FroedtertFroedtert

A Publication of Froedtert & Medical College of WisconsinApril 2005 V10.1

ALSO

• Surviving Menopause

• Battling Male Infertility

• New CardiacSecond Opinion

Program

Everything You AlwaysWanted to Know About

SLEEPDISORDERSBut Were Too Tired to Ask

2 April 2005

Quality InitiativesHealthcare Heroes and More

From the Science EditorResQ-Valve: Improving Heart Attack Survival

FEATURE STORY DYING FORA GOOD NIGHT’S SLEEPGroundbreaking Procedures for Sleep Disorders

FEATURE STORY A CHANGE FORTHE BETTERHelpingWomen Stay Healthy in Life's Second Act

Exceptional Staff ROBYNWITTENBERG, RN & DOBIE GILES, MDNurse and resident earn respect of patients, peers

Empowered ConsumerCardiac Second Opinion Program

Empowered ConsumerResources at Small Stones

April 2005 Volume 10.1

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Froedtert TODAY C O N T E N T S

DesignedThrough theEyes of Our Patients –A New Cancer CenterWilliam D. PetasnickPresident and CEO, Froedtert Hospital

This spring, Froedtert Hospital began work onan important expansion of the Froedtert &Medical College of Wisconsin Cancer Center –a carefully designed plan that will enhance ourunique approach to cancer services.

The new Cancer Center will build on a longtradition of outstanding cancer diagnosis,treatment and research, with 12 disease-specificcancer programs covering all types of cancer – from the morecommon breast and prostate cancers to complex or rare cancers,such as lung or brain tumors.

Our new Cancer Center will offer a patient-centered design toaccommodate an evolution toward outpatient services in cancer caredelivery. Designed through the eyes of our patients and the specialistswho care for them, the new Cancer Center will create a clinical andsupport “hub” around each patient. Treatment and follow-up visits,clinical trials, and support services – including dietitians, socialworkers, psychologists, chaplains and more – will be easily accessibleright in the Cancer Center. Parking will be convenient too, withmore than 500 spaces under the building.

The new facility will also enhance space to accommodate the importantwork being done by Medical College of Wisconsin researchersthrough clinical trials and other research – work that ultimately leadsto treatments with more cancer cure potential.

We have planned carefully, so cancer patients can be assured thatduring construction, their care will proceed as smoothly as always.The new Cancer Center will be completed in 2007.

If you would like to learn more, I invite you to call us with questionsat 414-805-3666 or 800-272-3666. You may also visit us atfroedtert.com for more details and to read about cancer survivors whohave already experienced the patient-centered services of theFroedtert & Medical College ofWisconsin Cancer Center.

April 2005 v 10.1

FROEDTERT HOSPITAL PRESIDENT/CEO

William D. Petasnick

EDITOR

Tamara Kroll

CONTRIBUTORS

Tom P. Aufderheide, MDVanessa Barnabei, MDHumberto Battistini, MD

Rose Franco, MDDobie Giles, MD

Ahmad Nasef, RPSGTRonald G. Pirrallo, MDJay Sandlow, MD

Marlys Swanson, RN, BSNRobyn Wittenberg, RNB. Tucker Woodson, MD

Froedtert TODAY is published three times each year by FroedtertHospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226–3596.Reproduction in whole or in part without permission is prohibited.Letters to the editor are welcomed. Letters for publication shouldinclude your name, address, and daytime telephone number.

MISSION STATEMENT

Froedtert Hospital will advance the health status of individualsand communities we serve through:

• High-quality patient care• Teaching the next generation of health professionals• Advancing scientific discovery and technology

FROEDTERT & MEDICAL COLLEGE HEALTH SERVICES LINE

Patient appointments, information, and communityeducation registration: 414–805–3666 or 800–272–3666(outside Milwaukee).

SMALL STONES: A HEALTH RESOURCE CENTER

Nurse educators, books, videos, unique health products,screenings, and more. Memberships available. Call414–805–6520 or visit us online at smallstones.com

SUBSCRIBE TO FROEDTERT TODAY

To receive your own copy of Froedtert Today, or to be removedfrom our mailing list for the magazine, please send yourrequest to Froedtert Marketing at 9200 W. WisconsinAvenue, Milwaukee, WI 53226–3596. You can also contactus online at froedtert.com, or call our Health Services Line at414–805–3666 or 800–272–3666.

