Summa Flourish

How to introduce moderate exercise into your routine

Fri, 31 Aug 2018 00:00:00 -0400

Study after study has shown the positive effects of light-to-moderate physical activity and the negative effects of little or no exercise. Regular exercise is one of the most beneficial (and cost-effective) activities you can do to better your health.

Some benefits include:

Reduced risk of cardiovascular disease: Stroke and heart disease are two of the leading causes of death in the U.S. According to the CDC, just 150 minutes a week of moderate-intensity activity can put you at a lower risk for these diseases.
Weight control: While this is a well-known benefit of exercising, even minor physical activity can impact your waistline. Taking the stairs, putting a little more pep into household chores and regular walks can help maintain a healthy weight.
Better sleep: Consistent physical activity can help you fall asleep quicker and can even better the quality of your sleep. However, try to limit the activity to several hours before bedtime to get your heart-rate and endorphin levels back to sleep-friendly levels.
Improved mood and energy: A lack of energy can often result from a lack of activity. Exercise enables your cardiovascular system to function more effectively by pumping oxygen and nutrients into your body tissue. Healthy, happy body tissue can also reduce the negative effects of stress.
Reduced risk of some cancers: There are a lot of factors we cannot control when it comes to cancer, but more and more research shows the link between a healthy lifestyle and lower cancer rates. According to the CDC, physically active people have a lower risk of colon and breast cancer than do people who are not active.

We’ve tackled a few of the benefits of physical activity, but what if you don’t know where to start? Searching for exercise programs or even beginning one without realistic expectations can quickly turn people away. There is also a crucial point in the process around week 3 or 4 where people are most likely to abandon a new, challenging habit in that time frame. A few tips below can help fight off that fatigue.

The easiest and cheapest form of physical activity is walking - that’s a great place to start! A few other ideas to help get more calories burning are:

Join a community sports league or activity class: Did you play volleyball or basketball in high school? Maybe a dancer in college? You’d be surprised how quickly muscle memory can kick back in. Plus, you’ll get to enjoy activities as part of a team/social aspect.
Use the buddy system: Walking or working out with a friend helps by having someone to talk to and provides someone to keep you accountable to your new lifestyle.
Focus on activities you like: If you don’t like running, don’t run! Between cardio machines, fitness classes, bicycles or swimming, you can get cardio in many ways. Do an activity that you enjoy doing right now.
Make small, achievable goals: If you do like to run, but it has been years since you broke out your tennies, start with an app that gets you “from couch to 5K” and aim to run a 5K after you reach that milestone.
Don’t focus on the scale: Yes, maintaining a healthy weight is important, but so is sticking with a new routine. Be mindful of the way your body starts to feel, instead of the numbers on a scale.
Listen to your body: If something is hurting, stop doing it, plain and simple. Sore muscles are not a sign of a problem but swelling and serious pain are. Stick to those achievable goals and you’re more likely to keep at a new exercise routine, with minimal injuries.

If an injury does occur, it’s very important to let it rest and recover in the amount of time your primary care physician prescribes. Ask them to recommend activities that keep you in the groove but allow healing time.

Summa Health’s sports medicine physicians have extensive experience caring for children, adolescents and adults. They care for athletes and non-athletes, helping them recover from injuries. Our physicians offer same day/next day appointments and expedited referrals to the top orthopedic surgeons in the area. Most insurance companies are accepted. For more information, call 330.379.8190.

Nilesh Shah, MD Sports Medicine, Summa Health

Thinking about a vasectomy? 5 things to know

Wed, 29 Aug 2018 00:00:00 -0400

Perhaps you and your partner are thinking of a more permanent solution to birth control. If you’ve had the conversation of vasectomy versus tubal ligation - “getting your tubes tied” - you might be interested to learn that a vasectomy is a much easier procedure, is more effective at preventing pregnancy and has a much lower risk of side effects or complications. It’s also much cheaper; tubal ligation requires general anesthesia and surgery; a vasectomy only requires local anesthesia and an oral sedative.

If the idea of a vasectomy has crossed your mind but you may have some reservations, below are 5 things to know.

The procedure is actually pretty quick, completed in an office setting. The whole procedure usually takes less than 30 minutes. It’s outpatient, minimally invasive and only requires a local anesthesia and an oral sedative. You may feel some discomfort or pain after the procedure, but most patients don't require more than rest, over-the-counter pain medication and ice. You may have some light bruising and swelling for the first few days, but most patients can return to strenuous physical activity in about a week.
During a no-scalpel vasectomy, the doctor will make two tiny puncture holes to reach each of the tubes. The tubes are tied off and cauterized and there is no need for stitches on the skin.
While they are reversible, you should approach this procedure as a permanent form of birth control. Although it is possible to perform a reversal surgery, there’s no guarantee the reversal procedure will actually work; plus, it is more expensive.
It’s not an immediate form of birth control. It will take up to three months post-procedure for the semen to be completely sperm-free. Your physician will need to test the sperm to make sure it is sperm-free before you should discontinue the use of other methods of birth control. Vasectomies do not prevent sexually transmitted diseases.
It will not affect your sex drive. Vasectomies are permanent and one of the most effective kinds of birth control that is 99 percent effective. Because it takes the pressure off using other birth control, like condoms, partners can be more present in the moment. You can’t mess it up or forget to use it, like other common forms of birth control. It prevents pregnancy 24/7 for the rest of a patient’s life.

A few side effects, while very rare, do include: infection at the incision site and a condition called sperm granuloma. This happens when a lump forms from leaking sperm where the vas deferens has been tied or blocked off. Because sperm are still producing after the procedure, this can cause a build-up in the duct behind the testes and testicle. Usually, these small lumps cause no problems and disappear on their own. However, some may require an anti-inflammatory or antibiotic to help them clear.

You should call your doctor if you have a fever over 101° F, or pus coming from the incision site and/or excessive pain or swelling in your scrotum or testicle area. These symptoms could be a sign of an infection.

Whether you and your partner are struggling to get pregnant, or you’ve made the decision to no longer be able to have children, the Summa Medical Group Urologists are ready to discuss your treatment options. Our highly qualified physicians perform outpatient vasectomies and also provide the latest in infertility testing and treatments.

Kevin Spear, M.D. Summa Health Urology

Why Adult Immunizations Are Important Too

Mon, 20 Aug 2018 00:00:00 -0400

August is National Immunization Awareness Month. While we mostly think of trips to our child’s primary care physician for shots, it’s very important to maintain our immunization record as we age. Even if you received all of the recommended vaccines as a child, the protection on certain immunizations can decrease over time. You could also be at a higher risk for certain diseases due to travel, job, age, lifestyle or other health conditions.

The flu shot is what most adults think about when it comes to recurring shots; but, did you know that each year thousands of American adults get sick from diseases that could have been prevented by vaccines?

A vaccine works with the body’s natural defenses to fight off certain diseases. Even if you do not have an increased risk factor for a certain disease, you are not only protecting yourself by getting vaccinated, you are protecting the people you come in contact with. We all have immunities to certain viruses but we can still carry them and infect others.

The CDC estimates that about 1 out of every 3 people in the U.S. will develop shingles in their lifetime. As you grow older, the severity of shingles can be quite debilitating and cause issues that last for years. Here are a few vaccines you should consider if you are an adult:

Influenza: aka the flu shot. Even if you are one of those lucky people who don’t get the flu every year, consider those who aren’t as fortunate. You may be immune to certain strains of the flu but that does not eliminate your ability to carry the disease and pass it on to someone who may have chronic health conditions, be pregnant or older in age. The CDC strongly encourages everyone to get the flu shot every year.
Tdap: the whooping cough vaccine. If you did not receive this shot during your adolescent years, you should consider getting it as an adult. It’s also recommended to get a booster shot every 10 years. Women are encouraged to get a vaccine during pregnancy, ideally between 27 - 36 weeks. Prolonged symptoms from whooping cough can lead to violent coughing episodes that can make it hard to breathe, eat or drink. It can also cause rib fractures from coughing and lead to pneumonia in adults but can cause serious, life-threatening illness in infants
HP vaccine: this vaccine is most effective before sexual activity begins but can be given to both males and females up to the age of 26. It helps prevent against the human papillomavirus that causes most cervical cancers, anal cancer and genital warts.
Shingrix: the new shingles shot. This vaccine is recommended for everyone over the age of 50. Unlike its friend chickenpox, shingles can appear more than once. This vaccine reduces the risk of shingles by more than 90 percent and can help prevent future occurrences if you’ve already had shingles. This new vaccine is recommended even for persons who have previously received the older shingles vaccine, Zostavax.
Hepatitis A: protects against hepatitis A – a potentially serious liver disease that is spread through food and liquid contaminated with the virus.
Hepatitis B: protects against hepatitis B - which is similar to A but needs a different vaccine. Hepatitis B is spread when blood, semen, or other body fluids enter the body of a person who is not infected.
Pneumococcal: Pneumococcal disease most commonly is associated with acute pneumonia. Older adults are at greatest risk of serious illness or death. There are two kinds of vaccines that help prevent disease. Pneumococcal vaccine is recommended for all adults over 65 and adults between age 18 and 65 who have certain medical conditions (such as chronic heart or lung disease or diabetes)

For a detailed chart on what the CDC recommends for all adults, learn more here.

By Thomas File, M.D.

Infectious Diseases, Summa Health

Summa Health's primary care team is focused on coordinated care for our patients and long-term positive health. We offer comprehensive care for the whole family, from infants to seniors, and can coordinate all of the care you may need. Our team includes more than 280 board-certified general practice physicians and advanced practice support staff.

What is a Lung Nodule?

Wed, 15 Aug 2018 00:00:00 -0400

Lung nodules are abnormal clusters of tissue that appear as “spots” on chest X-rays and CT scans. All lung cancers starts as a nodule; however, these spots are very common and almost 95 percent of them are not cancerous.

Lung cancer is a very tragic disease. It has the lowest 5-year survival rate of all cancers and leads to more deaths that the next 3 deadliest cancers (colorectal, pancreatic and breast) combined.
Most lung cancers are not diagnosed and treated at an early stage, contributing to the low survival rate. However, early detection, by low-dose CT screening, can increase that rate by up to 20 percent in high-risk patients.

While any spots on the lungs can be alarming, nodules are so common that they appear on one in about every 500 X-rays. Lung nodules usually cause no symptoms. That is why they are almost always found accidentally on an X-ray or CT scan.

A few signs of malignant (cancerous) vs benign (noncancerous) lung nodules include:

Size: The majority of nodules range from 0.2 inches to 1.2 inches. A nodule larger than 1.2 inches is more likely to be cancerous than a smaller one. The shape can also play a factor. The more irregularly shaped the nodule is, the more likely it could be cancer.
Age: If you are younger than 40, the nodule(s) has a greater chance of being benign.
Smoking: If you are a smoker and your primary care physician discovers nodules, you may want to consult an expert and get a low-dose CT screening.
Location: Nodules found in the upper portions of the lung are more likely to be cancerous.

If it’s not cancer, what is it?

It’s just not cancerous, yet. If you don’t have any risk factors associated with smoking, age or the size of the growth, your primary care physician may just want to watch and assess. Generally speaking, malignant nodules grow fast, usually doubling in size in just six months. Nodules that grow slower are less likely to be cancerous.
Inflammation in the lung resulting from an infection or disease. An infectious fungus, a lung abscess and even tuberculosis can cause nodules in the lungs.
Inflammation from noninfectious diseases like rheumatoid arthritis can cause lung nodules.

Because all lung cancers start as a nodule, the challenge is determining which nodules are or will become cancer. Some nodules may only require surveillance and routine follow-ups by a specialist, while others may require something more invasive, like a biopsy.

If it is malignant, there are also a variety of things it could be related to, including:

Lung cancer
Carcinoid, a small, slow-growing tumor
Lymphoma, a growth that contains lymphoid tissue
Tumors that have spread from cancer in another part of the body
Sarcoma, a tumor containing connective tissue

If a nodule is discovered during an X-ray, your doctor may recommend a CT scan. CT (or CAT) scans are special tests that produce cross-sectional images of the body using X-rays and a computer. These specific types of scans can give more information on the nodule, including its size, shape and exact location.

Early detection is crucial to achieving the best outcomes. Evidence shows that screening with low-dose CT scans can reduce lung cancer mortality risk in individuals who have smoked 30 pack-years or more. A pack-year refers to the number of cigarettes smoked per day, per year over a period of time.

Summa Health has developed a specialized Lung Nodule Clinic with a dedicated team of experts who can handle everything along the continuum of lung care, including: lung cancer screenings, rapid evaluation of nodules and a multidisciplinary approach to lung cancer treatment.

By Brian Bauman, M.D.
Pulmonary and Critical Care Medicine

Summa Health

Ticks and Lyme Disease: Why are rates so high?

Wed, 08 Aug 2018 00:00:00 -0400

Warmer weather is in full force now, and for many of us this season means outdoor activities including camping and exploring, plus the insects that call these spots home.

According to the Centers for Disease Control, there are more than 36,000 cases of Lyme disease reported each year and hundreds to thousands of cases go unreported. Since the CDC began tracking this disease, the number of annual cases has increased dramatically. Between 2004 and 2016, researchers found cases almost doubled from 19,804 to 36,429.

Before we get into possible causes of this increase, let’s explore what Lyme disease is and how to tell if you may have been infected.

What is Lyme disease?

Caused by the bacteria Borrelia burgdorferi, Lyme disease is transmitted to humans by the bite of an infected blacklegged (or deer) tick. It’s the most common vector-borne disease in the U.S., surpassing West Nile and the Zika virus combined. Vector-borne diseases are illnesses that are transmitted by mosquitoes, ticks and fleas.

The only way to get Lyme disease is from the bite of an infected tick. Generally speaking, this tick needs to be attached for 36 to 48 hours before the bacteria can be transmitted. There are exceptions to this time rule, but the sooner you remove the tick, the lower your chances of contracting the disease are.

Individuals who have been bitten by an infected tick usually report symptoms of fever, headache and fatigue. However, the clearest symptom of Lyme disease is the skin rash that can appear around the infected bite, usually resembling a red ring, which appears on average of 7 days after the bite (but can vary from 3-30 days).

If the disease is caught in the early stage of the rash, within a few days or weeks, an antibiotic can be quite successful at treating the illness. However, if left untreated, the infection can spread to the heart, joints and even the nervous system as part of later stage infection, which can occur up to several months after the bite. The infection can become a serious condition that causes symptoms such as arthritis, heart palpitations, nerve pain and brain swelling. Antibioitcs may also help in treating these later stages of infection.

The only way to prevent Lyme disease is to not get bitten by an infected tick. When exploring outdoors, it’s highly recommended that you use insect repellent. Consider wearing long sleeves, pants and closed-toe shoes in wooded or high-grass areas. After coming indoors from being in a wooded or grassy area, check your clothes and skin for ticks. If you find a tick on your skin, remove as soon as possible. A plain set of fine-tipped tweezers works well. Grasp the tick as close to the skin as possible and pull upward with a steady, even pressure.

Why have rates almost doubled in the last 10 years?

In 2015, 95 percent of confirmed cases were reported from 14 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin. Infected ticks can also be found in neighboring states and a few areas in Northern California, Oregon and Washington. Since that time, the geographic distribution of ticks has widened to other states. Infection of Lyme within Ohio used to be uncommon. In fact during the 1990s, the Ohio Department of Health (ODH) reported one to two dozen cases. Since then the number of reported cases has increased substantially. In 2017, the ODH reported 270 cases, and these numbers continue to increase throughout 2018.

One reason for such a heavy increase in cases is a much larger and longer “tick season.”

As parts of the country experience earlier springs and longer falls, the optimal deer tick activity season (May-October) is ending later, and in some cases starting earlier. Ticks can be found year-round if the “freeze” season is short. Warmer temperatures also shorten the duration of development from larvae to adult tick.

On the positive side, researchers suggest the increase could be attributed to people knowing more about Lyme disease. Now, people know what to look for and they are seeking treatment at the onset of symptoms.

If you or someone you know may be experiencing signs or symptoms of Lyme disease, see your primary care physician as soon as possible. Diagnosis can be based on the presence of the rash in the early stage or by a blood test in the later stages.

Thomas File, M.D.

Infectious Diseases, Summa Health

What you should know about urological cancers

Thu, 02 Aug 2018 00:00:00 -0400

Did you know one out of every 10 men in the US will develop prostate cancer? This form is the most common cancer in men. Bladder cancer, another common cancer in the US, affects as many as 68,000 individuals every year. It’s the fourth leading cancer for men and the eleventh for women. For men ages 15 to 44, testicular cancer is the leading type of cancer. What do all of these have in common? They are cancers that form in or affect parts of the urinary tract.

