BDN Perspective 2011: Hospitals and Healthcare by Bangor Daily News

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Persepctive May 7

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Perspective May 7

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2, Saturday | May 7, 2011, Bangor Daily News PERSPECTIVE 2011 HOSPITALS

Children with Type 1 Diabetes Have Fun at Adventure Camp

ARIBOU — Erica Laplante of Van Buren was a teenager when the “awesomeness” of the Cary Medical Center’s Camp Adventure taught her that children with Type 1 diabetes could do anything they want with their lives. Laplante, now the coordinator of the 2011 camp, kept attending Camp Adventure year after year, learning more about the disease and the lessons from the camp that it should not limit the lives of the adolescents paid off. The lessons instilled in her a desire to become a nurse so that she could help others with the disease. She became a registered nurse, a certified diabetes educator, a professional volunteer at the annual camp, then co-coordinator, and now is the head of the program that changed her life. In her 14th year with the program, Laplante is looking forward once again this spring to being among the professionals helping youngsters at the 2011 camp that will be held at Mapleton‘s Baptist Park June 19-24. Thirty campers and junior counselors, 16- and 17-year-olds who have attended the camp in the past, will be aided by professionals, including endocrinologists, medical doctors, certified diabetes educators, licensed dieticians, RNs, lifeguards, para-

Chris Farley expresses his thoughts - “two thumbs up” - about having a good time at Camp Adventure. Photos Courtesy of Cary Medical Center

Young people attending the Cary Medical Center’s Camp Adventure relax at an overlook after hiking to East Peak at Quaggy Jo Mountain in Aroostook State Park. Camp Adventure is designed for children with Type 1 diabetes.

medics, Maine Guides, and game wardens. Laplante remembers Camp Adventure as being a wonderful experience, an intense project where kids learn they can do anything they want in life. Children find the thrill of accomplishment as they learn new skills in the out-of-doors, for many of them a

first-time experience. Adolescents come from throughout the state, even out of state, for the annual camp held at a different location each year. The camp is sponsored by local individuals, businesses, organizations, and national and multinational medical groups. Even medicine and equipment is

donated. It costs $100 to attend the camp, but no children have been denied attendance because of a lack of funds. The Sunday through Friday camp ends with a family barbecue and closing ceremonies on Friday afternoon. Over the years, campers have been to Cross Lake in northern Maine, Schoodic Point in southern Maine, climbed mountains in Baxter State Park, canoed and kayaked the St. John River, hiked, done some mountain biking, fished, and done some tubing. “We want to teach kids that they can do anything the want,” Laplante said. For many of them, these are activities they have never done. “It’s quite a feeling for them to accomplish these activities,” she said. “These are great experiences Campers attending the Cary Medical Center’s Camp Adventure paddle canoes across Madawaska Lake near for them. It’s amazing for them.” Stockholm. Each year the camp’s organizers ask the children what they would like to do and then work to make it happen. The group is limited in the number of spots they have for children, but organizers hope to expand the program and get more volunteer staff in the 150 Mile Scenic Two Day Bike Ride Through Aroostook County future. “The kids want more, more camp time,” Laplante said. “It’s amazing to see these children grow from Sunday to Friday.

Some children call it a diabetes vacation, and they like being surrounded by other people with Type 1 diabetes.” The group attempts to do different things each year. Children who return another year see and participate in new things, go new places with a great group of volunteers. Some children and volunteers return year after year. “Once they come, they are hooked,” said Laplante.“We teach them that they can do anything they want even though they have Type 1 diabetes. “They get inspired, and it gives them a great feeling of accomplishment when they complete a task or new adventure,” Laplante said. “With management we help diabetes children grow. “There are no parents,” she

said. “They bring us their children and leave them with us. At first some parents are apprehensive. At the end of the week, parents see a difference in their children. Children with diabetes learn to grow.” It isn’t an easy project. There is a lot of preparation, paperwork, getting supplies, and places to go. In the end, volunteers see the project as a very rewarding experience. “When we see children’s faces light up, it makes it all worthwhile,” Laplante said. “I feel blessed to be part of it year after year.” More information on the program can be acquired by calling the Diabetes Care Program at Cary Medical Center at (207) 498-1283.

RIDE AROOSTOOK

Kaitly Schweikert (left) and Megan Curtis enjoy water sports while attending the Cary Medical Center’s Camp Adventure.

PERSPECTIVE 2011 HOSPITALS & HEALTHCARE

JULY 16-17, 2011

SPECIAL SECTIONS WRITING TEAM Debra Bell David Fitzpatrick Brian Swartz ADVERTISING SALES TEAM Brian Cotlar Ben Drouin Amy Hayden Linda Hayes Kristin Hurd Kathy Keegan

Debbie Niles Jeff Orcutt Michelle Thomas CREATIVE SERVICES TEAM Josh Alves Faith Burgos Bridgit Cayer Michele Prentice Chris Quimby Pam Tweedie Sam Wood

Perspective 2011 is online at

www.bangordailynews.com If you would like to advertise in Perspective 2012 or if you would like to publish your own special advertising supplement,please contact Sales Managers Beth Grant at (207) 990-8251,bgrant@bangordailynews.com, or Nicole Stevens at (207) 990-8213,nstevens@bangordailynews.com, or (toll free in Maine) at 1-800-432-7964,Ext.8251 or 8213.

Helping Children with Diabetes “Ride Aroostook is a new, annual, fundraising two-day bicycle tour event to benefit children’s health, specifically to support and

FIND US ON

expand Camp Adventure, a regional summer

ADVERTISER INDEX

camp for children aged 12-17 with Type1 diabetes. In existence for over 10 years, the

ASSISTED LIVING

goal of Camp Adventure is to “provide a safe,

Ross Manor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

exciting experience dealing with diabetes

CAREERS & TRAINING

while conquering its challenges and creating opportunities to develop greater independence and accept responsibility for

RIDEAROOSTOOK Helping Children with Diabetes

Maine Army National Guard . . . . . . . . . . . . . . . .22

COMMUNICATIONS Oxford Networks . . . . . . . . . . . . . . . . . . . . . . . . . .21

self-management.”

EDUCATION

www.RideAroostook.org Sponsors Cary Medical Center, AstraZeneca HealthCare Foundation, Aroostook Savings and Loan, S. W. Collins Company, Thompson- Hamel, McCain Foods, Barresi Financial, Jepson Financial Services, Maine Mutual Group, TD Bank, Dead River Company, Garelick Farms, Hal Stewart, United Insurance.

University of Maine College of Natural Sciences, Forestry, and Agriculture . . . . . . . . . . . . . . . . . . .12 University of Maine Department of Communication Sciences and Disorders . . . . . . . . . . . . . . . . . . . .17 University of Maine School of Nursing . . . . . . . .13

HEALTHCARE Beltone New England . . . . . . . . . . . . . . . . . . . . . .19 Black Bear Medical . . . . . . . . . . . . . . . . . . . . . . . .17 Soulas Hearing . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Sunbury Primary Care . . . . . . . . . . . . . . . . . . . . . .5

HOSPITALS Calais Regional Hospital . . . . . . . . . . . . . . . . . . . .9 Cary Medical Center . . . . . . . . . . . . . . . . . . . . . . . .2 Eastern Maine Medical Center . . . . . . . . . . . . . . .8 Eastern Maine Medical Center . . . . . . . . . . . . . . .16 Maine Coast Memorial Hospital . . . . . . . . . . . . . .4 Mayo Regional Hospital . . . . . . . . . . . . . . . . . . . .10 Pen Bay Medical Center . . . . . . . . . . . . . . . . . . . . .6 Redington Fairview General Hospital . . . . . . . . . .7 Waldo County General Hospital . . . . . . . . . . . . . . .3

NATIONAL NURSES CARE WEEK Bangor Nursing & Rehab Center . . . . . . . . . . . . .11 Brewer Rehab & Living Center . . . . . . . . . . . . . . .11 CHCS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 Eastside Rehabilitation & Living Center . . . . . . .11 Hibbard Nursing & Rehab Center . . . . . . . . . . . . .11 Maine Coast Memorial Hospital . . . . . . . . . . . . . .11 Main Street West . . . . . . . . . . . . . . . . . . . . . . . . . .11 New England Home Health Care . . . . . . . . . . . . .11 Westgate Manor . . . . . . . . . . . . . . . . . . . . . . . . . . .11

PROFESSIONAL SERVICES Bangor Seat Cover . . . . . . . . . . . . . . . . . . . . . . . .20 ServiceMaster . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Spectrum Office Essentials . . . . . . . . . . . . . . . . .20

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PERSPECTIVE 2011 HOSPITALS

Therapist Is Seeing Patients in Brooks and Stockton Springs

atients at Arthur Jewell Community Health Center in Brooks and Stockton Springs Regional Health Center have a new service available right at the health center. Kathy Muzzy,

LCSW, a therapist, has been seeing people there since November. While some of the patients she sees only need a visit or two to deal with a particular issue or to get a referral to another mental health professional, others need her services for longer. Since late October when Muzzy started spending time at the two health centers, she has seen patients for a variety of issues, such as depression following a stroke or related to chronic pain; anxiety; long-term depression; sleeping problems; substance abuse; anger; grief; and feelings around being a caregiver. She also has a background in working with patients who are dealing with isolation issues following hearing loss. Photos Courtesy of Waldo County General Hospital Muzzy identifies Therapist Kathy Muzzy, LCSW, has been seeing two clear advantages patients at the Arthur Jewell Community Health of having a therapist Center in Brooks (below) and the Stockton at the health center. Springs Regional Health Center (above, right) The first is the since November 2010. heightened confi-

dentiality since the patient is going into the doctor’s office instead of going specifically to his or her therapist’s office. The second benefit is the ability of the medical and mental health providers to treat the physical and emotional issues together. She says that patients often need most to be reassured that what they are feeling is normal and to know, for example, that depression often goes along with a stroke or medical issue. Muzzy is actually an employee of Midcoast Mental Health, who contracts with the two practices to provide on-site therapy services. The billing is done by the practices and in many cases, insurance coverage for her services is the same as for other medical services. Muzzy, who also has a private practice in Belfast one day a week, has a Masters degree in social worker from the University of Maine at Orono and is licensed as a therapist by the state of Maine. She has been practicing for 18 years and also worked as an in-house therapist for PenBay Pediatrics for two years. Muzzy says she enjoys her new position, both because of the variety of issues she sees and the

positive response from patients and the doctors at the health centers. To make an appointment with Muzzy, you must be a patient at

either the Arthur Jewell Community Health Center or the Stockton Springs Regional Health Center. She is available for appointments at Arthur Jewell,

(207) 722-3488, on Thursdays and Wednesday afternoons and at Stockton Springs, (207) 5674000, on Tuesdays and Wednesday mornings.

Food Consumed at the Next Meal Can Improve Skin Care ■ BY NEWS USA

onsumers today are bombarded by a wide variety of anti-aging products for the body and face, whether they are simple cosmetics or surgical procedures. But the fountain of youth really just comes from better nutrition, one health expert says. A survey by the American Academy of Dermatology found that 94 percent of women are confused by all the available anti-aging treatments (over-the counter and prescription) as well as the procedures available in a doctor’s office. Yet according to Cherie Calbom, author of “The Wrinkle Cleanse,” you can look younger starting with your next meal. Her book outlines a fourstep approach to getting softer, younger-looking skin, explaining that a diet rich in raw foods, vegetable juices, whole grains and lean protein can cleanse the body of toxins and protect it from the causes of wrinkles and other symptoms of aging. The mention of vegetable juices might ring a bell: Calbom, who has a master’s degree in nutrition, is better known as “The Juice Lady” for her work with juicing and health. She has appeared regularly on the QVC channel for the last eight years and is the author of several books, including “Juicing for Life.”

Calbom stresses that several factors affect how our skin ages, including environmental toxins, sun exposure, free radical attacks on the cells, inflammation and a weakened immune system. Her approach to creating a better diet geared toward reduced wrinkling has four components: • Step 1 involves quick cleanses with either an all-day vegetable juice fast or a two-day raw-food program, designed to help repair damaged cells. • Step 2 introduces a low-carbohydrate diet for 14 days that has plenty of vegetables, sprouts, vegetable juices, low-sugar fruit, whole grains and lean proteins. • Step 3 is composed of cleaning programs for your intestinal tract, liver, gallbladder, kidneys and blood. Detoxification is key, according to Calbom, in the effort to fight wrinkles. • Step 4 outlines the vitamins and minerals needed to fight the symptoms of aging and how they can be incorporated into your diet. Calbom offers several nutritional guidelines and more than 75 easy-to-make recipes and menu plans. Her strategy emphasizes what she calls the “wrinkle fighters,” foods that are rich in nutrients to help strengthen collagen and elastin for better skin. Some examples include carrots, which add luster to the hair; artichokes for better energy; and almonds, a good source of vitamin B.

