Keck Medicine of USC Prevention can go a long way when it comes to avoiding injury and strain on your joints, particularly as you get older. Stretching, home exercise routines that build up muscles, maintaining a healthy weight and icing after exercise can all be very beneficial to your joints. Some joint pain is common after rigorous exercise and overuse. But, what happens if that nagging pain won’t go away? Redness, swelling or tenderness and warmth around the joint could be indicators that you need to make an appointment with one of doctors at the USC Joint Preservation and Replacement Center. Joint deformity, intense pain and swelling and a complete inability to use the joint are all red alarms that you should seek medical attention immediately. Our orthopaedic surgeons provide relief for patients from diagnoses through rehabilitation for conditions such as arthritis, damaged cartilage and hip impingement. Using the latest advances in surgery such as robotic surgery, our surgeons can perform minimally invasive procedures to help speed recovery time. Jay R. Lieberman, MD, chair of the Department of Orthopaedic Surgery, explains that there are simple measures that can be employed — far short of surgery — that can make a world of difference. “There are a number of things we can do to help patients. First they can take anti-inflammatory medications and we can prescribe physical therapy and a home exercise program — and that’s what we start out with,” he said. “If further treatment is necessary, we may use cortisone injections and platelet rich plasma — and additionally, now there is some interest in using stem cell injections — to reduce inflammation.”
Prevention can go a long way when it comes to avoiding injury and strain on your joints, particularly as you get older. Stretching, home exercise routines that build up muscles, maintaining a healthy weight and icing after exercise can all be very beneficial to your joints. Some joint pain is common after rigorous exercise and overuse. But, what happens if that nagging pain won’t go away?
Redness, swelling or tenderness and warmth around the joint could be indicators that you need to make an appointment with one of doctors at the USC Joint Preservation and Replacement Center. Joint deformity, intense pain and swelling and a complete inability to use the joint are all red alarms that you should seek medical attention immediately.
Our orthopaedic surgeons provide relief for patients from diagnoses through rehabilitation for conditions such as arthritis, damaged cartilage and hip impingement. Using the latest advances in surgery such as robotic surgery, our surgeons can perform minimally invasive procedures to help speed recovery time. Jay R. Lieberman, MD, chair of the Department of Orthopaedic Surgery, explains that there are simple measures that can be employed — far short of surgery — that can make a world of difference.
“There are a number of things we can do to help patients. First they can take anti-inflammatory medications and we can prescribe physical therapy and a home exercise program — and that’s what we start out with,” he said. “If further treatment is necessary, we may use cortisone injections and platelet rich plasma — and additionally, now there is some interest in using stem cell injections — to reduce inflammation.”]]>
To provide clarification to the situation today, Keck Hospital of USC reports the following:
You may or may not be familiar with what it is.
Scoliosis is a condition in which the spine takes on an S-shaped curve.
Sometimes, it happens in adolescence. Other times, it happens later on in life.
Often times, scoliosis shows no symptoms. However, it can result in chronic back or leg pain.
• The initial treatment for pain is conservative treatment including medications, physical therapy and injections
• If conservative treatment fails, surgery is often recommended
At the USC Spine Center of Keck Medicine of USC, we use a team approach. This allows us to come up with the most minimally invasive and effective treatment method for each individual patient.
One of the most powerful treatment techniques we utilize is when a small incision is made in the side of a patient and a straight plastic spacer is inserted into the disc space in between two of the vertebrate.
After screws are placed through small incisions on the patient’s back, the scoliosis curve is corrected.
This procedure requires a short hospital stay and rehabilitation; the patient is often able to return to normal function in as little as six weeks.
Want to learn more? Watch a few of the videos here.
Feel that you may have some spinal issues?
Request an appointment by calling (800)USC-CARE (800-872-2273) or by visiting spine.keckmedicine.org/request-an-appointment.]]>
Whether it is a jog around the neighborhood, a quick run or some exercises we do in our homes, we’re on top of it. Getting on top of things gets our adrenaline flowing and prepares us for the workday ahead.
Exercise is something that we dread and hope we never have to participate in.
But are there really any correlations as to how exercise can affect our lives.
These are questions that many people want answered.
According to the American Heart Association, the recommended amount of moderate exercise per week is 150 minutes. That is 30 minutes a day, 5 days a week.
But how does that compare to someone who doesn’t exercise? Or better yet, to someone who exercises more?
661,137 men and women, with the median age of 62 years were included in a study where 116,686 deaths were included in a study.
How much each person exercised was calculated out.
The people who didn’t exercise were at the highest risk of death. No surprise there.
People who exercised in between not doing any physical activity and exercising 150 minutes a week had a 20% less chance of mortality.
