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Global Patient Services Spring 2013

A-Fib Patient in Lebanon Receives Surprise Visit Following MyConsult Second Opinion

Regardless of where you live, it is a troubling experience when an unexpected health issue arises. But, what about patients who live overseas and would like to receive an expert medical opinion from a physician at a top hospital in the United States?

Paul Gholam is one of those international patients. The 28-year-old lives in Beirut, the capital of Lebanon, where he spends his free time taking photographs, working on home improvement projects, and spending time with his family.

“I was always a healthy person, and always on-the-go,” Paul said. “Then, starting in 2008, I had a few strange episodes with my heartbeat. But, the episodes were short and went away on their own so I never thought much of them.”

What Paul didn’t know at the time is that those episodes were actually the result of a condition called paroxysmal atrial fibrillation, or A-fib, which is the most common type of irregular heartbeat.

It wasn’t until 2010, when Paul experienced the strange palpitations again, that he finally sought medical attention. In the emergency department, the physician found his heart rate to be very high at more than 130 beats per minute. After undergoing a series of tests, the results ultimately showed no additional signs of abnormality. After 24 hours of treatment, Paul’s heartbeat went back to normal and he was sent home with medication to help manage his condition. But in December, and again in March 2011, Paul’s unpredictable A-fib symptoms landed him in the hospital.

“I wanted answers about my heart condition, but I didn’t know where to turn,” Paul said. “So I started doing my own research.”

Paul was using an Internet search engine when he came across Cleveland Clinic’s world-renowned Heart and Vascular Institute and Walid Saliba, MD, a Cardiovascular Medicine Staff Physician who studied medicine right in Paul’s hometown of Beirut.

“Almost immediately after reading about the Heart and Vascular Institute, I knew I wanted to have my health condition evaluated by Dr. Saliba,” Paul said. “But, traveling across the world to get there seemed unrealistic. So when I discovered the MyConsult program online, I was extremely happy.”

The MyConsult® Online Medical Second Opinion program is a sophisticated, web-based extension of Cleveland Clinic’s 90-plus-year role as one of America’s respected referral institutions. The secure, online program provides medical second opinions from Cleveland Clinic specialists for more than 1,200 diagnoses that may impact quality of life or may be more serious.

Paul gathered his medical records and sent them to the Cleveland Clinic MyConsult Clinical Operations team to be reviewed by Dr. Saliba.

“I was happy that Cleveland Clinic was able to provide me with a second opinion from a specialist who trained in the country I am from and is familiar with the culture here,” Paul said.

Paul received Dr. Saliba’s MyConsult second opinion report quickly, and his recommendations reassured Paul that the treatment he was currently receiving for his A-fib was indeed appropriate.

Dr. Saliba recommended that Paul continue using the “pill in the pocket” technique, meaning he should always have medication on hand to be taken in the event of an A-fib episode. He also indicated that in the future, if Paul’s A-fib episodes became more frequent, lasted longer than 48 hours, or burdened him with extreme mental anxiety, that he would likely benefit from an ablation procedure.

“I felt as if Dr. Saliba truly understood my concerns,” Paul said. “In the MyConsult second opinion report, he indicated that at Cleveland Clinic, 85 percent of ablation surgeries are successful for patients like me with paroxysmal A-fib. He offered to have my visit to Cleveland Clinic facilitated if I ever decided to make the journey overseas. This really gave me hope.”

Coincidentally, only months after the MyConsult second opinion, Dr. Saliba visited Lebanon to give a lecture at a medical conference and immediately thought of Paul.

“Dr. Saliba contacted me and let me know he would be in my country,” Paul said. “I felt very lucky that he found time to fit a meeting into his schedule. I was able to see him in person and ask him questions.”

Paul said that his A-fib symptoms have not worsened since he completed his MyConsult second opinion and met with Dr. Saliba. Because he feels stable at the moment, he has not yet made the decision to travel to Cleveland Clinic. He did indicate, however, that if he ever needs surgery in the future, he would certainly be willing to follow Dr. Saliba anywhere on the globe.

