New Year, New You

L A N G L A DE HO SP I TA L
Winter 2014
To Health, Healing and
Enriching Lives
Walk in a winter
wonderland: Drs.
Noel and Lakshmi
Deep with their
children, Nikki and
Nathan.
New Year, New You
Make your resolutions stick
page 2
www.langladehospital.org
New Year,
New You
Keep your resolutions from unraveling
IT’S THAT TIME OF YEAR when many of us sing an old
familiar tune—and it’s not “Auld Lang Syne.” Around the
New Year’s holiday, we vow to change—perhaps to lose
weight, stop smoking or reform our couch-potato ways.
Unfortunately, the resolutions we’re good at making,
we’re also good at breaking. But it doesn’t have to be like
that. Th is year, set the stage for resolutions that stick:
➜ Don’t overhaul too much at once. Ditch the total
makeover—you’ll get overwhelmed. It’s often easier to
focus fi rst on one or two lifestyle goals.
➜ Keep it real. Don’t expect to drop 30 pounds by
February or to dive right in at the gym every night. Pin
your hopes on something more realistic—like a modest
weight loss of maybe 10 pounds at fi rst.
➜ Break it down. See your goals as small steps, not
sweeping reform. For example, you can start to
improve your daily diet just by putting more fruits and
veggies on your plate.
➜ Be specific.
Vague resolutions—
such as “I’ll exercise
more”—won’t go far. Be clear about
what you plan to do. For example, how
many days will you work out each week and for
how many minutes?
➜ Measure your progress. Track those efforts, and be
willing to recalculate. For example, if exercising after
work turns out to be a drag for you, then try exercising
in the morning instead.
➜ Don’t let setbacks stop you. If you do fall back into an
old habit, don’t abandon your resolution—and all that
you’ve accomplished. Figure out what went wrong, and
work toward a fi x.
Sources: Academy of Nutrition and Dietetics; American Psychological Association
Take the first step to a healthier 2014.
Call today to set up
your personalized
fitness program.
Center for Health & Performance • 715-623-9924
2
Pathways • www.langladehospital.org
Contents
4}
8}
WINTER 2014
7
Cardiac Care. After half a century of hope and
frustration, Bob Flaa’s heart trouble is over.
Baby and Family. Be a healthier you for a
healthier pregnancy and a healthier baby.
10}
Pink Shield. You could qualify for a free
11}
Q&A. Dr. Turnbull answers three frequently asked
questions.
mammogram.
Follow Sara Arrowood’s path from decision
through commitment to success.
Thank you, Sisters!
By Dave Schneider, Executive Director, Langlade Hospital
SISTERS of the Religious Hospitallers of St. Joseph
were asked to come to Antigo to open the new
hospital that had been standing empty for many
months after it had been built during the Great
Depression. They opened the doors of Langlade Hospital for the fi rst
time in April 1933 and have been operating the facility ever since.
The Religious Hospitallers of St. Joseph was founded by a layman,
Jérôme Le Royer, a tax collector and father of five children, in La Flèche,
France, in the 17th century. A little later, some of the Sisters traveled
from France to help settle Canada. Their history is fi lled with stories
of incredible courage and vitality, but most important, their work was
carried out with deep faith, compassion and a love of all persons in need.
Today their ministry of good works extends to Canada, the United
States, Mexico, the Dominican Republic, Peru and France.
When the hospital fi rst opened in 1933, many of the employees and
managers and the hospital administrator were Religious Hospitallers of
St. Joseph. They nurtured the hospital, its patients and the community for
generations. But the number of Sisters has grown smaller and smaller. In
1976, the fi rst lay administrator of Langlade Hospital was appointed.
Today, three Sisters remain and continue to love, serve and minister
to patients, employees, providers and volunteers at Langlade Hospital.
Sister Dolores Demulling, Sister Jean Bricco and Sister Adele Demulling
continue to work tirelessly in the care of others. While their roles have
changed over the years, they continue to serve as role models expressing
their deep faith in God and paying witness to what is good in the world.
Langlade Hospital has been blessed for 80 years by the presence of
the Religious Hospitallers of St. Joseph and we are hopeful that Sisters
Dolores, Jean and Adele will continue to serve the patients and this
community for many more years to come. It is a privilege for all of us at
Langlade Hospital to have served with these wonderful women, who have
taught us so much about what health care is really all about.
LANGLADE HOSPITAL’S PATHWAYS is a free publication
intended to provide health information to the people
living in and around Langlade County. Langlade Hospital
is proud to offer this publication as a resource to you and
your family. This publication is also available online at
www.langladehospital.org.
Langlade Hospital
112 E. Fifth Ave., Antigo, WI 54409
715-623-2331
715-623-9200
www.langladehospital.org
David Schneider
Executive Director
Pat Tincher
Director of Finance
Janelle Markgraf
Director of Human Resources
Ruth Risley-Gray
Director of Patient Services and Quality Management
Betsy Kommers
Marketing and Fund Development Manager
bkommers@langhosp.org
Sarah Olafson
Marketing and Fund Development Assistant
solafson@langhosp.org
Information in this publication is not intended to replace
medical advice, nor is it for self-diagnosis. Individuals
should speak with their primary care provider or other
health care professionals regarding medical concerns.
