Issue 14

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Issue 14

Health LINES Penn Highlands Healthcare

Here. Here for you. Here for our communities.

Penn Highlands Opens


World-Renowned Neurosurgeons Join Medical Staff

Jefferson Manor

Joins Penn Highlands Family

INSIDE THIS ISSUE Keto Diets! We want to hear from you! Ask The Expert What is a DEXA Scan? Advice From A Doctor


CEO Perspective


Keto Diets!


Here With Ostomy Care


Welcome to the Family, PH Jefferson Manor

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Penn Highlands Opens Brain & Spine Center Ask The Expert - What is a DEXA Scan?


We want to hear from you!


New Faces at Penn Highlands


Short Scripts


Advice From A Doctor

HealthLines is a publication of Penn Highlands Healthcare which includes the hospitals of Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk. It is produced by the system’s Marketing Team and is always available on our website at

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If you wish to subscribe to HealthLines electronically, sign up at Printed copies may be found in the waiting rooms of Penn Highlands Healthcare facilities throughout the region and at several local businesses. You may pick one up at anytime. For more information, please contact the Marketing Team at HealthLines@ or call on weekdays from 8:00 AM to 4:00 PM. The Penn Highlands Healthcare HealthLines Team Mary Jo Yebernetsky, Senior Coordinator/Editor, 814-375-3495 Mary Jo Herzing, Graphic Design Coordinator/Webmaster, 814-375-6539 Holly Shok, Marketing & Communications Coordinator, 814-375-6508 Michele Yale, Marketing & Communications Coordinator, 814-375-3494 The information in this magazine does not take the place of health advice given to you by your healthcare provider. Always call 9-1-1 for any emergency.

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It’s hard to believe that this time last year, we were launching our three-year Master Facilities Plan at Penn Highlands Healthcare. Since then, we’ve made considerable progress in growing our health system, all to better serve you and all those who call our region home. Not only are our eight major construction projects underway across the region (have you checked out the West Annex at Penn Highlands DuBois lately?), but we made our affiliation with Penn Highlands Jefferson Manor – a Brookville-based continuing care retirement community – official. In addition, we recruited a Chief of Penn Highlands Neurosurgery, Dr. Ghassan Bejjani, who is trained in both spine and cranial based surgery, as well as his colleague Dr. Zafar Chowdhry, board-certified neurosurgeon. These are very exciting times for our health system and the communities we proudly serve. In this issue of HealthLines, you’ll also learn about our new outpatient group therapy program at PH Brookville, as well as one of the most talked about topics in weight management: keto diets. In addition, our experts discuss the benefits of DEXA scans in diagnosing osteoporosis, and as always, we’ve included information on the latest providers we are honored to welcome to our system. I hope you’ll enjoy this edition and that it gives you a small glimpse into the hard work we are doing to provide you with the finest healthcare services and ensure our region’s generations to come have access to a healthy future. Sincerely,

Steve Fontaine, CEO Penn Highlands Healthcare

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What is ketosis? After 3-4 days of fasting or following a very low carbohydrate diet, the body, deprived of dietary sugar and starch, reduces its insulin secretion and switches to burning fat for fuel. The resulting overproduction of a co-enzyme for metabolism, known as acetyl-CoA, leads to the formation of ketones. Though the brain cannot use fatty acids for fuel, ketones can cross the blood-brain barrier, providing fuel to the typically glucose-hungry brain and to other tissues.


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The keto diet is a very lowcarbohydrate diet that essentially swaps out dietary carbohydrates for dietary fat. “For the diet, a person’s carbohydrate intake is typically less than 50 grams a day – that’s less than the amount in a medium, plain bagel!” Jeril Goss, MS, RD, LDN, CDE, Manager of PH DuBois Diabetes and Nutrition Wellness Center, said. If you compare average healthy eating to the keto diet: • Fat is normally 20-35 percent of your daily intake; keto requires 70-80 percent. • Protein is usually 10-35 percent daily; keto is 20-25 percent. • Carbohydrate is usually 46-65 percent of your intake; keto is 5-10 percent. “The protein amount on a ketogenic diet is kept moderate in comparison to other low-carb, high-protein diets - like Atkins - because eating too much protein can prevent ketosis,” Jeril said.

“This transition to physiological or nutritional ketosis usually takes a week. This type of ketosis does not raise blood levels of ketones as high as what occurs with diabetic ketoacidosis (DKA),” Joyce Kulick, RD, LDN, CDE of the Diabetes and Nutrition Wellness Center of PH DuBois, said. DKA is a life-threatening complication of Type 1 diabetes that lowers blood pH. But the diet isn’t perfect. “When you first make the shift from carbs to fats for energy, you can anticipate the ‘keto flu’ side effects of carb restriction that mirror the actual flu,” said Marie Michelini, MS, RD, LDN, CDE at PH Elk Diabetes and Nutrition Wellness Center. “These side effects include nausea, vomiting, diarrhea, fatigue, headache, cravings, muscle cramps and soreness, dizziness and trouble concentrating. This is a result of the body’s rapid excretion of sodium and fluids as carbohydrates are restricted.” Kelly Schreiber-Straub, RD, LDN, CDE at

