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Archive for October, 2015

The Programs That Make Us Great

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News and World Reports recently ranked Nebraska Medicine as one of the best hospitals in the country for its expertise in six adult specialties: cancer care, gastroenterology and GI surgery, nephrology, neurology and neurosurgery, pulmonology and urology. This is the best performance for the hospital in terms of national recognition in these rankings.

In a series of blog posts, the experts from each nationally-ranked department will highlight what makes Nebraska Medicine a leader in providing care to its patients.

For the third year, U.S. News & World Reports ranked The Nebraska Medical Center as a “Best Hospital for Pulmonary Care.”

In our pulmonary division, we’ve worked hard to meet our patients’ needs throughout the region—eastern Nebraska, western Iowa, South Dakota, and Kansas. We handle a great deal of general pulmonary care, like chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis, bronchitis, shortness of breath, and cough.

Our national reputation is based on several well-established programs that are vital to treating patients with the most complex pulmonary problems, including:

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Joe Sisson, MD

Pulmonary Hypertension Program

Our pulmonary hypertension clinic, under the leadership of Austin Thompson, MD, is known nationally. We diagnose and treat very sick patients who need specialty care for this condition. Pulmonary hypertension (PAH) is shortness of breath during routine activities—caused by increased pressure in arteries that carry blood from your heart to your lungs.

Many people in this region suffer from PAH, and we are the primary regional referral center for these patients. Our nurse case manager works very closely with Dr. Thompson to treat each PAH patient. Also, our PAH patients are often enrolled in clinical trials, which is very important since these trials offer novel treatments to our patients who have not responded to conventional medications.

Adult Cystic Fibrosis Center

Our adult cystic fibrosis (CF) program, led by Peter (Jim) Murphy, MD, is unique in this region, as we handle growing numbers of adult patients. CF patients are living much longer today, thanks to excellent patient care. Now they’re having children of their own—and we can and often treat the whole family. We are a certified Adult CF center and are recognized by the National Cystic Fibrosis Foundation as a high performing benchmark program. In fact, our team travels to other CF centers in the nation to help improve their patient outcomes—in lung health maintenance as well as nutrition.

Critical Care Medicine (CCM)

At The Nebraska Medical Center, our intensive care units (ICU) are staffed with critical care specialists called intensivists. Many of our patients aren’t familiar with that term. Essentially, it means we are specialists in treating critically ill patients in the intensive care unit. Our CCM teams manage life-and-death situations—including talking with anxious patients and their families.

Our Division’s critical care specialists, in partnership with intensivists from anesthesia, lead three CCM teams who work closely with heart surgeons, neuro surgeons, neurologists and other specialists to manage their critically ill patients while they require intensive care. The CCM teams guide the patient’s overall care including supporting lung function with ventilators, administering IV fluids & medications, providing nutrition and getting patients up and walking. This proactive and team-based approach to the care of critically ill patients helps prevent infections, blood clots, pneumonia and other complications. That is why our shared patients have very good outcomes—and a key part of why our hospital ranking is high.

But that’s not all…our allergy, sleep and pulmonary services are growing.

Allergy

Our well-established allergy program is growing. We have a nationally recognized allergy specialist, Jill Poole, MD, who is an expert at developing region-specific allergy testing and treatments for adults. We will expand our allergy program in the summer of 2015 when a second allergist joins Dr. Poole allowing us to reach more adult and pediatric patients with our allergy clinics.

Sleep

Our busy sleep laboratories and clinics will soon be more visible in the Omaha community, as we expand our sleep program. Our sleep patients typically suffer from complex problems, and that’s where our sleep medicine experts excel. With our certified sleep laboratory, continued program development, and collaboration with other specialties such as otolaryngology, we are investigating new and innovative solutions for these complex sleep disorders.

Lung Transplantation

We will add lung transplantation to our portfolio in early 2015. This is especially exciting because no other facility in our region can provide this option for their severely ill pulmonary patients. Lung transplantation will be an important new dimension for our other pulmonary programs and will round out the types of organ transplantations offered at The Nebraska Medical Center.

As you can see, our Pulmonary, Critical Care, Sleep and Allergy division is rising in the U.S. News & World Report “Best Hospitals” rankings for good reasons. We’re proud of the progress we’re making.

