March/April 2012
Coordinated Health The Magazine
What’s Inside: Leave your Seasonal Allergies in the Dust! Ways to Exercise at Home Without Equipment Improving Sports Performance Avoiding Springtime Hand Injuries Fad Diets And Much More!
“Your Prescription for Better Health” Feel free coordinatedhealth. to take this magazine home! com
As you age, your risk of developing breast cancer increases.
Bring Someone You Love Schedule a Mammogram Today! Coordinated Health Hospital Network is proud to welcome
Advanced Imaging for Breast & Body.
Advanced Imaging brings a new dimension of care to Coordinated Health. Services offered are: • • • •
Screening & Diagnostic Mammograms Ultrasound PET Mammography (PEM) Breast MRI
• Breast Biopsies • PET/CT • HDR Brachy Therapy
Same Day Appointments Breast imaging services available at: Allentown Campus at Cetronia Road 250 Cetronia Road, Suites 102 & 110 Allentown, PA 18104
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March/April 2012
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Letter From the Editor Editor
Amanda Boyce
Writer
Hannah Ropp
Design and Layout Rick Woods
Contributing Authors Scott Sauer, MD Orthopedic Foot & Ankle Surgeon
Charles Norelli, MD Physical Medicine and Rehabilitation
Barry Sirard, MD Primary Care
Ryan Smith, DO Primary Care
Mary E. Loftus, DPM Podiatry
Raymond E. McCarroll, DPM Podiatry
Gayllyn Faust-Rakos, DO Gynecology
Dr. Deborah Villeneuve Gynecology
Dr. Bruce Viechnicki Gynecology
Amy Pucklavage, PA-C Physician Assistant
Ramia Atiyeh Pulse Performance Specialist
Molly B. McNeil Certified Athletic Trainer
Jeff Kroboth, CSCS Pulse Performance Specialist
Spring is traditionally a time of growth, which is something that Coordinated Health has seen an abundance of over the last couple of months. We’ve added several exciting new services and locations in an effort to streamline patient care and make your life easier. Some of our new specialties include Cardiology, Gynecology, Breast Health, Primary Care as well as Care on Demand walk-in facilities. We also continue to offer the same great services you have always known us for including, Orthopedics, Physical Therapy and Imaging. In this issue, we have several articles to introduce you to some of our doctors and services. For example, if you or a loved one suddenly suffers from bouts of sneezing, coughing or wheezing every spring, you don’t want to miss our article on seasonal allergies. Primary Care physician’s Dr. Barry Sirard and Dr. Ryan Smith will offer up some tips on how you can keep those allergy symptoms at bay so you can get out and enjoy the spring weather! Also, if you’ve ever struggled to find comfortable shoes then check out our article on what you should be looking for in footwear. Podiatrist’s Dr. Mary Loftus and Dr. Raymond Carroll will help put the spring back in your step with some practical guidelines to follow when it comes to buying shoes. You may also be surprised to find out what type of shoes you should avoid! Since this is the time of year when many people are eager to get outside and resume or begin a running regime, Orthopedic foot and anlke surgeon Dr. Scott Sauer has some advice on what runners can do to improve their performance and avoid injuries. He’ll also take you through the treatment options for some of the most common running injuries. If you’ve ever had back problems, you’ll definitely want to read what Coordinated Health Physician Dr. Charles Norelli has to say about preventing back pain. He’ll give you some ideas on what you can do at home and at work to ensure you keep your back healthy. He’ll also give you some tips on what you can do to stay comfortable during those long car trips. Endometriosis is a problem that plagues many women. Get the facts on this bothersome condition as well as some treatment options from Coordinated Health Gynecologist’s Dr. Gallyn FaustRakos and Dr. Deborah Villenueve. They have all the latest information about how you can manage endometriosis. One of our goals at Coordinated Health is to offer information you can trust to assist you in making the most educated decisions concerning your health. In addition to the Coordinated Health magazine, we have more details available at coordinatedhealth.com, where you can find information on all of our doctors and services. We also have several events and seminars coming up featuring some of our top physicians and clinicians. Check out the listings in the back of the magazine for more information. We’re excited about our continued growth and we thank you for continuing to choose us for your healthcare needs. v
Amanda Boyce coordinatedhealth. com
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March/April 2012
Too Much, Too Fast, Too Soon
Coordinated Health’s foot and ankle surgeon Dr. Scott Sauer lets you know to avoid common foot and ankle running injuries ........ 6
Leave your Seasonal Allergies in the Dust
6
Do you suffer from seasonal allergies? Find out what you can do to keep your symptoms at bay ................. 10
What You Can Do to Prevent Back Pain
Coordinated Health Physician Dr. Charles Norelli gives some tips on what you can do to prevent back pain .............. 14
Endometriosis
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Get the facts about this condition that affects millions of women from Coordinated Health’s Gynecologists ...................... 16
Could Your Shoes Be Wearing Out Their Welcome?
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Coordinated Health podiatrists point out what you should be looking for when you go shoe shopping ......................... 18
2D Echocardiogram
Find out more about this non-invasive cardiac test .............................. 22
Ways to Exercise at Home without Equipment
29 Features
Featured Physician Coordinated Health Cosmetic, Plastic and Reconstructive Surgeon Manny Iyer, MD
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Calendar of Events
28
Can’t afford the fancy equipment you find at a gym? Here are five exercises to do at home ............................................... 24
Improving Sports Performance
What you can do to improve on your sport’s perfornance ............... 26
Avoiding Springtime Hand Injuries
Enjoy spring gardening without hand injuries ................................. 29
Cough that Just Won’t Quit
What you can do about that nagging cough .................................... 30
Fad Diets
Find out more about today’s hottest diets ...................................... 34
What our Patients are Saying
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Welcoming Stephen Ksiazek, MD Cardiologist
&
Mohamed Salem, MD Interventional Cardiologist
to the Coordinated Health team Clinical Services • New patient evaluations • Pre-operative cardiac clearance • Lipid clinic • Anticoagulation clinic • Coronary artery disease • Heart failure • Valvular heart disease • Arrhythmia management • Syncope (fainting) • Hypertension • High cholesterol • Peripheral vascular disease
• Real time arrhythmia monitoring • Nuclear Cardiology • Nuclear stress tests • Echocardiograms • Stress tests • Echo/TEE • Vascular duplex imaging • Cardiac catheterization • Complex angioplasty - Coronary arteries - Peripheral vascular
For more information visit coordinatedhealth.com or call (610) 861-8080 coordinatedhealth. com
Warm weather is coming, which means it’s time to dust off the outdoor sporting equipment. However, one of the most common spring sports requires no equipment at all, that’s running. Whether you are a veteran runner, who has been hitting the gym or treadmill throughout the winter, or a novice runner, just trying to get into shape after “a long winter’s nap,” you can begin running too aggressively too soon. Since this is the time of year I see an influx of runners with foot and ankle pain, I’d like to offer some insight regarding the more common running injuries I see. With this in mind, I hope you can better understand your own foot and ankle pain, and take measures to prevent it.
