Health and Hope - Spring 2012

Health & Hope S A I N T PAT R I C K . O R G S A I N T J O E S. O R G

YO U R G U I D E TO H E A LT H Y L I V I N G

SPRING 2012

MORE INSID

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• Alive and th after heart su riving rgery • Healthcare designed just for wom en • Supportiv e care at St. Joe’s

losing Winning by After bariatric surgery at St. Pat’s, Rebecca Mackey is healthier, happier ... and down to a size 6

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Do you have a healthcare plan?

What is an advance directive? Why do I need one? Do I really need to have a healthcare plan? What if I have a health event and am unable to speak for myself? Learn the answers to these questions and much more during an Advance Care Planning Presentation. This is a one-hour long presentation explores the importance of having an advance care plan in the event of a future healthcare situation in which you may be unable to speak for yourself about your healthcare choices and decisions.

Advance Care Planning Presentations

by Linda Bierbach, RN, BS, CHPN Palliative Care and Advance Care Planning Coordinator Tuesday, May 15 1:30 PM

Tuesday, June 19 1:30 PM

Tuesday, July 17 1:30 PM

All presentations are in the Broadway Building Conference Center.

Free and open to the public. No registration necessary.

Call 406-329-5714 for more information.

ADVANCE CARE PLANNING

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CONTENTS 4

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UPFRONT WITH ST. PAT’S St. Pat’s makes an Epic change to its healthcare records; the Women’s Care Center redefines the healthcare experience; a smartphone app that lets you find the closest ER or doctor.

DREAM TEAM Teamwork is critical in cancer care, because no single professional can do everything. Our roster compiles those you’d be likely to work with on your road to beating the disease.

WINNING BY LOSING

Bariatric surgery helps Missoulians like Sandra and Jim Steele return to happy, healthier lives. PAGES 8–11

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BACK ON THE BEAT Thanks to the International Heart Institute of Montana, a University of Montana student with heart failure is back to enjoying the life she loves.

43 ANDCOUNT ING With 43 Providence Medical Group clinics throughout western Montana, one is bound to be near you.

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EASING THE WAY The Supportive Care team at Providence St. Joseph Medical Center helps patients relieve complications of life-limiting diseases, including chronic conditions.

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PERSON OF PROVIDENCE “Judy B.,” the front desk supervisor at St. Joe’s, lives our Mission every day.

On the cover: Rebecca Mackey went from a size 26 to a size 6 after bariatric surgery.

Our Mission As people of Providence, we reveal God’s love for all, especially the poor and vulnerable, through our compassionate service.

Our Vision Together, as people of Providence, we answer the call of every person we serve: Know me, care for me, ease my way.

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Health & Hope SENIOR EDITOR: Sam Mittelsteadt MANAGING ART DIRECTOR: Tami Rodgers PRODUCTION TECHNOLOGY DIRECTOR: Mary Winters PRODUCTION MANAGER: Laura Marlowe

UP F RONT W IT H S T. PAT ’ S

EXECUTIVE V.P./ CHIEF CREATIVE OFFICER: Beth Tomkiw CREATIVE DIRECTOR: Lisa Altomare IMAGING SPECIALIST: Dane Nordine COVER ART: Mark Bryant

ST. PATRICK HOSPITAL 2012 COMMUNITY MINISTRY BOARD Stephen Hiro, M.D., Chair Dan Barz Brad Berry, M.D. Martin Burke Scott Burke Jeff Fee

Anne Guest Leonard Landa Kim Mansch Fr. Richard Perry Alex Philp Molly Shepherd Michael Snyder, M.D.

James Foley Health & Hope is published three times annually by McMurry, 1010 E. Missouri Ave., Phoenix, AZ 85014. © 2012 McMurry.

The material in Health & Hope 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.

For permission to reprint any portion of this magazine, to give us a new address, to let us know that you are receiving more than one copy or if you would prefer not to receive Health & Hope, call 888-626-8779.

Printed on recycled paper.

Want to receive Health & Hope electronically?

It’s easy—just email info@saintpatrick.org with “Health & Hope” as your subject line.

