July-August 2013 HealthScope

July/August 2013

A bi-monthly update on leading-edge care from

NON-PROFIT U.S. POSTAGE

PAID UNITED MAIL

1850 State Street New Albany, IN 47150

HealthScope is published by Floyd Memorial Hospital and Health Services.

1850 State Street New Albany, Indiana 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 & Public Relations, Writer Angie Glotzbach Writer Stacey Rudy Contributor CUSTOMER SERVICE Floyd Memorial customer service inquires can be made to our Customer Service Hotline at (812) 981-6510.

Cancer Patient Gets a Second Chance

HOW TO HELP HealthScope is designed to support the 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.

Follow us on Facebook at facebook.com/fmhhs and Twitter at twitter.com/Floyd_Memorial

Brown Recluse Spider Bites: What You Need to Know

National reputation.

Indiana address.

Childhood Sleep Disorders SOUTHERN INDIANA CANCER

2012-13

Right here at Floyd Memorial you’ll find the only comprehensive cancer center in Southern Indiana. You’ll find radiation oncologists from the James Graham Brown Cancer Center, using modern advanced technologies so precise they can reduce treatment times by up to 90 percent. And you’ll find advanced treatment options, including the latest clinical trials and integrative medicine such as massage therapy and biofeedback. All to help you overcome the challenges of cancer. All right here.

812-945-4000 • floydmemorial.com/cancer

Floyd Memorial Board of Trustees Welcomes Donn R. Chatham, MD FMMG Welcomes Physician Associates of Floyds Knobs

Floyd Memorial Medical Group is proud to welcome their newest primary care physician practice, Floyd Memorial Medical Group – Physician Associates of Floyds Knobs, located at 800 Highlander Point Drive in Floyds Knobs.

FMMG – Physician Associates of Floyds Knobs is a group of board certified or board eligible internal medicine, pediatric and family medicine physicians specializing in the needs of the entire family.

The providers are: • Daniel Eichenberger, MD Internal Medicine/Pediatric Physician • Stuart Eldridge, MD, Pediatrician • Christina Minrath, MD Internal Medicine/Pediatric Physician • Stephen Karem, MD Family Medicine Physician • Phillip Johnson, MD Family Medicine Physician • Kristi Upton, APRN Services offered include but are not limited to: • Annual check-ups and screenings • Vaccinations • Routine physicals • Illness diagnosis and treatment • Minor procedures • Women’s health • Chronic disease management Pediatrician Stuart Eldridge, MD and Kristie Upton, advanced registered nurse practitioner are both accepting new patients.

If you have any questions or would like to schedule an appointment, call (812) 923-2273.

Winning Contest Photo The winning photo of the Floyd Memorial Birthing Center’s Beautiful Baby Facebook Photo Contest, sponsored by Babies R Us, was submitted by Tara Seng Spears, receiving 1226 votes. Congratulations to Tara and her beautiful daughter, and thanks to all who entered the contest.

2

The Floyd County Commissioners recently appointed Donn R. Chatham, MD, to serve on Floyd Memorial Hospital and Health Services’ Board of Trustees. Dr. Chatham began his term on May 28, 2013. He replaces Stuart Eldridge, MD, who has served for over six years and made many significant contributions to Floyd Memorial during his tenure.

“Dr. Eldridge’s medical expertise and insights into the realities of front line patient care have been critical to our informed decision making over the years. He has had an exemplary term, and we would like to thank him for his service. We are also very much looking forward to the unique contributions Dr. Chatham will offer. He will be an integral part of our board and we are honored by his willingness to lend his time and talents to Floyd Memorial,” said Jerrol Z. Miles, chairman of the board of trustees.

Dr. Chatham is a board certified, fellowship trained facial plastic and reconstructive surgeon with Chatham Facial Plastic Surgery and Medical Skin Care in New Albany and Louisville with over 28 years experience. In addition to his practice, Dr. Chatham is also a clinical instructor of otolaryngology at the University of Louisville Medical School, has

served on the board of directors of the Greater Louisville Medical Society, is a past president of the Floyd County Medical Society, a past chairman of the Floyd County Board of Health and was a three term board member and president of the American Academy of Facial Plastic and Reconstructive Surgery in 2008-2009.

Dr. Chatham also donates his services to many worthy organizations locally, nationally and internationally, including the Hope Southern Indiana (formerly Floyd County Interfaith Community Council) Operation Santa program, Women’s Choice Resource Center in New Albany, Necole’s Place in Louisville, Noah’s Ark in Jeffersonville and St. Elizabeth’s Home in New Albany, just to name a few. He was also a founding member of the American Academy of Facial Plastic and Reconstructive Surgery Foundation’s Faces of Honor program, which offers free plastic surgery to military veterans of the wars in Iraq and Afghanistan who have suffered facial injuries. Dr. Chatham’s international charity work includes work with Saving the Children in Ecuador, Mustard Seed International in Indonesia, Face to Face International in Croatia and many more.

Dr. Chatham lives in Floyds Knobs with his wife Janet, son Andrew and daughter Julianna.

Cancer Center Opens Corydon Location The Floyd Memorial Cancer Center of Indiana is now offering services at a convenient new location in Corydon.

Hematologist and board certified medical oncologist Roseline Okeke, MD, provides oncology and hematology services, including hematology and oncology physicians consults and CT, mammography, X-ray and bone density radiology studies.

The Cancer Center of Indiana also offers services at satellite locations in Jeffersonville, Scottsburg and Salem. For more information call (812) 945-4000.

Cancer Center of Indiana satellite locations and the physicians available at each include: Corydon-Roseline Okeke, MD 313 Federal Drive, Suite 010 Jeffersonville-Roseline Okeke, MD 1507 Spring Street Salem-Ajay Kandra, MD 1101 N. Jim Day Road, Suite 107B Scottsburg-Yasoda Devabhaktuni, MD 1430 N. Gardner Street

Cancer Center Awarded Susan G. Komen Foundation Grant The Floyd Memorial Cancer Center of Indiana is pleased to announce the recent receipt of a $21,150 grant from the Louisville Affiliate of Susan G. Komen for the Cure®.

