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[ Your guide to Healthy Living from Georgia Health Sciences Health System ]

Fall 2012 | georgiahealth.org

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excess weight is heavy on the heart

9 early signs of Parkinson’s disease

new robotic center

simplifies surgery

the material in Your Health Today is not intended for diagnosing or prescribing. consult your physician before undertaking any form of medical treatment.

For more information, please call 800-736-CARE (2273) or visit our website at georgiahealth.org.

copyright © 2012 Georgia Health Sciences Health System

INSIDE THIS ISSUE

PAGE 3 Tips for a safe and healthy fall

PAGES 4-5Focus on Women In vitro fertilization: A gentler, less

expensive approach Ovarian cancer: Little-known symptoms

Heart Healthy Living Excess weight: Why it’s heavy

on the heart

PAGE 8

Family Health Gastric pacemakers Kids & school: 4 tips for achievement

PAGES 10-11

Georgia Health Sciences Medical

Center?As part of an academic health center, we are

continuously upgrading our services, technology and outreach. Here are a few of our latest initiatives,

achievements and honors.

wHat’S new andnotewortHy at

A DIGESTIvE HEALTH CENTER THAT IS UNPARALLELED IN OUR AREA

Gastrointestinal and liver problems can be difficult to diagnose. Georgia Health Sciences digestive Health center can help. this regional referral center offers: • the area's most comprehensive team of gastroenterologists and hepatologists • the widest range of conventional and advanced diagnostic tests and treatments in the region• specialty clinics for motility disorders, pelvic floor disorders, lactose and fructose intolerance, dysphagia (difficulty swallowing), Gerd, irritable bowel syndrome, gastroparesis and constipation • multidisciplinary care• nutritional services by registered dietitians

call 706-721-9522 to arrange a quick, convenient appointment.

LOOkING FOR A TOP DOCTOR? THEy'RE RIGHT HERE

Fifteen physicians at Georgia Health Sciences Health System are included in the list of “america’s top doctors,” a national patient reference guide published by castle connolly Medical Ltd. by identifying the top 1 percent of physicians in the nation, the guide helps patients make wise treatment choices. these physicians are the only ones in the augusta-aiken area included on this prestigious list, highlighting the quality of care available at Georgia Health Sciences Health System. For a full list of our physicians who were selected for this honor, visit georgiahealth.org.

PAGES 6-7Choosing Us New center for advanced

robotic surgery

PAGE 9Neurology 9 early warning signs of

Parkinson's disease

PAGE 12In the News Missy Pratt named CSRA

Nurse of the Year

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SeaSon’S eatings

[A]s weather cools and days grow longer, many people tend to eat fewer fruits and vegetables. but fall also offers a bounty of healthy fruits and vegetables. tomatoes

and strawberries may be past their prime, but other fruits and vegetables come into their own during cool weather. roast a few acorn squash or sweet potatoes. Serve a side dish of broccoli, cabbage or cauliflower. bake apples and pears or make a pumpkin pie for a warm and comforting dessert.

FLu SHotS: timing prevention

[T]he centers for disease control and Prevention recommends you get your flu shot as soon as it’s available in your area, but not later than december. Flu season is

unpredictable. it can begin as early as october, and it takes two weeks for the antibodies that protect you from getting the flu. Having your flu shot by december ensures that the protective antibodies are active before flu activity generally peaks.

KidS & carS: keys to success

[I]f your child will be driving this year, make sure he or she understands the rules of the road. in fact, it may be a good idea to get them to sign a “Safe driving agreement” in

which they promise to follow all laws regarding teen driving in your state. they should also promise to avoid cell phone use, eating, fiddling with the radio and listening to loud music while driving. Finally, they should understand the risks and consequences of driving when drinking, drowsy or taking drugs or medications, all leading causes of accidents in teens.

breaK the fast

[E]veryone, especially school children, should eat a healthy breakfast. Kids’ growing bodies and developing brains need regular energy. if your kids skip breakfast, they

may go as long as 18 hours without nourishment. Make sure your children eat a serving of protein with breakfast. avoid fast and fatty foods and sugary cereals in favor of whole-grain breads or cereals, fresh fruits, low-fat dairy products, lean meats, eggs and other healthy choices. don’t limit your menu to typical breakfast foods. beans and brown rice, hummus and pita … even pasta and tomato sauce can perk up your children’s appetites and supply the nutrition they need.

