Michiana Medical Update Winter 2012

WINTER 2012 • PremiEr Issue

sJMED.com

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from the physicians of saint joseph regional medical center

Robotic Surgery

The Future of Orthopedics Is Here

Breast Cancer

Combined Surgeries Can Reduce Recovery Time

Heartburn Medicine

Are Your Bones At Risk?

winter 2012 “ We’re called on to care, in every sense of the word.”

contents

Albert Gutierrez

Breast Cancer..................... 3

President and CEO

Know what to expect after a diagnosis and learn more about a new single-stage reconstruction procedure.

Sports Medicine................. 4

Advanced diagnostics and treatment to improve your performance.

Joint Pain............................ 5 What could be wrong? Common causes abound, but if the pain is severe, it could signal a serious problem.

New Medical Staff.............. 7 Robotics Technology......... 8

Introducing the next generation of orthopedics for knee and hip.

Cardiovascular................. 10

Speed counts: Our cardiology and neurology teams strive to improve outcomes for emergency patients.

Diabetes Care................... 12

You can turn things around if you are on the road to developing type 2 diabetes.

Digestive Health............... 13

An accurate diagnosis can help you manage digestive disorders.

Classes & Health Tips..... 14 Foundation News............. 15 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 574-335-2351 with any questions or comments. Inquiries or ideas can be addressed to medicalupdate@sjrmc.com.

Albert L. Gutierrez, President and CEO Pamela Henderson, V.P. of Marketing Medical Advisors: Physicians from SJRMC’s Integrated Leadership Team SJRMC Production Team: Mai Nguyen, 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.

You may see members of our Michiana community pictured throughout this publication. They are featured for illustrative purposes only. We would like to thank all those who have participated in our SJRMC photo shoots. We are looking forward to capturing even more familiar faces!

A Message to Our Readers

W

elcome to the first issue of Michiana Medical Update, brought to you by the physicians of Saint Joseph Regional Medical Center.

This update will publish quarterly to offer you health and wellness information and keep you informed on the latest medical trends.

As you will read in this publication, we make significant investments in technology to ensure we are setting the standard for care in our community. On page 8, read about our new robotic-assisted joint replacement surgery. The procedure offers a new level of precision and world-class treatment for patients with arthritis of the knee or hip.

Our system is also home to talented providers who strive to provide patients

with peace of mind. Confidence is never needed more than during an emergency.

Turn to page 10 to learn more about how our emergency code protocol is improving outcomes for heart attack and stroke patients and setting the gold standard for care.

We’re called on to care, in every sense of the word. This means an unwavering focus and commitment to all we serve. I hope you find the following pages and subsequent publications a valuable resource for your health.

Albert Gutierrez President and CEO 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.

STAY CONNECTED WITH Saint Joseph Regional Medical Center www.sjmed .com

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Diagnosis: Breast Cancer Newer surgical methods at SJRMC make it possible to preserve the nipple and other natural breast tissue, and perform mastectomy and breast reconstruction in one Choosing Your Treatment operation.

Your age, health, and family “The nipple-sparing surgery history will be taken into account, Michael C. enables the preservation of all and tests such as X-rays and CT Rotkis, MD the skin of the breast while or PET scans will determine how Medical Director, removing the cancer and breast SJRMC Breast Cancer far your cancer has spread. After Services tissue,” says Michael C. Rotkis, your oncologist suggests a MD, medical director of Breast course of treatment, which can Cancer Services at SJRMC. “This allows for include treatment before, after, or reconstruction of the breasts in a single, instead of surgery, get a second opinion. solitary procedure with mastectomy.”

Every three minutes, a woman hears the words, “You have breast cancer.”

What happens next?

Facing Surgery Early-stage cancers can usually be treated with a lumpectomy, which removes only the lump and some surrounding tissue, sparing most of your breast. For advanced cancers, surgeons might perform a mastectomy, removing the entire breast.

