Oregon Health & Science University

About OHSU Health

Your family’s well-being is important to us. That’s why OHSU’s Health magazine brings you the latest research news, expert advice and event listings to help you stay current and keep your family healthy. Our magazine is intended to educate and inform: If you have urgent medical issues or in-depth questions, please talk to your health care provider.

Got questions or suggestions? We’d love to hear your feedback: Email us at editor@ohsu.edu

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UpFront

Virtual urgent care at OHSU

Getting urgent care has never been easier. With OHSU Virtual Visits–Urgent Care, OHSU providers can treat a range of nonemergency medical conditions for children and adults through a secure video visit. You can live chat from anywhere in Oregon with an OHSU medical professional using your smartphone, tablet or computer. We are open seven days a week between 7 a.m. and 10 p.m. We can even electronically send prescriptions to your pharmacy.

“This new platform allows us to remove the barriers that can prevent people from receiving the care they need at a time that meets their needs,” says Dr. Todd Clark, medical director of OHSU Virtual Visits-Urgent Care. “We want to help our patients avoid spending their valuable time and money in urgent care or emergency rooms whenever possible. Our providers are able to diagnose and treat over 90 percent of the patients who use this service, so we can help you get back on your feet as quickly as possible.”

Depending on your insurance coverage, virtual appointments typically cost less than an urgent care or emergency room visit. Price varies depending on your benefits, but you will never pay more than $49. If we determine that a virtual visit is not appropriate for your condition, there is no charge.

Conditions we commonly treat:

Allergies
Asthma
Back pain
Constipation
Cough
Diarrhea
Fever
Headache Insect bite
Minor cuts/scrapes/burns
Nausea/vomiting
Nicotine addiction
Pink eye
Poison oak/poison ivy
Runny nose
Skin rash
Sore throat
Strains/sprains
Urinary tract infection

Discoveries

Creating 14 million heartbeats a year

The heart is the athlete of the body’s organs, pumping 14 million beats each year. For patients needing a new heart, the gap in available organ transplants can mean a long wait. The only artificial heart currently approved in the U.S. is a short-term fix, intended only for temporary use. OHSU has been a leader in pursuing a better, more permanent solution for decades, since OHSU surgeons co-invented and successfully implanted the world’s first artificial heart valve in 1960. Today, OHSU is designing a battery-powered artificial heart device that is simple and durable, with few moving parts for less chance of mechanical problems. The OHSU device mimics a pulse, unlike existing designs. The next step in development is a clinical trial in animals to test the device. A successful artificial heart could extend the lives of the approximately 75,000 Americans who die of heart failure every year.


Opening a gateway to understanding the nervous system

Within the amazing communications system of the human body, ion channels (tiny proteins that act as gatekeepers) decide which messengers to let through which cells. Scientists believe acid-sensing ion channels play a role in how we feel pain and in mental disorders. Recently, researchers at OHSU’s Vollum Institute used advanced imaging studies to reveal the unique chemistry of acid-sensing ion channels. Through this discovery, OHSU scientists hope to open the door for new research into how manipulating these acid-sensing ion channels could be used to treat nervous system problems such as stroke and chronic pain.

This study was published in the journal Nature.


Forget the salt and pass the banana?

High blood pressure can be deadly, leading to an estimated 7.5 million deaths worldwide, according to the World Health Organization. There are many known causes, such as eating too much salt. Patients with hypertension often follow low-sodium diets as part of their treatment. About 10 years ago, an OHSU doctor who specializes in kidney function discovered that the kidneys can balance salt and potassium, a natural mineral found in foods like sweet potatoes and bananas. Now, OHSU is part of an international research project to examine how the kidneys handle potassium, and how a potassium-rich diet can lower blood pressure. Through this five-year study, researchers hope to find new ways to control or even prevent high blood pressure.

Your Questions, Our Answers

Q. I had an abnormal cardiac stress test, so my doctor says I need a coronary angiogram to determine if I need a stent or bypass surgery. How is that decided?

