Everything Baby 2023

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COOPERATIVE EFFORT BY:

Midwives focus on each mother’s needs

Certified Nurse Midwife

Jennifer Simpson had to chuckle when recalling a woman searching for the right hospital to have her baby.

“She had a whole list of things she wanted to do, and I was like, yes, and yes, and yes. We already do those things,” Simpson said. “And she said, ‘I think I found the place where I want to deliver.’”

The woman appreciated that at The Family Place, the obstetrics unit at Evangelical Community Hospital, midwives handle the majority of births.

“It’s perfect because midwives are the experts in normal, physiological birth, but when complications arise we can count on our skilled OB/GYN partners to collaborate in the management of labor when things deviate from normal,” Simpson said.

When prenatal patients come to OB/GYN of Evangelical and show Simpson a written birth plan, she goes through it with them line by line.

“I’ll say, yes, we can accommodate this, or this one‘s going to be hard to accommodate, and here’s why,” she said. “And just having that open and honest conversation about the risks and why we

don’t recommend something … it all comes down to having that communication so that they feel they can be open with you.”

Aside from insurance and location issues, patients look for what options a birthing place offers, and Simpson is happy to explain why she recommends The Family Place.

“I feel like Evangelical is a good place to come because it is a smaller community hospital,” she said. “You definitely have a more personal touch, and you know the people who are taking care of you a lot better.”

Giving birth can be daunting, especially for individuals who have never gone through it before. Midwives prepare mothers for what to expect, and a good first step is a childbirth class at Evangelical Community Hospital. During prenatal visits, midwives answer questions on medications, comfort techniques, and how to handle unexpected challenges.

When medication is needed, midwives take the time to explain why.

“We try to honor people’s wishes, but we balance that with things like, ‘Okay I know you really didn’t want medication, but I think we need it because your

water’s been broken for x amount of hours and your labor has not progressed. Ultimately, we want to avoid infection,’” Simpson said. “Midwives use their training, experience, and wisdom to help women make the most informed decisions regarding their pregnancy and birth.”

IVs and monitors are necessary but can be adjusted for each situation. An IV can be inserted then connected to fluids or meds only if needed. Two monitors on the mother’s belly track contractions and the baby’s heart rate, but as long as the pregnancy is low risk, the patient can be placed on intermittent, cordless monitoring that gives her the freedom to get up and move around.

2 EvErything BaBy March 2023
For The Daily Item
(Cindy O. Herman/For The Daily Item) Wearing a T-shirt that says “It’s a Beautiful Day in the Laborhood”, nurse midwife Jennifer Simpson is ready for her next labor and delivery patient at The Family Place of Evangelical Community Hospital, in Lewisburg. (Photo provided)
Continued on Page 4
With intermittent, cordless technology, midwives can monitor contractions and the baby’s heart rate while allowing the mother to get up and move around. Pictured are the wireless fetal monitors.

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Two more often requested techniques are delayed cord clamping and skin-to-skin contact, both of which The Family Place does routinely.

“When the baby is born, we put baby on mom’s chest as long as there aren’t any indications for it to go right over to the warmer to be checked out,” Simpson said. “We let her hold her baby, skinto-skin, until the cord pulsing has significantly decreased or stopped. It gives the baby a better blood supply and more

specifically a better iron store. And skin-to-skin is so much better for the baby. It regulates so many things: the heart rate, the blood sugar, temperature. Mom’s body will actually change temperature to make baby’s what it needs to be.”

If an induced labor is planned, midwives explain “all the tools in our toolbox we can use,” Simpson said. Everyone’s birthing experience is unique, but The Family Place focuses on the needs of each mother.

“We have a really great staff here, not just midwives but all our staff that help kind of talk them through and help them cope with the contractions,” Simpson said. “If they want an epidural, if they don’t want an epidural, we’re there to support them no matter what.”

As for C-sections, they can be planned or unexpected, but once again, midwives allay fears by explaining as much as possible— during prenatal visits and then again during labor,

sometimes even during emergency situations.

“Sometimes I’ll say something like, ‘What we’re going to do is, all the staff is going to be real busy around you, and we’re going to get everything ready while I’m going to stay right here with you,’” Simpson said in a calm voice.

