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Low vitamin D levels linked to premature death

The debate over vitamin D continues, and the latest research has found a link between low levels of the fat-soluble vitamin and premature death, Medical News Today reported.

In a new study published in the American Journal of Public Health, researchers from the University of California-San Diego conducted a review of 32 studies that analyzed participants’ blood levels of vitamin D and mortality rates. The studies included 566,583 participants from 14 countries, who had an average age of 55.

Researchers found that participants with lower levels of 25-hydroxyvitamin D— the main form of vitamin D found in human blood— were twice as likely to have a premature death, compared to those with higher blood levels of 25-hydroxyvitamin D.

Furthermore, researchers found that approximately half of the participants who were at risk for early death had a vitamin D blood level of 30 ng/ml. An estimated two-thirds of the U.S. population has a blood vitamin D level below 30 ng/ml.

The National Institutes of Health recommends children and adults ages 1 to 70 should consume 600 IU of vitamin D per day. But researchers believe this amount should be increased.

“This study should give the medical community and public substantial reassurance that vitamin D is safe when used in appropriate doses up to 4,000 International Units (IU) per day,” said Heather Hofflich, a professor in the UC San Diego School of Medicine’s Department of Medicine.

Hofflich advised patients to have their 25-hydroxyvitamin D blood levels checked annually and to consult their doctor before changing their vitamin D intake.

Vitamin D helps the body regulate absorption of calcium and phosphorus in the bones, aids cell communication and strengthens the immune system. Vitamin D deficiency has long been associated with poor bone health, but in the past few years research has linked deficiencies in the vitamin to brain damage and increased preeclampsia risk for pregnant women. Other studies have suggested a lack of clear evidence for vitamin D’s health benefits.


I Wish I Hadn’t Waited So Long

by Lisa French, RN, Senior Director of Quality Improvement
May 13— Just like many of us, I got so involved with life and mundane tasks that I continuously put off my annual mammogram screening. One year turned into two, two into four. I figured, “Hey, I’m still young. What’s another year, right?” At the end of April, I had finally run out of excuses for not having my screening and I made my scheduled appointment at the Penobscot Valley Hospital Imaging department. But, the results shook my world.

Within 24-hours of my mammography screening, I received a call from my primary care physician. There were some unusual calcifications detected and I’d need to go in for a higher level, diagnostic mammogram.

“For a screening mammogram, we take four views (two views of each breast) and as long as they are good quality, we let the patient leave. The radiologist will read it that day,” states Heather Hines, Director of Imaging at PVH. “For a diagnostic exam, we schedule it at a time when the radiologist is on site. We take any additional images that the radiologist requested like magnification views of the calcifications or “spot compressions” or views at different angles. We may also do an ultrasound if the radiologist feels it is necessary. The radiologist checks the images before the patient leaves. Sometimes, if the diagnostic views make the abnormality go away or if it is clearly benign, we are able to tell the patient before they leave that everything is okay.”

The PVH Imaging department was able to get me in for the follow-up exam two days later and determined I would need a biopsy. This minimally invasive procedure was scheduled three days later at Eastern Maine Medical Center and I received the results just a few days after that.

It took a team of nearly a dozen people to coordinate scheduling, orders, interpretation, communication and procedures at PVH and Health Access Network. I couldn’t have imagined the compassion, timeliness and thoughtfulness of all those included in my care team. My family and I are so grateful.

Luckily my biopsy was benign. My healthcare team did an amazing job coordinating my care, shortening the length of time I was waiting and wondering. From my initial screening to the final benign results, it was amazingly only a week and a half!

It is so important to have routine screenings for breast exams and all of your recommended testing. Whatever your reason for putting off testing whether it is financial, fear of the unknown, or timing, your healthcare team can assist you. There are resources out there to help you pay for screening mammograms, fast processes to alleviate undue stress, and schedulers to help you coordinate care.

Now that I know I am cancer free, I would never, ever wait to have my mammogram or any other preventative care tests performed. The stress I was carrying around every day weighed on me more than I knew. I can now attend my daughter’s college graduation with a piece of mind and a big weight lifted off my chest. To all you ladies out there putting off your screenings, talk with your physician and get them scheduled; you will feel so much better just knowing. And if the results are scary, there are some wonderful people in our local healthcare community that will put you first and get the quality care you need.

For more information on mammograms, contact the PVH Imaging department at 794-7271 or visit Their department will be hosting a fundraiser for the PVH Cancer Support Group on Friday, May 16 from 10am to 2pm in the main lobby. Stop by and learn more about mammography, get a pink manicure, chair massage, buy some pink Help Whip Cancer products from The Pampered Chef, and enjoy some tasty baked goods. Proceeds from the event help fund transportation, education and other costs for area cancer patients. Please show your support of this great cause. 

Staff members Melissa Grant, Jeni Ward and Heather Hines from the Penobscot Valley Hospital imaging department are hosting a Breast Cancer Awareness Day on Friday, May 16 from 10am to 2pm in the main lobby. The event is a fundraiser for the PVH Cancer Support Group, so stop by, learn more about the importance of annual mammography screenings, and help a great cause. 

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

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, 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 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.

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