If you would prefer not to receive Pathways magazine,
call Sarah Olafson at 715-623-9877 or email solafson@
langhosp.org and provide your mailing address.
Models may be used in photos and illustrations.
Copyright © 2013 Coffey Communications, Inc.
CUM29930
www.langladehospital.org • Pathways
3
Sync
Back in
Atrial fibrillation treatment puts an end to frustration
WHEN THEN23-YEAR-OLD
Kenneth “Bob” Flaa returned
from active duty in the Michigan
National Guard in 1959, he was
forced to stay in the hospital for an
extra week with a heart murmur
before he could be discharged—at
least that’s what he was told.
He didn’t know it at the time,
but he was misdiagnosed, and the
hospitalization proved to be just a
preview of what was to come many
years later. After being discharged
from the service, Flaa and his
wife, Lu, moved from the Upper
Peninsula to Kenosha, Wis., where
he worked for 32 years.
It wasn’t until he was
in his early 50s that
Flaa’s heart began
to act up again.
“When they
Kenneth
“Bob” and
Lu Flaa are
relieved to
have gotten
the answers
they needed.
4
Pathways • www.langladehospital.org
fi rst discovered my murmur during
my discharge test, I didn’t even
feel it, and it never bothered me
all those years I worked, either,”
says Flaa, now 77 years old. “It
wasn’t until I retired that I began
to notice that my heart would go
out of rhythm when I reached for
something, but it never stayed that
way for very long.”
It Gets Worse
Not long after his retirement in
1991, the Flaas moved back to the
Upper Peninsula, where the couple
of 53 years still resides. Shortly
thereafter, Flaa’s heart fell out
of rhythm again, but this time it
failed to correct itself, prompting a
trip to the emergency room.
At the hospital,
doctors performed
a cardioversion, a
procedure that uses
electricity to shock
the heart back
into rhythm.
Flaa learned
that his
heart was
beating
180 times
per minute
before being put back into rhythm.
He also learned that the heart
murmur diagnosis he received
34 years prior was wrong, and
instead he had atrial fibrillation,
sometimes called a-fib, which is
a common heart condition where
a faulty electrical impulse causes
the heart to beat irregularly and
greatly increases a person’s risk for
stroke.
After leaving the emergency
room with his heart back in
rhythm and an accurate diagnosis,
Flaa began a medication regimen
in an attempt to control his a-fib.
Starting in 1995, the Flaas began
logging countless miles as they
made hourslong trips from one
doctor appointment to the next
in Michigan, Minnesota and
Wisconsin.
“Every six months we’d have
to go to the doctor for a follow-up
appointment and every time the
medications didn’t work, they put
me on a different one,” Flaa says. “I
tried different doctors and pretty
much every available drug.”
Th is pattern continued for
17 years until 2012, when the
Flaas saw an advertisement in the
newspaper for a free a-fib seminar
offered by Aspirus at Gogebic
Community College. At this point
they were
beyond frustrated
and Bob’s heart was almost always
out of rhythm, so they attended
the seminar looking for any shred
of hope.
The Wait Is Finally Over
At the seminar, they listened
to Aspirus heart surgeon John
Johnkoski, MD, talk about a
surgical treatment for a-fib called
minimally invasive Maze, or
mini-Maze. When one of Dr.
Johnkoski’s former patients also
spoke about having the procedure
and how it gave her a new lease
on life, the Flaas were convinced
that this was the solution that
had eluded them for years.
The Flaas were excited about
what they had learned about
mini-Maze,
but Bob wanted to
remain loyal to his physician in
Wisconsin. Four months after the
seminar at his next appointment,
he asked his physician about
mini-Maze and after hearing his
answer, Flaa knew he’d be
making an appointment with
Dr. Johnkoski.
“My other physician told me
that he didn’t perform the
mini-Maze procedure and that he
wanted to put me on a new trial
drug for another six months to see
if it worked,” Flaa says. “I’d already
been through all the medications
and they didn’t work, so that was
the last time I saw that doctor.”
Upon meeting with
Dr. Johnkoski in Wausau,
Flaa underwent some tests to
determine whether he was a
candidate for the procedure.
Unfortunately for Flaa, he was not
a candidate for the mini-Maze
because it was determined that
he also needed bypass surgery.
Instead, Flaa had to have a full
Maze, which is a more invasive
procedure, but is performed at
the same time as the bypass.
Flaa underwent bypass and
full Maze surgery in October
2012 and spent just over three
days in the hospital. His heart
went into normal rhythm
immediately after surgery and
has been that way ever since.
Following surgery, Flaa was
able to complete his cardiac
rehabilitation closer to home
at Aspirus Grand View. Within
six months of the surgery, Flaa
was completely off medications,
including Coumadin, a blood
thinner that requires frequent
blood monitoring tests.
“It’s so awesome that specialists
like this come up here to the U.P.,”
Lu says. “The procedure has made
such a huge difference because you
always wondered, ‘I hope his heart
doesn’t go out,’ and it was scary
always having that hanging over
your head, but now we don’t have
that anymore.”
