Oxford Health & Life: Fall 2020

OXFORD T H E G O O D L I V I N G M A G A Z I N E F R O M M C C U L L O U G H - H Y D E | T R I H E A LT H

FALL 2020

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TRIHEALTH.COM

EASY TELEHEALTH OPTIONS A VITAL SCREENING FLU SHOTS MORE VITAL THAN EVER

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Q: What is the Ohio First Steps for Healthy Babies program?

Developed by the Ohio Hospital Association and the Ohio Department of Health, the program recognizes maternity hospitals in Ohio that have taken steps to promote, protect and support breastfeeding in their organizations. The program is based on implementing the Ten Steps to Successful Breastfeeding, as defined by the World Health Organization and Baby-Friendly USA, awarding one star for every two steps implemented by participating maternity centers.

Q: McCullough-Hyde Memorial Hospital Obstetrics Department is a participant in the Ohio First Steps for Healthy Babies program. How does that benefit OB patients?

COMMITTED TO MOMS AND BABIES

Meeting the standards of this program shows our commitment to protect, promote and support breastfeeding for maternal and infant health by helping mothers breastfeed successfully. It also underscores our dedication to sharing current, evidence-based practices with each patient we serve, regardless of their feeding plan. The program offers OB patients a number of opportunities for learning and for networking with other nursing moms to encourage successful breastfeeding.

Q: So far, the hospital has earned three stars in the program. Which six Steps of Successful Breastfeeding have been implemented into patient care to date?

BREASTFEEDING PROVIDES major benefits for both moms and babies. To learn more about its importance and about the significance of McCullough-Hyde Memorial Hospital | TriHealth’s participation in the Ohio First Steps for Healthy Babies program, we spoke with Maria Kreitzer, Director of Obstetrics and Labor and Delivery.

Currently, our patients are benefiting from the following steps: • Have a written breastfeeding policy that is routinely communicated to all healthcare staff • Help mothers initiate breastfeeding within one hour of birth (this step applies to all infants, regardless of feeding method) • Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants • Practice rooming-in—allow mothers and infants to remain together 24 hours a day (this step applies to all infants, regardless of feeding method) • Encourage feeding on demand (this step applies to all infants, regardless of feeding method) • Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital.

Q: Why is breastfeeding important for both moms and babies?

Q: Are there plans to continue working to implement additional steps?

Mothers who breastfeed their babies quickly establish a strong emotional bond. Additionally, breastfeeding reduces a woman’s risk of ovarian cancer, breast cancer, cardiovascular disease, type 2 diabetes and hypertension. It also assists with weight loss postpartum. For babies, breastfeeding supports positive neurodevelopmental outcomes and reduces the risk of SIDS (sudden infant death syndrome), childhood obesity, childhood diabetes and other childhood Maria Kreitzer, RN, CLC diseases and illnesses.

The McCullough-Hyde Obstetrical Department—a talented team of obstetric and pediatric providers, obstetrical nurses, lactation consultants, lactation counselors, perinatal educators and unit coordinators—is committed to achieving all five stars awarded

by The Ohio First Steps for Healthy Babies program. We’ll continue working until we’ve implemented all of the required 10 Steps of Successful Breastfeeding.

THE OHIO FIRST STEPS FOR HEALTHY BABIES PROGRAM HELPS INFANTS GET OFF TO THE BEST POSSIBLE START.

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TO LEARN MORE ABOUT GIVING BIRTH AT MCCULLOUGHHYDE MEMORIAL HOSPITAL, CALL THE BABY BOUND OFFICE AT 513.524.5689.

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DON’T DELAY THIS

VITAL SCREENING A RADIOLOGIST AND BREAST-CANCER SURVIVOR SHARES WHY IT’S IMPORTANT—AND SAFE—FOR WOMEN TO HAVE THEIR ANNUAL SCREENING MAMMOGRAMS. REGULAR BREAST CANCER screening is key to catching the disease early, when there are more treatment options and, in general, better outcomes. “As women, we need to be proactive about taking care of our health, for ourselves and for our loved ones,” says Mary Knoedler, MD, a staff radiologist at McCulloughHyde Memorial Hospital | TriHealth.

“And having an annual screening mammogram is one of the best ways we can do that.”

One in eight women will have breast cancer over the course of her lifetime, and most of them won’t have a family history of the disease. “The simple fact that you have breasts and female hormones puts you at risk,” says Dr. Knoedler.

She advises following the American College of Radiology guidelines, which recommend that women of average risk have a yearly screening mammogram beginning at age 40.

“Women with a family history of breast cancer or other risk factors may be advised by their doctors to start screening at an earlier age,” says Dr. Knoedler.

