Pathways to Health by Providence Health & Services

pathways to spring 2010

Spring Toward Better Health Tips to Avoid Spring Cleaning Mishaps Reasons to Keep Fit as You Age A Guide to Healthy Eating Spring Recipes

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Dual Diagnosis Help for those with co-occurring emotional disorders and substance and alcohol addictions

Knock Out Severe Sepsis Learn about the Severe Sepsis Project Team

Free Lecture Series Tips for a Healthy Pregnancy  Pain Management for Cancer Patients  Chronic Pelvic Pain in Women 

6 Spring Toward Better Health  Tips to Avoid Spring Cleaning Mishaps  Reasons to Keep Fit as You Age  A Guide to Healthy Eating  Spring Recipes

feature stories 4

in every issue 13 ask the doc

Teaming Up to Knock Out Sever Sepsis

14 community corner

Learn about the Severe Sepsis Project Team

10 Bridging the Treatment for Dual Diagnosis

17 support groups, programs and classes

Help for those with co-occurring emotional disorders and substance and alcohol addictions

18 prenatal & safety

12 Is it Alzheimers?

19 free community lectures

How early detection can improve the quality of life

The Providence Little Company of Mary Mission & Core Values As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service. Respect All people have been created in the image of God. Genesis 1:27

Compassion Jesus taught and healed with compassion for all. Matthew 4:24

Justice This is what the Lord requires of you: act with justice, love with kindness and walk humbly with your God.

Excellence Much will be expected of those who are entrusted with much.

Stewardship The earth is the Lord’s and all that is in it. Psalm 24:1

Luke 12:48

Micah 6:8

Pathways to Health Pathways to Health is a quarterly publication of health articles and a calendar of the classes, lectures, programs and support groups held by Providence Little Company of Mary. The materials in Pathways to Health are not intended for diagnosing or prescribing. Consult your physician before undertaking any form of

medical treatment or adopting an exercise program or dietery guidelines. For permission to reprint any portion of this magazine, or to do one of the following—give us a new address, let us know that you are receiving more than one copy, or tell us you prefer not to receive Pathways to Health—please call 1.800.618.6659.

Editorial Staff Diane Bassett Roneale Branning Brenda Goettemoeller Juanita Perea Traci Smith Kathryn Sprague

How to Contact Us Providence Little Company of Mary Marketing & Community Relations 4101 Torrance Boulevard Torrance, CA 90503 1.800.618.6659

Providence Little Company of Mary Medical Center Torrance

We know you have HIGH HOPES

So do we! Providence Little Company of Mary Medical Center Torrance

NICU

Neonatal Intensive Care Unit 4101 Torrance Boulevard Torrance, CA 90503 For more information or to schedule a maternity tea and tour, please call

We know you have big dreams for your baby that start from day one. That’s why our goal is to help you experience the true joys of delivering your baby—from labor and delivery to postpartum care—in a state-ofthe-art facility where compassion and personalized care await you. While all expectant parents look forward to a routine delivery, if something unexpected should occur, your future athlete or astronaut is in good hands in our NICU. With staff specially trained in newborn intensive care using the latest technology, along with new single-family rooms, your baby will benefit from an exceptionally healing environment. We do all we can to ensure your bundle of joy arrives home safe and sound.

1.800.618.6659

Providence Little Company of Mary Medical Center San Pedro

Teaming up to Knock Out

Severe Sepsis The staff at Providence Little Company of Mary Medical Center San Pedro recently achieved outstanding results on a project aimed at reducing the number of preventable deaths in the hospital from an infection in the blood known as “severe sepsis”.

including the kidneys, liver, lungs, and central nervous system—may stop functioning normally in shock. “We are continually targeting causes of preventable death and building programs to improve patient outcomes, and we specifically wanted to address deaths from severe sepsis,” said Performance Improvement Director Deborah Cameron. “We launched a coordinated program involving our nurses and physicians. We called it the ‘Severe Sepsis Project Team’.”

Sepsis is often life-threatening, especially in people with a weakened immune system or other illness. The infection is often confirmed by a blood test, but a blood test may not reveal the infection in people who have already been receiving antibiotics. In sepsis, blood pressure may drop, resulting in shock. Major organs— 4

“Our team started by thoroughly researching the latest best practices from a variety of organizations to determine the absolute best protocols and procedures when treating severe sepsis in order to identify it early and treat it effectively,” explained Emergency Department Chief Sameer Mistry, MD. “We wanted to eliminate variation in how we managed this disease and promote specific ‘bundles of care protocols’ that we knew would improve survival.”

It’s important to catch sepsis early. Once it advances to severe sepsis it The team took clinically-proven is much harder to treat successfully. solutions from Institute for Healthcare “We wanted to increase everyone’s awareness of the early warning signs of sepsis, With the help of the Severe which may be as subtle as Sepsis Project Team, Sepsis a change in mental status,” mortality at Providence Little Cameron explained.

Meet the Severe Sepsis Project Team: (from left) My Le; Lori Mullenhour, RN; Paul Pratt, RN; Sameer Mistry, MD; Herbert Webb, MD; Glenn Russ, RN; and Deb Cameron, RN

As a blood infection, sepsis can travel throughout the body, causing a myriad of problems in various organs. It’s caused by a bacterial infection that can begin anywhere in the body. In hospitalized patients, sites of infection can include catheters, surgical wounds, surgical drains, and bed sores.

may be needed. Dialysis may be necessary if there is kidney failure and a breathing machine may be used if there is respiratory failure.

