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FALL 2015

Health LINES Penn Highlands Healthcare

Working together for a healthy community.

Don’t miss an issue! Subscribe now to this Digital Magazine. See Page 2





Cover Story Low-Dose CT Saves Lives


Home Care Services

Quality 7 8 PHH Opens Two New Community Health Buildings 10 New Faces 12 Yearly Mammograms ... Are They Necessary? 13 Can’t You Just Hold It? ShortScripts 14 16 Advice From A Doctor

Welcome to Penn Highlands

Don’t miss an issue! Subscribe now to this Digital Magazine.

HealthLines gives you the most up-todate news about services at the four Penn Highlands hospitals and what is available to help you lead a healthier life.

The Penn Highlands Healthcare system covers eight counties in western Pennsylvania with 75 miles from east to west. We hope this is a tool that will keep you informed about what is happening in healthcare throughout your region. This FREE magazine will always be available: • On our website, www.phhealthcare.org/magazine. • By e-subscription. Filling out the online form at www. phhealthcare.org/getmagazine; you will recieve an e-mail directly to you as soon as it hits the newsstands. • In the lobbies, waiting rooms and offices throughout the Penn Highlands Healthcare system, you can pick up a hard copy of this magazine. The magazines are also available at the DuBois Mall Community Booth.

HealthLines is a publication of Penn Highlands Healthcare. It is produced quarterly by the Marketing Team of Penn Highlands Healthcare which represents the four hospitals of the Penn Highlands system – Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk.

If you don’t see the magazine in your visits to our facilities, our magazine will also be available, for those who request it, via U.S. Mail. To the left of this column is a list of names and phone numbers of our team. Call for a copy to be mailed to you as they come off the presses. Share your name, address and telephone number if you leave a message.

The HealthLines magazine will always be avaialble on our website at www.phhealthcare.org/magazine. If you wish to subscribe to HealthLines, sign up at phhealthcare.org/getmagazine. For more information please contact the Marketing Team at HealthLines@phhealthcare.org or call on weekdays from 8:00 a.m. to 4:00 p.m.

Next time you’re online

Printed copies may be found in the waiting rooms at Penn Highlands Healthcare facilities throughout the eight-county region. You may pick one up at anytime if you prefer.

Be sure to visit www.phhealthcare.org also check us out on

The information in this magazine does not take the place of health advice given to you by your healthcare provider. Always call 911 for any emergency. The Penn Highlands Healthcare HealthLines Team Mary Jo Yebernetsky, Writer/Editor, 814-375-3495 Mary Jo Herzing, Graphic Design Specialist, 814-375-6539 John Brennan, Marketing/PR Director, 814-375-3494 Amy Duke, Marketing/PR Director, 814-768-2827 Karen Hazlett, Marketing/PR Specialist, 814-788-8532 Brian Musser, Community/Physician Outreach Specialist, 814-375-6508 Lori Rancik, RN, The Women’s Health Center, 814-371-9666

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Penn Highlands now has My eHealth Portals available for all patients at www.phhealthcare.org/myehealthportal. Get your username and password at your next visit with your health provider.

Home Care Services When you think of Penn Highlands Healthcare, it may automatically bring to mind the state-of-the-art hospitals or the convenient physician offices that are located throughout our region. But did you know that Penn Highlands Healthcare has four award-winning home care agencies that provide all types of services right in the comfort of your home? For thousands of residents across the Penn Highlands Healthcare region, the most important healthcare provider is a member of our home health team.

OUR HEALTHCARE TEAM Our healthcare team provides specialized care for patients of all ages, newborn to adult. The team is comprised of: • Registered Nurses • Licensed Practical Nurses • Physical, Occupational and SpeechLanguage Therapists • Medical Social Workers • Home Health Aides • Registered Dietetic Technicians All professional staff are licensed or certified in their area of specialty. All staff members are regularly evaluated and attend ongoing continuing education programs to maintain high standards of clinical excellence.

• • • • • • • • •

Pediatric Care Maternal Child Care Diabetic Disease Management Congestive Heart Failure Care Chronic Obstructive Pulmonary Disease Management Disease and Pain Management Social Work Assessment and Counseling Nutritional Counseling Telehealth Monitoring

PAYMENT Home health services are covered by Medicare, Medicaid and most commercial insurance companies.

Ask your healthcare provider to refer you to the home health agency that serves your location, or feel free to call any of our home health offices for more information.

