I Want The World to Know TV

T A B oF FreSH AIr PAge  YoU’re So VeIN eT r ID oF Ar ICoS e INS Age 49 HYTHM A D BL Ue S: WHeN YoUr HeArT SKIPS A BeAT PAg 4 winter 2005 $2.95 P T K WS S S K CK IN g A SM IN g HAB T. WHAT CA Y oU L rN F ro M H M? brad habits HeALTHY LIVINg For INDIANA’S FAMILIeS vim & vigor winter 2005 making a difference et g n t ho id ay By Stacey Kellogg ith the winter holidays Healthcare System is offering a vari ety of options for people to show their loved ones and the community at large how much they care. LIgHTS oF LIFe The Sixth Annual Lights of Life program is under way to raise funds for cancer research at Community Hospital, one bright-pink light at a time. For a $5 donation per light, you can honor or remember someone who lights up your life. A gift card will be sent to each honoree, and all be listed in a display case near the lighted trees. Funds raised through the Lights of Life program are helping to bridge the gap so area residents have local access to cancer research clinical trials. The Lights of Life tree-lighting ceremony will be at 6 p.m. on Wednesday, Dec. 7 out- side the Community Hospital out- patient entrance, 901 MacArthur Blvd. in Munster. You can find a visiting www.comhs.org and click- ing on “Community Hospital,” or by calling (219) 836-4582 eArTS oF oPe A crimson light twinkles, and another life is saved. The lights on the Hearts of Hope trees outside St. Mary Medical Center represent donations made to the Community Healthcare System Foundation vital research for heart disease right here, close to home. Each light shines in honor or memory of those who fill our hearts with love and joy. Honor someone close to your heart today. Donors and honorees are invited to the Hearts of Hope tree-lighting ceremony at 6 p.m. on Thursday, Dec. 8 at the new patient tower entrance, 1500 S. Lake Park Ave. in Hobart. You can find a Hearts of Hope donation form by visiting www.comhs.org “St. Mary Medical Center,” or by calling (219) 947-6041 WINgS oF eA INg For a $10 donation, a personalized angel is hung on the Wings of Healing tree in the St. Catherine Hospital lobby in East Chicago cele brating the life of a loved one who has passed away. A personalized greeting card is sent to the family. For a $25 donation, the donor also All proceeds benefit the commu nity outreach and education pro grams sponsored by St. Catherine Hospital, including the scholarship program that helps area students pursue careers in healthcare or other fields. The Wings of Healing tree-lighting ceremony will take place at 2:30 p.m. on Tuesday, Dec. 13 in the main lobby at St. Catherine Hospital, 4321 Fir St. in East Chicago. You can find a Wings of Healing donation form by visit ing www.comhs.org and clicking on “St. Catherine Hospital,” or by calling (219) 392-7014 Patrons and recipients gather around Community Hospital’s glowing pink trees known as the Lights of Life. vim & vigor winter 2005 community message Se am s ro s t e ne hospital. Three campuses. For the hospi- tals of the Community Healthcare System, we’ve moved a step closer to that goal with the com pletion of our electronic diagnostic system linking the campuses and outpatient centers of Community Hospital in Munster, St. Catherine Hospital in East Chicago and St. Mary Medical Center in Hobart. A $750,000 investment in a new high-speed micro wave communication system is making it possible to send not only diagnostic images but also other vital medical information between the three hospital campuses and our many outpatient centers. With the exception of our mammography systems, we can now electronically transmit diagnostic images throughout the healthcare system. There’s no longer a need to locate films and physically transport them. With these enhancements, vital health information and diagnostic images are available almost instantly, regardless of where patients may arrive within the Community Healthcare System or where their physicians may be located. Patients of the Community Healthcare System can move between the hospitals and outpatient centers with greater convenience, knowing all their records are easily accessible to the physicians treating them. Physicians can quickly gather this important health information and more easily consult with other specialists. Our emergency department physicians can gather electronic images and information from across town or across the hall. In uniting these three hospitals, it is our goal to bring to our patients the best that each has to offer. To accomplish this, we are continuing to invest in new information technology. These improvements will bring even greater efficiencies and conveniences, making it feel seamless to our patients as they move throughout the continuum of care we provide, from our physicians’ offices and outpatient centers to hospitals, home health and rehabilitation. These investments are also helping us to make good on another promise: improving the quality of care in Northwest Indiana. John gorski, senior vice president of hospital operations, Community Healthcare System CoMMUNITY HeALTHCAre SYSTeM President and Chief executive officer Donald S. Powers Board of Directors Donald S. Powers, chairman of the board; James J. richards, vice chairman; Frankie L. Fesko, secretary; David e. Wickland, treasurer; Steven Beering, M.D.; Albert J. Costello, M.D.; Alan Harre, Ph.D.; richard S. McClaughry; Joseph T. Morrow; Sister Kathleen Quinn; Donald F. Sands; William K. Schenck; Monsignor Joseph Semancik; M. Nabil Shabeeb, M.D.; Palmer C. Singleton Jr.; robert J. Welsh; edward L. Williams, Ph.D., Joe Williamson executive Staff John W. Mybeck, senior vice president and chief administrative officer; John gorski, senior vice president of hospital operations; David W. McCoy, senior vice president of finance and CFo; Donald P. Fesko, o.D., chief operating officer, Community Hospital; JoAnn Birdzell, administrator, St. Catherine Hospital; Milton Triana, administrator, St. Mary Medical Center regional editors Mylinda Cane, regional director of marketing and corporate communications Shelley Sepiol, media relations and publications specialist ProDUCTIoN editorial Senior editor, Stephanie Conner editor, Andrea