Winter2016

WINTER 2016

Health LINES Penn Highlands Healthcare

Working together for a healthy community.

INSIDE THIS EDTION:

THE HEART CENTER

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WINTER 2016 | PENN HIGHLANDS HEALTHCARE

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Cover Story The Heart Center

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Behavioral Health Services

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Day of Dance

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.

The Penn Highlands Healthcare system covers eight counties in western Pennsylvania with 75 miles from east to west. We hope this is a tool that will keep you informed about what is happening in healthcare throughout your region.

5 Quality

10 New Faces

This FREE magazine will always be available: • On our website, www.phhealthcare.org/magazine.

• Get on our e-subscription list by filling out the online form at www.phhealthcare.org/getmagazine; 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.

12 How to Exercise in Winter Weather

13 How May I Help You? ShortScripts 14 16 Advice From A Doctor

Don’t miss an issue!

Subscribe now to this Digital Magazine.

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

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.

The information in this magazine does not take the place of health advice given to you by your healthcare provider. Always call 911 for any emergency.

The Penn Highlands Healthcare HealthLines Team Mary Jo Yebernetsky, Writer/Editor, 814-375-3495 Mary Jo Herzing, Graphic Design Specialist, 814-375-6539 John Brennan, Marketing/PR Director, 814-375-3494 Amy Duke, Marketing/PR Director, 814-768-2827 Karen Hazlett, Marketing/PR Specialist, 814-788-8532 Brian Musser, Community/Physician Outreach Specialist, 814-375-6508 Lori Rancik, RN, The Women’s Health Center, 814-371-9666

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Welcome to Penn Highlands

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

Next time you’re online Be sure to visit www.phhealthcare.org also check us out on

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, www. phhealthcare.org, you can find a provider by name, by location, by specialty or by hospital.

You can even search by gender.

Also, a complete listing of all our providers can be downloaded or call a Penn Highlands Healthcare marketing specialist in your area. Names and phone numbers are listed on this page.

PENN HIGHLANDS BROOKVILLE Senior Transition Unit Inpatient/Outpatient 100 Hospital Road, 3rd floor Brookville, PA 814-849-1850 or 814-849-1844

BEHAVIORAL HEALTH SERVICES

PENN HIGHLANDS CLEARFIELD Bright Horizons Unit Inpatient 809 Turnpike Avenue, 2nd floor Clearfield, PA 814-768-2184 Outpatient 1033 Turnpike Avenue, Suite 300 Clearfield, PA 814-768-2137 PENN HIGHLANDS DUBOIS Child and Adolescent Inpatient Program Inpatient East Campus - 635 Maple Avenue DuBois, PA 814-375-6363 Adult Inpatient Program Inpatient East Campus - 635 Maple Avenue DuBois, PA 814-375-6337 The Behavioral Health Center Outpatient East Campus - 635 Maple Avenue DuBois, PA 814- 375-6379 The Behavioral Health Center Outpatient St. Marys Community Medical Building 1100 Million Dollar Highway, Suite 1 St. Marys, PA 814-781-3875 PENN HIGHLANDS ELK Generations Unit Inpatient 763 Johnsonburg Road, 2nd floor St. Marys, PA 814-788-8876

Sometimes, our heart is hurting – but not in a physical way. Sometimes, we need someone to talk to that will help us make things better.

What is in our minds is just as important to Penn Highlands Healthcare as what happens to the body.

That’s where Behavioral Health Services can help. Penn Highlands Healthcare hospitals offer specialized care for those 5 years old and up in both outpatient and inpatient settings.

CHILD AND ADOLESCENT Our program at Penn Highland DuBois is offered to young people age 5-18 who are exhibiting behavioral health problems impairing their ability to function in the home and/or school.

The types of problems addressed by the Child and Adolescent Unit team include, but are not limited to, the following: • Depression • Mood disorders • Thought disorders • Developmental problems • Adjustment problems • Attention deficit disorders For inpatient care, admission of a child is dependent upon a thorough review of the child’s needs and the presenting information and symptoms.

ADULT Our program at PH DuBois with locations in DuBois and St. Marys is offered to individuals 18 years or older whose behavioral health problems impair their ability to function on a daily basis.

We can help those who are facing: • Depression • Mood disorders • Thought disorders • Anxiety disorders • Adjustment disorders • Cognitive disorders • Psychosis If admitted, a patient receives a thorough physical examination to determine general health status and to ascertain whether underlying physical conditions or medications may be contributing to the patient’s problems.

GERIATRIC Our programs at Penn Highlands Brookville, Penn Highlands Clearfield and Penn Highlands Elk, treat adults age 55 and over with problems specific to the senior population or in a way that is more understanding of aging, such as: • Depression • Suicidal threats and/or actions • Acting out or dangerous behaviors • Hallucinations and delusions • Paranoia • Schizophrenia • Bipolar disorder • Excessive fears and anxiety • Confusion or mental status changes • Behavioral disturbances and

problems associated with dementia Inpatient care is also provided at these hospitals with privacy and dignity of the patient being of primary importance.

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Throughout the year, programs are planned by The Women’s Health Center of Penn Highlands Healthcare to provide women and their families an opportunity to learn about health and the services available throughout Penn Highlands.

are also encouraged to participate if they wish. Each group provides a 10-15 minute demonstration and performance followed by opportunities for the audience to join in.

As Penn Highlands Healthcare prepares to celebrate its 10th annual Day of Dance, the plans bring more excitement and anticipation than ever before, according to Lori Rancik, RN, BSN, and case manager of The Women’s Health Center of Penn Highlands Healthcare.

Day of Dance, a signature event of the Spirit of Women program, is held in over 60 cities across the country, and Penn Highlands Healthcare is proud to be hosting four of these events throughout our region. “As we strive to build healthier communities, Day of Dance is unique as it blends health information, education and access to health care professionals with the fun and pleasure of dancing,” Lori said.