Penn Highlands Healthcare Home Health Services Penn Highlands Brookville-New Bethlehem Home Health Care 240 Allegheny Boulevard Suite M Brookville, PA 15825 Phone 814-849-3739 Penn Highlands Clearfield Home Health and Hospice 438 W. Front Street Clearfield, PA 16830 Phone 800-281-8000 Penn Highlands DuBois Home Health and Hospice 100 Hospital Avenue PO Box 447 DuBois, PA 15801 Phone 814-375-3300 Community Nurses Home Health and Hospice, Inc. 757 Johnsonburg Road Suite 200 St. Marys, PA 15857 Phone 800-841-9397

SERVICES We offer a complete range of skilled professional services on a short-term basis for patients limited to their home because of an injury, illness, surgery or chronic health condition. Services that can be provided at home include: • Skilled Nursing Care • Physical, Occupational and SpeechLanguage Therapy • Wound and Ostomy Care • Foley Catheter Management • Chronic Disease Management • Medication Management • Home Infusion Therapy (PICC Line, Central Line, Infusa-port and TPN Care)

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screenings and treatments,” Dr. Bansal said. Susan Mitchell, clinical director and nurse practitioner with The Lung Center, said screenings are important because lung cancer is insidious. Usually, there are few early symptoms. Nearly half of the people diagnosed when symptomatic have a late stage of the disease.


“So someone can have it and never know it. And even when symptoms do show up, some symptoms of lung cancer may not seem related to the lungs or breathing,” she said.

challenged by lung cancer. The keys to taking control of this horrible disease are prevention and early detection,” Dr. Koch said.

As a primary care physician, Dr. Daniel Huckestein is an advocate for preventive health screenings. “Keeping my patients in good health is my top priority. Routine health screenings can provide early detection of disease or condition when a person is not currently experiencing symptoms. In most cases, the earlier a problem is detected, the more effective the treatment will be and the chances for a successful outcome,” he said. So when Penn Highlands Healthcare began offering low-dose CT scan screenings for lung cancer, he didn’t hesitate to share the news with his patients. “The survival rate from lung cancer is better when caught early, so I counsel patients about the importance of this screening,” said Dr. Huckestein, whose office is located on the Penn Highlands Clearfield campus. Another Penn Highlands physician that is pleased with the addition of this powerful screening tool is Dr. Steven Koch an obstetrician/gynecologist based at Penn Highlands Elk. “Unfortunately, nearly all of us have had friends or family whose lives have been

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He added that it takes tremendous strength to overcome one of the major risk factors – chemical dependency on nicotine – and the courage to acknowledge the risks of lung cancer, especially for those who are smokers or have smoked. “It is not easy or comfortable to talk about these risks, but we are all in this together. What happens to one of us affects everyone around us. Long-term and heavy smokers should have a conversation with their physician first about the health benefits of quitting, and then discuss how low-dose CT screening could save their lives,” he said. Since the screening program’s implementation at Penn Highlands Healthcare in 2014, more than 600 referrals have been made – in line with the numbers projected by Dr. Sandeep Bansal, clinical assistant professor, Temple University School of Medicine and medical director at The Lung Center of Penn Highlands DuBois, and his team who initiated the lung cancer screening program.

The low-dose radiation CT scan is available at all four Penn Highlands Healthcare hospitals: Brookville, Clearfield, DuBois and Elk. It is noninvasive and involves no prep or fasting beforehand. There is no IV or dye used, and the whole process takes about 15-20 minutes. Any spot or nodule greater than 4 millimeters is a positive finding. A number of people will have nodules or findings, but only 3-4 percent of that population will have lung cancer. The majority of the nodules are benign, or non-cancerous. “Once a nodule is found, a team of doctors will review the findings – the team includes pathologists from the lab, oncologists, radiologists, medical doctors, pulmonologists and thoracic surgeons. For the difficult cases, this multi-disciplinary team helps to decide if these findings should be followed with a watchful waiting approach or if a biopsy should be pursued,” Dr. Bansal said. For those who have ever smoked, the criteria for a low-dose CT scan may depend upon your insurance and your “pack

Make an appointment for a Low Dose CT Scan

“The response from our physicians has been tremendous, and I applaud them for their commitment to their patients and to saving lives. Lung cancer is the number one cancer killer in the United States and is the third most common cancer in our region, so it’s vitally important to ensure those at risk have access to the latest diagnostic

by calling your provider or 814-375-3770.

years.” A “pack year” is a year that a person smoked 20 cigarettes, or one pack, every day for a year. For example, smoking one pack per day for 5 years equals “5 pack years.” Smoking two packs a day for one year is two pack years, and for 10 years of smoking two packs per day is 20 pack years. Medicare, Blue Cross/Blue Shield and UPMC insurances require that patients are between 55-77 years old and smoked for 30 pack years before the test is covered by insurance. Other insurances vary based on age and pack years. Some even go below age 55. Penn Highland Healthcare offers a self-pay option to those whose insurance companies will not pay for this screening, who are ages 55-80 years old and have smoked for 30 pack years. The cost is $99. The Lung Center offers a team of three highly trained nurse navigators – Candace Cole, RN, Jessica Gerst, LPN, and Morgan Ludwig, LPN – to guide patients through the process. When referrals are made for lung cancer screening, either by physicians or patients themselves, they will be contacted by Candace. She will interview each patient to determine if they meet the necessary criteria for screening. She follows up with each patient after their scan to discuss these results and navigate them toward appropriate care. Candace also offers smoking cessation tips, tools and strategies to the participants. Jessica and Morgan offer navigational support post screening through The Lung Center. They facilitate appointments with medical and radiation oncology as well as cardiothoracic surgery if needed, ensuring that patients receive the highest level of care possible. To make an appointment for a low dose CT scan for lung cancer screening, please speak with your primary care physician or call The Lung Center at 814-375-3770 from 9:00 a.m. to 3:00 p.m. Monday through Friday.

