get healthy: hope for headache relief

8/9/2019 Get Healthy: Hope for Headache Relief

1/12

Featured in this issue ...

Hope for

headache reliefSee page 6.

a publication of Norton Healthcare

GETHealthy

nFibroids and family planning

nIs it allergies or asthma?

nKnow the signs of stroke

nSurviving aortic aneurysm

nFitness fun at home

See pullout calendar

for screenings and

special events

April/May/June 2010


2/12G e t H e a l t h y 2

On the cover: Ron Cutler found relief from uncommon headache pain.See page 6.

Nick

Bonura

photos

Edna Voyles of Louisville

When physicianswork as a teamits a win

for patientsE

dna Voyles celebrated her 90th birthday on

Valentines Day. In spite of coping with some serious

health issues over the years Type 2 diabetes, heart

attack and stroke she considers herself very blessed.

Part of Voyles longevity can be attributed to well-

coordinated care among her physicians, on whom she

depends to meet her changing health care needs. She gets

annual physical exams and listens to the advice of her

primary care physician when he recommends a referral forspecialty care.

Recently Voyles had difculty walking, so her primary

care physician Robert W. Shaw III, M.D., referred

her to Louie Williams, M.D., physical medicine and

rehabilitation.

I didnt want her falling, Dr. Shaw said. I knew Dr.

Williams could help her regain strength and improve her

balance.

Anytime I have a problem, I tell Dr. Shaw, Voyles said.

Hes been taking care of me for many, many years. Hes

very upbeat and shows a lot of care.

Dr. Williams diagnosed Voyles with drop foot

syndrome, a weakening of the foot and ankle that impairs

walking. He prescribed a special leg brace and a course of

rehabilitation. After just three months of physical therapy,

Voyles physicians are pleased with her progress.

Medical care that is seamlessly coordinated by primary

and specialty care physicians not only helps patients

but helps keep health care costs down by avoiding

duplication of services. Specialists often are brought in asconsultants while the patient is in the hospital to discuss

transition of care after discharge, and the primary care

physician follows up to ensure specialty care meets the

patients needs.

The primary care physician stabilizes patients

medically, Dr. Williams said. Then my goal is to address

their rehabilitation and pain needs to allow them to return

to the level of independence and activity to which they are

accustomed.

Tammy Warren

Changing health care needs as

we ageNorton Audubon Hospital is offering a

free eight-week series of health and wellness

classes for anyone age 65 and older or those

caring for aging relatives. Upcoming classes

are Transitioning from One Level of Care

to Another and Medicare Confusion?

Updates on Whats Covered and Not

Covered. Attend any or all sessions.

See the pullout calendar for dates

and times.

Edna Voyles of Louisville


3/12

When it came down to either treating her

uterine broids or starting a family,

having to choose wasnt good enough forLeslie Hogle.

Fibroids are noncancerous growths in

or on the uterus. They are fairly common

in women in their 30s and 40s, and can

cause heavy menstrual bleeding, pelvic

pain and hinder the ability to become

pregnant or stay pregnant.

When I was diagnosed with broids, I

was single and not thinking about starting a

family, Hogle said. The options presentedto me would not preserve my uterus because

my broids were so large.

Traditional treatment options include

hysterectomy removal of the uterus and

ovaries among other procedures that either

negate the ability to get pregnant or make it risky.

After Hogle was married and ready to start a family, she

turned to Jonathan Reinstine, M.D., obstetrics/gynecology,

for a solution. Dr. Reinstine had been trained in the

da Vinci robotic surgical system for myomectomy, the

minimally invasive removal of broids without removing

the uterus.

Leslie was told by other surgeons that she would need

a hysterectomy, Dr. Reinstine said.

Dr. Reinstine was very encouraged about using the

da Vinci system to do the procedure laparoscopically,

Hogle said. He thought this option would give me a

better chance of being able to have children.

The da Vinci system eliminates the need for

a large abdominal incision, yet gives the

surgeon the visibility needed to safelyremove the broids and repair the

uterus. The system transmits 3-D

images to a computer screen to allow

better visualization, like an open

surgery, according to Dr. Reinstine.

da Vinci also offers patients

several potential benets, such

as a shorter hospital stay, less

pain and scarring, less risk of

infection and faster recovery.

For Hogle, recovery was a

breeze I didnt even need pain

medication.

Leslie Hogle, of Louisville, with her 4-month-old son Joshua

FIBROIDS AND FAMILY PLANNINGTreatment advancements could preserve fertility

For women who want to have children,

myomectomy is the only treatment option,

Dr. Reinstine said.

