evolves the

about health
Y O U R G U I D E T O H E A LT H Y L I V I N G I N E A S T T E N N E S S E E
SPRING 2008
THE
ER
EVOLVES
5
LIVE A
HEARTHEALTHY
LIFE
WAYS THE ER IS
BETTER THAN
EVER PAGE 12
FdAHSP0834_00_cover_lh.indd 1
HERE ARE LITTLE TIPS THAT’LL
MAKE A BIG DIFFERENCE PAGE 6
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30
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PAGE 14
3/14/08 10:07:15 AM
I n t r od u ci n g Me rc y He al t h Pa r t n e r s .
We are pleased to announce that St.Mary’s Health System and Baptist Health System
of East Tennessee have joined together to form Mercy Health Partners. Our new name is truly a
reflection of our respective faith-based missions, foundations upon which we have provided
compassionate, quality medical care to the people of Knoxville and East Tennessee for decades.
Together this new system offers patients an unparalleled degree of care never before possible –with more
than 1,500 physicians and a comprehensive array of first-class medical specialties and technology.
In fact, Mercy’s hospitals now represent centers of excellence in Cancer, Heart, Women’s Care,
Neurosciences, Orthopedics, Imaging, Sleep Medicine and Senior Services. Mercy Health Partners is a
celebration of faith, as we open wide the door to strengthen and grow our healing ministry while
serving you with the utmost in medical care – from discovery to recovery.
Visit our websites for a complete listing of physicians, services and facilities,
along with the latest health news and medical information.
www.stmaryshealth.com
FdAHSP0834_02_C2 Ad.indd 1
www.baptistoneword.org
3/14/08 10:08:19 AM
PERSPECTIVES
30 Days to a
Healthier You
A lot can happen in 30 days.
The season can change
from winter to spring. A
baseball player can get out
of a slump. And you can
watch the moon progress
from crescent to complete.
But did you know in 30 days
you can also transform
your health?
Find out how in this
issue’s cover story, “It’s the
Little Things.” We offer 30
tips on everything from daydreaming
and wearing bright colors to eating highfiber cereal and drinking from a straw.
And if you incorporate one tip into your
routine each day, by the end of the month
you’ll be a healthier person—and maybe
even a happier one.
Some things take longer than 30 days
to evolve. In “Not Your Grandfather’s ER”
you’ll learn emergency medicine wasn’t
even a specialty 30 years ago. Over the
years, emergency medicine has evolved,
thanks to better training, tools and techniques. Today, emergency physicians at our
St. Mary’s and Baptist hospitals save lives
and treat illnesses in ways doctors could
have only dreamed about in years past.
Speaking of St. Mary’s and Baptist,
so much has happened in the three short
months since the merger of these two
health systems on January 1. I’m sure
you have read and heard much about our
efforts to bring together two faith-based
institutions to extend the healing ministry of Jesus throughout our region. At
Mercy Health Partners, our ultimate goal
is to provide excellent care to our patients
and their families.
Yes, a lot can happen in 30 or so days.
You can remodel a room in your home or
make over your health. At this beautiful
time of year, I encourage you to plant your
spring garden full of healthy seedlings
and, who knows, by the time they start to
sprout in 30 days or so, you may be well
on your way to a healthier lifestyle.
Healthy Wishes,
Debra K. London
President & CEO
Mercy Health Partners
TABLE OF
CONTENTS
FEATURES
6
From munching on walnuts to learning
how to say no to people, here are 30 small
ways to make a big impact on your health.
8
12
14
Mercy Health Partners Facilities
■
■
■
■
■
■
■
■
President and CEO:
Debra K. London
Editor:
Ann Metz
FdAHSP0834_03_TOC_lh.indd 3
Regional Director/
Marketing and
Public Relations:
Lisa Stearns
Cover Art:
Jeff Newton
Cover Art Stylist:
Shauna Thibault
About Health® is published four
times annually by McMurry,
1010 E. Missouri Ave., Phoenix, AZ
85014. Volume 13, Number 2
© 2008 McMurry.
