The correct diagnosis is the first step toward successful treatment.

“We have made little progress over the past 10 years in properly diagnosing patients with migraines,” says Sylvia Awadalla, MD, a Washington University neurologist at Barnes-Jewish Hospital. The fact that there is no definitive test for migraine is a large factor. Incorrect self-diagnosis and failure to seek treatment is another issue. “Many people who diagnose themselves with tension or sinus headaches are incorrect,” Dr. Awadalla says. “Those headaches can be undiagnosed migraine.”

Dr. Awadalla advises that anyone having headaches which interfere with the ability to function at home or at work, frequent headaches and those with neurological symptoms such as numbness, weakness, visual changes or speech problems should seek the attention of a medical professional.

After diagnosis, patients and the physicians can work together to find the triggers and the treatment.

Most migraine treatment begins with the search for the triggers that set off the headache. Triggers can range from the controllable, such as food choices and sleep cycles, to the unpredictable, such as barometric pressure changes and stress. Dr. Awadalla recommends people who suffer from chronic headaches keep a daily journal of their meals and activities to share with their doctors.

“If we can identify a trigger and figure out a way to remove that trigger from a person’s environment, we can improve their quality of life immensely,” says Dr. Awadalla. “Certainly there are some factors we cannot control, like changes in the weather or someone wearing a strong perfume in a public place. But even understanding that these are triggers can help us understand the patient’s headaches better and develop a customized treatment plan.”

Some patients respond well to pain medication designed to stop a headache in its early stages. Several over-the-counter pain medicines are branded for migraine sufferers, and prescription options are also available. When these drugs aren’t effective, patients may benefit from long-term preventive medications. Non-medical interventions such as relaxation techniques and exercise routines have also helped with pain relief and headache prevention for some patients.

Dr. Awadalla hopes that headache sufferers will remain positive and not give up in their search for the best treatment methods. “Family and friends who do not suffer with headaches often do not understand the struggle,” she says.  “But knowledge is power. Empowering ourselves often renders us hopeful and realistic about what can be done.”

Resources:

• American Headache Society
• National Headache Foundation
• American Headache and Migraine Association

One in every two men will have some form of heart disease. In fact, it is the leading cause of death in both men and women in the United States, but it is the most preventable.

Typically, people associate men with high cholesterol and coronary artery disease; however, there are other heart conditions that men should be aware of such as arrhythmias, heart failure, congenital heart disease, pericardial disease, heart muscle disease, heart valve disease, vascular disease and coronary artery disease. The key to all of these conditions is prevention.

To better protect your heart and prevent heart disease, you must first understand your family history and risk factors. Discuss these with your primary care physician and understand what lifestyle modifications or treatment options may work best for you. The earlier you see your doctor, the better as some studies find the plaque build-up in your arteries can begin at the age of 2. Continue to see your doctor annually, or as directed.

Cholesterol checks are also recommended every 5 years, beginning at the age of 20. A small sample of blood will be drawn from your arm and will be analyzed by a laboratory. You must work to prevent the progression or development of heart disease. Become an active member of your care by eating right, not smoking and living a more active and healthy lifestyle.

It is very important for men to understand that their health is in their hands. Starting early and living a healthy life style will add valuable years to your life.

Your Disease Risk is a simple assessment tool developed by Washington University experts to help determine your risk of developing disease. Once you’ve completed the questionnaire, you will find information about your risk factors and health.

Learn more about the Washington University and Barnes-Jewish Heart & Vascular Center.

A recent conversation with Arnold Bullock, MD, a Washington University urologist at Barnes-Jewish Hospital, reveals that ED is both common and treatable. Here are Dr. Bullock’s answers to some frequently asked questions about what we know is a rather sensitive topic.

Exactly what is ED?
Erectile dysfunction is defined as the consistent inability to achieve an erection that allows for satisfactory intercourse. Note the use of the word “consistent.” If a man is unable to achieve an erection on occasion (2 out of 10 attempts), he may be experiencing stress or has had one too many glasses of wine, but this is not ED.