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One patient, one record ELECTRONIC FILES MEAN LESS PAPERWORK, FASTER CARE This year, Providence Health & Services and St. Patrick Hospital will implement an electronic health record system called Epic, which will create a single medical record for each patient across all care settings—from the physician’s office to the hospital.

One record means less paperwork for patients to fill out, saving valuable time—you won’t have to keep writing down your allergies, the medications you’re taking or your emergency contacts. Instead, the provider taking care of you verifies that the information on the electronic medical record is still valid.

Thanks to Epic, healthcare providers will see patient vital signs, lab results or notes from the physician in real time, making patient care faster. The information is completely secure with state-of-the-art technology.

Epic will support, but never replace, the knowledgeable and compassionate human touch of our caregivers. Epic will help us continue and enhance the high-quality care our patients expect and deserve. And we’re in good company—it’s the same system used by Kaiser Permanente, Cleveland Clinic and Memorial Sloan-Kettering Cancer Center.

Select Providence Medical Group clinics in western Montana will launch Epic in summer 2012. St. Patrick Hospital, Providence St. Joseph Medical Center and the remaining Providence Medical Group clinics in western Montana will install Epic this fall.

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EMBERS Empowering women to make better choices Because environmental issues and relationships can affect health as much as other factors, the Women’s Care Center now uses an “EMBERS” approach to healthcare, examining Emotion, Mind, Body, Environment, Relationship and Spirit. By helping women learn about influences that affect health and healing, we empower them to make better choices for themselves and their family. Education includes ongoing Celebrating Women events and the Turning the Tide Conference.

Watch the results To watch a video about the Women’s Care Center, go to saintpatrick.org and under “Health Services,” select “Women’s Care Center.”

The link to the video is at the bottom of the page.

A whole, new woman WOMEN’S CARE CENTER REDEFINES HOW WOMEN FEEL ABOUT HEALTHCARE Thanks to a grant from Providence Health & Services, the Women’s Care Center is transforming healthcare with novel approaches that treat the whole woman.

MORNING OF WELLNESS A one-stop annual healthcare visit with a built-in social aspect In their morning visit, patients meet with healthcare providers for physical exams and any needed labs, including mammograms. Breakfast follows, along with conferences on pertinent health topics like hormone balancing, stress management, nutrition and sleep. Yoga or tai chi offers a “stretch break,” and at the end of the morning, a wrap-up visit with care provider includes lab results and a plan of action.

THE HAPPINESS PROJECT Paying kindness and respect forward Kevin Dohr, Ph.D., presents research about happiness during a six-week series of sessions for staff at Providence St. Patrick Hospital. This information includes tools for finding balance, defusing stress, remembering our spirituality and more. Through this work, each person can be a source of calm, support and energy (rather than stress, which can inadvertently add to the stress of others). Happiness is also important for creating and sustaining a healthy and satisfying workplace.

BECAUSE INJURIES HAPPEN Scan the QR code for a FREE smartphone app • Use Symptom Checker • Find closest emergency room or doctor • Research procedures, tests and treatments

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Dream

team

When it comes to fighting cancer, these professionals each play an important role in your care

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ach athlete on a team must perform superbly in his position to secure a win.

Each actor of an ensemble cast plays a role in wowing audiences. Every employee needs to be in the right job for a company to excel. Whether it’s a playing field, a stage or an office, teamwork is everything. It’s also critical in cancer care.

Why build a team?

“Nobody knows everything, and nobody can do everything,” says Ted Gansler, M.D., director of medical content for the American Cancer Society. That’s why it’s important to bring together professionals from multiple disciplines.

For simpler cases of cancer, such as an early stage skin cancer, you might need one doctor—in this case, your dermatologist. But when cancer is more complicated, more people get involved.

These professionals might include a primary care doctor, radiation oncologist, medical oncologist and surgeon.

And when that happens, it’s important that they function as a team.

“You want everyone on the same page,” says Katherine Markette, M.D., radiation oncologist at St. Katherine Markette, M.D. Patrick Hospital. “You 6

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don’t want chemotherapy drugs interfering with radiation treatments, for example. Or depending on which chemotherapy drug you’re on, your blood pressure could go up and down.

