More@Mercy - Nazareth Hospital - Spring 2019

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SPRING 2019 METABOLIC SYNDROME

How bariatric surgery may help There are many reasons t o consider bariatric surgery if you’re obese, and one of them might be if you have metabolic syndrome.

Metabolic syndrome is a condition categorized by having three or more of these health problems: a high fasting blood sugar level, high blood pressure, a low HDL cholesterol level, a high blood level of fats

called triglycerides or a large waist circumference.

Many people who are obese have metabolic syndrome.

“More than 80 percent of obese adults will develop metabolic syndrome, putting them at risk for serious health complications, such as cardiovascular disease, fatty ­— Continued on page 2

IN THIS ISSUE

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HEALING WITHOUT HARM How we protect your heart when you need cancer treatment.

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STAY HEALTHY AT HOME How home health can help you avoid needless hospital stays.

CHECK IT OUT To sign up for a free information session about bariatric surgery at Nazareth Hospital, call 1.855.LESS YOU (1.855.537.7968).

Bariatric surgery ­— Continued from front page liver disease, peripheral artery disease, insulin resistance and diabetes,” says Abhiman Abhiman Cheeyandira, Cheeyandira, MD, a bariatric MD surgery specialist at Nazareth Hospital.

You can help control metabolic syndrome by eating a healthy diet and exercising. But if you still can’t get your body mass index (BMI) below 35, your physician may recommend weight-loss surgery.

Types of surgery Common bariatric surgeries include: Gastric bypass surgery. “This is one of the most common and effective weight-loss surgeries performed today,” Dr. Cheeyandira says.

Surgeons create a pouch in the upper part of the stomach, and food is routed—or bypassed—around the stomach to the small intestine. This helps with weight loss by restricting food intake and absorption.

Vertical sleeve gastrectomy.

For this surgery, doctors reshape the stomach and reduce its size by as much as 80 percent.

A high rate of success Studies show that after bariatric surgery, metabolic syndrome goes away in nearly 90 percent of patients, Dr. Cheeyandira says.

However, it’s important to remember that bariatric surgery is just one aspect of treating metabolic syndrome and obesity.

“Patients must maintain a healthy diet before and after surgery and exercise regularly to avoid regaining lost weight,” Dr. Cheeyandira says.

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More @ Mercy Spring 2019

Nazareth recognized for top stroke care When you’re having a stroke, you want to be treated quickly and effectively by a team of experts. Fortunately, you don’t have to go far for that kind of care.

Nazareth Hospital has been certified once again as a Primary Stroke Center by The Joint Commission. This designation lets you know that Nazareth provides the specialized, quality care required to meet the needs of stroke patients.

“Our most recent recertification as a Primary Stroke Center by The Joint Commission demonstrates Nazareth’s commitment to ensure that our community has access to high-quality stroke care,” says Ed O’Dell, DO, FACOI, Chief Medical Officer at Nazareth Hospital.

FAST action required Most strokes occur when a blood vessel in the brain is blocked by a blood clot. Swift treatment is needed to restore the flow of blood and oxygen to minimize damage to the brain.

You can help ensure quick treatment by recognizing the signs and symptoms of a stroke. Use the acronym FAST to remember these signs:

F A S T Face.

Arms.

Speech.

Time.

Does the person’s face droop to one side or is it numb?

Ask the person to raise both arms. Does one arm drift downward?

Is the person’s speech slurred or hard to understand?

Call 911 right away, even if the symptoms go away.

BREAST HEALTH

Stereotactic breast biopsies now available at Nazareth Early detection and a fast, accurate diagnosis are essential for helping women survive breast cancer.

Nazareth Hospital now offers a major advance in diagnosing breast cancers: stereotactic biopsies, which cause little or no scarring and offer a minimally invasive biopsy option.

Radiologists at Nazareth perform these minimally invasive biopsies using leading-edge technology—the Hologic® Affirm® breast biopsy system, now available at Nazareth. This system can biopsy calcifications found on both 3-D and 2-D imaging. Because some cancers can only be seen on a 3-D mammogram, that 3-D capability is crucial for letting radiologists see and sample potentially cancerous abnormalities that might not be visible otherwise.

