Archive for the ‘Articles’ Category

U.S. News Ranks Nebraska Medical Center as the Best Hospital in Nebraska

U.S. News & World Report evaluates nearly 5,000 hospitals nationwide to come up with their annual list of Best Hospitals. And once again, for the seventh straight year, Nebraska Medical Center is the No. 1 rated hospital in the state. Additionally, the Nebraska Medical Center Gynecology Program received a national ranking, the only hospital in the state to have a nationally ranked specialty.

U.S. News also rated Nebraska Medical Center as high performing in eight other specialties, receiving more high-performing rankings than any other facility in Nebraska. Those specialties are:

  • Cancer
  • Gastroenterology and GI Surgery
  • Geriatrics
  • Nephrology
  • Neurology and Neurosurgery
  • Orthopaedics
  • Pulmonology
  • Urology

Finally, the medical center received the highest ranking possible in five procedures/conditions:

  • Abdominal Aortic Aneurysm Repair
  • Colon Cancer Surgery
  • Heart Bypass Surgery
  • Heart Failure
  • Hip Replacement

“This ranking is because of the dedication of our physicians, caregivers and staff who care for patients every day. I have the highest respect for their commitment,” says CEO James Linder, MD. “To again earn this recognition reflects our belief that continual improvement allows us to provide the highest quality services for the people of Nebraska, the surrounding region, and referred patients from around the world. My thanks to everyone at Nebraska Medicine who makes this possible.”

The annual Best Hospitals rankings, now in their 29th year, are designed to assist patients and their doctors in making informed decisions about where to receive care for challenging health conditions or for common elective procedures.

For the 2018-19 rankings, U.S. News evaluated medical centers nationwide in 25 specialties, procedures and conditions. In the 16 specialty areas, 158 hospitals were ranked in at least one specialty. In rankings by state and metro area, U.S. News recognized hospitals as high performing across multiple areas of care.

The U.S. News Best Hospitals methodologies in most areas of care are based largely or entirely on objective measures such as risk-adjusted survival and readmission rates, volume, patient experience, patient safety and quality of nursing, among other care-related indicators.

Nebraska Medical Center Earns Chest Pain Accreditation

Nebraska Medical Center has again earned full accreditation as a Chest Pain Center with Primary PCI (percutaneous coronary intervention) from the American College of Cardiology (ACC). The designation is awarded based on a rigorous on-site evaluation of the staff’s ability to evaluate, diagnose and treat patients who may be experiencing a heart attack.

PCI is also known as a coronary angioplasty. It is a non-surgical procedure that opens narrowed or blocked coronary arteries with a balloon to relieve symptoms of heart disease or reduce heart damage during or after a heart attack.

Hospitals that have earned ACC Chest Pain Center with Primary PCI Accreditation have proven exceptional competency in their ability to integrate evidence-based science, clinical best practices, and the latest ACC/AHA guidelines to deliver consistent, reliable, safe, and high-quality care to heart and vascular patients.

“This designation is an important distinction for Nebraska Medicine and is especially relevant in our journey in becoming a highly reliable organization,” says Melissa Lederer, manager, Heart and Vascular Quality and Outcomes. “The ACC’s framework has allowed us to demonstrate our commitment and continued efforts around performance improvement, standardization, education, and community outreach. The end result is a dedicated team providing state-of-the-art heart and vascular care to patients presenting with heart attack symptoms. I am extremely proud of the Chest Pain team for their effort and dedication to improving outcomes for this patient population.”

According to the Centers for Disease Control and Prevention (CDC), more than 735,000 Americans suffer a heart attack each year. The most common symptom of a heart attack for both men and women is chest pain or discomfort. However, women are more likely to have atypical symptoms. Other heart attack symptoms include, but are not limited to, tingling or discomfort in one or both arms, back, shoulder, neck or jaw, shortness of breath, cold sweat, unusual tiredness, heartburn-like feeling, nausea or vomiting, sudden dizziness and fainting.

New Radioactive Cancer Drug Available at Nebraska Medicine

Marilyn Cody became the first Nebraska Medicine patient to receive Lutathera, a newly approved radioactive cancer drug, which is flown in from Italy.

