Dr. Bobbie Sutton adds to her credentials in Molecular Genetic Pathology

The Medical Foundation’s Dr. Bobbie Sutton, a pathologist and Director of Molecular Pathology, has recently passed her Maintenance of Certification Part III examination in Molecular Genetic Pathology. This achievement fulfills the 10 year requirement for maintaining an accolade she earned years ago.

It all began in July of 2006, when The Medical Foundation sponsored her training at the University of Oklahoma Health Sciences Center (OUHSC) where she completed a fellowship in Molecular Genetic Pathology.

At the time, The Foundation knew that molecular diagnostics was a rapidly expanding field and with so many changes on both the clinical and anatomic sides of pathology, they needed someone to take the reins and master the discipline.

Dr. Sutton did just that. Following the one year fellowship, she successfully passed the Molecular Genetic Pathology Subspecialty board certification exam in September of 2007.  But passing this exam hardly meant that she was finished learning.

“This field is very demanding.  Keeping up with the medical genetics literature, as well as all the new technology that impacts our testing, is something that really keeps me on my toes.  However, I am confident that participating in the Maintenance of Certification process and monitoring trends and best practices in the industry, will help me to keep our molecular pathology lab ahead of the curve,” said Sutton. 

Each year, she must complete 70 hours of continuing education modules, 20 hours of self-assessment module credits, and to maintain her certification she must also keep her full medical license, as well as active medical privileges.  In addition, to the yearly maintenance, she must complete lengthy recertification exams every 10 years, such as the one she passed this March.

Oversight of the examination is shared by The American Board of Pathology and The American Board of Medical Genetics, which ensures that diplomats, such as Dr. Sutton, are competent in the following six areas: patient care and procedural skills, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice.

According to the American Board of Medical Science (ABMS), Dr. Sutton stands among only 265 pathologists who have been certified in Molecular Genetic Pathology.

Dr. Sutton’s knowledge and expertise in the field led to increased test offerings in the Flow Cytometry/ Molecular Pathology department at The Medical Foundation. 

Most recently, The Foundation joined efforts with Harper Cancer Research Institute (HCRI), Beacon Health System and St. Joseph Health System to bring state-of-the art testing to the region, concentrating in areas of colorectal cancer, melanoma and lung cancer.

New instrumentation acquired in early 2014 will analyze a small sample of DNA from tumor cells and identify up to 105 mutations in one reading.  Such mutations can determine which chemotherapy drugs are most likely to be effective.  This allows pathologists and oncologists to spare patients unnecessary treatment-associated toxicity by a drug that is unlikely to affect their particular tumor. 

“This is what patient centered care is all about. It’s my hope that this will help patients who need genetic data to get the optimum treatment for their cancers,” said Sutton. 

As the field of Molecular Genetic Pathology continues to rapidly advance, one thing remains constant: The Medical Foundation’s Dr. Bobbie Sutton will continue to learn and add to her expertise in the field, while she shares her expertise with her colleagues and physicians in the communities served by the Foundation.

Dr. Joyce Simpson replaces Dr. Robert Tomec as president of The Medical Foundation

At the 2015 annual meeting The Medical Foundation board of directors voted in Dr. Joyce Simpson to serve as President of the organization beginning June 8.  Dr. Simpson replaces Dr. Robert Tomec following his retirement after 35 years.

As president, Dr. Simpson will oversee the multiple facets of the organization that provides clinical and pathology services in four states, more than one hundred hospitals and thousands of physicians. She will lead over 700 employees and 20 pathologists.

Dr. Simpson is a graduate of Indiana University School of Medicine, completing her residency at Methodist Hospital of Indiana. She has a Fellowship in Surgical Pathology and is certified in anatomic and clinical pathology and cytopathology. She joined The Medical Foundation staff in March 2007 and was named the Executive Vice President in 2013.

“I have the utmost confidence about turning over the organization to a smart, capable leader that will take the organization through future changes in healthcare,” said Dr. Tomec. “Dr. Simpson is a person who truly cares about the patients and clients we serve and values our many long-term loyal staff.”

At the same time, Dr. Amobi Ezenekwe will become The Medical Foundation’s Executive Vice President, replacing Dr. Simpson. Dr. Ezenekwe is a graduate of the University of Nigeria College of Medicine, Enugu-State, Nigeria. He completed his Pathology Residency and his fellowship in hematopathology at St. Louis University School of Medicine in Saint Louis, Missouri.  He is certified in anatomic and clinical pathology by the American Board of Pathology. Dr. Ezenekwe has been a staff pathologist since 2005.