A. The coronary arteries that supply your heart muscle with blood can become clogged over time, putting you at risk for a heart attack. If only one artery has narrowing, angioplasty and stenting are good options with a shorter recovery time. However, if multiple vessels are diseased, coronary artery bypass grafting (CABG) is recommended. This is especially true for patients with diabetes. Studies show the results from CABG last longer and are more effective than adding several stents into diseased arteries. With CABG, we create a bypass for the blood around the blockages. At OHSU, we specialize in using arterial grafts to form bypasses, borrowing arteries from the arm and chest wall. Following surgery, patients can return to normal activity within three months with improved cardiac symptoms.

Danielle Smith, M.D.
OHSU Knight Cardiovascular Institute
503-494-1755


Q. Medication is no longer controlling my epilepsy. Is surgery an option?

A. Fewer than 10 percent of people with epilepsy get surgery, though technological and surgical advances may offer more opportunities for treatment. For many years, we have surgically removed the area of seizure focus, which is still the best option for some patients. However, many people with epilepsy have more than one focus or the focus is in a tricky place in the brain. They can have intractable seizures, or seizures that don’t stop with medication. Until recently, we didn’t have a surgical treatment for them. Now, in some cases, we can use a tiny laser to eliminate the focus with a minimally invasive method. For others, we can implant a device called an RNS that can sense a seizure before it happens and stop it with a small electrical charge. With the tools currently available, we have expanded our ability to help people with intractable epilepsy resume normal lifestyles.

Ahmed M.T. Raslan, M.D.
OHSU Brain Institute
503-494-4314


Q. I’ve had nagging back pain for some time, but now I am getting intense shooting pain down my leg. Is it a disc problem?

A. Shooting pain down the arm or leg is a classic sign of a herniated disc. Rubbery discs in our spines have soft, gel-like centers surrounded on the outside by tough, fibrous bands. As we age or experience trauma, these bands can tear. The gel can protrude out from the tear, or herniate, pinching a nerve. Herniated discs are often in the lower back. They occur twice as often in men and usually to people in their 30s to 50s. Herniated disc pain is uncomfortable. Some people also feel weakness or numbness in an arm or leg or have bladder/bowel trouble. In 60 to 70 percent of cases, the body heals, and pain improves within two to three months. For others, an outpatient surgery called a microdiscectomy can resolve the pain quickly. If you have disc symptoms, visit your primary care doctor. If the pain continues after basic treatment, you may be referred to a spine surgeon.

Josiah Orina, M.D.
OHSU Spine Center
503-418-9888


Q. If I’m having trouble with my prostate, does that mean I’ll get prostate cancer?

A. As men age, they commonly experience symptoms while urinating that are related to an enlarged prostate gland, such as a weakened stream and urinary frequency. In most cases, these symptoms are not a sign you have or will get prostate cancer. If urinary symptoms are significant, however, we would want to rule cancer out as a cause. A simple and inexpensive blood test called a PSA (prostate-specific antigen) is the best way we know to screen for prostate cancer. After a discussion of PSA testing with your doctor, we generally recommend that men get a baseline PSA in their 40s, because the results at this age can guide us in your risk level and determine how often we may need to see you again. If you are African-American or have a family history of prostate cancer, we move the timeline up and recommend you get a PSA starting at age 40.

Christopher L. Amling, M.D., F.A.C.S.
OHSU Knight Cancer Institute
503-346-1500


Q. Is it true that girls on the autism spectrum are diagnosed later?

A. Yes, research suggests girls are identified about two years later, especially if they are very verbal and bright. Various factors likely influence this delay. First, four times more boys have autism, so parents may not immediately consider autism spectrum disorder (ASD) in girls. Historically, we’ve defined autism around a male norm, but are slowly realizing girls differ. For example, girls often have intense interests that seem more “typical” (like animals). They may be better at masking symptoms or imitating peers to blend in. However, this effort takes a toll on them. Older girls with ASD are more likely to be depressed or anxious, which can also lead to misdiagnosis or missing the underlying autism. Overall, girls may present as more withdrawn, whereas boys attract attention earlier with disruptive behavior. So, in many ways, girls with ASD can fly under the radar. If you have concerns about your daughter, discuss an evaluation with your pediatrician.

