Oxford Health& Life: Fall 2021

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 2021

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TRIHEALTH.COM/MHMH

BATTLING HEARTBURN FOOD ALLERGIES AND SCHOOL LIVING WITH HEART FAILURE

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{ PHARMACY HIGHLIGHTS }

DESIGNED FOR HEROES A WINNING T-SHIRT DESIGN THAT CELEBRATES HEALTHCARE WORKERS FOR THE SUPERHEROES THEY ARE.

Bridee Morris, CPhT, being presented with a framed T-shirt featuring her contest-winning design by Mark C. Clement, TriHealth President and CEO, (right) and David Cook, TriHealth Senior Vice President and Chief Human Resources Officer (left).

HEALTHCARE WORKERS have been invaluable during the COVID-19 pandemic, so TriHealth wanted to take honoring them to the next level with this year’s Healthcare Heroes Week festivities. The celebrations included a T-shirt design contest, won by Bridee Morris, CPhT, a Certified Pharmacy Technician at McCullough-Hyde Memorial Hospital | TriHealth (MHMH). Morris was inspired by the phrase “not all heroes wear capes” when working on her design.

“And I’ve always loved typography,” she says. “Word clouds look like a form of poetry to me.” Morris’s design features a word cloud arranged inside the Superman symbol. Words like “serve,” “compassion,” “essential,” “community” and “respect”

appear in various typefaces surrounding the phrase “Healthcare Hero,” which is highlighted with a yellow background.

Morris works at the MHMH pharmacy, which supplies medications to the entire hospital—a job that was especially critical during the pandemic. The excellent work of the pharmacy team is part of what Healthcare Heroes Week celebrates.

The competition winner was announced at a Healthcare Heroes team member town hall. Morris won a framed T-shirt featuring her design and a $500 cash prize. With the prize money, she took a close friend out to restaurants and left enormous tips. Of that experience she says, “It felt amazing!”

STRONGER TOGETHER HOW THE PHARMACY TEAM AT MHMH WAS ABLE TO HELP TREAT COVID-19 PATIENTS AND ROLL OUT AN IMMUNIZATION PROGRAM THAT MADE THE MOST OF ITS VACCINE SUPPLY. FROM CARING FOR patients affected by the SARS-CoV-2 virus to combatting misinformation about vaccines, medical providers have been on the front lines for the last year and a half.

The pharmacy team at McCulloughHyde Memorial Hospital | TriHealth (MHMH) is no exception. “I ended up putting in many more hours—close to 50 extra hours per week—during the pandemic,” says Nathan Simmons, director of the department. The pharmacy was involved in approving Nathan Simmons

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new therapies to treat COVID-19, obtaining those medications and delivering them to treating physicians.

GETTING SHOTS INTO ARMS More recently, the pharmacy team has been focused on getting vaccination rates up. “Ironically, the vaccine clinics were more labor-intensive than the inpatient unit,” says Simmons. “It was a challenge to obtain and use the ultra-low freezer and to make sure no doses were wasted.”

The pharmacy team maximized its vaccine supply by keeping a patient wait list for any doses left over at the end of each day. “It was well worth going the extra mile and working through all of the logistics,” says Simmons.

MHMH pharmacists also faced the challenge of combatting widespread misinformation about COVID-19 vaccines, partly due to the daily emergence of new information. “Keeping up on the current information took approximately 20 hours per week of literature reading,” says Simmons. By staying on top of the research and having one-on-one discussions with community members, MHMH pharmacists worked to dispel myths and increase vaccination rates.

Fighting the pandemic brought people closer together. “There was an abundance of information sharing throughout the healthcare world,” says Simmons.

“Collaboration was at levels never seen before. Competitors became allies.”

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“I have a passion for providing excellent, safe healthcare for our patients,” says Nate Chaney, the new Interim Director of Nursing at McCullough-Hyde Memorial Hospital | TriHealth.

Nurse for 23 years and has earned certifications in Emergency Nursing, Orthopedic Nursing and MedicalSurgical Nursing. Prior to working at MHMH for four years, he worked for Mercy Health for 13 years in various roles, including Regional Manager of Nursing Practice.

INFLUENCED BY OUTSTANDING CARE

A COMMITMENT TO

EXCELLENCE POSITIVE HEALTHCARE EXPERIENCES EARLY IN LIFE LED McCULLOUGH-HYDE MEMORIAL HOSPITAL’S NEW INTERIM DIRECTOR OF NURSING TO THE PROFESSION. WHEN AN EMPLOYEE retires after nearly 40 years on the job, as Pamela Collins did on July 2, 2021, it’s an occasion not only to celebrate an extraordinary tenure but also to greet the replacement who will step into her place.

