connect-summer-2010 by LMH Health

connect Lawrence Memorial Hospital

Women’s healthcare:

getting better

Vanishing varicose veins Who is “Penny” Jones?

Summer 2010

LMH offers

enhanced services

for

women

Susan Henderson, her mother Elaine Schmidt, and her grandmother Sarah Schmidt are long-time Lawrencians and users of LMH’s health services. Whether having a routine bone density scan, undergoing surgery for appendicitis or giving birth to two adorable boys, their healthcare needs have been met here at Lawrence Memorial Hospital.

As mom to a 7-year old and a 4-year old, Susan has made use of LMH’s community education offerings and the emergency department. “Our youngest son paid a visit to the ER in December 2009 for a concussion. That experience was harrowing as a parent but the care we received was good and the staff was great with both us and him,” Susan says. Women’s healthcare just keeps getting better at LMH. In addition to the women’s health services that Susan, Elaine and Sarah have utilized, LMH offers new and expanded services for women throughout the region. LMH obstetricians, gynecologists, urologists and physical therapists are using new diagnostic and treatment methods in a variety of areas. SILS LMH now offers a state-of-the-art modification to hysterectomy procedures. Samantha Durland, MD, of Lawrence OB-GYN Specialists is one of the few surgeons in the region — and the only one in Lawrence — performing hysterectomies through single incision laparoscopic surgery, known as SILS. The procedure offers removal of the uterus through a small, single incision in the patient’s belly button. SILS is less invasive and less painful than abdominal or vaginal procedures, and it is the method of choice for women with a large uterus, pelvic mass or history of C-section, where scar tissue is an issue.

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Dr. Durland says an increasing number of women in the area are benefiting from the SILS training she received in Baltimore last winter. “The SILS procedure is less painful and cosmetically more appealing than abdominal surgery, and it offers a much easier recovery,” she says. The procedure takes only one to two hours, and while a one-night hospital stay is standard, some patients can be released the same night. Treatment for urinary incontinence One topic of recent discussion is incontinence, where the greatest advancement is just that — making it a topic of discussion. According to Lawrence gynecologist Kathy Gaumer, MD, it is no longer the hush-hush topic of days past. “Media campaigns and television ads promoting medication and products for incontinence have helped women become much more comfortable talking with their physicians about their concerns,” she says. About one-third of American women experience some degree of incontinence, with more likely suffering in silence. Dr. Gaumer says that of the 20 patients she sees per day, about two or three patients seek advice. Many patients suffer from urge incontinence, characterized by a hyperactive bladder due to involuntary muscle contractions. For these patients, who commonly get out of bed three or four times per night to empty their bladders, medication is the treatment of choice. The most common type of incontinence is stress incontinence, caused by any kind of pressure to the pelvic floor including coughing, exercising or lifting. Women who have a weakened pelvic floor due to child bearing or the natural loss of hormones are particularly vulnerable. Methods of treatment include exercise, medication, surgical intervention or insertion of a removable pessary into the vagina that offers support to the pelvic organs. This method, especially helpful for patients who are not good candidates for surgery, requires regular follow-up with the physician. Dr. Gaumer says that stress incontinence may require in-depth treatment or further evaluation and treatment by an urologist. “The bladder is just one part of the equation,” she says. “There could be several other problems with pelvic floor support, such as uterine prolapse.” Urologist Doug Klingler, MD, adds that while a diagnosis is made primarily by the patient’s history, urodynamics — tests that measure bladder and urethra function — are often utilized to determine the underlying cause of the problem. www.lmh.org