People who followed the American Heart Association’s recommendation of 150 minutes a week had a 31% less chance of mortality.
People who went above and beyond to exercise for 450 minutes a week had a 39% less chance of death.
With such a huge data set, it was hard to deny the results of the findings.
It was interesting to find, that as exercise levels increased, so did the probability of the longevity of one’s life.
I’m going to find some extra time to get in some exercise today.
Or do you need help with creating a workout routine?
Schedule a visit with your primary care physician to discuss optimal workout levels and healthy diets to go with your workout routine.
If you are in the Los Angeles area and are looking for exceptional care from some of the top physicians in the world, be sure to schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting keckmedicine.org/request-an-appointment.
By Leonard Kim]]>
Dr. Dasgupta is the associate program director of the Sleep Medicine Fellowship and the assistant program director of Internal Medicine residency program. His mission in life is to educate patients, students and aspiring doctors for better patient care.
Here’s what you won’t fine on his resume:
“When I was growing up, I always knew I wanted to be a doctor. I wanted to combine teaching, entertaining and patient care together.”
“I always admired how Michael Jordan was never afraid of any challenge. It was inspiring to see that he could carry the team on his shoulders if necessary. I find I have similar traits to Michae l— like my competitiveness.”
“I enjoy teaching and have taught the first 3 steps of the USMLE (United States Medical Licensing Examination) and Internal Medicine board review around the world. I am also working on my book, “Medicine Morning Report: Beyond the Pearls.” I have been fortunate enough to be called in as an expert to appear on various media platforms, including the TV show, ‘The Doctors.’”
“Medicine is such a humbling field. There is always something I learn everyday to help my patients. In order to be a great mentor to my students, I have to be motivated to actively learn because my students, residents and fellows are only getting smarter.”
“The hardest part of my day is when I need to stop working. This includes reading journals, preparing lectures, writing for articles and teaching others.”
“I chose to work with Keck Medicine of USC, an academic medical center, because I have a passion for teaching and have always been a believer in life-long learning. The most rewarding moment of my day is when I have made a positive difference in patient care. I find it very gratifying when a medical student, resident or fellow learns something new or appreciates the effort I put in to my teaching.”
“If we had to cross paths in the hospital, I would be very easy for you to get along with. I find myself to be a non-intimidating, friendly and very positive person.”
“Being around others that have the same passion for learning, teaching and patient care inspires me and helps me feel like I am fulfilling my purpose in life.”
Dr. Dasgupta is the assistant program director of the Internal Medicine residency program.
Click here to view Dr. Dasgupta’s full biography.]]>
The disputes between NUHW and Keck, on the one hand, and NUHW and Sodexo, on the other hand are due to disagreements over economic issues. We can say, emphatically, that the strike is unrelated to patient care or patient safety.
With respect to the work stoppage by Keck employees, we can emphatically say that our organization continues to offer competitive benefits packages that attract top talent. Our last, best and final proposal, which the Hospital implemented last week, provides for a minimum of nine percent wage increases over the life of the contract, with larger increases for positions that are under market. Moreover, Keck Hospital will continue to offer NUHW employees the option for a healthcare plan with all premiums paid by the hospital. No other group within Keck Hospital has this option.
The Union has rejected the Hospital’s wage proposal and is demanding that the Hospital provide education benefits not available to any other represented group within the Keck Health System. Any allegations that our refusal to concede on this benefit is discriminatory are patently untrue.
In anticipation of the Feb. 10 strike Keck Hospital will bring in trained contract workers. We will have additional administrative and managerial oversight to make sure operations run smoothly. Our doctors, nurses and support staff will work hard to maintain the safe environment that our patients, their families and our employees expect from us every day. Ultimately, our organization remains focused on our top priority – collaborating across the organization to provide our patients with beyond excellent care.]]>
Director, USC Eye Institute
President, USC Care Medical Group
Rohit Varma, MD, MPH, Dr. Varma is chair of the Department of Ophthalmology, professor of Ophthalmology and Preventive Medicine and holds the Grace and Emery Beardsley Chair in Ophthalmology. He also serves as President of USC Care.Dr. Varma earned his medical degree at the University of Delhi, India. He also obtained a Masters in Public Health from Johns Hopkins University. He completed his residency at the Wilmer Ophthalmological Institute at Johns Hopkins Hospital in Baltimore, Maryland and two glaucoma fellowships, one at the Wills Eye Hospital in Philadelphia, and the other at the University of Southern California.