Avery editor, Shelley Flannery V.P./editorial Director, Beth Tomkiw Senior Art Directors, Susan M. Knight, Laura Butler Art Director, Kay Morrow Creative Director, Marc oxborrow Production Production Manager, Laura Marlowe Prep Specialist, Allison S. Aamodt Imaging Specialist, Dane Nordine Circulation Circulation Director, Joseph Abeyta LIeNT erVICeS 888-2-89 V.P./Client Services, erin Zilis Account Supervisors, Brady Andreas, Barbara Mohr, Jennifer Nikolou, Jessica Yaw DVerTISINg ALeS Advertising Sales repr sentatives New York, Phil Titolo, Publisher, (212) 2-835 Chicago, Tom Meehan, (312) 2-800 Mail order, Bernbach Advertising reps, (914) 9-0051 ADMINISTrATIoN Vim Vigor Founder, J. Barry Johnson Chairman, Preston V. McMurry Jr. President/Chief executive officer, Christopher McMurry Chief Financial officer, Audra L. Taylor Senior V.P./group Publisher, Fred Petrovsky Vim Vigor Winter 05, Volume 21, Number 4. Indiana region 2 is published quarterly by McMurry, McMurry Campus Center, 1010 e. Missouri Ave., Phoenix, Arizona 85014, (02) 395-5850. Vim Vigor™ is published for the purpose of disseminating health- related information for the well-being of the general public and its subscribers. The information contained in Vim Vigor™ is not intended for the purpose of diagnosing or prescribing. Please consult your physician before undertaking any form of medical treatment Vigor™ does not accept advertising promoting the consumption of alcohol or tobacco. Copyright © 2005 by McMurry. All rights reserved. Subscriptions in U.S.: $4 for one year (4 issues). Single copies: $2.95. For subscriptions and address changes, write: Circulation Manager, Vim Vigor,™ McMurry Campus Center, 1010 e. Missouri Ave., Phoenix, Arizona 85014. 905 ridge road, Munster, IN 4321 If you prefer not to receive our magazine or other health and wellness information from Community Healthcare System, please call us at (219) 83-4582 or write to Community Healthcare System, 905 ridge road, Munster, IN 4321. Heart-Pounding excitement Your heart beats in rhythm for a reason. And when it “skips a beat,” your heart could be trying to tell you something. Just Breathe If you suffer from any kind of lung disorder—from asthma to emphysema—the Lung Center at St. Mary Medical Center is a breath of fresh air. Radiology films are becoming a thing of the past. New technology allows your diagnostic images to be viewed and transferred electronically. Lean on Me Don’t go it alone— family, friends, your physician and other cancer survivors can help you cope with your cancer diagnosis. operation: get Healthy you can’t work full time in a seden tary job and get fit? Five cubicle dwellers offer testimonials on how they did it. on the Mend After the initial shock of a heart attack, you can make adjustments and return to a normal life. Test Yourself Many people false diabetes. Don’t be one of them. Secrets to Longevity Forget fads and trends—learn how time-tested lifestyle choices can lead to a longer, better life. You’re So Vein Varicose veins are not only unsightly, they also can be harmful to your health. Learn about the treatments available. For centuries, women have been trying to figure out when they are most fertile. Now, with the Creighton Method, they can. Home-Team Advantage Community Healthcare System is recruiting future healthcare workers by making the transition from student to professional a little easier. The Triple-A Challenge strike without any warning at all. Find out if you are at risk, and what you can do to protect yourself. Body of evidence The nurses of Community Healthcare System are looking for better ways to care for you with a new technique called evidence-based nursing. CoVer PHoTogrAPH BY ALex BerLINer/BeIMAgeS contents WINTer In every Issue Making a Difference Community Message Seniority 10 Appetite for Health 12 A Healthy Dose Cover Feature Can Pitt Quit? ne of today’s hottest actors is not alone in his battle to winning that battle. Page 40. Features Features vim & vigor winter 2005 page 52 page 8 vim & vigor winter 2005 Editor: SC | Designer: The heart palpitations began for Margaret Gallegos in 1998. At the time, the 65-year-old retiree was working as a laborer and the pounding heartbeats were definitely getting in the way of her work. “It made me slow down and dent. “It was pounding so hard I felt like my heart was going to fly out of my chest. I could literally see my chest pounding.” These episodes were frighten ing, “especially when I started realizing that I could have a heart attack.” They seemed to happen mostly in warmer weather, about five times every summer, with a couple episodes every winter. doctor, but [my heart] wasn’t still beating fast and I felt like they didn’t believe me,” Gallegos says. One ambulance call to her worksite finally documented an episode and led Gallegos to the office of cardiologist P. Ramon Llobet, M.D. He diagnosed her con dition as atrial fibrillation, a type of abnormal heart rhythm, and referred her to cardiovascular sur cedure called Maze. “They also said there was a pocket in there that could fill up with blood and burst and cause a stroke,” Gallegos says. rhythm and Blues Rhythm is part of life. And Mother Nature doesn’t settle for just any rhythm; it’s got to be good. If the rhythm of the heart is off, we have what is known as atrial fibrillation. heart from the lungs are responsible for the synchronized contraction of the heart’s two upper chambers. This synchronized contraction gives the heart its rhythm. For the more than 2 million peo ple suffering from atrial fibrillation, the electrical messages passing into the heart from the lungs are chaotic, causing the heart to quiver rather than pump assuredly. Atrial fibrilla tion can be corrected surgically by snipping the veins responsible for conducting these electrical currents from the lungs to the heart. “You can cut the electrical con nections but still keep the heart functional,” Jayakar explains. “You can then keep the electrical abnor malities in the lungs, where they are not felt.” Known as the Maze procedure, Cardiovascular surgeon David Jayakar, M.D., performs surgeries at all three hospitals of the Community Healthcare System to correct