Better Living Fall 2016

better living FALL 2016

COORDINATED HEALTH MAGAZINE

GET RID OF

TAILGATING TREATS

SHOULD YOU BE TESTED FOR THE

BREAST CANCER GENE?

Physician-owned hospital system.

PAINFUL VARICOSE VEINS ONCE & FOR ALL

SOARING AFTER SURGERY

BETTER. TOGETHER.

better living FALL 2016

CONTENTS

9

10

6 CH in the News 8 Access on the Field 9 Antigravity Treadmill

10 Microblading 11 Healthy Tailgating

VISIT US AT COORDINATEDHEALTH.COM OR CALL 1 (877) 247-8080 TO SCHEDULE AN APPOINTMENT TODAY.

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Classics

12 Opioid Addiction

15 Healthy 14 Staying This Fall

15 Sleep Comfortably

After Shoulder Surgery

18 17 Vein Ablation 18 Soaring After Surgery

21 20 Is a Tummy Tuck Right For You?

21 Fractured Game

16 Genetic Testing for Breast Cancer

FALL 2016 | 3

OUR TEAM FLORENCE BROWN OLIVIA BROWN JESSICA FLATTO

DIRECTOR OF COMMUNICATIONS MARKETING & EVENT COORDINATOR JUNIOR GRAPHIC DESIGNER

CASSY KLISCH

GRAPHIC DESIGNER

BRIAN MENECOLA

CREATIVE DIRECTOR

DEBBIE MORGAN HANNAH ROPP MARTY WAMBOLD

INTERNAL COMMUNICATIONS SPECIALIST CONTENT MANAGER VIDEO PRODUCER

CONTRIBUTING AUTHORS CARA GUILFOYLE, MD, FACS GREGG GUILFOYLE, DO NATHAN JOHNSON, MD WAYNE LUCHETTI, MD

BREAST SURGEON PLASTIC AND RECONSTRUCTIVE SURGEON FAMILY MEDICINE PHYSICIAN CHIEF OF STAFF, CHIEF OF SURGERY, CHAIR OF ORTHOPEDICS

RICH MARTINETTI, PT

PHYSICAL THERAPIST

THOMAS MEADE, MD

DEPARTMENT CHAIR ORTHOPEDIC KNEE SURGERY

PRASANT SEAN PANDEY, MD

CARDIOLOGIST

JASON RUDOLPH, MD

ORTHOPEDIC SURGEON

NICK SLENKER, MD

ORTHOPEDIC SURGEON LAFAYETTE COLLEGE TEAM PHYSICIAN

JOANN STUHL

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LICENSED AESTHETICIAN

ON-SITE SPORTS PERFORMANCE TRAINING Coordinated Health is now offering on-site sports performance training for all high school, middle school and youth athletic teams!

WHAT IS ON-SITE SPORTS PERFORMANCE TRAINING? Strength Training • Injury Prevention • Speed • Agility • Sports Performance Testing

CURRENT TRAINING PARTNERS Bangor Area School District • Bangor Basketball Youth Association • Palisades School District Nazareth Girls’ Volleyball • Nazareth Field Hockey • Parkland Wrestling Parkland Girls’ Basketball • Upper Nazareth Clippers Football For more information on how your program can benefit from Coordinated Health’s Sports Performance Program please contact Performance@coordinatedhealth.com or 610-861-8080 x32021 @CHSportsPerformance

FITNESS & SPORTS PERFORMANCE

FALL 2016 | 5

CH IN THE NEWS COORDINATED HEALTH BREAKS GROUND ON NEW MEDICAL OFFICE BUILDING AND AMBULATORY SURGICAL CENTER

these businesses," said Jim Feher, The Morning Call's vice president of advertising. "They know who is the best and have told us."

“Our goal is to always provide the best patient experience,” says Coordinated Health CEO Emil DiIorio, MD. “We are SIMPLY THE BEST...AGAIN gratified to see that The Morning Call’s readers recognize our dedication to excellence.”

In addition to the Readers’ Choice award, both of Coordinated Health’s hospitals have HOSPITAL* earned Top Performer 484-273-4224 CHOOSE VICTORY. coordinatedhealth.com/quality ratings from The Joint Commission and have received the Healthgrades Patient Safety Excellence Award™ and Outstanding Patient Experience Award™. Coordinated Health’s Bethlehem Hospital is the only hospital in the Lehigh Valley to earn 5 stars from Medicare’s Quality Star Ratings System in 2016*, and CH physical therapists rank among the top 15% in the nation according to Focused on Therapeutic Outcomes (FOTO).

