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Hospitalists are here when you need them

Feb. 11— Over the last seven months, the team of Hospitalists at Penobscot Valley Hospital have been settling into their new positions and making a positive impact. Doctors Agarwal, Javed, Junaidi and Roa started as Hospitalists on July 1, 2013 and have been delivering excellent patient care for the inpatients who spend the night at the hospital.
The Hospitalists are providers who specialize in caring for patients during their stay in the hospital. They are the physicians who organize the patient’s care between departments and serve as the point of contact for other doctors and nurses, including the patient’s primary care physician (PCP). A good part of their job involves communications and coordination of care.
“Communication with other physicians has enabled us to better understand a patient’s health status and allows us to provide individualized care,” states Hospitalist Devesh Agarwal, MD.

The Hospitalists enjoy collaborating with families on patient care to ensure the best possible outcome for their loved ones. In a recent survey, one patient noted, “[My] daughter was very pleased with communication with doctors and able to contact them.”

Another patient commented in the survey, “All staff [are] very intelligent and kind - made me feel like I would be better soon. [I] would tell others how super the hospital is, we are fortunate to have this wonderful facility.”

Since the Hospitalists now cover the service 24/7 in-house, they are able to meet with families after regular business hours. This is much more convenient for many working families who may have missed rounding during the day. If you have a loved one in the hospital, simply ask your nurse any time you would like to meet with the Hospitalist.

Evening coverage by a doctor also means that the hospital is able to care for more critical cases. In the past, very sick patients sometimes were transferred to other facilities that could monitor their care more closely over night. Now patients can remain at PVH for their recovery, minimizing unnecessary and uncomfortable transportation requirements.

To expand and enhance the services provided to our community, the Hospitalists have each joined committees within the hospital. They are involved in quality assurance, medical records and utilization, inpatient care, computerized physician order entry, and maternal fetal medicine. Their commitment to quality care is evident not only in their work with patients, but in their desire to accomplish new goals within the facility.

Dr. Agarwal adds, “I’ve enjoyed my time serving on the Computerized Physician Order Entry Committee and Maternal Fetal Medicine Committee. Our work identifies process improvements to ultimately enhance patient safety and care.”

The next time you—or someone you know—is admitted to PVH, rest assured that our team of Hospitalists has the qualifications and tools to render excellent care during your hospital stay. They will work together to coordinate patient care while reducing the length of stay in the hospital and keeping treatment costs to a minimum. 

Hospitalist Babar Junaidi, MD and Unit Coordinator Lynn Welch review a chart at Station 1 in Penobscot Valley Hospital to help coordinate care with a patient’s primary care physician. (Photo courtesy of Penobscot Valley Hospital)

Wear Red on February 7

by Brittany Libbey, Hospital Intern

Feb. 4 — Although heart disease is the #1 killer among women in America, most women are unaware of the risks and don’t recognize the symptoms of cardiovascular stress. February 7 isNational Wear Red Day ®, a day that brings attention to a silent killer. This year marks the 11th year of bringing awareness to the fight against heart disease in women. Join the Penobscot Valley Hospitalstaff and others around the nation in supporting heart disease awareness by wearing red on Friday, February 7.

Be a part of the fight,
· Wear red on Friday, February 7
· Share that heart disease affects more women than men
· Learn the facts about heart disease along with risk factors
· Eat a heart-healthy diet and get physically active

Do you know what causes heart disease in women? What about the survival rate? The fact is: Heart disease is the number one killer of women, causing one in three deaths each year. That’s approximately one woman every minute!

The statistics are shocking and that is why PVH has joined the fight to raise awareness for heart disease. Posters have been created for entrances of the building including the downtown locations of Rehab and Billing. Heart healthy flyers with tips for food substitutes are also being distributed throughout the hospital and on our Facebook page at www.facebook.com/pvhme. Awareness is key; join PVH and show your support locally.

Lori Mosca, author of a women’s heart disease awareness study from 2012 says, “Habits established in younger women can have lifelong rewards. We need to speak to the new generation and help them understand that living heart healthy is going to help them feel better, not just help them live longer. So often the message is focused on how many women are dying from heart disease, but we need to be talking about how women are going to live and live healthier.”

