@ COLORECTAL CANCER BY THE NUMBERS
55 to 84 The age range in which most MEN AND WOMEN ARE DIAGNOSED with colorectal cancer.
1.3 million+ The estimated number of people in the U.S. living with COLORECTAL CANCER. Source: National Cancer Institute
FALL 2017
It’s a test you don’t want to miss
IN THIS ISSUE
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WHY YOU SHOULD BE SCREENED FOR COLORECTAL CANCER Steven Screening for colorectal cancer gives you the rare Lichtenstein, DO opportunity to undergo a test that can actually prevent cancer. “Some colorectal screening tests are good at finding cancer early, when it’s most easily treated,” says Steven Lichtenstein, DO, Gastroenterologist at Mercy Fitzgerald Hospital. “Other tests can actually help prevent the disease.” — Continued on page 2
GENTLER HEART SURGERY Faster healing and less pain
DEALING WITH PAIN Get the right help for pain that persists
LEARN MORE Read about the many cancer services at Mercy Fitzgerald Hospital. Go to mercyhealth.org/cancer.
— Continued from front page During those preventive kinds of tests, doctors can find precancerous polyps in the colon and remove them before they become full-blown cancer. Whichever colorectal screening test you choose, you should have it when you turn 50. If you’re African American—or your doctor says you’re at high risk for the disease—have the test at 45. Here are some common colorectal screening tests. Talk with your doctor about which one is right for you and how often you should be tested: Colonoscopy. Dr. Lichtenstein calls this test “the gold standard” because it is the best test for finding and removing polyps from the entire colon. Its main downside is the prep work you must do to empty your bowels before the test, though the prep is a lot easier now than in the past. Flexible sigmoidoscopy. Similar to a colonoscopy, this test can only examine the inside of the lower colon, which means it could miss polyps deeper inside. You still have to do the bowel prep work for this test and if a polyp or cancer is found, you’ll need to have a colonoscopy. FIT test. This test detects blood in your stool, a possible sign of cancer. You can do the test at home. You place a tiny amount of stool in a vial or on a card using a small stick or probe, and you mail the sample to our lab. If results are positive, you’ll need a colonoscopy.
LEARN MORE Read about the many cancer services at Mercy Fitzgerald Hospital. Go to mercyhealth.org/cancer.
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More @ Mercy Fall 2017
Targeting tumors without surgery Surgery is often a crucial part of Ablation. With this procedure, treating cancer. But what if it isn’t an doctors use a thin, needle-like probe option for you? to kill cancer cells—either by heating At Mercy Fitzgerald Hospital, them to high temperatures or freezing our highly skilled interventional them. Ablation can destroy tumors radiologists treat many cancers with throughout the body. minimally invasive procedures. What’s more, “These minimally These treatments precisely target invasive procedures are only tumors, sparing nearby one part of the healthy tissue. And comprehensive, compared to standard university-level care you surgery, the procedures can count on here,” says could be less painful and Carol Fluegge, MBA, MA, have a shorter recovery RN, Vice President of time, says Gerard Berry, Clinical Service Lines for Gerard Berry, MD MD, Section Head of Mercy Health System. Interventional Radiology A multidisciplinary at Mercy Fitzgerald. team of physicians— Typically, they’re delivered including specialists in in two ways: interventional oncology, Embolization. In these chemotherapy, radiation catheter-based procedures, therapy and pathology— doctors use tiny beads that creates a personalized Carol Fluegge, release radiation or cancer treatment plan for each of MBA, MA, RN drugs to treat tumors. our cancer patients.
Easy access to 3-D mammography Mammograms save lives. And at Mercy Fitzgerald Hospital, we want to make it as easy as possible for you to get screened for breast cancer. That’s why we offer two options for getting a screening mammogram: You can schedule an appointment by calling 610.237.2525. O r you can opt to walk in and get a mammogram every Wednesday, Thursday and Friday from 8:00 a.m. – 4.00 p.m. No
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appointment is necessary. All you need is a signed prescription from your doctor, along with your insurance card and photo ID. (Women with a history of breast cancer or breast surgery or who have breast implants are not eligible for walk-in screening mammograms.) Want another reason to get your mammogram at our hospital? We have 3-D mammography, which helps catch more breast cancers at an early stage.
