More@Mercy - Mercy Fitzgerald Hospital - Spring 2017

@ DOCTOR VISITS

BY THE NUMBERS

54%

The approximate percentage of visits made to PRIMARY CARE PHYSICIANS in the U.S. each year.

136,100 The approximate number of men and women in the U.S. diagnosed with COLORECTAL CANCER each year.

Source: Centers for Disease Control and Prevention

SPRING 2017 2016

A special time for better health WHY YOU NEED AN ANNUAL WELLNESS VISIT Most of us would agree: Going to the doctor when we’re sick makes a lot of sense. But what about when we’re feeling fine?

It turns out, seeing a primary care physician when you’re healthy makes just as much sense—if not more.

“Yearly wellness visits with a doctor can help you stay healthy by preventing certain health problems

from starting or by finding problems early, when they may be easier to treat or control,” says James M. Minnella, MD, an Internal Medicine Physician at Mercy Fitzgerald Hospital. “In fact, wellness visits might even be one of the keys to living a longer, better life.” ­— Continued on page 2

IN THIS ISSUE

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HOW TO SAVE A LIFE Judith Hoffman is thankful she got screened.

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NEED HELP AT HOME? Mercy Home Health is here for you

NEED A CHECKUP? Make an appointment with a primary care doctor. Call 1.877.GO MERCY (1.877.466.3729).

A quick guide to digestive diseases What comes to mind when you hear the term digestive diseases?

Chances are, you immediately think of tummy troubles. But digestive diseases are much more than that.

The digestive system is made up of the gastrointestinal (GI) tract—the long muscular tube that extends from the mouth to the anus—along with the liver, pancreas and gallbladder.

Some diseases and conditions that affect this system are acute—meaning that they last only a short time—while others are chronic, or long-lasting. And they can include a wide range of problems, such as:

• Acid reflux • Crohn’s disease • Irritable bowel syndrome • Ulcerative colitis

“We have an excellent team of digestive specialists at Mercy Fitzgerald who can help you, from testing to diagnosis and treatment.”

—Steven Lichtenstein, DO

• Colon polyps • Hemorrhoids • Stomach ulcers

GUT CHECK

For issues like these, a gastroenterologist is the doctor to call for help.

“Digestive health problems affect millions of Americans—and some of those problems can be life-threatening,” says Steven Lichtenstein, DO, Medical Director of Digestive Health Services at Mercy Fitzgerald Hospital. “We have an excellent team of digestive specialists at Mercy Fitzgerald who can help you, from testing to diagnosis and treatment. Our team is among the best.”

Read about our expert care for digestive problems at mercyhealth.org/gi.

A special time for better health ­— Continued from front page

What happens during a wellness visit?

Among other things, a doctor may: •• Ask about all the medicines, both prescription and over-the-counter, that you take to make sure there isn’t potential for a dangerous interaction.

•• Do a physical exam.

•• Recommend that you get certain screening tests based on things like your age, sex or medical history. Examples include blood pressure and cholesterol checks (to help assess your heart attack and stroke risks) and breast or colon cancer screenings.

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More @ Mercy Spring 2017

•• Offer tips on healthy lifestyle habits, such as eating right and being active.

•• Ensure that your James M. adult vaccines Minnella, MD are up-to-date.

If the doctor does find a problem, then what? He or she may offer treatments, such as medicines, or refer you to a specialist, if needed.

“Wellness visits are a great way to help protect your health and to establish an ongoing relationship with a doctor who knows and understands your health needs,” Dr. Minnella says.

Leading the way to better digestive health If you had a digestive health issue, who would you call? Here’s an idea: You might want to get in touch with an expert on the subject. And that would be a gastroenterologist.

These doctors specialize in treating diseases of the gastrointestinal (GI) tract and liver. Mercy Fitzgerald Hospital has a team of board-certified GI doctors.

Want to know a bit more about them and their training and skills?

Steven Lichtenstein, DO: Fellowship: Mercy Catholic Medical Center Residency: Mercy Catholic Medical Center (internal medicine) Medical school: Philadelphia College of Osteopathic Medicine

An inside job SWALLOWING AND DIGESTIVE PROBLEMS ARE THE FOCUS AT OUR HEARTBURN AND REFLUX CENTER

Ugh. It’s happening again—that pain in your chest after you eat, along with a burning sensation traveling up toward your throat.

If that description sounds all too familiar, you might want to make an appointment at the Heartburn and Reflux Center at Mercy Fitzgerald Hospital. The gastrointestinal specialists at the center have the latest stateof-the-art equipment and tests to help ease your symptoms.

