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a Woman’s Heart

WINTER 2017


SOURCE

WINTER 2017

In THIS ISSUE Oh, baby!................................................................................................................... 4 A very special delivery........................................................................................ 5 A decade of pediatric cancer care................................................................. 6 News & Advancements ..................................................................................... 7 Back to life................................................................................................................ 8 To catch a killer.....................................................................................................10 Diabetes dilemma...............................................................................................11 The heart of a woman.......................................................................................12 Sockin’ it to falls ..................................................................................................16 BMW Brunch........................................................................................................17 Out and about in our community ...............................................................18 Senior Horizons ..................................................................................................20

On the Cover: Did you know heart disease is the No. 1 cause of death for women both nationally and in Alabama? For our cover, we brought together six Huntsville-area women who have witnessed cardiovascular disease from different perspectives – as patients trying to beat it, and as physicians working to prevent it. They are (from left to right) cardiologist Patricia Gurczak, MD; patient and Mended Hearts Inc. Regional Director Fredonia Williams; patient and Huntsville Hospital Chief Financial Officer Kelli Powers; cardiologist Rashida Abbas, MD; patient Judy Clemmons; and cardiologist Navdeep Mann, MD. All rights reserved. No material in this publication may be reproduced in any form without prior written permission from the publisher. Articles in this magazine are written by Huntsville Hospital professionals who strive to present reliable, up-to-date information, but no publication can replace the care and advice of medical professionals. Contact your physician when considering and choosing health care treatments. For more information on the editorial content of Source, please call Huntsville Hospital Public Relations at (256) 265-8317 or Huntsville Hospital Foundation at (256) 265-8077. Please contact us if you wish to have your name removed from the list to receive fundraising requests or other mailings supporting Huntsville Hospital Foundation in the future.

Upcoming classes and events February 24 Cheers to Five Years! Celebrating Madison Hospital five year anniversary Campus 805 28 Madison Hospital Celebrates 5-year anniversary March 30 Doctor’s Day Has a doctor made a difference in your life? Call (256) 265-8077 to honor your Care Champion April 8 Heart Walk Downtown Huntsville 8

NICU Reunion Huntsville Hospital for Women & Children

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Deadline for application Community Health Initiative grant program. Visit huntsvillehospital.org/chi for more information

22 Heart Society Ball The Westin May 6-12 Nurse’s Week Has a nurse made a difference in your life? Call (256) 265-8077 to honor your Care Champion 11-13 Huntsville Classic

Dinner & Golf Tournament

For a complete list of blood drives, health screenings, support groups and other community events, visit huntsvillehospital.org/events


Your Community Hospital We hope your new year is off to a great start. For those of us who work in health care, 2017 promises to be one of the most interesting and challenging years that we’ve faced. The Trump Administration is in office and efforts are underway to repeal and replace the controversial Affordable Care Act (ACA). There is no guarantee on what the final product may look like, but it will likely retain some elements of the ACA—keeping the elimination of the pre-existing condition clause and continuing to allow eligible children up to the age of 26 to remain on their parent’s insurance. Regardless, change is coming to the nation’s health care insurance system and that creates a lot of uncertainty for patients and providers.

David Spillers, CEO

Our Mission Provide high quality care and services that will improve the health of those we serve. Our Vision To be one of the best health systems in America and consistently strive to provide clinical and service excellence. Our Values Integrity, Excellence, Innovation, Accountability, Compassion and Safety

For hospitals in Alabama, this uncertainty stretches to the state level as well. The long term future of Alabama Medicaid remains unpredictable. You may have read that the State of Alabama has again postponed the beginning of the new Medicaid managed care program until October 2017. The decisions that are made at the federal and state level will have significant impact on Huntsville Hospital Health System. Today, over 60% of our patients have their insurance through Medicare, Tricare, and Medicaid. Our approach to uncertainty is to continue to work on the things that will make us better than the rest of the hospitals in the country. Continuous quality improvement is an old term but it describes well what we must do to remain a national leader in clinical quality and patient safety. Customer Service must remain a top priority and managing what we spend is not optional. Speaking of quality care and service, our team excelled during the recent Joint Commission survey. We are very proud of our staff. While we see challenges ahead, we also see exciting opportunities to continue to serve our growing communities. Over the next five years we are going to significantly increase the investments we make in our IT systems and facilities. Historically we invest about $60 million per year in maintaining our facilities, building new facilities, and purchasing new equipment. We will accelerate our investments in our communities by replacing our clinical IT systems, adding beds in Madison, seeking state approval to build a new bed tower and additional parking at Huntsville Main, and making major investments at Decatur Morgan, Athens-Limestone and Helen Keller facilities. We are committed to having the facilities and equipment that our staff needs to provide excellent care to our patients. We have served this community for more than 120 years. The investments we are making will ensure we are prepared to continue that long tradition of service to the community and region. It will be an exciting time but it will also be difficult at times. Thank you for allowing us to serve you and your family,

Source | Winter 2017

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Alexis Collins cuddles her newborn daughter, Irabella Hill, at Madison Hospital.

10 Steps to Successful Breastfeeding An initiative of the World Health Organization and the United Nations Children’s Fund, the BabyFriendly USA program recognizes hospitals and birthing centers with an especially strong emphasis on the 10 research-based steps that support infant feeding and early mother/baby bonding. 1. Have a written breastfeeding policy that is routinely communicated to all health care staff.

OH, BABY! Expectant moms delivering at Madison Hospital can experience more unique mother-baby closeness after birth. The hospital was designed to be a friendly place for infants and families, and is now the first Baby-Friendly USA hospital in North Alabama. Fewer than 400 U.S. hospitals have earned the Baby-Friendly designation, including just four in Alabama. Madison Hospital wants all new parents to know the benefits of breastfeeding and help them make an informed choice for their baby. Once a family makes their feeding decision, the hospital team supports safe feeding practices for both breastfeeding and bottle-feeding moms. Regardless of feeding choices, moms are taught to feed their babies on cue and engage in practices that promote bonding. Lead Coordinator of OB Services Renee Colquitt said the Baby-Friendly designation tells parents that Madison Hospital is committed to help them succeed at bonding with and feeding their infant. The hospital has four International Board Certified Lactation Consultants available to support mothers who choose to breastfeed.

