Issue 15 by Penn Highlands Healthcare

Issue 15

Health LINES Penn Highlands Healthcare

Here. Here for you. Here for our communities.

INSIDE THIS ISSUE Penn Highlands Huntingdon Joins Penn Highlands Family Hematuria and Kidney Cancer

ASK THE EXPERT What should we know about heart health?

Father Walks Daughter Down Aisle Thanks To Innovative Lung Treatment

Issue 15 | PENN HIGHLANDS HEALTHCARE

CEO Perspective

What Is Service Excellence?

Hematuria and Kidney Cancer

PH Huntingdon, Welcome to the Family

8 10

Innovative Lung Treatment What Should We Know About Heart Health?

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, Penn Highlands Elk and Penn Highlands Huntingdon. It is produced by the system’s Marketing Team and is always available on our website at www.phhealthcare.org/magazine.

The shift from Autumn to Winter has often reminded me of the need to keep moving forward and to embrace change. At Penn Highlands Healthcare, we are focused on constant forward movement because we are steadfast in our commitment to caring for all those who call our region home. For instance, to provide you with access to advanced care, we’re focused on bringing the most innovative treatments and procedures to our area. You’ll read about this in our feature on The Lung Center, which recently became the first in the region to offer bronchoscopic lung volume reduction using the first FDA-approved lung valve for helping emphysema patients breathe easier without major surgery.

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If you wish to subscribe to HealthLines electronically, sign up at www.phhealthcare.org/getmagazine. 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@ phhealthcare.org 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.

You will also read about our new chief of Penn Highlands Neurosurgery, Dr. Ghassan Bejjani, who specializes in treating tumors in the brain and spine, making advanced radiation treatment available for more patients with cancer; patients who otherwise would have been referred to Pittsburgh, Cleveland or Danville for a specialized neurological consult and treatment. Also, bringing the latest advancements, we’re focused on increasing your access to care across the region and ensuring that we’re delivering the best service possible. You’ll read about how we recently welcomed Penn Highlands Huntingdon to our system and how we’re taking important steps to better understand and enhance the patient experience journey throughout our system. As always, I hope you’ll enjoy this issue of HealthLines. Within the following pages, we have tried to capture a glimpse of the great progress we are making across our system to even better care for our communities.

Sincerely,

On the Cover

After struggling with COPD for years, Carl Chittester was able to walk his daughter, Keri Keller, down the aisle thanks to The Lung Center of Penn Highlands Healthcare, the first medical facility in the region to offer bronchoscopic lung volume reduction using the first FDAapproved lung valve for helping emphysema patients breathe easier without major surgery. Cover and page 9 photos courtesy of Kimberly Groll Photography.

Steve Fontaine, CEO Penn Highlands Healthcare

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Our Commitment to the Patient Experience At Penn Highlands Healthcare, making a difference in the lives of others is the reason so many of our team members chose to dedicate their careers to healthcare. Our employees and physicians are united by the individuals they serve, and each plays an important role in caring for our patients and communities. Istikram Qaderi, MD, Chief Quality and Transformation Officer for Penn Highlands Healthcare, explains a patient’s experience as the sum of all their interactions with our organization. “It’s simply how they feel about us at the end of the day,” he said. “Their experience is shaped by the first person they speak with when they call to make an appointment, the employee they ask for directions from in the hallway, the phlebotomist who draws their blood, the employee who serves them in the cafeteria, the member of housekeeping who cleans their inpatient room, the nurse who cares for them, the provider who explains their treatment plan, the therapist who helps them recover after a surgery, the list goes on and on.”

Our pledge to providing our patients and visitors with the best experience possible is demonstrated by our service excellence promises, which make up the word CREATE: Communicate, Respect, Empathy, Accountability, Teamwork and Exceeding expectations.

This year, we are taking important steps to better understand and enhance the patient experience journey through Penn Highlands Healthcare.

These words describe how our employees and physicians strive to interact with all those who walk through the doors of any of our facilities.

Under the direction of Dr. Qaderi, we recently rolled out our new transformation vision: We will CREATE a caring community of excellence with a high-quality, safe and an outstanding experience, all the time, every time.

The CREATE promises are being integrated into our culture and every aspect of our service to our patients and visitors. That’s because service is at the heart of what we do at Penn Highlands Healthcare. We are

committed to making the patient experience the best it can possibly be.

PATIENT SURVEYS Do you fill out your surveys? Patient surveys are sent after a stay at one of our hospitals. If you receive one, please fill it out. We want to know how we are doing. Some come via U.S. Mail (especially if you are a Medicare patient) and others may come via emails and text message.

Need a doctor? — Visit us at www.phhealthcare.org/findadoc

Hematuria and Kidney Cancer By John S. Banerji, MD, Urologist Hematuria, pronounced hee·muh·tur·ee·uh, means blood in the urine, and is a symptom of disease involving the genitourinary, or reproductive and urinary, system. Someone might have visible blood in the urine which might be a frank reddish urine or wine colored, tea colored, or brownish or pinkish colored. This can be associated with passage of clotted blood. This kind of visible hematuria is called gross hematuria, which is always almost pathological, or a sign of disease, and a prompt consultation to a urologist with thorough investigation and appropriate treatment is mandatory.

