Housecall_Fall 2023

FALL 2023

HOUSECALL HOUSECALL

OUR MISSION TO SERVE THE COMMUNITY

WHERE YOU'RE

MORE THAN A PATIENT Bob, Scott Township Man On A Mission 21,186 Miles and Counting Hip Replacement Recipient

stclair.org

inside

SINCE 1954, St. Clair Health has been dedicated to quality, innovation, responsiveness to community needs, and the humanity of the physicians, nurses, caregiving staff, and volunteers.

ARTICLES

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PATIENT ACCESS Strategic initiatives drive coverage of St. Clair service areas, tied directly to the healthcare system’s brand pillars.

INTERNAL MEDICINE 10 After 50 years of care, one patient sings the praises of the doctor keeping her healthy during her golden years.

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FAMILY MEDICINE Shepherding chronic disease management builds lifelong kinship by easing the pain of chronic migraines.

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HOSPITAL MEDICINE + CRITICAL CARE Collaboration between physician-leaders and their teams ensures around-the-clock compassionate care.

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FOOD ASSISTANCE MATCH Born out of crisis, one doctor with deep local ties furthers partnerships with farmers markets to fight food insecurity.

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BREAST CANCER CARE For one patient, the strength to keep the faith finds its roots in the community she’s helped support in myriad ways.

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HOUSECALL HOUSECALL A publication of St. Clair Health

Articles in this publication are for informational purposes and are not intended to serve as medical advice.

Please consult your personal physician.

Please call 412.942.DOCS or visit physicians.stclair.org/primary-care to find a PCP within the St. Clair Medical Group network.

ST. CLAIR HEALTH I HOUSECALL I 3

FIRSTCALL

OUR MISSION TO SERVE THE COMMUNITY Ground-breaking: 1951. Doors opened: 1954. In the decades since, every element of groundbreaking growth has been designed with one thing in mind: personalizing your care to humanize healthcare.

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t the heart of every great recipe is the ingredients. For more than 60 years, the Fatigati family of Bridgeville were proud restaurateurs. Today, internal medicine is the family business—one that sprouted from a strong desire to want to be in the mix.

“I grew up working in the restaurant, and every single day was a test,” Mario says. “The whole family was right there in the room, and we were always ‘on call’—that was the message: you’re only as good as the next dish you put out and the service you provide.

There was a tremendous amount of family pride.”

Inspired by the generational branches of his family tree that brought their personal best to the table, Mario ventured overseas to earn his medical degree in Italy after completing undergrad at Allegheny College.

“My grandparents immigrated to Pittsburgh and their life of service to the community was through the restaurant. I was born at St. Clair Hospital. I went to high school in Canonsburg. And I went back to Italy with the goal of returning to practice medicine in this community,” he says. “It means so much because my family’s history is right here.”

Mario’s daughter, Nina, traces her medical roots to one very influential memory at St. Francis Medical Center, where her father trained and first started practicing.

“I have two sisters, but I was the lucky one who got to go to the take-your-daughter-to-work day. I vividly remember the dress I wore—blue with white flowers—because every time I think about that day it fills me with so much passion,” she says. “I was six years old and I loved every minute of it—awestruck by watching

how my dad interacted with his patients. That day set the stage for wanting to be in the mix.”

Nina’s flashback creates a collision course of memories for Mario.

“This is my 34th year at St. Clair and I take care of six of my high school teachers,” he says. “Nina’s created so many of her own tight-knit relationships with the community, and that’s the heartbeat of both what we do and why we do it.”

Believing. In standing up for what’s on your heart.

Striving. In service of the people and the place you call home.

Committing. To bringing the best version of yourself to the arena every day.

For Nina, those messages were delivered through sports.

“My sisters and I all played college volleyball. My dad’s early message wasn’t, ‘You have to be a doctor.’ It was, ‘You have to want to be in the mix.’ We learned how to compete and put ourselves out there—even when it’s not comfortable,” she says.

“What really stuck with us is the idea that when the game is on the line, you want to have the ball in your hands.”

And from the outset of his career, Mario has been running with it throughout the community he’s so proud to serve.

“For me, it’s all about your actions speaking louder than your words ever could,” he says. “That’s why I wanted to get involved with so many different aspects of the community, even as a young physician, and continue to elevate that link over the years.

The wonderful work we’ve been able to carry out with Kane Community Living Centers, through different opportunities with leadership and the medical staff at St. Clair—it’s always been driven by the critically important goal to increase our ability to connect at every level.”

Nina picked up on that lesson early and applied it throughout her journey to St. Clair Health. She worked one high school summer at Glen Hazel Community Living Center and then earned her medical credentials at larger, city-based institutions.

“Nothing ever clicked—and I never felt at home—until I came here. There’s just nothing that creates the same kind of connection as this community,” she says. “I didn’t want to miss the opportunity to help the people who helped raise me.”

Which brings us back to the dinner table—around which Nina is now raising her own young family with yet another medical expert, her husband, Christopher Pray, MD, FACC, Director of Non-Invasive Cardiology, Cardiac Imaging & Heart Failure Service at St. Clair Health.

“Chris believes that the best way to curate care is to really dig into the personal perspective of each patient. And when you see the care that the partner you’re building your life with gives every day, it doesn’t get more personal than that,” Nina says. “We live in Peters Township, and Bethel Park is the best place in the world to him—he loves it. We’re all-in!”

The spirit of common experiences that almost can’t be put into words infuses Mario Fatigati with the feeling that whether his grandchildren become doctors or find another vocation, they’ll no doubt find their way into the future in service of the community.

He’s equally adamant that the Fatigatis are far from the only

MORE THAN A PATIENT. Personalizing your care.

Humanizing healthcare.

South Hills family at St. Clair Health whose business is delivering expert care.

“It’s one of the rare things that has always made this place so special—many of our doctors are from here, they live in the same neighborhoods as many of their patients, and together, we all feel the difference that makes,” he says. “At St. Clair Health, you’re not a number—and we’re carrying that forward for generations to come.”

Nina is particularly passionate about system-wide growth and integrated services that allows their multi-generational story to help St. Clair Health lead the region forward in tandem with every dedicated physician, nurse, and staff member across St. Clair Medical Group Internal Medicine.

“When we talk about taking care of your family, we’re really talking about trust. It’s a privilege to be able to refer our patients to specialists right under the same roof because that’s not just what our community demands—it’s the level of care they deserve,” she says. “People need to feel heard. Beyond physical health, mental health and lifestyle goals are more important than ever.

One of the best parts of what we do every day is knowing that here…we make things personal.” n

MARIO J. FATIGATI, MD, FACP, CMD

Dr. Fatigati specializes in internal medicine and primary care. He is board-certified by the American Board of Internal Medicine and the American Board of Internal Medicine— Geriatric Medicine. Dr. Fatigati earned his medical degree at Universita Di Roma, Italy, before completing an internal medicine residency at St. Francis Medical Center, where he also completed an internal medicine fellowship. He practices with St. Clair Medical Group and was named a Top Doctor by Pittsburgh Magazine in 2023.

To contact Dr. Fatigati, please call 412.221.3377.

NINA M. FATIGATI, MD

Dr. Fatigati specializes in internal medicine and primary care. She is board-certified by the American Board of Internal Medicine.

Dr. Fatigati earned her medical degree from the University of Pittsburgh and completed residency at UPMC. She practices with St. Clair Medical Group. To contact Dr. Fatigati, please call 724.731.0090.

ST. CLAIR HEALTH I HOUSECALL I 5

GROWTH. FOR THE GREATER GOOD.

For nearly 70 years, St. Clair Health has been driven by a relentless commitment to deliver advanced care close to home.

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hat, exactly, is patient access? For St. Clair Health, it all started when the Hospital doors opened in 1954, creating the very first access point at the heart of the South Hills.

In the decades since—as St. Clair expanded into an integrated healthcare system—access to expert care across wide-reaching specialty services expanded in turn.

“Fundamentally, patient access is built on increasing your ability to

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benefit from our wide-ranging resources,” says Barry S. Zaiser, SVP & Chief Strategy Officer. “Functionally, that access plays a direct role in the quality of care you receive.”

