HealthSpring/Summer 2011

at Iowa

Stopping a‘GOING’ PROBLEM

3 Fixing fast heartbeat4 NICU to the rescue5 Jaw cancer treatment6 Car seat safety7 Cosmetic surgery just for you9 Prozac® for stroke?

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YOUR FREE GUIDE TO HEALTHY LIVING AND EXPERT MEDICAL CARE

minimally invasive surgeryrestores control

and activelifestyle

STOPPING a ‘going’ problem Uterine prolapse is fairly common among older women, especially if they’ve had children.

Life for 73-year-old Carolyn Ritter always seemed to revolve around one basic question: Where’s the nearest restroom? Everyday activities—shopping, playing bridge, attending a concert—had become increasingly difficult. Ritter had urinary incontinence—a sudden urge to “go” whether her bladder was full or not. Sometimes leakage occurred. Ritter visited the UI Women’s Health Center at University of Iowa Hospitals and Clinics. Catherine Bradley, MD, a specialist in urogynecology and pelvic reconstructive surgery, identified the problem as prolapse. Carolyn’s pelvic muscles, ligaments, and tissues had weakened. This allowed the uterus and other pelvic organs to “drop.” Bradley’s UI team determined that Ritter was a good candidate for minimally invasive robotic surgery. Robotic surgery could be used to remove the uterus, reposition the bladder, and apply a synthetic material to help reinforce the wall that supports the pelvic organs. All went well and she was able to go home the next day. She now can do the things she loves without interruption. “If you have this condition and qualify for the robotic surgery option,” she says, “I’d highly recommend it!”

For more information or for an appointment, contact UI Women’s Health at 319-356-2294or visit uihealthcare.org/healthatiowa

Urogynecology and pelvic reconstructive care is also available at our Quad Cities location, 563-355-2244

Carolyn Ritter of Grinnell is active again after minimally invasive robotic surgery.

Robotic surgery

+ Small incisions

+ Less discomfort

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+ Fewer pain meds

+ Quicker recovery

For more of Carolyn’s story, including a video, visit uihealthcare.org/healthatiowa

Radiofrequency ablation

Radiofrequency ablation is just one minimally invasive option used by UI heart specialists to treat some types of rapid heartbeat. During the procedure, doctors guide a catheter into the heart, then transmit a painless radiofrequency energy to destroy carefully selected cells. This stops those cells from giving off electrical signals that stimulate the irregular and fast heartbeat.

Marilyn Swanson, anxiety-free, at home in Iowa City.

Slowing the speeding heartAt times, Marilyn Swanson’s heart would suddenly race out of control, as if someone were stomping the gas pedal. While the condition called arrhythmia was not immediately life-threatening, it became so unnerving that Marilyn feared going anywhere alone. The turnaround came after she moved from Passau, Germany, to Iowa City. While playing bridge with an old college friend, she received some encouragement. The friend—James Martins, MD, a cardiologist with UI Heart and Vascular Care—felt the condition might be fixable. Martins and a team of UI heart specialists subsequently diagnosed the source of the arrhythmia. The team then used radiofrequency ablation to destroy a small, troublesome area of heart tissue. This ended Marilyn’s scary racing heart episodes. “I’m free of my anxieties and I live like a normal person again,” she says. “It’s really great!”

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For more information about UI stroke care, call UI Health Access at 319-384-8442 or 800-777-8442.

about Arrhythmia• Very common abnormal heart rhythm

• Harmless unless lightheaded or near passing out

• Doctor’s evaluation can make the difference

between unnecessary anxiety and confidence

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For more of Marilyn’s story, including a video, visit uihealthcare.org/healthatiowa

Against impossible odds Weighing 1 pound, 1 ounce at birth, little Alexis Hutchinson was not much bigger than a block of butter. Now—thanks to a team of specially trained experts in the highest level Neonatal Intensive Care Unit in Iowa—Alexis is one year old and well on her way to a normal life. Alexis’s mother, Chrissy Carpenter, had a normal pregnancy until 22 weeks. An infection caused her to go into labor with an extremely high probability of miscarriage. Chrissy was quickly transferred to the high-risk obstetrics service at University of Iowa Hospitals and Clinics, where Alexis was born with no heart rate. Despite seemingly impossible odds, Alexis was resuscitated and nursed along for 84 days on a ventilator in the NICU at UI Children’s Hospital. She finally pulled out of the danger zone and joined her family at home. “Alexis is our miracle baby,” Chrissy says. “She wouldn’t have survived at any other hospital in Iowa!”

