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May/June 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. 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.

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Where families are born.

How to Create a Birthing Plan

At the Floyd Memorial Birthing Center, we put your family first. You’ll find luxurious and spacious labor and delivery rooms, and our obstetricians and certified nurse midwife provide whole-family care, education and support throughout your entire pregnancy, labor and delivery. We even

Vascular Disease Treatment Options Abound

personalize your birthing plan to meet your wishes, and provide options including doulas and garden tubs for labor. And after your bundle arrives, we encourage kangaroo care, quiet time for the new family and we provide breastfeeding support from certified lactation experts. Discover why Floyd Memorial is the first choice for families. www.floydmemorial.com/baby

Cancer Center of Indiana Oncologists Bring National Reputation to Southern Indiana.


Online Health Assessment Tools Now Available Floyd Memorial has launched four innovative, easy-to-navigate online tools offering free pregnancy calculators and information, and personalized assessments to help individuals suffering from knee pain, hip pain and obesity to make smart decisions about treatment options that can help them once again enjoy a healthier, more active lifestyle. The due date calculator and Pregnancy Central tools can be accessed at floydmemorial.com/baby. Pregnancy Central offers information on prenatal care, fertility and conception, planning for baby’s arrival, labor and delivery and your baby’s first weeks. Hip and knee pain assessment tools can be found at floydmemorial.com/joint and the weight loss assessment tool can be accessed at floydmemorial.com/weightloss. These tools are designed to guide healthcare consumers through interactive question and answer assessments so they can learn about the underlying causes of knee and hip pain, learn about their personal weight status, assess nutrition and exercise behaviors and make better informed decisions about medical and surgical care. The free assessments provide

personalized reports customized to an individual’s specific needs and conditions. Additionally, the assessments provide access to extensive resources and tools to support short and long-term knee and hip pain recovery, as well as methods to connect consumers to education programs, physicians and other health and fitness experts. These include: • Recommended reading lists and links to articles • Questions to ask physicians and other healthcare professionals • Non-surgical treatment methods to alleviate knee and hip pain • Screenings and seminars on preparing and recovering from joint replacement surgery • How to make appointments with medical experts in orthopedics, physical therapy, rehab services and weight management • In-depth information about surgical options • Weight status and eating behavior assessments • Support groups and online communities • Tips for healthy grocery shopping

Floyd Memorial Birthing Center Sponsors Zebra Baby Naming Contest New Occupational Health Program Floyd Memorial is proud to once again offer occupational health services to local businesses for worker’s compensation injuries or work-related health and drug testing. Floyd Memorial Occupational Health will provide quick and comprehensive care through the worker’s compensation insurance process when an injury occurs. Employees can be seen at any Floyd Memorial Urgent Care Center or, in emergency situations or after Urgent Care Center hours, at the Floyd Memorial Emergency Department. Floyd Memorial Urgent Care Centers offer X-rays and treatment for most minor injuries. Also, businesses partnered with Floyd Memorial Occupational Health will enjoy the clinicbased rates for non-emergent injuries seen in the Emergency Department (after Urgent Care Center hours). Floyd Memorial Occupational Health has partnered with Occupational Health Partners (OHP) for follow-up care. OHP has offices at Floyd Memorial Hospital in New Albany, downtown Louisville and Shepherdsville. Floyd Memorial can also provide worker’s compensation claimants with ancillary services for injuries after the initial treatment including diagnostics, physical therapy, pain management, outpatient rehabilitation and home healthcare. For more information on the Floyd Memorial Occupational Health program, call (812) 542-4988.

In partnership with the Louisville Zoo, the Floyd Memorial Birthing Center is sponsoring a Zebra Baby Naming Contest. If you have the perfect name for the new female zebra foal, submit your entry online at louisvillezoo.org from May 13 to 26. The zookeepers will choose three names and display them at the zoo June 10 to 23 for visitors to vote. There will also be ballot boxes at Floyd Memorial Hospital’s main lobby. The winner will be announced the

If you would like more information on becoming a volunteer, call (812) 948-6734 or visit floydmemorial.com/volunteers. 2

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 Michael R. Marvin, MD Hepatobiliary and Pancreatic Surgery University Surgical Associates 401 E. Chestnut St., #710 Louisville, KY 40202 (502) 583-8303 Mohamed A. Saad, MD Pulmonary Medicine Floyd Memorial Sleep Disorders Center 1850 State Street New Albany, IN 47150 (812) 949-5550

New Albany Farmers’ Market at Floyd Memorial

Tuesday’s, beginning June 18 • 11 am - 2 pm Floyd Memorial Wound Healing Center Entrance (on State Street) Shop fresh produce, foods and goods from local farmers, food producers and artisans.

