Regional Report - Gundersen Health System

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MedWatch Gundersen Lutheran Medical Foundation is dedicated to advancing quality healthcare by focusing on research, medical education and community health outreach. MedWatch highlights the work of the Foundation, as reported by A. Erik Gundersen, MD, retired cardiac surgeon and vice chairman of Gundersen Lutheran Medical Foundation Board. Robotics offer another option for prostate cancer surgery Beginning in late 2008, the Gundersen Lutheran Urology department introduced a significant technical advance for the treatment of prostate cancer, robotic prostatectomy. Since that time, nearly all prostate cancer surgery has been done in this manner. By November 2009, more than 120 cases have been performed. Robotic prostatectomy is one of several choices available at Gundersen Lutheran for patients with prostate cancer. After a diagnosis of prostate cancer, a urologist will discuss all of the options with the patient along with the risks and benefits of each. For patients with prostate cancer and no evidence that it has spread beyond the prostate gland, the two most common choices are robotic prostatectomy and radioactive seed implantation. Both procedures have advantage and disadvantages. With robotic prostatectomy the entire prostate gland is removed through several small incisions. Pain and blood loss are generally minimal and there is usually only an overnight stay. Patients are able to start resuming normal activities after two weeks. Most patients regain full continence within several months. Those patients with normal erectile function before surgery have a 60-70 percent chance of regaining erectile function. As with any treatment, there is a chance the cancer may recur after surgery, but if it does, most patients could have radiation as a secondary treatment option. The robotic prostatectomy surgical program began at Gundersen Lutheran less than two years ago; consequently long-term follow up is not yet available. However, large studies have shown it to be as effective for controlling cancer as traditional open prostatectomy with faster patient recovery. So, who makes the choice for the patient’s treatment? At Gundersen Lutheran the urologist and the radiation oncologist work with the patient to choose a treatment option that is best for him. RR Total ankle replacement – continued from p. 1 met him,” says Roxanne. “He suggested a two-staged approach, including a Total Ankle Replacement ® —a procedure which preserves ankle motion.” According to Dr. Caldarella, the ideal candidates for the procedure are individuals with advanced arthritis of the ankle, those who have not responded to previous treatment options, and patients who are not excessively overweight, neuropathic or have metabolic bone disorders. Roxanne fit the description perfectly, but first she needed a repositional triple arthrodesis to straightened her foot alignment. Dr. Caldarella completed the triple arthrodesis surgery at Gundersen Lutheran and then worked alongside board-certified orthopedic surgeon Gregory Berlet, MD, at the Orthopedic Foot & Ankle Center, (Ohio State University) Columbus, Ohio, to perform Roxanne’s Total Ankle Replacement. Following the surgery, Dr. Caldarella handled the follow-up care at Gundersen Lutheran. The result, Roxanne says, has been life-changing. “I cannot remember the last time I walked without ankle pain, and my quality of life has improved drastically.” Roxanne even shocked Dr. Caldarella this past June when she announced she had completed a triathlon. “It was fun but very challenging,” she admits. Despite having to use crutches for part of the 5K, she finished and says, “Just wait until next year!” Dr. Caldarella is committed to providing an evidence-based treatment algorithm that incorporates emerging trends in the management of severe ankle arthritis. He recently became credentialed in Total Roxanne was just six months post-operative at the time of this picture. Ankle Replacement surgery and is now offering this service at Gundersen Lutheran Medical Center. If you have a patient who might be a candidate for this type of surgery, please contact Dr. Caldarella via MedLink. RR MedLink (800) 336–5465 4 In La Crosse 775–5465
