For Your Health - Winter 2016

Committed to the Health & Well-Being of El Dorado County

WINTER 2016

LISTEN TO YOUR HEART

Don’t Ignore The Warning Signs

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Marshall honored for quality of cardiac care

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How to prevent and contain the flu

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TCC celebrates 25 years

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BETTER CARE FOR YOU

Patricia Dolphin

New Chief of Medical Clinics Looks to the Future Tell us about how you’ll approach your new role with Marshall.

I’ll be at the clinics to listen to our patients, staff and physicians. It’s my goal to bring best practice recommendations to the organization, helping to facilitate improvements in the quality, continuity and coordination of patient care.

Why did you choose Marshall Medical Center?

Patricia Dolphin, the newly hired Chief of Medical Clinics for Marshall Medical Center, is a proven visionary and strategic leader in the healthcare field. In her new role, she’ll work closely with Marshall’s leadership team, including CEO James Whipple, to ensure that Marshall Medical’s clinics deliver quality patient care.

After growing up in Southern California and working for more than 25 years in healthcare there — most recently as the Chief Ambulatory Officer at UC Irvine Health — Pat traded in her flip flops for hiking boots and moved to El Dorado County this fall.

“I’ve always wanted to live in an area where the people are warm, friendly and welcoming, which is what I’ve found here,” Pat says. She recently shared some thoughts about her new position at Marshall:

In addition to its many accolades, Marshall has a company culture that is truly exceptional as one of the last remaining independent hospital organizations in California. The mission of Marshall really resonates with me: Improving the health of our community, offering health services of superior value and quality, and most of all, striving to deliver service that exceeds our patients’ expectations.

What is the biggest area of opportunity for Marshall Clinics?

Marshall will be transitioning its hospital and clinic electronic health record systems (EHR) to a system that is fully integrated.

Our patients’ medical history will be much easier to access, affording a more seamless approach to care. Becoming a fully integrated health system is essential as we continue to strive to provide the highest quality of care to our community.

Marshall Is Now

All Marshall locations, including the Hospital and all clinic and outpatient facilities, no longer allow smoking on Marshall property. This policy includes vaporizers or e-cigarettes.

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As an advocate for health and the well-being of our community, Marshall Medical Center adopted a smoke-free policy for all campuses on July 1, 2016.

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FOR YOUR HEALTH

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www.marshallmedical.org

ABOUT MARSHALL MEDICAL CENTER Marshall Medical Center is an independent, nonprofit community healthcare provider located in the heart of the Sierra Foothills between Sacramento and South Lake Tahoe. Marshall Medical Center includes Marshall Hospital, a fully accredited acute care facility with 113 beds located in Placerville; several outpatient facilities in Cameron Park, El Dorado Hills, Placerville and Georgetown; and many community health and education programs. Marshall has over 200 board-certified physicians and a team of over 1,500 employees providing quality healthcare services to more than 175,000 residents of El Dorado County.

For Your HEALTH is published as a community service by MARSHALL MEDICAL CENTER 1100 Marshall Way Placerville, CA 95667 telephone 530-622-1441 or 916-933-0913; www.marshallmedical.org It is intended to provide information about health in general as well as healthcare services and resources available in El Dorado County.

Information comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider.

If you have questions, concerns or suggestions for future topics, contact the editor, Mark DeVaughn, at (530) 626-2816 or via email at mdevaughn@marshallmedical.org.

DID YOU KNOW?

Marshall Is Tough on Treating Sepsis Marshall staff members are tough on their stance against sepsis — a potentially life-threatening complication of an infection. This growing health concern affects nearly 750,000 people each year and is the tenthleading cause of death in the United States.

In fact, Marshall’s aggressive approach has been recognized by Healthgrades® with a 5-Star rating for five years in a row (20132017) for the hospital’s quality outcomes in the treatment of sepsis.

The result of a simple infection, sepsis can progress into life-threatening conditions like organ dysfunction, kidney failure and septic shock. Sepsis is most common in older adults or those with weakened immune systems.

“Early detection and treatment are the keys to successful treatment,” said Bradley Barnhilll, MD, an internal medicine physician at Marshall Medical Center. Marshall has taken several proactive steps to help prevent sepsis among patients and aggressively identify and treat any infection as early as possible.

Know Your Cholesterol Risks

Staying healthy includes knowing your risks and making smart decisions about preventive care. For instance, getting screened for high cholesterol can help you and your doctor determine the best steps — medication, lifestyle changes or other therapies — to help lower your levels and prevent heart disease.

About one in eight Americans has high levels of total cholesterol, according to the US Centers for Disease Control and Prevention.

This increases risk for heart disease, heart attack and stroke.

“Ask your doctor at your next visit if you should be screened for high cholesterol,” advised Loni Jay, MD, a family medicine physician at Marshall Sierra Primary Medicine. “High cholesterol usually has no symptoms, so it can be a silent force that causes damage to your body.”