It’s personal MANY PEOPLE HAVE A STRONG BOND WITH THEIR PRIMARY CARE PHYSICIAN It may be easy to go to an urgent care center or a retail health clinic when we’re feeling sick. But neither one can replace the more personalized care we get from a primary care physician (PCP). That’s the conclusion of a study conducted earlier this year by the Harris Poll on behalf of Mercy Health System of Southeastern Pennsylvania. The survey asked more than 1,700 U.S. adults about their relationship with their PCP and if they had recently been treated someplace other than their doctor’s office— such as an urgent care center—for a health problem. Among the survey results: 6 in 10 (59 percent) of the respondents ✓ Nearly believed their PCPs care about them. half (49 percent) believed their PCP knows ✓ Nearly them personally. out of four respondents (75 percent) knew the ✓ Three name of their PCP. In contrast, very few knew the name of a care provider who most recently treated them at a retail health clinic (15 percent), urgent care center (12 percent) or free clinic (8 percent).
Although the study respondents did value their time with their PCP, many would go to an urgent care center if, for instance, it was too much hassle to make an appointment with their PCP or if their actual PCP wasn’t always available when they came in for an appointment. “We did the study because we wanted to enhance our understanding of the dynamics that affect interactions between patients and their PCPs,” says William J. Strimel, DO, President, Mercy Physician Network. “Urgent care centers and retail health clinics provide needed care for minor health problems in the evening or on the weekends, when it’s not possible to see a PCP. But they aren’t a substitute for the type of continuous medical care that a PCP provides. In other words, having a personal connection with your PCP matters.”
Only 36%
75% of patients
OF PATIENTS say they followed up with their primary care doctor after their most recent urgent care center visit.
know the name of their primary care doctor.
This study was conducted online by Harris Poll on behalf of Mercy Health System of Southeastern Pennsylvania in February 2017 among 1,735 U.S. adults ages 18 and older who have a primary care physician, whom we describe as patients.
Physician Date Physician Date
12%
of patients know the name of the urgent care center medical professional who most recently treated them.
65%
of patients assume their doctors receive updates on their urgent care visit automatically.
RX RX
2
9
23
30
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SCHEDULING ISSUES with their primary care office would cause two-thirds of patients to seek services elsewhere.
WHAT’S UP, DOC? Check in with your Mercy doctor by calling 1.877.GO MERCY. mercyhealth.org
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MINIMALLY INVASIVE HEART SURGERY
TINY INCISIONS,
a big help
FOR YOUR HEART Which would you choose if you needed heart surgery? A. Surgery with a far easier recovery time than is typical. B. The status quo. A, right? Well, with the help of the highly skilled Mercy cardiothoracic surgeons, you might get your wish. Together, they perform a wide range of minimally invasive heart surgeries at Mercy Fitzgerald Hospital and the Lourdes Cardiovascular Institute. And many people are candidates.
An impressive list of benefits To perform these operations, surgeons use tiny incisions to access the heart and nearby blood vessels. But instead of splitting the breastbone, they insert instruments under it or between the ribs. Compared to standard openheart surgery, this minimally invasive approach has important advantages, says Deon Vigilance, MD, Chief of Cardiac Surgery at Mercy Fitzgerald Hospital. It:
•• Reduces pain. •• Reduces bleeding and the need for blood transfusions.
•• Lowers the risk of infections and complications. •• Results in minimal scarring. •• Speeds healing—you’ll probably return to your normal routine in just three to five days.
PUT YOUR HEART IN OUR HANDS Learn more about our cardiac programs at mercyhealth.org/heart.
Leading the way for heart health John J. Finley IV, MD
A delicate, inside job Here’s a look at the often life-saving heart surgeries our doctors perform as minimally invasive procedures: Heart bypass surgery. This diverts blood flow around dangerously blocked heart arteries. Doctors take a healthy blood vessel from the leg or chest and connect it to the heart so that blood bypasses the blockage. In a standard surgery, the heart is stopped and a heart-lung machine keeps blood filled with oxygen. “But in a minimally invasive surgery, the heart still beats,” explains Dr. Vigilance. “This reduces the risk of a stroke, a possible complication of the heart-lung machine.” Through a special partnership, our surgeons also perform robotically assisted bypass surgery at Lourdes Cardiovascular Institute. The use of a robot helps make this surgery, which is also minimally invasive, even more precise. Heart valve surgery. Again using tiny incisions, our surgeons can repair or replace damaged heart valves that can cause serious heart problems. At Lourdes, our surgeons also perform a type of minimally invasive surgery called transcatheter aortic valve replacement—or TAVR for short. It is used to treat a badly
Now see this: A new CT scanner
MERCY FITZGERALD IS THE FIRST IN THE STATE TO USE SPECIALIZED HEART STENT
Deon Vigilance, MD damaged aortic valve, one of the four valves in the heart. Ablation surgery. This surgery treats atrial fibrillation (A-Fib), a condition in which the heart beats in an irregular way. A-Fib raises the risk of stroke. During ablation surgery, doctors use a catheter to deliver radiofrequency energy (similar to microwave heat) to a small area of heart tissue that is causing the irregular heartbeats. The radiofrequency energy destroys the abnormal tissue and helps restore a normal heart rhythm.
