An Alana HealthCareTM PublicationSummer 2011www.alanahealthcare.com

• A Look Inside Alana HealthCare’s New Infusion Center

• The Science of Sleep Apnea • The Power of Yoga and Meditation • The Flow: a Bleeding Disorders Blog in Print

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Dear readers:

As Alana HealthCare continues to grow, our challenges become greater. Since the beginning of 2011, our May/June average monthly specialty pharmacy revenue has grown 91% compared to January/February. Also, the emphasis that our president, Jason Shiflet, has put on wound therapy and APAP ventilation therapy has increased our medical equipment business by over 20% during the same timeframe. The challenges are all part of the growth process, and are a direct result of the hard work put in by every member of the Alana HealthCare team. Of all the challenges that mergers and growth create, however, corporate culture is often the most difficult to explain or change. Generally, corporate culture is defined as the values, customs, and traditions of a particular company. The one cultural value that I believe our company should seek to create is the culture of quality.

I spent the first half of my career in the manufacturing of components sold to U.S. automotive companies. This was at a time when “Made in America” meant cars that were gas-guzzlers and were less stylish and inferior in quality to foreign competitors. Japanese automakers supplied high mileage cars that U.S. consumers wanted to buy. Why? The cars were attractive, fuel efficient, and the quality was excellent. In fact, the Japanese share of U.S. auto sales in 1975 was 7.93%; by 2010, it had grown to 38.1%.

Japan’s productivity was heavily influenced by the work of Dr. W. Edwards Deming, the “Father of the Quality Evolution.” In his book Out of the Crisis, Deming formulated 14 Points to serve as management guidelines. These guidelines improved product quality and, in turn, customer satisfaction. To the detriment of slow-to-act U.S. automakers, Deming contributed directly to Japan’s phenomenal export-led growth and its current technological leadership in automobiles, shipbuilding, and electronics.

I share this story because I have come to realize that many of Deming’s philosophies relate directly to Alana HealthCare. Some of these maxims include:

• Create and communicate to all employees a statement of the aims and purposes of the company.

• Adapt to the new philosophy of the day; industries and economics are always changing.

• Build quality into a product throughout production.

• Work to constantly improve quality and productivity.

• Institute on-the-job training.

• Teach and institute leadership to improve all job functions.

Letter from the CEO

Table of Contents

Letter from the CEO ...................................................... 2

Not Your Average Medical Office ................................ 4

Getting to Know: Dr. Paul Carter and Billy Foster ...... 7

Resting Assured .............................................................. 9

Getting to Know: Chris Schlecht ................................ 11

Changing Positions ...................................................... 12

Finding Your Voice ...................................................... 14

The Flow: A Bleeding Dosorders Blog in Print ........ 15

Wellness 360°An Alana HealthCare™ Publication

Editor: Cory SchneiderGraphic Designer: Barbara MorrisContributors: Mike Gallagher, Bill Griffis, Joan WardPublisher: Amy Massey

208 Dragon DriveDickson, TN 37055Toll-free: (877) 796-9679Fax: (615) 375-1132www.alanahealthcare.com

Steven A. Schneider, CEOJason Shiflet, President

Wellness 360TM is published by Alana HealthCare. The information provided in this newsletter in no way replaces the information and advice provided by a health care professional. A doctor or nurse should be contacted regarding the diagnosis and treatment of any medical condition. Websites and reference information are provided for your convenience only, and Alana HealthCare neither endorses nor supports the statements they contain in any way. Alana HealthCare does not verify the authenticity of these websites or the content they provide.

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• Drive out fear; create trust.

• Strive to reduce intradepartmental conflicts.

• Eliminate pressure for the work force; instead, focus on the system and morale.

• Remove barriers that rob people of pride of workmanship

• Educate with self-improvement programs.

• Include everyone in the company to accomplish the transformation.

How, then, do I believe a culture of quality translates to Alana HealthCare?

The rising cost of healthcare has an impact on our nation’s budget deficit, the Federal government’s policies, and health insurance premiums. The insurance industry, including Medicare and the commercial health insurance plans, are driving down reimbursement rates to all providers. Access to insurance networks is growing more restrictive. The ability of Alana HealthCare to compete in the future will be in part determined by proving our ability to provide high quality patient care and demonstrating that our integrated delivery model of medical equipment and specialty pharmacy services has long-term cost benefits to patients and insurance payers.

The marriage of DME Tennessee, Alana HealthCare Pharmacy, and Alana HealthCare Infusion Centers is unique. Together we have the opportunity to service patients across the healthcare spectrum, with services that include: respiratory therapy, mobility equipment, wound therapy, hospital and home ventilation equipment, home infusion, oral medications, and alternative infusion centers for the treatment of chronic diseases. As we continue to expand our capabilities, we’ll even be delivering door-to-door within hours of a physician referral.

The most important steps that we need to take are happening right now. We are upgrading software across the company in order to link multiple departments for the first time. With the proper education and training, we will best be able to gather the type of information that will improve the health and well-being of our patients—and to provide to Federal, state and commercial insurers the type of outcome data that helps to lower the cost of the care they seek. Alana HealthCare can position itself as a regional leader in the delivery of a basket of healthcare services that our competitors do not provide, with the high degree of patient care they do not even attempt to include.

