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skin substitutes, biological and bio- sy nthetic dressings, grow th factor t herapies, a nd hy perba r ic ox ygen therapy (HBOT). HBOT is an adjunct therapy that uses a pressurized, oxygen-rich envi- ronment to trigger the body's natural wound-healing abilities to function more efficiently and effectively. During the therapy sessions, oxygen is delivered to the body's tissues at up to 20 times the normal volume. "We use HBOT in conjunction with other modalities to try to heal some of the more difficult wounds," Dr. Rowe explains. These include diabetic ulcers, soft tissue radionecrosis, osteoradione- crosis, chronic refractory osteomyelitis, and compromised skin grafts. Recently, his team utilized HBOT to control internal bleeding of a 12-year-old girl with acute myeloid leukemia (AML). As a 5-year-old, she had five rounds of chemotherapy, which resulted in remission of her AML. Six years later, however, the cancer returned. This time a bone marrow transplant was needed. "As a side effect of the transplant, she developed severe internal bleeding requiring daily blood transfusions," Dr. Rowe explains. "Before she was referred to our wound care center, she had undergone all other modalities of treatment and none were successful." The young girl received HBOT for two hours a day, five days a week. Soon a f ter treatment began, there was a decrease in the amount of bleeding and daily blood transfusions were no longer needed. After eight weeks, the bleeding stopped altogether. "We generally don't see pediatric patients for HBOT. This was a special case referred to us by a pediatric oncolo- gist at UH Rainbow Babies & Children's Hospital," says Dr. Rowe. He points out that HBOT is more com mon ly u se d to t reat d ia b et ic ulcers — something that can be pre- vented. A nd that's why the Wound Care & Hyperbaric Medicine Center works together with the UH Bedford Diabetes Center … for prevention and early detection of diabetic wounds. Prevention and Early Detection Compliance is the key, and that's one of the goals of the UH Bedford Diabetes Center. Staffed by a nurse practitio- ner, clinical dietitian, nurse educator, pharmacist and physical therapist, the Center focuses on eliminating barriers to compliance and empowering patients through education. Yvonne Evans-Warren is the nurse pract it ioner. " We work w it h each patient and his or her physician to develop a personalized plan of care that's accessible to all of the patient's healthcare providers. We also establish baselines that will enable providers to monitor each patient's progress," she explains. "It's a collaborative effort." The Diabetes Center staff strives to improve pat ient s' d iabetes self management and overall well-being by educating them about the importance of, and making them accountable for, t heir HgbA 1c, lipid ma na gement, blood pressure control, smoking ces- sation, annual eye exam including a fundoscopic exam, routine daily foot inspections and annual foot exams, and annual screens for nephropathy. "Diet is also addressed by our reg- istered dietitian," says Evans-Warren. "And we have a physical therapist who speaks at our educational sessions about the importance of physical activity and exercise." The series of four 90-minute edu- cational classes meet on Thursdays. Both afternoon and evening sessions are available. (Visit UHBedford.org to view the class schedule.) "The Diabetes Center does not replace a patient's physician. It collaborates with them," emphasizes Evans-Warren. "The result is better patient compliance and well-being." For more information about the Diabetes Center at UH Bedford Medical Center, visit UHBedford.org/Diabetes. To refer a patient, call 440-735-4700. To learn more about UH Bedford's Wound Care & Hyperbaric Medicine Center, visit www.uhbedford.org and click "services." To refer a patient, call 440-735-4755. ■ HBOT is an adjunct therapy that uses a pressurized, oxygen-rich environment to trigger the body's natural wound-healing abilities to function more efficiently and effectively. During the therapy sessions, oxygen is delivered to the body's tissues at up to 20 times the normal volume. 2 0 1 4 M AY/J U N E ■ M D N E W S . CO M ■ MD NEWS Cleveland/Akron/Canton | 2 3