Healthy July | August 2013 YOU Been THere, LosT THaT NothiNg to SNeeze At pAge 16 pAge 12 Skin-Safe Summer pAge 10 A pAssion for better medicine Contents 12 6 14 5 18 coVer story in this issue 10 Protect yourself 3 how Lia ‘Struck out’ Stroke A young girl’s story From the Sun Your guide to preventing 12 Nothing to Sneeze At melanoma Women – learn how PT can help you (Photo by Olaf Starorypinski) 13 ‘What i did With my extra time’ People who thrived after heart surgery depArtments 14 how Aliana breathes easier Guidance for children with asthma For more iNFormAtioN get StArted About ANy oF our StorieS, 4 She’s the CrNP 16 been there, Lost that visit LVhN.org/healthyyou Plus: Prepare for fall A doctor’s personal weight-loss journey or call 610-402-CAre. sports and get the latest 17 empower yourself LVHN news A new column straight from the For more iNFormAtioN doctor’s mouth About ANy oF the doCtorS tAke ChArge FeAtured iN thiS iSSue 6 heart disease 18 N o more tears (such as practice name, location or Living with complex Robotic surgery helps Ray Jones hours), visit LVhN.org/find_a_doctor heart disease 20 mommies on the run or call 610-402-CAre. 8 diabetes Can you keep up with them? How diabetes impacts 21 your guide to a healthy you cancer care New and ongoing programs 2 LEHIGH VALLEY HEALTH NETWORK P. mark Li, md Neurosurgery How Lia ‘struck out’ stroke Her family saw tHe signs As she threw out the first pitch at a recent Lehigh To treat Lia’s stroke, health network caregivers first gave her Valley ironPigs game at Allentown’s Coca-Cola Park, blood thinners. Yet her symptoms continued. “After two days, Lia Sampson celebrated the latest step in her recovery we saw signs that tight pressure was causing working parts of from a stroke. her brain to shut down,” Li says. To reverse that, Li performed The Allentown girl’s story began on the day her family decompressive hemicraniectomy, removing a piece of Lia’s celebrated her sixth birthday last June. After the celebration, skull to give her swelling brain room to expand. Lia developed a bad headache and lay down. “We thought she That procedure helped at first, but two days later, Lia was sleeping,” says her mother, Rebekah. “Then we found her needed a second procedure called a lobectomy. This surgery having a seizure and vomiting.” successfully removed nonfunctioning parts from the front of Lia was rushed to Lehigh Valley Hospital–Cedar Crest, her brain and helped her recovery. home to the region’s only Joint Commission-certified Compre- “We realized the severity of the situation, but we had an hensive Stroke Center. overwhelming sense of hope,” Rebekah says. “We felt very “I noticed Lia’s smile wasn’t even,” Rebekah says. “I knew confident in Lia’s doctors.” Lia’s medical team, family members something was really wrong. As soon as the nurse saw it, every- and members from their church all offered support. one jumped into action.” An MRI at the hospital confirmed Today Lia continues to recover. “She’ll have some weak- Lia had suffered a stroke. ness, but the young brain has a remarkable ability to rewire “Strokes are rare in children, but not unheard of,” says itself,” Li says. “She’s doing very well intellectually.” In fact, neurosurgeon P. Mark Li, MD, with Lehigh Valley Health Lia is back in kindergarten. “Her life has changed drastically,” Network. “On average, six strokes occur in every 100,000 Rebekah says, “but we consider ourselves lucky.” children.” While strokes in children often are caused by genetics, there is no family history of stroke for the Sampsons. –Richard Laliberte next step reCoVeriNg From Stroke? sign up for our Brain Warriors stroke support Group. see page 22, call 610-402-CAre or learn more about strokes at LVhN.org/stroke. WAtCh LiA’S Lia sampson Watch! Story at LVhN.org/ healthyyou. (center) and her family were guests of honor at a recent IronPigs game. VVIISSIITT LLVVHHNN..OORRGG CCAALLLL 661100--440022--CCAARREE 33 get started use THese Tips and sTarT your personaL journey To BeTTer HeaLTH Today LVHN and GHHA the boards of the greater hazleton health Alliance (ghhA) and Lehigh Announce Valley health Network (LVhN) in April signed an agreement for a full asset merger pending regulatory approval. Agreement The agreement, announced by GHHa president and chief executive officer (Ceo) jim edwards (left) and LVHn president and Ceo ron swinfard, Md (right), builds upon formal clinical partnerships between GHHa and LVHn. These include: to Merge  Mi alert for Heart attack Care at Hazleton General Hospital (HGH)  emergency department coverage at HGH by LVHn physicians  TeleHealth services in the areas of obstetrics, infectious disease, burn and stroke care at HGH GHHa includes HGH, with 150 licensed beds, and the Hazleton Health & Wellness Center, an outpatient center providing diagnostic