595 West State Street, Doylestown, PA 18901 (215) 345-2200

Tuesday, March 24, 2015

BRCA and Assessing Your Personal Risk

Angelina Jolie, who has the BRCA1 gene which increases your risk of developing breast cancer and ovarian cancer, recently announced she had her ovaries removed to prevent cancer.

"This really is an individual decision for each woman," said genetic counselor, Cheryl Knight, MS, LCGC with Doylestown Health's Cancer Institute. Cheryl is the Cancer Risk Evaluation Program Coordinator. "Each woman needs to plot a course based on her own personal health history and her reproductive decisions. Current guidelines suggest a woman who has a BRCA1 mutation make a decision by age 40. It should be a process. Each woman needs to consult with her doctor and consider all the options."

FORCE, Facing Our Risk of Cancer Empowered, holds support groups for women with the BRCA1 in the Philadelphia area. FORCE is also holding their international conference in May in Philadelphia for people and families affected by hereditary cancer or BRCA mutation.

About Doylestown Health's Cancer Institute

Accredited by the American College of Surgeons Commission on Cancer, Doylestown Health's Cancer Institute offers patients the quality care they expect from a leader in cancer diagnosis and treatment— close to home. Comprehensive services include oncology-certified patient navigators, a state-of-the art infusion suite, Penn Radiation Oncology on site, and access to cutting-edge therapies and innovative clinical trials through the Penn Cancer Network.

Visit Doylestown Health's Cancer Institute or connect with us on Facebook or Twitter.

Certified Nurses Provide Expert Care

Doylestown Health celebrates its certified nurses. The letters behind the nurse's name represent knowledge, commitment and improved patient care.

Joan Sable, RN, PCCN knows the importance of advanced certification for nurses. She provides care to acutely ill patients and earned her Progressive Care Certified Nurse credential.

"Certification improves the quality of care delivered to patients," she said. "I earned certification to continue expanding my knowledge base."

Nearly one-third of Doylestown Hospital's 589 registered nurses have earned advanced certification in about 20 different specialties. Nationally, about one-quarter of nurses hold certifications.

Doylestown Hospital recently celebrated Certified Nurses Day to honor this group of exemplary nurses. Nursing, like health care in general, has become increasingly complex. Board certification of nurses plays an increasingly important role in the assurance of high standards of care for patients and their loved ones. Certification requires further education and testing, representing a commitment of time and money.

Angela Schill, RN, BSN, is currently working towards her Clinical Nurse Leader certification. "Healthcare continues to change with a greater focus on wellness and disease prevention. I want to make sure I can continue to grow to meet the changing needs of the patient population," said Angela.

"Most of the nurses on my unit are certified," said Kathy Donahue, RNC-OB, MSN, IBCLC, RLC, director, Maternal-Child Services and The Della Penna Pediatric Center. "The patients know they're getting the best care. The nurses are dedicated to a career – it's more than just a job. They are proud of being certified."

The more than 120 nursing certification specialties include medical-surgical, pediatric, pain management, cardiac vascular, oncology, hospice, case management, emergency nursing, critical care and many others.

"Specialty certification demonstrates the nurse's commitment to the profession and lifelong learning," said Eleanor Wilson, RN, MSN, MHA, vice president and Chief Operating Officer. "It also ensures a high standard of nursing practice. I am proud of the significant number of nurses at Doylestown Health who have chosen to be certified in their specialty."

Doylestown Hospital encourages national board certification for all its nurses.

Watch Video: Certified Nurses Day

"There are many reasons we promote certification," said Patti Stover, RN, MSN, NE-BC, senior executive director of Nursing Services at Doylestown Hospital. "Certification represents a level of clinical competence and shows that nurses maintain their knowledge base. And it enhances professional credibility."

Janey Ierubino, RNC, is a nurse with more than 28 years experience who earned certification in Maternal Newborn Nursing. "Certification represents professionalism. It means that I'm an expert in my field," she said.

Certified Nurses Day is an annual worldwide event that honors the birthday of the late Margretta "Gretta" Madden Styles, an international pioneer of nursing certification who designed the first comprehensive study of nurse credentialing.

Doylestown Hospital celebrates Certified Nurses Day each year with a special luncheon and speaker presentation at the hospital. This year, Kimberly Carson, RN, MSN, nursing education coordinator, spoke about nursing standards of practice. Kim started her nursing career at Doylestown Hospital in 1981.

