Michiana Medical Update - Summer 2013

summer 2013

sJMED.com

MICHIANA M

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from the physicians of saint joseph regional medical center

Healthcare Reform What’s Happening in 2013

Tendon Pain?

We Can Help Bike Safety Tips Enter to Win a Free Bike Helmet

summer 2013

contents

“ We’re called on to care, in every sense of the word.”

Sunlight: Good or Bad?........ 3

Albert Gutierrez

Healthcare Reform ............... 4

President and CEO

New Lung Screening ........... 6 Perks of Quitting Smoking....7 Having a Baby? Meet Our Laborist Team ............... 8 New Era in Heart Care....... 10 Bike Safety Essentials ........ 12 Benefits of Priority Care........................ 14 Uncovering Sleep Disorders............................. 16 Asthma Relief ..................... 17 Foot Ailments You Shouldn’t Ignore ................ 18 Have Tendon Pain?............. 19 Summer Sandwiches ........ 20 The Great Outdoors ............21 Is it Heartburn or GERD?.... 22 Upcoming Events ............... 23

This free quarterly medical update is prepared by the Marketing Department of Saint Joseph Regional Medical Center with the assistance of the medical staff. Please call 574-335-2540 with any questions or comments. Inquiries or ideas can be addressed to medicalupdate@sjrmc.com.

Albert L. Gutierrez, President and CEO Pamela Henderson, VP of Marketing Medical Advisers: Physicians from SJRMC’s Integrated Leadership Team SJRMC Production Team: Jessica Benko, Laura Snell, Christine Weist and Lindahl Wiegand The material provided in this magazine is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

YourBabyStop

LEARN MORE

YourBabyStop.com

Your local resource for all things baby for moms and dads-to-be.

A Message to Our Readers 2013 promises to be a year of significant changes within the healthcare industry with several provisions of the Affordable Care Act rolling out. The Act is one of the most sweeping changes to legislation of the healthcare system in our country, and SJRMC recognizes that taking a proactive stance is one of the best ways we can serve our community’s interests. You can rest assured we have been working diligently in this regard.

Together, we are working to protect the interests of our community as a whole, the patients we serve, and the physicians in our system so we can sustain a level of exceptional care for all. We envision an affordable healthcare system that leaves no one behind.

And we are already taking action by: • Focusing on coordinated care for seamless, holistic patient experiences • Leveraging technology to continually raise the standard of local care

• Collaborating with our physicians and clinical staff to create a stronger healthcare future for the region While we do not feel the Act is perfect, we agree that it advances the creation of a health system that works for everyone.

We, along with other Catholic-sponsored providers, will continue to lead the transformation of healthcare, seeking new and better ways to provide compassionate, high quality care in the communities we serve. We will continue to improve outcomes and to advocate for those we serve. We’re doing it today and will continue in the months and years ahead, because we’re called to be better.

Albert L. Gutierrez, MBA, FACHE, RT(R) President & Chief Executive Officer Saint Joseph Regional Medical Center

The Best Ideas Come from You! Is there a particular health topic you’d like to read about in a future issue of Michiana Medical Update? Please email medicalupdate@sjrmc.com with “story idea” in the subject line.

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Sunlight: Good or Bad?

Being outdoors, whether in sunshine or shade, exposes us to sunlight and ultraviolet radiation. There are two types of radiation: ultraviolet A (UVA) and ultraviolet B (UVB). Sunburns are primarily caused by exposure to UVB radiation; exposure to both UVA and UVB radiation has been found to age the skin and increase the risk for skin cancers.

Sunlight is also important in the production of vitamin D, and exposure to sunlight is known to improve mood. So how do we take advantage of the sun’s benefits while protecting our skin?

Fifteen minutes of sunlight exposure to the face, neck, and arms daily is more than enough to provide 25,000 units of vitamin D. That’s more than enough to give us our daily requirement of 1,000 units. Vitamin D is also available through vitamin D-fortified milk, orange juice, and vitamin supplements.

“We know that sunburns, especially blistering sunburns, and large amounts of cumulative radiation increase the likelihood of any of the most common skin cancers such as basal cell carcinoma, squamous cell carcinoma, or melanoma — particularly in people with a family history of skin cancer, or those with a light complexion,” says dermatologist Miles Andrew, MD. “To reduce the likelihood of skin cancer, be proactive. Reduce the amount of radiation you’re exposed to. Stay out of the sun between 10 am and 2 pm, use sunscreen and wear protective clothing to help diminish exposure.”

Choosing a Sunscreen Sunscreen labels can be confusing. According to the U.S. Food and Drug Administration, “broad spectrum” products protect against both UVA and UVB radiation. “Broad spectrum” and “SPF 15” (or higher) sunscreens protect against sun-induced skin damage. There is no evidence that SPF values greater than 50 offer more protection.

Remember, it’s important to wear sunglasses with a UV rating to protect the eyes’ cornea from UV radiation, which can cause cataracts and sunburn.

Miles Andrew, MD Granger Community Medicine On Staff at SJRMC

Sun Safety Tips • Apply sunscreen 15 minutes before going outside and cover the entire body.

• Limit time in the sun, especially between the hours of 10 am and 2 pm, when the sun’s rays are most intense.

• Reapply sunscreen at least every 2 hours.

Sunscreens only last about 2 hours unless they contain a stabilizer, which extends the effectiveness to 3-4 hours.

• Reapply if you are in and out of water or are perspiring. No sunscreen is waterproof.

Sunscreens labeled water resistant are effective up to 80 minutes in a wet environment, compared to 40 minutes for regular sunscreens.

To learn more about your risks for skin cancer, talk to your primary care physician.

Need a primary care physician or specialist? Call our Physician Referral Line at 866-757-6248 or go to sjmed.com and click on Find a Physician.

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Confused about Healthcare Reform?

Welcome to the Hub. If you’re like many Americans, the new Affordable Care Act (ACA) may seem confusing and overwhelming. There are certainly many changes about to take place — one of the most critical being how uninsured individuals and families access health coverage under the Act. At Saint Joseph Regional Medical Center (SJRMC), we are committed to being a resource for our community and ensuring that everyone has access to affordable, high-value care. To that end,

we will be opening new Resource Centers, with the first targeted to open on July 1 at our Mishawaka campus and the second Center to follow in Plymouth.

The new Resource Centers will provide the Michiana community with convenient and accessible locations where individuals and families can learn more about their health insurance options as well as enroll for coverage in the new Health Insurance Marketplace.

For more information on how the Affordable Care Act (ACA) will affect our community, visit sjmed.com/healthcarereform and plan to visit our new Resource Centers starting in July.

For more information on ACA at the national level, visit healthcare.gov in English or cuidadodesalud.gov en español.

