Live Well: Women's Health

Live Well: Women’s Health

A Great Day to Be a Woman Women’s health care in the Dayton region is keeping women healthy and active

By Jennifer Pat terson Lorenzet ti

“I

t’s a great day to be a woman” in the Dayton area, says Dr. L. William Rettig, chair of the Women’s Health Institute at Premier Health. Two of the area’s largest health networks, Premier Health and Kettering Health Network, are dedicated to providing health care throughout a woman’s life cycle that addresses her concerns and needs while exploring cutting edge treatments and techniques.

Addressing the Problems of Greatest Need The state of Ohio has one of the highest rates of infant mortality and preterm birth nationally, says Lori Scalise, vice president, service integration – women’s health for Premier. To combat this, Premier offers “centering,” a care concept that allows a group of expectant mothers to receive pre-

natal care and education in a group, with educational sessions focusing on information about pregnancy, breast-feeding, and

lows mothers the security of knowing that they can pursue natural birthing options right next door to a world-class PICU (peri-

“It’s not about treatment but about prevention and early detection.”

- Dr. Caroline Peterson, director of bre ast screening and e arly detection at Ket tering He alth Net work

child care. The groups are led by a midwife for a “high touch, low tech” support system aimed at lowering the preterm birth rate among a younger, urban population. One of the largest centering programs is offered through Miami Valley Hospital, which al-

natal intensive care unit), which provides specialized care for high- and at-risk mothers before, during and after birth.

Of course, a woman’s health concerns are not limited to her possible role as a mother. Premier was the first health DAYTON MAGAZINE . October/November 2015

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Live Well: Women’s Health

From left: Dr. L. William Rettig, Premier Health; Lory Scalise, Premier Health; and Dr. Caroline Peterson, Kettering Health Network system in the Dayton region to offer 3-D mammography or tomosynthesis. This technology takes images in a continuous arc across the breast as opposed to the two

images taken at right angles taken during traditional mammography. This allows the radiologist to see more clearly through the various layers of breast tissue in a 3-D view.

Premier is also dedicated to education about women’s health. Among many educational programs, they also offer a community education series for women

HEALTH PROFILE Dayton VA Medical Center 4100 W. Third Street, Dayton, Ohio 45428 937-268-6511 | dayton.va.gov

T

he Dayton VAMC is a state-of-the-art teaching facility that has been serving Veterans for 148 years, having accepted its first patient in 1867. The Dayton VA Medical Center provides a full range of health care through medical, surgical, mental health (inpatient/outpatient), home and community health programs, geriatric (nursing home), physical medicine and therapy services, neurology, oncology, dentistry, and hospice.

The Surgical Service at the Veterans Affairs Medical Center (VAMC) is fortunate to have received funding from VISN 10 to develop a state of the art simulation center.

The center is equipped with: • Two anesthesia capable high-fidelity mannequins • Two wireless and portable physiologic mannequins • Two computerized trainers for pelvic examination • Computerized virtual reality trainers for • Laparoscopic surgery (with and without haptic feedback) • GI endoscopy and bronchoscopy • Arthroscopy • Endovascular surgery and cardiac catheterization The simulation center has Internet-based audiovisual recording equipment, which allows for remote viewing of activities, training debriefing and analysis.

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The program also focuses on documentation, patient handoff reports and working with complex, high-tech equipment routinely used in critical care settings.

In addition to the mannequin and task trainer strategies, Dayton VAMC is actively collaborating with the Wright State University College of Engineering in the area of virtual environments and process modeling. Major projects include the development of an interactive virtual patient with underlying neural nets.

A grant from Women’sA Health is supporting the development of a simulation-based curriculum for primary care providers about common breast and gynecological conditions. The program will include virtual patient scenarios and pelvic training-based education.

Live Well: Women’s Health called “Women, Wisdom, and Wellness.”

This speakers series is offered several times a year and is designed to educate women about topics of interest to them, including difficult-to-discuss topics like obesity and pelvic floor disorders (like slippage or prolapse of the pelvic organs).

Educational efforts like these help women learn more about issues and conditions that may affect their lives and help them ask the right questions of their primary care physicians and OB/GYNs, who can then put them in contact with the right services in the Premier Network.

Understanding Risk Cancer is always a scary thought, but understanding one’s risk is an important step in helping determine screening and detection strategies. Dr. Caroline Peterson, director of breast screening and early detection at Kettering Health Network, works closely with a genetic testing program called TRAC, short for Transforming Risk Assessment in Cancer. “It’s not about treatment but about prevention and early detection,” she explains.

Through the TRAC program, select family practice physicians, OB/GYNs and multi-specialty providers can identify their patients for testing for genes that may impact the patient’s risk for breast, ovarian, uterine, colon, gastric, pancreatic or prostate cancer. The results may indicate future screening and prevention strategies.

For example, women who exhibit certain genetic risk factors for breast cancer may be advised to begin annual mammography and breast MRIs and to make certain lifestyle changes that minimize risk. They might also be advised to take certain

Dr. Rashmi Bolinjkar with Premier Health can, in genetically at-risk populations, sometimes present itself in a patient’s 30s or 40s, well before the usual recommended beginning of screening colonoscopy. Peterson recommends patients share their

“We’re ahead of the rest of the country.”

- Dr. Caroline Peterson, director of bre ast screening and e arly detection at Ket tering He alth Net work

pharmaceutical prevention strategies. For example, some women may be advised to take a course of tamoxifen, which can significantly decrease the risk of developing breast cancer. Similar strategies are involved when a patient tests with a greater hereditary risk for colon cancer, which

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genetic information with their family, since many of the genes are inherited and thus shared among a family group.

Peterson reports that this type of testing “allows physicians to ID genes they didn’t even know patients had,” giving them a much more nuanced picture of risk and

the ability to tailor strategies much more closely to the patient’s needs. “We’re out ahead of the rest of the country,” she says.

Helping a Common Problem Some 50 percent of postmenopausal women and nearly 70 percent of premature menopausal and postmenopausal breast cancer survivors suffer from vaginal atrophy. In this condition, the loss of estrogen can cause sensitive tissues to become dry, increasing the chances of pain during intercourse and urinary incontinence.

“It’s extremely common,” says Dr. Janelle Evans but what is “normal from a physiological standpoint” can be troublesome to an individual woman. Previously, the only solution was topical estrogen cream, a long-term commitment that doesn’t always work for all women.

However, now Kettering Health Net-

Live Well: Women’s Health work offers MonaLisa Touch, a procedure pioneered in Italy that is currently in its second year in the U.S. The procedure uses a carbon dioxide laser to “make a matrix of marks on the vaginal wall that stimulates remodeling,” says Evans. Evans’ urogynocology practice is the first in Dayton to provide this treatment that helps a woman’s body rebuild these tissues and reverse the problems of loss of estrogen.

The procedure takes approximately five to seven minutes per treatment, with a woman initially receiving three treatments each spaced by six weeks, then a “touch up” procedure annually. “Some women have significant symptom relief after the first treatment,” Evans says. She notes that she hears women say, “Wow, I can’t believe this wasn’t available before.”

Whether a woman is a teenager, a mom, a busy professional or a retiree, there are many options to help her travel through her life in a healthy way right here in Dayton.

Our experts agree that this begins with a conversation with your primary care physician or OB/GYN. ■

Dr. Janelle Evans and Dr. Marc Ashby of Kettering Health Network

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