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Protect Yourself, Protect Your Family Page 11
HEALTHY TIMES A Regional West Publication
FEBRUARY 2020
Introducing
Robotic-Assisted Surgery Page 8
Smoke Alarm: The Risks of Vaping Page 5
John Mentgen, FACHE Regional West President & CEO
A MESSAGE TO OUR READERS
2019 was an an exciting year at Regional West; not only did we celebrate our 95th anniversary, but we also expanded the number of physician clinics throughout the panhandle, upgraded the Cardiac Catheterization Lab with state-of-the-art technology, added 3D tomography at the Breast Health Center, and activated a system-wide electronic health record. Soon, we’ll be opening our new, expanded Critical Care Unit and offering surgical procedures using the da Vinci Surgical System. Regional West is focused on advancing the health and wellness of the individuals and communities throughout the region we are honored to serve. We’re committed to serving you as the region’s only acute care referral center, and we’re able to do so in large part due to the caliber of our physicians, providers, and staff. We will continue to strive to deliver exceptional patient care and the most positive patient experiences possible. Thank you for allowing us to be your partner in health for over 95 years.
contents Did You Know?
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Leading With Experience
RWHS.org
Healthy Times is published as a community service for friends and patrons of Regional West. The content and information provided is for informational and educational purposes only and is not a substitute for professional medical care. Consult a qualified medical professional for diagnosis and treatment of any medical condition and before beginning any exercise or diet program.
Comments, questions? Email Joanne.Krieg@RWHS.org.
John Mentgen, FACHE Regional West Health Services President & CEO
TA BL E OF
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4021 Avenue B Scottsbluff, NE 69361 308.635.3711
Julie Franklin Director of Marketing & Public Relations Joanne Krieg Writer/Editor Ken Kurtz, Spectrum Photo Stenbakken Media Contributing Photographers
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Home Delivery of Compassionate Care
Telehealth: Bringing Specialists to YOU
Introducing Robotic-Assisted 8 Surgery: Advanced Surgical Technology
Smoke Alarm: 5
The Risks of Vaping
1 0
Do You Have Diabetes?
11
Fight the Flu
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Did You Know? Regional West’s new plastic surgeon, Matthew Malamet, MD, is now seeing patients at Regional West Physicians Clinic-Plastic & Reconstructive Surgery. To schedule an appointment, call 308.630.2500. “MyRegionalWest” is your personal connection to your provider’s office. You can check your lab and radiology results, view important health information, request an appointment, and securely message your health care provider anytime, anywhere. Learn more at RWHS.org.
Urgent Care offers walk-in treatment for minor injuries and illnesses. Located at 3011 Avenue B. Monday through Friday, 8 a.m. to 6 p.m. Saturdays, 8 a.m. to 5 p.m. Sundays, 10 a.m. to 4 p.m.
Meet our bariatric surgeons and learn about weight-loss surgery at our FREE monthly educational seminars at Regional West. See how our accredited Bariatric Surgery Center can help restore your health. For more information, call 308.630.2249 or visit RWMCWeightLossOptions.com.
Monthly support groups are offered at Regional West for breastfeeding, stroke, weight loss, amputation, and cancer. For dates and times, check out the event calendar online at RWHS.org. Regional West’s Sleep Disorder & Diagnostic Clinic is dedicated to helping patients with sleep disorders find a solution to sleepless nights. Talk to your provider about a referral. For more information, call 308.630.2409.
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Leading With
EXPERIENCE Amanda Vick’s career has taken her from the patient care side of nursing to the administrative side. That depth of experience made her an ideal fit to lead the nursing staff at Regional West. Inspired by a mentor, Amanda Vick, MBA, BSN, RN, transitioned into nursing administration after spending years as an intensive care and perioperative services nurse. She joined Regional West in July as the new vice president of Patient Care Services and chief nursing officer (CNO) after serving as CNO at SageWest Health Care in Lander and Riverton, Wyo. “I love working with and coaching nursing teams to bring out their gifts and talents,” Vick says. “We want to make patients feel valued, because caring for them is the most important part of a nurse’s job.”
