Making a joyful noise: Joey finds his ‘real voice’

Emory Voice Center patient Joey Finley

Last year, seven-year-old Joey Finley sang Christmas carols for the first time in his life. For most parents, this would be uneventful, but for Joey’s mom, Melanie, it was a breakthrough.

Joey was literally silenced all these years because of a rare disease called recurrent respiratory papillomatosis (RRP). The disease allows tumors to grow in the respiratory tract, and is caused by the human papilloma virus (HPV). Currently there are 20,000 active cases in the United States.

Although the tumors mostly occur in the larynx on and around the vocal cords, these growths may spread downward and affect the trachea, bronchi and sometimes the lungs, obstructing breathing. RRP papillomas are the same tumors that cause cervical cancer. There is no cure for RRP. And left untreated, the lesions may grow and cause suffocation and death.

Initially, doctors confused Joey’s RRP symptoms with pediatric GERD or acid reflux disease. Since Joey was two months old, he’s been in and out of hospitals, OR’s and doctor’s offices, and had more than 60 surgeries to remove the tumors on his vocal chords.

RRP adversely affected Joey’s speech. He began compensating for the “frogs” as he called them, by using other vocal muscles to talk.

When Joey met Edie Hapner, PhD, a speech pathologist at the Emory Voice Center, she says he sounded “like a little old man.” His voice was very raspy like that of a 60-year-old smoker.

After several sessions with his speech therapist, Joey is a normal sounding child. Joey now sings in the school chorus and takes gymnastics and swimming lessons. It’s hard to imagine these activities for a child that not so long ago had trouble breathing because of HPV tumors blocking his airways.

Read more about Joey’s journey to ‘find his voice’ and hear him speak in the new issue of Emory Health magazine.

Listen to Emory patient Karon Schindler recount her experience at the Voice Center.

Posted on August 6, 2009 by admin in Uncategorized Leave a comment

Dialing 911 saves time and lives

In the time it takes to write this short piece, more than 90 people across the United States will have suffered a heart attack â€“ and almost 40 of them will have died. In the same time frame, a call to 911 could have a patient in an ambulance and on the way to a nearby hospital where lifesaving treatment is ready on a momentâ€™s notice. More often that not, the difference between surviving a heart attack and becoming another statistic is a matter of a few minutes. Precious time.

EMS representative prepares

The very best way someone suffering a heart attack can save time and have a fighting chance for survival is to call 911 instead of driving to the hospital. Here in the Atlanta area, a one-of-a-kind initiative, appropriately named TIME, makes it possible for Emergency Medical Services (EMS) to quickly respond to a patient and transmit life-saving data to local Atlanta hospitals in order to shorten the time to treatment and increase a heart attack victim’s chance of survival. Two Emory hospitals â€“ Emory University Hospital and Emory University Hospital Midtown â€“ are partners with three other local hospitals in this effort to make Atlanta one of the safest cities in America in which to have a heart attack.

Bryan McNally, MD, emergency medicine physician at Emory University Hospital and co-director of the TIME program, says the collaboration is the first cooperative urban program in the United States. It was developed to provide the most rapid response to a cardiac emergency by improving every step of care from the onset of symptoms to treatment at the hospital. The time from the onset of the heart attack to the opening of the artery is critical in reducing heart damage and improving survival.

An EMS call results in quick evaluation, treatment and vital information transmitted to the nearest hospital where a team will stand ready to meet the patient at the door and begin opening a blocked artery within minutes. Kate Heilpern, MD, chair of the Emory Department of Emergency, says the chain of survival from pre-hospital 911 to the emergency room to the catheter lab is available 24 hours a day, seven days a week at our institutions. In these instances, when EMS suspects a heart attack, getting the patient to the right place at the right time with the right providers to do the right thing definitely optimizes patient care and enhances quality and outcome.

Read more about chest pain center accreditation.