Dr. Jay encourages people to learn more about their risk for cardiovascular disease by talking with their healthcare provider. She also recommends an online risk calculator such as cvriskcalculator.com to determine your 10-year risk of heart disease or stroke.

Loni Jay, MD

Flu Prevention Season: Timing Is Essential

Flu season typically runs from December into spring each year, though each season can vary.

A flu shot stands out as one of the best ways to protect against the flu. Timing is essential. It typically takes about two weeks after the shot for the body to build immunity against the flu.

“Getting the vaccine before flu season hits is important,” El Dorado County Health Officer Dr. Nancy Williams said.

Other important flu prevention methods include: •Covering your cough with your elbow or a tissue instead of your hand

•Frequently washing hands with warm water and soap

•Staying home if you are sick so you don’t spread germs You may be contagious for up to two days before you develop symptoms. If someone in your home is sick, please consider yourself exposed and take the appropriate precautions. “Antiviral medications (such as Tamiflu) can sometimes help reduce the symptoms of the flu if given within 48 hours after symptoms first appear,” Dr. Williams said.

The El Dorado County Health and Human Services Agency, Public Health Nursing is offering low-cost flu shots at numerous community flu shot clinics. For a list of dates and locations visit www.edcgov.us/publichealth or call the County flu hotline at (530) 621-6188.

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With Marshall Hospital already reporting cases of the flu, Marshall Medical Center joins the El Dorado County Health & Human Services Agency in reminding you how to prevent the illness – and limit its effects.

For more information about Marshall, visit www.marshallmedical.org or follow us on Facebook.com/ marshallmedicalcenter, twitter.com/MarshallMedical or Google+ Marshall Medical Center. www.marshallmedical.org | FOR YOUR HEALTH

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COVER STORY

Signs of Heart Attack Differ Between Men, Women Subtle Symptoms May Reveal Serious Condition

indicated the need for a cardiac specialist, so he referred her to Dr. Avedissian. “She quickly became my best friend,” says Carolyn with a smile. “Dr. Avedissian’s depth of knowledge, as well as her caring heart, told me I was in good hands. She is top notch,” she adds.

Heart attacks don’t feel the same in women as they do in men.

For women, the signs of a heart attack can be subtle, says Lena Avedissian, MD, a board-certified cardiologist with Marshall Medical Cardiology.

The most common symptom of coronary artery disease in both men and women is chest pain, tightness or pressure with exertion. But in women symptoms can have atypical presentations such as burning sensation that can occur with rest or mental stress. Other common symptoms in women are fatigue, weakness or shortness of breath.

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Dr. Avedissian points out that the symptoms of acute heart attacks in women are also often not dramatic, such as having crushing chest pain. “Women can experience a heart attack without chest pressure,” she explains. They can have subtle signs such as abdominal or back pain, nausea and vomiting.

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Reggie Higashi, MSS, Exercise Physiologist and Carolyn Scott

Heart Attack Signs in Women 1. Pain, pressure or fullness in the chest Be aware of uncomfortable pressure, squeezing sensation or “heaviness” or in the chest. The feeling will usually last several minutes, may go away and come back.

2. Pain in one or both arms, radiating to the neck or jaw Be aware of pain or discomfort in one or both arms, the jaw, or back, especially if the pain is hard to pinpoint. If the discomfort begins or worsens with exertion, and then stops when you quit exercising, consult your healthcare provider right away.

3. Shortness of breath, sweating, nausea or vomiting Sudden sweating or shortness of breath without exertion can also signal a heart attack. So can clamminess, nausea or vomiting, especially when accompanied by other symptoms such as chest pain.

Further tests indicated that Carolyn’s arteries were clogged — which put her at a high risk for a heart attack or stroke. Her cardiologist performed a cardiac catheterization, which led to an intervention on her coronary arteries within the week. Carolyn is recovering from having two stents inserted into her artery. The stents hold the artery open, allowing blood to flow more freely.

As part of her recovery, Carolyn works with rehab therapists at Marshall’s Cardiac Rehabilitation Department to help strengthen her heart, learn techniques to reduce further heart problems and stay motivated to improve her health.

How does Carolyn feel about her experience? “I wasn’t nervous 4. Unusual fatigue when Dr. Avedissian ordered According to the American Often busy taking care of others, women sometimes shrug off the stent procedure. I didn’t Heart Association, even though feeling tired. But pay attention if you are suddenly worn out, worry about a thing. I trusted my heart disease is the No. 1 weak or feeling excessively tired, even with simple activities. doctors completely, and I am a killer of women in the United If you have any of these signs, call 911 and get to a hospital strong person of faith,” she said.

States, women often chalk right away.