Tips For a safe and healthy fall

MiniMaL StiMuLationin vitro fertilizationA gentler, less expensive approach

FocuS on women

[I]f you’rE Among ThE 10 To

15 percent of women who

experience difficulty conceiving,

you know the frustration, anger and

sadness that it can cause. Yet the

number of women struggling with

this issue is increasing because many

couples are waiting longer to have

children.

“A woman’s chance of having a

baby decreases slightly every

year after age 30,” says Lawrence

C. Layman, MD, a reproductive

endocrinologist and geneticist with

Georgia Health Sciences Reproductive

Medicine and Infertility Associates.

When to seek help“If you’re under 35 years of age and

have tried unsuccessfully to become

pregnant for a year, or if you’re 35 or

older and have tried for six months,

it’s time to consult a physician,”

Dr. Layman says.

He and the other reproductive

endocrinologists at Georgia Health

Sciences Reproductive Medicine

and Infertility Associates offer

state-of-the-art diagnostic tests and

advanced solutions for both male

and female infertility.

“This includes a type of in vitro

fertilization [IVF] known as minimal

stimulation in vitro fertilization

[MS-IVF] that is showing good

results in many women,” says

Dr. Layman.

Understanding IvFIn traditional IVF, women self-inject

multiple doses of fertility drugs to

stimulate the production of multiple

eggs. The eggs are harvested and

fertilized in vitro, then transferred

into a woman’s body, where one will

hopefully develop.

“This approach requires large

doses of expensive medications,

numerous lab tests and frequent

visits with physicians. As a result,

traditional IVF can be costly and

stressful,” Dr. Layman says.

Reducing side effects and costsWith MS-IVF, women take fewer,

smaller doses of medications to

gently stimulate the production

of eggs, which are fertilized and

transferred to the woman’s uterus.

This milder stimulation can also

help reduce multiple pregnancy

rates in IVF.

“Since this approach uses less

medication, it significantly decreases

the side effects and lowers the cost

of medication. In fact, MS-IVF

costs thousands of dollars less than

traditional IVF,” Dr. Layman says.

“We have also reduced costs for

standard IVF and offer military

discounts and other programs to

make IVF more affordable.”


WE'RE HERE TO HELP Visit one of our two locations:

Reproductive Medicine and Infertility Associates

810 chafee ave., in augusta

Reproductive Medicine and Infertility Associates—Evans618 Ponder Place, Suite 2 in evans

For more information or to schedule an appointment at either location, call 706-722-4434.

oVarian cancerLittle-known symptoms

[W]hEn shAron smITh, rn, of North Augusta, began

experiencing nausea and abdominal

bloating and pain—symptoms she’d

rarely experienced—she assumed she

had a digestive disorder.

A gastroenterologist at a local

hospital ran a series of tests and found

nothing wrong. But when Sharon

had her annual gynecological (GYN)

exam, her physician discovered a large

ovarian tumor that turned out to be

malignant.

Like many people, Sharon was

unaware that digestive symptoms can

indicate ovarian cancer. “It never even

crossed my mind,” she says.

A not-so-silent killerThis is a story Sharad A. Ghamande,

MD, the director of GYN oncology

at Georgia Health Sciences Cancer

Center, whom Sharon consulted, has

heard before. “Ovarian cancer was

once known as a silent killer because


THE AREA’S LARGEST, MOST DIvERSE TEAM OF CANCER SPECIALISTS

that’s what Georgia Health Sciences cancer center offers. our physicians work in teams

to deliver multidisciplinary care in a spacious atmosphere filled with light, art and color. to schedule an appointment for care or a second opinion, call 706-721-2273 (CARE).

