                                                                                      and down 110 floors.
                                                                                    • Childhood obesity is up along with instances of
                                                                                      “adult” conditions, such as high cholesterol and gall-
                                                                                      stones, in children.

           3 Stay up-to-date:                    4 Get down with your digits:
             Find out the latest trends in           Learn how to lower your risk
             health and medicine                     for heart disease                                   WWW.RUSH.EDU
                                                                                                                     magnetic stimulation
                                                                                                                     LEADING-EDGE TREATMENT
                                                                                                                     FOR DEPRESSION
                                                                                                                     For adults whose serious depression does not
                                                                                                                     respond to medication, there’s another option:
                                                                                                                     transcranial magnetic stimulation (TMS).
                                                                                                                       TMS directs highly focused magnetic pulses to
                                                                                                                     the left prefrontal cortex, increasing activity in
                                                                                                                     this and other areas of the brain that are associ-

                                                                                                                     ated with mood regulation. The treatments are
                                                                                                                     noninvasive, require no sedation and produce

                                                                                                                     remarkably few side effects.
                                                                                                                       Rush University Medical Center was one of the
                                                                                                                     original study sites for the trial that led to approval
                                                                                                                     of the clinical device used to deliver TMS. Clini-
    Everyone experiences life’s ups and downs. But for people with depression,                                       cians at Rush have the most extensive experience
                                                                                                                     with TMS in the Chicago area.
    the downs stick around — and can feel overwhelming.
                                                                                                                       Among patients receiving TMS at Rush, 60 per-
    People with depression may                                   They’ll lower my libido. The effects of             cent experience either remission or moderate
    experience lethargy, dimin-                               antidepressants on sexual function can vary            relief from their symptoms.
    ished interest in normal                                  among individuals. For some people, the effects
    activities, altered sleeping                              can be positive. “Depression itself can decrease                   For people whose depression
    or eating patterns, feelings                              libido, so with treatment, sexual function often                   or mood disorders do not allow
    of guilt or anxiety, and sui-                             improves,” Pollack says.                               them to function outside of a hospital
    cidal thoughts.                                              But, he says, some patients will experience         setting, the Mood Disorders Unit offers
       “We have many options                                  decreases in sex drive. “This can be managed           intensive care in a safe environment. Call
    to help people improve and,     Mark Pollack, MD, is      or reversed, either by switching to alternative        (888) 352-RUSH (7874) for information.
    in some cases, fully over-      chairperson of the De-    treatments or by supplementing with other
    come their depression,” says    partment of Psychiatry,   medications, including some that increase
    Mark Pollack, MD, a psy-        where he specializes      dopamine functioning.”                                notices new, unusual thoughts, that’s the time to
    chiatrist at Rush University    in treating mood and         I’ll gain weight. Though putting on pounds         call the physician,” he says.
    Medical Center.                 anxiety disorders.        with antidepressants is less common with the             I’ll become addicted. SSRIs and SNRIs are not
                                                              newer medications, it may still happen. If it does,   addictive, like substances such as alcohol, nicotine
    ADVANCED MEDICATIONS Among the treat-                     your doctor might suggest switching to a differ-      and opiates. However, if they’re discontinued too
    ment options are the antidepressant medications           ent antidepressant or augmenting with anoth-          quickly, it’s possible to have withdrawal symptoms,
    known as selective serotonin reuptake inhibitors          er medication to reduce or reverse the weight         including dizziness, sleep disturbances or flu-like
    (SSRIs) and serotonin and norepinephrine reup-            gain. And, as Pollack notes, “It’s always impor-      symptoms, so it’s best to wean yourself off of
    take inhibitors (SNRIs). Compared to older types          tant to attend to diet and exercise in order to try   them gradually, with the guidance of a physician.
    of antidepressants, these drugs are safer and             to control weight gain while on medication.”             They’ll interact with other drugs. “While
    better tolerated by patients.                                They cause suicidal thoughts. “Although            adverse drug interactions are not generally a
      SSRIs and SNRIs are believed to work by                 antidepressants are much more likely to allevi-       problem with SSRIs or SNRIs, they can occur, so it
    affecting the levels of brain chemicals called            ate suicidal thoughts associated with depres-         is absolutely critical, before starting these medica-
    neurotransmitters — like serotonin and                    sion than to cause them, a small proportion of        tions, to tell your doctor about all the other drugs
    norepinephrine — that are involved in regulating          individuals taking them — usually young adults,       you take,” Pollack says. “That helps your doctor
    mood, anxiety and thinking.                               adolescents and children — may develop agita-         select an appropriate antidepressant that mini-
      Here, Pollack addresses some common con-                tion or suicidal thinking,” Pollack says.             mizes the potential for interactions.”
    cerns people may have about antidepressants.                  For this reason, communication between               In the end, it comes down to this: “Seeking
      They’ll change my personality. SSRIs and                patient and doctor (and parents, when chil-           treatment is critical,” says Pollack. “And there
    SNRIs don’t change who you are. In fact, treat-           dren are involved) is critical — especially early     is reason to be optimistic. With persistence, we
    ment often allows one’s personality to emerge             on in treatment.                                      can help most people with depression get their
    without the overlay of anxiety and depression.               “If a patient starts to feel uncomfortable or      lives back to normal.”