Considering Your Options You might have other treatments before, after, or instead of surgery. These options target cancer from the inside and include: • Radiation therapy: High-energy rays or particles destroy cancer cells • Chemotherapy: Medications either kill cancer cells or prevent them from dividing • Hormone therapy: Medications block the action of hormones like estrogen • Targeted therapy: Drugs use genetic information to attack cancer cells without harming normal cells • Clinical trials: These are studies of new therapies or approaches with state-ofthe-art treatment

New Surgery Option: Single-Stage Reconstruction For women facing the loss of one or both breasts due to either an incidence of cancer or uncommonly high risk factors, there are both physical and emotional concerns.

Kari Hazelbacker, wife and mother of two, was diagnosed with breast cancer at age 35.

“It plays in every woman’s mind who has had breast cancer, the worry of it returning. I had a mammogram. I had an MRI and a PET scan that did not detect the invasive cancer. So after I got through all my treatment, I had time to think about it,” she says.

“We discussed a double mastectomy and I thought for me that was the best route to go.”

Kari underwent a single-stage reconstruction procedure following her mastectomy at SJRMC. “This was the right thing for me to do because of the fear of the cancer coming back,” she says.

Pictured: Patient Kari Hazelbacker underwent single-stage reconstruction surgery following a double mastectomy.

Early Detection Saves Lives Are you due for a mammogram? Schedule your appointment with SJRMC. Call 574-247-5400.

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Emerging Technologies in

Sports Medicine Help Treat More Cases

The Sports Medicine Institute at SJRMC provides advanced diagnostics and treatments for all athletes, regardless of skill level. Led by Stephen Simons, MD, we use cutting-edge technology to treat pain while improving performance.

Stephen Simons, MD

Sports Medicine

Musculoskeletal Ultrasound Improved imaging technology over the past few years has made it possible to easily diagnose sports-related injuries.

SJRMC’s musculoskeletal ultrasound system gives us a detailed view of internal organs and tissues so we can more easily find and treat problems, such as: • Tendon tears • Muscle abnormalities • Tumors that may exist in soft tissues • Rheumatoid arthritis • Other problems related to inflammation

Platelet-Rich Plasma Therapy

How to Reach Us: Saint Joseph Sports Medicine Institute, 611 E. Douglas Rd., Mishawaka, IN 46545 574-335-6214

Platelets in our blood help us heal, build tissues, and stop bleeding. Platelet-rich plasma therapy takes advantage of this natural healing process.

The procedure allows us to draw blood from a patient and separate out the platelet-rich plasma. The plasma can then be injected into an injured area (such as an affected tendon) to promote faster, more effective healing. Risks from the treatment are minimal because the platelets come from the patient’s own blood and will not be rejected by the body.

Benefits can include: • Decreased inflammation and pain • Increased tissue repair • Increased bone density • Improved development of new blood cells “This therapy is particularly useful in treating chronic problems that do not respond well to traditional medicines, stretching, and icing routines,” says Dr. Simons.

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Concussion Study Under Way Dr. Simons recently began using the Axon Sports Computerized Cognitive Assessment Tool (CCAT) to help with a study that will benefit children across the country. The study will track young people ages 5 to 18 using online tests to understand the development of the brain.

“These tests are used to establish normal reaction time, short-term memory, and concentration for children participating in sports that put them at high risk for concussion. The results of this study will help establish age-based standards,” he says.

With standards in place, researchers can develop percentile charts similar to those for children’s height and weight, which will allow physicians to better distinguish between changes related to normal childhood development and changes that result from injuries.

Goals for this study are: • Understand the normal changes in cognitive function at key age ranges during development • Compute ranges for normal performance • Compare the performance on tests while in supervised clinical settings vs. performance while completing tests at home

Joint Pain:

What Could Be Wrong?

While the occasional twinge is probably not a worry, joint pain that lingers or is severe could be a sign of a serious problem.

Determining the Cause Pain is a signal that something is wrong. But with joint pain, it is often difficult to determine the cause.

Common causes include: • Sprains or tears to surrounding ligaments, dislocated joints, and other injuries • Fluid that accumulates around the joint • Bursitis, an inflammation of the fluid-filled sacs that ease friction between tendons and bones, typically affecting the shoulders, elbows, or knees • A variety of other illnesses, including fibromy­algia, lupus, congenital bone disease, hepatitis, Lyme disease, thyroid disorders, and diabetes • Certain medications, such as steroids • Arthritis, a group of more than 100 different diseases

Natali Balog, MD Rheumatologist

Osteoarthritis and rheumatoid arthritis are two of the most common forms. Rheumatoid arthritis is more common in women, and osteoarthritis is more likely to strike women than men after age 55.