Coffee Bar

MeeTING rooMS

 Architectural rendering of the new Mishawaka Resource Center opening July 2013

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4 Michiana Medical Update I Summer Winter 2013 2013

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Test Your Knowledge of Healthcare Reform

2. Do I have to enroll for coverage if I already have health insurance through my employer, Medicare or other program? a. Yes b. No 3. Will I be able to select my doctor under the new law? a. Yes b. No

GaTHerING SPaCe

4. When can individuals and families begin enrolling in insurance plan(s)? a. January 2014 b. October 2013 c. Individuals and families will be automatically enrolled in a plan by the government 5. Will the government provide assistance if I cannot afford any of the insurance plans? a. Yes b. No

Quiz Answers 1) a, 2) b, 3) a, 4) b, 5) a

1. When will individuals and families be required to carry health insurance? a. January 2014 b. January 2015 c. There is no requirement for individuals and families to carry health insurance

HealTH INSuraNCe eNrollMeNT CeNTer

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INforMaTIoN STaTIoN

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What is the Health Insurance Marketplace?

Come October 2013, individuals and families who are not covered under a health insurance plan will have the opportunity to enroll in coverage and avoid federal penalties that go into effect in 2014. The Health Insurance Marketplace, a key component of the Act, is designed to make buying health coverage easier and more affordable. It will allow individuals and small businesses to: • Look for and compare private health plans • Get answers to questions about their health coverage • Get a break on costs • Enroll in a health plan that meets their needs As required under the Act, insurance plans in the marketplace will offer comprehensive coverage stated in plain language, making it easier to compare plans.

The new Resource Centers at the Mishawaka and Plymouth Campuses will provide the following services: • Application Assistance • Children Health Insurance Program (CHIP) • Health Coverage Enrollment • Healthy Indiana Plan Enrollment • Insurance Education and Seminars • Insurance Enrollment • Insurance Qualification Assistance

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Our Capacity to Care Continues to Grow New Lung Screening Program Streamlines Treatment

If you’ve been diagnosed with a lung nodule, you likely have many questions:

What is a lung nodule?

• Is the nodule benign (non-cancerous) or malignant?

• What are my options for treatment?

• How will my care be coordinated?

With these concerns in mind, Saint Joseph Regional Medical Center (SJRMC) announces our new Lung Screening Program, providing a streamlined, holistic approach to treatment of lung nodules. Working with your primary care physician, our cardiothoracic surgeons will coordinate a comprehensive care plan so your treatment is seamless at every step.

A lung nodule is a small round or oval-shaped growth less than 3 centimeters in diameter. Most lung nodules do not present any symptoms; an estimated 90 percent are discovered when a person seeks medical care for another concern. However, if you experience a persistent cough, contact your primary care physician for further evaluation.

“Early detection and diagnosis, using appropriate evaluation tools, treatment, and surveillance are critical in the management of both benign and malignant lung nodules,” says Truc Ly, MD. Once a nodule is detected, your primary care physician can contact SJRMC’s cardiothoracic surgeons to schedule an evaluation. Approximately 60 percent of lung nodules are benign, which may or may not require surgery. If surgery is not required, your condition will be monitored based on your risk factors, with follow-up testing, and/or referral to a pulmonologist if need be.

“The Society of Thoracic Surgery recommends CT screening for patients at high risk of developing lung cancer,” says Michael Savitt, MD.

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At the Lung Clinic, a collaborative effort between SJRMC and Michiana Hematology Oncology (MHO), located at MHO, you will be seen by a SJRMC cardiothoracic surgeon, a MHO medical oncologist and a MHO radiation oncologist — all during a single clinic visit.

Your testing, appointment(s), treatment, and follow-up care will be coordinated to minimize time lost from your job and family, and avoid unnecessary testing and visits.

Truc Ly, MD, FACC

Saint Joseph Cardiothoracic Surgery On staff at SJRMC

Are You At Risk for Lung Disease?  I am a current or former smoker.  I am often exposed to secondhand smoke.

I have had long-term contact with dust,  fumes, gases, vapors, smoke, or mists.

I have been exposed to asbestos, arsenic,  silica, or chromium at work.

I often cough, wheeze, feel short of breath,  or have a tight feeling in my chest.

Michael Savitt, MD, MSE

Saint Joseph Cardiothoracic Surgery On staff at SJRMC

I have trouble with simple physical tasks  such as climbing stairs, doing the wash, or shopping.

I have lived in a house with a radon gas  problem.

 I have a family history of lung disease.

If you checked any of these boxes, you could be at increased risk for lung cancer, chronic obstructive pulmonary disease, asthma, or other lung diseases and should contact your primary care physician.

If a lung nodule is identified, or you have a previous lung nodule and want a second opinion, you or your primary care physician may call the Lung Referral Line 574-335-6020.

It’s Never Too Late to Quit Smoking A Healthier You After 20 Minutes For the one in five Americans who smoke, quitting isn’t easy. But the struggle is worth it: A recent study showed women who succeed in quitting may gain up to 10 extra years of life.

Tobacco smoke contains more than 7,000 chemicals, and at least 250 are known to be harmful. They harm nearly every organ in your body, contributing to one in five U.S. deaths.

Ex-smokers of both Lindsey genders reduce their Anderson, MD risk for everything Granger Community from aneurysms to Medicine pneumonia to On staff at SJRMC stomach cancer.

“Patients who quit smoking enjoy multiple health benefits in addition to the well-known benefits of decreased risk for cancer, heart disease, and lung disease,” says Lindsey Anderson, MD. “These benefits include increased energy, increased sense of taste and smell, decreased risk of respiratory infections, decreased back pain, and even improved dental health.”

The health benefits begin the minute you put out your last cigarette. Here’s a timeline of how quickly your body repairs the damage wrought by tobacco.

After:

20 minutes: Your blood pressure and heart rate drop to normal.

Eight hours: Levels of carbon monoxide in your blood drop, and your blood oxygen level returns to normal.

24 hours: Your risk of sudden heart attack, once higher than average, decreases.

48 hours: Damaged nerves repair themselves, restoring your sense of taste and smell.

Two weeks to three months: Blood flow improves, wounds heal more quickly, and it’s easier to walk and breathe.

One to nine months: You’ll have more energy and fewer symptoms such as coughing, congestion, fatigue, and shortness of breath.

One year: Your risk for heart disease is cut in half.

Five years: Compared to people smoking a pack a day, you’re half as likely to develop cancer in your mouth, throat, bladder, or esophagus. Your risk of lung cancer falls by nearly 50 percent.

10 years: Your risks of stroke and lung cancer are similar to those of someone who never smoked.