THANK YOU LEHIGH VALLEY

Coordinated Health is continuing to grow. A groundbreaking ceremony was held on August 11, 2016, to initiate the start of construction on a new 42,000-square-foot, state-of-theart medical campus and ambulatory surgical center (ASC) in Humboldt Station in Hazle Township.

The six-acre campus will be Coordinated Health's 17th location and is projected to open in Spring 2017. It will offer orthopedics, sports medicine, joint replacements, spine care, foot and ankle care, hand and wrist care, cardiology, women’s health, specialty care, advanced imaging and rehab.

Additionally the medical campus will feature a primary care and employer clinic for occupational health, workers’ compensation and on-site/near-site care.

“We believe that the residents and employers of Hazleton and Luzerne County deserve the highest level of quality, access and care,” said Emil DiIorio, MD. “With the addition of our new ambulatory surgical center, patients will now have a choice for a new level of out-patient surgical procedures in a beautiful, safe and modern environment, close to home. “

Coordinated Health is proud to be The Morning Call’s Reader’s Choice for BEST ORTHOPEDIC SERVICES and BEST SURGEON. We have been helping our patients achieve everyday victories for over 28 years with our unmatched access, which includes same-day appointments, the region’s only orthopedic urgent care, evening hours, onsite imaging and our five star Bethlehem hospital.

5 STAR CH - BETHLEHEM

Physician-owned hospital system.

*CH Bethlehem is the only hospital in the Lehigh Valley to earn 5 stars in Medicare’s Quality Star Rating Stystem

MEDICAL CAREERS PATHWAY PROGRAM AT COORDINATED HEALTH HELPS PREPARE STUDENTS FOR HEALTHCARE CAREERS A new program at CH is designed to assist and prepare high school students to make career choices in healthcare. The Medical Careers Pathway Program, jointly managed by Deb Mannicci, director of education, and Jen Roeder, vice president of Clinical Operations, kicked off this fall with eight students from Palisades High School.

READER’S CHOICE VOTES COORDINATED HEALTH AS BEST SURGEON AND BEST ORTHOPEDIC SERVICES Coordinated Health was announced by The Morning Call as the winner of two Reader’s Choice awards: Best Surgeon and Best Orthopedic Services.

Each year, readers of The Morning Call vote in July and August for companies they think are the best in their business. "The voters are the people who shop, eat or use services from

*As rated by patients in Medicare survey

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The students will visit Coordinated Health for one hour per week for ten weeks. The program is designed to give students tours of departments and introductions to caregivers at each point along the continuum of care for a Total Knee Arthroscopy (TKA) patient; the outpatient clinic, Imaging department, hospital lab, cardiology department, operating room, inpatient unit, TCC and finally the rehabilitation department. Many of our healthcare providers will speak to the students about what they do and schooling required for their positions. “They’ll get to meet a variety of our healthcare providers who treat and care for our patients and see first-hand their role in patient care,” says Mannicci. So far, the students have looked at MRI and CT scans of the knee, saw tests being performed in the hospital lab and watched an ultrasound in Cardiology.

Coordinated Health was proud to partner with Lehigh as the exclusive medical providers for the race.

Coordinated Health had a great presence with three physicians, one PA, two MAs, 18 athletic trainers and several ESU athletic training students. “With nearly 6,000 runners in attendance we were kept on our toes,”said Stephanie Gehman, LAT, ATC, CEAS and AT Administration Team Lead.

Medical Staff were located throughout the race in ancillary tents, at the Finish Line and the Main Medical Tent. In addition, four staff members roved the course on golf-carts, prepared to transport any ill or injured athletes. The team also worked in collaboration with area ambulance crews who were also on-site and patrolling on their gator. “It was a long day, but well worth the effort,” Gehman exclaimed.

CAN DO CURB APPEAL On September 22, Hazleton area economic development corporation, CAN DO, presented its ninth annual Curb Appeal Awards to its industrial park and corporate center tenants.

Coordinated Health co-sponsored the event with its future

The students will also hear about the business side of healthcare with discussions on the economics of healthcare.

At the conclusion of the program, students will be asked to provide a presentation for their classmates and teachers on what they experienced and learned. The program will run twice per year; once during the fall semester and once during the spring semester. “This is a great opportunity to showcase our organization and to help the students determine if a healthcare career is a good option for them,” Roeder said.