This generous grant will provide funds to continue the operation of the Cancer Center of Indiana’s Breast Cancer Nurse Navigator Program, and provide outreach in the community to underprivileged residents of the New Albany Housing Authority. The goal of the breast cancer nurse navigator program is to lessen the burden on breast cancer patients and their loved ones by providing them with a single contact in charge of coordinating their care and treatment. This program helps to improve patient outcomes by insuring the early detection and treatment of breast cancer and wellcoordinated communication between patients, physicians and the rest of the healthcare team.

Foundation Receives Cardinal Health Foundation Grant The Floyd Memorial Foundation has received a grant of $22,695 from the Cardinal Health Foundation in order to implement a World Health Organization (WHO) project which aims to reduce adverse events in surgery.

The WHO checklist will be utilized to improve the quality outcomes for surgery patients at Floyd Memorial Hospital. This will involve educating all surgical team members as well as providing opportunities for simulation to instill the process in a safe setting without the use of real patients.

Floyd Memorial Foundation Provides Grant Support to the Floyd County Family Health Center The Floyd Memorial Foundation recently donated $25,000 to the Floyd County Family Health Center. The Family Health Center provides comprehensive medical and preventative healthcare services to low-income, uninsured residents who would otherwise be without the appropriate care needed. The monies from the Foundation will support continued operating expenses of the Center.

Your Community Bank Pledges $50,000 to Floyd Memorial Foundation Capital Campaign On March 27, 2013, the Floyd Memorial Foundation officially kicked off their community fundraising drive for the $3 million Food and Nutrition Services renovation capital campaign project. During the kickoff breakfast, Your Community Bank generously pledged to give $50,000 over a five-year period towards the campaign.

Renovation officially began in September 2012, with an anticipated completion of Phase I by this summer. The phases include: Phase I: • A more calming environment for visitors and associates • Complete renovation of the dining room, the first in more than 30 years • Improved heating and cooling system • More seating and open space for visitors • Space for more grab-and-go food items and associates and healthier eating options • A more streamlined process and flow for Phase II: visitors and associates to receive meals faster • Room service to patients and families

Pictured: Diane Murphy, Director of Community Relations for Your Community Bank, presents the Floyd Memorial Foundation Advancement Committee with a check for $50,000. From left to right: Angie Rose, Floyd Memorial Marketing/PR Director, Glen Smith, Floyd Memorial Foundation Board Member, Mark Shugarman, President/CEO of Floyd Memorial, Diane Murphy, Your Community Bank, Kevin Cecil, President of Your Community Bank, Ruth Heideman, Floyd Memorial Foundation Executive Director and Leslie Lewis-Sheets, Floyd Memorial Foundation Board Member.

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 www.floydmemorial.com. We can help you find the doctor that’s just right for your specific needs.

New Physicians Chitra Arumugam, MD Neonatal Medicine U of L Physicians – Division of Neonatal Medicine 601 South Floyd Street, #804 Louisville, KY 40202 (502) 852-8470

Kavita K. Mehta, MD Anesthesiology Southern Indiana Anesthesia Consultants 100 Mallard Creek Drive, #320 Louisville, KY 40207 (502) 690-8782

Michael P. Flaherty, MD Interventional Cardiology U of L Cardiovascular Medicine 1919 State Street, #302 New Albany, IN 47150 (812) 542-1880

Renate A. Stingl, MD Hospital Medicine Floyd Hospitalist Program 250 East Liberty Street, #801 Louisville, KY 40202 (502) 587-9596

Cameron Luo, MD Neurology Luo Neurological Institute, PLLC 5120 Charlestown Road, Suite 5 New Albany, IN 47150 (812) 725-8621

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 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.

Amy Gooch, RN ICU Ashley Humphrey, RN PICC Team Becky Wolfe Care Café Coordinator C.M. Hocker, MD FMMG – State Street Kevin White, MD Radiology Associates

Lisa Beckingham, RN Cam Graves, MD Emergency Department Sarita Dyer Environmental Services Natasha Eversole, RN MIPS Daniel Eichenberger, MD Chief Medical Officer FMMG – Physician Associates of Floyds Knobs

On the cover...Floyd Memorial Wound Healing Center physicians pictured left to right include: Tariq Mehmood, MD, Syed Ahmed, DPM, Nicholas Ferro, DPM and Rodney Chou, MD. For a full listing of physicians who practice at the Wound Healing Center, see page 5.

3

Brown Recluse Spider Bites A Total Transformation

Expert Wound Healing Any wound or sore that doesn’t respond to traditional treatment within 30 days should be given medical attention promptly. At the Floyd Memorial Wound Healing Center, patients receive personalized, state of the art treatments with our compassionate, multidisciplinary team that is ready to treat any wound regardless of the complexity.

Our physicians specialize in: • Infectious disease • Plastic surgery • Vascular surgery • Physical medicine/rehabilitation • Podiatry • Interventional Radiology • Family Medicine There are many common wounds that often require treatment including: • Diabetic wounds/foot ulcers • Arterial ulcers/lower leg ulcers • Pressure ulcers • Venous stasis ulcers • Trauma wounds/accident injuries • Burns • Spider bites • Compromised skin grafts and flaps • Complex soft tissue wounds • Bone infections (Osteomyelitis) • Osteoradionecrosis • Problem surgical wounds

• Post-operative infections • Soft tissue infections • Skin tears or lacerations • Gangrene • Late effects of radiation therapy Along with more traditional treatment options, the Center offers adjunctive therapies including bioengineered skin substitutes, wound vacuum systems, debridement, platelet growth technologies, the latest in skin grafting, compression wraps and specialized dressings, along with Hyperbaric Oxygen Therapy (HBOT).

