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H2 — The Sentinel at

Health & Recreation

Sunday • February 26, 2012


A look at Health and Recreation Major healthcare systems expand borders

New transport company is set apart from other EMS services



Medical studies spark changes in approach

Virtual rehab drives motivation in patients




CRMC personnel prepare for emergencies I6

Area expects surge of Civil War tourists for 150th year

Every Thursday

Robotic system offers option for tumor removal

Expansion planned for Appalachian Trail Museum




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Health & Recreation

The Sentinel at

Sunday • February 26, 2012 — H3

Cumberland County

Healthcare systems expand borders The three major healthcare systems in the county expand into each other’s regions as well as offer new services in 2011. â–

By Naomi Creason Sentinel Reporter

When it comes to services for Cumberland County residents, a number of healthcare systems are crossing new boundaries in an effort to attract more patients or even offer something new to the community. The geographical area used to make medical treatment pretty cut and dried – Carlisle area residents went to Carlisle Regional Medical Center, Camp Hill area residents to Holy Spirit Hospital and Harrisburg area residents to PinnacleHealth’s Harrisburg Hospital. But those healthcare systems have since expanded into other areas of the region. The Fredricksen Outpatient Center has operated at PinnacleHealth’s Cumberland Campus in Me-

chanicsburg for years, and each of the health systems have begun offering smaller offices across the county. This past year, each of the three health systems made some development in offering services to new areas.

Holy Spirit Holy Spirit Health System made one of the biggest moves this past year when it decided to build a new medical facility off York Road in South Middleton Township. The move marked the first time Holy Spirit had a fullservice facility in the Carlisle area. “We have historically had emergency medicine services in the area through the West Shore EMS and a cardiac rehab office in Carlisle,� said Rick LaVanture, senior vice president of Strategic

• See Facilities, H5

Sentinel file photo

Holy Spirit Health System built a new medical facility off York Road in South Middleton Township.

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H4 â&#x20AC;&#x201D; The Sentinel at

Sundayâ&#x20AC;˘ February 26, 2012

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The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; H5


Submitted photo

PinnacleHealth-Fox Chase Regional Cancer Center opened in April 2011.

â&#x20AC;˘ Continued from H3 Planning and Business Development at Holy Spirit. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;ve also historically done preventative health education programs in Carlisle, including our Spirit of Women program, which was very well received. This will be our first full facility in Carlisle.â&#x20AC;? â&#x20AC;&#x153; Ho ly S p i r i t h a s e n joyed serving patients in the Carlisle community for many years,â&#x20AC;? LaVanture continued. â&#x20AC;&#x153;The numbers of Carlisle area residents who choose Holy Spirit Hospital and our outpatient services continues to increase. This center will allow us to provide residents with additional care and services in a more convenient and integrated manner.â&#x20AC;? The Holy Spirit Carlisle Center opened the Carlisle Family Health Center portion of the facility in midDecember 2011 and later opened up its laboratory and imaging services in midJanuary 2012. The facility offers family medicine and walk-in urgent care services, as well as routine EKGs. LaVanture noted that there are plans to include rotating office hours for Holy Spiritâ&#x20AC;&#x2122;s physicians and digital mammography in the future. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;re trying to make the delivery of health care services more convenient and more efficient,â&#x20AC;? LaVanture said. â&#x20AC;&#x153;The watch words in health care reform are quality and value. Thatâ&#x20AC;&#x2122;s what residents need in their health care. We want to be mindful of the changing needs and changing health care environment.â&#x20AC;? LaVanture noted that the move isnâ&#x20AC;&#x2122;t so much of an

â&#x20AC;&#x153;We can treat people with a very highquality patient focus.â&#x20AC;? dr. brij sood

director, pinnaclehealth-fox chase regional cancer center

encroachment on CRMCâ&#x20AC;&#x2122;s geographical area but more of a natural growth that all of the health systems are currently undergoing. â&#x20AC;&#x153;The Southcentral Pennsylvania healthcare market is shared by a number of health systems,â&#x20AC;? he said. â&#x20AC;&#x153;We already have strong relationships with Carlisle and the Harrisburg area. Many of us are migrating within the larger market. We complement, compete, collaborate and even supplement healthcare services and offerings throughout the area.â&#x20AC;?

CRMC While Holy Spirit was expanding westward, Carlisle Regional was doing the same, opening new buildings in Shippensburg and Perry County, as well as heading east to Mechanicsburg. In a statement to The Sentinel about Holy Spiritâ&#x20AC;&#x2122;s move to Carlisle, CRMC highlighted what it does in the Carlisle community. â&#x20AC;&#x153;Carlisle Regional will continue our focus to pro-

Submitted photo

PinnacleHealth opened the PinnacleHealth-Fox Chase Regional Cancer Center in April and offers the technology and advancements in cancer research from the main Philadelphia branch to the Harrisburg area. vide excellent services, state-of-the-art equipment and access to specialized physicians in Carlisle and the communities we serve,â&#x20AC;? the statement said. â&#x20AC;&#x153;In support of this goal, CRMC has also recently expanded its services in Mechanicsburg, Shippensburg and Loysville.â&#x20AC;?

CRMCâ&#x20AC;&#x2122;s new facilities include Bent Creek Internal Medicine in Silver Spring Township, West Shore Hand and Orthopedics in Mechanicsburg, Medical Specialists of Shippensburg, Advanced Wound Healing Center of Shippensburg and Perry County Surgical and

Medical Specialists.

PinnacleHealth PinnacleHealth was doing some expansion of its own in 2011, launching its Cardiovascular Institute and opening its Silver Spring FamilyCare off the Carlisle Pike, near Cumberland Val-

ley High School in Silver Spring Township. The Moffitt Heart & Vascular Group also combined forces with PinnacleHealth, giving them a presence in Carlisle, Wormleysburg and Chambersburg in addition

â&#x20AC;˘ See Facilities, H6

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H6 â&#x20AC;&#x201D; The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012

Cumberland County

Studies spark changes in approach The last two years saw substantial changes to recommendations for prevention, including screenings for breast, prostate and cervical cancers. â&#x2013;

By Naomi Creason Sentinel Reporter

A study can sometimes mean an overnight change of a recommendation for screening or treatment, even for some that have been stuck in the medical community for decades. Dr. Peter Cardinal, medical director of physician practices at Holy Spirit Hospital, remembers when the treatment for menopause drastically changed after a study. â&#x20AC;&#x153;The treatment was to give a woman hormones to keep her body younger,â&#x20AC;? Cardinal said. â&#x20AC;&#x153;But a study showed that the risks of doing that were higher than the benefits. Literally, overnight, it changed in my career how we treated someone.â&#x20AC;? Itâ&#x20AC;&#x2122;s those kinds of changes that force patients and physicians to rethink how current recommendations are set up, and the past few years saw some major changes and controversy when it came to routine tests. Despite being recommended by the U.S. Preventive Services Task Force for years, new reports also showed that people who are at low risk for heart disease do not need annual EKGs or other cardiac screening when blood pressure and cholesterol screenings worked just as fine or better,

according to the Associated Press. Studies also questioned the need for regular bone scans in women who have no signs of osteoporosis, X-rays and other scans for back pain for less than six weeks and annual cholesterol screenings for people who donâ&#x20AC;&#x2122;t have high numbers. Some of the headlining changes, however, dealt with cancer screenings. Studies called into question whether or not mammograms were required annually for women between the ages of 40 and 49 who have no risk factors, and if prostate cancer screenings could do more harm than good, considering the slow development of the cancer. Associated Press Most recently, there was a closer look at pap smears In this photo provided by the University of Chicago Medical Center, Dr. Gautam Jayram assists during as routine cervical cancer prostate cancer surgery, watching an internal video of the patientâ&#x20AC;&#x2122;s body, at the University of Chicago checks. Instead of an annu- Medical Center in Chicago. al check, after a certain age, healthy women would inIn Focus stead only need it every three years, which also means that Tips on keeping healthy women may not need yearly pelvic exams either. The American Cancer Society lists tips on how people can try

Change over time For a lot of people, those changes threw a wrench into quite a few annual checkups at the doctorâ&#x20AC;&#x2122;s office. Even though the new recommendations came up within

to stay cancer-free and reduce their risk for cancer and other diseases. â&#x20AC;˘ Stay away from tobacco. â&#x20AC;˘ Stay at a healthy weight. â&#x20AC;˘ Get moving with regular physical activity. â&#x20AC;˘ Eat healthy with plenty of fruits and vegetables. â&#x20AC;˘ Limit how much alcohol you drink (if you drink at all). â&#x20AC;˘ Protect your skin. â&#x20AC;˘ Know yourself, your family history, and your risks. â&#x20AC;˘ Have regular check-ups and cancer screening tests.

â&#x20AC;&#x153;...You need to take hundreds of thousands of people over decades to see if the screening process isnâ&#x20AC;&#x2122;t showing a benefit.â&#x20AC;? dr. peter cardinal

medical director of physician practices, holy spirit hospital

â&#x20AC;˘ See Prevention, H7

Facilities â&#x20AC;˘ Continued from H5 to Harrisburg. Though the health system has been getting closer to Carlisle area residents, it also focused on bringing something new to the region. PinnacleHealth opened the P innacle Health-Fox Chase Reg i o n a l C a n ce r Ce n te r in April and offers the technology and ad vancements in cancer research from the main Philadelphia branch to the Harrisburg area. The cancer center is located at the Medical Sciences Pavilion on Londonderry Road in Lower Paxton Township and offers comprehensive cancer services across a number of disciplines.

In addition to treatment, the cancer center also has an outpatient diagnostic area, offices for oncologists in varying specialities, the radiology team and staff of the Breast Care Center. Some of the new medical systems the cancer center are offered are the Cyberknife Robotic Radiosurgery System, Trilogy with RapidArc Radiotherapy and High-Dose Brachytherapy. â&#x20AC;&#x153;We can treat people with a very high-quality patient focus,â&#x20AC;? said Dr. Brij Sood, director of the cancer center. â&#x20AC;&#x153;By offering comprehensive cancer services across many disciplines in this new facility, we can expedite care from the first symptom to treatment for each patient.â&#x20AC;?

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Health & Recreation

The Sentinel at

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; H7

Prevention â&#x20AC;˘ Continued from H6 a short period of time, Dr. Cardinal noted, the changes in screening guidelines can take a long time to develop. â&#x20AC;&#x153;One of the reasons why weâ&#x20AC;&#x2122;re only seeing some of these changes now is that it takes a long time for this to come up,â&#x20AC;? he said. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;re talking about preventive screenings, and you need to take hundreds of thousands of people over decades to see if the screening process isnâ&#x20AC;&#x2122;t showing a benefit. If you look at prostate cancer, the cancer is a slow-growing one. It can take many decades, and you have to get a large amount of people.â&#x20AC;? Studies can be paid for and provided by a number of different companies and organizations. Cardinal noted that medical specialty organizations and interest groups, such as the American Diabetes Association, will give recommendations based on their specialty. The studies that Cardinal personally trusts comes from the U.S. Preventive Services Task Force, a government-supported but independent panel of experts in prevention and evidencebased medicine. The USPSTF makes a number of recommendations on medical prevention â&#x20AC;&#x201C; it doesnâ&#x20AC;&#x2122;t make recommendations on treatment â&#x20AC;&#x201C; and it regularly reviews those recommendations. â&#x20AC;&#x153;They go through a rigorous review and weigh not only the benefit but also other things you have to consider â&#x20AC;&#x201C; the amount of time off a woman has to take to get a mammogram and how uncomfortable the screening is,â&#x20AC;? Cardinal said. â&#x20AC;&#x153;It also takes into account that there may be false positives. â&#x20AC;&#x153;A false positive of a mammogram could lead to another mammogram or a biopsy, which could turn to nothing. So you have increased costs and time, and the biopsy may have put the woman at risk, and it could have created a good bit of psychological problems when I give you that phone call about something odd in the mammogram.â&#x20AC;? Because of those additional factors, screening guidelines can be changed if a study finds that the benefit is no greater or worse than the risks. False positives can be a large part of that conce r n , a n d wh i l e wo m en may be put at higher physical and emotional risk by getting biopsies, men can also suffer side


In Focus On the Web Not every website boasting medical information is trustworthy. Holy Spiritâ&#x20AC;&#x2122;s Dr. Peter Cardinal listed a few that are worth checking out to discover more information about screenings, treatment and everything in between. â&#x20AC;˘ U.S. Preventive Services Task Force. The website can be found by simply Googling USPSTF, but you can go directly there here: â&#x20AC;˘ Mayo Clinic. The center offers quite a bit of information on a variety of diseases and even has a symptom checker for patients. â&#x20AC;˘ Family Doctor. The American Academy of Family Physicians runs a website that will also help educate patients on diseases and prevention. â&#x20AC;˘ Holy Spirit Hospital. The hospital itself also gives readers a chance to use interactive tools and learn information to stay healthy. PinnacleHealth also has a health resources guide on its website, located at:

â&#x20AC;&#x153;The recent report says that screening doesnâ&#x20AC;&#x2122;t make a difference - thatâ&#x20AC;&#x2122;s not the view of most physicians in the medical field.â&#x20AC;? dr. brij sood

medical director, pinnaclehealth-fox chase regional cancer center

effects for treating prostate cancer. For a prostate cancer screening, all a man has to do at first is get a blood test to see how high his PSA (protein-specific antigen) number is. A zero to four is in the normal range, and higher than that is a possible indication of prostate cancer. Some men do have higher numbers, so some doctors wait to test how much the PSA number increases from year to year. A large increase would be more indicative of the presence of cancer than a high number alone. However, treating prostate cancer can lead to a lot of side effects â&#x20AC;&#x201C; impotence, incontinence, rectal pain from radiation burns â&#x20AC;&#x201C; that studies now argue arenâ&#x20AC;&#x2122;t always worth the price of getting rid of the cancer. Studies show that those who are screened for cancer donâ&#x20AC;&#x2122;t necessarily live any longer since prostate cancer is slow-growing and patients often die of something else before the cancer even becomes a problem. That report doesnâ&#x20AC;&#x2122;t sit well with every patient or physician. â&#x20AC;&#x153;The recent report says that screening doesnâ&#x20AC;&#x2122;t make a difference - thatâ&#x20AC;&#x2122;s not the view of most physicians in the medical field,â&#x20AC;? said Dr. Brij Sood, medical director of the PinnacleHealth-


Fox Chase Regional Cancer Center. â&#x20AC;&#x153;I personally think screening is fine as long as we can come up with a better way to diagnose prostate cancer. â&#x20AC;&#x153;We donâ&#x20AC;&#x2122;t know who is affected by cancer that needs treatment. We end up treating all patients, which includes 30 to 40 percent of people who are being treated unnecessarily. The test is sensitive and it doesnâ&#x20AC;&#x2122;t tell us which patients have aggressive tumors.â&#x20AC;? What Sood and other physicians suggest is more open discussion between physicians and patients and to talk about what each individual wants â&#x20AC;&#x201C; if someone can live with not knowing their PSA number of if someone else really needs to know what it is.

