Oxford Health & Life Summer 2022

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A BETTER WAY TO DIAGNOSE SWALLOWING PROBLEMS NEW TECHNOLOGY THAT HELPS EVALUATE PATIENTS WITH DIFFICULTY SWALLOWING PROVIDES A HOST OF BENEFITS. IN MID-JUNE, the imaging department at McCulloughHyde Memorial Hospital | TriHealth (MHMH) will install new technology that makes diagnosing patients with difficulties related to swallowing more accurate, faster and easier for patients. This new technology, a TIMS DICOM unit, is used for video recording modified barium swallow (MBS) evaluations—an exam speech therapists and other providers use to study patients as they swallow. MBS is a fluoroscopic exam, which is like an X-ray “movie.” It’s designed to determine whether food or liquid is entering a person’s lungs, which is called aspiration. The exam permits the medical team to watch how the anatomical structures in the mouth and throat work together while the patient is chewing, drinking and swallowing, which helps them identify the reason for aspiration.

SUPPORTING RECOVERY A NEW PROGRAM CONNECTS PEOPLE STRUGGLING WITH SUBSTANCE USE DISORDER TO THOSE WHO HAVE RECOVERED. RESEARCH HAS found that when people with substance use disorders (SUDs) are hospitalized or visit the emergency department, there’s a critical window of opportunity to connect them to recovery-related services and treatment. Support that’s started in an acute care environment can effectively extend the reach of treatment beyond the clinical setting into the everyday lives of those seeking a successful, sustained recovery process. Peer support workers do just that. In peer support, a person who has dealt with the recovery challenges the patient is facing is trained to give and receive encouragement and assistance that helps build long-term recovery. Peer support workers share knowledge, teach skills, offer emotional support and provide practical help. They also connect patients with resources, opportunities and communities of support.

IMPROVED SAFETY AND EFFICIENCY “Aspiration is a high safety risk for patients across multiple diagnoses,” says Kim Richards, MSOL, RT, MRSO, Imaging Manager at MHMH. “Previously, we had no way of recording these tests, so often the test had to be performed multiple times. That resulted in increased exposure to radiation for the patient and therapist, was inefficient for the imaging department and inconvenient for the patient.” With the new TIMS unit, the speech therapist is able to record faster and higher-quality images during the exam, and those images can be viewed later by the radiologist and the physician. The recorded exam can also be used to help patients better understand their diagnosis and treatment plan. “This is a huge win for our campus and the patients we serve!” says Richards. CALL TRIHEALTH SCHEDULING FOR AN APPOINTMENT AT McCULLOUGH-HYDE MEMORIAL HOSPITAL: 513.523.2111.


REDUCING HOSPITAL STAYS Peer support has been shown to improve well-being for those recovering from SUDs, resulting in fewer hospital stays and improved self-esteem, confidence and social skills. McCullough-Hyde Memorial Hospital | TriHealth is now offering peer support on-site, thanks to a $1 million grant from the U.S. Health Resources & Services Administration to help rural communities address SUD. The hospital, along with the Butler County Mental Health and Addiction Services Board, the Coalition for a Healthy Community—Oxford Area, Miami University and Talawanda School District, formed a consortium to address SUD in Oxford and the surrounding communities. In addition to the peer support program, other initiatives target prevention and treatment of SUD, along with more recovery programs. FOR MORE INFORMATION ON THE PEER SUPPORT PROGRAM, CALL 513.524.5421.


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APPOINTMENTS AVAILABLE The pain clinic at McCulloughHyde Memorial Hospital | TriHealth is located at 110 N Popular Street, 2nd floor, Suite 2, in Oxford, Ohio. The clinic is open on Thursdays.

• Dr. Fortman offers appointments on the second and fourth Thursdays of the month from 12 p.m. to 3:15 p.m.


• Jennifer Welte, NP, offers appointments on the first and third Thursdays of the month from 8 a.m. to 3:45 p.m.

FOR PAIN NOW THERE’S SPECIALIZED CARE AVAILABLE CLOSE TO HOME FOR PEOPLE STRUGGLING TO MANAGE PAIN. WHEN THE CAUSE OF PAIN is clear and the problem short term, doctors have many effective treatment options. But when pain becomes chronic, safe and effective management is more challenging. Fortunately, a new pain clinic at McCullough-Hyde Memorial Hospital | TriHealth offers expert care to the Oxford community and surrounding areas. The clinic, led by James Fortman II, MD, who is board-certified in both pain medicine and anesthesiology, provides specialized diagnosis for acute and chronic pain, as well as a wide array of pain-management treatments. These include epidural steroid injections, nerve blocks and ablation (burning the nerve supply to joints). “Patients suffering from pain are an James Fortman II, MD

underserved population,” Dr. Fortman says. “There are basically 10,000 chronic pain patients for every pain doctor. We’re pleased to be bringing these services to our community— and to patients who once had to drive 45 minutes to find such innovative procedures.”