Compassionate, close-to-home care Living in the Philadelphia area, you have many choices for where to have heart surgery. That’s why you should know that the types of minimally invasive heart surgeries our specialists provide are equal to those at any major academic center, Dr. Vigilance says. And, just as important, our care is as personalized as it is advanced. “Mercy Fitzgerald Hospital has deep roots in the community,” Dr. Vigilance says. “And many of the people who turn to us say they feel more like neighbors or family members than patients.”
Less radiation, dramatically improved pictures and faster CT imaging. That’s what you’ll find this fall at Mercy Fitzgerald Hospital. The hospital has invested in a new Siemens CT scanner. “This scanner will provide Delaware County the lowest dose of radiation with the highest possible accuracy of any CT scanner in
Interventional cardiologists rely on minimally invasive, catheter-based procedures to treat heart and blood vessel problems. And at Mercy Fitzgerald Hospital, these procedures are state-of-the-art. Here’s just one example: Last May, the hospital became the first in the state to use a special kind of stent just approved by the U.S. Food and Drug Administration for people with extra-large heart arteries. The stent emits a drug that helps keep newly opened arteries from narrowing again after an angioplasty, and doctors can expand it so that’s it’s perfectly sized for very large arteries. “Arteries come in different sizes,” explains John J. Finley IV, MD, an interventional cardiologist at Mercy Fitzgerald. “Until now, we only had small-, medium- or large-sized stents. But we also needed extra-large stents. The fit with this new stent gives our patients the best possible chance that they won’t need to come back for a repeat procedure because their arteries have narrowed again.” The stent is also easier for doctors to see as they implant it, allowing for more precise placement.
our area,” says Lisa Curtin, RT, Mercy Fitzgerald Administrative Director of Radiology. The scanning will take only a few seconds. You’ll be in and out of the CT suite in just 15 minutes. The new CT scanner accommodates body sizes up to 676 pounds, and it has many unique diagnostic capabilities. mercyhealth.org
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The right help for persistent pain You’re in lingering pain— maybe from a bum knee, a sore back or a hip with arthritis. And you want one thing: to feel like yourself again. Your doctor wants that too. Even so, he or she may advise against taking a prescription opioid drug like oxycodone. Yes, these drugs can help with some types of pain, such as cancer pain, in the short term. “But they also come with serious risks, including addiction,” warns Ruth Martynowicz, Vice President of Operations at Mercy Home Health. That’s why your doctor may suggest other ways, besides taking an opioid, to ease your pain. For example, pain relievers such as acetaminophen (brand name Tylenol) or ibuprofen (brand name Advil) might help. So might steroid shots, physical therapy or exercise. If your doctor does prescribe an opioid drug, you should: Be frank. Tell your doctor if you’ve misused—or have been addicted to— alcohol or other drugs. If so, taking opioids could be very risky for you.
Speak up. Tell your doctor about all the medicines you take. Some aren’t safe to use with opioids. Take the opioid exactly as prescribed. Don’t take an extra or higher dose, even if you still hurt. Talk to your doctor instead. And
don’t drink alcohol while you’re on an opioid. Keep others safe too. Never share an opioid with friends or family. And keep the drug out of the sight— and reach—of curious kids. You might even store the opioid in a lockbox.
Prescription opioid drugs come with serious risks.
Don’t risk the flu—get your shot
WE CAN HELP Interested in the services Mercy Home Health provides? Call 1.888.690.2551 or visit mercyhomehealth.org.
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More @ Mercy Fall 2017
You want to stay healthy and feel good. And one way to do that, especially this time of year, is to get a flu shot. Some people develop serious complications from the flu, like pneumonia, and need to be hospitalized. Older adults are at especially high risk for flu complications, such as death. So are those with chronic health problems, like diabetes or heart or lung disease. Those are some key
reasons why nearly everyone 6 months and older should get a flu vaccine every year. “Getting an annual flu shot is the best way to help avoid getting very sick and infecting others who are more vulnerable,” says Donna Raziano, MD, Chief Medical Officer of Mercy Home Health. Why do you need a new shot each year? Because the viruses it prevents can change from one flu season to the next. Also,
the immunity depends on the strains of active influenza virus that year. It’s true that sometimes you can still get the flu even if you’ve had a flu shot. “But chances are, you won’t get as sick if you’ve been vaccinated,” says Dr. Raziano. “That’s why the vaccine is still your best defense against the flu.” Flu season can last for many months. So it’s not too late to get a flu shot if you haven’t done so yet. Talk to your doctor.