Aspirus Heart & Vascular Institute has been seeing
patients at the new location since November. Call
715-847-2611 or toll-free 800-441-4013
to make an appointment for
the Antigo location.
www.langladehospital.org • Pathways
5
What Do
Triage Nurses Do?
TRIAGE NURSESwear many hats
throughout the day, not only
triaging phone calls, but providing
hands-on care to patients as well.
Here’s a look at many of the tasks
they perform.
Providing Care on the Phone
A majority of time throughout the
day is spent on the phone with
patients. When a patient places
a call to the clinic, it may be
forwarded to a triage nurse.
Calls to triage are often for the
following reasons:
➜➜Patient medication refills.
➜➜Pharmacy medication refills.
➜➜Acute issues such as shortness
of breath or cardiac symptoms.
➜➜Chronic problems.
➜➜Requests for appointments.
Veronika Gagovic,
MD
Giving Care in Person
Another aspect of a triage nurse’s
job is providing hands-on care to
patients. Some examples include:
➜➜Allergy injections.
➜➜Drug screenings.
➜➜Dressing changes.
➜➜Bladder scans.
Accepting New Patients:
Veronika Gagovic, MD
Veronika Gagovic, MD, is a
board-certified Gastroenterologist
trained in the care and treatment
of digestive health disorders of
the stomach, intestines, liver and
pancreas and swallowing disorders.
Dr. Gagovic’s special interests
include colon cancer prevention,
inflammatory bowel disease such as
Crohn’s and colitis, Hepatology, and
women’s digestive health.
Dr. Gagovic graduated cum laude
with a degree in Biochemistry from
North Central College in Illinois. She
earned national recognition as a Soros
6 ➜➜General advice or information.
➜➜Requests for results.
➜➜Critical lab values.
➜➜Concerns about patients at
Eastview, Rosalia Gardens, Care
Partners, Evergreen Terrace,
or other assisted-living or
skilled-nursing facilities.
Triage nurses also receive
calls about prior authorizations,
questions from other health care
facilities regarding a mutual
patient, looking up immunization
records for parents, and even more!
Pathways • www.langladehospital.org
Kim
Kennedy, RN
➜➜Inserting or replacing Foley
catheters.
➜➜Peripherally inserted central
catheter (PICC) line dressing
changes.
➜➜Blood draws from PICC lines.
➜➜Flushing port-a-caths.
➜➜Assessing walk-in patients.
➜➜Teaching, such as showing
patients how to use glucometers
or insulin pens.
Triage nurses also are in charge
during a code blue (cardiac arrest)
at the clinic.
Deciding the Next Step
When assessing a patient, triage
nurses decide the next step, whether
it be informing the provider,
Had a good experience at Langlade
Hospital? Tell us! Go to www.
langladehospital.org, and
click on “Compliment a
Staff Member.”
Fellow in addition to other honors
and awards.
After graduating from Stritch
School of Medicine at Loyola
University in Chicago, Dr. Gagovic
completed her residency at
Indiana University in Indianapolis,
followed by a fellowship program in
Gastroenterology and Hepatology
at the University of Wisconsin in
Madison.
Dr. Gagovic sees patients in clinic
and performs procedures in Antigo.
Call 800-847-4707 to schedule an
appointment with her.
scheduling a future appointment,
requesting a provider to see the
patient at that time, or a fast
intervention such as a visit to
the Emergency Department.
There are three
full-time triage registered
nurses employed at the
clinic, as well as one
who is part-time. They
are knowledgeable,
empathetic, able to
prioritize, dependable
and ready to help.
No More Wondering
PCOS diagnosis solves mysterious weight gain
SARA (KOSS) ARROWOOD is the youngest of eight
siblings, a graduate of Antigo High School and now an
employee of Langlade Hospital. Thanks to a diagnosis
that led her down a path to a new lifestyle, she has been
on a weight-loss journey this past year and has racked up
a number of accomplishments.
Diagnosis Provides an Answer
A year ago, Sara was diagnosed with polycystic ovary
syndrome (PCOS). Th is is a common hormonal disorder
among women of reproductive age. Women with
PCOS often have symptoms of infrequent or prolonged
menstrual periods, excess hair growth, acne and obesity.
In women past adolescence, difficulty becoming pregnant
or unexplained weight gain may be the fi rst sign. In Sara’s
case, she remembers that for years, her family wondered if
something was wrong with her health. She didn’t look like
her siblings. She ate what they ate and exercised the same
as her family, but she was always heavier.
When Sara received her PCOS diagnosis from Dennis
McFadden, DO, OB-GYN, she was relieved. For years she
had wondered what was wrong, and now she understood.
Moreover, she felt like her life could
begin. Dr. McFadden prescribed
a medication to help her blood
sugar and suggested she try
again to lose weight through diet
and exercise.
A New Life
Sara and her husband began working
out at 4 a.m. five days a week at the
Cardiac Rehab Gym, where they
used treadmills and did weight
training. In June 2013, when
the new Center for Health &
Performance opened, they joined
WelFit. They also walk two miles
every night after dinner.
