Appalachian Health: Spring 2018

Appalachian Health LIVING WELL WITH ARH

A Lifesaving Screening Kids & Asthma Telemedicine: Keeping Patients Healthier

SPRING 2018 | ISSUE 3

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Chronic Care: Keeping Patients Healthier

THE BEST CARE

CLOSE TO HOME

At Appalachian Regional Healthcare, telemedicine technology is helping patients stay healthier with less travel.

To help make healthcare more accessible to more patients, ARH is building cutting edge telemedicine programs. “Telemedicine is ideal for ARH and for our patients because the communities we serve are spread throughout the mountains of Appalachia and travel can be a challenge,” says Isaac Hallam, ARH’s director of corporate strategy. “Using telemedicine limits, and sometimes eliminates, travel for patients as well as providers.”

Last year, the Mid-Atlantic Telehealth Resource Center honored ARH with the Telehealth Excellence in Service for Rural and/or Medically Underserved Populations award for its Remote Patient Monitoring (see sidebar at right) and Chronic Care Management programs.

This year, ARH continues its commitment to using the latest technology to improve patient health with the launch of a new telehealth service.

In early June, ARH will begin offering patients at the ARH Morgan County Clinic and ARH McDowell Clinic virtual access to specialists from ARH Cardiovascular & Thoracic Associates in Hazard.

“The telemedicine programs are part of an ongoing effort to make healthcare within our service area more convenient and more accessible,” says Hallam. “We envision it as a key component of how we deliver care moving forward.”

ARH’s new telemedicine program puts patients face-to-face—via a computer monitor— with a specialist at another location. That specialist may be an ARH doctor, or one working in partnership with ARH. The program gives patients access to the best medical resources without having to drive hours away from home.

Telemedicine visits are similar to a traditional visit with a doctor in an exam room and are billed as a face-to-face office visit. Clinic staff will show you to an exam room with telemedicine equipment, including a large computer monitor, and connect you to the doctor you are scheduled to see. Clinic staff may remain in the room to facilitate the visit or may leave the room but remain nearby to provide assistance if needed.

ARH will be rolling out the program to 14 clinic locations. The first phase of that rollout focuses on cardiac services, but other specialties will be offered and may include endocrinology, psychology and dermatology.

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ARH’s award-winning Remote Monitoring Program helps patients with chronic conditions such as heart disease, congestive heart failure, COPD, hypertension and diabetes maintain their health and stay out of the hospital. Patients spend a few minutes every day using a set of simple digital tools—a blood pressure monitor and weight scale as well as a blood-glucose meter and pulse oximeter if needed.

The tools are easy to use and intended to become part of a patient’s daily routine, says Isaac Hallam, ARH’s director of corporate strategy.

The readings taken by these tools are sent automatically via Bluetooth to a pod that transmits the data (through internet, cellular phone service or landline phone) to a nurse. If there are any abnormalities, the nurse calls the patient to discuss health, diet and medication. If needed, he or she also contacts the patient's primary care provider. If patients forget to do a reading, the remote monitoring nurse gives them a reminder call, keeping them on track to stay healthy.

FOR MORE INFORMATION ABOUT THE PROGRAM, TALK TO A MEMBER OF YOUR CARE TEAM OR GO TO WWW.ARH.ORG.

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POWER FOOD

THE MIGHTY WATERMELON This juicy giant can quench your thirst, satisfy your sweet tooth and contribute to a healthy diet, too.

Have you ever wondered how much of a watermelon is water? The delectable fruit’s name, it turns out, is no lie— it’s 92 percent water. (By contrast, you’re only about 50 to 65 percent water.) This summertime staple was first harvested nearly 5,000 years ago in Egypt. Today, luckily, you can find it in just about any food store.

in watermelon production. (China’s the runaway champ, and among U.S. states Florida is the leader.) The U.S. was also home to the heaviest watermelon ever, according to the website Guinness World Records. In 2013, Chris Kent of Sevierville, Tennessee, grew a colossal watermelon that weighed in at an incredible 350.5 pounds!

POWER UP

BUY | STORE | SERVE

DID YOU KNOW?