“Osteoarthritis typically occurs in middle age when the cartilage that protects joints deteriorates because of injury, overuse, or disease. The spine, knees, hips, thumbs, and big toes are commonly affected. Pain usually worsens when sufferers use the affected joint,” says Natali Balog, MD, rheumatologist on the medical staff at SJRMC. “Rheumatoid arthritis usually strikes between the ages of 30 and 60. It may be caused by a viral infection or an overactive immune system. The wrists and knuckles are most commonly affected. Sufferers usually feel stiff and achy when they get up in the morning. Joints are inflamed and warm to the touch.”

When to Seek Help Pain from minor injuries and bursitis may be relieved with the following steps—often referred to by the acronym RICE: • Rest • Ice the affected joint • Compress the area with elastic dressings • Elevate the affected limb above the heart If these self-care strategies don’t help, call your physician.

Also, always seek medical attention for joint pain that is severe, persistent, or accompanied by swelling, fever, or other serious symptoms.

Fast Forward: Learn about an innovative procedure for joint replacement, on page 8.

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Heartburn Medicine May Put Your Bones At Risk The “purple pill” and its brethren are no strangers to our television screens—or our medicine cabinets. These heartburn drugs, called proton pump inhibitors (or PPIs), are the most popular acid-suppressive medications used worldwide.

For this reason, recent research linking PPIs to an increased risk for hip, wrist, and spine fractures has physicians alarmed. The latest findings suggest nearly 5 percent of all hip fractures could be blamed on PPI use.

In another report, published in the Annals of Family Medicine, scientists combined the results of 11 previous studies. They found that people who took PPIs were significantly more likely to break their hip bone or any other bone.

Behind the Burn Heartburn occurs when the muscle between your stomach and esophagus weakens, letting stomach acid back up into your throat. PPIs stop your stomach from producing most of this acid. This eases painful burning symptoms and can also treat ulcers.

6 Michiana Medical Update I Winter 2012

“This relief may come with unintended side effects,” says Dawn Simala, DO, of Saint Joseph Family Medicine at Elm Road. “Lowering the acid level in your stomach may affect your ability to absorb bone-boosting calcium. Long-term use of PPIs may also cause vitamin B12 deficiency, which may damage your nerves and increase your risk for falls.”

Are You At Risk?

The FDA recently issued a warning about the increased fracture risk from PPIs. People most at risk, it noted, include: • Those who take prescription-strength rather than over-the-counter formulas • Adults ages 50 and older • Those who take PPIs frequently or for long periods of time, for a year or longer Another form of heartburn medication, histamine-2 receptor antagonists, blocks about 70 percent of your stomach acid. This type hasn’t shown the same link to fractures.

Dawn Simala, DO Family Medicine Saint Joseph Physician Network

Like SJRMC on Facebook and view our daily health tips: Visit www.facebook .com/sjrmc.

Our Capacity to Care Is Growing

PHYSICIAN NETWORK

The Saint Joseph Physician network is backed by experts from every specialty and one of the most advanced hospital systems in the region. Why does this matter? Because we connect good doctors with a team of resources, expertise, and technology to help them do their jobs even better. Learn about our new physicians and practices.

Saint Joseph OB/GYN Specialists 611 E. Douglas Rd., Suite 408, Mishawaka, IN 46545 574-335-6440

Marshall County Pediatric Physicians 1919 Lake Ave., Suite 110, Plymouth, IN 46563 574-941-3100

Nickole R. Bazger, DO, graduated from Michigan State University’s College of Osteopathic Medicine. She completed her residency at Mercy St. Vincent in Toledo, Ohio, and the John Paul II Fellowship in Medical and Surgical NaPro Technology at the Pope Paul VI Institute for the Study of Human Reproduction.

She specializes in natural fertility, natural family planning, OB/GYN care, reproductive endocrinology, diagnostics, and a preventive and holistic approach to patient care.

