Spotlight On: Mammography & the MMU

Kudos to the staff of the Mobile Medical Unit, including Mammography Tech Denise Hammerquist,  for her excellent work not only as a technician, but also for delivering compassionate, personalized patient care.

In Fiscal Year 2009, the MMU provided 505 screening mammograms. In 2010, Denise and the MMU provided 993. What’s more, during Breast Cancer Awareness Month in October 2010, Denise did 203 screening mammograms – double the number of mammograms from last October!

A patient recently offered this testimonial about Denise:

“I have walked out of mammogram after mammogram in tears. This woman was so wonderful. I could hardly tell she was giving me a mammogram, and then it was over. She was so great and she needs to be acknowledged for her care.”

Thank you Denise for increasing prevention and early detection of breast cancer to so many in our community. Thank you for being a wonderful representative of SJRMC!

Learn more about the MMU at http://www.sjmed.com/medicalservices/mmu/

Plymouth Hospital to Celebrate 100-Year Anniversary

The former Parkview Hospital

In 1910, two physicians built a three-story facility at 310 North Michigan Street in downtown Plymouth, establishing a foundation for quality health care in Marshall County that would continue for the next 100 years.

While the name and location of the community hospital has changed over the years, what remain are a dedication to medical advancements, outstanding community support, an ambition to grow and a commitment to increase access to quality health care.

On Saturday, October 30, 2010, past and present employees of SJRMC and their families are invited the Marshall County Historical Museum in downtown Plymouth to view a special exhibit about the hospital.

The Celebration of 100 Years exhibit will be on display at the newly renovated museum from 11 am – 1 pm. Bring the little ones – the trains will be running!

Starting on Monday, November 1, the exhibit will continue to be on display for the general public. Special thanks to the Marshall County Historical Museum for partnering with us to celebrate this milestone.

Thanks to all of our past and present employees, physicians and patients for 100 years of continued community support.

The Museum is located at 123 North Michigan Street in Plymouth. For more information call 574.936.2306.

SJRMC Names New President & CEO

Saint Joseph Regional Medical Center (SJRMC) today announced the appointment of Albert L. Gutierrez to President and Chief Executive Officer. He succeeds Interim President and CEO Thomas A. Reitinger. Gutierrez will take his post at the hospital on November 15, 2010.

Albert L. Gutierrez, CEO/President of SJRMC

“I am personally delighted that Al sought this position and agreed to join us at SJRMC,” said Mike Hammes, Chairman of SJRMC’s Board of Trustees. “He has done a phenomenal job leading Shore Memorial and, in him, we have an energetic and enthusiastic leader who will be able to continue the momentum built by Tom and take our hospital forward to a new level. He brings the kind of thoughtful and decisive leadership this position demands. We are fortunate to have him.”

Gutierrez has been with Shore Memorial Health System in Somers Point, New Jersey, since 1985, and has served as the President and CEO since 2002.  His administrative experience includes several other senior leadership positions, including Administrative Director of Radiology, Administrative Director of Professional Services, CQI, and Regulatory Affairs, and Vice President of Professional Affairs.

Shore Memorial Health System is the parent corporation of four related subsidiary corporations: Shore Memorial Hospital, Shore Health Services Corporation, Shore Health Enterprises, Inc., and Shore Memorial Health Foundation, Inc. Under Gutierrez’ leadership, Shore Memorial Health System enjoyed rapid growth with the building of a cancer center, cardiovascular center, and surgical expansion. Gutierrez also developed an affiliation with the University of Pennsylvania Healthcare System, which has been crucial to the future of healthcare in the Somers Point communities.

After 25 years of service to the hospital, though, Gutierrez sought a change that would put him to work in a faith-based setting. 

“The opportunity to lead at Saint Joseph Regional Medical Center was attractive to me and my wife, Margaret, for its reputation and its ties to a renowned national Catholic health care system,” said Gutierrez.  “With its strong ties to the University of Notre Dame, Saint Mary's College and the Congregation of the Sisters of the Holy Cross, SJRMC is the perfect place for me at this point in my career. I am delighted about getting started and about partnering with associates, leadership, and medical staff to serve patients and their families in Michiana communities.” 

Of Gutierrez, Reitinger said: “Our Board of Trustees has made an excellent decision in appointing Al as he embodies the Mission of Saint Joseph and Trinity Health. His enthusiasm and experience, combined with the energy our new hospital creates, will provide an exciting future for SJRMC and everyone we serve.”

Gutierrez holds a B.S. in Radiologic Science from Thomas A. Edison State College in Trenton, New Jersey, and an M.B.A. from St. Joseph University in Philadelphia. He is married with two adult children.

In Memory of Dr. Roland Chamblee

Dr. Roland Chamblee

November 23, 1923 – September 23, 2010

The community lost one of its pioneers in medicine and civil rights, a very dear friend, and a good and giving man with the passing of Dr. Roland Chamblee.

Born in Atlanta, Dr. Chamblee served the United States in World War II reaching the rank of First Lieutenant with the Army Corps of Engineers. He received a Purple Heart for injuries he suffered during the Normandy Invasion. Following the war, Dr. Chamblee earned a Bachelor of Science degree from Tennessee State University and a PhD from Meharry Medical College in Nashville. That’s where he met his wife Dorothy and the couple went on to have six children. Dorothy passed away in 1995.

Dr. Chamblee arrived in South Bend in 1953, serving an internship at what is now Saint Joseph Regional Medical Center. He went into private practice a year later.

Dr. Chamblee worked just as tirelessly to promote racial justice as he did as a physician. He became deeply involved in efforts to end discrimination in South Bend, accepting patients of all races and assembling an integrated staff.

A longtime advocate of public health, Dr. Chamblee helped establish the Sister Maura Brannick, CSC, Health Center on Chapin Street and Western Avenue in South Bend, serving as its medical director while volunteering much of his time to provide healthcare for the poor and underserved. He also volunteered at many free health screenings.

“He loved this community,” said Carla Bice, manager of the Health Center. “He loved the clinic and he loved serving all of our patients.”

Always looking for ways to improve the delivery of healthcare throughout the entire community, Dr. Chamblee served as the Director of the St. Joseph County Board of Health.