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“Parents receive a lactation consultant visit every day they are with us,” said Colquitt. “When they leave, they take our consultants’ cell phone numbers so they can call or text if they have problems. We also have a free breastfeeding class and support groups that meet twice weekly.” That extra encouragement helps explain why Madison Hospital has one of the highest breastfeeding initiation rates among Alabama hospitals. Nearly 83 percent of mothers who gave birth there in 2016 attempted nursing, said Colquitt. Becoming a Baby-Friendly USA hospital is no small feat. Shari Crowe, Madison Hospital’s Director of OB Services, said the process took about two years. To be certified Baby-Friendly, a hospital must prove it has implemented the Ten Steps to Successful Breastfeeding and eliminated practices that could interfere with mother/baby bonding. Madison Hospital has been doing most of those things all along, including skinto-skin contact between mother and baby immediately after both vaginal and cesarean births, and having healthy babies stay in their parents’ hospital room instead of the nursery.

2. Train health care staff in the skills necessary to implement this policy. 3. Inform all pregnant women about the benefits and management of breastfeeding. 4. Help mothers initiate breast feeding within one hour of birth. 5. Show mothers how to breastfeed and how to maintain lactation even if they are separated from their infants. 6. Give infants no food or drink other than breastmilk, unless medically indicated. 7. Practice rooming-in—allow mothers and infants to remain together 24 hours a day. 8. Encourage breastfeeding on demand. 9. Give no pacifiers or artificial nipples to breastfeeding infants. 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.


Krishna Kakani, MD, surrounded by part of the Labor & Delivery team at Huntsville Hospital for Women & Children. Dr. Kakani has delivered nearly 10,000 babies in her 30-plus years as an OB-GYN.

A very special delivery Huntsville OB-GYN Krishna Kakani, MD, expects to deliver her 10,000th baby at some point in 2017. It’s a remarkable milestone for one of the area’s longestpracticing obstetricians. January marked 31 years since Dr. Kakani joined the Huntsville Hospital medical staff.

Dotha Cunningham, an RN who just retired from Huntsville Hospital for Women & Children’s Labor & Delivery Unit, watched Dr. Kakani in action for 25 years. “We have a lot of wonderful, compassionate doctors, but she’s at the top of the list,” said Cunningham. “She is sad with the patient when sad things happen and rejoices with them when good things happen. You won’t find a more genuine physician.”

Counting medical school and her OB-GYN residency, she has brought enough people into the world to fill all 9,000 seats at Propst Arena in downtown Huntsville and then some. Her legacy Dr. Kakani originally planned to work as an OB-GYN in her includes one set of quadruplets, three sets of triplets and more native India after medical school. That changed when she met her twins than she can count. future husband, Babu Rao Kakani, who had left India to pursue a master’s degree in business from Alabama A&M University. Last year, Dr. Kakani was recognized by the Women’s Economic Development Council Foundation for serving as an inspiration She joined him in the Rocket City in 1979 and completed an to other women. The emcee at the ceremony asked how many OB-GYN residency program in Savannah, Ga., before joining the audience members had been through childbirth with Dr. Kakani. Huntsville Hospital medical staff in January 1986. A sea of hands went up. More than 30 years into her career, Dr. Kakani remains Raised in a modest farming family in southeast India, Dr. Kakani passionate about mothers and babies and hopes to work found herself drawn to nursing at an early age. A college for another decade before retiring. She said she draws daily counselor persuaded her to take the medical school entrance inspiration from Mother Teresa, the missionary who devoted her exam instead. life to helping the poor. “During medical school, I found that I liked both internal medicine and OB-GYN and had a hard time deciding between them,” says Dr. Kakani. “But the more deliveries I helped with, there was just something special about the happiness. I call deliveries ‘birthday parties.’

“I always think that if I could do just 1 percent of the good that Mother Teresa did, I would be so happy,” says Dr. Kakani. “One of her sayings is, ‘Not all of us can do great things, but we can all do small things with great love.’ “That’s what I’ve always tried to practice.”

“Complications can happen, of course, but most of the time it’s a happy ending.” Source | Winter 2017

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A decade of pediatric cancer care Little more than a decade ago, there were no pediatric oncologists in North Alabama. Kids in the region diagnosed with cancer and blood disorders traveled to Birmingham, Nashville or Memphis for doctor visits, radiation and chemotherapy.

welcomed its first patient. It remains the only St. Jude-affiliated pediatric hematology/oncology clinic in Alabama and one of just eight nationwide.

That all changed with a magazine article.

Physicians and staff at the clinic sites work in collaboration with St. Jude in Memphis to deliver the most up-to-date care and clinical trials to children with cancer and blood disorders.

One day in 2006, Dr. Kevin Olson, then-medical director of the Pediatric Emergency Department at Huntsville Hospital for Women & Children, read about the affiliate program at St. Jude Children’s Research Hospital in Memphis.

Located on the third floor of the Women’s Pavilion, the Huntsville affiliate clinic treats 15-20 young patients a day with leukemia, brain cancer, sickle cell disease, anemia and related disorders.

“I remember Kevin coming in with this medical journal article and saying, ‘Do you think we could be one of these affiliate clinics?’” said Cathy Hubler, Director of Women and Children’s Services. “He asked if he could call and make some inquiries. I said sure.”

“We provide almost all the things you would get at a larger cancer center much closer to home,” said clinic Medical Director Jennifer Cox, MD. “Families from the Huntsville area don’t have to make this huge driving commitment, which gives the kids more time to be kids.”

Those initial calls led to St. Jude sending a delegation to check out the hospital. While Huntsville lacked pediatric oncology, the group was impressed with the wealth of other specialized health care services for children.

Dr. Cox, a pediatric hematologist/oncologist, said there are 30-40 new childhood cancer cases diagnosed annually in North Alabama. Many of those children start radiation and chemotherapy at St. Jude in Memphis before being sent home to continue their treatment at the Huntsville affiliate clinic.

“It was perfect timing,” said Hubler. “They were looking to expand their affiliate program and had a good feeling about Huntsville.”

The clinic recently welcomed its second pediatric hematologist/ oncologist, Natalia Colorado, MD.

On Jan. 30, 2007 – 10 years ago last month – the St. Jude Affiliate Clinic at Huntsville Hospital for Women & Children

“With Dr. Colorado on board, we can take on more patients and help more kids,” said Hubler.