testing, rehabilitation and ambulatory surgery. GHHa employs more than 1,000 people and has a medical staff of more than 100 physicians. Leaders from both organizations say they anticipate the health care needs in each of their communities will continue to grow. pending regulatory approval, they plan to do a needs assessment to determine how the merged organization can meet those needs going forward. CrnP she’s the her patients sometimes call her “dr. martin,” but brenda martin is actually a certified registered nurse practitioner (CrNP) with Lehigh Valley health Network. To become a Crnp, Martin received bachelor’s and master’s degrees in nursing, achieved certification in family medicine and has 10 years of experience in various levels of nursing. “To develop our skills, we become expert as a registered nurse in a specific area of practice,” Martin says, “Then we expand on that expertise through advanced education and one-on-one clinical hours with a preceptor.” a Crnp in family medicine can provide primary care, diagnose and treat people of all ages, and prescribe medicine. if you’ve never received care from a Crnp before, you likely will in the future. Martin is one of 172 Crnps on the health network’s medical staff. LeArN more at LVhN.org/find_a_doctor or call 610-402-CAre. 4 LEHIGH VALLEY HEALTH NETWORK Stories by Kyle Hardner, Gerard Migliore and Ted Williams Get Ready for Fall Sports leAVe A legAcy As a not-for-profit, charitable ready to raise your game (or your child’s game) to a whole new level this fall? organization, Lehigh Valley health Try sports performance training at LVHn Fitness. it’s for athletes ages 8 and up. Network relies on your generosity. This training can help: every gift – regardless of its size – has an impact, and a bequest through your  increase power, speed and agility will helps ensure leading-edge care for  prevent injury by correcting dysfunctional movement our community for generations to come.  Foster leadership and accountability ruth ann Halteman, rn, a behavioral grouP ANd iNdiViduAL SeSSioNS health nurse at Lehigh Valley Hospital– (including evenings) are available. Muhlenberg, created her legacy by see more on page 23. To register, establishing the Behavioral Health call 610-402-CAre. endowment Fund. “Many people with behavioral health challenges stop taking their medications because they can’t afford them,” she says. “My dream is to provide education and resources that will help our patients reach and maintain their highest level of functioning.” 30 LeArN more about supporting LVHn. Call 610-402-CAre or visit LVhN.org/donate. new rooms for ortHoPediC Care if you are recovering from an orthopedic surgery (such as total joint replacement) at Lehigh Valley hospital–Cedar Crest, you now can enjoy private patient rooms and new surroundings. The new seventh floor of the hospital’s Kasych Family pavilion includes 30 rooms, each one with a private bathroom. The unit also features a large rehabilitation gym that’s twice the size of the former space. The gym includes items like a car simulator that can help you return to full function faster. LeArN more at LVhN.org/bones-and-joints. VISIT LVHN.ORG CALL 610-402-CARE 5 take Charge Heart disease Tips, HinTs and supporT To HeLp you ManaGe your HeaLTH LivinG WiTH CoMpLex HeaRt DiSeaSe you Can stay aCtive by being ProaCtive twenty-four hours after she  At age 10, she had a second open- complex heart disease. The team was born, Lindsay Siegle made heart surgery to repair a second VSD. includes heart failure specialist headline news in Philadelphia.  Her pacemaker generator, which is Ron Freudenberger, MD, and She became the youngest baby ever battery-operated, had to be changed heart rhythm specialist Robert to receive a pacemaker to control an regularly because her heart uses it on Malacoff, MD. irregular heartbeat. every beat. Last year, she received her Under their care, Siegle’s heart is Having been diagnosed with eighth pacemaker. stronger. “We’ve been able to reverse multiple heart conditions and un-  At age 22, she was diagnosed with Lindsay’s heart failure,” Freudenberger dergone numerous procedures and mitral valve prolapse, a condition in says. “Now the amount of blood her surgeries, Siegle, now 26, knows which the valve between the heart’s heart pumps is near normal.” how to live a productive life with upper and lower left chambers “Understanding the complex complex heart disease. “When you doesn’t close properly. electrical problems of the heart has have a chronic condition, you have  Her weakened heart became allowed us to offer new therapies not to be proactive when it comes to unable to supply her organs with available when Lindsay was born,” your health,” she says. enough oxygen-rich blood, a condi- Malacoff says. People with complex heart tion known