Some women might be tempted to skip this year’s Mary Knoedler, MD

mammogram because of COVID-19related concerns. “As a physician and a breast cancer survivor, I highly recommend all women continue screening,” says Dr. Knoedler. “My cancer was detected after I had an “all-clear” the year before. If I’d skipped a year, my diagnosis would have been delayed. Getting a mammogram yearly is the best way you can take care of yourself.”

98.9% 5-year survival rate for stage I breast cancer

NEW SAFETY PROTOCOLS McCullough-Hyde Memorial Hospital has implemented strict protocols to ensure that breast screenings are done safely and efficiently.

“We’re open for screening and are taking significant COVID-19 related precautions,” says Dr. Knoedler Steps taken by the hospital to protect patients, visitors and staff include screening everyone before they enter the facility; requiring face coverings and social distancing; and implementing expanded cleaning practices. “And rest assured,” says Dr. Knoedler, “when you come in for a mammogram, you won’t go through any area of the hospital where there are COVID-19 patients.”

One of the reasons Dr. Knoedler became a radiologist is to help women take care of their breast health. “Get an annual mammogram,” she says. “It can make a real difference in your life.”

40%

Mammography has helped reduce breast cancer deaths in the U.S. by 40% since 1990

1 in 6

breast cancers occur in women aged 40–49

75%

of breast cancer patients have no family history of the disease

TO SCHEDULE A MAMMOGRAM, CALL 513.523.5555.

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FLU VACCINE:

MORE IMPORTANT THAN EVER

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WITH A RESURGENCE OF COVID-19 LIKELY IN THE FALL, GETTING A FLU SHOT WILL OFFER ADDED BENEFITS THIS YEAR. EVERY FALL, HEALTH experts advise that almost everyone over 6 months of age be vaccinated against the flu. This year, with the possibility of another wave of COVID-19 hitting during flu season, that advice is more important than ever.

One reason: Some people might become infected with both viruses at once, which could be especially dangerous. Another concern is that a fall surge in COVID-19 cases could strain healthcare resources, with seasonal flu hospitalizations occurring at the same time.

Unfortunately, it’s not yet known when a COVID-19 vaccine will become available. But people can start getting a flu vaccine in late September or early October. The flu vaccine has been proven time and time again to be effective at reducing the incidence of flu. The vaccine is safe, there are no serious side effects and it’s typically covered by insurance.

It’s important to be vaccinated for the flu every year. Flu viruses are constantly changing, so the vaccine is updated annually to protect against the viruses that research suggests may be most common during the upcoming flu season. It takes about two weeks after you receive the vaccine for antibodies to develop and provide protection against

the flu. That’s why experts recommend being vaccinated before flu season gets underway. Although some people who’ve been vaccinated still get the flu, they generally have very mild symptoms.

Talk to your doctor before getting a flu shot if you have an allergy to eggs or any of the ingredients in the vaccine, a history of Guillain-Barré Syndrome, or an acute illness or fever.

FLU VACCINE BENEFITS According to the Centers for Disease Control and Prevention, the flu vaccine prevented an estimated 6.2 million flu illnesses, 3.2 million flu-associated medical visits, 91,000 flu-associated hospitalizations and 5,700 flu-associated deaths in the U.S. during the 2017-18 flu season (the most recent season for which these estimates are available).

Some people, including babies and young children, people 65 years of age and older, those with chronic lung disease and those with diabetes, are especially vulnerable to complications from the flu. Getting the flu vaccine not only reduces your own risk, but also helps protect the people around you— something that’s especially important for those in high-risk groups.

WHO’S AT GREATEST RISK? According to the Centers for Disease Control and Prevention, people in these categories are at increased risk for developing complications from the flu and should see a doctor at the first sign of symptoms: • Children younger than 5 • Older adults • Pregnant women • People with weakened immune systems • People with cancer

• People with chronic illnesses, including asthma, COPD, heart disease, kidney disease and type 2 diabetes • People with a body mass index (BMI) of 30 or more.

PROTECT YOURSELF— AND OTHERS In addition to getting a flu vaccination this fall, here are some ways to avoid viral infections, including the flu and COVID-19.

1. Keep Germs Out. Avoid coming into contact with viruses by using disinfecting wipes to clean things you have to touch in public spaces, including shopping carts and gas pump handles. Carry your own hand sanitizer to use when you return to your car after a stop at a store, the doctor’s office or other public space. Keep your hands away from your eyes, nose and mouth while out in public. When you get home, wash your hands thoroughly with soap and warm water, for as long as it takes to sing the Happy Birthday song twice through.

