UVA Health System Blog

Stories about the patients, staff and services of UVA

 

Cholesterol: The Good, the Bad, & the Balance

On February 25, 2015 | At 9:16 am
Running shoes in my office desk

Running shoes in my office desk: Walking is one way I’m beating my high cholesterol.

I’ve always had high cholesterol. But I’ve never worried about it. Why?

  • My mother told me it was genetic – “Grandma had high cholesterol, and she lived to age 93!”
  • My good cholesterol has always been the really high part – so doctors have never had a problem with my final number.
  • I’m an active, healthy person: I’ve always exercised regularly and eaten my vegetables.
  • Also, I was a vegetarian for several years. Surely that means something?

So everything was fine…

…until a couple months ago, when my new doctor at UVA, Allison Lyons, MD, reviewed my numbers and put up a red flag.

The Red Flag of Bad Cholesterol

She emailed me (how cool is it that my doctor and I email back and forth when I have questions?) saying:

Your HDL (good cholesterol) is great but your bad cholesterol (LDL) is a little higher than I would like. My goal would be <130 for you. How much do you eat in terms of cheese, red meat, dairy, sweets, etc.? I would like to control it with some changes in diet first, and we can then recheck in one year.

I balked. Me? Have a health issue? But considering our family had followed the Paleo diet for a while, so that we still tend to avoid carbs and rely heavily on meat, and also I’d fallen off my running routine, maybe this was a sign that I did need to make some changes. I asked Lyons what she recommended I do. Her reply:

I would try to cut back on red meat (only having once per week). I would also try to walk for 30-40 minutes per day. Both of those things together should help.

Oh dear. This prescription sounds fairly simple, but for me, this seemed impossible. A rush of resistance flooded my brain, as I thought of all the reasons I absolutely would flunk my doctor’s charge.

The Barriers to Balance

  • I’m not that big a fan of chicken. My kids would not want it every night.
  • I only like fresh fish. Which is hard to get and expensive.
  • Pork is red meat, and it’s my favorite.
  • I don’t have time to walk for 40 minutes EVERY DAY!
    • Mornings are out, because I can’t wake up early enough in the winter (not to mention it’s cold!).
    • My lunchtime is when I meet with friends I can’t see otherwise.
    • After work is when I’m spending time with my kids, helping with homework and getting them fed and bathed and put to bed.
    • And after that, I’m exhausted, it’s dark, and it’s time to spend with my partner.

Cholesterol, Not All Bad 

What is cholesterol, exactly?

Believe it or not, cholesterol is not the evil trespasser in your blood whom you should vow to destroy at all costs. In fact:

  • You need it. As Lyons told me, “Cholesterol is a fatty substance that is present in everyone’s blood and is necessary for your body to function.”
  • You make it. Also, you don’t just get cholesterol from meat, dairy and eggs. Your own liver produces cholesterol, all on its own.

The kicker? The liver is an overachiever. Lyons says, “When you eat a diet that is high in cholesterol, your liver tends to make more cholesterol as well.”

Good thing the U.S. government decided to stop warning us about cholesterol recently.

Cholesterol, Not All Good

So, why worry about cholesterol, if your own body makes it? As with most things in life, the issue boils down to balance.

There’s two types of cholesterol:

  • LDL, the “bad” cholesterol, is the culprit responsible for blockages and deposits.
  • HDL, the “good” cholesterol, actually tries to eat up and remove LDL cholesterol.

“When you have too much cholesterol in your body, it starts to deposit in your blood vessels, like dirt in a pipe. When it sits on the surface of the blood vessels for a long time, it becomes calcified and hardens.” The result?

  • Blockages that clog the pipe, slowing blood flow, causing heart disease and peripheral artery disease
  • Deposits or plaques that weaken, flake off and get lodge in arteries, causing heart attacks and strokes

Your cholesterol numbers help doctors determine if you’re in the right balance of good and bad.

The best-case scenario: Bad cholesterol under 100, good over 50, and the total number less than 200.

My numbers:

Total Cholesterol: 250
LDL: 159
HDL: 74

I felt doomed.

Making Hard Heart Changes

But I couldn’t stop thinking about my dad. His was a number even worse than my cholesterol. He was only 52 when he suddenly, with no warning, dropped dead of a heart attack. It was the worst thing that ever happened to me. And I just can’t imagine doing that to my kids.

