Silent Nights at PinnacleHealth

At this time of year another popular song comes to mind too- Silent Night. Much like most women would want for a little more me time, most would like a little more quiet too.  Patients in hospitals agree too! In fact studies show that reduced noise levels help patients sleep better. That means they heal and recover more quickly.

At PinnacleHealth we work to ensure silent nights all year long through our Shhh program—Silent Hospitals Help Healing.  Shhh is a program that has educated employees on the ways we can decrease noise so patients can enjoy a quieter environment in our hospitals. It also means that employees can concentrate better and experience less stress.  Our efforts include:

• Setting cell phones and pagers to the lowest ring setting or to vibrate. 
• Speaking more quietly and in appropriate areas. 
• Closing patient doors when possible and safe. 
• Wearing soft-soled shoes. 

With our efforts, patients at PinnacleHealth will find the restful nights they need to enjoy a healthy and happy new year.

Let it go! Let it go! Let it go!

Blog contributed by Dr. Metropoulos.

The holidays are a time of socializing, enjoying festive food and drink , and helping a certain bearded fellow meet the expectations of wide eyed children.   While all of these aspects make the holidays enjoyable, it can be stressful when added onto an already busy life, such as the kind most women lead today.  So if asking Santa for less stress hasn’t worked in years past, why not take a different approach this year?

Much like the holiday song, Let It Snow, this season try making Let It Go, your mantra.  Having a positive thought to focus on can help center and calm you in the midst of the holiday chaos.  When you realize our being pushed to your limits, stop, take a few deep breaths and just repeat, Let it go, Let it go, Let it go.

Managing stress can also be aided by having realistic expectations.  Many women, myself included, try to be superheroes, especially at the holidays.  We try to buy all the presents, bake all the goodies, cook all the meals and decorate the house, all in hopes of providing a “perfect” holiday for those we love.  While the intent of these actions comes from a good place, it can cause us to suffer and in the end that can negatively affect our loved ones, those who we started doing all these stressful things for.   Ask yourself, will the holiday be ruined if I don’t make that extra pie? Will my loved ones suffer if I don’t have put all the decorations up this year? Focus on the important traditions and give yourself permission to let the rest go.

Family squabbles can add stress as well.  A snide remark about someone’s weight or a question about when you are going to get married or have a baby, can raise anyone’s ire.  Having a clear focus on the occasion and realizing that the goal of the holidays is to enjoy yourself, should lead you to let it go.  Let go of the remarks, the animosities and any bad feelings and just seek the good in the season.  

In the end, holidays are about enjoying yourself, enjoying time with family and friends and making new memories. Learning to manage stress will enable you to have a happy and healthy holiday season and new year to come.

So repeat after me, Let it go, Let it go, Let it go.

All I Want For Christmas is a Little More Sleep!

Blog contributed by Greg Barnes, BS, PinnacleHealth Sleep Center Supervisor 

This time of year many women sacrifice sleep while trying to balance holiday tasks with the rest of the busy American lifestyle. Shopping, decorating, cooking and other holiday activities are just a few of the demands this time of year. Be careful though, a lack of sleep can increase stress and reduce your ability to enjoy the season.

Here are a 8 tips for a more restful holiday season:

1. Sleep schedule: Try to maintain a sleep schedule, go to bed and wake up at the same time every day. Keep your schedule even on your days off and holidays.
2. Watch what you eat: The holidays bring lots of opportunities to overindulge and eat foods that you might not usually eat. A light meal before a party might help keep you from overindulging! Heartburn indigestion can make it difficult to sleep. Don’t go eat right before bed, it can be tough to sleep with a full belly.
3. Caffeine and alcohol: Both can be a detriment to quality sleep. Did you know that caffeine effects can last for up to 12 hours? Contrary to popular belief, alcohol also negatively effects sleep for most people.
4. Your sleep environment: Make certain your bedroom is ideal for sleeping. Cool, dark and quiet usually works best.
5. Naps: Daytime naps that are too long can interfere with nighttime sleep; keep naps to 30 minutes or less.
6. Physical activity: Daily physical activity can promote better sleep. Give yourself plenty of time to wind down before bedtime.
7. Manage stress: When you have too much to think about, your sleep is likely to suffer. So get organized, set priorities and delegate tasks.
8. Try to anticipate and budget the extra time needed to carry out your holiday 'to-do' list. Start early and do a little each day to save time and reduce stress. Delaying until the last possible minute not only leads to sleep loss, it brings heavier traffic, aggressive crowds in stores and the stress of spending lots of money at once.

