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Pain Management Services Now Available in Lincoln

April 14 - Did you know that pain affects more Americans than diabetes, heart disease and cancer, combined? That is why Penobscot Valley Hospital is offering a new service in their Specialty Clinic: Pain Management with specialist Jonathan Herland, D.Sc., M.D.

Pain Management is the branch of medicine that focuses on treatments of many different types of pain. “Pain may arise from an array of different reasons whether it be injury, nerve damage, surgery, or even metabolic problems like diabetes,” adds Dr. Herland. “Many patients come to me seeking relief from lower back or neck pain.”

In addition to back and neck pain, Dr. Herland also works to alleviate joint pain without the use of narcotic medications. He is board certified in both anesthesiology and pain management and has over 16 years of experience in the field. Dr. Herland earned his medical degree at University of Massachusetts, his residency in anesthesiology at Massachusetts General Hospital, and a pain fellowship at Dartmouth-Hitchcock Medical Center. Since 2000, he has practiced in Bangor and across northern Maine.

“We are very excited to have Dr. Herland on board providing this new service in our community. We hope to fill a void that will benefit many patients. Now people can seek treatment for pain and not have to worry about extensive time away from work or travel for services,” states PVH physician practice manager, Kathy Schneider, RN.

Recent data from the Center for Disease Control and Prevention and National Center for Health Statistics suggest that most people in chronic pain have multiple sites of pain, including:
- low back pain (28.1%),
- knee pain (19.5%),
- severe headache or migraine (16.1%),
- neck pain (15.1%),
- shoulder pain (9.0%),
- finger pain (7.6%),
- and hip pain (7.1%).

Many people suffering from pain report a negative impact on their overall quality of life, feelings of depression, trouble concentrating, negative impact on energy levels, and trouble sleeping.

“My ultimate goal is to improve the function and lives of my patients,” states Dr. Herland.

If pain is having a negative impact on your life, you may be a good candidate for interventional pain management services. Speak with your primary care physician about a referral for pain management at the PVH Specialty Clinic. Dr. Herland works closely with his patients' primary care physicians to insure good communication, which in turn helps provide the optimum treatment for patients.

The new pain management specialist at Penobscot Valley Hospital, Dr. Jonathan Herland, reviews his schedule with PVH Specialty Clinic medical assistant Tory Blomsma. Dr. Herland is accepting new patients, so speak with your physician to see if his services might be a good fit for you. 

Cancer Support Group News: Mobile & Online Resources for Cancer Patients and Survivors

by Terri Coolong, CSG Leader


April 1- – Instead of dragging notebooks and texts to your next doctor’s appointment, why not go high tech?! Many of us have leapt into the digital age by purchasing either smart phones or tablets. Although a good round of Candy Crush can’t be beat, why not put your phone to good use by adding some cancer apps? This puts a wealth of information right at your fingertips.

Cancer.Net Mobile is a great app that has received e-Healthcare Leadership awards. It has an overview of 120 different types of cancers, along with statistics, risk factors, prevention, symptoms and signs, diagnosis and stages. An interactive tool allows you to store questions to ask your healthcare providers and record either voice or written answers. The prescription medication tool is a place to save information on your medications, including the dosage and the prescribing doctor. If your device has a camera, you can photograph the label of the bottle and the pill itself. A symptom tracker helps you log symptoms, their severity, and times they appear, such as appetite loss, insomnia, headache or vomiting. There is also a section featuring podcasts, videos, and Cancer.Net articles. Download this free app through iTunes or Google Play.

CURE Magazine is a wonderful quarterly publication available free to anyone diagnosed with cancer. It contains information not only on innovative research, but also on issues of interest to patients and survivors. Although not yet available on Android, iTunes is now a source for the magazine. You can also read it on the web.

Novartis Oncology has an app called ClinicalTrialSeek that lets patients search the National Institutes of Health for clinical trials that could be a fit based on the treatments and diseases under investigation, the location, phase of development and other aspects of the studies. The app also explains how trials work. This was launched in hopes of educating patients and boosting enrollment. Free from both iTunes and Google Play, I could not try it out because it was incompatible with my tablet but it should work on most phones.
Numerous patient support tools help cancer patients stay connected with friends and other patients. One of the most popular is CaringBridge. Developed after the website, it doesn’t have as many features, but is handy to quickly add or check updates and supportive messages. It is easy to keep a large group of people informed of your cancer progress. The live chat function can also provide quick answers to questions. Free from iTunes and Google Play.