Floyd Memorial is Now a Grasshoppers Distribution Site As a healthful service to associates and community members, Floyd Memorial Hospital has become a bi-weekly community distribution site for Grasshoppers Distribution. Grasshoppers offers locally grown produce, beef, chicken, pork, bison and turkey raised on pastures without prophylactic antibiotics

Thanks to Our Volunteers for Lending a Helping Hand Floyd Memorial Hospital is grateful to the 240 adult volunteers who selflessly dedicated their time and talent to the organization in 2012. They gave approximately 35,000 hours of service, which equates to nearly $675,000. Their help has extended to patients, family members and our staff in several areas including: • Patient Ambassadors – escorting patients and visitors to their destination within the hospital • Family Advocates – serving as a resource to patients’ families in outpatient surgery, emergency and CVCU/ICU waiting areas • Mended Hearts – volunteers who have previously had a heart attack or heart surgery provide mentoring and comfort a patient who has just had a heart attack or heart surgery • Information Desk – answering and directing phone calls, giving directions and providing customer service to patients, families and visitors at the main entrance • Gift Shop – running the cash register and providing customer assistance • Shuttle Driver – responsible for picking up and dropping off patients, family members and visitors from their vehicle to and from the appropriate on-campus entrance • Various Departments – providing assistance to over 30 areas including Education, Finance, Health Information, Joslin Diabetes Center, Cancer Center of Indiana and more

week of June 24. The top three winners will receive a zoo prize package including items from their gift shop, four zoo adventure ticket packages and a tote from the Floyd Memorial Birthing Center. The grand prize winner will also receive a behind-the-scenes tour, bonding session, certificate and photo with zebra mom and baby. In addition, if you delivered your baby at Floyd Memorial, you will receive a $5 discount on a new Louisville Zoo family membership between May 13 and June 24. See contest for details.

Looking for a Physician?

There are always volunteer opportunities available at Floyd Memorial. Volunteering is a great way to give back to the community and add a little sunshine to someone else’s day. It is a rewarding way to spend your time. As a hospital volunteer, you will receive the following benefits: • Flexible weekday and weekend hours • Cafeteria discounts while on duty as well as a complimentary meal ticket on your birthday and when volunteering for eight consecutive hours • Free access to the Cardiac Rehab gym • Discounted tickets to local attractions and services • Free flu shots • Invitation to our annual Volunteer Recognition Banquet

or added hormones or steroids, goat and cow cheeses, milk, butter, cream and much more from over 70 local family farms and artisans in Kentucky and Southern Indiana. If you are interested in ordering goods online for bi-weekly pick-up at Floyd Memorial’s Green Valley Road lobby,

you may sign up at localfoodnow.com. May/June distribution dates at Floyd Memorial are May 29 and June 12 and 26 from 3 - 5 pm. For more information, go to localfoodnow.com or call (502) 708-1881.

Guardian Angel 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. Braidi Huecker, MD OB/GYN Associates of Southern Indiana Karen Nalley, RN Bobbie Nauch, RN Emergency Department C.M. Hocker, Jr., MD FMMG – State Street Clarrissa Payne Sherry Potts Environmental Services

Margaret Graves, RD, CDE Joslin Diabetes Center Affiliate Deb Steck, RN Medical Care Management Donna Burkhead, NA Kayle Lepper, Clinical Educator Nikita Smith, NA Medical Inpatient Unit Kim Payton Teresa Whitehouse Patient Accounting

Dianna Caldwell, RN Progressive Care Unit Elaine Duncan, Pharmacist Pharmacy Lisa Satori, RN Rachel Burrows, RN Surgical Inpatient Unit Janet Folden, RN Birthing Center Susanne Wolf, RN Wound Healing Center

On the cover...Floyd Memorial Cancer Center of Indiana oncologists Pictured L to R include: Ifeoma Roseline Okeke, MD, Ajay Kandra, MD, Yasoda Devabhaktuni, MD, and Neal Dunlap, MD. Not pictured: Anthony Dragun, MD, and B.O. Jose, MD. Naveed Chowhan, MD, is no longer affiliated with the Floyd Memorial Cancer Center of Indiana, however, he remains on staff at Floyd Memorial Hospital. His current office address is 825 University Woods Drive, Suite 3, New Albany, IN 47150.

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A Total Transformation

Tackling Even the Most Complicated of Cancers “Abdominal cancers, including colorectal cancer with metastases to the liver, primary liver, pancreatic and bile duct cancers, can require complex treatment plans. But here at the Cancer Center of Indiana, we’re equipped to handle even the most stubborn cancers, all in one convenient location for Southern Indiana patients. There’s no need to cross the river for top notch cancer care, it’s all right here.” Ifeoma Roseline Okeke, MD Hematologist and Board Certified Medical Oncologist Floyd Memorial Cancer Center of Indiana Cancer Survivors’ Reunion Friday, June 21, 11 am – 1:30 pm Floyd Memorial Cancer Center of Indiana Enjoy a day at the carnival with fellow cancer survivors. This free event will feature carnival-style food booths, an old-fashioned photo booth, balloon animals, magic shows, face painting, bingo and chair massage. All Floyd Memorial Cancer Center of Indiana patients, survivors and their loved ones are invited to attend. “I felt great after surgery. There wasn’t much pain, and I only needed one week of rehab before I was back to my normal self, enjoying life with my husband, sons and grandkids.” – Mary Albertson

