Oxford Health & Life: Winter 2017

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 LO U G H - H Y D E | T R I H E A LT H

WINTER 2017

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TRIHEALTH.COM

OXFORD’S NEW ONCOLOGIST PT: HELPING PATIENTS HEAL OBSTETRIC EMERGENCY

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{ IN GOOD HEALTH }

EMERGENCY R

AFTER A ROUTINE DELIVERY, JULIE JOLIFF FOUND HERSELF IN A LIFE-THREATENING MEDICAL EMERGENCY. MHMH DOCTORS AND STAFF WORKED TIRELESSLY TO GIVE HER STORY A HAPPY ENDING. 2

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CHILD CHILDBEARING IS NOT RISK-FREE. BUT THIS WAS TRULY AN ALL-HANDSON-DECK SITUATION. WE HAD PEOPLE INVOLVED THAT I RECOGNIZED FROM OTHER DEPARTMENTS ALL AROUND THE HOSPITAL.” —DANIEL STEIN, M.D., OB-GYN

On June 26, 2017, Julie Joliff checked into McCullough-Hyde Memorial Hospital | TriHealth to induce delivery of her baby girl McKenzie, who was eight days past her due date.

The pregnancy was her second— she and her husband Mike also have a 3-year-old son, Jake. Julie says the second pregnancy was much easier than her first, and that the delivery progressed quickly. “McKenzie came right away. It was a perfect birth,” she says. “But then about a half an hour later, I felt like I needed to push again, and there was a huge blood clot. Then I started hemorrhaging and we couldn’t get it stopped.”

Julie’s case was unusual but not unheard of. In the U.S., hemorrhage accounts for nearly 12 percent of pregnancy-related deaths according to the Centers for Disease Control and Prevention. One of the most common reasons for postpartum hemorrhage is a condition called placenta accreta, in which the placenta embeds itself into the uterine wall during pregnancy, causing uncontrolled bleeding after delivery. Regardless of the cause, if a hemorrhage isn’t noticed and treated right away, the mother can experience significant blood loss in a matter of minutes.

When Julie first hemorrhaged, her care team immediately suspected placenta accreta and rushed her to an operating room for an emergency procedure called dilation and curettage (D&C) to clear

the inner uterine walls. “After the D&C, I was really unstable,” says Julie. “I didn’t come out of it well, and I had a horrible headache for four days.”

After that fourth day, Julie was sent for a CT scan to check for blood clots near her brain, and when she arrived back at her hospital room in the early hours of the morning, she began hemorrhaging for a second time. Julie was rushed to the operating room again, this time for an emergency hysterectomy. “After that surgery, I came out feeling much better,” she says. “My headache was immediately gone.”

Julie’s Ob-Gyn, Daniel Stein, M.D., explains further. “Julie had unexplained postpartum hemorrhage twice, which is impossible to diagnose beforehand.

I had already left the hospital as if it were a routine delivery.” The emergency surgeries were performed by his partner, John T. Harlan, M.D., and he now suspects the bleeding was caused by a burst blood vessel in the uterus.

Fortunately for Julie, the entire team around her recognized the problem right away and sprang into action to save her life. The biggest concern in women experiencing postpartum hemorrhage is blood loss, and the hospital needs to have an adequate supply of blood on hand for transfusions until the bleeding is under control.

“At the hospital, every expectant mother has their blood typed and held in the lab in case of a blood transfusion,” says Dr. Stein. “And we also always have

O-negative blood that can be transfused into anybody.” Julie wound up receiving about 15 units of blood during her ordeal, roughly equivalent to replacing the entire blood volume in her body.

“Childbearing is not risk-free. Many people who aren’t involved with it on regular basis don’t realize that,” says Dr. Stein. “But this was truly an all-hands-ondeck situation. We had people involved that I recognized from other departments all around the hospital.”

Julie says she was overwhelmed by the care and compassion she received.

“The nurses treated me with such kindness and tenderness, and they took great care of McKenzie and my husband,” she says. In fact, Julie was in the hospital over her husband’s birthday, and she says the staff went above and beyond by setting up a date night for them to spend quiet time together. “They brought in a bed for my husband to lie next to me, and set up a TV with a movie.

I was feeling so stressed, and that really helped me relax for a while.”

