LAWRENCE MEMORIAL HOSPITAL
connect So many decisions:
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Battling cancer as a team LMH, Health Department launch H1N1 campaign Leg pain may be a sign of blocked arteries Fall 2009
Thinking about having a
W H AT Y O U N E E D T O K N O W Is it time to add a new bouncing baby to your life? Along with preparing the baby room, buying clothes and picking names, prenatal checkups are important. But to ensure a healthy start, a preconception visit with your physician is a must. During this visit your physician can help you prepare for a healthy pregnancy prior to conception and assist you with any issues you may have with conceiving. Two of our community’s obstetrics experts recently shared ways to increase chances of conception and start a healthy pregnancy.
During your pre-pregnancy visit your health care provider can perform or recommend various tests and screenings before and during pregnancy as well as recommend lifestyle changes that will increase the chances of having a healthy baby. Some of the pre-pregnancy screening tests physicians often encourage are rubella, sickle-cell anemia and cystic ﬁbrosis. Many physicians also recommend that all women who could become pregnant take a vitamin with 400 micrograms to 1 milligram of folic acid. “While we don’t know what causes most birth defects, we do know that many birth defects happen early in pregnancy when the organs of the baby are forming,” says Samantha Durland, MD, from Lawrence OB/GYN Specialists. “A woman could be pregnant several weeks before she realizes it. Taking the B-vitamin folic acid before and early in pregnancy has been shown to reduce the risk of birth defects aﬀecting the brain and spine,” she adds.
Journey through parenthood with us! See www.lmh.org/birthingcenter
To better increase your chances of conceiving and giving birth to a healthy baby, physicians recommend that you keep the following tips in mind. Timing is everything. A woman is most fertile when she is ovulating — usually around the fourteenth day of her menstrual cycle. The exact time of ovulation varies from woman to woman due to diﬀerent lengths of menstrual cycles. Increasing the frequency of intercourse during ovulation increases the chances for conception. Your physician can help you determine your most fertile time and home ovulation test kits are also available to aid in detection. Age also affects a couple’s ability to conceive. Though most women have few pregnancy-related issues and give birth to healthy babies after the age of 35, it is important to note that a woman’s ability to release eggs ready for fertilization declines with age, Dr. Durland explains. The ability to conceive decreases after age 35 and makes a sharp drop after age 40. Women in this stage of life have an increased chance of giving birth to babies with genetic disorders. So physicians may also consider additional genetic testing for this group prior to conceiving.
Maintain a healthy weight. Being overweight or underweight can interfere with the production of estrogen, a female hormone that regulates the menstrual cycle and ovulation. Proper nutrition and a healthy weight also contribute to a healthy baby and pregnancy. Minivan or sports car? It’s just one of many things to consider. Pamela Huerter, MD, from Lawrence Family Medicine and Obstetrics reminds women to talk to a doctor about the prescription and over-thecounter medications they take regularly. “Even some routine medications, such as acne medications, can decrease the chances of getting pregnant, and some medications may also prove to be harmful to your fetus while in utero,” she says. Avoid smoking, caffeine, alcohol and drug use. Dr. Huerter points out that these substances may not only be extremely unhealthy for an unborn child, but they can also increase the risk of infertility. Drs. Huerter and Durland oﬀer this information as a general guideline for care. Please talk to your physician about the care that is most appropriate for you and your baby.
DocTalk Tifﬁnie R. Mercado, MD
Mickelle Hirschman, DO
Elizabeth Beal, MD
Dr. Mercado has joined Lawrence OB-GYN Specialists. She recently completed a residency in obstetrics and gynecology at the University of Kansas Medical Center, where she was administrative resident chief. She received her medical degree from the University of Kansas School of Medicine in 2005 and her bachelor of science degree in genetics from KU in 2000. She is board eligible in obstetrics and gynecology.
Dr. Hirschman has joined Family Medicine of Baldwin City. She recently completed a residency at Research Family Medicine in Kansas City. She received a doctor of osteopathy degree in 2006 from Kansas City University of Medicine and Biosciences. In 2002 she earned a bachelor’s degree in biology from Central Methodist University, Fayette, Mo.
Dr. Beal has joined Family Medicine of Tonganoxie. She recently completed a residency in family medicine at Research Medical Center in Kansas City and received a doctor of medicine degree from the University of Kansas School of Medicine in 2006. She graduated from Wichita State University in 2002 with a bachelor’s degree in Spanish and ﬁeld majors in biology, physics and sociology. Dr. Beal also completed a minor in chemistry and is conversant in Spanish.
