EVERY MINUTE. Ahuja. Our certified stroke center provides leading-edge care Page 4. The best way to treat sports concussions

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1 UHAhuja.org Fall 2014 Ahuja EVERY MINUTE MATTERS Our certified stroke center provides leading-edge care Page 4 The best way to treat sports concussions Page 21 Get faster test results with same-day imaging Page 3 Want to skip a lengthy ER wait? Our InQuicker service lets you "check in" from home. See page 22

2 A Winning PARTNERSHIP has long been known for its excellence in the field of sports medicine. That reputation has been formally galvanized in the community as UH has become the Official Health Care Partner of the Cleveland Browns for the next decade. As Official Health Care Partner, UH provides a dedicated team of physician specialists covering every aspect of the team s health care, insuring they are in the best condition on game day. In addition, the organizations are working to co-create an individualized, innovative and cutting-edge sports medicine program based on medical and scientific evidence-based research to enhance the athletic performance and overall health and fitness of all Browns players. The goal, says UH CEO Thomas F. Zenty III, is to redefine sports medicine in ways that will benefit professional and amateur athletes at every level. What does this mean for you? With our network of regional hospitals and health centers located throughout Northeast Ohio, you can now find convenient, close-tohome access to the same level of care that s provided to our beloved Cleveland Browns. Study ParticipantsNEEDED Researchers at the Harrington Discovery Institute at University Hospitals Case Medical Center are currently seeking healthy adult volunteers for two clinical trials. Participants must have no known blood, lung or circulatory disorders. Financial compensation will be provided. EXERCISE STUDY This clinical trial will investigate how the human body responds to decreases in oxygen availability. Participants will inhale a safe nitric oxide-like gas and then exercise on a bicycle in a hypobaric chamber that simulates a high altitude atmosphere. For more information on either study, contact Jenna Stump, at jenna.stump@uhhospitals.org or BLOOD TRANSFUSION STUDY Researchers will study how blood storage affects the ability of banked blood to deliver oxygen. First, participants will be asked to donate a pint of blood. About two to three weeks later, they ll receive a transfusion of that same blood, while being monitored for changes in heart rate, blood pressure and oxygen consumption. 2 Fall 2014 MyUHCare.org

3 WELCOME THINKSTOCK Same-Day Imaging Ahuja Medical Center electronically archives all imaging exams on a central computer. What does that mean for you? It allows physicians to quickly access results, and that means faster treatment for patients, says Paul Benjamin, Radiology Manager at UH Ahuja Medical Center. Image archiving also allows images to be interpreted by the radiologist with the most expertise in a particular field, resulting in a more accurate diagnosis, says Tim Moore, MD, Radiology Medical Director. Insurance Network Ahuja Medical Center is considered in-network for all major insurance plans in the region, including those named here. For a complete list, visit UHAhuja.org/insurance or call the insurance access line at Medical Mutual of Ohio (including SuperMed) Cigna Anthem Blue Cross and Blue Shield Aetna United Healthcare SummaCare HealthSpan Picture Perfect To learn more about our imaging services, visit UHHospitals.org. Committed to Caring At Ahuja Medical Center, we continue to meet our community s demand for high-quality health care by providing an array of services based on medical best practices and delivered in ways that meet your needs. In this issue, you ll learn about a few of the ways we re doing that, including: Reinventing the emergency room. Our fast-track program allows us to expedite care to our patients, which makes the overall patient experience better and more efficient. Expanding the Ida & Irwin Haber Imaging Suite hours. You can now schedule tests until 10 p.m. on weekdays and 5 p.m. on weekends to make it more convenient for people who work or have families. Becoming an accredited Chest Pain Center and certified Primary Stroke Center. This means you can expect to receive the highest standards of care and efficiency during heart attack and stroke when time is critical. Opening our new Rainbow Babies & Children s Hospital unit. This new unit offers specialized pediatric inpatient care, in addition to our pediatric emergency room and surgical capabilities. While we provide many ways to help you stay healthy through our community health fairs and programs, we re honored to be here for you when you need topnotch medical care. We hope you enjoy this issue of My UH Ahuja Care. To learn more about our services or anything you read here, please visit us online at UHAhuja.org. Be well, Susan V. Juris, President UH Ahuja Medical Center MyUHCare.org Fall

4 When Every Minute Matters UH Ahuja Medical Center s Emergency Department is stroke-certified. Here s why that makes a difference. Time is of the essence. That phrase may never be truer than in the case of a stroke. There is a narrow window of opportunity to administer clot-busting medications during a stroke, explains Jessica Resnick, MD, Division Chief of Emergency Medicine at University Hospitals Ahuja Medical Center. It s About Time The first way to save time is to recognize the symptoms of stroke, Dr. Resnick says. But once you arrive at the hospital, time is no longer in your hands you rely on the hospital staff to treat you as quickly as possible to stop the stroke. Administering clot-busting medications within three hours of the onset of a stroke is ideal, Dr. Resnick says. Hospitals that are equipped to efficiently and effectively treat patients with the most complex strokes can apply to undergo a voluntary evaluation with The Joint Commission to become certified as a Primary Stroke Center. UH Ahuja Medical Center became certified in February Certification Matters Being a Primary Stroke Center means we have a team ready to treat stroke symptoms with a rapid, coordinated effort that gets patients diagnosed and treated in the shortest time possible, says Alan Hirsh, MD, Chief Medical Officer, UH Ahuja Medical Center. In addition, the Emergency Department is set up with easy access to the Radiology and Pharmacy departments to minimize delays. Stroke patients are given specialized attention from the moment we are alerted to their arrival, Dr. Resnick says. Particularly if they arrive by ambulance, we can mobilize resources even before they arrive. We re proud to provide our community with a certified stroke center as part of our commitment to provide world-class care that is close and convenient, Dr. Hirsh adds. Serious Stroke Care To learn more about stroke services available at UH Ahuja Medical Center, call UH4- CARE ( ). 4 Fall 2014 MyUHCare.org

