Smart Health 2024

2024 EDITION FEATURING ADVICE FROM A NUMBER OF MEDICAL EXPERTS TO KEEP YOU FEELING HEALTHY AND WELL

A SAVVY CONSUMER’S GUIDE TO MEDICAL SERVICES IN THE GRANITE STATE

A publication of

THE FUTURE OF HEALTH

magazine

CARE

IN NH

A new vision for rural health care page 5

Acting on Your Family Health History page 10

The Connection Between Heart Disease and Brain Health

page 12

The state-of-the-art hybrid operating room at The Elliot seamlessly combines our The state-of-the-art hybrid operating room at The Elliot seamlessly combines our highly skilled surgical team with cutting-edge technology. The integration of the highly skilled surgical team with cutting-edge technology. The integration of the ARTIS Pheno system and theoperating hybrid ORroom tableat creates an integrated and optimized The state-of-the-art hybrid The Elliot seamlessly ARTIS Pheno system and the hybrid OR table creates an integrated and combines optimized our environment for performing complex procedures.

This setup enables precise highly skilledfor surgical team complex with cutting-edge The integration ofpatient the environment performing procedures.technology.

This setup enables precise patient positioning, seamless imaging coordination, and enhanced surgicaland workflow.

In critical ARTIS Pheno system and the hybrid OR table creates an integrated optimized positioning, seamless imaging coordination, and enhanced surgical workflow.

In critical trauma situations, this real-time imaging plays a crucial role,enables saving valuable time. environment for performing complex procedures.

This setup precisetime. patient trauma situations, this real-time imaging plays a crucial role, saving valuable positioning, seamless imaging coordination, and enhanced surgical workflow. In critical trauma this real-time imaging plays a crucial role, saving valuable time.

Learnsituations, more at ElliotHospital.org Learn more at ElliotHospital.org Scan the QR code to take a virtual tour > Scan the QR code to take a virtual tour > Learn more at ElliotHospital.org Scan the QR code to take a virtual tour >

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The future future of of The surgical care is already alreadyhere. here.

The future ofis surgical care surgical care is already here.

W H AT ’ S I N S I D E A Publication of

NHMAGAZINE.COM

Vice President/Publisher Ernesto Burden x5117 ernestob@yankeepub.com Editor Mike Cote x5141 editor@nhmagazine.com Managing Editor Emily Heidt x5115 eheidt@nhmagazine.com

A SAVVY CONSUMER'S GUIDE TO MEDICAL SERVICES IN THE GRANITE STATE

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Bridging the Rural Health Gap page 4

10

Once You Know, It’s Time to Act page 10 NEW

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The Connection Between Heart Disease and Brain Health page 12

RESOURCES: New Hampshire Hospitals page 2 Walk-In and Urgent Care Centers page 22 Ambulatory Surgery Groups page 23 Elder Care Services page 26 Adult Day Care Centers page 26

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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.

SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 1

N H H O S P I TA L S

N

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 / alicepeckday.org

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

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 / concordhospital.org

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

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

90 Swiftwater Rd., Ste. 2, Woodsville (603) 747-2900 / cottagehospital.org

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

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

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

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 / cheshire-med.com

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

Crotched Mountain Rehabilitation Center

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

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

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 DHH 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

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

1 Elliot Way, Manchester (603) 669-5300 / elliothospital.org

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, Littleton Elliot Retail Pharmacy, Regional Hospital Elliot Medical Centers in Londonderry and Cottage Hospital Hooksett, and The Elliot at River’s Edge.

Bed Count: 296





Upper Connecticut Valley Hospital



Weeks Medical Center Hospital

Androscoggin Valley Hospital





 Memorial Hospital

 

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

2 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

254 Pleasant St., Concord (603) 226-9800 encompasshealth.com/concordrehab

Elliot Hospital 

Dartmouth Hitchcock Medical Center 

Dartmouth Hitchcock Health (DHH) 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. DHH 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

Encompass Health Rehabilitation Hospital 



Dartmouth Hitchcock Medical Center



Alice Peck Day Memorial Hospital

Speare Memorial Hospital Huggins Hospital





Lakes Region General Hospital



New London Hospital

 Crotched Mountain Rehabilitation Center





Monadnock Community Hospital

Frisbie Memorial Hospital

Franklin Regional Hospital

Valley Regional Hospital

Cheshire Medical Center



 

Encompass Health Rehabilitation Hospital New Hampshire Hospital Concord Hospital

 

Veteran’s Affairs Medical Center St. Joseph Hospital Southern NH Medical Center

Wentworth-Douglass Hospital

Catholic Medical Center Elliot Hospital

   

Portsmouth Regional Hospital Exeter Hospital

 

Hampstead Hospital Parkland Medical Center Northeast Rehabilitation

Exeter Hospital 

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

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 / lrgh.org

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 / frisbiehospital.com

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 / hampsteadhospital.com

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 / hugginshospital.org

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 / lrgh.org

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 / littletonhealthcare.org

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 / memorialhospitalnh.org

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 monadnockcommunityhospital.com

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 dhhs.state.nh.us/dcbcs/nhh

New Hampshire Hospital (NHH) is a stateoperated, 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 / newlondonhospital.org

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 / northeastrehab.com

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 parklandmedicalcenter.com

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 / portsmouthhospital.com

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 / snhhealth.org

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 / spearehospital.com

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 / stjosephhospital.com

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 / ucvh.org

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 / vrh.org

As well as a critical-access hospital, Valley Regional Healthcare 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 / manchester.va.gov

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 / weeksmedical.org

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 / wdhospital.com

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

SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 3

T O Y O U R H E A LT H

4 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

BRIDGING THE

RURAL HEALTH GAP with a

community-partner-driven vision

BY KRYSTEN GODFREY MADDOCKS

Those living in rural communities have fewer primary care doctors to choose from compared to their urban peers. They also tend to be older and more likely to be uninsured. This scenario sets the stage for health care inequity for people who live in sparsely populated areas, including parts of New Hampshire.

For example, according to a 2017 article published by The Commonwealth Fund, a foundation that supports independent research on health care issues: • 18.6% of the rural population is over 65, compared to 14.1% of the urban population.

• 17.2% of the rural population lives in poverty, compared to 14.3% of the urban population.

• 32.8% of rural men are smokers, compared to 26.5% of urban men.

