Smart Health 2023

Page 1

A publication of A SAVVY CONSUMER’S GUIDE TO MEDICAL SERVICES IN THE GRAN ITE STATE Annual Checkups That Pay Dividends page 4 Create a Family Health History page 10 Once You Know, It’s Time to Act page 12 Care for a Common Sports Injury page 20 magazine 2023 EDITION FOR HEALTH & WELL-BEING YOUR FAMILY’S CHECKLIST

Surround Yourself with Great Care

Core Physicians’ Primary Care

Core Physicians offers comprehensive primary care in seven Seacoast communities, with same day appointments, extended hours and weekends, and an online patient portal. Core Pediatric & Adolescent Medicine provides care for infants, children and adolescents in Epping, Exeter, Plaistow and Stratham.

Core physicians’ Specialty Services

Core Physicians also has more than 20 specialty care services for adults and children, sharing one electronic medical record (EMR) with primary care so all providers have immediate access to your health records.


Allergy & Immunology


Diabetes & Endocrinology Gastroenterology

General Surgery Infectious Disease Neurology Obstetrics & Gynecology Orthopedics

Otolaryngology & Audiology (ENT)

Pediatric Dentistry

Physiatry/Spine Care

Plastic & Reconstructive Surgery


Pulmonary & Critical Care Medicine


Sports Medicine


Vascular Surgery

Departments of Exeter Hospital

As a 100-bed community hospital serving New Hampshire’s Seacoast region, Exeter Hospital’s scope of care includes a wide variety of comprehensive services:

Adult & Pediatric Rehabilitation Athletic Performance Center of Exeter Hospital Center for Breast Health Center for Cancer Care Center for Cardiovascular Specialties Center for Occupational & Employee Health (COEH) Center for Orthopedics & Movement

Center for Reproductive Care & Maternal Fetal Medicine

Center for Sleep Disorders Center for Wound Healing DriveAbility

Family Center at Exeter Hospital Joint Replacement

Rockingham VNA & Hospice

Rockingham Visiting Nurse Association & Hospice is a community based home health and hospice agency that provides high quality home care, hospice and community outreach programs within Rockingham County and parts of Strafford County.

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SMART HEALTH NH 2023 | NEW HAMPSHIRE MAGAZINE 1 This guide does not serve as a recommendation or endorsement by New Hampshire Magazine. Submit corrections and additions to Smart Health NH, New Hampshire Magazine 250 Commercial St., Suite 4014, Manchester, NH 03101. This publication is designed as a health care resource and is not intended for commercial use.
NH Hospitals Page 2 Let’s Get Physical: Annual Exams Page 4 Tips on Creating a Family Health History Page 10 Once You Know, It’s Time to Act Page 12 Walk In and Urgent Care Centers Page 14 Ambulatory Surgery Groups Page 16 Elder Care Services Page 18 Rotator Cuff Tears Page 20 WHAT’S INSIDE A SAVVY CONSUMER'S GUIDE TO MEDICAL SERVICES IN THE GRANITE STATE
P An Employee-Owned

ew Hampshire is one of the healthiest states in the country, and to help keep it that way the state is blessed with a variety of hospitals charged with sustaining the quality of health for their communities. Hospitals are the capitals of health care for the regions they serve. Although equipped to handle everything from emergency care to diagnostics and surgery, many hospitals focus on special areas of medicine like cancer and heart disease. Many have developed their own centers for medical specialties. Even the smallest hospitals are hubs for private specialists and group practices. They are a perfect starting point for anyone seeking medical treatment or advice.

Specialty Hospitals are Highlighted in Red Alice Peck Day Memorial Hospital  10 Alice Peck Day Dr., Lebanon (603) 448-3121 /

Since 1932, Alice Peck Day Memorial Hospital (APD) has been the community hospital of the Upper Valley, delivering high-quality care in a friendly environment where patients come first. Today, APD has more than 95,000 patient encounters from communities throughout New Hampshire and Vermont. Long known for providing personalized care, APD also offers a wide range of services that include orthopaedic surgery, neurosurgery, pain management, primary and family care, senior care and women’s care. Through APD’s affiliation with Dartmouth-Hitchcock in 2016, we affirm our commitment to creating a sustainable health system to improve the lives of the people and communities we serve for generations to come.

Bed Count: 25

Androscoggin Valley Hospital  59 Page Hill Rd., Berlin (603) 752-2200 /

Androscoggin Valley Hospital is the leading provider of health care to thousands of families in the small-town communities of New Hampshire’s North Country. As a critical access hospital, AVH offers 24/7 emergency care, in-house treatment of most medical issues and an arrangement for treatment of all other problems with the nearest tertiarycare facility. AVH is a community-owned, nonprofit, critical-access hospital that has positioned itself to continue to provide comprehensive, quality medical care for the greater Androscoggin Valley.

Bed Count: 25

Catholic Medical Center  100 McGregor St., Manchester (603) 668-3545

Catholic Medical Center (CMC) is a nonprofit regional health system, with a commitment to delivering the highest quality and most advanced health care to patients across New Hampshire. CMC is the home of the New England Heart & Vascular Institute, listed among Becker’s Hospital Review’s “100 Hospitals with Great Heart Programs” for 2016. CMC’s birthing unit, The Mom’s Place, was the first hospital in the state to have a neonatal unit based on “couplet care.” With primary care practices that care for the very young to the young at heart and our dedication to community outreach programs, CMC is helping to foster a healthier community, every day.

Bed Count: 330

Cheshire Medical Center/ Dartmouth-Hitchcock  580 Court St., Keene (603) 354-5400 /

The unique partnership of a regional medical center and a multispecialty physician practice has resulted in an integrated health system with a clear focus and coordinated approach

to providing high-quality services. Cheshire Dartmouth-Hitchcock Keene offers primary and specialty care physician services, state-of-the-art diagnostic tools, programs for improving the health of the community, preventing illness and treating infirmity.

Bed Count: 169

Concord Hospital  250 Pleasant St., Concord (603) 225-2711 /

Concord Hospital is a nationally accredited nonprofit health system providing comprehensive acute-care services and programs to residents throughout New Hampshire. Our cornerstone Centers of Excellence for orthopaedics, cancer, cardiac, urology and women’s health reinforce Concord Hospital as a regional health resource for specialized care that consistently provides unprecedented diagnoses, treatment and support for more than 40 medical specialties.