In general, who gets ED?
ED is most often the symptom of an underlying problem. Fifty-two percent of all men over the age of 40 have some degree of ED. It is most commonly experienced by men with diabetes, vascular disease (a problem with blood flow), neurological disease or pelvic-level surgery. Two-thirds of men with diabetes or hypertension have ED. Men who smoke double their risk of ED. Quite often, men who experience a heart attack or stroke had ED in the years preceding the episode.

How is ED treated? Is it curable?
It’s important to note that just one out of five men talk to a doctor about their ED. That is unfortunate because the condition is treatable and is often a symptom of a more serious problem. For some men, treatment of the underlying condition can result in improved erections.

Though a patient may be referred to another doctor for management of hypertension, diabetes, a vascular problem or other causes of the condition, ED treatment can begin at the first doctor visit.

The first line of treatment for ED is an oral medication—Viagra, Cialis or Levitra—that improves blood flow into the penis. The good news is that six out of 10 men with ED are successfully treated with one of these medications. And effective treatment is available for men not helped by medication. A doctor might prescribe a vacuum device, testosterone injections, urethral suppositories, penile surgery or penile implant. Virtually all men with ED can be treated successfully.

In honor of Father’s Day and Men’s Health Week, this week we’re dedicating a series of articles to men—fathers, brothers, sons, uncles and grandfathers—and the health issues important to you. 

Today, we’re looking at men’s health tips from Jeremy Koerber, manager of the BJC WellAware Center.

1. Hey Dads, do you want to have healthy sons and daughters? Make sure you’re modeling healthy eating behaviors and exercise habits. They learn their exercise and eating habits from you.
2. Stop putting off those check-ups. There are a lot of people counting on you.
3. Want to lose the spare tire? Ditch the diet and practice the 85 percent  rule- meaning you are consciously making the best food choices possible 85 percent  of the time. For many men, this will take their nutrition from a subpar to a B+ overnight.
4. No time for exercise? Up the intensity and focus of your workouts. 25 minute interval training at greater intensities may replace 60 minutes of low, slow and boring cardio.
5. Can’t figure out why you’re irritable, cranky and feel horrible? Are you getting at least seven-and-a-half hours of sleep every night? Exercise and nutrition are important, but so is recovery.
6. Take your kids fishing, hiking or biking. It’s important for your mental wellness and family bonding— and one day, they’ll be grown up. Seize the moment, be proactive and make sure you’re the one influencing and shaping who your children will become.
7. Is uncontrolled stress affecting your personal life? Manage your stress or it will manage you. Take a break, lift some weights, get a massage or simply meditate. You’ll perform better at work and will be a happier person at home.

For more information about the BJC WellAware Center, visit our website.

Wiley, a former engineer for the U.S. Navy, is 76. Curtis is 64. They have been together for 23 years. “What we had just worked for us,” Wiley says. “We were both independent people. We didn’t see any need to change it.”

Curtis was equally satisfied with their relationship. Wiley carried the diamond solitaire ring in his briefcase for 21 years.

But last Friday, Wiley received devastating news: the cancer that he had been battling was not responding to treatment. He might only live for a few more weeks.

“He talked to me about proposing for a long time after he got the news,” says Shelbi Kruse, RN. Kruse, a staff nurse on surgery unit 16300, had become a friend of the couple during Wiley’s frequent visits to Barnes-Jewish Hospital over the course of his cancer treatments. “We talked for hours. Marrying her was the only thing he wanted to do.”

Confined to his hospital bed, Wiley asked Curtis to bring him a gray box that he kept in his briefcase. She had no idea that she was bringing him her own engagement ring. “I didn’t even say ‘yes’ at first,” Curtis recalls. “I was just so shocked.”

When Curtis finally accepted, Kruse and her coworkers sprang into action. “I knew we could do it here at the hospital,” Kruse says. “Everyone wanted to make it special. We knew that because of his condition, we didn’t have much time.”

