Danville Regional Medical Center Health Talk Spring Edition 2012 (Showcase Magazine)

The HealthTalk Edition written and produced by Andrew Scott Brooks All content reviewed by Dr. Saria Saccocio, Chief Medical Officer, Kelly Fitzgerald, Director of Marketing and | MARCH 2012 Leslie Smith, Director of Community Relations for Danvillewww.showcasemagazine.com Regional Medical Center

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HEALTH TALK EDITION Spring 2012

Changing Your Life One Wise Decision at a Time Decision making is a life skill that isn’t necessarily taught in schools. It’s learned behavior that often comes from the phrase, “He’ll have to learn that for himself.” On some levels it’s an element of maturity, but on another level it’s a culmination of our life experiences. Too often, the ability to make good decisions in any given situation is a skill that we could all improve upon. It is the primary way in which to improve our quality of life.

One of the reasons that people often make bad choices is the sheer amount of things to consider. These factors range from our personal goals, the financial costs, the impact on our family and friends, and countless other factors. Just as in nature, humans are more drawn to the path of least resistance. Unfortunately, the path of least resistance is often the path to bad consequences.

Boiled down to its elements, there are two primary questions to consider when making a decision. Do you have the facts to make the decision? Do you know the consequences of the decision?

Having the facts to make a decision comes down to educating yourself about the situation. In today’s information age, we are often encased under an avalanche of data.

Albert Einstein once said that he didn’t need to know every pointless piece of information; he only needed to know where to find it. And that is very true today. Learning how to effectively use the tools available to you, such as internet search engines and libraries, is vital.

Without having the facts, knowing the consequences of a decision is a bit like fortune telling. It’s kind of a shot in the dark. But, once you know the factors surrounding a decision, and understand your options, the consequences become much clearer.

Some of the biggest decisions of our lives are related to our health care. And many of these choices have impacts on both our quality of life and the length of our life. Consider smoking. A young person who makes the decision to start smoking often doesn’t know or can’t comprehend the consequences. That is a bad decision that begins to take time off of their life with every puff but is one that could be chalked up to “he’ll have to learn that for himself.” But as time goes by and that

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individual matures and learns that decisions have consequences, begins paying their own bills including insurance and health care costs, and gains access to more and more information, the matrix changes.

This “habit” now becomes a series of bad decisions, each cigarette smoked subtracting eleven minutes from their life. And not only is it reducing the length of life, it is drastically damaging the quality of life, even right that very moment. Simple things like shortness of breath plays a role in how we do the things that we enjoy doing. Heart Disease, Cancer, and many other conditions…all of these things are directly attributable to smoking and are health issues that can destroy your quality of life.

Making Wise Health Decisions There are a lot of things in this world that are out of our control, including our DNA and our propensity for certain diseases. But, one thing that is totally within our control is how we make the most of the life we’ve been given. In your lifetime, you are going to have to make health decisions for yourself and your family.

These decisions will influence your well-being as well as the quality and cost of your care. Knowing your options will have a huge impact in the consequences you face.

The best formula for making wise health care decisions is to use the best information available to you combined with your own personal core values. In other words, know the medical facts and know yourself. It’s very important to work with medical professionals whom you trust, so that you aren’t constantly second guessing your decisions, while simultaneously seeking the ever-growing data you need to continue to make the wisest decisions moving forward.

HEALTH TALK EDITION Spring 2012 Steps for Making Wise Health Decisions

The following steps can help you make a smart health decision. Some questions can be answered in seconds and others may take weeks, but it’s important that you don’t delay your choices unnecessarily.

1. What are the choices? Ask your doctor to clearly state the choices and the consequences as he or she sees them.

2. Learn the facts. Find out what you need to know by using resources such as reliable websites like webmd.com (the source of these steps, for instance), the library, your doctor, and support groups. Make sure to focus on reliable information from a sound medical source, not just the results from a single source or from a company that benefits from you using their product.

3. What feels right to you? Think about your own core values and the results you desire. Talk with family members who will be affected by your decision. Sort through the information and share your findings with your doctor.

4. Try on a decision. Write down the consequences you expect from each possible decision. Reconfirm the probable side effects, pain, recovery time, cost, and long term prospects for each option. See which choices feel right on you.

5. Create an Action Plan. Humans function better with a plan. Once you’ve made a decision, talk with your doctor and take the steps necessary to ensure the best possible outcome.

6. Remember your goal. When you share in a decision, you share in the responsibility for the outcome. It is your job to fully implement every step in your action plan in which you control.

Preventative Care We all want to enjoy our lives but we can only do so if we stay healthy.

Most health problems can be avoided by a few simple steps done at home.

Dr. Anupreet Oberoi of Family Healthcare Center says that we should avoid the empty calories in soda and fruit juices. “Instead of drinking fruit juice, eat the fruit,” she says. She recommends drinking 6-8 glasses of water per day, eating small well balanced meals, and not smoking.

“Everyone needs 150 minutes of exercise per week and good uninterrupted sleep.” (Exercise can be as simple as walking to the point of elevating your heart rate or as complex as going to a personal trainer.) Limiting alcohol consumption and avoiding unnecessary drugs whether illegal or legal.