Sara has also changed her diet
to be high in protein and low in
carbohydrates with lots of fruits
and vegetables, and she carefully
limits breads and pastas. She
hasn’t followed any fad diets and
doesn’t count calories, and she
knows that weekends and holidays can be
difficult.
Overall, Sara credits her weight loss to hard work and
dedication. She’s lost 75 pounds since October 2012. She’s
had to buy a new wardrobe—not once but twice—and the
weight loss has helped her get her energy back. Her blood
pressure a year ago was 138/90 mm Hg, and today it is
120/80, and she monitors her weight and blood pressure
as a WelFit member. A year ago Dr. McFadden said she
was prediabetic, but today, her blood glucose levels are in
the normal range.
Sara worked as a certified nursing assistant (CNA) for
years, at nursing homes and facilities in the area, and saw
what untreated diabetes can do to the body. After years as
a CNA, she changed careers and went into the kitchen to
become a cook. Sara now works as a nutritional services
assistant for Langlade Hospital.
Decide, Commit, Succeed
For Sara
Arrowood,
her doctor’s
diagnosis
meant a
new life.
Her number one supporter is her husband, who is also on
the weight-loss journey with her. He works for Plaspack,
a local packaging company in Antigo. The company offers
an incentive program for employees to work out and
maintain their health. He hasn’t missed a day of work in 19
years. “The power of a positive attitude will take you a long
way,” he says. The two of them live by these three words:
decide, commit, succeed.
Sara’s co-workers have also been supportive as well
as Dr. McFadden, of whom she says, “He genuinely cares
about my health.”
And Sara adds, “As an employee of Langlade Hospital
and a patient of the General Clinic, I never want to be
anywhere else.”
www.langladehospital.org • Pathways
7
Bill Burt and Dr.
Meghan O’Brien
and their children,
Mya, Liam, Ruby,
and baby Elsy,
with their family
physician, Dr. Bart
Kneeland
PREGNANCY
Healthier You,
Healthier Baby
WHEN YOU’RE PREGNANT, a lot
of things that you do can have an
effect on your baby—even long
after he or she is born.
That’s why it’s crucial to make
good decisions. The best way to
take care of your baby is to take
care of yourself.
Prenatal Care
Pregnant women who see a health
care provider regularly have fewer
problems during pregnancy and
delivery and healthier babies than
women who don’t get adequate
prenatal care, according to the
March of Dimes.
Your provider will talk
with you about the best
ways to give your baby a
healthy start in life, answer
questions, and make sure
you and your baby are
healthy. Regular
prenatal care
also gives your
provider
a better
8
Pathways • www.langladehospital.org
chance to detect and treat
problems early, according to
the Office on Women’s Health.
Diet
Aim to eat a low-fat diet filled with
fruits, vegetables, whole grains,
protein and calcium-rich foods.
Avoid fish that contains high levels
of mercury. Cook meat, lunch meat,
eggs and fish thoroughly. Avoid
unpasteurized milk and cheeses.
Exercise
Following a regular exercise
program during pregnancy may
help labor and delivery go more
smoothly, and being in good
physical condition may make it
easier to get back in shape.
If you were exercising before you
became pregnant, it’s usually OK
to continue. But ask your provider
about which exercises are safe.
If you don’t already exercise,
start slowly and don’t overdo it.
Consider light exercises, unless
your provider says otherwise.
Expect the best when
you’re expecting. Visit
www.langladehospital.org,
and select “Birthing Center.”
More Healthy Hints
➜ Do not smoke or use alcohol or
illegal drugs during pregnancy.
➜ Talk to your provider about your
medications or supplements.
➜ Limit coffee and other caffeinated
drinks to one or two cups a day.
➜ Ask your provider how much
weight you should gain. For
many women, 25 to 35 pounds
is about right.
➜ Get 400 to 800 micrograms of
folic acid a day—some women
may need up to 2,000. Ask
your provider about taking a
multivitamin.
➜ If you have a cat, have someone
else change the litter box to help
prevent toxoplasmosis.
➜ Ask your provider whether there
are vaccinations you may need.
PRIMARY CARE PHYSICIANS
Your Partners in Health
A COUGH THAT WON’T GO AWAY. A
swollen ankle. A sore wrist.
These could signal something as
benign as a common cold or a mild
sprain or as serious as cancer. It’s nice
to know you can take these concerns
to someone you trust—someone who
knows more than just your name.
Lakshmi Deep,
That person is your primary care
MD
physician (PCP). PCPs can respond to health issues ranging
from the straightforward to the more complicated. And
they are familiar with you and your health care needs.
Not Just Any Doctor
When you have a health issue, your PCP is the fi rst person
you call. PCPs are doctors who specialize in treating the
whole person. For example, they can:
➜ Offer preventive care.
➜ Answer medical questions with sound, specific advice.
➜ Manage care for chronic conditions, such as diabetes
or heart disease.
➜ Refer you to a specialist, such as a neurologist, surgeon
or oncologist, when you need to see one.