Faster healing with hyperbaric oxygen therapy Sometimes traditional wound care methods don’t provide healing as quickly as we’d like.

The Floyd Memorial Wound Healing Center can provide the extra time and tools necessary to address your wound. Among its arsenal of state-of-the-art technology, the Center is equipped with three HBOT chambers.

Candidates with wounds that qualify for this type of treatment are able to breathe 100 percent oxygen inside a pressurized chamber, infusing their bodies with the oxygen needed to jump-start the natural wound healing process.

Circulation improves, new blood vessels are stimulated and recovery times are shortened.

And in numerous cases, limbs have been saved from amputation.

Many patients qualify for Hyperbaric Oxygen Therapy. In fact, Medicare, HMOs and other insurance carriers provide reimbursement for 15 different conditions including: • Diabetic wounds of the lower extremity • Compromised skin grafts and flaps • Delayed radiation injury • Necrotizing soft tissue infections • Osteomyelitis • Crush injury, compartment syndrome and other acute traumatic reduction of blood flow • Gangrene • Other select problem wounds Indications that a wound needs medical attention: • Worsening redness around the edges • Red streaks • Increase in pain or swelling • Unpleasant odor, drainage or lack of response to topical antibiotics • Any wound that doesn’t respond to traditional treatment within 30 days

Wound Healing Center Physicians

Rodney Chou, MD Medical Director Board Certified Physical Medicine and Rehabilitation Physician

Syed Ahmed, DPM Podiatrist

Nicholas Ferro, DPM Podiatrist

Steven Gray, MD Board Certified Family Medicine Physician

Brian Heimer, MD Kelli Hall, MD Board Certified Hospital Medicine Family Medicine Physician Physician

Shad Jawaid, MD Board Certified Hospital Medicine Physician

Fall is just around the corner, and as you reclaim the sweaters and put warm-weather clothes back in the closets, you could encounter an unexpected nuisance along the way – the brown recluse spider. Often called the fiddle back spider because of the violin shaped marking on its back, the brown recluse spider tends to set up camp in dry, undisturbed areas like piles of clothing, shoes, bedding, woodpiles and under sinks. These arachnids do not seek out human contact, but when it happens, their bite can pack a powerful punch. The brown recluse, along with the black widow, are two of the most common poisonous spiders found in the Kentuckiana area.

Frequently asked questions The experts at the Floyd Memorial Wound Healing Center often see patients with spider and insect bite wounds. Some insect bites can result in a bacterial infection which is usually treated with antibiotics and topical antimicrobial creams. However, some patients have more serious bites. Board certified plastic surgeon, R. Kevin Majzoub, MD, answered some frequently asked questions regarding the treatment of brown recluse spider bites.

1. What are the symptoms of a brown recluse spider bite?

Initially, an individual may report little or no pain. After a few hours, increased swelling over the bite site, redness or blisters may develop. The patient may experience an itchy feeling. Within a day or more, the site may become firm and resemble a bruise. Within five days, the tissue may start to dry up resulting in tissue necrosis (dead cells) and clear or bloody drainage. Severe tissue loss may result in scarring over the surface of the skin or a depression in the soft tissue.

2. What can a bite do to the tissue, is there ever fear of losing functionality?

The brown recluse spider bite is venomous and may result in tissue loss. The venom causes the destruction of tissue though the disruption of cellular membranes. There is also a release of inflammatory agents, such as cytokines and histamines which may result in

a cascade of immune-related events eventually leading to additional tissue damage. If the bite occurs over a finger or toe, there is the possibility of tissue loss over the involved digit with eventual exposure of a tendon, or in severe cases, loss of blood flow to the digit itself.

3. How do you treat these bites in the Wound Healing Center?

We typically see these spider bites many days to weeks after the initial contact with the spider. Patients presenting with tissue necrosis or loss are treated with dressings designed to remove the necrotic tissue and preserve the underlying healthy tissue. While it is uncommon to encounter significant tissue loss, it is not uncommon to have a spider bite with a bacterial infection, which we treat with antibiotics and local wound care. At the Floyd Memorial Wound Healing Center, we have a number of different high tech dressings that are used, including silver impregnated foam dressings, enzymatic dressings and topical antimicrobial agents. If needed, the wound may be debrided (removal of damaged tissue) in the procedure room while under a local anesthetic.

4. How long does it generally take for the bite to heal?

Bites with tissue loss may take weeks to heal. Depending on the amount of tissue destruction and an individual’s other underlying conditions (diabetes, vascular disease, tobacco use, etc.) it may take even more time to heal.

5. Are there any long-term effects, damage or scarring?

Occasionally patients require operative debridement of the bite site with local skin flaps or skin grafting to aid in the healing of the open wound. There is often a scar left behind and possibly loss of sensation over that region of the body.

6. What may happen if the bite is not treated?

Bites may become infected with local bacteria over the skin which may result in the development of cellulitis and additional soft tissue loss.

What to do after a spider bite:

Tariq Mehmood, MD, FACP Associate Medical Director Diplomat American Board of Internal Medicine and Infectious Diseases Certified by American Board 4 of Wound Healing

R. Kevin Majzoub, MD Board Certified Plastic Surgeon

Abdul Munis, MD Board Certified Hospital Medicine Physician

Daryl Potter, DPM Board Certified Podiatrist

Kevin White, MD Board Certified Interventional Radiologist

Dean Wickel, MD Babar Zuberi, MD Board Certified Board Certified Vascular Surgeon Hospital Medicine Physician

(not pictured) Ammar Tayara, MD, Board Certified Infectious Disease Specialist

• Wash the region with soapy water to remove any bacterial contaminants on the skin

• Take ibuprofen to help control pain and decrease local inflammation over the bite site

• Apply ice wrapped in a wash cloth to the region on and off to help with local inflammation

• Try to contain/keep the spider in a jar for identification purposes

• Elevate the extremity above your heart to help with swelling

“If you feel like you’ve been bitten by a spider, it’s wise to seek medical treatment early to prevent additional complications that may arise from the bite. At the Floyd Memorial Wound Healing Center, we have trained wound care specialists who treat a variety of complex wounds, including spider bites. The Center offers advanced wound management strategies including hyperbaric oxygen treatment, biologic dressings and surgical care, just to name a few.”