The pillars of patient access—obtaining pertinent information, utilizing innovative services, building stronger bonds, and creating healthier communities—are essential to the strategic efforts driving every level of the organization.

PATIENT ACCESS Running parallel to those pillars: the very elements that St. Clair Health brings to every patient, every day. The organization’s success in setting standards that lead the region forward begins with a relentless commitment to continuous improvement.

“Our passion is fueled by the knowledge that St. Clair Health is the quality leader— the patient experience leader,” Zaiser says.

“Our mission is to serve the communities of Southwestern Pennsylvania through excellent clinical programs in tandem with creating more patient access points throughout the region so we can meet you where you are and deliver the advanced care you deserve.”

From recruiting physicians to synchronizing programs and services across the St. Clair Health system, the blueprint is designed with unifying goals—growing not to be the biggest, but the best. Buoyed by a fierce sense of independence, St. Clair Health is focused on creating a healthier region by providing excellent care and being a good neighbor.

“We strive each and every day to set the standard of excellence across Southwestern Pennsylvania,” Zaiser says.

And that aspiration is tied directly to The Golden Rule.

“We treat every patient, partner, and person like we’d want to be treated ourselves—with compassion and respect at every step,” he adds.

St. Clair Health’s main campus in Mt. Lebanon serves as the hub, with Dunlap Family Outpatient Center’s more than 280,000 square feet of one-stop, sameday services serving as the crown jewel of integrated innovation.

Zaiser points to St. Clair’s Village Square and Peters Township Outpatient Centers and the Robinson Township Multispecialty Suite—plus affiliate partner satellite offices throughout the region (including Caste Village, Bridgeville, and more)—as pin drops that serve a much greater purpose than increasing the sheer size of St. Clair’s footprint on any map.

“The groundbreaking growth of a stateof-the-art building is something you can see—and that’s always exciting,” he says. “One of our greatest strengths is connectivity, and that’s rooted in our strategic objective to build coordinated clinical programs that make it more convenient and cost-effective for patients to have access to our world-class healthcare system.”

The primary focus? Primary care.

“That’s the foundation of our healthcare system—and we’re expanding aggressively. In order to continue building excellent specialty services from cardiology and neurology to oncology, OB/GYN, and beyond, it all ties back to primary care,” he says. “Delivering expert care at the outset of your health care journey and maintaining that level of care throughout your life is then linked directly to any specialty services you may need along the way.”

Antonio M. Riccelli, MD, FACP, who practices with St. Clair Medical Group (SCMG) Internal Medicine and sees patients at both the Caste Village and Village Square Outpatient Center locations, has had a front-row seat to St. Clair Health’s ever-expanding commitment to the community since 1992.

“At every stage of our growth, one critical factor that’s been a driving force is that we’re always accepting new patients,” he says.

“Expert care from people who care means that we want you to feel like that door is always open—we’re here, for you.”

Beyond his expertise in internal medicine and primary care, Dr. Riccelli has also served

in another crucial capacity: Hospital Information System (HIS) Clinical Liaison with St. Clair’s cross-function Information Technology (IT) partners.

“Another key marker of system-wide growth is ensuring that our Electronic Health Record (EHR) efforts have continued to evolve,” he says. “No matter which physician you see across the St. Clair system, we all have the ability to access that vital information in order to deliver the best patient experience every time we see you.”

In the near future, SCMG Internal Medicine and their primary care partners will be able to put your EHR to even greater use across five new exam rooms at the expanded Caste Village office and the newly-renovated Professional Office Building (POB) on the first floor of the main Hospital, which is being redesigned as a Primary Care Center. Being directly connected to Dunlap Family Outpatient Center provides added convenience: immediate access to diagnostic and imaging services as needed.

Expansion of the Peters Township Outpatient Center is also currently being planned in turn, as St. Clair Health continues to seek the most innovative and comprehensive ways to meet the needs of patients in the area.

“It’s an incredibly exciting time for patient access at St. Clair Health,” Dr. Riccelli says.

“Family Medicine and Internal Medicine are coming together more seamlessly than ever before so we can deliver the expert care your whole family needs.” n

ANTONIO M. RICCELLI, MD, FACP

Dr. Riccelli specializes in internal medicine and primary care. He is board-certified by the American Board of Internal Medicine. Dr. Riccelli earned his medical degree at Penn State and completed residency at UPMC Mercy. He practices with St. Clair Medical Group Internal Medicine.

To contact Dr. Riccelli, please call 412.942.9105.

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With 25 locations in the Greater Pittsburgh area, Preferred Primary Care Physicians (PPCP) serve as key collaborators with St. Clair Health.

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PCP, an independently owned physician group, was founded in 1995 by 10 primary care physicians in the South Hills of Pittsburgh. They came together with a shared devotion to create exceptional doctor-patient relationships while delivering the highest quality care. Today, 25 PPCP primary care doctors practice across the St. Clair Health system (with 27 more across Allegheny, Washington and Fayette counties).

Frank Civatarese, DO, formerly served as President of the St. Clair Health Medical Staff, during which time he was the recipient of St. Clair’s Physician Recognition Award—given annually to a physician who goes above and beyond to support their colleagues, patients, and the community. Dr. Civatarese, who has served as PPCP Board President since 2007, offers unique perspective that augments the alliance.

"The healthcare system is very complex. PPCP has been purposeful in building a primary care model centered on value–providing the highest

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quality of care at the right time and in the right setting. We consistently ask our patients to call us first whenever they think they may need care of any sort so that we can guide their decision-making and help them navigate the system," he says. "Often times, an in-person or telehealth visit with the PCP is sufficient. But when testing or specialty care is warranted, we are confident that our long-standing relationship with St. Clair Health will drive positive patient outcomes."

This synergy is stoked by PPCP’s brand pillars that mirror St. Clair’s own: • Delivering quality care • Increasing patient access • Independent, forward-thinking mindset • Enhancing the primary care patient experience That begins with being nimble enough to adopt programs that provide a total range of primary care services and help you manage

“Patient access is about creating options and choices for you, and, as a primary care private practice, that’s our sole focus. " KEVIN KOTAR, DO, FAAFP Chair of Family Medicine

chronic conditions. Of equal import, it’s supported by a team-based approach, comprehensive clinical programs, and state-ofthe-art outpatient centers.

In addition to his family medicine work at PPCP, Kevin Kotar, DO, FAAFP, serves as Chair of the Department of Family Medicine at St. Clair.

“What makes our relationship unique in the region is the deep appreciation for primary care,” he says. “With St. Clair Health, it’s at the forefront and together we’re all focused on being the communicator for each patient’s coordinated care.”

That connection is as humbling for Dr. Kotar as its uniqueness in the region.

“If you don’t have your health, nothing else matters. When you’re coming in each day in service of the community…what else could be better than that?” he asks. “I truly believe there’s no greater job, and, we’re extremely proud of the long-term trust we earn over each patient’s—and their family’s—longitudinal care. There’s nothing more rewarding.”

When it comes to treating your whole life for your whole life, those distinct relationships blend directly between PPCP and St. Clair.

“Patient access is about creating options and choices for you, and, as a primary care private practice, that’s our sole focus. Our priorities are clearly defined and our goal is to deliver the best primary care, period,” he says.

Dr. Kotar, who calls South Fayette home, appreciates living in the same neighborhood as many of his patients.

“I grew up here and look forward to seeing you around town—and that happens almost every day,” he says. “It’s a privilege to be able to care for friends and family, retired former teachers of ours—it runs the whole spectrum.

There’s a little different level of care involved when you live in the community that you serve.”

That sentiment is echoed by Joshua Goldman, DO, an internal medicine specialist at PPCP. He grew up in Rockland County, New York, met his wife-to-be during medical school in Fort Lauderdale, Florida, and they settled in Pittsburgh during the 1990s.

“We lived on Firwood Drive right across the street from the Hospital and after residency (at St. Francis Medical Center), I started practicing at St. Clair more than 25 years ago,” he says.