LUNG CANCER CAN BE SILENT Carl Duttry of DuBois wasn’t thinking about cancer. He was at the DuBois Senior Center listening to Candace Cole, a nurse at Hahne Regional Cancer Center and The Lung Center, and waiting for his lunch. Carl and his wife, Ruth, go to the center once in a while. The nurse told anyone who smoked a lot that they should get a low-dose CT scan to check their lungs for cancer. This sparked something in Carl’s mind. When Dr. Gregory Austin’s office from Penn Highlands DuBois called about something else, he asked them about it and if his insurance would pay for it. If so, he would get it done. “They called me and said that they got the authorization number (from the insurance) and made the appointment,” Carl, age 76, said. “I did smoke a lot,” he said. “I drove truck for 44 years, but I haven’t smoked for 15-16 years.” “They took the scan, and they found a spot on my lung,” Carl said. “I had a chest x-ray a month before that – that didn’t show it.” The next step was to have the spot biopsied by Dr. Sandeep Bansal, pulmonologist and medical director of The Lung Center. “It was cancer,” Carl said. During the procedure, his lung collapsed and he was in the hospital for several days. After that was resolved, Dr. Bansal shared that there is only a little spot, and it could be removed. Dr. Hadi Hakki , cardio-thoracic surgeon with The Heart Center of Penn Highlands Healthcare, operated in mid-July. The upper lobe of the left lung was removed, and he spent two days in the Cardiovascular Intensive Care Unit on the fifth floor of Penn Highlands DuBois to recover. Afterwards, Carl met with Dr. Bansal. “He was smiling and shook my hand,” Carl said. “’You don’t have any more cancer,’ he said. ‘ You don’t

Carl Duttry of DuBois with his wife, Ruth, enjoy an afternoon on the porch. have to take any more treatments because we got it.” “I just thank God that I went and got that scan,” Carl said. More than 400 scans have been taken, and it has detected only 6-8 cancers in patients. Carl said he was one of two with stage one lung cancer. Did Carl think he might ever have lung cancer? “I never thought about it before,” Carl said. It was hearing about the low-dose program that got him thinking. Having quit smoking, “it doesn’t mean you can’t have it,” he said. “My advice to someone who did smoke: you should have a low-dose CT scan.” Carl had no symptoms or any signs that he had cancer. A regular at the DuBois Area YMCA, he and his wife, Ruth, exercised with the Silver Sneakers program, swam and used the treadmill. He was in good health. “It’s scary. It took a lot to get over it (emotionally),” Carl said of hearing his cancer diagnosis. He is hoping to get back into his routine at the YMCA. Dr. Bansal has him using oxygen at night and before he walks, such as before a trip to the store. “I watch it pretty close. I’m doing a lot better,” he said.

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SCREENING IS PROACTIVE Elizabeth Mattox of Ridgway went for a regular check-up at Dr. Steven Koch’s office in St. Marys. She was a bit surprised that he, an obstetrician and gynecologist, suggested that she have a lung screening test performed. But Elizabeth went. She received a low-dose CT scan at Penn Highlands Elk in September. “I was nervous about what they might find,” she said. She had already had some other medical problems and was hoping nothing else was wrong. “Dr. Koch is a really good doctor,” she said. “I had been a smoker for about 20 some years. I tried quitting, but I started up again, especially when something comes up and stresses you out. Dr. Koch is pretty thorough. He wanted me to be checked out. I thought ‘What the heck,’ and took a chance.” The CT was simple. “They put me through the doughnut hole,” she laughed referring to the CT’s round opening that a person goes through for the image to be made. She had been in bigger CTs and through more tests for her heart previously, so this wasn’t scary. “They found two nodules (in my lung),” Elizabeth, age 63, said. “But they are too small to even worry about them.” Elizabeth didn’t need any further tests or treatments for her nodules. She will have CT scans done every year to be sure they don’t grow. That was good news to her.

Elizabeth Mattox of Ridgway.

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A new tool was rolled out by Medicare a few years ago. If you are on Medicare, it is a good one to take advantage of. It’s the Annual Wellness Visit, and Penn Highlands Healthcare hopes that you ask about it the next time you visit your primary care physician. The Annual Wellness Visit is a free benefit of Medicare, and it is often called a personal prevention plan, according to Michelle Smith, assistant vice president for Physician Network which oversees physician offices.

Quality at Penn Highlands Healthcare isn’t just about what we do. It is also about what you do with us.