If you have a question for UI Children’s Hospital, call 319-384-5437 or 800-777-8442

For more of this story, including a video, visit uihealthcare.org/healthatiowa

Chrissy enjoying some family time with ‘miracle baby’ Alexis at their home in Manchester, Iowa.

NICU teamThe NICU team includes doctors, nurses (often called ‘guardian angels’ by families), nurse practitioners, respiratory and rehabilitation therapists, pharmacists, nutritionists, clinical lab scientists and technicians, imaging specialists, social workers, and the baby’s family.

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Every time Jeff Jensen brushed his teeth, his gums would bleed. He knew he needed to see a dentist but his job and his passion for turkey hunting kept getting in the way. Jeff eventually saw an oral surgeon who removed an impacted wisdom tooth and took a routine tissue sample that led to shocking news: Jeff had oral cancer that had spread to his jaw. Jeff feared his days were numbered. The oral surgeon recommended that Jeff entrust his care to the head and neck cancer service in the Department of Otolaryngology – Head and Neck Surgery at University of Iowa Hospitals and Clinics. There, a team led by Gerry Funk, MD, evaluated his biopsy and CT scans and created a treatment plan that included removal of the tumor, reconstruction of his jaw with a free tissue transfer of bone from his leg, and postoperative radiation. All went well and Jeff was declared cancer-free. “I’m really grateful to Dr. Funk,” he says. “My life is back to normal!”

For more of Jeff’s story, including a video, visit uihealthcare.org/healthatiowa

For more information about our head and neck cancer services, call patient care coordinator Nancy Scroggs at 319-384-6487

For questions about cancer, call 800-237-1225 or e-mail cancer-information@uiowa.edu

Jeff Jensen of Independence, Iowa, plays football with 9-year-old son Jered.

Taking the BITE out of jaw cancer

“Being part of an academic medical center offers a huge advantage for physicians. If the patient has an unusual condition and we want other expert advice, it’s only a matter of walking down the hall.” Gerry Funk, MD

Oral cancer ALERT• A sore in the mouth that does not heal

• Pain in the throat or mouth that persists

• A visible growth in the mouth!

Free tissue transferA very demanding technique in which specially trained surgeons remove healthy tissue from one area of the body and use it to reconstruct a defect somewhere else. Blood vessels in the transplanted tissue are connected to blood vessels in the defect. The procedure is of particular value for reconstructing defects in the head and neck.

UI free tissue transfer teamRodrigo Bayon, MDKristi Chang, MD

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Gerry Funk, MDNitin Pagedar, MD

Every day, an average of four children are killed and 529 injured in motor vehicle accidents within the U.S. Age- and size-appropriate vehicle safety seats can make a huge difference.

Vehicle safety seats reduce the risk of death in cars by 71 percent for infants and 54 percent for toddlers between ages one and four. Not all vehicle safety seats are created equal and it’s important to know which one is best suited for your child.

The American Academy of Pediatrics recommends that infants ride in a rear-facing safety seat until age two.

Infant-only seats usually have weight limits of five to 22 pounds and length limits of 26 inches.

Shoulder straps should be snug at the infant’s shoulders.

Please note that outgrowing an infant seat is not a reason to switch to a front-facing car seat. Most infants outgrow their infant seat before their first birthdays and need to switch to a rear-facing convertible car seat. Current recommendations suggest that children should be rear-facing as long as possible due to the extra protection of the head and spine.

Next in the progression of safety seats is the forward- facing car seat. Iowa requires children to ride in a car seat or

booster seat through age five.

Health at Iowa welcomes your questions about general health topics. To submit a question, e-mail health@uiowa.edu.

ask the expert

Natalie Lanternier, MD

Most forward-facing safety seats have a weight limit of 40 pounds, but some extend to 65 pounds. Once a child exceeds these weight limits, it is time for a booster seat. For kids ages six to 11, Iowa law requires a booster seat or seat belt regardless of seating position in a vehicle.