If you or a loved one still struggle to get restful sleep, you may have an underlying condition.  Many sleep disorders can be treated.

For more information or to set up an appointment call the PinnacleHealth Sleep Center at 920-4325 or visit us on the web at pinnaclehealth.org/sleep

No place like home for the holidays—but Community General Osteopathic Hospital is close!

Women tend to be the ones that make home so homey over the holiday season so we know they pay special attention to the feel and amenities available when they or a loved one is hospitalized. While there is no place like home for the holidays, we can offer the next closest thing in our larger, private patient rooms.

In September, PinnacleHealth opened 2 new floors at Community General Osteopathic. Our culture and philosophy centers every decision on what is best and most helpful for the patient. Joan Silver, Vice President of Organizational Quality and Performance Improvement explains,  “ These rooms have been designed specifically for the patients that will be occupying them.  These are all private rooms with the same type of amenities found in some of the finest hotels.”  Ina addition to the comforts of home, each room has the latest point-of-care technology to improve care coordination, safety and efficiency.

We added specific amenities to make a patient’s stay as comfortable as possible- these include

•  Private patient rooms with a pullout sofa bed and additional space to accommodate family and friends
•  Furniture customized for joint-replacement and spine patients
• Natural lighting for comfort and healing
• Spacious bathrooms designed for safety
• Flat-screen cable TVs  
• Patient rooms that are designed for convenient and proper storage of equipment necessary for patient care.

While everyone hopes to be home for the holidays, if you find yourself in need of a hospital this holiday season, rest assured your comfort will central to your stay at PinnacleHealth.  

Reducing Lung Cancer Risk Through Screening

Jennifer Laudenslager, RN-CCRN
PinnacleHealth Pulmonary Nodule Clinic

Lung cancer is the leading cause of cancer-related death in the United States. More than 150,000 Americans die from this disease each year – that is more than colon/rectum cancer (50,830) breast cancer (39,620) and prostate cancer (29,720) combined.*

Because lung cancer often causes no symptoms in the early stages, having a screening study is the best way to ensure early diagnosis and treatment and the best possible chance for a cure. In addition, there is now clear evidence that screening people at high risk for lung cancer with a low-dose CT scan leads to 20% fewer deaths from this disease. The benefits of screening include:

• Better chance for a cure
• Early diagnosis and treatment
• Reduction in mortality

Who is considered high risk and should be screened?
The PinnacleHealth Lung Cancer Screening Program recommends screening the following individuals:

• Ages 55-79 who have smoked the equivalent of one pack daily for 30 years
• Ages 50-79 who have smoked the equivalent of one pack daily for 20 years and have one additional risk factor
• Additional risk factors are:  radon exposure, asbestos exposure, cancer history, strong family history of lung cancer, significant second hand smoke exposure, chronic obstructive pulmonary disease (COPD), or pulmonary fibrosis.

What is involved with screening?
At PinnacleHealth, we offer a low-dose screening CT scan to identify nodules or other findings suggestive of lung cancer. Currently, this screening is not covered by insurance. The screening costs $99.

Individuals who meet the screening criteria can simply call (717) 230-3700 to schedule their screening at one of PinnacleHealth’s imaging locations. Payment is made at the testing site. We accept exact cash, check, or most major credit cards.

Individuals who do not meet screening criteria should ask their family doctor if the screening is right for them. A prescription from the family doctor is necessary to schedule the screening. There are other risk factors that may increase an individual’s risk of lung cancer, including: radon exposure, family history of lung cancer, exposure to diesel fumes or working as a firefighter.