The urinary tract is our body’s drainage system. It removes urine, which is essential for waste removal. The system works in tandem with multiple parts of the body to eliminate toxins. If one of these vital organs is disrupted, the entire system can be affected. The biggest parts of this system include the kidneys, ureters (thin tubs of muscles on each side of the bladder) and the bladder.

The four types of cancer associated with the urinary tract are bladder, kidney, prostate and testicular.

Bladder cancer is one of the most common cancers in the US. While it occurs much more frequently in older men, it can affect both women and younger individuals. While this cancer forms in the bladder, it can also be found in other parts of the urinary tract. This cancer is highly treatable and usually found at the early stage, however follow-up tests may need to be conducted for many years post recovery.

Common symptoms include: blood in the urine, painful urination and frequent (or feeling the need) to urinate without any results.

There are several different types of kidney cancer. Renal cell carcinoma (RCC) is the most common and accounts for roughly 9 out 10 kidney cancers. There are several different subtypes of RCC as well. While it is usually characteristic of a single tumor within one kidney, sometimes multiple tumors in one or even both can occur at the same time. Other forms of kidney cancer include transitional cell carcinoma, Wilms tumor and Renal sarcoma.

Early kidney cancers usually don’t show any symptoms. Larger tumors sometimes cause symptoms associated with a poorly functioning urinary tract, like blood in the urine, fatigue, unexplained weight loss, lower back pain on one side and anemia.

Prostate cancer is the most commonly diagnosed cancer in men. According to the CDC, after lung cancer, prostate is the leading cause of cancer deaths in American males. The good news is that while an average American man has a 30 percent chance of developing prostate cancer, there is only a three percent risk of dying from it. It’s more common for a man to die with prostate cancer than from it.

Just like most of the urinary tract cancers, prostate cancer usually does show any signs or symptoms until the tumor has progressed into a large mass. Once large enough, the tumor can cause painful or burning urination, difficulty starting or holding back urination, bloody urine and pain in the lower back, hips, pelvis or thighs.

Testicular cancer, when detected early, is highly treatable, curable and usually pretty rare, compared to other cancers. However, it is the most common form found in men ages 14-35. Self-exams are extremely important in early diagnosis.

This form of cancer has some of the clearest signs and symptoms, including a lump or enlargement in either testicle, dull aching in the abdomen or groin, pain or discomfort in the testicle or scrotum and/or a feeling of heaviness or sudden collection of fluid in the scrotum.

Summa Health urologists will work with your primary care physician to make sure all of your health needs are being fully discussed and treated. It can be difficult to talk about urologic conditions but you can be confident that you’re being seen by compassionate, fellowship-trained urologists who can treat a range of issues including infertility, cancer and female pelvic medicine. Our physicians provide urology services that utilize innovative therapies, treatments, minimally invasive techniques and robotic surgery.

For more information on urological cancers, contact the Summa Health Urology Team at 330.374.1255 or visit Summahealth.org/Urology

Joshua B Nething, M.D.

Summa Health Medical Group - Urology

Immunotherapy for Melanoma

Mon, 30 Jul 2018 00:00:00 -0400

Did you know skin cancer is the most common cancer in the United States? If caught early, skin cancer is one of the easier cancers to treat. However, every hour of every day one American dies from melanoma, its deadliest form.

There are various treatments for melanoma, depending on the stage at which a patient is diagnosed, including: surgery to remove the affected area, chemotherapy, radiation therapy or a relatively new treatment called immunotherapy.

Immunotherapy, in plain terms, is using the body’s immune system to fight off cancerous cells. For the past few decades, immunotherapy has become an integral part of treating certain types of cancers, such as melanoma and lung cancer. By using a patient’s own immune system, doctors can now battle cancer smarter, while circumventing some of the terrible side effects patients suffer with chemotherapy. Doctors can either stimulate the immune system to work harder and smarter at attacking the cancer cells or administer certain types of man-made immune system proteins to do the same.

The FDA-approved treatment has been highly successful at treating melanoma. Statistically speaking, before immunotherapy, the survival rate for patients with stage 4 melanoma was 8-10 percent. Using the first generation of immunotherapy drugs, the rate for survival jumped to 21 percent. With the second generation of drugs, doctors are hopeful it will rise even higher. Best of all, the patients who do respond well to immunotherapy, continue to thrive for the long term.

There are a few different types of immunotherapy, the most common are:

PD-1 inhibitors are drugs that target PD-1, a protein that normally keeps T cells from attacking other cells in the body. By blocking PD-1, the immune system gets a boost at fighting melanoma cells and can shrink tumors.
CTLA-4 inhibitor is another drug that enhances the immune system’s defenses. However, this drug blocks CTLA-4, another T cell protein. For melanoma patients where surgery is not an option or when the melanoma has spread to other areas of the body, this drug has been shown to help people live longer.
Cytokines are proteins in the body that just generally boost the immune system. The man-made versions of cytokines are sometimes used in melanoma patients, post-surgery or in conjunction with chemotherapy. Some patients and/or their caregivers can learn how to administer this treatment at home.

Compared to chemotherapy, these treatments are very well tolerated by patients. Administered in the same way, through intravenous (IV) infusions, in a comfortable setting every few weeks, these drugs do not have the same effects on the body. While there are side effects associated with immunotherapy, patients do not lose their hair or experience the amount of nausea and fatigue many chemotherapy patients do.

Serious side effects tend to happen more often with CTLA-4 treatment than with the PD-1 inhibitors. Generally speaking, these are not nearly as common as those experienced during chemotherapy. Because the immune system is in attack mode, it can become too aggressive and fight normal, healthy organs and cells. Those side effects can involve skin (rashes), endocrine (hormone-making glands) system, bowel and lungs. You should report any issues to your oncologist immediately as there may need to be an abrupt stop in the treatment to restore proper immune system defense modes.

Summa Health Cancer Institute is a leader in cancer treatments, with nationally recognized cancer centers that serve thousands of patients each year. We make the difficult journey from cancer diagnosis through treatment and survivorship as easy and seamless as possible. Our goal is to cure the cancer, if possible, while improving our patients’ quality of life. By combining the latest cancer treatment technology with personalized, compassionate, patient-centered care, we create an environment focused on whole-person healing.

Going Natural: Anti-Aging Tips for Over 40

Tue, 24 Jul 2018 00:00:00 -0400

It is never too late to adjust your skincare routine. Think of it like a new exercise routine: with a little dedication, determination and education you can undo or halt bad habits.

Around the age of 30, the body’s collagen production slows down. Collagen plays a big part in the elasticity our skin has. When that production slows down, we tend to see our skin change with the addition of dark spots, larger pores, fine lines and wrinkles.

There is no shortage of anti-aging products that promise youthful, supple skin; but some contain ingredients that can do more harm than good. Further, what you put inside your body is just as important as what you put on the outside. Below are a few suggestions and tips to keep skin healthy and glowing at any age.

Keeping skin healthy from the inside:

Sleep is a crucial element to any skincare regimen, no matter your age. A lack of sleep can cause skin to lose elasticity, create dark circles under the eyes and advance the signs of aging. On top of that, sleep deprivation can also decrease the skin’s ability to recover from sun exposure.
Sodium in large doses can strip the skin of moisture while also causes under-eye puffiness by retaining water. Maintain your recommended daily amount of 2,300 mg, or just 1 teaspoon, to keep skin looking healthy.
A deficiency in protein can lead to dull hair, skin and nails. Eating a well-balanced diet full of healthy fats and proteins can produce the opposite: healthy skin and shiny hair.
Hydration is essential to healthy skin and keeps it looking vibrant and firm. Water is also the Holy Grail to keeping the skin under your eyes supple and dark circle free.
Sugar is everywhere! It, along with other simple carbohydrates found in white bread, soda and fruit juices can cause your insulin levels to spike, which is just as bad for your skin as it is the waistline. This spike can cause a burst of inflammation felt throughout the entire body. Inflammation can break down collagen and elastin, which are essential enzymes in youthful skin. Your daily sugar intake should not pass 6 tsps. for women or 9 tsps. for men.

A few suggestions to keep skin looking great on the outside:

The importance of protecting your skin from the sun’s harmful ultraviolet rays simply cannot be overstated. People should wear a daily facial moisturizer with a minimum SPF of 30.This can be applied to your face, neck and chest to protect against even incidental sun exposure (such as walking to and from your car), as the sun is what really ages our skin more than anything. It is also very important to wear a hat; the bigger the brim, the better.
Meditation, exercise and laughing are great ways to alleviate stress. Severe stress can show physical symptoms that make skin more sensitive and reactive, which can lead to breakouts and rashes. It can also exacerbate certain skin conditions like rosacea and psoriasis. Sunscreen in the rain, shine, clouds, full sun, partial sun - apply it every day. Did you know as much as 80 percent of the sun’s ultraviolet rays (UV) can pass through clouds? Damage to the skin caused by UV rays can lead to skin cancer. It can also lead to age spots, discoloration and skin aging and wrinkling.
Alcohol-free skincare can help with skin that feels dry or skin that produces too much oil. However, not all types of alcohol are bad for your skin. When selecting ‘alcohol-free’ products, you want to avoid alcohols like ethanol and alcohol denat; but natural alcohols, like the ones found in coconut oil, tocopherol (vitamin E) and retinol (vitamin A), can help troubled skin.
Less is more when it comes to skincare. The fewer ingredients listed in a product the better. Some natural anti-aging super powers are coconut oil, vitamin C, tea extracts, peptides and niacinamide.

Summa Health’s dermatology services provide our patients with high-quality, compassionate care for the skin and for diseases of the hair and nails. Our board-certified dermatologists are experts in diagnosing and treating a wide range of dermatological health issues for children, teens and adults.

To schedule an appointment with a Summa dermatologist, call 800.237.8662.

Carbs: The Good, the Bad and the Yummy!

Thu, 19 Jul 2018 00:00:00 -0400

Atkins, paleo, low-carb, no carb, how do you choose? If weight loss is a priority for you, or if you are just looking to eat healthier, there is an abundance of diets, meal plans and fads out there.

But what exactly are carbohydrates (carbs) and why are some of them so “bad” for us? Below is a breakdown of the types of carbohydrates, what they do to our bodies, which ones we can eat and those to avoid.

What are carbs?

A carbohydrate is a macronutrient. Protein, fat and carbohydrate make up the trio of macronutrients that fuel our bodies. This trio is required in relatively large amounts for human growth and development. Carb’s important role is to provide the majority of energy to fuel our body. However, it’s the type and amount of carbs you are consuming that can cause weight gain.

Carbohydrates can be divided into three categories:

Sugars are short-chain carbohydrates found in most foods, natural and processed. Glucose, sucrose and fructose are a few examples of sugar carbs.
Starches are long-chains of glucose molecules that will eventually break down into glucose in your digestive system.
Fiber is actually not digestible by humans. Instead, it passes through the stomach, small intestine and colon almost completely intact. Fiber can be broken down into two categories: soluble, which dissolves in water and insoluble, which does not. Both are important and can help maintain bowel health, lower cholesterol, control blood sugar levels and maintain a healthy weight.

Why do I keep hearing that they are so bad then?

All of the carbohydrate that we consume is turned into glucose so that we can absorb it and use it as energy. When we eat more carbs than we need, our body stores some of the extra glucose in the liver for future use, and then stores the rest as fat.

Carbohydrates can be divided again into two basic groups: simple carbs and complex carbs.

Simple carbohydrates are sugars made of just one or two sugar molecules. They are digested very quickly and provide the most energy. While some of these occur naturally in milk and fruit, most are added to foods and are not part of a healthy diet. Raw sugar, brown sugar, corn and high-fructose corn syrup, fruit juice concentrate and glucose are all obvious simple carbs. Simple carbs are turned into glucose most easily.

Most complex carbs fall under the starches category. They can be found in grains, beans, sweet potatoes and sprout breads. This category also includes refined complex carbohydrates. Refined complex carbs have undergone processing that removes much of the fiber, vitamins and minerals, which makes them no different than a simple carb. This is where most breads, flour, pastas and rice fit in, including those labeled as whole wheat, whole grain, and brown rice. Unfortunately, the majority of the food in our grocery stores is highly processed, so even those labeled as “whole grain” act like a simple carb in our bodies.

When we introduce a large number of refined and/or simple carbohydrates to our diet, this can cause some serious health effects. These types of carbohydrates are almost always lacking in essential nutrients, making them likely to cause:

Obesity: While glucose is very important in regards to maintaining a healthy weight and blood sugar levels, too much can lead to weight gain. When the body is consuming carbohydrates, especially refined and simple, it will quickly burn the glucose in the carbohydrates for energy. If there is more glucose than what we need for immediate energy, some will be stored in the liver for later needs, but the excess will be turned into fat and stored in our liver and fat cells. It is helpful when fewer carbs are eaten as the body will then turn to some of the fat stored in the liver for fuel and also will not store the excess carbs as additional fat throughout the body.
Type 2 diabetes: Our bodies require insulin to process glucose, Insulin is a hormone made in the pancreas. When the pancreas stops producing insulin, or if the cells cannot respond to insulin, this results in diabetes. In most cases, oral medications or insulin injections must be taken to manage the blood glucose. If too many carbs are eaten by someone with diabetes, the insulin is not able to control the level of blood sugar. Uncontrolled blood sugar levels over time can damage your eyes, kidneys, nerves and even heart. A doctor managing diabetes or a dietitian will prescribe the number of grams of carbohydrates that a patient with diabetes should eat to try to control the blood sugar levels and prevent long term complications.
Insulin Resistance: In people who are obese, the body will sometimes stop responding to insulin. This results in the pancreas producing more insulin. Excess insulin then leads to weight gain. Insulin resistance can be treated with a medication calls metformin in combination with a diet that is high in protein and low in carbohydrates.

Countless studies have shown that a low-carb diet can be very effective for weight loss and managing chronic diseases that care caused by excess weight, such as Type 2 diabetes and some forms of heart disease. However, a low-carb diet without the right tools can actually be harmful. If the goal is weight loss, you need to eat a higher amount of protein, and you need to eat a small amount of healthy carbohydrates to make sure you get the key nutrients found in fruits and other high-fiber goodies. Any diet instructing you to eliminate all carbs from your diet is not a well-balanced diet for the long term. There are good carbs that can and should be eaten when trying to lose weight.

Good carbs:

Veggies
Fruits such as berries and apples
Nuts and seeds are a great way to snack healthy and avoid reaching for refined carbs.
Tubers or potatoes, sweet potatoes, artichokes, etc. (avoid white potatoes)
True whole grains, like quinoa and oats

Carbs that should be avoided when trying to lose weight:

Starchy vegetables such as corn and lima beans
Fruits that are high in sugar (bananas, watermelon, mangos, halo and cutie oranges)
White potatoes
White and brown rice (wild rice is ok)

Bad carbs:

Sugary drinks are very unhealthy (diet drinks are also a bad choice because of the artificial sweeteners)
Fruit juices also have similar health effects as sugar-sweetened drinks because they are processed and almost all of the fruit is removed. The fruit contains the fiber and is the healthy part. Always check the amount of actual fruit versus sugar content.
Baked desserts are usually made with refined flour and sugars.
Candies and other sweet treats tend to be very high in sugar too. If you are a chocoholic, opt for dark, quality chocolate.
Processed potato and other vegetables; French fries and chips of all kinds.

The Summa Health Weight Management Institute has been helping people lose weight since 2004. The Institute offers both surgical and non-surgical options for weight loss, including appointments with dietitians, obesity medicine physicians, psychologist, and surgeons. Depending upon the degree of your obesity and the level of knowledge you have regarding the options for addressing it, we can help you decide which of our weight loss options best fits your needs.

What Exactly is a Kidney Stone?

Fri, 13 Jul 2018 00:00:00 -0400

A kidney stone is a solid, stone-like deposit made of minerals and salt that can form in one or both of your kidneys. These deposits can be as small as a grain of sand or as large as a pebble.

Did you know there are actually four different types of kidney stones?

Calcium stones: This is the most common stone and is a form of calcium oxalate. Oxalate is a naturally occurring substance found in some fruits, vegetables, nuts and chocolates. Your liver also produces oxalate.
Uric acid stones: These form in people who either don’t drink enough fluid or lose too much throughout the day. Individuals who suffer from gout also experience these types of stones.
Struvite stones: This type of stone often forms in response to an infection, usually a urinary tract infection, and grows quickly and quite large. Due to their size, these stones require immediate medical attention.
Cystine stones: These form in people with a very rare hereditary disorder known as cystinuria. This disorder causes the kidneys to produce too much of an amino acid known as cysteine.

