Better Living March 2017 by Coordinated Health

better living MARCH 2017

COORDINATED HEALTH MAGAZINE

WRESTLING WITH AN

INJURY

YOUR HEALTHIEST YEAR YET Physician-owned hospital system.

HEALTHY SWEET TREATS

BETTER. TOGETHER.

better living WINTER 2017

CONTENTS

6 CH in the News 10 Winter Workouts 8 CH Plastics Gets A Facelift 11 New Imaging Results in Earlier Diagnosis 9 Appointment Checklist VISIT US AT COORDINATEDHEALTH.COM OR CALL 1 (877) 247-8080 TO SCHEDULE AN APPOINTMENT TODAY.

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16 Not Your 12 A Team Effort Ordinary Bakery 14 Positive Results From Unexpected Surgery 18 Walking to a Better Life

21 19 Zip Tuck 20 Fibromyalgia vs Lupus 21 Wrestling With an Injury

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OUR TEAM FLORENCE BROWN OLIVIA BROWN JESSICA FLATTO CASSY KLISCH GREG LEH BRIAN MENECOLA DEBBIE MORGAN HANNAH ROPP MARTY WAMBOLD

DIRECTOR OF COMMUNICATIONS MARKETING & EVENT COORDINATOR JUNIOR GRAPHIC DESIGNER GRAPHIC DESIGNER DIRECTOR OF MARKETING CREATIVE DIRECTOR INTERNAL COMMUNICATIONS SPECIALIST CONTENT MANAGER VIDEO PRODUCER

CONTRIBUTING AUTHORS CARA GUILFOYLE, MD, FACS

BREAST SURGEON

GREGG GUILFOYLE, DO

PLASTIC SURGEON

STEVEN HULTGREN, CSCS SUSAN LEE, MD WAYNE LUCHETTI, MD MICHAEL NIMEH, MD MIKE PRICE, PT

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FITNESS & SPORTS PERFORMANCE TEAM LEAD RHEUMATOLOGIST ORTHOPEDIC SURGEON PRIMARY CARE PHYSICIAN PYSICAL THERAPIST

JASON RUDOLPH, MD

ORTHOPEDIC SURGEON

NICK SLENKER, MD

ORTHOPEDIC SURGEON

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CH IN THE NEWS

DR. DIIORIO INTERVIEWED BY WFMZ

On February 1, Coordinated Health CEO Dr. DiIorio appeared on the evening newscast of WFMZ in a segment titled, “Experts Discuss Effort to Rein in Prescription Prices.” During his discussion, Dr. DiIorio outlined his thoughts on how the federal government might leverage its spending power to control drug price inflation. Echoing strategies discussed by President Trump during his January 31 meeting with pharmaceutical executives, Dr. DiIorio also advocated lowering regulations and taxes, thus bringing research and manufacturing jobs back to the United States.

DR. MEADE VOICES SUPPORT FOR PROPOSED PERSONAL HEALTH INVESTMENT TODAY ACT IN LEHIGH VALLEY BUSINESS ARTICLE A health-related tax bill in Congress could reduce healthcare expenses for employers and employees. The Personal Health Investment Today Act would provide an incentive for people to stay active to prevent healthcare costs related to inactivity and chronic, long-term disease.

Dr. Tom Meade supports the PHIT Act and has several quotes in a Lehigh Valley Business article including, “This does everything that our legislators want in healthcare.” To read more about the Act and Dr. Meade’s perspective, please visit http://www.lvb. com/article/20170130/LVB01/301269998/bill-proposes-pretaxaccount-for-gym-sports-fees-equipment