2     CLICK   For more about how clinicians at Rush treat depression, watch Pollack’s video at

WHAT’S UP (AND DOWN)                                                                                            Easy as 1, 2, 3 ...
In life we tend to equate up with good and down with something less than positive. However, in
                                                                                                             The rise and fall
                                                                                                             of blood sugar
medicine this simplistic split does not always hold true. For example, in the field of cancer what’s                                  If you have diabetes, you know the
down is downright impressive. In the last two decades, the death rate from cancer in the U.S.                                         importance of keeping your blood
dropped dramatically — by about 23 percent in men and 15 percent in women.                                                            sugar, or glucose, levels in balance.
  Here, two experts at Rush University Medical Center talk about the ups and downs in their fields.                                   If you have friends or loved ones
                                                                                                                                      with diabetes, it’s equally important
                                                                                                                                      to know how you can help them
                                                                                                                                      keep their glucose numbers from
   Heart attack survival rates are up                                                                                                 going too far up or down.
                        Neeraj Jolly, MD, is director of the Cardiac Catheterization Lab at Rush. He         Rasa Kazlauskaite,         “You’re not doing your friends
                        specializes in adult structural heart disease, endovascular procedures and inter-    MD, is acting medical or loved ones with diabetes a
                        ventional cardiology.                                                                director of the Rush     favor if you bring them treats or
                         For patients having a heart attack, the amount of time between entering the         University Prevention    pressure them to eat,” says Rasa
                         hospital and having angioplasty (what’s called door-to-balloon time) is down        Center. She special-     Kazlauskaite, MD, an endocrinolo-
                         and survival rates are up. This is in part due to new strategies that have          izes in endocrine and    gist at Rush University Medical
                         shortened the time it takes to clear blocked arteries and get blood flow-           metabolism issues.       Center. “But if you follow their
                         ing again. Quickly restoring blood flow prevents the death of heart muscle.                                  balanced diet along with them,
     “It used to take two or more hours just to open an artery and place a stent,” says Neeraj Jolly,        you’ll help everyone stay healthier.”
   MD, an interventional cardiologist at Rush. “Now, our profession has agreed that it is optimal to           Kazlauskaite offers these three recommendations for keep-
   provide all necessary care within 90 minutes of a heart attack victim arriving at the hospital.”          ing blood sugar in balance:

                                                                                                                      Stay on schedule. If you tell a person with
                                                                                                               1      diabetes dinner is at 6 p.m., make sure you eat at
   Getting kids up and running                                                                               6 p.m. People with diabetes need to space their meals
                        Srikumar Pillai, MD, is director of pediatric surgery at Rush. He focuses on liver   about four hours apart. Otherwise, blood sugar levels can
                        and biliary tract diseases in infants and children.                                  fall too low. That can lead to shakiness, dizziness, irritabil-
                        The last decade has seen a steady rise in the use of minimally invasive sur-         ity, confusion and increased hunger. And to fend off
                        gical techniques for pediatric procedures at Rush. This includes laparoscopy,        hunger, people often make bad food choices — which can
                        which utilizes a small camera and scope inserted into the patient through            result in blood sugar levels rising too high.
                        small incisions. These techniques are now considered the standard of care
                        for appendectomy and gallbladder removal for children, says Srikumar                          Follow the meal plan — always. People with dia-
                        Pillai, MD, a pediatric surgeon at Rush.                                               2      betes need to avoid foods that have too much salt,
      As the use of these techniques has gone up, rates of postoperative complications have                  are high in sugar, or are creamy or fat-filled — these will all
   gone down. In fact, the smaller incision of a laparoscopic appendectomy means fewer infec-                drive up blood sugar levels. If you live with someone who
   tions, less postoperative pain and shorter recovery time. “With these techniques, we can get              has diabetes, help him or her by not keeping these types of
   young people back up on their feet much more quickly,” Pillai says.                                       foods in the house. Instead, stock up on vegetables, healthy
                                                                                                             proteins and fiber-filled foods.

Jolly and Pillai are among the clinicians settling into Rush’s new hospital, the Tower. The Tower                     Bring on the water. If people with diabetes
houses the innovative interventional platform — a treatment area that brings many medical spe-                 3      experience blood sugar levels that are consistently
cialties together to perform diagnostic, therapeutic and surgical procedures in one location.                too high, their diabetes medication may need to be adjusted
  “With the interventional platform, physical boundaries are down and collaboration is up,”                  by a doctor. While blood sugar remains high and until they
Jolly says. “When we are all in the same place, that makes it easier to bring together everyone’s            can get medical attention, it is important that they drink
expertise and really push the envelope. We believe that such a diverse group working so closely              enough water to quench thirst. This will help remove sugars
together will increase treatment options for patients across many fields.”                                   through the kidneys and bring glucose levels down.

              FETAL AND NEONATAL MEDICINE: Survival rates for premature babies (those born
              before 37 weeks’ gestation) have gone up, because of new treatments and technologies.                                                                       3
                                                                 UP OR
                                                                                                                                        Heart health is a numbers game.
                                                                                                                                        Numbers, along with your family
                                                                                                                                        history, offer physicians the biggest

                                                                                                                                        clues about your heart disease risk.

                                                                                                                              Numbers give you a picture of your risk profile
                                                                                                                            as it relates to many of these factors. Some you
                                                                 MIND THESE NUMBERS FOR HEART HEALTH                        can calculate yourself, some your doctor will need
                                                                                                                            to tell you and some are a result of your lifestyle.
                                                                                                                              This infographic provides target numbers
                                                                         for the key risk factors related to heart health and specifies whether it’s better to be above or
                                                                         below each value.
                                                                           Take a look. And if your numbers aren’t where they should be, pay careful attention to the
                                                                         icons that appear below each box and the key you see on the left. These icons indicate how
                                                                         you can move your numbers up or down for better heart health: Green is for elements you
                                                                         should incorporate more of, and red indicates things to avoid or limit.

                                                                             Total cholesterol
                                                                             Cholesterol is a waxy, fatlike substance in the blood. Your levels are measured in             200
                                                                             milligrams per deciliter of blood. Aim for a total below 200 mg/dL; at 240 mg/dL, your risk for heart

                                                                                                                 disease is more than twice that of a level below 200 mg/dL. Your
                                                                                                                 total cholesterol is made up of the three elements below.