PH Elk Diabetes and Nutrition Wellness Center added that “other side effects are increased risk of kidney stones, osteoporosis and increased blood levels of uric acid, a risk factor for gout. Nutrient deficiencies are possible if a variety of foods are not included to ensure adequate intakes of fiber, B vitamins and minerals, such as iron, magnesium and zinc.” “A ketogenic diet has been shown to provide short-term benefits in some people including weight loss and improvements in total cholesterol, blood sugar and blood pressure,” Bernie Clark, RD, LDN at PH Clearfield, said. “However, these effects after one year — when compared with the effects of conventional weight loss diets — are not significantly different. Eliminating several food groups and the potential for unpleasant side effects may make compliance difficult.” The bottom line: A ketogenic diet may be an option for some people who have had difficulty losing weight with other methods. If you choose to start a ketogenic diet, it is recommended to consult with your physician and a dietitian to closely monitor any biochemical changes after starting the regimen and to create a meal plan that is tailored to your existing health conditions and to prevent nutritional deficiencies.

Our outpatient dietitians are available to help you as you determine your best choice for weight management. Ask a provider to refer you to their services available in Brookville, Clearfield, DuBois, Punxsutawney and St Marys. The phone number for any questions or scheduling an appointment at any location is 814375-3890.

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Although ostomy surgery can bring great relief, many people have concerns with practical and social issues related to having this type of surgery. Come to the Ostomy Support Group!

Here with Ostomy Care

The only ostomy support group in the region, meetings are free to attend no matter where a person’s care was provided. They are held April through June and September through November on the first Tuesday of each month from Noon to 1:00 PM in the Central Resource Center, 204 Hospital Avenue, DuBois, the former school building. The Ostomy Support Group meetings are informal, round-table discussions on topics of interest, new product demonstrations and a question-andanswer session with Heather. “People facing life with an ostomy, whether temporary or permanent, have many questions and concerns. We are here to provide them with the resources and information they need,” Heather explained.

The Wound Center of Penn Highlands DuBois is now offering an Ostomy Clinic Day every • Ileostomy diverts from Thursday for the small intestine patients who • Colostomy diverts need ostomy attention. Perhaps the skin around an ostomy site is from the colon red and moist, or there is chronic • Urostomy diverts leaking or a need for frequent from the kidneys changing. Perhaps you just need some basic education to feel more confident. Heather Kisamore, BSN, RN, CWOCN, Certified Wound Ostomy For more information or an and Continence Nurse, is available to appointment, call The Wound Center at help. 814-371-4320 or call Heather directly at 814-375-3056. Don’t let an ostomy issue lead to a larger problem or keep you home in fear “something” will happen, Heather said. She also added that she is able to help patients find speciality item samples, sometimes available at no cost.

Types of Ostomies:

A life-saving treatment can sometimes change the body. For some patients, it may be that ostomy is the answer to a serious health issue. Ostomy changes the way urine or stool leaves the body. An opening, or stoma, is created on the abdomen and a pouch is worn over it to collect waste. Some are done short-term to allow for an area to heal without use. Some are permanent to solve a health problem for a patient. Medical conditions that might require it include complications from diverticulitis, colon or bladder cancer and inflammatory bowel disease.


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Outpatient Group Therapy Program Penn Highlands Healthcare is offering another option for emotional and personal distress, and though intense, it allows for people to still spend time at home. Penn Highlands Behavioral Health Services just introduced its new Outpatient Group Therapy program, which launched at Penn Highlands Brookville. Outpatient Group Therapy is a physician-supervised treatment program for adults 40 and older who continue to live within their community but need additional support. The program is designed to relieve emotional and personal distress for patients suffering from: • Anxiety and panic disorders • Complicated grief • Confusion and memory loss • Depression

• Dysfunctional patterns of behavior that impede daily living • Grief reaction • Mood changes • Psychosis • Reaction adjustment • Sleep disorders • Unfounded fears • Unspecified pain

• Medication monitoring • Consultation • Social service referrals • Education • Caregiver training • Bereavement counseling • Family counseling • Coordination and referral for ongoing care

This program is for older adults who don’t require the level of care provided by one of our inpatient adult or geropsychiatric units, according to Richard Nenneau, Service Line Director of Penn Highlands Behavioral Health. Instead, patients attend an Outpatient Group Therapy, or OGT, program Monday through Friday, from 10:00 AM to 2:00 PM in a warm and inviting setting.

“People can transition out of the program and then come back if symptoms return,” Richard said. “This can be a good way to get help and head off an inpatient stay.”

