Summer 2014
y o u r g u i d e t o h e a l t h & w e l l n e ss
Care d e z nali Perso
Medical Modernization Advancing The ways we care for you
Bill Calhoun
Everywhere I go, my phone follows. It talks to me in beeps, chimes and tings – notifying me of accumulating emails, text messages and news briefs. Thanks to innovators like Steve Jobs, Jeff Bezos and others, we have been taught to expect the novel thing. We yearn for the newest phone, the smartest car, the savviest TV. Those who desire and own the newest innovations are called early adopters. Here at Affinity, we strive to bring you the best in modern healthcare. Recently, we opened our new hybrid operating room at St. Elizabeth Hospital in Appleton. The space, which is three times the size of a normal operating room, allows doctors of multiple specialties to use the most advanced technology available and see inside your body with magnified, high-definition clarity. Check out the features on page 15. We now offer a creative alternative to patients with chronic conditions called shared medical appointments, which has been proven to increase patient access and vastly improve health outcomes. Read about the successes on page 13. And for patients who suffer from a chronic heartburn disorder, getting connected to one of the nation’s top general surgeons who performs an advanced new treatment is now
much easier. Learn about one man’s journey to regaining his “old self” on page 10. These are just a few of the advancements we’re featuring within the pages of this issue. We are doing as early adopters do – relying heavily on our intuition and making educated decisions on boundary-pushing concepts and technology. It’s our duty to make sure you have a seamless experience no matter the ailment or condition, and receive better, more compassionate care. You want the best, and we want to give you the best. After all, we can’t enjoy the hottest new device if we don’t have our health! Sincerely,
Bill Calhoun President and Regional Vice President Affinity Health System/Ministry Health Care
s p sn @
e e for th to be an r a c t s oud n’t ju We do ity, we’re pr is a glimpse un e comm rt of it. Her ctivities in a pa active of our recent rve. e se of som munities we the com On May 21, Ca lum associates and et Medical Center (CMC) thei ground at the ne r families came out to break w community ga hospital campu rd s. Staff from CM en on the C’s Nutritional Services departm en t pl an s to offer fresh vegetables fro m th staff; and comm e garden to patients and unity members can purchase a food plot and ge t is offered thro their hands dirty. The garden ugh CMC in pa rtner Calumet Coun ty Master Garde ship with ners and the UW-Extension.
lth System Affinity Hea other year of an ed et pl m co ene products gi hy g in ct colle e Homeless th p el H for the 2014. ch ar Drive in M om Affinity fr ns io at on D ve averaged associates ha of product th or w $15,000 a e 2008. Extr annually sinc ssen Buses bu thanks to Ko le in helping r ro Ltd. for thei . e collections to deliver th
eth Hospital’s pril, St. Elizab lts and made A in y da g rin be On a warm sp snapped on their tool nteer day am part of a volu tion aims as na leadership te au uk Ka za ni in e ga or us e ho a Th repairs to r Fox Valley. mmunities fo e ing Together co ild d bu an Re es m ith w os ho e th d liz ta an vi s re or and ifically seni to preserve wners – spec inue to live in warmth, eo m ho e m low-inco can cont ies – so they with disabilit pendence. de safety and in
Fourteen-year-old Braxton Verner, wh o was featured in @Affinity this past winter, was invited to first pitch and run the bases at the W throw out the isconsin Timber Rattler game on Ma y 31. Rattlers put on “Surv Together, Affinity and the Timber ivor Games” throu ghout the summer when individuals wh o ha and come out on top ve gone through a health crisis are honored on an d off the field. Braxton helped to “Stri story with the crowd ke Out Stigma” by sharing his .
S u mmer 2 0 1 4
Affinity Health System Menasha, WI www.affinityhealth.org
FEATUREs
President and Regional Vice President, Affinity Health System/Ministry Health Care Bill Calhoun, FACHE Vice President – Chief Marketing Officer, Ministry Health Care Vince Gallucci Editorial Management Jennifer Wagner Mauk John Egan Alison Fiebig Mayer Volume 4, Number 1 The material in @Affinity is not intended for diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines. @Affinity is published four times annually by Affinity Health System. For permission to reprint any portion of this magazine, change your address, discontinue multiple copies or stop receiving @Affinity, please contact us at editor@affinityhealth.org. © 2014 Affinity Health System. No portion of this magazine may be reproduced without written permission from Affinity Health System.
10 Change of Course
Collaboration gives chronic acid reflux sufferers fast relief
13 Common Denominator
Patients with similar conditions try group doctor appointments
15 The Hybrid Advantage
DEPARTMENTS 4 SHORT CLIPS 5 BY THE NUMBERS 6 CHEW ON THIS 8 IN SEASON 18 AFTER CARE 20 GIVING BACK 21 GIVING BACK FOUNDATIONS 22 You asked 23 IN THE KNOW
New hybrid OR in Appleton is reducing risks and saving lives
Mission, Promise, Vision and Values At Affinity Health System, our mission guides our actions.
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8
Mission
Photographs by Shane Van Boxtel, Image Studios Cover illustration by Davide Bonazzi
Our mission as a Catholic healthcare system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve.
AFFINITY HEALTH SYSTEM IS.
Promise We promise to provide personalized care by listening, treating you with respect and putting your needs and interests first.
Vision Healthcare that works. Healthcare that is safe. Healthcare that leaves no one behind!
Values The way we accomplish our mission is as important as the mission itself. These values of our sponsor, Ministry Health Care, guide our actions.
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• St. Elizabeth Hospital ‑ Appleton • Mercy Medical Center ‑ Oshkosh
• Calumet Medical Center ‑ Chilton • Affinity Medical Group Clinics • Affinity Occupational Health
For a complete list of Affinity clinic locations or to find a physician, go to our website at www.affinityhealth.org or call Affinity NurseDirect at 800.362.9900.
Our blog: www.affinityhealth.org/blog Follow us:
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S HORT
clips
From Hearing Loss to Hearing Win
Digital Disease Your job could be making you sick
Admitting hearing loss and how to overcome it
We literally have the world at our fingertips thanks to technology, but it comes at a cost. Studies indicate there’s a trend of reduced physical activity driven by use of electronics.
T ravis F oster
By Nicholas Heenan
L
udwig Van Beethoven once said, “My defective hearing appeared everywhere before me like a ghost; I fled from the presence of men, and was obliged to appear to be a misanthrope although I am so little such.” One of history’s greatest musicians could not hear his own music for the majority of his career. Because his life’s calling was to create masterpieces of sound that, even today, remain as popular as ever, his frustration with his own hearing loss led him down a dark road. As acknowledged in the quote above, he preferred to avoid humankind rather than acknowledge his deafness. Minus the classical masterpieces, does this sound like a familiar story? You are having a conversation with a friend or relative whom you suspect suffers from hearing loss, and you ask them if they’ve taken out the trash. They respond with: “No, I didn’t take out any cash! I didn’t even go to the bank today.” According to Dr. Susan Iwanski, an audiologist at Affinity Medical Group’s Koeller Street Clinic in Oshkosh, acknowledging hearing loss can be difficult for some, especially those who already struggle with admission of 4 | @Affinity
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aging. For instance, the very mention of the term “hearing aid” conjures up the image of an aging relative struggling to pick up conversation. The proper term being used now is “hearing instruments.” “One of the biggest objections to admitting hearing loss is seeing the instruments as a sign of getting old,” she says. Age is one of life’s great situations that cannot be ignored, no matter how hard we try. Still, to talk frankly and openly about age and hearing loss is the key to prevention of not only further hearing loss, but of other health factors as well. “Untreated hearing loss can lead to social isolation and loss of enjoyment of social activities,” Dr. Iwanski explains. “That can lead to other health conditions, such as depression or dementia.” The cost of hearing instruments is also a major deterrent in the epic struggle to stop hearing loss. But don’t let that be a hindrance. “You don’t need the Cadillac of hearing instruments to get where you need to be,” Dr. Iwanski adds. “Most instruments are much more affordable than is popularly believed.” For friends and family of someone who
According to the U.S. Bureau of Labor Statistics, nearly half of all jobs required physical activity in the 1960s. In 2010, less than 20 percent did. Today, more than 80 percent of Americans work jobs that require little to no physical activity. It’s no wonder – with a vast majority of careers keeping us behind a desk. Zero in on your sedentary habits; take frequent breaks to stand, stretch and walk around. What do you do to beat the deskbound blues? Upload photos of your creative ideas to combat sedentary habits using the hashtag #standingupforhealth for a chance to be featured in the next issue of @Affinity!
