healthy regards

SPRING 2014

WE ARE PLEASED that Healthy Regards now includes news from the Care New England Health System—Butler, Kent,

Memorial, and Women & Infants hospitals, the Care New England Wellness Center, and the VNA of Care New England. Providing health and wellness news is another way that we are helping to keep you and your family healthy.

All in the Family

Join Us for

Day of Dance!

Feb. 22, 12–4 p.m.

Warwick Mall

(see page 6)

regardshealthy

Care New England Health System45 Willard AvenueProvidence, Rhode Island 02905401-453-7900 or 1-888-4CARENE

Editorial Board: Jim BeardsworthAmy BlusteinJeffrey Borkan, MD, PhDHolly Brown-AyersDavid Carcieri, MDJoseph Diaz, MDAna Fulton, MD

May KernanSusan McDonaldMaureen Phipps, MD, MPHStephanie RegineJoseph Spinale, DOJames Sullivan, MD

Butler Hospital 345 Blackstone Boulevard Providence, Rhode Island 02906 401-455-6200

Care New England Wellness Center 2191 Post Road Warwick, Rhode Island 02886 401-732-3066

Kent Hospital 455 Toll Gate Road Warwick, Rhode Island 02886 401-737-7000 or 1-800-892-9291

Care New England Health System

Memorial Hospital 111 Brewster Street Pawtucket, Rhode Island 02860 401-729-2000

VNA of Care New England 51 Health Lane Warwick, Rhode Island 02886 401-737-6050

Women & Infants Hospital 101 Dudley Street Providence, Rhode Island 02905 401-274-1100

Healthy Regards is a quarterly publication produced as a

community service of Care New England Health System

of Rhode Island. To be added to or deleted from our

mailing list, please call us at 401-276-7800.

This publication is for general information only and is not

intended to replace the advice of your doctor or other

health care provider. Articles published in Healthy Regards

reflect the views of those quoted and do not necessarily

represent the opinions of all health care providers

associated with Care New England Health System. ©2014.

2 carenewengland.org Spring 2014

KEEPING YOUR HEART strong and healthy requires a lifetime commitment

to maintaining vigilant cardiovascular disease fighting strategies.

“While they may not realize it, men and women in their 20s are vulnerable to heart disease,” says Chris Furey, MD, Kent Hospital primary care physician and member of

REGULAR CARDIOVASCULAR SCREENINGS are important to help detect risk factors early.

High blood pressure [hypertension], smoking, high cholesterol and diabetes have a tremendous effect on the risk of developing cardiovascular disease. Patients with one or more of these factors are in danger of having an arterial blockage or a heart attack, but early screenings help your primary care provider address these risks before they turn deadly.

The U.S. Preventive Services Task Force recommends the following cardiovascular health screening tests:• Blood pressure—Starting at age 18, every two years• Blood glucose—Starting at age 18 if you have a sustained

blood pressure level of 135/80 mm HG or greater• Body mass index (BMI)—Starting at age 18• Lipid (cholesterol and triglyceride) levels—Starting

in men at age 35; starting in women at age 45 or older if cardiovascular risk factors are present

➻ For the name of a primary care provider or family practitioner, please call one of our physician referral lines: Kent Hospital 401-737-9950; Memorial Hospital 1-800-MHRI-DOC; Women & Infants 1-800-921-9299.

Screen for Early Detection and Protection

➻ For the name of a primary care provider or family practitioner, call one of our physician referral lines: Kent Hospital 401-737-9950; Memorial Hospital 1-800-MHRI-DOC; Women & Infants 1-800-921-9299.

Heart Health for 20-Somethings

Affinity Physicians. “Smoking tobacco, not exercising daily, and eating high-fat, fried, or fast foods—common behaviors for people in this age group—can severely impact the heart’s health in negative ways for the rest of a person’s life.”

Take good care of your heart by stopping bad habits before they start, and remembering the following tips for heart health, no matter your age: • Do not smoke.• Eat a low-fat, high-fiber diet.• Exercise for 30 minutes a day or 150 minutes

a week.• Have regular wellness exams and heart

health screenings.• Know your family history and risk of

heart disease.• Maintain a healthy weight.

Spring 2014 carenewengland.org 3

PERHAPS YOU EXERCISE daily and eat right to promote your physical health, but what about

your mental health? A healthy mind can help you savor life’s joys to the fullest and navigate rough patches with grace.

To kick off the conversation, we launched A Healthy Mind, an online community that focuses on cultivating wellness in mind, body and spirit.

