Health + Wellness Magazine Spring/Summer 2021 by Cheshire Medical Center

Health + Wellness Living healthier together. Spring/Summer 2021

Let’s get vaccinated! Getting vaccinated and continuing to wear a mask means more than just protecting yourself—it means you’re helping your community and your loved ones survive a pandemic. And that is truly heroic.

Aalok Khole, MD, Infectious Diseases Physician at Cheshire Medical Center, on why he got vaccinated:

“Reasons are plenty, but at the end of the day, I believe in science. This is the key way of getting out of the pandemic. It’s the right thing to do.” Others share their reasons on page 6.

ALSO INSIDE: Vaccinating the region: A true community effort

Making the most of Virtual Visits Weight-loss surgery at Cheshire

Expanded help for substance use disorder Workforce training programs

Health + Wellness tips and educational program offerings And more...

Health + Wellness Living healthier together.

Health + Wellness magazine is a publication of Cheshire Medical Center. To support the health and wellness of the people of the Monadnock Region, we provide information about our services and medical care, as well as local resources available to support wellness goals. This publication is intended to provide health information to our readers and should not be considered a substitute for consulting with a physician. PHOTOGRAPHY CREDITS

Lori Pedrick: cover and pages 6, 7, 12, 16, 23 Mark Washburn: pages 4, 8, 9, 13, 25 Cheshire Medical Center has served the communities of the Monadnock Region with high-quality health care since 1892. A member of the Dartmouth-Hitchcock Health system, Cheshire is a nonprofit medical center, providing a continuum of care spanning primary care and specialty medicine, to surgical services and acute inpatient care, comprehensive cancer treatment, and inpatient physical rehabilitation. The educational programs listed in Health + Wellness magazine are developed and coordinated through the Center for Population Health. The Center for Population Health (CPH) is a department of Cheshire Medical Center focused on health and wellness education, outreach, and support to individuals, families, worksites, schools, and the community. CPH provides staff for the Greater Monadnock Public Health Network and support for the Healthy Monadnock community. To sign up to receive Healthier Together, a monthly e-bulletin, and view previous issues of Health + Wellness magazine, visit: cheshiremed.org.

message from the president

A new season of hope. It’s been more than a year since New Hampshire declared a state of emergency due to the coronavirus outbreak on March 13, 2020. At the time, we had no idea the significant impact it would have on our lives here at home or around the globe. I remember driving into Cheshire’s parking lot around that time and seeing the word “HOPE” displayed in the window by our Intensive Care team. It struck me at that moment how significant the COVID pandemic was for our employees, our community, and the country. I thought about our frontline workers and their role as protectors of our community’s health and wellness. Day in and day out since then, I know that everyone who works at Cheshire is an example of what it means to be a hero. It’s been difficult work, and we’ve endured hardships, but our commitment and resilience got us to where we are now. Our community has faced many challenges, and there are still unknowns about this deadly disease, but, with the massive rollout of the vaccine, we have a real solution. Thankfully, we have the vaccine available, and I encourage everyone to get it when it’s your turn. If we continue to follow the state and federal guidelines even after receiving the vaccine, we will continue to see dramatic reductions in new cases, hospitalizations, and deaths from COVID-19. Getting as many people vaccinated is our light at the end of the tunnel. When the state reached out to request our commitment to vaccinating our community, we were completely on board. Cheshire’s capacity to serve as a force for good extends far beyond our Keene campus. The vaccine efforts in the Monadnock Region are remarkable and illustrate just how strong we are together. You can read about the community vaccination work we’ve done on page 4. Everything we do at Cheshire is fueled by our commitment to deliver excellent, compassionate care in a safe, well-run environment. We are here for you and your health needs. Many people have put off important visits during this pandemic, and we want to see you again. We are open, safe, and here for you, so please take advantage of the options we offer for scheduling your appointment as either an in-person or Virtual Visit. You can read tips on making the most of your Virtual Visit on page 10. In addition to always being there in times of illness or hardship, we continue to focus significant resources on wellness-oriented activities and preventative measures that help community members avoid hospital time. Be sure to check our events and programs in this issue of Health+Wellness magazine on page 28. Every year, the signs of spring appear slowly in New Hampshire. Anyone who has driven on a dirt road in late March or April during mud season knows there is a transition period between our seasons. This happens every year—and we see it happening again in 2021. This change of season and seeing the rebirth of what was dormant over the winter fuels us with hope. After more than a year of not knowing what to expect from one moment to the next, the hope that this spring brings brighter, safer times seems even more significant.

Don Caruso, MD, MPH President and CEO, Cheshire Medical Center

Inside: PAGES 4-5

PAGES 8-9

When tasked with rolling out the COVID-19 vaccines for the Monadnock Region, Tricia Zahn and Jana Parayil were more than up to the task.

Lessons learned, innovations made, and a community united in the midst of a global pandemic.

A culmination of community effort PAGES 6-7

We can do it!

Rising to the moment

PAGES 10-11

Making the most of Virtual Visits

A glimpse at the faces— and arms—of those who have chosen to get the vaccine, and why they made their decision.

Simple ways to maximize your next telehealth appointment with your provider.

PAGES 12-14

PAGES 16-18

From a broken ankle to a hip replacement, Cheshire Orthopaedics team shows expert care for local couple. Plus, a Q&A with the department section chief.

When she was diagnosed with breast cancer, Cathy Schlichting knew exactly where she wanted to undergo treatment.

PAGE 15

Women's Health at Cheshire is using a new screening process to identify— and help care for—the challenges patients are facing.

῾A bubble of care’

New Hampshire Top Docs

Twelve Cheshire physicians earn Top Doc awards—including the cover spot— in New Hampshire Magazine.

Compassionate care, close to home PAGE 19

Innovation in Women’s Health PAGES 20-21

Help for substance use disorder

Medication-assisted treatment is now offered at The Doorway in Keene and Mothers in Recovery program has expanded support for families.

PAGES 22-23

PAGE 26

Cheshire introduces new bariatric surgery program. Plus, perspective and advice from someone who’s enjoying life after the procedure.

What one Keene company is doing to keep employee wellness at the forefront during the pandemic.

Is weight-loss surgery right for you? PAGE 24

Workforce training at Cheshire

New programs help people interested in nursing start—and further— their careers at Cheshire Medical Center. PAGE 25

Circle of Gratitude Spotlight

A patient uses the Circle of Gratitude program to say “thank you” to a cardiology nurse who likely saved his life.

Wellpowered Worksites

PAGE 27

Barley salad recipe

This healthy (and often overlooked) ingredient is good for way more than simply soup and beer. PAGES 28-31

Health + Wellness Programs

Upcoming classes and programs on a variety of health-related topics.

At Cheshire Medical Center, we’re here for you, every day.

Urgent primary care visits are now available on our main campus, 365 days a year. Call 603-354-5484 for screening and registration.

Learn more at cheshiremed.org/urgent

MONADNOCK REGION COVID-19 VACCINATIONS

A culmination of

community effort

“We have amazing partners who are part of the National Guard, as well as both state and local partners. Whenever it feels like too much, we know we have community partners to lean on and pull in to help us over the more challenging waves of this pandemic.” – Tricia Zahn, MPH, Director of Community Strategic Partnerships, The Center for Population Health at Cheshire Medical Center

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Jane Parayil, left, and Tricia Zahn have been essential in the COVID-19 vaccine rollout in the Monadnock Region through their work and coordination with the Greater Monadnock Public Health Network. Here they are shown leading the community effort at the state-run fixed site in Keene, where a partnership of Cheshire Medical Center staff and volunteers and the National Guard are administering the vaccines to the public.

hen tasked with managing the distribution of the COVID-19 vaccines to the bulk of the Monadnock Region, Tricia Zahn and Jane Parayil were up for the challenge. Through their efforts with the Greater Monadnock Public Health Network (GMPHN)—one of 13 public health networks statewide, serving Cheshire County and the 10 western-most towns in Hillsborough County—they’ve spearheaded the vaccine rollout of our region. “This isn’t about a plan that sits on a shelf. This is about the relationships and trust built among partners that each person, organization, or group leans into their strengths when our community needs us the most,” said Zahn, MPH, director of community strategic partnerships for the Center for Population Health (CPH) at Cheshire Medical Center. “Our COVID-19 vaccine distribution has been a culmination of all of these preparedness efforts. This is what we built relationships for; this is what we recruited, vetted, and trained volunteers for. This is what we planned for. This is what we drilled for.” Zahn praises the dedication, flexibility, and hard work of Parayil, MPH, public health emergency preparedness coordinator for CPH, who joined mid-pandemic. The crucial relationships and collaborations they’ve built with community partners help them manage the vaccine rollout. “We have amazing partners who are part of the National Guard, as well as both state and local partners,” Zahn said. “Whenever it feels like too much, we know we have community partners to lean on and pull in to help us over the more challenging waves of this pandemic.” Some partners include Cheshire staff that have donated their time to volunteer at the state-run fixed site. That, too, has been rewarding, said volunteer Elaine Carey, RN, BS, CGRN, the clinical leader of Cheshire’s Endoscopy team. “It’s groundbreaking to take on the task of vaccinating such a large population—and in traditional New England weather, at that!” Carey said. “We (as family and staff) are so grateful for the very hard work that is being done—and has been done—by Jane, Tricia, the National Guard, and the dedicated volunteers. … It has allowed us to be a part of the solution with the hope of bringing healthier and safer days back, so we can all once again gather together for celebration.” 

Volunteer Elaine Carey, RN, BS, CGRN, clinical leader of Endoscopy at Cheshire, gives a COVID-19 vaccine to her father, John, in February 2021.

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“I got it because I have a 90- year-old mother who I help take care of and I want her to be protected.“ –James Day, Facilities Staff, Cheshire Medical Center

“After witnessing first-hand the health issues the coronavirus has produced for my patients, family and friends—both short term and long term—I wanted to be a part of the solution.” –Gabby Kiniry, RDCS, NRAEMT, Cardiac Sonographer at Cheshire and Advanced EMT for Spofford Fire Department and Diluzio Ambulance Service

“I got it for myself, for my family and friends, but equally as important is the community. This is an opportunity to do something good together.” –Beth Healy, Harrisville Resident

–Sandra Allen, Regional HR Director for Genesis Healthcare, Ironwoman

“I am very grateful to receive the COVID-19 vaccine. But I really see this as just one step in our battle to control the coronavirus pandemic.”