Neha Batra, MD, graduated from the Government Medical College in India. After her residency in pediatrics at Michigan State University, she completed an additional fellowship in rheumatology and is specially trained to treat conditions and diseases that affect joints, muscles, and bones. Dr. Batra is board certified in pediatrics and enjoys caring for children of all ages.

Community Pediatric Physicians 611 E. Douglas Rd., Suite 401, Mishawaka, IN 46545 574-335-6242 Melanie Gatewood, MD, graduated from the University of Michigan Medical School and completed her residency in pediatrics at the Indiana University School of Medicine.

Dr. Gatewood is especially interested in caring for adolescents and looks forward to the opportunity to work with new patients and their families to meet their health needs and build strong relationships.

Lake Shore Clinic 921 N. Lake Shore Dr., Culver, IN 46511 574-842-3327 Michael F. Deery, MD, graduated from the Indiana University School of Medicine and completed his residency at Marion County General Hospital. He is board certified in family medicine and geriatrics and has 46 years of medical experience. Dr. Deery’s philosophy of patient care includes treating all his patients as if they are friends or family.

Warren K. Reiss, MD, graduated from the University of Cincinnati College of Medicine and completed his residency at Methodist Hospital in Indianapolis. He is board certified in family medicine and has more than 35 years’ experience. Dr. Reiss believes in patient-centered care and developing strong physicianpatient relationships.

River Park Family Medicine 1122 S. Ironwood Dr., South Bend, IN 46615 574-335-8399 Michelle Pearson, MD, graduated from the Indiana University School of Medicine in 2002 and completed her residency at Saint Joseph Regional Medical Center. Board certified in family medicine, she has practiced primary and urgent care within the community and is Medical Director for the School City of Mishawaka Employee Clinic and Laboratory Director for the Healthy Family Center in Mishawaka.

South Bend Neurology 611 E. Douglas Rd., Suite 305, Mishawaka, IN 46545 574-335-6450 Michael Englert, MD, graduated from the Indiana University School of Medicine and completed his residency in neurology at the University of Minnesota. Board certified in neurology and sleep medicine, he has special interests in caring for patients with multiple sclerosis, Parkinson’s disease, and sleep disorders.

Paula Toth-Russell, MD, graduated from the Indiana University School of Medicine and completed her residency at the Indiana University Medical Center. Board certified in neurology, Find a doc.

Dr. Toth-Russell has special interests Get a network. in caring for patients with multiple www.sjmed.com sclerosis and epilepsy.

800-274-1314

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The Next Generation of Orthopedics Robotic Technology Offers Option for Osteoarthritis If pain from osteoarthritis gets in the way of your life and the way you live it, you could be a candidate for a new surgery guided by robotic technology.

SJRMC is the first hospital in Indiana to offer robotic-assisted joint replacement surgery powered by the RIO® Robotic Arm Interactive Orthopedic System. This system uses the world’s most advanced orthopedic robotic arm and computer software system to perform total hip and knee procedures with exact precision, to the millimeter. This surgery offers patients world-class surgical arthritis treatment and restores natural range of motion to the hip or knee in a way that was previously unattainable.

This robotic-assisted surgery offers patients a less invasive treatment option. The new technology enables surgeons to precisely target only the diseased portion of the knee or hip, without compromising the surrounding healthy bone and tissue.

Potential benefits for patients include a shorter hospital stay, quicker recovery, and a smaller incision as compared with traditional surgeries. Many patients return to an active lifestyle within weeks.

“Robotic surgery allows us to treat patients with osteoarthritis at earlier stages and with much greater accuracy,” says Fred Ferlic, MD, who along with Robert Clemency, MD, and J. Michael Kelbel, MD, performed the first procedure in Indiana at SJRMC. “Because it is less invasive and more of the natural joint remains, including the ACL and PCL, the goal is for patients to have more natural motion postoperatively.”

About the Procedure The RIO® Robotic Arm Interactive Orthopedic System features a tactile robotic arm and a three-dimensional virtual patientspecific visualization system. This gives the surgeon a presurgical plan that details the technique for bone preparation and customized implant positioning using a CT scan of the patient’s joint.