15 years: You’re now no more likely to develop heart disease than if you’d never lit a cigarette.

For more information on smoking cessation, speak with your primary care physician. Need a primary care physician or specialist? Call our Physician Referral Line at 866-757-6248 or go to sjmed.com and click on Find a Physician.

Freedom from Smoking Classes Available Locally As the lead agency for Tobacco-Free St. Joseph County, SJRMC works to eliminate the tobacco industry’s influence through advocacy, social alteration and policy change.

SJRMC offers: • The only nationally-certified tobacco specialist in the county • Bilingual tobacco education to over 1,200 individuals • Tobacco education to teens in more than three counties For more information contact Jill Sabo at 574-335-3896 or email saboj@sjrmc.com.

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The Future of OB/GYN

Hospital Care in the United States

Tracy Swetz Byrne, MD

Medical Director, The Family Birthplace

8 Michiana Medical Update I Summer 2013

Saint Joseph Regional Medical Center (SJRMC) and OB/GYN Associates of Northern Indiana (OBNI), a division of Allied Physicians of Michiana, LCC, have joined forces to offer an unparalleled level of maternal-child services to Michiana, with the recent launch of the OB Laborist Program at the Mishawaka Campus.

Offered through The Family Birthplace, this specialized program consists of board-certified OB/GYNs from OBNI who are onsite throughout the night and on weekends to provide the highest level of care to pregnant and laboring women. The first of its kind in the area, this service gives our families greater peace of mind when it matters most.

The Laborist Program provides SJRMC patients with immediate access to a board-certified OB/GYN physician should the need arise in the middle of the night.

The expert team of OBNI physicians, supported by our hospital staff, is here to provide immediate consultation, emergency management or assistance in delivery or cesarean section.

The Laborist Program does not change the relationship the patient has with her regular OB/GYN physician. Instead, the role of the Laborist is to provide timely,

SJRMC Launches Resource For Moms and Dads-to-be:

YourBabyStop.com This community defines us. That’s why SJRMC has launched a local, resource-based website for moms and dads-to-be. YourBabyStop.com connects users with websites, apps, books, blogs, and more on topics from pregnancy and baby preparations to nesting, newborn care and financial expectations. Dads and siblings can also find helpful information specific to their roles during this special time.

YourBabyStop.com is a unique site that also offers: • Information on SJRMC’s OB, Laborist & Level III NICU programs.

• Opportunities to sign up for SJRMC childbirth classes and OB unit tours.

• Rotating “Featured Vendor” discount coupons.

• A chance for users to find, suggest and share their favorite resources.

SJRMC is proud to serve our community in this new capacity.

Visit YourBabyStop.com today to learn more about this special delivery and spread the word to expectant and new parents in our area.

advanced care for patients who are at the hospital with emergent needs.

The board-certified OB/GYN physicians of OBNI include: Michele L. Ashton, MD, FACOG Tracy Swetz Byrne, MD, FACOG Leonard R. Ferguson, MD, FACOG Kelly Wayne McGuire, MD, FACOG “We are seeing this model not as a trend, but now developing into the future of OB/GYN hospital care in the United States,” says Tracy Byrne, MD, Medical Director of The Family Birthplace. “This new partnership and the depth of resources offered by the SJRMC health system ensure a direct connection to high-risk and advanced care, if and when needed.”

The program is coupled with 24-hour dedicated OB anesthesia services and 24-hour access to a neonatologist to attend difficult births. SJRMC and OBNI are proud to set a new standard for access to specialty OB services and high quality care in the greater Michiana region. SJRMC also has the ability to provide immediate diagnosis and care for newborns who need extra attention in our Level III Neonatal Intensive Care Unit (NICU).

To learn more about delivering your baby at SJRMC in Mishawaka or Plymouth or to schedule a tour, call 866-757-6248 or go to sjmed.com. For your local resource for all things baby for moms and dads-to-be, visit YourBabyStop.com.

Pregnancy Past 30 Record numbers of women are becoming pregnant later in life. Research confirms that most women who become pregnant in their 30s and early 40s have safe, healthy pregnancies.

But they do face a higher risk of some problems: • Trouble conceiving.

Starting in their early 30s, women become less fertile, and it may take them longer to get pregnant.

• Complications during pregnancy. Women older than age 30 have a higher risk for diabetes and high blood pressure during pregnancy.

• Greater risk of miscarriage.

Women ages 35 to 45 have a 20 – 35 percent chance of miscarriage and women older than 45 have a 50 percent chance. For younger women, the rate is between 10 and 25 percent.

Early and regular prenatal care is key to having a healthy baby at any age. Discuss any pregnancy plans with your doctor, who can identify any special need you may have and help make suggestions.

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Laying the Groundwork P HY SI C I AN NET W O R K

Physicians of Midwest Cardiology Join with Cardiothoracic Surgeons to Enhance Patient Experience In April, the Saint Joseph Physician Network (SJPN) welcomed Midwest Cardiovascular Specialists into our network of care. Combined with our cardiothoracic surgery team, SJPN is providing our community with a new standard for cardiac care.

The newly affiliated practice, now named Midwest Cardiology, was the first to have accredited nuclear and echocardiogram labs in the Michiana area. For more than 30 years, it has provided our community with a full range of state-of-the-art cardiovascular treatments and procedures.

The highly advanced cardiac care physicians at Midwest Cardiology work together as a team to provide patients with the best and most promising treatment strategies. Their vision for the future of cardiovascular care could only be realized by joining the SJPN network.

“We are very excited to be joining the Saint Joseph healthcare team,” says Sachin Patel, MD. “Our services, paired with SJRMC’s cardiothoracic surgery team, lay the groundwork for providing the highest level of cardiac care for the Michiana area.”

“SJRMC has been partnering with the physicians at Midwest Cardiovascular Specialists for over 30 years because of their high degree of expertise and commitment to cardiac patient care,” adds Michael Savitt, MD, MSE. “This new structure will strengthen our ability to enhance the patient experience by working as an integrated heart care team.”

In 2012, SJRMC welcomed cardiothoracic surgeons Dr. Savitt and Dr. Ly to provide highly specialized treatment of heart and lung disease including open heart and bypass surgery, heart valve repair and replacement, treatment for lung cancer and disorders of the chest area, and all minimally invasive cardiac surgeries.