Dr. Varma’s primary research focuses on epidemiologic studies of eye disease in children and aging populations. He is the principal investigator of the Los Angeles Latino Eye Study (LALES), The Chinese American Eye Study (CHES), the Multi-Ethnic Pediatric Eye Diseases (MEPEDS) Study, and the African American Eye Disease Study (AFEDS). He is an expert on changes in the optic nerve in glaucoma, and is also studying new imaging techniques in the early diagnosis of glaucomatous optic nerve damage. More recently, Dr. Varma has been involved in the development of novel implantable IOP sensors and drainage devices. He has over 247 publications in various peer reviewed ophthalmic journals, and co-authored 2 ophthalmic books.]]>
Dr. Gilbert is the new medical director of orthopaedic surgical services at USC Verdugo Hills Hospital (USC-VHH). He has been an orthopaedic surgeon for more than 30 years. Here’s what you will not find on his resume:
“My family and I have lived in the Foothills community for my entire career. Both of my sons were born at USC Verdugo Hills Hospital, thanks to the efforts of Joseph Mutch, MD, who is an OB/GYN. He helped us with infertility. Without him, our children wouldn’t be here today. Since USC acquired Verdugo Hills Hospital, we have been able to really develop orthopaedic surgery at USC-VHH.”
“My entire family enjoys scuba diving. My son, Chris, and I are certified rescue divers. We have done dives in Borneo, Belize, Hawaii and more.”
“Because my father was in the Air Force, we moved every couple of years. I never went to an elementary school or high school for more than 2 years. I lived in various states in the U.S., but I also was able to live abroad. I lived in London, and my junior and senior year of high school, we were in Wiesbaden, Germany. I really liked moving around because it gave me the opportunity to meet new people and go to different places.”
“I take a lot of characteristics from my dad, such as integrity and hard work, but the one that I feel is the most underrated is honesty. It’s a trait that I try to aspire to and value the most, especially in the field of medicine. If you try to exaggerate, you just miss the mark. If you don’t know the answer, say it. If you do know it, make sure you say it right. I strive to not only be honest with my patients, but with myself as well.”
“Once when I called Domino’s, they were able to tell me how many pizzas I had ordered in the last few years and what the most common was. They knew more about my pizza order than I knew about it. The reason for that was because they had my order history on their computer database. Similarly, in surgery, the data is critical. Innovative tools, such as advanced robotic and computer systems, provide and contain so much valuable, immediate data that helps us improve procedures and patient experience.”
“Ten years ago, I went on my first trip with Operation Walk. Operation Walk is a charitable organization that does free total joint replacement procedures on people who do not have access to advanced care. We have traveled across the world to do joint replacements. The first week of December, we do surgeries for people in our own neighborhoods that can’t afford them. Now I’m on the board of directors for the Los Angeles chapter of Operation Walk.”
Paul K. Gilbert, MD, is assistant professor of orthopaedic surgery at the Keck School of Medicine. Click here to view Dr. Gilbert’s full biography]]>
If not treated properly, it can lead to your or a loved one’s untimely death.
As scary as it may be, there are early warning signs.
If acted upon quickly, you will significantly lower the risk of death.
Otherwise, time will no longer be on your side, as your risk of dying from a heart attack increases the longer you wait.
Watch for these early warning signals seen in this infographic:
If you are having a heart related emergency, call 911.
We have some of the best cardiologists in the world. If you want to check your heart’s health, please visit cvti.keckmedicine.org to schedule an appointment.]]>
For most of the 35 years since her retirement as a layout and graphic design artist, Eula-Lee Geisert, 93, has kept physically active. A Sierra Club leader, she regularly hiked in the San Gabriel Mountains and visited the gym five days a week.
But early in 2013, she found herself short of breath, unable to do much more than walk from room to room in her home. Her cardiologist diagnosed her with aortic valve stenosis (a narrowed aortic heart valve) and sent her to Keck Medicine of USC’s CardioVascular Thoracic Institute (CVTI) for help.
CVTI’s experienced surgeons and other specialists determined that Geisert’s age made the traditional approach to valve replacement through open-heart surgery — which includes stopping the heart and using a heart-lung bypass machine — too risky because of potential complications. Instead, they recommended a less invasive therapy called transferal transcatheter aortic valve replacement (TAVR).
“This procedure allows us to replace the malfunctioning heart valve by making a puncture in the leg, inserting the new valve, moving it into place with a guide wire and inflating it inside the damaged valve — all without stopping the heart,” said interventional cardiologist Ray Matthews, MD, one of Geisert’s two physicians. “We also use a specialized operating room so we can do high-level digital imaging for accuracy.” Matthews is head of the TAVR team and trains other surgeons in TAVR procedures.
People who have typical open-heart surgery stay in the hospital for 10 days to two weeks and often must transfer to a skilled-care facility. Full recovery takes about three months if there are no complications. In contrast, most TAVR patients are hospitalized for only five or six days before going directly home, said Matthews.
