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Fall 2010

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Pacemaker surgery in Lawrence

Advanced cancer care close to home

Stepping Out Against Breast Cancer: October 30

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Staffed with three physicians and 30 additional health professionals, including 18 certified oncology nurses, the LMH Oncology Center provides chemotherapy treatment, education and counseling, as well as optional participation in clinical trials. Additionally, state-of-the-art radiation services are provided by the privately owned Lawrence Cancer Center located right next door.

Before the opening of the LMH Oncology Center a decade ago, cancer diagnosis and treatment in the community were overseen by just one physician, Matthew Stein, MD, an oncologist/hematologist who started his private practice in Lawrence in 1983. Local cancer patients had to travel to other cities when treatments were not available.

Lawrence resident Judy Henderson remembers it well. In 1994, the high school French teacher — now retired — was diagnosed with endometrial cancer. Putting her fear in check, and with a plan in place to continue working as much as possible, she began a six-week treatment regimen that included commuting five days a week to Topeka for radiation therapy. The drive to and from Topeka was physically uncomfortable for Judy and only added to her stress.

Upon discovering last winter that she would be facing yet another battle with cancer, there was some reassuring news: She could receive her care close to home.

“I had seen signs for the cancer center and read about it, but I didn’t realize it had been here for almost 10 years,” she says. “And I was surprised to see how big it was and how many types of caregivers are working there.”

Judy is halfway through a six-round chemotherapy plan for leiomyo-sarcoma, a form of smooth muscle cell cancer, and says she has no qualms about receiving treatment locally. She expresses the utmost confidence in her physician and the rest of the center’s staff.

A long-time local resident, Judy says that having medical professionals who are also “hometown people” is a comfort to her. She adds that hometown care helps caregivers as much as it does patients, noting that her husband has more freedom this time around to run errands or go home during her four-hour treatments.

Advanced cancer careclose to home

Cancer care is advancing at an astounding pace. Nowhere in our area is that more evident than at the Oncology Center at Lawrence Memorial Hospital, on the cusp of its second decade.

www.lmh.org

© iStockphoto.com/borchee

Take a virtual tour of Lawrence Memorial Hospital at www.lmh.org/virtualtour. 3

Judy is one of hundreds of area patients benefiting from the Oncology Center at LMH. In 2009, nearly 700 new patients were treated. In August 2010 alone, there were 1,597 “treatment encounters,” defined as any treatment, ranging from dressing changes to the ad-ministration of chemotherapy treatment.

The fact that increasingly more can-cer patients can receive care in Lawrence is gratifying to Ron Stephens, MD, an oncologist and the Oncology Center’s medical director, who has been on staff since the center’s inception. Recruited by hospital administration to enhance the oncology program, he has seen the center expand from a small consulting and out-patient treatment facility to a full-time, inpatient/outpatient care center, offering a broad range of cancer services.

The center officially opened in 2001. That year, more than $118,000 for the center was raised in community donations to the Hearts of Gold Ball. Dr. Stein came on board the LMH Oncology Center staff in 2001; and in 2003 hematologist/oncologist Sharon Soule, MD, joined the team. A fourth physician, Michelle M. Affield, MD, will be joining the Oncology Center in November 2010.

The facility itself has grown from a few treatment rooms to a large center that houses 15 treatment rooms, 10 exam rooms, a pharmacy, four nursing stations and a front office.

“We have great surgical expertise — including plastics and ENT, for example,” Dr. Stephens says. “And we have more research protocols than our larger neighboring facilities.” The Oncology Center at LMH provides outstanding care; still, Dr. Stephens notes they are always working to make it better. His hope is to add more support staff, such as additional social workers and nutritionists.

