Beverly Casey
Keeping Diabetes
on a Short Leash

           November/December 2007

Living with Diabetes       ...
Cover Story

Keeping Diabetes on a Short Leash

i  n	2001,	Beverly	casey,	a	former	welder	
   and	aerospace	worker,	was	in...
Cover Story Continued . . .
new	generation	of	diabetes	medications.	as	      works	full-time	and	enjoys	shopping	and	     ...
da Vinci Enhances the Art of Surgery at Northwest Hospital

                                                  a state-of-t...
November - December 007
                                                     To find more class and events, visit www.nwho...
November - December 007 (Continued)
        To find more class and events, visit

Quality of Care                         PuT CoLD WEATHER EmERGENCiES oN iCE
In the Community

Playing Favorites with Graham Kerr
Imagine eating all the foods you really      you can’t have rules. I...
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Keeping Diabetes on a Short Leash


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Keeping Diabetes on a Short Leash

  1. 1. Beverly Casey Keeping Diabetes on a Short Leash November/December 2007 Inside: Living with Diabetes 2 New Robot at Northwest Hospital 4 Gamma Knife Treats 3000th Patient 4 Ready for Anything - Emergency Preparedness 7 Graham Kerr Talks About Healthy Eating 8
  2. 2. Cover Story Keeping Diabetes on a Short Leash i n 2001, Beverly casey, a former welder and aerospace worker, was in the midst of a busy, happy retirement when things went sideways. During a vacation with her husband in Maine, she fell from the ladder of the couple’s camper, twisting her foot, breaking her fibula and severely distorting her ankle. an orthopedic surgeon at the local hospital restored the foot using screws and a metal plate. When she tried to thank him following the surgery, the doctor told casey, a diabetic, Beverly Casey walking her dogs with that she was not yet out of the woods. her her daughter Cheryl Cummings on diabetes, he said, could significantly impact the Burke-Gilman Trail. her body’s ability to fight infection and heal. the path through those woods would home in new york to bring her to seattle gery was compounded by the sudden loss of eventually lead casey across the country to and northwest hospital. her husband, but even while grieving, casey the award-winning diabetes and wound care tackled therapy with determination. “i had programs at northwest hospital & Medi- one of the first people casey saw was to learn how to walk all over again,” she says. cal center – and to the care of her daughter orthopedic surgeon, Dr. robert clawson, “then i bought a car and drove myself and cheryl cummings, the hospital’s clinical who consulted with the northwest hospital my crutches back to seattle.” coordinator of diabetes services. Wound care center about casey’s care. phy- sicians there removed the worst of the screws soon after, endocrinologist Dr. robert casey, one of the 21 million people in the in casey’s foot, and she began rehabilitation. Kanter began working with casey to better U.s. who suffer from diabetes, was diagnosed incorporate diabetes care and maintenance with the disease when she had a heart attack “the Wound care center is a great resource into her lifestyle. she began to attend diabe- at age 56. she says the diagnosis wasn’t a for cases like this,” clawson says. “it’s the tes education classes at northwest hospital, surprise, since her brother, father and grand- appropriate setting for treating wounds that ranging from understanding diabetes and mother also had diabetes. “i started working are slow in healing, such as those in diabetic modern monitoring technology to stress on controlling it, but i wasn’t very success- patients.” management. ful,” she says. casey was put on insulin to control her blood sugars just about the time “i had every confidence that the Wound “in the 11 years she’d had diabetes, Beverly the accident in Maine happened and she was care center could handle Mom’s case,” had not had much diabetes education, and confined to a wheelchair to recover. cummings says. “they treated her for seven she hadn’t seen a dietician for more than weeks, and for the first time, nobody men- five years,” Dr. Kanter recalls. “she had high as her surgeon had predicted, it was not an tioned that she might lose her foot. it had blood pressure, high cholesterol, decreased easy recovery. an infection resulted in an- been said so often.” sensation in her feet due to the diabetes and other hospital stay and more surgery. casey’s she was significantly overweight. We had a blood sugars were unstable and she was Doctors also recommended a bone graft lot of catching up to do.” told she might lose her foot. then, her body to repair casey’s fibula, which was still too started rejecting the hardware the doctor in