“I want to be able to have my turn to get it. I’m excited to show my Band-Aid off. I’ll wear it with pride!” –Emma Manderville, Keene State College Student and MCVP Intern

–Bill Chase, MD, Retired Surgeon

“Just as I wear PPE to protect the patients we see, I got the vaccine to protect myself and my family.”

“I got vaccinated for my patients, who need to be protected by us, and our staff members, and for my family.“

–Jake Poulin, Keene Firefighter and Advanced EMT

–Alison Poulin, Cardiology Nurse, Cheshire Medical Center

“I got it because I believe in science, and it’s the least I can do to protect myself, my family, and my community.”

“I’m doing it for my students. They’re my kids. I want to be able to sit next to them and help them again.” –Amber Larareo, 6th-Grade Teacher

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“I'm ready to get mine as soon as I'm able. It's the best way we can begin to get back to normalcy.” –Jackson Cunningham, College Student

Mary Pierce, RN, is an infection preventionist at Cheshire Medical Center, and has been instrumental in our response to the pandemic. Here, she shares her thoughts on the importance of the vaccine and what we can all do every day to stop the virus.

“The vaccine is the piece that will help us turn the tables against the virus. It’s what I can do to help protect everyone else.” –Betsy Follansbee, Mailroom Clerk, Cheshire Medical Center

“Basically, I’m doing it for my family because if we want to be together, this is the best way to do it.” –Dan Mitchell, WKBK Radio Host

As we move through this much-anticipated vaccination process, the one thing I really want to impress upon everyone is patience. This is a massive undertaking in which the federal, state, and local governments are trying to inoculate an entire population. We are working fast, furious, and non-stop to provide every person every resource we have to support this work in our community. We have been quite successful with the vaccine rollout thus far, and when it’s your time, we will be there for you too. Vaccines are just one of many tools we have to fight this pandemic. In the meantime, prevention is the most powerful tool we have to keep each other safe. Yes, we are all sick and tired of this pandemic, but you’re a hero and you have superpowers! The part YOU have control over is what you’ve been doing for more than a year. Beyond vaccination, the effective tools you have are masking, physical distancing, disinfection, hand hygiene, avoiding crowds, limiting unnecessary travel, staying home when you’re sick, and getting tested if you become ill. These are the things you have absolute power over. These are the things that will keep us safe. Until a greater percentage of the population is vaccinated, these recommendations remain the same. The evidence is clear and the guidance works. Even though the vaccine is here, it’s not quite time to let up on any of these actions.

We are all tired of living this way. We miss our lives, our loved ones, our jobs. There IS light at the end of the tunnel, but if we give up too soon on prevention, we forfeit a swift return to normal. To reach that normal, we have to drop the rate of community transmission. We have to reduce the burden on our health care system. We need to vaccinate the population to a point where we no longer have pockets of disease. This is no small feat. It’s a careful balance between many things. When it’s time to get your vaccine, we encourage you to do so. When you’re vaccinated, you’re not just preventing yourself from getting sick, you’re helping to protect others—you’re helping your community and your loved ones survive a pandemic. Reach out to family, friends, and neighbors who may need some assistance signing up on the Internet or getting to the vaccine site for their appointment. Share your belief in science and your trust in the medical community. Follow guidance from the state and CDC— these are scientists and epidemiologists, nurses and doctors, who use evidence to base their recommendations. You’ll see their recommendations start to shift toward normal as we reach our goals of lower community transmission and as we approach vaccination rates that get us closer to herd immunity. It’s really up to each of us, to help one another understand, to empathize, and to support each other. We all have to be in this together. I understand that’s hard to do in these challenging times, but I implore each of you to do your part. Be superheroes. We can do it! 

“Vaccines are just one of many tools we have to “I got the vaccine to protect myself, family, friends, and our community—along with contributing to science and research. It signifies hope for the future in which we can all gather again.” –Olivia Stack, Community Health & Education Coordinator, The Center for Population Health at Cheshire Medical Center

fight this pandemic. In the meantime, prevention is the most powerful tool we have to keep each other safe. I understand that’s hard to do in these challenging times, but I implore each of you to do your part. Be superheroes. We can do it!” – Mary Pierce, RN, Infection Preventionist, Cheshire Medical Center

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RISING TO THE MOMENT Lessons learned, innovations made, and a community united in the midst of a global pandemic

rom greeters at the hospital entrance ”All position titles went out the door, and there was just this awed feeling to innovations in cleaning of how true this family organization is. You forget that until you have and reusing personal protective equipment (PPE) to enhanced testing to go through something like this. People stepped up from all different protocols to a community coming levels to help with screening at the doors. People were willing to take on together in a time of crisis, Cheshire Medical Center has much for which to that role to give back—and they were thanking me for the opportunity.“ be grateful a year into the COVID-19 pandemic. – Christine Scheffler, Director of Volunteer Services, Cheshire Medical Center One friendly face familiar to staff and patients is Christine Scheffler, who has been employed at Cheshire for more than “We are there for the community, but it is there for us as well,” 40 years. She currently serves as director of volunteer services and says Dr. Khole. also oversees patient relations. At the start of the pandemic in March Early on, as shortages in PPE plagued medical settings worldwide, 2020, Scheffler was impressed by the “all-hands-on-deck” approach community members sewed and dropped off masks for Cheshire to Cheshire’s staff. Regardless of titles and roles, anyone willing at staff. Dental offices shuttled their extra PPE to the hospital’s frontthe Medical Center pitched in at the front door to greet patients, and line workers. Local restaurants donated meals to nourish exhausted perform basic health checks to ensure community wellness. doctors and nurses as they worked to prevent and treat an unknown “All position titles went out the door, and there was just this awed disease. Scheffler’s volunteers eagerly returned to their posts when feeling of how true this family organization is,” says Scheffler. “You deemed safe. forget that until you have to go through something like this. People “It went a long way toward strengthening the rapport that already stepped up from all different levels to help with screening at the exists,” says Dr. Khole. doors. People were willing to take on that role to give back—and they From the beginning, Dr. Khole adds, innovation helped Cheshire’s were thanking me for the opportunity.” staff adapt to the evolving circumstances of COVID-19. The teamwork described by Scheffler, One of the most significant of those innovations was a partnership combined with innovation and with the larger Dartmouth-Hitchcock Health (D-HH) system that compassion, has ensured a unified facilitated bulk purchasing of PPE. It also led to the establishment approach to managing the pandemic. of a reprocessing protocol for N95 masks—typically discarded after Aalok Khole, MD, an infectious one use with one patient—that allowed each mask to be sanitized diseases physician who joined the and reused up to 20 times. Innovations at the Cheshire lab also Cheshire staff in August 2019, noted the allowed reduced turnaround time in COVID testing. Simultaneously, symbiotic relationship between hospital connections through the Red Cross and pharmacies within the and community that exists—and has been D-HH system helped Cheshire gain access to necessary therapies. strengthened—by the pandemic. Meanwhile, everything over the past year has been done with patient well-being at the forefront. Chris Tkal is the vice president for Erika Farhm, Patient Care Tech operations, quality, and patient safety at Cheshire. Figuring out how for COVID-19 testing. to safely deliver elective, non-urgent procedures became a primary challenge for Tkal and his staff as COVID-19 emerged. For nearly

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two months, anything not related to the pandemic was shut down, pandemic’s silver linings, Dr. Khole says, is the increased awareness leaving gaps in treatment options for patients. of infectious diseases and public health. People are now more “Our mission is to take care of our population here, and shutting mindful of their own hygiene and how they interact with others. down [out of necessity] made that more difficult,” says Tkal. “Our “That personal etiquette with respect to interactions goes a long operating room is critical.” way,” Dr. Khole says. “We knew this had to be a group effort. Every Operationally, the Post-Anesthesia Care Unit (PACU), member of the hospital and beyond has demonstrated the ability Emergency Department, and Intensive Care Unit (ICU) spaces were to deliver—and each one has a role to play, whether it’s those doing converted to treatment areas for COVID in anticipation of a surge. laundry, preparing meals, or caring for patients. This has been a Meanwhile, Tkal and staff developed processes around isolating and great lesson in team-building that is here to stay. Something like caring for infected patients. Staff members practiced drills to learn this makes you value what you have and reminds you that you how to protect themselves from exposure when treating COVIDneed a support system to get through it.”  positive patients, while testing protocols eventually helped to revive elective procedures safely. “Our biggest concern,” says Tkal, “was that we did not want to delay patient care. Non-urgent care today can become urgent tomorrow. Crisis exposes true character. What we have seen is what a great team we have [at Jodi Turner penned this Letter to the Editor in The Keene Sentinel in February, 2021. Cheshire]. It has been impressive to watch something with We thank Jodi for the kind words, and her willingness for us to share them here. so much fear associated with it and see how the people here supported each other and showed compassion not I would like to put a big shout out there to all the doctors, nurses, and staff at only for the patients, which is the norm, but for each other.” Cheshire Medical Center for making it possible to send this note of thanks. Communication has become even more crucial in I went to the Emergency Room on Christmas night. I had the most educating the hospital campus during the pandemic. Tkal wonderful, easy-going, relaxed holiday and was just sitting in reflection of the is proud of the thorough messaging that keeps Cheshire’s days when it hit me. I was in excruciating pain and had no idea why. We drove 1,300 employees informed during the crisis. That to the ER around 11 p.m. I ended up in the operating room by 3 a.m., with 5½ education goes beyond the campus as well. One of the inches of colon being removed.

Thank you for the thank you.

