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Health News & Information for Healthy Living
A noninvasive option for uterine fibroids Page 4
Neurosurgery team accepts the tough cases Page 6
Estate planning? Consider Altoona Regional’s Foundation Page 7
Hospital’s outpatient surgery center offers unique experience Page 3
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Healthy Living Altoona Regional’s Healthy Living
Magazine is published four times a year by the Marketing and Communications department. President/CEO Jerry Murray Chief Operating Officer Ronald J. McConnell Director, Marketing and Communications Dave Cuzzolina
Some tips as hunting season approaches
Staff Writers Patt Keith Anne Stoltz Intern Ashley Boyer Designer Chip Mock Mock Creations LLC For more information, please contact: Altoona Regional Health System Marketing and Communications 620 Howard Ave. Altoona, PA 16601-4899 889.2271 firstname.lastname@example.org
On the cover Matthew Newlin, M.D., performs surgery at Altoona Regional’s Surgery Center, assisted by (from left) Jessica Wilt, surgical technologist; Daniel Van Riper, M.D., anesthesiologist, and Jennifer Eckenrode, surgical technologist.
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Tick season started early this year and the risk of bites will carry into the fall and hunting season. Ticks are mainly seen in woods, fields and brush-filled areas and can transmit Lyme disease, an infection spread by bacteria in a tick’s mouth. Not all ticks carry Lyme disease, and most people bitten by a tick do not get it. Many symptoms are similar to the flu, so it can be tricky to diagnose. However, some signs to look for are: A round, red rash at the site of the bite Joint pain Headaches Lack of energy Weakness Matthew Bouchard, M.D., stresses the importance of protecting yourself from ticks.
Dr. Bouchard warned against the use of lighters or other home remedies that may cause harm during tick removal. He advises going to the ER or calling your family doctor if you cannot remove the tick yourself or have any other concerns about a tick bite. The doctor said he has seen about a 30 percent increase in tick-related complaints this year in the ER and blames it on earlier hatching of eggs as a result of a warmer winter. So, more people are getting bitten in the spring and summer compared to other years. It’s important to do your best to avoid tick exposure and check yourself carefully after spending time outside. If you find a tick, use a safe method for removal and seek help from a medical professional if you have questions or problems.
Prevention is key “The best ways to prevent ticks from attaching to you in the woods are to stay in wide, clear trails and use insect repellents, such as DEET, but no more than 10 percent formula for children,” said Dr. Bouchard, medical director of Emergency Medicine. “Try to avoid exposing areas of the skin as much as possible by wearing longsleeved shirts and long pants and tucking pants into socks, reducing the area of potential tick contact. Dr. Bouchard said removing ticks is generally easy and can be done with products available at pet stores and pharmacies. “While many people come to the ED for tick removal, it can often be done at home without difficulty,” he said. “It is important to remove the entire tick as anytime you leave a foreign body under the skin there is a risk of infection.”