Cleveland Clinic Debuts New Hospital Gowns

Innovative design brings together form and function

One of the ways in which Cleveland Clinic puts “Patients First” is by focusing on making every aspect of the patient experience as positive as possible. The comfortable, stylish and functional hospital gowns that are debuting this spring for inpatients are one example of that commitment.

“When you’re admitted to the hospital, one of the first things that you’re usually asked to do is to disrobe and put on a hospital gown,” says Jeanne M. Murphy RN, BSN, BC, Executive Liaison for Delos M. Cosgrove, MD, president and CEO of Cleveland Clinic. “Although hospital gowns tend to be functional, they usually aren’t very dignified or comfortable. So we set out to design a gown that would improve dignity and comfort while remaining highly functional.”

They also decided to focus on something that typically isn’t even a consideration in hospital gown designs: They wanted them to be attractive—and yes, even stylish.

Designing a one-of-a-kind gown

Ms. Murphy and colleagues already had been researching how to make the best gowns possible for patients when something serendipitous happened. While attending a conference for executives, Dr. Cosgrove crossed paths with world-famous fashion designer Diane von Fürstenberg—who is best known for her iconic “wrap dress.”

Although Ms. von Fürstenberg’s designs typically appear on high-fashion runways, not in hospital hallways, Dr. Cosgrove eventually convinced her to meet with his team to develop the design for the new gowns.

“We went to New York and met with one of her designers and fabric experts,” Ms. Murphy says. “It was great to have the perspectives of a world-class fashion design team.”

Ms. Murphy emphasized the importance of both form and function to the designers, based on the research that had already been done. “We knew that the fabric couldn’t be too scratchy, heavy or cumbersome,” she says. “The gowns also needed to be able to stand the rigors of commercial laundry.”

Once the prototype was designed for the gowns, they were tested with patients, adjusted and perfected.

Form and function

The new gowns have a v-neck in the front and back that is somewhat reminiscent of Ms. von Fürstenberg’s famous wrap designs, while remaining stylish and functional for both male and female patients. They can be worn as a traditional gown, and/or backwards as a robe.

What really sets the gowns apart is a simple but brilliant design feature—they cross in the back for optimal modesty. Any patient who has walked in a hospital while simultaneously trying to hold his or her gaping gown together will appreciate this design feature. The gowns also have a side opening with ties for functionality.

Other highlights include:

  • The gowns are embellished with an attractive graphical print that uses Cleveland Clinic’s famous blue and green geometric logo.
  • The gowns are now available in four sizes—small, large, 3x and 10x. Each size comes in a distinct color to make them easy to identify for caregivers. The gowns even have adjustable waists, to make them more attractive.
  • They are made from a lighter, softer fabric than typical hospital gowns (70/30 cotton/polyester blend).
  • They have snap sleeves to make medical procedures such as IVs easier.

“The goal was to keep the gowns functional while making them more attractive, so that patients feel good about what they are wearing when they have visitors,” Ms. Murphy says.

She adds: “We definitely feel that we succeeded in what we set out to do.”

Spotlights on the Endocrinology & Metabolism Institute

Cleveland Clinic’s Endocrinology & Metabolism Institute (EMI) is committed to providing the highest quality healthcare for patients with diabetes, endocrine and metabolic disorders, and obesity. Our staff is dedicated to exploring ways to improve the care of these patients and to teaching the best methods for treating them. Our diabetes and endocrinology services are ranked second in the nation by U. S. News & World Report.

Our institute caregivers work together to provide the finest care in the country. Over 30 staff physicians, 18 fellows, and more than 80 nurses, medical assistants, diabetes educators, secretaries, patient service representatives, coders, administrators and managers work in our Institute’s departments and centers to ensure streamlined diagnosis and treatment of our patients. The institute includes the oldest subspecialty at Cleveland Clinic, and continues a steady rise to be among the best treatment providers of diabetes and endocrine conditions in the nation.