“Most people start out attending the program three times-per-week, then back off as they feel better,” Richard said. “There is no set length of time one attends.” In his past experience with OGT, people stayed in the program for 2-3 months and others for 2-3 years. The program goal is to help patients regain as much of their independence as possible by providing the following specialized care: • Assessment and evaluation • Individual and group therapy

“I like this program because people can come for an extended period of time, have access to the psychiatrist and a physician assistant, and have the support of the group environment,” Richard said. “It often helps folks to know that they are not alone and that others have the same struggles. There is a very supportive environment.” At PH Brookville, the program is held next door to the hospital in the Education Conference Center where all outpatient behavioral health services at PH Brookville have relocated to a newly-renovated space. “My hope is that there will be other programs like OGT throughout the PHH system,” Richard said.

For questions about the Outpatient Group Therapy, call us at 814-849-1396.

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Welcome to the Family, Penn Highlands Jefferson Manor! In October 2018, the boards of directors of both Jefferson Manor Health Center, a Brookville-based continuing care retirement community, and Penn Highlands Healthcare signed a letter of intent that, after months of due diligence, paved the way for an affiliation between the two organizations. Effective April 1, 2019, Penn Highlands Jefferson Manor became the second skilled nursing facility affiliated with Penn Highlands Healthcare. Serving the residents of Jefferson County for more than 100 years, PH Jefferson Manor first opened as the county home in 1901 before it was relocated and transformed into a nursing home facility in 1984. The facility continued to grow in order to meet the needs of the community it serves, adding personal care services in the early 1990s and independent living services in 2001.

The campus of PH Jefferson Manor houses 160 skilled nursing beds, 48 personal care beds and five independent living residences. Committed to the medical, physical, spiritual and psychological needs of every resident, the facility offers around-the-clock professional nursing care at all acuity levels, which includes comprehensive physical, occupational and speech therapy services. The goal throughout the facility is to offer residents a home-like environment where they are treated with dignity and respect each day. PH Jefferson Manor offers a secured unit that provides specialized care to residents suffering from dementia, as well as a specialty care unit that offers additional care and rehabilitation services to those in need of a shortterm stay following hospitalization. In the secured Memory Support Unit, residents are cared for by staff who

To learn more about PH Jefferson Manor visit us at www.jefferson


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have received specialized training that better equips them to meet medical, emotional, spiritual, physical and psychological needs. This education includes behavioral management and communication technique training. In addition to their beautifully-decorated rooms, residents in the Memory Support Unit enjoy an assortment of activities designed to stimulate and strengthen tactile abilities. Residents also have access to an outdoor courtyard that allows them to enjoy the serenity of the outdoors while maintaining their safety. “Our team works with each resident’s family members to ensure we create a plan of care that addresses all of their needs and concerns,” Misty Fleming, Administrator of PH Jefferson

Manor, said. “It’s important to us that family members have an opportunity to provide input. We welcome their insight and are happy to be partners in providing compassionate care to their loved one.” “Often times, the interaction with family members is just as beneficial to them as to their loved one in our facility,” Misty added. “Getting to know our team, and understanding the care plan can be a tremendous relief and gives family members a great piece of mind in knowing that we are dedicated to providing experienced care based on respect and understanding.” PH Jefferson Manor employs approximately 175 staff members throughout the facility who are committed to providing residents with high-quality, compassionate care. Each member of the team works in collaboration to ensure that every resident attains or maintains their highest level of independence. “We are proud to be the newest member of the Penn Highlands family,” Misty said. “We have joined a strong healthcare system that is well-known for the exceptional care provided to communities throughout the region. Having their support is incredibly beneficial to our facility as well as to our residents. The continuity of care that is now available to our residents, thanks to the strength and scope of the Penn Highlands system, is invaluable.” “We are proud of the exceptional care provided at our facility. The experience and high-quality services that we offer to community members will be an asset to Penn Highlands,” Misty said. “This affiliation is a perfect fit that will ensure our facility has the resources needed to continue to offer the highest quality of care for generations to come.”

Project Updates

PENN HIGHLANDS HEALTHCARE MASTER FACILITIES PLAN Eight major expansion and renovation projects will modernize and improve upon the services we offer patients at our four hospital campuses and numerous outpatient facilities in the 12-county region we serve. Known as the Master Facility Plan, Penn Highlands is expanding its footprint throughout the region.

You can help us grow. Your donation will help bring even more advanced care right here. Go to www.phhealthcare. org/footprint.

Work continues on the West Wing Annex located at Penn Highlands DuBois West Campus. Ground broke in June 2018 on this five-story addition to the hospital at 100 Hospital Avenue, DuBois – the first of eight new projects announced that same month by Penn Highlands Healthcare.

