Download jh health win11 intl

Compliments
of Johns Hopkins
Medicine
International
Winter 2011
Take
Heart
Don’t fear
your family
tree. The
tragedy of
sudden cardiac
death may
be avoided
Insight and news from Johns Hopkins Medicine
Help for
hearing-impaired
children
Hard facts
on treating
kidney stones
Options for
women with
fibroids
Contents
w i n t e r 2 011
4| Skipping Stones Qu ic k Con s u lt
B
End your kidney stone
misery.
5|Hearing Clearly Getting cochlear implants
early helps hearingimpaired children.
1 0|Organ-Sparing Care First Pe rson
Frightened by the prospect
of major surgery, Kathleen
O’Brien Thompson found
an alternative solution for
removing her pancreatic
tumor.
11|Power to Choose Fibroid center offers treatment options to women
facing hysterectomy.
1
ake sure you are well-hydrated,
M
and eat frequent meals to replenish
your fat stores and glycogen.
2
3
4
ear a hat and mittens. Most heat
W
loss comes from your head and hands.
ON THE COVER
6| Take Heart
Don’t fear your family tree.
Johns Hopkins experts
tackle the tragedy of sudden
cardiac death.
Join Our Online
Communities
emember to wear goggles if
R
you’re skiing to protect your eyes
from corneal freezing.
5
o your exercise warm-up
D
inside first, and make sure you’re
conditioned to working or exercising
in the cold.
Welcome
@HopkinsMedNews
YouTube.com/johnshopkinsmedicine
Search Johns Hopkins Medicine
Learn more
News and publications
Hopkinsmedicine.org/news
Clinical trials
Trials.johnshopkins.edu
ealth seminars
H
Hopkinsmedicine.org/healthseminars
2 | johns hopkins health
efore you head outdoors to shovel the sidewalk or ski cross-country, make
sure you plan ahead. Sameer Dixit, M.D., a sports medicine specialist and an
assistant professor in orthopedic surgery and medicine at Johns Hopkins, says
people often forget to prepare for dropping temperatures, wind and precipitation, as well as how these factors affect their comfort and health when they’re
active in cold weather.
“The main issue with doing activities in the cold is hypothermia,” Dixit says.
Mild hypothermia causes dizziness, fatigue, increased breathing and heart rate, and
poor judgment. If you don’t go inside to warm up, mild hypothermia may lead to severe
hypothermia, hallucinations and even a profound coma.
Avoid the risk of injury or illness by bundling up properly and preparing your body
for outdoor activity:
ive yourself adequate layering.
G
Wear an inner layer of hydropolyester
to wick moisture from your body. Use
a middle layer of fleece or other insulating synthetic. Make sure your outer
layer is windproof and waterproof.
S econ d Opi n ion
|
Avoid Injury with Five
Winter Exercise Tips
winter 2011
Sibley Memorial
Hospital!
Johns Hopkins Medicine recently welcomed
Sibley Memorial Hospital as a new member
of the Johns Hopkins Health System. Located
in northwestern Washington, D.C., Sibley
Memorial Hospital is best known for its clinical expertise in oncologic, orthopedic, obstetric
and geriatric services. It is a 328-bed hospital
with an assisted living facility on campus.
Learn more at sibley.org.
+1-443-287-6080 | hopkinsmedicine.org/international
healthinsights
Dry Eyes?
Mouth-to-Mouth Not
Needed in Some CPR Cases
People who hesitate to
perform CPR because they don’t
know the correct ratio of reviving
breaths to chest compressions or
because they are uncomfortable
with mouth-to-mouth contact—
well, they can breathe easy.
According to two new studies, mouth-to-mouth resuscitation,
or rescue breathing, isn’t necessary during CPR in some cases.
Between 2004 and 2009, U.S. and
European researchers followed
more than 3,000 CPR patients
and found that survival rates were
similar for adults who received
CPR with only chest compressions
and those who received CPR
with chest compressions and
rescue breathing.
Mouth-to-mouth still is recommended in certain circumstances.
“It is very important to understand that the patients in this study
were adults and that for most
children who suffer cardiac arrest,
such as near-drowning victims, we
must do rescue breathing,” says
cardiologist Myron Weisfeldt, M.D.,
physician in chief at The Johns
Hopkins Hospital.