“We live in Upper St. Clair today and one of my favorite things about the region is the connected spirit within the communities.”

That proximity creates acute attention to detail on a patient-by-patient basis.

“We really get to know you and your family, and that’s important as families grow and evolve over their lives,” he says. “We’re not just getting a snapshot or seeing something change on a chart—we’re picking up on it in real time so we can help you put together a total care plan and work together to get ahead of challenges we can anticipate better because we’ve been side by side the whole time.”

For Dr. Goldman, timing is everything—and staying one step ahead of the ever-changing

PRIMARY CARE needs of the region means being available as much of the time as possible.

“Whether it’s a Friday night or a Sunday morning, we encourage patients to try here first. We have a Preferred First™ Call Center with extended evening and weekend hours, plus a direct line to a registered nurse,” he says.

“No problem is too small—if you’re concerned so are we—so it’s always the right call to make that call.”

From recommending over-the-counter solutions to setting up an immediate telehealth consult, scheduling your next-day in-office appointment, or directing you to seek immediate care in an emergency, PPCP has one goal in mind.

“We’re solely focused on maintaining your continuity of care,” Dr. Goldman says. “Our long-standing collaboration with St. Clair Health means that when diagnostic, specialty, or inpatient care is required, there's a depth and breadth of advanced services available that can support great clinical outcomes." n

KEVIN KOTAR, DO, FAAFP

Dr. Kotar serves as the Chair of the Department of Family Medicine at St Clair Health. He is board-certified by the American Board of Family Medicine. Dr. Kotar earned his medical degree at the Lake Erie College of Osteopathic Medicine and completed his residency at UPMC St. Margaret. He practices with Preferred Primary Care Physicians, Inc. To contact Dr. Kotar, please call 412.831.1522.

JOSHUA GOLDMAN, DO

Dr. Goldman specializes in internal medicine. He is boardcertified by the American Board of Internal Medicine and also holds memberships in the American College of Physicians and the Pennsylvania Osteopathic Medical Association. Dr. Goldman earned his medical degree from Nova Southeastern College of Osteopathic Medicine, Fort Lauderdale, Florida. After a one-year internship at St. Francis Central Medical, he completed his residency at St. Francis Medical Center. Dr. Goldman practices with Preferred Primary Care physicians, Inc. To contact Dr. Goldman, please call 412.831.1522.

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CARE THROUGH THE GOOD TIMES & THE BAD TIMES A primary care provider’s thorough approach to health care leads a grateful patient to recommend her to family and friends.

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udy Binek has been coming to St. Clair Health for nearly all of her health care needs for 50 years. The former Mt. Lebanon resident has visited St. Clair Health providers for everything from routine checkups and inpatient treatment to the birth of her three children and emergency care. Out of all the providers she has seen over the years, she sings the praises of one in particular these days. It’s Amanda Hercules-Smith, MD, of St. Clair Medical Group Internal Medicine, as Judy credits her for keeping her healthy during her golden years.

Judy had previously seen Joseph P. Endrich, MD, also of St. Clair Medical Group Internal Medicine, for her primary care needs.

When he announced his retirement, Judy immediately knew she wanted to transition to another provider in the same practice. She says, “When I asked Dr. Endrich who he would recommend, he said Dr. Hercules-Smith. I thought, good, because I saw her once before.

I liked her and got along with her.”

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Dr. Hercules-Smith was easily able to familiarize herself with Judy’s medical history prior to their first appointment. She explains, “For some patients, it requires a quick review of the charts to get a better understanding of their past medical history and any ongoing medical problems. All of our physicians do pretty comprehensive chart updates which makes transition of care seamless.”

But this first appointment wasn’t just a routine checkup. Judy needed to discuss a rash and other concerning symptoms she was experiencing. She explains, “I thought the rash may have been caused by the fabric softener my daughter-in-law used while on vacation in Ocean City. But there were other symptoms, too.”

“Judy was exhibiting stroke-like symptoms, so I said to her, ‘Why didn't you go to the emergency room?’ She said she thought she'd see me first,” says Dr. Hercules-Smith. “After examining her, I realized this wasn’t a stroke but rather Bell’s palsy.”

Bell's palsy is a condition that causes sudden weakness of the muscles on one side of the face. As many as one in four cases of the condition are caused by Lyme disease, a bacterial infection spread to humans by infected ticks that can lead to serious longterm side effects if left untreated.

“When Dr. Hercules-Smith sent my blood to be tested, we learned it was Lyme disease.

Nobody knew what was wrong with me, but she figured it out,” says Judy. After making the diagnosis, Dr. Hercules-Smith worked with an infectious disease physician at St. Clair Health to create a personalized care plan for Judy and begin treating her right away.

“I headed right to the hospital, where I was admitted so I could start an antibiotic treatment as an inpatient,” shares Judy.

“Obviously they couldn't keep me as an inpatient for a whole month, so I had to travel back and forth using St. Clair Health courtesy vans to continue to get the antibiotic treatment as an outpatient.”

Judy currently resides at the Hillcrest Residences, a newly-constructed senior community in Carrick. Despite the added distance and a lack of personal transportation, Judy did not have to worry about getting to and from this series of follow-up appointments thanks to St. Clair Health’s signature blue and white vans. She was able to access the care she needed, when she needed it, to treat both conditions.

Though the antibiotics cured her Lyme disease, the Bell’s palsy is considered a chronic condition. Dr. Hercules-Smith explains, “It can totally resolve in some patients, but Judy still has some persistent symptoms of the facial paralysis. She’s one of about 20 percent of people who are left with unilateral facial paralysis.”

Judy began seeing Dr. Hercules-Smith for more regular checkups following this episode because she didn’t just have the Bell’s palsy to monitor. She shares, “I kept up with my appointments. I also have high cholesterol, high blood pressure, and a history of aneurysms. I think it’s hereditary because my uncle had one, too.”

An aneurysm is an abnormal swelling or bulge in the wall of a blood vessel that can occur anywhere throughout the circulatory system. If left untreated, an aneurysm can rupture and may result in internal bleeding, stroke, or sometimes even death.

Having previously experienced two aneurysms, Judy didn’t hesitate to mention a lump in her groin area when seeing Dr. Hercules-Smith for a routine checkup.

Dr. Hercules-Smith emphasizes, “It was not just a lump. It was very big and quite pulsatile, so we got her to the ER right away. The aneurysm was eight centimeters at diagnosis, and had very a high risk of rupture."

While the vascular surgeon who treated Judy’s earlier aneurysms was called in to repair this femoral artery aneurysm, Dr. HerculesSmith stayed involved to ensure Judy was well taken care of. Judy says, “Dr. Hercules-Smith called me in the ER. She went above and beyond to keep an eye on me and said she would keep in touch—which she did. She's good that way.”

Dr. Hercules-Smith not only cares for Judy.

She also cares about her. This approach to health care is why Judy has referred several patients—including her daughter, son, grandson, and sister—to Dr. Hercules-Smith

INTERNAL MEDICINE

St. Clair Health’s courtesy van service ensures patients in need never miss the care they deserve.

for care. Judy says, “I can't even describe in words how I feel about her. Dr. Hercules-Smith makes me feel like I’m number one on the list.

It’s why I have family going to her now and try to encourage people from my apartment building to see her, too.”

Judy and Dr. Hercules-Smith now like to joke that every time she has an appointment, there is a chance they’ll find a new health issue given her track record. Fortunately, Judy is feeling good, so there has been more talk of lifestyle changes and preventive care recently—rather than emergency treatments—to ensure she maintains a good quality of life while managing her chronic conditions.

“I certainly discuss physical health ailments and lab results with patients, but more importantly, I focus on improving their quality of life and what’s most valuable to them when it comes to their health,” shares Dr. HerculesSmith. “For patients I see regularly, we talk about a lot more than just medicine. I talk to them about what's going on socially.”

She continues, “I ask about what they do in a day if they’re retired. I also find out who they live with, if they have good social support.

I learn where their children live and if they see their grandchildren. All of that makes a difference for their health.”

