Protect your eyes from UV light

Residents of the Pacific Northwest often joke that summer doesn’t officially arrive until July 5. While days can be gloomy in May or June, ultraviolet (UV) light from the sun still poses a threat to your eyes this time of year. Clouds and haze don’t block the harmful effects of UV light, whose levels are three times higher in the summer months.

Too much exposure to UV light can raise your risk of a number of eye problems, including cataracts, painful corneal sunburn, growths on the eye (called pterygia) and skin cancer around the eye. The threat is compounded if you are continually out in the mid-day sun, at higher altitudes or along the water, where reflective surfaces intensify the sun’s hurtful rays.

May is UV Awareness Month and eye care organizations such as the American Academy of Ophthalmology and American Optometric Association have launched public education campaigns to raise awareness about protecting eyes from sun damage.

Here are a few eye healthy tips to keep in mind as we approach the summer season:

  • Everyone who is outside is at risk, no matter their eye color, skin tone or age. Your best protection is wearing a broad-brimmed hat and sunglasses that block 99 percent of UV-B and UV-A rays. Try to find sunglasses that cover your eyelids, lashes and the white part of your eye.
  • Keep in mind that some polarized or adaptive lenses (such as Transitions® lenses) don’t always block the full spectrum of UV rays. Although contact lenses and intraocular lens implants may offer some UV protection, sunglasses are still recommended.
  • Babies and children especially need to don sunglasses and hats. Unlike adults, little ones aren’t able to shade their eyes and because their pupils are bigger, are more vulnerable to the sun’s damaging rays. Protective gear will help them avoid serious eye problems from a lifetime of sun exposure.

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Derek Louie, M.Sc., O.D., is assistant professor of ophthalmology at OHSU Casey Eye Institute. A fellow of the American Academy of Optometry, he specializes in adult eye care with a special interest in medical contact lenses for patients with disorders of the cornea or other  eye conditions. When not seeing patients, he enjoys exploring the cuisines of Portland’s neighborhood restaurants and playing soccer (out of the sun) at indoor arenas several evenings a week.

Calorie-free thirst quenchers

Now that spring has brought warm, sunny days, do you find yourself craving a cold, refreshing beverage? Beware the liquid calories lurking in many drinks!

Calories from fluids typically aren’t filling, meaning you’ll still eat the same amount of food during the day. These liquid calories become “bonus” calories that can easily contribute to unwanted weight gain — not a good thing for your health or the upcoming swimsuit season!

Liquid calories include any beverage that isn’t calorie-free, such as regular soda, fruit drinks (fruit punch, lemonade, etc.), coffee drinks (mochas, sweetened lattes, etc.), sweet tea, energy drinks and sports drinks.

Staying hydrated is important, particularly if you’re outside in hot weather, so I aim for 64 ounces of calorie-free, caffeine-free fluids every day. Water is always a great choice, but what should you do when craving a sweet drink?

Try these tips for tasty and healthy thirst quenchers:

  • Fruit juice spritzers: 100 percent fruit juice is all-natural, but the calories add up quickly. Fiber-filled whole fruit is always a better choice. Try mixing four ounces of 100 percent fruit juice with 16 ounces of sparkling water, or squeeze lemon or lime juice into club soda for a refreshing spritzer. If you’re a regular soda drinker, the carbonation will help satisfy your craving for fizz.
  • Herbal teas: A delicious way to get flavor without any calories, sugar or caffeine is by making herbal tea. Many of my patients love The Good Earth’s Sweet & Spicy herbal tea, and I am addicted to the various fruity herbal teas at adagio.com (piña colada is my favorite—I drink it iced all summer long!).
  • Infused waters: Another tasty, low-calorie option is to add herbs, fruit and even vegetables to a large pitcher of water and steep overnight; the next morning you’ll have a delicately-flavored beverage that’s both refreshing and beautiful. I like the recipes at infusedwaters.com.
  • Other calorie-free drinks such as Crystal Light or Mio are also fine to include.

Some drinks with calories also provide other essential nutrients, such as the protein and calcium from low-fat or fat-free milk (or soy milk)—include eight ounces of skim or 1 percent milk (or soy milk) as part of your 2-3 servings of dairy each day.