Avoid ‘home remedies’
Smooth operation Patient, surgeons applaud Altoona Regional’s Surgery Center and staff Bonnie Kaup
Advantages at a glance Advanced technology
When exercise enthusiast Bonnie Kaup arrived at Altoona Regional’s Surgery Center in June for surgery on her right knee, she was in her “comfort zone.” Why? Because just a mere 10 weeks before that, the Altoona resident went through the same surgery on her left knee and had nothing but positive things to say about her experience. “Knowing my surgeon was using state-of-theart equipment made me feel very comfortable and at ease, especially for my second procedure,” said Bonnie. “I knew the atmosphere would be pleasant and that the staff was highly skilled and could attend to my needs. I was in good hands.” Bonnie’s surgeon, Jack Rocco, M.D., of Southern Alleghenies Elite Orthopedics, said he tries to do as many of his cases at the Surgery Center as possible. ‘Top-notch all around’ “I consider myself an advocate for my patients and am astutely aware of a facility’s quality when I decide to perform surgeries there,” he said. “For the past eight years, I have found the Surgery Center to be topnotch all around. “The staff is fantastic, the facility is clean and up to
date, and my patients have consistently reported having a positive experience.” Bonnie said it was obvious the staff was committed to working together to provide exceptional service in a safe environment. “They made me feel like I was their only patient,” she recalled. “Before my first surgery, I expressed concerns about how anesthesia makes me feel sick. The anesthesiologist and nurse anesthetist spoke with me, and after our discussions I was no longer worried. A reassuring feeling “For my second surgery, I asked the admitting nurse to pull my records so they could see how my anesthesia was handled earlier. The anesthesiologist reviewed everything with me, and I went into surgery once again feeling reassured.” Being able to communicate like that with her health care team, Bonnie said, made her “feel good.” That is exactly the type of care that L. Jolene Moyer, D.P.M., of Advanced Regional Center for Ankle and Foot Care, knows her patients will receive when she operates at the Surgery Center. “From the minute patients and their family members
arrive, they are met by staff who are among the best trained I have ever worked with,” she said, “and the personal care that is provided by the staff is exceptional through discharge. Praise for the safety “My patients have been extremely satisfied with their experiences and that makes me more comfortable when knowing that the needs of my patients are met and exceeded.” Dr. Moyer, who serves as Altoona Regional’s chief of Podiatry, also praises the Surgery Center’s safety. “The safety of the facility is considered equally as high as being in the hospital setting itself — you have the same group of anesthesiologists and nurses you would have in the hospital,” she said. “In the case of a rare emergency, patients could be admitted to the hospital within minutes.” Bonnie, who’s on the road to a full recovery, says the staff’s overall commitment to safety was evident throughout her entire experience, including discharge.
“They gave me specific instructions and made certain that I was in a safe and stable condition before allowing me to leave,” she said. “The care even continued after I was home, as staff made follow-up calls to check on my well-being and recovery. “When they called, I told them I’d soon be back to enjoying all of my exercise and sporting activities. Reminding myself of this keeps me in a positive frame of mind with a smile on my face.” Altoona Regional’s Surgery Center is at 800 Howard Ave., on the Altoona Hospital Campus.
Altoona Regional’s Surgery Center has six state-ofthe-art operating rooms. All boast the most modern medical technologies for our surgeons so your procedure can be faster, less invasive and more comfortable.
Proven customer satisfaction Our friendly, experienced health care professionals have been a proud team for years and have been honored consistently for excellent patient satisfaction. They are recipients of the Top Performer Award and the 5-Star Customer Service Award from Professional Research Consultants, a national research company with a goal of making hospitals better places for patients to be treated.
Not for profit When your doctor recommends Altoona Regional’s Surgery Center, it’s for only one reason: the best care possible. Our Surgery Center revenues are used to improve local health care for you and your family. Revenues at investorowned centers go into the owners’ pockets.
Safety In that rare instance when you might need a hospital, it is right next door.
Free parking Convenient hours
Dr. Moyer and Dr. Rocco 3
An option for treating uterine fibroids Radiologists offer UFE — a noninvasive alternative to hysterectomy or myomectomy surgery For years, uterine fibroids — very common noncancerous (benign) growths that develop in the muscular wall of the uterus — have been the number one reason for a hysterectomy. Now, women have a highly successful, safe, noninvasive choice to treat fibroids of any size. It’s called uterine fibroid embolization, or UFE, and this major advance in women’s health is available at Altoona Regional. Interventional radiologists Peter James, M.D, David Rose, M.D., and Richard Wertz, M.D., all of Lexington Radiology, perform UFE as an alternative to surgery or hormone therapy. “Twenty to 40 percent of women age 35 and older have uterine fibroids of a significant size,” said Dr. James, medical director of Lexington Radiology, an Altoona Regional affiliate. “Most cases are asymptomatic, but 10 to 20 percent of women with uterine fibroids seek treatment for painful or health-threatening symptoms.” Symptoms vary Depending on size, location and number of fibroids, the tumors may cause: • Heavy, prolonged menstrual periods and unusual monthly bleeding, sometimes with clots. This can lead to anemia. • Pelvic pain and pressure. • Pain in the back and legs. • Pain during sexual intercourse. • Bladder pressure leading to a frequent urge to urinate. • Pressure on the bowel, leading to constipation and bloating.