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ATC KATI HOLMES STEPS UP DURING AN EMERGENCY

On January 27, 2017, CH Athletic Trainer Kati Holmes was working at Palisades High School with some athletes when a school employee suffered a heart attack. Kati was one of the first on site to respond and immediately started performing CPR, which she is certified to do. She was assisted by the school nurse and fire squad until the paramedics and EMTs arrived. After approximately 10 minutes of CPR and some help from an AED (automated external defibrillator), they were able to get a pulse for the bus driver. Kati’s quick response and the high quality of CPR that was performed enabled a positive outcome. “It was truly a group effort and I’m happy to have been in a position to help,” Kati said. Today the employee is doing well and continuing to recover in a local hospital. “Kati’s actions serve as a good reminder that you can never let your guard down,” said CH ATC Bryan Schapley, who was onsite with Kati when the emergency situation occurred. Vice President of Clinical Operations Jen Roeder also praised Kati’s actions. “While these employees are often out of sight since they work at the schools, it’s important to remember how they represent CH in our communities.” Thanks, Kati for doing what you are trained to do in such a positive way!

ATHLETE OF THE WEEK

The Winter season of the Coordinated Health/ Morning Call Athlete of the Week scholarship program is now in full swing. So far, Lehigh Valley voters have selected 16 winners to receive $1,000 scholarships. There are still 20 more athletes to be selected in the Winter and Spring seasons, with the final Athlete of the Year banquet occurring on May 24, 2017. Nominate your favorite high school athlete by visiting mcall. com/athleteoftheweek

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COORDINATED HEALTH

PLASTICS WEBSITE GETS A FACELIFT

Coordinated Health recently unveiled its new Plastics Website, which prominently features Plastic Surgeon Gregg Guilfoyle and Aesthetician Joann Stuhl. The website also features all of the services offered through the Coordinated Health Plastic Surgery and Aesthetics Service line as well as real before and after photos that feature patient reviews.

In addition to the new website, there is also a new Facebook platform for the Plastic Surgery Service line. The Facebook page was created to help promote our specials, allow potential patients to view before and after photos of the procedures we offer and also allow our online audience the opportunity to watch webinars through Facebook Live.

The new site is built with a modern responsive framework to be optimized for both desktop and mobile viewers. It is also has real-time integration with RealSelf, a website dedicated to helping people choose a plastic surgeon by providing real before and after photos and patient testimonials. Specials and Promotions are also prominently uploaded on the new site.

“We’re excited to offer this new Plastic Surgery and Aesthetics website., says Director of Plastic Surgery and Aesthetics Rebecca Beltzner. “It has a bold look and comprehensive content to help people shopping for plastic surgery services feel comfortable looking at what we can offer. It also highlights our beautiful facilities and shows how we stand out from the competition with our skilled board-certified surgeon.”

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APPOINTMENT CHECKLIST Are you ready to make 2017 your best and healthiest year yet? According to Coordinated Health Family Medicine Physician Michael Nimeh, M.D., the best way to take care of yourself is by following the guidelines when it comes to preventative testing.

related ailments. It is helpful in screening for cancer, diabetes and heart disease. Annual physicals are beneficial to answering patient questions about health and lifestyle and to help steer them in the right direction,” says Dr. Nimeh.

“Annual health exams help patients live healthier lifestyles, conduct diagnostic screenings and help prevent behavioral

CHECKLIST FOR ANNUAL HEALTH EXAMS AGES 18-39

AGES 40-64

AGES 65 AND OVER

• Screen for medical issues • Assess risk factors for future medical issues • Encourage healthy lifestyle • Update vaccines • Blood Pressure screening • Cholesterol screening • Diabetes screening

• Blood Pressure screening • Cholesterol screening • Diabetes screening • Colon cancer screening • Immunizations • Breast exam/mammogram • Osteoporosis screening

• Everything above • Pneumococcal vaccination • Depression screening • Fall Assessment • Cognitive Assessment

