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Health LINES Penn Highlands Healthcare

Working together for a healthy community.





Cover Story Community Pharmacy Now Open!


Pinecrest Manor


Family Ties

CEO Perspective

We live in an age where convenience is very important to us. If we need gas in our car at 4:00 AM, there is a station open on the corner. If we want to buy groceries at midnight, no problem.

8 Ask The Expert - Q&A Geropsychiatry 7 Not Just Lyme Disease Comes From Ticks 10 New Faces 11 What to Bring to a Doctor’s Appointment 12 Preteen/Teen Vaccines ShortScripts 14 16 Advice From A Doctor

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HealthLines is a publication of Penn Highlands Healthcare. It is produced quarterly by the Marketing Team of Penn Highlands Healthcare which represents the four hospitals of the Penn Highlands system – Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk. The HealthLines magazine will always be available on our website at If you wish to subscribe to HealthLines, sign up at Printed copies may be found in the waiting rooms at Penn Highlands Healthcare facilities throughout the eight-county region. You may pick one up at anytime, if you prefer. 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, Writer/Editor, 814-375-3495 Mary Jo Herzing, Graphic Design Specialist, 814-375-6539 John Brennan, Marketing/PR Director, 814-375-3494 Amy Duke, Marketing/PR Director, 814-768-2827 Karen Hazlett, Marketing/PR Specialist, 814-788-8532 Brian Musser, Community/Physician Outreach Specialist, 814-375-6508 Lori Rancik, RN, The Women’s Health Center, 814-371-9666 The information in this magazine does not take the place of health advice given to you by your healthcare provider. Always call 911 for any emergency.

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In our business, our Emergency Departments are never closed. We have dedicated physicians and staff working in our hospitals 24 hours a day, 7 days a week, 365 days a year. We know the need for care doesn’t stop. Now, with our full-service community pharmacy in DuBois, our pharmacists who work around the clock already for patients are extending their work to the community and a 24-hour driveup window for filling and picking up prescriptions. No other pharmacy in our region can offer this level of access to your prescription medications. This is just one way Penn Highlands Healthcare is trying to make lives better in our region. Please be sure to read about it and so many other great things happening in our region. Sincerely,

Steve Fontaine, CEO Penn Highlands Healthcare

HealthLines gives you the most up-to-date news about services at the four Penn Highlands hospitals and what is available to help you lead a healthier life. This FREE magazine will always be available: • On our website, Get on our e-subscription list by filling out the online form at; you will receive an e-mail directly to you as soon as it hits the newsstands. • In the lobbies, waiting rooms and offices throughout the Penn Highlands Healthcare system, you can pick up a hard copy of this magazine. The magazines are also available at the DuBois Mall Community Booth and at several local businesses. Our magazine is also available, for those who request it, via U.S. Mail. To the left of this column is a list of names and phone numbers of our team. Call for a copy to be mailed to you as they come off the presses. Share your name, address and telephone number if you leave a message.

The Penn Highlands Healthcare system has its own skilled nursing facility. Located in St. Marys, Pinecrest Manor offers exceptional care for those needing short-term rehabilitation, long-term care or a respite stay. On the campus of Penn Highlands Elk, Pinecrest Manor offers special amenities like vibrant gardens, a beautifully landscaped courtyard and various dining options. Rooms are semiprivate and offer individual telephones, WiFi and cable hook-up.

When you want the best for your loved one, choose


Pinecrest Manor offers the latest treatments to help residents achieve their highest level of functioning. Each resident is seen regularly by either a physician or an advanced care provider. A dietitian helps ensure each resident eats a nutritious, healthy diet. The Activities Department keeps residents engaged in things to keep the their mind, body and spirit active, while offering social interaction. This department plans special events throughout the year from car shows to concerts, holiday celebrations to art exhibits, too. Pinecrest is fortunate to have the full support of the Rehabilitation Center at PH Elk. Residents have access to the area’s best physical, occupational and speech therapists. Therapy may be done in the resident’s own room or in Pinecrest’s spacious Rehab Suite. The goal is to strengthen the body and help the resident perform activities of daily living as independently as possible. Pinecrest Manor also offers specialized medical care like pain management, respiratory therapy, wound care, IV therapy, palliative care and hospice. If family is unable to transport the resident to doctors’ appointments, the staff can do that with handicapped accessible vans. A location beside PH Elk offers the convenience of acute care, if needed. To keep residents looking good on the outside, a hair salon and complete laundry services are on-site. A specialized unit – called Reflections – helps individuals with Alzheimer’s disease or cognitive impairment. Here, the residents have daily activities and routines to help support memory. Pinecrest Manor has been providing 24-hour nursing care since 1970. Committed to excellence and focused on personcentered care, it honors individual choice and dignity. For more information on Pinecrest Manor, please call 814-788-8488, or visit us online at pinecrest.