➜ Coordinate your health care, lab tests and medications
among multiple health care providers.
What can we do for you? Call the
Aspirus General Clinic to make an
appointment at 715-623-2351.
Choosing a PCP
A good relationship with your PCP can have a positive
effect on your health and health care. If you don’t already
have a PCP, make choosing the right one a priority. Look
for someone you feel comfortable with.
Be sure to choose the right doctor for your age
and health history. Often, PCPs are internists, family
physicians or pediatricians. Family physicians
treat people of all ages, from infants to older adults;
pediatricians specialize in children’s health; and
internists focus on health issues
common just to adults.
Sources: American Academy of
Family Physicians; American
College of Physicians
2014: The Affordable Care Act
Hits Full Stride
JAN. 1 MARKED MORE than the beginning of 2014. It
also marked the date when many key provisions of the
Affordable Care Act took effect.
These provisions are intended to make it easier for
you to purchase health insurance. They also provide new
protections if you already have health care coverage. For
instance, as of Jan. 1:
Health exchanges offer affordable insurance
options. The exchanges are online marketplaces where
you can shop for health plans. All of the plans must meet
certain standards for benefits and costs. Some of the
exchanges are run by the federal government. Others
are run by individual states. You can sign up online
at www.healthcare.gov.
Tax credits help many people buy insurance. These
credits are available to people with incomes between 100
and 400 percent of the poverty guidelines who can’t afford
coverage elsewhere.
Access to Medicaid increases. In Wisconsin, if
you earn less than 100 percent of the Federal Poverty
Level,
you’re
eligible to
enroll in this
government-based
insurance program.
Coverage can’t be
denied because of
pre-existing conditions. Th is protection applies if you’re
seeking new coverage or renewing an existing policy.
Annual benefit caps are banned. Th is means
insurance companies cannot put limits on the benefits
you receive in any given year.
Originally, another key aspect of the law was expected
to kick in on Jan. 1: Large employers were supposed to
begin offering their workers affordable health coverage or
face fi nes. That provision has now been delayed a year in
order to help businesses comply with the law.
Sources: Healthcare.gov; U.S. Department of the Treasury
www.langladehospital.org • Pathways
9
You May
Be Covered
Think you can’t afford
mammograms or breast
care? Keep reading.
If you are a woman who is 40 or older and
meets financial requirements, you could qualify
for a free mammogram and diagnostic services
through Aspirus.
Qualifying women receive:
w
w
w
A clinical breast exam.
Screening mammography.
Breast health educational materials.
And if needed:
w
w
w
Diagnostic mammography.
Ultrasound.
Biopsy.
Program Support
If you cannot afford these services, call the Aspirus Information Center at 800-847-4707 to see if
you qualify for the free mammogram program. Pre-qualification and appointments are required.
This program is supported by a grant from the Central Wisconsin Affiliate of Susan G.
Komen for the Cure®. Additional support is provided by Radiology Associates of Wausau,
Associates in Pathology, Aspirus Health Foundation, Aspirus Wausau Hospital, Aspirus
Clinics, Langlade Hospital, Memorial Health Center, Park and
Associates, and Central Wisconsin Radiologists.
DO YOU QUALIFY?
Find out at
www.aspirus.org/
freemammogram.
WELCOME,
New Providers!
Aspirus General Clinic is pleased to
welcome Angela Buchman, PA, to our
experienced team. Buchman graduated
from the University of Wisconsin–Madison
and has more than 11 years of experience
in health care. She is dedicated to working
with family members of all ages and
guiding them in making informed health
Angela Buchman,
care decisions to help them lead healthier
PA
lives. Buchman and her husband, Mark,
have two children and enjoy being a part of the community.
Mark Buchman has worked for Langlade Hospital for more
than six years.
Buchman’s special interests include disease prevention,
healthy lifestyle modifications and family wellness.
Call 715-623-2351 to schedule an appointment.
10
Pathways • www.langladehospital.org
Langlade Hospital and the
General Clinic are welcoming
Helen Cueny, LCSW. Cueny
graduated from Western
Michigan University with her
master’s degree in Social Work. She has
practiced in upper Michigan as a mental
health therapist for almost eight years.
Helen Cueny,
Cueny and her husband relocated to
LCSW
the Antigo area and are excited to become
a part of the community. She enjoys fishing, kayaking, oil
painting, photography, and scrapbooking.
Her special interests include psychiatric disorders,
depression and anxiety disorders.
Call 715-623-2351 to
schedule an appointment.
Your Questions
Answered
Jay Turnbull, MD, is a Family Medicine Physician
with Aspirus General Clinic. Exclusively for readers
of Pathways, he shares his expertise on some
frequently asked questions.
Q I was just diagnosed with
diabetes. Do I have to give
up sugar?
I’ve heard a lot about
whooping cough recently.
What can I do to avoid it?
A A The quick answer: Give up, no;
cut back, yes.
People with diabetes can have a
sugary treat once in a while. But it
should be a small serving enjoyed
in the overall context of a diet and
exercise plan that keeps diabetes
under control.
Of course, if you’d asked this
question years ago, you probably
would have gotten a different answer.