A native of Kansas, Dr. Mercado and her husband have a 4-year-old son. Her personal interests include spending time with her family, traveling, working out and running. In 2008 she was team physician for a Peru medical mission, Amazon Hope. She is conversant in Spanish. Dr. Mercado is happy to be joining the Lawrence Memorial Hospital Medical Staff. “There is no doubt in my mind that this is where I wanted to be,” she says.
Dr. Hirschman’s interests in addition to family medicine procedures are preventive care and women’s health. “I chose to do family medicine because I love to work with all sorts of different populations,” she says.Originally from the Kansas City area, Dr. Hirschman chose to practice in Baldwin City because of its small-town charm. “I wanted a smaller town close to a larger city, and here I get the small-town practice feel.” Her personal interests include boating, ﬁshing, traveling, watching Chiefs football and spending time with her family.
To make an appointment with Dr. Mercado, call 785-832-1424.
To make an appointment with Dr. Hirschman, call 785-594-2512.
Becoming a doctor was an obvious career path for Dr. Beal, she says. “I love helping people, I love medicine and I love science.” She has a particular interest in women’s health. Dr. Beal and her husband have a 1-year-old daughter and have lived in Basehor for six years. Originally from Larned, she says she enjoys smalltown living. Her personal interests include SCUBA diving, biking, traveling and spending time with family. She especially enjoys water skiing at Clinton Lake. To make an appointment with Dr. Beal, call 913-845-8400.
Cardiologists to afﬁliate with Lawrence Memorial Hospital Lawrence Memorial Hospital oﬃcials announced recently that four cardiologists in practice at the Lawrence oﬃce of Cardiovascular Consultants, P.A. have agreed to an aﬃliation with the hospital. LMH will employ John Hiebert, MD; Michael Zabel, MD; Michael Hajdu, MD; BOE3PHFS%SFJMJOH .% FĊFDUJWF November 1, 2009. A ﬁfth cardiologist, Tapas ‘Joey’ Ghose, MD, will join them in December. The group’s name will be Cardiovascular Specialists of Lawrence. Gene Meyer, LMH president and chief executive oﬃcer, says the aﬃliation supports the hospital’s strategic focus to work closely with physicians as partners to deliver the best health care to the community. “We are pleased to partner with these outstanding local physicians who are respected by their patients and their peers,” Meyer says. “LMH is committed to the expansion of cardiac services in Lawrence and surrounding communities, and this aﬃliation will allow the cardiologists to support this goal with a stronger local focus.”
Dr. Dreiling, who specializes in interventional cardiology, will serve as medical director for the new practice. Speaking on behalf of the group, he noted that the cardiologists have a longstanding commitment to the community. “A closer relationship with the hospital will enhance continuity of care for our patients and provide an opportunity for our practice to grow,” he says. “We are very satisﬁed that this will be a productive and positive long-term relationship that contributes to our mutual goal to deliver the best cardiac care to our patients.” Meyer says the cardiologists will continue to practice according to their professional judgment, and their aﬃliation with LMH will in no way interfere in their practice of medicine. Cardiovascular Specialists of Lawrence physicians will continue their longstanding collegial relationships with the cardiovascular physicians of Cardiovascular Consultants, P.A. Dr. Dreiling says he expects the transition to be a seamless process with no impact to patients.
Ken Huber, MD, president of Cardiovascular Consultants, P.A., says, “Cardiovascular Consultants, P.A., has been pleased to provide cardiovascular services in Lawrence for the past 15 years. We look forward to collaborating with LMH and Cardiovascular Specialists of Lawrence as they further develop the model for cardiovascular care for the Lawrence community.” Cardiovascular Consultants, P.A. of Kansas City opened its Lawrence oﬃce in 1994. Dr. Hiebert has been practicing in Lawrence since 1988. Dr. Zabel joined the oﬃce in 1995 and Dr. Hajdu joined in 2003. Services were expanded to include interventional cardiology at LMH in 2005, and Dr. Dreiling has provided interventional cardiology services in Lawrence since 2008. The practice is located in the Lawrence Health Plaza medical building, adjacent to the hospital. Their phone number will remain the same; patients should continue to call 785-841-3636.