Now a 36-year-old mother of two,Hogle has advice for other women with

broids who think they may never be

able to have children:

Some doctors were very negative about

me having kids, and now I have two beautiful

babies, she said. Never say never!

Jennifer Reynolds

Want to know more?da Vinci surgical technology is available

at Norton Hospital and Norton Suburban

Hospital. If you have broids, ask your

physician if you are a candidate for da

Vinci myomectomy. For more information

about minimally invasive da Vinci procedures, visit

NortonHealthcare.com/daVinci.

3

da Vinci robotic surgical system


4/124 G e t H e a l t h y

Seasonal

allergies orasthma?

(Left to right) Rachel, Mackenzie and Kyle Schoeld

Spring is right around the corner. While most people

are looking forward to the world becoming green

again, the Schoeld family is gearing up for trouble.

Two of their three children have severe allergies.

At 3 months old, Mackenzie Schoeld, now 5, had

her rst bout of bronchiolitis. By 7 months, she had

her rst set of ear tubes. She continually suffered from

sinus infections or other allergy-induced illnesses.Kyle Schoeld, now 3, had his rst set of ear tubes at

5 months. He always had a runny nose and frequent

sinus infections.

I knew there had to be an underlying cause, said the

kids mother, Michelle Schoeld. We decided to have

Mackenzie tested for allergies when she was around

2 years old and Kyle at 18 months.

According to James L. Sublett, M.D., allergy and

immunology, these are common complaints when kids

have allergies.

An allergy is when the immune system mistakes a

harmless substance for a dangerous one and produces

an antibody called immunoglobulin E, Dr. Sublett said.

Most people think that allergies start when kids are

around 6 or older. In reality, we see kids

as young as 6 months old who suffer

from symptoms.

Though the best way to

control allergies is to avoid them

altogether, that can be easier said

than done. Your childs pediatricianmay recommend one of many

medications approved for children.

Another option is allergy shots, or

immunotherapy, which help build

up tolerance to the allergen. Its

important to speak with your

pediatrician or allergist before

giving your child any

medication.

The Schoeldsstory illustrates that

children can

have many

different

Determiningthe difference

Dean

Lavenson

photos


5/125

Pediatric expertise comes

to northeastern Jefferson

CountyKosair Childrens Medical Center Brownsboro,

opening May 26, is bringing childrens health care

designed Just for Kids to northeastern Jefferson

County. The full-service outpatient center will beequipped with the latest technology for testing

lung function so that a personal asthma therapy

plan can be developed for each patient. The

center also will offer emergency services, pediatric

diagnostic imaging, a pediatric outpatient surgical

center and more all designed to be friendly and

accommodating to children, teens, young adults

and families.

For more information about the new

pediatric outpatient center, visit

MedicalCenter.KosairChildrens.com.

Want to know more?Tune in to the Get Healthy with Norton Healthcare

TV show April 10 at noon to learn more about

childhood asthma and allergies. For details, visit

www.wlky.com/gethealthy.

symptoms that can signal allergies. To further complicate

things, its easy to mistake the signs and symptoms of

asthma as allergies, colds or coughs. Asthma often goes

undiagnosed because the symptoms may be hard for

parents and physicians to recognize.

According to Nemr S. Eid, M.D., pediatric pulmonology,

asthma doesnt generate the concern it should from doctors

or parents.Asthma is a condition in which the bronchial airways

become inamed and over-reactive, causing increased

mucus, swelling and muscle contraction. Asthma becomes

serious when repeated swelling of the airways leads to

scarring and blockage, according to Dr. Eid.

When asthma goes untreated or is not treated properly,

children are at risk, Dr. Eid said. Once airway damage

sets in, it may become irreversible.

Could it be asthma?Consider the following questions:

Does your child cough a lot at night or in the

morning?

While exercising or playing does your child wheeze or

cough?

When exposed to dust, allergens, smoke or strong

odors does your child wheeze, cough or experience

chest tightness?

When your child has a cold, does it seem to settle

into his or her chest and take more than 10 days

to clear up? Do you have to give your child cough medicine

more than once a month?

Has your child had pneumonia or bronchitis more

than once in any given year?

If you answered yes to any of these

questions, your child may have asthma. Talk to

a pediatrician about your childs symptoms.