Sometimes, we might send the patient to their primary care physician, who can stay involved and help us monitor those things.”

Meet the players Your team will depend on your specific diagnosis and needs. Here’s a roster of the professionals you’re most likely to work with on your road to beating cancer, the order of which is determined on a case-by-case basis.

PRIMARY CARE PHYSICIAN. Your regular doctor is often the first person you tell about troubling symptoms or who sees an abnormality in a routine screening. He or she also will help monitor your health during treatment and manage any long-term side effects afterward.

MEDICAL ONCOLOGIST. “Medical oncologists prescribe medication for cancer,” Gansler says. Most often this refers to chemotherapy drugs, although targeted drug therapies for cancer—which work mainly on cancer cells instead of also affecting the surrounding healthy cells—are evolving, he adds.

SURGEON. For the removal of some tumors, a general surgeon will be part of your team. For others, you might have a specialist, such as a thoracic surgeon for lung cancers.

RADIATION ONCOLOGIST. This doctor will create a plan for using radiation to destroy cancer cells. Two-thirds of cancer patients receive radiation therapy, according to the American Society for Radiation Oncology.

SOCIAL WORKER. Like therapists, oncology social workers can help you understand the psychological and social effects of cancer.

They also can connect you to various services— support groups, community programs or even pharmaceutical grant programs.

THERAPIST/PSYCHOLOGIST. You may see a counselor to help you cope with the social and psychological challenges of dealing saintpatrick.org

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A PLAYBOOK FOR PATIENTS Instead of sitting on the sidelines, take an active role in your cancer care.

Here’s how.

Ask questions. If your doctor is using words you don’t know, speak up, says Mark Fesen, M.D., author of Surviving the Cancer System: An Empowering Guide to Taking Control of Your Care.

Tape the conversation. Fesen advises bringing a recorder so you can listen to it later or play it for a family member.

Practice active listening. Repeat everything your doctor says to make sure you understand.

Bring a loved one. A family member can offer doctors additional insight and help you make important decisions.

Advocate for yourself. “If you’re unhappy with the care you’re receiving, you shouldn’t hesitate to get a second opinion,” says Ted Gansler, M.D., director of medical content for the American Cancer Society.

Choose a cancer treatment path with cancer. “Some degree of psychological distress is very, very common among people with cancer,” Gansler says. “People should never be reluctant to get that care.”

DIETITIAN. Depending on your treatment, you might need a special diet. “Rather intensive chemotherapy or radiation can cause mouth sores that make it difficult for the patient to eat,” Gansler explains. “So, a registered dietitian might help them find ways to get their nutrition.”

SUPPORTING PLAYERS. Don’t forget the team of professionals supporting your doctor—and ultimately, supporting you. saintpatrick.org

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Anesthesiologists, nurses, radiation therapists and others help ensure you get the best care possible.

MOST VALUABLE PLAYER. Never forget that you are the most important person in this process. At the end of the day, you choose your treatment and how aggressive it will be, Markette says. That’s why it’s important to understand the options your doctors present, and to know and trust your team.

“Make sure everyone on your team is on the same page and in agreement,” Gansler advises.

“Make sure your team is taking care of your medical, social and psychological needs.”

If you or a loved one is diagnosed with cancer, there’s a good chance you’ll face decisions about treatment. The American Cancer Society offers information about the usual treatment of various cancers, including interactive NexProfiler Treatment Option Tools to help you make decisions. Visit cancer.org, then select “Treatment Decision Tools” under “Find It Fast.”

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BY JOANN HOVEN P H O T O S B Y M A R K B R YA N T

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Winning by

ebecca Mackey had always been big— an “emotional eater” who started gaining the weight after high school.

The pounds crept up until she wore a size 26–28 and weighed 298 pounds.

Her body mass index (BMI) was 47.

“I tried to exercise, but exercise physically hurts when you are that big,” Rebecca recalls.

“I ached all the time; I was tired all the time.

I couldn’t walk very far. I found out that I had sleep apnea, too, and was well on my way to diabetes.”

