Learn how our region’s hospitals are helping women and their families achieve a better quality of life.
When you picture yourself “living your best life,” you’re probably healthy in that mental image.
As new technology and more medical specialists enrich Chicago-area hospitals, it’s easier for women in our region, in all walks of life, to live healthier lives – whether you’re navigating a pregnancy, managing your reproductive health, eradicating arthritic pain, or worrying about the health of your children.
Learn how our region’s hospitals are helping women and their families achieve a better quality of life.
Getting pregnant isn’t easy for every woman. But knowing that you’re ready to begin a family is a big milestone in itself.
“I think it’s great when a woman knows she’s ready to begin her family planning,” says Dr. Dennie Rogers, maternal fetal medicine specialist at Mercyhealth. “It’s always a smart idea to seek a pre-conception consultation. That way we can optimize the pregnancy and decrease the risk factors that could be associated.”
It’s best for hopeful mothers to begin management of chronic conditions, such as severe anemia, diabetes, hypertension and kidney disease, before getting pregnant. Rogers can help patients navigate these and other chronic conditions before and during pregnancy. Usually, diet modifications and pregnancy-friendly medications are necessary.
But sometimes, perfectly healthy mothers can experience high-risk pregnancies if complications develop with the baby.
“It can be things ranging from multiple births, so the mother may have twins or triplets, or maybe the baby develops some type of abnormality, like a cleft lip or palate,” Rogers explains. “It can also be that the baby develops with an abnormal genetic blueprint, so chromosomal abnormalities. But these are things that we can absolutely manage so the baby is born healthy.”
Rogers is also prepared to step in if things go wrong in the delivery room. Sometimes, an entire pregnancy can be healthy for both the mother and baby, but complications may develop as the baby arrives.
“It could be problems with the mother’s heart, thyroid, blood pressure – we take care of those things as well,” Rogers says.
Once a woman becomes pregnant, regular appointments with an obstetrician are crucial to monitoring the health of both the mother and baby. The mother’s blood pressure, weight, and blood work/labs are all watched closely in case anything falls outside of the range for what’s normal. Ultrasounds in each trimester are routine to monitor the health of the baby.
For high-risk pregnancies, mothers can expect adjustments in medication, more ultrasounds, more specialists involved in prenatal care, more in-depth instructions for delivery, and, depending on the severity of the situation, instructions for lifestyle modifications.
“Each patient is different and every situation is unique,” Rogers says. “And, you know, the conversations aren’t easy. The first step, of course, is to be transparent, to be honest, and to be empathetic. Realize that the parents are afraid and they’re counting on you as the expert to tell them what’s going on and to walk them through the process. We share the good possibilities that can occur, but sometimes we also have to share what the reality is.”
“I try to work with families to have reasonable expectations, but at the same time I never take away hope,” she continues. “No matter how much we know in the medical profession, we don’t know everything. There’s always hope.”
The majority of high-risk pregnancies end in a good outcome, at least for Rogers’s patients. It helps that the quality of ultrasound technology has improved and genetic testing has become more widely available. The biggest factor is a mother’s access to health care in both the pre-conception and pregnancy timeframes, Rogers adds.
“As soon as people come to our unit, they’re nervous, their thoughts shift to something negative. But we can absolutely have successful outcomes,” Rogers says.
Gynecologic Robotic Surgery
The days of robotic surgery being “new” are over, especially in gynecology.
The FDA approved the first medical robot in 2001 for urology, and then in 2005 the da Vinci robot was approved for gynecology, says Dr. Michelle Luthringshausen, director of robotics at Northwest Community Healthcare (NCH). She’s been doing robotic surgeries since early 2007.
“We’re now on the third-generation robot, and there have been many improvements over time with the optics and capabilities based on surgeons’ feedback,” she says.
When Luthringshausen started at NCH in 2011, the hospital only had one da Vinci robotic system. Now, there are three, and the robotics program has gone from about 15 physicians and surgeons to more than 40. The surgeries cover a range of specialties, from urology and gynecology to general surgery. Luthringshausen makes sure the entire robotics program runs smoothly and safely.