All research and clinical material published by Froedtert & Medical College ofWisconsin in this publication is for informational purposes only. This publication isnot designed to, and does not provide medical advice and is not a substitute for ahealthcare provider’s clinical judgment. Do not disregard professional medicaladvice, or delay seeking it, because of something you have read in this publication.Please consult your own physician with respect to symptoms or medical conditions,as diseases commonly present with variable signs and symptoms. As always, it isthe responsibility of the healthcare provider treating an individual to determine theappropriateness of any given course of treatment in light of that individual'sunique clinical situation and the provider's expertise.

9200 W. Wisconsin Ave.Milwaukee, WI 53226-3596froedtert.com

Froedtert TODAYF ROM THE PR E S I D EN T / C EO

Above: A sleep study can detect anumber of disorders that keep peoplefrom getting a restful night. Duringthe study, sleep clinicians monitorheart rate and other vitals, and canview and track episodes of sleep apneaand other disorders, such as restless legssyndrome.Pictured (left to right):Ahmad Nasef, RPSGT, clinical directorfor the Sleep Lab,Medical College ofWisconsin physicians Rose Franco,MD (pulmonologist) and B.TuckerWoodson,MD (otolaryngologist)discuss a patient's sleep study results.

On the Cover: Sleep disordershave long-term affects on healthand quality of life. Left untreated,common conditions – such as sleepapnea – can even lead to early death.

April 2005 3

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Battling Male InfertilityWhen a couple is having trouble

getting pregnant, many people think theproblem lies with the woman. But that'sa common misconception.In fact, men are just aboutas likely to have problemswith fertility as their femalepartners. It's a health issuethat can cause a great deal ofemotional stress, but thegood new is, there is help.

Jay Sandlow,MD,MedicalCol lege of Wiscons inurologist and vice chairmanof Urology, specializes intreating male infertility. "Two commoncauses of infertility in men are lowsperm production that can come from a

varicocele (dilated veins around thetesticles) – and impaired sperm delivery,which is usually caused by a blockage in the

vas deferens, the duct carryingsperm from the body.We cantreat the varicocele by fixing itsurgically, and most blockagescan be repaired throughsurgery as well. In somecases, abnormal hormoneproduction may be a factor,and this can be addressedmedically."

Dr. Sandlow addsthat certain lifestyle factors

can affect male fertility – such as smokingor street drug use, both of whichinfluence sperm production.

The Froedtert & Medical College ofWisconsin Reproductive Medicine Clinicoffers a wide range of treatment optionsfor male and female infertility, startingwith a thoroughmedical exam and history,followed by a coordinated team approachto plan individualized treatment.

"It's less expensive and less invasiveto do a complete work-up on the man,"Dr. Sandlow says. "So by having the malepartner involved right from the start,we can save a couple time and money."

To learn more about the Froedtert& Medical College of WisconsinReproductive Medicine Program, visitfroedtert.com or call 414-805-3666 or800-272-3666.

ResQ-Valve with CPR May IncreaseSurvival of Heart AttackCardiopulmonary resuscitation, or CPR, is a life-saving

procedure that incorporates timed compressions of thechest wall, alternating with mouth-to-mouth breathing toprovide oxygen to vital organs while stimulating the heart toresume pumping.

If performed within four to six minutes of cardiac arrest,CPR can increase the chances of survival for someone who ishaving a heart attack. But a Medical College of Wisconsinresearch team found performing CPR with a simple devicecalled a ResQ-Valve can double survival rate long enough toadmit heart attack patients to an intensive care unit. Theone-way valve prevents air from entering the lungs on thedecompression phase of CPR, but does not stop ventilation.

"Our findings demonstrate the ResQ-Valve significantlyimproved short-term survival rates for victims of cardiac arrest,"says Tom P. Aufderheide, MD, Medical College ofWisconsinemergency physician. The study, led by Dr. Aufderheide andEmergency Medicine colleague Ronald G. Pirrallo, MD, alsoshowed many more patients survive to get further treatmentin the hospital if CPR included the ResQ-Valve.

Healthcare Heroes!Froedtert & Medical College of

Wisconsin is proud to have outstandingstaff and physicians listed among the SmallBusiness Times' first annual Health CareHeroes program's 18 finalists:

• For corporate achievement in healthcare - Froedtert Hospital

• For community service - Beth Erickson-Wittmann, MD, Medical College ofWisconsin radiationoncologist and James Ninomiya, MD, Medical College ofWisconsin orthopaedic surgeon

• JoAnn Lomax, RN, supervisor, Patient Relations and Mark Schaefer, president,Volunteer ServicesAssociates were also honored for their work at Froedtert.