So, after the winter holidays, I did what a lot of people do and made some New Year’s Resolutions, including lowering my cholesterol. I made this goal a priority – to myself, to my partner, to my kids, to my friends.

And the impossible became possible.

Finding Time to Exercise

I started walking 30-40 at lunch every day at work. This actually happens to be a refreshing break, even when it’s cold. My mind is cleared for the rest of the day, I get some fresh air and light and some personal time. I look forward to this. I eat at my desk. I limit friend-lunches to once a week, even if that means pushing people out a while.

And if I miss a day walking, I have found other ways to exercise at home that aren’t too disruptive to my kid time: either having a half-hour dance party with the kids or doing a free, half-hour workout video on grokker.com. On the weekends, I walk the dog (who needs to lose weight).

Food Fix

This actually wasn’t as hard as I had anticipated.

  • I found out pork (red meat? White meat?) was allowed.
  • I now stop for fish on my way home one night a week. I get the fast-cooking kind that doesn’t take a lot of time and effort.
  • We use ground turkey instead of ground beef.
  • I keep my vegetable portions larger than everything else on my plate.
  • I drink almond or coconut milk and mostly avoid cheese and other dairy, though I do eat a yogurt at lunch every day.

Of course, I have to wait until October to see if these changes have had the desired effect. But I will check in then and let you know!

Find Out More About Cholesterol

Want to know more about your cholesterol and getting heart-healthy? Check out the articles and recipes at Club Red.

 
 

Babies, The Heimlich and Celiac Disease: January 2015 Roundup [VIDEO]

On February 6, 2015 | At 9:21 am
Lentils are a gluten-free alternative for people with celiac disease.

Have celiac disease? Lentils are gluten-free and add texture and protein to your meals.

These three things don’t sound related, but we wrote about all of them in January 2015, and then some.

For celiac disease sufferers, avoiding gluten is essential. One writer shared her personal story, tips for managing celiac disease and why most people shouldn’t eliminate gluten.

Kenneth Liu, MD, decided to become a neurosurgeon after watching a PBS show when he was eight — and he loves his job. He answered our 7 Quick Questions.

Did you know physical and occupational therapy is a major part of our Neonatal Intensive Care Unit? Meet two therapists who work with premature babies.

One of our nurse practitioners performed the Heimlich maneuver on a man who was choking. Read her story and learn how to perform this lifesaving technique.

We spent Martin Luther King, Jr. Day discussing diversity in healthcare and teaching local students about careers in medicine. View the photos from our events.

Finally, we continued our weekly podcasts:

The Health System in Charlottesville News

Becker’s Hospital Review named the Medical Center to its list of “100 hospitals with great women’s health programs.”

Quitting smoking is extremely difficult, even after a cancer diagnosis. Cancer Center employee Lindsay Hauser helps cancer patients give up cigarettes for good.

Thanks to a holiday book drive, the Ronald McDonald House is getting 10,000 new books. The house provides lodging for families while their kids get treatment at the Children’s Hospital.

George Hoke, MD, explained what a hospitalist is and why he loves his job.

Brad Haws, CEO of the UVA Physicians Group, lost 120 pounds by changing his diet and exercise habits. He and other locals and doctors share tips for living healthy at any age.

 
 

Lung Cancer in Women: Time to Face the Facts and Get Screened

On November 24, 2014 | At 10:30 am

Which cancer do you think kills the most women? Chances are, you guessed breast cancer. Incorrect! Believe it or not, lung cancer is the leading cause of cancer death among women. In a recent study by the American Lung Association to measure awareness of lung cancer risk, only 1 percent of women surveyed selected lung, compared to 87 percent who selected breast.

Lung cancer surpasses pancreatic, ovarian and other types of aggressive cancer as the leading cause of cancer deaths in both women and men. Although smoking is a major risk factor of the disease, approximately 20 percent of patients diagnosed with lung cancer have never smoked. Of this 20 percent, most are women.

Richard Hall, MD, UVA Cancer Center

Richard Hall, MD is a medical oncologist at UVA Cancer Center who specializes in lung cancer.

“When looking at lung cancer across the board in the United States, the number of patients who are diagnosed with the disease is almost the same in both men and women. However, when I look at my practice and consider patients who were never smokers, almost all of my patients happen to be female,” says UVA medical oncologist Richard Hall, MD.