short after several months of healing. casey “Dr. Kanter is a marvel!” casey exclaims. “he Maine had installed. at that point, cum- had the procedure in Wisconsin, where her got my blood sugar down, and got me into a mings stepped in, traveling to her mother’s other daughter, Kelly, lived. the difficult sur- weight management class. i think it’s really important to keep up the relationship with your endocrinologist, to get back to good “The Wound Care Center is a great resource for cases health.” like this. It’s the appropriate setting for treating wounds casey benefited from both inpatient and that are slow in healing, such as those in diabetic outpatient diabetes care at northwest hos- patients.” - Dr. Robert Clawson pital and was also able to take advantage of a continued on page 2 for a free physician referral call (206) 633-4636 or (800) 633-4636
  3. 3. Cover Story Continued . . . new generation of diabetes medications. as works full-time and enjoys shopping and Former Galloping Gourmet, a result, she’s now using almost 75 percent renovating the home she shares with her son less insulin than she did when she first came robert. Graham Kerr - November 27th @ Third Place Commons in Lake Forest Park to the hospital. “she was supposed to get a single-level Join this internationally famous “We have so many resources to help people condo near me, and be safe,” cummings television chef and author for the with diabetes adapt to the disease,” says laughs, “but that’s who she is – energetic, Northwest Hospital Diabetes Education cummings. “We have a direct link to an vibrant and ready to go back to work.” Forum at 7:00 p.m. Kerr will sign copies endocrinologist for consultations; a clinical of his latest book, “Day-by-Day Gourmet nurse specialist dedicated to the program; for more information on diabetes education Cookbook,” and talk about improving diabetes classes, forums and support groups; classes, call (206) 368-1564 or visit the Dia- your health by making reasonable diet and protocols for managing high blood betes education section of the northwest choices. Between 6-7:00 p.m., Northwest sugars.” hospital Web site at Hospital nurses will offer blood sugar classes. for information about the north- and blood pressure screenings. Call anyone can tell casey is feeling better. she west hospital Wound care center, call (206) (206) 368-1564 for more information. now lives independently with her two pugs, 368-1244. to find a doctor for diabetes care, roxanne and Buster, on an eight-acre farm call the northwest hospital physician refer- near Kingston on the Kitsap peninsula. she ral line at (206) 633-4636. November is American Diabetes Month Each week in November focuses on a different face of diabetes: the first week is all about caregivers; the second on promoting healthy lifestyles in the work- place; the third week on rising numbers of diabetes cases around the world; the Sugar’s Favorite Disguises fourth week will be about at-risk popula- If you are diabetic, or even pre-diabetic, favorite soft drink, for example, might tions; and the fifth week will be all about the tricky part of managing sugar in the find it hard to believe how much sugar is children and Type 1 diabetes. Nearly 21 diet is that it’s not always identified as lurking in a serving. million children and adults in the U.S. “sugar” or “sucrose” on the lists of ingre- are living with diabetes, and another 54 dients found on processed foods. Rather, Here’s a list of the sugar content in just a million are at risk. it can show up as: few popular processed foods: • Glucose ½ c sugar-coated cereal = 9 tsps added • Dextrose sugar • Fructose 1 slice iced layer cake = 9 tsps added • Lactose The Med-Info newsletter is published sugar • Maltose bi-monthly as a community service 2 small cookies = 4 tsps added sugar by the Marketing Public Relations These are other forms of sugar and may 12 oz regular soda pop =12 tsps added Department. raise blood sugar levels. It’s important to sugar read food content and nutrition labels To contact us about the newsletter, 1 c fruit-flavored yogurt = 7 tsps added e-mail or call carefully, to identify sugars in disguise. sugar (206) 368-1645. Not all foods labeled “sugar-free,” “sug- The good news is, you don’t have to Managing Editor: Pam Sowers arless” or “no sugar added” are free of stop eating these foods. Instead, look all forms of sugar. In fact, manufacturers Design: Erin Dekker for products with non-caloric sugar may use these labels while still adding Cover Photography: Nichole DeMent substitutes, such as Equal, Sweet n’ Low fructose, corn syrup or concentrated or Splenda, that don’t raise blood sugar fruit syrups to their recipes, as long as Main Campus: levels. there is only a half a gram per serving. 1550 N 115th Street (Adapted from “Living Well with Diabetes: Many processed foods contain sugar, Outpatient Medical Center: Education for Self-Management,” by Patricia but it can be difficult to determine how 10330 Meridian Ave N Clement RD, CD, CDE Pauline Sheehan much sugar a food item contains just RN, CDE, for Northwest Hospital’s Diabetes Phone: (206) 364-0500 or from the taste alone: consumers who Education classes) (800) NWH-HOSP (694-4677) are accustomed to the sweetness of their Visit for information and directions. noVeMBer/DeceMBer 2007