Read more about Froedtert's "healthcare heroes" at froedtert.com.

A Great Workplace EnvironmentCorporate ReportWisconsin recently recognized Froedtert Hospitalas aWorkplace of Distinction, based on five categories: benefits,facilities, communication, training, and community involvement.If staff members are happy, customers are usually happy too.Read more at froedtert.com.

J.D. Power Recognizes Froedtert HospitalFroedtert Hospital has been recognized for service excellence under the J.D. Power and

Associates Distinguished Hospital Program. Froedtert Hospital is the only hospital inWisconsin thatcurrently holds this distinction,which acknowledges its strong commitment to providing an outstandingpatient experience.

Milwaukee Magazine Names FroedtertOne of "Best Places to Work"

Froedtert Hospital has been selected as one of 10 Large Company Best Places toWork by Milwaukee Magazine.

To be selected for this list, companies were required to undergo an extensive onlinesurvey comprising 500 questions in nine categories, including: salary, training,turnover, benefits, perks, work-life balance, diversity, employee voice and communityinvolvement. All companies were ranked according to the score they received on thefinal survey.

The results of this meticulous selection process were published in the February2005 issue of Milwaukee Magazine.You can also read more at froedtert.com.

QUAL I T Y I N I T I AT I V E S

Froedtert TODAYS C I E NC E ED I TOR

Froedtert TODAY

April 2005 5

Honored for their work at Froedtert, the Small BusinessTimes' 2005Healthcare Heroes

Jay Sandlow,MD

April 2005 76 April 2005

F E ATUR E S TORY

Froedtert TODAY

Proven Techniquesand GroundbreakingProcedures Bring

Long-Awaited Cures toPatients Who Are

DYING FOR AGOOD NIGHT’S

SLEEPMost people know nutrition

and physical activity are essentialto good health. But few understand the

importance of sleep. B. Tucker Woodson, MD,Medical College ofWisconsin otolaryngologist andcertified sleep physician, says proper rest is no sideissue: "Sleep – along with diet and exercise – is partof the 'critical triad' of health."

Dr.Woodson is medical director of the Froedtert& Medical College of Wisconsin Sleep DisordersProgram.The program brings together specialistsin several disciplines to help people overcome arange of debilitating sleep disorders.

Some disorders, like restless legs syndrome, cankeep patients from achieving deep sleep. Manyconditions, like narcolepsy and shift work sleepdisorder, jeopardize daytime safety. All sleepdisorders can negatively impact a person's overallquality of life.And one of the most common sleepproblems – obstructive sleep apnea syndrome –can even lead to early death.

April 2005 9

Beating Up the Heart"The same people who have sleep

apnea also get high blood pressure,diabetes, congestive heart failure andcoronary artery disease," saysRose Franco,MD, Medical College of Wisconsinpulmonologist and the Sleep Disorders

Program fellowshipdirector. Sleep apnea, sheexplains, is a conditionin which the throat closesdown during sleep,causing breathing to stopfor seconds at a time."When the throat closes,it creates negativepressure in the chest,"she says. "This, in turn,

puts tremendous pressure on the heartand lungs." It also causes the body toconsume its store of oxygen, furtherstraining the heart.

"When this happens 30 to 50 timesa night, you are beating up the heart,"says Dr. Franco. "It's like you're runninga marathon – you never give the heart achance to recover."

Heart disease is not the only problem."Evidence suggests that obstructive sleepapnea may heighten a person's risk ofstroke," says Humberto Battistini, MD,Medical College ofWisconsin neurologist.Dr. Battistini, the Sleep DisordersProgram's expert on sleep disordersrelated to neurological diseases such asepilepsy,multiple sclerosis andAlzheimer'sdisease, says screening for sleep apnea isimportant. "We screen patients for riskof sleep apnea and treat them early inhopes of preventing stroke."

A deadly side effect of sleep apnea is anincreased risk of causing a vehicle crash.According to Dr. Franco, people withapnea are three to seven times more likelythan others to be in a crash. In fact, one ofthe warning signs of this disorder is havingone or more near-miss incidents. Othersigns include tossing and turning in bed,persistent daytime grogginess, chronicgrumpiness and, most of all, snoring.

"Snoring is abnormal," says Dr.Woodson. "In the presence of othersymptoms like high blood pressure, itneeds medical evaluation."