Dancing provides a wonderful opportunity to get moving for not only your heart, but also to increase physical activity for overall health and wellness. During the two-hour event, as attendees watch and are entertained by local dance groups, they

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This year, the theme is “The Power to Boogie” with all of our invited dance groups to be creative in their dance styles to energize and motivate you. “We want people of all ages to want to get up and move! “ Lori said.

In addition to the dancing and fun, Day of Dance provides an opportunity to meet members of the Penn Highlands Healthcare team from a wide range of service lines from maternity and pediatric care to home health and physical therapy, from outpatient testing teams to the inpatient specialty units. Penn Highlands Healthcare employees will be at information tables to provide screenings and displays to show you what they are doing in their areas to provide quality care to patients.

DAY OF DANCE Saturday, February 27, 10 - 12 Noon The DuBois Mall in DuBois and Sacred Heart Parish Center in St. Marys.

Saturday, March 5, 10 – 12 Noon Heritage House in Brookville and EXPO 1 Building in Clearfield.

In 2016, there will be at least four programs as part of a seminar series. Often times, there are smaller programs planned as ideas and request arise through the year. This list may grow with more opportunities to join in the fun of Spirit of Women events, and the program year ends with Spirit Girls Night Out, our fall signature event.

All Spirit of Women events are advertised through local media, ads, post card mailings to Spirit members, Facebook postings and on our Women’s Health website, www.phhealthcare/ spiritofwomen. Check it out to learn more about our Spirit of Women programs and sign up to receive personal invitations.

SEMINAR SERIES April 2016 – “Fight Fatigue” education about COPD, heart failure and sleep apnea June 2016 – “Love Your Self” - support for patients who are diagnosed with cancer and must face the challenge of accepting a new normal way of life September 2016 – “Conquer Cholesterol” - updates on heart health and controlling risks including cholesterol October & November 2016 – “Overcome Obesity” - help to those struggling with diabetes GIRLS NIGHT OUT October 2016

PH DUBOIS NAMED AMONG THE BEST IN HEART FAILURE TREATMENTS Penn Highlands DuBois has been recognized as one of the best hospitals for 2015-16 in the treatment of Heart Failure by U.S. News & World Report. The annual U.S. News Best Hospitals rankings, now in its 26th year, recognize hospitals that excel in treating the most challenging patients.

“We are extremely proud of The Heart Center, our employees and the medical staff,” John Sutika, president of PH DuBois, said. “We are here to do the best we can for our patients, and this shows that we are doing just that.”

For 2015-16, U.S. News evaluated hospitals in 16 adult specialties and ranked the top 50 in most of the specialties. Less than 3 percent of the nearly 5,000 hospitals that were analyzed for Best Hospitals 2015-16 were nationally ranked in even one specialty.

“A Best Hospital has demonstrated expertise in treating the most challenging patients,” said Ben Harder, chief of health analysis at U.S. News. “A hospital that emerged from our analysis as one of the best has much to be proud of.”

U.S. News publishes Best Hospitals to help guide patients who need a high level of care because they face particularly difficult surgery, a challenging condition or extra risk because of age or multiple health problems.

Objective measures such as patient survival and safety data, adequacy of nurse staffing and other data largely determined the rankings in most specialties.

The specialty rankings and data were produced for U.S. News by RTI International, a leading research organization based in Research Triangle Park, N.C. U.S. News used the same data, as well as the new Best Hospitals for Common Care

also recognized as a “Benchmark Hospital” for a second time, meaning it exceeded performance standards when compared with other hospitals in the Highmark network. ratings, first published in May, to produce the state and metro rankings.

The rankings are freely available at http:// health.usnews.com/best-hospitals and appear in the U.S. News “Best Hospitals 2016” guidebook.

PH CLEARFIELD RECOGNIZED

BY HIGHMARK FOR PROVIDING SAFE, HIGH QUALITY PATIENT CARE For the fifth year in a row, Penn Highlands Clearfield has been recognized by Highmark for providing safe, high quality patient care.

Specifically, Penn Highlands Clearfield was one of only three hospitals to be recognized as a best practice hospital for its efforts on the reduction of patients needing to return to the Emergency Department within seven days of discharge, as well as readmissions three and 30 days after discharge.

“Safe patient care is of paramount importance. On behalf of hospital administration and the board of directors, we congratulate our medical and hospital staffs for their exceptional work in achieving maximum results in Highmark’s QualityBLUE program,” stated Gary Macioce, hospital president.

According to Catherine Civiello, PhD, Director of Performance Improvement, the Highmark report scores are reflective of the hard work of all the physicians and hospital’s staff in advancing several initiatives, including participation in Highmark’s QualityBLUE Hospital Pay for Performance Program, which focuses on improving patient care and safety across Highmark’s hospital network.

Penn Highlands Clearfield earned “A’s” this year in blood clot prevention, reducing readmissions to the hospital and reducing or eliminating healthcare-acquired Infections in all four areas monitored, surgical site, central line bloodstream, foley catheter and C-Diff infections.

Further, Penn Highlands Clearfield was

Laura Sherick, RN, a Penn Highlands Clearfield nurse on the Medical/Telemetry/Surgical/Pediatrics Unit.

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What can The Heart Center surgeons do?

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ince 2001, thousands of residents of our region have chosen The Heart Center of Penn Highlands DuBois for specialized cardiac care. The Heart Center offers a full spectrum of 24-hour cardiac, or heart, management services ranging from diagnostics to open-heart surgery and rehabilitation.

Located on the fourth and fifth floors of PH DuBois West, The Heart Center includes two specialized operating rooms, 12 Cardiovascular Intensive Care Unit patient rooms, three catheterization labs, a non-invasive cardiology suite and a Cardiac Rehabilitation Unit.

With advanced cardiac, thoracic and vascular services normally found in only large cities, The Heart Center is leading the way for local heart patients.