The Annual Wellness Visit, or AWV, is not a physical exam nor is it an annual physical. It can be done in conjunction with those or a regular appointment, but the AWV is more of a check list, and it is done with pen and paper. The AWV is a review of risks. It asks about things that can lead to problems down the road. It looks at a person’s medical history so nothing is missed from a time when a person saw a different doctor. For example, a person may have had his appendix out while stationed at an Army base in 1959. That information may never be on current medical records if never shared previously, and perhaps, it may be needed some day. The AWV also looks at family history. For example, if a medical event occurred in a parent’s or sibling’s life, such as stroke, then looking for ways to decrease a patient’s risk for stroke are stressed. Then, there are other risk factors to look at. Is the person depressed? Is he a fall risk? Is she hearing impaired? Is the person eating a healthy diet? There is a check-list of cancer screenings and vaccinations to review, and an area to discuss over-the-counter medications. This helps when people get vaccinations outside of the physician offices, such as those provided by pharmacies, and for those who may not think about their over-the-counter medications not mixing well with a prescription one. This risk assessment tool allows providers to create a personal prevention plan just for that patient. The information does not leave that person’s file, and it is not shared with anyone outside of the doctor, according to Megan Devlin, director of Quality Programs, said.

Melissa Hill of Penn Highlands Internal Medicine reviews health history information with Marie Russell of DuBois.

Why do this? “It’s easier to take care of a healthier patient than a sick patient,” Michelle said. “It helps people to live a longer, healthier and good life.”

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Penn Highlands Healthcare Opens Two New Community Health Buildings

DuBois Community Medical Building

DuBois Community Medical Building Healthcare is changing across the country, and Penn Highlands Healthcare is changing to meet those demands. There has been a rapid transformation of the traditional reimbursement for services to rewarding healthcare providers for reducing inpatient admissions, improving quality outcomes and focusing on prevention and outpatient services as a way to reduce overall health care costs. Two new buildings in our region show that Penn Highlands Healthcare is ready for that change by bringing more or expanding outpatient services in communities. “We’re in this for the long-haul,” Raymond A. Graeca, CEO of Penn Highlands Healthcare, said. “A strategic plan of the healthcare system showed specific needs, and we are meeting those needs as we grow services throughout the region.” To that point, Penn Highlands Healthcare invested in two new multi-million dollar buildings. In DuBois, the new DuBois Community Medical Building at 621 S. Main Street., opened its doors in August.

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The first to occupy the building was the office of Dr. Angelo Illuzzi, pulmonologist and sleep medicine physician. He oversees the Sleep Disorders Lab of Penn Highlands

DuBois which was moved next to his office on the second floor. Drs. Albert Abrams and Dr. V. Kim Newsome, rheumatologists, moved their practice to the second floor, as well. They see patients with diseases that affect the joints, muscles and bones. Penn Highlands Infusion Services relocated to the Penn Highlands Rheumatology area as many rheumatology patients use this service to receive medications via IVs. On the first floor is the newest QCare for our area. QCares are urgent care centers for minor aches, pains and problems, such as earaches, bladder infections, tick bites and sprains. It shares space with The Fracture 3,636 JOBS ClinicIN for THE patients who have already REGION visited the Emergency Department with an orthopedic emergency and now need follow-up care. It is the office of Drs. William Fritz, Rafik Muawwad and Keith Zeliger. The Penn Highlands Community Pharmacy, also located on the first floor, should be open by the end of the year along with the new ground floor office of Dr. Richard Latuska, gastroenterologist, and the Endoscopy Center for procedures such as colonoscopies. An open house was held in late October. “We are happy that we can provide the needed services to the community and grow to meet those needs as the healthcare landscape changes,” John Sutika, president of Penn Highlands DuBois, said.

Moshannon Valley Community Medical Building In the Philipsburg area, the new Moshannon Valley Community Medical Building is located along Railroad Street in Rush Township, Centre County. It officially opened for business on Wednesday, November 18. An open house was held on November 14. This building will house QCare Moshannon Valley urgent care center. It will also offer outpatient diagnostic testing, including blood draws, EKGs, specimen collections for lab orders, ultrasound and x-ray. Bone-density tests and digital mammograms can also be done there. A mobile MRI will also be on-site. The Moshannon Valley Community Medical Building will be the new home of Philipsburg Medical Services, previously housed in the Peebles Plaza. They include the offices of Drs. Wilkerson Compere and Salman Azim, internal medicine physicians; Dr. Mary Clare Maninang-Ocampo, pediatrician; Dr. Robert Steward Jr., general surgeon; Dr. Ryan Bisbey, ophthalmologist; and Drs. Mark Nartatez and Rodolfo Polintan, both orthopedic services.

continued growth and commitment to providing state-of-the-art facilities and services for the communities we serve,� said Gary Macioce, president of Penn Highlands Clearfield.

Coming in late 2015 The Punxsutawney Community Medical Building is scheduled to open later this year. Located at 551 W. Mahoning Street., it is in the Punxsutawney Plaza. The space will provide offices for a primary care practice, specialty practices and the pediatric practice of Penn Highlands Medical Group. There will also be a QCare Punxsutwaney urgent care center. Outpatient diagnostics may also be done there though x-ray and laboratory services.