After it was all over and she had gone back home, Julie organized a breakfast brunch at the hospital and invited everyone who had been involved in her care. “I couldn’t believe how many people were there who had worked behind the scenes or I didn’t recognize in the fog of everything that happened,” she says. “I didn’t think I was going to make it, but thanks to their excellent care I did.

We’re so thankful to everyone in every department who helped us.”

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{ IN GOOD HEALTH } PHYSICAL THERAPY: A PROBLEM SOLVER

Tim Holder, P.T., director of physical therapy at MHMH, works with a patient.

PT: HELPING PATIENTS HEAL

PT has a wide range of medical uses.

Below is a partial list, along with a brief description of the benefits it offers.

Ti

Accident or sports injury

Reduces or eliminates pain n and increases strength

Stroke

Strengthens areas weakened by stroke

Older patients

Improves balance and strength, preventing falls

Circulatory conditions

Increases stamina and overall wellness

Postsurgery

Builds strength,, helping patientss regain function

Neurological conditions

Helps with coordination, strength and balance

AN IMPORTANT MEDICAL RESOURCE, PHYSICAL THERAPISTS CAN REDUCE PAIN AND IMPROVE MOBILITY. David Gilbert was lifting weights in the gym when he damaged his shoulder, tearing both his rotator cuff and his bicep muscle. David is retired and lives in West Chester, but after the surgery to repair the injury, his doctor referred him for physical therapy (PT) at McCulloughHyde Memorial Hospital | TriHealth in Oxford. “The most important thing to me is playing golf, so it was critical for me to get my shoulder back in shape,” he says.

“My doctor recommended I go to the therapist he views as the best in area.”

That therapist was Tim Holder, director of the physical therapy and rehabilitation department at MHMH, where David’s rehab process started with an initial evaluation. “We always start by talking about their injury, medical history, lifestyle and their goals for the therapy,” explains Holder. “From that we can develop a plan specifically designed to make this patient better. It’s always helpful to find that activity they want to get

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back to, whether it’s golfing or working in their garden.”

Whether they’re doing PT after a surgery or to recuperate from a sports injury, most patients take between six and ten sessions with a therapist, going once or twice a week. During those visits, the therapist will normally provide therapies like soft tissue mobilization to reduce pain and swelling, and help the patient work through exercises that they’ll continue doing independently at home.

“I think what really sets us apart is our patient experience and our dedication to doing what the research has shown is best for their injury,” says Holder. “We’re well versed in making good decisions with patients.”

After finishing his PT, David says of his experience: “I can’t describe how much I appreciate Tim, and how he kept me focused. I’m really satisfied with my recovery, and now I’m back to playing golf two to three times a week.”

NO REFERRAL NEEDED Physical therapists are trained in diagnosis and screening, so you don’t need a doctor’s referral to receive care. To schedule an evaluation with a McCullough-Hyde Memorial Hospital | TriHealth Direct Access physical therapist, call one of the numbers below.

OXFORD: 513 664 3800 ROSS: 513 856 5960 HAMILTON: 513 863 2215

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{ IN GOOD HEALTH }

NEW ONCOLOGIST COMES TO OXFORD RENOWNED ONCOLOGIST EDWARD CRANE, M.D., IS NOW SEEING PATIENTS AT MHMH, EXPANDING THE AVAILABILITY OF CANCER CARE LOCALLY.

Highly regarded Cincinnati oncologist Edward Crane, M.D., has joined TriHealth, and is now offering appointments two days a week at McCullough-Hyde Memorial Hospital |TriHealth. Dr. Crane is one of two oncologists who see patients on-site, so a cancer specialist is now available in Oxford four days each week.

Dr. Crane trained at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla., one of the top cancer centers in the country. Over the past 11 years, he has built a reputation as a leading medical oncologist/hematologist in the tri-state area, treating a wide range of cancers and helping patients throughout their cancer journey.

“Dr. Crane is a brilliant doctor, yet

so humble,” says Benita Cannane, a long-term patient of Dr. Crane’s from Springfield, who has been seeing him for five years for a rare form of ovarian cancer. “He’s always willing to listen, he’s always fighting for you, and he never makes you feel like you have to give up hope.”