And when a 2-D image is the appropriate choice, this new system offers the highest resolution and truly superior imaging. It can pick up faint microcalcifications—tiny deposits of calcium that may be an early warning sign of breast cancer.

“We’re so excited to offer women this new option,” says MaryAnn Blohm, BS, RT, (R), (CT), manager of medical imaging at Nazareth. “This affirms our deep commitment to protecting the health of the women we serve with MaryAnn excellent breast care.”

Blohm, BS, RT, (R), (CT)

Less stressful, safer biopsies

This system is designed to work together with another innovation: the Hologic ® Brevera® breast biopsy system. Nazareth is the only hospital in the area to invest in this technology, which helps make biopsies shorter—and safer—for women.

The Brevera® system allows radiologists to immediately know if they have collected a sufficient tissue sample. That typically means less tissue needs to be removed, which significantly shortens the time a biopsy takes.

How to prepare for a breast biopsy If your doctor suggests you need an x-ray-guided biopsy, take these three simple steps beforehand:

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ell your doctor about all the medicines T you take. You may be advised to stop taking aspirin, blood thinners or certain herbal supplements three to five days before your biopsy to reduce your risk of bleeding.

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ell your doctor if there’s any chance you’re T pregnant.

Don’t wear deodorant, powder, lotion or perfume under your arms or on your breast the day of the exam. They may interfere with the imaging used to perform the biopsy.

Less tissue removed also means a safer procedure with a lower risk of complications, such as bleeding.

“Together, these two technologies give women a streamlined, improved experience and a diagnosis they can trust,” Blohm emphasizes.

TIME FOR A MAMMOGRAM? To schedule a mammogram at Nazareth, call 215.335.6158. Appointments are also available in the evening and on Saturday. mercyhealth.org

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CANCER

your heart LEARN WHAT DOCTORS AT NAZARETH DO TO PREVENT CANCER TREATMENTRELATED HEART PROBLEMS

Sonela Skenderi, DO, FACC

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More @ Mercy Spring 2019

When you’re being treated for cancer, you may not be concerned about the health of your heart. But your doctors are.

At Nazareth Hospital, heart doctors and cancer specialists work together to try to prevent a condition called cardiotoxicity.

That’s a term to describe side effects from cancer chemotherapy or radiation treatments that can sometimes damage the heart and potentially trigger conditions such as an irregular heartbeat or congestive heart failure.

To help reduce those risks, doctors at Nazareth may check your heart for problems before and during your cancer treatment.

“The key is to prevent disease potentially caused by cancer treatment,” says Sonela Skenderi, DO, FACC, a cardiologist at Nazareth.

Checking your risk Most people being treated for cancer will not have heart-related damage as a side effect. So preventing it starts with evaluating your risk.

“We want to know how likely it is that you will get these kinds of conditions based on your risk factors,” Dr. Skenderi says.

She’s talking about traditional heart disease risk factors, such as being 65 or older; being overweight; having diabetes; smoking; having high blood pressure or cholesterol levels; or having a strong family history of heart disease.

You also may be at risk for cancer treatment-related heart damage if you already have heart disease. Your chances of experiencing effects of cardiotoxicity are also higher if you’re being treated with a specific

New technology helps spot heart damage Because cancer treatments can sometimes hurt the heart, it’s important for doctors to learn if someone with cancer may have a pre-existing heart problem that could be worsened by treatment.

One new tool doctors at Nazareth Hospital use to study the hearts of cancer patients is called strain echocardiography. Like other echo scans, it uses sound waves to take video pictures of the inside of the heart. But with strain echo, doctors can assess heartmuscle health with more detail than before.

Also now available at Nazareth is 3-D technology that can measure the heart’s ejection fraction (how well blood is pumped to the rest of the body) with even greater accuracy.

These developments may help doctors in their efforts to find and treat heart problems in cancer patients and prevent or minimize side effects from cancer treatments.

type of chemotherapy drug that is known to potentially cause heart muscle damage, Dr. Skenderi says.

The most common warning signs and symptoms of heart damage from cancer treatment include: •• Shortness of breath when you’re physically active or lying flat •• Heart palpitations •• Chest pain, discomfort or tightening that occurs with physical activity •• Swelling in your lower legs or feet “Your symptoms may be subtle,” Dr. Skenderi says. “For instance, maybe you’re only able to walk a block now after your cancer therapy, but maybe three months ago you could walk a mile.”