”It has been impressive to watch something with so much fear associated with it and see how the people here supported each other and showed compassion not only for the patients, which is the norm, but for each other.“ – Chris Tkal, VP for Operations, Quality, and Patient Safety, Cheshire Medical Center

This was quite a surprise as I eat well, exercise, and try to do everything right; sometimes we forget about other factors we allow ourselves to endure, so this will be my focus for 2021. A great amount of stress was relieved recently, and I am on my way to being my happy self once again. I would not be here today without the commitment and dedication of the hospital staff. Dr. Santos, Dr. Weaver and Dr. Sanders— I appreciate all your expertise. You are kind and caring surgical specialists. My nurses and LNAs were also incredibly supportive. I have never been in the hospital for anything more serious than the delivery of my son. This was so different. Being in the hospital for eight days gives you time to get to know the staff. I appreciate the colostomy specialist, the nutritionist (especially for my first real food), the food staff, the cleaning people, and especially Stephanie V., Emma, and the rest of the nursing team on the second floor. While there, I was impressed by their dedication and bedside manner. The nursing staff should be recognized as hard-working, tireless individuals. These are not just any old times. This is COVID. Besides the everyday activities, they are all directed into departments that need them and asked for their flexibility. We as a community are so fortunate to know you are there for us in our time of need. Please take care of yourselves as well. Thank you, one and all!

–Jodi Turner, Swanzey, NH

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Getting the most out of your next Virtual Visit In addition to in-person visits, Cheshire also offers virtual telehealth appointments. Often saving you time and money, you can have a Virtual Visit—whether the appointment is with your primary care provider, a specialist, or as part of an urgent visit—from the comfort of your own home or workplace. From registration through the actual visit, the process is simple, safe, and convenient. Here are a few helpful tips to make the most of your visit. Download Zoom and test it. We use the free video conference app Zoom for our Virtual Visits. Before your appointment, take some time to make sure it’s set up correctly, and you know how Zoom works. You can also connect to Zoom through a web browser on your computer, but it’s often simpler to use your smartphone or other smart devices, such as a tablet or iPad. The link to your Virtual Visit will be available in your myD-H patient portal. If you don’t have a myD-H account, ask your provider’s office to email or text the registration link to you. Make sure you have a quality Internet connection. If you are on a smart device, we

recommend connecting to your appointment via WiFi for the best chance of having a stable, uninterrupted connection during your visit. You can connect through your cellular network (such as 4G), but the connection may not be as strong or as reliable. Check your lighting. You and your surrounding area should be well lit so your provider can clearly examine you. This tip may not seem important, but it can make a big difference. Find a private, quiet area. Try to find a room where you can close the door if possible. A quiet area will also make it easier for you to hear each other.

Gather all necessary medical information before you connect for your appointment. This may include a list of medications and your injury or illness history. For example, if you scheduled an appointment because you’ve been having headaches, write down the dates of the most recent headaches. Also, please review the list of your medications on myD-H and note which ones you are or aren’t taking. Information is power, and it’s best to come prepared. Following these tips will help make the most of your Virtual Visit. For more information, visit cheshiremed.org.

A few preparations ahead of your appointment can set you up to have a successful Virtual Visit.

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Back to the basics

Now is a good time to recommit to a lifestyle that supports your health For many of us, the past year has featured more video conferencing and way more time in our sweatpants than ever before—resulting in some not-so-healthy habits. Whether you’ve already had your vaccine or are eagerly anticipating your turn, it’s never been more important to maintain a lifestyle that supports your health. And while there’s no magic bullet, the advice from medical professionals couldn’t be simpler. “Eat well, drink plenty of water, exercise daily, and stay healthy,” says Aalok Khole, MD, infectious diseases physician at Cheshire Medical Center. “This will help your immune system function and help in protecting you, not only against COVID-19, but diseases and ailments in general.” One of the most common questions patients ask Don Caruso, MD, MPH, president and CEO of Cheshire Medical Center, is what else they can do to boost their immunity. He echoes Dr. Khole’s advice. It’s the same things he’s been recommending for decades: exercise, eat right, get quality sleep, and wash your hands. “It has to do with staying physically active and eating appropriate meals with plenty of vegetables,” Dr. Caruso says. “When we don’t do this, we put ourselves at risk for things like diabetes and hypertension, which are comorbidities that significantly increase how poorly people do if they get this virus. And so, it is about a healthy lifestyle.”

Patients sometimes ask about taking supplements aimed at boosting their immune system rather than actions. When it comes to added vitamin C or E, Dr. Caruso says there’s not much medical evidence either can make a significant impact on immunity. Instead, people should focus on living an active lifestyle and eating right. As the weather warms, it’s a perfect time to get outside to exercise. Whether it’s running, hiking, biking, swimming, or taking a stroll, the Monadnock Region offers many hiking trails, bike paths, and swimming holes—so do your body a favor and take advantage of them. Another important health tip: While it is safer to delay some things during the pandemic, medical care isn’t one of them. Virtual Visits are an easy way to assess many problems. Regular in-person physicals and screenings allow your health care team to find and treat illnesses early, and could save your life. Call your primary care team to learn more: (603) 354-5400.

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Visit the Health + Wellness section on cheshiremed.org to learn more clinically proven methods to support overall health.

Mind racing with worry or stress? Try to S.T.O.P. For many of us, the past year has brought high levels of stress and uncertainty. Finding time to stop, come down from the worried mind, and get back into the present moment can help ease stress’s negative effects. Practicing mindfulness can help us gain perspective and a sense of calm. Here’s one simple exercise you can try. Stop, take a few deep breaths, and reflect on what is on your mind—remembering that thoughts are not facts, and not permanent. Notice how your emotions are being expressed in your body. Then, notice your posture and scan for any aches or pains. Proceed with something that will support you at the moment; talk to a friend, stretch, have a cup of tea. Look for opportunities in the day to S.T.O.P., such as waking up in the morning, before eating a meal, at a stoplight, before sitting down at work—or even waiting in line for your vaccine!

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Excellence in Care

Cheryl Belair of Keene lived with pain for two years before being diagnosed. Following surgery, after the pain medication wore off, she experienced immediate relief from the agony she had been living with for so long. ”I wish I hadn’t been so stubborn,” she says.

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Taking steps to address hip pain

with an expert Orthopaedics team I f not for a broken ankle in April 2019, Cheryl Belair might not have known she needed a hip replacement. “I had what I thought was a groin pull, but I never had anybody look at it,” Cheryl, a Keene resident, says. The pain was preventing her from doing a lot of normal activities, but she kept hoping the “muscle pull” would heal. But it didn’t. To make matters worse, she broke her left ankle. That left her in an air cast and on crutches, so she was putting most of her weight on her right leg, which caused the pain in her hip area. “I was well along with the wonderful folks in physical therapy and the ankle was healing fine, but I still had what I thought was a groin pull,” Cheryl says. It was during a follow-up on her ankle break that she learned she was suffering from something more serious. During that appointment, Russell Arpin, MPAS, PA-C—the physician assistant for Dr. Anthony Presutti at the time—tried to flex Cheryl’s right hip during an examination, but it wasn’t going anywhere. She received an X-ray just down the hallway and, within a few minutes, was informed she needed a hip replacement. “I didn’t believe it,” Cheryl says. “I was just 56 years old. Old people get replacement hips, and I’m not old! Well, I learned it’s not just old people who need hip replacements.” The pain that Cheryl was feeling is common for those with osteoarthritis of the hip, Dr. Presutti says. “A lot of people think their hip is in their butt,” he says. “But your hip sits in the groin and it receives its nerve supply from higher up in your back. Anything that irritates your hip is felt in the groin and the front of your thigh, sometimes in the knee.” Even with this information, Cheryl says it took her another year to admit to herself she needed surgery. But, over that year, her husband, Stephen Bragdon, learned he also needed a right hip replacement. “I said to my husband, who had been complaining about his own groin pull longer than me, you need a new hip,” she says. “We both procrastinated about a year and he ended up getting the surgery before me.” Steve let his wife know that, from diagnosis through surgery to physical therapy, a long line of providers at Cheshire Medical Center treated him with compassion and care. “I felt very well taken care of, from surgeon to chef,” says Steve, who had the surgery in August of 2019. It was seeing firsthand the level of care that Steve received that set Cheryl’s mind at ease. “From a spouse’s perspective, the experience was great,” she says. “I was totally wound up about him going into the hospital, but all the providers were great. I just can’t say enough about them.” Finally, two months later, Cheryl went in for her own operation, characterizing the whole experience as “a bubble of care.”

“They really enjoy their jobs, the entire crew,” she says. “The level of care was superb, and I felt it was offered on a personal level.” “The Orthopaedics team is like a family, so you want to be able to talk with them and bounce ideas off of them,” Dr. Presutti says. “I trust my partners, the PAs, the athletic trainers, and that makes delivering the care more enjoyable.” It’s that level of expertise across the entire Orthopaedics Department that the division takes pride in, says Paul Bettinger, MD, section chief. “The amount of experience here is incredible,” Dr. Bettinger says. “The doctors have all been recognized by our peers as ‘Top Doctors.’ Everyone in the entire department—from receptionists, to nurses, to athletic trainers to physician assistants—does a great job of taking care of our patients.” Cheryl says all the providers were incredibly patient, especially during the year when she was hemming and hawing about actually getting the surgery. “I wasn’t mentally ready to wrap my head around that fact,” she says. “But Dr. Presutti patiently said ‘You’ll know when it’s time.’”

“The Orthopaedics team is like a family, so you want to be able to talk with them and bounce ideas off of them. I trust my partners, the PAs, the athletic trainers, and that makes delivering the care more enjoyable.” – Anthony H. Presutti, MD Orthopaedic Surgery, Cheshire Medical Center

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ASK THE EXPERT:

Orthopaedic Care at Cheshire Paul Bettinger, MD Section Chief of Orthopaedics

In addition to being the Orthopaedics Department section chief, Dr. Bettinger is its hand and wrist specialist, who has been taking care of people in the community for more than 20 years.

What are the most common symptoms you see in new patients? When patients first come in to the office, they typically complain of hand pain or numbness. From there, we become detectives and start asking questions. The most common condition that causes numbness is carpal tunnel syndrome. Pain can be caused by an injury (fractures, dislocations and ligament ruptures) or conditions such as trigger fingers, arthritis, and ganglion cysts. Palmar hand lumps (Dupuyten’s disease) are becoming increasingly common, and we now have nonoperative treatment for it.

Other than the rigorous safety precautions, how has the pandemic affected your practice? In the last year, we’ve seen more people with advanced stages of their disease. They are waiting longer to come in to see us. Arthritis may be flaring up or they are hoping that their injury will resolve on its own.