• History of smoking or prolonged exposure to benzene and naphthyl amine containing chemicals.

It is gross hematuria that requires urgent investigation. Patients with gross, visible hematuria should have a detailed history and physical examination.

Common causes of gross hematuria include: • Urinary tract infections. It could be cystitis - infection/inflammation in urinary bladder - or pyelonephritis - infection of the kidneys • Urinary stones. These can be especially large stones in the kidney, or stones in the ureter, the tube bringing urine down from kidney to the bladder, or stones in the bladder • Kidney cancer anywhere in the kidney, including the inside lining of the urine collecting portion of the kidney • Cancer in any part of the ureter • Cancer of the bladder • Cancer of the prostate • Cancer of urethra in males and females though it is a rarer cause of hematuria

Particular note should be made of associated symptoms like: • Burning while passing urine • Increased frequency • Urgency, difficulty to postpone urination • Pain in the lower abdomen or at the back • Presence of fever • Loss in weight

With cancer being listed the most among those possibilities, all patients with gross hematuria must undergo a thorough history and physical examination and subsequent investigations. These include having a urine examination, a urine cytology to look for cancer cells in the urine and a renal function test which tests how blood is filtered in the kidneys.

Microscopic hematuria is blood found in urine that is not visible to the naked eye and is found on routine urine examination. Microscopic hematuria should be investigated especially in patients above the age of 40, but the chances that this is due to cancer involving the urinary tract is low. Most cases of microscopic hematuria are related to bacterial infections.

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Risks for Kidney Cancer Some risks for kidney cancer can be controlled, and some cannot. They include: • Family history/genetic makeup • Tobacco use • Obesity • High blood pressure • Use of certain medications • Exposure to some herbicides, cadmium and organic solvents • Kidney disease Also, a CT scan will be ordered. Called a CT-IVP, it will show a cross-sectional image of the entire urinary tract area. It will be done without and then with IV contrast. If a patient cannot have contrast, a MRI scan, called MR-urogram, can be done. All patients should and must also have a cystoscopy. A cystoscopy is an endoscopic look into the urethra and urinary bladder with a flexible tube with a camera. Both cross sectional imaging (CT-IVP or MR urogram) and cystoscopy are a must and are complementary to each other.

Kidney Cancer Unfortunately, kidney cancer is a major cause of gross hematuria. Kidney cancer is among the ten most common cancers in both men and women, according to the American Cancer Society, and the lifetime risk for developing kidney cancer in men is about one in 48 and in women about one in 83.

At Penn Highlands Healthcare, specialists can perform surgeries, such as: • Laparoscopic, or minimally invasive through small incisions in the belly, radical nephrectomy which is the removal of an entire kidney if a tumor is large.

Most kidney cancers are now detected incidentally - when a CT of the abdomen and pelvis is done for some other symptom and a tumor is detected.

• Laparoscopic partial nephrectomy, which is minimally invasive surgery to remove only the tumor and leave the rest of kidney intact.

But it is important to find cancer early for more successful treatments.

• Open radical or partial nephrectomy. This is reserved for very large tumors or complex tumors in the center of the kidney.

A large proportion of kidney cancers need surgical treatment and removal. An exception is made for smaller tumors less than 3 centimeters in older patients who are not fit for surgery. These patients can be managed either with ablative (tumor destroying) therapies like radio frequency ablation (heating the tumor with radio-frequency waves) or cryotherapy (destroying the tumor with extremely cold temperatures) or with “active surveillance” where the tumors are just followed up with periodic imaging. Current recommendations for surgical treatment of kidney cancer depends on the size of the tumor, the location, the number of tumors, if it involves one kidney or both kidneys and renal function. Kidney tumors less than or equal to 4 cm in size (1.6 inches) are managed with partial nephrectomy - removing only the tumor, leaving healthy intact kidney in the patient. The indications of partial nephrectomy are expanding and can be even safely done for larger tumors, limited to one end of the kidney.

Patients who undergo laparoscopic kidney surgery (either partial or radical nephrectomy) have much quicker time to recovery, are back home in about two days, have less postoperative pain and are back to their daily lives sooner. For more information or if you have further questions, call Penn Highlands Urology at 814- 375-9200. John S. Banerji, MD, Penn Highlands Urology, provides comprehensive urology services and cutting edge treatment options for disorders of the male and female urinary tract and the male reproductive system in a comfortable, compassionate environment.