5 Screening Saves Lives O ne in eight women will be diagnosed with breast cancer. All women are at risk and should start an annual screening at age 40. The most advanced mammography is 3D imaging. It provides one-millimeter images for a more detailed look through the breast tissue. 3D imaging is significantly better at detecting cancer and less likely to produce a false alarm than traditional mammography. While some risk factors are out of your hands, there are some that you can control: 3 A SEDENTARY LIFESTYLE. To minimize your breast cancer risk, stay active. Donna Plecha, MD, Co-medical director of the Breast Centers, and Director of Breast Imaging at UH Seidman Cancer Center, recommends exercising three to four times a week for 30 minutes at a time. 3 DRINKING. Large alcohol intake can increase your risk of breast cancer, says Dr. Plecha. Women who regularly have two or more alcoholic drinks a day have about 1½ times the risk of breast cancer as women who don t drink, according to the American Cancer Society. 3 A FAMILY HISTORY. If a woman or man in your family has been diagnosed with breast cancer, you are at high risk. Your doctor can help you determine a specialized screening schedule to be proactive in protecting yourself. 3 SKIPPING SCREENINGS. Screen- CALL TODAY Schedule your annual mammogram at any University Hospitals location by calling BRST(2778). ings won t decrease your risk, of course, Dr. Plecha points out, but they can help you catch cancer earlier. Start annual breast cancer screenings at age 40, even if you don t have a family history of the disease. Seventy-five percent of cases are in women with no family history. MyUHCare.org Fall

6 Northeast Ohio s LARGEST Health Center Network Keeping you and your family healthy wherever you live. W hen it comes to receiving exceptional patient-centered care, University Hospitals has Northeast Ohio covered. Our outpatient health centers expand across eight counties and include: 3 Primary care and specialist physician offices 3 UH Rainbow Care Network pediatricians and specialists 3 Full-service laboratories 3 Advanced diagnostic technologies Additionally, some of our health centers feature full-service emergency departments, outpatient urgent care capabilities and surgery suites, as well as outpatient rehabilitation and sports medicine. So, wherever you live, the expert care you need is always within reach. IN-NETWORK FOR MOST INSURANCE PLANS health centers are considered in-network for all major insurance plans in the region, including, but not limited to: Medical Mutual of Ohio (including SuperMed), CIGNA, Anthem Blue Cross and Blue Shield, Aetna, United Healthcare and SummaCare. For a complete list, call our Insurance Access Line at Fall 2014 MyUHCare.org

7 1. Amherst Health Center* Fairlawn Health Center* Opening Sheffield Health Center Ashtabula Health Center Aurora Health Center Avon Health Center* Bainbridge Health Center Hudson Health Center Landerbrook Health Center Madison Health Center Mantua Health Center Solon Health Center Streetsboro Health Center Southwest General Strongsville Medical Center* Twinsburg Health Center* To schedule an appointment at the UH health center in your neighborhood, call UH4-CARE or visit UHhospitals.org/ Network. 6. Southwest General Brook Park Urgicare* Mayfield Village Health Center University Suburban Health Center *Urgent Care or Emergency Room Location 7. Southwest General Brunswick Medical Center* Medina Health Center* Wellpointe Health Center Chagrin Highlands Health Center* Chesterland Health Center Concord Health Center* Mentor Health Center* Otis Moss Jr. Health Center Sharon Health Center Westlake Health Center* LAKE 15 ASHTABULA 11. Euclid Health Center CUYAHOGA GEAUGA LORAIN MEDINA SUMMIT PORTAGE MyUHCare.org Fall

8 Expanding Options the Minimally invasive treatments for heart and vascular conditions Many heart and vascular conditions that once required traditional surgery and long recovery times can now be performed more easily and with faster healing thanks to advanced minimally invasive approaches. These innovative techniques are creating new treatment options for patients who might not be candidates for open surgery. To schedule an appointment, call or visit UHhospitals.org/ Heart. For more information on clinical trials, contact Stacey Mazzurco, Research Manager, at or 8 Fall 2014 MyUHCare.org

