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

FALL 2013

The New Face of Surgery

with da Vinci Robotic-Assisted Surgery 

Marshall and Shingle Springs Health and Wellness

Prostate Awareness Month

Gynecology Services Now in El Dorado Hills

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Did You Know?

Gynecology Appointments Now in El Dorado Hills Marshall OB/GYN is pleased to expand its services to more women in our community by offering gynecology appointments in our El Dorado Hills Family Medicine office. Robert Carter, MD, who has over 30 years experience, is seeing patients in El Dorado Hills as well as his main Placerville office. Dr. Carter specializes in gynecology and is no longer seeing pregnant women nor delivering babies. This has allowed him to further focus on the health needs beyond childbearing. Dr. Carter is also certified in robotic-assisted minimally invasive surgery using Marshall’s state-of-the-art da Vinci surgical system. For an appointment in El Dorado Hills with Dr. Carter, call 530-344-5470.

Tails of Health Children’s Reading Program Marshall Community Health Library in Cameron Park is offering a new children’s program that’s sure to get tails wagging. “Tails of Health” is a new monthly event where children of reading age or young pre-readers can spend 15 minutes reading a children’s book to an American Kennel Club (AKC) therapy dog. Children are welcome to bring their own books or select from the library’s children’s collection.

Kids can read to dogs and enhance their reading skills in a fun, comfortable setting at Marshall Community Health Library.

Marshall Community Marshall Librarian Alison Clement says this type of Health Library program is used at many libraries and its effect on 3581 Palmer Drive, Suite 101 both the children and the dogs is beneficial. “Children Cameron Park, CA get to boost their confidence in their reading ability in 530-626-2778 a quiet, positive space, and enjoy interacting with the friendly dogs,” Alison says. “And of course, with these dogs being specially trained as therapy dogs, they also thrive on the interaction.”

The program runs monthly and parents should call to register for a limited number of 15 minute appointments. The sessions occur on the fourth Thursday of every month from 3:30-4:30 p.m. Call 530-626-2778 for more information or to register. 2

For Your Health / 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 in 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, Carrie Poggio, at (530) 626-2816 or via email at cpoggio@marshallmedical.org.


Better Care for You

Timely treatment is important to all patients, but it’s critical for patients experiencing a stroke. That’s why Marshall Medical Center has been working toward Primary Stroke Center certification through the Joint Commission. After an intense and lengthy evaluation process, the Joint Commission awarded Marshall its gold seal of approval and certification. Moreover, the evaluation found absolutely zero deficiencies in Marshall’s program. “I am so proud that Marshall has received this certification. It’s a testament to the teamwork of people dedicated to patient care here, and reflects the excellent medical care we provide,” says Marshall Emergency Department Medical Director Alexis Lieser, MD. As a Primary Stroke Center, Marshall participates in stroke prevention education for the community, adheres to timesensitive treatment of stroke patients in the Emergency Department and provides the latest in follow-up care for stroke patients. A physician-led committee was formed to oversee quality and to ensure that stroke team members, who are comprised of medical specialists, nurses and support staff, respond appropriately to stroke situations.

F A S T

Is it a stroke? Act FAST! FACE: Smile - does one side of the face drop? ARMS: Raise both arms. Does one arm drift downward? SPEECH: Say a simple phrase. Is it slurred or strange? TIME: If you observe any of these signs, call 911 immediately!

Note the time when any symptoms first appear. It’s important to receive treatment within the first three hours to reduce long-term disability for the most common type of stroke.

Partnering for Better Community Health Access Due to insurance complexities, Marshall’s physician offices are not always able to accept Medi-Cal insurance. There are resources in the county for people covered under Medi-Cal and similar programs such as CMSP. In addition to the Community Health Center run by the County, there is also the Shingle Springs Health & Wellness Center, formerly known as Shingle Springs Tribal Health. The center is open to everyone in the community and offers culturally compassionate care in a safe, welcoming environment. The center accepts most private insurance and is one of the only in the area that accepts Medi-Cal and Medicare, CMSP. For those completely uninsured, they offer a sliding payment scale based on income. Choosing a healthcare provider is an important decision for you and your family. This stateof-the-art facility is home to family medicine, behavioral health, and specialty services such as orthopedics, physical therapy and podiatry. Dental services include general dentistry as well as orthodontics. Center Manager Kasey Lonbaken, R.N., explains, “Our providers and staff provide personalized, compassionate, high-quality care.” She reminds us that, “the time to choose a healthcare provider is now, before you need one. That way, we can be your partner. We like to take an active role in your healthcare and focus on prevention.” Shingle Springs Health & Wellness Center is located at Highway 50 at Red Hawk Parkway, 5168 Honpie Road, Placerville. The phone number is 530-387-4975.