Penn Highlands Urology

A Service of Penn Highlands DuBois Our Urology Team: John S. Banerji, MD Urologist

Joseph F. Chang, MD Urologist

Anuj K. Chopra, MD Urologist

Kumaresan Ganabathi, MD Urologist

Michael J. Martynik, MD Urologist

Crista M. Bennett, PA-C Board Certified Physician Assistant

Breann M. Leamer, PA-C

Board Certified Physician Assistant

Shae Lowry, MPA, PA-C

Board Certified Physician Assistant

Office Locations: Charles Medical Center 240 Allegheny Boulevard Brookville, PA 814-849-8858 Medical Arts Building 807 Turnpike Avenue, Suite 140 Clearfield, PA 814-765-1484 Medical Arts Building 145 Hospital Avenue, Suite 200 DuBois, PA 814-375-9200 St. Marys Community Medical Building 1100 Million Dollar Highway, Suite 2 St. Marys, PA 814-781-5427

To learn more about UROLOGY SERVICES at Penn Highlands visit us at www.phhealthcare.org/urology Need a doctor? — Visit us at www.phhealthcare.org/findadoc

Penn Highlands Huntingdon W E LC O M E TO T H E FA M I LY Penn Highlands Healthcare welcomed Penn Highlands Huntingdon to its family of hospitals on June 1, 2019. Penn Highlands Huntingdon is the former J.C. Blair Memorial Hospital and Health System. As the healthcare leader in Huntingdon County for over 100 years, its mission to deliver the best outcome for every patient is a good fit for the PHH system. PH Huntingdon includes the hospital, physician offices that include primary care and specialty physicians, physician assistants and nurse practitioners, and a foundation. It also has an auxiliary that has supported the hospital since 1913. The hospital itself is a 71-bed facility located on “Hospital Hill” overlooking the community of Huntingdon. Founded in 1911 by Kate Fisher Blair

to memorialize her late husband John Chalmers Blair, the hospital has experienced many expansion and renovation projects to continuously meet the changing healthcare needs of residents in its surrounding communities. Penn Highlands Huntingdon is the only hospital in rural Huntingdon County. The health system serves over 45,000 permanent county residents, Juniata College students and an additional one million annual vacationers to the Raystown Lake region. THE HEALTH SYSTEM’S KEY SERVICES INCLUDE: • Emergency Department • Catheterization Lab • Urgent Care • Orthopedics • Surgical Services

To learn more about PH Huntingdon visit us at www.phhealthcare. org/huntingdon

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• Gastroenterology • Behavioral Health Services • Intensive Care Unit • Medical/Surgical Unit • Wound Healing Center • Laboratory • Cardiopulmonary • Radiology/Imaging The Laboratory has several locations through the region, and an imaging center in State College. PH Huntingdon will continue to have a board of directors representing the communities it serves, and two of those members will be a part of the Penn Highlands Healthcare system board. President Joe Myers and his team continue to oversee day-to-day operations.

40+ 500+ 30+

Providers

Employees Volunteers

A PH Huntingdon Update From Joe Meyers, President It’s a new day for healthcare for Huntingdon County and the surrounding communities. JC Blair Memorial Hospital has started another chapter in its history as a part of the Penn Highlands Healthcare system. Though we changed our name to Penn Highlands Huntingdon, we are continuing in the spirit of our founder, Kate Fisher Blair, and her husband, John Chalmers Blair, to provide the highest standard of healthcare to the residents of Huntingdon County and surrounding communities. As our Board of Directors anticipated, our affiliation with PHH has been a great fit. We had to make some tough changes at first, but we have already started upon our growth plan to ensure this community has healthcare for many years to come. Already, we have added another family medicine physician to our quality medical staff. In the near future we will open an office of Penn Highlands Lung Center, a nationally recognized program that will be offering services here. We are also actively recruiting 10 new providers for our area. As Penn Highlands Healthcare grows its footprint, PH Huntingdon can only benefit from the vision and foresight that PHH brings to healthcare in our region.

Penn Highlands Huntingdon operates the PH Huntingdon 611 State College Imaging Center. It is an outpatient imaging center located at 611 University Drive, State College. Shown is the front of the building and, below it, the multislice, low-dose CT scanner. The 611 Center offers open MRI, high-resolution MRI, ultrasounds, 3D mammograms, general x-rays and arthrograms. An arthrogram uses a special x-ray machine called a fluoroscope to help the radiologist guide a needle directly into a joint. X-ray dye is injected into the joint and additional images are then obtained with CT or MRI to better see the inside of the joint and the soft tissues around the joint. Opened in 2015, staff can have results to a provider within 24 hours, and if needed, they can provide results within an hour of an exam, all by board-certified and fellowship trained radiologists in the fields of musculoskeletal radiology, neuroradiology and body imaging. For an appointment, call 814-234-2600. As the newest part of The Heart Center of Penn Highlands Healthcare, the Cardiac Catheterization Laboratory is the second in the Penn Highlands Healthcare system. It is located on the second floor at Penn Highlands Huntingdon. There, cardiologists perform both elective and emergent, diagnostic and interventional cardiac catheterizations. They also perform diagnostic and interventional peripheral angiography to detect blockages in the arteries of the body other than the heart. Also, doctors can implant pacemakers and cardiac defibrillators to keep the heart in rhythm. The PH Huntingdon uses stateof-the-art equipment, including its navigation system for procedures involving sinuses, shown. PH Huntingdon staff are able to load a patient’s specific CT scan into this system and, using special instrumentation, doctors can see where they are in the patients’ sinuses in relation to the CT scan - all in real time. This allows for safer probing of the sinus and navigation around difficult anatomy – and avoids eye injury and entry into the brain or carotid artery. Need a doctor? — Visit us at www.phhealthcare.org/findadoc