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UAB’s Huntsville medical campus gets new dean UAB’s Huntsville Regional Medical Campus has a new dean. Roger D. Smalligan, MD, former regional chair of internal medicine at Texas Tech University Health Science Center, assumed the post in January. In his new role, Dr. Smalligan oversees 60 UAB family medicine and internal medicine residents who do much of their training at Huntsville Hospital. Because many of those physicians choose to stay in North Alabama following their residency, the program improves access to primary care across the region. Huntsville Hospital is pleased to partner with UAB and Dr. Smalligan on this important endeavor.

Hospital security earns badge of honor Huntsville Hospital’s Security Department has been named a “Program of Distinction” by the International Association for Healthcare Security and Safety (IAHSS). Only 55 hospital security programs in the U.S. and Canada carry that designation. To become a Program of Distinction, at least 70 percent of a hospital’s security staff must be certified through the IAHSS. Also, the director has to be a Certified Healthcare Protection Administrator. “We’ve taken our training to the next level so our staff, patients and visitors can be confident that we’re trained to keep them safe,” said Brett Bramlett, Huntsville Hospital Director of Safety and Security. Shop online Huntsville Hospital for Women & Children launched a new online gift shop in November. You can now purchase balloons, gift cards, fresh flower arrangements, baby gifts and more from the comfort of home and have the items delivered to your loved one’s hospital room. “Everyone likes the convenience of online shopping, so we’re thrilled to give our customers this option,” said Jamie Bruno, Women & Children Gift Shop manager. Visit shop.hhwomenandchildren.org. Gift Shop purchases are tax-free. Hospice Achievement Kristina Johnson and Lee Shaw of Hospice Family Care recently earned their ® Certified Hospice and Palliative Care Administrator (CHPCA ) certificate. They are two of only five administrators in Alabama to earn this certification.

Source | Winter 2017

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BACK TO LIFE Are back problems keeping you from living life to the fullest? If so, you’re not alone. About 80 percent of adults will experience lower back pain at some point in their lives. Back pain typically first strikes between age 30 and 50, and it becomes more common later in life. There are many different triggers for back pain: muscle strains from lifting a heavy object; traumatic injury; spinal disc degeneration; nerve damage. Source spoke with Huntsville Hospital neurosurgeon Holly Zywicke, MD. She is part of the Spine & Neuro Center, which includes Rhett Murray, MD, Joel Pickett, MD, Cheng Tao, MD, Jason Banks, MD, Derrick Cho, MD, Hayley Campbell, MD and Brent Newell, MD.

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Exercises to strengthen lower back Positional Sidelying Lie on your side. Bend top leg, and straighten bottom leg. Cross arms across chest, and slowly rotate back until a stretch is felt in lower back. Holds for 20 seconds, repeat five times. Single Knee to Chest While lying on your back grab knee with both hands, and pull knee to chest until a stretch is felt in the lower back and buttocks. Hold for 20 seconds, repeat five times. Lower Trunk Rotation Lie on your back and rotate both knees to one side while keeping shoulders flat. Hold for 20 seconds, rotate knees to opposite side and repeat. Repeat five times. Glute Set While lying flat on your back with legs outstretched, tighten and squeeze buttocks together. Hold for five seconds, repeat 10-30 times. Piriformis Stretch Lie on your back and cross the involved leg over knee. Grasp knee with both hands and pull to opposite shoulder. Hold for 20 seconds, repeat five times. Hamstring Stretch-Supine Lying on back, hold behind the knee with both hands. Extend leg toward ceiling. Progress to leaving opposite leg straight. Hold for 20 seconds, repeat five times. Hamstring Stretch-Seated While seated in chair, straighten one leg and place on small stool. Keeping back straight, slowly bend forward at the waist. Hold for 20 seconds, repeat five times. Calf Stretch Using step or calf wedge, keep knee straight and stretch calf muscle. Can be performed one leg at a time if needed. Hold for 20 seconds, repeat five times.

At what point should a person consider calling a neurosurgeon? Neurosurgical consultation should be pursued after non-operative treatment has been maximized including physical therapy, osteopathic or chiropractic manipulation, anti-inflammatory medications, and injections. Additionally, prior to surgical evaluation, X-ray studies should be completed. Sometimes, other studies are necessary to fully understand how changes in the back may be causing pain. In some cases, neurosurgical evaluation may be sought sooner. This is usually when back pain is accompanied by symptoms such as weakness, sensory change/loss, or pain radiating to the leg. Can certain chronic back problems be effectively treated with physical therapy alone? Yes. Most back pain is due to multiple factors rather than a single cause. Physical therapy targets many different potential pain generators. Maintaining an active lifestyle, keeping a healthy weight and not smoking are some of the best ways to prevent and improve back pain. If physical therapy isn’t working, are there other non-surgical alternatives that you might recommend? Osteopathic or chiropractic manipulation, injections, acupuncture, and biofeedback therapy are alternative ways of treating back pain. Regular low-impact exercise including Pilates and yoga are also recommended. Pain management can also be beneficial, but long-term narcotic pain medication use should be avoided. Narcotics provide poor back pain relief and can have very significant side effects. When does spine surgery become the best course of action and how effective is back surgery at giving a person long-term relief? Although surgery is performed on the back, the majority of spine surgeries actually have a much greater chance of improving leg symptoms rather than back pain. How well surgery can improve back pain depends on the

cause of the pain. With the right leg symptoms and right X-ray findings, there is a 90 percent or greater chance of relieving leg symptoms including pain, weakness and sensory loss. Under perfect circumstances, it is usually a 60 percent chance of improving back pain to a person’s satisfaction. Back pain that is most responsive to surgery is mechanical pain. Mechanical pain is generally worse with standing and walking yet better with sitting or lying down. Constant and non-radiating (i.e. pain that stays in one place) back pain does not respond well to surgery. There are exceptions to this, of course, but back pain generally is less well treated with surgery than leg troubles. If the right back pain is surgically treated, however, relief can be long standing. What are the most common types of back and spinal injuries you encounter at Spine & Neuro? The most common back troubles include muscle strains and lumbar stenosis. Muscle strain is usually sudden pain due to overuse or other injury such as heavy lifting or twisting. This can be very intense pain, and many people are convinced something that hurts that badly cannot be just muscle. The back muscles, however, are very strong so when injured the pain is severe. Depending on age and the extent of the injury, it can take up to a year for the pain to completely go away. Lumbar stenosis results, most commonly, from degenerative changes. Degenerative changes can also be called aging or arthritic changes. This causes narrowing of the spaces where nerves run. It generally causes leg pain, weakness, and sensory change. Lumbar stenosis can also be experienced as back pain, but this is less common. Dr. Zywicke specializes in the treatment of cranial and peripheral nerve damage and spine deformity at Spine & Neuro Center. Call (256) 533-1600 to schedule an appointment.