“Dr. Chamblee was motivated by all the right values,” said Dr. Steven Gable, SJRMC’s Vice President of Medical Quality Improvement. “Love of his patients, the good and ethical practice of medicine, generosity of his time and his talents, and a strong belief in the Mission of Saint Joseph Regional Medical Center.”

May he rest in peace.

Ann Rathburn-Lacopo Named Chief Development Officer

We are excited to announce Ann Rathburn-Lacopo as the Chief Development Officer for the Foundation of Saint Joseph Regional Medical Center!

Ann Rathburn-Lacopo

Ann has nearly 20 years of fundraising experience in our community, most recently serving as the Chief Development Officer for the Indiana University School of Medicine/South Bend on the campus of the University of Notre Dame. Prior to that, she held several positions at Notre Dame, including Assistant Director of Corporate Relations, Development Officer and Director of Foundation Relations, and Director of Corporate and Foundation Relations. Some of her responsibilities included managing multi-million dollar gift portfolios, cultivation and oversight of undergraduate and graduate student scholarship programs, marketing and communications, and directing alumni volunteer programs and community outreach.

"We are excited and pleased to have Ann join Saint Joseph as our Chief Development Officer," said Al Gutierrez, SJRMC President & CEO. "Right now, the need for our Foundation services is greater than ever and Ann's blend of experience and expertise in fund raising here in Michiana is pivotal in Saint Joseph advancing our Mission throughout the many communities we serve."

The Foundation of SJRMC serves as the philanthropic arm of the hospital system, securing and stewarding financial gifts to ensure the viability of essential services and programs.  These gifts and grants support hospital-based services such as cardiology, pediatrics, oncology and nursing education and outreach programs such as our health clinics, the Mobile Medical Unit, tobacco cessation programs, our Pediatric Specialty Clinics, the Women’s Task Force and many more.

“In the tradition of the Catholic Church, SJRMC is a leader in the community regarding service to the poor, uninsured, and underinsured through its outreach health centers and many other health and education initiatives,” said Ann. “This is a new era for Saint Joseph with a beautiful new hospital and I am delighted to be a part of this wonderful team.”

Ann will begin at SJRMC on February 14, 2011. Please join us as we welcome her to the Saint Joseph team!

To learn more about The Foundation, go to http://www.sjmed.com/mission/foundation.

Spotlight on Plymouth: Diane Meister, Medical Lab Technician

Diane Meister, Lab Tech

As a Medical Lab Technician at SJRMC - Plymouth for the past 15 years, Diane Meister truly believes she has the best of both worlds.

Every day she has the chance to talk with patients, ease their fears and help put them on the road to recovery.

“My job is to turn your negative event into a positive one. Nobody wants to be in a hospital,” she said. “And after that? I get to use all types of really cool technology and equipment.”

It’s not a surprising comment coming from someone who built lawn and garden tractors for 12 years before getting the itch to go to nursing school. But Diane was never meant to be a nurse.

“I jumped into the lab tech program, and I’m so glad I did,” she said. “There is so much diversity in my job. I get to work with every department and move between a lot of different areas.”

At the Plymouth Cancer Institute, Diane is proud to be able to provide her patients point of care testing. The ability to do draws and run tests in one location provides patients with even more convenience.

Every month when rounding with Lab Associates, Diane is the number one person recognized by the staff for going above and beyond.

“Diane staffs the Oncology Laboratory, where her compassion for our sickest and most complicated patients is truly a gift,” said Barb Holcomb, Lab Manager. “Patients and her co-workers often request her abilities and assistance – and she is always there with a smile on her face.”

In addition, Diane is the Lead Tech for Coagulation, where her responsibilities include maintaining The Joint Commission standards. She also serves as a lead person for Chemistry and assists with reporting proficiency testing to the College of American Pathologists.

Diane is proud to work for an organization that works to improve the health of the community.

“I feel like I have a vested interested. Every patient who comes in could be my neighbor, or my mechanic or someone I will end up seeing at the grocery store. I don’t want them to remember me at the one who stuck them,” she laughed. “I want them to remember having a good experience.”

Spotlight on Plymouth: Diane Soike, Environment of Care Coordinator

Diana Soike, Environment of Care Coordinator

The go-to girl. The paperwork junkie. The person to call to get things fixed. What kind of title do you give to someone with that kind of job description?

That would be the Environment of Care Coordinator, and at the SJRMC- Plymouth Campus, Diana Soike is known for all of the above.

With previous experience as a legal secretary, Diana joined the Saint Joe Team working at the front desk of the Cancer Institute in 1999. In 2003, she applied for and was hired into her current position. And 7 years later, Diana swears she still learns something new every day.

"I never thought I'd know so much about healthcare,"she laughed. "I always thought Saint Joseph was a wonderful hospital and would be a great place to work – and I was right."

Diana works to help the hospital maintain its credentialing, regularly working closely with a wide variety of hospital staff and The Joint Commission. Recently, she helped to coordinate the community-wide disaster drill. If there is any type of renovation going on across the campus,you can bet she knows every detail.

"There are new challenges every day," she said. "I'm always working with new people and committees, and our staff is always so kind. When I have to learn new things about the individual departments, they are so patient and willing to help."

Diana maintains a close relationship with allof the ancillary departments – specifically maintenance, environmental, dietary and materials management.

"Those Associates really keep our hospital running," she said. "All of our Associates are so wonderful and [President] Lori Price is just a terrific leader. And I love my boss. I really do."

From the adjoining office her manager Safa Saddawi lets out a laugh. "I didn't even pay her to say that!"

After overhearing part of the conversation, Saddawi has something to add.

"Diana is an asset to this hospital," he said. "She's too good. People have confidence in her because she gets things done. It's not always easy to have that reputation. Sometimes you never get a break."

A Plymouth native who remembers the former hospital location across from Centennial Park, Diana is proud to work for an organization that provides for her family, friends and neighbors.

"People in Plymouth are fortunate to have this," she said. "We have excellent physicians and staff and I've heard on more than one occasion it's nice to receive the care you need close to home.Our hospital is like a little family and I love it."

Could Aquatic Therapy Benefit You?