You are invited to join A Healthy Mind online to:• Connect with others and get inspired.• Share your ideas on what helps you to have a

healthy mind, reduce stress and think positively.• Celebrate good times and good deeds.• Support each other in achieving your healthy

mind goals—and offer some kind words during difficult times.

• Learn healthy mind tips from brain and behavioral health experts.

➻ Participate in A Healthy Mind. Visit our Facebook page at facebook.com/ahealthymind.butler.“STRESS IS A SIGNIFICANT risk

factor for heart disease,” says Audrey Tyrka, MD, PhD, director, Laboratory for Clinical and Translational Neuroscience at Butler Hospital. “When stressed, people often eat poorly, smoke more, and use alcohol or drugs, all of which can harm the heart.”

Stress also causes the body to release hormones that lead to inflammation. Over time, these factors can damage blood vessels in the heart and brain. Changing unhealthy behaviors in response to stress may help protect your heart health.

According to Dr. Tyrka, simply taking care of yourself—eating well, getting enough sleep, exercising, limiting caffeine and alcohol, and making time for social connections—is the best way to prevent problems with stress before they start.

To get a grip on your stress response, first learn to recognize the signs of stress. Physical signs of stress include muscle tension, heart palpitations, insomnia, nausea and fatigue. Emotional symptoms include feeling anxious, irritable, overwhelmed or tearful.

Screen for Early Detection and Protection

As you experience thoughts that trigger stress symptoms, write them down. Then, identify the things on the list that you cannot control, and determine how you can minimize the negative effect these have on you. Next, cross off anything that isn’t very important. After these steps, you will be ready to focus your energy on important stressors that you can do something about.

“If you find yourself dwelling on issues that are not on your list, remind yourself that you are only going to be concerned with important things that you can control,” Dr. Tyrka says.

Also, exercise, yoga, meditation and listening to music can all reduce psychological and biological stress responses.

➻ Looking for more tips on managing stress? Visit the Care New England Wellness Center at wellnessctr.org and search for “stress.”

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STRESSLESS

✱

✱

✱✱

Stress can give you a pounding

HEADACHEand tie your

STOMACH in knots, but did you know it could also harm

YOUR HEART?

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4 carenewengland.org Spring 2014

Read the SignsClassic warning signs of a heart attack may include one or more of the following:

· Unusual sensations in the chest, often described as pain, pressure, tightness, fullness or squeezing

· Pain or soreness in the stomach, back, neck or jaw

· Shortness of breath

· Cold sweat

· Nausea

· Lightheadedness

· Fatigue

These symptoms often appear suddenly, are unexplained, and last for more than 15 minutes or go away and come back.

If you experience these symptoms, call 911 immediately.

to Your HeartWhat is this life-sustaining muscle telling you?

UNEXPECTED SIGNS“Women can experience typical symptoms of a heart attack (see “Read the Signs”), but atypical symptoms are also more common in women and may go unnoticed,” says Heather Hurlburt, MD, FACC, director of Noninvasive Imaging at Kent Hospital. “Those include nausea or vomiting, sweats, pressure across the chest, shoulders, neck or back, and unexplained shortness of breath.”

Women may experience some, all or none of these symptoms when they have a heart attack. Dr. Hurlburt recommends anyone with new or concerning symptoms call 911 immediately.

WHEN YOU ARE EXPECTINGWomen with heart disease who are pregnant or may become pregnant should work closely with a high-risk pregnancy specialist to ensure a safe pregnancy.

“During pregnancy, the amount of blood in women’s bodies increases by about 50 percent. The heart pumps more blood per minute, blood becomes more prone to clotting, and heart rate increases and arrhythmias [abnormal heart rhythms] are more common,” says Erika Werner, MD, MS, maternal-fetal medicine specialist at Women & Infants Hospital. “These factors put additional strain on the heart, making it more likely for underlying heart issues like ischemia (restriction of blood supply to tissues) to surface or new ones to develop.”

THOSE GOLDEN YEARSNaturally higher estrogen levels help protect women from developing high

levels of LDL (bad) cholesterol and promote increased levels of HDL (good) cholesterol during childbearing years.

“After menopause, estrogen levels dip, so women lose this natural heart attack protection,” says Priya Kohli, MD, MPH, FACC, a cardiologist at Memorial Hospital. “Although it is possible for women to have a heart attack at any age, the average age of a woman when she experiences her first heart attack is 70, about 10 years older than the average man.”