Shin Splints
The tibia is the large bone that extends from your knee to your ankle. It is that sharp edge that you can feel on the front of your leg, something we commonly refer to as “the shin.” The tibia has a thick covering that blends in with the muscles on the front and back of the leg. When these muscles are moving forcefully, as with running, the lining of the shin can get pulled off of the bone, microscopically. Bleeding and inflammation occurs at these sites. You will also notice pain in these areas, most commonly just behind or in the front of the middle part of your shin bone. This injury occurs with repetitive activity, such as running. Treatment of shin splints is always conservative. You may have to stop running for a short time until the pain subsides. Rest, ice, compression, and elevation (RICE) can help alleviate immediate symptoms. Antiinflammatory medicine can help. Physical therapy and stretching exercises are also common treatments for long term relief and prevention. Do not ignore shin splints. If you try to run through the pain, shin splints can result in a stress fracture of the tibia. Treatment of a tibial stress fracture would involve ceasing all running activity, and being placed in an immobilizing cast boot.
Tendinitis
Tendons are thick, fibrous structures that connect muscle to bone. They help you move and bend your toes, feet, and ankles. When tendons are inflamed and painful, it is called tendinitis. You can get tendinitis when tendons are overloaded for a long period of time, or forced to work too quickly. It commonly occurs in running athletes. The most common tendon to become inflamed in the runner is the Achilles tendon. This is the large tendon in the back of your ankle that propels you forward. Other tendons that cross the ankle and are critical to running include the posterior tibial tendon and the tendons that flex the toes (on the inside of the ankle), the anterior tibial tendon and the tendons that extend the toes (on the front of the ankle), and the peroneal tendons (on the outside of the ankle behind the bony “knob” of the fibula). Tendinitis is often treated with the RICE method. NSAIDS can also be used when appropriate. Immobilization may be necessary if the pain is too great. Stretching and therapy may be helpful for a quick return to activity.
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Plantar Fasciitis
The planter fascia is a thick strap of tissue that originates on the bottom of the heel bone and extends toward the toes. It serves as a spring-like pulley that helps you walk and stand. The point where the fascia attaches to your heel bone is prone to injury. Small micro tears can occur at this point on the inner heel. This is the point of pain with plantar fasciitis. Typically, when you rest, the foot relaxes into a flexed position. This allows the plantar fascia to relax and subsequently tighten. When you get up from a sleep or sitting position, the foot is pushed upward, stretching the fascia. This pulls on the injured area and can cause pain. Once the area has warmed up, the pain subsides. Runners who don’t stretch diligently are often tight in the plantar fascia. This can contribute to acute injuries and subsequent chronic plantar fasciitis. Treatment is almost always conservative with stretching, NSAIDS, and gel heel pads as the initial treatment. Cortisone injections and surgery can be considered in extreme cases. The best treatment is prevention, so be sure to warm up and stretch the Achilles and plantar fascia routinely before and after activity.
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Common Foot and Ankle Injuries in Runners (continued) Stress Fractures
Stress fractures can occur in any bone of the foot and ankle. The repetitive pounding your foot takes with running can weaken a bone, eventually creating a “microfracture.” You should suspect a stress fracture when pain that has been very minor during running worsens over time and distance. You may even feel pain with normal walking. It is important to be evaluated to rule out a stress fracture since it is an easily treated injury.
Ankle Pain/Sprain
Ligaments are thick, fibrous structures that hold bones together. When these ligaments tear, it is called a sprain. Ligament disruptions, partial and complete, are common about the ankle. A sprain is probably the most common reason any athlete gets ankle pain. There are multiple causes to sprains, and most are associated with trauma. Running and impact sports put the ankle in precarious positions and can forcibly “roll” or invert the ankle in a painful position. Pain, swelling, instability, and bruising on the inside and outside of the ankle are common, often moving down the foot and into the toes.
Examining the ankle is essential. X-rays are often taken to rule out a fracture. These injuries are often treated without surgery in a fracture boot or brace. Severe injuries may require a cast. Surgical repair can be done, but is usually reserved for the late effects of multiple sprains to the ankle.
Tips to prevent foot and ankle pain: 1) 2) 3) 4) 5)
Before starting a run, be sure to spend 5-10 minutes warming up and stretching Instead of “too much, too soon”, gradually increase your distance and speed. Pay attention to your footwear, and make sure it is appropriate for your foot shape It can’t be stressed enough: stretch, stretch, stretch. If you are experiencing foot and ankle pain, don’t ignore it.
If you are experiencing foot and ankle pain, and would like a specialist’s opinion, I would be happy to talk to you. I have experience caring for athletes on the high school, college, Olympic, and professional levels. I currently see patients in the Allentown, Bethlehem, Easton, Lehighton, and Wind Gap offices. Do not hesitate to call, and do not ignore your foot and ankle pain! v
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Featured Physician Manny Iyer, MD
Cosmetic, Plastic and Reconstructive Surgeon fat and skin, typically women who have had children or lost a considerable amount of weight,” says Dr. Iyer. Dr. Iyer suggests scheduling a liposuction or tummy tuck about three to six months before you would like to see results. He says the first step in having one of these procedures done is an initial patient evaluation, where you will be given your customized options. The next step is scheduling the procedure, which is usually done a few weeks in advance. He says that some people who have severe medical conditions like heart conditions or diabetes may not be suitable candidates for cosmetic surgery. He cautions patients that there is a recovery time associated with both tummy tuck and liposuction. “Patients who have a tummy tuck or liposuction can expect to resume normal activity within two to three weeks and more strenuous activity in about four weeks,” says Dr. Iyer.
