October - December 2014 HealthScope

October/November/December 2014

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HealthScope is published by Floyd Memorial Hospital and Health Services.

1850 State Street New Albany, Indiana 47150

Health Happens Here.

SM

1850 State Street New Albany, IN 47150

If you no longer wish to receive marketing/communications materials from Floyd Memorial Hospital and Health Services, please call 1-800-476-8723.

Cindy Ferree Editor, Writer Angie Rose Director of Marketing & Customer Relations, Writer Angie Glotzbach Writer

Health Happens Here.

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Stacey Rudy Contributor

Fran Cohn found unexpected blessings in a rare breast cancer diagnosis

HOW TO HELP HealthScope is designed to support our Healthier Community Initiative by providing up-to-date health tips and wellness information to benefit our community’s health. Through this publication, the Floyd Memorial Foundation hopes to encourage healthier active lifestyles for the residents of Southern Indiana. As a non-profit organization, Floyd Memorial relies on your support of our Foundation to provide health screenings, educational programs and hospital improvements. To learn how to help, visit FloydFoundation.org or call (812) 949-5519.

CAREER OPPORTUNITIES Visit “Careers” at FloydMemorial.com to find out more about exciting career opportunities available at Southern Indiana’s premier regional healthcare provider.

VOLUNTEER OPPORTUNITIES Visit FloydMemorial.com/Volunteer or call (812) 948-6734 for information about our rewarding volunteer programs.

Ann decided to end her knee pain for good.

Paralyzed man walks again Diagnosing irregular heartbeats with the world’s smallest insertable cardiac monitor

Varicose veins respond beautifully to sophisticated in-office treatments

Floyd Memorial Medical Group Welcomes Pediatric Practice Floyd Memorial Medical Group is pleased to welcome board certified Bahram Sepehri, MD pediatrician and pediatric cardiologist, Bahram Sepehri, MD, and board certified pediatrician, Laleh Rezaei, MD, to our growing list of providers. Floyd Memorial Medical Group – Pediatrics specializes in general pediatric and Laleh Rezaei, MD pediatric cardiology services. They also believe in promoting healthy lifestyle behaviors, meeting the special needs of their patients and families, and they are focused on providing excellent care to every child from birth to young adulthood. The practice is accepting new patients. For more information, call (812) 945-BABY(2229).

WHAS Crusade for Children Provides Generous Grants The WHAS Crusade for Children recently granted $34,413 to the Floyd Memorial Foundation in order for Floyd Memorial Hospital and Health Services to purchase essential pediatric medical supplies. The grant funding will allow the

Floyd Memorial Medical Group-Endocrinology Moves Jeffersonville Office

The Floyd Memorial Heart and Vascular Center recently became the first and only hospital in Southern Indiana to offer cardiac electrophysiology (EP) services. Cardiac EP is the science of diagnosing and treating problems relating to the electrical activities of the heart.

Endocrinologist, Vasdev Lohano, MD, of the Floyd Memorial Joslin Diabetes Center Affiliate and Floyd Memorial Medical GroupEndocrinology office, has recently moved his Jeffersonville office from its former location at 207 Sparks Avenue to a new office located at 41 Quartermaster Court in Jeffersonville. Dr. Lohano’s new Jeffersonville office space is the home of the Floyd Memorial Medical Group-River Cities Cardiology office, and offers patients more convenient parking and easier access in a larger, more updated space.

EP studies and procedures require a specially outfitted cardiac catheterization lab. A new lab capable of supporting EP services opened in September of this year. In addition to EP services, the lab will also offer expanded traditional cardiac catheterization services to meet the increasing needs of our community.

For more information about services available at the Floyd Memorial Heart and Vascular Center, call (812) 949-7088 or visit FloydMemorial.com/Heart.

Hospital to purchase two bili blankets to treat babies born with jaundice, a pediatric orthopedic instrument set, an interactive pediatric patient simulator known as SimJunior, a peripheral kit for the SimJunior and a variety of pediatric surgical equipment.

The generous support of the WHAS Crusade for Children allows Floyd Memorial to remain

For more information about services available at the Floyd Memorial Joslin Diabetes Center Affiliate, or to schedule an appointment with Dr. Lohano, call (812) 949-5700 or visit FloydMemorial.com/Joslin.

on the cutting edge of pediatric healthcare, and continue to provide a vital service to the children of our community. Floyd Memorial greatly appreciates WHAS Crusade for Children’s continued partnership!

For information on how you can help the Floyd Memorial Foundation, call (812) 949-5519 or visit FloydFoundation.org.

Floyd Memorial Home Healthcare Receives Perfect Scores In May, the Accreditation Commission for Health Care (ACHC), which prides itself on being the leader for home healthcare accreditation, performed an unannounced survey of Floyd Memorial Home Healthcare.

The surveyors reviewed policies, organizational structure, patient charts, financial billing records, service contracts, risk management, home visits, performance improvement activities, personnel records and more.

Floyd Memorial Home Healthcare, once again, earned the three-year ACHC accreditation. It is an achievement which marks a commitment to quality in the provision of home healthcare services.

Also, in June, two surveyors from the Indiana State Department of Health (ISDH) performed a validation survey at Floyd Memorial Home Healthcare for a full week. Similar to the ACHC survey checklist, the ISDH found the organization to have zero deficiencies or non-compliance.

Congratulations to Floyd Memorial Home Healthcare for showing a commitment to quality and outstanding care with excellent scores from both agencies.

FMMG-Orthopedics Welcomes Norman Silva, PA Floyd Memorial Medical Group – Orthopedics is pleased to welcome physician assistant, Norman Louis Silva, PA, to the practice.

Norman graduated from Cornell University School of Agriculture and Life Sciences in 2004. Then in 2014, he completed his masters of medical science degree in physician assistant studies at Wake Forest School of Medicine.

Norman has completed specialty training in the areas of internal and family medicine, orthopedics and pediatric medicine. He is a member of the American Academy of Physician Assistants (AAPA), Kentucky Academy of Physician Assistants (KAPA), Indiana Academy of Physician Assistants (IAPA), North Carolina Academy of Physician Assistants (NCAPA) and Katherine Anderson Society of the Student Academy of the American Academy of Physician Assistants (SAAAPA). Norman, a Floyds Knobs native, along with his wife Jennifer, have twins, Alexina and Jasper. In his free time, he enjoys woodworking, pottery, camping and spending time with friends and family.