The Lung Center Among First in U.S. to Use Innovative Technology More than 90 percent of people diagnosed with lung cancer do not survive the disease, largely because it is often found at an advanced stage. Now, new technology available at Penn Highlands Healthcare can assist in diagnosing lung cancer earlier. The Auris Health’s Monarch™ Platform, a new robotic system, enables earlier and more accurate diagnosis of small and hard-toreach nodules in the periphery of the lung. The technology, which allows the team at The Lung Center to view the inside of the lungs and obtain a tissue sample for biopsy, integrates the latest advancements in robotics, software, data science and endoscopy – the use of small cameras and tools to enter the body through its natural openings. Penn Highlands Healthcare is among the first in the United States to utilize the platform, which was recently cleared by

the U.S. Food and Drug Administration, or FDA. “Lung cancer is the leading cause of cancer deaths worldwide, in part because there are not symptoms in its early stages,’ Dr. Sandeep Bansal, medical director of The Lung Center and Intensive Care Services at Penn Highlands DuBois, said. “We are committed to bringing the latest innovative treatments and procedures to our region and we are thrilled that this new technology can offer a more hopeful future for our patients with lung cancer.” Up until robotic bronchoscopy, there were a variety of diagnostic options available for lung cancer, but all had limitations in accuracy, safety or invasiveness.

Should You Be Screened for Lung Cancer?

Penn Highlands Healthcare is the first medical facility in the region to offer bronchoscopic lung volume reduction using the first FDA-approved lung valve for helping emphysema patients breathe easier without major surgery.

FAQs - Robotic Bronchoscopy If I Have A Spot On My Lung, Does It Mean That I Have Cancer? Not all lung spots, also called lung nodules, are cancerous. In fact, more than half are noncancerous. Lung nodules can have different causes, including smoking, scar tissue or old infections. The only way to determine if a nodule is cancerous is by taking a small piece of tissue and having it examined. A bronchoscopy helps your doctor determine whether your lung nodule is cancerous. What Happens During Robotic Bronchoscopy? Before the procedure starts, you will be put to sleep using anesthesia. Your doctor will insert a thin tube called a bronchoscope through your mouth and throat into the lung and take a tissue sample of the nodule. The sample will be sent to a laboratory to find out more information about your nodule. Is Robotic Bronchoscopy Safe? Yes, it is safe. Every medical procedure will carry some risk. The primary risk factors for lung biopsy procedures are a collapsed lung and bleeding. The Monarch™ Bronchoscopy was designed to keep risks as low as possible while maintaining a high rate of diagnosis. Does The Robot Actually Perform The Procedure? No, your doctor has complete control over the robot throughout the entire procedure. The robotic bronchoscope is a tool that helps your doctor reach and biopsy the lung nodule easier than controlling it by hand.

Those who meet the following criteria should consider annual lung cancer screening: • Individuals between ages 55-77 with at least a 30 pack-year smoking history and continue to smoke or quit smoking less than 15 years ago. One pack-year is equal to smoking 20 cigarettes, or one pack, every day for one year. • Individuals age 50 or older with at least 20 pack-years and one or How Long Does The Procedure more risk factors: long-term exposure to asbestos, asbestosTake? related lung disease, COPD, pulmonary fibrosis, family history To learn The procedure times may vary of lung cancer, long-term exposure to silica, cadmium, arsenic, but will generally take about 30more about 90 minutes. beryllium, chromium, diesel fumes, nickel, coal smoke and soot. Pulmonary Care

Schedule your lung cancer screening by calling 814-375-3770. 8|

visit us at www.phhealthcare. org/lung

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Where Does The Procedure Take Place? Robotic bronchoscopy is an outpatient procedure and takes place in the Bronchoscopy Suite at PH DuBois.