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FAMILY TIES Physicians Return to Hometowns to Practice for Penn Highlands Healthcare After graduating from medical school in Philadelphia four years ago, Amy Kelly, DO, could have practiced anywhere. But her home – and heart – were in St. Marys. “I always wanted to return, especially for my family. They supported me throughout my entire education, and it was important to me to remain geographically close to them. It’s nice to have a mom-cooked meal just a couple blocks away! Professionally, I enjoy the breadth of challenges practicing rural medicine affords me every day, and Penn Highlands’ community-oriented approach to health care is a great fit for me,” she said. Dr. Kelly is one of several physicians who have returned to their hometowns and Penn Highlands Healthcare to practice medicine. “The goal of our health system is to recruit high quality, compassionate physicians and advanced practice providers,” said Steven Fontaine, chief executive officer of Penn Highlands Healthcare. “I’m extremely pleased to say we have been successful at doing so. What’s even more gratifying is when natives of the communities we serve choose to practice for Penn Highlands. It’s a win-win for everyone - the physician, our health system and most important, the residents.” He went on to say a physician who returns to the region has “a hometown advantage” because he or she already has a connection to the community.

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“I have been fortunate to be able to establish an intimate, family-like practice where my staff knows nearly every patient by name. This really goes a long way toward making them as comfortable as possible with the care we provide,” Dr. Kelly said. Christopher Varacallo, DO, a DuBois native who also returned to the area to practice sports medicine, said service to the community is a family tradition – his father, the late Albert Varacallo, MD, was a family practice physician at the Reynoldsville Medical Center. “My family is still living in DuBois, so it is really nice to be around them. I also value the opportunity to care for and help people in the community where I grew up – people who helped me along the way. It is nice to be able to help them in some small fashion with their health and well-being,” he said. Connecting with physicians and medical students, especially those with local ties, is just one of many methods Penn Highlands uses when it comes to recruiting talent. This strategy is becoming more important in light of the challenges most rural hospitals deal with in today’s healthcare environment. Recruiting challenges “Most, if not all, rural hospitals

(Top) Dr. Amy Kelly of St. Marys is one of several physicians who have returned to their hometowns and Penn Highlands Healthcare, to practice. (Below) Dr. Christopher Varacallo of DuBois with his grandmother, Patricia Varacallo and his father, the late Albert Varacallo, MD, in the summer of 2008. face recruiting challenges. To begin with, there is a nationwide shortage of physicians. And, right now, there are not enough students graduating from medical school to fill those anticipated shortages,” states Gary DuGan, MD,

chief medical officer for Penn Highlands Healthcare. To illustrate, Dr. DuGan noted that The Association of American Medical Colleges estimates that by 2025, the United States will have a shortage of almost 95,000 physicians due to an aging workforce. Further, the AAMC predicts that 15 million people will be eligible for Medicare at that time, as well as 32 million insured patients through the Affordable Care Act. To complicate matters, rural areas are the least preferred regions in which physicians wish to live and practice, according to a 2015 Physician Practice Preference Survey conducted by The Medicus Firm, one of the nation’s largest physician search firms. More than half of the survey respondents indicated they preferred a suburban or major metropolitan area; rural settings ranked at the bottom.

Finally, most young physicians rank work/ life balance as an important factor when deciding on where to practice. Most prefer to join a physician group or hospital for which they are required to be on call once every several weeks, if at all. This becomes a major hurdle for rural hospitals, especially when it comes to specialties. Often, rural hospitals do not have enough specialists to accommodate candidates’ preferred call schedule. Dr. DuGan said Penn Highlands is overcoming these challenges with innovative initiatives and competitive strategies. Recruiting efforts On a daily basis, Penn Highlands’ Recruitment Department professionals – Megan Hanzely, director, and Linda Cindric, Wayne Saxton and Hilaree Liegey, recruiters – network with medical schools, professional recruiting firms and individual candidates. In addition, they attend numerous career fairs, advertise in professional journals and use social media to reach physicians in the job market.

medical school, especially those who have grown up in the eight-county area served by Penn Highlands’ hospitals in DuBois, Brookville, Clearfield and St. Marys. Jessica Ayres, a native of Clearfield, is one of those physicians. A graduate of the Philadelphia College of Osteopathic Medicine, Dr. Ayres is in her last year of a family medicine residency and plans to begin practicing at Penn Highlands Clearfield next year. She said when she decided to pursue studies in medicine, she had no specific plan as to where she wanted to eventually practice. Stints in New York City and Philadelphia helped to make up her mind, though. “That experience helped me realize that a small town was where I wanted to practice my profession and raise a family. Growing up in Clearfield,

The ongoing emphasis on recruiting physicians has yielded success during the past two fiscal years for Penn Highlands, according to Megan. Close to 50 physicians have been recruited system-wide. Among the specialties recruited include obstetrics/gynecology, radiation oncology, non-invasive cardiology, emergency medicine, plastic surgery, child psychiatry, general surgery, radiology, internal medicine, family medicine and urology.