“Everyone on the team was so nice, and helped explain things,” Geisert said. “I had excellent treatment and wonderful results, and never suffered any pain. When I went home, it was like a miracle — I felt like my old self again.”
Her TAVR medical team, one of the most experienced in Southern California, included Vaughn Starnes, MD, chair of the Department of Cardiothoracic Surgery at the Keck School of Medicine of USC, who specializes in the surgical replacement of valves and co-directs the CVTI with Matthews, a specialist in using guide wires
and catheters; Alison Wilcox, a radiologist trained in reading scans for TAVR procedures; and Mary Schoenbaum, a nurse practitioner who coordinates patient procedures, medications and treatment plans.
Both Geisert’s medical care providers and fellow active seniors admire Geisert’s resilience.
“They want to know my secret — I’m the oldest one in my gym class, and they think I’m outstanding because I do all the exercises, and I never sit down,” she said. “I tell them it’s a combination of the physical abilities you inherit, the self-discipline to eat right and exercise, and the power of positive thinking.”
By Robin Heffler
Learn more about the USC CardioVascular Thoracic Institute]]>
Palos Verdes High School was a long shot to take the CIF football championship in 2015 and when the underdogs took the prize, their senior quarterback, Steven Delcarson, was showered with accolades. He was named the league’s most valuable player, the most valuable player in CIF, and Palos Verdes High’s athlete of the year.
The honors were particularly important to Delcarson because he, too, was something of a long shot. He had a serious injury to his knee just before starting high school that, had it not been handled better, might have kept him on the bench.
It was during a routine tackling drill at football practice, one that he had done hundreds of times before, that Delcarson somehow caught his foot on the field. He knew it was stuck, but he tried to stay upright and he wrenched his knee.
An orthopaedic surgeon near his home in Palos Verdes examined the eighth-grader and determined he probably had a small tear in the ligament. He prescribed time off from sports to let the knee heal, physical therapy to strengthen his muscles and assured the active teen that he would be back on the field in a few months.
“It was pretty painful, but the PT seemed to be working,” says Delcarson, who graduated from Palos Verdes High School in 2015. “I did the therapy for three months and by early November, it was feeling pretty good.”
Sports were always a big part of Delcarson’s life. He played football, basketball and lacrosse on school teams. After school and on weekends, his circle of friends often headed to nearby parks for games of pickup basketball or to kick soccer balls around. As soon as he got a clean bill of health from his doctor, Delcarson returned to playing sports. Almost immediately, he knew something was still wrong.
“I could tell when I made cuts, had to stop quick and change direction, that my knee still wasn’t 100 percent,” recalls Delcarson.
It wasn’t long before he had another collision on the football field, one that landed another player on top of Delcarson’s leg, which made him realize that his knee was in far worse shape than his doctor thought.
“I felt the same thing that I felt during the first injury,” says Delcarson. This time his surgeon realized the meniscus was completely torn and Delcarson needed surgery, but he wasn’t prepared to perform it. Delcarson’s injury was a complex tear and repairing it would involve drilling through the growth plate in his knee, which might have stunted his growth.
The surgeon referred Delcarson to George ”Rick” Hatch, MD, assistant professor of orthopaedic surgery at the Keck School of Medicine of USC and a faculty surgeon in the USC Center for Sports Medicine. Delcarson says Hatch explained clearly to the family that there were risks because his injury was not a straightforward case. Repairing his knee would involve two surgeries and a lengthy recovery, during which time Delcarson would have to keep his knee completely straight to avoid another injury, and months of physical therapy.
Delcarson had the surgery and he now says Hatch is the reason he was able to play both quarterback and linebacker as a senior at Palos Verdes and was recruited to play football at USC, and several other universities around the country. In the end, he chose to attend the University of Pennsylvania. Although he isn’t playing football this year, he is grateful that — thanks to surgery — sports will always be part of his life.
USC sports medicine physicians are dedicated to returning athletes and weekend warriors to their activities. The doctors of the USC Center for Sports Medicine are the official team doctors to the USC intercollegiate teams.
by Hope Hamashige
Learn more about USC Orthopedic Surgery]]>
In sports, we hear about the MCL (medial collateral ligament) and ACL (anterior cruciate ligament) injuries.
These injuries relate to the knee and can be painful and debilitating. But in the world of knee injuries, another term that really sticks out is: cartilage.
Cartilage is the tissue at the end of the bones and in your joints. Cartilage is a firm tissue that allows you to have pain-free range of motion of your joint.
The following tips will help prevent injury and become more important, particularly with age:
Depending on the degree of your injury, you will likely be given a set of guidelines for recovery after visiting with your orthopaedic surgeon, which may include:
In many instances, this treatment solves the problem.
If you still have pain, then your physician may try to directly relieve the inflammation in the joint with an injection (i.e. cortisone, hyaluronic and platelet rich plasma).