ListenWomen, KnowYour Heart

HEART DISEASE IS the leading cause of death for both men and women, but

women are more likely to lose their lives in the year following a heart attack and more likely to experience a second heart attack within six years. The reason? Women may be more affected by post-heart attack depression and metabolic syndrome (a combination of abdominal obesity, high blood pressure, high cholesterol and high blood sugar). Pregnancy and menopause may also play roles. Additionally, women tend to delay seeking treatment, which is sometimes due to unusual symptoms.

Spring 2014 carenewengland.org 5

Fast-Tracked Care, Rapid RecoveryHeart attack—caused by a blocked

artery in the heart—damages and

destroys heart muscle by cutting

off the blood supply.

A heart attack diagnosis is

confirmed when trained medical

professionals use tests, such as an

electrocardiogram, to determine if

there is a blocked artery. Patients

with blocked arteries are moved

to the cardiac catheterization

laboratory, where interventional

cardiologists insert balloon-tipped

catheters into the arterial pathway

to push aside the blockage and

restore blood flow. If needed, the

physician also places a stent— a metal mesh tube—to serve as architecture for a damaged artery.

Careful monitoring of blood pressure and heart rhythm are used to assess patients with cardiac symptoms. Further tests, such as a stress test, may be ordered to diagnose symptoms.

After emergency heart issues are addressed, recovery continues with a discharge plan that includes a referral to a cardiologist and cardiac rehabilitation designed to teach patients strategies to improve cardiac health and get back to their lives.

to Your HeartWhat is this life-sustaining muscle telling you?

YOU ARE RECLINING on the couch after dinner and start to have indigestion and

heartburn. You take an antacid, but it does not seem to help. The thought occurs to you: Could this be something more serious?

DELAYED REACTIONThe advice for anyone experiencing a heart attack is simple—call 911. Unfortunately, many men put off seeking medical attention for heart attacks.

“Men don’t think there could be a problem with their heart, so they attribute

symptoms to common issues like a muscle pull or heartburn,” says

Chester M. Hedgepeth III, MD, PhD, executive chief of cardiology at

Care New England. “Also, many men don’t call 911 because they don’t want the ambulance to come to their house and disrupt their neighbors

or family.”

Classic heart attack signs—left-sided chest pain and discomfort radiating into the arm, neck or jaw——are the most commonly reported symptoms in men.

Another reason men delay seeking help is that their symptoms may not mimic a classic “chest-clutching” heart attack. According to Dr. Hedgepeth, approximately 10 percent of men who have a heart attack do not experience any significant chest pain at all. This may be more likely among men with diabetes, as changes in their microvascular nervous system can affect their ability to sense pain.

“The important thing to know is early intervention saves lives,” Dr. Hedgepeth says. “If you’re having chest symptoms that are getting worse, don’t wait to seek help. The problem won’t get better if you wait— it’ll get worse.”

Men,Take Action

➻ For the name of a primary care provider or cardiologist, call one of our physician referral lines: Kent Hospital 401-737-9950; Memorial Hospital 1-800-MHRI-DOC; Women & Infants 1-800-921-9299.

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LEADING AN INACTIVE LIFE and being overweight are significant risk factors for

heart disease, but you have the power to modify them. Unfortunately, too many Americans pass up the opportunity to improve their health by working out—32 percent of adults don’t participate in physical activity during their free time, according to the American Heart Association (AHA).

“Physical activity improves cholesterol levels, helps control diabetes and increases muscle efficiency because a toned muscle burns more calories, which contributes to weight loss,” says Matthew McSoley, RN, BSN, CDOE, cardiac care coordinator at Memorial Hospital. “Muscles need more nutrient-

= Healthier HeartEvery time you exercise, your heart pumps for joy.

Celebrate good health, come on!Saturday, February 22

Time: 12–4 p.m.

Location: Warwick Mall, Bald Hill Road, Warwick, RI

Admission: FREE

Be part of the biggest dance party for better health in the United States. Bring your family and friends to dance, listen to music, participate in health screenings, and learn about simple and fun ways to stay healthy.

To become a Spirit of Women member, go to carenewengland.org/spiritofwomen.

and oxygen-rich blood during exercise, so the heart grows stronger with regular activity as it works to meet demand.”

At rest, an active person’s heart does not have to pump as vigorously to circulate blood. Exercise also improves blood pressure by helping blood vessels stay open, elastic, and less susceptible to hardening and narrowing due to plaque accumulation.

