Improving your health, one bite at a time

Spring is just around the corner, and with it the first asparagus and greens of the season. Great news for those of us trying to eat a healthy diet and getting a little weary of root veggies. This month we bring you the nutritional wisdom of Dr. Kent Thornburg, director of the OHSU Bob & Charlee Moore Institute for Nutrition & Wellness.

The Institute has been conducting amazing research on the effect of diet on health—as well as how girls’ and women’s diets can affect the health of future generations. We asked Dr. Thornburg what that really means for women and girls and specifically for tween and teen girls whose diets can be rather challenging, to say the least.

What’s the one piece of advice about nutrition that you would give to a young woman?

“The best advice for young women is to eat a balanced and nutritious diet and to avoid excessive amounts of junk food. A healthy daily diet is one that includes fruits and vegetables, legumes (like beans), nuts, whole grains and a source of healthy fat (fish and olive oil). Also, there are foods that stress the body and should be used sparingly, including dairy fat, red meat, processed sugars and high-fructose corn syrup.”

And now the research suggests that what we eat when we are going through puberty and beyond can also affect the health of any future children.

“Most of us don’t realize that our nutrition is largely determined by our food culture. We consume the foods that our families and our friends like to eat. So even if a young person knows the elements of a good diet, they are not likely to deviate very far from friends and family. To make matters worse, most “junk” foods are designed to taste good and satisfy appetite. The question we need to ask ourselves is how can we change the food culture for this generation?”

So how can we help young people make smarter food choices?

“One small way is to ask young people what healthy foods they like to eat. If they like apples, for example, make apples available to replace candy bars and other snacks.”

So try replacing the candy in your cabinets with trail mix, dried fruit and other healthy snacks. Ask your kids to make one or two healthy “swaps” a week and see how they like it. We bet they will. Here’s to good health, one bite at a time.

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Drs. Michelle Berlin and Renée Edwards are co-directors of the OHSU Center for Women’s Health. Dr. Berlin specializes in OB/GYN and preventive medicine and Dr. Edwards specializes in urogynecology and reconstructive pelvic surgery. 

To keep up with the latest from the Center for Women’s Health, sign up for the Center’s monthly newsletter.

 

What you need to know about the dense breast notification law

Breast cancer screening can save lives, but there are no one-size-fits-all recommendations on when to start cancer screenings and how often to repeat the test. The right formula is particularly challenging for patients with high risk factors, such as dense breast tissue, which can make it difficult to spot early signs of tumors and increase the risk of disease.

State lawmakers took a step toward helping those patients in 2013, when they passed the dense breast notification law. As of March 1, doctors must notify patients with extremely dense breast tissue. Dr. Karen Oh, director of breast imaging at the Knight Cancer Institute, answers some common questions about what the new law means for patients and the different screening technologies available.

What is the breast density notification law?

The OHSU Knight Cancer Institute, like all health-care institutions, is now required to send a breast density notification to women if they are determined to have extremely dense breast tissue on their screening mammogram. The notice is designed to raise awareness and promote discussion between the patient and their health-care provider about the patient’s risk of breast cancer and the best screening approach.

What should patients do if they receive the notification?

The notification advises patients with dense tissue to contact their health-care provider to set up an appointment to discuss an individualized approach.

What do patients need to know about breast density?

Unlike a breast with dense tissue, even a small cancer can be identified in a breast with mostly fatty tissue.

Breast tissue is made up of both fibroglandular and fatty tissue; dense breast tissue has more fibroglandular tissue than fatty tissue in the breast. Dense breast tissue is common and not abnormal, and it decreases with age in most women.  However, it can mask tumors and make it more difficult to find cancer on a mammogram. It also may be associated with an increased risk of breast cancer.

There are many breast cancer screening technologies available, which of these technologies are best for women with dense tissue?

Screening mammography is the only tool which has been shown to decrease deaths from breast cancer in large trials. According to the USPTSF, mortality drops by 17 percent when women ages 50 to 69 get screened every other year.

Other tools are available as well. Tomosynthesis (3-D mammography), recommended for women with dense breast tissue, has the potential to detect more cancers and decrease the chance of a false positive. That combination could leads to fewer follow-up tests and unnecessary biopsies. Patients should consult with their health-care provider to discuss the trade-offs. Breast MRIs, meanwhile, are recommended for women with a greater than 20 percent lifetime risk of developing cancer. However, these tests can lead to more false positives than mammography.

Where can patients learn more about breast density and breast health?

Learn more about services and comprehensive breast care from the Knight Cancer Institute and learn more about breast density at http://www.breastdensity.info.

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Karen Oh, M.D., is the director of breast imaging at the Knight Cancer Institute. Oh received her M.D. from the Mayo Medical School in 1998, and joined the OHSU faculty in 2007.

Knight Cancer Challenge Heroes

Thousands of donors in Oregon and beyond have responded to Nike Co-founder Phil Knight and his wife Penny’s fundraising challenge by giving more than $86 million to date in support of OHSU’s ambitious two-year, $1 billion campaign to revolutionize early cancer detection and treatment. We are thankful to all of our donors for their support. Here are some of their stories.

Second grader honors her grandfather – and everyone sick with cancer.

Genevieve Olson Rocha, age 8, raised a $1000 by making and selling approximately 100 rainbow bracelets to family and friends in honor of her grandpa, who is undergoing cancer treatment at OHSU.

What could be more “Oregon” than beer, wine and coffee? Curing cancer.