Hopefully these tips will help quench your thirst and whittle your waistline this spring!

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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.

A Mother’s Day Thank You

Judy Orem always knew she wanted to be a mom.  She and her husband, Frank, built their lives around their two children, Peter and Nancy.

When Judy was diagnosed with chronic myelogenous leukemia (CML) in 1995, the prognosis was grim. She likely would be dead in five years. But Dr. Brian Druker, a researcher at OHSU, was  launching  testing that would lead to a clinical trial using a drug that would become known as Gleevec®. In January of 1999, she and Frank traveled from their home in San Francisco to Portland, Oregon, hoping for a miracle.

Now, each day Judy is making history as one of the first patients to receive this life-saving treatment, which was approved by the FDA thirteen years ago today. Today, patients taking Gleevec have the same life expectancy as the general population.  Judy’s life is full with gardening, traveling and taking on projects like helping with her high school’s centennial celebration.

Because of Dr. Druker’s discovery, Judy was able to become a grandmother, and—this Mother’s Day—is planning surprises for her daughter Nancy with her grandchildren Ryan and Elizabeth.

“I want to say thanks to Dr. Druker and Oregon Health & Science University,” Judy said. “Because of Gleevec, I’ve had 15 more Mother’s Days with my family that might not have been.”

Learn more at onedown.org.

OHSU Celebrates Asian Pacific American Heritage Month

Learn about diverse Asian Pacific Islander (API) American communities at two events hosted by the API Employee Resource Group to celebrate Asian-Pacific American Heritage Month.

The month of May is celebrated across the country as Asian-Pacific American Heritage Month, an opportunity to recognize the contributions of diverse API communities in the United States. According to the 2010 U.S. Census, there are 18.5 million Americans who identify as Asians and Pacific Islanders. At 43 percent, the rate of growth of the Asian-American population is the largest among all racial and ethnic communities since the 2000 census.

Oregon is home to more than 154,000 API residents that represent a wide variety of ethnic groups, including Chinese, Vietnamese, Filipino, Korean, Indianand more.  API communities include native Oregonians and newcomers who come from diverse national histories, linguistic and religious backgrounds. Here at OHSU, APIs represent about 10 percent of our total student, faculty and staff population across all academic programs and mission areas.

OHSU’s emerging API Employee Resource Group invites the OHSU community to these upcoming conversations. Both events are free and open to the public.

Speaker, Ronault “Polo” Catalani

May 15Noon-1 p.m. at the OHSU Auditorium (Old Library):  Ronault “Polo” Catalani, J.D., an activist-lawyer will present on “Families Move: Facts and Fears About Human Migration.” In his role as manager of New Portlander Programs at the City of Portland Office of Equity and Human Rights, he works with immigrant and refugee community partners to develop and deliver valuable city services to their robust neighborhoods. The vehicle for newcomer integration is civic engagement, the goal is participating in democracy. Polo is well-known in the community for his advocacy work, as well as his column in The Asian Reporter.

May 17, 8:30am-3pm at the Center for Health & Healing: Join the Asian Pacific American Network of Oregon’s 6th annual State of Healthcare Cultural Competency Community Forum for “Stronger Families, Stronger Communities.”

May 29Noon-1pm at the BICC Gallery: Join us for a panel discussion among OHSU faculty and providers on the topic of cultural competent care.

Panelists will discuss their personal and clinical experiences in providing culturally competent care for API and other diverse patients. The discussion will touch on psychosocial and cultural facets that are unique to API communities, and highlight each provider’s unique perspectives about integrating a patient’s belief systems into their treatment or care plan.

Confirmed panelists include:

• Anna Marie Chang, M.D., M.S.C.E., assistant professor, Department of Emergency Medicine

• Amy Mee-Ran Kobus, Ph.D., M.C.R., assistant professor, Department of Psychiatry

• Frances Lee-Lin, Ph.D., R.N., O.C.N., C.N.S., associate professor, OHSU School of Nursing

• John Ng, M.D., F.A.C.S., orbital trauma specialist and a member of the Division of Oculoplastic and Orbital Surgery at the Casey Eye Institute

For questions, to request accommodation to attend either event, or to learn more about the OHSU API Employee Resource Group, contact cdi@ohsu.edu or visit www.ohsu.edu/diversity.