Company of Mary Medical People with severe sepsis are often treated in an intensive Center San Pedro is 19% care unit (ICU). As soon as better than the international severe sepsis is suspected, benchmark that hospitals intravenous antibiotics are strive to achieve. administered to kill the bacteria and the source of the infection is discovered, if Improvement’s “Surviving Sepsis possible. In more severe cases, oxygen, Campaign” and examined them with vigorous intravenous fluids, and medications that increase blood pressure additional data from national and local

2010 Association of California Nurse Leader Awards

Award-Winning Nursing Leadership

patient management protocols. “We also invited local and national experts in sepsis management to speak to our staff, at the beginning and at the six-month mark,” explained Chief of Staff Miles Shaw, MD. “We had a tremendous turnout of physicians, nurses and ancillary staff at these conferences.” “I don’t think people realize that we do these kinds of data-driven, quality control programs in the medical center,” Cameron said. “We’re constantly scrutinizing what we do, to provide higher levels of care for our patients. Fortunately, the whole staff here shares that commitment to excellence and we had complete buyin on this from every department, from the emergency room to the ICU. Our top management was tracking the data right along with us. It had everyone’s attention. But the best part is looking at the results. Knowing that we’ve saved an additional 61 lives so far as a result of this effort is what makes this so exciting to me personally.”

Our nurses leaders have been recognized for their influence on the future of healthcare. Congratulations! Contribution to Nursing Award Kathy Harren, RN, MHA Providence Little Company of Mary Medical Center Torrance

Administration Award Paul Pratt, RN, BSN Providence Little Company of Mary Medical Center San Pedro

Contribution as a Humanitarian Award Melissa Punnoose, RN-BC, MSN Providence Little Company of Mary Medical Center Torrance

Kathy, Paul and Melissa (pictured above from left to right) exemplify the Mission and Core Values of Providence Little Company of Mary. Their distinguished achievements have earned them the recognition of their peers for their contributions to the advancement of nursing leadership. Our patients, staff and physicians are reaping the benefits of their passion, professionalism and commitment. 5

toward better health Providence Little Company of Mary wants to help you stay healthy! Following are a few tips from how to avoid injury during Spring cleaning to adding a little physical activity in your daily lifestyle.

Tips for Avoiding Spring Cleaning Mishaps Springtime for many people brings extra cleaning and yard work—but if they’re not careful, it might also bring a trip to the ER. Mishaps with ladders, gardening tools and lawn mowers alone cause hundreds of thousands of injuries a year that require medical attention, according to the U.S. Consumer Product Safety Commission. Many of these household accidents are preventable, says one group. “Many spring-cleaning injuries occur when people rush or do not follow the proper safety precautions,” Dr. Danton Dungy, a spokesman for the American Academy of Orthopaedic Surgeons, said in a news release from the academy, which offered tips for avoiding such accidents and injuries: Before starting a project, put on proper protective clothing for the task—a hat, gloves or goggles, as appropriate. Before using products such as cleaners, paints and pesticides, read the label and follow usage directions carefully. Afterward, store all chemicals according to the label directions and make sure they’re out of the reach of children and pets.

When lifting, carrying or bending, start with your feet shoulder-width apart. Keep your back straight and upright and bend at the knees, while tightening the stomach muscles. Use your legs, not your back, to lift as you stand. And get help with items that are too big, heavy or oddly shaped.

Spring cleaning and need to donate your gently used items? Bring them to the Providence Little Company of Mary Auxiliary Thrift Shop at 3737 Torrance, Blvd., 1.310.543.6748.

When trying to reach high areas in your house, use a small ladder or sturdy step-stool rather than risk standing on furniture that could tip or slide. When using a ladder, always make sure its feet are secure and on a flat, firm surface. Never use a ladder on uneven, soft or wet ground or flooring. To avoid reaching too high or leaning too far to one side on a ladder, keep your belly button within the top step and sides of the ladder. Avoid long periods of repetitive-motion activities—such as raking, digging or pruning—while doing yard work. Take frequent breaks and replenish fluids to prevent dehydration. SOURCE: American Academy of Orthopaedic Surgeons, news release, March 2009

Spring Toward Better Health

Reasons to Keep Fit As You Age “Physical activity has been engineered out of our daily lives,” laments David Atkins, MD, MPH, chief medical officer in the Center for Outcomes and Evidence at the Agency for Healthcare Research and Quality.

you start or add to an exercise plan. Even a little bit of exercise will help. “A little activity is better than no activity,” Dr. Bryant says.