The material in About Health is
not intended for diagnosing or
prescribing. Consult your physician before under taking any form
of medical treatment or adopting
any exercise program or dietary
guidelines.
■
■
■
For permission to reprint any portion of this magazine, give us a new
address, let us know that you are
receiving more than one copy or if
you would prefer not to receive About
Health, call 888-626-8779.
a student
for life
Cardiac rehabilitation teaches the skills
you’ll need for life after a heart attack.
■
Senior V.P./External Afffairs:
Jerry W. Askew
not your
grandfather’s er
Better training, tools and techniques have
transformed emergency care.
■
Mercy Health Partners
900 E. Oak Hill Ave.
Knoxville, TN 37917
(865) 545-8000
Mercy.com
here, there & (just
about) everywhere
Find a Mercy Health Partners facility in
your neighborhood. A special pull-out guide.
■
about health
It’s the
Little Things
■
■
■
■
■
■
■
■
■
■
■
■
St. Mary’s Medical Center
St. Mary’s Medical Center North
St. Mary’s Medical Center of Campbell County
St. Mary’s Jefferson Memorial Hospital
St. Mary’s Medical Center of Scott County
St. Mary’s North Cancer, Imaging and Women’s
Centers
St. Mary’s Ambulatory Surgery Center
St. Mary’s Health & Fitness Center
St. Mary’s Residential Hospice
St. Mary’s HomeCare Services
St. Mary’s HomeCare Equipment Company
St. Mary’s East Towne
St. Mary’s Northshore
St. Mary’s Health & Rehabilitation Center,
Campbell County
St. Mary’s Rehab Center, Union County
Baptist Hospital of East Tennessee
Baptist Hospital West
Baptist Hospital for Women
Baptist Hospital of Cocke County
Baptist Convalescent Center of Cocke County
Baptist Primary & Senior Health Care Centers
Baptist Hospice
Baptist HomeCare
Baptist Home Medical Equipment
Baptist Therapy Center
Claiborne County Hospital
3/24/08 11:47:32 AM
HEALTH BEAT
Blood Brothers
Gargle,
Spit,
Detect?
If your brother or sister has suffered a stroke, you may
want to keep a close watch on your blood pressure. That’s
because siblings of stroke victims are nearly twice as likely
to suffer a stroke as well, according to research presented
to the American Academy of Neurology. The study found
Mexican-American male siblings and white female siblings to be most affected.
To reduce your risk, eat a healthy diet, exercise regularly,
don’t smoke, and keep your blood pressure and cholesterol under control.
ARE YOU
AT RISK?
Take our STROKEaware
Online Risk Assessment.
It’s a 7-minute test you’ll
find at mercy.com. You’ll
receive a personal health
risk report and tips on
what you can do to reduce
your chances of suffering
a stroke.
SUPPORT SYSTEM
Your dentist has been hounding
you for years about using mouthIf you are caring for a sibling or another
wash, but you only gargle the stuff
loved one who has suffered a stroke,
before a big date, right? Well, in
visit the American Stroke Association
the future you may be gargling for
online at strokeassociation.org for
a much different reason: detectinformation, tips and discussion boards.
ing head and neck cancers in their
early stages.
Scientists at the University of
Miami’s Sylvester Comprehensive
Cancer Center say an oral rinse
they are developing detects a
protein that signals possible
cancer or pre-cancer. Some
amount of the protein,
CD44, exists in healthy
cells, but levels
increase when canSomet
cer exists. Patients
takes t imes encou
ragem
o lif
ent
simply swish the
cance t the spirits
of som is all it
r. Visit
S
eon
t
. Mary’s
Cance
rinse and spit, and
r Cent
and Ba e with
e
m
r
ptist’s
s
ercy.c
on the
the protein level
om fo
r inform Internet at
suppo
is measured.
ation a
rt gro
bout
emotio ups and
More studies
nal car
e.
are ongoing.
If caught early,
head and neck cancers
have a cure rate of more than
80 percent.
4 | SPRING 2008
K
YoureHep
e
Up ad
FdAHSP0834_04-05_healthbe_lh.ind4 4
3/14/08 10:16:42 AM
Cleaning
with Caution
WE’RE #1
4
%
Approximate
percentage of
adults 65 and
older living in
nursing homes
in 2004.
