healthmatters Jeanes Hospital
Sophisticated Care. Personal Touch.
Cancer Risk Factors and Prevention for Women Also inside ④ t eamwork targets faster diagnosis for heart attack patients ⑤ FAST: The One Word that Can Save a Life During a Stroke ⑥ H yperbaric Oxygen Therapy for wounds that won’t heal
www.jeanes.com
Fall 2012
Women’s health matters
Cancer Risk Factors and
Prevention for Women S
ome cancer risk factors, such as family history, age, and ethnicity, are beyond your control. But you can change other factors, including diet, smoking, and exercise. Read on to learn about some risk factors and prevention strategies for five types of cancer. Breast Cancer Breast cancer most often strikes women older than age 40, and the risk continues rising with age. “Other risk factors besides age include having a breast cancer gene, a family history of this disease, beginning menstruation early, beginning menopause
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health matters // Fall 2012
late, drinking alcohol, and obesity,” said Mary Daly, MD, PhD, FACP, chair of the Department of Clinical Genetics at Fox Chase Cancer Center. You can’t change some breast cancer risk factors, but you can control others. “To lower your chances of developing this disease, maintain a healthy weight and drink no more than three alcoholic drinks per week,” said Debra Somers, MD, FACOG, a gynecologist with Temple Physicians. “Also, don’t smoke, get plenty of exercise, and talk to your doctor about when to begin regular screening mammograms.”
Uterine Cancer “Experts believe that hormone imbalances most often are to blame for uterine cancer,” said Dr. Somers. Other risk factors include: • Being older than age 50 • A family history of this cancer • Obesity • Being African-American • Beginning menopause late • Beginning menstruation early • A history of breast, colorectal, or ovarian cancer Try to avoid as many uterine cancer risk factors as possible. “Keep your
weight in check with regular exercise and a healthy diet,” Dr. Daly said. “Also, discuss other potentially protective steps with your doctor.” Melanoma Melanoma is the most uncommon — but most deadly — skin cancer. “Blond or red hair, fair skin, a family history of this cancer, freckles, and blue eyes can raise the risk for melanoma,” Dr. Daly said. “So might a history of blistering sunburn, many normal moles, any abnormal moles, and tanning bed use.” Healthy habits may lower your melanoma risk. “Some smart steps are using sunscreen, avoiding tanning beds and excessive sun exposure, and getting regular skin cancer checks from your doctor,” Dr. Somers said. Cervical Cancer This type of cancer begins in the cervix, which connects the uterus and vagina. It most often strikes women in their 40s. The most significant risk factor is infection with some forms of the human papillomavirus. HPV is a very common virus that can be transmitted through sexual activity and intimate skin-to-skin contact. Other risk factors include: • A diet low in fruits and vegetables • Smoking • Personal or family history of the disease • Long-term oral contraceptive use Fortunately, cervical cancer is very preventable. Ask your doctor about
Mary Daly, MD, PhD, FACP Clinical Genetics
Pap tests, which can detect cervical changes early. Not smoking, limiting the number of sexual partners, eating healthy, and using condoms during intercourse also might help protect you. Bladder Cancer “Bladder cancer is much more common among men than women,” said Tia Schellato, DO, a urologist with Urologic Consultants of Southeastern Pennsylvania. “Nevertheless, experts estimate that 18,000 American women will be diagnosed with bladder cancer this year.” Some other risk factors besides gender are: • Being Caucasian • Age, since most cases occur in people older than age 70 • A family history of bladder cancer • Smoking • Exposure to chemicals used in the printing, rubber, metal, textile, and other industries • Long-term bladder infections and irritation “You may be able to help protect yourself by not smoking, eating plenty of fruits and vegetables, drinking a lot of fluids, and avoiding potential workplace hazards,” Dr. Schellato said. The more you know about cancer risk factors, the more you can protect yourself. Make it a point to discuss these risk factors with your doctor, and use this information to take charge of your health and wellness.