“Since it is a noninvasive procedure, UFE can be performed under conscious sedation as opposed to general anesthesia,” said Dr. Rose. “It’s a fast, easy, valuable procedure with proven results.” Block blood flow During UFE, the physician maneuvers a small vascular catheter, about the diameter of a pencil lead, through the artery in the upper thigh to deliver tiny particles into the vessels that supply blood to the fibroids. The particles block the blood flow to the fibroids, ultimately shrinking and killing them. “On average, 85 to 90 percent of women experience significant or total relief of heavy bleeding, pain and/or bulk-related symptoms,” said Dr. Wertz. “Since there is no open surgery, most patients are discharged within 24 hours and return to normal activities in seven to 10 days.”
“ It’s a fast, easy, valuable procedure with proven results.”
If you have been diagnosed with uterine fibroids and want to learn more about UFE, call Lexington Radiology at 889.2590. Please follow up with your family physician or gynecologist if you’re experiencing symptoms of uterine fibroids.
• Abnormally Dr. Rose enlarged abdomen.
What is an interventional radiologist? Interventional radiologists are board certified physicians who specialize in minimally invasive, targeted treatments. They use X-rays, ultrasound, CT and other imaging to advance a catheter in the body, usually in an artery, to treat at the source of the disease nonsurgically. Today, many conditions that once required surgery can be treated nonsurgically by interventional radiologists. Compared to open surgery, interventional radiology treatments offer less risk, less pain and less recovery time. 4
Peter James, M.D.
David Rose, M.D.
Richard Wertz, M.D.
Fellowship trained in Angiography and Interventional Radiology
Fellowship trained in Interventional Radiology
Fellowship trained in Interventional Radiology
Dr. Rose graduated from Baylor College of Medicine in Texas. He completed his residency and fellowship at the Scott and White Memorial Hospital, also in Texas.
Dr. Wertz graduated from The Pennsylvania State University College of Medicine and completed his residency and fellowship at the Medical College of Wisconsin.
Dr. James graduated from the University of Alberta, Canada. He completed his residency at the University of New Mexico and his fellowship at the Western Pennsylvania Hospital.
‘High intensity’ Cutting-edge program optimizes care in ICUs
medical director of critical care (pictured above left), who came to Altoona Regional in 2008 as intensivist program development began. “We are quite ahead of the curve here now. More patients are staying here for treatment. Our intensivists treat the most complex patients so we no longer have to send them out to tertiary facilities. We have significantly improved all aspects of care.”
Paulette Way left her 83-year-old relative’s bedside and told her husband she would return shortly. Brief moments away from the Medical Intensive Care Unit were all she had managed during the daytime since her relative’s admission three days before — except to sleep. Love keeps Paulette at the bedside, not fear. “I don’t hesitate to leave at night, and that’s a really big thing,” Paulette said. “I spent 30 years as a nurse at a hospital outside this area, so I know excellent care. From the first minute and every day since then, the nurses greeted us at the door with an update on her condition. The intensivist physician immediately examined her, ordered tests and took control. I had total confidence in him.”
Data from Jan. 1 through June 30 shows a one-day shorter than predicted stay in Altoona Regional’s Surgical ICU and a half day in the Medical ICU, said Dr. Linnane Batzel, chief medical officer and senior vice president for quality. While the data is preliminary, Dr. Batzel said, the program’s impact on ICU mortality rates is better than predicted: The intensivist program is saving lives.
The intensivist, or critical care physician, was Terrence A. Gilbert, D.O. Intensivists complete residency training and board certification in internal medicine, anesthesiology or surgery, as well as a fellowship in critical care medicine. They treat only ICU patients.