We are all connected; without sales, we do not bill or collect. If we do not carry the correct inventory of the products the physicians prescribe, or we do not deliver and service the patients on a timely and professional basis, our reputation will suffer and our sales teams have a tougher sell. Making the commitment to earn the reputation for delivering the highest quality of care means that management must provide the training and resources to make that goal come true.

The integration of the durable medical equipment and pharmacy businesses was not easy. Merging or changing cultures never is. If all of us make the choice to deliver the highest level of care possible to the patients of our referral sources, the rewards will follow. And through that commitment, we will no doubt find that we have created and nurtured a culture of quality.

Thanks,

Steven A. Schneider Chief Executive Officer

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For many people, just the thought of getting a medical procedure conjures up thoughts of an unpleasant experience: a waiting room crowded with other patients (often coughing left and right); an interminable wait just to get attention; and the numbing effect of beige walls and sterile plastic chairs. When it started thinking about what its new Infusion Center in Nashville would be like—what it would feel like for patients—Alana HealthCare decided to turn that paradigm on its head.

Why should the patients who visit the Center be forced to stare at bland paint-by-number watercolors and flip through a three month-old issue of Highlights magazine? Instead, the individuals behind the Center, which opened its doors in April, brainstormed ways to enhance the patient experience and make those coming in for their monthly, bimonthly, semiannual, or annual infusions feel right at home.

Leading the Charge

Behind all of its decisions, Alana HealthCare is driven by finding healthcare solutions that streamline the services patients receive. Living with a chronic condition is difficult enough and the last thing anyone wants is to have his or her life impeded on any further.

While the Alana HealthCare Infusion Center certainly will not be utilized by every patient referred by their physician to the company, it will significantly improve the lives of those individuals with

conditions—ranging from autoimmune disorders to Crohn’s disease to rheumatoid arthritis and multiple sclerosis and primary immune deficiencies—that require intravenous therapies of specialty medications.

Dr. Paul Carter is the Medical Director of the Center. An allergist and immunologist based in Knoxville, he joined the Center in March to help develop its protocols. Since then, Carter has taken on an active role and supervises the nurses and nurse practitioners that provide patient care. Carter has a regularly scheduled on-site presence to manage all of the Center’s administrative and clinical needs, while coordinating with its staff of nurses and pharmacists.

According to Carter, it is the Center’s novel approach to patient care that first encouraged him to join in its creation.

“In the past, patients who needed infusions had to go to the hospital, get admitted, and usually stay overnight,” he said. “For those patients to receive the treatment they needed, and maintain their qualities of life, they had to spend as much as a day-and-a-half at a time—sometimes every month. It just didn’t make any sense.”

Alana HealthCare Infusion Center changes all of that. In contrast to the typical hospital ordeal, patients are able to come in, receive their infusion, and go home within hours. Moreover, a major perk patients will notice right away is the Center’s convenient location near Centennial Park (at 214 25th Avenue North) and within blocks of three major

medical centers in Nashville—Baptist Hospital, Vanderbilt University Medical Center, and Centennial Medical Center.

“The ease of access is one of our greatest assets,” Carter said. “We’re doing something new for Nashville—and helping to lead the charge for healthcare, too.

Steven Schneider, Alana HealthCare’s Chief Executive Officer, echoed Carter’s sentiments about bringing a new form of patient services to the area.

“Nashville has one of the highest concentrations of healthcare services companies in the country, but there are less than a handful of alternative infusion sites,” he said. “This is a chance for us to improve the lives of our patients while diversifying

By Cory Schneider

Not Your Average Medical OfficeAlana HealthCare Infusion Center of Nashville is taking the company’s “Patient First” mission to a whole new level

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our business and adding a service that our competition just doesn’t have.”

But the Center aims to improve patients’ treatment experiences with more than a well-located building. In addition to free on-site parking, once patients are greeted by reception, they will be privy to the various benefits chosen

with them in mind. The Center features ergonomically designed reclining chairs to sit in while receiving infusions, wireless Internet, brand-new individual flat-screen televisions, and beverages and snacks.

Receiving a life-sustaining infusion is always going to come with a certain amount of discomfort, but the minds behind the Center have tried to make

the patient experience as painless as possible—in more ways than one.

A Smooth Transition to a New Kind of Care

As Senior Charge Nurse, Billy Foster has been responsible for administering patient care each day since the Center opened.

“So far, everything has gone really well,” he said. “The patients that we’ve worked with have really enjoyed their experiences. The homey feeling we wanted the Center to convey is definitely being felt. Patients come in, receive their treatments, watch some television or surf the ‘web,’ and before they know it, it’s time to go home.”

In addition to administering patients’ medications, in his position, Foster is responsible for another important component of the Alana HealthCare Infusion Center experience: education. That is, he works with patients to teach them about the medications they are receiving and what to expect both during and after therapy. Foster sees this as an essential service that sets the Center apart.

“We do what is necessary to make patients as comfortable as possible,” he said. “That includes making sure they have all of the information they need. That information is peace of mind. It’s just another way to add to the already relaxed atmosphere we’re trying to provide.”

Patients may be so relaxed, Carter added, that they might not notice some other big

New Infusion Center continued on page 6

In contrast to the typical hospital ordeal, patients are able to come in, receive their infusion, and go home within hours.

advantages of receiving their infusions at the Center.