Sick and TiredJeff Boutin, 44, had a snoring

problem for 10 years. "I slept onthe couch almost every night," hesays. "I snored so loudly, my wifehad to send me to another room.My kids could hear me on theother side of the house!"

Boutin, a project manager at atool and die company, lives inWestBend. His wife and children werenot the only ones who sufferedfrom his snoring. "I felt tired allthe time, because I never reallygot deep sleep," he explains. "Ihad a really rough time getting upin the morning, and I often feltdrained at work."

Last year, after living with theproblem for a decade, Boutin learnedfrom a coworker about the SleepDisorders Program at Froedtert &Medical College of Wisconsin. He camein for an initial evaluation with Dr.Woodson and was soon scheduled for asleep study in the program's state-of-the-art clinical sleep laboratory.The six-bed lab is fully accredited.

"We can do any kind of sleep studyhere – apnea, abnormal movement,teeth grinding, seizure studies," saysAhmad Nasef, RPSGT, the lab's clinicaldirector. The entire staff, he notes,focuses on making the patient's staycomfortable and positive.

After a patient arrives around 8p.m., a registered sleep lab technicianexplains the testing procedure, then fitshim or her with a series of monitorleads. "In the lab, most patients fallasleep quickly," says Nasef. During thenight, the technician monitors thepatient's indicators from a controlroom. Apnea patients, who account formost of the studies, are usually wakenedaround 2 a.m. and fitted with a deviceknown as a continuous positive airwaypressure mask (CPAP). This provendevice uses simple air pressure to keep

the patient's throat open. Beginning at alow setting, the technician graduallyincreases the pressure level. "We arelooking for the comfort zone," saysNasef, "the point where the patient isachieving deep sleep with no breathingevents or arousals."

Sleep specialists say CPAPs help upto 90% of patients with sleep apnea.The relief can be dramatic. In fact,according to Dr. Franco, using a CPAPcuts the incidence of car crashes amongsleep apnea patients to below thenational average. Still, while CPAPs canhelp many patients, they do not workfor everyone.

Boutin says his sleep study showedhe got only 15 minutes of deep sleep allnight. The medical team decided hewas a good candidate for a CPAP.Unfortunately, after three months ofworking with the device, he proved tobe one of the people a CPAP does nothelp. "I always ripped the mask off inmy sleep," he explains. Dr. Woodsonand Boutin agreed his best option wasnow surgery.

Innovative TechniquesDr.Woodson is known internationally

for pioneering work in surgicalapproaches to sleep apnea. He was thefirst surgeon in the United States to treatthe disorder with a tongue suspensionsuture – a simple procedure that helpskeep the tongue base from collapsing

during sleep.Hewas also an early pioneertreating apnea using non-invasiveradiofrequency energy. "The last resorttreatment for patients used to be atracheotomy," says Dr. Woodson."Now, surgical options are more than90% effective."

Boutin's surgery took place in late2004. Dr. Woodson improved thepatient's air flow by reconstructing hisuvula (the small lobe of flesh at the backof the mouth). He also opened up acollapsed nostril by placing a suture inthe bridge of his nose and tying it to atiny screw anchored in the facial bone.

For Boutin, recovery was quick. Hesays he felt the effects of the nostrilprocedure immediately: "When I woke, Iwas shocked at howwell I could breathe."He left the hospital the next day and in ashort time, noticed he was sleeping muchbetter. Soon, his snoring was history.

Research Hits HomeBoutin's successful outcome is due in

part to the Sleep Disorders Program'sUpperAirway Imaging Study, a research

project that helps surgeonsplan and understand howreconstructive procedureswork. "The challenge ofassessing apnea patients is thattheir throat muscles are veryactive when they are awake,"says Dr. Woodson. "Thatmakes it impossible tovisualize the throat anatomy."In the Upper Airway Lab,physicians create a "virtualsleep state" in the patient'st h ro a t u s i ng top i c a lmedications and a ventilator.Th ey t h en u s e MR Itechnology to create a 3Dimage of the airway.

Dr. Franco is conducting research onthe link between sleep apnea and hearthealth. She is investigating "inflammatorymediators," substances that are elevatedin the blood of apnea patients and linkedto a higher risk of coronary artery disease.The subject hits home for Boutin. Hisfather died from heart disease at age 59.

Dr. Woodson says the program'sresearch focus translates directly into ahigher level of care: "When you areinvolved in cutting-edge research, yousee patients with disorders all across thespectrum." Patients – whether theysuffer from insomnia, neurologicalissues like narcolepsy, or the increasinglyrecognized problem of restless legssyndrome – also benefit from theprogram's multidisciplinary approach.