9 3 Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure used to treat aortic stenosis, a condition in which the aortic valve that leads blood from the heart to the rest of the body becomes obstructed. During TAVR, a replacement valve is inserted via a catheter through the groin or between the ribs and placed inside the patient s natural aortic valve. Patients do not require general anesthesia and just need sedation during the procedure. In addition to having a shorter hospital stay and faster recovery, patients also typically experience fewer respiratory and cardiac complications. TAVR has transformed the way we treat aortic valve disease, says Marco A. Costa, MD, PhD, Director of the Interventional Cardiovascular Center and Research & Innovation Center at Harrington Heart & Vascular Institute. Recent data demonstrate that this procedure is actually superior to open-heart surgery for William Burr with nurse practioner Kehllee Popovich and Dr. Marco Costa high-risk patients. William Burr of Avon Lake was one such high-risk patient. At 93, open-heart surgery wasn t an option for Burr, and he d previously been considered too old for TAVR. But a life-threatening fall in April 2013 left his medical team with no other options: His hip could not be repaired without first fixing his heart, and TAVR was performed. Now nearly two years on, Burr is still going strong and says he feels better than he has in years. I m very thankful to Dr. Costa and his crew for the wonderful job they did. I was practically on my deathbed and they saved me. 3 Parachute is an investigational (still under study in the U.S.) catheter-based device used to treat heart failure. It partitions coronary muscle damaged by a heart attack, keeping the nonfunctional heart segment separate from the healthy, functional muscle to decrease the overall volume of the left ventricle and allow it to restore its shape, size and function. Patients who have received this procedure tend to do extremely well, Dr. Costa says. We just presented three-year data which show it has drastically reduced the need for rehospitalization and significantly improved the survival rates of study patients. Dr. Costa is the co-principal investigator in the landmark U.S. Parachute trial. 3 Thoracic endovascular aortic repair (TEVAR) and endovascular aortic repair (EVAR) are minimally invasive procedures used to treat aneurysm, a bulge in the arteries in the thoracic aorta (in the chest) or the abdominal aorta (in the stomach). A stent graft is placed inside the aneurysm via a catheter, creating a new pathway for the blood to flow while also reducing pressure on the aneurysm and the risk of rupture. Traditional open surgery can be extremely challenging to recover from especially for our older patients, says Vikram Kashyap, MD, FACS, Chief of Vascular Surgery and Endovascular Therapy, and Co-Director of the UH Harrington Heart & Vascular Institute. These options really hasten the time to recovery and offer a minimally invasive approach to fix complex problems. When Rose Booth s abdominal aortic aneurysm grew large enough to necessitate surgery in August 2012, her EVAR procedure required a single overnight hospital stay. I left the hospital with a small gauze bandage on the right side where they entered with the needle, and one on the left side, and that was it, the 73-year-old says. Today, she stays active by attending fitness classes twice a week and working out on her treadmill and bike at home. MyUHCare.org Fall

10 Rainbow Care in Your NEIGHBORHOOD Rainbow Babies & Children s Hospital is expanding its pediatric care network to include more than 100 locations from pediatric primary care and family medicine to urgent care and emergency services. Rainbow is one of the top children s hospitals in the country and we extend that expertise across the network and into the primary care offices and beyond, says Andrew Hertz, MD, medical director of Rainbow Care Network. That means your family now has access to nationally recognized pediatric and obstetric specialists, no matter where you live in Northeast Ohio. FIND A DOCTOR Choosing a pediatrician in the Rainbow Network means you re also getting the expertise of one of the best children s hospitals in the country. To find a pediatrician or UH Rainbow Care Network specialty care location near you, call 216-UH4-KIDS ( ) or visit RainbowBabies.org/ Network. PEDIATRIC PRACTICES Ashtabula Pediatrics West 19th Street, Ashtabula, OH D W Main Road, Conneaut, OH Chardon Pediatrics Ravenna Road, Chardon, OH Children s Medical Group Darrow Road, Hudson, OH East Market Street, Akron, OH Columbro Group Clague Road, Westlake, OH Comprehensive Pediatrics Crocker Road, Westlake, OH, Lorain Road, Fairview Park, OH Elyria Pediatric Care 9 Gates Medical Center, 125 East Broad Street, Suite 302, Elyria, Ohio Healthy Kids Pediatrics bk 9480 Rosemont Drive, Streetsboro, OH Kids in the Sun bl 6909 Royalton Road, Brecksville, OH bm Pearl Road, Strongsville, OH Medina Pediatrics bn 4001 Carrick Drive, Medina, OH Northeast Pediatrics bo 4212 State Route 306, Willoughby, OH Otis Moss bp 8819 Quincy Avenue, Cleveland, OH Parma Pediatrics bq 6681 Ridge Road, Parma, OH Partners in Pediatrics br 960 Clague Road, Westlake, OH Pediatric & Adolescent Health Professionals bs Bagley Road, Middleburg Heights, OH Pediatric Cardiology bt 4135 Boardman-Canfield Road, Canfield, OH Pediatric Practice at UH Rainbow Babies & Children s Hospital Euclid Avenue, Cleveland, OH Pediatric Services ck 4065 Center Road, Brunswick, OH cl 6707 Powers Boulevard, Parma, OH PediatriCenter cm 8185 East Washington Street, Chagrin Falls, OH cn Granger Road, Garfield Heights, OH co 6001 Landerhaven Drive, Mayfield Heights, OH cp 9075 Town Centre Drive, Broadview Heights, OH cq 8819 Commons Boulevard, Twinsburg, OH Zane Saalouke, MD cr 5850 Landerbrook Drive, Mayfield Heights, OH Sandusky Pediatrics cs 1218 Cleveland Road, Sandusky, OH Suburban Pediatrics ct 3461 Warrensville Center Road, Shaker Heights, OH dk Solon Road, Solon, OH Sundaresh dl Euclid Avenue, Euclid, OH UH Geauga Medical Center dm Ravenna Road, Chardon, OH University PediatriCenter of Lorain dn 3600 Kolbe Road, Lorain, OH University Premier Pediatricians do 9000 Mentor Avenue, Mentor, OH dp Lakeshore Boulevard, Euclid, OH cs el ERIE 10 Fall 2014 MyUHCare.org