Bed Count: 295

Cottage Hospital 

79 Swiftwater Rd., Ste. 2, Woodsville (603) 747-2900 /

For 110 years, Cottage Hospital has served the residents of the Upper Connecticut Valley. Today, Cottage Hospital is a thoroughly modern, 25-bed critical-access hospital that has been recognized for providing exemplary care. Staffed by just over 250 employees, 37 medical staff providers and dozens of dedicated volunteers, Cottage Hospital offers low-cost, high-quality health care by using creativity and common sense, and by keeping an eye to the future as well as the present.

Bed Count: 25

Crotched Mountain Rehabilitation Center

1 Verney Dr., Greenfield (603) 547-3311 /

Crotched Mountain Specialty Hospital is a post-acute facility for pediatric and adult patients who require acute and sub-acute rehabilitation following injuries and other complex medical conditions including traumatic brain injuries, stroke, spinal cord injuries, ventilator management, and weaning and wound care.

Bed Count: 62

Dartmouth-Hitchcock Medical Center 

1 Medical Center Dr., Lebanon (603) 650-5000 / (603) 650-8034

Dartmouth-Hitchcock Health (D-HH) is New Hampshire’s only academic health system and the state’s largest private employer, serving a population of 1.9 million across northern New England. D-HH provides access to more than 2,400 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon. DHMC was named again in 2020 as the No. 1 hospital in New Hampshire by U.S. News & World Report,

and recognized for high performance in nine clinical specialties and procedures.

Dartmouth-Hitchcock Health also includes the Norris Cotton Cancer Center, one of only 51 NCI-designated Comprehensive Cancer Centers in the nation; the Children’s Hospital at Dartmouth-Hitchcock, the state’s only children’s hospital; affiliated member hospitals in Lebanon, Keene, New London and Windsor, Vt., and Visiting Nurse and Hospice for Vermont and New Hampshire; and 24 Dartmouth-Hitchcock clinics that provide ambulatory services across New Hampshire and Vermont. The D-HH system trains nearly 400 residents and fellows annually, and performs world-class research in partnership with the Geisel School of Medicine at Dartmouth and the White River Junction VA Medical Center in White River Junction, Vt.

Bed Count: 396

Elliot Hospital  1 Elliot Way, Manchester (603) 669-5300 /

Elliot Health System is a nonprofit organization serving the needs of the community since 1890. The largest provider of comprehensive health care services in Southern New Hampshire, Elliot Hospital, a 296-bed acute-care facility and the first community hospital in the state, serves as the cornerstone of the health system. Elliot is home to Manchester’s designated Regional Trauma Center, Elliot Breast Health Center, Elliot Urgent Care, a Level-3 Newborn Intensive Care Unit, Elliot Physician Network, Elliot Regional Cancer Center, Elliot Senior Health Center, Visiting Nurse Association of Manchester and Southern New Hampshire, Elliot Health System/ Dartmouth-Hitchcock 1-Day Surgery Center, Elliot Memory & Mobility Center, NH Arthritis Center, Elliot Retail Pharmacy, Elliot Medical Centers in Londonderry and Hooksett, and The Elliot at River’s Edge.

Bed Count: 296

Encompass Health

Rehabilitation Hospital  254 Pleasant St., Concord (603) 226-9800

Formerly HealthSouth Rehabilitation Hospital, Encompass Health Rehabilitation Hospital of Concord provides a higher level of comprehensive services designed to return patients to leading active, independent lives. Accredited by the Joint Commission for meeting or exceeding their national standards of quality and safety, Encompass Health specializes in stroke, orthopedic, spinal cord and brain injury rehabilitation utilizing intensive, customdesigned occupational, physical and speech therapy programs coupled with specialized nursing care.

Bed Count: 50

                       
Connecticut Valley Hospital Cottage Hospital Littleton Regional Hospital
Valley Hospital Weeks Medical Center Hospital Memorial Hospital Alice Peck Day Memorial Hospital Speare Memorial Hospital Valley Regional Hospital New London Hospital Lakes Region General Hospital Huggins Hospital Franklin Regional Hospital Cheshire Medical Center Crotched Mountain Rehabilitation Center Monadnock Community Hospital Encompass Health Rehabilitation Hospital New Hampshire Hospital Concord Hospital Veteran’s Affairs Medical Center Catholic Medical Center Elliot Hospital St. Joseph Hospital Southern NH Medical Center Hampstead Hospital Parkland Medical Center Northeast Rehabilitation Frisbie Memorial Hospital Wentworth-Douglass Hospital Portsmouth Regional Hospital Exeter Hospital Dartmouth-Hitchcock Medical Center

Exeter Hospital 

5 Alumni Dr., Exeter (603) 778-7311 /

Exeter Health Resources is comprised of three affiliates: Exeter Hospital, Core Physicians and Rockingham Visiting Nurse Association (VNA) & Hospice.

Exeter Hospital is a 100-bed community hospital with comprehensive services in breast health, cardiovascular, orthopedics, emergency care, the Family Center, the Center for Cancer Care with Massachusetts General Hospital Cancer Center physicians and more. Core Physicians is a patientcentered group practice offering primary care, pediatrics and more than 20 specialty services at locations throughout the Seacoast area. Rockingham VNA & Hospice provides high-quality home care, hospice and community outreach programs in the greater Seacoast area.

Bed Count: 100

Concord Hospital – Franklin 15 Aiken Ave., Franklin (603) 934-2060 /

Franklin Regional Hospital is a critical-access community hospital, offering a wide range of medical, surgical, specialty, diagnostic, as well as therapeutic services, wellness education, support groups and other community outreach services.

Bed Count: 25

Frisbie Memorial Hospital  11 Whitehall Rd., Rochester (603) 332-5211 /

Frisbie Memorial Hospital has provided quality health care services to the greater Rochester community for over 80 years. By creating space for new services, programs and the latest diagnostic and surgical technology available, they are committed to meeting the ever-changing health care needs of those communities they serve.