Thursday, March 19, 2015

Can Colon Cancer Be Prevented?

During National Colorectal Cancer Awareness Month, it's important to look at risk factors for colon cancer and what you can do to reduce that risk. It starts with screening and includes healthy lifestyle changes. 

Colorectal cancer is the second leading cancer killer of men and women in the United States. Found early before it has spread, it is highly curable. Diagnosed at an early stage, the relative five-year survival rate for colorectal cancer is about 90%. But only about 4 out of 10 colorectal cancers are found at the early stage when they are most treatable, according to the American Cancer Society.

Watch Video: Colon Cancer Awareness

American Cancer Society discusses the importance of talking to your family about family history of colon cancer, and the importance of screening.

Have you been screened?

There is a reason why screening for colon cancer is so highly recommended. If everyone age 50 years or older had regular screening tests, at least 60% of deaths from colon cancer could be avoided, according to the Centers for Disease Control and Prevention (CDC).

Colorectal cancer usually starts from abnormal growths in the colon or rectum called polyps. Over time, some polyps can turn into cancer. Screening tests find polyps, so they can be removed before they become cancerous. That's a powerful tool for prevention.

Still, only about half of people eligible for colorectal cancer screening get the tests they should. The American Cancer Society recommends regular screening starting at age 50 for people with no identified risk factors (other than age). People with risk factors or a family history of colorectal cancer should talk to their doctor about getting screened earlier.

Both men and women with normal risk should start getting screened at age 50. "Risk is slightly lower in women but women are still at risk," says gastroenterologist Alan Chang, MD.

Reducing your risk

You can make lifestyle changes to lower your risk of developing colorectal cancer.

These include:
  • Increasing the amount and intensity of physical activity. Try to get at least 30 minutes of exercise on most days of the week.
  • Maintain a healthy weight. Avoid weight gain around the midsection.
  • Limit intake of red and processed meats. Decrease use of fats, oils, butter and red meats.
  • Eat a variety of fruits, vegetables and whole grains. Eat more cruciferous vegetables like cabbage, broccoli, cauliflower and Brussels sprouts.
  • Limit intake of charcoal-broiled foods and avoid salt-cured foods.
  • Avoid excess alcohol.
  • Stop smoking.

These guidelines not only help reduce the risk of cancer, they are beneficial to your overall health and can help fight heart disease, diabetes and other related conditions.

Tuesday, March 17, 2015

Teaching and Learning During Nurse Exchange

A group of Native American nursing students completed clinical rotations at Doylestown Hospital last week. They hope that what they learn can benefit patients back home.

Their local hospital can’t treat a heart attack.

"Our hospital back in New Mexico is in a very rural area bordering on the reservation," said Michelle Kellywood, RN, MSN. "There are no cardiac services there. If a patient comes in with a heart attack, they have to go two hours away for treatment."

Michele accompanied a group of six Native American nursing students visiting Doylestown Hospital last week. They are the second group of what is an annual exchange program between nursing students at the University of New Mexico/Gallup and Doylestown Hospital nurses. Read about last year's visit in our blog.

Through Bucks County-based nonprofit Americans for Native Americans (ANA), the students came to the area for clinical and cultural learning. This year’s group rotated through the cardiac cath lab, Cardiac Services, Emergency Department and VIA Maternity Center.

During one rotation, nurse educators Kim Mikula and Anne Dunlap from the Emergency Department taught the nursing students about emergency newborn care. The students were impressed by more than the technology and equipment they saw here. They learned about processes for patient care they could apply back home.

Student Angeliana Yazzie was interested by all facets of cardiac care she saw at Doylestown Hospital, particularly the protocol to handle heart attack. Doylestown Hospital excels at treating heart attack, quickly getting patients up to the cath lab for emergency angioplasty.

Doylestown Hospital's door-to-balloon time, which measures the time from when a patient enters the hospital to the time of a clogged artery is opened through angioplasty, averages about 60 minutes, which is 30 minutes faster than the national guideline. Teamwork between emergency responders, the Emergency Department and cath lab makes this possible.

"Seeing that whole pathway of care is very interesting to me," said Angelena. "I see how their success depends on everyone working together."