Children should ride in a booster seat until their knees bend over the edge of the vehicle seat and their feet touch the floor while sitting all the way back. This is about 60 to 80 pounds and 4 feet 9 inches. This is important to remember because some parents remove their children from the booster too quickly and put their children at risk. Additionally, children under 13 should ride in the back seat, away from the air bag.

As your children get older it’s also important to remember that Iowa law requires all rear seat occupants under age 18 to wear a safety belt.

Nine out of 10 car seats are used improperly regardless of the owner’s education or economic background. Parents should have the safety seat checked by a certified car seat technician.

Parents and adults should set a good example: Buckle up on every trip, no matter how short.

For more information about keeping your kids safe, how to buy the proper vehicle safety seat, and where to find a certified car seat technician near you, contact the University of Iowa Children’s Hospital Safety Store. Visit uihealthcare.org/safetystore or call 319-356-3543.

In response to a car seat question from Amy in North Liberty the following tips are offered by Gretchen Vigil, MD, clinical associate professor of pediatrics at University of Iowa Children’s Hospital.

Gretchen Vigil, MD

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UI’s world class plastic surgery and cosmetic team helps people fulfill their dreams

Refresh your beauty!Do you have unwanted wrinkles, scars, or blemishes? Would you like to refresh the appearance of your body or face? If so, the experts at University of Iowa Plastic Surgery and Cosmetic Services might be just what you need. Based at UI Hospitals and Clinics, the plastic surgery and cosmetic team offers a wide array of options—from body contouring to tattoo removal—for enhancing all parts of the body. Among the newest techniques is Fraxel® laser treatment. Fraxel combines the best (heat and non-heat) aspects of previous laser skin care technologies to make skin rejuvenation easier and safer. UI’s other types of laser resurfacing include carbon dioxide, V-Beam, Diolite®, and sclerotherapy. Most are outpatient procedures.

For more information about the full range of UI’s plastic surgery or cosmetic options:

Call (toll-free) 855-469-8456 or 319-384-8100

E-mail myuilook@uiowa.edu

Visit uihealthcare.org/healthatiowa

Full range of servicesRhinoplasty

Facelift

Browlift

Blepharoplasty

Cheek enhancement

Chin enhancement

Otoplasty

Neck lift

Liposuction

Tummy tuck

Body contouring

Post-bariatric

Breast surgery

Botox

Fillers

Chemical peels

Dermabrasion

Laser resurfacing

Laser hair removal

Tattoo removal

Skin care products

Cover-ups

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Photograph provided by Thinkstock

MyChart®

At your fingertips!Did you know you can stay in touch with your health care team at home or anywhere in the world? With a free MyChart® account, patients at University of Iowa Hospitals and Clinics can use their computers to safely and securely:

• See test results• Request prescription renewals• Request appointments• View your medical record• Use secure messaging to contact your health care team• Quickly access trusted health information and health tips

Ask about setting up your own account at your next UI doctor’s appointment or visit uihealthcare.org/mychart.

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Free AppFor immediate access to your medical records using an IPhone®, iPad®, or ITouch®, search for ‘My Chart’ in the Apple® App StoreSM and download the iPod application for free.

Find out about setting up your account today at uihealthcare.org/mychart

Photograph provided by Thinkstock

Is Prozac® good for stroke patients?

A University of Iowa study finds that patients treated with a short course of antidepressants like Prozac® after a stroke have significantly greater improvement in physical recovery than patients given placebo. Moreover, the study is the first to demonstrate that this physical recovery continues to improve for at least nine months after the antidepressant medication is stopped. “The idea that antidepressants might benefit early recovery from stroke has been around for a couple of years,” says Robert Robinson, MD, senior study author. “But one major question left unanswered was, ‘Does the effect last after the medication stops?’ Our study demonstrates that not only does the beneficial effect last, but the improvement in recovery continues to increase even after the patients stop taking the medication.” Harold Adams, MD, co-author, said that if future studies confirm these observations, the public health impact could be huge. The study was published by the American Journal of Geriatric Psychiatry.

Quality stroke careUniversity of Iowa Hospitals and Clinics is a major comprehensive stroke center where stroke patients are often transferred for observation and, if necessary, highly specialized care following treatment with the stroke drug, tPa. For questions about stroke, call the UI stroke service at 319-356-2572 or e-mail neurology-scheduling@uiowa.edu.

