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SUMMER 2017 | VOL. 9, NO. 1
inside...
EDITORIAL
Alicia Wittkopf - Executive Editor Chelbie Birdwell - Design Editor Joe & Emily Shipman - Photography
WHAT’S THE STORY?
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Welcome to the new look of healthbeat! Have you got a story or feedback for the team?
I chose Hunt Regional
REACH US AT contact@huntregional.org
Amber Weaver talks about how Hunt Regional helped her heal from a concussion
STAFF HMHD Board Chair - Ron Wensel HRH Foundation Chair - Paul Painter HRH CEO - Richard Carter HRH Foundation Director - Alicia Wittkopf
DISTRIBUTION For inquiries or questions regarding distribution please contact: 903.408.1064
ONLINE Follow us at: www.huntregional.org www.facebook.com/huntregional www.twitter.com/hunt_regional
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08 P08 WE CHOSE HUNT REGIONAL One local family shares how their delivery turned into an unexpected stay in Hunt Regional’s Level III NICU
PLUS DON’T MISS ALL THIS
14 P14 COLLEGE HEALTH Make sure your college student stays healthy by reading a new study on chemicals in dorm rooms
16 P16 I AM HUNT REGIONAL Anesthesiologist Romeo Baltazar, M.D. talks about what Hunt Regional is doing to combat opiate abuse
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The Brain: Treating traumatic brain injuries
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What’s in a Number: Breaking down the NICU
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Cardiac Care: Cath lab re-opens
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Upcoming Events: What not to miss this season
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Director’s Notes: Foundation updates from
Alicia Wittkopf
MESSAGE FROMTHE CEO
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ummer is officially upon us. I hope you make time to take a break with family or friends. Recharging is always good for mental and physical health. Summer is also a time when we encourage the men of Hunt County to lead the charge in making wellness a priority for you and your family. Research has shown that women are much more vigilant about annual examinations and preventative services. Early detection and screening are the keys to health. We men should also be being more proactive about our health. Our healthcare organization is home to primary care physicians, cardiology consultants,
urology, neurology, and gastroenterology teams, general surgeons, orthopedic specialists, and additional experts for virtually every area of care. If you do not have a primary care physician, visit our website to help locate a doctor right where you live. This is an exciting time in the history of Hunt Regional Healthcare. As we move into a new era of cardiac care, we will continue to constantly look for ways to improve healthcare in Hunt County, including the addition of sports medicine specialists in the fall. We are committed to making advancements in each of the services we
offer to our great citizens. I can’t wait to see what the future of healthcare holds for our great community.
Richard Carter Chief Executive Officer
healthbeat: the pulse of health in northeast texas
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WELCOME
welcome
ublished by Hunt Regional Healthcare Foundation in partnership with Hunt Regional Healthcare, healthbeat is a publication for friends and supporters of the Foundation. The goal of the publication is to increase awareness of healthcare advances, opportunities and challenges in the area. Staff members of the strategic marketing & communications department are responsible for the production of healthbeat. All material in this publication is the property of the publisher and is not intended for purposes of medical diagnosis or prescription. Please discuss your health with your doctor if you are considering a medical treatment, therapy or procedure. Stories may not be reprinted or copied without written permission from the publisher. Some photos may include models and may not represent actual patients or situations. Unless otherwise noted, the physicians featured in healthbeat have been granted staff privileges at one or both Hunt Regional Healthcare hospitals but may not be employees or agents of the hospitals or the hospital district. Reader letters, suggestions and questions are welcome. Please call 903.408.1066 or write Editor, Office of Strategic Marketing & Communications, Hunt Regional Medical Center, P.O. Drawer 1059, Greenville, Texas 75403-1059. If you receive multiple copies of healthbeat, need to change your mailing address, or wish to be removed from our mailing list, please write to the address above and enclose a copy of the mailing label from your publication. This publication is neither printed nor distributed at taxpayer expense.
July 28 is World Hepatitis Day Currently, 80% of people living with hepatitis C are not aware of their status. Hunt Regional Liver Center offers a comprehensive liver disease treatment program for multiple conditions including hepatitis C, fatty liver, and non-alcoholic cirrhosis. SOURCE: HUNTREGIONAL.ORG/LIVERCENTER
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AMBER WEAVER TALKS ABOUT HER ONGOING RECOVERY FROM A CONCUSSION THANKS TO NEUROLOGICAL CARE
I chose Hunt Regional TO PICK ME BACK UP BY CHELBIE BIRDWELL
feature When your job is taking care of other people, It can be hard to find time to take care of yourself. But when a serious fall grounded her, Commerce resident Amber Weaver had no choice but to put healing on her schedule.