Weisfeldt also notes that adult
patients with sudden, acute heart
failure; severe chronic lung disease;
acute asthma; or cardiac arrest also
may require rescue breathing.
Read This
Don’t Overlook
One Autoimmune
Disorder
If you’re middle-aged or older
and have significant trouble
with dry eyes, you might be
suffering from Sjögren’s syndrome, an autoimmune disorder that affects millions of
people, most of them women.
Dry eyes, of course, can
be due to any number of
issues—from wind exposure
to menopause—but if you’re
also experiencing dry mouth,
fatigue and joint pain or other
seemingly unrelated symptoms, these problems may be
part of a systemic illness.
Left untreated, Sjögren’s
can lead to serious complications, including kidney
disease and lymphoma, says
Esen Akpek, M.D., associate
director of Johns Hopkins’
Sjögren’s Syndrome Center,
which brings together a
multidisciplinary team of
rheumatologists, neurologists,
otolaryngologists, dentists
and gynecologists to diagnose
and treat the condition.
The good news about
Sjögren’s, Akpek says, “is that
if it’s treated early, you do
get better.”
“For people who are not
well-trained or who are looking for
a simple way to help save a life,”
Weisfeldt says, “chest compressions
only—at least until the emergency
care unit arrives—can be lifesaving,
even without rescue breathing.”
DID YOU KNOW?
50 years ago, CPR
was invented at Johns
Hopkins. Watch videos
here to learn more:
hopkinsmedicine.org/heart.
Before Giving Your Kids
Cold or Flu Medication
A
lthough you don’t want to see
your children suffer during a bout of
cold or flu, be careful how you provide
symptom relief, particularly if you use
over-the-counter, or OTC, medications without a doctor’s direction.
“There has never been a study showing that
over-the-counter cough and cold medications work
in children,” says David Tunkel, M.D.,
director of pediatric otolaryngology
(also called ear, nose and throat,
or ENT) at Johns Hopkins.
So, instead of giving your kids
decongestants and cough syrups,
consider using simple remedies
such as honey (for kids age 1
and older) to relieve a cough
or sore throat, a humidifier,
or saltwater drops to ease
nasal congestion.
When it comes to the
flu, age-appropriate doses of
ibuprofen (Advil, Motrin)
and acetaminophen
(Tylenol) can relieve
your child’s pain and
fever. But remember
not to give aspirin,
which has been
hopkinsmedicine.org/international | +1-443-287-6080
associated with Reye’s syndrome, a potentially fatal
disease affecting organs such as the brain and liver.
For children younger than age 2, Tunkel cautions
against giving any OTC cough and cold medications without medical advice, as the medications
have been known to cause severe side effects.
Negative reactions can be seen even in older children, particularly when the recommended doses
are exceeded, Tunkel says.
“The potential for harm is significant,”
he says, noting that caregivers often don’t
measure medicines accurately and can easily give an infant or toddler an accidental
overdose. Plus, OTC preparations
have similar or identical ingredients, creating the potential for
overdose when more than one
product is used together.
OTC cough and cold
medications also can be
harmful to some adults.
Decongestants, for
example, work by
constricting blood
vessels, meaning
they can raise blood
pressure. Talk to
your physician
before using them.
For more information,
appointments or
consultations, call
+1-443-287-6080 or
visit hopkinsmedicine.
org/wilmer.
FREE Online Seminar
Cold and Flu
Symptoms in
Children
Wednesday, February 23, 7–8 p.m.
Join Johns Hopkins pediatric otolaryngologist Emily Boss, M.D., as she discusses
common childhood ear, nose and throat
issues and treatment. To register,
visit hopkinsmedicine.org/
healthseminars.
winter 2011
johns hopkins health | 3
|
quickconsult
Skipping Stones
End your kidney stone misery
with these hard facts from
Brian Matlaga, M.D.,
director of stone disease at
the Johns Hopkins Brady
Urological Institute
Do kidney stones that don’t pass
on their own require surgery?