Watermelon is the most consumed melon in the country in terms of weight, and the U.S. ranks fifth among nations

92% water

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30%

daily value of vitamin C

Pick a watermelon that feels solid and heavy for its size. It should have little or nothing in the way of bruising, cuts, dents or other imperfections. But that big yellow spot on the bottom is OK; it’s caused by the sun and shows that the fruit has ripened, or started to ripen.

Believe it or not, watermelons should be washed. The Food and Drug Administration recommends washing watermelon the way you do all fruits and vegetables—whether you plan on peeling it or using the rind. This is so that bacteria and dirt aren’t transferred when you cut it. Store watermelons at around 55° F. Whole melons can stay at room temperature for seven to 10 days, while cut watermelon can be refrigerated for three to four days.

25%

daily value of vitamin A

5th

U.S. rank in production

7-10

days stored uncut at room temperature

Appalachian Regional Healthcare | SPRING 2018

Hydration is watermelon’s best nutritional asset, but the sweet-tasting fruit also provides a healthy dose of vitamins.

A two-cup serving supplies your body with 30 percent of your daily value of vitamin C and 25 percent of vitamin A. It also contains vitamin B6, potassium, magnesium and phosphorus. Eating watermelon is a guilt-free way to satisfy your sweet tooth too. Its water content makes it quite filling, and it can boost your energy while reducing your risk of kidney problems and heart disease.

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KNOW

SPRING 2018 |

WWW.ARH.ORG

While not curable, asthma can be carefully managed to let children breathe easier.

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Spring flowers can take your breath away. And not just because their beauty is such a welcome break from winter landscapes. For children with asthma, the high pollen counts that come with spring can spell breathing trouble.

During an asthma attack, the airways swell, produce excess mucus and become more narrow, limiting the amount of air that gets into the lungs.

Asthma is a chronic condition, and attacks can vary from mild to severe enough that they require immediate medical attention.

Pediatric asthma is a leading cause of emergency room visits and absences from school.

Allergic reactions to environmental triggers, such as pollen from grasses and trees or pet dander, can cause asthma attacks. Exposure to smoke and cold air also can trigger attacks, as can physical expressions of emotion (crying, laughing or yelling, for example).

Many children with asthma experience symptoms when they’re physically active, a condition called exercise-induced bronchospasm. Your child’s doctor can help create an

action plan that makes it safe to participate in sports, for example by using an inhaler before physical activity. Exercise can actually strengthen airway muscles, improving their function.

The exact cause of pediatric asthma is unknown, but research suggests interplay between the immune system and early exposure to environmental irritants.

Genetics may also play a role.

Though there’s no known cure for asthma, most serious effects are avoidable with proper treatment. Your child’s doctor can help you identify and avoid triggers, and develop an action plan to share with school personnel.

Medications can help prevent asthma attacks by reducing inflammation in the airways, and inhalers can be used to relax the muscles around the airways during an attack.

In some children with environmental allergies, immunotherapy (allergy shots) can help reduce asthma symptoms, making it easier for children and parents alike to relax and enjoy the many pleasures of spring.

EMERGENCY SYMPTOMS

So out of breath he can’t finish a sentence

Wheezing nonstop

Breathing with the help of stomach muscles

Changes in facial color, like bluish lips

Flaring nostrils while breathing

Asthma symptoms can occur without any obvious cause, but often asthma is aggravated by common triggers like these:  Allergens, including pet hair and dander, dust mites, mold and pollen  Infections, including a cold or the flu  Weather changes, especially colder weather  Pollutants like cigarette smoke and general air pollution  Physical and emotional exertion, including exercise, strong emotions and stress

COMMON SYMPTOMS

Consult your child’s pediatrician if you suspect asthma.

Symptoms to watch for include:

 Frequent cough  Wheezing while breathing  Trouble breathing, shortness of breath, rapid breathing  Chest pain, tightness  Fatigue  Poor sleep  Breathing trouble that limits play

Appalachian Regional Healthcare | SPRING 2018

Since asthma affects breathing, it can be deadly in a worst-case scenario. When in doubt, go to the hospital.

Definitely go to the emergency room if your child is:

COMMON TRIGGERS

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SPRING 2018 |

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THE SCREENING YOU SHOULDN’T AVOID

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The colonoscopy’s unpleasant reputation is, for the most part, undeserved—and it can save your life.