Looking back I realize that now, but I did anyway,” remembers Amber. That ill-advised trip began a long path to sickness and ultimately back to wellness. Returning home from California, Amber began to experience episodes of severe vertigo that left her and her husband Barry scared and confused. Follow-up physician visits provided few answers, other than the possibility that she was experiencing seizures as The fall a result of her concussion. The vertigo came and went, but her flying didn’t stop. Amber tried her In many Hunt County communities, the name best to continue living life normally. Amber Weaver is synonymous with health. Former “I fly pretty often with work but slowed down owner of popular franchise P31 Fitness, national after I had the fall and would just fly here and there. marketing director for Juice Plus+, certified We started noticing that every time I would fly personal trainer, health coach, and wellness I would have this episode of major vertigo,” said advocate, Amber makes clean eating and healthy Amber, who began to connect the vertigo with her living a priority in her life. fall. While teaching a business distinction program Although the elevation changes during flying at Texas A&M University-Commerce in March 2015, contributed to her vertigo, Amber experienced an accident Amber’s episodes remained as she was walking that set her on sporadic, and she continued a very unexpected course. with business as usual. But as “It’s a big deal when As she was walking down a a new year came and went, flight of stairs, Amber tripped, you’re struggling with the unsteadiness went from causing her to fall to the platform occasional to frequent. By brain health, anything at the bottom of the stairs. On November 2016, her vertigo neurological. It can just her way down, she hit her head became an almost daily sidekick. on a brick wall before landing on be so frustrating.” “The day after Thanksgiving a concrete floor. I could not get out of bed. I was AMBER WEAVER “I remember thinking, ‘do not just so dizzy,” she said. hit your back on these stairs.’ Concerned and tired of feeling That’s all I could think about,” sick, Amber asked for a referral said Amber, who was found by an to a neurologist, expecting to employee who heard the crack of Amber’s skull receive a recommendation to a larger healthcare hitting the ground and called 911. system, such as Baylor. Instead, she was surprised Stunned, Amber remembers thinking she would to learn of a new neurologist in Greenville, Dr. Eyad be fine and trying to get up before realizing that Zonjy. she was, in fact, losing consciousness. Having had both children in Dallas with high“I do remember trying to get up. I actually just risk pregnancies, Amber—like many people— said to her, ‘I’m going to be fine.’ Then when I went assumed that a bigger hospital would mean better to stand up, I knew I was not okay. I remember care. slowly sitting down and she said, ‘I’m going to go Dr. Zonjy and the rest of her healthcare team call 911.’ The next thing I remember was waking quickly changed her outlook. up and being surrounded by paramedics,” Amber recalled. At the emergency room, doctors were unable to close the wound in Amber’s head with staples A clear picture since the fall—and the wall—had removed so much skin from her scalp. Other than a concussion and More than just wanting to feel better, Amber pain, her CT scan was clear and she was released knew that her career depended on her ability to to go home. But she was determined to do more think and speak clearly. than rest. “I do a lot of public speaking and was really “I needed to fly the next day. I was supposed to struggling with my speech. I was realizing my brain go to California to film for Juice Plus+ and also to was not working as fast as it used to,” said Amber. be at conference. I really should not have done that.
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feature “It’s a big deal when you’re struggling with chiropractic care among the alternative therapies brain health, anything neurological. It can just be so used. frustrating,” she said. “I think the thing for me, more than anything, is Amber’s initial visit with Dr. Zonjy gave her the sometimes I do have to find the right doctor who chance to talk through just how much of an impact has a similar philosophy, because otherwise you’re her injury had on her quality of life. not coming from the same place. He was just really good to offer that balance,” she said. “I don’t know that I’ve ever had a doctor be as thorough and really sit down and talk to me,” she Amber’s MRI also revealed possible damage said. from the fall, which will need to be monitored for future risk. To get a clearer picture of her brain function, Amber was scheduled for an MRI and an EEG at “It’s easy to start to blame everything on the Hunt Regional Medical Center, where she says she concussion. At the same time, you want to make felt like family from the time she walked in the sure it’s not something else. In that regard, he is a door. very proactive doctor,” said Amber. “From the time I walked in the door to pay, the “It was the best care I feel like I’ve had while registrar was wonderful. It was just really a great treating this injury,” she said. conversation, very helpful. Then I went to get the MRI. They were so kind. I could have stayed there all day,” said Amber, who says it Moving forward was the small things like warm blankets and headphones that Now on the last leg of added an extra level of comfort her recovery, Amber says she and a personal touch to her visit. “I really felt like this is how has no reservations about “Everyone was just nice. I you would treat someone recommending Hunt Regional to really felt like this is how you who’s in your family.” anyone who asks. would treat someone who’s in “Even the other day, I told your family,” she said. AMBER WEAVER one of my good girlfriends how much I loved him. I was so shocked that this doctor was in Patient choice Greenville. I think it was more than that. I think I was just really After an MRI and EEG, Amber was diagnosed shocked by the whole process,” said Amber. with post-concussion syndrome, a condition that “It’s just not like that most of the time with can last for several years and cause headaches, healthcare.You can kind of feel like a number,” she dizziness, memory problems, and