Posted on August 5, 2009 by admin in Uncategorized Leave a comment

Heart care in women is key to long life

Heart care for women

Many women do not realize the seriousness of heart disease â€“ in women. Many more do not realize that some of the symptoms of heart attack for women may be different than symptoms experienced by men. Heart disease, also called cardiovascular disease (CVD), is the number one cause of death in women in the United States.

Enter Emory Heart & Vascular Centerâ€™s Michele Voeltz, MD. Her work in both the clinical setting and in research focuses on women and heart disease.

Voeltz, who practices at Emory University Hospital Midtown, says the number of women developing CVD is on the rise, with nearly 37 percent of all female deaths in the United States caused by heart disease. She is working to raise awareness about heart disease in women, and she wants to let women know about the resources available to them to take care of themselves.

With women making up 60 to 70 percent of her practice, Voeltzâ€™s mission is to help women and men gain a greater understanding of the differences in risk factors, symptoms and treatment of heart disease in women as compared to men. She has found that women represent an underserved population with regard to cardiovascular care and hopes that her work can help bridge these gaps for women.

Voeltz conducts research in women with heart disease using percutaneous coronary intervention (angioplasty and stenting). With clinical trials to compare stents, medical devices and medications, all of which enroll both men and women, Voeltz analyzes female patientsâ€™ outcomes.

Posted on August 4, 2009 by admin in Uncategorized Leave a comment

Rapid radiation delivery increases accuracy

RapidArc for prostate cancer

Doctors in Emoryâ€™s Department of Radiation Oncology are the first in Georgia to use a new radiation delivery system that speeds up treatment and increases accuracy.

The first patients treated have been men with prostate cancer, but the treatment can also be used for patients with head and neck cancers or brain tumors, says Walter Curran, MD, chair of the department and chief medical officer of the Emory Winship Cancer Institute.

Curran says the main advantage to the new system, called RapidArc, is faster treatment so a patient is not lying on a treatment table for a long period of time. Limiting the time it takes can help with patient comfort as well as minimizing the chance of movement, which affects accuracy during treatment.

Treatments that once took five to 10 minutes can be performed in less than two minutes. For patients getting radiation daily over several weeks, that can make a significant difference, Curran says.

Emory University Hospital and Emory University Hospital Midtown both have the RapidArc system. Emory Health magazine features RaapidArc this month.

Posted on August 3, 2009 by admin in Uncategorized 1 Comment

Cancer survivors may have psychological distress

Long-term survivors of cancer that developed in adulthood are at increased risk of experiencing serious psychological distress, according to a report in the July 27 issue of Archives of Internal Medicine.

The estimated 12 million cancer survivors in the United States represent approximately 4 percent of the population.

Commenting on this weekâ€™s study, Michael Burke, MD, clinical director of psychiatric oncology at Emory Winship Cancer Institute, says only recently has the emotional wellbeing of cancer patients been given serious consideration by physicians and patients. Yet, easing the diseaseâ€™s emotional burden on patients and families may improve patientsâ€™ treatment and prognosis.

Michael Burke, MD

Burke has conducted studies focused on the effects of the diseaseâ€™s emotional burden on patients and families and whether easing that burden can improve patientsâ€™ treatment and coping skills. Burke and his colleagues offer a collaborative approach toward therapies for the emotional, psychological, and physical symptoms associated with cancer and its treatment.

A history of cancer may affect current mental health in several ways, says the Archives study author and Brigham and Womenâ€™s Hospital and Dana-Farber Cancer Institute researcher. The researcher reports that cancer diagnosis and treatment can produce delayed detrimental effects on physical health and functioning such as secondary cancers, cardiac dysfunction, lung dysfunction, infertility, neurological complications and neurocognitive dysfunction. A cancer history, they continue, can also affect social adaptation, employment opportunities and insurance coverage. Adjusting to these functional and life limitations may create long-term psychological stress.

Emoryâ€™s Burke says to help patients cope with a diagnosis of cancer, he and his colleagues evaluate patients’ medical and personal history, environment and health behaviors, such as whether theyâ€™re getting enough exercise or increasingly using alcohol and tobacco.