R. Kevin Majzoub, MD Board Certified Plastic Surgeon Floyd Memorial Wound Healing Center

The brown recluse spider is unique because of the violin-shaped marking on its back and it only has 6 eyes (most spiders have 8 eyes).

Brown Recluse spider bite

Brown Recluse

Most common locations of brown recluse spiders

• Seek advice from your physician if excessive pain, redness or swelling result, or if there are additional systemic signs such as a fever, chills, nausea or restlessness 5

Second Chances “Bob’s specific type of lymphoma was highly treatable with chemotherapy, and I was confident he would respond well, despite what he had previously been told.”

Yasoda Devabhaktuni, MD Board Certified Oncologist/Hematologist Interim Medical Director, Floyd Memorial Cancer Center of Indiana Bob McCutcheon, a retired minister and bus driver from Leavenworth, is a classic case of second chances. In December 2010, he was sweating excessively, bloated and feeling weak, when he underwent exploratory surgery of his abdomen at a local hospital.

The news he received was shocking.

“The surgeon told me that my abdomen was full of cancer and that there was nothing they could do to treat it,” said Bob. “He sent me home and recommended initiating end-of-life care. A few days later, I started getting really sick, and my wife took me to the emergency department at Floyd Memorial

instead of the hospital I’d previously gone to.

That decision ultimately saved my life.”

“Bob was in very bad shape when I first met him,” explained Yasoda Devabhaktuni, MD, a board certified medical oncologist/ hematologist with the Floyd Memorial Cancer Center of Indiana. “His entire family was around his bed crying because they thought it was the end. The first thing I told them was to calm down, look at things in a positive way and be optimistic, this was treatable and he would live.”

“He had Non-Hodgkin Extra Lymphatic Lymphoma, which means the cancer was free floating in his abdomen instead of confined to his lymph nodes. While rare, it was still very treatable. The most immediate concern, however, was that he was in kidney failure, so the first step was to put him on dialysis for a brief period to stabilize him. Once he was stabilized, we started chemotherapy immediately. He received his first dose in the hospital and completed five additional rounds after being released. In a matter of a few months, he had gone into complete remission. He’s a perfect example of why you should never lose hope.”

Bedtime and Childhood Sleep Disorders “There’s no question Dr. Dev saved my life,” said Bob. “My health made a complete turnaround after she came into the picture. I’m a faithful man, and I know God led the right person to me at the right time. She gave me more time with my wife of 38 years, my two children and grandchildren, and I’m eternally grateful for that.”

“It’s an amazing thing to be given time that you were told you wouldn’t have. I went from dying to completely well in a matter of months.”

- Bob McCutcheon, with wife Jeanne

Types of Blood Cancer Blood cancers affect the blood, bone marrow and lymph nodes. They include leukemia, lymphoma and myeloma. Ajay Kandra, MD, a board certified medical oncologist/hematologist at the Floyd Memorial Cancer Center of Indiana, explained each type, its symptoms and treatment options available.

Leukemia Leukemia is a cancer of the blood. The two main types of leukemia are lymphoid, which involves a proliferation of a type of white blood cells called lymphocytes; and myeloid, which involves proliferation of another type of white blood cells called granulocytes. Leukemia is further classified as acute, which progresses rapidly, or chronic, which progresses slowly.

Symptoms: severe fatigue, unexplained bleeding, infection, fever and weight loss.

“The earlier the diagnosis, the better the prognosis for certain leukemias,” explained Dr. Kandra. “I recommend that adults request a CBC blood count check at their yearly physical to screen for blood disorders.”

Treatment: highly individualized and involves looking at the molecular markers (malfunctioning genes) of the cancer before determining the exact course of action.

Common treatments include chemotherapy, 6

“Something many people don’t realize is that peripheral blood stem cell transplants have almost completely replaced traditional bone marrow transplants. It is no longer the painful process it once was. Now we simply take blood from the donor, filter out their stem cells and infuse them into the patient so that the donor cells can regenerate new healthy bone marrow.”

Ajay Kandra, MD Board Certified Oncologist/Hematologist Floyd Memorial Cancer Center of Indiana targeted therapies and for certain patients, stem cell transplantation.

Lymphoma Lymphomas are cancers that start in the lymph nodes. The two main types of lymphoma are Hodgkin Lymphoma, which is highly treatable, with cure rates of 80 to 90 percent, and Non-Hodgkin Lymphoma, which can be classified as T-cell or B-cell, with many variations within each classification. Some variants are highly treatable and/or slowly progressive, while others are difficult to treat and progress quickly.

Symptoms: enlarged lymph nodes, fever, weight loss, fatigue, night sweats and multi-organ failure.

Treatment: based on the specific subtype of cancer. Chemotherapy, targeted therapies, biological targeted agents and radiation therapy are common options.

Myeloma Myeloma is a cancer of the plasma cells, which are the antibody producing cells found in the bone marrow.

Symptoms: multiple bone fractures, anemia, high calcium, kidney failure and infections.

“Men aged 66 years or older are at greatest risk, and African Americans are about two to three times as likely to develop myeloma as Caucasians,” added Dr. Kandra.

Treatment: chemotherapy, immune system regulating medicines and stem cell transplantation.

For more information about services offered at the Floyd Memorial Cancer Center of Indiana, call (812) 945-4000 or visit floydmemorial.com/cancer.

Be the Match. Save a Life.