Whether it’s your laugh lines or those love handles that you can’t quite get rid of, most people can think of at least one thing they would like to change about their appearance. Dr. Manny Iyer says that he and his Cosmetic, Plastic and Reconstructive team at Coordinated Health can help make those little improvements so you look and feel your best. Dr. Iyer has been with Coordinated Health for six years, but he’s been transforming the lives of patients throughout the Lehigh Valley for over 20 years as a Board Certified Plastic Surgeon. He was drawn to a career in plastic surgery because it appealed to him on two different levels. “A career in plastics was attractive to me because of the idea that I could change not only form, but also function,” he says. Dr. Iyer performs a variety of both cosmetic and reconstructive procedures and states there is a distinct difference between the two. “Cosmetic surgery is based purely on aesthetics and is something like breast augmentation while reconstructive surgery is considered medically necessary and is generally something like breast reconstruction after a mastectomy,” he says. Some of the procedures that Dr. Iyer routinely performs include tummy tucks, liposuction, breast augmentation, breast reduction, eyelid lifts, Botox and Juvederm. He says that 90 percent of his procedures are done on an outpatient basis right in Coordinated Health’s surgical center. With summer right around the corner, many people may be considering a procedure to help them look their best in summer clothing and swimsuits. Tummy tuck and liposuction are both popular procedures, but many people don’t know which one is better suited for them. “Liposuction is geared towards younger patients who have excess fat, but not excess skin. Tummy tucks are geared towards patients who are a little bit older and have some excess
If you are looking for nonsurgical facial improvements, Dr. Iyer suggests either Botox or Juvederm. Both are done by injection right in his office. He says Botox can be used around frown lines and crow’s feet and works for up to six months. Juvederm is used to fill in deep creases around your mouth and cheeks and last up to a year. One thing that Dr. Iyer believes sets Coordinated Health’s Cosmetics Department apart from the rest is his Patient Coordinator and Licensed Esthecian Deb Moyer. Deb facilitates patient care by educating people about their options and personalizing their cosmetic procedures.
“Cosmetic surgery can give people’s selfesteem a boost. They can walk with their head a little bit higher and have more confidence in their everyday life,” says Dr. Iyer
While many people think that cosmetic surgery is for the rich, Deb says it’s really for the average person. “Most of our patients are your everyday housewives who would like breast augmentation or a tummy tuck after having kids,” she says. Dr. Iyer says he truly likes what he does. “I enjoy seeing the smile on my patient’s face when they see improvements through either cosmetic or reconstructive surgery,” he says. For more information about Dr. Manny Iyer and his Cosmetic, Plastic and Reconstructive team or to make an appointment, visit Coordinatedhealth.com or call (610) 861-8080.
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Because of the unusually mild winter we had, this year’s allergy season is predicted to be one of the longest and worst on record. Many people associate spring with warmer weather and the opportunity to spend more time outdoors. But, if you suffer from spring allergies, spring may hold a different meaning. It could mean the onset of spring allergy symptoms like runny nose, sneezing, coughing and nasal congestion. And because of the unusually mild winter we had, this year’s allergy season is predicted to be one of the longest and worst on record. Seasonal allergies occur when the IgE portion of your immune system is over active and attacks common allergens, like pollen and dust. When IgE antibodies, a component of your immune system, attacks common allergens, it prompts the body’s allergic reaction. If IgE antibodies come across an allergen, IgE antibodies stimulate other cells of your immune system, called mast cells, to release histamine and other chemicals, which causes swelling and inflammation and creates familiar allergy symptoms like a runny nose, itchy eyes, and sneezing.
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How can you tell if you’re suffering from seasonal conditioning vents, which can collect dust and mold allergies or a cold? “It’s difficult to tell the difference throughout winter and aggravate allergy symptoms. between spring Don’t forget your allergies and a cold basement and attic. because they share Mold is most likely so many of the to accumulate in same symptoms,” those areas and says Coordinated can spread if it’s Health Primary not taken care of. Care Physician If dust and mold Dr. Ryan Smith. bother you, make “Generally allergies sure you wear a are identified mask. by looking at a You can also patient’s medical limit the time you history. If they spend outdoors come in every between the hours spring with the Skin prick allergy test of 10 a.m. and 4 same symptoms it’s p.m. when pollen counts are at their highest. Also, if most likely going to be allergies.” pollen counts are high, be sure to keep your doors According to Dr. Smith there are two tests that and windows closed and avoid using fans that may determine if you are suffering from allergies, a skin draw pollen inside. You can get daily pollen updates at test and a blood test. A skin allergy test is the quickest www.aaaai.org/nab. (Continued on next page) and most reliable way to reveal what you are allergic to. Your doctor will prick your skin to allow an allergen, like dust or mold to enter your system and then wait 15 to 20 minutes to see if you have a reaction like swelling, redness or hives. The blood test is an allergen specific IgE anti-body test and screens blood for specific allergens. The good news is that if you do suffer from allergies, there are several over-the-counter medications available that can help. “Benadryl is one of the best because it prevents the release of histamine to a higher degree,” says Dr. Smith. He warns people to be sure they read the side effects since many allergy medications like Benadryl can be sedating. In addition to over-the-counter medication, there are other things you can also try to reduce your exposure to allergens with regular house cleaning. Pay special attention to areas like windows, book shelves and air
Over-the-counter allergy medications
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Seasonal Allergies (continued from previous page) How you do laundry can also make a difference in the severity of your allergies. Make sure you wash your bedding weekly in hot water. Also, dry your laundry indoors. While you might like the fresh scent line drying your sheets and clothing provides, hanging your laundry on an outside line makes it an easy target for blowing pollen. You should also ditch the morning showers in favor of nighttime showers. Pollen can accumulate in your hair and skin throughout the day, so it’s important to shower before getting into bed. If you don’t shower at night, you may notice an increase in your symptoms throughout the evening. Many people are surprised to find out that pets can cause allergy symptoms, even if you aren’t allergic to pet dander. Dogs and cats that are outdoors can bring pollen and other allergens inside. Be sure to keep your pets off the furniture and bed to prevent having any type of reaction. If conservative actions don’t help with your allergies it may be time to see a doctor. “If seasonal allergies are disrupting your life and over-thecounter medication isn’t helping than it’s probably time to see your family doctor or an allergist who can give you more specific treatment,” says Coordinated Health Primary Care Physician Dr. Barry Sirard. Don’t let your seasonal allergies sideline you from all the fun this spring. If you take the appropriate precautions, you can still enjoy spring without suffering from allergies. v
Check Out Coordinated Health On Facebook Learn tips and tricks to treat your pain from CH physicians and therapists Get the latest updates on what’s going on at CH Post your questions & comments We want to hear what you think! 12
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2 6 6 8 17 11 0 9 17 6 1 Hospitals
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What You Can Do If you have back pain, you’re not alone. Nearly 85 percent of American’s suffer from back pain at some point in their life and it’s one of the leading causes of disability. While most people think that back pain is a natural part of life that comes with age, Coordinated Health Physician Dr. Charles Norelli says that in many cases back pain can be prevented. “What many people don’t realize is that back pain is earned. It’s all about the way you move and the amount of pressure you put on your back on a daily basis. When people hurt themselves doing daily chores or activities, like bending down to tie their shoes or putting a dish away, it’s generally because they aren’t moving correctly to begin with,” says Dr. Norelli. According to Dr.Norelli, in order to shield your back against injury, it’s important to maintain the natural curvature of your spine. Your spine’s curves work like a coiled spring to absorb shock, however, if you don’t maintain your natural curvature then there could be too much pressure put on your back, which could lead to back pain and injuries like herniated discs. Dr. Norelli says it’s important to practice good posture in order to preserve your spine’s natural curves. Your body has three natural curves, an inward forward curve at your neck, an outward curve at your upper back and an inward curve at your lower back. Maintaining good posture will help preserve all three natural curves. In order to have good posture, hold your chest high and keep your shoulders back and relaxed. Pull in your abdomen and buttocks and keep your feet parallel with your weight balanced evenly between them.