In the past, major surgery was the only answer. But
now people with small kidney stones that can be easily
seen by X-ray can be treated with a procedure called
extracorporeal shock wave lithotripsy—or ESWL—
without an incision. During ESWL, a machine generates shock waves, which are focused by X-ray onto the
kidney stone. The shock waves travel into the body,
through skin and tissue, and reach the stone, breaking
it into smaller and smaller pieces until it becomes like
grains of sand and washes out of the kidney. Most ESWL
treatments last about one hour and are performed on an
outpatient basis.
Does diet play a role in kidney
stones?
Yes. The most simple and important dietary change to
prevent stones is to drink plenty of fluids. Water is best.
One guideline is to drink enough liquids throughout
the day to produce at least 2 liters of urine every day.
That’s roughly six to eight glasses of water, depending
on your activity level and the outdoor temperature.
|
4 | johns hopkins health
winter 2011
Now that I have a kidney stone, I know why
the pain of passing one has been compared to
childbirth. Should I expect a normal delivery?
Fortunately, most stones pass through the urinary system after the
patient drinks plenty of water and takes pain medication as needed.
But some stones require special care if they cause constant pain and
don’t pass after a reasonable time.
Do only adults get kidney stones? Or
should I be concerned about my children?
A recent study performed at Johns Hopkins showed a dramatic
increase in kidney stones among children. We looked at a nationwide
database to see how many children were hospitalized with kidney
stones between 1997 and 2003 and discovered a dramatic rise—a
365 percent increase among girls and 274 percent increase among
boys. We also found that children up to age 5 with a kidney stone
are more likely than their peers to have high blood pressure and
diabetes. So we now know that kidney stones have ties to other very
serious disease processes in young children. n
For more information, appointments or consultations, call
+1-443-287-6080 or visit hopkinsmedicine.org/urology.
+1-443-287-6080 | hopkinsmedicine.org/international
Getting cochlear implants
early helps children catch up
in language skill development
Hearing
If
Clearly
your child has major
hearing trouble or loss of hearing, cochlear
implants can make a significant difference
in his ability to develop language skills. And
the earlier he receives those implants, the better, Johns Hopkins researchers say. Studies
there have shown that children who receive
implants before 18 months of age have the
best chance of catching up with their peers
in language skills before reaching school age.
Each year those implants are delayed
can mean putting your child one more year
behind in language development. Howard
Francis, M.D., a Johns Hopkins associate
professor of otolaryngology, head and neck
surgery, says the benefits of cochlear implants
are apparent immediately upon activation as
children gain access to sound, although it can
take six months to a year for them to demonstrate the acquisition of verbal language.
“The surgery in general is well-tolerated,”
he says, and most children recover from the
two-hour outpatient procedure within a
couple of days. It’s not a magic fix, however,
for correcting hearing loss. “It’s not just
the child; it’s also the environment,”
Francis adds, citing the extensive rehabilitation program at Johns Hopkins that
extends beyond surgery. “Children need a
support system and engagement. To help
them catch up, it takes time and effort on
the part of parents, rehabilitation therapists,
teachers and schools.”
Francis says not all children are good
candidates for the surgery, as some may have
undeveloped inner ears, making implants
impossible, or they may not be medically
stable enough to undergo surgery.
But for some, two implants may be
better than one.
“Traditionally, we only implanted one
ear,” Francis says, “but recent data suggest
that there are significant benefits to having
implants in both ears.” Those benefits include
the ability to identify where sounds are coming from as well as the ability to hear better
in noisy situations, such as in the classroom
or on the street. n
3
Signs of
Hearing
Loss
Although all infants should
have their hearing screened
as soon as possible after birth,
some babies and toddlers
develop hearing loss later. In
those instances, it is difficult for
parents to pick up problems
in children who are nonverbal.
Here are some clues:
w Y
our
child doesn’t respond to
environmental sounds such as
clapping or a door slamming.
w Infant
babbling doesn’t transition to purposeful words like
“Mama” or “Dada.”
w L
anguage
skills regress or
change.
Watch and listen to hearing expert John Niparko, M.D., explain hearing loss and treatment options.