Aquatic Therapy has always offered an ideal and unique medium in which to provide therapy. Today, aquatic therapy is used for both preventative and conditioning purposes as well as for rehabilitation after injury. The unique properties of water will often afford patients the ability to perform and tolerate the progression of exercises that would not otherwise be tolerated on land. 

In the water, the unique properties of buoyancy and hydrostatic pressure can be used to the patients’ advantage. 

• Standing in water waist high decreases body weight by 50%
  
• Chest high decreases body weight 70%
  
• Neck high decreases body weight by 90%

This allows the patient to stand, walk or move with decreased pain using no external supports or braces, canes, walkers, etc. The patient is able to work on gait, transfers and balance in a safe and protective environment.

Muscular strength and endurance can be improved or maintained in the water, as water is 600-700 times more resistive than air.

• It takes more force to push the body through the water than through air
  
• The faster an object is pushed through the water more turbulence is produced, resulting in greater resistance to the movement.

This makes for an ideal environment to work with those patients who are very weak and in the early stages of strengthening.

The water in therapeutic pools s much warmer than a traditional pool, ranging from 91-99 degrees F.

• Warm environment results in a rise in superficial tissue temperature creating a palliative like effect decreasing pain.
  
• Acts to decrease pain by bombarding the nervous system with sensory information of warmth promoting relaxation and a decrease in muscle guarding.
  
• Warmth and buoyancy of the water act together to provide increased support to an injured and painful limb.

Additionally, therapy in the water has psychological and social benefits in addition to the physiological benefits. Patient morale is improved with the ability to move and return to some normal activities. As the patient moves and becomes more confident in their abilities the fear of falling or pain diminishes.

Aquatic Services at SJRMC
Saint Joseph Regional Medical Center offers Therapeutic Aquatic Services at the 4 West Facility located at the corner of 4th and West streets in Mishawaka.

Our Physical Therapists Kathy Jeter and Marilyn Ross bring over 40 years of aquatic experience and background to the program. A prescription for aquatic therapy from a physician is required to get started.

After a thorough evaluation by a Physical Therapist, patients are set up on an individualized program and each session is designed to help the patient meet his/her goals and return to the highest level of function possible.

• 18,000-gallon pool ranges in depth from 3-6 feet
  
• Very comfortable at a therapeutic temperature of 92 degrees
  
• Poolside hydraulic lift, electronic lift and handrails make the pool accessible to patients of all abilities
  
• Non-swimmers can be accommodated with various flotation devices and are treated with one-on-one assistance by the therapy staff
  
• Large variety of resistive equipment to be used by our pool patients as appropriate
  
• Aqua joggers and wet vests for deep-water running, non-weight bearing exercises and unloading programs
  

For more information or scheduling contact the Aquatic Therapy Department at (574) 252-0333.

Family Medicine Residency Program Recognized for Increasing Childhood Immunizations Rates in Underserved Areas

The American Academy of Family Physicians Foundation has announced Saint Joseph Regional Medical Center’s Family Medicine Residency Program as a winner of the 2010 AAFP Foundation Pfizer Immunization Awards. 

SJRMC’s program was one of ten in the United States recognized. These celebrated family medicine residency programs have achieved excellence in clinical practice by developing creative solutions that result in increased immunization rates in their communities. 

“This recognition shows the dedication our Family Medicine Residency Program has to all those we serve here everyday,” said Dr. Martin Wieschhaus, Program Director. "This was truly a team effort and reflected an impressive blend of organizational, clinical, and academic skills within a group of high functioning individuals.”

The awards provide monetary grants and scholarships for residents to attend the AAFP’s National Conference, a three-day event held during July in Kansas City designed for residents and medical students to share ideas with family medicine educators and leaders from across the nation. 

“Following the efforts in past years of residents Lindsey Lira, M.D. and Laura Foudy, M.D., the SJFMC PI committee began considering the next cycle of improvement in immunization rates in the winter of 2009-2010,” said Dr. Daniel Triezenberg, Associate Director of SJRMC’s Program. “In collaboration with staff from MHIN, and including efforts from Nurses Betty Swisher and MaryAnn Rompola, a plan was drafted. The plan was implemented in January and a team of nurses and residents including Marin Garcia, Richard Zentz, Laura Foudy, Betty Landesman, Heidi Scott, Betty Swisher, and MaryAnn Rompola, will soon be reviewing the progress made an recommending further improvements.”


Award Categories

The 2010 AAFP Foundation Pfizer Immunization Award winners were chosen for their ability to find and implement team-based solutions that increase immunization rates. The 2010 recipients were chosen for one of the following award categories:

• Best Practices — Effective systems in place that are achieving high immunization rates within a specified 12-month period
• Most Improved — Overcoming barriers to greatly improve immunization rates within a specified 12-month period
• System Implementation — Implementing a new system that will increase immunization rates in medically underserved children

“The AAFP Foundation applauds this year’s program winners for their dedication to protecting children from infectious diseases and to raising awareness of the importance of immunizations to a community’s health and well-being,” said Craig M. Doane, executive director of the AAFP Foundation. “We are proud to recognize programs that share our vision of achieving optimal health for everyone.” 

From left, SJRMC's Betty Landsmen, Betty Swisher, Heidi Scott, Mary Ann Rompola, Dr. Richard Zentz, Dr. Dan Triezenberg, Dr. Laura Fondy, and Dr. Marin Garcia proudly display the AAFP Foundation Pfizer Immunization Award.

Perry Pugno, Director of Medical Education for American Academy of Family Physicians presents Dr. Martin Wieschhaus, Director of SJRMC's Family Medicine Residency Program, with the AAFP Foundation Pfizer Immunization Award.

Tips for Summer Cuts, Burns, & Bites

Minor cuts and scrapes are a part of every summer and for some people the inconvenience and expense of seeking medical care may outweigh health concerns about the injury itself.

"It often isn't easy for the average person to judge the severity of a bite, minor burn or cut so people tend to wait to seek treatment,” said Scot Stepleton, Director of Plymouth’s Wound Healing Center. “Minor scrapes can be treated with supplies from a well-stocked first aid kit, but major injuries or infections need to be seen by a health care professional before they have time to develop into something more severe."

