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eHealthlinesbr Fall 2013

At Cleveland Clinic Florida, it’s our goal to keep you informed of the latest news in healthcare. Our patient care philosophy is based upon the principles of cooperation, compassion and innovation. Cleveland Clinic Florida has grown to become a fully integrated academic medical center that integrates clinical and hospital care with research and education. With locations in Weston, West Palm Beach, and now Palm Beach Gardens and Parkland, we are expanding to meet the needs of the communities that we serve. Physicians at Cleveland Clinic are experts in the treatment of complex conditions that are difficult to diagnose.


eHealthLines - Fall 2013

Fall Recipes

HEALTHY PUMPKIN PIE

Ingredients:
  • 1 tsp pumpkin pie spice
  • 2 tsp cinnamon
  • 1/2 tsp salt
  • 2 tsp baking powder
  • 1/3 cup flour
  • 1/3 cup of brown sugar
  • 2 packs of SPLENDA®
  • 1 (15-oz) can pumpkin puree
  • 1 cup of skim milk
  • 1/3 cup of unsweetened applesauce
  • 1 tbsp of ground flax
  • 1/2 tsp pure vanilla extract
Preparation:

Preheat oven to 400 F, and grease a 10-inch round pan. In a large mixing bowl, combine first 7 ingredients, and stir very well. In a separate bowl, combine all liquid ingredients with the flax, and whisk. Pour wet into dry, stir to combine, then pour into the pan and bake 35 minutes. Allow to cool completely before storing it in the fridge. Set for at least 6 hours before trying to slice. Makes 8 servings.

Nutritional Information Per Serving:
  • Calories: 89
  • Sodium: 40 mg
  • Protein: 2 g
  • Saturated Fat: 0.1
  • Total Fat: 0.5 g
  • Dietary Fiber: 2 g
  • Carbohydrates: 19
  • Cholesterol: 0 mg

LIGHT CRANBERRY MOUSSE

Ingredients:
  • 6 leaf of peppermint fresh
  • 4 cups of low fat plain yogurt
  • 4 oz of sweetened cranberry sauce
  • ¼ cup dry oatmeal
Preparation:

Drain yogurt in a fine strainer over a bowl for 1 hour. Toast oats in a baking pan for 15 minutes in a 350 degree oven, shaking pan occasionally. Reserve. Place yogurt in a bowl and beat with electric mixer for 2 minutes; fold in oats. With a rubber spatula, gently swirl in cranberry sauce to obtain a marbled effect. Do not overmix. Chill at least 2 hours. Serve in wide wine glasses, garnished with mint sprigs. Makes 6 servings.

Nutritional Information Per Serving:
  • Calories: 141
  • Sodium: 105 mg
  • Protein: 8 g
  • Saturated Fat: 0.7
  • Total Fat: 1.5 g
  • Dietary Fiber: 0.5 g
  • Carbohydrates: 24
  • Cholesterol: 10 mg
Innovations in Angiography: More Efficient Techniques

To diagnose and treat blocked arteries of the heart, cardiologists often use angiography. Interventional cardiologists at Cleveland Clinic Florida offer an innovative technique for performing angiography that achieves the same results as the more common method—but with much less discomfort and fewer risks for their patients. Eight or nine times out of 10, angiography involves threading a thin tube through the arteries of the leg and up to the heart, in order to inject dye that will show any blocked arteries on a computer monitor. The newer procedure uses the radial artery in the arm.

“It’s called transradial coronary angiography,” says Howard Bush, MD, a Cleveland Clinic Florida interventional cardiologist. “Using the arteries of the wrist and arm, we can reach the heart to both diagnose any blockages and to treat them. Our patients love it, in part because they have less discomfort compared to using arteries in the leg. But overall, this approach also has fewer complications and allows patients to go home more quickly. It’s simply more efficient, on many levels.”