10 Michiana Medical Update I Summer 2013

for A New Era in Heart Care Michael Savitt, MD, MSE

Truc Ly, MD, FACC

Cardiothoracic Surgeon

Cardiothoracic Surgeon

Medical Education: Duke University Medical Education: Saint George’s University School of Medicine Residency: Surgery, Hospital of the University of PennsylvaResidency: General Surgery, Saint Joseph Mercy Hospital, nia & University of California, San Francisco Ann Arbor, MI Fellowship: Cardiothoracic Surgery, University of Minnesota Fellowship: Cardiothoracic Surgery, University of Texas Board Certification: Surgery & Thoracic Surgery Health Science Center; Adult Cardiac Surgery, Medical Interests: Cardiac & thoracic surgery, minimally invasive & robotic Northwestern University vascular heart surgery, surgical treatment of lung cancer, atrial fibrillation, Board Certification: General Surgery & Thoracic Surgery Medical Interests: Adult cardiac & thoracic surgery: minimally invasive heart vascular surgery of the thoracic aorta and lung surgery; surgical treatment of mitral and aortic valvular disease, atrial fibrillation, and vascular surgery of the thoracic aorta

Josephine Randazzo, DO, FACOI

Aajay Shah, MD

Undergraduate: Loyola University of Chicago Medical Education: Chicago College of Osteopathic Medicine Residency: Chicago Osteopathic Medical Centers Board Certification: Cardiology, Internal Medicine Medical Interests: Heart failure, preventive medicine, heart disease in women, arrhythmia management

Undergraduate: AG College, Ahmedabad, India Medical Education: NHL Medical College, India Residency: Tufts University, Boston Board Certification: Cardiology Medical Interests: Preventive cardiology, heart failure, atrial fibrillation, coronary heart disease

Cardiologist, Marshall County Cardiology Specialists

Cardiologist, Marshall County Cardiology Specialists

Farid Jalinous, MD, FACC, FSCAI

Sachin Patel, MD, FACC

Cardiologist, Midwest Cardiology

Cardiologist, Midwest Cardiology

William Sarnat, MD, FACC

Ajazuddin Shaikh, MD, FACC

Medical Education: Georgetown University School of Medicine Residency: Internal Medicine, Georgetown University Medical Center Fellowship: Cardiac Transplant Fellow & General Adult Cardiology, Georgetown University Medical Center; Interventional Cardiology, Minneapolis Heart Institute Board Certification: Cardiovascular Disease, Interventional Cardiology Medical Interests: Cardiology, interventional cardiology

Cardiologist, Midwest Cardiology

Cardiologist, Midwest Cardiology

Medical Education: Wayne State University Residency: Internal Medicine, Michael Reese Hospital & Medical Center Fellowship: Cardiology, University of Iowa Hospitals & Clinics Board Certification: Internal Medicine, Cardiovascular Disease Medical Interests: Cardiology

Ashfaq Turk, MD, FACC Cardiologist, Midwest Cardiology

Medical Education: University of Southampton Residency: Internal Medicine, Medical Center of Delaware Fellowship: Four year Clinical & Research Fellowship in Cardiology, Thomas Jefferson University Hospital Board Certification: Cardiovascular Disease Medical Interests: Cardiology

Medical Education: University of Sind, Pakistan Residency: Internal Medicine, College of Medicine at University of Illinois Urbana-Champaign Fellowship: Interventional Cardiology & Adult Cardiology, Mount Carmel Medical Center Board Certification: Cardiovascular Interventional Cardiology, Cardiovascular Disease & Internal Medicine Medical Interests: Cardiovascular interventional procedures, PV disease, endovascular interventions & abdominal aortic aneurism repairs

Medical Education: Liaquat Medical College, Pakistan Residency: Internal Medicine, Louis A. Weiss Hospital, Chicago Fellowship: Cardiology, University of Illinois at Chicago Board Certification: Cardiovascular Disease, Internal Medicine Medical Interests: Cardiology

SJPN is pleased to welcome Mohamed Homsi, MD, Electrophysiologist, and Zachary J. Leshen, MD, Interventional Cardiologist.

Both will be joining Midwest Cardiology this July.

For more information, contact: Saint Joseph Cardiothoracic Surgery at 574-335-6000 Marshall County Cardiology Specialists at 574-948-5340 Midwest Cardiology at 574-232-5928

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Helmets Essential for Bike Almost three in four kids ages 5 to 14 ride bikes.

And every one of their parents fears for their safety.

Paula Toth-Russell, MD

South Bend Neurology On staff at SJRMC

While you can’t prevent every accident, you can take an important step to protect your young cyclist. Have him or her wear a helmet.

“The most serious and potentially fatal injuries in bicycle accidents are due to head trauma,” says Paula Toth-Russell, MD. “In the event of a bicycle accident, helmet use has been estimated to reduce head injury

12 Michiana Medical Update I Summer 2013

risk by at least 80 percent or greater.

Unfortunately, the vast majority of deaths associated with bicycle injuries involve people not wearing helmets.”

Choose a helmet that fits properly and has a label inside that says “CPSC.” That means it’s been tested for safety. Talk to your child about these other bicycle safety tips and rules of the road.

Adjust your bicycle to fit. Stand over your bicycle. There should be 1 to 2 inches between you and the top tube (bar) if using a road bike and 3 to 4 inches if a mountain bicycle. The seat should be level front to back. The seat height should be adjusted to allow a slight bend at the knee when the leg is fully extended. The handlebar height should be at the same level with the seat.

Check your equipment. Before riding, inflate tires properly and check that your brakes work.

See and be seen. Always wear neon, fluorescent, or other bright colors when riding, day or night. Remember, just because you can see a driver doesn’t mean the driver can see you.

Control your bicycle. Always ride with at least one hand on the handlebars.

Carry books and other items in a bicycle carrier or backpack.

Watch for and avoid road hazards.

Be on the lookout for hazards such as potholes, broken glass, gravel, puddles, leaves, and dogs. If you are riding with friends and you are in the lead, yell out and point to the hazard to alert the riders behind you.

Avoid riding at night. It is far more dangerous to ride at night than during the day because you are harder for others to see. If you must ride at night, wear bright, reflective clothing and ensure your bike has headlights and taillights.

Road Rules • Stop and check for traffic in both directions when leaving your driveway, an alley or a curb.

• When with friends, always ride single file on the street.

• Ride with your hands on the handlebars.

• Use bike lanes wherever you can.

• Stop at all stop signs and obey streetlights just as cars do.

• Cross the street only at intersections.

• Never ride against traffic. Ride on the right-hand side of the street, so you travel in the same direction as cars do.

Need to find a primary care physician or specialist? Call our Physician Referral Line at 866-757-6248 or visit sjmed.com and click on Find a Physician.

Bike Safety Quiz Take our Bike Safety Quiz and submit your entry for a chance to win a free bicycle helmet. Take the quiz, check your answers at the bottom of the page and mail this page to: Saint Joseph Regional Medical Center Attn: Marketing 5215 Holy Cross Pkwy.