While these deposits don’t have specific causes, several factors can increase your risk of developing kidney stones:

Dehydration: If you are not getting your eight glasses of water a day, you’re at a higher risk.
Family and personal history: If an immediate family member experiences kidney stones or if you have had one, your risk increases for more in the future.
Weight: Individuals with a high body mass index and large waist size have a higher chance of developing kidney stones.
Eating habits: Certain diets that are high in protein, sugar and especially sodium can increase the amount of calcium your kidneys have to process, increasing your risk.

Some stones can pass without you even knowing they were there. Most symptoms of a kidney stone are not actually felt until it moves. And when it does, you’ll know! Symptoms include sharp pain in your back, abdomen, groin or sides.

Smaller stones may be resolved with an increase in fluids to help pass them through the urinary tract. But those that do not, if not treated by a healthcare professional, can affect any part of your urinary tract, including the bladder and kidneys. The stone can become lodged in the urinary tract and block the flow of urine.

If you experience any of the following severe symptoms, contact your primary care physician immediately:

Blood in urine (pink, red or brown in color)
Nausea and vomiting
Fever and chills
Unmanageable pain in the side and back
Large fluctuations in intensity of the pain in any area
Inability to urinate without extreme pain

Your urologist will use a combination of urine, blood and imaging tests to confirm the presence of a stone. Depending on the size of the mass, your physician may recommend fluids and pain relievers for mild cases. For more serious issues, there is an option called ESWL or extracorporeal shock wave lithotripsy. That translates to using sound waves to break up the stones, making them smaller and easier to pass naturally. In extreme cases, surgery may be required to prevent permanent damage to the urinary tract.

When you come to see the physicians at Summa Health Medical Group – Urology, you can be confident that you’re being seen by compassionate, fellowship-trained urologists who can treat a range of issues including kidney stones, infertility, cancer and female pelvic medicine. Our physicians provide urology services that utilize innovative therapies, treatments, minimally invasive techniques and robotic surgery.

Summa Health urologists will also work with your primary care physician to make sure all your health needs are being fully discussed and treated.

For more information on kidney stones, contact the Summa Health Urology Team at 330.374.1255 or visit Summahealth.org/Urology

Joseph S Dankoff, MD

Summa Health Medical Group - Urology

PTSD: Not A Life Sentence

Wed, 27 Jun 2018 00:00:00 -0400

June 27^th is PTSD Awareness Day (and all of June is PTSD Awareness Month). PTSD, or Post-traumatic Stress Disorder, is a condition that can develop following highly stressful life experiences. Some examples of these traumatic events are military combat, sexual assault, transportation accidents, and natural disasters. Such trauma exposure is quite common. Most people will experience at least one traumatic event in their lifetime.

There are many common emotional, cognitive, physical and behavioral reactions to traumatic experiences. Emotionally, these can include feelings of sadness, hopelessness, anger or fear. Cognitively, it can include difficulty concentrating, confusion or paranoia. Physical symptoms can include nausea, headaches and feeling faint or dizzy. Traumatized individuals may engage in reckless or self-destructive behaviors such as excessive alcohol or other substance use, often in an attempt to cope with their distress. These are all just some examples of the kinds of reactions people might have.

Virtually everyone exposed to a traumatic event experiences some of these symptoms. They are normal reactions to highly frightening or dangerous experiences. Fortunately, for many people these tend to improve with time without formal clinical intervention, often with the help of a strong social support network of family and friends.

However, for some people the symptoms persist or worsen and interfere with functioning in life. PTSD is one possible persistent condition that could emerge following trauma exposure. It is one of the more common mental disorders, with 5-10% of people estimated to suffer from it at some point in their lives.

There are four main categories of PTSD symptoms:

Re-experiencing symptoms include intrusive trauma-related thoughts, recurring nightmares, flashbacks and emotional or physical reactivity to things (“triggers”) that remind you of the traumatic experience. For example, a combat veteran who hears sudden loud noises might experience intense anxiety and elevated heart rate, because the noise triggers memories of combat, which can elicit emotional and physical distress.
Avoidance symptoms include excessive avoidance of thoughts, feelings, people, places or activities that in some way remind one of a traumatic experience. For example, someone might not only avoid a dangerous place where they were assaulted, but they might also avoid safe places like grocery stores or anywhere other people might be.
Negative alterations in cognition and mood include feeling emotionally detached from other people, distorted sense of blame of self or others for the traumatic event that happened, difficulty feeling positive emotion, decreased interest in previously enjoyed activities, persistent negative emotions, exaggerated negative beliefs about oneself or the world, and difficulty remembering details about the traumatic experience. For example, someone who has experienced interpersonal violence might have difficulty trusting others and feeling emotional close to people, including close family and friends.
Alterations in arousal and reactivity include irritability, risky behavior, being easily startled, difficulty sleeping, difficulty concentrating and being hyper-alert for possible danger. For example, when in a public place like a restaurant, someone might not feel safe unless they are at a table with an unobstructed path to an exit and are seated with their back to a wall so they can see everything around them.

If you experience enough of these symptoms for at least a month and if they are causing significant impairment in your quality of life or overall functioning, you might be suffering from PTSD and you could benefit from consulting a qualified health care provider for an evaluation and, if recommended, treatment.

Do not lose hope! Despite what seems to be a common perception, PTSD is NOT a life sentence. Fortunately, there are effective treatments for PTSD, most notably, different forms of cognitive-behavioral psychotherapies such as Prolonged Exposure Therapy and Cognitive Processing Therapy.

The Summa Health Traumatic Stress Center is an outpatient specialty clinic located at Summa St. Thomas Campus in Akron, OH. Our mission is to address the mental and behavioral health needs of traumatized individuals and families in Northeast Ohio. We do this in three inter-related ways: providing compassionate evidence-based clinical assessment and treatment services, training current healthcare providers and the next generation of providers in trauma-informed best practices, and conducting research to advance the understanding and treatment of traumatic stress. Clinically, we conduct comprehensive diagnostic evaluations and provide the most evidence-based, effective psychotherapies for treating PTSD and other trauma-related conditions. We can be reached at 330.379.5094 for more information or to schedule an appointment.

Patrick A. Palmieri, Ph.D.

James and Vanita Oelschlager Chair in Traumatic Stress

Director, Summa Health Traumatic Stress Center

Battling Bladder Control: Male and Female Incontinence

Tue, 26 Jun 2018 00:00:00 -0400

Normally associated more with females than males, urinary incontinence affects at least 25 million Americans each year. And while 75 percent are female, the issue can affect any person, at any age.

Interesting fact: Incontinence is not a disease, it is always a symptom or cause of something else. There are at least 4 different types of incontinence and a host of causes and issues that can cause bladder leakage.

First, let’s explore the different types:

Stress incontinence is the most common type of bladder control issue in younger and middle-aged women. It occurs when urine leaks due to exercise, coughing, sneezing or anything else that can put pressure on the bladder.
Urge incontinence is a sudden, intense urge to urinate, followed by an involuntary loss of urine. It can feel like you need to urinate often, with little to no urine released or inability to control when it is released. This is usually caused by some sort of minor infection, like a urinary tract or kidney infection. However, in some cases, this can be an indication of something much more sever, like diabetes, Alzheimer’s, Parkinson’s or another type of neurological disorder.
Overflow incontinence happens when small amounts of urine leak from a bladder that isn’t emptying completely. In males, this can be an indication of an enlarged prostate. It can also indicate diabetes or result from spinal cord injuries in both men and women.
Functional incontinence happens when an underlying physical or mental issue keeps you from reaching the bathroom in time. This type of incontinence isn’t necessarily connected to the bladder. It can be a result of physical conditions like surgery, a debilitating injury or arthritis and not being able to physically make it to the bathroom in time.

There are also several health and lifestyle issues that can contribute to bladder control issues, including:

Pregnancy and childbirth: during pregnancy the baby can position itself on top of the bladder or hormonal changes can lead to stress incontinence. A vaginal delivery can sometimes cause the muscles to weaken and the nerves and tissue around the bladder can be damaged.
Urinary tract infection: this infection, easily treatable with antibiotics, can irritate your bladder and cause strong sensations of having to urinate.
Enlarged prostate or prostate cancer: incontinence in older men usually stems from an enlargement of the prostate gland. This can cause stress or urge incontinence if left untreated. In some instances, incontinence can also be a side effect of prostate cancer treatments.
Neurological disease: certain issues can arise when the nerves that tell the bladder when to empty are damaged or the signal is blocked from the brain. This can occur in multiple sclerosis, Alzheimer’s and Parkinson’s disease patients. It can also occur with diabetes and after a stroke.
Menopause: during this time, women produce less estrogen. This hormone is crucial in keeping the lining of the bladder and urethra in shape. Once these tissues start to deteriorate, incontinence can be a side effect of the loss of the lining.
Age: just like our other muscles, age can affect the strength of the bladder and its capacity to hold urine.
Obesity: when you add pounds to your body, either due to inactivity or poor diet, your bladder feels more pressure. That can trigger incontinence by making it feel like you have to urinate more often.

There are a variety of treatments for incontinence issues. And the first step should be consulting with your primary care physician to determine what those underlying causes may be.

At Summa Health, we understand that it can be hard to talk about urologic conditions. If you or a loved one is suffering, our urologists will work with your primary care physician to make sure all of your health needs are being fully discussed and treated. It can be difficult to talk about urologic conditions but you can be confident that you’re being seen by compassionate, fellowship-trained urologists who can treat a range of issues including infertility, cancer and kidney disease.

Our physicians provide urology services that utilize innovative therapies, treatments, minimally invasive techniques and robotic surgery.

For more information on incontinence, contact the Summa Health Urology Team at 330.374.1255 or visit Summahealth.org/Urology.

Lawrence L Geller, MD

Summa Health Medical Group - Urology

Alzheimer's Awareness Month: Seven Tips For Caregivers

Wed, 20 Jun 2018 00:00:00 -0400

Did you know 5.7 million Americans are living with Alzheimer's disease? Every 65 seconds, someone in the US develops this disease. It is the most common form of dementia and affects women at almost double the rate of men. Dementia diseases relate to the brain’s ability to regulate memory and cognitive skills. Other forms of dementia include Parkinson’s and Huntington's disease and vascular dementia, dementia with Lewy bodies and mixed dementia.

June is Alzheimer’s Awareness Month. This disease can be stressful, debilitating and challenging for patients but can also significantly affect the lives of the patient’s family and primary caregiver. Below are a few tips to help mitigate the challenges associated with caring for someone with this disease:

Develop easy routines and reduce frustrations. One of the biggest challenges in the beginning stages of Alzheimer's is figuring out how much assistance to give and when. This is where it is helpful to begin easy routines. Try to eat meals around the same time every day. If you can determine what time of day your loved one is most alert, plan the majority of activities or decision-making tasks at that time. For example, if you know that planning what to eat can become frustrating by the middle of the week, ask for help in preparing a grocery list and food prep early in the week. Always assume your loved one can make decisions on their own. Only offer suggestions or help once it appears the task is turning stressful. A routine is great but always allow some flexibility for difficult days.
Safeguard the living space. Consider the same steps new parents make when baby-proofing their home. You want to prevent accidents like slips, falls and the use of harmful chemicals.
Prepare and plan for a “wandering” incident. Six in 10 people with dementia will wander away. When this happens, a person may not remember their address, phone number or even their own name. When proofing the living space, consider devices that can alert you when a door or window has been opened. Keep a current photo and contact information with you and in bags, purses and wallets that are easily accessible. Have a list of phone numbers ready and inform all your neighbors and friends to alert you should they see your loved one out alone. Spend no more than 15 minutes looking outside before calling 911 and alert them your missing person has Alzheimer’s and is a “vulnerable adult.”
Maintain regular activities the person enjoys. If your loved one enjoys crafting, keep simple project materials around. Or if they play an instrument, keep those within eyesight.
Keep things simple yet engaging. Keeping the brain stimulated and active is a big resource in the fight against this disease. To mitigate frustrations and mood changes, keep things simple but still ask questions, preferences and opinions on ideas. For example, give two clothing options and ask for their opinion. Or provide two outdoor activities you could do together and let them pick.
Evaluate your emotions and expectations. It goes without saying that this will be stressful at times. It is important to check in and evaluate your mental health as well. Find a support group. There are a variety of reasons to do this but the most important is to find people to share your experiences, frustrations and tips (or failures) with.
Know when it is time to explore additional care options. The last stage of Alzheimer’s can last from several weeks to years. As it progresses, symptoms can drastically affect a patient’s quality of life. Patients can require 24-hour care and help with eating, walking and personal care. They can also be extremely vulnerable to infections, like pneumonia. This care can sometimes exceed what can be provided at home. Though this decision is often the most difficult one, knowing your resources and options gives you the best opportunity at providing your loved one with the care they need.

Caring for an older adult or someone with complex medical needs is hard work. Summa Health System is proud to assist with the resources and medical services your loved ones may need with one of the largest teams of geriatricians and senior healthcare specialists in Northeast Ohio.

Natalie Kayani, M.D.

Geriatric Medicine

Seven Myths About Mental Health Debunked

Mon, 11 Jun 2018 00:00:00 -0400

Mental health is as complex as physical health. It can fluctuate up or down, it can be affected by genetics and physical trauma and is something that may require treatment by a medical professional.

In the US, one in five individuals is affected by a mental health condition. To address the stigma associated with mental health, here are seven myths, debunked:

Only adults suffer with mental health disorders. One in 10 young people will experience a period of major depression. People of all ages can suffer from mental health conditions, even very young children. Did you know 50 percent of all mental health conditions begin to show symptoms by age 14? Early support and treatment is one of the most crucial elements of a successful recovery.
Individuals suffering from a mental health disease are dangerous. On the contrary, people suffering from mental health conditions are four times more likely to experience some form of violence perpetrated against them. Symptoms of certain mental health conditions can be stressful, confusing and in some cases severe. A person suffering from a mental illness is in fact much more likely to harm themselves than others.
Mental health issues are not the same as physical illness issues. While you may not be able to see the signs and symptoms of mental illness on the outside of the body, it does not mean it is any less painful than a physical injury. Mental health conditions can feel as bad, or even worse, than a physical injury and often require a medical professional’s diagnosis and treatment. Mental health conditions can also cause the body to feel actual pain. Stress from a mental illness can even cause your body to negatively react in a physical way.
People with a mental health condition cannot maintain a job or school. Stressful situations can be difficult for everyone, not just those living with a mental illness. Research shows that up to 70 percent of people with common mental health conditions are working.
Depression can be “willed” away. Depression is a very complex condition that is caused by a variety of factors, including: genes, physical illness or trauma and brain chemistry. You cannot “shake off” depression. It is a serious condition that can physically affect the body’s health and may require medication and/or a treatment plan.
Mental health conditions are permanent. While some disorders do require a lifelong commitment to therapy, recovery and treatment plans and medications, innovations in the mental health system have made it possible to successfully treat many conditions. There are anxiety and depression disorders that can be treated and resolved with short-term medication. However, just because an individual feels better after a tailored, mental health care plan, never discontinue the use of medication or therapy treatments without the approval of your primary care physician.
I can't do anything for a person with a mental health problem. One of the biggest hurdles in mental health is getting the proper diagnosis and care. Less than 20 percent of children and 45 percent of adults receive comprehensive treatment. Friends and family can be the biggest advocates for people who may not be able to advocate for themselves. They are usually the first people to notice unexplained, or unusual, behavior that deviates from a person's normal routine.

Mental health is an intricate system that can include a variety of conditions and diseases and the symptoms can be short term or long term. Individuals can experience a range of issues that can affect mood, behavior, cognitive processing and physical pain.

Summa Health Behavioral Health Institute can help you, or someone you love, experience relief from symptoms while gathering hope for new possibilities in life. With several practices throughout the Akron area and teams of dedicated psychiatrists and psychologists, those wanting psychiatric and psychological services can find treatment options.

We practice a patient-centered philosophy and are committed to meeting each patient’s mental health needs in a holistic manner. Most insurance companies are accepted. For more information, call 330.379.8190.

Joseph D. Varley, M.D., DFAPA

James and Vanita Oelschlager Endowed Chair

Department of Psychiatry

Summa Health Saint Thomas Hospital

Pride Month: Transgender Travels- Understanding the Journey

Wed, 06 Jun 2018 00:00:00 -0400

Lesbian, Gay, Bisexual and Transgender Pride Month is currently celebrated throughout the world annually. The majority of events are held in June to commemorate the anniversary of the Stonewall Rebellion in New York City on June 28, 1969, which most historians consider the birth of the modern LGBTQ movement.