Student connection Recruiters are also forming relationships with students well before graduation from

She added, “Clearfield is a good place to raise a family. Good things are happening in the town, such as the River Walk, the YMCA and community pool expansions and improvements. I have family and childhood friends in the area. I also think the school system is a good one.” Another consideration was the encouragement and support Dr. Ayres received from physicians and Penn Highlands Healthcare. “I want to give back to the community including friends and neighbors that helped to raise me and helped me realize my goals. I value being able to work with physicians who helped me and encouraged me to pursue a career in medicine. I like Penn Highlands’ emphasis on community medicine and outpatient care, and the professional opportunities this will afford me starting out as a new family practice physician,” Dr. Ayres said. Penn Highlands served as a career pathway for Dr. Varacallo, who put his summer breaks from college to good use by working in various Penn Highlands DuBois departments including Occupational Health and Transport. “Penn Highlands expressed interest in me returning to DuBois very early on in my training and they supported me while I was finishing my training. I was also familiar with the health system as I had worked three consecutive summers in some capacity. That was great, and I met a lot of really wonderful people and gained some valuable experience,” he said.

While there have been many gains, there have been a few losses, so the recruiters understand their work is far from done. “Physician and advanced practice provider recruitment are top priorities for Penn Highlands Healthcare,” Megan said. “Our team has and will continue to work diligently to engage the best medical professionals for our community. Our goal is to expand patients’ access to physicians and advanced practice providers. We believe Penn Highlands Healthcare and our community have a lot to offer, especially in terms of quality of life, and we capitalize on those assets in our recruiting efforts.”

I liked being close to friends and places such as the library, playgrounds, church and the community pool. We knew that we would be safe wherever we were because there were parents, neighbors and other grownups that would look out for us,” Dr. Ayres said.

(Top) Dr. Jessica Ayres, a native of Clearfield, will return to Clearfield and begin practicing at Penn Highlands Clearfield in 2017. (Below) Dr. Lisa Witherite-Rieg, director of Medical Education, says Penn Highlands Healthcare is very supportive of medical students and offers training opportunities.

Medical student teaching Another way Penn Highlands Healthcare connects with future physicians is through on-site education. Penn Highlands has affiliations with Lake Erie College of Osteopathic Medicine (LECOM), the largest medical school in the country, as well as Penn State College of Medicine Continued on Page 10

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ASK THE EXPERT - GEROPSYCHIATRY As the body ages, it changes. The same can happen to our minds. An older population often has different behavioral health issues than a younger one. Geropsychiatry is a subspecialty of psychiatry dealing with the study, prevention and treatment of mental disorders in humans as they age. To address these specific needs in our older population, there are geriatric psychiatric units at three of the four Penn Highlands Healthcare hospitals: Senior Tranistions Unit at PH Brookville, 814-849-1845; Bright Horizons at PH Clearfield, 814 768-2137; and Generations Unit at PH Elk, 814-788-8876.

WHAT SORTS OF ILLNESSES DOES A GERI-PSYCH UNIT TREAT? Our units treat major neurocognitvie disorders (previously known as dementia), depression, anxiety, bipolar disorder, schizophrenia, suicidality, behavioral disturbances, hallucinations, psychosis and other mental health disorders. Shannon Mitchell LCSW, CCDP-D Director Bright Horizons Penn Highlands Clearfield

WHO MAY GO TO THE UNITS? WHAT SYMPTOMS ARE SIGNS OF NEED FOR INPATIENT HELP? The units are for individuals age 55 and older who may be experiencing depression, suicidal thoughts or actions, fears or anxiety that is impacting their daily lives, and psychotic symptoms such as hallucinations and delusions. And we also treat people who have behavioral problems associated with dementia. Sometimes with dementia, a person will have dangerous behaviors such as aggression or combativeness or a lack of ability to care for themselves. Nancy Florio, BA Community Relations Coordinator Senior Transitions Unit Penn Highlands Brookville

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WHAT DOES THE UNIT DO FOR THE PATIENT? WHO WORKS IN THE UNIT? Along with focused one-to-one therapy sessions, the programs place strong emphasis on wellness and therapeutic activities, such as music and exercise, all in a home-like environment and close to the families and support systems of the patients. A psychiatrist attends to the patients along with a team of dedicated and caring registered nurses, certified nursing assistants, therapy staff and social workers. These caring professionals have valuable experience understanding and meeting the needs of the elderly mental health patient and care, not only for the patients, but they include the entire family in the treatment plan. Mary Helen Coroso, RN Director Generations Unit Penn Highlands Elk