Lark Huang-Storms, Ph.D.
OHSU Doernbecher Children’s Hospital
503-349-0640


Q. When is a pregnancy considered high risk?

If there is a complication in the pregnancy that can affect either the mom’s or the baby’s health, we consider it a high-risk pregnancy. Some women have known medical conditions before pregnancy (such as diabetes or high blood pressure) that can make pregnancy high risk. For others, the complication develops during pregnancy. A pregnant woman may have premature bleeding or vaginal bleeding, as examples. In other cases, we may discover an abnormality in the fetus, such as a heart defect, during an ultrasound. In all these examples, we would recommend the mother get an evaluation by a perinatologist (also called maternal-fetal medicine specialist), an OB-GYN doctor who has three years of additional training in high-risk pregnancies. Perinatologists can also offer counseling before pregnancy for women who have medical illnesses or increased risk for genetic complications, such as a family history of genetic disease or maternal age above 35.

Leonardo M. Pereira, M.D., M.C.R.
OHSU Maternal-Fetal Medicine
503-418-4200


Living Well

Mindfulness in motion: Stay in the moment on the go

When your body is on autopilot, your mind may wander. Dwelling on the past or future is fertile ground for stress to arise, advises OHSU researcher Jeffrey Proulx, Ph.D.

Instead, Proulx encourages mindfulness, a pause from the whirlwind of our lives and minds.

“Being mindful can be as simple as asking yourself, ‘What am I thinking about? Is my mind somewhere else?’” he says. “I encourage people to consciously engage in whatever it is they are doing, even if it is just sitting on the bus. Sit on that bus fully and do it well, with awareness of your posture and breathing. Do the next activity with continued awareness of inner and outer posture.”

Simple ways to be mindful include settling your mind on bodily sensations, but not identifying the sensations as your own. Listen to the universe of sounds all around. Experience 10 deep breaths from beginning to end. Allow yourself to relax in body and mind and concentrate on what is happening now. Whatever you were worried about will still be there two minutes or two hours later. “The weight of doing stuff all the time is heavy; so non-doing, being still and quiet and opening ourselves to the present moment without judgment, is a recipe for resilience,” Proulx says. “Life can be stressful; mindfulness is a lovely way to realize that underneath our busy thoughts, we are already free.”

Jeffrey Proulx, Ph.D.
OHSU Brain Institute

Summer Safety: Here comes the sun — tips and tricks for the best (and safest) summer ever

Sunburns, bug bites, dehydration — all are common pitfalls that can quickly derail your family’s summertime fun. As you gear up for lazy days by the pool and long walks in the woods, keep these health and safety tips in mind.

Full coverage

Choosing a high-SPF sunscreen is the best way to protect your children from the damaging effects of the sun, right?

“Sunscreen is important but it is actually my second line of defense in sun protection,” says Dr. Tracy Funk, a pediatric dermatologist at OHSU Doernbecher Children’s Hospital. “Sun-protective clothing is foolproof and doesn’t wear off over time, unlike sunscreen.”

Funk recommends clothes with UPF (UV protection provided by fabric) ratings — including rash guards or swim shirts for water activities — but regular clothing might work in a pinch. “Hold up clothing to a light,” she explains. “If it has a tight weave and not a lot of light goes through, then it’s got pretty good sun protection.”

Consider a sunshade over outdoor play areas, and don’t forget hats and sunglasses. “It can be difficult to keep these on kids,” admits Funk, “but just keep trying. Straps are useful.”

Of course, sunscreen is still essential for protecting the face and other exposed skin. Regardless of SPF, you still must reapply it every one to two hours. In fact, spending more on high-SPF sunscreen is generally a waste. “SPF 50 is almost as effective as SPF 100,” says Funk. “What’s more important is that the sunscreen is broad spectrum, which means it protects against UVA and UVB light.” If your kids will be swimming or playing in water, look for “very water resistant” varieties, which will last through 80 minutes of water activities.

