AdvantageFall 2012
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LiveWell update
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 don’t receive IORT typically require six weeks of whole-breast radiation.”
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 overwhelming.”
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. It’s a new technique and is now available at St. Luke’s 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. “We’re 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 you’ve 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 Foundation
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 treatment options.
All events are free. Classes are held at St. Luke’s 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. Luke’s new website stlukescr.org.
It offers:
Results. It’s easy to fi nd what you need, thanks to our new search feature.
Online chats. Ask hospital departments questions about your medical records, upcoming events and classes, St. Luke’s job opportunities and more.
St. Luke’s Heart Scan can help men and women between the ages of 40 and 70 identify their risk for heart disease. All that’s needed is a doctor’s referral.
Call 319/369-8909 to learn more or schedule yours.
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$99 Heart Scan
News and events. You’ll 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 the go!
St. Luke’s new technology reduces treatment time for select cancer patients.
New procedureIORT uses specialized equipment to deliver a single, targeted dose of radiation to a tumor site during surgery. St. Luke’s 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’ we’ve had up to this point, and the best part is the desired effect is the same – to get rid of the cancer.”
Imagine receiving radiation during surgery to the precise site where your tumor was just removed. St. Luke’s 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 radiation
Jody Meyer is now cancer free thanks to her treatment at St. Luke’s.
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 hypothalamus.
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 chosen.
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 (SNP).
Before choosing a plan, compare costs of your prescriptions with the benefi ts provided by each. You’ll 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. Luke’s 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 shotsIt’s 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 fl 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 body’s resistance to infection.
Call your family doctor or clinic to schedule an appointment for your vaccinations.
Kerri Nowell, MD and Robert Brimmer, MD, Physicians’ Clinic of Iowa general surgeons
IORT continued
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. Luke’s Breast Cancer Coordinator at 319/369-7216. Watch IORT technology in action at stlukescr.org/radiationtherapy.
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. Luke’s. 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.
Holub’s 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 said.
The VNA provided certifi ed nursing assistants, physical therapy, occupational therapy and skilled nursing to assist Holub’s 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 Holub’s 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, Holub’s 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 mom’s overall recovery.”
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 isn’t 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 glands.
Dr. Rao is welcoming new patients, please call 319/363-3565 to schedule your appointment today.