Guardian Angels Congratulations to Floyd Memorial’s recent Guardian Angel recipients: The Guardian Angel program offers patients and visitors a way to say thank you to a special

Looking for a Physician? Call Floyd Memorial’s Physician Referral Line at 1-800-4-SOURCE (1-800-476-8723) or visit us online at FloydMemorial.com.

associate, physician or volunteer who has made a positive difference in their hospital experience by making a donation in their honor to the Floyd Memorial Foundation. For more information, call (812) 949-5803.

New Physicians

Jessica Parker, RN ICU

Daniel Altman, MD Radiology Radiology Associates 1214 Spring Street, #2 New Albany, IN 47150 (812) 283-5950 Kenneth A. Burckardt, MD Anesthesiology Southern Indiana Anesthesia Consultants 320 Whittington Parkway, #301 Louisville, KY 40222 (502) 690-8782 Scott Farner, MD Hand and Orthopedic Surgery Kleinert Kutz & Associates 3605 Northgate Court, Suite 102 New Albany, IN 47150 (812) 944-4263 2

Floyd Memorial Becomes First to Offer Cardiac Electrophysiology in Southern Indiana

Marie Gurka, MD Radiation Oncology Floyd Memorial Cancer Center of Indiana 2210 Green Valley Road New Albany, IN 47150 (812) 945-4000 Jonathan E. Hodes, MD Neurosurgery Center for Advanced Neurosurgery 3900 Kresge Way, #41 Louisville, KY 40207 (502) 896-1313 Shon Hubert, MD Emergency Medicine Floyd Emergency Medicine Associates 700 East Spring Street, Suite 200 New Albany, IN 47150 (812) 945-7536

Mana Moghadamfalahi, MD Pathology Floyd Pathology Associates 1850 State Street New Albany, IN 47150 (812) 948-7408 Matthew H. Nett, MD Radiology Radiology Associates 1214 Spring Street, #2 Jeffersonville, IN 47130 (812) 283-5950 Michael C. Nicoson, MD Plastic and Hand Surgery Kleinert Kutz & Associates 3605 Northgate Court, Suite 102 New Albany, IN 47150 (812) 944-4263

Henry B. Sadlo, MD Cardiology U of L Cardiovascular Medicine 1919 State Street, #302 New Albany, IN 47150 (812) 542-1880 Matthew C. Sniegowski, MD Oculofacial Plastic and Orbital Surgery Eye Specialists of Louisville 301 East Muhammad Ali Blvd.

Louisville, KY 40202 (502) 852-7443 Pawel Zieba, MD Neonatal Medicine Kosair Children Neonatal Specialists Suburban Medical Plaza III 4121 Dutchmans Lane, #301 Louisville, KY 40207 (502) 896-2500

C.M. Hocker, MD FMMG-State Street

Paul Bender, DDS Pediatric Dentist

Massage Gift Certificates for the Holidays Floyd Memorial Rehabilitation Services offers massage gift certificates for that special holiday gift. Clients can choose from Swedish, deep tissue, injury, sports or prenatal massage.

The cost is $35 for 30 minutes and $60 for an hour. Gift certificates may be purchased at Floyd Memorial Outpatient Rehab. For more information, call (812) 948-7416 or visit FloydMemorial.com/Massage.

Holiday office massages at your location are also a great way to relieve stress in the workplace while treating your employees to

a special gift. Appointments are required and can be made by calling (812) 948-7416.

Massage therapy services are performed by appointment at Floyd Memorial Outpatient Rehabilitation, located at 1700 State Street in New Albany Monday through Friday, the Floyd County YMCA Tuesday through Saturday and now at Floyd Memorial Physical Therapy - Charlestown Road (behind Kohl’s) on Fridays. Call (812) 948-7416 to schedule a massage at Floyd Memorial Outpatient Rehab and the Floyd County YMCA, or (812) 945-3440 for Floyd Memorial Physical Therapy – Charlestown Road.

Grandparents Day Facebook Photo Contest Winner The winner of the Grandparents Day Facebook Photo Contest was Whitney Pease, receiving 678 votes. Thanks to everyone who participated in the contest.

Whitney won a 60-minute massage and Yoga/Pilates package from Floyd Memorial Rehabilitation Services.

Floyd Memorial is proud to announce the expansion of our physical therapy services.

On November 4, Floyd Memorial will open two new clinics, one in Charlestown and the other in Clarksville. These former STAR Physical Therapy clinics are located at: • Floyd Memorial Physical Therapy in Clarksville 1615 Blackiston View Drive, Suite B in Clarksville (next to Neil Huffman Honda) (812) 288-8817 • Floyd Memorial Physical Therapy in Charlestown 9407 State Road 403 in Charlestown (812) 256-0528 Services will include physical therapy, sports therapy, occupational rehabilitation, manual therapy, orthopedic/spine therapy and balance/dizziness therapy, as well as functional capacity evaluations. We are especially pleased to be able to offer a new service, women’s health physical therapy at the Clarksville location.

This will make a total of six locations for Floyd Memorial Physical Therapy in Floyd, Clark and Harrison Counties, allowing us to better serve patients throughout our region.

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Rare Breast Cancer Diagnosis Brings About Unexpected Blessings When Fran Cohn, a New Albany resident and recently retired elementary school teacher, began suffering from frequent respiratory issues and feeling unusually fatigued in the spring of 2013, she chalked it up to normal life stresses.

At the time, she was volunteering at a school in New Albany, and just figured the students were not only passing on their respiratory illnesses, but also wearing her out. When she noticed dimpling on the side of her left breast, again, she thought it was just normal aging.

“Life gets busy and you don’t put yourself first,” said Fran. “It’s easy to explain away symptoms and assume that you’re invincible.

I’m a single mother, and I was busy raising my daughter and working, so I wasn’t thinking about myself. I had gone seven years without a mammogram, and the more I thought about it, the more I felt compelled to see my doctor and make sure things were okay. Thank God I did.”

Diagnosis, times two “I scheduled a visit with my family physician, Dr. Phillip Johnson,” she continued. “He felt a lump during my exam and ordered a mammogram, which showed a suspicious area. After a biopsy, I was diagnosed with stage two invasive ductal breast cancer.”