Quality Care, Close to Home

You don’t have to travel far from home to get quality health care. Waldo County General Hospital operates a number of primary care offices, including five health centers, where dedicated, friendly staff can help you get the care you need, when you need it. Take advantage of special services, such as priority sick visits and on-site lab work. If you qualify, we also offer programs that can help you pay for doctor visits or prescriptions. For help finding a doctor, please call our physician referral line: 207-930-6766.

Departments of Waldo County General Hospital

ARTHUR JEWELL COMMUNITY HEALTH CENTER 55 Reynolds Rd., Brooks PH: 207-722-3488

SEARSPORT HEALTH CENTER 37 Mortland Rd., Searsport PH: 207-548-2475

DONALD S. WALKER HEALTH CENTER 43 W. Main St., Liberty PH: 207-589-4509

STOCKTON SPRINGS REGIONAL HEALTH CENTER 11 Cape Jellison Rd., Stockton Springs PH: 207-567-4000

LINCOLNVILLE REGIONAL HEALTH CENTER 2399 Atlantic Highway, Lincolnville PH: 207-236-4851

HOSPITAL-BASED DOCTORS 118 Northport Ave., Belfast PH: 207-930-6766

qualitycare.wcgh.org 118 Northport Ave | Belfast, Maine 04915 207-338-2500 | 1-800-649-2536

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Education, Patient Involvement Key to MCMH Total-Joint Program ■ BY DAVID M. FITZPATRICK SPECIAL SECTIONS WRITER

ichael Hangge was 56 last year when his ailing hips caught up with him. It had been getting harder for him to cross his legs or to bend over, but he’d assumed it was stiff muscles. When the pain set in, he went to his doctor. The diagnosis: osteoarthritis, with the cartilage gone, and bone rubbing on bone. “Osteoarthritis is kind of slow oncoming, and eventually kind of sneaks up behind you and bites you,” said Hangge, the fire inspector for the city of Ellsworth, who is an on-his-feet kind of guy. “It gets to the point where … it dawns on you: ‘I can’t do what I used to be able to do.’” Orthopedic surgeon Paul Denoncourt at Maine Coast Memorial Hospital, who specializes in joint replacement, told Hangge that he needed both hips replaced. The plan was to do one in 2010 and the second a year later. As it turned out, this plan would give Hangge a unique perspective on MCMH’s totaljoint program. His first surgery, a success, was under the old program. But a year later, with MCMH’s new total-joint program in place, Hangge saw a whole new way of patients meeting the challenge.

NEW PROGRAM

MCMH had been seeing an increase in total-joint replacements — namely, knees, hips, and shoulders. The time constraints on the doctors demanded that they meet the challenge to expand the program and streamline how it worked. “It has gotten to a point where we felt to do an even better job it was time to create a formal program,” said Denoncourt. Unlike the old days, total-jointreplacement patients aren’t necessarily retirees putting their feet up. They’re often younger, or they’re older but more active. They’re unwilling to give up their mobility and on-the-move lives. They’re

Photos by Terry Farren

Dr. Paul Denoncourt (left), an orthpedic surgeon at Maine Coast Memorial Hospital in Ellsworth, meets with Michael Hangge. Hangge had both hips replaced in two surgeries a year apart at MCMH. Here he’s holding a hip joint similar to the two now in his body.

also better informed and have higher expectations. “They want to go into the hospital knowing everything that’s going to happen to them, and know that we know what we’re doing,” Denoncourt said. “And they want to come out of the hospital sooner and get back to their lifestyles.” The first thing Denoncourt did was begin developing a complete, efficient program, which began with hiring a total-joint nurse. Denoncourt found one in MCMH medical-surgical nurse Susan Dugas. Dugas provides an in-depth education to each patient, serves as the patient’s primary contact after the initial consultation, and coordinates with various hospital departments and medical services outside MCMH. With Dugas handling patient education, the doctors can dedicate more time to direct patient care. This year the monthly totals show a 13 percent increase in patients served. The program wasn’t created overnight. After Dugas came aboard, she researched procedures and consulted

with various departments and other hospitals with total-joint programs. Then she worked to develop concise manuals about the various surgeries for patients, seeking input from the doctors, physical therapists, rehab, medical-surgical nurses, and others to be sure she hadn’t missed anything. Where patients received a one-page fact sheet before, now they get a booklet packed with information — and they have Dugas as a contact if they have any questions. And MCMH will soon launch classes for the general public, for those who are considering such surgery and want to learn more well in advance. SURGERY AND RECOVERY

After the initial education, Dugas connects patients with Physical Therapy early on as they prepare for the surgery. For example, for a knee replacement, patients work beforehand to exercise and strengthen their leg muscles. Obese patients are encouraged to exercise and reduce their weight. Dugas also helps identify the home situation. Does the patient live alone?

Will there be someone there to help? Are there stairs to climb? Patients often don’t consider such questions, and don’t realize they can’t go home alone. Following the education and surgery comes the recovery, which falls to the physical-therapy department. Charlotte Jordan is the physical therapist who works with the TJ program — or, as people joke, the “physical terrorist.” She’s unpopular at first with patients, as she makes them get up and move within hours of surgery — and walking, if possible. But that immediate movement is vital and pays off quickly. “A month from now, when you’re walking your dog on the beach, without any pain in your knee, and you can bend your knee and get down and do your gardening — you will thank me for what I’m doing right now,” Jordan said. It’s a big change from not too many years ago, when everyone stayed in the hospital for 10 days. Today, we know that getting the patient up and moving can severely reduce the risk of infection, blood clots, pneumonia, bowel obstructions, and other side effects. This is part of the comprehensive education through the new total-joint program. “The more they know about what to expect after surgery, what exercises to do ... prior to surgery, the more quickly they’ll recover after surgery,” said Jordan.

something that is good and then know once they go up stairs and they’re rehabbing... in a hospital that’s been nationally recognized.” As for Hangge, after two hip replacements, he’s back to normal. He drives his stickshift with its clutch. He wades in streams while fly-fishing. He rides his mountain bike. And with his unique before-and-after perspective, Hangge says he thinks the new total-joint program will be a big help. “I was very apprehensive at first,” he said of the first surgery. “[But] the second time around … any questions, they were able to help. In a good way, they were constantly checking up on me, even at home… I think it’s an awesome program.”

TEAMWORK

Establishing the new total-joint program has been the result of widespread teamwork, which has always been at MCMH’s core. “I think that’s the biggest thing — it’s totally a team approach, from the doctors to the nurses to the therapists to the Charlotte Jordan, the total-joint program’s physical therapist, works with Hangge. case managers,” Jordan said. “That’s sort Physical therapy is vital for joint-replaceof the way it works here.” ment patients following surgery to get And having that team there makes things much better for Denoncourt. “It’s them healthy and agile again. Although in [good] to have a competent team behind the past patients were bedridden for days or weeks following surgeries, today we me that I know will do it and do it right,” know better. Jordan works to get patients he said. “We work at a great hospital,” Dugas on their feet as quickly as possible, which helps reduce the risk of many possible said. “We’re recognized for our ability to side effects. take care of patients, so it’s nice to do

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PERSPECTIVE 2011

HEALTHCARE

Personal Health Records Can Organize Medical Information ■ BY ARA

hen most Americans access their personal medical information, they need to go through a filing cabinet at home and try to find the folder somewhere in between last year’s tax returns and old bank statements. Even if you are incredibly organized, this system has some flaws. You may know every single detail in that folder, but would the rest of your family know what is in there (or even where the folder is)? And who wants to bring an entire folder to every doctor visit? One relatively new solution to this problem is the Personal Health Record (PHR), an online resource which contains information such as insurance claims, doctors’ visits and prescribed medications. PHRs are frequently offered through an individual’s health insurer and are maintained on a secure, passwordprotected Internet site. According to Charles Cutler, M.D., a national medical director with Aetna, PHRs can help individuals take a more active role in managing their health care. “One of the most important things a patient can do is to keep an updated, accessible, and accurate record of their essential health information,” Cutler says. “Using a PHR can help simplify this process.” There are several other advantages to using a PHR, including: • Improving the doctor/patient relationship. Even though a PHR is maintained online, individuals can print up a copy to share with their doctor at any time. Having detailed, easy-to-understand patient information can make a visit to the doctor much more productive. “It’s great to have organized information in front of you when a patient first comes in, especial-

ly when that information includes medications and tests done by other physicians” Cutler says. “It can also engage the patient in the details and self management of their condition in new and supportive ways.” Some advanced PHRs can also analyze the information that is entered into a PHR, comparing it to recent medical literature and alerting both the patient and the doctor of any possible issues with treatment or opportunities to improve care.

• In case of emergency, use your PHR. In many emergencies — whether it is a car accident that leads to the emergency room, a high fever while you are on vacation or a natural disaster that uproots you and your family — your first concern is likely the health of the people closest to you. While you might have a wallet or personal identification, you probably won’t have access to medical information such as prescription medications or allergies, details that could be crucial, and even life-saving, to the care you receive. With a PHR, this information is accessible with any Internet connection. Having your health records readily available online can impact the quality of care

you receive when you’re far away from home or experiencing an emergency. • More information leads to better care. In addition to the data a health insurer would have, such as insurance claims, doctors’ visits and prescriptions, many PHRs allow individuals to enter in additional information. This can include family health history, over-the-counter medications and even current diet or exercise programs. Knowing this type of personal information is incredibly helpful for doctors, and adding this type of information can also further enhance an advanced PHR’s ability to analyze a patient’s information against medical literature. Despite all of these positive features, PHRs are still significantly underutilized. Even though the trade organization America’s Health Insurance Plans (AHIP) estimates that 70 million people have access to PHRs, a recent survey of more than 2,100 adults conducted by Aetna and the Financial Planning Association found that 64 percent do not know or are unsure about what a PHR is. “Personal Health Records are still a relatively new idea, so it’s not that surprising that people are somewhat unaware of them,” Cutler says. “However, with all of these benefits, individuals should really take the initiative and find out from their insurer if they have access to a PHR.” One resource where consumers can learn more about Personal Health Records that Cutler recommends is www.planforyourhealth.com, a Web site that provides valuable health benefits information. This site recently added a section that describes what Personal Health Records are, how to maximize and personalize your PHR, as well as the top five reasons consumers should use a PHR.

Finding the Right Doctor is a Key Factor in Conquering Pain ■ BY ARA

ne of the greatest challenges people with pain face is access to appropriate care. Although chronic pain disables more than 50 million Americans, chronic pain sufferers are among the most undertreated patients in the United States. According to The National Pain Foundation, pain accounts for 80 percent of all physician visits, yet sufferers are often shuffled from one health care provider to another without relief. “Pain patients wrongly believe that pain is something they must accept as part of their lives, that it’s associated with their injury, that it’s part of their disease or that it’s a natural part of growing older,” said Dr. Robert L. Tiso of the New York Pain Center.“What they need to realize is that pain isn’t something they have to accept. They can find relief with proper pain management.” Pain physicians recommend patients take control of their pain by researching pain and pain management options and by seeking a referral to a pain specialist who knows how to treat pain effectively. Pain physicians focus on the evaluation, treatment and rehabilitation of persons in pain. Some pain physicians work with one therapy while oth-

ers are multidisciplinary and offer a number of different treatments, which range from medication management to advanced therapies like spinal cord stimulation. Several resources are available to help patients find a pain physician and learn about treatment options. Pain sufferers can visit the American Board of Pain Medicine’s Web site, www.abpm.org, to locate a doctor and www.painpathways.com to explore treatment options. Once patients have identified a pain physician, they can take several steps to prepare for their visit: • Check to see that the pain provider is in your insurance network. • Find out if the pain clinic requires a referral. • Visit www.paintyourpain.com to create and print a “map” of your pain. • Gather your medical records for your visit. “The best advice I have for other pain suffers is to seek specialized help,” said Michelle Revello, a chronic pain sufferer who was treated effectively by a pain management specialist. “We all call in expert help for trivial household inconveniences like a leaky sink. We should all do the same for our bodies.”