Currently, the center participates in a government-funded program called the Wichita Community Clinical On-cology Program (WCCOP). Established in 1983, CCOPs are designed to ensure that cancer patients have access to lead-ing-edge medical care in their communi-ties. The program consists of a network of community hospitals and physicians conducting cancer prevention and treat-ment studies. Patient participation is voluntary. Dr. Stephens says the affili-ation with the WCCOP provides our patients with treatments not available in other parts of northeastern Kansas.

Jodi Carlson, RN, BSN, OCN, clinical research coordinator, says some patients have come to LMH from Topeka and Kansas City to participate in studies not available in those communities.

“Patient participation is important, because these trials pave the way for new treatment strategies,” Jodi explains. “Currently, we are following about 120 patients who are participating.”

Dr. Stephens adds that most local cancer patients benefit by having their day-in and day-out cancer challenges met right here at home, and oncology care doesn’t get any better than at LMH.

Step out for Halloween!Grab your costume and get your ticket to the Stepping Out Against Breast Cancer dance — a favorite annual community event, to be held this year on Saturday, October 30, at Crown Toyota in Lawrence. You’ll dance to music by Disco Dick and the Mirror Balls, have fun trying to win amazing theme baskets, and be inspired by the Breast Cancer Survivors Ceremony.

Tickets are $35 and can be purchased at the LMH Gift Shop, Weaver’s, The Etc. Shop, Hurst Fine Diamonds or Baldwin Academy of Dance in Baldwin City. Call 505-3315 for more information.

Proceeds support breast cancer education and detection for the community.

Specialty services at the LMH Oncology Center:

• 24-hourhematology/oncology consultation

• Secondopinions• Geneticcounseling• Medicalcounselingbyadoctorof

pharmacy trained in cancer care• NutritionalcounselingthroughLMH• Mario’sCloset(openingin2011)• Lymphedemaeducation/

management• Communityeducation• Financialcounseling• Severalsupportgroups—abreast

cancer survivors group; a group for children whose parents or grand-parents have been diagnosed with cancer called CLIMB (Children’s Lives Include Moments of Bravery), funded by Richard and Khaki Raney in memory of their daughter Michelle Raney; I Can Cope; and Look Good, Feel Better

Lawrence resident Judy Henderson is pleased she can receive treatment close to home.

Though installing pacemakers is not a new procedure in our community, there is a new physician in town performing this type of surgery. David Rios, MD, from Cardiovascular

Specialists of Lawrence has joined surgeon Stephen Myrick, MD, in offering this life-saving surgery.

Pacemakers are implanted in some cardiac patients to help control the heart rate. These devices are surgically placed in a patient’s chest just below the collarbone and are attached to the heart by tiny wires. When necessary, pacemakers deliver a small electric stimulation to help the heart maintain a proper rhythm. Pacemakers are about two inches in diameter and are less than an inch thick. They are powered by an internal battery that usually lasts five to eight years.

After the pacemaker is implanted, many patients report feeling better than they have in years and are able to go about their normal activities without much trouble.

“With these devices most patients are able to live a normal life and most do not even notice when the pacemaker is at work,” says Dr. Rios.

Monitoring pacemakersAfter surgery and the initial adjustment period,

pacemakers require monitoring from home every three months, and most patients see the cardiologist one time a year for an exam in the office.

For many years pacemakers have been monitored by phone. Once every three months the patient uses a special device to record the heart’s activity and transmits the information via phone to the cardiologist’s office. The office then reviews the information to ensure the pacemaker is working properly.

The newest technology now allows some pacemakers to record the information on a special monitoring device that sends the information to the cardiologist’s office via the Internet for review.

The future of pacemakers Pacemakers have come a long way since they were

first offered to patients in the late 1950s, notes Dr. Rios. “The device is now only a fraction of the size of the original models, and the surgery to install one is much less invasive than before, allowing for better outcomes and a faster recovery,” he says.

The device has also become “smarter.” The original devices were set to monitor the heart at a set heart rate, making it difficult to exercise. The newer pacemakers are now rate responsive, allowing patients to exercise freely by allowing the heart rate to increase during exercise. As technology evolves, many experts expect the device to continue to add features and more advanced monitoring technology.