Bed Count: 112

Hampstead Hospital  218 East Rd., Hampstead (603) 329-5311 /

Built in 1974, Hampstead Hospital was the first private psychiatric hospital licensed by the State of New Hampshire. The 100-acre landscaped grounds are a fully accredited private specialty hospital serving the psychiatric and chemical dependency needs of patients and their families throughout the area.

Bed Count: 111

Huggins Hospital  240 S. Main St., Wolfeboro (603) 569-7500 /

Huggins Hospital is a nonprofit community hospital that endeavors to offer the best of two worlds: the warmth and friendliness of a small town and the technical expertise of modern medicine. Huggins provides medical services to a year-round population of 30,000 residents and approximately 120,000 seasonal residents and visitors who come from all over the world to enjoy the Lakes Region of New Hampshire.

Bed Count: 25

Concord Hospital – Laconia 80 Highland St., Laconia (603) 524-3211 /

Nestled in the beautiful Lakes Region of New Hampshire is LRGHealthcare, a nonprofit health care charitable trust representing Lakes Region General Hospital (LRGH) and Franklin Regional Hospital (FRH). It is a comprehensive provider

network with a broad array of services and programs.

Bed Count: 137

Littleton Regional Healthcare  600 St. Johnsbury Rd., Littleton (603) 444-9000 /

Little Regional Hospital values integrity, compassion, accountability, respect and excellence. It has made significant improvements, including expanding the campus and adding the latest in technology. More importantly, they have increased specialty services provided by highly skilled physicians and clinicians. LRH continues to work hard to meet the growing health care needs of those they serve.

Bed Count: 25

Memorial Hospital 

3073 White Mountain Hwy., North Conway (603) 356-4949 /

Since 1911, Memorial Hospital has served with distinction all the critical access and health care needs of the Mt. Washington Valley community. Its hospital services include a 24-hour emergency room, surgery center, clinical laboratory, heart health and wellness programs, family birthing center, sleep center, wound care and hyperbaric medicine center.

Bed Count: 25

Monadnock Community Hospital  452 Old Street Rd., Peterborough (603) 924-7191

In 1919, Robert M. Parmelee donated his summer home in Peterborough for use as a community hospital, and in 1923 “The Peterborough Hospital” opened its doors. Now known as Monadnock Community Hospital, its physicians and staff offer extensive services utilizing state-of-theart technology while maintaining the personalized care of a community hospital.

Bed Count: 25

New Hampshire Hospital  36 Clinton St., Concord (603) 271-5300

New Hampshire Hospital is a state-operated, publicly funded hospital providing a range of specialized psychiatric services. NHH provides acute treatment services for children, adolescents, adults and elders with severe mental illness. NHH advocates for and provides services that support an individual’s recovery.

Bed Count: N/A

New London Hospital  273 County Rd., New London (603) 526-2911 /

New London Hospital is a rural community hospital with a long-term extended care center dedicated to serving the Lake Sunapee region. Also a critical-access hospital, NLH shares an established relationship with a tertiary care hospital, met by a collaborative agreement with Dartmouth-Hitchcock Medical Center.

Bed Count: 25

Northeast Rehabilitation Hospital Network  70 Butler St., Salem (603) 893-2900 /

Since opening its flagship location in Salem in 1984, Northeast Rehab has added three more acute rehabilitation hospitals located

in Nashua, Portsmouth and Manchester. Additionally, the network includes over 20 outpatient centers, a home care division, a sports medicine division, an outpatient pediatric division and many other services for those in need of rehabilitation. The leader of that effort, Howard Gardner, M.D., was an Army neurosurgeon who had seen firsthand the benefits rehabilitation was offering wounded soldiers. Returning to the Merrimack Valley and establishing a neuroscience practice, New England Neurological Associates, Dr. Gardner and his associates set out to build the first free-standing acute rehabilitation hospital in New Hampshire.

Bed Count: 150

Parkland Medical Center  1 Parkland Dr., Derry (603) 432-1500

Parkland Medical Center serves southern New Hampshire with comprehensive, personalized medical care around the clock. Partnerships with The Lahey Hospital & Medical Center and the New England Heart and Vascular Institute bring specialized medicine by highly skilled physicians, innovative approaches to treatment and advanced technology to their patients.

Bed Count: 86

Portsmouth Regional Hospital  333 Borthwick Ave., Portsmouth (603) 436-5110 /

Since the late 1800s, Portsmouth Regional has been delivering compassionate medical, surgical and mental health services with a tradition of exceptional responsiveness, patient satisfaction and community involvement. Portsmouth achieves high honors for quality patient care and holds several prestigious accreditations.

Bed Count: 209

Southern New Hampshire Medical Center  8 Prospect St., Nashua (603) 577-2000 /

Southern New Hampshire Medical Center began as an eight-bed emergency hospital in 1893 and has grown to an acute-care facility that retains the personal touch of a traditional community hospital. As a clinical affiliate of Massachusetts General Hospital, SNHH provides its patients with access to collaborative programs in pediatric specialties, cancer care, trauma and the management of stroke.

Bed Count: 188

Speare Memorial Hospital  16 Hospital Rd., Plymouth (603) 536-1120 /

From humble beginnings as a soldiers’ and sailors’ hospital to being nationally recognized as one of the best community hospitals, Speare Memorial Hospital is a 100,000-square-foot critical-access hospital adjacent to Plymouth State University. It strives to be a leader in helping the communities of central New Hampshire achieve optimal health.

Bed Count: 25

St. Joseph Hospital  172 Kinsley St., Nashua (603) 882-3000 /

St. Joseph Health is a regional fullservice health care system comprising St. Joseph Hospital, founded in 1908, and a large multispecialty physician group practice serving the greater Nashua area,

western New Hampshire and northern Massachusetts. The organization provides high-quality, compassionate care that contributes to the physical, emotional spiritual well-being of its community.

St. Joseph Hospital, with 208 beds, is a designated Magnet hospital for nursing excellence, a Top Performer, and leads the way in the prevention, diagnosis and treatment of disease. Its extensive physician practice network is recognized for outstanding quality measures and personalized, patient-centered care.