Keeping fit and healthy is important during both cancer treatment and survivorship. MyFitnessPal is an app and website that helps track your nutrition and exercise to determine optimal nutrients and caloric intake for the user’s goals. Consumer Reports rated it the best free program in overall satisfaction, calorie awareness and food variety. With the largest food database of any app (over 3 million), the user can either enter the name of the food or scan the barcode to add to their list of most frequently eaten foods. It shows the calories needed per day based on your current weight and future weight goals, and keeps a running tally as foods eaten (or exercise performed) are added. Free from iTunes and Google Play.

A cancer patient created Chemo Brain Doc Notes to help remember important questions for her next doctor’s appointment. Many cancer patients who have drug therapy suffer from memory problems. Before your appointment, you can record your critical issues either in text or voice memo, so that during the visit you can refer back to your questions to make sure your needs are addressed. You can also add information from your visit, such as complex medical terminology, relevant medical issues, or next steps to take. You can include reminders about prescriptions, side effects, and test results. Free from iTunes and Google Play.

My Pearlpoint Cancer Side Effects Helper app features a list of common cancer treatment side effects and evidence-based advice on how to manage them. This app also provides nutritional guidance. The user picks a side effect and is given simple suggestions from registered dieticians and convenient access to educational articles and videos. Downloadable at iTunes or Google Play (free).

There are hundreds more free apps related to cancer that can be found through a search of the internet, but these are ones that either I have found useful myself, or that have been highly rated by other users.

Upcoming Cancer Support Group meetings are set for April 8, with Margo Stevens presenting information on the Millinocket Relay for Life fundraiser. On April 22, Marcia Larkin will be presenting information on accessing cancer care and free transportation options available through Penquis. Meeting times are from 6:00-7:15 pm in Conference Room B at Penobscot Valley Hospital and are open to any patient, survivor, or caregiver. Call the CSG hotline for more information at 207-794-7149    

April is National Donate Life Month

April 9- This April marks the 11th annual National Donate Life Month, a celebration commemorating those who have given the gift of life through organ and tissue donation. For those whose lives have been saved or healed by a transplant, National Donate Life Month provides a chance to share their story to encourage more people to register as donors.

Suellen Canfield was a happy wife, mother and grandmother when she died suddenly in 2001. Her family had no doubt that if given the opportunity, she would continue to help others even after she had passed. At 61 years old, Suellen’s gift of organ donation saved the lives of three people. Her husband, Bob, volunteers for New England Organ Bank sharing his story of how in great loss he found comfort in his wife’s ability to help others.

“The transplant waiting list is made up of people of all ages,” says Laura Dempsey of New England Organ Bank. “It’s important to show that people of any age can make a powerful difference in someone’s life by being a donor. Donation saves and heals lives every day, but it can only happen when someone makes the important decision to register as an organ and tissue donor. You can make that lifesaving difference by registering your decision to donate.”

In addition to organ donation, tissue donations help over one million individuals each year. Heart valve, bone and skin donations give recipients a new chance at a healthy life, the recovery of tendons and ligaments can help heal a severe sports injury, and cornea donations give the gift of sight.

Thanks to a group effort made up of Penobscot Valley Hospital, New England Organ Bank, motor vehicle department offices and Donate Life volunteers, the number of registered donors continues to climb. There are now 112 million registered donors in the United States, over 5 and a half million from New England. Still, the number of people in need of transplants continues to outpace the supply of donated organs. More than 120,000 people are currently awaiting a transplant, and sadly, an average of 18 patients die every day because the organ they needed was not donated in time. The solution to this problem is to continue educating the public about the lifesaving effects of donation and transplantation and encourage them to sign up through their state donor registry.

To register to be a donor or for more information visit www.DonateLifeNewEngland.org

PVH Emergency Room Receives High Marks

March 25- If you’ve visited the Emergency Department (ED) at Penobscot Valley Hospital recently, you’ve probably noticed some familiar faces. The hospital has successfully recruited physicians Steven J. Fisher, MD and Michael J. Lescord, MD to work with physicians David Dumont, MD, David L. Ettinger, MD, John Shannon, DO, and Paul E. Turnquist, MD. And patients couldn’t be happier!

This brings the PVH ED up to full staff with local providers. Dr. Fisher had previously worked fulltime in Vermont and prior to that had been on the staff for many years at Mid-Coast Hospital in Brunswick, Maine. Dr. Lescord comes to PVH after working in the Emergency Department at Eastern Maine Medical Center in Bangor for almost 20 years.