Michele Kellywood is passionate about expanding her students’ horizons. Kellywood is one of few Native Americans with an advanced nursing degree. A community leader and member of the Dine/Navajo Nation, Michele’s ultimate goal is to encourage these students to continue on for advanced degrees and have a real impact on the health of Native Americans.

"We are hoping these are experiences our students can take back with them and use to improve nursing care at home," said Kellywood.

A group of nurses from Doylestown Hospital visited New Mexico last fall and provided health screenings for students at the Baca/Dlo Yazhi Community School. Kim Mikula was among them and plans to return in September. Read about her experiences in a special guest blog.

Barbara Taubenberger, RN, MSN, CEN, director of Emergency Services at Doylestown Hospital, first visited New Mexico in October 2013. For her, the exchange is more than just a way to give back to the larger community. Taubenberger and her nurses learned a great deal from their experience, as well.

"The Navajo concept of walking in beauty is a concept of balance that we often try to bring to our lives but rarely achieve. Life is a constant journey and family, work, spirituality and health all play a part in our path. I personally think we have a lot more to learn from the Native American students then we could ever teach," said Taubenberger.

Thursday, March 12, 2015

Colon Cancer Symptoms Not to Ignore

During Colon Cancer Awareness Month, it's important to know the signs and symptoms of colorectal cancer. Treatment is most likely to be successful if colon cancer is caught early.

Colorectal cancer (commonly known as colon cancer) is the third leading cause of cancer-related deaths in the United States among both men and women.

Early colon cancers may not cause any symptoms, which is why preventive screening is recommended. During a procedure like colonoscopy, a physician can detect and even remove non-cancerous growths called polyps, which can become cancerous and bleed.

Still, it's important to know the signs and symptoms of colon cancer and see your doctor if you're experiencing any of them.

Colon Cancer Symptoms

  • Constant tiredness and fatigue
  • A change in bowel habits that lasts for more than a few days. This includes diarrhea, constipation, narrowing of the stool, or a change in consistency of the stool.
  • Blood in the stool (either bright red or very dark) or rectal bleeding
  • A feeling that your bowel does not empty completely
  • Frequent gas pains or cramps, or feeling full or bloated
  • Weight loss for no known reason
  • Nausea and vomiting

A Few Things to Remember

"The main symptom for colon cancer is fatigue caused by anemia, which usually doesn't cause dark or bloody stools," said Doylestown Health colorectal surgeon Robert Akbari, MD. "Fatigue can be vague and may be a symptom for a number of conditions, so that makes screening all the more important."

The American Cancer Society recommends that at age 50, both men and women with average risk for developing colorectal cancer should get a screening test.

Watch Video: Colon Cancer: Don't Ignore Your Symptoms

American Cancer Society created "Colon Cancer: Don't Ignore Your Symptoms." It took losing her mother to colon cancer to prompt Alyson Smith to talk to a doctor about her symptoms. She shares her emotional story of colon cancer diagnosis and survival.

"There are more ways to screen for colon cancer than just colonoscopy," said Dr. Akbari. "They include a yearly fecal occult blood test, which is usually given by your primary doctor. Virtual colonoscopy or barium enema can be done every five years. And if you do not have a family history, colonoscopy is recommended every 10 years."

It's important to note that colonoscopy cannot only diagnose cancer, it can also prevent it, since the physician can remove pre-cancerous polyps detected during the procedure.

Remember, too, that colon cancer is not gender specific. "Sometimes people think of colon cancer as a man's disease, and breast cancer as a woman's disease," Dr. Akbari said. "The truth is, both men and women are affected by colorectal cancer."

Of cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related deaths in the U.S. and the third most common cancer in men and in women, according to the Centers for Disease Control and Prevention (CDC).

Talk to Your Doctor

Even Dr. Akbari admits the subject can be hard to broach.

"Anything related to the bowels doesn't make for great table conversation," he said. "That plays a role in the lack of comfort some people might feel in discussing the subject."

But things are changing, thanks to awareness raised by people like Katie Couric, who, after losing her husband to colon cancer at age 42, started a public campaign that included having her colonoscopy shown on the Today Show in 2000.

Bottom line: speak up, especially if you're experiencing changes to what's normal for you or any symptoms.

"You have to be your own health advocate," advised Dr. Akbari. "If you're having symptoms, don't ignore them. It may be nothing, but it's better to get it checked out for sure."