But with ovarian cancer, the symptoms

are persistent and worsen over time. “If

you suddenly develop these symptoms

and they occur almost daily and last for

more than a week, see your gynecolo-

gist,” Dr. Ghamande says.

physicians thought that there were

no identifiable symptoms in the early

stages,” Dr. Ghamande says. “We now

know that there are early symptoms

of ovarian cancer, especially in post-

menopausal women. Unfortunately,

many people, including some physi-

cians, are still unaware of them.”

Ovarian cancer can be lethal,

largely because most patients are

diagnosed in advanced stages. Thank-

fully, Sharon’s cancer was diagnosed

at a very early stage, and she is now

cancer free.

What are the symptoms?Early symptoms of ovarian cancer

may include:

• abdominal pressure or

bloating

• changes in bladder habits, in-

cluding a frequent need to urinate

• changes in bowel habits, such

as constipation or diarrhea

• loss of appetite or quickly

feeling full

• pelvic discomfort or pain

• persistent indigestion, gas

or nausea

“Obviously, these symptoms are

relatively common and may indicate

a variety of disorders, including

digestive and bladder problems,”

says Dr. Ghamande.

SurGery,simplified

Georgia Health Sciences opens Center for Advanced Robotic Surgery

cHooSinG us

[s]urgEry oncE mEAnT long incisions, scarring and a

lengthy hospital stay and recovery.

But in many cases, there is now a

better, less invasive option known as

robotic surgery.

Robotic surgery is fast becoming the

standard of care in many specialties.

“This technology offers surgeons better

vision, more range of motion and great-

er precision, factors that are particu-

larly important in cancer surgery,” says

Rabii Madi, MD, a urologic oncologist

and robotic surgeon at Georgia Health

Sciences Medical Center.

For patients, it means less pain,

blood loss, scarring and risk of

infection. It also reduces hospital stays

and shortens the recovery period. To

make these procedures easily available

to you and your family, Georgia Health

Sciences has opened the Center for

Advanced Robotic Surgery under the

direction of Dr. Madi.

Strength in numbers Many hospitals offer robotic surgery,

but statistics show that outcomes are

better if the surgery is performed by

experienced surgeons at a high-volume

center. Yet there are few such centers

in the nation, and only one in our area.

The center offers the largest, most

experienced team of robotic surgeons

in the region. “Our team is made up

of fellowship-trained physicians in a

range of specialties, each of whom

has performed hundreds of robotic

procedures,” Dr. Madi says.

A range of specialtiesThe center centralizes robotic

surgery across various specialties led

by pre-eminent surgeons, including:

• oTolAryngology (EnT). David

Terris, MD, an otolaryngologist

who was among the first surgeons

in the world to perform robotic

thyroidectomies, pioneered a “facelift”

The robotic surgical system cannot be

programmed or operated independently. It works in a servant-master mode, with the surgeon firmly in control of every move.”

– Dr. Rabii Madi



thyroidectomy that leaves no visible

scars. He appeared on a recent episode

of CBS’ “The Doctors.”

• urogynEcology. Brent

Parnell, MD, has performed more

than 100 robotic surgeries for vaginal,

uterine and bladder prolapse.

• gynEcologIcAl oncology. Sharad A. Ghamande, MD, is the

most experienced robotic GYN cancer

surgeon in the region and a proctor, or

teacher, with the manufacturer of the

da Vinci® Surgical System.

• urology. Dr. Madi is

internationally renowned in the

surgical treatment of prostate,

kidney and bladder cancers. He has

performed more than 400 robotic

surgeries and published more than

40 articles on the topic.

“We also offer advanced

procedures not performed

at other regional centers.

These include removing the

bladder for bladder cancer, salvage

prostatectomy, which is often

necessary when prostate cancer

recurs after radiation treatment,

and the ‘facelift’ thyroidectomy,”

Dr. Madi says.

Multidisciplinary care fosters better outcomesThese specialists, and other

physicians at Georgia Health Science

Medical Center, work together to

deliver multidisciplinary care.

“A recent patient who had both

kidney and uterine cancer was able

to have kidney and gynecological

surgery at the same time, through

the same incisions, thanks to the

breadth and depth of our expertise,”

Dr. Madi says.