“For example, we now have testing that allows us to better diagnose and treat conditions like heartburn, swallowing problems and chest pain not related to the heart,” says Steven Lichtenstein, DO, Medical Director of Digestive Health Services.

Rafael A. Amaral, MD:

New testing available

Fellowship: Mercy Catholic Medical Center Residency: Mercy Catholic Medical Center Medical school: Ponce School of Medicine

One of the new tests is called manometry. It uses a pressure-sensitive tube to measure how well your esophagus moves food down to your stomach.

Here’s how manometry works: •• First, the inside of your nose is numbed with medicine. Then a thin tube is passed through your nose, down your esophagus and into your stomach.

•• The tube is slowly pulled back up from your stomach into your esophagus.

•• The doctor will ask you to swallow. The tube will measure the pressure of muscle contractions in your esophagus.

•• The doctor also can check acid (pH) levels in your esophagus and perform other studies while the tube remains in place.

Depending on the results of the manometry, the doctor might prescribe medications, a second procedure or surgery.

If you have frequent heartburn or swallowing problems, talk with your doctor.

Austin F. Hwang, MD: Fellowship: Lankenau Hospital Residency: Thomas Jefferson University (internal medicine) Medical school: Upstate Medical University

Expert care and happy patients The GI specialists at Mercy Fitzgerald can help assess and treat a wide range of digestive issues, including: • Heartburn and GERD • Ulcers • Irritable bowel syndrome • Swallowing problems • Unexplained abdominal pain • Diarrhea or constipation “Our team performs all the usual GI procedures, such as endoscopy and colonoscopies,” says Dr. Lichtenstein, Medical Director of Digestive Health Services at Mercy Fitzgerald. “And we have extremely high patient satisfaction scores.”

GIVE US A CALL For more information about the Heartburn and Reflux Center, call 610.534.6270. mercyhealth.org

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A test in time helps

SAVE A LIFE Steven Lichtenstein, DO

As far as Judith Hoffman is concerned, S teven Lichtenstein, DO, a gastroenterologist at Mercy Fitzgerald Hospital, saved her life.

It was early in 2015 when Judith came to Dr. Lichtenstein’s office as a follow-up from a hospital stay. During that office visit, Dr. Lichtenstein asked the 64-year-old from Southwest Philadelphia a crucial question.

“He asked me if I’d ever had a colonoscopy,” Judith says, “And I told him I had not. So he suggested I get one done.”

She scheduled the colonoscopy with Dr. Lichtenstein, who is also the Medical Director of Digestive Health Services at Mercy Fitzgerald Hospital. After the procedure was done, she learned he had removed a large suspicious growth from the wall of her colon.

The pathology report called it “an advanced precancerous polyp.”

“I said, ‘Oh my God. I came in just in time,’” Judith says. “It was dangerously close to cancer.”

Cured by a colonoscopy “Most colon cancers start as a polyp,” Dr. Lichtenstein explains. “But there are different stages of precancerous polyps.

Mrs. Hoffman’s showed high-grade dysplasia cells. Those kinds of cells are only one hair away from being cancer.”

There are different ways to screen for colon

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cancer. But a colonoscopy is considered the gold standard of tests—and Judith’s case shows why. It’s the only test that views the entire colon. And if any polyps are found, they can be removed during the test.

That means a colonoscopy does more than look for signs of cancer—it can prevent cancer from occurring.

Six months after removing the polyp, Dr. Lichtenstein did another colonoscopy on Judith. It showed no signs of cancer.

“Mrs. Hoffman was cured by the scope,” Dr. Lichtenstein says. “She’s very lucky. She didn’t need any radiation or surgery, the typical treatments for colon cancer.”

“I don’t have to go back for three years,” Judith says. “That’s how successful the colonoscopy was.”

‘A very easy thing to do’ Most people should have their first colonoscopy when they turn age 50. African

One-stop scheduling DIRECT ACCESS ENDOSCOPY IS CONVENIENT

“It was a very, very easy thing to do.

It seemed like the test itself took only five minutes, and I didn’t feel a thing.”

—Judith Hoffman

Americans should have their first test at age 45 because they are at higher risk for colorectal cancer.

Judith knew she should have had the test earlier. She just never got around to it.

“That’s not unusual,” Dr. Lichtenstein says.

“People often say they knew about it but didn’t do it.”

