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.
Butter Crunch or Chocolate Chip
• First 1 with coupon • SAVE up to $140
LNWI on» tw pn coupon Toe coupon p r custoffie Coupon oM 11 W Ihr«
--------- Jt your
i>»pon
skew's
sto»«
nr pf MiNor • nwatp- jnd S * Was^r gt
« yow
Onpon
Mimv
stom
« A
%
V >7 COUWh fJMWlOT K downe
000000089593
Visit Safew ays Web site at
Thompson Seedless Grapes
http://www.safeway.com
• Imported from Chile
i
• SAVE up to $1.10lb.
Price* I »tec It» * Weitnenetay M m cli I f . Zi
thru Tiipsrt.ty M.errh 7 5 . M u ln iq h t
N obody does
it
B etter ’ for L ess
I
I