Roseline Okeke, MD, a medical oncologist at the Floyd Memorial Cancer Center of Indiana, was Fran’s medical oncologist. “During my first visit with Fran, I performed a thorough physical exam of her breast and felt two more small nodules that hadn’t shown up on the mammogram. I ordered a breast MRI, which was followed by a second biopsy. These tumors, however, were different from the first. She had stage two invasive lobular cancer. Fran fell into the rare five percent of breast cancer patients who present with two separate primary tumors at the same time.”

Surgery “After my second diagnosis, I met with my surgeon, Dr. Gore,” said Fran. “The Cancer Center’s breast cancer nurse navigator, Kristy Helm, met me at his office to offer her support and help me sift through all of the information I was presented with. Dr. Gore and Dr. Okeke both felt strongly that the fact that I had two primary cancers in different areas of the breast meant that mastectomy was my best option, and I agreed. I asked a lot of questions, and Dr. Gore was incredibly patient with me.

Kristy helped me understand what to expect.”

Fran continued, “During my mastectomy, Dr. Gore biopsied seven lymph nodes and found cancer in one of them. I spent three days in 4

“Fran’s case was very unique in that she had two primary breast tumors.

This happens in less than five percent of breast cancer cases.”

Roseline Okeke, MD Hematologist and Board Certified Medical Oncologist Floyd Memorial Cancer Center of Indiana “Breast cancer patients offer input in their surgical decision more than any other type of cancer. Multiple options are given and we talk through the pros and cons of each. In Fran’s case, the fact that she had two primary tumor sites meant that mastectomy with reconstruction at a later date was her best option.”

Lanny Gore, MD Board Certified General Surgeon Floyd Memorial Medical Group-Surgery “Fran’s story is a perfect example of why it’s so important to have yearly mammogram screenings.

She had a normal mammogram in 2006, then life got in the way and she didn’t have another until 2013, when her cancer had already advanced to stage two. An earlier mammogram may have caught it before it spread to the lymph nodes.”

Phillip Johnson, MD Board Certified Family Medicine Physician Floyd Memorial Medical Group-Physician Associates of Floyds Knobs

Schedule Your Annual Mammogram Women should have yearly screening mammograms after age 40. Schedule yours today by calling the Floyd Memorial Women’s Imaging Center at (812) 949-7799 or Floyd Memorial Diagnostic Imaging-Corydon at (812) 734-3920.

the hospital and absolutely everyone from the transporter to my nurses to the woman cleaning my room treated me with such a caring, positive attitude. It’s amazing to me that people can deal with such difficult situations every day and remain so positive.

It was really inspiring.”

Treatment “I was terrified of chemo,” said Fran. “Kristy and Dr. Okeke were so patient with me, they explained everything and made sure I was ready in every way. The treatments lasted for seven months, and I actually did really well.

My main side effects were extreme fatigue, always feeling hungry, neuropathy and gastrointestinal issues. They arranged for a dietitian to meet with me to give me some recipes and ideas for what to eat that would curb the hunger, and that really helped.”

“After chemo I had three weeks of radiation therapy. My radiation oncologist, Dr. Dragun, was absolutely wonderful. He was incredibly down to earth and treated me like a friend. I did really well with radiation too. I didn’t experience any burns or other side effects at all.”

Support from all over “One of the things that really astounded me about the Cancer Center was how incredibly caring and supportive everyone was,” continued Fran. “They had discussed support groups and massage therapy with me when I started treatment, but I just didn’t feel like those kinds of things were for me. Little did I know that even if I didn’t go looking for it, that support would still find me.”

“One day after a radiation treatment, I ran into Susan Waiz, a massage therapist at the Cancer Center. She told me that my shoulders seemed out of balance and asked if she could try to discern what was going on. I ended up having six free sessions of massage therapy with her, and it made such an amazing difference in my wellbeing and outlook.”

“Later, I was telling Dr. Okeke about some issues I was having raising my arm above my head and she suggested that I take advantage of the free Pink Ribbon Pilates program that the hospital offers. I have never been a fan of group exercise, but I have been hooked on that program since day one! The ladies that I exercise with every week have become like a family to me. They’re the support group I never thought I needed. And Susie Stewart, the instructor, is absolutely wonderful. I’ve been able to gain back so much strength and confidence thanks to her.”

“Radiation therapy has come a long way in the past decade. The technology we have today can shorten treatment timeframes and virtually eliminate side effects.”

Anthony Dragun, MD Board Certified Radiation Oncologist Floyd Memorial Cancer Center of Indiana

“I wouldn’t wish cancer on anyone, but I feel very blessed that I’ve had this experience. It’s introduced me to a whole new world of people that have become like family to me.”

– Fran Cohn Breast cancer survivor, with Susie Stewart, Certified Pink Ribbon Pilates Instructor

Feeling blessed “I just finished all of my treatments in May, and I’m feeling great, both mentally and physically. Cancer is a journey, and while it started off bumpy for me, I’ve ended up in a great place. I feel like I’ve truly been blessed with this experience. It opened up a whole new world of wonderful people to me that I never would have known otherwise. And, I’ll never put my health on the back burner again. Good health is so important, it’s worth the effort to keep up with it.”

Free Pink Ribbon Pilates Classes Classes are offered at the Floyd Memorial Physical TherapyCharlestown Road location free of charge to breast cancer patients and survivors thanks to a generous grant from the Floyd Memorial Foundation. Class times are Wednesdays at 4:30 and 5:30 p.m. Attendance is limited, so please call (812) 945-3440 to reserve your spot in advance.

Know Your Risk The Floyd Memorial Cancer Center of Indiana’s High Risk Breast Cancer Clinic helps women determine their breast cancer risk, and take proactive steps to manage and prevent it. Call (812) 945-4000 to schedule a consultation today, or to learn more, attend our free Breast Health Seminar on October 16.

To register, call 1-800-4-SOURCE.

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Varicose Veins Respond Beautifully to Sophisticated Treatments

World’s Smallest Insertable Cardiac Monitor Helps Diagnose Irregular Heartbeats Signs & Symptoms of Cardiac Arrhythmia If you experience any of these symptoms, speak with your primary care physician about whether cardiac monitoring may be needed. When arrhythmias last long enough to affect how well the heart works, more serious symptoms may develop, so time is of the essence.