Recently, rumors have circulated about the potentially harmful effects of chemical UV filters, such as oxybenzone. “I think there’s a lot of misinformation out there,” says Funk. “All the sunscreens that are available are safe and effective.” The mineral sunscreens, which contain zinc oxide and titanium dioxide, are great options for people that have concerns about sunscreen safety. Sunscreens to avoid are the spray-on variety, which often are inadequately applied and are easy to accidentally inhale.

But won’t sunscreen lead to low vitamin D? In short, no. People get vitamin D from their diet as well. More importantly, sun damage has a cumulative effect, which means the exposure your kids get now will affect them in adulthood. “Sunlight is a powerful carcinogen, and exposure can lead to skin cancer,” Funk says. “It’s easy to supplement the diet with vitamin D if necessary.”

Itchy and scratchy

Sunburns can surprise even the most vigilant parents, and according to Funk, sunburned kids should stay out of the sun until any redness is gone. In the meantime, a lukewarm bath can offer some relief, as can ibuprofen and topical hydrocortisone cream. Usually, though, it’s bug bites that have us begging for itch relief. What’s the best way to keep mosquitoes from treating our children like an all-you-can-eat buffet?

“DEET is the most effective insect repellent,” says Funk. “It has been shown to be safe even for kids as young as two months of age.” Products with 10 to 30 percent DEET are plenty effective, and last for between two to five hours.

Dr. Funk recommends repellents with DEET if you’re in an area with insect-transmitted disease. There are several more natural insect repellents on the market, and these may be reasonable options when insect-related diseases are not a concern.

If you’re tempted to get one of those bug repellent/sunscreen combo products, resist. Sunscreen must be applied every two hours, which would be far too much repellent.

Beat the heat

Children are experts at playing outside. Staying hydrated? Not so much. “Pay attention when it’s hot out,” says Dr. Sarah Green, a pediatrician at OHSU Doernbecher Children’s Hospital. “Make sure your kids are taking breaks to drink water.”

With some children, though, that’s easier said than done. “Having their own water bottle with special straw can be helpful,” says Green. “Putting ice in it can be appealing.” If all else fails, try DIY juice Popsicles. (At that point, juice is preferable to nothing.)

When it’s very hot out, Green recommends seeking shade and avoiding the outdoors during peak sun hours. “One dangerous situation can be sports practices, when children don’t feel well and are asked to perform,” she warns.

Signs of dehydration include dry, cracked lips, decreased urine, darker urine and low levels of sweat despite the heat. For babies, watch out for unusually dry diapers or less wet diapers in a day. If you see any of these signs, it’s time to “get out of the sun, get in a cooler spot, and work on drinking fluids,” says Green.

If your child seems disoriented, sleepy, confused or nauseated, it could mean a dangerous rise in core temperature, which warrants a trip to the emergency room. “While we want to keep babies out of the sun, be careful about covering strollers as it can make the baby even warmer,” Green says.

To learn more about keeping your child safe in the summer months, talk to your child’s pediatrician or call OHSU Doernbecher Children’s Hospital at 503-346-0640.

Volunteer Spotlight

The Fur Cure

Sometimes the best therapy comes in on four legs

A pair of soulful brown eyes and a soft, fleecy coat are just the good medicine many hospital patients need. Whenever Oskar and his owner, Barb Harford of Portland, knock on a door, patients’ eyes light up with excitement. Oskar and Barb are one of 15 teams of volunteers who bring pet therapy to OHSU and Doernbecher hospitals.

“As a therapy dog, Oskar just loves on people,” Harford says. “I’ve noticed he can pick up on people’s responses and needs — he just senses it. He knows instinctively to be careful and gentle.”

Patients pepper Harford with questions while petting Oskar, or even inviting the 75-pound pup to come up on the bed. Their curiosity about Oskar often leads to stories of their own.

“Patients are missing their pets and will tell me stories about their own dogs and cats,” Harford says. “Seeing the looks on people’s faces and hearing their stories makes my day. I find it uplifting.”