 

 

Jamie shares his story: Gluten-free isn't so bad...

Blood Donor Attendant Jamie McGraw wanted to share his story
about being diagnosed with celiac disease with those who have
lab work completed at The Medical Foundation.

Jamie McGraw has had a few battles to fight in his 28 years, but has developed into a rather independent, hard-working young man. His latest battle? Celiac Disease.

Celiac disease is a genetic autoimmune disease that damages the villi of the small intestine and interferes with absorption of nutrients from food.

The Medical Foundation Blood Donor Attendant noticed some problems with his stomach several years ago and sought medical advice. 

“I had to have a blood test because the doctor thought maybe I had celiac.  I got the blood test and it didn’t even hurt,” said Jamie.

Following the blood test, which triggered a positive result, Jamie endured two scopes and a biopsy at St. Joseph Regional Medical Center. Soon after, Jamie began a gluten-free diet.

“I’m gluten-free and it’s not that bad, I’m doing well being gluten-free,” said Jamie.

Jamie, who dreams of one day being a flight attendant, mentioned that he doesn’t even have trouble getting a good gluten-free snack on a flight.  According to him, “Delta and United both serve gluten-free items.  I had a granola bar, oh my God it goes well with Sprite,” he said with a little laugh and a huge smile.

Celiac is a condition he shares with his mother, who has also changed her eating habits over the last few years. But according to Jamie, she’s a great cook and makes a mean Quinoa salad, which happens to be his favorite unless Ian’s gluten-free chicken nuggets are on table!

Before his change in diet, Jamie said he felt, “lousy, my stomach would hurt every night.”

According to the National Foundation for Celiac Awareness, approximately 1 in 133 Americans has celiac disease, which affects both men and women across all ages and race. This number is probably a bit skewed, since about 83% of Americans who have the disease are undiagnosed or misdiagnosed with other conditions.

The first step in being diagnosed with celiac disease is doing exactly what Jamie did by getting a blood test. Recommendations from the National Foundation for Celiac Awareness include tests offered in the CeliacPanel offered by The Medical Foundation for $150.  To view the description of the test and for more information on ordering the test, please click here.

Are you unsure if you have celiac disease? If so, don’t make dietary changes until after you have diagnosed.  The Medical Foundation has added a blood test, celiac serology profile, to our Direct Access Testing website at www.YourDirectTest.com.  Take the first step in managing your health by ordering the test. If the test is positive, we recommend you visit your primary physician who can follow up with further testing including a biopsy.

 

 

Counting Down To ICD-10: Implementation "Go Live" Date is October 1, 2015

After several years of delaying the implementation of ICD-10, healthcare providers, payers, clearinghouses and billing services should be ready to finally implement the new system on October 1^st, 2015. 

The International Classification of Disease, or ICD, is a list created by the World Health Organization (WHO).  It is mandated that anyone using the Health Insurance Portability Accountability Act (HIPAA), should also use the ICD-10 system of disease classification.

The new system is being implemented because ICD-9 procedures limit data regarding patient medical conditions and hospital inpatient procedures.  The current ICD-9 system is over 30 years old, had outdated terms and is inconsistent with current medical practices; hence, the need for the updated ICD-10 system which allows the collection of a plethora of information regarding patients.

The ICD-10-PCS will be used in the United States for inpatient settings only.  The codes will use 7 alphanumeric digits instead of the current system which consists of 3 or 4 numbers.  The additional numbers will allow physicians to include the category of disease, etiology of disease, body part affected and the severity of the illness.  Having a uniform structure of code used throughout the United States will allow for better tracking of illness and disease.

If you have any questions about the role The Medical Foundation plays in ICD-10 or our preparedness for the October 1^st deadline, please contact Joel Fletcher at jfletcher@sbmf.org or 574.234.4176 *64529.   

New Medical Foundation Pathologists: Canfield and Alam join TMF Staff

The Medical Foundation would like to introduce two new pathologists who have recently joined our team over the last few months.   