Tuesday, March 10, 2015

President’s Perspective: Doylestown Health – A renewed focus on health and wellness

In the weeks and months ahead, you will see visible signs of this transformational change in health care as Doylestown Hospital and all of its related parts adopt the Doylestown Health name and a new logo that pays tribute to 120 years of community service. Doylestown Hospital was founded in 1923 by the Village Improvement Association. The VIA was formed by a group of women in 1895 who organized themselves to improve the health of the community. Today, we are building on our illustrious past to be a leader in the shifting healthcare market of the future.

These are exciting and inspirational times for the future of health care. Today, there is movement to branch out from the traditional ways of responding to illness to more proactive ways of promoting healthy lifestyles. In addition to high-quality, cost-effective treatment for illness when it occurs, an emphasis is being placed on health and wellness.

Doylestown Hospital is the flagship of the Doylestown Health system of services that includes Pine Run Community, physician practices, outpatient services, surgical center, nursing home and home health. Together under the Doylestown Health banner, all of our parts are more closely aligned, helping to connect patients, families and the community with streamlined healthcare services. A key ingredient to our success is the history of partnership with our medical community, which sets our tone for clinical excellence.

The addition of a new logo for our health system helps bring our vision of the future and the successes of the VIA to mind. Look closely and you will see the V, I and A in the shape of the icon, which has a modern look and suggests forward movement. The check mark of the "V" represents our continuing commitment to excellent care and affirmation of our mission to continuously improve the quality of life and proactively advocate for the health and well-being of the individuals and community we serve.

It is poetic irony that we expand our mission beyond illness to wellness in the 120th anniversary of the founding of the VIA, an organization of forward-thinking women who continue to guide us today. Doylestown Health is looking forward, literally and figuratively, to building upon our tradition of health. These truly are exciting and inspirational times.

Jim Brexler

Thursday, March 5, 2015

The Truth About Chest Pain

Don't ignore chest pain. Join Emergency Medicine physician Thomas DiEnna, DO, for a free program March 10 to learn about the causes of chest pain and treatment options.

Heart attacks don't always announce themselves like they do in the movies, with someone clutching their chest, bowled over in pain.

Sometimes cardiac symptoms are more subtle and may even start slowly. Whatever the cause, chest pain is not normal and warrants medical attention right away. If you are concerned that you may be experiencing a heart attack, call 911.

Know the symptoms

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

But there can be other symptoms, particularly in women.

These symptoms may include:
  • Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
  • Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
"Women may brush off the symptoms for something minor," said Thomas DiEnna, DO, of Doylestown Hospital's Emergency Department. "They tend to put other people first, whether it's kids or spouse or parent, before themselves."

Any kind of delay in treatment could mean a worse outcome.

When in doubt, call 911

Time is muscle, as the saying goes. The sooner a heart attack patient receives treatment, the better the outcome. That treatment can actually start before the patient arrives at the hospital.

Importance of calling 911
  • EMS personnel can perform an EKG to confirm if the patient is having a heart attack.
  • The EKG findings are sent to the Emergency Department at Doylestown Hospital.
  • The cath lab team (that performs life-saving angioplasty) can be activated and ready when the patient arrives.
  • EMS can begin treatment (by giving aspirin or nitroglycerin) and can manage arrhythmias (irregular heartbeats), even performing defibrillation if the heart stops beating.
"EMS can diagnose a heart attack in your living room and the cath lab can get ready while the ambulance is en route to the hospital," said Dr. DiEnna.

What if it's not a heart attack?

People are sometimes reluctant to call 911 in case they're not actually having a heart attack. "We'd rather be able to rule out an emergency than have people not come to the ER and suffer the consequences," said Dr. DiEnna.

Chest pain can be a symptom of many disorders. A trip to the ER gives the medical team the opportunity to closely monitor the patient. "That gives them and us reassurance," Dr. DiEnna notes.

Tests done in the ER may reveal another cause for the chest pain, and the need for important follow-up care.

Learn more about chest pain

The Truth About Chest Pain
Tuesday, March 10, 7 pm
Conference Room J, Doylestown Hospital
This is a free program. Register online or call 215-345-2121.

Your accredited Chest Pain Center

Doylestown Hospital's Woodall Chest Pain Center first received accreditation from the Society of Cardiovascular Patient Care (SCPC), just after the new Emergency Department opened in 2010. The accreditation signifies the hospital's efficiency and effectiveness in treating heart attack and other cardiac issues that present with chest pain.