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Setting the pace Two Lawrence physicians offer pacemaker surgery

www.lmh.org

Dr. Rios

ABOUT YOUR PHYSICIANS

Stephen W. Myrick, MDLawrence General SurgeryMD Degree: University of Kansas School of Medicine, 1977Residency: St. Francis Hospital of Wichita,1982Board certified in surgery785-505-2200

C. David Rios, MD, FACCCardiovascular Specialists of LawrenceMD Degree: Stanford University Medical School, 1991Residency:MassachusettsGeneralHospital,1994Fellowship: University of Iowa Hospitals and Clinics, 1998Board certified in internal medicine and cardiology785-841-3636

Dr. Myrick

Moody’s upgrades LMH bond ratingIn July Moody’s Investors Service, one of the country’s top credit rating agencies, upgraded Lawrence Memorial Hospital’s long-term bond rating from A3 to A2.

This was especially noteworthy because Moody’s has reported increasing numbers of downgrades for not-for-profit healthcare providers in the second quarter of 2010. In issuing the report, Moody’s noted that LMH’s strengths are its dominant market position in a favorable service area and a track record of strong operating results with 10 years of increasing growth.

Sunderland Foundation gives $100,000 for GI Lab relocationThe Sunderland Foundation has awarded a grant of $100,000 to Lawrence Memorial Hospital for the relocationof endoscopyservices(GILab).

TheGILab,currentlylocatedatLMHSouth(atthecornerof ClintonParkwayandKasold),willberelocated to the main LMH facility at 325 Maine Street. The relocation is expected to improve efficiency of patient care, facilitate inpatient consultations, and improve physician retention and recruitment. The GI Lab relocation is expected to be complete in spring 2011.

LMH’s Lawrence Specialty Care practice opens in OttawaLMH has opened Lawrence Specialty Care, located at1402MainStreetinOttawa,toofferseveralspecialty services, including cardiology, neurology and gastroenterology.

Darren Klish, MD, of Lawrence Cancer Center, provides radiation oncology services in this location. The physicians of Lawrence Otolaryngology — Robert Dinsdale, MD; Stephen Segebrecht, MD; and Lee Reussner, MD — have been treating patients in Ottawa for more than 20 years and recently opened an office in the new space as well.

LMH a United Way PacesetterLawrence Memorial Hospital is proud to once again serve as a Pacesetter organization for the United Way. LMH employees pledged more than $46,000totheUnitedWay—10%morethanourgoal. LMH is proud to be part of the Lawrence community and to support our local United Way agencies that enrich the lives of our families, our neighbors and our friends.

LMH offers a wide array of health-related classes. Visit lmh.org and click on “Classes and Programs”. 5

When should you have a mammogram?

Join several LMH physicians and area professionals on Tuesday, October 19, for a discussion of breast health. Topics will include breast changes throughout the lifespan, screening, diagnosis and treatment of breast diseases and conditions, and lifestyle practices

andhealth.SpeakerswillincludeKathyGaumer,MD;JackStuber,MD;MarkPraeger,MD;SharonSoule,MD;andFarhangKhosh,ND. Enjoy refreshments and enter for a chance to win door prizes.This program is free but advance registration is requested. To register, call the Connect Careline(749-5800)orenrollonlineatwww.lmh.org.

Breast Health Symposium: October 19Exhibits and refreshments 6-6:30 p.m., Program 6:30-8 p.m.

This gift pays you back

Much has been written about possible changes in guidelines for screening mammograms. Despite a widely publicized government task force finding suggesting that screening mammograms should begin at age 50, LMH breast cancer specialist Sharon Soule, MD, stresses that there has been no official change in the guidelines. According to the American Cancer Society:•Abaselinemammogramshouldbetakenatage35.•Annualscreeningmammogramsshouldbeginatage40.