affect day-to-day said. life. Perhaps most importantly, Amber has finally For Amber, that included everything from found relief from her headaches and vertigo. changing positions while standing to lying down, to “I’ve only had one episode in the last, probably her ability to travel for work. 45 days, where I’ve woken up with severe vertigo,” With a background in wellness, Amber tries said Amber. to treat every area of her life in the most natural “You hear horror stories with a concussion. We way possible. Although she knows there is a have seen people who wake up one day and have a place for pharmaceutical medicine, she says she major issue. I think so much relief was simply peace appreciated Dr. Zonjy’s respect for her lifestyle of mind,” said Amber. and his willingness to think outside the box to find “It’s so easy to blow it off. But once you get solutions that worked for her. an MRI and you get your EEG, even if there’s “He actually recommended that I get on a something there, you know where you’re at. I think certain type of medicine I wasn’t really comfortable that’s been the best part, just being able to say, with. He said, ‘That’s no problem, that’s totally okay. ‘Okay, now we know how to move forward,’” she We can do acupuncture. We can try these other said. things,’” she said. “He was just so gracious to not pressure me into doing something,” said Amber, who lists changes in her diet, whole food supplementation and plant-based omegas, exercise, acupuncture, and 6 / healthbeat /
LEARN MORE ABOUT NEUROLOGY: WEB: www.huntregionalmedicalpartners.org
THE BRAIN TAKING INJURIES SERIOUSLY
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very year, one million people go to hospital emergency rooms with brain injuries. Traumatic brain injury (TBI) is caused by some sort of external force that damages the brain, for example, a slamming of the head against the ground or the floor that basically bruises the brain. Many athletes suffer concussions when this happens. You do not have to lose consciousness to have a concussion. Although some athletes may minimize concussions, the American Academy of Neurology says this is a mistake; that there is no such thing as a “minor” concussion; and that repeated concussions can cause, not only permanent brain damage, they can even be fatal. TBI can also be caused by a forceful hit, a car
accident, or a fall down some stairs that can result in a fractured skull. Many deaths of young children you hear about on the news are TBI’s, the result of the child being hit or the child be thrown into or against something. In an infant, brain injury can result from even less impact. Shaken Baby Syndrome is a term used to describe a range of symptoms resulting from violent shaking of an infant or small child. The degree of brain damage depends on the amount and duration of the shaking. Signs and symptoms range from irritability and lethargy to seizures, coma and even death. Infants should never be shaken. Head injuries are not to be taken lightly. It is impossible to tell what damage the brain has suffered just from looking at
someone. If a person is knocked unconscious, they should be taken to a hospital as soon as possible. Delay could be life threatening. If you hit or anyone you know hits their head, even mildly, and experience symptoms such as headache, dizziness, problems concentrating or dizziness you should contact your doctor right away.
Find a specialist
LOCATE TRAINED HEALTHCARE EXPERTS NEARYOU
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eurologists are trained to diagnose, treat, and manage disorders of the brain and nervous system such as dementia, Alzheimer’s, Parkinson’s, epilepsy, migraine, ALS, multiple sclerosis, traumatic brain injury, and stroke. Other specialties found at Hunt Regional include surgery, gastroenterology, internal medicine, cardiology, orthopedics, wound care, and more. Hunt Regional’s medical staff includes experts for multiple healthcare needs.Visit www.huntregional.org/ourdoctors to find a primary care physician or specialist near you.
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Neurologic care helps curb unnecessary health care costs. Sixty-five percent of patients were discharged earlier as a result of neurologic consultation.
SOURCE: AAN.COM
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THE HARRINGTON FAMILY SHARES THE STORY OF THEIR STAY AT HUNT REGIONAL’S LEVEL III NEONATAL INTENSIVE CARE UNIT
We chose Hunt Regional TO DELIVER US FROM CRISIS BY CHELBIE BIRDWELL
feature Preparing to bring a new baby home is exciting. An unexpected complication can quickly turn that excitement into fear. For Jaci and Clayton Harrington, the comfort of a Level III NICU next door helped turn that worry into calm.
Because of his size, Jaci and Clayton weren’t worried about his development. But as the night progressed, things took a scary turn.
Needing intensive care
Babies are tougher than they seem. Even the smallest babies are fighters. When everything seems okay, sometimes there is a fine line between a baby that is simply taking their time adjusting to a new After a smooth delivery with her first baby world and one who needs extra help making that Stockton, it wasn’t surprising to Jaci Harrington that adjustment. her second pregnancy was, by all accounts, “normal.” That is, until her 37-week appointment with Dr. Jaci and Clayton knew in their hearts that Malissia Zapata. something was off with Stetson. His breathing had a rattle to it and seemed to grow more labored with “I went to my 37-week appointment that morning each passing hour. with Dr. Zapata and I was in active labor. She sent me over to the hospital and we had him by C-section “He got to stay in the room with us that night, but that afternoon on December 22 at 5:14,” said Jaci, I noticed when he was brought in from recovery that remembering how quickly everything moved with the he was breathing kind of funny. He was wheezing, and birth of new baby Stetson. So quickly, in fact, that her it just wasn’t normal. It wasn’t how my other son was. husband almost missed the delivery It was more like a rattle,” remembers because he was working out of town. Jaci. As it turned out, Stetson’s early “During the middle of the night, arrival was only the beginning. Older the nurses continued to check him. “They were just amazing in brother