“Without having to check in and stay overnight at the hospital, patients are cutting back on the money they’re spending on their care,” Carter said. “Part of improving healthcare is making sure that it’s cost effective. Patients aren’t only saving time; with us, they’re saving money.”

And while patients may certainly be aware of the cost benefits to their insurance company, they might not be aware of the fact of just how much better a visit to the Center is for their health.

“At the Infusion Center, you’re not coming into contact with various forms of viruses and diseases, as you might naturally be confronted with in a hospital setting,” he said.

In fact, patients are saving themselves from headaches in more ways than one.

Improving On a Good Thing

In its ongoing effort to change the way its patients receive healthcare, the company also decided that the Center alone was not

enough; it needed a limited pharmacy to support its goal of giving infusion patients the best service possible. In May, the Tennessee Board of Pharmacy licensed a new on-site pharmacy that now allows its pharmacist to consult with patients and mix and dispense medications.

“This opening takes our mission of making patients our top priority one big step forward,” said Jeff Black, Director of Pharmacy Operations for the Center. “By opening a pharmacy focused on our patients at the Center, we are delivering quality care that just cannot be beat. We’re making the experience even more seamless for patients and, at the same time, taking our company to the next level.”

Enrique “Henry” Hernandez, Alana HealthCare’s Director of Pharmacy and Clinical Operations, called the opening of the pharmacy he oversees a “win-win situation” for patients.

“Patients are no longer limited in any way,” he said. “They don’t have to go to the hospital every twenty-eight days in order to be infused. They can get their medications in a relaxing environment with highly trained professionals and then they can go straight home. And they’re receiving their infusions in a way that keeps their costs way down.”

If Alana’s mission is to make a difference in patients’ lives, Black observed, than this new pharmacy is “improving on a good thing.”

While the Alana HealthCare team is proud of the Infusion Center and its new pharmacy, according to Carter, it certainly is not planning on resting on its laurels.

“Down the road, we’re going to expand,” he said. “We’ve been able to accomplish this huge undertaking so flawlessly—though not without considerable effort—and I am excited to see what the future holds for us. I know everyone at the Center is eager to be a part of doing what a lot of people in this business aren’t worried about: simply making patients lives better.”

For now, though, the dedicated staff just wants its patients to sit back, relax, and enjoy their surprisingly brief stay at the Center. After all, there are worse ways to spend a few hours than catching up on current events or the latest game or what is happening on a favorite soap opera—even if that has to happen while receiving a life-sustaining drug therapy.

New Infusion Center continued from page 5

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Getting to Know...

By Cory Schneider

When you walk into a doctor’s office or other medical facility, it is pretty evident who is responsible for providing care. Or, in some cases, who can save your life. But when you are attending a college friend’s wedding or are out hiking this summer, such matters of personal health may be far from your mind. Of course, doctors and nurses are people, too—and they just might be crooning the first dance song as you sway to the beat.

At least that’s the case for Dr. Paul Carter and Billy Foster, two recent additions to the Alana HealthCare team and the men responsible for much of the care administered at the company’s new Infusion Center in Nashville. Carter is the Center’s Medical Director, while Foster is its Senior Charge Nurse. Both have played important roles in helping the Center to get up and running and become an instant success for the company. (For more about the Infusion Center, please see our article, “Not Your Average Medical Office,” in this issue.)

Dr. Paul Carter, an allergist and immunologist with a private practice in Knoxville, first joined Alana HealthCare Infusion Center in March to help develop its protocols. He said he was drawn to work with Alana HealthCare because of his larger interest in improving the quality of healthcare nationwide.

“Giving top quality care to patients outside of home and hospital settings is something that’s important to me,” he said. “We can keep the cost to patients and their insurance companies lower,and that’s exciting. But we can also make the care more personalized. That’s not something that everyone’s invested in doing.”

Carter has sought out ways to contribute to the improvement of healthcare in a number of ways. He still devotes 40 hours every week to his practice in Knoxville, but dedicates time each day to check in with the Infusion Center and supervise the nurses and nurse practitioners that provide patient care. He also has a regularly scheduled on-site presence to manage all of the Center’s administrative and clinical needs and to coordinate with its staff of nurses and pharmacists.

“I’ve always had extracurricular activities,” he said.

One such activity includes the pursuit of his Master’s Degree from Harvard University’s School of Public Health a few years ago. After receiving his medical degree from the University of Tennessee and performing his internship in Memphis, Carter went on to join the United States Air Force and serve as an emergency medical physician for a couple of years. He made the

Dr. Paul Carter and Billy FosterAlana HealthCare Infusion Center’s Team

decision to pursue allergies and immunology in 2000 and has not looked backed since.

The Master’s Degree came as a result of wanting to do and contribute more to his field. The unique program allowed Carter to remain in Knoxville—where he lives with his wife and in close proximity to his family—and take his coursework in condensed sessions over the summers and during regularly scheduled weekends. Aside from having the chance to meet and exchange with a diverse cross-section of people in his field, Carter credits his time at Harvard with allowing him to intellectually go beyond what he learned earlier in his career.

“I knew that I had to understand the delivery of healthcare better, to get a clearer snapshot than the one I received in medical school,” Carter said. “I began to learn about the business side of healthcare and realized as much as practicing medicine is important to me, I was also interested in looking at opportunities in administration.”

His new role at Alana HealthCare has provided Carter with the outlet he was seeking.