She rallied her resources. Reverend Julie Berger, a Barnes-Jewish Hospital chaplain, agreed to officiate the ceremony in Wiley’s hospital room. David Linehan, MD, the Washington University hepatobiliary surgeon who operated on Wiley, filled out paperwork to expedite the marriage license application. Unit secretary Krystal Fulton arranged for her father, a professional photographer, to come shoot the ceremony and create a wedding album.

Flowers were ordered from the hospital gift shop and the bride had her hair done at the Philip Johnson salon, located in the hospital. Kruse brought her young daughters to act as flower girls. Fulton arranged decorations, draping the walls of Wiley’s room with sheets to hide the hospital machines and brightening up the space with stars and garlands. Team members brought food and drinks, including a wedding cake. One generous employee provided wedding bands for the couple.

Surrounded by two dozen family, friends and staff, Wiley and Curtis wed in room 16342 on Tuesday afternoon.

“All I asked for was to marry her,” Wiley said after the brief ceremony ended. “I never, ever expected anything like this.”

“When you ask for something around here, you’re going to get the best,” Kruse responded.

Rev. Berger says that in her role as a palliative care chaplain, weddings are few and far between. “People tend to think of palliative care as a very sad thing,” she says. “Today proved that the tears really can be happy ones.”

Providing excellent care begins with good communication between the patient and caregiver. In order to convey complex information to each and every patient, the hospital relies on a team of trained medical interpreters.

“Of course we translate Spanish and American Sign Language, but our interpreter network also includes Kizigua, Urdu or even Zo’é. Either by phone or in person, we can provide translation in 104 languages,” says Eva Enoch, supervisor, Interpreter Services. “We provide this service free of charge to the patient and within the last year, we’ve been called upon more than 53,000 times. This is just one more way we ensure each and every patient receives safe and effective care.”

The department also provides cross-cultural consultation for patients and staff and reaches out to the deaf, refugee and immigrant communities providing health screenings and education. If your English is limited or you are speech or hearing impaired, please ask your provider or nurse to contact interpreter services to arrange for an interpreter to assist you during your stay.

Learn more about Barnes-Jewish’s interpreter services on our website.

Gerald Andriole, MD, a Washington University urologist at Barnes-Jewish Hospital, recommends a risk-adjusted approach to PSA testing for prostate cancer.

In honor of Father’s Day and Men’s Health Week, this week we’re dedicating a series of articles to men—father’s, brothers, sons, uncles and grandfathers—and the health issues important to you. Today, we’re looking at prostate health and the PSA, or prostate-specific antigen, test.

Who needs a PSA test? And when?

Recent news reports have called attention to the issues of prostate cancer and the role the PSA test plays in discovering cancer and calling for treatment. One of our experts in this field, Gerald Andriole, MD, is a urologist and the chief of urologic surgery at the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. He recommends that men take a “risk-adjusted screening” approach to the PSA test.

What is risk-adjusted PSA screening?

Andriole says, “Risk-adjusted screening means making sure men at the highest risk for developing prostate cancer receive regular PSA tests. For the rest of men—the majority—it means getting a baseline PSA test around the age of 45 and then getting screenings every five to 10  years thereafter, according to the rate at which their PSA rises.”

What groups of men are at the highest risk for prostate cancer?

High-risk groups include:

• African-American men
• Men with two or more first-degree relatives with prostate cancer, especially if they were diagnosed at age 60 or younger
• Men in their 40s who have high PSA scores

Andrew Bullock, MD, a urologist at the Siteman Cancer Center, says, “Rates of prostate cancer in African-American men are twice as high as those in other American men.” He continues, “It is very important for African-American men to get their first PSA test between ages 40 and 45. If those results are within acceptable ranges, then at age 50 they should begin getting PSA screenings annually. Men in the other high-risk categories should consider following the same course of screening.”

Is the PSA test harmful?

The PSA test itself is not harmful, but the actions a man may take after receiving test results that indicate high PSA levels sometimes are. A man with an elevated PSA level may decide to have a biopsy and, if cancer is discovered, that may lead to surgery or radiation treatment, which can result in serious adverse side effects like impotence and incontinence. Andriole and colleagues recommend active surveillance for men diagnosed with prostate cancer.