A common question is about Oskar’s breed. He is a 5-year-old goldendoodle, a golden retriever and poodle mix. He was such a mellow and social puppy, Harford registered for training to become a certified pet therapy pooch. Oskar’s certification comes from the Alliance for Therapy Dogs. Harford explains that pet therapy dogs can be any breed but need a certain laidback personality and obedience training to be successful. Oskar is her first pet that she ever considered for this role, as her previous dogs were all too rambunctious for this service.

Once a week for a couple of hours, Oskar and Barb make the rounds of designated wards.

“Oskar is kind of a celebrity,” she says. “I think the nurses and staff get as much loving from the dogs as the patients.”

Desza Dominguez, who supervises OHSU’s volunteer services, would like to bring in more pet teams to visit patients.

“We used to have 20 teams, but we are down to 15,” she says. “We have 14 dogs and one cat who regularly visit, but there are more patient requests than we can fulfill. We work with several certifying agencies, and we are always looking for new teams.”

Animal-assisted therapy is increasingly used in health care settings as studies show interacting with animals can reduce pain, anxiety, depression and fatigue. Even patients’ family members who sit in during a visit with a pet therapy animal feel better.

Though Harford may seem to be simply the entourage supporting the star, she feels her role is important too. She provides a welcome distraction of conversation, patience and empathy.

“After those two hours each week, I feel great,” she says. “To see people’s joy when we arrive, sometimes even their tears. It’s so moving to be there for them.” Want to learn more about the Animal-Assisted Therapy Program at OHSU? Visit their website to learn more about how animals help patients and how to become a volunteer team.

Calendar

Request reasonable accommodation for these events at 503-494-2834 or hsmktg@ohsu.edu.


Get Your Rear in Gear

Saturday, Aug. 4, 8 a.m.
Walk with us at this year’s event! Join the OHSU “Torchbearers” and walk to help support colon cancer awareness. At OHSU Knight Cancer Institute, we are ending cancer as we know it. For more information, please visit www.ohsuknightcancer.com/events.
Location:
Mt. Tabor Park
S.E. 60th Avenue and Salmon Street, Portland, OR 97215

Ask the Health Experts Seminars
OHSU Center for Health & Healing (CHH)
3303 S.W. Bond Ave., 3rd Floor, Portland, OR 97239
To learn more and register, please visit ohsuhealth.com/seminar or call 503-494-1122.

June 6
7 p.m.
Christopher Amling, M.D. and Hilary Shreves, M.S.N., A.C.N.P.-B.C.
Prostate cancer: Diagnosis and recovery
Prostate cancer is the second most common cancer in men, occurring in one of every nine males. However, with diagnosis and treatment, most men recover. Learn about risk factors and screening guidelines for prostate cancer, as well as regaining function, vitality and quality of life in survivorship.

June 20
7 p.m.
Janelle Trempe, P.T., A.T.C. and Hannah Scholter, P.T.
Knee osteoarthritis and physical therapy
Have you been diagnosed with knee arthritis? Learn about knee arthritis and how physical therapy could benefit you.

August 15
7 p.m.
Teni Davoudian, Ph.D.
Sleep better: Therapy for Insomnia
One in five Amercians suffer from chronic insomnia and it is especially common in women. Learn about effective treatments for insomnia, including group cognitive behavioral therapy.


FYI

Alert: Tram closed June 23 – July 29, 2018

The Portland Aerial Tram will be closed for five weeks for routine maintenance. Free shuttles between Marquam Hill and South Waterfront will run every 10 minutes for patients, but it could add 30 to 45 minutes to your travel time. You can find more information at www.gobytram.com/closure.

Each issue, we bring timely health tips and information to help you and your family live healthier lives. Got a question or health issue you’d like our experts to address? Email us at editor@ohsu.edu.


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Fine Print

Health is a quarterly publication of OHSU serving the greater Portland area. Information is intended to educate and is not a substitute for consulting with a health care provider.

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Editor-in-chief: Ashley Uchtman
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Graphic designer: David Riofrio