           NUTRITION It’s important to avoid trans fats and limit
           foods high in saturated fats and cholesterol. That means
           lean meats and low-fat dairy products are preferable to full-
                                                                             Low-density lipoprotein (LDL) cholesterol
                                                                             Your bad cholesterol, together with other substances, can form plaque and build up on          100
                                                                             artery walls, hardening the arteries. If plaque breaks away from the artery, a blood clot may form around

           fat varieties.                                                                                                  it, which may lead to a heart attack. Individual targets for LDL
           SMOKING Smoking is the nation’s most important                                                                  vary according to a person’s risk factors, but generally the goal
           preventable cause of premature death. It damages blood                                                          is to keep LDL below 100.
           vessels, reduces HDL (good cholesterol), raises your risk of
           blood clots and makes it harder to exercise.

           ALCOHOL If you drink, limit daily consumption to one
           drink per day for women, two for men. Moderate consumption
           may boost your HDL, or good cholesterol, and reduce your risk     High-density lipoprotein (HDL) cholesterol                                                               mg/dL for
           of developing blood clots. Heavier consumption may contribute     Your HDL, or good cholesterol, clears bad cholesterol from your arteries. So a low level

           to high blood pressure, obesity and other problems.
                                                                             of HDL (below 50 mg/dL in women, 40 mg/dL in men) means bad cholesterol may be                           mg/dL
           SALT Keep daily sodium intake below 1,500 milligrams.
           To decrease sodium, eat fewer processed meats, chips and                                              more likely to accumulate. Higher HDL levels —                       for men
           other salted foods; read food labels to choose products                                               above 60 mg/dL for men and women — may help
           containing less sodium; flavor food with spices and herbs
           instead of salt; and eat more fruits and vegetables.                                                  protect against heart disease.
           EXERCISE Exercise helps to improve all the numbers
           discussed here. See the exercise section of the infographic
           for details.
           WEIGHT LOSS Maintain a healthy weight, and talk to
           your doctor about ways to lose weight if you’re overweight.       Triglycerides are a type of fat in the blood that raises the risk for heart disease. Aim to keep            mg/dL
           Remember to keep calorie intake in balance with your              yours below 150. Combined with low HDL or high LDL, high triglycerides may speed up hardening of
           activity level.
                                                                                                              the arteries. Foods and drinks that are high in simple sugars —
           STRESS Find healthy ways to deal with stress. For
           example, spend some time doing deep breathing every day                                            refined grains, added sugars and alcohol — raise triglycerides.
           or doing something you enjoy, and strive to accept things
           you can’t change. Use positive self-talk: “I’ll do the best I
           can” rather than “I can’t do this.”


Blood pressure
Your blood pressure indicates the force of your blood on your artery walls.      120/80
The first number indicates pressure when the heart is beating and should not exceed 120; the second
                                                                                                           mm/Hg       What’s up with
                                                                                                                       my blood pressure?
indicates pressure when the heart’s at rest. It should stay below 80. High blood pressure is the single most
significant risk factor for heart disease, because it damages blood vessels, increasing the risk of plaque buildup                               If your blood pressure is up, you
                                                         and heart attack. It may also increase your heart’s                                    have good reason to be concerned.
                                                         workload, leading to heart failure. See the sidebar for                                  After all, high blood pressure
                                                         more information on high blood pressure.                                               can damage your arteries and
                                                                                                                                                lead to health problems, including

                                                                                                                                                heart attack, heart failure, kidney
Exercise                                                                                                                                        disease and stroke.
Exercise strengthens your heart; helps you manage weight; improves your cho-                             minutes                                  Certain factors, such as age, ex-
lesterol; and lowers your blood pressure, glucose levels and stress. Aim for at least 150 min-                         Rupel Dedhia, MD,        cess weight, a sedentary lifestyle
             utes per week of moderate-intensity exercise, such as walking at a pace of 3.5 miles per                  specializes in high      and stress increase your risk.
             hour or biking at a pace of less than 10 miles per hour.                                                  blood pressure and         “Think of your arteries as
                                                                                                                       diabetes at the          a plumbing system,” explains
                                                                                                                       practice Rush            Rupel Dedhia, MD, a primary