ONE PATIENT’S STORY Among the advanced techniques available at the clinic is spinal cord stimulation, in which a device is implanted under the skin. This stimulator sends mild electrical pulses through the nerves, and those pulses interrupt pain signals to the brain. This was the device Dr. Fortman recommended for his patient, Tracey Steele, 50, who suffered from a spinal tumor at age 16. Strong radiation saved her life, but it left her later with disintegrating nerves and painful neuropathy in her feet. Tracey had almost given up hope

A physician referral is required. If you have one, call 513.246.2300 to make an appointment.

when she was referred to Dr. Fortman. “He really listened to me and was so sympathetic,” Tracey says. “He told me about the stimulator and that it was my only option. I was nervous, but I listened to him. After some fine-tuning, it has worked out well.” Medication management is another component of the clinic. “We use all types of medications,” Dr. Fortman says, “from NSAIDs to neuropathics to opioids. Because we use them in conjunction with physical therapy, we can employ smaller dosages, resulting in fewer side effects.” Dr. Fortman is joined at the clinic by nurse practitioner Jennifer Welte, who sees patients, assists in evaluations, orders procedures and prescribes medications. “She’s very supportive of patients and is always there to listen and lend a helping hand,” Dr. Fortman says. “Jennifer has great compassion.” The techniques available at the clinic typically improve physical capabilities and pain control. “Some patients even experience 100 percent improvement,” says Dr. Fortman, “and are able to regain lost mobility and function.”


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CHARLES WITHROW, 47, of Oxford, Ohio, a street pastor and laborer, knew something was wrong last October when his left toe developed a strong odor and a greenish color. Though he felt no pain, he headed to the Emergency Department at McCullough-Hyde Memorial Hospital | TriHealth (MHMH), and a doctor immediately admitted him to the hospital. It wasn’t long before Tatyana Hamilton, DPM, of the recently opened MHMH Wound Care Center, became involved in the Tatyana Hamilton, DPM

case. “When Charles arrived at the hospital, he was extremely ill,” says Dr. Hamilton. “He looked gray, and he admitted that he hadn’t seen a doctor in 10 years.” As a podiatrist with a specialty in wounds, Dr. Hamilton is trained to provide the most current diagnostic tests and treatments for patients like Charles. After an X-ray, MRI and blood work, Dr. Hamilton was able to deliver a diagnosis: She told Charles that his foot was gangrenous and that he was septic, meaning that an infection had spread throughout his body. But the hardest news was still to come. Charles remembers: “She said that I had to have my toe amputated. I’d always believed I was borderline


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LEADING-EDGE WOUND CARE The goal of the McCullough-Hyde Memorial Hospital Wound Care Center is to quicken the recovery of patients like Charles Withrow (see main story) so they can resume a pain-free life without the discomfort of a chronic, non-healing wound. For each patient, the center provides leading-edge wound care services and treatments, including a multidisciplinary assessment, a customized treatment plan and ongoing monitoring of progress. Diabetic wounds are among the most common wounds treated at the center, along with sacral ulcers (bed sores), dog bites, wounds from accidents and arterial ulcers. “We deal with any open, long-lasting sores,” says Tatyana Hamilton, DPM. “Basically I recommend that any open sore that has not shown improvement within a month or so should be assessed by a medical provider.” THE MHMH WOUND CARE CENTER TREATS:

• Diabetic wounds/ulcers • Pressure ulcers • Venous stasis ulcers • Non-healing surgical wounds • Arterial ulcers • Vasculitic ulcers • Complex soft tissue wounds • Traumatic wounds • Infected wounds • Burns and radiation wounds After evaluation, a customized treatment is chosen for patients that addresses the underlying cause of the

diabetic, but I was in denial about the truth—that I had a full-blown case of the disease. I was in tears when she told me.” Because diabetes can lead to decreased blood circulation in the lower extremities, foot wounds and ulcers can become serious quickly.