atrial fibrillation and drastically reduce the risk of stroke. ou di tem The pounding in your chest may be your heart trying to tell you something By Shelley Sepiol vim & vigor winter 2005 four above the heart and four below. Occasionally, as in Gallegos’ case, a “mini-Maze,” in which only four veins are snipped, is all that’s required. Fewer veins need to be cut in a mini- Maze because these patients have fewer abnormal currents. Gallegos underwent her mini- Maze just before Thanksgiving last year at St. Catherine Hospital in East Chicago. To access these veins, Jayakar made a 3-inch incision on each side of her chest, thereby elimi nating the need for a full open-heart procedure in which the breastbone is split open. Smaller incisions offer signifi cant benefits. A traditional open- heart surgery with the splitting of the breastbone requires consider able recovery. These patients have considerable discomfort following surgery, have very limited use of their arms and can’t drive for six to eight weeks. The minimally invasive approach, however, carries with it very little discomfort, and patients can drive two weeks later. Jayakar also performed Gallegos’ procedure as a beating-heart, or off-pump, surgery. This means that she was not transferred to a heart- lung machine, but continued to pump blood and breathe on her own during surgery. Traditionally, patients have been put on the heart-lung bypass machine to allow surgeons to operate on the heart while it is still. Jayakar is able to avoid putting patients on this machine by instead stabilizing small parts of the heart as he operates on them one at a time. Patients have less pain and a speedier recovery from the combination of this minimally invasive alternative to open-heart surgery and allowing the heart to continue beating. After snipping the errant veins, Jayakar also removed Gallegos’ left atrial appendage, a little pocket-like protrusion in the heart that can contribute to stroke in patients with certain medical conditions (see sidebar). Its removal is considered a prophylactic, or preventive, measure because of the significant stroke- fighting result. “I was amazed that there was not much pain involved,” Gallegos says of her recovery. And best of all, the palpitations are gone. An Ounce of Prevention There’s a little pocket in everyone’s heart known as the left atrial appendage. In a person with normal heart function, the blood flows through the appendage on its usual course. For people with atrial fibrillation and other physical ailments, the blood is more sluggish and tends to pool in the appendage. This can lead to blood clots, which can make their way into the brain and cause a stroke. Fortunately, this troublesome appendage can be dispensed with. Cardiovascular surgeon David Jayakar, M.D., believes in the preventive benefits of removing the appendage. Because there are no nerves in the heart muscle and the incision site is anesthetized, patients experience minimal pain after surgery. Jayakar will preemptively remove the appendage in patients who are receiving other heart treatments, such as a valve repair or Maze procedure, if they possess one or more of the following risk factors for stroke: hypertension congestive heart failure atrial fibrillation “These are the patients who are known to have clots in that area,” Jayakar explains. “Studies have shown that a vast majority of blood clots that cause stroke form in this area. The goal in removing the left atrial appendage is to reduce the stroke risk among these patients.” This is done by creating two lines of sutures to seal off the appendage from the rest of the left atrium and then cutting it off. vascular heart disease smoking chronic obstructive pulmonary disease tem vim & vigor winter 2005 Editor: SC | Designer: For such a complicated metabolic process, breathing is something we take for granted. At least most of us do. nature for those suffering from lung disease. It’s a daily struggle that leaves patients feeling as if they’re literally drowning. The Lung Center at St. Mary Association of Indiana, a partner ship fostered as a result of the grave need to address lung health in our heavily industrialized little corner of the world. It serves as a compre- hensive resource center for those asthma to emphysema. According to the Centers for Disease Control and Prevention, a whopping 27.3 percent of the Indiana population smokes. Still others are faced with hereditary lung disease that is exacerbated by poor air quality. In fact, according to the American Lung Association, lung disease is the only major killer of Americans that is on the rise. A Breathy Definition Educating the public about lung disease means helping them under common, is in fact a disease and needs to be treated like one. So what is lung disease? Asthma is one example. This long term, or chronic, disease is characterized by inflammation in the airways that carry air to the influences such as dust, cold air and smog, asthma can occur in acute epi sodes, making it extremely difficult to breathe. Chronic obstructive pulmonary disease (COPD) includes bronchitis, emphysema or a combination of the If your breath is elusive, we’ll help you catch it ea By Stacey Kellogg vim & vigor winter 2005 two. In bronchitis, airways become restricted due to infection, inflammation or other triggers that cause phlegm and coughing. Emphysema occurs when tiny air sacs inside the lungs become damaged, trapping air and causing shortness of breath. A Breath of Fresh Air Many of the services the Lung Center provides have been offered for quite some time at St. Mary. Now, they come under one umbrella, with an updated set of proto cols and the sanction of the American Lung Association. Over time, the center will have access to outcome data to help determine the effec tiveness of lung health inter ventions in our area and how to best tailor treatments. “I have asthma myself, but this is my profession and I’m lucky I have the tools I need to keep it in check. Others don’t. I know how they feel, and that’s why we’re here to help,” says Bill Willer, RCP, director of the Lung Center. Charles Rebesco, M.D., gives medical direction to the Lung Center. Lung Center