Dr.SouleaddsthatearlydetectionisessentialandremainstheNo.1defenseagainstthedisease.Accordingtothe2009AmericanCancerSociety statistics report, 192,370 women and about 1,900 men were diagnosed with breast cancer. To schedule your mammogram, please call the LMH Breast Center at 785-505-3300

LMH Endowment Association is pleased to now offer our donors a new and very beneficial way to support LMH — the charitable gift annuity.

A gift annuity is an agreement between an indi-vidual and a charitable organization or institution. The donor transfers assets in return for fixed payments for the rest of his or her lifetime and/ or the lifetime of another person. The rate of payment on a particular gift annuity agreement is set when your annuity begins. A sample gift annuity rate for an individual at 65 years of age is 5.5%. But if you give additional gift annuities — as many people do — the rate will generally be higher for annuities in subsequent years.

The gift annuity agreement requires that payments be made for as long as a recipient lives. Also, you can designate a loved one to receive the payments with you or following your death. This can result in a double gift — one to the charitable entity, and another to a relative or special friend.

A gift annuity can be created with minimal effort. If you are interested in creating a gift annuity or would just like more information, please contact theLMHEndowmentofficeat785-505-6134.

You can research health conditions from A to Z at www.lmh.org.

You can see the compassion in Dorothy Kurtz’s eyes and hear the tenderness in her voice as she describes how, at Lawrence Memorial Hospital, every patient is cared for using best practices from the moment of birth through their last hours of life.

Dorothy, a registered nurse and certified hospice and palliative care nurse (CHPN),isamemberof thehospital’spalliative care team — a group of physicians, nurses, social workers and chaplains focused on providing pain and symptom management for patients with advanced diseases.

Historically, the approach to caring for chronically ill patients was to ad-dress each medical episode individually. But palliative care focuses on working with the patient and family members to discuss their wishes for medical care and symptom management, providing emo-tional and spiritual support, helping with decision making and communicating the patient’s wishes to health care providers.

TeresaSikes,RN,CHPN,programdirector and nurse consultant for the palliative care team, says, “We provide collaborative care based on the patient

and family goals, and we provide appropriate medical interventions to support those goals.” She says such interventions can range from continued aggressive care to hospice care.

“People have a lot of questions about the last days and weeks of life,” shares Dorothy. “They want to know, ‘Where do we go from here?’ People are faced with hard decisions of how to care for their loved ones as they leave this world.”

One way the specially trained palliative care team works with families is to secure hospice care for patients who want to stay in their own homes. For others, they open the doors of LMH’s special palliative care rooms. These rooms are homelike, with carpeted floors, artwork and comfortable furnishings. They are equipped with conveniences such as a sleeper sofa, refrigerator and micro-wave for family members who don’t want to leave their loved one’s bedside.

The palliative care team also offers community education classes on advanced directives and advanced care planning. And they conduct staff educa-tion so nurses are better equipped to meet the unique needs of patients who are at the end of life.

As understanding about palliative care grows, so do the number of patients the team assists. In 2003, the team had fewer than 50 consultations. By 2009, that number had jumped to 177. For the palliative care team, each one of these consultations has provided an opportu-nity to help a patient and his or her loved ones replace fear with peace.

Compassionate, comprehensive palliative care

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People have a lot of questions about the last

days and weeks of life. They want to know,

Where do we go from here?”

“ }© iStockphoto.com/tepic

www.lmh.org 7

Lawrence Memorial Hospital initiated a new program in March to extend health and wellness services beyond the hospital walls. The com-munity care navigator program aims to achieve a continuum of care and optimal health for vulnerable patients at risk for complications after going home from the hospital.

Linda Gall, MSN, RN, ACM, director of the care coordination department at LMH, says the new program, which is funded by the LMH Endowment Association, links hospital care, primary care, specialty care and community resources in a coordinated effort. The goal is to improve the continuum of care for underserved patients suffering from complex medical and social conditions in order to produce quality health outcomes and reduce preventable hospital readmissions.