2. Avoid Spreading Viruses.

Because people without symptoms can be sick with the coronavirus or the flu virus, during the COVID-19 pandemic the Centers for Disease Control and Prevention is recommending that almost everyone wear a mask while out in public in a situation that makes it difficult to stay six feet apart from others.

(Children under age 2 or anyone who has trouble breathing should not use cloth face coverings.) Some areas of the country and some businesses have made face coverings a requirement.

3. Support Your Immune System. Help keep your immune system working at its best by staying on top of fundamental health habits. Get plenty of sleep and exercise. Drink a lot of fluids, particularly water, maintain a well-balanced diet and take steps to manage stress.

FOR A FLU SHOT, CALL YOUR PRIMARY CARE PROVIDER. DON’T HAVE A PERSONAL PHYSICIAN? FIND ONE NEAR YOU BY VISITING TRIHEALTH.COM FOR OUR PHYSICIAN DIRECTORY.

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CONVENIENT CARE DAY OR NIGHT YOU DON’T HAVE TO BE TECHNICALLY SAVVY TO SEE YOUR DOCTOR IN A VIDEO VISIT. VIRTUAL DOCTOR VISITS have been available for some time, but since the COVID-19 pandemic, use of this tool has soared. Stay-at-home orders during the lockdown played a huge role, but other factors are also speeding up the adoption of telehealth.

Historically, there’s been an expectation that patients and physicians need to by physically together in order to get the best possible care. But as technology has become embedded in our daily lives, we’ve become more open to using it for medical care. The development of straightforward apps and videoconferencing tools that make it easy to receive virtual

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care securely also has increased its use.

Another boon to telehealth: the growing number of medical monitoring devices available for home use. These can be used by patients to collect data that’s transmitted to a physician’s office, expanding the usefulness of virtual visits. Examples include blood pressure monitors, blood glucose monitors, pulse oximeters and wireless scales.

Virtual visits are popular with patients because they offer many benefits, including the convenience of being seen at home or at the office, which results in very little time away from family responsibilities or work. Being seen virtually also eliminates the

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TELEHEALTH CHECKLIST Below are a few things to think about before a virtual appointment.

• If you need an interpreter, let your physician’s office know ahead of time.

HOW TO SET UP A VIRTUAL VISIT

• Be sure the device you’re using (phone, tablet, computer) is fully charged or plugged in.

McCullough-Hyde Memorial Hospital | TriHealth offers three ways for patients to consult with a doctor without going to a practice in person.

• Make the call from a well-lit, quiet room and turn off other electronics to enhance the quality of the video and audio.

1. Established patients can arrange a virtual visit by calling their doctor’s office—the staff will help you make an appointment.

• Set your camera at eye level to provide the best view for your healthcare provider.

2. Patients who have a TriHealth MyChart account can set up an e-visit, which uses MyChart’s secure messaging.

After logging into MyChart, select e-visit and complete a symptom questionnaire. If submitted by 4 p.m., you’ll receive a recommended course of treatment the same day via electronic message from a TriHealth provider. For a list of conditions that can be treated with an e-visit, see www.trihealth.com/tools/mychart/e-visits.

• Be aware that there may be lag time during your video visit. It’s helpful to pause briefly after your provider speaks before responding.

• In advance, write down your symptoms, when they began and how frequent they are, and list any medications you’re taking.

• Keep a pen and notepad handy to take notes during the visit.

3. Those who are new to the TriHealth system can set up a virtual visit through the TriHealthNow app, which can be downloaded for free. After enrolling, simply request a consult, provide medical history and pay a flat fee of $49 for the visit. Receipts are provided and can be submitted to insurers for possible reimbursement.

WHEN TO USE TELEHEALTH

need to drive to and from the doctor’s office and spend time in the waiting room.

Given all the advantages, it’s easy to see why this new way of receiving care has taken off.

Minor medical issues and many chronic conditions, including congestive heart failure, diabetes and asthma, often can be managed through a virtual visit. Doctors can make a diagnosis, recommend treatment and prescribe medication, if necessary, for many medical issues, including: • Allergies

• Rashes

BENEFITS OF VIDEO

• Arthritic pain

• Respiratory infections

Being able to see each other offers several advantages that lead most doctors and patients to prefer video visits to phone calls.

For example, if a patient has a sore throat, she can show the doctor the back of the throat and tonsils. Problems like cuts, rashes and swollen feet also can be shown. Patients who can’t remember the name of a medication they’re taking can get the bottle and show it to the doctor. In addition, being able to see and read each other’s expressions improves communication and, in some cases, helps doctors assess patient health.