Raised in Iowa, Vick attended Northwestern College (now University of Northwestern-St. Paul) in Minnesota, where she received a Bachelor of Science degree in biology before moving on to the University of Wisconsin Oshkosh for a Bachelor of Science degree in nursing. She holds a Master of Business Administration degree from Colorado State University. During her spare time, Vick enjoys being outdoors with her husband — she loves living close to the Wildcat Hills — and running.
Telehealth: Bringing Specialists to YOU Telehealth is now available for patients in Oshkosh and the surrounding communities. Regional West is committed to providing excellent care to patients throughout the region and making specialty care accessible to as many community members as possible. For this reason, Regional West Garden County now offers telehealth services for some specialist appointments. “Telehealth is similar to a traditional doctor’s visit,” says Martha Stricker, MBA, RN, executive director of Regional Services at Regional West. “Patients check into our Oshkosh location and go back to an exam room, where there is a television screen that lets the provider talk with the patient face to face.” A nurse in the patient’s room
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can perform tests to share vital signs with the telehealth provider. Test results and other information are transmitted digitally between providers at Regional West and the outlying facility via a secure internet connection. As a result, the Regional West specialist has the tools he or she needs to make a diagnosis and recommend treatment. If additional testing, counseling, or follow-up care is necessary, that can usually be done on-site at Regional West Garden County with the guidance of the telehealth provider.
BRINGING SPECIALTY CARE TO PATIENTS Telehealth is currently available for:
• • • • •
Behavioral health Skin and medical aesthetics Nephrology Gastroenterology Dietary medicine
Services offered through the telehealth program may expand in the future. “Telehealth allows our patients to have high-quality appointments while saving time,” Stricker says. “We’re doing this to benefit the people of western Nebraska. With telehealth, we can bring providers to them so they can receive the care they need close to home.” To schedule a telehealth visit, call 308.772.3283.
SMOKE ALARM: The Risks of
Vaping
Many people think using e-cigarettes, also known as vaping, is harmless, but it’s unhealthy for teenagers and adults alike. One of the most common myths about e-cigarettes — battery-powered devices that heat a liquid to produce an inhalable vapor — is that they’re safe. In fact, most e-cigarette vapor contains nicotine and other potentially hazardous chemicals, including nickel, tin, lead, and agents linked to lung disease and cancer. Vaping’s potential to help cigarette smokers kick the habit is dubious at best — the U.S. Food and Drug Administration has not approved e-cigarettes as smoking cessation aides. “Most of the time, I see patients add vaping to a cigarette smoking habit rather than quitting,” says Joseph Hong, MD, pulmonologist at Regional West Physicians Clinic-Pulmonology, Critical Care. “Vaping can exacerbate lung disease that’s already present, such as asthma or chronic obstructive pulmonary disease (COPD).”
DANGEROUS ATTRACTION More young people use e-cigarettes — Juul is a popular brand — than any other tobacco product, according to the Centers for Disease Control and Prevention. E-cigarettes appeal to teenagers for a variety of reasons: They’re easy to obtain, there are a variety of flavors from which to choose, and the devices may hide in plain sight because they often resemble flash drives, key fobs, and other everyday
items. Vaping just once makes teenagers more likely to try cigarettes and other tobacco products, the American Academy of Pediatrics reports. The father of a teenager, Dr. Hong advises parents worried about their children vaping to better understand the stressors that may drive them to use e-cigarettes, and to help them find more constructive ways of coping.