Linda points out that, on a national average, one in five hospitalized patients experiences complications after going home. Patients sometimes find their recovery at home more difficult than anticipated and may require additional services.Research has shown that hospitals which make discharge phone calls to patients following their hospitalizations can reduce readmissions between 20 and 30 percent, while at the same time increas-ing patient satisfaction and compliance with primary physician follow-up visits.

“Discharge calls produce better clinical outcomes and are the right thing to do for patients and families,” she says. “It’s also a great way to verify that patients understand post-care instructions, which in turn

promotes successful continued recovery at home.”

Kristen Byington, a social work graduate student at the University of Kansas, is serving in the role as LMH’s first community care navigator. She attempts to contact patients who have been identified as being at risk for complications within 72 hours after their hospital discharge. Byington discusses their discharge instructions to assist patients in their continued recovery at home, encourages them to follow up with their primary care providers, and assesses any needs for community resources. Some of the resources she has arranged for patients include transportation for appoint-ments, prescription assistance,

in-home meals, Health Care Access and Heartland Clinic referrals, and in-home care programs.

Linda reports that the program is accomplishing its goals. In the first five months, Kristen completed 149 phone calls with 99 patients after discharge, and she made 93 referrals to commu-nity agencies. Only nine patients out of the 99 who were contacted had an inpatient readmission within 30 days, which is a 6 percent readmission rate. The expected 30-day readmission rate for Medicare inpatients nationally averages close to 20 percent, Linda says.

“Most importantly,” she emphasizes, “the community care navigator program is enhancing and saving lives.”

As community care navigator at LMH, Kristen Byington follows up with patients who may have complications or questions following their discharge from the hospital.

at your serviceCommunity care navigator assists vulnerable patients

325 Maine StreetLawrence,KS66044

connect is published by Lawrence Memorial Hospital. The information in this newsletter is intended to educate readers about subjects pertinent to their

health and is not a substitute for consultation with a personal physician. To have your name added to or removed from this mailing list, please call 785-505-3315.

Gene Meyer | President and CEO, Lawrence Memorial HospitalEditorial Board | Kathy Clausing Willis, Sherri Vaughn, MD, Janice Early, Heather Ackerly

8 Lawrence Memorial Hospital • 325 Maine Street • Lawrence, KS 66044 • 785-505-5000 • www.lmh.org

Hospital food that’s worth talking about LMH patients choose meals from new “spoken menu”

People often talk about the food at Lawrence Memorial Hospital — they say it’s tastier, more visually appealing and perhaps even more nutritious than your typical “hospital food.” Now,patientshaveevenmoretotalkabout.

Every morning, volunteers at LMH known as “food service ambassadors” visit with patients to see what they actually feel like eating. Patients choose their lunch and dinner options forthatday(aswellasbreakfastitemsforthefollowingday)fromamenuprovidinganicevariety of choices without being overwhelming.

This new “spoken menu” program was initiated by the food and nutrition services department at LMH on July 1. According to Debbie Miers, CDM, CFPP, director of food and nutrition services, it’s based on the idea that when people are sick, choosing to eat something in particular might make them feel better. Say, chicken soup. Or something else that might suit — or stimulate — their appetite.

“Comparedwitha24-hourfoodorder,whereapatientdecidestodaywhatshemayormaynotfeellikeeatingtomorrow,thisnewsystem gives patients the freedom to choose what sounds good to them at the moment,” Debbie says.

Each patient’s menu options align with his or her dietary restrictions, of course. Choices may include grill items, cold sandwiches, salads, soups and even a variety of desserts.

The new program also increases communication among patients, their families, the dietitians, other associates on the health care team, and the food and nutrition services staff.

Debbie reports that the new service has been well received by patients. “They love it!’ she says.

© iStockphoto.com/teine