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Patients Benefit From Services Available at Pen Bay Surgery ■ BY BRIAN SWARTZ SPECIAL SECTIONS EDITOR

MEET THE SURGEONS AT PEN BAY SURGERY

or people living in the Midcoast and as far away as Augusta, Bangor and Brunswick, the medical services available at Pen Bay Surgery represent lives saved, less time spent traveling to distant hospitals, and lower medical bills. Located at Pen Bay Medical Center in Rockport, the board-certified surgeons at Pen Bay Surgery treat patients of all ages. “We provide a higher level of surgical services than you would expect to find at a community hospital,” said Dr. Gordon Paine. “We perform all the types of general surgery that you would find at a surgical practice.” General surgery includes surgery of the abdominal cavity, colorectal surgery, breast surgery, cancer-related skin and soft tissue surgery, gallbladder surgery, and hernia surgery. Pen Bay Surgery physicians also perform laparoscopic and vascular surgeries. In laparoscopic procedures, a surgeon makes several small incisions rather than one large incision during surgery. “Generally, laparoscopic surgery is less invasive, results in shorter hospital stays, causes less pain, and allows quicker recovery at home,” said Dr. Joel Lafleur. Vascular surgery was not available in the Midcoast area until Dr. Julie White joined Pen Bay Surgery in January. White performs specialized surgeries that improve blood flow and prevent serious ailments like strokes. MULTIDISCIPLINARY APPROACH TO TREATING BREAST CANCER

“With better mammography and better detection, we’re seeing much earlier stages of breast cancer,” said Paine. “We want to detect breast cancer as early as possible.” A University of Cincinnati graduate, Paine completed his internship at Parkland Memorial Hospital in Dallas and his residency at Maine Medical Center. Treatment often involves surgery, and Paine and his colleague, Dr. Cristan Anderson, consult other medical specialists before operating. Anderson is a Loyola University graduate who completed her internship and residency at UMDNJ-Robert Wood Johnson in New Brunswick, N.J. “In breast surgery, we approach patient care in a multidisciplinary fashion,” Anderson said. “I interact with the primary care doctor, the oncologist, the pathologist, and the radiologist to figure out the best care plan for the individual patient.” She discussed the multidisciplinary tumor boards established to formulate care plans for cancer patients. Board members include primary care

fashion, I might be discussing the case over the phone prior to surgery. Of course, we always discuss the case with the medical oncologist before determining the right level of care,” she said. As a general surgeon who performs laparoscopic surgery, gallbladder, colon, and hernia surgeries in addition to breast surgeries, Anderson likes “treating the whole patient — not just taking care of one organ system or one disease, but taking care of general surgical diseases that arise in a broad spectrum of patients. I like the diversity. That’s why I stayed a general surgeon and didn’t choose to specialize.” PERIPHERAL VASCULAR SURGERY TREATS MANY MEDICAL CONDITIONS

“Vascular disease usually affects people over the age of 50 and into their 80s and 90s,” said White, a Boston University School of Medicine graduate who completed her internship and residency at University Hospital in Boston. She also completed a fellowship in vascular surgery at University Hospital. White specializes in peripheral vascular surgery, which involves taking care of the all the blood vessels outside of the heart, including the carotid arteries leading from the heart to the brain, arteries Dr. Gordon Paine, M.D. Dr. Joel Lafleur, M.D. in the abdomen, feet, and legs, and arteries leading to such internal organs as the kidneys. “The population in this area has a lot of arterial disease, mainly because so many people have a significant smoking history,” White said. “One common operation I perform is to clean out the carotid arteries. The second most frequent condition I treat is hardening of the arteries in the legs.” This type of surgery involves a catheterization procedure that inserts a balloon or a stent into an artery to improve the blood flow. “The third most common condition I treat is varicose veins,” White said. “Usually we see it in women more than in men. It can occur in patients from the 20s on up to the 80s. Childbirth, genetic predisposition to varicose veins, and trauma are the three most common causes of varicose veins.” She usually treats varicose veins as an outpatient procedure involving injections or radio-frequency ablation. White is the director of both the Wound Healing Center and the Vascular Services Lab at Pen Bay. The Wound Healing Center is where patients are sent for management of their wounds by a physician and a certified wound-care nurse. The Vascular Services Lab offers non-invasive testing to look Dr. Cristan Anderson, M.D. Dr. Julie White, M.D. at different arteries and veins and see how well they physicians, pathologists, radiologists, and sur- Commission on Cancer. function. Specialized ultrasound equipment geons. “We meet, sit down, and discuss individual “Sometimes we consult with specialists from screens for carotid artery disease so that it can be See PEN BAY SURGERY, Page 7 cases,” said Anderson, a member of the Maine State other hospitals. If we’re doing surgery in a timely

HEARTBURN

YOU DON’T HAVE TO

is a common problem. PUT OUT THE FIRE FOR GOOD. IF YOU HAVE ANY OF THESE SYMPTOMS, YOU MAY BE A CANDIDATE FOR TREATMENT: • Frequent heartburn • Worsening of symptoms when bending or lying down • A bitter or sour taste in the back of the mouth

• Belching • A burning feeling in the chest • Pain in the upper abdomen • Chronic cough & hoarseness

live with it. Call 207-593-5737 to make an appointment

PEN BAY MEDICAL CENTER CAMPUS, ROCKPORT

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1 IN 8

BREAST CANCER:

the most common non-skin cancer in American Women.

WOMEN ARE AFFECTED.

YOU DESERVE THE BEST CARE. AT PEN BAY, WE USE ALL OUR RESOURCES TO TREAT YOUR CANCER: • In-house Cancer Care Center with a medical oncologist and in-house pathologist • Sentinel lymph node biopsy offered on site • Family Resource Center on campus

• Dedicated oncology nurses and social worker • In-office tissue diagnosis • Emphasis on breast conservation • Specialized tumor review board

Call 207-593-5737 to make an appointment

PEN BAY MEDICAL CENTER CAMPUS, ROCKPORT

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IN ADDITION TO SCREENING SERVICES, PEN BAY OFFERS COMPLETE TREATMENT OF: • Basal & squamous cell skin cancers • Melanoma • Dysplastic and atypical nevi

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THE RIGHT CARE. RIGHT HERE.

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Pen Bay Surgery Continued from Page 6 treated before it causes a stroke. The risk factors for carotid artery disease include an age older than 60, a family history of stroke, high blood pressure, high cholesterol, and smoking. “Patients who have these risk factors should have the ultrasound done, even if they’re not showing any symptoms of carotid artery disease,” White said. MANY SURGERIES ARE PERFORMED LAPAROSCOPICALLY

can also be treated laparoscopically, including some incisional hernias and some complex bilateral hernias. The four surgeons at Pen Bay Surgery often confer with their colleagues in other hospitals, especially those that, like Pen Bay Medical Center, are part of the MaineHealth system. Lafleur’s responsibilities extend beyond Pen Bay Surgery. Last fall, the Pen Bay Healthcare trustees elected him as the board chairman, the first time an active, practicing physician has taken that role. “It’s a sign of the times; physicians and hospitals are working better together and collaborating more,” said Lafleur. “It’s clear that with health care, we have a fixed amount of money, and we’re trying to do more with that same amount. The only way to do that is for everyone to have a say in what’s happening and to cooperate effectively to do our work more efficiently,” he said.

Lafleur performs laparoscopic surgery for a variety of medical conditions. A general surgeon who joined Pen Bay Medical Center 10 years ago, Lafleur graduated from the University of Vermont and also completed his internship and residency there. “I do laparoscopic surgery for gastro-esophageal TREATING SKIN CANCER WITH SCREENING, reflux — problems related to heartburn,” Lafleur BIOPSIES, AND EXCISIONS said. Besides performing surgeries related to hernias, “Not every patient needs surgery for heartburn, but some people with severe, chronic heartburn are gallbladders and thyroids, Paine performs many skin cancer surgeries in an outpatient setting at Pen Bay Surgery. “Skin cancer is the mostdiagnosed cancer these days,” he said. “Basal cell, squamous cell, and melanoma are the three major types of skin cancer we see.” Despite the long winters, Maine still has a high rate of skin cancer. “Many people — fishermen, sailors and others — have a lot of exposure in the summertime to potentially damaging sunlight,” Paine said. “People do need vitamin D from the sun, so we encourage the use of sunblock and wearing a hat, practicing judicial sun exposure. Absolutely no tanning booths, especially for teen-agers. Skin cancer is the most frequently diagnosed cancer, according to Dr. “It’s not what happens Gordon Paine, M.D., a surgeon at Pen Bay Surgery in Rockport. today or yesterday in terms of exposure,” he said. “A lot not helped by medication. These are the patients of damage happened 30 years ago. Skin cancer can we see for surgery,” he said. Pen Ben Surgery can take a long time to appear.” screen patients for gastro-esophageal reflux. Early detection can lead to early, successful treatLafleur also performs laparoscopic surgery of ment of skin cancer. “General practitioners are the the intestine and colon to repair adhesions and best place to start during an annual physical exam,” remove polyps. In addition, some classes of hernias Paine said. “Your doctor will check you for any-

thing that doesn’t look right,” such as the nevus (or freckle), especially the atypical nevus. This is a dark freckle that should be looked at by a physician if it changes size, shows vertical growth, or has an irregular border. “Pen Bay Surgery provides complete body scanning for atypical nevi,” said Paine. “We look at all of the skin to see if there are any lesions that are abnormal. “A lot of skin cancer can be treated with careful screening, judicious biopsies, and excisions of particular cancers. We do this in an office setting; it saves money for the patient,” he said. The Pen Bay Surgery physicians have “a wealth of experience that we share,” he said. “We work well together as a team. We assist each other with surgery. For major surgeries, it’s teamwork. I will not do colon surgery without another surgeon assist-

ing.” The four surgeons rotate on-call duty, which benefits all Pen Bay Surgery patients. “If one of our patients develops right upper quadrant pain, which can be a gallbladder attack, we certainly will assist that patient, no matter whose patient that person is,” Paine said. Working with the four surgeons is Catherine Crochetiere, the nurse practitioner. “She does so much,” said Paine. “She sees her own patients. She assists at surgery, she makes rounds, she does a lot of the skin cancer screenings. Catherine is wonderful with breast cancer patients. She’s just a great asset. “I love the practice of medicine,” he said. “I love the hospital here. This is a great group of physicians and staff. I really enjoy going to work every day.”

Various Factors Affect When a Person Needs a Hip Replacement ■ BY JEREMY REITHER ORTHOGATE.ORG

t is certainly true that not everyone with hip joint pain needs a total hip replacement, but when your quality of life grows increasingly diminished due to hip joint pain, it may be advisable to consider your options for hip replacement surgery. Ultimately, it’s up to you to decide when you’ve had enough pain and are ready to seek out a medical solution. Many people will endure the pain for months and even years before speaking with their physician. Dr. Ian C. Clarke, medical researcher and founder of Peterson Tribology Laboratory for joint replacement at Loma Linda University in California, writes that with regard to hip pain, “When you can’t do the quality things in life that you need to be doing, you know you need a hip replacement.” Clarke goes on to qualify this statement by saying “painful twinges” due to excessive activity, such as too much running or

lots of dancing, does not necessarily mean you need a hip replacement. On the other hand, if you are unable to accomplish normal, daily activities such as dressing in the morning, taking a shower, walking, and getting into bed, then your quality of life is being impacted. If you cannot conduct your business due to pain in your hip joint, or if you cannot comply with your job description, then you probably should consider hip replacement surgery. Another case may be if you need medication to sleep at night because your pain is so severe, then you might want to look into hip replacement surgery. Remember that hip pain can radiate from anywhere in or around the hip joint. In some cases, you may not be able to feel the pain directly over the hip; you may feel it in your thigh. Pain in the hip can also sometimes suggest problems with the back. By identifying the specific type of pain that is impacting your life, you have a better

chance of arriving at a medical solution. Your surgeon will help you to decide if hip replacement surgery is necessary. From a clinical standpoint, a surgeon will consider total hip surgery for a patient when alternative methods such as changes in activities, mild painkillers, and physiotherapy have been exhausted. Depending on the age of the patient and the damage to the tissue, the surgeon may suggest arthroscopy or a partial hip replacement before a total hip. Through the use of radiographic technology such as Xrays, CT, MRI, and ultrasound testing, a surgeon will be able to see how much joint cartilage has been lost and therefore how justified a total hip surgery is in each patient scenario. When all other alternative therapies have either failed or wouldn’t work in the first place, and when radiographic tests show a loss of cartilage that make up the “joint space”, then a surgeon may recommend a total hip replacement. Contact your doctor.