During the procedure, the system creates a live-action view of the patient’s bone surface and correlates the image to the preprogrammed surgical plan. As the surgeon uses the robotic arm, its tactile, acoustic, and visual feedback limits the bone preparation to the diseased areas and provides more optimal implanting position for each individual patient.

“Precision is key in these surgeries,” says Dr. Ferlic. “For the best possible outcome, you need to align and position the implants just right, and this technology ensures we do that.”

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Signs of Osteoarthritis Osteoarthritis is the most common form of arthritis and a leading cause of disability worldwide, according to the American Academy of Orthopaedic Surgeons. A chronic degenerative joint disease that affects mostly middle-aged and older adults, it involves the wearing away of cartilage that protects bones.

Heredity and age do influence whether people will develop osteoarthritis. However, making healthy lifestyle choices just may help prevent or delay the disease. Risk factors include heredity, obesity, and injury/overuse.

Symptoms of osteoarthritis usually develop slowly over many years. The following are the most common symptoms: • Joint pain • Joint stiffness, especially after sleeping or inactivity • Limited joint movement as the disease progresses • Grinding of joints when moved (in more advanced stages of osteoarthritis) as the cartilage wears away In addition to joint surgery, other treatments may include: • Exercise. Regular, aerobic exercise and stretching and strengthening exercises may help reduce the symptoms of and pain associated with osteoarthritis.

• Heat treatment. It may help reduce pain.

• Physical and occupational therapy. They may help to reduce joint pain, improve joint flexibility when performing daily activities, and reduce joint strain.

• Medication. Medication for specific symptoms may include pain relievers (in pill form or topical cream) and antiinflammatory medications, if inflammation is present.

• Proper weight management.

Fred Ferlic, MD

Orthopedic Surgeon at SJRMC

Robert Clemency, MD

Orthopedic Surgeon at SJRMC

J. Michael Kelbel, MD

Orthopedic Surgeon at SJRMC

For more patient information or to schedule a physician consultation, please call 866-757-6248.

Learn more at www.careformyjoints.com.

Total knee replacement is not always optimal for patients with early-to mid-stage OA in just one or two compartments of the knee. For patients with partial OA, robotic-assisted surgery may be a better solution.

During the procedure, the diseased portion of the knee is resurfaced, sparing the patient’s healthy bone and surrounding tissue. An implant is then secured in the joint to allow the knee to move smoothly again.

During the hip replacement surgery, the robotic arm guides your surgeon in, preparing your socket in the pelvis and positioning the implants.

Real-time information and images allow your surgeon to know and control accurate implant placement, which can be difficult to achieve using traditional surgical techniques without a robotic arm.

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Stroke Warning Signs If you recognize any signs of a stroke, act immediately. Call 9-1-1. Signs include: • Sudden numbness, paralysis, or weakness in face, arm, or leg, especially on only one side of your body • Unexpected difficulty walking or keeping balance • Slurred speech or drooling • New vision changes • Problems speaking or understanding others • Feeling confused • Sudden, severe headache

Speed Counts

Cardiac Protocol Provides Better Care in Heart and Stroke Emergencies At SJRMC, our cardiology and neurology teams are continually striving to improve outcomes for our emergency patients. That means responses must be fast, accurate, and well-coordinated across all aspects of treatment.

We already rank near the top of all U.S. hospitals when it comes to cardiac care. And we’re continuing to improve each day.

Code STEMI

Did You Know?

The SJRMC Mishawaka Campus Stroke Unit is certified by The Joint Commission.

Achievement of certification signifies compliance with national standards and performance measurement expectations.

10 Michiana Medical Update I Winter 2012

In recent years, SJRMC has enacted a system specifically designed to respond to heart attack emergencies. Dubbed “Code STEMI” (for ST-Segment Elevation Myocardial Infarction), this protocol ensures a timely response from key personnel.

“Our system is an entirely coordinated effort among the EMS units, ER, CathLab, and cardiologists,” says Farid Jalinous, MD, medical director, Cardiac Rehab. “EMS teams alert emergency rooms that a cardiac patient is on the way.”

“The system is incredibly efficient,” says William S. Sarnat, MD, program director, Cardiology Services.