DR. MICHAEL NIMEH primary care WINTER 2017 | 9

WINTER WORKOUTS Keeping up with your workouts during the winter months is never easy, even if you’re the most devoted of athletes. But, according to Coordinated Health Sports and Performance Coach, Steve Hultgren, it’s important to keep up with your routine – even when your couch and a big bowl of popcorn are calling your name. “Exercise throughout the year is important, but exercising during the winter months is especially important because it boosts serotonin, which can help reduce depression and anxiety, both of which are common during the winter months,” says Hultgren. In addition, studies have shown that regular exercise can boost your immune system during the winter months by improving both lymphatic and cardiovascular circulation. Although the effects on your immune system from exercise are short lived so it’s important to exercise regularly. In fact, just a 20 to 30-minute walk will do the trick! If you shiver at the thought of heading out to your car to go to the gym, have no fear. Hultgren stresses that you don’t need to go to the gym in order to get a good workout. “You can get a good workout in your own home. Concentrate of things like squats and lunges along with planks for strengthening your muscles. For aerobic activity, choose jumping jacks and even jump rope,” he says.

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STEVE HULTGREN fitness & sports performance

LUNGES Keep your body straight, with your shoulders back and relaxed with your chin up. Keep your core tight. Step forward with one leg, lowering your hips until both knees are bent at a 90-degree angle.

SQUATS Stand with your head facing forward and your chest held up and out. Place your feet shoulder with apart or slightly wider. Extend your hands in front of you to help your balance. Sit back and down like your sitting in a chair. Lower down so your thighs are as parallel to the floor as possible, with your knees over your ankles. Keeping your body tight, push through your heels to bring yourself back to starting position.

PLANKS Start by getting into a press up position. Bend your elbows and rest your weight onto your forearms and hands. Your body should form a straight line from shoulders to ankles. Engage your core by sucking your belly button into your spine. Hold this position for at least 10-15 seconds.

RUSSIAN TWISTS Lie down on the floor and place your feet under something that will not move. Your legs should be bent at the knee. Elevate your upper body so that it creates an imaginary V-shape with your thighs. Your arms should be fully extended in front of you, perpendicular to your torso, with your hands clasped. Twist your torso to the right side until your arms are parallel with the floor. Hold that pose for a second and then move back to the starting position. Next move to the opposite side while performing the same technique. Repeat as desired.

NEW IMAGING RESULTS IN EARLIER DIAGNOSIS When it comes to the fight against breast cancer, early detection continues to be the key to the best outcome. Thanks to better imaging equipment, like 3-d mammograms, it's easier than ever to diagnose breast cancer early. 3-D mammograms or Breast tomosynthesis has been FDA approved as an additional upgrade to standard mammography. Tomosynthesis is a modified mammogram that uses threedimensional data to generate very thin slices of breast images, making it easier to tell the difference between a mass verus an overlap of normal tissue. The screening is generally performed in conjunction with a conventional mammogram. While the process is the same, the unit sweeps cross the compressed breast to take pictures in multiple views. It then creates a 2-D image from the 3-D tomosynthesis images. Though Tomosynthesis is considered to be useful for all women, it’s especially helpful for women who have dense breast tissue. Breast Surgeon Cara Guilfoyle, MD, says that tomosynthesis has multiple benefits. “In the screening setting, tomosynthesis helps to decrease the amount of times a patient has to come back for additional imaging and has even been shown to improve cancer detection rates,” she says.

DR. CARA GUILFOYLE breast surgery WINTER 2017 | 11

A TEAM EFFORT Easton High School Senior Shelby Stocker knew that she didn’t want to give up her final basketball season after tearing her ACL, so she depended on Orthopedic Surgeon Nick Slenker, MD and Physical Therapist Mike Price to get her back into shape. Eighteen-year-old Shelby Stocker is no stranger to athletic injuries. She’s been playing basketball since she was in third grade and has had multiple sprains and strains and even dislocated her elbow twice. However, when she hurt herself in a game last summer, she knew it was serious. “I was playing hard because it was a showcase and there were college recruiters there. I tried to block someone and ended up getting knocked down. I heard my knee pop and couldn’t move,” says Stocker. Because Stocker’s mom works at Lafayette College she knows their team physician, Coordinated Health’s Orthopedic Surgeon Nick Slenker, MD, and made an appointment for Stocker to see him right away. After a thorough exam and MRI, Dr. Slenker told her that she had torn her ACL. “My heart just sank when he told me and I cried. But I knew that I didn’t want to miss my senior year playing basketball, so I was going to have to work hard,” she says. Dr. Slenker performed a minimally invasive arthroscopic ACL reconstruction that allowed Stocker to go home the same day. During the procedure he used a small camera that transmits pictures from inside the knee to a TV monitor as a guide. He then took a small piece of tissue from the front of the knee, which has bone on both ends with a section of tendon stretched between, and inserted it into place between the end of the thighbone and the top of the shin.