TAKE ACTIONAerobic exercises, such as running, swimming and dancing, are the most beneficial activities for your heart. But a well-balanced workout regimen also includes strength training and flexibility activities. If you’re new to regular exercise, speak with your physician about

the safest way to work up to the AHA’s recommendation of at least 150 minutes of moderate-intensity aerobic exercise per week.

In the meantime, don’t discount the value of everyday exercise. Each time you take the stairs at work, walk the park with your family or friends, or kick around the soccer ball with your children, you help your heart.

➻ For the name of a primary care provider or family practitioner, call one of our physician referral lines: Kent Hospital 401-737-9950; Memorial Hospital 1-800-MHRI-DOC; Women & Infants 1-800-921-9299. For more information about starting an exercise program, call the CNE Wellness Center at 401-732-3066.

Active Life

KENT HOSPITALAdvanced Cardiac Life Support— Initial and RenewalThis course will provide health care professionals with the knowledge and skills of advanced cardiac life support. Topics include airway adjuncts and intubation, arrhythmia recognition and defibrillation, cardiac pharmacology, and cardiac algorithms. For information, contact Kent Hospital’s Education Department at 401-737-7010, ext. 31471. Fee: $150

CPR Initial and Renewal/Health Care Provider Basic Life Support CPR Initial is a five-hour class in which the participant will be trained in basic cardiac life support theory and psychomotor skills. Topics include information about prudent heart living, prevention of unnecessary death from heart attack, signals and actions for survival and performance in management of airway obstruction, respiratory and cardiac arrest, in the adult, child and infant. Fee: $40

CPR Renewal is a three-hour class. For information, contact Kent Hospital’s Education Department at 401-737-7010, ext. 31471. Fee: $35

Comprehensive Medical TerminologyThis is a three-hour class to help you learn the complex language of medicine in a fun interactive program. Topics will include principle parts of medical words, body systems review and abbreviations/symbols. For information, contact Kent Hospital’s Education Department at 401-737-7010, ext. 31471. Fee: $120.

Prepared Childbirth All-Day ClassThis one class teaches first time parents about all stages of the childbirth experience. Topics include the signs and stages of labor, physical and emotional preparation for birth, medical intervention, and basic labor breathing relaxation techniques. Participants usually attend this class about 30-32 weeks gestation. Register via email at mybaby@kentri.org or call 401-736-1988. Fee: $60.

For a full description of these and other classes offered by Kent Hospital, visit kentri.org/healtheducation.

Kent Hospital physician referral line: 401-737-9950

MEMORIAL HOSPITALAARP Drivers Safety Program This is a refresher course designed to meet the needs of older drivers. Topics include physical changes related to age, rules of the road, local driving problems, the effect of alcohol and medications on driving and requirements for license renewal. Attendees who are age 55 and older and who have cars registered in Rhode Island are eligible for the automobile insurance discount. Registration must be made in advance. Interested drivers age 55 and older can contact Memorial’s Public Relations Office at 401-729-2459 to register.

Free Hearing Screening ProgramAudiologists from the Physical Medicine Department at Memorial will conduct free hearing screenings and analyze the results. Hearing screenings are open to everyone and take about 15 minutes. Don’t miss an opportunity to have your hearing checked. For more information and to schedule an appointment, call 401-729-2022.

Cancer Care—Facts You Should Know about Breast, Colon, Ovarian/Cervical and Skin CancersMarch 19, 9–10:30 a.m. Join speakers Dr. Skip Granai (ovarian/cervical), Dr. Sabrina Witherby (breast), Dr. Christine Emmick (colon), Dr. Gladys Telang (skin) for an informative lecture. Also available will be cholesterol and blood pressure screenings, skin cancer screenings, and information from the American Cancer Society and the Colon Cancer Alliance. Fee: Free

Let’s Talk about How to Avoid Foot PainApril 29, 6:00–7:30 p.m.Join Dr. Aaron Shemenski for an informational program. Blood pressure screenings and foot screenings will be available. Fee: Free

All about Hernias—Signs, Symptoms and Treatment of Hiatal Hernias Hiatal hernias are common, especially in people over the age of 50. In most cases, a hiatal hernia doesn’t cause any symptoms. Speaker is Dr. Peter Gill. Blood pressure screenings will be available. Fee: Free

For a full description of these and other classes offered by Memorial Hospital, please visit mhri.org/healtheducation.