is suffering from hearing loss, keep in mind some strategies for helping your loved one cope with this invisible condition, as well as encouraging them to seek help. Dr. Iwanski recommends: » Increase the amount of time you speak with them one-on-one. » Reduce distractions by turning off the TV or radio. Speak clearly and enunciate your words well. » Above all, remain patient. If they sense frustration, they may avoid social situations, and that can lead down the dark road once trod by Beethoven. » Remain vigilant. Don’t be afraid to talk about hearing loss. Beethoven eventually overcame the depression surrounding his deafness to write the Ninth Symphony, which contained a Fourth Movement aptly named, “The Ode to Joy.” Thankfully, you don’t need to write a world-famous symphony for your own ode to joy. You only need to talk about your hearing loss. To make an appointment with an Affinity Medical Group audiologist, call 920.730.4443 in Appleton and Neenah or 920.223.7330 in Oshkosh. w w w. a f f i n i t y h e a l t h . o r g / b l o g
by the
numbers
00,000,000 The company that makes sriracha – a popular, peppery sauce – harvests about
100 million pounds of peppers each year. To read more about the sweet and spicy condiment, turn to page 7.
80% of harmful ultraviolet rays can pass through clouds, and your risk of skin cancer doubles if you have had five or more sunburns. Baseball fans will consume an estimated
21,357,316 hot dogs during the
Protect yourself, rain or shine!
2014 Major League season (plus a whopping 5,508,887 sausages), according to the National Hot Dog and Sausage Council. That’s enough hot dogs to stretch from Dodger Stadium in Los Angeles to Wrigley Field in Chicago!
click
16,000,000,000 photographs have been shared on Instagram at a rate of 55 million images a day, while Facebook users were uploading 350 million photos daily (as of last September). Do you partake in the “foodtography” movement? Flip to our back cover to learn how to contribute to our #whatsforlunch hashtag.
737 737marathons are scheduled in the U.S. and
The Boldt Company has poured more than 7,000 cubic yards of concrete
Canada this year. One of them – the 24th annual
into the new bed tower at St. Elizabeth Hospital, which is slated to open
Community First Fox Cities Marathon – will be held
early next year. If you were to take that amount of concrete and build a
on Sunday, September 21. Flip to page 9 to read one
four-feet-thick by four-feet-wide sidewalk, it would stretch almost 27 miles
woman’s account of training for two half-marathons,
long. That’s the distance from St. Elizabeth Hospital to De Pere!
five months apart, for the first time in her life.
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chew on this
Sriracha Marinated Salmon Recipe by Jay Rommelfanger, executive chef at Mercy Medical Center’s cafeteria Serves 2
Ingredients
2 salmon fillets* 1/4 c. olive oil 1/8 c. apple cider vinegar 2 tbsp. sriracha 1/4 tsp. lime zest Pinch of salt and pepper
Directions
T hinkstock
1. Combine olive oil, apple cider vinegar, sriracha, lime zest, salt and pepper in a bowl, and pour over the salmon. Allow to marinate refrigerated for 30 minutes.
Some Like It Cold Beat the summer scorch with homemade ice pops
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elieve us when we say you can eat a sweet treat and not feel guilty. We’re longing for a frozen Latin American treat called a paleta. These popular ice pops are traditionally made with fresh fruit and are creatively combined to make flavors like mango-chile, avocado-coconut, peach-vanilla and spicy blackberry-pineapple. They’re so popular in Mexico, in fact, that one city in Michoacán even raised a statue of a paleta at the entrance to the town. Many area stores and online retailers carry ice pop molds (go for the smaller, 3- or 4-ounce option), which makes assembling and lifting them out to devour easy. If you have kids, let them get in on the action and you’ll find that they love making them almost as much as they love eating them!
Mix and match Liquid ingredients:
• Water • Milk (your preference) • Pureed fruit • Fresh juice (or fresh lemonade) • Greek yogurt • Honey
Solid ingredients:
•F ruit: strawberries, raspberries, blueberries, kiwi, pomegranate, peach, mango and melon • Mint, basil, rosemary or tarragon • Zest from a lime or lemon • Unsweetened coconut flakes • Shaved dark chocolate • Almond slivers
Tip: Sprinkle in a little bit of salt to bring out the natural sweetness of the fruit.
It’s summer – the best time to get your hands on local, seasonal produce. Collect your loot at the local farmer’s market and get mixing! But if you’re on the go and need a fix, stop by the ice cream counter at La Michoacana (also called The Chicken Palace) in Appleton. They offer two blends of paletas: crema (cream pops) and agua (water pops) for less than $2. They use fresh ingredients and prepare flavors like pineapple, currant, cantaloupe, guava and lime. Need some inspiration? Check out a variety of paleta recipes on our “Good Eat’n” Pinterest page at www.pinterest.com/AffinityHealth. 6 | @Affinity
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2. Place the salmon on a baking sheet or into a glass 9x9 pan. Bake in the oven at 350F for 10-15 minutes, checking to see that it is cooked through to your liking. Salmon can also be grilled (the cook time will be a little less than cooking it in the oven). Start belly side down and finish by flipping to the skin side. Make sure that your grill is very hot prior to putting the fillets on the grill to prevent sticking. Chef’s note: This marinade does provide a little heat. If you would like a little more, increase the sriracha in small amounts. Once you add it you can't take it back, so add and taste as you go! * This marinade also works great on shrimp. Chef Jay mixes sriracha with ketchup for dipping fries and adds a drizzle to his burgers. Every Wednesday, he features ethnic food days in the cafeteria at Mercy Medical Center. Stop in to try dishes like paella (Spanish rice dish), Thai curry pork, Lebanese chicken Shawarma (like a gyro), Mexican posole soup with a torta (sandwich), and more.
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Sayonara, ketchup. Hello, sriracha.
E
By Hannah Darling
ven if you aren’t quick to reach for hot sauce at mealtime, you may be drawn to the unique taste of the garlic and red chili sauce called sriracha (pronounced “SIR-rotch-ah”). The hot, tangy and slightly sweet condiment is well-loved as a dipping sauce, on eggs, sandwiches, tacos or burgers, and even an addition in noodle dishes, soups, and marinades. If you’re an avid fan, it’s likely you enjoy sriracha on just about any savory dish. The bright red sauce is often found on the tables of Thai, Vietnamese and Chinese restaurants across the U.S., but has also made its way onto grocery store shelves and the pages of culinary magazines. Even for those who aren’t big on heat, many have found its wellbalanced combination of ground chilies, garlic, vinegar, salt and sugar to be the perfect way to introduce a little zest in the kitchen. A teaspoon of sriracha carries five calories, one gram of
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carbohydrates and 100 milligrams of sodium. While its mild kick might clear your sinuses, it may also help fight a common cold since chili peppers contain capsaicin – an inflammation-fighting chemical compound that occurs naturally in plants. Sriracha is named after the coastal city of Si Racha, located in the Chonburi Province of Eastern Thailand, where it was first served at local seafood restaurants. In 1983, Huy Fong Foods, a company in Los Angeles, created a chili sauce made from fresh red jalapeño chili peppers that contains no added water or artificial colors.