Possible signs of nasal allergies Stuffy or runny nose for more than two weeks

Sneezing

Itchy nose and/or eyes

Clear mucus drainage from the

nose or coughing up clear-

colored mucus

Dark circles under the eyes

Other common childhood

ailments, such as ear infections

Maggie Skibba Roetker



With as much as 90 percent of

the population experiencing

at least one headache a year, feware lucky enough to say they never

get headaches. Ron Cutler was one

of those lucky few until shortly

after Christmas last year when he

experienced severe headache pain

like he had never felt before.

Thinking it was a sinus infection,

Cutler visited an urgent care center

before ying out for a business trip.

After I left the doctor, I startedhaving double vision, but I couldnt

miss my trip, Cutler said. Tylenol

and other pain relievers wouldnt

help. I was in pain and dealing with

double vision over the course of more

than a week.

Once Cutler was back in

Louisville, his wife brought him

to the emergency room, where he

underwent tests and nally got some

pain relief. But the source of his

headache and double vision was not

discovered, so Cutler was referred to

Tad Seifert, M.D., a neurologist who

specializes in treating headaches and

concussions.

There are so many different things

that can trigger a headache, making it

sometimes very difcult to treat, Dr.

Seifert said. In migraine, for example,

some known triggers include weatherchanges, strong scents, stress,

hormonal changes and alcohol intake.

Since these triggers are encountered

by most of the general population in

everyday life, trying to tackle each of

these potential problems head-on can

be quite difcult.

Making headwayHeadaches can be complex and r

Tad Seifert, M.D., medical director of theHeadache & Concussion Center, with

Ron Cutler


7/12



Each year, nearly 800,000 Americans experience astroke, and most dont recognize the warning signs.Thats what happened to Judy Lococo of LaGrange.

I couldnt move half of my body, Lococo said. I was

home alone but was able to scoot across the oor to a

phone to call for help.

Once Lococo reached the phone, she realized she was

experiencing another symptom of a stroke the inability

to speak clearly.

When I tried to talk, my words were jumbled and

confused, she said. Luckily, the person on the other end

recognized my voice and knew something was wrong.

She instantly called for help.

A stroke, often referred to as a brain attack, occurs

when vital blood ow and oxygen to the brain is cut off

either from a blockage or hemorrhage. According to the

National Stroke Association, stroke is the third leading

cause of death in the U.S. and a leading cause of serious,

long-term disability.

Strokes can occur suddenly and with little to

no advanced warning, said Asad Ehtisham, M.D.,

neurology. Two million brain cells die every minute

during a stroke, increasing the risk of permanent brain

damage, disability or death. Its critical that people learn

the symptoms of a stroke and act fast.

Acting F.A.S.T. during astroke could save your life

I am one of the lucky ones, Lococo said. I was

immediately taken to the hospital and later transferred to

Norton Hospital for treatment. After several weeks in thehospital and time in rehabilitation, Im pretty much back

to normal with no long-term lasting effects.

STROKE ActF.A.S.T. to save a life

FACE Ask the person to smile.Warning sign One side of the face does not move

as well as the other.

ARMS Ask the person to raise both arms.Warning sign One arm does not move or onearm drifts.

SPEECH Ask the person to repeat a simplesentence, such as You cant teach an old dog new

tricks.

Warning sign The person slurs words or cannot

speak.

TIME Find out when the person was last seen well.Advantage More advanced treatment options maybe available if medical care is received within three

hours of the start of symptoms.If someone you know is experiencing one or more of these

warning signs, call 911 immediately.

Steven Jenkins

Comprehensive stroke care in LouisvilleRecently accredited as a Primary Stroke Center,

Norton Hospital, in conjunction with Norton Neuroscience

Institute, provides full-time comprehensive stroke care.

Patients at Norton Hospital have access to physicians

and surgeons fellowship trained in stroke care,

Dr. Ehtisham said. Norton Neuroscience Institute is home

of the regions only endovascular neurosurgeons specially

trained in advanced treatment of strokes.

For a free stroke symptoms ink pen, call

(502) 629-1234. For more information about

stroke prevention and treatment options, visit

NortonNeuroscienceInstitute.com.

Sal and Judy Lococo with neurosurgeon

Christopher Shields, M.D.


9/12N o r t o n H e a l t h c a r e . c o m / G e t H e a l t h y 5 0 2 - 6 2 9 - 1 2 3 4 9

Five years ago after leaving a bowling tournament,

Ronald Kaelin nearly lost his life to a silent killer

lurking in his chest an aortic dissection. A dissection

occurs when the inner layer of the aorta, the large artery

that supplies blood from the heart to the body, splits

open.