And that’s what studies say should happen. According to the Society of Critical Care Medicine, more than 160,000 lives nationwide could be saved each year if critical care was delivered by intensivist-directed, multi-professional teams.
Doctors always on hand
Reduced risk of death
Altoona Regional has a “high intensity” intensivist program — the type that has a significant reduction in ICU length of stay and mortality rates, according to the New England Journal of Medicine (May 31, 2012).
Staffing ICUs with critical-care medicine doctors reduces a patient’s risk of dying in the ICU by 40 percent, according The Leapfrog Group, a voluntary program aimed at informing Americans about hospitals’ quality issues and performance.
“A ‘high intensity’ program is when an intensivist is physically present in the ICU or elsewhere in the hospital and immediately available to manage ICU emergencies,” said John Hoyt, M.D., national leader in critical care medicine and a member of Altoona Regional’s intensivist team.
A closer look at intensivists Intensivist physicians care for medical and surgical ICU patients with life-threatening illnesses such as respiratory failure, cardiac arrest, blood infections, kidney failure, severe pneumonia and digestive-related problems. An ICU patient requires constant, careful care and monitoring, performed by a certified critical care nurse. If a patient’s condition changes, treatment changes are needed immediately, especially if the patient is declining. “Intensivist-delivered ICU care provides patients with specialty physician availability at the bedside 24 hours a day,” said Sandralee Blosser, M.D., intensivist and medical director of critical care at Altoona Regional. “The intensivists have no other clinical responsibilities; they are dedicated to the ICU full time. They interact with families to keep them informed.” Dr. Blosser is also chief of the intensivist development program at Pittsburgh Critical Care Associates. She has worked with many ICU nursing staffs across the country and is impressed by her encounters here. “The nursing staff here has been overwhelmingly receptive and helpful,” she said. Each ICU patient has a multiple-member care team, consisting of the intensivist, the patient’s primary care physician, consulting specialist(s), critical care-trained nurse, registered dietitian, registered pharmacist, registered respiratory therapist, a pastoral care staff member and a care coordinator.
“Altoona Regional is one of a few community hospitals in Pennsylvania to offer intensivists in the ICUs,” Dr. Batzel said. “We continually seek to improve the quality of our services as a regional referral center with the goal of improving the health of the community.
He is the founder of Pittsburgh Critical Care Associates, which assists hospitals in setting up new programs or managing them, and helped Altoona Regional establish its program.
“Physicians from a larger geographic area are referring patients here. A greater number of people no longer have to travel great distances. They have access here to the highest quality critical care offered.”
“The program at Altoona Regional is on the cutting edge of the intensivist movement that is becoming very popular because of improved quality and reduced cost of care,” Dr. Hoyt said.
Paulette, who is from Clearfield, agrees. “I have had various family members to Cleveland Clinic and various Pittsburgh hospitals, and the care here from the intensivists and the nursing staff has been phenomenal,” she said. “You could not get better care, no matter where you go.”
‘Ahead of the curve’ “Only 30 percent of ICUs in the country use full-time intensivists,” said Mehrdad Ghaffari, M.D., assistant 5
The nurses station in a critical care unit is a very busy place.
Neurosurgeons teaming up to tackle the complex cases “A patient can come to us in pain, really suffering, and we can help.”