Patient survey scores are showing extremely high satisfaction levels with the care they receive during their time in the Emergency Department at PVH. In the fourth quarter of 2013 and so far through the first quarter of 2014, patients completing the satisfaction survey have given PVH top ranks in every question of the survey, which is a tremendous feat considering there are 34 questions. This ranking puts the PVH ED above both the state and national averages in all categories!

“The stability of our healthcare team, both providers and nurses, reflects in our scores,” states PVH Director of Nursing Clinical Practice Lisa O’Connor, RN. “Covering more shifts with in-house doctors and nurses assures the staff know our processes extremely well and can focus on providing top-notch patient care.”

Patients who are admitted to PVH for overnight care are randomly selected by a third party to receive an HCAHPS (Hospital Consumer Assessment of Healthcare Providers Survey) questionnaire requesting information about their recent inpatient visit. This organization tallies responses and publishes data nationally at www.hospitalcompare.hhs.gov, although there is a time delay in the site’s reported data. Responses received by these surveys help all healthcare facilities improve care, access, communication, coordination, and safety. At PVH, survey responses are highly regarded and help bring about new projects based on patient suggestions.

For example, the Emergency Department nursing staff implemented the follow-up phone call process to improve communications, discharge and patient outcomes after they leave the hospital. ED staff review the patient chart prior to the call, taking a close look at the discharge instructions. During the call, staff ask patients if they are feeling better, offer some easy remedies like elevating an extremity, ice, heat, or stretches. If a follow-up appointment with their primary care provider was recommended, ED staff ask if the appointment has been made and if it has not, urge them to do so. If prescriptions were written, staff ask if they were able to fill their prescriptions. Staff then ask if they have any questions about their care while they were here or any questions in general. The majority of patients like the follow-up calls and appreciate the staff’s concern even after they’ve left the ED.

The ED’s highest ranks were in patient safety on medications. Before giving any new medication, staff discuss possible allergies, other medications currently being taken, and what the new medication is for. Staff always ensure the 5 R’s before administering medication – the Right Drug, Right Dose, Right Route, Right Patient, and Right Time. PVH ED staff also ranked high in emotional support, respect, education, involvement of family and friends, and physical comfort.

"We are very fortunate to have such a strong team of nurses and physicians," remarks Dr. Dumont, Chief of Emergency Medicine and the hospital's Chief Medical Officer. "All of our ED physicians have a wealth of emergency medicine experience. Our staff also has a tremendous knowledge of being able to care for patients in a rural location, where there is often a limited amount of specialty medical care. We are seeing this improvement in patient satisfaction and outcomes because of the stability of our healthcare team and because of their strong skills."

Nursing staff in the Emergency Department at Penobscot Valley Hospital conduct follow-up phone calls to ensure positive patient outcomes after they leave the hospital. Communications, experience and quality care in the ED have led to patient satisfaction levels that have never been higher.

Enjoy the Taste of Eating Right

March 11 - While taste drives most food choices, eating nutrient-rich foods that provide the most nutrition per calorie is one of the best ways to "Enjoy the Taste of Eating Right," according to the Academy of Nutrition and Dietetics. As part of the 2014 National Nutrition Month® theme, the Academy encourages everyone to choose the most nutritionally-packed foods you can from each of the five MyPlate food groups every day.
Nutrient-rich foods and beverages provide vitamins, minerals, protein, carbohydrates and other essential nutrients that offer health benefits with relatively few calories.

PVH Registered Dietitian Mark Robinson adds, “This year’s National Nutrition Month theme, ‘Enjoy the Taste of Eating Right’ tackles the problem of empty calories in a positive way. It highlights the benefits of flavorful, nutrient-dense foods over choices that have more calories from added sugars and fats than we often realize. Most of us could probably take a look at some of our food choices and find a few simple ways to choose more nutritious alternatives that we can enjoy just as much. Small changes over time can yield big results.”

"When your daily eating plans include foods like vegetables, fruits, whole grains, lean meats, poultry, fish, eggs, fat-free or low-fat dairy, beans, nuts and seeds in the appropriate amounts, you are able to get many of the nutrients your body needs, all with relatively low amounts of calories," says registered dietitian nutritionist and Academy spokesperson Debbi Beauvais.