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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.

Is chocolate good for your heart?

Cocoa has been long been known for its good taste. But several epidemiological studies and some small prospective studies have shown that cocoa exerts beneficial cardiovascular effects. These beneficial effects seem to be mediated by its polyphenols, especially flavanols, a group of natural chemicals found primarily in fruits and vegetables.

The beneficial effects of cocoa include improvement in endothelial function (the lining of your artery wall), the reduction in platelet function (decreasing the chances of a blood clot), and the potentially beneficial effects on blood pressure, insulin resistance, and blood lipids.

But before you rush out to stock up on chocolate, know this: the manufacturing process to make chocolate from cocoa seeds significantly decreases the concentration of the flavanols. Milk chocolate in particular has the lowest flavanol content compared with cocoa powder and dark chocolate.

And many chocolate products contain milk or processed fats, e.g., palm oils. Your best bet – cocoa powder itself (especially raw cacao powder) because, unlike chocolate, it is low in sugar and fat.

And when you crave a chocolate fix – look for dark chocolate, particularly those with more than 80% cacao. Everything in moderation!

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Tina Kaufman Ph.D. leads the Heart Disease Prevention program at the OHSU Knight Cardiovascular Institute. Her specialty is exercise, nutrition and lifestyle modification. Within the preventive cardiology practice, she assesses cardiovascular risks, counsels and treats patients with specific dietary goals, and provides exercise prescriptions, smoking cessation, and blood pressure and cholesterol management.

How head and neck cancer screenings can save lives

More than 48,000 cancers that occur on a patient’s head or in their throats and mouths are diagnosed in the U.S. every year.

Understanding the underlying causes of these cancers, as well as ensuring they are caught early, drives Neil Gross, M.D., to organize free screenings at the OHSU Knight Cancer Institute that draw hundreds of people each year. He shared insights into what he’s learned after holding the screenings, now in their seventh year, and helping other health care institutions start them in Salem and Coos Bay.

What does a head and neck cancer screening entail?

A head and neck cancer screening is quick, painless and low-tech. It involves a visual evaluation of the face and scalp, skin, mouth, tongue, throat and neck. To better view the tongue, mouth and throat, physicians often use a light and tongue depressor. They use their hands to feel the neck and shoulder areas to check the thyroid and other potentially impacted areas.

Screenings are conducted by OHSU physicians, dentists, and other physicians. The medical staff will help participants learn how to differentiate between harmless symptoms and potentially dangerous signs of cancer. Following the exam, patients can arrange for a follow-up appointment, if necessary.

What research studies have you advanced through past screenings?

Researchers asked participants at the 2013 screenings if they wanted to take part in a study about human papillomavirus (HPV), its prevalence in Oregon, and the risk to long-term partners of those with HPV-associated cancer.

This year, OHSU researchers will ask screening participants if they are willing to give a saliva sample that will be studied for its microRNA content. MicroRNAs are small snippets of material in human cells that regulate how genes function. Researchers will explore a potential link between microRNA counts in different types of head and neck cancer and compare those to samples from healthy participants recruited during the screening.

Can you tell us about a patient who was helped by one of your screenings?

Last year, a physician’s assistant told Dick Brack, suffering from long-running sinus issues, to get checked at our free head and neck cancer screening. Following a short check and conversation at the screening, he was referred for further examination.

Mr. Brack had cancer involving lymph nodes in the neck, which were removed. As part of Brack’s treatment, he was enrolled in a clinical trial to test a common steroid medication, dexamethasone, to reduce pain and improve swallowing after surgery. He went on to receive radiation therapy at the OHSU Knight Cancer Institute.

And one year later, Brack is happily retired, living cancer-free.

Tell me about this year’s screening?

As part of national Head and Neck Cancer Awareness Week, the OHSU Knight Cancer Institute is offering free screenings from 7 a.m. to 3:30 p.m. April 25 in the OHSU Center for Health & Healing lobby, 3303 S.W. Bond Ave., Portland. No appointment is necessary. Learn more about the screening here.