• Dizziness • Fainting or near-fainting spells • Lightheadedness • “Fluttering” feeling in the chest • Rapid heartbeat or pounding • Slow heartbeat • Shortness of breath • Chest pain

Causes of Cardiac Arrhythmia Many things can lead to an arrhythmia, including: • A heart attack that’s occurring right now • Heart tissue scarring from a prior heart attack • Changes to your heart’s structure, such as from cardiomyopathy • Blocked arteries in your heart • High blood pressure • Diabetes • Obstructive sleep apnea • Overactive thyroid gland (hyperthyroidism) • Underactive thyroid gland (hypothyroidism) • Smoking/tobacco use • Drinking too much alcohol or caffeine • Drug abuse • Stress • Certain prescription medications • Certain dietary supplements and herbs • Electrical shock

Types of Cardiac Arrhythmias Doctors classify arrhythmias not only by where they originate in the heart (atria or ventricles) but also by the speed of heart rate they cause: • Tachycardia is a fast heartbeat — a resting heart rate greater than 100 beats a minute.

• Bradycardia is a slow heartbeat — a resting heart rate less than 60 beats a minute.

Not all tachycardias or bradycardias mean you have heart disease. For example, during exercise it’s normal to develop a fast heartbeat as the heart speeds up to provide your tissues with more oxygen-rich blood. During sleep or times of deep relaxation, it’s not unusual for the heart beat to be slower.

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“Heart rhythm disorders can sometimes be difficult to diagnose due to the infrequent symptoms patients can experience. The new LINQ insertable cardiac monitor allows us to continuously monitor the heart for up to three years with a simple, painless injection that can be administered in an outpatient setting.”

Bapineedu Gondi, MD Board Certified Cardiologist Floyd Memorial Medical GroupCardiovascular Associates of Southern Indiana The Floyd Memorial Heart and Vascular Center recently became one of the first hospitals in the Kentuckiana area to begin using the new Reveal LINQ™ Insertable Cardiac Monitor to diagnose heart rhythm disorders in patients experiencing recurrent fainting, heart palpitations, unexplained stroke or atrial fibrillation.

Heart rhythm disorders, also called cardiac arrhythmias, occur when there is a malfunction in the heart’s electrical impulses that coordinate how it beats. As a result, the heart can beat too quickly, too slowly or irregularly. In some cases, abnormal heart rhythms are not serious or life threatening and can be addressed with simple lifestyle changes. In other cases— such as when a patient experiences recurrent fainting, palpitations, unexplained stroke or atrial fibrillation — arrhythmias can be more serious and potentially life threatening.

Continuous monitoring of the heart’s rhythms Insertable cardiac monitors (ICMs) allow physicians to continuously and wirelessly monitor a patient’s heart rhythms for up to three years. The LINQ ICM, which was approved by the U.S. Food and Drug Administration in January 2014, is approximately one-third the size of an AAA battery, making it more than 80 percent smaller than ICMs previously available.

ICMs provide remote monitoring by notifying physicians if patients have significant cardiac events between regular medical appointments.

Cardiologist Bapineedu Gondi, MD, explained why this can be particularly helpful. “Because abnormal heart rhythms and their accompanying

cardiac symptoms often come and go in a transient manner, they may be difficult to detect. Tests such as electrocardiograms only allow a doctor to look at the heart’s activity at one point in time. Until a patient is diagnosed with an arrhythmia, he or she may be at risk for future symptoms or events.”

Dr. Gondi continued, “To determine the cause of recurrent fainting, palpitations, unexplained stroke or atrial fibrillation, a patient’s heart must be monitored effectively over time so the doctor can diagnose the disorder accurately. An ICM such as the LINQ system notifies the physician when irregularities occur, so that we can be proactive and begin treatment as soon as possible. Patients feel very secure knowing that no matter where they are-be it at home, work or away on travel, someone is keeping an eye on their heart and can alert them to any potential issues.”

World’s smallest cardiac monitor The LINQ monitor is the world’s smallest ICM. It is so discreet that most patients will not even know it is there and can go about their lives without any interruption or discomfort.

“While ICMs are not a new technology, the size of the LINQ monitor is what makes it so cutting edge,” added Dr. Gondi. “Previous generations of ICMs were so large that they had to be inserted in an operating room and were externally visible beneath the skin.

This meant that they were used infrequently in favor of external event monitors, which the patient wears externally for 30 days.

The sensors on event monitors have to be changed daily, and they are cumbersome to wear 24 hours a day, seven days a week for 30 days. Plus, some patients experience irregularities so infrequently that the 30 day monitor may not record an episode that is nonetheless present.”

“The LINQ monitor makes implantable cardiac monitoring much more accessible to patients,” Dr. Gondi continued. “It can be inserted in the Heart and Vascular Center’s outpatient cardiovascular area, with a local anesthetic and a simple injection that doesn’t even require a suture to close. The ease of insertion, coupled with the fact that it’s nearly invisible once implanted, makes it a viable option for many more people.”

Varicose veins are much more than a cosmetic problem. They can cause aching, itching, cramping and swelling, and eventually lead to eczema, ulceration and bleeding. Treating them used to involve a traumatic process of stripping the damaged veins, which left scarring and required a lengthy recovery. Today, however, the most advanced minimally invasive treatments are available at Floyd Memorial.

What are varicose veins?

An estimated 20 to 25 million Americans have varicose veins. “Varicose veins are swollen, twisted and enlarged veins that you can see under the skin that are red or blue in color,” explained vascular surgeon, Dean Wickel, MD. “They usually appear in the legs, and are more common in women than in men. Smaller varicose veins that can be seen on the surface of the skin are called spider veins. They occur on the legs, but can also be found on the face, particularly around the nose. Spider veins vary in size and often look like a spider’s web.”

Vascular surgeon, Waheed Ahmad, MD, described how varicose veins form. “Most varicose veins are caused by valvular insufficiency,” he explained. “The job of veins is to return blood to the heart. Normally, valves in leg veins open and close to allow blood to flow in an upward direction only.

When valves are defective, they let blood leak back down and pool inside the vein.

This pooling causes veins to become distended and protrude under the skin.”