11 dq 7500 Auburn Road, Concord, OH dr Euclid Avenue, Cleveland, OH ds 8055 Mayfield Road, Chesterland, OH dt Rockside Road, Bedford, OH HOSPITALS AND SPECIALTY CENTERS Crocker Corporate Center ek 2055 Crocker Road, Westlake, OH Firelands Regional Medical Center el 1111 Hayes Avenue, Sandusky, OH Lake West Medical Center em Euclid Avenue, Willoughby, OH Mercy Allen Hospital en 200 W Lorain Street, Oberlin, OH Mercy Regional Medical Center eo 3700 Kolbe Road, Lorain, OH Rainbow Physicians & Surgeons Canfield ep 4137 Boardman-Canfield Road, Canfield, OH Southwest General Brunswick Medical Center ck 4065 Center Road, Brunswick, OH Southwest General Health Center eq Bagley Road, Middleburg Heights, OH St. John Medical Center er Center Ridge Road, Westlake, OH TriPoint Medical Center es 7590 Auburn Road, Concord, OH LORAIN MEDINA SUMMIT L AKE do bo es dq dp dl em crco ds 3 fl GEAUGA 7 dr ct br6 8 fo dm dneo9fn br bp fk ek et CUYAHOGA cn bs dt fm cm en er eq fpcl cp dk bq bl bm cq bk ck 4 5 PORTAGE bn fq UH Ahuja Medical Center et 3999 Richmond Road, Beachwood, OH UH Amherst Health Center fk 254 Cleveland Avenue, Amherst, OH UH Avon Health Center fl 1997 Healthway Drive, Avon, OH UH Chagrin Highlands Health Center fm 3909 Orange Place, Orange, OH UH Concord Health Center dq 7500 Auburn Road, Concord, OH UH Elyria Medical Center fn 630 E River Street, Elyria, OH UH Geauga Medical Center dm Ravenna Road, Chardon, OH UH Landerbrook Health Center cr 5850 Landerbrook Drive, Mayfield Heights, OH UH Lyndhurst Surgery Center fo Cedar Road, Lyndhurst, OH UH Medina Health Center bn 4001 Carrick Drive, Medina, OH UH Mentor Health Center do 9000 Mentor Avenue, Mentor, OH UH Parma Medical Center fp 7007 Powers Boulevard, Parma, OH UH Rainbow Babies & Children s Hospital Euclid Avenue, Cleveland, OH UH Solon Health Center dk Solon Road, Solon, OH UH Sharon Health Center fq 5133 Ridge Road, Wadsworth, OH UH Twinsburg Health Center cq 8819 Commons Boulevard, Twinsburg, OH UH Westlake Health Center Clague Road, Westlake, OH KEY: Primary care pediatric practice Inpatient pediatric services Neonatal/high-risk pregnancy services Outpatient pediatric surgery center Pediatric emergency services Specialty clinic UH Rainbow urgent care Primary care pediatric practice only Locations with various services 1 ASHTABULA TRUMBULL MAHONING bt ep 2 MyUHCare.org Fall

12 Close to Home Wherever you live in northern Ohio, you ll find nationally recognized cancer care near you THE BEST CARE, CLOSE TO HOME For more information on the state-ofthe-art cancer care available at UH, visit UHSeidman.org. For a physician referral, call UH4-Care. When faced with a cancer diagnosis, there s a lot on your mind. Survival rates and treatment options fill your thoughts, and you want to make sure you re getting the best possible treatment. That s why has locations throughout northern Ohio ensuring that you have access to nationally recognized care and the most advanced treatment options close to home. In addition to the inpatient and outpatient facility on the campus of UH Case Medical Center, Seidman Cancer Center physicians coordinate clinical care at 16 community-based locations across northern Ohio. Experts in surgical oncology, medical oncology, radiation oncology, pathology, nursing, social work and psychology come together to develop an integrated care plan personalized for each patient. Plus, patients have access to more than 300 clinical trials. UH Seidman Cancer Center is part of the Case Comprehensive Cancer Center at Case Western Reserve University one of just 41 Comprehensive Cancer Centers in the country. UH Seidman Cancer Center named a top 18 cancer hospital by U.S. News & World Report is one of only a few sites in the nation with NCI funding for early phase clinical trials. MAIN HOSPITAL UH Seidman Cancer Center at UH Case Medical Center Cleveland, OH LOCATIONS EAST UH Chagrin Highlands Health Center Orange Village, OH UH Geauga Medical Center Chardon, OH UH Landerbrook Health Center Mayfield Hts, OH Lake Health University Hospitals Seidman Cancer Center Mentor, OH Physician Services at UH Geneva Medical Office Building Geneva, OH Physician Services at UH Conneaut Medical Office Building Conneaut, OH LOCATIONS WEST UH Westlake Health Center Westlake, OH St. John Medical Center Westlake, OH Southwest General Health Center Middleburg Hts, OH UH Parma Medical Center Parma, OH Mercy Cancer Center Elyria, OH Firelands Regional Medical Center Sandusky, OH Physician Services at Magruder Hospital Port Clinton, OH LOCATIONS SOUTH UH Sharon Health Center Wadsworth, Ohio UH Seidman Cancer Center in Medina Medina, OH Fall 2014 MyUHCare.org

13 UH Seidman Cancer Center offers lifesaving test for smokers Lung Cancer New Screening for SCHEDULE A SCREENING To schedule a lung cancer screening, call at UH4-CARE ( ). Finding cancer early offers the best chance for survival. But until a few years ago, there was no recommended screening for lung cancer, which remains the leading cause of cancer death in both men and women. The disease typically isn t caught until it s advanced, making it difficult to treat. Seidman Cancer Center was the first in Northeast Ohio to offer a low-dose computed tomography (CT) lung cancer screening. The CT scan may help detect the disease in high-risk patients when it is still curable. In a recent National Cancer Institute (NCI) study, the screening was shown to reduce the risk of dying from lung cancer by 20 percent in middle-aged and elderly smokers. At UH Seidman Cancer Center, through this screening, we have found early-stage lung cancers that would have otherwise gone undetected. This simple screening has had a major impact on our ability to find the disease when it is at a more treatable stage. The noninvasive scan uses low-dose X-rays to provide detailed, 3-D images of the lungs. The entire chest is scanned in seven to 15 seconds, and radiologists review the images for small spots on the lungs (called nodules) as well as masses and other abnormalities. The test is available to those who meet the following criteria: 3 Men and women ages 55 to 74 3 Those who smoked at least one pack a day for 30 years or more, or two packs a day for 15 years 3 Those who quit smoking less than 15 years ago The test isn t yet covered by insurance as a lung cancer screening method, but UH offers the screening available at various locations for just $99. MyUHCare.org Fall