  4. 4. da Vinci Enhances the Art of Surgery at Northwest Hospital a state-of-the-art alternative to conven- • Less risk of infection tional laparoscopic and traditional open • Less blood loss and fewer surgery methods. It uses 3-D, high-defini- transfusions tion vision and four “robotic hands” as • Faster recovery extensions of the surgeon’s own eyes and • Quicker return to normal activities hands to go where human hands typi- cally cannot. Northwest Hospital has invested in the da Vinci “S” Surgical System, the most Guided by the surgeon, who sits at a advanced da Vinci system to-date, which separate viewing console, the da Vinci incorporates many capabilities that This November, the surgeons and operat- robot translates the natural movements earlier versions did not. Newly installed ing room staff at Northwest Hospital of the surgeon’s hands, wrists and fingers in an operating room, da Vinci was used received a helping hand – four of them, into micro-movements of the robot, in to perform its very first procedures in actually. order to create and maneuver within early November. Over the next year, the smaller incisions and to perform delicate hospital expects to expand the use of da As part of its efforts to offer world-class and complex procedures with greater Vinci to enhance gynecologic, cardiac, surgical services and the latest advance- precision and dexterity. urologic and a number of other surgical ments in medical technology, Northwest areas. Hospital is now home to the da Vinci da Vinci also offers patients a variety of Robotic Surgical System. benefits, including: For more information about the da Vinci Surgical System, visit www.davincisurgery. Used for a wide variety of minimally inva- • Shorter hospital stays com. For more on da Vinci services at sive surgical procedures, da Vinci offers • Less pain and scarring Northwest Hospital, call (206)368-1811. Northwest Hospital Gamma Knife Center Treats 3000th Patient In addition to the arrival of the da Vinci of post-operative complications, such as Surgical System, November marked an infection and hemorrhage, are elimi- Sally important and exciting milestone for nated. Most patients recover quickly and Jacobs Northwest Hospital. On November 6, the are able to resume their normal activities and her Northwest Hospital Gamma Knife Center within 24 hours. daughter performed its 3000th procedure, more shortly than any other program in the Pacific Sally Jacobs, the center’s 3000th patient, after Northwest. had been diagnosed with a meningioma Jacobs’ during a CT scan several years ago to Gamma The first to introduce Gamma Knife discover why a sinus infection would not Knife Radiosurgery to the region in 1993, the subside. Meningioma, the most common treatment. Northwest Hospital Gamma Knife Center type of benign brain tumor, forms from is also the area’s largest and busiest, the meninges, or the membrane cover- with the goal of halting the tumor’s treating patients from throughout Wash- ing the brain. growth and, in ideal cases, causing it to ington State and across the country. shrink. When Jacobs’ tumor began to grow, her The Gamma Knife is a non-invasive, doctor referred her to neurosurgeon Dr. “I’m doing great and feeling pretty state-of-the-art technology that uses James Raisis at the Northwest Hospital normal,” Jacobs said a day following the focused beams of high-dose cobalt radia- Gamma Knife Center. Raisis is part of the surgery. “The Gamma Knife treatment tion to deliver precise treatment to a center’s multi-disciplinary team of medi- was so interesting because of all the dif- specified target while protecting sur- cal professionals, whose combined ex- ferent steps they took, even before the rounding normal tissue. It is used to treat pertise in brain anatomy, neurosurgery, actual procedure. I’m so thankful that I functional diseases of the brain, such as radiation oncology, and radiation physics had such competent people taking care essential tremor, Parkinson’s and trigemi- provides patients with comprehensive, of me.” nal neuralgia, as well as brain tumors and world-class care. a number of vascular conditions. For more information about Northwest During Jacobs’ surgery, Raisis focused Hospital Gamma Knife Center, call Most patients require only a single out- the Gamma Knife’s beams on the tumor. (206) 368-1626 or (800) 695-0654, or patient treatment. Since the procedure The treatment will gradually kill the visit is non-invasive, or “bloodless,” the risks tumor cells over months and even years, for a free physician referral call (206) 633-4636 or (800) 633-4636