How do you treat those conditions? We typically get an X-ray to check the bones and joints. We’ll conduct an exam to evaluate hand and wrist function. Is there a clicking sound when you move your fingers? Do you have numbness? Depending on the condition, it can be treated with different medications, splints, cortisone injections and, if necessary, surgery.

What would you like people to know about seeking care from your department? We see patients using a team approach. Our team includes orthopaedic surgeons, physician assistants, athletic trainers, nurses, and medical assistants. Together, we give outstanding care to the greater Keene community. To learn more about Orthopaedics at Cheshire, visit cheshiremed.org/ orthopaedics. While your medical insurance may require a primary care referral, you can call Orthopaedics directly to make an appointment or learn more at 603-354-5482.

Dr. Presutti says many, but not all, of the patients who come to him are reluctant to admit they might need serious surgery. “The thing you have to understand about osteoarthritis is it’s neither life or limb threatening,” Dr. Presutti says. However, the limitations imposed by the condition can really affect a person’s quality of life. “You start to have trouble, like struggling to get a pair of pants on or putting socks and shoes on and tying your laces,” Dr. Presutti says. Looking back on it, Cheryl realizes she should have spoken up sooner about what she thought was a simple pulled muscle. “I was diagnosing myself,” she says. “I crazily lived with the pain for two years before I was diagnosed.” Cheryl said following surgery, after the pain medication wore off, she experienced immediate relief from the agony she had been living with for so long. “I wish I hadn’t been so stubborn,” she says. If you’re in pain, Dr. Bettinger says, it’s important to start the conversation with your primary care provider so he or she can get you the help you need. “Don’t wait. Together, we can explore the problem and determine the best options for further care.”

The Benefits of Orthopaedic Virtual Visits If there’s one thing we’ve all become more comfortable with as a result of the pandemic, it’s video conferencing. Zoom and other similar programs have become an integral part of life. That’s especially true at Cheshire Medical Center, where Virtual Visits are an increasingly popular and convenient way to connect to a provider or doctor. You or someone in your family may have already had a Virtual Visit with your primary care provider or as part of an urgent visit. Virtual Visits can also be a great option to see a member of Cheshire’s acclaimed Orthopaedics team. “We are just scratching the surface of what we can do with Virtual Visits,” says Dr. Bettinger. “They’re a great tool for patients who cannot come in to our office for a face-to-face visit. Telehealth can be the answer for nursing home patients, a parent who is home working and taking care of the kids, or someone who can’t take time off from work.” When it comes to Orthopaedics, patients who are experiencing chronic pain or numbness in their extremities and joints can be put in quick contact through Virtual Visits with a doctor or physician assistant, said Dr. Mark Silbey. Patients can schedule an initial telehealth evaluation at their own convenience, then schedule in-person follow-up care if necessary. “Telehealth provides an opportunity for patients experiencing non-acute joint symptoms to be evaluated,” says Dr. Silbey, a shoulder and knee specialist. “Their provider can then, if necessary, order an X-ray or start treatment, such as prescribing medication or physical therapy.” 

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Congratulations! Twelve Cheshire Medical Center physicians have been named among the best doctors in New Hampshire, according to New Hampshire Magazine’s annual “Top Doctor” survey conducted by the national research firm Castle Connolly. The March/April 2021 issue features Cheshire’s Chief Medical Officer Cherie A. Holmes, MD, MSc, as the cover image and in a profile article in which she reflects on the changing world of medical care. You can read the full article online at nhmagazine.com. The following Cheshire Medical Center physicians were named “Top Docs” in 2021 by New Hampshire Magazine:

Barbara A. Bates, MD, Family Medicine “My personal motto is ‘Ubuntu.’ In English, it means ‘I am because you are.’ It’s an African philosophy based on common humanity or, as I understand it, the individual’s relationship with family, community, and the world around them. I am a Black, female orthopaedic surgeon. I am a chief medical officer. I have come to recognize that I am only who I am because of my family, my patients, my staff, my colleagues, and my community. I feel like the positivity, help, and strength I share and gain from all of them collectively is the greatest gift in my life. I am not particularly special. I am because they are. I have the pleasure of working with a very talented and accomplished group of orthopaedic partners.”

Paul C. Bettinger, MD, Orthopaedic Surgery Todd F. Dombrowski, MD, MS, Rheumatology Sherry A. Guardiano, DO, Rheumatology Cherie A. Holmes, MD, MSc, Orthopaedic Surgery Gregory P. Leather, MD, Orthopaedic Surgery Lisa A. Leinau, MD, Palliative Medicine Anthony H. Presutti, MD, Orthopaedic Surgery Matthew J. Rockacy, MD, Gastroenterology Mark B. Silbey, MD, Orthopaedic Surgery Andrew G. Tremblay, MD, Family Medicine Jill M. Winslow, MD, Hematology Oncology

Please join us in congratulating these physicians. We thank them, and all of our extraordinary clinicians across the organization, for providing compassionate, high-quality care to our patients and communities.

– Cherie A. Holmes, MD, MSc Chief Medical Officer, Cheshire Medical Center

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Excellence in Care

Staying close to home for patient-centered, compassionate breast cancer care

little more than two years ago, Spofford resident Cathy Schlichting fainted after giving blood at a Red Cross blood drive. Her fall led to a concussion that proved to be fortuitous. While resting at home from her head injury, Cathy felt a lump near her collarbone. Aware that cancer runs in her family, she mentioned the lump at an appointment with her primary care physician, Leslie Pitts, MD. Cathy had already lost a brother to lung cancer and a niece to metastatic breast cancer. Her older sister had beaten the disease two years earlier. Dr. Pitts, too, felt the suspicious lump and ordered diagnostic imaging. “Everything moved really quickly to diagnosis,” Cathy recalls. “Every person I encountered, from receptionists to nurses to MRI, mammogram, and ultrasound techs, could not have treated me with more respect, empathy, and compassion.” Cathy immediately appreciated the team approach at the Breast Care Center at Cheshire Medical Center. She also felt grateful for her

community as she faced her diagnosis and treatment. Her sister had received successful radiation treatment for breast cancer at Cheshire. The ultrasound technician, whose sons had played baseball with her grandson, held Cathy’s hand through her first biopsy. Cathy’s granddaughter, Breanna, had worked as a nurse at Cheshire and suggested she see Guy Burman, MD, a surgeon also recommended by Dr. Pitts. “I felt from the time Dr. Pitts said, ῾We’ll check this [lump] out,’” Cathy shares, “everything flowed from there, and they were taking care of me down the line.” Dr. Pitts personally notifies patients of biopsy results and was the first link in a supportive chain for Cathy. Dr. Burman, she adds, was another reassuring voice. Dr. Burman, the Breast Care Center’s medical director says, “Care of the patient with breast disease involves treatment with…a multispecialty group with over 20 members. Our main goal is to provide world-class care right here in Keene.”

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L to R; Arvind Randhawa, MD, Hematology Oncology; Paul Koutras, MD, Radiology; H.E. Guy Burman, MD, General Surgery review breast scans.

A Nationally Accredited Breast Center

“You have to have faith in the people taking care of you, and I felt I couldn’t ask for better care. I don’t believe I would have had the same level of treatment and support anywhere else.”

Cheshire’s Breast Care Center is proud to have achieved full accreditation by the National Accreditation Program for Breast Centers (NAPBC). Accreditation is awarded by an independent organization, and is only granted to institutions that prove they are providing patients the highest standard of care for diseases of the breast.

–Cathy Schlichting Cheshire Breast Care Center Patient Cathy’s care team included Arvind Randhawa, MD, a clinical oncologist known for her medical expertise, along with her compassion and consideration of patient preferences. Cathy says Dr. Randhawa’s knowledge and kindness made her immediately trust that she was in good hands. Before she met Cathy, Dr. Randhawa was familiar with her case, as each is presented to a multidisciplinary Tumor Board. A treatment plan is made with input from specialties that include pathology, radiology, surgery, pharmacy, nursing, family medicine, radiation, and medical oncology. Cheshire patients also benefit from the Medical Center’s affiliation with the Dartmouth-Hitchcock Health system; Keene-based doctors often consult with additional experts at other locations, such as such as Dartmouth-Hitchcock’s Norris Cotton Cancer Center in Lebanon, New Hampshire. “We keep our patient preferences forefront as we develop a treatment plan for them,” explains Dr. Randhawa. “I met Cathy during a challenging time in her life. I saw her after her surgical resection with Dr. Burman, and we explored further options of treatment together. A cancer diagnosis can create an emotional and physical upheaval in our lives. I was impressed by how gracefully Cathy went through this.”

Born and raised in Spofford, Cathy has been employed as a student services advisor at Antioch University for 16 years. She and her husband, Benny, have been married for 43 years and have three children and four adult grandchildren. The availability of high-quality local care enabled Cathy to benefit from both staff support at Cheshire and her community. Family and friends accompanied her to treatment. Colleagues offered emotional support when she had to leave work for daily radiation treatments after completing three months of chemotherapy. “I don’t care who you are or what age,” says Cathy, who completed her treatment in fall 2019 and is now in remission, “when somebody says cancer, it’s scary. People asked why I didn’t go to Boston or Lebanon for treatment. I thought about it, but there is this great program at Cheshire. They explained the whole treatment process so I could make an informed decision. You have to have faith in the people taking care of you, and I felt I couldn’t ask for better care. I don’t believe I would have had the same level of treatment and support anywhere else.”  To learn more about the Breast Care Center at Cheshire Medical Center, visit: cheshiremed.org/breast or call (603) 354-6503. To schedule a mammogram or other breast screening at Cheshire, call (603) 354-6580.

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ASK THE EXPERT:

Breast Self-Care H.E. Guy Burman, MD

Medical Director of the Breast Care Center at Cheshire Medical Center

What are the keys to breast self-care? Breast self-care has a lot to do with overall personal health. To minimize risk, it is important to maintain a normal weight, as estrogen can be created in fat cells. A healthy diet and exercise also help. Maintain a good awareness of your breasts and alert your provider of changes.