Surgical repair is called for only after non-invasive measures have been tried. Dr. Klingler says that urologists peform most incontinence and bladder suspension procedures, while gynecologists perform most posterior repairs and uterine/ cervical surgeries. “There is a fair amount of overlap, however, between the two specialties when it comes to incontinence and prolapse,” he says. Physical therapists at Kreider Rehabilitation Services can play an important role in the treatment of incontinence. A 30- to 45-minute session per week provides exercises to strengthen the pelvic floor, coordination on timing of pelvic floor contraction and electric stimulation to strengthen muscle contraction, as well as behavior modification. Physician referral is required. For more information, talk to your doctor or call Cari or Heather at Kreider Rehabilitation Services, 785-505-2712. Nuchal translucency test Another advancement is the nuchal translucency test, a fetal ultrasound diagnostic tool performed early in pregnancy to determine the risk for Down syndrome. The high-definition image measures the accumulation of fluid in the nuchal fold behind the neck. Fetuses at high risk for Down syndrome tend to have a larger amount of fluid. The test can be performed only in the first trimester so timing is critical, but the advantages are numerous. “The test provides higher sensitivity, fewer false positives and earlier detection,” Dr. Durland says. “Prior to this, the diagnostic tool we used was a blood test that was reliable at only 15 to 20 weeks.” She adds that the goal of the test is to empower women to prepare better for their futures. A negative result offers peace of mind, while an early positive result allows time for parents to make plans. The test is offered to all pregnant women, regardless of age or family history. She estimates that about five procedures take place in her office each week. The test is performed at her office by a specially trained sonographer. For more information about the women’s health issues mentioned here, or any others, contact Lawrence OB-GYN Specialists at 785-832-1424.

and holding

What is Penny Jones? That’s a question a lot of people in Lawrence can answer: It is the annual golf tournament that benefits LMH Endowment Association (LMHEA) and, over the years, has garnered a reputation for being one of the best golf tournaments in the region. Who is Penny Jones? Well, that one might be harder for some to answer. H. P. “Penny” Jones was a surgeon in Lawrence — but he was more than that. He was a Lawrence native who went to medical school at Harvard and chure Golf Tournament bro The first Penny Jones , served in photo of Tom Groene in 1981 featured this ” Jones. the Army at left, and H. P. “Penny Medical Corp in World War II before returning to Lawrence and serving the community for over 40 years — but he was more than that, too.

The H. P. “Penny” Jones Open Golf Tournament: A tradition in Lawrence Faye Jones, Penny’s widow, says she still hears new stories about him and his generosity. She tells a story she heard after he died. Upon seeing a new doctor walking to the hospital, Penny stopped him and asked why he was walking. He told Penny that he was just starting out and couldn’t afford a car. The next day Penny showed up at the doctor’s house with keys to a car that was parked out front and said that “his job was too important to this community” for him to not be able to get to the hospital quickly. Faye adds, “That was just the kind of guy Penny was.” Tom Groene approached Penny in 1981 about holding a benefit golf tournament in his honor. Tom remembers that it took some convincing for Penny to agree to it. “We had a modest goal — we wanted to let people know a little bit more about LMH,” says Tom, who served as the tournament’s chair for 25 years. “We hoped it would make a little money.” Over the past 28 years, the tournament more than $800,000 has been raised for Lawrence Memorial Hospital. “We feel so fortunate that area golfers and sponsors have consistently supported the

29th Annual Penny Jones Golf Tournament Friday, September 10 Tee times: 8 a.m. and 1:15 p.m. To sign up: Call 785-505-3317

Penny Jones Tournament and LMH,” says Kathy Clausing-Willis, VP and LMHEA’s chief development officer. “We know a lot of people look forward to this tournament every year, so we always do what we can to make it better and exceed everyone’s expectations. We are confident our team of volunteers, led by our co-chairs Mark Gonzales and Gary Sollars, will deliver a quality tournament again this year.” As part of this year’s event, Faye is reuniting and sponsoring the team that won the very first Penny Jones Tournament in 1982. So this year, Tom Groene, Harley Catlin, Gary Olson and John Tacha will be on a quest to win it a second time. She adds, “I think that Penny would be really proud of the good that has been made possible because of his tournament.”

Role reversal

You expect doctors to go out of their way to help their patients get well. But on April 29, roles were reversed when 600 people went out of their way to help a doctor and a friend get well.