Stockton almost made an He was asleep, but I was getting no early arrival three years ago, but sleep because we were growing more there. And it wasn’t just one instead hung around for the full-term, shift. It was the entire time.” concerned,” she said. growing to a healthy 9 pounds. Clayton, a cattle-breeder, also “With Stockton, I also went into knew that something wasn’t right, JACI HARRINGTON labor at 37 weeks, but Dr. Zapata simply from his experience with helped me go the full 40 weeks. I animals. ended up being in labor for 29 hours “He works with cattle, and when and couldn’t have him, which led to a calves are having trouble with their C-section,” she said. breathing, he knows when there is fluid in their lungs. With her history of big babies, Jaci was scheduled He knew,” she said. for another C-section for Stetson on January 4. But The nurses agreed they needed to keep a close eye unlike Stockton, Stetson was coming whether they on Stetson and took him from the room to monitor wanted him to or not. him. After he returned to the room several hours later, “This time, Dr. Zapata said no, you’re in active neonatologist Asif Khattak, M.D., let Jaci and Clayton labor.You’ve got to go have him. I went expecting to know it was time for a full evaluation. His x-rays and be monitored, but when we got here, the nurses said, tests confirmed what they all suspected. Stetson did ‘you’re having a baby today,’” she said. have fluid in his lungs. Jaci’s mother, Trina Coldiron, works as a home This time, instead of coming back to the room, he health marketer and was making her daily rounds at would be moving to the neonatal intensive care unit. physician offices. She planned to meet Jaci for lunch. Thinking it was a false alarm, Trina continued with her usual plans. But it wasn’t a false alarm. And instead A family history of meeting to have lunch, they met in the labor and delivery area to have a baby. Although older brother Stockton had a healthy “I thought she was being dramatic, so I was taking birth, this wasn’t the first time the Harrington’s had my sweet time. I got here and it was so fast. They were visited the NICU. amazing,” Trina said. “I knew it was a Level III because my cousin Even though he was technically premature at 37 delivered her little girl, Leighton, and she was very weeks, Stetson followed in his big brother’s footsteps early...she only weighed 5 pounds. I had gone through it and had already grown to 7 pounds and 4 ounces.
A normal pregnancy
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feature with her and when they put her in the NICU, I watched the doctors and nurses do everything,” said Jaci. “They were just fantastic. I really didn’t have any fear,” said Jaci, who says Stetson even shared some of the same nurses from his cousin’s stay the previous year. Even knowing you are in good hands, hearing that your baby would be staying in the NICU—even for a short stay—can be jolting. Still, Jaci says she thinks her previous experience kept her from being afraid. “I had already seen the process. I was still very emotional, but not nearly as bad as I was with Leighton because they had such a good experience. When he had to go, I was thinking to myself, they did great with her, they’re going to do awesome with him. I knew, and my husband said, you have nothing to worry about,” she recalled. Mothers (and grandmothers) tend to worry. But for grandmother Trina, having a deeper knowledge of Hunt Regional and a family history of receiving specialized care helped to provide comfort during the short—but scary—stay. “I felt very comfortable because Jaci’s youngest sister has Down syndrome, and we went through a lot of this when she was smaller. I’ve been through a lot of children’s healthcare issues,” said Trina. “When I got there and started asking questions, I felt really comfortable with their expertise.You could tell they weren’t just nurses that had been there for six months. They were seasoned NICU nurses that knew their business,” she said. Some infant urgent care needs are planned. High-risk pregnancies aren’t uncommon. Today, many expecting parents choose their hospital based on the presence of a high-level NICU. Other emergencies are total surprises. In either case, the Harringtons say knowing that help was just down the hall gave them peace of mind.
Staying close A new baby comes with a lot of new firsts: their first cry, the first bath, a first smile, the first diaper change. When your situation changes and that baby is sick, suddenly your plans to capture every moment can get tossed by the wayside. Jaci says the staff knew how important it was for her to share these moments, and let her be involved every step of the way. “They let me come in any time I wanted to, I could do skin to skin. I was involved and very interactive with everything that they did. I thought I was going to miss his first bath because he was in the NICU, but I was able to watch them,” said Jaci, who was also able to breastfeed beside his bed. 12 / healthbeat /
The first 12 hours of Stetson’s NICU stay required him to have little contact with anyone, including his parents. Minimal stimulation helps NICU babies focus on breathing and healing. “I couldn’t do anything with him at first. But during that I time, I was able to pump for him and bring it to them. After that, they would let me stay in there as long as I wanted to. It was really great. My husband was in there for everything. He only left for one afternoon to be with Stockton,” said Jaci, recalling how much Clayton “loved” Dr. Khattak. “He went in the day we were going to leave. He got to watch the doctor do the circumcision in the NICU. He let him do everything. He wanted to be right there, hands-on and he just let him. Anything he wanted to watch or do, Dr. Khattak let him,” she said. Although his stay wasn’t long, it was still frightening. Jaci says the nurses took the time to explain each step so that she would be informed and calm. “I was scared when they moved his tube from his mouth to his nose because I didn’t want him to hurt in any way. I also knew there was a risk for puncturing when they did that. They were very thorough with everything they said. They explained to me that they do this on a daily basis,” she said. “They were just amazing in there. And it wasn’t just one shift. It was the entire time,” she said.