The actual screening process is simple. There is no contrast dye involved, so there are no injections or preparations. Individuals opting for the screening first change into a gown and then they are guided to the CT scanner. The next step is to lie on the table, allow the CT scanner to make a few rotations around the chest and the test is complete. Results are mailed to the patient and the referring physician.

PinnacleHealth has partnered with the Department of Environmental Protection’s Radon Division to offer all lung cancer screening patients radon kits for radon testing of the patient’s home, which is included in the $99 screening fee. A certificate will be mailed to the patient attached to the test results with further instructions.

What happens if there is a positive finding with the screening?Should the CT scan identify concerning findings, PinnacleHealth offers a multidisciplinary Pulmonary Nodule Clinic. The clinic provides rapid evaluation and treatment of pulmonary nodules by a team of skilled specialists including thoracic surgeons, pulmonologists and interventional radiologists. This team works together to thoroughly evaluate each nodule, develop a comprehensive individualized plan of care utilizing the most advanced technologies, and significantly reduce the time from detection to treatment.

The PinnacleHealth Pulmonary Nodule Clinic offers access to the latest advances in lung cancer care, including:

• Low dose and volume CT scanning
• PET/CT
• SuperDimension Electromagnetic Navigational Bronchoscopy
• Endobronchial ultrasound
• Transthoracic needle biopsy
• Video-assisted thoracic surgery
• da vinci® Robotic-assisted thoracic surgery
• CyberKnife Robotic Radiosurgery system
• Personalized approach to tissue analysis

For more information on the lung cancer screening program or the pulmonary nodule clinic, please call (717) 231-8339 or visit pinnaclehealth.org/lung.

For more information about how to quit smoking, plan to join us on November 21 at the Camp Hill Giant for a presentation by Troy Moritz, DO, FACOS, as part of the Great American Smokeout.

*American Cancer Society, estimated cancer deaths, 2013

Diabetes and Family

Renu Joshi, MD
Chief of Endocrinology at PinnacleHealth System

Renu Joshi, MD

I have seen it all. Over twenty years of caring for patients with diabetes, I have seen its innumerable consequences. Among them all, I have been struck the most by the devastating effects it has on families and how hard it is for families to cope with this terrible disease. Its effects run far beyond the many organs that it damages: the eyes, heart, kidneys, skin, brain, feet and the list goes on.

While I feel for the ways in which families are negatively impacted by the disease-in other words what the disease does to families, I am equally struck by how much families can impact the disease positively—in other words what families can do to help the disease process.  Food habits are a major example. If the entire family is eating whole grain pasta, it makes it so much easier for the diabetic patient himself to follow healthy diet habits.

What many diabetic patients do not realize is how much it actually affects their spouse. As an example, many of my Type 1 Diabetic patients’ wives cannot get adequate sleep because of a constant concern that their husband may not develop low blood sugars at night.

So my humble request is for families to take an active part in controlling this chronic disease in their loved ones. Such care pays rich dividends in that complication rates are so much lower when the disease is well controlled. Get involved in the life of your diabetic counterpart by cooking the right food, eating out sparingly and exercise together. Listen to what they are experiencing and visit the doctor with them so you can learn how to take better care of them.  Such care will positively transform the life of your loved one.

This Balancing Act Called Life

Contributed by Kristy Bush, Breast Cancer Survivor

In today’s day and age, we women seem to always have many things that we are trying to juggle.  From family to work and beyond, there are things constantly vying for our attention and we must decide what is a priority, and more importantly, what is not.  The question then becomes, how do we decide when everything seems so important?

Last year at this time, I was running around trying to climb the corporate ladder while keeping my status as “super mom”.   I had applied to return to school to obtain my Masters degree, but on December 6, 2012, this all changed.  I received the news that I had a very aggressive type of breast cancer, and in an instant, my priorities changed.