New Radiosurgery Technology Provides Improved Speed and Accuracy

Advancements in radiosurgery technology continue to improve the speed and accuracy in which radiation treatment can be delivered to treat challenging malignant cancer tumors. Nebraska Medicine recently became the first in the region to adopt the Varian TrueBeam STx radiosurgery system, which opens the door to new possibilities for the treatment of difficult to treat cancers like those in the brain, spine, lung, liver, pancreas and prostate.

Charles-Enke

“This technology is designed to do stereotactic radiosurgery and stereotactic body radiation therapy with greater speed and precision than possible with other systems,” says Charles Enke, MD, radiation oncologist at Nebraska Medicine. “This is two generations beyond our current Novalis stereotactic system with accuracy measured in increments of less than a millimeter. While most radiosurgery systems use up to two targeting systems, our institution has added a total of four additional targeting technologies to improve treatment accuracy.”

The TrueBeam STx can deliver treatments up to four times faster than other radiosurgery systems. Radiosurgery treatments that may typically take 30 to 60 minutes to administer, may now take just five to 20 minutes, depending on the type and location of the tumor being treated, notes Dr. Enke. This provides a more comfortable experience for the patient and less chance for tumor movement during the treatment. “Ongoing studies are showing that higher doses per treatment delivered over fewer treatments may be more effective,” says Dr. Enke, “especially in areas such as prostate and lung cancer.”

For tumors that are subject to movement such as in the lung, liver and prostate, the system offers a respiratory-gated treatment feature that allows the machine to deliver a continuous treatment of radiation while rotating around the patient and compensating for movement of the tumor while the dose is being delivered. The radiation beam is shaped and reshaped as it is continuously delivered from many different angles, improving accuracy and reducing treatment time. It also uses a more sophisticated method of calculating radiation dose which is much more accurate than current dose calculation algorithms. This is very important when treating sensitive areas such as in the head and lung.

“While we offer single fraction intraoperative breast radiation for appropriately-selected patients, this is an excellent option for women with left-sided breast cancers who are not eligible for intraoperative breast radiation,” advises Dr. Enke.

The system also provides other benefits to breast cancer patients. Not only can TrueBeam STx shorten the treatment course by half, but it also offers a dependent breast positioning technique that allows the patient to lay on her stomach rather than her back. This enables the system to deliver radiation while the breasts are falling away from the patient, which can help minimize radiation to healthy tissues and organs like the heart and lungs, says Dr. Enke.

“The TrueBeam STx represents a significant advancement in radiation technology this is specifically designed for to deliver radiation very quickly and in fewer treatments with greater precision than we have ever had at our disposal,” says Dr. Enke. “We believe this will result in better outcomes for our patients.”

Hope for Stroke Patients: Recent Treatment Advances Offer Better Chances for Recovery

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Stroke is a severely debilitating disease that can permanently change the lives of patients and their families. Everyone knows a family member or a friend whose life has been permanently changed by stroke. Stroke is a very common disease around the world. Every year more than 795,000 people in the United States will suffer a stroke and more than 130,000 will die as a consequence of stroke. In Nebraska, stroke is the fourth leading cause of death and more than 36,000 people live with stroke. Despite these frightening numbers there is hope for stroke patients.

Stroke prevention

The best way to prevent a stroke is to take care of yourself. More than 90% of strokes are the result of poorly controlled medical conditions. Avoid tobacco, control your weight, watch your diet, exercise and follow up regularly with your primary care physician. Work closely with your doctor to control your high blood pressure, diabetes, high cholesterol or heart disease. Just by reducing your blood pressure by 10 points you can decrease your chance of having a stroke by one-third. Controlling the other risk factors will decrease your chances even further.

Sudden signs of stroke: remember them easily with “FAST”

Stroke can present in many different ways: confusion, severe headache, dizziness, double vision, facial droop, difficulty swallowing, arm or leg numbness or weakness, sudden loss of balance, inability to speak and slurred speech all are symptoms of stroke. One easy way to remember the sudden signs of stroke is by using the F.A.S.T. acronym. F is for facial droop, A is for arm weakness, S is for speech difficulties and T is for time to call 9-1-1. If you think you or a loved one is having a stroke, the best course of action is to call 9-1-1. Patients who call 9-1-1 arrive faster to the nearest hospital capable of treating stroke and have better chances of receiving treatment.
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Stroke types and treatments

There are two major types of strokes: ischemic and hemorrhagic. Ischemic strokes are by far the most common type in the United States and in Nebraska. An ischemic stroke is usually the result of a blockage in a blood vessel, whereas a hemorrhagic stroke is due to a blood vessel rupture. Treatment is different for each type; however rapid treatment is essential in both.