Many other health problems can be avoided with simple immunizations. “Most of

the sicknesses of early and middle life can be avoided completely with simple immunizations like flu shots.Young girls should get a vaccination against HPV, a virus which causes cervical cancer. Even some of the more common bacterial infections in older life such as bronchitis, sinusitis and pneumonia can be reduced with immunizations such as the influenza virus vaccination or the bacterial pneumococcal vaccination,” Dr. Oberoi says.

Dr. Sanjay Jaswani of Southside Internal Medicine says “An ounce of prevention is worth more than a pound of cure. Basically, medical management becomes a lot more complicated and expensive when diseases are caught at a later stage rather than caught early via health screening and routine checkups. Studies have shown that folks do better overall if they practice good preventative medicine.”

Annual checkups are usually deductible-free elements of most health care plans including Medicare and Medicaid and for those without insurance, are still very cost effective. In fact, Dr. Jaswani says that the great majority of major illnesses would be preventable, manageable, or curable if diagnosed early. “If you catch diabetes at an early age you can manage your blood sugar better and can prevent www.showcasemagazine.com

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HEALTH TALK EDITION Spring 2012 things like diabetic retinopathy, which is patents losing their eye sight because the diabetes wasn’t caught early and wasn’t controlled early. Kidney disease can be secondary to diabetes, in which case is called diabetic nephropathy. High blood sugar can overwork the kidneys, causing them to stop working properly. In the worse case scenario, it can also lead to losing kidneys and going to dialysis simply because their diabetes wasn’t diagnosed early enough.”

If you catch issues early you are saving yourself the economic and life costs associated with major health issues. “It’s much more economical to institute preventative medicine than allow yourself to succumb to a disease and then have to be hospitalized.”

Tips for Employers Health Care costs are one of the largest expenses for an employer and include the cost of insurance, lost work, and unproductivity.

Here are 6 Ways to have a healthier and happier team.

1. Allow preventative care visits to be “on the clock”.

2. Start a self-care program which includes access to books, videos, and internet links.

3. Highlight employee success stories in the company newsletter and award the employees with a healthy lunch from a local restaurant.

4. Put together a “doctor bag” of self-care medical supplies for the home for display. Encourage employees to submit a picture of their own “doctor bag” and give a prize for the most creative entry.

5. Have a medical workshop day which includes information about such things as preventative care focusing on the top 3 healthy lifestyle topics, which are exercising, eating healthy, and quitting tobacco.

6. Distribute a flyer on recommended immunizations, medical exams, tests, etc. Include a quiz in with paychecks and encourage employees to complete the quiz. Give a prize to the employees who answer all the questions correctly.

7. Implement a weight loss or fitness contest and work and award significant prizes. Remember, people like cash.

8. Coordinate a healthy recipe contest with a cook-off that the employees could enjoy together.

Good Sources for Health Care Information American Academy of Family Physicians Agency for Health Care Policy Research Centers for Disease Control and Prevention National Institutes of Health US Department of Health and Human Services WebMD Medscape American Medical Association

www.familydoctor.org www.ahrq.gov www.cdc.gov www.nih.gov www.hhs.gov www.webmd.com www.medscape.com www.ama-assn.org

We used many of these sites as sources for this healthcare issue. In addition, do an Internet Search for national organizations that represent a particular disease.

Danville Regional Medical Center has an extensive network of community-based primary care providers who offer preventative care services throughout the region. Dr. Oberoi can be found at Family Healthcare Center on Piney Forest Road and you can call her office at 434.797.2828. Dr. Jaswani can found at Southside Internal Medicine on Executive Drive and you can call his office at 434.797.2751.

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HEALTH TALK EDITION Spring 2012

Diabetes

The Silent Killer According to the American Diabetes Association, 25.8 million children and adults in the United States – a whopping 8.3 percent of the population – have diabetes. Type 2 diabetes, specifically, is increasingly considered a national epidemic – a health crisis that has hit working class and poor communities with a powerful punch.

Let’s take a closer look at the disease and the steps you can take today to help prevent it.

What is diabetes?

Diabetes is a disease in which the body has a shortage of insulin, an insensitivity to insulin, or both. Insulin is important because it allows glucose (sugar) to enter our cells and be converted to energy. When diabetes is not controlled, glucose remains in our blood and, over time, damages vital organs.

The most common form of diabetes is type 2 diabetes. While most cases can be prevented, it remains the leading cause of diabetes-related complications, such as blindness, chronic kidney failure, and non-traumatic amputations, among adults.

“Type 2 diabetes most commonly occurs in people who are overweight and over the age of 40. Sadly, the disease is also increasingly appearing in children, because of the rise in obesity in our nation’s youth,” says Dr. Saria Sacoccio who is the Chief Medical Officer at Danville Regional Medical Center.

The good news, according to Dr. Sacoccio is that the risk of developing type 2 diabetes can be reduced with a firm commitment to a healthy lifestyle.

5 Simple Steps to Help Prevent Diabetes 1. Get moving and stay moving! Regular physical activity can help:

• Lower your blood sugar and boost your sensitivity to insulin, helping

prevent type 2 diabetes by keeping your blood sugar within a normal

range;

• Reduce your risk of cardiovascular disease;

• Reduce your risk of certain cancers;

• Control your weight;

• Strengthen your bones and muscles; and

• Improve your mental health and emotional health.

2. Lose extra weight. If you’re overweight, diabetes prevention may be largely dependent on your ability to lose excess weight. In fact, every pound you lose can improve your health.