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in season
WHAT TO WATCH FOR:
Common signs of concussion (what others may see in an injured athlete): » Dazed or stunned appearance » Change in the level of consciousness or awareness » Confused about assignment » Forgets plays » Unsure of score, game, opponent » Clumsy » Answers more slowly than usual » Loss of consciousness » Asks repetitive questions or has memory concerns
Heading Off Brain Injury
Concussions take a collective hit thanks to increased education and collaboration By Paul Nicolaus
Common symptoms of concussion (what an injured athlete may feel): » Headache » Nausea » Dizziness or unsteadiness » Sensitivity to light or noise » Feeling mentally foggy » Problems with concentration and memory » Slow or easily confused
travis foster
Call Affinity NurseDirect
I
t wasn’t until her own son dealt with the lasting effects of a series of concussions that the severity of the issue set in for Jill Pascarella. “We had no idea about the memory loss he would suffer or the inability to retain the information he was getting in school,” she says. As the principal at Traeger Elementary in Oshkosh, Pascarella says her personal experience completely changed her approach to dealing with this health concern in the schools, and she views education as a tool that can help create greater awareness. Dr. Willa Fornetti, a non-surgical orthopedic and sports medicine physician at The Kennedy Center at Mercy Medical Center in Oshkosh, is working in conjunction with Traeger, other area schools, and the Oshkosh YMCA to help parents and professionals who supervise youth sports better understand head trauma and how to appropriately respond. Dr. Fornetti is one of several providers collaborating with Affinity
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CONCUSSION 101
A concussion is a type of traumatic brain injury that interferes with normal function of the brain and can be caused by a blow to the head or even a blow to the body alone. It is important to know that loss of consciousness is not required to have a concussion. In fact, according to the Wisconsin Interscholastic Athletics Association (WIAA), less than 10 percent of athletes lose consciousness. Even what appears to be a mild blow to the head or body can cause the brain to suddenly shift or move.
licensed athletic trainers (LATs) who are in the schools assisting student athletes. While images of smash-mouth hockey or helmet-to-helmet football might be the first to conjure up discussion of concussions, it’s
at 800.362.9900 to schedule an appointment with one of these Affinity providers who specialize in treating concussions: »D r. Willa Fornetti, non-surgical orthopedic and sports medicine physician, The Kennedy Center at Mercy Medical Center, Oshkosh »D r. Christoffer Birn, pediatrician, Children’s Health Center at St. Elizabeth Hospital, Appleton »D r. Wendy Schroeder, family physician, AMG Greenville Clinic »D r. Cheryl Pitre, family physician, AMG Airport Road Clinic, Menasha »D r. Alex Garcia, orthopedic physician, St. Elizabeth Hospital, Appleton »D r. David Olson, orthopedic surgeon, Calumet Medical Center Clinic, Chilton
important to note that this type of traumatic brain injury can affect young athletes participating in a wide variety of sports and activities. And parents can be key players in the detection process. “Knowing what to look for is very important,” Dr. Fornetti says. “Parents may see their kids having signs of a concussion and be the first to recognize they had an injury.” If head trauma is suspected, parents, coaches and sporting officials should work to ensure that young athletes are pulled from the practice or game so they can receive a full evaluation by a medical professional before returning to play. Doing so will help prevent further injury, more serious long-term damage, and even death in the most serious of cases. Remember: when in doubt, sit them out. w w w. a f f i n i t y h e a l t h . o r g / b l o g
Reflections
hammies ! Meet Your _____________________
An essay by Robyn West, cardiac and pulmonary rehab specialist, about a race eight years in the making
By Janine Boldra
Did you know there is a wrong and right way to stretch?
DO
DON’T DO
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ever in a million years would I have considered myself a runner. I despised every aspect of it and couldn’t understand why people would “run for fun.” My journey as an avid exerciser started eight years ago after having my daughter. I knew that in order to be able to keep up with my children, my husband and I needed to make several lifestyle changes. So I put together and managed to maintain an exercise program, which includes running four days a week along with strengthening exercises. I try to eat as best as possible by meal planning and clean eating. If I’m putting good foods in my body, then my body will be good to me. The end result? I lost almost 100 pounds. My plan did not include becoming a runner. In fact, I hated every minute of it! But as time went on, I found myself being able to tolerate longer distances and eventually faster speeds. Fast forward to January 1, 2014, when I started a 16-week half-marathon schedule. I didn’t really think that I would be able to finish the program, but after several weeks of following a schedule, the idea of running a half-marathon became more real. With the help of my friend, I not only signed up for the Oshkosh halfmarathon this past spring, but the Fox Cities half-marathon this September. Two in one year! Running has taught me a lot about my body and my well-being. I’ve learned to listen to my body. I’ve learned that a “rest day” means absolutely no exercise. I’ve learned what it means to pace myself. I’ve learned that you can’t control the weather. Because we had a very rough winter, I was forced to train on a treadmill indoors at 4:30 in the morning. I dreaded those runs, but it was worth it in the end. I was not completely confident I could complete a half-marathon until week 10 of training when I had to run 12 miles. After achieving this, I knew I had a chance. Running my first half-marathon was a huge accomplishment and is probably one of the hardest things I have ever done mentally and physically. I could not have done it without the support of my husband and friends. I am very excited to jump into my training program for the Fox Cities half-marathon. My goal is to improve my speed and endurance. My advice to you: have a plan and stick with it! The Community First Fox Cities Marathon and Half-Marathon will take place on Sunday, September 21, with a variety of other events on Friday and Saturday, September 19-20. For more information, visit www.foxcitiesmarathon.org.
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hrough my work as a physical therapist, I have spent my career working with people who have musculoskeletal issues (and have even endured them myself). I love inspiring people to exercise, and to do it the right way. Exercise consists of three areas – aerobic, strengthening and flexibility – and a person needs balance in all three in order to avoid injury. One of my missions as a professional is to have everyone stretch their hamstrings correctly (seriously). I often see someone place their foot up on an elevated, flat surface and lean forward until their face touches their knee. What is really being stretched in that position is the back, which can cause injury. Here’s what you should be doing: Stand up straight with your feet under your hips. Take one small step forward (you may have to bend your supporting knee) with your heel on the ground. Then, while keeping your knee straight, slowly bend at the hip keeping a slight arch in your back (stick out your buttocks). Say “hello” to your hamstrings! Hold for about 2030 seconds for a nice relaxed stretch. About Janine: Having been a physical therapist since 1976, Janine Boldra is currently the manager of rehab services for Affinity and has spent the last 30 years of her career in various rehabilitation roles at St. Elizabeth Hospital. Her career allows her to spend time with people and restore or optimize their functionality. In her free time, Boldra participates in endurance sports and has completed 24 Birkebeiner XC ski races and 30 Ironman triathlons. She's also done an Ultraman World Championship: a three-day race that requires each participant complete a 6.2 mile open-ocean swim, a 261.4 mile cross-country bike ride, and a 52.4 ultra-marathon run.
Good Form
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ooking for advice on your running form or how to alleviate running injuries? Affinity licensed athletic trainers (LATs) facilitate a Running Analysis Clinical Evaluation (RACE) program, which examines an individual’s shoe-wear patterns and foot, knee and hip anatomy in order to identify abnormal running traits. They also assess strength and flexibility in the ankles, knees and hips to pinpoint imbalances or weaknesses. Included in the cost of the program is a video running analysis in which your foot strikes and running form is recorded as you run on a treadmill. Using slow-motion playback, LATs help you visualize the full running form from heel strike to toe-off. For program details, visit www.affinityhealth.org/RACE or call 920.996.3700 to make an appointment at St. Elizabeth Hospital in Appleton. Summer 2014
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Med ic a l Mo d e r n i z at i o n
Change of
Course By A l i s o n F i e b i g M ay e r
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/ P h oto g r a p h s by SHA N E VA N BOXT E L , I m ag e St u d i o s
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For nearly a decade, Rasper lived with gastroesophageal reflux disease, also known GERD as GERD, which is a chronic heartburn Gastroesophageal condition in which stomach acid backs up into refers to the stomach the esophagus and causes a burning feeling. and esophagus. Reflux means to The 56-year-old first started experiencing flow back or return. sporadic symptoms of the digestive disorder. Gastroesophageal “I’d feel bad for a day and sort of write it reflux is the return off,” Rasper says. “I’d pop a pill, it’d go away of the stomach’s and I’d be fine.” contents back up into But that only worked for so long. He the esophagus. became more sensitive to the matter when symptoms intensified into a constant cough, difficulty swallowing and severe acid reflux. Then, in 2011, he started feeling chest pains and shortness of breath, which scared him into thinking he was having heart issues. “Everyone around me, including my general practitioner, thought I was having heart issues,” Rasper remembers. “I can’t count the number of EKGs and chest x-rays I had. Every time the symptoms would flare up, that was the process. No one was thinking outside of the box. It was exhausting.” He wasn’t experiencing obvious heartburn symptoms, so he had no idea his illness was linked to the food he was eating. So he did what most people do when they don’t feel well: Google his symptoms. All signs pointed to acid reflux. “Looking back, it would have been nice to have an easier way to get to Dr. Janu faster,” he says. “I had to find out more about it and find out if there were other options.” He made an appointment to see Dr. Timothy Edison, gastroenterologist with Affinity Medical Group, who performed a scoping test. The results showed that Rasper did have GERD, as well as early signs of Barrett’s esophagus, which is when the lining of the esophagus (the tube that carries food from the throat to the stomach) is damaged by stomach acid and changed to a lining similar to that of the intestine. In addition, Rasper also had Schatzki ring, a condition in which food becomes stuck in the throat when swallowing, and a hiatal hernia, which occurs when the small opening in the diaphragm where the esophagus passes through enlarges to allow the upper part of the stomach to slide upwards into the chest. An engineer by day, it’s no surprise that he became engrossed in the mechanics of his disorder. Even so, its complexity overwhelmed Rasper, and he resolved to find a fix.