“Everyone who’s cared for me at up the symptoms to less lifeMarshall has been so gracious, threatening conditions like Carolyn Scott suspected that something courteous and professional. I could not acid reflux, the flu or normal aging. wasn’t right with her heart in October. “I ask for better treatment.”

They don’t identify the symptoms as felt a knot in the center of my chest, like related to the heart and don’t seek Dr. Avedissian says that any indications of someone was pushing a finger into the medical advice. Cardiovascular disease a heart problem — like those experienced middle of my ribs,” says the 86-year-old is also considered a “man’s disease”

by Carolyn — should be taken seriously.

Placerville resident. which results in less referrals to “Act quickly if you suspect you or someone Cardiology specialists. This can result She’d always been healthy and never you’re with is exhibiting signs of a heart with manifestations of heart failure or experienced a heart problem, yet this felt attack,” Don’t wait. Call 911.” sudden death as initial presentation of suspicious. “The pain only lasted about a Finally, Dr. Avedissian advises, “Talk heart attacks in female patients. minute, but something inside of me said, with your doctor about your heart ‘get to the doctor.’ “ It’s important to pay attention to signs health and understand your risks by that the body gives you and request An EKG performed by Carolyn’s primary monitoring your blood pressure, blood medical care, doctors advise. care physician, Philip Abela, MD, sugar and cholesterol levels.” |

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www.marshallmedical.org

Meet the Cardiology Team At Marshall Cardiology, caring for your heart is close to ours. From overseeing chronic or ongoing cardiac conditions to providing rehabilitative care following a cardiac incident, our board certified cardiologists offer care grounded in the latest in medicine and treatments for cardiac conditions.

Kristin Sornborger, FNP

Uygur Tekin, MD

Scott Vasconcellos, MD

Lena Avedissian, MD

Debra Bugbee, FNP

Stanley Henjum, MD

Wendy Wells, MD

Scott Yoder, MD

Daming Zhu, MD

National Honors for Marshall Cardiology Marshall Medical Center recently received five stars for the quality of its cardiology care from Healthgrades®, the leading online resource helping consumers make informed healthcare decisions. Marshall was recognized for superior outcomes in the Treatment of Heart Attacks in 2016 and the Treatment of Heart Failure for the years 2015 and 2016.

“I’m extremely proud,” said Stanley Henjum, MD, a board certified cardiologist at Marshall Cardiology. Touting a well-coordinated care team, he added, “Ours is a team approach. No one person does all the work or gets all the credit.”

A FREE event focused on heart health TUESDAY, FEBRUARY 21, 2017 • 4:00 PM – 7:00 PM Cameron Park Community Center • 2502 Country Club Dr., Cameron Park

JOIN US FOR

PRESENTED BY

www.marshallmedical.org | FOR YOUR HEALTH

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Educational Sessions Healthy Bites Cooking Demonstration Boutique Shopping Free Health Screenings Wine Tasting Exercise Demos |

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DID YOU KNOW?

What You Need to Know About Zika and Puerto Rico,” said Alicia Tobin-Williams, MD, who specializes in obstetrics and gynecology at Marshall’s Cameron Park location.

Zika has made national headlines, with a growing number of people confirmed with the virus. The good news: Many people infected with Zika don’t have symptoms. For those who do, the illness usually is mild with symptoms lasting several days to a week.

However, Zika infection during pregnancy can cause serious birth defects. “Pregnant women should not travel to areas with Zika, including parts of Florida

Zika virus primarily is spread to people through the bite of an infected mosquito, according to the U.S. Centers for Disease Control and Prevention. “Because there is no vaccine or treatment for Zika, anyone traveling to areas with Zika should take steps to prevent infection,” says Dr. Tobin-Williams. “Use insect repellent and wear long-sleeve shirts and long pants to prevent being bitten.”

In addition, Zika can be sexually transmitted— even if the infected person does not have symptoms at the time. Couples with a partner who lives in or has traveled to an area with Zika should use condoms, which help reduce the chances of transmission.

Alicia TobinWilliams, MD

Transitional Care Center Celebrates 25 Years of Helping Patients and Their Families

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Marshall Hospital’s Transitional Care Center is celebrating 25 years as the region’s only short-stay nursing and rehabilitation resource. The TCC specializes in helping patients transition from acute care to their home or a long-term care facility.

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Patients who aren’t quite ready to leave the hospital become more stable in the TCC prior to being discharged, thanks to the TCC staff’s 24-hour nursing care and assistance with additional services like nutrition, spiritual care and rehabilitation. Coordination with Marshall’s occupational, physical and speech therapy departments helps many TCC patients get back to their lives following a stroke, heart attack, knee or hip replacement. |

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“The TCC takes a team approach that focuses on each patient’s successful outcome,” said Terra Nair, Director of the TCC. “We meet daily to discuss each patient’s needs. Families are very involved. We help determine the support they need to get the patient home or to a long-term care facility.”