Beyond everyday concerns of pain and delivery options, midwives are sensitive to past issues that affect patients. An unpleasant previous hospital experience, sexual abuse,

a childbirth trauma— situations like these need to be handled with candor and compassion.

“We have one of the most cohesive and professional groups of midwives here at Evangelical,” Simpson said. “I am completely biased, but you really can’t go wrong with whoever is going to take care of you.”

4 EvErything BaBy March 2023
Cindy O. Herman lives in Snyder County. Email comments to her at CindyOHerman@gmail. com (Cindy O. Herman/For The Daily Item) Certified nurse midwife Jennifer Simpson is happy to explain to expectant parents why she recommends The Family Place of Evangelical Community Hospital.

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Becoming savvy in weight control

Tall and athletic, Dr. Jon Gabrielsen, FSMBS, bariatric and foregut specialist at the Bariatric Center of Evangelical, is sensitive to the stigma attached to overweight people.

“I struggled with my weight up until the summer between fifth and sixth grade. I remember what it felt like to have somebody call me chubby or insinuate that I was fat,” he said.

For Gabrielsen that was the start of his passion for understanding how the body works and addressing his own family history of weight, diet, and more. As a result, he lost about 25 percent of his body weight but still carries with him the understanding of “subtle discrimination and shame” overweight people experience.

“From having to ask for a seatbelt extension in an airplane, to the looks you get from

somebody sitting next to you, to being unable to ride rides at Knoebels,” he said. “People often make judgments in their head and in their heart. They see somebody who’s overweight and they just immediately say that person is lazy, right?”

As a society, we all have a propensity to be lazy in some ways, he said, but that judgement is too simple.

“That can be part of the picture and I don’t

want to say it’s not any of the picture,” he said, “but I’m saying that (attitude) is way too reductionist. There’s far more to it.”

Being metabolically healthy is more important than our weight, Gabrielsen said. People might be surprised to know that about 20 percent of people considered obese are, in fact, metabolically healthy.

“There actually is a term that we use, metabolically healthy obese,” Gabrielsen

said. “And the reason for that most likely is where their fat is distributed ... Conversely you can have relatively skinny people walking around who are metabolic train wrecks.”

Genes can influence our health. A new study called epigenetics is looking at how people’s habits or the foods they eat can turn on genes that cause them to gain weight. They might even turn on genes in a baby while it’s developing.

“My mantra to people is, you have to control what you can control,” Gabrielsen said. “So one of the very, very first things that really has to be part of the discussion is not counting calories as much as what you are

10 EvErything BaBy March 2023
(Cindy O. Herman/For The Daily Item)
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In general, if food comes out of a package, you ought to minimize it or avoid it, says Dr. Jon Gabrielsen.

eating. Are you eating a lot of processed foods? If you look at the rates of obesity in this country and the increase in processed food, they’re going to parallel pretty well.”

One of the biggest problems with processed foods, which lack nutrients and fiber, is that manufacturers are savvy enough to make them look healthy. One example, is a popularly touted “heart healthy” cereal that contains at least 12 grams of sugar. For the shopper, choosing that option over a clearly fruitycolored, sugar cereal makes no difference. They are equal in their unhealthy nature.

“High fructose corn syrup is particularly damaging. The food that is processed and coming out of bags is so full of it,” Gabrielsen said. “Manufacturers put different types of sugars in there and call them by different names. High fructose corn syrup, natural fruit concentrate … it sounds healthy. It’s not healthy. You have to be very savvy.”

Sugar leads to glucose spikes, leads to insulin output, and ultimately can lead to weight gain and Type 2 diabetes.

“Fiber is your friend when it comes to weight loss because fibers keep you from

really absorbing all the calories you take in,” Gabrielsen said.

Changing attitudes toward food can help people overcome or avoid obesity.

“Our bodies are beautifully designed machines that require fuel,” Gabrielsen said. “Giving it good fuel can be empowering.”

Specialist Care When is it time to see a specialist? Some early signs would be diagnoses like high blood pressure, cholesterol, or prediabetes.

“When those things start creeping up and you start getting on more medications, the cheese is beginning to slide off the cracker,” Gabrielsen said. “You don’t want to let that happen.”

