it’s how medicine should be ® | spring 2014 T h e begin nings issu e The beginning of Rush Medical College preceded the incorporation of the city of Chicago by two days. At the beginning of life, humans have either blue or gray eyes. Permanent color isn’t set until a child is about one year old. After the Great Chicago Fire of 1871, the city experienced a new beginning called “the Great Rebuilding.” Beginning in 2004, sports medicine doctors from Rush began serving as team physicians for the Chicago Bulls. Chicago streets were designed on a grid, beginning in the Loop at the intersection of State (which runs north-south) and Madison (which runs east-west). The CTA Blue line runs 24 hours a day, beginning at O’Hare International Airport and ending at Forest Park — stopping at the Illinois Medical District to drop off patients heading to Rush. www.rush.edu A GREAT b eg i n n i ng A c r y, a b r e a t h — a n d s o i t b e g i n s A baby is born — wet and a little cold but hardwired to shift from the first time. Mom’s milk hasn’t arrived yet, but her breasts contain colostrum, which provides many warmth of mom’s womb to breathing, eating and thriving independently. protective factors and all the nutrients and fluid a Newborns aren’t on their own, of course. In the THOSE FIRST 20 MINUTES Most babies take newborn needs. first 20 minutes of life, they’re the center of a lot their first breath just seconds after birth. “With that Soon after delivery, the medical and nursing of attention. And according to Robert Kimura, breath, the baby’s blood vessels open, and you sud- staff is assessing not only baby’s breathing, but MD, a neonatologist at Rush University Medical denly have blood flow to the lungs,” Kimura says. heart rate, muscle tone, reflexes and skin color- Center, the attention babies get in the delivery “The newborn is now taking in oxygen and getting ing as well. The results — the Apgar score — tell room sets the stage for the rest of their lives. That’s rid of carbon dioxide.” doctors whether an infant needs additional medi- why Rush brought its labor and delivery, neonatal, That exchange is key because every cell in the cal attention. At five minutes old, most newborns and obstetrical surgery services together on one floor. body needs oxygen. “If a baby doesn’t get enough score above seven (out of 10), which means oxygen, those cells can be injured,” Kimura says. they’re adjusting well to life outside the womb. “And that can mean a lifetime of problems, from That’s the beginning every mother-to-be imag- Robert Kimura, MD, is a neonatologist who ﬁrst learning disabilities to cerebral palsy.” Fortunately, ines, and it’s what happens for most full-term envisioned the beneﬁts of most newborns begin breathing just fine. babies. However, for the small percentage born pre- having the neonatal intensive A baby’s first breath is quickly followed by a first maturely or with a medical problem, doctors who care unit near labor and cuddle. Most full-term babies born at Rush are specialize in treating newborns — neonatologists — delivery more than snuggling on their mom’s chest within moments. intervene. At Rush, that intervention takes place on 20 years ago. This helps stabilize the baby’s temperature and the eighth floor of Rush’s hospital, the Tower, in the is also a chance for the baby to nurse for the new, specially designed Rush Family Birth Center. 2 www.rush.edu Ready to begin On the eighth floor, you’ll find the following: » The Renée Schine Crown Neonatal Intensive Easy as 1, 2, 3 ... Care Unit (NICU). Beginning the new year » 10 individual labor and delivery suites, each with two neonatal stations for parents wel- with practical pledges coming more than one baby. The suites offer The new year is a great time to turn over a new leaf. But the best space for vulnerable babies: low transforming your good-intentioned New Year’s resolutions into lighting, quiet and privacy for families. healthy habits takes a strong strategy. Jason Ong, PhD, a clinical » Newborns rooming in with their parents — psychologist at Rush University Medical Center, offers three for the very best beginnings. pieces of advice for setting your goals: » Neonatologists, 24/7, every day of the year. Rush was the first NICU in the Chicago area Make your target tangible. “You can say you to have at least one neonatologist on-site at 1 want to lose weight or decrease stress, but these all times. Other specialists on duty include are really concepts, not goals,” Ong says. “It’s hard to advanced practice neonatal nurses and NICU- gauge the progress of a concept.” However, if you say you trained respiration therapists. want to lose 10 pounds in the next three months, you have » 55 NICU beds. a realistic, concrete goal and a way to measure your success. 2 your brain can be easier if you modify your envi- Take control of your surroundings. Retraining ronment. Want to eat more fruits and vegetables? Have obstetricians and some prepped for when you’re in a hurry or idly looking for CLICK neonatologists at something to snack on. Have a weakness for the sweets rush can help you have your in the office break room? Don’t linger after refilling your coffee cup. own new beginning. Visit rsh.md/meetdocs. 