Even before the pandemic, rural residents experienced higher mortality rates, and the disparity between rural and large metropolitan areas tripled between 1999 and 2019. COVID-19 only exacerbated this disparity. About 37% more rural Americans than urban Americans throughout the pandemic died from COVID-19 when deaths are adjusted for population size. ➜

SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 5

T O Y O U R H E A LT H

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“P

eople living in rural communities are older, sicker, poorer and die at younger ages,” says Dr. Sally Kraft, M.D., M.P.H., vice president of population health at Dartmouth Health and director of its Center for Advancing Rural Health Equity. “This disparity begins at birth, and the gap widens over time — in the wrong direction.”

In 2022, Dartmouth Health launched the Center for Advancing Rural Health Equity (CARHE) to forge community partnerships and develop programs to support all individuals in northern New England to live their healthiest lives. The center received funding through an anonymous foundation grant and $448,000 brought to the state by Sen. Jeanne Shaheen, D-N.H., through the congressionally directed spending process.

Addressing rural health care inequity requires more than adding more health care providers to a small community, Kraft says. People living in these locations often have less access to factors that impact health, such as high paying jobs, child care, transportation and affordable housing, Kraft says.

Combined with difficulty accessing health care services — finding a doctor, getting transportation to a clinic or paying for health care — rural residents have worse health outcomes compared to their urban counterparts. That’s why CARHE is taking a multi-pronged approach toward addressing the social drivers that lead to good health and ensuring everyone benefits from these improvements, she says.

BUILDING A LARGER VISION The center isn’t looking to re-create existing social programs but rather to bring together researchers and leaders from health care, schools and social services organizations to consider new ways to improve health outcomes in different areas.

It’s about looking at solving historical problems by working with partners in a fresh, ambitious way.

“Our goal is to bring together folks dealing with common problems to help all of us understand these problems and to work together to find solutions. Rural communities are resourceful and resilient. If we can learn together and problems solve together, we hope to find solutions that can help our region.” she says.

A diverse group of leaders and community members on CARHE’s leadership and community advisory committees created a five-year strategic plan to guide the organization’s efforts. In December 2022, CARHE issued a Request for Ideas (RFI) for projects to help improve rural health equity in northern New England. Ideas were reviewed by the center’s Leadership Council and Community Advisory Council members.

CARHE ultimately selected four projects in 2023, which have focused on: • Improving access to healthy food for cancer patients in Vermont, in partnership with the Osher Center for Integrative Health at the University of Vermont.

• Building early childhood supports in rural New Hampshire, in partnership with the Monadnock United Way. • Improving food security for individuals living in public housing in the Upper Valley, in partnership with Willing Hands.

• Addressing the impact of climate change on allergies and asthma in children in Central New Hampshire, in partnership with New Hampshire Healthcare Workers for Climate Action and the Boys and Girls Club of Central New Hampshire.

CARHE will issue its next RFI for one-year health equity projects this fall. Applicants whom the committee selects receive financial support and support from CARHE staff. The goal is to bring partners together to work as a team to find solutions, Kraft says.

ECHOING THE NEED FOR COMMUNIT Y-DRIVEN SOLUTIONS By hosting knowledge-sharing events and courses, CARHE further broadens input into these issues by bringing diverse groups together to learn more about health care inequity.

Beginning in September, the center will host a bi-weekly series of free virtual sessions through December. Through Project ECHO® (Extension for Community Healthcare Outcomes)

SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 7

T O Y O U R H E A LT H

IMPROVING HEALTH EQUITY FOR OTHER POPULATIONS Although rural populations share a geographic commonality, particular groups within these communities face additional obstacles to better health.

On September 18, CARHE sponsored a panel discussion at Dartmouth Hitchcock Medical Center, “Working Toward Health Equity for the LGBTQ+ Community,” to look at ways LGBTQ+ people get the care they need, no matter where they live. The event included representatives from Seacoast Outright, Keene Pride, and White River Junction’s Veteran’s Administration LGBTQ+ Veteran Care.

“We recognize that LGBTQIA populations experience discrimination in many communities. Studies have shown us that these individuals may avoid or delay health care because of fear of discrimination in a health care setting,” Kraft says. “Access to health care services in rural areas is already difficult, compounding difficulties for LGBTQIA populations.”

8 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

video technology, participants will connect with community and health system experts and use case-based learning to explore solutions to health equity challenges.

Clinicians, researchers, educators, community service organizations and others are invited to join the “Rural Health Equity ECHO: Tackling the Social Drivers of Health.” During these sessions, participants will learn from experts about rural health issues. They will explore challenges to health equity in rural areas and how, by working together, communities and health systems can shape social drivers of health to achieve better outcomes. The ECHO will cover the topics of housing, food and nutrition, child care, access to health care, and unique challenges to well-being and care.

At the end of the course, the ECHO team will debrief and identify ways to share lessons learned from the ECHO, Kraft says. All ECHO presentations will be publicly available and are listed on the Dartmouth Health website.

CARHE will hold its second annual gathering on October 30 at the Lake Morey Resort in Fairlee, Vermont. Last year, approximately 150 people met at the same location to learn from one another about health disparities and look at ways to advance health equity through partnership and collective action.

By continuing to tackle “upstream” health problems (such as hunger, transportation and housing) that impact rural people, Kraft says communities can keep their residents healthier and hopefully out of the hospital.

While most health systems typically work separately from community groups, CARHE is optimistic about its holistic approach.

“No single group has all the answers,” she says. “But we can come together and learn from each other, especially from those who are most severely impacted by conditions that lead to poor health. Together, we can create solutions so everyone can be as healthy as possible.”

For more information on Dartmouth Health’s Center for Advancing Rural Health Equity, visit www.dartmouth-health.org/carhe. ●

FOCUSED C A R E

THE ART AND SCIENCE OF

DENTAL IMPLANTS

BY NEW HAMPSHIRE ORAL & MAXILLOFACIAL SURGERY The smile. It’s a universal symbol of warmth, friendliness, and confidence. But what happens when a missing tooth disrupts this picture-perfect expression? Thankfully, modern dentistry has a solution that not only restores lost teeth but also rejuvenates self-assurance and quality of life — dental implants. In this article, we embark on a journey through the art and science of dental implants, exploring how these remarkable innovations are changing the face of tooth replacement.

The Rise of Dental Implants Dental implants have transcended the boundaries of conventional dentistry, bringing hope and transformation to countless lives. Unlike traditional bridges and removable dentures, dental implants offer a permanent and aesthetic solution that feels and functions like natural teeth. This remarkable advancement in dental science has revolutionized the way we approach tooth replacement.

The Implant Process Unveiled At the heart of the dental implant procedure lies a meticulous process that combines artistry and precision: 1. Consultation and Planning: The journey begins with an in-depth consultation with our oral & maxillofacial surgeon. This phase involves a comprehensive evaluation of your oral health, determining your suitability for the procedure, and designing a personalized treatment plan tailored to your unique needs.