What are your recommendations for the frequency of mammograms? There are different recommendations, so knowing your own personal family history, and asking relatives about that history, can help people know if they should be under a closer screening regimen. Some doctors recommend screening every year or every other year, beginning at the age of 40. Most recommend an annual mammogram and an annual clinical breast exam. It’s important to note that men can get breast cancer as well, so men should also be doing their own routine self-exams.

How often should self-exams be done? We used to recommend picking a day of the month that’s important to you, so it’s easy to remember, and do the exam on that day. For women, it is best to do your self-exam within a week or two after the menstrual cycle ends, as breasts are at their quietest at that point and you will get the best exam result. There is some data out there now that says breast self-exams on a regular basis have not been shown to make a difference. But getting to know your own body can’t possibly be a bad thing.

What should a patient look for when doing a self-exam? Nipple retraction or a change in the contour of the breast or a palpable lump in the breast. Sometimes a patient will also have persistent crusting of the nipple. It is very uncommon for breast tenderness to be associated with cancer. But often a patient will have some tenderness and will find a lump because they are examining their breasts more carefully because of that tenderness.

When should someone contact their physician? If you find a lump or any of the things I just described, if the breast seems to be getting red, or there is a change to the breast that is new for you, you should be evaluated. Finding abnormalities early is always best, as breast cancer is most treatable when found early. The nice thing now, compared to when I started treating it more than 20 years ago, is that we are able to do more about breast cancer and more to help patients, while actually doing less and less from a surgical standpoint.

Breast Cancer Resources Dartmouth-Hitchcock’s Norris Cotton Cancer Center offers online resources for those with breast cancer, including a typical patient journey: cancer.dartmouth.edu/breast CancerCare provides support, stories of hope, and resources for patients, survivors, caregivers, and health care professionals: cancercare.org The National Breast Cancer Coalition focuses on eliminating breast cancer through advocacy and action: stopbreastcancer.org NH Breast Cancer Coalition is a grassroots organization that advocates for and provides assistance to New Hampshire residents with breast cancer: nhbcc.org The Susan B. Komen Foundation is dedicated to supporting research that can prevent and cure breast cancer: komen.org Cancer.net provides information to help patients understand all levels of their diagnosis and care: cancer.net American Cancer Society offers a wealth of resources for patients and families of those diagnosed with breast cancer and non-cancerous breast conditions: cancer.org/cancer/ breast-cancer

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Health Care Innovation Spotlight

An innovative preventative care model

Physical Health & Safety

Emotional & Mental Well-being Social & Economic Challenges

within Women’s Health at Cheshire Medical Center Through confidential screenings and a shared decision-making process, patients can learn about their options for support and decide what next steps they’d like to take. Providers in Women’s Health at Cheshire Medical Center have long embraced a biopsychosocial model of health care—one that recognizes how biology, psychology, and socio-economic factors interact to impact our well-being. Now, they are taking this commitment one step further with the Right Care Prevention Model, a screening process designed to identify challenges patients are facing during pregnancy—from food insecurity to substance use to a lack of housing—and connect them with care and resources using evidence-based interventions. “By the time people get to needing treatment for substance use, they’re really at a crisis point in their lives. And, so, we wanted to take a step back and think about, what are some of the ways we could prevent those troubles for our patients?” says Autumn Versace, MSN, CNM, APRN, Chief of Obstetrics for Cheshire Medical Center. Under the model, which was implemented over eight weeks in 2021 as part of Versace’s doctoral research, patients are asked about their housing situation, personal support network, and experiences with violence or trauma, as well as any struggles with depression, anxiety, or substance use. Through a shared decision-making process, patients then learn about their options and decide what next steps they’d like to take, whether it be a referral to the center’s Pregnancy Wellness Program, its Mothers in Recovery program, or a community partner such as the Monadnock Center for Violence Prevention or Home Healthcare, Hospice and Community Services. In the first six weeks of implementation, the team identified unmet needs in about 59 percent of the patients screened, Versace says. “We can use pregnancy to connect people with resources. It’s a time when a lot of those resources are really available, and families are

really motivated to take advantage of them because they’re thinking about how their family is either starting or growing,” Versace says. “… And it’s also a time that they see a lot of us in health care.” That ongoing relationship is crucial, she notes, because these challenges are complex and often require follow-up over multiple appointments. And, because patients are directly involved in the decision-making process, they have a better understanding of the care they’ll receive, says Rose Hitchings, PsyD, who offers wellness classes, birth preparation consultations, birth story exploration, and other support at Cheshire through the Pregnancy Wellness Program. “I think they have a keener idea and more personal selection and understanding of the referral,” Dr. Hitchings says. “So I think that shared decision making is helpful in giving patients an opportunity to know about and decide what support they are seeking.” The screening also helps normalize open discussion of social and emotional challenges, and communicate to patients that addressing these needs is a priority at Cheshire. Some patients might worry, “‘If I state these symptoms, how am I going to be treated?’” Dr. Hitchings says. “So knowing that we value emotional health as much as we value physical health additionally decreases that stigma as well.” Versace says the research findings will help Cheshire hone in on the community’s needs and improve its screening process and interventions for the future. “I think really the most exciting thing about working in health care is solving those mysteries, and doing it in partnership with the patients and the provider group and our partners in the community,” she says. 

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Community Health Spotlight

Help for substance use disorder

Medication-assisted treatment now offered by the Doorway The Doorway at Cheshire Medical Center now offers medication-assisted treatment (MAT)— medications in combination with counseling and behavioral therapies—which is effective in the treatment of opioid use disorders (OUD) and can help some people sustain recovery. The Doorway prescribes buprenorphine, a medication approved by the Food and Drug Administration (FDA) to treat OUD, combined with face-to-face counseling and reporting via phone app, to provide patients with a comprehensive patient-centric treatment program. “With COVID-19, many of the MAT programs were only offering a weekly virtual group therapy option combined with medication,” says Nelson Hayden, MA, MBA, LADC, director/clinician at the Doorway at Cheshire Medical Center. “We wanted people to have the option to connect with a counselor and meet face-to-face if desired, so we created

our program with our board-certified addiction specialist, Dr. Dawn Harland.” As a medical provider at The Doorway, Dawn Harland, MD, FACP, FASAM, has helped at Cheshire Medical Center to increase referrals to the program from Cheshire’s hospitalists and Emergency Department providers. Harland also supports primary care physicians and hospitalists in the initiation of MAT. “Recovery is real, it’s great, and it’s available today by calling 211 or visiting our Keene location,” says Hayden. “We are ready to take care of you or your loved one and connect you to support.” Whether you are seeking help for yourself or a loved one or are only looking for information and resources related to drugs or alcohol, The Doorway is the right place. The Doorway is a free service. It is supported by the Center for “We wanted people to have the Population Health (CPH) at Cheshire.

To learn more about The Doorway at Cheshire Medical Center, and view stories of those in recovery, visit: cheshiremed.org/community-programs/the-doorway.

option to connect with a counselor and meet face-to-face if desired, so we created our MAT program

Getting help

with our board-certified addiction

Misuse of potentially harmful substances, such as opioids or alcohol, to the extent that it interferes with a person’s well-being and/or ability to participate in daily activities, is referred to as a substance use disorder (SUD). Starting with the right treatment and support, many people can sustain recovery from SUD.

specialist, Dr. Dawn Harland.”

It’s important to remember that SUD is a diagnosable medical condition that requires treatment. It is not a moral failing—it is a treatable illness that can affect anyone. No group or individual is immune to the reach of SUD. Learn more about substance use disorder in New Hampshire and the help available at: thedoorway.nh.gov.

– Nelson Hayden, MA, MBA, LADC, Director, the Doorway at Cheshire Medical Center

Do you or your loved one need help? Call 211 to talk with someone at The Doorway or visit us at 24 Railroad Street in Keene, Monday–Friday, 8:00 a.m.–5:00 p.m.

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Through community partnerships, the Mothers in Recovery program extends support to families beyond birth If you are pregnant and struggling with opioid use disorder, Cheshire Medical Center’s Mothers in Recovery (MIR) program is here for you leading up to birth. We also recently added support after birth—thanks to a community partnership with Home Healthcare, Hospice & Community Services (HCS). MIR offers pregnant people with opioid use disorder a combination of medicationassisted treatment (MAT) and comprehensive prenatal through postpartum care. Participants attend weekly group therapy with others who understand the recovery journey from opioid use disorders. Group therapy and medical management continue after you give birth, focusing on substance use therapy and just being a parent—with others who can understand. In 2020, MIR partnered with Healthy Starts, a voluntary, strength-based prevention program at HCS. Six to twelve months after birth, MIR participants graduate and are welcomed into the Healthy Starts expanded MIR program. The Healthy Starts team of social workers, nurses, and home visitors partner with families to offer parenting education, connection to resources, and support. Healthy Starts focuses on building a social network of healthy relationships so you can share the struggles and joys of parenting while in recovery. You will also learn about your child’s growth and development. Better Life Partnerships provides MAT for the program and facilitates group support. “The evolving options for parents that have entered into our program speak to the commitment our community has in supporting those affected by opioids,” says Rose Hitchings, PsyD, who leads the MIR program. “Because we so closely work with Healthy Starts during prenatal care and into postpartum adjustment, there is trust and comfort for people to transfer into community programs specifically tailored for their family needs.” For treatment and care to be successful for both you and your baby, it’s essential to be open to joining with others in healing. The MIR health care team includes an obstetric and gynecologic (OB/GYN) physician or certified nurse-midwife, a clinical psychologist, and a nurse care coordinator. It’s important to collaborate with your health care team to create a treatment plan that works for you. You’ll also benefit from working with community agencies supporting recovery coaching and resource coordination. “I love this program,” said one MIR graduate. “It is life-changing. The amount of support you get—not only about recovery but everything else about being a parent—is amazing. And resources? Having HCS be a partner is so good. If you need anything, they will help. We got housing, day care, insurance, and so many other needs met.”

m thers in recovery

P R O G R A M

If you are pregnant and in need of medication-assisted treatment for opioid use disorder, contact us to learn how you can participate in the Mothers in Recovery program. Located in the Women’s Health Center at Cheshire Medical Center in Keene, this special program offers you and your baby the care and support you both need to get a healthy start.