No longer was I concentrating on climbing the corporate ladder, rather, I was focused on fighting to live and to love the people who were in my life and important to me.   It is one thing to assess our priorities when we are forced to, however, what about the rest of the time?  Why don’t we make the time to assess what matters most to us regularly to make sure we are staying on track so that we perhaps have fewer regrets later in life?  Or do we as women require hardships to wake us from our “super woman” fog to realize the areas of our life that we are neglecting?

My journey through breast cancer was an unexpected eye opener.  I maintained a positive attitude and did what I had to do to get through it: that was my priority at that time.  I tackled chemo and bilateral mastectomies and was declared cancer free in May of 2013. 

Since then, I decided to decline my acceptance for my Masters degree and focus my time on touching people’s lives in a positive way, especially my children.  We all have goals in life, however, now I try to make sure that I look at my goals and ask myself if they will really matter to anyone 10 years from now if I die today.  Staying healthy, loving the people that I am blessed with, and making my unique mark on the world by touching others is what God has placed on my heart as my new goals in life. 

A person cannot go through an illness like breast cancer and not come out the other end unchanged.  Some will have a limited time to touch lives, while others of us who have beaten cancer have a second chance at life and how we live it.

It is clear that my life and perspective on things are changed.  Now I move forward at a slower pace, assess my priorities daily, and ask myself why I am making the choices I am making and is it benefiting others.

It took breast cancer to awaken me from my fog, but this does not need to be the catalyst for you.  My gift to you is my story.  Take time for yourself and to enjoy those around you…..slow down and live!

Watch Kristy's video to hear her story:

Staying Positive when Facing a Serious Illness

Katherine Barton, MD, FACS

Contributed by Katherine Barton, MD, FACS.
PinnacleHealth Breast Care Center, Breast Surgeon

Patients often ask me, “Did I get the breast cancer because I took estrogen?”  “Did my husband get these gallstones because of his diet?”  “Had I come in sooner, would we have caught this earlier and had a better prognosis?”

I try to diffuse these questions without really answering them because, although we know certain risk factors exist, we never really KNOW what causes disease.  We all know examples: a non-smoking individual that gets lung cancer or a thin runner who gets heart disease because of bad genetics.

I think that it is important to remember this so that we don’t self-flagellate too much when we do end up ill.  So often we blame ourselves… even blaming ourselves for something like cancer.  Perhaps we feel we deserve it for something “bad” we did in the past.  I see this all too often.  One patient of mine even showed me a letter from a “friend” stating that she was going to pray for her sins (because she developed breast cancer).

Prevention is a very important part of medicine and we should all strive to live a healthy lifestyle.  Quit smoking, exercise, maintain a healthy weight, reduce stress in our lives, eat a well-balanced diet including lots of fruits/ vegetable/ and omega-3-fatty acids, etc.  But please don’t beat yourself up for being human.

In fact, I think this is the key ingredient to success in whatever healthy pursuit you are attempting (whether its quitting smoking or losing weight or starting an exercise program or reducing stress in your life).  You have to forgive yourself for your slip-ups and start over again.  Tomorrow is a new day.  So… whatever you have been trying to achieve, start today with a positive “can-do” attitude and do not torture yourself for yesterdays “ice cream sundae”, “couch-potato TV watching” or that “quick cigarette” while on break.  Forgive and try again!  It’s been shown that those who keep trying are ones that are successful!  GOOD LUCK!

Click here to learn more about the PinnacleHealth Breast Care Center. 

Let's Talk About Mammograms!

Contributed by the PinnacleHealth Mammography Department

October is Breast Cancer Awareness month. What better time to talk about Mammography!

Mammograms have improved greatly over the last decade from film to digital imaging and now there is even 3-D Tomosynthesis imaging. Ten years ago your images were on film; now we have Digital imaging, which is faster, more sensitive and can be done with a lower radiation dose. They can even be manipulated, similar to digital photos you take today with your camera.

There are only two things you need to know to get ready for your mammogram.

• First, it will be easier for you if wear a two piece outfit because you need to remove your clothing from the waist up and put on a gown. 
• Second, do not wear deodorant or powder the day of your study. Deodorants and powders can contain small metallic particles that can affect the quality of the image.