3 People who focus on putting tangible steps into Remember it’s a journey, not a destination. practice do better than those who just fixate on the end goal. “When basketball players come to the line to make THE BEGINNING OF A NEW MODEL way, the dream-come-true space Kimura and free throws, those who pay attention to mechanics make During the planning stage for the Tower, Kimura his colleagues designed departs from a set-up more shots than those who are only thinking about win- and his colleagues had a rare opportunity: to that’s common in many hospitals, where the ning the game,” Ong says. create the optimal obstetrics, labor and deliv- NICU may be a few floors away — or even Jason Ong, PhD, specializes in ery, and neonatal intensive care unit (NICU) across town. addressing factors that interfere with facility. Based on their years of experience, After delivery, families move across the sky sleep. He also works with the Rush that meant making sure the best staff and the bridge to the mother-baby unit on the Atrium’s University Prevention Center, where most advanced equipment were together, in eighth floor. Newly renovated suites offer privacy he promotes using mindfulness- close proximity. for quality time together. “The mother-baby unit based techniques, such as relaxation and breathing exercises, to help On the Tower’s eighth floor, the center’s new has space not only for babies and moms, but support lifestyle changes. labor and delivery rooms, with their large win- also for dads, siblings and other family mem- dows, city views and natural light, have all the bers,” says Kimura. necessities and amenities to support mothers Kimura believes the Rush Family Birth Center during labor, including birthing balls, showers is a model for the next generation of obstetric and help with pain management. And if a and neonatal care in hospitals. “When people baby needs additional care, neonatologists, see it, they often say, ‘Why isn’t everyone doing surgical operating rooms and the NICU are just this?’” Kimura says. “Our hope is we’ll be cop- steps away. This provides the ready availability ied. That would be a great compliment — but of needed staff in those unpredictable occa- even better, it would mean more babies and sions when a baby needs help at birth. In this moms receiving optimal care.” 3 A brand-new start BREAST CANCER: FACING THE FEAR, THEN LETTING IT GO As a little girl, Karen Lewis lost four aunts to breast cancer. Karen was petrified that she would die as they had, and her fear grew with age. At 40, she had her first mammogram. After evaluating the findings and noting an abnormality, the radiologist recom- mended Karen return in six months. Instead of six months, Karen waited six years. FINDING AN ALLY “I thought if I did nothing, whatever it was would just go away,” Karen says. But after years of worrying, Karen dug deep to find the strength to get another mammogram. In doing so, she laid the groundwork for beginning a new chapter in her life. “I knew I had to take care of myself,” she says. The second mammogram revealed something suspicious, and Karen’s anxieties skyrocketed. Finally, at the urging of a friend, Karen sought the help of Andrea Madrigrano, MD, a breast cancer surgeon at Rush. Andrea Madrigrano, A biopsy confirmed Karen had an early form of breast cancer, ductal MD, performs minimally carcinoma in situ, in which abnormal cells appear in the milk ducts. Her invasive breast cancer cancer had the potential to spread into her breast tissue and lymph surgery that spares nodes, which is why treatment was crucial. “I was crying, but Dr. breast tissue. Her Madrigrano touched my arm and said, ‘You are not going to die research interests include preserving from this,’” Karen recalls. “She always made time for me. She fertility during cancer made me feel like I was her only patient.” treatments. TOUGH CHOICES Because Karen’s disease affected a large portion of her breast, Madrigrano recommended a mastectomy. Karen then made a seemingly odd request: She asked Madrigrano to remove both breasts. “We approach each patient’s treatment individually — for some patients a breast-sparing operation and radiation therapy may be in order; for others a mastectomy,” Madrigrano says. “We don’t take removing a cancerous breast, much less a noncancerous one, lightly. But considering Karen’s almost crippling anxieties, it was the right call for her.” A NEW PERSPECTIVE Today, Karen feels confident for the first time. “That fear I carried around since I was nine is gone,” Karen says. And now that she’s faced down breast cancer, she’s conquering other fears as well. She speaks publicly to share her experiences and help Treatment and breast reconstruction: It’s personal others. And for the first time ever, she is self-assuredly The best course of treatment for breast cancer depends on one thing: you. If you’ve been diagnosed with wearing sundresses, thanks to her reconstructive