American Cancer Society guidelines The American Cancer Society doesnâ&#x20AC;&#x2122;t agree with every study on new early cancer detection guidelines, but on occasion, it will amend its recommendations on how often people should receive various testing. These are the current guidelines on what the ACS suggests people do to make sure they catch cancer early: â&#x20AC;˘ Breast cancer: Yearly mammograms starting at age 40 for those in good health. Clinical breast exams every three years for women in their 20s and 30s, and every year for women age 40 and above. â&#x20AC;˘ Colorectal cancer: Beginning at age 50, men and women should receive a colo-

purely for the benefits. Itâ&#x20AC;&#x2122;s not that there are too many tests now, but that there is a potential harm and we need to take that into consideration.â&#x20AC;? The recommended decrease in screenings are also not the only suggestions out there. Cardinal said that new studies are showing up indicating that needs for increased screening in other areas. â&#x20AC;&#x153;Thereâ&#x20AC;&#x2122;s a proposal or draft recommendation to have physicians screen all

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adults for obesity and to offer counseling for those with a body mass index bigger than 30,â&#x20AC;? he said. â&#x20AC;&#x153;Thereâ&#x20AC;&#x2122;s also another one to increase the amount of counseling for skin cancer. Both of those are commonly in the news now.â&#x20AC;? With the medical recommendations for prevention, treatment and everything in between changing every year, Cardinal suggests a good collaboration with the physician as well as some individual

research people can do on their own. â&#x20AC;&#x153;I think people should first try to educate themselves,â&#x20AC;? he said. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s hard for us as physicians to explain all of the changes when weâ&#x20AC;&#x2122;re short on time. There are good websites out there with consumerbased information. You do need to make sure itâ&#x20AC;&#x2122;s a trusted website. People can look up recommendations and what some of the other discussions are about them.â&#x20AC;?

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Change in thinking Though many of these studies are reporting back with recommendations to cut down on screenings and extra costs, Cardinal made sure to point out that itâ&#x20AC;&#x2122;s not about there being too many tests out there, but a change in the way physicians are looking at screenings as a prevention tool. â&#x20AC;&#x153;I think people are realizing that some screenings do have a potential negative aspect,â&#x20AC;? he said. â&#x20AC;&#x153;I think people are looking at the cost and at it as a whole than

noscopy every 10 years, CT colongraphy every five years and yearly fecal occult and immunochemical tests. â&#x20AC;˘ Cervical cancer: At the beginning, screening should be done every year with regular Pap test or every two years with the new liquid-based PAP test. Starting at age 30, if test results are normal, then the woman can be screened every two to three years. Women 70 years or older with normal PAP tests in the last 10 years can choose to stop having PAP tests. â&#x20AC;˘ Prostate cancer: Men 50 years of age or older should make informed decision about testing with their physicians.


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Health & Recreation

H8 â&#x20AC;&#x201D; The Sentinel at

Sunday â&#x20AC;˘ February 26, 2012


Nationwide epidemic

Type 2 diabetes is a serious concern Area physicians and organizations aim at battling obesity and diabetes before the disease affects millions more people. â&#x2013;

By Naomi Creason Sentinel Reporter

â&#x20AC;&#x153;Epidemicâ&#x20AC;? is not a word physicians use lightly, but itâ&#x20AC;&#x2122;s one that everyone is using to describe the status of diabetes in the country. And if nothing is done about it, itâ&#x20AC;&#x2122;s a problem that will grow as fast as Americaâ&#x20AC;&#x2122;s collective waistline. Many physicians and organizations are putting childhood obesity and diabetes at the forefront of their concern in an effort to slow down the growth of the disease and reverse some habits that have led many people to diabetes. There are two major types of diabetes, but the one that physicians are most concerned about is Type 2, which makes up 90 to 95 percent of all diagnosed cases in adults, according to the Centers for Disease Control. Unlike Type 1, which starts mostly in juvenile years and involves the bodyâ&#x20AC;&#x2122;s own immune system destroying the cells that make insulin, Type 2 diabetes is associated with older age, family history, impaired glucose metabolism, physical inactivity and obesity. Itâ&#x20AC;&#x2122;s those last two factors that have progressively increased the numbers of diagnosed and undiagnosed diabetes cases. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s an exploding epidemic, and itâ&#x20AC;&#x2122;s not getting any better,â&#x20AC;? said Dr. Andrew Behnke, a physician at Cumberland Valley Endocrinology Center in South Middleton Township. â&#x20AC;&#x153;The CDC predicts it will only get worse, and you can see that

if you look at the adultsâ&#x20AC;&#x2122; and the childrenâ&#x20AC;&#x2122;s problem. â&#x20AC;&#x153;Children arenâ&#x20AC;&#x2122;t exercising as much as their parents did when they were little. Itâ&#x20AC;&#x2122;s really going to be bad when they grow up. Generally, diabetes sets in with people after the age of 40, but now Iâ&#x20AC;&#x2122;m seeing diabetes setting into the 30s, 20s and even into the teens. Iâ&#x20AC;&#x2122;m seeing teenagers develop Type 2 adult diabetes. Itâ&#x20AC;&#x2122;s a big problem.â&#x20AC;? The CDC estimates that, in 2010, 25.8 million people, or 8.3 percent of the countryâ&#x20AC;&#x2122;s population, was affected by diabetes â&#x20AC;&#x201C; 18.8 million diagnosed cases and another 7 million undiagnosed cases. The highest number of cases is in the older population, 65 years or older, which has 10.9 million sufferers, or 26.9 percent of that population. Though the older population has the highest number of cases, thatâ&#x20AC;&#x2122;s not the population with the fastest increasing number. In fact, itâ&#x20AC;&#x2122;s the slowest growing number of adult diabetes cases. In 2010 alone, more than 1 million people aged 45 to 64 were newly diagnosed with diabetes, while 465,000 adults aged 20 to 44 and 390,000 people over 65 years old were diagnosed with diabetes, according to CDC projected estimates. The projection for the future may be even bleaker as physicians consider how many people out there have â&#x20AC;&#x153;prediabetes,â&#x20AC;? a condition in which blood glucose is elevated but is not high enough to be diagnosed as diabetes. While the estimates put diabetes at almost 26 mil-

lion, estimates for prediabetes increases that number to 79 million. With Type 2 diabetes showing up at younger ages and prediabetes present in a lot more people, the disease is putting more pressure on the healthcare system.

Costs Diabetes patients can retain control over the disease, but it can also lead to a number of complications and other diseases. According to the CDC, diabetes is the leading cause of blindness, kidney failure and non-traumatic lower limb amputations, and it is the seventh leading cause of death in the country. The disease also has an effect on heart disease, stroke, hypertension, nervous system diseases, dental diseases and complications with pregnancy. The CDC estimates that in 2007, diabetes cost the United States $174 billion â&#x20AC;&#x201C; $116 billion in direct medical costs and $58 billion in indirect medical costs for disability, work loss and premature mortality. Diabetes can also be costly to the patient. In addition to paying for treatment for all of the additional problems and complications that comes with diabetes, controlling the disease also costs a pretty penny. Glucose meters are often given out for free, but the test strips can cost up to $9 per strip or $35 for a small bottle of test strips. Those costs add up, considering some test their blood sugar levels three times a day or more.



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Insulin shots can also be costly, and insulin pumps can range anywhere from $5,000 to $7,000 and are largely not an option for most diabetic patients because of the cost. Because there are so many new cases of Type 2 diabetes, more organizations are finding themselves unable to help out with diabetic services it formerly provided for free. Sadler Health Center in Carlisle had offered test strips with the help of a non-profit, but within a year that organization couldnâ&#x20AC;&#x2122;t keep up with demand.

With the help of the Andy Towne Memorial Endowment, Sadler continues to offer diabetic services free of charge while keeping up with its other duties and services as a community health center.

Prevention While Sadler and other organizations are doing what they can to handle the newly diagnosed patients, many more are working on preventing some of the future estimates from coming true. Diabetes is one of the most targeted diseases in the country because it is also



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one of the most preventable diseases. â&#x20AC;&#x153;The bottom line is that itâ&#x20AC;&#x2122;s the patientâ&#x20AC;&#x2122;s responsibility,â&#x20AC;? said Dr. Renu Joshi, chief of endocrinology at PinnacleHealth Endocrinology Associates in Mechanicsburg. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s a what they eat issue, a will power issue and an exercise issue. Itâ&#x20AC;&#x2122;s all about watching that plate, in my opinion. All of this wasnâ&#x20AC;&#x2122;t here 25 years ago. Itâ&#x20AC;&#x2122;s mainly an environment issue, not a genetic one.â&#x20AC;? Most of the effort is being aimed at children in order

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â&#x20AC;&#x153;The bottom line is that itâ&#x20AC;&#x2122;s the patientâ&#x20AC;&#x2122;s responsibility. Itâ&#x20AC;&#x2122;s a what they eat issue, a will power issue and an exercise issue. Itâ&#x20AC;&#x2122;s all about watching that plate, in my opinion. All of this wasnâ&#x20AC;&#x2122;t here 25 years ago.â&#x20AC;?

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Pennsylvania statistics The entire country is battling the epidemic of diabetes, and Pennsylvania is no exception to that. In 1994, every adult age group had fewer than 200,000 people diagnosed with diabetes. The Centers for Disease Control split the age groups into those between 18 and 44, those between 45 to 64, those between 65 and 74 and those more than 75 years of age. Combined, those 65 and above had the most diabetics at 249,000 people (162,000 between 65 and 74 and 87,000 above 75 years old). Without that combined number, those between 45 and 64 years of age made up the highest group at 188,000 people. Adults between 18 and 44 had the lowest number of cases at 62,000. All of those numbers have since increased. The highest increase occurred in the 45-to-64 age range, which jumped to 390,000 in 2010. The second highest increase was among the 75 and older population, which was at 203,000 in 2010. Also increasing steadily every year was the number of diabetics in the 18-to-44 age range, which increased to 135,000 by 2010. The group of people between 45 and 64 wavered in the last decade, but its numbers also increased, settling at 205,000 in 2010. The CDC estimates that between 1994 and 2010, the percentage of Pennsylvanians affected by diabetes increased to 9.7 percent from 5.5 percent. - Source: The Centers for Disease Control

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The Sentinel at

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; H9

Diabetes â&#x20AC;˘ Continued from H8 to prevent some unhealthful lifestyle habits from forming and get them outside more. First lady Michelle Obama declared her war on childhood obesity when her husband came into office, and other organizations are doing the same. The Carlisle Area Health & Wellness Foundation announced its battle against childhood obesity at its Health Summit in June 2011, and earlier this year, the foundation issued its first grants to three area school districts to help improve physical education and nutrition. For years, PinnacleHealth has offered KidShape, which gives students a chance to learn about nutrition, a place where they can exercise and have fun and a sup-

port group that will listen to any problems they may face as obese or overweight children. This year, Carlisle Regional Medical Centerâ&#x20AC;&#x2122;s annual Family Fun Day also focused on childhood obesity and offered stations and information on how parents and children can fight it. â&#x20AC;&#x153;(It was) our way to make people more aware of what calories theyâ&#x20AC;&#x2122;re eating and how to get rid of those calories,â&#x20AC;? said Dr. Virgilio Centenera, a surgeon at Carlisle Urology who organized the Family Fun Day. â&#x20AC;&#x153;For me, thatâ&#x20AC;&#x2122;s what I find to be the biggest challenge,â&#x20AC;? Centenera said. â&#x20AC;&#x153;I want to show people just how many calories are in a hamburger, what those 500 calories mean and what they really need to do to lose it. â&#x20AC;&#x153;I think people are kind of not aware of what classi-

fies you as being overweight or obese,â&#x20AC;? he said. â&#x20AC;&#x153;People know when theyâ&#x20AC;&#x2122;re morbidly obese, but many people donâ&#x20AC;&#x2122;t know at what point are they considered obese. Everyone thinks theyâ&#x20AC;&#x2122;re normal, but youâ&#x20AC;&#x2122;d be surprised. It goes by the guidelines of height and age. You have to be pretty slim to be considered fit.â&#x20AC;? Diabetes prevention is shaping up and targeting a larger audience, but physicians and organizations are still trying to make sure everyone knows just what they can do to prevent themselves from ending up with medical complications that they could have avoided. â&#x20AC;&#x153;I think everyone knows itâ&#x20AC;&#x2122;s a problem, but it just doesnâ&#x20AC;&#x2122;t get the attention Sentinel file photo it should,â&#x20AC;? Joshi said. â&#x20AC;&#x153;The more awareness we can give Dr. Andrew Behnke of Cumberland Valley Endocrinology discusses ways that people, the better.â&#x20AC;? diabeties can be controlled through physical fitness and diet.

