Are you prepared to save a life?

By James Chesnutt

It wasn’t the usual rush to get to the plane; I was there ahead of time and there was a delay to board. The crew was running late due to car trouble, we were told. I was in Boston for a sports medicine meeting for a few days and now — on the night of January 17 — headed back home to Portland with six hours of travel ahead.

I was eager to get on the plane and snooze away for the duration of the trip like usual.

But this wasn’t going to be a normal flight. The last thing I expected was to hear a jostling in the back of the plane and then a woman saying something is wrong. I jumped out of my seat and headed back to help.

I noticed a man shaking and looking like he was having a seizure. My first impression was not to overreact and let the seizure course through. But as I sat down next to him to talk with him, I had a feeling that this was more than a seizure.

Although the symptoms stopped for about 30 seconds, they then got worse. He became less responsive. I positioned him to lie down across the airplane row’s three seats and checked his pulse, which was rapid and weak. I thought to myself, “You can’t forget that 60 percent of sudden cardiac death events have seizure activity as well.” I asked for the AED (automated external defibrillator) that was fortunately stowed very near us on the plane and an emergency kit and asked someone to call 911. Just as I laid him down across the seats, he turned blue and had no pulse.

All hands on deck.

The situation did not look good. It was time for CPR, and just at that moment another doctor and nurse practitioner came to assist, confirmed he had no pulse and that he was not breathing. He was dying before us and we had to do something fast.

I shouted to the other doctor to start CPR and the nurse practitioner placed the AED pads on him while I kept his airway open and shouted directions to the team. I looked around and everyone on the plane was staring at us with looks of shock on their faces. The three of us looked at each other and I think we all felt this may not end well. But we were doing all the right stuff and I felt a renewed hope to press forward.

By this point we had been doing CPR for about a minute without any response from him. I told the team to continue CPR, get ready to analyze the rhythm and prepare to shock if needed, as if following a script. We stopped CPR long enough to see that he was in ventricular fibrillation — which is a deadly irregular heart rhythm— and that he needed a shock. And in fact the machine told us that exactly.

Just as we were ready to shock him, we realized that the three of us and his wife were all too close to him and the seat he was on. We yelled for everyone to stand clear and had to rapidly move his wife out of the way from between the seats. We all stood back: The last thing you want to do when shocking someone is to create another casualty by shocking someone who is either touching the person being shocked or the bed they are on.

We shocked him and … it worked! His heart rhythm returned to normal and he woke up, stunned, wondering what he was doing lying down and why we were all standing over him.

“Hey, you’re alive,” I said. “What’s your name?”

“I’m Marv,” he said, very matter of fact. I explained to Marv that he’d had a cardiac arrest and we just shocked him back to life with the AED.  We reassured him he was looking good and he would be going to the hospital as soon as the paramedics arrived. We quickly helped him chew and swallow an aspirin to help clear any clots in his heart that could have been causing the deadly rhythm. Every second counts in cardiac arrest.

We hardly had time to say goodbye but I quickly wrote down my phone number and gave to it to his wife, asking that she please let us know how he recovers.

As the paramedics took him away, the three of us looked at each other and smiled and gave high fives and embraced. The passengers on the plane erupted in cheers and clapping. They had experienced a miracle. They had lived through the trauma of the moment and now felt the victory as his life was saved.  They were calling us heroes, but to me I did what I was trained to do and had practiced. No one should be called a hero for doing what we’re trained to do.

I lecture on preventing and treating sudden cardiac death so I should be able to practice what I teach. I’m just glad I was there to help, that others came to help and that the AED was right there where we could use it.

Be prepared to save a life.

CPR is essential in cardiac arrest. Start it as soon as you find someone who is unresponsive and without a pulse. It’s easier now that you only have to start with chest compressions (recent medical recommendations say that CPR with chest compression alone ensures that CPR can be started more quickly and gives the patient a better chance of surviving).

But AEDs are what really saves lives. That’s why Marv was lucky that the airline had the AED on its plane. And that’s why many people are lucky that AEDs are in shopping malls and schools and various public places across the nation. But AEDs are not available in many places — and every minute without treatment affects survival after cardiac arrest. If CPR is started within one minute and an AED is used within three minutes, survival is the highest. We were lucky that everything was there when and where we needed it to save Marv’s life.

In order to save more lives, we need to find a way to train more people in CPR and make AEDs more available. It’s a good feeling to save a life. I’m glad I was trained for it and that I was there at the right time and place to help. Be ready when it’s your turn.  Prepare yourself to save a life — be charged (trained) and ready to go!