Mishawaka, IN 46545

Here’s your chance to win one of five bike helmets!

This offer is open to children under 12.

1) W hen should a bike helmet be worn? a. Only when you are riding in the street b. Every time you ride your bike c. Only when you are riding in heavy traffic

6) Always use the bike path, if there is one. a.True b. False

2) A bicyclist should use hand signals: a. When turning left or right b. To let vehicles know your intentions c. At stop signs d. All of the above

8) Your helmet fits correctly if: a. It rocks from side to side when you shake your head b. The strap digs into your chin and hurts c. It sits level on your head and one or two finger-widths above your eyebrow

3) When riding your bike, you do not have to stop at all red lights and stop signs. a.True b. False 4) You should walk your bike across busy intersections. a.True b. False 5) You should ride your bicycle: a. On the left side of the road against the flow of traffic b. In the middle of the road c. On the right side of the road with the direction of traffic

7) It’s okay to wear your headphones while riding your bike. a.True b. False

9) If an emergency vehicle with a siren comes by, you should: a. Pedal faster to get to your destination before it passes you b. Slow down, but keep going c. Pull over to the side and stop 10) If you are riding with friends, you should ride: a. Side-by-side so no one can pass you

b. It does not matter

c. Single file

NAME:__________________________________________________ AGE:_____ PARENT/GUARDIAN NAME:_________________________________________ PHONE NUMBER:__________________________________________________ ADDRESS:_________________________________________________________ __________________________________________________________________ Deadline for submission: June 30, 2013

1) b, 2) d, 3) b, 4) a, 5) c, 6) a, 7) b, 8) c, 9) c, 10) c

Safety



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Welcome to Priority Care

Membership

Recognizing the need for an after-hours alternative to urgent care and emergency room visits for non-emergent medical care, SJRMC created Priority Care, a primary care practice that is open after-hours and over the weekend.

This program, the first of its kind in this area, strives to make medical care available as a value-added benefit to patients of the SJRMC network practices.

Has Its Privileges

Did you know that if your primary care physician is with the Saint Joseph Physician Network (SJPN), you have a convenient and cost-effect alternative to non-emergent medical care?

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Interested in Benefiting from Priority Care?

Advantages of Priority Care • Staffed by SJRMC network doctors • No appointment necessary • Open Monday through Friday – 5 to 9 pm, Saturday – 9 am to 5 pm, Sunday – Noon to 5 pm • Cost is the same as a regular physician office visit

Who Has Access to Priority Care?

Priority Care is an exclusive benefit available to: • Patients of the Saint Joseph Physician Network practices • Patients of Family Medicine Faculty physicians • Patients of Family Medicine Center • Patients of School City of Mishawaka Employee Clinic “We recognize that it is not always convenient to see your doctor during office hours,” says Michael Ferry, Interim Administrative Director, Saint Joseph Physician Network. “So we created Priority Care as a convenient, cost-effective alternative for the valued patients of our network.”

If your primary care physician is part of the Saint Joseph Physician Network, Family Medicine Faculty Physicians, the Family PHYSICIAN NETW O RK Medicine Center, or School City of Mishawaka Employee Clinic, this benefit is already available to you. If you would like to find a doctor with this network, we have several physicians located throughout Michiana who are currently accepting new patients.

Physicians Currently Accepting Patients

Lindsey Anderson, MD Granger Community Medicine On staff at SJRMC 574-335-8300

Melanie Gatewood, MD Community Pediatric Physicians On staff at SJRMC 574-335-6242

Camille Kureth, MD Community Pediatric Physicians On staff at SJRMC 574-335-6242

Jean Miller, DO University Park Family Medicine On staff at SJRMC 574-335-8400

Frank Murphy, MD Northwest Family Medicine On staff at SJRMC 574-335-8450

Michelle Pearson, MD River Park Family Medicine On staff at SJRMC 574-335-8399

Richard Zentz, DO University Park Family Medicine On staff at SJRMC 574-335-8400

Martin Wieschhaus, MD Family Medicine Faculty Physicians On staff at SJRMC 574-335-6580

Jennifer Ludwig, MD Family Medicine Faculty Physicians On staff at SJRMC 574-335-6580

Brian Huber, MD Family Medicine Faculty Physicians On staff at SJRMC 574-335-6580

Leah Ortiz, MD Family Medicine Faculty Physicians On staff at SJRMC 574-335-6580

Theodore Neumann, MD Family Medicine Faculty Physicians On staff at SJRMC 574-335-6580

How Priority Care Works Devoted to bringing you a higher level of service when your primary care physician’s office is closed, Priority Care is located at the Medical Office Building on the SJRMC hospital campus in Mishawaka. A Priority Care physician will conduct your exam and provide you with the appropriate discharge information. Your regular doctor will be notified of your visit so that appropriate follow-up care can be coordinated.

Priority Care Hours & Location Monday through Friday – 5 to 9 pm Saturday – 9 am to 5 pm Sunday – Noon to 5 pm David Wyncott, MD Family Medicine Faculty Physicians Starting on staff at SJRMC July 1, 2013 574-335-6580

Priority Care 611 E. Douglas Rd., Ste. 105 Mishawaka, IN 46545 574-335-6599

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Uncovering Sleep Disorders

Better sleep leads to better health

Our bodies need sleep to function properly. Without enough shut-eye, we’re more likely to experience moodiness, confusion, slowed reaction time and poor concentration. Research shows that too little sleep is linked to diabetes, depression, obesity, cardiovascular Michael Englert, MD disease, and even heart attacks.

South Bend Neurology “With sleep consuming one-third On staff at SJRMC of our lives, the effect it has on our well-being cannot be overstated,” says Michael Englert, MD. “Sleep affects all organ systems and poor sleep can potentially have wide-spread adverse consequences on all aspects of our health.”

A study published in Circulation found that people who suffer from frequent insomnia have a higher risk of heart attack, and women may be especially at risk.

A Chronic Problem?

Could you have a sleep disorder?

Talk to your primary care physician.

Need a primary care physician or specialist? Call our Physician Referral Line at 866-757-6248 or go to sjmed.com and click on Find a Physician.

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An occasional restless night likely isn’t cause for concern.

But chronic sleep problems may indicate a sleep disorder.

One of the most common is insomnia, the inability to fall or stay asleep at least three nights a week for more than a month. Sleep apnea is another prominent sleep problem. People with sleep apnea periodically gasp or temporarily stop breathing while asleep, causing sleep interruptions.

Most adults function best after seven to nine hours of sleep. But each person’s sleep needs are different. Talk with your doctor. You may have a sleep disorder if you experience any of the following on three or more nights a week: • You aren’t able to fall asleep within 30 minutes after going to bed.