If you suffer from a knee injury, make an appointment with an orthopaedic specialist. To learn more about USC Orthopaedic Surgery, visit ortho.keckmedicine.org.
To schedule an appointment, call (800) USC-CARE (800-872-2273) or visit http://ortho.keckmedicine.org/patient-information/request-an-appointment/]]>
“It’s a cute little thing with sort of paperclips on each end,” says 73-year-old Carole Sharp. The Placentia resident isn’t referring to a whimsical handicraft posted on Etsy but, rather, the first and only FDA-approved medical device designed to keep heart-failure patients — like her — out of the hospital.
Called the CardioMEMS™ HF System, this dime-sized sensor is implanted directly in a patient’s pulmonary artery via cardiac catheterization. Once in place, CardioMEMS™ sets about its wireless work of measuring pulmonary-artery pressure.
Measuring pulmonary-artery pressure is both pivotal and preemptive. David Shavelle, MD, associate professor of clinical medicine at the Keck School of Medicine of USC and a staff member at the USC CardioVascular Thoracic Institute’s Center for Advanced Heart Failure, explains: “An increase in pulmonary artery pressure can signal an impending heart-failure issue, and we can initiate treatment before the patient’s condition reaches an advanced state.”
Prior to CardioMEMS™, cardiologists could do little more than monitor patients’ heart failure symptoms, including swelling in the lower extremities, abdomen, and neck veins; weight gain; fatigue; and shortness of breath.
It was the latter – while walking her shih tzu Sophie in April of this year – that prompted Sharp to dial 911. Three days later, she left the hospital with a diagnosis of diastolic
heart failure, which occurs when the heart can’t properly fill with blood during the resting period between each beat.
Sharp has a history of heart problems, including a 2001 heart attack and a 2013 double coronary artery bypass graft and aortic valve replacement at Keck Medical Center, under the surgical direction of Vaughn Starnes, MD, Hastings Distinguished Professor and Chairman of the Department of Cardiothoracic Surgery, Keck School of Medicine. While Sharp – who retired two years ago after spending five decades as a registered nurse – would have preferred to skip yet another heart-related diagnosis, at least said diagnosis was serendipitously timed. That’s because in May of 2014 St. Jude Medical received FDA approval for CardioMEMS™ based on a clinical trial showing that patients using the device
had a 28 percent reduction in heart failure hospitalizations at 6 months, and a 37 percent reduction in heart failure hospitalizations over the entire follow up period.
Shavelle saw Sharp as an ideal CardioMEMS™ candidate. Not only did she meet the requirements of experiencing New York Heart Association Class III heart failure and being hospitalized for heart failure within the past 12 months, but she was highly motivated.
“When Carole developed heart failure she got fairly sick, and she really wants to do everything she can to prevent being readmitted to the hospital,” Shavelle says. USC Center for Advanced Heart Failure physicians have implanted some 40 CardioMEMS™ devices to date; Shavelle implanted Sharp on June 9 of this year.
Since then, Sharp starts her days by laying for five minutes on an antennae-embedded pillow next to a bedside monitor that sends pulmonary-artery and heart-rate readings to a secure website that can be accessed by Shavelle and Sharp’s local cardiologist. CardioMEMS™ data already has driven several changes to Sharp’s medications – changes predicated on preventing heart failure incidents.
Commenting on her post-CardioMEMS™ life, Sharp says that – although she doesn’t sense the device’s presence – she likes its impact. “It makes me feel much more confident,” she explains. “Now I don’t worry that something’s going to happen to me without warning. My medical team will get to me before that.”
by Carrie St. Michel
Learn more about the USC CardioVascular Thoracic Institute]]>
It’s a story that began with a conversation on a treadmill, led to an operating room and ended with the gift of life. For veteran Los Angeles County Sheriff’s deputies Javier Tiscareno and Jorge Castro, it’s a story of friendship, extraordinary generosity and perseverance in the face of terminal disease.
“He’s given me life,” Castro said a week after undergoing a successful operation to replace his diseased liver with part of Tiscareno’s. “It’s something he did out of his heart, and it’s something that I will never be able to repay.”
The two law enforcement officers took part in a living donor transplant performed on June 4 at Keck Hospital of USC in which Tiscareno donated part of his liver to save Castro, who had been diagnosed with a rare illness that was attacking his own liver.
Donning black USC T-shirts, Tiscareno and Castro shared their story a week afterward during a news conference alongside Keck Medicine of USC CEO Thomas Jackiewicz, Los Angeles County Sheriff Jim McDonnell and physicians Saro Khemichian and Yuri Genyk.
McDonnell thanked the physicians and nurses at Keck Medical Center of USC, calling the transplant a “tremendous story.”
