Region health survey in mail

by Robyn Minor, The Daily News, originally published on 1/2/2012

A community health survey was sent to thousands of southcentral Kentuckians last week with the goal of getting to the root of health issues affecting the region.

The relatively short survey – which was mailed to 60,000 residents in Commonwealth Health Corp.’s Wellness News and appears on the Daily News’ website and will be sent elsewhere – asks questions such as: “Which of these health issues is the most important for you and your family?”

Answers include obesity, drug abuse and addiction, heart disease, lung cancer, diabetes, none of these, or other” and “What has been helpful in keeping your family healthy? Support of family members; Support of friends; Wellness program at work; My doctor/health care provider; Support group/Health education class; Being physically active; Quitting tobacco use; Healthy eating; or Controlling stress.”

The information gathered from the survey will be used as part of a comprehensive health plan for the region being developed by the Barren River Community Health Planning Council. The council has been meeting since September and so far has established what members perceive to be the top health issues in the region, including obesity, drug abuse and addiction, diabetes, lung cancer and heart disease.

Now it’s residents’ turn to see if they agree with those concerns and to help identify any gaps in services to help manage those issues.

“This is something we’ve done for a long time, only not in such a structured way,” said Doris Thomas, vice president of CHC, the parent company of The Medical Center.

Performing a community needs assessment is a formal requirement for nonprofit hospitals under the Patient Protection and Affordable Care Act, Thomas said. The assessment must be done at least every three years.

Thomas said organizers of the survey this year thought it would be a good idea to partner with the Barren River District Health Department in doing the survey through the council.

“We are very focused on improving the health of residents,” Thomas said. “The council allows us to work collaboratively with other key stakeholders throughout the region.

“The survey is good way to start pulling in some good feedback to bring to council. Maybe it will help validate some of the key areas that we have already identified.”

Dennis Chaney, executive director of the health department, said he hopes the survey helps identify gaps in residents’ access to health care resources in order to proactively address the five health issues already identified, or maybe others that weren’t identified.

“Then I hope we can write grants and the hospitals will work more closely together to align their resources to address those gaps,” Chaney said.

Chaney said they hope to get responses from about 10 percent of the population throughout the region. For Warren County, that would be more than 11,000 people, or 28,000 for the region.

“I don’t know how realistic that is, but we want to try,” he said.

In addition to the surveys, some area residents in positions such as a community, church or education leader, patient or caregiver, might be asked to participate in one-on-one interviews with district health department staff. The interviews will help reveal personal experiences people have had in accessing health care here.

“If an individual gets a call ... I hope they will see the importance and make the time to spend some time with interviewers,” Chaney said.

Copyright 2012 News Publishing LLC (Bowling Green, KY)

2012's first birth: Honor ‘makes me feel special,’ mother says

by Deborah Highland, The Daily News, originally published on 1/2/2012

Just 91⁄2 hours into 2012, Kayla Perkins and Tyson Dewalt celebrated the birth of their second child, a girl, and the first baby born in the new year in Bowling Green.

Kay'lyn Dewalt was born by cesarean section at The Medical Center at 9:32 a.m. Sunday. She weighed 6 pounds and 11⁄2 ounces.

The infant came into the world with a head full of curly black hair and was swaddled in her mother's arms Sunday night while her proud father looked on. Perkins, who was on a morphine drip, sat up cradling her daughter looking fresh-faced, displaying not a hint of having gone through major surgery earlier in the day.

"It makes me feel special," Perkins said about giving birth to the first baby of the new year.

As the first baby of 2012, The Medical Center presented little Kay'lyn with several new items, ranging from a tiny New Year's baby hat to a baby tub filled with gifts such as bottles and teethers.

Perkins, of Bowling Green, went into labor late Saturday. She knew she would have to deliver the infant by C-section, but Perkins wasn't expecting her baby girl for another nine days. As her contractions began to come closer together Saturday night, she headed to the hospital at about 10:30 p.m.

Kay'lyn's older brother, Tyson, 5, is looking forward to welcoming his new baby sister home, Perkins said.

"He was excited," Perkins said about Tyson. "He called this morning to wish me a happy new year and said, ‘Mommy, is the baby coming out?' "

Dewalt plans to do as much as he can at home while Perkins recovers.

"It's a beautiful thing," Dewalt said about the birth of the couple's second child. "It's a blessing.

"It's a good way to open up the new year," he said.