A Christmas miracle Photos taken of Stetson’s birth by dad, Clayton, show a terrifying situation he didn’t even know he was capturing: a large knot in the umbilical cord. As it turns out, Stetson’s early delivery was more of a miracle than his family originally thought. Dr. Zapata later told the Harringtons that if he would have turned one more time, the knot in the cord would have killed him. “There was something by the grace of God that we didn’t know that let me deliver him early,” said Jaci, who was able to bring Stetson home on Christmas Day. Now at home in Lake Creek, Jaci and Clayton say they would choose Hunt Regional again for the level of care both she and Stetson received. “Every time I needed to get in the shower or needed help, somebody was right there. Or with him. They’re kind. They’re very real, very hands-on, and knowledgeable,” said Jaci. “The care was just amazing,” she said. WANT TO KNOW MORE? ONLINE: www.huntregional.org/maternity CALL: 903.408.5180
CHILDBIRTH PREPARING FORA NEW BABY
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ou’ve just spent 9 months trying to make sure you have a healthy baby.You spent hours in labor. Now comes the next hard part. The first four months of life are crucial for any child. They can also be the most nerveracking for any new parent. If you are a first-time parent, there will be so many new things going on. Some you’ve heard about and maybe some you haven’t. Babies are all different. They react to things differently. Anything you read about can only be a guide to your baby’s development and health. You need to discuss what is happening with your doctor. You will know your baby better than anyone else. A healthy pregnancy starts before conception. If you are thinking about having a baby, now is the time to prepare your body. You could be pregnant for weeks before you realize it. The first few weeks are a time when it’s especially easy for the fetus to be impacted by drugs, alcohol, smoking and lack of nutrients. That’s
why good health is so important. Having a baby can change your life. For first-time parents, there are many new things to learn. Even experienced parents can sometimes find it overwhelming. One thing that can help you keep track is a family health file. For moms, dads, and other family members, it can also help to read up on some of the things you can expect in the first few years of your child’s life. Early and often is the best advice when it comes to prenatal visits. Again, try to see your healthcare practitioner if you’re even thinking about becoming pregnant. In the beginning, expect to be seen at least once a month. Later on, near delivery, you may be seen once a week. The Truett and Margaret Crim Maternity Center provides prenatal care, childbirth classes, breastfeeding assistance, new parent education programs, modern labor and delivery suites, comfortable post-
delivery rooms for parents and babies to get to know one another, and skilled nursing at every turn. Should your child be born prematurely or with special needs, our Level 3 NICU (Neonatal Intensive Care Unit) is adjacent to the maternity center to provide the necessary technology and expertise, along with compassionate care.
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For more information about pregnancy and childbirth, visit www.huntregional.org/ childbirth.
What’s in a number?: BREAKING DOWN THE NICU BY LEVELS
Not all NICUs are the same. NICU levels are defined by the American Academy of Pediatrics with standards that are upheld by each unit’s medical director.
Level 4: Highest level available, maintaining a full range of pediatric medical and surgical subspecialists and pediatric anesthesiologists on-site Level 3: Provide sustained life support and prompt, readily available access to full range of pediatric subspecialists Level 2: Intensive care for sick and premature infants who need extra support Level 1: Regular nursery care available at most hospitals that deliver babies
Between 2007 and 2012, overall NICU admission rates demonstrated a relative increase of 23%.
SOURCE: JAMANETWORK.COM
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real health
Spotlight on college:
NEW STUDY REVEALS CHEMICALS IN DORM ROOMS
Do you have a student making the transition from high school to college this summer? Encouraging them to clean their dorm room may be worth nagging about. 14 / healthbeat /
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ollege students may be getting heavy exposure to chemicals in flame retardants. A new study shows that students living in college dormitories are exposed to high levels of flame retardants in dust. Scientists say they measured dozens of flame retardants in dorm dust samples, including carcinogens, hormone disruptors, and chemicals that affect brain function. The results also included some of the highest levels ever reported. “College students spend a lot of time in their dorms; it’s their home away from home. So the fact that they’re being exposed to hazardous chemicals where they sleep, study, and hangout raises important health concerns,” says lead author Robin Dodson.
Until recently, manufacturers routinely added flame retardants to furniture—to the interior foam, the fabric, and other parts of the furniture— in order to meet flammability standards. However, the chemicals easily migrate out into the air and dust. Researchers analyzed close to 100 dust samples collected from two U.S. college campuses in the northeast. The researchers detected 47 different flame retardant chemicals in total. Some chemicals were nine to five times higher than the highest levels reported in studies from the last 10 years. “Encouraging students to vacuum their dorm rooms every once in a while is not a bad idea,” says Dodson.
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/ healthbeat / 19
feature Surgery is a tool used to heal our bodies. To stitch them up when they are broken, to remove foreign bodies that are making us sick. But a national prescription drug abuse crisis has many hospitals fighting to keep weapons of healing from turning into weapons of harm.
A national epidemic
few opioids as possible while they are here and in the operating room. People who are depressed, abuse alcohol, or who have chronic pain, are prone to overdose on prescription medication,” says Dr. Baltazar. “And how do we do it? By using our nerve blocks. Also, by using non-opioid medication like IV Tylenol,” he said. “We did it to ourselves around 1990 with our vital sign measurements. We didn’t want our patients to hurt. So, what did we do? We really did a knee jerk reaction. We pumped them with all this medication. All these opioids and look what happened,” he said.