Number of adults
65 and older in the
U.S. in 2005.
36.8
MILLION
You know it’s spring when the flowers are blooming, the birds are chirping and
the garage is just begging to be cleaned out.
Spring-cleaning can be good exercise, but it also can result in injury. Stay
safe with these tips from the American Association of Orthopaedic Surgeons:
R Stretch and perform warm-up exercises before undertaking physical tasks.
R Lift heavy objects with your feet shoulder-width apart and bend with your
knees while tightening your stomach muscles.
R Use a step stool instead of a chair to reach high places.
R Use ladders on firm, level ground.
R Have your lawn mower serviced to ensure it’s working properly. Wear closedtoe shoes when mowing.
R Wear gloves while working in the garden and trimming trees.
R Store chemicals in their original containers at the proper temperature, and
keep them away from small children and animals.
According to the 10th Annual
HealthGrades Hospital Quality
in America Study, St. Mary’s
Medical Center is best rated in
East Tennessee for orthopedics
care. The study, the largest of its
kind, analyzed patient outcomes at
virtually all of the nation’s 5,000 hospitals for the years 2004, 2005 and
2006. HealthGrades researchers
also found that St. Mary’s is ranked
in the top 5 percent in the nation
for orthopedic surgeries. To learn
more about our quality ratings, visit
mercy.com.
77.8
The average life expectancy
in the United States in 2004,
the highest it has been.
Source: National Center for Health Statistics, Administration on Aging
Surgery
Uncertainty?
FdAHSP0834_04-05_healthbe_lh.ind5 5
your doctor to outline the methods,
what type of anesthesia will be used
and recovery time.
R Realize that costs may be associated with surgery, even if you have health
insurance. Call your insurance company beforehand to clarify expenses.
R Get a second opinion if you’re
not completely comfortable with
the answers your doctor gives you.
Some insurance companies require
patients to obtain second opinions
before undergoing surgery.
D
SEEING
DOUBLE
Getting a second opinion can
increase your insight—and
your peace of mind. If you’re
facing surgery and want a second opinion from a St. Mary’s
doctor, call (865) 545-MD4U,
or for a Baptist doctor, call
(865) 632-5200.
SPRING 2008 | 5
Whether it’s your first or your 10th
procedure, surgery can be unnerving.
To help ease your fears, talk through
it with your doctor and ask questions
until you feel comfortable.
The Agency for Healthcare
Research and Quality also recommends that you:
R Understand completely what your
surgery will correct or improve and
what risks are involved.
R Are aware of exactly what will take
place during the procedure, and ask
3/14/08 10:16:56 AM
BY B E T H TO M KIW
M A I N P H OTO G R A P H Y BY J E F F N E W TO N
I T ’S E
TH
e
l
t
t
i
L
T
S
G
N
I
H
6 | SPRING 2008
30 days. 30 simple ways
to improve your health
Maybe you eat too much junk food or prefer the couch to the
walking path. Maybe you skip your annual doctor’s appointments. Or maybe you live a perfectly healthy lifestyle but are
stuck in an eating and exercise rut.
Whatever habits keep you from feeling your best, there’s
good news: Healthy living doesn’t require radical change.
“Most people I talk to want to look better, feel better and live
happier, more fulfilling lives,” says Ellie Krieger, M.S., R.D.,
host of Food Network’s Healthy Appetite and author of Small
Changes, Big Results (Clarkson Potter, 2005). They just don’t
know where to begin.
With advice from Krieger and other health authorities,
we’ve devised a month-long plan that identifies 30 little
ways to make a big difference in your well-being.
PHOTOGRAPH BY XXXXXXXXX
FdAHSP0800_06-09_littlethings.in6 6
2/21/08 11:30:52 AM
DAY 1: SLURP ON
WATERMELON
Researchers have found that watermelon raises
levels of arginine, an amino acid shown to improve
blood-vessel function. That means the sweet treat
might provide protection against heart disease.
Day 2:
Day 3:
BUDDY UP
SCHEDULE
YOUR EXERCISE
Partnering with
someone to achieve
your health goals may
help you stay on track.