Beauvais offers practical ways to add nutrient-rich foods and beverages to your daily diet:

Make oatmeal creamier by using fat-free milk instead of water. Mix in some raisins, dried cranberries, cherries or blueberries, too.
Make sandwiches on whole-grain bread, such as whole wheat or whole rye. Add slices of avocado, tomato or cucumber to lean roast beef, ham, turkey or chicken.
When eating out, look for nutrient-rich choices, such as entrée salads with grilled seafood and low-calorie dressing, baked potatoes topped with salsa, grilled vegetables and reduced-fat cheese and yogurt parfaits made with strawberries and blueberries.
Drink nutrient-rich, low-sugar beverages such as low-fat or fat-free milk or 100-percent fruit juice.
Top foods with chopped nuts or reduced-fat sharp cheddar to get crunch, flavor and nutrients from the first bite.
Spend a few minutes to cut and bag vegetables so they are in easy reach of every family member: some ready-to-eat favorites include red, green or yellow peppers, broccoli or cauliflower flowerets, carrots, celery sticks, cucumbers, snap peas or radishes.
Serve meals that pack multiple nutrient-rich foods into one dish, such as hearty, broth-based soups that are full of colorful vegetables, beans and lean meat. Make chili with a dollop of low-fat yogurt. Serve these with whole-grain breads or rolls.
For dessert, enjoy a tropical treat by blending mango, plain low-fat milk, ice and a splash of pineapple juice, or stir chocolate syrup into a cup of coffee-flavored yogurt, freeze and enjoy.
"You should enjoy the foods you eat. In choosing nutrient-rich foods, you'll find they are familiar, easy to find and represent the five MyPlate food groups," Beauvais says. "Achieving balance and building a healthier diet can be simple and stress-free. Selecting nutrient-rich foods and beverages first is a way to make better choices within your daily eating plan."

Beauvais also recommends limiting added sugars and reducing the major sources of solid fats. "Drink few regular sodas, fruit drinks and sports drinks, and cut back on cakes, cookies, ice cream, cheese and fatty meats like sausages, hot dogs and bacon," she says.

"You don’t have to give up these foods entirely, but find ways to enjoy small amounts occasionally," Beauvais says.

Visit the Academy’s website at www.eatright.org to view a library of recipes designed to help you "Enjoy the Taste of Eating Right." As part of this public education campaign, the Academy’s website includes a variety of helpful tips, games, promotional tools and nutrition education resources, all designed to spread the message of good nutrition based on the "Enjoy the Taste of Eating Right" theme.

Students from Barb Hamlin’s class at Hichborn Middle School have put together artwork on the amount of sugar found in common beverages and educational materials on fitness. Their items will be on display at Penobscot Valley Hospital in the main lobby near the Cafeteria through the month of March as part of National Nutrition Month.

Cancer Support Group

by Terri Coolong, CSG leader

March 4- A cancer diagnosis can be a very lonely and isolating experience, especially if the patient doesn’t already have familiarity with cancer. This isolation can lead to distress, fear, and feelings of abnormality. Numerous studies show that attending a support group can help alleviate these feelings. Research has further shown that giving cancer patients information in a support group setting can help reduce tension, anxiety, fatigue, and may lower the risk of depression.

People give numerous reasons for not attending cancer support groups: they may not feel well enough to attend, they may feel that they have good support at home, they may feel uncomfortable opening up about their feelings, or they may be avoiding contact with cancer. Although these are all valid reasons, research shows that patients who attend support groups generally have a greatly improved quality of life and tolerate treatment better than those who try to go it alone. Research has shown that people with cancer are better able to deal with their disease when supported by others in similar situations.

A 1989 study by Dr. David Spiegel linked attendance at support groups with an overall increased length of survival. Although this study was flawed, more recent studies show that patients are more likely to attend their appointments and take prescribed medications if they are actively involved in a supportive group. According to CURE magazine, patients with support can tolerate more chemotherapy over time, compared with patients who lack support, and are 60% less likely to drop out of their chemotherapy regimens.

So what can you expect from a cancer support group? Most attendees say that they look for encouragement, inspiration, optimism, hope for improved survival and quality of life, advice, and relief from depression, fear, and anger. Participants say that they get a sense of belonging from the group, and a feeling that they are not alone. Group members are tolerant of emotions, without requiring an explanation or offering solutions. They also are more open to discussions of cancer and death than family members might be. A strong level of humor is usually present, which is effective in coping with adversity.

Benefits of participating in support groups may include:
- Gaining a sense of empowerment and control
- Feeling less lonely, isolated or judged
- Improving your coping skills
- Talking openly and honestly about your feelings
- Reducing anxiety, distress, and depression
- Understanding your situation better
- Getting practical advice or information about treatment options
- Comparing notes about resources, such as doctors and alternative options

A cancer diagnosis is not only about how long you live, but also how well you live. And the research is clear: support groups can improve your quality of life and help you to live better. The PVH Cancer Support Group meets the 2nd and 4th Tuesdays of the month from 6:00-7:15pm in Conference Room B. Meetings this month are March 11 and 25. For more information, leave a message on the hotline at 794-7149.