While Pride events play a key role in raising the profile of the community and commemorating the history of the LGBTQ social movement, it also marks an opportunity for the community to come together, take stock and recognize the advances while providing education and understanding.

As members of A+PLUS (Allies and People Like US), Summa’s Employee Resource Group for the LGBTQ population, we have previously discussed the importance of our Allies and how they help create a platform for activism to fight homophobia and transphobia while simultaneously advocating for equality. Therefore, during this June Pride month we want to discuss the “T” in LGBTQ population and provide education about the Transgender Community.

The Transgender Community is often misunderstood, and, therefore, as health care professionals in order for us to provide appropriate, individualized and educated care we must have a better understanding of this community. Often, due to this lack of knowledge from health care professionals, the Transgender patient does not seek medical care and the appropriate health care resources, interventions and treatments are not utilized. Simply put, for us as health care professionals it is not only important to understand the specific needs but also to understand the struggles this community has navigating our current health care system.

To learn more about this important issue, please join us for a Lunch and Learn on June 12from noon to 1 p.m. in the Raymond Firestone Auditorium for the panel discussion, “TRANSGENDER TRAVELS-UNDERSTANDING THE JOURNEY.”

Karen Carson, Physical Therapist, Exercise Physiologist
A+PLUS Leadership

Summa Health

Outstanding Stroke Care at Summa Health

Tue, 08 May 2018 00:00:00 -0400

In May, we celebrate Stroke Awareness Month. Stroke is the fifth leading cause of death, and the leading cause of adult disability. A stroke occurs when part of the brain does not get blood flow. A blood clot can block a blood vessel or artery, or a blood vessel can break. When this occurs, brain cells die quickly. When the cells die, the body loses control of the abilities that area of the brain once controlled.

At Summa Health, we provide award-winning stroke care and have the ability to care for all types of strokes. In the last 10 years, more than 7,000 patients have suffered a stroke and received care with us. Over 3,000 stroke teams have been called, and over 600 patients have been treated with acute rescue treatments at Summa.

It is with great pride that I announce the recent recertification of our Stroke Center. It has been nearly ten years since its original certification. Our quality shines across our community, state and country. We are the ONLY hospital in the Akron area to have received the American Stroke Association Get with the Guidelines Gold Plus Award since 2010. In addition to quality, we added speed, and for the past two years we have also been awarded for treating our patients faster than national benchmarks, achieving maximum recognition as Honor Roll Elite Plus.

Why is speed important? Because time is brain, and every minute we wait, 2 million brain cells die. Speed helps improve outcomes and helps protect our patients’ futures. So the fact that we averaged 49-minute treatment times in 2017, 11 minutes faster than the national benchmark of 60 minutes, is a big deal for our patients. That’s a savings of approximately 22 million brain cells per patient. And the fact that we beat the national standard of 60 minutes 87 percent of the time on average is an even bigger deal. Compare those numbers to 70 percent for other hospitals in Ohio and across the nation. These numbers are important for our community members who can rest assured knowing that Summa Stroke Team will RUN for them when the time comes.

Why do so few patients fail to receive clot busting treatment that can reduce disability? It is because they either do not recognize the signs of a stroke or wait too long to seek treatment. Do you know the warning signs of a stroke?

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness or loss of balance
Sudden severe headache

Act FAST! Call 911 immediately in the community for any sign of stroke.

In 2015, Summa launched a telestroke program at both Akron and Barberton Campuses, allowing stroke expert physicians to be at the bedside of patients within minutes, day or night. The introduction of telestroke services helped facilitate faster treatment times.

We have also strengthened our acute aneurysm rupture (Subarachnoid hemorrhage) program by offering a less invasive treatment option. I am particularly proud of this program because it is a true collaboration between clinicians across institutions to achieve best care for patients with the goal of keeping patients in the community.

Our success is due to great partnership with our community EMS providers and collaboration from so many different departments: ED, radiology, residents, nursing, critical care, lab, rehab services, pastoral care, cardiology, palliative care and research. The success of our stroke care is truly a success for our community.

Our program continues to grow to meet the demands of our patients. There is so much more to come. Watch for more updates in the near future.

Susana M. Bowling, M.D., FAHA

Director, Summa Health Neuroscience Institute

How Does Anxiety Influence Your Health?

Mon, 30 Apr 2018 00:00:00 -0400

According to the National Institute of Mental Health, about 40 million U.S. adults have some type of anxiety disorder. Anxiety is often a normal part of life. Public speaking, job interviews, even meeting someone for the first time can increase your heart and breathing rate and/or send a surge of blood flow to your brain inducing feelings of anxiety.

Your body is capable of dealing with short bursts of this physical response as it is preparing you to face a stressful situation. However, after a prolonged period of time, anxiety disorders can have significant negative effects on your overall physical, relationship and mental health and wellbeing as well as one’s ability to function at work.

Although anxiety is silent, it still ravages an effect. Just like one doesn’t need to know how electricity works, you can still see the effect of electricity. Likewise, it may be the silent and unidentified cause in sleep disorders, GI diagnoses and stress – all factors adversely impacting health outcomes.

Let’s discuss the different ways that anxiety can manifest so that you might be able to identify it in yourself, a friend, a spouse or a coworker. Listed below are several different types of anxiety disorders; a few of the most common are:

Social anxiety, also referred to as social phobia, can have a crippling effect on day-to-day activities. It is usually characterized by a feeling or fear of being judged, rejected or of offending others in social situations.
Panic attacks are sudden periods or bursts of intense fear or a feeling of impending doom. These attacks can trigger heart palpitations, sweating, shortness of breath or in severe cases it can feel like a heart attack resulting in visits to the emergency room.
GAD, or generalized anxiety disorder, affects roughly 6.8 million Americans every year and is very common. GAD is defined as excessive anxiety for no specific reason often with an inability to stop the worry and can have a huge toll on your life.
Post-traumatic stress disorder occurs after witnessing or experiencing a traumatic event. Symptoms can arise immediately after the event or can take years to manifest themselves.
Obsessive-compulsive disorder can include excessive hand-washing, continuously counting items, endless “security” checks or repeatedly obsessing and ruminating over certain thoughts. People who suffer from this disorder often are unable to stop themselves from performing routines or rituals or stopping the unwanted thoughts despite their best effort.

How anxiety affects the body
Prolonged emotional stress and worry can lead to a variety of health concerns and can even influence hormonal levels. The body’s central nervous system goes into overdrive and releases cortisol that can boost sugar levels and triglycerides. But if cortisol is constantly being triggered it can result in physical reactions, including: short-term memory loss and concentration problems, digestive disorders, sleep disorders, lowered immune system, elevated blood pressure and in rare cases even a heart attack.

Patients report that emotional symptoms are just as debilitating and include incessant worry, dread, inability to relax, spinning thinking, racing thoughts, negativity and projected negative outcomes, fixation on thoughts surrounding safety or death, having a looming dark cloud over one’s head, feeling hopeless about the future and at times feeling like one is losing their mind. These thoughts are often all-consuming and inescapable and are difficult to control.

Research shows there may be a cyclical effect of anxiety when related to the brain. When anxiety disorders are left undiagnosed and untreated, certain areas of the brain, such as the prefrontal cortex and hippocampus, can decrease in size. Those particular parts of the brain are where anxious feelings are registered, even created. When those areas are reduced or weakened, it can contribute to the negative, anxious thoughts that are already present creating a cycle of negative thinking.

Experiencing anxiety can be a very lonely, isolating, stressful or overwhelming experience which often adversely impacts mental, physical and emotional functioning. But it doesn’t have to be. Anxiety is a manageable disorder and treatment options can make a big difference in your overall health and well-being. Help is available through Summa Health Behavioral Health Institute so you can experience relief from mild, moderate or debilitating symptoms of anxiety. You might even come to face the world with renewed hope for new possibilities in your life.

Sometimes people are uncomfortable discussing their anxiety or are stymied because they don’t know where to turn for help or whom to call. Summa has several practices throughout the area and teams of dedicated, skilled and knowledgeable psychiatrists and psychologists who are familiar with treating patients experiencing anxiety. The great advantage is coordinated and seamless care often under one roof within our system that allows for real time care as well as communication and coordination of treatment between your providers.

We practice a patient-centered philosophy and are committed to meeting each patient’s mental health needs in a holistic manner. Most insurance plans are accepted. For more information, call 330.379.8190.

PrEP: An important tool in HIV prevention

Wed, 11 Apr 2018 00:00:00 -0400

In the United States, about one million people are living with HIV infection, but it’s estimated that 1 in 7 of those infected is not aware that that he or she is HIV positive.

These facts can lead to the spread of more infections with up to 40,000 new cases per year. Men who have sex with men and people of color are most affected. Safe sex with condoms is always recommended, but there are other methods of HIV prevention available to high-risk individuals. Pre-Exposure Prophylaxis, or PrEP, is where HIV-negative people take a medication to reduce their risk of getting HIV. Currently the only FDA-approved medication for PrEP is Truvada, which is taken once daily for prevention. Following are some key points about PrEP.

PrEP is very effective. Many studies have been done on PrEP in different countries on men, women, gay, straight, transgender and bisexual persons. When taken correctly, which is very important, Truvada reduced HIV risk by at least 90 percent and in some cases up to 99percent. PrEP was also shown to reduce risk significantly in injection drug users who may be at risk for HIV. In addition, studies show PrEP to be safe with very few side effects and no major adverse events. PrEP needs to be taken for about 1-3 weeks before becoming fully effective.
PrEP is indicated for those who want to reduce HIV risk. Those most at risk where PrEP may be used include those who have an HIV-positive sex partner, men who have sex with men, heterosexual women of color, those who do not regularly use condoms, injection drug users or people who have other sexually transmitted diseases. PrEP can also be used in pregnancy counseling of HIV discordant couples.
Testing is needed when on PrEP. When on Truvada, close monitoring needs done. This is to monitor for HIV infection, other STDs and tests for kidney function. Testing must be done every three months. Ongoing condom use is encouraged and important as Truvada does NOT prevent other STDs. It is extremely important to know if one becomes HIV-positive while taking PrEP, although this is unlikely to happen. If someone becomes HIV-positive while on PrEP, they need to stop PrEP and enter HIV care as soon as possible. This is to avoid HIV drug resistance occurring while on PrEP, although this occurrence is very rare. Doctor visits on PrEP usually occur every 3-6 months.
PrEP is easy to access. While some doctors have limited information about PrEP, there are providers who have knowledge about PrEP and prescribe Truvada. Some PrEP providers are HIV or Infectious Disease Specialists, but many primary care providers are comfortable prescribing PrEP. While PrEP can be expensive, most insurance plans cover Truvada for PrEP, including Medicaid plans. There are also co-pay assistance and patient assistance programs for those in need. A listing of PrEP providers in Ohio may be found at www.ohioprep.org. This site also has information on payment assistance.

If you feel you may be at risk for HIV infection, please discuss this with your health care provider. Some patients may feel uncomfortable talking about their sexual health, but open and honest communication is extremely important. Asking questions about your risk and how to reduce it should be a normal part of your health care visits. Remember YOU are your most important health advocate!

The CARE Center is located at the Summa Health System – Akron Campus, 75 Arch Street, Suite 104, and has many PrEP providers. Physicians are available for appointments to discuss HIV prevention including PrEP.

For those interested in more information or scheduling an appointment for PrEP, call the CARE Center at 330.375.4851. Please visit www.ohioprep.org for additional information.

4 Questions to Ask Your Primary Care Physician When Prescribed New Medication

Tue, 03 Apr 2018 00:00:00 -0400

According the Centers for Disease Control and Prevention, almost 25 percent of new prescriptions are never filled at the pharmacy. Even more staggering is the fact that medication is not taken as prescribed up to 50 percent of the time. Before your primary care physician (PCP) prescribes any medication, we review all medical history, possible allergies and evaluate and treat the cause for your visit.

There are many different reasons a PCP may prescribe new medication:

A temporary prescription that may eliminate/heal a sickness or injury that will gradually heal and no longer need medication
A more permanent prescription to aid in a chronic pain, long-term injury, illness or disease management care plan
A prescription that must be taken daily for serious health issues - often combined with multiple medications
A replacement to a permanent medication that is no longer effective or is not the best option for the patient due to complications/side effects

In order to help you become the most informed patient, we’ve compiled a list of the top 4 questions you should ask your primary care physician when prescribed a new medication:

1. What exactly is this medication for and how should I take it? This question is important, especially for the management of a chronic health issue. Over time, your PCP may add to, eliminate or completely change your medication. It is important to know what you are taking, for how long and in what way. Should you take it on an empty stomach or with food? Should you take it with a full glass of water or just enough to swallow the medication? Is there a specific time? Some antibiotics say “every six hours,” which means waking up if you need to take it in that window - not just 4 times a day when you are awake.

2. I take vitamins or supplements, will this affect my prescription? Homeopathic medicine has inspired many advances in modern science, even aiding in the production of new elements in the prescription field. However, most health products and supplements branded as “natural” are not evaluated by the Food and Drug Administration (FDA). Nearly half of patients who take supplements/vitamins do not discuss it with their primary care physician. Fun fact: ginkgo biloba can lower blood sugar and blood pressure and can place an individual at higher risk for bleeding. Patients must discontinue the supplement prior to surgery.

3. Does this medication interact with other things, including food? It is very important your physician knows every medication you are currently taking. Some prescriptions can interact with others and some cannot. And certain foods can seriously impact your overall wellbeing while on certain prescriptions.

4. Can I stop taking this medication on my own? Always consult your PCP immediately if you experience any uncomfortable side effects. But depending on the reason this medication was prescribed, you and your physician should discuss the duration of the prescription. You should never stop taking a medication without consulting with your physician. You should always complete the entire course of prescribed antibiotics, even if you are feeling better.

A few hard facts about new medication: Try to establish a routine by taking your medication as the label describes, at exactly the same time of day and in the way directed by your physician (with or without food or water). Always provide a complete medical history to your primary care physician. If you do not take your medication as instructed, it could lead to your condition getting more severe, an emergency situation or in extreme cases, death.

If you or your family are in need of a primary care or specialty physician, call 800.23.SUMMA (78662) to schedule an appointment at a Summa Health location convenient for you. Or, click here (hyperlink: https://www.summahealth.org/patientvisitor/patients/requestappointment) to request an appointment online.

Mental Health in the LGBTQ Community

Thu, 29 Mar 2018 00:00:00 -0400

LGBTQ individuals are almost three times more likely than others to experience a mental health condition such as depression or anxiety and LGBTQ individuals have a higher rate of suicide as compared to those in the general population. Much of this is due to minority stress. Minority stress within the LGBTQ community stems from a variety of factors including social stigma, discrimination, prejudice, denial of civil and human rights, abuse, harassment, victimization, social exclusion and family rejection.

LGBTQ people confront stigma and prejudice based on their sexual orientation or gender identity while also dealing with societal bias against mental health conditions. Thus, it can be harder for LGBTQ people to seek or get help.

The following are four things to remember if you or someone you know is struggling:

You aren’t alone and you deserve help.

As much as you feel alone, I can guarantee that some of the people that walk in and out of your daily life have experienced similar pain.

Your suffering and pain absolutely deserves to be addressed and helped.

You aren’t “crazy” or “disturbed” if you’ve felt depressed or thought about suicide.

Suicidal thoughts are a product of intense pain, feeling hopeless about decreasing that pain and feeling isolated/alone and/or burdensome to others.

For LGBTQ individuals, this isolation and pain can be caused and/or heightened by the stress and fears one experiences in daily life from being LGBTQ.

Help is available 24/7.

Get help from a trusted friend or relative.

Reach out to places that will have your back and not judge you. National resources include:

The Trevor Project Crisis for LGBTQ youth: call 1.866.488.7386 24/7
Trevor-Crisis Texting: text the word “Trevor” to 1.202.304.1200 24/7
Trans Lifeline: call 877.565.8860 24/7
GLBT National Help Center: call 1.888.843.4564 Monday – Friday 4 p.m. to 12 a.m. ET; Saturday 12 p.m. to 5 p.m. ET

4. Finding a local provider

You may feel hesitant to access care because you fear being discriminated. While these concerns are completely understandable, it is important to seek help.

Find a mental health care provider that takes into account your personal experiences.