14 Heart and Vascular Care for Cancer Patients Chemotherapy and radiation therapy can cause heart disease, Dr. Oliveira says. The Onco-Cardiology Program, a collaboration between UH Harrington Heart & Vascular Institute and UH Seidman Cancer Center, provides comprehensive cardiovascular assessment and risk reduction for cancer patients undergoing treatment to ensure success in a heart-friendly way. For more information, visit UHhospitals.org/ Oncocardiology. Unexplained Shortness of Breath: Getting to the Source For patients with both heart and lung disease, determining the dominant cause of shortness of breath can be challenging. The Dyspnea Center at UH Harrington Heart & Vascular Institute can help provide answers. We re one of only a handful of centers in the country to offer invasive cardiopulmonary exercise testing that measures pressures inside the heart and lungs during exercise, says Trevor Jenkins, MD, Co-Director, Dyspnea Center. For more information, visit UHhospitals.org/Dyspnea. Treating Heart Failure New treatments extend lives and provide alternatives to heart transplantation Over 5 million Americans live with heart failure, a condition in which the heart can t pump enough blood to meet the body s needs for energy and oxygen. Patients with heart failure experience exertional breathlessness and lack of energy, says Guilherme Oliveira, MD, Director of the Advanced Heart Failure & Transplant Center and Onco-Cardiology Program at University Hospitals Harrington Heart & Vascular Institute. Treatments include medications, stents, pacemakers and surgery. If heart failure worsens, patients may need a transplant or a heart pump, also known as left ventricular assist device (LVAD). LVADs substitute the pumping function of the heart s left ventricle, serving as a bridge to transplant and extending the lives of those not transplant-eligible. For those with very advanced heart failure, the expected one year survival rate is dismal at about 25% despite optimal medical management. With LVAD therapy, it improves dramatically to about 85%, and patients enjoy a much improved quality of life, says Soon Park, MD, Chief of Cardiac Surgery at Case Medical Center, and Co- Director of the UH Harrington Heart & Vascular Institute. To learn more about heart failure, download a Living with Heart Failure patient guide at UHhospitals.org/Heartfailure. To schedule an appointment, call or visit UHhospitals.org/Heart. 14 Fall 2014 MyUHCare.org

15 Pediatric Emergency Care, CLOSE TO HOME Rainbow brings pediatric emergency services to your community With a growing number of locations across Northeast Ohio, University Hospitals Rainbow Babies & Children s Hospital is raising the bar for pediatric emergency care. Here is a look at what goes into building pediatric emergency services worthy of the Rainbow name. GUIDELINES THAT SET THE STANDARD. Rainbow s comprehensive clinical practice guidelines for conditions such as diabetes, asthma and sickle cell disease ensure that your family can expect the same evidence-based, family-centered model of care at every location. No matter which pediatric ER you visit, your care will match what you d get downtown at our main location, says Michelle Moegling, RN, BSN, CPN, a quality improvement nurse who provides oversight for Rainbow pediatric emergency services locations. EXTENSIVE TRAINING. Our emergency clinicians must complete continuing education training beyond what is required for typical emergency medicine physicians and nurses from pain management and appropriate dosing for pediatric patients, to pediatric advanced life support (PALS). Teams at the main campus perform periodic audits to confirm that protocols are being followed, says Brendan Kilbane, MD, a Rainbow pediatric emergency medicine physician serving on the Rainbow pediatric emergency services team. A COMMITMENT TO COMFORT. Our Rainbow pediatric emergency services locations feature kid-friendly waiting room spaces for pediatric patients and families with children s activities, furniture and atmosphere. In addition, exam rooms have adult-sized beds large enough for parents to hold and soothe their child. Other common comfort measures include special diversionary techniques using pinwheels and bubbles to comfort children during procedures. UH RAINBOW PEDIATRIC EMERGENCY SERVICES LOCATIONS UH Rainbow Babies & Children s Hospital Marcy R. Horvitz Pediatric Emergency Center / Level I Pediatric Trauma Center Euclid Ave., Cleveland, OH UH Ahuja Medical Center Marcy R. Horvitz Pediatric Emergency Center 3999 Richmond Rd., Beachwood, OH *NEW UH Amherst Health Center 254 Cleveland Ave., Amherst, OH *NEW UH Avon Health Center 1997 Healthway Dr., Avon, OH *NEW UH Elyria Medical Center 630 East River St., Elyria, OH UH Geauga Medical Center Ravenna Rd., Chardon, OH UH Twinsburg Health Center 8819 Commons Blvd., Twinsburg, OH St. John Medical Center Center Ridge Rd., Westlake, OH Mercy Allen Hospital 200 West Lorain St., Oberlin, OH Mercy Regional Medical Center 3700 Kolbe Rd., Lorain, OH Southwest General Brunswick Medical Center 4065 Center Rd., Brunswick, OH Southwest General Health Center Bagley Rd., Middleburg Heights, OH To find your nearest Rainbow Pediatric Emergency Services location, call 216-UH4-KIDS ( ) or visit RainbowBabies.org/Network. MyUHCare.org Fall