What is active surveillance?

An increasing number of men are taking this option when a biopsy shows a small amount of cancer in the prostate and microscopic examination indicates it has a low chance of growing aggressively.  Instead of opting immediately for surgery, these men and their physicians are taking a wait-and-watch approach. Andriole says, “For these patients, we repeat PSA testing every three to six months. If there is no change or it rises only slowly, we do another biopsy in a year’s time. If the cancer has worsened, then we can begin discussing treatment options.”

It was an event to offer Jewish Hospital alumni a chance to reminisce about the great care and training provided within the walls of the hospital founded in 1902. About 250 people, including many former nursing students and hospital staff, enjoyed a reunion-type atmosphere, hors d’oeuvres and a healthy helping of hugs.

In his remarks, Rich Liekweg, Barnes-Jewish president, thanked attendees for honoring the past and looking to the future as the hospital begins the first phase of campus renewal. “I recognize this is a bittersweet moment for many of you who began your career at Jewish Hospital or attended nursing school at the Jewish College of Nursing,” he said. “While we understand we must update our facility, we want to pause and remember the people who cared for the patients here — the doctors, nurses and support staff who made this a special place.”

Former Jewish Hospital board chairman John Dubinsky put the hospital in historical and cultural context. “The mission of the Jewish Hospital was to ‘afford medical and surgical care and nursing to sick or disabled persons of any creed or nationality’ – and we are still living the mission at Barnes-Jewish,” he said. “At a time when Jewish patients and Jewish doctors could not receive care or become educated at other hospitals, Jewish Hospital opened its doors to all.  That is a tremendous legacy that still lives today at Barnes-Jewish Hospital.”

During the celebration, the below slideshow was played for attendees.

Jewish Hospital Memories from BJH Communications on Vimeo.

Nurses will be honored at a gala dinner Nov. 9 at the Chase Park Plaza in St. Louis. The purpose of the event is to raise the public’s awareness of and interest in the diverse and rewarding careers available to registered nurses. From emergency care to education and advance practice, these awards recognize the contribution that registered nurses are making in Missouri and help fund the mission of the March of Dimes to improve the health of babies.

Say thank you to the thousands of nurses who provide excellent care to our patients. Nominations are due by June 30. Complete details and nomination forms (due June 30) can be found online here.

It’s truly a team effort when it comes to providing the very best care for patients who are critically injured. We’re taking a look inside the daily lives of some of our trauma team members. Today, we’re following Megan Wojick, RN, CEN, a trauma nurse specialist at Barnes-Jewish Hospital.

The Barnes-Jewish Hospital Charles F. Knight Emergency and Trauma Center, designed to take care of the sickest patients, is one of the busiest trauma centers in Missouri. Last year, it recorded about 12,000 trauma patient visits, resulting in more than 2,500 trauma patient admissions to the hospital. About half of the patients seen at the Barnes-Jewish Trauma Center are transferred from other hospitals.

Our trauma program is only one of four in Missouri that has earned the distinction of Level I verification from the American College of Surgeons. This is the highest national recognition possible. The Trauma Center is also designated Level I by the states of Missouri and Illinois.

At the Trauma Center, everything from trauma and spine surgeons to the highest quality available in interventional radiology and imaging are accessible 24 hours a day, seven days a week.

Trauma nurse specialists are integral to the trauma team’s ability to care for the critically injured. We’d like you to meet one of them—Megan Wojick, RN, CEN, TNS.

Please click on a thumbnail to bring up the larger image. Then use the ‘next’ and ‘prev’ buttons to scroll through more pictures.

   

   

While waiting for the CT scan, Wojick and Dimitri Sioumcas, RRT, a Washington University respiratory therapist at Barnes-Jewish Hospital, review information that will help them to develop the patient’s care plan. When the scan is complete, Wojick, Sioumcas and their patient head back to the trauma room.