View “Can You Hear Me?” at hopkinsmedicine.org/healthseminars. For more information, appointments or consultations, call +1-443-287-6080 or visit hopkinsmedicine.org/listeningcenter.
hopkinsmedicine.org/international | +1-443-287-6080
winter 2011
johns hopkins health | 5
|
Video Seminar
ABCs of Prevention
of Cardiovascular
Disease
Roger Blumenthal, M.D., and Dominique
Ashen, CRNP, Ph.D., discuss the lifestyle
choices that affect your heart health. Visit
hopkinsmedicine.org/healthseminars/
seminar_video.html and click
“ABCs of Prevention of
Cardiovascular Disease.”
Johns Hopkins
experts tackle the
tragedy of sudden
cardiac death
Take
Heart
Thirty-year-old
John Campanella, who’d been
happily married for a mere three months, felt as though he’d been handed
a death sentence.
“I was in shock,” he recalls of the day in November 1997 when his doctor
broke the news that he had arrhythmogenic right ventricular dysplasia, or
ARVD for short. This sneaky heart condition had struck down his father,
Joe, a former player for Baltimore’s American football team who later became
the team’s general manager, in his mid-30s during a vigorous game of handball. The family blamed his father’s death on a massive heart attack until
Campanella’s sister, Carrie Campanella Becker, died just as young, at age 36,
and just as suddenly, after riding a horse on the family farm.
Now Campanella, a former college lacrosse player, knew that ARVD
stalked members of his athletic family, causing sudden cardiac death in the
prime of their lives. He couldn’t help but wonder, will I be next?
Be Heart
Healthy
A Stealthy Stalker
Each year, sudden cardiac death, also known as sudden cardiac arrest
(SCA), hits hundreds of thousands of people like a lightning bolt. Many
never suspect they have hidden heart disease—then die within minutes
of the first symptoms. >
hopkinsmedicine.org/international | +1-443-287-6080
winter 2011
For more information,
appointments or
consultations, call
+1-443-287-6080 or visit
hopkinsmedicine.org/heart.
johns hopkins health | 7
|
“It’s not uncommon for sudden cardiac
death to occur in someone who is apparently
healthy—a 50- or 55-year-old vigorous man or
woman who has sudden cardiac death with little
or no warning,” says cardiologist Hugh Calkins,
M.D., director of the arrhythmia service for
Johns Hopkins Medicine.
Although SCA victims appear perfectly healthy,
looks deceive. Ninety percent of adult victims had
two or more major coronary arteries narrowed by
fatty buildup, while scarring from a prior heart attack
is found in two-thirds of its sufferers, according to
the American Heart Association.
“While a heart attack is different from sudden
cardiac death, the typical risk factors for a heart
attack, like high blood pressure, smoking, sedentary
lifestyle, elevations in blood lipid levels, diabetes
and obesity, are all relevant to sudden cardiac death,”
says Gordon Tomaselli, M.D., director of cardiology
at The Johns Hopkins Hospital.
In those startling news accounts of young athletes who suddenly drop dead, a heart abnormality
is the likely culprit. Adrenaline courses through the
body during intense physical or athletic activity
and triggers sudden cardiac death in an abnormal
heart. During most sudden cardiac arrests, the electrical impulses in the diseased heart become rapid
(ventricular tachycardia) or chaotic, or both (ventricular fibrillation). This irregular heart rhythm,
also known as an arrhythmia, causes the heart to
suddenly stop beating effectively.
Subtle Symptoms Never to Ignore
In 1967, no one detected warning signs that John
Campanella’s father was seriously ill. On a brisk
winter’s day, Joe ran vigorously back and forth
across the handball court during a fiercely competitive game with his coach and two other friends. All
of a sudden, Joe staggered a few steps and muttered,
“I’ve got to stop.” That’s when he collapsed; immediate attempts to revive him failed. Nearly 30 years
later, Campanella’s sister, Carrie, didn’t suspect a
connection when she started seeing a local doctor
after experiencing fainting spells. After all, she suffered from a usually benign condition that caused
her blood pressure to drop when she stood.
But fainting spells, or syncope, while often
benign, may be one of the warning signs of sudden
cardiac death. “Any fainting spell, particularly one
that seems unexplained, should be investigated by
|
8 | johns hopkins health
winter 2011
It’s Not
Just a
Man’s
Disease
If you’re a woman who thinks that heart disease
is more likely to endanger the men in your life,
think again. The American Heart Association
reports that more women die each year of
heart disease than men.