It increases bone density and limits osteoporosis. Osteoporosis affects Starting a new 10 million men and fitness routine? women, according Remember to talk with your doctor first. If you would like to the National a physician referral, call us at Osteoporosis 1.800.618.6659. Foundation, while an additional 34 million Americans have low bone mass, putting them at risk for “We used to rake leaves by developing osteoporosis. hand and walk to the market,” Dr. The disease makes your bones Atkins says. “Now we have leaf blowers weak and brittle. Exercise increases bone and take the car everywhere.” So a lot strength. The best kinds of exercise to of us don’t get the kind of day-to-day make bones stronger are weight-bearing physical activity we need. exercises like walking and resistance Cedric Bryant, PhD, agrees. Dr. Bryant exercises such as lifting weights. But is chief exercise physiologist for the you don’t need to become a competitive American Council on Exercise. “Most walker or body builder. Just living an people plan for financial independence,” active lifestyle will help your bones he says. “But too often, they neglect stay strong. “Do things you enjoy,” what they need to be physically Dr. Atkins says. “Work in the garden. independent.” Walk to the store. Go dancing. Just a “Physical activity” means any movement little exercise every day...will make a difference.” (You also need vitamin D of the body that is made by skeletal and calcium for good bone health.) muscles—and requires energy to accomplish. “Physical fitness” means the ability of a person to do physical activity. Physical fitness can be measured by determining endurance, power and flexibility. How physically independent you are, he says, depends on how well you can function physically. That is one of the best reasons to stay physically active— but it’s not the only reason. ACE has put together a list of 10 reasons you should make physical activity a part of your everyday life. To be safe, talk with your doctor before

their lives. Those who don’t exercise, if they live long enough, are sure to experience disability. It increases metabolism. Metabolism measures how your body handles and uses nutrients. Strength training increases muscle mass, which raises metabolism. One benefit is that your body uses more of the calories you take in because your resting metabolic rate increases. That leads to less body fat and makes it easier to control your weight. Just being a few pounds overweight puts you at high risk for many health problems. “Physical activity lowers that risk,” Dr. Atkins says. It reduces your risk for falls. There are two reasons for this. The first is that exercise lets you practice keeping your balance and reacting to things around you. The second is that exercise can help arrest a natural decline in muscle fitness. “Of all the various

It helps you stay independent. The point of being active, Dr. Bryant says, is to maintain your ability to function. “As we get older, most people don’t care how much oxygen they can inhale or what their percentage of body fat is,” he says. “Those things won’t motivate. What is important is being able to play with grandchildren, go out with friends and just do the things you have to do.” Studies show, he adds, that people who exercise over their lifetimes can avoid being disabled at the end of

benefits from exercise,” Dr. Bryant says, “the most important for seniors is muscular fitness. Things people take for granted when they are younger all require a certain level of muscle strength. That includes just getting up out of a chair or walking fast enough to get across the street before the light changes.” Exercise will keep your muscles fit. It makes you more flexible. Doing things that put your body through the full range of movement helps keep it flexible. Dr. Bryant says these activities don’t need to be structured. “Any kind of activity is going to produce results,” he says. Dr. Atkins adds: “The ideal is to work exercise into what you do. Walk instead of drive. Rake instead of using a blower. If you take up some overly hard routine, you won’t stick with it.” It’s important to maintain your fitness efforts, he says. It’s a reason to be sociable. Exercise groups are a good way to meet people. Since one of the best strategies for

Healthy Reminders

Have you scheduled your mammogram this year? The American Cancer Society recommends women age 40 and older should have a screening mammogram every year. To schedule your mammogram, call 1.310.303.6500 (Redondo Beach) or 1.310.831.0371 (San Pedro). Have you had an annual physical within the last 12 months? If you don’ t have a primary care doctor, call our physician referral line at 1.800.618.6659 and we will find one that is right for you. Do you need to see a doctor but don’ t have insurance? Our Vasek Polak Health Clinic, located in Hawthorne, offers low-cost quality medical care on a cash pay basis. We’ re here for all your primary care needs. For more information, call 1.310.355.0100. Have you had a baseline EKG? Having a cardiac risk assessment and baseline EKG has been proven in studies to have a significant clinical value including a reduction in unnecessary hospitalization. For more information, call 1.800.618.6659. 8

increasing your activity is to do it in a group, Dr. Atkins says, exercise can lead to meeting new friends. Check at the community center or local health club for special exercise groups for seniors. You can also ask your friends to join you. It improves your mood. Exercise is good for your mind. Studies show it reduces depression. It can also lift your selfesteem. “People’s mental and social well-being is closely related to their physical well-being,” Dr. Bryant says. “When you are physically active you improve your sense of what you can do.” It helps your entire body. It improves the way your lungs work, helps prevent and control diabetes and is good for your heart. “There is not a single system in the body that is not positively affected by exercise,” Dr. Bryant says. All of the body’s systems deteriorate with age. “We used to think that was a function of aging,” he says. “But as much as 50 percent of it can be attributed to a lack of physical activity. Exercise will alter that. It will slow the breakdown. In some cases it can even reverse it.” Being active will help you live well.

A Guide to Healthier Eating Eating less junk food and adding more nutritious food to your diet is one change that can make a significant improvement in your nutrition and health. You should cut back on foods that have only limited nutritional value, that are overprocessed or that contain too much fat, salt, sugar and refined white flour.

Instead, eat more of these kinds of foods:

• More nutritiously prepared: broiled meats and vegetables that are raw, steamed or lightly cooked in the microwave. Avoid deep-fried foods and fatty sauces such as gravy, cheese and Hollandaise.

• Close to their natural state: fresh or frozen fruits and vegetables. • Less processed: whole grains. • Plain rather than flavored: unflavored milk, plain cottage cheese, plain yogurt. Choose low- or nonfat versions when available.