Since 1996, the only FDA approved treatment for acute ischemic stroke has been to administer alteplase. This is a medication that is given to patients with an ischemic stroke who arrive to the Hospital within 4 ½ hours from the onset of symptoms. Patients who receive this drug have a 33% increased chance of being independent or less disabled at three months after their stroke, when compared with people who did not receive the drug. In the last six months there have been significant advances in the treatment of acute ischemic stroke. Five new studies show that patients who suffered a large stroke and were treated with new devices called stent retrievers – within 6 hours of onset, in an experienced stroke center – have a 33% to 71% percent chance of regaining independence or experiencing less disability at three months.

New, advanced treatment options available at Nebraska Medicine

Nebraska Medicine has the capacity to offer these novel treatments to stroke patients who qualify. We are also working to make these crucial advancements in treatment options available to more people in Nebraska and neighboring states by establishing a telestroke network with hospitals throughout the state. Telestroke brings neurology expertise to bedside of community hospitals. Working together, the neurologist and emergency department physician collaborate on the most appropriate treatment for the stroke patient. This program will provide local emergency rooms with 24- hour access to stroke neurology expertise and the advanced treatment options available at Nebraska Medicine.
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‘Raise that beam!’

by John Keenan, UNMC public relations
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A Kiewit representative helps Emily Stephenson, 3, and sister Julia, 5, signal for the beam-raising as their mom, Amy Stephenson, looks on with UNMC Chancellor Jeffrey P. Gold, M.D.

“Raise that beam!”

With that cry from 3-year-old Emily Stephenson — echoed by her 5-year-old sister, Julia — the first signed beam was raised to the top of the Fred & Pamela Buffett Cancer Center.

For a photo album of the beam raising, click here.

Emily Stephenson, who her mother said is being treated at Nebraska Medicine for a blood disorder, may have been the tiniest VIP in attendance, but she was as enthusiastic as any of the other cancer center supporters.

See beam signings throughout Nebraska here.

Omaha Mayor Jean Stothert was on hand to extend congratulations on the construction milestone, saying the tower cranes on the Omaha skyline point to “a future of growth.”

See campus leaders discuss the impact of the Fred & Pamela Buffett Cancer Center here.

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The signed beam, with the U.S. flag attached, is hoisted to the top of the Fred & Pamela Buffett Cancer Center.

Calling the project “a commitment to save lives,” Mayor Stothert said the Fred & Pamela Buffett Cancer Center will provide important job opportunities before and after the building is completed, adding $500 million to the local economy.

Speaking before the beam-raising, UNMC Chancellor Jeffrey P. Gold, M.D., welcomed faculty, staff, donors and local officials, including Mike Yanney and Gail Walling Yanney, M.D.; Ruth Scott; representatives from the Cattlemen’s Ball; Omaha City Council members Pete Festersen, Chris Jerram and Ben Gray; state Sens. Jim Smith, Merv Riepe, Sue Crawford, Al Davis, Bob Hilkeman, Rick Kolowski and Mark Kolterman; and former U.S. Sen. Ben Nelson and others.

“This is truly a great day for our campus,” Dr. Gold said. “This facility represents how health care will be delivered in the future, and also how our campus will integrate clinical care, discovery and education, all for the benefit of our patients. It’s really an exciting day.”

Ken Cowan, M.D., Ph.D., director of the Fred & Pamela Buffett Cancer Center, pointed out that it would only be 18 more months before the group gathered again for the center’s opening.

signed0812Nebraska Medicine staff and UNMC faculty, staff and students, came out — along with donors, campus and community leaders and other supporters — to sign the beams and see them raised.
“Tremendous progress has been made, and every day we are closer to this state-of-the-art cancer center that will really transform Nebraska, the region and the country,” Dr. Cowan said.

Nebraska Medicine interim CEO Rosanna Morris said that when the Fred & Pamela Buffett Cancer Center opens, “it will have everything our cancer center patients need, all in one place. How do we know? Because we’ve involved physicians, researchers, staff members and — most importantly — cancer patients in every aspect of the design of the facilities.

“We know, and they know, that curing cancer is not just about eradicating cancer cells,” she said. “It’s about so much more. It’s about treating the whole person – mind, body and spirit.”

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