In addition, Dr. Madi has removed

a kidney tumor and prostate tumor

on a patient at the same time, using

the same incisions. The team also

includes anesthesiologists, registered

nurses and other caregivers with

special training in robotic surgery.

The area’s most advanced robotic technologyThe center offers the most

advanced technology of its kind—the

da Vinci three-dimensional surgical

system with the area’s only Firefly

Fluorescence Imaging technology.

Firefly uses near-infrared imaging

to detect dye injected into the blood.

The dye helps identify vascular

flow and distinguish normal from

cancerous tissue. “This lets us

identify tumors with unparalleled

accuracy and improve outcomes,”

Dr. Madi says.

The system also includes the area’s

only simulation module, which lets

surgeons fine-tune their skills and

train other physicians, as well as a

dual console that allows two surgeons

to collaborate on one surgery.

John Lue, Md, ob/Gyn, center for advanced

robotic Surgery, stands with the da Vinci robotic surgical system.

ExPERIENCE THE DIFFERENCEas part of an academic health center, the center for advanced robotic Surgery staffs a team of highly experienced surgeons who have performed hundreds of procedures. Several helped pioneer robotic surgery in their specialties and are listed among “america’s top doctors.” to learn more or to schedule an appointment, visit georgiahealth.org/robotics or call 706-721-CARE (2273).


exceSS weiGHt:

Why it’s heavy on the heart[A] lThough obEsITy Is A

serious health condition, it

has become almost the norm in our

society. About one-third of American

adults are obese. Many more are

overweight. “Despite being very

common, obesity should not be taken

lightly,” says Sheldon Litwin, MD, a

cardiologist at Georgia Health Sciences

Medical Center. “Obesity is a serious

health condition that affects much more

than your appearance.”

Long-term effects of obesityOver time, obesity:

• lowers HDL, or “good” cholesterol,

which is linked with a reduced risk of

heart disease and stroke

• raises blood cholesterol and

triglyceride levels

• raises blood pressure

“Obesity can also induce type 2 diabe-

tes, which makes the above-mentioned

risk factors for heart disease much

worse. Sadly, 21 million people in the

United States have type 2 diabetes and

Heart-HeaLtHy living

another 54 million have pre-diabetes.

Approximately 90 percent of them are

overweight or obese,” Dr. Litwin says.

Diabetes and heart disease: A deadly duoUncontrolled diabetes contributes to

high levels of fat in the blood. This and

other effects of diabetes harden and

narrow blood vessel walls and clog the

arteries. In fact, diabetes doubles the

risk of heart attack and stroke.

Unfortunately, many people find

it impossible to lose weight through

diet and exercise. For those patients,

bariatric surgery may be the answer.

Overcome diabetes with bariatric surgeryAlthough most people don’t think of

bariatric surgery as a treatment for

diabetes, it is.

“Bariatric surgery has been proven

to be the most effective treatment for

morbid obesity and type 2 diabetes

when patients are more than 80 to 100

pounds overweight,” says Brian Lane,

MD, a surgeon at Georgia Health Sci-

ences Weight Loss Center.

The center offers a range of surger-

ies, including minimally invasive

options, customized to each patient’s

circumstances.

FREE WEIGHT-LOSS SURGERy SEMINARSGet the facts about bariatric surgery at an informational seminar held at:

Columbia County LibrarySecond thursday of each month at 7 p.m. 7022 evans town center blvd. in evans

GHS Alumni CenterFourth thursday of each month at 7 p.m.919 15th St. in augusta

NEED MORE INFORMATION?

to learn more or register, visit georgiahealth.org/weightloss or call our bariatric nurse coordinator

at 706-721-2609. registration is encouraged but not required.


neurology

Learn tHe [9] earLy warninG SiGnS oF

Parkinson’s diseaseDepend on the area’s only movement disorders center

[P] ArkInson’s dIsEAsE Is a neurodegenerative brain

disorder that can take a heavy physical

and psychological toll on both patients

and their caregivers.