The local experts at both SJRMC’s Wound Healing center’s in Mishawaka and Plymouth, National Healing Corporation Wound Healing Centers, offer the following guidance on when to seek medical treatment.

Sunburns can be treated with over-the-counter remedies, yet can be associated with shock, heat exhaustion and dehydration which need professional attention. Symptoms indicating a serious reaction can include severe painful blisters, nausea, fever, chills, extreme thirst, rapid breathing, faintness and dizziness.

Deep puncture wounds made by nails and knives are especially susceptible to tetanus bacteria commonly found in soil. All wounds should be cleaned immediately. Adults who have not had a tetanus-diphtheria shot in 10 years or children who have not been vaccinated should seek professional attention and receive the vaccine.

People with certain medical conditions such as diabetes and vascular disease as well as the elderly and those who have had radiation therapy should closely monitor all wounds for signs of infection or failure to heal, especially those on the lower extremities.

·Seek medical treatment if a burn or wound shows signs of infection including increased pain at the wound site, redness or swelling spreading away from the wound, a foul wound odor, change in color or amount of drainage from the wound, or if you experience fever, chills, nausea or vomiting.

Bites from unknown or wild animals require immediate medical attention. Also seek treatment if the bite is deep or large, on the face, neck or hands or if there is swelling, redness, pain or infection draining from the wound. Animal bites also pose a tetanus threat to those who have not been vaccinated.

·Seek emergency assistance for insect bites if you are experiencing trouble breathing, facial swelling or turning blue, weakness or tightening of the throat. Emergency rooms and wound healing centers equipped with hyperbaric oxygen chambers are needed to treat some serious spider bites, like those of the brown recluse spider.

For more information on treating chronic or infected wounds, contact the Saint Joseph Wound Healing Centers at 574-335-6210 or 574-941-3140.

Welcome to SJRMC, Dr. Piazza!

Saint Joseph is excited to welcome Plymouth native Brian L. Piazza, MD to the Medical Staff.

Dr. Piazza specializes in general surgery as well as upper and lower Endoscopy. He has been in practice for 15 years and will be joining the staff at Marshall County Surgery Associates.

After graduating from Plymouth High School in 1982, Dr. Piazza attended Valparaiso University and then Indiana University School of Medicine. In addition, one of his professional highlights included a teaching stint at Michigan State University’s Department of Surgery, where he worked with an expert office and hospital staff and had the opportunity to touch the lives of many patients.

Dr. Piazza takes a team approach to patient care – for the physician, the patient and the patient’s loves ones.

“We are all on the same team,” he said. “The patient is the coach and the doctor serves as the quarterback, acting in the coach’s best interests.

Most patients are apprehensive when they are coming in for a surgery or procedure, no matter how invasive it may be. While many patients ask about the benefits, risks and possible outcomes, it can be a lot of remember. Dr. Piazza encourages his patients to bring a family member or trusted friend to appointment.

“I also truly believe each person is created in God’s image,” he said. “It’s my personal philosophy to treat every patient with the utmost dignity and respect.”

Dr. Piazza enjoys spending time with his wife and two children, all while trying to keep in touch with his six brothers. In his spare moments he enjoys staying active in his church, photography and downhill and cross-country skiing.

For more information on services offered by Dr. Piazza, contact:
Marshall County Surgery Associates
1919 Lake Ave Suite 102
Plymouth, IN 46563
(574) 941-2967

Where the Grass Really is Greener

What was just 6 months ago a new construction site is now a peaceful escape at the new Saint Joseph Regional Medical Center.

The pond fountains are up and running, walkers are using the new paths around the campus, our historical statuary is in place outside and birds can be heard singing.

But the most noticeable difference? All the green!

Creating new landscaping across the 90 acres of your new hospital was no small feat. And not only is the new campus easy on the eyes – it’s easy on the environment.

The grasses, plants and wildflowers you see out the windows of our hospital are all part of Native Planting, a concept that uses plants that were growing naturally in an area before humans introduced species from distant areas.

In short, the campus was never supposed to look like the rolling fairways of a golf course. The goal was to recreate a prairie environment to resemble what was in place here hundreds of years ago.

While everything has not quite filled in – it takes up to two years for this landscaping to take hold – this concept will benefit our area for years to come.

Water Efficiency
Native plants have a deep root structure. As a result, they generally require little or no irrigation once established. In comparison, turf grass has a root system 2 to 3 inches deep and requires frequent, intensive irrigation.

Rain Water Management
Native plants have a high capacity for rainwater uptake and infiltration, enabling areas to effectively manage storm water flows on sight and keep the water out of the sewer system. Their root system creates a matrix of soil that readily absorbs water deep underground.

Carbon Sequestration & Climate Regulation
Native plants naturally pull carbon from the atmosphere and store it in their living biomass both above and below ground. When their roots die off, this material decomposes below the surface and enriches the soil in the process. Additionally, native ecosystems naturally cool the local climate.

Reduced Toxins
Native plantings resist pests and disease, which limits the need for chemical pesticide or herbicide treatments. The result is a healthy habitat for pollinators, butterflies, birds, amphibians and other wildlife.

Low-Cost Maintenance
Native plant systems generally do not require mowing or regular maintenance, and as a result reduce the energy, manpower and equipment needs associated with maintenance. This will generate tens of thousands of dollars in cost savings and further reduce the carbon footprint of a site.

Give Your Body a Sporting Chance Against Injury this Summer

By Dr. Stephen Simons, Sports Medicine Institute

In my line of work, it’s a common occurrence. People coming into my office with muscle pain, or worse, shortly after declaring that this is it, they’re going to get in shape this summer. Right now – this week, this month – they’re going to reverse what is sometimes months or years of relative inactivity to lose those extra pounds, improve their cardio, or simply scratch that competitive itch.

There are obviously many reasons to embark on athletic endeavors and, more than most, I’m in favor of people getting out and being active. However, as both an athlete and doctor, I advise patients that they need to gradually get into a consistent pattern of exercise. It doesn’t happen overnight ... at least not without first suffering the sensation of pain and/or injury.