surgery breast cancer, it’s important to know as much about your cancer as possible, says Andrea Madrigrano, MD. performed by plastic surgeon George Kouris, MD. “After For example, what is the stage, location or size? Are there genetic factors? something so life-changing, all these little fears seem like It’s also crucial that you are aware of all your treatment options. That’s why Madrigrano recommends no big deal.” a second opinion and the involvement of a team of breast cancer specialists. “Your cancer is unique to you,” she says. “Your decisions should be based on the nature of your cancer, your doctors’ perspectives CLICK meet other breast cancer specialists at rush and your preferences.” through our breast cancer video playlist at rsh.md/breast-cancer-doctors. www.rush.edu TWO PATIENTS RECEIVE THE GIFT OF LIFE Edward Hollinger Jr., MD, PhD, is a surgeon who specializes in kidney, liver and pancreas transplantation. give Tom one of his. But there was one compli- cation: Liam and his wife were expecting their second daughter — their own new beginning — in five months. “We thought, ‘OK, how can we time the surgery around the baby?’” Liam says. Their daughter was born in mid-January. The next month, surgeons at Rush removed one of Liam’s kidneys and transplanted it into Tom’s body. “When I woke up, I felt better immediately,” Tom says. “I felt like a new person. It was amazing.” A NEW NORMAL Edward Hollinger Jr., MD, PhD, who performed Tom’s surgery, says that kind of immediate improvement is common in living donor transplants. “A kidney from a deceased donor can sometimes take longer to work, but with a living donor it tends to work well right away,” Hollinger explains. Tom and Liam still had to recover from their GETTING A NEW KIDNEY — AND WAKING UP A NEW PERSON surgeries, each taking time off before returning During the summer of 2012, Tom Bresnahan felt like he was living in a fog. to work. And Tom continues to take medicines to keep his Wegener’s in check and prevent his body “I was tired all the time,” says the 39-year-old Chicago police officer. from rejecting his new kidney. “My head felt like it was full of water. Looking Michele Bailey, DO, a primary care doctor at Rush, But new beginnings are giving way to a new back, I don’t know how I got up and went to who ordered tests that revealed two things: Tom normal. Liam’s daughter turned one last month; work every day feeling like that.” Only since his had Wegener’s granulomatosis, a rare condition Tom and his wife now take walks — which new beginning has he been able to take stock of that causes inflammation of the blood vessels. before would have been too tiring for him — how bad his symptoms had gotten. And this condition had blocked blood flow to his and might even go on a celebratory vacation. The symptoms — fatigue, achiness, sinus kidneys, which were failing. “We’re thinking about Europe,” Tom says. “Or pain — progressed slowly over several years. “I maybe Australia.” would say, ‘Oh, I’m getting old,’” Tom says. “Or TWO NEW BEGINNINGS “I got a call that Tom doctors would think I had a sinus infection.” By was in the hospital,” remembers his younger did you know? some people CLICK 2012, though, he was beginning to realize some- brother, Liam Bresnahan. “The next day we have three or four kidneys. learn thing else must be wrong. found out he was going to need a new kidney.” why — and read more organ donation That August, he made an appointment with Liam, 34, knew right away that he wanted to facts — at rsh.md/organ-donation. 5 RUSH IN THE NEWS CLINICAL TRIALS AT RUSH MIND-BODY MEDICINE AND ULCERATIVE COLITIS The Department of Gastroenterology is conduct- ing a study to determine if one of two eight-week, mind-body medicine courses has an effect in re- ducing stress and impacting the course and severity of ulcerative colitis. Both courses have been shown to beneﬁt other aspects of health and well-being. Food for thought: Fat linked to memory loss Participants will be enrolled in one of two separate, People with high amounts of belly fat are more than three times as likely to develop memory loss eight-week mind-body courses. and dementia later in life, according to researchers at Rush — and it’s linked to the liver’s hanker- Participants must meet the following criteria: ing for a protein that’s also relished by the brain. The study, which appeared in the August 2013 • Have a clinical diagnosis of moderately severe issue of Cell Reports, found that the liver burns belly fat with the help of the protein PPARalpha, ulcerative colitis which the brain uses for memory. • Be between the ages of 18 and 70 The liver works extra hard in people who have a large amount of belly fat, using up the • Have at least one documented ﬂare-up of ulcer- PPARalpha. And if the liver doesn’t have enough PPARalpha around it to use, it turns to ative colitis within the past year other parts of the body, including the brain, to find more. The brain’s hippocampus, which This is a partial list of inclusion and exclusion cri- plays a role in memory and learning, is essentially