Diabetes support group

March 4 - St. Joseph Diabetes and Nutrition Center sponsors a free diabetes support group for diabetics and their family members 1-2 p.m. the first Wednesdays of March, April, May, September, October and November, at Willette Conference Center, Building 1, St. Joseph Healthcare Park, 900 Broadway, Bangor. Group members share tips on diabetes management, and the discussion is led by a diabetes specialist. St. Joseph Healthcare’s Diabetes and Nutrition Center at 907-1836.

Choking Hazards in Children

by Christopher Grindle, MD, reprinted from the American Academy of Otolaryngology

Feb. 25— Choking is a leading cause of unintentional injury and death in children; especially those under three years of age. In 2001, 17,500 children under 14 were treated in emergency departments for choking. According to the American Academy of Otolaryngology, choking is the fourth leading cause of death in children behind motor vehicle injuries, drowning and fires. Hazards come in the form of small household items, button batteries, and even food. In fact 60 percent of the episodes were caused by food items according to reports from the International Journal of Pediatric Otolaryngology.

Often, the risk of choking is either overlooked or underappreciated and therefore not avoided. In light of this, the following are some suggestions to reduce the risk of choking.
· Recognize the problem. The foods that pose the highest risk of a choking hazard according to the American Academy of Pediatrics are:
Nuts Seeds Raw Carrots
Hot Dogs Whole Grapes Popcorn
Meat and Cheese Chunks Hard Candy Fruit Chunks
Peanut Butter Chunks Chewing Gum
· Do not feed children younger than four years old round firm food, unless it is chopped completely. Pieces should be no larger than ½ inch (1.27cm). Hot dogs should be cut lengthwise as well as widthwise.
· Do not give peanuts to children younger than seven years old.
· Chewing gum is inappropriate for young children.
· Actively supervise your children while eating. Do not let children run and play while eating.
· Teach your children to chew and swallow food before talking and playing.

Since 1980, the Consumer Product Safety Commission has mandated that all toys that fit within a small parts test cylinder (diameter 1 ¼ inch) must be labeled for children over three years as a choking hazard. It is important to read and pay attention to manufacturers warnings. If you are not certain about a toy, you can purchase a small parts test cylinder, or easier, you can use a toilet paper roll (diameter 1 ¾ inch). If the toy passes easily through the roll, it may pose a choking risk.
· Common household items that pose a choking risk are:
Balloons Marbles Small Balls
Coins Toys with Small Parts Pen or Marker Caps or Medicine Syringes
· Toys that can fit entirely into your child’s mouth.
· Balloons remain a hazard for children up to eight years of age.

Of particular concern, are small button-type batteries. These are becoming more commonly found, even in greeting cards. They are a problem not only because of their size and shape, but also because of the energy that they discharge when contacting inner body parts. This can lead to damage (erosion or perforation) within two hours of ingestion.

From 1997–2010, an estimated 40,400 children 13 or younger were treated in hospital emergency departments for battery-related injuries. There was a 2.5-fold increase in these cases, from 1,900 in 1998 to 4,800 in 2010. From 1995-2010, there were 14 battery-related deaths, all involving children age four years or less. The risks of battery ingestion are significant and require prompt attention and management.   


In summary: Avoidance is the best way to prevent childhood choking.
· Learn CPR (cardiopulmonary resuscitation or basic life support).
· Insist that children eat while sitting down.
· Be aware of older children’s actions – many choking incidents occur because the older sibling unknowingly gave the dangerous food or item to the younger sibling.
· Follow age recommendations on packages.
· Check under furniture and between cushions for small parts that may cause choking.
· Do not let infants and young children play with coins.

Only through a concerted and collaborative effort between parents, teachers and healthcare providers can there be a reduction in choking related injuries and deaths.

At Penobscot Valley Hospital, Brian Miller, MD is an otolaryngologist who sees ENT (Ear, Nose & Throat) patients in the Specialty Clinic located at 252 Enfield Road in the PVH Medical Arts Building. “With some concerted effort, we all can play an important role in reducing childhood choking hazards,” states Dr. Miller. Parents and caregivers wishing to learn child and infant First Aid & CPR techniques should attend the hospital’s two-night course for just $50 on March 4 & 6 from 5-8pm. Call 794-7101 and register today as space is limited.

A child can suffer from dangerous chemical burns in as little as two hours if a button battery is ingested. Keep these and other small hazards away from children. http://www.cpsc.gov//PageFiles/115601/buttonbattery.pdf 

 

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