Stroke is the leading cause of adult disability and the third-largest cause of death in the developed world.

STROKE WarningSigns

Act FAST and CALL 9-1-1 IMMEDIATELY at any sign of a stroke.

Use FAST to remember the warning signs:

FACEAsk the person to smile. Does one side of the face droop?

ARMSAsk the person to raise both arms. Does one arm drift downwards?

SPEECHAsk the person to repeat a simple phrase. Is speech slurred or strange?

TIMEIf you observe any of these signs, call 9-1-1 immediately. Note the time when any symptoms first appear. If given within three hours of the first symptom, there are FDA-approved medications that may reduce long-term disability for stroke.

Visit www.stroke.org (choose Signs and Symptoms) to download the FAST wallet card to keep a reminder of stroke warning signs with you wherever you go!

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RADON ALERT: Screen to be safeHere’s a friendly tip that might even save your life: Have your home tested for radon. Performing a radon test is the first step to assessing your exposure to this major environmental cause of cancer mortality, says R. William Field, PhD, a University of Iowa radon expert. “Every home should be tested because one home could have a low reading and their next door neighbor could have a very high reading,” he says. Iowa has the highest percentage of homes in the U.S. with radon concentrations exceeding the EPA’s action level of 4 pCi/L.

Radon test kitsIowa residents can purchase easy-to-use radon test kits by mail for $6 or by pick-up for $4. For more information, contact the Iowa Air Coalition at 800-206-7818.

What to doLet your family doctor know right away if your home test suggests a high level of radon exposure. Be sure to report how long you have been living in the home, and what level of radon was discovered. Consider installing a radon mitigation system in your home if radon tests indicate your radon concentrations exceed EPA action levels. If you have a question about cancer and radon, e-mail the UI Cancer Information Service at cancer-information@uiowa.edu or visit uihealthcare.org/healthatiowa.

RADON

Radon is the second-leading cause of lung cancer, after smoking. Smokers exposed to radon may have a higher risk for cancer.

Radon is:An invisible gas that has no smell or taste

Released over time as the uranium found in rocks and soil breaks down

Spread into the air and found at low levels in outside air and ground water

Photograph provided by iStockphoto

Protect your family and have your home tested today!

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Enjoy these heart- and diabetes-friendly recipes from the dietary staff at University of Iowa Hospitals and Clinics. Watch Chef Hilbert Stoelk make these recipes on video at uihealthcare.org/healthatiowa.

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Good Health Recipes

Garlic Brussel Sprout Leaves with Chestnuts

Ingredients16 Brussel sprouts (leaves removed)12 whole cooked chestnuts2 garlic cloves (sliced)1 thyme sprig1 Tbsp. extra virgin olive oil½ Tbsp. butter

DirectionsTo prep the Brussel sprouts, pick leaves from the whole sprout and reserve in a bowl of water. Discard center core of Brussel sprout. In a medium pan of boiling water, blanch the drained Brussel sprout leaves for approx. 20 seconds, drain and pat dry.

In a skillet, heat 1 Tbsp of olive oil; add the chestnuts and garlic, heat for a couple of minutes stirring. Add the Brussel sprouts and butter cook for one minute.

To PlateTransfer from skillet to plate and garnish with sprig of thyme.

Yields four servings. Nutrition facts per serving: Calories 135; Total Fat 5.5 g; Sodium 30 mg; Carbohydrates 20 g; Fiber 3 g; Protein 3 g

Korean BBQ Chicken Wraps with Kimchee

Ingredients1 chicken breast5 garlic cloves 3 inches ginger root (peeled)1 small onion (chopped)1 Asian pear (peeled, cored, chopped)¼ cup low-sodium soy sauce1 tsp. sesame oil1 Tbsp. brown sugar1 Tbsp. sesame seeds½ bunch green onions (trimmed & cleaned)¼ cup mirin or sherry1 head of lettuce (leaves separated) ¼ cup kimchee

DirectionsPlace all the ingredients with exception of the chicken, lettuce, and kimchee in a processor. Blend well. Transfer to a bowl and add chicken to marinate 1-2 hours.Grill chicken.

