Healthwaves Summer 2018

SUMMER 2018

healthwaves B AY H E A LT H

Keeping up with his kidneys — PAGE 4

IN THIS ISSUE: 6

Safely skipping into summer

12

Poised to battle prostate cancer

19

The power of nature in healing

healthwaves Healthwaves is a quarterly publication of Bayhealth.

The information is intended to inform and educate.

It’s not a substitute for consultation with a physician. Always consult your physician for individualized care.

Bayhealth does not discriminate against any person on the basis of race, color, national origin, disability, or age in admission, treatment, or participation in its programs, services, and activities, or in employment.

If you have any questions, please call JoAnn Davis at 302-744-7405. Bayhealth’s TDD or State Relay number is 1-866-237-0174.

TERRY M. MURPHY, FACHE President and CEO, Bayhealth

GWEN GUERKE Writer, Healthwaves

PAMELA J. MARECKI Senior Editor, Healthwaves

Marketing Specialist, Bayhealth DANIELLE PRO-HUDSON Writer, Healthwaves

Assistant Vice President Marketing Communications, Bayhealth

Media Center Coordinator, Bayhealth

AMANDA C. BOWIE Editor, Healthwaves

JENNIFER MYERS Writer, Healthwaves

Marketing Operations Manager, Bayhealth

Marketing Specialist, Bayhealth ALICE RAUSCH Contributor, Healthwaves

LEIGH ANN COLEMAN Photographer, Healthwaves Webmaster, Bayhealth

Southern Region Strategy & Brand Program Manager, Bayhealth

JENNIFER DAILEY Writer, Healthwaves

BRANDON HOWIE Photographer, Healthwaves

Marketing Specialist, Bayhealth

Marketing Videographer, Bayhealth PAUL STECCA Designer, Healthwaves J&P Stecca LLC

IN THIS ISSUE feature story: 4 Keeping ●

up with his kidneys PICTURED ON COVER Judy and James Mims are enjoying retirement — and staying on top of their health.

To view Healthwaves online visit: Bayhealth.org/Healthwaves

6 ●

Safely skipping into summer

16 ●

Chronic disease management 101

8 ● 10 ● 12 ●

A whole new woman

18 ●

Connecting with cancer patients

19 ●

The power of nature in healing

14 ●

Stepping out for exercise

2018 Summer Classes Poised to battle prostate cancer

BAYHEALTH HOSPITAL, KENT CAMPUS

BAYHEALTH MILFORD MEMORIAL

640 South State Street Dover, Delaware 19901 302-674-4700

21 West Clarke Avenue Milford, Delaware 19963 302-422-3311

Letter from the President DEAR NEIGHBORS, As a resident of either Kent or Sussex county, you or someone you know has most likely been served

by Bayhealth. While we’re driven to provide you and the entire community with the nation’s best healthcare at both Bayhealth hospitals, our ultimate goal is to keep you healthy and out of the hospital.

This entire issue of Healthwaves is packed with information and tips to help you and your family live your healthiest lives.

You may find inspiration reading James Mims’s story.

After attending a community lecture on kidney health, he took the time to talk to his primary care doctor about his own kidney function. It turns out that Mr. Mims’s kidneys needed care and attention. He’s been working with Nephrologist G. Jeffrey Milan, MD, ever since. Read his story beginning on page 4.

If you’re a parent, the health and safety of your child is always top of mind. Now that school is out for the summer, your child will likely be exposed to the sun’s rays and heat and may be participating in more outdoor activities. Pediatrician Elsayed Abdelsalam, MD, offers 10 tips to help parents keep their children healthy this summer. Read his tips starting on page 6.

Kim Mayhall may be a familiar face to some of our longstanding readers. She was first featured in the fall 2016 issue of Healthwaves after having a successful weight loss surgery. Now 130 pounds lighter, Mayhall no longer struggles with yo-yo

dieting, diabetes, and high blood pressure. Instead, she’s spending this summer playing rugby with her daughter. Based on her experience, she offers tips to those who may be considering weight loss surgery.

Learn more beginning on page 8.

Perhaps the sunshine and warm weather are enticing you to take up a new fitness routine outdoors.

Before you lace up your walking shoes and head outside, read some of Athletic Trainer Taylor Hatfield’s tips to exercise safely and successfully in the heat and humidity. As always, please consult your primary care doctor before starting any workout regimen. Read more starting on page 14.