2. Implant Placement: The next step is a surgical procedure during which a small, biocompatible implant is gently and precisely placed into the jawbone. This implant acts as a durable and stable foundation for the replacement tooth.

3. Healing and Integration: Over the course of several months, a remarkable process known as osseointegration occurs. The implant gradually fuses with the jawbone, creating a solid and unshakeable bond. This fusion ensures the implant’s stability and long-term success.

At this point, you will receive a temporary tooth until the final restoration.

4. Restoration: The final touch is the attachment of your custom-made crown to the implant placed by your general dentist. Crafted to match

the color, shape, and size of your natural teeth, the crown blends seamlessly with your smile, achieving an incredibly lifelike appearance.

The Transformational Impact For individuals who have experienced the life-changing effects of dental implants, the results extend far beyond aesthetics: Restored Confidence: Dental implants empower individuals to smile, laugh, and speak confidently, shedding the burden of self-consciousness.

Improved Oral Health: By preventing bone loss and preserving the integrity of neighboring teeth, dental implants promote long-term oral health.

Effortless Functionality: Eating favorite foods without restrictions becomes a reality, as dental implants provide a stable and comfortable chewing surface.

Enhanced Quality of Life: Beyond aesthetics, dental implants significantly enhance overall well-being by ensuring better health and restoring the joy of a complete smile.

Looking to the Future The world of dental implants continues to evolve. Innovations such as same-day implants and computer-guided implant placement are paving the way for faster, more precise, and even more accessible tooth replacement options.

Dental implants are more than just a solution to missing teeth; they are a testament to the marriage of art and science in modern dentistry. If you or someone you know is facing the challenges of tooth loss, consider the transformative power of dental implants. Embrace the artistry of a confident smile, and experience the science behind a brighter, more joyful future. Call NHOMS at 1-800-NEWSMILE to schedule your consultation. With 7 locations throughout New Hampshire, their expert surgeons will get you the smile you deserve. ●

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SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 9

DETECTION & PREVENTION

KNOWING

is just not ENOUGH

ACTING ON YOUR FAMILY HEALTH HISTORY Knowing about your family health history of a disease can motivate you to take steps to lower your chances of getting the disease. You can’t change your family health history, but you can change unhealthy behaviors, such as smoking, not exercising or being active, and poor eating habits. Talk with your doctor about steps that 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 about your diagnosis.

If you have had genetic testing done, share your results with your 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. Be sure to share this information with your younger relatives so that you may all benefit from knowing this family health history information.

10 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

IF YOU HAVE A FAMILY HEALTH HISTORY OF:

COLORECTAL CANCER

BREAST OR OVARIAN CANCER

HEART DISEASE

DIABETES

OSTEOPOROSIS

HEREDITARY HEMOCHROMATOSIS

THIS IS WHAT YOU CAN DO: 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 starting at a younger age, being done more frequently, and

using colonoscopy only instead of other tests. Your doctor may recommend that you have 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 cancer genetic counseling to find out if genetic testing is right for you. In some cases, your doctor might recommend taking tamoxifen, raloxifene or aromatase inhibitors — 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 any screening tests that your doctor recommends, 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 your 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 type 2 diabetes. But there are important steps you and

your children can take to prevent type 2 diabetes and reverse prediabetes if you have it. Ask your doctor whether you need earlier screening for diabetes. Find out more about the National Diabetes Prevention Program’s lifestyle change program and how to find a program near you.

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 screening for osteoporosis earlier (at about age 55, compared with age 65 for most women).

Hereditary hemochromatosis is a disorder in which the body can build up too much iron and can lead to serious liver damage and other problems. If you have a brother or sister with hemochromatosis, you

may be more likely to develop the condition yourself. Talk to your doctor about testing for hemochromatosis and whether you should take steps to lower the amount of iron in your body. ● SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 11

RESEARCH

THE CONNECTION BETWEEN

HEART DISEASE AND BRAI EXPERTS DISCUSS HOW AVOIDING HEART DISEASE CAN INFLUENCE BRAIN HEALTH

BY KAREN A. JAMROG

Change is hard. Maybe that’s why so many of us continue to line up for fast food even though we know it’s not good for us, and why we spend too much time lounging on the couch rather than going for a walk or engaging in some other form of actual movement. Meanwhile, health professionals continue to warn of the dangers of heart disease, and rightly so. After all, cardiovascular disease is the No. 1 killer of men and women worldwide.

But even though most of us are fully aware of what we should do to keep our heart healthy, many don’t realize that the factors that make us more likely to develop heart disease — such as obesity, diabetes, inactivity and smoking — also raise our risk of Alzheimer’s disease and other forms of dementia.

12 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

In addition to risk factors that are shared between heart and brain disease, “there are several types of heart disease that potentially affect the brain,” says Paul F. Boffetti, M.D., F.A.C.C., director of interventional cardiology at Foundation Cardiology at Southern New Hampshire Medical Center in Nashua. People who have an irregular heartbeat condition such as arrhythmia or atrial fibrillation, for example, face an increased risk of developing dementia.

Some of the factors that make us more likely to have brain as well as heart disease are beyond our control, such as age and genetics. But research offers overwhelming evidence that we can tilt the odds of staying healthy in our favor through the lifestyle choices we make each day. Many of those choices can help safeguard the condition of our blood vessels, which are crucial not just to the heart, but also to the brain.

Cardiovascular disease “affects the vascular system, and the brain is a vascular organ,” Boffetti explains, which means the brain is vulnerable to trouble that occurs in the heart and in the blood vessels. For example, the same atheroscle-

THE DANGER OF “SILENT STROKES”

N HEALTH rosis that gradually and quietly over the years gums up arteries near the heart with plaque can also impede blood flow in the vessels that feed the brain, and possibly lead to a stroke and cognitive impairment. “Atherosclerosis is a systemic disease that can affect many organs, but the heart and the brain are the two most commonly affected,” Boffetti says. “Heart disease and stroke correlate because frequently it’s a similar process that causes the heart attack or the stroke to occur.”

People who experience a stroke face a heightened risk of vascular dementia, the second most common form of dementia after Alzheimer’s disease. Stroke damages the vessels that supply blood to the brain, killing brain cells by depriving them of vital blood and oxygen, and weakening the brain’s ability to concentrate, analyze, remember or perform other cognitive tasks.