If you’re looking to get into jogging or biking – maybe you want to enter that 5k race at the end of the summer – that’s great. Such time-based activities are naturally conducive to beginners because you can start slow and gradually increase your minutes over time. Just make sure to give your muscle tissue the proper time it needs to recover from the stress you apply to it. Perhaps start off by only participating in the activity every other day instead of daily. As a general rule, one shouldn’t increase exercise time by more than 10 percent each week as your body needs time to adapt to a new level of workout.

Weekend Warriors
What if your buddies need another player for a weekly pickup basketball or soccer game? You’re pretty good, need the exercise, and don’t mind getting back out there and playing. Unfortunately, it’s also been a few years.

This is where you really have to be disciplined because the decision of how long to exercise is no longer just about you ... the individual. In other words, if your group normally plays for two hours and you are just getting started with them, it takes a fair amount of discipline to say that you’ll play for 30 minutes the first week and then increase your time next week ... and so on. Peer pressure comes into play and it’s easy to succumb to that – especially if you’re feeling good at the time.

Like everything else, the older you get, the more likely you are to run into some type of problem just jumping into an activity. An 18-year old can get away with a lot more than a 48 year old.

One of the main problems that occur in these situations is DOMS (delayed onset muscle soreness) – when the connective tissue gets strained and produces subtle swelling in the muscle. That is manifested through muscle soreness 24 to 48 hours later. People often call it a ‘good hurt’ but there’s not much good in feeling that way. When suffering from DOMS, a little muscle movement (i.e. stretching the muscle) is advisable because it helps massage that interstitial fluid that results from a subtle vascular leak at the point of the injury.

Tendonitis and bone stress injuries are also potential risks. However, unlike DOMS, symptoms of these injuries generally occur following repeated heavy activity over time. Symptoms of such injuries involve continuing achiness in a narrowly focused area of the body – even while at rest. Finally, muscle strains become more common in 40 and 50 year-old athletes as the result of their bodies becoming stiffer with age.

Kid Concerns
What about our children? What are their risks associated with participation in summer sports and other activities? For those aged around 9 to 16 – before skeletal maturity – the issue is dealing with their open growth plates. Because they are still growing, it’s easy for kids to have heel pain, knee pain, ‘little leaguers elbow’ – all those problems that result from overuse of the growth plates.

Such injuries usually occur during a growth spurt – about the time you notice your son or daughter has already outgrown the pair of pants you bought them four months ago. That’s when they are more susceptible to the growth plate injuries.

Typically, I see heel pain at younger ages (10 to 12 years of age) and knee pain two to three years later. And in any sport where there is constant throwing, there are always potential growth plate problems in the elbow or shoulder.

The key here is that, just because they are kids – young and strong – they are not impervious to muscle and bone injury. In fact, because of the growth plate issues, at times they are more prone to injury than adults.

Therefore, kids need to make sure they are properly stretched before exertion and that they keep their muscles loose and warm during the game to keep them pliable. We’ve all seen the little league outfielder standing out there an entire game and then – all of a sudden in the seven inning – having to make a long throw to home plate. Not a good situation for the arm, shoulder or elbow.

Summer is a special time of year for most people – regardless if they are looking to get out on the court, field or diamond again, or simply trying to look a little better for the beach. Just keep in mind that you may find your way back inside on the couch quicker than you think if you try to make it all happen overnight.

More Info
Dr. Stephen M. Simons is board certified in sports medicine and family medicine. An avid runner, Dr. Simons also served as a US Olympic Team Physician in 2004. He can be reached at the Sports Medicine Institute at 611 E. Douglas in Mishawaka at (574) 335-6214.

Moisturizers: The Cream of the Crop

By Aaron Young, MD, Saint Joseph Family Medicine

I’m often asked what is the number one preventive measure people can take to keep their skin looking as youthful as possible for as long as possible. Quite simply, the biggest factor regardless of age or gender is sun protection – especially for those in their 20s and 30s – because, if you’re taking care of your skin during this time in your life, it will positively affect how you look in your 40s and 50s.

For women, there is makeup and moisturizers that already have SPF 15 in them. If you incorporate these products into your daily routine – with base products, lip stick, lip gloss, etc. – you don’t even have to think about being caught off guard by being out in the sun for a prolonged period of time when maybe you don’t anticipate it. By using these products, you’re already covered.

While such SPF protective makeup has been around for a few years, they are now more common and attainable to the general public. Until recently, they were viewed as more of a high-end, specialty product but now the technology and applications have trickled down to the less expensive brands.

What I also recommend for all age groups is the use of skin moisturizers as they are effective treating those fine lines that start to become apparent around the eyes and the mouth with aging. Moisturizers plump up and lessen the appearance of facial lines. Also, like makeup, you don’t have to purchase an expensive brand that you find at the department store for it to be effective. It can essentially be any type of moisturizer – even something you find at the corner drug store. What is important is buying a moisturizer that works for you and sticking with that particular brand.
One cautionary note: if you suffer from acne and you’re looking to purchase a moisturizer, try to use a brand that is non-comedogenic (oil-free) so you are not compounding your problem.

As you approach middle age, it’s best to continue these healthy skin practices that ideally were established in your 20s and 30s. As you get older, however, the pursuit of youthful looking skin obviously becomes a little more complicated. For many women, the approach of menopause signals the onset of hair in places where it hadn’t grown previously. Combating this commonly means the use of electrolysis, tweezers or doctor-prescribed creams. While there are hair removal creams available over-the-counter, they tend to either not work very well or not at all. So, if you really want something that will work – talk to your doctor about it.

Finally, there’s a lot of focus these days – especially through TV commercials and infomercials – on collagen formation. Collagen is the primary structural protein in your skin that determines how firm and tight it is. Unfortunately, as we grow older, natural collagen formation does not occur as frequently as it does in our youth. Thus, the proliferation of wrinkles and lines as we age.

However, despite the popularity of these anti-wrinkle creams in some circles, I tend to recommend that people stick with a basic moisturizer. That’s going to fill in those lines just as well and you don’t have to worry about them damaging your skin. But, if you do put an over-the-counter cream on your face and it just doesn’t feel right – perhaps it burns slightly or tingles – stop using it immediately. Also, never combine the use of multiple skin products as it is sometimes difficult to predict how these products will interact with one another.