“The work we’re doing is really at the forefront of trying to provide patients with accountable care,” he said. “We’re working closely with insurance companies and hospitals to develop strategies for delivering services in new, exciting ways. And it’s all being done at a lower cost, which I know is important to our patients.”

When he’s not working out ways to improve healthcare, Carter is enjoying living in a state rich with chances to partake in outdoor recreation. He named activities such as hiking, biking, skiing, and water sports as among some of his favorite pastimes throughout the year.

Dr. Paul Carter and family

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Carter and Foster continued on page 8

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“We have plenty of warm months, but we also get our taste of winter,” he said. “That’s what I love about Tennessee. It definitely has its own flavor.”

While he’s certainly no stranger to the hiking trails of Nashville, you’re more likely to find Billy Foster behind a microphone at local music institutions, like Tootsie’s, in his free time. Foster’s love of music stretches back to his childhood and

his time attending Western Kentucky University on a full music scholarship. Though he originally wanted to become a music teacher, he found a career in nursing that ultimately allowed him to pursue two passions at once—working with patients during the day and singing his heart out by night.

“I moved to Nashville out of college and got started at a big hospital here,” he said. “The more I worked in healthcare, the more I appreciated the people I was meeting and helping. I went on to become a director of nursing at a surgery center, but everything I did led me to work with infusions now.”

In addition to administering patients’ medications, Foster cited education as an essential component of the role he plays at the Infusion Center. Each day, he works with patients to teach them about the medications they are receiving and what to expect both during and after therapy. He said that this step isn’t just important for patients, but it helps set the Center apart in terms of patient experience.

“We do what is necessary to make patients as comfortable as possible,” he said. “That includes making sure they have all of the information they need. That information is peace of mind. It’s just another way to add to the already relaxed atmosphere we’re trying to provide.”

Foster, who also joined Alana HealthCare in March, said he, too, appreciates the opportunity to provide infusion patients with an alternative to being admitted to the hospital each month. He explained that he’s thrilled to be part of a healthcare trend that’s “catching on,” and is looking forward to playing a part in continuing to push patient care in more positive directions.

In the meantime, though, Foster will be pushing himself to add new songs to his repertoire, which already includes music that ranges from country and contemporary Christian to what he called “Josh Groban-style music.” His voice has landed Foster at weddings, rodeos, and in recording studios where has provided backup vocals for other artists. This is all the more impressive when you realize that he’s gotten work mainly through word of mouth.

“I’m hungry for it, but not hungry enough,” he said. “Still, I love to sing and I grew up listening to old country music with my parents.”

Interestingly, Foster’s career in nursing has been just as diverse as his musical interests.

“With nursing, you can go down any avenue you want to and I’ve had the chance to try out all kinds of specialties,” he said.

When he’s not nursing or singing, this Scottsville, KY native spends time with friends and his two Jack Russell terriers. And he’s always finding new ways to take advantage of Nashville—and more than just its music scene.

In general, though, he’s looking to live a laid back life—mirroring the kind of relaxed environment he and Carter try to create in the Alana HealthCare Infusion Center.

“We’ve found a way to make the Center feel homey, not clinical. I’m really enjoying myself,” he said. “So far, everything’s gone smoothly and our patients have given us really positive feedback.”

Carter brought it back to the patients, too.

“In my office, I can only work with one patient at a time, but with Alana, I’m able to effect changes on a larger scale. We all are,” he said. “Together, we’re setting a good example for other companies hoping to do the same thing and we’re improving lives.”

Billy Foster

Getting to Know...

We do what is necessary to make patients as comfortable as possible. ... We’ve found a way to make the Center feel homey, not clinical.

Carter and Foster continued from page 7

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By Cory Schneider

On a recent weekend road trip, Chris Schlecht realized he forgot his continuous positive airway pressure machine (CPAP) at home. Schlecht uses the CPAP to combat the symptoms of sleep apnea, which have the power to leave him feeling enervated the next day after a fitful night of sleep. Having become used to using the machine nightly, Schlecht, a respiratory sales representative for DME Tennessee (DME), a subsidiary of Alana HealthCare, knew his vacation wouldn’t be nearly as relaxing as he planned if he tried to sleep without it.

“I hate the feeling I have the next day when I don’t use the CPAP the night before,” he said. “I’m sleepy, my blood pressure feels elevated, and my body feels totally off. Mentally, physically, I’m out of it.”

Schlecht knew what he had to do: he turned the car around, got the machine, and went right back on the road to resume his vacation. His story demonstrates the power of the CPAP, a device that, while sometimes

uncomfortable, is the key to transforming the nights of patients diagnosed with sleep apnea.

The Science of Sleep

Sleep apnea is a disorder characterized by disturbances in breathing – lasting anywhere from a few seconds to minutes – that can occur several times an hour. Obstructive sleep apnea occurs when the upper airway

becomes narrow as the muscles relax naturally during sleep. This reduces oxygen in the blood and causes arousal from sleep. Patients are rarely aware of these disturbances in breathing, but common symptoms that identify sleep apnea include snoring and daytime sleepiness and fatigue.

Dr. Teresa Zygleska, a neurologist based in Nashville, has become something of an expert in sleep apnea. She first became interested in the disorder years ago when she made the connection between her father’s death from a heart attack and the likelihood of his having suffered from sleep apnea.