As women age, their risk of heart disease
rises, sparking controversy over estrogen’s exact
role (if any) in protecting the heart. Until that
controversy is ironed out, cardiologist Pamela
Ouyang, M.B.B.S., director of the Johns Hopkins
Women’s Cardiovascular Health Center, lists
four action steps women need to take today to
protect their hearts:
Stop smoking. “For women who smoke, their life expectancy is
14 years less,” Ouyang warns.
Focus on fitness. “Across our population, women do much less
physical activity than men,” she says.
Know your numbers. Don’t assume that your blood pressure
and cholesterol levels are good—ask the next time you’re in the
doctor’s office.
Call 911 immediately if you think you’re having a heart attack.
Don’t wait for someone to give you a ride to the hospital.
+1-443-287-6080 | hopkinsmedicine.org/international
Watch and listen to Johns Hopkins heart experts explain irregular heartbeat and
atrial fibrillation. View “Atrial Fibrillation” at hopkinsmedicine.org/healthseminars.
a physician,” says Joseph Marine, M.D., director
of electrophysiology at Johns Hopkins Bayview
Medical Center. Although even healthy people
can feel lightheaded or weak after standing quickly
or for long periods, Marine warns that blackouts
that occur suddenly or during exertion or exercise
are serious signals, especially when accompanied
by a racing heart, shortness of breath, or chest
tightness or pain.
Marine recommends also being on the lookout
for heart attack warning signs, including chest
discomfort—squeezing or tightness under the
breastbone or in the upper abdomen that may
radiate down the left arm and up into the neck—
or feeling especially winded or fatigued after
normal exertion.
“Even if they’re fairly mild, these are potentially
serious symptoms that may signal a problem with
blood flow to the heart,” Marine says. “And a problem with blood flow to the heart is the leading cause
of sudden cardiac arrest in adults.”
Screen Savers
Meanwhile, it pays to delve into your family history, because people can inherit conditions that
make them prone to arrhythmias, placing them at
increased risk for sudden cardiac death. Examples
of inherited disorders include ARVD, a progressive condition in which the muscle of the right
ventricle is replaced by fat and fibrosis, which
causes abnormal heart rhythms; and long QT syndrome, or LQTS. Because of problems with tiny
electrical pores on the surface of the heart muscle
cells, LQTS can cause sudden, uncontrollable,
dangerous heart rhythms.
Thanks to advances in screenings available at
Johns Hopkins, it is possible to get ahead of a genetic
predisposition and halt the progress of cardiovascular
disease. Tomaselli says screenings include a detailed
family and personal history, a physical examination
and diagnostic tests such as:
• An ECG, or electrocardiogram. This simple,
painless test records the heart’s electrical activity.
• An echocardiogram. During this gentle test,
sound waves create pictures of your heart, giving
your doctor information about the size and shape
of your heart and how well its chambers and valves
are working.
• An electrophysiology study. Doctors use cardiac
catheterization to record how your heart’s electrical
hopkinsmedicine.org/international | +1-443-287-6080
system responds to certain medicines and
electrical stimulation.
• A CT (computed tomography) angiogram.
This enables doctors to evaluate blood vessels
and look for signs of atherosclerosis.
• Genetic screening. “We have an excellent
genetic counseling program in our Center for
Inherited Heart Disease that we recommend
as part of genetic screening,” Marine says.
“We’re doing some of the leading research in the
United States related to genetic and imaging predictors of sudden death,” says Robert Weiss, M.D.,
director of the Donald W. Reynolds Cardiovascular
Clinical Research Center at Johns Hopkins. “One
of the new things we’re looking at is the use of MRI
[magnetic resonance imaging] to identify scar tissue
that’s interspersed with normal heart tissue. That
may be a very strong predictor for sudden death.”
The Beat Goes On
Once tests showed that John Campanella had
ARVD, he had surgery to help control his
heart rhythms.