Rebecca experienced common problems associated with obesity. More than 4 million people in the United States are more than 100 pounds overweight, or “morbidly obese.”

They usually also have other health problems such as heart disease, type 2 diabetes, sleep apnea, high blood pressure, gastroesophageal reflux, incontinence, arthritis, infertility and some cancers.

Rebecca had started researching weight loss surgery for her husband, who also was overweight and has type 2 diabetes. Bariatrics can include surgery that restricts the amount of food a person can consume or reduces the number of calories the person absorbs.

Bariatric surgery is intended not as a “quick fix,” but it works as a tool to induce and maintain permanent weight loss. With weight loss comes improved health, better quality of life and a reduction in weight-related diseases.

losing

Bariatric surgery helps Missoulians return to healthier lives

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Gastric bypass (Roux-en-Y) Gastric bypass, the most common weight loss surgery in the country, is the “gold standard” in the sense that it has been done for many years and has proved to be effective and safe.

Surgeons create a small stomach pouch by stapling shut a larger portion of the stomach.

This newly formed pouch empties directly into the small intestine, so it reduces calorie consumption. So the results of the surgery are combined—a patient can’t eat as much, and can’t absorb as many calories.

Studies show that after five years, nearly three-quarters of the patients have maintained a 70 percent loss of their excess weight. In addition, more than 95 percent of all weightrelated health problems are relieved by one year after the operation.

Adjustable gastric banding (the Lap-Band® System) In this procedure, surgeons place an adjustable band around the upper portion of the stomach, restricting how much food the stomach can hold. The Lap-Band can be adjusted to suit your situation, much like a wristwatch, and can be removed if necessary. The stomach is not stapled or rerouted of normal digestion.

The procedures at St. Pat’s are done laparoscopically, which allows for incisions as small as half a centimeter, leading to a quicker recovery.

The surgeon is trained to use instruments and follow images displayed on TV monitors to magnify the surgical elements.

Vertical sleeve gastrectomy surgery During this laparoscopic procedure, bariatric surgeons remove about 85 percent of the stomach so that it takes the shape of a tube or sleeve.

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Instead of making one large incision, surgeons make a few small ones so they can insert a tiny camera (laparoscope) and other instruments to remove part of the stomach. The tube-shaped stomach that is left is closed with staples.

Gastric sleeve surgery may be appropriate for people who can’t return as often for the followup visits required by adjustable gastric banding procedures such as the Lap-Band.

How to decide?

You and your physician will have to decide which procedure is best for you. Which would fit your lifestyle? What is your commitment?

When bariatric surgeons Brad Pickhardt, M.D., and Charles Swannack, M.D., talk to potential weight loss surgery patients at Providence Medical Group Bariatric Services Program, they emphasize that this type of surgery is only a “tool.” The patient has to be committed to follow nutritional and fitness recommendations.

“These are some of the most motivated and educated patients I see,” says Dr. Pickhardt.

“They have done their research, and they want to change their lives. Charlie and I are perfectionists in the surgical technique of both procedures, but the patients are the ones who change their lives. They are the ones that have to use this as a tool. They are getting their lives back, and we get to be a part of it.”

Drs. Pickhardt and Swannack have done more than a thousand procedures since the program began in 2000.

Rebecca decided to have the gastric bypass surgery and has never looked back.

She is now 137 pounds, with a BMI of 24.6, and wears a size 6. She is starting a new chapter.

“I can exercise more—without hurting. I have to eat certain foods that are low carb, low sugar, low fat—and so my diet is helping my husband, too.”

WHAT IT TAKES TO START To be considered candidates for bariatric surgery, patients must have: • A primary care provider recommendation from the caregiver who will know a patient’s history and how well he or she may do in the program.

• A personal health and diet recap including family history, diets tried, what has and hasn’t worked, exercise patterns and more.

• A mental health evaluation to determine if patients are emotionally and mentally ready for the surgery. Are expectations realistic? Do patients know how they will eat after the surgery and how they will feel after losing the weight?