"Patients can benefit from thecompounded knowledge of severalspecialists," says Dr. Franco. "Here, apatient receives a diagnosis and getscomplete treatment – therapy, counseling,curative procedures – all under one roof."

Dramatic DifferenceThese days, just months after his

surgery, Jeff Boutin's life has changeddramatically. "I sleep great," he says."I wake up at 6 or 6:30 a.m. and feelrefreshed." He reports having muchmore energy. "I am a lot more active.I work out at a health club every day."

Boutin says taking care of his sleepdisorder improved his quality of life allthe way around. "It sure beats beingtired all the time – I didn't realize whata difference it would make."

Rose Franco, MD

Various surgical options are now more than 90% effective in treatingsleep apnea.

Sleep studies can detect apnea, abnormal movement,teeth grinding and seizures – all of which can add up toa restless night. (Pictured here: B.TuckerWoodson,MD.)

Humberto Battistini, MD treats sleep disorders related toneurological diseases, including narcolepsy and Alzheimer's.Early treatment of disorders such as sleep apnea can preventa stroke.

Sleep Lab clinical director Ahmad Nasef, RPSGT, demonstrates acontinuous positive airway pressure mask used to resolve sleepapnea.The CPAP helps up to 90% of people who have sleep apnea.

8 April 2005

10 April 2005

Every woman goes through it; yet, it is a unique individualexperience.And although it's a natural part of life, it leaves manywomen feeling baffled and concerned.The "it," of course, ismenopause.Technically, menopause is the time in a woman'slife when she has her last menstrual period. In reality, it's atime marked by physical, mental and emotional changes thatcan span years as a woman makes the transition to midlife.

A host o f booksand websites discussmenopause, but manywomen find they needto talk through midlifechanges with others.Thatwas the case for ChrisBadano. She turned to alogical source for advice –her mother. "My momdidn't remember," saysBadano. "She said it wassomething that wasn'ttalked about back then."Soon after,Badano learnedof a new program throughher workplace intranet."It caught my eye becauseit mentioned midlifewomen," she explains.

The Froedtert & Medical College of Wisconsin TotalHealth for MidlifeWomen Program was designed for womenbetween the ages of 40 and 60 to help them better understandthe changes they are experiencing. It encourages them to takea proactive role in their health by focusing on prevention,wellness, health risks and education. A knowledgeable nursespecialist takes time to listen, obtains a full health history andconducts a series of assessments that address perimenopausaland menopausal symptoms, as well as serious disease andother health issues. "We want the program to be an enhance-ment to the care provided by a woman's own doctor," saysMarlys Swanson, RN, BSN, nurse specialist for the program."Women can sit in a quiet, private and unhurried setting totalk and ask questions."

The program was developed in 2003 by a team of MedicalCollege of Wisconsin health care providers and administratorsled by Vanessa Barnabei, MD, PhD, Medical College ofWisconsin obstetrician/gynecologist and the program's medicaldirector. "In the first group of women to go through the program,we found their main concerns – along with changes they wereexperiencing – were weight and stress management," says Dr.

Barnabei. "We addressthose issues, but also makewomen aware of risksfor other health issues,such as osteoporosis andcardiovascular disease."

Badano admits she wasunaware of a woman's riskfor heart disease. "I wentto Total Health becauseof problems with hotflashes and mood swings.But I learned somethingI didn't know – heartdisease is the number onekiller of women," saysBadano. Swanson agreesthere is a great need toeducate women aboutheart disease. "Compared

to men, women are at a greater risk for having a heart attack,are more likely to die from a first heart attack and are morelikely to have a second heart attack within that first year. Anda woman's risk increases when she goes into menopause."

The program's comprehensive assessment also addressesosteoporosis. "That's a big one, too," Swanson adds. "I've metmany women who had no idea their calcium intake was too lowto maintain bone health."According to Dr. Barnabei, osteoporosiscan be life threatening. "Many women don't realize a hip fracturecan significantly impact quantity and quality of life.The rate ofdeath in the year following a hip fracture for an elderly woman is50 percent. Up to one half of women will have a significantfracture in their lifetime,which can lead to a chronic disability."

F E ATUR E S TORY

Froedtert TODAY Women should work with theirdoctors to screen for signs of early boneloss and pursue ways to prevent furtherbone loss. Lifestyle changes can help,and medications can slow down or evenreverse bone loss. All women need anadequate calcium intake – about 1,200 to1,500 milligrams a day – and may needto take supplements, although it is idealto get calcium in foods and beverages.