In the United States, about half of all adults have a chronic condition. This means about 117 million people are living with diabetes, hypertension, depression, asthma, and other conditions. While a diagnosis of any of these chronic conditions can be life-altering, you can find guidance and hope in the right primary care doctor. Read tips from Primary Care Physician Joseph Rubacky, DO, on how to work with your doctor to manage your chronic disease beginning on page 16.

If you’re inspired to live a healthy life, start by having a conversation with your primary care doctor. If you don’t have one, visit Bayhealth.org/Find-A-Doc or call our physician referral service line at 1-866-BAY-DOCS for a list of doctors accepting new patients. Also, check out our classes and events available to community members on pages 10 and 11.

Here’s wishing you a healthy and adventurous summer!

Sincerely,

Terry M. Murphy, FACHE President and CEO Bayhealth

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Keeping up with his kidneys James Mims wanted to know more about his kidney function after attending a community lecture about kidney health. That’s when he learned his weren’t functioning as well as they should be. Since then, he’s been taking charge of his health.

Several years ago, while volunteering at Bayhealth Hospital, Kent Campus, James Mims attended an educational lecture on kidney health. The lecture inspired Mims to make an appointment with his primary care physician to find out how his kidneys were doing. Mims didn’t have any signs or symptoms of kidney problems, but he did have

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high blood pressure and type 2 diabetes. And while Mims manages his conditions well, both are still risk factors for kidney disease. His test results were worse than expected.

“I couldn’t believe my kidneys weren’t functioning 100 percent; I still can’t believe it, to be honest,” said Mims. “I didn’t show any outward signs of kidney disease, and I didn’t feel bad or different in any way.”

SYMPTOMS OF KIDNEY DISEASE INCLUDE SWELLING OF THE FEET AND LEGS, NAUSEA, VOMITING, AND POOR APPETITE. The kidneys are crucial for the body. They work with the liver to filter toxins out of blood. The kidneys handle water regulation in the body.

They also convert Vitamin D into a form the body can use.

“The truth is there is no silver bullet when it comes to kidney health,” said Mims’s nephrologist G. Jeffrey Milan, MD. “Diet and exercise are important. Two of the main risk factors are diabetes and high blood pressure.

Mr. Mims is a great example of the importance of having a primary care physician and getting routine checkups.”

Mims and his wife Judy moved to central Delaware in 1968 for a position at a local university and have been here ever since. Both are now retired. As they’ve aged, the Mimses have been acutely aware of staying on top of their health.

“You have to be proactive about your health, especially as you get older,” said Mims. “I work closely with Dr. Milan, but I also make sure my whole care team knows about my kidney health.

I try to eat well and get exercise when I can.”

“Mr. Mims is very knowledgeable and aware of his health,” said Dr. Milan. “He pays attention to all of his lab work and adheres to any advice I give. I truly enjoy working with him.” ■ Need a doc? Call 1-866-BAY-DOCS or go to Bayhealth.org/Find-A-Doc to be matched with one.

Kidney health basics DIET According to Dr. Milan, new research suggests a diet low in protein is better for those with kidney disease. It’s also important for those with kidney disease to watch their salt intake since it affects water regulation.

“I definitely pay close attention to what I eat,” said Mims. “I try to eat well-balanced meals with lots of greens.”

EXERCISE “The trick is to just get moving,” said Dr. Milan. “I ask patients to start small, like taking the stairs instead of the elevator or parking your car a little farther from the door in parking lots. Even just losing one pound per month can make a big difference.” Mims exercises using home gym equipment.

HYDRATION Dr. Milan says the amount of water needed varies from person to person, but generally drink only when you’re thirsty, and just enough to quench your thirst. Try to get eight glasses each day. “I’m more aware now about my water consumption,” said Mims. “I make sure I’m not drinking too much or too little.”

MEDICATION “Chronic use of medications known as NSAIDS (nonsteroidal anti-inflammatory drugs) can cause kidney injury,” said Dr. Milan. “People with kidney issues have to avoid these pain relievers. Acetaminophen is safe.” Be careful of vitamins and herbs too.

Mims takes a daily multivitamin specifically made for renal function.

CHECKUPS “It’s crucial to have a primary care doctor and get yearly physicals,” said Dr. Milan. “Primary care doctors will order blood tests that monitor everything, including kidney function.”

“I’m very proactive about my doctors’ appointments and always on top of my numbers,” said Mims.

“You have to be when you get older.”