Ninety-one Americans die every day from an opioid overdose. That means that opioids now kill more people than car accidents. The number of unintentional overdose deaths from prescription pain relievers A different approach has soared in the United States, more than quadrupling since 1999. As a result of addiction, some addicts even turn to heroin When a patient undergoes surgery, a abuse when they are combination of medications— unable to find the pain often referred to as a cocktail— relief they need. may be used to sedate the patient and relieve pain. Today’s These aren’t people understanding of the human on the streets, or junkies. “33,000 a year die. It body allows for patients to be These are mothers and awake for many procedures. The teenagers, fathers who had used to be what you call a absence of general anesthesia back surgery and never straight overdose. Now, it’s means a faster recovery time, found true relief from prescription drug overdose.” less pain, and an intact immune the pain, and even dental system. patients asking for one DR. ROMEO BALTAZAR more refill. “General anesthesia depresses your immune system. Several factors By not giving the general contribute to the severity anesthesia, your immune system of the current prescription stays intact so it is able to fight drug abuse problem. They infection. It’s common sense,” he said. include drastic increases in the number of prescriptions written and dispensed, greater Patient surveys at Hunt Regional typically social acceptability for using medications for reveal great pain management and an different purposes, and aggressive marketing by overwhelming appreciation for our nerve pharmaceutical companies. block protocol. Dr. Baltazar attributes our success to doing this differently than many Hunt Regional’s medical director for organizations. anesthesiology, Romeo Baltazar, MD, is combating that epidemic locally with the use “In studies of 10,000 total knee of nerve blocks and a commitment to finding replacements around the United States, they new methods to combat pain after surgery. found that only 20% of those people who had total knee replacements had some kind of “Every year, 33,000 die. It used to be nerve block or epidural, while 80% received what you call a straight overdose. Now, it’s general anesthesia,” said Dr. Baltazar prescription drug overdose. If you combine the use of cocaine, Fentanyl, and heroin, “It is the reverse at our institution. We do prescription overdose is twice as much around 90 to 95% epidural with our total joint compared to street drugs overdose. This is replacements. Because studies have shown that only in America,” said Dr. Baltazar. when you do spinal anesthesia, it decreases the amount of blood loss. The most important Last fall the Surgeon General gave a call to thing research shows is that it decreases your action to healthcare providers, asking for help surgical site infection risk,” he said. in combatting prescription drug overdose. Which cocktail is used and how long “One of the answers to this is to use as 16 / healthbeat /
ANESTHESIOLOGIST DR. ROMEO BALTAZAR REVEALS HOW HUNT REGIONAL IS RELIVEVING PAIN AND RISK ONE NERVE BLOCK AT A TIME
I am Hunt Regional BECAUSE I HAVE THE POWER TO STOP PAIN BY CHELBIE BIRDWELL
feature the block lasts depends on the surgery and the needs of the patient. Someone with a wrist fracture may undoubtedly have different pain relief needs than someone undergoing exploratory abdominal surgery. By using other non-opioid medications such as antiinflammatories, Celebrex, and Lyrica, which alters how you perceive pain, the surgical team can help patients feel “normal” faster. “Our goal is for them to be mobile right away and for them to go home and begin their therapy right away. We want to decrease the amount of time they stay in the hospital so they can be discharged right away,” says Dr. Baltazar.
He says the blocks also help your body recover faster by not introducing it to as much pain medicine which can be difficult for the body to metabolize for example, in the case of a liver transplant or a patient with kidney damage.
Part of a team
Dr. Baltazar has been part of Hunt Regional’s anesthesiology team for 10 years. He says his success is based on the willingness of a forwardthinking team. “When I came here, I was “We want to decrease the fortunate we had people who had an Blocking out the pain amount of time they stay in open mind, and we also have surgeons that have really appreciated the the hospital so they can be technique,” he said. Nerve blocks are performed using discharged right away.” Dr. Baltazar says the nerve blocks the aid of ultrasound to find the nerve. are positive tools for both the patients DR. ROMEO BALTAZAR “It’s almost like a ping pong ball. and the nurses. You hit the ball, the ball hits the wall, “They don’t get called for pain. In and it comes back to you with a sound my experience, if you practice these right?” explains Dr. Baltazar. methods, and you do the right nerve blocks, you’ll never “That’s what it’s like. The sounds transmitted goes get called,” he said. to a monitor and it comes out as a picture of whatever you want to see. For example, the nerve looks like white and then it’s a little bit dark at the center,” he said. Finding the exact location of the nerve is important to make sure the relief goes where it’s needed. Before ultrasound guided nerve blocks, physicians had to rely on nerve stimulators to locate the nerve. “Now it’s a lot safer because when you stimulate the nerve, you don’t know where you are. How close are you are to the nerve? Are you inside the nerve?” said Dr. Baltazar. “If you can see the nerve, you can be more precise,” he said. The injection of the nerve block happens before surgery is performed, giving the block time to go to work. By the time the patient is out of surgery, patients “You make rounds, you have to follow-up, or if the are in little to no pain. patient is an outpatient, you call them up, and ask how The actual process of blocking the pain involves they are doing? They say, ‘Oh, I did great,’” he says. surrounding the nerve with a local anesthetic that can Hunt Regional’s designated block area—along with last up to 72 hours. Not only does this prevent pain, the anesthesia department’s mastery of nerve blocks— it also keeps surgeons from having to insert catheters has many patients choosing to stay local for surgery. which are cumbersome and increase the risk of “I have surgeons that tell me, ‘Dr. Baltazar, thank you infection. because my patient doesn’t have any pain,’” I say, ‘well, Nerve blocks can be used for any number of that’s what I’m here for,’” he said. surgeries including shoulder, rotator cuff, arm fractures, abdominal surgery, laparoscopy, port placement, breast surgery, and more. LEARN MORE ONLINE “Basically you drown the nerve so it will absorb ONLINE: www.huntregional.org/surgery all the local anesthetic agent. By absorbing the local CALL: 903.408.1200 anesthetic, it numbs them,” said Dr. Baltazar. 18 / healthbeat /