Before surgery

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After surgery

Every type of cancer is a challenge to overcome, but some can be more complex to treat than others. Abdominal cancers, including colorectal cancer that has spread to the liver, primary liver, pancreatic and bile duct cancers, often require complicated treatment planning that can encompass multiple specialties and procedures. Until recently, many of these patients could only receive part of their care in Southern Indiana, but thanks to recent technology and physician additions, Floyd Memorial Hospital and the Floyd Memorial Cancer Center of Indiana are now able to provide comprehensive abdominal cancer care, all right here. Tri-Modality Therapy Ifeoma Roseline Okeke, MD, a hematologist and board certified medical oncologist with the Cancer Center of Indiana, explained the role tri-modality therapy plays in abdominal cancer treatment. “Tri-modality therapy is a three pronged approach to cancer treatment that includes surgery, medical and radiation oncology. Surgical resection to remove the cancerous tumor provides the best chance of reducing recurrence, and is an integral part of treatment. However, these are highly complex procedures, which is why we are incredibly lucky to have Michael Marvin, MD, a transplant,

“I’m excited to bring the hepatobiliary and pancreatic surgery specialty to Southern Indiana. Floyd Memorial is a cutting edge facility that provides the perfect opportunity to begin offering surgeries of the liver, pancreas and bile duct in this area, many of which can be done laparoscopically.” Michael Marvin, MD, FACS Transplant, Hepatobiliary and Pancreatic Surgeon Chief, Division of Transplantation, Director of Liver Transplantation and Associate Professor of Surgery, University of Louisville hepatobiliary and pancreatic surgeon, available to patients at Floyd Memorial.” Stereotactic Body Radiotherapy Offers New Hope Stereotactic Body Radiotherapy (SBRT), a highly concentrated, precise form of radiation therapy that was recently introduced at the Cancer Center of Indiana, offers an excellent alternative for patients who aren’t good surgical candidates and for general control of tumor growth before and after surgery. SBRT

Patient Makes Remarkable Recovery from Brain Tumor Surgery Mary Albertson, a three-year lung cancer survivor, had fallen several times before her routine visit with her Floyd Memorial Cancer Center of Indiana oncologist, Yasoda Devabkaktuni, MD, in November 2012, but hadn’t put much thought into it. She was busy enjoying life with Ernie, her husband of 46 years, and their two sons and six grandchildren. But Dr. Devabhaktuni immediately sensed something was wrong, ordering a CT scan that delivered the news every cancer survivor dreads: it had spread. Mary was immediately admitted to the hospital, where board certified neurosurgeon Michael Doyle, MD, of the Floyd Memorial Spine Center, consulted on her condition. A Delicate Location “Mary’s tumor was the result of her lung cancer metastasizing to the brain, which is actually fairly common,” said Dr. Doyle. “The lungs and brain are both highly vascular, so it’s common for cancer in the lung to spread to the brain via the blood. We were lucky to catch her tumor before it had gotten so large that it started causing irreversible damage. It was located in the cerebellum, an area of

“Mary’s tumor was located in an area of the brain that doesn’t have a lot of room. I knew if it wasn’t removed soon, the swelling would cause her condition to deteriorate very quickly. To compound that, the tumor was very close to her brain stem, making surgery even more delicate. But I was confident she would do very well, and I’m thrilled to see her thriving after surgery.” Michael Doyle, MD Board Certified Neurosurgeon Floyd Memorial Spine Center the brain that is already very closed in, and was near the brain stem, making her condition all the more delicate.” Image-Guided Brain Surgery Dr. Doyle’s strategy was to remove the tumor via surgical resection, also known as a craniectomy. The procedure involves opening the skull to access and remove the tumor, then closing the skull back up with titanium mesh. “This is accomplished via a specialized

can focus an extremely powerful beam of radiation in the exact size and location of the tumor, eliminating damage to surrounding tissues and reducing side effects and treatment time frames. Neal Dunlap, MD, board certified radiation oncologist with the Floyd Memorial Cancer Center of Indiana and James Graham Brown Cancer Center, explained the recent developments in radiation treatment of abdominal cancers, “Gastrointestinal malignancies have historically been very difficult to treat. One reason for this is that the abdomen has many vital organs located in a small space, and until recently, we couldn’t safely get a high enough dose of radiation to tumors located in the abdominal area to effectively control cancerous growth. But with the advent of technology such as SBRT and Intensity-Modulated Radiation Therapy (IMRT), we can safely and effectively target just the cancerous area.” “We also now use IMRT to try to convert patients who weren’t surgical candidates into those who are,” added Dr. Dunlap. “If a tumor is borderline operable, we can administer chemotherapy and IMRT with Image-Guided Radiotherapy (IGRT) to try to shrink the tumor to an operable size. In addition, where stereotactic navigation system that I liken to GPS for the brain,” he explained. “It uses real-time image guidance to visualize the precise shape and location of the tumor so that I can see exactly where my instruments are within the brain, and remove the mass with pinpoint accuracy. An additional benefit of this system is that it allows for smaller incisions, which means faster, less complicated recoveries.” Back to Normal in No Time at All “My recovery was a breeze,” said Mary. “You think of brain surgery and immediately you assume you’ll have a long, difficult recovery process, but mine couldn’t have been further from that. I had very little pain and only spent one week in inpatient rehab before I got to go home. I rested at home for about a month, and then completed 10 radiation treatments at the Cancer Center of Indiana. Now I’m back in remission, enjoying life. I’ve had a recent bout with the shingles, and I can safely say that shingles is worse than brain surgery any day!” “Mary’s great attitude, toughness and resilience are a testament to her remarkable recovery,” added Dr. Doyle. “She’s living proof that a positive attitude makes all the difference.”

