October 2013
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October 2013 posts

Quality of Life Following CyberKnife Treatment for Prostate Cancer

The Swedish Radiosurgery Center is the lead site in a national multi-institutional study evaluating CyberKnife for treating men with intermediate-risk prostate cancer (clinical stage 2). As the principal investigator of this study, I reported on the quality of life outcomes at the annual meeting of American Society of Radiation Oncology.

We now know that in low-risk prostate cancer patients (stage 1), active surveillance is a safe option. But men with intermediate-risk cancer have a significant risk of dying of their disease, so intervention is necessary. Conventional treatments (surgery, radioactive seed implants and external beam radiotherapy) can adversely affect patients’ quality of life.  We sought to determine if the unprecedented accuracy of CyberKnife treatment would translate into improvement in these patients’ quality of life.

We treated ..

What causes bedwetting and when to be concerned

Bedwetting (also called nocturnal enuresis) is a very common childhood problem.  The number of children with this problem varies by age. For example, at five years of age, an average of 16% of children will have a bedwetting accident.  By 15 years of age and older, 1-2 % continue to wet the bed.  For most children, this will improve or resolve without any treatment as they get older.

What can cause bedwetting?

Bedwetting may be related to one or more of the following:

  • The child’s bladder holds a smaller than normal amount
  • Genetics (parents who had nocturnal enuresis as a child are more likely to have children with the same concern)
  • Diminished levels of vasopressin (a hormone that reduces urine production at night)
  • The mechanism for the bladder and brain to talk to each other is “off line”
  • Underlying medical/emotional concerns (i.e. diabetes, urinary tract infection, ADHD, etc)

When does a child achieve dryness at night?

Typically, children will learn to stay dry during the daytime first, then they will achieve night time dryness. This whole process generally can take up age 4-5.

When is bedwetting a concern? 

Typically, when ...

Q13 Interview with Dr. Jennifer Jaucian, Issaquah OBGYN

Swedish’s Dr. Jennifer Jaucian, an OBGYN physician serving patients at the Issaquah hospital campus, spoke with Q13’s Tina Patel on Friday, Oct. 4 to talk about how much weight expecting mothers should gain during pregnancy.

The interview came after a new study shows that expecting mothers who gain more weight than is recommended have an increased risk of having overweight children.

Dr. Jaucian advised women to understand how much weight they should gain during pregnancy based on their body mass index, to work with their doctors to track their weight through each trimester and ideally to reach an ideal weight before becoming pregnant.

Watch Dr. Jaucian’s Q13 interview here.

Tips for reducing hot flashes for women with breast cancer

Hot flashes are the most common complaint from women going through menopause. And for women who are breast cancer patients, the problem is often more acute. Surgery, chemotherapy and estrogen blocking medications can bring on hot flashes or make them worse if you already have them. And for women who must discontinue hormone replacement therapy, the instant onset of hot flashes and night sweats can severely impact quality of life.

Fortunately, there are several strategies you can easily and safely employ to decrease the severity and frequency of hot flashes and night sweats. Everything I recommend here is non-estrogenic so while it is generally safe for breast cancer patients and survivors, you should always check with your oncologist before trying any new supplement.

First, a few notes on diet. I recently had a patient who stopped eating refined sugars for general health reasons, and her hot flashes nearly disappeared. Your mileage may vary on this one but there are clear health benefits from lowering sugar intake, so it may be worth a try. You might also try ...

Feeding Tips for Picky Eaters

It is important that children develop healthy eating habits early in life. Here are some ways to help your child eat well and to make meal times easier.

What to Expect:

  • After the first year of life, growth slows down, and your child's appetite may change.
  • It's normal for your child to eat more on some days and very little on other days.
  • A child may refuse to eat in order to have some control in his life.
  • A child may be happy to sit at the table for 15 to 20 minutes and no longer.
  • A child may want to eat the same food over and over again.

How can I encourage my child to eat more?

  • Set regular meal and snack times. Avoid feeding your child in between these times, so that they are hungry at meal and snack times. If you want your child to eat dinner at the same time you do, try to time his snack-meals so that they are at least two hours before dinner.
  • Limit juice and milk between meals. Offer water between meals, which will satisfy thirst without spoiling the appetite. Serve drinks at the end of the meal.
  • Respect tiny tummies. Keep portion sizes small. Here's a rule of thumb – or, rather, of hand. A young child's stomach is approximately the size of his fist. A good serving size for a young child is 1/2 slice of bread, 1 oz of meat, or 1/4 cup of fruit or vegetable pieces.
  • Respect changing appetites. Offer ...

Swedish Digestive Health Network – call 1-855-411-MYGI (6944)

In the fall of 2011, Swedish opened the largest, most advanced endoscopy center in the Pacific Northwest. This state-of-the-art unit serves as the procedural space for a broad range of minimally invasive cases performed by gastroenterologists, colorectal specialists, thoracic and bariatric surgeons and pulmonologists on patients with a broad range of digestive and respiratory diseases.  As we celebrated this accomplishment, we were reminded of the complexity of digestive disease and that many times, patients and possibly even referring physicians aren’t sure of what type of specialist is best suited to a particular digestive problem.

There is nothing more distressing as a health care professional than hearing patient horror stories about trying to access care. A chronic illness can cause depression and discouragement; an acute illness or a cancer diagnosis can overwhelm the patient and the patient’s family with plenty of unknowns. 

To address these challenges, a group of 50+ specialists came together and created the Swedish Digestive Health Network.

The Swedish Digestive Health Network focuses on collaboration to ease the way for ...

Swedish's Dr. Reisner Elected President of State Medical Association

Swedish Medical Center’s Dr. Dale Reisner, MD, has been elected the new president of the Washington State Medical Association. The WSMA represents physicians, residents, medical students, and physician-assistants throughout the state.

Dr. Reisner is medical director of Obstetrical Quality and Patient Safety at Swedish in Seattle and is a maternal fetal medicine specialist. She is one of the regional experts in the management of neonatal alloimmune thrombocytopenia, and also has extensive experience in the management of connective tissue disease and autoimmune disorders in pregnancy.

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