The Heart Center has top-rated cardiovascular and thoracic surgeons, Dr. Raj Kaushik and Dr. Hadi Hakki. Employed

by Penn Highlands Healthcare, they see patients in their office in the Medical Arts Building in DuBois and perform procedures in The Heart Center.

It also has a top-rated Catheterization Lab that works with the cardiologists of DuBois Regional Cardiology Associates.

There is no need to go to a big city if you make The Heart Center your first choice for care. It is easily accessible with no traffic jams and with free parking. Close to home, it allows for families to visit daily without taking time off from work or with the expense of a hotel.

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The names of the procedures sound very technical, and there are many. The surgeons can perform coronary by-pass surgery, thoracic surgery on the chest, vascular surgery for carotid artery disease.

They can operate on the lungs and on arteries and veins, too.

The most notable procedures are coronary artery bypass grafting, known as CABG, and heart-valve repair or replacement.

CABG Calcium and fat build up along the walls of the heart and block the flow of oxygen-rich blood to your heart muscle. A heart attack can occur when your heart is deprived of this oxygen-rich blood. The cardiac surgeons can bypass these blockages using a piece of vein or artery taken from other places in your body to bring blood to your oxygen-starved heart muscle. The most common site to obtain veins is your legs.

HEART-VALVE REPAIR OR REPLACEMENT The four valves in your heart are the mitral, aortic, tricuspid and pulmonic. The job of these four valves is to be open and close to direct the flow of blood through your heart and out to your body. When they become diseased, you may feel tired, short of breath or dizzy. Often the mitral or aortic valves are the affected valves.

Heart valves may become malformed due to hereditary defects or illnesses. Valves may be narrowed or may not close completely. These structural problems can restrict blood flow through the heart, robbing the body of blood, oxygen and nutrients it needs. The restricted blood flow can also cause blood to build up inside the heart, creating pressure that may eventually damage the heart and lungs.

Surgeons can either repair or replace valves depending on the amount of damage present. At The Heart Center, biologic valves made of organic tissue or artificial valves may be offered. The surgeon will discuss the best choice with the patient.

Biologic valves actually grow into the patient’s own heart tissue within six months. Because these types of valves contain no metal or plastic, it does not

Raj Kaushik, MD, FACS, FACC, is a board-certified cardiovascular and thoracic surgeon. He is the Chief of Cardiovascular Surgery at The Heart Center.

A. Hadi Hakki, MD, FRCS (C), is a board certified cardiovascular and thoracic surgeon at The Heart Center.

require the patient to take life-long anti-coagulant, or blood thinner, therapy.

Artificial valves can cause blood clots. For this reason, patients with these implants must take anti-coagulants in order to thin the blood.

Valve repair, when possible, is a reconstruction to the diseased valve leaflets, or the parts that make up the valve.

TECHNOLOGY PROVIDES A NEW TOOL:

CardiacMEMs How can you tell when your heart is going into heart failure?

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nfortunately, your heart isn’t good at sending “S-O-S” messages.

Heart failure, or HF, occurs when the heart is unable to pump enough blood to meet the body’s demands. According to the Centers for Disease Control and Prevention, more than 5.1 million Americans have heart failure, with 670,000 new cases diagnosed each year. Patients with HF are frequently hospitalized, have a reduced quality of life and face a higher risk of death.

Healthcare providers use a number of indirect ways to monitor HF. Patients can self-monitor with scales to measure weight for body-fluid. Gaining fluid weight is often a sign of HF. Patients can also have frequent office visits to monitor for changes.

In recent years, however, health professionals have found that selfmonitoring and going to an office for monitoring has its limits. Subtle HF changes may be missed, and frequent visits are not convenient for patients.

When changes are caught too late, it can result in increased admissions to the hospital.

What to do?

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ow, there is another option. A new miniaturized, wireless, monitoring sensor to manage HF is available. It’s called the CardioMEMS HF System from global medical device manufacturer St. Jude Medical, and it is being used here at Penn Highlands Healthcare through the work of cardiologists from DuBois Regional Cardiology Associates.

CardioMEMS is the first and only Food & Drug Administration-approved heart failure monitoring device that has been proven to significantly reduce hospital admissions when used by physicians to manage heart failure.

It’s not for every patient, Dr. Scott Reese, cardiologist with DuBois Regional Cardiology Associates, cautions. The patient would have to meet criteria along with having a weak heart muscle.

The CardioMEMS HF System starts with a sensor that is implanted in the pulmonary artery during a procedure performed in the Cath Lab in The Heart Center of Penn Highlands DuBois. It is done under sedation, and it’s not risky, Dr. Reese said.

This sensor directly measures pulmonary artery pressure. Increased pulmonary artery pressures appear before weight and blood pressure changes are even noticeable.

“Patients are monitored from home,” Dr. Reese said. The system allows patients to transmit daily sensor readings from their homes to their health care providers using an electronic pad that is placed against the outside of the body under the shoulder.

“The information goes out as a signal through a HIPAA compliant and secure internet so our office can review the pressure measurements from inside the chest,” he said.

High readings or changes serve as early warning signs. This allows for personalized and proactive management to reduce the likelihood of hospitalization. Data from a clinical trial showed that the CardioMEMS technology reduces heart failure hospital admissions by up to 37 percent.

woman wouldn’t wait until she has a lump big enough to feel and see. She would want to have it detected early. The same with HF. The earlier a problem is found, the better off the patient would be.

“We could wait – that’s what we have been doing,” he said. “I think this is more useful. It isn’t for everybody but it is helpful...

It is not magical. It doesn’t provide all the information of every minute of every day, but it helps.”

Also, the device doesn’t interfere with daily living. It is not risky. Patients can do what they did before, Dr. Reese said. The implanted piece is inert. It doesn’t have batteries and there is no electrical activity.

The only power comes from the external equipment that relays the information to the office.