“People with Parkinson’s need the

care and support of a multidisciplinary

treatment team,” says Shyamal Mehta,

MD, PhD, a neurologist at Georgia

Health Sciences Neuroscience Center

who specializes in movement disorders.

One-stop careAs an academic health center, Geor-

gia Health Sciences University staffs

such a team at its Movement Dis-

orders/Parkinson’s Disease Center.

Designated by the National Parkin-

son’s Foundation Inc. as a Center of

Excellence, it is the only facility of its

kind in Georgia or South Carolina.

The center offers multidisciplinary

clinical care, support services and a

comprehensive research program.

Its skilled movement disorder

specialists, neurosurgeons, neuro-

psychologists and neuroradiolo-

gists are in the forefront of motion

disorders. They diagnose, treat and

study Parkinson’s disease, essential

tremor, dystonia, Huntington’s dis-

ease, Tourette’s syndrome, restless

legs syndrome and other movement

disorders.

The early warning signs“Parkinson’s disease can be difficult

to diagnose, particularly in the early

stages. This makes it important for

patients to seek care at a movement

disorders center,” says Dr. Mehta.

According to the National

Parkinson’s Foundation, early warning

signs include:

[1] consTIPATIon

[2] loss of smEll

[3] mAsk-lIkE fAcE

[4] smAll hAndWrITIng

[5] sofT or loW voIcE

[6] sTooPIng or hunchIng

[7] TrEmors or shAkIng

[8] TroublE slEEPIng

[9] TroublE movIng or WAlkIng

Comprehensive careThe center offers: physical,

occupational and speech therapy; botulinum toxin (botox) injections;

deep brain stimulation for tremors;

gamma knife surgery; and more.

Staff members provide

patient and caregiver

education, a support

group meeting and

links to assistance

programs.

CLINICAL TRIALS: ANOTHER bENEFIT OF ACADEMIC MEDICINEthe center’s patients also have access to ongoing clinical trials. current studies include trials for:

• a long-acting agent for restless legs syndrome

• a new type of physical therapy to help with gait and balance

• agents to slow the progression of Parkinson’s disease

• novel agents to treat involuntary, uncontrolled movements (dyskinesias) in Parkinson’s disease

MAkE AN APPOINTMENT

For more information or to schedule an appointment, visit georgiahealth.org/neuro or

call 706-721-2798.


FaMiLy health

GaStric pacemakersA new treatment for improved digestive health

[I] f you hAvE normAl dIgEsTIon, you probably take it for granted.

You may not even be aware of the

strong muscular contractions that

propel food through the digestive tract

in a process called gastric motility.

But if the muscles or nerves in the

wall of your stomach don’t work, and

the stomach doesn’t empty properly,

you could have a condition that makes

digestion a major issue.

“Known as gastroparesis, this

disorder can cause chronic nausea

and vomiting, making life and eating

a day-by-day challenge,” says Satish

Rao, MD, a neurogastroenterologist,

or motility specialist, who directs the

Georgia Health Sciences Digestive

Health Center.

A new treatment: The gastric pacemakerGastroparesis can be the result

of diabetes, abdominal surgery,

infections, certain medications and

other factors. Whatever the cause, it

requires expert care.

“Our multidisciplinary team of

physicians and surgeons delivers

highly skilled care for patients with

gastroparesis,” Dr. Rao says. This

includes traditional treatments such

as lifestyle changes, medications,

feeding tubes, botulinum toxin (botox)

invasive digestive surgery and has

vast experience with these devices,

implants the pacemakers.

“We are one of the few minimally

invasive and digestive diseases

surgery sections in the country

approved to implant the pacemaker,”

Dr. Edwards says.

THE AREA’S MOST COMPREHENSIvE DIGESTIvE HEALTH CENTERGeorgia Health Sciences operates the area’s most extensive digestive health center. the staff includes physicians who specialize in virtually every area of gastroenterology.the center is home to one of only 10 motility centers in the nation to be designated a center of excellence by the american neurogastroenterology and Motility Society. “the Motility center is equipped with the technology needed to diagnose and treat even subtle disruptions in the way food moves through the digestive tract,” Satish rao, Md, says. to schedule an appointment, call 706-721-CARE (2273).

injections and gastroparesis surgery.