professionals are available to answer questions, do initial assessments, and refer patients to appropriate physicians or services so they may start a healthy process of disease manage ment. These services and education materials are free. An initial assessment is a series of questions about lung and general health. Based on those answers, Lung Center professionals may recommend additional physician referred testing to determine if lung disease is the culprit in patients experiencing shortness of breath. Testing can include measuring the amount of oxygen in the blood, pulmonary function testing and certain tests that measure the metabolic process of breathing. Treatment and Beyond Because St. Mary Medical Center is part of Community Healthcare System, the Lung Center has access to valuable resources that can help patients obtain care in their com munities. These include pulmonary function testing at Community Hospital in Munster, the Asthma Care Center at St. Catherine Hospital in East Chicago, and smoking cessation programs at all three hospitals in the system. Lung Center professionals also work closely with patients’ doctors to encourage patients to incorporate disease management into daily living. An important tool is pulmonary rehabilitation— an exercise regimen to strengthen the heart, which in turn can strengthen the breathing pro cess by putting more oxygen into the blood. A support group run by lung dis ease patients and supported by St. Mary is also available. Lung Center staff visit area schools upon request to provide teachers, students and parents with asthma education. Pulmonary Power Michael Feller, 52, of Lake Station, has emphysema from a hereditary lung condition. Diagnosed 10 years ago, the past four years have been the worst. Unable to work, Feller relays his despair. “A 10-minute shower took me an hour. I was on oxy gen 24/. I couldn’t even drive, go to the library, take a short walk. It was awful,” he says. He speaks in the past tense because he has since found hope. Feller has learned—albeit the hard way— to partially overcome his disease. realizing he will never be cured, he’s doing all he can to get back on track managing his disease. “I went to pulmonary rehab when I was first diag nosed, but after that I kind of slacked off. Boy, did I find out the hard way that what they tell you about exercising is true. I got worse and worse and worse,” Feller recalls. His condition led to lung surgery. After the surgery, Feller began pulmonary rehabilitation again at St. Mary Medical Center—but this time, he stuck with it. “I was thinking, ‘oh my golly. I’m having a hard enough time breathing as it is and you want me to pedal how hard? You want me to walk how long?’” Feller has gone from using  liters of oxygen while exercising to about 2.5 liters. He wears his oxygen only a few hours a day now, compared to 24/ before. He walks frequently, takes the stairs, rides an exercise bike, does home repairs, and still has time and energy to help his wife cook, clean and run errands. “I have learned that if you listen to the ladies in pul monary rehab and you push yourself, you can live the quality of life you deserve,” Feller says. According to the American Lung Association , lung disease is the only major killer of Americans that is on the rise Breathing easier Short of breath? Dial the Lung Center at St. Mary Medical Center at (219) 94- 11 for more information about how to get help. You can also visit the American Lung Association of Indiana online at www.lungin.org ea vim & vigor winter 2005 magine the following scenario: You are suffering from a herni ated disk and completed all your diagnostic tests at St. Catherine Hospital in East Chicago. A week later, while in Hobart, you suffer debilitating pain and have to be rushed to the nearest hospital, St. Mary Medical Center. Wouldn’t it be nice if you had all your films of previous tests to ride along with you to the hospital? who just happens to be on vacation in Hawaii this week, were able to confer with those treating you now? Not to worry. When traveling between the hospitals and outpatient centers of Community Healthcare System, prior diagnostic images are avail able to your doctors instantly. This valuable health information is now stored electronically, rather than on traditional films that had to be physically transported between facilities and doctors. Investments in electronic imaging and high- made by the System also make it possible to speed a copy to the per sonal computer of your doctor on vacation in Hawaii. It PACS a Punch New digital diagnostic imaging technology—the picture archiving and communication system (PACS) by Philips Medical—linked with the power of a high-speed micro wave communication system, allows St. Catherine, Community Hospital in Munster and St. Mary to share diagnostic images at the same time. The System went online with Hospital and has recently completed an expansion to include all diag nostic areas at St. Catherine and St. Mary. The only major diagnostic area within the System not included in PACS is mammography, which still uses traditional films for diag nosing. The System will upgrade to digital mammography equipment over the next three years, thereby including breast imaging in PACS. This computerized method brings with it many additional tools to help doctors achieve faster, more accurate diagnoses. All radiologists Among the specialists are radiolo gists fellowship-trained in body imag ing, neuroradiology, interventional radiology and vascular radiology. A fellowship-trained dedicated breast radiologist is also on staff. These doctors interpret examinations for patients at all three hospitals and all outpatient centers. They can see various views of the same organ, for example, with the click of a button, while traditional diagnostic results would require radiologists to place a separate film onto a viewer for every angle they PACS allows doctors in separate locations to view the same film simultaneously. This means physi cians can consult each other more quickly and conveniently. With viewing stations in every radiology reading room, as well as strategically placed throughout the hospitals, doctors also are able to