Cooking influences many aspects of nutrition. Heating food decreases its vitamin content. Boiling food dissolves vitamins, minerals and other plant nutrients in the water, which is often discarded. Frying or deep-frying meats add to the fat content, but broiling, barbecuing or boiling reduces the fat content. When broiling or barbecuing, the fat drips off the meat. When boiling, the fat comes to the surface and must be skimmed off to reduce fat content.

• Healthier: olive oil instead of vegetable oil; vegetable oil instead of shortening; low trans fat vegetable margarine over butter. • Better meat choices: poultry, fish and the leanest cuts of red meat.

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Bridg ng the Treatment

for Dual Diagnosis Treating mood disorders and substance/alcohol abuse together

Understanding “Dual Diagnosis” A person who has both an alcohol or drug problem and an emotional or psychiatric problem is said to have a “dual diagnosis”. It’s not unusual among addicts. According to a report published by the Journal of the American Medical Association, 37% of alcohol abusers and 57% of drug abusers also have at least one serious mental illness. On the other hand, most people who have psychiatric disorders don’t also abuse drugs and alcohol. The increased risk of becoming an addict ranges from just 3-15% depending on the disorder. In other words, the population of people with psychiatric disorders is very large and a relatively small portion of them become addicts. But of the population of addicts, a relatively large portion of them are also suffering from at least one psychiatric disorder as well. To recover fully, a patient needs effective treatment for both problems.

Providence Little Company of Mary Medical Center San Pedro

Seeking Treatment “When choosing a dependency treatment program, it’s a real benefit to have an integrated approach that can treat the addiction and recognize and treat psychiatric and medical issues as well,” explained Crescenzo Pisano, MD, medical director and certified addictionologist at the Recovery Center. “We’re unique in that regard.” “When a person is ‘detoxing’ from drugs or alcohol, mood swings and agitated behavior are not unusual,” said James Brust, MD, medical director of the Bridges psychiatric program. “It takes special training to discern between what’s normal in addiction withdrawal and what’s actually a symptom of another underlying co-occurring issue. We’re experts at that have all the expertise in one place to treat it all simultaneously. Our psychiatric and medical doctors work together, involving other specialists when needed, to ensure that each patient receives the highest quality of care and is able to optimize their recovery.” The most common psychiatric problems occurring in tandem with alcohol or drug dependency include depressive disorders (such as depression and bipolar disorder); anxiety disorders (including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and phobias); and various forms of schizophrenia and personality disorders.

two. In adolescents, however, drug or alcohol abuse on its own (without psychiatric symptoms) may stunt maturation and brain development, continuing into adulthood, contributing to the later development of emotional difficulties and psychiatric disorders. “In other cases, alcohol or drug dependency is the patient’s primary condition and recovering from the addiction also addresses psychiatric symptoms like episodes of depression, hallucinations, fits of rage, or suicide attempts,” Dr. Pisano explained. “It’s important to work with experts who can discern the difference between a psychiatric disorder that stands on its own and needs treatment versus symptoms that are part of the substance abuse.” The patient is medically supervised during withdrawal and detoxification which can take from a few days to a week or more. Doctors can administer carefully chosen medications to substantially ease withdrawal symptoms, making it safer and less traumatic than most people realize.

“Often the psychiatric problem develops first and as the person attempts to manage it, they knowingly or unknowingly try to ‘selfmedicate’ by drinking or using drugs. They’re trying to cope.”

After detoxification (if there is an underlying psychiatric diagnosis), dual treatment begins. Rehabilitation for the substance abuse problem involves individual and group psychotherapy, education, exercise, proper nutrition, and participation in a 12-step recovery program. Treatment for the psychiatric problem depends upon the specific diagnosis, but may involve a combination of individual and group therapy as well as medications.

“People often wonder which -James Brust, MD develops first, the emotional problem As with any illness, a person with dual or the substance abuse? It depends,” diagnosis can improve with proper care. Dr. Brust explained. “Often the If you know someone who may be suffering from alcohol or psychiatric problem develops first and as the person attempts drug dependencies and emotional or psychological problems, manage it, they knowingly or unknowingly try to ‘selfencourage them to seek help. Please call the Recovery medicate’ by drinking or using drugs. They’re trying to Center at Providence Little Company of Mary Medical cope.” This can lead to dependency on the alcohol or drugs Center San Pedro at 1.310.514.5300. and then the person suffers from not just one problem, but

Providence Little Company of Mary Medical Center Torrance

is it

Alzheimers?

Q&A: How early detection can improve the quality of life

Providence Little Company of Mary Medical Center Torrance is leading the way with technology that helps diagnose brain dysfunction earlier and with more certainty. We spoke with Nuclear Medicine physician Lalitha Ramanna, MD, about the technology and its benefits for patients and their families.