                                                                                                                       University Internists.   care physician at Rush University
Body mass index (BMI)                                                                                                                           Medical Center. “They move blood
Your BMI is a number calculated from your weight and height. If it is 25 or higher, it may indicate                    throughout your body just as pipes move water through
that your weight puts your health at risk. Excess weight may raise blood pressure, blood cholesterol                   a building. Sometimes, though, just as pipes can clog
                                 and triglyceride levels, and lower HDL. It can also increase your risk for            and narrow, the arteries narrow. Then pressure goes up
                                 type 2 diabetes. To calculate your BMI, visit                  in order to keep blood moving through.”
                                                                                                                         Narrowing can happen for various reasons. Genetics
                                                                                                                       may be partially responsible. What you ingest can also have

                                                                                                                       an effect. Nicotine can narrow the arteries, and salt (sodi-
Waist circumference                                                                                     inches for     um) makes you retain water, increasing blood volume and
Your waist circumference, measured in inches, indicates how much fat you                                women          the workload for your heart and blood vessels. And more
                                 carry around your midsection. It offers more
                                 insight into your weight-related health risks than
                                 BMI alone.
                                                                                                40      inches for
                                                                                                                       than two alcoholic drinks daily can raise blood pressure.
                                                                                                                         Common medications can even cause high blood
                                                                                                                       pressure, including nonsteroidal anti-inflammatories, cor-
                                                                                                                       ticosteroids, oral contraceptives and some cold medicines.
                                                                                                                         But when nothing else seems to explain high blood
Fasting glucose                                                                                                        pressure, a medical cause could be the culprit.
Your fasting glucose, or blood sugar, level indicates how well your body uses insulin. Levels
                                 of 100 mg/dL or higher may indicate that you have pre-
                                 diabetes or diabetes — both of which can damage the
                                                                                                100            mg/dL
                                                                                                                         In sleep apnea, for instance, interrupted breathing dur-
                                                                                                                       ing sleep decreases oxygen levels, signaling blood vessels
                                                                                                                       to rush more oxygen-rich blood to your heart and brain,
                                 heart and blood vessels.                                                              making pressure go up.
                                                                                                                         And while high blood pressure can cause kidney
                                                                                                                       disease, the opposite is also true. The kidneys release hor-
                         Keep in mind that the numbers and suggestions referenced here are general                     mones that help regulate blood pressure, and damaged
                         guidelines. To stay on top of your heart health, it’s important to see your doc-              kidneys do this less effectively.
                         tor regularly. Talk about your specific goals and how often to get these num-                   Treating such medical conditions may bring high blood
                         bers checked. Then discuss strategies for moving your numbers up or down.                     pressure down. If not, your doctor may recommend life-
                           “You can improve cardiovascular health with the essence of what’s highlight-                style changes and possibly medication. “Working closely
                         ed here — life’s simple seven,” says James E. Calvin, MD, a cardiologist at Rush              with your doctor will help your blood pressure get back
                         University Medical Center. “Eat better, get active, lose weight, stop smoking,                down to — and stay at — a healthy level,” Dedhia says.
                         manage blood pressure, control cholesterol and reduce blood sugar.”
                                                                                                                                       To find a primary care physician,
James E. Calvin, MD, has clinical expertise in heart failure and cardiac prevention, including personalized             MORE
                                                                                                                                       call (888) 352-RUSH (7874).
medicine. He is the section director of Clinical Preventive Medicine in the Department of Preventive Medicine.