The 50th birthday. It’s quite a milestone. Those who make it to the half-century mark rightly feel a sense of accomplishment. But that feeling can be tinged with just a little apprehension. In the back of our minds, we know: It’s time for that first screening for colorectal cancer.

While preparation for a colonoscopy is still quite a comedown from birthday cake, it doesn’t necessarily have to be the stressful experience you may have heard about from a friend or family member.

A dangerous disease Colorectal cancer is the second leading cause of cancer death in the U.S., but when colorectal cancer is detected at an early stage, the five-year survival rate is 90 percent. That rate goes down drastically if the cancer spreads outside the colon or rectum.

Screening gives doctors a chance to find and remove polyps before they become cancer—a process that can take five to 10 years—and to excise small cancers before the situation becomes critical.

The scoop on preparation In order to detect polyps, doctors need to get a clear view, which means the colon has to be emptied.

While that used to mean drinking a large amount of unpleasant liquid in a short timeframe the night before the procedure, today the process is far easier.

There are a few factors that put you at increased risk for colorectal cancer.

Some of them, like your age or family history, you can’t control. But here are a few factors you can influence.

WEIGHT: Excess weight and larger waistlines increase risk. Work to reach or maintain a healthy weight.

ACTIVITY: Regular exercise reduces risk. A half hour of moderate physical activity (brisk walking, swimming, mowing the lawn) five days a week is recommended.

DIET: Eat more vegetables, lean proteins, fruits and whole grains. Eat fewer red and processed meats, such as hot dogs.

Appalachian Regional Healthcare | SPRING 2018

RISK FACTORS FOR COLORECTAL CANCER

Now, you can drink about half of the bowel-clearing liquid the night before, and the remaining dose about six hours prior to the colonoscopy. Planning to be home during this time will, of course, ensure you’re as comfortable as possible.

Starting a few days before the procedure, you’ll be asked to start eating a low-fiber diet free of grains, nuts, seeds, dried fruits and raw fruits and vegetables. The day before your colonoscopy, you’ll be restricted to clear liquids, such as broth, black coffee or tea and clear juice. For the exam itself, you may be advised to take the day off work and should ask a friend or relative for a ride home afterward, as you’ll likely still be under the influence of a sedative.

Although having a colonoscopy every 10 years is the “gold standard” for colorectal cancer screening, there are other options. CT colonoscopy, also known as a virtual colonoscopy, usually is done every five years. This method uses X-rays and computer imagery to give doctors a picture of the colon.

Another choice is flexible sigmoidoscopy, which allows doctors to check the inner lining of the rectum and the lower colon. There are even highly sensitive home-test kits that can detect unseen blood in the stool. Those require no bowel preparation, but must be done every year. Talk to your doctor about the best screening option for you based on your health history, symptoms and risk level.

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WEST VIRGINIA

Beckley ARH Hospital 306 Stanaford Road Beckley (304) 255-3000 Summers County ARH Hospital 115 Summers Hospital Road Hinton (304) 466-1000

Mary Breckinridge ARH Hospital 130 Kate Ireland Drive Hyden (606) 672-2901 McDowell ARH Hospital Route 122 McDowell (606) 377-3400

KENTUCKY

Middlesboro ARH Hospital 3600 West Cumberland Ave. Middlesboro (606) 242-1100

Barbourville ARH Hospital 80 Hospital Drive Barbourville (606) 546-4175

Morgan County ARH Hospital 476 Liberty Road West Liberty (606) 743-3186

Harlan ARH Hospital 81 Ball Park Road Harlan (606) 573-8100

Tug Valley ARH Regional Medical Center 260 Hospital Drive South Williamson (606) 237-1700

Hazard ARH Regional Medical Center 100 Medical Center Drive Hazard (606) 439-6600

Appalachian Regional Healthcare, Inc. ARH System Center—Hazard 100 Airport Gardens Road Hazard, KY 41701

Whitesburg ARH Hospital 240 Hospital Road Whitesburg (606) 633-3500

READY TO LIVE, LEAD &

Whether you have twenty years on the job or you’re just out of nursing school, you’ll find great benefits, room to grow, and lots of opportunities for advancement at Appalachian Regional Healthcare. Plus, qualifying RNs could receive a $5,000 sign-on bonus!

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