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Your get-ready guide to surgery Women: Take heart
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w e l l n e s s
g u i d e Winter 2010
Easy ways to get fit now ER tips for parents
Kentucky Harlan ARH Hospital | Hazard ARH Regional Medical Center | McDowell ARH Hospital | Middlesboro ARH Hospital | Morgan County ARH Hospital | Whitesburg ARH Hospital | Williamson ARH Hospital West Virginia Beckley ARH Hospital | Summers County ARH Hospital
Anywhere, anytime fitness Ways to sneak activity into your routine When it comes to fitting fitness in during the winter months, all you need is a little creativity and the desire to do your mind and body some good. Here are some ideas to get you started:
Around the house
Put some muscle into your housework. Scrub, vacuum and wash windows with vigor for a burst of energy that gets your home sparkling and your heart pumping. Go ahead, watch TV! “Just keep moving while you watch,” says Dr. Prasad L., a physical medicine and rehabilitation specialist at Williamson, McDowell and Morgan County
ARH Hospitals. Walk or march in place, jump rope or climb stairs during commercials.
In the car
Take a traffic break. Don’t let a red light get you down. Instead, do some muscle-strengthening exercises recommended by Denise Abraham, an occupational therapist at Harlan ARH Hospital: Ñ Press your lower back into the seat and tighten abdominal muscles to tone your tummy. Ñ Squeeze the steering wheel to firm your forearms. Place hands at the 9 and 3 o’clock positions, and press arms inward. Take the pain out of parking. Grab the spot farthest away from the store entrance. “It’s a great way to sneak in a brisk, healthy walk,” says Dr. Prasad L.
At work
Head for the halls. Get up once or twice a day and take a two- to five-minute walk, longer if possible. Stretch it out. “A good stretch can rejuvenate tired, achy muscles,” says Abraham. Turn your head from side to side and rotate it in a clockwise and counterclockwise motion. One arm at a time, reach over your head and try to touch your back between the shoulder blades. Stand up, hold your arms above your head, interlace your fingers and stretch toward the ceiling.
Get back your get-up-and-go! If you’re sidelined with an injury or disease, ARH Rehab Services can help you get back to enjoying your days faster. Patients work with a team of rehabilitation specialists that includes: Ñ a physical therapist who helps patients build muscle strength, develop coordination and improve activity levels. Ñ an occupational therapist who restores function or teaches patients daily living skills to compensate for lost function. Ñ a speech therapist who evaluates and treats a wide range of speech, language and swallowing (dysphagia) problems and helps patients recover from strokes or neurological disorders.
Bounce back! To find an ARH Rehab Services center near you, visit www.arh.org/rehab.
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7 things to know before heading to the ER Nothing can send you into panic mode faster than seeing your child sick or hurt. But before you race off to the emergency room (ER), consider these tips provided by Vahid Mahrpouan, MD, a pediatrician at Whitesburg ARH Hospital, and Bradley Moore, DO, a family practice physician at McDowell ARH Hospital: 1. Identify emergency symptoms. Is your child having difficulty breathing? Is he or she disoriented? Does he or she have a cut that won’t stop bleeding? “These all warrant a trip to the ER as soon as possible,” says Dr. Mahrpouan. 2. Determine whether nonemergency symptoms need the ER. If your child’s condition isn’t life threatening, call your pediatrician. “We can help determine if a trip to an urgent care center or a visit to the office would better serve you,” says Dr. Mahrpouan. 3. Know your child’s medical history. Let hospital staff know about his or her medications, allergies or illnesses and any surgeries he or she has undergone. 4. Take the evidence with you. “If your child has ingested medication or a household product, take it to the ER with you,” says Dr. Moore. “And if an object, like a marble, was swallowed, bring an example of it to the hospital.” 5. Expect to wait. Hospitals treat critical patients first, and your child may not be the most urgent case. Bring items to help your child pass the time, such as coloring books and toys. 6. Comfort your child. Let your son or daughter know that the hospital is the place to get better. Tell him or her what to expect to ease the anxiety and remain calm. If you’re calm, your child is more likely to be calm, too.
Is it a medical emergency? Conditions or symptoms that require emergency treatment include: Ñ rapid or labored breathing Ñ becoming disoriented or confused Ñ severe bleeding
7. Take notes. Bring a pen and paper to record what doctors and nurses tell you about your child’s condition, treatments, care instructions and the names of medical personnel who see your child. “Accurate notes can help your doctor provide the appropriate follow-up care,” says Dr. Moore. Severe choking, a drug overdose or a serious injury may require an ambulance. Dial 911 for emergency medical help.