Father Walks Daughter Down Aisle Thanks to Innovative Lung Treatment Before his diagnosis with chronic obstructive pulmonary disease, or COPD, DuBois resident Carl Chittester said he lived a very full life. “We raised five kids. I was a mechanic for a glass company, a community fire chief, and I coached my daughter’s softball teams for many years. We were avid campers, too, and I was camping when I first noticed the symptoms of COPD. I started to get short of breath while setting up the camper,” he said. About five years ago, Carl landed in urgent care with breathing difficulties, and ultimately was referred to Dr. Sandeep Bansal at The Lung Center of Penn Highlands Healthcare. Carl had quit smoking about seven years earlier, so his COPD diagnosis came as a surprise. Although he tried medication after medication, his symptoms continued to worsen to the point that he was using oxygen just to get from his house to his car. According to Dr. Bansal, this isn’t uncommon for individuals with COPD. Despite using COPD medications, over one million patients continue to suffer symptoms of hyperinflation causing severe shortness of breath. “I couldn’t go camping anymore because of the campfires. I couldn’t go to a ballgame because of the humidity,” Carl said. “That was hard because I loved watching our Penn State team and my grandson play ball. It broke my heart to miss his games.” His whole life became limited by his disease. He had multiple hospitalizations and ICU stays due to pneumonia and sepsis. Then, when his daughter announced she was getting married, Carl knew something had to change. He told Dr. Bansal, medical director of The Lung

Center and Intensive Care Services at Penn Highlands DuBois, Carl Chittester that there was one and his daughter Keri. thing he wanted to be able to do, and that was walk his daughter down the aisle and Carl only continued to feel better. dance with her without oxygen. “I walked my daughter down the aisle oxygen free! It was one of the best Up until recently, there were very few moments of my life,” he said. “I was even treatment options for most patients able to have a dance with her without with severe emphysema or COPD. the oxygen. I felt like my prayers had However, to bring the latest and most been answered.” innovative pulmonary care to patients in western Pennsylvania, The Lung Center became the first medical facility in the region to offer bronchoscopic lung volume reduction using the first FDA-approved lung valve for helping emphysema and COPD patients breathe easier without major surgery.

“We are thrilled to be able to offer this new treatment option to our emphysema patients who consistently struggle with their breathing despite medication,” Dr. Bansal said. “Up until now, the only options for relief were highly invasive treatments, including lung surgeries. This minimally invasive procedure has the potential to improve the quality of life for many emphysema sufferers in our region of Pennsylvania and beyond.” Carl was the first patient treated at Penn Highlands with the new Zephyr Valve. “The procedure went as planned and within hours I felt fantastic,” he said. “I stayed for a few days in the hospital. I felt good, and I was treated like a king by my wonderful nurses.”

According to Dr. Bansal, this one-time, 30-60 minute procedure is completed during a simple bronchoscopy that doesn’t require any cutting or incisions. During the procedure, four tiny valves, on average, are placed in the airways to block off the diseased parts of the lungs where air gets trapped. Keeping air from getting trapped in the diseased parts of the lungs allows the healthier parts of the lungs to expand and take in more air. This results in patients being able to breathe easier and experience less shortness of breath. “Providing our communities with cutting-edge treatment options is a priority for us at The Lung Center,” Dr. Bansal said. “Our patients deserve to have access to this level of life-saving care right here, close to home, and it is our privilege and mission to provide it.” Not everyone with emphysema qualifies for this treatment. The patient selection is done based on rigorous inclusion and exclusion criteria. The treatment is performed in close collaboration by a multidisciplinary team consisting of interventional pulmonology, thoracic surgery, interventional radiology, anesthesiology and nurse and respiratory therapy navigators at The Lung Center.

Need a doctor? — Visit us at www.phhealthcare.org/findadoc

ASK THE EXPERT - What should we know about heart health? What is the most common heart disease? The most common type of heart disease in the United States is coronary artery disease or CAD, which affects the blood flow to the heart. Decreased blood flow can cause a heart attack.

Your heart is an amazing muscle about the size of your fist. Nestled between the lungs and in the middle of the chest, the heart is the center of your well-being! The heart moves life-sustaining oxygen and nutrient-rich blood throughout our bodies to muscles and organs. When the heart doesn’t work right, the entire body can be affected. That is why it is important to know about heart diseases or heart conditions, especially if they are common in your family. Having heart disease is not hopeless. There are ways to prevent them and control them. 10 |

Statistics show that every 40 seconds, someone in the United States has a heart attack. A heart attack, also called a myocardial infarction or MI, occurs when a part of the heart muscle doesn’t receive enough blood flow. The more time that passes without treatment to restore blood flow, the greater the damage to the heart muscle. Some heart attacks are called silent – where damage is done but the person wasn’t aware that it occurred. Many people blame symptoms on other factors, such as heart burn. Raj R. Kaushik, MD Cardiovascular/Thoracic Surgeon Medical Director, The Heart Center What is heart failure? Heart failure, or congestive heart failure, is a serious condition that occurs when the heart can’t pump enough blood to meet the body’s needs. It causes a recognizable buildup of fluid in the lungs, liver, gastrointestinal tract, and the arms and legs. It causes shortness of breath and fatigue along with noticeable swilling in the ankles, feet, legs, abdomen and veins in the neck. Steven Sprankle, MD Cardiologist DuBois Regional Cardiology Associates