If you can’t reach out to an LGBTQ specific mental health center, look for providers that advertise themselves as LGBTQ friendly.

Come with questions you want to ask so that you can be better prepared to share your concerns. Ask about your provider’s experiences with the LGBTQ community. Get a sense of how they may work with you. After your initial visit think about your interactions. Did this person seem at ease with you? Did he or she talk openly about your sexuality or gender identity? Did you feel comfortable?

Remember that seeing a counselor or psychiatrist may be uncomfortable even with the best fit because you are likely working through difficult issues, but if you feel you are being judged for who you are then change providers. It is always your right to find the best provider for you.

American Psychological Association. (2018). The minority stress perspective. Retrieved March 26, 2018, from, http://www.apa.org/pi/aids/resources/exchange/2012/04/minority-stress.aspx

Centers for Disease Control and Prevention. (2014, July 22). Lesbian, Gay, Bisexual, and Transgender Health. Retrieved March 15, 2018, from https://www.cdc.gov/lgbthealth/index.htm

The Fenway Institute. (2012). Improving the Health Care of LGBT People: Understanding and Eliminating Health Disparities. Retrieved March 15, 2018, from https://issuu.com/lgbtagingcenter/docs/12-054_lgbthealtharticle_v3_07-09-12/3

National Alliance for the Mentally Ill. (2018). Find Support/LGBTQ. Retrieved March 26, 2018, from https://www.nami.org/Find-Support/LGBTQ.

Ellen Bronder, Ph.D. joined Summa Health Medical Group – Psychology in January 2018. Dr. Bronder has a special interest working with LGBTQI individuals and clients from diverse racial and cultural backgrounds.

To make an appointment with Dr. Bronder, call 330.375.7474.

How to Deal with your Spring Allergies

Wed, 28 Mar 2018 00:00:00 -0400

Warmer air, flowers blooming, sunshine! Most of us are happy to be headed into spring, especially with this last round of March cold. But for some of us, this is the time of year we dread the most - spring allergy season. Did you know spring allergies can actually begin as early as February, depending on your location and the duration of your winter season? And, they can last until the middle of summer!

First, let’s talk about the most common cause of allergies: pollen. It’s an allergen, which means it can cause an allergic reaction in people sensitive to it. It’s technically harmless to humans who are not hypersensitive. But for those who are, their immune system speeds into overdrive to produce antibody cells to fight this invader. The overproduction of these antibodies can activate other cells and this chain reaction can result in histamine production. That is what creates the common symptoms associated with spring allergies: itchy eyes, congestion and sneezing. Fun fact: pollen can travel for miles. Well, that’s actually a not-so-fun fact!

Second, some of your daily activities can help or hinder your allergy management. A few tips:

Monitor pollen counts and mold levels in your area. Keep windows closed and minimize your outdoor exposure on high count days.
Consider a no-shoes-inside policy during peak time. That will limit the amount of pollen tracked inside.
Shower after prolonged outdoor exposure on high-count days.
Avoid outdoor activity on windy days, that’s prime seasonal allergy time. A few other spring-related allergens can include: chlorine in pools, smoke from campfires and overusing your humidifier (dust mites LOVE humidity). Some allergies can be treated with over-the-counter medication but more severe reactions do require a visit to your primary care physician (PCP).

Additionally, as with most conditions, prevention is best. Don’t wait until your symptoms are severe. Staring therapy just before or at the very beginning of the allergy season may help prevent the most severe symptoms from developing.

If you suffer from seasonal allergies and drug store meds don’t cut it, here are a few questions to address with your PCP:

How can I tell if it’s allergies or if I have a head cold? Most colds last 7-10 days. If you have symptoms that last longer than that, and seasonal allergies can last for months, you mostly likely don’t have a cold. With allergies, your runny, watery nose causes a clear, watery mucus, not so with a cold.
I didn’t have allergies as a kid, why do I have them now? You can actually “grow out of or into” an allergy. But, if you grow into one as an adult, you can count on it staying with you. Allergies can also appear if you live in a different climate than where you grew up, something you should mention to your PCP.
Do I have to take allergy medicine all the time? Medications like Zyrtec and Allegra usually last 24-hours. If you take those medications right when you wake up, you should be able to make one dose last through the night. But, with others, you may actually wake up to allergy symptoms. If your PCP prescribes allergy medication, always take the medication as directed. You will most likely have to take allergy medication for the duration of your specific allergy season. If you know you suffer from spring allergies, consider beginning treatment before your first symptoms appear.
My allergies are pretty intense, so what’s an allergy shot and should I get one? An allergy shot, also known as allergen immunotherapy, is actually a long-term form of treatment. It will require multiple physician visits for a duration of time. Some PCP’s perform this therapy, some do not and a referral to an allergy specialist may be necessary. This treatment is reserved for the most severe allergies that do not respond to appropriate therapy. There are two phases to allergen immunotherapy: the buildup phase and the maintenance phase. Initially, you’ll receive a shot once or twice a week for up to six months. Once the effective dose is reached, meaning your allergies are under control, you’ll begin to lengthen the time between shots to establish your maintenance phase. If you have severe, seasonal allergies that begin every year and last for months, you may benefit from immunotherapy.

If you or your family need a primary care or specialty physician, call 800.23.SUMMA for an appointment.

National Lesbian Gay Bisexual and Transgender LGBT Health Awareness Week

Tue, 27 Mar 2018 00:00:00 -0400

The medical definition of sexual orientation is “an enduring, emotional, romantic or sexual attraction that one feels toward men or women, or both.” While this definition may suffice for the purposes of education, one truth I have learned is there is no single definition that can encompass all of human sexual orientation, identity or gender identity.

Summa Health is an inclusive healthcare provider whose mission is to provide the right access to the right care for the community we serve. The LGBTQ community faces many healthcare challenges and barriers to the appropriate healthcare for their needs.

We know from research that women who identify as lesbian or bisexual are likely to face barriers to healthcare that include: limited access to care or insurance, concerns about confidentiality, and concerns about discriminatory attitudes and treatment. In addition, there may be additional challenges relating to provider understanding of specific health risks.

Being a lesbian or bisexual does not inherently affect health status, and there are no physiologic differences between lesbian, bisexual and heterosexual women. There are, however, specific issues more common among lesbians and bisexual women that have health consequences. The prevalence of obesity, tobacco use and alcohol use is increased. In turn, these conditions may increase the risk of diabetes, lung cancer and cardiovascular disease. All of these are issues to be discussed and addressed in various ways.

Many patients and healthcare providers incorrectly believe lesbian women do not require routine screening because they are perceived as being at low risk for cervical cancer. This is incorrect. It is incorrect to assume lesbian and bisexual women have, or will, limit their partners to women. Many people experience fluidity in sexual identity and orientation, and may be fluid in the sex of partners they choose. Routine cervical cancer screening is recommended for all women. In fact, cervical dysplasia has been reported in women who have not previously had intercourse with men.

I would be remiss to not mention issues related to mental health and intimate partner violence. Sexual minorities are more likely to have depression and other mental health concerns. This may in part be due to stress caused by isolation, prejudice, stigmatization and a lack of support from peers, family and healthcare providers. These same stressors may contribute to an increase in substance abuse, which should be specifically addressed as part of routine care. Finally, intimate partner violence is a real public health issue, and should be addressed for all patients regardless of sexual identity.

Beyond the issues above, there are a variety of topics that could be discussed, including: how lack of pregnancy affects risk for specific diseases, use of hormonal contraception for reasons other than contraception, and access to fertility services.

I want to express how pleased, and proud, I am to write in support of our call to action supporting National Lesbian, Gay, Bisexual and Transgender Health Awareness. This is a huge topic, and one that can only be incompletely addressed in a setting such as this. More than anything, my hope is that we can start a collective conversation that will lead to quality care for all.

G. Dante Roulette, MD is an obstetrics & gynecology specialist in women’s health. He currently sees patients at our Summa Health Akron Campus and the Park West office. To make an appointment with Dr. Roulette, call 800.23.SUMMA (78662).

Reducing the Risk of Colorectal Cancer

Thu, 22 Mar 2018 00:00:00 -0400

March is Colorectal Cancer Awareness month. Colorectal cancer remains the #2 cancer killer in the U.S., yet it is one of the most preventable types of cancer. Statistically, 1 in 22 men and 1 in 24 women will develop colorectal cancer in their lifetime. According to the American Cancer Society, in 2018 more than 140,000 people will be diagnosed with colorectal cancer and 50,000 of them are expected to die of this disease. Colorectal cancer screening could save more than half of them.

Although great progress has been made, we are not yet meeting colorectal cancer screening goals as a nation. Ohio ranks #31 out of the 50 states for screening people for colorectal cancer age 50 or older. The Ohio colorectal cancer screening rate is only 66%.

Regular screening for and removal of colon polyps can reduce the risk of developing colorectal cancer. Colonoscopy with polyp removal can also reduce the number of deaths from colorectal cancer, as much as 53% according to the national polyp study published in the New England Journal of Medicine in 2012. The American College of Gastroenterology recommends colonoscopy every 10 years for average risk individuals starting at age 50 and at age 45 for African-Americans.

Colonoscopy is considered the best test for colorectal cancer screening because it not only identifies precancerous lesions or polyps, but it also allows for their removal during the same procedure. However, the best test for colorectal cancer screening is the one that actually gets done. There are alternatives to colonoscopy. These include testing the stool for occult or hidden blood, with a fecal immunochemical test or FIT and a stool DNA test called Cologuard, to name only two.

The National Colorectal Cancer Roundtable began an initiative in 2014 with the goal of screening 80% of all Americans age 50 and older for colorectal cancer by 2018. The reason for this initiative was that screening rates had reached a plateau; too many people were not getting screened and were developing preventable colorectal cancer.

Today, because of the 80% by 2018 initiative, colorectal cancer screening rates have significantly increased. Although this initiative will conclude on December 31, 2018, the work to screen all Americans age 50 and older will continue beyond this date. It must continue, because colorectal cancer is one of most preventable cancers through screening. The 80% by 2018 initiative has put in place significant resources and infrastructure, and has also raised awareness, so that this work will not end this year.

When we think about all of the ways by which we can improve screening rates for colorectal cancer, we must also consider removing existing barriers. One such barrier is the issue of co-insurance, when patients present for a screening colonoscopy and a colon polyp is found and removed. Often, patients are left with a co-insurance payment for a screening procedure that should be covered. In my work with professional gastroenterology societies and digestive disease advocacy groups, I have had the privilege of traveling to Washington, D.C., and advocating on behalf of our patients for colorectal cancer screening. Earlier this month I was on Capitol Hill advocating with the Digestive Disease National Coalition for a bill that addresses this co-insurance issue (the Removing Barriers to Colorectal Cancer Screening Act).

Colorectal cancer is mostly preventable. If you have not yet had your own colorectal cancer screening test, please consider doing so; it may save your life.

Get the colonoscopy that could save your life!

Get the to right colorectal screening test that could save your life! To schedule an appointment with a Summa Health specialist, call 888-720-5318 or visit summahealth.org/colon to learn more.

Compassion and the Opioid Epidemic

Thu, 01 Mar 2018 00:00:00 -0500

As many of you know, our community has been struggling to effectively manage the addiction epidemic, which is now widely considered to be a public health crisis. The American Society of Addiction Medicine defines addiction as a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations.

While much of the scientific and medical community adhere to this disease-model, many individuals continue to align with the moral model, a framework that describes addiction as a choice people make to seek out self-destructive pleasure due to a lack of willpower.

Regardless of your personal stance or belief system, the fact remains that those suffering from addiction often desperately need assistance from external sources. The afflicted are plagued with a crushing array of negative emotions. The spectrum of denial, fear, and guilt these individuals routinely experience is strongly related to the development of debilitating anxiety, depression and potentially even suicidal thoughts. In addition to the negative physical and psychological issues caused by the addiction, they must contend with overwhelming societal barriers resulting from misunderstanding and stigmatization.

Because these patients are human beings like you and me, they are deserving of our utmost compassion. An intervention as simple as active listening can impart tremendous therapeutic benefits. When we validate the concerns of others, we often develop a better understanding of our own emotions.

With that said, our compassion must not begin and end with the individual. So much work still needs to be done at the community level, and collectively we need to embrace treatment centers, sober housing, and harm-reduction projects. Fighting against the stigma associated with addiction and the “not in my backyard” mentality of those in opposition to the development of treatment centers is necessary to make an impact on this epidemic.

Due to the lethality of our current epidemic with opiates, the belief that a person must “hit rock bottom” before they can change is not a rationale option. We must meet addicts where they are at while encouraging treatment options and sobriety. Relapse should be expected and plans for continuous re-engagement should be in the contingency plans.

Two concepts are essential to the successful treatment of patients with addictions and mental health disorders.

First, we must focus on the person and not the chemical when treating those with addictions. The chemical will change over time as we have seen with the various drug epidemics of the past, but by focusing treatment on the person we can navigate the changes related to substance use in the future.

Secondly, treatment should be focused on capabilities rather than pathology with an emphasis on patient’s strengths and worth, for example, “what is right, not what is wrong.” Also, we must focus on the trauma to the individual and question, “what happened to you, not what is wrong with you.” Interventions should target the core issue instead of the symptoms thus eliminating maladaptive behavior.

The Summa Health Behavioral Health Institute offers a variety of inpatient and outpatient services to combat a variety of addiction as well as mental health disorders. We recently have expanded to include Intensive Outpatient Services in Hudson for mental health and addiction services and are now offering medication assisted treatment for those with Alcohol or Opiate Dependence through our Vivitrol^TM Clinic at our St. Thomas Campus in Akron.

If you have any questions, or know of someone that needs help, please call us at 330.379.9841.

Jaimie A. McKinnon MBA, BSN, RN, NE-BC
Vice President, Behavioral Health Institute

The Power of Vitamin D

Thu, 15 Feb 2018 00:00:00 -0500

You may have heard of the health benefits of vitamin D in the fight against the common cold.

A British investigation published in February 2017 concluded that taking vitamin D supplements can help protect against respiratory infections like colds, bronchitis and pneumonia. The researchers looked at data from 25 clinical trials involving some 11,000 patients from 14 countries and found a significant but modest benefit. These results occurred mostly among those who had very low levels of vitamin D to begin with. No benefit was seen in people who received one big dose of the vitamin instead of regular (daily or weekly) supplementation.

Vitamin D is thought to protect against illness by boosting levels of natural, antibiotic-like peptides in the lungs. This may be one of many reasons why colds and flus are most common in the winter, when sunlight exposure, and therefore the body’s natural vitamin D production, is at the lowest, some researchers say. It may also explain why vitamin D appears to be protective against asthma attacks, which can be triggered by respiratory viruses.

Interestingly, vitamin D supplementation in community dwelling elderly people also has unique health benefits. It has been shown to reduce the risk of broken bones by improving muscle function and reducing the risk of falls.

Best Sources of Vitamin D

So, where do you get vitamin D? Sometimes referred to as the “sunshine” vitamin, your body makes vitamin D when skin is directly exposed to the sun, and most people meet at least some of their vitamin D needs this way. Skin exposed to sunshine indoors through a window will not produce vitamin D.

Very few foods naturally have vitamin D. That’s why fortified foods play an important role in your diet to help you get a sufficient amount of vitamin D. The best food sources include:

Fatty fish such as salmon, tuna, and mackerel
Milk
Beef liver, cheese and egg yolks provide small amounts
Mushrooms (some mushrooms that are newly available in stores have vitamin D content boosted by exposing these mushrooms to ultraviolet light)
Breakfast cereals and some brands of orange juice, yogurt, margarine and soy beverages

Having an insufficient level of vitamin D can cause rickets, where the bones become soft and bend. It’s a rare disease but still occurs, especially among African-American infants and children. In adults, vitamin D deficiency can cause bone pain and muscle weakness.

Risk Factors

You might be at a higher risk of vitamin D deficiency if you:

Have dark skin
Are elderly
Live indoors too much or are far from the equator where the sun is not abundant
Don’t drink milk
Don’t eat fish
Are obese
Have celiac disease or inflammatory bowel disease
Have osteoporosis

Most healthy adults, including pregnant women, do not need screening for vitamin D deficiency unless they have one or more of these risks factors. Talk with your doctor about your vitamin D levels and if testing is necessary. And be sure to pay attention to your daily diet to ensure you are getting the vitamin D your body needs.

Lynn M. Hamrich, M.D., FAAFP
Family Medicine
Associate Director of Residency Education
Summa Health Family Medicine Residency Program - Akron Campus

Winter Blues… or something more?