The Myth of the Smoker’s Disease

Hall adds that in other parts of the world, the majority of women who develop lung cancer never smoked. That’s especially true in East Asian countries such as:

  • Japan
  • South Korea
  • China
  • Taiwan

Lung Cancer: The Leading Cause of Cancer Deaths

Because the incidence of lung cancer in non-smoking women is higher than in non-smoking men, organizations such as the American Lung Association (ALA) are trying to raise women’s awareness of the disease. The ALA surveyed 1,000 women to measure awareness, knowledge and perceptions about lung cancer and found:

  • Only 1 percent selected lung cancer as a leading cause of cancer death among women, compared to 87 percent who selected breast cancer.
  • Only 1 in 5 women knew that less than half of all women diagnosed with lung cancer would live a full year after diagnosis.

Lung cancer has one of the lowest 5-year survival rates of all cancers, with only 18 percent of patients surviving at least 5 years, as reported by the ALA.

According to Hall, women who have never picked up a cigarette are shocked upon diagnosis of lung cancer. “Naturally it raises questions of other environmental exposures that contribute to their diagnosis, and unfortunately, there is still a lot we don’t yet understand.”

The first step to improving the statistics surrounding lung cancer is educating the public about the disease. Although we have a lot to learn about what causes lung cancer, there are critical steps you can take to prevent the disease: Quit smoking and get screened.

Quit smoking

Quitting smoking is the #1 way to reduce your chances of developing cancer.

Smoking cessation is the single most important thing someone can do to reduce their risk of developing lung cancer. It also helps them save money. Screening is the second most important action to take, especially for patients with a history of smoking,” says Hall.

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) approved CT screening for patients who qualify based on age and smoking history. The United States Preventative Services Task Force recommended the CMS approve lung screening after the results of the National Lung Screening Trial showed that people who underwent CT chest screening lived longer than those who underwent annual chest x-rays.

UVA offers a comprehensive Low-Dose CT Lung Screening Program and encourages those at high-risk to get screened.

Treating Lung Cancer

Without screening, lung cancer is generally diagnosed at later stages, making it more difficult to treat.

However, certain lung cancers can be treated by targeting the genetic changes in lung tumors, stopping the growth and survival signals of cancer cells at the molecular level.

While UVA provides these treatments, Hall and his team are also conducting clinical trials to identify additional therapies for patients at all stages of disease.

If you…

  • Are concerned about lung cancer symptoms
  • Are high risk and would like to be screened
  • Want a consultation with the lung cancer team at the UVA Cancer Center

Call 434.924.4246 to make an appointment.

Related Podcast: Lung Cancer: Myths vs. Facts

Filed under : Cancer,Pulmonary,Women's Health | By
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The Detective Work of Autoimmune Disease

On October 31, 2014 | At 8:25 am

Angela Crowley, MD, is up-front about it. Accurately diagnosing an autoimmune disease can be tricky.

UVA rheumatologist Angela Crowley finds autoimmune diseases fascinating.

UVA rheumatologist Angela Crowley, MD, finds autoimmune diseases fascinating.

“People on average see six doctors over a period of 4 years before they get a diagnosis.”

This is because, in general, autoimmune diseases tend to arrive unpredictably, disguised as other conditions, offering only confusing clues as to what they are.

Why Are Autoimmune Diseases So Mysterious?

One reason is that the list of what’s considered to be autoimmune is long and ranges from the very common to the extremely rare.

Did you know? The following are all autoimmune diseases:

  • Celiac disease
  • Diabetes type 1
  • Multiple sclerosis (MS)
  • Psoriasis
  • Inflammatory bowel disease

While very different, all these disorders have one thing in common: They occur when a person’s immune system decides to attack healthy body cells. Instead of fighting infection with antibodies, the body produces autoantibodies. The body is essentially fighting itself.

Where and how this self-attack occurs determines the disease and its symptoms. But the occurrence of these symptoms is not simple, clear or predictable. Other situations make diagnosis problematic:

Asymptomatic or Delayed Symptoms. You can have osteoporosis, for example, and have no symptoms at all — only getting diagnosed after a bone fracture. Or with ankylosing spondylitis, the average diagnosis timeframe is 10 years — about how long it takes for the condition to be visible on an X-ray.