Kay'lyn was the first of four babies born New Year's Day at The Medical Center.

Copyright 2012 News Publishing LLC (Bowling Green, KY)

Prescription Drug Shortage: Prescription Drug Shortage

by Alyssa Harvey, The Daily News, originally published on 12/20/2011

Southcentral Kentucky hospital officials say local facilities are being affected by a nationwide prescription drug shortage, but they are striving to continue to provide good and safe care to patients.

"It affects us every day. In my 30 years of being a pharmacist, this is the worst I've seen it," said Jim Morris, director of pharmacy at Greenview Regional Hospital. "There were 37 on the short supply list in 2006. There are over 220 on the short supply list this year. A lot of these are generic drugs where there are limited manufacturers remaining in the market."

According to the American Society of Health-System Pharmacists, a variety of drugs are in short supply. On its website, www.ashp.org, the national professional association that represents hospital pharmacists said there are various reasons for the shortage, including temporarily halted drug production because of quality problems; shortages of raw materials because of ingredient quality or severe weather; amount changes of drugs supplied to different hospital systems, community pharmacies and chain drugstores; and company decisions to stop making a product.

"It puts pressure on who's making that particular drug to put more of that drug out," said Robert McClelland, corporate director of pharmacy at The Medical Center. "There's more demand."

That demand creates a drug shortage for everyone, according to Kevin Adams, director of pharmacy for T.J. Samson Community Hospital in Glasgow.

"As soon as one company has a problem, everyone migrates to the other companies," he said. "We get a lot of back orders that occur from that."

Logan Memorial Hospital has had difficulty obtaining some medications, particularly anesthetics and antibiotics including Toradol, Zofran, Levaquin, Morphine, Valium injections and Lidocaine as well as Vitamin K, hospital Chief Nursing Officer Julia Murphy said.

"Our pharmacy has had to deal with these shortages for several months and spend several hours each day on the phone with suppliers and other facilities locating needed medications," she said. "We have had some success in obtaining needed supplies from drug wholesalers, but often at a higher than normal price."

McClelland agreed.

"Instead of, say, 30 cents a dose it may be $5 a dose," he said. "We're buying it at higher rates to be able to provide services."

Many hospitals are trying to steer away from the "gray market," which are like drug bootleggers and which charge more, Adams said.

"We order through our main wholesalers that hospitals go through or from the manufacturers," he said. "We have some that can compound products. Sometimes we have luck ordering products that are customized. They are well-trusted and well-manufactured."

Some hospitals have seen shortages not only in anesthetics, but also in drugs used to treat cancer and pain medications. The drug shortages make the cost of everything go up, but the majority of the burden falls back on the hospital, Adams said.

"It's just absorbed," he said. "With Medicare and Medicaid, we're paid what we're paid. It's not affecting how much we're paid."

Murphy said the physician team treating patients at Logan Memorial has been working to identify alternate medications.

"We continue to monitor the situation," she said. "Fortunately the drug shortages we have encountered have not affected the quality of our patient care."

Even finding alternatives can be difficult, Morris said.

"We share with 11 other HCA hospitals in greater Nashville. We start to see alternatives coming in short supply because everyone is using alternatives," Morris said. "If you announce a drug shortage, they will hoard and start buying up supplies."

President Barack Obama is trying to get drug manufacturers to tell the U.S. Food and Drug Administration about shortages before they become dire, McClelland said.

"They can ramp up production or, if the company is the sole provider, they can try to get another manufacturer to pick up that item," he said.

Adams said that if the U.S. can increase its self-reliance in producing drugs rather than rely on foreign materials to make them, then some of the issues might get better.

"You see a lot of ripple effects. Companies choose not to make products or are purchased by another company," he said. "The FDA has very stringent rules. Before a company can produce another product, there are a lot of regulations that protect the public."

Still, hospitals want to make sure patients get the best care possible, Adams said.

"We'd rather deal with the issue we can rather than compromise our patient safety," he said. "It's not just cost. It's a potential life."

Copyright 2012 News Publishing LLC (Bowling Green, KY)

New wellness center opens to the public: Officials hope site on Cave Mill Road expands center's local presence

by Alyssa Harvey, The Daily News, originally published on 12/20/2011

Eva Sadler remembers using The Medical Center Health and Wellness Center when it first opened more than 13 years ago in the Sears wing of Greenwood Mall.