We all know someone who has gotten Lyme disease from an infected tick, but what many people do not know is that there are other diseases that come from ticks, too, like babesiosis, ehrlichiosis and anaplasmosis. Grace Jesberger of St. Marys knows first-hand about anaplasmosis. Last spring, she came to the QCare St. Marys, a Penn Highlands Healthcare urgent care center, with severe chills and muscle pain. She was then sent to the Emergency Department at Penn Highlands Elk because of tenderness to her abdomen. She was tested for Lyme disease, but did not have it. After some deduction, Grace was diagnosed with anaplasmosis. According to the Centers for Disease Control, anaplasmosis is a disease caused by the bacterium anaplasma phagocytophilium. These bacteria are transmitted to humans by the bite of an infected tick. The black-legged tick is the common carrier in the northeast, and they are in our area. The first symptoms of anaplasmosis typically begin within one or two weeks after the bite of an infected tick. A tick bite is usually painless, and some patients who develop anaplasmosis do not remember being bitten. The most common symptoms are: • Fever • Headache • Muscle pain • Malaise • Chills • Nausea with or without abdominal pain • Cough Few people with the disease will develop all symptoms, and the number and combination of symptoms varies greatly from person to person. Doxycycline should be the first line of treatment. Since Grace has an allergy to this antibiotic, doctors had not previously given her the medication. After the diagnosis, it was determined the benefits outweighed the risks, and Grace began a Doxycycline regimen. In a few days, she was feeling much better. Now Grace wants to spread the word about anaplasmosis. “Ticks are so tiny,”

she said. She didn’t realize the mark on her arm was from a tick. With this disease, there is no bull’s-eye as with Lyme disease, and a rash is rarely reported in patients with anaplasmosis. If there is a rash, it usually comes from a co-infection with Lyme disease or another tickborne disease, such as Rocky Mountain Spotted Fever. Anaplasmosis can be fatal if not treated correctly. The CDC estimates less than 1 percent of people infected die; however, severe reactions will likely involve hospitalization. Treatment is most effective when started early. Anaplasmosis is difficult to diagnose, as the symptoms are characteristic of many illnesses. Also, antibodies do not show up in the blood for a week or more. Doctors must use their judgment, based on clinical suspicion. Knowing that a patient has been bitten by a tick or has had exposure to ticks is important. Other clues include a low platelet count, low white blood cell count and elevated liver enzymes. “We agree that people should know there are many tick-related diseases out there,” Dr. Gary DuGan, chief medical officer at Penn Highlands Healthcare, said. “Diseases from ticks are very common in the Northeast region of the U.S. Pennsylvania continually ranks high in the number of reported Lyme disease cases. Taking precautions to avoid tick bites is important in our area. We all love spending time in the outdoors, and we at Penn Highlands Healthcare want you to continue to enjoy it.” The Pennsylvania Department of Health offers this advice for lowering your chances of getting a disease from a tick bite. • Use a tick repellent that contains DEET or permethrin. • Wear long sleeves and pants as much as possible when outdoors.

Talk to a veterinarian about tick control for your pets. Take a shower after spending time in the woods. Showering within two hours has been shown to reduce the likelihood of tick attachment. Use tweezers and a tissue to remove ticks. Shield fingers from the tick’s fluids or feces. Then, wash well with soap and warm water.

And if you experience any signs of illness after being out in the woods, be sure to see your primary care physician.

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This January, the Penn Highlands Community Pharmacy, located in the DuBois Community Medical Building, 621 South Main Street, DuBois, opened to the public. The public can now get its prescriptions filled and buy over-the-counter medications at a convenient location near Penn Highlands DuBois West. And if you don’t want to walk in or if it’s late, there is a drive-thru, and it’s now open 24-hours, 365 days a year. It is convenient for those who don’t have time (or sometimes energy) to get out of their cars. It will be open when nothing else is – even on holidays. The walk-in area of the pharmacy is open from 9:00 AM to 9:00 PM daily and is closed only on Easter, Thanksgiving and Christmas. “We want the Community Pharmacy

to be a convenience for its customers,” Eric Wolfgang, PharmD, manager of the Community Pharmacy, said. “It’s easy to get into and out of, and we carry everything from canes and walkers to diabetic testing supplies and cough drops.” The pharmacy is also a 340B prescription drug program provider which can help the uninsured and underinsured.

What else makes this pharmacy so different?

“The majority of our pharmacists have worked in the hospital in a clinical setting,” Francis Iorfido, service line director of all Pharmacy Departments at Penn Highlands Healthcare, said. “This is a different perspective than most pharmacists get,” he said. “They’ve learned to work closely with the providers who order medications and are vigilant about what is prescribed. It makes for a unique situation.”

The new pharmacy has a state-of-theart mixing and compounding area. In the back, out of customer sight, pharmacists are working in a sterile environment to mix complex drugs for IV infusion medicines for rheumatology treatment.

Jeff Moore, RPh

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Infusion Medications The proximity to the Infusion Center upstairs in the same building was not an accident. It was the result of planning. The Penn Highlands Rheumatology physicians are upstairs and often have patients who require infusion.

This saves time for the patients and physicians.