What also makes a difference for patients like Judy is getting the highest level of evidencebased care in a personalized environment that is close to home. Dr. Hercules-Smith explains, “We're constantly striving to have the most comprehensive model of care so patients can get all their health care needs met in one location.”

Spending less time in health care facilities means Judy has more time do the things she loves. Boating at nearby lakes with her children and grandchildren. Cooking German food.

Baking for special occasions. Vacationing at the beach with family. Playing cards with her friends at Hillcrest Residences.

It means a lot that she can do all this at her age, since Judy maintains she is lucky to be alive given her medical history. And should another health issue arise, Judy is confident that Dr. Hercules-Smith will once again see her through every step so she can continue enjoying a quality life for years to come. n

AMANDA HERCULES-SMITH, MD

Dr. Hercules-Smith serves as the Medical Director of St. Clair Health Urgent Care. She is board-certified by the American Board of Internal Medicine. Dr. Hercules-Smith earned her medical degree from St. George's University School of Medicine and completed her residency in Internal Medicine at AHN’s Allegheny General Hospital.

She also earned a master’s degree in Medical Management from Carnegie Mellon University. Dr. Hercules-Smith practices with St. Clair Medical Group. To contact Dr. Hercules-Smith, please call 412.835.4886.

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FAMILY MEDICINE

FROM DOWN FOR THE COUNT TO MASTERING MIGRAINE MANAGEMENT How a young woman’s long-term relationship with her primary care provider leads to better chronic disease management.

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mma Hull was just 10 years old when she experienced her first migraine. She knew it was not just a headache after watching her mother endure chronic migraines throughout her childhood. But it wasn’t until she experienced the throbbing head pain herself that Emma realized how this neurological disease can disrupt daily life.

“It usually started with me feeling tired or groggy, then got worse when I began to feel pain above one eye. The migraines could really take a toll on me, to the point where I often couldn’t put my best foot forward.”

For the approximately 10 percent of children ages 5 to 15 who get migraines, the pain is severe enough to keep them from attending school, enjoying activities, and being at their best. Emma knows this first-hand, as she experienced three or four migraines per week for years.

“I was a little girl, still growing up with all of my friends who didn't really experience a major health issue like mine,” says Emma. “They kind of just went along and did their thing, while I wasn’t able to play as much or enjoy sleepovers. I'd either be picked up early or wake up the next day and just be down for the count.”

This pattern continued into her teenage years, as the self-proclaimed go-getter and people person could not spend time as much time as she wanted with friends nor participate in activities at Canon-McMillan High School.

Emma explains, “Things were so bad during my teenage years that I would have to call off work or miss school.

Which is hard when you're growing up, because you don't want to miss the little things or the major milestones.”

Though Emma received an early medical diagnosis based on her symptoms and family history, she felt like she was only able to begin effectively managing her chronic migraines after seeing Lauren H. Ayersman, DO, for primary care starting in 2019. The whole family actually began seeing Dr. Ayersman at that time and have stayed with her as she transitioned to St. Clair Medical Group Family Medicine earlier this year.

“As a family practitioner, we get to see everybody.

I think caring for every member of the family gives me an advantage, as it gives me more insight into their lives outside of the office and how what’s going on in their lives could be tied into some of the symptoms they exhibit,” says Dr. Ayersman.

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Continued from Page 13

Every conversation builds on the key learnings from their shared health care journey.

“I try to approach the patient as a whole as opposed to just dealing with the symptoms. It's about listening to the patient, asking a lot of questions, and being present,” she continues.

“I get to know them on both a medical and personal level to determine how I can best care for them.”

Because Emma is young and chronic migraines are a lifelong condition, Dr. Ayersman focused not only on management but also prevention of migraines. She explains, “Emma’s diagnosis is intractable migraines without aura, meaning there are no warning signs to tell her a migraine is coming. It kind of just hits her. So we worked to identify what could potentially be triggering her migraines.”

“Everyone has different triggers, but lighting and smells are a huge thing for me. I can also get really bad migraines during the summer because of the heat or when I have a drink with a lot of sugar and caffeine,” Emma says.

After better understanding her triggers, Dr. Ayersman initially recommended Emma make lifestyle changes such as increasing water intake and finding ways to better manage stress, which have led to better sleep. She also suggested Emma begin taking magnesium and 14 I ST. CLAIR HEALTH I HOUSECALL

riboflavin supplements that have been shown in research to help with migraines.

Dr. Ayersman says, “I'm really upfront with my patients. I tell them what I suggest, while emphasizing that they won’t notice much difference if they aren’t motivated to take control of their health and participate in it.

Physicians are partners in their patient's care, so the patient has to hold up their part in order to thrive.”

So that’s just what Emma did. She cut out the drinks with sugar and caffeine, among other things, to try to kick her migraines before they

got started. And Emma didn’t hesitate to talk with Dr. Ayersman when the lifestyle changes, supplements, and current treatments were no longer enough to manage her migraines.

She began taking new medication to inhibit a migraine attack and control symptoms, while seeing a neurologist to make sure there was nothing else going on with her brain.

“Dr. Ayersman did everything she could to treat my migraines before referring me to a specialist, which is why I will always go back to her,” Emma reveals. “She knows me and my health concerns like the back of her hand, so I

LAUREN H. AYERSMAN, DO

Dr. Ayersman is board certified by the American Board of Family Medicine. She earned her medical degree from the Philadelphia College of Osteopathic Medicine (PCOM) before completing both her internship and residency at PCOM/Lehigh Valley Health Network. Dr. Ayersman practices with St. Clair Medical Group. To contact Dr. Ayersman, please visit stclair.org/ayersman/ or call 412.942.8570.

“She knows me and my health concerns like the back of her hand, so I know she can give me the best advice. I trust Dr. Ayersman to tell me that any medication or treatment is both helpful and safe since I’m still growing into adulthood.”

EMMA HULL Patient

know she can give me the best advice. I trust Dr. Ayersman to tell me that any medication or treatment is both helpful and safe since I’m still growing into adulthood.”

Emma continues, “Dr. Ayersman really set me on track to stop migraines before they even start so I can just not even worry about it.

We've taken it from three to four migraines to one migraine per week, or two if I'm unlucky.

And when there is a migraine now, it's not as bad as it may have been before.”

Reducing the frequency and severity of her chronic migraines has enabled Emma to be more present in her daily life and do more than she ever has before. Emma is proud to have earned straight A’s during her first semester at Westminster College, while participating in several campus activities.

The sophomore is now a leader with student organizations such as the Alpha Epsilon Chapter of Alpha Gamma Delta and the Public Relations Student Society of America (PRSSA).

When she isn’t busy excelling inside and outside the college classroom, Emma enjoys running with friends or searching for the next book to speed-read. She appreciates that reading allows her to go on a journey without moving her feet. But that doesn’t mean she doesn’t love to travel as well!

“I went to Cancun, Mexico last summer— that was my first international trip—and I’m hoping to study abroad in London next year. I really just want to see the world,” says Emma. “Time is so limited when traveling, so it’s essential that I’m feeling one hundred percent, one hundred percent of the time.”

Emma hasn’t been everywhere yet, but it’s on her list. And she will be able to satisfy her wanderlust thanks to the personalized care she has received from Dr. Ayersman and her care team. Whether traveling the world or away at college, Emma and Dr. Ayersman can continue to check in and adapt her care plan as needed thanks to telemedicine visits and their enduring partnership.

“I started treating Emma in high school, and now she has transitioned to college. It's been nice to see her progress over the years and watch her become the young woman she is today,” says Dr. Ayersman. “She's at a good place right now, trying to be proactive and preventive, as opposed to being reactive with her migraines.”

Emma adds, “I've known Dr. Ayersman since I was younger, and she has helped me through my migraines and so much more as I’ve grown up. I’m planning to continue seeing her as an adult because she genuinely cares about her patients, and I value the one-on-one partnership we’ve built over the years.” n

No longer missing for Emma: missing out.

ST. CLAIR HEALTH I HOUSECALL I 15

24/7 PERSPECTIVE. COORDINATED EXPERTISE. St. Clair Health hospital medicine and critical care teams work together to solve the most acute patient puzzles.

