UNIVERSITY OF COLORADO HEALTH SCIENCES CENTER
January 3, 1996 Contact: Sarah Ellis
(303) 315-5571
January health and medical stories from the University of Colorado Health Sciences Center
1. Bloodless surgery available at Denver's University Hospital 2. Hepatitis C Virus: what everyone should know 3. Sickle cell disease: facts and fallacies 4. Shingles Pain, rash can strike without warning
Bloodless Surgery Available at University Hospital
Robin, a 39-year-old media buyer for a large Houston advertising agency, was known for her unflagging research efforts before making business decisions. As a result, no one was surprised when she waged an exhaustive examination of options for her mother's upcoming gastrointestinal surgery. But this time she faced a particular challenge: a deeply-held religious conviction prevented her mother from receiving a blood transfusion.
After an extensive search, Robin's mother was treated at University Hospital in Denver where the University of Colorado School of Medicine offers the Bloodless Medicine and Surgery Program, one of a handful in the United States. The program specializes in medical and surgical care without blood transfusions.
CU doctors created the program on one basic principle: Respect for individual religious beliefs and medical preferences.
Some people have religious convictions -- such as that held by Jehovah's Witnesses -- preventing blood transfusions. Others, in this era of blood-borne illnesses such as hepatitis and HIV, just feel more comfortable undergoing hospital procedures that don't risk the use of blood transfusions.
CU surgeon Greg Van Stiegmann, MD, helped create University Hospital's program. "It's a special service for adult patients who don't wish to receive blood transfusions," says Dr. Stiegmann. "And most simply put, it involves doctors
making a commitment to use slow, methodical techniques so that patients don't lose a significant amount of blood."
But much more is involved. In addition to meticulous surgical skill, he says, Bloodless Surgery also involves state-of-the-art medical technologies, such as lasers, the argon beam coagulator to speed blood clotting, volume expanders or intravenous liquids to enhance blood circulation, and cell savers to recirculate the patient's blood.
University Hospital offers the Bloodless Medicine program in a wide variety of medical and surgical specialties. For more information about the Bloodless Medicine and Surgery Program, call (800) 466-6633.
University Hospital is the Rocky Mountain region's only academic tertiary care and referral center. Located in Denver, Colo., the hospital is part of the University of Colorado Health Sciences Center campus, one of four campuses in the University of Colorado system. ###
Hepatitis C Virus: What Everyone Should Know
When a blood donation drive was held at Jackie's workplace, she eagerly volunteered to help to save someone else's life by donating blood. Her decision ultimately helped save her own, however, when the screening process uncovered the fact that Jackie had the hepatitis C virus.
Like Jackie, as many as 20,000 Coloradans are infected with the hepatitis C virus (HCV), a potentially fatal virus that causes severe liver damage. One of the most alarming things about HCV is that most patients have no outward symptoms, and don't even realize they're sick.
"Like HIV, hepatitis C is transmitted through exposure to blood or blood products, including transfusion, needle-stick injury and intravenous drug use," said Greg Everson, MD, a professor of medicine and liver specialist at the University of Colorado Health Sciences Center. Approximately 170,000 new cases of HCV develop in America each year, and as many as 85 percent of people who are exposed become chronically infected.
Hepatitis C can take anywhere from two weeks to six months to develop in the body, and it can do a great deal of damage without causing any perception of illness on the part of the infected person. "It's possible to have the disease for a long time before it is diagnosed," Dr. Everson said. "Meanwhile, people unwittingly carrying the disease run the risk of infecting others."
As the body battles HCV and the inflamed liver works to repair itself, fibrous tissues develop. This scarring of the liver, when extensive, is called cirrhosis and can result ultimately in liver failure." A few chronic HCV patients will also go on to develop liver cancer," Dr. Everson added. Deterioration caused by HCV is usually slow. It can take up to 40 years for serious liver damage to occur.
Currently there is no cure for hepatitis C. The treatment that has shown the best results so far is a drug called interferon, a synthetic form of a substance produced naturally in the body to defend against infection and bolster the immune system.
At the CU-Health Sciences Center, Dr. Everson is studying the effects of interferon taken in combination with another drug, Ribavirin, to improve overall patient outcomes. Early results in this study have been promising, he said.
People can take steps to avoid being infected with hepatitis C by always practicing safe sex and never sharing objects that could transmit blood, like needles, razors or even toothbrushes. If you think you may have been exposed, a simple blood test can confirm whether or not you've been infected.
The University of Colorado Health Sciences Center is one of four campuses in the University of Colorado system. Located in Denver, Colo., the campus includes schools of medicine, nursing, pharmacy, dentistry, graduate school and two hospitals.