Symptoms and risk factors Varicose veins usually don’t cause problems for most people. However, in some cases, they can lead to painful symptoms, including: • An achy or heavy feeling in your legs • Burning, throbbing, muscle cramping and swelling in your lower legs

• Pain after sitting or standing for a long time • Itching around one or more of your veins • Skin ulcers near your ankle, which can mean you have a serious form of vascular disease that requires medical attention Risk factors for varicose veins include: • Age – veins fail as we get older • Multiple pregnancies – the pregnancy hormone progesterone relaxes the veins and their valves, leading to insufficiencies that progress with each pregnancy • Female – women are three times more likely to develop varicose veins than men • Diabetes • Family history • Obesity • Standing or lifting for long periods of time • Pelvic trauma • Previous groin surgery or radiation Treatment options “In many cases, you can take care of mild pain from varicose veins on your own. Avoid long periods of sitting or standing, get regular exercise, maintain a healthy weight, elevate your legs several times per day and wear compression stockings,” said Dr. Wickel.

“However, in some people, they can lead to serious conditions, such as leg swelling and pain, burning sensations, blood clots, ulcers and skin conditions. If you experience any of these symptoms, talk to your physician right away. There are several very effective treatment options that can be done in the office, with minimal discomfort and quick recovery times.”

EndoVenous Laser Treatment (EVLT): “EVLT is a minimally invasive laser procedure that works particularly well on large varicose veins,” added Dr. Ahmad.

“During EVLT, a thin laser fiber is inserted in the vein and the laser seals the faulty vein.

“Most cases of varicose veins are mild and can be managed with weightloss, exercise, compression stockings and elevating the legs several times per day. However, if you experience serious symptoms such as leg swelling, blood clots, burning sensations, pain or ulcers, treatment is necessary.”

Dean Wickel, MD Board Certified Vascular Surgeon Floyd Memorial Medical GroupVascular Surgery

Treatment takes less than an hour and is performed in the surgeon’s office. Patients experience immediate relief of symptoms and immediate return to normal activity, with minimal-to-no scarring. The procedure is highly tolerated with very little pain, and is typically covered by insurance.”

Sclerotherapy is a procedure used primarily to treat cosmetic vein issues such as spider veins and small varicose veins. A chemical solution is injected directly into the vein, which causes the vein to die off and gradually disappear. Depending on the number of veins, the treatment session may last up to 30 minutes and several sessions may be needed.

Microphlebectomy is indicated for medium to large surface level varicose veins. The procedure is done in the office with a tiny micro-incision of less than ¼ inch in length.

The varicose vein is gently extracted through the incision, which is then closed with sterile tape-sutures are not needed. Even though a large vein has been removed, there is no negative effect on the blood flow or circulation in the leg. The blood that has been carried by that vein is simply rerouted to another vein deeper in the leg. Circulation and blood flow continue as before, but better and more efficiently. Most patients return to normal activities within 24 hours.

Cutaneous Laser Therapy is an alternative or add-on to sclerotherapy which is more effective for spider veins that are smaller in size or have been previously treated. “We consider this a ‘clean up’ treatment after sclerotherapy to eradicate the veins that did not fully respond to the first treatment,” explained Dr. Wickel. “Cutaneous laser therapy is also effective for erasing age spots and cherry angiomas, which are small red bumps that appear on the skin. And it’s the preferred treatment for spider veins that appear on the face, usually around the nose.”

“There are minimally invasive options for treatment of varicose veins, which leave no scar and allow patients to resume normal activities quickly.”

Waheed Ahmad, MD Board Certified Surgeon Comprehensive Vein Treatment Center of Kentuckiana

Normal vein

Varicose vein with valvular insufficiencies

To learn more about treatments at the Floyd Memorial Vein Treatment Center, call (812) 949-5575 for Dr. Wickel’s office or (812) 945-3372 for Dr. Ahmad’s office.

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The ABC’s of Healthcare Providers When you encounter a healthcare provider such as a doctor, nurse, physician assistant or other medical professional, understanding their credentials can be very confusing.

Here is a breakdown of common healthcare credentials to help decipher the ABC’s of healthcare providers: MD: An MD is a doctor of medicine who has received a medical degree from an accredited medical school, completed a medical residency training program and passed the U.S. Medical Licensing Exam. To be board certified, an MD must pass an evaluation by a national accrediting agency such as the American Board of Medical Specialties. Fellowship training is further training in a specialty field. MDs are fully licensed and able to diagnose, treat and prescribe medications.

DO: A DO is a doctor of osteopathy medicine who is fully trained and licensed and must also pass the same type of exams as an MD. The major difference is that osteopathic doctors have special training in the musculoskeletal system. They treat the person as a whole, mentally and physically, with a holistic and preventative approach.

PA: A physician assistant is clinically and academically trained to provide healthcare services directly under the guidance of an MD or DO. They have obtained a master’s degree and are nationally certified and state licensed.

PAs complete nine different clinical rotations and many choose areas of specialty interest to practice. Their courses during the program are similar to prerequisite courses for medical school. A PA is able to perform diagnostic, therapeutic, preventative and health maintenance services and is able to prescribe medications.

You may encounter a PA at your primary care physician office, the hospital and other healthcare settings.

Nurse Practitioners: There are several variations in credentials for nurse practitioners.

You may see them listed as an ARNP, APRN, NP, NPC or FNP-BC. Each has graduate level training and is certified.

Carla Layne, APRN, CNM Advanced Practice Registered Nurse and Certified Nurse Midwife Floyd Memorial Birthing Center

and record symptoms, reactions and progress, which provides the basis for care. They educate patients and families and develop and manage nursing care plans.

Registered nurses can specialize by becoming certified by an accrediting body. For example, an RN, OCN, is a registered nurse who is specially trained in helping cancer, or oncology patients.

You’ll find registered nurses in doctors’ offices, hospitals, surgical centers, clinics, long-term care facilities, home healthcare and many other settings.

LPN: A licensed practical nurse is able to do many of the same functions as an RN, but does not have the same amount of training and certification. They typically work under the direction of an RN. There are many healthcare facilities who have LPNs on staff such as medical offices, including Floyd Memorial Medical Group offices, nursing homes, home healthcare agencies and community health centers.

specialist and (CNP) certified nurse practitioner.

They also must receive training in at least one of six categories; family/individual across the lifespan, adult-gerontology, pediatrics, neonatal, women’s health/gender-related or psychiatric/mental health.

Working under the direction of an MD or DO, you may see an APRN or PA in place of your family doctor during a wellness check or sick visit to evaluate, diagnose, manage and treat you.