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PERSPECTIVE 2011 HOSPITALS

Telemedicine Link Lets Specialists “See” Patients in Calais ■ BY BRIAN SWARTZ, SPECIAL SECTIONS EDITOR

his month, Calais Regional Hospital will unveil a new telemedicine link with Eastern Maine Medical Center’s Critical Care Connection and Tele-ED services that will let CRH doctors and nurses confer visually and audibly with medical specialists in Bangor. And CRH patients will benefit, according to Cheryl Zwingman-Bagley, RN, chief nursing officer. “Telemedicine improves our ability to respond to changes in a patient’s condition,” she said. “This should assure the public that their level of care in eastern Washington County is as good as it can be.” She indicated that Tele-ED (encompassing TeleTrauma, Tele-PICU, and Tele-Stroke) “provides additional monitoring and specialist consultation.” The EMMC-CRH collaboration presents potential cost savings for patients and “supports continuance of care in the patient’s primary hospital with local family and support systems,” Zwingman-Bagley said. The collaboration may allow CRH to decrease the number of patient transfers and increase the use of such internal hospital services as the laboratory and x-ray. The 25-bed Calais Regional Hospital serves a region stretching from Topsfield south to Pembroke along Route 1 and west to Wesley on Route 9. As a critical access hospital, CRH provides many medical services, and the hospital’s Emergency Department is “the first place people are going to come if there’s a medical issue,” said Mark Nischwitz, RN, the interim ED director. Rural hospitals like Calais Regional often lack doctors specializing in such areas as cardiology and trauma. When treating such patients in the past, CRH doctors and nurses conferred by phone with EMMC-based specialists. “The doctor or nurse in Bangor depended on our description of the patient’s condition to recommend what we should do,” Zwingman-Bagley said. “They couldn’t ‘see’ the

NEWS Photos by Brian Swartz

“Telemedicine improves our ability to respond to changes in a patient’s condition,” says Cheryl Zwingman-Bagley, RN, chief nursing officer at Calais Regional Hospital.

With the advent of telemedicine at Calais Regional Hospital, specialists based in Bangor “can examine the patient right along with us,” said Luann Reppert, RN, director of CRH’s inpatient-care unit.

Mark Nischwitz, RN, is the interim Emergency Department director at Calais Regional Hospital. “We see the entire gamut of patients and medical conditions in the ED,” he said.

patient.” “Telemedicine closes that gap,” said Luanne Reppert, RN, director of CRH’s inpatient-care unit. “The specialists in Bangor can examine the patient right along with us.”

telemedicine center. Today, the Telemedicine Center provides 24/7 specialty consultations in trauma, stroke, pediatric and adult intensive care, oncology, pharmacy, psychiatry, radiology, and rehabilitation medicine. Covering an area of 26,000 square miles, the system currently links EMMC with: • The Aroostook Medical Center in Presque Isle; • Houlton Regional Hospital; • Charles A. Dean Memorial Hospital in Greenville; • Mayo Regional Hospital in Dover-Foxcroft; • Blue Hill Memorial Hospital; • Mount Desert Island Hospital in Bar Harbor; • Inland Hospital in Waterville;

• Sebasticook Valley Health in Pittsfield; • Reddington-Fairview General Hospital in Skowhegan; • Penobscot Bay Medical Center in Rockport; • St. Joseph Hospital in Bangor; • The Acadia Hospital in Bangor. Calais Regional Hospital is the newest hospital to join the Northern New England Telemedicine System. “This advanced and comprehensive service allows Eastern Maine Medical Center to assist our partners in outlying areas, provide expert consultation, and in many cases, enable patients to be cared for right in their home setting, close to family and other community support,” said Mary McCarthy,

EMMC TELEMEDICINE CENTER

Eastern Maine Medical Center established the Northern New England Telemedicine System in 1996 “to provide an interactive communication system linking Maine’s healthcare providers,” according to www.emh.org. Serving central, eastern, and northern Maine, the Telemedicine Center at EMMC is the state’s first comprehensive

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Calais telemedicine

Bagley said. “It’s literally like they’re in the room with us. They operate the camera from Bangor; the resolution is so high, they can zoom in close enough to measure [a patient’s] pupil size.” Continued from Page 9 Telemedicine will provide EMMC doctors and nurses with access to a CRH patient’s electronic medical records, including laboratory RN, Telemedicine Center manager. test reports. The telemedicine cameras will also “see” each patient’s “But, if needed, we can bring them right here for the specialty care monitor and the critical information that it reports. that’s not available at home,” she said. “Through the telemedicine link, we ‘know’ them before they arrive, and in many cases, they and IMPROVING PATIENT CARE their families recognize the voice and the face that they’ve seen on the Like similar rural hospitals, Calais Regional Hospital lacks an TV screen in their ED or hospital room, so the transition from their intensive-care unit. In 2010, the hospital remodeled two regular hospital to ours is easier.” patient-care rooms as special-care rooms, designed for “the patient “IT’S LITERALLY LIKE THEY’RE IN THE ROOM WITH US” who needs a little higher level of care, but not at the ICU level,” Zwingman-Bagley said. A nurse’s station connects the rooms. At Calais Regional Hospital, the telemedicine capabilities involve “Specially trained nurses care for the patients in those rooms,” devices placed in two inpatient-care (or special care) rooms and two Reppert said. “Depending on the patient, the nurses could be stabiEmergency Department critical-care rooms. The ICU cameras will lizing an arrhythmia, caring for a post-op patient who might need to connect via dedicated Internet connections to EMMC’s Critical Care be on a ventilator a little longer after surgery, or caring for a patient Connection, staffed 24/7 by trained nurses. in a diabetic crisis.” “The patients in these rooms are very sick,” ZwingmanBagley said. “Someone with cardiac disease could have very bad pneumonia. They could be getting a combination of therapies. They are sick, but don’t need treatment in a tertiary level ICU. However, they do need close monitoring, which we are able to provide in our special care rooms.” The decision to contact EMMC lies with CRH doctors or nurses, Reppert indicated. “This gives us the option to confer with their telemedicine nurses or physicians. We call them and let them know which room we’re using.” “In the Emergency Department, we can have them (EMMC staff) online and ready to go before an ambulance arrives,” Zwingman-Bagley said. “We see the entire gamut of patients and medical condtions in the ED: MVAs (motor vehicle accidents), cardiac, strokes, pediatrics,” Nischwitz said. Staffed 24/7 by doctors and nurses, the Emergency Department treats 10,800 patients annually, with approximately 8 percent admitted to Calais Regional Hospital. Others are transported elsewhere. According to Nischwitz, telemedicine will give the Emergency Department “another resource for giving quality patient care.” NEWS Photos by Brian Swartz “The trauma specialist at EMMC can look at the patient Beth Maxwell, RN, works at the special-care unit nurses’ station at Calais Regional right along with you,” Zwingman-Bagley said. “The doctors Hospital. Maxwell covers two special care rooms that are being equipped with will make the decisions together.” technology to provide a telemedicine connection with Eastern Maine Medical “Our doctors will use the EMMC doctors in a consultative Center in Bangor. manner, from assessing the patient to deciding on treatOnce an ICU patient is identified, CCC nurses and specialists are ment,” Nischwitz said. “We will be able to get additional medical available to support the CRH nurses and providers. The Emergency information on patients we are treating and determine a quicker disDepartment cameras are part of the Tele-ED solution, and “in-room” position of the patient from the hospital without delaying care.” access to EMMC’s trauma, pediatric ICU, and stroke specialists is just “Disposition” can mean transporting a patient to a tertiary care a call away. hospital in Bangor, Portland, or Boston; this happens after doctors Hard-wired into existing wall-mounted computer monitors and decide exactly where a patient can receive the best appropriate care. equipped with microphones, the room cameras will let EMMC Nischwitz indicated that EMMC physician intensivists can recomphysician intensivists and intensive care nurses visually examine mend patient transportation and the specific hospital to which a CRH patients and “see and talk with our staff,” Zwingman-Bagley patient should be sent. said. According to Reppert, doctors may decide that a patient can stay at She described the technology as similar to Skype. “Our doctor can Calais Regional Hospital, close to family and home. “It might be a ask their doctor to come onto the camera and talk,” Zwingman- matter of stabilizing a patient so they don’t need to travel,” she said.

“It could be a few hours or just a day to stabilize a patient. “Given our rural setting and the distances to where a patient might need to travel for a higher level of care, if we can provide it here with the aid of telemedicine, the patient and family can save money and time,” Reppert said. “It’s good for a patient to be near their home whenever possible,” she said. “So often they just seem to do better when they’re in familiar surroundings.” Doctors and nurses at Calais Regional Hospital are “very excited” about telemedicine and its capabilities, Zwingman-Bagley said. “I think telemedicine is fantastic. It’s such a boon for a hospital our size. Just having the specialists available at your call will mean so much for our staff and our patients.” According to Zwingman-Bagley, EMMC provided the telemedicine equipment; Calais Regional Hospital contributed approximately $15,000 toward the project. In late January 2011, the U.S. Department of Agriculture awarded EMMC a $152,095 grant to expand the Telemedicine Center; the grant was made through the USDA Distance Learning and Telemedicine Program.

Telemedicine cameras and related equipment placed in two Emergency Department critical-care rooms at Calais Regional Hospital will let nurses and physicians based at Eastern Maine Medical Center in Bangor “see” patients being treated by CRH nurses and doctors.

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Medical Advancements Help Many Patients Battling Cancer ■ BY AMY FAGAN, THE WASHINGTON TIMES

anessa Koppel of Cherry Hill, N.J., began fighting for her life in September 2006 when she found out she had Hodgkin’s lymphoma. “I was really active and ate well. I was young,” said the 27-year-old fitness instructor, who was terrified of chemotherapy and radiation. “What was God putting in my life and why?” she said she wondered. Koppel’s battle led her to the Cancer Treatment Centers of America (CTCA) in Philadelphia, one of the privately held facilities in a network that focuses on integrative care. It provides each patient with oncologists, radiologists, surgeons, nutritionists, naturopaths, mind/body doctors and spiritual counselors in one place, with a coordinated treatment plan. Koppel said that the CTCA “heard my concerns ... actually talked to me.” Over the past few decades, the medical field has experienced several advancements in the fight against cancer, a complex group of diseases characterized by rapidly multiplying abnormal cells. Today, new drugs and treatment plans are available, and new methods are used to care for cancer patients. CTCA is one such advancement. Cancer cost about $219 billion in direct medical expenses and lost work productivity last year alone, according to the National Institutes of Health (NIH). Each year, the disease claims about a half-million lives in the United States. The American Cancer Society predicts that 1.4 million cancer cases will be diagnosed this year and that about 565,650 people will die from the disease. About 170,000 of the cases will be tied to tobacco use. Still, many more people are becoming cancer survivors. One of them is Koppel, who finished treatment in the fall and is cancer-free. The National Cancer Institute estimated that 10.8 million Americans with a history of cancer were alive in January 2004, meaning some were cancer-free and others still had evidence of cancer and may have been undergoing treatment. Cancer death rates have been declining since the early 1990s, although with a growing and aging population, the number of cancer deaths has generally risen each year, with the exception of 2003 and 2004 when it decreased, according to the ACS. Simply put, “there’s a lot of good news and still a long way to go,” said Dr. Timothy Birdsall, vice president of Integrative Medicine at CTCA.

BATTLING THE ENEMY

Death rates for the most common cancers — prostate, breast, lung, and colorectal — and for cancers overall continued to decline last year, according to NCI’s 2007 Cancer Trends Progress Report. Researchers credit advances such as earlier detection, a better understanding of the causes of cancer and how the disease develops, technology that improves diagnosis and treatment, and new drugs, a 2004 cancer survivorship report from the American Society of Clinical Oncology shows.