“Somehow, everything aligned,” McDonnell said. “It’s one of those things that only happens in the movies. “To think that this surgery was undertaken and today both of our deputies are able to walk into this room,” he added, “I would say it’s a miracle.”
Castro, a 14-year veteran of the sheriff’s department, received a diagnosis in January 2014 of primary sclerosing cholangitis, a rare autoimmune disease that attacks the liver’s bile ducts. His liver was quickly failing, and his health situation was dire.
“We realized very soon that there was no cure for this, and he needed a liver transplant,” said Khemichian, MD, assistant professor of clinical medicine and transplant hepatologist. “We were facing an uncertain future.”
Castro was put on the liver transplant list, but his outlook was grim.
“With the way this disease is, he wasn’t going to get a transplant any time soon through our usual means,” Khemichian said. “We discussed with him the possibility of a living donor.”
Despite his terminal diagnosis, Castro continued to work at Twin Towers Correctional Facility in downtown Los Angeles, where he works with Tiscareno, an 18-year veteran.
The two deputies were exercising on treadmills when Castro mentioned his illness and his desperate need for a new liver.
“[Tiscareno] is a big jokester and he told me, ‘Let’s do it this Saturday,’” Castro said. “I said ‘I’m not fooling around. This is serious.’ He stopped his treadmill and said, ‘I’m not fooling around either.’”
The two men talked and Tiscareno soon decided that if he were a match, he would donate part of his liver to his sick colleague.
“I’m just so thankful,” Castro said.
Tiscareno called his wife, Carmen, to discuss his decision. Although she was initially hesitant, she supported him. Tiscareno contacted USC physicians to begin the testing process. He soon learned he was an ideal candidate.
“After learning that I was a match, I said, ‘Let’s get this done,’” Tiscareno said. “I could already see the wear and tear on Jorge. It was my understanding that timing was of the essence.”
Genyk, MD, associate professor of surgery and surgical director of the liver transplant program at Keck Medicine of USC, said that living donor liver transplants are possible because the human liver can regenerate itself from healthy tissue. During the 11-hour surgery, Tiscareno had about 60 percent of his liver removed. In about two months, the livers of both men are expected to grow back to their normal size.
“The operations went successfully and both deputies have recovered,” Genyk said. After the surgery, Castro’s young children visited Tiscareno in his room at Keck Hospital to thank him for saving their father’s life.
“That gave me so much happiness,” Tiscareno said. “I’m thankful to have him here. May the rest of his life be long, healthy and prosperous.”
by Douglas Morino
Learn more about the USC Transplant Institute at transplant.KeckMedicine.org]]>
You are feeling more confident. Your career is taking off. You are considering neighborhoods you may want to settle down in, so that your children can receive a solid education.
Your life is full of responsibilities both at work and at home.
As we grow older, we become more prone to risk of disease. A stroke or heart attack is no longer an afterthought, but something we have to thoroughly avoid with changes in our lifestyle.
But with so many responsibilities, how in the world do you find time to maintain a healthy lifestyle?
All it takes to make sure you’re on track is to schedule one day from your busy schedule to see your doctor for a checkup.
But what happens in this process? What are they looking for during these visits? We reached out to one of our most trusted resources on the topic.
When you are in your 30s, the first thing your primary care physician is going to want to check is your blood pressure. If anything looks out of the ordinary, physicians like Dr. Rose Taroyan will be able to provide you with tips and instructions on how to keep it under control.
This process includes a screening for dyslipidemia. Big word, I know! It means checking for an abnormal amount of cholesterol or fat in the blood.
The next thing your primary care physician checks for is your BMI. Your BMI is your Body Mass Index. In other words, it is a value that you get when you combine your weight and height. This number indicates how healthy your weight is.
During this process, your primary care physician is going to do an obesity screening. If this value seems out of the ordinary, counseling will be provided.
This is a good time to talk to your primary care physician about your:
This discussion will determine whether there should be some counseling on:
While seeing your primary care physician, they will be checking for signs of depression. If you feel down or think you may be suffering from depression, be honest with your doctor.
During this screening, they will go through a quick and simple test that consists of 10 questions:
Your answers are recorded in between 0 to 3, depending on whether you have these feelings:
Not at all = 0 points
Several days = 1 point
More than half the days = 2 points
Nearly every day = 3 points
Based off these scores, your doctor will be able to tell you if you suffer from no depression, minimal depression or major depression. This will help your physician be able to identify whether or not you may or may not need an antidepressant or even psychotherapy.
(Request an appointment)
In your 30s, you have responsibilities, both financially and to your family. That could make anxiety a factor in your life. After the depression screening is complete, another quick screening is done to identify your level of anxiety.