PAUL SHORT RUN On Saturday, October 8h, Lehigh University hosted the 43rd annual Paul Short Run, one of the largest cross country meets in the nation with approximately 6,000 athletes from nearly 450 colleges and high schools competing this year.

Humboldt Station location neighbor, the Residence Inn. CH gynecologist Dr. Tasscia Williams, Women’s Health Manager Dawn Milisits and Director of Communications Florence Brown attended the mixer event and met community leaders and business owners, many of whom were thrilled with the addition of CH’s future clinic and surgical center to Humboldt Station.

FALL 2016 | 7

ACCESS ON THE FIELD

HAVE YOU EVER WONDERED WHAT WOULD HAPPEN IF YOUR CHILD WAS INJURED PLAYING SPORTS? Coordinated Health Orthopedic Surgeon Jason Rudolph explains what parents of young athletes need to know in case their children are ever injured on the playing field.

As I was sitting in the stands at a recent high school football game, I realized how much confusion, concern and anxiety parents face when their child is injured on the field. Since I have been on both sides (serving as a team doctor on the field, and having a son who plays the game and suffered an injury), I wanted to try to alleviate some anxiety for parents.

The first person out on the field when a player is hurt is always the athletic trainer. At varsity football games, each team brings their own trainer, however, in many other sports or at the Junior Varsity level, the home team will usually provide the trainer. During all varsity football games, a team doctor will be present. If the injury is severe enough, the trainer will ask a team doctor to come onto the field. Finally, there is always an ambulance crew present, but they only come onto the field if the trainer and doctor request the ambulance.

The chance of severe injuries is rare, even in a contact sport.

The most common cause of a player not getting up right away is muscle cramping. This is especially the case during hot weather, when many players get dehydrated. Other common injuries include ankle sprains, deep contusions, and muscle strains. One of the more serious injuries, and a hot button topic today, is a concussion. A concussion is always related to some sort of head contact (helmet to helmet, player to player, player to ground, etc). However, every head contact does not cause a concussion. It is up to the medical staff to make this diagnosis. If a concussion diagnosis is made, SAME DAY RETURN TO PLAY is not possible.

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Serious injuries, although rare, may occur. These injuries include cervical spine injuries, fractures and dislocations.

ACL tears are one of the more common injuries as well. The medical staff on-site is well versed on the field treatment of these injuries, immobilization of the injury and rapid transport to a hospital or our orthopedic urgent care for definitive treatment.

One of the important jobs of the team trainer and doctor is to properly communicate with the parents of the injured player.

As a team doctor, I make a specific point to find the player's mom or dad after a player is injured. We talk about the severity of the injury, the plan to treat the injury, and how long to expect the player to be out of his sport. Hopefully through proper communication, I can help to alleviate those anxious moments any family member feels, when their loved one is injured on an athletic field.

JASON RUDOLPH, MD ORTHOPEDIC SURGEON

THE

ANTIGRAVITY TREADMILL A new piece of equipment at Coordinated Health is giving patients the opportunity to recover even faster without being slowed down by anything, including gravity. The Alter-G antigravity treadmill is only available at our 2030 Highland location and offers patients a unique experience when it comes to rehab after a joint replacement or sports injury by eliminating gravity.

Patients begin by putting on a special pair of pants over their regular clothing. These pants have a zipper that attaches to a large plastic bag that goes over the treadmill. Once patients are properly ‘zipped’ in, a physical therapist calibrates the machine by entering the patients body weight along with how much weight they want to take away. This gives patients the opportunity to begin moving much sooner after surgery.

“This machine is great for injured athletes who are allowed to walk, but not able to bear their weight because it hurts.

We can put them in at 80% weight bearing and they can run and perform normal movement patterns without injuring themselves,” says Coordinated Health Physical Therapist Leslie Lupin.

Lupin also says the antigravity treadmill is a great tool to get post-operative knee replacement patients walking sooner after their surgery. She believes that overall the treadmill helps patients build their confidence while they work on proper mechanics.

According to Lupin, patient's response to the machine has been very positive. “Patients have been very excited. We’ve had some athletes who were not allowed to run for a week or two, but because we could take away some of their body weight they were allowed to run sooner. Plus, it’s kind of fun and it feels like you're walking on the moon or water so it’s kind of neat.”

LESLIE LUPIN, PT

PHYSICAL THERAPIST

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FALL 2016 | 9

PERFECT EYEBROWS MADE EASY Finally, women who suffer from lackluster eyebrows can throw their pencils and gels away! Microblading is a popular new tattoo technique that has taken the Internet by storm, and celebrities like Bella Thorne swear by the results.