While perhaps a medical cliché, the key to maintaining healthy skin is – as it is with most healthcare issues – prevention. And if you find yourself starting this process a little late in life, don’t try to make up for lost time through quick fixes. At the risk of using another medical cliché – see your doctor first.

More Info
Dr. Young is a certified family practitioner within the Saint Joseph Physician Network with a special interest in dermatology. He currently practices out of the Saint Joseph Family Medicine - Elm Road office. He can be reached at 574-252-3616.

Real Stories: A Letter of Thanks

The following is a letter sent to Saint Joseph Regional Medical Center from Dr. Carol Ecker, Director Humane Society of St. Joseph County, in thanks of supplies donated from the former SJRMC/South Bend.

When I received a phone call from Sister Laureen Painter, I was in seventh heaven, if there is such a place. She graciously told me that the Humane Society could have articles from the former Saint Joseph Regional Medical Center/South Bend that would be of possible use to us. Since we were building our new shelter for the animals, this was great news. Little did I know that it would be thousands of dollars worth of savings for us. My Aunt Mary always told me “Good things that go around come around.”

Sister Laureen took precious time out of her schedule to show some others and me around the hospital so that we could see exactly what items we could use. It was like Christmas at Wal-Mart. I found so many things that we could put in our new shelter that would diminish the cost tremendously. The stainless steel sinks, lights, cabinets, furniture, IV stands, stainless steel instrument stands, tool cabinets, paper towel holders, vanities and many more things.

So one Wednesday morning, we again toured the facility, after an okay from Sister Laureen. I brought men from Casteel Construction Company, the folks building our new building, and we marked all of the prizes that we were allowed to take. They brought a plumber and we were in business. I have 24 sinks, enough for my surgery, treatment and triage areas. I have vanities for the bathrooms, furniture for the grieving room. The grieving room is where people will be allowed to say good-bye to the animals before they are put to sleep by owner request. The other rooms that need furniture are the play areas where we have people come and visit with their potential pet to get to know them better and to make sure that it gets along with their family members.

In the cattery, which will have outside porches, we need all kinds of plastic items so that they can be cleaned readily. So chairs, tables, benches and milk carton boxes will be used in these rooms for the cats to climb up on and play. We are on a constant hunt for these items.

The Staff has never had any place to really relax and eat their lunch and now will have a staff room. It has tables and chairs from the cafeteria. A refrigerator and a microwave will be used to make their lives better. We do not have a high pay scale here but we will try to make the work conditions improve. The staff is so dedicated to the animals and their well being, that little amenities are really all that we can offer aside from the joy when animals are adopted into the community.

My surgery is being put together little by little. I now have to load the animals in a van, take them to Michigan to a friend’s hospital, spay or neuter them, wake them up and load them in the van and bring them back to our shelter. It is a laborious task and can only be done a few times per month. The surgical supplies that I received from you are most precious to us. Suture material, gowns, drapes, gauze and the many other items that you all bring on a regular basis are most valued. Thank you!

Saint Joseph Regional Medical Center, we owe you so much for all you have done for us! We will keep you posted as to what we are doing with the materials that you so graciously donated to our facility. The gift from the hospital will keep on giving to a really good cause - the animals that have so little. 

Physician's Personal Experience Helps SJRMC Provide Unique Cancer Care

Dr. Mohamed Farhat, MD

September 1, 2009, is the day cancer treatment was dramatically enhanced in Michiana. That’s when Mohamed Farhat, MD, joined Michiana Hematology Oncology at Saint Joseph Regional Medical Center’s Cancer Institute.

Not only is Dr. Farhat triple Board Certified in the areas of Hematology, Oncology, and Medicine, he is also an Assistant Professor at Rush University Medical Center in Chicago, where he completed his Fellowship and Residency.

“We are so happy to be here in this area,” said Dr. Farhat. “Not only is this a great place to live and raise a family, but being here helps provide a university-based cancer treatment program to this area. We have at our disposal whatever we want and access to some of the greatest minds in cancer treatment.”

Rush University is home to one of the first medical colleges in the Midwest and one of the nation’s top-ranked nursing colleges, as well as graduate programs in allied health, health systems management, and biomedical research.

For more than 170 years, Rush has been leading the way in developing innovative and often life-saving treatments. Today, Rush is a thriving center for basic and clinical research, with physicians and scientists involved in hundreds of research projects developing and testing the effectiveness and safety of new therapies and medical devices.

This unique combination of research and patient care is now available in Michiana thanks to the connection and care provided at SJRMC by Dr. Farhat, as well as some poignant personal motivation.

“The patients have been very happy and enthusiastic about receiving the same care as they would in Chicago,” said Dr. Farhat. “I’ve always wanted to bring what I know to an area like this – a place where I can do the most amount of good.”

It wasn’t until his second year at Chicago Medical School that Dr. Farhat realized what “the most amount of good” would be.

Arriving in the United States with his family from France in 1988, Dr. Farhat took four years off between high school and the beginning of undergraduate work at Loyola University in Chicago to help his parents and two older siblings make ends meet at home. When he arrived at Chicago Medical School after graduating from Loyola, he still wasn’t sure what route medicine would take him.

“But during my second year of med school, one of our uncles who was very close with our immediate family developed Leukemia and died two weeks after being diagnosed,” Dr. Farhat explained. “I wanted answers – wanted to know how and why something like this could happen so fast. But nobody could tell me.
“From that point on, I decided that I wanted to be that person who could give answers and help patients and their families,” he continued. “Since that day, I’ve never looked back.”

Using an inherited work ethic from parents who took on extra work to make sure their children would have a solid foundation when it was their time to have families of their own, Dr. Farhat took extra classes and rotations to better prepare him.

“It’s very hard to do but you really have to lock yourself in a room or the library from 8am – 10 pm to just study, study, study,” he said. “But like anything, you get out of it what you put into it.”

At age 35, triple Board Certification and Assistant Professor status on his resume is all the proof one needs to see that Dr. Farhat has made the most of his young life.

“Needless to say, our parents are very proud,” he said with a big smile. “My sister is a lawyer in California and my brother is in his final year of Residency in neurosurgery in Miami. We are blessed with great parents.”

Local cancer patients and their families are feeling the results.