“My father used to snore loudly and everyone thought he was sleeping well,” she said. “We didn’t know what it was. Since then, I have looked into a potential cause [for his heart attack] and I’ve found it. There is a close correlation between heart attacks and sleep apnea, and there is a lot of work to be done here.”

That work begins when a patient comes to Dr. Zygleska for a sleep study. The sleep study, or polysomnography, attempts to formally diagnose the presence of a sleep apnea by measuring the number of apneic events per hour of sleep. Using data from the sleep study along with symptoms such as excessive daytime sleepiness and fatigue, physicians like Dr. Zygleska can make a determination about a patient’s condition.

Dr. Zygleska recommends that before they come to her, if patients become aware of

these symptoms on their own they should not hesitate to speak with their regular doctors.

“Initial tests of lower oxygen levels could point to a larger problem,” she said. “It’s important to talk to your physician if you notice excessive snoring or you’re often sleepy during the daytime. Those symptoms, combined with being overweight, could mean that there’s a problem.”

But the presence of sleep apnea is not necessarily due to being overweight, alone. In fact, Dr. Zygleska explained that other major contributing factors include the size of a patient’s neck, his anatomical variation, how his tongue is situated, and the tissue at the back of a patient’s throat. Taken together with other information, these physical symptoms may indicate an obstruction in breathing.

Beyond heart attacks, Dr. Zygleska’s work has shown significant linkages between sleep apnea and other potentially fatal diseases and

Resting Assured

Dr. Teresa Zygleska

Often a silent killer, sleep apnea is increasingly simple to diagnose and treat – and Alana HealthCare is committed to working with physicians to help patients breathe easier

Rest Assured continued on page 10

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keeping the airway open under air pressure so that unobstructed breathing becomes possible.

“The CPAP is the most effective and reliable device we have for treating sleep apnea,” said Dr. Zygleska.

In order for a patient diagnosed with sleep apnea to receive and begin using a CPAP, Dr. Zygleska must write a prescription to a medical equipment company. DME Tennessee has proven to be the company she trusts.

“There are many DME companies on the market,” she said. “Unfortunately, many of them do McDonald’s, fast food-type business. That’s not the case with DME Tennessee. They are one of the few who care.”

Dr. Zygleska’s go-to person at DME Tennessee is Melissa Begin, a respiratory therapist. Begin

visits patients’ homes to help them set up to use the CPAP and to steer them through the often difficult transition of sleeping with the machine.

“We’re improving the quality of patients’ lives, but it isn’t always easy,” said Begin. “Often, in addition to the CPAP, we’re recommending a whole change in lifestyle. To keep sleep apnea in check, patients need to think about their diets, the amount they exercise, and how they can live healthier lives.”

In their work together, Dr. Zygleska has noted that Begin seems to have a magic touch with patients, who are often turned off by the uncomfortable nature of the CPAP machine.

“For people to understand what it’s like to sleep with the machine, imagine driving 70 miles per hour with your head out of

the open window. That’s how patients can feel,” said Dr. Zygleksa. “Patients need that pressure when they’re sleeping, but not when they’re awake, so it can be hard to get used to falling asleep. It’s not easy to be compliant. You need people like Melissa to work with patients, to emphasize the importance of using the equipment. Melissa takes extra steps and extra time. She has a caring personality that not everyone has.”

Physicians and patients also need to work with people who understand the disorder and CPAP firsthand. That’s why, in addition to speaking with physicians on behalf of DME Tennessee, Schlecht helps out with patient setups and compliance.

“Because I sleep with the CPAP, I respect the machine,” he said. “But I also know how difficult it can be. It takes some getting used to, but in the end, I wouldn’t sleep without it. I let patients know that. It’s important for them to know how much it can change their lives.”

For DME Tennessee, part of effecting that change includes remaining a constant presence for patients. According to Begin, after their initial setup, many patients don’t see other companies’ representatives again. DME Tennessee, she said, does things differently.

“We’re constantly following up with patients and making sure that things are going smoothly with their machines,” she said. “We keep their doctors in the loop, but we don’t want patients to have to visit their physicians every time there’s an issue. We’re more than happy to come out and take care of any issues right away. It’s what should be done.”

It’s that thoughtfulness and quality of care that Dr. Zygleksa has come to depend on.

“We used to have relationships with many companies, but we’ve had to end many of them,” she said. “I’m only interested in working with people who care—and that’s DME Tennessee. We’re happy when our patients are satisfied and, so far, we know they have been.”

conditions, such as diabetes, hypertension, strokes, and, in some cases, neurological disorders. She uses the data from the initial sleep studies—during which patients come to her office and sleep for one night with electrodes attached to their heads, chests, and bellies and a probe on their fingers to measure heart rate and oxygen intake—to determine what course of action patients need to take. Often, there are simple answers, like changing the sleep position

“There are certainly mild cases, “ she said. “Position therapy can help as we guide

patients toward sleeping on heir sides, rather than on their backs.”

But in more severe cases, Dr. Zygleska recommends a more aggressive treatment. That is where her work with Alana HealthCare and DME Tennessee begins.

Towards a Better Night

When a patient needs more than a change in sleep position, Dr. Zygleska is likely to recommend that same device that Chris Schlecht swears by: the CPAP. The machine is a mobile ventilator that can be used at home. The CPAP machine stops the reduction of oxygen in the blood and the arousal from sleep by delivering a stream of compressed air via a hose to a nasal pillow, nose mask, full-face mask, or hybrid,

Rest Assured continued from page 9

Chris SchlechtRespiratory Sales Representative

Chris Schlecht

Getting to Know...