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Safely skipping into summer Summer calls for playing in the sand, splashing in the pool, exploring local parks, and running barefoot through the yard. With all of the giggles and excitement that come with summer, dangers are also nearby. Pediatrician Elsayed Abdelsalam, MD, known best by his patients as Dr. Sayed, provides parents with 10 tips to help them and their children have a summer to remember.

SUN SAFETY Always keep babies in the shade. If you go to a pool or beach, use a tent or umbrella. A hat with a brim is recommended, along with sunglasses to protect the eyes. There aren’t any sunscreens approved for babies under six months old. For those over six months, use a sensitive skin product containing an SPF of 70 or higher. Limit sun exposure during peak times of 11 a.m.– 4 p.m.

Exposure to the sun during peak times could lead to skin cancer in the future.

CLOTHING CONSIDERATIONS Don’t dress babies in too many layers because they can overheat. And avoid tight clothing, which can make children sweat more and overheat and could result in heat rash. Loose clothing made of 100% cotton will help them stay cool and dry. Light colors are best because they help deflect the sun’s rays, whereas dark colors attract them.

STAYING HYDRATED Keep your children hydrated! If your child is thirsty, they are already dehydrated. Be sure they drink lots of fluids, since the sun and heat lead to loss of electrolytes and water through sweating.

Limit intake of sugary drinks and always keep cool drinks nearby — water is preferred.

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BIKE RIDING No helmet means no bike riding! Take a minute to put knee and elbow pads on your child as well. Remind them to look both ways when crossing the street.

INSECTS TO WATCH FOR Use a natural bug repellent for children ages four and younger so they can’t ingest harmful toxins, but are protected from mosquitoes and other bugs.

Every time a child goes outside, even if just for a few minutes, do a full-body check for ticks when they come back in. If you find a tick try to pluck it out, but don’t rock it back and forth. If you can’t remove it, call your doctor to be seen the next day.

WATER SAFETY If you have a pool in your yard, you must install a fence. It takes just seconds for a child to drown.

According to the Centers for Disease Control and Prevention, drowning is the leading cause of death for children ages 1–4. Never leave your child alone in a pool, even if he or she is a good swimmer.

Anyone learning to swim and any passenger on a boat, no matter their age, should wear a life jacket.

Anytime you’re near open water, you should watch for lightning. If you see it near, get away from the water immediately.

BEE STINGS

HEAT ILLNESS

If a bee stings your child, the area will swell. Apply ice immediately, give your child a pain reliever such as Tylenol, and apply an antihistamine to the area.

But if a rash spreads, the child complains that their lips feel like they’re swelling, their throat tightens, they have a cough, or they’re wheezing or vomiting, call 911 if you don’t have an EpiPen®. Do not drive to the hospital! An ambulance can get to the child faster if there’s traffic.

There are several signs that your child may have heat illness, including thirst, vomiting, dizziness, lightheadedness, muscle cramps, headache, pale or flushed face, heavy sweating, cold clammy skin, and fatigue. If your child complains of any of these, have them drink fluids to rehydrate, get them out of the sun, and have them rest in a cool place. If your child seems confused, seek medical attention.

KIDS IN VEHICLES

Arm yourself with the tools you need to protect your children. Learn CPR and first aid. That way you’ll know what to do if your child is choking on a hotdog during a summer barbeque, for example.

Go to Bayhealth.org/Classes-and-Events to sign up for educational opportunities. ■

Never leave kids alone in the car, even if the car is running and the air-conditioning is on. Kids can lock themselves inside, fiddle with buttons, and turn off the air-conditioning. Within a few minutes without air-conditioning, it can get up to 120 degrees inside a car during the summer, which can be fatal.

GET EDUCATED

Visit Bayhealth.org/Find-a-Doc or call 1-866-BAY-DOCS to be matched with a pediatrician who meets your child’s needs.

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A whole new woman Five years after undergoing weight loss surgery, Kim Mayhall is 130 pounds lighter and living life in a whole new way.

Kim Mayhall is a whole new woman. Five years ago she was living with diabetes and high blood pressure. After watching her mother’s health fail, she decided it was time for a change. That’s when Kim started researching Bayhealth’s Surgical Weight Loss Program. She’s now lost 130 pounds and is doing things she never dreamed of. Mayhall now exercises daily and pays keen attention to her diet.

Before surgery, Mayhall was on medication for diabetes and high blood pressure. Soon after her surgery, Mayhall was able to go off both medications.

Now she’s living a full, active life, thanks in part to losing the weight and keeping it off.