Get virtual support
at sparkpeople.com,
an online community
that offers inspiration
and encouragement.
Lack of time is a common excuse for being
sedentary. That’s why
Krieger recommends
scheduling workouts like any other
appointment. Begin
by blocking off 30
minutes a few times a
week, then work your
way up to more.
Day 7:
SCHEDULE
YOUR ANNUAL
CHECKUPS
When you’re feeling
healthy, you may be
inclined to blow off
regular screenings.
But doing so can compromise your health.
A Harvard study
found that women
who skipped their
annual pelvic exams
had nearly four times
the risk of developing ovarian cancer as
those who didn’t.
Day 4:
Day 8:
SIP FROM A
STRAW
THINK AHEAD
A bright smile is a
sign of good health.
If you drink soda,
or iced coffee or tea,
drink from a straw
so the sugars bypass
your teeth.
Day 5:
TAKE A
BREATHER
Slowly inhale and
exhale for five minutes, focusing on how
your body feels, and
your heart rate will
slow, Krieger says. Do
it regularly to control
stress levels.
Day 6:
WEAR A
BRIGHT COLOR
Day 9:
BEGIN POTTY
PATROL
Do you wonder if
you’re drinking
enough water? The
color of your urine is
one way to tell. Dark
urine is an indicator
of dehydration while
clear and frequent
urination is a sign
that water consumption is on track,
Krieger says.
Purses, briefcases
and workout bags
keep getting bigger—
and we keep managing to fill them.
Alternate the side on
which you tote your
bag to maintain good
posture and protect
lower back muscles.
Day 11:
DAYDREAM
Long periods of
intense focus can
fatigue your brain,
says Eric Klinger,
Ph.D., a psychology professor at
the University of
Minnesota, Morris.
That’s why he
advocates letting
your mind wander.
“Daydreaming makes
us more relaxed,
helps us organize our
lives, increases selfunderstanding and
helps us solve problems,” Klinger says.
DAY 12:
ESTABLISH A
BEDTIME
Adults need eight hours
of shut-eye for optimal
health, according to the
National Sleep Foundation.
To ensure you’re getting the
right amount, establish specific bedtime and wake-up
times—and stick to them.
SPRING 2008 | 7
Leatrice Eiseman,
author of Colors for
Your Every Mood
(Capital Books, 2000),
says wearing something orange, red or
yellow can boost your
energy because the
hues elicit a sense
of excitement.
It takes 20 minutes
for your stomach to
tell your brain you’re
full. “The key to recognizing this seemingly magical satiety
point,” Krieger says,
“is to eat slowly, chew
each bite and stop
periodically to note
how you are feeling.”
Day 10:
BALANCE
YOUR LOAD
PHOTOGRAPH BY XXXXXXXXX
FdAHSP0800_06-09_littlethings.in7 7
2/21/08 11:31:05 AM
Here, There & (just ab
ck
Kentucky
Kent
ucky
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al
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oof Scott County
63
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St. Mary’s Health & Rehabilitation
n
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St. Mary’s Medical Center
S
St
ooff Campbell County
27
63
LaFollette
33
11W
St. Mary’s Rehab Center,
Union
Un County
61
11E
www.mercy.com
St.
St Mary’s Residential Hospice
St.
S Mary’s HomeCare Services
St. Mary’s Jefferson
n
al
Memorial Hospital
J
Jefferson City
11W
St. Mary’s Medical Center North
S
St
92
St. Mary’s North Cancer, Imaging and Women’s Centers
St.
St Mary’s Health & Fitness Center
St. Mary’s East Towne
25W
33
aryy’s Me
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St
S
t Mary’s
St.