Source | Winter 2017

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Radiologist Roderick Zalamea, MD, reviews images of a lung tumor.

TO Catch a Killer Lung cancer has long been the leading cause of cancer death for both men and women in Alabama, but Huntsville Hospital is determined to help change that.

pulmonary nodules and identify possible early lung cancer. By using low-dose CT screening in combination with smoking cessation physicians can dramatically improve lung cancer survival.

“It’s deadlier than breast, prostate and colon cancers combined,” said Roderick M. Zalamea, MD, a radiologist on Huntsville Hospital’s medical staff. “The main reason for that is lack of early diagnosis and treatment.”

Medicare and most private health insurance plans will cover the screening cost for current and former heavy smokers over 55 who do not have any symptoms of lung cancer. Talk with your physician to schedule a screening.

Through Huntsville Hospital’s lung cancer screening program, the hospital is working to reduce mortality rates by detecting the disease in the earliest stages – before a person even has symptoms. The screening test involves a low-dose CT (Computed Tomography) scan of the chest. Offered at both the downtown Medical Mall and Heart Center, the scan is superior to a standard X-ray at providing detailed images of any abnormalities within the chest. “Low-dose” means the test uses a lower level of radiation than a regular chest CT. The scan is akin to a 3D X-ray that allows physicians to detect very small 10 huntsvillehospital.org

LUNG CANCER

“It’s deadlier than breast, prostate and colon cancers combined.” Roderick M. Zalamea, MD

In 2016, screenings done through Huntsville Hospital detected three cases of lung cancer and one unrelated cancer in people who were not showing any signs of disease.

Many lung cancer victims don’t exhibit symptoms until the disease has spread to other parts of the body. At that point, treatment is much more difficult. Dr. Zalamea said the five-year survival rate for lung cancer patients is 15 percent to 20 percent, compared to 90 percent-plus for people with breast cancer and prostate cancer. The American Cancer Society estimates lung cancer killed 158,080 people nationwide in 2016, including 3,260 Alabamians. Several years ago Huntsville Hospital helped form the Southeast Lung Alliance to raise awareness about the importance of low-dose CT screenings. Cardiothoracic surgeon Evan Cohen, MD, and oncologist Marshall Schreeder, MD, co-chair the group. “Our goal is very simple: To diagnose lung cancer sooner and expedite getting those patients into treatment,” said Karen Adams, RN, manager of Huntsville Hospital’s Cancer Program.

To schedule a screening, call (256) 539-0457.


Diabetes Dilemma Diabetes is a growing public health crisis nationally, with about 29 million Americans affected. Another 86 million Americans have prediabetes – elevated blood sugar levels that put them at increased risk of developing diabetes, heart disease and stroke. The American Diabetes Association estimates 610,458 Alabamians have diabetes and another 1.3 million have prediabetes. Endocrinologist Ankur Jindal, MD, from the Huntsville Hospital Endocrinology & Diabetes Clinic, said the vast majority of cases he sees are type 2 diabetes. That’s the type linked to bad eating habits and lack of exercise. “Diabetes and obesity really go hand in hand,” said Dr. Jindal. “Type 2 diabetes used to be something you would develop in your 40s and 50s after years of unhealthy living. But now we’re seeing kids as young as 12 or 13 being diagnosed.” Jindal said much of the blame lies with our diet of fried foods, sweet tea and processed goodies packed with high fructose corn syrup. While diabetes generally is not reversible, it can be kept in check if the person is willing to make lasting lifestyle changes. That includes regular exercise, getting the bulk of your calories from lean proteins and non-starchy vegetables, and being vigilant about taking medicine to regulate your blood sugar levels.

Some people with type 2 diabetes are given oral medications that stimulate the pancreas to produce more insulin or enable cells in the body to use insulin more effectively. Others need insulin shots. “Managing diabetes is a big challenge,” said Dr. Jindal, “and the entire family really needs to be involved.” Many newly-diagnosed patients are referred to Huntsville Hospital’s Diabetes Control Center, where they receive an initial assessment by an registered nurse or registered dietitian certified in diabetes education. The center also offers “Diabetes 101” – a four-hour introduction to the disease and how to manage it – plus more advanced classes. The program is covered by most insurance plans. About 500 people attended the classes last year. “If we can help patients achieve even a 1 percent reduction in hemoglobin A1C (a measure of blood glucose control over several months), that can dramatically reduce the odds of future complications,” said Diabetes Control Center Program Manager and Registered Dietitian Pam Glover. “Our goal is to make behavioral changes to create good outcomes.”

Dr. Jindel is an endocrinologist at the Huntsville Hospital Endocrinology & Diabetes Clinic.

“Diabetes 101” instructor Sara Steger, a registered dietitian, talks about mealtime do’s and don’ts. Top, class member Elteaser James uses plastic food to assemble a diabetes-friendly dinner.

Source | Winter 2017

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THE HEART OF A WOMAN For decades there wasn’t a lot of research on women’s heart health because most of the studies focused on men. Women’s health research was more plentiful on other illnesses and conditions, like breast and lung cancer. Though unintended, this situation was made more challenging because women often presented with different symptoms than men. For the treating physician, diagnosis was more difficult and often led to a more conservative line of treatment. In some occasions, a woman’s unique symptoms masked a more advanced development of the disease. 12 huntsvillehospital.org