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Neil Gross, M.D., is an associate professor of head and neck clinical trials and robotic surgery for the Knight Cancer Institute. He is responsible for developing the annual head and neck awareness and free screening day at OHSU. His current research focuses on treating HPV-associated head and neck cancers, minimally invasive surgical approaches including transoral robotic surgery (TORS) and developing tools to better predict the results of treatment for patients with head, neck and thyroid cancers.

Put some “Spring” in your step

With the days growing longer, it’s the perfect time to take advantage of spring weather and enjoy the outdoors. As a trainer for OHSU’s March Wellness Center, I see how exercise benefits my clients physically and mentally every day.

At age 30, a woman’s bone density starts to decline, and it’s crucial to build that back up. Exercise is one of the best things you can do to rebuild and maintain your bone mineral density. Working out with weights and walking help build bone density, as well as strength.

America is a nation of sitters. If we are hunched over a computer all day, our posture suffers, and when our spines aren’t in alignment, we put extra strain on our bodies. When I work with clients, I focus on reversing “computer hunch” with back strengthening moves like rows, which stabilize and work the back, and stretches for the chest and the front of the body.

And don’t overlook the incredible psychological benefits of exercise. The hormonal effects are amazing. When you exercise, you release endorphins, and that’s your body’s ‘happy drug’”—something we could all use a little more of, don’t you think? Simple walking, with correct posture and gluteal muscles engaged, is a terrific overall exercise.

Want to walk the talk? Be sure to mark your calendars for Portland’s American Heart Association Heart Walk on May 17th. You can join a walking team or donate directly to the AHA.

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Kimi Daniel Kimi Daniel is a trainer at the OHSU March Wellness Center. She also helps train high-school athletes at St. Mary’s Academy in Portland. Daniel earned her B.S. in exercise science at Portland State and her M.S. in athletic training from Florida International University.

Ask the Health Expert: When are statins effective?

You ask. OHSU experts answer.

Q: When are statins effective? And what are the side effects?

A: Your question is a timely one. Statins are a class of drugs used to lower LDL cholesterol levels, and they’re one of the safest classes of medications that we have.

Recently (November of 2013), the American Heart Association and American College of Cardiology published the new national guidelines on the treatment of blood cholesterol to reduce the risk of atherosclerotic cardiovascular disease (ASCVD) in adults. They identified four groups at risk for ASCVD events – heart attack, stroke, and death – who warrant treatment with a statin:

  • Diagnosis of ASCVD (primarily coronary artery disease or stroke)
  • LDL cholesterol > 190 mg/dl
  • Diabetes with LDL >70 mg/dl
  • Estimated 10 year risk of having a heart attack or stroke >7.5%

These groups have demonstrated major benefits from statins to the extent that the benefits outweigh the risks. But it is important to understand the side effects. For a minority of patients, these may include muscle aches and pains and a very small increased risk of diabetes in individuals already at risk. Again, in individuals who belong to one of the four benefit groups, the number of heart attacks and strokes that are prevented is much greater than the incidence of side effects with statins.

Click here to submit your own question to OHSU cardiology experts.

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Michael Shapiro, D.O., is the medical director of the Heart Disease Prevention program at the OHSU Knight Cardiovascular Institute and is a board certified cardiologist with sub-specialty board certifications in Lipidology (cholesterol) and Cardiovascular Computed Tomography (CT).

Eight-year-old pneumonia patient recovers close to home thanks to telemedicine

Ryan was one of the sickest patients I had managed in years. Pneumonia was robbing his bloodstream of oxygen, and I was sure I would have to send him to Portland for specialized care.

But that didn’t happen. Instead, interactive video technology allowed doctors from OHSU Doernbecher Children’s Hospital to consult on Ryan’s case from a distance. He made a full recovery at Bay Area Hospital, without the expense and family disruption of traveling to Portland.

A healthy 8-year-old, Ryan had been sick for a week with fever and cough when I first examined him. Pneumonia had infected both lungs. Ryan’s oxygen level was so low; he needed to be hospitalized to receive extra oxygen and additional treatments.