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What causes CAD? CAD is caused by plaque buildup in the walls of the arteries that supply blood to the heart and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over time, which could partially or totally block the blood flow. When your heart muscle doesn’t get enough blood, you may have chest pain or discomfort, called angina. Angina is the most common symptom of CAD. Over time, CAD can weaken the heart muscle. This may lead to heart failure, a serious condition where the heart can’t pump blood the way that it should. An irregular heartbeat, or arrhythmia, also can develop. Louis Russo, MD Cardiovascular/Thoracic Surgeon The Heart Center What is PAD? Peripheral arterial disease, or PAD, is an extremely prevalent disease in the U.S. PAD occurs when the arteries that supply blood to the arms and legs - the periphery arteries - become narrow or stiff. PAD usually results from the buildup of plaque and narrowing of the arteries. With this condition, blood flow and oxygen to the arm and leg muscles are low or even fully blocked. Signs and symptoms include leg pain, numbness, and swelling in the ankles and feet. Michael Sabatini, MD, PhD Cardiologist Interventional Cardiology Cardiology Specialists of Altoona

How serious is arrhythmia? Arrhythmias are irregular or unusually fast or slow heartbeats. Arrhythmias can be serious. One example is called ventricular fibrillation. This type of arrhythmia causes an abnormal heart rhythm that leads to death unless treated right away with an electrical shock to the heart (called defibrillation). Other arrhythmias are less severe but can develop into more serious conditions, such as atrial fibrillation, which can cause a stroke. Atrial fibrillation, or a fib, is a type of arrhythmia that can cause rapid, irregular beating of the heart’s upper chambers. Blood may pool and clot inside the heart, increasing the risk for heart attack and stroke.. Jay Ambrose, MD Cardiologist DuBois Regional Cardiology Associates

The good news is that there are controllable risk factors! These are opportunities to create better health for yourself. How?

Be Heart-Ready Heart disease affects millions of Americans. It is the leading cause of death and a major cause of disability. But did you know that cold weather can affect the heart, especially if you have a heart condition. Our bodies work harder to keep warm if their temperatures drop. Sudden exertion, like lifting a heavy shovel full of snow or even walking through heavy, wet snow or snow drifts can strain the heart. That is why this is a good time of year to think about your heart or your loved one’s heart. If you’re concerned about your loved ones, get them or yourself ready for the upcoming winter season. How? Put together emergency items. It only takes a little bit of time and effort to prepare. When seconds count, have the following on hand: • •

• •

A bottle of uncoated aspirin in key locations such as a medicine cabinet, near the kitchen sink, in one’s purse and in the car. If heart attack symptoms occur, the person should take one immediately. Have a list of emergency contact phone numbers posted by all home phones, in cell phones and in one’s wallet. It should start with 9-1-1 and list non-emergency phone numbers for police and fire departments, the poison control number (800-222-1222), people to call in case of emergencies and one’s physician. If the person prefers a specific ambulance company, list it there by name. Prepare a document that contains a list of all of the person’s medications, allergies and a brief medical history of chronic health issues. Have him or her put it in a wallet with a copy of the emergency numbers. Place pens and papers near telephones. Though not always possible, the person can jot down symptoms in case he or she is unable to communicate when medical help arrives.

There are also other ideas that give peace of mind and heart. A medic alert bracelet can announce health issues, especially heart problems, for a patient when a patient cannot speak. They can be ordered from many Internet sites. There are also services that can summon emergency help at the touch of a button worn on a small device. It activates a series of phone calls for help through a landline in case someone has “fallen and can’t get up.”

To learn more about

Plan to do outside chores that lead to heart stress, like shoveling walkways and driveways or find someone now to hire later.

• Control your diabetes • Stop using tobacco Buy house numbers that are visible. If an ambulance needs to Heart Care find a home immediately, are the person’s house numbers • Exercise visit us at visible from the road at 2:00AM in the worst weather • Eat a healthy, low-fat www.phhealthcare conditions? Many municipalities require visible house numbers and low-sodium diet – usually about 6 inches high. And don’t just buy them. Make .org/heart • Be within 20 pounds sure they are installed on the house where the owner wants of your recommended them. weight • Control your cholesterol Taking the time now to prepare can save needed time later. • Keep your blood pressure at 120/80 mm/Hg If you even think you or a loved one are having a heart attack, call 9-1-1. • Get eight hours of sleep daily • Reduce stress where you can | 11 Need a doctor? — Visit us at www.phhealthcare.org/findadoc

AT PENN HIGHLANDS

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

PHYSICIANS

Cameron Bobbett, MD Emergency Medicine Physician Penn Highlands Clearfield 809 Turnpike Avenue Clearfield, PA 814-765-5341

Gurvinder Dhaliwal, MD Family Practitioner Penn Highlands Family Medicine 90 Hospital Road Suite 200 Brookville, PA 15825 814-849-1874

Michael Felix, MD General Surgeon Penn Highlands General Surgery 761 Johnsonburg Road Suite 130 St. Marys, PA 814-781-1188

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Benjamin Gangewere, MD Psychiatrist Behavioral Health Services 635 Maple Avenue DuBois, PA 814-375-6379