                                                                                                                                                       CLINICAL TRIALS AT RUSH

                                                                                                                                                  HIGH BLOOD PRESSURE RISK
    Daily physical activity may reduce Alzheimer’s risk                                                                                           IN YOUNG BLACK WOMEN STUDY
                                                                                                                                                  The Rush University College of Nursing and the Department
    Don’t have the desire to run a marathon? Run                      activity were more than twice as likely to develop                          of Clinical Nutrition are conducting a study of an Internet-
    some errands instead.                                             Alzheimer’s disease as people in the top 10 per-                            based lifestyle program for black women at risk for high
      Many ordinary activities, such as cooking, playing              cent. In addition, people in the bottom 10 per-                             blood pressure. The study aims to evaluate online education-
    cards, meeting with friends and washing dishes,                   cent of physical activity intensity were almost                             al modules that focus on adopting healthy eating habits or
    may reduce the risk of Alzheimer’s disease and                    three times more likely to develop Alzheimer’s                              physical activity. Participants must meet the following criteria:
    cognitive decline even in older adults, according to              disease than people in the top 1 percent.                                   • Be a black female between 18 and 45 years old
    a new study by researchers from Rush University                     “These results provide support for efforts to                             • Have blood pressure slightly above the normal range
    Medical Center. The study is highlighted in an                    encourage all types of physical activity, even in very                        (120 to 139 for the top number and 80 to 89 for the
    article in Neurology, the medical journal of the                  old adults who might not be able to participate in                            bottom number)
    American Academy of Neurology.                                    formal exercise but can still benefit from a more                           • Have reliable Internet access
      The research found that people who ranked                       active lifestyle,” says Aron Buchman, MD, lead                                            This is a partial list of inclusion and exclusion
    in the bottom 10 percent in daily physical                        author of the study.                                                                      criteria. For more information, please contact
                                                                                                                                                  Beth Staffileno, PhD, RN, at (312) 942-6101 or Beth_A_

    Rush’s Tower sets green milestone                                                                                                             MINIMALLY INVASIVE VERSUS OPEN SURGERY
    One of Chicago’s most distinctive new buildings has now been certified as one of the greenest.                                                FOR RECTAL CANCER STUDY
      Rush University Medical Center’s innovative new hospital building, the Tower, which opened in January,                                      The Department of General Surgery is participating in a
    earned Leadership in Energy and Environmental Design (LEED) Gold certification, making it the largest                                         randomized, multicenter, phase III trial comparing minimally
    new-construction health care building in the world to be given that distinction. It is the only full-service                                  invasive resection versus open resection for rectal cancer.
    green hospital in Chicago.                                                                                                                    Participants must meet the following criteria:
      The recognition is given by the U.S. Green Building Council and verified by the Green Building                                              • Be at least 18 years old
    Certification Institute.                                                                                                                      • Have adenocarcinoma of the rectum
      Hundreds of energy-savings ideas were incorporated into the plan-                                                                           • Have completed preoperative 5-FU- or capecitabine-
    ning, construction and design of the Tower, which scored highly in the                                                                          based chemotherapy and/or radiation therapy
    LEED point system in energy efficiency, lighting control, water conser-                                                                                     This is a partial list of inclusion and exclusion
    vation and material choices, as well as a variety of other features.                                                                                        criteria. For more information, please call
      “From the outset of our facilities planning, we made a commitment                                                                           Amanda Francescatti at (312) 942-7462.
    to sustainability because, in the long run, it is good for our patients,
    our employees and the entire community,” says Peter Butler, president                                                                         For other current clinical trials,
    and chief operating officer of Rush.                                                                                                          visit

       DISCOVER RUSH is published as a service         Chief Executive Officer                          Information in DISCOVER RUSH comes
       for the Rush community.                         Larry J. Goodman, MD                            from a wide range of medical experts.
                                                                                                       Models may be used in photos and
       RUSH UNIVERSITY MEDICAL CENTER                  For information about DISCOVER RUSH,            illustrations. If you have any questions          Rush is a not-for-profit
       1700 W. Van Buren St., Suite 456                contact Erin Thorne at     about your health, please contact your            health care education
       Chicago, IL 60612-3244                          or (312) 942-3215. For general information      health care provider.                             and research enterprise                                    about Rush or for help finding a physician,      ©Rush University Medical Center                   comprising Rush University
                                                       call (888) 352-RUSH (7874).                     CUM28100                                          Medical Center, Rush
                                                                                                                                                         University, Rush Oak Park
       PLEASE NOTE: All physicians featured in this publication are on the medical faculty of Rush University Medical Center. Some of the physicians     Hospital and Rush Health.
6      featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.

