ADVANCING OUR MISSIONS

PATIENT CARE BIOMEDICAL RESEARCH EDUCATION & LEADERSHIP COMMUNITY ENGAGEMENT

At the Heart of an Unprecedented Procedure

ANDREW DAGLAS CONTRIBUTING WRITER

Texting Against Diabetes

ROB MITCHUM STAFF WRITER

Students Have Questions, Senior Leaders Have Answers

MEGAN E. DOHERTY STAFF WRITER

Reaching into the Asian Community

MAGGIE HIGGINS STAFF WRITER

STOP THE messaging is now a common Text VIOLENCE of communication for people of form Kenneth Berger has survived three heart all ages and backgrounds. As more and attacks and a triple bypass. But last more people learn how to type with summer, the 56-year-old retired truck their thumbs, a team of the University driver from Lowell, Indiana faced a new of Chicago Medicine physicians looked complication that could have cost his at whether all that texting could be used life, had it not been for the ingenuity of to help community members manage his physicians at the University of chronic disease. Chicago Medicine.

American Heart Month

Berger came to the medical campus after experiencing severe congestive heart failure. His left ventricle ejection fraction the amount of blood being pumped out of his heart and into his bodywas just 15 percent, far below the normal 6570 percent range. While Bergers lungs, liver and kidneys were failing due to a shortage of blood, his heart was swelling with an excess of it. He was bedbound, said Atman Shah, MD, FACC, FSCAI, assistant professor of medicine. The moment he would even sit up in bed, he would become very distressed. Attempts to alleviate the strain were unsuccessful. Physicians implanted a device to pump blood directly from Bergers left ventricle to the rest of his body. Berger then developed a leaky aortic valve, allowing blood to flow backwards to his heart. Surgical repair of the faulty valve would have required another very high-risk open heart surgery.

On November 10, Pritzker medical students met with Kenneth Polonsky, MD, dean and executive vice president for Medical Affairs, and Sharon OKeefe, president of the University of Chicago Medical Center, for a brown bag dinner in the Billings Auditorium. These forums facilitate a direct conversation between students and senior leaders. The November event focused primarily on questions about the New Hospital Pavilion (NHP), which is on track to serve its first patients in January 2013. Many students wondered how the use of space in the NHP will affect current patient logistics, staff-patient ratios and the medical student experience. Because of the added space in the NHP, other areas of the medical campus can be repurposed for example, Mitchell may house a new student lounge area. One student asked about nurse-patient ratios, particularly outside of the ICU. With the increase of ICU beds at the NHP, the senior leaders were optimistic that the medical campus will offer an improved ratio of nurses to patients for general care, as increasing ICU resources will put less strain on general care staff. Another topic close to the students hearts was food. The NHPs seventh floor will house the Sky Lobby with a new cafeteria. While Polonsky and OKeefe are in talks with vendors, they said they intended to bring in healthier food options, which generated much excitement among the students. Students wanted to know about the medical campuss vision for the next 10 years and how students can benefit from the new Bucksbaum Institute. Polonsky and OKeefe emphasized that the University of Chicago Medicine will continue to focus on complex cases, transplants, neuroscience, building high-tech operation rooms and improving access to primary care for its faculty and staff.

The Office of Community Engagement and Cancer Disparities is educating the community one population at a time. Most recently, theyve reached into the Asian community, a population that is often short-changed by public health initiatives. Generally, Asian-Americans are lumped together as other or as a homogenous group, which ignores the differences in immigration history, culture, language and health resources, said Karen Kim, MD, associate professor of medicine and director of the Office. Dovetailing her role as president of the Asian Health Coalition, a nonprofit based in Chicago, Kim looks at the disaggregated groups to understand their individual health needs.

