Regional Report - Gundersen Health System

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3D Imaging Lab – continued from p. 1 surgeons to point out to patients what will occur during surgery. “Patients appreciate being able to recognize the anatomy and understand what their doctor is explaining. With cross-sectional pictures from a CT scan, this is challenging,” says Becky Freier, CT scan technologist. So far, the most common uses of 3D imaging are bone anatomy, vessel analysis, fractures and trauma cases. As Nicole points out, “It’s important to know exactly what structures the ordering provider is looking at so we can create images that are the most efficient for the radiologist.” For questions or to learn if your department could benefit from 3D imaging, contact Nicole Blackbourn via MedLink. RR With advanced computer technology, imaging specialist can now remove bones (such as the femur) to get a better look at the fractured hip socket. Gundersen Lutheran renal dialysis unit comes to Richland Center Gundersen Lutheran provides outpatient renal dialysis in a number of regional locations—the newest is in the Center Creek Professional Building in Richland Center, Wis., in partnership with the Richland Hospital and Richland Medical Center. A registered nurse serves as a care manager for each dialysis patient and the care team also includes licensed practical nurses, technicians, social worker and registered dietitian. An on-call nephrologist is always available. Because of their complex medical problems, it is important for dialysis patients to see a nephrologist every month. So Gundersen Lutheran nephrologist Kumari Usha, MD, sees dialysis patients in Richland Center. Dr. Usha also provides outreach services at the Richland Medical Center, seeing patients with chronic kidney disease or conditions such as hypertension and diabetes which can lead to renal problems. “Our goal is to catch potential problems early so patients can avoid dialysis,” Dr. Usha explains. “Early referral to a nephrologist is important in managing a patient’s chronic kidney disease. Early intervention is also helpful in managing anemia and bone disease associated with kidney disease. Outpatient services also include evaluation of patients with acid-base abnormalities, electrolyte disturbances, difficult-tocontrol blood pressure, urinary abnormalities such as blood and/or protein in the urine and metabolic work up for patients with recurrent kidney stones.” “We work with the patient’s primary care provider to establish an individualized disease management program,” explains Gundersen Lutheran nephrologist Fadi Ghandour, MD, Nephrology section chair, who also provides outreach and telemedicine services. Kumari Usha, MD Specialty: Nephrology MD Degree: Government Medical College, Netaji Subhash Chandra Bose, Jabalpur, India Residency: University of Texas Medical School, Houston Fellowship: University of Missouri Hospital, Columbia “We provide patient education about hypertension and managing other diseases related to kidney failure and kidney disease,” Dr. Ghandour continues. “Education also helps patients make informed decisions about different options for dialysis as well as kidney transplantation if they progress to end-stage kidney disease.” Currently, Gundersen Lutheran Nephrology offers in-center hemodialysis, home peritoneal dialysis and home hemodialysis as therapy options for patients with end-stage kidney disease. For a consultation or more information about outreach programs, contact Nephrology via MedLink. RR Gundersen Lutheran Nephrology Outreach Black River Falls, Wis.: Gundersen Lutheran Outpatient Dialysis Center in Black River Memorial Hospital Prairie du Chien, Wis.: Gundersen Lutheran – Prairie du Chien Clinic and Dialysis Unit at Prairie du Chien Hospital Richland Center, Wis.: Gundersen Lutheran Outpatient Dialysis Center in the Center Creek Professional Building and Richland Medical Center Sparta, Wis.: Gundersen Lutheran – Sparta Clinic Tomah, Wis.: Gundersen Lutheran – Tomah Clinic Viroqua, Wis.: Dialysis Unit at Vernon Memorial Hospital West Union, Iowa: Gundersen Lutheran – West Union Clinic and West Union Dialysis MedLink (800) 336–5465 2 In La Crosse 775–5465