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Although Stocker said she was sore after the surgery, she knew she was going to need to push through the pain in order to get back on the court. She began physical therapy with Mike Price, PT who worked with her on regaining her strength in her injured leg. “The success of physical therapy is really up to the patient. You need to work hard in physical therapy and keep up with it at home in order to see results. Shelby was very motivated,” says Price. Price says the overall goal for physical therapy after an ACL tear is to reduce swelling, restore mobility, regain range of motion, and improve overall strength of the quad and hamstring muscles. He says this is done through a variety of movement and strengthening exercises, and in the end, some light jogging.

DR. NICK SLENKER orthopedics

After several months of hard work, Dr. Slenker cleared Stocker to play her senior year of basketball. Now she’s got her sights set on bigger goals. “I’m really hoping that this is a great season for us. I’d love to make it to states this year,” she says. Stocker is also hoping to continue her basketball career at Lafayette College, but hopes that she only sees team physician Dr. Slenker on the sidelines. Stocker credits both Dr. Slenker and Mike Price, PT for her success. “I think that Dr. Slenker and Mike worked great as a team. They were always in communication with each other and I think that really helped to speed up my recovery,” she says.

MIKE PRICE, PT physical therapy

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POSITIVE RESULTS FROM UNEXPECTED SURGERY Melanie Strange was delighted to play in a recreational volleyball league, but an injury ended up sidelining her. Thanks to Coordinated Health Orthopedic surgeon Jason Rudolph, MD.

Though Bethlehem resident Melanie Strange hadn’t played volleyball since high school, she was thrilled when her coworkers asked her to join them in a league. In fact, she enjoyed playing volleyball so much that she eventually joined two leagues, and it became a big part of her routine. “It was a great way to be social and stay active,” she says. However, last summer her routine was shaken when she suffered an injury during a game. “I was playing on macadam and I just stepped forward and heard a pop and went down. I initially thought that someone stepped on the back of my foot, but soon realized that I had hurt my Achilles,” she says. Strange went to a local ER, where a physician told her to consult an orthopedic surgeon. Her family had been to Coordinated Health before so she called and got an appointment with Orthopedic Surgeon Jason Rudolph, MD. She was so sure that Dr. Rudolph was going to tell her she had a minor injury that she brought sandals to wear after her appointment. However, much to her surprise, Dr. Rudolph told her that she had a ruptured Achilles. “Diagnosing an Achilles rupture is usually pretty straight forward. On exam you can feel a defect in the tendon. When squeezing the calf, the foot doesn’t move. Also, when the

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patient is lying on their stomach, the affected ankle seems more flat compared to the normal ankle. Checking strength is not usually helpful, since other muscles can take over,” says Dr. Rudolph. An X-ray confirmed no fractures, and the exam was consistent with an acute Achilles rupture. Dr. Rudolph told Strange that she would need surgery sooner rather than later. He was able to schedule her for just two days later. “I was shocked. I had no idea that I was going to need surgery. I just kept saying, are you sure,” she laughs. Dr. Rudolph says the surgery to repair an Achilles rupture is done on an outpatient basis at one of Coordinated Health’s own hospitals. He explains that during surgery an incision is made and the tendon is sewn back together. Right after surgery, a splint is placed on the affected foot to keep it pointed down while the tendon heals. After the first week a cast is applied, again keeping the patient on crutches. After three weeks, the sutures are removed, the patient is placed into a boot, and therapy is started. Strange had to be in the boot for six weeks after surgery, which meant she was unable to drive for that time as well. “That was the hardest part, just trying to figure out the logistics of everything while I couldn’t drive,” says Strange.