                                   RUSH UPCOMING EVENTS

                    FREE CLASSES FOR YOUR HEALTH                             FALL 2012
                             For a complete and up-to-date list of community wellness events
                             at Rush and online health chats, visit,
                   where you can also find presentations from previous talks.

                   Advances in Treatment                     Treatment Options
                   for Prostate Cancer                       for Common Conditions

                   Tuesday, Sept. 11                         of the Foot and Ankle
                   6 to 8 p.m.                               Thursday, Oct. 25
                   Armour Academic Center                    6 to 8 p.m.
                   600 S. Paulina St., Room 994              Armour Academic Center
                   Comprehensive care that is indi-          600 S. Paulina St., Room 976
                   vidualized to each patient is espe-       The foot and ankle program at Rush
                   cially important in the treatment of      provides care for patients affected by
                   cancer. This is why The Coleman           foot and ankle disorders caused by
                                                                                                      Rush Generations presents:

                   Foundation Comprehensive Prostate         conditions such as arthritis, trauma,
                   Cancer Clinic at Rush offers men the      fractures, diabetes, sports injuries     Older adult and caregiver programs

                   opportunity to meet with a urolo-         and congenital deformities. Join         Unless otherwise stated, the Rush Generations programs are held at
                   gist, medical oncologist and radia-       experts at Rush to learn about the       Rush University Medical Center, Searle Conference Center, Fifth Floor
                   tion oncologist in a single visit. Join   latest treatment options available       (Elevator II, Professional Building), 1725 W. Harrison St.
                   some of these physicians to learn         for ankle arthritis, bunions and flat
                   about advanced treatments for pros-       feet at this free event.                 Insomnia: Do You Have                 Understanding Your
                   tate cancer, such as TomoTherapy                                                   a Sleep Problem?                      Medicare Options
                   and the da Vinci Surgical System.         Women’s Health:                          Wednesday, Aug. 29                    Tuesday, Sept. 25
                                                             Osteoporosis, Menopause                  1 to 3 p.m.                           1 to 3 p.m.
                   Diagnosis of and Treatment                and Incontinence                         Insomnia gets more prevalent          Get the latest updates on

                   for Heart Failure                         Tuesday, Nov. 6                          as we age, affecting half of          Medicare health and prescrip-
                   Thursday, Sept. 20                        6 to 8 p.m.                              all adults 60 years of age and        tion drug insurance just in time

                   6 to 8 p.m.                               Armour Academic Center                   older. Insufficient sleep affects     for the upcoming enrollment
                   Armour Academic Center                    600 S. Paulina St., Room 976             quality of life and can cause seri-   period. Whether you are new to
                   600 S. Paulina St., Room 976              As women age, their health is affect-    ous concerns, including injuries,     Medicare or you want to be sure
                   Heart failure can result from a vari-     ed in a variety of ways. At Rush,        accidents and mood problems.          you’re getting the most out of the
                   ety of causes — including coronary        medical science blends with a com-       Join experts from Rush to learn       program, join us to learn about
                   artery disease, high blood pres-          mitment to provide women with the        more about the causes of sleep        your benefits!
                   sure and heart attack — and lead          absolute finest, most compassionate      difficulties, when you should see

                   to a variety of symptoms. Patients        care. Specialists and subspecialists     a doctor for your sleep problem
                   with advanced heart failure need          work together to address the special     and the role relaxation tech-
| M O N D AY

                   specialized, top-quality care to          needs of women, from common              niques can play in treatment.
                   help their hearts function bet-           to complex. Find out more about
                   ter. The Advanced Heart Failure,          what to expect and what treatment                   You can get helpful health information in your email inbox
                   Heart Transplant and Mechanical           options are available for osteoporo-                each month with our e-newsletter, Discover Rush Online. Sign
                   Circulatory Support Program at Rush       sis, menopause and incontinence.         up today at
                   provides the gold standard in heart
                   failure treatments from internation-
                   ally renowned cardiac surgeons and