Steel erection is almost completed, Brad Long, Director of Design and Construction at Penn Highlands DuBois, said. Brad and his department are overseeing the construction of all projects for PH Healthcare. Along with the steel erection, underground plumbing is in process, masons are onsite constructing the elevator and stair tower shafts and crews are prepping and pouring the concrete floors. Soon, external and internal framing will begin. “Construction is a process,” Brad added. “We are moving along close to schedule and are happy with how things are progressing.” The original Maple Avenue Hospital building – now just one section of Penn Highlands DuBois East – will be demolished soon. It is 100 years old, and was built with the help of John E. DuBois – founder of the City of DuBois and lumber baron. That section of the building was only used for offices and storage for the past 20 years. The PH DuBois East site will have a new Behavioral Health Hospital building constructed to update and expand the services already available. During construction, the inpatient and outpatient Behavioral Health Services units will still be accessible and functional. Those services will not be disrupted. Other projects slated to start soon include: the Centers of Excellence medical office building across from PH DuBois West, updates to Pinecrest Manor in St. Marys, renovations to Penn Highlands Clearfield, a medical office building in Brookville, an addition of a new Emergency Department and patient tower at PH DuBois West and a Clarion Community Medical Building off I-80 in Clarion.

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Penn Highlands Opens

already.” Now, patients do not need to travel for care.

BRAIN AND SPINE CENTER World-Renowned Neurosurgeons Join Medical Staff

When Dr. Ghassan Bejjani, board-certified neurosurgeon came to Penn Highlands Healthcare at the end of 2018, he became its first chief of the newly formed Penn Highlands Neurosurgery Department at the Penn Highlands Brain and Spine Center.

Surgery isn’t the answer for many conditions. “Only one in 15 patients need surgery,” Dr. Bejjani said. “The rest manage their care through physical therapy, injections or medications.” Surgery is reserved for those who have progressive neurological impairment, uncontrollable pain or deformity that’s getting worse.

Dr. Zafar Chowdhry, board-certified neurosurgeon, joined him soon after along with certified physician assistants, Laura Sasala and Renee Krugger.

Why is The Brain and Spine Center needed? “There is big need for tertiary care and neurosurgery in the area,” Dr. Bejjani said. “There was no neurosurgeon from Williamsport to Buffalo and Erie…A good portion – 20 percent - of my previous practice was from here

Employed by Penn Highlands Healthcare, the neurosurgeons and PAs see patients in their offices throughout the region. Penn Highlands Neurosurgery offfice locations: • CLARION Cricklewood Medical Arts Building Suite 102,1008 South Fifth Avenue • DUBOIS Medical Arts Building Suite 106, 145 Hospital Avenue • GREENSBURG Rugh Street Complex Suite 2000, 542 Rugh Street • INDIANIA 119 Professional Center Suite 204, 1265 Wayne Avenue • ST. MARYS St.Marys Community Medical Building 1100 Million Dollar Highway Second Floor • STATE COLLEGE Parkway Medical Center 233 Easterly Parkway, Suite 100 For more information or to reach any of the offices, call 814-503-4433.

With the neurosurgeons comes the knowledge and skills to provide highlyspecialized care for disorders that affect the nervous system, brain or spinal cord. They can perform simple and complex brain and spine procedures, as well as peripheral nerve and surgical pain procedures. These specialized surgeons can treat simple and complex brain tumors, pituitary tumors, skull base tumors, acoustic neuromas, cerebral hemorrhage, brain trauma, spinal cord tumors, compression fractures, spine infections and tethered cord syndrome.


Meet our team:

(L to R) Jessica Michaux, office staff; Maggie Shank, office manager; Dr. Ghassan Bejjani, Laura Sasala, PA-C; and Renee Krugger, PA-C.

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First Patient

Kyphoplasty Kenneth Carnahan, 85, was on his way from Ridgway along Route 219 to Aldi’s grocery store in DuBois on January 7, 2019. It was a high of 31 degrees that day. The sun was out, but it still was below freezing. That’s when Kenneth’s truck hit the black ice. “I was not in control. I could do nothing,” he said. “I hit the brakes – nothing.” And his truck slid side-to-side before hitting an embankment. When he got out to check, the truck didn’t have but a little scuff. Kenneth was a little shaken up as he never had something like that happen to him before. “I’ve been driving for 68 years, and it was the first time I ever put a mark on a vehicle,” he said. He continued on his way to the store, got what he needed and went back home. But something wasn’t right. Kenneth was in pain. What he thought would improve did not. It hurt bad enough he knew he couldn’t drive. He called the ambulance to take him to Penn Highlands Elk. He was hurting too much to go back home. An MRI test showed he needed help from just the right type of doctor – one that happened to be new to Penn Highlands Healthcare who just happened to be opening his first office of several to come. Kenneth was sent by ambulance to Penn Highlands DuBois to see Dr. Ghassan Bejjani. Dr. Bejjani came to Penn Highlands Healthcare at the end of 2018. He is a board-certified neurosurgeon and chief of the newly formed Penn Highlands Neurosurgery Department at the Penn Highlands Brain and Spine Center.

Dr. Bejjani can provide highly-specialized care for neurosurgical conditions, disorders that affect the nervous system, brain or spinal cord. As for Kenneth, Dr. Bejjani saw what he needed to on Kenneth’s images – a damaged vertebrae. He explained kyphoplasty to Kenneth who was happy there was a way to stop the pain. Kyphoplasty is a procedure to treat a vertebral fracture. It is done by injecting a special cement into the vertebrae bone to give it the strength it needs. To get the cement to the right spot and create the right opening – a small balloon is injected first to expand and shape the vertebrae correctly. Though it sounds simple, the procedure is done through a tiny incision in the back, and the doctor guides the small, tube-like instruments through the use of fluoroscopy, a process of using x-rays to obtain real-time images of the interior of the body.