The Bowling Green woman continued going there from time to time to get her blood pressure and weight checked, as well as various screenings when the center moved to the front of the mall, where it was located for about four years.

Sadler is happiest with the center’s new location at 1857 Tucker Way off Cave Mill Road, next to Chandler Park Dental. She dropped by Monday to get her blood pressure checked.

“It’s always been handy because I live near the mall,” she said afterward. “Now it’s closer. I think it’s great.”

The distance from her home wasn’t the only thing that Sadler liked about the center. “The parking is better,” she said. “I think it will make me come more often.”

The Health and Wellness Center opened the doors of its new facility to the public Monday. The first group to use it was the Girls Scouts of Kentuckiana, whose members were taking a baby-sitting class.

“I like it,” said Jennifer Johnson, Girl Scouts of Kentuckiana program delivery coordinator, about the center. “It’s really well put together.”

Staffed by registered nurses, dietitians and health educators, the Health and Wellness Center has become more than a place seen by mall shoppers, said Linda Rush, director of community wellness for The Medical Center, which draws from 800 to 1,000 patron visits a month.

“It has become more of a destination point for patrons,” she said. “Before, we were in the mall and people would drop in to get blood pressure screenings.”

The decision to move came after Greenwood Mall chose not to renew the center’s lease, Rush said. They had until Dec. 31 to move.

“We started the process of looking for another place in October,” she said. “We’re starting the new year off in a new space.”

The center needed to be in a place with room to offer educational and exercise classes, blood pressure and other health screenings, body fat analysis, support group meetings and a lending health library. Rush said the new building is comparable in size to the previous location, and the center will be able to offer the same services it offered there.

“The Health and Wellness Center is a health education resource center and a department of The Medical Center,” she said.

The center also offers medical nutritional counseling, diabetes education program and the Healthy Weight Program for Kids available with doctor referral, Rush said.

“Physicians are also referring patients for regular blood pressure screenings, particularly if they’re starting a new medication,” she said. “They come in, and we track it for a few weeks.”

Rush said she is pleased with the new location.

“We’re arranging it to meet the needs of our programs,” she said. “Chandler Park is a growing area. There’s more activity happening on Cave Mill Road, and we’re still near the mall.”

Center Community Wellness Manager Andrea Norris, a registered dietitian, was teaching the baby-sitting class Monday. She said she is enjoying the new venue and believes the class will help people find out about the center.

“It’s great to gather people out here so they’ll know where we’re located,” she said. “We’re having families being able to tell other families. Hopefully that will help.”

The Health and Wellness Center’s new hours will be from 8 a.m. to 6:30 p.m. Mondays, Tuesdays and Thursdays from 8 a.m. to 4:30 p.m. Wednesdays and Fridays.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Fighting the holiday flab: Easier access to food can bring weight gain

by Alyssa Harvey, The Daily News, originally published on 12/3/2011

Laura Young is ready to fight against weight gain during the holiday season.

The Richardsville woman has been working out regularly for several weeks at Workout Anytime, a new 24-hour gym. She works out six days a week and with a personal trainer two days a week. So far she has lost 15 pounds.

“I feel good. I feel a lot better,” she said. “I’m not worried about the holidays.”

Many people worry about putting on pounds during the season. Experts say people can navigate their way through the whirlwind of family dinners, parties and general merry-making and still either lose or maintain weight by eating healthy foods and exercise.

Ann Embry, food and nutrition services director at Greenview Regional Hospital and a registered dietitian, said people often lose their internal radar a bit during the holidays when it comes to food.

“There’s such an easier access of food, and we get this mental thing that it’s the holidays. It’s time to celebrate,” she said. “It’s OK, but the holiday season keeps going longer and longer. Instead of indulging over the holiday season, we’re indulging for two or three weeks, and that can catch up with you.”

It’s important to keep as much of a normal routine as possible, Embry said.

“I know it’s busy. Typically homemade food is healthier for us than foods on the fly,” she said. “Try to schedule shopping at times that we have time to cook. There’s something about spending money on food that makes us want to eat all of it.”

Andrea Norris, community wellness manager at The Medical Center Health and Wellness Center and a registered dietitian, suggests not skipping meals.

“It’s recommended to eat a light snack to curb your appetite so you don’t overindulge,” she said. “Eat until you’re satisfied, not until you’re stuffed.”

People should also watch their portion sizes, Norris said.