Bed Count: 208

Upper Connecticut Valley Hospital  181 Corliss Ln., Colebrook (603) 237-4971 /

Upper Connecticut Valley Hospital strives to improve the well-being of the rural communities it serves by promoting health and assuring access to quality care. Presiding over the nurses station, an etched portrait of Dr. William H. Gifford, considered to be the founding father, hangs with the inscription that he was “a man of magic, medicine and miracles.”

Bed Count: 16

Valley Regional Healthcare  243 Elm St., Claremont (603) 542-7771 /

As well as a critical-access hospital, Valley Regional health care professionals are available to address cardiac care, childbirth, health care careers, hospital services, pediatric/child care tips, weight control and more. VRH also coordinates hospital tours and other programs for local organizations. The hospital offers these informational programs free of charge as a community service.

Bed Count: 25

Veterans Affairs Medical Center  718 Smyth Rd., Manchester (603) 624-4366 /

Honoring America’s Veterans with quality health care services, part of the largest integrated health care system in the U.S., the Veterans Affairs Medical Center in Manchester has expanded acute inpatient contract care at Concord Hospital.

Bed Count: N/A

Weeks Medical Center  173 Middle St., Lancaster (603) 788-4911 /

Weeks Medical Center’s caring and compassionate staff is committed to providing the highest quality and efficient health care services to the communities of New Hampshire’s North Country with satellite physicians offices in the towns of Whitefield, Groveton, North Stratford and Lancaster.

Bed Count: 25

Wentworth-Douglass Hospital 

789 Central Ave., Dover (603) 742-5252 /

Conceived on March 15, 1904, WentworthDouglass Hospital is an acute-care hospital in the Seacoast region. In 1982, it became the first Seacoast hospital to be designated as a trauma center and incorporated as a nonprofit community hospital. Today, it is one of the largest acute-care hospitals in the Seacoast region.

Bed Count: 178




If you are one of the more than 40% of Americans who skipped your annual checkup during the height of the pandemic, you might consider scheduling an appointment soon. Your wellness exam isn’t something to fear; rather it’s an opportunity for you and your health care provider to reassess the current state of your health and ways you can improve it. These exams can also include important screenings that could potentially save your life.

“Most adults should consider getting a health maintenance exam every year,” says Dr. Brendan Murphy, family practice physician at Wentworth Health Partners Adult and Children’s Medicine of Dover. “If you only come when you’re sick or have an injury or illness, it’s really unlikely (you and your provider) will have time to go over all of the things you are due for. During your yearly visit, you can go through the list of screenings you’re overdue for and get those done.” ➜




The nature of your annual exam will vary, depending upon your gender and age. Children typically are encouraged to get a well child check every year; however once they’re in high school, they may only require a physical every other year, says Dr. Holly Mintz, chief medical officer of ambulatory services for Elliot Medical Group.

At their annual exams, young children receive developmental screenings, lead screenings and vaccines for diseases such as measles, mumps, rubella and polio, among others. After age 9, they are also eligible to receive the HPV vaccine, which helps prevent genital warts and cervical cancer. According to the CDC, since the vaccine series was first recom mended in 2006, infections that cause most HPV cancers and genital warts have dropped 88% among teen girls and 81% among young adult women.


Adults can typically expect to get their weight, blood pressure and cholesterol checked as part of their preventative exams. By checking these numbers, your provider can assess your risk for cardio vascular disease. High cholesterol leads to heart disease, but it can be reduced with the right medicine, diet and exer cise, Mintz says. Some people may have high cholesterol and not even know it.

“Some people have familial (heredi tary) high cholesterol, regardless of their

weight or physical activity, and those people are also candidates for medica tion,” she says.

If you’re wary of getting blood drawn, that’s not a reason to skip your appoint ment. You may not need bloodwork done every year if your numbers are where they need to be, unless you need to be monitored for high cholesterol or diabetes, Murphy says.

Women are encouraged to get annual cervical screenings between the ages of 21 and 65; however, depending on your results, you may not need one as frequently, Mintz says.

“We know the cause of cervical cancer is HPV and that the vaccine prevents HPV and cervical cancer,” she says.

“Women still need screenings because the vaccine covers nine of the strains,

but there are others.”

Adults and children are both en couraged to get an annual flu shot and should consider staying up to date with their COVID-19 vaccines and booster shots. This fall, an updated version of the COVID booster will target the most recent Omicron subvariants, BA.4 and BA.5, thought to be more contagious and more resistant than earlier strains of Omicron.

“We really don’t know what’s going to happen with COVID, and people who are high risk for serious illness — those with heart disease, diabetes, obesity, or those who have any immunocompro mised condition — should really get a COVID booster,” Mintz says.


Once men and women reach their 40s, providers encourage them to participate in additional screenings that help reduce their risk of the most prevalent cancers: breast, colon, prostate and lung. Provid ers suggest that women get breast cancer screenings, or mammograms, every other year beginning at age 40. According to the American Cancer Society, mammo grams often find or detect breast cancer early, when it’s small and before a woman can feel a lump. At this stage, breast cancer is easiest to treat. Depending upon family history, men should speak with


Firmly rooted in our community and trusted for generations, we are a truly compassionate team of health care professionals relentlessly dedicated to providing innovative, life-changing and life-saving health care every day to every individual. We are The Elliot.

Life-Changing & Life-Saving Care.

Elliot Health System, 1 Elliot Way, Manchester, NH

Dr. Susanne Griffin Elliot Hospital Emergency Medicine


their providers about getting prostate screenings, which could include a physi cal exam and blood test.

Colon cancer screenings are one of the most important preventative health care screenings that both men and women should get once they reach age 45, says Murphy. Previously, this screening was recommended at age 50; however, because one in seven people are diagnosed with colorectal cancer before age 50, the guidelines were recently changed, says Mintz. The earlier colorectal cancer is detected, the easier it is to treat. At the same time, the inconvenience of bowel preparation before a colonoscopy and fear of being put under sedation for the procedure often keep patients from following through with it. The good news: There

are ways you can screen for colon can cer without undergoing a colonoscopy if you’re at low risk, Mintz says.