• A meeting with a nutritionist or dietitian to discuss postsurgery restrictions. Patients need to know where sugars, carbs and fats may be hidden. They will be able to eat the same foods—just not in the same way or amounts, so it’s important to learn about portion control.

• A meeting with an exercise physiologist, physical therapist or orthopedist to know about any physical limitations and how to work with them.

When patients lose weight they will feel better but may need to modify their exercise techniques.

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That’s not even the best thing: Before she had the surgery, Rebecca had lost three pregnancies, which her physicians attributed to her obesity; the babies just weren’t getting enough nutrients. At her most recent checkup, she was told to go ahead and start having babies.

“I was so excited,” she says. “I am so happy that I gave this gift to myself!”

Your new life starts now!

A call to Providence Medical Group Bariatric Services can answer your questions and help you decide if the program is for you. Call 406-329-5866.

The couple that changes together …

Sandra Steele had gained weight steadily after having a baby, and was from the “clean your plate” kind of Depression-era family. She was understandably anxious about her future—her mother had lost both her legs to diabetes and had a triple bypass probably caused by her weight, and Sandra didn’t want that kind of future for herself. She had tried the Scarsdale diet, weight loss injections, fen-phen, the Atkins diet and hypnosis, but still reached 255 pounds, with a BMI of more than 42.7.

Then came a severe knee injury, fibromyalgia, and pelvic floor and leg issues. Exercise became almost impossible, even though she tried desperately not to gain any more weight to compromise her knee.

Then, Jim, her husband, a director of business development for a software company, decided he was tired of losing weight and gaining it back. His blood pressure and cholesterol were high, and he had a bad back and was 361 pounds: He was miserable, and was going to be miserable the rest of his life if he didn’t do something about it.

Jim researched the surgeries and programs from around the country, but heard that St. Pat’s had a very good program with preand post-follow-up and good results.

He had gastric bypass surgery in August 2008 and is now down to 232 pounds.

Are you a candidate?

The National Institutes of Health set criteria for surgical treatment of morbid obesity in 1991. Generally accepted criteria for the surgery include patients who: • Are well-informed and motivated • Have a severely impaired quality of life because of morbid obesity

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• Participate in treatment and commit to long-term follow-up • Clearly and realistically understand surgical risks and benefits and how their lives may change after surgery • Are 100 pounds over their ideal calculated weight, or have a BMI of 40 or above

• Have a BMI of 35 to 40 with associated severe comorbidities

• Have failed at nonsurgical measures within the past year or more, shown by detailed weight loss history in established weight control programs

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Left to right: certified bariatric nurse Vickie Johnson, R.N.; Amelia Shepard, insurance billing representative; bariatric surgeons Brad Pickhardt, M.D., and Charles Swannack, M.D.; registered nursing care coordinator Janet Klaudt; registered dietitian Sara Engberg; patient service representative Marcia Maloney; fitness tech Maranda Herner; patient service representative Rozann Schuhbauer.

“People have to understand that it is not a fix-all,” Jim says. “You have to come to grips with all the reasons you overeat before the surgery.

Those things that entangle you to overeat before the surgery will still be there after the surgery.

“Now I can play 18 holes of golf, and I couldn’t do that before. I travel a lot for my job, and that’s much easier, too.”

… stays healthy together It seems Jim was the stimulus Sandra needed.

She had gastric bypass surgery in November 2010 and is down to 152 pounds and a BMI of 25.7. Her cholesterol and blood pressure levels are down, and she is exercising more—“I’m thrilled to be able to walk more than one block!

“The best decision besides the surgery was to be very public about it,” she says. “This kept me on track and accountable, but also educated others about how the surgery works. Many people weren’t watching me out of judgment or condemnation, but out of curiosity. I found people’s concern supportive and motivational in helping me change my lifestyle choices.”

Sandra reinforces Dr. Swannack’s thoughts that the surgery is not a one-time fix-all: “It provides me only with a tool; it’s up to me to use it correctly. I go to support groups for monthly reinforcement, where we share ideas and experiences.”

“We see these patients three to six months after the surgery, and you realize what the surgery has done for them,” Dr. Swannack says.