Though many women may be scared off by the word tattoo, Coordinated Health Aesthetician Joann Stuhl swears that there’s no need to worry. “When people hear tattoo they think of the painted on look that their grandmother used to wear, but Microblading gives women a much more natural look,” she says.

The procedure is semi-permanent with results that last between one and three years. It is done in the office and only takes a few hours, but Stuhl recommends an initial consultation beforehand to make sure you are a good candidate as well as a follow up appointment to see if any touch up is necessary.

Microblading is done using a handheld tool with small needles at the end to deposit pigment just under the skin. It is a very meticulous process since each hair is drawn on one by one and generally takes up to two hours. The first hour is just drawing in the shape and outline of the eyebrow and the second hour is the actual tattooing.

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Before the tattooing is done, Lidocaine cream is applied to numb the area and to lessen any discomfort, which Stuhl says is minimal anyway.

Following the procedure, there is no down time and no special care required, although Stuhl recommends a follow up appointment in about a month for a touch up. She also warns that the eyebrows will appear darker at first and fade gradually over a few days to their natural color.

“Microblading is perfect for anyone that has been using pencils, gels or other procedures to get the look they want. It can really change your entire appearance,” says Stuhl.

JOANN STUHL

LICENSED AESTHETICIAN

HEALTHY TAILGATING CLASSICS Football tailgating parties can be a lot of fun, but can wreak havoc on your waistline! However, there are ways to host a tailgating party using the traditional foods you love without all the calories. Check out some fan favorite recipes with a healthy twist!

FIVE LAYER DIP

DEVILED EGGS

INGREDIENTS

INGREDIENTS

Substitute a layer of corn for the ground beef in this tasty five layer dip and cut your calories in half!

• 6 (8-inch) flour tortillas • Cooking spray • 1/2 teaspoon paprika • 2 teaspoons fresh lime juice • 1/2 teaspoon ground cumin • 1 (16-ounce) can organic refried beans (such as Amy's or Eden Organic) • 1 cup organic bottled salsa (such as Muir Glen) • 2/3 cup frozen whole-kernel corn, thawed • 1/4 cup chopped green onions • 2 tablespoons chopped black olives • 3 ounces preshredded 4-cheese Mexican blend cheese (about 3/4 cup) • 3/4 cup (6 ounces) light sour cream • 2 tablespoons chopped fresh cilantro PREPARATION

1. Preheat oven to 350°.

2. Cut each tortilla into 8 wedges, and arrange wedges in single layers on 2 baking sheets. Lightly spray wedges with cooking spray; sprinkle with paprika. Bake at 350° for 15 minutes or until lightly browned and crisp. Cool.

3. Combine juice, cumin, and beans in a medium bowl, stirring until well combined. Spread mixture evenly into an 11 x 7-inch glass or ceramic baking dish coated with cooking spray.

Spread salsa evenly over beans. Combine corn, onions, and olives; spoon corn mixture evenly over salsa. Sprinkle cheese over corn mixture. Bake at 350° for 20 minutes or until bubbly.

Let stand 10 minutes. Top with sour cream; sprinkle with cilantro. Serve with tortilla chips.

Give these deviled eggs a heavenly spin by substituting the mayonnaise with greek yogurt and Dijon mustard.

• 12 hard-cooked large eggs, peeled* • About 2 tablespoons finely chopped spring onion* • 1/2 cup plus 2 tablespoons low-fat Greek yogurt • 3/4 teaspoon kosher salt • 1 tablespoon country Dijon mustard • About 1 tablespoons finely chopped chives • About 2 tablespoons finely chopped spring onion PREPARATION

1. Cut eggs in half lengthwise and pop yolks into a food processor; reserve whites. Add yogurt and salt to food processor and whirl until smooth, scraping down bowl as needed.

2. Transfer yolk mixture to a medium bowl and stir in mustard, 1 tbsp. chives, and 2 tbsp. onion to blend. Set egg whites on a platter, hollow side up. Scoop yolk mixture into a piping bag fitted with a star tip and pipe mixture into hollows. Sprinkle with more chives and onion if you like. *For perfect hard-cooked eggs, cover them in cold water in a small saucepan and bring to a boil. Remove from heat and let stand 12 minutes. Plunge cooked eggs into ice water, crack all over, and let sit in the water for a few minutes before peeling.

Look for spring onions (regular onions picked young) at farmers' markets in spring and at Latino markets year-round.

They have a fatter bulb than green onions--which have less crunch but make a good substitute.