Treatments at

Penn Highlands Neurosurgery • Brain tumors, simple and complex • Tumors of the skull base, spinal cord, pituitary gland or spine • Spinal trauma, including compression fractures and herniated disk • Tethered cord syndrome • Spinal stenosis

Surgical Procedures • Craniotomies • Kyphoplasty • Spinal cord stimulator placement • Microdiscectomy • Cervical or lumbar laminectomy and fusion • Brain and spine stereotactic radiosurgery • Nerve and muscle biopsy

“Kyphoplasty changed dramatically the way we manage vertebral compression fractures,” Dr. Bejjani said. “Before Kyphoplasty was introduced, the patients had only two choices: stay in pain for weeks or months at a time, To learn until the fracture heals, or unmore about dergo a major and extremely Neurosurgery risky spinal procedure with visit us at extended recovery.”

to,” he noted. A machinist for 30 years, he owned a service station www.phhealthcare. from 1960-63 “Kyphoplasty offers an org/neuro before building alternate treatment option, a garage at his where a minimally invasive, 20 house in 1965 where minutes procedure, with practically he worked on vehicles no recovery time and low complication nightly until 1998. rate, has a very high success rate in controlling the pain. It is truly a remarkable achievement,” he added. In no time, Kenneth is back to where he was before the accident. At his age, he has a muscle spasm in his back that causes him grief once in a while. He takes a Tylenol occasionally, he said. He keeps himself busy by repairing small engines for fun. “Nothing like I used

Though he isn’t gardening like he used to, he looks forward to the summer and will enjoy watching other’s gardens grow. (Some may remember “Carnahan corn” – the sweet corn raised by his family for years in the Ridgway area.) “I’m feeling pretty good now,” he said happily. “It was good care.”

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ASK THE EXPERT - What is a DEXA Scan? To find a

Osteoporosis is a bone disease that occurs when the body doesn’t have enough bone mass. Under a microscope, this disease makes bones look like a honeycomb. They are weak and may break easily from a fall or, in severe cases, even from a little bump or a sneeze. Known as the silent disease, it gradually weakens bones without pain nor symptoms. Osteoporosis, and its precursor, osteopenia, are diagnosed by a visit to your health care provider and, possibly, a bone density test, known as a DEXA scan. What is a dexa scan? DEXA scans, or dual energy X-ray absorptiometry scans, are painless procedures easily performed by each of Penn Highlands Healthcare hospitals. The DEXA machine sends a thin, beam of low-dose of radiation passing through soft tissue and bone. The soft tissue amount can be subtracted from the total and what remains is a patient’s bone mineral density. DEXA machines feature special software that computes and displays the bone measurements on a computer monitor. Patricia K Szczotka, RT (R) (M) (BD) Lead DEXA Technologist Penn Highlands Elk

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Who should get a bone density test? Bone density tests are strongly recommended if you are a postmenopausal woman over 65 or are a man over 75. They are also recommended for men and women who have experienced height loss, have taken steroids for three months or who have a thyroid condition. Risks for osteoporosis include being physically inactive, tobacco use, not consuming enough calcium, drinking alcohol, using certain prescriptions or having lowestrogen. Body size – being slender, a thin-boned or a taller woman- can increase risk along with having a family history of osteoporosis. Those with risks should be tested, too. Ashley Wells, RT (R) Radiologic Technologist Penn Highlands Brookville How often should you be tested? This depends on several factors which include: the age of the individual, previous test results, increased risk factors for bone loss and if the person is currently having treatment for bone density loss. DEXA scans are covered by most health insurance plans every other year and by some plans every year. An individual with bone density results which fall in a normal range would need to ask his or her doctor who may want to wait longer between DEXA tests. Glenna Bloom, RT (R) (M) (CT) (BD) Mammography Technologist Penn Highlands DuBois

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DEXA Scan location near you, visit us at www.phhealthcare .org/dexascan

What can we do to prevent bone loss? To build up bones, we need to do physical activity that is weight-bearing, such as walking, running, dancing or golfing, and we need the right amounts of calcium to build up bones and vitamin D to allow calcium to be absorbed. Adults ages 19-49 - both men and women – need 1,000 mg. of calcium per day and 400-800 IU of vitamin D. Ages 50 and over need to have 1,200 mg. of calcium and 800-1,000 IU of vitamin D. Food is the best source of calcium. Dairy products, such as milk, yogurt and cheese are high in calcium, and three servings a day can help fill your daily needs. Certain green vegetables and other foods contain calcium in smaller amounts, and some foods and drinks have added calcium. Vitamin D comes from sunlight, food and supplements. Most foods with added calcium have Vitamin D added. April Mowery, RT (R)(CT)(MR)(BD) Radiologic Technologist Penn Highlands Clearfield