Marilyn Cody loves being outside on her 400-acre farm and hopes her new cancer drug treatment will allow her to continue to mow and garden.

Marilyn Cody may be one of the most optimistic people you’ll ever meet.

“I rely on God, my church and my family – you just have to have faith!”

After losing her husband, sister, son and son-in-law, to different forms of cancer, the 74 year old was diagnosed with stage 4 liver cancer. Cody underwent surgery and chemotherapy, which prolonged her life for four years. Until recently, the Griswold, Iowa, woman thought she was out of options – until her team at Nebraska Medicine suggested a new therapy.

“I like being the guinea pig,” smiles Cody.

On June 14, Cody became the first Nebraska Medicine patient to receive Lutathera, a newly approved radioactive cancer drug, which is flown in from Italy. It’s used to treat a type of cancer that affects the pancreas or gastrointestinal tract, called gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

“This is one of the newest types of drugs, which are directed at specific molecules on the cancer cells,” explains radiologist Neil Hansen, MD. “It’s radiation, but it goes inside the patient, gets targeted directly to the cancer, and hones in on that cancer to deliver it without the side effects of radiation to other parts of the body.”

“I feel so much better with this therapy,” adds Cody. “Chemotherapy was hard, but this is better.”

Because the drug is radioactive, radiation safety officers are there to monitor the risk of radiation exposure. The nurses also have a device that measures the amount of radioactivity in the room, emitting from the patient.

“We have a great team here – our infusion nurses, radiation safety officers and nuclear medicine technologists; everyone is on board and we’ve kept the dose very safe,” says Dr. Hansen.

Cody will receive the treatment three more times – in August, October and November. She’s hopeful it will give her extra years with her family, and the ability to do the things she loves the most such as gardening and mowing the lawn.

“I live on a farm with 400 acres, so I love being outside,” says Cody. “With this treatment, I really do think it will prolong my life. I just have to go for it.”

“This is the future of medicine,” adds Dr. Hansen. “We have a big neuroendocrine tumor clinic here at Nebraska Medicine and this is going to be a great therapy for those who don’t have a lot of options. It’s an exciting time.”

To learn more, watch this story from KMTV.

 

Enhancing Sexual Health After Cancer

Christofer-Deibert-Urology-2015.jpg
Christopher Deibert, MD, urological surgeon

Receiving a cancer diagnosis can be difficult for anyone to endure. But even after treatment is over, some people may still have to deal with the lingering health effects that cancer treatments may cause.

Cancer can dramatically change a person’s life. It can affect your self-image. It can physically change your body’s appearance. It can suppress your sexual desire, and for men, it can reduce testosterone production. All of these can lead to erectile dysfunction (ED).

Cancers in the pelvic area such as the prostate, bladder, rectum or colon, typically have the greatest impact on a man’s sexual health. That’s because surgery or radiation therapy for these cancers are more likely to affect the nerves and blood vessels that are responsible for an erection. Some chemotherapies can also cause some degree of ED. These issues can be short or long term. If nerves are damaged during surgery, sometimes they may heal with time and your ED issue will be resolved.

The good news is in many cases, we can improve the situation with one of several treatments.

When I evaluate a man for ED after they’ve completed cancer treatment, I like to discuss the types of changes they are experiencing and try to quantify these. The type of cancer treatment you received, as well as any history of diabetes or high blood pressure are also discussed. This includes physical changes, sexual desire and erectile issues. I may recommend testosterone testing to determine if it’s a hormonal problem.

At the Nebraska Medicine Men’s Health Program, we can offer many options to help you. Sometimes putting men on testosterone replacement therapy is all that is needed. However, if ED is not due to decreased testosterone production, there are other possible treatments. Oral medications that fall into a class of drugs called phosphodiesterase inhibitors (Viagra and Cialis), can relax muscles and increase blood flow to the penis, making it easier to get an erection and maintain it. Another procedure involves a vacuum erectile device that slides over the penis. The device pulls air out of the cylinder, which helps pull blood into the penis. A suppository can be placed inside the penis to stimulate an erection or medication can be injected with a tiny needle into the penis. If none of these medical options are effective or they have stopped working, surgery may be an option. Surgery involves the placement of a prosthetic implant inside the penis that includes an activation pump that will produce an erection when activated.