“Watch your portions so you don’t feel like you’re eliminating anything. If they’re small portions in moderation, I think that’s fine. If you eat heavy one meal, then eat a lighter meal the next time,” she said. “Try to get the smaller plates. Don’t go back for seconds. If you do, try to make a healthier choice, like vegetables and fruits.”

In fact, starting with fruits and vegetables can be a good thing, Norris said.

“If you can start your meal with raw vegetables you don’t tend to eat as much because they’re high in fiber,” she said. “They tend to fill you up more.”

Beverages can be a roadblock to maintaining weight, Norris said.

“Beverages can be high in calories. People don’t realize they’re drinking calories,” she said. “Those calories add up. Just because we don’t feel full after we drink doesn’t mean it’s not high in calories.”

Norris and Embry agree that those who are watching their waistlines should bring healthy dishes to potlucks.

“Bring something you know is a little healthier for you that you can share with people. I always love fresh vegetables, relish trays, fruit salad – that’s a nice healthy choice,” Embry said. “If you want to do a dessert, do a yogurt parfait. It’s still good and you can put a holiday twist on it.”

Although you may feel obliged to attend an event, you don’t have to say yes to every single party or gathering, Embry said.

“If you’re really overindulging, you can say, ‘I can’t make it to eat, but I’ll come a little later.’ There’s less temptation than if you were there at the beginning,” she said. “Your meals are not going to be as bad for you as the cheese balls, summer sausages and crab dips. You can still have that fellowship, but bypass the high calorie items.”

Plan time to exercise, Norris said.

“Not only does it help with weight gain, but it also helps release holiday stress. Be realistic. Don’t try to lose pounds during the holidays. Just try to maintain your weight,” she said. “A moderate daily increase in exercise can help decrease weight gain. You burn more calories in the cold because your body temperature tries to stay warm.”

Dale Chaffin, general manager of Workout Anytime, said his staff talks to people when they join the gym to find out what they need.

“We find out what they’re interested in as far as working out and what their goals are,” he said. “We try to find out if they’re doing anything at all. If they’re not, we usually suggest starting with cardio, like walking for 25 minutes. Some people have their own routine already.”

For those who don’t like to work out around a crowd, Workout Anytime’s members are spread out over 24 hours, Chaffin said.

“It helps spread it out to where it’s never really crowded,” he said. “It’s accessible to people who work different shifts.”

Since the gym’s opening on Nov. 1, they have signed up quite a few people, Chaffin said.

“We signed over 20 new members on Monday,” she said. “It could be a mixture of us being new and being after the holidays.”

Young plans to continue exercising her way through the holidays. She said the price of having a personal trainer is worth it because being healthy now can help her avoid many doctor and hospital fees in the future.

“I’m so motivated right now,” she said.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Medical Center begins project to update first-floor main corridor

The Daily News, originally published on 12/1/2011

The first phase of renovation of The Medical Center’s first-floor main corridor began today and will continue through Jan. 11. Updates such as new flooring, rails and paint, as well as modernization of public bathrooms, will be included in the renovation, according to a release from The Medical Center.

During this phase, two public entrances will be closed: the outpatient entrance on Park Street and the side entrance on the Second Avenue side of the campus.

All patient registration normally completed in the outpatient area will be moved to the Diagnostic Imaging Center registration area. Patients and visitors coming to The Medical Center for outpatient services or procedures should use the Diagnostic Imaging Center entrance on the High Street side of the campus.

Temporary parking will be designated in the back of the emergency room parking lot across the street from the Diagnostic Imaging Center on High Street.

Patients and visitors who normally use the Second Avenue entrance should enter through the main entrance of The Medical Center on Park Street.

Two other sections within the main corridor will be closed for renovation. Signs will be posted to direct patients and visitors through alternate routes.

The renovation will be divided into three phases to minimize inconvenience and to ensure that alternate access routes are available. Completion of the entire project is expected in early May.

The cost of the renovation is $750,000, according to The Medical Center Vice President Doris Thomas.

Copyright 2011 News Publishing LLC (Bowling Green, KY)

Surgical Weight Loss Program offers options for patients

by Alyssa Harvey, The Daily News, originally published on 11/5/2011

Keri Clark hadn’t always been overweight.

“I gained a little bit after getting married and having kids,” she said.

In 2001, she had twins and nearly died.

“I had high blood pressure issues. They were premature,” she said. “I was going into kidney failure. I stayed in the hospital for almost a month.”