Dr. Rodney Barnes

Rod Barnes, MD, a family physician of more than 32 years, has been battling chronic lymphcytic leukemia for five years. Upon hearing that Dr. Barnes would need a bone marrow match, Carla Phipps, MD, a friend and former physician partner, wanted to help. “It’s always tough to know how you can be of help to someone going through a difficult time,” says Dr. Phipps. “I heard of the need for a match and knew immediately that was something I could help organize.”

Dr. Carla Phipps, at right, speaks with volunteers at the bone marrow drive for Dr. Rod Barnes.

So Dr. Phipps, along with Scott Solcher, MD, Sherri Vaughn, MD, and others, quickly organized a bone marrow drive. Dr. Barnes’ staff, led by Joni Lawrence, recruited volunteers, secured donor registration kits and got everything in order. At 7:30 am on April 29, the donors started to arrive — and they kept arriving. By 6 pm, 554 donors were successfully registered and more than $23,000 was raised to help cover the costs of donor testing and registration. This outpouring of support was overwhelming for everyone involved.

“I had no idea what kind of turnout to expect,” Dr. Phipps says. “It was an unequivocal success!” The best news of all came in a June 2 entry on Dr. Barnes’ Caring Bridge journal, when he announced that a bone marrow match had been found. He anticipates a transplant date will be set this summer. Thanks to the outpouring of support shown to one of Lawrence’s own, there now are 554 more potential bone marrow matches.

www.lmh.org

Vanishing varicose veins According to the National Institutes of Health, varicose veins affect about 50 percent of the population.You often can spot these veins easily because they are visible above the skin and appear to be bulging or twisted. They are more common in women, but also occur in men. Spider veins are thin, threadlike veins that lie close to the skin’s surface. They are similar to varicose veins but much smaller.

What causes them? Varicose veins typically develop when valves in the veins become weak or damaged. This can cause blood to pool in the veins, making them expand and become weak. Spider veins can be caused by the backup of blood, hormone changes, exposure to the sun or injury. What are the risk factors? The U.S. Department of Health and Human Services lists the following risk factors for varicose and spider veins: • Increasing age. As you get older, the valves in your veins may weaken and not work as well. • Medical history. Being born with weak vein valves increases your risk. Having family members with vein problems also increases your risk. About half of all people who have varicose veins have a family member who has them, too. • Hormonal changes. These occur during puberty, pregnancy and menopause. Taking birth control pills and other medicines containing estrogen and progesterone also may contribute to the forming of varicose or spider veins. • Pregnancy. During pregnancy, there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The growing uterus also puts pressure on the veins.Varicose veins usually improve within three months after delivery. More varicose veins and spider veins usually appear with each additional pregnancy. • Obesity. Being overweight or obese can put extra pressure on your veins. This can lead to varicose veins. • Lack of movement. Sitting or standing for a long time may force your veins to work harder to pump blood to your heart. This

may be a bigger problem if you sit with your legs bent or crossed. • Sun exposure. This can cause spider veins on the cheeks or nose of a fairskinned person.

Treatment options There are many medical and cosmetic issues related to varicose veins and spider veins. The good news is that a treatment option is now available in Lawrence that is effective and minimally invasive. Traditionally varicose veins have been treated by surgically removing, or stripping, the troublesome veins from the leg. This procedure requires making an incision in the groin, tying off the vein and then removing it with a long © iStockphoto.com/sdomnick surgical instrument through a second incision below the knee. It often takes two to six weeks to recover from this procedure and some patients report significant bruising and discomfort. The Lawrence Vein Center now offers the Closure® procedure, a less invasive procedure that simply closes the problem vein by inserting a thin catheter into the vein through a small opening. The catheter delivers radiofrequency energy to the vein wall, causing it to heat, collapse and seal shut. Once these veins are closed it allows healthy veins to empty blood from the legs. This procedure is performed on an outpatient basis and takes about an hour to complete, though patients normally spend two to three hours in the facility. Patients typically report little, if any, pain during the procedure. To learn more about treatment options for varicose and spider veins, call the Lawrence Vein Center at 785-856-VEIN.