Visit marrow.org to find out how you can potentially save a life by joining the National Bone Marrow Donor Registry.

“Children need very specific amounts of sleep, and if they’re not getting enough, it can take a toll on their health, weight, school performance and social skills.”

Azmi Draw, MD, FCCP Sleep Medicine Specialist & Board Certified Pulmonologist, Critical Care and Internal Medicine Physician Floyd Memorial Sleep Disorders Center Lung and Sleep Specialists, PLLC Every parent knows it can be difficult for a toddler or young child to get a good night’s sleep, especially when that child is having nightmares and trouble staying asleep. As young children grow into adolescents it’s not always easy to get them to bed at a decent hour and wake up in time to get ready for school.

Pediatric sleep issues may be partially to blame for some nighttime struggles. Board certified pulmonologist and sleep specialist at the Floyd Memorial Sleep Disorders Center, Azmi Draw, MD, FCCP, has been treating children ages 2 and above for more than 10 years. He explained, “Pediatric sleep disorders are very common and can range from difficulty falling asleep and staying asleep, to movement disorder, bed wetting, sleep walking, sleep talking, nightmares, night terrors, sleep apnea and insomnia.

And the scope of the sleep disorder changes with age.” Dr. Draw gives valuable information on pediatric sleep disorders in the article below.

Toddlers and young children The most frequent issues in children between ages 2 and 5 are parasomnias like sleep walking, sleep talking, bedwetting and some sleep apnea. Sleep walking and talking affect approximately 10 to 15 percent of children, and many outgrow them.

Night terrors and nightmares are common and can occur at almost any age. The child appears to awaken frightened, not arousable, confused, sweating, extremely irritated and exhibits fast breathing and heart rate. They are also unable to recall the event. With a nightmare, the child awakens frightened, but is fully awake, with less severe systemic reactions and they can remember the dream.

Periodic nightmares and night terrors are normal, but parents should speak with their pediatrician if they become frequent to check for possible nocturnal seizures.

Sleep apnea is common in children, but treatment is different than adults. In children, sleep apnea is mainly attributed to anatomical problems like enlarged adenoids or tonsils or allergies rather than muscular issues. The solution is usually to surgically correct the upper airway, which typically involves adenectomy and tonsillectomy. CPAP machines are not used on a growing child because they can lead to anatomical changes.

Many times aggressive treatment of allergies to prevent re-growth of adenoids or nasal obstruction is necessary.

Teeth grinding could be a manifestation of sleep apnea or an underlying disorder.

Nocturnal seizures need to be ruled out if teeth grinding is extensive.

Nocturnal seizures can cause abnormal parasomnias. We can rule these out with an in-lab pediatric sleep study.

Special equipment is used including an extended electroencephalograph (EEG) to measure brainwaves.

How much sleep do you really need?

Sleep needs

Age

(including naps)

Newborns (0-2 months)

12 to 18 hours

Infants (3-11 months)

14 to 15 hours

Toddlers (1-3) years)

12 to 14 hours

Preschoolers (3-5 years)

11 to 13 hours

School-age children (5-10 years)

10 to 11 hours

Teens (10-17 years)

8.5 to 9.5 hours

Adults

7 to 9 hours

Tips for getting a good night’s sleep: • Turn off TV, electronics, video games, etc. one hour before bedtime • Use adequate sleep hygiene, go to bed at the same time every night, and try to wake up at the same time • Allow plenty of time to get ready for bed, don’t do homework right before bed • Sleep environment should be dark, quiet and normal room temperature • Avoid stimulants like caffeine after 3 pm • Eat an adequate diet. Avoid large meals and high vitamin C components close to bedtime • Get regular exercise, but it should be at least two hours before bedtime

Arousal disorders are also measured in brain waves during a sleep study, which can determine if the problem is a movement or breathing disorder or just spontaneous.

A medical history and list of medications are the first things your pediatrician will look at when you suspect a sleep disorder. Many medications for allergies contain a stimulant and can cause hyper-reaction in children, which can induce significant sleep disorder behaviors.

Sleep habits and nighttime routines are also evaluated. In addition, if parents notice excessive drooling, sleeping with an open mouth, a preference to sleep face down, snoring and restlessness at night, these could be signs of sleep apnea.

Adolescents and young adults Sleep requirements at ages 12 to 16 are still high and we start to see more problems with insomnia. A circadian rhythm, or internal biological clock, disorder is a common problem.

There is a correlation between bedtime, light exposure and internal hormone regulations such as melatonin and cortisol, and it is all cued according to the person’s circadian clock.

When the body senses it is bedtime, the body temperature drops slowly, the melatonin levels go up and the cortisol goes down, signaling sleep. However, if you expose yourself to bright light from TVs or computer screens, or mental activity with video games, you are sending a signal to the brain that it is still daytime. It creates a complex issue that over a period of time can become an acquired cycle and difficult to reverse.

Chronic sleep deprivation is also a common problem in this group. If a child is consistently falling asleep in school, it’s a good idea to have your pediatrician check for sleep disorders. Sometimes a sleep study may be required.

There is also a strong correlation between sleep apnea and obesity in children. Sleep apnea can lead to obesity and obesity can lead to sleep apnea, becoming a vicious circle. It can also lead to psycho-behavioral changes that affect school performance and social activities. Studies have shown that children with a high body mass index and poor social skills tend to have unsatisfactory school performance.

To find out more information or to make an appointment at the Floyd Memorial Sleep Disorders Center locations in New Albany or Corydon, call (812) 949-5550.

7

When a Simple Screening is a Life Saver

FLOYD MEMORIAL’S IMPACT ON OUR COMMUNITY Each year, Floyd Memorial Hospital and Health Services invests millions of dollars in the health and wellness of our community. The hospital offers community members the security and peace of mind that a comprehensive healthcare system is easily accessible and always available to care for the needs of all populations, regardless of a person’s ability to pay. Floyd Memorial is a major contributor to the economic growth, development and health of our community, ensuring a secure today and a promising tomorrow.