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to Prevent Back Pain Good posture is always important, but Dr. Norelli points out that it is especially important when bending or exercising. “The most important issue in maintaining proper posture when bending; is flexing primarily through the hips and knees while maintaining the natural curve of the lumbar spine. This is often best done by splitting the legs (one in front of other) when light weights are involved.” While you should always protect your back against injury, Dr. Norelli warns that you should be especially careful in the morning. “At night when you’re laying down, your discs fill with fluid, which means when you get up in the morning you are actually putting considerably more pressure on your discs. This leaves you more susceptible to an injury if you aren’t careful.” He recommends doing some light stretching, like pelvic tilts and leg raises, before even getting out of bed in the morning. He also suggests rolling over on your side and gently raising yourself out of bed, rather than sitting straight up. Dr. Norelli says that if you are one of the many people who spend their days at work sitting behind a computer, you should make sure that your workspace is set up as ergonomically as possible. Some tips include having a chair with good lumbar support and adjustable seat and back rest height, placing your mouse and keyboard as close together as possible, having your monitor about an arm’s length away from where you’re sitting and keeping everything you use on a daily basis within reach. Dr. Norelli points out that the way you sit in the car can also impact your back. “People spend a lot of time in the car so it’s important to watch the way you drive. Stop frequently for long trips and relieve pressure on your back by placing your left leg on the floor board and raising your body up slightly.” While Dr. Norelli admits that it may not be possible to prevent all back pain, you should be able to stave off any major injuries by watching the way that you move and sit. To schedule an appointment with Dr. Norelli call (877) 247-8080 or go to coordinatedhealth.com v
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Endometriosis: What You Need to Know Do you have severe cramping with your periods, pelvic pain, and pain with intercourse? These symptoms are commonly reported by women with endometriosis. While some women with endometriosis have no symptoms, others may experience severe symptoms and even have difficulty getting pregnant.
be made clinically and initial treatment started. The only way to make a definitive diagnosis is through surgical evaluation and biopsy,” she says. Radiologic and laboratory studies are limited in making the diagnosis of endometriosis but help to rule out other diagnoses. Pelvic ultrasound can also be useful in identifying endometriomas of the ovary.
Endometriosis is a common problem for many women, If you suspect endometriosis, you may want to keep especially those of childbearing age. It occurs when a log of your symptoms to show your doctor. Try to the tissue that lines the uterus, the endometrium, note when your symptoms occur, how long symptoms develops in areas other than the lining of the uterus. last, any worsening These areas are called endometrial “Because the symptoms of endometriosis of symptoms, pain that limits activity, implants. The are similar to other disease processes, and pain during endometrial lining intercourse. is what sheds other diagnoses, such as irritable bowel during menses. syndrome, pelvic inflammatory disease, “Treatment for Women who have endometriosis and interstitial cystitis, must be excluded. endometriosis is pharmacologic can have pain A diagnosis of endometriosis can be made or surgical, or a and irritation in the areas where clinically and initial treatment started. The combination of both. Plans for implants are located only way to make a defi nitive diagnosis is future pregnancy as these areas impact the cause symptoms through surgical evaluation and biopsy,” treatment choice. during menses. For Medical therapies Coordinated Health Gynecologist instance, implants Dr. Deborah Villeneuve can alleviate can be found on the pain symptoms, intestines, causing but there is a painful bowel movements or diarrhea with periods. high recurrence of symptoms when treatment is An endometrioma, which is a cyst on the ovary due discontinued,” says Coordinated Health Gynecologist to endometriosis, may develop. Sometimes the Dr. Gayllyn Faust-Rakos. endometriosis implants may cause scarring in the pelvic cavity, causing pain and possibly infertility According to Coordinated Health Gynecologist Dr. Deborah Villeneuve, diagnosing endometriosis can sometimes be difficult. “Because the symptoms of endometriosis are similar to other disease processes, other diagnoses, such as irritable bowel syndrome, pelvic inflammatory disease, and interstitial cystitis, must be excluded. A diagnosis of endometriosis can
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Medical management includes nonsteroidal antiinflammatory drugs, such as ibuprofen and naprosyn. Hormonal management includes birth control pills, danazol and Lupron. If medical management fails or is not tolerated, surgical treatment is considered. Surgery can include; excision or burning of endometrial implants and
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removal of endometriomas. Most of the time, surgery can be performed with the minimally invasive laparoscopic approach. While most women experience immediate pain relief, about 45 % have recurrence of symptoms. Suppressive hormonal therapy after surgical treatment may decrease the recurrence of symptoms. Long-term oral contraceptive pill use has been effective in decreasing the recurrence of endometriosis and the painful symptoms. Hysterectomy and removal of ovaries is definitive surgical treatment for endometriosis. Rarely, recurrence may even occur after hysterectomy. Some women who suffer from endometriosis have a difficult time conceiving. “Surgical management and removal of endometriomas has been shown to improve pregnancy rates but the full impact is still unclear. Ovarian conservation is important during surgery,� claims Coordinated Health Gynecologist Dr. Deborah Villeneuve. Regular exercise can help you feel better because it can reduce pain by improving blood circulation and producing endorphins. Acupuncture, meditation and yoga may also be helpful in relieving endometriosis symptoms. For more information about endometriosis or to make an appointment with one of our Coordinated Health Gynecologists, please visit coordinatedhealth.com or call (610) 861-8080
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Could Your Shoes Be Wearing Out Their Welcome? There’s no denying that women love their shoes. Whether it’s high heels or sandals, shoes have become more than just a necessity; they’ve become a fashion staple. In fact, more and more women are trading in comfort for style when it comes to their shoes, a mistake that could cost them.