Debra Somers, MD, FACOG Gynecology
Total Care for Women. In a Place Created for Women. Temple Health Women’s Care is located at 8380 Old York Road, on the beautiful Salus University Campus, in Elkins Park. Women of all ages can receive a comprehensive health care and wellness experience in an environment created with women in mind. Included is Jeanes Hospital’s Women’s Imaging Center, offering digital mammography, ultrasound, and Dexa scans. To make an appointment or for more information, call 215-517-5000 or visit www. templehealthwomens.org.
Tia Schellato, DO Urology
www.jeanes.com
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Heart health matters
Teamwork Targets
Faster Diagnosis
F
rom the moment paramedics bring a severe heart attack patient to the emergency department (ED), the clock starts ticking. If the patient can get from the door of the ED to the cardiac catheterization lab for a procedure that restores blood flow to the heart, such as balloon angioplasty, in a “door-to-balloon” time of 90 minutes, that’s success, according to the American Heart Association. Studies show that patients treated within 90 minutes suffer less heart damage and have an improved chance of survival. Through a partnership with Burholme Emergency Medical Services (EMS), a private ambulance service covering more than 100,000 homes in northeast Philadelphia, and the use of wireless technology, Jeanes Hospital has reduced its door-to-balloon time to as little as 58 minutes. “Data shows that if you restore blood flow within 60 to 90 minutes of a heart attack, it leads to the very best outcome,” said Dana Weber, MD, medical director of the Jeanes Hospital ED. “Jeanes is doing better than 90 minutes and it continues to improve. We’ve had several cases where the door-to-balloon time was under 40 minutes. Minimizing door-to-balloon time is key to getting through a heart attack with minimal damage.” That’s because during a heart attack, a blood clot severely reduces or cuts off the blood supply to the heart. Starved of life-giving oxygen, cells begin to die and don’t regenerate, which can cause disability or death. When heart attack patients call Burholme EMS, paramedics can perform a 12-lead electrocardiogram (EKG) right in the patient’s home and wirelessly transmit the vital information to Jeanes Hospital’s ED through radio, cellphone or internet. “The emergency physician can make a diagnosis while the patient is being transported to the hospital,” said Ted Parris, MD, FACC, medical director of the catheterization laboratory at Jeanes Hospital. “That’s a huge head start,” he added, saving as much as 20 minutes. “When patients arrive at Jeanes Hospital, they can be quickly evaluated by the ED physician and sent directly to the catheterization lab for angioplasty, if necessary,” said Timothy C. Hinchcliff, managing director of Burholme EMS. Jeanes Hospital is the only hospital in Philadelphia to have invested in this technology with an EMS partner. If you think you may be having a heart attack, call 911 immediately. Don’t wait and see, and don’t drive yourself to the hospital.
Dana Weber, MD Medical Director, Emergency Department
Ted Parris, MD, FACC Medical Director, Cath Lab
Know the Signs of a Heart Attack • Chest pain: Uncomfortable pressure or pain that lasts for more than a few minutes or goes away and comes back • Pain in the jaw, neck, or back • Shortness of breath: The feeling that you can’t catch your breath • Sweating: When suffering the chest pain of a heart attack, it’s common to break out in a cold sweat. • Feeling weak, light-headed, or faint • It’s possible for women to experience a heart attack without feeling chest pressure. They may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure, or extreme fatigue. —American Heart Association
Timothy C. Hinchcliff Managing Director, Burholme EMS
For more information about wireless transmission of EKGs to Jeanes Hospital, call Tim Hinchcliff at Burholme EMS at 215-745-1550. ④
health matters // Fall 2012
FAST:
Stroke health matters
The One Word that Can Save a Life During a Stroke
I
n the United States, 133,000 people die annually of heart disease or stroke. Because stroke is so common — about 800,000 Americans suffer a new or recurrent stroke each year — it’s something that should be on everyone’s radar. Like a heart attack, a stroke is a medical emergency. During a stroke, brain cells starved of oxygen die and don’t regenerate. Time lost can increase the chances of a poor outcome. “If you get to the hospital quickly — within three hours of when stroke signs first appear — you may be a candidate for clot-busting drugs and other techniques that can open up blood vessels, improving your chances for a full recovery,” said Marcia Halpern, MD, Jeanes Hospital’s stroke care medical director. Use this helpful memory technique to recall stroke symptoms, recognize them in yourself and others, and act FAST: Face Try to smile or ask the person you’re with to smile. Does one side of the face droop? Arms Try or ask the person you’re with to raise both arms. Does one arm drift downward? Speech Try or ask the person you’re with to repeat a simple phrase, such as “It’s nice outside.” Is the speech slurred or strange?