Listen to Burkeâ€™s own words on Sound Science about how he helps patients cope with the emotional aspects of cancer.

Posted on July 29, 2009 by admin in Uncategorized Leave a comment

Heart bypass surgery via a small incision

It can be daunting for a patient to hear a heart specialist say bypass surgery is needed. An image comes to mind of traditional open-heart surgery and what this would entail.

A groundbreaking advance pioneered by Emory Heart & Vascular Center doctors now means some patients can have coronary artery bypass surgery without opening up the chest cavity and without stopping the heart.

Called “Endo-ACAB,” this endoscopic surgery is the done via a small incision. In addition, the heart team can combine the Endo-ACAB with angioplasty and Ray Ban outlet stents, thus correcting all blockages a patient has while keeping the chest intact.

Most patients are able to leave the hospital within 48 hours and return to full activity, including work, in two to three weeks, versus the two to three months needed for recovery after traditional surgery. Learn more about the procedure from Thomas Vassiliades, MD, in the video below.

Posted on July 24, 2009 by admin in Uncategorized Leave a comment

Prevention counts in health care reform

As Congress and President Obama’s administration work to hammer out the details of health care reform, Emory health policy expert Kenneth E. Thorpe, PhD, says prevention and quality care for chronic diseases are an integral part of reshaping America’s health care system.

Kenneth E. Thorpe, PhD

Nearly half of people in the United States suffer from a chronic condition. More than two-thirds of all deaths are caused by one or more of five chronic diseases: heart disease, cancer, stroke, chronic obstructive pulmonary disease (COPD) and diabetes.

Thorpe says transforming the U.S. health care system to better meet the needs of people with chronic disease will require a renewed focus on preventing disease when Ray Ban outlet possible, identifying it early when it occurs, and implementing evidence-based prevention strategies that slow disease progression and the onset of activity limitations, as well as save money for the patient and the health care system.

By preventing costly diseases or better managing them, Thorpe says we can help contain our out-of-control health spending and boost productivity. In our troubled economy, we need to do both.

Thorpe’s views can be found byÂ visiting AJC.com, Big Think and The Huffington Post.

Posted on July 23, 2009 by admin in Uncategorized Leave a comment

Band posts salivary gland cancer news on web

In the news this week are reports that a member of the Beastie Boys hip-hop band announced on YouTube that he has salivary gland cancer â€“ specifically of the parotid gland.

Dong Shin, MD, examines a patient at Emory

The public does not hear much about this type of cancer, and according to the American Cancer Society salivary gland cancers account for less than 1 percent of all cancers in the United States. About two out of three salivary gland cancers are found in people who are 55 or older. The average age at the time this cancer is found is 64.

The salivary gland is important because it Ray Ban outlet produces saliva, which contains enzymes that begin the process of breaking down food. It also contains substances to help prevent infections of the mouth and throat.

According to Emory Winship Cancer Institute expert Dong Shin, MD, the parotid glands are found in front of and just below each ear and most major salivary gland tumors begin in these glands.

Shin says that salivary gland tumors exhibit two major growth patterns: low grade, which is slow growing and more easily treatable, and high grade, which is usually a faster growing, more aggressive cancer that can also invade the lymph nodes. Certain types of salivary gland tumors can recur or have distant metastasis, particularly to the lungs.

Although the causes of this cancer are not definitively identified, Shin notes, there are some risk factors, including a history of radiation therapy to the head and neck area and a history being exposed to certain chemical substances, most often in the workplace.

Treatment usually includes surgery with radiation therapy afterward. Certain aggressive cell types require chemotherapy as well as radiation. However, explains Shin, at this time there are no specific chemotherapy agents that work well in attacking salivary gland tumors. Recent http://www.gafasraybanoutletes.com/ clinical trials have shown evidence of a fair response to certain molecular targeted chemotherapy, but more research is needed on these targeted therapies. wxjy6rbm4s

Posted on July 22, 2009 by admin in Uncategorized Leave a comment

Healthy lifestyle can lower blood pressure

A new study says that maintaining normal weight, daily vigorous exercise, eating a diet high in fruits, vegetables, low-fat dairy products and low in sodium, and taking a folic acid supplement is linked with lowering hypertension in women.