A FRIGHTENING TURN OF EVENTS Charles was placed on antibiotics, but before Dr. Hamilton could perform surgery, he suffered cardiac arrest— his heart suddenly stopped beating. He was airlifted to a larger TriHealth facility, Bethesda North Hospital, for emergency care. Dr. Hamilton explained, “I work

wounds. This is followed by patient education, including a healthy diet and exercise routine to minimize the chance of recurrence. One of the newest treatments that Dr. Hamilton has used with success are skin substitutes: substances made from synthetic, animal or human sources that are placed over the wound to aid healing. “These have been very helpful for many of my patients, including Charles,” says Dr. Hamilton. OTHER INNOVATIVE TREATMENT METHODS AVAILABLE INCLUDE:

• Debridement (removal of dead/contaminated tissue and foreign matter) • Infection control • Revascularization (reestablishing blood flow in blocked arteries or veins) • Growth factor therapy (use of substances produced by the body that stimulate the growth and spread of cells that aid healing) • Compression therapy (use of bandaging to reduce pressure on veins, which improves blood flow and reduces swelling) • Negative pressure wound therapy (covering a wound in an airtight dressing, then using a vacuum pump to draw out fluid and infection) • Off-loading techniques (equalizing the distribution of foot pressure) Dr. Hamilton concludes: “The Wound Care Center at McCullough-Hyde is an important, much

needed resource for our community.”

at Bethesda North as well as McCullough-Hyde—both are part of our TriHealth system, so I was able to continue treating Charles there. He had to undergo a number of heart procedures before we could perform his amputation.” After his amputation, Charles remained on antibiotics and was hospitalized for three months. He was in a wheelchair and underwent physical therapy to regain his mobility. In the meantime, the wound center taught him how to change his diet and lifestyle so that he can remain healthy in the future. Charles says, “It’s been a long haul, but Dr. Hamilton has been a blessing from God. And the nurses were always

there to lift me up if I got depressed.” Dr. Hamilton is upbeat about Charles’s recovery. “I’ve known Charles for seven months now, and he has made a 180 degree turn in his life. His wounds have mostly healed, and he should be able to walk again and return to work.” “I’m a street pastor,” Charles says. “That’s what helped me get through this. I count every day as a gift.”



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SYMPTOMS TO ACT ON NOW Everyone is busy. It’s a fact of life in our fast-paced world. So the last thing any of us wants to do is make a doctor’s appointment for a seemingly manageable problem. But for these eight symptoms, that appointment could save your life. See your physician if you experience any of these problems.

Unexpected weight loss While sudden, unexpected weight loss may sound like the stuff of infomercial dreams, it can signal serious problems, including endocrine-system disorders, diabetes and cancer. Losing 10 pounds or more without trying is cause for concern.

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Blood in the stool Changes to bowel habits, such as diarrhea or constipation lasting more than two days, accompanied by blood in the stool can be a symptom of hemorrhoids, inflammatory bowel disease, irritable bowel syndrome or colorectal cancer.


Skin changes

Sudden confusion

Any mole or freckle that changes color, shape, texture or size could be a natural part of aging, or it could be skin cancer. There are many types of skin cancer, and luckily, if caught early, most are easily treated by removing the offending mole.

A sudden bout of confusion, inability to concentrate or a change in personality could be caused by any of the following: dehydration, low blood sugar, an infection, a stroke, a brain tumor or bleeding in the brain.




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15 minutes A typical office visit with a primary care doctor takes only 15 minutes. That’s time you can afford to spend on your health!


Shortness of breath Difficulty breathing or shortness of breath is called dyspnea. Many people suffer from dyspnea occasionally, but if it is sudden, severe and limits your activities, you should seek medical attention. Breathing problems could indicate asthma, lung infection, blood clot, stroke or heart attack.


Seeing flashes of light

Swollen legs

Constant fatigue

Flashes, bright spots or other unexplained oddities in your vision may indicate the onset of a migraine or a detached retina, which can quickly lead to permanent blindness without swift medical intervention.

Hot, red and swollen legs or pain in the back of your calf can be symptoms of vein problems, thyroid issues or heart failure. Pain in the back of your legs also can indicate a blood clot that could be fatal if not treated promptly.

Being tired all day, every day despite an early bedtime should be addressed by a medical professional. Persistent fatigue could indicate depression, sleep apnea, anemia, hypothyroidism or cancer.




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THE RATE of cancer screenings has rebounded almost to prepandemic levels since its sharp drop in the spring of 2020. That’s good news, because when cancer is caught early, treatment has the best chance for success. Still, the number of Americans who get regular, recommended cancer screenings has long been below the target levels set by the U.S. Centers for Disease Control and Prevention.