After being admitted to a Bay Area Hospital, Ryan deteriorated further. His breathing became more labored and rapid, and he needed even more oxygen. We decided to obtain a telemedicine consultation with Doernbecher’s pediatric intensive care specialists. Like Skype on steroids, telemedicine offers ultra-high definition video conferencing.  An OHSU PICU doctor can position the robotic camera as needed, zooming in and out to examine a patient in Coos Bay.

Dr. Laura Ibsen was the first pediatric intensivist to examine Ryan from afar. Using interactive live video, she could direct questions to Ryan’s parents and view the child’s vitals and lab results in real time. Ryan’s mother, Michelle, thought it was fantastic. Dr. Ibsen offered us a small suggestion, along with reassurance that we could keep Ryan at Bay Area Hospital. The next day, however, a new chest X-ray looked much worse. We again turned to telemedicine, consulting OHSU Doernbecher’s Dr. Miles Ellenby.

Dr. Ellenby affirmed our treatment of Ryan and stayed in contact with us throughout the day. Dr. Ellenby’s confidence in us and his suggestions made a big difference to our efforts.  Ryan began showing sustained improvement. His family was relieved. “It was reassuring to know there was not a better option,” his mother, Michelle, said. “Everything was being done appropriately.”

Several days later, no longer needing supplemental oxygen or IV medications, Ryan went home!

Telemedicine helps us in many ways:

1. It improves patient care.  Our community has eight well-trained pediatricians, but we spend most of our time in the office seeing mild illness. Thanks to modern vaccines, we use our hospital skills much less than in the past.  Having a specialist co-manage our patients keeps us up to date.

2. It improves patient safety. We have consulted OHSU physicians while caring for critically ill patients.  Not only did they provide extra knowledge, they helped focus on the basics, such as CPR and proper placement of endotracheal tubes.

3. It bolsters staff confidence. Nurses are more confident when they are part of the consultation with OHSU.

4. Families can stay together. Ryan’s sister was also sick, but she did not have to be in the hospital. If Ryan had been sent to OHSU, the family would have struggled to find childcare for his siblings.

5. We save money and resources. A transport from Coos Bay to Portland might cost as much as $30,000 – not including the cost of the stay at OHSU. Also, eliminating the trip means the highly trained pediatric ICU nurses and respiratory therapists on OHSU’s transport team can stay in Portland, caring for other patients.

Telemedicine is the best of both worlds. Patients have access to some of the best specialists in the country while staying in their community hospital, with their own provider.

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Jon Yost, M.D., F.A.A.P. was raised in Bandon, Ore., and earned his medical degree from OHSU. He received his pediatrics training at Children’s National Medical Center in Washington, D.C., and has been treating patients at Bay Clinic since 2003.

Celebrating doctors everywhere

A message from OHSU clinical leadership

March 30 is National Doctors Day – a day set aside in 1990 to celebrate the contributions physicians make to care for people across this country. Beyond this occasion, we think it’s appropriate to let OHSU physicians know how much we appreciate their effort and expertise.

The unique responsibilities of a physician in academic medicine make it a job unlike any other. Our physicians are dedicated, selfless and innovative. They deliver life-changing interventions, teach the next generation of physicians and search for tomorrow’s cures every day. In short, they do amazing things.

As we navigate this time of unprecedented change in the nation’s health care system, we are grateful to be able to count on them. We also recognize that during this evolutionary period, it is our responsibility to ensure they have a stable platform from which to conduct their important work, and we are undertaking initiatives that will allow them to continue to do so.

To physicians everywhere – and to our colleagues at OHSU – thank you for everything you do.

Sincerely,

Joe Robertson, M.D., MBA, president, OHSU

Mark Richardson, M.D., MBA, dean, School of Medicine and president, FPP

Tom Heckler, MBA, senior associate dean for the clinical practice and chief executive officer, FPP

Peter Rapp, executive vice president, OHSU and executive director, OHSU Healthcare

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In honor of National Doctor’s Day, you can honor a physician at OHSU with a donation in his or her name. When you give online, write a personal message, and the OHSU Foundation will share it with your favorite doctor.

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.

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