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About Portland observer. (Portland, Or.) 1970-current | View Entire Issue (March 19, 1997)
ß *4" • « ** »".3 - - , *v P age A4 t* I J 1 M arch 19, 1997 • Tm P ortland O bserver ■■■MB Children’s Health Fair Kinder heart surgery With four different minimally invasive surgical techniques at their disposal, Cleveland Clinic cardiac surgeons provide the most com prehensive options for patients re quiring coronary artery bypass or heart valve surgery. In 1996, 7 percent o f the heart surgeries performed at The Cleve land Clinic Heart Center — one o f the highest volume cardiac surgery centers in the country — were per formed via3-inch incisions, in what is generally referred to as “mini mally invasive heart surg ery .” Delos M. Cosgrove, M.D., chair man o f The Clinic’s Department of Thoracic and Cardiovascular Sur gery, said that percentage will cer tainly increase this year and be yond. “Minimally invasive techniques obviously will play a significant role in cardiac surgery for years to come,” said Dr. Cosgrove. “ Pa tients need to be aware, however, that there is no single minimally invasive technique applicable to all cases. Instead, there is a myriad o f technology available, depend ing on the type and progression o f the patient’s heart disease. With the breadth of experience and avail ability o f new techniques here at The Clinic, our strength is the abil ity to provide individual patients with the most appropriate surgery for their condition.” Minimally invasive heart sur gery is performed without opening the chest, as in conventional open- heart surgery. Instead o f an inci sion down the center o f the chest and through the breastbone, mini mally invasive surgery usually is performed through a 3-inch inci sion. Because of the size o f the incision, the new technique may result in fewer complications, less pain after surgery, quicker recov ery time, smaller scars and lower cost. The techniques fall into two gen eral categories — those performed on beating hearts and those during which the heart is stopped. Within those categories, there are differ ent methods and instrumentation available. The Cleveland Clinic is cur rently working with two devices for minimally invasive coronary artery bypasses on beating hearts — the Medtronic Octopus(TM) device and C a rd io T h o ra c ic S y ste m s Inc. MIDCAB(TM) system. The Octo pus and MIDCAB systems hold a small area o f the beating heart mo tionless so the surgeon can place the sutures with precision MIDCAB stabilizes the area with pressure on either side o f the artery to be by passed, while Octopus uses small suction cups to lift and immobilize a portion o f the heart. T hese proce dures eliminate the need to stop the heart and route the blood through a heart/lung machine, as is done dur ing standard open-chest cardiac sur gery. “ Since the heart is not stopped and the need for anti-clotting agents is lessened, the recovery time from minimally invasive surgery on a beating heart is believed to be even less than recovery following other minimally invasivetechniques,” said Nicholas Smedira. M.D., the heart surgeon who is working with the O ctopus and MIDCAB systems. “ But these techniques currently can be used only for single- and double vessel bypasses on the anterior side o f the heart, and, from a technical standpoint, they are more difficult to perform.” For minimally invasive bypass surgery on non-beating hearts. The C lin ic is using H eartport Port Access(TM). With the Heartport system, surgeons stop the heart and attach the patient to the heart/lung m ach in e through a sm all tube (cannula) that is inserted in the femo ral artery and guided to the heart. “Obviously, if the heart is not beating, it is easier to work with,” said Joseph Sabik, M.D., the heart surgeon using Heartport. “ For ex ample, it allows us to do two or more grafts, and it can be used for by passes on the back o f the heart.” Finally, there’s the minimally invasive procedure developed by Dr. Cosgrove more than a year ago for heart valve repair or replacement. Since performing the first minimally invasive aortic valve surgery at The Cleveland Clinic in January 1996, Dr. Cosgrove has performed nearly 300 minimally invasive procedures involving the mitral and aortic valves using this technique. Dr. Cosgrove's procedure involves one 3-inch incision — horizontal for aortic valve surgery and vertical for the mitral valve through which he connects the patient to the heart/ lung machine and performs the surgery. “ We have the greatest experi ence with this procedure,” said Dr. Cosgrove, "and the first-year data has been clear: the procedure is safe, patients are leaving the hospi tal sooner and direct hospital costs are reduced." Still, Dr. Cosgrove cautioned, “Minimally invasive sur gery is not a panacea. Often, par ticularly with complex cases, the traditional open-chest surgery re mains the best option. It is clear that we are experiencing a major change in cardiac surgery which will reduce surgical trauma. These techniques and others will be in creasingly applied.” The Cleveland Clinic Founda tion continues to advance the fron tiers o f medicine by providing state- of-the-art care in a multispecialty academic medical center model. Since its founding in 1921, clinical and hospital care have been inte grated with research and education in a private, non-profit group prac tice which has distinguished the C leveland C linic in A m erican medicine. T oday at The Cleveland C lin ic and C le v e la n d C lin ic Florida, over 850 full-time salaried physicians represent more than 100 m e d ic a l s p e c ia ltie s and subspecialties. Every year, the Cleveland Clinic and Cleveland Clinic Florida provide for more than 1.182,300 outpatient visits and 49,987 hospital admissions from throughout the United States and m orethan80countries. TheCleve- land Clinic Health System com prises The Cleveland Clinic Foun dation, Fairview Health System, L akew o o d H o sp ita l and Marymount Hospital. This not- for-profit health system will pro