“With the recent addition of Stereotactic Body Radiotherapy (SBRT) technology, not only can we offer a promising alternative for patients who aren’t surgical candidates, in some cases we can actually shrink the tumor to the point that it can become operable.” Neal Dunlap, MD Board Certified Radiation Oncologist Floyd Memorial Cancer Center of Indiana James Graham Brown Cancer Center surgery falls in the treatment process is something that has also recently evolved. For example, the standard of care for colorectal cancer that had spread to the liver was previously to perform a surgical resection and then proceed with chemotherapy and radiation. However, now we know that patients are better able to tolerate their treatment, suffer fewer side effects and have a reduced chance of recurrence if they undergo surgery after completing chemotherapy and radiation.” Genetic Testing Offers a Highly Targeted Approach “Another recent development is the advent of genetic and tumor biology testing,” added Dr. Okeke. “We can now test tumors for certain mutations that allow us to individualize each patient’s treatment plan. Genetic tests for early colon cancer also help us to determine which patients are at risk for relapse and may benefit from chemotherapy.” She continued, “In addition, we can screen for genetic mutations that may indicate potential colon cancer genetic syndrome. This gives loved ones a chance to practice prevention tactics and undergo screening.”

“When undergoing treatment for cancer, it’s important to stay mindful of everything happening in your body. Balance issues and falls were Mary’s first warning signs that her cancer had spread to the brain, and we were lucky to catch it and perform surgery before the tumor became too large and caused irreversible damage.” Yasoda Devabhaktuni, MD Board Certified Medical Oncologist/Hematologist Interim Medical Director, Floyd Memorial Cancer Center of Indiana

James Graham Brown Cancer Center Provides Radiation Therapy Services at Floyd Memorial Cancer Center of Indiana Patients of the Floyd Memorial Cancer Center of Indiana have access to the expertise of James Graham Brown Cancer Center radiation oncologists, close to home. For over eight years, the expert radiation oncologists of the James Graham Brown Cancer Center have provided radiation therapy services to Southern Indiana patients at the Cancer Center of Indiana location in New Albany. With James Graham Brown physicians, patients have access to world-renowned radiation therapy expertise and the most cutting edge technology available, all without ever having to cross the river. These physicians include: Anthony Dragun, MD Board Certified Radiation Oncologist Co-Director, Multi-Disciplinary Breast Cancer Program, James Graham Brown Cancer Center & Floyd Memorial Cancer Center of Indiana Assistant Professor, Department of Radiation Oncology, U of L School of Medicine Area of Interest: Breast Cancer Neal Dunlap, MD Board Certified Radiation Oncologist James Graham Brown Cancer Center & Floyd Memorial Cancer Center of Indiana Assistant Professor & Assistant Residency Director, Department of Radiation Oncology, U of L School of Medicine Areas of Interest: Lung, Head & Neck Cancer B.O. Jose, MD, FACR Board Certified Radiation Oncologist James Graham Brown Cancer Center & Floyd Memorial Cancer Center of Indiana Vice Chairman & Professor, Department of Radiation Oncology, U of L School of Medicine Area of Interest: Genito-Urinary Cancer For more information on services offered at the Floyd Memorial Cancer Center of Indiana, call (812) 945-4000 or visit floydmemorial.com/cancer. 5


Vascular Disease Treatments Constantly Evolving “The most important thing patients can do when it comes to vascular disease is to regularly follow up with their physician. Vascular conditions can deteriorate into serious problems very quickly, but with proper follow up care, they can be caught and treated before larger issues develop.” Waheed Ahmad, MD Board Certified Surgeon Comprehensive Vein Treatment Center of Kentuckiana

Carotid Artery

Thoracic Aorta

Heart

Vascular disease refers to conditions of the blood vessels. The blood vessels are arteries or veins, and can be located anywhere in the body. Vascular surgery is performed to open up diseased arteries or to bypass them with new blood vessels. It is also performed to access arteries or blood vessels for procedures such as dialysis. Waheed Ahmad, MD, a board certified surgeon with over 40 years of vascular surgery experience, explained that there are a wide variety of vascular conditions with many treatment options available. Some of the more common conditions include: Venous Disease is a catch-all term for a collection of conditions associated with the veins. Veins are flexible, hollow tubes with flaps inside called valves that open and shut to keep blood flowing in one direction through the veins. If these valves become damaged as a result of venous disease, they may not close completely, allowing blood to leak backward or flow in both directions. Peripheral Artery Disease, also known as PAD, becomes more common as we age. It is classified by a narrowing of the peripheral arteries, usually of the pelvis and legs, and is caused primarily by a build up of plaque in the walls of the arteries.