3 simple swaps to promote heart health

The sudden influx of heart-shaped decorations, balloons, cards and candy has hopefully served as a reminder to ask yourself what you’re doing to improve your heart health. February is American Heart Month, so put down the heart-shaped chocolates and instead do something really special for your loved ones:  Try three simple swaps to promote a healthy heart.

  1. Meatless Monday:  Adopting a more plant-based diet will help reduce saturated fat and cholesterol intake while increasing fiber. These important heart-healthy goals can help lower your cholesterol and blood pressure. Try going meat-free one day of the week: Swap beans, lentils, nuts, tofu or tempeh for your usual meat, chicken or fish. Visit these websites for recipe ideas.
  2. Skip the salt: Less sodium means lower blood pressure; this reduces your risk of heart attack and stroke.
    • Love snacking on high-sodium foods such as chips, pretzels and microwave popcorn? Look for low-sodium or no-salt-added versions, such as unsalted whole-grain tortilla chips or air-popped popcorn.
    • Better yet, snack on fresh fruits and veggies. I love pairing vegetables such as carrots, bell peppers and sugar snap peas with a fiber- and protein-rich dip like this hummus recipe.
    • Check out this infographic for more tips on salty foods to swap out of your diet.
  3. A whole lot of whole grains: Making the switch to whole grains helps lower LDL cholesterol, triglycerides and insulin levels. Studies show people who eat more whole grains are less likely to develop cardiovascular disease.
    • Like cereal in the morning? Switch to oatmeal instead of Cream of Wheat, or look for the words “whole grain” in your cereal’s ingredient list.
    • At lunch, ask for your sandwich on whole-wheat bread, or opt for brown rice in your stir-fry.
    • For dinner, switch to whole-wheat pasta on spaghetti night, or get creative and try quinoa, barley or wild rice for a side dish.

Show your love this month by committing to these three simple swaps. Every small change you make to reduce your intake of saturated and trans fats, sodium, refined grains and sugar adds up to improved heart health. Your loved ones will thank you!

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Tracy Severson is an outpatient clinical dietitian at OHSU. She moved to Portland from Tucson in 2010, and has worked at OHSU since 2011.

Tracy works with the OHSU Surgical Weight Reduction clinic and Cardiac Rehab program, and also provides medical nutrition therapy for General Adult Outpatient Clinics at OHSU.


Stories that matter.

By Eric Switzer, OHSU Communications

We work where the extraordinary is commonplace.

We see people at their most intimate and vulnerable. Illness is diagnosed. Healing occurs—or, sometimes, isn’t possible. Babies are born.

It’s why most of us work here. Because it’s a privilege to care for others in these moments. Because we want to cure disease or teach the next generation of healers or  just, in the end, be part of something so much bigger than ourselves.

Every person at OHSU has a story. This Spring, a few of these stories will begin to show up on TV, in bus shelters, online and in an occasional magazine. One way to think of them is as an ad campaign. Another is as a reminder that what seems commonplace for us is extraordinary for most.

But they’re mostly an invitation—a way for the people we serve to connect to the amazing things that go on here. Every. Single. Day. #OHSUAmazing

 

Love yourself. Love your heart.

By Kate Geller, Knight Cardiovascular Institute

This Valentine’s Day, try to take inspiration from all of the heart-shaped cards, chocolate boxes and balloons to show yourself some love, by focusing on your own heart health. Almost everyone has risk factors for heart disease, but thankfully, we can all practice prevention by exercising heart-healthy eating habits.

Margarine vs. Butter?

A question our experts often get from patients is around cooking with margarine or butter. According to Tina Kaufman, Ph.D., of the Heart Disease Prevention program at the OHSU Knight Cardiovascular Institute, “neither one is optimal for heart health” for two important reasons:

  • Butter contains high levels of saturated fat and cholesterol, which increases blood cholesterol levels and the risk of heart disease
  • Many margarines, while containing mainly vegetable oils, also contain trans fat (partially hydrogenated fats). Trans fat, like saturated fat, increases blood cholesterol levels and the risk of heart disease.

More important, says Kaufman, is that you read the label of margarines and stay away from “partially hydrogenated” or “trans fat.” Look for products such as Smart Heart and Promise Activ, fortified with plant stanols and sterols that can actually help decrease cholesterol levels.

For more ways to love your heart, attend one of our free Heart Month lectures or a free heart screening in your area.