Young women are more likely to report not discussing heart disease with their doctor. Women in their 20's should:
· Check family history
· Avoid smoking
· Avoid alcohol or drink moderately
· Choose birth control wisely
All women should be sure to learn the facts, eat heart healthy foods, stay physically active, and be aware of stress.

If you or someone you know is experiencing signs of heart attack or stroke call 9-1-1 immediately. These signs may or may not include chest discomfort, discomfort in other areas of the upper body, shortness of breath, facial drooping, arm weakness, speech difficulty, or sudden loss of responsiveness. It is extremely important to take immediate action for treatment.
Let's ‘Go Red’ to raise awareness and beat this silent killer. For more information about National Wear Red Day, visit www.goredforwomen.org

The flu is now widespread in Maine

January 14 - The Maine CDC has reported there is widespread influenza activity across the state. The flu vaccine is still available and is strongly encouraged to protect those people at risk of severe disease.

Influenza can be a serious disease that may lead to hospitalization and sometimes even death; anyone can get sick from the flu. Signs of the flu can include fever, cough, sore throat, runny or stuffy nose, feeling weak or more tired than usual, headache, chills, body aches and less commonly vomiting and diarrhea.

Although most people can stay home to recover without seeing a healthcare provider, it is possible for healthy people to develop severe illness from the flu. Anyone with the flu should seek medical attention if you’re experiencing:

- difficulty breathing or shortness or breath

- pain or pressure in the chest or stomach,

- sudden dizziness,

- confusion,

- serious or constant vomiting,

- flu-like symptoms that improve but then return with fever and worse cough.

For a child with the flu, seek medical attention with signs that include:

- rapid breathing or troubled breathing,

- bluish or gray color skin,

- not drinking enough fluids,

- serious or constant vomiting,

- not waking up or not interacting,

- being so irritable that the child does not want to be held,

- flu-like symptoms that improve but then return with fever or worse cough.

Antiviral drugs can be used to make the illness milder and shorten the time you are sick. It is very important that antiviral drugs be used early on to treat people who are sick with the flu or have a greater chance of complications either because of age, or high risk medical conditions.

The Maine Center Disease Control and Prevention recommends:

· Washing your hands

• Make sure you wash your hands often with soap and warm water for 15-20 seconds, especially after touching a sick person or handling their tissues or laundry. If soap and water are not available, use an alcohol based hand rub.

· Covering your cough

• Cover your nose and mouth with a tissue or your arm when you cough or sneeze. Throw the tissue in the trash after you use it.

· Staying home when you are sick

• The flu virus can “live” on some surfaces for up to 24 hours. Cleaning products that contain chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols can help to kill the flu virus.

• People can spread influenza before they realize they are sick. They may be able to infect others from 1 day before symptoms appear and up to 5-7 days after symptoms begin. Children may be able to spread the flu even longer.

· Getting Vaccinated

• Call your physician or local pharmacy. Recommended by the CDC, everyone 6 months of age or older should receive the vaccination. Those people at risk of serious flu complications include young children, pregnant women and those with chronic health conditions like asthma, diabetes, or heart and lung disease, and people 65 years and older.

Penobscot Valley Hospital prepares for the flu season by vaccinating their employees. The influenza immunization rate of PVH employees this year is 96%, well above the national average of 66.9% as reported by the CDC for 2011-2012. During flu season, unvaccinated employees wear a mask when within six feet of a patient. Other preventative steps are taken to minimize the spread of influenza such as educational posters on hand hygiene and cough etiquette. Staff also implement additional cleaning rounds in the public areas and restrooms and ensure proper stock of supplies and medications. PVH does request patients coming into the hospital with a fever and cough wear a mask to help contain the virus; masks are available at each entrance and registration desk. Here’s hoping you stay safe from the flu this season!

New norovirus spreading

There's a new norovirus spreading around the country. CLICK HERE to read more about it.

Blood Drive December 19

Diabetes and flu: what you need to know

There are certain groups of people who are at risk of serious flu complications each year, including those with diabetes.