Now, at age 43, he enjoys a full life as a senior
managing director of a commercial real estate firm
in Washington, D.C., and as a husband and father
of 11-year-old Caitlyn and 8-year-old Jack. He
has given up competitive games of basketball and
high-impact running in favor of milder forms of
exercise, such as biking, golf and yoga. But that’s
a small price to pay for the joy of watching his
children grow up.
“The happiest day in my life was when their
genetic tests for ARVD came back negative,”
Campanella says. “I knew I
wouldn’t have to be watching
and wondering every day,
will they be running down
the stairs or bouncing on the
trampoline and then have an
arrhythmia and die?”
Instead, Campanella and
his wife, Kathy, exuberantly
cheer for Caitlyn and Jack as
they play lacrosse and basketball for their school teams.
And he can’t help but notice
how his father’s legendary
athleticism and competitive
spirit live on. n
winter 2011
Turning
Tragedy
into
Triumph
When John Campanella
was diagnosed with a
potentially fatal heart condition—arrhythmogenic
right ventricular dysplasia,
or ARVD—in November
1997, he and his wife, Kathy,
became the engine behind
Johns Hopkins School
of Medicine’s mission to
unravel the mysteries surrounding a disorder that
strikes young athletes. The
couple have raised millions
of dollars for research and
established a Web site that
has drawn patients from all
around the world to Johns
Hopkins for evaluation and
treatment. Most exciting of
all, researchers have pinpointed the gene responsible for ARVD. To find out
more, visit arvd.com.
johns hopkins health | 9
|
firstperson
Organ-Sparing Care
Frightened by the prospect of major surgery, Kathleen O’Brien Thompson
found an alternative solution for removing her pancreatic tumor
When I started having
Comparing
Pancreatic
Surgeries
w
w
w
The standard operation
for pancreatic cancer is
called the Whipple, which
involves removal of the
head of the pancreas, the
gallbladder, the end of the
bile duct, and sometimes
part of the stomach.
Minimally invasive
procedures use smaller
incisions, which typically
mean less pain and
scarring and a faster
recovery. Johns Hopkins
surgeons can assess the
best treatment approach
in each patient’s case.
S urgeons at Johns
Hopkins regularly
perform minimally
invasive operations to
remove tumors in the
head of the pancreas.
unexplained abdominal pain,
my gynecologist thought I might have appendicitis. But the reality was much worse—
at least that’s how it looked at first. I was living in Arizona at the time, and my doctors there gave me a CT scan, an MRI and two ultrasounds. The diagnosis? A 5- to
6-centimeter tumor on my pancreas. I was terrified. I was only 40, and I thought I
might have pancreatic cancer. The only way to know for sure was to have surgery.
I visited two surgeons, both of whom wanted to do open-cavity surgery on me
and remove my spleen, my gallbladder and part of my pancreas. I balked. I didn’t
want to just go in willy-nilly and start having organs removed.
One of the surgeons referred me to Johns Hopkins’ Web site. That’s how I found
Dr. Martin Makary. After careful research, I learned that unlike the procedure
that had previously been recommended, the minimally invasive laparoscopic
procedure at Johns Hopkins would, in my case, offer less risk and
quicker recovery.
I knew Johns Hopkins was the leading facility in the country for treating pancreatic cancer, so I sent Dr. Makary my
CT scan, and the very next day he called me. He told me
he thought the tumor did not seem like cancer and that
I qualified for the minimally invasive surgery.
Dr. Makary had a viewpoint of really wanting to
help. He wanted to advance my comfort and care, and
his plan would allow me to keep my spleen, gallbladder and almost my entire pancreas. Fortunately, my
tumor turned out to be noninvasive.
After I had the surgery, I was up and
walking right away, and in three weeks I
was back to doing many of my normal
activities. Going to Johns Hopkins was
life-changing; my recovery time was
cut in half, and I felt my surgical result
was better and my doctor was a true
partner in my care. n
In Her Own Words
To watch a video of Kathleen O’Brien Thompson
telling her story, visit hopkinsmedicine.org/
mystory. For more information, appointments
or consultations, call +1-443-287-6080 or
visit hopkinsmedicine.org/pancreatic.
|
10 | johns hopkins health
winter 2011
+1-443-287-6080 | hopkinsmedicine.org/international
secondopinion
Power
to Choose
Options for women
with fibroids
U
terine fibroids, or
noncancerous tumors in the
uterus, can negatively affect your
quality of life, resulting in heavy
bleeding, prolonged menstruation
or bleeding between periods.