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A recent survey done by the American Podiatric Medical Association indicates that 42% of women say they would wear a shoe even if it hurts in the name of fashion. And now there is new research that suggests women as young as 25 may suffer permanent damage from wearing unsupportive shoes like high heels or flip flops for extended periods of time. One of the worst shoes you can wear is high heels. Anything with a heel over two inches can cause a problem with your feet and ankles. In fact, women who wear high heels on a regular basis may actually begin walking in an elevated position while barefoot.
“There are many risks to wearing high heels on a daily basis. You risk getting stress fractures, ankle sprains from falling, and hammertoes. It’s also bad for your While all high heels can be harmful to your feet, there are back because it puts you at an some types that are worse than others. For example, spike abnormal position,” heels put an abnormal amount
“There are many risks to wearing high heels on a daily basis. You risk getting stress fractures, ankle sprains from falling, and hammertoes. It’s also bad for your back because it puts you at an abnormal position,” says Coordinated Health Podiatrist Dr. Mary Loftus.
of pressure on the ball of your Coordinated Health Podiatrist Dr. Mary Loftus foot and could cause acute pain in that area and hammertoes from the unnatural positioning. Pointy toed pumps can cause neuroma, an inflammation between the third and fourth toe. Neuroma’s are generally treated with injections, physical therapy and surgery. According to Dr. Loftus, high heels should be worn in moderation. “There’s nothing wrong with wearing high heels every once in a while. If you’re going to a wedding or event, just give your feet a break and don’t wear them on a daily basis,” she says. She also suggests banishing those pointy toed shoes from your closet. She says if you really want to wear high heels to the office, take them off when you are sitting behind your desk and wear an overthe-counter or custom made gel cushion. Also, never combine a sky high heel with a pointy toe since it could throw off your balance.
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High heels aren’t the only type of footwear that can be harmful to your feet. Ballet flats are just as bad. They don’t offer the foot any support or cushioning and don’t allow it to function the way it should. Wearing ballet flats can also lead to tendonitis and plantar fasciitis. As an alternative to ballet flats, choose a shoe that resembles a ballet flat, but offers more support. If you can fold up your shoe and put it in your purse, it’s not offering you enough support. Another popular shoe that can cause foot problems is the flip flop. While flip flops are certainly convenient, they were never intended for everyday wear. They don’t offer your arch any support or protection, which leaves your feet vulnerable to injury. Some common foot and ankle problems that are associated with flip flops include tendonitis, plantar fasciitis and sprained and strained ankles. Your best bet is to save flip flops for the beach and walking poolside and stick to sandals with a little more support for everyday wear. So what is the best type of shoe to wear on an everyday basis? “You want to look for something with good shock absorption and a thicker sole. A lot of the newer brands have a nice thick sole like sneakers. There are also a lot of brands that combine style and comfort like Merell and Aravon, which both have the APMA seal of approval,” says Dr. Loftus.
You don’t have to sacrifice style in the name of comfort. There are a number of shoes on the market that offer both.
She suggests limiting your heel to about 1 to 1.5 inches and looking for something that offers good arch support and a wide toe box. She also says it’s a good idea to have laces or buckle closure for added support.
Women aren’t the only ones who need to be careful when it comes to choosing appropriate footwear. While there aren’t as many styles to choose from, men are just as likely to have foot problems because of uncomfortable shoes. In fact, some popular women’s styles have transcended the gender line and become popular with men too. Some of those styles include the pointed toe box dress shoe and flip flops. Coordinated Health Podiatrist Dr. Raymond McCarroll has some advice for men looking for a good, comfortable shoe. “I like something that’s flexible across the widest part of the foot and rigid from the ball of the foot to the back of the foot. It’s also important to have a wide toe box,” says Dr. McCarroll. You don’t have to sacrifice style in the name of comfort. There are a number of shoes on the market that offer both. Just remember, the shoes that you wear now, could have an impact on your health in the future. v
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Mark A. Gittleman, MD, FACS and
Breast Care Specialists now at
Coordinated Health Hospital Network welcomes Dr. Gittleman and his patients from
Breast Care Specialists, P.C. As the Lehigh Valley’s leading breast care specialist, Dr. Gittleman brings to Coordinated Health 35 years experience in the surgical management of breast cancer and breast disease.
Now Accepting New Patients Breast care services available at: Allentown Campus at Cetronia Road 250 Cetronia Road, Suite 302 Allentown, PA 18104
(610) 366-7333 | coordinatedhealth.com
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2D Echocardiogram A 2 D Echocardiogram is a non-invasive cardiac test, which means there is no surgery involved and there are no instruments inserted into your body. The entire test is performed externally. The echocardiogram is performed by using a hand-held device (transducer), which the technician places on the surface of your chest. The transducer sends special sound waves, called ultrasound, through your chest wall to your heart. These ultrasound waves bounce off the structures of your heart. The returning signals are processed by a computer within the echocardiogram machine, which then displays motion pictures of your heart on a screen.
An echocardiogram can tell your cardiologist about: ♥ The size, shape and function of your heart; and if it is normal, weakened, or enlarged. ♥ Whether your heart valves open and close normally. ♥ If there are possible heart defects such as holes, or other structural abnormalities in the heart that may have been present since birth. ♥ Possible blood clots or tumors inside the heart ♥ Possible fluid build up in the sac around the heart (pericardium). ♥ Problems with the aorta, which is the main artery that carries oxygen – rich blood and nutrients from your heart to the remaining parts of your body.
The echocardiogram is a simple, painless test that provides valuable information about the health of your heart. You may feel the pressure of the transducer as it is held to your chest to image your heart. The test itself may be performed in the cardiology office or hospital. There is no special preparation required and you may usually eat, drink and take your medications as you normally would. Before the test you will be asked to disrobe from the waist up. Women will be provided a patient gown, which opens in the front. The echo-technician will apply soft, sticky patches known as electrodes to your chest, which are connected to the electrocardiogram (ECG). You will then be asked to lie on your left side on a stretcher. During the test, lights in the room will be dimmed so the computer screen is easier to see. Warm gel is applied to your chest, which allows for the transducer to move over different areas of your chest and upper abdomen, looking at different areas of your heart. The entire test should take about 45 minutes.
