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Surgeon Chronicles Decades of Humanitarian Trips

dennis-gatesBy Dennis Gates, MD

I have been taking part in medical missions for more than 50 years. My first trip was as a medical student at Loyola University, when I worked as a laboratory technician for a couple of doctors in Brazil. That experience enlightened me to the far greater need for orthopedic and medical care in Brazil than in the U.S. A child in America with a club foot is going to get treatment somehow, whereas in Brazil, that’s not the case. There aren’t adequate medical facilities, and patients can’t afford treatment or simply don’t have access to care. Then, two years in the Peace Corps as a family doctor in Nigeria and Ghana reinforced to me the incredible medical needs of developing countries.

Once in orthopedic practice, some colleagues and I started making regular mission trips to Brazil. We’d go down to a little clinic on the Amazon River, called Esperanca, to perform many surgeries and train orthopedic residents. When we started in the mid-1970s, there was only one local orthopedist; by the time we stopped making the trips 30 years later, there were seven well-trained orthopedic surgeons in town. That was pretty satisfying.

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Diving in: a Cardiologist’s Transition to a Vegan Diet

jeffrey-sobleBy Jeffrey Soble, MD

Nearly two years ago, I decided to follow a vegan diet, or an almost vegan diet, anyway. As I tell my patients, the decision to embrace a plant-based diet is a very personal one. People choose it for a variety of reasons, and it’s just one of several ways to eat more healthfully. Just look at your priorities and do what’s right for you.

For me, a plant-based diet made sense. Here, I share how I made the transition and why.

Health, environment, animal welfare

Several factors in my life converged to convince me to go vegan.

Certainly, there were health reasons: I have a family history of heart disease, and my father died of a heart attack. Heart medications didn’t agree with me, so I took a more serious look at my diet. That thinking coincided with my evolving views of animal rights and a growing desire to do good things to help the planet. I had already started driving less and riding my bike more for health and environmental reasons. Helping to reduce our dependency on the meat industry seemed like another way to be a good world citizen: It can help conserve land, water and energy resources as well as prevent pollution.

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5 Things Dietitians Wish People Knew About Cholesterol

heart-healthy-foodsBy Justine Britten, Liz Page and Allison Wood

September is National Cholesterol Awareness Month, so it’s a great opportunity to educate yourself about the vital role cholesterol plays in your health.

Most people are aware that you want to have low LDL (“bad”) and high HDL (“good”) cholesterol. But there are a lot of misconceptions about what makes your LDL and HDL go up or down. Should you avoid egg yolks? Should you stick to low-fat foods, or is sugar the real culprit?

To help clear things up, we’ve compiled a list of tips that we, as dietitians, routinely share with our patients — especially those who are trying to improve their cholesterol numbers, or who have a family history of heart disease and want to reduce their own risk.

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Defending Personal Health Data in the Digital Age

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Shafiq Rab, MD

As medicine becomes more precise and individualized — and as technology makes collecting and dispensing data easier than ever — you may wonder about the safety of your personal health information.

The federal Health Insurance Portability and Accountability Act (HIPAA) requires protection of certain electronic data — such as any information that can identify you or that pertains to your physical or mental health, including treatments.

“But Rush goes beyond what’s HIPAA-mandated by protecting all of your health information against outside intrusion and inside breaches, including data that doesn’t contain your name or other identifiable information,” says Shafiq Rab, MD, MPH, senior vice president and chief information officer at Rush University Medical Center.

‘Moral and ethical duty’

Rush has the following safeguards in place to protect and defend your data:

  • Thanks to encryption software, any would-be cyber-thief who tries to gain access to digital data would be unable to unscramble and use it.
  • Privacy is a top priority of Rush employees. As part of their training, they learn to rigorously protect patient info by following several internal security guidelines.
  • Rush is constantly checking the identity of authorized personnel to ensure that only people who need to know can see your patient health data.
  • Rush hires outside security firms to test its computer system for weaknesses.

But what makes Rush stand out is a culturally embedded belief in the sanctity of patient health information. That belief is held by people across the organization — from doctors to nurses to patient registration specialists. “Patients come to Rush because they trust us with their health care,” Rab says. “It’s also our moral and ethical duty to take care of their health information.