We want to hear from you! Does Penn Highlands care about what you think? Or listen? We do! And we want to hear from you! Delivering high quality care, safety and patient experience is a major initiative within our healthcare system. Improving service to our patients is a top priority, according to Dr. Istikram Qaderi, Chief Quality and Transformation Officer for Penn Highlands Healthcare. “We always want to do our best!” Dr. Qaderi says. “We ask our patients to give their opinions so we can see where we can improve and evolve. We want our patients to have a ‘Wow!’ experience each time they come to Penn Highlands.” What does Dr. Qaderi mean by a “Wow!” experience? It means having the best experience possible from the time a person arrives until they leave. It means patients and visitors being treated kindly and professionally by everyone who sees them. It means that your course of care as a patient is clear for you to understand, that care is timely and that you were kept informed step-by-step as partner in your care. We don’t only want you to return home feeling better, we want to know whether every aspect of your experience was as excellent as it could have been.

As part of our focus on quality, safety and patient experience after you’ve visited Penn Highlands Healthcare, you may receive a survey by U.S. Mail, e-mail, or text from an independent organization that helps us measure our patients’ experience – Press Ganey. Who receives a patient experience survey? Almost everyone: inpatients, outpatients, ambulatory surgery patients, behavioral health patients, emergency department patients, physician office patients, skilled nursing patients and home health patients. The survey is administered at random to adult patients anywhere from 48 hours to six weeks after discharge. Though the results of the inpatient surveys are shared with government agencies, the rest are completely for PH Healthcare use.

What is a Transformation Officer?

At Penn Highlands Healthcare, Dr. Istikram Qaderi is the system’s Chief Quality and Transformation Officer. He is overseeing the quality, safety, patient experience and performance improvement at all Penn Highlands Healthcare hospitals, the Penn Highlands Physician Network and Penn Highlands Community Nurses. His role is vital to the organization. As the word transformation implies, he is changing the system to have even higher quality standards and enhance the patient experience for all. Dr. Qaderi comes to Penn Highlands with more than 15 years of experience in transforming healthcare organizations across the country – from Alaska to California to New York and Maine. He has been a guest speaker on quality initiatives at the hospital, state and national level and has published many articles on safety, quality and success in healthcare.

We take patient feedback very seriously at Penn Highlands Healthcare as it gives us insight on where to improve and what we are doing well. This information is shared with our staff, leadership and the boards of directors. Comments are reviewed. We recognize staff and Please help us to celebrate our care team’s successes provide you and when positive your family with comments are received. the best health care Others show us experience possible opportunities to improve. by completing your

“We need to ‘walk’ our values every day to be the best place to receive care and the best place to come to work,” Dr. Qaderi said.

patient care survey!

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


Treva Amrstrong, MD Pathologist Penn Highlands DuBois 100 Hospital Avenue DuBois, PA 814-375-3238

John Banerji, MD Urologist Penn Highlands Urology Medical Arts Building 145 Hospital Avenue, Suite 200 DuBois, PA 814-375-9200

David Barr, MD Family Practitioner Brookville Rural Health Center 22 Industrial Park Road Brookville, PA 814-849-0990

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Ghassan Bejjani, MD Neurosurgeon Penn Highlands Neurosurgery Medical Arts Building 145 Hospital Avenue, Suite 106 DuBois, PA 814-503-4433

Zafar Chowdhry, MD Neurosurgeon Penn Highlands Neurosurgery Medical Arts Building 145 Hospital Avenue, Suite 106 DuBois, PA 814-503-4433

Lisa Coughlin, MD, FACS General Surgeon Penn Highlands General Surgery 807 Turnpike Avenue, Suite 250 Clearfield, PA 814-205-1900

Find A Doctor

Dale A. Danneker, MD, FACS, CWS Certified Wound Specialist Hyperbaric Oxygen Treatment Center and The Wound Center 635 Maple Avenue DuBois, PA 15801 814-371-4320

Lisa Jaramillo, DO, FACOG Obstetrician/Gynecologist Penn Highlands Life’s Journey 190 West Park Avenue, Suite 9 DuBois, PA 814-371-1900

James Phillip, DO Family Practitioner Moshannon Valley Rural Health Center 271 Railroad Street Philipsburg, PA 814-342-9701

Are you looking for a healthcare provider? Do you want to know a little more about whom your next appointment is with? 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/findadoc, you can find a provider by name, by location, by specialty or by hospital.