She also does benign gynecologic procedures, so any procedure related to the female reproductive system that doesn’t involve cancer. This could be the removal of painful ovarian cysts, the removal of painful tissue and scar tissue for women with endometriosis, hysterectomy procedures, and much more.
“Really almost any surgery that’s in the pelvis can be approached robotically,” Luthringshausen says. “And what’s nice about robotics is that it’s taken laparoscopic surgery and made it accessible to everyone of all body types. The robotic instruments free up the surgeon’s hands – it gives us four hands, basically. So, we can do more-complex things for a wider range of patients.”
From a patient perspective, preparation for robotic gynecologic surgery isn’t different from other minimally invasive surgeries. Patients must refrain from eating or drinking after midnight prior to the day of surgery, and occasionally, the patient may need to consume a solution to clean out their bowels. On the day of surgery, it’s just a matter of undergoing general anesthesia.
From there, the surgeon makes an incision at the base of the patient’s belly button and introduces carbon dioxide, which makes a pocket of air inside the abdominal and pelvic cavities so that there’s room to operate.”
“There isn’t a space there, so we have to create a space so that we can put our instruments inside to operate,” Luthringshausen explains.
Once the carbon dioxide is inside the patient, the surgeon can put a camera into the belly button. The surgeon then makes other incisions that are less than a half an inch in size to help make room for other necessary instruments, such as the cannulas, or “metal straws” that attach to the arms of the robot. Once all the instruments are inside the patient and the robot is docked, the surgeon sits at a separate console, places her head into the upper console to view the surgical area, and uses hand controls similar to joysticks to control the robot.
The 3-D view is impeccable.
“It’s as if I were standing inside the patient’s abdomen,” Luthringshausen explains. “I have full range of motion in my wrists, which you don’t have in straight laparoscopy. So, that’s why robotic surgery allows you to do more-complicated things, and you have better visualization.
“Basically, it’s a platform that makes you superhuman as a surgeon.”
Robotic gynecologic surgery typically takes around an hour and a half to complete, but more-complicated surgeries may take up to 5 hours. Most of the time, after the patient recovers from anesthesia, they get to go home within 3 to 4 hours.
“That’s an advantage – the recovery is so quick,” Luthringshausen says. “Most patients don’t need narcotics or pain control after the first 72 hours because there’s less damage and bruising to the abdominal wall. Patients get out of the recovery room faster and return to normal life faster than after typical surgery.”
Joint Replacement Surgery
While important, OB/GYN needs are just one component of a woman’s overall health. All areas of health play a role in maintaining a desirable quality of life.
It’s Dr. Brian Flanagan’s job to help his patients improve their quality of life. As an orthopedic surgeon specializing in joint replacement at Northwestern Medicine Huntley Hospital, he helps people return to the activities they enjoy, even if it’s just simply going for walks.
“A lot of my patients enjoy spending time with their kids and grandkids, or traveling – I have a lot of people who used to love going to Italy and France and now they can’t do it because the roads are uneven and hilly,” Flanagan says. “For people making the decision of when to get a hip or knee replaced, I usually tell them it’s when you’ve exhausted all the non-operative options – things like injections, therapy, weight loss, medications – and when you’re giving up things you like to do. When nothing else works, joint replacement is the last option, but it’s a really good option.”
Arthritis is a leading cause of needing a joint replacement. For some reason, arthritis affects more women than men. Flanagan and other experts postulate that genetics and female hormones play a role in the onset of the disease.
Typically, pain is the most common indication that a joint needs replacement. Other symptoms may include stiffness, especially in the morning, and swelling.
Even just 15 years ago, joint replacement surgery wasn’t nearly as advanced as it is today, Flanagan says. But improvements in technology and techniques have made joint replacement surgery better and safer.