We thank Pamela Collins, MSN, MS, RN, FACHE, who has served McCullough-Hyde Memorial Hospital |

TriHealth (MHMH) in a number of roles for 39 years, most recently as Chief Patient Services Officer. Her expertise and kindness will be sorely missed!

To replace Collins, we welcome Nate Chaney, currently the Director of MHMH’s Quality Improvement and Case Management Departments, who has been named the Interim Director of Nursing.

Chaney has been a Registered

Chaney grew up on a farm in Lakengren and remembers visiting MHMH as a boy. In fact, his passion for nursing is rooted in his youth.

“When I was a junior in high school, my grandfather passed away from metastatic colon cancer,” says Chaney. “It was at a time when I was deciding what career path to take, and the outstanding nursing care that I observed influenced me to become a nurse.”

In 2012, Chaney’s father had a heart attack and was transported by ambulance to MHMH. While in the Emergency Department, he suffered a cardiac arrest, was resuscitated and transported by air for emergency cardiac catheterization. “Miraculously,” says Chaney, “he survived and is now 89 years old.”

These personal experiences shaped Chaney’s desire to perform work that helps save lives. “I have a passion for providing excellent, safe healthcare to our patients—the kind I want for myself and my family.”

McCullough-Hyde’s uniquely warm, welcoming environment is treasured by Chaney, as well as by local residents of Oxford and the surrounding area.

“Working at MHMH has been very rewarding for me,” Chaney says. “I believe community hospitals provide an especially personal, caring environment. I feel blessed to work at McCullough and serve my community, where I now live with my wife and two teenage daughters.”

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Kathy Snodderly, a member of the pharmacy staff at MHMH, and her husband, Bill, are grateful for the expert care TriHealth provided after Bill suffered a stroke.

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STROKE CARE:

‘THE BEST OF THE BEST’ FOR ONE INDIANA PATIENT, FAST ACTION AND ACCESS TO SPECIALIZED CARE AT A COMPREHENSIVE STROKE CENTER RESULTED IN A HAPPY OUTCOME. AFTER BEING MARRIED to her husband, Bill, for 45 years, Kathy Snodderly was well aware of how he sounded when she spoke to him on the phone. That’s why she was so alarmed when she called one afternoon to tell him she’d be late returning from work.

He sounded drowsy and his speech was slurred, even though he insisted he hadn’t been asleep. Bill didn’t even reply to several of the questions Kathy asked him.

As a member of the pharmacy staff at McCullough-Hyde Memorial Hospital (MHMH) for 26 years, Kathy had gained enough medical knowledge to know that something was seriously amiss.

She called her son Derick and asked him to meet her at home, seven miles away in the small town of West College Corner, Ind. When she arrived, she found Bill in his recliner with their dog, Bailey, at his side.

“I immediately saw that the right side of his face was drooping and that he was drooling. His speech was slurred, and he didn’t make sense— all signs of a stroke. I called 911 and the First Responders team, made up of our neighbors and friends, quickly arrived. I knew they’d be taking him back to McCullough-Hyde, so he’d be in good hands.”

Derick and his son had arrived at the house and followed the squad to the hospital.

Kathy met them there. Due to the COVID-19 pandemic, she was the only one Aaron Bender, MD allowed inside.

Bill’s Emergency Department physician was Aaron Bender, MD. “When I first saw Bill,” says Dr. Bender, “he was awake, but unable to express himself. This expressive aphasia— knowing what you want to say, but not being able to say it—was his main symptom. His right leg was also weak.”

Dr. Bender quickly ordered a CAT scan for Bill. This confirmed that he’d indeed had a stroke—a hemorrhagic one, caused by bleeding in the brain, not by a blood clot. In this type of stroke, blood can collect and compress surrounding brain tissue.

A MORE DAMAGING TYPE OF STROKE “Hemorrhagic strokes make up about 20 percent of all strokes and are generally more damaging than others,” says Dr. Bender. “Most of them are secondary to high blood pressure and a ruptured artery to the brain.” Bill had been suffering from severe headaches that he’d thought were from a neck vertebrae problem, but turned out to be due to uncontrolled high blood pressure.

“Because hemorrhagic strokes are treated differently than other strokes, a specialized neurosurgical consultation was necessary.”

Thanks to Dr. Bender’s rapid diagnosis, the MHMH team was able to make immediate arrangements to have Bill airlifted to their affiliate, Good Samaritan Hospital (GSH) in Cincinnati, which has a comprehensive stroke center.

As part of the TriHealth System, MHMH and GSH are able to offer patients advanced resources and a crucial continuum of care. This

connection and timeliness make all the difference in a health emergency like Bill’s.