As a HeartCaringTM health system, Penn Highlands is committed to excellence in cardiovascular care.

Visit us on the web at

“This system is helpful, because www.phhealthcare.org/heartcare we are trying to catch progressive heart failure before it reaches the for more information. point where patients get symptomatic and potentially get admitted to the hospital,” Reese said. “Heart failure is not good. The more uncontrolled it is, the worse it is. This helps us to maintain control of HF.” In comparison, Dr. Reese gives the example of mammogram versus self-checks only. A

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LifeVest C

A lifesaver in rural areas

harles Williams of Sigel was told that his heart muscle wasn’t pumping as well as it should be. He was diagnosed with an unknown virus of the heart in March 2015.

He was being seen by DuBois Regional Cardiology Associates’ Stacey Smiley, a certified registered nurse practitioner.

This virus caused dilated cardiomyopathy.

This disease might not have symptoms, but for some people it can be life-threatening.

Dilated cardiomyopathy is a common cause of heart failure. With the heart's inability to supply the body with enough blood, it can lead to irregular heartbeats, or arrhythmias, blood clots or sudden death.

Most common in men ages 20-60, anyone of any age, including infants and children, can be affected.

Charlie was 63 at the time, and his first thought was that he may die. If something should happen, he lives a good distance from ambulance services and the hospital.

He had “a grave concern and worry that due to my residence being in a rural area that I may expire before help could arrive,” he said.

To help, he was told about LifeVest. Had he ever heard of it before? “No,” he said. And neither have many other people.

LifeVest is a wearable defibrillator.

A defibrillator is a small machine that issues electrical energy to the heart to reestablish rhythms. Many people are familiar with the paddles seen in emergency room scenes on TV shocking people back to life. Or they may know about the smaller version that gets put under the skin near the heart to shock it.

This LifeVest is the first wearable defibrillator. Unlike an implantable

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cardioverter defibrillator, the LifeVest is worn outside the body on, well, a vest.

This device continuously monitors the patient's heart with dry, non-adhesive sensing electrodes to detect life-threatening abnormal heart rhythms.

If a life-threatening rhythm is detected, the device alerts the patient prior to delivering a treatment shock. The alert allows a conscious patient to delay the treatment shock. If the patient becomes unconscious, the device releases Blue™ gel over the therapy electrodes and delivers an electrical shock to restore normal rhythm.

It is a treatment option for sudden cardiac arrest – when the heart beats too fast and out of rhythm - that offers patients advanced protection and monitoring as well as improved quality of life.

For Charlie, the vest gave him peace of mind. “Being a police veteran, The LifeVest wearable I have seen defibrillator is a the direct treatment option for results of not sudden cardiac arrest responding that offers patients in time Charles Williams and not advanced protection and at his home having a monitoring as well as in Sigel, PA defibrillator improved quality of life. available. The LifeVest gave Charlie got his LifeVest me complete because there were confidence I a multitude of unknown would survive. Most variables that made it the safest importantly I was able to option. convey this to my one and only, Rose.”

“The LifeVest is prescribed for patients “The LifeVest was a true blessing,” Rose while we evaluate whether their heart Warnsing, his life partner, said. “The vest function is going to improve and while gave me an invaluable peace of mind. It also optimizing their medical therapy,” Dr. Jay gave us a confidence that if Charlie had a Ambrose, cardiologist with DuBois Regional serious issue the vest would give him the Cardiology Associates, said. “For patients greatest chance of survival.” She hopes that such as Charlie whose heart function did more people learn about the vest. improve, he didn’t need an ICD. For others,

What is heart failure? it is a necessary protection, and if the heart function doesn’t improve, they can go on to get an ICD. For most people in our rural area, it allows for immediate response and treatment when time is of the essence.”

The LifeVest is lightweight and easy to wear. It allows for common activities of daily life like work, shopping and moderate exercise, or in Charlie’s case, playing jazz guitar, studying history and following baseball. “The only limitations the vest posed were the ability to mow my yard or engage in activities that would require power type tools,” Charlie said.

The vest is really unnoticeable under clothing. Only a small battery pack is worn on a belt. It is worn all day and night comfortably, and it is only taken off during a shower or bath.

Charlie said people didn’t really notice him wearing it, but he told others about it. “I felt it my duty to let others know about what was available to people who may face similar situations. They thought that this was a great technology that could greatly aid in rural settings where emergency help is often too late.”

oday, Charlie and Rose are still enjoying rural life, and since July, Charlie is no longer wearing his vest.

Under the care of his physician, his heart function improved to the point that he was no longer at risk for sudden cardiac arrest.

“The LifeVest and all connected with this technology should be commended,” Charlie said. He was thankful for the staff that helped him get the vest quickly and “I am truly grateful for all who are connected with this innovation. May God bless you and your families.”

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H

eart failure happens when the heart cannot pump enough blood and oxygen to support other organs in your body. Heart failure is a serious condition, but it does not mean that the heart has stopped beating, according to the Centers for Disease Control.

Common symptoms of heart failure include: • Shortness of breath during daily activities • Having trouble breathing when lying down • Weight gain with swelling in the feet, legs, ankles or stomach • Generally feeling tired or weak How do you get heart failure? Diseases that damage your heart also increase your risk for heart failure. These can include: • Coronary heart disease (the most common type of heart disease) and heart attacks • High blood pressure • Diabetes Unhealthy behaviors can also increase your risk for heart failure, especially for people who have one of the diseases listed above. Unhealthy behaviors include: • Smoking tobacco • Eating foods high in fat, cholesterol and sodium • Not getting enough physical activity • Being obese Early diagnosis and treatment can improve quality and length of life for people who have heart failure. Treatment usually involves taking medications, reducing sodium in the diet and getting daily physical activity.

Heart failure affects about 5.1 million people in the United States. About $32 billion is spent each year on heart failure related costs, such as health services, medications and missed days of work.