Moshannon Valley Community Medical Building

“This is an exciting time for residents of the Moshannon Valley and Penn Highlands Healthcare. This project highlights our

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We’re proud to introduce the newest members of our heathcare team from July 2015 to September 2015. They look forward to being there for your healthcare needs.

Salman Azim, MD Internal Medicine 271 Railroad Street Philipsburg, PA 814-342-9701


Kristina Brown, MD OB/GYN 190 W. Park Avenue Suite 9 DuBois, PA 814-371-1900 Erin Lingenfelter, PA-C QCare St. Marys 763 Johnsonburg Road St. Marys, PA

Taylor Barger, PA-C QCare DuBois 621 S. Main Street DuBois, PA

Dianna Edwards, PA-C Plastic, Reconstructive and Cosmetic Surgery 90 Beaver Drive DuBois, PA and St. Marys Community Medical Building 1100 Million Dollar Hwy. St. Marys, PA 814-503-8368

Robert E. Metts, MD Orthopedics/Orthopedic Surgery 761 Johnsonburg Road Suite 310 St. Marys, PA 814-834-1686

Pamela Null, CRNP QCare DuBois 621 S. Main Street DuBois, PA

Robert Oelhaf, MD Emergency Medicine 763 Johnsonburg Road St. Marys, PA

Darlene Brink, NP-C QCare DuBois 621 S. Main Street DuBois, PA

Irina Komarova, MD Hospitalist 763 Johnsonburg Road St. Marys, PA

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Amanda Miller, PA-C QCare DuBois 621 S. Main Street DuBois, PA

Ben Park, MD Anesthesiology 100 Hospital Avenue DuBois, PA 814-375-3034

Find A Doctor Are you looking for a healthcare provider? Do you want to know a little more about who your next appointment is with?

Lisa Witherite-Rieg, DO Family Medicine 22 Industrial Park Road Brookville, PA 814-849-0990

Penn Highlands Healthcare wants you to know all of your healthcare providers and who is available to help you with your healthcare needs. On our website, www.phhealthcare.org, you can find a provider by name, by location, by specialty or by hospital. You can even search by gender. Also, a complete listing of all our providers is available by downloading our Physician Directory. You can download the entire handbook, a specific search or a single page.

Speakers Bureau Lisa Pfingstler, MD Dermatology 105 Beaver Drive Suite 200 DuBois, PA 814-371-7546

George A. Saborio, MD Internal Medicine/Sports Medicine 531C Hannah Street Clearfield, PA 814-765-4786

Christopher Varacallo, MD Family Medicine/Sports Medicine 145 Hospital Avenue Suite 311 DuBois, PA 1-800-505-2101

As the community’s resource for health information, Penn Highlands Healthcare is always pleased to provide speakers, free of charge, for your community organization or event. To make this easier, we now have an online form to make a speaker request at www.phhealthcare.org/speakersbureau. We ask that you please make speaker requests at least fourweeks in advance of the date requested. Penn Highlands Healthcare will attempt to fulfill all requests, but we cannot guarantee an expert on every subject. We try our best to fill each request. The person who fills out the form will be contacted by a member of the Marketing Team on the status of the request. Topics are limited to the services that Penn Highlands Healthcare provides. Some of our most popular topics include diet and nutrition, heart health, cancer awareness, and exercise and healthy bones. We have many physicians, physician assistants, nurse practitioners, certified specialists and technicians who would enjoy educating your group.

Imran Syed, MD Hospitalist 100 Hospital Avenue DuBois, PA

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Yearly mammograms …are they necessary? In 2009, the United State Preventative Health Services Task Force issued a startling statement. They said that mammogram screening should not begin until age 50 and screening every two years was acceptable. Recently, the American Cancer Society, ACS, said that annual screenings could start at age 45 and after 55 be done every two years. But both groups have said that starting mammograms at age 40 saves more lives. This is also a true statement of the American College of Radiology, the governing and regulatory agency of the mammogram departments at Penn Highlands Healthcare. This message has left many women asking, “Does waiting or skipping a year really make a difference in diagnosing breast cancer?” The answer from Penn Highlands Healthcare is a resounding, “Yes!” It is first and foremost important to begin the discussion about breast health and when to begin screening mammograms with one’s health care provider. Sharing information about personal risk factors for breast cancer can help guide this decision. It is also important to note that breast cancer mortality has decreased significantly, nearly 30 percent since 1990 due in large part to the earlier detection of breast cancer through mammographic screening. “Mammograms save lives through early detection. And that is a key benefit of yearly screens,” says Dr. Kelley Smith, surgeon at Penn Highlands Healthcare. “When women have mammograms every year, breast cancers can be detected up to two years earlier than what may have been found through self-breast awareness or clinical breast examination by a provider.” This can make a huge difference in the treatment plan and outcome. It can be the difference as significant as a woman requiring mastectomy or removal of the entire breast versus a lumpectomy. Or, it is