Your Cardiologist will review your echocardiogram and discuss the results with you at a later date. Should you require additional testing, your Cardiologist will discuss that with you as well. v
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Choose a Location Near You: 1503 N. Cedar Crest Blvd. Allentown, PA 18104 877-247-8080 Hours: Monday-Friday 8am-5pm
2310 Highland Ave. Bethlehem, PA 18020 877-247-8080 Hours: Monday-Friday 7am-11pm Saturday/Sunday 8am-8pm
1097B N. Church St. Hazle Township, PA 18202 877-247-8080 Hours: Monday-Friday 8am-4:30pm
511 VNA Rd. East Stroudsburg, PA 18301 877-247-8080 Hours: Monday-Friday 7am-11pm Saturday/Sunday 8am-8pm
1411 Jacobsburg Rd. Wind Gap, PA 18091 877-247-8080 Hours: Monday-Friday 7am-11pm Saturday/Sunday 8am-8pm
239 N. First St. Lehighton, PA 18239 877-247-8080 Hours: Monday-Friday 8am-4:30pm
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No Equipment Needed!
Ways to exercise at home without equipment I’d love to be able to afford the fancy equipment at a gym, but for many of us, that’s not an option. Since the benefits of exercise are endless, here are some easy, time saving exercises to do early in the morning, after dinner, or after the kids go to bed. It is important to properly stretch and warm up before ANY kind of activity, even if it is a quick 15 minute workout. Stretching your muscles before activity prevents injury.
Single Leg Balance Balance is crucial for all ages. Balance exercises are good for your hip and leg muscles. Single leg exercises can be done with the knee straight for more hip activation, or with slight bend in the knee for more quadriceps activation. If you’re worried about losing your balance, this exercise should be done near a chair or wall for support.
Steps Whether you’re going up and down the stairs to get your laundry or taking the stairs instead of the elevator, steps are great exercise! Standing in front of the steps, you can lead with the right foot, lead with the left foot, turn 90o and side step leading with one foot, then turning the other directions and leading with the other.
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Push-ups Push-ups are a great way to strengthen your upper body and can be done in a number of ways, including, against the wall, on an incline, kneeling, and traditionally. Against the wall is the easiest on the shoulders. On an incline bench or table would be slightly more difficult. Kneeling (girl push-ups) are more challenging, followed by traditional push-ups.
Modified or Regular Jumping Jacks Regular jumping jacks are a total body workout. If jumping jacks are too hard on your knees and joints, a modified jumping jack can be done. Keep one leg on the floor, extend the other out to the side, while taking your hands through the jumping jack motion.
Bicycles Bicycles are a good core exercise. Lay down on the bed or floor, start by bringing the knees to the chest. Alternate left arm/right knee and right arm/left knee until you feel the burn in the front and side abs. v
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improving sports performance Power Training and Reactive Explosiveness The quest for carry over of strength training to improve performance and prevent injury has long been a challenge for coaches and athletes looking for the edge. The key to linking the strength developed in the weight room to the field is the ability of the body to use the strength gain at game speed in competition. Part of the training needed to accomplish the carry over, needs to occur at speeds closer to competition and involve movement patterns close to the actual sport itself. Power training has been utilized for many years to help this transition take place. Olympic style lifting is one of the more commonly used methods. Plyometric training is another form that uses body weight and medicine balls to mimic sport movement.
know you have the ability to handle the demands of plyometric training. You should also assess your functional flexibility, core strength, and rotational stability. Any deficiencies in these areas need to be addressed before implementing power training as part of your routine. If you’re deficient in one of these areas and it is not corrected they are susceptible to an injury, particularly if they are overloaded. Increasing the resistance or load when power training is a common mistake made by both coaches and athletes. Sometimes egos can get in the way and the focus on good technique and speed is lost in order to see how much weight can be moved. (the quantity over quality mentality, more is not always better)
The quest for carry over of strength training to improve performance and prevent injury has long been a challenge for coaches and athletes looking for an edge.
Power is the ability to apply strength with speed or in a more scientific form: Power = (force x distance)/ (time). The two most important factors to work on is increasing force or strength and attempting to decrease the time to accomplish the task. Strength training alone does not imply an increase of power if speed of the movement/activity is decreased. It’s a good idea to combine the types of training once you
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The main purpose of power training is to increase the efficiency of the neuromuscular system. The central nervous system controls muscle coordination, reaction, and power output by increasing efficiency. Efficiency and power are gained through timing and muscle fiber recruitment to react to external forces acting on the body. Another way to think of power/plyometric training is
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elastic training. If you compare your muscles to a rubber band that is stretched out, there is stored energy in the band, when you release the rubber band that energy is released. With muscle tissue there is a very brief period when the stretch (lengthening) becomes a contraction (shortening). If this brief period is too long, energy and power are lost. If the timing, stabilization, or coordination is off, power is lost. There are several levels of power training. It can be divided into low stress to high stress demand, or a slow response to a quick response exercise. When beginning a plyometric program it is important to teach proper landing technique before progressing to higher level jumps you may want to begin with. Part of this progression is to have a good athletic ready position with flexed knees, hips and a good spine and neck position. Once this position becomes second nature you can work on landing quietly and holding the athletic position to train the core stabilizers. As you master that position you can then progress to multi-planar jumps and multi-planar hops. Jump ups and depth jumps using boxes to increase the neuromuscular demand can be slowly added as well. Lower body plyometrics will increase your vertical jump, acceleration and agility. The use of medicine balls or push ups for upper body power is advantageous for sports that require throwing or swinging. You just need to follow the same principles of good technique, starting with light medicine balls and progress as tolerated. v
For more information on power training, personal training, or team training, please contact the PULSE program at Coordinated Health.
610-861-8080 x32021 or email:
pulse@coordinatedhealth.com Please visit our website at
coordinatedhealth.com
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Calendar of Events APRIL
MAY
4th
Shoulder Injuries in Athletes Seminar Bethlehem Campus at Highland Ave. - 6pm
2nd
Stretching Class (second of four classes) Allentown Campus - 6pm
7th
Care on Demand Free Weekend East Stroudsburg Campus - 8am (Sat. & Sun.)
5th
Care on Demand Free Weekend East Stroudsburg Campus - 8am (Sat. & Sun.)
14th
Community Open House Wind Gap Campus - 10am
8th
The Xiaflex Experience Seminar Bethlehem Campus at Highland Ave. - 6pm
19th
Dancers Clinic (Foot & Ankle Seminar) Bethlehem Campus at Highland Ave. - 6pm
9th
Stretching Class (third of four classes) Allentown Campus - 6pm
24th
What is Minimally Invasive Surgery? Seminar Bethlehem Campus at Highland Ave. - 6pm
16th
Stretching Class (forth of four classes) Allentown Campus - 6pm
25th
Stretching Class (first of four classes) Allentown Campus - 6pm
Go to coordinatedhealth.com for more information or to register for one or more events
Honest... we’re not just pulling your leg.