READY...SET...GO! In an effort to encourage community wellness and promote the services of LMH, the Lawrence Memorial Hospital Endowment Association is hosting a “small town BIG CAUSE” series of 5K run/walk events. The ﬁrst “small town BIG CAUSE” run/walk was held in Baldwin City on August 22. On a gorgeous Saturday morning, 65 runners and walkers moved through the course that was set up on the Baldwin City Golf Course. The Overall Top Male runner was Denny Gayton with a time of 19:38.77. The Overall Top Female runner was Jill Boyle with a ﬁnishing time of 22:52.56. A 5K run/ walk was also held in Tonganoxie on September 26 (race winners were not known at the time of publication). The next 5K run/walk will be in Eudora on Saturday, October 17. There is a $25 fee to register. For more event information and to register for the race, please contact Melissa Hess at 785-505-3317 or Melissa.firstname.lastname@example.org.
Baldwin City runners Austin Braddock (left), Overall Winner in 18-Under category and his father, Scott Braddock (right), 2nd in the 40-49 group, enjoy the day with race steering committee member George McCrary (center).
Leg pain may be a sign of blocked arteries © iStockphoto.com/thelinke
If you have aches, cramps or pain in your legs when you walk or exercise, it may be a sign that the arteries in your legs are becoming narrowed or blocked. Pain, in this instance, occurs because of decreased blood ﬂow to the legs. Peripheral artery disease (PAD) is the technical name for this blockage. According to Scott A. Gard, MD, a board-certiﬁed vascular surgeon who specializes in peripheral vascular surgery, PAD occurs when the arteries that carry blood to the arms or legs become clogged, partially or totally blocking the ﬂow of blood to the extremities. This condition is caused by fatty plaque that builds up over time and clogs the arteries. Left untreated, PAD is quite dangerous. If blood circulation becomes severely restricted, gangrene (tissue death) can occur. Gangrene is a very serious condition that may require amputation of the foot or leg. Dr. Gard says, “People with PAD are also likely to have blocked arteries in other areas of the body. Thus, they are at increased risk for heart disease, heart attack and stroke.”
Peripheral artery disease is a serious condition that will not go away without treatment.
The most common symptom of PAD is pain or cramping in your hips, thighs or calves while walking or exercising. As the disease progresses, symptoms may include numbness, tingling or weakness in the leg; coldness of the leg or foot; paleness of the leg or foot when elevated; blue or red discoloration of the foot or toes; loss of hair on legs or feet; and sores that don’t heal. Symptoms of PAD should not be considered a normal part of aging.
S Y M P TO M S |
Are you at risk for peripheral artery disease? The following activities and conditions put you at greater risk of PAD: s SMOKING s DIABETES s HIGH BLOOD PRESSURE s HIGH CHOLESTEROL s OBESITY s LACK OF EXERCISE s HEART DISEASE s FAMILY HISTORY OF HEART DISEASE s BEING OVER AGE
Did you know? A recent study by the Tests used to check for signs of PAD include: t "OLMFCSBDIJBMJOEFYPS"#* (used to compare the blood pressure in your feet and arms) t 6MUSBTPVOEFYBNTPGUIFFYUSFNJUZ t "OBOHJPHSBQIZPGUIFBSUFSJFTJO the legs (x-rays and a special dye to see inside the arteries) t "O.3*TDBO The new Non-Invasive Vascular Laboratory at the Wound Healing Center of Lawrence oﬀers a range of non-invasive diagnostic screenings performed by a registered vascular technologist. DIAGNOSIS |
Diet and exercise to lose weight, control high blood pressure and lower cholesterol may control PAD. The most important thing you can do to slow the progression of PAD is stop smoking. When lifestyle changes are ineﬀective in controlling PAD, medications may be prescribed. Other treatments may include balloon angioT R E AT M E N T O P T I O N S |
American Vascular Association underscored the magnitude of undiagnosed vascular disease in the United States and in the Lawrence area. Based on the national prevalence rate, as many as 22,100 people in the LMH service area (excluding Topeka) could have some form of vascular disease.
plasty (a non-surgical procedure used to widen narrowed or blocked peripheral arteries), sometimes followed by stent implantation, laser treatment, or other treatments. Surgery is performed when cases are severe. PAD will not go away without treatment. Early detection and treatment are important. If you experience symptoms, see your doctor immediately. Dr. Gard sees patients in his Lawrence Vascular Surgery oﬃce located at 6th and Maine, as well as at the Family Medicine of Baldwin City oﬃce. For more information, contact Lawrence Vascular Surgery at 785-841-9600. For more information about the Vascular Laboratory, call 785-840-9292.