Dr. Patty Canfield will serve as the medical director at several of our southwest hospital locations.  She has been certified in Clinical Pathology by the American Board of Pathology since May of 1998.  Most recently, Dr. Canfield has been teaching pathology to osteopathic medical students at the West Virginia School of Osteopathic Medicine.  Her background also includes experience as lab director, medical director, medical review officer and consulting pathologist. 

 

 

 

 

 

 

 

Dr. Shadia Alam graduated from the University of Cincinnati College of Medicine and continued at the Ohio State University Medical Center in Columbus where she completed her fellowship in Hematopathology. Prior to her employment with the Medical Foundation, she was located in Battle Creek, Michigan working as a staff pathologist for Regional Pathology Consultants. Dr. Alam is a member of the Michigan Society of Pathologists, Integrated Health Partners, and College of American Pathologists. She is also a certified personal trainer and wellness coach who is focused on mind-body healing and has taught community workshops on holistic health.

Transfusion Thoughts with Dr. Bobbie Sutton

We have known for decades that blood transfusion is a life-saving medical intervention.  Just ask any survivor of severe traumatic injury, a complicated surgical procedure, or cancer, where necessary chemotherapy slowed the body’s ability to replace oxygen carrying red blood cells, infection fighting white blood cells or hemorrhage stopping platelets:  Transfusion saves lives.  However, an accumulating body of data also shows that there are significant risks associated with transfusion, and in some circumstances, those risks may outweigh the benefits.  For example, a large meta-analysis of transfusion data published in early 2014 in the Journal of the American Medical Association found that a restrictive approach to transfusion, i.e., giving less blood rather than more, was safer for many patients.  These researchers found that the risk of serious hospital-acquired infection was lowered substantially among patients whose doctors ordered a blood transfusion at a lower hemoglobin level, compared with those whose caregivers used a higher cutoff [1].  For surgical patients, blood transfusion has been associated with more postoperative pulmonary and infectious complications, prolonged ventilator support, and higher mortality.

In response to these and other data, today there is broad recognition that we should improve overall  patient blood management.   Broadly defined, patient blood management is an evidence-based, multidisciplinary process that is designed to promote optimal use of blood products in the hospital.  This concept places patient safety first, and includes transfusing only when medically necessary, thus potentially reducing overall patient morbidity and mortality.  In the cost conscious medical environment of today, a secondary goal of blood management is reduction of costs associated with treating any adverse events we now understand could be associated with transfusion, as well as just not having to collect, process and transfuse as much blood.   

Throughout the state, many of the hospitals we serve have embraced patient blood management.   At one hospital, posters reminding physicians to carefully consider transfusion requests are prominently displayed in physician elevators and other areas.  At another, blood utilization and management data spanning several years was published as an abstract at the AABB 2013 national meeting, entitled  “Reducing Platelet and Red Blood Cell Utilization in a 325 Bed Hospital” [2; on display, 4^th floor, Main Lab TMF].   Dr. Bobbie Sutton, Medical Director of Blood Donor Services and Blood Bank Services at The Medical Foundation, has lectured about Blood Management to multiple groups regionally.  Dr Sutton is working with clinicians at facilities to update existing transfusion policies and better reflect these new ideas.    “The data is out there, and the time to act is now” she says.  “Having shared hospital transfusion criteria in our region as a readily available practice guide for all physicians is a big step in the right direction.  It should facilitate more appropriate blood utilization and transfusion data review.”

1.  Rohde JM, Kimcheff DE, Blumberg N et al.  Health Care-Associated Infection After Red Blood Cell Transfusion.  A Systematic Review and Meta-analysis.  JAMA 2014;311(13):  1317.

2.  SuttonBC, RobertsD, Wright M et al.  Reducing Platelet and Red Blood Cell Utilization in a 325 Bed Hospital.  2013 AABB National Meeting.  Poster AP1.

Shed Some Light On Your Vitamin D!

Over the last few years you may have heard some buzz about Vitamin D.  Although you may have heard bits and pieces, and you obviously know there is such a thing as Vitamin D, do you know its benefits? How much you should have on a daily basis? Read on to find out why Vitamin D is such a hot topic.

Vitamin D is needed in your body for the regulation of the minerals calcium and phosphorus.  Having the proper amounts of Vitamin D in your system is important because it has proven to aid in preventing the weakening of bones, bone loss and low calcium.

It can also be used to help conditions such as high blood pressure, high cholesterol, diabetes, obesity, weak muscles, multiple sclerosis, rheumatoid arthritis, asthma, and even tooth and gum disease. 