In recent years, the increased use of drugs that block the growth and spread of cancer — known as “targeted” therapies — has improved cancer treatment dramatically, doctors said. Such drugs target specific molecules that help cause or spread the disease. By focusing on molecular and cellular changes specific to cancer, targeted therapies may be more effective and less harmful to normal cells, according to the NCI. “Chemotherapy ... still has a role, but there’s no question of where the excitement and action is today,” said Dr. J. Leonard Lichtenfeld, deputy chief medical officer at ACS. “It’s in the targeted therapy arena.” Such drug therapies include: • Gleevec, which targets abnormal proteins, or enzymes, that form inside cancer cells and stimulate uncontrolled growth, according to the NCI. It was approved by the Food and Drug Administration

The Human Genome Project has been enabling scientists to identify inherited and acquired genetic alterations that contribute to a person’s cancer risk, eventually allowing doctors to calculate risk based on the individual patient, Dr. John E. Niederhuber, director of NCI, wrote in NCI’s Cancer Trends Progress Report. New imaging technologies, he wrote, are allowing doctors to examine the inner workings of the cancer cell. “These advances are happening at a pace never seen before,” he wrote. Doctors said the field is moving toward a day when cancer may be treated like a chronic disease. That was what happened with AIDS, and “that’s the same model we’d like to see for cancer,” said Lichtenfeld. New ways to deliver treatment have emerged as well. Radiation, for example, “probably changed more in the last 10 years than it changed in the previous 50,” said Dr. Curt J. Heese, a radiation oncologist at CTCA’s Philadelphia hospital. Among the developments, he explained, is the tomotherapy machine, which produces 3-D images of the cancer before treatment and then rotates around the patient, delivering radiation to the tumor “from all directions” and minimizing damage to surrounding tissue. Standard radiation hits the tumor only from a few directions, he said. NEW WAY OF CARING

(FDA) in 2001 to treat chronic myelogenous leukemia and in 2002 to treat a rare form of stomach cancer. • Iressa, which targets a protein that is overproduced by many types of cancer cells and helps spread the disease. It is FDA-approved to treat advanced non-small cell lung cancers, according to the NCI. • Avastin, which prevents the formation of new tumor-feeding blood vessels. It is approved by the FDA to treat, in combination with other drugs, late-stage colorectal cancer, certain non-small cell lung cancers and certain breast cancers, according to the NCI. Dr. Edgar D. Staren, chief medical officer at CTCA, said targeted therapies are “exploding and there’s [now] more than a thousand targeted therapies being reviewed by the FDA.” Researchers also are examining evidence that a small percent of cancer cells in some tumors have tumor-initiating capacity. The theory, said Lichtenfeld, is that these cells, also called stem cells, spearhead the development of cancer cells. If they can be stopped, the cancer may stop, too, he said. Dr. Larry Norton, deputy physician in chief for breast cancer programs at Memorial Sloan-Kettering Cancer Center in New York City, said the medical field already can make prognoses on infectious diseases and “we’re working towards being able to do that in cancer.”

Heese and the other specialists at CTCA take an integrated approach to treatment and meet three times a week to discuss patient cases. Some said this model is the wave of the future for cancer care. “It’s really the forefront for oncology, there’s no question about it,” said Dr. Rudolph Willis, chief of medical oncology at CTCA. Many cancer patients turn to alternative or complimentary treatments, ranging from vitamin supplements and diet modification to coffee enemas and therapeutic touch, according to a 2001 review in the Journal of Clinical Oncology. The CTCA is set up to “look at the things that cancer patients value through the filter of scientific validity and our ability to deliver them in a clinical setting,” said Birdsall. The CTCA network treats about 13,000 patients a year nationwide, including 3,000 new patients, and focuses mainly on advanced cancer. Meanwhile, survivorship is changing the cancer landscape. A few years ago, breast cancer clinics in Seattle were overflowing with women who had survived breast or gynecological cancer. “Our clinics were filled with return patients, many years out from their treatments,” said Dr. Julie Gralow, associate professor of medical oncology at the University of Washington and director of breast cancer oncology at Seattle Cancer Care Alliance. Gralow set up a follow-up clinic, the Women’s Wellness Clinic, which has 800 patients and focuses on nutrition, fitness, counseling and emotional support, physical therapy and natural medicines. Gralow said more hospitals and clinics will have to make similar moves. “It’s a real wake-up call that we have all these survivors,” she said. See CANCER FIGHT, Page 14

Health and Biomedical Sciences Interested in a career in health professions or biomedical sciences? Comprehensive academic offerings, close advising, outstanding research opportunities, high placement rates and strong relationships with leading research institutes and top medical schools make UMaine a destination for health-related studies. The UMaine School of Nursing is rigorous and competitive. Not only do our students gain hands-on experience in a range of healthcare settings, they also learn how to apply current research to their clinical work. Our intensive Clinical Laboratory Sciences curriculum culminates in a yearlong practicum, which gives students the background and experience they need to achieve professional certification as a medical technologist. Human Nutrition and Dietetics students work closely with faculty on research and outreach in some of the best facilities in the Northeast, and many volunteer with community groups and nonprofits.

Students in any major can pursue Pre-Medical, Pre-Dental, Pre-Pharmacy and Pre-Optometry studies. Biology and Zoology both offer formal concentrations in Pre-Med, while Chemistry offers a PrePharmacy track. Other majors most commonly chosen include Biochemistry, Microbiology, and Molecular and Cellular Biology. Our Health Professions Office keeps students up-to-date with scholarship information and admission requirements for professional schools nationwide. Students interested in biomedical research have the opportunity to work alongside faculty researchers in state-of-the-art laboratories on campus through UMaine’s Bioengineering and Molecular and Biomedical Sciences programs. Our graduates are sought after by top graduate schools, corporations and research programs.

UMaine’s offerings in Communication Sciences and Disorders prepare students for careers in speechlanguage pathology and audiology, as well as careers in a variety of human-services and educational settings. The Psychology program explores the subject as both a biological science and as a social science. A researchintensive track is available for academically qualified students. UMaine’s School of Social Work balances academic and practical education to prepare students for whatever their next step may be. Small classes, close studentfaculty interaction and an individualized field practicum are hallmarks of the school. Rigorous coursework and hands-on clinical experience ensure that our Athletic Training students are ready to work in a school, medical or private-practice setting after graduation, while some go on to graduate or medical school. In addition, the Exercise Science track in the Kinesiology and Physical Education major prepares students for graduate studies in allied health.

umaine.edu/healthandbiomedicalsciences

Selected majors at UMaine that can prepare students for careers in health sciences • • • • • • • • • • • • • • • •

Athletic Training Biochemistry Bioengineering Biology (Pre-medical Studies Concentration) Chemical Engineering Chemistry Clinical Laboratory Sciences (Medical Technology Concentration) Communication Sciences and Disorders Food Science & Human Nutrition (Human Nutrition and Dietetics Concentration) Kinesiology & Physical Education (Exercise Science - Administration and Science Options) Microbiology Molecular and Cellular Biology Nursing Psychology (Biological/Cognitive Concentration) Social Work Zoology (Pre-medical Studies Concentration)

For contact information and a more in-depth view of how UMaine can prepare you for a career or graduate work in the health sciences, visit umaine.edu/healthandbiomedicalsciences

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PERSPECTIVE 2011 EDUCATION

Nurses Use Degrees to Make a Difference in Home Communities ■ BY DEBRA BELL, SPECIAL SECTIONS WRITER

he University of Maine’s School of Nursing is well known for producing well-prepared professional nurses. In fact, the School of Nursing’s graduates are in high demand throughout Maine and the nation. That’s because the School of Nursing encourages nurses to take learning out of the classroom and into their communities. UMaine’s School of Nursing has made a commitment to provide opportunities for students and graduates to connect their coursework, clinical skills, and the communities they live in. Recent graduate Amanda Mathis and May graduates Donna Stanley-Kelley and Sonya Poiesz know this connection first-hand. These nurses are employees at their respective community health facilities, and utilized UMaine’s program to enhance their skills while also impacting the people who live and work around them. That’s because they know that as nurses they have a civic responsibility to connect their education with leadership in healthcare. After graduating from the University of Maine School And their degrees from UMaine only strengthen of Nursing, Amanda Mathis, RN, started working as a that understanding. nurse at Penobscot Valley Hospital in Lincoln.

COMMUNITY NURSING CLASS CONNECTS STUDENTS

Amanda Mathis recently graduated from the School of Nursing and is now working as a nurse at Penobscot Valley Hospital in Lincoln. Mathis, a Howland resident, used her nursing degree to make an impact on her home community while she was still a student. Mathis chose the UMaine School of Nursing to earn her degree. Inspired by her personal experience with a nurse during the birth of her second daughter, she decided to go into nursing to make a difference. “The nurse was the difference between a bad outcome or a good outcome,” she said of her high risk pregnancy and delivery. “She was [my] driving force for going into nursing school.” Mathis honed her skills at UMaine and worked in tandem with expert nurses at Penobscot Valley Hospital in obstetrics as well as in general patient care during her 192-hour partnership. That partnership gave her an advantage when it came to looking for employment after graduation. But she learned how to put theory into practice during her community-based health promotion project. This project consisted of a health assessment of a community and was followed by a leadership project. Mathis’ group, which included four classmates, chose to use her home community of Howland because of her access to the schools. Mathis has two children in the Howland school system. Over the course of the semester, Mathis’ group investigated all the factors that affected the health of the community and developed an assessment of what was working and what could be improved. “We had a lot of help from the town manager and the town office,” she said. “They all wanted to give info about the town.” For the leadership portion of their project Mathis’ group utilized her connection with the Howland schools to work with teenagers to help them understand how to develop healthy lifestyles at an early age by using fun and educational activities. The activities, combined with huge hometown support, made the project a success. In return, Mathis’ group hopes to make recommendations based on their findings from the project to the town’s school board. “[The project] gave me more pride for my community,” she said. “This is where I live, where my children are, and I’m proud that there are people in the community who are paying attention.” And the school of nursing played a huge part in the success of the community nursing project as well as her preparation for the working world. “Attending the school of Nursing at the University of Maine was a wonderful experience and I feel that I am a better person for having done it,” Mathis said. “I feel the same way about my position at Penobscot Valley Hospital, I now understand that until now I have never been happy in my work. I can gladly state that I love my job and I love being a nurse,” she said. FLEXIBLE CLASS SCHEDULES HELPS RN TO BSN NURSING STUDENT

Good nurses know that learning doesn’t end once they earn their degree and license. In fact, for many nurses, going back to college enhances their current skill-set while also providing new skills to be utilized on the job. And for Donna Stanley-Kelley, a registered nurse from Lubec, going back to college to earn her RN to BSN degree has been an exhilarating journey. Stanley-Kelley earned her three-year diploma in nursing through Eastern Maine Medical Center’s school of nursing and was a member of the last graduating class from that school. But she knew she wouldn’t stop with one degree. She was determined to further her education by earning a Bachelor of Science degree in nursing before she turned 50. She began working on that degree in 2008. And in the spring of 2012 — at age 48 — she’ll have met that goal. “Maybe I need to realign my goal to earn a masters degree in the next two years,” she joked. And she’s doing it while also working as an infection prevention nurse at Downeast Community Hospital in Machias. That real world experience

Donna Stanley-Kelley, RN, hails from Lubec. Next year she will graduate from UMaine with a bachelor of science degree in nursing.

