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.

***

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.

***

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.

***

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

***

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.

Enjoy the taste of eating right

March is National Nutrition Month, and the theme for 2014 is “Enjoy the Taste of Eating Right.” Following a healthy diet should not make you feel deprived – instead, eating a diet filled with foods that are delicious, beautiful, and nutritious should make you feel satisfied and content.

Nutrition Month may be coming to an end, but your resolution to eat better doesn’t have to. Here are three goals to incorporate more enjoyment into your diet:

  • Focus on flavor: Seek out foods you enjoy so that eating well doesn’t feel like a chore. Eat fruits and vegetables that are in season (tomatoes will be much more flavorful in August than they are now!), try new and appealing recipes from healthy cookbooks or websites (I love EatingWell magazine and website), and make sure to incorporate lots of variety so you don’t get bored with your diet (chicken breasts…again?). Make a weekly meal plan to help ensure your meals are healthy, varied, and fit within your budget.
  • Savor your meals: Do you feel like meals have become one more thing to check off your to-do list? Turn off the TV and set the table! Make mealtime more meaningful by minimizing distractions, sitting down, and allowing yourself to enjoy your food. This will help you better control your portions, reconnect with loved ones, and set a good example for your kids—little ones who see their parents eating fruits and vegetables are much more likely to eat these foods themselves.
  • Eat with your eyes first: In order to get maximum enjoyment from a healthy diet, it’s vital that foods look as good as they taste. As a bonus, the more visually appealing the food, the better the chance any picky eaters in your family will dig in!
    • Take advantage of the vibrant colors of fruits and vegetables to add visual appeal to your plate. Again, choosing produce that is in season will be more vibrant and beautiful. Use this list for new ways to increase your fruits and veggies this month.
    • Use small amounts of fruit or veggie purees or other sauces to add pizzazz to meals.
    • Use fresh herbs, citrus fruit, or even edible flowers as creative (and healthy!) garnishes.
    • Ready to unleash your inner Top Chef? Use these tips to start plating meals like a pro.

I feel so fortunate to live in Oregon, where we have such great access to a variety of fresh, gorgeous, and delicious fruits, vegetables, and seafood. Soak in the first hints of spring this month as you enjoy the taste of eating right!

***

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.

Reflections on Match Day

Today, members of the OHSU medical school Class of 2014 found out where they will be spending the next few years of their lives as they transition from medical student to resident. Although separated by only a few weeks in time (Match Day is in March and the first day of their internship is usually July 1), the gap between being a student and being a resident is vast.

Of course there are the obvious differences: the title of “doctor,” the long white coat, covering all the patients on service, the constant interruptions, far less sleep, an actual paycheck, etc. And yes, the learning curve is much steeper and the stakes are far higher once the threshold is crossed. However, it is only through the reflective lens of time that one truly grasps what has occurred now that the envelope has been opened.

For most of the class, the next few months will bring all of the joy and frustration of moving to a new city and starting a new job. Those are big events associated with major change that nearly everyone goes through from time to time.

But that’s not what I mean. What I am referring to is life-altering – perhaps not as dramatic as a monarch butterfly emerging from a chrysalis, but it is just as profound. When one considers that medical residents bear daily witness to the trials and tribulations associated with acute and chronic illness, this transformation comes as no surprise. In contrast, what is surprising is the slow but steady fusion of one’s personal identity with those of the profession. Reading the words on the paper within the envelope opened by most U.S. medical students today signifies the arrival of a new sister or brother to the ranks of each medical specialty. Four years of hard work during medical school will melt into the gradual realization that a life of service to humanity has begun, that one has been fundamentally changed, and that there is no going back.

Congratulations and welcome to your new home! Click here to read more and see photos from Match Day 2014.

***

George Mejicano, M.D., M.S., is senior associate dean for education in the OHSU School of Medicine. He is also professor of medicine and board certified in both internal medicine and infectious diseases.

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.

***

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.

***

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.

 

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

Participation Guidelines

Remember: information you share here is public; it isn't medical advice. Need advice or treatment? Contact your healthcare provider directly. Read our Terms of Use and this disclaimer for details.

Categories