That was then. Welcome to now. 2017. You might say that women have caught up with men in the arena of cardiovascular disease; but more correctly, you should say that medicine now clearly recognizes and treats cardiovascular disease as the number one killer of women in the United States. SOURCE visited recently with three cardiologists with the Heart Center for a discussion on women and heart disease. It so happens that each of these cardiologists is a woman—Rashida Abbas, MD, Navdeep Mann, MD and Patricia Gurczak, MD. All three are board certified in their specialty and are fellows of the American College of Cardiology. Abbas and Mann practice at the Heart Center’s Huntsville office and Gurczak is in the Madison office. “The stats are alarming,” said Dr. Gurczak. “For so long medicine emphasized other illnesses in women and didn’t realize the risk of heart disease. Women were presenting later in life with non-classic symptoms and in many cases with more advanced heart disease.” Dr. Mann put it this way, “We’ve had to learn some things and unlearn some things. The fact is most of the large cardiac studies were 85% men.” The increase in heart disease, according to Dr. Gurczak, mirrors the epidemic in obesity and diabetes across the nation. Alabama, of course, is in the center of the “diabetes belt.” Diabetes is just one of the many factors that increase the risk of developing cardiac disease. So is smoking, an unhealthy diet, lack of exercise, family history, and simply not paying attention to your numbers, like your weight, blood pressure and cardiac lipid levels. Knowing the risk factors and taking the right steps is the best way to help lessen the development of coronary

vascular disease, said Dr. Abbas. “It’s very simple…risk factor modification. We can’t say it enough.” “With the shape and face of coronary vascular disease changing, we now see more women and younger patients. In the past we were late to recognize heart disease in women,.” said Dr. Abbas. “Today, we are more aware, and are diagnosing it earlier.” “The standard of care is the same for men and women,” said Dr. Mann. “In fact, mortality from heart disease for women over the age of 65 is twice as high as that of men of the same age.” All three cardiologists pointed to atypical symptoms that are often experienced by women. “For women, it’s often shortness of breath or fatigue, not necessarily chest pain which is the primary symptom of many men,” said Dr. Mann. Further complicating the diagnosis and treatment of women is that some patients have disease involving the smaller rather than the major arteries. The presence of “microvascular angina” does not necessarily mean a woman has blockages in her arteries, but the symptoms can still be very real. These patients are often younger and can be treated with aspirin, statins (cholesterol reducing drugs) and nitrates (drugs for angina and chest pain), according to wthe physicians. Drs. Gurczak, Mann and Abbas agree that educating women on the risks of heart disease is a top priority along with taking steps to a healthier heart. And that’s one of the reasons why Huntsville Hospital and the Heart Center are partnering with the American Heart Association in raising awareness of the risks of heart disease in women through the 2017 Go Red for Women campaign, the American Heart Walk, and the Heart Society Ball.

2017 Rx for heart health Stop smoking Eat healthy and watch your weight Know your numbers—blood pressure and cholesterol Got diabetes? Treat it. Exercise…get moving Get a heart check-up

Heart Screenings $99 Blood Pressure Check Risk Factor Review Calcium Score Call (256) 519-8490

Source | Winter 2017

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My heart. My story. Judy Clemmons Less than a week after celebrating Thanksgiving at home in Limestone County, Judy Clemmons checked into Huntsville Hospital for aortic valve replacement surgery. Complications from atrial fibrillation – a rapid, irregular heartbeat – had plagued Clemmons throughout 2016. She spent both her 50th wedding anniversary and 71st birthday at the hospital. Valve replacement surgery is serious business, but Clemmons, a former surgical nurse, said she had complete faith in cardiothoracic surgeon Richard Clay, MD, and Huntsville Hospital’s entire cardiac care team. “They explained everything so well that I really had no fear going into surgery,” she said. Dr. Clay successfully swapped Clemmons’ defective aortic valve with a healthy valve from a cow. He recently gave her the all-clear. “I feel great, like I can do anything.”

Fredonia Williams, Ph.D. Fredonia Williams was exhausted. When she flew to Chicago in April 2008 and was too tired to walk off the plane, she knew it was more than work-related fatigue. Tests revealed a leaking heart valve. Ten days after retiring as principal of Johnson High School, Williams had open-heart surgery at Huntsville Hospital. The recovery was difficult, and she sought comfort from other cardiac patients in the Mended Hearts support group. “I was convinced after the first meeting that I wanted to be part of the organization,” she said. “They did so much to get me back on track.” Today, Williams is president of the Huntsville Mended Hearts chapter and oversees 45 other chapters across the South. In addition to monthly support group meetings at Huntsville Hospital’s Dowdle Center, Mended Hearts volunteers visit hospitalized heart patients to answer questions and provide encouragement. “I love what it does for patients, and I get as much out of it as they do,” said Williams.

KELLI POWERS Kelli Powers is no stranger to migraines, but this headache on May 16, 2015, felt different. It came on strong after hiking with her husband in Jackson County’s Paint Rock Valley. A few hours later, Powers’ speech became slurred and she had trouble moving her left arm. Her husband drove her to the nearest emergency room at Athens-Limestone Hospital. A CAT scan showed Powers, 46, was having a stroke. She was rushed by ambulance to Huntsville Hospital, where she works as chief financial officer. Neurologists Theodros Mengesha, MD and Amit Arora, MD directed her treatment. Powers was given the drug tPA (tissue plasminogen activator) to dissolve a dangerous blood clot that was restricting blood flow to her brain. “Within about 30 minutes, I was able to talk again,” she said. “I never thought I’d have a stroke in my 40s. Thank goodness my husband recognized something serious was happening and got me to the hospital.” Follow-up testing revealed a possible cause of the stroke: Powers was born with a hole in her heart that may have allowed the blood clot to pass into her brain. She takes a daily blood thinner and anti-cholesterol medication to help prevent future problems. 14 huntsvillehospital.org