The quiz looks like this:
Over the last 2 weeks, how often have you been bothered by the following problems?
These answers will be measured on a four-point scale which includes not at all, several days, over half the days and nearly everyday.
Your score will be able to determine whether or not you have little or no anxiety, severe anxiety and everything in between. This will allow your doctor to determine exactly how they can best serve your needs.
(Request an appointment)
Your primary care physician is going to want to check for is alcohol misuse. This is done through a screening and behavioral counseling interventions.
This starts off by identifying your CAGE score. To figure this out, your primary care physician will ask you 4 simple questions:
A total score of two or greater is considered significant.
During the checkup, your doctor will be asking about your use of tobacco, providing counseling (if necessary) and discussing pharmacotherapy intervention (if needed). Pharmacotherapy invention is basically medication to help end tobacco use: for instance, nicotine gum, the patch or prescription pills.
The next step your primary care physician goes through is a process called cytology. What cytology means is the study of cells. So in this process, your physician is checking your cells to see if there are any abnormalities that may potentially be causing cervical cancer.
But how often are these done?
A cytology and HPV screening is done every 5 years.
(Request an appointment)
Some people end up in homes with domestic violence and they don’t know where to turn. If something is happening in your life and you have been looking for someone to share it with, discussions with your primary care physician are safe.
What follows shortly afterwards is a screening for any sexually transmitted infections. These can range from chlamydia to HIV and includes gonorrhea and syphilis. Some counseling is done to educate patients on what can be done to protect you from any possible infections.
Hepatitis is something that is easily contractable. Did you know that some people live with it and never even know?
Your doctor will provide a screening knowing that being in your 30s, you can potentially be at high risk for Hepatitis B.
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Understanding what your primary care physician is looking for will help you be prepared for your visit. Remember, both you and your physician have the same goal – to keep you healthy. If your current doctor is missing out on some of these crucial screenings, maybe it is time to consider a new primary care doctor.
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By Leonard Kim]]>
In the fall of 2007, Jennifer Weir was dropping her daughter off at college in the Bay Area. Weir is a young mom; just 39 years old at the time, she was happily married, had recently re enrolled in college for nursing and spent much of her time involved in her Thousand Oaks community. She was thrilled to be seeing her 17-year-old begin a journey toward becoming a speech pathologist.
“I was so excited,” she says. “I was a healthy, active person, and I was ready to get my daughter all set up.”
So when Weir began to feel pain and discomfort in her stomach on the weekend of her daughter’s move, she thought very little of it. It wasn’t until the aching worsened over the course of the following week that she finally went to the emergency room. It was then, she says, that she and her husband got the shocking news: Weir had stage 4 colorectal cancer.
I asked the doctor, ‘is there a stage 5?’ and he said, ‘no.’“ With that, she adds, “I didn’t figure I had very long to live.”
“Cancer was the furthest thing from my mind,” she says now. “I was 39. I didn’t know anyone with cancer.”
Weir had a colon resection at a local hospital in Chico, CA almost immediately. When she returned to Los Angeles, she began searching for a local doctor to continue her care. But the first one she visited gave her a dismal prognosis; he didn’t believe she would recover, and wasn’t going to operate on her liver. “It was very depressing,” says Weir. “He gave me no hope.”
But Weir isn’t one to take no for an answer. “I’m strong,” she says. “I’m healthy. I didn’t buy it.”
She began looking around for a second opinion, and in the process a friend suggested she go to USC Norris Comprehensive Cancer Center and see Heinz-Josef Lenz, MD, co-director of the USC Norris Gastrointestinal Cancers Program. Weir took the suggestion, and the first time she and her husband met Lenz, she knew immediately that he was the right person to handle her care.
After hearing the plan put in place by Weir’s other doctor, Lenz said, “that’s not what I would do,” Weir recalls. “He said, ‘you need a team, you need a new plan’ — I thought, ‘yup, this is my guy.’ I had complete confidence in him.”
Her confidence was not misplaced. Along with Lenz, a team of surgeons and doctors at USC Norris created a new plan for Weir. In December of 2007, she had a liver resection and her right ovary was removed, as the cancer had metastasized. “I was in such good hands,” says Weir. “I feel so fortunate to be able to go to USC Norris. I just love everybody there. I can’t say enough about it.”
For the following six months, Weir underwent chemotherapy. After 12 sessions, she and her doctors thought she was in the clear.
But in December of 2008 — exactly one year after her initial surgery — another tumor was discovered in her left ovary. Lenz decided it needed to be removed. He recommended a surgeon in Washington, DC, who would perform a hysterectomy, remove Weir’s gall bladder, and — the most strenuous part of the surgery — provide chemotherapy while Weir was still on the operating table.