“It was harder than I thought,” she said. “I still struggle sometimes with my self-image. I don’t always recognize how much weight I’ve lost.

But then I do things like play rugby with my daughter and her friends and I see how far I’ve come.”

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Here are Mayhall’s tips for success: MODIFY YOUR DIET RIGHT AWAY “As soon as you start thinking about weight loss surgery, start addressing your diet. Focus on protein first, then vegetables. It’s a good time to get rid of soda and bread.”

GET MOVING “Even if you can only walk for a short period of time, just do it. The sooner you get moving the sooner it will get easier. I love exercise now.”

I DON’T ALWAYS RECOGNIZE HOW MUCH WEIGHT I’VE LOST. BUT THEN I DO THINGS LIKE PLAY RUGBY WITH MY DAUGHTER AND HER FRIENDS AND I SEE HOW FAR I’VE COME.

A day in the life: WATER!

Kim’s goal is one gallon of water per day.

VITAMINS

She takes a daily multivitamin.

— KIM MAYHALL

BREAKFAST IDENTIFY YOUR SUPPORT SYSTEM “My husband and children have been through the good and the bad with me. I couldn’t have done it without them. They lift me up on the hard days and celebrate with me on the good ones.”

GO TO AN INFORMATION SEMINAR “The seminars are a great way to learn more information and listen to what others are going through. I now speak at many seminars so people can hear about my experience.”

TAKE YOUR VITAMINS “After weight loss surgery, you have to take a daily vitamin to make sure your body gets all the vitamins and minerals it needs. And it has to be chewable.”

IT GETS EASIER WITH TIME “I know how hard it all seems at first. It can be overwhelming. But you’d be amazed at the things you don’t miss once you have your weight under control. Five years later it all feels normal. This is my life.” ■ Visit Bayhealth.org/Surgical-Weight-Loss to take the first step. There you can sign up for one of our information seminars.

Kim usually starts her day with eggs or yogurt.

LUNCH

For lunch, Kim usually pairs a salad with a protein like chicken or steak.

PM PROTEIN

In the afternoon, she reaches for a cheese stick, yogurt, or nuts.

DINNER

Kim sticks with a lean protein like chicken with a side salad or vegetable for dinner.

EXERCISE

Her routine consists of cardio and weights several days a week.

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VISIT BAYHEALTH.ORG/CLASSES FOR A COMPLETE LIST OF CLASSES AND EVENTS.

Maternity BIRTH CENTER TOUR AT BAYHEALTH HOSPITAL, KENT CAMPUS We invite you to an open house tour of the facility where you will meet your new baby for the first time.

Visit Bayhealth.org/BirthCenterTour to register.

BIRTH INN AND BEYOND TOURS AT MILFORD MEMORIAL Come for a tour of our unique facility, where we offer the convenience of birth and recovery in the same private room.

For more information, call 302-430-5739.

PUMPING, MILK, AND MORE Expectant mothers will learn the ins and outs of what kind of pump works best, based on personal circumstances and preferences.

Visit Bayhealth.org/Classes to register.

LABOR AND CHILDBIRTH Classes are offered both in-person and online for expectant mothers and their partners. Mothers-to-be are encouraged to register early in their pregnancy.

Call 302-744-7135 to register.

This class has a fee.

INFANT CARE These classes focus on basic infant care to give parents confidence in their ability to care for their babies.

Call 302-744-7135 to register.

This class has a fee.

HELLO BABY Adjusting to a new brother or sister can be difficult for the older sibling.

Bayhealth’s “Hello Baby” program is designed to help children accept their new role.

Call 302-744-7135 to register.

This class has a fee.

BREASTFEEDING 101 Come learn the basics about breastfeeding. Support persons are encouraged to attend. This class is offered the first Tuesday of every month at Milford Memorial and the third Tuesday of each month at Bayhealth Hospital, Kent Campus.

Visit Bayhealth.org/Classes to register.

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RIVERWALK “FREEDOM” FESTIVAL Join Bayhealth at the 18th Annual Riverwalk “Freedom” Festival on Saturday, Sept. 8, from 9 a.m. to 4 p.m. The event will feature a car show, a special area for kids, and live entertainment. Be sure to stop

by Bayhealth’s tables to learn more about the new health campus projects and our services.

BREASTFEEDING SUPPORT GROUP While breastfeeding is natural, it’s not always easy for new moms.

Our Breastfeeding Support Group offers an encouraging environment.

For more information, call 302-744-7233.