“We do more medical good—they are off blood pressure medicine, off diabetes medicine. They are more able to participate in their own lives and their families’ lives. It is just so rewarding to see them become alive.”

Ready to take a fiRst step?

St. Pat’s offers several ways to support those on their weight loss journey.

Weight loss surgery informational meetings are free and open to anyone seeking more information on the gastric bypass or Lap-Band surgeries. Meetings are held twice monthly from 5:30–7:30 p.m. in the Broadway Building Conference Center, 500 W. Broadway.

The bariatric program coordinator and the surgeons present straightforward information to potential patients and their support people.

There is time for questions, answers and discussion. A representative from St. Patrick Hospital’s Billing Department speaks also about payment options.

A support group meets monthly 5:30– 6:30 p.m. in the Duran Learning Center, also in the Broadway Building. Topics range from coping with holiday stress to taking walks in Missoula to plastic surgery after weight loss.

24-hour nurse support can help you answer questions both simple (“what might be causing my reaction to this food?”) and serious (“should I go to the Emergency Department?”) Weight loss is a new experience for you, and you need to be able to talk through your concerns.

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Back on the

Kelli Whithorn’s heart was failing when she consulted with specialist Bradley Berry, M.D., at the International Heart Institute at St. Patrick Hospital. But after making lifestyle changes and having a defibrillator implanted, she manages the condition through medication and regular checkups.

beat Thanks to International Heart Institute, UM student is not just alive, but thriving

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BY H E AT H ER J U RVA

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s a child, she had been treated for cancer with an experimental chemotherapy drug in doses that are now considered lethal. Although the treatments pulled Kelli Whithorn from the brink of death, they were extremely toxic to her heart. Given time, doctors said, her heart would certainly fail.

When she was 8, Kelli was placed on a heart transplant waiting list, and within five years every other child who had received the drug died of heart failure. “I just believed I wouldn’t ever have that problem,” says Kelli. And for many years, that belief held true.

Almost two decades later, however, her body started showing signs of heart failure. Kelli, then 26, was studying sociology and anthropology at The University of Montana and working two jobs, but was also carrying an extra 25 pounds of water weight in her legs—her pants fit tightly, and she could squeeze into only one pair of shoes. But it wasn’t until she struggled to climb a single flight of stairs that she realized something was truly wrong.

“If I’m not dying, I don’t go to the doctor,” Kelli says. “But you should be able to climb one flight of stairs.”

Taking changes to heart A visit to the UM student health center confirmed that Kelli’s symptoms were those of congestive heart failure, and she was sent to Providence St. Patrick Hospital. There, specialist Bradley Berry, M.D., told her she was in Stage 4 heart failure, an advanced stage that is treatable but has a high mortality rate.

“It was catastrophic in every sense,” Kelli says. She sat in the front row in all of her classes. She worked hard—more than full time—at her two jobs, just as her parents had done. And like many Missoulians, she loved the outdoors. To nearly lose it all was devastating.

“I couldn’t hike. I couldn’t swim in the river anymore,” Kelli says. “It felt like my life was over, essentially. And that wasn’t acceptable to me.”

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P H O T O G R A P H Y B Y M A R K B R YA N T

So she did her research and followed every expert suggestion. On the advice of the International Heart Institute at St. Patrick Hospital, she gave up social drinking and smoking, cut back on hours at work and eliminated high-sodium foods, such as chips and pickles, from her diet. For months after her initial diagnosis, she returned for follow-up visits once a week.

Unlike many heart failure patients across the nation, Kelli was admitted to the hospital only once, when an electronic defibrillator was implanted in her chest. Since then she has managed the condition with a combination of medication, regular checkups and lifestyle changes recommended by the doctors at St. Pat’s.

The best score in the nation As it turns out, Kelli’s story is more common at St. Patrick Hospital than anywhere else in the country. A recent report by the Centers for Medicare and Medicaid Services shows that St. Pat’s has the lowest readmission rate in cardiac failure patients nationwide: 18.2 percent between 2007 and 2010, strikingly low compared with the national average of 24.8 percent during this time.