So nice to see you! VIDEO CALLS GIVE TELEHEALTH NURSES A CLEARER PICTURE OF HEALTH “Let me see what your ankles look like today.” That’s a request a nurse might make to a patient enrolled in the Telehealth Monitoring program at Mercy Home Health. And it’s a request that’s now possible because many patients on telemonitoring will have the use of a tablet for video conferencing. As part of the telehealth program, patients with heart failure, chronic obstructive pulmonary disease (COPD) or other serious diseases send blood pressure readings, daily weight and blood-oxygen levels over the phone from their home. Nurses from Mercy Home Health see this data on a screen, and they call the patient if anything needs prompt attention. And now many patients can see the nurse who responds because they have tablet computers that can make a video call.
“We see them, and they see us,” says Jayne Green, Regional Director of Operations at Mercy Home Health. “Being able to look at a patient helps us have a better idea of how they’re feeling.” For instance, a nurse can see if a patient is short of breath or if their ankles are swollen. Those might be signs of a change in the patient’s health. But the tech upgrade helps patients in more ways than one. Video makes a nurse’s call more personal, which many patients enjoy. “It’s nice that you get to put a face to the voice,” Green says.
ON-SCREEN HELP To learn more about the Telehealth Monitoring program, call 1.888.690.2551. Or visit mercyhomehealth.org.
THE A1C TEST
Your blood sugar report card Do you have any idea how well your diabetes is being controlled? You can have a very clear picture if you are getting regular A1C tests every 3 to 6 months. “This simple blood test lets you and your doctor know what your blood glucose level has averaged over the previous two to three months,” says Donna Raziano, MD, Chief Medical Officer for Mercy Home Health. Having a high A1C result means your blood sugar was not well-controlled during that time. “The higher your A1C result, the greater your chance of developing irreversible diabetic complications, such as eye disease, kidney disease or nerve damage,” says Dr. Raziano. A person without diabetes has an A1C level of less than 5.7 percent. For people with diabetes, a good goal may be keeping their A1C less than 7 percent. It is very important to have A1C tests and to not rely solely on the blood sugar testing you do at home. Those tests show your blood sugar level at a particular moment in time, but they don’t provide the overall picture that an A1C test does. It is a good idea to occasionally check your blood sugars at different times of the day, such as before dinner and bedtime, and not just exclusively when you are fasting in the morning. You should get an A1C test minimally at least twice a year. Your doctor may recommend you get it more often if your blood sugar levels are not well-controlled or your treatment plan changes. mercyhealth.org
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Advice about OTC drugs and supplements for heart patients When you feel a cold coming on, reaching for an over-the-counter (OTC) cold medicine might seem like a good idea. But you should be cautious if you have a heart problem or high blood pressure. Omeche J. Idoko, MD, a family physician at Mercy Fitzgerald Hospital, explains why. What are some potential risks when heart patients take OTC cold medicines? Answer: The major concern is for people who have high blood pressure, which includes most people who have a heart condition. In particular, they should avoid OTC decongestants that contain pseudoephedrine. These medicines tend to elevate blood pressure. And that could indirectly worsen your heart condition by keeping your blood pressure elevated even if you’re on many different blood pressure medications. Some other OTC cold medicines, such as Coricidin, are often recommended for people with high blood pressure.
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AND LOOKING FOR DOCTOR RIGHT? We’ll help you find the perfect match. Call 1.877.GO MERCY (1.877.466.3729) or visit mercyhealth.org/find-a-doctor.
Omeche J. Idoko, MD What about taking OTC herbs or supplements? Answer: Just because you bought something over the counter doesn’t mean it’s safe. For example, if you’re on a cholesterol-lowering statin, I would ask you not to take St. John’s wort because it makes a statin less effective. Even vitamin E can interfere with the blood thinners many heart patients take to prevent clots.
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What if I have questions about taking OTC cold medicines or supplements? Answer: Don’t hesitate to talk with your doctor or pharmacist. It’s also a good idea to bring all of your meds to your doctor visits. At those visits, you and your doctor can discuss drug-to-drug interactions and the potential for side effects.
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