FALL 2016 | 11

THE RISE OF SPORTS INJURIES &

OPIOID ADDICTION Though opioids have been used in modern medicine to alleviate pain, a Coordinated Health Orthopedic Surgeon and Team Physician warns parents of an alarming trend they may not see coming.

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The explosion of opioid use in the last two decades has been described as one of the great mistakes of modern medicine.

From 1999 to 2014, sales of opioids quadrupled in the U.S – and so did the number of opioid related overdose deaths.

Death rates now rival those of AIDS during the 1990s, with overdoses from prescription opioids and heroin killing more than 27,000 people a year.

factor” against prescription drug misuse and heroin use. The physical activity and positive social connections found in sports are likely an overwhelmingly positive developmental experience.

Although the results of this study are encouraging, others argue that it misses the point, as this is more of a medical issue than a recreational drug issue. “The issue with young This alarming trend is clearly on display in the rampant use athletes is medical use, not nonmedical use. Young athletes and abuse of opioids by our young athletes today. Playing are becoming addicted to opioids through medical through injuries, as well as pain, has always treatments for injuries. And playing sports may been a part of sports. But now, as many top actually increase risks of addiction if injuries are professional athletes sign contracts and treated with opioids.” describes Dr. Andrew endorsement deals worth 100’s of millions YOUNG Kolodny, director of the Phoenix House. of dollars the pressure to succeed in sports has never been higher.

ATHLETES ARE What is clear is that those of us who BECOMING ADDICTED are caring for these athletes must do Nowhere is this growing epidemic a better job. It starts with being much more evident than in our National TO OPIOIDS THROUGH more vigilant in our prescribing practices, Football League, with two huge as well as using alternative pain control lawsuits recently brought against MEDICAL TREATMENTS strategies that have proven to be highly the league. The lawsuits allege, FOR INJURIES. effective. There is good evidence that relying among other things, that the overuse of on opioids for pain control actually leads to narcotic pain medications has significantly worse clinical outcomes. In our practice, we contributed to the problems of concussion, believe it is essential to focus on a multi-modal CTE, addiction, and some of the other approach to pain management, which includes the devastating medical problems players are facing at appropriate rehabilitation, cold therapy, early mobility, healthy the end of their careers. diet, anti-inflammatory medications, and patient education.

While it is much easier for professional athletes to obtain It is imperative that we educate athletes on the significant narcotic pain medications, this is also a serious problem risk associated with using prescription painkillers, which among our younger athletes in high school and college. With is something we have largely ignored in the past. It is also the arduous physical demands of training and competition, critical that we address the culture that surrounds our high school and college athletes are at a particularly high athletes today. That starts with parents, coaches, family, and risk for acute pain from injuries. In the most recent NCAA friends. survey, 23 percent of college athletes reported receiving a prescription for a pain medication and 6 percent reported using an opioid without a prescription in the prior year. In high school we see the same thing, with several national studies showing that youth who are highly involved in competitive sports are at a greater risk of being prescribed opioid medications, misusing opioid medications, and being approached to divert (eg, give away) these opioid medications.

“

”

While we have seen that adolescent athletes clearly have more exposure to prescribed narcotic painkillers, a new University of Michigan study published in 2016 did suggest that teen athletes are not as likely to abuse prescription painkillers or heroin as non-athletes. The results of this study suggest that participation in sports may serve as a “protective

NICK SLENKER, MD

ORTHOPEDIC SURGEON, LAFAYETTE COLLEGE TEAM PHYSICIAN

FALL 2016 | 13

STAYING HEALTHY THIS FALL It’s that time of year again. You or a family member may begin to experience familiar symptoms like runny nose, cough, and body aches. The big question is, do you have the flu or a cold? Although they share similar symptoms, they are actually two very different conditions.

COLD SYMPTOMS DEVELOP SLOWLY AND INCLUDE: a fever up to 102°F runny or stuffy nose sore throat coughing sneezing

fatigue muscle aches headache watery eyes

FLU SYMPTOMS APPEAR SUDDENLY AND INCLUDE: typically more severe symptoms fever often over 102°F more intense body aches

If you have the flu, getting a prescription for an antiviral in the first two days of symptoms can have modest benefits, reducing the duration of your illness by about a full day.

Because both colds and the flu are viral, antibiotics are not effective.