Patients considering bariatric surgery need to understand it is a powerful weapon but it doesn’t win the battle.

“It’s not like the atom bomb, that you’re going to drop it and the war is over,” he said. “Surgery has to be accompanied by behavioral and lifestyle changes.”

That can include simple things like chewing your food well, giving your body time to signal that it’s had enough. It can mean getting out of your comfort zone and becoming more active.

“You have to get comfortable being uncomfortable,” Gabrielsen said. “It’s the same thing with life. When you get pushed to a point

where things are not comfortable, then you actually start to grow.”

To learn more about the Bariatric Center of Evangelical visit www. EvanHospital.com or call 570-523-3290.

Cindy O. Herman lives in Snyder County. Email comments to her at CindyOHerman@ gmail.com

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March 2023
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13 EvErything BaBy March 2023
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Evangelical Community Hospital is Nationally Recognized for High-Quality Stroke Care

Evangelical Community Hospital received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes the Hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines ultimately leading to more lives saved and reduced disability.

Evangelical earned the Association’s Gold Plus award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for 24 consecutive months or more. These measures include

evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Prior to discharge, patients receive education on managing their health and have multidisciplinary follow-up visits arranged.

Evangelical also received two additional honors. The Hospital was given the American Heart Association’s Target: Stroke Honor Roll Elite award. To qualify for this recognition, Evangelical met specific criteria to reduce the time between an eligible patient’s arrival at the Hospital and ischemic stroke

treatment with clot-buster medication.

In addition, it received an award associated with Type 2 Diabetes. Individuals living with Type 2 diabetes have an increased risk for heart disease and stroke. The American Heart Association’s Target: Type 2 Diabetes aims to ensure patients with Type 2 diabetes, who might be at higher risk for complications, receive the most up-to-date, evidence-based care when hospitalized due to stroke.

The Primary Stroke Center at Evangelical was established in 2013. As a primary stroke center, Evangelical offers 24/7 patient-centered care from inpatient through rehabilitation

services including emergency medicine, laboratory, radiology, hospitalist and neurologist care, and physical, occupational, and speech

Evangelical Community Hospital Recognized for Efforts Supporting Organ Donation

Evangelical Community Hospital received statewide recognition for its efforts to support and raise awareness about organ, eye, and tissue donation.

Evangelical was honored with a platinum designation through The Hospital and Healthsystem Association of Pennsylvania’s (HAP) 2022 Donate Life PA Hospital Challenge.

The annual campaign encourages Pennsylvania hospitals to increase organ, eye, and tissue donation awareness and designations within their hospitals and communities. HAP partnered with the Pennsylvania Department of Health and the two organ procurement organizations serving Pennsylvania—the Center for Organ Recovery & Education and Gift of Life Donor Program—to support the challenge.

“As a community hospital, we are uniquely positioned to not only tend to the direct healthcare needs of our

patients, but to inspire our neighbors and friends to be mindful of wellness in all aspects of life,” said Kendra Aucker, President and CEO, Evangelical Community Hospital.

“The more people we can inspire to become organ donors, the better we can serve our mission to be advocates for the well-being of our entire community. Becoming an organ donor and committing to give the gift of organs after death can provide direct lifesaving or quality of life improvements for others in need.”

The Hospital will take part in the effort again in 2023, during the month of April by supporting education and awareness through this statewide challenge. Efforts will include staff development trainings focused on the topic of organ donation and advocacy as well as social media reminders for community members to take the time to commit and sign-up for organ donation.

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You are our sunshine!

Love Mom & Dad

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15 EvErything BaBy March 2023

A headache journal can guide in care

Pounding and pulsing or unrelentingly steady, headaches make it tough to focus on daily activities. Doctors at the Headache Clinic of Evangelical can help.

“There are a lot of different headaches,” said Dr. Jessica Ahlum, Neurology of Evangelical, where headache clinics are held every Monday. “I would say the most common ones I tend to see are migraines, and there are different types of headaches.”

Classic migraine symptoms include a one-sided, throbbing headache, which can be associated with light sensitivity, sound sensitivity, nausea and vomiting. There are also nonmigrainous headaches, which include tension headaches, occipital neuralgia and atypical headaches.

