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52406-3026 2012 by St. Lukes Hospital, Cedar Rapids, IA
Connect with St. Lukes at stlukescr.org
Healthcare information on your phone or computer
Living Longer. Living Well.
Breast cancer treatment in half the time
treatment and applies radiation precisely where most cancers
recur, said Robert Brimmer, MD, Physicians Clinic of Iowa general
surgeon. For example, select breast cancer patients will only need
three weeks of whole-breast radiation therapy following surgery.
Patients who dont receive IORT typically require six weeks of
Jody Meyer, of Cedar Rapids, was diagnosed with breast cancer in
December of 2010. I had a lumpec-tomy followed by four chemotherapy
treatments over a 12-week period and about six weeks of radiation
treat-ment, Meyer said. I was constantly fatigued. It was
Meyers works full-time and scheduled her treatments over her
lunch hour. It was a tough time for me physi-cally and mentally,
she said. If IORT had been available to me when I was treated for
breast cancer I would have gone for it in a heartbeat.
International research trialIntraoperative radiation therapy
(IORT) is a precise, less invasive cancer treat-ment for early
stage breast cancer. Its a new technique and is now available at
St. Lukes through an international research trial. To date, IORT
has not been used as standard treatment of breast cancer, said
Robert Brimmer, MD, Physicians Clinic of Iowa gen-eral surgeon.
Were hoping that our research will provide one more standard option
for select breast cancer patients.
Stop Diabetes Before It StartsTuesday, November 13 6:30 p.m.
Speakers: Dr. Rao (see page 2) and Dr. Eugene Nassif
Diabetes is running rampant in America, and you have the power
to stop it. Learn how you can reverse the trend and stop diabetes
before it starts, or at least lower your risk. If youve already
been diagnosed with diabetes, attend to learn valuable tips.
Arthritis Is A Pain!Monday, December 3 6:30 p.m
Speakers: Dr. Cherascu (PCI Rheumatology) and The Arthritis
Living with arthritis can be challenging, but there are many
things you can do to ease your pain and enjoy the activities you
want to. Learn the basics about the condition as well as various
All events are free. Classes are held at St. Lukes Hospital, 3rd
fl oor Nassif Heart Center classrooms. Register by calling
319/369-7395 or visit stlukescr.org/livewell.
Looking for great health information? Take a look at St. Lukes
new website stlukescr.org.
Results. Its easy to fi nd what you need, thanks to our new
Online chats. Ask hospital departments questions about your
medical records, upcoming events and classes, St. Lukes job
opportunities and more.
St. Lukes Heart Scan can help men and women between the ages of
40 and 70 identify their risk for heart disease. All thats needed
is a doctors referral.
Call 319/369-8909 to learn more or schedule yours.
$99 Heart Scan
News and events. Youll fi nd a news ticker of up-to-date health
information on main hospital pages.
Find a doctor or clinic. Search for healthcare providers based
on location or specialty.
Mobile website. At stlukescr.org/m get Urgent Care and ER wait
times, turn-by-turn directions and health information for users on
St. Lukes new technology reduces treatment time for select
New procedureIORT uses specialized equipment to deliver a
single, targeted dose of radiation to a tumor site during surgery.
St. Lukes is the only hospital in Cedar Rapids to offer IORT.
I would seek this treatment out for myself if I or any family
member was diagnosed with breast cancer, said Kerri Nowell, MD,
Physicians Clinic of Iowa general surgeon. It will allow women to
get back to their families, work and nor-mal activities in much
less time than the traditional methods weve had up to this point,
and the best part is the desired effect is the same to get rid of
Imagine receiving radiation during surgery to the precise site
where your tumor was just removed. St. Lukes offers that option,
called intraoperative radiation therapy (IORT), for certain cancer
patients. This new technology applies a concentrated dose of
radiation to the tumor site during surgery. It eliminates weeks of
Jody Meyer is now cancer free thanks to her treatment at St.
Ask the Expert: When are people referred to an
endocrinologist?The endocrine system is a complex group of glands.
Glands are organs that make hormones. These are substances that
help control activities in your body. Different types of hormones
control reproduction, metabolism (food burning and waste
elimi-nation), and growth and development. Hormones also control
the way you respond to your surroundings, and they help provide the
proper amount of energy and nutrition your body needs to function.
The glands that make up the endocrine system include the thyroid,
parathyroid, pancreas, ovaries, testes, adrenal, pituitary and
Medicare prescription drug coverageOpen enrollment for the
Medicare prescription drug benefi t, called Part D began October 15
and continues until December 7. This is the time anyone enrolled in
Medicare can change plans for drug coverage for 2013.
There are several plans to choose from in Iowa. Participants pay
a monthly premi-um and a portion of the cost of prescrip-tions. The
amount paid, drugs covered and pharmacy used depend on the plan
Types of plans Medicare contracts private companies to offer
prescription drug plans. One option is to receive medical benefi ts
and prescription drug coverage from the traditional Medicare
program and Medicare drug plan. The other is through joining a
Medicare Advantage Plan with drug coverage. Medicare Advantage can
be a Health Maintenance Organization (HMO), Preferred Provider
Organization (PPO), Point of Service Option (POS),
Private-Fee-For-Service plan (PFFS) or Special Needs Plan
Before choosing a plan, compare costs of your prescriptions with
the benefi ts provided by each. Youll want to com-pare premiums,
deductibles, medications covered, costs for prescriptions, coverage
during the gap and the pharmacies you can use.
The Senior Health Insurance Information Program (SHIIP) offers
free counseling at St. Lukes to help you compare Medicare Part D
choices. Call 319/369-7475 to schedule an appointment.