Dr. Crane says he made the move to MHMH because of the tight-knit community in Oxford and the quality of care and expertise available through the TriHealth system. “I grew up in rural Illinois, so I really like the sense of family and duty to the patient at McCullough-Hyde,” says Dr. Crane.

“I also get to work with a great mix of patients, from college professors to farmers.”

Edward Crane, M.D., with his long-time patient Benita Cannane.

In addition to the two days a week he’s seeing patients at MHMH, Dr. Crane is helping to create supportive cancer clinics for TriHealth that focus on relieving pain and improving quality of life for patients and their loved ones. “I’ve had several family members who succumbed to cancer, so I understand the burden,” says Dr. Crane.

“My goal is to always provide the same high-quality care for my patients that I would expect for my own family.”

Now that Dr. Crane’s practice has moved to Oxford, Benita says she plans to continue driving from Springfield to Oxford for all her appointments.

“There’s nobody like him, and I wouldn’t go to anyone else,” she says. “I feel special every time I talk to him.”

MY GOAL IS TO ALWAYS PROVIDE THE SAME HIGHQUALITY CARE FOR MY PATIENTS THAT I WOULD EXPECT FOR MY OWN FAMILY.” —EDWARD CRANE, M.D., ONCOLOGIST

FOR AN APPOINTMENT WITH A TRIHEALTH ONCOLOGIST AT MHMH, CALL 513 524 5540.

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{ TASTES }

BOWL OF

GOODNESS

MOVE OVER ACAI AND POKE. THIS DELICIOUS VEGETARIAN RECIPE OFFERS A FRESH TAKE ON THE FOOD-BOWL TREND.

Golden Shakshuka ONIONS, PEPPERS AND EGGS IN CUMIN AND TURMERIC SAUCE SERVES: 2

INGREDIENTS

DIRECTIONS

n 2 onions, thinly sliced n 2 yellow bell peppers, thinly sliced n ½ tsp. ground cumin n ½ tsp. freshly grated or ground turmeric n ½ tsp. thyme (dried or fresh) n ½ tsp. ground coriander n pinch of cayenne pepper or ½ tsp. spicy harissa n 2 cups yellow cherry tomatoes, chopped n 2 garlic cloves, finely chopped to a paste with ½ tsp. salt n 2 free-range eggs

Prepare the yogurt sauce by mixing the ingredients in a bowl, then set aside. Add a drizzle of olive oil to a skillet and place over medium-low heat. Stir-fry the onion until translucent, about five to 10 minutes.

YOGURT SAUCE n ½ cup Greek yogurt n 1 tsp. honey n juice of ½ lemon

Use the back of a spoon to make two shallow indentations in the surface of the shakshuka and crack an egg into each. Leave the shakshuka to slowly bake the eggs for 10 minutes, keeping the heat low. The result should be a dry sauce with the eggs just set. Remove from the heat.

TO SERVE n handful of fresh herbs (cilantro, mint, parsley), chopped n dusting of za’atar n fresh bread

Add the peppers, cumin, turmeric, thyme, ground coriander and cayenne to the skillet. Stir to coat the onions and peppers with the spices. Add the cherry tomatoes and garlic-salt mixture and cook over low heat for 15 minutes, stirring frequently.

If the sauce begins to dry out, add a little oil and water, but add sparingly as the shakshuka should not be watery.

Serve in bowls with the yogurt sauce drizzled over, and top with fresh herbs and za’atar. Enjoy with bread to scoop up the shakshuka sauce.

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That feeling when your heart flutters, misses a beat, speeds up or slows down can be alarming. Though these palpitations are often harmless, they can signal serious malfunctions in the heart’s muscles and nerves.

The most common type of irregular heartbeat, or arrhythmia, is atrial fibrillation—AFib for short. At least 2.7 million Americans are living with AFib, and that number is expected to grow as the average age of the population rises.

Untreated AFib significantly increases both risk of heart-related death and risk of stroke.

Treatment for AFib aims to regulate the heartbeat and prevent clots from forming.

If the AFib is caused by an underlying condition, that will be treated first. The heart’s regular rhythm (called sinus rhythm) can be re-established using medication, an electrical shock or a combination of the two.

If those treatments don’t work, a minimally invasive procedure can be used to ablate, or destroy, the tissues that trigger or maintain the disruptive rhythms. This stops the arrhythmia at its source.