It also includes the new gastric

pacemaker. Similar to a cardiac

pacemaker, this tiny implantable

device uses an electric current

to cause stomach contractions.

Michael Edwards, MD, a surgeon

who specializes in minimally


KidS & school4 tips for achievement

[I] f you WAnT your chIldrEn to enjoy academic success,

keep them fit and healthy.

“Untreated hearing or vision

problems, uncontrolled diseases,

obesity, lack of sleep and other issues

can derail academic success,” says

David L. Freeman, MD, a primary

care pediatrician at Georgia Health

Sciences Children’s Medical Center.

To put your child on the road

to achievement, Dr. Freeman

suggests you:

[1] Encourage healthy eating

and plenty of sleep. “One

of the best ways to do this is by

setting a good example. Ask your

children to help select and prepare

healthy meals and snacks. And set

strict bedtime rules to ensure

adequate rest,” Dr. Freeman says.

[2] Keep your kids active.

Again, you can set the

pace. “Limit screen time in favor of

family bike rides, hikes and swims.

Shoot hoops, do lawn work together

or encourage your kids to join sports

teams or gyms,” Dr. Freeman says.

[3] Make sure your children

have annual physical

exams. This lets their physicians

monitor their growth and

development, body mass index

(BMI), blood pressure, hearing and

vision. Physicians can also identify

and treat any problems and perform

a sports physical, if needed. “Many

people neglect exams for teens,

but regular exams are at least as

important for them as they are for

younger children,” Dr. Freeman says.

“Wellness visits are a great time to

discuss issues of special interest to

teens.”

[4] Protect your children with

vaccines and flu shots.

“Following the vaccine schedule and

having annual flu shots can help

keep your children healthy and in

the classroom,” Dr. Freeman says.

“Remember, your children are

likely to follow the health habits

they establish in childhood for

much of their lives. By facilitating a

healthy lifestyle now, you can help

protect them for years to come.”

WE'RE WITH yOUR CHILDREN IN SICkNESS AND IN HEALTHGeorgia Health Sciences children’s Medical center staffs the area’s largest, most diverse team of pediatric primary care physicians and specialists. the team offers everything from wellness visits to advanced treatments for cancer, heart and neurological disorders.

PROTECT yOUR CHILD’S HEALTH

to schedule an appointment, call 706-721-kIDS (5437) or visit georgiahealth.org/kids.

1120 15th Street, ad 1114 augusta, Ga 30912

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Connect to Georgia Health Sciences

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in tHe news

Earns 16 awards, including Nurse of the Year

[I] f you cAn judgE A hosPITAl

by the quality of its nursing

staff, Georgia Health Sciences

Medical Center excels.

Our nurses earned a whopping

16 awards at the 2012 Nursing

Showcase hosted by the Central

Savannah River Area (CSRA) chapter

of the Georgia Nurses Association, a

banquet event that kicks off National

Nurses Week each spring.

Among those awards was CSRA

Nurse of the Year, an honor that went

to Angeline “Missy” Pratt, assistant

vice president of perioperative services

at Georgia Health Sciences Medical

Center. Pratt also received the Nurse

Administrator of the Year award.

Pratt was cited for being a skilled

mentor, educator and nursing hero

who lives by the guiding principle

that in her own words, “You can never

be wrong if you always do what is best

for the patient.’’

Pratt has done that consistently

during her 10-year tenure at


Center, where she oversees

20 operating rooms.

Her efforts have significantly

reduced the average cost per surgery

as well as the amount of blood used.

She has also improved employee

retention and reorganized the

perioperative services staff into a more

patient-focused, service-oriented team.

GeorGia HeaLtH ScienceS MedicaL center rocKS

nursing showcase

More important, Pratt and the

other nurses honored at the event

have touched the lives of thousands

of families by doing what nurses at


Center do every day: deliver skilled

and compassionate care to people

in need.

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