Kathy remembers: “My boys were eventually allowed to go in and see Bill long enough to say ‘Goodbye and I love you.’ Then we all stood outside waiting for the helicopter to take off. Thoughts of his survival were heavy in our hearts.”

After an hour’s drive to Cincinnati, Kathy found Bill resting comfortably in the Intensive Care Unit (ICU) at GSH, receiving IV drip medications to stabilize his blood pressure.

“The physicians and nurses were so genuine and compassionate in their care,” says Kathy. “They checked in with us every two hours.”

ON THE ROAD TO RECOVERY There was speculation that Bill might require surgery if his brain bleed continued, but in the end, it wasn’t necessary; instead, controlling his blood pressure was key.

Within two days, he was transferred to a step-down ICU and then released as an inpatient to an acute rehabilitation facility near Bill and Kathy’s home.

Finally, Bill was allowed home, with prescribed physical and occupational therapy for another two months.

Kathy says that Bill is a lucky survivor of his brain injury, which he calls an “accident,” not a stroke.

“Physically, he’s 90 percent back to normal,” she says. “He still gets frustrated when he has trouble communicating, but with a little help he manages to get his point across. He doesn’t remember any of the details about the accident, but one thing he does realize is that his care was the best of the best.”

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BACK TO SCHOOL WITH

FOOD

ALLERGIES HOW PARENTS CAN WORK WITH STAFF TO MAKE SCHOOL A SAFE ENVIRONMENT FOR THEIR CHILDREN WITH FOOD ALLERGIES.

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IF YOUR CHILD has food allergies, the start of the school year requires extra planning. In addition to packing allergy-free lunches and snacks, it’s important to speak with the school’s nurse and your child’s teacher to make sure they’re aware of his or her allergies and what to do if the food in question is accidentally eaten.

Milk, egg and peanut are the most common food allergies for school-age children. Others include wheat, soy, tree nuts, shellfish and sesame.

For those parents who are new to sending a child with food allergies to school, we’ve put together some guidelines. Even if you’re an old hand at this, read on to learn about resources and possible treatments.

Schools have different policies about food allergies, so your first step is to find out what guidelines your child’s school has in place and tell them about his or her needs.

HAVE AN ACTION PLAN Children with a food allergy need to have access to an auto-injectable epinephrine (EpiPen or AUVI-Q) to treat emergency reactions. For younger children, the auto-injector is generally kept in the school nurse’s office.

The school nurse and your child’s teacher should have a copy of your child’s food allergy emergency care plan, which you and your child’s doctor fill out. This plan explains what your child is allergic to; what his or her food-allergy symptoms are; how to use the auto-injector; your child’s emergency contacts; and when to call 911.

WORK WITH YOUR SCHOOL It’s rare for a child to be so allergic to peanuts, for

example, that they cannot be in the same room with another child eating a peanut butter sandwich. But some parents prefer their children eat lunch at a nut-free or allergen-free table. Find out if your school sets aside space for children with food allergies.

Ask the teacher to alert you ahead of time if there will be a celebration at school that involves food so you can send your child to school with his or her own treat.

The group Food Allergy Research and Education (www.foodallergy.org) has information for schools on food allergies that parents can share with school staff.

This includes national guidelines from the Centers for Disease Control and Prevention on managing food allergies in schools; training on how to keep students with food allergies safe and included; and a checklist for teachers with students diagnosed with a food allergy.

THE FUTURE OF FOOD ALLERGIES Some children who are allergic to egg or dairy are able to eat them if they’re in baked goods. Eventually, they can build up enough tolerance to consume egg or dairy directly.

Peanut and tree-nut allergies have been more challenging. Food allergy immunotherapy is still experimental and not yet ready for widespread use. Other treatments are on the horizon, however.

One such treatment, which is in the midst of the U.S. Food and Drug Administration’s approval process, is a wearable daily patch that delivers small amounts of peanut protein through the skin. This low-dose exposure over time can help to protect the allergic person from larger exposures. It’s for children ages 4 to 11 and is expected to become available in 2022.

TO SCHEDULE AN APPOINTMENT WITH A TRIHEALTH ALLERGY/IMMUNOLOGY PHYSICIAN, CALL 513.246.7001.

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LIVING WELL WITH

HEART FAILURE

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IT’S POSSIBLE TO FEEL GOOD AND STAY ACTIVE, EVEN WITH A DIAGNOSIS OF HEART FAILURE. THE TERM “HEART FAILURE” means that this vital organ is damaged in some way. Despite its dire sounding name, however, a diagnosis of heart failure is far from a death sentence.