Sonya Poiesz, RN, of Madawaska will graduate this May from the UMaine School of Nursing with a master’s degree as a family nurse practitioner.

was essential to connecting to her community through hands-on learning in class and in clinical rotations. “The nice thing about going to school at this point in my life is that I can apply it every day,” she said. “Coming from Washington County there are very few resources there.” Her UMaine education provided her with the advanced skill-set she needed to be a better nurse at her hospital. In fact, her education and experience has made her even more valuable to her hospital and her community. She has become a resource for her patients and co-workers. And in a rural setting, she noted, taking advantage of as many resources as possible is very important. “UMaine took all the classes that I had taken from nursing school [at EMMC],” she said. “I’ve taken some classes in Machias. And the faculty has been absolutely amazing. They’ve been very good at helping me. With the UMaine system, I have the ability to look at classes and see what the colleges are offering. It’s more interest driven.” One thing that she has learned has been that age shouldn’t stop someone from attaining their educational goals. “I’d encourage anyone who is thinking about the RN to BSN to know that there’s no time limit,” she said. “The experience has felt more like a familytype atmosphere than education classes.” COMMITMENT TO THE STUDENTS ENHANCES RURAL NURSE’S DEGREE

Sonya Poiesz knows that to be a good nurse, you have to be invested in your patients. And by working in a rural health care setting in long-term care, she’s able to connect with patients while also helping the community she lives in. See UMAINE NURSING, Page 20

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14, Saturday | May 7, 2011, Bangor Daily News PERSPECTIVE 2011 HEALTHCARE

Creative Exercises Can Improve Physical Health & Stamina

he public knows that exercise is good for them. But despite service announcements and words of wisdom from doctors, at least 60 percent of adults in this country are not physically active. Many people argue that they just don’t have time for it with jobs, family, chores, and other time commitments often taking precedence over fitness routines.

gym. By integrating tasks and changing habits, one just may find he is challenging his body with enough daily exercise. Exercise can offer the following: extended longevity, improved mood and protection against the development of coronary heart disease, stroke, hypertension, obesity, non-insulin-dependent diabetes mellitus, osteoporosis, colon cancer, and depression. Regular physical activity

Photo by Brian Swartz

Combining exercise with a day trip to historic Harpers Ferry in West Virginia, a man and woman walk up the stone steps that “lift” the Appalachian Trail to the heights south of the town.

Contrary to popular belief, even busy individuals can make time for exercise if they think creatively. Remember, exercise doesn’t necessarily have to mean uninterrupted time at the local

improves the overall quality of life. 1. Take the stairs: Modern conveniences like elevators and escalators are handy, but you don’t exert any energy by using these

devices. Make a habit of using the stairs at malls, office buildings, apartment buildings, and even take a few extra trips up and down your home staircase. 2. Find excuses to walk: In an effort to save time, people often park as close to store entrances as possible, or drive around neighborhoods looking for the closest spot when visiting friends or family. Break this habit and park further away. By doing so you’ll be adding exercise to your routine and it really won’t take up much of your time. You can also walk the track at an area high school or join a walking club. Seniors who enjoy walking in a climate-controlled environment may find a few laps around the mall is an enjoyable way to exert energy and pass the time. 3. Pump iron during commercials: Resistance and strength training is an important component of fitness and doesn’t require a lot of fancy equipment. Simply store a set of dumbbells or resistance elastics by the sofa. During the commercials of your favorite show, do a few repetitions of exercises that will work the major muscles of the body (you can find charts of exercises online or consult with a fitness professional). During one hourlong program you could put in 20 minutes of strength training. 4. Make mundane activities fitness-friendly: Just tackling chores around the house can add up to a workout. Vigorous housecleaning, including mopping and vacuuming can burn between 180 and 130 calories per 30 minutes depending upon weight and gender. Similarly, gardening, playing with the kids or joining a

Almost 50,000 Americans died of colon cancer is 2009. Early detection can result in more than 90 percent of colon cancer cases being cured.

A Colonoscopy Can Detect Early Stage Colon Cancer ■ BY ARA

olon cancer is the second-deadliest form of cancer in the United States, yet it doesn’t have to be. More than 90 percent of colon cancer cases are curable if caught in their early stages. In an effort to showcase the important message that screening equals prevention when dealing with colon cancer, an awareness campaign called Stop Colon Cancer Now, and powered by AmSurg, aims: • To educate the public about early detection and prevention of the disease; • To eliminate the stigma associated with colonoscopies; • To increase regular screenings for people over 50 and for other groups at added risk for the disease. The risk of a person having colorectal cancer in his/her lifetime is about 1 in 19. Almost 75 percent of colon cancer cases have no prior family history, and

most have no symptoms. Scientists are still unsure of exactly what causes colon and colorectal cancer, but some risk factors have been identified, including a high-fat diet, diabetes, smoking, alcohol, ulcerative colitis, Crohn’s disease, and other inflammatory bowel diseases. Americans continue to battle this disease at alarming rates, with 49,920 reported deaths in the United States in 2009. It is important to understand who is at risk, and what the available prevention methods are, to eliminate the onset of colon cancer. Colon cancer indiscriminately affects people regardless of race, sex, economic status, or geography. There often are no symptoms. It is important to get screened if you are: • 45 and older and AfricanAmerican; • 50 or older; • 40 or older and have a family history of polyps or colon or

rectal cancer; • Have a history of cancer or polyps found earlier. The easiest way to prevent colon cancer is to schedule a colonoscopy. A colonoscopy is a painless screening test that provides important information about your digestive health. For most patients, a colon cancer screening does not have to be performed at a hospital. Today, many outpatient centers provide screenings by highly skilled physicians in a more relaxed, personal environment and usually with much lower out-of pocket costs for the patient. No matter where you live or work, stopcoloncancernow.com provides valuable education, colon cancer screening options, screening locations, insightful patient stories, and more. Additional information on colon cancer and prevention methods can be found online at www.stopcoloncancernow.com.

sports team can be fun ways to burn calories — and won’t seem like exercise at all. 5. Vary your routine: The same activities everyday can grow tedious over time, causing you to slack off. Make a list of activities that you enjoy (horseback riding, hiking, in-line skating) and integrate them into your exercise

routine. Not only will you be mentally recharged, but you’ll work different muscles and areas of the body. 6. Get others involved: Any exercise can be more enjoyable with a friend or partner, even if it’s just the loyal family dog. Parents can even take young children out for walks or outings at a

park, helping to foster a love of exercise at a young age. Industrious workers can broach the topic of setting up a company-sponsored sports team or exercise club at work — on company time. This way, friendly coworkers can enjoy exercising together and not have to cut into their own time.

New orthodoctic treatments allow many patients to wear clear braces rather than traditional metal braces.

Some 80 Percent of Orthodontic Patients Are Children or Teens ■ BY ARA

bout 4.5 million Americans wear braces or other dental appliances to straighten their teeth, according to the American Association of Orthodontists (AAO). Many more — an estimated 50 to 75 percent of the population — have some form of malocclusion or misaligned teeth and could benefit from orthodontic treatment. The majority of orthodontic patients are children or teenagers, commonly starting treatment between 9 and 14 years of age. Now, however, with innovative treatment alternatives to traditional metal braces, more adults are opting to go into treatment. One in five patients is an adult age 18 or older, according to the AAO, and many parents are going into treatment with their children, which can be a great way to save time by scheduling joint appointments. Invisalign clear braces are available for adults and teens, and can save even more time with shorter and fewer office visits. Orthodontists consistently say that anyone with healthy teeth and gums can straighten their smile at any time, regardless of age. “Today there are many ways to straighten your teeth with new leading-edge technology that can make orthodontic treatment healthier, more comfortable, cosmetically appealing, and affordable, too,” says Beverly Hills, Calif.-based orthodontist Dr. Alexander Waldman. “These new innovative alternatives to traditional wires and brackets, such as Invisalign, address the concerns over comfort, esthetics, and cost that may prevent some people from seeking orthodontic treatment that could improve their smiles and quality of life.” Teeth that are crooked, misaligned, or have too much or too little space in between are among the most common problems treated with braces. Hereditary factors like a smaller palate can contribute to these problems. Environmental factors including thumb-sucking or accidents are other causes. In addition to impacting one’s appearance, teeth that are badly misaligned can impede eating and speech. Here are some tips for finding the right treatment for you or your child, addressing common problems and keeping cost-saving considerations

Cancer fight Continued from Page 12 The situation, she said, requires “a bit of a shift” in the overall cancer-care landscape to recognize the needs of survivors. The University of Michigan is building a bigger program for breast, prostate and childhood cancer survivors. Dr. Max S. Wicha, director of UM’s Comprehensive Cancer Center, said he hopes the university’s survivor program will be able to provide critical information and statistics about cancer survivors. A LONG WAY TO GO

While the death rates for many cancers have decreased over the past decades, other cancers have become more fatal. The death rates for liver and bile duct cancer have increased 28 percent in women and 40 percent in men from 1990 to 2004, while lung cancer death rates in women have risen 9 percent and esophageal cancers in men are up 8 percent, the ACS report shows.

in mind: • An orthodontist or dentist can tell you if you need braces or some other treatment to correct misaligned teeth. The initial consultation to determine if you need braces is almost always a budget friendly, free-of-charge visit, making it easy to get more than one opinion. • One of the most cosmetically appealing treatments for aligning your teeth can also be very affordable. Invisalign straightens teeth like metal braces and costs about the same, but is virtually invisible on your teeth. A series of clear aligners, made from smooth plastic custom-made to fit to your teeth, eliminates the gum and mouth irritation often associated with metal braces while moving your teeth in small increments so there’s little pain. This treatment can also prevent costly emergency visits for broken wires, as well as post-treatment teeth whitening or repair. Fixed wire and bracket braces can make it difficult to brush and floss leaving teeth vulnerable to developing decay, plaque, periodontal disease, and stains that must be taken care of after braces are removed. Because Invisalign wearers can remove their aligners to brush and floss, they can more easily maintain good oral hygiene. “Compared to traditional metal braces, my patients that are treated with removable appliances find that it is much easier to maintain good oral hygiene which results in fewer post-treatment procedures,” adds Waldman. • Many dental insurance plans cover orthodontic treatment, but when less than 100 percent is covered or for those without dental insurance, many orthodontists now offer payment plans that allow you to spread the cost of treatment out over the course of treatment rather than paying in budgetbusting lump sums at the beginning and end of treatment. • Setting aside pre-tax dollars in a Flexible Spending Account (FSA) through your employer is another way to make paying for braces easier. According to Waldman, “Braces have almost become a rite of passage for teens. Now adults who didn’t have their teeth straightened as teens, perhaps because of financial or cosmetic concerns at the time, can improve their smile as adults — and maintain a professional appearance for work — The incidence rates of cancers of the liver, pancreas, kidney, esophagus, and thyroid have continued to rise, according to NCI. There also are disturbing cancer-related health disparities, including that blacks and low-income people have the highest rates of both new cancers and cancer deaths, according to NCI’s 2007 trends report. In 2005, NCI began a five-year initiative to reduce these disparities. Smoking is a key cancer-related concern. According to the NCI report, the number of adult smokers in the United States has been dropping since the early 1990s, to 21 percent in 2006. NCI said the goal is to lower that number to 12 percent by 2010. In 2006, 43 percent of adult smokers were trying to quit, but that number should rise to 75 percent by 2010, NCI said. Debate about funding continues. Spending for cancer treatment is rising along with total health care expenditures, according to the NCI. Norton said that total spending on cancer each year is about $11.5 billion, which is one-sixth of what is spent annually on soft drinks. “It is so grossly underfunded an effort compared to the impact of the disease,” he said.

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PERSPECTIVE 2011 HEALTHCARE

UMaine CSD Continues to Help Clients and Students Excel ■ BY DEBRA BELL

application for the graduate program that didn’t have some level of service with children or adults. Many of them have personal stories and exposure to the profession prior to applying.” For graduate students Katie Farrell and Susanne Mallon, the decision to continue their education at UMaine was an obvious choice.

SPECIAL SECTIONS WRITER

ommunication is essential to quality of life. But for people who struggle with speech, hearing, and other communication disorders, having a person available to help them is life changing. And at the University of Maine’s Department of Communication Sciences and Disorders, learning to help others learn to communicate effectively is par for the course. The University of Maine Department of CSD offers the only undergraduate and graduate degrees in Communication Sciences and Disorders in the State of Maine. The department provides academic and clinic education, research and service in speech-language pathology and audiology to serve individuals with communication disorders across the lifespan. The Madelyn E. & Albert D. Conley Speech, Language and Hearing Center is central to the department, where graduate student/faculty teams provide quality evidence-based services to over 500 children and adults with cognitive, speech, language, and hearing impairments and their families annually. The Department of CSD also has a large number of community outreach programs that provide services to preschool programs, public schools, medical facilities, state agencies and governing bodies concerned with the welfare of individuals with communication disorders. NEW DIVISION BRINGS NEW OPPORTUNITIES

With an eye to the future, the University of Maine is forming a new division of Health and Biomedical Sciences which brings with it new opportunities for collaboration. In addition to Communication Sciences and Disorders, other allied health that will be part of the new division include the School of Nursing, Social Work, Center on Aging and Food Science and Human Nutrition.

