Key points from today’s guests:
Morning Rounds – Updates on Current News
Dr. Julia Slater, medical director, Burnett Burn Center, The University of Kansas Health System
- Since last week, we've seen and evaluated 11 different patients with frostbite and we have five more coming into the hospital in an outpatient setting. We were able to discharge two from the ER but all the rest had to be admitted and we're seeing some pretty severe cases and a lot of use of thrombolytics.
- Frostbite is really ice crystals that form in your tissues. And those ice crystals destroy the cells and cause cell death, which is what leads to the ischemia or the loss of blood flow in your extremities -- anywhere that's far away from your blood supply -- your fingers, your toes, your nose, your ears, on your face are all particular sites that we commonly see frostbite.
- What we have found so far is that clot busting or thrombolytics is one of the only medications that can help decrease the risk of needing an amputation. If a patient does need an amputation, these drugs can actually help preserve as much tissue as possible so that we can amputate smaller parts of fingers or toes.
- The first step in treating frostbite is really prevention. Having multiple layers of clothing, especially loose layers that allow some air to get between them, making sure that all of your extremities are covered so face masks and goggles, as well as gloves, often two pairs of socks on the feet, and most importantly staying dry.
Focus Topic
Dr. Steve Stites, chief medical officer, The University of Kansas Health System
- We're learning more about a rare genetic condition that creates thousands of polyps in the colon. When left untreated, it effectively guarantees patients will get cancer.
- The CDC recommends starting colonoscopies at age 45. And for people with the condition we're focused on today, colonoscopy could start as young as the age of 10.
- It's called FAP -- familial adenomatous polyposis. Familial as in family, meaning it's an inherited condition. Adenomatous polyposis refers to a common type of polyp, which can turn into cancer if it's not removed.
- When we say evidence based medicine, what it is means that we're looking at research and scientific data that's been shown in patients to demonstrate a certain way of prescribing medications or treating patients. When we follow those guidelines, we're doing it with evidence based medicine.
- The advantage over 20 or 30 years ago is there's a lot more evidence research. There are a lot more tools of the trade, and we are much better at it because we've got a lot more information at our disposal to guide our therapies.
- All academic medical centers lead the way in that and probably the best research in the world comes out of this country. We clearly lead the way around evidence based medicine.
Kay Secker, living with FAP (Familial Adenomatous Polyposis)
- Her father passed away from colon cancer when she was 16.
- Her family didn’t know what that meant for them.
- She had some severe intestinal symptoms and had a scope that found polyps. Her siblings were brought in the next day, and 4 of the 5 tested positive for FAP.
- Kay ended up with Stage 3 colorectal cancer. She had her first colon surgery at age 21. She now has one-fourth of a normal small intestine, which does affect her with nutrition and hydration.
- She recommends that people listen to your body and watch for trends.
Dr. Ajay Bansal, gastroenterologist, medical director, Gastroenterology Cancers Prevention Clinic, The University of Kansas Cancer Center
- FAP is an inherited disorder where you have a gene abnormality you are born with, and with time that causes increased number of polyps. And that increases the risk of these polyps forming at a very young age -- as young as age 10.
- Patients with FAP can be at increased risk of colon cancer, stomach cancer, brain cancer, skin cancer, and pancreatic cancer, so that's why it's very, very important to diagnose this condition in time so you can be proactive.
- The main treatment option is definitely surgery at the right time. But with the right medications and the right amount of colonoscopies, you can delay surgery by 3-5 years.
- This is very rare. In the general population, the defect that causes FAP is about one in 100,000.
- There is more hope on the horizon for people with FAP, including a potential vaccine.
- There needs to be more legislation to help with costs to families with this condition.
COVID Updates
Dr. Dana Hawkinson, medical director of Infection Prevention and Control, The University of Kansas Health System
- This week, the COVID count is at 23 active inpatients, which is down from 33 COVID patients last week.
- Over the past few weeks, COVID, RSV, and influenza patients in the health system have increased, but it looks like cases may be hitting a plateau.
- The idea that COVID is the same as influenza is false – more patients are being hospitalized and admitted to the ICU with COVID than influenza.
- There are many factors as to why. Mainly, this has become a disease of those people whose age and comorbidities can make them more vulnerable.
Friday, January 19 at 8 a.m. is the next Morning Medical Update. From skin removal to breast reconstruction surgery – weight loss surgery is a goal, but not a finish line. Learn more about one woman’s journey after losing 150 pounds.
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