Q. What is the best modality for diagnosing neurological disorders such as Alzheimer’s disease? Today, PET scans are emerging as one of the best resources for helping to diagnose patients with Alzheimer’s disease and other dementias. Positron emission tomography, also called PET imaging or a PET scan, is a type of nuclear medicine imaging that uses radioactive materials called radiopharmaceuticals or radiotracers. This allows us to observe metabolism in any part of the brain. Q. Why is the metabolism in the brain important? In a PET scan, the patient is injected with a very small quantity of radioactive synthetic glucose. The PET scan then traces the distribution of the radioactivity. Brain cells use glucose as fuel, so the more active the brain cells are, the more radioactive glucose they will consume, or metabolize. Q. How does this help you diagnose the patient? Using the radioactive distribution data, the computer “maps out” the metabolic activity of the brain—showing us the areas where brain activity levels are 13 12

higher or lower. We analyze this data both visually and through quantitative analysis—comparing information obtained from the patient to a reference group. This helps us diagnose the patient more quickly and with greater accuracy. Q. Why can’t you use CT or MRI scanning for detecting Alzheimer’s disease and other dementias? Conventional CT and MRI technology provides amazing detail about the structure of the brain but, unfortunately, cannot tell us anything about its function. A PET scan can show the brain’s biological changes attributable to dementias such as Alzheimer’s disease before any other diagnostic test. In fact, with PET, Alzheimer’s disease can be detected several years earlier than the onset of symptoms. Q. Are there benefits to early detection? While there is no current cure for these types of dementias, the early detection and confirmation of Alzheimer’s disease allows us to provide early drug therapy to slow the loss of the patient’s ability to function. In many cases, patients find it reassuring

that they will have time to plan for the future before they lose mental capacity. And, of course, early diagnosis also helps in the discovery and development of new therapies that offer hope to patients and their families.

Lalitha Ramanna, MD, is board certified in nuclear medicine with a sub specialty in nuclear cardiology. Her focus at Providence Little Company of Mary Medical Center is nuclear medicine and PET imaging. Dr. Ramanna was named one of the Best Doctors in America® for 2009-2010. Only doctors recognized to be in the top threeto-five percent of their specialty earn this honor. She has extensive experience using nuclear medicine imaging in neurology, cardiology, oncology and thyroid therapy. She received her PET fellowship at USC and continues there as an associate clinical professor. She is actively involved in the Society of Nuclear Medicine and is a member of the American Board of Nuclear Medicine.

ask the doc

How safe are robotic assisted surgeries? I have

prostate cancer and I’m worried about the side effects from surgery. What are my best options? answered by Garrett Matsunaga, MD, Urologist Thanks to modern robotic technology, most men are good candidates for a robotic-assisted laparoscopic prostatectomy, which significantly reduces the risk of prostate cancer surgery. It is a minimally invasive surgery which I perform using the Da Vinci robot at Providence Little Company of Mary Medical Center Torrance.

Garrett Matsunaga, MD, (left) Urologist Gregory R. Keese, MD (right) Orthopedic surgeon, Hand & Elbow Specialist

them. There is no need to bank your own blood or have blood donated for you prior to robotic surgery. The Da Vinci robot gives me 12x magnification and 3-dimensional vision. We only got 3.5x magnification with open surgery performed with surgical magnifying loupes. This allows me to accurately remove the entire prostate cancer, while sparing the nerves (which are responsible for erections) and while preserving the urinary sphincter (which is responsible for urinary control). I’ve seen a dramatically improved return of urinary continence with less than 1% risk of leaking by a year after surgery. 90% of patients have urinary continence within 3 months after surgery.

The surgery is performed through six, half-inch incisions, rather than a larger 6-8 inch incision with traditional open surgery. As a result, post-operative pain is minimal with the majority of patients never even requiring pain medication. Open surgery requires a few days in the hospital, whereas patients who had robotic surgery go home the next day.

This may be high tech, but it’s by no means experimental. Robotic prostatectomy has been FDA approved since 2002 and about 85% of all radical prostatectomies were performed robotically in 2009. Try not to worry, because your treatment options are excellent!

Another significant advantage of the robotic prostatectomy is the minimal blood loss—usually just 3-4 ounces. As a result blood transfusions with robotic prostatectomy are not needed whereas 25% of open prostatectomy patients need

Could it be carpal tunnel syndrome? I have developed some pain, numbness and tingling in my ring finger and little finger on the same hand?

answered by Gregory R. Keese, MD, Orthopedic Surgeon, Hand & Elbow Specialist The tingling in those two specific fingers makes me suspect cubital tunnel syndrome instead of carpal tunnel

syndrome. Cubital tunnel syndrome happens when the ulnar nerve in your arm is pinched at the elbow. There is a bump of bone on the inner portion of the elbow (called the medial epicondyle, also called “the funny bone”) under which the ulnar nerve passes. There, the nerve lies directly next to the bone and can receive pressure that can disturb the way the nerve works—resulting in numbness, tingling, and pain that may be felt in the elbow, forearm, hand, and/or fingers. The symptoms are usually felt when the elbow is bent for an extended period such as talking on the phone or driving a car. While the symptoms are very similar to carpal tunnel syndrome, the cause and treatments are quite different. To determine if it is in fact cubital tunnel syndrome, I would assess the pattern, distribution, and constancy of your symptoms and test for muscle weakness, irritability of the nerve to tapping or bending of the elbow, and changes in sensation. I’d take into account any other medical conditions you may have such as diabetes (which can cause nerve damage). Tests called electromyography (EMG) and nerve conduction studies (NCS) help confirm the diagnosis of cubital tunnel syndrome and stage its severity. (These tests also check for other possible nerve problems, such as a pinched nerve in the neck, which can also cause similar symptoms). Symptoms may sometimes be relieved without surgery with elbow bracing and nerve gliding exercises, particularly if the EMG/NCS testing shows that the pressure on the nerve is minimal. When symptoms are severe and constant especially in the presence of muscle weakness surgery may be needed to relieve the pressure on the nerve.