The treatment for colds and the flu is very similar and is based on controlling the symptoms. Use a humidifier and clean it daily. Drink plenty of fluids, enough so that your urine is light yellow or clear like water. Ease pain and reduce fever with: Acetaminophen (Tylenol and generic) Ibuprofen (Advil and generic). Be careful when taking over-the-counter cold or flu medicines and Tylenol at the same time. Many of these medicines have acetaminophen, which is Tylenol and you don’t want to double your dose.

Wash your hands often and well with plain soap and water or hand sanitizer. Get the Flu (influenza) vaccine once a year.

October or November is best. When you turn 65, get two shots of the Pneumonia vaccine six months apart. All adults should get the Tdap vaccine for tetanus, diphtheria, and pertussis (whooping cough) once, and then get a booster shot every 10 years. Get extra sleep. Scientist at UCSF tracked the sleep of a 164 participants and then exposed them to the cold virus. Those who averaged less than five hours of sleep as measured by a Fitbit type device got sick 45 percent of the time. Only 17 percent of those with over seven hours sleeping got sick. Control your stress. The more stressed you are the more susceptible you are to infections. Regular exercise and mindfulness meditation have both been proven to reduce infection rates. Taking at least one gram of vitamin C per day has also been shown to reduce colds in several studies.

FOR NASAL DISCOMFORT use saline (salt water) drops or spray.

TO SOOTHE A SORE THROAT, gargle with salt water, drink

warm beverages, or eat or drink something cool.

TO EASE A COUGH, breathe steam from a kettle or shower.

For mild, short-term relief, try an over-the-counter cough medicine that has dextromethorphan. A rub containing camphor, menthol, and eucalyptus oil (Vick Vapo Rub) or buckwheat honey can also help with the cough.

Zinc gluconate lozenges or Echinacea may REDUCE THE DURATION OF COLDS, but studies are mixed.

You can’t always avoid getting sick in cold and flu season, but there are ways to reduce your risk.

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NATHAN JOHNSON, MD

FAMILY MEDICINE PHYSICIAN

SLEEP COMFORTABLY

AFTER SHOULDER SURGERY

The first six weeks after any type of shoulder surgery, including rotator cuff repair, labral repair or arthroscopic debridement, can be difficult. But, one of the most common problems people have is finding a comfortable position to sleep.

Following surgery, many people need to wear a post-operative sling to keep their shoulder in place and safe while it is healing. The sling is equipped with an abduction pillow, which is a small pillow built into the sling to keep your shoulder slightly away from your body. The sling has to be worn at all times, including at night while you are sleeping. This can make for a difficult night of rest.

not, have someone place a few pillows underneath the back of your arm, between your arm and the bed or recliner. This will position your upper arm forward. Therapists refer to this position as the plane of the scapula. This puts less stress on the front of the shoulder and keeps the joint in better alignment, making for a more comfortable sleep.

It’s also important to remember to take all of your medication as directed throughout the day to minimize any discomfort.

Most people who undergo shoulder surgery are prescribed (at minimum) several days of narcotics and in some cases up to two weeks. In addition, you can take an anti-inflammatory 30 minutes before you go to bed. This will give the medication time to work and allow you to get comfortable to sleep.

In many cases, the best way to sleep after shoulder surgery is in a recliner. The recliner allows you to lie down and rest without giving you the freedom to turn over.

To maximize your comfort and protect your shoulder while it is immobilized, look over at your surgical arm when you are lying down and check to see if you can see your elbow. If

RICHARD MARTINETTI, PT, MSPT PHYSICAL THERAPIST

FALL 2016 | 15

GENETIC TESTING GENETIC

TESTING

BREAST CANCER FOR FOR BREAST CANCER

12% About 1 in 8 women in the US will develop invasive breast cancer during their lifetime.

Who should consider

How is the genetic

What

genetic testing?

does genetic testing look for?

testing done?

Genetic testing looks to see if a person is a carrier of a genetic mutation, which could account for an increased risk of breast cancer or other cancer’s like ovarian.

OR You have a family history of ovarian cancer

12% of women in the US will develop invasive breast cancer during their lifetime.

A first or second degree relative who was diagnosed with breast cancer under the age of 45

What are the next steps, if genetic testing is positive?

20

3 WEEKS

A simple blood test is done in the office and sent to a special lab.

Generally, it takes up to three weeks for results.

Why

should women, especially those who are high risk, consider having testing done?

Invaluable information for family members.

GENES

A meeting with her physician to discuss what the results mean to her.

Recommendations can vary depending on the genetic mutation involved.

Prophylactic risk reducing surgery & high risk screening protocols can help reduce risk early.

Facts provided by American Cancer Society, Inc.