Sometimes people are put off by the preparation for the test, which requires taking laxatives to clean out the bowel. But Judith didn’t think it was bad at all.

“It was a very, very easy thing to do,” she says. “It seemed like the test itself took only five minutes, and I didn’t feel a thing.

“It’s a lot better than getting cancer,” she adds.

Judith has two grown children.

“So I’m on them to make sure they get the test when they turn 45. They’re nowhere near that age now, but I’ll stay on them,” she says.

Your primary care doctor wants you to have a colonoscopy. Not because you’re having any problems, but because you recently turned 50 years old. And that’s when most people should have their first colonoscopy to screen for signs of colorectal cancer.

Which of these next steps do you prefer?

A. You make an appointment with a gastroenterologist (also known as a GI doctor).

The GI doctor agrees you should have the test. You then make yet another appointment for the colonoscopy itself.

B. You just make an appointment for the colonoscopy.

If you prefer option B, you’re in luck. You can call the Direct Access line of Mercy GI at Mercy Fitzgerald Hospital. You’ll be asked a few questions,

and if all goes well, you can make an appointment for the test.

Fast-tracked Direct Access Endoscopy can save you time and money. In addition to a colonoscopy, you can use Direct Access to make appointments for: •• Upper endoscopy •• Flexible sigmoidoscopy •• Wireless capsule endoscopy Steven Lichtenstein, DO, Medical Director of Digestive Health Services, calls Direct Access “a fast track for patients.” If you don’t need to see the GI doctor, “why not just cut to the chase?” he says.

If you prefer to meet with the GI doctor before your procedure, that’s OK. And if you have any health issues, you may be told you need to see a GI doctor.

GET SCREENED To make an appointment for a colonoscopy, call Direct Access Endoscopy at 610.237.7360.

100,000+ The number of lives that could be SAVED EACH YEAR if everyone in the U.S. got the preventive healthcare that they need, including screening tests and regular visits with a doctor. mercyhealth.org

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When you need a hand at home Sometimes you need a little help at home. And sometimes that little bit of help can help you stay in your home.

That’s the goal of Mercy Home Health, which sends nurses, therapists, social workers and health aides to homes throughout the Philadelphia area. They offer a hand to people who—without that bit of help—might otherwise need to be admitted to a hospital or moved into a nursing home.

“Most people do better when they’re at home,” says Ruth Martynowicz, Vice President of Operations at Mercy Home Health.

“It’s our goal to keep them there— out of the hospital or nursing home and in the community.”

Mercy Home Health provides a variety of services to about 3,000 people every day. Among these services: Skilled nursing care. A nurse can come to your home to help you manage a chronic illness, such as diabetes, heart disease or a lung condition. If you need help managing multiple medications or taking care of a wound, a nurse can help with those tasks too.

In-home telemonitoring. This program helps safely monitor patients from home. If you’re one of them, you’ll receive a monitor, a blood pressure cuff and other equipment so that health care

staff can check on things like your vital signs and weight seven days a week. “We can even do a mini-health assessment over the telemonitor,” Ruth says.

Rehabilitation therapy. If it’s hard for you to walk, talk or perform other daily activities, physical, occupational and speech therapists can help you get stronger or teach you new ways of doing those activities.

Palliative care. If you have a chronic condition like heart failure or lung disease, a palliative care nurse can teach you how to manage your symptoms. A social worker can talk to you and your family about quality of life improvements.

Support services. Home health aides can come to your home a few times a week to help with personal care, like bathing or getting dressed.

The Mercy-ful Companion program can provide companionship and spiritual support.

The kind of services you might be eligible for can depend on your health condition and what your doctor recommends.

COULD HOME HEALTH HELP YOU? If you’d like more information about Mercy Home Health, call 1.888.690.2551. Or visit mercyhomehealth.org.

Beyond the Emergency Department Many people who visit the Emergency Department could use some follow-up care at home once they are discharged. Mercy Home Health helps provide that care— which may help them avoid another trip to the Emergency Department or a future hospital stay.

Mercy Home Health offers programs

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to patients who might have been in the Emergency Department because of a wound that is not healing properly, an injury from a fall, complications from chronic illnesses like diabetes or high blood pressure, or even a reaction to a new medication.

“We bring the care to you,” says Rose Riggio, RN, Nurse Manager

for the Emergency Department Liaisons.

Going home after an Emergency Department visit can be stressful. Mercy Home Health gives patients and their families peace of mind, knowing that a registered nurse is coming to their home to ensure they are on the right path to healing.