Blood thinners are prescribed to help prevent blood clots. Because AFib can occur without symptoms, many patients continue these medications even after normal heart rhythm is reestablished.

With active monitoring, patients who have AFib can reduce their risk of complications. It’s important to keep follow-up appointments with a primary care provider, who will watch for and help manage additional stroke risk factors, including high blood pressure, diabetes, high cholesterol, smoking and obesity.

DON’T MISS

A BEAT

WHAT IS AFIB? When the heart beats, it squeezes and that pushes blood through each of the heart’s four chambers. With AFib, the top two chambers of the heart quiver instead of beating regularly. This means the heart can’t pump well so some blood is left sitting. And when blood is stationary, clots form. Blood flowing through the heart can sweep clots out into the circulatory system, where they can cause blockages that lead to complication such as stroke.

ANALYZING SYMPTOMS The first step in assessing an arrhythmia is a thorough patient history. Doctors look for clues: When do symptoms occur? Are they associated with specific activities? Do lifestyle factors contribute?

Will weight loss help? For instance, sleep apnea, associated with obesity, can cause arrhythmia, including AFib. Stress and medications also can play roles.

Several tests are used to diagnose AFib. An electrocardiogram (ECG) records electrical signals as they move through the heart and can show irregularities. To further evaluate how the heart is working, patients may be asked to wear a portable ECG device called a Holter monitor for 24 hours or longer. An event recorder is a portable device that monitors heart activity over longer periods—a few weeks to a few months. Patients activate the device when they experience symptoms and doctors are able to review the heart’s rhythm at the WHY IT’S CRUCIAL time symptoms occurred.

TO TREAT ATRIAL FIBRILLATION, THE MOST COMMON TYPE OF IRREGULAR HEARTBEAT.

RESETTING RHYTHM

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That feeling when your heart flutters, misses a beat, speeds up or slows down can be alarming. Though these palpitations are often harmless, they can signal serious malfunctions in the heart’s muscles and nerves.

The most common type of irregular heartbeat, or arrhythmia, is atrial fibrillation—AFib for short. At least 2.7 million Americans are living with AFib, and that number is expected to grow as the average age of the population rises.

Untreated AFib significantly increases both risk of heart-related death and risk of stroke.

WHAT IS AFIB? When the heart beats, it squeezes and that pushes blood through each of the heart’s four chambers. With AFib, the top two chambers of the heart quiver instead of beating regularly. This means the heart can’t pump well so some blood is left sitting. And when blood is stationary, clots form. Blood flowing through the heart can sweep clots out into the circulatory system, where they can cause blockages that lead to complication such as stroke.

ANALYZING SYMPTOMS The first step in assessing an arrhythmia is a thorough patient history. Doctors look for clues: When do symptoms occur? Are they associated with specific activities?

Do lifestyle factors contribute? Will weight loss help? For instance, sleep apnea, associated with obesity, can cause arrhythmia, including AFib. Stress and medications also can play roles.

Several tests are used to diagnose AFib. An electrocardiogram (ECG) records

WHO IS AT RISK? If you have one or more of the conditions listed at right, you may be at higher risk for atrial fibrillation, or AFib.

electrical signals as they move through the heart and can show irregularities. To further evaluate how the heart is working, patients may be asked to wear a portable ECG device called a Holter monitor for 24 hours or longer. An event recorder is a portable device that monitors heart activity over longer periods—a few weeks to a few months. Patients activate the device when they experience symptoms and doctors are able to review the heart’s rhythm at the time symptoms occurred.

RESETTING RHYTHM Treatment for AFib aims to regulate the heartbeat and prevent clots from forming.

If the AFib is caused by an underlying condition, that will be treated first. The heart’s regular rhythm (called sinus rhythm) can be re-established using medication, an electrical shock or a combination of the two.

If those treatments don’t work, a minimally invasive procedure can be used to ablate, or destroy, the tissues that trigger or maintain the disruptive rhythms.

This stops the arrhythmia at its source.

Blood thinners are prescribed to help prevent blood clots. Because AFib can occur without symptoms, many patients continue taking these medications even after normal heart rhythm is reestablished.