Healthy Aging STEPS CARDIOVASCULAR CLINICS Your personal numbers — blood pressure, heart rate, pulse oximetry, and weight — can tell you a great deal about your health. Bayhealth nurses take careful readings when you come to one of our STEPS clinics. And it’s free!

For more information, visit Bayhealth.org/STEPS or call 302-744-7135.

A MATTER OF BALANCE A Matter of Balance is an awardwinning program designed to manage falls and increase activity levels in older adults. The program is free, but registration is required!

To register, visit Bayhealth.org/Classes or call 302-744-7135.

STEPS EDUCATION LECTURES Led by expert speakers, these lectures cover a wide variety of health topics targeting the 50+ age group.

For more information, visit Bayhealth.org/STEPS or call 302-744-7135.

2018 SUMMER CLASSES Weight Loss BARIATRIC INFORMATION SEMINAR Learn more about the Bayhealth Bariatric Program including the Laparoscopic Roux-en-Y Gastric Bypass and the Laparoscopic Sleeve Gastrectomy. Find out about the risks, benefits, and outcomes. Meet the surgeons and staff of the bariatric program, ask them questions, and see if you meet the criteria for bariatric surgery. These seminars are free of charge and all are welcome.

To register, call the Bayhealth Bariatric Office at 302-430-5454.

CPR & First Aid HEARTSAVER ADULT CPR/FIRST AID This course reviews the steps of cardiopulmonary resuscitation (CPR) for adults. Participants will learn how to use an AED (automatic external defibrillator).

The first aid section covers general principles, injuries, and medical and environmental emergencies.

To learn more, call 302-744-7135.

This course has a fee.

HEARTSAVER PEDIATRIC CPR/FIRST AID This American Heart Association course reviews the steps of cardiopulmonary resuscitation (CPR) for children and infants.

It also provides information on how to manage a child’s injury during the first few minutes of an emergency until professional help arrives.

To learn more, call 302-744-7135.

This course has a fee.

SAFE SITTER Safe Sitter® teaches boys and girls ages 12 to 15 how to handle emergencies when caring for children. Certified instructors teach safe and nurturing childcare techniques, behavior management skills, and appropriate responses to medical emergencies. Students will also learn CPR. To learn more, call 302-744-7135.

This course has a fee.

BETTER BREATHERS This support group is for people with chronic obstructive lung disease and their family members.

For more information, please call Clinical Educator Jamann Caselles at 302-744-6227 or Respiratory Care Manager Rachael Ali-Permell at 302-430-5648.

FREEDOM FROM SMOKING® This free seven-week program offers support and guidance to help you quit using tobacco products.

For more information, call 302-744-7135.

2018 RUNWAY OF HOPE August 3, 2018, 11 a.m.– 3 p.m.

Rehoboth Beach Country Club Join us for an afternoon of friends, fashion, fun, and fundraising! The Runway of Hope is a fundraiser supporting the Bayhealth Cancer Survivorship Program, which helps cancer survivors enjoy full and productive lives after treatment.

For more information, call 302-744-7015 or visit BayhealthFoundation.org.

Screenings MAMMOGRAMS Each month, Bayhealth hosts regular mammogram screenings at multiple locations at no cost to those who are uninsured or underinsured.

To register, call 302-430-5143 or 302-744-6528.

CLINICAL BREAST EXAMS A clinical breast exam is a physical examination done by a healthcare practitioner trained to notice abnormalities in the breast tissue.

Bayhealth offers free clinical breast exams to the community.

Registration is required!

To register, call Harriet Pinkston at 302-744-6528.

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Poised to battle prostate cancer When it comes to cancer treatment at Bayhealth, we take an interdisciplinary approach — meaning our medical oncologists, radiation oncologists, surgeons, and other specialists work together to customize a treatment plan for each patient that addresses his or her individual needs. As a member of the Penn Cancer Network, we also provide genetic testing and counseling as appropriate, which further guides the development of the patient’s personalized treatment plan.

SURGERY Radical prostatectomy is a procedure in which the prostate is laparoscopically removed with the assistance of a surgical robot. It involves minimal, small incisions, and the surgery takes an hour and a half to three hours to complete. Patients typically stay in the hospital overnight and go home the next day, and most return to normal activity within two to three weeks.