Strange continued physical therapy for several months after surgery. The focus of her therapy was on stretching and flexibility as well as strengthening the tendon and surrounding muscles. She admits that physical therapy was difficult, but it paid off in the end. “There were times that it was difficult, but I knew that it had to be done and now I’m better than ever,” she says. Dr. Rudolph credits much of Strange’s swift recovery to her work ethic and positive attitude. “She had a great can-do attitude when it came to her recovery. She was willing to work hard and it paid off,” he says.

DR. JASON RUDOLPH orthopedics WINTER 2017 | 15

NOT YOUR ORDINARY BAKERY WE JUST CAN’T BAKE THIS STUFF UP! Baked owner Missy Boehrer-Walters loves bringing her customers happiness through the food that she makes them. The fact that she uses all organic ingredients and packs her treats with nutrients is an added bonus. It’s safe to say that the neighborhood café/bakery Baked has made a name for itself in Emmaus. Even with the doors locked and a closed sign up, Owner Missy Boehrer-Walters finds herself having to turn away customers who knock on her door looking for fresh bread, baked goods and soup. “I guess it’s a good problem to have,” she laughs with a modest shrug. Bohrer-Walters interest in food and baking began in high school. She took classes at a vo-tech high school and found she loved baking. She began entering and winning competitions and even garnered a scholarship, which she later applied to culinary school, Johnson and Whales in Rhode Island, where she majored in pastry arts. After graduating, Bohrer-Walters took a job in Philadelphia, but always knew that she wanted to work closer to her home

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in Slatington. She thought Emmaus was the perfect location for a neighborhood bakery and decided to open the doors to Baked six years ago. “We really wanted it to be a place where people could stop in for a good cup of coffee and also get a delicious and nutritious treat,” she says. Baked offers customers a variety of fresh breakfast and lunch options as well as treats like cookies and cakes. All of their food is made in house and they use as much organic and locally sourced products as possible. Bohrer-Walters also does her best to “sneak” in nutrients to her foods. Salads she packs with protein like nuts and lean meats. Many of her baked goods often include nuts and fruits. Baked also has savory tarts, which she likens to quiche. One thing she really wants to stress to people is the fact that it’s possible to have a treat every once in a while. “There is definitely comfort in food and here at Baked we show you that you can have a treat without being overly indulgent and still be satisfied,” says Bohrer-Walters.

ALMOND ROSE TART RECIPE ALMOND ROSE PIE DOUGH:

• 1 C Organic all purpose flour • C Organic whole wheat flour • 1/8 C Organic granulated sugar • 1/4 tsp Salt • 2 Sticks ( 1/2 C) Organic butter- cold and cut into cubes

1 In a bowl or a food processor place all of the dry ingredients. 2 Mix well to combine. 3 Add the cubed butter. 4 Pulse the ingredients in the food processor of use your hands and work the butter into the dry ingredients until the butter is the size of peas.

5 Add 1/4 Cup of cold water and combine. If it is still dry, add one TBSP of cold water at a time until the dough comes together. 6 Form the dough into a disc, wrap with plastic wrap and refrigerate until firm.

ALMOND PLUM ROSE FILLING: • Organic Plums- at least 6 • 1/4 C sliced almonds • 3TBSP Organic Agave • 1 TBSP Organic All Purpose Flour • Pinch of Cinnamon • 1/2 tsp vanilla extract

1 Combine the agave, flour, cinnamon and vanilla in a bowl. 2 Slice the plums- you will end up with some slices that are a full circle, slice those in half.

3 Toss the sliced plums in the bowl with the agave mixture. 4 Roll out the pie dough into a rectangle. The dough needs to be very thin, or it will not bake thoroughly in the center of the rose.

5 Roll the dough into a 12" wide rectangle and how ever long you can. Cut the rectangle into strips 2 1/2 inches wide. 6 Lay the sliced plums onto the top half of the strip, shingling the slices as you go. 7 Fold the bottom half of the pie dough strip up onto the sliced peaches. This creates a pocket with the peaches in the middle. 8 Roll the strip from one side to the other, creating a rose as you roll.