Bubble or Blister Pack

Bubble or Blister Packs Need help keeping your medication doses straight? With so many things to think about and do, it’s easy to forget to take medications or wonder, “Did I take my pills today?” The Penn Highlands Community Pharmacy can pre-sort the prescriptions that you buy there into daily doses through its Dispill program. The doses can also be further divided into morning, noon and evening pills. The doses are put into plastic bubbles packs– similar to the way some over-thecounter cold medicines come in a box. And the pack sheets can be done for a whole month. Pre-sorted pills can help patients keep track of dosages. It can help with the tedious process of sorting medications each week, and it can help with those who have finger dexterity issues, such as arthritis. Even people with vision problems can benefit from pre-sorting. The pharmacy can only do this with pills at the time of purchase. Be sure to ask for “bubble packs” if this can help you or a loved one. “Brown Bag Days” - Reviewing Your Meds Some medications should never be taken together. Perhaps one physician prescribed one thing that you picked up at a pharmacy, and another physician prescribed another that you bought over-the-counter somewhere else.

The pharmacists at the Community Pharmacy will take the time to review your medications with you. Called “Brown Bag Days,” you can walk in with your medications in a bag any Tuesday from 4:00 - 6:00 PM. for a pharmacist to review what you are taking to be sure nothing interacts with each other. This should include over-the-counter medications, vitamins and supplements. If you cannot stop by on a Tuesday, call for an appointment. It’s free, and it could save your life. Pharmacy Days Learning more about good health is always a good thing to do. The Community Pharmacy is making it easier with monthly health education. Organized by The Women’s Health Center of Penn Highlands Healthcare through its Spirit of Women programming, education is for both men and women. Vaccines for General Health and Travel Are your vaccines up-to-date? “We can give vaccination shots. You can come to us for your flu shot, and your pneumococcal and shingles vaccinations,” Jeff Moore, pharmacist, said.

When you visit with the pharmacist, he or she will need to know where you are traveling, the activities you have planned, your current health status and your vaccination history.

UP COMING DAYS! July 28, 1:00 - 3:00 PM A Lung Cancer Assessment by The Lung Center of PH DuBois August 25, 1:00 - 3:00 PM Blood Pressure Screening Bring in your home blood-pressure monitor to see if it’s accurate, too! September 21, 12 Noon - 4:00 PM October 26, 12 Noon - 4:00 PM Cold or Flu? Learn about the differences between a cold and the flu. Flu shots will be available these days. More events will be announced soon. Watch for them on-line at www. More Information For more information about the Community Pharmacy or its programs you can call at 814-375-6165.

If you are traveling, the Community Pharmacy can help you determine what vaccinations you will need before you leave the country as some types of international travel, especially to developing countries and some rural areas, have higher health risks.

Silas Wonderling, PharmD, and Kristi Simpson, pharmacy tech

Eric Wolfgang, PharmD, Manager

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Protect yourself and your family Mosquitoes are more than pests. Mosquitoes can carry viruses. In the summer in Pennsylvania, we worry about West Nile virus. This year, we can add Zika virus to that list. The illness from the Zika virus is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. Though the disease is not prevalent here, mosquitoes can carry the virus if it bites an infected person who has traveled to Zika-rampant locations. It can also be transmitted from an infected man to his sex partners. Though a mild disease in most adults, the same Zika virus infection during pregnancy can cause a serious birth defect called microcephaly, as well as other severe fetal brain defects. Microcephaly is a defect that causes an unusually small head and a damaged brain. By protecting yourself, you are protecting babies everywhere. Remember to limit you and your family’s exposure to mosquitoes by: Use Environmental Protection Agency, EPA, registered insect repellents with one of the following ingredients: DEET, picaridin or IR3535. For ages 3 and older, you may use oil of lemon eucalyptus or para-menthane-diol, too.

Do not use insect repellent on babies younger than 2 months old.

Do not apply repellent to a child’s hands, eyes, mouth or cut/ irritated skin.

Turn over, throw out or cover items that hold water outside. Empty and scrub them once a week.

Tightly cover water storage containers, such as buckets and rain barrels or use wire mesh smaller than an adult mosquito.

Keep windows and doors closed to keep mosquitoes out. Repair window screens.

Once a week, empty or throw out any items that hold water like vases and flowerpot saucers.

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Continued from Page 5 and Commonwealth Medical College, and routinely trains students throughout their medical school careers, according to Lisa Witherite-Rieg, DO, director of Medical Education at Penn Highlands Healthcare. During this training, students are required to rotate through different medical specialties and treat patients under the supervision of physicians. Within weeks, a new group of LECOM students will begin yearlong clinical rotations at Penn Highlands’ hospitals. “This is something new for Penn Highlands and that is really exciting. What this program does is have those young people here in our community for a prolonged time, and our hope is these energetic, vibrant, young physicians-in-training will develop the same passion for this area as we have and will want to return here to practice,” Dr. Witherite-Rieg said. She said another benefit of the program will be realized by the teaching physicians. “When we, as physicians, teach, it keeps us sharp and on top of things. It makes us better doctors, which, in turn, makes our health system a better place,” Dr. Witherite-Rieg noted. Penn Highlands is exploring other educational programs and considering a Graduate Medical Education Program. Recruiters eager to connect with local students The recruiting team is interested in connecting with local residents who are pursuing studies in pre-med or who are currently in medical school or residency. Relatives or friends of potential candidates may also contact the recruiters at 814-768-2838. A stipend is offered to medical students in their last year of training provided they commit to practice for Penn Highlands Healthcare.