Bayhealth’s Genitourinary Tumor Conference offers six primary options as part of this interdisciplinary approach to prostate cancer treatment. Urologist and Conference co-chair Gregory Spana explains them: ACTIVE SURVEILLANCE This treatment approach is for patients with low-risk prostate cancer. It entails regularly checking the patient’s prostate-specific antigen (PSA) levels to monitor changes. If there are changes, this may require modifying the patient’s prostate cancer treatment plan.

DR. SPANA IS AMONG NINE SURGEONS WHO ARE TRAINED TO DO ROBOTIC PROCEDURES AT BAYHEALTH. VISIT BAYHEALTH.ORG/ROBOTICS TO LEARN MORE ABOUT OUR ROBOTICS PROGRAM.

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APPROXIMATELY 11.2% OF MEN WILL BE DIAGNOSED WITH PROSTATE CANCER AT SOME POINT DURING THEIR LIFETIME, BASED ON 2013-2015 DATA. — NATIONAL CANCER INSTITUTE

RADIATION THERAPY Radiation therapy is a noninvasive treatment for prostate cancer. A specific type of radiation therapy is Intensity-Modulated Radiation Therapy or IMRT. This form of radiation therapy is delivered externally and precisely using image guidance to the prostate (typically taking less than 15 minutes), daily for approximately eight weeks.

CRYOTHERAPY This prostate cancer treatment is done at the hospital as an outpatient procedure. It involves placing needles through the skin into the prostate to freeze the cancer. The procedure typically takes about an hour and a half.

HORMONE THERAPY This treatment is for patients who have cancer that has spread outside of the prostate. It is administered as an intramuscular shot that slows the progression of the cancer. It is often followed by chemotherapy.

CHEMOTHERAPY This involves certified and trained chemotherapy nurses (RNs) delivering intravenous drug therapy through infusion in a series of treatments. ■ Visit Bayhealth.org/Cancer to learn more about cancer care at Bayhealth.

PEDAL AWAY PROSTATE CANCER Saturday, Sept. 15, 2018 Eden Hill Medical Center 200 Banning St., Dover, DE 25-mile bike race to support prostate cancer awareness; 9 a.m. start time Pedal Away Prostate Cancer is a 25-mile electronically timed race sponsored by the Delaware Prostate Cancer Coalition and Bayhealth to promote awareness of and early screening for prostate cancer. The race offers competitive and noncompetitive groupings. The course involves a single loop that begins and ends at the Eden Hill Medical Center in Dover. Police will escort riders throughout the race with rolling road closures and traffic control.

Join us at Eden Hill Medical Center at 200 Banning St., Dover, Delaware. Go to Bikereg.com/Pedal-Away-Prostate-Cancer to register.

GO BLUE HEALTH FAIR Saturday, Sept. 15, 2018 9:30 a.m.–12 noon Eden Hill Medical Center 200 Banning St., Dover, DE While you’re watching the race, get free PSA vouchers and sign up for free prostate screenings. Event includes includes vendors focused on health and wellness and free massages. A picnic lunch is also open to fair participants.

Come for the race, stay for the fair and fun!

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Stepping out for exercise Do summer’s bright sunshine and warm weather call you to take your exercise out of the gym and into the great outdoors? Fresh air and sunshine are great — but not so fast! Heat and humidity, if not taken seriously, could be hazardous to your health. Bayhealth Athletic Trainer Taylor Hatfield offers some tips to exercise safely and successfully throughout the summer.

SELECT PROPER SHOES

Wondering how to get started? “Every person is unique, so it’s imperative to keep in mind your fitness level, age, and any preexisting conditions when considering working out,” said Hatfield.

When you exercise, you can lose a lot of water. Drink plenty of fluids to stay hydrated.

“Replenish the body with water and electrolytes,” said Hatfield. “The intake of fluid should match the fluid lost through sweating and urination.”

You should always consult a doctor before beginning a new exercise program. Undiagnosed preexisting conditions, such as asthma, diabetes, and high blood pressure, can lead to additional complications if not managed properly prior to exercise.

Don’t be aggressive when starting a new workout program. Hatfield says it can take five to seven days to become acclimated to the heat and the humidity.

She suggests starting with a lighter workout such as walking, cycling, or swimming; running increases greater work for the body and also increases your body’s core temperature.

When possible, consult with a professional, such as an athletic trainer, personal trainer, exercise specialist, or physical therapist, to set up a workout routine that will help you meet your goals.

Now that you’ve made up your mind to focus on fitness, you must be prepared. Here are Hatfield’s tips on how to exercise safely: WEAR THE PROPER ATTIRE What you wear can help prevent heat-related injuries. Wearing loose, light-colored clothing helps deflect the sun’s heat and keeps the body cooler when exercising outside.