Her metabolism changed and Clark said she “really blew up,” going from 180 pounds to 269 pounds from 2002 to 2003.

“I didn’t exercise,” she said. “I never did when I was younger.”

After having the twins, Clark became a labor and delivery nurse, often working 12-hour shifts.

“My knees and back were hurting. It was a very demanding job,” she said. “It’s what made me want to do it.”

“It” was weight loss surgery. Clark had a duodenal switch, which involves making the stomach smaller and rerouting the small intestine. She had the surgery in March 2010 in Nashville.

“I don’t think it’s for everybody, but I think everybody should have the option,” she said of weight loss surgery. “You have to do your own research. Be honest with yourself. Is this surgery right for me?”

Clark is now helping others have the option as a bariatric nurse liaison for The Medical Center’s new Surgical Weight Loss Program. Located on the first floor of Riverside Professional Center, the program offers support for patients before and after their operations, which will be done at The Medical Center. The service offers everything a patient may need, including a seminar to help potential patients learn more, insurance specialists, a nurse practitioner, a psychologist and a dietitian. There is also a support group that works in conjunction with the program.

“We do laparoscopic surgery. It’s minimally invasive,” said Dr. John Oldham, who, along with his partner, Dr. Derek Weiss, will do the operations. “It’s much better for patient outcomes. We’ve done 6,000 procedures and haven’t had to convert anyone to an open procedure.”

Oldham and Weiss are bariatric surgeons with Bluegrass Bariatric Surgical Associates in Louisville. They will perform different types of surgery, including the adjustable gastric band, which is placed around the top part of the stomach to reduce food intake; sleeve gastrectomy, in which the outer 85 percent of the stomach is removed, making it the size of a banana; gastric bypass, in which a pouch for food is made at the upper end of the stomach and the pouch is connected to the upper small intestine; and the greater curvature plication, which is new.

“No insurance covers it yet. It’s an investigative procedure,” he said. “You fold the outer portion of the stomach in and make it smaller.”

Patients usually have to have a body mass index of 35 or greater and some related condition such as sleep apnea, diabetes or heart disease, in order for insurance to cover surgery, Oldham said. Those with a BMI of 40 and up don’t have to have a health condition for insurance to cover it. Gastric band surgery is available for those with a BMI of 30 to 34.9, but insurance does not cover it.

Each surgery is a tool designed to help the patient get to a healthy weight, and each one is different, Oldham said. Gastric bypass and sleeve gastrectomy patients lose the majority of their weight in the first year – 60 percent to 70 percent of excess body weight. The gastric band procedure is the safest because there is no cutting the stomach or rerouting the intestines.

“There is no magic procedure. They have to commit to do this,” he said. “There is a lot of education involved. A lot require a six-month diet before they have surgery.”

There is also more education after the surgery, including time with an exercise physiologist and support group meetings, Oldham said.

“They commit to being patients for the rest of their lives. Once a year, we check their vitamin levels and make sure their bodies are doing what they should be doing,” he said. “Exercise has to become an important part of their lives as well. You have to be committed to make changes in your lifestyle to do it.”

Clark said she started thinking about weight loss surgery in 2007. She had family members who were obese and wanted her life to be different.

“I worked with people who had it done,” she said. “It’s scary because you’re choosing to have surgery. What kind of life am I going to have if I don’t?”

After her surgery, Clark was in the hospital for five days. Her surgery was not laparoscopic. She understands that people worry about the possibility of complications, but today’s surgeries are more advanced, she said.

“We have to overcome ’70s and ’80s surgery,” she said. “People died during those surgeries.”

Clark has made some lifestyle changes since her surgery and is about 8 pounds from her goal weight.

“When you start to feel full, you stop,” she said. “If you try to stuff yourself, for me it really hurts. It’s not just an uncomfortable feeling.”

Clark said her feelings about food have changed. Some people feel as if they should have an entire cake after they have had one piece.

“I had a piece of cake, and it was really good, but I don’t have to eat the rest of it,” she said. “I’ll get cravings, but it’s not like I have to go eat all of it.”

She eats a high protein, low carbohydrate diet and no longer craves empanadas, which was her favorite food.

“It changes your taste buds,” she said. “You’ve got to change a little bit.”

Clark said weight loss surgery is a tool, not a cure.

“You can gain it back,” she said. “It’s a tool, like you would use health equipment at BAC.”

Copyright 2011 News Publishing LLC (Bowling Green, KY)