Challenges of treating movement disorders also bring rewards Despite the complexity and challenges of Parkinson’s disease and other movement disorders, Jason Aldred, MD, says getting to know patients is part of what drive him as a physician. Dr. Aldred recently joined Gundersen Lutheran Neurosciences as director of the Movement Disorders Center. Prior to joining our organization, he completed a two-year fellowship in Parkinson’s disease and movement disorders. He is also a board certified vascular neurologist. Using his expertise in these specialty areas, Dr. Aldred has quickly established himself as a leader in the Movement Disorders Center. Dr. Aldred specializes in the diagnosis and management of complex movement disorders; botulinum toxin injection for movement disorders; deep brain stimulation patient selection, surgery and post-op programming; electromyography and nerve conduction studies; and educational talks for providers and patient groups in the region. “I’m excited to help build a comprehensive center for Parkinson's disease and movement disorders in the region. It’s always rewarding to know that I have tried my best to solve a problem, used all available resources to maximize my patients’ abilities to function and made a difference in their quality of life,” says Dr. Aldred. A movement disorder such as essential tremor, dystonia or Parkinson’s disease can have a significant impact on a patient’s quality of life. There’s not only the physical and functional limitations, but also social interaction, communications, confidence and self-esteem can be negatively affected. That’s why Gundersen Lutheran established the Movement Disorders Center. The Center is a collaborative effort between Neurology, Physical Medicine & Rehabilitation, Neurosurgery, Physical and Occupational Therapy, Speech Pathology and Social Services. The goal is to provide comprehensive, coordinated medical and surgical care for improved quality of life, including diagnosis, rehabilitative services and continued medical management for complex movement disorders. Be sure to look for upcoming provider and patient seminars from the Movement Disorders Center. The Center’s team consults on, evaluates and/or treats patients with a wide range of movement disorders, including: • Parkinson’s disease • Tremors of any type • Cervical dystonia • Generalized dystonia • Blepharospasm and facial spasm • Dyskinesia • Corticobasal degeneration • Progressive supranuclear palsy • Multiple system atrophy • Normal pressure hydocephalus • Gait and balance problems • Huntington disease MedLink (800) 336–5465 5 In La Crosse 775–5465 Jason Aldred, MD Specialty: Neurology MD Degree: University of Tennessee Health Science Center, Memphis Residency and Fellowship: Oregon Health & Science University, Portland • Tourette’s syndrome • Ataxia • Other non-specified movement disorders The Movement Disorders Center team works together to maximize comfort and control with treatment options such as medication; physical, occupational and speech therapy; surgery or deep brain stimulation if appropriate; braces and other assistive devices; and more. You should consider a consultation or referral to the Movement Disorders Center if you have a patient who was recently diagnosed and wants to better understand treatment options and what to expect as the disease progresses. We can also help those with new or worsening symptoms, especially when speech, mobility or strength are affected. There is also support for patients who need help coping with a progressive disease and maintaining their independence. After the teams meets with your patient, a follow-up letter will be sent to you as the patient’s primary care provider with findings and recommendations. For more information, a consultation or referral, contact Dr. Aldred via MedLink. RR News Brief New hematology-oncology fellowship program receives approval The Accreditation Council for Graduate Medical Education recently approved Gundersen Lutheran's application for accreditation of a new Gundersen Lutheran Medical Foundation-sponsored fellowship program in hematology-oncology. Alcee Jumonville, MD, is the program director and Ronald Go, MD is the associate program director. “This is a significant milestone for our post-graduate medical education programs at Gundersen Lutheran,” says David H. Chestnut, MD, director, Medical Education for Gundersen Lutheran Medical Foundation. “This program will not only strengthen our existing medical education and research programs, but it will also increase the visibility of our clinical programs in hematology-oncology and enhance the quality of care for our patients.” “We are very fortunate to have the full commitment and support of Gundersen Lutheran Medical Foundation and Gundersen Lutheran Executive Committee to give us the opportunity to train future hematologists and medical oncologists. This is especially important because of the expected shortfall in the United States by 2020,” says Dr. Go. The addition of the new hematology and medical oncology fellowship furthers the commitment of Gundersen Lutheran Medical Foundation. It not only is a major advancement for Gundersen Lutheran medical education, but it will also advance cancer research. Ultimately, the entire Tri-state Region will benefit with better patient care and community health.
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Regional Report - Gundersen Health System

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