Dr. Denning, LMH team up to provide Vein Center The Lawrence Vein Center is now affiliated with Lawrence Memorial Hospital. Dale Denning, MD, a Lawrence general surgeon, established the center in 2005 to serve patients with all forms of vein disease from cosmetic spider veins to advanced chronic venous insufficiency. Dr. Denning has discontinued his general surgery practice to focus his time on the Lawrence Vein Center. Over the past five years Dr. Denning has expanded his knowledge and experience and became a diplomat of the American Board of Phlebology in the spring of 2009, making him one of about 400 physicians in the country who have achieved this recognition.

Dr. Dale Denning

Dr. Denning is practicing in the office of Cardiovascular Specialists of Lawrence, located in the 4th Street Health Plaza Building adjacent to LMH. He is looking forward to working with the cardiologists, especially Tapas Ghose, MD, an interventional cardiologist who also has a keen interest in the treatment of patients with acute and chronic vein disease. “I now believe that all the pieces of the puzzle are in place to provide state-of-the-art inpatient and outpatient treatment for patients in our community who suffer from venous disease,” Dr. Denning says.

To make an appointment at the Lawrence Vein Center, call 785-856-VEIN (8346).

to your health! 6

LMH expansion and building construction help meet community needs Lawrence Memorial Hospital is expanding, renovating and upgrading spaces to accommodate our growing community’s health care needs. Currently LMH is working on a variety of projects on the main campus and in the region. One such project is renovation of the area that formerly housed surgical services. This vacated space, made possible by the hospital’s recent expansion, will become the new home of the Endoscopy Center (GI Lab), the Infusion Center and the Pain Management Clinic. The hospital’s laboratory will expand into part of that space, as well. Endoscopy Center (GI Lab) Relocating the GI Lab to the main hospital campus from its current location at LMH South, about four miles away, will make it easier to provide patient care. Physicians will continue to offer consultations in the emergency departments and perform outpatient procedures in the GI Lab, but won’t be traveling between two facilities to do so. More than 3,000 patients were treated in the GI Lab in 2009. Patients come for screenings and to receive treatment and referrals for hiatal hernias, ulcerative colitis, GERD (gastroesophageal reflux disease), Chrohn’s disease, Barrett’s disease, polyps and strictures. Pain Management Clinic The relocation of the Pain Management Clinic from LMH South to the main hospital campus will provide similar efficiencies. Minimizing travel time will allow anesthesiologists, who also staff the hospital’s surgical services department, to be more readily available to inpatients and outpatients for consultations and treatment. At LMH, the Pain Management Clinic will be housed in a larger location, offering additional exam rooms and space to grow. In 2009, there were more than 3,600 patient visits for pain management.

Skanda Skandaverl, LMH’s director of facilities management, walks through what will become the new GI Lab.

These physicians and the staff strive to identify the true cause of a patient’s pain and help design a personal treatment program to restore the individual’s lifestyle. They provide a variety of services for treatment of both chronic and acute pain including medication evaluation and management, epidural procedures, trigger point injections, kyphoplasty, discography, radiofrequency ablation, neurostimulator placement and intrathecal pump placement. Laboratory The staff in the hospital’s laboratory has nearly doubled in size since the 1970s when the department was last remodeled. While aesthetically the space may be stuck in the 1970s, the lab’s technology is state of the art and continues to improve. Over the last decade, the staff has added nearly 50 new tests to their capabilities and doubled the volume of tests performed annually. The complexity of testing has also increased due to new hospital services such as interventional cardiology, neurology and oncology. The lab is in operation 24 hours a day, 365 days a year and offers more than 400 different tests. Each year the 75 lab employees complete about 500,000 tests, ranging from general screenings to toxicology testing and pathology. The expansion and renovation of the lab space couldn’t have come at a better time. Much-needed “elbow room” will allow space for additional equipment and increase efficiency. “Our world has changed dramatically since the ’70s,” notes Connie Broers, laboratory director. “This remodeled space will allow us to continue to grow and provide the space for new technology.” The lab is currently 7,500 square feet. When the new space opens, it will have expanded to 12,000 square feet. Construction will be completed in three phases: • Phase 1 | The area of the hospital that formerly housed surgical services will be renovated to house the Endoscopy Center (GI Lab), the Pain Management Clinic and the hospital laboratory. • Phase 2 | The Endoscopy Center (GI Lab) and Pain Management Clinic will move from LMH South to the newly renovated space at the hospital. The laboratory will move all operations from the current space into the newly renovated space. • Phase 3 | The space that currently houses the laboratory will be renovated, too, providing additional space for the laboratory.