as heart failure. In October, Siegle and her fiancé, disease have multiple problems with  She received a biventricular pace- Mike, will marry. Amid the wedding their heart. For Siegle, receiving a maker, a device that synchronizes plans, Siegle finds time to share her pacemaker was only the first step in the heart’s lower chambers so they story at community health events. her health journey. contract at the same time. Her message, “It doesn’t matter if  At age 2, she had open-heart sur- When Siegle moved to Allen- you’re young or old, a man or woman, gery to fix a hole between the lower town, she started seeing a Lehigh heart disease can affect everyone.” chambers of her heart (ventricular Valley Health Network team with –Rick Martuscelli septal defect or VSD). experience in caring for people with Take Charge now Get a second opinion. Call 610-402-CAre. Learn about cardiac rehabilitation ronald robert at LVhN.org/heart or call 610-402-CAre. Freudenberger, md malacoff, md Cardiology Cardiology Join LVHn’s Heart faiLure support Group. Call 610-402-CAre. WatcH Videos about Heart care. Watch! Visit LVhN.org/heartvideo. 6 LEHIGH VALLEY HEALTH NETWORK LiNdSAy’S Top 5 Tips if you’re living with complex heart disease, take Siegle’s advice to be proactive. 1 kNoW WhAt your body iS teLLiNg you. “young people think they’re invincible, but they can have chronic conditions too,” she says. regardless of your age, talk to your doctor about any symptoms you experience. 2 doN’t be AFrAid to exerCiSe. it makes your heart muscle stronger and reverses the symptoms of heart failure. if you’re worried about how much exercise your heart can handle, Exercise and a healthy diet help consider a cardiac rehabilitation Lindsay siegle program. you’ll be constantly monitored by a specialist while you manage heart disease. exercise. Talk to your doctor about the workout that is best for you. 3 SeArCh For ALterNAtiVeS. “new treatments for people with heart failure are helping people live longer with an improved quality of life,” Freudenberger says. 4 LeArN About NeW treAtmeNtS. Transcatheter aortic valve replacement (TaVr) is a procedure that replaces a diseased aortic valve using a catheter instead of open-heart surgery. a left ventricular- assist device (LVad) is a small mechanical pump that helps circulate blood in people with advanced heart failure. 5 ShAre your Story. siegle says, “it’s comforting to be with people who can relate to what you’re going through.” VVIISSIITT LLVVHHNN..OORRGG CCAALLLL 661100--440022--CCAARREE 77 take Charge diabetes Tips, HinTs and supporT To HeLp you ManaGe your HeaLTH eliot Friedman, md Hematology-oncology HoW diaBeTes iMpaCTs CanCer Care Careful management of blood sugar Can HelP monitored throughout, and his insu- lin adjusted as needed. “When his blood sugar rose, we’d increase his As a person with type 2 diabetes, immune system, increases infections, insulin,” Habeck says. “Then after glenn miller has long known the breaks down body tissue and causes chemo, when his appetite was poor importance of keeping his blood weight loss – all symptoms that also and his blood sugar dropped, we sugar under control. But he never can occur from cancer, especially reduced his insulin.” suspected how doubly important it during treatment. “Keeping your Habeck also worked with Miller’s is during cancer treatment until he blood sugar under control eliminates wife, Rosemarie, who kept a food log needed chemotherapy last November. that added negative stress on your for her husband and monitored his Miller, 76, of Parkerford, Chester body,” Barilla says. blood sugar at home. When Miller County, learned he had colon cancer In addition, cancer treatment began losing weight, Habeck sug- in 2011, then learned he also had also may worsen diabetes. “We use gested ways to help him keep eating lung and thyroid cancer. Each time, steroids as anti-nausea therapies during and increase his strength. doctors removed a section of the chemotherapy, but one side effect is “Most people with diabetes are affected organ surgically, and Miller increased blood sugar,” Friedman says. told to eat moderate carbohydrate didn’t need any follow-up treatment. “So when patients receive steroids, we portions because they increase blood But when Miller’s lung cancer work with their primary care providers sugar,” Habeck says. “But it’s differ- returned last October, his Lehigh to control their blood sugar.” ent when someone is losing weight Valley Health Network hematologist- The team approach to cancer treat- the way Miller was. I encouraged medical oncologist, Eliot Friedman, ment and blood sugar control that Rosemarie to watch his sugars and MD, recommended chemotherapy, Miller received is relatively unique. feed him high-protein, high-calorie along with radiation treatments under Lehigh