H

ospitalists are physicians whose primary focus is on patients who become hospitalized for any number of reasons. At St. Clair Health, they’re available 24/7 to react to any inpatient or emergent challenge that may arise—and their adaptability is key to St. Clair’s relentless commitment to expert around-theclock care and compassion.

At its core, hospital medicine is episodic care.

“One good example is when a patient comes to the emergency department—that’s an episode,” says Gena M. Walker, MD, Associate Chief Medical Officer. “A crucial part of a hospitalist’s role is helping your care team determine whether you can be discharged or if you need closer monitoring. Let’s say you present with pneumonia and need to be

16 I ST. CLAIR HEALTH I HOUSECALL

hospitalized—that’s when I get the privilege of taking care of you.”

At St. Clair Health, the general medical care of hospitalized patients is rooted in Dr. Walker’s genuine appreciation for everything—and everyone—that goes into the patient experience.

“We’re diagnosticians who also lead treatment protocols,” she says. “Each patient is like a puzzle, and, based on our working diagnoses, we direct your care by determining exactly what you need. That’s what I love about acute care medicine: collecting wide-reaching information to solve your puzzle.”

Hospitalists are not surgeons, but have direct ties to them and all other physicians across St. Clair Health, as needed.

“Part of what we do is respond to emergencies—we help rescue patients when

they’re in trouble. In addition to our clinical role, we also help manage elements related to the quality of care you receive during your stay— things that really matter to patients—like effective communication within your care team,” she says. “When you add it all up, we’re natural conduits with our peers across St. Clair Health.”

Diversity. Acuity. Teamwork. At St. Clair Health, being safe in our hands is built on a foundation of hands-on experience.

“We truly value the ability to consult across disciplines to actively reach decisions that work best for each patient,” she says. “Because of the complexity of illnesses and corresponding care needed on a case-by-case basis, we know that patients benefit when they have someone actively managing their care.”

Dr. Walker’s role as Associate Chief Medical Officer at St. Clair Health builds off of her prior

"Each patient is like a puzzle, and, based on our working diagnoses, we direct your care by determining exactly what you need. That’s what I love about acute care medicine: collecting widereaching information to solve your puzzle.”

GENA M. WALKER, MD Associate Chief Medical Officer

experience as a medical director both here in Pittsburgh and in Charlotte, North Carolina, where over nearly two decades she has seized multiple opportunities to rise to the challenges of leading health systems forward by delivering impactful patient care for the communities they serve.

“I’m a doctor first—that’s what I spent my entire educational career and the bulk of my professional career developing. It’s a skillset I’m extremely proud of because helping patients get better simply creates the most joy,” she says.

“It’s important to realize that hospital medicine has only been around for less than 30 years—so it’s neat to think that I’ve been a hospitalist for almost 20 of them.”

Together with their critical care counterparts, hospitalists form a tag team.

“Hospitalists shepherd patients to get better. In cases where the expected response to treatment does not occur, our critical care team is right there,” she says.

On the health care spectrum, critical care is medical care for patients with the most serious illness or injuries, usually administered in an intensive care unit (ICU).

“Our role revolves around helping patients in the most severe state, where their condition requires interventions for life-threatening challenges,” says Andrew Perez IV, MD, FCCP, Chief of Critical Care. “We work very closely with the hospitalist team. Let’s take Dr. Walker’s

pneumonia patient example. Upon admittance, they may experience increasing respiratory distress or fail to respond appropriately to antibiotics. We know quickly that they need to be transferred to the ICU.” And from diabetic ketoacidosis to postoperative complications, COVID, and beyond, the critical care specialists at St. Clair Health strive to deliver one-to-one patient care.

“That’s key across your care team— how we’re able to identify and confront any significant change in your condition, conducting a rapid response to evaluate you right at bedside and determine whether we can address the challenge right there in the medical unit or get you to the ICU,” he says.

For Dr. Perez, one of the most encouraging elements is the two-way street between the respective care teams.

“It’s incredibly rewarding to know that because of the people at St. Clair, the reverse is also true,” he says. “When a critical care patient improves, they’re able to graduate out of the ICU.” Critical care teams see patients from every specialty across the healthcare system.

HOSPITAL MEDICINE + CRITICAL CARE And because of the interventional nature of their work, they’re often able to help patients experience results more immediately than other disciplines.

“It’s one of the most challenging aspects of health care—one that requires a vast knowledge base, including understanding that in some cases, patients are terminally ill,” he says. “When you can help a person or a family feel better, coming off a ventilator or coming through a substance withdrawal issue…there are almost no words to describe the opportunity to serve this community.”

At the moment of truth, St. Clair Health is here for you.

“There’s so much support from everyone. It’s like a family here, that sense of bond that helps each of us know that no one can deliver expert care on their own,” he says. “And when we get letters from patients' families because of that care, the feeling that creates is something you carry with you every day.” n

GENA M. WALKER, MD

Dr. Walker serves as Associate Chief Medical Officer at St. Clair Health. She specializes in internal medicine and is board-certified by the American Board of Internal Medicine. Dr. Walker earned her medical degree from West Virginia University School of Medicine and completed her internal medicine and pediatrics residency at UPMC. She practices with St. Clair Medical Group Hospital Medicine. To contact Dr. Walker, please call 412.942.4000.

ANDREW PEREZ IV, MD, FCCP

Dr. Perez serves as Chief of Critical Care at St. Clair Health and specializes in critical care medicine, pulmonary medicine, and sleep medicine. He is board-certified by the American Board of Internal Medicine—Pulmonary Medicine, Critical Care Medicine, and Sleep Medicine.

Dr. Perez earned his medical degree from the University of Texas Medical Branch in Galveston. He completed his internal medicine residency at Pittsburgh Mercy, where he served as Chief Resident, and then completed a pulmonary and critical care medicine fellowship at UPMC. He practices with St. Clair Medical Group Pulmonary & Critical Care Medicine. To contact Dr. Perez, please call 412.942.5620.

ST. CLAIR HEALTH I HOUSECALL I 17

For the Ciukszas, looking for the helpers always starts by leaning into each other.

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FARM 2 ABLE

COMMUNITY OUTREACH

Food Assistance Match program (FAM) doubles the spending power of those facing food insecurity across Allegheny County.

T

he origin of FAM was as simple as it was staggering: immediate need.

At the national level, one in five Americans face food insecurity every day. Across the state, 1.9 million Pennsylvanians—including 43 percent of older adults—are food insecure. And nearly 160,000 residents of Allegheny County utilize Supplemental Nutrition Assistance Program (SNAP) benefits, formerly known as food stamps.

The Bellevue Farmers Market has a long history of offering SNAP access and serving as a food insecurity harbor for its neighbors.

“We want to make sure that everyone in our community has access to locally-grown food so that everyone can experience the difference better nutrition can make,” says Bryan Davidson, who manages the market.

“Helping to fight food insecurity is a passion of mine, and that’s shared by the entire Farmers Market Committee.”

Davidson grew up in the South Hills before moving first to Brighton Heights and then settling in Avalon. A high school English teacher with a wide-open Summer schedule, he wanted to get more involved in the community and started at the market as a volunteer. Like so many involved, his role has grown right alongside the people this kind of welcoming environments is designed to serve.

“One of my favorite things about the region is how the different communities rally around each other,” he says. “You can make a such a big impact just by donating some of

your time—and you never know where that will lead.”

Today, FAM is a rising resource that helps support local communities by partnering with farmers markets in Southwestern Pennsylvania to double the benefits of food assistance programs like SNAP. In 2020, it began as the Feeding Neighbors Program (FNP).

“Every Wednesday, all Summer long into October, we could literally see and often experienced the great work Bryan and his team were doing right across the street— the market is really a wonderful event with dogs and kids running around and live music playing,” says Mallory S. Ciuksza, MD, FACP, FAM Chair. “Through working with the Farmers Market, we knew that there were many families in our own neighborhood—a handful of families on our block alone—who would struggle to put food on the table in the wake of the pandemic. FNP was born out of a desire to continue the mission of addressing this need in our backyard.”