“The ER already knows what is going on before the patient arrives—and this makes the ER a critical link in the chain. They have been excellent in getting a jump start on things.”

Code STROKE Strokes kill more than 150,000 Americans each year and leave many more disabled. They happen when the brain doesn’t get enough blood, either because an artery burst or a clot blocked the blood flow.

Support After a Stroke Recovering from a stroke and regaining independence is a process that changes your life. The Saint Joseph Rehabilitation Institute Stroke Support Group provides education and encouragement. Survivors, families, and caregivers gather to share stories and offer support. Call 574-335-8800 today to learn more about this free program.

“The single most important thing to know about stroke treatment is that time is critical,” says Devin Zimmerman, MD, neurologist at SJRMC. “The earlier a person who has suffered a stroke can be treated, the better the outcome will be.”

Once again, speed counts.

“The Code STEMI activation has been so successful in improving outcomes for heart attack patients that the stroke team replicated this team mobilization for patients who arrive in the ER with strokelike symptoms,” says Steven Susler, MD, emergency department medical director.

Key steps include: • EMS performs the Cincinnati Stroke Scale, a simple neurological test on anyone with strokelike symptoms • EMS alerts the ER that a patient with stroke symptoms is on the way • ER nurse triages the patient upon arrival to assess for stroke symptoms and initiates a stroke protocol to make sure all appropriate tests are ordered • ER physician or ER nurse activates the Code Stroke system, which alerts all the team members including CT, X-ray, EKG, lab, pharmacy, and the stroke nurse • The neurologist is also contacted to determine immediate treatment for the patient

Devin Zimmerman, MD

Neurologist on staff at SJRMC

William S. Sarnat, MD

Cardiologist on staff at SJRMC

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Guide to Diabetes Prevention Are you on the road to developing type 2 diabetes? If so, turn things around. For those with metabolic syndrome, diabetes prevention is easier than you may think.

Diabetes 101 Cyprian A. Gardine, MD

Endocrinologist on staff at SJRMC

Your pancreas releases insulin. This hormone helps glucose, the fuel from your food, move from your bloodstream into your cells. In type 2 diabetes, your cells don’t respond well to insulin, and your pancreas cannot make enough insulin to keep up. So glucose stays in your blood. This can lead to complications, such as heart disease, stroke, nerve problems, and blindness.

Four Changes You Can Make Today “Your everyday choices can reduce your risk for diabetes, even if you have pre-diabetes. People with pre-diabetes can cut their risk by more than half with modest lifestyle changes,” says Cyprian A. Gardine, MD, endocrinologist on staff at SJRMC. “Eat healthfully, exercise regularly, and slim down if your body mass index (BMI) is 25 or higher.”

1. Choose foods wisely. Create meals that feature vegetables and whole grains. Cut back on total fat, saturated fat, sugar, salt, and refined grains. Need a simple way to start? Switch from full-fat to nonfat dairy products.

2. Move your body. Exercise helps your body use insulin and burn calories, which helps you reach and maintain a healthy weight. Be active for at least 30 minutes most days. Try walking briskly during your work lunch break to squeeze extra exercise into your day.

3. Eat smaller portions. This helps control your weight by reducing your calorie intake. If you’re overweight, losing just 5 percent of your weight helps lower your diabetes risk. Need help cutting back on how much you eat? Ten minutes before your meal, drink a glass of water to help you feel full on less food.

4. Ask for help. High blood pressure, high triglycerides, and low HDL, or “good,” cholesterol contribute to diabetes risk. So do smoking, depression, and too little or too much sleep. Ask your doctor for help with these issues.

Diabetes Support at SJRMC SJRMC offers diabetes educators who help individuals balance diabetes care and lifestyle needs.

• “Taking Charge of Your Diabetes” is a class designed to provide complete education and self-management skills. It is recommended for individuals newly diagnosed with diabetes or for those people with diabetes who have not previously been educated in diabetes care. A physician’s order is required to attend these classes. To register, call 574-247-5400.

• Join our Diabetes Support Group.

Call 574-335-2372 in Mishawaka and 574-935-2224 in Plymouth.

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Deciphering Digestive Disorders Living with digestive disorders is uncomfortable and wreaks havoc on your daily life.