STUDENT PERSPECTIVES: KATIE FARRELL

Enrolled in the graduate program at the University of Maine Department of Communication Sciences and Disorders, Katie Farrell says the program “allows firstyear students to begin working with clients immediately and concurrently with coursework.” Farrell is a native of southern Maine.

Susanne Mellon is a graduate student at the UM Department of Communication Sciences and Disorders. The program “offers us the opportunity to work with clients at ... The Conley Speech Language and Hearing Center.”

According to Judy Walker, chair of the Department of CSD, “Although our program will continue to reside in Dunn Hall, we believe that the move to the new division will create many more interdisciplinary teaching, research and service opportunities for our students and faculty. “Students will have more opportunities to take interdisciplinary courses where they will learn patient care from the perspectives of other health professionals. Having this experience in school will give them an advantage when joining the workforce where they will be a member of interdisciplinary health professional teams,” Walker says. According to Judy Stickles, clinical director for the department, the advantages of this merger are immense. “I think there’s a tremendous potential

for collaboration,” she said. “We already do a little collaboration with nursing [which will be] part of the new division.” National economic and demographic trends show that more jobs are being created in the health professions field. According to Walker, UMaine’s CSD program has a 100 percent employment rate for graduate students in their program and many stay in Maine to work. Stickles noted that there has been a large influx of students into the graduate program. “We’re working with a very high level of student in the program,” she said. In addition, many of the students the department is seeing have a strong service background. “I don’t think we had one

NEWS Photo by Debra Bell

For Katie Farrell, a native of southern Maine, UMaine provided her with an opportunity to stay in Maine to earn her degrees. Farrell became interested in the career when she volunteered at Morrison Developmental Center in Portland, a center that helps individuals with special needs. “I found speech therapy especially important and intriguing as I saw the strong link between communication and a person’s identity in the world,” Farrell said. After finishing an undergraduate degree, she applied and was accepted for the graduate program in CSD. One of the biggest reasons for this choice, she said, was there was no delay in learning in a hands-on environment. “The graduate program allows first-year students to begin working with clients immediately and concurrently with coursework, which I strongly believe is essential to the overall learning process,” Farrell said. “Other programs in New England require students to have a year of graduate coursework before beginning work with clients. Additionally, the different expertise of the professors in our department allows us to have a well-rounded education,” she said. Farrell has been working with Dr. Allan Smith since her first year of graduate school in September 2009. Dr. Smith is involved in researching information regarding vowel production in very young children and recently published a paper about speech timing and pausing for children who have specific language impairment. Farrell has assisted See COMMUNICATION, Page 21

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PERSPECTIVE 2011 HEALTHCARE

Federal Bill Could Create Tax Credits for Hearing Aids â&#x2013; BY ARA

in July 2005. If you look hard enough, it is sometimes possif your child broke an arm, youâ&#x20AC;&#x2122;d get a cast put ble to find financial aid to defray the costs, accordon. If your mother could no longer walk, ing to Kochkin. He advises people to turn to state and local youâ&#x20AC;&#x2122;d get her a wheelchair. So why do millions of people â&#x20AC;&#x201D; both young and old â&#x20AC;&#x201D; choose departments of social services, fraternal organinot to wear hearing aids when they have hearing zations like the Kiwanis and Lions Club International, or one of the other sources listed on problems? Often, itâ&#x20AC;&#x2122;s because they canâ&#x20AC;&#x2122;t afford them. the Better Hearing Institute Web site. go to â&#x20AC;&#x153;Many people donâ&#x20AC;&#x2122;t realize that hearing aids are (http://www.betterhearing.org, not covered under Medicare or under the vast Resources/Financial Assistance) Many advocates for people with hearing probmajority of state mandated insurance programs,â&#x20AC;? says Dr. Sergei Kochkin, executive director of the lems are pinning hopes on legislation now working its way through both houses of Congress, the Better Hearing Institute. Private insurance plan sometimes cover them. Hearing Aid Tax Credit Act (H.R. 414 and S.1060). But more than 70 percent of hearing aid purchas- The bill would give a $500 tax credit to people who buy hearing aids, if they are age 55 or older or are buying them for a dependent child. Identical versions were introduced by Representative Jim Ryun (R-KS) and Senator Norm Coleman (R-Mont.) in 2005. Some say the bill is a good first step but much more needs to be done. â&#x20AC;&#x153;We support it, but itâ&#x20AC;&#x2122;s not nearly enough,â&#x20AC;? says Brenda Battat, associate executive director of the Hearing Loss Association of America, the nationâ&#x20AC;&#x2122;s largest membership organization Hearing aids are not covered by Medicare or most state-mandated insurance for the hearing-impaired. programs, but legislation pending in Congress could authorize tax credits for â&#x20AC;&#x153;A lot of our members people who purchase these medical devices. ask us, â&#x20AC;&#x2DC;Why does it help only people who are 55 and es involve no third party payment, so consumers older?â&#x20AC;&#x2122; They are 40-something or younger, in the often bear the entire burden. workplace, and they also need help,â&#x20AC;? she said. â&#x20AC;&#x153;Medicare, state insurance programs, or private According to Kochkin, about 40 percent of peoinsurers cover canes and crutches and often help ple with hearing loss make less than $30,000 a people afford glasses, braces on their teeth, cos- year. metic surgery, Viagra for better sex lives, and other â&#x20AC;&#x153;A tax credit obviously isnâ&#x20AC;&#x2122;t going to solve the solutions to improve quality of life,â&#x20AC;? says Kochkin, cost problem completely but at least it will make a â&#x20AC;&#x153;but hearing loss is like a neglected orphan in this dent,â&#x20AC;? Kochkin says. health care system.â&#x20AC;? The tax credit bill has picked up a growing The average hearing aid costs $1,800, and many number of sponsors in both houses of Congress. people require two of them. While 95 percent of people with hearing loss can be helped with hear- To find out more about this issue, visit www.bettering aids, only 23 percent currently use them, hearing.org and check out â&#x20AC;&#x153;News.â&#x20AC;? according to a study published in Hearing Review

Retirement can be a time when a couple finally develops that small business they have discussed creating for many years, but never had the time do devote to it.

Retirement Brings Opportunity to Pursue a New Job or Career

etirement is different today than in our parentsâ&#x20AC;&#x2122; and grandparentsâ&#x20AC;&#x2122; generations. More Americans are choosing to work during their golden years â&#x20AC;&#x201D; because they want to or because they have to in these trying times. Whether youâ&#x20AC;&#x2122;re choosing to work to keep the juices flowing or simply because you need the paycheck, working during retirement can be an exciting way to start a new chapter in your life and take on new challenges. â&#x20AC;&#x153;As baby boomers reach their 50s and 60s, they are redefining what it means to retire. Many are still choosing to work or create a new life entirely,â&#x20AC;? says David C. Borchard, author of the book, â&#x20AC;&#x153;The Joy of Retirement.â&#x20AC;? â&#x20AC;&#x153;Almost all retirees are seeking the same things,â&#x20AC;? he said. â&#x20AC;&#x153;First, they want more freedom to manage their lives and be more autonomous. And second, they want the freedom to do the things that interest them and be who they want to be â&#x20AC;&#x201D; at home or at work.â&#x20AC;?

Put simply, retirement can be a great time for a change that allows you to reinvent yourself and work at things you enjoy, while reaping the benefits of keeping income flowing into your golden years. Here are some options to consider as you take on new work or a new career in retirement, as suggested by Borchard in his book â&#x20AC;&#x153;The Joy of Retirement.â&#x20AC;? â&#x20AC;˘ Reflect on what roles interest you and will be meaningful. Options literally abound when you reinvent yourself, such as: entrepreneur, business owner, peace corps worker, bed and breakfast owner or manager, tour guide, skilled craftsman, crafts artist, politician, or even becoming a vintner or nightclub entertainer. Itâ&#x20AC;&#x2122;s all about dreaming up your own future. â&#x20AC;˘ Transitioning into a totally new and challenging career can be tough. For help, consider engaging the services of a career coach or counselor. â&#x20AC;˘ Return to college to obtain a degree or certificate to initiate a career in a new area such as nurs-

ing, architectural landscape, French pastry chef, bike mechanic, massage therapist, bar tender, vintner or organic farmer. â&#x20AC;˘ Find a niche to transfer a special knowledge, a natural talent or a unique personality asset into a new career direction â&#x20AC;&#x201D; such as a tour guide for an attraction for which you have an affinity, sportscaster for a local sports team, scoutmaster or public official. â&#x20AC;˘ Find a new work challenge that puts your talent and full potential to the test. A good reference to find work to suit your talent is Career One Stop at www.careeronestop.org. Click on â&#x20AC;&#x153;Explore Careers.â&#x20AC;? â&#x20AC;˘ Join the Peace Corps or similar types of organizations, such as A m e r i C o r p s (www.americorps.org), Vista (www.friendsofvista.org), Cross Cultural Solutions (www.crossculturalsolutions.org) or Earth Watch Institute (www.earthwatch.org). â&#x20AC;˘ Develop a proposal and seek funding for a project you care about.

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Patients Must Share All Concerns When Meeting With A Doctor ■ BY ARA

ith 25 years experience in health care, as a nurse and now certified physician assistant, Patti Emfinger admits that when she’s in an examination room as a patient, she used to feel a little hesitant about talking with her doctor beyond exchanging pleasantries and basic information. Now an assistant professor in the College of Health Professions at South University’s Savannah, Ga., campus, Emfinger worked previously in an internal medicine/internist setting. “A lot of my patient interaction has been with people over age 65,” she says. “And they were raised to have a great deal of respect for medical professionals.” She says that she was troubled then, and still is, that people are

reluctant to talk openly when they get into the doctor’s office. “They worry that questioning the physician or the physician assistant suggests a lack of confidence in the health care professional’s competence. And many people, of all ages, are embarrassed to talk about personal medical issues,” she says. Emfinger acknowledges that some medical practitioners intimidate patients, usually unintentionally. “Some take the approach ‘I’m the provider, so what I say goes.’” But advances in diagnosis and treatment, along with changes in the health care delivery system, are changing the way patients and health care professionals interact one-on-one, according to Emfinger. “In health care today, there’s an expectation that patients will be involved in making decisions about their own

UMaine nursing Continued from Page 13 Poiesz lives in Madawaska, but she works in Van Buren. She earned a bachelor’s degree in nursing from the University of Maine at Fort Kent in 1998 and decided to go to graduate school three years ago to earn a master’s degree as a family nurse practitioner. “I worked in Van Buren as a residential care director, but I never saw myself as stopping at that level,” she said. “There are things to learn every day and I had reached the top of the ladder. I’m going to be 35 and I found myself too young to stop acquiring knowledge at this point.” And she liked the opportunities that being a family nurse practitioner offered. Her decision came down to the experiences of some nursing colleagues she worked with. “UMaine was more accommodating for our schedule,” she said. “I have three children at home and one on the way and I needed balance. UMaine provided the balance that I needed.” In addition to balance, she said, UMaine provided a “top-notch” education. “I’m very pleased with the way they accommodate us,” Poiesz said. “We have to work hard, but there is no second guessing because they see that you’ve worked hard.”

health care,” she said. “With so many options available now, we appreciate that our patients want to know the reasons behind what we’re recommending and prescribing.” For Emfinger, the best outcomes are achieved when patients and health care professionals work together. “Physicians have the responsibility to evaluate and diagnose disease and to make recommendations based on their best clinical knowledge and experience. At the same time, they need to create an environment where patients feel respected.” So what should patients do? “First of all, you absolutely have to tell the doctor or physician assistant all your concerns,” Emfinger said. “Even if you feel embarrassed to talk about certain parts of your body, go ahead and talk. After all, we’ve seen and

Scheduling was a major factor in her degree path too. “The school is very in tune with you,” she said. “If you live three-and-a-half hours away, we’ll make sure that your classes fall at [convenient times]. They don’t have to do that.” Poiesz also noted that student input is taken seriously at UMaine’s School of Nursing. In 2010, the school went through an accreditation process and Poiesz was one of the students the accreditation committee interviewed. When the committee asked for things that “she’d do differently”, she noted that polycomming — formerly known as ITV classes — and online classes would be helpful to nursing students who come from rural areas. “Within six months they were polycomming and putting classes online,” she said. “That, to me, shows that they’re definitely interested in the students and want us to succeed.” Poiesz spent her clinicals working in women’s health, pediatrics, and a family practice. This semester is her “last hurrah — one last chance to grasp every piece of knowledge that [I] can from someone else.” Poiesz will graduate this May, but she knows that her degree from UMaine will help her succeed, especially in a rural Maine healthcare setting. As a family nurse practitioner, she’ll be able to help families live healthier.