What’s even worse is the idea that the only
way to correct the problem is through hysterectomy. Although it’s true that hysterectomy offers
the only permanent solution for fibroids, there
are other options. Through the collaboration of
gynecologist Catherine Sewell, M.D., M.P.H.,
and interventional radiologist Kelvin Hong,
M.D., at the Johns Hopkins Fibroid Center, it’s
easier than ever to review and customize your
treatment options in a single doctor’s visit.
Among the less-invasive treatment possibilities are uterine artery embolization, or UAE,
during which tiny pellets injected through
the groin block blood flow to fibroid-feeding
arteries, and MRI-guided focused ultrasound,
in which high-frequency ultrasound waves
target and kill fibroid tissue. Sewell says the
best candidates for these procedures are women
hopkinsmedicine.org/international | +1-443-287-6080
who have completed childbearing or are not
interested in having children. And because
neither procedure involves major surgery, many
patients can go back to their normal routines
quickly—as soon as one day after MRI treatment
and about a week after UAE.
“The overall success rate for UAE is 80 percent,” Sewell says, “and women have satisfactory
reduction in symptoms.” The success rate is
slightly lower for MRI-guided focused ultrasound, at 70 percent. Also, the fibroids may
grow back, but because most patients receiving
treatment are in their 40s and close to menopause, regrowth isn’t a major issue.
“Gynecology and radiology have generally
been operating separately rather than working
together,” says Hong, who points out that the
Johns Hopkins Fibroid Center brings the two
disciplines together to create more diverse treatment options. Patients can visit with Sewell and
Hong at the same time.
“That bridges most of the treatment options
available,” Hong adds. “You can have all your
questions answered in one go.” n
winter 2011
Fibroid
Facts
w T
hree
out of four women
will have uterine fibroids,
which are noncancerous
tumors that grow in the
uterus.
w S
ymptoms
may include
heavy menstrual bleeding
or unusually long periods,
pelvic discomfort or pain,
constipation, backache,
or frequent or difficult
urination.
w B
ecause
most women
experience no symptoms,
they may not even be
aware they have fibroids.
w U
terine
fibroids are
not life-threatening and
only require treatment if
they’re causing unpleasant
symptoms.
johns hopkins health | 11
|
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or e-mail it to a friend,
visit hopkinsmedicine.org/
international
For comments, requests or
changes of address:
E-mail
[email protected]
NEW YORK
PHILADELPHIA
BALTIMORE
Johns Hopkins Medicine
International coordinates
the highest-quality
care for thousands
of patients from more
than 100 countries, so
we understand and
anticipate your cultural
expectations. A
caring, knowledgeable
international care
coordinator will be there
to assist you during all
phases of your medical
visit, tailoring each step to
your individual needs.
WASHINGTON, D.C.
Before Your Visit
n Appointment scheduling
n Financial counseling
n Accommodation arrangements
n Ground transportation
During Your Treatment
n Personal escort to medical appointments
n 24/7 language interpretation
n Care management nurse during inpatient stay
n Equipment and/or home care arrangements (if needed)
n Private duty nurse arrangements (if needed)
n Follow-up appointment(s) scheduling
n Concierge services for dining and entertainment
n International newspapers and Internet access
n Relaxing, hospitable executive lounge
After Your Departure
Assistance with medical records
n Assistance with prescriptions
n Follow-up with clinical and administrative staff
n Future appointment scheduling
n Consolidated final bills
Write
Johns Hopkins Health
c/o Johns Hopkins Medicine
International
5801 Smith Ave., Suite 305
Baltimore, MD 21209 USA
Call
+1-443-287-6080
Kathy Smith
Director, Market Development
Steven J. Kravet, M.D.
Physician Adviser
n
Johns Hopkins Health is published quarterly
by the Marketing and Communications office
of Johns Hopkins Medicine. Information is
intended to educate our readers and is not
a substitute for consulting with a physician.
Designed by McMurry.