consult each other quickly in emer gencies. “A doctor can call me from the emergency department and say, ‘Take a look at this,’ and I can look at it at the same time he’s looking at it,” says Community Healthcare John Gustaitis Jr., M.D. Immediate Access PACS also gives physicians immediate access to diagnostic images during critical situations without the down time of locating films. “As soon as the image is processed it’s available, whereas before they would have to hand-deliver a film,” Gustaitis says. There’s no more risk of losing films with PACS, either. If a patient requests a copy of his test image, it can easily be printed on film or burned to a CD and shared with multiple physicians. radiologist John gustaitis Jr., M.D., dictates notes while reviewing diagnostic images on PACS. w t ec hnolo y allows diagnostic images to be viewed remotely il By Shelley Sepiol vim & vigor 49 winter 2005 here is something admirable and indicative of a healthy self-image when a person doesn’t worry about every imperfec tion in his or her appearance. After all, very few among us don’t have a deviated septum, a patch of cellulite it comes to dealing with varicose veins, it can actually be good for your health to be more, well, vain. When left untreated, varicose veins of the legs can lead to other medical problems down the road, such as blood clots, ulcers, bleeding, infections and stasis skin changes, which are brown stains on the skin caused by blood leaking into the tis restless legs, burning, itching and throbbing. To combat these potential conditions, the Vein Care Center in Highland offers compre hensive, minimally invasive care for varicose veins that allows patients to literally return to their normal routine after treatment. “Patients leave after the proce dure and can return to work the Haddadin, M.D., FACS. “We encour age them to walk and move around as much as possible following varicose vein treatment.” Haddadin has been treating varicose veins since 1980 and provides medical leadership for the Vein Care Center, a service of Community Healthcare System. The center offers everything a cose veins, from diagnostic testing to outpatient procedures. Beneath the Surface Heredity is the most common factor in the development of spider and varicose veins. Varicose veins are present when the valves in the veins don’t function properly. The veins become congested with blood and enlarge. While small more superficial and generally considered to be cosmetic, occa sionally they can be an indicator of a more serious problem. “Varicose veins, however, are not only a cosmetic problem; they can cause a lot of symptoms and problems in the legs and should be evaluated by a doctor,” Haddadin says. Varicose vein hyper-pigmentation legs and ankles) and swelling often precede venous ulcers. Many patients battle these ulcers for years, but they will never properly heal according to Haddadin, without treating the source: the faulty valve deep in the vein. Treatment Patients seeking relief from vari- Varicose veins may be unsightly, but they can also be dangerous By Shelley Sepiol You’ So vim & vigor 50 winter 2005 examined with the aid of a vein light to see the veins close to the skin’s surface. Vein mapping is then conducted on one or two sepa rate days. To do this mapping, the doctor oversees a Doppler ultra sound of each leg. Since it takes about an hour to map each leg, they are often done separately for better patient comfort. After the ultrasound, a treat- ment plan is then devised that typically involves outpatient pro cedures done under local anesthetic while the patient is awake. A laser may be used to seal off the source of varicose veins high and deep in the thigh. Varicose veins generally improve once the source of the problem is fixed, Haddadin says. Residual veins can be treated by sclero- therapy, which involves the injection of a chemical to help shrink and close the veins. Other treatment options include compression stockings that can be individually fitted and prescribed to aid in proper blood flow, alleviat ing discomfort. For patients wishing to remove spider and blue cluster veins, sclerotherapy is commonly successful. A cutaneous laser can be utilized for patients whose veins require additional treatment during sclerotherapy. Can Pitt Quit? continued from page 44 smoking—and also make it harder to quit. Kleinman, who provides specialized smoking-cessation pro grams for entertainment industry clients, says, “They work extremely long hours, sometimes 16 hours a day. Quitting can be difficult when you’re not getting enough rest.” Glynn says smoking gives stressed- out individuals some relief—but it’s only temporary. “If someone like Brad Pitt comes out of a restaurant, and paparazzi surround him, the first thing he’s going to think is, ‘I need a cigarette.’ Nicotine does, in the very short term, reduce stress. But over the long term, it has the opposite effect,” he says. And for people like Pitt whose professions require good looks, and for those of us who just want to look good, cigarettes are a bad idea. “They cause wrinkles,” Glynn says. “They ruin your teeth and mouth. The cumulative effect is going to show after 20 or 40 years.” As Pitt’s battle to quit smoking plays out, Glynn sees an opportu nity for him to set an example for his millions of fans. “If he’s going to share this,” Glynn says, “it’s good for him to show not only his desire to quit, but also the difficulty he’s encountering. He can say, ‘I’m determined to do it for myself, and for my fans.’” Treatment Options for Varicose Veins No treatment: Some patients may live their entire lives with varicose veins and never develop complica tions more serious than a chronic dull ache. Compression hose: Upward gradient compression helps to squeeze the blood back out of the legs. In many cases the stockings provide moderate relief. Ultrasound-guided sclerotherapy: Under the guid ance of ultrasound, a needle is inserted into the greater saphenous vein and a chemical is injected directly into the diseased vein. This chemical irritates the vein wall, causing it to collapse and scar down. endovenous ablation: A catheter is inserted into the greater saphenous vein at the