But what does it mean? Ever heard of a TAVR? How about Percutaneous Coronary Intervention? Those are just two of the many advanced cardiovascular procedures offered at Huntsville Hospital. Each year, our nationally-recognized cardiac program treats about 38,000 heart patients from across Alabama and southern Tennessee. Here’s a brief look at some of the cardiovascular procedures available to our patients. CardioMEMS – This small sensor is implanted into the distal pulmonary artery to continuously measure a patient’s heart rate and pulmonary arterial pressures. Data is wirelessly transmitted to Huntsville Hospital’s Heart Failure Clinic. Convergent Procedure – A CV surgeon and electrophysiologist working together use radiofrequency ablation to create a pattern of scars inside and outside the heart to stop the irregular heartbeats associated with atrial fibrillation. Typically for persistent or chronic atrial fibrillation. Cox-Maze Procedure – Similar to a Convergent Procedure. A cardiothoracic surgeon uses a combination of radiofrequency ablation and cryoblation – hot and cold energy to create a series of scars on the heart that permanently block the electrical signals that corrects an irregular heartbeat. For patients with atrial fibrillation undergoing heart surgery. ECMO (extracorporeal membrane oxygenation) – A mechanical system that temporarily takes over the functions of a patient’s lungs. Blood drawn from the patient passes through an oxygenator which removes the carbon dioxide so it can be returned to the body. For patients with acute cardiac and/or respiratory failure. Impella – A catheter-based heart pump. The device pulls blood from the heart and pumps it into the aorta distributing blood to the body, brain and organs. To help heart failure patients recover or gain enough strength for potential additional cardiac procedures. Implantable Loop Recorder – A small cardiac monitor inserted under the skin of a patient’s upper chest. The device continuously monitors and records heart rhythms up to three years to help diagnosis infrequent symptoms of fainting or rhythm problems. Minimally Invasive Cardiac/Valve Surgery – An alternative to open heart surgery. CV surgeons can perform a variety of heart and valve procedures through small incisions in the chest, eliminating the need to cut through the breastbone. For many patients, the result is less post-operative pain and a quicker recovery.

Off-Pump Bypass Surgery – Also called “beating heart” surgery. The surgeon holds the artery being bypassed with a stabilizing device and grasps the outer layer of heart tissue with suction pods. This allows the artery to be bypassed without putting the patient on a heart-lung machine. For higher-risk cardiac patients. Percutaneous Coronary Intervention – Also known as angioplasty. A small mesh tube called a stent is used to treat narrow, blocked or weak coronary arteries and restore normal blood flow. The stent is placed with a catheter and supports the inner wall of the artery for months or years afterward. Huntsville Hospital’s Cath Lab performs more than 2,000 of these procedures annually – the most of any hospital in the state. Robotic Thoracic Surgery – A less-invasive alternative to traditional or laparoscopic surgery. Seated at a console away from the patient, the CV surgeon controls four miniaturized robotic arms that offer greater range of motion and dexterity than the human hand. TAVR Procedure (transcatheter aortic valve replacement) – The cardiologist and surgeon use a balloon catheter to replace a thickened aortic heart valve allowing blood to flow freely out of the heart into the aorta once again. For patients with aortic stenosis who are too weak for traditional aortic valve surgery. Leadless Pacemaker – A small pacing device and battery which is inserted via the leg and deployed inside the heart as a single unit to pace when no heart beat is present. There are no wires as with traditional device implants. Limited presently to patients with infrequent need for pacing. Left Atrial Appendage Closure Device (Watchman) – A device that can be deployed in a unused appendage of the heart to close off an area that is prone to clot formation in patients with atrial fibrillation, thus preventing stroke event. Currently an alternative to traditional blood thinners required with the diagnosis of atrial fibrillation.

MitraClip Procedure – Using a catheter, the tiny MitraClip device is advanced through a leg vein toward the heart. The metal clip pinches together small flaps of heart tissue so the mitral valve will close properly and not allow blood to flow backwards. For patients with mitral regurgitation who are too weak for open-heart surgery. Source | Winter 2017

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Sockin’ it to falls For as long as hospitals have existed, patients have been falling while in the hospital and hurting themselves. Patients weak from sickness or surgery tumble to the floor trying to get out of bed without assistance. Others get tangled in the tubes of their IV pole, or become dizzy walking to the bathroom, or lose their grip trying to raise off the toilet because they don’t ask for help. The Agency for Healthcare Research and Quality estimates between 700,000 and 1 million hospital patients fall each year nationwide. While most are not badly hurt, some patients suffer cuts, broken bones, even internal bleeding. We stress “Call Before You Fall” campaign. Clinical Nurse Specialist Geneva Llewellyn and Safe Patient Handling Coordinator Debra Kenchel co-chair the hospital’s Falls Prevention Committee. Their job: Find creative new ways to tackle an age-old problem.

Special alert. With new chair alarms, nurses are alerted when fall risk patients try to leave their chair.

Did you know? According to The Joint Commission, a serious fall-related injury adds 6.27 days, on average, to a patient’s hospital stay and costs the hospital more than $13,000 for additional care.

“The hospital exists to heal people, so it breaks our heart when one of our patients is injured in a fall,” said Llewellyn. “Our goal is to keep patients as safe as we can while they are under our care.” About 400 patient rooms at Huntsville Hospital were recently equipped with chair alarms, in addition to standard bed alarms. If a seated patient tries to get up, the chair pad senses their shifting weight and emits a loud beep that is heard both in the room and at the nurses’ station. The alarm system also immediately texts the nurse assigned to the patient. Nurses who hear the alarm are instructed to hurry to the room to offer the patient help getting out of the chair. Llewellyn said chair-related falls in the Neurology Unit dropped to almost zero during a three-month trial of the alarm system last year. Based on that success, the alarms were installed in other units including Family Practice, Oncology, General Medicine and Medical ICU. “The chair alarm is an extra set of eyes in the room, so to speak, so a patient’s movements are monitored even if there are no nurses or family members present,” said Kenchel. Huntsville Hospital also recently switched from one-size-fits-all patient socks with no-skid surface on the bottom only to fitted socks with rubber tread all over. Even if the sock becomes twisted on the patient’s foot, there will be tread gripping the floor. “We’re trying to be creative and think outside the box to make our patients’ hospital stay as safe as it can be,” said Llewellyn.

16 huntsvillehospital.org


BMW Brunch Supporters of Huntsville Hospital Foundation always enjoy kicking off the holiday season with the Foundation’s “oldest,” most traditional event, the BMW Brunch. The 2016 event marked the 31st anniversary of the Brunch, which was held on November 20 in the BMW showroom at Century Automotive. Patsy and John Shields, and Tracy and George Jones host the event each year, and many of the guests attending have made it a fall tradition. Proceeds from the Brunch benefited The Caring House, a cheerful place where children and teens can work through the grief process after the loss of a loved one. The Caring Dr. Paul Tabereaux and his wife, Christina, with Melinda and Dr. Shaf Holden House staff also provides bereavement counseling services for area schools.

Emcees Dr. Jason Smith and Dr. Jim McCarty “dressed up” for the occasion!

The BMW Brunch committee planned a festive event. Pictured (left to right) are: Donna Palumbo, Bree Wilburn, Anne Robinson, Sarah Gessler, Marilyn Hull, and Marilyn Grundy.