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By Cory Schneider

AlanaHealthCare prides itself in the fact that its patients can feel safe and secure in the care of all of its employees. But one member of the team, in particular, is actually trained to keep all of us out of harm’s way—and not just protected from disease or medical discomfort. Chris Schlecht, a respiratory sales representative, came to Alana HealthCare with two years of active duty in the United States Army and six years of service with the National Guard. If that isn’t a commitment to well-being, he isn’t sure what is. As a respiratory sales representative, Chris Schlecht works with the respiratory health team of DME Tennessee (DME), an Alana HealthCare Company, to speak directly with physicians and patients about the services the company provides to those with breathing-related complications. Moreover, a trained respiratory therapist himself, Schlecht works with the other therapists on the team to set patients up for services such as continuous positive airway pressure (CPAP) machines to aid with sleep apneas, work with labs to obtain patient test results, and continue working with patients to maintain compliance with their service protocols.

There is a lot involved with the position, then, but that isn’t something that Schlecht was thinking about when he first considered entering the profession. Originally, he was faced with the choice of pursuing nursing or respiratory therapy.

“This field has so much to offer,” he said, “but I didn’t really care for the hospital setting. I was looking to help people maintain a healthy standard of life in a different way.”

Respiratory therapy provided Schlecht with that opportunity. He received his respiratory training through the U.S. Army and recalled that he “enjoyed the heck out of it.”

His decision to join the army came as a result of a couple of factors. First, Schlecht said, he had felt the call to serve his country since he was young boy growing up in Mobile, AL.

“It had been something I wanted to do since high school,” he said. “I was at a point in my life where I wanted to, needed to, grow up. The Army provided a great avenue to do that.”

Second, he had a close cousin who had been in the Army and had great success. As luck would have it, the Army was looking for additional medical personnel, and Schlecht’s two interests intertwined. He ended up stationed at Fort Sam Houston in San Antonio, TX and though he did not see “any action,” he said that the training he received and the friendships he made have lasted him to this day.

“Each soldier is truly there for you,” he said. “I can’t even explain the camaraderie. You just have to be there to know it. But I have lifelong friends and I’m grateful.”

Following his duty, Schlecht moved back to Alabama where he began his career as a therapist in earnest. While there, his responsibilities in patient care increased and he grew in the various positions he held.

Eventually, however, family obligations brought Schlecht to Nashville in 2008. He said he wanted to spend time with his aging parents and to play a more active role in the lives of his niece and nephew. Since then, he has found Nashville to be “absolutely great,” and said that aside from the occasional traffic jam, he has no complaints.

Schlecht came to Alana HealthCare six months ago after working for another home healthcare organization. He said that he was encouraged to join Alana and DME because of its “patient first” philosophy.

“The people who work here are true patient advocates,” he said. “That’s something that’s hard to find with your larger medical equipment companies. They’re more focused on the bottom line and they put their patients second.”

Moreover, Schlecht was excited to get back into a position and an area that he knew so well. What his patients often don’t know when first meeting him is that Schlecht uses a CPAP at night and has for the past three years. His experiences with the CPAP and initially going through the motions to get one have given him “great respect for the benefits of sleeping with one.” Knowing firsthand what it’s like to sleep with the machine has allowed Schlecht to bond with patients that much faster.

“I was once travelling to Kentucky for a short vacation and realized I forgot my machine at home,” he said. “Even though I had already driven two hours, I turned around and went to get my CPAP because I just didn’t want to go four nights without it. It wasn’t worth it to have my body all out of whack.”

If Schlecht is willing to brave the Nashville traffic he isn’t fond of for a CPAP machine, then the patients and physicians he works with each day can be confident that they’re working with one dedicated man.

12 www.alanahealthcare.com

You know the headlines: “Chronic stress has been linked to increased reports of illness.” You’ve felt busy, hectic, and out of control. Everyone has. But behind the headlines lies the truth that stress does take a toll on your well-being.

Certainly, we can try to manage our stress as a way of coping and lessening our chances of becoming ill. While stress is not going to go away, with effort, we can work to diminish it and the negative effects it may bring about in our lives.

Stretching the Stress Away

One way to cope with life’s stresses is yoga. Yoga offers a gentle, tolerant, and non-competitive approach to life. The practice of yoga helps develop a focused awareness of what is happening within your body physically, mentally, and emotionally. Developing an awareness of bodily sensations and feelings is the first step to reducing stress and using yoga therapeutically in healing.

First, yoga teaches us to be mindful of the onset of stressful stimuli and then teaches practices to prevent or counteract the physiological responses that typically follow. With regular yoga practice, awareness develops and students can extend more and more control over what happens to them physiologically and psychologically. What was once a body’s automatic reaction soon becomes nipped in the bud before becoming a full-blown stress response. In the face of challenges, yoga practitioners can remain calm and centered and experience balance and poise. The attention to breathing is calming and any anxiety or stress felt can be suspended.