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Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012


Couple introduces salt cave to area The therapy involves the use of mineral-rich salt to help relieve symptoms and provide alternative treatment to some health problems. â&#x2013;

By NAOMI CREASON Sentinel reporter

Last year, Lisa Ramseyâ&#x20AC;&#x2122;s youngest daughter, Leslie, was expected to have sinus surgery. The 17-year-old had sinus problems for years, and it had gotten so bad that doctors recommended surgical treatment. So it was with some surprise that the two visited their physician only to find out that the sinus problem had cleared and surgery was no longer necessary. â&#x20AC;&#x153;The doctor told us a week ago there was no need for the surgery,â&#x20AC;? Ramsey said at the time. â&#x20AC;&#x153;Her sinuses had totally turned around.â&#x20AC;? It was the result Ramsey had been hoping for after she and her husband, Scott

Ramsey, read about halotherapy, or salt therapy. Salt therapy involves the use of mineral-rich salt to help relieve symptoms and provide alternative treatment to some health problems. One method revolves around a salt cave, where bricks of salt make up the walls and grains of salt cover the floor. In the cave, people can relax on chairs while breathing in minerals and what proponents call negative ions that are released into the air. That idea led the Ramseys to create their own salt cave in Carlisle, and Leslie was the first to try it out as well as the Ramseysâ&#x20AC;&#x2122; first success story. â&#x20AC;&#x153;She spent three weeks in the salt therapy room,â&#x20AC;? Lisa Ramsey said. â&#x20AC;&#x153;Sheâ&#x20AC;&#x2122;s been using it since we put it in. She goes about four times

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a week and sits in there for about 40 minutes each time. You have to experience it to understand it.â&#x20AC;?

Salt The salt cave is one more health alternative that uses salts to help relieve some health-related problems. Plenty of people already use the Neti pot or other saline solutions to wash out nasal passages during colds, allergies and sinus infections. Others also use Epsom salts a bit more recreationally as bath salts. Halotherapy is something similar to those uses, and though its a rather new idea to the United States, itâ&#x20AC;&#x2122;s been around for more than a century in Eastern Europe. The designer of the Ramseysâ&#x20AC;&#x2122; salt cave is from

Poland. Designs of caves in other parts of the country were developed by Polish or Czech businesses that were familiar with halotherapy. Those who enter the Ramseysâ&#x20AC;&#x2122; salt cave may be surprised about what they see. The design makes the interior of the room look much like a cave. The walls are made of salt bricks and grains of salt cover the heated floor. Scott Ramsey estimates that they have about 12 tons of salt in the room, and one important factor is what type of salt theyâ&#x20AC;&#x2122;re importing to the cave. â&#x20AC;&#x153;The salt is all from the Himalayas,â&#x20AC;? he said. â&#x20AC;&#x153;The salt is really rich in minerals. The darker the color, the more minerals the salt has. Everything is hand-mined.â&#x20AC;? Everything is also handsawed by Ramsey, who spent about 700 hours cutting the bricks and putting them together in the walls. The Mt. Holly Springs man also purchased wood from the

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Scott and Lisa Ramsey discuss their salt cave, Tranquility, in Carlisle. Big Spring mill to add to the cave, and a few hand-carved salt statues and lamps from the Himalayas also decorate the room. The Ramseys then added reclining chairs for people to sit on while relaxing in the salt cave.

Lisa Ramseyâ&#x20AC;&#x2122;s new salon and holistic center, Tranquility, located off Penrose Place in Carlisle. In addition to the salt cave, Tranquility offers organic hair services using Aveda products, massage therapy and an oxygen bar. Single and couple massages Tranquility are also available inside the The salt cave is a part of salt cave.

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The Sentinel at

Sunday• February 26, 2012 — H11

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Does knee pain have you between a rock and a hurt place? You can’t function with an aching knee. But, you’re not yet a candidate for total knee replacement. Carlisle Regional Medical Center is one of only two hospitals in Central Pennsylvania to offer MAKOplasty® partial knee resurfacing. Robotic-assisted technology allows our surgeons to resurface the affected area of your knee while leaving healthy bone and tissue intact. This minimally invasive procedure offers more consistent results and minimizes hospital stays, recovery time and rehabilitation. See if MAKOplasty is right for you.

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Sunday• February 26, 2012

Proudly serving Cumberland County for over 88 years.

Health & Rec • February 26, 2012 • Section I

Annual Report MEETING THE CHALLENGE 2012 • Part five in a five-day series •

Offering proper care Lower Allen Township

New transport company shows ‘respect’ RESPECT Ambulance, a private business, is set apart from other EMS services. ■

By Naomi Creason Sentinel reporter

Fra n M u n cy h a d h e r doubts when a new ambulance transport company wanted her to join the business. After all, Muncy hadn’t had the best experiences when it came to transport services. Muncy had worked in the acute care and dialysis business for about 20 years before retiring, and over that time she had seen more than a few instances where her patients deserved much better care from EMS transport employees. “I didn’t like the way they handled my patients,” Muncy said. “Everybody was always in a hurry. They would

just put the patient down and walk away. I’ve seen them bring a patient in and make them lay there on the stretcher. And they’re often late - which is a big, big crux for me. They would always be late picking up the patients. There were some good EMTs, but that’s mostly what I saw.” It was that kind of experience, however, that made her the perfect fit at RESPECT Ambulance. The transport company is a private business in Lower Allen Township, and executive director MJ Sullivan was looking for someone who would have a background in dialysis and who would help set the business apart from


Sentinel file photo

EMT Debbie Sgrignoli from RESPECT Ambulance will transport people to scheduled appointments.

I2 — The Sentinel at

Health & Recreation

Sunday • February 26, 2012

RESPECT • Continued from I1 other EMS services. With Muncy on board as dialysis advocate and RN director and a grand opening held last Wednesday, RESPECT Ambulance and its staff are interested in letting people know just how different they are.

Focus on dialysis

RESPECT Ambulance offers state-ofthe-art equipment and transports people to scheduled appointments at medical facilities.

“If a patient goes with a 911 service, they have to wait until they respond to their 911 calls. If we have a patient who is done at 10:35, we’ll be there no later than 10:40.”

Dialysis patients are a major focus for the transport company. With Muncy’s background in dialysis treatment, she’s made sure that the company’s ambulance - as well as the other two in the pipeline - are equipped to handle dialysis patients, and the six full-time and two part-time EMTs have all undergone specialized training to take care of those patients. Debbie Sgrignoli is one of the EMTs who has fran muncy undergone that training and, for her, that’s been emt, respect amublance particularly important. “I had an uncle who was actually a patient of Fran’s,” said Sgrignoli, who has 25 years experiget sick. I wanted to get back into the service, but ence in EMS and fire. “He had to go on dialysis, not the 911 hours.” and he really didn’t want to go... He said he’d go As a private transport company, RESPECT on one condition - that I come with him. So I Ambulance does not respond to 911 calls. took him there the first two or three visits. I’ve handled dialysis before. There are side effects you need to know about - like sometimes they’ll • See RESPECT, I3

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Health & Recreation

The Sentinel at

Forest Park Health Center & Rehabilitation PTA Kyle Staley helps Mildred Albright use the new virtual rehab system that provides exercise for senior patients with limited mobility. Sentinel file photo


Virtual rehab drives motivation Patients at Forest Park Health Center & Rehabilitation participate in game-like activitites. â&#x2013;

By Naomi Creason Sentinel reporter

When it comes to giving patients the rehabilitation they need, motivating patients to get up and do it is a bit of an obstacle for therapists. A new virtual system, however, could change that. Therapists at Forest Park Health Center & Rehabilitation in Carlisle

are finding that they not only are seeing more interest but that they also sometimes have to limit the amount of time patients spend in the therapy room and specifically in front of their new system - the OmniVR. The OmniVR is a virtual rehabilitation system for aging adults who are recuperating from an injury or surgery. A 3-D camera captures the patientâ&#x20AC;&#x2122;s image and puts them in a

game-like environment where they participate in a variety of interactive exercises and activities on the monitor. The technology is based off of what patients have already been using with the Nintendo Wii and Xbox 360â&#x20AC;&#x2122;s Kinect, but where most of those are games designed for children, the OmniVR targets rehabilitation specifically. â&#x20AC;&#x153;We have been using the Wii gaming system, but thatâ&#x20AC;&#x2122;s making something fit an older personâ&#x20AC;&#x2122;s needs,â&#x20AC;? said Connie Lester, director

â&#x20AC;˘ See Virtual, I4

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; I3

RESPECT â&#x20AC;˘ Continued from I2 Dialysis patients and others needing transport to a hospital or medical facility can schedule an appointment with the company, and the ambulance will take them anywhere in the Central Pennsylvania region - Dauphin, Cumberland, Perry, York, Franklin, Adams and Lebanon counties - as long as there is 24 hoursâ&#x20AC;&#x2122; notice. Muncy believed that it was a benefit that all of their time is scheduled and they do not respond to 911 calls. â&#x20AC;&#x153;We have the advantage of not being a 911 service,â&#x20AC;? she said. â&#x20AC;&#x153;If a patient goes with a 911 service, they have to wait until they respond to their 911 calls. If we have a patient who is done at 10:35, weâ&#x20AC;&#x2122;ll be there no later than 10:40.â&#x20AC;?

Showing RESPECT Being on time is just one way the company hopes to build a reputation for itself. To the staff, RESPECT means just that, and they want to make sure the people they serve and the people they meet will recognize more than just their vehicle. â&#x20AC;&#x153;If we get a phone call, weâ&#x20AC;&#x2122;ll drop off a brochure - in person,â&#x20AC;? Muncy said. â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;ll never send it through the mail. I want people to see a face with the company. So Debbie, MJ and I are almost always on the road

â&#x20AC;&#x153;I think itâ&#x20AC;&#x2122;s important to show people we care.â&#x20AC;? fran muncy emt, respect ambulance

dropping off brochures. I think itâ&#x20AC;&#x2122;s important to show people we care, and what better way to do that than to be right in front of you.â&#x20AC;? To schedule an appointment or for more information, call 412-7861. Muncy is the dispatcher for the ambulance and all calls will go to her or her voicemail. RESPECT Ambulance is not yet equipped with wheelchair-accessible vans, though they are creating a waiting list for those who would still like their services in the future. The ambulance company took over the former Lower Allen Township municipal building on Hummel Avenue, which was already equipped with bays for emergency vehicles. For more information on the company, go to www.respectambulance. com.


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I4 — The Sentinel at

Health & Recreation

Sunday • February 26, 2012

Virtual • Continued from I3

Forest Park Health Center & Rehabilitation Physical Therapy Assistant Kyle Staley adjusts the camera on the new virtual rehab system that provides exercise for senior patients with limited mobility.

of marketing at Forest Park. “The OmniVR is designed specifically for the older population.” The OmniVR is closer to how the Kinect works. There are no controllers and no balance boards, just a video camera that picks up what the patient is doing. It also means the patient can still use the system even if they have limited mobility. So if the patient is limited to wheelchair use, there are still programs designed to give the patient a workout, even if standing is not possible. “There are different levels of programming,” said Courtney Pincin, director of rehab services. “In one part, they can lean left or right, but in a different level, they can try to lean further. There’s only positive feedback. There’s no X or being called a loser - it gives you rewards for what you can do.”

Motivation And what the system has been doing is getting patients to the therapy room. The OmniVR does not replace any of the other methods therapists use at Forest Park, but the addition has certainly gained the attention of the

Sentinel file photo

• See Virtual, I5

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Health & Recreation

The Sentinel at

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; I5

Cumberland County

Program helps kids battle obesity KidShape is a national program that has gained enough momentum to begin classes in Cumberland County. â&#x2013;

By Naomi Creason Sentinel reporter

Sentinel file photo

Forest Park Health Center & Rehabilitation patient Karen Haynes uses the new virtual rehab system that helps to provide exercise for senior patients with limited mobility.

â&#x20AC;&#x153;Normally itâ&#x20AC;&#x2122;s hard to get people motivated to do therapy, but they really love this. For some people, this is also something they can do with their grandkids.â&#x20AC;? courtney pinchin

director of rehab services, forest park health center & rehabilitation

Virtual â&#x20AC;˘ Continued from I4 short-term and long-term care residents. â&#x20AC;&#x153;Our rehab patients truly love working with the OmniVR,â&#x20AC;? Pincin said. â&#x20AC;&#x153;It gives them something fun and entertaining to do that achieves the same therapeutic goal ... and with some people, inspires them to do things they might not ordinarily try. â&#x20AC;&#x153;Thereâ&#x20AC;&#x2122;s also bingo, and the geriatric population here loves bingo,â&#x20AC;? Pincin added. The system focuses on a number of areas including strength, balance, mobility, safety, walking, endurance and memory. Some of the ways the OmniVR accomplishes those goals are games like the carnival, which helps patients take aim at a target and works the muscles in the arm as they push their arms toward the screen, and the fox game, where patients can be the fox on the screen and catch falling fruit by leaning left or right or reaching up. There are also objective measures where therapists can help build up their patientsâ&#x20AC;&#x2122; bodies and balance to diminish fall risks.