Libby and Ray Jones have attended almost every BMW Brunch, and always celebrate the event with their family.

Children from The Caring House presented Century BMW with a special painting for BMW’s showroom. Pictured with Dr. Smith, Dr. McCarty and Caring House director Lee Shaw are Jack Rigsby, Olivia Rushbrook, Ethan Rushbrook and Cade Rigsby.

Dan and Susan Currie (center) were the lucky winners of a BMW X3 for one year. The Curries are pictured with George and Tracy Jones (left), and Patsy and John Shields (right) with Century Automotive Group. Source | Winter 2017

17


Out and About

in our community with the foundation

Members of the Civitan Clubs of Huntsville, Lakewood and South Huntsville celebrated the holidays by making a generous donation to the Pediatric Therapy & Audiology department. After the check presentation, club members enjoyed a festive party with patients and their families.

In January, Huntsville Hospital, in partnership with local mental health organizations and local schools, launched SPEAK in an effort to increase awareness and prevent the incidence of youth suicide. Huntsville Hospital Foundation is funding the program and co-hosted a Jan. 13 suicide prevention conference for 225 school health professionals – counselors, social workers, nurses and school resource officers. Huntsville Hospital held a press conference on January 18 to introduce SPEAK to the community. SPEAK educators will train K-12 teachers in Madison County and provide suicide prevention classes for middle and high school students. 18 huntsvillehospital.org

For the past three years, the Randolph School Basketball program has hosted “Shoot for the Cure” in support of the hospital’s Pediatric Oncology department. In addition to this year’s January 13 game, players held a silent auction and also got their classmates involved by selling opportunities to tape their teacher to the wall!

Mike Chappell (center) facilitated an panel discussion at the SPEAK conference for school health professionals. Panelists were Officer Patrick Salvail, School Resource Officer at Huntsville High School; David Barnhart, EdD, Clinical Mental Health Counselor, Behavioral Sciences of Alabama; Amy Bryan, LPC, Assessment & Referral Director, Decatur-Morgan West and Huntsville Hospitals; and Janet Gabel, Executive Director, Crisis Services of North Alabama.


The Societies of 1895 & 2012 Recognition Dinner In November the Foundation hosted the 31st annual Societies Dinner, named for the years Huntsville and Madison Hospitals were established, to honor major donors who supported the hospital over the past year. The theme of the program was “Because of You,” and featured hospital employees who shared touching stories of how the lives of their patients have been touched because of the generosity of donors. The evening ended with a surprise “No Mo Chemo” celebration in honor of 3-year old Evie Frith who recently completed her cancer treatments.

At the dinner, several Foundation friends were recognized for their outstanding gifts of time, talent and donations on behalf of the hospital: Mitch Coley and Richard Anderson, Robins & Morton (Outstanding Foundation Partner), Dr. Paul Tabereaux (Carl A. Grote, Jr., MD Outstanding Physician Advocate), Katie Carpenter (Outstanding Employee Volunteer), Phil and Julia Schmidt (Outstanding Foundation Volunteers), and Krishna Srikakolapu (Trustee Leadership Award).

Drs. Craig and Libby Shadinger, Dr. Amy Halliburton and her husband Troy, and Nicole Farrell.

Evie was the belle of the dinner, and was honored on stage with her parents Tosha and Andy Frith.

Foundation Trustees and Authority Board members Dr. Amit Arora and Frank Caprio. Source | Winter 2017

19


SAVE THE DATE

FOR MEMBERS OF

SENIOR

February 14

Lunch Bunch, 11 a.m. AM Booths Lumberyard (American) 108 Cleveland Avenue, 35801

16

Day Trip to Red Bay, 2:30 – 11 p.m.

25

Annual Storytelling Festival, 10 a.m. Trinity United Methodist, New Room 607 Airport Road, 35802

MARCH 14

Lunch Bunch, 11 a.m. Olive Garden (Italian) 3730 University Drive, 35816

21

Tasty Tuesday, 11:30 a.m.

23-27 4-Day Trip to Natchez & Biloxi, MS and Theodore, AL with Excursions Unlimited APRIL

TASTY TUESDAY Tuesday, March 21, 11:30 a.m. Cost: $5 Location: Trinity United Methodist Church, Wesley Hall 11 a.m. – Blood Pressure Checks 11:30 a.m. – Potluck Luncheon Spine & Neuro Center Neurosurgeon Holly Zywicke, MD specializes in the treatment of cranial and peripheral nerve damage and spine deformity at Spine & Neuro Center. She will present advancements of spine health and technology.

LOCAL OUTINGS 22nd Annual Storytelling Festival February 25 (Sa), 10 a.m. Location: Trinity United Methodist Church Cost: $15 plus $8 for a barbecue lunch Award winning storytellers Donald Davis, author and minister from Waynesville, NC, and Michael Reno Harrell, songwriter and master teller from Southern Appalachia, will delight devoted fans. A barbecue lunch is available for an additional cost.

11

Lunch Bunch, 11 a.m. The Brickhouse Cafe (In Providence) 7 Town Center Drive, 35806

20

1818 Farms Tour and Lunch

25

Wildflower Walk at Hays Nature Preserve, 9 a.m.

1818 Farms April 20 (Th), 9:00 a.m. Location: Meet at Ashley Furniture to board the motor coach Cost: $37 (includes tour, lunch and transportation)

Day Trip to Crossville, 7 a.m. Lunch Bunch, 11 a.m. Cotton Row (American) 100 South Side Square, 35801

Celebrate Spring at 1818 Farms in Mooresville, AL. Natasha McCrary and her Babydoll Southdown sheep and other charming animals provide a glimpse of life on the farm the way it used to be. Afterwards we will join in a traditional Egg Roll and enjoy a gourmet box lunch by Albany Bistro in Decatur.

MAY 9 10

18 Picnic at Green Mountain Pavilion 11:30 a.m. - 1:30 p.m. June 6

Tasty Tuesday, 11:30 a.m.