Five Great Reasons to Find a Primary Care Provider 1. Faster appointments and same day visits for established patients 2. Free annual wellness visits through most insurance 3. Consolidate your health information before you get sick 4. You’re more likely to get preventive care and avoid the Emergency Department* 5. You’re more likely to have better health and earlier disease detection*

To find a Primary Care Office location closest to you, visit us at www.phhealthcare .org/primarycare

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* The International Journal of Health Services, Volume 37, Number 1, Pages 111–126, 2007


Tabitha Ashoff, PA-C Board Certified Physician Assistant

Penn Highlands Gastroenterology 621 South Main Street DuBois, PA 814-371-0600

Michael Astorino, CRNP Certified Registered Nurse Practitioner

Ann Becquet, NNP

Elayna Oaks, NNP

Laura Sasala, PA-C

Neonatal Nurse Practitioner

Neonatal Nurse Practitioner

Board Certified Physician Assistant

Kristy Brownlee, CNM

Michelle Olson-White, CNM

Nicholas Sipes, PA-C Board Certified Physician Assistant

Penn Highlands DuBois Neontal Intensive Care Unit 100 Hospital Avenue DuBois, PA 814-375-6428

Penn Highlands DuBois Neontal Intensive Care Unit 100 Hospital Avenue DuBois, PA 814-375-6428

Penn Highlands Neurosurgery 145 Hospital Avenue, Suite 106 DuBois, PA 814-503-4433

Certified Nurse Midwife

Certified Nurse Midwife

Penn Highlands Life’s Journey 190 West Park Avenue, Suite 9 DuBois, PA 814-371-1900

Penn Highlands Life’s Journey 190 West Park Avenue, Suite 9 DuBois, PA 814-371-1900

Penn Highlands DuBois Interventional Radiology 100 Hospital Avenue DuBois, PA 814-375-3261

Renee Krugger, PA-C

Kirstie Pistner, PA-C

Jaclyn Zazworsky, FNP

Penn Highlands Family Medicine 465 State Street Curwensville, PA 814-236-1123

Board Certified Physician Assistant

Mary Barton, CRNP, PMHNP-BC

Penn Highlands Neurosurgery 145 Hospital Avenue, Suite 106 DuBois, PA 814-503-4433

Certified Registered Nurse Practitioner

Behavioral Health Services 635 Maple Avenue DuBois, PA 814-375-6379

Board Certified Physician Assistant

Behavioral Health Services 635 Maple Avenue DuBois, PA 814-375-6379

Family Nurse Practitioner

QCare Clearfield 1900 River Road Clearfield, PA 814-205-1250

Here for you. Here when you need us - 24/7/365. Amanda Meyer, PA-C Board Certified Physician Assistant

Penn Highlands Elk Hospitalists 763 Johnsonburg Road St. Marys, PA

Emergency Care

at Penn Highlands Healthcare

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The Rehabilitation Center

Imaging (Radiology) Services

Comprehensive care and recovery from the very best, close to home. Whether you’re recovering from an injury, illness or surgery, Rehabilitation Services at Penn Highlands Healthcare will help you improve mobility and get you back to the quality of life you’re used to. Our team of specialists will provide individualized therapies specific to your needs. From traditional physical and occupational therapy to speech therapy and specialized services, we have the comprehensive capabilities and latest equipment to provide you with the best care.

17 Convenient Locations

16 Convenient Locations At Penn Highlands Healthcare, our goal is to make your radiology visit convenient and quick. We offer 16 locations across six counties. To help prepare you for your visit, please bring your photo identification, most recent Insurance card and your paper order along with you. Visit us at xray to find a location near you.

Occupational Health Services Five Convenient Locations Helping keep your employees safe and healthy. Penn Highlands Healthcare is pleased to offer Occupational Health Services to help local companies manage the health and wellbeing of their employees. Many companies face government mandates by OSHA, the Department of Transportation or other regulatory bodies that focus on workplace safety. Our team is here to help companies understand and implement these safety protocols. the tri-county area. Visit us at occhealth to find a location near you.

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Laboratory Services 18 Convenient Locations Blood testing is the most widelyused service at our Penn Highlands facilities. Some patients need blood work routinely and feel very comfortable with the process. For others, this process is new. At Penn Highlands Healthcare, our goal is to make your laboratory visit convenient and quick. We offer 18 locations across seven counties. To help prepare you for your visit, please bring your photo identification, most recent insurance card and your paper order along with you. Visit us at lab to find a location near you.

Here for your heart.

Visit us at rehab to find a location near you.

All four of our hospitals have modern Emergency Departments ready to take care of your emergencies any time of the day or night, 365 days a year. Our highlytrained physicians and nurses provide quality care in a timely manner. For more information visit us at

Stay close to home while receiving the best cardiac care available - The Heart Center at Penn Highlands Healthcare. Learn more about The Heart Center at /heartcare.