“The implants themselves have gotten infinitely better,” Flanagan explains. “The materials are lasting 25 years, as opposed to 10 years. That’s a huge factor, because if you needed a joint replacement in the 1990s, and you were 40-something years old, the surgeon would have told you it’s not a good idea. It’s going to have to be redone when you’re 50, and 60, and 70 years old, and by the time you’re in your fourth surgery there’s nothing left in your joint. Nowadays, if somebody in their 40s comes in, total joint replacement is an option.”
In addition, techniques for joint replacement surgery have become less invasive.
“Incisions are probably about half the size they used to be, so the way we can preserve muscles and ligaments is the best it’s ever been,” Flanagan adds. “We’re ideally not changing somebody’s anatomy very much – we’re just putting what they used to have back in.”
And, since X-ray can now be used throughout the entire surgery, joint replacement procedures have also become more accurate.
“When we’re putting pieces in, we’re checking the position as we’re going,” Flanagan says. “It’s a foolproof way of making sure that we’re not putting something in at an incorrect angle or an incorrect size.”
Recovery time is also faster. Before, patients would need to spend multiple nights in the hospital, or even go to a nursing home for rehabilitation. Now, patients may need to spend one night in the hospital, and same-day procedures are oftentimes possible.
“I actually think women tend to be a little bit tougher,” Flanagan says. “Usually what I hear is that this is nothing compared to childbirth. But overall, whether you’re male or female, I think patients tend to do really well with these procedures.”
Worrying about the health of your child can be more stressful than worrying about your own health. With that in mind, AMITA Health is launching new pediatric telehealth services in its Women and Children’s Hospital in Hoffman Estates.
Pediatric telehealth services will operate in both inpatient and outpatient settings, says Dr. Erik Johnson, vice president of medical affairs for pediatric services at AMITA Health. Telehealth will be rolled out in the specialty clinics in Hoffman Estates and Hinsdale this fall, while primary care offices will have the technology in 2020.
Whether your child is at a routine check-up or in the emergency room, telehealth can be useful.
“What we’ve noticed over the years is it’s more and more difficult for parents to come to doctor’s appointments, and as a result of that, sometimes only one parent can attend, or somebody comes in place of the parent when they would really want to be there,” Johnson says. “So, with technology being as it is today, we thought we could create an environment in an exam room where the parent could basically be there on a web conference.”
It’s as simple as clicking on a link through a secure email, which begins to connect you to your child’s exam room. A health care provider must then approve the connection, which adds a layer of privacy. All a parent needs is a device with a camera such as a phone, tablet or laptop.
It’s convenient for parents who don’t have sick days or vacation days to take time off work to get their child’s sore throat or ear infection looked after by a pediatrician. Telehealth can also be convenient when children need multiple follow-up appointments to manage conditions such as diabetes or seizures.
“There’s a lot of information to cover, and it’s a high-stress time,” Johnson explains. “In the situation of decisions being made about a child’s health care, both parents usually want to be involved in that. It’s much more efficient for a decision to be made at the same time versus one parent coming home, explaining it to the other parent, and them calling back with further questions. It just delays care for that child, so this allows all of that to happen in real time.”
Telehealth can also help to bridge language barriers. If a parent speaks by sign language or a primary language other than English, a certified medical translator can be conferenced in, which helps parents get more-accurate information about their child.
There’s no additional fee for telehealth services. It’s available as part of a child’s appointment with a pediatrician.
In addition to outpatient telehealth services, AMITA will also offer inpatient pediatric telehealth.
“For instance, we have a pediatric patient who’s been admitted to the hospital and needs a specialist to see them, and say that specialist is down in Joliet that day,” Johnson describes. “The patient could wait until the specialist drives back to the Hoffman Estates area, but say it’s February and we we’ve got 2 feet of snow. That could really delay the care for that patient. With inpatient telehealth technology, the specialist can immediately use a camera to look in ears and mouth, etcetera, listen with an electronic stethoscope, and see exactly what they need to see in an exam room at a much higher level of quality.”
Again, like with outpatient telehealth services, inpatient telehealth services don’t add cost to parents.
“It’s all added to part of your experience,” Johnson says.