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her knowing that finding breast cancer early reduces the risk of dying from the disease by 25-30 percent or more. The guidelines from the American College of Radiology and Society of Breast Imaging speak differently than the task force and ACS. They support annual mammograms beginning at the age of 40. Penn Highlands Healthcare recognizes the recommendation of the American College of Radiology as our guideline and standard of practice throughout the system. No matter what Penn Highlands hospital is chosen for mammography services, there is a team at each location to help guide the patient through the process. Care is taken to assure that questions are answered, comfort is a priority and privacy is maintained. When breast cancer is diagnosed or even suspected, Penn Highlands has nurse navigator resources available to the entire region. A nurse navigator is specially trained to facilitate and support patients through the complex process of testing, treatment and follow-up. Penn Highlands is also proud to have the expert care of Dr. Smith who has a special interest in providing breast health care for women throughout our region. Finally, cost should never deter a woman from getting her mammogram. There are assistance programs available through Susan G Komen. Vouchers for screening mammograms are available to any woman as long as the she has a physician’s order. In addition, if a woman does not have a physician or she is having a problem and needs a diagnostic mammogram, to facilitate getting an order, appointments can be arranged through Adagio Health. At Penn Highlands Healthcare, there is a growing effort to encourage eligible women to participate in the recommended screenings for yearly mammograms. In this effort, we are striving to educate women on wellness and early detection so that breast cancer mortality can continue to be minimized.

If you are interested in learning more about yearly mammograms and what is being done to support breast cancer screening and care at Penn Highlands Healthcare, you can request a guest speaker to present at your group or organization. Simply complete the on-line form located within the Speaker’s Bureau at www.phhealthcare. org. See page 11 for details.

Have You Scheduled Your Mammogram? All women age 40 and over should have an annual mammogram, according to Penn Highlands Healthcare. It should start even younger if there is a family history of cancer. Though the staff at all four Penn Highlands Healthcare hospitals are keenly aware of the need for mammograms and breast cancer prevention, they also know that not everyone has health insurance that covers a mammogram. That is why all four hospitals – Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk – partner with Adagio Health. Adagio is a non-profit agency network of health services in 23 counties of western Pennsylvania. Talk to someone at the Penn Highlands Healthcare hospital nearest you for more information: Penn Highlands Brookville: 814-849-1870 Penn Highlands Clearfield: 814-768-2276 Penn Highlands DuBois: 814-375-4636 Penn Highlands Elk: 814-788-8844

Can’t You Just Hold It? Treatments Available to Reduce Symptoms of Overactive Bladder

embarrassed to speak with their doctor about their symptoms, or believe there’s not much that can be done. That is simply not the case,” Dr. Chopra said. Overactive bladder is not a disease, but the name given to a group of troubling urinary symptoms. The condition happens when the nerve signals between the brain and one’s bladder tell the bladder to empty even when it isn’t full. Overactive bladder can also occur when the muscles in one’s bladder are overactive and contract before the bladder is full. Dr. Chopra said the most common symptom is a sudden urge to urinate. A person experiencing this physical feeling may be concerned that he or she might not make it to the bathroom in time.

Those with overactive bladder know that a simple trip to the grocery store – or anywhere, for that matter – isn’t really that simple.

Both men and women are at risk for overactive bladder, and the risk increases with age. Women who have gone through menopause and men who have had prostate problems seem to be at greater risk, Dr. Chopra explained.

The good news is there are several treatments available to help regain one’s independence and quality of life, according to urologist, Dr. Anuj Chopra of Penn Highlands Urology.

In addition, people with neurological diseases, such as stroke and multiple sclerosis, are at higher risk of overactive bladder.

“Many patients are either too

According to the American Urological Association, other symptoms of overactive bladder include: • Urine leakage. One may leak urine after feeling an urge to go that doesn’t give one enough time to make it to the bathroom. This kind of incontinence is called “urge urinary incontinence.” This is different from “stress urinary incontinence” when one leaks urine while sneezing, laughing or other physical effort. • Frequent urination. One may need to go to the bathroom more than eight times a day. The number of times a person urinates during the day varies from person to person, but many experts consider urinating more than eight times in 24 hours “frequent urination.” • Waking up at night to urinate. Waking up more than once a night to urinate is another symptom.

Treatment includes medication and behavioral interventions, or a combination of both, according to Dr. Chopra. Drugs called anticholinergics and beta-adrenergics block the nerve signals related to bladder muscle contractions. Research suggests that these drugs also might increase bladder capacity and decrease the urge to go. As for behavioral interventions, Dr. Chopra said bladder training, pelvic floor exercises as well as modifying drinking habits are helpful treatments for overactive bladder. He said those wishing to reduce the symptoms of overactive bladder should avoid caffeine and not drink a lot of fluids before activities or going to bed. Bladder training helps change the way one use the bathroom. Instead of going whenever one feels the urge, one urinates at set times of the