Within minutes of talking with neurosurgeon Matthew B. Maserati, M.D., he reveals his passion for restoring a patient’s quality of life. When deciding his medical specialty, Dr. Maserati said brain and spine surgery (neurosurgery) appealed because it quickly restores patients to their former selves, or close to it, including patients with some spinal conditions. “I especially like spinal surgery because it is about providing the patient with a better quality of life,” he said. “A patient can come to us in pain, really suffering, and we can help.” Dr. Maserati brings to Altoona advanced surgical techniques as the result of his specialized spine surgery training at the University of Pittsburgh. He gives patients new options and he brings something in short supply — hope to patients who have a history of back problems, including previous surgeries. Specialized abilities His specialized surgical abilities will help adults with spinal deformities, such as the spinal curvatures found in adult scoliosis, and those spinal conditions related to aging (degenerative disc disease). Back pain results when structures in the spine, including the discs, are damaged due to daily wear and tear, accidents, injuries and even birth defects. “In this area, the population is aging,” said neurosurgeon James P. Burke, M.D., Ph.D. “Our patients are very hard-working and less likely to seek treatment at the first ache and pain. By the time we see a patient, they often have advanced disease and have the need for more complex operations.” Complex operations often require two surgeons, two sets of hands and several hours to perform — all of which requires resources that were unavailable until Dr. Maserati’s arrival. “We plan to tackle those complex surgeries together,” Dr. Burke said. “At the same time, we expect to use more minimally invasive approaches on these complex problems with the two of us together.” A minimally invasive option Although surgical intervention remains a last resort, advances in surgical techniques are making spinal surgery less frightening for patients. Conventional spinal surgery is often associated with long hospital stays, greater blood loss and prolonged periods of rehabilitation. Minimally invasive techniques, although not for every person or every problem, offer shorter hospital stays and quicker recovery times, fewer complications and lower costs. “The most exciting part about minimally invasive surgery on the back,” Dr. Maserati said, “isn’t just about the size of the hole on the surface of the skin. While that is a plus cosmetically for the patient, the real benefit — the key benefit — is you are not stripping muscles away from bone.” Instead, the minimally invasive technique allows the neurosurgeon to gently spread the large muscles of the back to gain access to the spine. By not cutting into these large back muscles, post-surgery pain is greatly reduced and healing is more rapid. In openincision surgery, the muscles may revert to their previous shape but lingering postsurgery pain and muscle atrophy remain a risk. Contact: Allegheny Brain and Spine Surgeons 501 Howard Ave., Building E-1 Altoona, PA 16601 Phone 946.9150
New surgeon trained at University of Pittsburgh Matthew B. Maserati, M.D., has joined Allegheny Brain and Spine Surgeons with James P. Burke, M.D., Ph.D., and Carroll P. Osgood Jr., M.D. Dr. Maserati is a fellowship-trained neurosurgeon whose specialties are minimally invasive spine surgery, spinal deformity, degenerative spine and spine trauma. He received his medical degree from Columbia University College of Physicians and Surgeons, New York. He did his general surgery internship, neurological surgery residency and spine surgery fellowship at the University of Pittsburgh.
Willing to give Legacy gifts to Foundation for Life benefit local health care
The Foundation for Life received a gift from the estate of Beverly A. Williamson, who retired as a nurse’s aide from Mercy Hospital in 1980. A 20-year employee, Mrs. Williamson made provisions before her death to direct whatever remained from her estate after payment of outstanding debt and funeral expenses to support her community health care system. “The person handling her final arrangements shared that she specifically asked that any remaining assets from her estate be directed to the Foundation to benefit the health of the people in our community,” according to Fred Thursfield, president of the Foundation for Life. Mrs. Williamson’s thoughtful and generous act is a reminder that each of us can make a meaningful gift at death to support charitable causes. Smaller gifts appreciated “A legacy gift is very easy to make, whether leaving a remainder interest, a specific dollar amount or a percentage of an estate for a charitable purpose in a community,” said Fred. “And it does not need to be a large gift or bequest to help Altoona Regional’s continuing health care mission.” Bequests received by a charity can also be used to fund endowments, which can continue the annual donations many of us make to our favorite charities during our lifetimes, Fred explained.
