UVA Health System Blog

Stories about the patients, staff and services of UVA

 

Junior Volunteers Help Breach Communication Barriers with MyChart

On August 1, 2014 | At 10:03 am

Cassie Hobbs is a rising high school senior, and this is her third summer volunteering through our junior volunteer program. Did you miss her first post this summer? Find out what she had to say about orientation and hospital rules.

There’s an easy way to communicate at UVA, and it’s an electronic medical record (EMR) known as MyChart. Staff at University Medical Associates, otherwise known as UMA, requested assistance linking this UVA service to the patients in their waiting room. MyChart allows patients access to their medical records via an interactive resource: The internet. Patients can access information such as medical history, available prescriptions, future appointment dates and laboratory test results, which they may not have had immediate access to before. In addition, it allows for quick and efficient communication between patients and their doctors.

A volunteer helps with MyChart.

Volunteer Initha Setiady helps patients sign up for the Health System’s electronic medical record.

But for some patients, signing up for MyChart is more than a little confusing. That’s where Junior Volunteers (JVs) come in. Part of the JVs’ job is to mingle with patients, to chat with them, and hopefully discuss MyChart, encouraging patients to use the new resource. JVs provide information and assistance, offering to walk patients through the sign-up process. Sometimes their attention is received positively, but other times it’s unwelcome. One JV said that most of the patients she has dealt with are very honest about their opinions of MyChart: “[Some] patients will deny any interest before you begin explaining,” she said, “[but] some patients are very interested in it, which is also good.”

Erin Sams, another JV, says she thinks patients sometimes find them an inconvenience. “Some say yes [when asked to sign up for MyChart], but I think some think we’re annoying.” According to Sams, others refuse because they don’t have internet at home.

But patient response notwithstanding, the JVs that work with UMA find MyChart to be a good idea. “It’s a good experience,” said Sams, when asked about her work with UMA and MyChart. “[MyChart] is a good idea. It makes health easier for the patient and Health System.” Peggy Nees, clinical operations coordinator for UMA, reported that the JV’s helped 75 patients sign up for MyChart in the first 4 weeks of the program this summer!

Need a MyChart Account?

Access your EMR and talk to your doctor from your computer or smartphone. Sign up and download the iPhone or Android app.

Filed under : Technology,The People of UVA,Volunteering | By
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Q&A: What’s The Deal with Soy? Take A Quiz!

On July 31, 2014 | At 9:46 am

Registered dietitian Carole Havrila, who works with cancer patients, and Brandy Patterson, MD, discuss the benefits of soy and debunk myths surrounding the controversial food.

Soy, like these edamame beans, can help decrease your heart disease risk and lower cholesterol.

Soy, like these edamame beans, can help decrease your heart disease risk and lower cholesterol.

Soy and Estrogen

Q: Many people are concerned about estrogen in soy, but is there really enough estrogen in soy for it to make a difference?
Havrila: Plant-based estrogen (or what is often referred to as estrogen), called isoflavone, isn’t actually estrogen. Isoflavones have a chemical structure that looks somewhat like estrogen, which explains their name “phytoestrogens.”

However, isoflavones are NOT the same as female estrogens and soy foods do not contain estrogen. In some studies, soy acts more like the medicine Tamoxifen, preventing estrogen from binding to cells and exerting harmful effects in women’s body.

Large research studies show no significant effect of eating whole soy foods in amounts typical to a traditional Asian diet (1-2 servings) on male hormones. Since isoflavones are not estrogen, they do not have feminizing effects in men.

Soy and Heart Disease

Q: Can soy help prevent cancer? Does it have any helpful or preventive traits?
Havrila: Studies seem to show that whole soy foods, and the intake of these foods may be associated with lower incidences of breast cancer. Whole soy foods are products that contain unprocessed soy, such as edamame and soy beans. Tofu, a common soy food, is not considered a whole food because it is slightly processed. Research studies show that diets that include whole soy foods tend to be associated with a decreased likelihood of breast cancer recurrence in those who have had the disease. In some men, soy food intake is associated with decreased risk of developing prostate cancer, but this is not seen in all men.