“When you treat cancer patients, many times you are committed to life-long therapy and patients become more like your own family members,” Dr. Farhat said. “It can be tough when you see them go when you have completely cured them because you’ve been a part of each others’ lives for a long time. But you can never experience anything quite like it when you know your patient is feeling better.”

National Healthcare Decisions Day: Advanced Directives

April 16, 2010 is National Healthcare Decisions Day. From 11:30 am - 1:30 pm tomorrow, Saint Joseph Chaplains will be available at a table outside Lakeside Dining at the Mishawaka hospital to provide information about Advanced Directives and tools for talking about wishes with family, friends and healthcare providers and executing written advance directives in accordance with Indiana state laws. Packets of all the forms will be available.

National Healthcare Decisions Day was established to encourage people to initiate conversation about their personal healthcare decisions and advanced directives.

By creating a dialogue, fewer families and providers will have to struggle with making potentially difficult decisions in the absence of guidance from the patient. Healthcare providers and facilities will be better equipped to address a crisis and honor a patient's wishes.

What is an advance directive? All adults can benefit from thinking about what their healthcare choices would be if in the future they were unable to speak for themselves. These decisions can be written down in an advance directive so that others know.

Advance directives come in two main forms:

• A healthcare power of attorney (or proxy, agent or surrogate) documents the person you select to be your voice to make decisions should you not be able to.
  
• A living will documents the types of medical treatments you would or would not want at the end of life.

 Our Saint Joseph Chaplains are always available to help patients and families discuss Advance Directives and complete necessary paperwork.

For more information contact Rev. Sue Breiner at (574) 335-2312.

Feedback from the Community

Big thanks to everyone on our Saint Joe team for working so hard to provide an excellent patient care experience. Below read some recently received letters commending your quality, compassionate care:

Mishawaka Campus Associates
I am very pleased to thank you for the thorough care and treatment I received at your new facility. Everyone I encountered, from the Emergency Entrance to Surgical Room to Critical Care through to my exit out the front door with my stent, treated me with courtesy and kindness. I am amazed at the great skill and talent of the highly committed army of people serving directly one to another to save, improve and extend human life.

Plymouth Campus Critical Care
It’s so very difficult to find the right words to tell each of you just how special you truly are. Over and over again, you have shown compassion and excellent care. How can we ever thank you enough? God bless each and every one of you.

Mishawaka Campus & Valet Service
The new hospital is beautiful, I took my husband there yesterday for outpatient surgery. Everyone was very friendly, I got a good feeling from the moment I approached the door and the valet said "Good Morning.”

To all of our patients - thank you trusting us with your health care needs.

National Cancer Control Month: Hyperbaric Oxygen Therapy Assists in Cancer Treatment Recovery

April is National Cancer Control Month and thanks to early detection and new therapies, the Centers for Disease Control estimates that 64 percent of adults whose cancer is diagnosed today can expect to be living in five years.

Yet after beating cancer, many patients who undergo radiation therapy discover a hidden complication that may not come to light until years after they concluded treatments.

"Radiation doesn’t differentiate between cancerous and healthy tissue," says Dr. Carol Ann Royer, panel physician at The Wound Healing Center at Saint Joseph Regional Medical Center in Mishawaka. "Radiation causes a lack of oxygen in the body's tissues but visible symptoms of soft tissue radiation injury may not occur until as much as 20 years later. In fact, one study showed an average time of eight years and seven months before patients who underwent radiation experienced these complications."

Of the more than one million people who will be diagnosed with cancer this year, half will undergo radiation therapy which, according to the American Cancer Society, will result in serious radiation complications for up to five percent.

"Hyperbaric oxygen therapy is the only therapy known to reverse the vascular compromise responsible for late radiation effects," Royer explains. "There are no alternative therapies that correct the problems these patients have although narcotics and antidepressants have been used to control the pain with limited success and significant side effects. Nothing is a cure-all but hyperbaric oxygen therapy offers 60 to 80 percent of patients either improvement or complete resolution of the injury."

While receiving hyperbaric oxygen treatments, patients watch movies while relaxing on a bed incased in a large see-through plastic shell as they are surrounded by 100 percent oxygen at higher-than-normal atmospheric pressure which enables oxygen molecules to pass through the plasma to the body more easily and speed healing.

The local experts at the Saint Joseph Wound Healing Center in Mishawaka and Plymouth offer hyperbaric oxygen therapy and provide these tips to identifying and treating radiation therapy: 

• Unlike more typical chronic wounds, soft tissue radiation injuries are usually not as visible. A biopsy is not always practical so all other causes of symptoms need to be considered before a diagnosis is made. 
• Most common symptoms that suggest radiation injury are presence of blood in urine, rectal bleeding, vaginal discharge and pain.
• Post-irradiated skin initially may resemble early skin changes consistent with thermal injuries: redness or alterations in pigmentation, itching, wounds caused by excess scratching and pain.
• Areas especially prone to tissue injury are those covering bony prominences, surgical areas and those on the face. Moist skin folds such as those under the breast, the armpit and around the anus and genitals are also vulnerable.
• Soft tissue radiation injuries often arise after tooth extraction in patients with prior radiation therapy. The second most common group of patients are those who have received radiation to treat gynecological, prostrate and colon cancer.
• Radiation injuries may occur spontaneously or in response to a traumatic injury or infection. The wounds may appear superficial and the pain associated with these injuries is often the reason a patient seeks treatment.
• Patients who are currently receiving chemotherapy must have a thorough review by a hyperbaric physician before being treated for injuries since some drugs may have adverse affects.

For more information about radiation injury and treating and preventing chronic wounds, contact the Wound Healing Center located at the Saint Joseph Regional Medical Center in Mishawaka by calling 574-335-6210. For Plymouth, call 574-941-3140.

Real Stories: Making your health a priority, not a hassle

Too important to put off: Making your health a priority, not a hassle
By May Lee Johnson
South Bend Tribune, March 25, 2010

Last week my soul cried.

I don’t know why I had avoided being checked for breast cancer for so long.

Maybe I was afraid and didn’t want to know. But whenever my doctor asked about a mammogram, I had an excuse.

Finally, she stopped listening. If I didn’t get one, she would drop me as a patient.