16 The More YOU KNOW Why men need to understand the risks and benefits of prostate cancer screening KNOW YOUR OPTIONS Talk to your doctor about prostate cancer screening risks and benefits. Need a doctor? Call University Hospitals at UH4-CARE ( ). Not every cancer needs to be treated right away. It seems counterintuitive, but that s the reality of prostate cancer and why there s so much discussion around screening. Know the Risks and Benefits There are currently two methods used to screen for prostate cancer: a digital rectal exam to detect any physical findings, and a blood test to screen for elevated prostatespecific antigen (PSA) levels. Some groups recommend screening for all men after age 50, while others say that s unnecessary. Lee Ponsky, MD, a urologist at UH Case Medical Center, says the best advice probably lies in the middle, and advises men to talk to their primary care physicians about screening. The education component is key, Dr. Ponsky says. Patients should know the risks and benefits of being screened and the risks and benefits of not being screened. An elevated PSA often leads to a biopsy, a procedure that carries minimal risk. The real question is what happens next. Treatment vs. Waiting? Prostate cancer has been over-diagnosed and over-treated in the past, Dr. Ponsky explains. That s because doctors weren t sure which cancers needed treatment and in which ones the treatment could wait. Today, that s different. Studies have demonstrated that there are clearly low-risk groups where the risk of life-threatening cancer is extremely low, he notes. You might need treatment eventually, but not necessarily right away. Your urologist can monitor the cancer (called active surveillance) to see if and when treatment might become appropriate. Active surveillance can help men avoid the potential side effects of treatment, such as incontinence or impotence. For men who have more aggressive forms of the disease, screening can help catch the cancer when it s most treatable. If there is a potentially life-threatening prostate cancer, intervening can help save a life, Dr. Ponsky says. For patients put on active surveillance, doctors have various tools to track the cancer. At, MRI and genetic testing are used to monitor any progression of the disease. We have one of the most robust MRI programs in the nation, Dr. Ponsky says. If there is an abnormality detected on the MRI, we can do a targeted focused biopsy of the abnormality. Our MRI program is improving the way we treat patients. 16 Fall 2014 MyUHCare.org

17 When Your The latest on diagnosis and treatment of atrial fibrillation W hen you think of serious heart problems, a heart attack is likely the first thing that comes to mind. But having an abnormal heart rhythm like atrial fibrillation (or A-fib) can sometimes be just as serious. A-fib occurs when the heart s electrical system malfunctions and its upper chambers (the atria) beat fast and irregularly. As a result, blood doesn t flow normally to the heart s ventricles and the risk of clotting increases as does the risk for stroke. In fact, if left untreated, A-fib doubles your risk of death from a heart-related condition and increases your risk of stroke by four to five times, according to the American Heart Association. HEART Skips a Beat Restoring Your Rhythm A proper diagnosis and a thorough evaluation are critical to finding the right course of treatment, but this can be challenging because the symptoms of A-fib may not be that noticeable. While atrial fibrillation often causes heart palpitations, for many people, their only symptoms are the consequences of being out of rhythm, which are shortness of breath, fatigue and a general lack of energy, says Mauricio Arruda, MD, Director of the Electrophysiology Center and Atrial Fibrillation Center at Harrington Heart & Vascular Institute. Treatment typically requires medications such as beta blockers or calcium channel blockers to decrease your heart rate, or antiarrhythmic drugs that can alter the electrical properties of your heart. When medications aren t enough, catheter ablation may help. During this nonsurgical procedure, a catheter is guided through a blood vessel to your heart, ablating the area of tissue causing A-fib, thereby restoring normal rhythm. To learn more about A-fib, from medication management to ablation options, check out our online patient education tool at UHhospitals.org/AFseminar. To schedule an appointment, call or visit UHhospitals.org/Heart. MyUHCare.org Fall

18 SCREEN PREVENT To Is To C Understand your colon cancer screening options ancer screening is typically about detecting the disease as early as possible. With colon cancer, however, screening can actually catch cancer before it even develops. Colorectal cancer is the No. 2 cancer killer in the U.S., claiming about 50,000 lives annually, according to the Centers for Disease Control & Prevention (CDC). The CDC estimates that at least 60 percent of these deaths could be prevented if everyone over age 50 had regular screenings. The Gold Standard While there are various options for colon cancer screening, the gold standard remains colonoscopy, which involves inserting a thin, flexible tube to examine the colon. Colonoscopy is the best option, says John Dumot, DO, Chief of Staff and Digestive Health Institute Medical Director at Ahuja Medical Center. It s the only option that can prevent cancer. That s because if your doctor finds a polyp (a precancerous growth) during the procedure, he or she can remove the polyp right there. Plus, Dr. Dumot says, preparing for the test is getting easier all the time. Newer preps are more palatable and involve drinking less liquid. Another Option The Fecal Immunochemical Test (FIT), which detects hidden blood in the stool, is another screening test. The main benefit is that it s easy to do there s no bowel prep or dietary restrictions, explains Gregory Cooper, MD, Program Director of Gastroenterology at UH Case Medical Center; and Co-Program Leader for Cancer Prevention and Control at UH Seidman Cancer Center. The downside is that it is not as ac- 18 Fall 2014 curate as colonoscopy, and if someone has a positive test, a colonoscopy is required to investigate, he adds. Plus, it needs to be done every year, whereas a colonoscopy is needed only every 10 years (for those of average risk). Dr. Cooper says the most important thing is to get screened. Through screening, both the incidence and mortality (of colon cancer) have gone down significantly, he says. The best test is the one that gets done! MyUHCare.org Schedule a Screening Today If you are 50 or older and haven t had a colonoscopy in 10 years or more, schedule one today. Talk to your doctor or call UH4-Care.