WOMEN & INFANTS HOSPITALCPR for Family and Friends Whether an adult family member is experiencing a heart attack or an infant or child is choking, you will know how to respond quickly and appropriately. Classes are available evenings and weekends in Providence and East Greenwich. Call Women & Infants Health Education Department at 401-276-7800 to register. Fee: $30.

Babysitting Academy The perfect class to provide pre-teens and teens with the information, skills and confidence they need to become great babysitters. Our Academy includes complete CPR and First Aid training, accident prevention and safety information, child growth and development education, positive discipline techniques, and much more. Call Women & Infants Health Education Department at 401-276-7800 for information or to register. Fee: $75

Childbirth ClassesWomen & Infants Health Education Department offers an extensive array of childbirth preparation classes for expectant parents. These classes cover labor and delivery, breastfeeding, infant care, planned Cesarean birth, CPR, First Aid, Marvelous

spring classes and programs

Subscribe to CNE Talks Your Health monthly e-newsletter and receive the latest health news, tips and updates from Care New England hospitals. Discover support groups, community events, classes and other opportunities to connect with Care New England in your area, and link from our community calendar to register to attend. Our goal is to help you feel like an empowered advocate for your own health.

Want to connect with us? Visit carenewengland.org/socialmedia.

Spring 2014 carenewengland.org 7

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Multiples, hospital tours, grandparent classes, sibling preparation, Alternative Birthing Center classes and more. Call Women & Infants Health Education Department at 401-276-7800 for information or to register.

New Mother’s GroupConnect with other new mothers to share your story and find the support and camaraderie of those who appreciate the excitement of new parenthood. For more information and directions, call Women & Infants Health Education Department at 401-276-7800. Fee: Free

For a full description of these and other classes offered by Women & Infants, please visit womenandinfants.org/healtheducation.

Warm Line/Breastfeeding Support Services (Women & Infants Hospital)1-800-711-7011Monday—Friday, 9 a.m. —9 p.m.Saturday and Sunday, 9 a.m.—5 p.m.Call with concerns regarding you and your baby or with questions about breastfeeding.

Online Support for Expectant Parents (Women & Infants Hospital)Our weekly e-newsletter for expectant parents will keep you up-to-date on the development of your baby. Our research-based publication will follow your pregnancy with pertinent information, recommendations and timelines for your consideration, hospital initiatives to enhance your stay, and much more. It is easy, fast and free! Sign up at womenandinfants.org/tpr.

SUPPORT GROUPSFor a complete list of all of the support groups offered by Care New England, visit us at carenewengland.org/supportgroups.

Nonprofit OrganizationU.S. Postage

PAIDWomen & Infants

Hospital of Rhode Island

45 Willard Ave.Providence, Rhode Island 02905

carenewengland.org

Spring 2014 carenewengland.org 8

IT IS A PASSION that carries into her practice at Brigham and Women’s Cardiovascular Associates at Memorial Hospital.

“There are many ways to diagnose heart issues, including capturing detailed images, which is a specialty of mine,” Dr. Kohli says. “I pull from years of research and data to help find the right solutions for patients. When I recommend a treatment, I can tell patients why, and that’s a powerful thing.”

REACHING NEW HEIGHTSHeart health is not just a profession for Dr. Kohli, it is a priority. When she is not caring for her patients, she and her husband, cardiologist Michael Burke, pursue an active lifestyle and love to travel.

“One of our favorite things to do is explore new places,” she says. “During a recent trip to Argentina, we took a 10-mile hike around Aconcagua—the highest peak in the western hemisphere. It was amazing.”

Heart to Heart with Priya Kohli, MDAs a medical student, cardiologist Priya Kohli, MD, MPH, FACC, was drawn to the complexity and clarity of caring for the human heart.

Dr. Kohli attended medical school at the Northwestern University Feinberg School of Medicine in Chicago, IL, and completed her internship, residency, fellowship and an additional fellowship in advanced cardiac imaging at Northwestern Memorial Hospital (McGaw Medical Center of Northwestern University).

She joined the team at Memorial Hospital in 2011 and is a passionate advocate for women’s cardiac issues and preventive heart health.

“A lot of progress has been made in understanding how heart problems affect women,” Dr. Kohli says. “It’s not just a men’s issue. Now, there’s a real focus on including female patients in clinical trials and understanding their unique needs.”

➻ Dr. Kohli sees patients at Brigham and Women’s Cardiovascular Associates at Memorial Hospital. To schedule an appointment with her, call 401-729-2262.