As part of the treatment and recovery process, men need to recognize that they may experience significant sexual changes and these need to be discussed with their doctors. I also encourage men to have frank, sexual-intimacy conversations with their partners. They should discuss how their body image has changed, what their desires and expectations are and how they feel mentally and physically. Sometimes intimacy in the relationship may change but it can still be meaningful even if it doesn’t look the same. When this is discussed with their partners, and both understand these issues, many couples can continue to have a deep and rich intimate relationship.

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

About the Author

Christopher Deibert, MD, urological surgeon
Urological surgeon, co-director, Men’s Health Program

Pancreas Disease Program Expands beyond Omaha Metro

Luciano Vargas, MD

The Pancreas Disease Program continues to grow and is now expanding outside of the greater Omaha metro. Patients in Hastings, Nebraska, and the surrounding area, can receive expert and specialized care for complex hepatobiliary diseases at the Nebraska Medicine Liver and Pancreas Diseases Clinic at Mary Lanning Healthcare.

Surgical director, Luciano Vargas, MD, and Shaheed Merani, MD, are spearheading the clinic, which specializes in the clinical evaluation and surgical management of liver, pancreatic and biliary disorders. The goal of the clinic is to limit undesired travel for patients and to offer diagnostic, evaluative and follow-up appointments close to home.

“Aside from being in much closer proximity to patients living in the Hastings area, our outreach clinic allows patients to meet their physicians prior to coming to Omaha in the event that their treatment plan requires a surgical procedure that cannot be performed at Mary Lanning,” says Dr. Vargas. “This helps decrease anxiety when patients do need to travel to Omaha for follow-up care.”

Shaheed Merani, MD

Drs. Vargas and Merani are the only specialty-trained liver and pancreas surgeons in the tri-city region (Hastings, Grand Island and Kearney). Physicians with patients in the area who need liver, biliary and pancreatic surgical evaluation or for those who have patients seeking a second opinion can refer their patients to the clinic.

The Liver and Pancreas Diseases Clinic is an expansion of the Pancreas Disease Program, the only program in the region that is recognized and designated as a National Pancreas Foundation Center. Drs. Vargas and Merani are currently at the outreach clinic on the second and fourth Thursdays of the month.

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Epilepsy Program Expands to Meet Growing Patient Needs

deepakmadhavan_0.jpg
Deepak Madhavan, MD, epilepsy specialist

The Nebraska Medicine Epilepsy Program is expanding. The program will be adding three new neurologists who are fellowship-trained in epilepsy care in July, and will soon be opening a new clinic in the Bellevue community.

It is estimated that more than 20,000 people in Nebraska have epilepsy and approximately 6,000 of these people have intractable epilepsy, which means they need specialized care beyond medications to control their seizures.

We don’t have enough epilepsy specialists in the state to handle the volume of patients in Nebraska and the surrounding area. This expansion will allow us to see more patients in a more timely fashion.

Timelier Appointments Now Available
The recent expansion of our staff is allowing us to make timelier appointments for you. To schedule an appointment with one of our epilepsy specialists, please call us at 800.922.0000.

The Nebraska Medicine Epilepsy Program is the largest and most comprehensive epilepsy program in the state and region, and follows more than 3,000 patients. Nebraska Medical Center was designated as a Level 4 Epilepsy Center by the National Association of Epilepsy Centers, providing the highest level of care to patients with seizures and epilepsy. Level 4 centers use a multidisciplinary approach and offer intense neurodiagnostic monitoring and treatment methods including medications and surgical options.

Patients who come here have access to specialty medications, social work, nurse case management, neuropsychology, neurosurgery, registered dietitian-provided diet options and community resources.

We have always been at the forefront of offering the newest and most advanced technology as well as clinical trials with the goal of helping our patients become seizure-free and improve their quality of life.

Approximately 55 percent of patients can become seizure-free with the proper medications.  Approximately 35 percent will need surgery combined with medications, and the remaining 10 percent will see significant improvement but may still experience some seizures. In addition to expanding its staff, the program will also be adding additional services and technology to help the most difficult-to-treat cases.