Digestive disorders can range from an occasional upset stomach to more complex conditions such as irritable bowel syndrome.

“Digestive disorders can be caused by bacteria or viruses, or even aggravated by stress and certain foods. There also is a strong family link to certain conditions,” says Chang Oh, MD, gastroenterologist on the medical staff at SJRMC. “Talk with your physician if you regularly experience heartburn, gas, constipation, diarrhea, or stomach pain.”

Following are some conditions and accompanying symptoms that compromise your digestive health: • Peptic ulcers are sores in the lining of your stomach. Caused by a type of bacteria (called Helicobacter pylori) or the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs)— including aspirin and ibuprofen—ulcers are associated with stomach pain, bloating, and weight loss.

• Irritable bowel syndrome (IBS) is a functional disorder, meaning that the bowel looks normal but doesn’t work properly. Characterized by gas, chronic

abdominal pain or discomfort, bloating, and diarrhea and/or constipation, IBS does not lead to more serious digestive diseases and often is aggravated by stress.

• Inflammatory bowel disease (IBD) is a general name for two diseases that cause inflammation or ulcerations in the small and large intestines: Crohn’s disease and ulcerative colitis. Symptoms can include intestinal bleeding and fever, as well as cramping, abdominal pain, and diarrhea. Weight loss may occur over time.

• Colorectal cancer often develops from abnormal growths, called polyps, on the wall of the colon. If polyps are detected at an early stage, they can be removed before they become cancerous. Many people do not experience any symptoms early on.

However, you should see your doctor if you have frequent gas pains, blood in or on the stool, and diarrhea or constipation.

“Although some digestive disorders can produce similar symptoms, treatment approaches vary,” says Dr. Oh. “That’s why an accurate diagnosis by your physician is essential in managing your condition.”

Chang Oh, MD

Gastroenterologist

Patient Resources If you are having digestive issues, speak with your doctor. Need to find a primary care physician or specialist? Call 866-757-6248.

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Join the Breakfast Club

Classes at SJRMC Health and Wellness Senior Fit For those ages 55 and older, this free physical fitness program focuses on upper and lower body strength, cardiovascular endurance, flexibility, and balance.

Fitness professionals teach each class.

Health Tip from Josephine Randazzo, DO

Cardiologist Saint Joseph Physician Network

In one small study, women ate a breakfast of whole-grain bran flakes with low-fat milk every day for two weeks. Then they skipped breakfast for two weeks.

Both their total and “bad” cholesterol levels were higher when they skipped breakfast. They also had lower insulin sensitivity, which raises the risk for type 2 diabetes and heart disease.

So start the day with a meal—your heart will thank you!

American Journal of Clinical Nutrition, vol. 81, no. 2

Preventive Screenings Community Health Services provides free blood pressure checks, glucose screenings, and cholesterol checks at numerous locations throughout the week.

For more information, see our online calendar at www.sjmed.com or contact Bettye Green at 574-335-8230.

Childbirth and Adoption Childbirth Education Free classes include an optional tour of the OB Unit. We also offer classes for Spanish-speaking patients. To register, call 866-757-6248. To speak with a childbirth educator or nurse, call: Mishawaka Campus 574-335-2323 Plymouth Campus 574-935-2140

Winter Vegetable Stew Ingredients:

1 lb. banana or Hubbard squash 1 sweet potato 2 carrots 1 cup parsnips 2 cloves garlic 1 red bell pepper

1 cup onions, cut into ½-inch wedges 2 cups low-sodium, low-fat vegetable broth 1 cup puréed tomato 2 tbsp. lime juice ¼ tsp. cayenne 1 (10-oz.) package frozen peas ¼ tsp. salt ⅛ tsp. black pepper 1 bunch cilantro sprigs, rinsed, or thinly sliced green onions

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OB Unit Tours Welcome expectant parents! Tour the Family Birthplace at the Mishawaka Campus and the New Beginnings Birthplace at the Plymouth Campus.

For more information or to speak with a childbirth educator or nurse, call: Mishawaka Campus 574-335-2323 Plymouth Campus 574-935-2140

Adoption Class For anyone who is considering adopting a child, is preparing to go through the process, or has a newly adopted baby, this free class offers an opportunity to meet others in similar situations and to connect with resources for adoptive families. For more information or to register, call 574-335-2323.