Finding His True North
ark Rasper is a mellow fellow. He lives to cruise in his ’56 Thunderbird with his wife, Sharon – the top down, radio cranked and wind whooshing about them. But there came a time when life wasn’t so carefree – when a health disorder literally started to eat away at his easygoingness.
m
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Dr. Edison prescribed him Prilosec, a medication that treats conditions causing the stomach to produce too much acid. "That helped, but it didn’t eliminate the symptoms because they were mostly based on the type of food I was eating, how I was sitting, how I was sleeping, how I was putting pressure on my stomach – anything that caused activation of the acid,” Rasper explains. In summer 2011, he received an issue of @Affinity magazine in the mail and came across an article on GERD and a procedure that corrects the underlying cause of acid reflux. The piece also noted that about 10 to 20 million people in the U.S. have this chronic condition to which certain medications don’t respond. In needing to better understand his condition, Rasper and his wife attended a seminar presented by Dr. Peter Janu, general surgeon with Affinity Medical Group, who is currently ranked number four in the nation for performing the minimally-invasive procedure that cures GERD. Transoral incisionless fundoplication, or TIF, is one of the most advanced procedures for safely and effectively treating GERD. Using a device called EsophyX, the surgery is performed through the mouth, rather than through an abdominal incision. A completely incisionless procedure, TIF is performed under general anesthesia and reconstructs the body’s natural physical anti-reflux barrier. Most patients can go home the same day and return to work within a few days. Looking around at 100 other people packed into the conference room to see Dr. Janu, Rasper suddenly didn’t feel so alone. And it Summer 2014
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was good timing, because his symptoms had become so acute that he was no longer able to live a normal life. “My biggest take away from Dr. Janu’s seminar was that my disorder could be fixed, not just treated,” he says. After the seminar, Rasper took time to think about whether it was a good time to have surgery and figure out cost and insurance. A year passed before he decided the time was now. DR. Peter Janu “We like to go out and have dinner, and I was sick of being careful about everything I ate,” Rasper explains. “It was a drag, and I was afraid to go anywhere in case something would happen. My health was holding me back.” He met with Dr. Janu in fall 2012 to go over the varying degrees of the disorder and surgery. Then, in spring 2013, in order to confirm that Rasper would benefit from TIF, Dr. Janu would have to implant a sensor in his esophagus and observe his natural reflux, meaning Rasper had to go off his medication for 48 hours. “I tell people like Mark that this surgery is a lifestyle choice,” Dr. Janu explains. “Deciding to have surgery done should be based on how badly the condition is bothering you. That decision is different for each person.” The sensor indicated acid levels in Rasper’s esophagus were four or five times what they should normally be, and a scoping examination revealed the flap in his stomach that normally stops the reverse flow of acid was not only failing to function properly – it was non-existent. Rasper was the perfect candidate.
From GERD to Great
Rasper’s TIF surgery was the first of four scheduled on October 18, 2013. First, Dr. Janu repaired Rasper’s hiatal hernia and then performed the TIF procedure. When he came out of anesthesia, he had some pain in the surgical area of his chest and pain in his shoulder due to nerves of the diaphragm crisscrossing the nerves of the shoulder – all of which is normal. Feeling good otherwise, Rasper went home the next day. “The very first night I was home, I went upstairs to go to sleep, laid down and waited to feel reflux, but there was nothing,” he remembers. “I tried not to get too excited, because I was used to waking up in the middle of the night, but I woke up the next morning and thought – it’s gone.” Dr. Janu, together with his partners at Affinity, has now formed a Reflux Center of Excellence that brings AMG board-certified surgeons, gastroenterologists, and ear, nose and throat (ENT) specialists together to improve the quality and quickness of care for patients who experience GERD and other reflux disorders. “Back in 2010, we performed a TIF on our first patient,” Dr. Janu says. “It was in its infancy, and we had no idea how it was going to work for people, but we wanted to be on the cutting edge of new technology. Now, we’ve grown and advanced to a multi-specialty approach to treating the disorder.” The Reflux Center of Excellence is a unique collaboration of expertise blossoming into a “one-stop-shop” for patients – some traveling from as far away as Ohio and Tennessee for treatment. “There is a starting point for every GERD patient,” Dr. Janu explains. “Whether they first see a gastroenterologist, ENT or surgeon, they will have doctors coming at them from all different directions. It’s a lot more efficient, not to mention packed with added brain power.” Dr. Janu (who sees patients at St. Elizabeth Hospital in Appleton and Calumet Medical Center in Chilton) also now offers a newer procedure called LINX, in which a magnetic bracelet-like device is permanently implanted around the end of the esophagus to stop reflux. This gives patients another cutting-edge option to treat their condition.
GOT GERD? Common symptoms include: • Feeling that food is stuck behind the breastbone • Heartburn or a burning pain in the chest • Nausea after eating Less common symptoms: • Regurgitation (food coming back up) • Coughing or wheezing • Difficulty swallowing • Hiccups • Hoarseness or change in voice • Sore throat Symptoms may get worse when eating, bending over or lying down. If you’re experiencing these symptoms, call 920.849.3800 to set up a consultation with Dr. Janu. For more information, visit www.affinityhealth.org/reflux. live with a narrowed esophagus and severe reflux, you live by a different set of standards. “The TIF procedure is not designed to fix the problem and then allow the patient to go crazy,” Dr. Janu reassures. “It’s designed to fix the mechanical problem and guide you to eating smarter.” Rasper agrees. Chicken marsala and red wine used to be a distant memory; that is, until he had the surgery. Today, he’s slowly easing back into different foods to see what happens, and he hasn’t had any issues to date. “Instead of eating three large portions in a day, I now eat four or five smaller portions,” Rasper says. “I no longer get that burning sensation in my chest. And I can drink wine again!” In fact, he’s was so impressed with the procedure that he proposed the idea of speaking at one of Dr. Janu’s upcoming TIF seminars. This past spring, that’s exactly what he did. “I feel strongly about the success of this procedure, and I believe GERD isn’t talked about enough for as common as it is,” Rasper says. “The whole process of getting to Dr. Janu was filled with fear and concern. When you’re having symptoms that model a heart attack, at my age, it’s very scary. If there had been a vehicle like the Center of Excellence in place when I was going through the system, maybe I would have been feeling better sooner.” Whether he ends up being Dr. Janu’s poster child for the disorder or not, Rasper is just happy to have been gifted a new normal. You’ll find him on the open road, en route to his next, pined-after Italian meal.