Common symptoms. Or you could have severe joint pain as a result of any number of autoimmune diseases, but lack any other symptoms to help doctors determine exactly which one you have. Vasculitis, for instance, is systemic, which means, along with causing inflammation of blood vessels, it can cause pain anywhere and everywhere in your body.

Co-Conditions. Your celiac disease or Grave’s disease could lead to or just show up with rheumatoid arthritis; having both means one condition can mask the other.

Misconceptions. You might be in pain and avoid seeing a doctor. “People ignore their pain, thinking they are too young to have arthritis, which isn’t true,” says Dr. Crowley. “It can happen to kids. Rheumatoid arthritis and osteoarthritis are two different things.”

Mimics. Dozens of diseases can look like MS, for instance, from lupus to other neurological conditions. And it takes time to rule out.

Uniqueness. Lupus in one person can show up with a set of symptoms completely different than the ones that show up in another person. Doctors can’t rely on symptoms alone to determine the nature of the affecting disease.

Diagnosing Autoimmune Disease

Varied, numerous and inherently elusive, the diagnosis of autoimmune disease can be tough detective work.

But what might seem daunting to others is precisely why Crowley became a rheumatologist. “I find it to be fascinating. Everyone is different, so I’m surprised and challenged daily. It’s really rewarding to be able to identify a rare disease and to be finally able to give a patient an answer to symptoms and something that can help them. Or to find a rare presentation of a common disease.”

So how does one diagnose if you can’t count on symptoms entirely?

Myth vs. Fact: Celiac Disease

The proliferation of gluten-free options at restaurants and grocery stores might look like just another trend. But celiac disease is a serious autoimmune disease. And though sometimes treated as such, it is not an allergy one can grow out of or ignore. If a person with celiac disease ingests gluten, she can trigger a number of symptoms, not all stomach-related; over time, eating gluten can give rise to more autoimmune diseases.

Diagnostic tests include, but are not limited to:

  • Antinuclear antibody (ANA) test—the presence of autoantibodies does not automatically mean you have an autoimmune disease, but a high level can indicate lupus, scleroderma, juvenile arthritis, others
  • Comprehensive metabolic panel
  • Tests associated with inflammation and arthritis
  • Urinalysis

Rheumatoid arthritis I can usually diagnose in the first visit; it’s normally straightforward.” Which is good, since it’s very important to be diagnosed early. “The earlier we can treat it, the more likely it is that it will be easier to treat later on and you won’t need as much medication.”

Which is why Crowley is excited about the advances being made in the field.

The latest? “We have a new imaging technique, a new type of CT scan, to diagnose gout. We’ve never been able to do it with imaging before. I’ve had patients who didn’t know it was gout until we used this technique. To diagnose gout you have to look at joint fluid and see gout crystals, but there’s not always a big collection of joint fluid to examine. Or you can look at uric acid, but some people have high levels of uric acid and no gout. You might suspect, from the symptoms and the blood tests, that the person has rheumatoid arthritis. Which is a problem, as rheumatoid arthritis and gout require very different treatments.”

But with the dual-energy 3D CT scan, diagnosis is straightforward. “The gout crystals look green. Fun pictures,” adds Crowley.

Flares & Triggers: Autoimmune Disease

While an ultimate cause for autoimmune disease remains unknown, research has shown that:

  • People can have a genetic propensity for an autoimmune disease
  • A trigger can activate or turn on the gene
  • Suspected triggers include environmental, chemical, sunlight, stress, drugs and infection factors
  • These triggers can cause a disease to “flare” up
  • These disorders can appear at any and all ages, making it difficult to pinpoint exact causes

Another thing is clear to Crowley and others in the field. “In the last two decades, we’ve seen a significant increase in autoimmune diseases, and a lot of experts think it’s the environment.”

Specific research has shown that tobacco use can turn on these genes, and gum disease can turn on rheumatoid arthritis genes.

But as with most aspects of autoimmune disease, these are hints, not answers. “We suspect it’s not just one thing, not one sole cause.”

No Quick Fixes: Treatments and Hope

There are no known cures for autoimmune diseases. Rheumatologists look to medications, supplements and physical therapy for the relief of symptoms and suppression of the immune system.