www.lmh.org

DocTalk John S. Goza, MD

Medical office building to be built in Eudora Eudora is a booming community. Though there has long been a family practice office in town, the small space has not been efficient in meeting the needs of the patient population. After years of planning, a project to build a new building on the south side of K-10 to house Daniel Dickerson, MD, PhD, and the staff of LMH-affiliated Eudora Family Care is under way.

Dr. Goza, a board-certified general surgeon, has joined Lawrence General Surgery. A native of Atlanta, Dr. Goza has spent the last 12 years in practice in the south Atlanta area. He earned his medical degree from the University of South Carolina School of Medicine and completed a general surgery residency at Baptist Medical Centers in Birmingham, Ala. He served as president of the medical staff and chairman of the Department of Surgery at Piedmont Fayette Hospital in Fayette, Ga. He was voted by physicians as “Best Surgeon South Atlanta” for the past four years. Dr. Goza has a special interest in advanced laparoscopic surgery, especially in performing single incision gall bladder removal. He has served as an associate professor for general and laparoscopic surgical resident training at Atlanta Medical Center and as a physician instructor and preceptor. Lawrence attracted Dr. Goza because he believes it is a great town with a great university and lots of diversity. He and his wife, MarySue, and their eight children, ranging in age from 10 months to 16 years old, also are looking forward to spending time with family in the Kansas City area. Dr. Goza enjoys family time, camping, rafting, bicycling and reading. To make an appointment with Dr. Goza, call 785-505-2200.

When the 10,500 square-foot, single-story medical office building is complete, Eudora Family Care expects to add an additional physician to help meet the medical needs of the community. The office building will have ample space for two physicians. The physician office will accommodate 11 exam rooms and a procedure room and have a dedicated X-ray machine. The building will also accommodate Byrne’s Pharmacy, and LMH’s Kreider Rehabilitation Services will offer outpatient physical therapy services at the location.

C. David Rios, MD, FACC Dr. Rios has joined Cardiovascular Specialists of Lawrence. He specializes in general cardiology, including pacemaker insertion and diagnostic cardiac catheterization procedures. Dr. Rios has practiced cardiology in the Kansas City area for the past 13 years. He earned a bachelor’s degree in biology from Harvard University and graduated from Stanford University School of Medicine. Dr. Rios was an internal medicine resident at Massachusetts General Hospital and completed a cardiology fellowship at the University of Iowa College of Medicine. He is board certified in internal medicine and cardiology. Dr. Rios was born in Bronx, New York, the youngest of seven children. He said he always had a strong interest in science and math and thought medicine fit his personality. He chose cardiology as his specialty because he likes helping sicker patients. “Cardiology is an exciting field that’s always evolving,” he says.

The building will feature a stone facade

Dr. Rios is married to Karin Chang-Rios, PhD, a research associate at the University of Kansas Institute for Educational Research, and they have two active teenagers, Chris and Samantha. Dr. Rios enjoys family activities, running and golf. He speaks fluent Spanish.

and many windows to capture natural light,

To make an appointment with Dr. Rios, call 785-841-3636

helping to minimize the electrical consumption of the building. Construction is expected to begin after a July 16 groundbreaking. The much-anticipated project is expected to be complete in the summer of 2011.