Brain function can also be impaired by what are sometimes described as “silent strokes,” which can be influenced by some of the same factors that lead to heart disease. “Silent strokes are when you have a lack of blood flow to a certain part of the brain but do not have overt symptoms,” says Syed Peeran, M.D., a vascular surgeon at Appledore Medical Group Coastal

Factors that increase our risk of developing heart disease can also make it more likely that we will develop dementia, in part by raising our likelihood of having small strokes known as “silent strokes.”

During a typical stroke, a blood clot abruptly blocks blood flow to a specific region of the brain, resulting in an acute change in cognitive function or physical ability, says Paul F. Boffetti, M.D., F.A.C.C., director of interventional cardiology at Foundation Cardiology at Southern New Hampshire Medical Center in Nashua. In contrast, a silent stroke is more diffuse, and occurs in the smaller vessels of the brain, “so it’s not like all of a sudden a third of the brain has no blood flow,” Boffetti explains. “It’s more like all throughout the brain there is small vessel disease that leads to damage of the functioning brain cells — the neurons — and that can cause cognitive decline.”

These mini or silent strokes gradually erode brain function. “They are silent in the sense that you can’t identify the moment in which the stroke occurred,” Boffetti says, unlike a full-blown stroke, which leads to “an obvious, significant change in the ability to do something,” such as speaking or moving.

People can have multiple silent strokes without realizing that they’ve had one. Family members who notice a subtle change in a loved one who has had a silent stroke often chalk it up to age or forgetfulness. “But it’s more than that,” Boffetti says. “There has been damage to the brain.

The brain will shrink a little bit as you age anyway, but this is beyond the normal aging process of the brain.”

And the damage wrought by smaller strokes is lasting.

“Once you’ve lost brain tissue,” Boffetti says, “it doesn’t regrow.”

SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 13

RESEARCH

REDUCE YOUR RISK

Cardiothoracic & Vascular Surgery, based out of Portsmouth Regional Hospital. While a person who has what we think of as a typical stroke might exhibit slurred speech, a halfdrooped face, or paralysis on one side of the body, someone who experiences a silent stroke might appear only to have difficulty finding the right word while speaking, Peeran says, or might experience a tingling or numbness in one hand.

Because silent strokes are subtle, people don’t always realize that they’ve had one. In many instances, they or their loved ones attribute any noticeable symptoms to something else, such as aging or simple forgetfulness.

A silent stroke causes less profound harm to brain tissue than a large, acute stroke does, but the damage it causes is permanent — and a silent stroke can be a harbinger of a more significant stroke to come. “It can be a warning sign that a pending stroke is about to happen,” says Peeran, who stresses that such an omen should be taken very seriously.

Ultimately, the best approach to maintaining brain as well as heart health is prevention. But unfortunately, characteristics that are linked with heart and brain disease are all too common among U.S. residents, Boffetti says, due to the typical American lifestyle. More than a third of American adults are now considered obese, for example, and high blood pressure and diabetes, which often go hand in hand with obesity, make us more likely to develop both heart and brain disease, thereby raising our chances of experiencing earlier onset dementia, Boffetti says, as well as dementia in general.

If you want to minimize your chances of developing heart and brain disease, make smart lifestyle choices that include getting regular exercise, managing blood pressure, cholesterol and blood sugar, and not smoking. Doing so, Peeran says, will help steer you away from factors that “contribute to

14 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

Safeguard the health of your brain and your heart by reducing your chances of developing brain or heart disease in the first place. The following are among the most crucial steps you can take to create a healthful lifestyle for yourself, as recommended by the American Heart Association:

• Get plenty of physical activity.

• Eat a balanced diet that includes enough fruit,

vegetables and whole grains. Choose low-fat dairy, lean protein and fish over foods that contain saturated fats, and avoid “empty calorie” items such as soda, candy and pastries.

• Maintain a proper body weight.

• Do not smoke.

• Manage your blood pressure, blood sugar and cholesterol.

For more information about how to prevent heart disease, see the American Heart Association’s website: www.heart.org/en/healthy-living/healthy-lifestyle/ how-to-help-prevent-heart-disease-at-any-age.

For more detail about vascular dementia, see the Mayo Clinic’s website: www.mayoclinic.org/ diseases-conditions/vascular-dementia/basics/ definition/con-20029330.

cardiovascular disease and poor health all the way around,” and that definitely doesn’t do your brain any good. “Poor cardiac function and cardiac disease,” Peeran says, “can only be detrimental to brain function.” ●

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rockinghamvna.org SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 15

FOCUSED C A R E

THE FUTURE OF

BARIATRICS

BY SOLUTIONHEALTH

Once upon a time there were Blockbuster movie rentals, Nirvana on the radio and a comical group of Friends to laugh with on TV. The 90’s were not only a decade of iconic music and movies, but also innovative technology. For those in the medical world, weight-loss surgery, known as Bariatrics, was on the verge of a major expansion.

A Surgical Breakthrough While bariatric surgery, the process of surgically modifying the stomach and intestines to achieve weight loss, was introduced in 1966, it wasn’t until 1994 that the first laparoscopic gastric bypass was performed. Dr. Robert Catania, director of metabolic and bariatric surgery at Southern New Hampshire Weight Management, describes this moment as transformative and a

critical point in the field. “We went from doing open surgeries to laparoscopic surgeries, which resulted in less pain, faster recovery times and a better quality of life for patients right after surgery.”

Another notable advancement in the field of bariatric surgery was the recognition of the importance of optimizing a patient’s overall health before undertaking surgery. By focusing on improving overall health before surgery, medical professionals aimed to reduce potential complications, enhance postoperative recovery and ensure better long-term outcomes for patients. It emphasized the idea that successful bariatric surgery wasn’t merely a standalone procedure but an integral part of a comprehensive health and wellness transformation.

16 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

Treating the Source, Not just the Symptoms In addition to advancements in surgical techniques, there has been a shift towards comprehensive weight management, emphasizing the benefits of treating obesity with a team approach incorporating nutrition, exercise, behavioral health and medication.

Obesity, we now know, can have profound health implications on multiple organ systems. Rather than solely addressing individual conditions through pulmonologists, cardiologists and endocrinologists, the focus has moved toward helping patients achieve weight loss, which often leads to concurrent improvements in conditions like sleep apnea, diabetes and high blood pressure.

Additionally, the field of medical weight management has evolved with the introduction of new drugs like Wegovy and Ozempic. Along with these changes, there has been a focus on increased collaboration between medical doctors and surgical specialists. This alliance has yielded improved outcomes for patients.

Why Don’t More People Pursue Bariatric Surgery?