Thu, 08 Feb 2018 00:00:00 -0500

This time of year, it feels like our world is gray and gloomy, bright sunshine will never reappear and the cold winds dampen our spirits at every turn. It’s easy to experience the winter blues.

But, for some people winter is quite literally depressing. Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer.

As the days become short and dark, people with SAD develop a predictable set of symptoms. Sufferers have dramatic drops in energy, difficulty concentrating, changes in appetite that include craving sweet or starchy foods, increased irritability, and feelings of hopelessness. SAD can also lead to feeling sluggish, agitated and even anxious. Since the syndrome is linked to a lack of light, people with SAD may become depressed during cloudy weather at any time of year, or if they are confined to windowless offices or basement apartments.

The specific cause of SAD is unknown, but factors such as circadian rhythm, serotonin levels and melatonin levels have been found to have a major impact on severity. Seasonal decreases in sunlight are correlated with disruptions in your body’s internal clock, which can lead to sleep disturbance and can trigger depression. Women and younger adults have been found to be at higher risk.

You may be wondering why one should be concerned about “winter blues,” but SAD can have negative effects on work performance, relationship satisfaction and overall quality of life. SAD negatively impacts one’s ability to gain restful sleep, to focus on tasks, and to maintain the motivation and interest to engage in social activities.

The good news…there is hope. SAD is treatable. Many have found relief with:

Light therapy, also called phototherapy
Medications, such as antidepressants
Psychotherapy, also called talk therapy
Mind-body connection using relaxation techniques, meditation and guided imagery

It may be difficult to envision life out of bed while suffering from SAD, but if left untreated, SAD can escalate to feelings of worthlessness or thoughts of death. If you are finding yourself battling with thoughts of death or suicide, please contact your healthcare provider or the Summit County Suicide Prevention Coalition at 330.434.9144 for help. Do not hesitate to visit your local emergency room for support, if you find yourself unable to reach your specific provider while in crisis.

With the support of loved ones and caring professionals, you can find your zest for life and overcome SAD.

Patricia Galbraith ATR, LPCC-S

The Gift of Heart Health

Tue, 06 Feb 2018 00:00:00 -0500

When you think of February, you may think of Valentine's Day, chocolate and flowers. February also marks American Heart Month, a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health. Heart disease is the leading cause of death for men and women in the United States. But the good news is it's also one of the most preventable.

Making heart-healthy choices, knowing your family health history and the risk factors for heart disease, having regular check-ups and working with your physician to manage your health are all important parts of living longer with a healthy heart.

7 Tips for a Healthy Heart:

Avoid smoking and using tobacco products.
Be physically active every day.
Eat a heart-healthy diet.
Keep a healthy weight.
Keep your blood pressure normal.
Keep your total cholesterol healthy.
Keep your blood sugar normal.

We encourage everyone to make small changes toward a heart healthier lifestyle all year long. Cardiovascular disease is the broad category for all diseases of the heart and circulation, including: heart disease, stroke, heart failure, cardiomyopathy and atrial fibrillation. Remember, heart trouble can happen at any age. You are never too young, or too old, to take care of your heart.

The perfect gift this Valentine’s Day? A healthy heart.

Michael Hughes, M.D.
President, Summa Health Barberton Campus
Cardiologist

Strategies for the Big Game

Thu, 01 Feb 2018 00:00:00 -0500

The excitement is growing for Super Bowl LII. Before we know it, it will be the kickoff for the Big Game, the must watch commercials, and of course, the anticipated halftime show. It will also be a kickoff to the Big Party with friends and family where we will root for our favorite team.

As we celebrate, there will be an abundance of traditional game day snack foods and drinks— wings, sandwich platters, beer, you name it. All of this will be accompanied by an abundance of temptation! It is not uncommon for an avid football fan to consume more than a days’ worth of calories within the short span of a four-hour game. With a game plan of your own, you can enjoy Super Bowl Sunday and come out a winner yourself!

Pre-Game Strategy:

Have a nutritious breakfast and lunch and maybe even a healthy snack before going to watch the Big Game. If you skip meals in anticipation of the game day spread, you will be extra hungry and more tempted to overindulge.
Stay well hydrated by drinking water throughout the day. This will help to curb food cravings later on.
Be active before the game: sneak in your favorite workout or take a brisk walk.

Have a Game Plan:

Before leaving for the party, anticipate the types and amounts foods that may or may not fit into your meal plan.
Be sure to consider alcohol, mixers and other drinks that may pile on the calories.
Decide on a strategy that may help you to stay in control. For example, plan to stand up and stretch during the commercials or plan on how to best stay away from your biggest temptations.

Offense: You are in control of the ball.

If you are a guest, bring a recipe that you know is a healthier version of traditional game day food. Greek yogurt is a good substitute for sour cream in dips. Flavor with your favorite seasonings.
If you are hosting, load your table with sliders made with lean meat, low fat cheeses, low fat turkey chili, hummus, baked chips and healthy nuts.
This is a great time to try new recipes that will satisfy your guests and your own eating goals.

Defense: Stay in control and don’t let the opponent run with the ball.

Before you load your plate, survey the playing field. Identify higher calorie and lower calorie choices and make a strategy to block the play.
Choose the smallest plate available. Limit yourself to only one plate of food.
Begin with healthier choices including raw veggies and protein based items to help fill the plate. This will leave less space on your plate for the higher calorie pizza and wings.
If you do choose to eat chips and dips, place them on your plate instead of standing next to the bowl and eating them mindlessly.
Try to finish your snacking before halftime.
If you drink alcohol or soft drinks, alternate each drink with equal amounts of water. This will slow down the caloric intake and help prevent dehydration (and hangovers).

The Fumble: If you fumble the ball and overindulge, don’t let one fumble cause you to quit the game.Re-evaluate your strategy and get right back on track.

Post Game Conference: Celebrate the winning team! Keep in mind, the Super Bowl is once a year and should be a fun time. There’s no need to feel guilty as long as the indulgences end with the game. Re-evaluate your choices and get right back on track tomorrow!

Rose Ann Chiurazzi, MA, RDN, LD, CDE

Medical Nutrition Therapy or Nutrition Education?

Mon, 22 Jan 2018 00:00:00 -0500

Medical Nutrition Therapy or Nutrition Education?

Obesity currently affects 34% of all Americans. It contributes to many other conditions, including Type 2 Diabetes, GERD, Sleep Apnea, Hypertension, Hyperlipidemia, Joint Disorders, and a variety of cancers. Improving or eliminating obesity often can improve or cure these conditions, including Type 2 Diabetes.

A registered dietitian can approach obesity through either medical nutrition therapy or nutrition education.

Medical nutrition therapy (MNT) involves registered dietitians treating medical conditions such as obesity through the use of nutrition assessment and intervention techniques which will include patient education. The dietitian uses the patient’s medical history, a physical examination, and a dietary history to develop an appropriate plan. The plan is reviewed with the patient, and the patient is monitored at regular intervals to determine progress made and the need for modifications to the plan. MNT requires a physician referral.

Nutrition Education is a less intensive approach to treating obesity, but is also provided by a registered dietitian. The focus is on educating the patient regarding topics such as meal planning, nutrient content, portion sizes, and label reading. A physician referral is not needed for nutrition education.

Who Qualifies for Medical Nutrition Therapy?

You may want to consider Medical Nutrition Therapy if you have obesity and Type 2 diabetes, and/or if you have obesity with or without other comorbid conditions.

If you have Type 2 Diabetes and are also struggling with overweight or obesity and you feel that Medical Nutrition Therapy with a registered dietitian would be helpful, consider asking your doctor to refer you to the Summa Health Weight Management Institute. The goal is to address the obesity as the root cause of the Type 2 Diabetes, while simultaneously assisting you with learning how to manage the nutritional aspects of their diabetes.

If you are struggling with obesity without comorbid Diabetes, you may also benefit tremendously from MNT, with a focus on improving or eliminating the obesity, which will in turn improve the length and quality of your life.

Referrals for MNT are managed by the Summa Health Weight Management team, and each patient is scheduled with a registered dietitian with expertise in the treatment of obesity. The dietitians work closely with our board certified Obesity Medicine Specialist, to make sure all MNT treatment plans are based upon the most current research in obesity. Plans are individualized for each patient as needed.

Some patients with Type 2 Diabetes do not need to lose weight, and some patients with Type 2 Diabetes need to lose weight but are not ready to do so. We can still provide the MNT that you may need for your diabetes care if you do not want/need to lose weight.

Who Qualifies for Nutrition Education

If you are struggling with overweight or obesity, but do not have insurance coverage for medical nutrition therapy, consider seeing a dietitian for Nutrition Education.

The education you receive will be tailored to your needs, and will be provided by the same team of registered dietitians that provides the MNT. Current research in obesity medicine will still serve as the underlying foundation for the education you receive.

Nutrition education can include topics such as healthy eating, label reading, understanding carbohydrates, getting enough protein, and any other topic that you feel would help you with your goal of a healthy weight.

Fees for Nutrition Education are lower than those for Medical Nutrition Therapy, and are comparable to most copayments charged by insurance companies

If you are interested in scheduling an appointment, call us at 330.375.6201. Appointments can take place on Summa Health System’s Akron or Barberton Campuses or at our Hudson, Green, Medina and Wadsworth-Rittman Medical Centers.

Rose Ann Chiurazzi, MA, RDN, LD, CDE

Eating Mindfully

Mon, 15 Jan 2018 00:00:00 -0500

We eat for many reasons beyond hunger, which is why learning to eat mindfully helps you maintain or even lose weight if desired. As we celebrate Healthy Weight week this week, here are ten tips that provide some food for thought.

1. Reject the Diet Mentality. Throw out the diet books and magazine articles that offer you false hope of losing weight quickly, easily and permanently. Get angry at the lies that have led you to feel as if you were a failure every time a new diet stopped working and you gained back all of the weight.

2. Honor Your Hunger. Keep your body biologically fed with adequate protein, fat and the right amount of carbohydrates. Once you reach the moment of excessive hunger, all intentions of moderate, conscious eating are fleeting and irrelevant. Learning to honor this first biological signal sets the stage for re-building trust with yourself and food.

3. Make Peace with Food. Call a truce and stop the food fight! Give yourself permission to eat. If you tell yourself that you should not have a particular food, it can lead to intense feelings of deprivation that build into uncontrollable cravings and, often, bingeing. When you finally “give-in” to your forbidden food, eating will be experienced with such intensity it usually results in “Last Supper” overeating, and overwhelming guilt. Practice the 80/20 rule. Eight percent of your food should fuel your body, 20 percent to fuel your soul.

4. Challenge the Food Police. Scream a loud “NO” to thoughts in your head that declare you’re “good” for eating minimal calories or “bad” because you ate a piece of chocolate cake. The Food Police monitor the unreasonable rules that dieting has created. The police station is housed deep in your psyche, and its loud speaker shouts negative barbs, hopeless phrases, and guilt-provoking indictments.

5. Respect Your Fullness. Listen for the body signals that tell you that you are no longer hungry. Observe the signs that show that you are comfortably full. Pause in the middle of a meal or food and ask yourself how the food tastes, and what is your current fullness level?

6. Discover the Satisfaction Factor. In our fury to be thin and healthy, we often overlook one of the most basic gifts of existence— the pleasure and satisfaction that can be found in the eating experience. When you eat what you really want, in an environment that is inviting and conducive, the pleasure you derive will be a powerful force in helping you feel satisfied and content.

7. Honor Your Feelings Without Using Food. Find ways to comfort, nurture, distract and resolve your issues without using food. Anxiety, loneliness, boredom and anger are emotions we all experience throughout life. Each has its own trigger, and each has its own appeasement. Food will not fix any of these feelings. It may comfort for the short term, but ultimately you will have to deal with the source of the emotion, as well as the discomfort of overeating.

8. Respect Your Body. Accept your genetic blueprint. Just as a person with a shoe size of eight would not expect to realistically squeeze into a size six, it is equally as futile (and uncomfortable) to have the same expectation with body size. But mostly, respect your body, so you can feel better about who you are.

9. Exercise–Feel the Difference. Get active and feel the difference. Shift your focus to how it feels to move your body, rather than the calorie burning effect of exercise. If you focus on how you feel from working out, such as energized, it can make the difference between rolling out of bed for a brisk morning walk and hitting the snooze alarm.

10. Honor Your Health. Make food choices that honor your health and taste buds while making you feel well. Remember that you do not have to eat a perfect diet to be healthy. You will not suddenly get a nutrient deficiency or gain weight from one snack, one meal, or one day of eating. It is important to remember, it is what you eat consistently over time that matters; progress not perfection is what counts.

Kathy G. Wise, RDN, LD, CWP, CWC
System Director, Human Resources Employee Wellness
Summa Health

Source: Intuitive Eating: A Revolutionary Program that Works Paperback – August 7, 2012 by Evelyn Tribole M.S. R.D. (Author),‎ Elyse Resch M.S. R.D. F.A.D.A. (Author)

Maintain, Don’t Gain This Holiday Season

Thu, 07 Dec 2017 00:00:00 -0500

The holidays are upon us! But before we can dive head first into family time, social gatherings and frantically buying last minute gifts, ask yourself, “How am I going to stay on track this holiday season?”

Here are a few tips to get started:

One good approach is to plan activities that don’t revolve around food. Enjoy ice skating, visit Stan Hywet to enjoy the holiday lights, or make homemade cards and ornaments. The holidays are a great time for catching up with loved ones. Appreciate the time you have to spend together more than the food you eat together.
When you go to social gatherings you can be mindful of what you eat and still enjoy yourself, I promise, just be proactive. If you’re nervous there won’t be any healthy dishes at a party you’re going to, then bring one. Similarly, don’t show up to a get-together ravenously hungry. Make sure to eat every three to four hours throughout the day. This way you’ll be able to eat until you’re satisfied, not stuffed.
During the holiday season it is easy to be hard on yourself when you over-indulge, but it’s important to remember that no one eats healthy 100% of the time. If you find yourself feeling worried about how you’re eating, look at your plate. Focus on eating leafy greens and lean meats for most meals. The fiber and protein in these foods will help you feel full and leave less room for sweets.
When filling up a plate, it may be tempting to try a little bit of everything, but this can add up pretty quickly. With mashed potatoes, bread, stuffing, casseroles and baked goods, starch and sugar take the spotlight over the holidays. Making an effort to limit these foods will help you stay on track.
It’s also a good idea to keep an eye on what you drink. Having water before meals and throughout the day can be an important tool to help prevent overeating. The body needs water to function and stay hydrated, but it doesn’t need hot cocoa, apple cider or mixed drinks.
Lastly, although you might be on vacation from work, don’t take a vacation from physical activity. Exercise is great for stress relief and burning some extra calories. Short on time? Do two 10-15 minute walks with loved ones.

If you're struggling with weight and would like to learn more about Summa Health's non-surgical weight loss options, click here.

Have a happy and healthy holiday season!

Alyssa C. Diamant, RD, LD
Clinical Dietitian

Being a volunteer is good for your health!

Tue, 05 Dec 2017 00:00:00 -0500

It's International Volunteer Day! Volunteering can be emotionally rewarding, but did you know it can also keep you healthier?

Researchers at the Harvard T.H. Chan School of Public Health published a study that found volunteers were more likely to use preventative health care services. For instance, people who volunteered were 47 percent more likely to get cholesterol checks and 30 percent more likely to get flu shots than those who didn’t volunteer.

Earlier research from the same study found that people who volunteered on a regular basis (at least 200 hours a year) were less likely to develop high blood pressure over a four-year period than non-volunteers. Volunteers also had greater increases in psychological well-being and physical activity.

Another large, ongoing study of volunteerism, Baltimore Experience Corp Study, has also documented physical, social, and cognitive improvements in volunteers. It showed volunteers tend to walk more steps, be less depressed, find it easier to do everyday tasks, and have better thinking skills.

Another intriguing potential benefit is that volunteering may give people a greater sense of purpose in life. The researchers said a sense of purpose is associated with better heart health above and beyond the effects of optimism and a positive outlook.

In fact, a 2016 report in Psychosomatic Medicine that pooled findings from 10 different studies found that people with a high sense of purpose in life had a lower risk of having a cardiovascular event (such as a heart attack or stroke) and of dying from any cause, compared with people who had a lower sense of purpose.

Summa Health offers a number of volunteer opportunities for both adults and teens with a variety of tasks, scheduling options and skill requirements available. Click here to learn more, or contact Volunteer Services at volunteer@summahealth.org or 330.375.3247.