Peripheral Arterial Aneurysms affect the arteries in the body other than the aorta. Most peripheral aneurysms occur in the popliteal artery, which runs down the back of the lower thigh and knee. Less commonly, peripheral aneurysms also develop in the femoral artery in the groin, carotid artery in the neck or sometimes the arteries of the arms. Another type of peripheral aneurysm that forms in the arteries feeding the kidneys or the bowel is called a visceral aneurysm. Thoracic & Abdominal Aortic Aneurysm is a condition that occurs when a weakened area of the thoracic or abdominal aorta expands or bulges. The aorta is the largest artery in the circulatory system, carrying blood away from the heart to all parts of the body. The portion of the aorta that runs through the chest cavity is called the thoracic aorta, while the portion running through the abdomen is known as the abdominal aorta. Carotid Artery Disease is a deteriorating of the blood vessels that supply blood to the brain. Known as the carotid arteries, these vessels are located on each side of the neck under the jawline. Carotid artery disease is a condition in which these arteries become narrowed or blocked.

Minimally Invasive “Endovascular” Procedures Are on the Rise The care of patients with vascular disease is evolving rapidly, and minimally invasive “endovascular” options are on the rise. Dean Wickel, MD, a board certified vascular surgeon who recently joined Floyd Memorial Medical Group-Vascular Surgery, explained what endovascular procedures entail. “Endovascular means that the treatment is performed inside the blood vessels using long, thin tubes called catheters,” said Dr. Wickel. “The catheters are inserted through the skin into arteries in the groin or arms, and are guided through the blood vessels to the location of the blockage. During the procedure, the surgeon utilizes live X-ray pictures viewed on a video screen to guide their way. These procedures are performed in a catheterization lab rather than an operating room, and have lower complication rates, faster recovery times and less pain than traditional open procedures. While not all vascular surgeries can be performed using endovascular techniques, they are an excellent option for the right patient.” The Importance of Prevention “While vascular disease carries a high genetic component, it also responds well

to proper prevention and management strategies,” said Dr. Ahmad. Below, he shares some helpful tips to keep your vascular health in check: • Don’t smoke or use tobacco. Smoking is probably the most important risk factor for peripheral artery disease (PAD). • Eat a diet low in cholesterol and saturated fat to reduce your risk of atherosclerosis. This is the process of plaque buildup in your arteries. The plaque slows or stops blood flow to and from your blood vessels. • Start a walking program to improve circulation to your legs and promote growth of new blood vessels. • Lose weight if you are overweight. For every pound of fat, your heart needs to pump blood through an extra mile’s worth of blood vessels. • Watch your blood pressure. If you have high blood pressure (hypertension), you are at an increased risk for heart attack, stroke, heart failure or kidney damage. • If you have diabetes, work to keep your blood glucose in good control. People with diabetes are at greater risk because of the damage that diabetes can do to blood vessels.

“I’m excited to bring minimally invasive endovascular procedures to Southern Indiana patients here at Floyd Memorial. Endovascular techniques allow us to access many regions of the body via major blood vessels, rather than open surgery. They tend to be less painful, with lower risk of complication and quicker recovery than traditional open vascular surgery procedures.” Dean J. Wickel, MD Board Certified Vascular Surgeon Floyd Memorial Medical GroupVascular Surgery Floyd Memorial Wound Healing Center Stroke & Aneurysm Vascular Screenings Every Tuesday & Thursday by appointment Stroke & Aneurysm Vascular Screenings are offered by the Floyd Memorial Heart & Vascular Center. They include noninvasive screening for Abdominal Aortic Aneurysm, Peripheral Artery Disease and Carotid Artery Disease. The cost is $49 for all three. Call 1-800-4-SOURCE (1-800-476-8723) for an appointment.

Abdominal Aorta

Renal Artery

Free Peripheral Artery Disease Screening Saturday, August 17 • 8 - 10:30 am Floyd Memorial Heart & Vascular Center

Femoral Artery

Popliteal Artery

Tibial Artery

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Are you at risk for stroke, heart attack or limb loss due to Peripheral Artery Disease (PAD)? This free screening includes a comparison of blood pressure levels in the arms and legs to determine your Ankle Brachial Index (ABI), as well as a written questionnaire and physician consultation for those found to be at high risk. Registration required. Call 1-800-4-SOURCE (1-800-476-8723) for an appointment.