• You frequently wake up at night and have problems falling back asleep.

• You feel sleepy during the day and may nod off unexpectedly.

• You don’t feel well-rested after sleeping seven or more hours.

The reasons for unsound sleep vary. Possible sleepstealers include stress, caffeine, alcohol, certain medications, and conditions such as heartburn and arthritis. But bad sleep habits are often to blame. Simple lifestyle changes, such as following a consistent sleep schedule—going to sleep and awakening at the same time every day—and keeping your bedroom TV- and gadget-free can help alleviate many sleep problems. For chronic sleep troubles, your doctor may recommend medication or refer you to a sleep specialist.

Breathe Easy:

Relief for Severe Asthma Now Available Have you or a loved one frequently missed work or school, or even needed to visit the emergency room on a re-occurring basis due to severe asthma? If so, you may be interested in a new, non-drug, outpatient procedure offered at Saint Joseph Regional Medical Center called bronchial thermoplasty.

Bronchial thermoplasty is a FDA-approved procedure for the treatment of severe, persistent asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids or long-acting beta-agonists.

“Treatment using this procedure has been shown to improve the quality of life for those suffering from severe asthma by reducing asthma attacks, decreasing visits to the emergency room and less lost time from work, school, or other activities,” says Paul Guentert, MD. Performed under moderate sedation or light anesthesia, this minimally invasive bronchoscopic procedure is performed by a trained physician, typically a pulmonologist. The procedure is performed in three outpatient visits, scheduled approximately three weeks apart, each treating a different area of the lungs. After all three procedures are performed, the bronchial thermoplasty treatment is complete.

Paul Guentert, MD

Pulmonary and Critical Care Associates, PC On staff at SJRMC

Am I a Candidate for Bronchial Thermoplasty?

You may be a candidate for bronchial thermoplasty if you are: • 18 years or older and have severe, persistent asthma • Have asthma that is not well controlled despite taking inhaled corticosteroids and long-acting bronchodilators You are not a candidate for bronchial thermoplasty if you have: • A pacemaker • Internal defibrillator • Other implantable electronic device like a pacemaker Your bronchial thermosplasty treatment may be delayed if you have any of the following conditions: • Active respiratory infection • Asthma attacks or changing dose of systemic corticosteroids for asthma in the past 14 days • Known bleeding disorder • Unable to stop taking anticoagulants, antiplatelet agents, aspirin, or non-steroidal anti-inflammatory medications (NSAIDS) before the procedure

For more information on bronchial thermoplasty, speak with your primary care physician. Need a primary care physician? Call our Physician Referral Line at at 866-757-6248 or go to sjmed.com and click on Find a Physician.

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On Your Feet:

Foot Ailments You Shouldn’t Ignore

Damian Dieter, DPM Portage Foot Clinic On staff at SJRMC

“Walk it off!” is advice that athletes may give one another when an injury occurs on the playing field. But when pain radiates from the foot itself, this tough-it-out approach can needlessly delay recovery and contribute to disabling problems.

Three common foot ailments—plantar fasciitis, sprained ankle, and Achilles tendonitis—require medical attention to prevent long-term discomfort and possible complications. Here’s how to recognize these disorders.

Plantar fasciitis is inflammation of the tissue on the sole of the foot, extending from heel to toes. The result is persistent heel pain that gradually worsens over several months. This pain often flares up first thing in the morning or after sitting for prolonged periods. People with foot arches that are overly flat or overly high are most susceptible.

“Structure and function go hand in hand,” says Damian Dieter, DPM. “As the large heel bone rolls outwards, the height of the arch decreases, putting extra tension on the plantar fascia and causing it to become overstressed. If the foot does not function properly and the heel bone does not turn back in throughout the gait cycle, then the arch collapse continues and never bounces back to normal.”

Stretching, ice, medicine, and other traditional treatments can help, but the key is to keep the foot in proper position from step to step. Obesity, wearing shoes

Have you been benched by foot pain? For more information about joint sprains, muscle strains, and other injuries, speak with your primary care physician. Need a primary care physician or specialist? Call our Physician Referral Line at 866-757-6248 or go to sjmed.com and click on Find a Physician.

18 Michiana Medical Update I Summer 2013

with poor support, and an occupation requiring long periods of standing can also trigger plantar fasciitis.

A physician’s assessment is necessary for proper diagnosis and treatment. Effective therapy includes stretching exercises, orthotic shoe supports, and a foot splint worn while sleeping at night.

Sprained ankles occur about 25,000 times a day.

This painful injury results when the ligaments holding the ankle bones and joint are stretched beyond their normal range. Always seek medical care for a sprain.

A physician will assess the severity of the injury and recommend appropriate treatment, which may include diagnostic tests, rest, compression wraps, and rehabilitation. Improperly treated, a sprain may lead to chronic ankle instability and weakness, and susceptibility to future sprains.

Achilles tendonitis/tendonosis is a persistent aching, stiffness, tenderness, or pain in the tendon that connects the calf muscle to the heel bone. It’s common among so-called “weekend warriors” because the condition typically develops after a sudden increase in physical activity. The pain associated with the condition is caused by microscopic tears in tendon fibers. Improperly treated, this ailment can result in chronic long-term pain.

Rest and ice provide short-term relief. But the most effective long-term treatment may involve pain medication, physical therapy and immobilization of the foot in a cast or a removable walking boot.

Have Tendon Pain? We Can Help.

New minimally invasive FAST Technique offers patients a new treatment option for tendon-related injuries TM

More than 10 million people in the U.S. suffer severe pain due to tendon scar tissue, which limits their range of motion and keeps them from living an active life. Until recently, the only treatments available were rest, pain medication, cortisone injections or physical therapy. Open surgical procedures provide an alternative, but carry risks, including damage to the surrounding healthy tissue and a lengthy recovery time.

A new advanced treatment that quickly and safely removes the source of tendon pain is now available at Saint Joseph Regional Medical Center (SJRMC).

Stephen Simons, MD, is one of the first doctors in the country trained to perform the new Fasciotomy and Surgical Tenotomy (FAST) Technique. Based on technology developed in collaboration with the Mayo Clinic, the FAST Technique is a minimally invasive treatment option for tendon and soft tissue injuries, such as tennis elbow, golfer’s elbow, jumper’s knee, Achilles tendonitis, and plantar fasciitis.

Unlike conventional treatments, the FAST Technique removes damaged tissue in a minimally invasive manner. The technique usually takes 15 minutes or less, requires only an adhesive bandage to close the micro-incision and offers a quick recovery.

“Chronic tendon-related injuries are common problems without a good solution,” says Dr. Simons.