To learn more about Mothers in Recovery, call 603-354-5440 or visit: cheshiremed.org/pregnancy-birth/mothers-recovery. Dr. Rose Hitchings interacts with one of the children who have benefited from the Mothers in Recovery program.

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Excellence in Care

A weight-loss plan that includes bariatric surgery can help you make lasting improvements to your health and well-being.

Bariatric weight-loss surgery Is it right for you? The team of experts at Cheshire Medical Center are here to help you find the best weight-loss plan for your health and well-being. If you have obesity, bariatric surgery can help you get to and maintain a healthier weight and more active lifestyle. However, it is not a quick fix. Bariatric surgery is just one part of your weight-loss journey— the other part requires a lifelong commitment to a healthy lifestyle. During the evaluation and inquiry phase, you will learn more about the various options and the pros and cons of each. Our Cheshire Medical Center Bariatric Surgery Department—opened in 2020—will also work with your primary care team to look at your overall health and wellness to determine if you are a candidate for weight-loss surgery.

Weight-loss surgery may change your life A weight-loss plan that includes bariatric surgery can help you make lasting improvements to your health and well-being. Health benefits can include:  Improving diabetes  Eliminating sleep apnea  Helping control high blood pressure  Reducing the risk of heart disease  Decreasing symptoms of joint disease, such as arthritis  Reducing gastroesophageal reflux disease (GERD) symptoms, such as heartburn  Improving fertility Depending on your procedure, bariatric surgery may help you lose 40% to 70% of excess body weight over two to three years. The outcome of your weight-loss journey all depends on your commitment to the individualized plan you create with our team.

BARIATRIC SURGICAL PROCEDURES At Cheshire Medical Center, we offer bariatric surgical procedures and revisions of previous procedures. If you are a possible candidate for bariatric surgery, our team will discuss which procedure is best for your needs. Learn more about the procedures we offer at cheshiremed.org/wtlosssurgery.

Gastric Bypass Surgery reduces the size of the stomach. It reroutes a small portion of the small intestine so you feel full after eating only a small amount of food and absorb fewer calories. Laparoscopic Sleeve Gastrectomy is where a small, sleeveshaped stomach is created. The sleeve reduces the size of the stomach. There is no rerouting of the intestine. Laparoscopic Adjustable Gastric Banding can be managed at Cheshire Medical Center. We offer band adjustments, removal, and conversion to another bariatric procedure.

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Am I a candidate? Keep in mind that bariatric surgery is not a magic cure for people with obesity. It is a tool to help you lose weight along with a healthy diet and regular daily exercise. Bariatric surgery may be an option for you if you have:  A Body Mass Index (BMI) of 35 or more  Not maintained long-term weight loss with diet and exercise  An absence of any untreated major psychiatric or eating disorder  No active substance misuse  The ability to follow dietary, exercise, and behavioral recommendations  No plans to become pregnant around the time of surgery After an introductory session, you’ll work with our bariatric team to determine whether bariatric surgery is the right choice for your weight-loss journey.

“After surgery, make sure you keep your follow-up appointments, get your lab work tested yearly, and just keep in touch with your doctors and your team. They will be your support from the day you make that commitment.” –Neena Howland

One patient’s experience and advice

Cheshire’s team-based approach A weight-loss journey, including bariatric surgery, requires ongoing care. Our comprehensive, team-based approach is designed to help you achieve long-lasting results so you can get the most out of life. Our team of bariatric specialists includes psychologist Rose Hitchings, PsyD; bariatric dietitian Ashley Bombacino; nurse practitioner Kate Ingram, MSN, APRN; bariatric surgeon Paul Sanders, MD; and patient navigator Samm Johnson to help you every step of the way.

Connecting with a community of support Sustained lifestyle change is easier when you have the support of a community of people who share your goals. After your procedure, you will benefit from a monthly support group that embraces the same healthy, active lifestyle.

Take the first steps to learn more Call 603-354-5476 to register for a free introductory session where you will:  Learn about the options, benefits, and risk factors of weight-loss surgery.  Understand how your commitment to a healthy lifestyle is vital to success.  Determine if this is the right choice for your health and wellness.

Neena Howland remembers coming to grips—at 24 years old—with the fact that she needed to make a change. Obesity and high blood pressure prevented her from carrying her 2-year-old daughter without getting short of breath. “I knew I had to do something for myself,” Neena, now 29, says. After researching her options and meeting with a surgeon, she made the decision to undergo weight-loss surgery at Cheshire Medical Center in 2015. It changed her life. In the years since her surgery, she’s lost 144 pounds and her weight is no longer holding her back. “I’m able to actually enjoy my life,” Neena says. “I’m able to play with my kids. I can run around with them without getting short of breath, without having any kind of medical issue. I can run a 7-minute mile. I can look forward to seeing my kids graduate, get married, and have kids. I can enjoy life with them and not sit out while they’re having fun. I’ve been able to improve my life for the better.” In the years since her surgery, Neena meets regularly with Kate Ingram, MSN, APRN, a nurse practitioner and member of the bariatric surgery team, who helps her balance out her diet and exercise regimen so she can stay at a weight where she’s comfortable—and healthy. “After surgery, after losing weight, after reaching goals (or not) but being satisfied with what you have accomplished, you still want those people in your corner,” Neena said. “You want the person you can send an email to via your myD-H account to just make sure you’re doing the right thing, to come into the office to do a weight check, or even if you’re just losing your motivation and need a pep talk, you want that person to say, ‘Remember where you started? Look at what you have accomplished! Look at what you are now! You are a rockstar!’ “Make sure you keep your follow-up appointments, get your lab work tested yearly, and just keep in touch with your doctors and your team. They will be your support from the day you make that commitment.” For anyone considering this type of surgery, Neena says knowledge and commitment are critically important. “Make sure you do your research, talk to your providers, and do everything you’re told to do,” Neena says. “In the long run, it may seem scary, but it’s totally worth it. Some people may say that it’s a cop-out, but in the end, it’s not. It will help you.”

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Careers at Cheshire Spotlight Colton Mailloux and Malorie Powers, shown here working with a training mannequin, are participants in the Nurse Assistant Training program offered at Cheshire Medical Center.

At Cheshire Medical Center, our priority is to hire well-trained, competent individuals to care for our family members, friends, neighbors, and community. Training programs are not plentiful in our region, so we’re answering the call and building our own. We focus on developing educational opportunities and career training programs that expand the skillset and expertise of our current employees so they can advance their careers. Cheshire also has been expanding its workforce development programs that train individuals for specific careers through a collaboration with Dartmouth-Hitchcock’s Workforce Readiness Institute. “With these training programs, we are able to ensure that our organization has the workforce we need and that our staff have the skills needed to serve our community,” says Anthony McLean, DEL, RN, FACHE, NEA-BC, Cheshire’s director of inpatient services. “These programs are absolutely essential to the continued success of our mission.” Nurse Assistant Training Programs Cheshire offers two workforce development programs on-site for individuals to become Licensed Nurse Assistants. Both of the programs include Cheshire employees, as we hire individuals into the programs or they are current employees that transfer: One is taught by Cheshire staff instructors, the other is taught by River Valley Community College and includes community members. Candidates for both programs apply to the program and, if accepted, are paid a training wage during the 125-hour program. Upon successful completion, the participants work as Licensed Nurse Assistants in our inpatient units for a minimum of two years in return for Cheshire’s sponsorship of their tuition and testing fees.

Training programs are growing our workforce

Our Nurse Assistant training programs are offered year-round with both daytime and evening class options. Medical Assistant Apprenticeship Training Program Cheshire’s on-site Medical Assistant Apprenticeship training program—an 11-week, US Department of Labor Registered Apprenticeship—is offered annually. Students who successfully complete the program earn 25 credits from Colby-Sawyer College, and can earn an additional 21 college credits during their 2,000-hour apprenticeship for free. Trainees can use the credits earned toward completion of an Associate of Science in Health Science (60 credits) at Colby-Sawyer. While pursuing their degree, Cheshire employees can use their tuition reimbursement benefits, potentially paying minimal—if any at all—out-of-pocket expenses to earn their degree. Upon completion of the classroom training, the student must pass a national exam to become a Certified Clinical Medical Assistant, then complete a 2,000-hour apprenticeship where they are evaluated on behavioral and technical competencies. Cheshire employees have a 100% pass rate on the national exam. In addition to these programs, Cheshire also collaborates with Dartmouth-Hitchcock’s Workforce Readiness Institute to offer training programs for Surgical Technologists and Pharmacy Technicians. For more information on these and other programs, please visit: cheshiremed.org and dhwri.org. Or contact Sarah Tatro at statro@cheshire-med.com.

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Circle of Gratitude Spotlight

A routine visit becomes a lifesaver

and a gesture of gratitude completes the circle of caring and connection Brooke Garger, MSN, APRN, now a nurse practitioner in Cheshire’s Cardiology Department, chose a career in health care after first pursuing wildlife biology. “I switched paths because I didn’t feel like I was making a difference,” Garger says. “Now I do.” In addition to bringing Garger personal and professional fulfillment, her decision to change career paths also has saved lives. This is certainly the case for patient Michael Chirichella, who had been feeling “a little off ” before a routine check-up with Garger. His visit took an unexpected and serious turn after Garger reviewed his electrocardiogram (EKG) results. “I probably would not be here today if Brooke “I am extremely honored. hadn’t done her job so well,” Michael says of the It feels really good to be care Garger provided. “She appreciated and to know that looked at me and said, I made a difference in their ‘You’re not going home.’” Michael was immediately lives when they needed it escorted to Cheshire’s most. Everyone at Cheshire Emergency Department works hard, regardless of the for monitoring, then to Dartmouth-Hitchcock department they are in. It is

Medical Center in Lebanon, where he eventually underwent triple bypass surgery. To show their appreciation of Garger’s focus and dedication, Michael and his wife, Lillian Chirichella, recently honored her through Cheshire’s Circle of Gratitude program. “Brooke was just awesome,” says Lillian. “The immediacy of her response really impressed us. We wanted to recognize her for her commitment and follow-through. We are just so incredibly grateful.” The Chirichellas are delighted that the Circle of Gratitude gave them a way to acknowledge the exceptional care Michael received. After going through a significant health crisis, they hope their story will inspire other patients to recognize providers and staff who made a difference in their care through the Circle of Gratitude. “I am extremely honored,” Garger says. “It feels really good to be appreciated and to know that I made a difference in their lives when they needed it most. Everyone at Cheshire works hard, regardless of the department they are in. It is amazing to have a personal connection and recognition because of the work you do.” To learn more about the Circle of Gratitude, or to honor a provider or other employee who has made a positive difference in your visit or care, please visit: cheshirehealthfoundation.org/circle-of-gratitude.

amazing to have a personal connection and recognition because of the work you do.”