DuBois Regional Cardiology Associates is a team of cardiologists, nurse practitioners and support staff who specialize in heart health. They partner with Penn Highlands Healthcare and see patients at Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk. Through The Heart Center at PH DuBois, they perform heart catheterizations, stenting, peripheral angiograms, arrhythmia ablations, electrophysiology studies, device implants (pacemakers, defibrillators, biventricular devices), cardioversions and transesophageal echocardiograms.

They also provide device interrogations and follow-up for pacemakers, defibrillators and bi-ventricular devices, echocardiograms and carotid, arterial, venous, renal aorta and aorta ultrasounds. The team is also involved in outpatient testing, including stress testing, cardiac MRI, calcium scores, event monitoring and EKGs. Photo above from left are, seated in front, Dr. Scott Reese and Dr. Brent Barnes.

Standing are Stacey Smiley, nurse practitioner; Mary Lee DeFrain, nurse practitioner; Dr. Prasad Gupta, Dr. Steven Sprankle, Dr. Jay Ambrose, Dr. Marco Cavagna, Crystal Sayers, nurse practitioner; and Sarah Evans, nurse practitioner.

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

AT PENN HIGHLANDS Juan Carrere, MD Gastroenterology 621 S. Main Street DuBois, PA 15801 814-371-0600 Penn Highlands Healthcare is pleased that all 4 of our hospitals; Penn Highlands SCREENING Brookville, Penn Highlands CENTER OF Clearfield, Penn Highlands EXCELLENCE DuBois and Penn Highlands Elk have each been named a lung screening “Center of Excellence” by two organizations: the Lung Responsible Screening & Care Cancer Alliance and the UPMC Health Plan. This designation is given only to those organizations that demonstrate outstanding quality and patient safety.

Rajesh Rao, MD Critical Care, Pulmonary and Sleep Medicine 100 Hospital Avenue, First Floor DuBois, PA 15801 814-375-3770

Lung Cancer Alliance

A Center of Excellence is able to provide low-dose lung screenings that are reimbursable by insurance. These screenings are responsible for tens of thousands of lives saved each year across the United States. Anyone with a history of tobacco use or who has other risk factors for lung cancer should consider being screened. The process is quick and painless and involves a CT scan of the chest.

In addition, the Breast Imaging Center at Penn Highlands Elk has also become a “Center of Excellence” by the American College of Radiology.

This represents the highest standards of professionalism and image quality in mammography, breast ultrasound, ultrasoundguided breast biopsy and stereotactic breast biopsy.

Penn Highlands Elk is one of only 106 facilities across the country to achieve this distinction.

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Shelby Davison, PA-C QCare Ridgway 104 Metoxet Street First Floor, Side Entrance Ridgway, PA 15853

Heather Griffith, FNP QCare Punxsutawney 551 W. Mahoning Street Punxsutawney, PA 15767

Melissa Hilliard, PA-C General Surgery 145 Hospital Avenue Suite 301 DuBois, PA 15801 814-375-4000

Mary Schimp, PA-C QCare Cameron County North Broad Street Emporium, PA 15834

Ashlee Spack, PA-C QCare Punxsutawney 551 W. Mahoning Street Punxsutawney, PA 15767

James Sweetland, MD Emergency Medicine 100 Hospital Road Brookville, PA 15825

CARDIAC REHAB: A LIFESTYLE CHANGE Kathleen Rickard of Johnsonburg had a heart attack in September. From the Emergency Department at Penn Highlands Elk, she was rushed to The Heart Center at Penn Highlands DuBois where a stent was put in to improve the flow of blood from her heart. She was safe in the hospital with the staff on hand.

But when she went home, she had many unanswered questions. Lifestyle changes were needed, but where to start? She walked a little at first, but she didn’t go too far. She didn’t want to cause herself any more problems with her heart.

Kathleen was scheduled for Cardiac Rehabilitation at PH Elk, and she went.

“They put me on different exercise machines,” Kathleen said. “I wore a heart monitor that they watched as I exercised.

If there were any issues, they are aware of it.” Her blood pressure and heart rate were closely monitored, too, during exercise.

“They knew how far to push me, watched my heart monitor and could see what I needed to do. They are so skilled and knowledgeable. They are serious about helping you get better. They go over and above because they care that you improve your health.”

“That is what gave me the desire to do better. They really give you the courage to take better care of yourself. I was comfortable that they knew what they were doing,” Kathleen said. “When you are by yourself, you don’t know if you are doing it right or your heart is ok. It gave me confidence to do things again,” Kathleen said.

Through Cardiac Rehab, she learned about healthy eating. “There were things I thought I knew but I didn’t,” she said. As Kathleen likes to go out to eat with friends and family, she was happy to learn she could still do that, but do it in a healthier way.

“Yvonne (Challingsworth, RN) said it was a new beginning. I got that in my mind and tell myself I am going to work to change this lifestyle and maintain this,” Kathleen said.

“Karen (Haramis, RN) would say challenge yourself. I think of them even now as I pay attention to what I do,” she said. “They were just a good support system. They make so much effort to help.”

Cardiac Rehabilitation is available at all four Penn Highlands Healthcare hospitals to assist patients who are recovering from heart surgery, heart attacks and other illnesses related to heart disease. Registered nurses and an exercise physiologist work along with other supporting staff, such as a registered dietitian and pharmacist, to help patients regain their strength, improve their activity tolerance, modify risk factors for heart disease and maintain a healthy lifestyle.

Cardiac Rehab is to improve the patient’s health and quality of life, and it reduces the risk of future heart problems.

The Cardiac Rehabilitation program for most patients is 36 visits usually done one hour, three times per week over 12 weeks .

Kathleen went from September to the first part of December.

“If I hadn’t had cardiac rehab, I wouldn’t be where I am today. I would be sitting on the couch and not wanting to do anything.”