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Sickle Cell Disease: Facts and Fallacies
When Roberta and William had their first child, their joy was tempered with concern when they learned their infant son was at risk for developing sickle cell disease. The new parents talked to Kathryn Hassell, MD, associate director of the Sickle Cell Treatment and Research Center at the University of Colorado Health Sciences Center, the only comprehensive center of its kind in the Rocky Mountain Region, to learn about sickle cell disease.
Q: What is sickle cell disease?
Dr. Hassell: In sickle cell disease, the hemoglobin which carries oxygen in red blood cells is abnormal. The cells, which are normally round, become long and stiff, shaped more like a banana or sickle. Q: Is it painful?
Dr. Hassell: In sickle cell disease, misshapen cells become clogged in tiny blood vessels causing pain, as well as damage to vital organs. These blockages in the lungs can cause severe breathing problems. Eye blockages can cause blindness. Even when there is no pain, sickle cell disease destroys red blood cells faster than the body can replace them, resulting in anemia. The most severe form of sickle cell disease is sickle cell anemia. Q: Is sickle cell disease contagious?
Dr. Hassell: Sickle cell disease is an inherited genetic disorder. If each parent carries one sickle cell gene, and their child inherits both genes, that child will have sickle cell disease.
Q: Aren't African-Americans the only ones at risk? Dr. Hassell: Anyone who inherits two sickle cell genes will have sickle cell disease. Although the majority of patients in this country are African- American, the disease also affects some people of Mediterranean, Middle Eastern, and Indian descent. In Colorado, all newborns are tested for the disease.
Q: Is sickle cell disease fatal?
Dr. Hassell: It can be fatal, but advances in treatment and long-term care have given patients every advantage. It was once thought that the most severely afflicted patients would not live beyond age 20. Now the average life expectancy for this group is 45. People with milder forms of sickle cell disease have nearly the same life expectancy as someone who is perfectly healthy.
Q: Is there a cure?
Dr. Hassell: Currently there is no cure for sickle cell disease. However, researchers at the CU-Health Sciences Center and around the world are making great strides in the search for a cure. Bone marrow transplants are now available on a research basis for the most severe forms of sickle cell disease. However, a bone marrow transplant puts a tremendous strain on the body and may be, in many cases, more risky for the patient than simply living with sickle cell disease.
The University of Colorado Health Sciences Center is one of four campuses in the University of Colorado system. Located in Denver, Colo., the campus includes schools of medicine, nursing, pharmacy, dentistry, graduate school and two hospitals.
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Shingles Pain, Rash Can Strike Without Warning
Jack first noticed the red lumps on his back in the shower one morning. They itched like crazy, and were starting to hurt too. By the time he arrived at the doctor's office that afternoon the pain was excruciating and the rash had spread.
The doctor's preliminary diagnosis was shingles. Laboratory results confirmed that Jack suffered from a form of herpes fairly common to anyone who has had chicken pox. More than half a million Americans suffer from shingles each year.
"Shingles, or herpes zoster, is a recurrence of the chicken pox virus," said John Aeling, MD, professor of dermatology at the University of Colorado Health Sciences Center. "When you get the chicken pox as a child, it clears up but hibernates in your body, usually in a nerve root along the spine. For some reason later in life the virus becomes active again and spreads through the nerves, causing shingles."
The result is a painful, blistering rash, usually on the back. But shingles lesions can appear on any part of the body, and in some rare cases they spread over the body like chicken pox.
Because shingles is the result of a dormant virus that has awakened, it strikes without warning. Most people who develop shingles are healthy in every other way. The disease is somewhat more common in people age 50 and older, and in patients whose immune systems have been altered or depressed, such as chemotherapy patients or people with HIV or who have had organ transplants.
Shingles is not highly contagious. People who have not had chicken pox are most likely to catch the virus, and those people will develop chicken pox rather than shingles. Still, people with an active case of shingles should avoid contact with newborns, the very ill, chemotherapy patients and pregnant women.
The biggest complaint among shingles patients is severe pain. "Shingles can be very painful because it causes inflammation of the nerves," Dr. Aeling said. "That pain can persist even after the shingles heals. It's a troublesome and sometimes debilitating illness."
There is no "magic bullet" cure for shingles. Because it is a virus, antibiotics do not help. "The newer anti-viral drugs can be effective," Dr. Aeling said. "The problem is you have to catch the disease early - within the first 72 hours - to treat the pain. Untreated the lesions last for about three weeks, start to finish. But the pain can persist for months and even years."
Post-herpetic neuralgia is the clinical name for pain that continues long after shingles lesions have healed. Post-herpetic neuralgia is extremely difficult to treat, and frustrating for both patients and their doctors. A doctor may be able to recommend over-the-counter creams or oral cortisone, which seems to help some people. Severe pain may require treatment with stronger narcotics and antidepressants.
University Hospital is the Rocky Mountain region's only academic tertiary care and referral center. Located in Denver, Colo., the hospital is part of the University of Colorado Health Sciences Center campus, one of four campuses in the University of Colorado system. ###
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