For your calendar Small Town Big Cause 5k run/walks

• Tonganoxie | Saturday, July 24, 7:30 a.m. at Family Medicine of Tonganoxie, 410 Woodfield • Baldwin City | Saturday, August 28, 8 a.m. at Baldwin City Golf Course • Eudora | Saturday, September 25, 8 a.m. at Eudora Parks and Recreation Center, 1638 Elm Street Contact: Melissa Hess, 785-505-3317 or Melissa.Hess@lmh.org

LMH offers a wide array of health-related classes. Visit lmh.org and click on “Classes and Programs”.

325 Maine Street Lawrence, KS 66044

LMH joins statewide effort to track community benefits Not-for-profit health care organizations like Lawrence Memorial Hospital have a rich tradition of providing health and wellness benefits other than patient care to our community. As of January 1, 2009, LMH joined many Kansas Hospital Association member hospitals in voluntarily tracking, reporting and analyzing activities that provide community benefits. Community benefits are defined as programs or activities that provide treatment or promote health and healing as a response to identified community needs. They must meet at least one community benefit objective: improve access to health care services; enhance health of the community; advance medical or health care knowledge; and/or relieve or reduce the burden of government or other community efforts. LMH reports that in 2009 community benefits totaled more than $7 million and impacted the lives of more than 50,000 people throughout the community. Examples include LMH’s support of Health Care Access, serving as a clinical training site for students, the shortfall between the cost of providing services for Medicaid patients and the reimbursement received, and community education programs. Read on about one in particular. group in 2008. Hoffman, community education Support group helps new moms cope specialist for prenatal and parenting programs at After the birth of her son, Nicki* was nearly LMH, was inspired to start a group after she crippled by anxiety. She was afraid to give her experienced her own anxiety as a first-time mom. baby a bath in case he might accidentally drown. She didn’t want to carry him up stairs for fear of Each 10-week session of Build Your Village is based dropping him. On walks, she wouldn’t cross the on a research-driven curriculum. Moms may join street because she worried that the baby would the group, which meets on Monday evenings, be hit by a car. at any time. On family and friends’ night, loved

Melissa Hoffman, community education specialist, works with a participant of the Build Your Village support group.

“All I wanted to do was sit and cry,” she remembers. “I didn’t understand what was happening to me.”

ones come to learn more about perinatal mood disorders. In 2008, the program saw 61 visits from moms. One year later, that number climbed to 87.

At LMH’s Build Your Village Perinatal Adjustment Support Group, Nicki discovered she was suffering from a postpartum mood disorder. And in this safe, supportive group, she took her first steps toward healing.

“This is not meant to be a long-term support system but a bridge to get them through the toughest times, while they take healthy steps outside the group,” Hoffman explains. She recommends each participant also seek a medical and psychological evaluation and treatment plan.

“These were moms who were going through the same thing,” she explains. “Sometimes we pass the Kleenex box around and have a good cry, but we feel better when we go home.” That’s exactly what Melissa Hoffman had in mind when she launched the Build Your Village support

For Nicki, Build Your Village has made a huge difference in her daily life. “The group gave me very simple solutions,” she explains. “My anxiety is not entirely gone, but now it’s something I can live with and get past.”

connect is published by Lawrence Memorial Hospital.The information in this newsletter is intended to educate readers about subjects pertinent to their health and is not a substitute for consultation with a personal physician.To have your name added to or removed from this mailing list, please call 785-505-3315.

Gene Meyer | President and CEO, Lawrence Memorial Hospital Editorial Board | Kathy Clausing Willis, Sherri Vaughn, MD, Janice Early-Weas, Heather Ackerly

Lawrence Memorial Hospital • 325 Maine Street • Lawrence, KS 66044 • 785-505-5000 • www.lmh.org