The New Normal
Now, about nine months post-surgery, Rasper is living by a new mantra. As encouraged by Dr. Janu, he takes small bites, chews well, swallows and does not eat too much at any given time. Seems basic, but when you 12 | @Affinity
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Medic a l Mo d e r n i z at i o n
Common
A new type of doctor's appointment brings patients with similar conditions together to increase their chances at success and combat chronic diseases
Denominator + By A l i s o n F i e b i g M ay e r
Todd Jacobson sees his Affinity Medical Group doctor in a shared medical appointment, where he can also talk to other individuals who suffer from severe seasonal allergies
ou’re staring at a door, eyes on the knob, anticipating the light but lively knock before your doctor steps into the room. But just as soon as he or she enters the room, they are gone because visits with your doctor are commonly known to take about 15 minutes. A “hi,” “how are you?” and brisk question-and-answer session later, you’re on your merry way. Some patients don’t mind an accelerated appointment, but for others, it’s not enough time. And when you don’t have time to connect and interact with your doctor, you may feel less motivated to make a change or stay on course. What if you could see your doctor for a whole 90 minutes? Seems pie-in-the-sky, but there is a new type of doctor’s appointment available for some Affinity Medical Group (AMG) patients who wish to
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see their doctor for an hour and a half in a group setting called shared medical appointments (or SMA). This format offers an array of benefits, including more time with their provider and members of their healthcare team, and – the differentiator – other patients who see that provider for related reasons. Recently, a handful of AMG physicians across different specialties started offering SMAs in which 10-15 patients gather to ask questions, and share stories and concerns. The unique aspect to SMAs is the discussion not only includes a medical provider’s perspective, but also the perspective of the patients in attendance. “There is a lot of information to squeeze into a standard 15-minute office visit,” says Dr. Todd Meyer, ENT physician with AMG, who started SMAs in his practice as soon as he could. “In the one-on-one visits, I often don't have enough time to do all the education I’d like to do. The shared medical appointment has helped me transcend that time barrier by allowing me to spend more time in the group environment on the educational component. In my opinion, my w w w. a f f i n i t y h e a l t h . o r g / b l o g
patients are learning more, which provides them the opportunity to influence better outcomes.” For both new and existing patients who have chronic conditions like allergies, asthma, diabetes and hypertension, SMAs are particularly valuable because “concerns can be openly discussed with the group and the risk and benefits of different options can be fully explored,” Dr. Meyer explains. “It’s no longer just a doctor preaching to them – it’s real people sharing their struggles and successes.” In this case, most patients enjoy the opportunity to learn from and relate to others who are dealing with similar health issues and truly create a bond. Exploration takes place around medications, side effects and symptoms, even insurance issues. It’s not unreasonable for Dr. Melissa Koehler skeptics to say that
doctors like SMAs because they can see more patients per day. But patient satisfaction scores have gone up, and people like Todd Jacobson, who learned he had severe seasonal allergies in October 2013, are finding them to be a convenient, supportive option in helping to better understand his condition. “The biggest take away from my first group visit was that my situation wasn’t as bad as I initially thought it was,” says Jacobson, who attended his first SMA with Dr. Meyer this past March. “I was surprised to hear people had more severe experiences than mine. I definitely gained perspective.”
It All Adds Up For a man who spends his days teaching methods for solving equations, it’s easy to find value in an educational setting. But the ninth grade algebra teacher at Neenah High School didn’t need to plug into the quadratic formula to yield a resolution for his allergy health crisis; it required only simple math: Todd + his doctor + others going through the same thing = objectivity. “It’s like group therapy,” Jacobson explains. “Some people elaborated on the insurance portion because the drops are expensive. It was helpful to hear what works or doesn’t work for people. And I suddenly didn’t feel so alone in what I was going through.” Patients still get an abbreviated, one-on-one visit with the doctor when they arrive for the SMA. They are asked to sign a confidentiality form in order to comply with Health Insurance Portability and Accountability Act (HIPPA) and ensure they will not discuss other patients’ experiences outside of the visit. After being greeted, they are escorted into a spacious room with chairs arranged in a circular formation. Snacks and beverages are available to encourage conversation and shape a casual environment. The doctor, nurse or other healthcare team
DR. Todd Meyer
DR. Thomas Rowell
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members start the visit by taking aside each individual in a private room to record vitals and discuss recent shortfalls and successes in their condition. These tidbits help the doctor guide group conversation later in the appointment (patients must agree to let the doctor talk about their personal circumstance). Then, the group portion of the appointment begins. The doctor goes around the room and encourages patients to ask questions, talk about recent health happenings, new symptoms or developments, and share reflections on overcoming particular obstacles. “When you see someone who has just learned that they need allergy management, there is a lot of information for them to process and understand,” says Dr. Meyer. “Management options don’t seem as daunting when patients are able to relate to others in the group who share similar experiences. I am seeing my patients benefit greatly from this.” Dr. Thomas Rowell, psychiatrist at St. Elizabeth Hospital, started offering his patients the option to participate in SMAs this past February. He’s joined by his nurse, a licensed clinical social worker, patient registrar and a scribe, so he can facilitate the discussion. He has found SMAs benefit patients who struggle with addiction to opioids (like OxyContin, Percocet or Vicodin). However, those who live with psychotic disorders, autism or Asperger syndrome, or severe personality disorders don’t do well in a group environment. Six months in, he has also been able to free up about two or three appointment slots a week to see patients who require emergency attention – something he wasn’t able to do much of before starting SMAs. “I think shared medical appointments are a major advancement in medicine,” he says. “It brings a whole new dimension to outpatient care. SMAs are allowing me more time with my patients. Having a scribe allowed me to push my computer aside, look at each individual, look at their medications; I was paying more attention to them overall.”
Dr. Edward Noffsinger, the pioneer of shared medical appointments (SMAs), spent a week last August educating Affinity Medical Group providers on how to effectively run an SMA
The Man Who Started It All In spring 2013, Dr. Barbara Strand, regional vice president of primary care for AMG, and Liz Gillis, manager of clinic operations at Calumet Medical Center Clinic, heard Dr. Edward B. Noffsinger, Ph.D., the pioneer of group visits, speak about SMAs at Cleveland Clinic. Inspired by his solution, they applied for a grant through Ministry Health Care’s Education and Development Department to fly Dr. Noffsinger to the Fox Valley, where he presented to and trained AMG providers on the function of group visits for a week in August 2013. Dr. Noffsinger conceived the SMA concept when he was battling a serious illness. During that time, he grew dissatisfied with the healthcare system and wanted to do something about it. He believes that properly run SMAs “offer patient-centered care that improves access, quality, outcomes, productivity, revenues and both patient and physician satisfaction.” “I asked myself, how could we (healthcare providers) give patients more, not less?” he said during an interview when he was in the Fox Valley last summer. Dr. Melissa Koehler, OB/GYN with AMG, will begin offering an SMA to her third trimester patients this fall, giving moms-to-be the opportunity to chit-chat and connect with other women who are on the same journey. “I tend to answer the same questions over
To learn more about the providers interviewed in this article, visit www.affinityhealth.org/doctor. more time in her schedule to see patients coming in for regular gynecologic visits. And for those who opt not to participate in a group visit, they can see Dr. Koehler for a regular office visit as well – no questions asked. Yet, she foresees SMAs will add significant value to her pregnant patients. “Many of my patients come in and say, ‘I had so many questions but I don’t remember them anymore!’” Dr. Koehler explains. “If you get a large group of women together asking questions, you’re more likely to get a better answer.” The Driving Force As of 2012, about half of all adults – 117 million people – had one or more chronic health condition, and one in four adults had two or more chronic health conditions. It is predicted that by 2020, about 157 million Americans will have more than one chronic disorder, with 81 million having multiple conditions. The increasing need for health management of these disorders has challenged providers across the country to think creatively on how they can care for their patients, and AMG providers are motivated to rise to the occasion. “There were concerns when we first started
“It’s no longer just a doctor preaching to them – it’s real people sharing their struggles and successes.” — Dr. Todd Meyer, ENT, Affinity Medical Group In addition, SMAs are greatly improving access. In behavioral health, sudden needs emerge with no warning, but with the shortage of providers (which is a nationwide issue), the option to see Dr. Rowell within a few days wasn’t a possibility. By holding an SMA every other Monday and a few Tuesdays each month, he can now check in on his patients more often. “I have very good rapport with many of my patients,” he says. “I can see how refreshing it is for them to do something different in their treatment. They’re able to better understand my style of practice and how I approach various mental illnesses. I’m able to explain my thought process in more detail than I would have time to do in a one-on-one appointment.” 14 | @Affinity