“I thank God. I thank him that I am alive,” Kathleen said. “I give a lot of claim to Him to bring me through all this. I had people praying for me which means so much as well. God gave me a miracle.” It was a change in attitude, and she knew she would have to change things.

Not one to get into exercise a lot, she exercises regularly now because she knows how important it is and is walking far beyond what she could before. “It is good to do what I can,” Kathleen said.

Kathleen is happy to be back to her routine.

She is active in her church and her family is very important to her. She is spending time with her grandchildren who range from a teen to a newborn. She babysits, goes for walks with her granddaughter and enjoys every minute with them.

Kathleen Rickard, patient, exercises under the direction of Yvonne Challingsworth, RN, and program director of the Cardiac Rehabilitation at PH Elk.

PENN HIGHLANDS BROOKVILLE Cardiac Rehabilitation 2nd Floor Annex Building 100 Hospital Road Brookville, PA 15825 814-849-1818 PENN HIGHLANDS CLEARFIELD Cardiac Rehabilitation 2nd floor 809 Turnpike Avenue Clearfield, PA 16830 814-768-2144 PENN HIGHLANDS DUBOIS Cardiac Rehabilitation 100 Hospital Avenue DuBois, PA 15801 814-375-3591 PENN HIGHLANDS ELK Cardiac Rehabilitation 757 Johnsonburg Road St. Marys, PA 15857 814-788-8400

WINTER 2016 | 11

George A. Saborio, MD Penn Highlands Internal Medicine/Sports Medicine

814-765-4786

A nip in the air and snow on the ground shouldn’t be cause to abandon the outdoor sports or activities you love.

By taking a few extra precautions, you can maintain your exercise routine and stay in shape when the weather turns chilly, according to Dr. George Saborio, an internal medicine and sports medicine specialist who practices at Penn Highlands Clearfield and the Moshannon Valley Community Medical Building in Philipsburg.

“Research shows that engaging in regular exercise not only helps with weight management, but it wards off many serious and chronic medical conditions such as diabetes and heart disease,” Dr. Saborio states.

He offers the following tips for exercising safely outdoors during the winter months: Be Aware of Weather Conditions Before heading out, check the weather conditions. Several factors should be taken into consideration, including temperature, wind chill and moisture.

The wind chill is of particular importance.

“Wind chill can have serious health consequences because it speeds up the rate at which your body loses heat, even if you dress for conditions,” Dr. Saborio said. At wind chill levels below minus 18 degrees Fahrenheit, frostbite can occur on exposed skin in 30 minutes or less. If the temperature dips below zero or the wind chill is extreme, don’t venture out.

Dr. Saborio also says that it’s best to avoid early morning or late afternoon workouts.

“For one thing, the temperatures are lower during those times. Plus, when it’s dark out, visibility is poor and that can be a safety hazard,” he noted.

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HOW TO EXERCISE IN WINTER WEATHER Further, Dr. Saborio advises those exercising to limit their time outdoors to an hour. If you plan to be outdoors for several hours, make sure you can take an indoor break every hour.

Be Mindful of Surfaces It’s wise to avoid walking or running on snow, Dr. Saborio said, but if it can’t be avoided, it’s best to be on top of snow that is new or padded.

Dress Appropriately It goes without saying that proper attire is necessary when heading outdoors.

If there is new snow, check to make sure there isn’t ice underneath.

The proper way to dress for cold weather workouts is in light layers. Overdressing will cause you to sweat more, which can lead to dampness, chills and discomfort.

You should dress in three layers. The first is the base layer, which should be of a material that helps to “wick” sweat away from the body. Synthetic fibers like polyester and, in some cases, wool, are best. The second is an insulation layer. Light and breathable fleece pullovers, jackets and vests are ideal.

Finally, you should have a protective outer layer, such as a jacket or pullover that is wind- and water-resistant. Look for fabrics that breathe, such as a polyester blend. Avoid materials made from rubber or plastic as they trap heat and prevent evaporation, allowing sweat to build up and cold to creep in.

Make sure your hands and head are covered. It’s also important to wear bright colors, reflective tape or vests when exercising outside.

Dr. Saborio said the shoes you select should have good traction in snow.

If you have exercise-induced asthma, you should wear a mask as cold air may trigger an attack.

Warm Up and Cool Down Indoors Dr. Saborio said “Warming up indoors is a must, a brisk walk in place, climbing stairs several times and stretching exercises will warm you before you face the cold air.”

Likewise, an indoor cool-down, such as a slow walk and stretching exercises, is recommended.

Stay Hydrated Staying hydrated while exercising is a must.

Water is the best drink to rehydrate.

“It’s important to drink before, during and after exercise because your body loses water as it works to maintain proper body temperature. Keeping your body hydrated is necessary to keep it functioning properly,” Dr. Saborio said.

And Finally If you are sensitive to the elements, there are plenty of opportunities to exercise indoors. Dr. Saborio suggests joining a gym or using indoor pools, treadmills, gymnasiums and weight rooms at your local YMCA or community center.

“Walking at the mall is a great way to stay in shape over the winter and it doesn’t cost anything,” he states.

As for how much to exercise, Dr. Saborio recommends exercising for 60 minutes, five or six times a week. Cardio-exercises such as walking, jogging, aerobics and cycling are best.

If you haven’t exercised before and wish to start, he recommends first consulting with your primary care physician, and then starting with an exercise routine of perhaps 20 – 30 minutes per session.

How may we help you?

Penn Highlands Healthcare features full-service Rehabilitation Centers throughout the region. Our facilities are staffed by highlyskilled therapists who evaluate and develop individuallytailored rehabilitation programs for our patients.

Outpatient Therapy Across the Penn Highlands Healthcare service area, there are 14 outpatient rehab facilities for the convenience of our patients. These facilities are located in Brookville, New Bethlehem, Clearfield, DuBois, Brockway, Force, Curwensville, Reynoldsville, St. Marys, Johnsonburg, Ridgway, Emporium, Kane and Fox Township.