Kaelin underwent surgery and responded well to

medication, until he was threatened by another killer, a

thoracic aortic aneurysm, which is a common occurrence

in people who have had an aortic dissection.

An aortic aneurysm is a bulging in the wall of the

aorta. Most people have no symptoms until the aneurysm

leaks or expands, causing sudden chest or back pain. If

the aneurysm bursts, the result can be deadly.

I was coming out of a bowling alley again and the

pain was so severe I went to my knees, Kaelin said.

Aortic aneurysm is considered a type of heart disease,

our nations No. 1 killer. Those at risk for heart disease

can experience an aneurysm, most commonly men overage 60 who smoke and have high blood pressure and

cholesterol.

Lucky for Kaelin his doctor had begun performing a

new minimally invasive procedure called endovascular

stent grafting to treat aortic aneurysms.

An endovascular stent graft, or endograft, is a mesh

device placed in the aortic artery. In most cases it can be

placed through a catheter inserted into a small incision

near the groin, said John Edwards, M.D., vascular

surgery. This allows the surgeon to x the aneurysm

without all the risks of open chest surgery.

A strike for treatinga deadly vascularcondition

Endograft repair is generally less painful, has a much

lower risk of complications and requires a shorter hospital

stay than traditional surgery, according to Dr. Edwards.

Today, at age 70, Kaelin is back to bowling and working

at his construction business. As the rst patient to receive

an endograft at Norton Suburban Hospital, Kaelin is a

testament to this remarkable advancement in treatingaortic aneurysm.

Im in as good health as I probably ever have been,

Kaelin said. Ive slowed down over the past three years

but only because Dr. Edwards told me I should.

I shouldnt be here, but I am because of him.

Jennifer Reynolds

Want to know more?See the pullout calendar for information about how

you can be screened for vascular disease, including

aortic aneurysm.

As the rst patient to receive an

endograft at Norton Suburban

Hospital, Kaelin is a testament

to this remarkable advancement

in treating aortic aneurysm.Ronald Kaelin of Louisville


10/12G e t H e a l t h y 0

NickBonura

photo

:30 Start with 25 to 30 jumping jacks to warm

up your muscles and get your blood pumping.

:27Push-ups to strengthen the upperbody. Start on knees if traditional position istoo hard; keep abs pulled in and dont let your

back drop. Repeat 10-20 times.

:24Leg lis for core strength. Lying on yourback with your feet in the air or legs bent to

make it easier on your back lower legs toward

the oor and then raise back up.

Repeat 15-30 times.

:21 Jog in place:19 Crunches to strengthen the abs.

Lying on your back, knees bent with feet

on the oor and arms crossed on

your chest, slowly lift your head and

shoulders off the ground using your

abs. Do not pull with your arms.

Repeat 20-30 times.

:16 Squats to work the legs andglutes. Try this exercise with a chairto get the correct form. Stand with your

feet a little wider than shoulder width

apart and slowly bend your knees while

sitting back in the chair, then stand

back up. Repeat 10-20 times.

Give yourself30:13 Lateral shoulder raises. Grab two canned

items from your pantry and use them as weightsor use dumbbells if you have them. Stand up

straight, feet shoulder-width apart and use your

shoulders to raise the arms out to the side until

they are parallel to the ground, then lower arms

back to sides. Repeat 10-20 times.

:10 Bicep curls. Using the same weights, standwith feet hip-width apart, arms by sides and

elbows squeezing your sides, keeping elbows

steady. Using your biceps, curl hands up

toward shoulders and then lower back to

starting position. Repeat 10-20 times.

:07 March in place to cool down. :04Stretch it out

Good job! Youre done!

Workout developed by Lauren Fetz,

certied personal trainer,

[email protected].

Fetz also is pictured in the photo.

A half-hour workout you can do at home


11/1211N o r t o n H e a l t h c a r e . c o m / G e t H e a l t h y 5 0 2 - 6 2 9 - 1 2 3 4

Do you have a cancerprevention strategy?