Though the games are certainly the kind of fun that attracts a crowd in the therapy room, the system is still a way to help patients recuperate. â&#x20AC;&#x153;It has a lot of benefits,â&#x20AC;? Pincin said. â&#x20AC;&#x153;Normally itâ&#x20AC;&#x2122;s hard to get people motivated to do therapy, but they really love this. For some people, this is also something they can do with their grandkids. With regular therapy, thereâ&#x20AC;&#x2122;s not much for the kids to do, but with this system, the kids can be there with them during therapy.â&#x20AC;? Forest Park has only had OmniVR since July - the first in the state to have the virtual system - but itâ&#x20AC;&#x2122;s already showed its worth, according to Lester. â&#x20AC;&#x153;Theyâ&#x20AC;&#x2122;re getting motivated to do therapy,â&#x20AC;? she said. â&#x20AC;&#x153;If itâ&#x20AC;&#x2122;s something they enjoy, theyâ&#x20AC;&#x2122;re more likely to do it. Weâ&#x20AC;&#x2122;ve had a lot of success with it. It utilizes the whole body. Itâ&#x20AC;&#x2122;s helped patients with their range of motion. They just have fun using it.â&#x20AC;? For more information about the OmniVR and how Forest Park is using it, call the center at 960-7700 or visit them at its location off of Walnut Bottom Road.

Tracey Bottiglia is used to the stares she gets at the grocery store. It isnâ&#x20AC;&#x2122;t all that unusual for Bottiglia to find herself in an in-depth discussion with her children Vincent and Victoria over the nutritional value of a particular food. â&#x20AC;&#x153;We go to the grocery store together,â&#x20AC;? she said. â&#x20AC;&#x153;Theyâ&#x20AC;&#x2122;d pick out things they want, and the first thing (Vincent) does is turn it over and look at the label. We get a lot of attention and stares when we have this conversation in the grocery store.â&#x20AC;? This wasnâ&#x20AC;&#x2122;t always a habit with the Bottiglia family. The family struggled with trying to figure out how to help Vincent, now 13, who weighed between 220 and 230 pounds, lose some weight. â&#x20AC;&#x153;We had tried a lot of things on our own,â&#x20AC;? Bottiglia said. â&#x20AC;&#x153;We talked to our pediatrician, and got information from him. Weâ&#x20AC;&#x2122;ve been to different specialists, like nutritionists. We tried to get more information from different places. But none of them made an impact.â&#x20AC;? The Swatara Township family finally decided to seek outside help. That was when Bottiglia saw information about PinnacleHealthâ&#x20AC;&#x2122;s KidShape program. â&#x20AC;&#x153;We heard about it maybe a year and a half ago,â&#x20AC;? she said. â&#x20AC;&#x153;We were investigating some programs for my son when we stumbled upon a newsletter from PinnacleHealth. I went online to its website, and at that point, I tried to get him involved.â&#x20AC;? The program when they investigated it last year was booked solid, so Bottiglia had to wait until the following nine-week program started before she could enroll Vincent. The wait, however, was worth it. â&#x20AC;&#x153;It actually helped because we got to look forward to it,â&#x20AC;? she said. â&#x20AC;&#x153;We started talking about that this was not something we were going to do for eight weeks. This was going to be a new lifestyle for us. Vince is healthier now than heâ&#x20AC;&#x2122;s ever been. Heâ&#x20AC;&#x2122;s down around 200 pounds, but heâ&#x20AC;&#x2122;s also about 9 inches taller than he was when we went to the program.â&#x20AC;?

Losing weight, staying healthy Itâ&#x20AC;&#x2122;s the kind of success story that seems to be rather common in the KidShape program. KidShape is a nation-


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al program that started in 1986 and reached Harrisburg in 2009 when PinnacleHealth and Highmark Blue Shield partnered to bring the first class to the area. The program has since gained enough momentum to spawn classes in Cumberland County, which will start in April, and a new session in Hershey, for which the Hershey Medical Center will partner. â&#x20AC;&#x153;One of our children, who started in the first KidShape program, was seeing a physician at Hershey Medical,â&#x20AC;? said Barbara Terry, vice president for mission effectiveness at PinnacleHealth. Sentinel file photo â&#x20AC;&#x153;Before the program, he had high cholesterol, high With the help of KidShape, Vincent Bottiglia, 13, blood pressure and was has slimmed down to a much healthier weight. pre-diabetic. In fall 2009 after Thanksgiving, he went to the doctor, and not only did he lose weight, but his blood pressure was normal, his cholesterol was lower and there were no signs PinnacleHealthâ&#x20AC;&#x2122;s Kid- the children meet with of pre-diabetes. The docShape program offers a the mental health protor asked, â&#x20AC;&#x2DC;What have you weekly two-hour class fessional to discuss emodone?â&#x20AC;&#x2122; The child explained over the span of nine tional eating, self percephow he made healthy choicweeks, where families can tion and issues such as es over Thanksgiving and learn more information bullying. While the chilhow he had so much fun in about nutrition as well as dren are with the mental the program. The doctor provide support for their health professional, the was so impressed she called children who are attend- parents spend 30 minutes me, and weâ&#x20AC;&#x2122;ve been talking the program. with the registered dietiing this past year and a half KidShape Site Coordi- cian, further discussing about getting the program nator Abby Wagner ex- family nutrition. there.â&#x20AC;? plained how the program â&#x20AC;&#x153;After the 30 minutes, Nationally, the program works and what families the parents meet with boasts that 87 percent of can expect. the mental health prothe children who take part â&#x20AC;&#x153;Families have a healthy fessional, and the chillose weight during the ninesnack as they are arriv- dren spend 30 minutes week session, and 80 pering to class and children in physical activity with cent of the children maincomplete a kid-friendly the physical activity intain that weight for two healthful â&#x20AC;&#x2DC;fun quiz.â&#x20AC;&#x2122; After structor. The evening years after theyâ&#x20AC;&#x2122;ve left the a brief recap of the pre- concludes with a 10program. PinnacleHealth vious weekâ&#x20AC;&#x2122;s class and minute wrap-up session, has had six KidShape proa summary of what will reviewing that nightâ&#x20AC;&#x2122;s grams since starting in Sepbe covered in class that class and setting goals for tember 2009, and of the night, the entire family the upcoming week, such youth who attended, they participates in a 10-min- as having a vegetarian achieved an average 1.0 ute family activity with meal, drinking less sugchange in the body mass inthe physical activity in- ary drinks or exercising dex percentile for age. structor. as a family. The families Abby Wagner, a site coorâ&#x20AC;&#x153;Then, the entire fam- are provided all the madinator for KidShape, attriily participates in a 30- terials they will need for butes that kind of success to minute interactive session class and at home as well, what the program targets. with the registered dieti- including parent and stuâ&#x20AC;&#x153;KidShape is a nine-week cian, where topics such as dent binders and trackers family-based lifestyle modserving sizes, label read- to journal their food and ification class that stresses ing and healthful snack- activity throughout the the importance of a healthy ing are discussed. Next, week.â&#x20AC;? diet, regular exercise and positive self-perception as opposed to dieting,â&#x20AC;? Wagner said. â&#x20AC;&#x153;Nutrition is a family-based activity. Not only do parents have the majority of the control over what the family eats, but children also mirror what they see their parents doing. Therefore, the entire family needs to be involved to truly see 3442 Orrstown road, Orrstown, Pa 17244 long-term results from the Rev. Kathleen Coleman â&#x20AC;˘ Church: 532-3611â&#x20AC;˘ Home: 300-3371 KidShape program. â&#x20AC;&#x153;Additionally, the program is designed for children ages 6-14, so the classes are designed to be ~ 10:30am ~ ~ 9:30am ~ fun and hold the childrenâ&#x20AC;&#x2122;s

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I6 â&#x20AC;&#x201D; The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012


MinuteClinic offers immediate primary care Two clinics open at CVS stores in Harrisburg and Hampden Township. â&#x2013;

By Naomi Creason Sentinel reporter

From what Robert Spencer has seen, thereâ&#x20AC;&#x2122;s a lot of pressure on primary care providers to provide all of the immediate care for area residents. Families can go to emergency rooms, and there are businesses like Concentra that handle urgent care, but when it comes to the little things, like shots, physicals and exams, family doctors may need an extra hand to take care of all of their patients. And thatâ&#x20AC;&#x2122;s where the MinuteClinic comes into play. Spencer is a nurse practitioner and division manager for MinuteClinic, the largest provider of retail-based medical clinics in the country. In 2006, it was bought by CVS and has been opening clinics within the walls of CVS stores across the country. In October 2011, it opened two MinuteClinics at CVS stores in the Harrisburg region - one on Progress Avenue in Harrisburg and the other at the corner of Sporting Hill Road and the Carlisle Pike in Hampden Township. The two are the first in the region and are part of a drive to have 100 new clinics open in 2011, with 600 already operating in 26 states and Washington, D.C.

With those two new clinics, MinuteClinic can treat more patients looking for immediate care and canâ&#x20AC;&#x2122;t quite schedule something with their family physicians. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;re convenient,â&#x20AC;? Spencer said. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;re open seven days a week, and thereâ&#x20AC;&#x2122;s no appointment necessary. All of our nurse practitioners are board certified, weâ&#x20AC;&#x2122;re credentialed by The Joint Commission and we cost a lot less than other care providers.â&#x20AC;? Though MinuteClinic was designed to treat almost anyone who walks through the door with a minor injury or illness, Spencer noted theyâ&#x20AC;&#x2122;re not trying to steal any patients away from anyone else. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;re not trying to compete with or take patients away from anybody,â&#x20AC;? he said. â&#x20AC;&#x153;We want them to have primary care providers. More than half of the patients we see donâ&#x20AC;&#x2122;t have a local PCP. People need PCPs, because our care is intermittent. Weâ&#x20AC;&#x2122;re here seven days a week, but people need to establish a relationship with their PCP.â&#x20AC;?

How it works What MinuteClinic can do is treat a lot of the overflow - the people who need immediate assistance but who donâ&#x20AC;&#x2122;t want to go to an urgent care center or emergency

â&#x20AC;˘ See Clinic, I7

Sentinel file photo

A portable hospital that can hold up to 20 patients at a time is set up at Carlisle Regional Medical Center.


Personnel prepare for emergencies CRMC and the Emergency Health Services Federation, Inc., operate a drill under the scenario that the hospital would lose power. â&#x2013;

By Naomi Creason Sentinel reporter

The sweltering June heat wasnâ&#x20AC;&#x2122;t much of a concern for Susan Dutko. After all, weather isnâ&#x20AC;&#x2122;t always going to be on her side when sheâ&#x20AC;&#x2122;s working. Dutko is the director of system preparedness at the regional chapter of the Emergency Health Services Federation, Inc. Her job is to make sure everything runs smoothly, no matter what the emergency and no matter what the weather. â&#x20AC;&#x153;In the real world, temperatures are probably going to be like this, especially

after a severe storm,â&#x20AC;? Dutko said, decked out in cargo shorts and a sun hat. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s going to be hot out, and itâ&#x20AC;&#x2122;s going to be fairly uncomfortable.â&#x20AC;? While the only thing Dutko and the 60 emergency personnel could do to beat the heat was to power up some generators and air conditioners, their main duty was to make sure they and Carlisle Regional Medical Center would be prepared should the hospital require assistance. So on that hot Wednesday last June, CRMC and the federation teamed up for a drill involving a portable hospital - a series of tents

Sentine file photo

Ernie Powell, director of system operations, talks about the benefits of a portable hospital at the Carlisle Area Regional Medical Center. that would act as hospital beds and care centers for patients. The drill was operating under the scenario that the hospital would lose power - a situation that seemed very possible after the May 2011 storms that

shut down power to much of Cumberland County. â&#x20AC;&#x153;It has a real-world significance,â&#x20AC;? Dutko said. â&#x20AC;&#x153;Just last month we saw Joplin (Missouri) had its hospital

â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s been great. Heâ&#x20AC;&#x2122;s much more aware of his choices, even when heâ&#x20AC;&#x2122;s not with us. He came back from a party and said, â&#x20AC;&#x2DC;Mom, I canâ&#x20AC;&#x2122;t believe it. There was this kid who had four pieces of pizza. I just had one.â&#x20AC;&#x2122; Theyâ&#x20AC;&#x2122;ve also learned about helping size. Itâ&#x20AC;&#x2122;s not a bad thing to eat certain things - itâ&#x20AC;&#x2122;s about how much of it youâ&#x20AC;&#x2122;re eat-

ing. That was a big thing for them. It takes more responsibility about their choices. I think him realizing heâ&#x20AC;&#x2122;s not in this alone was good for him.â&#x20AC;? The program is free for children ages 6 to 14 who are clinically overweight by their BMI but are healthy enough to participate in the program. For more information, call 231-8900.

â&#x20AC;˘ See Drill, I7

KidShape â&#x20AC;˘ Continued from I5 attention. They also get to meet other kids their own age who may be experiencing similar things they are, and they can discuss their feelings and emotions in a safe, understanding environment.â&#x20AC;?

Family matters Itâ&#x20AC;&#x2122;s that emphasis on fam-


ily that Bottiglia said worked best for Vincent. â&#x20AC;&#x153;A lot of it was something we could do together,â&#x20AC;? she said. â&#x20AC;&#x153;My husband and son like to cook together, so nutrition was something we could learn together as a group. Itâ&#x20AC;&#x2122;s been good because itâ&#x20AC;&#x2122;s something weâ&#x20AC;&#x2122;re doing together. We all have that same background, and we can refer back to it and

weâ&#x20AC;&#x2122;ll all know what weâ&#x20AC;&#x2122;re talking about. We can go out to dinner and make good choices. It wonâ&#x20AC;&#x2122;t be like one person is in this alone.â&#x20AC;? Similar to how anyone would react when faced with a complete lifestyle change, Vincent was notably resistant at first when it came to attending the program.