knee. A laser fiber is then fed up the catheter into the proximal greater saphenous vein. The laser fiber is slowly withdrawn as it fires energy into the vein, causing damage to the vein wall. This damage causes the vein to close down. Ambulatory phlebectomy: After endovenous laser therapy has destroyed the proximal greater saphe nous vein, the branches of the varicose veins are surgically removed through tiny incisions. The veins are hooked and pulled out of the leg. No sutures are required. In most cases, patients return to work the next day. Ligation and stripping: This is the traditional surgi cal method to remove varicose veins. This procedure involves numerous incisions, requiring suturing and prolonged recovery. These before and after photos show the improved appearance of varicose veins after treatment at the Vein Care Center in Highland. Vein Damage The treatment of most venous conditions is covered by Medicare and commercial insurance plans. Call (219) 923-2400 for a consultation. Before ter vim & vigor 51 winter 2005 W hether she wants desper- ately to get pregnant, prefers to postpone mother hood for the time being or is having gynecologic problems, every woman should be in touch with her inner Fertile Myrtle. However, not every woman is comfortable using, or is able to use, pills, patches, implants and other chemical and mechanical devices related to fertility. That’s why Hobart Family M.D., offers counseling in the Creighton Method, a form of natu ral family planning requiring only a solid education in the method’s use and some simple charting. “People are serious about family planning and infertility,” says Barajas, who is on staff at St. Mary Medical Center in Hobart. “They want to work within their conscience.” The Creighton Method has been around since the mid-1970s. While the Creighton Method is consistent with the teachings of the Catholic women, not Catholics per se.” Monitoring Is Key The method teaches women and their partners to monitor and chart the consistency of her cervical dis charge. There are no temperature readings or other requirements associated with other methods. “Most people, when they think of family planning, think of the calen dar or rhythm method,” Barajas says. “The problem with this method is that it doesn’t apply if your cycle is not regular.” monitor vaginal discharge when urinating throughout the day. “It’s not time-consuming,” Barajas says. “It becomes a secondary habit, kind of like brushing your teeth.” The type of mucus that’s present correlates to a woman’s fertility. A record is kept on a special chart. For the first month of training on the Creighton Method, couples are asked to abstain from inter course while they become adept at its use. Once versed in the Creighton Method, couples who wish to pre course during the woman’s fertile days as determined by the charting. The Creighton Method’s effec tiveness ratings are comparable to chemical and physical forms of birth control. The annual effectiveness rate is 99.5 percent, which is compa rable to other forms of birth control, including the birth control pill. Fertility Awareness The Creighton Method also can be very helpful for couples experi encing difficulty conceiving. It an understanding of the most fertile point in her cycle. “Such couples who use the charting alone to identify their peak zone achieve pregnancy 20 percent to 40 percent of the time,” Barajas adds. other Issues Doctors and patients also use the Creighton Method as a tool to better assess and treat gynecologic prob lems, such as irregular periods, ovarian cysts and premenstrual syndrome. Being aware of a woman’s cycle allows doctors to treat her her progestin levels are expected to rise. Known as cooperative hor monal therapy, it’s considered by some to be a treatment more in sync with the body’s natural rhythms. ve Chart It out To learn more about the Creighton Method, The Family Life Clinic at (219) 94-09 FIgUrINg oU YoUr oS er e e JUS go eASIer e ll-Nat ura By helley epiol Editor: SC | Designer: hink of when you were little and had big dreams of what you would do when you grew up. Did you picture yourself working in your hometown? Much of today’s generation doesn’t. They’re taking their talents elsewhere, so the hos- System are responding. We’re acknowledging our com munities’ young and superlative students, and we’re giving them opportunities and tools to bring that brilliance home after finishing school, ultimately making for a better community. Take, for example, 20 college students who grew up here and now attend medical schools mer, they came home for an eight week externship that thrust them into a day in the life of a doctor. An Insider’s View More than 20 years ago, Vijay Dave, M.D., medical director of education at St. Mary Medical Center in Hobart, began wel- coming students into his profes sional life to help them learn about being a doctor. Partnering with St. Mary, other physicians and, most recently, Indiana University and the Indiana Area Health Education Center, Dave has been able to offer a comprehensive program in which students shadow professionals across all areas of patient care in the hospital. “This gives us an excellent oppor tunity to show our aspiring leaders that the care we provide in the com many ways as progressive and inno vative as the care at university med ical centers,” Dave says. “We hope to not only guide them in their career paths, but also invite them to return to their roots and possibly set up practice here when they are ready.” An Invaluable opportunity “We don’t get to do this anywhere Normally this kind of access doesn’t come until later in medical school,” says Amanda Brewer, a Portage resident and second year medical student at Indiana University Northwest. She hoped the program nt Te vim & vigor 52 winter 2005 would help her narrow down her fields of interest, which include psychology, pediatrics, neurology and emergency medicine. Many of the students were surprised St. Mary is a leader in ele c trophysiology research. They didn’t know a neighborhood - based ho s pital like Community Hospital in Munster has a fellowship - trained dedicated breast radiologist pro- viding instant mammogram results