So how much Vitamin D is enough? And where does it come from? The recommended dietary allowance http://www.webmd.com/food-recipes/ss/slideshow-vitamin-d-overview  for vitamin D is 600 IU (international units) per day for adults up to age 70. Adults above the age of 70 should aim for 800 IU daily.  Amounts for children and newborns vary and can be viewed here. http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/   Those of us in Indiana during the winter may be a bit lacking as far as receiving natural Vitamin D lately, because the sun hasn’t been shining very much!   Experts http://www.webmd.com/food-recipes/ss/slideshow-vitamin-d-overview  for vitamin D is 600 IU suggest that if you can tolerate two 15 minute sessions of sunlight each week, it will be enough natural Vitamin D from sunlight.

There are also several foods which include Vitamin D.  These include: some fish, fish liver oils, egg yolks, and fortified diary and grain products. 

So if you are one of those people who isn’t in the sun very much, suffer from milk allergies and are on a strict vegetarian diet, you might be Vitamin D deficient. But how can you be sure?

Although there are some warning signs for people who are lacking in Vitamin D, such as bone pain or muscle weakness, blood tests can tell you for sure if you are deficient.

The Medical Foundation http://www.sbmf.org/index.php/clinicaltests/search/  offers the two most common types of Vitamin D testing: Vitamin D, 1,25-Dihydroxy and Vitamin D, 25-hydroxy, total.  Vitamin D undergoes two hydroxylations in your body for activation.  The first is in the liver where it is converted to Vitamin D 25-hydroxy.  The second occurs in the kidney and creates Vitamin D, 1, 25-hydroxy.  The concentration of Vitamin D 25-hydroxy is the best indicator of your Vitamin D status.  It reflects the amount of Vitamin D produced and obtained by your body.  However, this test does not indicate the amount of Vitamin D stored in your body’s tissue.  To see how much is stored in your tissue, opt for the Vitamin D, 1, 25-hydroxy, which is a better indicator.

Although it is still a little too soon to tell and further studies are being conducted, it is thought that maintaining adequate Vitamin D levels will reduce the likelihood of colon cancer and may help to prevent both breast and prostate cancer. It has also been associated with boosting the immune system and preventing autoimmune disease.

While it may seem as though the benefits far outweigh the negatives associated with Vitamin D, more isn’t necessarily the best option.  Rather, too much Vitamin D can damage blood vessels, causing damage to the heart and kidneys.

So as the snow flies throughout the Midwest and Vitamin D from the sunshine is a little less than preferred, let your ears perk up next time you hear some buzz about Vitamin D. 

Now you can order Vitamin D labs at http://www.yourdirecttest.com. 

Healthy Me! In Deborah's Words...

The following was written by Healthy Me! Program participant, Deborah Gordon. On April 1st of 2014, she weighed 244 pounds. Last week when she weighed in on February 5th, she weighed 181 pounds, having lost a total of 63 pounds. Not only has her weight decreased, but her labs have improved greatly and she feels better!
Deborah reflected on her time in the program and here's what she had to say:

Finding the Healthy Me!

     My name is Deborah Gordon and I was one of the lucky and fortunate individuals to get picked to participate in the SBMF ‘s 2014-15 Healthy Me program.  When I first read about the program, I was already saying to myself, that this is the push I need to start getting control of my health, weight, and happiness.  I found it funny that the Healthy Me program would start on April 1^st 2014; April Fools Day!  I’m embarking on the one year journey and proud to say that I have embraced this program like a job.  My goal weight for the end of this program is ideally 160 pounds and per my February weigh-in I was at 181 pounds, so just 21 pounds left to go.  Also, it has been 21 years since I weighed 160 pounds and my one regret is that I didn’t have the drive or motivation to lose the weight before.  My ultimate goal weight is 140 pounds, by the 4^th of July 2015, but whatever it is, I will stay on track and keep at it.

     I look at the word “diet” as an acronym for D-daily I-intake of E-edible T-treats.  Yes, even an orange pepper can be a treat for the body.  A healthy one!  When someone asks me what have I been doing to lose weight, I advise them lots of exercise and eating good healthy food.  Everyone wants the “magic pill” or the “miracle diet” to follow.  Sorry it doesn’t exist.  The first time I heard of losing weight and keeping it off was considered a “lifestyle choice,” was Dr. Phil on his talk show.  I am living proof, that he is correct.  Being healthy is a commitment you make to everyday choices in life. 