Gundersen Lutheran disagrees with new mammography recommendation Women should continue to have annual mammograms starting at age 40 according to the clinical breast radiologists at Gundersen Lutheran’s Norma J. Vinger Center for Breast Care. An announcement by the U.S. Preventive Task Force has caused a stir, suggesting women don’t need screening mammograms until age 50, and then every other year, rather than annually. “Early detection is the key to saving lives, and annual mammograms give women the best chance for early detection,” said Jeannette Gasal-Spilde, MD, a Gundersen Lutheran clinical breast radiologist. “Screening women age 40-49 is reducing their risk of death from breast cancer by 15 percent, but because women in their 40s are at lower risk of breast cancer than women 50 and above, the U.S. Preventative Task Force says the actual number of lives saved isn’t enough for widespread screening. We disagree,” said Richard Ellis, MD clinical breast radiologist and co-director of the breast center at Gundersen Lutheran. “If this is about saving money, Gundersen Lutheran has a better solution,” he adds. “If our team approach to caring for breast cancer patients was implemented on a national scale it could save $4.15 billion in healthcare costs.” The model is centralized and coordinated meaning breast tumors are detected when they are 24 percent smaller, and the discovery-totreatment timeline is 2.5 times faster, resulting in 35 percent lower treatment costs. Gundersen Lutheran is one of only two organizations in the country with every available accreditation for the full scope of Research conducted at Gundersen Lutheran further explored the use of a simple blood test that may help reduce the number of repeat scans and non-diagnostic exams some women undergo. The research, which was published in the December issue of the American Journal of Roentgenology, focused on women who do not have normal menstrual cycles who needed to have a breast MRI. Breast MRIs are sometimes used to help diagnose and detect breast cancer and other breast abnormalities. “Normally, we try to schedule a woman’s breast MRI between days three and 14 of her menstrual cycle. This is the time we can get the clearest images, making it easier to detect breast cancer,” explains Richard Ellis, MD, the lead author of the study and a clinical breast radiologist in the Norma J. Vinger Center for Breast Care at Gundersen Lutheran. However, many premenopausal women do not have normal menstrual cycles. “Doctors often perform a breast MRI on these women without considering the timing of the patients’ hormonal cycle,” he says. “This can result in images that don’t MedLink (800) 336–5465 3 In La Crosse 775–5465 Richard L Ellis, MD Specialty: Breast Cancer MD Degree: Southern Illinois University Medical School, Springfield Residency: University of Wisconsin Hospitals and Clinics, Madison Fellowship: Howard Hughes/NIH, Bethesda, Maryland and University of Alabama, Birmingham Jeannette M Gasal Spilde, MD Specialty: Breast Cancer MD Degree: University of Texas Health Science Center, San Antonio Residency: University of Wisconsin in Madison Fellowship: Lynn Sage Breast Center, Northwestern Memorial Hospital, Chicago breast care, diagnosis and treatment from the American College of Radiology. The La Crosse-based breast center has two fellowship-trained clinical breast radiologists—Drs. Ellis and Gasal-Spilde. Dr. Ellis is a Fellow in the Society of Breast Imaging, one of only 100 in the nation. Gundersen Lutheran was also the first in the nation to achieve the highest level of distinction from the National Quality Measures for Breast CentersTM Program. A white paper highlighting Gundersen Lutheran’s Norma J. Vinger Center for Breast Care and their innovative approach to providing better care for breast cancer patients while reducing costs is available online at gundluth.org. RR Research may help some women avoid repeat breast MRIs allow for a diagnosis, which means a need for repeat scans.” Using what is known about the hormones released during a woman’s cycle and their effects upon breast tissue, Dr. Ellis reasoned that a simple blood test could be use to determine the optimal time for the breast MRI. He used the blood test to time the exam in 11 women with irregular menstrual cycles. None of the women required a repeat breast MRI. “This is good news for the ever increasing number of women who need a breast MRI to help in a breast cancer diagnosis or who need the scan because they are at a high genetic risk for breast cancer,” Dr. Ellis comments. Dr. Ellis’ research was supported by the Norman L. Gillette, Jr. Breast Cancer Research Fellowship of Gundersen Lutheran Medical Foundation. Gundersen Lutheran’s work in breast cancer research, treatment and outcomes has positioned the organization as a national leader in breast cancer care. For more information on research and breast cancer care at Gundersen Lutheran, go to gundluth.org. RR
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