FROM BAD TO WORSE Dr. Hong specializes in caring for adults with lung disease. For them, the danger of vaping lies in its potential to cause flare-ups in other airway diseases such as COPD, asthma, bronchitis, allergic rhinitis. Dr. Hong advises patients to avoid vaping. “Beyond nicotine, other byproducts of e-cigarette combustion, such as glycerol, can have adverse effects within the airway,” he says. “People need to understand that vaping is not a safe alternative to smoking cigarettes. We’re just scratching the surface of vaping’s health implications, and we may not understand them fully until five or 10 years from now.” If you want to quit smoking, Regional West’s Smoking Cessation Program can help. Learn how at RWHS.org/ SmokingCessation.
You may not vape, but if you spend time around people who do, you put your health at risk. You can inhale nicotine, heavy metals, and volatile organic compounds when exposed to secondhand e-cigarette emissions, according to the U.S. Surgeon General.
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A Continuum of
Compassionate Care Regional West’s Home Care and Hospice services help patients smoothly transition through life’s stages.
Although home care and hospice care are designed to address different needs in a patient’s health care journey, the goal of both is to provide the best comprehensive in-home and supportive services for patients and their families. Home Care is just what it sounds like: health care services to help treat an illness, injury, or chronic condition delivered in the comfort of one’s home. Home care is focused on healing the patient through restorative treatment and rehabilitation. It can be short or long term and can extend into hospice care in the future, if needed. By contrast, Hospice focuses on support and caring but not curing. Hospice is designed to provide the best quality of life possible for patients whose life expectancy is six months or less. A specially trained team of professionals and caregivers provide care for the whole person,
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including physical, emotional, social, and spiritual needs. The common link between Home Care and Hospice is that both services use a team approach to deliver care directly to patients, in the comfort and privacy of their home. “Hospice and Home Care are both designed to fill unique needs and are delivered to the patient at home, rather than at the hospital or clinic,” says Vicki Holt, MSN, RN, CHPN, director of Home Care and Hospice at Regional West. “Over time, some patients may benefit from both services. Having these services under the same umbrella of care means that while patients may be working with different providers at different points in time, they will always be supported by people who know them, know their past history, know what they have going on, and have an established relationship with their primary care provider.”
HOME CARE Accredited by The Joint Commission and certified as a Medicare and Medicaid provider, Regional West’s Home Care services are designed to provide both continually and temporarily homebound patients with comprehensive support services, including intravenous (IV) medication administration; tube feeding; wound care; and physical, speech, and occupational therapies. Home Care or Hospice is available as a stand-alone service or in conjunction with palliative or hospice care to patients in the following counties: • • • • • • • • • •
Arthur Banner Box Butte Chase Cherry Cheyenne Dawes Deuel Garden Grant
• • • • • • • • •
Hayes Keith Kimball Lincoln Morrill Perkins Scotts Bluff Sheridan Sioux
“Home Care helps take care of the things patients cannot do on their own,” Holt says. “In addition to providing high-quality health care, these services ease the burden of treatment for patients whose mobility is an issue.”
HOSPICE Hospice is an end-of-life service line designed to help patients feel more fulfilled and comfortable during their final months. In order to qualify, a physician has to determine that a patient has a life expectancy of six months or less based on the progression of his or her disease process. “That does not necessarily mean they are going to pass away in that time frame,” Holt says. “Sometimes, a patient’s condition will improve as a result of the nurturing care offered through hospice. When this happens, it allows the patient and their family and friends time to focus on what matters most to them. They start eating again, gain
weight, and get to the point where their provider determines that it is unlikely for them to continue to meet Hospice criteria.” Hospice services are available to patients in Scotts Bluff, Banner, Kimball, Cheyenne, Morrill, Box Butte, and Sioux counties. Regional West tries to maintain a distance and time limit of 60 to 65 miles or one hour in order to be able to reach a patient and meet their needs in a timely manner. “If a patient is in need of assistance, it’s vital that our staff can reach them without unreasonable delays,” Holt says. “Staying within the Medicare guidelines helps to ensure that the maximum number of patients is able to benefit from Regional West’s Hospice services.” Holt says they hope to extend their reach by establishing a new, centrally located branch office that is within range of some of the panhandle’s more rural areas.