Crowley says that’s no reason to lose hope. “There is a lot of good research going. We have a lot of great treatment options. One hot topic in research is trying to predict the right treatment for each person. We have to do trial and error to see what can put someone in remission, but with more knowledge about disease features and genetics, we can narrow down the options and go straight to the most appropriate medicine right away.”

Stress and Self-Care

Along with medication, Crowley advises her patients to practice good self-care. She knows living with an autoimmune disease can be stressful. “People break down into tears in my office at least once a day,” she says.

But stress can make symptoms worse. “People get flared up when stressed, so I tell people we can’t fix the situations, but we can control the response. Good sleep and exercise are things we can work on. Tai chi and yoga are good for the body and mind (and there’s free videos for these on YouTube),” and can help manage symptoms. She also checks patients’ vitamin D levels, which are important for bones and the immune system.

Open for Business: UVA Rheumatology on Pantops

You can visit Crowley at her office on Pantops, where there’s plenty of free parking and friendly staff. View clinic directions, hours, contact info.

And while there aren’t published studies showing that diet benefits autoimmune diseases, she does see that diets can affect individuals, some of whom find that removing gluten, dairy, meat, sugars, fats and artificial ingredients help.

Even without a cure, Crowley finds her work rewarding. “We can put someone in remission and take them from not being able to do much of anything to being able to return to work and play ball with their kids. I get to develop relationships with people. It’s a team approach between us and our patients.”

And because an autoimmune disease can affect various parts of the body, Crowley also teams up with doctors in other fields. She doesn’t just treat one thing, she says. “We treat the person as a whole.”

Do You Have an Autoimmune Disease?

It’s hard to know without the care of a specialist like Crowley. If you have inflammation, joint pain or other vague symptoms, see your primary care physician for a referral. You can even schedule an appointment with Crowley herself!

 
 

Podcast Tuesday: Preventing and Treating PCOS [AUDIO]

On September 9, 2014 | At 10:45 am

 
 

Podcast Tuesday: Reducing Your Ovarian Cancer Risk [AUDIO]

On June 24, 2014 | At 8:34 am

Filed under : Cancer,Podcast Tuesday,Women's Health | By
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Do Mammograms Work? A Recent Study Says No: A Response

On May 15, 2014 | At 8:32 am

A study questioning the effectiveness of mammograms in preventing breast cancer has recently hit the news and caused a lot of women to wonder what to do. Jennifer Harvey, MD, a UVA radiologist who specializes in breast cancer treatment and research, offers her take on the study and its implications. 

About the Mammogram Screening Study

This article reports the combined follow-up data at 25 years for two Canadian mammography screening trials: One study of women ages 40-49 and the other for women ages 50-59. The study finds that annual mammography in these women during the study period did not reduce mortality from breast cancer compared with women who had only clinical examination.

The Mammogram Study in Perspective

The important context of this study is that this is one of nine randomized clinical trials that were performed between the late 1960s and the 1980s. Of those nine trials, seven showed a reduction in breast cancer mortality with screening mammography; the Canadian trial was not one of those seven. The fact that the results did not change at 25 years of follow-up is not news. This trial was also one of the most highly criticized, due to likely randomization errors and quality control.

We should also consider the time frame of this study. Today’s mammogram is not your mother’s mammogram. Mammograms obtained today are considerably better in quality than those that were used in the study, which took place when I was a child! Mammography was also in its youth at that time. Mammograms, like our phones and cameras, have advanced in technology over the years.

The Evolution of Mammograms in Pictures

This slide shows the technical changes in mammography over time. Most of the randomized trials were performed in the 1970s and 1980s. Although randomized trials are the “gold standard” for judging a test, the technical changes make the results a bit outdated. Mammography today is far more advanced, and now includes tomosynthesis (3D mammogram). I’ve changed a bit over the years, too!

Mammography today is far more advanced, and now includes tomosynthesis (3D mammogram).

Mammography today is far more advanced, and now includes tomosynthesis (3D mammogram).

Does Mammography Work?

Yes. All countries that have adopted routine screening mammography have experienced a significant reduction in breast cancer mortality, including the United States. While mammography is imperfect and does not detect all cancers at an early stage, it does reduce breast cancer mortality by at least 25%.