CATCHING CANCER EARLY There are many reasons people avoid screenings, including fear of hearing bad news. Although it’s not pleasant to deal with the possibility of a cancer


diagnosis, in the U.S., one in two men and one in three women will be diagnosed with some sort of cancer during their lifetime. Catching cancer in its early stages, when the tumor is more likely to be small and the cancer less likely to have spread, makes it easier to treat. Today, there are many new treatments available, especially for cancer that’s caught early, making screenings even more important. Think of your primary care doctor as your number one resource for understanding screening recommendations and how they apply to you as an individual. He or she can answer any questions

you might have about screenings and talk to you about what to expect and how to prepare, if necessary. Medicine is constantly evolving and improving, and screenings are no exception. For example, if it’s been a while since you had a colonoscopy, you’ll find the preparation experience has become a lot easier in recent years.

A SYSTEM OF CARE When patients are dealing with fragmented care—for example, looking for a dermatologist in one healthcare system, then for a mammogram in another—they find that care can be delayed or a diagnosis missed


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because of the complexity of sharing medical records. On the other hand, once a patient enters a comprehensive system like TriHealth, which McCullough-Hyde Memorial Hospital is part of, every type of screening is available within the system, along with every type of specialist. This makes sharing results and following up seamless and easy. NEED A PRIMARY CARE DOCTOR? CALL OXFORD INTERNAL MEDICINE AT 513.523.4195.




Breast (women)


Women ages 40 to 44 have the choice to start annual screenings; women ages 45 to 54 should have mammograms every year; women 55 and older can switch to every other year or can continue yearly screening.

Women at high risk should have a mammogram every year beginning at age 30. This includes women who have a specific gene mutation (BRCA1 or BRCA2) or who have had radiation to the chest between ages 13 and 30.

Breast (men)

Physical exam, followed by diagnostic mammogram or other tests if needed

A lump or swelling, skin dimpling, nipple retraction, skin redness or nipple discharge should be examined as soon as possible.

A family history of breast cancer, inherited gene mutations, chest radiation and certain testicular conditions may increase male breast cancer risk.


For women, a Pap test every three years and/ or an HPV (human papillomavirus) test every five years

Regular screening for women between ages 25 and 65.

Both males and females can get HPV-related cancers. The HPV vaccine, recommended for children and adolescents between the ages of 9 and 16, can prevent HPV infection.


Colonoscopy is a highly effective screening for early detection.

For people of average risk, regular screening at ages 45 through 75. After that, discuss with your doctor.

People at increased risk may need earlier screenings: those with a personal or family history of colorectal cancer, or a personal history of radiation to the abdomen or pelvic area.


Low-dose CT scan (LDCT)

For people ages 50 to 80 who currently smoke or have quit in the past 15 years and who have a 20pack-year smoking history.

Research has shown that LDCT scans for people at higher risk of lung cancer save more lives than X-ray screenings.


A prostate-specific antigen (PSA) blood test and/or a digital rectal exam

Discuss with your healthcare provider at age 50.

If you are African American or have a family history of prostate cancer, have the discussion starting at age 45.


A visual self-exam by the patient or clinical exam by a doctor

Risk factors include exposure to natural or artificial sunlight, having fair skin and having several large or many small moles.

Report any suspicious moles or spots to your doctor.


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KNOWING THE BASICS CAN CHANGE—OR SAVE—YOUR LIFE. MORE THAN one in 10 Americans has diabetes, but millions of others don’t realize they’ve developed this oftensilent metabolic disease. Learning what causes diabetes and how to prevent it could save your life. It’s important to prevent serious complications resulting from unchecked diabetes, such as heart disease and nerve damage. Here are facts you should know.

WHAT IT IS Diabetes is a chronic disease that occurs when the body stops producing or responding to insulin, a hormone created in the pancreas. Insulin delivers glucose, or blood sugar, from the bloodstream into cells for energy. With diabetes, insulin can’t do its job, and blood sugar goes up. There are two types of diabetes, Type 1 and Type 2, with Type 2 being more common. In Type 1 diabetes, which typically occurs in children and young adults, the body simply doesn’t produce insulin. In Type 2 diabetes, the body produced insulin at one time, but


either is no longer making enough or has stopped responding to insulin. Having diabetes increases risks for complications including cardiovascular disease, circulation problems, kidney damage and nerve damage.

HOW IT HAPPENS Heredity plays a significant part in putting one at risk for developing diabetes. Type 2 diabetes has other risk factors, including being overweight or obese, eating poorly and not exercising. Having excess fat cells can make insulin less or completely ineffective.