Valley Health Network is foods – even comfort foods – basically the direction of radiation oncologist studying how effective it is and how it anything he would eat.” Charles Andrews, MD. To keep his might impact care in the future. diabetes under control during treat- AFter treAtmeNt ment, Miller partnered with other hoW the teAm APProACh With cancer treatment now over, health network experts – endocrinolo- WorkS Miller is gaining weight again. He gist Donald Barilla, MD, and diabetes Before he began therapy, Miller’s A1C now uses one oral medication (and educator Cara Habeck, RN, from the (a blood test measuring blood sugar no insulin) to control his diabetes, Helwig Health and Diabetes Center. over time) was high at 9.8 percent. and his A1C is a healthier 7.2. He So his team prescribed a combination also is back tending his vegetable the diAbeteS-CANCer of oral medications and insulin to garden. “My grandfather and dad CoNNeCtioN better manage his blood sugar during both were gardeners,” he says, “and They are two separate conditions, but treatment. I’ve had a garden since I was diabetes and cancer are linked. For Miller also received steroids prior married.” And he’s grateful for the example, diabetes causes high blood to each chemo treatment to control support of Rosemarie. “I’d be in sugar, which in turn weakens the nausea. Then his blood sugar was real trouble without her,” he says. –Sidney Stevens 8 LEHIGH VALLEY HEALTH NETWORK Charles Andrews, md donald barilla, md Radiation oncology Endocrinology Support from his wife Glenn Miller helped during cancer treatment. Take Charge now take a cLass. see page 21 for a list of “Living with diabetes” classes and support groups. Call 610-402-CAre to register. arm YourseLf WitH knoWLedGe. Helwig Health and diabetes Center has certified diabetes educators who are specially educated nurses and dietitians focused on helping you learn how to manage your diabetes. For more information, visit LVhN.org/diabetes or call 610-402-CAre. VISIT LVHN.ORG CALL 610-402-CARE 9 take Charge CanCer Tips, HinTs and supporT To HeLp you ManaGe your HeaLTH your Guide To preVenTinG MeLanoMa stay Clear of tHis dangerous skin CanCer Not only is melanoma the you’re At greAter riSk For line were drawn through it. deadliest type of skin cancer, it’s meLANomA iF you hAVe: borders – Look for moles with also the cancer with the fastest  Fair skin, blond or red hair, light- edges that aren’t smooth or even. growing incidence. Why? colored eyes and freckles (although Color – Be wary of moles with The answer may be traced back to people with dark complexions can multiples colors or shades. the 1960s. Back then, people spent develop melanoma too) diameter – Cancerous moles usually time in the sun without sunscreen  A history of sunburns are larger than an eraser on a pencil. because they didn’t know they were  Excessive exposure to UV light evolving – Look for moles that grow, putting their skin at risk. Unprotected from the sun or tanning beds change color or shape, or start to itch sun exposure then is causing more  A family history of melanoma or bleed. cases of melanoma now.  Many moles or large moles We’ve learned a lot about to moNitor A moLe, melanoma since the ’60s. We know WhAt to Look For take a digital photo of it next who is at greater risk, how to prevent If found early, melanoma is cur- to a coin or ruler. Two months later, it and more effective ways to treat able. “That’s why it’s important take the same photo to see if the it. Here is your guide to protecting to check your skin regularly for mole has changed. yourself and your family. changes in existing moles, or new and unusual growths,” says health iF you FiNd A SuSPiCiouS Where meLANomA StArtS network family medicine doctor moLe Melanoma develops in the cells of Ken Ryder, MD. “Ask a partner to Talk to your family doctor or der- your skin that produce melanin, the examine areas you can’t see.” matologist. If necessary, a portion of pigment that gives your skin its color. Everyone has moles. Normal the mole will be removed and tested “Exposure to ultraviolet (UV) light moles are uniform in color (usually for melanoma. “If found early, from the sun or tanning beds increases brown or black), round or oval, 80 percent of melanomas can be your risk,” says surgical oncologist and small. When examining the cured by removing only the affected Rohit Sharma, MD, with Lehigh skin, look for unusual moles by skin,” Sharma says. If melanoma Valley Health Network. “Untreated, thinking about A-B-C-D-E: is advanced, further testing will be melanoma can travel throughout the Asymmetrical – A suspicious mole done to determine if it has spread to body, attack organs and be fatal.” has two halves that don’t match if a other areas of the body. –Rick Martuscelli 10 LEHIGH VALLEY HEALTH NETWORK