OHSU Telemedicine Network is a lifesaver for Medford Man

By Kory Herrick, M.D.

When 64-year-old David DeNoma awoke to a loud ringing in his head, he knew something was wrong.  He tried to get out of bed, but the room was spinning so violently that he had difficulty maintaining his balance and could barely support himself sitting on the edge of the bed.  By the time paramedics had brought him to Asante Rogue Regional Medical Center in Medford, he was having double vision and difficulty speaking.

His emergency room physician, Michael McCaskill, M.D., immediately suspected a stroke and called OHSU to request a telemedicine consultation.  A few minutes later, using a telemedicine robot equipped with two-way video communications technology, I was able to speak with Mr. DeNoma about his symptoms, medical history and medications, and then perform a careful neurologic examination – despite being 275 miles away.

Mr. DeNoma’s symptoms and exam findings suggested that a blood clot had blocked his basilar artery, the major artery supplying blood to the brain stem. Strokes caused by basilar artery occlusions carry a particularly poor prognosis and usually result in death. Many of the patients who survive are left in a “locked-in” state, wherein they retain awareness but are almost completely paralyzed from head to toe and unable to communicate verbally.  I discussed the case with his emergency room physician in Medford. We decided that Mr. DeNoma’s best chance of survival was to receive t-PA, a potent clot-busting medication, and then be flown to OHSU to attempt to have the blood clot removed by a procedure known as mechanical thrombectomy.  A few hours later the clot was successfully removed, and Mr. DeNoma was recovering in OHSU’s neurosciences intensive care unit.  Within 48 hours, his stroke symptoms vanished and he went home.  Two months later, he was vacationing in Hawaii.

Mr. DeNoma’s case stands out as a poignant reminder of how indispensable telemedicine is in providing emergent specialty care to patients living in areas without specialist support.  When patients arrive in an emergency room with symptoms of an acute stroke, the earlier an accurate diagnosis is made and treatment initiated, the better the outcome.  The OHSU Telemedicine Network enables our stroke neurologists to arrive at a patient’s bedside in minutes, meet with the patient and family, perform a detailed physical examination, make a diagnosis and formulate a treatment strategy best suited to the patient’s particularneeds.

Since its inception in April 2010, OHSU has provided acute telestroke care to more than 420 patients like Mr. DeNoma.  As this technology continues to evolve, and as the number of sites using it grows, we will provide immediate, quality care to an even larger number of Oregonians when and where they need us.

Learn more about how telemedicine helped Mr. DeNoma make a remarkable recovery. Check out this story on KTVL Channel 10 in Medford.

Picking the Best Diet for the New Year

It’s January, and polls show that the number one New Year’s resolution is to lose weight. Even if you didn’t make a resolution, there’s still a good chance you’re hoping to lose the few pounds you gained during the holidays. Wondering the best way to go about achieving your weight loss goal? US News & World Report recently evaluated 32 popular diets and chose the best based on ease, nutrition, safety, and effectiveness.

The top ten best diets on the list are all safe, smart, and healthy diet plans. Use this report as a guide to pick a plan that will work best with your lifestyle and goals. Better yet, you can call the OHSU Nutrition Clinic for a personalized plan from a registered dietitian.

What’s best for you?

Although they aren’t designed specifically for weight loss, I love the DASH (#1 on the list) and Mediterranean (#3 on the list) diets for their focus on balanced nutrition from whole foods such as fruits, vegetables, whole grains, and proteins including seafood, beans, nuts, and low-fat dairy. Most people find that they do lose weight when they follow these plans as they reduce their intake of higher-calorie processed foods. You can find more information on the benefits of a mediterranean diet here.

My favorite weight loss plan is Volumetrics (#6 on the list), which is based on the idea that people tend to eat the same volume of food every day, regardless of how many calories they are consuming. According to this program, by choosing foods that are high-volume yet low-calorie (think foods that are bulky from fiber and water such as fruits, vegetables, and broth-based soups), you can eat much bigger portions than if you choose foods that are more calorie-dense (such as higher-fat foods and sweets).

This means you’ll feel more satisfied and not as deprived or hungry as with other “diets.” No foods are off-limits, but as you learn the Volumetrics principles, you’ll find it easier to make lower-calorie choices that lead to weight loss and still allow you eat a full plate of food at meals.

Want faster results with less work?