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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Marshall Certified as Primary Stroke Center

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Cover Story his opinion about abdominal pain she was having. As a surgical and GI technician for Marshall Hospital, Denise was well aware of many stomach and related conditions. Her recurring stomach irritation led to several ultrasounds that never showed anything, along with an upper endoscopy scope that was similarly inconclusive. “I just kept putting up with it,” she remembers. “The pain told me something just wasn’t right, but it would go away for a while and I’d let it go. Then it would come back worse. Finally, I got help.”

Robin Locke, MD and his patient Denise Collins Ford worked together to determine that da Vinci minimally invasive surgery was the right choice for her multiple surgical needs.

The

New Face of

Surgery

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with da Vinci robotic-assisted surgery

The two lessons Denise Collins Ford came away with from her recent medical challenges are: 1) listen to your body and, 2) get the input of an excellent physician. It took her a while to heed lesson one, but fortunately she knew about Marshall general surgeon Robin Locke, MD, and eventually sought out

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For Your Health / www.marshallmedical.org

Dr. Locke suspected a problem with her gall bladder and scheduled a special nuclear medicine exam called a hida scan. Essentially, it simulates how the gall bladder reacts to a fatty meal. “Sure enough, after they gave me the dose of the medicine to test my reaction, I felt sick, bloated and experienced the same pain I’d been having over time,” Denise recalls. “It was sad because I put up with it and shouldn’t have.” The test confirmed that Denise’s gall bladder needed The da Vinci robotic arms provide amazingly precise and dexterous movements, resulting in less tissue manipulation, scarring, blood loss and pain.


to be removed. She also had a lingering need for an umbilical hernia repair and diagnostic tests had found a questionable area on her appendix. Together, they decided to take care of it all at once.

The robotic arms are controlled entirely by the surgeon sitting at a nearby console that provides amazing visualization of the surgical field, as well as precise movements of the surgical instruments.

From her work experience, Denise knew about Marshall’s recent implementation of da Vinci robotic assisted surgery, but wasn’t sure she would be a candidate for it. Dr. Locke determined that even though Denise had prior laparoscopic abdominal surgery, the da Vinci would be a good option for her.

An added plus was the possibility of doing a single site surgery for the gall bladder removal. “One small incision at the belly button area is a remarkable advancement from even laparoscopic minimally invasive procedures,” Dr. Locke explains. Denise was scheduled and during her surgery, Dr. Locke determined that he would, remarkably, be able to accomplish all three objectives through that one small, nearly invisible incision: gall bladder and appendix removal and umbilical hernia repair. “The da Vinci gives such far superior visualization into the body and there is just simply less tissue manipulation,” Dr. Locke says. “For me, that means I’m able to do things I couldn’t do before. And for the patient, it typically means less pain and quicker recovery.”

Dr. Locke and all da Vinci certified surgeons go through rigorous training to ensure quality care.

Denise was amazed when she woke up that the surgery was done through one incision – and thrilled about it. “I’m a big proponent of the da Vinci,” she says. “And whenever I talk to anyone about it, I dispel the myth that it’s somehow the robot doing the surgery. The surgeon is right there next to you, controlling everything that happens.” Dr. Locke is currently using the da Vinci for surgeries with gall bladder, hiatal and umbilical hernias, anti-reflex/GERD and others planned in the future. Denise is happily back at work and has recovered very well. If you have questions about da Vinci minimally invasive surgery for a general surgery need, you can schedule an appointment with Dr. Locke. We have two locations for your convenience:

Marshall General Surgery 941 Spring Street, Suite 1 & A Placerville, CA

da Vinci Surgery for Gynecological Needs The da Vinci robotic system was originally designed to address minimally invasive gynecological surgery needs. It has since become a standard and often preferred option for these surgeries. It requires fewer and smaller incisions and allows the surgeon unparalleled views of the body, resulting in the most minimally intrusive surgical experience available. Recovery is typically easier and quicker with da Vinci surgery. At Marshall, Robert Carter, MD is performing da Vinci surgeries for a number of benign gynecological conditions, including: hysterectomy, fibroid tumors, adhesions and endometriosis. If you are considering surgery for a condition such as these, you may consult with Dr. Carter about a plan for your condition. He sees patients in Placerville and El Dorado Hills.