CHRONIC PAIN EXPLORING ALTERNATIVES
J
ust about everyone gets aches or pains at some point. But for some people, pain is a constant presence in their lives. Normally, we experience pain as a result of a specific injury. The sensation lets us know something has happened, so we can take appropriate action. But chronic pain is different. Chronic pain lasts. For someone with chronic pain, pain signals keep firing in the nervous system for weeks, months, or even years. The pain may start with a specific incident, such as a sprain. Or there may be an underlying condition or disease such as arthritis or a slipped disk that causes chronic pain. Pain complaints such as headache, low back pain, arthritis pain or neurogenic pain, which results from damage to the peripheral nerves or to the central nervous system itself, are especially common as we
get older. Pain can be caused by diseases and conditions such as chronic fatigue syndrome, sickle cell disease or post-polio syndrome. Pain can also result from cancer or cancer treatments. In addition, some people suffer chronic pain without having experienced any apparent past injury and many of these people spend years trying to pinpoint the source of their pain. If you or someone you love is experiencing chronic pain, it’s important to see a doctor to rule out specific underlying causes that require immediate medical treatment. Because the causes of chronic pain are so varied, there is no single treatment that can work for everyone. For some forms of chronic pain, such as back conditions, surgery may be the best option. Some patients have also benefited
from talk therapy, rehabilitation, biofeedback, and behavior modification. Although chronic pain remains a difficult problem to tackle, research continues into possible causes and better treatments. The important thing is that you shouldn’t ignore pain. See a doctor as soon as possible. To learn more about alternative pain management therapies, visit www. huntregionalmedicalpartners. org.
How does it work: QUESTIONS AND ANSWERS
Q
A
60%
feature
: What is the On-Q pain pump and why is it used less frequently? : The On-Q pump is occasionally used for orthopedic procedures. The system delivers local anesthetic through catheters to the surgery site, allowing the patient to be pain-free. Because it involves the use of a catheter and selfcare at home, patient education is required. Instead, our team opts to use nerve blocks more frequently.
The majority of drug overdose deaths (more than six out of ten) involve an opioid.
SOURCE: CDC,GOV
/ healthbeat / 19
real health
Spotlight on the heart: HUNT REGIONAL EXPANDS CARDIAC SERVICES
During a cardiac emergency, time is muscle. In the past, someone experiencing a cardiac event had to be transferred to other facilities. Now, Hunt Regional will be able to provide care that patients previously experiencing a life-threatening heart attack would have had to travel elsewhere to receive.
H
unt Regional Healthcare announced the re-opening of the cardiac catheterization lab at Hunt Regional Medical Center in Greenville at a press conference June 1. The cath lab will benefit patients with onsite, rapid diagnosis and treatment, which can save lives and reduce heart damage. Cardiac catheterization labs—or cath labs— allow doctors to place stents in a patient’s cardiovascular system to open blocked passageways and perform other related life-saving procedures. With the help of digital imaging, cardiologists can diagnose problems with blood flow, pressure, and valve function. During a cardiac emergency, time is muscle. In the past, someone experiencing a cardiac event had to be transferred to other facilities. Now, Hunt Regional will be able to provide care that patients previously experiencing a life-threatening heart attack would have had to travel elsewhere to receive. To perform a cath, a thin wire is inserted by the physician in an artery or vein in the groin, neck, or arm. The wire catheter is then threaded through blood vessels to the heart. If necessary, a balloon or stent can be placed in those arteries, unblocking them to restore blood flow to the heart to stop a heart attack or alleviate chest pain. A state-of-the-art imaging machine with a speed of 30–60 frames per second performs the diagnostic imaging required in the lab. The machine can produce images of the five major vessels of the
heart, the peripheral arteries, and the extremities. Results allow the physician to formulate an appropriate treatment plan, which may include surgery, medication modification, or angioplasty. Interventional cardiologists Ahad Hassan, MD, and Roger Belbel, DO, will oversee cath lab operations, along with registered nurses and diagnostic imaging technicians. The lab will provide emergency and interventional coverage 24/7, 365 days a year. “Our staff has been working for a long time to bring this much-needed, expanded service to our community,” said Hunt Regional CEO, Rich Carter. “Around-the-clock coverage will allow physicians to get patients the help they need in our hospital immediately and increase the preservation of cardiac function.” he said. In addition to emergency heart care, scheduling will also begin this month for expanded cardiovascular services, including pacemaker placement, pressure management, and endomyocardial biopsy. Diagnostic catheterization may be ordered if a screening examination, such as an electrocardiogram, points to the likelihood of an underlying heart condition that needs further evaluation. A doctor also may order the procedure to evaluate blood flow to the heart when pain occurs after a patient experiences a heart attack or if a patient has recently experienced chest pain, fatigue, dizziness, or shortness of breath. For more information, visit www.huntregional.org/cardiology. / healthbeat / 21
events
season events this
CHECK OUT WHAT IS HAPPENING IN HEALTHCARE THE NEXT FEW MONTHS
JULY 18
FREE VEIN SCREENING If you are living with painful, swollen legs, we can help. Hunt Regional Medical Center Vein Center hosts a free vein screening the third Tuesday of each month from 4-6 p.m. in conference room 2, located
so call ahead to reserve. MORE INFORMATION: 903-408-5770 JULY 28
WORLD HEPATITIS DAY Viral hepatitis is inflammation of the liver caused by a virus. There are five different hepatitis viruses, hepatitis A, B, C, D and E. Hunt Regional offers a comprehensive liver disease center for Hep C, fatty liver, cirrhosis, and other diseases of the liver. Talk to your doctor or visit one of our lab solutions locations to be tested.