It’s important to note that a visit can begin as a video or phone call or an e-visit and then become an in-person appointment if necessary. If you aren’t sure what the best course of action is, call your physician’s office, tell them what’s going on and they’ll help determine the best type of visit.

During the early stages of the pandemic, Medicare, Medicaid and many private insurers expanded their coverage for telehealth.

The situation is evolving, so check with your carrier, but it’s expected that coverage for telehealth will continue and expand.

• Asthma

• Sinusitis

• Bronchitis*

• Skin inflammations

• Colds and flu

• Sore throats

• Diarrhea

• Sprains and strains

• Infections

• Urinary tract infections

• Insect bites

• Vomiting

• “Pink eye” or conjunctivitis

• Other non-emergency conditions.**

*Adult patients only **Some conditions may be adult only

TO LEARN MORE ABOUT OPTIONS FOR CONNECTING WITH A HEALTHCARE PROVIDER VIRTUALLY, VISIT WWW.TRIHEALTH.COM/TELEMEDICINE.

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COMPASSIONATE CARE

FOR WOMEN OF

ALL AGES

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AN EXPERT OB/GYN RELOCATES FROM CHICAGO TO PROVIDE A FULL RANGE OF HEALTHCARE TO WOMEN IN THE OXFORD AREA. EVER SINCE HER medical training days, Padmaja Sanaka, MD, has been interested in taking care of women. “I enjoy having patients of all ages, from teenage girls to older women,” she says. “The oldest patient in my previous practice was 98!”

After completing her medical training at the prestigious Kurnool Medical College in India, Dr. Sanaka completed her residency at John H. Stroger, Jr. Hospital of Cook County and Northwestern Memorial Hospital, both in Chicago. After practicing for eight-plus years in Chicago at Franciscan Health, she moved to Oxford to join the staff of McCullough-Hyde Memorial Hospital | TriHealth.

Dr. Sanaka is expert in a wide range of women’s medical conditions and also in preventive care. “I see patients for menstrual irregularities, sexually transmitted infections, family planning, well-woman visits, endometriosis, fibroids, infertility (the first three to six months of treatment), both high-risk and normal pregnancies, and more,” she says.

A skilled robotic surgeon, Dr. Sanaka explains why robotic surgery is a crucial tool. “Because it allows us to perform many gynecologic procedures through one or more dime-sized incisions, robotic surgery offers many patient benefits,” she says. “These include less pain, reduced use of narcotics, reduced infection risk, a lower risk of blood clots and a faster recovery than traditional surgery, which involves much larger incisions.”

Robotic surgery is a good option for many patients.

It can be used Padmaja Sanaka, MD

to treat gynecologic cancers, endometriosis and fibroids, among other conditions. “Robotic surgery is especially useful with certain patients who would be high risk with traditional surgery,” says Dr. Sanaka.

“For example, those who are obese or have diabetes.”

Though Dr. Sanaka loves all of the patient care areas she’s involved in, one stands above the others. “Delivering babies is my passion,” she says.

“I’m a very spiritual person. It’s very meaningful to me that I’ve been given the opportunity to welcome babies into this world. In fact, the first words I say to every baby are, ‘Welcome to the world.’”

STAYING HEALTHY When it comes to health advice, Dr. Sanaka strongly recommends that women follow preventive screening guidelines and make positive lifestyle choices. “Follow healthy diet habits, exercise regularly and make use of family planning to space children,” she says. “Also, don’t put off seeking care—whether for an acute problem or preventive services—because of COVID-19. We’re taking all the precautions recommended by the Centers for Disease Control, including requiring masks for both staff and patients, making hand sanitizer available and ensuring that social distancing is maintained. It’s critical to stay on top of your health.”

Although COVID-19 has kept Dr. Sanaka from enjoying the Oxford area to its fullest, she’s happy to be here and knows that she’ll love her new home town. It doesn’t hurt that both of her children are at Miami University; her son a rising sophomore and her daughter an incoming freshman. “I think they’re excited to have me nearby,” says Dr. Sanaka. “We’re a close family.”

TO MAKE AN APPOINTMENT WITH DR. SANAKA AT OXFORD OBSTETRICS & GYNECOLOGY, CALL 513.523.2158.

Catrina Ward with her third child, Mila, born in July, and her husband, Kurt.

BABY BOUND! Bringing a new baby home is the beginning of a huge adjustment, for mothers and families alike. Getting ready for an infant’s arrival in advance can reduce stress and free parents up to bond with the baby and enjoy family time.