Healthy artery with blood flowing freely

Wound Center Puts the Focus on Healing Are You at Risk of Vascular Disease? If you are 50 or older and have one of the following conditions, you may have poor circulation and be at risk for vascular disease: • High blood pressure • High cholesterol • Diabetes • Smoker • Known cardiovascular disease • Family history of aneurysms

Unhealthy artery with plaque formation beginning to restrict blood flow

Artery that is rupturing, clotting and has blocked blood flow

Vascular disease causes poor circulation and oxygenation of tissues, particularly in the legs and feet. This can often lead to wounds that are difficult to heal and can even lead to amputation. Knowing when to seek medical attention for a wound is key to treatment. Floyd Memorial’s Wound Healing Center is dedicated to the treatment and prevention of wounds, both acute and chronic, using the latest techniques for healing and preservation of limbs while minimizing reoccurrence. “The important thing about a wound healing center is that it allows the doctor to dedicate 100 percent of their energy to healing wounds,” said Dr. Wickel. “In a traditional medical office setting, there are so many other things that the doctor needs to focus on, and wounds don’t get the attention they need in order to be healed promptly and properly. But in a wound center environment, we have the time, expertise and proper

equipment to really make a big difference in how wounds are treated.” The Center offers a dedicated, multidisciplinary team of physicians and wound care specialists, including: • General surgery • Plastic surgery • Vascular surgery • Primary care Hyperbaric oxygen therapy (HBOT) helps • Physical medicine wounds heal faster. • Rehabilitation • Podiatry Along with more traditional treatment options, the Center offers adjunctive therapies including bio engineered skin substitutes, wound vacuum systems and hyperbaric oxygen therapy (HBOT). HBOT is a simple but effective treatment in which the patient breathes 100 percent oxygen inside a pressurized chamber.

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 heal within a week.

For more information on Floyd Memorial’s Wound Healing Center, call (812) 949-7964 or visit floydmemorial.com/wound.

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How-to Guide for Creating a Birthing Plan Choosing a provider: Both obstetricians and nurse midwives are able to deliver your baby at the Floyd Memorial Birthing Center. They work closely together in case a C-section birth or emergency procedure is necessary.

Obstetrician (OB)

Certified Nurse Midwife

Stems from the Latin obstare, “to stand by.” An obstetrician is a physician who is specially trained in obstetrics, providing care to women during pregnancy, childbirth and postpartum. They are qualified to perform necessary surgical procedures pertaining to childbirth including cesarean delivery (C-section). The term midwife means “with woman.” A Certified Nurse Midwife (CNM) is an Advanced Registered Nurse Practitioner who specializes in nursing and midwifery for low risk pregnancies and general women’s care from puberty to menopause. Able to perform deliveries and prescribe medications, a CNM does not perform surgeries including C-sections. A nurse midwife cares for women before, during and after pregnancy and delivery. They are able to stay with the expectant mother during her entire labor and delivery. A midwife does not just focus on natural birth, but uses all that modern medicine can provide, depending on what the expectant mother desires.

“We’re excited that the Floyd Memorial Birthing Center now offers it all. You can have virtually any birthing experience here, safely. If complications should arise, we are ready to handle them quickly and safely. When we have a high risk pregnancy and know there could be issues, we work closely with maternal fetal specialists and neonatal experts who are always on stand-by. And, having a certified nurse midwife gives our patients more options. We also welcome doulas to help support the expecting family.” Jacqueline Riely, MD Board Certified Obstetrician and Gynecologist Floyd Memorial Birthing Center OB/GYN Associates of Southern Indiana

Prenatal and Infant Massage Pregnancy and childbirth are wonderful experiences, but they can bring some discomfort for the expectant mom. Weight bearing joints experience additional stress during pregnancy. Prenatal massage can help alleviate that discomfort, as well as ease sore muscles of the neck, back and hips, and can ease pressure and pain on the lower back, a common source of pain for many expectant women. The soothing touch of massage promotes the release of emotional and physical tension, and has been shown to have positive effects on the developing baby, as the baby responds to the mother’s stress levels registered by her heartbeat. After the baby arrives, infant massage can also play an important role in the newborn’s development. Benefits include: • A stronger bond between parent and baby • Stimulation of the nervous system helps develop muscle tone, coordination and brain functioning

• Increased immune system functioning • Improved circulation • More easily digested feedings • Deeper, more restful sleep for baby and mom The Floyd Memorial massage therapists are certified in both prenatal massage and infant massage instruction. Classes are held several times a year for expectant parents, during which they are instructed in various infant massage techniques. Therapists are equipped with a complete side-lying bolstering system for the normal prenatal massage position, as well as a pregnancy massage table that has a removable section, allowing the motherto-be to lie face down, while safely supporting the baby. The skilled hands of expert therapists can help alleviate some of the stress and tensions of pregnancy for you or your loved one.

“Every mom carries her birthing story with her. It’s part of who she is. When women get together they almost always discuss these stories. I want that experience to be a great one, just as she imagined. One of the first things I ask expectant mothers is how they want this delivery to be different from the last one.” Carla Layne, ARNP, CNM Certified Nurse Midwife Floyd Memorial Birthing Center OB/GYN Associates of Southern Indiana

Massage gift certificates make great baby shower or new mom gifts. Call Floyd Memorial Outpatient Rehabilitation at (812) 948-7416 to schedule your appointment. All major credit cards are accepted.