Angela Smith, MPA, CAVS
System Director, Volunteer Services
Summa Health

The impact of diabetic foot ulcers

Thu, 30 Nov 2017 00:00:00 -0500

When do adults need their tonsils removed?

Tue, 28 Nov 2017 00:00:00 -0500

Even though it’s not as common as it once was, tonsillectomies are still mostly done on children. But, sometimes adults need to have their tonsils removed too. Here are a few things that may lead to a tonsillectomy as an adult.

Sore Throat

One of the most common reasons for a visit to your primary care doctor is a sore throat. The most likely reason your doctor may refer you for tonsillectomy are very frequent sore throats or a chronic infection in your tonsils. If you have infrequent, uncomplicated infections, your doctor will probably just treat you as needed.

Abscess On Your Tonsils

If you experience severe pain, fever, significant bulging around your tonsil, pain when you open your mouth or you notice your uvula is shifted to one side, you may have an abscess on your tonsils and should seek medical attention immediately. While it is typically treated with antibiotics and drainage, 10 to 15 percent of the time the abscess returns, prompting some clinicians to recommend tonsillectomy early in the course of treatment rather than waiting for it to come back.

Sleep Apnea

If your tonsils are enlarged, they may actually obstruct your airway when you lie down and cause you to completely stop breathing in your sleep, a condition called sleep apnea. You may wake up in the middle of the night gasping for breath. Chances are, if you have sleep apnea, you may have been told that you snore loudly as well, though loud snoring does not necessarily mean you have sleep apnea. Not all sleep apnea is caused by enlarged tonsils, but if your doctor suspects this is the problem, he or she may recommend tonsillectomy.

One Big Tonsil

If one of your tonsils is much larger than the other, your doctor may recommend tonsillectomy as a precaution to rule out a serious underlying cause. Surgery is typically recommended only if you have other related symptoms. If you don't have other "red flag" problems, such as difficulty swallowing, persistent pain, swelling of the glands in your neck, or one tonsil that keeps getting larger and larger over time, it is extremely unlikely that the difference in size of your tonsils is important. Most of the time, having one enlarged tonsil is simply due to a minor issue.

If you’re concerned about your tonsils, but need a primary care physician, visit summahealth.org to find one.

Christina M. Emanuel, M.D.
Family Medicine
Summa Health

Am I at risk for gestational diabetes?

Fri, 24 Nov 2017 00:00:00 -0500

It is reported that nearly 11 percent of women over age 20 living in the United States has diabetes, a disease that causes high glucose, or sugar, in the blood. Diabetes can occur for different reasons and may be treated in different ways.

Diabetes can be diagnosed before pregnancy or can be a new diagnosis associated with pregnancy. Women who have diabetes before pregnancy are known as “pregestational diabetics” and those who develop the disease during pregnancy are “gestational diabetics.”

All pregnant women should be tested with lab work between 24-28 weeks of gestation, or earlier if risk factors are present. Women at risk include those that are obese, who belong to ethnic or racial groups at risk for Type 2 diabetes, who have a prior history of gestational diabetes, or a family history of diabetes. In women with risk factors, lab work should be completed. The lab test, known as a glucose tolerance test, takes approximately one hour to complete with results available within 24 hours. If the test is abnormal, your obstetrician will discuss the next step in management.

Pregnancies complicated by gestational diabetes have risks to both mom and baby. Mothers are at risk for developing pre-eclampsia (high blood pressure in pregnancy) and undergoing a cesarean section. Babies are at risk for macrosomia (weighing almost 10 pounds at birth), high bilirubin levels, and shoulder dystocia, which occurs when the baby's shoulders are stuck inside the mother's body during delivery.

Recent studies have even shown women with high glucose during pregnancy may even increase their child’s future risk of developing diabetes and obesity. That is why it is important to institute interventions such as adhering to a healthy diet, participating in regular exercise, and, if needed, starting medications to decrease blood sugar. Each of these interventions should be approved and under the direct supervision of an obstetrician.

Expectant mothers who have been diagnosed with gestational diabetes should have more frequent office visits with their obstetricians and often times will require extra testing during the third trimester. Ultrasounds may be ordered to assess the baby's growth and NSTs, or non-stress tests, will be administered to evaluate the baby's well-being. Timing of delivery depends on blood glucose control and fetal well-being. This recommendation will always be at the discretion of your physician.

After delivery, mothers diagnosed with gestational diabetes will need to repeat their glucose testing as they are at increased risk of developing Type 2 diabetes in the future. This again emphasizes the importance of healthy living and the need for regular check-ups with your primary physician.

In closing, your obstetrician will do a full evaluation to monitor your risk for gestational diabetes.

If you still need an OBGYN, visit the physician directory at summahealth.org to find a provider in your area.

Liz Seagraves, D.O.
Third Year Resident
OBGYN

Should I Be Screened for Lung Cancer?

Tue, 21 Nov 2017 00:00:00 -0500

Currently, lung cancer screening is recommended for those who are between the ages of 55-77, have a smoking history of 30 years or more (an average of one pack a day for 30 years, two packs a day for 15 years, etc.), and are current smokers or have quit in the past 15 years.

If you are a current or former smoker, your risk of developing lung cancer may be up to 25 times higher than someone who never smoked. A CT scan is the only proven effective way to screen for lung cancer.

If you are considering being screened for lung cancer, it is important that you and your healthcare team make this informed decision together. There are important benefits to being screened for lung cancer, but as with all tests, there are also risks to consider. You should discuss the risks and benefits with your healthcare provider.

Screening is testing with a CT scan which can identify small nodules or other abnormalities in your lungs. Finding a problem at an early stage, before there are symptoms, may make it easier to treat.

Studies have shown that screening those at high risk with CT scans before symptoms appear can find lung cancer early when it is easier to treat and more likely to be cured. In addition, lung cancer screening might also show if you have other conditions or diseases that need to be treated.

Talk to your doctor about the results of your first screening to determine what you need to do next. For most people, a yearly scan is recommended.

Lung nodules, which are spots on the lung, are common. Some people screened will have a nodule that needs further testing. Most of these nodules will not be cancer and this will be determined by additional CT scans. A small number of nodules will need additional tests, such as other imaging tests, needle biopsy or surgery. Biopsies and surgery have other possible risks.

You will be exposed to low levels of radiation during the test. This level of radiation is more than an x-ray but much lower than a regular CT scan that you might have if you have symptoms of cancer. To put it into perspective, you will receive about the same amount of radiation from six months in your natural environment.

Once you have talked to your doctor about risks and benefits, it might be useful to talk about why you may or may not want to be screened. Some questions to consider include:

What are my reasons for wanting to be screened?
Would I undergo surgery and possible treatment should cancer be found?
What are my reasons for not wanting to be screened?
Do I have all the information I need to make a decision with which I feel comfortable? If not, what other questions can my doctor help answer for me?
Do I need to talk with someone else about this decision besides my doctor? If so, who could help me make this decision?

Here are some other important things to consider:

Screening is not a one-time test. In order for it to work, you have to come every year for as long as your doctor recommends, so that any cancer that may be small and slow growing will be found as early as possible.

If you smoke, it is still important to consider quitting. You might think it doesn’t matter but there are lots of benefits to quitting, even now. Don’t be afraid to ask for their help. Summa Health offers smoking cessation classes. You can learn more about those classes and about lung cancer screening here.

Brian Bauman, M.D.
Pulmonary and Critical Care Medicine
Medical Director

Seven tips to manage stress over the holidays

Mon, 20 Nov 2017 00:00:00 -0500

1. Have an attitude of gratitude.

Making an effort to remember all of the things you’re grateful for is very important this time of year. Research has shown that taking time to express gratitude or even acknowledge thankfulness in our own thoughts increases well-being and creates positive feelings. Gratefulness can be the antidote to increased stressors of the holiday season.

2. Create a budget and stick to it.

Overspending at the holidays is a common experience that can add to your stress by creating financial pressures after the season is over. Make a plan before you go shopping about how much money you can afford to spend and then follow your budget. Remember, a mountain of gifts won’t create happiness.

3. Perfect the art of polite refusal.

It’s hard to say no, but saying “yes” to every holiday invitation and demand could leave you exhausted. Decide what matters most, whether it’s baking, seeing friends, volunteering, etc. When you know your priorities, it’s easier to say “no” when you’re aware of what you’re gaining in return. When saying no, always be honest, short and thankful.

4. Plan ahead.

There’s no rule that says everything needs to be handled right before a celebration. Stretching out holiday activities over a longer period of time can help reduce stress by alleviating time constraints. For things that do need to be done last minute, checklists can help keep you organized.

5. Take time for yourself.

Spending just 15 minutes alone, without distractions, can refresh and rejuvenate. Clear your mind, slow your breathing and restore inner calm. Some options may include stargazing, listening to music, taking a bath, meditation or reading a good book.

6. Ask for help.

If you feel overwhelmed with all that you have to do, don’t hesitate to ask others for help. Doing it all yourself won’t make the holiday any better. If you’re not careful, you’ll miss out on enjoying the celebration. Be flexible in your plans, ask for and accept help from others, and remember Tip #7…

7. Set realistic expectations.

There are factors beyond your control that can negatively impact any celebration. Be prepared that things may not turn out exactly the way you want or expect, and people may not act the way you want them to. Try to identify what you can and cannot change. Be realistic in what you have real power over, and try not to let what you don’t weigh too heavily on you.

David Brinkman-Sull, Ph.D.
Vice Chair of Psychiatry and Chief Psychologist
Summa Health Behavioral Health Institute

Things to consider when shopping for individual and family health insurance

Thu, 16 Nov 2017 00:00:00 -0500

Open enrollment for individuals and families to secure health insurance for 2018 is November 1 through December 15. When shopping for health insurance during the open enrollment period, keep in mind the following considerations:

You may be eligible for a savings on your monthly health insurance premium. To be eligible, you must be under age 65 and not eligible for coverage through your employer, Medicare or Medicaid. Savings is based on income, household size and plan options available in your area. In a household of one person, you may qualify if your income is between $12,060 and $48,240. You can find out if you are eligible for savings by using the Premium Subsidy Calculator at MySummaCare.com
There are plans with free office visits to your primary care physician.When comparing plans, check to see if you are able to visit your primary physician at no cost to you. For example, most 2018 SummaCare plans offer three free visits to your primary care physician. This applies to each person on your policy.
Check to see if your doctor is in the network. Don’t wait until you need healthcare services to find out if the doctors you want to see are in the plan’s provider network. Likewise, if you have a hospital preference, make sure that hospital is in the network of the plan you select.
Compare each plan’s deductible. This is the amount you’ll have to pay for medical care before the insurer starts to pay for the services.
Look at the cost of care. Pay attention to how much the copays are for services such as specialist visits and the cost of using generic drugs.
See what extras are included. Are preventive drugs covered at no cost? Are there vision discounts? Does the plan have personal health coaching available?
It will likely cost you if you don’t have health insurance in 2018. If you don’t purchase a health plan by December 15, 2017, you could owe a tax penalty for not having insurance. The penalty may be up to 2.5% of your household’s adjusted gross income, which will be deducted from your tax refund.
There may be a difference in monthly premium for On- vs. Off-Marketplace plans. For 2018, many carriers that offer insurance in Ohio have Off-Marketplace plans with a lower premium compared to the same plan On-Marketplace. Keep in mind, if you choose an Off-Marketplace plan for the lower rate, you will not be eligible for a savings on your monthly premium if your income changes.

SummaCare, based in Akron, Ohio, offers health insurance plans to individuals and families who live in Summit, Portage, Stark and Medina counties. Plans feature the SCConnect provider network which offers access to many of the area’s finest doctors, facilities and hospitals, including Summa Health, Mercy Medical Center in Canton and Akron Children’s Hospital. Go to MySummaCare.com to get a quote, compare plans and enroll. Or call 888-956-5714 (TTY 800-750-0750) to speak with an experienced representative.

Anne Armao
SummaCare
Vice President, Marketing & Medicare and Individual Products

Should your dog sleep in your bed?

Tue, 14 Nov 2017 00:00:00 -0500

A recent study released by the Mayo Clinic has certainly gotten a lot of tails wagging. The study looked at whether or not letting your canine companion sleep with you in your bed disrupts your peaceful night’s sleep.

The study, “The Effect of Dogs on Human Sleep in the Home Sleep Environment,” evaluated the sleep of 40 healthy adults without sleep disorders and their dogs over five months. The participant and his or her dog or dogs wore activity trackers to track their sleeping habits for a week.

According to the study, sleeping with a dog does help some people sleep better, no matter how large or small the size of the dog. However, there’s a catch! The sleep benefit extends only to having dogs in your bedroom—not in your bed. According to the study, adults who snuggled up to their pups in bed sacrificed quality sleep.

The researchers found many people actually find comfort and a sense of security from sleeping with their pets. So go ahead, let your four-legged friends into your bedroom, just make sure they have their own space to snooze instead of taking up some of yours.

To learn more about Summa Health's Sleep Medicine Program, visit https://www.summahealth.org/specializedservices/sleep.

Rami Abboud, M.D.
Sleep Medicine
Summa Health Medical Group

Symptoms, solutions for carpal tunnel syndrome

Thu, 09 Nov 2017 00:00:00 -0500

One of the most common causes of numbness in the hand is carpal tunnel syndrome. Think of it as a pinched nerve in the wrist. Patients often complain of numbness, burning, or tingling in the thumb, index, middle and ring fingers. This usually affects people at night in their sleep, or during the day with prolonged grip or repetitive motion activities. Some carpal tunnel patients say their fingers feel swollen and useless. In more advanced cases, carpal tunnel syndrome can cause loss of muscle tone and weakness in the hand.

The symptoms often first appear in one or both hands at night with patients waking up and feeling the need to “shake out” to affected hand. This occurs because we tend to sleep with our wrists in a flexed position. Flexing your wrist causes an increase in pressure within the carpal tunnel. This increased pressure causes the nerve in your wrist to malfunction, which leads to the classic carpal tunnel symptoms of numbness, burning, and tingling in the hand. The diagnosis can usually be made with a history and physical exam performed by a medical professional, but often times a nerve conduction study is needed to confirm that the nerve problem is at the wrist and not elsewhere, such as the neck.

Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. People with diabetes or other metabolic disorders that directly affect the body's nerves are also at high risk.

A first-line treatment of carpal tunnel syndrome is a night splint, which serve the purpose of keeping your wrists from flexing during your sleep to prevent the added pressure on the nerve. Steroid injections are a second-line treatment that can help decrease inflammation around the nerve. An injection given in the office may make your symptoms go away completely, or the effect may only be temporary.

If symptoms are persistent or more severe, then a carpal tunnel release may be recommended. This requires consultation with a hand specialist. The procedure is performed on an outpatient basis requiring minimal anesthesia. For select patients, the surgery can be performed with an injection of numbing medicine into the palm and no anesthesia at all.

The goal of surgery is to release a tight ligament in the wrist that is causing pressure on the nerve and the entire surgery takes less than 10 minutes. The recovery is usually very rapid, with most patients achieving resolution of their thumb and finger numbness and pain immediately. Pain in the palm can last for a few weeks to a few months and is most aggravated by heavy gripping, lifting, or weight bearing of the hand. If carpal tunnel is not severe, a full recovery is expected, with full grip strength returning by three months.

While at work, you can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, and ensure correct posture and wrist position to prevent the development of carpal tunnel syndrome.

If you think you have the symptoms of carpal tunnel, call the Summa Health Orthopedic Institute at 888.381.6713, or visit https://www.summahealth.org/orthoinstitute to schedule an appointment.

Derek Klaus, M.D.
Summa Health Orthopedic Institute

Recognizing and treating BPH

Tue, 07 Nov 2017 00:00:00 -0500

While many men are growing mustaches in recognition of prostate health this Movember, how many are making the changes key to the prevention and treatment of prostate health issues?

One of those issues is Benign Prostatic Hyperplasia (BPH), an enlargement of the prostate due to an increase in the number of cells in that gland. BPH begins in an area of the inner prostate called the transition zone, a ring of tissue that makes a natural circle around the Urethra (the tube that carries urine from the bladder through the prostate to the penis). In BPH, the growth is inward toward the prostate’s core, constantly tightening around the urethra, and may interfere with urination.

The risk of BPH increases every year after age 40: BPH is present in 20 percent of men in their fifties, 60 percent of men in their sixties, and 70 percent of men by age 70.

Is BPH Prostate Cancer?

Remember, the “B” stands for Benign. BPH is not prostate cancer, and having BPH doesn’t mean a man is more or less likely to get prostate cancer.

How is BPH Treated (and When)?