Wi th t he i n f o rmat i on andencouragement Swanson provided,Badano made lifestyle changes thataddressed her physical and emotionalsymptoms, as well as her risk for heartand other diseases. She quit smoking,developed coping skills for dealing witheveryday stress, improved her diet andexercises more.Additionally, she followsSwanson's advice to receive regularmedical exams and screenings, such asmammograms and cholesterol tests.

Badano also found ways to deal withhot flashes. Approximately 80 percentof American women experience hotflashes as they approachmenopause and inthe years that follow. But the experienceis different for each, Swanson notes, andshe counsels them to try differentapproaches."Dressing in layers and naturalfibers like cotton, keeping the room cool,sipping cold water or doing deepabdominal breathing at the start of a hotflash helps some women," she says.There is also relief in over-the-counterremedies such as vitamin E, blackcohosh and soy, or by avoiding known

triggers, such as spicy foods.When hotflashes significantly affect quality of life,women need to discuss it with theirdoctors and may want to considerprescription medication.

In addition to the one-on-one adviceshe received, the Total Health Programintroduced Badano to additional sourcesof information. She now regularly visitsSmall Stones, a health resource centerof Froedtert & Medical College ofWisconsin. "The nurse educators atSmall Stones helped me find books ondiet, exercise and heart health, andintroduced me to aromatherapy," shesays. Total Health participants receive afree one-year membership to SmallStones. Badano also attends a menopausesupport group sponsored by Froedtert& Medical College ofWisconsin. Led bySwanson, the group meets once amonth. "It's open to all interestedwomen," Swanson explains. "Sometimeswe invite a speaker to talk about aspecific subject, such as osteoporosis."

An all-female advisory boardcomprised of nurses and physicians from abroad spectrum of medical specialtiesoversees theTotal Health for MidlifeWomen Program. (The advisoryboard includes experts fromprimary care, gynecology, sportsmedicine, surgery, psychiatry,women's health research,pediatrics and patient education.)Julie Mitchell, MD, MedicalCollege ofWisconsin internist,serves on the board and says itsmultidisciplinary team takes acomprehensive approach towomen's health and wellness.

"Midlife is a classic exampleof the interaction of mind,body and spirit.

Women look at their lives and reflect onwhat they've done and where they'regoing," notes Dr.Mitchell, "But it's alsoa time when heart, bone and otherdiseases can become apparent, so it's agood time for women to think aboutlifestyle, take stock in their health and findinformation on how to stay healthy."

Says Badano about her experiencewith the program, "It was wonderful tohave everything explained to me and tobe given options for dealing with it all.It felt so good to find out what I wasfeeling was perfectly normal."

For more information about theTotalHealth for MidlifeWomen Program, call414-805-3666 or 800-272-3666.

A CHANGE FOR THE BETTERHelping Women Stay Healthy in Life's Second Act

Women experiencing the midlife transition find support and empowerment through a monthlysupport group at Froedtert & Medical College of Wisconsin.

Through the Total Health for Midlife Women Program,Chris Badano found a wealth of resources that helpedher make decisions to enhance her health duringmenopause and beyond.

Marlys Swanson, RN, BSN,Nurse Specialist

April 2005 11

OB/GYN Resident's Journey

Not many nurses can say theyactually help couples achievepregnancy and then help themdeliver their bundles of joy.Robyn Wittenberg, RN, can. She splits her time

between the Froedtert & Medical College of WisconsinReproductive Medicine Clinic, where she helps treatfertility issues, and the hospital’s Birth Center.

Wittenberg joined Froedtert & Medical College ofWisconsin almost eight years ago as a new graduateworking full-time in labor and delivery. But severalyears back, she wanted another challenge. Her timingwas impeccable, as the Reproductive Medicine Clinicwas one of the hospital's newest programs.

Working at Froedtert &Medical College ofWisconsin,Wittenberg comments, "helps broaden my knowledgebase a lot. I find continuous learning opportunities,because everything is constantly evolving."

"I enjoy becoming connected with my patients; I havethe chance to know them verywell," she adds. "We spenda lot of time on the phone, talking, counseling, andcomforting. Sometimes, we get to share good news withcouples who have tried to get pregnant for a long time.At other times,we break the bad news. I consider myselflucky to be with them throughout the whole process."