Floyd Memorial Foundation Community Giving Statistics $250,000 – Cafeteria renovation grant

$5,000 – Choices for Women Resource Center donation

$100,000 – Floyd Memorial Healthier Community Initiative

$4,500 – Nurses’ Day appreciation gifts

$32,500 – Healthcare career scholarships

$1,000 – Wellness Coalition of Southern Indiana grant

$25,000 – Floyd County Family Health Center donation

$1,000 – St. Marks Health Fair grant (targeting the poor and homeless)

$22,041 – Associate ASSIST program $15,850 – Massage therapy for cancer patients and caregivers

$1,000 – St. Elizabeth’s Catholic Charities grant

$9,189 – Diabetes education materials and nursing supplies

$1,000 – Riverside Aquatic Club grant

$1,000 – New Albany Track Club grant

Healthier Community Initiative (HCI)

Floyd Memorial Auxiliary & Volunteer Services Community Giving Statistics 240 – Number of adult and junior volunteers serving Floyd Memorial 34,000 – Hours of service donated by volunteers in 2012 $674,799.34 – Dollar equivalent of volunteer hours donated (equivalent to 16 full time employees) $100,000 – Cafeteria renovation $30,000 – Nursing scholarships $11,771 – New Admin Rx system for Outpatient Surgery Department

The Healthier Community Initiative and all its activities are wholly funded and made possible by the generous support of the Floyd Memorial Foundation.

$5,000 – Sponsorship of Floyd Memorial Foundation Golf Classic

$100,000 – Funds donated to HCI by the Floyd Memorial Foundation

75 – Peripheral Artery Disease (PAD) screenings

$2,625 – 35 internal feeding pumps

7,000 – Free health screenings

37 – Occult blood colon cancer screenings (40 percent abnormal results)

4,000 – Community members served 500 – Take 2 for Heart and Stroke screenings 190 – Skin cancer screenings

105 – Community outreach events and education classes 150 – Units of blood donated through Red Cross blood drives

(provided by Floyd Memorial)

$36.3 million $33 million

$35,000,000

$30,000,000

$36.9 million

$32.5 million

$1,300 – Prepared childbirth books $1,217.95 – Breast pump for associate lactation room

$692 – Relaxation chair for Surgical Inpatient Unit $125 – Bus tokens for patients without the means for transportation

Community Health Improvement Services: $1,152,459

$27.8 million

Clinical and non-clinical services provided to the community for free or for fees that did not cover costs (health fairs, screenings, support services and subsidized services such as the Floyd Memorial Joslin Diabetes Center Affiliate and various cancer services).

$20,000,000 0 2008

2009

2010

– Ruby Clark, with Shannon Carroll, RN

2011

her heart. I could sense that she wasn’t as concerned about her condition as I felt she should be, so I repeated myself four or five times to make sure that she understood how grave the situation really was.”

On that day in January 2013, Floyd Memorial Healthier Community Initiative clinical educator, Shannon Carroll, RN, was holding a free blood pressure screening in the YMCA lobby. As Ruby explained, “I had been past the screening booth several times that morning as I was cleaning, and hadn’t paid much attention to it. But after my shift was over and I was walking out the door to go home, I decided, what the heck, I’ll give it a go. The screening had ended and Shannon was cleaning up, but she said she’d still check me.”

“What unfolded next was an absolute whirlwind,” said Ruby. “The screening was on a Wednesday, Thursday I saw my primary care doctor, who did an EKG and ordered several types of stress tests, which I completed on Friday. By Monday I was having triple bypass open heart surgery.

My surgeon told me that I was days away from a massive heart attack, and that there’s no question the blood pressure screening saved my life. Now I’m back to work at a wonderful job that I’m so grateful for, and cherishing every day I have with my husband of 49 years, Chippy, and my sons and grandchildren. Shannon could have easily told me that the screening was over that day or that the machine was broken when it couldn’t register my blood pressure, and I wouldn’t have thought anything of it. But Floyd Memorial’s free screening program and her simple act of kindness saved my life.”

Shannon continued, “When we first took Ruby’s blood pressure, I thought the machine was malfunctioning because it wouldn’t give a result. So I decided to manually check her pulse. What I found was astounding. I’ve been doing community screenings for a long time, and it was easily the most irregular heartbeat I’d ever assessed. I advised her to see her doctor immediately and to request an EKG of

Local Jobs 2,243 – Number of associates working for Floyd Memorial $117,297,400 – Wages and benefits paid to associates 463 – Number of physicians on medical staff

Services Rendered at Floyd Memorial 236 – Licensed patient beds 15,886 – Inpatient discharges 358,308 – Outpatient visits 12,621 – Surgical procedures 25,076 – Urgent Care visits

$25,000,000

8

$1,764 – New touch screen monitor and keyboard for the Gift Shop

$750 – Training for Ultrasound department staff

Uncompensated/Charity Care $40,000,000

$1,975 – New wheelchairs for the Emergency Department

“I take advantage of every free screening I can now. I never had any symptoms or history of heart problems at all, and I was on the verge of a massive heart attack. There’s no question that a simple blood pressure screening saved my life, and I am eternally grateful for it.”

When Ruby Clark made the last minute decision to have her blood pressure checked as she was ending her shift as a housekeeper at the Floyd County YMCA, she could never have guessed that it would save her life.

23,102 – Home Healthcare visits 45,616 – Emergency Department visits 954 – Births

Financial contributions: $43,240

Contributions that included cash and in-kind items made to non-profit organizations.

Capital Investments $15,000,000

$11.6 million $10,000,000

$10.6 million $7.1 million

$8.2 million

$10.6 million

$5,000,000

0

2008

2009

2010

2011

2012

Floyd Memorial Hospital and Health Services is a public not-for-profit healthcare system, meaning that we re-invest all earnings into healthcare technology, improvements, education and care in our community.