“If you’re average risk, you can instead do stool testing annually or every three years,” she says. However, if you do have a family history or have gastrointestinal symptoms, it may be a procedure you can’t afford to skip.

Another preventative screening adults

may be unaware of is a procedure that can detect early lung cancer, which is the second most common form of can cer, according to the American Cancer Society. The average age of lung cancer diagnosis is age 70, but a screening may help identify it sooner. If you were a heavy smoker at one time and quit less than 20 years ago, you may eligible, Mintz says. For those adults between

“It’s much better to catch something early than have it treated later.”
— Dr. Holly Mintz

50 and 80 years old who qualify, a lung cancer screening consists of a low-dose CT scan that can pick up lung cancer in asymptomatic patients.

The Centers for Disease Control also recommends that adults older than 50 receive a Shingles vaccine. Even if you’ve already had Shingles, the vaccine can prevent it from reoccurring.


As we age, we also face new health challenges related to our cognition and memory. It’s important to ensure that the seniors in your life not only see their providers annually to keep up with their medications, but also to assess where they are mentally. Depression, for exam ple, is common and often goes untreated in older adults, Murphy says. It can also be difficult to pinpoint memory deficits without the help of a provider.

“Cognitive testing varies between providers and practices, but one of them involves a short-term word recall in

which the provider introduces three new words and has the patient repeat them back several minutes later,” he says. “An other test is the clock draw test, in which seniors are asked to draw a clock face and make it read a certain time. In combina tion, there are good, brief screening tools for both memory and cognition.”

Age is a key risk factor for falls, and one out of five falls causes a serious injury such as broken bones or a head injury, according to the CDC. One way a provider may assess falls risk during an annual exam is by observing how long it takes for a patient to get out of a chair and walk, Murphy says. At the same time, hearing and vision should be evaluated during an annual exam and providers at this time can help seniors further identify if there are any overdue screening tests they should consider, Mintz says.

Because pneumococcal pneumonia kills approximately 1 in 20 older adults who get it, the CDC recommends that adults over 65 consider getting a pneu

monia vaccine. If you are younger than 65 and have certain risk factors such as lung disease or diabetes, you may discuss with your provider whether or not you need one sooner, Murphy says.


If you have fallen behind on your an nual exams, there’s no need to worry. If you’re unsure of what screenings or vac cinations you’re due for, your provider can help you access your health records and prioritize what’s most important for you now, Murphy says.

The cornerstones for a healthy lifestyle continue to include a healthy diet, regular exercise and a smoke-free lifestyle. You should also use alcohol in moderation. Even if you feel great, it doesn’t hurt to check in with your doctor once a year.

“Prevention is always better,” Mintz says. “It’s much better to catch some thing early than have it treated later.” ●


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At your next family reunion or gathering, consider discussing a different type of family tree: the family health history. Find out how to collect, organize and use information about your family’s health at Creating a Family Health History ( creatingafamilyhealthhistory/toc.html), the newest topic on the NIHSeniorHealth website. NIHSeniorHealth is a health and wellness website designed especially for older adults from the National Institute on Aging (NIA) and the National Library of Medicine (NLM), both part of the National Institutes of Health.

Older family members are uniquely positioned to help create a family health history. “Older adults are more likely to know about the health conditions of previous generations,” says Surgeon General Regina Benjamin, M.D., M.B.A. “I like to think of the family health history as an heirloom that can help current and future generations live longer, healthier lives.”

My Family Health Portrait ( is an online tool developed by National Human Genome Research Institute (NHGRI) and the Surgeon General’s Office as a part of the Family History Initiative. The tool can help users pull together information about their own family health history. The topic also includes information about disease risk, the role of genetics and ways to promote the health of family members.

Knowing what diseases run in the family is important for you, your children and grandchildren. “A family health history, especially as one ages, can be used by health care providers to assess

individual health risks and employ prevention strategies to avoid a variety of health conditions, from cardiovascular disease to cancer,” says Eric D. Green, M.D., Ph.D., director of the National Human Genome Research Institute (NHGRI), which developed the topic for NIHSeniorHealth. “I encourage all Americans to take advantage of family gatherings this summer to make health history a topic of conversation. This information can save lives.”

Older Americans are increasingly turning to the internet for health information. In fact, more than 70% of online seniors look for health and medical information when they go on the web. NIHSeniorHealth (, which is based on the latest research on cognition and aging, features short, easy-to-read segments of information that can be accessed in a number of formats, including various large-print type sizes, open-captioned videos and an audio version. Additional topics coming soon to the site include alcohol use among older adults, long-term care and anxiety disorders.●

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 institutes and centers, and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical and translational medical research, and is investigating the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit


A little reminder to stay healthy.

Primary Care team is dedicated to keeping you and your family well. Now more than ever, it’s important to stay on top of your health. CMC is here for you and the ones you love, offering:

(phone or video) and in-person appointments

to a network of specialty care providers

locations throughout Bedford, Goffstown, Hooksett & Manchester


Where heart meets health.

C onvenient
And when life’s little emergencies and illnesses can’t wait, CMC’s Urgent Care provides the
trusted care you get from your CMC primary care provider. Call us today to find a primary care provider who’s right for you 603.314.4750

KNOWING is just not ENOUGH



Knowing about your family health history of a disease can motivate you to take steps to lower your chances of getting it. You can’t change your family health history, but you can change unhealthy behaviors, such as smoking, not being active or poor eating habits. Talk with your doctor about steps you can take, including whether you should consider early screening for the disease. If you have a family health history of disease, you may have the most to gain from lifestyle changes and screening tests.

If you have a medical condition, such as cancer, heart disease or diabetes, be sure to let your family members know. If you have had genetic testing done, share your results with other family members. If you are one of the older members of your family, you may know more about diseases and health conditions in your family, especially in relatives who are no longer living. Share this information with younger relatives, so you can all benefit from knowing this.


If you have a mother, father, sister, brother or other close family member who had colorectal cancer before age 50 or have multiple close family members with colorectal cancer, talk to your doctor about whether you should have screening at a younger age, more frequently, and using a colonoscopy instead of other tests. Your doctor may recommend genetic counseling, and a genetic counselor may recommend genetic testing based on your family health history.