Q: Does soy help reduce your risk of heart disease?
Patterson: There is much controversy over the many potential health benefits of consuming soy. Furthermore, there have been differences in Eastern and Western health outcomes and consumption of the legume. Soybean consumption in Asia, typically around 100-200g per day, almost always involves a form of the legume that is whole-food-related. In sharp contrast, consumption of soy in the United States seldom involves a whole food form. This includes soy protein powders, soy cheese, and soy “meat” products, which often contain less nutritional benefit than less or unprocessed whole soy foods.

Reports on cardiovascular health have been mixed, with some studies showing larger impacts on lowering LDL (or “bad”) cholesterol and others showing minimal effects. In 2006, a study concluded that soy protein’s effects on LDL cholesterol and other cardiovascular disease risk factors was not significant, compared with other proteins. The study suggested that “a very large amount of soy protein, more than half the daily protein intake, may lower LDL cholesterol by a few percentage points when it replaces dairy protein or a mixture of animal proteins.”

With that in mind however, they also reported that “soy products such as tofu, soy butter, soy nuts, or some soy burgers should be beneficial to cardiovascular and overall health because of their high content of polyunsaturated fats, fiber, vitamins, and minerals and low content of saturated fat. Using these and other soy foods to replace foods high in animal protein that contain saturated fat and cholesterol may confer benefits to cardiovascular health.”

Introducing Soy to Your Diet

Q: Sometimes people want to cut down on meat or fatty foods by introducing soy into their diets. What are some good ways to do this? Any recipes?
Patterson: According to Whole Foods Market, “genetically modified (GM) soybeans have reached 90 percent market penetration in the United States.” Therefore, they recommend you select organically grown soy products to avoid GMO. An easy way to introduce soy into the diet may be as simple as using soymilk, soy protein powder and fruit to make a wonderful smoothie. Simply tossing edamame beans into your salad is also an easy way to incorporate soy. Soy products such as soy hotdogs, which can be dressed up with chopped onions, mustard and ketchup, make it difficult to taste the difference between meat and soy. Tofu may replace chicken or meat in pad thai, tacos or stir-fry. Soy hotdogs, soy cheese, soymilk and edamame are some of my favorite products

Havrila provides her soy cheat sheet:
Shelled versus unshelled edamame: Most people don’t eat the pod, and it is hard to shell the edamame unless the pod is cooked, so I recommend cooking and then popping out the edamame to eat. Many places sell shelled edamame already cooked, which is an easy and convenient protein source to add to soups or salads or for a snack.

Additives: If you don’t want any, buy plain tofu and season it yourself or eat it plain. They do sell Asian, smoked and other flavors that make eating on a salad, or part of a stir fry, very easy.

Calcium: When tofu is bought fresh, it is usually in a water bath that has added calcium. If you are looking to increase the calcium intake of your diet, look at food labels for those with the most calcium per serving (look for a higher percentage on the Nutrition Facts section).

Fat: I look for lower fat versions of tofu, as these products usually contain fewer calories per serving. Silken, or soft, tofu is usually lower in calories than firm or extra firm tofu.

Patterson adds: There is recent evidence that consuming soy protein may lower systolic blood pressure and that it contains active antioxidants such as flavonoids and isoflavonoids. Another group of antioxidant phytonutrients called phenolic acids has also been recently investigated in soybeans. When we enjoy this antioxidant-rich legume, we also benefit from its phenolic acids.

Want to learn more about soy and vegetarian diets? Check out:

Filed under : Cancer,Healthy Living,Heart,Nutrition | By
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Pseudotumor Cerebri: A Diagnosis That Helped Devon Hendricks Regain Her Life

On July 30, 2014 | At 9:56 am

Devon Hendricks, 33, enjoys nail polish, playing with her dog, and spending quality time with her boyfriend, Dennis. Throughout her life, she always experienced headaches, but her struggle to find out what caused them began six years ago.

Devon Hendricks, pseudotumor cerebri patient

Devon Hendricks

What started as headaches soon grew into a more serious condition. Hendricks began to experience a “whoosing” sound in her ears as if she were holding up a seashell to them. In addition, she began losing vision and feeling an aching crook in her neck. At their worst, her headaches were so bad that Hendricks missed about two weeks of work and was unable to withstand bright lights.