During a visit with Lynda D. Roman, MD, co-director of the Lynne Cohen & Georgia Cord Preventive Cancer Care Clinic at USC Norris, who performed the removal of Weir’s ovary, Weir broke down thinking about the possibility of the surgery not working.
“I just have to tell my kids,” she told Roman, “that I did everything I could do to be here with them.”
Tearing up, Weir now explains, “Dr. Roman took my hands, and she said, ‘if that’s what you want, then that’s what we’re going to make happen.’ All the doctors at USC were just so supportive.”
Weir traveled to Washington, DC for the surgery, then returned to do chemotherapy at USC Norris.
Following five months of chemotherapy, Weir’s health slowly began to improve. Part of that, she says, is due to the hospital staff’s human touch.
“They treat you like a person,” she says. “They really care. The nurses, the guy who took my blood, the doctors — I love them all.”
Perhaps more than that, though, her team at USC Norris never gave up.
“Dr. Lenz and the team down there are willing to fight,” she says. “They are willing to fight insurance companies, they are willing to fight on any level to make it happen for you. They are not taking the easy way out.”
With the support of her husband and children, Weir began opening her mind to the possibility that she may have more time left than she originally thought — and it’s given her a new lease on life. Since recovering from chemotherapy, Weir has taken a new job doing social media for a radio personality.
She’s taken her aging mother into her home to live. She and her husband are making long-term travel plans — because, she says, “what are we waiting for?”
As for Weir’s children, they’re quickly growing into young adults. Her youngest daughter is enrolled in nursing school, and her son is in college as well. And her oldest daughter, whom she was dropping off at college at the time of her diagnosis, has graduated.
Weir was there.
“I cried tears of joy,” she says of the graduation day. “The same that any parent would cry when her baby graduates … and a few extra.”
By Jessica Ogilvie
Visit cancer.KeckMedicine.org for more detailed information about the USC Norris Comprehensive Cancer Center.]]>
It has been two years since Janae Monfort, who was diagnosed with juvenile rheumatoid arthritis before her second birthday, has experienced any of the joint problems that plagued her for as long as she can remember. But the inflammation in her eye, a condition called uveitis, an eye disease that is a common companion to juvenile rheumatoid arthritis, still gives her problems.
The whites of her eyes sometimes redden, giving the appearance of pink eye, and her vision occasionally fogs, particularly in bright light. It doesn’t cause her trouble in her day-to-day life, but she knows that unchecked, her uveitis could cause permanent damage, even blindness. And so every six or eight weeks, she pays a visit to Narsing Rao, MD, professor of ophthalmology at the Keck School of Medicine of USC and director of uveitis services at the USC Eye Institute, to make sure her treatment regimen is keeping the uveitis in check.
Although fairly common, there is little public awareness about the disease, according to Rao. Uveitis typically presents as redness in the eyes that is usually accompanied by pain, blurred vision, or sensitivity to light. Perhaps because it is not well-known, the condition is sometimes missed by both patients and their doctors.
“If there is redness or some pain, people may not immediately recognize it as a serious condition,” says Rao. “In children, it can be missed by their parents unless the child is really complaining.”
Misdiagnoses or missed diagnoses of uveitis can have devastating consequences. It can lead to cataracts and glaucoma, even in children. The inflammation and swelling is also accompanied by tissue damage that can cause permanent damage to the retina, leading to blindness. In the developing world, unchecked uveitis is still one of the most common causes of blindness. While uveitis can be dangerous, it can be controlled if it is diagnosed and carefully monitored. Rao explains there have been advances in treating uveitis in recent years with the introduction of several new biologic treatments, which has given doctors a wider range of options when looking for the best treatment for their patients. Patients need to see an ophthalmologist with experience treating uveitis to decide which treatment is best.
Rao has been treating patients with uveitis and conducting research on the disease for 40 years. He has conducted clinical trials to assess the efficacy of new treatments and is currently studying the cellular mechanisms that lead to damage to the retina in an effort to find ways to stop it.
Monfort is currently treating her uveitis with eye drops containing corticosteroids. Keeping her eyes healthy also means making an appointment to see Rao every few weeks, who checks the pressure in her eyes and checks the white blood cell count to evaluate the status of her disease and the efficacy of the current course of treatment.
“It is important to stay on top of it because we have to keep tabs on how the patient is responding to treatment,” says Rao.
Because of her arthritis, the Seattle native, who is a senior at USC, says she has spent more time seeing doctors than many people her age. She knows from experience that Rao takes a very different approach to patient care than many doctors.
“I am used to having doctors talk about me or talk at me,” says Monfort. “Until I started seeing Dr. Rao, I never understood this condition. It is nice to feel like it is a collaborative relationship.”
By Hope Hamashige]]>