While this plan is still in its infancy, Holt hopes that Regional West will be able to expand the reach of its Hospice services in the upcoming future. In the meantime, she says, their focus remains on providing quality care. “Whether it is Hospice or Home Care, we want to be there for our patients wherever they are at in their disease process so that we can give them the appropriate care and services they need,” Holt says. “We will always respect the decisions patients make regarding their own health care and will do our best to accompany them throughout their individual health journeys.” For more information about Regional West’s Home Care program, call 308.630.1430. For more information about Regional West’s Hospice services, call 308.630.1149.
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Introducing
Robotic-Assisted
Surgery: Advanced Surgical Technology Regional West is pleased to announce the opening of its new robotic surgery suite featuring the da Vinci®Surgical System — the next era of surgical innovation.
THE EVOLUTION OF SURGERY Years ago, all surgery was performed through large open incisions, but the development of laparoscopic surgery made many procedures minimally invasive — allowing the surgeon to perform the procedure through quarter-inch incisions while a miniature camera displays the surgical field from within the body. The benefits of laparoscopic surgery are numerous. They include: less pain, shorter hospital stays, quicker recovery times, less scarring, and reduced blood loss. “Now, with robotic surgery, it’s exponentially better. The visualization and magnification is unbelievably enhanced, and you have the control and precision of open surgery,” says Rommie Hughes, MD, FACS, RPVI, a general and vascular surgeon at Regional West. Robotic-assisted surgery is completely different from open surgery, but as in laparoscopic surgery, a miniature camera is inserted through a tiny incision and the surgeon performs the procedure by watching the surgical field on a monitor. In a robotic-assisted procedure, the scrub nurse and robot are positioned next to the patient, while the surgeon sits at a console. The console displays
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a 3D high-definition view of the surgical area and includes the controls for the surgical instruments. The surgeon performs the procedure by guiding the surgical instruments and the camera while sitting at the console. The robotic computer system translates the surgeon’s hand movements in real time to manipulate the instruments as he or she performs the procedure.
THE ADVANTAGES OF ROBOTIC-ASSISTED SURGERY Robotic-assisted surgery allows for smaller incisions and increased precision, meaning patients can potentially spend less time in the hospital, lowering their costs and that of their health insurance companies. Regional West’s newest general surgeon, Bradley Hertzler, MD, completed his surgical residency at Mount Carmel Medical Center, Columbus, Ohio, where he was trained on robotics to perform a wide range of abdominal surgeries. “I found that the robot really shined in dealing with the parts of the abdomen that are much harder to reach, such as the upper abdomen, upper stomach, lower esophageal area, and the deep pelvis,” Dr. Hertzler said.
ROBOTIC SURGERY IS WELL-SUITED FOR:
Gynecologic surgery
Prostate surgery
Robotic surgery is ideal for parts of the body that are hard to reach because the instruments can rotate a full 360 degrees and are more flexible than the human hand or wrist. In addition, their movements are easily controlled. Regional West OB-GYN physician, Matthew Bruner, MD, FACOG, was also trained to perform robotic-assisted surgery while in residency nearly a decade ago. The University of Nebraska Medical Center had one of the earliest da Vinci Surgical Systems ever made. “It’s an excellent tool for gynecological surgery,” Dr. Bruner says. “The big advantage over laparoscopic surgery is that the enhanced depth perception and wrist movement improves precision and allows the surgeon to do fine dissection and suturing. Because it’s so precise, you can remove some ovarian cysts while preserving the ovary. The same is true for large uterine fibroids — in some cases, they can be removed and the uterus can be preserved. This would preserve a woman’s ability to have a baby after surgery.”