MONICA PEEK, MD, LEFT, AND SHANTANU NUNDY, MD, ARE USING TEXT MESSAGING TO HELP PATIENTS CONTROL THEIR DIABETES. PHOTO BY MEGAN E. DOHERTY

In some areas of Chicago the diabetes rate is as high as 25 percent, and AfricanAmerican populations have much higher rates of diabetes complications such as blindness and amputation. So UChicago Medicines Shantanu Nundy, MD, clinical instructor of medicine at UChicago Medicine, and Jonathan Dick, MD, currently a resident at Columbia University Medical Center, decided to test whether an automated textmessaging system could help patients control their diabetes. The study recruited 18 participants who are not your typical teenage texters, instead reflecting an age range (3872) more commonly afflicted with diabetes. Participants received regular reminders to check their blood sugar, examine their feet and take their diabetes pills. It needs to be able to work in people I see in clinic, said Monica Peek, MD, assistant professor of medicine and co-designer of the study. If it works for a 55-year-old black woman with diabetes, Im interested. The results of the pilot study were very encouraging, with all but one participant reporting high satisfaction with the text reminders. For a follow-up study, the researchers plan to recruit UChicago Medicine employees with diabetes (call 773-702-2939 if you are interested, or email info@southsidediabetes.org ). What surprised and inspired us the most was how much people seemed to care about it, and how such a little thing as a text was such a big deal in somebodys schedule, said resident Dick. It doesnt take a whole lot to make people think that somebody cares about them, and that little thing can be enough to motivate behavior.

KAREN KIM, MD, LEADS OUTREACH PROGRAMS IN THE ASIAN COMMUNITY FOR THE OFFICE OF COMMUNITY ENGAGEMENT AND CANCER DISPARITIES. PHOTO BY DAVID CHRISTOPHER

Over the years, Kim has conducted significant outreach around hepatitis B, a disease that disproportionally affects the Asian-American population. Hepatitis B affects about 1.5 million individuals in the United States of whom over 50 percent are of Asian descent, Kim explained. Currently, she and her team are pushing the Chicago City Council to support more active hepatitis advocacy and education. Kim and her team have also worked closely with the network of 1,500 Asian-American homemakers in Chicago, introducing breast and liver cancer awareness programs. Results of this initiative will soon be published in a paper examining the attitudes and beliefs about breast cancer among Chinese immigrants. In partnership with the Chinese-American Service League, the Office launched an annual health fair to provide free flu vaccinations. Students from the Pritzker School of Medicine volunteered to screen for hypertension, eye checks and provide breast cancer education. We use every opportunity to talk about cancer while providing other needed services, Kim said. This coming year the team will look at culturally competent linguistic practices within the Korean-American community and kick off a cancer survivorship program in the ChineseAmerican community. Its amazing what a small group can do with great partnerships and hard work, Kim said.

ATMAN SHAH, MD, LEFT, AND PATIENT KENNETH BERGER. PHOTO BY MEGAN E. DOHERTY

Physicians decided to try to repair the tear percutaneously with a device normally used to close holes between the hearts left and right atria. According to Mark J. Russo, MD, co-director of the Center for Aortic Diseases, this unprecedented approach carried more than a few risks. Vascular injury, stroke and even death were all possible. Furthermore, the device had never been used to fix a leaky valve. Shah recalled presenting the proposal, and the risks, to Berger. He said, I know if nothing happens Im going to die. If this gives me a 10 percent chance of living the life I want to live, Im okay with it. The odds turned out to be in Bergers favor. On September 1, the procedure was performed successfully; within 24 hours, his liver and kidney functioning had improved markedly. While several months ago he had difficulty getting out of bed, today hes able to spend hours walking a shopping mall with his grandchildren.

MEDICAL CENTER PRESIDENT SHARON OKEEFE AND DEAN KENNETH POLONSKY, MD, HOSTED A BROWN BAG DINNER FOR PRITZKER STUDENTS. PHOTO BY MEGAN E. DOHERTY

The Bucksbaum Institute will offer scholarships and fellowships to students and junior faculty who are particularly interested in patient care. Inaugural student scholars are Liese Pruitt, Alex Ruby and Jasmine Taylor; faculty fellows are Monica Peek, MD, and Alexander Langerman, MD. It also will recruit and support one master clinician each year to serve as mentor to students and faculty.