If you have a parent, sibling or child with breast cancer, talk to your doctor about when you should start mammography screening. If your relative was diagnosed with breast cancer before age 50, if you have a close relative with ovarian cancer, or if you have a male relative with breast cancer, your doctor might refer you for genetic counseling to find out if genetic testing is needed. Your doctor might recommend taking tamoxifen, raloxifene or aromatase inhibitors. These are drugs that can decrease risk of developing breast cancer in some women.



If you have a family health history of heart disease, you can take steps to lower your chances of getting heart disease. These steps can include eating a healthy diet, being physically active, maintaining a healthy weight, not smoking, limiting your alcohol use, having screening tests and, in some cases, taking medication. If you or a family member has LDL cholesterol levels over 190 mg/dL (or over 160 mg/dL in children), talk to your doctor about getting checked for familial hypercholesterolemia (FH), especially if you have a family health history of early heart disease or heart attacks. If you have FH, you might need to take additional steps to maintain your health.

If your mother, father, brother or sister has type 2 diabetes, you and other family members could have prediabetes and are more likely to get type 2 diabetes. While most people with type 2 diabetes are older adults, more and more children, teens and young adults are developing it. There are steps you and your children can take to prevent type 2 diabetes and reverse prediabetes if you have it. Ask your doctor if you need earlier screening for diabetes. Look into the National Diabetes Prevention Program’s lifestyle change program and how to find a nearby program.


This is a medical condition where bones become weak and are more likely to break. A family health history of osteoporosis is one of a number of factors that make you more likely to develop osteoporosis. For example, if you are a white woman whose mother or father fractured a hip, talk to your doctor about early screening (at about age 55, compared with age 65 for most women).


This is a disorder in which the body can build up too much iron and leads to serious liver damage and other problems. If you have a brother or sister with hemochromatosis, you may be more likely to develop it. Talk to your doctor about testing and whether you should take steps to lower the amount of iron in your body ●


Three Hospitals.


We are a charitable organization which exists to meet the health needs of individuals within the communities we serve.


250 Pleasant Street Concord, NH 03301 80 Highland Street Laconia, NH 03246 15 Aiken Avenue Franklin, NH 03235

Access Walk-In Injury Clinic

Located at Access Sports Medicine & Orthopaedics

1 Hampton Rd., Exeter (603) 775-7750 /

Barrington Urgent Care

426 Calef Hwy., Barrington (603) 664-0955 /

Cheshire Medical Center Walk-In Clinic

The Center at Colony Mill

149 Emerald St., Keene (603) 354-5484 /

Catholic Medical Center

5 Washington Pl., Bedford (603) 314-4567


24 Homestead Place, Alton (603) 822-4713

96 Daniel Webster Hwy., Belmont (603) 267-0656

1 Beehive Dr., Epping (603) 734-9202

9 Old Lake Shore Rd., Gilford (603) 760-7755

558 Mast Rd., Goffstown (603) 621-2879

410 Miracle Mile, Lebanon (603) 276-3260

33 Railroad St., Lincoln (603) 605-1441

127 Plaistow Rd., Plaistow (603) 605-0265

750 Lafayette Rd., Portsmouth (603) 427-8539

558 Mast Rd., Goffstown (603) 232-1790

1228 Hooksett Rd., Hooksett

75 Laconia Rd., Tilton

636 Lafayette St., Seabrook (603) 967-4015

Concentra Urgent Care

1 Pillsbury St., Concord (603) 223-2300

1279 South Willow St., Manchester (603) 644-3330

14 Broad St., Nashua (603) 889-2354

Concord Hospital Walk-In Urgent Care

60 Commercial St., Concord (603) 230-1200

Occupational Health Services Convenience Care

Hillside Medical Park

14 Maple St., Lot C, Gilford (603) 527-2896 /


3 Nashua Rd., Bedford (603) 472-6700

73 Daniel Webster Hwy., Belmont (603) 737-0550

8 Loudon Rd., Concord (603) 226-9000

14 Webb Place, Dover (603) 742-7900

351 Winchester St., Keene (603) 352-3406

551 Meadow St., Littleton (603) 761-3660

42 Nashua Rd., Londonderry Coming soon

2 Dobson Way, Merrimack (603) 471-6069

565 Amherst St., Nashua (603) 578-3347

599 Lafayette Rd., Portsmouth (603) 942-7900

1 Portsmouth Ave., Stratham (603) 772-3600

125 Indian Rock Rd., Windham (603) 890-6330

Core Physicians Advanced Appointment Access

Offering same-day appointments and extended office hours. After hours available at:

9 Buzell Ave., Exeter

Early Morning Pediatric Walk-In

9 Buzell Ave., Exeter

212 Calef Hwy., Epping

Elliot at River’s Edge

185 Queen City Ave., Manchester (603) 663-3000

Elliot Urgent Care at Londonderry

40 Buttrick Rd., Londonderry (603) 552-1550

Elliot Weekend After Hours Clinic

275 Mammoth Rd., Manchester (603) 626-5113

Exeter Hospital: Fast Track

Division of the Emergency Department (ED)

5 Alumni Dr., Exeter (603) 580-6668

ExpressMED Urgent Care

1 Highlander Way, Manchester (603) 625-2622

35 Kosciuszko St., Manchester (603) 627-5053

159 N. Broadway, Salem (603) 898-0961

Health Stop

228 Daniel Webster Hwy., Nashua (603) 888-9200

Immediate Care of Southern NH

8 Limbo Ln., Amherst

300 Derry Rd., Hudson

112 Spit Brook Rd., Nashua

29 Northwest Blvd., Nashua 33 Windham Rd., Pelham (603) 577-2273 for all locations

Laconia Clinic Convenience Care

724 Main St., Laconia (603) 527-2896

St. Joseph Urgent Care Milford

444 Nashua St., Milford (603) 673-5623

MinuteClinic (at CVS)

4 Hall St., Concord 321 Lafayette Rd., Hampton 271 Mammoth Rd., Manchester

214 Daniel Webster Hwy., Nashua 512 South Broadway, Salem 250 Plainfield Rd., West Lebanon (866) 389-2727 for all locations shire