Dr. Berry, a congestive heart failure and cardiac imaging specialist at the International Heart Institute, speculates that St. Pat’s unique approach to follow-up care is the key to keeping readmissions low. In addition to high-quality primary care, patients are provided with ample information regarding healthy living habits. They are also seen at frequent follow-up appointments to monitor the patient’s progress and provide additional education.

Now, five years after her diagnosis, Kelli has graduated from UM and returned part time to one of the jobs she worked before her diagnosis. She now sees Dr. Berry only once every three months. The health of her heart has greatly improved.

“The doctors are amazed with me,” Kelli says. “I am amazed with me.”

TAKE CARE OF YOUR TICKER Lifestyle changes can prevent and help manage heart disease. Alcohol consumption, smoking, cholesterol, lack of exercise, obesity and stress can all harm the health of your heart.

Excessive alcohol consumption can constrict coronary arteries and elevate triglyceride levels, as well as contribute to obesity and high cholesterol with empty calories.

Smoking reduces the amount of oxygen available to the heart and contributes to atherosclerosis, a buildup of waxy material in the coronary arteries. The risk of heart disease can drop by 50 percent as early as the first year after quitting smoking.

Cholesterol is a primary component of the plaque built up in atherosclerosis. Plaque buildup can narrow the arteries and restrict blood flow to the heart.

A stressful lifestyle is likely to encourage heart-harmful behaviors like smoking, overeating and physical inactivity. Emotionally upsetting events, particularly those invoking anger, are the most commonly reported “triggers” before a heart attack.

Go to ihimontana.org for advice on lowering your cholesterol level and improving your heart health.

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BY JENNI GRAFF

43 and

counting unting

Providence Medical Group expands offerings throughout western Montana

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he number of Providence Medical Group clinics across western Montana has surged to 43 within the past four years. Although the disciplines may vary, from family practice clinics to specialty organizations such as the International Heart Institute of Montana, compassionate, comprehensive healthcare is consistent across them all.

Providence Medical Group was formed in western Montana in 2008 as part of the greater Providence system, which also includes medical ministries in Alaska, Washington, Oregon and California.

The success of Providence Medical Group is largely due to the caliber of healthcare providers within the clinics. “Our providers embody the Mission and Core Values, which keep our patients at the center of all that we do,” says Jennifer Ellis, senior director of operations for Providence Medical Group.

The best gets even better The new organization has already earned several awards and accolades for its accomplishments, including its 2011 launch of the first accredited Patient-Centered Medical Home (PCMH) in Montana.

A PCMH is a clinic staffed by healthcare providers who work as a patient-centered team.

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Led by a primary care provider, the team manages the patient’s healthcare needs, including routine and urgent care, preventive care and referrals to outside providers or specialists when necessary. To become a recognized PCMH, clinics are reviewed on multiple standards, including: Access to care. Patients are able to reach the clinic during or after hours and usually get an appointment the same day.

Coordination of care. Whatever tests or specialty care are needed, the medical home clinic makes sure patients get the necessary care and all healthcare providers are kept current on the patient’s progress.

Patients are empowered to take care of their own health. You are the most important partner in managing your health. Medical home clinics make sure you understand your care and the steps you can take to improve your health.

Excellent quality care. Medical homes are constantly tracking and improving the quality of patient care.

Find the best doctors around With 43 clinics in western Montana, it’s easy to find the physician or clinic who will make a great fit for your needs. Search by specialty or last name with the Find a Provider tool on the home page at saintpatrick.org.

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L O C A L CARE

Members of the Supportive Care team at Providence St. Joseph Medical Center include, from left: chaplain John Payne; registered nurse Randy Stillson; registered dietitian Wanda Wildenburg; medical director Adam Smith; social worker Nancy Viegel; and registered nurse coordinator Barb Fairchild. (Not pictured: pharmacist Landon Godfrey.)

sure we give the best care possible. Our goal is to do the right thing.”

PHOTO BY MARK BRYANT

FIRING ON ALL CYLINDERS

EASING THE WAY Supportive Care team at St. Joe’s helps those with life-limiting conditions

The Supportive Care team at Providence St. Joseph Medical Center includes a physician, registered nurses, a social worker, a pharmacist, a registered dietitian and a chaplain who all understand what it takes to prevent, control or relieve complications of a life-limiting disease.