3. Make sure you’re getting your daily amounts of recommended fiber, as it may reduce the risk of diabetes by improving your blood sugar control. Foods high in fiber include fruits, vegetables, whole grains, legumes, nuts, and seeds.

4. And don’t forget about whole grains. Research suggests that whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your daily grains whole grains. Just look for the word “whole” on pasta products, breads and cereals.

5. Talk to your doctor about regular blood glucose screenings. If you’re age 45+ and overweight, or if you’re overweight and have one or more additional risk factors for type 2 diabetes, such as an inactive lifestyle or a family history of diabetes.

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HEALTH TALK EDITION Spring 2012 “It’s also important to recognize the symptoms of diabetes and talk to your doctor about these and other health concerns,” says Dr. Sacoccio.

According to the American Diabetes Association, symptoms of type 2 diabetes include:

• Frequent urination • Unusual thirst • Unusual weight loss • Extreme hunger • Extreme fatigue or irritability

• Blurred vision • Cuts or bruises that are slow to heal

• Tingling or numbness in the hands or feet

• Recurring skin, gum, or bladder infections

To learn more, visit www.diabetes.org or talk to your personal physician.

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A Conversation with Dr. Michael A. Caplan

of Piedmont Internal Medicine, Inc. SM: Your Practice has been very successful in treating Diabetes patients with exceptional results. To what do you attribute that success?

Dr. Caplan: Our diabetes patients are almost always obese, hypertensive, and many have high cholesterol, so when we treat diabetes we will focus on the whole picture. The philosophy that we like to adopt is that you treat patients to a given target (goal). When the patient comes in we’ll sit down with them and say this is what your blood sugar should be and this is your cholesterol goal. We need to make it happen. This is what your blood pressure is supposed to be to get you out of trouble. We are usually treating those 3 or 4 problems at the same time. Medical management is what we call cognitive skills. They aren’t procedural skills.

It’s about using your brain and knowing the drugs, being willing to use them in combination, and be willing to treat many conditions at one time. The main emphasis is education, education, education.

SM: It sounds like diabetes is the root of many other major issues.

Dr. Caplan: Most people think diabetes is simply a blood sugar problem, when it’s really a vascular problem. If your sugars aren’t good then you wind up with a lot of vascular diseases in your life time like stroke, blindness, heart attack, kidney failure, dialysis, and limb loss.Very few diabetics just have high blood sugar. If you teach people about their disease and the disease process, what it is and what the risks are, then they can take ownership over their condition.

When they learn how their behavior or lifestyle influences their diabetes, they can take ownership and responsibility for their health.

Our process is to get the patient motivated because to do it right means success. We use the right amount of the right meds for the right person to get the right result.

SM: So, the secret is to treat the patient and not the illness?

Dr. Caplan: You give them an idea it’s not just take this pill and come back to see me.

We show them what is really in it for them.

We can show them that if they take ownership of their condition, and are part of the team in treating it, they will likely have good results. In fact, on a national average 30% of patients with diabetes have gotten their blood sugar, LDL cholesterol or blood pressure to where they need to be while being treated. But, at our practice, it’s 65% and 70%. We realize that if you practice to the best standards of care,

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HEALTH TALK EDITION Spring 2012 “Our process is to get the patient motivated because to do it right means success.” treat to target goals, treat the people as individuals, and provide health care literacy, great results are possible. It will never be at 100% because people fall off the wagon. They don’t comply, eat the wrong things, don’t follow up, and stop taking their medications. But, we strive to give every patient every chance at success.

SM: So the people who actually stay on the programs and follow through, are they drastically reducing their chances of stroke?

Dr. Caplan: Yes, and heart attack, blindness, dialysis, and so on. Their reward is they stay healthy.You can’t live your life twice; once having done it, once not. We teach them that. If your blood pressure is awful, your risk for stroke is enormous. But you don’t feel any different to have your blood pressure normal because high blood pressure is a silent killer. If your cholesterol is up you have no physical symptoms. It’s the leap of faith. We try to get them to understand their number and their goals. The reward is to say that they did it. Not that they feel a whole lot better. They just live longer better lives.

SM: Preventative care is huge and probably the most important thing right?

Dr. Caplan: I think most companies are starting to get that. I am a medical director for an insurance company and give lectures on medical management and wellness, so we know if you spend a dollar getting someone to lose weight, not smoke, and have a normal blood pressure, while keeping their sugars good, you’ll save three dollars.

SM: Health Insurance companies have a vested interest in making people healthier. Is that why they often offer no deductibles on preventative care?

Dr. Caplan: Correct. If you change the concept of “waiting until they get sick so we can treat them” and change it to “lets prevent people from getting sick by reducing chronic disease” then they won’t need procedures like cardiac bypass years from now.

Danville Regional Medical Center has an extensive network of clinics throughout Danville and Pittsylvania County that can help you take control over diabetes. For more information visit www.DanvilleRegional.com. Dr. Caplan is a DRMC Board of Trustee who is passionate about teaching people to be proactive in their healthcare.You can find him and his associates at Piedmont Internal Medicine or by calling 434.791.1345.