When angiography is done through a leg artery (called transfemoral angiography, named for the main artery in the thigh), patients treated with a stent often require an overnight hospital stay. To treat a blockage with a stent using transradial angiography typically only takes about 30 minutes, and just a few hours for recovery before patients return home. In addition, patients have less risk for bleeding with the newer procedure. Despite the advantages, only about 10 to 15 percent of all angiographies nationwide are transradial.

“This procedure is highly technical, and interventional cardiologists have a steep learning curve to become competent at it,” Dr. Bush says. “But at Cleveland Clinic Florida, our specialists have the training and experience, and we can offer it to about 95 percent of our patients.”

Bradley Morem, 54, of Jupiter, FL, can testify to both the ease and success of the procedure, from the patient’s perspective.“I had what I thought was indigestion for several months, but during a visit to my cardiologist at Cleveland Clinic Florida, he found that I might have something more serious,” he says.

Dr. Bush performed transradial angiography the next day and diagnosed Mr. Morem with a 95 percent blockage in one artery. So Dr. Bush placed a stent to successfully open up the blood flow—during the same visit and the same procedure. “All I felt was a slight pinprick, and soon after I was walking out of the hospital, heading home,” Mr. Morem says. “It was a wonderful experience. And it saved my life.”

Killing cancer using ‘Band-aid surgery’

Cancer experts at Cleveland Clinic Florida offer patients a wide range of innovative options for cancer care. This includes radiofrequency ablation, or RFA. For patients, this procedure and the results seem to be the stuff of science fiction.

“We refer to it as ‘Band-aid surgery’ because the patient doesn’t even have an incision, so they go home with only a band-aid after the procedure” says Kevin Stadtlander, MD, Cleveland Clinic Florida interventional radiologist. “Using RFA, we’re able to treat and cure many patients, with a very short recovery time.”

Radiofrequency ablation is a way to burn and kill tumor cells. The technology is so exact that little tissue around the tumor is affected. It is most commonly used for kidney and liver tumors, but physicians also utilize it to treat bone, lung and many other types of cancer.

Though RFA is usually reserved for tumors less than three centimeters in size (a little over an inch), Dr. Stadtlander has been able to offer RFA to patients with tumors more than twice as large.

“I had a seven centimeter tumor on one kidney, and one doctor said I needed to have the entire kidney removed,” says Anthony Romano, 82, from Hallandale, FL. “But I wasn’t sure I was healthy enough for a major operation. So I went to Cleveland Clinic Florida for a second opinion, and I’m so very thankful that I did.”

Dr. Stadtlander treated him with two rounds of radiofrequency ablation. During the procedure, interventional radiologists use computer images created by CT scan or ultrasound, to guide a tiny needle and electrode to the site of the tumor. The electrode carries radiofrequency waves that heat the tumor cells, destroying them. Mr. Romano’s latest tests show he has no active tumor cells.

“So now, I no longer have cancer, and I still have both kidneys,” Mr. Romano says. “What’s even more amazing to me is that for both RFA procedures I never felt a thing —not one thing. I couldn’t even find the scar when I got home.”

In addition to helping many patients avoid surgery, RFA might be the only treatment for those who cannot have surgery because of other health issues or for those who have tumors that are hard to reach.

“Many patients like Mr. Romano are actively seeking information about cancer care,” Dr. Stadtlander says. “That’s something that our team of multispecialty experts at Cleveland Clinic Florida fully supports. Know your options, so you can make the best choices for you.”

Open Wide, Then Let a Digital Pill Do All the Work

Have you been working with your doctor to find out why you have nausea, vomiting, bloating, constipation or heartburn? New technology called the SmartPill™ is making diagnosis easier for patients than ever before. “Finding the exact causes of and best treatments for digestive problems can be difficult because many symptoms are not very specific, and several different parts of the digestive tract can be involved,” says Alison Schneider, MD, Cleveland Clinic Florida gastroenterologist. “Before this technology became available, our best options for diagnosis involved radiation or tests that could take many hours. The SmartPill™ simplifies testing and gives us days’ worth of important information.”