The epilepsy monitoring unit at Nebraska Medical Center, which uses EEG monitoring to diagnose epilepsy patients, will be expanding the number of available beds from six to eight and will be offering more high-level diagnostic procedures.

The epilepsy program currently offers an implantable responsive neurostimulator for people with intractable epilepsy that works similar to a heart pacemaker. The stimulator monitors brain waves at the focal point of where the seizure begins. When it senses unusual electrical activity that can lead to a seizure, it emits small pulses of stimulation that help interrupt the activity before it becomes a seizure.

Responsive neurostimulation has been shown to reduce the incidence of seizures by 50 percent in the first year and by as much as 75 percent in the fourth and fifth years.

The technologies and treatment methods we offer provide much promise for people with the most severe cases of epilepsy. Our goal is to achieve freedom of seizures for everyone.

About the Author

Deepak Madhavan, MD, epileptologist
Epileptologist, medical director of the Epilepsy Program

The Global Game-changer Ready for Next Chapter

Nizar Mamdani, executive director, International Healthcare Services, has truly seen the world. Born in Tanzania, Africa, educated in Tokyo, Japan, and fluent in seven languages, Mamdani has spent nearly the past two decades building the medical center’s international presence.

Nizar Mamdani, executive director, International Healthcare Services

It started in 1999 when Mamdani’s wife, Nancy, was battling non-Hodgkin lymphoma when they were living in Atlanta, Georgia.

Her cancer was advanced. She received two rounds of chemotherapy at Emory University Hospital in Atlanta, but the cancer had returned. Her only hope was a peripheral stem cell transplant.

A successful international businessman, Mamdani checked out three of the leading cancer centers in the country – Johns Hopkins, MD Anderson and Memorial Sloan Kettering – to find the best place for his wife.

A physician at Memorial Sloan Kettering said there was only one physician who could possibly help her. His name was James Armitage, MD, and he was located at UNMC and Nebraska Medicine.

The Mamdanis came to Omaha, Nebraska, but unfortunately, Nancy’s cancer was too far along to allow for a transplant. She was in and out of the hospital over a 16-month period before passing away.

Despite the sad ending, Mamdani was impressed. He knew the medical center had a world-class cancer program. The world just didn’t know it.

Using his international connections, Mamdani offered to spread the word around the globe. He was named executive director for International Healthcare Services for Nebraska Medicine and made a five-year commitment to get the job done.

Traveling tirelessly, he established partnerships with 133 institutions in 45 countries. He brought in hundreds of patients from 57 countries for treatment. He generated tens of millions of dollars of business for the medical center.

“It’s very competitive internationally,” Mamdani says. “It’s all about relationships.”

The five-year commitment came and went. He loved the job. He wanted to keep going. He also found an amazing woman, Marsha Davidson, PhD, and they tied the knot 13 years ago.

With his 73rd birthday approaching in two months, Mamdani has decided it’s time for the next chapter. He will retire at the end of this week.

“I have been blessed to work with the most fantastic and caring physicians, nurses, health care professionals, colleagues and in particular, my dedicated and compassionate co-workers, Mohammed Al Kadhim and Ana Chavez,” says Mamdani. “They went out of their way to help me and our international patients. You develop such a bond – they become a part of your family. Many of these patients have become my lifelong friends. I will truly miss them and working at this great institution.”

“He’s done an amazing job,” says Dr. Armitage. “He’s done things that others couldn’t do. He placed articles on UNMC in international publications. He brought in a large number of foreign referrals that pay at a higher rate than most U.S. patients. But, more than that, he’s an exceptionally good person. He’s been a great friend.”

One Busy Man

Active on numerous charitable organizations, Mamdani is CEO of First Sight, a nonprofit that provides visual screening and prescription eyeglasses at no cost to needy individuals around the world. In the past few years, First Sight distributed 80,000 eyeglasses. Since 2005, Mamdani also has served as president of eTransMed, a medical documentation company. Among his numerous accomplishments at Nebraska Medicine and UNMC, Mamdani has:

  • Travelled to 57 countries to market Nebraska Medicine and UNMC internationally
  • Put Nebraska Medicine and UNMC’s name on the world map as an exceptional international patient referral center
  • Provided no-cost training and observational/educational programs for more than 100 health care specialists from 26 countries
  • Facilitated a lucrative paid training program for health care professionals from partner institutions
  • Provided personalized patient care services to international patients visiting Nebraska Medical Center
  • Hosted hundreds of professionals, dignitaries, diplomats and country leaders
  • Arranged and accompanied more than 20 visits for medical center health care teams to participate in conferences in nine countries
  • Participated in more than two dozen international conferences and exhibitions showcasing Nebraska Medicine and UNMC
  • Established an electronic second opinion program

UNMC-chaired Pan Pacific Lymphoma Conference in 24th year

Julie Vose, M.D.