Patient Safety Programs

Improving the Experience by Improving the Process A couple of years ago, a recall of hand sanitizers from hospitals brought Patient Safety Awareness to the forefront of the health care discussion. Improving patient safety practices and significantly decreasing preventable medical errors has long been a goal of hospitals around the country. At Danville Regional Medical Center, Patient Safety Officer Teresa Pruitt is dedicated to improving patient safety on an ongoing basis. “Patient safety is a major priority for us. It is all about doing the right thing for our patients. The foundation for this is building and fostering a culture of safety throughout our organization in which all associates readily speak up if they have any concerns. In addition we must build our processes with safety and best practices in mind.”

Patient safety is one of the most vital aspects of a hospital’s duty to its patients.

Across the country, some examples of preventable errors include wrong-site surgery, medication errors, facility acquired infections, falls, diagnostic errors, and readmission within 30 days for the same issue.

Danville Regional is committed to minimizing all instances of preventable mistakes. And when mistakes are made, making sure to quickly and appropriately correct the issue. “Most mistakes are a result of a breakdown in a system or process,” Teresa says. “We must consciously build our processes to ensure the risk of an adverse event is greatly reduced or eliminated, when at all possible.

The safety of our patients must always be part of the planning when building new processes or even when reviewing current ones. In the field of medicine, things change fairly quickly and we are committed to building proven, evidencebased practices into our patient care processes.”

Danville Regional Medical Center is committed to continue building a strong patient safety program.To get more information or to offer your comments, call 434.799.3761 or email teresa.pruitt@lpnt.net.

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HEALTH TALK EDITION Spring 2012

Love Your Heart When someone says “you have a big heart,” they usually mean you are a generous and loving person. But, do you give back to yourself? Even the most giving individuals can neglect their own heart.

Statistics have shown that our community does not have the best track record when it comes to making good, heart-healthy decisions. Good health starts with the heart. There are many factors that contribute to a healthy heart and making smart choices can extend your life by decades. Not only that, healthy living will improve your quality of life and allow you the freedom to enjoy many more things that make you happy.

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Here are four simple steps to becoming more heart healthy. #1 Cutback on unhealthy fats and cholesterol by paying attention to what you eat

This is the most important step you can take and it doesn’t require an ounce of sweat. Saturated and trans fats lead to bad cholesterol which can lead to buildup of plaque in your arteries. This buildup of plaque increases your chances of heart attack and stroke.

Dr. William Sweezer, (Bill), Medical Director of the Cardiac Surgery Program at Danville Heart and Vascular Center summed it up very well. “There are a lot of healthy foods that you can prepare that taste great and sometimes it’s just switching one ingredient for another. Simply trimming the fat off of meats or using olive oil instead of vegetable oil can drastically change fat intake.” When grocery shopping, looking for “partially hydrogenated” (which is another name for trans fats) in the ingredients list of snacks such as chips and cookies and choosing food with better ingredients is a start. Combined with a concerted effort to limit your intake of butter, margarine and shortening in the food you prepare will not only help you live healthier, but is a “big hearted” way to feed those for whom you cook.

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HEALTH TALK EDITION Spring 2012 Cutting back on unhealthy fats is one vital step in an overall heart healthy diet. In our summer health issue, we will have a full feature on a heart healthy diet. But, don’t wait for our feature. The sooner you start eating better, the sooner you will be on the path to better health.

Here are the basic steps to eating better: • Eat low fat proteins such as egg whites, fish, skinless chicken, and beans • Eat more vegetables and fruits • Eat whole grains • Lower your sodium intake • Eat smaller portions and eat several small meals a day instead of a few large meals

#2

Manage Your Stress

The American Heart Association lists stress levels as one of the biggest determiners of heart attack and stroke. Put simply, the higher your stress level, the more likely you are to die from a heart attack or stroke. Dr. Sweezer stated that “In recovery, I tell patients to take time out for themselves each day to reduce the amount of stress in their life. If only I could have given them that advice before their heart attack.” It is great advice.

There are many ways to reduce stress in your life. In this issue, there is a feature story on reducing stress in children’s lives. This article indirectly applies to people of all ages.

Here are some quick stress reduction tips: • Practice positive self-talk. As corny as it may sound, it works when you say positive things to yourself.

• Practice cool down techniques such as counting to ten, taking deep breaths, or going for a walk.

• Relax. Relaxing doesn’t include watching television or having a conversation. Both of these stimulate you. Relax by taking ten minutes a day, sitting comfortably in a quiet place and do nothing but let your mind come to rest.

• Do something you enjoy such as a hobby, playing golf, reading, or listening to music. Remember to exclude stressful items such as your smart phone from the equation.

#3 Quit Smoking If you are a smoker, then you are fully aware of the ramifications of your actions.You’ve read all

the facts. But, did you know that every cigarette you smoke reduces your expected lifespan by 11 minutes.

ELEVEN minutes.

It’s been said that you can’t buy time, but at 3 hours and 40 minutes taken off of your life per pack of cigarettes smoked, you can sure give time away.

Sandra Greene is a Registered Nurse in Danville Regional Medical Center’s nursery. She had a heart attack in 2011 and in the emergency room when the doctor asked if she smoked, she said “not anymore.” He asked her how long ago she quit and she said, “on the way over here.”