The device helps gastroenterologists diagnose digestive problems caused by poor “motility,” or how quickly the body processes food and waste, for example. Delayed gastric (stomach) emptying, or gastroparesis, is one example of poor or slow motility. During a 20 to 30 minute office visit, the patient swallows the pill-like device. They can then return to regular activity — from work to hobbies and exercise. Over the next several days, the SmartPill™ records pressure, acidity and temperature along the digestive tract and transmits this data to a receiver that the patient wears on a belt.

Once the device passes entirely through the digestive tract and exits during a bowel movement, the receiver beeps to alert the patient that the test is complete. The device is environmentally safe and can be flushed. The patient then returns the receiver to the physician.

“This technology is especially helpful if someone has more than one slow area along the digestive tract, and it’s one of the only ways that we have to evaluate motility of the small intestine right now,” Dr. Schneider says. Physicians at Cleveland Clinic were among the first in the state to provide SmartPill™ technology to patients.

Emerging Technologies: The Future of Spine Care is Here

For over a decade, spine specialists have used computers and X-ray images to help guide them during intricate surgery. Today, the most experienced of these spine surgeons are working with a new and astoundingly accurate computer-guided device that uses three-dimensional (3D) images. This gives them precision that is “far superior to the human mind,” according to experts at Cleveland Clinic Florida.

The device is the O-Arm®, and surgeons utilize this state-of-the-art system to aid in the stabilization, restoration or reconstruction of the spine after injury, illness or deterioration over time. Only about 10 percent of spine surgeons and relatively few medical centers in the U.S. employ this technology, but its benefits are many, says Graham Mouw, MD, spinal neurosurgeon at Cleveland Clinic Florida. In just 12 seconds in the operating room just before surgery, the O-arm® provides the surgical team with a 3D computer image of the patient’s spine in real-time. “That’s an innovation we’ve not had before, and the benefits to patients are significant,” according to Dr. Mouw. “The O-Arm® allows us to be more precise than with other techniques. It is safer for our patients because it gives experienced surgeons the precision of a computer.”

Having detailed 3D computer images allows surgeons to identify the precise location for treatment along a patient’s spine before surgery, and the computer helps guide tools to this exact location. This precision means that incisions are as small as possible. That leads to less blood loss, fewer complications, faster surgery and quicker healing, Dr. Mouw says. As another important benefit, the device exposes the patient to less radiation than other imaging (X-ray) techniques.

“Cleveland Clinic Florida is committed to providing our patients with the most innovative and technologically advanced care available,” Dr. Mouw says. “The O-Arm® represents the future of spine care, but our patients don’t have to wait for it. It’s here now.”

Would you treat someone differently - if you only knew?

Cleveland Clinic Empathy

This is the central question in the Cleveland Clinic "Power of Empathy" video. Nearly 1 million people have watched, shared, presented and commented on this powerful video. Created earlier this year for Cleveland Clinic's 40,000 employees (known as caregivers) as a reminder of the importance to stand in someone else's shoes, the empathy video has gone near viral; seen in more than 187 countries and currently is being used by healthcare organizations around the world to teach employees the importance of empathy.

"We wanted to drive home what empathy really is in a hospital," says Chief Experience Officer James Merlino, MD. "That it is not just about understanding the patient's perspective, but also our co–caregivers' perspective. That every day it is important to understand how our emotions or what is going on in our own life, relates to what is going on in the lives of people around us."

The video was written and produced by Cleveland Clinic's Media Production Department and has won several national awards including the Telly, Communicator and Hermes Awards. It has provoked an international discussion of empathy and patient experience that promises to have a lasting impact on healthcare.

The message of this short (just over 4 minutes) video is one not to be missed. It speaks to everyone without saying a word. Because the video is so impactful and has been received so positively, we invite you to watch it and share it with your friends, family, and colleagues. Be part of this growing movement to restore empathy and compassion to the healthcare experience.