Childbirth Options Epidural A continuous drip medication that numbs the lower one-third to one-half of the body for pain control during labor and delivery. Women need to have one liter of fluid and lab work done to check platelet count when they are admitted before an epidural can be administered. If the platelet count comes back within normal range, an epidural can be given at relatively anytime during labor before the baby comes. Natural birth Un-medicated delivery using relaxation and breathing techniques for pain control. IV pain medication Analgesic that helps mom relax between contractions and promotes general relaxation. C-section

Baby Fair

Saturday, June 22 • 10 am - Noon Floyd Memorial Main Lobby Wondering what you’ll need for your new arrival? Join Floyd Memorial obstetricians, pediatricians, certified nurse midwife, doulas and baby specialty vendors at the Floyd Memorial Birthing Center’s annual Baby Fair. Register for great door prizes and take home helpful giveaway items and information. 8

Calling All Beautiful Babies!

Doulas

Cesarean birth is a surgical procedure to deliver the baby without the mom going through vaginal delivery. It is indicated when the baby is presenting in a wrong position in the birth canal, such as breech. It is also performed if there is fetal or maternal distress, if mom develops severe hypertension, a decrease in amniotic fluid or other medical concern. Our physicians are ready to perform a C-section if the situation arises, but strive to allow mom a vaginal birth when possible. Hydrotherapy and Garden Tub Labor Floyd Memorial has two labor and delivery suites with garden labor tubs, which can be requested by expectant moms. The tubs are specially equipped with hand held shower heads which help with relaxation and relieve pressure on the mother. Warm water and compresses also help the perineum to stretch and reduce the incidence of tearing.

A doula is a non-medical support person who assists the family during labor. A doula gives reassurance to mom and partner and explains the different stages of labor and delivery while they are happening. Our obstetricians, midwife, nurses and doulas work closely to give mom the birthing plan she desires. Birthing balls Many women choose to sit on a large yoga ball that helps take pressure off the lower back, facilitates movement of the baby and helps in the progression of labor. Walking during labor with remote fetal monitoring By request, we offer bluetooth telemetry enabled fetal monitoring so mom can walk around during labor. The monitors are waterproof and can be used while in a labor tub. Kangaroo care immediately after birth Skin to skin contact that is recommended immediately after delivery and anytime after birth. This contact helps regulate baby’s temperature, heart rate and breathing and stabilizes the blood sugar. It creates a symbiotic bond between mom and baby. Breastfeeding within an hour of birth Breastfeeding is encouraged within the first hour since the baby is most alert and more apt to latch on to mom’s breast. The baby imprints, recognizing mom’s smell, and will naturally navigate toward her breast. The baby then remembers this, leading to more successful breastfeeding. All Floyd Memorial Birthing Center nurses are trained in assisting with breastfeeding, and there are two certified lactation consultants on staff. The consultants will also follow up with mom at home to answer any questions and give advice. Moms can schedule outpatient visits with the lactation consultants if necessary for up to one year.

Through the month of May, proud moms, dads, family members and friends can submit a baby photo in our Facebook Beautiful Baby Photo Contest, sponsored by Babies R Us. Children in the photos should be newborn to 36 months of age. Go to facebook.com/fmhhs and click on the “Contests” tab to enter and/or vote. One vote per Facebook account per day will be allowed, so encourage your friends and family to vote too. The winner will receive a $100 Babies R Us gift card, professional photo shoot with photo package and goodie basket from the Floyd Memorial Birthing Center. The contest runs from May 1 to 31, and the winner will be announced June 3. See contest page for rules and details.

March of Dimes 39 Week Campaign The March of Dimes 39 Week Campaign stresses the importance of letting your baby develop through the 39 week mark instead of having an earlier induction or cesarean delivery. If possible, moms should allow the baby to develop in the womb for at least 39 full weeks. The brain, lungs, liver, eyes and ears are still developing and growing through the 39th week. Babies born too early are more likely to have vision and hearing problems later in life. And, your baby is still learning to suck and swallow, and some born early are not able to perform these actions. If you and your baby are healthy, wait for labor to begin on its own. Healthy babies are worth the wait. Speak to your provider about things you can do to help you and your baby get to at least 39 weeks. 9


MAY/JUNE 2013 Calendar of Events

To register, call 1-800-4-SOURCE (1-800-476-8723), or visit www.floydmemorial.com, unless another number is listed.