vide broad geographic coverage, a full continuum o f care, improved quality and lower cost o f care to residents o f Northeast Ohio. The 3rd a n n u a l N o rth e a st Children’s Health Fair will be held on Saturday, April 12, 1997 at the L utheran Community Center. Sponsored by the M ultnom ah Dental Society, in association with OHSU and the Multnomah County Health Services, the Fair will offer tree developmental screenings, den tal screenings, eye and hearing tests, immunizations, lead testing, and other services. Volunteers will be on hand to answer questions about O r egon Health Plan eligibility, com munity health services, poison con trol, and nutrition. Entertainment for the event will include internationally known ma gicians W eiss and Patricia and Portland's own S h rm ers Clowns. Prizes, face painting, and snacks will also be provided. The goal ofthe Children’s Health Fair is to provide a healthy, fun, and informative day for the whole family. The Lutheran Community Cen ter is located at 4219 NE Martin L u th er K ing Blvd. (M LK and Skidmore). Hours will be from 10:00 am to 4:00pm. For additional information please contact Kathy Smith at the Mult nomah Dental Society at 223-4738. Kaiser Permanente expands Community Choices 2010 has received a contribution from Kaiser Permanente for $50,000 for each o f the next two years. T his is the third c o n se c u tiv e y e a r th a t K a ise r Permanente has provided CC 2010 with financial support, CC 2010 will direct the funding toward general operations. Involved since CC 2010’s estab lishment in 1995, Kaiser Permanente has been an instrumental partner in guiding and implementing CC 2010- sponsored initiatives. In addition to funding support, the health mainte nance organization has provided lead ership and expertise. Allan Weiland, MD, Medical Director o f Kaiser Pennanente’s Northwest Division and a Clark County resident, serves on the CC 2010 Steering Council. “ P eople's individual health is better when they can live in a vi brant, healthy community. T hat’s why Kaiser Permanente feels it’s so important to support Community Choices 2010," he said. “ Kaiser Perm anente’s roots in Clark County go back more than half a century. As a long-time corporate member o f this area, we are committed to help Clark County residents build a bet ter community in which to live, work, and raise a family.” Other Kaiser Permanente execu tives and physicians serve on vari ous CC 2010 committees and the HMO actively encourages its em ployees to volunteer with CC 2010. "This grant demonstrates Kaiser Perm anente's strong commitment to creatinga healthy comm unity here in C lark C o u n ty ,” said L ynne Conner, CC 2010 executive direc tor. “ Their partnership across so many aspects o f CC 2010 has pro vided the impetus for broad-based community involvement with our organization.” Community Choices 2010 strives to foster positive behaviors and ac tions that enhance Clark County’s physical, social, economic, and en vironmental health. Central to all CC 2 0 10 program strategies are part nerships with community sources such as Kaiser Permanente, as well as addressing issues early on, before they become larger problems. CC 2010 is an affiliate o f the Greater Vancouver Chamber o f Commerce. For more inform ation about CC 2010, phone (360) 694-2588. Working parents lose out in M arian W kigii i E deim an At the end o f each month, Tom and Michelle Lancaster would gather up all the new medical bills that poured into their Vestaburg. PA. home and tuck them into a quiet rom er o f the living room. “All I can do is stick those bills somewhere out o f the w ay,” said Michelle, who. along with her hus band Tom, is struggling to make ends meet and yet makes too much to qualify for Medicaid for themselves and their three daughters. “ I just got two bills in the mail for over $1,000. I really want to pay them, but I can't do anything about them right now. My kids have to be fed, we have to have heat in the house, and we can’t do without electricity.” A lthough M ichelle w orks fu ll time and Tom w orks 20 hours a w eek-he goes to technical school for an o th er 20 hours-n eith er is provided health insurance through their jobs. T heir m ortgage costs $ I 84 a m onth, and their m onthly grocery bill is over $100. They no longer have a car paym ent be cause their car was recently repos se sse d . T o g e th e r, th ey earn ed $15,000 last year. The Lancasters’ middle daugh ter. Candi, age 9, has asthma and other medical complications, which cost $300 a month to treat. And all three children and both parents have caught the flu several times this winter and visited doctors. In addi tion, Michelle broke her arm and l oin had to get extensive tests to see if he had a blood clot in his lungs. They are still waiting for the results o f his exams—and the latest stack o f medical bills. “A lot o f people forego doctor visits for their kids because they can’t afford it,” said Michelle, who suffers from asthmatoo. “ But I would never do that to my kids. If they get sick, we go to the doctor, they bill me, and we do the best we can to pay. I can only give what I have.” T he good new s, is th at the Lancasters were notified just days after the original interview for this column that they now qualify for a special Pennsylvania health insur ance plan that will cover the chil dren The bad news is that there are m illio n s o f o th e r p a r e n ts in A m erica who work hard every day to provide for their fam ilies and still earn too little to afford private health insurance and too much to qualify for M edicaid—and there is no special state plan to rescue their fam ilies. STOCK-UP SAVINGS & SAFEWAY FOOD & DRUG SAFEWAY COUPON EXPIRES 3/P5W PtU 8959 Snow Star Ice Cream Fresh Whole Oregon Fryers Ovenjoy Bread • or Cut-Up Economy Pack • First 4 • Additional at regular price • Washington Fryers sold in Washington • SAVE up to 500 lb. 22.5-oz. • Wheat or White »First 3 SAVE up to $1.55 on three • Hall gallon • Vanilla. Chocolate Neapolitan. 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