13

Lunch Bunch, 11 a.m. Phil Sandoval’s (Mexican) 6125 University Drive, 35816

18

Ragtime (musical), 2 p.m. Lee High School 2500 Meridian Street, 35810

Call (256) 265-7950 for reservations. Huntsville Hospital Senior Horizons 101 Sivley Road · Huntsville , AL 35801 www.huntsvillehospital.org/senior-horizons sharon.darty@hhsys.org 20 huntsvillehospital.org

Hike in the Hays Nature Preserve April 26 (W), 9:00 a.m. Location: Hwy 431 in Owens Cross Road (past Publix) Restaurant Location: 3980 Old Highway 431 S, 35763 Cost: Free plus cost of lunch Enjoy a stroll on the paved trail along Flint River Greenway at Hays Nature Preserve. Senior Horizon member Barbara Roberts will lead us on a nature walk pointing-out wildflowers and native and migratory birds. Lunch will follow at Grandma’s House famous for their made-from-scratch plate lunches. Maps are available. Summer Picnic May 18 (Th) 11:30 a.m. – 1:30 p.m. Cost: $5 Location: Green Mountain Pavilion, Madison Co. Nature Trail Celebrate early summer with a picnic, fellowship and games. Catering will be provided by Ted’s barbecue


HORIZONS

All Senior Horizons trips and local outings are open only to its members. For information on becoming a member, or to learn more about trips and outings, call the Senior Horizons office at (256) 265-7950. Trips and activities fill quickly. Please make reservations early!

Ragtime, Independent Musical Productions June 18 (Sunday) 2 p.m. Location: Lee High School Theater, 2500 Meridian Street, NE Cost: $17 (reservations limited) At the dawn of a new century, everything is changing and anything is possible. This Tony Award-winning musical is set in the volatile melting pot of turn of the century New York, and is comprised of three American tales of characters united by courage compassion, and belief in the promise of the future. Day Trips Red Bay, Alabama Bay Tree Council of the Arts production of “Curious Savage,” by John Patrick and dinner at the Weatherford Center Date: Thursday, February 16, 2:30 – 11 p.m. Cost: $65

Destination Travel

with Collette Vacations

Important Note: Prices include round trip air fare from Huntsville, air taxes and fees/surcharges and transfers. A $250 deposit is required to initiate the reservation process. Travelers have seven days to withdraw their reservation to receive a full refund. Prices are subject to increase prior to the time travelers make full payment. Cancellation insurance is available. Reservations are limited and available on a first come, first served basis. National Parks – Tour # 764714 Dates: August 15-26, 2017 (12 days) Deadline for deposit: February 9, 2017 Cost: $4,499 (double) Final payment due: June 14, 2017

In this entertaining and fanciful play, Mrs. Savage wants to make the best use of the $10 million her husband left her. Her greedy step-children cannot manipulate Mrs. Savage in to giving-up any of the money so they have her committed to a sanatorium. There she meets good people who have just had difficulty adjusting to life. Find-out what happens to Mrs. Savage, her step-children and her new friends. A tasty dinner precedes the play.

Highlights: Scottsdale, Lake Powell, Grand Canyon, Bryce Canyon, Zion, Salt Lake City, Jackson Hole, Grand Teton & Yellowstone National Parks, Old Faithful, Sheridan, Bighorn Mountains, Mount Rushmore, Crazy Horse Memorial.

Natchez & Biloxi, Mississippi and Theodore, AL with Excursions Unlimited Dates: Thursday-Monday, March 23-27, 2017 Deadline for full payment: February 15 Cost: $790 double, add $250 for single supplement Trip Cancellation Insurance: $75

Reflections of Italy – Tour # 764712 Dates: November 9-17, 2017 (9 days) Deadline for deposit: May 4, 2017 Cost: $3,699 (double) Final payment due: September 7, 2017

Join us for 4-day trip to celebrate spring in the South. We will enjoy Natchez, Mississippi and the spring pilgrimage of historic homes and plantations, explore the spring Festival of Flowers at Bellingrath Gardens and Home outside of Mobile, followed by an overnight stay and dining at the elegant Beau Rivage Resort & Casino in Biloxi. Full itinerary is available through the Senior Horizons office. This tour requires average physical activity. Travelers should be in good health, able to climb stairs and walk reasonable distances, possibly over uneven ground. Crossville, TN Cumberland County Playhouse presents “A Second Helping” of the hit “Church Basement Ladies” Date/Time: Tuesday, May 9, 7 a.m. – 8 p.m. Cost: $88 It’s 1969 and the world is changing. As folks protest the Vietnam War and women are demanding equal pay for equal work in their small rural Minnesota community, the Church Basement Ladies are experiencing changes of their own. Experience the heart warming humor and hilarious antics of the Church Basement Ladies in “A Second Helping”. We will enjoy a buffet lunch at the Homestead Harvest Restaurant overlooking Byrd Lake inside the Cumberland Mountain State Park.

Highlights: Rome, Colosseum, Assisi, Perugia, Siena, Florence, Chianti Winery, Venice, Murano Island, Milan Southern Charm Holiday – Tour # 764717 Dates: December 3-8, 2017 (6 days) Deadline for deposit: May 30, 2017 Cost: $2,629 (double) Final payment due: October 1, 2017 Highlights: Historic Charleston, Boone Hall Plantation or Patriots Point Naval & Maritime Museum, James Island County Park Holiday Display, Savannah, Andrew Low House, Jekyll Island, Christmas Caroling Spotlight on San Antonio Holiday – Tour # 782318 Dates: November 30-December 4, 2017 Deadline for deposit: June 22, 2017 Cost: $2,179 (double) Final payment due: September 29, 2017 Highlights: The River Walk (Paseo del Rio), Mission San Jose, The Alamo, LBJ Ranch, Fredericksburg, El Mercado and Olive Orchard Source | Winter 2017

21


Out and About WITH

senior Horizons

Top: Surviving the Biscuits at Loveless Cafe, Betty Dunaway, Charlie Nix, Jennie Coe, Terry Nix, Beta and Pat McIngvale and Rebecca Broad. Above: Group enjoying a Christmas Trip to Nashville. Senior Horizon’s members enjoying holiday activities. Left side, top to bottom: Fredda Wolfe and Marvella Prevatt; Sylvia Pavia, Carolyn Johnson and Karol Kapustka; Shirley Williams, Ann Hopkins and Phyllis Mammana; and Jackie and Wallace Turnam.

22 huntsvillehospital.org


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PRSRT STD US Postage PAID Birmingham, AL Permit #40

SOURCE 101 Sivley Road, Huntsville, AL 35801

Top 5% in The naTion 2017

Top 5% in The naTion 2017

Top 10% in The naTion 2017


Source - Winter 2017