â&#x20AC;&#x153;My son very much did not want to do it,â&#x20AC;? Bottiglia said. â&#x20AC;&#x153;When we first got there, he was rather negative about it. But by the end of the night, he met some friends he knows from school and was really enjoying it. It would be hard to get him to go, but once he was there, he loved it. After three weeks, heâ&#x20AC;&#x2122;d keep reminding us not to forget to go.

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Health & Recreation

The Sentinel at

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; I7

Drill â&#x20AC;˘ Continued from I6

â&#x20AC;&#x153;The worst time youâ&#x20AC;&#x2122;d want to have to meet someone is in the middle of a disaster. Having that relationship established beforehand is very, very important.â&#x20AC;?

shut down (because of the tornado).â&#x20AC;? The federationâ&#x20AC;&#x2122;s strike team hadnâ&#x20AC;&#x2122;t yet responded to a local incident - though it did get dispatched for Hurricanes Katrina and Gustav - but running the simulations is an opportunity for both the federation and the hospital to prepare for the worst. susan dutko The hospital does such director of system preparedness, regional drills about twice a year chapter, emergency health services federation, inc. to identify any potential weaknesses in their systems. a walkway. The structure is merely meeting the peodepends on the response ple theyâ&#x20AC;&#x2122;ll see in a real-life Portable hospital area. We have to take a emergency. In the portable hospital look at whatâ&#x20AC;&#x2122;s going on and â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s all about preparadrill, the hospital sends the where weâ&#x20AC;&#x2122;re requested to tion,â&#x20AC;? she said. â&#x20AC;&#x153;The worst request for help, to which go. time youâ&#x20AC;&#x2122;d want to have the federation responds by â&#x20AC;&#x153;We had everything set to meet someone is in the calling its workers as well up in 55 minutes,â&#x20AC;? she add- middle of a disaster. Havas private and volunteer ed. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s our best time so ing that relationship estabemergency services per- far.â&#x20AC;? lished beforehand is very, sonnel. W h i l e t h e e m e rge n - very important. We would â&#x20AC;&#x153;My objective during the cy personnel are working all be a lot more comfortdrill is to track real-time on setting up the portable able with what we had to notification and to track hospital, the hospital staff do if we knew each other. real-time response,â&#x20AC;? Dutko are working on contact- In the real world, stuff hapsaid. â&#x20AC;&#x153;These people leave ing utility companies, po- pens, and you donâ&#x20AC;&#x2122;t know their homes or home bases, lice departments and ad- who is going to show up. get the equipment and get ditional staff, but they are Knowing at least one person here. Weâ&#x20AC;&#x2122;ll have a tent up also working on evacuating would overcome that burfour hours within a request patients - in the drill, they den. You also get to know being made. Our full sys- were mock patients - and in advance what the place tem is 50 beds. The beauty treating them in the porta- looks like. Iâ&#x20AC;&#x2122;m absolutely is itâ&#x20AC;&#x2122;s Velcro. You can con- ble hospital. confident that if Carlisle figure the system any way The drill went off with Regional called us tomoryou want it. You can choose little problems, but what- row and told us the hospital Sentinel file photo the shape of it - it doesnâ&#x20AC;&#x2122;t ever the results, Dutko be- was shut down, weâ&#x20AC;&#x2122;d be able Susan Dutko, director of system preparedness, shows the inside of a portable have to be all deep. We can lieves that one of the most to set up and do this withhospital that was used for a mock drill at the Carlisle Area Regional Medical Center. use the anterooms to make important parts of the drill out a problem.â&#x20AC;?

Clinic â&#x20AC;˘ Continued from I6 room when their family physicians are unavailable for a week. To get treated at a MinuteClinic, all a patient needs to do is go to one of the participating CVS stores, find the clinic and go the electronic kiosk where patients can sign up for treatment. There, they can list their name (which will only show up as first name and last initial) and answer a few questions about what they need from the clinic - whether that means an exam, a vaccination, a screening or counseling. The nurse practitioner will then be able to use that information to get Photo illustration everything ready before The process of seeing a patient at the MinuteClinic calling in the patient. Assuming thereâ&#x20AC;&#x2122;s no waitusually doesnâ&#x20AC;&#x2122;t take any longer than 15 minutes. ing list, Spencer added, the process of seeing someone usually doesnâ&#x20AC;&#x2122;t take any longer than 15 minutes. The setup seems to work for a lot of people, according to Sandy Leathery, a nurse The MinuteClinics lo- including those for acne, practitioner at the Hampcated within the walls of chicken pox/shingles, lice, den Township location. the Hampden Township ringworm, poison ivy/oak â&#x20AC;&#x153;I go out and tell people and Harrisburg CVS stores and cold sores about this, and I hear a lot offer treatment for a variâ&#x20AC;˘ Wellness and physical of people say â&#x20AC;&#x2DC;Thatâ&#x20AC;&#x2122;s exactly ety of minor cases to help exams, including asthma, what I need,â&#x20AC;&#x2122;â&#x20AC;? she said. â&#x20AC;&#x153;Pewith some of the patient blood pressure, cholesriodically a parent will be backlog that primary care terol and diabetes/glucose called by the school nurse providers face. screenings; college and to pick up their child from Among some of those sports physicals; and ear school, and they want to go services are: wax removal, weight evalsee a doctor, but canâ&#x20AC;&#x2122;t get an â&#x20AC;˘ Minor illness exams, uation, pregnancy evaluappointment in. There are a including those for aller- ation and smoking cessalot of moms who donâ&#x20AC;&#x2122;t know gies, ear infection, flu, uri- tion what to do with their sick nary tract infection, pink â&#x20AC;˘ Vaccinations, includchild (in that case). They eye and mononucleosis ing those for the flu, hepacanâ&#x20AC;&#x2122;t get in to see a doctor, â&#x20AC;˘ Minor injury exams, titis A and B, DTaP, HPV, but they donâ&#x20AC;&#x2122;t want to go to including those for minor meningitis, pneumonia, the emergency room either.â&#x20AC;? burns and cuts, sprains, MMR and tetanus. The staff at the Minutesuture/staple removal, For a full list of services Clinics are trained to evalblisters, bug bites/stings that MinuteClinic prouate colds - and separate and splinter removal vides, visit its website at them from allergies - and â&#x20AC;˘ Skin condition exams, provide doctorâ&#x20AC;&#x2122;s notes as well as prescriptions. If

MinuteClinic services

there isnâ&#x20AC;&#x2122;t much of a wait, the staff can also help the patient look at the different types of over-the-counter medication at CVS and tell them what will work for them. Where the patient buys the medication or fills the prescription will be up to the individual, Spencer noted. Though the Hampden Township location is next to Patient First, which handles both urgent and primary

care, Spencer and Leathery added that urgent care and emergency rooms are the only ones that handle more severe cases, like broken bones, or treatment that requires testing through blood draws - MinuteClinic does not have a lab.

Because they donâ&#x20AC;&#x2122;t need to pay for upkeep on X-ray machines or laboratories, however, that means the prices can be lower, and MinuteClinic shares all of its pricing on the electronic kiosk and on its website at www.

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Health & Recreation

I8 — The Sentinel at

Sunday • February 26, 2012


Device helps treat obesity The result of the lap-band is similar to gastric bypass surgery, where those who receive the device can only eat a limited amount. ■

By Naomi Creason Sentinel reporter

Before 2000, the main way bariatric surgeons treated obesity was gastric bypass, an invasive procedure that was quick to help the patient but required plenty of recuperation. In 2001, however, the FDA approved use of the gastric lap-band, a less-invasive option to treat obesity. The FDA expanded the use of the lap-band in February, something that Dr. Luciano DiMarco thinks will prove useful given the rising number of obese patients. “There really is an obesity problem right now,” said DiMarco, medical director at PinnacleHealth Bariatric Surgery. “The numbers are staggering throughout the country and the world. Pediatric obesity rates have nearly tripled over the past decade. There are more and more children heading toward obesity issues, there’s no question about it. For now, all we can offer is prevention and diet. We can get more aggressive with surgery. It requires a cul-

Gastric bypass surgery

tural change. It’s going to get worse before it gets better. “Obesity is a twofold problem,” he added. “There’s the problem that you get from genetics. You see a mom and a dad who are obese, so the child is usually obese, too. The second problem is that all families eat way too much food. I think people are eating twice as much as what they should be eating. If you have the genetic predisposition and you live in today’s society, that’s when obesity comes in.” Though DiMarco has seen an increase in the number of patients, he’s also seen the lap-band work to dramatically decrease the patients’ weight. “I have 500-pound patients who have lost a lot of weight with the band,” DiMarco said. “The vast majority of people are up to 100 pounds over their body weight category. They will definitely lose the weight necessary. Those are by far the best candidates.”

band is placed at the top part of the stomach, and the balloon is inflated to restrict how much food can fit in the stomach. The result is similar to gastric bypass surgery, where those who receive the lap-band can only eat about a half cup, or four ounces, of food per meal. “There are a lot of advantages of the band,” DiMarco said. “They feel full more often and with small amounts. The half-cup of food is a lifelong process. It curbs the volume of how much they eat, not what they eat.” DiMarco estimated a person with a lap-band could ingest the amount of food you could fit in your hand. Though the surgery involves cutting back significantly on food intake, dieticians would help patients choose the foods they should be eating, and not opting to eat four ounces of potato chips. Because there is a change with the diet and with a person’s eating habits, one of the top requirements to How it works receive the band is to prove The lap-band is a device that a patient is willing to involving a ring and an in- make the necessary sacriflatable balloon. The lap- fices to change.

While the lap-band will help provide a permanent surgical method for weight loss, gastric bypass surgery is also an option, especially when a result is needed more quickly. The lap-band is a device that restricts how much food the stomach can take. It is a permanent device that will remain in the patient’s body, though the inflatable balloon could be loosened should the patient ever wish to not have the restriction. Gastric bypass is a much more permanent surgery with a similar goal - restricting how much food a person can eat before feeling full. In gastric bypass surgery, surgeons make the stomach a smaller size and then realign the system so that food would bypass the first part of the intestines. “It’s a much stronger surgery,” said PinnacleHealth Bariatric Surgery medical director Dr. Luciano DiMarco. “The bypass is faster and much more aggressive.” The surgery is an option for those in need of a faster weight loss, especially

“When a patient comes in, the dietician works with them, and we’ll talk with them for about six months before we even get to surgery,” DiMarco said. “We want to make sure this is what they want. They can’t make a decision willy nilly. Otherwise, it’s just a waste of time. We put the band in anybody that can show

those suffering from diabetes. The surgery, however, is much more invasive than the lap-band option. “With the band, it’s offered as an outpatient procedure,” DiMarco said. “You’re out within eight to 10 hours of the operation. If the surgery is held later in the day, they can stay overnight. They can be back to work in three to five days. For gastric bypass, they can be in the hospital for two to three days and return to work in two to three weeks.” The bypass also requires more followup from dieticians. Because food bypasses parts of the stomach and intestines, the nutrients from the food aren’t absorbed. Patients who undergo the bypass must take certain vitamins to make up for the lack of nutrients most people would absorb from food. Another surgical option is a combination of the lap-band and bypass - the sleeve gastrectomy - which would surgically reduce the size of the stomach while also implanting a band so patients can still absorb food properly.

the effort and ability to lose weight. They have to show us this is what they want. It’s a pretty rigorous diet program. We want to make sure patients are really interested in it. Beyond that, the band will work on anybody.” According to Allergan, which makes the lap-band system, the FDA approved the expanded use of the de-

vice to adults with obesity who have failed weight-reduction options - such as diet, exercise and medicine - and have a BMI of 30 to 40 as well as at least one obesity-related comorbid condition, such as diabetes. Allergan’s release indicated that about 37 million Americans fit that description.

Cumberland County


Robotic system Radon levels offers option for high in county tumor removal The CyberKnife system is a noninvasive alternative to surgery. ■

By Naomi Creason Sentinel reporter

When it comes to removing a tumor, surgery is usually the first option that is presented. While that option is the most common and can be effective, there are patients for whom surgery is a dangerous alternative. Tumors can be located in areas that are too critical to treat with surgery or external beam radiation therapy because of how invasive the procedures are. Surgery may be unable to reach areas near the spi-

nal cord, optic nerve or some parts of the brain without putting those critical areas in danger, and external radiation may do too much damage for those with small tumors near important tissue that could easily be destroyed by radiation. An answer to that is the CyberKnife Robotic Radiosurgery System. The CyberKnife system is a non-invasive alternative to surgery for treatment of both cancerous and noncancerous tumors anywhere in the body, including the prostate, lung, brain, spine, liver, pancreas and kidney. The robotic system can treat a tumor with radiation with 1.2 millimeter precision, targeting the tumor alone and sparing the surrounding

• See Robotic, I9

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Sentinel Reporter

There are a number of concerns when buying or owning a home, but the Department of Environmental Protection is hoping homeowners pay attention to a specific odorless and radioactive gas - radon. Bob Lewis, the program manager for DEP’s Radon Division, finds that most people don’t really think of radon, even though Pennsylvania residents should worry about the levels in their home. “Pennsylvania could be one of the worst states in the country,” Lewis said. “There’s a handful of states that show high levels of ra-

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• See Radon, I10

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don, and we’re up there. I think about 49 of the 67 counties in the state are EPA zoned 1 counties. It’s just a characteristic of our geography. It’s easy for gas to migrate through the ground.” The Environmental Protection Agency splits the country into three zones of radon levels, with Zone 1 being the highest and Zone 3 having the lowest levels. Pennsylvania just happens to find itself in a Zone 1 hotspot, where levels of radon are most often above the acceptable limit. Though not all of Pennsylvania is Zone 1, the entire Sentinel file photo region of Central PennsylJim Hetrick, owner of Hetrick Constriction and vania is.