“Non-migrainous headaches like occipital neuralgia can be triggered by things like arthritis and muscle spasm in the neck, or can present as pain in the back of the head, so that it radiates up over the sides,” Ahlum said. “And then tension headaches are more of the band-aroundthe-head, squeezing sensation that people can have.”

Most headaches can be soothed with over-the-counter pain relievers, but some require a specialist’s help.

“What I typically say is, if you find that you’re requiring escalating doses of over-the-counter pain medication, and it’s not significantly helpful, at that point I think it would be time to ask for a referral to a specialist,” Ahlum said.

The referral typically comes from a primary care provider (PCP). If headaches are worsening or changing in some way, specialists would likely request an MRI, which could also be ordered by the PCP and brought to the first appointment. There, neurologists start with listening to the patient’s story.

“The most important thing for me is hearing in the patient’s own words what their headaches are like, how often they get their headaches, and different symptoms that could be associated with them,” Ahlum said. “It’s really the patient’s report that I go by.”

A headache journal can help find pain triggers and track things like intensity, frequency, location and quality – is it a sharp,

shooting pain, is it a dull, aching pain? Is it triggered by different foods, smells or stressful experiences?

“Stress is very important in dealing with headaches,” Ahlum said. “One of the things we definitely ask is, do you feel muscle tightness, muscle spasm in the neck or shoulders? Do you feel like that could be contributing to the headaches?”

In a clinical exam, doctors might use an ophthalmoscope to look for swelling at the back of the eyes, a rare sign of certain types of headaches. Treatment typically starts with oral medications.

“Sometimes there is an element of trial and error,” Ahlum said. “You may try one

thing and it may not be effective, or it may be a little bit effective and then you need to determine the correct dose for that patient. It’s a matter of finding what medication is best for which individual.”

Chronic migraine— technically defined as least 15 headache days per month with eight of those having migraine features— can be helped with a procedure of 31 Botox injections made with a tiny needle in the head and around the neck, usually once every three months.

“I’ve had patients say, ‘This has really changed my life,’” Ahlum said. “I can say that, for the right person, Botox is a good option.”

Neurologists work to find the best plan for each situation. Sometimes that can require continued follow-up evaluations, but most of Ahlum’s patients report seeing progress.

“I’m glad I can offer this service to people and be able to help them,” she said. “You know, that’s why I went into medicine, so I’m really happy that’s an outcome we can have.”

To learn more about Neurology of Evangelical and headache care, visit www.EvanHospital.com or call 570-522-9771.

O. Herman lives in Snyder County. Email comments to her at CindyOHerman@ gmail.com

16 EvErything BaBy March 2023
Cindy (Cindy O. Herman/For The Daily Item) Dr. Jessica Ahlum, of Neurology of Evangelical, uses an ophthalmoscope to look for swelling at the back of the eyes, a rare sign of certain types of headaches.

Couple Shares Birthday with Son

Marrying a partner with the same birthday is quite unique. But what are the odds of those two people then having a baby that also shares the same birthday?

Tuesday, January 17, 2023, was an extraordinary day at The Family Place at Evangelical Community Hospital when Dawson and Kayla Schlegel of Millersburg welcomed their son, Jackson Lee, to their family. Initially due January 19, 2023,

Jackson decided sharing a birthday with his parents was a great idea and naturally came two days early.

Jackson arrived at 3:14 am on January 17, weighing 7 pounds, 10 ounces, and measuring 19 ½ inches in length.

To honor the occasion, The Family Place staff, with the help of Patient Experience, held an impromptu birthday party for the

family, complete with cake and balloons and a softly sung Happy Birthday song so as not to wake Jackson, who was napping after a busy night of coming into this world.

Jackson is the second child for the couple, joining Cayson, who is one and a half, at home. Cayson has his own birth date separate from the rest of the family on June 18.

Evangelical Community Hospital Adds Transesophageal Testing as Part of Echocardiography Accreditation

Evangelical Community Hospital added accreditation for adult transesophageal testing (TEE) to its existing Echocardiography Accreditation by the Intersocietal Accreditation Commission (IAC). The accreditation demonstrates the Hospital’s ongoing commitment to providing quality patient care in echocardiography through the Heart and Vascular Center of Evangelical.