HEART FAILURE

Menu makeover EATING WELL WITH COPD Eat better, breathe better?

It might sound a little strange, but if you have chronic obstructive pulmonary disease (COPD), your diet can have an impact on how well your lungs work.

“COPD can vary in severity,” says Donna Raziano, MD, Chief Medical Officer for Mercy Home Health. “And, generally, if your lung disease is more severe, it can be taxing on your body. You may be using a lot of energy—or calories—to breathe. So you need to make sure your diet meets the demands of your respiratory rate.”

How do you do that? Dr. Raziano suggests focusing on a well-balanced diet that includes: Protein from eggs, lean meats and dairy products. If milk thickens your mucus, choose yogurt and cheese.

A good amount of fiber—gained from eating fruits; vegetables; and whole-grain products, like whole-grain bread and pasta.

A limited amount of added sugars, candies, sweet bakery products and sugary soft drinks.

Plenty of water. Not only will water ease a dry mouth; it will help thin mucus. Aim to drink six to eight glasses a day.

You also might want to switch to eating four to six small meals every day. Eating smaller amounts of food may help you breathe better. Also, eat your food slowly.

Sometimes indigestion becomes a problem for people with COPD, Dr. Raziano says. In that case, avoid foods that can make you feel full and gassy, such as beans and cabbage.

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GIVE US A CALL Interested in how Mercy Home Health can help you or a loved one? Call 1.888.690.2551.

Drink less, feel better WHY YOU MAY NEED TO DRINK FEWER FLUIDS When you have heart failure, it’s important to follow your doctor’s instructions for staying well. And one of those instructions might be to limit your fluid intake. Here’s why: Heart failure can cause fluid to build up in your body.

As a result, your legs might swell or you might feel out of breath. But limiting what you drink can help keep fluid from accumulating.

“It can help you feel better and lower your risk of having to go to the hospital,” says Linda Ricci, RN, BSN, a Mercy Home Health nurse.

Your doctor will tell you how much water or other fluids to drink every day. To track your fluid intake: •• Find out how much fluid your regular drinking glasses hold. That way you won’t have to measure every time.

•• Remember that some foods, like soup, and foods that melt (such as ice cream) contain fluid. So also count these as part of your fluid intake.

may mean your heart failure symptoms are changing and your treatment needs adjusting,” Linda states.

Call your doctor if your weight suddenly goes up.

Generally, that means by more than 2 to 3 pounds in a day or 5 pounds in a week. But ask your doctor for guidelines specifically related to your condition.

Watch for weight gain How can you tell if you’re retaining fluid? One of the best ways is to step on the scale every day—before you eat breakfast and after you use the bathroom.

“A sudden weight gain mercyhealth.org

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IBS and diet: What you need to know AND

Everybody has an unruly stomach now and then. But people with irritable bowel syndrome (IBS) can face symptoms that disrupt their lives.

Melissa Barry, RD, Clinical Nutrition Manager at Mercy Fitzgerald Hospital, answers questions about this common disorder—and how to help control it with diet.

Q

Eating foods with probiotics—such as yogurt and a fermented drink called kefir—may help too.

What is IBS?

Answer: It’s a problem that affects the large intestine. IBS can cause abdominal cramping, bloating and a change in bowel habits. Some people have diarrhea, and some have constipation. Others alternate between having both. There’s no test to diagnose IBS. So often you’re said to have it when symptoms last for at least three months.

Q

Melissa Barry, RD

Can symptoms be eased?

Answer: Yes—and making dietary changes is one of the best ways to help control symptoms, though no one diet helps everyone. It may help to eat at regular times; have small, frequent meals; gradually increase your fiber; and drink plenty of water.

Do certain foods make IBS worse?

Answer: Some can. It may help to limit fatty foods, some milk products, foods that cause gas, alcohol and drinks with artificial sweeteners. Keeping a food diary can also help you tell if certain foods make your symptoms worse.

You may also want to ask your doctor or a registered dietitian about what’s called a low-FODMAP diet. It eliminates certain foods tied to symptoms of IBS and may be beneficial.

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THINK YOU HAVE IBS? Make an appointment with one of our gastroenterologists.

Call 1.877.GO MERCY (1.877.466.3729).

MORE @ MERCY is published as a commu­nity ­service for the friends and patrons of ­Mercy Health System. Information in MORE @ MERCY comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider. Models may be used in photos and illustrations. If you would like to stop receiving this publication, please email IAtMercy@mercyhealth.org. 2017 © Coffey Communications, Inc. All rights reserved.