Save the Dates

community corner • EVENTS

2010 Successful Aging Expo

May 22 • 2010 9am - 3pm Torrance Marriott • 3635 Fashion Way, Torrance 1.310.316.3636 Designed especially for people ages 40 and older. This FREE one-day event will be rich in resources and information. Visitors and participants will have the opportunity to visit over 50 booths of companies and firms with something of value for everyone.

Lecture Topics and Times

Providence Little Company of Mary Medical Center Torrance is proud to be the title sponsor.

23rd Annual Palos Verdes Street Fair & Music Festival

June 12 • 2010 10am - 10pm and June 13 • 2010 10am - 9pm www.pvstreetfair.com

Stroke....................................... 9:15am - 10:00am Heart......................................... 10:30am - 11:15am Orthopedic.......................... 11:30am - 12:15pm Advanced Directives, Wills and Trusts................. 12:30pm - 1:15pm

Providence Little Company of Mary Medical Center Torrance is proud to be the title sponsor.

Located on Crossfield Drive in Rolling Hills Estates between Promenade on the Peninsula and Peninsula Shopping Center FREE PARKING at Promenade parking structure. Enter on Indian Peak Rd. • FREE ADMISSION includes the following fun at the fair: - Two days of events and live music - Jazz festival - 200+ street vendors - Eco-friendly goods and clothing drive - “Living Green” demonstrations - Carnival and kiddie rides - Pony rides and petting zoo - International food court - Healthy lifestyles and Providence Bloodmobile - TOP DOGS dog show (Show your furry friends - Saturday 10am)

Events

• community corner

Providence Little Company of Mary Foundation 2010 Events 25th Annual For Our Children Food & Wine Festival April 25, 2010

Honda presents the 25th annual For Our Children Food and Wine Festival, partnering with Providence Little Company of Mary Foundation and Sandpipers. The Festival offers the best in food, wine and auctions — and is held on the grounds of American Honda Motor Co., Inc. in Torrance.

30th Annual Golf Classic May 17, 2010

At the 30th annual Golf Classic, golfers will tee off at the Palos Verdes Golf Club, playing either a morning or afternoon flight. Enjoy a hosted cocktail reception, dinner, silent and live auctions, and trophy presentation. Presenting Sponsor: The George P. Johnson Company

Sellabration Gala November 6, 2010

Experience the elegance of the Los Angeles Biltmore Crystal Ballroom at the Sellabration Gala honoring the Little Company of Mary Sisters and their 50-year healing presence in Southern California. Sellabration is an elegant black-tie dinner, dance and auction held since 1975. Presenting Sponsor: American Honda Motor Co., Inc. Foundation Special Event proceeds benefit our charitable care and community outreach programs. For information, please contact Leslie Chung at 310.303.5346 or go to www.plcmfoundation.org.

Relay for Life

May 22-23 • 2010 San Pedro High School

Providence Little Company of Mary is proud to be a sponsor and participate in these ACS events.

July 17-18 • 2010 Alta Vista Elementary July 31-August 1 • 2010 Carson High School Information/registration: www.relayforlife.org Relay For Life is a life-changing event that brings together more than 3.5 million people — to celebrate the lives of those who have battled cancer: remember loved ones lost to the disease; and fight back against a disease that takes too much.

“Think of giving not as a duty but as a privilege.”

-John D. Rockefeller

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Providence Little Company of Mary Medical Centers San Pedro and Torrance

From a routine test to emergency surgery...

A Bear to

L VE Employees from Toyota recently went to Build-A-Bear in Torrance for a teambuilding retreat. Afterward, they delivered the bears to sick children in the pediatric department at Providence Little Company of Mary Medical Center Torrance. “The children were absolutely delighted with the gifts” said Children’s Services Manager Judy Wolstein. “There were all kinds — ballerina bears, football-playing bears, and more. The children lit up and it made their hospital stay a bit brighter.”

Providence Little Company of Mary Medical Centers offer the technology and compassionate care you deserve...

close to home! 16

Thank you, Toyota, for your kindness to our little patients.

support groups, programs and classes 12-Step Meetings Meetings are held at Providence Little Company of Mary Recovery Center, 1386 West 7th Street, Bldg. A, San Pedro Info: 1.310.514.5300

Alanon When: Tuesdays (Men’s Meeting) 7 – 8:30 p.m.; Tuesdays (Women’s Meeting) 7 – 8:30 p.m.

Info: Claire Towle or Stephanie LaFranchi, 1.310.374.6323 or www.griefcenter.info

Osteoporosis Support Group Where: Providence Little Company of Mary Medical Center Torrance Info: Carol Harrison, volunteer facilitator, 1.310.329.9313

When: Saturdays 3:15 – 4:30 p.m. (Open Meeting); Saturdays 7 – 8:30 p.m. (Open Speaker Meeting) When: Fridays 8 – 9:30 p.m.

Overeaters Anonymous When: Tuesdays 5:30 – 6:30 p.m.

S.A. When: Saturdays 10 – 11:15 a.m.