Ñ stiff neck and fever with or without a rash Ñ rapid heartbeat Ñ head trauma
Know where to go!
Ñ ingestion of a poisonous substance or medication
To find an ER close to you, visit www.arh.org.
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Get ‘hip’ to replacement Worn-out, arthritic knee and hip joints can become so painful that simple actions like walking, bending or standing up become unbearable. But with the introduction of high-mileage artificial hip and knee joints, millions of former sufferers have reclaimed active, normal lives.
Making a joint decision “Today, both older and younger adults are eligible for joint replacement surgery,” says Prakash Puranik, MD, an orthopedic surgeon and chief of staff at Beckley ARH Hospital. “A patient’s overall health and joint condition will help determine if he or she is suitable for a hip or knee replacement.” Start by answering some questions: Ñ Are you still in pain even after losing excess weight? Ñ Does your pain keep you awake at night? Ñ Does your pain interfere with your ability to earn a living? Ñ Has your quality of life suffered because of your pain? Ñ Have you exhausted all your other options, including anti-inflammatory drugs to alleviate joint pain, walking with a cane, power-walking or swimming instead of jogging?
Getting new parts “If surgery is still the best option, we help the patient select an artificial knee or hip that’s best suited for his or her age, activity level and expectations,” says Matloob Khan, MD, an orthopedic surgeon at Williamson ARH Hospital. Following the operation, expect to be on your feet—using crutches, of course—the day after surgery and discharged within five days. Barring the unforeseen, you should be walking unassisted six weeks later. “Grueling workouts like tennis or
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10-mile runs will still be too tough for artificial hips and knees within six months of surgery,” says Dr. Khan, “but patients can resume favorite leisure activities after about six months.”
Hospital to home The thought of undergoing joint replacement surgery is daunting. To help put your mind at ease, Dr. Puranik recommends these tactics to ensure a smooth transition from hospital to home: Learn about your surgery. Ask your surgeon how long the procedure normally takes, how much pain to expect post-op and how to manage it. If you’re still nervous, ask him or her to suggest relaxation exercises or music or to prescribe a medication to help calm you. Ask, too, about recovery and how long it may be before you’re back on your feet. Find out what to quit. If you smoke, stop about a month before surgery. Avoid alcohol for at least two days before and ask your surgeon which of your medicines—including over-thecounter drugs and supplements—you need to modify or stop. “Aspirin and vitamin E can affect blood clotting, so patients should stop taking them a few days before surgery,” says Dr. Puranik. Designate a contact person. Your surgeon and other surgical staff will need to know who to update about your condition or contact in case of emergency. Provide hospital staff with your designated contact’s name, address and phone number.
surgery Create a medical information file. Place a list of all your previous surgeries and conditions plus allergies and diet restrictions in a file. List, too, all the medications and supplements you take and why. Bring the file with you on the day of surgery for a smooth admission process.
Stay safe on the slopes It’s prime time to enjoy skiing! Staying safe and having fun are key to a successful run. While all skiers should practice good common sense and courtesy, the National Ski Areas Association provides the following responsibility code to ensure a great season: Ñ Stay in control.
Take care of business. Add a folder to your medical information file with a copy of your insurance card or policy and your living will. If you don’t have a living will or other advance directive, consider making one; your doctor can help.
Ñ Give right-of-way to people ahead of you.
Think about saving your blood. Since blood transfusions may be necessary, you may want to save and use your own blood. Your surgeon can help you with this process.
Ñ Observe signs and warnings, and keep off closed trails.
Ñ Stop in a safe place for you and others. Ñ Look uphill and yield when starting downhill or merging. Ñ Use devices to help prevent runaway equipment. Ñ Know how to use the lifts safely.
Shape up. Being fit before surgery shortens recovery time. Ask your healthcare provider about exercises for toning your muscles and increasing endurance. Plan for homecoming. Because driving, shopping and performing your usual routine may be difficult after surgery, plan to have household help. If you live alone, you may need to hire home-care service. You may also want to shop for items that will maximize your independence, such as a long-handled sponge for bathing or a grabbing tool. “The better a patient can plan, the easier coming home will be,” says Dr. Khan.
Stand up to joint pain! To learn more about orthopedic and joint replacement services, visit www.arh.org/joints.