Ciuksza, an internist at St. Clair Health who specializes in internal medicine and primary care, was eager to dig in. In tandem with her husband, Albert Ciuksza, Jr., a serial entrepreneur who serves as Vice President of consulting firm Solutions 21 and Vice Chair of FAM, and the help of countless others from the surrounding area, they started preparing and delivering meals in the kitchen of a local Bellevue church.

“Albert has this unique ability to see the solution to every challenge—and then do the work to find the way through in a real, logistical, tangible way. I’ve long kidded him that I fix people and he fixes companies,” Mallory says. “As our awareness increased about the proximity of food insecurity in our own backyard, I couldn’t help but think of one of Fred Rogers’ favorite sayings—the idea that when bad things happen, you look for the helpers.”

Throughout 2020, a little bit of help started cooking up a big difference in their corner of the city. The Feeding Neighbors Program delivered as results took root. 30,000 meals went out to more than 300 families in need within an eight-mile radius. More than $100,000 was raised by individuals, foundations, and in-kind contributions. And more than 250 volunteers contributed every step of the way.

“This was a big problem worth serving— and it was abundantly clear that there was a lot more we could do because of what we learned throughout the process—starting with how many people were willing to roll up their sleeves and help the community,” Mallory says. “Our mindset shifted not just toward building something bigger, but something better, where we could create a community nexus through the market model and be part of a solution as sustainable as the work these multigenerational farmers Continued on Page 20 ST. CLAIR HEALTH I HOUSECALL I 19

Continued from Page 19

Dr. Ciuksza’s work: incredibly meaningful. The impact of FAM: tangible, obvious, and good.

were doing to help create more farm-totable access.”

Support from The Heinz Endowments and The Pittsburgh Foundation helped drive a test run of their market match program for all community assistance benefit programs— FAM was officially piloted as a repeatable model to validate the concept, mostly through a successful crowdfunding effort, in 2021.

Additional support was gained from local business leaders throughout the year. And in 2022, the Bellevue Farmers Market won a federal Community Development Block Grant.

“Watching the success of this program in transitioning from the idea that really started with simply helping to feed our neighbors become a more sustainable match across the board was incredible,” says Davidson. “The work FAM is doing absolutely amplifies the Farmers Market’s own goals—it’s one of the best things we provide.”

Two additional forces supply ample sustenance for the Ciukszas going forward.

The first: Pennsylvania is one of a handful of states that does not have a statewide doublematch program for SNAP benefits. For Albert, that fact drives home the all-important element of increasing food insecurity awareness.

20 I ST. CLAIR HEALTH I HOUSECALL

“I was a ‘WIC kid’ growing up,” he says— referring to the federal nutrition program for Women, Infants, and Children (WIC) in lowincome families. “In wanting to become a sustainable resource for the region, I know that it can feel bad needing to get help. But getting access to that help shouldn’t have to. We’re building something that doesn’t exchange dignity for that access.”

In fact, with FAM, there’s no special token or card needed. You simply shop with eligible vendors at the market and get a receipt for your items. A volunteer brings the items to you and vendors are reimbursed for the total amount of eligible items purchased.

For Mallory, the second force bears communal fruit as nature and nurture unite.

“One of the reasons I love what I do is that St. Clair is so focused on what it means to be a good neighbor—and one of our greatest privileges is stepping up to meet the needs of the communities we serve,” she says. “A lot of my work is preventative care and focused on long-term patient health. But in a space like this, you can see the benefit in real time—and then it also adds up over time. That’s rare.”

On Mallory’s side, teaching others about the undisputedly connected truths is as organic as it gets.

“Education plays a crucial role in every aspect of your health care at St. Clair—and this was exactly that kind of opportunity,” she says.

“We know that food incentives increase the consumption of more nutritious foods. The vast majority of match program participants report that their family’s health improves. And vendors and farmers reap the benefits, too, because for every $100 spent, $62 stays in the local economy and $99 remains in the state.”

Ciuksza, the internist, is slated to become the Assistant Director of St. Clair Health’s Residency Program while also serving as Clerkship Director between St. Clair and Duquesne University’s College of Osteopathic Medicine.

“The spirit of continuous learning is embedded in my work in the office and the nonprofit space,” she says. “It’s extremely meaningful to know that what I do extends far beyond the walls of our healthcare system.”

And that ever-resourceful footprint is only expanding.

In conjunction with educating her patients about the role nutrition plays in their long-term health, Dr. Ciuksza educated herself about the levels of food insecurity among the residents of the South Hills.

"Our mindset shifted not just toward building something bigger, but something better, where we could create a community nexus through the market model and be part of a solution as sustainable as the work these multigenerational farmers were doing to help create more farm-to-table access.”

MALLORY S. CIUKSZA, MD, FACP FAM Chair

“What I’ve truly learned is that it’s not a linear thing and it’s not even necessarily a long-term thing, but you never know when your neighbor might be in need,” she says. “Expert care from people who care means really listening to what your patients are saying, and understanding that it’s imperative to meet them where they are—especially for those who can’t travel to take advantage of a program like FAM.” In order to do just that, Dr. Ciuksza sought the advice of G. Alan Yeasted, MD, SVP & Chief Medical Officer Emeritus at St. Clair Health.

“He’s been a champion for me across the board, and I’m so grateful for his support,” she says. “Alan made the connection with St. Clair’s Community Outreach team and together we were able to get that ball rolling.”

St. Clair Health’s most recent Community Health Needs Assessment (CHNA) displayed an uptick in high blood pressure, high cholesterol, and heart disease for residents of the South Hills.

“Enhancing nutrition through increased access to healthy fruits and vegetables can help with so many of the health care challenges our communities face every day,” says Lindsay M. Meucci, VP, Marketing, Communications & Advocacy at St. Clair Health. “It’s an absolute honor to be able to use our Community Outreach resources for the greater good.

The wonderful efforts of Dr. Ciuksza and the

FAM team in Bellevue made bringing the program to Bethel Park a no-brainer.”

Knowing that providing greater access to fresh fruits and vegetables can help improve people’s lives creates an impact that Lindsey Sibert, who coordinates the Bethel Park Farmers Market, is already seeing.

“The program started here in June and it’s already been such a tremendous benefit for everyone involved. Our vendors get to meet new customers, which positively impacts the local economy,” she says. “And people who might not otherwise be able to have access to this wonderful assortment of fresh, nutritious food do now. St. Clair’s involvement has been nothing short of extraordinary—with FAM we matched over $10,000 in August alone.” n

Scan to watch and learn more about the impact FAM is making across the region 

Help fight food insecurity at: foodassistancematch.org/stclair

MALLORY S. CIUKSZA, MD, FACP

Dr. Ciuksza specializes in internal medicine and primary care.

She is board-certified by the American Board of Internal Medicine. Dr. Ciuksza earned her medical degree from Drexel University College of Medicine. She completed her residency at Allegheny General Hospital and was named a 40 Under 40 Honoree by Pittsburgh Magazine in 2022. She practices with St. Clair Medical Group Internal Medicine. To contact Dr. Ciuksza, please call 412.942.8500.

ST. CLAIR HEALTH I HOUSECALL I 21

22 I ST. CLAIR HEALTH I HOUSECALL

BREAST CANCER CARE

OVERCOMING OBSTACLES TO BEAT THE ODDS Faith, loved ones, and a multidisciplinary care team all played a role in successfully treating an aggressive type of breast cancer.

D

evout Christian. Supportive wife and mother. Compassionate community leader. Loving sister and daughter. Nonprofit founder and executive. These are just a few of the myriad roles Brenda Atkins Lockley has inhabited throughout her lifetime. She never imagined that breast cancer survivor and activist would be added to the list.

Brenda had no history of breast cancer in her family, so she wasn’t sure what to think after unexpectedly discovering a lump on her breast the same night of her 40th wedding anniversary celebration. She says, “It was so prominent and protruding that I wondered where the lump had been before. And when it wasn’t getting any smaller a week later, I thought this could be serious.”