19 Get the Cancer Care You Deserve For more information on the state-of-theart cancer care available at UH, visit UHSeidman.org/ radiation. For a physician referral, call UH4-Care. LEADING F the Way urthering its commitment to providing the most advanced cancer care, Seidman Cancer Center recently broke ground on a $30 million Proton Therapy Center. The UH site will be the first of its kind in Ohio and one of an elite group of cancer centers nationwide to offer this revolutionary technology. What Is Proton Therapy? This advanced type of radiation therapy uses a powerful beam of protons (traditional radiation uses photon or electron beams) to precisely target tumors. Proton beams deposit a greater amount of their energy to the tumor area, and thus can reduce radiation dose to uninvolved normal tissues. This has the potential of reducing side effects of treatment in certain situations. Mark Your Calendar Scheduled to open to patients in late 2015, the 11,000-square-foot Proton Therapy Center will be located on the UH Case Medical Center campus in University Circle. The technology, which will complement the UH Seidman Cancer Center s existing range of treatment options, will primarily benefit patients with certain types of brain, spine, and head and neck tumors, as well as children. Proton therapy is particularly beneficial in the treatment UH Seidman Cancer Center breaks ground on Proton Therapy Center of children because it significantly reduces radiation exposure to normal tissues. Children are at especially high risk for developing radiation-induced long term effects, so proton beam therapy should help to lower these risks. One of the most exciting aspects of our new proton center is its proximity to UH Rainbow Babies & Children s Hospital, which will allow easy access for our pediatric patients and families, says David Mansur, MD, Director of the Proton Therapy Center. Clinical research trials studying the best means of using protons are in development, and we will be among the leaders in research studies of proton beam radiotherapy. MyUHCare.org Fall

20 Learn more at UHAhuja.org/ Rainbow RAINBOW EXPANDS High quality pediatric care in your neighborhood As a parent, you want your child to receive the best care possible. You also value this trusted care when it is offered in a location close to home. That s why University Hospitals Rainbow Babies & Children s Hospital now provides pediatric services for children and teens with general medical and surgical needs at Ahuja Medical Center. We offer the same advanced, familycentered, high-quality care close to home that we do downtown on the main campus, says Robyn Strosaker, MD, medical director of Inpatient Services at UH Rainbow Babies & Children s Hospital. What does it all mean for parents and families? Features include: 3 24/7 staffing by pediatricians and nurses 3 Specialized inpatient pediatric unit featuring UH Rainbow pediatricians and nurses and bright, spacious private rooms with kid- and family-friendly amenities and décor 3 Expanded pediatric surgical services with a multidisciplinary team of UH Rainbow surgeons, anesthesiologists, pre- and post-operative nurses, child life specialists and other pediatric experts 3 Child-friendly, 24/7 pediatric emergency services with board-certified UH Rainbow pediatricians and emergency medicine physicians experienced in pediatric emergencies 3 Free parking These services are in-network for all major insurance plans, including Medical Mutual of Ohio/SuperMed, Anthem and United Healthcare. 20 Fall 2014 MyUHCare.org

21 Sometimes, just watching a football tackle can make your head hurt. And all those hard hits can take a toll on even the best athletes, in the form of concussions. A concussion occurs when the brain moves forcefully inside the skull, resulting in temporary impairment of overall neurological function, says J. Britten Shroyer, MD, Sports Medicine Orthopaedic Surgeon, Ahuja Medical Center. While there are ways to reduce the risk of concussion by wearing proper-fitting helmets, athletes may not be able to avoid them entirely. Here, our experts answer some common questions about this injury. QHow is a concussion diagnosed? A A concussion is often assessed on the sidelines by a coach or team physician asking a series of questions that can help evaluate orientation, memory and ability to concentrate, Dr. Shroyer says. We grade them on a scale of 1 to 3. In some cases, a physician may perform a CT scan to check for a brain bleed, which could require surgery. THINKSTOCK QWhat are the treatment options? AIf the concussion is significant, brain rest may be recommended. Typically that requires no schoolwork or screen time for a few days to a week, depending on the severity of the concussion, explains Dan Ellenberger, Director, EMS Training & Disaster Preparedness Institute, UH Ahuja Medical Center. QWhen is it safe to start playing again? AAthletes shouldn t return to play until they are fully recovered and a physician releases them, Ellenberger says. After that, we do a graduated return to activity to test how players are doing until they are able to fully return to their sport, Ellenberger says. This helps minimize the chance of multiple concussions. Keep Your HEAD Managing sports concussions properly can prevent long-term damage GAME How's Your Head? in the To learn more about treatment for sports concussions at UH Ahuja Medical Center, call UH4-CARE ( ). MyUHCare.org Fall