  5. 5. November - December 007 To find more class and events, visit CANCER LIFELINE CLASSES SUPPORT and aerobic movement with great infant CPR and to relieve an obstructed GROUPS music! Appropriate during or after airway. This class does not provide a cancer treatment and for anyone with CPR certification card. Cancer Lifeline at Northwest Hospital (or at risk for) lymphedema. Please Cost: $40 per couple classes and groups are free and open to register. Fine to start any time during the public. Call (800) 255-5505 or the series. Mondays, November 12 (206) 297-2500 for more information - December 17, 12-1 p.m. Professional Breast-Feeding Basics or to register. You can also register Building, Ste #3. This class is designed to educate online at parents on proper feeding techniques and positioning. Cost: $40 per couple Brain Cancer Support Group CHILDBIRTH EDUCATION Drop in any time - no registration Foundations for Fatherhood necessary. Second Tuesdays of the Childbirth, parenting and new baby A class for expectant dads. Taught by an month, 6-7:30 p.m. Professional classes are offered in conjunction experienced father, this popular class Building, Ste #3. with Gracewinds Perinatal Services. addresses topics and issues associated All classes are held on the Northwest with fathering. Cost: $30 Hospital campus. Please call Breast Cancer Support Group Gracewinds Perinatal Services Comprehensive Education Package; Drop in any time - no registration at (206) 781-9871 or visit www. Purchase all six classes and save $70. necessary. First and third Wednesdays Package Cost: $245 per couple of the month, 4:30-6 p.m. Professional for scheduling and registration Building, Ste #3. No meeting Nov 21st. information. continued on page 6 Colorectal Cancer Support Group Childbirth Prep Series Drop in any time - no registration A four- and seven-week course that is necessary. First Wednesdays of the designed to give expectant parents the month, 7-8:30 p.m. Professional tools and information needed during Building, Ste #3. childbirth. This course is also available in a condensed weekend format. Cost: Four Week, $115 per couple Lung Cancer Support Group Seven Week, $200 per couple Drop in any time - no registration Weekend, $125 per couple necessary. Second and fourth Thursdays of the month, 7-8:30 p.m. Professional Building, Ste #3. New Family Skills This important class addresses the specific changes that affect new parents. Gentle Yoga Costs: $40 per couple Combines easy stretches, postures, guided meditation and breathing exercises. Please register. Fine to start Newborn Care Class any time during the series. Wednesdays, This course is an excellent primer for November 7 - December 13, 6:30-8 p.m. first time parents, grandparents and McMurray Building, Cardiac Fitness baby-sitters. Costs: $40 per couple Center. No class Nov 24th. Lebed Method, Infant Safety/CPR Lymphedema Exercise A class designed to give new parents, This gentle and fun exercise program grandparents and baby-sitters the skills combines easy stretches, strengthening to help prevent accidents, to perform noVeMBer/DeceMBer 2007
  6. 6. November - December 007 (Continued) To find more class and events, visit EMERGENCY SERVICES EDUCATION Grief Support Group A six-week support group for those CPR Training coping with the death of a loved one. Learn life-saving skills from Medic In this safe and non-judgemental II personnel. Offered on the third environment participants will focus Tuesday of each month, 7-10 p.m. on the normal aspects of grieving Registration required. Call (206) and grief-work tasks, consider ways of 368-1564 for more information. Cost: providing self-care and develop coping Donations are greatly appreciated. strategies for getting through difficult Checks should be made out to Medic II times. CPR. Next group series: Tuesdays, January 8 - February 12, 6-8:30 p.m. Pre- registration is required. Please call PRENATAL SERVICES (206) 368-1891. Baby Your Back Back pain is a frequent complaint of pregnant women and has many WELLNESS CLASSES causes. Baby Your Back is a two-hour class for expectant mothers taught Living Well with Diabetes by a licensed physical therapist. It is This program has been formally offered the second Thursday of each recognized for excellence by the month at Northwest Physical Therapy American Diabetes Association. Services, located in Northwest Hospital Participants will gain information and Medical Center’s Outpatient Medical skills to manage diabetes in this four- Center. Cost: $10. Call (206) 368-6032 session series offered monthly. Note: to