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and over for third trimester OB patients,” Dr. Koehler says. “What does labor feel like? When should I call the doctor? What are my pain options? Is the epidural safe? What type of birth plan is recommended? Shared medical appointments will allow me more time to field those questions in great detail, and patients can hear and learn from one another.” When patients arrive, they’ll meet privately with Dr. Koehler and another member of the healthcare team for a belly measurement, check of the baby’s heart tones, and a brief cervix exam – all of which can be done within a few minutes. Then, the women will gather to kick off the discussion and address questions. SMAs will allow Dr. Koehler to carve out
offering SMAs, but we have worked through those challenges and now have a very refined program that meets our goals and the demands of our patients,” Dr. Meyer says. The SMA model uncovers a solution to problems posed by the limitations of current structures of care and the demands of a growing chronic illness load. For patients like Jacobson, the common denominator – which started as his condition – ended up being perspective. But even for patients who don’t suffer from chronic conditions, SMAs are an added perk to their healthcare. By bringing people who have the same condition together, the odds of better, healing outcomes multiplies. w w w. a f f i n i t y h e a l t h . o r g / b l o g
Medi c al Moder n i zati on
The Hybrid Advantage New hybrid operating room reduces risks and saves lives By B e c k y Ko p i tz k e
magine an operating room (OR) that allows doctors to see inside your body with magnified, high-definition clarity, using the most advanced technology available. A room where physicians from multiple disciplines work side by side to diagnose and repair what ails you – performing multiple procedures in the same place at the same time, for the best possible outcome. This isn’t science fiction. The most innovative surgeries are available here, today, in the new hybrid OR at St. Elizabeth Hospital in Appleton. One look around the OR and you’ll see several flat-screen monitors used to view real-time scans of the inner body. A singular rotating machine takes pictures of the patient’s internal functions before, during and after surgery for a complete view of healing. And advanced communication technology enables physicians to consult during surgery with specialists who are not in the room or even in the building. How? First of all, the hybrid OR is three times bigger than a typical operating room, which means a team of doctors can perform multiple procedures from one operating table. In addition, the hybrid OR equipment uses much less radiation than traditional surgical equipment, which is healthier for both patients and staff. Yet the radiation technology is not at all weaker; on the contrary, it far surpasses anything seen before at the hospital. These state-of-the-art advancements will pave the way for new surgeries, Hofmann says, such as transcatheter aortic valve replacement (a minimally invasive heart surgery that wedges a replacement valve into the aortic valve’s place). “We have the most advanced technology at our fingertips,” he adds. “Our patients will benefit tremendously from the merger of medical science and compassionate care.” DR. Wojciech Nowak
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“Patients would see a lot of different changes if they have a procedure in a hybrid room. It is safer, using less radiation, and procedures can be done in much faster time.” — Dr. Wojciech Nowak, interventional cardiologist with Affinity Medical Group
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Reducing risks, saving lives “This hybrid OR allows me to target a tumor more specifically than I ever have in the past, delivering a high dose of radiation or chemotherapy while saving more normal tissue.”
During surgery, images are projected on a 56inch monitor for highdefinition viewing of radiological images and video simultaneously during surgery.
— Dr. Douglas Conners, interventional radiologist with Radiology Associates of the Fox Valley
See for yourself Visit www.affinityhealth.org/hybridOR to see video of the space and hear from our physicians about how St. Elizabeth Hospital offers the best surgical care in the Fox Valley and beyond.
The hybrid OR is built around the Artis Zeego Multi Axis Imaging System with DYNA CT by Siemens, a state-of-the art “camera” mounted on a robotic arm that moves up, down and around the operating table, capturing realtime images of the inner body.
“The room allows us to keep the patient in one place and do all the things we need to do without having to transport them. This eliminates any risks associated with moving a patient to multiple platforms. We’re able to do more complex procedures safer.” — Mike Hofmann, director of perioperative services for St. Elizabeth Hospital 16 | @Affinity
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Large monitors and video integration allow images from any source to display on a monitor at the push of a button. LED lights with cameras built in provide exceptional visualization of the area of the body being operated on.
What exactly is a “hybrid” OR? The term “hybrid” refers to a merging of surgery and diagnostics. The hybrid OR unites surgeons and radiologists using both endoscopic video and highend radiologic equipment. Together, this integration of skilled physicians and multiple technologies creates a higher quality, less invasive surgery. The patient lies on a carbon-fiber surgical table top that provides 360-degree imaging. These specialized materials offer an ideal combination of safety and innovation. The table top and robotic arm are so sophisticated that each piece of technology knows where the other is in the space. This allows for the arm to move freely around a patient and get the best angles and images.
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“This room really is one of the more sophisticated rooms technologically, not only in Wisconsin, but in the United States and the world. This is a tremendous advantage for us that we can bring to our patients.” — Dr. Joseph Introcaso, interventional radiologist with Radiology Associates of the Fox Valley, whose providers partner with Affinity surgeons Summer 2014
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after c@re
Get to know your care provider
Setting Sail By Paul Nicolaus
Dr. Tomasz Miaskowski shares why his lifelong passion will serve him well as he sets off on a new adventure at Affinity Medical Group’s Neenah clinic
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r. Tomasz Miaskowski is buoyed by sailing. He believes it is an activity that can allow you to become a better person, teach you limitations, and even reveal future possibilities. “Sailing allows you to experience a fine balance of nature, and if you allow yourself into it you can experience a practical and sole meaning of freedom at its best,” he says. “The view from the deck, regardless of its size, is always outstanding – moving and fulfilling at many different levels.” This deep appreciation took hold early on for the new family physician at Affinity Medical Group’s (AMG) Main Street Clinic in Neenah. Born in Gdansk, Poland, Dr. Miaskowski says the city’s ship port made the sport a natural fit. At that time, communism existed in Poland, so there were very few people who actually owned a boat, he says. The only way to get on one was to belong to a club. So that’s precisely the route he took. Along with his teenaged friends, Dr. Miaskowski signed up as a helping hand, which allowed him to feed his budding interest. Popular summertime vacations and camps provided another means of access to sailing. “It was a part of my life from early childhood, and I carried that through the years,” he says. However, when his family emigrated from Poland in the late 1980s shortly before the collapse of the Berlin Wall, sailing was put on the backburner. Upon arriving in the United States, his family didn’t have the means to pursue his passion, so Dr. Miaskowski kept his love of sailing in mind in a different way. “I did look at pictures a lot,” he recalls. Following a brief stint in Minneapolis, Dr. Miaskowski found himself in a residency program in Appleton, and his family has remained in Northeast Wisconsin ever since. Before his arrival at AMG Neenah clinic, he spent years working in emergency medicine at various area hospitals and family practice care in Green Bay.
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“Sailing is a great experience, but it is also a great lesson of life that definitely applies to what I do in many ways. It reminds me that nothing is easy. You have to work for things... give passion, dedication and always respect.”
He also reached a point where he was able to reimmerse himself in sailing. “Eventually I came to a position in my life where I was able to buy a boat,” he explains. “It was a Pearson 30-footer that was built in 1976.” Dr. Miaskowski docked it mainly in Door County, exploring the waters of Lake Michigan with his wife and four boys whenever the opportunity presented itself. He has since sold it. More recently, he has taken the chance to delve into new destinations through charter trips at locations that have included Greece, Florida and the Baltic Sea. The Caribbean, however, remains his favorite sailing locale. “I think the temperature of the water and air makes for a special feeling,” he says. His time on the water has provided memorable experiences along the way, including occasional rough waters and close calls. He was in the British Virgin Islands, for example, when Hurricane Omar hit. Remarkably, and perhaps tellingly, the very next day he was right back on the water. “You cannot forget those moments,” he reflects. “They make an imprint on your life and who you are.” The challenges involved with facing the elements seem to provide Dr. Miaskowski with learning opportunities that inform his outlook. “Sailing is a great experience, but it is also a great lesson of life that definitively applies to what I do in many ways,” he says. “It reminds me that nothing is easy. You have to work for things and you have to give passion, dedication, and always respect.” These sporadic scares that interrupt an otherwise joyous hobby also provide added appreciation for a wise thought shared by a fellow sailor. When he sent this man a card for his 85th birthday, Dr. Miaskowski w w w. a f f i n i t y h e a l t h . o r g / b l o g
brought his note to a close with “smooth sailing, my friend.” In return, he received a beautiful, simple, homemade piece of art that included a brief response: “Smooth seas never made a skilled sailor.” “And isn’t that the truth,” Dr. Miaskowski says. Dr. Tomasz Miaskowski, He has continued to hold onto that piece, and evenpractitioner when he’s at not family Affinity out harnessing the powers of the winds and navigating hisGroup way through Medical in Neenah. the open waters it allows him to reflect on his hobby, his life, and his life’s work of caring for others.