Note the time when symptoms first appear and mention it to emergency medical professionals. “Some patients drive themselves to the Emergency Department (ED), then take a number and sit down when they get there,” said Maryellen Nelson, MSN, CRNP, stroke program coordinator at Jeanes Hospital. That wastes valuable time and can be dangerous, she explained. When you call 911, medical care can start right in the ambulance. You’re in good hands once you get to the ED, too. Jeanes Hospital is accredited by The Joint Commission as a Primary Stroke Center, signifying the demonstrated ability of the hospital’s stroke team to meet or exceed performance measures established by the American Stroke Association (ASA) and the Brain Attack Coalition. Jeanes Hospital’s stroke care program has also received a Gold-Plus Award from the ASA for three years in a row. This award recognizes the hospital’s success in stroke care. The ASA has been recognizing the hospital’s excellence in stroke care for six years.
Call for an Appointment To schedule an appointment with a stroke specialist at Jeanes Hospital, call 215-728-CARE (2273) or visit www.jeanes.com.
Time If you observe any of these signs, call 911 immediately.
Marcia Halpern, MD Medical Director, Stroke
Maryellen Nelson MSN, CRNP, Stroke Program Coordinator www.jeanes.com
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Wound Healing health matters
Hyperbaric Oxygen Therapy
For Wounds That Won’t Heal
P
eople with diabetes who develop ulcers, those with bone infections or pressure ulcers commonly known as bed sores, and cancer patients undergoing radiation are particularly susceptible to wounds that won’t heal after four or more weeks of standard treatment. Whatever their cause, chronic non-healing wounds can impair quality of life, lead to limb amputation, or even lead to death. Here’s help to speed the healing process. The Center for Advanced Wound Healing and Hyperbaric Medicine at Jeanes Hospital offers state-of-theart care for chronic wounds, including hyperbaric oxygen therapy (HBOT). Normally, the air we breathe is about 21 percent oxygen. Patients who receive HBOT inhale 100 percent oxygen in an enclosed tanning-bed-like chamber with amplified atmospheric pressure. “The objective of HBOT is to increase the amount of oxygen that’s dissolved in a patient’s plasma,” said Michael A. Crivaro, MD, an integrated wound specialist and the Center’s medical director. Driving more oxygen into the blood releases growth factors and inhibits bad bacteria growth, both of which aid wound healing by treating
Michael A. Crivaro, MD Integrated Wound Specialist
Wanda Dutton Program Director
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health matters // Fall 2012
Learn More About Wound Care For more information or to schedule an appointment, call the Center for Advanced Wound Healing and Hyperbaric Medicine at 215-214-3010.
the underlying inflammation. “Nationally, HBOT heals 95 percent of patients who receive treatment. At Jeanes Hospital, our success rate is 98 percent,” said Wanda Dutton, the Center’s program director. HBOT patients typically receive up to 40 two-hour treatments, which are scheduled consecutively five days a week, Monday through Friday, depending on their diagnosis and evidence-based clinical practice guidelines. The use of HBOT is covered as adjunctive therapy only after there are no measurable signs of healing for at least 30 days of treatment with standard wound therapy, and must be used in addition to standard wound care, explained Dr. Crivaro. If you think you’re a candidate for HBOT, ask your doctor to refer you to the Center for Advanced Wound
Healing and Hyperbaric Medicine. The Center also accepts self-referrals and will work with your treating physician to establish a collaborative plan of care. HBOT is covered by Medicare and most health insurance plans. “Many patients wait months or years before they seek advanced treatment,” Dr. Crivaro said. “But getting treated sooner is better. HBOT is more effective when it isn’t a last resort.” The treatment is painless, too. In the hyperbaric chamber, you can watch movies and easily communicate with the hyperbaric technician through the clear Plexiglas. For more information or to schedule an appointment, call the Center for Advanced Wound Healing and Hyperbaric Medicine at Jeanes at 215-214-3010.