Mental Health Bridges Psychiatric Outpatient Day Program This program offers psychiatry, group therapy and socialization. Assessments for the program are free of charge, and transportation and lunch services are provided. The therapy covers a wide range of topics from depression and anxiety to coping skills and healthy relationships. Medicare and most private insurances are accepted. When: Mondays,Wednesdays and Fridays 10 a.m. – 2 p.m., (Partial Program) Monday – Friday 9:45 a.m. – 2:30 p.m. Where: Providence Little Company of Mary Medical Center San Pedro Info: Steve Gerstung at 1.310.241.4325

support groups Grief Support Group Adult bereavement groups for individuals who have lost a child, spouse, or parent. Support groups are also offered for children and teens.

Speak one-on-one with a diabetes nurse educator and a registered dietitian to learn how to better manage your diabetes. Family members are welcome. Doctor referral needed to schedule appointment.

Where: Providence Little Company of Mary Medical Center San Pedro, DeMucci Center for Health Education Info: Jane Kimball, RN, 1.310.732.6272

Cocaine Anonymous

When: Sundays 5:45 – 7:15 p.m.

Diabetes Management

Where: Providence Little Company of Mary Medical Center Torrance, Del Webb Center for Health Education Info: 1.310.303.5580

Alcoholics Anonymous

Narcotics Anonymous

diabetes programs

Pre-Operative Classes for Joint Replacement Surgery This class is designed to help patients prepare for and recover from joint replacement surgery. The program includes everything from instructions for the night before surgery to how to prepare your home for recovery. Reservations required. When: Thursdays 10:00 a.m. – 12:00 p.m. Where: Providence Little Company of Mary Medical Center Torrance, Surgical Ortho Conference Room (First Floor) Info: 1.800.618.6659

Rehabcentre Community Stroke Group A free support group for family members, caregivers and patients who have experienced a stroke, traumatic brain injury or degenerative neurological disorders such as Parkinson’s disease and multiple sclerosis. When: First Wednesday of each month (except holidays) 6:30 – 7:30p.m. Where: Providence Little Company of Mary Medical Center San Pedro, 3 Central Acute Rehab Info: Dr. Melanie Ropelato, 1.310.832.3311, ext. 6954

Survivors After Suicide

Diabetes Forum Join Dr. Olga Calof, MD, Board Certified Endocrinologist, at a free open forum for anyone with a family history of diabetes, gestational diabetes, polycystic ovarian syndrome (PCOS) and other risk factors which may pre-dispose someone to diabetes. When: Fourth Thursday of each month; 11:30 a.m. – 12:30 p.m. Where: Providence Little Company of Mary Medical Center San Pedro, DeMucci Center for Health Education Info: 1.310.832.3311, ext. 4067

Diabetic Support Group A bi-monthly informational meeting for anyone who has questions related to diabetes. Free to the community. When: First and third Wednesday of each month 3:30 – 5 p.m. Where: Providence Little Company of Mary Medical Center San Pedro, Four West Conference Room Info: Jane Kimball, RN, 1.310.732.6272 When: Second and fourth Wednesday of each month; 3:30 – 4:30 p.m. Where: Providence Little Company of Mary Medical Center Torrance, Del Webb Center for Health Education Info: 1.310.303.5580heart and lung

Where: Providence Little Company of Mary Medical Center Torrance, Del Webb Center for Health Education Info: 1.310.895.2326

Where: The Gathering Place at Beach Cities Health Center, 514 North Prospect Avenue, Redondo Beach 17

support groups, programs and classes heart and lung programs Better Breathers’ Club Monthly meetings with guest speakers on topics of interest to people with respiratory difficulties. Free to the community. When: Third Wednesday of each month; 2:30 – 4:30 p.m. Where: Providence Little Company of Mary Medical Center San Pedro, DeMucci Center for Health Education Info: 1.310.832.3311, ext. 6268

Cardiac Support Group

All classes take place at Providence Little Company of Mary Medical Center Torrance. Reeservations required for all classes. Call 1.800.618.6659

Baby Care Basics

Designed for the healthcare provider to learn the skills of CPR for infant, child and adult victims. Participants will receive an American Heart Association completion card good for two years.

When: Second and third Monday monthly; 7 – 9 p.m. Fee: $30 per couple

Breastfeeding Class Fee: $35 per couple (includes breastfeeding book)

Infant/Child CPR

Where: Providence Little Company of Mary Outpatient Center, 514 North Prospect Avenue, Redondo Beach Info: Yvonne Hashimoto, RN, 1.310.303.7070

The Happiest Baby on the Block™

Fitness program, supervised by a registered nurse, open to people with lung problems. When: Tuesdays & Thursdays; 10 a.m. – noon Where: Providence Little Company of Mary Medical Center San Pedro, 3-East Cardiopulmonary Gym Fee: $40 for 10 sessions. Info: 1.310.832.3311, ext. 6268

Pulmonary Education Program (PEP) PEP Pioneers is a nationally certified education program that will teach you about your lung disease and allow you to increase your daily activities and independence. Where: Providence Little Company of Mary Outpatient Center, 514 North Prospect Avenue, Redondo Beach Info: 1.310.303.7079pre-natal

Pulmonary Rehab Self-Training Classes are designed to increase knowledge, physical stamina and independence. Where: Providence Little Company of Mary Medical Center San Pedro Info: Kris Brust, RN, BSN, AE-C, 1.310.832.3311, ext. 6268

safety classes

All classes (except Maternity Tour - San Pedro) take place at Providence Little Company of Mary Medical Center Torrance. Reservations required for all classes. Call 1.800.618.6659

For cardiac patients, family and friends to meet and provide mutual support and discuss concerns and problems.