Although you may be a little nervous about getting a mammogram let me reassure you, it isn’t the horrible experience you’ve been imagining or hearing about.  Your breast will be compressed, and while it may not be comfortable, it should not be painful. Some locations use a “Mammo Pad” that cushions you a bit during the compression.

The technologist will usually take four pictures, two of each breast with the machine at different angles. Your breast will only be compressed for about 15-20 seconds for each picture.  We have several offices that offer different options for your results.

• If you want to wait for your results, there are locations where you can get them immediately.
• Or, If you aren’t having problem and want to get your mammogram done, leave and get your results the next day, you can.

We also offer a new technology called Digital Breast Tomosynthesis.  The exam simply requires one additional image of each breast and will provide the Radiologist with a 3D view of your breast. Tomosynthesis helps to reduce the amount of radiation to you by decreasing the need to have additional views done. This service is offered on the East Shore at the Medical Sciences Pavilion located at our Community General campus. In mid October we will have Tomosynthesis on the West Shore in our Grandview office located just off Erford Road.

Although we offer both Breast Ultrasound and Breast MRI procedures as follow-up procedures to mammography, these studies alone do not replace a Digital Mammogram for breast cancer screening.


For more information visit www.pinnaclehealth.org/mammography

Getting Schooled on the Symptoms of Female Cancers

blog contributed by Margaret L. Grotzinger, MD, OB/GYN, Partners in Women's Healthcare, P.C

September is National Gynecology Oncology month; as many of us are sending our kids back to school; it’s time to also educate ourselves about the typical signs and symptoms of the common cancers that can affect our reproductive organs.

           

We often hear about ovarian cancer and how difficult it is to diagnose in early stages, but actually the most common reproductive cancer in women is uterine cancer.  This type of cancer typically arises in the endometrium, the lining of the uterine cavity.  Uterine cancer occurs mostly in women who have already gone through menopause, and the typical symptom that it presents with is bleeding.  We define menopause as being without periods for a year; therefore, any kind of vaginal bleeding (even if it is just spotting) after menopause needs to be evaluated by your health care provider, and endometrial cancer ruled out.  Although uterine cancer is most common in postmenopausal women, it can also occur in women before menopause.  In this scenario, heavy bleeding with periods, or bleeding in between periods, is the most common symptom.

Cervical cancer arises in the cervix, the lower part of the uterus that connects to the vagina.  Although the cervix is part of the uterus, cancers that develop on the cervix are very different from those that arise in the uterine cavity.  Cervical cancer is caused by Human Papilloma Virus (HPV), a very common sexually transmitted virus.  Cervical cancer can be prevented by getting regular Pap smears, which allows us to diagnose abnormal cells before they turn in to cancer.  The guidelines for Pap smear screening have changed, so be sure to consult with your health care provider about what an appropriate screening interval is for you.   Cervical cancer is most common in women age 30-60, and the typical symptom is abnormal bleeding, most notably bleeding after sex, or bleeding in between periods.  For women who are already past menopause, any vaginal bleeding is the most common symptom of cervical cancer.

Ovarian cancer continues to be a difficult cancer to diagnose early and cure.  Currently we do not have any good screening test for ovarian cancer.  To complicate matters more, the typical symptoms for ovarian cancer are often symptoms of other disorders that are not so serious.  These symptoms include pelvic pain, low back pain, indigestion, changes in bowel habits, abdominal bloating or a sense of “feeling full” after eating.  A good rule of thumb is that if  you have any of these symptoms persisting for more than 2-3 weeks, see your health care provider and make sure they evaluate you for the possibility of ovarian cancer.

The last type of reproductive cancer that is not so well known is vulvar cancer.  The vulva includes the labia, clitoris , vaginal opening and perineum (the area between the vagina and the anus).  These cancers are not very common, but again, are very curable if caught early.  The typical symptoms are a persistent sore or open spot on the skin, persistent itching, or burning and pain.  Vulvar cancer can also arise in a genital wart that is growing or not responding to typical treatment

. 