BE SAFE ON THE STREET If you wear earbuds or headphones while walking or running, be aware of possible hazards, including traffic.

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Hatfield suggests going to a shoe store to get fitted; some stores offer free computer analysis to help you select the right shoe. Cushioned inserts can also be used to reduce shock. “It’s one way to decrease injuries such as shin splints,” she said.

AVOID DEHYDRATION

SCHEDULE YOUR EXERCISE AROUND THE SEASON During the summer, try to schedule exercise early in the morning or later in the day based on the weather. Midday exercise, when the temperature is usually the hottest, can lead to increased risk of heat-related injuries.

PLAN A COOLDOWN As part of your exercise routine, incorporate time to cool down. “It’s important not to get overheated,” Hatfield added. Muscle cramping, profuse sweating, or vomiting suggest that the body’s core temperature is too high, which could lead to life-threatening conditions such as heat stroke or heat exhaustion.

STRETCH! Hatfield recommends dynamic, or moving, stretches before exercise. Afterwards, do static, or slow and stationary, stretches. Finally, after exercise, you should fuel your body with proper nutrition, such as protein and carbohydrates, as well as replenish your body with water and electrolytes to make up for any fluid loss. ■ If you’re ready to start your own fitness journey, and need support from a Bayhealth doctor, visit Bayhealth.org/Find-A-Doc or call 1-866-BAY-DOCS.

[CUSHIONED INSERTS ARE] ONE WAY TO DECREASE INJURIES SUCH AS SHIN SPLINTS. — TAYLOR HATFIELD

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Chronic disease management 101 A chronic disease is defined as any long-term illness that will have an impact on a patient’s life and health.

According to the Centers for Disease Control and Prevention, roughly 117 million people in the United States — about half of adults — suffer from one or more chronic conditions. Chronic diseases account for seven of the top 10 causes of death.

While most of these diseases may not necessarily have a cure, they can be treated.

What conditions are considered chronic diseases?

Family Medicine Physician Joseph Rubacky, DO, sees the following long-term illnesses on any given day:

takes the same approach for each patient regardless of the condition — educate, encourage lifestyle modifications, create a medication regime, and monitor the condition.

EDUCATE YOURSELF Each patient is educated about the diseases, including what to expect in terms of living with the illness.

They’re also informed on what steps they can and should take to maintain control.

CHANGE YOUR LIFESTYLE

• Hypertension, also called high blood pressure

With a lot of chronic conditions, lifestyle changes and diet can make a world of difference. Losing weight can significantly improve conditions like high cholesterol, diabetes, and high blood pressure.

• Hyperlipidemia, or high cholesterol

FOLLOW A MEDICATION REGIME

• Diabetes • Coronary artery disease

• Asthma

In some cases, patients need medications in addition to lifestyle changes.

• Chronic obstructive pulmonary disease • Depression

MONITOR THE CONDITION

• Anxiety • HIV • Inflammatory bowel disease • Cancer • Kidney disease When it comes to helping patients combat these diseases, Dr. Rubacky says the team at his practice

Physicians schedule follow-up appointments to see if the patient’s condition is improving or getting worse. These appointments can be set every three to six months, or longer if the patient has stabilized.

If a patient misses a follow-up appointment or test, they’re notified. There’s also a care manager on staff to work with the most complex patients with chronic diseases.

WHAT I TRY TO EMPHASIZE WITH MY PATIENTS IS THAT I MAY NOT BE ABLE TO CURE YOUR DISEASE, BUT I CAN HELP YOU MANAGE IT. — JOSEPH RUBACKY, DO

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“Most of our patients with chronic diseases are on more than 10 medications because if they have one chronic disease, they most likely have others, and we have to make sure we’re managing those conditions as a whole,” Dr. Rubacky said. “These patients require special care. Even if they’re seeing multiple specialists for the varying illnesses, we have to look at their care as a whole and make sure that controlling one disease isn’t interfering with another.”

Another part of the process is working with the patient’s family. For one, it’s important to consider all factors of a condition. Sometimes there are environmental or social causes that can be changed. Families can help navigate a patient’s care at home and if a patient is admitted to the hospital. In the past, family physicians saw their patients in the hospital. This isn’t as common anymore, but Dr. Rubacky and his coworkers make this a priority. “Chronic disease management doesn’t stop when a patient is in the office,” he said. “We can’t manage a condition only when it’s convenient. If one of our patients goes to the hospital, we treat them there as well.”