                   cardiologists. Join specialists at Rush                 Because space is limited, please call to reserve your seat.
                   to learn more about the diagnosis
                                                                        For more details and to register, call (888) 352-RUSH (7874).
                   and treatment of heart failure.
                                                                       Free parking in the Rush garage is available with validation.                                             7
                                                                                                         1700 W. Van Buren St., Suite 456                Nonprofit Org.
                                                                                                                                                          U.S. Postage
E-NEWSLETTER: DISCOVER RUSH ONLINE                                                                       Chicago, IL 60612-3244                             PAID
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Whether you’ve got a spare tire or a little extra padding, it’s hard to shed
belly fat. Read the August issue of Discover Rush Online to learn the risks
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THROUGH LIFE’S UPS AND DOWNS                                                                                                                     MORE
                                                                                                                                                           If joint pain
                                                                                                                                                           is keeping
                       Most of us use just two words,         kinds of activities will be,” Bigosinski says. But with time,                     you down, call (888)
                       standing up, to describe that          you can adjust. To reduce the risk of injuring your knees,                        352-RUSH (7874) to
                       common movement. But                   start slowly and gradually increase the length, and then                          find a doctor.
                       Krystian Bigosinski, MD, can fill      the intensity, of your workouts.
                       a paragraph: “First your feet hit         Control the number on the scale. If you are
                       the ground,” says the primary          carrying excess weight, normal ups and downs such
                       care orthopedic specialist at Rush     as taking the stairs or getting up from a chair can
                       University Medical Center. “Then       be stressful for your joints, leading to tendonitis,
Krystian               the motion works its way up            arthritis and other conditions. “Every extra pound
Bigosinski, MD,        through your ankles; your knees        of weight on your body is like five extra pounds
is a primary care      and hips activate to straighten        of force on your knee,” Bigosinski explains. “So if
orthopedic special-    your legs. You’re using your core      you’re 20 pounds overweight, it’s like an extra 100
ist whose practice     muscles and, if you’re tired, you      pounds coming down on your knee each time you
focuses on sports      might put your hand on your            go down a step.” The solution? Consult your doctor
medicine for both      seat to help push yourself up,         and, if necessary, work to make the number on your
recreational and       using your wrists, elbows and          scale go down — or at least keep it from going up.
high-level athletes.   shoulders. It’s a kinetic chain.”         Use proper lifting technique. The shoulder
                         Joints are key links in this         joint is largely supported by muscles — which tend
 chain of movement, which travels up and down our             to be less protective than, for example, the bones
 bodies every time we sit, reach, step or make virtu-         and ligaments that support the ankle. That makes it
 ally any other motion. Under the wrong conditions,           particularly important to protect your shoulder joints
 some common motions can strain these important               when picking up heavy objects. Just as you can pro-
 links, putting our joints at risk of injury. But by taking   tect your back by lifting with your leg muscles, you
 the right precautions you can avoid such problems.           can shield your shoulders by lifting with your arms
 Bigosinski offers the following advice on how to pro-        close to your body and your elbows bent. Lifting
 tect your joints through everyday ups and downs:             with straight arms can strain your shoulder muscles
    Don’t jump in too fast. The ups and downs of high-        and even lead to a rotator cuff injury.
 impact exercise — such as running stairs or activities          “Whether you’re lifting something or moving
 that involve jumping — can lead to injury if done with-      up and down yourself, understanding your joints’
 out proper preparation. “Some people get tendonitis of       mechanics can help you avoid overstressing them,”
 the knee because they don’t realize how taxing these         Bigosinski says.

      MORE ONLINE                            Calculating health. Our fitness calculators can help you learn if your numbers, from body weight to heart rate, need
                                             to go up — or down. Visit, click on “Health Information” and select “Wellness Tools.”

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