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• All events are free and meet in Floyd Memorial’s Paris Health Education Center unless otherwise stated. SCREENINGS 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, June 6, July 3 and August 1 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 May 24, June 7, 21, July 5 and 19 Free Skin Cancer Screening Thursday, May 23, 2 - 4 pm Floyd Memorial Cancer Center of Indiana Free skin cancer screenings by local, certified dermatologists. Registration required. Free Screenings at the New Albany YMCA Tuesday, June 11, 4:30 - 6:30 pm The Floyd Memorial Spine Center will be on hand with free screenings and information, as will educators from Floyd Memorial’s HMR Weight Management and Joslin Diabetes Center. Free Peripheral Artery Disease Screenings Saturday, August 17, 8 - 10 am Floyd Memorial Heart and Vascular Center Are you at risk of stroke, heart attack or limb loss due to Peripheral Artery Disease (PAD)? This free screening at Floyd Memorial’s Heart and Vascular Center includes a comparison of blood pressure levels of the arms and legs to determine the patient’s Ankle Brachial Index (ABI), as well as a written questionnaire. Registration required. 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. 10

HEALTH EDUCATION Kidney Disease Treatment Options Classes Wednesday, June 19 and July 17, 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. American Red Cross Blood Drive Thursday, May 30, 12 - 5 pm Floyd Memorial Cancer Center of Indiana Donate blood and give the gift of life. Safe Sitter Wednesday, June 5, 19 and July 24, 9 am - 4:30 pm Babysitting classes for 11 to 13 year olds. Students will learn a variety of techniques to keep themselves and the children they are watching safe. Choking and rescue skills will also be taught. The one-day course is $45 and includes materials and lunch. Registration required. Free Hormone Replacement Therapy Seminar Tuesday, June 11, 6 - 7 pm Explore options in treating common concerns of women 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.

OFFERED BY

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. Surgical Weight Loss Seminar Wednesday, June 19 and July 17, 6 - 7 pm Floyd Memorial Cancer Center of Indiana 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. HMR Summer Boot Camp Session I: Tuesdays, June 4 - July 9 Session II: Tuesdays, July 16 - August 20 11 am - Noon or 6 - 7 pm YMCA of Floyd County 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.

Free Street Drugs 101 Class Thursday, June 13, 6:30 - 7:30 pm Learn about the harmful drugs that may be closer to your family than you might think. Join Saeed A. Jortani, Ph.D., DABCC, FACB, toxicologist and associate professor of pathology and lab medicine at the University of Louisville as he discusses the threats of common drugs such as ecstasy, cocaine, marijuana, methamphetamines, bath salts, smiles and others, and how they can hurt the body. Seating is limited, so register early. Registration required. Free Bone & Joint Pain Seminar Thursday, June 20 and Tuesday, August 6, 6 - 7 pm 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. 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.

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. 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.

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

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

La Leche League of Southern Indiana Third Monday of each month, 6:30 - 8 pm Breastfeeding support and information Contact: Lisa, (812) 941-1960

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

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

Balancing Life with Diabetes Support Group Tuesday, May 21, 10 - 11 am Topic: Cooking Demo with Dietitians Tuesday, June 18, 10 - 11 am Topic: Medications Tuesday, July 16, 10 - 11 am Topic: Mindlessly Eating Better To register, call 1-800-4-SOURCE. Meets at Floyd Memorial 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 Gluten Free Support Group Fourth Tuesday of each month, 6:30 Contact: Jennie Olmstead, (812) 945-4500

OFFERED BY

FLOYD MEMORIAL CANCER CENTER OF INDIANA Look Good…Feel Better Monday, May 28, June 24 and July 22, 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, May 23, June 20 and July 18. To register, call (502) 560-6045. Cancer Survivors’ Reunion Friday, June 21, 11 am - 1:30 pm Floyd Memorial Cancer Center of Indiana Enjoy a day at the carnival with fellow cancer survivors. This free event will feature carnival-style food booths, an old-fashioned photo booth, balloon animals, magic shows, face painting, bingo and chair massage. All Floyd Memorial Cancer Center of Indiana patients, survivors and their loved ones are invited to attend.

Multiple Sclerosis Support Group Fourth Monday of each month, 6 pm Contact: Michael Quinn, (502) 797-5878 Parkinson’s Support Group First Tuesday of each month, 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 Tobacco Cessation Community Support Group Every Tuesday, 6 - 7 pm Meets at Vance Center off State Street Contact: Floyd County Tobacco Prevention and Cessation, (812) 945-3400 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 cosurvivors.org

BABY FAIR

FLOYD MEMORIAL BIRTHING CENTER

OFFERED BY

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

Breastfeeding Class Thursday, May 16, 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. New Family Fundamentals: Midwives, Doulas and Dads Wednesday, May 22, June 19 and July 31, 6:30 - 7:30 pm 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. Babysavers Class Thursday, May 23, 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, July 11 – August 15, 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. Prepared Childbirth Class Wednesday, May 22 – June 26, 6:30 - 8:30 am (6-week series) Saturday, July 20 and 27, 8:30 am - 12:30 pm (2-part 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.

Saturday, June 22, 10 am - Noon Floyd Memorial Main Lobby If you are wondering what you will need to do before the baby arrives, then let Floyd Memorial help. Floyd Memorial’s main lobby will be filled with baby specialty stores and services, obstetricians and midwives who deliver at Floyd Memorial, pediatricians and much more.

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May-June 2013 HealthScope