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Heart disease A woman’s greatest health threat True or false? More women die each year of heart disease than breast, cervical and ovarian cancers combined. If you answered “true,” you’re correct: Nearly 214,000 American women die from coronary heart disease (CHD) each year.
Many women mistakenly believe CHD is a man’s disease. “These beliefs are dangerous myths,” says Vidya Yalamanchi, MD, a cardiologist at Hazard ARH Regional Medical Center. “Since many women think that CHD will not affect them, they tend to downplay symptoms and underestimate their severity.” Understanding the differences between men’s and women’s heart health is important to treating heart conditions early, before serious damage occurs.
The differences between the sexes CHD tends to occur in women about seven or eight years later than in men. Women are about five years older on average
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A better kind of heart care Good news for cardiac patients: ARH Heart Institute in Hazard now offers expanded cardiac services in Eastern Kentucky. By partnering with the state’s leading heart hospital, Saint Joseph Heart Institute, ARH Heart Institute is bringing leading-edge cardiac care to your community. With nationally-recognized surgeons and a tradition of quality care, you and your loved ones can now enjoy state-of-the-art cardiac care close to home.
than men are when they experience a first heart attack. Why the differences? “One reason is that women have built-in hormone protection in their premenopausal years,” says Dr. Yalamanchi. “Estrogen helps shield women from heart disease by helping to raise good cholesterol levels and lower bad levels. Once a woman reaches menopause, her estrogen levels drop and her CHD risk rises.” Women don’t always suffer from the same heart attack symptoms as men and so may deny they’re having a heart attack. Women take longer—about a half-hour longer—to seek help at an emergency room. They’re also less likely than men to be admitted to the hospital for evaluation of coronary artery disease and tend to be underdiagnosed. While women may be aware of the classic signs of an attack, such as chest pain radiating down the left arm and difficulty breathing, they aren’t aware of symptoms they are more likely to experience. In fact, one-third of women experience the
following symptoms, often with no chest pain at all: Ñ sudden onset of severe weakness Ñ stomach upset or nausea with passing weakness Ñ mild burning sensation in the middle of the chest that extends outward Ñ vague chest discomfort Ñ palpitations, cold sweats or paleness
Heart disease symptoms to look out for Spotting heart disease symptoms can prevent an attack and save your life. Warning signs include: Ñ chest pain—known as angina—ranging from mild to severe Ñ shortness of breath Ñ extreme fatigue Ñ swelling in your feet or ankles Ñ palpitations Ñ a feeling of heaviness, pain, tightness, burning or pressure behind your breastbone or in your arms, neck or jaw
What’s a woman to do? “Simple lifestyle changes can dramatically reduce women’s risk of CHD,” says Dr. Yalamanchi. Both women and men can improve their heart health by getting back to tried-and-true basics: Ñ Don’t smoke. Women who smoke risk having a heart attack 19 years earlier than nonsmokers. Ñ Maintain a healthy body weight. Ñ Eat a low-fat, low-cholesterol diet and limit salt intake. Ñ If your cholesterol is high, lower it. Ñ Control high blood pressure. Ñ Keep diabetes under control. Women with diabetes are two to three times more likely to have heart attacks. Ñ Limit your alcohol use. Ñ Exercise regularly.
Stay heart healthy! To learn more about cardiac services at ARH Heart Institute, visit www.arh.org and click on “ARH Heart Institute.”
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Get your health grade Understand blood test results
Tales from the heart “Blood tests are the gold standard for evaluating your heart disease risk,” says James D. Frederick, MD, a family practice physician at Morgan County ARH Hospital. Tests look at: Ñ Lipids. A blood serum test shows how much HDL (good) and LDL (bad) cholesterol you have and if triglyceride levels are high. Ñ Cardiac enzymes. Enzymes leaking from the heart muscle signal that a heart attack has struck or is imminent. Ñ Oxygen. Blood in the arteries should be oxygen-rich. “If this test shows oxygen is lacking, there may be a problem with your heart or lungs,” says Dr. Frederick. “Doctors may perform this test if a patient has heart disease risk factors.”
Counting cells Other tests can find signs of diabetes, leukemia, alcoholism, lupus, bone marrow disorders and anemia. For instance, a complete blood count (CBC) measures the concentration of: Ñ red blood cells Ñ oxygen-carrying hemoglobin in red blood cells Ñ white blood cells Ñ platelets (which help blood clot to prevent bleeding)
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Easy access to your health Looking for a convenient way to manage your healthcare on the go? Log on to ARH eHealth, where you can e-mail your doctor, request appointments, refill prescriptions, review lab results and get valuable health information. Register today for this free service at www.arh.org/eHealth.