The joy she felt after commemorating a milestone anniversary with her husband, Elmore, and their loved ones was replaced by worry. “I'm a pretty confident person, but I quickly became fearful. So as a Christian, I asked God to remove my fear. I also scheduled a mammogram since I hadn't had one in 12 years,” shares Brenda.

Given her symptoms, Brenda worked with her primary care physician, Kevin Kotar, DO, FAAFP, of Preferred Primary Care Physicians, to schedule a diagnostic mammogram at the St. Clair Hospital Breast Care Center. She leaned into her faith instead of the internet while awaiting her appointment, saying, “I've never been through anything like this, so I had to look to God. We have to pray when we don't know what to do.”

After multiple imaging tests and a biopsy, Brenda learned that she had triple negative breast cancer—an aggressive type with a faster growth rate and higher risk of metastasis and recurrence that is more common among Black women. According to Dr. Kotar, “Brenda was very concerned about her health, rightfully so, and so she resolved she would be an active participant moving forward.”

Brenda also wanted Dr. Kotar, the physician who has cared for her and Elmore for more than eight years, to be part of her cancer journey. She shares, “I didn’t want to go through cancer without knowing

Continued on Page 24

ST. CLAIR HEALTH I HOUSECALL I 23

Continued from Page 23

The care team’s successful plan was evident from imaging and diagnostics through surgery and into the next chapter.

somebody I trust was on my side. So I was glad to learn he would monitor things and get all the reports.”

Dr. Kotar explains, “We try to really make sure that we're the home base for patients. So anything that they have done in health care, we are aware of it so that we can coordinate care or explain what results and testing may look like.”

Her unwavering faith, Dr. Kotar’s support, and the love of family and friends largely prepared Brenda for the journey ahead. She was also comforted by the fact that she would be in good hands at St. Clair Health.

Not long before Brenda received her breast cancer diagnosis, Elmore completed treatment for prostate cancer at St. Clair Health. She says, “Elmore told me how impressed he was and how great everybody was as he went through the whole treatment process.”

Brenda’s care team included specialists Gaurav Goel, MD, FACP, and Felicia E. Snead, MD, FASTRO, of the St. Clair Hospital Cancer Center Affiliated with UPMC Hillman Cancer Center, along with Sarwat B. Ahmad, MD, of St. Clair Medical Group Breast & General Surgery. Knowing the variety of treatment options to consider and decisions to be made can seem overwhelming to patients, these cancer experts made sure Brenda and her family not only understood but felt good about the proposed treatment plan during their initial consultations.

“My consultations are at least one hour or more so I can go through the biology of what's going on, the disease stage, the prognosis, and what we're going to do about it. We go through everything,” shares Dr. Ahmad. “Patients usually come to me with so much fear and uncertainty, but I often see that anxiety melt away by the end of our conversation as we help make this curveball seem more manageable.”

Brenda’s personalized treatment plan included six months of chemotherapy and an immunotherapy regimen, followed by surgery, and finally radiation. Dr. Ahmad explains, “Most breast cancers are treated

24 I ST. CLAIR HEALTH I HOUSECALL

with surgery first, but Brenda’s type of breast cancer responds particularly well to chemotherapy, so we arranged for her to see a medical oncologist early in the process.”

Brenda was troubled after learning more from the care team about her diagnosis and how it would require aggressive treatment. Still, her faith remained a guiding light and source of strength as she began a series of chemotherapy treatments. After just her first appointment, Brenda was pleasantly surprised to find the lump in her breast begin to decrease in size. She emphasizes, “This thing shrunk more every day. I felt it was God’s way of reassuring me that this was working.”

This remarkable progress wasn’t the only reason Brenda looked forward to her weekly visits to the Cancer Center. She enjoyed spending time with the care team, saying, “Elmore and I felt welcomed and surrounded with love. I've never experienced anything like it. I thought, if these people make me feel this good, then God must be doing something.”

Though Brenda fondly remembers the good days during treatment, she also endured her fair share of bad days when immunotherapy drugs caused debilitating complications and the steroids used to treat the inflammation led to blood sugar spikes. Brenda says, “Inflammation spread throughout my body and joints so much that I couldn't stand up, so they admitted me to St. Clair Hospital.”

These setbacks forced Brenda to learn humility, as she is a generous and kind individual who doesn’t readily ask for support—even when it’s needed. She clarifies, “For someone who has always been pretty confident, I had to be humble. It wasn’t easy, but God helped me to trust that the team of skilled providers were going to take care of me and make the right decisions for my health.”

“I talked with both Dr. Goel and Brenda to get a better idea of what she was experiencing so we could change the timing of tests and

"Patients usually come to me with so much fear and uncertainty, but I often see that anxiety melt away by the end of our conversation as we help make this curveball seem more manageable."

SARWAT B. AHMAD, MD St. Clair Medical Group Breast & General Surgery

medications as needed, as well as eliminate anything that would be too painful for her at that time,” shares Dr. Ahmad. “I think she really appreciated that I called and also felt reassured about her ongoing treatment when I reinforced that it's alright to make adjustments.”

Dr. Kotar adds, “There was good coordination between Drs. Ahmad and Goel, myself, and other providers who care for Brenda. Everyone was on the same page.”

The speedy response and seamless coordination enabled Brenda to successfully complete chemotherapy on time. She rang the bell after her final appointment not only to mark this significant milestone but to thank the care team, along with Elmore, for providing support at every step.

Next, it was time for surgery.

Dr. Ahmad says, “Brenda had a really excellent response to the chemo, which allowed us to do just a lumpectomy instead of a mastectomy. I was so glad, as I didn't want her to have to go through a big surgery or be off her feet too long afterward. I wanted her to be able to be present for her family.”

“I remember the morning of the surgery. I looked up. I saw Dr. Ahmad, who is vibrant and warm and very positive. And she just smiled at me,” shares Brenda. “I knew then that God was there with me. It was as if he was saying, she is focused and ready to take care of you. I knew I was in good hands.”

While the chemotherapy treatments effectively wiped out Brenda’s cancer cells, Dr. Ahmad proceeded with the surgery as planned to ensure all tests came back negative—which they did. Brenda was cancer free! Dr. Ahmad says, “Her complete pathological response to the chemotherapy is a good indicator for prognosis going forward. Still, the care team recommended Brenda complete radiation therapy under the guidance of Dr. Snead to reduce the risk of recurrence.”

Brenda will continue to follow up regularly with providers such as Dr. Ahmad and Dr. Kotar to check for recurrence. In the meantime, she is once again working to help her community—when she isn’t enjoying retirement with Elmore of course. She explains, “I said to Dr. Ahmad that if I come through this, and I fully expect to come through it, I want to partner with established health organizations and local churches to increase awareness among our communities.”

Activism is in Brenda’s blood, as she previously helped underserved youth in the area by incorporating and directing a nonprofit organization called Melting Pot Ministries. Now, she is finding ways to highlight a new cause close to her heart among our communities: breast cancer awareness and education.

“I trusted that God was going to heal me, and we came through this together, so now I want to tell the world,” says Brenda. “I want to tell everyone that we can do better, and we cannot just sit here when Black women are more likely to die from breast cancer and be affected by more aggressive subtypes like mine.”

Brenda has already begun spreading the word in small but meaningful ways. She asked her nieces to wear breast cancer awareness hats she purchased to encourage more conversations. She says, “You tell them to be more proactive. Ask them if they're doing regular self-exams and getting annual mammograms—all the things I didn’t do.”

Additionally, Brenda shared testimony at her church—Mt. Zion Baptist Church of Library—and was stunned by the number of women who came to her afterward saying they too were breast cancer survivors.

She strongly believes in sharing her story to not only inspire others to take charge of their health but to empower more women to share their stories. She says, “If you don't share your pain, then you can't celebrate the healing with them.” n

SARWAT B. AHMAD, MD

Dr. Ahmad specializes in breast surgery and surgical oncology. She is board-certified by the American Board of Surgery—General Surgery and Complex General Surgical Oncology. She earned her medical degree at The Ohio State University College of Medicine before completing residency at the University of Maryland Medical Center and a fellowship in Complex General Surgical Oncology at UPMC. Dr. Ahmad previously served as a surgical oncologist at Mayo Clinic and assistant professor of surgery at Mayo Clinic School of Medicine.