One-quarter of men with BPH (more than 350,000 a year in the United States alone) will eventually require treatment, some more than once, to relieve the urinary obstruction caused by BPH.

Based on the figures mentioned above, it’s likely that after age 60, a majority of men will either be taking medication for BPH or considering it.

BPH is treated with medications that relax the muscles of the urinary sphincter or medications that shrink the volume of the prostate. Medication doesn’t help everyone. If you’re experiencing more severe symptoms, or waited to see your doctor until the disease has advanced, you might find surgery is the best option.

As always, it’s important to see your doctor if you’re having any prostate or urinary issues.

If you’re due for a checkup or are struggling with prostate issues, call Summa Health Medical Group – Urology at 330.374.1255 or visit https://www.summahealth.org/medicalservices/urology.

Joseph Dankoff, MD
Summa Health Medical Group
Urology

Source: Prostate Cancer Foundation

What’s the best time for an orthopedic surgery?

Thu, 02 Nov 2017 00:00:00 -0400

While some people may feel there is never a good time to have surgery, others find this time of year appealing for scheduled surgery. The advantage of many orthopedic surgeries is that they can be postponed and performed when it’s convenient for the patient. Here are a few reasons why patients may choose the end of the year as their surgery time.

Less expenses. This late in the calendar year, many patients have already met their deductible and sometimes even total out-of-pocket expenses. If that is the case, a patient’s insurance plan will cover covered expenses at 100 percent. Elective surgery can be attractive to you if you know you won’t have many medical bills to deal with. However, surgeons’ schedules fill up quickly for this reason, so surgeries need to scheduled months out.

Insurance plan concerns. Just like some patients are thinking of their insurance plan this year, they also may be concerned about next year’s plan. With high deductible insurance plans becoming more popular, patients have seen deductibles and out-of-pocket expenses increase dramatically. This year might make more sense for your surgery as your insurance plan next year may have more out-of-pocket costs.

More free time around the holidays. Although you may not need to be in the hospital long for an orthopedic surgery, some surgeries require you to be off your feet and away from work for weeks. Holidays are a time of year many people plan to be off from work or school. Having to be off your feet and incapacitated in some way is easier for some when they were already planning to be off.

Extra help from family and friends. The same free time concept also supports the ability for more friends and family members to be free to help provide assistance and support as needed. Young adults may be home for semester break and can help take care of surgical patients that may require more assistance at home as they recovery. Extra hands can help with running to therapy sessions and doctor appointments. The support of family and friends is one of the most important factors in determining the overall success and recovery time of orthopedic surgery.

Look (and feel) good for the New Year. Maybe your surgery has been put off for some time and you have been dealing with chronic pain for years. Usually my patients know when they just can’t take the pain and inconvenience any more. Starting the New Year off in better shape can kick start a great year.

Consider these factors as you discuss surgery plans with your doctor. Regardless of when you decide it is time for surgery, Summa Health’s experienced orthopedic surgeons can help.

Visit summahealth.org/orthopedic for more information, or call 330.835.5533 to schedule an appointment with our orthopedic specialists.

Kiel Pfefferle, M.D.
Orthopedic Surgery
Summa Health

Managing diabetic foot ulcers

Tue, 31 Oct 2017 00:00:00 -0400

November is Diabetes Awareness Month and an estimated 30.3 million people in the U.S. have the disease, including 7.2 million who have no idea they have it. The percentage of adults with diabetes increases with age, reaching a high of 25.2 percent among those aged 65 years or older. In addition to age, risk factors for diabetes also include diet, activity level, obesity and heredity.

Diabetes may be accompanied by other co-existing conditions such as blindness, heart disease, kidney failure or lower-limb amputation.

High blood sugar levels, poor circulation, immune systems issues, nerve damage and infection may contribute to a non-healing diabetic foot ulcer. Approximately 15 percent of people living with diabetes will develop a foot ulcer. An estimated 14-24 percent of people with foot ulcers will experience an amputation. Even more alarming, people with an amputation have a 50 percent mortality rate within five years.

There are several common factors of diabetic foot ulcers including neuropathy and peripheral arterial disease (PAD). Neuropathy is a result of damage to peripheral nerves and often causes weakness, numbness and pain in hands and feet. Similarly, PAD is caused by narrowed arteries which reduces blood flow to the limbs.

The Summa Health Wound Care and Hyperbaric Medicine Center recommends the following to help prevent diabetic foot ulcers:

Stop smoking immediately
Comprehensive foot examinations each time you visit your healthcare provider (at least four times a year)
Daily self-inspections of the feet, or have a family member perform the inspection
Regular care of the feet including cleaning toenails and taking care of corns and calluses
Choose supportive, proper footwear (shoes and socks)
Take steps to improve circulation such as eating healthier and exercising on a regular basis

Proper wound care techniques are imperative to healing diabetic foot ulcers. Debridement and Hyperbaric Oxygen Therapy (HBOT) are a few of the leading-edge treatments offered at Summa Health. Debridement, the removal of damaged tissue, is widely recognized as one of the most important methods of advanced wound care. Hyperbaric Oxygen Therapy is where a patient receives 100 percent oxygen and an increased atmospheric pressure inside an acrylic chamber. These specialized wound care therapies can aid in wound closure, new tissue growth, wound tissue regeneration and much more.

Summa Health Wound Care and Hyperbaric Medicine Centers at our Barberton and St. Thomas campuses consistently have better than a 90 percent healing success rate. They heal most wounds within 14 weeks of admission.

To schedule an appointment, or for more information call 330.375.6363 to reach our St. Thomas campus and 330.615.3908 for our Barberton Campus.

Sources: CDC, NIH, American Diabetes Association

Faster and more accurate cancer treatment

Thu, 26 Oct 2017 00:00:00 -0400

Cancer continues to affect millions of Americans every year. Summa Health’s goal is to find ways to better treat patients, and ultimately, cure this dreaded disease.

As a radiation oncologist, I’m one of the three primary specialties used to treat cancer, the other two being surgical and medical oncology. A Radiation Oncologist is a medical specialist doctor with training in the use of radiation therapy (also called radiotherapy) to cure or reduce the symptoms of cancer, and in the overall care of cancer patients. We use the latest advancements in radiation therapy to provide whole-person healing and care.

Over the past several years, advances in radiation have changed how treatment is delivered. Earlier this month, Summa Health’s Barberton Campus began offering a new tool in its cancer-fighting options: the Elekta Versa HD^TM. This versatile, state-of-the art radiotherapy treatment machine gives Summa Health Cancer Institute professionals the flexibility to deliver a variety of treatments from standard therapy to advanced, highly precise treatment. Versa is designed to provide the precision and speed necessary to deliver the maximum accuracy in tumor targeting and protection of critical structures.

Versa HD leverages the latest advances in technology to enable sophisticated approaches to traditionally challenging cases. The system’s patented technology provides superior conformance to tumor size, shape and volume, allowing Summa Barberton clinicians to administer higher dose rates that can enhance treatment effectiveness while protecting important structures such as the heart, spine, or bladder. The result is faster treatment times, minimizing the risk of movement by patients who are receiving treatment in the vicinity of critical structures.

Shortened treatment times can also improve patient comfort, particularly for older patients who may find it difficult to remain in one position over extended periods of time. Softer streamlined shapes and ergonomic features combine with low mechanical noise and ambient lighting help create a relaxed patient treatment environment. From enhanced patient safety features to greater environmental friendliness, Versa HD reflects carefully conceived design innovations while delivering expanded patient treatment capabilities. Ultimately, this investment will provide patients with reduced treatment times, individually tailored treatments and the potential for improved outcomes.

Schedule a wellness checkup today.

Douglas R. Keyser, M.D.
Summa Health Medical Group— Radiation Oncology
Barberton Campus- Parkview Pavilion

Embracing life with a confident smile

Tue, 24 Oct 2017 00:00:00 -0400

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Rake leaves without hurting your back!

Thu, 19 Oct 2017 00:00:00 -0400

Fall is finally here and with it the nice cool weather, football, pumpkin spice latte, and the changing leaves! However, when those leaves start to fall in your yard, the work starts.

Raking leaves is good exercise and also a great way to hurt your back if not done correctly. A back injury will lead to time in the physical therapist’s office instead of outside enjoying fall. So, in an attempt to help keep you out of my office, I want to share five helpful hints to avoid a back injury while raking leaves.

Start with the right tools – Don’t just buy the first rake you see or the cheapest one on the shelf. Find a rake that is a good fit for your height and is comfortable to hold. A rake with a good thick handle is also usually better to help avoid hand fatigue.

Warm up and stretch – As I said, raking leaves is exercise therefore it is a good idea to get your joints and muscles ready for the activity. Work to stretch out your legs, low back, arms and shoulders. Maybe do some knee to chest lifts, side bends and arm circles to help loosen up.

Rake with good posture – Raking hunched over is very bad for your back and places undo strain on all of the muscles. Rake standing up straight and rake the leaves to the side of you, making sure to switch sides from time to time. Maintain the natural curves of the back paying particular attention to the inward curve of the lower back. If you feel your back starting to strain take a break and make sure you are standing up straight and continually remind yourself “stand up straight” while raking.

Avoid Twisting – There are leaves all around you that need to be reached and most of the time you plant your feet and twist side to side to reach them. This is very hard for the low back and should be done by keeping a slight bend in your knees, moving at the hips, and shuffling your feet from side to side. Do not twist at the low back!

Lift Correctly – After filling your bags with leaves, you can be left with a heavy bag. Therefore it is important to remember proper lifting posture. Make sure to bend at the hips and knees and utilize the power of your legs and not your back. Keep the load close to your body, and if it is too heavy just wait for help, do not overdo it.

You can enjoy fall with a healthy back and a leaf-free yard if you start with the right tools, warm up and stretch, use good posture, avoid twisting and lift correctly!

Schedule a wellness checkup today.

Lucas C. Smith PT, DPT, MBA, CSCS
Summa Health Green Medical Center

Six things to consider when choosing a Medicare Advantage plan

Tue, 17 Oct 2017 00:00:00 -0400

If you are eligible for Medicare, now is the time to take a look at and decide upon a Medicare Advantage plan. The Annual Enrollment Period runs until Dec. 7. During the enrollment period, you can transfer from Original Medicare to a Medicare Advantage plan or you can switch from your current Medicare Advantage plan to another Medicare Advantage plan. When you choose a Medicare Advantage plan, you are choosing to receive care through the network of doctors, hospitals, pharmacies and other providers that are within the company’s plans.

Here are six things you need to consider when choosing a Medicare Advantage plan:

1. What is my share of the costs for services and supplies?
You’ll want to look at each plan’s out-of-pocket maximum. This is the most you will have to pay in one year for services received through the plan’s network providers.

2. Are the doctors and hospitals I prefer to use in the plan’s network?
If you have a primary care doctor or specialists you have been seeing and you want to keep seeing them, make sure they are in the network of the Medicare Advantage plan you are selecting. It doesn’t hurt to ask your doctor or other providers if they are in the network you are considering. Likewise, check the list of hospitals, if you have a preference.

3. Are the drugs you normally take covered under the plan?
Insurance companies that offer Medicare Advantage plans will help you determine if your medications are in their formulary (list of drugs covered). Often this list can be searched online on the company’s website.

4. Does the plan have dental, vision and hearing coverage?
Sometimes plans have these benefits built into the plan and sometimes you have to pay more for these extra benefits.

5. What is the quality rating of the plan?
The Centers for Medicare and Medicaid (CMS) gives star ratings every year for health plan quality, with the top rating being five stars. The number of stars a plan has reflects things such as customer satisfaction and the quality of care delivered.

6. Am I covered while traveling?
You may travel during the year for vacation, to visit family or you’re a “snow bird.” If so, you’ll want to check to see if the plan has nationwide and even worldwide coverage. Many plans cover emergency and urgent care while traveling.

You can get more information about Medicare Advantage plans at summacare.com/medicare, or by calling 800-217-3974 (TTY 800-750-0750).

In addition, SummaCare offers an extensive series of “Talk About” informational meetings throughout its key service areas. See the website for a complete list of times and locations.

Anne Armao
SummaCare
Vice President, Marketing & Medicare and Individual Products

SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. A salesperson will be present with information and applications. For accommodation of persons with special needs at sales meetings call 888-464-8440 (TTY 800-750-0750). A representative is available to take your call 8:00 a.m.- 8:00 p.m. seven days a week. Medicare evaluates plans based on a 5- star rating system. Star Ratings are calculated each year and may change from one year to the next.

H3660_18_124 Accepted 10132017

Responding to the prescription drug abuse epidemic

Thu, 12 Oct 2017 00:00:00 -0400

Prescription drug and opioid abuse is a serious problem facing much of the country, including right here in our area. Summa Health is utilizing new ways to help patients safely dispose of their pharmaceuticals.

The Deterra® Drug Deactivation System allows you to put your unused medication in a bag containing a carbon that bonds to pharmaceutical compounds when water is added. The person adds water and shakes it up to neutralize the active ingredient in the drug. The biodegradable bag can then be placed into the trash.

In the past, pharmacists have told patients to dispose of unused or expired medications by putting them in cat litter, sawdust or used coffee grounds, but those materials only absorb a small percentage of the medication allowing it to still be used.

Here at Summa Health, the Deterra Bag program is a venture with the Summit County Community Partnership (SCCP). According to the SCCP, four out of five heroin users began with recreational use of prescription pain relievers. Summa Health Pharmacy’s Meds to Beds program hands out the bags to anyone who receives an opiate prescription. Depending on the initial success, we will evaluate expanding the program into other areas of the health system.

This is one component of our response to the heroin and prescription drug abuse epidemic. Other collaborations include Dispose of Unused Medication Properly (D.U.M.P.) boxes at our Summa Health System - Barberton and Akron Campuses, as well as bi-annual Drug Take Back Days throughout our service areas.

The goal, not only for Summa, but also for many of our community partners is to provide people with a number of easy ways to conveniently dispose of unused medication. Research shows most people who abuse prescription and/or street drugs have started by experimenting within the medicine cabinet of an immediate or close family member or friend.

These programs could not have been possible without the assistance and support of Summa Health Pharmacy System Director John Feucht and Director of Pharmacy Operations Glenn Huth along with our various community partners (Summit County Community Partnership, Summit County Opiate Task Force, Summit County Public Health, the ADM Board, and many others).

To learn more, visit our website devoted to responding to the prescription drug epidemic.

Det. WK Heilmeier, B.S. MCI
Summa Health Police Department

Heart Patient Experiences a Miracle

Tue, 10 Oct 2017 00:00:00 -0400

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The top myths about the flu

Thu, 05 Oct 2017 00:00:00 -0400

Coming down with the flu is pretty awful. In addition, chances are some of the things you’ve heard and read about avoiding or dealing with the virus are wrong. Here are few of the top myths about the flu.

MYTH: You can catch the flu from the vaccine.
No, a flu shot cannot cause flu illness. The vaccine is made from an inactivated virus that can't transmit infection. So people who get sick after receiving a flu vaccination were probably going to get sick anyway.

MYTH: Healthy people don't need to be vaccinated.
Anyone can benefit from being vaccinated. The CDC recommends that everyone six months of age and older get a flu shot every season.

MYTH: Getting the flu vaccination is all you need to do to protect yourself from the flu.

There are a number of steps you can take to protect yourself during flu season besides vaccination. Avoid contact with people who have the flu, wash your hands frequently, and consider taking anti-viral medications if you were exposed to the flu before being vaccinated.

MYTH: The flu is just a bad cold.
Influenza may cause bad cold symptoms, like sore throat, runny nose, sneezing, hoarseness, and cough. But in the United States alone, 36,000 people die and more than 200,000 are hospitalized each year because of the flu.

MYTH: You don't need to get a flu shot every year.
The influenza virus changes (mutates) each year. So being vaccinated each year is important to make sure you have immunity to the strains most likely to cause an outbreak.

MYTH: You can catch the flu from going out in cold weather without a coat, with wet hair or by sitting near a drafty window.
The only way to catch the flu is by being exposed to the influenza virus. Flu season coincides with the cold weather. So people often associate the flu with a cold, drafty environment. But, they are not related.

MYTH: Feed a cold, starve a fever.
If you have the flu (or a cold) and a fever, you need more fluids. There's little reason to increase or decrease how much you eat. Though you may have no appetite, "starving" yourself will accomplish little. And poor nutrition will not help you get better.

So, when it’s flu season, take the necessary steps to stay well such as getting your flu shot!

Schedule a wellness checkup today.

Vivek Bhalla, MD
Summa Health Family Medicine

*Sources: Harvard Health, CDC