“With the FAST Technique, I’m able to intervene

Stephen Simons, MD earlier in my patients’ care, change the nature of the disease and get them back to their daily activities.”

The technique is performed using a local anesthetic.

Patients are awake and alert through the entire procedure. Conventional ultrasound imaging is used to identify the location of the scar tissue. Then, an instrument the size of a toothpick is inserted into the damaged tendon. It delivers ultrasonic energy specifically designed to cut, break up and remove damaged tissue safely and quickly, without disturbing the surrounding healthy tissue. The procedure can be done in the office or in a hospital setting if the patient prefers sedation.

The FAST Technique is considered if pain and weakness continue after all other treatment options such as rest, therapy and medications fail.

Saint Joseph Sports Medicine Institute On staff at SJRMC

To learn more about the FAST Technique, contact the Sports Medicine Institute at 574-335-6214.

Preventing Tendon Injuries • Warm up before any activity, and stretch gently after you finish.

• Strengthening your muscles can reduce stress on your soft tissues. A physical therapist, an athletic trainer, or your doctor can teach you specific exercises for strengthening specific areas.

• In your daily routine, change activities involving repeated movements that may strain your muscles or joints.

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Summer Sandwiches When you want to beat the heat, serve cold sandwiches for lunch or dinner. Pump up the nutrition by taking advantage of the abundance of summer produce—sliced tomatoes and cucumbers, fresh lettuce, and onion slivers.

The Ginger Shrimp Open-Faced Sandwiches can be served as an appetizer or midday snack. The Apple Tuna Sandwich lightens up a high-fat favorite by substituting vanilla yogurt for mayonnaise.

Apple Tuna Sandwich Ingredients:

2 6-oz. cans unsalted tuna in water, drained 1 medium apple, chopped 1 celery stalk, chopped ¼ cup low-fat vanilla yogurt 1 tsp. prepared mustard 1 tsp. honey 6 slices whole wheat bread 6 lettuce leaves 6 slices tomato

Ginger Shrimp Open-Faced Sandwiches Ingredients:

4 oz. soft light cream cheese 1-inch piece fresh ginger, peeled and minced 1 tsp. low-sodium soy sauce 24 cooked medium shrimp, about 1/2 lb.

4 scallions, trimmed and washed 24 grape tomatoes 24 slices whole wheat cocktail bread

Directions:

Directions:

Combine and mix the tuna, apple, celery, yogurt, mustard, and honey. Spread ½ cup of the mixture on three bread slices. Top each slice of bread with lettuce, tomato, and remaining bread slice. Cut sandwiches in half or as desired. Makes three sandwiches.

In a small bowl, mix cream cheese, ginger and soy sauce. Set aside. Slice shrimp lengthwise. Chop scallions into rings. Halve grape tomatoes lengthwise. Spread ginger-soy cream cheese on cocktail bread slices. Arrange two halves of shrimp and tomato and a sprinkle of scallions on each slice. Serve at once or refrigerate until ready. Makes 24 mini-sandwiches.

Per Serving: calories–330, fat–4 g, saturated fat–1 g, calories from fat–11%, cholesterol–35 mg, sodium–370 mg, carbohydrates–37 g, fiber–6 g, protein–38 g

Per Serving: calories–47, fat–1 g, saturated fat–0.5 g, calories from fat–19%, cholesterol–21 mg, sodium–112 mg, carbohydrates–5 g, fiber–1 g, protein–10 g

Healthy Cooking Starts in the Herb Garden Want to trim fat and sodium from your cooking without sacrificing flavor? Fragrant herbs liven up even the simplest recipes.

You can grow herbs in a sunny section of your backyard. A windowsill that gets ample sunlight also is the perfect spot for small pots of parsley, basil, and chives.

Dill, tarragon, or thyme are great for seasoning fish. Try oregano, rosemary, or sage when preparing chicken. Basil, chives, and parsley are great additions to salads and vegetables.

20 Michiana Medical Update I Summer 2013

Explore the Great Outdoors Near You It’s summer—time to gather up the family, load up the car, and explore the great outdoors. Consider these state and county parks within easy driving distance to most people in our area.

Indiana State Parks (Northern Indiana)

Indiana Dunes State Park Indiana Dunes includes 15 miles of coastline, more than 70 miles of trails, and hundreds of species of birds. For more information, visit www.indianadunes.com.

Potato Creek State Park A haven for campers, fishermen, bird watchers, and boaters, this 3,800-acre park has bike trails, bridle trails, mountain bike trails, and more. For more information, visit www.visitsouthbend.com.

St. Joseph County Parks This group of nature preserves—Bendix Woods in New Carlisle, Ferettie/Baugo Creek in Osceola, and St. Patrick’s Park in South Bend—offers ample opportunities for picnicking, hiking, bird watching, and bicycling.

For more information, visit www.sjcparks.org.

Elkhart County Parks Whether you’re fishing, picnicking, or pitching a tent, these parks are for you. For more information about Bonneyville Mill County Park in Bristol, River Preserve and Ox Bow Park in Goshen, Cobus Creek in Elkhart, and Pumpkinvine Nature Trail in Middlebury, visit www.elkhartcountyparks.org.

Marshall County Parks Centennial Park on the banks of the Yellow River in Plymouth is home of the popular Blueberry Festival (Aug. 30-Sept. 2) and many other community events. Jellystone Park in Plymouth includes a campground with beach, paddleboat rentals, fishing, and more for the whole family.

Cass County Parks Michigan Set your GPS for Cass County for a host of outdoor activities from mountain biking and hiking to bird watching, boating, and swimming. T.K. Lawless Park in Vandalia, Fred Russ Forest Park in Decatur, Arthur Dodd Memorial Park in Niles, and Harmon Park on the Shavehead Peninsula in Cassopolis are popular year-round recreation spots, and are especially fun during the summer. For more information, visit www.casscountymi.org.

Mark Your Calendars for These Important Health Observances June is…

National Men’s Health Month. Men are more at risk for death from heart disease and chronic liver disease than women, and face unique health challenges such as prostate cancer. Yet men are often reluctant to seek care, reports the U.S. Department of Health and Human Services. Urge the men you love to get screening tests that can detect medical problems early and help safeguard their long-term health.

July is…

National UV Safety Month. Enjoy the sun, but protect your skin against ultraviolet radiation. UV rays are the primary cause of skin cancer, age spots and wrinkles, so limit sunbathing, wear protective clothing, and always wear sunscreen with a minimum SPF of 15 or higher, advises the Environmental Protection Agency.

August is…

Child’s Eye Health and Safety Month.

One in three children under age 6 have never had an eye examination, yet the Centers for Disease Control and Prevention reports that 12.1 million have vision problems. Early detection increases the likelihood of effective treatment, so the CDC recommends regular eye exams for your youngsters.

