By Ravi Iyengar, MD
Transgender and gender-diverse individuals are not a novel concept, and the idea of existing beyond the binary of female or male is centuries old. However, this population has notoriously faced discrimination, verbal and physical abuse, some of which still continues in the health care community.
A 2015 national survey of almost 28,000 transgender and gender-diverse individuals demonstrated that a third had a negative experience with a health care provider and a quarter of patients have had to educate their own providers about care.
When we look at the complexly layered barriers to care, we have to ask ourselves — would these numbers suffice for any other population seeking care? Encouragingly, there have been great strides within the past decade driving greater advocacy for and research surrounding gender-affirming care.
By Salina Lee, MD
Despite remarkable advances in detection and treatment of colorectal cancer, it remains the second-largest cause of cancer mortality in the United States. This statistic looms despite the fact that colorectal cancer is one of the most treatable cancers there is because early detection, thus cure, is entirely possible.
What makes this unique among the other cancers for which we have screening tools is that prevention is also possible. This is because we can identify and remove premalignant lesions before they become cancer. So what accounts for the stark contrast between this grim statistic and our known ability to prevent, detect and cure this cancer? Lack of screening. The most common signs and symptoms of early colon cancer are — nothing at all. That’s why we so strongly recommend screening for colorectal cancer.
Current guidelines recommend colorectal cancer screening for adults between the age of 50 and 75. This may start earlier for those at higher risk (family history of colorectal cancer, chronic inflammatory bowel disease, polyposis syndromes or patients of African-American descent).
After the age of 75, we recommend screening on an individual basis. There are a variety of recommended screening tests. The gold standard is the colonoscopy, which provides both screening and prevention. Not only can it detect early stage cancers, but also precancerous lesions called polyps, can be removed to potentially prevent a cancer from developing.
By Michael Hanak, MD
Last year more than 23,000 patients were seen for high blood pressure as part of a visit with a doctor in one of Rush’s outpatient practices. By the end of the year, 75 percent of this group brought their blood pressure into a healthy range.
This great news was among data about various clinical measures just released this week. The turnaround puts Rush University Medical Group, known as RUMG*, in the top 10 percent of physicians who treat hypertension nationwide, according to the National Committee for Quality Assurance, a non-profit organization that promotes health care quality. More importantly, it means that more than 17,000 of Rush’s patients significantly have reduced their risk of heart attack and stroke, and of dying from these preventable conditions.
High blood pressure, or hypertension, is known to be a silent killer, because people often don’t notice they have high blood pressure. Far too many are at risk: According to the Centers for Disease Control and Prevention, about one in three people in the United States (75 million) have high blood pressure, and only about half (54 percent) have their blood pressure under control.
By Donald M. Jensen, MD
In retrospect, it seems like it was the dark ages. When I was a medical resident at Rush in the mid-’70s, hepatology had few therapies and even less ability to change the course of chronic liver disease.
We had neomycin for hepatic encephalopathy (a complication of advanced liver disease that affects your behavior, mood, speech and other neurologic functions); corticosteroids for autoimmune hepatitis (liver inflammation), and diuretics for ascites and edema (swelling in the abdomen and legs). That was about it.
However, I was fortunate to have three attending hepatologists (unusual for any medical center in those days): A.W. (Bill) Holmes, John Payne and Richard B. Capps. I was struck by how smart they were and how they could glean so much information from a patient’s history and physical examination. Perhaps as important, each had a sense that liver disease would continue to grow as a specialty, and that bright new things were on the horizon. How right they were.
By Deb Song
I just want to thank everyone for the overwhelming response to part one of the video series on my cancer journey at Rush.
Testing and diagnosis have been key parts of this wild ride I am currently on.
Like most women, I dreaded the idea of having to take time out of my busy schedule to get a mammogram.
In my career as a media relations expert covering breast cancer stories, I have filmed many mammograms.
They looked uncomfortable and unpleasant.
The doctors and technicians are so nice and make such a huge effort to make it seem less scary, but let’s be real. Who wants to have their breasts examined and squished in a machine? Definitely not me.
So, when it was time for me to schedule my first mammogram, I wasn’t really up for it. I could have made every excuse to put it off or ignore it.
I had a good excuse, too! I just had an unrelated major surgery and was recovering from it. I had a huge abdominal scar that hurt and was still healing, and I had just started back at work. Did I really want to be back in the hospital for more tests and procedures? I just wasn’t in the mood to do it, and I didn’t want to take the time off to get a mammogram.
By Patty Normand, MD
Many of us want to begin the new year fresh. Clean slate. Except that … it’s the same you. The calendar may have changed, but you are still you. You may have the best of intentions to get healthier, find a new job, or create more time with your kids, and yet you just can’t get off the launchpad or can’t stick with a new resolution.
So what about trying something different this year? First step. Don’t do anything. Just be. If this sounds unique, it is.
Here’s a brief exercise from Susan Gray, a Mindfulness-Based Stress Reduction instructor at Rush:
“Right now, tune your attention into where you are located in this moment. You might be reading this at your office, on your phone, in transit or at home. Just get a sense of your environment. Now deliberately place your awareness on your breath. Allow your attention to rest on your breath. You are not trying to make anything happen. Just notice inhaling and exhaling. If you can feel the rise and fall of your chest or expansion of your lower belly, then guess what? You are in your body. Welcome to this moment. You are practicing mindfulness. By purposely placing attention on the present moment nonjudgmentally, awareness arises. If the breath isn’t a comfortable area for your body you could place your attention on sensations in your feet — feel them on the floor.”
By Yadira Montoya
When I was 5, my family migrated from Mexico, to Little Village — a predominantly Mexican immigrant neighborhood on the West Side of Chicago. Despite my parents working several jobs, our family’s limited income made us eligible for public benefit programs. These programs were a lifeline and provided us with access to healthy food and medical care and enabled my parents to take care of us and keep us healthy.
My experience as an immigrant and living in Little Village influenced my decision to pursue a career in health care. As a senior community engagement coordinator at the Rush Alzheimer’s Disease Center, I’m responsible for planning and implementing the Latino education and recruitment efforts for Alzheimer’s disease research. Specifically, I work with older adults, family caregivers and community organizations in Latino and immigrant communities throughout the city. Beyond my work at the RADC, I am very involved in several Rush-wide efforts to reduce health inequities on the West Side and make our institution more immigrant friendly.