on the second floor of Hunt Regional Medical Center. Space is limited so call to reserve your spot.
JULY 18
Join surgeon Viet Phuong, MD, FACS, of Hunt Regional Medical Partners Surgical Associates for a free seminar about bariatric surgery. Learn more about the benefits, types of surgery, and what to expect. The seminar is held at 6 p.m. in the 6th floor boardroom at Hunt Regional Medical Center. Space is limited
TUESDAY, JULY 11
NAMI SUPPORT GROUP National Alliance on Mental Illness (NAMI) Hunt County hosts a free monthly support group for family members and caregivers of individuals with mental illness. Meetings are facilitated by trained NAMI members and allow family members to talk freely about their challenges and help one another through their experiences. Meetings are the second Tuesday of each month at 6 p.m. in the sixth floor boardroom of Hunt Regional Medical Center. READ MORE: www.huntregional.org/supportgroups FOR MORE INFORMATION CALL: 903.408.1506
MORE INFORMATION: 903-408-4080
FREE BARIATRIC SEMINAR
featured event
MORE INFORMATION: www.huntregional.org/livercenter AUGUST
BREASTFEEDING MONTH The FDA reports that breastfed babies have fewer illnesses because of antibodies passed on from the mother. A breastfed baby’s digestive tract has larger
numbers of Lactobacillus bifidus, a beneficial bacterium that prevents growth of harmful bacteria. The American Academy of Pediatrics says breastfeeding for the first 6 months of life. MORE INFORMATION: www.huntregional.org/breastfeeding SEPTEMBER
AFIB AWARENESS MONTH Atrial fibrillation, or afib, is the most common irregular heartbeat and is characterized
by palpitations, dizziness, and shortness of breath. It is progressive and can lead to stroke, heart failure, Alzheimer’s disease, and death. MORE INFORMATION: www.huntregional.org/cardiology
PUD KEARNS AND DANA CASH WERE ANNOUNCED AS THE RECIPIENTS OF THE HAROLD CURTIS FRIEND OF THE FOUNDATION AWARD AT THE THE TWELFTH ANNUAL MUSIC IS THE BEST MEDICINE FOUNDATION GALA. CASH AND KEARNS ARE THE ORGANIZERS OF BRAS FOR THE CAUSE, ALONG WITH FOUNDATION DIRECTOR ALICIA WITTKOPF. TOGETHER, THE WOMEN WORK YEAR-ROUND TO CARRY ON THE COMMUNITY-WIDE EVENT ESTABLISHED BY LOCAL PHILANTHROPIST AND CALICO CAT OWNER, JANEEN CUNNINGHAM.
Notes
FROM FOUNDATION DIRECTOR ALICIA WITTKOPF I have the pleasure of working with many donors for our annual gala. They are all generous in their sponsorship of an event and a project that resonates with their corporate or personal interests. This year marked the third gala I have celebrated with our sponsors. While they are all to be admired for their local philanthropy, there is one in particular I wish to recognize for his continued pledge to support the gala, Dr. Jerry J. Ransom. Jerry has been the headlining sponsor for the gala for nine consecutive years, but he wouldn’t do anything he is not willing to ask someone else to do. He has committed to sponsoring the gala in the future, but he won’t boast about it. He doesn’t ask for anything in
return, but he expects that we use our resources wisely to provide for our patients. When we tried to recognize Jerry for his generosity at this year’s gala, he redirected the focus to an outstanding employee for her excellent customer service and commitment to Hunt Regional. His quiet humility is to be admired. Jerry continually sings the praises of others and recognizes the qualities in them that connect with others in a meaningful way. His philanthropy is never about him; it is about others. He is treasured by many, including his friends on the Foundation board, the patients of Hunt Regional, and the many people he serves in our community. I am honored he continues to make
philanthropy and Hunt Regional a priority. Jerry, we are all grateful for you!
Alicia A. Wittkopf, Director Hunt Regional Healthcare Foundation / healthbeat / 23
P.O. Drawer 1059, Greenville, Texas 75403 Web: www.huntregional.org Facebook: facebook.com/huntregional Twitter: twitter.com/hunt_regional Instagram: @huntregional