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The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; I9

Robotic â&#x20AC;˘ Continued from I8

Procedure may cut treatment time for prostate cancer

healthy tissue. The system can also adjust treatment and take into account a patientâ&#x20AC;&#x2122;s breathing pattern and movement. According to PinnacleHealth Department of Radiation Oncology Director Dr. Brij Sood, CyberKnife provides a number of benefits for patients seeking cancer treatment, including a lower overall dose of radiation. â&#x20AC;&#x153;The patient does this as an outpatient process,â&#x20AC;? Sood said. â&#x20AC;&#x153;They come in, and they go home. The treatment targets the small tumor, so only a small amount of radiation hits anywhere else on the body. The side effects during the treatment, immediately after the treatment and months down the road are even less than external beam radiation therapy.â&#x20AC;?

New cancer center The CyberKnife system is one of the new pieces of technology being used at the PinnacleHealthFox Chase Regional Cancer Center, which opened

â&#x20AC;˘ See Robotic, I10

Submitted photo

The CyberKnife Robotic Radiosurgery System can treat cancerous and non-cancerous tumors.

It was a given in the medical community that large doses of radiation were to be avoided. However, a new study may open up a treatment that increases the radiation while decreasing the number of days a patient is in treatment. Prostate cancer is surrounded by plenty of questions about whether or not treatment is worthwhile for patients. With side effects, such as urinary problems and rectal pain and bleeding, that greatly reduce the quality of life for patients, researchers have looked at ways to make treatment more efficient while lessening the side effects. More than a decade ago, the search for better technology resulted in the intensity-modulated radiation therapy (IMRT), a technique that uses multiple beams of varying intensities to radiate tumors while minimizing exposure to nearby healthy tissue. Recently, Fox Chase Cancer Center released results of a study of two groups of prostate cancer patients treated with IMRT. One group received conventional IMRT, and the other was treated with hypofractionated IMRT, which delivers a higher total dose of radiation in fewer

sessions. The results indicated that there was no change in side effects or quality of life between the two groups of men. â&#x20AC;&#x153;The question was, can we do better by reducing the total time and increasing the daily dose,â&#x20AC;? said Dr. Brij Sood, director of the department of radiation oncology at PinnacleHealth. â&#x20AC;&#x153;The process reduces (the treatment days) from 38 fractions to 25 fractions and increases the dosage by 30 percent. Instead of 2 gray, itâ&#x20AC;&#x2122;s 2.7 gray, and it cuts down on the total time period from 9 to 5 weeks.â&#x20AC;? Generally, being in treatment for any shorter period of time is a benefit to the patient, so the fact that the high-dosage IMRT seemed to provide no change over a low-dosage IMRT on a longer schedule is a positive. Though there is still more followup and a larger study required to see if there is a real benefit for prostate cancer patients with hypofractionated IMRT, itâ&#x20AC;&#x2122;s a needed push to start more research on the matter. â&#x20AC;&#x153;The first study is to show that it does no harm at a period of 2 to 3 years,â&#x20AC;? Sood said. â&#x20AC;&#x153;We need larger data (and see if the results are the same).â&#x20AC;?

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I10 â&#x20AC;&#x201D; The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012

Robotic â&#x20AC;˘ Continued from I9 last year. Along with CyberKnife, the center will also offer state-of-theart treatment with Trilogy with RapidArc Radiotherapy and High-Dose Brachytherapy. Having the technology to

do procedures is only one half of why the PinnacleHealth staff are excited to open the new facility. The cancer center team will also get some help from the Fox Chase Center, which has been using CyberKnife for a year, and be able to coordinate patient care.

â&#x20AC;&#x153;We can have cancer conferences in conjunction with Fox Chase,â&#x20AC;? said Sood, who will be the director of the new center. â&#x20AC;&#x153;Patients donâ&#x20AC;&#x2122;t have to go to Fox Chase (in Philadelphia) to get treatment. Weâ&#x20AC;&#x2122;ll be capable of providing treatment and research trials, and if we need

information, we can get answers directly from Fox Chase.â&#x20AC;? The new facility is on the campus of PinnacleHealthâ&#x20AC;&#x2122;s Community General Hospital on Londonderry Road in Harrisburg. The cancer center is actually attached to the hospital, so patients

can receive all their care and treatment at one of the two buildings. According to Betsy Kopp, director of cancer services and research at PinnacleHealth, the cancer center includes an outpatient diagnostic area, a treatment area and administrative

offices. The facility also houses various physicians, including radiation oncologists, the radiology team and the staff at the Breast Care Center. Infusion procedures also are done at the new facility, which will include blood infusions and chemotherapy.

effect on a residentâ&#x20AC;&#x2122;s body. Radon is the second leading cause of lung cancer, and the leading cause in non-smokers. Radon is expected to be the cause of 20,000 lung cancer deaths every year, according to the DEP. â&#x20AC;&#x153;Radon affects the lungs,â&#x20AC;? Lewis said. â&#x20AC;&#x153;Because itâ&#x20AC;&#x2122;s a gas, you breathe it in. The particles lodge on the lining tissue in the tracheal/bronchial part of the lung, and those particles are radioactive. It gives off radioactive emissions in the lung, which affects the DNA.â&#x20AC;? There isnâ&#x20AC;&#x2122;t a set exposure level of radon that means all residents will get lung cancer. Those who smoke

are much more likely to get lung cancer when being additionally exposed to radon, while it could be hit-andmiss for non-smokers who live in homes with high levels of radon, especially depending on how long a person has lived in that home. Jim Hetrick, however, doesnâ&#x20AC;&#x2122;t believe in leaving that up to chance. Hetrick owns Hetrick Construction and HomeSafe Radon based out of East Pennsboro Township, and for more than a decade, he has tested and installed radon mitigation systems to help keep the levels down in homes. The EPA suggests action be taken if lev-

els reach 4, but Hetrick has seen much higher numbers in area houses. â&#x20AC;&#x153;In one home we started out at 175,â&#x20AC;? Hetrick said. â&#x20AC;&#x153;175 is unusual. I have gone into homes where theyâ&#x20AC;&#x2122;ve said they tested it and the radon levels were 300, but the highest one Iâ&#x20AC;&#x2122;ve mitigated was 175. Generally speaking, 20 is about average.â&#x20AC;? Twenty, however, is five times too high for the safe level of radon suggested by the EPA - a number that some argue should be lowPhoto courtesy of EPA er. According to the EPA, of Most of Pennsylvania is in Zone 1, depicted in red, 1,000 residents in a home

Radon â&#x20AC;˘ Continued from I8 Itâ&#x20AC;&#x2122;s a statistic that requires some work on the part of homeowners if they want to avoid being at risk for lung cancer.

Radon Radon is a gas that rises from the soil. Outside, radon levels are low - .3 - so no one really has to worry about the risk being outside. However, radon can build up in enclosed spaces, such as homes, and increase the level of indoor radon to dangerous levels. When there is an overabundance of radon in the air, it can have an adverse

which is the highest level of radon in EPAâ&#x20AC;&#x2122;s zoning. The orange areas are Zone 2, and Philadelphia is in yellow as the only county in the state in Zone 3.

â&#x20AC;˘ See Radon, I11

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Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; I11

Radon â&#x20AC;˘ Continued from I10 with radon at 20 pCi/L (picocuries per liter), about 260 smokers will get lung cancer and about 36 non-smokers will get lung cancer. While those numbers can be frightening, they can be fixed. And for homebuyers in Cumberland County, Hetrick noted that the high numbers shouldnâ&#x20AC;&#x2122;t scare them away. The numbers can always be lowered to safer levels, sometimes more easily than the homes with low numbers to start. â&#x20AC;&#x153;The levels primarily drop down into one or below in most cases,â&#x20AC;? Hetrick said. â&#x20AC;&#x153;It really doesnâ&#x20AC;&#x2122;t depend on what level you start out at. In one home, we started out at 175 and got it all the way down to .3. There are areas with more clay and tighter soil where there are lower concentrations of radon. Itâ&#x20AC;&#x2122;s not only hard for us to dig through but itâ&#x20AC;&#x2122;s hard for radon to get through. But itâ&#x20AC;&#x2122;s

also hard to get from 7 down back to 4. While itâ&#x20AC;&#x2122;s easier for radon to get through shale-y ground, itâ&#x20AC;&#x2122;s also much easier to pull it down from 175 to below one. I wouldnâ&#x20AC;&#x2122;t let the area affect homebuyers.â&#x20AC;? Hetrick himself lives in East Pennsboro Township near Wertzville Road, and that area is prone to higher levels of radon because of the shale in the ground. Hetrickâ&#x20AC;&#x2122;s work was enough to convince his neighbor Scott Arentz to test his house for radon. â&#x20AC;&#x153;It was just scary,â&#x20AC;? Arentz said. â&#x20AC;&#x153;It was several times above the normal level - on what would be the acceptable limit. I think it was around 70. It was very high.â&#x20AC;? Arentz, his wife and three children had lived there for five years before they tested it, and he was set on making sure he did something about lowering that number. â&#x20AC;&#x153; G e t t i n g t h e sys te m wasnâ&#x20AC;&#x2122;t even a question,â&#x20AC;? he said. â&#x20AC;&#x153;Why would I not do that as a parent?â&#x20AC;?

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Hetrick installed the mitigation system for his neighbor three to four years ago, and since then, all Arentz has had to do was periodic radon testing to make sure everything is working properly. â&#x20AC;&#x153;There really isnâ&#x20AC;&#x2122;t much to do once itâ&#x20AC;&#x2122;s in,â&#x20AC;? Arentz said. â&#x20AC;&#x153;It has an easy identification light to make sure itâ&#x20AC;&#x2122;s working. I donâ&#x20AC;&#x2122;t think anyone would even know where it was unless you pointed it out.â&#x20AC;?

Mitigation system Arentzâ&#x20AC;&#x2122;s mitigation system is located in his basement, where a pipe is placed in the ground and snaked to the outside. Itâ&#x20AC;&#x2122;s a common system for those installing radon mitigation systems into existing houses. â&#x20AC;&#x153;Most of the jobs we do in the area are called sub-slap depressurization systems,â&#x20AC;? Hetrick said. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;re basically drilling a hole through the concrete floor and removing five gallons of material - stone and dirt. That

gives us a pocket where we will force air out of from under the slab. We pipe it to a fan, which can be outside of the home or in an attic crawlspace or above the garage. It vents the air out or at least away from the windows if the fan is outside. Radon is a noble gas, so once it gets outside it will keep rising, much like helium.â&#x20AC;? Also important to the mitigation system is the balance of pressure and suction to make sure the radon lingering in the basement moves its way out of the house. â&#x20AC;&#x153;When we pull air out of the slab, it creates low pressure under the slab,â&#x20AC;? Hetrick said. â&#x20AC;&#x153;It has to be sealed in, otherwise it ends up pulling air from the basement. We want to get it from under the slab and not the basement air. It causes a high pressure in the basement. Itâ&#x20AC;&#x2122;s a natural barrier of pressure holding back any air trying to come up. Without suction on the slab, the radon will find a way through a little crack.â&#x20AC;?

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Either system is rather low-maintenance, according to Hetrick, and fans are guaranteed for five years and often last 10 to 15 years. A gauge on the tubing will tell homeowners when suction is low and when the fan should be changed. In Lewisâ&#x20AC;&#x2122; mind, itâ&#x20AC;&#x2122;s not a lot of work for an important prevention measure. â&#x20AC;&#x153;The best possible thing you can do is test your house,â&#x20AC;? he said. â&#x20AC;&#x153;People donâ&#x20AC;&#x2122;t realize they could test for it. Iâ&#x20AC;&#x2122;ve been doing this for 25 years, and that seems to be the biggest misconception.â&#x20AC;?

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Hetrick noted that the mitigation system works best when there is crushed stone under the basement floor, which often is the case in new homes given that some municipalities require that in new home construction. Since Hetrick is also in home construction himself, he also works with installing a passive system, which can be installed during the build. It does much of the same as a depressurization system but can be hidden behind insulation and dry wall since it will be installed during construction.


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Health & Rec • February 26, 2012 • Section J

Annual Report MEETING THE CHALLENGE 2012 • Part five in a five-day series • Cumberland County

Anniversary preparation

Area expects surge of Civil War tourists for 150th year Estimates are that about 4 million will travel to Gettysburg and Adams County in 2013. ■

By Joseph Cress Sentinel Reporter

Cumberland County is already digging in for the next big invasion of historic proportions. Early estimates are that about 4 million people from across the country and around the world will visit Gettysburg and Adams County sometime during 2013, said Shireen Farr, director of tourism at the Cumberland Valley Visitors Bureau in Carlisle. That is 1 million more visitors than the typical year, she explained, with

the highest concentration anticipated for late June or early July 2013 — the 150th anniversary of the Confederate invasion of Pennsylvania and the Battle of Gettysburg. “All eyes in the nation will focus on that event,” said Jack Giblin, director of visitor and education services with the Army Heritage and Education Center. “We are going to support that massive national look at Gettysburg. It is more than their infrastructure can handle.”