Following is a spotlight on some of our EMI services:

Diabetes Center

Cleveland Clinic's Diabetes Center optimizes care for patients with Type 1 and Type 2 diabetes. The center’s clinical caregivers are dedicated to diabetes care and include physicians, nurses and nurse practitioners, diabetes educators, registered dietitians and surgeons.

The Diabetes Center works closely with our bariatric surgeons to provide services to obese patients on the advisability and timing of weight-loss surgery for diabetes control. And our endocrinologists have led the way in ground-breaking research showing that gastric bypass surgery can reverse the effects of diabetes in type 2 diabetics.

Department of Endocrine Surgery

Our endocrine surgery service has the largest experience in the world in the surgical care of thyroid, parathyroid, adrenal, endocrine and pancreas disorders, including complex endocrine problems, endocrine malignancies or reoperative surgery needs. Our department places special emphasis on coordinating care so that patients can experience a comprehensive consultation in one visit.

Advanced minimally invasive technology is often used for many of the procedures we perform including thyroidectomies, parathyroidectomies and adrenalectomies. We are also one of the few hospitals offering “scarless” robotic thyroid and parathyroid procedures, and are one of the busiest centers in the country for laparoscopic radiofrequency thermal ablation of neuroendocrine tumors that metastasize to the liver.

Our endocrine surgery team’s thyroid and parathyroid surgery case volume has more than quadrupled in the past 10 years. Patients are increasingly referred for complex conditions such as reoperative problems, advanced cancers and hereditary endocrine syndromes.

Children's Health Essentials: Health & Wellness Updates to Keep Your Family Healthy

We hope that you have enjoyed this issue of Cleveland Clinic’s Global Patient Services Newsletter. Now, we would like to give you the opportunity to have even more health and wellness information from our clinical experts delivered right to your inbox. Sign up below for free, for our Children's Health Essentials and Parents Children's Health Essentials e-Newsletters.

Children's Health Essentials: Knowledge for Better Living.

Our Children's Health Essentials e-Newsletter is dedicated to encouraging good health and wellness. Each monthly issue offers health information and updates as well as a healthy recipe, tips for living well from Cleveland Clinic experts and much more.

Some of our most popular topics have included:

  • Inflammation-Fighting Foods and Why You Need Them
  • Heart Healthy Diet & Exercise Tips
  • Risks & Benefits of Aspirin Therapy
  • Osteoporosis: 5 New Drugs to Challenge Bone Loss
  • 7 Myths About Medication—and the Facts Behind Them
  • 6 Inexpensive Ways to Stay in Shape
  • Prostate Cancer Prevention
  • Women’s Health Myths
Parents Children's Health Essentials: Knowledge for Better Living for You & Your Family.

Our free monthly parents’ e-Newsletter offers features and mythbusters for you and your family on lifestyle, nutrition and fitness, tips on kids’ health, healthy recipes and more. You’ll enjoy health and wellness advice from trusted Cleveland Clinic Children's experts and free downloadable health guides.

Some of our most popular topics have included:

  • Sibling Rivalry Tips: 5 for Prevention, 5 for Intervention
  • The Family Table: 5 Dos and Don'ts for Young Kids
  • Kids’ Fevers: When to Worry, When to Relax
  • Is Anesthesia Safe for Children?
  • Inflammation-Fighting Foods and Why You Need Them
  • 7 Myths about Calcium, Vitamin D and Healthy Bones
  • Multitasking: Why It’s Bad for You and Your Kids

Recipe Corner: Roasted Garlic, Tomato and Zucchini Bake

This colorful and healthy side dish will brighten any meal. Garlic is a super veggie that helps reduce risks for cancers of the colon, stomach, esophagus, pancreas and breast. Tomatoes and zucchini are packed with vitamins and minerals, too.