Scientists once thought eating sugar
would send blood glucose levels
dangerously high. It was off-limits
for people with diabetes.
Today, we know that glucose
levels are affected by the total
amount of carbohydrates you eat.
The exact type of carb, such as
sugar, isn’t as important.
So a small amount of sugar is
probably OK as long as you swap
it for other high-carb foods. For
instance, you might skip having
a roll with dinner so that you can
have some dessert.
Keep in mind that even a small
portion of a sugary treat is likely
to have a lot of calories and little
nutritional value. That’s another
reason it should be enjoyed only
occasionally.
Most of the time, stick to a
healthy meal plan that features
vegetables, whole grains, fruit,
nonfat dairy products, fish and
lean meat. Your doctor or diabetes
educator can help you devise a plan
that’s right for you.
Q Get vaccinated. Whooping
cough, also known as
pertussis, is a serious respiratory
infection that can be deadly for
babies. The DTaP vaccine protects
young children from whooping
cough. Kids should receive five
doses of DTaP as part of their
regular childhood immunizations.
Children ages 11 or 12 and adults
need a one-time booster shot,
known as Tdap, to continue to be
safe from whooping cough. These
shots are especially important if
you are going to be around babies.
If you have a newborn, keep your
baby away from anyone with cold
symptoms. Ask everyone coming
into contact with your child on a
regular basis to get vaccinated. If
you have concerns, talk with your
doctor.
Make an appointment
with a provider for
one-on-one counseling.
Call the General Clinic
at 715-623-2351.
Q
A
Jay Turnbull, MD
My dad has colorectal cancer.
Should I get tested?
If you’re between the ages
of 50 to 75, you should be
screened for colorectal cancer
regardless of family history.
And if you have a close relative
with the disease, your doctor
may recommend earlier or more
frequent screening.
People with an average risk
have about a 5 percent chance
of developing colorectal cancer.
(Men’s risk is slightly higher than
women’s.)
Your risk can be nearly double
that, however, if you have a parent,
sibling or child with the disease.
And if your relative was diagnosed
before age 45, your risk may be even
higher.
A family history of cancer in
further-removed relatives, such as
aunts, uncles and grandparents, is
also relevant and should be shared
with your doctor.
Talk with your doctor to decide
on an appropriate screening
schedule.
www.langladehospital.org • Pathways
11
The
Healing Power of
Hyperbaric
Oxygen
Jon
Zwirschitz
Therapy
FOR MOST PEOPLE , noticing a
small crack or cut on their toe
wouldn’t be much cause for
concern—it’s likely to heal in a few
days. But for Jon Zwirschitz, the
small crack that developed on one
of his toes had him on the verge of
losing his entire foot.
Zwirschitz, who has diabetes,
went from having to deal
with what was seemingly an
insignificant cracked toe to facing
the possibility of having his left
foot amputated in a matter of
months. It all started when he
noticed his toe was not healing.
“About a week after I fi rst
noticed the crack in my toe, I went
to the doctor because it didn’t
seem to be getting any better,”
says the 61-year-old Mattoon,
Wis., resident. “We tried some
different salves and medicine,
but nothing worked, and I dealt
with it always throbbing for nine
months.”
Zwirschitz’s doctor informed
him that his toe wasn’t healing
because of his diabetes, which
can cause circulation problems.
His foot was not receiving enough
blood flow to help his toe heal.
After
those nine
months passed
without any
improvement,
his toe became
infected, and doctors
had no choice but to
amputate.
Kick-Starting
the Healing Process
After his toe was removed,
Zwirschitz began hyperbaric
oxygen therapy at Aspirus in
an attempt to promote healing
after surgery. Hyperbaric
oxygen therapy treatments
over an extended period of
time can stimulate healing by
delivering oxygen in a pressurized
environment to tissues that aren’t
getting enough oxygen naturally
because of poor blood circulation.
Zwirschitz also underwent a
vein grafting procedure where
doctors attempted to reroute
blood flow in his leg to improve
circulation.
“Within a day or two, my doctor
could tell right away that the vein
graft had failed, and he even told
Need oxygen? Find out what you need to know
about hyperbaric oxygen therapy at Aspirus
Wausau Hospital. Call 800-847-4707.
12
Pathways • www.langladehospital.org
me that he had never seen one fail
so quickly,” Zwirschitz says. “Right
after that, the other four toes on
my foot became infected, and they
all had to be amputated.”
The second amputation
occurred just a month after he lost
his fi rst toe, and now Zwirschitz
had only two options—restart
hyperbaric treatments and hope
that his body would heal after the
six-week oxygen therapy treatment
period, or amputate his entire
foot. It was an easy decision for
Zwirschitz, who did not want to
lose his foot.
“They told me that if I chose
amputation that I wouldn’t have
to do hyperbaric treatments, and
I told them ‘But I’ll have my foot,
and that’s important,’” he says. “I
told them I wanted to stick with
the treatments, and they said if
I want to keep fighting that they
would work with me.”
Safety First
Using your own medications
at Langlade Hospital
And It Helped!