Dr. Anuj Chopra, MD day, called scheduled voiding. With this method, a person learns to control the urge to go by waiting – for a few minutes at first, then gradually increasing to an hour or more between bathroom visits. Pelvic floor exercises help to strengthen the muscles that control urination. During these pelvic floor exercises, called Kegels, one tightens, holds and then relaxes the muscles that he or she uses to start and stop the flow of urination. Should behavioral interventions and medications not control the symptoms of overactive bladder, other options are available. These treatments include Botox injections to the bladder muscle and the Interstim sacral nerve modulation. As a member of the Penn Highlands Healthcare urology team, Dr. Chopra provides comprehensive adult and pediatric urology services. He, along with the other Penn Highlands’ urologists, Dr. Kumaresan Ganabathi, Dr. Joseph Chang, Dr. Donald Rudick and Dr. Michael Martynik, offer a wide range of state-ofthe-art treatment options, surgical and nonsurgical. The doctors have offices in Brookville, Clearfield, DuBois and St. Marys. There is also the option of Pelvic Floor Physical Therapy at Penn Highlands Healthcare.

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The Penn Highlands Clearfield Charity Ball will be held at Clearfield-Curwensville Country Club on Saturday, December 12, 2015. The theme is Moonlight & Mistletoe.

Lung Cancer Alliance

The Lung Center of Penn Highlands DuBois has been named a Screening Center of Responsible Excellence Screening & Care by the Lung Cancer Alliance, or LCA, for its ongoing commitment to responsible lung cancer screening.


Low dose CT screening for lung cancer carried out safely, efficiently and equitably saves tens of thousands of lives a year. The Lung Center has promoted low-dose CT throughout the region and has partnered with many other providers to encourage people to be screened for lung cancer. “We are proud and honored to be working with The Lung Center as a Lung Cancer Alliance Screening Center of Excellence. Their commitment to practice responsible lung cancer screening will lead to advancements in research and many lives saved. They are an example to follow,” says LCA President and CEO, Laurie Fenton Ambrose. Designated Screening Centers of Excellence are committed to provide clear information based on current evidence on who is a candidate for lung cancer screening, and to comply with comprehensive standards based on best practices developed by professional bodies such as the American College of Radiology , the National Comprehensive Cancer Network and the International Early Lung Cancer Action Program for controlling screening quality, radiation dose and diagnostic procedures within an experienced, multi-disciplinary clinical setting.

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Penn Highlands DuBois Hospice is coordinating its Tree of Doves, again, for 2015. Trees located in the atrium at PH DuBois West will be adorned with doves representing a donation to the program. Each dove will bear the name of someone special and the person who made the donation in their honor or memory. The doves are color coded with white for a memorial, red for in honor of a person or yellow just as a thoughtful gift. Donors may ask for an American flag to be placed on a veteran’s or first responder’s dove. Trees will be on display throughout the holidays through mid-January. For more information about the trees, call PH DuBois Hospice at 814-375-3300. The 29th Annual Pinecrest Bazaar will be held 9:00 a.m. to 4:00 p.m., Sunday, November 22, 2015! There will be crafts, a bake sale, a basket drawing, food and more. All proceeds benefit the Pinecrest Manor residents, and this event is sponsored by the residents and the Activity Department staff. It’s a great way to do some holiday shopping and support a great cause.

The cost is $150 per couple and $75 per individual. Black tie is optional. Appetizers are served at 6:00 p.m., and dinner is at 7:00 p.m. The band is “Live Bait” starts at 9:00 p.m. Contact Leslie Jeffries, 814-768-7317, for tickets and information.

The Penn Highlands DuBois Auxiliary annual Holiday Ball will be held from 8:00 p.m. to 1:00 a.m., Saturday, December 5, 2015, at the DuBois Country Club. Dirty Martini will perform from 8:00 -10:00 p.m. followed from 10:00 p.m. to 1:00 a.m. by The Avenue, a dance band. Hors d’oeuvres will be provided by local restaurants and caterers, as well as the country club. Cost is $70 per ticket or $100 per couple. For tickets, contact Laura Gasbarre at 814-769-6226. Donors to the ball will be listed in the program book: Patron, $150 and up; Friend, $250; Benefactor, $500; and Philanthropist, $1000. For the Penn Highlands VIP donor of $2500 or more, there is a great opportunity for a business, group of friends or staff to treat them with a night out. VIPs get reserved seating for eight with the donor name displayed on the table and a special favor. Donations are tax-deductible.

The Breast Cancer Support Group meets on the second Sunday of each month at Hahne Regional Cancer Center, 100 Hospital Ave., DuBois, with the exception of October when the group meets at a local restaurant. All breast cancer survivors at any stage – newly diagnosed or longtime survivors – can attend. It is for survivors only with a goal to provide a comfortable place for listening, learning and sharing. There is no cost to attend, and it doesn't matter where a participant received treatments. For more information, call Hahne Regional Cancer Center at 814-375-3535.

Are you looking for health information that is informative, up-to-date and easy to read? Wouldn’t it be great if there was a website with this great information and inspired you to follow its advice?