     Some of the choices are as simple as: do I get up early or sleep in today, do I eat breakfast or skip it, and on and on.  I found that when shopping for groceries for my family, I have to be mindful about making the “healthy choices” of food products that I’m buying.  I also make exercise a priority in my life and find new things to try at the gym.     

     Do you remember when you were a kid, everyone wanted to go out and play?  Play with a jump rope, a hula hoop, ride a bike, kick a ball around, shoot baskets, run or play tag, the list goes on.  Exercise should be fun and as I grew up, I forgot to have fun with exercise.  I remember the first time I saw someone using the “battle ropes” and I said that looks like fun.  They were difficult to manipulate at first, but I got the hang of them and found it to be a great upper body warm up exercise.

     The best fun is the exercise I do with my husband and two tween daughters.  We like to go on bike rides, swim, and play together as a family.  It was for my family that I wanted to become a healthier person, so that I will be there for my children and husband in the future.  I did not want my daughters to have poor eating habits or experience weight issues like I did when I was young.  I want to be a role model for them and hope that they too will live their lives as healthy as me. 

If your thyroid gland isn’t working properly, neither are you!

More than 30 million people suffer from thyroid disease and about half, 15 million, don’t realize they have it.

The thyroid can be thought of as the master gland of metabolism. The butterfly shaped gland is located in the base of the neck, just below the Adam’s apple. When the thyroid isn’t properly functioning, it affects weight, depression and energy levels.  It also affects the heart, brain, liver, kidneys and skin.  As you can imagine, if the thyroid gland isn’t working properly, then neither are you!

Dr. Jeffrey R. Garber, http://www.thyroidawareness.com/about-your-thyroid breaks the thyroid down into a manageable analogy by comparing the thyroid to a car engine.

A car engine sets the pace of a vehicle, just as the thyroid gland sets the pace at which your body operates. While the engine produces energy for how fast the car moves, the thyroid manufactures energy, or thyroid hormones, which prompt cells to move at a certain rate.

In order to make the vehicle run, it must have gasoline, just as the body needs fuel to be able to move.  The body doesn’t use gasoline, but rather iodine, which ends up producing two much needed hormones called thyroxine, or T4 and triiodothyronine , or T3.

Although you may have the engine and the gasoline in place, the car is unable to move along unless you press the accelerator, right? Well, the body is very similar because it also needs something to tell it how fast to go.  This master gland is located in the brain and is referred to as the Pituitary gland.  This pea-shaped master gland sends messages to the thyroid in the form of thyroid stimulating hormone, better known as TSH.  TSH levels rise and fall depending on how much of the hormone is produced. 

Someone who is battling fatigue and/ or weight issues might be experiencing symptoms of a poorly performing thyroid gland.  Although thyroid disease is predominately found in women, many men suffer from the disease, as well.  You may want to consider a thyroid evaluation if a parent, sibling or child suffers from a thyroid disease or if you have taken the prescription medications Lithium or Amiodarone.  Finally, if you have had head or neck radiation and are experiencing some of the symptoms listed above, you may also have an increased risk of thyroid disease. 

Having a blood test at The Medical Foundation that determines your TSH levels can be instrumental in diagnosing whether or not you are suffering from hyperthyroidism or hypothyroidism.  Hyperthyroidism is a condition where your thyroid is being overactive and hypothyroidism is where your thyroid is under performing and may be causing you to feel sluggish.

As part of our new Direct Access Testing program called, Your Direct Test, visit our website at www.YourDIrectTest.com and order the Thyroid Stimulating Hormone test for $35.00.

If you are currently taking corticosteroids, lithium, dopamine or other various thyroid medications, you will want to have your blood drawn for the test before you take your medication for the day.

You may notice blue paisley ribbons in the community as a way to gain awareness and advocacy for thyroid disease, because January has been noted as the month of observance.  The blue paisley was chosen to represent thyroid disease because of its resemblance to cross-sections of thyroid follicles.

To learn more about the thyroid and its functions visit the Thyroid Disease Awareness page on Facebook www.facebook.com/ThyroidDiseaseAwareness or the American Association of Clinical Endrocrinologists website,  www.thyroidawareness.com.