Improving Mammography: A Look Ahead

This and other studies have raised a good point, however. We do need to screen smarter. As we better understand breast cancer and breast cancer risk factors, we should work to tailor screening to an individual woman’s risk. Women who are low risk, or at risk for low-grade disease, could be screened less frequently. Women who are at higher risk or at risk for aggressive disease could be screened more frequently with tools other than mammography, such as ultrasound or MRI.

We are not there yet. Current risk models are not very good at telling which women are going to develop breast cancer and which are not. At the UVA Breast Care Center we are currently developing a breast cancer risk model that includes breast density. We believe this will help women better understand their breast cancer risk and make decisions about screening based on that information.

What type of mammography is right for you?

Visit UVA Breast Care Center to find out about the options, including 3D mammograms.

 
 

From Cystic Fibrosis to Marathon Ambitions: How a Lung Transplant Changed a Mom’s Life

On April 14, 2014 | At 8:07 am

Tina Tinsley’s dream was to be a mother, and her wish was granted after years of trying. But because of cystic fibrosis, she couldn’t do basic tasks that most moms take for granted. She couldn’t go to the grocery store or give her children baths. When she left the house, she had to take an oxygen tank along with her.

Tina Tinsley with her husband, Phillip and twins Sara and Cole

Lung transplant recipient Tina Tinsley with her husband, Phillip, and twins Sara and Cole

It wasn’t always this way. Tinsley, now 38, was a physically active child, but cystic fibrosis changed all that as she got older.

A hereditary condition that develops during childhood, cystic fibrosis primarily affects the respiratory system, pancreas and sweat glands. The body produces excess mucus that clogs the bronchi, which are the main passageway into the lungs. This leads to breathing difficulties and infections.

Infertility and IVF

Cystic fibrosis also causes infertility. Tinsley, who lives in Staunton, Va., was told she’d never have children, but she wasn’t one to take no for an answer. She and her husband, Phillip, kept trying. After numerous procedures and two in vitro fertilization (IVF) attempts over eight years, they were successful, and twins Cole and Sara were born in 2009.

Her faith in God kept her going through the long and often-disappointing process, she says. The twins were in the NICU for many weeks after their birth. “UVA took excellent care of them and made sure they were coming home,” she says.

After the birth of the babies, her cystic fibrosis symptoms worsened. “My husband says it really took a toll on my body,” she says. “But even if I knew that, if I had been warned, I don’t know if I would’ve listened. I really wanted to have kids.”

Family History of Cystic Fibrosis

Things took a turn for the worse in October 2013, when Tinsley was admitted to UVA with a lung infection and put on a ventilator and feeding tube. “I nearly left here. I almost died,” she says. For Tinsley, that was a very real possibility. Her brother died of cystic fibrosis three years ago at the age of 39. She also has two cousins with the condition, one of whom died from it.

Antibiotics controlled her infection, and eventually she was strong enough to be put on the lung transplant waiting list. Still, she wasn’t ready to admit she needed a transplant. She thought she might still get better and needed the convincing of her doctor, Max Weder, MD. “He said I wasn’t going to live if I didn’t have the transplant,” Tinsley says. “He’s by far the best physician I’ve ever had. We make a good team. The whole transplant team is just phenomenal.”

Tinsley also got support from other members of the transplant team at UVA, including social worker Bill Potts and pre-transplant coordinator Heidi Flanagan, RN.

“Heidi knew how nervous I was, and she was so compassionate. She told me to look ahead a year to what my life was going to be like.”

Potts, she says, asked her what she wanted from the rest of her life. “I told him I just wanted to be a mama to my babies. He said, ‘Transplant can give you that.’”

Lung Transplant and Recovery

While Tinsley was in the hospital, Phillip, Tinsley’s husband of 18 years, would drive 40 miles from Staunton to Charlottesville to be with her and then drive home to be with their children.

Christine Lau, MD, performed Tinsley’s lung transplant, which lasted almost 10 hours. Tinsley was removed from the ventilator the first day after her surgery. “I was up sitting in a chair the next day and walking in the hallways the day after that.”

She stayed in the MICU (medical intensive care unit) for two weeks following the surgery and worked with a respiratory therapist, physical therapist and nutritionist to regain normal function. Tinsley also takes immunosuppressants, drugs that prevent her body from rejecting her new lungs. Transplant recipients take anti-rejection medications for the rest of their lives.