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You can make an appointment for a Low Dose CT Scan by calling your provider or The Lung Center at


Penn Highlands Healthcare /KTH Golf Classic Warm sunny days are on the way, and we can’t think of a better way to spend a Friday in June than on the golf course raising funds for a good cause. The 2019 Penn Highlands Healthcare/ KTH Golf Classic will be held on June 21, 2019, with a 9:00 AM tee time at each of the four main communities that make up Penn Highlands Healthcare. All local businesses and community members are invited to join us. Golfers are able to choose the location they wish to golf: • Bavarian Hills Golf Course, St. Marys • Eagles Ridge Golf Course, Curwensville • Pinecrest Country Club, Brookville • Treasure Lake Silver Course, DuBois We are very excited to be able to hold this tournament in four locations all on the same day! The day includes great golf, skill contests, raffles, prizes, food and drinks all day long. To top off the day, golfers will enjoy happy hour and dinner immediately following golf at the course played. Sponsors will also have the opportunity to choose where their donations are directed: • Penn Highlands Healthcare Shared equally among all four hospitals • Penn Highlands Brookville Operating Room Equipment • Penn Highlands Clearfield Digital Mammography Suite • Penn Highlands DuBois Endo-Bronchial Ultrasound Scope • Penn Highlands Elk Vital Sign Monitors For more information or to register, e-mail, call 814-375-3901.

Golf Classic registration is available online at www.phhealthcare. org/golfclassic

Dr. Gary Dugan Memorial Walk/Fun Run Event Come run with us on Saturday, September 21, 2019, at 9:00 AM at the Beaver Meadow Walkway in DuBois. Registration is free, but donations will be accepted at the event or online at www.phhealthcare. org/donate. All proceeds will benefit the Graduate Medical Education Program at Penn Highlands Healthcare. Dr. DuGan was instrumental in the establishment of this program. For more information about this event, please call Becky Snedden at 814-375-6105.

Penn Highlands Community Nurses Chili Bowl This event will be held September 19, 2019, from 5:00 - 9:00 PM at the Clearfield Driving Park, Expo II Building, Clearfield. The theme for this year’s event is “Pet & Friends.” There will be many different chilis to taste, a band, children’s activities and more! Admission is free. All Chili Bowl proceeds benefit PH Community Nurses hospice patients and their families facing end-of-life issues, as well as the bereavement program. For more information, call 814-768-2012 or 800-8419397.

2019 Butterfly Release Events Butterfly Release events will be held this summer by the Penn Highland Community Nurses hospice program. At the events, hundreds of butterflies are released to honor and remember loved ones. Some flutter away immediately, and others stay to delight the crowds, resting on hands and nearby flowers. The community is invited to attend any or all of these events without having to purchase a butterfly. Seating is limited, so guests may wish to bring lawn chairs. SATURDAY, JULY 27, 2019 2:00 PM DuBois City Park Parkway Drive | DuBois, PA SUNDAY, JULY 28, 2019 2:00 PM Clearfield Fairgrounds & Park Stadium Drive | Clearfield, PA SUNDAY, AUGUST 10, 2019 2:00 PM Pinecrest Manor Johnsonburg Road | Saint Marys, PA People are invited to sponsor one or more butterflies for $25 each, with proceeds going to hospice program. For more information, please call 814-781-1415 or 800-841-9397.

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Advice From A DOCTOR Maofu Fu, MD, FACS Nathaniel D. Yingling, MD Cancer Center 814-768-2132

If I am iron deficient and taking an iron pill, why do I need a colonoscopy or other tests? When you do not have enough iron in your system, you can have a decrease in the number of cells in the blood that carry oxygen or anemia. Iron deficiency anemia in the most common form of anemia in our community as well as worldwide. While taking an iron pill may improve/resolve the anemia, it is even more important to determine the underlying cause of the iron deficiency anemia. In older adults, especially those older than 50, iron deficiency anemia may be caused by colorectal cancer. Therefore, a colonoscopy is always needed to exclude this condition. Also, a colonoscopy can reveal more

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For questions or more information, on Cancer Care visit us at www.phhealthcare. org/cancercare

benign conditions such as diverticulosis, hemorrhoids (internal or external), or abnormal blood vessel structures within the bowels, which are all potential causes of iron deficiency anemia, too. This is the rationale behind your provider scheduling you for a colonoscopy.

Another potential cause is stomach (gastric) cancer; therefore, an esophagogastroduodenoscopy (EGD or upper endoscopy) may be performed as well to exclude this possibility. Not all causes are cancers. Several other potential causes of iron deficiency anemia include malabsorption/poor absorption of iron, which is seen in patients with a history of gastric bypass surgery or Celiac disease, anemia of chronic disease/inflammation, and female patients with heavy menstrual periods. As you can see, iron deficiency anemia is often an indicator of an underlying medical condition Therefore, it is crucial to determine the underlying cause of the iron deficiency anemia and treat that, too. If you show signs for anemia, be sure to get tested.

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Did you know...

When you have anemia, your body lacks oxygen, so you may experience one or more of the following symptoms: • Weakness • Shortness of breath • Dizziness • Fast or irregular heartbeat • Pounding or “whooshing” in your ears • Headache • Cold hands or feet • Pale or yellow skin • Chest pain

We Provide Cancer Care Close to Home At Penn Highlands, we will provide you with the best cancer care available and also be there to answer your questions and listen to your concerns. Services offered: • Chemotherapy • Hematology • Immunotherapy • Medical Oncology • Radiation Oncology

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