THE NEXT GENERATION OF SURGERY Robotic-assisted surgery combines the best
Kidney surgery
Gallbladder surgery
Colorectal surgery
features of open surgery and laparoscopic surgery. It uses the small incisions of laparoscopic surgery with the control, precision, and wristed movements of open surgery. “In certain patient populations, it is going to be the right way to do surgery, while there’s still going to be room for laparoscopic and open procedures,” Dr. Hertzler says. Robotic-assisted surgery has been used in academic centers across the country to train new surgeons for many years, and surgeons are now certified in robotic-assisted technology when they complete their residencies. More and more community hospitals across the country are adding it to their surgery departments. “As a regional referral center, local and regional patients rely on Regional West for exceptional care,” said Regional West general and bariatric surgeon Jeffrey Holloway, MD, FACS. “They expect us to have the latest technology and top-quality providers.” To learn more about the benefits of robotic-assisted surgery using Regional West’s new da Vinci®Surgical System, visit rwhs.org.
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Millions of People Have Diabetes, But Don’t Know It.
Do You? In 2017, the Centers for Disease Control and Prevention (CDC) released an alarming report on the state of American health: Over 30 million Americans have diabetes, and another 84.1 million have prediabetes — a condition that, left untreated, often leads to Type 2 diabetes within five years. Even more alarming is the fact that most of the people with prediabetes don’t know they have it. “Before developing Type 2 diabetes, most people have prediabetes,” says Serozan Amroliwalla, MD, internal medicine physician with Regional West Physicians ClinicInternal Medicine, known to his patients as Dr. Sero. “The good news is that prediabetes can be reversed. That’s why we recommend blood glucose screening for all adults by at least age 40, even if they don’t have symptoms of diabetes.” Diabetes is a chronic disease caused by excess blood sugar (glucose). The glucose comes from the food you eat. With the help of insulin, which is produced by the pancreas, glucose is transferred from food into your body’s cells to provide energy. If your body does not make enough insulin or convert it properly, the glucose stays in the blood and does not reach your cells. Over time, the excess blood glucose may lead to diabetes and serious health problems including heart disease, stroke, kidney disease, eye problems, and nerve damage. 10 Healthy Times | RWHS.org | 308.635.3711
Type 1 diabetes occurs when the immune system destroys pancreatic cells that make insulin. It is usually diagnosed in children and young adults, but can occur at any age. Symptoms are serious and usually develop quickly. People with Type 1 diabetes must take insulin every day. About 5% of people with diabetes have Type 1. With Type 2 diabetes, the body does not use insulin well and cannot keep blood sugar at normal levels. About 90% of people with diabetes have Type 2. Symptoms often develop slowly, over several years, and can be overlooked. People who are overweight, obese, or physically inactive are at increased risk for Type 2 diabetes. Although there is no cure, steps can be taken to manage Type 2 diabetes and maintain health. Gestational diabetes develops in pregnant women who have never had diabetes. It usually goes away after the baby is born, but mothers with gestational diabetes have a higher risk of developing Type 2 diabetes later in life. In addition, it puts the baby at greater risk for childhood or teen obesity and the development of Type 2 diabetes.
Prediabetes means blood sugar levels are higher than normal, but not high enough to be diagnosed as Type 2 diabetes. It’s possible to prevent or delay the onset of Type 2 diabetes by making lifestyle changes. “By being more physically active, losing weight, and eating healthier, you can reduce your risk of developing Type 2 diabetes and prediabetes and improve your overall health,” says Jason Beals, RN, BSN, diabetes educator with Regional West Physicians ClinicDiabetes Care Center. The three main symptoms of Type 2 diabetes are increased thirst, increased hunger, and increased urination. If you have these symptoms, Regional West Physicians Clinic encourages you to schedule an appointment with your health care provider. For those who have diabetes, the Diabetes Care Center offers Diabetes Self-Management Training, as well as medical care, education, and support to help patients better understand and manage their condition. To schedule an appointment, call Regional West Physicians Clinic-Diabetes Care Center at 308.630.3700.