Marshall OB/GYN 1095 Marshall Way Placerville, CA

Marshall Gynecology 5137 Golden Foothill Parkway, Suite 120 El Dorado Hills, CA Call 530-344-5470 for both locations

3501 Palmer Drive, Suite 301 Cameron Park, CA

Call 530-626-3682 for both locations www.marshallmedical.org / For Your Health

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Foundation News

$65,000 Gift to Fund Robot Robots have long been the object of imagination and invention, but in the world of medicine they have now become reality. Surgical robotics was little more than a medical curiosity until 1999, and Marshall Foundation never imagined a donor would fund a robot. But in the past year, when the daVinci® Surgical System was considered for Marshall Hospital, the Marshall Hospital Auxiliary team - a group of forward-thinking volunteers - liked the idea of raising money for the latest in surgical technology. This robotic-assisted minimally invasive equipment used for surgery became the focal point for the Auxiliary’s annual project. “It’s important to understand the surgeon continues to be the one in control but can see much better and with better dexterity,” related Karen Good, executive director of the Foundation. “And to realize the incisions are smaller, there’s less scarring, pain, and bleeding, you’re home sooner and more importantly, back on your feet sooner. To receive such a wonderful donation that will improve patient outcomes is a double blessing.” In addition to contributing wonderful gifts each year to assist Marshall Hospital, the Auxiliary contributes more than 20,000 hours of volunteer time. We are grateful to each and every Auxiliary member for the contributions they make all year long.

2013 1st place Non-Handicap Division winners, l-r: Blair Combellack, Gayle Combellack-Rohl, Janice Combellack and Devon Combellack.

HONOR-A-NURSE EVENT supports scholarships Thanks to caring donors and in celebration of 75 nurses/groups honored at the Honor-A-Nurse event in May, the Mathewson-Bonser Scholarship program will award $20,000 to assist Marshall Employees in continuing their education and upgrading their skills. This is the biggest granting opportunity since 2007 and we are very excited to benefit our community through this occasion that directly benefits our patients. UNION BANK, the executive sponsor for the HonorA-Nurse event, greatly honors the exceptional care provided from our Marshall Nurses. We know Drs. Mathewson and Bonser would be pleased to know their passionate spirit to help nurses continues to be fulfilled year after year.

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Teeing off “Fore” Health

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The 30th Anniversary Bob West Drive for Marshall sponsored by UNION BANK celebrated a milestone and honored its roots by raising more than $47,000 – the best ever! 137 jubilant golfers teed off at Cold Springs Golf and Country Club on one of the hottest days of the year. By 1:30 P.M., we had run out of water, but our faithful volunteers quickly replenished supplies to keep our golfers cool and happy! The renowned event focused on cancer awareness with health screenings in addition to the upcoming “new” Cancer Center in Cameron Park. It was a fun day for a great cause….Marshall’s community health programs. We thank everyone who participated or sponsored this event to help our community excel in healthcare excellence.

For Your Health / www.marshallmedical.org

Honor-a-Nurse recipients Brittany Barboza (left) and Jill Lohnes (right) enjoy a reception with other honorees. Also pictured is Jill’s husband Ron.

Nurses may be honored at any time of the year by accessing the Foundation Website www.marshallfound.org and completing the online form with your donation of $100 for each nurse honored. Or, mail your donation to Marshall Foundation, PO Box 1996, Placerville, CA 95667. The nurse you choose will receive a special recognition letting them know you appreciate their caring and compassionate ways.


Making Changes

Men and Prostate Health

New Healthcare Providers

Marshall’s New Urologists Discuss Key Men’s Health Issue

Prostate cancer is the most common cancer in men--regular exams and PSA testing can catch it early, making it very treatable.

Women are typically thought of as the primary healthcare consumers in the United States. They tend to take care of routine health screenings more than men do and are the ones encouraging their husbands to get to the doctor if something is wrong. Getting more men to be proactive about their health and routine screenings will be an ongoing effort at Marshall as time goes on. Two new physicians at Marshall are helping bring an increased focus to men’s health with an expanded Urology service.

September is Prostate awareness month and is the perfect time to encourage men to be proactive about their prostate health and obtain recommended screenings. As Marshall urologist John Montorello, MD, reminds us, “Prostate cancer is the most common cancer in men, affecting one in six men during their lifetime. But it’s also one of the most treatable cancers when found early.” Fellow Marshall urologist Jason Nelles, MD, adds, “This cancer is uncommon before 40, but prevalence increases rapidly after that. It’s also interesting that as much a 80% of men over the age of 80 may have a small amount of prostate cancer only found at autopsy, and that there were never any symptoms or ill effects from it.” Despite this, which may be due to the sometimes slow-growing nature of the cancer, ongoing vigilance is warranted. One of the challenges with prostate cancer is that it often has no signs or symptoms until it is quite advanced. Symptoms at advanced stages include severe pain in the bones of the hips, shoulders and spine. “To detect prostate cancer early and prevent it from spreading, we recommend an annual prostate exam and ongoing PSA testing every 1-2 years between the ages of 55 and 69,” says Dr. Montorello.