Unfortunately, there is still no magic bullet for weight loss (there are also no flying cars – this is not the 2014 I envisioned as a child!). The good news is the FTC is cracking down on false claims made by companies selling weight loss products, which should make it easier to decipher bogus claims. Case in point, the makers of weight loss supplement Sensa just settled for $26.5 million for making false advertising claims that sprinkling their product on food will help reduce hunger. Keep the FTC’s Common Sense Guidelines in mind when considering a weight loss product. If it sounds too good to be true, there’s a very good chance it is!

***

Tracy Severson is an outpatient clinical dietitian at OHSU. She moved to Portland from Tucson in 2010, and has worked at OHSU since 2011.

Tracy works with the OHSU Surgical Weight Reduction clinic and Cardiac Rehab program, and also provides medical nutrition therapy for General Adult Outpatient Clinics at OHSU.

 

Angioplasty, Discovered at OHSU, Celebrates 50 Years

By Kate Geller, Knight Cardiovascular Institute

It’s one of the most common medical interventions on the planet. Each year, millions of people undergo the procedure. And it has spawned some of the most important innovations in biotechnology.

It’s angioplasty, and it all started in a small radiology suite on the 11th floor of OHSU’s Hospital 50 years ago.

The Father of Interventional Radiology

On Jan. 16, 1964, Dr. Charles T. Dotter performed the world’s first percutaneous transluminal angioplasty, a procedure in which a catheter was used to open a blocked artery with the help of a live X-ray shown on a television monitor. The procedure allowed an 83-year-old woman to keep her gangrene-infected left foot, which was nearly amputated due to a blocked artery.

Today, 50 years later, angioplasty is one of the most common procedures for opening blocked blood vessels. It is performed more than a million times each year in the United States and is used in virtually every major artery and tubular structure in the human body. More than 60 million patients worldwide have benefited from angioplasty of arteries; hundreds of millions have benefited from image-guided intervention on other organs. And all of that started on the 11th floor of the main hospital at OHSU, in a room still used today.

Dr. Dotter’s Vision

Although Dotter is credited with conceiving and performing the first angioplasty on an artery, his vision went far beyond blood vessels. He foresaw the use of imaging guidance and catheters to perform many different types of procedures on almost every organ in the body.

Learn more about OHSU’s Dotter Interventional Institute and what they are doing to advance Dr. Dotter’s vision and future developments in this exciting area of medicine.

 

Focusing on the Future of Health Care

By year 2050, the U.S. Census Bureau estimates that over half of the people in the United States will belong to diverse communities. In states like California, Hawaii, Texas, and New Mexico, the population shift has already begun: large cities in those states are now “majority-minority” areas.

However, because of a variety and confluence of factors, students from underserved and underrepresented communities have limited access to educational opportunities, enrichment experiences, resources, and mentors in health and science careers.

Identifying and supporting outstanding diverse students with an interest in careers in health and science is an important first step toward narrowing the gaps. A critical part of OHSU’s charge as an academic medical center is to train culturally competent physicians, nurses, dentists and other healthcare professionals. Moreover, health care providers of color are more likely to work in underserved areas and to serve diverse communities.

How can you get involved?

The Center for Diversity & Inclusion(CDI) is helping to strengthen the “pipeline” of diverse health care professionals through focused and intentional outreach. We are accepting applications for summer research and clinical shadowing opportunities. Applications are due on Friday, February 7. Students selected for each program will receive a stipend for their work.

For college students: The Summer Equity Research Program offers a paid internship opportunity for undergraduate students to receive career mentoring and shadowing opportunities from OHSU faculty mentors from the Schools of Medicine, Nursing, Dentistry and Graduate Studies. Students selected for the program receive a stipend for working with research faculty in a laboratory and/or clinical setting. The competitive application process draws students from colleges across the United States. www.ohsu.edu/equity-research

For high school students: The Ted R. Lilley Cancer Continuing Umbrella of Research Education (CURE) Project is supported by CDI and the OHSU Knight Cancer Institute. The program targets high school students to provide hands-on research experience and science exposure to increase participation of historically underserved and disadvantaged students in biomedical research and health-related fields. www.ohsu.edu/CURE-program

On Friday, February 21, OHSU will also host the annual Career Conference for high school and college students who want to pursue a career in health sciences. CDI brings more than 400 students from diverse backgrounds to hear student and faculty panels on fields of study and career paths in health care and research. The conference will offer tips on admission processes and other relevant information, as well as introduces students to OHSU educational programs, faculty, facilities and resources. Click here to learn more.

 

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Maileen Hamto is Communications Manager for the Center for Diversity & Inclusion, which leads and supports university-wide initiatives to create a culture of respect and inclusion for all people.