TEE uses high-frequency sound waves (ultrasound) to make detailed pictures of the heart and the arteries that lead to and from it. Unlike a standard echocardiogram, the echo transducer that produces the sound

waves for TEE is attached to a thin tube that passes through the mouth, down the throat, and into the esophagus. Because the esophagus is so close to the upper chambers of the heart, very clear images of those heart structures and valves can be obtained.

TEE is just one part of Evangelical’s Echocardiography program used to assess different areas of the heart and can detect heart disease or signs of serious conditions. With the addition of TEE accreditation, the IAC accreditation for the Hospital’s existing echocardiography program covers TEE, adult stress testing, and adult transthoracic testing.

There are many factors that contribute to an accurate diagnosis based on echocardiography. The training and experience of the sonographer performing the procedure, the type of equipment used, and the quality assessment metrics each facility is required to measure, all contribute to a positive patient outcome. IAC accreditation is a “seal of approval” that patients can rely on as an indicator of consistent quality care and a dedication to continuous improvement.

For more information about the Heart and Vascular Center at Evangelical, visit www.EvanHospital.com.

17 EvErything BaBy March 2023

By the Numbers

In 2022, 648 babies, including 3 sets of twins, were born at The Family Place of Evangelical Community Hospital. Of those births, 305 were girls and 342 were boys, and from those, the most popular area names emerged.

Evangelical Community Hospital Introduces First Baby of 2023

Top Ten Girl

Names in 2022:

1. Isla

2. Nova

3. Audrey

4. Charlotte

5. Chloe

6. Ella

7. Ellie

8. Layla

9. Nora 10. Paisley

Top Ten Boy

Names in 2022:

1. Asher

2. Lucas 3. Waylon 4. Cooper 5. Isaac 6. James 7. Oliver 8. Owen

At The Family Place, the highest number of births in 2022 happened in April when 67 babies were born.

On Monday afternoon, January 2, 2023, at 1:46 pm, Kevin and Stephanie Kline of Middleburg welcomed a brand-new 5 pounds, 11.5 ounces, 18 inches long addition to their family.

Oliver Arthur Kline was originally due to arrive on January 21, 2023, but decided to make an early appearance to become Evangelical Community Hospital’s first baby of 2023 to be born at The Family Place, the Hospital’s obstetrics unit. Oliver was delivered by

Oliver is the third baby for the couple. He joins sisters, Cora, who is 3, and Carla, who is 18 months old.

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9. Wyatt 10. Alexander
Jennifer Simpson, Certified Nurse Midwife with OB/GYN of Evangelical.

Hospice of Evangelical Earns 5-Star Rating

Hospice of Evangelical, a comprehensive program that assists patients and their families with physical, emotional, and spiritual needs that may accompany a lifelimiting illness, was awarded the 5-Star rating by the Centers for Medicare and Medicaid Services (CMS).

The rating is part of CMS’ Hospice Compare program that gathers data to assist families in choosing a hospice program for loved ones. The data is compiled from family and caregiver surveys.

The program measures eight key areas: communication with family, getting timely help, treating patients with respect, emotional and spiritual support, help for pain and symptoms, training family to care of the patient, willingness to recommend, and rating of the Hospice provider.

Hospice of Evangelical scored well in all categories, well above the national and state average, reaching 93 percent or higher in the areas of treating patients with respect, emotional and spiritual support, and willingness to recommend the

program to others. In all other categories, Hospice received 80 percent or higher.

“We are extremely proud of the Hospice program and the care our team is able to provide to patients and their loved ones as they transition to needing hospice care,” said Kathy Paul, Director of Hospice of Evangelical.

“We are grateful to be part of

their care and support system and strive to provide the highest quality of life.”

To learn more about Hospice of Evangelical and to gain guidance on when hospice care may be right for someone you love, visit www.EvanHospital. com/Hospice or call 570-5222550.

19 EvErything BaBy March 2023
(Metro Graphic Photo)

Caredesignedfor allofyou.

20 EvErything BaBy March 2023
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