Newport Health Center

11 John Stark Hwy., Newport (603) 863-4100

Parkland Urgent Care at Salem

31 Stiles Rd., Salem (603) 890-2727

Saco River Medical Group

7 Greenwood Ave., Conway (603) 447-3500

15 Rte. 302, Glen (603) 383-3005

Seacoast RediCare

396 High St., Somersworth (603) 692-6066

Walk-In Care at Memorial Hospital

3073 White Mountain Hwy. North Conway (603) 356-5461

Wentworth-Douglass Express Care

701 Central Ave., Dover (603) 609-6700

65 Calef Hwy., Lee (603) 868-8507

White Mountain Medical Center

2531 White Mountain Hwy. Sanbornville (603) 522-0186


AVH Surgical Associates

7 Page Hill Rd., Berlin (603) 752-2300 /

Interventional Spine Medicine

141 Rte. 125, Barrington / (603) 664-0100

Bedford Ambulatory Surgical Center

11 Washington Pl. #1, Bedford (603) 622-3670 /

Concord Ambulatory Surgery Center

60 Commercial St., Ste. 301, Concord (603) 415-9460

Concord Eye Center Hospital Campus

248 Pleasant St., Ste. 1600, Concord (603) 224-2020

South Campus

2 Pillsbury St., Ste. 100, Concord (603) 228-1104

The Cottage Hospital Day Surgery Center

90 Swiftwater Rd., Woodsville (603) 747-9156 /

Elliot Health System and Dartmouth-Hitchcock 1-Day Surgery

Elliot at River’s Edge 185 Queen City Ave., Manchester (603) 663-5900

Laconia Clinic Ambulatory Surgical Center

724 Main St., Laconia (603) 524-5151 /

Nashua Ambulatory Surgical Center

15 Riverside St., Nashua (603) 882-0950 /

Nashua Eye Associates

5 Coliseum Ave., Nashua / (603) 882-9800

555 Nashua St., Milford / (603) 672-8800

30 Lowell Rd., Hudson / (603) 598-6400

NH Eye SurgiCenter

105 Riverway Pl., Bedford (603) 627-9540 /

Orchard Surgical Center

16 Keewaydin Dr., Salem (603) 401-6466

Concord Orthopaedics –

Orthopaedic Surgery Center

264 Pleasant St., Concord

14 Tsienneto Rd., Ste. 100, Derry (603) 224-3368 /

Portsmouth Regional Ambulatory Surgery Center

333 Borthwick Ave., Ste. 200, Portsmouth (603) 433-0941 /

Skyhaven Surgery Center

13 Health Care Dr., Rochester (603) 509-9161 skyhaven-surgical-center

Stratham Ambulatory Surgery Care

4 West Rd., Stratham (603) 772-2076 /

Surgery Center of Greater Nashua

10 Prospect St., Ste. 101, Nashua (603) 578-9909

Wentworth Surgery Center, LLC

6 Works Way, Somersworth (603) 285-9288

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Clipper Harbor of Portsmouth 188 Jones Ave., Portsmouth (603) 431-2530

25 Worthen Rd., Durham (603) 292-3147 /

Harmony Homes Assisted Living 40 Briggs Way, Durham, (603) 292-5175

1 Stagecoach Rd., Durham (603) 292-6087

Langdon Place of Dover 60 Middle Rd., Dover / (603) 743-4110

Maple Suites 30 Holiday Dr., Dover (603) 617-4413 /

Wentworth Senior Living 346 Pleasant St., Portsmouth (603) 436-0169

RiverWoods at Exeter

7 Riverwoods Dr., Exeter (800) 688-9663 /

Langdon Place of Exeter 17 Hampton Rd., Exeter (603) 778-1024

Webster at Rye 795 Washington Rd., Rye (603) 964-8144 /


All American Assisted Living 1 Button Dr., Londonderry (603) 537-9898 /

Arbors of Bedford 70 Hawthorne Dr., Bedford (603) 647-9300

Bedford Falls 5 Corporate Dr., Bedford (603) 471-2555

Bentley Commons 66 Hawthorne Dr., Bedford (603) 644-2200

Birch Heights 7 Kendall Pond Rd., Derry (603) 505-4398 /

The Birches at Concord

300 Pleasant St., Concord (603) 369-4417

The Courville at Bedford 40 Route 101, Bedford / (603) 472-2000

The Courville at Manchester 44 West Webster St., Manchester (603) 647-5900 /

The Courville at Nashua-Aynsley 80 Lake St., Nashua / (603) 881-4190

The Courville at Nashua 22 Hunt St., Nashua / (603) 889-5450

Granite Ledges of Concord 151 Langley Pkwy., Concord (603) 224-0777 /

Greystone Farms 242 Main St., Salem (603) 898-5393

Hanover Hill Health Care Center 700 Hanover St., Manchester (603) 627-3826 /

Havenwood-Heritage Heights 149 East Side Dr., Concord (800) 457-6833 /

Hunt Community 10 Allds St., Nashua (603) 882-6511 /

Huntington at Nashua 55 Kent Ln., Nashua (800) 298-6608

Langdon Place of Nashua 319 East Dunstable Rd., Nashua (603) 888-7878

Nashua Crossings 674 West Hollis St., Nashua (603) 882-2898

Pleasant View Retirement Community

227 Pleasant St., Concord (603) 225-3970

Presidential Oaks

200 Pleasant St., Concord (800) 678-1333

The Residence at Salem Woods

6 Sally Sweets Way, Salem (603) 890-0580

RiverWoods at Manchester

200 Aliance Way, Manchester (603) 645-6500 /

Windham Terrace

3 Church Rd., Windham (603) 437-4600


Bentley Commons

197 Water St., Keene (603) 499-4546 /

Langdon Place of Keene 136 Arch St., Keene (603) 357-3902

Maplewood Assisted Living 201 River Rd., Westmoreland (603) 399-4912 /

RiverMead Retirement Community 150 Rivermead Rd., Peterborough (603) 924-0062 /

Summerhill Assisted Living 183 Old Dublin Rd., Peterborough (603) 924-6238 /


Harvest Hill 125 Mascoma St. #23, Lebanon (603) 448-7474 /

Kendal at Hanover 67 Cummings Rd., Hanover (603) 643-8900 /

Summercrest Senior Living 169 Summer St., Newport (603) 863-8181 /

Sunapee Cove Independent and Assisted Living 1250 Route 11, Sunapee (603) 763-0566 /