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LMH offers cancer patients the most clinical trials in northeast Kansas It may surprise you to learn that Lawrence Memorial Hospital oďŹ€ers more clinical trials for cancer patients than any hospital or medical center in northeast Kansas, including Kansas City and Topeka. â€œWe had access to almost 200 trials last year,â€? SFQPSUT3POBME4UFQIFOT .% NFEJDBMEJSFDUPS PGUIF-.)3FHJPOBM0ODPMPHZ$FOUFS â€œEvery trial we conducted was approved by the National Cancer Institute, and received scientiďŹ c scrutiny at the highest level across the country.â€? A key reason for the growth in cancer research at LMH is a program created by the National Cancer Institute (NCI). Since 80 percent of patients stay close to home for cancer treatment, the NCI established Community Clinical Oncology Programs (CCOPs) that bring state-of-the-art cancer research to local communities. LMH has expanded its available trials through a new partnership with Wichita CCOP, one of the most respected CCOPs in the country.
O N C O L O GY T R I A L S C U R R E N T LY AVA I L A B L E AT L M H * Breast ......................18 Leukemia .................14 Lung.........................13 Cancer Control ......13 GI.............................11 GU.............................8
GYN ..........................6 Brain ..........................5 Myeloma ...................5 Lymphoma ................4 Melanoma ................. 3
* partial list
The clinical trials were a natural development in the history of the LMH Oncology Center, which began in May of 2000. Since then, the center has expanded to include 15 private outpatient treatment rooms. Dr. Stephens is joined by Matthew Stein, MD; 4IBSPO4PVMF .%3BPOBL&LSBN .% and Eston Schwartz, MD, in treating cancer patients at LMH. Darren Klish, MD, provides radiation therapy in a facility adjacent to the Oncology Center. The physicians, along with an oncology pharmacist and full-time social worker dedicated to the center, and a caring
staďŹ€ of certiďŹ ed oncology nurses work together with patients, their families and their primary care physicians to customize treatment. â€œWe are serving patients and physicians with a dedicated, highly capable staďŹ€ in a safe and caring environment,â€? concludes Dr. Stephens. For more information about clinical trials at the Oncology Center, contact Jodi Carlson, clinical coordinator for research and education, at 785-505-2800.
What is a clinical trial? Clinical trials are research studies in which people help doctors and researchers ďŹ nd ways to improve health care. Each study tries to answer scientiďŹ c questions and to ďŹ nd better ways to prevent, diagnose, or treat disease. The purpose of a clinical trial is to ďŹ nd out whether a medicine or treatment regimen is safe and effective for the treatment of a speciďŹ c condition or disease. Clinical trials compare the effectiveness of the study medicine or treatment against standard, accepted treatment.
Battling cancer as a team
Cancer can be all consuming. Many people who are diagnosed are scared and confused, and their lives quickly become absorbed with navigating the medical system. Waiting for test results, keeping track of multiple appointments and taking medications often leaves little time for family and work. But Sue Durand from Gardner, Kan., had a much different experience battling cancer with the Lawrence Memorial Hospital Oncology Center on her side. One year ago, Sue, a second-grade teacher, mother and wife, was diagnosed with breast cancer and began navigating the medical system in the Kansas City area for her treatment. â€œIt just wasnâ€™t working for me. It was difďŹ cult and I didnâ€™t feel like I was getting the care, attention and information I needed,â€? she says. Sue asked a breast cancer survivor in Gardner for advice and her friend referred her to the LMH Oncology Center. The friend had a positive experience at LMH and asked Sue to give it a try. And on Sueâ€™s ďŹ rst visit, the difference in care struck her. â€œI immediately felt at ease,â€? Sue notes. â€œThey spent hours talking to me and answering questions. I knew I was in the right place.â€? Throughout chemotherapy, surgery and reconstruction Sue felt like she had the whole department behind Th her. She felt fortunate because the team at LMH helped her coordinate care and make appointments. They even kept in contact with her primary care physician in Gardner and her cardiologist in Kansas City. Though S! JOIN U she wouldnâ€™t say it was easy, Sue does believe her experience at LMH was the best possible scenario. Out g in p p e r t Because of the extra level of support she was offered at LMH, she could concentrate on her work and B S ance Breast C t s family life. She was even able to keep teaching with minimal interruption. in a g A Dance T From the volunteers, nurses and coordinators to the physicians and surgeons, Sue is grateful for H IG nMIDN | PM R E the excellent care they provided. As she begins this school year, she is still battling the disease, but now B