starved of PPARalpha. More research is teria. For more information, contact Annika Gorenz needed to find a way to maintain normal PPARalpha levels in the brain to potentially prevent at (312) 942-1181. memory loss. In the meantime, exercise and eat healthy to keep belly fat in check and stay sharp mentally. OBESE ADULT AND GUT BACTERIA STUDY The Department of Clinical Nutrition is conduct- Testing testosterone uncovers tie to Parkinson’s ing a study to investigate whether promoting gut There may be yet another reason for men to consider keeping an eye on their testosterone levels. health through the use of a new dietary strategy A new study by researchers at Rush showed that a sudden decrease in testosterone (the can improve the health of obese adults. Partici- male sex hormone) may cause symptoms that are connected to Parkinson’s disease, a disorder pants will be asked to take a dietary supplement of the nervous system that causes tremors and slow movement. The findings were published for three weeks and will be required to complete in the July issue of the Journal of Biological Chemistry. four visits to Rush University Medical Center. “In men, low levels of testosterone have already been linked to problems such as loss of Participants must meet the following criteria: sexual function and muscle mass,” says Kalipada Pahan, PhD, the study’s lead author and a • Be between the ages of 18 and 65 neuroscientist at Rush. “Now we know that preserving healthy testosterone levels in males • Be a healthy, clinically obese adult may be an important step to avoiding Parkinson’s disease.” • Have no chronic diseases (e.g., heart disease, dia- Researchers found that as testosterone levels decreased, nitric oxide levels went up. When betes) too much nitric oxide is produced, neurons — which transmit information throughout the This is a partial list of inclusion and exclusion nervous system — may begin to die, leading to symptoms of Parkinson’s. Testosterone therapy criteria. For more information, contact CALL is sometimes used to treat problems associated with low levels of the hormone, but it’s still Krista Shawron at (312) 563-3907. too early to say if it would help treat Parkinson’s symptoms. “We’re excited by our find- ings,” Pahan says. “If we can build on the results, our hope is that it will help lead to a viable For other current clinical trials, treatment.” visit www.rush.edu/studies. 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 email@example.com about your health, please contact your health care, education chicago, il 60612-3244 or (312) 942-3215. For general information health care provider. CALL and research enterprise www.rush.edu about rush or for help ﬁnding a physician, © rush university medical center comprising rush university call (888) 352-RUSH (7874). cum29839 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. | s At u r d AY www.rush.edu RUSH UPCOMING EVENTS Free clAsses For Your heAlth | spring 2014 F r i d AY CLICK For a complete and up-to-date list of community wellness events at Rush and online health seminars, visit www.rush.edu/calendar, where you can also find presentations Rush Generations from previous talks. presents: | Culture of a Woman’s Heart Older adult and t h u r s d AY note date change: saturday, Feb. 22 caregiver programs 8 a.m. to noon Unless otherwise stated, the Rush searle conference center Generations programs below are professional building, Fifth Floor held at Rush University Medical 1725 w. harrison st. Center, Searle Conference Center, You may be aware that heart disease affects women differently than Fifth Floor (Elevator II, Professional men, but did you know that your ethnicity can have an impact as well? Building), 1725 W. Harrison St. Join experts at Rush for an informative program that will outline your risk | factors based on your ethnicity and explain how you can take charge of Maintaining Your Bone your heart health. Breakout sessions include African-American, Asian, Health w e d n e s d AY Caucasian, Latina and Southeast Asian groups. wednesday, march 26 1 to 3 p.m. Join us from your computer: At any age, you can take steps to Sensitive Topics: Online Discussion Series keep your bones strong. Join us to tuesday, march 11: Symptoms and Treatment of Irritable Bowel learn from experts at Rush how to Syndrome maintain bone health as we age. thursday, march 27: Treatment Options for Urinary Incontinence Presenters will discuss how best to tuesday, April 8: Colon Health and Colon Cancer Prevention maximize bone health by maintain- Join physicians from Rush for a free, online discussion series on topics ing an active lifestyle, participating in | you may not want to discuss at your next dinner party. From your own bone-building exercises and eating a t u e s d AY computer, you’ll learn how to take charge of your health and reduce your calcium-rich diet. risk factors for a variety of conditions, and about the available treatment Stroke: Know the options. All seminars begin at noon and include a brief presentation fol- Pelvic Health Warning Signs lowed by a