“A legacy gift is very easy to make …”
Legacy gifts are usually directed to charities through a provision in a person’s will. However, as Mrs. Williamson did, instructions can be given to a trusted family member, friend or financial adviser. “People may also find it easy to designate charities as beneficiaries of all or a percentage of a life insurance or annuity contract,” Fred said. “If arranged during life, insurance or annuity gifts will provide future benefit for a charity and the opportunity for a donor to be acknowledged and recognized while living. In addition, such gifts may provide the added benefit of an income tax deduction or charitable estate tax deduction.” Donor will be recognized Fred said Altoona Regional was unable to acknowledge Mrs. Williamson’s generosity before her death. As a result, the Foundation for Life will posthumously recognize her generosity as a legacy donor. If you have directed, or are considering directing, a gift to support the health care mission of Altoona Regional through your will or other means, please call the Foundation for Life at 889.6406. We welcome the opportunity to help you, your attorney, financial planner or personal representative make sure your charitable intent is fulfilled and your generosity appropriately recognized. For more information on ways to make a gift, including a legacy gift or bequest, call the Foundation for Life or visit www.altoonaregional.org/gift_giving/how-to-give.htm.
On the bubble Searching for a unique baby gift that gives again and again? New grandparents, relatives and friends can honor the birth of a child by placing his or her name on a sea-themed recognition wall — “Sea of Tiny Bubbles” — in Maternity for a donation to Altoona Regional Health System’s Foundation For Life. Made possible through a gift from the Altoona Mirror, the “Sea of Tiny Bubbles” wall dominates Maternity’s main hallway. Each bubble will include the baby’s name, date of birth and footprint. All proceeds from the Sea of Tiny Bubbles program will support 7 the Labor and Delivery department at Altoona Regional.
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ASK THE SPECIALIST Linnane R. Batzel, M.D., M.B.A., is Altoona Regional’s chief medical officer and senior vice president for quality.
Medicine is your second career and the fulfillment of your childhood dream to follow your father’s career as a physician. Your father encouraged you to pursue engineering, not medicine, when deciding upon college. Why? By the 1980s my father was burned out on medicine, and the culture of medicine had started to change. I took an aptitude test in high school and my scores led to recruitment letters from colleges to increase women in engineering. So, he strongly encouraged me to pursue engineering. I became a mechanical engineering student at the University of Texas.
Does anything you learned in engineering apply to being chief medical officer and senior vice president for quality?
those who work with me, focus on quality initiatives, standards and processes that make the patient care we provide the best it can be.
are viewed differently by an engineer, a business person and a physician. I hope my background gives me a unique view on the challenges ahead.
One of the first lessons learned in engineering design class is failure analysis — how to think objectively about what can go wrong, and where, with a design. Failure analysis is also a good place to start when improving quality standards within the health care setting.
While in medical school at Jefferson Medical College in Philadelphia, you were accepted into the MBA program in business and health care administration at Smeal College of Business at Penn State. Then, you completed your residency in emergency medicine at Geisinger Medical Center in Danville. In general, what have you learned from your many years of education?
Improving the quality of care for patients is my priority. I believe my experiences in engineering and medicine provide me with unique skills to accomplish this as I, and
Education gives you different tools for problem-solving. Problems
Will you continue to practice medicine?
I plan to work a shift or two in the Emergency department every month to keep my skills sharp. I also feel it’s a great way to see how things are working. How do you juggle your multiple responsibilities and demands upon your time? Not just career demands, but those of your husband, Todd, and children, Ben, 13, Owen, 11, and Abby, 8.
Before entering medicine, Dr. Batzel worked as a commercial sales engineer in the industrial lubricant division of Mobile Oil Corp. for nearly four years. In 1993, her $4 million territory achieved the highest sales growth in the country (154 percent). In 2002, when she finished her residency at Geisinger, her plans couldn’t have been better scripted. An Altoona native, her husband, Todd, an electrical engineer at Penn State, transferred to Penn State Altoona. And Dr. Batzel was hired as an Emergency department physician here. In addition to “being a proud parent at my children’s activities,” which are hockey, dance, baseball and basketball, Dr. Batzel is an accomplished equestrian.
If I schedule it, it will happen. This has always been how I work. I thought I could schedule a baby, finish my MBA, and medical school at the same time. I thought that I would read and study while the baby napped. I learned babies don’t quite conform to your plan. But it worked out because that is how I scheduled it and there was no turning back.
Altoona Regional’s Healthy Living Magazine is published four times a year by the Marketing and Communications department.