A Patient’s Story health matters
Two Separate Surgeries, One Renewed Man
B
efore having double knee replacement surgery last April, Joseph Gable could barely walk. “The arthritis in my knees was so bad that I had to crawl up the steps of my two-story home,” said the 62-year-old Fox Chase plumbing supply worker. “My knees hurt even when I was lying down or sitting.” It turns out, though, that osteoarthritis in Joseph’s knees, which he suspects developed after years of kneeling as a commercial plumber, was the least of his medical problems. Before having knee replacement surgery, Joseph underwent a nuclear stress test, which measures blood flow to the heart, as a precaution. Jeanes Hospital physicians wanted to make sure Joseph’s heart was fit for surgery. In fact, the test showed that part of his heart wasn’t getting enough blood. A follow-up cardiac catheterization indicated that Joseph had three blocked arteries and was at risk for a heart attack. His situation was so severe that instead of going home after the catheterization, he was admitted to the hospital. The diagnosis caught Joseph off guard. Like many people with heart disease, he didn’t have any symptoms. “Even though I was a smoker, I was never short of breath,” he said. Two days later, still at Jeanes Hospital, Satoshi Furukawa, MD, performed heart surgery on Joseph — a coronary artery bypass graft, which treats blocked arteries by creating new passages for blood to flow to the heart. “It was a major operation but it didn’t take long to recover,” Joseph said. After a month of rehabilitation at home, he got the green light for knee-replacement surgery at Jeanes, performed by orthopedic surgeon John Beight, MD. Now, a few months later, Joseph is getting stronger on his feet and discovering the joys of walking without pain. Proud to now call himself a former smoker who is exercising regularly and trying to eat healthier, he expects to return to work next month. “I got a big overhaul and I’m so pleased, from the nurses on up, with my experience at Jeanes Hospital,” he said.
“ I got a big overhaul and I’m so pleased, from the nurses on up, with my experience at Jeanes.” — Joseph Gable Satoshi Furukawa, MD Division Chief, Cardiac & Thoracic Surgery
John Beight, MD Orthopedic Surgeon
www.jeanes.com
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Temple University Health System
Jeanes Hospital 7600 Central Avenue Philadelphia, PA 19111
Visit our website at www.jeanes.com
healthmatters Jeanes Hospital, the only Quaker-founded acute care hospital in the United States, is part of Temple Health. The hospital provides communities in Northeast Philadelphia, Montgomery County, and Bucks County with advanced medical, surgical, and emergency services.
Where You Find the Best Education for Your Health, Wellness and Safety! Our seminars are delivered by a faculty of specialists from the Jeanes Hospital medical staff, the Fox Chase Cancer Center medical staff and other physicians from the Temple University Health System. Jeanes Hospital presents Community Classroom Seminars FREE, made possible through funding from the Anna T. Jeanes Foundation. Seminars are hosted in the newly renovated Cheltenham Friends Meetinghouse on the Jeanes Hospital campus.
Health Matters is published quarterly by Jeanes Hospital to provide its community with health, wellness, and safety information; however, it does not replace the advice of your physicians. You should always consult your physician regarding any medical concerns and before making any changes in your lifestyle, physical activities or treatment plan. If you would like to be removed from our mailing list please call Jeanes Hospital at 215-728-3313 and request removal from Health Matters distribution. Jeanes Hospital does not exclude participation in, and no one is denied the benefits of, delivery of quality medical care on the basis of race, religious creed, sex, sexual orientation, gender identity, disability, age, ancestry, color, national origin, physical ability, or source of payment. Temple Health refers to the various health care, educational, and research services provided by, and/ or the locations of, the affiliates of TUHS and TUSM.
To explore Community Classroom opportunities, visit www.jeanes.com or call 215-728-4861 to register. Space is limited, so register early. Parking is always free and convenient. Refreshments, giveaways, and raffle prizes provided.
Jeanes Hospital • 7600 Central Ave. • Philadelphia, PA 19111
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