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Is it Heartburn or GERD? Queasy stomach.

Burning sensation in your chest. Bitter acid taste in your mouth. These symptoms might be heartburn. Or, depending on frequency, they might signal a chronic illness called gastroesophageal reflux disease (GERD).

What Is GERD?

Treatment Options

When the muscle valve at the lower end of the esophagus doesn’t close completely, stomach acid can flow back up into the esophagus, causing the burning discomfort of heartburn. If you have frequent heartburn, you may have GERD. According to Brian L. Piazza, MD, who treats GERD, “When GERD goes undiagnosed and treated, serious complications can occur, including severe chest pain, a narrowing or obstruction of the esophagus, bleeding, or Barrett’s esophagus, a precancerous condition.”

“There are some simple lifestyle changes that can help relieve GERD,” says Dr. Piazza. These include: • Maintaining a healthy weight • Eating smaller meals • Avoiding fatty, fried, or spicy foods; alcohol; chocolate; and caffeine • Not smoking • Medication

Separating Heartburn from GERD A test that monitors the amount of acid in the esophagus can help determine if frequent or uncontrollable heartburn is GERD. “We use the Bravo esophageal pH test at SJRMC because it’s much more comfortable for patients than the conventional catheter method,” explains Dr. Piazza.

During this test, a tiny pH capsule is attached to your esophagus. The capsule measures pH levels and transmits readings to a pager-sized receiver that is worn for 48 hours. The receiver has several buttons that let you record symptoms such as heartburn as they occur.

For more information on GERD, speak with your primary care physician. Need a primary care physician or specialist? Call our Physician Referral Line at 866-757-6248 or go to sjmed.com and click on Find a Physician.

22 Michiana Medical Update I Summer 2013

“If lifestyle changes don’t work,” says Dr. Piazza, “there are drug treatments that decrease the production of acid.”

Brian L. Piazza, MD Marshall County Surgery Associates, On staff at SJRMC

Incisionless GERD Solution In cases where medication isn’t effective, SJRMC offers an innovative procedure that treats the underlying cause of GERD without incisions.

ExophyX TIF allows surgeons to lower a scope through the mouth and reconstruct the antireflux valve, restoring the body’s natural protection against GERD. “Patients have an 80 percent chance of coming off their acid-blocking medications after this procedure,” explains Dr. Piazza, one of only two ExophyX TIF–trained surgeons in Michiana.

Other patient benefits include rapid recovery, no scarring, and a return to a normal diet within about two months.

“Saint Joseph’s investments in innovative diagnostic and surgical tools help us determine which patients will benefit most from treatments like ExophyX TIF and give them the highest possible standard of care,” says Dr. Piazza.

Upcoming Events at SJRMC Obstetrics & Fertility Care

Diabetes Education

Childbirth Classes – Mishawaka Campus

Sept. 7 (Noon) Sept. 16 (6 pm)

Two-Session, Tuesday Class: (6 – 8:30 pm) Please bring pillows.

July 2 & 9 Aug. 6 & 13 Sept. 3 & 10

Registration is required.

For more information or to register, call 866-757-6248.

Taking Charge of Your Diabetes This class, designed to provide education and self-management skills, is recommended for people newly diagnosed with diabetes and those not previously educated in diabetes care. The fee is covered by most insurances and Medicare.

Two-Session, Thursday Class: (6 – 8:30 pm) Please bring pillows.

July 11 & 18 Aug. 1 & 8 Sept. 5 & 12 One-Session, Saturday Class: (9 am – 2:30 pm) Bring pillows and lunch.

June 22, July 27 Aug. 24, Sept. 8 Registration is required.

For more information or to register, call 866-757-6248.

Childbirth Classes – Plymouth Campus One-Session, Saturday Class: (10 am – 2 pm) Please bring a lunch.

Snacks will be provided.

June 22, July 27 Aug. 31, Sept. 28 Registration is required.

For more information or to register, call 866-757-6248.

Mishawaka OB Unit Tours Expectant mothers and couples are invited to attend a free tour of The Family Birthplace at our Mishawaka Campus.

June 17 (6 pm) July 6 (Noon) July 15 (6 pm) Aug. 3 (Noon) Aug. 19 (6 pm)

Sibling Classes For children ages 3 – 5, this class helps set realistic expectations for big brothers and sisters.

A parent must attend with each child. Please bring a stuffed toy.

One-Session Class: June 17 (5 – 6 pm) July 6 (11 am – Noon) Aug. 19 (5 – 6 pm) Sept. 7 (11 am – Noon) Registration is required.

For more information or to register, call 866-757-6248.

FertilityCare Center Classes These sessions introduce the Creighton Model FertilityCare System. This scientific system assists couples wanting to effectively achieve or avoid pregnancy as well as women seeking solutions for infertility, miscarriage, endometriosis, PCOS and much more.

One-Session Class: (7 – 8:30 pm) July 9, 25 Aug. 8, 19 Registration is required. For more information or to register, call 574-335-6474.

Mishawaka Campus: Four-Session Class: July 9, 16, 23, 30 (5:30 – 8 pm) Aug. 13, 14, 15, 16 (1 – 3:30 pm) Plymouth Campus: Three-Session Class: June 18, 19, 20 (9 am – Noon) July 16, 17, 18 (4 – 7 pm) Aug. 20, 21, 22 (1 – 4 pm)

Senior Services Senior Fit This exercise program for those age 55 and older focuses on increased energy, reduced joint pain, lower blood pressure, increased strength and better balance. It’s free to 55+ members with written permission from their healthcare provider.

A physician’s order is required to attend Taking Charge of Your Diabetes.

Registration is required.

For more information or to register, call 574-247-5400.

Diabetes Support Group – Mishawaka Attendees and families can provide support and insight by sharing experiences and tips for better health.

July 17 (5 – 6 pm) Sept. 18 (5 – 6 pm) Free. No registration is required.

For questions or more information, please contact SJRMC’s Diabetes Educators at 574-335-2372.

O’Brien Center: Tuesdays & Thursdays (10:40 – 11:20 am) Martin Luther King, Jr. Recreation Center: Monday, Wednesday & Friday (10:30 – 11:15 am) Sanctuary at St. Paul’s: Monday & Wednesday (5:45 – 6:30 pm) For more information, call 574-335-3891.

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Saint Joseph Regional Medical Center South Bend Campus 5215 Holy Cross Pkwy.

Mishawaka, IN 46545

Nonprofit org.

U.S. Postage

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Saint Joseph Regional Medical Center South Bend Campus

Having a Baby?

Learn about our Laborist Program. page 8

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