Find A Doctor Are you looking for a healthcare provider? Do you want to know a little more about who your next appointment is with? 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,, you can find a provider by name, by location, by specialty or by hospital. You can even search by gender. Also, a complete listing of all our providers can be downloaded.

TAKE CARE OF YOUR HEALTH HOW SHOULD I PREPARE FOR A DOCTOR’S APPOINTMENT? Going to a healthcare provider for an appointment shouldn’t be stressful. Being prepared can make it a whole lot easier, according to Debra Thomas, chief nursing officer at Penn Highlands Brookville. “Being prepared and taking an active role will allow you to have better results and better health,” she said.

BEFORE The first step is checking with your insurance company or the office to be sure where you make your appointment is covered. Insurance companies can change what they cover from year to year, and you don’t want any surprises. When you make your appointment, offer a few details about why you need an appointment so the proper amount of time can be scheduled.

illnesses. You may not need a specific date, but list the year. Know your family’s health history, such as your parents’ health conditions. Jot down a few notes if it helps you to remember. Ask a friend or family member to go with you. If you cannot hear well or are nervous, a second person can help you keep things straight. Get a notepad and pen to bring along, too.

DURING “Bring your current health insurance card and your photo ID to each appointment,” Debra said. You may be asked to pay your co-pay when you arrive. Be prepared for that, too. Share your symptoms, relevant health history and the list of medications.


• •

• •

What is my diagnosis? Are there any warning signs I need to watch for? What are my treatment options? What are the benefits of each option? What are the side effects? Will I need a test? What is the test for? What will the results tell me? What will the medicine you are prescribing do? How do I take it? Are there any side effects? Why do I need surgery? Are there other ways to treat my condition? Do I need to change my daily routine? How do I reach you if I have concerns?

Then, write a complete list of all your symptoms to share during your appointments, and write a list of questions for the provider.

During your appointment, make sure to ask the questions you prepared before your appointment. Start by asking the ones that are most important to you.

Make a list of what medications you take. Include the over-the-counter ones, vitamins and supplements on this list. If it is easier, prepare by putting them in a bag to take with you.

“Asking questions about your diagnoses, treatments and medicines can improve the quality, safety and effectiveness of your health care,” Debra said. “It’s important to hear and understand the answers you get, too.”

“Using your appointment time with your healthcare provider wisely can save you a trip back to him or her. We want you to get the most out of your appointments and be at your best health sooner than later,” Debra said.

Write down your health history. List your current conditions and past surgeries or

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These shaded boxes indicate when the vaccine is recommended for all children unless your doctor tells you that your child cannot safely receive the vaccine.

These shaded boxes indicate the vaccine is recommended for children with certain health or lifestyle conditions that put them at an increased risk for serious diseases. See vaccine-specific recommendations vaccines/hcp/acip-recs/index. html

Flu Influenza

Tdap Tetanus, diphtheria, pertussis

HPV Human papillomavirus

7-8 Years

9-10 Years

11-12 Years

13-15 Years These shaded boxes indicate the vaccine should be given if a child is catching-up on missed vaccines.

This shaded box indicates the vaccine is recommended for children not at increased risk but who wish to get the vaccine after speaking to a provider.

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16-18 Years More information:

Preteens and teens should get a flu vaccine every year.

Preteens and teens should get one shot of Tdap at age 11 or 12 years.

Both girls and boys should receive 3 doses of HPV vaccine to protect against HPVrelated disease. HPV vaccination can start as early as age 9 years.

“All parents want to protect their children. Safety is at the forefront of everything you do,” said Megan Devlin-Bussard, pharmacist, quality program director with Penn Highlands Healthcare Practice Management. “You had baby gates in your house, car seats in your cars ... Later, they wear bike helmets, elbow and knee pads. You will do anything to keep them safe, right?” That’s why it’s important to make sure your child is vaccinated and that the vaccinations are up-to-date. “When a parent refuses to vaccinate, they are putting their child’s life at risk. Vaccines have helped millions of children avoid getting life-threatening

diseases, like polio and whooping cough. Years ago, parents feared these diseases because they could cause serious injuries and death. Today, we have safe and effective vaccinations to help fight off these awful diseases; we can help keep our kids safe and healthy.” And vaccines don’t just protect kids they also shield the people around them who are endangered by any illness, like elderly relatives, pregnant women and infant siblings. It’s a community-wide effort. As summer is here and school is out of session, we urge everyone to schedule children for their shots. They’ll avoid missing any important class work, and you won’t be stressed if there is a

vaccine needed before the school year starts. Each year, the Advisory Committee on Immunization Practices, ACIP, publishes immunization schedules for persons age birth through 18 years. These schedules summarize recommendations for routine vaccines for children age 18 years and younger. This schedule also has been approved by the American Academy of Pediatrics, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists. Be sure to review it below, and if you have questions, call your child’s healthcare provider.