CARA GUILFOYLE, MD, FACS BREAST SURGEON

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VEIN ABLATION Many people think of varicose veins as an unsightly nuisance.

But, the common condition that causes swollen ankles and jagged, bluish lines along the calves and legs can also be extremely painful. Fortunately, there are ways to treat this painful condition.

VARICOSE VEINS

NORMAL VEINS

One cause of varicose veins is venous reflux disease. Healthy leg veins contain valves that open and close to assist the return of blood back to the heart and keep blood flowing in one

direction back to the heart. Venous reflux disease develops when these valves become damaged or diseased. Symptoms of venous reflux disease include prominent varicose veins, leg pain, leg fatigue and heaviness, and leg ulcers. Coordinated Health Cardiologist P. Sean Pandey, M.D. treats varicose veins through radiofrequency ablation, sclerotherapy and microphlebectomy.

He says all of these procedures are done on an outpatient basis and are performed under local anesthesia and result in relief of symptoms.

RADIOFREQUENCY ABLATION

MICROPHLEBECTOMY

Radiofrequency ablation is a minimally invasive procedure that uses radiofrequency energy to heat up the wall inside a vein, which generally closes off the varicose vein. Radiofrequency energy is distributed through a catheter that is inserted into the vein through a small incision. You will be able to walk right after the procedure and the recovery period is short. After the procedure, you will need to wear a compression sock for a week and your physician will use ultrasound to make sure the vein is closed.

Microphlebectomy actually removes the varicosed vein through several small incisions. In most cases, stitches aren’t even necessary. You will be able to walk immediately following the procedure, though compression hosiery is recommended. The procedure is done either in the office or on an outpatient basis.

SCLEROTHERAPY During sclerotherapy a salt solution is injected directly into the vein, which irritates the lining of the blood vessel, causing it to collapse. The vessel turns into scar tissue over time that fades. The procedure only takes between 15 and 30 minutes and can be done right in the office.

Following the procedure you will need to wear compression hosiery. It generally takes anywhere from three weeks to four months for veins to respond to the treatment, depending on the size of the vein.

Dr. P. Sean Pandey at Coordinated Health is trained in diagnosing and treating venous reflux disease using multiple techniques which he has been doing for over three years.

He is board certified in Cardiology and also evaluates cardiovascular problems.

P. SEAN PANDEY, MD CARDIOLOGIST

FALL 2016 | 17

SOARING AFTER SURGERY Russ Frank thought that he had to live with his chronic knee pain in order to continue skydiving. But, thanks to Coordinated Health orthopedic surgeon Thomas Meade, MD, he was able to have both knees replaced and still enjoy skydiving.

No one can ever accuse 75-year-old Russell Frank of taking it easy as he ages. The retired taxidermist not only spends his time at his grandchildren’s sporting events, but stays active by taking part in hunting excursions in Canada and Montana and also routinely goes skydiving.

skydiving. I just fell over because it was too much of an impact.

I remember one time someone coming over and asking if I was hurt and I said nope, just my pride,” Frank sighs.

Frank saw several orthopedic physicians and they all said the same thing. He was going to eventually need a knee replacement, but would not be able to skydive after the surgery. Unwilling to give up his passion, he chose to forgo the knee replacement and instead opted for cortisone injections and physical therapy.

Frank began skydiving in 1979 when his wife bought him a session for father’s day. From that point on he was hooked.

“There is nothing like it. I just love the freedom of flying through the sky,” he says.

About a year ago, Frank met a fellow skydiver who had undergone a knee replacement with Dr. Thomas Meade. Frank called and made an appointment the next day.

However, about six years ago Frank wondered if he would be able to continue skydiving. He had severe knee pain from arthritis that affected his ability to do day-to-day activities let alone skydive. “I couldn’t even come to a landing when I was

After imaging studies, Dr. Meade confirmed that Frank’s knees were bone on bone and he would need a knee replacement. At the time it was October, since Frank wanted to be skydiving by spring, Dr. Meade suggested he have the surgery within the week.

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Even though having the surgery would mean missing the rest of archery season, Frank agreed. He had the surgery done at the Allentown Hospital and he chose to have both of them done at the same time.

Dr. Meade applies the rapid recovery protocol to all of his joint replacement patients, which includes specific patient education, regional anesthesia as opposed to general anesthesia, non-opioid medication, same-day mobilization and same-day physical therapy. Because Frank was having both knees replaced, he was not a candidate for the same-day joint replacement and was required to stay overnight.