Hendricks visited doctors in Lynchburg and Roanoke who treated singular symptoms but not her condition as a whole. She saw an ophthalmologist for her swollen optic nerve and a neurologist to look for ways to reduce the pressure in her head. To control her symptoms, Hendricks began self-medicating, modified her diet and quit smoking. She was delighted when her symptoms began improving.

Diagnosing Pseudotumor Cerebri

However, Hendricks’ gratification was short-lived, and her symptoms returned.  She underwent more testing and was eventually diagnosed with pseudotumor cerebri, a high-pressure condition inside the skull. In some cases, this condition occurs when the veins that drain blood from the brain become narrow and cause pressure to build up. Many patients experience symptoms like:

  • Headaches
  • Loss of vision
  • Dizziness
  • Ringing in the ears

Pseudotumor cerebri usually affects women ranging in age from 30s to 50s and is often associated with obesity. To help lessen symptoms and to control blood pressure, doctors often recommend weight loss and a low-sodium.

Learn More
Pseudotumor Cerebri Symptoms & Treatment

In Remission: Relieving Pressure with a Stent

During her struggle, Hendricks went through a CAT scan, an MRI, a spinal tap and an angiogram. Finally, in June 2014, she decided she was done taking pills and done being held captive by her symptoms. It was then that she was referred to Kenneth Liu, MD, in Charlottesville to get the information and care she needed.

Liu performed a novel procedure to implant a stent in Hendricks’ brain to open veins and improve the drainage of blood. The pressures in her brain dropped instantly.

Since the procedure, Hendricks has not experienced headaches or the whoosing sound in her ears. Her vision has returned to normal, and she has noticed a positive shift in her mood. Her only side effect – minor pressure in her head – occurs after she sneezes.

“Pseudotumor cerebri is a disorder that has historically been difficult to treat effectively,” says Liu. “It’s great that we’ve got this new approach that appears to be providing real relief to most patients. At UVA, we have been able to demonstrate that stenting reliably returns intracranial pressures to normal in appropriate patients.”

Liu told Hendricks that she may experience something called stent headaches. She will have to monitor her condition while following up with a neurologist and ophthalmologist. She will also need to have an angiogram performed in December.

“I’m happy to continuously get better,” says Hendricks, who says any discomfort she now experiences is nothing compared to what it used to be.

Her boyfriend also acknowledges that since the surgery, Hendricks has transformed into a happier and healthier person. They both attribute Hendricks’ success to the quality of care she received from Liu and his medical team. Everything was clearly explained from the beginning, and she felt an astounding level of comfort and confidence with the staff, Hendricks says.

Prior to seeking treatment at UVA, Hendricks felt that no one believed that her condition was either real or serious. She says that the hands-on care provided by Liu “was the answer to everything.”

Her advice to others in similar situations:

  • Do your own research on the condition.
  • Be patient in the search to find a trustworthy doctor.
  • Explain all of your symptoms to your doctor, no matter how big or small they may seem

Hendricks believes understanding exactly what she had, knowing the process she would endure ahead of time, and a steady dedication to getting better were essential to her success.

Have you been diagnosed with pseudotumor cerebri or another pituitary tumor? Get more information about the UVA Skull Base Center.

Filed under : Neurosciences,Patient Stories | By
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Podcast Tuesday: Diagnosing ALS and Other Neuromuscular Disorders [AUDIO]

On July 29, 2014 | At 8:15 am

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The Ache is Gone: How Elbow Surgery Can Help

On July 23, 2014 | At 9:39 am

The story follows up on a previous blog post, Tennis Elbow: To Operate or Not, That is the Question.

Lisa Green has graduated.

Elbow surgery left a scar, but removed the tennis elbow pain from this elbow.

Elbow surgery left a scar, but removed the pain.

Today was her last checkup with Angelo Dacus, MD, the orthopedic surgeon who operated on her tennis elbow back in May – successfully, it turns out.

“It’s July 7, and I’m back,” she says, excited. “Back on my bike, back on the kayak in the water, now I can mow my grass and do the things I need to do to run the household. I have no more appointments.”