9 Place the roses into a greased muffin tin. Bake at 350 degrees for 15 minutes, decrease the 10 temperature to 300 degrees and bake for roughly 20 minutes or until golden and baked through.

Remove from the muffin tin while still warm. 11

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WALKING TO A BETTER LIFE Knee pain was affecting Terri’s everyday life so when Coordinated Health Orthopedic Surgeon Wayne Luchetti suggested a knee replacement, she was more than ready for the procedure.

Dr. Luchetti’s team prepared Orris for the surgery by having her attend a joint replacement class. There she learned what to expect throughout the entire process. “It really helped me get ready for the surgery. I knew what I needed around the house when I came home and there were no surprises,” she said. After her knee replacement, Orris stayed in the Coordinated Health’s Bethlehem hospital for three days. She says the day of her surgery she walked up and down the hallway with help from nurses. On the second day she began PT and on the third day she was discharged. Orris says that her goal throughout her recovery was to be able to once again walk her dog Bailey and go for walks with her husband without any pain. She admits that reaching her goal wasn’t as easy as she thought, but she knew that going to her physical therapy appointments three times a week and keeping up with her home exercises would get her there quicker. Whitehall resident Terri Orris says she was never able to pinpoint one thing that caused her debilitating knee pain, she just knows that it was gradual. “Over time fluid built up in my knee and caused a great deal of pain,” she said. To combat the pain, Orris often iced her knee and took over the counter anti-inflammatories. But, when those methods stopped working and she was no longer able to do everyday activities like walking, cleaning the house and cooking she knew that she had to get help. That’s when she went to see Orthopedic Surgeon Wayne Luchetti, M.D. After a thorough physical and an MRI, Dr. Luchetti told Orris that she had arthritis and there was essentially no cartilage in her knee, which meant that the bones were rubbing against each other and causing her pain. He told her that if she wanted to resume her daily activities she would need a knee replacement.

Orris claims that her physical therapists really kept her spirits up when she was feeling disheartened. “They were my cheerleaders and always encouraged me to keep going,” she says. Three months after surgery Orris was able to walk Bailey up and down her street and she is now back to going on walks with her husband and Bailey. Though it was difficult at times, Orris says she is glad that she had her knee replaced. “It has changed my life. Everyday I am able to do different things, go on vacation andgo on walks. I’m able to live my life without having to worry about being in pain,” she says.

Although she was surprised, Orris says she was more than ready to have the surgery. “I wasn’t scared. I was excited about the prospect of regaining my life,” she says.

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DR. WAYNE LUCHETTI orthopedics

Everyone wants a flat, contoured stomach, but for some people it’s just not easily attained. Fortunately, for those people Coordinated Health Board Certified Plastic Surgeon, Dr. Gregg Guilfoyle, can perform abdominoplasty or a tummy tuck along with his signature “zip tuck”, which enhances tummy tuck results. A tummy tuck removes excess skin and subcutaneous fat and restores weakened or separated muscles to create an abdominal profile that appears smoother and firmer. Dr. Guilfoyle reminds his patients that tummy tucks are not a substitute for weight loss. “I see the best results on those within 20 pounds of their ideal weight,” he says. A tummy tuck is ideal for women or men who have abdominal sagging skin or loose hanging skin. Some common reasons for this issue are aging, heredity, pregnancy, past surgery or a significant fluctuation of weight. Some patients are better candidates for tummy tuck surgery than others. They include those who have realistic expectations, are physically healthy and at a stable and consistent weight, and are non-smokers. Those who are bothered by the appearance of their abdomen or would like their clothes to fit better could also benefit from the procedure.