She practices with St. Clair Medical Group. To contact Dr. Ahmad, please call 412.942.7850.

ST. CLAIR HEALTH I HOUSECALL I 25

LASTCALL

THE PASSIONATE PURSUIT OF CONTINUOUS LEARNING

How do you find the path to the perfect career for you? A pair of former St. Clair Health student learners share unique perspective that proves what matters most is getting where you’re going.

G

rowing up in Mt. Lebanon, Ashley Shock, Certified Medical Assistant, was a bit of a wallflower.

“One thing that’s really neat about what I’m doing now is that I see a lot of people I went to high school with. If you knew how shy I was back then, it’s easy to see how much I’ve come out of my shell,” she says.

Beginning in March of 2022, Ashley’s path was forged at Bidwell Training Center, a hands-on career training and academic enrichment organization that offers Pennsylvania residents who have earned their high school diploma or equivalent a fast track to new career paths—all at no cost.

St. Clair is incredibly proud of its regional partnership with Bidwell, helping students problem solve their way to professional prosperity by finding their best fit across the St. Clair Health system. Externships allow students to fulfill their program requirements while experiencing the best prospective full-time employment environment that will help them thrive long-term.

“It really made sense for me,” Ashley says. “I was a stay-athome mom for nine years, and, going back into the working field felt very daunting. Knowing there were going to be 30—or okay, a few more—candles on that next birthday cake meant something needed to change. The time had arrived where I looked in the mirror and knew that I wanted to do something better for my son.”

Navigating a new schedule and managing all the moving parts became a testament to taking a chance on herself.

26 I ST. CLAIR HEALTH I HOUSECALL

“A big part of the growth in this new chapter of my life is learning how to put myself in situations where I wouldn’t be comfortable—taking that risk and working my way through it,” she says.

The Castle Shannon resident is quick to share props.

“As a single mom, none of this would have been possible on my own. I simply couldn’t have done it without my mom—she was such a big help every step of the way.”

As the calendar turned to Fall and Ashley was deciding on an externship site, her personal experience made one option shine brighter than all the rest.

“Having been a patient at St. Clair, I just always loved the care I received,” she says. “People make a place, and, I wanted to be in that kind of compassionate environment.”

Ashley spent a month in Bethel Park with St. Clair Medical Group Internal Medicine, and quickly impressed.

“It was completely a two-way street—I really enjoyed the experience and they encouraged me to apply. When you’re in the right place at the right time…everything just sort of clicks,” she says. “When I joined in November, that coming-full-circle moment hit me: in less than eight months, my whole life changed.

And that will always put a smile on my face.”

Right next to that grin? New goals.

“My next step is to become a nurse. St. Clair offers a program that helps with tuition assistance and I plan on going back to school again. I’ve gained so much confidence getting to this point, and I’m determined to earn my bachelor’s degree and become an

RN, BSN,” she says. “I’m not sure exactly what field, but I know one thing: I want to become a nurse here at St. Clair.” ::: Lucy Lansing, Certified Surgical Technologist, is a student of the world.

Born in San Antonio, Texas, the 29-yearold was raised in Cheyenne, Wyoming, until the family moved to Bend, Oregon, when she was 10.

“My parents are doctors—they actually met in medical school—and helping people is what they’re all about,” she says.

When Lucy was in high school, she job shadowed her dad and knew it was something that could be for her one day—and the wide-reaching opportunities remain something the family often talks about.

“So-of-course I studied Philosophy and minored in Spanish at Santa Clara University,” Lucy jokes. “I was really thinking about law school.”

Up first: a plan to pay off her student loans. The first step: moving back in with her parents.

“I worked three jobs and accomplished that goal,” she says. “And almost immediately, I thought, ‘Now what’s the furthest point away from where I’ve ever been?’ I wanted to see the world.”

Answer: New Zealand. The “career” move: acquiring a working holiday visa that allowed Lucy to pick grapes for local winemakers.

Then fate intervened.

“I met my fiancé while traveling in Melbourne, Australia. He’s from Erie, and, he really had a great sense of community here in Pennsylvania,” she says. “They say you never know who you’re going to meet, and, my path to Pittsburgh is absolutely proof of that!”

Stuck in line on another trip, Lucy struck up a conversation with a nice lady waiting with her. Small world: she just so happened to work at Carnegie Mellon University.

When Lucy made her way back stateside, an opening for an executive assistant at CMU became her ticket into the city.

“I liked the job and my team was great…I just knew there was something more out there for me,” she says. “When my dad reminded me about all the options across the medical field, I had another stroke of timing luck on my side: Pittsburgh Technical College (PTC) offered night courses, so I could keep my day job and figure out the next step at the same time.”

The driving force behind Lucy’s new path?

“I didn’t want to just be a number in whatever I chose, and that might be the luckiest thing about getting to become a student at St. Clair Health—I’ve been treated as a whole person every step of the way. The doctors wanted to get to know me, and they did,” she says. “My story is a lot of fun to tell, and, the relationships I’ve already built here…they just hit different.”

PTC’s Surgical Technology program is a two-year journey where students serve internships along the way. For Lucy, the expectations for St. Clair were great.

“Because I can’t tell you how many people had so many good things to say!

From, ‘Oh, I was born there!’ to, ‘There’s nothing else like it,’ and a litany of expert care-related experiences,” she says. “My experience as a student was one of, ‘We’ll teach you everything you need to know,’ and that never went away—I’m still learning every day.”

Lucy is also quick to point out how refreshing it is to be surrounded by teammates who want to help you grow.

“As a Surgical Technology student, you’re required to complete a specific number of surgeries in each specialty and achieve those benchmarks while taking classes. I loved the variety of cases because you could go from general surgery one day to something as specific as cataracts

Expert care from people who care. It’s more than our tagline—it’s the relentless drive we bring to carry out our mission every single day. Interested in joining the team? Follow St. Clair Health Careers on Facebook and LinkedIn or visit stclair.org.

the next—no two days have ever been the same,” she says.

Lucy will already be celebrating her one-year anniversary as a full-time employee in January, and that first milestone has her taking stock of potential next steps.

“At St. Clair Health, you can become a Team Lead in orthopedics, plastics, general surgery, eye, and more,” she says. “My goal is to gain more experience, continue developing my skills and building my knowledge with physicians across service lines, and find the one that really feels like my calling.”

The open-ended nature of the program—where St. Clair focuses on helping you find the right fit for your skills and interests—also earned Lucy’s highest praise.

“It’s really the spirit of the OR—every member of the surgical team is relentless in finding new ways to bring their personal best to every patient,” she says. “It’s all about getting it right—as a care team—and I love that vibe.”

The system-wide organizational support has Lucy feeling like she’s really coming into her own, an empowering element she implores other students to consider when making their next academic or professional choice.

“If you’re a student thinking about the first step in your career, you should choose St. Clair because everyone is supportive and you have so many options as you go,” she says. “Even with my specific job, fundamentally my role is essentially the same—but the case mix is different every single day. And one of the coolest things is that when I’m working over at Dunlap Family Outpatient Center, we’re able to send patients home the very same day!”

From globetrotting to goal-setting, Lucy’s excited about whatever comes next.

“I know down the road I could pivot into nursing, become a physician’s assistant, or even work in marketing and sales. Right now I’m very happy learning and developing and honing my skills, ready for the opportunity tomorrow will bring,” she says. n

ST. CLAIR HEALTH I HOUSECALL I 27

1000 BOWER HILL ROAD PITTSBURGH, PA 15243 STCLAIR.ORG

@StClairHealth

Please call 412.942.DOCS or visit physicians.stclair.org/primary-care to find a PCP within the St. Clair Medical Group network.

THANK YOU More than 500 supporters gathered on July 21 for great fun on the southern marsh.

Our incredible donors made this year’s event a record-breaking success with $370,000 dedicated to education, helping to ensure Expert care from people who care.

For generations to come.

Save the date for next year’s event: Friday, July 19, 2024.