Full Sail Brewing Company is an independent, employee-owned company that puts its hops where its heart is. Talented employee-brewers are invited to craft a special beer and then designate a worthy organization to receive a portion of the sales proceeds. Read more about this year’s philanthropic brew.

Dollars to doughnuts, these kids are with us.

Every penny counts in our fight – and a recent gift from students at Portland’s West Hills Montessori School came in the form of dollar bills, rolled quarters, and loose change in a shoebox.

Portlander donates Grimm location fee.

Location scouts for NBC’s Grimm discovered the perfect house for their “Mommy Dearest” episode: a Portland home with a giant weeping cherry tree owned by OHSU employee and longtime supporter Ann Skoog. NBC offered to pay Skoog’s family to vacate the house for three days, putting them up at a hotel while the crew took over the block for late-night filming. Instead, Skoog asked the production company to tally the amount they would have paid for the location fee and donate the money to the OHSU Knight Cancer Institute.

Nike employees spread the word worldwide.

Nike employees aren’t just letting their company’s co-founder do all the work. In February, they launched the Nike Meet Cancer Supper Club, a brilliantly simple fundraising opportunity that is uniting the global Nike community from Beaverton to Brazil. Employees provide the menu, the venue and the vibe. Catered dinners, virtual dinners, raffles of baked goods, pizza parties—anything goes.

Young actor takes on the role of philanthropist.

After watching a close family member’s experience as a patient at the Knight Cancer Institute, eleven-year-old Olivia Gieselman decided to donate the proceeds (so far more than $5,000) from her role in a TV commercial.

Hoffman Construction employees dig deep.

“A campaign is like building a building,” says Wayne Drinkward, long-time OHSU supporter and president of Hoffman Construction Company. “You have a vision, but it doesn’t work until you get the right people together and stick a shovel in the ground. So that’s what I chose to do: create a challenge here that sticks a shovel in the ground and just start raising money.” Learn how Drinkward and his team raised more than $1 million toward our quest to end cancer.

Thank you, Oregon.

By Joe Robertson, OHSU President

Friday, Mar. 7, 4:55 p.m

Moments ago, the Oregon House passed a budget bill that includes full funding of OHSU’s $200 million request for the state partnership component of the Knight Cancer Challenge . The Senate passed the bill earlier this afternoon, and we expect the Governor will sign the bill into law. Today’s action marks a very significant milestone on the road to successfully meeting the Knight Challenge and, most importantly, providing the scientific breakthroughs that save millions of lives.

I want to take a moment to thank legislators and the Governor for their support. The Knight Challenge was embraced on a bipartisan basis by legislators from all parts of the state of Oregon. Along the way to the bill becoming law, the Knight Challenge proposal passed the subcommittee 8-0, the full committee 25-1, then passed the Senate 28-2, and finally the House 55-3.

This is a big day not just for OHSU but for Oregon. I hope all Oregonians take pride in what we’re building here. Today’s action demonstrates to the rest of the country that Oregon is the place where bold, innovative ideas are embraced and lives are changed for the better. We will change the face of cancer. We will end cancer as we know it.

This marks the end of the legislative portion of the journey to meet the Knight Cancer Challenge. The $200 million from the state counts towards the $500 million match, and now we turn our full attention to philanthropy. We have been raising funds steadily ever since the September 20 announcement by Phil and Penny Knight, and next week we will announce the total raised to date. I am excited about the progress we’ve made – and yet in some ways we’re just getting started.

Stayed tuned for more information. And in the meantime, thank you for everything you do for OHSU and for Oregon.

Click here to learn more about the vision for the Knight Cancer Challenge.

 

A tribal gathering: Strengthening partnerships with Native communities

With a focus on building and strengthening community partnerships, Oregon Health and Science University convened the 2014 Tribal Gathering that brought together faculty and staff, along with members of the 43 federally recognized tribes in Oregon, Washington and Idaho.

While the event was a collaborative effort, our team at the Center for Diversity and Inclusion led the charge in planning and executing details. Leaders and members of the Native American Employee Resource Group served as ambassadors during the event.

We were pleased to host leaders and members of the Northwest Portland Area Indian Health Board (NPAIHB), as they described their work in legislation, training and research. The board houses a tribal epidemiology center (EpiCenter), several health promotion disease prevention projects and is active in Indian health policy. For years, NPAIHB has worked with OHSU researchers and faculty on projects that focus on health care delivery, education, and the elimination of health disparities.

It takes a village.

NPAIHB executive director Dr. Joe Finkbonner and Chairman Andy Joseph underscored the importance of cultural competency when working  on health care and research programs with the Native American community. OHSU’s Dr. Norwood Knight-Richardson, Sr. Vice President and Chief Diversity Officer, highlighted the importance of continued communication between the Health Board and other members of the Native American community in order to end health care disparities among Native Americans.

OHSU Provost Jeannette Mladenovic described the university’s commitment to addressing healthcare disparities, and School of Medicine Deans Dr. Mark Richardson and Dr. George Mejicano detailed OHSU’s efforts in medical curriculum transformation that would likely have great impact on underserved communities. Presentations by Drs. Tom Becker, Anthony Baptista and Miles Ellenby highlighted great work already in progress thanks to partnerships led by OHSU’s Center for Healthy Communities, the Institute for Environmental Health, and the OHSU Telemedicine Network.

Our team is eager to move toward formulating a strategy that is actionable. As OHSU moves forward with strategies to continue to engage the Native community, we’ll be sure to keep you updated on the progress of tribal collaborations.  And when another tribal gathering is convened in the future, we hope that you’ll join us.

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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.

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.

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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