Care for heart failure patients has improved so dramatically in recent years that, although this is a chronic problem, patients who have it can live long and productive lives.

The key to a positive outcome is simple—but not necessarily easy. Heart failure patients must take medicine as directed and make the lifestyle changes recommended by their doctor.

UNDERSTANDING THE TERMS About 5.7 million U.S. adults have heart failure, according to the Centers for Disease Control and Prevention.

“Heart failure” is a generic, umbrella term that covers different disease entities in which the heart is failing to perform its role as a pump. That failure can fall into two different categories, which often exist together: left-sided and right-sided dysfunction. (See “Two Sides of Heart Failure” at right.)

Some people get confused when they hear “heart failure” and think they’re

going to have a heart attack, but these are two very different health issues. Heart failure doesn’t lead to a heart attack.

Also, heart failure develops gradually, whereas a heart attack happens suddenly, when blood flow to an artery leading to the heart is blocked. However, in either case, patients will receive similar advice to adopt a heart-healthy lifestyle.

GETTING TO GOOD HABITS Those recommendations will likely come as no surprise: Take medication as directed. Exercise. Eat a healthy, low-salt diet. Stop smoking. Get enough sleep.

Manage stress. Still, many patients don’t follow doctors’ orders. People’s lives are so busy, and heart failure tends to be a problem that doesn’t feel like an immediate threat. Many patients think they can pay attention to it tomorrow, but that’s not the case.

At the first sign of weakening or abnormality of the heart muscle, most patients should start medications to help their heart muscle and begin to exercise.

Walking is the easiest way to start an exercise habit.

Patients with heart failure also will benefit from a healthier diet and reducing

EVALUATING HEART FAILURE Determining the degree of a patient’s heart failure allows doctors to make the best recommendations for treating it. The American Heart Association puts heart failure into four classes based on symptoms: • CLASS I: Ordinary physical activity does not cause undue symptoms (fatigue, palpitation, shortness of breath) • CLASS II: Comfortable at rest, but ordinary physical activity results in symptoms • CLASS III: Comfortable at rest, but even minimal physical activity causes symptoms • CLASS IV: Symptoms at rest, and any physical activity increases discomfort In addition to classifying a patient’s heart failure based on symptoms, cardiologists use tests, such as X-ray, electrocardiogram, stress test and echocardiogram, to assess its degree.

TO SCHEDULE AN APPOINTMENT WITH THE TRIHEALTH HEART INSTITUTE, PLEASE CALL 513.246.2400.

or eliminating use of alcohol, which is a direct toxin to the heart muscle. In addition, alcohol can lead to other issues, such as excessive salt intake and dietary carelessness.

Heart failure patients will find that the benefits of a heart-healthy lifestyle— improved energy, feeling better and living longer—far outweigh the effort required to create new habits. You can live a very productive and positive life with heart failure—as long as you follow the guidelines shared by your doctor.

TWO SIDES OF HEART FAILURE In left-sided (or left ventricular) heart failure, the muscle in the left side of the heart weakens so that the heart can’t pump enough blood properly (systolic dysfunction) or stiffens (diastolic dysfunction) so that the pressures in the heart go up.

Either case can result in fluid in the lungs and reduced heart output, decreasing exercise capacity and causing breathing difficulty and fatigue.

In right-sided (or right ventricular) heart failure, the right side of the heart loses pumping power, leading to a backup of blood in the veins that results in swelling and congestion.

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BATTLING HEARTBURN LEARN MORE ABOUT CHRONIC ACID REFLUX AND HOW TO KEEP IT IN CHECK. IF YOU EXPERIENCE a burning sensation in your chest or a bitter taste in your mouth after eating, you may be among the 20 percent of people who suffer from chronic heartburn, also known as gastroesophageal reflux disease (GERD).

At the McCullough-Hyde Memorial Hospital | TriHealth Digestive Institute, patients are assessed to determine the best treatment. Here, gastroenterologist Robert Cucinotta, MD, answers common questions about GERD.

WHAT CAUSES GERD? GERD occurs when stomach acid backs up into the esophagus—a muscular tube that connects the throat to the stomach—instead of moving through the gastrointestinal tract. The acid causes a burning sensation, sore throat or cough, hoarseness and frequent burping. If symptoms occur more than twice a week for a few weeks, you may have GERD.

IS IT SERIOUS? It can be. Chronic acid reflux can cause the esophagus to narrow, which interferes with swallowing and can cause food to get stuck. Over time, chronic inflammation in the esophagus can lead to precancerous changes and cancer.

About 10 to Robert Cucinotta, MD 15 percent of

people with GERD develop precancerous changes known as Barrett’s esophagus.