What’s important for patients to keep in mind when it comes to living with a chronic disease is that if they’re willing to fight, their physician will work diligently to help them live the best life they can. “What I try to emphasize with my patients is that I may not be able to cure your disease, but I can help you manage it,” Dr. Rubacky said. “I will work closely with you and, with lifestyle modifications, we can change your health for the better.” ■ To find support in a Bayhealth doctor, visit Bayhealth.org/Find-A-Doc or call 1-866-BAY-DOCS.

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Connecting with cancer patients The Bayhealth Foundation, Bayhealth’s Oncology Service Line, and Bayhealth Cancer Institute recently co-hosted an evening reception at Dover Downs Hotel & Casino for Bayhealth cancer patients and their families. The event — which was held in a small conference room — featured a presentation about Bayhealth’s vision for providing exceptional cancer care to the local community.

Attendees and their guests also had the unique opportunity to pose any questions they had about Bayhealth’s cancer program to Bayhealth participants and presenters, including the medical leadership team from the program: Iftekhar Khan, MD, chief of oncology services and medical director of medical oncology; John Lahaniatis, MD, medical director of radiation oncology; and Rishi Sawhney, MD, medical director of the Bayhealth Cancer Institute. In addition to the medical leadership, John D. Shevock, FACHE, FACMPE, senior director of operations, oncology service line, and executive director of the Bayhealth Cancer Institute, participated in the question-and-answer session and engaged in conversation with patients and their family members.

“The event, which had an excellent turnout, was the first time we interfaced with one of our medical service lines to provide patients and their families the unique opportunity to not only interact with Bayhealth Foundation members but medical staff as well,” said Bayhealth Foundation President Lindsay Rhodenbaugh.

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It also allowed the patients to learn more about Bayhealth’s cancer care and services beyond those that they were already familiar with or had used.

“We have premiere cancer care and treatment capabilities that not everyone in the community may be aware of,” Rhodenbaugh said. “It’s also nice when folks with a lot in common are given the chance to gather together, share their experiences, and learn from one another.”

“It was a pleasure to host our patients for an evening,” said Dr. Sawhney. “The event provided a great opportunity to reconnect with our patients and their families outside of the cancer center and hear their perspective as cancer survivors.”

Rhodenbaugh says there are plans to hold similar events with other Bayhealth medical service lines in the future. ■ Visit BayhealthFoundation.org or call 302-744-7015 to learn more about the Bayhealth Foundation.

The power of nature in healing We know there’s far more to the healing process than rest and rehabilitation. That’s why we’ve made an investment to plant more than 10,000 flowers in the park, walking paths, and many gardens on the Bayhealth Sussex Campus. When the new Bayhealth Sussex Campus opens early next year, it will contain an abundance of trees and plants that are either native to Delaware or that will do well in the local climate — in fact, all of the trees were grown at local tree farms.

Each will contain unique foliage along with some plants that will be found in all three. There will always be some greenery on the campus, even in the winter.

“Landscaping is an investment, so it’s important to choose plants and trees that will thrive and survive,” explained Bayhealth Health Campus Project Director Jerry Peters. “With regard to the trees, we picked trees that upon maturity will be substantial and fit well with the site. Our selection included the largest-caliber tree that still was within our budget. We recently started planting the trees where construction will allow so they can acclimate to the site and have a chance to grow before the campus opens. Another key consideration was to include plants that bloom or retain foliage through all four seasons of the year.”

Reed Grass, Red Twig Dogwood, Rosa

Here’s just a sampling of the types of plants that will be found in each of the three main gardens: ENTRY GARDEN Winterberry, Oakleaf Hydrangea, Rosa DINING GARDEN

HEALING GARDEN Bluestar, Oakleaf Hydrangea, Red Twig Dogwood ■ Visit BayhealthSussex.org to learn more about how the Bayhealth Sussex Campus is all being built around you.

While trees, plants, and flowers will be found across the campus, there are three primary gardens that were specifically designed and created to enhance the patient and visitor experience. They include the entry garden, dining garden, and healing garden.

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We’re making it easier for you to manage your health online.

mychart online patient portal Take an active role in the management of your health. With MyChart, you can review health information, view most test results, schedule appointments, and more.

Go to Bayhealth.org/MyChart to register for MyChart.

MYCHART IS ALSO AVAILABLE AS AN APP FOR IOS & ANDROID PHONES