to women, or that St. Catherine Hospital in East Chicago is one of the few places in the nation to offer CyberKnife ® technology for cancer treatment. They could be involved in all this by coming home after medical school to practice here. Learning from a Distance The education doesn’t stop there. Recruiters and educators within Community Healthcare System have been working diligently to help area medical - field graduates realize the benefits of working at our hospitals. Most recently, the System has partnered with Purdue University to offer distance learning at work for nurses who wish to advance from R.N. to BSN, or from BSN to M.S. Nurses can clock out and go to a hospital conference room to attend classes via videoconferenc ing to earn degrees. No fighting traffic, juggling schedules or racing to a campus in another part of the region. The nurses have the prestige of becoming Purdue nursing stu dents, with a convenient way to learn. Plus, after some longevity, the System will reimburse healthcare students’ tuition costs. Supporting Success The nurse fellowship program sup ported by the System is another opportunity for learning. The pro gram gives aspiring nurses the support and training they need to succeed in the field. After the nurses complete a semester of clinicals, they are hired as nur - sing aides while continuing school. This provides the opportunity to see patient care firsthand and also become more familiar with the hospitals, should they choose Community Healthcare System for work after graduation. “By offering a fellowship pro gram, we are saying to nursing students, ‘We’re here to invest in your career, and we invite you to invest in Community Healthcare System.’ Compared to the unsteady job market many other graduates face today, we’re providing a ter - rific opportunity to grow and develop longevity with us,” says Tony Ferracane, vice president of human resources for Community Healthcare System. After graduation, nursing stu dents who were once employed as aides in the fellowship program are invited to a shadowing process that enables them to experience patient care as closely as possible, without actually passing out medications or handling the work of an experienced, licensed nurse. They are then welcome to join the System as employees. Not Just for Nurses Students in other medical fields also have the opportunity to learn within the System. At St. Mary, a partner ship has been formed with Indiana University to allow radiation therapy technician students an opportunity to take clinicals at the hospital. Respiratory therapy also works with students for clinicals at St. Mary. “We cannot stress enough that the hospitals of Community Healthcare System are dedicated to improving the quality of life and care for the people of Northwest Indiana. Part of that commitment lies in making sure our young stu dents have a reason to work here, live here and contribute to making our communities the best they can be,” says John Gorski, senior vice president of hospital operations for Community Healthcare System. The recruiters of Community Healthcare System work with edu cators at Community Hospital, St. Catherine Hospital and St. Mary Medical Center to develop unique ben efits and programs for those interested in fostering careers at the hospitals. The Path to Your Profession nterested in Community Healthcare System? Visit www.comhs.org and click on “ mployment pportunities.” Here, you can also read more about different medical fields to choose from. vim & vigor 53 winter 2005 vim & vigor 54 winter 2005 Editor: SC | Designer: AAA S ome might say William Suarez is a lucky man. The 70-year-old Ogden Dunes resident under went surgery in July to repair four abdominal aortic aneurysms (AAAs). AAAs account for the deaths of 15,000 Americans a year. Generally, as in Suarez’s case, there are no symptoms, making potential vic tims particularly vulnerable and reliant on screenings to detect covered in April when his family doctor decided to order a CT scan to screen for abnormalities consid ering previous vascular problems. It was a good call: Suarez had five aneurysms, four of which needed immediate attention. Fortunately for Suarez, within the past six years a minimally invasive aneurysm repair, known as AAA endovascular stent grafting, has become available. This newer approach is much less traumatic, painful and dangerous than tradi tional aneurysm repair and is Munster by cardiovascular surgeon J. Michael Tuchek, D.O., one of the country’s leading experts and one of only 40 surgeons in the country who also repair aneurysms of the thoracic aorta using this less invasive approach. What Is an AAA? AAA is a ballooning of the abdomi nal aorta, the portion of the main artery branching off of the heart from just below the kidneys to the split known as the bifurcation lead ing to the iliac artery in each leg. This ballooning can be caused by fatty buildup on the walls of the the blood vessel, physical trauma and heredity. AAA is the 13th leading cause of death in the United States and the 10th leading cause of death in men 55 and over. “More men over 65 die from ruptured aneurysms than from heart attacks,” says Tuchek, who is the primary investigator in numerous endovascular clinical research trials for the repair of abdominal and thoracic aneurysms. While AAAs happen to women, they strike four times as often in men. The typical AAA patient is a 65-year-old white male, 5 feet tension and chronic obstructive pulmonary disease (COPD). Those who have a history of smoking and/ or high blood pressure have an ele vated risk of developing an AAA, which can be hereditary. A healthy abdominal aorta is three-fourths to 1 inch in diameter. With an aneurysm, it can reach many times that diameter. A typical AAA grows about one- quarter inch per year, accord ing to Tuchek, depending upon blood pressure and genetics. The treatment for aneu rysms depends upon their tors take a watch-and-wait approach for those 4 to 5 centi meters in diameter. The risk of death is very high if an aneu rysm ruptures, so surgeons need to repair it if the risk of rupture becomes too great. AAAs 5 centimeters in diameter or larger run an increased risk