County will play a significant role in helping to house this surge of visitors to the region, Farr said. “We will show them where we are in relation to Gettysburg and provide them with information on other activities that might extend their stay,” she said. The expectation is that the majority of visitors will be coming from within a fivehour drive of Adams County, Farr said. Work has begun to identify attractions in Cumberland County that could be bundled into Civil Preparing for the surge War-themed tour packages. While there are plans the With more than 4,400 hotel rooms, Cumberland next two years to expand the

Sentinel file photo

Union bugler Alan Tolbert, 13, of Shippensburg sounds off a call during a skirmish on West King Street in downtown Shippensburg during the March to Destiny event in 2011. annual March to Destiny event in Shippensburg, there is no effort within the county to stage any other major Civil War event to coincide with the 150th anniversary of the invasion or the battle, Farr said. “Part of our challenge is there is a limited community of reenactors and they are all going to be busy,” Farr said. “Everybody is fighting for quality talent to carry out these events. Our community organizations are all-volunteer with limited resources.” Farr and Giblin serve as co-chairs of the Cumberland County Civil War 150 committee. While major

“We are going to support that massive national look at Gettysburg.” jack giblin

director of visitor and education services, army heritage and education center

events are out for 2013, there Side attractions are minor events planned D i c k i n so n Co l l e ge i s for Cumberland County, working with AHEC and the including an ongoing Civil Cumberland County HisWar exhibit at AHEC and an torical Society to present exhibit planned for Dickin• See Civil War, J2 son College’s Trout Gallery.

Cumberland County

Expansion planned for Appalachian Trail Museum Sentinel file photo

Gary Chiodo of Village Restorations and Consultating cleans up after replacing timber in the World War I trench exhibit.

Middlesex Township

AHEC plans permanent soldier exhibit

Foundation plans upgrades to campus infrastructure including a special event courtyard and plaza. ■

By Joseph Cress Sentinel Reporter

What began as a concept 10 years ago has transformed an empty field in Middlesex Township into a salute to soldiers past and present and an emerging tourism draw. As the Army Heritage and Education Center enters its second decade, plans are in the works to develop a permanent exhibit for the public to experience how being a soldier has evolved over time, said Jack Giblin, director of visitor and education services. “It will be an holistic view of the Army through the

eyes of the soldier,” Giblin said. Each person coming in will receive a dog tag card they can swipe at different readers throughout the exhibit to get information about their soldier, he explained. The idea is to put a human face to how the Army has changed from the SpanishAmerican War to current operations. “They will meet their soldier in the end,” Giblin said. Set to open around Veterans Day, this exhibit will be located in the gallery of the Visitors and Education Center on the

• See AHEC, J3

Local officials outline changes in outdoor facilities. ■

By Joseph Cress Sentinel Reporter

The Appalachian Trail Museum Society is looking to expand the exhibit space of what may be the only museum in the United States dedicated to hiking. Society members are hoping to convert the second floor of a restored 200-year-old mill into a combination display and research area, said Jason Zimmerman, manager of Pine Grove Furnace State Park, where the museum is located. “The plans are still in development,” Zimmerman added. “They do have the funding through grants. They need permit approvals through the Department of Labor and Industry.” Society members also want to renovate the mill basement into a children’s learning area sometime this year. About 15,000 people have gone through the museum since it first opened in early June 2010, Zimmerman said. “All the staffing is done by volunteers,” he noted. Located across the road from the Pine Grove General Store, the museum is just two miles from the midway point of the 2,179-mile trail that connects 14 states from Maine to Georgia. With displays honoring trail pioneers and early thru-hikers, the museum touches on the founding, construction, preservation, maintenance, protection and enjoyment of the Appalachian Trail.

Sentinel file photo

The Appalachian Trail Museum Society plans to expand the museum’s exhibit space.

parking areas along with a network of hiking trails and foot bridges to link the new acquisition with already developed center property. Kings Gap Much of the labor will be done through volunteers, Meanwhile, the Kings Gap Environmental Education Hackenburg said. Center in Dickinson Township is facing its own expansion. Rails-to-Trails Last year, the center acquired 1,077 acres in nearby Penn and Cooke townships, effectively doubling the size of the Sometime this year, the Cumberland Valley Rails-tocenter grounds, Manager Scott Hackenburg said. This ac- Trails Council hopes to hire an engineering firm to conquisition restores much of the original estate of James Mc- duct a master plan study on 10 miles of PPL right-of-way Cormick Cameron, a member of the politically prominent that the all-volunteer organization acquired last DecemCameron family from Harrisburg. ber, said Jim Mader, council board member. The plan over the next three to five years is to phase in “Nobody is going to see anything for a year or two. We a project to improve accessibility into the interior of this hope to turn the new section into as much trail as we can,” tract — parts of which have been untouched by man for he said. 100 years, Hackenburg said. Council members plan to work around sections where “You can get to the edge of it, but to really truly see it, you have to get out and walk,” he explained. The project will include the construction of two gravel • See Outdoors, J4

J2 â&#x20AC;&#x201D; The Sentinel at


Civil War

Sentinel file photos

Left, top: Onlookers cheer as the Union army passes by during a parade on West King Street in downtown Shippensburg during the March to Destiny event in 2011.

â&#x20AC;˘ Continued from J1 an exhibit of more than 100 Civil War-era pencil drawings from the Becker Collection scheduled for June to October 2013, said Philip Earenfight, gallery director and an associate professor of art and art history. The images depict scenes of period encampments, soldiers and battles spanning the whole geography and time line of the war, Earenfight said. â&#x20AC;&#x153;We are hoping they add a dimension to our understanding of the conflict,â&#x20AC;? he said. The drawings were used as a basis for making engravings that were published in Civil War-era newspapers, he said. The collection is organized by McMullen Museum and is underwritten by Boston College. Five years ago, Dickinson College launched its House Divided research engine, de-

â&#x20AC;&#x153;We are hoping they (Civil War-era pencil drawings) add a dimension to our understanding of the conflict.â&#x20AC;?

Left, bottom: Carolyn Luttrell, right, of Wilmington, Del., describes different types of food during the Civil War at the McLean House.


signed to help school teachers bring the era to life using the latest technology, said Mark Pinsker, an associate professor of history and Pohanka Chair in American Civil War History. â&#x20AC;&#x153;We are trying to teach students how to do deeper and better research using firsthand accounts,â&#x20AC;? said Pinsker, adding that the engine has links to letters, newspapers, journal entries and diaries. â&#x20AC;&#x153;We have over 10,000 public domain im-

ages from the period.â&#x20AC;? With more than 1 million pages views to date, the outreach effort has trained more than 2,500 teachers in 49 states. Dickinson College is also working to create a platform for students and teachers to contribute material to the research engine. â&#x20AC;&#x153;Our goal is to complete it by the end of the Civil War anniversary and then to keep it alive and sustain it,â&#x20AC;? Pinsker said. â&#x20AC;&#x153;It is still a work in progress.â&#x20AC;?

Above: Reenactor Rich Adams of Camp Hill rides his horse Ginger during a skirmish on West King Street in Shippensburg. Right: Emily Pickering, left of West River, Md., and Sharon Rohrbaugh, right, of Chambersburg look over Civil War recipes.

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Health & Recreation

The Sentinel at

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; J3

AHEC â&#x20AC;˘ Continued from J1 AHEC campus at 950 Soldiers Drive. It will include an electronic rifle range, a parachute drop simulation and a night attack on a bunker during the Korean War.

Campus upgrades Meanwhile, construction could begin in April on infrastructure improvements to help support current needs and future expansions, said Mike Perry, executive director of the Army Heritage Center Foundation. The foundation has about $1.1 million in state grant money and donations left over from the construction of VEC phase one, Perry said. The plan is to use this money for storm water drainage upgrades and a new parking lot and to construct both a special event courtyard between Ridgway Hall and VEC and an event plaza and commemorative walkway along the Army Heritage Trail. The annual membership dinner is set for Sept. 14, during which the foundation will honor an individual or organization instrumental in the development of AHEC with an award named after Maj. Gen. John Armstrong Sr., a visionary, soldier and statesman, Perry said. On Oct. 11, 2001, then Secretary of the Army Thomas E. White Jr. announced in a letter that the Military History Institute at Carlisle Barracks would be developed into AHEC. This letter

Sentinel file photos

Above: Jonathan Groman of Village Restorations and Consulting cleans up after replacing timber in the World War I trench exhibit. Right: Gary Chiodo, left, and Aaron McConnell of Village Restorations and Consultating clean up. served as a catalyst to generate local interest and to form a public/private partnership to develop land Cumberland County had donated in Middlesex Township.

Ongoing development In September 2004, Ridgway Hall became the first AHEC building to open to the public. A state-of-theart archives and library, it serves as the new home of MHI, which had moved its holdings from Upton Hall on post. Last May, AHEC opened phase one of the Visitor and Education Center, which includes two multi-purpose rooms, a small kitchen, a museum store and of-

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fice space for both AHEC and foundation staff. The 37,000-square-foot, $12 million building also includes the first exhibit gallery of a future Army Heritage Center. This past September, AHCF staff launched a campaign to raise $10 million for phase two of VEC, with the goal of starting construction by mid-2013. Phase two will consist of about 37,000 square feet and include additional exhibit space and multi-purpose rooms along with a larger kitchen for ca-


tered events. Construction was completed last fall on a conservation facility on the AHEC campus. This building is strictly off limits to the public and will go operational in late spring or early summer, when all 50,000 artifacts housed in a temporary storage building are transferred to the new facility. AHEC campus also includes the Army Heritage Trail featuring outdoor exhibits from various periods of Army history.


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Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012

Outdoors â&#x20AC;˘ Continued from J1 private land owners are resisting having a proposed t ra i l f ro m New v i l l e to Carlisle run by their property, Mader said. â&#x20AC;&#x153;As we go forward, we are going to talk to them,â&#x20AC;? he said. In the short term, the council plans to install along the Shippensburgto-Newville section of trail a series of 13 educational signs that focus on the agricultural history of the valley and of the use of the Cumberland Valley Railroad during the Civil War, Mader said. This was funded by $9,000 in grant money from the South Mountain Partnership and the Cumberland Valley Visitors Bureau. The partnership also donated money for trail counters to be put up at certain locations. One of the first questions would-be donors ask is how many people use the trail, Mader said. â&#x20AC;&#x153;The counting devices will get us from guessing to harder numbers,â&#x20AC;? he said.

State projects Meanwhile, state parks and forests within Cumberland County are doing what they can to expand programs and build new infrastructure in the midst of tight budget constraints. At Colonel Denning State Park, the hope this spring or summer is to open brandnew orienteering courses â&#x20AC;&#x201D; one for beginners and one for those of immediate skill level, Park Manager Ryan Donovan said. In orienteering, enthu-

siasts use a map and compass to find points along a course. Professional-level orienteers often participate in timed events to challenge their skills and compete with others. Members of the Susquehanna Orienteering Club are working to plot new courses to replace the existing antiquated course at Colonel Denning. Donovan added the park is planning a summer concert series on the second Saturday of each month from June to August. At Michaux State Forest, District Forester Roy Brubaker said, the hope this year is to reopen two segments of the ATV trail. One segment had to be rerouted to offer more of a buffer between the vehicles and ecologically sensitive seasonal ponds where protected species of amphibians breed. The other segment is a highly eroded section of what is called the Log Sled, which is in need of repair, Brubaker said. â&#x20AC;&#x153;We are hoping to get the grant money. We donâ&#x20AC;&#x2122;t have a time line,â&#x20AC;? he said. For the second year in a row, Michaux State Forest will offer hunters and outdoor enthusiasts a habitat tour sometime in the fall. The purpose of the tour is to brief the public on some of the land management decisions that go into maintaining the forest and its ecology. Volunteers at Pine Grove Furnace State Park will focus much of their attention this year on the removal of invasive plant species that are choking land along parts

Sentinel file photo

Jason Zimmerman, Pine Grove Furnance State Park manager, holds the National Gold Medal Award for excellence in the field of park and recreation management. of the Appalachian Trail and in the historical areas of the park, Manager Jason Zimmerman said. This year, the state park is working closely with the Cumberland County Historical Society to present a

series of special events designed to celebrate the role the Pine Grove Furnace area has played in local history. This series will include a special family day at the park on May 20 featuring Noel Potter, a retired pro-

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Health & Recreation

The Sentinel at

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; J5

Submitted photo

The Fort McHenry Guard Fife and Drum Corps marches at Army Heritage Days at AHEC in 2010.


Area to celebrate bicentennial War of 1812 events to include appearance by Dolley Madison Much of the focus will be in Baltimore and the New York-Canadian border, where major combat took place. â&#x2013;

By Joseph Cress Sentinel Reporter

James and Dolley Madison were a portrait of stark contrasts. While the president was an introvert and scholar, the first lady thrived as a flamboyant socialite skilled in the art of politicking. Under her influence, the White House became a place of regal splendor as the executive mansion of a chief of state. It was also the scene of that glorious moment when Dolley insisted on staying behind just as British troops were about to torch the nationâ&#x20AC;&#x2122;s capital. She wanted to make sure the famous painting of George Washington by artist Gilbert Stuart had been removed from the mansion wall and taken to safety. Local residents will see that feisty spirit come to life when Cynthia Janzen portrays the first lady at two presentations scheduled for Sept. 28, said John Lyter, president of Historic Carlisle, Inc., a non-profit


Submitted photos

Above: The Baltimore United Volunteers stand at attention during a drill during Army Heritage Days. Right: The Baltimore United Volunteers. organization that promotes Carlisle and Cumberland County history. A living historian with the American Historical Theatre in Philadelphia, Janzen will speak before high school students in the morning, followed by a free community event later in the day at a time and location still to be determined, Lyter said. HCI has a track record of organizing annual events that feature living historians who portray figures from American history. Many times, these presentations are tied to an anniversary observance such as the bicentennial of the start of the War of 1812. To mark the occasion, HCI decided to bring in Janzen to portray the wife of the man who was president during


the course of a war few people recall. This May, the Army Heritage and Education Center outside Carlisle plans to focus part of its annual Army Heritage Day on the War of 1812, said Jack Giblin, director of visitor and education services. â&#x20AC;&#x153;We are bringing in some high-level speakers.â&#x20AC;?

