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Archive for December, 2015

You Can Take Steps to Stop Congestive Heart Failure

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Hareeprasd Vongooru

Most of us are guilty of it. We’re not feeling well, but we can’t put our finger on it, so we put off going to the doctor. But when it comes to congestive heart failure, seeking treatment early on can have a big impact. Early and appropriate treatment may be able to stop the progression of congestive heart failure and improve your quality and length of life.

The key to managing congestive heart failure is intervening before you have reached progressive stages and require advanced therapies. Too often, we are finding patients are not receiving optimal medical therapy for heart failure beyond diuretics. Today, we have advanced diagnostic equipment that allows us to more effectively diagnose and monitor you so we can treat the underlying problem or administer advanced medications that allow us to manage your condition more effectively to prevent the need for a heart transplant or  left ventricular assist device (LVAD).

Dr. Vongooru is one of four board certified heart failure specialists at Nebraska Medicine. Brian Lowes, MD, Eugenia Raichlin, MD, and Ronal Zolty, MD, PhD, are the other heart failure certified specialists at Nebraska Medicine.

When should you see a heart failure specialist?

Dr. Vongooru recommends that you be referred to a heart failure specialist when you meet one or more of the following criteria:
•You have been classified with Class 3 or 4 heart failure and have limited exertional capacity.
•You have required two or more hospitalizations for your condition in the last six months.
•You require high doses of diuretics or have difficulty tolerating optimization of heart failure targeted medical therapy.
•You are have low blood pressure.
•You are having liver or kidney complications.

One of the largest areas of growth for the heart failure program has been the use of the LVAD. Traditionally, heart transplantation has been the gold standard of care for treating severe, end-stage heart failure. However, when transplantation is not a viable option due to advanced age, other concurrent medical conditions, or the increasing shortage of hearts suitable for transplantation, the LVAD has become a long-term option for many people with end-stage heart failure.

In a small, but growing number of people, use of the LVAD device has allowed them to recover from end-stage heart failure and forgo the need for a heart transplant.

The bottom line, no person is too sick or too healthy to be seen by our advanced heart failure cardiology team. There is a growing number of therapies available to help you no matter what stage of congestive heart failure you are in. We may be able to either slow the progression of the disease by optimizing the your medications or provide other interventions to extend your life.

Nebraska Medicine has the largest heart failure program in the state and the only United Network for Organ Sharing (UNOS) certified heart transplant center. Nebraska Medicine has also received certification for advanced heart failure and LVAD and is one of the top 10 programs in the country. The program performed 38 heart transplants in 2014 and 61 LVADs.

 

The Truth About Lung Cancer

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Alissa Marr, MD

There are many myths surrounding lung cancer, one of the deadliest of all cancers. While the death rate still remains very high for lung cancer, we are making tremendous strides in diagnosing and understanding the underlying genetic changes in the different types of lung cancer that are helping us provide new therapies that we hope will ultimately improve survival rates. Oncologist and lung cancer specialist Alissa Marr, MD, sheds some light on lung cancer.

Lung cancer is the number one cause of cancer-related deaths in both men and women.

True
Each year in the United States, more people die from lung cancer than from colon, breast and prostate cancers combined. Of the approximately 228,000 cases that are diagnosed each year, almost 70 percent result in death.

You will know when you have lung cancer.
False

A lack of symptoms often allows lung cancer to go undetected until it reaches advanced stages. Symptoms such as chronic cough, coughing up blood, shortness of breath, chest pain and unexplained weight loss -may be some of the symptoms that result from lung cancer.

Anyone can get lung cancer.
True
While smokers have a 10 to 30-fold increased risk of developing lung cancer, 15 percent or more of cases occur in people who have never smoked. Approximately 23,000 deaths occur annually among non-smokers in the U.S. Smoking cigars and pipes and exposure to second-hand smoke also increase one’s risk. Other non-smoking causes include radon and possibly exposure to diesel fumes, lead, arsenic, grain dust, farming chemicals or home cleaning products.

You may have radon in your home and not know it.
True
Radon is a colorless, odorless gas that’s a decay product found in soil and rocks and can get trapped in houses and buildings. It is estimated that one in 15 homes in the U.S. will have high radon levels. In Nebraska, that number is even higher. Approximately one out of every two radon tests conducted in the state have elevated levels of radon. You can get your house tested for radon with an in-home kit or by a certified service provider.  Winter is a good time to do testing as you get the best results when a closed home is maintained for 12 hours prior to and during the test.

Once you have been a smoker, you cannot reduce your risk for lung cancer.
False
It is never too late to quit. Smokers can gain an estimated six to 10 years of life by quitting smoking and will see a reduction in cancer risk within five years of kicking the habit and an estimated 80 to 90 percent risk reduction in 15 years.

There is no way to screen for lung cancer.
False
A low-dose CAT scan is offered at Nebraska Medicine. Screening CT scans can hopefully detect lung cancer at an early stage, when cure rates are much higher. The screening test is recommended for high-risk groups that includes individuals who are at least 55 years old; have a 30-pack history (equivalent to smoking one pack each day for 30 years or three packs each day for 10 years) and are either currently smoking or have quit within the past 15 years. Please discuss with your primary medical provider if you think you may qualify for this screening test.

Clinical trials may be the best treatment option.
True
Clinical trials are carefully monitored research studies that may give you access to potentially life-saving treatment. Nebraska Medicine participates in many clinical trials for lung cancer. Talk with your doctor about whether a clinical trial is the right treatment decision for you.

To learn more or to schedule an appointment with a physician, call (800) 922-0000.