WhatWittenberg particularly relishes about her jobis that it has taught her "more about people: how todraw them out; learn from them; and teach them. I'vefound that people are a lot stronger than they think."

Working at Froedtert &Medical College ofWisconsinis not just a job. "We have a lot of autonomy workinghere,"Wittenberg explains, "and that's part of why I likeit so much. Specialty nurses work closely with physiciansand they respect all the expertise we can offer."

Nurse SpecialistHelps MakeDreams Come True

Before Dobie Giles, MD,Medical College ofWisconsinchief resident of Obstetrics/Gynecology, embarked on hismedical career, he spent many of hisformative years in the hospital: his youngersister was born with several birth defects.

"I later realized that from the day she wasborn, I was drawn to the medical profession,"Dr. Giles says.

He is the first in his family to attend college.

Giles, who hails fromTennessee,wanted toexperience a different part of the country whilepursuing his ambition. "I thought Froedterthad a super program," he said. "And I fell inlove with the place.The surgical experience isvery diverse and extensive;more so as comparedto other hospitals in the country. It is definitelyhelping me become a better surgeon."

As his residency comes to an end,Dr.Gilesreflects on howworking at Froedtert &MedicalCollege of Wisconsin and with patients herehave also made him a better person: "Beinginvolved in our patients' lives makes meappreciate my family and the wonders oflife," he comments. "I get a great deal ofsatisfaction from helping patients get throughthe most difficult, as well as the happiesttimes of their lives."

For the care Dr. Giles has shown hispatients, they in turn express their appreciationthrough holiday cards, pictures of their kids, andlong letters thanking his team "for being quickand responsive" in obstetrical emergencies.

When his journey comes to an end atFroedtert & Medical College of Wisconsin,Dr. Giles will proceed to Louisiana StateUniversity in New Orleans to pursue a three-year urogynecology fellowship. "This programwill help me further improve my surgical skills,specifically in relation to vaginal reconstructionand correcting incontinence issues," he says.

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Froedtert TODAY

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New Cardiac Second Opinion ProgramThe Froedtert & Medical College ofWisconsin Cardiovascular Center is pleased to announce a new program.The Cardiac

Second Opinion Program provides people with answers so they can make the right decisions about their care.

The Cardiac Second Opinion Program offers a coordinated, comprehensive approach through a nurse coordinator to thehighly regarded team of Medical College ofWisconsin cardiologists and cardiac surgeons.Through the program's system of rapidaccess, an appointment can be set up for people seeking a second opinion within 72 hours.Tests that have already been performedwill not be repeated unless absolutely necessary.

The Cardiac Second Opinion Program is staffed by exceptional physicians with extensive cardiac expertise using the latesttechnology available to treat heart disease. For more information or for an appointment, visit froedtert.com or call 414.805.3666or 800.272.3666.

New Clinic Specializes in Heart Valve DiseaseA new clinic just for people with simple or complex heart valve disease is now welcoming patients at Froedtert & Medical

College ofWisconsin.

TheValvular Disease Clinic offers patients quick access to full evaluation, including consultations with cardiologists who diagnoseand manage the disease and, when necessary, with cardiothoracic surgeons. Patients at the new clinic also benefit from specialmultidisciplinary conferences in which multiple heart specialists review each case and provide their expertise and recommendations.

The clinic also provides ultrasound imaging, stress tests and cardiac catheterization for efficient evaluation of second opinionreferrals. For an appointment at theValvular Disease Clinic (available within 24 hours), please call 414.805.3666 or 800.272.3666.

P A R T N E R S H I P S

Froedtert TODAY

OsteoporosisClinic Opens atCommunityMemorialHospitalOsteoporosis is a commonbone disease characterizedby low bone mass andthinning of bone tissue. Itis also known as the "bonethinning" disease. Thiscondition leads to the bonesbecoming more fragileand thus, more likely tofracture.Osteoporosis wasonce thought to be aninevitable result of gettingold. However, it is nowrecognized as a treatabledisease that can oftenbe prevented.

The Osteoporosis Clinic at Community Memorial Hospitalwas developed to help prevent and treat osteoporosisthrough education, clinical care, nutrition, physical therapyand medications. Our approach includes a thorough healthassessment, screening, nutrition assessment, diagnosis, andtreatment. Our primary goal is to prevent fractures bystopping or slowing bone loss, maintaining bone strengthand eliminating factors that contribute to falls.