The ability to prevent the progression of chronic disease
inspires endocrinolo-gist Prasuna Rao Madhavaram, MD, who goes by
Dr. Rao. She began prac-ticing in the new endocrinology clinic at
Internists, PC, in November. The role of an endocrinologist is a
unique blend of both a healthcare provider and an educator. It is
essential to educate patients regarding their disease process. It
is possible to lead a productive and healthy life despite having
diseases like diabetes, but not taking them seriously can be
deadly, Dr. Rao said.
Dr. Rao recently moved to Cedar Rapids from Little Rock,
Arkansas, where she completed her fellowship in endocrinol-ogy at
the University of Arkansas for Medical Sciences and Central
Arkansas Veterans Health Care System. Dr. Rao,
IPC welcomes Endocrinologist Dr. Rao
along with her husband, Pavan Chepyala, MD, have two young sons,
ages 6 and 4 months. I know Cedar Rapids as a family- friendly city
and a great place to raise kids. My sister moved here two years ago
and strongly recommended it, Dr. Rao said.
In January 2013, Dr. Rao will open an obesity and weight
management clinic and is forming a strong weight-loss support team
to staff a full-fl edged obesity center. Obesity is an epidemic
affecting over half the U.S. adult population. Obesity increases
the likelihood of various health problems particularly heart
disease, type 2 diabetes, obstructive sleep apnea and
osteoarthritis, she said.
Hear Dr. Rao speak at the LiveWell event on Nov. 13. See back
page for details.
Flu and pneumonia shotsIts time to get your fl u (infl uenza)
and pneumonia (pneumococcal) vaccines. The good news is they can be
given at the same time. All adults should get the u vaccine. The
pneumonia vaccine is recommended for adults older than 65 and those
under 65 who smoke, have long-term health problems such as heart
disease, diabetes, asthma, etc. and those with a disease or
condition that lowers the bodys resistance to infection.
Call your family doctor or clinic to schedule an appointment for
Kerri Nowell, MD and Robert Brimmer, MD, Physicians Clinic of
Iowa general surgeons
During surgery, after the doctor removes the tumor, a radiation
oncologist applies a concentrated dose of electron beam radiation
directly to the tumor bed. A shield and cone protect skin and
healthy tissue from unnecessary radiation. In two minutes or less
patients receive radiation equal to fi ve to seven daily treatments
of traditional radiation, but with fewer side effects and a quicker
recovery. Afterwards, a patient will only need half the amount of
radiation treat-ments typically required. Studies show IORT offers
low recurrence rates because it treats the precise area where most
breast cancers recur.
For select women with early stage breast cancer, IORT may be an
alterna-tive to mastectomy, or lumpectomy with six to seven weeks
of radiation, said Dr. Brimmer. In rural Iowa, IORT could save
signifi cant drive time, stress and expense to cancer patients. It
is hard to see a woman choose to have a mas-tectomy because she
cannot tolerate the time commitment required of radiation therapy
after breast conservation.
To learn more about IORT, contact a St. Lukes Breast Cancer
Coordinator at 319/369-7216. Watch IORT technology in action at
Fast track home after hip surgeryOn a cold day in January,
billing specialist Jean Ann Holub, of Monticello slipped on a slick
spot of black ice in the parking lot at the offi ce where she
works. The next thing I knew I was face down and the left side of
my face slapped against the concrete parking lot, Holub said.
She reached for her purse and called 9-1-1. Soon, the ambulance
arrived and paramedics put Holub on a back board and took her to
St. Lukes. She was treated for a broken thumb and had back-to-back
surgeries for a broken hip and wrist, receiving numerous implants
of screws, plates and rods. After recovering from the surgeries,
she went to inpatient rehabilitation. I was in the hospital two
weeks and one day total, she said.
Holubs options when she was released from the hospital were to
go to a care facility for further therapy or go home and receive
home healthcare services. Because I work for the Visiting Nurse
Association (VNA), I was aware of the services available and I knew
I had to have their help and assistance to function and remain safe
in my own home, as I was considered a high fall risk, Holub
The VNA provided certifi ed nursing assistants, physical
therapy, occupational therapy and skilled nursing to assist Holubs
husband, Lyle, and their daughters in caring for Holub at home. A
van load of equipment was delivered to their home and a ramp was
installed. Holub was shown how to use the equipment safely and
properly, how to perform simple tasks without putting weight on her
injuries and how to strengthen her leg, hip, thumband arm. VNA
skilled nurses showed Holubs family how to care for her wounds and
monitor progress between appointments at the Wound Clinic.
They encouraged me at each visit to push myself a little more
and to make faster progress than on my own. It truly was a team
effort along with my husband, daughters, other family members and
the VNA staff, Holub said.
Julie Perrine, Holubs daughter, said, The care the VNA provided
was excellent. Scheduling their visits was effi cient. I can
honestly say the VNA team was another critical component to my moms
Call VNA at 319/369-7990 for a consultation.
Fast track home after hip surgery
Jean Ann Holub received healthcare services at home.
Prasuna Rao Madhavaram, MDendocrinologist, Internists, PC
You may need to see an endocrinologist if your hormone levels
are too low or too high or if your body isnt responding properly to
your hormones. An endocrinologist will diagnose your hormone
imbalances and work to restore them to normal.
Diabetes is the most common endocrine disease in the U.S. Other
major areas of endocrinology include: bone/osteoporosis, growth,
hypertension, lipid (cholesterol) disorders, obesity, pituitary
gland, thyroid, reproduction/ hirsute and cancer of the endocrine
Dr. Rao is welcoming new patients, please call 319/363-3565 to
schedule your appointment today.