She hasn’t smoked since. But, her husband still smokes. It’s not easy to quit even when you see the ramifications first hand. Dr. Sweezer says that “second hand smoke is a major concern for us as health care providers. When you treat the patient you must also treat the family. Cigarette smoke, whether it’s the person smoking themselves or someone in the house smoking, can obviously be a negative factor and concern.” It’s hard enough to quit smoking and when someone smokes around you, it’s like being taunted and tempted over and over again. Given that after a heart attack, 63% of smokers return to smoking within 9 months and 50% within 20 days, family support is vital.

I’ll guarantee you one thing. There will likely come a time when you would trade everything you own for 11 more minutes of life. Is that cigarette really worth it?

#4

Lose Weight

This is the first tip that requires you to actually do something physical. But, even losing a few pounds can drastically improve your cardiovascular fitness. Nearly 70% of American adults are overweight and about a third are obese. The word obese is thrown around a lot, but it simply means someone is more than 20% over their ideal body weight.

We’ve discussed reducing the bad fats that you eat, but in addition to that, it’s important to just eat a little less. Don’t make drastic changes. Take baby steps. And the same applies to burning calories. It really doesn’t take much effort. According to Dr. Sweezer, “thirty minutes of exercise at least 3 times a week will help condition your heart. Exercise should be personal. Just because one activity is good for one person doesn’t mean it’s right for you. It needs to be something that one can accomplish and is fun to do. There are lots of ways to burn calories. Even normal daily activities, such as doing laundry or going up and down stairs, burn calories.”

Begin with a simple exercise that combines several of our tips into one. Take a walk by yourself and if you smoke, leave your cigarettes at home. Put your phone on silent. Take your mp3 player with you and listen to one of your favorite albums. Turn around after 6 songs and head home. Those forty minutes every day or so could save your life. Gradually, when it feels right, you can add a little exercise routine to your life.

Something simple.

Each month in Showcase, fitness guru Dave Gluhareff writes about ways to get healthier. He says, “There are no secret pills or shortcuts to losing weight. The most important thing is to gradually eat less and gradually move more.” Very few people can dedicate a huge portion of their life to physical fitness for appearance sake. But, we all have time to invest in our heart so that we can live longer. Love your heart and it will love you back.

Danville Regional Medical Center in affiliation with Duke Medicine offers a state of the art Heart and Vascular Center. In addition to the rapid response team that saves lives after a life threatening event, the vascular program at DRMC offers preventative programs that evaluate and treat your arteries for potential blockages that could cause heart attacks, strokes, and aneurisms, before they happen.

Losing weight is a two-part process. Eat less and move more. It’s a pretty simple formula. We’re bombarded daily with advertisements for diet pills, exercise facilities, diet books, diet du jour, exercise equipment…the list is endless. But, beyond all that, is the simple equation. Eat fewer calories than you burn and you will lose weight. www.showcasemagazine.com

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HEALTH TALK EDITION Spring 2012

Home Health Care Moving Forward

An injury or illness can be a life changing event. It can result in a series of medical steps that each have the goal of returning you to the quality of life you had before. Each transition has its own goals and challenges. But, reaching certain milestones helps make the challenging journey rewarding.

When people have to be hospitalized, one of their biggest goals is to get back home. It’s an important step, both physically and emotionally on the road to recovery. Sometimes continued care is needed and that’s where Home Health care comes into the picture. Many companies have Home Health care in their name. But, some companies like Danville Regional Home Health have it in their DNA. “Home Health care is much more personal,” says Lynn Belton, Director of Danville Regional Home Health. “You become one of the family. Working one-on-one allows you to focus on that patient’s needs and develop an individualized plan of care to meet those needs.

It also allows time to build a relationship and provide in-depth teaching. It’s vital to help the patient and their family members understand the importance of taking care of themselves. This includes lifestyle changes, diet, and taking their medications properly.”

Home Health care is basically for people who have had a change in their medical condition and are able to continue their treatment at home or in an assisted living facility. Home Health care is for people who are actively trying to get well and return to their normal lives. It can be short-term or long-term and often includes rehabilitation services, as well. Lynn says, “After people have been in the hospital we can provide post hospital follow-up and teaching to make sure that they understand their medication and management at home.”

Home Health care is the unique opportunity to help patients in their element. The services assess medical needs and provide a wide range of nursing services including teaching, wound care, and IV therapy. The provider assesses their support system and home safety issues and makes arrangements for equipment, supplies, or additional community services to meet the patient’s needs.

They look at mobility and function. Physical Therapy can improve range of motion, strength,

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and endurance. Occupational Therapy looks at process or home modifications to make tasks easier for the patient. Speech Therapy addresses problems with communication, eating, and swallowing. Lynn says, “We truly assess every aspect of patient care in order to identify and resolve challenges to allow them to remain in their home. Because it is so true….There’s NO place like home.”

For patients with Medicare, Medicaid, or private insurance, different things are covered or not covered based on medical necessity and policy. But, Medicare and Medicaid, like most insurance companies, have an innate desire to help a patient avoid expensive and extensive re-hospitalization.

Much of Home Health care is educational, so it’s important to choose a provider whose goal is to help you transition to taking care of yourself. “The goal is to teach the patient to manage their lives and move forward towards a productive life,” Lynn says. “It’s our passion to help people in a one-on-one setting and to help them remain at home.”