register. Healthcare provider referral Physician referral is required for class. NOVEMBER 007 required. Day and evening classes available. For more information contact your S M T W T F S physician, or call (206) 368-1564 to 1 receive a brochure. SUPPORT GROUPS 7 8 9 10 Diabetes Support Group Weight Loss Surgery Education 11 1 1 1 1 1 17 Join the diabetes instruction team to Is Weight Loss Surgery Right For You? 18 19 0 1 learn about and discuss topics such Join us for a free informational seminar as: meal planning, blood glucose to learn more about: weight loss surgery 7 8 9 0 monitoring devices, weight loss, options and risks; patient selection treatment for high and low blood criteria; nutritional requirements; and DECEMBER 007 sugars, medication management, insurance coverage. Question and dietary supplements, diabetes myth answer segment to follow each talk. All S M T W T F S busters, monitoring for complications sessions are free and are held on the 1 and what’s new in diabetes research Northwest Hospital campus. Call (206) and technology. 368-1350 to reserve your space today. 7 8 November 28 and December 6 19, 9 10 11 1 1 1 1 Second Tuesday of each month, 6:30-8:30 p.m. 1-2:30 p.m. and third Thursday of 1 17 18 19 0 1 each month, 7-8:30 p.m. To register visit and click on 7 8 9 “Classes, Events Support Groups” or 0 1 call (206) 368-1564. for a free physician referral call (206) 633-4636 or (800) 633-4636
  7. 7. Quality of Care PuT CoLD WEATHER EmERGENCiES oN iCE Even our mild Pacific Northwest climate has been known to let loose with snow and icy temperatures for days on end. The best way to cope with weather emer- gencies is to plan ahead by preparing both your home and your car for extreme temperatures. Ready for • Stock up on food items that can be prepared even if the electricity fails. Anything • Use fireplaces, wood stoves or other combustion heaters only if they are properly vented to the outside. Never use charcoal or gas grills indoors – the carbon monoxide fumes can be deadly. Suppose for a minute that you had to • Keep flashlights with fresh batteries handy to use during power outages. get ready for an important event without Use candles only when necessary and do not leave them unattended. knowing what that event might be. If you had to prepare for an earthquake, • Grab an extra flashlight for the car, and make sure you have warm clothing a flood, a fire and a wind storm, as well stored in the trunk, along with snow chains and a first aid kit. Even though you may have a cell phone, keep some change for a pay phone in the car, as a wide variety of man-made threats, too. You may find yourself in an area with poor cell phone coverage. where would you start? For more information on planning for extreme weather conditions, visit the That’s the question at the heart of Emergency Preparedness and Response section on the Centers for Disease Con- emergency preparedness at Northwest trol Web site at Hospital. The answer is what emergency planners like Peter Rigby call all-hazards planning. “Many people in the Seattle area depend on the medical center for to ensure patients’ health and safety as emergencies, thanks to the organiza- routine healthcare, but they also look to they are moved to other locations. All- tion’s continuing involvement in region- the hospital for reassurance and emer- hazards preparation and training uses al, statewide and national drills. gency care in the event of a community- established sectors of the organization wide disaster,” says Rigby, who wears sev- to respond appropriately to the needs “We often activate the emergency system eral hats at Northwest Hospital: director presented by each kind of emergency. during minor incidents, so we can be of therapies, safety officer and leader of better versed in it,” Ward says. “When the hospital’s emergency management So, who makes the decisions to deploy our usual operations show signs of be- committee. various departments and resources to ing overwhelmed by the demands of respond to an event? an event, such as a power outage, snow “If an incident were to occur, we can de- storm or other emergency in the com- ploy our personnel, supplies and other Rigby says, “We’ve adopted an incident munity, we activate the plan.” resources in whatever manner the disas- command structure for decision- mak- ter would require,” Rigby says. “We’re ing. In the event that the standard busi- According to Rigby, every member of the able to do this because we prepare for ness structure is not able to respond to a community, not just the hospital staff, these events using what’s called an all- particular situation, we are prepared to plays a role in the event of a regional hazards approach.” work under an alternate decision-mak- emergency. ing structure to effectively and efficiently Since many emergencies may