You may also choose an APRN, CNM, as your healthcare provider for labor, delivery and adolescent through postmenopausal care. APRNs are able to prescribe medications as needed.

•N PC and NP-BC stand for certified or board certified nurse practitioner

Floyd Memorial advanced practice registered nurse and certified nurse midwife, Carla Layne, APRN, CNM, explained, “Listening to women is a core belief of the American College of Nurse Midwives. CNMs and APRNs take the time with their patients to listen to their concerns and treat the whole person - not just the complaint of illness.”

States are changing credentials from ARNP to APRN, Advanced Practice Registered Nurses, to comply with national standards and to eliminate confusion. The APRN must be trained in at least one of four roles-(CRNA) certified registered nurse anesthetist, (CNM) certified nurse midwife, (CNS) clinical nurse

RN: A registered nurse is a healthcare advocate with at least an associate’s degree in nursing.

RNs with a bachelor’s degree in nursing have the credentials RN, BSN. They are required to pass board certification in order to obtain a state license to practice. RNs must have a wide knowledge base in order to observe, assess

• NP stands for nurse practitioner

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“Certified nurse midwives and advanced practice registered nurses take the time with their patients to listen to their concerns and treat the whole person - not just the complaint of illness.”

CNA/NA: Also known as a nursing assistant (NA or CNA), a certified nursing assistant helps patients under the supervision of a registered nurse (RN) or licensed practical nurse (LPN). No degree is required for this entry-level position, but a postsecondary certification program is typically required.

NAs have daily contact with patients by gathering vital information for the RN, administering basic care such as applying clean wound dressings and tending to the hygiene needs of patients. NAs work in nursing homes, assisted living facilities, hospitals and home healthcare agencies.

MA: Medical assistants work alongside physicians in offices, outpatient or ambulatory care facilities and clinics. Some MAs have a one-year certificate, while others have obtained a two-year associate’s degree from an accredited school. They are trained to perform administrative and clinical duties such as answering phones, updating patient medical records, coding and filing of insurance forms, scheduling appointments, taking medical histories, preparing patients for exams, collecting lab specimens, drawing blood, administering injections, authorizing prescription refills as directed by the physician, removing stitches and changing wound dressings.

Paralyzed Jeffersonville Man Able to Walk Again At age 61, minor aches, pains and the occasional weakness or numbness sets in. Add type 2 diabetes to the mix and you wonder if that’s what’s causing them. At least that is what Gene Lynch assumed was causing his bad weekend. On Friday, his toes were numb.

On Saturday, he was numb up to his knees, and by Sunday it had moved up to his waist with no feeling at all. On Monday, his family doctor sent him to Floyd Memorial’s Emergency Department. By the time he arrived, he was paralyzed from the neck down and scared beyond belief.

Fast Action Floyd Memorial Spine Center’s board certified orthopedic and spine surgeon, Frank Castro, MD, was on call that day and quickly saw Gene. CT and MRI scans of his neck showed that Gene had fractured and dislocated his spine at the neck.

There were two places where the spinal cord was being compressed, and surgery had to be done quickly. In order to stabilize him, Dr. Castro performed an anterior/posterior spinal fusion.

He explained, “I had to take out part of the C7 vertebral body from the front (anterior) to take pressure off the spine and attach a metal plate to fuse and stabilize it. Then we turned him over (posterior approach) and took out the fracture fragments that were compressing the spinal cord from the back and fused it.”

“It’s situations like this when medicine works its miracle. It is very reassuring that some of the things we do can have such a dramatic, positive effect on people’s lives.”

Frank Castro, MD Board Certified Orthopedic and Spine Surgeon Floyd Memorial Spine Center “The unique part about Gene’s case is he doesn’t remember any traumatic event that would have caused him to break his neck, and he was not symptomatic until that day,” he said.

Feeling Again After waking from his surgery, Gene could immediately feel his legs again and was virtually pain free in that area. He explained, “It took a few weeks, but I was able to get out of bed and move again. I spent a couple of weeks in a rehab facility in order to strengthen my legs and relearn how to use them.”

“I was surprised when I came home to find that my friends from Rolling Fields Church in Jeffersonville had put up hand rails and made my home more easily accessible.

They were a Godsend.”

Gene added, “If it hadn’t been for Dr. Castro, I wouldn’t be able to move, walk, talk or anything right now. I’d be in a wheelchair or confined to a bed.”

Gene’s wife, Mary, explained, “Knowing how bad Gene’s situation was, I can only thank the Lord every day for him.” Gene added, “I wouldn’t be doing as well as I am without the love and support of my wife.

She’s been by my side through all of it.”

“It truly was a miraculous recovery,” said Dr. Castro. “I’ve not seen anyone with that much damage come out of a surgery and still be able to walk. It’s situations like this when medicine works its miracle. It is very reassuring that some of the things we do can have such a dramatic, positive effect on people’s lives.”

Gene explained, “I will probably never be back to where I was before, but I can walk around and take care of myself. It’s hard to have to depend on someone else to help you with things; I’m not that kind of person. I am so thankful that I am able to be self-sufficient.”

Gene is now back to his woodworking and doesn’t take his health for granted.

For more information on the Floyd Memorial Spine Center and treatments offered, call (812) 949-5933 or visit FloydMemorial.com/Spine.

“Dr. Castro got me back on my feet and into my wood shop again. I can’t thank him enough.”

– Gene and Mary Lynch Osteoporosis and Spinal Compression Fractures Seminar Thursday, November 6, 6 -7 pm Paris Health Education Center An orthopedic spine surgeon will discuss treatments for osteoporosis and spinal compression fractures caused by the condition. Registration is required by calling 1-800-4-SOURCE or online at FloydMemorial.com/Events.

Hopefully you’ll have a better understanding of who is taking care of you the next time you enter a physician office or healthcare facility, as this is a key component to your relationship with your healthcare team.

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OCTOBER/NOVEMBER/DECEMBER 2014 Calendar of Events To register, call 1-800-4-SOURCE (1-800-476-8723), or visit FloydMemorial.com/Events, unless another number is listed.

All events are free and meet in Floyd Memorial’s Paris Health Education Center unless otherwise stated.

SCREENINGS Stroke & Aneurysm Vascular Screenings By appointment at Floyd Memorial Hospital in New Albany, Floyd Memorial Cardiovascular Center – Jeffersonville and Floyd Memorial Diagnostic Imaging – Corydon.