Jessica Gruver, OD Optometrist Penn Highlands Eye Center 529 Sunflower Drive Second Floor DuBois, PA 814-371-2390

Deanna Mascho-Cawley, MD Obstetrician/Gynecologist Penn Highlands Life’s Journey 190 West Park Avenue Suite 9 DuBois, PA 814-371-1900

Find A Doctor

Ryan Minnich, DO Family Practitioner Penn Highlands Family Medicine 761 Johnsonburg Road Suite 240 St. Marys, PA 814-834-6565

Joe Raziano, MD Emergency Medicine Physician Penn Highlands Elk 763 Johnsonburg Road St. Marys, PA 814-788-8000

Mitchell Rothenberg, MD Orthopedic Surgeon Penn Highlands Orthopedics 145 Hospital Avenue Suite 301 DuBois, PA 814-299-7432

Grace Wenzel, MD Cardiologist DuBois Regional Cardiology Associates 807 Turnpike Avenue Clearfield, PA 814-375-3722

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

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

ADVANCED PRACTICE PROVIDERS

Project Updates PENN HIGHLANDS HEALTHCARE MASTER FACILITIES PLAN Known as the Master Facility Plan, Penn Highlands is expanding its footprint throughout the region with eight new buildings or renovations.

Shelbie Jamison, PA-C Board Certified Physician Assistant

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

Brandon Riley, PA-C Board Certified Physician Assistant

Penn Highlands Orthopedics 761 Johnsonburg Road Suite 310 St. Marys, PA 814-299-7432

Kristina Torretti, PA-C Board Certified Physician Assistant

Penn Highlands Elk Emergency Department 763 Johnsonburg Road St. Marys, PA 814-788-8000

We’ve been keeping you up-to-date on the first one – the West Wing Annex Project – an addition at Penn Highlands DuBois West. This five-story construction project is coming closer to completion, and staff are coming together to coordinate final decisions. The building is on schedule to be finished in December 2019 or January 2020.

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

Ground has been broken for the new Medical Office Building in Brookville. Located next to Penn Highlands Brookville, this building will house physician offices and other outpatient services. Penn Highlands DuBois East work is starting. Crews are prepping to remove the 100-year-old structure while keeping the newer portions of the hospital intact and in use. Some items have been saved from the building for display in the new Behavioral Health Hospital. Penn Highlands Clearfield has decided upon its exact renovation plans for the Emergency Department. Work will begin in the former patient care area on the first floor for the new ED in the near future. The larger space within the hospital will provide patients with more rooms to be seen and a separate entrance directly for emergency use from Turnpike Avenue. The former ED on the ground floor of the hospital will be used for outpatient services. Other projects in the works are still coming together. They include: the Pinecrest Manor renovations in St. Marys, the Clarion Community Medical Building, The Centers of Excellence Building at PH DuBois West and the Emergency Department Expansion also at PH DuBois West.

Need a doctor? — Visit us at www.phhealthcare.org/findadoc

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ShortScripts Loving Touches Craft Sale The Penn Highlands Brookville Auxiliary Loving Touches Craft Sale is set for Friday, November 1, 2019, from 8:00 AM to 5:00 PM and Saturday, November 2, 2019, from 9:00 AM to 3:00 PM at the Heritage House, Sylvania Street, Brookville. Stop and browse the large assortment of gifts, decorations, ornaments and baked goods. It will also feature a selection of used books.

31st Annual Pinecrest Manor Bazaar

WE’RE GOING DIGITAL As more and more people prefer to have access to digital files on their phones, tablets and laptops - Penn Highlands Healthcare has decided to go 100 percent digital with HealthLines. After this printed edition, all HealthLines will be accessible only on the Penn Highlands Healthcare website, www.phhealthcare.org/ magazine. We have always had an electronic version of HealthLines available here and had past editions available, too.

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Will be held 9:00 AM to 4:00 PM, Sunday, November 24, 2019! 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. In order to mark the occasion of our last printed issue, we are offering a chance to win a new iPad to all of those who e-subscribe with their name and e-mail address at www. phhealthcare. org/subscribe by December 31, 2019.

Subscribing online is FREE. A a link to the e-magazine will be emailed directly to you when a new edition is ready. Our magazine will continue to have great feature stories. Don’t miss out!

SIGN-UP for HealthLines at www.phhealthcare.org/getmagazine

It’s a great way to do some holiday shopping and support a great cause.

Join the movement on #GivingTuesday - December 3, Donations can 2019. As a be made through not-for-profit our Annual Giving organization, Campaign by check Penn or online at Highlands phhealthcare.org. Healthcare is grateful for the support from all of our communities on this special day of giving. For more information, call our Fund Development Office at 814-3753901.