Finding a New Center

Meditation, like yoga, is a great stress reliever and there is increasing evidence that this ancient practice can make people happier and healthier. Just a few minutes per day spent meditating can restore your inner peace and calm. During mediation, you focus your attention and reduce that jumbled chatter in your mind that can make you feel anxious and distracted. The practice of meditation often results in better physical and emotional well-being.

When learning to meditate, a guided meditation may be the best place to start; typically a guide or teacher leads you through this process. With this method of meditation you form mental images of places or situations you find relaxing. You try to use as many senses as possible—conjuring up smells, sights, sounds, and textures. The more elaborate your guided imagery or visualization, the better. It’s not uncommon for your mind to wander during meditation. When it does, just gently remind yourself to bring the focus back to the relaxation.

One form of mediation, mantra meditation, requires you to silently repeat a calming word or phrase to prevent distracting thoughts. When the distracting thoughts arrive, and they will, you acknowledge the distractions and try not to attach judgment to them. Then you dismiss the interruption and return to your mantra.

Another form, mindfulness meditation, requires you to have an increased awareness and acceptance of living in the present moment. You focus on what you experience during meditation, such as the flow of your breath. You can observe your thoughts and emotions but let them pass through without judgment. As with yoga, meditation asks that you be gentle with yourself. A meditation break allows you to escape the stresses in your life and allows you to come back feeling recharged and refreshed.

Also keep in mind that meditation is a practice and, like yoga, the more you do it, the more effective it is in reducing your stress. Both practices encourage you to live “in the moment,” focusing less on what is going on outside your body and more on the sensations you are feeling in your body.

The Science Behind the Silence

The human body has two nervous systems: the sympathetic and the parasympathetic. The sympathetic system, commonly known as the “fight of flight system,” causes the blood pressure to rise, the breath to quicken, and stress hormones to flood into the body. Historically, this prepared our bodies to fight large animals when necessary. Fortunately, we rarely need to save ourselves from large animals today, but this is the same metaphysical experience our body goes through while sitting in traffic and our anxiety starts to increase.

When the sympathetic system is overly stimulated, it can result in negative health consequences. It sends messages to muscles, organs, and glands that cause the body to instinctively react. Powerful chemicals, such as adrenaline, neurotransmitters, and hormones, are

Changing PositionsUsing Yoga and Mediation to Undo the Stress

By Joan WardComprehensive Health Education Services

13

released and have multiple effects on the body. They cause increases in heart rate, blood pressure, stomach acid production, muscle tension, circulating levels of blood sugar, and cholesterol. These chemicals, when released in the body, can also cause blood to thicken as well as produce abnormalities in immune function. For the short term, these effects are adaptive and help a person prepare for responding to the stressor. However, these physical reactions, if left unchecked, can lead to illness. Many health professionals believe that 80% of all illnesses may be stress related.

The parasympathetic system, also known as the “rest and digest” nervous system, lowers the blood pressure and slows the pace of the breath. When blood isn’t needed to rush to the muscles it is free to rush to the digestive, reproductive glandular, and immune systems. Studies have shown that long, deep breathing encourages reaction in the parasympathetic nervous system and allows relaxation and healing to occur. The yogi practices breathing meditations called pranayama, a Sanskrit word meaning “extension of the life force.” These breathing meditations encourage the functioning of the parasympathetic nervous system.

The quality of the breath reflects the quality of the mind. When we are frightened our breath

is short and shallow.

Likewise, when we are relaxed or asleep our breath is long and deep. When you unwind and slow the pace of your breath, the pace of the mind is similarly calmed and quieted. When we become overwhelmed, yoga and meditation teach us to use our breathing to help find a state of serenity. While struggling with life occurrences that may make us feel out of control, breathing is something that can be controlled. Focusing on the breath also helps us stay in the present moment. And when you stay in the present moment you eliminate extreme thoughts about all that could go wrong.

The Relaxation Response

The simple practices of yoga and meditation may lead to optimal physical health as well as to a state of peace. Both yoga and meditation bring about the “relaxation response,” a phenomenon described by Dr. Robert Benson of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General as “a physical state of deep rest that changes the physical and emotional responses to stress (e.g., decreases in heart rate, blood pressure, rate of breathing, and muscle tension) and the opposite of the fight or flight response.”

Whether you practice meditation alone or as a part of a yoga routine, you will reap the benefits of coping with life’s daily stresses by activating other areas of the brain. When your body and mind are at peace, you’re better able to repair and rejuvenate. And then you can face the day—and all of its strains—with a whole new attitude: a positive one.

Sometimes, the key to a new attitude lies is lying down (or knotting up) and letting go

14 www.alanahealthcare.com

In my 25 years of working in healthcare, one of the consistent highlights of my career has been working closely with patients and having a hand in their care. But in the last couple of decades, I have noticed that some healthcare providers occasionally—and unintentionally—miss

the incredible opportunity to benefit from the “feedback and pulse” taken from the very people we serve.

It is vital to remember that every patient has a voice and, in turn, a unique perspective. As healthcare providers, we will never experience exactly what

the patient does and we need to realize that some of the best ideas concerning healthcare may indeed come from the outside. Patient feedback can be used by the provider in order to improve the quality of healthcare in many different ways.

Patient involvement in the process is extremely important and should include: obtaining the appropriate number to call in case there is a concern; having an e-mail or mailing address; giving precise information concerning the complaint or inquiry; providing company representative names, if possible and appropriate; and, offering suggestions on what could have been done differently.