Non-invasive screening for Abdominal Aortic Aneurysm, Peripheral Artery Disease and Carotid Artery Disease. Cost is $49 for all three. To make an appointment at the hospital or in Jeffersonville, call 1-800-4-SOURCE, or call (812) 734-3920 for Corydon appointments.

Harvest Homecoming Kid’s Tent Saturday, October 11, 12 - 3 pm Come to the Floyd Memorial booth at the Harvest Homecoming Kid’s Tent and measure your child’s height and weight. We will also provide educational materials and health-related giveaways.

Georgetown Southern Baptist Church Health Fair Saturday, October 25, 10 am - 2 pm Floyd Memorial will be present at this community health fair and will be offering height, weight and body composition screening as well as information about our lung cancer screening program.

Free Take 2 for Heart and Stroke Screenings Thursday, November 6, December 4 and January 8, by appointment Full lipid cholesterol panel, blood pressure, blood sugar, blood sugar A1C and body mass index.

Registration required.

FLOYD MEMORIAL WEIGHT MANAGEMENT CENTER OFFERED BY

HMR Orientation Floyd Memorial Weight Management Center Lose 10 to 200 pounds with HMR. Free informational sessions on Mondays and Thursdays. Call (812) 949-7151 to schedule.

Surgical Weight Loss Seminar Wednesday, November 19 and January 21 6 - 7 pm Paris Health Education Center Learn about gastric banding and gastric sleeve surgery and the support services offered by the Floyd Memorial Weight Management Center.

Registration required.

SPECIAL WINTER NOTICE: If Floyd county schools are closed due to bad weather, all classes and support groups will be canceled. If bad weather occurs late in the day, call 1-800-4-SOURCE (1-800-476-8723) or (812) 944-7701 to find out if the class will be held.

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Free Mammogram Screenings Tuesday, October 28, 3 - 7 pm Family Health Centers of Southern Indiana Floyd County Clinic 1000 E. Spring Street, New Albany In honor of breast cancer awareness month, Floyd Memorial is partnering with the Family Health Centers of Southern Indiana at their Floyd County Clinic to offer free breast cancer screening, education and referrals for mammograms to low-income women aged 40 and above. Women who are interested in receiving the services must register in advance with the Family Health Center by calling (812) 283-2792.

Free Screenings at the Floyd County YMCA Tuesday, October 28, 9 - 11 am Tuesday, January 20, 4:30 - 6:30 pm Screenings include: blood pressure, height, weight and body composition. Free health education resources and giveaways.

Free Body Mass Index Screenings Floyd Memorial Weight Management Center Free screenings of weight, body fat percentage, bone mass, metabolic age and degree of obesity.

By appointment. To register, call (812) 949-7151.

$89 Lung Cancer Screenings CT lung screening is a safe, quick test that is capable of detecting lung cancer at an early stage, when treatment can be most successful. If you are a current or past smoker age 50 to 74, have a 30-pack-year smoking history, a first degree family history of lung cancer and are age 50 or older, or have been exposed to asbestos and been a smoker, this screening could save your life. Referral not required. Cost is only $89 (due at time of screening), which includes a same-day review of your results with our patient navigator. To register, call (812) 981-6208.

Free Osteoporosis Screenings The pDXA screening is a scan of the bone density of the heel. By appointment. To register, call (812) 949-5570.

Free Sports Injury Screenings Every Wednesday, 3 - 4 pm All Floyd Memorial Physical Therapy Locations Sports injury screenings by licensed physical therapists for middle and high school athletes on a walk-in basis. Visit FloydMemorial.com/Rehabilitation for locations near you.

Free Physical Therapy Screenings Weekdays by appointment All Floyd Memorial Physical Therapy Locations A licensed physical therapist will answer questions and give recommendations for treatment and/or follow up care. Call (812) 948-7416 to schedule an appointment.

SUPPORT GROUPS Alzheimer’s Support Group Third Thursday of each month, 2 - 3:30 pm and 6 - 7:30 pm Contact: Sadie Powell, (812) 948-1311

Cancer Patient/Caregiver Support Group First & third Thursday of each month, 6:45 - 8 pm Floyd Memorial Cancer Center of Indiana Contact: Helen, (812) 945-4000 ext. 6231

Moving Forward – Amputee Support Group Third Monday of each month, 6:30 - 8 pm Meets at Southern Indiana Rehab Hospital Conference Room Contact: Brittany Bley, (502) 724-4990 or Belinda Jacobi (812) 620-3694

Gluten Free Support Group Fourth Tuesday of each month, 6:30 pm Contact: Jennie Olmstead, (812) 945-4500

Balancing Life with Diabetes Support Group Tuesday, October 21, 10 - 11 am Topic: Fitness activity Tuesday, November 18, 10 - 11 am Topic: Coping with the Holidays Tuesday, January 20, 10 - 11 am Topic: Vital Statistics Joslin Diabetes Center Affiliate 2019 State Street, New Albany To register, call 1-800-4-SOURCE. Bariatric Support Group First Monday of each month, 6 pm Contact: Floyd Memorial Weight Management Center (812) 949-7151 Brain Injury Support Group Third Thursday of each month, 7 pm Southern Indiana Rehab Hospital Contact: Beverly Setree, (502) 819-2542 Breast Cancer Support Group Second Thursday of every other month, 7 pm Contact: Pat Kasse, (812) 948-1215

La Leche League of Southern Indiana Third Monday of each month, 6:30 - 8 pm Contact: Lisa, (812) 987-3635 or www.lllSouthernIndiana.com Laryngectomy Support Group Third Wednesday of each month, 3 - 4 pm Contact: Susan Mathews, (812) 948-6725 Mended Hearts Support Group Fourth Monday of each month, 6 pm Contact: Jackie Lattis, (502) 819-2085 for meeting location Parkinson’s Support Group First Tuesday of each month, 6:30 pm Contact: Donna Mattox, (812) 256-5424 Stroke Support Group Second Tuesday of each month, 1 pm Southern Indiana Rehab Hospital Contact: Tori Vinson, OTR, (812) 941-6154 Together for Breast Cancer Survival Men’s Caregiver Support Group First Thursday of each month, 6:30 pm Floyd Memorial Cancer Center of Indiana Second Monday of each month, 6 pm Gilda’s Club of Louisville Contact: Doug Drake, (502) 649-6911 or CoSurvivors.org

HEALTH EDUCATION Saturday Morning Sports Injury Clinic Saturday, October 11 and 18, 8 - 10 am Floyd Memorial Urgent Care Center 800 Highlander Point Drive Floyds Knobs, IN 47119 Sports medicine physicians will evaluate and treat injured athletes on a first-come, first served basis.