For patients with obesity, working with a comprehensive weight loss team may seem like an obvious choice, yet only 1% of eligible patients currently choose to pursue weight loss surgery. Dr. Catania suggests that a significant factor contributing to this low utilization lies in the associated stigma. The American Medical Association (AMA) only officially

recognized obesity as a disease in 2013. According to Dr. Catania, “Prior to that, people didn’t view obesity as a disease; they looked at it as a personal failing or flaw.”

In fact, he believes that treating obesity should be approached with the same mindset as cancer treatment. He shares this perspective with his patients, emphasizing that when diagnosed with cancer, patients aren’t sent home by their medical provider with vague instructions to make lifestyle changes, but rather referred to a team of specialists who focus on treating the disease with all available modalities including medicine and surgery. He underscores the vital importance of recognizing obesity as a treatable medical condition, not a personal failing.

What’s Next?

The future of weight management is a bright one. Dr. Catania says that antiobesity medications and bariatric surgical procedures are continuing to evolve, and that endoscopic weight loss treatments will also become more popular as patients look to avoid major surgery. Although we have come a long way since the era of grunge and Palm Pilots, Dr. Catania hopes for a healthier future. “As a country, we need to be more proactive about our dietary choices and exercise.

There are not enough bariatric surgeons to operate on the millions of patients currently suffering from obesity, let alone the generations behind them. We must embrace a multidisciplinary approach to weight management to allow us all to live healthier, happier and longer lives.” ●

Dr. Robert Catania is fellowship trained in minimally invasive and bariatric surgery from the University of Maryland School of Medicine. Since 2007, he has performed over Southern New Hampshire 1,500 bariatric procedures.

TO LEARN MORE, VISIT GO.SNHHEALTH.ORG/ FINDYOURHEALTHY

Weight Management

A Member of

Helping you Helping you Helping you find your healthy. find your healthy. find your healthy.

Our Patient: Molly Ashooh of Manchester over 120 pounds!

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Our weight loss experts provide a variety of medical and surgical services to Our loss experts provide a self. variety medical andpatients surgical are services to help weight patients find their healthiest No of matter where in their Our weight loss experts provide a self. variety of medical andpatients surgical are services to help patients find their matter where in their weight loss journey, ourhealthiest team is here toNo provide expertise and guidance to help help patients find their self. No matterexpertise where patients are in their weight loss journey, ourhealthiest team is here provide and guidance to help them reach their goals.

Our team alsotooffers free informational sessions on weightreach loss journey, ourOur team is here tooffers provide expertise and guidance to help them their goals. team also free informational sessions on obesity and associated medical conditions. them reach goals. Our teamconditions. also offers free informational sessions on obesity and their associated medical obesity and associated medical conditions.

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FOCUSED C A R E

INNOVATIVE TECHNOLOGY FOR

ADVANCED COMPLEX SURGERY

BY SOLUTIONHEALTH When your treatment plan calls for surgery, you can count on The Elliot’s surgical team for expert, personalized and compassionate care. We are specially trained in performing minimally invasive laparoscopic and robotic-assisted surgeries using leading-edge technology for a range of surgical specialties for both children and adults.

We now offer a newly installed hybrid operating room (OR) that leverages the latest technology. Our hybrid OR is equipped with the innovative ARTIS Pheno system that offers video, monitoring and advanced medical imaging that are fully integrated and collaborative with each other for safer surgical approaches.

The hybrid OR table is optimized for complex procedures by enabling precise patient

positioning, imaging coordination and enhanced surgical workflow. It provides a range of adjustable features to accommodate various procedures and patients. The OR table seamlessly integrates with the ARTIS pheno unique robotic C-arm, which assists with both standard and challenging approaches. The ARTIS pheno system supports several types of imaging, including X-rays and vascular imaging, allowing for immediate and accurate diagnosis.

In critical trauma situations, this technology plays a crucial role, saving valuable time and potentially making a lifesaving difference. With its leading-edge capabilities, the ARTIS pheno empowers our health care professionals to perform precise interventions, resulting in improved patient outcomes in the hybrid OR setting.

18 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

“We are proud to bring the latest surgical technology to our community. As the needs of our patients evolve and grow, we are prepared to meet the variety of complex needs that come our way,” said Elliot Health System Vice President of Surgical Services Beverly Primeau. “This new technology, paired with the skill and expertise of our compassionate team of surgeons, gives our community the very best in timely surgical care.”

Hybrid operating rooms have become the standard of care for many vascular, thoracic and acute care procedures, as well as being flexible enough to utilize for other

surgical specialties. This new hybrid OR expands the range of the services and types of procedures we can provide to our community.

Several procedures, including vascular, thoracic and acute care, have already been completed in the hybrid OR since the first case in June 2023, which was done by Elliot Medical Director of Vascular Surgery Chelsey Lewis, M.D. Dr. Lewis said, “The addition of a hybrid operating room to The Elliot was essential. Hybrid operating rooms minimize operative times, optimize procedural success rates, and improve patient safety and experience. A hybrid operating room not only significantly improves the quality of many surgeries we already do here at The Elliot, but as technology evolves, allows us to continue to stay relevant in the care that we are able to offer in the future.” ●

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NH man in PPP fraud has regrets — up to a point In interview, Joshua Leavitt puts most blame on his partner

BY BOB SANDERS

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But … workforce issues, housing availability and affordability, inflation and the spillover effects of national and inter-

Before Joshua Leavitt started his 28-month sentence in federal prison in Lewisburg, Pa., for fraudulently obtaining pandemic relief funds, the self-described serial entrepreneur had a few things to say.

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FOCUSED C A R E Illustration of respiratory gated lung stereotactic body radiation therapy.

THE FUTURE OF

RADIATION

ONCOLOGY

BY SU METCALFE, M.D. Since engineers assembled the first primitive external beam radiotherapy devices in the early 20th century, radiotherapy techniques have become safer and more effective each year.

Integration of increasingly sophisticated computers and imaging systems have enabled continuous refinements in the accuracy and precision of the radiation’s delivery. Treatment of tumors without having to cut into or damage healthy tissue—radiotherapy’s original promise—is within reach. These innovations have produced radical improvements in the prognoses of those diagnosed with nearly every type of cancer.

Rates of lasting remission are increasing, and many once-fatal cancers have become treatable chronic conditions.

These techniques are the stuff of science fiction. Modern radiation delivery systems adapt to the natural motions of the human body and more deftly focus radiation to further reduce collateral tissue damage.

Patients can be treated with fewer visits and receive a higher dose of radiation, yielding better treatment outcomes. Highly trained treatment teams use the most up-to-date technology to deliver these cutting-edge treatments.