During what can be a difficult time, families are offered help with social services, insurance issues and home health care training.

Nancy Dean-Baxter, RN, the TCC’s Director of Staff Development, says that one of the advantages of having an acute rehab unit at Marshall — especially for those who are older — is that loved ones who live in the community can visit patients and be involved in their transition.

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Nancy Dean-Baxter (left) and Terra Nair

During her 47-year nursing career, Nancy has seen many changes in the field of medicine. One thing that hasn’t changed at Marshall’s TCC in the 25 years that she’s worked there, she says, is the compassion shown by staff to patients and their families.

“Everyone on the TCC staff, our specialists throughout the hospital and auxiliary volunteers do a wonderful job of catering to each patient’s

needs and assisting their families,” Nancy said, noting how the center’s size allows for individual attention.

“I feel so honored to be a member of this staff,” Nancy added.

“Congratulations to all of the TCC staff for the excellent work they do with patients and their families to provide the best possible outcome,” Terra said.

“They do a wonderful job.”

FOUNDATION NEWS www.marshallfound.org

Patients Who Help Patients And Now You Know the Rest of the Story

The Rest of the Story, a radio program hosted by the late Paul Harvey, often featured stories of interesting people, with some key element held back until the end. The broadcasts concluded with Harvey’s tagline: “And now you know the rest of the story.”

Our story began over a decade ago with an unassuming, grateful patient named Angelo Cardanini. On billboards and advertisements, Angelo’s photo appeared with the tag line, “Marshall saved my life -- twice.” These days, the little-known facts about Angelo include a generous spirit that impacts the lives of Marshall heart patients every day.

healthcare provider. A Duke University study demonstrated a nearly 50 percent reduction in the risk of death for patients who attend 36 sessions of cardiac rehab after a cardiac event.

Marshall Medical Center’s thriving Cardiac Rehabilitation Program offers classes two to five times a week. High demand has led to plans to open a second cardiac rehab location in Cameron Park in the near future.

And now you know the rest of the story. What a difference it makes when patients help patients at Marshall. Angelo paid it forward, with our patients benefitting each day from his generosity.

To learn more about how you can leave a legacy for future patients, contact the Foundation office at 530-642-9984 or www.marshallfound.org.

Angelo chose to show his gratitude for the care he received at Marshall by helping other patients. Over the past decade he has donated more than $30,000 worth of stateof-the-art exercise equipment to the Cardiac Angelo Cardanini Rehabilitation Program. Gifts include two elliptical trainers, total body exerciser, air bike, recumbent cross trainer, recumbent bike and a multi-function treadmill. Two laptop computers and an LCD projector used for heart health education round out the long list.

The availability of modern exercise equipment means a great deal to those referred to cardiac rehabilitation by their

Reggie Higashi, MSS, Exercise Physiologist, and Carolyn Scott

Marshall Nurses Advance With Scholarships Twenty-four years later, the Mathewson-Bonser Nursing Scholarship still benefits the community. Congratulations to the 2016 scholarship winners: Justine Dunham, North 2; Janelle Mayhugh, Cancer Services; Tamara Kinoshita, TCC; Kristen Soto, ICU; Melissa Stoker, TCC; Janelle Montgomery, North 1; and Amanda Wilkinson, ICU.

Now’s Your Chance to Honor a Nurse Recent scholarship winners include Janelle Mayhugh (pictured here is her husband, Roy, accepting on her behalf), Janelle Montgomery and Amanda Wilkinson with Marshall Foundation President Bob Gillett.

In 1992, Drs. John Mathewson and Quentin Bonser endowed a scholarship to benefit nurses who sought to further their education and training. It was their hope that patients in the community benefit from the advanced training Marshall Medical Center nurses would attain.

Have you received exceptional care from a Marshall nurse? If you would like to acknowledge exceptional nursing care, participate in the Honor-A-Nurse program and support the future of nursing at Marshall. With a $100 donation, a card will be sent to the nurse of your choice to let her or him know you value their caring work. You and the nurse will be invited to a reception in May where the nurse will receive special recognition. Proceeds from the Honor-A-Nurse event fund the Mathewson-Bonser Nursing Scholarship. For details, visit www.marshallfound.org/ intiatives/honor-a-nurse. www.marshallmedical.org | FOR YOUR HEALTH

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Named Top 10% Hospital in the Nation Pulmonary Care

Critical Care

Recognized with 5-Star Ratings

by Healthgrades® for Superior Outcomes in: • Treatment of Heart Attacks

• Treatment of Sepsis

• Treatment of Heart Failure

• Total Knee Replacement

• Treatment of Stroke

• Colorectal Surgeries

• Treatment of Pneumonia

• Treatment of Pulmonary Embolism

National quality, local care. www.marshallmedical.org/healthgrades