Patients must be signed in by 9 am. Most major insurance plans accepted. Call (812) 923-6336 for more information.

Breast Health Seminar Thursday, October 16, 6 - 8 pm Floyd Memorial Cancer Center of Indiana This free event will discuss the medical management of patients determined to be at high risk of developing breast cancer including genetic testing, risk evaluation, surgical options for breast cancer, prevention, treatment and other aspects of breast cancer care. A light meal will be provided.

Registration required.

Kidney Disease Treatment Options Classes Thursday, November 13 and December 11 10 am - noon Call (502) 895-1338 to register.

Free Bone & Joint Pain Seminar Thursday, December 4, 6 - 7 pm Learn about treatments that may offer relief of your shoulder, knee or hip pain, including medications, exercise and joint replacement surgery. Registration required.

Osteoporosis and Spinal Compression Fractures Seminar Thursday, November 6, 6 - 7 pm An orthopedic spine surgeon will discuss treatments for osteoporosis and spinal compression fractures caused by the condition. Registration required.

Give-Me-10 Facebook Video Contest Show the Floyd County Physical Activity Coalition how you fit at least 10 minutes of exercise in every day. Submit a video to their Facebook page between now and October 18 of you or your friends demonstrating creative exercise. Voting runs October 19 – November 7. Winners will be announced November 10. Go to facebook.com/ WellnessCoalitionOfSouthernIndianaWCSI for more information. Videos with the most votes win prizes including: • First place-$500 Visa gift card • Second place-$300 Visa gift card • Third place-$200 Visa gift card

Fight for Your Feet Foot Screening and Fair Saturday, November 8, 9 - 11 am by appointment Floyd Memorial Wound Healing Center Receive a free foot screening and take home valuable information on keeping your feet and eyes healthy. Diabetic snacks and great giveaways will be provided. Register for your appointment by calling 1-800-4-SOURCE. Affordable Care Act Navigation November 15, 2014 through March 15, 2015 will mark the enrollment period for the Marketplace Exchange Program. Floyd Memorial will have navigators available at different sites throughout our communities to help patients navigate the program and answer questions. Registration is not necessary and you do not have to be a patient of Floyd Memorial Hospital or Floyd Memorial Medical Group to receive assistance.

Monday, November 17, 2014, 5 - 7 pm Hope Southern Indiana Brown Starks Neighborhood Place 1200 Bono Road, New Albany Wednesday, January 14, 2015, 3 - 6 pm Northfield Plaza 313 Federal Drive NW, Corydon Wednesday, January 21, 2015, 3 - 6 pm Floyd Memorial Medical Group - Salem 1101 N. Jim Day Road, Suite 107A, Salem

Pilates, Diet and Diabetes Tuesday, November 11, 6 - 7:30 pm In honor of National Diabetes Month, join us for a free one-hour Pilates class with certified instructor, Susie Stewart, and a healthy smoothie recipe demonstration and tasting with registered dietitian and certified diabetes educator, Beth Ackerman, RD, CDE. Session will focus on learning low impact, diabetes-friendly stretching exercises that can improve your core strength and flexibility, as well as help you control your diabetes with reduced stress and improved physical health. Please bring a mat or towel.

Indiana Blood Center Blood Drive Thursday, December 4, 12 - 5 pm Register to donate at Donorpoint.org.

Cooper Clayton Smoking Cessation Classes For a full list of available smoking cessation classes, visit WellnessCSI.com/Tobacco.

Stroke Clinic Southern Indiana Rehab Hospital offers a free stroke clinic for anyone who has experienced a stroke. The survivor is screened by therapists, case managers, nurses and physicians who can review their ongoing recovery and make recommendations. Contact: (812) 941-6120 or (812) 941-6154.

FLOYD MEMORIAL BIRTHING CENTER

OFFERED BY

Free Prenatal Classes Thursday, October 9 – November 13 7 - 9 pm (6-week series) Thursday, January 8 – February 5 7 - 9 pm (6-week series) Should be taken at the beginning or middle of pregnancy. Physical and emotional changes, stages of fetal development, nutrition, anesthesia choices, basic infant care, post partum and babies first year. Registration required.

Prepared Childbirth Class Monday, November 3 - 24 6:30 - 8:30 pm (4-week series) Wednesday, January 7 - 28 6:30 - 8:30 pm (4-week series) Saturday, February 21 and 28 8:30 am - 12:30 pm (2-part series) Cost - $30 per couple. Classes discuss the physical preparation and education needed for a successful delivery, including relaxation techniques using a variety of methods, as well as tips for pregnancy fitness including physical therapy. Take during the middle of pregnancy.

Registration required.

Free Breastfeeding Class Thursday, November 20 and February 12 6:30 - 9 pm Help for you and your newborn to have a successful breastfeeding experience. Includes helpful hints, practical guidelines, common misconceptions and barriers. Registration required.

Babysavers Class Thursday, December 4 and February 19, 6:30 - 9 pm Designed to teach new parents infant CPR. Cost is $10 per couple. Registration required.

Free Sibling Class Saturday, December 13 and January 31 10:30 am - 12:30 pm For soon-to-be new brothers and sisters, ages 3 to 11, and their parents. Children will be shown how to diaper and hold a baby (doll), and tour the Birthing Center where they get to listen to the baby’s heartbeat. Registration required.

OFFERED BY

JOSLIN DIABETES CENTER The Floyd Memorial Joslin Diabetes Center Affiliate offers on-going education classes so patients can keep their condition in check.

Call (812) 949-5700 to register.

Balance and Control For individuals looking to get their diabetes under control, new to diabetes or new to insulin.

Covered by most insurance plans.

Diabetes Refresher Course Helps patients set goals for ongoing healthy management of their diabetes. Covered by most insurance plans.

Pre-Diabetes Class Designed to help determine what changes are needed to avoid developing type-2 diabetes and set goals for living healthier. Cost is $25.

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