bring large allocate resources and personnel.” Rigby recommends that everyone de- numbers of people to Northwest Hospi- velop a home emergency plan and then tal, the emergency management com- Gayle Ward, vice president of clini- practice that plan. He also emphasizes mittee makes sure that the security staff cal services and chief nursing officer that in the event of any emergency, lis- is prepared with training and adequate at Northwest Hospital, points out that tening to directions and information on supplies, to deal with a surge of people. administrators and directors of various TV or on the radio is extremely impor- Some hazards, such as earthquakes or departments within the hospital have tant. “For example, some emergencies windstorms, may incapacitate electri- been trained as incident commanders. may require you to stay where you are, cal and water systems, so the hospital’s rather than move around the commu- engineering division must also be “Any one of us can lead the organiza- nity or evacuate. Paying close attention prepared to provide utilities to support tion if an incident were to occur,” Ward to messages in the media will clear up healthcare operations. And some events, says. “That, and our integration into the any confusion about what to do next,” such as chemical exposures or biological larger community and regional emer- he says. hazards like anthrax, may require mass gency management leadership, makes decontamination. Northwest Hospital unique. We’ve put For more information on personal a lot of time and energy into that, quite and community emergency prepared- Some threats may even require evacu- successfully.” ness, visit 3 Days 3 Ways at www.govlink. ation of patients, so the hospital staff org/3days3ways. must be prepared to use several differ- Ward adds that the community can be ent kinds of equipment and techniques confident in Northwest Hospital during noVeMBer/DeceMBer 2007 7
  8. 8. In the Community Playing Favorites with Graham Kerr Imagine eating all the foods you really you can’t have rules. It has to be about developed like and never having to eat the ones you individual choices.” into a real don’t. Although that may be stating it a threat in little too simply, that’s the idea behind Kerr started over from scratch by asking the United Graham Kerr’s approach to healthy eat- Treena which foods she loved and which States,” Kerr says. “The ‘H Factor’ is the ing. she didn’t want to eat. He didn’t remove only thing that separates the two words. any of the foods Treena loved from the ‘H Factor’ foods are high in volume and Known for years as the Galloping Gour- list. Instead, he worked with his wife to high in repetition in our diet. In other met, Kerr wants to help people, particu- discover what a reasonable and moderate words, we eat too much of them and we larly those with diabetes, enjoy what they serving of those foods would be for her. eat them too often.” eat while avoiding the negative health effects associated with over-indulgence. “Since she loves bacon and likes to have Kerr points out that once people analyze four pieces, the reasonable and moder- their diets, they can then make reason- It all goes back to his beloved wife, ate choice for her was two pieces,” Kerr able, moderate changes that cut down on Treena. When she was diagnosed with explains. “She loves tomatoes and I love calories, fat grams and even cost. diabetes, Graham, the primary cook in to broil them, so now that goes on the the house, set a number of rules for what plate in place of two strips of bacon. We To learn more about Graham Kerr’s ap- Treena could eat. During the memorable have less of what harms her and more of proach to a satisfying, healthy diet, join argument that followed, Treena threw what will do her good. him at the Northwest Hospital Diabetes away almost everything in the kitchen Education Forum at 7 p.m., Tuesday, cupboards. “She was shouting, ‘There “Now our diet is all her preferences,” November 27, at Third Place Commons is nothing left in the world to eat with Kerr emphasizes. “This is not hardship in Lake Forest Park. He’ll sign his new you!’” Kerr recalls. – this is actually an enhancement that book, “Day-by-Day Gourmet Cookbook” makes life better.” after his presentation. Blood sugar and “I made rules, Treena rebelled, we blood pressure screenings will be avail- compromised and then eight years later, “I see the sublime need to have food able from 6 - 7 p.m. For more informa- she had a stroke. So now I tell people, as a treat, while I also see that food has tion, call (206) 368-1564. Northwest Hospital Medical Center has been awarded the 2007 HealthGrades Distinguished Hospital Award for Patient Safety and the Award for Excellence in Stroke Care. Non-Profit Org. U.S. Postage 10 N 11th Street PAID Seattle, WA Seattle, WA 981 Permit No. 1549