Don’t delay in seeing your health care provider if you notice any of these symptoms!  Although they may commonly be caused by something other than a cancer of the reproductive organ, there is no way for you to know for sure without getting checked out.  It’s better to be safe than sorry!  

For more information about visit the PinnacleHealth Resource Library or to find a doctor in the central Pennsylvania area search our Find a Doctor database or call (717) 231-8900 to speak with one of our friendly customer service agents.  

Watch Susan's Story - an Ovarian Cancer Survivor

8 Ways to Find More “ME” Time

You take the kids to school. You let the dogs out and feed them. You iron your husband’s work clothes. You pick the kids up. You pack lunches. You clean the house. You run errands. Am I missing something?

Easily enough, there are other things that you do that I didn’t mention. Women are often in charge of the household while holding down a full time job. You have many priorities in and out of the workplace. Often your health – mental and physical suffers as a result.

It’s time to change that! So the question is - how do you find time for you?

1. First, make yourself a priority. Yes, your family is important, too. But so are you! You should net not feel guilty for taking time out for you. At the end of the day, it really is a win-win for everyone. When you are stressed, tired and pulled in too many directions, it is hard to give your best. You may also be in a bad mood and take your emotions out on others, which could unintentionally hurt people you care about. Remember, self-time is not selfish—it's a necessary dimension of self-care! Plus it sets a good example for your loved ones. 

2. Ask for help. If you’re in the habit of doing lots of things for others, this might be a good time to reevaluate, and reassign tasks. What could the kids be doing for themselves? Could your partner pitch in more? Are you taking full advantage of the kids in your neighborhood looking for odd jobs? Often times you will find that people want to help. It might take time to realign day to day tasks effectively, but very soon you’ll gain more time for yourself. 

3. Learn to say no. This one, though self-explanatory, is likely one of the hardest for you to accomplish. Women are pleasers. However, by saying yes, we can easily become overloaded. Set boundaries for yourself and your time.  Maybe you won’t be bothered after 7pm on weeknights.  Or maybe you will try to only volunteer events that have you have a personal connection to. Eventually, you’ll be able to prioritize your yes events better and will find a little bit of me time. 

4. Find an activity that is relaxing.  Reading, knitting, taking a bath, yoga, drawing, massage. There are a lot of options out there of what you can do to spend some time for yourself.  Whatever your time out activity is, make sure that it is stress-free and a healthy choice.  Commit to not only doing it, but enjoying it without guilt as well!

5. Unplug. Take a half an hour every day to turn off all your notifications on your phone. Step away from your computer. Put your ringtone on silent. Or be extremely daring and turn off your phone completely.  On average, women use 22 percent more cell phone minutes than men, and they even text more, sending 154 more messages per month than the average American man. On average, we are on the phone for 646 minutes a month! That’s just over ten hours. Imagine how good it would feel if you took an hour away from your cell phone and used that time to do something for yourself.  You will be better equipped to notice the small, daily pleasures of life.

6. Incorporate exercise. This can be as simple as going for a 30 minute walk each day. Walking is easy because you can do it almost anywhere and at any time. It also offers a range of health benefits. Walking gives you energy and improves your stamina for everyday activities, improves your mood and reduces stress, helps you relax and sleep better, reduces your risk of disease, and keeps the weight off.

7. Create opportunities.  Me time doesn’t always have to be set in stone. Perhaps you find yourself with some time between appointments. Instead of trying to do more, consider taking that time as downtime. Find a quiet place to sit or go get a cup of coffee. Or practice relaxation techniques in a quiet location.  Me time doesn’t have to be glamorous or meticulously planned.  Sometimes the best times are those that just happen!

8. Make yourself accountable. It’s always easier to do something when you’re accountable to someone else for it. Talk to a friend or two and make a deal with them that you’ll both keep “tabs” to ensure the other is getting their “me” time. Perhaps some me time is hanging out with your friends. Whatever it is, challenge your friend to make a date with you!

The following blog was contributed by Melissa Brown, PsyD, of PinnacleHealth Psychological Associates.