During his hyperbaric treatment
schedule, Zwirschitz also received
specialized wound care at the
Aspirus Wound & Hyperbaric
Center to give his wounds the best
chance to heal. About halfway
through the treatments, he knew
he was on his way to recovery
when doctors began to see tissue
healing and the wounds fi nally
start to close.
Now, with his wounds healed
and a special shoe insert, he walks
normally. Th is would not have
been possible without hyperbaric
oxygen treatments.
“It was a long, tough grind,
but it sure was worth it,” he says.
“Foot amputation would have been
certain without hyperbarics.”
PATIENT SAFETY AT LANGLADE HOSPITAL is a top priority. One
important safety issue is medication management. Th is is how
patients can use their own medication in our hospital.
When patients are treated in the hospital, they typically receive
hospital pharmacy stock medications. There are a few exceptions
to this, including outpatient status and observation status patients.
Patients admitted with these statuses are allowed to use their own
medication supply if an order is written by the provider stating
the fact. This policy is in place because of the potential lack
of payment by insurance companies for “self-administrable”
medications.
Self-administrable medications include those medications that
a patient can give themselves, such as tablets, capsules, inhalers,
insulin injections, creams, ointments, eyedrops and eardrops.
In order to be able to use their own medication supplies, the
medication must meet the following criteria:
➜ The medications are in the original prescription bottle from the
pharmacy or manufacturer with an expiration date printed on it.
➜ The medications are not expired.
➜ The medications can be identified via markings or imprints.
A patient’s own medications will not be used if:
➜ The patient is in isolation (infectious condition) for any reason.
➜ The patient is being tested for MRSA or Clostridium difficile.
➜ The medications are not in the original prescription bottle from
the pharmacy or manufacturer bottle with an expiration date
printed on it.
➜ The medications are expired.
➜ The medications cannot be identified via markings or
imprints.
➜ The medications are considered to be herbal,
alternative or homeopathic medications.
When a patient brings in his or her own
supply of medication, it is sent to the inpatient
pharmacy for verification by a pharmacist.
The medication is labeled and barcoded
for safe medication administration by
a registered nurse. The medications
are kept secure in a locked area on the
inpatient unit. All medications are
returned to the patient upon discharge
from the hospital.
Getting ready for a
hospital stay? Visit www
.langladehospital.org,
.langladehospital.org
and select “Patients
& Families.”
www.langladehospital.org • Pathways
13
PELVIC ORGAN PROLAPSE
Am I at Risk?
Five Ways to
Prevent Pelvic
Organ Prolapse
Here are five steps every woman
can take to reduce her risk of
pelvic organ prolapse:
Keep your weight in a healthy
range. Carrying extra pounds raises
your risk for prolapse significantly.
Fend off constipation with a
fiber-rich diet and regular exercise.
Straining during bowel movements
adds to your risk.
Control your coughs. Frequent
coughing increases your risk, so see
a doctor if you cough frequently.
And don’t light up; you don’t want
to wind up with a smoker’s cough.
Avoid heavy lifting, which can
contribute to prolapse.
Do regular Kegel exercises. If
you’re not sure how to do them
correctly, ask your doctor at your
next pelvic exam.
1
2
3
4
5
Source: American Urogynecologic Society
Foundation
WOMEN’S BODIES
go through many
changes, from
menstruation
to menopause.
But there’s one
possible change
you may not be
aware of, even
though 200,000
surgeries are
performed every year in
this country because of it.
Doctors call this change
pelvic organ prolapse, and it
occurs when the muscles and
other tissue supporting pelvic
organs weaken or are injured. As a
result, these organs can drop down
from their normal position.
The uterus is especially likely
to slip out of place and can either
descend partially into the vagina—
or sometimes completely outside
of it. The bladder, urethra and
rectum are also particularly prone
to sagging.
instance, it might be hard to keep a
tampon inside the vagina.
But if prolapse worsens, these
symptoms might occur:
➜ Pressure or a heavy feeling in
the vagina that intensifies as the
day goes on or gets worse during
bowel movements.
➜ The sensation of sitting on a ball.
➜ Bulging tissue that protrudes
out of the vagina.
➜ Urinary incontinence.
➜ Difficulty urinating or emptying
the bowels completely.
➜ Recurrent urinary tract
infections (UTIs)
If prolapse doesn’t cause
any symptoms—and was only
discovered because of a physical
exam—treatment may not be
necessary.
But if you do have bothersome
symptoms, your doctor may fit you
with a pessary—a rubber or plastic
device inserted in the vagina that
helps support pelvic organs.
Why It Happens
If pelvic organ prolapse is
disrupting your life, surgery may
be your best option. Several types
of surgery can correct prolapse.
Ask your doctor about the risks
and benefits of each option, and
ask which would be best for you.
Giving birth is the main cause
of pelvic organ prolapse, the
American College of Obstetricians
and Gynecologists reports. And
women who deliver vaginally
face a slightly higher risk of this
condition than women who deliver
by cesarean section. But prolapse
can also be brought on by:
➜ A loss of muscle strength that
can accompany aging.
➜ Decreased estrogen production
after menopause.
➜ Pelvic surgery.