22 Your Heart Is In Good Hands If you or a loved one is experiencing heart trouble, you want nothing less than the very best. Look no further than Ahuja Medical Center. In collaboration with UH Harrington Heart & Vascular Institute, your community hospital is able to provide top-tier cardiac care. We offer the full spectrum of cardiovascular services, screenings, diagnostics and treatments, says William Wolf, MD, Medical Director, UH Harrington Heart & Vascular Institute, UH Ahuja Medical Center. You can be confident that you ll receive world-class cardiac care. To learn more about cardiac services at UH Ahuja Medical Center, visit UHAhuja.org. Get InQuicker Do you have a non-emergency situation but need to go to the Emergency Department? Now you can wait your turn from home with InQuicker, Northeast Ohio s only online waiting room service. This convenient service allows you to check in from home using your computer. Simply choose your preferred arrival time and provide a little information about yourself and the reason for your visit. Then show up at your projected treatment time and you ll be seen quickly. Patients really like this service; it s very convenient, says Dave Gordon, RN, Nurse Manager, Emergency Department, Ahuja Medical Center. READY TO CHECK IN? Just visit UHAhuja.org and click Skip Lengthy ER Waits. One Giant Leap for Lungs A new, state-of-the-art procedure for diagnosing lung nodules is now available at Ahuja Medical Center. This procedure employs an electromagnetic navigation bronchoscopy system called i-logic to create a 3-D image of the lungs, which allows pulmonologists to locate nodules with GPS-like accuracy during internal biopsies. That means doctors are better able to provide leading-edge therapies to patients with lung cancer. This technology allows for accurate biopsies of even small nodules with a much lower risk of pneumothorax, or collapsed lung, says Philip A. Linden, MD, Division Chief, Thoracic and Esophageal Surgery, UH Ahuja Medical Center. To learn more about pulmonology services including CT lung screenings at UH Ahuja Medical Center, call or visit UHAhuja.org. THINKSTOCK 22 Fall 2014 MyUHCare.org

23 For more information about hernia surgery at, visit UHhospitals.org/ Hernia. To make an appointment with a hernia specialists, call HERNIAS: Common Surgery, Extraordinary Attention UH Comprehensive Hernia Center provides leading-edge care THINKSTOCK Hernia repair is one of the most common procedures in the U.S. today. But at Comprehensive Hernia Center, the surgery is treated as anything but ordinary. The entire subspecialty of hernia surgery is relatively new, and stems from the realization that a large proportion of patients would benefit from care by a hernia specialist, says Yuri W. Novitsky, MD, Director, UH Comprehensive Hernia Center. Here s what sets our hernia care apart: Pioneering Techniques The center provides advanced surgical expertise for both routine and complex abdominal wall reconstructions that are not available elsewhere. Dr. Novitsky and his colleagues are nationally recognized experts in the field, and have pioneered improvements in surgical techniques that reduce the chance of hernia recurrence. We have experience treating extremely complicated recurrent hernias and many of COULD YOU HAVE A HERNIA? The most common type of hernia occurs when a weakness in your abdominal muscle walls allows your intestines or body fat to push out of its normal place. The most common symptom is a bulge in your abdomen or groin that wasn t there before, but it can also cause pain, nausea and vomiting. Not all hernias require surgery, but it s important to have the problem evaluated by a physician to determine the best course of action. the complications associated with hernia repairs, such as fistulas and mesh infections, notes Ajita Prabhu, MD, Co-Director, UH Comprehensive Hernia Center. A Multidisciplinary Approach In addition to hernia surgeons, the Center s team includes plastic surgeons, weight loss specialists, colorectal surgeons and wound care clinicians. This comprehensive approach ensures that not only will patients receive the best possible operation, they will also be adequately prepared for surgery and receive excellent care afterwards. Specialized Care For Women Hernia Center physicians have extensive experience in diagnosing and successfully treating women, who represent additional challenges. For one thing, they often don t have typical symptoms, so they may go undiagnosed for a long time. In addition, surgeons must tailor their repair techniques for women who plan to get pregnant in the future. MyUHCare.org Fall

24 Ahuja Medical Center 3999 Richmond Road Beachwood, OH Non-Profit Org. U.S. POSTAGE PAID UNIVERSITY HOSPITALS NOW PRINTED ON RECYCLED PAPER! Expert Orthopaedic Care CLOSE TO HOME When you or a family member has a bone or joint problem, Orthopaedics has got you covered. We re UH. We ve Got You Covered When you need health care, you want peace of mind, not closed doors and limits. You expect your insurer and your health care provider to work with you as a team, to ensure you receive the finest and most compassionate care. That s why works with every major insurer in this region to make sure that when you turn to UH, our trusted and renowned medical experts are available to you. Most or all UH physicians and hospitals are in-network preferred providers for nearly 70 insurance plans in all. Those plans represent firms ranging from Aetna to UnitedHealthcare small insurance carriers and big ones. The region s largest, Medical Mutual of Ohio, includes nine UH-affiliated medical centers, 25 UH outpatient health centers and 1,400 UH physicians in its SuperMed network.* To learn more about accessing services through your insurer or discover whether a particular UH physician or facility is in your network, call UH s Insurance Access Line at or toll-free at (844) * Case Medical Center (including UH Rainbow Babies & Children s Hospital, UH MacDonald Women s Hospital and UH Seidman Cancer Center) and UH Bedford Medical Center, a campus of UH Regional Hospitals, are not MMO SuperMed preferred providers. MMO members still have coverage options. Contact UH s Insurance Access Line for specific coverage details. Whether it s joint replacement surgery, or treatment for carpal tunnel syndrome, arthritis, scoliosis, neuromuscular disorders, sports injuries or a host of other pediatric and adult orthopaedic problems, our nationally recognized experts are available throughout Northeast Ohio to provide first-rate medical care combined with personalized attention. When surgery is required, our clinicians are skilled at performing minimally invasive procedures that allow you to heal faster and get back to an active and pain-free life more quickly. To request an appointment with an orthopaedics specialist at, call: UH4-CARE or My UH Ahuja Care is a publication of Ahuja Medical Center. President: Susan V. Juris. Ahuja Medical Center, 3999 Richmond Road, Beachwood, OH 44122, UH4-CARE. Copyright All rights reserved. Information in this publication is not intended for the purpose of diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment and/or advice contained in this publication. If you are receiving multiple copies, need to change your mailing address or do not wish to receive this publication, please send your mailing label(s) and the updated information to: My UH Ahuja Care, P.O. Box 17910, Phoenix, AZ