More on the physicians in

this issue of Get Healthy

Deborah Ballard, M.D.internal medicinedirector o community outreachNorton Cancer Institute Prevention

& Early Detection ProgramNorton Medical Plaza I SuburbanSuite 3004001 Dutchmans LaneLouisville, KY 40207(502) 899-6839

John D. Edwards, M.D.vascular surgeryNorton Vascular AssociatesNorton Medical Plaza II SuburbanSuite 1033991 Dutchmans LaneLouisville, KY 40207(502) 897-0635

Asad Ehtisham, M.D.neurologyNorton Neurology ServicesNorton Medical Plaza II SuburbanSuite 2003991 Dutchmans LaneLouisville, KY 40207(502) 899-6782

Nemr S. Eid, M.D.

proessor and section chiepediatric pulmonary medicine &cystic fbrosisDepartment of PediatricsUniversity of LouisvilleSchool of MedicinedirectorChildhood Asthma Care and Education

Center andthe Cystic Fibrosis Center571 S. Floyd St., Suite 414Louisville, KY 40202(502) 852-3772

Jonathan Reinstine, M.D.obstetrics/gynecologyAssociates in Obstetrics & GynecologyNorton Medical Plaza III SuburbanSuite 300

4121 Dutchmans LaneLouisville, KY 40207(502) 899-6700

Tad Seifert, M.D.neurologyHeadache & Concussion CenterNorton Medical Plaza II SuburbanSuite 2003991 Dutchmans LaneLouisville, KY 40207(502) 899-6782

Robert W. Shaw III, M.D.internal medicineNorton Community Medical Associates

Barret825 Barret Ave.

Louisville, KY 40204(502) 540-7200

James L. Sublett, M.D.clinical proessor and section chieallergy and immunologyDepartment of PediatricsUniversity of LouisvilleSchool of Medicine

Family Allergy & Asthma9800 Shelbyville RoadSuite 220Louisville, KY 40223(502) 429-8585

Louie N. Williams, M.D.physical medicine and rehabilitationNorton Rehabilitation Physicians

Norton Healthcare Pavilion, Suite 185Louisville, KY 40202(502) 629-5455

Physicians quoted in Get Healthyareon the medical staff of one or moreNorton Healthcare hospitals.

There is so much information out there

about cancer, it can be confusing.

Some may feel getting cancer is inevitable

or theres no way to prevent it. But there

is a strategy to reduce your odds of

developing cancer.

Currently, there are two very important

strategies people can employ to prevent

cancer or detect it early enough to improve

their chance of surviving it, said Deborah

Ballard, M.D., director of community

outreach, Norton Cancer Institute

Prevention & Early Detection Program.

The rst is primary prevention toavoid getting cancer through three proven

strategies, according to Dr. Ballard.

1. Do not smoke or use tobacco

products in any form. Lung cancer

is the leading cause of cancer and

cancer deaths in the United States,

and at least 80 percent of cases are

caused by cigarette smoking.

2. Eat healthy and exercise. Obesity

and an unhealthy diet areresponsible for about one-third

of all preventable cancers.

3. Consult a genetic counselor. If

you have at least one close relative

who developed breast, ovarian

or colon cancer before age 50, a

genetic counselor can help you

determine if you have the gene for

these cancers. Some cancers are

inherited; if you are at risk, you can

take steps to help prevent them.

Secondary prevention involves detecting

cancer in an early stage when there is a

better chance of it being cured, according

to Dr. Ballard. Currently, regular screenings

are the best way to detect cancer early.Screenings are recommended for breast,

cervical, colon and prostate cancer.

Many other types of cancer can be

discovered by a physician during a

comprehensive physical exam, Dr. Ballard

said. A yearly physical exam by your

primary care physician should be part of

your overall cancer prevention strategy.

Want to know more?For a free, easy-to-understand chart listingscreening guidelines for cancer prevention,

call (502) 629-1234.

Since the introduction of

Pap smears, deaths from cervical

cancer have decreased by about

85 percent in the U.S.

Even if colon cancer has already

developed, it can be cured in

80 to 90 percent of cases if

detected in its earliest stage.

The ve-year survival rate for

prostate cancer is nearly

100 percent when detected

and treated early.

On average, mammography will

detect 80 to 90 percent of the

breast cancers in women without

symptoms. Early detection by

mammography can lead to better,

less aggressive treatment options.


12/12

A Bariatric Surgery Center of Excellence provider, Norton Weight Management Services has helped more than 5,000 patients

begin new, healthier lives. With advanced surgical procedures and comprehensive weight loss plans to t your goals, we are

condent our expertise can help you. Our staff of dietary and mental health professionals and nurses guide you throughout your

weight loss journey and provide a lifetime of follow-up care because your success is our primary goal. Begin your journey today.

Call (502) 629-1234 to register for a free informational seminar.

We were with her every step of the way.

Norton Healthcare Inc.

P.O. Box 35070

Louisville, KY 40232-5070

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U.S. POSTAGE

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get healthy: hope for headache relief

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