At The Rehabilitation Centers, we offer expert physical, occupational and speech therapies, as well industrial rehab. We also provide athletic training in many area schools.

Here are some of the conditions we treat: • Balance disorders • Concussions • Sports Injuries • Rehab after orthopedic surgery • Amputation • Arthritis • Parkinson’s disease • Stroke

• Spinal cord injury • Urinary incontinence • Pelvic floor dysfunction and pain • Lymphedema • Work-related injuries • Speech and swallowing difficulties • Dementia/memory Three of our facilities have pools for aquatic therapy.

“Aquatic therapy offers many benefits to individuals recovering from illness or injury,” explains Mark Hoffman, director of rehab services and occupational health services at Penn Highlands Elk. “The heated water (92 - 94 degrees) has therapeutic properties and allows individuals the ability to perform activities that they may be otherwise unable to complete on land.”

PH Elk also has the system’s only certified hand therapist. With her advanced training, she provides non-operative interventions and care for a wide variety of hand and arm disorders.

Other services provided include wellness therapy, pediatric and developmental therapy, as well as wheelchair clinics to assure individuals are properly fit in a mobility device and they are able to maneuver it appropriately.

Inpatient Rehabilitation Should the time ever come when a loved one does need to be hospitalized, Penn Highlands DuBois has a designated inpatient care unit. The Rehabilitation Center is for those patients ready to step down from acute care but not ready to go home yet. “In this unit, patients still have the benefit of 24-hour nursing care while physical and occupational therapists focus on rehabilitation” explained Marty Maloney, director of rehabilitation services for Penn Highlands DuBois and Penn Highlands Brookville.

Patients participate in three hours of therapy throughout the day to regain the functional skills to return home. There are also daily care and visits from a rehabilitation physician.

“This is an especially helpful environment for those recovering from stroke, neurological conditions, weakness, total

joint replacement or significant fractures, like those to the hip,” said Marty.

Swing Beds All of our hospitals offer swing bed programming, which also provides stepdown care for patients before they head home. Often these patients need therapy while receiving wound care or IV medications.

“Our patients appreciate that they can stay a little longer to have rehab,” said Shelly Spicher, director of rehab services at Penn Highlands Clearfield. “They may not have the confidence to go home from the hospital and take care of themselves.

The swing bed program also allows family members to get involved in the patient’s care and therapy so they can help when the patient is discharged.”

Home Health When patients are finally discharged to their homes, they sometimes still need therapeutic support. In this case, one of the home health providers across the Penn Highlands Healthcare system will arrange for physical, occupational and/or speech therapists to visit the patient in the home.

A care plan is created, and therapists are scheduled to visit a certain number of days each week.

This can be especially helpful as the patient learns to resume daily activities in his or her own home. For example, in the hospital or inpatient rehab setting, patients learn to get in and out of the bath, but doing so in a person’s own bathroom is critical.

For more information about THE REHABILITATION CENTER at Penn Highlands Healthcare, visit our website at www.phhealthcare.org/ therehabilitationcenter, or call one of the numbers listed below.

• Penn Highlands Brookville 814-849-6878 • Penn Highlands Clearfield 814-768-2285 • Penn Highlands DuBois 814-375-3372 • Penn Highlands Elk 814-788-8490

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ShortScripts

Penn Highlands Healthcare is committed to not only serving those who need immediate medical attention, but providing education and wellness events that help to build healthier communities over time.

Join the Cardiac Support Group that is sponsored by The Heart Center of Penn Highlands DuBois for those who have been diagnosed with heart disease or are the family member or caregiver of someone with heart disease.

Get involved in your health and the healthcare of your community. Events are held throughout the year on each of our hospital campuses and across the region to promote, inform and celebrate health and wellness. See what’s going on at Penn Highlands Healthcare this month!

Visit us at www.phhealthcare.org

There will be guest speakers from Penn Highlands Healthcare who will provide a brief presentation to stimulate discussion and conversation among the group.

Attendees can also share concerns and challenges they are facing in making lifestyle changes to care for themselves after a diagnosis of heart disease has been made.

The first meeting is March 8. For more information, call 814-371-9666.

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If you have strong desire to help others and make a difference, then donate your time and talents by volunteering at a Penn Highlands Healthcare facility. Our volunteers truly make an impact on the quality of care we provide for the region.

Volunteering is for all ages: • Adults • College students • Youth ages 16-18 Steps to becoming a volunteer: 1. Interview 2. Application Process 3. Orientation 4. Training

Meetings will be held from 2:30-3:30 p.m. every second Tuesday of the month in The Heart Center’s Patient Conference Room located on the fifth floor at Penn Highlands DuBois.

Any patient who has heart problems or has undergone intervention for heart health such as bypass surgery or catheterization or their family members may attend.

Volunteer with Penn Highlands Healthcare

You can apply online at www.phhealtcare. org or for more information, contact: Penn Highlands Brookville 814-849-1474 Penn Highlands Clearfield 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

814-768-2491 Penn Highlands DuBois 814-375-2316 Penn Highlands Elk 814-788-8520

The Fox Township location of The Rehabilitation Center of Penn Highlands Elk is moving to the St. Marys Community Medical Building at 1100 Million Dollar Highway, 1st Floor, St. Marys, PA by the end of February 2016.

Look for us there!

Where is the nearest QCare Urgent Care Center and when is it open?

QCARE CAMERON COUNTY: 416 N. Broad Street, Emporium, PA 15834 Monday - Friday 10:00 am - 5:30 pm Closed Weekends & Holidays QCARE DUBOIS: 621 South Main Street, DuBois, PA 15801 Monday - Saturday 8:00 am - 8:00 pm Sunday - 9:00 am - 5:00 pm Closed Easter Sunday, Thanksgiving and Christmas Day

Senior Care Facilities - Penn Highlands Elk offers both skilled nursing and independent living facilities close to our hospital for seniors. Our facilities provide a safe, home-like atmosphere, with private and semi-private rooms and emergency alarm systems. Whether you require extra medical or personal assistance or do not feel capable of living on your own, we have a range of services available for you.