Seasonal flu activity can begin as early as October and continue to occur as late as May. Flu cases were reported at the University of Alabama at Birmingham as early as September, and now is the time to prepare for the upcoming flu season, said Fernando Ovalle, M.D., professor of medicine in the UAB School of Medicine and senior scientist in the UAB Comprehensive Diabetes Center.

“Diabetes can weaken your immune system against the flu, and it also puts you at an increased risk of flu-related complications,” Ovalle says. “The weakening of the immune system makes it harder for your body to fight the flu virus. Being sick can also raise your blood glucose and prevent you from eating properly. You are also at risk of flu-related complications like pneumonia.”

There are several things Ovalle said diabetics and parents of children with diabetes can do to give some protection from the virus:

• Get a flu vaccine shot. The nasal spray vaccine is not safe for people with diabetes.
• Talk to your health care provider about the pneumococcal vaccine. It will help protect against pneumonia.
• Keep track of blood glucose. It can be affected by illness.
• Wash your hands often with soap and water or an alcohol-based hand rub.
• Try to avoid close contact with sick people.
• Practice the good-health habits like getting plenty of sleep and exercise, managing stress, drinking plenty of fluids and eating healthy food.

For people with diabetes who think they have the flu, Ovalle suggests doing the following:

• Contact a health care provider immediately. Symptoms include fever or feeling feverish or experiencing chills, cough, sore throat, runny or stuff nose, muscle or body aches, headaches and fatigue. In children, vomiting and diarrhea can be common.
• Continue taking diabetes pills or insulin.
• Test blood glucose every four hours and track results.
• Stay hydrated; drink lots of calorie-free liquids.
• Try to eat normally.
• Weigh every day. Losing weight without trying is a sign of high blood glucose.

“Experiencing the flu is no fun for anyone, and especially those with diabetes,” said Ovalle, who has an active clinical practice and serves as the director of the Multidisciplinary Comprehensive Diabetes Clinic at UAB. “Be vigilant and smart, especially when it comes to washing your hands. And if you every have any questions or concerns, contact your healthcare provider.”

Source: University of Alabama at Birmingham Press Release 

Stopping diabetes in its tracks

For many of us, it is hard to imagine the daily care required to control diabetes. For those with the disease, a normal day consists of constantly monitoring blood sugar levels, coordinating meals, exercising, medications and/or insulin injections.

“Diabetes is rapidly growing and a leading cause of death in the U.S. impacting nearly 26 million people in the U.S. alone,” says Pat Cooper, vice president for clinical operations at Quorum Health Resources (QHR). “What's more, an estimated 7 million Americans have the condition but remain undiagnosed.” High blood sugar symptoms are easy to dismiss. Excessive hunger, increased thirst, frequent urination, blurry vision, numbness in hands/feet or a waistline that exceeds 40 inches in men and 35 inches in women--are all causes for concern.

To clarify the urgency of treating diabetes, Dr. Gene Barrett, president of the American Diabetes Association (ADA) recently introduced the term "prediabetes"--describing those individuals with high blood glucose (sugar) who are at risk for developing diabetes. Once a person has full-blown diabetes (Type 2), their bodies either do not make enough insulin or the insulin that they are making does not work properly.

November is National Diabetes Awareness Month and November 14 is World Diabetes Day. The month offers numerous opportunities to get involved locally and nationally to raise diabetes awareness.

The cause of diabetes varies, but obesity, inactivity and genetics are generally responsible. The various types of the disease include: type 1, which is typically diagnosed in children under 17-years-old (but has been seen in people who are in their 30’s); type 2 (typically seen in patients over 20 years-old, but has been diagnosed in children as well) and gestational diabetes, which occurs in pregnant women. Most women with gestational diabetes do not remain diabetic after the baby is born, however they are at increased risk of developing Type 2 diabetes in the future.
Patients with diabetes can help prevent complications such as cardiovascular disease or stroke with the right medical treatment. According to the ADA, reducing diastolic blood pressure from 90 mmHg to 80 mmHg in people with diabetes reduces the risk of major cardiovascular events by 50 percent.
When diabetes is left untreated it can lead to serious complications such as:
· Kidney failure

· Heart disease
· Stroke
· Nerve damage
· Blindness
· Non-traumatic lower-limb amputations
“Diabetes and other risk factors such as high blood pressure and high cholesterol can increase the likelihood of serious complications that affect your heart, blood vessels, nerves, eyes and kidneys,” explains Sherry McCafferty, RN and diabetes educator at Penobscot Valley Hospital. “It is important to take a diabetes or prediabetes diagnosis seriously to avoid life-threatening complications. Managing your diabetes can help reduce your risk of serious complications, give you more energy and a better sense of well being.”