Emphasis elsewhere

Much of the focus for events is on Fort McHenry in Baltimore and along the New York-Canadian border, where major combat took place. Maryland is organizing the biggest commemoration in the U.S., the Wall Street Journal reported earlier this month, including a paLocal tie rade of Navy and tall ships For local residents, the in June and events around the British bombardment biggest tie-in to the War of

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of Fort McHenry, which inspired â&#x20AC;&#x153;The Star-Spangled Banner.â&#x20AC;? When compared to other conflicts in U.S. history, the War of 1812 is relatively unknown and its bicentennial is being upstaged by the 150th anniversary of the Civil War, which resonates more with the American public, the Journal reported. The newspaper also reported how tight budgets in such key battleground states as New York and Michigan are limiting the ability of organizers to plan events.


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1812 is the Army post. In his 1939 book, â&#x20AC;&#x153;A Military History of Carlisle and Carlisle Barracks,â&#x20AC;? Lt. Col. Thomas Tousey explained how the abandoned post at Carlisle Barracks was reopened shortly after the U.S. declared war on Britain on June 18, 1812. The first garrison was under the command of Lt. Col. George McFeeley, who organized the post into the headquarters of a recruiting district. At one point, an average

of about 100 recruits per week were being clothed, equipped and trained at Carlisle Barracks, Tousey wrote. Old buildings on post that were used to manufacture and store powder and shot during the Revolutionary War were reconditioned for that same purpose during the War of 1812. Many of the tradesmen who worked there during the war with England came back to manufacture ammunition for the U.S. Army.

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J6 â&#x20AC;&#x201D; The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012

Festivals of 2011 April â&#x20AC;˘ Spring Carlisle Collector Car Swap Meet & Corral - a collector and classic car swap meet, car corral and auction, April 25-29, Carlisle



Sentinel file photos

Above: Emily Rose, 4, during the Summerfair Peanut Carnival at LeTort Park in Carlisle. Left: Christina,10, left, and Katrina Bielena prepare for the Summerfair dog walk in Carlisle.

â&#x20AC;˘ Army Heritage Days â&#x20AC;&#x201C; lectures, displays and interpreters highlight the U.S. Armyâ&#x20AC;&#x2122;s Soldiers, both past and present, May 19-20 (9 a.m. to 5 p.m.), Carlisle

â&#x20AC;˘ Carlisle Performance & Style â&#x20AC;&#x201C; motorsports and lifestyle festival in addition to a car show, May 1213, Carlisle â&#x20AC;˘ Carlisle Import & Kit Nationals - classic and high-performance vehicles show, May 18-20, Carlisle

â&#x20AC;˘ Auburn Spring Collector Car Auction, Swap Meet & Car Corral - classic and collector auction, swap meet and car corral, May 31-June 3, Carlisle

â&#x20AC;˘ See Fests, J7

Sentinel file photos

Above: Hunter Slear, 11, participates in the horseshoe toss during the Summerfair Peanut Carnival at LeTort Park in Carlisle. Left: Brandon Noggle, 14, left, and Jonathan Butler,14, center, lead the first annual Summerfair dog walk, on Noble Boulevard in Carlisle.

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study, music and fellowship Sunday School for all ages â&#x20AC;&#x201C; 9:50 a.m. Discipleship classes. Bible study. Choirs for all ages. Handbell choirs. Praise bands. Youth and childrenâ&#x20AC;&#x2122;s ministries.


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The Sentinel at

Health & Recreation

Sunday • February 26, 2012 — J7

Festivals of 2011 Fests June • Carlisle Ford Nationals – all-Ford event, June 1-3, Carlisle • Foundry Day Arts and Crafts Festival - juried arts and crafts in addition to music, food and entertainment, June 2 (9 a.m. to 4 p.m.), Boiling Springs • Jubilee Day - street fair with food, arts, crafts, rides, games and music, June 21 (10 a.m. to 9 p.m.),

Mechanicsburg • Carlisle GM Nationals – event organized by General Motors, June 22-24, Carlisle • March to Destiny - reenactment of the staging area for Confederate troops prior to the Battle of Gettysburg, June 22-24, Shippensburg

• See Fests, J8

Sentinel file photos

Above: Dylan Knisely, 5, receives a gift from Miss Tiki the Clown during the Summerfair Peanut Carnival at LeTort Park in Carlisle. Below: Trentin Walker, 8, tries the ping pong splash during the Summerfair Peanut Carnival.

Sentinel file photo

SSD Mitch looks to his owner for a treat before the start of the first annual Summerfair dog walk on Noble Boulevard in Carlisle.





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J8 â&#x20AC;&#x201D; The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012

Festivals of 2011 Fests June-July

â&#x20AC;˘ Carlisle Summerfair XXXV â&#x20AC;&#x201C; food, vendors and music take to the streets of Carlisle, June 28-July 7, Carlisle

July â&#x20AC;˘ Carlisle Chrysler Nationals â&#x20AC;&#x201C; classic, muscle cars and more from Chrysler, July 6-8, Carlisle â&#x20AC;˘ Carlisle Bike Fest â&#x20AC;&#x201C; premier motorcycle event, July 20-22, Carlisle

â&#x20AC;˘ See Fests, J10

Sentinel file photos

Above: Pete Connolly of New Zealand wipes sweat from his head and neck while visiting the Carlisle Bike Fest at the Carlisle Fairgrounds. Connolly was doing the Route 66 bike tour and was passing through Carlisle. Below: Bikers arrive at the Carlisle Bike Fest.

Sentinel file photos

Above: Jaxson launches off Lawrence Frederick during the Carlisle Bike Fest Frisbee Dog Performances. Below: Two time world champion Frisbee dog Harley Davidson catches a Frisbee during his performance at the Bike Fest.

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Health & Recreation

The Sentinel at

Sentinel file photos

Left: Thirty-three different shades of blue corvettes are displayed inside the front gates of the Carlisle Fairgrounds. Carlisle Blue was unveiled as the 2012 color during the first day of the annual Corvettes at Carlisle. Center: Ralph Mazurkiewicz of Depew, N.Y., at the Corvettes at Carlisle at the Carlisle Fairgrounds. Right: Lanny Kemble of Dillsburg, front, and his friend Mike Kennedy of Enola look over a “barn find” 1957 Corvette during Corvettes at Carlisle.



TV LISTINGS @ Air Quality Updates.

food. movies. entertainment. sports. parenting.

Sunday • February 26, 2012 — J9

Go ahead…

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Player Stats

Nancy Altmeyer 717-385-3907

Mary Lou Comune 717-503-3041

Benjamin Espenshade 717-385-3107

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Tricia Negley Heather Neidlinger Justin Neidlinger 717-226-2875 717-226-2876 717-385-4500

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We’re holding a FREE Real Estate Seminar on Thursday, April 26th. If you’re thinking of buying, selling or renting in the next 6 months, don’t miss being informed about our current market; technology you should use; negotiating; mortgage & appraisal changes, etc. Call Laura at (717)245-2100 for more information or to register.

3UXGHQWLDO+RPHVDOHFRP‡ 8 Brookwood Ave, Suite A, Carlisle, PA 17015

© 2012 BRER Affiliates Inc. An independently owned and operated broker member of BRER Affiliates Inc. Prudential, the Prudential logo and the Rock symbol are registered service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide. Used under license with no other affiliation of Prudential. Equal Housing Opportunity.

J10 â&#x20AC;&#x201D; The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012

Festivals of 2011

Sentinel file photos

Above: Cast members of â&#x20AC;&#x153;All Shook Upâ&#x20AC;&#x2122; dance to Elvis Presleyâ&#x20AC;&#x2122;s â&#x20AC;&#x153;Roustaboutâ&#x20AC;? at the Carlisle Theatre Company during Summerfair. Below: Gregory Athanasatos, center, plays Chad in the Carlisle Theatre Company production of â&#x20AC;&#x153;All Shook Up.â&#x20AC;?

Sentinel file photo

Gregory Athanasatos, center, plays Chad in the Carlisle Theatre Company production of â&#x20AC;&#x153;All Shook Upâ&#x20AC;? that featured Elvis Presley songs as part of the Summerfair series.

Fests August

Aug, 25 (8 a.m. to 4 p.m.), Shippensburg

â&#x20AC;˘ Carlisle Truck Nationals - event celebrating trucks, August-September Aug. 3-5, Carlisle â&#x20AC;˘ Auburn Fall Collector Car Auction, Swap Meet & â&#x20AC;˘ Corvettes at Carlisle - largest Corvette event in the Car Corral - classic car and collector swap meet, aucworld, Aug. 24-26, Carlisle â&#x20AC;˘ Shippensburg Corn Festival - huge street fair with tion and car corral, Aug. 30-Sept. 2, Carlisle food, crafts, entertainment and an antique car show,

â&#x20AC;˘ See Fests, J11

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The Sentinel at

Health & Recreation

Sunday â&#x20AC;˘ February 26, 2012 â&#x20AC;&#x201D; J11

Festivals of 2011 Sentinel file photo

Holly Sites and Ashley Holtry pose with the corn they bought for lunch at the Shippensburg Corn Fest.

Fests September â&#x20AC;˘ M&T Bank Harvest of the Arts Festival â&#x20AC;&#x201C; entertainment, juried and non-juried art and music, Sept. 29 (10 a.m. to 5 p.m.), Carlisle

October â&#x20AC;˘ Fall Carlisle Collector Car Swap Meet & Corral - all-automotive event, Oct. 3-7, Carlisle


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Sentinel file photo

Leiliana Forand was the youngest competitor in the Shippensburg Corn Fest corn eating contest.

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Giselle â&#x20AC;&#x153;The classic of all ballet classics.â&#x20AC;? The New York Times



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Saturday, aPrIL 21 | 1PM & 7PM Sunday, aPrIL 22 | 2PM Whitaker Center for Science and the Arts

tIcketS: 717.214.artS (2787) The Central Pennsylvania Youth Balletâ&#x20AC;&#x2122;s production of the internationally renowned ballet Giselle comes to the Whitaker Center stage! Giselle marks Alan Hinelineâ&#x20AC;&#x2122;s world premiere staging of desire, deception, betrayal and forgiveness from beyond the grave in the story of a young peasant girl cruelly betrayed by a prince disguised as a commoner. Live music by the Central Pennsylvania Symphony.

Photo Š


J12 â&#x20AC;&#x201D; The Sentinel at

e h t A r C t r a f t D e c C o o r

Sundayâ&#x20AC;˘ February 26, 2012

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Beads & Crystals in the Susquehanna Valley We are THE bead store in Central Pennsylvania for seed beads, Miyuki Delicas, and Swarovski crystals. Visit our...

2,000 sq ft showroom featuring over 5,500 items. We also carry a wide variety of Czech Pressed Glass and Fire Polished Beads, Findings, Clasps, Threads, Tools, and Books.

Sign Up For Our Bead Classes!

STOP IN AND MEET OUR FRIENDLY STAFF! or visit us on our website:

Your One Stop Shop for Beads

antiques on hanover street


hours: thursday-saturday 10am-5pm and by appointment

200 S. Spring Garden St. Carlisle, PA 17013

17 n. hanover street, Carlisle, Pa 17013 r


(Castles Commons- Across from GIANT)

(717) 243-5300

American try Craftmanship & t!Artis at its Bes

â&#x20AC;&#x153;Owl & Pussycatâ&#x20AC;&#x2122;s First Dateâ&#x20AC;? by Folk-Art carver Gay Foltz

321 Walnut Street, Boiling Springs 717-258-3256 Wed - Sat 10-6 Sun 12-5

Stop in for tea & shop afterwards.

36 West Pomfret St. $BSMJTMFt XXX$BNFMMJBT4JODPN Ranked

StoP in! TODAY

TOP 5 IN PA in!

Liliâ&#x20AC;&#x2122;s Place Country Market/Cafe Soups â&#x20AC;˘ Sandwiches â&#x20AC;˘ Salads Breads from a local Pennsylvania bakery

Watch for Saturday morning breakfast coming soon!

Eat in or takE out find us on facebook



Mon - Sat 9-5 10 West Pomfret Street, Carlisle

We leave the ordinary to others! Custom Picture Framing Handcrafted Jewelry â&#x20AC;˘ Fine Arts & Prints Unique Cards & Gifts â&#x20AC;˘Flamingo-Wear

r n e r 717-245-0382

30 W. Pomfret Street Carlisle, PA 17013 Hours: Mon.â&#x20AC;&#x201C;Th. 10â&#x20AC;&#x201C;7 â&#x20AC;˘ Fri.â&#x20AC;&#x201C;Sat.10â&#x20AC;&#x201C;8

Enola & Carlisle 717-249-8997 39 W. Pomfret St. Tues. thru Sat. 10 - 5pm Carlisle, PA 17013

One of a kind pieces for t s i t r A Market of every collector

Pomfret Street


C Fine art C Photography C Jewelry C Furniture

and so much more!

960-9201 St. 16 W. Pomfret St Carlisle



30 W. Pomfret Street Carlisle, PA 17013

M-Th 10-7 Fri & Sat 10-8


Annual report 2012  

February 27, 2012