Home Health nurses and therapists must have the knowledge and experience to identify needs and create a plan specific to the individual patient. So, it is vital to use a company with a committed team who are dedicated and passionate about the specific challenges and rewards of Home Health care. “Our team has been providing Home Health care services for more than 20 years. We love working with the patients in their home. It’s very rewarding. We desire to help the patient get well and reach their maximum potential.” Lynn, herself has been with Danville Regional for 14 years, working her way up from a visiting nurse to the Director of Home Health Services. “I am so blessed to be the coach of this incredible team of caring, dedicated professionals. We know and use each player’s experience and knowledge to produce winning results for our patients! We use our talents to serve others during their time of need and we, in return, are blessed in so many ways!”

For more information or to learn about Home Health care, contact Lynn Belton, Director of Danville Regional Home Health Services at 434.799.2382. Danville Regional Home Health’s experienced team will make transitioning from the hospital to your home a pleasant experience with the joint goal of helping you move forward.

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HEALTH TALK EDITION Spring 2012

Letting Go - Hospice When Medicine Is No Longer Enough

One of the buzzwords in healthcare today is “Compassionate Care”. It’s a catchy phrase that works well in ad copy but, it is also the way many healthcare providers approach their jobs. A prime example of “compassionate care” can be found in the actions of individuals who dedicate their lives to caring for patients with life-limiting illnesses and providing support to their families and caregivers. Lisa Marie DiLuigi, Certified Hospice & Palliative Care Nurse and Director of Legacy Hospice of the Piedmont, says “Hospice is a special kind of care provided to patients and families during one of life’s most sacred journey’s. Each patient’s journey is unique to that individual. It’s our commitment to treat each person with dignity, respect, and grace.”

Terminal illness is never an easy thing to face. When the time is right, hospice care is available. Understanding the options available when modern medicine is no longer enough, is vital for patients and their loved ones.

Managing Emotions This can be one of the most stressful times in our lives and our family member’s lives. No one can truly know how to handle the mixture of feelings that exist. Patients genuinely care about things other than simply extending their lives, especially when the added time is counted in days and weeks and not in years. Surveys of terminally ill patients show that people want to avoid unnecessary pain and suffering. They want to spend time with their family and get a chance to say goodbye on their own terms. They want to remain mentally acute, experience the touch of others, and many times, more than all the rest, not become a burden.

For millions of people throughout the United States, hospice may be the answer. According to Lisa Marie, “Patients eligible for hospice have a life expectancy of 6 months or less if the disease runs its natural course. Hospice manages patients with life limiting illnesses whose goals are no longer to seek curative measures, but to have the highest possible quality of life for as long as they have left. ” More than just health care, hospice is about compassion. Choosing the right hospice provider is about finding a team who treats patients and families with love and a genuine spirit of life. No matter the challenges that patients face, they still have goals and needs.

Hospice is centered around helping a person accomplish as much as they possibly can in the final stage of life. But, it’s also about bringing families closer together, with a special emphasis placed on enhancing the patient’s quality of life. It is designed to remove the burden of juggling all the different aspects of life care out of the hands of the family members who simply want to enjoy the

moments that remain. Hospice provides an interdisciplinary approach that manages the physical, social, emotional, and spiritual needs of patients as well as their families and caregivers.

“Everyone involved in our organization, from nurses and doctors, to volunteers, clergy, and our administrative staff, are very passionate about managing patients at the end of their life,” Lisa Marie says. “It is a sacred time and everyone who works with us or is a part of our team is committed to it.”

The services are all-inclusive. Hospice is 100% covered by Medicaid and Medicare with no out of pocket costs. It is also covered by most health insurance policies. The services of a hospice come at a vital time for a patient and a family. When medicine is no longer enough, hospice is there.

For more information about Hospice or to become a volunteer, contact Legacy Hospice of the Piedmont at 434.799.5313 or toll free at 855.799.5313. Legacy Hospice of the Piedmont is the area’s only health care provider that operates solely as a hospice. It provides hospice services wherever indicated including at your home or in the hospital. www.showcasemagazine.com

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HEALTH TALK EDITION Spring 2012

Hospice

An Interview Dr. Max Lassiter and his wife Laura served this community for fifty years. Dr. Lassiter recently retired after 46 years of service and is one of the most respected pediatricians in our region. Laura was a counselor, musician, and mother of five children.

When Laura was diagnosed with cancer two years ago, she and her family pursued an aggressive course of treatment. But, when the treatment didn’t cure the cancer, they turned to Legacy Hospice of the Piedmont to assist them in helping make Laura’s time as pleasant as possible.

or

with Dr. Lassiter

Focus Hospice provides care to the patient and family and focuses on comfort and quality of life. It manages the physical, emotional, social, and spiritual needs of the patient and family.

Eligibility Hospice is for patients with life limiting illnesses

SM: What was your experience with Legacy Hospice of the Piedmont?

Dr. Lassiter: I was surprised how much they could do for my wife. They came in and basically talked to us and explained to us what we could expect and that the nurse would come as often as necessary. They provided medication for comfort and told us how to use it if need be. Being a physician, myself, I certainly approved of the medication. They were there to make my wife comfortable and reassure the family that everything was being done. They really went above and beyond. The thing that I liked most is whenever we needed to call they had someone who could answer our questions or could come right out. They knew how to make Laura comfortable.

I highly recommend them. They highly exceeded all our expectations. They had the most wonderful nurse, named Gina Foley, who had approximately 40 years of experience. She was very good.