HONOREE Brooke Garger, MSN, APRN Nurse Practitioner, Cardiology

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Community Health Spotlight

Wellpowered Worksites Program

Fostering a culture of engagement and wellness during a pandemic Electronic Imaging Materials, Inc. (EIM), a family-owned label manufacturing company in Keene, is no stranger to rethinking how worksite wellness is done. EIM has been a member of the Wellpowered Worksites program since the spring of 2018, and, since joining, has become the gold standard for worksite wellness in the Monadnock Region. Wellpowered Worksites, a program offered through Cheshire’s Center for Population Health, helps organizations assess their employee wellness programs, policies, benefits, and physical workplaces to help create opportunities for employees’ well-being. EIM’s worksite wellness efforts include a progressive Babies at Work program, themed parties, Hawaiian shirt Fridays, on-site ice cream trucks, and even dogs in the workplace. However, when COVID-19 hit our region and half of EIM’s employees started working from home, Jillian Bishop, marketing and engagement manager and co-chair of their in-house Engagement Task Force (ETF), needed a new way to keep employees’ spirits up. Her solution? Keep the EIM family together even while they’re apart. “We’re always looking for ways to weave fun and laughter into our workdays. Throughout 2020, it had been a struggle for us to keep people engaged,” says Bishop. “We realized we needed to keep our office culture going even if we weren’t all together.” During 2020, EIM has hosted virtual Halloween costume competitions, gingerbread house “build-offs,” and has already signed up to participate in Right This Way, a 10-week wellness challenge offered through Cheshire’s Wellpowered Worksites program this summer. Bishop is excited for this year’s challenge, and says Pepper and Maddie—their two office pups—will help keep their teams active and motivated to get their 10,000 daily steps. “I can’t wait until we are all able to safely be back in the office again” says Bishop. “The EIM family welcomed two new babies in 2020—one human and one very energetic shepherd mix—and we are welcoming another baby in a few months. As a designated baby-holder, I am really looking forward to being back in the office.”

Office pup Pepper stands at the ready to be an inspiration and support for employees at EIM to get their 10,000 daily steps.

Emotional and mental well-being doesn’t follow a punch clock. Whether you’re working from home or still making that daily trek into the office, there’s all sorts of ways to ensure you're taking care of your emotional well-being, both while on the job and off it. Turn to page 28 to check out our educational program offerings, including “Paths to Well-being,” which will teach you habits and skills and to “hardwire” your mind and body toward greater resilience and well-being. Also, see our story on page 11 on using the acronym “S.T.O.P.” when you’re feeling overwhelmed or out of sorts.

Wellpowered Worksites, a program offered through the Center for Population Health at Cheshire Medical Center, is available to local organizations in the Monadnock Region at no cost. With the help of a certified wellness advisor, organizations are provided resources and concrete tools to enhance and improve their worksite wellness program. Learn more at: cheshiremed.org/community programs/wellpowered-worksites.

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{ Ingredients for Healthy Eating }

Good for so much more than just soup or beer! Rich in vitamins and minerals, this whole grain provides many health benefits.  Barley is an excellent source of both insoluble and soluble fiber, which aids in better digestion and can lead to the prevention of gallstones.  Barley contains beta-glucans, which have shown promise in lowering cholesterol.

Greek Toasted Barley Salad · 1 cup pearl barley · 2 ½ cups vegetable broth Preheat oven to 375 ̊ F . Place the barley on a cookie sheet and toast in the oven for about 8 minutes until toasty brown. Bring broth to a boil in a medium saucepan. Add barley to boiling stock and cook until tender (25–30 mins). Spread out barley on another cookie sheet and cool in the fridge. While barley is cooling, prep the other ingredients.

}

Barley works well in the place of rice and can be used as a stuffing to add an extra nutrient kick to your dishes. When toasted, it has a rich, nutty flavor. This easy recipe for Greek Toasted Barley Salad compliments that flavor with a tangy dressing and lots of veggies.

Serving size: 1 cup Yields: 5 servings

Dressing: · ½ cup extra virgin olive oil · ¼ cup red wine vinegar · 2 tsp chopped garlic · 1 tsp honey · ¼ cup fresh chopped basil · 2 tbsp fresh chopped oregano · 2 tbsp fresh chopped flat leaf parsley · Salt & pepper to taste Salad add-ins: · 1 cup diced or sliced cucumber · 1 cup halved cherry tomatoes · ½ red onion, finely diced · 1 tsp chopped garlic · 1 yellow bell pepper, chopped · 1 can chickpeas, drained & rinsed · 1 cup crumbled feta cheese

In a small bowl, combine dressing ingredients and whisk vigorously until well blended. In a large bowl, gently mix together the cooled barley and vegetables. Slowly add the dressing and continue mixing together. Chill before serving. When it is time to serve, crumble feta over each portion.

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Health + Wellness

E d u cati o nal P ro g ram s The 2021 spring workshop series will be offered on Zoom. Join us from the comfort of your home to learn about various healthrelated topics, ranging from mental health to retirement and everything in between. Download Zoom on your phone or desktop for easy access. Check out the listings below and visit cheshiremed.org/health-wellness/events to register.

Ongoing Virtual Support Groups Talkin’ Diabetes Support Group

Bariatric New Patient Support Group

Our free support group will help you connect with others who have diabetes and stay motivated to take care of yourself. Facilitated by Cheshire’s outpatient registered dietitian, this group is an informal opportunity to ask questions, share information, and learn new tools and coping strategies. Second Thursday of every month 5:30 - 6:30 p.m. Join on Zoom - Meeting ID: 832 4419 0373 Or Dial In: +1 (646) 558-8656

Everything changes after bariatric surgery, and for most patients, it’s not uncommon to feel frustration, regret, and anxiety as patients and their families struggle to adapt to the bariatric lifestyle. This group is designed for patients considering bariatric surgery or within the first year of their surgery. This is an open format that allows the opportunity to share anxieties, answer questions, demystify the process for family and friends, provide reassurance, and build confidence through a network of social support. First Wednesday of every month 5:00 - 7:00 p.m. Join on WebEx - Meeting ID: 120 314 1318 Password: Keene2021

Ruth Goldstein MS, RD, LD, Outpatient Registered Dietitian, Cheshire Medical Center

Flourishing Skills Group

Jennifer Begley and Tom Stearns, PhD, Cheshire Medical Center Resilient Living Team We could all use a little help reducing stress, building resilience, and cultivating joy to create more meaningful, happy lives. This monthly skills group will allow you to tune inward and use Positive Psychology tools to improve your life in a non-judgmental, supportive group setting. Think of it as a support group for happiness and well-being. First Tuesday of every month 5:15 - 6:30 p.m. Join on Zoom - Meeting ID: 843 7587 3329 Passcode: HAPPY Or Dial In +1 (929) 205-6099 OR

Meeting ID: 843 7587 3329 Passcode: 125731

Kate Ingram, APRN, Nurse Practitioner, Cheshire Medical Center

Bariatric Established Patient Support Group Kate Ingram, APRN, Nurse Practitioner, Cheshire Medical Center

This group is designed for patients who are at least one year postoperative. This format follows a structured topic each month and reinforces the key principles of success, celebrates milestones, assists and supports those who have gotten off track, and provides high-quality education to patients and providers. Third Wednesday of every month 5:00 - 6:30 p.m. Join on WebEx - Meeting ID: 120 511 5738 Password: Keene2021

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May Programs COVID-19 Vaccines: An Overview

Aalok Khole, MD, Mary Pierce, and Erin Patnode, RN Department of Infectious Disease, Cheshire Medical Center This workshop will provide information about COVID-19 vaccines that have been authorized for emergency use. We will talk about the technology behind these vaccines, indications, contraindications, side effects, immunization for special populations, and what the future holds with respect to the ever-changing landscape of COVID-19. Monday, May 3 6:00 - 7:30 p.m. Join on Zoom - Meeting ID: 873 7886 7840 Or Dial In: +1 (646) 558-8656

Thriving Parents, Thriving Children

Sue Ellen Sweeney, RN, MS, Transformational Life Coach, Life Mastery Consultant Are you a parent of an infant or young child feeling overwhelmed, stressed, and frustrated? Does this sometimes cause conflict with your partner? During this workshop you will go through six steps to help you get on the same page with your partner and begin creating a plan for your family to thrive. It is possible. You can be the conscious, competent, confident parent and partner you have always wanted to be and become your best self in the process. Choose a two-part session: Monday, May 3 & Wednesday, May 5 8:00 - 9:00 p.m. Join on Zoom - Meeting ID: 867 0047 8697 Or Dial In: +1 (646) 558-8656

Effective Communication Strategies Nichole VonDette, Volunteer, Alzheimer’s Association In this workshop, you will explore potential communication changes due to dementia. You will also learn the skills needed to connect and communicate successfully throughout the disease process. Join Nichole to learn how to foster compassionate communication with your loved one. Thursday, May 6 5:00 - 6:30 p.m. Join on Zoom - Meeting ID: 812 0971 8050 Or Dial In: +1 (646) 558-8656

Safe and Satisfying: Eating with Dysphagia Dietetic Interns, Keene State College People with dysphagia struggle to swallow properly and may find it difficult to stay nourished and hydrated. However, it is possible to prepare dishes that meet nutritional needs, while also ensuring a safe consistency. Join the KSC Dietetic Interns as they discuss how to create satisfying meals and beverages.* *Please note that this is a presentation for education purposes only with general nutrition education provided. For individualized medical nutrition therapy treatment, please make an appointment to see a Registered Dietitian. Learn more at cheshiremed.org/nutrition-services. Tuesday, May 11 6:00 - 7:00 p.m. Join on Zoom - Meeting ID: 835 0481 8416 Or Dial In: +1 (646) 558-8656