Weder says Tinsley’s case is a special one. It’s not often that patients go from being near death to walking out of the hospital several weeks later. “She is a unique case and serves as a great example of how everyone on our MICU and transplant teams work together in difficult transplant cases.”

Along the way, the Tinsley family received lots of help. People in their Staunton community raised funds to help cover some of their transplant medical expenses. Another group made sure the children had presents under the tree this past Christmas when neither parent had the time or resources to go shopping. The Tinsleys’ church community donated weeks of meals during her hospitalization. The Tinsleys also received a grant from a nonprofit that paid for one round of their IVF procedure.

Tinsley, whose motto is “Live to fight another day,” says she feels better now than she’s felt since she was a child. She can give her children those baths, she goes to the grocery store and the oxygen tank is gone. She hopes to share her story with local churches and maybe write a book someday. Her new goals also include running a marathon. “I know I can do it,” she says.

More Transplant Information

Find out more about UVA’s lung and other transplant programs.

Meet Dr. Weder

Learn more about his interests and research.

 
 

The Magic Week: Waiting for a Healthy Baby

On February 26, 2014 | At 8:07 am

To many women, having a baby at 37 weeks may seem about the same as having the baby at 39 weeks. Why endure another two weeks of backaches and swelling when you could induce labor?

Pregnant belly image

Babies born at 37 weeks are more likely to require NICU admission than babies born at 39 weeks.

Does it really make a difference for your child?

UVA obstetricians sometimes see expecting parents who want to schedule an induction at 37 or 38 weeks for logistical reasons. And that used to be considered OK.

But now doctors know that there’s a big difference between 37 and 39 weeks. Babies do best if delivered at 39 weeks or later.

The “Magical Gestational Age” of 39 Weeks

At 39 weeks, babies have better developed organs, including the brain and lungs, and:

  • Maintain temperature better
  • Eat better
  • Have a lower risk of breathing problems
  • Are less likely to need extensive medical care and interventions, including the neonatal intensive care unit

“It’s important to mention that most babies born spontaneously or due to medical necessity between 37-39 weeks do well,” says obstetrician Vanessa Gregg, MD. “But statistically, 39 weeks or beyond is best for babies.”

That’s why UVA does not schedule expecting moms for elective early deliveries, which is induction or Cesarean section before 39 weeks. The March of Dimes recently recognized UVA and just 12 other hospitals in Virginia for low elective early delivery rates and for implementing a delivery policy.

UVA had no elective early deliveries in 2012 and the first half of 2013 (numbers are not yet in for the second half of last year), compared to a national mean of almost 8 percent of all births.

“When we explain to women and their families that babies are better off if born after 39 weeks, they’re receptive to waiting until that magical gestational age for delivery,” Gregg says.

Earlier Deliveries

However, deliveries before 39 weeks can still happen if the mother goes into labor on her own. There are also medical reasons to induce, including:

  • Maternal high blood pressure
  • Maternal diabetes
  • Twins or other multiples
  • Fetal anomalies that need special care outside the womb
  • Abnormal placental development
  • Prior uterine surgeries that make the uterus too fragile to wait
  • Growth restrictions due to the fetus getting too big

Are you pregnant or thinking about having a baby? Find out more about our:

Filed under : Children's Hospital,Women's Health | By
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Vim & Vigor: Angelina Jolie, Genetic Testing & Controlling Diabetes

On February 7, 2014 | At 8:39 am

In August 1982, Thomas P. Loughran Jr., MD, was working in Seattle when a woman with a mysterious blood illness was transferred to his hospital. That patient and her condition changed the path of Loughran’s research forever.

Sudden cardiac arrest patient Helen Trimm with dog

Read about patient Helen Trimm’s cardiac arrest scare in Vim & Vigor.

Loughran and his research are featured in the Spring 2014 issue of UVA’s family health magazine, Vim & Vigor. Check it out for stories about:

  • Angelina Jolie’s double mastectomy and BRCA1 and BRCA2 genetic testing
  • Controlling diabetes without drugs
  • How much to hover when your kids are playing
  • The jobs that are hardest on your heart

Read the online version now.

Live in Virginia? Sign up to get Vim & Vigor in the mail for free.