SM: Being a health care professional your whole life it must be unique to be on the other side.

Dr. Lassiter: Oh yeah! She (Gina) knew how to reassure us and make us comfortable. She interacted with the family very well. She would give us an idea of what to expect for the next few hours (and day or two) and she knew when to come by and when we needed help. I couldn’t ask for better care from any group of people.

SM: Do you think people have a misconception of what hospice does and believe it is simply there to hold your hand?

Dr. Lassiter: Oh, yes. When we called Legacy Hospice they came right out. Lisa Marie DiLuigi and Vena Duncan (social worker) came and we talked to them. We were satisfied with what they had to offer us. I told them, “We would like for you to take care of Laura for us.” The next day the nurse, Gina, came by and told us what to expect and left us some medication. She told us how to control the nausea. Laura got a little worse over the next day or two and the next thing I know Legacy was at our home with what we needed. They anticipated her needs before they arose.

The nurse was here when Laura was declining. She explained how the children and grandchildren were going to react. They checked on Laura every few minutes while I slept beside her. The nurse was there beside her and she let us know when she passed away. She called all of us in there and comforted us and our needs. She met the needs of our family and my wife.

Legacy Hospice really helped us through the toughest time our family ever endured.

who are not seeking curative treatment. Services require a physician order and certification of life limiting illness. Hospice cares for people where they live, whether at home or a nursing facility.

But, the patient does not have to be home bound.

Services Hospice is all-inclusive (comprehensive, including all services) and treats the person, not the disease. Hospice provides 24/7 access to RNs and physicians for pain and symptom crisis management. It allows for increased visits by an interdisciplinary team based on need & without limit. Hospice provides a customized plan of care per patient/family & reassesses it as needed.

HOSPICE COVERS All-inclusive • Skilled Nursing Visits • Hospice Aide Visits • Medical Social Worker Visits • Spiritual Counseling/Chaplain Visits • Volunteer Support • Physician in-home Visits, as needed • Bereavement Support • Hospice Diagnosis Related Medications,

Supplies, Equipment, and Lab work

• Therapy Visits (Physical/Occupational/Speech)

for rehabilitation

• In-patient Care based on eligibility • Respite Care – 5 days as needed

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Home Health

HEALTH TALK EDITION Spring 2012

Which is Right For You?

Focus Home Health provides care to the patient and works with the family to focus on rehabilitation, disease management, and recovery. It manages issues dealing with the patient’s physical condition, home, safety and social needs.

Eligibility Home Health is for patients who have a short term or long term need for skilled nursing or therapy and are seeking to return to their normal lives. It requires a physician order and skilled need. Home Health requires patients to be homebound and is provided in the home or assisted living facility.

Services Home Health services are determined by diagnosis, medical necessity, and patient needs. The number of visits decreases as the patient moves toward recovery. It provides an individualized plan of care with established goals. Home Health has a 24/7 oncall nurse for treatment per orders or referral to ER if necessary.

HOME HEALTH COVERS Determined by diagnosis & medical need • Skilled Nursing Visits • Home Health Aide Visits • Medical Social Worker Visits • Therapy Visits (Physical/Occupational/Speech)

for rehabilitation

• Patient/Caregiver Education • Wound care including Wound Vac therapy • IV Administration • Disease and medication management • Supplies – treatment related • Coordinates equipment, supplies, and additional

services as needed

Defeating Cancer There is Hope

Cancer. Six letters that can change someone’s life forever. Fortunately, a cancer diagnosis no longer means what it did just a few years ago. Surviving cancer can make you a stronger person.

Cancer is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells. If the spread is not con¬trolled, it can result in death.

But, there is an upside. If you are one of the millions of people who battle cancer each year, the odds for survival are in your favor.You will more than likely defeat cancer so long as you make good decisions. Research has shown that 67% of people who develop cancer will survive it, with appropriate treatment. Olivia Newton-John has defeated cancer, as have Lance Armstrong, Sharon Osbourne, Sheryl Crow, and Rod Stewart to name a few. In fact, there are approximately twelve million Americans alive who have survived cancer.

Facts can be scary, but you play the most important role of all in your own survival.

The easiest battles to win are the ones you never have to fight.You see, most cancers are preventable before they even occur. In fact, according to the American Cancer Society, 63% of all cancer deaths are directly attributable to lifestyle choices and can be prevented. 173,000 will die in 2012 from cancer caused by cigarette smoking and heavy use of alcohol. A male smoker is 23 times (2300%) more likely to develop lung cancer than non-smokers. Another 190,000 cancer deaths will be related to overweight or obesity, physical inactivity, and poor nutrition. Certain cancers are related to infectious agents, such as hepatitis B virus (HBV), human papillomavirus (HPV), human immunodeficiency virus (HIV), Helicobacter pylori (H. pylori), and others, and could be pre¬vented through behavioral changes, vaccines, or antibiotics. In addition, many of the more than 2 million skin cancers that are diagnosed annually could be prevented by protecting skin from intense sun exposure and avoiding indoor tanning.

So, truly the best defense against cancer is a good offense. Stop smoking. Don’t drink alcohol to excess. Exercise. Eat Healthy. Avoid sun exposure. And practice preventative health care by getting annual checkups and screenings. These simple steps will drastically decrease your likelihood of getting cancer. www.showcasemagazine.com

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HEALTH TALK EDITION Spring 2012 Anyone can develop cancer. Since the risk of being diagnosed with cancer increases with age, most cases occur in adults who are middle aged or older.