HOW TO PREVENT IT Lower your risk of developing diabetes by eating healthy foods and exercising regularly. If elevated blood sugar is detected early in a condition known as prediabetes, lifestyle changes like these can reverse the disorder and help you avoid full-blown diabetes.

HOW IT’S DIAGNOSED The gold standard for diagnosis is the oral glucose tolerance test, or GTT,

but the hemoglobin A1C test is used along with the GTT to help determine the course of treatment. By measuring the percentage of sugar-coated hemoglobin proteins in your blood, doctors can estimate your average blood sugar level for the past two to three months. Results that fall between 5.7 and 6.4 percent are a sign of prediabetes, while results 6.5 percent or higher indicate you have diabetes.

HOW IT’S TREATED A multidisciplinary approach is often used to treat diabetes. Care teams can include primary care doctors, diabetes specialists, nutritionists and health educators. Oral medications are typically the first step, but doctors might suggest lifestyle changes before prescribing medication. They’ll look holistically at what will be the best treatment for any given individual. NEED A PRIMARY CARE DOCTOR? CALL OXFORD INTERNAL MEDICINE AT 513.523.4195.


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Little Red Dynamo NUTRITIONALLY SPEAKING, THE RASPBERRY, A TASTY FRUIT WITH A SILENT “P,” PACKS A POTENT PUNCH. THE RASPBERRY isn’t really a berry, botanically speaking. Part of the rose family, it’s actually several species of the genus Rubus, including Rubus idaeus (the European red raspberry) and Rubus occidentalis (the North American “black” raspberry). Growing on a bush three to six feet high, it’s cultivated in temperate zones the world over. Raspberries have a bumpy, “aggregate” quality: A fruit is made up of roughly a hundred tiny blobs called drupelets, each containing a seed. So is its cousin the blackberry (also not technically a berry!), but here’s a difference: Pluck a blackberry from the vine, and you’ll get its stem (called the torus), too; do that with a raspberry and its torus stays on the plant, leaving the fruit with an indentation. Greek mythology would have you believe red raspberries get their color from the blood of the nymph Ida, who sought to comfort Zeus. (Modern science tips its hat to the Greeks with that idaeus name, but attributes the hue to water-soluble pigments called anthocyanins instead.) The Roman agricultural writer Palladius wrote of raspberries, and their seeds were found in Roman Britain. Centuries later, Edward I (reign 1272–1307) was said to

be the first to call officially for the fruit’s cultivation. But today, if we connect raspberry with royalty, we’re apt to think of the late musician Prince and the color of a certain beret.

POWER UP The raspberry tops the Mayo Clinic’s hit parade of fiber-rich fruits, with about 8 grams of fiber per cup, lending a well-known boost to regularity and blood-sugar control. Just 80 grams of red raspberries provide 21 milligrams of vitamin C, useful for fighting off infections and protecting the immune system. That’s almost one-quarter of your daily need—for a modest 42 calories. A 2014 study showed that “black” raspberries helped suppress the effects of endothelial dysfunction, a coronary artery disease in which large blood vessels constrict. With a low glycemic index in addition to the fiber content, you can’t go wrong with raspberries. They’re a good source of folic acid for the development of red blood cells and potassium for the balance of fluid levels in the body. And considering the fruit is 86 percent water, you don’t have to worry a whole bunch about portioning. Paint the town red with them.

BUY/STORE/SERVE Your local grocery, fruit stand or farmer’s market most likely has this fruit in abundance from late spring through October. Look for uniformity of color and gloss on the exterior. Make sure fruits aren’t crushed or moldy. If the color of the raspberries looks dull or fading, pass that package by. (One trick: If you can, discreetly turn a plastic box of raspberries upside down. If some fruit adheres to the bottom, that’s a bad sign.) Raspberries have a short shelf life once picked; if rinsed, they can take on mold easily. So only wash them if you plan to eat them right away. Always go organic when it’s available, and keep unwashed berries in a covered, shallow container in your fridge. Raspberries can be served as they are, straight from the container. They can be pulverized into jams. They cameo well in a lot of breakfast items, such as cereal, oatmeal, yogurt or even your classic fruit salad. The tang of the fruit pairs well with a nice cheese if you’re preparing a platter, and even a barbecue sauce can be helped by the slightest hint of raspberry. The leaves of the raspberry plant? They can be used to make herbal teas.


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110 N Poplar Street Oxford, OH 45056

NON PROFIT U.S. POSTAGE PAID Harrisburg, PA Permit #324

This location is in network for traditional IN Medicaid and the following MCO plans: MDWise, MHS, Caresource and Anthem. Questions? Please feel free to call our Financial Counselor at 513.524.5600.

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