Pinecrest Manor At Pinecrest, patients receive 24-hour nursing care and rehabilitative therapy personalized to their condition and abilities.

From skilled nursing care and therapy to a specialized Dementia Unit, we have the facility and team to meet your unique senior care needs. Pinecrest Manor is located at 759 Johnsonburg Road, St. Marys. For more information call us at 814-788-8488.

ELCO Housing ELCO is a 32-unit independent living facility for low income elderly, handicapped or disabled individuals. With a private kitchen, living room, bedroom and bathroom, ELCO offers an affordable, safe living option that allows seniors to remain independent. ELCO Housing is located at 759 Johnsonburg Road, St. Marys. For more information call 814-781-3428.

QCARE MOSHANNON VALLEY: 271 Railroad Street; Philipsburg, PA 16866 Monday - Saturday 8:00 am - 8:00 pm Sunday - 9:00 am - 5:00 pm Closed Easter Sunday, Thanksgiving and Christmas Day QCARE PUXSUTAWNEY: 551 W. Mahoning Street Punxy Plaza Punxsutawney, PA 15767 Monday - Saturday 8:00 am - 8:00 pm Sunday - 9:00 am - 5:00 pm Closed Easter Sunday, Thanksgiving and Christmas Day QCARE RIDGWAY: 104 Metoxet Street, First Floor Ridgway, PA 15853 7 Days A Week 9:00 am - 7:00 pm Closed Holidays QCARE ST. MARYS: Medical Office Building, First Floor 761 Johnsonburg Road St. Marys, PA 15857 Monday through Friday 11:00 am to 6:30 pm Closed Weekends & Holidays THE CLINIC AT WALMART: OPERATED BY PENN HIGHLANDS DUBOIS 20 Industrial Drive DuBois, PA 15801 Monday - Saturday 8:00 am - 8:00 pm Sunday - 9:00 am - 5:00 pm Closed Easter Sunday, Christmas Day and Thanksgiving

Penn Highlands Healthcare offers a variety of Support Groups to help people deal with illness, loss, or stressful life changes. The groups, which are presented by members of the Penn Highlands's healthcare team, are designed to answer your personal questions.

• Breast Cancer Support Group • Diabetes Support Group • Compassionate Friends • Healing After Loss • HUGS for Kids and Teens • Ostomy Support Group • Parkinson’s Support Group • Prostate Support Group • Smoking Cessation Support Group • Stroke Support Group • Mom-To-Mom Breastfeeding Connection Visit us at www.phhealthcare.org/supportgroups

As the community’s resource for health information, Penn Highlands Healthcare is always pleased to provide speakers, free of charge, for your community organization or event.

To make this easier, we now have an online form to make a speaker request at www.phhealthcare.org/ speakersbureau.

We ask that you please make speaker requests at least four weeks in advance of the date requested. Penn Highlands Healthcare will attempt to fulfill all requests, but we cannot guarantee an expert on every subject. We try our best to fill each request. The person who fills out the form will be contacted by a member of the Marketing Team on the status of the request.

Topics are limited to the services that Penn Highlands Healthcare provides. Some of our most popular topics include diet and nutrition, heart health, cancer awareness, and exercise and healthy bones. We have many physicians, physician assistants, nurse practitioners, certified specialists and technicians who would enjoy educating your group.

WINTER 2016 | 15

Advice From A DOCTOR

Robert E. Metts, MD Penn Highlands Orthopedics

How can I protect myself when walking on ice and snow?

It is winter in Northwestern Pennsylvania, and we can usually expect about four feet of snow. That’s the annual average for our region. While we’ve been fortunate this year, we still need to be careful.

This is the time of year we see too many accidents. Falling on ice can be especially debilitating for older adults. As we age, our bones become brittle and thin. They are more likely to crack under impact. To complicate matters, older adults often have trouble with equilibrium and steadiness.

Statistics show that a third of senior citizens fall each year. A quarter of hospital admissions are due to falls, and falling counts for 40 percent of nursing home admissions. Of that 40 percent, many will

16 | WINTER 2016

not return to independent living. Falling is shown to contribute to a functional decline, depression and social isolation.

So, as much as I’d like to meet you, I don’t want it to be in the emergency room because of a fracture.

That is why I am offering these tips to help you walk safely on snowy or icy surfaces.

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Make sure your footwear has a good, gripping sole. No dress shoes or high heels. Even some of the boots currently sold are more for fashion than for practicality.

Take short, shuffling steps.

Use banisters and hand rails whenever available. Hold onto the car when getting in and out and when walking around the car.

Keep your hands out of your pockets so they are ready to catch you.

Avoid carrying heavy purses or boxes that might compromise your balance.

Don’t try to carry all your groceries at one time.

Wear something bright, like a hat or scarf, so that you can be seen by vehicles.

Be extra careful with steps and uneven surfaces.

Use caution when entering a building, especially one with slick floors. The entryways are likely to be slippery from melted snow and ice.

Use rock salt on your own stairs, walkways and driveway to reduce ice build-up.

814-834-1686

The most common injury – accounting for about 34 percent of snow-shoveling trips to the ER – is strain on lower back muscles.

So, let me offer some additional tips for safe snow shoveling.

• Push the snow instead of lifting it.

• Keep your back straight, and don’t bend at the waist.

• Warm up your muscles before you start, and take breaks when you get tired.

• During a heavy snow fall, shovel often to keep the accumulation low. Freshfallen snow is also usually lighter than snow that has piled.

Please don’t become a statistic this winter.

Be safe. And, think spring!