Choosing Elbow Surgery

Back when Green first saw Dacus, the question of whether or not to have surgery was a tricky one. It was possible that enough rest and physical therapy could allow her elbow to heal by itself; however, it was also possible that after several months, if her elbow did not heal, she would still need surgery.

Green’s goal was to get back to her active lifestyle as soon as possible. So, she chose to have surgery, opting for what she hoped would be a quick recovery time and less time overall out of commission.

It turns out Green made the right decision. “When he was in there doing the surgery, he said my tendon was a mess, and it was a good thing we were having this done.”

Two months later, Green is elated. “How do we give this guy enough praises?” she says, about Dacus. “He’s phenomenal. He does not rush in; you’re not just a case number. He listens, actually, literally listens to what you have to say. And that is what is hard to find in doctors today. I did not feel like I was on an assembly line.

Was she glad she had elbow surgery?

Green answers without hesitation. “Absolutely. I have no pain. I’m aching from getting back to strength. But the constant, everyday ache, 24 hours a day, is gone.”

What’s next for Green? “I tried to get Dacus to do my hip, but that’s not his specialty. So I asked him if he had a clone who did hips. He gave me a recommendation. I want to run again.”

Is Elbow Surgery for You?

You, yourself, can have a consultation with Dacus or any of the team at the UVA Hand Center. Call for an appointment today.

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Podcast Tuesday: Spotting and Treating Aortic Aneurysms [AUDIO]

On July 22, 2014 | At 9:24 am

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Poetry Friday: Insomnia

On July 18, 2014 | At 9:07 am

Every week for the past few months, we’ve published the winning poems from April’s medical poetry contest. This week’s poem, a runner-up in Category III: Grab the (Black) Bag: Miscellaneous Medical Moments, is the last one. Thanks again to all who submitted! Read all of the winning poems.

Insomnia
By Rabita Alamgir

Eyelids fail to block
late chats with the moon.
I’m lucky, it mocks,
that I can admire its beauty.
I don’t get nightmares,
but I’m robbed of sweet dreams.
I read to my soul’s content
then forget everything in a day.
I notice with useless clarity
the murmurs of the wind,
the drone of the heater.

Purple bags, my physician remarks,
are but a metonymy
for my endless despondence.
Yes, too saturated with bitter optimism,
sunlight always stings my eyes.
I have no right to be so melancholy,
yet I’m always awake and
alert, hopeful
sleep might come. Still,
My eyes never sparkle.

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Brugada Syndrome: A Dangerous Family Trait

On July 17, 2014 | At 10:09 am

This is the second story in a two-part series about genetic heart rhythm disorders. Yesterday, we told you about how genetic testing gave a family answers after a tragedy.

Adrian Chance, 40, has always been the picture of health. He’s a former high school football star and works as a personal trainer in Charlottesville for ACAC Fitness & Wellness Centers. He also stays fit keeping up with three young sons.

Adrian Chance, who has Brugada Syndrome, with his family

Adrian Chance with his family

But on Sept. 16, 2012, in the middle of the night, his heart suddenly stopped pumping. Three weeks later, it happened again. Fortunately, his wife woke up both times and performed life-saving CPR until paramedics arrived to rush Adrian to UVA Medical Center.

Blood tests eventually revealed that Chance inherited a rare heart disorder that can trigger nocturnal sudden cardiac arrest because of a dangerous heart rhythm. He is one of very few people to survive two cardiac arrests.

Diagnosing Brugada Syndrome

His condition is known as Brugada syndrome, which can be passed down from parent to child. Doctors originally thought Chance had long QT syndrome — the most common type of genetic heart defect seen in the U.S. There are several types of LQTS, and one was similar to Chances’ condition, in which a low heart rate during sleep or rest can be the trigger.

With LQTS, there is a lengthening of the time it takes for the heart to fire off a contraction and recover electrically. Chance’s EKGs (electrocardiograms) that record a heart’s electrical activity were normal.

“People with Brugada and LQTS can have a normal EKG, making it really difficult to determine,” says Rohit Malhotra, MD, a UVA cardiac electrophysiologist who specializes in heart rhythm disorders.