Complete our survey to register to win an iPod nano (drawings held monthly) Simply go to coordinatedhealth.com, under the “Services” tab click on Rehabilitation, scroll to the bottom of the page and click on the Rehabilitation Satisfaction Survey.
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Avoiding Springtime Hand Injuries For many people, warmer weather often signals the beginning of spring gardening. While you may enjoy gardening, clearing out debris, and preparing flower beds, lawns and gardens for planting season can take a toll on your body, especially your hands. However, there are preventative measures you can take to help make sure you enjoy gardening without encountering any pain. Overuse in the garden can lead to tendonitis, sprain/ strain injuries, and carpal tunnel syndrome. Here are some basic tips to keep your hands healthy:
1. Warm up before you start working. Take a walk around your yard or your neighborhood to warm up your muscles. Stretch out after your walk. A good overall stretch for your hand, wrist and forearm is to extend your arm out in front of you with your palm up. Using the opposite hand, gently stretch the wrist back toward the floor. Hold the stretch for 15-20 seconds and repeat five times. Then, with your elbow still extended, turn your palm down and use the opposite hand to again gently stretch the wrist towards the floor. Hold again for 15-20 seconds and repeat five times.
2. Use gloves. Wearing gloves protects your skin from lacerations and puncture
wounds from thorns or sharp sticks and brush. Gloves can also help keep your hands warm and protect you skin from dirt and chemicals that can dry out your skin.
3. Take breaks. Try to change your position about every 20 minutes. Get up from
what you are doing and give your hands a break for at least five minutes. Your tasks may take a little longer, but your hands will be a lot happier at the end of the day. If you have a lot of weeding or raking to do, consider spreading the work out over a couple of days.
4. Watch your position. Try to work while maintaining a neutral position in your wrists. Avoid extremes of motion in any direction and use both hands when doing heavier tasks.
5. Use ergonomic tools. Use gardening tools with padded, built-up grips
whenever possible. Wider and softer grips decrease the amount of force needed and are easier on the smaller joints in your hand. If possible, use an electric trimmer when pruning large grass or shrubs to cut back on the amount of hand work needed.
In general, PACE YOURSELF! It will be a long and (hopefully) fruitful gardening season. Following these tips can decrease your likelihood of injury. v
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COUGH THAT JUST WON’T QUIT Ever had to deal with a nagging cough that just won’t go away? It can often be difficult to pinpoint the reason for a chronic cough since there can be multiple causes. Chronic coughs can be due to inflammation of your airway or increased mucous production, which could block the free passage of air into your lungs. In addition, dripping mucous can slide down the back of your throat causing airway occlusion and irritation of your vocal cords. Ultimately, your body reacts with an explosive 60mph cough that effectively rids the airway of debris. There are generally three explanations for chronic coughs: asthma, gastric reflux, and chronic post nasal drip (PND). All three of these common ailments have similar component mechanism of irritation of the human airway, and each reflexively results in a cough. PND is the production of nasal mucous that can run down the back of your throat. While this may occur during most colds, chronic PND lasts longer than 6-8 weeks. Continuous nasal irritation by an allergen or irritant can also cause PND. Allergy medications or nasal sprays may relieve this type of cough.
Any cough lasting for over a month should have a chest x-ray for proper evaluation
Cough variant asthma can also cause a chronic cough. Unlike typical asthma, which presents itself with a wheeze and/or shortness of breath, cough variant asthma presents as a chronic dry cough. Like typical asthma, the cough can be brought on by multiple triggers like air temperature, allergen or irritants, and exercise. Even though the symptoms are slightly different, treatment for cough variant asthma is the same as regular asthma medications that are inhaled or taken orally.
The third reason for a chronic cough is esophageal reflux. Much of the time reflux is synonymous with abdominal pain or heart burn, however, in some people “silent reflux” may occur with the only symptom being a cough. Acid can arise from the stomach and easily pass down the larynx and bronchus. Irritation of the bronchus and vocal cords then stimulate the cough response. Cough can often be resolved with a reflux medication such as Prilosec (omeprazole) or Zantac (rantidine). Even though these conditions are responsible for most forms of chronic cough, there’s also the slight possibility it could be something more serious like cancer or infections. Any cough lasting over a month should have a chest x-ray for proper evaluation. If treatment fails for the most common reasons for a cough, you may need an appointment with a pulmonologist or your primary care physician. v
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We share more than just our name
We all have the same doctor Primary care is the foundation of your family’s health care. Our primary care providers work together to deliver comprehensive and expert care to you and your family. By using Coordinated Health’s Primary Care Services, you also benefit by having convenient access to specialists who, with our primary care providers, work together as members of your healthcare team to ensure that your medical needs are met quickly and compassionately.
Schedule appointments for your family today
(877) 247-8080 | coordinatedhealth.com | (610) 861-8080 coordinatedhealth. com
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W h at o u r pat ie nts a re s ay i my husband d n a , e m g n treati 23 se he’s been u a c e athletes) for b s d n is a e s W r e l r h a c a C Dr. tion te ians available ysical educa ic h s p y r h e p m y r n a fo m ( both ere were not th 8 8 9 1 nt to get you te in in k c e a th B . h s it r yea lly w podiatrist jury, especia A . in le c ib ti s le s o th p a s t fely a to trea to uickly and sa q s a I later found n t o a ti h c w a , g to in in in k bac usta nd risks, and Weiss after s a r. s D n o to ti e p o m , d m oble directe g plains the pr x e e s. He is carin H n . o L ti C s A e u n q r r to u a /o y be, e e to answer m ld. We feel w m e ti fi s is e k h ta in S e c Y rien ALWA above and s much expe s a e h o g d e n a H . h n g o u epti and thoro -without exc im h m o st in us, our e fr r e te r a in c n ty a li g a get qu as ine by showin s. Dr. Weiss h e v beyond medic li r u o d n a ther” family, Dr. Leo Sca me back toge t rpino - he u p “ ’s very thor play oug h, take to answer s time to continue to questions and makes ball sure that th tetive volley patient has e p m o c e had their n eeds met b ysical the room. efore he le and teach ph aves He’s access ible for ap any, pointments fo llow-up education m and care on a I am so timely basis many times. . He’s the o doctor I’ve and nly had at Coo l for his help fu rd inated H te a r g ealth. Plu seems to b s, he e the knee replacemen expertise. t surgeon of choice for my Linda C.
church - E VERYONE goes to Dr. Scarpino! I think I’v e chosen the best in the Valley! Kelly M.