Capital Investments include all investments in renovation and technology at Floyd Memorial Hospital and its outlying facilities.

2012

9

JULY/AUGUST/SEPTEMBER 2013 Calendar of Events To register, call 1-800-4-SOURCE (1-800-476-8723), or visit floydmemorial.com/events, unless another number is listed.

*

Free Joint Pain Screening Saturday, September 14, 7:30 - 11 am Floyd Memorial Wound Healing Center Free joint pain screening of knees and hips featuring X-rays and consultation with an orthopedic surgeon. You’ll also get an opportunity to meet our team of experts.

Space is limited and appointments are required.

Sponsored by:

Stroke & Aneurysm Vascular Screenings Every Tuesday & Thursday by appointment Stroke & Aneurysm Vascular Screenings are offered by the Floyd Memorial Heart & Vascular Center. They include non-invasive screening for Abdominal Aortic Aneurysm, Peripheral Artery Disease and Carotid Artery Disease. The cost is $49 for all three. To make an appointment, call 1-800-4-SOURCE. Free Take 2 for Heart and Stroke Screenings Thursday, August 1 and September 5 by appointment.

One-on-one screening with a registered nurse, full lipid cholesterol panel, blood pressure, blood sugar, blood sugar A1C and body mass index. Registration required.

Free Blood Pressure Screenings 1:30 - 3 pm every other Friday in the main lobby July 19, August 2, 16, 30, September 13 and 27 Free Screenings at the New Albany YMCA Monday, August 19, 9 - 11 am Tuesday, September 17, 4:30 - 6:30 pm Free blood pressure screenings, height and body composition as well as health education.

Free Skin Cancer Screening Thursday, September 12, 2 - 4 pm Floyd Memorial Cancer Center of Indiana Free skin cancer screenings by local, certified dermatologists. Registration required.

Free Health Fair at Greenville Christian Church Saturday, September 14, 10 am - 2 pm Free health screenings and education.

Free Colon Cancer Screening Kits Floyd Memorial Cancer Center of Indiana Free occult blood colon cancer screening kits are available for pickup at the Cancer Center of Indiana front desk.

Free Osteoporosis Screenings The pDXA screening is a scan of the bone density of the heel. The screenings take place in the Women’s Imaging Center and are offered by appointment only. To register, call (812) 949-5570.

Lung Cancer Screenings CT scanning of the lungs is a simple, quick radiological test that is capable of detecting lung cancer at a very early stage, when treatment can be most successful. If you are a current or past smoker age 50 or older, or have been exposed to heavy second-hand smoke, this screening could save your life. Physician referral not required. Cost is $150, which includes a results consultation immediately after your scan with a physician radiologist.

To register, call (812) 949-5570.

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 for information.

Balance and Control Program designed for individuals looking to get their diabetes under control, new to diabetes or new to insulin. Covered by most insurance plans. To register, call (812) 949-5700.

Diabetes Refresher Course Program helps patients set goals for healthy management of their diabetes. Highlights include: what’s new in diabetes, understanding the numbers, counting carbohydrates, latest treatment options, evaluating old goals and setting new ones. Covered by most insurance plans. To register, call (812) 949-5700.

10

Pre-Diabetes Class If you have pre-diabetes, or are overweight and 45 or older, you are at high risk of developing type-2 diabetes. Class is designed to help determine what changes are needed, and set goals for living healthier. Class is self-pay and costs $25. To register, call (812) 949-5700.

Free Guided Grocery Shopping Tour Thursday, August 29, 10 - 11 am Sav-A-Lot in Jeffersonville, Allison Lane Patients with diabetes have a lot of complicated decisions to make at the grocery store. Let a certified diabetes educator take you on a free, guided tour to help make sense of it all and ensure you’re making the best choices for your health.

Registration required.

HEALTH EDUCATION Kidney Disease Treatment Options Classes Wednesday, July 17, August 21 and September 18, 10 am - Noon Learn about the types of treatment for kidney disease including hemodialysis (home and in-center), peritoneal dialysis for home and kidney transplantation. Call (502) 895-7650 to register.

Indiana Blood Center Blood Drive Monday, July 29, 11:30 am - 6 pm Floyd Memorial Paris Health Education Center Donate blood and give the gift of life.

Free Bone & Joint Pain Seminar Tuesday, August 6, 6 - 7 pm Floyd Memorial Paris Health Education Center Learn about advanced treatments that may offer dramatic relief of your knee or hip pain. An orthopedic surgeon and nurse will discuss medications, exercise and joint replacement surgery. Registration required.

We Love Our Kids Health Fair Saturday, September 14, 1 - 4 pm Slate Run Elementary School Fun children and family activities, health screenings, health education and community resource information.

Free Hormone Replacement Therapy Seminar Tuesday, September 17, 6 – 7 pm Cancer Center of Indiana Explore the many options in treating common concerns of women today such as menopause, PMS symptoms and hormone imbalances. Learn about bio-identical hormone therapy, traditional hormone therapy and supplements that can give you a much better sense of well being. Presented

by Carla Layne, ARNP, CNM, and Precision Compounding’s Laura Pfaffenberger, PharmD, and Denise Orwick, RPh. Registration required.

Greenway 5K Family Health and Fitness Day Saturday, September 28, 10 am - Noon New Albany Amphitheater Zumba, obstacle course, bounce house, yoga, `Give Me 10’ kick-off, family fun and games!

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

Free Low Back Pain Seminar Tuesday, October 1, 6 - 7 pm Floyd Memorial Cancer Center of Indiana Orthopedic and spine surgeon, Mohammad Majd, MD, will discuss the latest technology and techniques in treating low back pain, from physical therapy to minimally invasive surgeries including artificial disc replacement and sacroiliac joint fusion. Registration required.