Successful management of osteoporosis involves a team ofhealthcare professionals including a primary healthcareprovider (which may be your doctor or nurse practitioner),dietitian, physical therapist and pharmacist. All of thesehealth professionals are available in the Osteoporosis Clinicat Community Memorial Hospital. From assessment todiagnosis and treatment, the team approach provides thenecessary information and treatment to improve your bonedensity and lower your risk of bone fracture.

For additional information about the Osteoporosis Clinicat Community Memorial Hospital or to schedule anappointment with a nurse practitioner at the Women'sHealth Center, call 262-257-5000.

EMPOWER ED CON SUMER

Froedtert TODAY

The bone marrow density test is a safe,painless screening procedure that evaluatesbone strength and predicts future fracturerisk. It is often prescribed for women whoare pre- or post-menopausal or have otherrisk factors for osteoporosis.

Our Cardiac Second Opinion Program givespeople with heart problems the opportunityto learn more about their condition andexplore advanced treatment alternatives.David Rutlen, MD,Medical College ofWisconsin cardiologist, or others on theCardiovascular Center team will discussyour concerns, evaluate your medicalhistory and tests and provide you withinformation and options.

Explore, Search, Findon froedtert.com

A new design andimproved functionalityare making it easier to usefroedtert.com to makedecisions about Froedtert& Medical College ofWiscons in ser vices.Whether you are newlydiagnosed with a medical

problem or searching for a primary care physician, the websitehelps you access the incredible care provided here every day.Frequent updates ensure you'll get the latest news and freshinsights into our programs, services and exceptional staff.

InnovationsThrough the newMy Froedtert, you can sign up one time to getall the healthcare news and tools you need.My Froedtert provides:

• Alerts on new programs, doctors and more• An e-newsletter• Tools and diaries to help you manage your health• Community education classes and workshopswith online registration

• Information about Small Stones, our health resource center

Every Day HeroesFind out how you can join our team by visitingcareers.froedtert.com.

Small Stones Recognized inAdvance for NursesA publication geared toward

nurses featured Small Stones, ahealth resource center ofFroedtert & Medical College ofWisconsin in a recent issue.Titled, “Thinking Outside theBox: Nurses Get Creative withResource/ Wellness Center,” thearticle said that at Small Stones"... Hospitality and a willingnessto find and share informationabounds."The article also noted Small Stones "... has garnerednational attention from healthcare professionals drawn tothe concept. Several individuals have sought advice fromSmall Stones on how to incorporate elements of the centerin their facilities."

To learn more about Small Stones, call 414-805-6520 orvisit smallstones.com.

Resources for SleepDisorders and Menopause

When you can't sleep at night, youbegin looking for answers – andresources to get the rest you need.Credible information about what mightcause your lack of sleep can bring youcloser to your goal.

"About 50% of people over 65 havesome sort of sleep disorder,with insomniabeing the most common," says SmallStones nurse educator Mary Freisleben,RN, BSN. "According to the NationalInstitute of Neurological Disorders andStroke, about 40 million people in theU.S. suffer from chronic long-term sleepdisorders every year and 20million morehave trouble sleeping from time to time."

"If someone comes to us with morethan occasional insomnia,we suggest theyconsult a certified sleep physician to

rule out a serious disorder, such as sleepapnea," adds Kathy Steele, RN, BSN,Small Stones' other nurse educator.

Mary and Kathy recommend usefulwebsites on the topic, along with booksand products. "People also find ourguided imagery and relaxation CDs veryhelpful in encouraging sleep," says Mary.

BOOKS• Sleep Better!• Learn to SleepWell• 100 Questionsand Answersabout Sleep andSleep Disorders

PRODUCTS• Essential oils and massage oils• Aromafloria Sleep EaseInhalation Beads

• Herbal sleep masks

Marlys Swanson, RN, BSN, nursespecialist for theTotal Health for MidlifeWomen Program, sends patients toSmall Stones for information about sleepproblems and other menopause issues.

"I recommend Take Charge of the Changeand The Change Before the Change," saysSwanson. "Both books provide anexcellent overview of changes womenexperience during perimenopause andmenopause. Small Stones also has agreat selection of cookbooks for womeninterested in improving nutrition."

Additionally, Swansonrecommends Small Stonesresources on hormonereplacement therapy,smoking cessation, andfitness aids such asexercise bands and

pedometers.

For more information, call 414-805-6520or visit smallstones.com.

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Froedtert MemorialLutheran Hospital9200W.Wisconsin Ave.Milwaukee,WI 53226-3598

Nurse educator Kathy Steele helps a patientconnect with resources on menopause.