A similar test—a blood chemistry workup—checks your liver and kidney function by measuring sodium, potassium, calcium, blood sugar and bilirubin in the bloodstream.
Give it your best Dr. Frederick recommends these tips to help you give a quality blood sample: Ñ Make time. Most tests call for “overnight” fasting—eight to 12 hours—so be sure to fast for the proper amount of time. Ñ Water it. Drink only water while fasting. Any other food or beverages could skew the test results. Ñ Keep your head. If having blood drawn makes you squeamish, ask the lab tech to help you through. Other ideas: Watch the clinic TV or close your eyes and recall a comforting place or a happy face.
Images on pages 2 and 5 © istockphoto.com/Scott Dunlap/Carey Hope
For many patients, a blood test is one of the least-liked parts of a physical. But when your doctor needs a quick, meaningful look at your health, a blood test is priceless.
Surgery 101 A manual for peace of mind When it comes to surgery, studies have shown that the “be prepared” principle can ease pre-op anxiety, reduce your hospital stay and speed recovery. “Knowing what to expect can defuse stress and help you approach surgery with a calm head,” says Charles Anthony Crumley, MD, a surgeon at Middlesboro ARH Hospital. Dr. Crumley and Fazal Husnain Ahmad, MD, a surgeon at Harlan ARH Hospital, offer some other ways you can make the time before, during and after surgery run more smoothly:
Before your procedure Ñ Follow your physician’s instructions about refraining from smoking, eating and drinking before the procedure. Ñ Ask your physician about taking aspirin or other antiinflammatory medications before surgery. “Because they’re blood thinners, these medications may cause excessive blood loss,” says Dr. Ahmad. Ñ Tell your doctor which prescription and over-the-counter medications you take. “This goes for vitamins and herbs, too,” says Dr. Crumley. “Certain herbal remedies, such as St. John’s wort and kava, may extend the effects of anesthesia or create other complications.” Ñ You won’t be allowed to drive after the procedure, so make reliable transportation arrangements. Ñ Organize your home before surgery. Make sure you have groceries or frozen meals on hand. If climbing stairs will be a problem, make sleeping arrangements downstairs. Ñ Practice relaxation techniques such as meditation or yoga. “Staying calm throughout the surgery process can speed post-op healing,” says Dr. Ahmad.
During your hospital stay Your cozy robe or a favorite photo will warm your surroundings and soothe you. Having family and friends visit will bolster you, but don’t be afraid to set limits: You’ll need some time to recuperate, and this includes time to yourself.
Home again A little help from your friends can come in handy. If worries about housework or bills are nagging at you, ask someone to take care of these chores. In the meantime, the relaxation methods you used before surgery can help you feel better now, too. With guided imagery, you can picture yourself in the near future doing something you enjoy, such as taking an invigorating hike in the woods.
When you need care With nine hospitals and 19 clinics serving Eastern Kentucky and Southern West Virginia, Appalachian Regional Healthcare (ARH) provides high-quality care close to home. For even more convenience, you can now find a local physician without leaving the comfort of your home. Visit www.arh.org and click “Find a Doc” to search ARH’s online physician directory.
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Whitesburg ARH Hospital
Kentucky
240 Hospital Road Whitesburg (606) 633-3500
Harlan ARH Hospital 81 Ball Park Road Harlan (606) 573-8100
Williamson ARH Hospital
Hazard ARH Regional Medical Center 100 Medical Center Drive Hazard (606) 439-6600
260 Hospital Drive South Williamson
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Revitalize yourself with medical spa services at The Rejuvenation Center The Rejuvenation Center at the ARH Medical Mall offers a variety of medically based products and services in a luxurious spa environment, including: Services
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Laser hair removal Botox Microdermabrasion Dermal fillers Metabolic screening
products
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Sclerotherapy vein treatment Skin composition analysis Chemical peels and facials Plastic surgery consultations
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Obagi skin care products ✺ Clarisonic skin SkinMedica skin care products cleansing system Glominerals makeup ✺ Candle Dance Latisse eyelash thickener aromatherapy candles
210 Black Gold Blvd. Hazard, Kentucky
1-877-243-4782