Often people adjust, and then they don’t notice these changes, she adds.

That’s why it’s important to tell your doctor if you have any of the warning signs or symptoms of cancer treatment-related heart damage.

Monitoring your heart If one of your doctors is concerned about your risk for heart damage, he or she may refer you to a cardiologist for screening before you start cancer treatment to check for

heart problems. The test most often used is a special echocardiogram scan available at Nazareth Hospital.

If your test reveals a heart problem that puts you at high cardiotoxicity risk, your doctors can take steps to protect your heart during cancer treatment.

For instance, your oncologist may suggest a different chemotherapy drug that is less likely to cause heart problems. If you’ll be having radiation, your doctor may modify your radiation dose. If you already have a heart problem, you may also need to take medication. Every situation is different.

“Fortunately, cancer treatment has evolved, and oncologists now have multiple ways of treating cancer,” Dr. Skenderi says.

Even after cancer treatment, your doctors will watch you closely for potential signs and symptoms of cardiotoxicity.

“Cancer patients are living longer and doing better,” Dr. Skenderi says.

“The last thing we want is for them to have a chronic heart condition because of their cancer treatment.”

PUT YOUR HEART IN OUR HANDS Find a cardiologist near you by calling 1.866.629.2738. mercyhealth.org

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WHAT IS HOME HEALTH? You might be surprised at the many services available through Mercy Home Health. Read about them at mercyhomehealth.org.

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Tell all. Be candid about your symptoms, medical history, habits and health concerns. “You won’t get the help you need if your doctor or other provider is in the dark,” Dr. Raziano says.

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Be your own advocate 3 WAYS TO GET THE HEALTHCARE YOU DESERVE For the best possible medical care, keep these two words in mind: Speak up.

“Doctors certainly know a lot about medicine,” says Donna Raziano, MD, Chief Medical Officer for Mercy Home Health. “But they may not know enough about you to give you truly appropriate care unless you tell them.”

Here’s how to communicate effectively for your health:

Ask questions. “You’re not bothering your doctor; you’re getting the information you need to take better care of yourself,” Dr. Raziano says. You might want to ask: •• What is my diagnosis? What does it mean for my future?

•• How should I take my meds? What are the side effects?

•• Will I need a test? What will the results tell me?

•• What are my treatment options?

•• Do I need to change my daily routine?

•• Could home health services help me recover?

•• Can you explain my condition as simply as possible?

If you don’t understand the answer, keep asking until you do.

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Clarify. Repeat the doctor’s advice using your own words. And at the end of the visit, take a few moments to review what the two of you agreed on.

Remember: You are your own best advocate, and taking an active role in your care is one way to ensure that you and your doctor are working together to improve your health.

Know the risks of opioids Opioid pain medicines are in the news a lot, and for good reason.

They can help treat different kinds of pain. But they also have serious risks, such as addiction and overdose. Opioids can also cause side effects like constipation. And they can be misused and abused.

What’s more, some of the risks from opioids are higher among older adults.

Could there be a better medicine?

If you need pain relief, opioids may not be the best option for you. “There are safer ways to treat chronic pain,” says Donna Raziano, MD, Chief Medical Officer, Mercy Home Health.

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More @ Mercy Spring 2019

“And some may even work better.”

Ask your doctor about: •• Over-the-counter pain relievers •• Physical therapy and exercise •• Counseling that helps you cope with pain and stress

Safety tips If your doctor says you do need to take an opioid, there are things you can do to help reduce your risk of opioid problems.

For instance, tell your doctor if you have ever been addicted to or abused a substance (even tobacco) in the past. And tell your doctor about any other medicines you take.

“It is very dangerous to use some medicines with opioids,” Dr. Raziano says. “Examples are sleeping pills and medicines for anxiety or seizures.”

If an opioid is your only option, be sure that you: •• Take your opioid as directed. Never take more than prescribed.

•• Don’t drink alcohol when taking one.

•• Never share your opioid with anyone.

•• Keep your opioid in a secure place so other people can’t get to it.