question-and-answer period. wednesday, April 30 wednesday, may 28 Submit questions during the discussion or in advance via Twitter using 1 to 3 p.m. 1 to 3 p.m. the #rushhealthchat tag or send an email to firstname.lastname@example.org. Changes in pelvic health frequently Did you know that stroke is the third For more information or to register, visit rushuniversity.webex.com. occur as we age, but experienc- most common cause of death in the | ing frequent urinary urges, pain and United States and occurs more fre- Arthritis of the Knee: Surgical and incontinence should not be ignored. quently in older adults? Come hear m o n d AY Nonsurgical Treatment Options Come hear from experts at Rush and experts from the Comprehensive wednesday, April 9 participate in a discussion about pelvic Stroke Program at Rush explain the 6 to 8 p.m. health, including common physical two main types of strokes and how Armour Academic center changes that occur with aging, and you can reduce your risk and learn how 600 s. paulina st., room 976 hear about the latest treatment options to recognize and respond to the warn- Arthritis in your knee can make even simple daily tasks hard to complete. available. ing signs. Join experts from Rush as they discuss nonsurgical and surgical treatment | options at this free event. Because space is limited, please call to reserve s u n d AY CLICK You can get helpful health information in your your seat. For more details and to register, email inbox each month with our e-newsletter, call (888) 352-RUSH (7874). Parking in the Rush Discover Rush Online. sign up today at rsh.md/discoveronline. garage is available with validation.7 1700 w. Van buren st., suite 456 nonproﬁt org. u.s. postage gottA go ... AgAin? chicago, il 60612-3244 PAID rush university medical center Millions of people suffer from too-frequent urges to urinate. But there are many ways to get relief. To learn about the latest treatments and tips for overcoming an overactive bladder, read the February issue of Discover Rush Online. Sign up for the newsletter at rsh.md/discoveronline. www.rush.edu A GLUTEN-FREE DIET — WHERE DO I BEGIN? You finally have something to attribute those pick the date, DeMeo suggests the » Finally, the key to a successful symptoms to: celiac disease. Now comes the realization following strategies: change is to concentrate on what that you need to get rid of the gluten in your diet. » Consult a registered dietitian you can eat, not what you can’t, who regularly counsels people says DeMeo. “There’s an initial disbelief when never suspect, such as soy sauce with celiac disease. This pro- “In the big picture, you actually people learn they have to give and cake frosting. fessional can be your guide have an abundance of choices, it up,” says Mark DeMeo, MD, But the only way to help the to eating — and learning to and over time, your new diet will a gastroenterologist at Rush small intestine heal — and stay enjoy — a gluten-free diet. become second nature,” he says. University Medical Center. That’s healthy — is to stay gluten-free. » Be a label reader. If any of these understandable, given how com- So how do you start? words are on a food label, glu- mon gluten is. It’s a protein ten is present: barley, graham, Celiac symptoms contained in wheat, barley and YOUR GAME PLAN The best malt, rye, wheat, wheat germ, rye, which means you’ll find it in first step is to pick a date to be spelt or semolina. Instead, look “Avoiding gluten is a lifelong must for bread, pasta and cereal made with completely gluten-free, says DeMeo. for alternatives like rice and anyone with celiac disease,” DeMeo these grains. It also shows up in That date shouldn’t be more than nut flours. stresses. That’s because when people countless processed foods and a month away — and you’ll want » Load up on foods that are natu- with the disorder eat even a tiny amount beverages — including ones you’d to ask your doctor about specific rally gluten-free. Look for foods of gluten, their immune system attacks timing. “Use this transition time on the outside aisles of the and damages the lining of the small to gradually eliminate gluten from grocery store: fresh fruits and intestine. That damage can keep needed your diet,” he advises. Once you vegetables; unprocessed meat, nutrients from being absorbed in the fish and poultry; and most bloodstream and cause diarrhea, consti- dairy products. pation, stomach pain and weight loss. It » Discover new gluten-free prod- can also raise the risk of serious health ucts. There’s a rapidly growing problems, including anemia and even variety, from pasta to pizza. certain cancers. Mark DeMeo, MD, is the director of gastroenterology and nutrition at Rush. He has a special interest in helping adults with celiac disease control symptoms and stay healthy. more online WONDERING WHETHER YOU SHOULD GO GLUTEN-FREE? dietitian sue mikolaitis weighs in on when the trendy lifestyle At www.rush.edu choice is an actual health necessity. read “the gluten-Free glut” at rsh.md/gluten-free-food.
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