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.

 

Deborah Gordon finds success in Healthy Me! Program

Healthy Me! Program participant, Deborah Gordon, has made the program her “job” this year. 

As a way to encourage the community to become healthier, The Medical Foundation spearheaded the Healthy Me! Program with the help of partners from Family Medicine of South Bend, P.C., Saint Joseph Regional Medical Center, Memorial Health and Lifestyle Center and Dr. Jeffrey Mader’s Office.

Six participants were chosen from the community and three men and three women agreed to have their weight published in the newspaper while they received quarterly lab work and met regularly with a dietitian, a physician, a fitness specialist. 

“I wanted to find a way to give these participants the tools they needed to become healthier individuals. I also hoped that through the process, they would inspire people to become healthier at home,” said Healthy Me! Coordinator Colleen Hahn.

On April 1^st when the program started, Deborah began her journey weighing 244 pounds.  She was eager to begin sessions with the dietitian, Erin, and immediately began working out.

“I work out every day, Monday through Friday, and sometimes I will pick up a Saturday or Sunday at Memorial Health and Lifestyle Center.  Prior to starting with the Healthy Me! Program, I was totally sedentary, so I took it easy at first with my workouts, but I wasn’t so out of shape that I was unable to perform any activities,” said Deborah.

Now, she is seeing a noticeable difference in her clothes and her muscle tone. She begins her 90 minute workout with rowing, then moves to the elliptical and treadmill, followed up with another rowing session.  She’s even started spin classes twice a week.

Her persistence in the gym, along with watching her intake of food has proven successful so far, marking the scale at 196 for her November weigh in. She’s lost a total of 48 pounds since the beginning of the program. More importantly, her laboratory test results have improved tremendously and during her November labs, Deborah had lab work that was completely within the reference ranges.

In April, Deborah’s triglycerides were 162, approximately 12 points above the highest recommended reference range. In July, they were as high as 203.  Last week, her triglycerides were at 72, completely in the middle of the recommended reference range.  She also was able to elevate her HDL cholesterol, which is typically referred to as the “good” cholesterol from 38 to 45.  These successes have led to her overall cholesterol numbers to fall within the recommended reference ranges.

“It’s exciting to know that doing a course correction in my daily food intake and exercising could change those numbers in my lipid panel, which will have lasting effects on my health. It was all well worth it,” said Deborah.

Early in the program, Deborah’s lab work reflected a sluggish thyroid and her Healthy Me! Program physician, Dr. Scheel, recommended medication for her. Since then, her thyroid has been performing at an optimal rate, allowing her to have energy to exercise.

The program has not only led to a change in the way Deborah feels about herself, but it has also changed the way her family approaches their health.

“My husband and I waited to have children and I am considered a ‘non-traditional’ mom.  I felt that it was vitally important that my children see the importance of a healthy lifestyle, because I would not want them to encounter poor eating habits from me.  Now my children are much more conscientious with regard to reading nutritional labels and looking for goods that are better for them to eat,” she said.

As Deborah reflects on her new “job,” it’s clear that she has put in the work necessary to be successful in the program and she’s using the tools that have been provided to her. 

“The Healthy Me! Program is appropriately named, because I am living a healthier life.  I’m excited that I’ve kept at it and have amazed myself with regards to how far I have come in my weight loss journey,” said Deborah.

Holiday Meals: From Bland to Grand

Shared meals and elaborate feasts often become the main focus for holiday celebrations.  The traditional holiday meal with cheese and crackers, turkey and stuffing, green bean casserole, mashed potatoes and pumpkin pie contains more than 75% of your daily calories, nearly twice the amount of fat and contains all of the sodium you should consume in one day…and all of this if you eat recommended serving sizes without having seconds.
Fortunately your holiday celebrations do not have to derail your health goals or leave you feeling tired and bloated.  Follow a few of these helpful hints to take your holiday meal from bland to grand.
• Add color to your plate.  Traditional holiday meals come in varying shades of brown and beige, which are typically the colors of added fat and starchy foods.  Fruits and vegetables add a variety of colors and flavors to any dish.  The more colorful your plate the more fruits and vegetables you consume, which means you get more fiber, fewer calories and less added sugar and fat

• Use smaller plates for your entrees.  Smaller plates hold less food and prevent you from dipping a supersized portion

• Make bite-sized desserts such as crust-less pumpkin pie in muffin tins, chocolate mousse made in ice cube trays or bite-sized cookies cut from holiday-shaped cutters

• Put down your eating utensil between each bite.  Focus on eating slowly and actually tasting each morsel of food you chew.  This will lead to better digestion with less gas and bloating, while also giving your body time to signal when you actually become full.  People who eat slower tend to eat less, even if they take longer at the table

• Follow the "one and done" rule.  Take a single serving of each item, then clear your plate and leave the table.  Take a 15-minute break before considering second helpings