John Montorello, MD Marshall Urology 3501 Palmer Drive, Suite 201 Cameron Park, CA 95682 530-672-7040

Jason Nelles, MD Marshall Urology 3501 Palmer Drive, Suite 201 Cameron Park, CA 95682 530-672-7040

Rashmi Ramasubbaiah, MD Marshall Hematology & Oncology 3102 Ponte Morino, Suite 100 Cameron Park, CA 95682 530-676-6600

“Although the PSA test isn’t perfect—it may give false positives or false negatives—currently it remains our best widely available screening test,” adds Dr. Nelles. “Early detection is the best way we have to attack this disease early and treat it.”

Marshall Urology 3501 Palmer Drive, Suite 201 Cameron Park, CA 530-672-7040

If you or someone you love is in the recommended age range for prostate screening, discuss this with your physician at your next appointment.

Nicole Pele, DO El Dorado Pathology Group Marshall Hospital 1100 Marshall Way Placerville, CA 95667

www.marshallmedical.org / For Your Health

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Programs & Classes

Marshall Health & Wellness Programs & Classes Marshall’s programs can help you get healthy and stay healthy. Offering services for all ages and stages of life, we hope to see you at one or more of the classes below. Our Community Health Education Classes include Smoking Cessation and Childbirth related classes, in addition to a babysitting class. Call 530-626-2990 for more information and to register. We also offer diabetes and Nutrition Education through our Physician Clinic Services. Call 530-672-7021 for more information.

COMMUNITY HEALTH EDUCATION CLASS SCHEDULE Healthy Pregnancy

Designed for women who are thinking about becoming pregnant or have recently become pregnant, the class focuses on nutrition and exercise, fetal development, prenatal tests, hazards to avoid and preventing preterm labor. Tuesday, October 8 Wednesday, December 11 7-9 p.m. (funded by generous grant from Marshall Foundation for Community Health) Childbirth Education

6-week series

This class provides information on labor, delivery and postpartum issues. Thursdays, October 3-7 7-9 p.m. Childbirth Education

1-Day Intensive A custom designed childbirth class for those who do not have the time for the traditional 6-week class format. Saturday, September 28 Saturday, November 16 Saturday, December 17 9:00 a.m.-3:30 p.m. Fee: $60

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The Breastfeeding ExperiencE

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This class will help you understand breastfeeding, learn techniques and positions, and will give you the confidence to handle common breastfeeding challenges. Wednesday, September 11 Wednesday, November 20 6-8 p.m. Fee: $25

Baby Basics

This class reviews basic newborn care for the first few weeks of life. Topics include newborn characteristics, physical and emotional needs of the baby, as well as health and safety skills. Tuesday, October 15 Wednesday, December 4 7-9 p.m. Fee: $25 HEALTH CAREER EXPLORATION DAY EVENT

Come spend a day with our medical professionals and gain insight into the exciting medical fields. Call 530626-2990 for more details. Monday, November 11 8 a.m.-4:30 p.m. Fee: $50 Smoking Cessation 7-Week Series

Pre-registration required and space is limited. Call 530-626-2990 for more information. Fee: $75

HEALTHY LIVING DIABETES EDUCATION CLASSES

Live your best life with diabetes! Our classes can help you gain the knowledge and tools to remain motivated with your healthy lifestyle in the days and years ahead. Individual Diabetes Education

Appointments with our Registered Nurse, Certified Diabetes Educators (CDEs), are strongly encouraged especially if: • You are newly diagnosed • Beginning a new medication • Need extra support to gain control. Learn about the latest tools and techniques for self-management of your diabetes.

For Your Health / www.marshallmedical.org

Individual Nutrition Education

Our Registered Dietitians (RDs) are available for appointments to discuss: • Diabetes meal planning • Weight management/Cholesterol control • Medical Nutrition Therapy for most medical conditions Healthy Living Class: Diabetes Essentials, Carbohydrates, Food & You

• What diabetes is • Controlling blood glucose levels • Using your meter effectively • Carbohydrates and diet • Meal planning • Managing your weight Tuesday, October 1, 1-3 p.m. Cameron Park Healthy Living: Your meter & gaining better control

• Making sense of your blood glucose numbers • Medication options • Tips on eating out Tuesday, October 8, 9:30-11:30 a.m. Cameron Park Wednesday, November 6, 1-3 p.m. Placerville Healthy Living: Your Plan for Success

• Reducing your risk—long term complications • Exercise—make it work for you • Staying motivated • Diabetes and emotions Wednesday, November 6, 9:30-11:30 a.m. Placerville Tuesday, December 3, 1-3 p.m. Cameron Park Class Locations: 681 Main St., Ste. 206/207, Placerville 3581 Palmer Dr., Bldg. 600 Cameron Park For more information call: (530) 672-7021


For Your Health - Fall 2013