Supportive care, also known as palliative care, is a specialized form of medicine that enhances the quality of life of patients faced with serious illness. Unlike hospice, supportive care is appropriate for patients in all stages of disease, including those undergoing treatment of curable illnesses and those living with chronic diseases, as well as patients nearing the end of life.

Supportive care centers on patients and families. “We recognize that patients and their families are the experts at knowing how they want to live their lives,” says Adam Smith, D.O., medical director of the Supportive Care program at St. Joe’s.

“Our team is available to help make difficult decisions, plan ahead and cope with problems as they arise.” saintpatrick.org

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CARE AND COMFORT, WHEN YOU NEED IT MOST The process starts when a primary care provider refers the patient to the Supportive Care program, and continues to be a partner in the patient’s care. Barb Fairchild, registered nurse coordinator, sets up an initial consultation with the patient and family members to discuss the illness and how the process will move forward.

Then team members coordinate the best course of action for each individual patient.

That might mean the team would be the chaplain for spiritual guidance, the social worker for end-of-life directives, the pharmacist to help with medication questions and the dietitian to assist with nutrition.

Once a plan is established, patients work with their primary care provider and the team to live a life as full and functionally as possible.

“Continued contact with the patient is the key to success,” says chaplain John Payne. “This way we can make adjustments in our approach. We can take the time to sit with someone and make

The team also makes sure there’s a smooth transition between the hospital and other services, such as home care or nursing facilities, if necessary.

“Communicating with family and the caregivers is a big part of the process as well,” says Fairchild. “Our goal is to ease their anxiety and confusion about what is going on with their loved one and educate them so they can manage moving forward.”

The Supportive Care program as well as the monthly support groups are free to patients at St. Joe’s who have chronic illnesses such as diabetes, congestive heart failure or multiple sclerosis.

As the Supportive Care program at St. Joe’s grows, a provider will become available to do home visits for those who are too sick to travel or don’t have a caregiver to help them. “It’s the next logical step,” says Dr. Smith. “Supportive Care is the original mode of care delivered and practiced by the early Sisters of Providence, so it is prudent we return to such all-encompassing care.”

The support you need To learn more about the Supportive Care program at Providence St. Joseph Medical Center, go to saintjoes.org and under “Our Services,” select “Supportive Care.”

Spring 2012 Health & Hope

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3/19/12 4:59 PM

St. Patrick Hospital 500 W. Broadway Missoula, MT 59802

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PUTTING UP A GOOD FRONT Front desk supervisor at St. Joe’s goes out of her way to help others

When you’re feeling sick, a smile or genuine concern might be the only thing to brighten up your day. Luckily, St. Joe’s offers that as you walk through the front doors.

The first person you see is Judy Bilile, front desk supervisor at Providence St. Joseph Medical Center. Living our Mission every day, “Judy B.,” as everyone calls her, goes out of her way to do the right thing for patients, staff and the community: coordinating quarterly food drives, participating in Relay for Life, giving Christmas gifts to the children of employees, baking goodies for staff meetings and even moving the car of a disabled patient to the front of the hospital in a snowstorm so she could get in her car more easily and back home safely.

“Very few do as much as she does,” says Sue Klein, Providence St. Joseph Medical Center Foundation director. “She cares about the patients and her community.”

Judy, who has worked at St. Joe’s for 17 years, has garnered a relationship with many of the people who come through the doors and seems to know how each patient needs to be treated. Her kind heart and spunky spirit can be a relief for those who would rather avoid the hospital.

“People always ask what keeps me coming to work all these years,” she says. “It’s our patients. Each one is special, and each one needs to be treated that way.”

See all St. Joe’s has to offer!

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PHOTO BY MARK BRYANT

Providence St. Joseph Medical Center can cover the healthcare needs of a lifetime—from the Birthing Center for deliveries to the Supportive Care team for end-of-life needs. For the full range, go to saintjoes.org and click “Our Services.”

3/19/12 5:00 PM