Respiratory gating enables tracking and treating of tumors in real time as they move with

20 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

the patient’s breathing. This simple idea requires a complex choreography of teamwork and technology. Tumors located next to the diaphragm, such as those of the liver or lung, rise and fall as the patient breathes. After a four-dimensional planning CT scan is performed, radiation can be synchronized to turn on and off in time with the patient’s breath as the tumor moves into and out of position.

Deep Inspiration Breath Hold (DIBH) further addresses the challenge of delivering radiation to moving targets. With DIBH, treatment teams coach patients to inhale deeply and hold their breath during treatment, creating not only a distance between tumors and adjacent organs, but also a pause, in the organ motion.

Liver radiosurgery harnesses

the therapeutic advantages of Respiratory Gating and DIBH. In standard treatment of the liver, the radiation dose spreads outside of the target to the surrounding healthy liver tissue.

When using these motion management techniques in conjunction with stereotactic radiosurgery, a liver tumor can be precisely treated while it is moving during the respiratory cycle or, held in place during breath hold, thereby minimizing liver damage. The treatment outcomes from these non-invasive outpatient radiosurgeries are comparable to those of traditional surgery while avoiding the effects of anesthesia and downtime of such procedures.

Tattoo-less Breast Radiation Therapy forgoes, for many patients, the permanent tattoos once used to mark the treatment area and provide consistent reference points used to maintain alignment across daily treatments. Instead, Surface Guided Radiation Therapy (SGRT) ensures repeated precision with 3D cameras that capture real-time, millimeter-accurate surface data.

Over the next 20 years, the technological breakthroughs that have changed the nature of radiotherapy will continue to advance. In 2020, 18 million people were diagnosed with cancer. By 2040, that number will grow to nearly 30 million. With the innovations that lie ahead, the Payson Center for Cancer Care at Concord Hospital will continue striving for a singular goal: eliminating mortality associated with cancer. ●

Su Metcalfe, M.D., is a radiation oncologist at the Concord Hospital Payson Center for Cancer Care. She is board certified by the American Board of Radiology.

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FR ANKLIN

WA L K- I N & U R G E N T C A R E Access Walk-In Injury Clinic

Located at Access Sports Medicine & Orthopaedics 1 Hampton Rd., Exeter (603) 775-7750 / accesssportsmed.com

Barrington Urgent Care

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

Cheshire Medical Center Walk-In Clinic The Center at Colony Mill

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

Catholic Medical Center 5 Washington Pl., Bedford (603) 314-4567 catholicmedicalcenter.org

ClearChoiceMD 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

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 convenientmd.com

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 corephysicians.org

Elliot at River’s Edge

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

Elliot Urgent Care at Londonderry 40 Buttrick Rd., Londonderry (603) 552-1550 elliothospital.org

Elliot Weekend After Hours Clinic

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

ccmdcenters.com

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 concentra.com

Concord Hospital Walk-In Urgent Care 60 Commercial St., Concord (603) 230-1200 concordhospital.org

Occupational Health Services Convenience Care Hillside Medical Park 14 Maple St., Lot C, Gilford (603) 527-2896 / lrgh.org

ConvenientMD 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

22 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

Exeter Hospital: Fast Track

Division of the Emergency Department (ED) 5 Alumni Dr., Exeter (603) 580-6668 exeterhospital.com

ExpressMED Urgent Care 1 Highlander Way, Manchester (603) 625-2622 35 Kosciuszko St., Manchester (603) 627-5053 159 N. Broadway, Salem (603) 898-0961 expressmednh.com

Health Stop

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

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 immediatecareofsnh.org

Laconia Clinic Convenience Care 724 Main St., Laconia (603) 527-2896 lrgh.org

St. Joseph Urgent Care Milford 444 Nashua St., Milford (603) 673-5623 stjosephhospital.com

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 cvs.com/minuteclinic/clinics/New-Hampshire

Newport Health Center 11 John Stark Hwy., Newport (603) 863-4100 newlondonhospital.org

Parkland Urgent Care at Salem 31 Stiles Rd., Salem (603) 890-2727 parklandmedicalcenter.com

Saco River Medical Group 7 Greenwood Ave., Conway (603) 447-3500 15 Rte. 302, Glen (603) 383-3005 sacodocs.com

Seacoast RediCare

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

Walk-In Care at Memorial Hospital 3073 White Mountain Hwy. North Conway (603) 356-5461 memorialhospitalnh.org

Wentworth-Douglass Express Care 701 Central Ave., Dover (603) 609-6700 65 Calef Hwy., Lee (603) 868-8507 wdhospital.com/express

White Mountain Medical Center 2531 White Mountain Hwy. Sanbornville (603) 522-0186 frisbiehospital.com/walk-in-care

A M B U L AT O R Y S U R G E R Y G R O U P S AVH Surgical Associates 7 Page Hill Rd., Berlin (603) 752-2300 / avhnh.org

Interventional Spine Medicine

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

Bedford Ambulatory Surgical Center

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

Concord Ambulatory Surgery Center

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

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 concordeyecare.com

The Cottage Hospital Day Surgery Center

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

Elliot Health System and Dartmouth Hitchcock 1-Day Surgery

Laconia Clinic Ambulatory Surgical Center 724 Main St., Laconia (603) 524-5151 / laconiaclinic.com

Nashua Ambulatory Surgical Center

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

Nashua Eye Associates

Skyhaven Surgery Center 13 Health Care Dr., Rochester (603) 509-9161 frisbiehospital.com/locations/ skyhaven-surgical-center

Stratham Ambulatory Surgery Care

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

Surgery Center of Greater Nashua

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

Wentworth Surgery Center, LLC

6 Works Way, Somersworth (603) 285-9288 wentworthsurgerycenter.com

5 Coliseum Ave., Nashua / (603) 882-9800 555 Nashua St., Milford / (603) 672-8800 30 Lowell Rd., Hudson / (603) 598-6400 nashuaeye.com

NH Eye SurgiCenter

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

Orchard Surgical Center 16 Keewaydin Dr., Salem (603) 401-6466 orchardsurgical.com

Concord Orthopaedics – Orthopaedic Surgery Center 264 Pleasant St., Concord 14 Tsienneto Rd., Ste. 100, Derry (603) 224-3368 / concordortho.com

Portsmouth Regional Ambulatory Surgery Center

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

Elliot at River’s Edge

185 Queen City Ave., Manchester (603) 663-5900 dartmouth-hitchcock.org

We place our client’s interests at the center of everything we do

Delivering Practical Counsel, Exceptional Service and Legal Innovation Since 1852 New Hampshire | Massachusetts | Maine | Vermont | Rhode Island | Connecticut

Sulloway.com | Info@Sulloway.com | 603-223-2800

SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 23

FOCUSED C A R E

John, At Home By Hunt member, 2020

PLAN WELL,

LIVE WELL!

