it’s how medicine should be
| spring 2014
T h 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.
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.
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
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
own new beginning. Visit
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.”
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.
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
from this,’” Karen recalls. “She always made time for me. She
fertility during cancer
made me feel like I was her only patient.” treatments.
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
TWO PATIENTS RECEIVE THE GIFT OF LIFE
Jr., MD, PhD, is
a surgeon who
specializes in kidney,
liver and pancreas
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,”
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
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.
RUSH IN THE NEWS
CLINICAL TRIALS AT RUSH
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
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 firstname.lastname@example.org 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
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.
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 email@example.com. 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
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.
gottA go ... AgAin? chicago, il 60612-3244 PAID
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.
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
nutrition at Rush. He has a
special interest in helping
adults with celiac disease
control symptoms and
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.