UNMC’s lymphoma program continues to have an impact internationally.Just one of the areas is the Pan Pacific Lymphoma Conference, which UNMC faculty have chaired since its inception in 1994. The goal is to provide clinicians with the latest evidence in lymphoma to improve disease management and ultimately patient outcomes.

The conference, which is co-chaired by Julie Vose, M.D., James Armitage, M.D., and Matthew Lunning, D.O., of UNMC, will include presentations by internationally recognized speakers. Registration for the conference, which will be held July 16-20 at the Hyatt Regency Maui Resort & Spa in Hawaii, is now open.

“The conference has provided educational updates on lymphoma care and research to thousands of physicians and health care providers from around the world over the last 24 years,” said Dr. Vose, Neumann M. and Mildred E. Harris Professorial Chair and chief of the oncology/hematology division in the UNMC Department of Internal Medicine. “The conference is a wonderful showcase for the work of the UNMC lymphoma team and now the Fred & Pamela Buffett Cancer Center facilities at UNMC and Nebraska Medicine.”

Brenda Ram, interim director of educational programs, UNMC Center for Continuing Education, said issues to be addressed include clinical challenges, “ask the experts” sessions, and insightful commentaries. A panel of expert faculty will discuss the current standards of practice, clinical trial information, and the emergence of new therapies for patients with leukemia, multiple myeloma, and lymphoma.

Target audience for the international conference is oncologists, hematologists, pathologists, clinical scientists, nurse practitioners, physician assistants, nurses, and pharmacists charged with the care of patients with lymphoma.

The conference will feature 58 submitted abstracts from around the world.

Registration for this year’s conference is the largest to date with 569 people representing 16 countries already registered.

This conference is administered by the UNMC Center for Continuing Education. It is certified for AMA PRA Category 1 Credits™, as well as ANCC and ACPE credits by the UNMC Center for Continuing Education and credits from the UNMC College of Nursing Continuing Nursing Education and the Postgraduate Institute for Medicine.

Watchman Procedure

In January 2018, Nebraska Medicine became the first health care system in Omaha to implant the WATCHMAN™ left atrial appendage occlusion device. This device is designed to lower your risk of stroke due to atrial fibrillation (afib) while at the same time allowing you to stop blood thinners. Clinical trials have shown this implant to be a safe alternative to the blood thinner warfarin (also known as Coumadin) with comparable stroke-risk reduction.

Watchman01-17-2018.jpg
The WATCHMAN™ device pictured above is about the size of a quarter.

Atrial fibrillation — irregular quivering of the upper chamber of the heart — affects more than 5 million Americans and is responsible for 15 to 20 percent of all strokes nationwide. The average person with afib is five times more likely to have a stroke than someone with a regular heartbeat. Afib leads to a decrease in the pumping capacity of the upper chambers of the heart. This results in decreased blood movement and encourages blood clots to form in a blind pouch connected to the left upper chamber, called the left atrial appendage. A blood clot could escape from this area and travel to another part of the body. When this part of the body is the brain, it can results in a stroke.

Medicines like warfarin that thin the blood to prevent clots have, until now, been the standard way to reduce the risk of stroke. However, these medications are not suitable for many patients due to bleeding risks, medication interactions, and other adverse reactions.

If you have a reason to seek an alternative to blood thinners, such as a history of bleeding or a lifestyle, occupation or condition that puts you at risk for bleeding, WATCHMAN™ may be right for you.

Why have this procedure done at Nebraska Medicine?

First in Omaha

We were the first in Omaha to offer the procedure, and we’re the only program in the state to offer a comprehensive team dedicated to treating atrial fibrillation.