BY KRISTIN MATTHESON AND KELLEY KENNEDY

We spend our lives planning for our education, buying a home, raising a family, growing our careers and funding our retirement. However, we often forget to plan for the care and assistance we may need during our golden years. It is important to know your options and secure your future with a Life Plan designed to fit your lifestyle.

What Is Continuing Care at Home?

Continuing Care Retirement Communities (CCRCs), sometimes referred to as Life Plan Communities, are becoming a popular retirement choice as people plan for their long-term care needs.

These Life Plan Communities offer independent living options

focusing on active healthy living with the security of on-site health care services should they be needed in the future. This means you will receive the care you need if and when your health changes. However, what if you had the option to receive this same concept of care without having to move from the home you love? Meet Continuing Care at Home. These programs offer a Continuing Care Life Plan without having to move. Enjoy the security of knowing you will receive services in your home when you need them, without the struggle of finding reputable and dependable care on your own. With the growing expense of health care, you will have the assurance of predictable costs

24 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

for your future long-term care needs, and guidance navigating the complex health care system.

Although the concept of Continuing Care at Home is not new to the U.S., there is only one program like this offered in New Hampshire. Welcome to At Home

By Hunt.

How Does At Home By Hunt Work?

At Home By Hunt is a membership program affiliated with Silverstone Living, a nonprofit organization with two Life Plan Communities in Nashua (Hunt Community and The Huntington at Nashua). As a member of At Home By Hunt, you can participate in the social and wellness groups offered at both of our communities, as well as care coordination and preventative care you may need within your own home. A

one-time membership fee, and predictable monthly service fees, protect your assets for when you require more support and assistance. You will never be alone in your journey; a Life Plan Coordinator is with you every step of the way.

Peace of Mind with a Personal Touch A Life Plan Coordinator is a health professional and advocate who will develop a trusting rapport with you now and support your choices as you age.

Finding the right services and care can be challenging, often adding stress for you and your family, while you are coping with a change in health condition. You and your family will have peace of mind knowing that you are part of a program that is invested in your overall safety, health and well-being. ●

Kristin Mattheson is director of sales and marketing for Silverstone Living, and Kelley Kennedy is executive director for At Home By Hunt.

TO LEARN MORE, VISIT SILVERSTONELIVING.ORG OR CALL (603) 821-1200.

Southern New Hampshire’s Premier Senior Living Communities

Silverstone Senior Living Communities have you covered!

Exclusive apartment homes and private cottages for independent and active retirement living in Nashua.

Premium apartment homes in downtown Nashua for independent and active retirement living.

Skilled rehabilitation, memory care, assisted living, and nursing care in the picturesque seacoast town of Rye, NH.

A long-term, continuing care program for those who choose to age in place in the home they love.

Join Us For An Event Visit our website today and register for an upcoming informational event.

Request A Visit Book a consultation with us.

We offer both Zoom and in-person meetings.

603-821-1200 | info@silverstoneliving.org Silverstoneliving.org

ELDER CARE SERVICES

SENIOR RESIDENCES BY REGION SEACOAST Harmony Homes Assisted Living

40 Briggs Way, Durham, (603) 292-5175 1 Stagecoach Rd., Durham (603) 292-6087 harmonyhomesnh.com

Langdon Place of Dover

60 Middle Rd., Dover / (603) 743-4110 genesishcc.com

Maple Suites

30 Holiday Dr., Dover (603) 617-4413 / holidaytouch.com

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

RiverWoods at Exeter

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

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

Webster at Rye

795 Washington Rd., Rye (603) 964-8144 / websteratrye.com

MERRIMACK VALLEY All American Assisted Living

1 Button Dr., Londonderry (603) 537-9898 / allamericanal.com

Arbors of Bedford

70 Hawthorne Dr., Bedford (603) 647-9300 benchmarkseniorliving.com

Bedford Falls

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

Birch Heights

7 Kendall Pond Rd., Derry (603) 505-4398 / birchheights.com

The Birches at Concord 300 Pleasant St., Concord (603) 369-4417 benchmarkseniorliving.com

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

Hunt Community

10 Allds St., Nashua (603) 882-6511 / huntcommunity.org

Huntington at Nashua

55 Kent Ln., Nashua (800) 298-6608 thehuntingtonatnashua.org

Langdon Place of Nashua

Maplewood Assisted Living

201 River Rd., Westmoreland (603) 399-4912 / co.cheshire.nh.us

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

Summerhill Assisted Living

183 Old Dublin Rd., Peterborough (603) 924-6238 / summerhillal.com

DARTMOUTH/ LAKE SUNAPEE Harvest Hill

319 East Dunstable Rd., Nashua (603) 888-7878 sunbridgehealthcare.com

125 Mascoma St., #23, Lebanon (603) 448-7474 / alicepeckday.org

Nashua Crossings

67 Cummings Rd., Hanover (603) 643-8900 / kah.kendal.org

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

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

Kendal at Hanover

Summercrest Senior Living

169 Summer St., Newport (603) 863-8181 / summercrest.net

Sunapee Cove Independent and Assisted Living

Presidential Oaks

1250 Route 11, Sunapee (603) 763-0566 / sunapeecove.com

The Residence at Salem Woods

32 Buck Rd., Hanover (603) 643-7290 wheelockterrace.com

RiverWoods at Manchester

356 Main St., New London (603) 526-2300 woodcrestvillage.com

200 Pleasant St., Concord (800) 678-1333 presidentialoaks.org 6 Sally Sweets Way, Salem (603) 890-0580 residencesalemwoods.com

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

Windham Terrace

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

MONADNOCK REGION Bentley Commons

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

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

The Courville at Bedford

40 Route 101, Bedford / (603) 472-2000 thecourvilles.com

The Courville at Manchester

44 West Webster St., Manchester (603) 647-5900 / thecourvilles.com

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

Wheelock Terrace

Woodcrest Village LLC

LAKES REGION Golden View Health Care Center 19 NH Route 104, Meredith (603) 279-8111 / goldenview.org

The Golden Crest

29 Baldwin St., Franklin (603) 934-6742 thegoldencrestnh.com

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

WHITE MOUNTAINS/ GREAT NORTH WOODS Genesis Lafayette Center 93 Main St., Franconia (603) 823-5502 genesishcc.com

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

Morrison Nursing and Rehabilitation Care 6 Terrace St., Whitefield (603) 837-2541 morrisonnh.org