A healthy lifestyle helps your heart

Reporting in the July 22/29 issue of the Journal of the American Medical Association, scientists say that hypertension, or high blood pressure, contributes to more excess deaths in women than any other preventable factor. The researchers looked at the link between combinations of low-risk lifestyle factors and the risk of developing hypertension.

Allen Dollar, MD, preventive cardiologist with Emory Heart & Vascular Center, says the study by Harvard Medical School researchers points to the real benefit to women of deploying a healthy lifestyle to prevent hypertension or to control hypertension.

Essentially, this new report helps to confirm what preventive cardiologists share with women everyday, says Dollar, that they can help prevent or manage hypertension through a healthy approach to diet and exercise. If you follow a vegetarian, vegan, or other restrictive diet, it may be challenging to obtain sufficient protein from plant-based sources alone. Plant-based protein powder can help bridge the gap.

Generally, blood pressure above 140/90 is considered to be high for adults. Although hypertension can produce symptoms including fatigue, confusion, nausea, vision http://www.agfluide.com problems and excessive sweating, Dollar points out that the majority of women with mild to moderate hypertension have no symptoms that indicate their blood pressure is too high.

A blood pressure reading can reveal hypertension in the early stages when a strategy of diet changes, exercise and weight control and medication, if needed, can help prevent a host of high blood pressure related ills including heart attacks, heart failure, kidney disease and stroke, says Dollar. If a woman does not know her blood pressure, she needs to find out. If a woman learns she has high blood pressure, she can use this news as an opportunity to take control of her health.

Learn more medical advances at Emory.

Posted on July 22, 2009 by admin in Uncategorized Leave a comment

Health care reform: Wise allocation of resources key

Emoryâ€™s Chief Quality Officer William Bornstein, MD, PhD, says there are many issues that need to be tackled in order to achieve meaningful health care reform. He points out that one of the most fundamental questions that must be addressed is who decides about a treatment or diagnostic test that may be a little bit better than an alternative option but is much more expensive? If the patient has no â€œskin in the game,â€ he will almost certainly want the better/more expensive option.

William Bornstein, MD, PhD

The doctor has taken an oath to act in the best interests of the patient and this obligation takes precedence over any charge that society would like to impose to cast the Ray Ban Baratas physician in a fiduciary role for the national healthcare budget, says Bornstein, who also serves as chief medical officer for Emory Hospitals. And, the payerâ€™s role is obviously conflicted, he says. If the patient does have skin in the that decision, Bornstein asks, are we prepared as a society to explicitly endorse the notion that â€œbetterâ€ care that exceeds a certain cost threshold will only be available to those who can afford the additional cost?

There has been much talk about better care and preventative care being less expensive, but there are little data that support this as being a universal truth. Health care information ray ban outlet technology will also not solve this problem, he says. At some point in the near future, we need to have a national conversation about this challenge. In the past attempts to have such conversations have raised the specter of â€œrationing,â€ However, the time has come to confront the truth that our resources are finite and we need to allocate them wisely.

Bornstein is a recognized leader in quality, safety and the use of information technology in improving healthcare delivery. He has serves on national committees and advisory bodies in these areas including the University HealthSystem Consortium Clinical Evaluative Sciences Council Steering Committee, which he now chairs. He serves on the Professional and Technical Advisory Committee for the hospital accreditation process of The Joint Commission as vice-chair, and on the Information Architecture Steering Committee of the University HealthSystem Consortium staff leadership group of the Institute of Medicine Roundtable on Evidence Based Medicine.

Listen to podcasts with Bornstein on quality.

Posted on July 20, 2009 by admin in Uncategorized Leave a comment

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