Reluctantly, I made an appointment with the mobile unit from Saint Joseph Regional Medical Center that visits the parking lot of the Sister Maura Brannick CSC Health Center on Chapin Street.

The day of my appointment, I was late. I’ll come back some other day, I told the nurse.

But she told me to stay. When she finished with another patient, she would be ready for me. It would only take a minute.

She was right. The procedure was simple and quick. After it was over, I breathed a sigh of relief.

I didn’t realize I was beginning a couple of the toughest weeks of my life.

A day or so after the mammogram, I got a message that they needed more images. They had found something. I was told to make an appointment to get a bilateral mammogram at the hospital.

Nothing could prepare me for sitting in that room, waiting to go in for the exam. I have never been in a room where no one would speak. Women flipped through their books, but no one was reading a word.

I just wanted to get it over with. Finally, I went in. A technician explained everything she was doing. I didn’t care about that. I just wanted to know if she was finding anything.

She told me there were a few areas the radiologist wanted to magnify. She advised me to go back into the waiting room while they looked at the pictures, but don’t get dressed yet.

She was right. I had to go back for more X-rays. By now, my stress level was way out of whack.

The good thing was that they read the pictures right there. That’s when I found out I would need a biopsy - but it would be about a week before I could get one.

That gave me more time to worry. Am I going to die? Who would take care of Annie? What is dying like?

Things got so bad that one day, as I sat worrying about everyone around me, Annie looked at a friend and said, “Who is this woman and what did she do with my Mama?”

I was caught in a storm that followed me wherever I went. I couldn’t shake the thoughts of cancer. I wasn’t sure I had the inner strength to fight cancer.

Finally, Friday came and I went in for the biopsy results. A friend, Sister Sue, was there waiting for me. Her calm and reassuring manner helped me survive the agonizing week.

Right away, my nurse told me the good news: The growth in my breast was benign.

I had been holding back tears, my heart racing. But at that moment, a waterfall streamed down my face.

I was too stunned to say anything. But as I composed myself, I thought of two things.

One, my heart goes out to all those who didn’t get the same good news that I did.

Secondly, I made a promise: I need to love myself as much as I have loved others. I won’t delay my next exam.

For years I had avoided the mammogram because of what I might learn. But good news or bad, we owe ourselves the truth.

Even if you’re afraid, please check it out. It could save your life.

You can listen to May Lee Johnson live at 5:30 p.m. Tuesdays on WUBS, 89.7-FM. 

National Nutrition Month: Ways to Shave Calories

Tips from Chris Senff, RD, CD, Saint Joseph Regional Medical Center 

When it comes to healthy weight management, small steps add up. In fact, little changes in eating and activity level have a more positive impact on health than drastic ones. This is because you are more likely to stick with smaller changes over time. Extreme diets and intensive exercise regimens may work well at first, but they rarely last over the long term.

Healthy weight is all about balancing food intake with physical activity. Most of us could improve our energy balance by shaving just 100 calories a day off our usual intake. It’s not difficult:

• Lighten up your favorite coffee drink with non-fat milk and sugar-free syrup
• Trim all fat from beef, pork and chicken. Remove the skin from poultry
• Dish up slow-churned, reduced-calorie ice cream in place of regular
• Enjoy raw vegetables with salsa or fat-free ranch dip instead of chips

Small Changes Add Up:  Here are more great ideas that will cut calories from your daily intake, possibly without your even noticing:

• Downsize Your Dishes. Use smaller plates and bowls to help you eat less. We tend to fill up the dish we’re using and then eat it all. Our brains also think we are getting more when the same amount of food is placed in a smaller dish.
  
• Savor Your Meals. Eating slowly helps you consume only what your body needs to feel satisfied. Eating too quickly, in less than 20 to 30 minutes, leads to overeating and feeling uncomfortably full afterwards.
  
• Leave Some Food on Your Plate. This is especially important if you grew up in the “clean plate club.” By leaving even a few bites, you can focus more on your internal signals of satisfaction and less on eating food just because it is there.
  
• Don’t Eat Out of a Bag or Box. When you eat out of a package, you are likely to keep eating until it’s all gone – no matter how many servings the package actually contains. Pour one serving into a small bowl.
  
• Choose Your Glass Wisely. Here’s another place where our eyes play tricks on us. When glasses are short and wide, we tend to fill them with more fluid and to drink more. Use a slender glass for any beverage except water.
  
• Rethink Your Drinks. High-calorie beverages like soft drinks, juice drinks, energy drinks, specialty coffees and alcohol add calories just like solid foods.

National Nutrition Month: Your Nutrition Questions, Answered!

Questions answered by SJRMC Registered and Clinical Dietitian, Kylie Harrold

What are considered lean cuts of meat? 

There are several cuts of red meat that are considered lean. Cuts that include the words "round", such as top round or bottom round, or "loin", such as sirloin, tenderloin and top loin are lean choices. Flank steak is also a lean cut. Also, look for any cut that is labeled 95% lean ground beef. 

Any cut of meat can be made leaner by trimming off visible, solid fat before cooking. Healthy cooking methods include roasting, broiling, grilling, stir-frying, braising, steaming and stewing.


Does "Made with Whole Grains" mean the food is a good whole-grain source? 

Not necessarily. "Made with whole grains" means that the product has some whole grain in it, but the product is not 100% whole grain. When looking for whole-grain choices, make sure the label says "100% whole grain" and the ingredient label says "whole" before the grain. Whole grains include brown rice, bulgur, oatmeal, whole-grain corn, whole oats, whole rye, whole wheat and wild rice.


If I am trying to cut back on caffeine, will switching from espresso to coffee help? 

Actually, espresso has less caffeine than coffee! On average, one 8-ounce cup of brewed coffee has 85 milligrams of caffeine, and one ounce of espresso (plain or in a coffee-drink) has 40 milligrams. If you are trying to decrease your caffeine intake, consider changing to black or green tea (with 40 milligrams of caffeine per 8-ounce serving) or half regular coffee and half decaffeinated coffee. 

If you normally drink quite a bit of caffeinated beverages, be sure to cut back slowly. For some people, cutting back quickly will cause headaches and drowsiness for the first few days.