➜ Being overweight or chronically
constipated, both of which put
pressure on the abdomen.
Warning Signs of Prolapse
The fi rst symptoms of pelvic organ
prolapse are often subtle. For
14
Pathways • www.langladehospital.org
What About Surgery?
Additional sources: American Geriatrics Society
Foundation; American Urogynecologic Society
Foundation; National Institutes of Health
Been meaning to
get that exam—and
always put it off ?
Simply call the Aspirus
General Clinic today
for an appointment
with our OB-GYN:
715-623-2351.
PALLIATIVE CARE
Comfort When
You Need It Most
Autumn Cole,
Nurse Practitioner
for the Palliative
Program
COMFORT. SUPPORT. SYMPTOM
RELIEF.
These are the hallmarks of good health
care. But for people with a serious
illness, there’s a type of medical care
devoted specifically to giving such help:
palliative care, says Autumn Cole, Nurse
Practitioner for the Palliative Program.
Unique From Hospice
Hospice, which addresses the needs of
people at the end of their lives, provides palliative care.
But not all palliative care is hospice-related.
A person receiving hospice care generally is not
expected to live more than six months and is not trying to
cure the condition.
Palliative care, by comparison, is available to anyone
with a serious illness, regardless of life expectancy. And
it’s possible to receive palliative care and treatment at the
same time.
Both kinds of care can be provided in many settings,
including your home, a hospital, a nursing home or an
assisted-living center.
Team Help
A multidisciplinary team is available through palliative
care. Physical or occupational therapists, for instance,
can help you regain function. Doctors and nurses work to
To learn more,
visit the National
Hospice and Palliative Care
Organization website at
www.caringinfo.org.
prevent or relieve physical symptoms of disease, such as
fatigue and pain.
A psychologist might help you and your family handle
the stress and emotional aspects of an illness. A social
worker can often identify community resources that
could help.
Chaplains may be involved too. They can help with
spiritual issues that your condition might raise.
When you’re the person who is ill, you can help set
treatment goals. Ultimately, the aim is to improve quality
of life and to support you and your family throughout
treatment.
Getting Care
Medicare, Medicaid and private insurance may cover
some treatments and medications, but there may
be limits. It’s best to check coverage before treatment
starts.
If you have questions about palliative care, talk to
your doctor.
www.langladehospital.org • Pathways
15
Contact us
Nonprofit Org.
U.S. Postage
Langlade Hospital
715-623-2331
Aspirus General Clinic
715-623-2351
PAID
112 E. Fifth Ave., Antigo, WI 54409
Wausau, WI
Permit No. 5
Marketing Department
715-623-9877
715-623-9455
Community Health Foundation
715-623-9557
Visit us online at
www.langladehospital.org
If you did not receive this issue at
your home address and would like
one sent to you, please email
solafson@langhosp.org.
L
Get Fit, Stay Injury-Free
BEING ACTIVE IS GOOD FOR YOU
in so many ways. Getting hurt
while exercising? Not so much.
Regular exercise can help you
maintain a healthy weight; keep
your bones, muscles and joints
strong; and decrease your risk
for heart attack, stroke and other
diseases.
Cori Bottemiller,
Sports Medicine
Technician
But many people with perfectly
good intentions see their efforts
end in an injury when they overdo
it or don’t follow safety precautions,
according to the American Academy
of Orthopaedic Surgeons (AAOS).
To enjoy the benefits of exercise
and help prevent injuries, consider
these tips from the AAOS and other
experts.
➜ Always warm up for at least three
to five minutes before exercising.
➜ Start your program with short
sessions—5 to 10 minutes—and
increase your activity gradually.
➜ Drink plenty of fluids when
working out, even if you don’t
think you’re thirsty.
➜ Try to avoid being a weekend
warrior. Being active on a regular
basis, instead of just on the
weekends, may reduce your risk
of injury.
➜ Always use the safety equipment
recommended for the exercise or
sport, such as helmets for bike
riding and supportive shoes for
walking or jogging.
Safety first. If you have health
problems, talk to your doctor
about an appropriate exercise
plan for you. Walking is a safe
place to start for most people.
Talk to your
doctor about an
appropriate exercise
plan for you.
Weigh the
Benefits of
Strength
Training
It’s not all about having big
muscles: Strength training can
also protect you from sprains,
strains and broken bones.
Research shows that strength
and resistance training helps
reduce injuries by strengthening
muscles, bones and connective
tissues such as tendons and
ligaments. You just want to make
sure you’re doing it safely.
To avoid injuries while
exercising and lifting weights:
✓ Learn how. A trained fitness
instructor or coach at a health
club or gym can show you how
to lift weights and use exercise
equipment safely.
✓ Start slow. Don’t lift more, or
exercise longer, than you should.
Build up your strength over time,
and take on more only when
you’re ready.
✓ Warm up and cool down.
Stretching, jogging in place and
doing calisthenics help prepare
your body for lifting weights and
can assist in recovery afterward.
✓ Be careful. Don’t do heavy
lifts without a spotter.
Sources: American College of Sports Medicine;
American Council on Exercise