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heard it all — and we are people, too.” She also says that we have to ask questions in order to make informed decisions. “If you’re diagnosed with a disease or condition, avoid your own unguided Internet search for answers,” she noted. “Instead, ask your physician or physician assistant for a reliable Web site or for literature or a journal where you can find reliable information. Ask about organizations that offer local support groups and other resources for people suffering

from the same or similar diseases.” What if you have doubts about the diagnosis or treatment? Emfinger advises asking for evidence-based data that support the effectiveness of the recommended treatment. “You want to know that a particular drug, or surgical procedure, or therapy actually helps patients get better,” she says. And second opinions, even changing doctors, are also OK. “If you feel that your doctor isn’t up to date on medical practices, switch to

someone else.” So how does Emfinger deal with her own reluctance in talking to her doctors? “First, I remind myself that this is my life, my health, and I’m in charge of it,” she said. “Then I remind myself that I know my body better than anyone else. So I talk. I’m open about my concerns. I know that if there’s not good communication, I’m missing out on getting the very best care possible and achieving the health outcome that’s best for me,” she said.

Stress Can Cause People to Eat ■ BY THE WASHINGTON POST

When life gets tough, the stressed often get hungry. “I’m a total stress eater,” notes a Lean Plate Club member who faces frequent deadlines in her job at a major magazine publishing house in New York. “It’s an ongoing battle for me. . . . Food not only placates, but it also allows me to procrastinate.” For others, working long hours is the trigger. “I’m a junior in college and often find myself craving salty snacks when I’m stressed and working late into the night,” a Lean Plate Club member in Annapolis noted in a recent e-mail. Exactly how many people experience stress-related eating isn’t known, but as the obesity epidemic worsens, there’s growing scientific interest in the topic — and how to explain it. “Fight-or-flight is the normal response to stress,” notes Tatjana van Strien, professor of psychology at Radboud University in the Netherlands. “All the blood goes to the muscles so that you’re ready for action and not for eating. . . . So stress eating is highly unadaptive and highly strange.” What’s more, when people are under great stress, such as the death of a family member, they tend not to eat. It’s easy to blame the urge to raid the refrigerator on job pressures, hectic schedules, family crises, and personal conflicts. “There’s definitely an association between stress and mood and increased eating,” notes Michael Lowe, professor of psychology at Drexel University in Philadelphia and author of several recent studies of stress-induced eating. “Loneliness, boredom, anxiety, depression: All of those fit in, too.” Lowe’s work suggests that there may be more at play. The

latest findings, published in the journal Appetite, show that people who are engaged in enjoyable activities that require mental focus overeat just as much as those who are stressed by onerous circumstances. “That suggests that there’s something more than negative emotions going on,” Lowe says. And increased appetite cannot be explained by the additional caloric needs of the brain. “If you do cognitively demanding work, you see a small increase in brain energy, but not a lot,” Lowe says. “So why would mental work or stress make anyone want to eat more? It’s not like you’ve gone out and run five miles.” What also intrigues scientists is that this superfluous eating doesn’t affect everyone equally. Those most susceptible appear to be so-called “restrained eaters,” people who watch their weight, whether successful at it or not. For example, Lowe’s research suggests that they are more likely to overeat in all circumstances than those who don’t have weight concerns. Add to that the 24-hour availability of food, and you have what Lowe calls “a new kind of hunger.” “It’s reflected in the paradox,” he says, “that both the absence and the presence of food are capable of making us hungry, but apparently in very fundamentally different ways.” So while it makes sense physiologically for people to be hungry four to six hours after eating a meal, it’s harder to explain why a plate of chocolate chip cookies can be so appealing shortly after a meal. “You’re not in a state of caloric deprivation,” Lowe notes. “But you experience the desire to have them.” It’s that kind of hunger that

scientists hope to better understand. Until they do, people who are most susceptible to so-called stress or emotional eating will have to look for ways to minimize the caloric damage, Lowe says. Some Lean Plate Club members are already doing that. “About 9 a.m., after I’m at work for a little more than an hour, the cravings prey on my brain,” notes Jennie Geisler of Erie, Pa. “I try to suck on hard candy, gulp down decaf coffee, drink water, eat South Beach protein bars, and Quaker oatmeal bars. That all helps,” she says. So does pacing how quickly she eats. “Pick it up,” Geisler notes in an e-mail. “Take a bite. Put it down. Work for five minutes. Start over. If I don’t do that, I’ll eat 10 cookies without thinking about it. Pretzels and bagels sometimes slow me down.” Geisler also uses physical activity to help thwart stress eating. “Sometimes I just have to get up and walk around the building until I can get my brain back in gear,” she says. That’s a strategy that also helps Lean Plate Club member Jody Nyers, a benefits analyst for the Department of Agriculture. Nyers gets up at 3:45 a.m. and begins her commute from Southern Maryland at 4:45 a.m. She doesn’t get home until 12 hours later. The long work days mean that she often has to fight the urge for midafternoon sweet snacks. “If I’m tempted, I walk the half-mile around the building,” says Nyers, who also teaches spinning classes at her gym and has recently started taking yoga to help reduce stress. Even so, “it’s a battle,” she says. “We live in a world where everything comes in huge portions, and there are so many foods to choose from. . . . I work out a lot because I love to eat.” Nyers begins the day with a healthy breakfast. She follows that with a healthy lunch. And she gets to the gym five to six times a week. “But 2 p.m. is my killer time,” she says. “If I’m stressed and trying to get something done, I could go down to the cafeteria and get more than I should have to eat.”

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PERSPECTIVE 2011 TELECOMMUNICATIONS

Businessowners Have Various Options for Telecom Services ■ BY ANITA CAMPBELL TECHNOLOGY.INC.COM

virtual smorgasbord of telecommunications selections these days means entrepreneurs have to choose what is best for business. The choices for business telephone services have exploded in the past few years. What’s more, some of these choices represent completely new product categories that did not even exist until recently. If you are baffled by all the choices, trust me, you’re not alone. I am going to attempt to cut through the confusion and give you a quick reference guide explaining the differences in some of the most common telephony choices and when and how to use them in your business. Let’s take a look: Landline telephones: Traditional landline telephones once were the only choice we had. Today, landline phone service is just the starting point. • My take: Traditional landline service is still the basic telephony service of choice for most businesses, due to its reliability, sound quality, and relative ease of getting started. Competition from new telephony alternatives like Voice over Internet Protocol (VoIP) is driving down the cost of business landlines in many parts of the country. Shop around. Look especially at providers that also offer wireless services. They can bundle wireless and landline services into one cost-effective package, along with convenience features such as unified messaging (the ability to check voicemails from landline and wireless phones in one place). Skype: Skype, which is owned by eBay, is a service that lets you make calls for free over the Internet to someone who also has downloaded the Skype software.

Communication Continued from Page 17 Dr. Smith in this project. She has coauthored four papers with Dr. Smith, Stickles said. After graduation, she’ll be returning to southern Maine to work in any number of types of jobs. STUDENT PERSPECTIVES: SUSANNE MALLON

Susanne Mallon, a Springvale native, also chose UMaine to do her undergraduate and graduate degrees because she wanted to stay in Maine, and because her life had been personally touched by impaired communication. “My grandfather had multiple strokes prior to beginning my freshman year of college, during which time I was still unsure of what I wanted to do,” Mallon said. “His speech and language were impaired follow-

But it’s even more versatile: For 2.1 cents per minute (currently free within the United States and Canada), you can call individuals who do not have Skype, but who use landlines or w ireless phones. • My take: Skype is a dirtcheap long disThe exploding plethora of telecommunications alternatance substitives offers entrepreneurs many options, including the tute, especially venerable cell phone. Among the options are Skype, well-suited for PDAs, and Voice over Internet Protocol. staying in touch with friends and family internationally. Business use of Skype is also increasing, especially among Web-savvy solo entrepreneurs and microbusinesses on tight budgets. However, Skype is not a complete replacement for traditional telephone service because it does not support emergency 911 calling. Best use for Skype: Use it selectively to hold down long distance costs. VoIP: VoIP lets you make calls over a broadband Internet connection instead of over traditional telephone lines.

ing these and he worked with a speech pathologist to try and gain those skills back. As I watched him go through this process of rehabilitation, I began to consider the profession of speech pathology.” As an undergraduate and undeclared student she joined the Honors College and made the connection to the CSD program. She joined the program as a sophomore. After finishing her undergraduate degree, she decided to stay at UMaine. “I applied to five schools for graduate work and after attending numerous information sessions and having tours of each school, I decided that UMaine was still the best fit for me,” Mallon said. “UMaine’s CSD graduate program offers us the opportunity to work with clients at the on-campus facility, The Conley Speech Language and Hearing Center.” At Conley, Mallon worked with a diverse population of people. “I was incredibly fortunate in that I was able to work with a variety of clients: children with various speech and

Options range from low-cost packaged solutions such as Vonage, which currently offers a small business package with unlimited local and long distance calling for under $50 per month, all the way up to sophisticated IP phone systems that require pricey hardware. Even traditional phone companies, pressured by the competition, are offering VOIP packages. • My take: VOIP gives you a large degree of control over your phone system, letting you reconfigure it quickly and easily to accommodate new hires or changes. VOIP also can coordinate employees in multiple locations under a single phone system. Low-end packages run off the same broadband connection you use for Internet access and can lead to sound quality issues. Midrange and higher solutions use private IP connections. Wireless phones: Will the need to count wireless minutes become a thing of the past? Today’s wireless offerings, with unlimited night and weekend plans, calling circles, and rollover policies are inching us closer to that day. • My take: An increasing number of solo entrepreneurs are going 100 percent wireless. They are eliminating landlines altogether in favor of wireless as their primary phone. Most likely, though, this is not a practical alternative unless you are a consultant or other sole proprietor. For businesses larger than one person, wireless phones are a supplement to the main telephone system, albeit an important, even indispensable one. PDAs: Personal digital assistants, palmtops, and the latest termdu-jour, smartphones, let you make phone calls like standard wireless phones. Compared with standard wireless phones, these devices add many more functions and features, including larger screens and sometimes typewriter-like keypads. Blackberry and Treo are well-known brands. • My take: These devices are the tool of choice if you regularly need access to e-mails, documents, or calendars while out of the office. Remember, while it may be possible to send and receive e-mails on a standard wireless phone, it’s agonizingly cumbersome — and who wants to peer at e-mail on a tiny one-inch screen? Virtual switchboard and voicemail services: In the past few years a whole new category of telephony service has entered the picture. These new software-based services provide a menu of options to beef up your existing phone system: central automated attendant, advanced voicemail features, conference calling, toll-free numbers, fax-to-e-mail, voice-to-e-mail, and customized on-hold messages. These new services are layered on top off — not in place of — basic phone connectivity. They work with landlines, wireless, and/or VOIP phones and require no extra hardware. GotVMail, RingCentral, and Freedom800 are three brands in this space. • My take: For a low monthly fee (as little as $10) these services can make your small business sound bigger and more professional. The services are excellent for businesses with employees and offices in multiple locales, giving the ability to seamlessly transfer calls and forward messages among them. And it’s all invisible to the caller, who does not know what location employees may be speaking from.

language difficulties, teenagers with social/literacy challenges, an accent modification client from China, and an older gentleman and his wife with Hearing loss.” The hands-on learning at Conley has also showed her a specific segment of therapy that she loves. “One of the things that I enjoyed most about doing clinical work at The Conley Center was its emphasis on family-based therapy,” Mallon said. “We are only able to work with these children for about two hours a week so it is important that we give the families the tools they need to continue to support the therapy process and skills even outside of the session. Throughout my experience at the Conley Center, I really began seeing the benefits/success of family-based therapy.” Mallon plans on using her degrees to work as a speech-language pathologist and anticipates working with clients who have speech, Anita Campbell is a writer, speaker, and radio talk show host who language and cognitive problems as well as closely follows trends in the small business market at her site, Small providing therapy for swallowing disorders. Business Trends.

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