Though a tummy tuck is an outpatient procedure, you will need someone to drive you home after the surgery. Dr. Guilfoyle says the surgery is generally about two hours long. He also stresses that a tummy tuck is a major abdominal surgery so the recovery time is generally about 10-14 days and for some people standing upright may be difficult for the first few days. He also explains that most of his patients require pain medication for the first four to five days. According to Dr. Guilfoyle, you should begin to notice the results from your tummy tuck within a week or two after the initial swelling from the surgery goes down For women who have had a cesarean section, the existing scars may be incorporated into the new scar. It may take up to a year for the scar to fade. “Cosmetic abdominoplasty and other mommy makeover patients are some of the happiest patients in our practice. It’s usually something that has been bothering them for years and when they finally get around to taking care of it, and themselves, they are thrilled,” says Dr. Guilfoyle. For more information or to schedule your free consultation today, call Coordinated Health at (484) 273-4222 or go to chplasticsurgery.com.

Dr. Guilfoyle’s tummy tuck procedure is different than others because it offers a supplemental process that he calls the “zip tuck”. He says the standard abdominoplasty contains a midline abdominal plication, or tightening of the abdominal muscles. He refers to it as an “internal corset” that puts the muscles back in the midline. This is in addition to the excess skin removal during a standard tummy tuck. He utilizes the “zip tuck” technique because of an observation he made during a tummy tuck procedures. “I developed the zip tuck because I noticed that as I tightened the abdomen the patient would develop an hour glass figure. I began doing the zip tuck, which also tightens the upper lateral oblique muscles (the muscles on the sides), which makes the hour glass shape even more noticeable,” says Dr. Guilfoyle.

DR. GREGG GUILFOYLE plastic surgery & aesthetics WINTER 2017 | 19

FIBROMYALGIA VS LUPUS Fibromyalgia and Lupus are rheumatoid conditions that affect millions of people each year. However, according to Coordinated Health rheumatologist Susan Lee, MD many people could confuse the two. “Fibromyalgia and Lupus may be confused because they share a lot of the same symptoms and are both rheumatic conditions that affect women mainly of childbearing age. You also hear a lot about both conditions right now,” she says. Dr. Lee describes lupus as an autoimmune disease in which your immune system attacks your own tissue. She says some of the most common symptoms of Lupus include fatigue, rash, fever, joint pain, and muscle stiffness and mouth ulcers.

JUST LIKE LUPUS, THOSE WHO SUFFER FROM FIBROMYALGIA CAN LEAD VERY FULL AND HAPPY LIVES WITH THE HELP OF TREATMENTS Some other symptoms include hair loss, rash, fever and light sensitivity. One hallmark of lupus is a butterfly shaped rash that shows up in many people. Unfortunately, Dr. Lee says that Lupus can be difficult to diagnose in part because it mimics so many other conditions. The other issue is that there is not one blood test that is done to diagnose lupus; instead it is a combination of many tests. “Lupus is diagnosed based on the Systemic Lupus International Collaborating Clinics Classification Criteria. Anyone who meets four or more of the criteria included in blood, urine and imaging tests will be diagnosed with lupus,” she says.

Though there is currently no cure for Lupus, Dr. Lee says that doesn’t mean that those who have the condition can’t have full and happy lives. “The outlook for those living with Lupus is better than it ever has been before due to accurate monitoring tests and medications we have to offer,” she says. Unlike Lupus, Fibromyalgia is a chronic non-autoimmune disease that causes widespread muscle pain. Dr. Lee says that the symptoms are very similar to lupus and include muscle tenderness, severe fatigue, muscle spasms, joint pain, depression, anxiety and insomnia. Those who are most at risk for Fibromyalgia are Caucasian females between 30 and 55. Dr. Lee says that Fibromyalgia is just as difficult to diagnose as Lupus and is based solely on the presence of symptoms rather than lab or imaging studies. “Fibromyalgia is diagnosed based on criteria of widespread pain index greater than or equal to seven and a symptoms severity score greater or equal to five. Symptoms also have to be present for at least three months with no other condition to explain the symptoms,” she says. Just like Lupus, those who suffer from Fibromyalgia can lead very full and happy lives with the help of treatments like patient education, physical therapy, aquatherapy and prescriptions like Cymbalta and Lyrica. While most patients see a reduction of at least 45% in pain, studies have shown that many patients with Fibromyalgia will continue to experience symptoms. Because there is no cure for Fibromyalia or Lupus, people who have these conditions will have do live with them, which Dr. Lee says can be challenging. “People with Lupus and Fibromyalgia face struggles like ongoing pain and difficulties with everyday activities as well as flare ups. But, there is relief with treatment” she says.

