November 2013
Blog

November 2013 posts

Technology can assist in diagnosis of heartburn, acid reflux and GERD

You may frequently interchange the terms heartburn, acid reflux and GERD, but it’s important to know if your heartburn is chronic and recurring.  Heartburn is a symptom we experience when acid from the stomach passes up through the esophageal sphincter into the esophagus, known as acid reflux.  For some people this can be acid that passes only a few inches up the esophagus or all the way to the mouth.  When acid from your stomach comes up as high as your mouth, you run the risk of aspiration (when fluids either going down to your stomach or coming up from your stomach enters your trachea and into your lungs). 

Gastroesophageal reflux disease (GERD) is described as severe or chronic acid reflux. Severe means that it happens when we have had a change in our body, like a pregnancy that causes pressure on our stomach forcing stomach content up into the esophagus. Chronic may mean there is a mechanical problem like a weak esophageal sphincter or a hiatal hernia that allows leakage into the esophagus. 

Whether intermittent, severe or chronic, acid reflux can feel miserable if it is not controlled and it can also cause cancer. We all suffer from heartburn from time to time, but when heartburn happens regularly or does not resolve with lifestyle or diet changes you may need to seek the assistance of a physician who can help you resolve it. Thankfully over the last 20 years, physicians’ ability to diagnose and treat these conditions has benefited by some excellent technology.

The first step to ...

2013 World Atlas of MS published

The 2013 World Atlas of MS has been published by MS International Foundation and is available here. The key findings are:

  1. The estimated number of people with MS has increased from 2.1 million in 2008 to 2.3 million in 2013
  2. The 2:1 ratio of women to men with MS has not changed significantly since 2008
  3. Substantial global inequalities remain in terms of access to treatment and medical care

Swedish/Edmonds Fire Response

On Thursday, November 21, the Swedish/Edmonds campus experienced a fire isolated in a lower-level, mechanical room at or about 7 PM. 

No injuries are reported. Swedish/Edmonds medical staff and emergency personnel have acted quickly to ensure the safety of all patients and medical staff.

There is smoke damage at the hospital, resulting in a partial patient evacuation, with transfers expected to both Swedish/Ballard and Providence Everett facilities.  We have confirmed that 11 patients from the Swedish/Edmonds Emergency Department have been transferred to Providence Everett, and 1 OB patient to Swedish/Ballard.

We are currently still confirming if additional patient transfers will be necessary. Current power outages in the hospital are not affecting patient safety.

(11/22/13 7:30 AM) Update: The majority of Swedish Edmonds is running on power. A portion of the hospital is currently without power. Patient safety is not affected at this time. Hospital staff and leaders continue to work quickly to restore power to all parts of the Swedish/Edmonds campus.

Click here to read a release from Snohomish County Fire District 1.

(11/22/13 9:20 AM) Update: The Emergency Department is open. Patients and families who have questions about patients or any scheduled procedures for today (November 22) should first contact Swedish/Edmonds main switchboard at 425-640-4000.

(11/22/13 7:35 PM) Update: Additional generator capacity at Swedish/Edmonds is in place and being gradually brought online to address the areas of the hospital currently without power. Site managers continue to prioritize patient care and services as they allocate power to meet Swedish/Edmonds needs.

Seizure Device Evaluated at Swedish Receives FDA Pre-Market Approval

FOR IMMEDIATE RELEASE: Nov. 21, 2013   

Contacts: Clay Holtzman, Swedish, 206-386-2748, clay.holtzman@swedish.org
                   Laura Allen – Swedish Epilepsy Center 206-320-3492

SEATTLE – The U.S. Food & Drug Administration has granted pre-market approval to a California company’s device for the treatment of medically refractory epilepsy that Swedish Neuroscience Institute played a key role in evaluating.

The NeuroPace® RNS® System, a treatment for adults with partial onset seizures that have not been controlled with two or more antiepileptic drugs, received FDA premarket approval on Nov. 14, 2013. Created by Mountain View, Calif.-based NeuroPace, the RNS System is a novel, implantable therapeutic device that delivers responsive neurostimulation, an advanced technology designed to continuously monitor electrical activity in the brain, detect abnormal activity and respond by delivering imperceptible levels of electrical stimulation to normalize that activity before an individual experiences seizures.

Swedish physician Ryder Gwinn, M.D., medical director of the Swedish Neurosciences Institute Center for Neuromodulation and Functional Restoration, served as a principal investigator for the device’s feasibility and clinical trials. Swedish was one of 11 centers that evaluated the device’s feasibility and one of 32 centers that conducted the pivotal trial that led to FDA premarket approval. Swedish Neuroscience Institute will initially be the only center in the Pacific Northwest to implant the device.

Gluten allergy: myth or fact?

Gluten is a hot topic these days, and is hitting the headlines again. Why? At the American College of Allergy, Asthma, and Immunology annual meeting, Dr. David Stukus (a pediatric allergist) set out to clarify frequent myths that he encounters in his practice.  So, why is he saying that gluten allergies do not exist?

Gluten is a protein found in foods processed from wheat and related grain products.  In celiac sprue (affecting up to 1% of adults), gluten intake leads to damage of the small intestine, impairing its ability to absorb nutrients.  I like to imagine that a healthy small intestine is like a shag carpet, and small intestine affected by active celiac sprue is more like a tile floor.  Celiac sprue is not a gluten allergy, but rather an autoimmune condition where the gluten is triggering an inflammatory response in the body.

Studies find that ...

Washington Health Benefit Exchange: Swedish Health Insurance Plans

Starting Oct. 1, 2013, Washington state residents were eligible to enroll in health-care coverage through the Washington Health Benefit Exchange (Exchange). The program gives individuals and families the ability to choose a health insurance plan that best fits their needs and their budget. The state has seen more than 55,000 enrollments during the first month.

Swedish is proudly supporting the Exchange and the implementation of the Affordable Care Act in our state. We are working to inform our patients about Exchange options and to direct them to resources to access these new benefits. We are also sharing these best practices with other caregivers.  

While we are collectively moving in the right direction, a transition of this scale is never seamless. That is why we strive to be a trusted resource to help our patients navigate these changes. Most recently, our patients have told us that there is confusion around which Exchange health insurance plans cover care at Swedish. As of Nov. 1, 2013, Swedish is a part of the following Exchange plans:

  • Community Health Plan of Washington (CHPW)
  • Coordinated Care
  • Molina

In addition to ....

Constraint induced movement therapy in MS may be equally effective as in stroke

Constraint induced movement therapy (CIMT), formerly called “forced use” is a treatment for impaired function of an upper extremity. It has been established as an effective evidence-based form of treatment for rehab of impaired upper extremity (UE) function for post stroke hemiparesis. The core features of CIMT are massed practice (high repetitions) and to overcome learned non-use thru behavior modification. The typical training protocol involves a 2 week period of physical restraint of the less-involved side (90% of the waking hours) and intensive training (3 hours/day) focused on movement patterns of the involved hand and arm. The physical restraint is usually a padded mitt, sling or glove thereby restricting stronger arm use.
At a recent ECTRIMS/RIMS meeting, this form of therapy was presented as being equally effective in

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