With active monitoring, patients who have AFib can reduce their risk of complications. It’s important to keep follow-up appointments with a primary care provider, who will watch for and help manage additional stroke risk factors, including high blood pressure, diabetes, high cholesterol, smoking and obesity.

• Alcohol use (especially binge drinking) • Coronary artery disease • Heart failure or an enlarged heart • Family history of AFib • Overactive thyroid gland (hyperthyroidism) • High blood pressure • Sleep apnea • Advanced age

WHEN T TO SEE YOUR DOCTOR The symptoms below have many possible causes—atrial fibrillation (AFib) is just one of them. Consult your physician if you experience: • Fluttering or thumping in the chest • Heart palpitations—periods of especially rapid, intense heartbeat • Confusion • Dizziness, lightheadedness • Fainting • Fatigue • Weakness • Loss of ability to exercise • Shortness of breath

NOW IN N OXF OXFORD: TRIHEALTH CARDIOLOGISTS As part of TriHealth’s commitment to bring specialty care to the Oxford community, two cardiologists now offer appointments at McCulloughHyde Memorial Hospital. Currently, appointments are available with Stephen J. Lewis, M.D., an interventional cardiologist, and Christopher Thoresen, M.D., a general cardiologist.

• High-performance or endurance athlete

FOR AN APPOINTMENT WITH A TRIHEALTH HEART INSTITUTE CARDIOLOGIST IN OXFORD, PLEASE CALL 513 745 9800.

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BANISHING

BACK PAIN LEARN WHAT CAUSES BACK PAIN, HOW IT CAN BE PREVENTED AND WHAT TO DO IF IT STRIKES. Back pain is one of the most common complaints for which patients visit their doctors. In fact, experts estimate that nearly 80 percent of people will experience back pain at some point in their lives.

CAUSES OF BACK PAIN Your back is made of many different moving pieces that connect to help stability and movement.

Bones, joints, ligaments and muscles are all intertwined, and injury or damage to any one of them can result in back pain.

You can irritate joints, sprain ligaments or rupture discs, sometimes with just a simple movement. Back pain also can be caused by problems and diseases of internal organs, such as kidney stones; blood infections; scoliosis (an abnormal curvature of the spine); arthritis; and some types of cancer.

HOW TO ALLEVIATE SYMPTOMS If you experience back pain or an injury, one to two days of rest can help, but resist the urge to stay in bed. Getting up, moving around and taking over-the-counter pain relievers can help alleviate stiffness, improve mobility and aid recovery.

24%

Of adults surveyed reported back pain within the past three months

10

$50

billion+

The amount Americans spend treating back pain each year

Applying heat to a sore back can increase blood flow and speed recovery of acute or chronic back pain. Treating with ice can reduce inflammation and ease pain. Sometimes alternating between the two is the best remedy. Trial and error is the best guide when figuring out what eases your particular symptoms most effectively.

Exercise is not advised for treatment of acute back pain, but stretching, yoga and core strengthening can help alleviate chronic back pain.

See a physical therapist or take a class to learn how to do these exercises properly.

WHEN TO SEE A DOCTOR Most of the time, back pain will subside on its own with or without treatment. However, it’s a good idea to see a doctor if you have tingling or numbness, if the pain is the result of a fall or injury, or if the pain is severe and doesn’t improve with rest.

It’s also important to be evaluated by a doctor if you have pain together with trouble urinating, numbness or weakness in your legs, fever or unintentional weight loss. These could be signs of a more serious problem.

2nd

Lower-back pain is the second leading cause of disability worldwide

80%

Of people will experience back pain in their lifetime

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5 TIPS FOR A HEALTHY BACK • Maintain a healthy diet and weight • Remain physically active and incorporate core-strengthening exercises into your routine • Wear comfortable and supportive shoes • Maintain proper posture • Bend at the knees to lift heavy objects and avoid any twisting motion while lifting

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Make the right move Direct Access Physical Therapy No referral needed!

Physical therapists are trained in diagnosis and screening • Doctors of physical therapy

Call today to schedule an evaluation with a Direct Access physical therapist Oxford 513 664 3800

• Board certified specialists • Experienced in evaluating musculoskeletal and neurologic impairments

Ross 513 856 5960

How can Direct Access Physical Therapy help you?

Hamilton

• Get better faster!

513 863 2215

• Saves you time and money!

TriHealth.com/mhmh

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