Dr. Scott Sauer’s treatment of my torn peroneus brevis ten don in my ankle was superb. As a highly competitive triathlet e, I knew that I wanted my treatm ent handled by an orthopedist who specialized in the foot and ankle - I didn’t want to leave such a delicate, intricate are a in the hands of someone who was more comfortable with knees and shoulders. I literally spent months searching for the rig ht surgeon. Dr. Sauer’s dia gnosis and treatment was excellent - he took the time to thorou ghly explain (and diagram) the ana tomy, physiology, and mechan ics of the joint and injury, and also the options that I had. Dr. Sauer performed the surger y with my continued athletic endeavors in mind: it wasn’t just good enough for me to wal k without pain again - he knew I needed to be able to run lot s of miles. He took all aspect s into consideration and did an excellent job. Three months post-surgery and I was runnin g again!
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i n g a b o u t o u r p h ys i c i a n s xplained e s a h e H etti... h c u benifits, L . d r n a D s k ris res, the isions. u c d e e d c y o r m p f portive o p u s ork as s w a t w o n d n id a d ocedure r p to send e h e t t a it s e When th e did no h , d e t c expe cialist. e p s in a p i me to a Luchett . r D u o Thank y A. Kathryn
Dr. Ialeggio was very professional, yet spent enough time with me to explain just what happened to my thumb (fracture) and why it w as so important to have it immobilized in a cast fo r 3 weeks because it coul d heal improperly and I could lose mobility in it for the future. He was very patient and m ade sure I understood everything well before he left. He had also op er ated many years ago on Dr. Wagener He my young son’s thumb for almost the same helped me get back Dr Bautista is my fav problem. His to who I am. I was physician orite at Coord was a more in so much pain and Health. He che inated cks his patients severe case. lk. wa t y rel h ba o uld co r o u g hly and h an aweso I remember as m e b e am I d him s to ks i an d Th My appoi e manner my son saying ntments ! h b a e v en easy t e always 100 percent back how neat it o s c h e d my convi u l e at en was to be to normal. waited lo ce and I haven‛t ng awake asking the doc w to get in to see Jason B. h him questions, have rec en scheduled. I ommende before they d of mine t o see Dr friends Dr. Jim .. He is . Bautist as well d finally knocked . a n u e a , t s o m u f h rteo I was with his ow impressed him out for Hof u o c , l a trea en ion asking so many. t and profess ins in detail, Dcarr. eB of my case. Thtm ank you autista! Deborah S. d expla
Summer an e h t t D. a h w y l t c exa ow h d n a is problem tify it! Love rec l l i w e h him! R. a l l e r o i F
To share thoughts about your favorite Coordinated Health physician visit
coordinatedhealth.com We’d love to hear from you!
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AS SEEN ON
TV
FAD DIETS
When it comes to losing weight, everyone wants a “quick fix” and that’s when people tend to try fad diets. A fad diet does not necessarily mean the diet will not work, it simply means that it is a weight loss solution that becomes popular very fast. Acai Berry Diet, Atkins, Zone Diet, HCG Diet, South Beach Diet, and the DASH Diet are some fad diets that have become very popular. The Acai Berry Diet became popular after Oprah promoted it on her show. This actually just supplements other weight loss plans. The acai berry is best known for its antioxidant benefits along with improving digestion, cleansing and detoxifying the body, boosting immunity, and cardiovascular health, essential fatty acids and amino acids, and improvement in metabolism. However, this diet can become expensive ranging from $40-80 per month for supplements and/ or juice.
A fad diet does not necessarily mean the diet will not work, it simply means that it is a weight loss solution that becomes popular very fast.
The Atkins diet was first introduced back in the 1970’s by Dr. Robert Atkins. Since then there have been some changes, but the diet is based on the process called Ketosis. The original Atkins was based on four phases of controlling the level of carbohydrate intake. In 2010 the New Atkins Diet was introduced. This diet emphasizes the importance of nutritional food choices, portion control, exercise, diabetics and vegetarians, and flexibility for people with busy lifestyles. The South Beach Diet was originally developed for overweight heart patients. This diet is based on whole grains, healthy fats, fish, chicken, fruits, and vegetables. There are three phases to this diet. These phases include the two week induction phase that has a restriction of most carbohydrates. The second phase focuses on specific meal plans and recipes, and also focuses on reintroducing foods that were avoided during the first phase. The third phase is a transition into a healthy lifestyle, with eating healthy foods and maintaining weight.
The DASH Diet stands for Dietary Approaches to Stop Hypertension. This diet is designed to help treat or prevent high blood pressure. It’s based on reducing the amount of sodium in your diet along with eating foods rich in potassium, calcium, and magnesium that help lower blood pressure. Along with lowering your blood pressure, The DASH Diet can also protect against osteoporosis, cancer, heart disease, stroke, and diabetes. While this diet is more focused on lowering blood pressure, the nutritional choices in this diet can also help shed unwanted pounds. Whether your goal is to lose weight or simply live a healthier lifestyle, you should always check with your primary care physician before starting any weight loss or exercise programs. v coordinatedhealth. com
#1 in Patient Satisfaction Based on Medicare Data, 2009-2011. Visit hospitalcompare .hhs .gov.
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(610) 861-8080
Allentown
Bethlehem
Easton
coordinatedhealth.com
(877) 247-8080
1503 N. Cedar Crest Blvd. Allentown, PA 18104
Brodheadsville
Rte 115 & Switzgable Rd. Brodheadsville, PA 18322
1611 Pond Rd., Suite 102 Allentown, PA 18104
East Stroudsburg
505 Independence Ave. East Stroudsburg, PA 18301
250 Cetronia Rd. Suites 102, 110 & 302 Allentown, PA 18104
ASC
511 VNA Rd. East Stroudsburg, PA 18301
2775 Schoenersville Rd. Bethlehem, PA 18017
Hazleton
1097B N. Church St. Hazle Township, PA 18202
2300 Highland Ave. Bethlehem, PA 18020
Lehighton
239 N. First Street Lehighton, PA 18235
2597 Schoenersville Rd. Bethlehem, PA 18017
Wind Gap
1411 Jacobsburg Rd. Wind Gap, PA 18091
2030 Highland Ave. Bethlehem, PA 18020
Hospitals
1503 N. Cedar Crest Blvd. Allentown, PA 18104
400 S. Greenwood Ave. Easton, PA 18045 3101 Emrick Bivd., Suite 112 Bethlehem, PA 18020
2310 Highland Ave. Bethlehem, PA 18020