Lupus generally affects women between the ages of 1545 years old and is three to four times more likely in nonCaucasians. Dr. Lee says she treats her patients with a combination of medications like steroids, anti inflammatories and disease modifying antirheumatic drugs. She also strongly believes in dietary and lifestyle modifications that can help.

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DR. SUSAN LEE rheumatology

WRESTLING WITH AN INJURY Nazareth freshman Andrew Cerniglia has been looking forward to wrestling with the high school team for years. After an injury early on in the season, he was able to make a remarkable comeback with the help of Coordinated Health Orthopedic Surgeon Wayne Luchetti, M.D. and even helped lead his team to a district win by beating Bethlehem Catholic and helped his team win gold the following week at states. The procedure Cerniglia had done is called open reduction internal fixation of the clavicle and is done on an outpatient basis. During the procedure, Dr. Luchetti began by repositioning the fragments back into their normal alignment and then held them in place with metal screws and plates that are attached to the outer surface of the bone. “The surgery is performed in high level athletes only and literally cuts their return to play time in half. It is very successful in a motivated patient like Andrew," says Dr. Luchetti.

Andrew Cerniglia has literally grown up with wrestling. The 16-year-old began wrestling at the age of six and already has a state title under his belt, which he won in 8th grade. He says he loves the feeling he gets once he steps off the mat after a great match. “Its just great to go out and do something good for your team. You just feel like you’re on cloud nine,” he says. Though wrestling is a highly physical sport, Cerniglia was fortunate in that he never suffered any major injuries aside from minor muscle pulls or strains. He never really thought about injuries until he was hurt in a match in December. “I was at a tournament in Delaware and a kid landed on top of me and the pressure broke my collarbone,” he says. Cerniglia says he knew right away that his collarbone was broken because he felt it snap. Fortunately, Coordinated Health Athletic Trainer Alfonse Dos Santos was at the meet and was able to triage him and recommended he come back to the Lehigh Valley to see Coordinated Health Orthopedic Surgeon Wayne Luchetti, M.D.

After surgery, Cerniglia had to keep his shoulder in a sling and then began physical therapy within two weeks. According to Physical Therapist Mike Price, most of his physical therapy was centered on stretching and muscle recovery. Throughout his recovery, Cerniglia stayed focused on his goal of getting back to wrestling in time to finish up the year. He ended up exceeding everyone’s expectations and returning to wrestling within just five weeks of his surgery. He also ended up wrestling in the district duals with the rest of his team. Going forward, Cerniglia says he is looking forward to continuing his wrestling career and hopefully getting a few more state titles under his belt. He is thankful that Coordinated Health was there for him when he needed them. “Dr. Luchetti, Alfonse and Mike Price were all wonderful. They all worked to get me back without rushing me and risking further injury,” he says.

Dr. Luchetti immediately got an X-ray of Cerniglia’s collarbone and determined that he had a broken clavicle, which is located between the ribcage and shoulder blade. He told him that he had two options. He could either put his arm in a sling, which would get him back in eight to ten weeks or he could have surgery, which would get him back in about six weeks. “At that point I was really just concerned with getting back to wrestling. I wanted to be back for the post season so I took the surgical route,” says Cerniglia. He admits he was a little nervous, especially since it was his first surgery. But, he also trusted Dr. Luchetti and says he put his mind at ease by reassuring him that he would be able to begin doing some cardio within two weeks of surgery.

DR. WAYNE LUCHETTI orthopedics WINTER 2017 | 21

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22 | WINTER 2017

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WINTER 2017 | 23

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