Researchers are hopeful that one day diabetes patients will only require insulin injections once a week or less. The Harvard Stem Cell Institute (HSCI) recently discovered a hormone that naturally regulates insulin. When tested in mice, the hormone triggered the pancreas to produce insulin up to 30 times more than the normal rate. While the hormone has not yet been approved for humans, the research is welcome news to the millions who administer insulin each day.

While there is no cure for diabetes, treatment options consist of following a meal plan that is low in sugar and solid fats, regular exercise, oral medications, and insulin injections. Consult your healthcare professional to understand your risk for diabetes or to determine the best treatment options that will help you manage the disease.
To curb symptoms, patients are encouraged to follow the suggestions below:
· Visit your local healthcare provider regularly for screenings and treatments
· Eat a diet plentiful in fruits and vegetables, moderate in lean protein and fish, whole grains, and skim milk/milk products.
· After seeking medical evaluation, engage in physical activity for 30 minutes, 5 days a week
· Do not smoke
· Limit refined sugars and grains
· Maintain a healthy body mass index (BMI)

For more information on diabetes and diabetes awareness, please visit the American Diabetes Association’s website at www.diabetes.org.
This article provided courtesy of Penobscot Valley Hospital and Quorum Health Resources, LLC (“QHR”). 

Flu shot may protect against heart disease

WebMD News from HealthDay

By Serena Gordon

HealthDay Reporter

TUESDAY, Oct. 22 (HealthDay News) -- If avoiding an achy, feverish week or so laid up with the flu doesn't motivate you to get a flu shot, a new study linking flu shots to a lower incidence of heart disease might persuade you to roll up your sleeve.

People in the study who got flu shots were one-third less likely to have heart issues, such as heart failure or a heart attack, compared to those who opted against vaccination. The flu shot was associated with an even greater reduction of heart problems if someone had heart disease to start with, according to the study.

"This is one further piece of evidence to convince patients to go out and get their flu shot," said the study's lead author, Dr. Jacob Udell, a cardiology and clinician scientist, at Women's College Hospital at the University of Toronto.

Results of the study are published in the Oct. 23/30 issue of the Journal of the American Medical Association.

Past research has suggested a link between the influenza virus -- the virus that causes the flu -- and an increased risk of heart events. And, conversely, previous research done on the influenza vaccine has suggested an association between the vaccine and a reduced risk of heart issues. But, most of these studies were small and none looked specifically for a heart-protective effect from the influenza vaccine.

The flu vaccine is currently recommended for everyone over 6 months of age in the United States, according to the U.S. Centers for Disease Control and Prevention. The vaccine is highly recommended for certain groups, including people with heart disease.

To get an idea of how well the vaccine might protect against heart events, the researchers reviewed all of the clinical trials done on the influenza vaccine from 1947 through mid-2013.

The investigators included six randomized clinical trials comprising nearly 7,000 people in their analysis. The average age of the study participants was 67, and about half were women. Just over 36 percent had a history of cardiac disease.

The researchers found that those who received an influenza vaccine were 36 percent less likely to have a heart event than those who hadn't had a vaccine.

When the researchers looked at just the three trials that included people with recent heart disease, they found an even greater potential protective effect. People with recent heart problems who got the flu vaccine were 55 percent less likely to have another event compared to those who didn't get the vaccine.

The risk of dying from cardiovascular disease was nearly 20 percent lower for those who received the flu vaccine versus those who hadn't, according to the study.

Udell said this study wasn't designed to prove that influenza vaccine can lower heart disease risk, but he said that the researchers believe they've come close to proving cause and effect without conducting a clinical trial specifically designed to look for a protective effect from the flu vaccine.

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