Lively Lungs

prenatal education

See Family and Friends CPR listing under Safety Classes In this class (developed by Dr.Harvey Karp), new parents will learn how to help their baby sleep better and how to soothe even the fussiest baby in minutes. Fee: Cost is $50 per couple (includes DVD and Soothing Sounds CD)

Labor Epidural & Neonatal Care Fee: No cost

Maternity Tour - Torrance Fee: No cost

Maternity Tour - San Pedro When: First Sunday of each month; 5 p.m. Fee: No cost Reservations: 1.310.514.5214

Preparation for Childbirth Fee: $100 per couple (includes childbirth preparation book)safety classes

BLS Healthcare Provider

When: (all classes held Saturdays from 9:00 a.m. – 3:30 p.m.) May 1 Fee: Course cost is $50.

CPR — Heartsaver AED Designed for lay rescuers needing to learn CPR, the use of an AED, and relief of airway obstruction in infant, child and adult victims. Participants will be tested on their skills and receive an American Heart Association completion card good for two years. When: (all classes held Saturdays from 9:00 a.m. – 2:00 p.m.) April 17; May 22; June 19 Fee: Course cost is $40.

Family and Friends (Infant/Child CPR) Designed for lay rescuers the skills of CPR for infant victims (birth-1 yr.) and child victims (1-8 yrs.). You will also learn procedures for clearing an obstructed airway. There will be plenty of time to practice skills on manikins. Participants will not receive a completion card. When: (weekday evening classes held 6:00 p.m. – 9:00 p.m.) April 27; May 6; May 25; June 28; (Saturday classes held 9 a.m. – noon) April 10; June 12 Fee: Course cost is $25.

Supersitter Designed for youths age 12 - 14, this course includes: planning for a babysitting job, knowing what to expect from children of all ages, selecting toys and games, preventing accidents, and the special care involved with taking care of infants. Participants receive a completion card. Fee: Course cost is $30. When: (all classes held Thursday afternoons from 3:45 p.m. – 6:00 p.m.) April 8 & 15; May 13 & 20; June 17 & 24

free lectures

2010 June 2010 freeMay lectures

April 2010

Tips for a Healthy Pregnancy

Conceiving a child can sometimes be difficult, even for couples where conditions are just right. If you have just begun trying to get pregnant, are currently pregnant, or have had pregnancyrelated problems in the past, this lecture is for you. Our discussion will include everything from the importance of prenatal vitamins, weight control and proper nutrition to high-risk pregnancy conditions, pre-term delivery risk assessment, and the optimal route of delivery when the big day approaches. When: Tuesday, April 20, 6:30 – 8:30 p.m. Where: Providence Little Company of Mary Medical Center Torrance, Del Webb Center for Health Education, 4101 Torrance Boulevard, Torrance Moderator: Toni Meek, RNC, Manager Women’s Health Speakers: Alexandra Bujor, MD, Obstetrics/Gynecology Becky Gerl, RD, CDE, Diabetes Educator Scott Naylor, MD, Perinatologist

Acute and Chronic Pelvic Pain in Women

Pain Management for Cancer Patients

Join Dr. Glen Komatsu to learn facts and common myths when it comes to pain management for cancer patients. Relief from pain is a patient’s right but not all patients diagnosed with cancer experience pain. For those who do, pain can be relieved or alleviated without interfering with the primary treatment of the disease. Sometimes the pain is unrelated to the illness. Getting pain relief will result in better patient quality of life and more effective cancer treatments.

Have you experienced abdominal pain or pelvic pain not associated with your menstrual period that has lasted for 6 or more months? You may have what is called chronic pelvic pain. It is estimated that about 20% of the visits to gynecologists are for pelvic pain. Chronic pelvic pain can lead to significant distress and even disability. The good news is that a laparoscopy (minimally invasive surgery) may be done to find the cause of symptoms such as abdominal pain, pelvic pain, or swelling of the abdomen or pelvic region. Dr. Speiser will discuss common conditions of chronic pelvic pain and your options for treatment. When: Thursday, June 17, 6:30 – 8:30 p.m. Where: Providence Little Company of Mary Medical Center San Pedro, DeMucci Center for Health Education, 1300 W. Seventh Street, San Pedro Speakers: David Speiser, MD, OB/GYN

When: Tuesday, May 11, 6:30 – 8:30 p.m. Where: Providence Little Company of Mary Medical Center Torrance, Del Webb Center for Health Education, 4101 Torrance Boulevard, Torrance Speaker: Glen Komatsu, MD, Palliative Care

Reservations requested: please call 1.800.618.6659 19

Providence Little Company of Mary Coporate Offices 20555 Earl Street Torrance, CA 90503

Providence Little Company of Mary Medical Institute

Caring for Our Community in a New Location Family Medicine Internal Medicine Urgent Care Our new address 1499 West 1st Street San Pedro, CA 90732 (Corner of 1st and Western) Primary Care 1.310.831.9482 Mon - Fri 8:30am to 5:30pm Urgent Care 1.310.241.2590 Mon - Fri 8:00am to 7:00pm Sat 9:00am to 5:00 pm

Building Relationships... One Family at a Time.