Healthcare providers should have a system in place to process these complaints, inquiries, and concerns in an efficient manner that results in action. Providers need to employ staff that is well trained and skilled at channeling the information to the appropriate individuals. Doing so will increase the probability of resolution. The “appropriate individual” should be someone of authority possessing the capability to facilitate a real outcome.

With complete and current information provided by patients, healthcare providers are not only able to rectify the immediate situation, but will most likely be able to make changes that improve the experiences of future clients.

Patients will benefit from this empowering process by using this outlet as a tool to express their concerns and their desires for changes in care and overall service and experience. If you are a patient who has had reservations about raising a concern in the past – or you know a loved one who has remained silent for any reason – now is the time for patients’ voices to be heard.

Finding Your VoiceKnowing when and how to voice a concern to your healthcare provider can make a major difference – for you and all patients

By Mike GallagherVice President of Government Affairs, Alana HealthCare

Advocacy

15www.alanahealthcare.com

Welcome to the inaugural entry of The Flow, our printed blog that explores Alana HealthCare’s bleeding disorder program. In each edition of Wellness 360, we will discuss important issues surrounding bleeding disorders, provide the most cutting edge information, and make sure that as soon as we are made aware of the facts you need to know, we are sharing them.

What We Do For Bleeding Disorders

Alana HealthCare is committed to helping those individuals and their families who struggle with chronic bleeding disorders live rich, fulfilling lives. Our company is a patient-focused organization dedicated to going the extra mile for people and making sure that when they call upon us, they always receive personalized service. Every employee gives our patients and their loved ones the complete attention we believe they deserve.

There are two things to know upfront: Alana provides all of the various clotting factors currently available for all bleeding disorders and we accept all patient referrals. If we are not able to service a patient, we will provide information for a participating provider. In addition, we take pride in offering coordination of benefits and insurance verification. Further, we also offer assistance with medication management and adherence.

At Alana, we recognize the importance of receiving your medication on time, every time. You can also always trust that we will deliver medication on time. We offer same day or overnight delivery of medication for our patients. Finally, Alana offers the peace of mind of having our pharmacy staff available 24 hours a day, 365 days a year. You will always have the opportunity to speak with a live person to ensure that the questions you have receive answers as soon as possible.

What We Do For You

In our next edition, we will start to delve into the important issues facing you and your bleeding disorder. But now that you know a bit about our company, I would also like to take the time to introduce myself. My name is Bill Griffis and I work directly with the bleeding disorder community for Alana HealthCare. I have lived with severe hemophilia for 41 years. In my lifetime, I have seen the trials and tribulations that have faced our community. My focus has been, and always will be, you, the patient. I approach our community with a positive attitude. I believe that a positive attitude can help a person through any situation. My goal is to educate the community and, most of all, listen. I am always here for you. I have been truly blessed to meet some of the most dynamic people in the world through events sponsored by the bleeding disorder community. My goal is to continue this tradition. I am truly proud to say that all of us at Alana live our company’s mission: “Healthcare solutions are our business, patient care is our promise.” If you ever have any questions, please feel free to contact me at bill.griffis@alanahealthcare.com or (484) 336-3357. And if you have ideas for issues you would like covered in future editions, I would love to hear that, too.

A Bleeding Disorders Blog in Print

By Bill Grffis Infusion Sales Specialist, Alana HealthCare

The Flow

Getting Into The Flow

My goal is to educate the bleeding disorders community and, most of all, listen. I will always be here for you. – Bill Griffis

Corporate Headquarters

Alana HealthCare, LLC208 Dragon DriveDickson, Tennessee 37055Telephone: (615) 375-1094Fax: (615) 375-1132Toll-free Phone: (877) 796-9679www.alanahealthcare.com

DME Tennessee, LLC: DME of Dickson760 Hwy 46S Dickson, TN 37055Office: (615) 446-7444 Fax: (615) 446-7483

DME of Jackson117 North ConalcoJackson, TN 38305Office: (731) 660-5080 Fax: (731) 660-0025 DME of Union City1200 B South Bishop St.Union City, TN 38261Office: (731) 885-2122Fax: (731) 885-2177 DME of Dyersburg1083 Vendall St. Dyersburg, TN 38024Office: (731) 286-1000 Fax: (731) 286-1001 DME of Clarksville1817 Madison St. Suite 5Clarksville, TN 37040Office: (931) 503-1309Fax: (931) 503-1313

subsidiaries

Alana HealthCare Pharmacy, LLC:208 Dragon DriveDickson, Tennessee 37055Telephone: (615) 375-1094Toll-free Phone: (877) 796-9679Toll-free Fax: (877) 471-2484

Alana HealthCare Infusion Centers, LLC:214 N 25th Avenue NNashville, TN 37203Office: (615) 375-1094

DME of Erin15C North Boone St.Erin, TN 37061Office: (931) 289-3947Fax: (931) 289-5308 DME Orthotics and Prosthetics127 Crestview Park Dr. Ste 104Dickson, TN 37055Office: (615) 740-0177 Fax: (615) 740-1154 DME Orthotics and Prosthetics1817 Madison St. Suite 5Clarksville, TN 37040Office: (931) 503-1309 Fax: (931) 503-1313

DME of Nashville214 N 25th Avenue NNashville, TN 37203Office: (615) 600-4909Fax: (615) 320-4842