About 77% of all cancers are diagnosed in persons 55 years of age and older.

Once you’ve developed cancer, getting the best treatment is vital.

The normal courses of action may include some combination of: surgery to remove the cancer, radiation treatment, or chemotherapy treatment. Radiation treatment uses a powerful x-ray to shrink a tumor before surgery or reduce the chance of cancer returning after surgery, or in place of surgery.

The goal of radiation is to stop cancer cells from multiplying while sparing as much healthy tissue as possible. Chemotherapy treatment uses drugs, or chemicals, to kill rapidly dividing cells. It kills both cancer cells and healthy cells. The goal is to kill as many cancer cells as possible. Typically this is given intravenously. A tiny catheter is inserted into a vein, usually in the hand or lower arm, and removed at the end of the session. There are various other delivery systems a doctor may employ.

Danville Regional Medical Center has a state of the art radiation oncology center and cutting edge chemotherapy unit. No matter where you receive your initial treatment for cancer, you can undergo your radiation or chemotherapy regimens close to your home and family.You can often continue working. Dr. Peter Leider who is a Radiation Oncologist at Danville Regional’s Center for Radiation Oncology says, “We have all of the newest, cutting-edge equipment, like onboard imaging, to precisely target tumors on a daily basis. We even do stereotactic brain radiosurgery (radiation treatments), which is a unique, nonsurgical option for brain tumors.”

Patients often have misconceptions about radiation therapy. “People think it makes you sick and throw up. In reality, most treatments are provided in an out-patient setting with the patient able to drive themselves to and from treatment. By doing the treatments locally, we help minimize the upheaval in a patient’s daily life,” Dr. Leider says. In fact over a normal, five-week, 25 treatment program, the major side effect experienced by most people in the first three weeks, is that of feeling tired. A couple of weeks after treatment ends, the patient usually starts feeling better. “Since radiation treatments are localized, the side effects are usually limited to the region being treated.”

Chemotherapy, on the other hand isn’t a localized treatment, so the side effects will likely be more visible throughout the body. But, it isn’t at all like the movies make it seem. Dr.Veshana Ramiah who is a Medical Oncologist at Danville Oncology and Hematology says “the reality is that 9 of 10 patients tell me the same thing. Nausea and vomiting and being sick all the time is no longer part of chemotherapy. We are very good at managing these kind of side effects and the quality of daily living is a high priority.”

“There is much to be hopeful about. We are beating cancer daily.You will find most cancer doctors are upbeat and optimistic. It’s how we are here in our practice.”

Cancer can be beaten. Cancer treatments are evolving every day. A treatment doesn’t exist today may very well exist three months from now. Remember, a few lifestyle changes can help prevent cancer.

If you are living with cancer:

• Ask questions. Learn what your options for treatment are.

• Educate yourself so that you know what to expect and how to best manage your treatment.

• Maintain as much adherence to your normal day-to-day routine as possible.

For doctors like Dr. Ramiah and Dr. Leider, treating cancer patients is a calling. “I love my job. I think it’s really a privilege that we are able to help patients through such a personal and often terrifying journey and give them hope and help them heal. I feel like I’m making a difference,” Dr. Ramiah says.

“The people I’ve trained with and others in this field all have similar attitudes.

It’s something sacred.”

Dr. Ramiah comes to Danville after having trained at The Royal Marsden Cancer Centre in London and serving on staff at Duke. The Royal Marsden is the second largest cancer center in the world and the experience she gained there helped shape her into the world-class oncologist she is today.

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• Choose to receive care at a facility close to your home to help ease the burden and minimize stress.

Check out our article this month on making wise health decisions, many of which can help you prevent cancer.

Local Resources: Danville Regional’s Center for Radiation Oncology and Danville Oncology and Hematology treat patients and coordinate care with their surgeons and other healthcare providers (whether local or based out of town).You can contact Danville Regional’s Center for Radiation Oncology at 434.799.4592 and Danville Oncology and Hematology at 434.799.0044.

Because there’s no place like home.

Skilled Nursing - IV Therapy, Wound Care, Wound Vacs, Post-hospital follow up, Diabetic and Other Disease Management Teaching. Nurses are on call and available 24 hours a day

Rehabilitation - Physical Therapy, Occupational Therapy and Speech Therapy

Counseling and Community Services Social Worker

Home Health Aides We’ll also coordinate - Home Medical Equipment, Oxygen and Respiratory Therapy, IV Pharmaceuticals and Lab Services

For more information call: LOCAL: 434.799.2382

TOLL FREE: 800.688.3762

C

ompassionate Care when needed most

L

egacy Hospice of the Piedmont is committed to providing compassionate care to patients, families and caregivers facing life-limiting illnesses. Home environments include private residences as well as independent, assisted, and nursinghome facilities.

Home Hospice Services Provide: t Pain control and symptom management t Medical equipment, supplies and medication t Caregiver training Legacy Hospice of the Piedmont serves all of Pittsylvania county and parts of Halifax, Henry, and Campbell counties.

For more information call: LOCAL: 434.799.5313 TOLL FREE: 855.799.5313