Alzheimer’s Support Group Third Thursday of each month, 2 - 3:30 pm and 6 - 7:30 pm Contact: Sadie Powell, (812) 948-1311 Amputees in Motion Support Group Third Thursday of each month, 7 pm Meets at Southern Indiana Rehab Hospital Contact: Brittany Bley, (502) 724-4490 or Bradley (812) 557-5484 Balancing Life with Diabetes Support Group Tuesday, July 16, 10 - 11 am Topic: Mindlessly Eating Better Tuesday, August 20, 10 - 11 am Topic: Recipe Makeovers Tuesday, September 17, 10 - 11 am Topic: Staying Active: Working through the Aches and Pains Meets at 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 Meets at 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 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 OFFERED BY

Gluten Free Support Group Fourth Tuesday of each month, 6:30 pm Contact: Jennie Olmstead, (812) 945-4500 La Leche League of Southern Indiana Third Monday of each month, 6:30 - 8 pm Breastfeeding support and information Contact: Lisa, (812) 987-3635 Mended Hearts Support Group Fourth Monday of each month, 6 pm Mended Hearts is a national and community-based non-profit organization that has been offering the gift of hope to heart disease patients, their families and caregivers. Our support groups help people understand that there can be a rich, rewarding life after heart disease diagnosis.

Contact: Jackie Lattis, (502) 819-2085 for meeting location Multiple Sclerosis Support Group Fourth Monday of each month, 6 pm Contact: Michael Quinn, (502) 797-5878 Parkinson’s Support Group Tuesday, August 6, 6:30 - 7:30 pm Wednesday, September 4, 6:30 – 7:30 pm Monday, October 7, 6:30 – 7:30 pm Contact: Richard Mattox, (812) 256-5424 Stroke Support Group Second Tuesday of each month, 1 pm Meets at Southern Indiana Rehab Hospital Contact: Deb Strickler, CTRS, or Tori Vinson, (812) 941-6154 Together for Breast Cancer Survival Men’s Caregiver Support Group Fourth Tuesday of each month, 6:30 pm Floyd Memorial Cancer Center of Indiana Contact: Doug Drake, (812) 945-4393 or www.cosurvivors.org

WEIGHT MANAGEMENT CENTER

HMR Orientation If you want to lose anywhere from 10 to 200 pounds, HMR can help. Free informational sessions are available on Mondays and Thursdays.

Call (812) 949-7151 to schedule. The program offers several diet options including a medically supervised plan, a moderate diet option and an at-home program.

HMR® Summer Boot Camp Tuesdays, July 16 - August 20 11 am - Noon or 6 - 7 pm New Albany YMCA Trim down this summer with a six-week Healthy Solutions Diet class session. Each six-week session is offered at a discounted rate of $100 (plus the cost of food). Morning and evening classes are available.

Call (812) 949-7151 for information and to register.

FLOYD MEMORIAL BIRTHING CENTER

OFFERED BY

All support groups meet in Floyd Memorial’s Paris Health Education Center unless otherwise stated.

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

SCREENINGS

SUPPORT GROUPS

Surgical Weight Loss Seminar Wednesday, July 17, August 21 and September 18, 6 - 7 pm Floyd Memorial Cancer Center of Indiana Interested in bariatric surgery? You have options.

Learn about gastric banding and gastric sleeve surgery and the support services offered by the Floyd Memorial Weight Management Center at this free informational seminar presented by our board certified surgeons.

OFFERED BY

FLOYD MEMORIAL CANCER CENTER OF INDIANA Look Good…Feel Better Monday, July 22, August 26 and September 23, 1 - 2 pm Floyd Memorial Cancer Center of Indiana This American Cancer Society class provides volunteer cosmetologists who teach make-up techniques and ways to disguise hair loss to women who are battling cancer. Registration deadline is Thursday, July 18, August 22 and September 19. To register, call (502) 560-6045.

All Birthing Center classes are held in the Floyd Memorial Paris Health Education Center.

New Family Fundamentals: Midwives, Doulas and Dads Wednesday, July 31, August 28 & September 25, 6:30 - 7:30 pm Paris Health Education Center Meet certified nurse midwife, Carla Layne, ARNP, CNM, and learn how a midwife can help during pregnancy, labor and delivery.

A doula will discuss how they provide education and support for both parents.

Dads will discover father fundamentals.

This is a free class. Registration required.

Fathering Fundamentals for New Dads Saturday, August 10 and September 14, 9 am - Noon Floyd Memorial Paris Health Education Center Expecting a new baby and have questions or concerns? Dad’s role is very important and this class will help prepare him when the baby arrives.

Voice concerns, ask questions and receive “hands on” interaction with babies. Previous participants are invited back to the class with their babies to help put other dads at ease. Cost is $25.

Registration is required by calling Jerry Geller at (754) 224-0157 or jpg0705@aol.com.

Prepared Childbirth Class Saturday, July 20 and 27, 8:30 am - 12:30 pm (2-part series) Tuesday, August 27 - October 8, 6:30 - 8:30 pm, (6-week series) Cost - $30 per couple. These classes discuss the physical preparation and education needed for a successful delivery. The classes involve 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.

Sibling Class Saturday, August 3, 10:30 am - 12:30 pm This free class is 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.

Breastfeeding Class Thursday, August 22, 6:30 - 9 pm This free class will help you and your newborn have a successful breastfeeding experience.

Discussion will include helpful hints and practical guidelines, as well as common misconceptions and barriers. Registration required.

Babysavers Class Thursday, August 29, 6:30 - 9 pm This class is taught by certified CPR instructors and designed to teach new parents infant CPR. Cost is $10 per couple for materials.

Registration required.

Prenatal Class Thursday, October 3 - November 14, 7 - 9 pm (6-week series) For the expectant mom and dad or other support person. This free class is a six-week session and should be taken at the beginning or middle of pregnancy. Taught by several of our highly skilled obstetrical nurses. Registration required.

11