2016 Recommended Immunizations for Children 7-18 Old Years Old 2016 Recommended Immunizations for Children 7-18 Years Talk to your child’s doctor or nurse about the vaccines recommended for their age. Meningococcal MenACWY

All 11-12 year olds should be vaccinated with a single dose of a quadrivalent meningococcal conjugate vaccine (MenACWY). A booster shot is recommended at age 16.



Hepatitis B

Hepatitis A

Inactivated Polio

MMR Measles, mumps, rubella

Chickenpox Varicella

Teens, 16-18 years old, may be vaccinated with a MenB vaccine.

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this type of medical device need to know that they are not alone – there is support available, and that’s why we started this support group back in 2007,” Heather Kisamore, group facilitator, said.

Be a Mall Walker!

Conquer Cholesterol! Learn to eat right and about good heart health. This program will be held at 5:30 PM, Tuesday, September 20, in the Central Resource Center at Penn Highlands DuBois. It is hosted by The Women’s Health Center of Penn Highlands Healthcare, but it is open to both men and women. Call 814-371-4666 to RSVP. Cost is $10 per person to cover the cost of a light meal.

The Penn Highlands Healthcare/DuBois Mall Walker program is free to join. Walk laps around the DuBois Mall, keep track per quarter and receive a small prize each time you complete the number of laps indicated. At the end of four quarters, walkers receive a PHH/ DuBois Mall Walker t-shirt. Walking inside the mall is a safe way to walk with temperature control and flat surfaces. It’s an easy way to stay in shape. The mall opens at 6:00 AM for walkers and closes at 9:00 PM. To join, go to the DuBois Mall office to register or call 814-375-3495 for a form.

Overcome Diabetes! Learn great advice and tips from the certified diabetes educators of Penn Highlands Elk and Penn Highlands DuBois. Two classes will be hosted. The first is Wednesday, October 26, in St. Marys. The second is Tuesday, November 1, in DuBois. Both events start at 5:30 PM. Call 814-371-4666 to RSVP. Cost is $10 per person to cover the cost of a light meal.

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A pill to improve your health can be taken and no one knows about it. Some medical devices, such as a pacemaker, can be inserted and never seen. But an ostomy-bag – though rarely visible - is something that people can be selfconscious of. A support group hosted by Penn Highlands Clearfield Home Health provides emotional support and useful information for individuals living with an ostomy. It is a unique support group not only in the Penn Highlands Healthcare system but in the country. “People who are living with

A registered nurse who is certified in wound, ostomy and continence care, explained that an ostomy is a surgically-created intestinal or urinary tract diversion that creates an opening (stoma) from an area inside the body to the outside . If an organ is affected, such as the small intestine, colon, rectum or bladder, there must be a new way for wastes to leave the body. An ostomy can be permanent, depending on the location of the affected area and the disease process, such as some types of cancer. It can be temporary, when the bowel or bladder needs time to heal after surgery. Medical conditions that might require this device include complications from diverticulitis, colon or bladder cancer and inflammatory bowel disease. There are many different types of ostomies, such as an ileostomy from the small intestine, a colostomy from the colon and an urostomy from the kidneys. The Ostomy Support Group meetings are informal, round-table discussions on topics of interest, new product demonstrations and a question-andanswer session with the enterostomal therapy nurse or wound, ostomy and continence nurse. Guest speakers are featured several times a year. Speakers include certified wound, ostomy and continence nurses, physicians, pharmacists, physical therapists, durable medical equipment representatives, dietitians, ostomy appliance companies and insurance representatives. There is no fee to attend meetings. Meetings are held the first Tuesday of each month from 12 Noon – 1:00 PM at the Penn Highlands Clearfield Home Health and Hospice office located at 440 Front Place, Clearfield. For more information about the support group in Clearfield, call 814-768-2025.

The Penn Highlands Healthcare Surgery Centers are outpatient surgical facilities built and designed to streamline the valuable time of patients and families in a private and comfortable setting. Each facility is equipped to perform a range of procedures for patients. The centers accept most major insurance plans. The Penn Highlands DuBois Surgery Center is located at 95 Hoover Avenue, DuBois, behind the Rice Complex at 90 Beaver Drive in DuBois. Its phone number is 814-503-8180. The Penn Highlands Elk Surgery Center is located at 1376 Bucktail Road, St. Marys, across from the Bucktail Plaza. Its phone number is 814-781-6565.