Fight the
FLU The flu, also known as influenza, is a respiratory infection caused by contagious flu viruses. Its symptoms can include achy muscles, a cough, a runny or stuffy nose, muscle aches, fatigue, headaches, fever, and sore throat, as well as vomiting and diarrhea. While these symptoms generally last about a week or less, many individuals have symptoms that last longer or develop more severe complications as a result of the flu. “You may think that the flu will not make you that sick, or that you will not get it at all,” says Paulette Schnell, RN, MSN, Community Health director at Regional West. “However, there are two things to think about when it comes to the flu: You want to make sure you are taking care of your own health, and you also want to protect the health of those around you. By getting a flu shot, you can do both. You are less likely to get sick and need to take time off work, and less likely to end up in hospital from flu-related complications, such as pneumonia.” Additionally, when a large portion of people in a community are vaccinated, it reduces the chance of
an outbreak, which makes it less likely for those atrisk individuals to get sick. Young children, older adults, and individuals with certain chronic diseases, for instance, are especially vulnerable to the flu.
THE FLU SHOT Schnell recommends that everyone 6 months and older get a flu shot annually. The vaccine is designed to protect people from the four strains of the flu predicted to be the most prevalent during a given flu season (peak flu season in western Nebraska starts in January and continues through March). Schnell notes that annual vaccination is important because immunity against the virus wanes over time. “When you get a flu shot, a small part of the virus is injected into you so that your body can build up immunity,” Schnell says. “However, it does not introduce you to a live virus. As long as you are receiving the injection (and not the nasal spray vaccine), you cannot get the flu from the flu shot.” For more information call Regional West Community Health Immunization Clinic at 308.630.1580.
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OM
Z IP C O 4 3 973
M AILED
FR
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Regional West 4021 Avenue B Scottsbluff, NE 69361
PRSRT STD U.S. POSTAGE
PAID
PERMIT NO. 93
Regional West Medical Center complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. For more information, see link on our website at www.rwhs.org/patients/nondiscrimination-notice-physicians-clinic. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al. (TTY: 1-800-833-7352). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số . (TTY: 1-800-833-7352). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電。 (TTY: 1-800-833-7352).
Award-Winning Care Our mission is to serve all the people in regional communities as a steward of their health and health care. Regional West is proud to provide:
Regional West Medical Center’s Air Link air ambulance service has again been awarded a full three-year accreditation by the Commission on Accreditation of Medical Transport Systems (CAMTS). The commission is a nationally recognized organization that ensures medical transport programs meet national standards for safety, education, and training. Air Link is one of four CAMTSaccredited medical transport programs in Nebraska and has been accredited since 2001. Nationwide, 162 programs have earned CAMTS accreditation.
• Acute Rehabilitation • Air Link-Rotor & Fixed-Wing Air Ambulance Service • Ambulance Service-Ground • Anesthesiology • Bariatric Surgery • Birth and Infant Care • Blood Banking & Transfusion Medicine • Breast Health Care • Cancer Services • Cardiology • Community Health • Diabetes Care • Ear, Nose and Throat, Head and Neck Surgery • Emergency Medicine • Endocrinology • Family Medicine • Gastroenterology • Heart & Lung Care • Home Care • Hospice • Hospitalist Service • Imaging Services • Internal Medicine • Interventional Radiology • Laboratory Services • Nephrology • Neurology
• • • • • • • • • • • • • • • • • • • • • • • • •
Neurosurgery & Spine Care N ewborn Intensive Care Unit Orthopaedics Outpatient Surgery Pain Management Pathology P ediatrics – Inpatient & Outpatient P harmacy – Inpatient & Community Pharmacy P lastic & Reconstructive Surgery P sychiatry & Behavioral Health Pulmonology, Critical Care Radiation Oncology Rehabilitation Medicine Rehabilitation Services Skin Clinic & Medical Aesthetics Sleep Disorder Treatment Smoking Cessation S urgery, Vascular Diagnostics Trauma Services Urgent Care Urology Vascular Services Weight-Loss Options Women’s Health Services Wound Care