An estimated 1 in 200 people with Barrett’s develops esophageal cancer.

WHO’S AT RISK? People who are overweight or pregnant, smoke or take certain medications— such as calcium channel blockers for high blood pressure, asthma drugs, painkillers, sedatives and antidepressants—are at increased risk for GERD. Those who have a hiatal hernia—in which an opening in the diaphragm allows the upper part of the stomach to bulge into the chest—are also predisposed to the condition.

HOW IS GERD TREATED? GERD symptoms can be improved by maintaining a healthy weight, eating lowfat foods, quitting smoking, not eating two to three hours before bedtime and raising

the head of your bed to prevent acid from rising into the esophagus. Avoiding or reducing consumption of foods and drinks that trigger symptoms, such as coffee, tea, chocolate, mint and tomato sauce, also can help. If these measures don’t work, you may need to take an over-the-counter antacid medication. Stronger medications, which are available over the counter and by prescription, include H2 blockers and proton pump inhibitors, which reduce acid production in the stomach. If medications aren’t effective, surgery might be an option.

WHAT TYPES OF SURGERY ARE AVAILABLE? In one procedure, the stomach is wrapped around the lower esophagus to strengthen the area and prevent acid from rising into the organ. Another procedure involves implanting magnetic beads around the lower esophagus to strengthen it.

ROBERT CUCINOTTA, MD, PROVIDES A FULL RANGE OF EVIDENCE-BASED GASTROENTEROLOGICAL SERVICES. TO MAKE AN APPOINTMENT WITH DR. CUCINOTTA, CALL 513.853.2120.

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{ POWER FOOD }

Corn, Revisited HOW WELL DO YOU REALLY KNOW THIS HEALTHY AND DELICIOUS STAPLE? EARLY FALL is prime time to enjoy one of our area’s most plentiful vegetables: plump, juicy sweet corn. The region’s farmers harvest millions of pounds of sweet corn each year, mostly from July through late September. And don’t be worried about genetic modification. True, that’s often used in producing field corn for feed and industrial purposes. But sweet corn— the kind you buy on the cob—is rarely grown using genetically modified organisms. And if you want to be super sure, organic produce is always GMO-free. With all the health benefits this low-fat, high-fiber, gluten-free food provides, it’s simply too good to pass up.

POWER UP A typical cup of raw sweet corn has 177 calories, 2.1 grams of fat and 5.2 grams of sugar. It also provides 4.6 grams of fiber (18 percent of the daily recommended value) and 5.4 grams of protein, not to mention an assortment of vital vitamins and minerals. For instance, that same one cup yields 17 percent of the daily recommended value of immune-boosting vitamin C (levels of this vitamin decrease when the corn is cooked) and a plethora of energy-building B-complex vitamins.

Sweet corn is rich in antioxidants, including lutein and zeaxanthin, both of which can help protect eye health and prevent cataracts. A Cornell University study found that sweet corn has even higher levels of antioxidants after being cooked. The cooking process releases a compound called ferulic acid, which has cancer-fighting benefits, the researchers say.

The rumor about humans not being able to digest corn is partly well-founded: It’s true that the casing of the kernel shell is made of cellulose, a fiber that the human digestive system can’t break down. But when corn is chewed properly, the body is able to benefit from the good stuff inside the kernel.

BUY/STORE/SERVE Corn’s sugars turn into starch as it ages, so it’s essential that you buy corn fresh and eat it soon after bringing it home. Fortunately, many local farms and produce stands offer newly harvested corn that can be enjoyed at the height of its sweetness. If you don’t plan to eat the corn the day you purchase it, keep it tightly wrapped in plastic in the refrigerator to retain its flavor. While shopping, resist the urge to peel back the husk. Instead, look for stalks that are green, firm to the touch and tightly wrapped. You should be able to feel plump kernels through the husk.

Grill or boil the corn on the cob until its color deepens and the kernels become tender. Traditional American cookout chefs may insist on serving the corn simply with butter, but consider other options for dressing. For instance, adding herbs to the butter (or better yet, using extra-virgin olive oil) will give it a lighter taste, or you can infuse the corn with a Southwestern kick by drizzling it with Mexican crema, a dash of chili powder or smoked paprika, and a squeeze of lime. When shaved off the cob, corn also pairs well with most other vegetables in salads and salsas. Mix it with avocado and cilantro or fresh tomatoes and basil for a refreshing side dish. And save the leftovers: Corn kernels work remarkably well as a pizza topping and in soups.

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Your health care partner.

To learn more, go to TriHealth.com/YourHealth or call 513 569 5400.

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