Come Sail Away With the warm weather in place and boats in the water, the urge to try (or revisit) sailing might be setting in. If you’re looking to join in on the fun, there are plenty of opportunities to learn the ropes. Who knows? You might just find a new friend, encounter nature from a fresh angle, or breeze into a favorite way of enjoying the scenic waters of Northeast Wisconsin. Consider checking out the following area sailing groups as a starting point: » Appleton Yacht Club (appletonyachtclub.com) » Ephraim Yacht Club (eyc.org) » Fond du Lac Sailing Club (fdlsail.com) » Fox Valley Sailing School (foxvalleysailingschool.org) » Green Bay Yacht Club (greenbayyachtclub.com) » Oshkosh Yacht Club (oshkoshyachtclub.org)
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giving b@ck
by Nicole Stephani, neonatal intensive care unit (NICU) nurse at St. Elizabeth Hospital
Mending Young Nicole Stephani and her daughters, McKenna and Gaby, in the arts and crafts room at Camp Hope
Views of children dancing and playing and the Each issue, we sound of laughter are not things you would expect at a grief camp. Yet share the story those are all part of the atmosphere you find at Camp Hope. of an Affinity The free, overnight camp held at the Wisconsin Lions Camp in Health System Rosholt (20 miles northeast of Stevens Point), is for any child who has team member lost a parent, sibling, close family member or friend. It is a safe place for who volunteers at children to grieve and share stories. They know that everyone – including a local non-profit organization. Affinity most of the staff – has dealt with a significant loss. The campers work through their grief by participating in activities, is committed to such as making memory collages, journaling and a candle light ceremony. supporting local Those activities are balanced with drumming, storytelling, arts and crafts, organizations and free time, water sports, and more. charitable events Volunteers meet the campers right where they are – meaning there is aligned with our mission of providing no pressure to share if they are not ready, and every child is included in all activities. It is amazing to watch so many new friendships form in such a services that short time. Watching a child realize they are not alone in their grief and promote the health that it is okay to move on, to enjoy life again without the guilt, to dance and well-being of and smile, is what draws me back to camp three times a year. the communities I didn’t know what to expect the first time I volunteered at Camp we serve. Hope, which was in 1998 while I was finishing my bachelor’s degree in psychology. I had always wondered what was available for children who were grieving, especially after my own personal experiences of loss as an adolescent. I was blown away by the structure of the program, and the love among the staff and campers was something I had never experienced anywhere else. I was hooked. A few years later, I was back in school to get my nursing degree. 20 | @Affinity
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Camp Hope stayed in the forefront of my mind. I knew I wanted to do more than just volunteer there. During one of my nursing classes, I was able to take that experience and bring it to my community by starting a support group for children experiencing loss. What started as a class project soon took on a life of its own. I continued to run the group for about a year after graduation. At that time, the Boys & Girls Club took notice of the need in our community and established a new program called the Center for Grieving Children. I volunteered there for a few years to help get it off the ground, and quickly found that I was able to draw from my experiences at Camp Hope to help reach the children in my groups. I loved every minute of it and knew what I was doing was worth all of the time and effort I put in. I am currently working as a neonatal intensive care unit (NICU) nurse at St. Elizabeth Hospital. My job here has put me in situations where I have the chance to talk to families about Camp Hope and the Center for Grieving Children. I tell these families about w w w. a f f i n i t y h e a l t h . o r g / b l o g
“The purpose of Camp Hope is to help heal the hearts of children and bring them hope for the future.” — Nicole Stephani
Hearts the many benefits of sending their children to these places. I use my experiences and talks with my campers to help guide some of the families I meet as they make difficult decisions about things, such as having their children present during the last moments of someone’s life or attending funerals. A few years ago, one of the families I worked with in the NICU had an infant boy who needed in-home care. I took this on part-time (aside from my full-time hours in the NICU). During the two years I helped care for him, our families became very close. My daughters learned so much about unconditional love and acceptance from that experience. After he passed away, I knew my girls would benefit from Camp Hope – attending for the first time as campers. They fell in love with it, and now, as teenagers, have taken up volunteer positions there as junior counselors. They have also taken what they have learned and used it to help their friends who have experienced grief and loss of their own. Death is a scary thing for so many of us. It leaves us empty, broken and alone. The purpose of Camp Hope, as well as the Center for Grieving Children, is to help heal the hearts of children and bring them hope for the future. Both provide a safe space to share stories, feelings, thoughts and experiences. I side with a sentiment commonly shared by those who give back: I get more out of volunteering than I put into it. This is how I feel about my time spent at Camp Hope, and I will always have a place in my heart for this organization.
SNAPSHOT: CAMP HOPE Camp Hope is a place where children and teenagers come together to work through the grieving process after a loved one dies. It’s where their pain is understood and shared. The camp gently guides the children and teenagers through complex emotions by showing them that they are not alone and teaching them that it is okay to laugh and play, and that to do so is not disrespectful to the memory of the person who died. The free, overnight camp is held three times a year. To learn more or make a donation, go to www.camphopeforkids.org.
CENTER FOR GRIEVING CHILDREN The Center for Grieving Children is another safe place for these children, teens and families to find compassionate peer support, education, opportunities to commemorate their loved ones, and express their feelings in an accepting group environment. The Center facilitates healing, removes isolation and builds a sense of hope. Visit the website to read more or make a contribution: www.centerforgrievingchildrenfoxvalley.org.
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Foundations for Giving Back
Caring for the Community: Then and Now By Alison Fiebig Mayer
“Z
eal and devotion bring dream to realization,” reads the topmost headline in the Chilton-Times Journal on June 28, 1956. The opening line spiritedly acknowledges, “Calumet County at last has a hospital.” In 1954, a man named Theodore Christoph offered up his field to become the site of Calumet County’s first hospital, which was named Calumet Memorial Hospital but is known today as Calumet Medical Center (CMC). What was once a beautiful, modern building 58 years ago is now insufficient in serving the needs of the growing community. It is in need of an expansion and patient-centered improvements, which is why Affinity Health System Foundations has embarked on a capital campaign. Throughout the last six decades, it has become increasingly difficult to manage patient volume and keep up with changing technologies. In 2012, about 12,000 people in the Chilton service area needed oncology treatment and outpatient specialty services account for 76 percent of all patients visiting CMC. Approximately $10 million is needed for the expansion and renovation. About $3.4 million has been raised in a “quiet phase” of the capital campaign thanks to generous donations made by Affinity associates and physicians, and community individuals and business, along with a dollar-to-dollar match from an anonymous donor who will continue to match gifts until a goal of $5 million is raised. “Calumet Medical Center is a not-for-profit that relies on community member partnerships in order to provide quality care, programs and services to individuals in our region,” says Tonya Dedering, regional director of Affinity Health System Foundations. “We look to them for support in revitalizing the community hospital that has cared for them all these years.” The rural roots and good-neighbor values of Chilton’s critical access hospital will remain true while it strengthens its commitment to providing personalized care – only on a higher, more efficient level. “The hospital has been a fixture in our community, servicing and celebrating our lives – our health,” says Bud Wieting, chairman of CMC’s board of directors. “We must personally commit to seeing that the hospital continues to do so for years to come.” As the June 1956 article notes, “Dream of generations are finally realized in the hospital’s brick exterior.” The next generation of Calumet Medical Center is within reach. Just as the townspeople anticipated the unveiling of Calumet Memorial Hospital, the hope is that residents of the rural, vibrant county come together again to make a personal investment in the future health of the community. To make a tax-deductible donation to support Calumet Medical Center’s “Coming Together” Campaign, please visit www.comingtogethercampaign.org and click on “Donate” under “Campaign Information.” To schedule a meeting or tour, call Trina Doxtator at 920.849.7550.