Butterfly Release events will be held this summer by the Penn Highlands’ and Community Nurses’ hospice programs. 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. The Community Nurses will hold its Butterfly Release on Sunday, August 7 at 2:00 PM. in the Pinecrest Manor courtyard. People are invited to sponsor one or more butterflies for $25 each, with proceeds going to hospice program. For an order form, please visit www. For more information, please call 814-788-8888. Penn Highlands Clearfield Hospice will release butterflies during the Vespers Service at the Clearfield County Fair on July 31.

The Penn Highlands Clearfield Hospice Chili Bowl will be held September 15 from 5:00 - 9:00 PM at the Clearfield Driving Park, Expo II Building, Clearfield. The theme for this year’s event is “Game On.” There will be many different chilis to taste, a band, children’s activities and more! Admission is free. All Chili Bowl proceeds benefit Penn Highlands Clearfield Hospice patients and their families facing end-of-life issues, as well as the bereavement program. For more information, call 814-768-2012.

On the day of the event, participants may give a donation of their choice and a butterfly will be released in memory or honor of loved ones. All proceeds benefit hospice patients and their families, as well as the bereavement program. Anyone interested in sponsoring this event should send a check, payable to Penn Highlands Clearfield Hospice Butterfly Release, to PHC Home Health & Hospice, PO Box 992, Clearfield PA 16830. For more information, please call 814-768-2012. ​

Next time you’re online Be sure to visit Penn Highlands Healthcare is on LinkedIn. LinkedIn is a business-oriented social networking service. As of October 2015, LinkedIn reports more than 400 million acquired users in more than 200 countries and territories. If you are LinkedIn member, follow us! We are also on other social medias. We are on Facebook as Penn Highlands Healthcare. Follow us for the latest news from our four hospitals. We are on Instagram where we post photos of daily activities and special events at Penn Highlands Healthcare. We are on Twitter. Providing up-todate information is important to Penn Highlands Healthcare. Take advantage of the many ways we try to keep you informed.

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.


Advice From A DOCTOR

David W. Bundy, DO Medical Director,

Stay safe this summer With summer here, it’s important to be safe while enjoying the great outdoors. The Emergency Department teams at Penn Highlands Healthcare want everyone to stay safe while enjoying warm-weather activities. Throughout the summer, we see an increase in ATV, swimming, sunburn and bug bite incidents. To prevent these problems, here are some tips to stay safe. Over the summer months, we see a lot of patients who were involved in ATV accidents. ATV accidents often lead to broken bones and muscle strains. When riding an ATV, a helmet should be worn at all times. It is also important to ride during the daylight hours to ensure you know where you’re going. Ride only on designated trails at safe speeds and as with any motor vehicle an ATV should not be operated under the influence of alcohol or other drugs.

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According to the National Safety Council, drowning is the number one cause of death in children aged one to four years. These deaths are mostly due to a child falling into a pool or being left alone in the bathtub. In order to ensure safety while swimming, I advise parents and caregivers to never leave a child alone when in the water, and keep a close eye on them. Despite its high prevalence in young children, drowning can happen at any age. All swimmers should remember to never swim alone, don’t jump or dive into unknown bodies of water and don’t push or jump on others while in the water. Severe sunburn is also commonly seen at emergency departments. Many patients who are seen in the emergency department were unaware at the time they were getting burned. You should seek medical care for these symptoms: a sunburn that forms blisters, covers a large area or is very painful; facial swelling; fever and chills; upset stomach; headache, confusion, or faintness; and signs of dehydration. To prevent sunburns, sunscreen should be applied often and reapplied after swimming and sweating. Use a sunblock with SPF 30 or higher. Also, avoid drinking alcohol while lying out in the sun, and be aware that sun exposure should be avoided when taking certain prescription medications. A downside to summer fun is insect bites. Insect bites are itchy, irritating and painful. In severe cases, bites or stings can cause serious allergic reactions that require medical treatment. If you do experience a minor bite or sting,

Penn Highlands Clearfield Emergency Department

clean the wound with soap and water. An ice pack may help to reduce swelling; hydrocortisone cream and calamine lotion can also help. In the case of a tick, which attaches itself to the skin, there are several methods for removal. I recommend using a Q-tip and Dawn or other brand liquid dish soap. Dip the Q-tip in the dish soap, and immediately place it on the tick which has attached itself to the skin. Begin using the Q-tip to spin the tick in circles, either clockwise or counter-clockwise. Usually within a few seconds to at most 30 seconds if properly done, the tick will detach from the skin and will be stuck on the end of the Q-tip. Dispose of the tick and Q-tip in a plastic shopping bag tied closed or a zip-lock bag, and then simply place in the trash. The physicians and nurses of the Penn Highlands Healthcare Emergency Departments hope everyone has a safe and healthy summer. In the event of a medical emergency, however, we are available any time of the day or night, 365 days a year.