Genetic Testing for Heart Disease

Knowing he inherited a life-threatening trait, Chance’s concern immediately turned to the health and safety of his family. At the Cardiovascular Genetics Clinic, Chance and his wife met with Matthew Thomas, a genetic counselor who specializes in inherited heart disease. Thomas explained that each of their three boys had a 50 percent risk of carrying the same genetic disorder.

“Fortunately, all of his boys tested negative,” Thomas says. “It was truly a best-case scenario. This is one of the few times in medicine where you can definitively say someone is not at risk for something.”

Chance doesn’t know any other family members with heart issues. But recent genetic tests have revealed that his father, aunt, brother, sister and two of his sister’s four children share the same genetic disorder. As a precaution, his brother and sister, like Chance, have a defibrillator device implanted next to their hearts. His sister’s two children are being closely followed by a cardiologist. “It makes me feel good that they are getting tested and being proactive about their health,” Chance says.

You and your children should be checked for an inherited cardiac defect if anyone in your family has had unexplained sudden cardiac death (especially at a younger age) or unexplained fainting episodes or seizures.

If you’re concerned about your family’s risk for a heart problem, talk to your doctor about a referral to the UVA Cardiovascular Genetics Clinic.

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Long QT Syndrome: Family Turns Tragedy Into Triumph

On July 16, 2014 | At 8:31 am

Kathy Cundiff loves the waves of the ocean, especially since she was raised on the coast of Virginia. Now that she is a mother of two in Culpeper, she is focused on waves of a different kind — the electrical waves of her heart. Doing so just may have saved her life, and the lives of her two daughters.

Kathy and her daughters all have long QT syndrome, a form of abnormal heart rhythm

Kathy Cundiff (center) and daughters Molly Winstead (left) and Emily Phillips

It all started three years ago. Kathy and her husband were driving on a beautiful summer evening when the couple received a tragic phone call. Kathy’s sister had died mysteriously in her sleep. “She was only 40 and she was very healthy,” she says. “We had no idea what happened and no one could give us any answers.”

There were no clues, until Kathy’s niece almost experienced the same fate. At age 24, she collapsed and her heart stopped beating. Fortunately, she was revived with CPR. Medical tests revealed that Kathy’s niece had a heart problem called long QT syndrome.

Long QT Syndrome and the Heart’s Electrical System

“Long QT syndrome is an inherited disorder with the electrical system of the heart,” explains Rohit Malhotra, MD, a UVA cardiologist with special training in electrophysiology, the electrical patterns of the heart. “It can cause fainting and seizures due to abnormal heart rhythms that lead to a drop in blood pressure,” he says. It can also cause sudden death.

An amazing power station located in the heart generates electrical impulses telling it when to beat. These are the up and down waves seen on an EKG. The letters P, Q, R, S and T are used to label EKG waves, and QT is a specific interval. In long QT syndrome, the QT interval is longer than normal.

Often there are no warning signs that someone has long QT syndrome. Because the disorder is inherited, genetic testing can play an invaluable role in revealing who is at risk for the condition. Kathy, her niece and two daughters all tested positive.

“Our first thought was, what can we still do? Can we ride roller coasters? Can we scuba dive?  What can trigger the problem?” Kathy says.

Malhotra provided reassurance and advice. Long QT syndrome can be managed with medication or an implantable cardioverter-defibrillator if needed. Malhotra says common drugs can cause a longer QT interval, such as certain:

  • Antihistamines
  • Antidepressants
  • Antibiotics

These need to be avoided, as well as caffeine.

“This was the hardest part for me,” Kathy says. “You always saw me with a Redbull before I found out I had this condition. I cut back of some on the volunteering I was doing, but one day I still hope to scuba dive.”

Armed with the knowledge that long QT syndrome can be managed, Kathy doesn’t let fear stop her. She says being under the care of a cardiologist with training in the electrical system of the heart brings her peace of mind.

Trips to the beach will always remind Kathy of her sister, and they also remind her that her family’s hearts are safe.

Do You Have a Heart Condition?

Find out more about our cardiologists and Heart & Vascular Center.

Make sure to check back tomorrow to find out why a personal trainer’s heart suddenly stopped beating.

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Podcast Tuesday: Treating Sarcomas, A Rare Cancer [AUDIO]

On July 15, 2014 | At 9:41 am

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