Shafiq Rab, MD, MPH, is passionate about information technology because of its potential to improve people’s lives. He believes technological innovation is one of the best ways to enhance health care for individuals and society as a whole.

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‘Lighting the Way’ for People With Huntington’s Disease

jennifer-goldman-mdBy Jennifer G. Goldman, MD, MS

Give light, and the darkness will disappear of itself. — Desiderius Erasmus

On May 18, 2017, a number of South American families living with Huntington’s disease had the chance of a lifetime: to hold an audience with Pope Francis I at the Vatican in Rome. This meeting was a collaborative effort between the medical communities in Venezuela, Colombia, and Argentina and the Huntington’s disease community worldwide to bring visibility to HD, reduce stigma, and offer a global stage for amazing individuals to share their stories and shine light on this debilitating condition.

Huntington’s disease is an inherited disease that causes certain nerve cells in the brain to degenerate or waste away. This degeneration causes uncontrolled movements, loss of mental capacities and emotional disturbance. According to the Huntington’s Disease Society of America, “Many describe the symptoms of HD as having ALS, Parkinson’s and Alzheimer’s — simultaneously.”

People are born with the defective gene, but symptoms typically don’t appear until age 30 or older, often in the prime of a person’s life. The disease is passed from parent to child through a mutation in the normal gene, so if one of your parents has Huntington’s disease, you have a 50 percent chance of getting it.

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Using Light Therapy to Treat Chronic Pain

light-therapy-horizontalBy Helen J. Burgess, PhD, and John W. Burns, PhD

Can light therapy help people with chronic pain? We conducted a study to find the answer. You may wonder why such a possibility occurred to us.

We already know that light treatment — particularly light treatment in the morning — can reduce depression. This effect appears due to special non-visual receptors in the eye that transmit light straight to the amygdala, a key mood center in the brain.

We also know that when you improve mood, you can decrease or diminish pain, and improve people’s ability to cope and function with pain. On the other hand, medications often prescribed for chronic pain, including antidepressants and antiseizure medications, can have only small effects on pain, and that the side effects are significant enough that many people stop taking them. Finally, we know that opioid medications carry many risks, and patients are looking for affordable non-drug treatments that they can use in their own homes.

Ten women tested

With these considerations in mind, we ran a pilot study to test if light treatment could help people in chronic pain. We enrolled 10 women with fibromyalgia — a condition characterized by chronic widespread pain — into a two-week study. For the first week, the women slept at home as per usual. Then we brought them into the Rush Sleep Disorders Service and Research Center and asked them to report on their baseline function by completing the Fibromyalgia Impact Questionnaire. This assessment asks about daily tasks such as how hard it is to walk several blocks, climb stairs and drive a car.

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Low Birth Weights Tell Troubling Tale of Two Cities

birth-weight-disparitiesBy Fernando De Maio, PhD, Patricia O’Campo, PhD, David Ansell, MD, MPH, and Raj C. Shah, MD

Health inequities — differences that are avoidable, unnecessary and unjust — are a striking feature of cities in the United States, including Chicago. While it is true that all of our city’s 77 communities have experienced an improvement in some key health indicators over the past three decades, inequities between communities have grown over this time.

New research from the Center for Community Health Equity — a collaboration of Rush University Medical Center and DePaul University — explores the prevalence of low birth weight deliveries in Chicago communities. (Our study defined this prevalence as the percentage of live births at less than 2,500 grams, or roughly 5.5 pounds.) This statistic is an important indicator of population health and is widely used to study the health effects of racism.

Good health, as we have seen again and again, is a product of social justice, and Chicago’s deep-rooted racial/ethnic segregation harms the health of its residents. Across Chicago communities, the proportion of low birth weight is 10 percent, with the best-off communities near 3 percent and the worst-off communities approaching 20 percent. Segregation plays an important role in explaining these differences: The most highly segregated African-American communities, among them Avalon Park and Washington Heights, have the most prevalent low birth weight rates. Accounting for 70 percent of the differences between communities are segregation, unemployment and low educational attainment, which are factors that all highly correlated with low birth weight.

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