Managing your Stress and Trauma

Monday, May 24 & Wednesday, May 26 7:00 - 8:00 p.m. Join on Zoom - Meeting ID: 859 5100 7074 Or Dial In: +1 (646) 558-8656

Sharon Leflamme, Certified Somatic Experiencing Practitioner, Creating Serenity LLC

Reframing Aging

Shawn LeFrance, Vice President, Center for Population Health, Cheshire Medical Center, and Jennifer Seher, Program Director, Service Link Learn about change efforts in New Hampshire to challenge conventional wisdom about aging that will provide you with communication tools when talking about aging. New research shows that aging is misunderstood in America. Misperceptions and stereotypes lead to discrimination against older people in many areas of life, from health care to the workplace. Our speakers will introduce you to resources of the national Reframing Aging Initiative and engage participants to improve their understanding of what aging means and the many ways that older people contribute to our society. Thursday, May 6th 10:00 - 11:00 a.m. Join on Zoom - Meeting ID: 844 6813 3894 Or Dial In: +1 (646) 558-8656

Managing your stress during these difficult times is crucial for your overall health and well-being. In this workshop, we will discuss chronic stress, trauma, and stressful events, as well as how stress affects us and how we can mitigate the effects. You will have the opportunity to explore Somatic Experiencing, along with body awareness, breathing techniques, and meditation. Wednesday, May 12 3:00 - 4:00 p.m. Join on Zoom - Meeting ID: 850 9882 9640 Or Dial In: +1 (646) 558-8656

Visit cheshiremed.org/health-wellness/events to register for these free programs.

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Health + Wellness E d u cati o nal P ro g ram s

Paths to Well-being

The Science of Being Calm

Jennifer Begley and Tom Stearns, PhD, Cheshire Medical Center Resilient Living Team

Mahmoud Rashidi, MD, Mind Medicine LLC

How can I manage stress more effectively? What are the habits and skills of daily living that contribute to greater happiness and well-being? People have been asking these questions for many years, if not millennia. Wisdom gathered through the years has guided us. More recently, scientific exploration has provided us with additional evidence regarding the types of practices that help answer these age-old questions. This program will provide an overview and introduction to practices and specific skills that contribute to “hardwiring” our minds and bodies toward greater resilience and well-being. Three-week session: Wednesdays, May 12 - 26 5:00 - 6:00 p.m. Join on Zoom - Meeting ID: 846 1294 7607 Or Dial In: +1 (646) 558-8656

Communicating Across Generations: Love Your Community, Family, and Workplace Sahana Hall, Deputy Director, Rockefeller Center at Dartmouth College In this highly interactive workshop, you will use storytelling to gain new perspectives and insights about different generations. You will develop ideas and strategies to improve communication with generations different from your own. We will focus on the positive attributes of generational differences and how to use them for building relationships and a vibrant workplace. You will also have a chance to get feedback from other participants about your strategies for improving your communication with different generations. Wednesday, May 19 6:00 - 8:00 p.m. Join on Zoom - Meeting ID: 880 5515 0790 Or Dial In: +1 (646) 558-8656

Transitioning in the Workplace Nick Ferraiolo, Elm City Coaching LLC In this presentation, Nick will share an understanding of the challenges he faced while transitioning gender in the workplace. Nick’s presentation is based on personal narrative storytelling, which will follow the stages of coming out in the workplace, corporate bullying, and personal growth from the lessons he learned from this experience. Be prepared to laugh, cry, and be empowered by this presentation. Thursday, May 6 5:00 - 6:30 p.m. Join on Zoom - Meeting ID: 823 0881 6644 Or Dial In: +1 (646) 558-8656

Dr. Rashidi, neurosurgeon and author of Mind Medicine: Use Your Thoughts to Heal, is dedicated to researching, teaching, and promoting ways to help the mind and body heal. A calm state of mind can have a profound effect on an individual’s well-being. Dr. Rashidi will provide a brief overview of stress, the different kinds of stress, and the impact of chronic stress on health and healing. He will also discuss the relaxation response versus the stress response and how to elicit a relaxation response, while touching upon anxiety, worry, and panic attacks and how to stay calm in any situation. There will be time for questions and discussion. Thursday, May 27 6:00 - 8:00 p.m. Join on Zoom - Meeting ID: 867 8172 9242 Or Dial In: +1 (646) 558-8656

June Programs Changing the Culture Surrounding Mental Illness: It’s Way Past Time John T. Broderick, Jr., Senior Director, External Affairs, Dartmouth-Hitchcock and former Chief Justice, New Hampshire Supreme Court John Broderick shares a presentation detailing his family’s journey with mental illness and the important lessons they learned. He explains the five most common signs of mental illness and how best to R.E.A.C.T. when you see the signs of emotional suffering in another person. Learn how common mental health issues are, when they are likely to begin, and how we might improve how we all view and treat mental illness. After his presentation, John will join us live for a robust discussion, including time for Q&A. Wednesday, June 2 6:00 - 7:30 p.m. Join on Zoom - Meeting ID: 844 8896 4119 Or Dial In: +1 (646) 558-8656

Thinking about Eating Organic? Here’s How to Get Started Ruth Goldstein MS, RD, Outpatient Registered Dietitian, Cheshire Medical Center Take a practical look into the wide world of organic food, including what makes organic foods unique and reasons to consider adding some into your diet. Learn what to look for on labels and how to navigate confusing terms, such as natural, free-range, pasture-raised, grass-fed, sustainable,

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organically-raised, and Certified Organic. This presentation includes links to some free resources to help you make choices in the grocery store and a 30-minute Q&A session to make sure your questions are addressed. Thursday, June 3 5:00 - 6:30 p.m. Join on Zoom - Meeting ID: 813 0117 3854 Or Dial In: +1 (646) 558-8656

Diversity and Cultural Competency Dawn Welshman, Tracy Clark, and Ruth Abbott, Cheshire Medical Center This training is designed to help participants understand the similarities and differences between the concepts of diversity and culture, identify some of their own cultural assumptions, and discern if these ideas are useful cross-culturally. If not, the presenters discuss ways to improve and identify areas that can better meet the needs of diverse populations. Note: Participants must be able to attend both sessions. Registration ends June 1, 2021 Two-part session: Monday, June 7 and Wednesday, June 9 5:00 - 7:30 p.m. Join on Zoom - Meeting ID: 886 3591 3335 Or Dial In: +1 (646) 558-8656

Healthy Eating in Retirement Dietetic Interns, Keene State College With every life transition comes new challenges to overcome. Making the decision to join a retirement community is a big step, and navigating a new food environment can be intimidating. Join the KSC Dietetic Interns as they discuss how to make healthy choices when you don’t have much control over the food you are served.

Vision Workshop: Three Keys to Accelerating Your Results

Sue Ellen Sweeney, RN, MS, Transformational Life Coach, Life Mastery Consultant Do you want to experience more prosperity and balance in your life, in spite of challenging times? Are you pouring your heart and soul into your work and still not getting the results you want? Would you like to increase your success while staying in complete harmony with your highest values and spiritual beliefs? If these questions resonate with you, then you are going to love this workshop! Monday, June 14 6:00 - 7:30 p.m. Join on Zoom - Meeting ID: 879 3307 7324 Or Dial In: +1 (646) 558-8656

Be Good to Your Feet: Common Foot and Ankle Problems David M. Pinegar, DPM, Podiatry, Cheshire Medical Center Did you know that foot and ankle complaints result in more than 5.3 million visits to doctors each year? Join us to learn about everyday foot and ankle problems, such as bunions, hammertoes, heel pain, flat foot, and common ankle pain. You will also learn about the causes, symptoms and treatments for plantar fasciitis (also known as “heel spurs”). Join Dr. Pinegar as he provides tips to help you be good to your feet. Wednesday, June 16 6:00 - 7:30 p.m. Join on Zoom - Meeting ID: 883 3877 2875 Or Dial In: +1 (646) 558-8656

Thursday, June 10 6:00 - 7:00 p.m. Join on Zoom - Meeting ID: 836 8841 1518 Or Dial In: +1 (646) 558-8656

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There are many ways to show your support for Cheshire Medical Center. ANNUAL FUND - Support Cheshire’s COVID-19 response, including purchases of personal protective gear, specialized equipment, and more.

to Cheshire's Annual Fund because “weWeknow,givefrom both personal and professional

Your gift

makes a world of

difference.

experience, that our donation not only helps the Medical Center carry out its mission of caring for the community, but also directly impacts the health and well-being of patients and employees. We are proud to be of service to others in this way.

”

– Neha Varma and Aalok Khole, MD, Cheshire Infectious Diseases Physician

CIRCLE OF GRATITUDE - Recognize and thank a Cheshire employee with a donation in their honor.

After my own, very favorable, experience “at Cheshire, it was important to acknowledge through the Circle of Gratitude how valuable the Medical Center’s staff were to me while promoting my wellness and recovery. It’s worthy of bringing attention to outstanding and supportive care, and a vital part of the give-back to the providers.

”

Nonprofit hospitals like Cheshire Medical Center rely on local support to keep pace with the growing needs of the communities we serve.

– Samantha Wilhelm, Grateful Patient

Your donations fund key investments PLANNED GIVING - Name Cheshire Health Foundation as a

beneficiary of your will, trust, retirement plan, or life insurance policy.

We have such a wonderful medical “facility, with caring, skilled staff, and it is right here–we don’t have to travel! I feel fortunate to have had Cheshire Medical Center’s level of care and medical expertise all these years, from when I was raising my children, to care throughout my own life. To show my appreciation, a bequest to Cheshire has been added to my will so that the Medical Center will one day receive a special gift.

”

– Ceil Goff, Cheshire Health Foundation Trustee

To learn more, visit cheshirehealthfoundation.org or call 603-354-6800.

in state-of-the-art technologies, health and wellness programs, educational opportunities, and patient financial assistance, ensuring exceptional care for our region.

Thank you!