The Nathaniel D. Yingling, MD, Cancer Center’s Support Group, “Hope is Alive,” holds a monthly afternoon meeting at the cancer center on Penn Highlands Clearfield campus. Attendees do not have to be receiving treatment at the Yingling Cancer Center to join the group. For a meeting schedule and more information, please call Patricia McCullough, group facilitator, at 814-768-2830.

Remember or honor someone special through the Penn Highlands Elk Auxiliary Christmas Trees. Bri’s Angels Cancer Support Group holds a quarterly evening meeting in the First Floor Conference Room at Penn Highlands Clearfield. The support group is comprised of area cancer survivors, residents currently undergoing treatment, family members and close friends. The purpose of the group is to offer families, friends and patients support and help when needed, and to lend an ear when someone needs to talk. New members are always welcome. For a meeting schedule and information, please call Salinda Cowder at 814-765-9347.

For a $5 donation, an angel will be placed on either the hospital or Pinecrest Manor lobby tree along with calligraphically-printed card with your loved one’s name. A card will also be sent to your honoree. For a $10 donation, the angel will be displayed on our trees at PH Elk or Pinecrest Manor, and you will also receive your own keepsake figurine. For more information about this program, contact any auxiliary member or call 788-8520.

CORE, the Center of Organ Recovery & Education hosts a CORE Task Force meeting for the region at Penn Highlands Brookville. This group is working on ways to educate and promote organ donation because it saves people’s lives. The meetings are held on the second Wednesdays of each month in the PH Brookville Education Center directly next to the PH Brookville hospital building. Anyone interested is welcome to attend.

The Women’s Health Center of Penn Highlands Healthcare now offers the Health & Wellness website which was created in conjunction with Spirit of Women network. Located at www.phhealthcare.org/ spiritofwomen the site has health topics, such as diabetes, digestive issues and heart health. It has tips on how to stay healthy throughout the decades of your life, and offers timely health information to keep you and your family well, all at your fingertips. It also has fun, informative articles and a blog by Lori Rancik, RN, case manager of The Women’s Health Center of Penn Highlands Healthcare Penn Highlands Healthcare is a proud member of Spirit of Women, a national network of leading hospitals dedicated to improving women’s lives with innovative health and community programs. We regularly schedule educational programs throughout the year and throughout the region. Want to be a Spirit member? Contact us at womensheatlh@phhealthcare.org to be put on our mailing list. Our next exciting health-u-tainment event for the area is Day of Dance. Held in February and March each year, it is a day we host dance demonstrations and health information at a community site and invite you to watch and learn. More information will be coming out soon. Watch for it!

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Advice From A DOCTOR David Girardi, DO Penn Highlands Brookville Hospitalist

How can you tell the difference between a cold and the flu? Influenza, or the flu, and the common cold are both respiratory illnesses and have similar symptoms. However, they are caused by different viruses and have different levels of severity. Generally, a stuffy nose, sneezing and a sore throat are more indicative of a cold. The flu is usually accompanied by a fever, body aches and fatigue. In my job as hospitalist for Penn Highlands Brookville, I see a lot of patients who have the flu. They become hospitalized because their illness develops into a very serious condition. The patient might get pneumonia or have life-threatening breathing problems. Usually, we see this in older adults, young children or people who already have chronic medical conditions, like COPD.

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For this reason, I always recommend flu vaccinations. Anyone over six months of age can have them, with rare exception. They are quick and usually covered by insurance. And, they are the absolute best way to stop the spread of the virus. In particular, anyone who works with the elderly or with small children should be inoculated. You’ll do your co-workers, classmates, friends and family a favor by getting the injection, too. The flu vaccine is not 100 percent foolproof. The medication is developed, based on scientific research about the strains of virus that are most likely to be present that year. Even so, if a person still gets the flu, the vaccine in his or her system will usually lessen the symptoms. Besides the vaccination, the best way to stay healthy is by washing your hands often. Also clean common surfaces, and avoid close contact with anyone who is sick. Home Remedies For The Flu • Use a humidifier to make breathing easier. • Gargle with salt water to soothe the throat. • Use a cool, damp washcloth to ease a headache. • Stay hydrated with water, broth, or sports drinks. • Rest. Over-the-counter Help For The Flu • Decongestants help with sinus and chest stuffiness. • Cough medicine helps with coughing and sore throats. • Ibuprofen and acetaminophen help reduce fever and relieve pain.

Do Antibiotics Help? Antibiotics are used to treat bacterial infections. They are not effective against viral infections like the flu. Some people have bacterial infections along with or caused by the flu and will need to take antibiotics. Severe or prolonged illness or illness that seems to get better but then gets worse may be a sign of bacterial infection. Contact your health care provider if you think you need antibiotics. The flu can cause complications in those who have weakened immune systems due to chronic disease or in the very elderly or very young. When complications like the following are present, seek medical attention immediately. • Shortness of breath or difficulty breathing (may also be characterized by blue discoloration of the lips). • Pain or pressure in the chest or abdomen. • Sudden dizziness or confusion. • Severe, persistent vomiting. • Seizures.

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