 

Alumni Miles: A lesson learned over a muffaletta

I was gifted a profound insight this past October. Over an outstanding muffaletta sandwich, shared with a very recent MD program grad in a New Orleans park, I had a chance to see the impact of OHSU’s teaching at work in a community vastly different from the Pacific Northwest.

Hearing my lunch colleague discuss the role of the southern diet on child and adult health, and the measures he was taking to change this through a school gardening program, filled me with admiration; admiration and pride, that something of the impact he was having on his New Orleans community was likely being played out in some form 35,000 times over across the nation. As we parted company, I realized that I had stumbled across a new measurement of distance – the Alumni Mile.

Stay with me on this. Regular miles describe two locations separated. Portland and New Orleans, for instance, are over 2,500 regular miles apart. Alumni Miles, however, describe two locations joined, through the individuals common to those communities, no matter how far apart in distance and culture. The impact of one OHSU alum on his or her community shrinks the distance between OHSU and that community to a negligible number. That is the magic of the Alumni Mile.

The Alumni Relations team has put in many regular miles this year, finding the pioneering spirit of OHSU alumni shrinking the distance between OHSU and communities as diverse as Klamath Falls, San Francisco and Birmingham. Within Oregon, we expanded our Specialty Speed Dating program to all four of the School of Nursing’s non-Portland campuses. Alumni and nursing professionals in Monmouth, La Grande, Klamath Falls and Ashland volunteered their time to meet with nursing students and spend a few minutes answering the questions about the specialty they had chosen for their careers. Thank you to all who helped our students through these sessions.

March saw us celebrating the national impact of OHSU-trained cardiologists at an American College of Cardiology gathering in San Francisco. In November a large number of OHSU alumni and friends joined Provost Jeanette Mladenovic at a reception in Klamath Falls to discuss OHSU’s rural campus proposal. That same month we greeted dental alumni, faculty and friends at the American Dental Association Annual Session in New Orleans, taking advantage of our new contracting mileage metric to connect us with alumni from a region many regular miles away from Portland.

Alumni Miles work for students, faculty and staff as well. In September, alumni in northern California responded generously to an institutional request to help our student and faculty recruitment efforts there. Our Help Our Students Travel (HOST) program has been particularly active this year, bringing fourth year medical students on residency interviews closer to 32 alumni nationwide who are orienting them to Birmingham, AL and many other home cities.

So what is your Alumni Mileage?  We’d love to know. Until we refine the concept of apparition you can use the magic of alumni@ohsu.edu to tell us. And please accept our closest wishes for happiness and prosperity in the new year.

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Mark Kemball and the alumni relations team are proud to count almost 35,000 dentists, nurses, physicians, researchers, technicians and other health professionals as OHSU alumni. The team strives to keep them all connected with the university, with its students and with each other.

You can also follow Mark on Twitter @mark_kemball.

Carolers share the sounds of joy

A time of giving, good-will and good cheer characterize the December holiday season.  Amplifying this spirit is its festive, seasonal song.  It is music grounded in spiritual celebration and contemplation, along with expressions of winter holiday joy.

For more than 30 years, OHSU and OHSU Doernbecher Hospitals have opened their doors to choirs and occasional instrumental music groups beginning in early December.  Nearly 20 groups perform for patients, families and staff throughout the hospitals. Many come from public and private schools, some are local entertainers, and still others visit from faith-based assemblies.  Finally, some singers have an OHSU connection. They are employees, medical staff and medical students.

The OHSU Carolers started singing in the OHSU units back in 1992.  Twenty of our community members walk the unit halls, sharing cheer and seasonal sounds. Mark Kemball, with Alumni Services, previously conducted the group.  Marti Mendenall, in our Department of Family Medicine, is the Caroler’s current director. Anne King, a Finance Director, organizes the group, and Amy Johnson, from the Legal Department, is the group’s longest participating member.

Watch the video below to meet the spirited group of OHSU carolers.

YouTube Preview Image

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James Berry, M.Div., B.C.C.
Chaplain, OHSU Spiritual Services

OHSU Health Fair at Pioneer Square.

Why 96,000 Square Miles?

President Robertson is fond of saying that OHSU has a 96,000 square mile campus, serving Oregonians “from Enterprise to Coos Bay, from Portland to Klamath Falls.”

This blog aims to highlight that breadth. 96,000 Square Miles (96K for short) will focus on the people of OHSU, the Oregonians we serve and the ripple effect of our work in Oregon and beyond.

Read more

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