Stroke Center Receives Fifth Consecutive Recertification

For the fifth consecutive time, Nebraska Medicine’s Stroke Center has been recertified by the Joint Commission as a Primary Stroke Center. The program has been certified by the Joint Commission since 2005 and was the first nationally certified stroke center in the state.

“This certification signifies that the services we provide have the critical elements to achieve long-term success in improving outcomes,” says Matt Pospisil, executive director of Neurology and Orthopaedic Services. “Nebraska Medicine’s Stroke Center has more neurovascular provider expertise than any other health system in the region including two vascular neurologists, a neuro hospitalist, stroke APRN, a neuro intensivist and is the only facility in the area with two fellowship-trained endovascular specialists.”

Nebraska Medicine Named Best in State

U.S. News & World Report Releases 2015-16 Best Hospitals

It’s happened again. U.S. News & World Report has named Nebraska Medicine – Nebraska Medical Center the state’s top hospital. The annual U.S. News Best Hospitals rankings, now in their 26th year, recognize hospitals that excel in treating the most challenging patients.

In rankings by state and metro area, U.S. News recognized hospitals that perform nearly at the level of their nationally-ranked peers in one or more specialties, as well as hospitals that excel in multiple common procedures and conditions.

Nebraska Medicine’s Nephrology and Urology programs ranked 43rd and 44th respectively.

“It’s very rewarding for everyone at Nebraska Medicine to receive this kind of recognition,” says Lisa Runco, executive director of Cardiology and Digestive Disease and Kidney. “It really speaks to the quality of care provided across our entire system.”

U.S. News publishes Best Hospitals to help guide patients who need a high level of care because they may face a particularly difficult surgery, a challenging condition or extra risk because of age or multiple health problems. Objective measures such as patient survival and safety data, adequacy of nurse staffing and other data largely determined the rankings in most specialties.

The specialty rankings and data were produced for U.S. News by RTI International, a leading research organization based in Research Triangle Park, N.C. U.S. News used the same data, as well as the new Best Hospitals for Common Care ratings, first published in May, to produce the state and metro rankings.

The rankings are available at http://health.usnews.com/best-hospitals and will appear in the U.S. News “Best Hospitals 2016” guidebook, available in August from the U.S. News Store.

75 Percent of Top Cancer Doctors in State are at Nebraska Medicine

When you’re battling cancer, you want to know you’re receiving care from the best. Now you can be sure. According to Newsweek’s list of “Top Cancer Doctors 2015,” 75 percent of the top cancer doctors in the state are at Nebraska Medicine.

“This recognition reinforces the commitment we have made to quality cancer care with the building of the Fred and Pamela Buffett Cancer Center and the world-class physicians that are leading this effort,” says Theresa Franco, Vice President, Cancer Center Clinical Operations. “It is an honor to work with such talented individuals who successfully integrated research, clinical care and education to provide the most comprehensive cancer experience for our patients.”

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“These rankings speak volumes for the quality of our program and emphasize the importance of the world-class facility that we are building,” says Jeffrey P. Gold, UNMC chancellor and chair of the Nebraska Medicine Advisory Council. “We are thrilled that so many UNMC and Nebraska Medicine physicians have been identified as among the country’s best in the field of cancer care.”

“Nebraska Medicine is unique in its collaboration among physicians and scientists that allows us to offer the latest cutting edge treatments to our patients,” says Sarah P. Thayer, MD, PhD, associate director for Clinical Affairs and physician-in-chief at the Fred & Pamela Buffett Cancer Center and chief of the Division of Surgical Oncology. “The high quality and level of caring provided by our physicians side-by-side with of our staff of nurses, therapists, techs and many other members of our team, reflect our dedication to providing the best in cancer care to our patients.

“When the Fred & Pamela Buffett Cancer Center project was launched, we committed to attracting the best physicians to provide the very best care for patients here in Nebraska,” says Kenneth Cowan, MD, PhD, professor of oncology at the Eppley Cancer Institute and director of the Fred & Pamela Buffett Cancer Center. “We are actively engaged in recruiting top physicians who are at the forefront of cutting-edge, compassionate cancer care, and will continue to recruit outstanding physicians to join the Cancer Center after it opens in early 2017.”

“Nebraska Medicine and the Fred and Pamela Buffett Cancer Center are very fortunate to have so many of the Top Cancer Doctors in the 2015 Newsweek list,” says Julie Vose, MD, chief of the hematology/oncology division in the UNMC Department of Internal Medicine and associate director of clinical research and co-chair of the lymphoma program at the Fred & Pamela Buffett Cancer Center. “This is an excellent example of combining the best patient care with education and research to optimize cancer care for the region.”

This list was compiled through peer nominations and extensive research conducted by a physician-led research team with Castle Connolly Medical LTD., the publisher of America’s Top Doctors. Each year, Castle Connolly receives nearly 100,000 nominations via this process. Doctors at Nebraska Medicine comprise 15 of the 20 doctors chosen. See list below.

Learn more about this recognition and the doctors who made the list. •Alison Freifeld, MD, infectious disease
•Carl Greiner, MD, psychiatry
•Daniel Lydiatt, MD, head and neck surgery, otolaryngology
•James Armitage, MD, hematology/oncology
•James Edney, MD, surgical oncology
•James Gigantelli, MD, ophthalmology
•Jean Grem, MD, medical oncology
•Julie Vose, MD, hematology/oncology
•Kenneth Cowan, MD, medical oncology
•Peter Coccia, MD, pediatric hematology/oncology
•Philip Bierman, MD, hematology/oncology
•Russell Smith, MD, head and neck surgery, otolaryngology
•Sarah Thayer, MD, surgical oncology
•Steven Remmenga, MD, gynecologic oncology
•William Lydiatt, MD, head and neck surgery, otolaryngology

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