Though Frank planned on staying at a rehabilitation facility for a few weeks following his surgery, he quickly discovered he would be able to recover at home and was released within a few days. After that, he began outpatient physical therapy and while he missed the rest of hunting season, he was ready to get back to skydiving by March of the following year.

“I was a little nervous. Right after I landed the first thing I did was look at my knees and once I realized that everything was good, I went right back to jump again. I couldn’t be happier,” he says.

Immediately following the surgery, Dr. Meade had Frank up and walking around. “I couldn’t believe how fast they got me up and moving. I was determined though and was going up and down the hallway,” he says.

THOMAS MEADE, MD ORTHOPEDIC SURGEON

FALL 2016 | 19

IS A TUMMY TUCK RIGHT FOR YOU? WHAT IS A TUMMY TUCK?

A SURGERY THAT REMOVES EXCESS FAT AND SKIN FROM THE ABDOMEN.

HOW IS THE SURGERY DONE? During the procedure, the surgeon makes a horizontal incision along the lower abdomen below the belly button. The upper abdomen is pulled down and excess skin is trimmed so that the remaining skin is sutured together. Finally, a new opening for the belly button is created.

HOW LONG IS THE RECOVERY The recovery from a tummy tuck is generally one to two weeks. Your initial results may be hard to see because of swelling, which will go down within a few days. A tummy tuck will give you a flatter and firmer abdomen.

WHO IS THE BEST CANDIDATE FOR A TUMMY TUCK? The best candidate for a tummy tuck is: Physically healthy and at a stable weight Has realistic expectations A non-smoker Bothered by the appearance of their abdomen

GREGG GUILFOYLE, DO PLASTIC SURGEON

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FRACTURED GAME Sports have always played a big part of 16-year-old Parkland High School student Dylan Rahm’s life. So when a clavicle fracture threatened his ability to play any sport, he turned to his team physician and Coordinated Health Orthopedic Surgeon Nick Slenker, M.D. for help.

Dylan Rahm has always loved sports. In fact, he’s been involved in some type of sporting activity since he was three and has always enjoyed watching professional football with his dad. He started playing football in kindergarten, but after finding lacrosse about six years ago, he knew that he had found a sport he was truly passionate about.

“I just like the quick, competitive drive of the game. I also enjoy the friendships that I have made along the way,” he says.

Since lacrosse and football are played during different seasons, Rahm chose to play both sports. However, an injury during a football game almost left him unable to play either.

“I received a wide receiver hand off and was making my way to the edge of the field when a smaller corner back took out my legs, causing me to flip and land on my clavicle,” explains Rahm.

Fortunately, a Coordinated Health Athletic Trainer was on the sidelines when his injury occurred and immediately sent him to the Care on Demand, which is just a few miles from the school.

designed titanium clavicle plate, Rahm would be back and better than ever for lacrosse.

The surgery Dr. Slenker performed on Rahm was an open reduction internal fixation of his clavicle. It is usually performed on an outpatient basis and generally done within an hour. He used a new anatomic plate made of titanium that was designed specifically to fit the clavicle bone. “The clavicle is actually an 'S' shaped bone, and previously we had been trying to conform a straight plate by bending it appropriately, but oftentimes it wouldn’t have good outcomes. This plate fits perfectly so patients don’t have any irritation,” he says.

After the surgery, Rahm was in a sling for about a week and started physical therapy right away. He was back to lacrosse in just ten weeks and has since decided to just stick with the sport that he loves. He is thankful for Dr. Slenker’s quick actions. “The process at Coordinated Health was amazing. I got an X-ray just 20 minutes after my injury. Dr. Slenker did an excellent job and my PT’s were great! Now if I’m ever injured, I know where to go,” says Rahm.

After an X-ray and a physical, Dr. Slenker determined that Rahm had a fractured clavicle. The clavicle is located between the ribcage and the shoulder blade and connects the arm to the body. Most breaks are in the middle of the bone and are caused by a direct blow to the shoulder like a fall.

While in some cases a clavicle fracture can heal with conservative treatment, Dr. Slenker concluded that since Rahm’s bones were displaced he would benefit from surgery.

“We’ve found over the last few years that patients do a lot better with surgery than just allowing them to heal in a poor position,” says Dr. Slenker.

Rahm’s main concern with surgery was whether he would be able to play lacrosse in the spring, specifically his college showcases. But Dr. Slenker knew that, thanks to a newly

NICK SLENKER, MD

ORTHOPEDIC SURGEON, LAFAYETTE COLLEGE TEAM PHYSICIAN

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