Together with your physician or midwife, McCullough-Hyde Memorial Hospital | TriHealth offers Baby Bound, a prenatal education program that helps you prepare for a new baby. As part of the program, you’ll meet once or twice during pregnancy with an obstetrical registered nurse at no charge.

These visits will include guidelines for caring for yourself and your baby throughout pregnancy, delivery and after delivery.

As part of Baby Bound, you’ll be assessed for pregnancy and delivery risk factors and discuss nutrition, pain management during labor and newborn care. You’ll also receive extensive breastfeeding education and support.

Catrina Ward, a mother of three, participated in the Baby Bound program during her most recent pregnancy. “The program guides you to take care of yourself as well as your baby,” she says. “They help you if you’re having difficulty breastfeeding, but they also remind you to organize a support team—friends or relatives—in advance so you can find time to nap or exercise.”

Even though she’s not a new mom, Catrina had questions from time to time. When she couldn’t find an answer in the educational material she’d received through the program, she could call the Baby Bound team. “It was nice to know that I could call and talk to someone I knew,” she says. “They were always happy to help, from the first question to the last.”

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WHEN KNEES WEAR OUT KNEE-REPLACEMENT SURGERY IS A HIGHLY EFFECTIVE OPTION WHEN YOU CAN’T FIND RELIEF FROM THAT ACHING JOINT. MORE THAN 600,000 knee replacements are performed each year in the U.S., and it’s considered one of the safest orthopedic procedures.

Most knee replacements are performed on people with osteoarthritis, which is caused by wear and tear of joints. Over time and with use, the cartilage that protects joints can be worn away. This often causes severe pain that can’t be eased by medications, weight loss, exercise and physical therapy.

For these patients, knee-replacement surgery can restore everyday use of the knee and improve quality of life.

The surgery usually takes 1 to 2 hours. Most patients are up and walking with a walker on the day of surgery. Typically, patients are discharged from the hospital 1 to 5 days after surgery, depending on the individual. During the recovery period,

patients work with a physical therapist to regain strength in the knee so they can return to their daily activities as soon as possible—usually in 8 to 12 weeks. Recovery to full strength takes 6 months to a year.

Risks do exist, but complications occur in fewer than 2 percent of cases, according to the American Academy of Orthopedic Surgeons. Most of the risks are the same as for any surgery, including developing blood clots, infection or nerve damage. Risks specific to knee replacement include allergy to the prosthesis and failure of the implantation, but these risks are extremely rare.

After recovery, 90 percent of kneereplacement patients find relief from their symptoms. This can make a huge difference in a person’s mobility, lifestyle and general well-being.

RECOVERY TIMELINE

Hospital discharge: 1 to 5 days after surgery

Return to normal activity: 8 to 12 weeks

Return to full strength: 6 months to 1 year

Surgery is the final option for resolving knee pain. But for patients who reach that point, the outcome is usually very favorable, making it well worth the recovery time and effort.

PARTIAL KNEE RESURFACING For some patients, partial knee resurfacing is a less invasive surgical option for knee pain that doesn’t respond to other treatments. Most often, the procedure is used in cases where arthritis is confined to a specific area of the knee.

Specially trained surgeons use robotic-assisted surgery to target only those areas of the knee damaged by osteoarthritis, resurfacing them without damaging ligaments or healthy bone and positioning implants more precisely. For surgeons, Mako robotic-arm assisted surgery provides increased accuracy. For patients, it means fewer complications, less recovery time, a more natural feeling in the knee, and nearnormal movement after recovery.

BAD KNEES? CALL THE TRIHEALTH ORTHOPEDIC & SPORTS INSTITUTE AT 513.856.5971 AND MAKE AN APPOINTMENT WITH DR. BRYAN McCULLOUGH.

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WHO CAN BENEFIT? It may be time to consider kneereplacement surgery if: • Knee pain prevents normal daily activity • All other possibilities for relief, such as physical therapy, weight loss, medication and supplements, have been exhausted.

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Delivering your birth plan, even if it changes between contractions.

BABY BOUND delivers an individualized plan perfect for you The next chapter of your story is about to begin, and the TriHealth team is by your side. McCullough-Hyde Memorial Hospital delivers more than state-of-the-art facilities, all-private Labor-Delivery-Recovery rooms and a home-like atmosphere, we also deliver a personalized, hands-on experience through our BABY BOUND maternity services. Registered nurses provide individualized plans for each expectant mom that includes pregnancy assessment and birth planning, prenatal education, nutrition counseling, breastfeeding support, follow up visits and more.

BABY BOUND, one more reason why no one else delivers an exceptional maternity experience quite like we do.

Learn more at TriHealth.com/MHMH or call 513 524 5689

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