Oncology Support Groups The Women’s Task Force offers several support groups for cancer survivors.

For information, go to www.womens taskforce.org or call 574-231-6465.

Follow us on Twitter (@stjoemed) to be reminded about classes and events!

Directions:

Peel the squash, sweet potato, carrots, and parsnips; cut into ¾-inch pieces. Peel and mince or press garlic. Stem and seed the bell pepper and cut into ½-inch strips.

Put squash, sweet potato, carrots, parsnips, garlic, onions, and 1 cup of the broth in a pan, cover, and cook for 10 minutes, stirring occasionally. Add a few tablespoons of water if mixture begins sticking to pan. Add remaining broth, along with the bell pepper, puréed tomato, lime juice, and cayenne to taste. Return to a boil, and then reduce heat. Simmer covered until vegetables are tender when pierced, about 12 to 15 minutes.

If stew sticks to pan or gets thicker than desired, add more broth as needed. Add peas and stir occasionally until hot, about two minutes. Add salt and pepper to taste.

Ladle into soup bowls, and garnish with cilantro or sliced green onions.

150 Calories per Serving (serves six) Source: Centers for Disease Control and Prevention, “Fruits and Veggies: More Matters”

Laying the Cornerstone for a Vibrant Future We find inspiration in our faith The Foundation of Saint Joseph RegionaL MEDICAL CENTER is excited to announce that the original 30-foot stainless steel cross from the former South Bend hospital will be placed within a brick memorial wall on the grounds of the Mishawaka Campus.

Join us in honoring those you care about and those who have cared for you and your family. Become an inaugural member of the Cornerstone Society and partner with SJRMC as we build our future on the strong foundation of our past.

Leading up to this symbol of our faith and Inscription history will be an ornamental brick and paver walkway. In addition to the cross, the wall will be flanked by the cornerstones from the original hospital buildings. A formal dedication and blessing of the cross will occur on April 26.

You can help us provide care for those in the community who need it most. Proceeds from the Cornerstone Society will be distributed by the Foundation to fund critical health services and programs. The Foundation is dedicated to ensuring that our region has a steadfast partner that will continue to take care of the community and give our patients the best care.

Each 4x8 brick can contain up to two lines, 14 characters each.

Each 8x8 brick can contain up to four lines, 14 characters each.

Request a Brochure & Buy a Brick

For information about inscribing an image such as a company logo, please contact The Foundation at 574.472.6368 or thefoundation@sjrmc.com.

For additional bricks, please copy this form or use additional sheets.

Jeff and Sara Williamson

Pave a Path to the Sacred Cross

Many thanks to Mary Croix, RN

In honor of Dr. Joe Smith

You can purchase an engraved brick to be placed in this permanent walkway. Your brick will be personalized with an inscription honoring someone or something special to you. In addition, you will receive a stamped commemorative brick from the original campus as a keepsake. Bricks for the pathway begin at $150 or a commemorative brick only can be purchased for $50.

Honor the past

For a brochure and more information, call Kristin Michel at 574-472-6368 or email foundation@sjrmc.com.

Line 1

Line 2

Lay a CorNErSToNE For a vIBraNT FuTurE.

Line 3 (for 8x8 bricks only)

Line 4 (for 8x8 bricks only)

Please complete both sides of this form and return in the provided envelope.

837 East Cedar Street, Suite 350 South Bend, IN 46617 574.237.7377 thefoundation@sjrmc.com

Saint Joseph Regional Medical Center I SJMED.COM

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Saint Joseph Regional Medical Center South Bend Campus 5215 Holy Cross Parkway Mishawaka, IN 46545

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Saint Joseph Regional Medical Center South Bend Campus

Breast Cancer: Combined Surgeries Can Reduce Recovery Time page 3

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This is why we care.

At Saint Joseph Regional Medical Center, we know the strength of an entire community depends on the health of every last individual in it.

So our doctors, nurses, and staff work tirelessly to offer the highest level of care. Except we don’t call it work — we consider it a calling.

Scan this code to see people from our community in our latest TV commercial.

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