After you take your vital signs at home, the results are automatically sent to a Mercy Home Health nurse.

Your connection to better health MERCY CARECONNECT TELEHEALTH MONITORING MAY HELP KEEP YOU HEALTHY AT HOME Do you have a chronic health condition, such as heart failure, diabetes, high blood pressure or chronic obstructive pulmonary disease (COPD)? Living with a serious condition isn’t always easy. Among other things, you need to stay on top of your symptoms to make sure your condition isn’t getting worse.

Having a nurse check on your vital signs, such as your heart rate or blood pressure, every day could give you peace of mind and help you avoid a trip to the emergency room (ER) or a hospital stay.

That’s what the Mercy CareConnect Telehealth Monitoring Program is all about. It is provided by Mercy Home Health. Since 2008, telehealth has helped more than 8,000 Home Health patients in the comfort of their homes.

Close monitoring Telehealth allows the Mercy Home Health team to keep track of your symptoms electronically on a daily basis. If you receive this service: •• Special medical equipment will be set up in your home at no cost to you. You will get a blood pressure cuff, a scale to weigh yourself and

a device that goes on your finger to check your heart rate and the oxygen levels in your blood.

•• You’ll use the equipment to check your vital signs each day.

•• The results will automatically be sent to a Mercy Home Health nurse through a tablet computer—which you’ll receive at no cost—designed specifically for this purpose.

Catching problems early A Mercy Home Health nurse will check your daily vitals on a computer screen.

Here’s what could happen next: Perhaps you have heart failure and you’ve suddenly gained several pounds. When the nurse notices this change on your reading, he or she will call you and (if necessary) your doctor so that your treatment plan can be adjusted as needed right away.

“We can reach out to the doctor in a much faster manner,” says Telehealth Supervisor Lauren

Sinclair. “We can recognize these little changes, after we’ve assessed the patient over the phone, to try to keep them out of the hospital.”

In other words, telehealth helps you and your Home Health team deal with little problems before they become big ones.

“The Mercy CareConnect Telehealth Monitoring Program works,” says Ruth Martynowicz, Vice President of Operations for Mercy Home Health.

“Over 90 percent of our patients who receive Mercy CareConnect services are able to avoid ER visits, emergency doctor visits or repeat hospital stays while in the program.”

Understand your triggers Mercy CareConnect can also help you recognize the symptoms of your disease and what may trigger them.

Because you’re able to track your vital signs daily, you can learn how decisions may affect your health.

GET CONNECTED Talk to your doctor if you think the Mercy CareConnect Telehealth Monitoring Program might be a good choice for you. You can also call 1.888.690.2551 to learn more. mercyhealth.org

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Mind your medications AND

Medicine is meant to help you feel better, Helen not worse. But a lot can go wrong if you don’t Thorpe, MD understand your medicine—and how to take it safely. Helen Thorpe, MD, a family practice doctor at Mercy Primary Care at Rhawn Street, answers key questions about medicines and the knowledge you need to help protect your health.

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What should I know when my doctor prescribes a medicine?

ANSWER: Make sure you understand the answers to these

questions: What is the name of the medicine, and what is it for? How much do I take, and when should I take it? What are possible side effects, and what should I do if I have any? Is there anything I shouldn’t eat or drink when I take this medicine? Will it cause problems if I take this drug with other medicines? What should I do if I forget to take a dose?

What should I keep in mind when taking over-the-counter medicines?

ANSWER: Always read the printed directions and warnings—and follow them. Know what you’re taking too. Review the ingredients in over-thecounter medications, and choose products that have fewer items listed.

Also check the expiration date. A medicine’s effectiveness wears off over time.

Q

NEED A PRIMARY CARE DOCTOR? Find a Mercy Physician Network doctor near you by calling 1.877.GO MERCY (1.877.466.3729).

Q

What else will help me take my medicines safely?

ANSWER: Make a list of all the medicines you take, plus vitamins

or supplements. Keep it handy—say, in your wallet or stored in your phone. And discuss your list whenever you see your doctor. That will help your doctor spot the possibility of dangerous interactions, duplicate medicines or a dose that needs changing.

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. 2019 © Coffey Communications, Inc. All rights reserved.