of rupturing. Traditional aneurysm-repair surgery involves an incision from the breastbone stem to the pubic bone, some 12 to 15 inches. The aneurysm is then either shut off from the func tioning portion of the vessel graft that is sewn into place. This open approach takes three to four hours in surgery, seven to 10 days recovery in the hospital and two to three months of recovery at home before strenuous activity can be resumed. All the risks asso ciated with surgery, such as bleed ing and infection, are also higher in this traditional approach than with a stent graft. “While heart surgery is riskier,” Tuchek says, “traditional AAA surgery is harder to recover from.” AA is the ause of death in the United States and the 10th leading ause of death in men 55 and over. When three As are worse than one hallen he By Shelley Sepiol vim & vigor 55 winter 2005 AAA Ship in a Bottle Fortunately for 96 percent of the patients Tuchek sees, the less invasive approach—an AAA stent graft—is an option. Generally only those with unusually large arteries are disqualified for AAA stent graft ing because their anatomy is too large for the necessary equipment. However, outward body size is not an indicator of this. “Some large guys have small arteries and some small women have big arteries,” Tuchek says. Compared to the traditional sur gery, stent grafting takes only two hours, patients can return home the next day, and they can engage in any strenuous activity two weeks after surgery. Plus, the incisions on either side of the groin are small, reducing the risk for bleeding and infection. The surgeon repairs the aneurysm by inserting all necessary devices and tools through the small inci- sion in the groin and threading them to the aneurysm site through blood vessels. The stent, which acts like a new aorta, keeps the blood flow con tained within its original pattern and away from the walls of the aneu rysm, which often shrink back around the walls of the stent. This achieves the goal of keeping the aneurysm from rupturing. Tuchek has led Community to become one of the largest endo vascular stent graft programs in the Chicagoland area. He was listed as the largest implanter of AneuRx abdominal stent grafts in the country last year by the graft’s manufacturer, Medtronic. Tuchek travels around the world teaching other surgeons how to perform the procedure. Earlier this year, cardiovascular surgeon Chris Carlos, M.D., began performing AAA endovascular stent grafts at St. Catherine Hospital in East Chicago. Leaders in the Industry When planning treatment for AAA, as with any medical condi- tion, you’ll want to select medical providers with experience and an excellent record. Community Hospital is the recipient of an award given to the top 5 percent of hospitals in the nation for vas- cular procedures. Presented by HealthGrades , an independent company that rates hospital perfor mance, this rating was attributed to all vascular procedures done by various doctors at Community. William Suarez Protect Yourself Since there are virtually no symptoms of AAA, detection through screening is the best protection against rupture. Monthly AAA screenings are offered throughout Northwest Indiana for $45. For more information on an upcoming screening, please call toll-free 800-324-1851 I magine how much better you could do your job if you were given the opportunity to come up with different ways to approach it and challenged to find evidence to support your new methods. The hospitals of Community Healthcare System—St. Catherine Hospital in East Chicago, Community Hospital in Munster Hobart—are giving nurses the sup port to implement evidence-based nursing practices. Through a part nership with the Purdue University Calumet School of Nursing, the Evidence-Based Nursing Practice Core Team is empowering nurses to improve patient care. “The main idea is that you do the right thing,” says Purdue University Associate Professor of Nursing Lisa Hopp, R.N., Ph.D., who is assisting right thing?” How It Works First, nurses ask themselves how successful their current methods of treatment are in meeting patient needs. “Do we indeed have a prob lem?” Hopp says. “If not, let’s keep doing what we’re doing.” If room for improvement is found, the nurses conduct research and/ or seek out the best body of evidence to guide them in developing new treatment plans. “By integrating we are continually challenging ourselves to deliver better out comes, improving the quality of care our patients receive,” says Gina Bondi Gorski, R.N., FNP, M.S., division director/ CNO of patient care services for St. Catherine and St. Mary. One of the first evidence- based nursing projects undertaken by the hospitals involved the chal lenge of reducing the number of pressure ulcers resulting from the are immobile. Pressure ulcers, or bed sores, are open wounds on the skin, typically over bony parts of the body, such as the backs of the heels and hips. Pressure ulcers can lead to severe infection and can be life threatening. Using evidence-based nursing principles, the Core Team, made up of staff nurses, educators, clini cians and managers, determined they could lower the number of pres sure ulcers. Instituted in July, the uses best standards of practice and research literature on pressure ulcers by the Registered Nurses Association of Ontario. Throughout the System nurses were using the Braden Scale to determine a patient’s score for seven pressure-ulcer risk factors. The Ontario research revealed that by implementing the Braden Scale on every shift for every high-risk patient, it could further reduce the incidence of pressure ulcers. “Our commitment to evidence- based nursing lets every one of our nurses come to work each day knowing that they are respected for their expertise and encouraged to take an active role in improving patient care,” says Deborah Krejci, R.N., BSN, MBA, the nurse quality assurance manager for St. Mary. vim & vigor 5 winter 2005 Bod iden of evidence-based nursing means better care for you By Shelley Sepiol “By integrating evidence-based nursing practices we are continually challenging ourselves to deliver better outcomes, improving the quality of care our patients receive.”