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

ADULT DAY CARE CENTERS All Generations Adult Day Program

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

Castle Center for Adult Group Day Care

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

Easterseals New Hampshire

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

Gateways Adult Day Service Program

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

Huggins Hospital — Adult Day Care

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

Kearsarge Good Day Respite Program

82 King Hill Rd., New London (603) 526-4077 kcpcnlnh.com/missions-good-dayrespite.html

Monadnock Adult Care Center 22 North St., Jaffrey (603) 532-2428 / mfs.org

The Courville at Nashua

Sarahcare Adult Day Services

Granite Ledges of Concord

Silverthorne Adult Day Care Center

22 Hunt St., Nashua (603) 889-5450 thecourvilles.com

151 Langley Pkwy., Concord (603) 224-0777 / genesishcc.com

Greystone Farms

242 Main St., Salem (603) 898-5393 benchmarkseniorliving.com

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

26 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

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

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

The Homemakers Health Services

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

Upper Valley Good Day Respite Program

18 School St., Lebanon (603) 526-4077 lakesunapeevna.org/services/ upper_valley_respite

FOCUSED C A R E find their way home, UNDERSTANDING can’t making it unsafe for them to

DEMENTIA

NOVEMBER IS NATIONAL ALZHEIMER’S DISE A SE AWARENESS MONTH This month honors those who are living with Alzheimer’s and promotes awareness and education. With more than 6 million Americans living with Alzheimer’s — this number is projected to rise to nearly 13 million by 2050 — it is important to recognize common early symptoms: • Memory Loss: Short-term memory loss is very common for people in the beginning stages of Alzheimer’s.

• Difficulty with Familiar Tasks: These could include steps involved in following a recipe, making a phone call or playing a favorite card game.

• Language Problems: They may forget simple words or be unable to use the correct word when speaking or writing.

• Confusion with Time or Place: People with Alzheimer’s disease often don’t know what day or month it is. They often don’t know where they are and

drive or even walk around their own neighborhood alone.

• Decreased or Poor Judgment: They may dress inappropriately, such as wearing a wool sweater on a hot day or undressing for cold weather.

Personal hygiene may suffer.

They might make poor decisions about money or fall victim to scams.

• Misplacing Things: Occasionally forgetting where you put your cellphone or your keys happens to everyone, but people with Alzheimer’s often put items in inappropriate places, such as storing the coffee pot in the freezer.

• Mood & Personality Changes: Individuals with Alzheimer’s disease may have rapid mood swings for no apparent reason, such as being calm one moment and suddenly bursting into tears or flying into a rage. Or the person who is usually sunny and outgoing may suddenly become withdrawn, anxious and suspicious.

If you notice these early warning signs in a loved one, make an appointment with a health care provider to discuss your concerns. Early diagnosis allows time for planning and building a support network to help as the symptoms progress.

Another helpful resource is alz.org. ●

FOR MORE INFORMATION, VISIT THEMORRISONCOMMUNITIES.ORG OR CALL (603) 837-3640.

#LivingTheDream Laughter. Adventure. Purpose.

Confidence. Joy. Ease.

The Summit by Morrison is a vibrant independent senior living community in the heart of the beautiful White Mountains in New Hampshire. With spacious cottages, modern apartments, and world-class amenities, you’ll feel at ease every day. Fall in love with a lifestyle that has you living your best life.

Schedule Your Tour!

themorrisoncommunities.org 56 Summit Drive Whitefield NH, 03598 info@themorrisoncommunities.org 603-837-3500 SMART HEALTH NH 2024 | NEW HAMPSHIRE MAGAZINE 27

FOCUSED C A R E

WHY AM I HAVING

HIP PAIN?

BY PETER EYVAZZADEH, M.D. I see some patients walk into my office complaining of new onset hip pain on the side of their hip that just came out of the blue, without any known injury that they can recall. Oftentimes, the pain worsens with sleeping directly on the side of that hip, walking, going up and down stairs as well as biking. They may have tried some anti-inflammatory medication that takes the edge off, but does not go away completely over time like tendinitis problems can.

These hip symptoms can come from what we know as trochanteric bursitis. The trochanter (aka greater trochanter) is the bony landmark/prominence along the side of the ball side of the hip joint where the abductor tendons insert. There is a fluid-filled sac also known as a “bursa,” that lines

those abductor tendons as they insert on to the greater trochanter. When that bursa becomes inflamed, it becomes bursitis — thus, patients develop trochanteric bursitis, which causes these symptoms that can be long standing. Sometimes chronic issues can show up on X-rays where you can see calcifications in the area of the bursa.

What is the cause of trochanteric bursitis of the hip? Sometimes it can be traumatic where patients have a history of falling directly on to the hip causing the inflammation, but sometimes it can just be idiopathic — meaning no good reason at all. Other times, it can be a secondary result from something else going on around the hip or pelvis such as an abductor tear of the hip or even the lumbar back with a

28 NEW HAMPSHIRE MAGAZINE | SMART HEALTH NH 2024

pinched nerve that can cause pain around the bursa.

What is the treatment? Vast majority of patients with isolated bursitis tend to recover with non-operative treatment including one-to-two rounds of cortisone injections into the bursa itself in combination with formal physical therapy to work on hip/abductor strengthening. Patients that have ongoing symptoms despite these treatments who also have ongoing weakness of the abductors, may have ongoing issues due to a tear of the abductor tendons. The abductor

tendons of the hip function the same as the rotator cuff tendons of the shoulder in that they help stabilize the joint. For the hip, the abductor tendons help with walking and other daily repetitive activities. Patients with tears can sometimes feel that their hip is not stable or cannot trust it with overlying bursitis.

If there is a suspected abductor tendon tear, typically we would evaluate this with an MRI to take a look at the soft tissues around the hip that you cannot see on an X-ray, and determine whether there is a partial vs. full thickness tear of the abductor tendons. Depending on MRI findings, some patients proceed with hip surgery, outpatient same-day surgery, where we clean up the bursa and repair the torn tendons back down to the bone with heavy braided suture and biocompatible suture anchors, about the equivalent of shoulder rotator cuff surgery. After the surgery, patients are typically on crutches afterwards for the first 4-6 weeks, but get started with physical therapy in the meantime to recover their hip range-of-motion and eventual strengthening. They can expect about a 4-month recovery on average to get back to full activity as tolerated. ●

Peter M. Eyvazzadeh, M.D., is a fellowship-trained orthopaedic surgeon. He is board certified by the American Board of Orthopaedic Surgery. He subspecializes in shoulder, hip, knee and sports medicine.

TO MAKE AN APPOINTMENT, VISIT NHOC.COM OR CALL (603) 883-0091.

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