100 Year Anniversary

Penn Highlands Healthcare’s

Penn Highlands Brookville will celebrate its 100 Year Anniversary on December 12, 2019. The public will be invited to join in festivities which will be held in December at the hospital. You can commemorate this milestone by making a gift to Penn Highlands Brookville online at www.phhealthcare.org or by sending a donation to PH Brookville, 100 Hospital Road, Brookville, PA 15825.

Auxiliaries Balls

Christmas Tree Program Remember or honor someone special through the Penn Highlands Elk Auxiliary Christmas Trees. For a $5 donation, a printed card with your loved one’s name will be placed on either the hospital or Pinecrest Manor lobby tree for the Christmas season. For more information about this program, contact any auxiliary member, call 814-834-1646 or send a donation to the PH Elk Auxiliary, 763 Johnsonburg Road, St. Marys, PA 15857.

Tree of Doves Please join us in supporting our exceptional, local hospice program with a donation to the “Tree of Doves.” The trees adorned with dove decorations will be on display this Christmas season in the atrium of Penn Highlands DuBois West, located at 100 Hospital Avenue, DuBois. The doves represent loved ones. Each dove will feature the name of the individual being honored or remembered. White will indicate memorials, and red will indicate “in honor of.” Donors may ask for an American flag to be placed on each veteran’s or first responders dove.

Wear your black and all your bling, and join the Penn Highlands Clearfield Auxiliary for the 109th Annual Charity Ball. The ball this year will be December 14, 2019, at Moena Restaurant in Clearfield. Advanced tickets are required and available for purchase as there is limited seating. Cost is $150 per couple or $75 individual for a sit-down, served dinner and entertainment by “Over the Influence.” Our goal this year is to purchase all new mattresses for the beds at Penn Highlands Clearfield. Please help us achieve this goal. Contact Laura Edwards at 814-5531073 to reserve your seats today! Join the Penn Highlands DuBois Auxiliary for their annual Charity Ball held at the DuBois Country Club on Saturday, December 7, 2019. Festivities begin at the preparty from 7:00 PM to 9:00 PM then enjoy the ball from 9:00 PM until Midnight. Cost is $100 per couple, $50 per person or $25 per college student with ID. Dress your best or wear cocktail attire. Proceeds from this year’s event will go towards the completion of a pledge made for a heart-lung machine with myocardial protection system. For more information or tickets, call Paula DuBois at 814-590-1116 or any auxiliary member. The Penn Highlands Huntingdon Auxiliary Gala is scheduled for Saturday, November 9, 2019, at Juniata College in Huntingdon. If you would like to be added to the mailing list of this black-tie preferred event, or need more information, please contact Wendy Garlock at the Penn Highlands Huntingdon Foundation office at 814-643-8889.

Send an eCard Penn Highlands Healthcare invites you to send some cheer to brighten the spirit of a loved one who is in the hospital! A free service, you can send an eCard to patients in any of our hospitals. www.phhealthcare.org/eCard

Join Us On Facebook! www.facebook.com /pennhighlandshc

For more information on Tree of Doves, please call 814-781-4722. Need a doctor? — Visit us at www.phhealthcare.org/findadoc

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Advice From A DOCTOR

Grae L. Schuster, MD Radiation Oncologist Hahne Regional Cancer Center 814-375-3535

Is stereotactic radiosurgery available at Penn Highlands? In 2016, Penn Highlands was excited to announce that Stereotactic Radiosurgery was going to be one of many potential treatment options for patients in the region. Since then, patients have been treated with cutting edge radiation treatments usually reserved for those willing and able to travel to big city hospitals. The Radiation Oncology team has given patients the one thing that anyone who has received this diagnosis can ask for: time.

energy to the treatment area in 30-minute treatments. And because of its accuracy and precision, it spares the healthy tissue, reducing side effects and opening up new worlds of treatment possibilities. SRS is not appropriate for every patient. But Dr. Bejjani’s special interest in treating tumors in the brain and spine may make this treatment available to more patients; patients who otherwise would have been referred to Pittsburgh, Cleveland or Danville for a specialized neurological consult and treatment. Hope. It’s hard to come by. But with the addition of Dr. Bejjani, more patients will find hope a little closer to home.

Now, Dr. Ghassan Bejjani has joined the team, adding his level of expertise in Neurosurgery to bring this exciting technology to more patients with a wider scope of practice. Stereotactic Radiosurgery, SRS, is different than conventional radiation treatment. It delivers intense, focused

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Dr. Bejjani joined Penn Highlands in November 2018 as the new Chief of Neurosurgery. Prior to joining Penn Highlands, Dr. Bejjani worked at the University of Pittsburgh Medical Center, where he served as Chief of Neurosurgery at UPMC East from 2012-2017. Dr. Bejjani performs simple and complex spine and brain procedures, and specializes in complex brain tumors and complex brain pathology. Penn Highlands Neurosurgery has office locations in Clarion, DuBois, Greensburg, Indiana, St. Marys and State College. For more information or to reach any of the office, call 814-503-4433.

VarianTrueBEAM® Linear Accelerator at Hahne Regional Cancer Center