Potential Permanent Solution

WATCHMAN™ is a permanent implant that provides an alternative to the lifelong use of blood thinners, while lowering your stroke due to afib risk. The device is about the size of a quarter and made from nitinol, a very light and compact material commonly used in many other medical implants.

Short Procedure Done Under General Anesthetic

We implant the WATCHMAN™ device through a vein in the leg using a minimally invasive catheter to reach the heart.  The procedure only takes about an hour and is guided by transesophageal echocardiography (TEE ultrasound).  A one-night hospital stay is typical.  The procedure is performed by Dr. Andrew Goldsweig and Dr. Jessica Delaney.

Medicare and many insurance companies now cover this device, which is approved by the FDA. Watch this video by Boston Scientific, manufacturer of the WATCHMAN™ device, to understand the procedure in more detail and to see statistics on its successful outcomes.

Normally, you’ll have to take blood thinners for about 45 days after the procedure. During this time, heart tissue will grow over the implant to form a barrier against blood clots. We’ll monitor this process by taking TEE ultrasound pictures of your heart to see when you can stop taking blood thinners.  Most patients will also need to take a medicine called clopidogrel (also known as Plavix®) for a few months and aspirin on an ongoing basis.

Our Team Offers a Wide Variety of Ways to Assist You

If this procedure is not the right fit for you, we offer a wide variety of other ways to help you with cardiac arrhythmias, of which afib is the most common.

See a list of insurance companies we accept.

The information contained on this page is for information purposes only. For specific questions regarding your medical condition or treatment, please consult with your doctor directly.

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Fred & Pamela Buffett Cancer Center Marks One Year

Today marks the one-year anniversary of the opening of the Fred & Pamela Buffett Cancer Center. Director Ken Cowan, MD, PhD, called it “an incredibly successful year and the beginning of a very exciting future.”

UNMC Chancellor Jeffrey P. Gold, MD, says the impact of the cancer center has exceeded all expectations.

“The Fred & Pamela Buffett Cancer Center has shown in its first year the breadth and depth of its efforts in the battle against cancer, through its state-of-the-art patient care, by providing a base for cutting-edge cancer research, and through its education of the next generation of cancer-fighting health professionals,” Dr. Gold says. “We are incredibly grateful for the public-private partnership with our community that made the cancer center possible and are so proud of the work that has been done here. We expect even greater achievements in the future.”

“Nebraska Medicine and UNMC share a mission to lead the world,” says Dan DeBehnke, MD, MBA, CEO of Nebraska Medicine. “The Fred & Pamela Buffett Cancer Center is a beautiful example of that partnership and mission. We’ve done some extraordinary things in the past year thanks to a dedicated team. This first year lays a foundation for all the years to come. We are just getting started.”

“This center shows what is possible when we focus on what is important and are determined to do it right and at the highest level,” says Sarah Thayer, MD, PhD, physician in chief at the cancer center. “And we will keep reaching for new breakthroughs.”

Feedback from patients, faculty and staff has been “incredibly positive,” Dr. Cowan says.

“Everybody is excited about working closer together to advance the opportunities to develop new therapies and treatments for patients and to make them available sooner,” he says. “And for patients — in terms of the ease of being able to see all of their oncology providers and all the services they need in one environment — it has been very successful.”

“When we look at where we were a year ago and the patient experience we can provide today it is transformational,” says Theresa Franco, vice president of Nebraska Medicine cancer services. “What the cancer team has dreamed, designed, and committed to our patients has come to life.”

Educationally, Dr. Cowan says, the center has been transformational in allowing graduate students in the PhD programs to learn more about clinical challenges while clinical trainees, residents and fellows learn more about cutting-edge cancer research.

“Our ability to put everybody together means literally everybody can learn from each other, from the earliest part of their education,” he says.

Dr. Cowan spoke for the medical center leaders when he praised the supporters of the Fred & Pamela Buffett Cancer Center.

“I want to say thank you to our state, city and county, who supported the vision of the cancer center early on, and to the many philanthropic donors and foundations and businesses that supported the vision and provided support for the building of the cancer center to make this the largest public-private partnership in the history of the state of Nebraska,” he says. “And I’d like to thank all of our patients, our staff and faculty and students.”

 

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Loading