Wheelock Terrace 32 Buck Rd., Hanover (603) 643-7290

Woodcrest Village LLC 356 Main St., New London (603) 526-2300


Golden View Health Care Center 19 NH Route 104, Meredith (603) 279-8111 /

The Golden Crest 29 Baldwin St., Franklin (603) 934-6742

Wolfeboro Bay Care and Rehabilitation Center 39 Clipper Dr., Wolfeboro (603) 569-3950


Genesis Lafayette Center 93 Main St., Franconia (603) 823-5502

Mineral Springs of North Conway Care and Rehabilitation Center 1251 White Mountain Hwy. North Conway (603) 356-7294

Morrison Nursing and Rehabilitation Care

6 Terrace St., Whitefield (603) 837-2541

Riverglen House of Littleton 55 Riverglen Ln., Littleton (603) 444-8880


All Generations Adult Day Program

460 Amherst St., Ste. 4, Nashua (603) 880-3473 /

Castle Center for Adult Group Day Care

312 Marlboro St., Keene (603) 352-2253 /

Easterseals New Hampshire

555 Auburn St., Manchester (603) 623-8863 /

Gateways Adult Day Service Program

200 Derry Rd., Hudson (603) 882-6333 /

Huggins Hospital — Adult Day Care

240 South Main St., Wolfeboro (603) 569-7500 /

Kearsarge Good Day Respite Program

82 King Hill Rd., New London (603) 526-4077

Monadnock Adult Care Center

22 North St., Jaffrey (603) 532-2428 /

Sarahcare Adult Day Services

201 Rte. 111, Hampstead (603) 329-4401 /

Silverthorne Adult Day Care Center

23 Geremonty Dr., Salem (603) 893-4799

The Homemakers Health Services

215 Rochester Hill Rd., Rochester (800) 660-1770 /

Upper Valley Good Day Respite Program

18 School St., Lebanon (603) 526-4077 upper valley respite

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Rotator cuff tears are common injuries that increase in frequency as we age. Tears may occur as the result of a specific injury or general wear and tear. Approximately 50% of people over the age of 60 and 80% of those over the age of 80 will have a rotator cuff tear, however, only one-third of these tears will cause symptoms. Those who frequently perform overhead activities, such as painters, carpenters or tennis players, may be at greater risk for rotator cuff tears. Overall, nearly 2 million Americans visit a doctor for rotator cuff tears each year.

When rotator cuff tears do cause symptoms, patients typically complain of pain with overhead activity, weakness and difficulty sleeping. Rotator cuff tears may be partial or complete tears and may range in size from less than 1 cm (small tears) to more than 5 cm (massive tears).

Larger, complete tears generally cause more pain and dysfunction than smaller, partial tears.

The rotator cuff is comprised of four muscles and tendons, which work together to rotate the shoulder and raise the arm.

An injury may cause one or more rotator cuff tendons to become

torn or detached from the bone. Without a functioning rotator cuff, patients are often unable to raise their arm overhead or reach behind their back. A large rotator cuff tear can cause significant dysfunction, affecting a person’s ability to work and perform daily activities. If a large tear is not repaired, the rotator cuff tendon will retract, and its corresponding muscle will shrink. These changes are irreversible, and after a few years, the tear may no longer be repairable. Over time, altered shoulder mechanics will lead to wearing and thinning of cartilage, also known as arthritis.

Fortunately, there are tests to identify rotator cuff injuries and therapies to treat symptoms and halt tear progression. The diagnosis is established by physical exam maneuvers and imaging studies. An X-ray series can identify signs of arthritis, while an MRI can visualize the torn tendon and evaluate muscle quality. Small or partial tears usually respond well to anti-in flammatory medication, physical therapy or steroid injections. Larger tears, especially those resulting from a recent injury, are more likely to require surgical repair.

While rotator cuff surgery previously involved a large incision, surgery can now be performed with minimally invasive arthroscopic techniques. This typically involves three or four small incisions (half inch each) to insert a camera and surgical instruments. The torn tendon is repaired with sutures and anchored back to its origin on the bone. Following surgery,

patients will wear a sling for four weeks and begin physical therapy. By three to six months after surgery, patients are ready to return to full activity. Surgery has a high success rate, however certain factors may negatively affect healing such as smoking, larger tears and more chronic tears.

Even if a patient does progress to arthritis because of rotator cuff disease, successful treatment options still exist. Physical therapy can help to strengthen the other shoulder muscles and allow symptoms to return to a tolerable level, especially in older patients. However, if symptoms are severe and impacting quality of life, a reverse shoulder replacement can improve pain and restore function. Though patients cannot perform high impact activities following a replacement, they may return to golf, swimming, fishing or other leisure activities as soon as 12 weeks after surgery.

In summary, rotator cuff tears are common, increase with age and occur on a spectrum from small partial tears to large, complete tears. Treatment depends on the severity of symptoms, time since the injury and size of the tear. While many patients respond well to non-operative management including physical therapy, others benefit from surgical interven tion. Most rotator cuff tears can be successfully repaired via minimally invasive arthroscopic surgery, while patients with non-repairable tears can benefit from physical therapy or reverse shoulder replacement. ●

Thomas A. Fortney is a fellowshiptrained orthopaedic surgeon. He is board certified by the American Board of Orthopaedic Surgery. He subspecializes in shoulder and sports medicine.



Groundbreaking research, Inn ovative treatments and therapies, P ioneering rural care, Warmth and understanding, where it matters most.

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Alice Peck Day Memorial Hospital I Cheshire Medical Center I Dartmouth Hitchcock Clinics I Dartmouth Hitchcock Medical Center Mt. Ascutney Hospital and Health Center I New London Hospital I Visiting Nurse and Hospice for Vermont and New Hampshire In partnership with Dartmouth and the Geisel School of Medicine.
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