To serve, slice cooked chicken, place one to two pieces in lettuce with one piece of kimchee.

Yields eight servings. Nutrition facts per serving: Calories 160; Total Fat 3.5 g; Sodium 425 mg; Carbohydrates 14 g; Fiber 2.5 g; Protein 19 g

Wasabi Furikake crusted Tuna with Mango Carpaccio with Rice Wine-Lemon Vinaigrette

Ingredients6 oz. sushi grade tuna1 mango peeled and sliced thinFresh watercress for garnish2 Tbsp. extra virgin olive oil1tsp. fresh squeezed lemon juice1tsp. rice wine vinegar1tsp. low sodium soy sauce1 oz. Wasabi Furikake

DirectionsIn a bowl whisk olive oil, lemon juice, rice wine vinegar, and soy sauce. Coat tuna with the Furikake on all sides then sear in a hot pan for 5 seconds on each side. Place sliced mango on a plate slightly overlapping.

To PlateSlice seared tuna on a bias. Place tuna on mango plated dish. Drizzle vinaigrette liberally over the plate. Garnish with fresh watercress.

Yields six appetizer servings. Nutrition facts per serving: Calories 114.3; Total Fat 5.3 g; Saturated Fat 0.8 g; Polyunsaturated Fat 0.8 g; Monounsaturated Fat 3.4 g; Cholesterol 16.4 mg; Sodium 113.2 mg; Potassium 215.3 mg; Total Carbohydrate 7.7 g; Dietary Fiber 1.0 g; Sugars 5.2 g; Protein 9.2 g

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HEALTH AT IOWAHealth at Iowa is your source for medical news and tips for keeping yourself and your family healthy. Health at Iowa is available on a complimentary basis to anyone who is interested in the topics we cover.

GO GREENTo receive your copy electronically rather than by U.S. mail, please send an e-mail request to health@uiowa.edu.

QUESTIONS OR REQUESTSWe regret any mailing problems such as duplicate copies. To receive or stop receiving Health at Iowa, or to change your mailing address:• Send e-mail to health@uiowa.edu• Visit uihealthcare.org/healthatiowa• Call 319-356-1009• Send correspondence to Marketing and Communications, University of Iowa Health Care, 200 Hawkins Dr., W319 GH, Iowa City, IA, 52242-1009

ABOUT UI HEALTH CAREUniversity of Iowa Health Care is Iowa’s only comprehensive academic medical center consisting of UI Hospitals and Clinics, the UI Roy J. and Lucille A. Carver College of Medicine, and UI Physicians, Iowa’s largest multi-specialty medical and surgical group practice.

FOR MORE INFORMATION• About our adult health care services, call UI Health Access at 800-777-8442• About our children’s health care services, call 888-573-5437

VICE PRESIDENT FOR MEDICAL AFFAIRS Jean Robillard, MDCEO, UI HOSPITALS AND CLINICS Kenneth KatesDEAN, UI CARVER COLLEGE OF MEDICINE Paul Rothman, MDASSOCIATE VP FOR MARKETING AND COMMUNICATIONS Ellen BarronEDITOR Michael SondergardDESIGNER Nancy ZearCONTRIBUTING WRITER Dave PedersenPHOTOGRAPHY Susan McClellen, SPM Marketing and Communications, Thinkstock, iStockphotoWEB MASTER Greg Johnson

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New children’s hospital in works

A new and thoroughly modern University of Iowa Children’s Hospital will serve generations of Iowans to come. The $270 million facility—approved by the state Board of Regents—will be located adjacent to UI Hospitals and Clinics and additionally encompass renovated space in the John Pappajohn Pavilion. The project involves a statewide, Iowa-specific children’s system of care that incorporates sophisticated health information technology and new hospital accommodations. Construction is targeted for completion in 2016. The project will be paid for with a combination of health care revenues, hospital bonding, and private gifts.

Muscular dystrophy breakthrough

Teamwork and a single patient with mild muscle disease and severe cognitive impairment have allowed University of Iowa biomedical researchers to identify a new gene mutation that causes muscular dystrophy. In addition, the researchers, led by Kevin Campbell, PhD, have engineered the human gene mutation into a mouse, creating a new mouse model that could help screen potential drugs to treat this type of muscular dystrophy.