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you @sked
Our experts weigh in on your questions
Is it still recommended for men to get a PSA test? I’ve been reading conflicting information. A prostate-specific antigen (PSA) screening – which is a simple, non-fasting blood test that detects a small protein secreted by the glands within the prostate – can come back “abnormal” with a host of prostate conditions, or prostate cancer. One in six men is diagnosed with the disease and up to 15 percent of these men will die from the disease, making it the second leading cause of cancer death among American men. A few years ago, the United States Preventive Services Task Force recommended against PSA testing citing the morbidity and over-treatment of prostate cancer as a larger problem. They also found that early detection of prostate cancer may lead to unneeded surgeries and radiation treatment. Interestingly, their decision was made without a single urologist on the panel. Many urologists – including myself – believe the Task Force over-reached in its recommendation. I recognize that no screening tool is 100 percent perfect, but I see metastatic prostate cancer on a near-daily basis. I recommend you have a conversation with your provider so you can make an informed decision on whether or not to have the test done. — Dr. Steve Baughman, urologist, Affinity Medical Group
Are e-cigarettes safe, and what are the risks? When looking for the lesser of two evils, don’t forget that both options are harmful. Both traditional and electronic cigarettes are tobacco products designed to addict the user by repeatedly hitting the brain with a “fast blast” of nicotine. Every major cigarette manufacturer now produces electronic cigarettes. Both needlessly expose the user to a variety of unhealthy chemicals by inhalation and are far better avoided. Electronic cigarette cartridges, or “tanks,” contain a highly-concentrated nicotine solution known as “juice.” Nicotine is a deadly toxin in these concentrations when drank or soaked into the skin. One ounce refill bottles sold at electronic cigarette stores may contain enough nicotine to kill several adults if swallowed. A child could absorb a fatal dose just by spilling the solution on their hands. In the past, only bug-killers contained nicotine in these strengths. There are no standards in place to inform an electronic cigarette user about the risks associated with inhaling these heated solutions of nicotine, propylene glycol, glycerin, volatile organic compounds and numerous contaminants. By the definition of the very people who make them, anybody who switches from traditional cigarettes to electronic ones has merely gone from one tobacco product to another. — Dr. Brian Harrison, medical director of Affinity Occupational Health and director of health and productivity management
What is MERS, and who is at risk? Middle East Respiratory Syndrome, or MERS, is a viral respiratory infection caused by a newly discovered coronavirus – similar to what caused the SARS outbreak in 2003-2004. It causes a severe respiratory infection very similar to influenza with fever, cough and shortness of breath that can lead to respiratory failure. Other symptoms that may also be present include nausea, vomiting and abdominal pain. It is believed to be spread from person to person in close contact. People most at risk for contacting this illness are those who have recently traveled to the Arabian Peninsula, especially those who undertake the Hajj in which millions of people gather in a relatively small area. If you have traveled to the Arabian Peninsula and develop respiratory symptoms within 14 days of travel, you should see your physician and practice good respiratory etiquette to prevent spread to others (i.e. cover your cough). While there are no known antiviral medications to treat this condition, supportive measures can be used to support life while your body fights off this infection. Disclaimer: Since this is an emerging infectious disease, information is ever-changing, as such the above information is considered up-to-date as of May 2014. — Dr. Anthony Zeimet, infectious disease specialist, Affinity Medical Group 22 | @Affinity
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Jeff Stieg » 30, Oshkosh resident » Health and Wellness Promotion at Goodwill NCW Jeff works to balance the lives of 1,400 fellow team members at Goodwill NCW in Menasha. He leads the company’s health initiatives, organizes events and fun wellness challenges, and has developed a comprehensive health and wellness coaching program that spans 35 counties. When he’s not balancing responsibilities on the job, he’s balancing in the yoga studio – teaching periodically at Inner Sun Yoga Studio downtown Oshkosh. w w w. a f f i n i t y h e a l t h . o r g / b l o g
in the know
By Becky Kopitzke
Online and Informed How can we help our children use their devices wisely? Start by knowing the risks
We bring you touchy health and safety topics impacting today’s youngest generation so you can stay current on the issues and feel equipped to broach certain subjects with your own offspring. How to talk to your kids
» Technology contract—Create a “technology contract” with your children that outlines usage time, allowed sites and apps, and consequences for misusing the internet/device. This empowers kids to make smart choices while still under your guidance. Start with a general rule like, “If you wouldn’t share it with your family, don’t share it online.” » Stranger danger—Online tools open the door for predators – many of whom use chatting, texting or social gaming to begin inappropriate relationships with kids and teens. Advise your children to connect only with people they know well in real life, such as close friends or trusted family members. » What goes online stays online—Explain that any information posted online, including pictures, locations and profiles, stays on the internet and could possibly come back to haunt them in the future.
Helpful resources For tips, tools and guidance on how handle the many aspects of technology with your kids, check out: » www.commonsensemedia.org » www.empoweringparents.com » www.cyberbullying.us/Questions_Parents_ Should_Ask.pdf
w w w. a f f i n i t y h e a l t h . o r g / b l o g
TEC H CO RNE R Smartphone apps you need to know your kids may be using:
» Snapchat: Used to send photos and videos to other users that then disappear from view 10 seconds after they’re received. Kids think the images can’t be saved and circulated, but users can take a screenshot before an image vanishes in the app. » Whisper: “Share Secrets, Express Yourself, Meet New People” by letting users set up anonymous accounts to make their messages or confessions overlap an image or graphic; other users can then like, share or comment on the confessions. What makes it even more dangerous is that it includes the user’s location with each post. » Yik Yak: Anonymous users post what are called “yaks” that
show up in a live feed for other users in their area. Younger users have been found to use it to post hurtful comments and rumors about their peers.
» Tinder: Often referred to as the “hookup app,” Tinder helps
people find others in their geographic location based on the number of mutual friends and common interests. Seven percent of the app’s users are now between 13-17 years old – the third largest group currently using Tinder according to one of the app’s founders. The location features and anonymous nature of the app put kids at risk for catfishing (users who pose as fake people on social media), bullying, stalking, etc.
» Ask.fm: An electronic bulletin board-like format where users
(many anonymous) can interact by asking and answering other users’ questions. The app is rated ages 13+ and is most popular in Europe but is gaining steam in the U.S.
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Affinity Health System 1570 Midway Pl. Menasha, WI 54952
#whatsforlunch hashtag: (noun) an unspaced word or phrase preceded by a hash or pound sign (#) and used to identify messages on a specific topic.
Follow us on Facebook and Twitter and watch for our designated hashtags! We’re kicking it off with #whatsforlunch. What's your healthy lunch go-to? Use the hashtag when you post a photo and we may publish it! (Tip: Click on the hashtag when surfing Facebook, Twitter and Instagram and you can see what others are eating.)
› Chris Dearing, Appleton Cobb salad (bibb lettuce, bacon, ham, pulled chicken, sunny side egg, tomato, avocado, blue cheese crumble and avocado cream) from one of Appleton’s newest restaurants, SAP. Brunch, Brown Bag and Bakery, whose mission is to source local and Wisco-grown products.
Amy Gaerthofner, Neenah, photographer with Ardent Photography Hard-boiled egg, yogurt and string cheese.
Liz Williams, Appleton Summer salad with brie, spinach, tomatoes, strawberries, grapes, blackberries, topped with flax seeds and a balsamic/oil dressing.
Julie Perez, Appleton Flax wrap with hummus, spinach, turkey, provolone and naked broccoli slaw.
‹ Marni Burton, Menasha, first grade teacher in Oshkosh BBQ grilled chicken with steamed carrots and brown rice leftovers. › Nicole Olson, Neenah, mother of two Fire-roasted tomato and black bean soup, and a chicken nugget for good measure.
Nikki Voelzke, Appleton Lunch al desko: spinach, roasted beets, bleu cheese salad with EVOO/white balsamic vinaigrette. “I’m obsessed with beets, especially on salads and in smoothies.”
› Abby Krostue, Winneconne, mother of two Power greens salad with baby cukes, orange pepper, strawberries, avocado, mini spinach tortellini with a side of grapes, and carrots and hummus. As far as adding tortellini to her salad? “I can’t take credit for the idea – my husband thought of it!”
Beth DesJardin, Appleton, owner of Trove Photography Homemade spring rolls with asparagus, avocado, sprouts, lettuce and basil, with a citrus and garlic-chili dipping sauce. “I found the recipe on Pinterest,” she says. “They were a mess to eat, but so tasty!”