Medical
Center
St. Mary’s Ambulatory Surgery Center
St. Mary’s HomeCare Equipment Company
Baptist Primary &
ter
Senior Health Center
62
Ba
Baptist Primary &
Sen Health Center
Senior
62
Knoxville
Baptist Hospital of East Tennessee
B
Ba
162
Baptist
Bap
ptis Therapy Center
Baptist Primary &
Senior Health Center
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Baptist Hospital West
Baptist
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Ba
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8 | SPRING 2008
411
Ba
Baptist
Primary &
Senior Health Center
Se
321
5 mi
FdAHSP0834_08-09_map.indd 8
oa
Alcoa
321
Maryville
3/14/08 11:31:37 AM
about) Everywhere
St. Mary’s Health System and Baptist Health System have merged all assets to become
East Tennessee’s largest nonprofit healthcare system called Mercy Health Partners.
Now, everyone in East Tennessee has access to a Mercy physician and quality medical
care. With 10 hospitals and more than a dozen additional healthcare facilities located in 10
counties, you’ll never need to travel far from home to receive care or services you can trust.
To learn more, visit us on the Internet at www.mercy.com.
ST. MARY’S FACILITIES
St. Mary’s Medical Center
900 E. Oak Hill Avenue, Knoxville, TN 37917
BAPTIST FACILITIES
Baptist Hospital of East Tennessee
137 Blount Avenue, Knoxville, TN 37920
St. Mary’s Medical Center North
7565 Dannaher Way, Powell, TN 37849
Baptist Hospital West
10820 Parkside Drive, Knoxville, TN 37934
St. Mary’s Medical Center of Campbell County
923 E. Central Avenue, LaFollette, TN 37766
Baptist Hospital for Women
10820 Parkside Drive, Knoxville, TN 37934
St. Mary’s Jefferson Memorial Hospital
110 Hospital Drive, Jefferson City, TN 37760
Baptist Hospital of Cocke County
435 2nd Street, Newport, TN 37821
St. Mary’s Medical Center of Scott County
18797 Alberta Street, Oneida, TN 37841
Claiborne County Hospital
1850 Old Knoxville Road, Tazewell, TN 37879
St. Mary’s North Cancer, Imaging
and Women’s Centers
7551 Dannaher Way, Powell, TN 37849
Baptist Convalescent Center of Cocke County
450 College Street, Newport, TN 37821
25E
Morristown
11E
er
ity
25E
St. Mary’s Ambulatory Surgery Center
1515 St. Mary’s Street, Knoxville, TN 37917
Newport
Baptist Convalescent
nt
Center of Cocke County
ty
St. Mary’s Health & Fitness Center
7540 Dannaher Way, Powell, TN 37849
321
Ba
Baptist
Hospital
of Cocke County
70
25
411
St. Mary’s Residential Hospice
7447 Andersonville Pike, Knoxville, TN 37938
St. Mary’s HomeCare Services
4127 E. Emory Road, Knoxville, TN 37938
St. Mary’s HomeCare Equipment Company
2001-A Broadway, Knoxville, TN 37917
32
St. Mary’s East Towne
4711 Centerline Drive, Knoxville, TN 37917
321
St. Mary’s Northshore
9546 S. Northshore Drive, Knoxville, TN 37922
Tennessee
FdAHSP0834_08-09_map.indd 9
North Carolina
St. Mary’s Rehab Center, Union County
149 Durham Drive, Maynardville, TN 37807
Baptist HomeCare
7203 Chapman Highway, Knoxville, TN 37920
Baptist Home Medical Equipment
4125 Chapman Highway, Knoxville, TN 37920
Baptist Therapy Center
137 Blount Avenue, Knoxville, TN 37920
Baptist Primary & Senior Health Center · Alcoa
244 S. Calderwood Street, Alcoa, TN 37701
Baptist Primary & Senior Health Center · Jefferson City
1413 Russell Avenue, Jefferson City, TN 37760
Baptist Primary & Senior Health Center · Broadway
2027 N. Broadway, Knoxville, TN 37917
Baptist Primary & Senior Health Center · Norwood
5541 Clinton Highway, Knoxville, TN 37912
SPRING 2008 | 9
St. Mary’s Health & Rehabilitation Center,
Campbell County
200 Torrey Road, LaFollette, TN 37766
Baptist Hospice
7203 Chapman Highway, Knoxville, TN 37920
Baptist Primary & Senior Health Center · West Hills
7009 Kingston Pike, Knoxville, TN 37919
Baptist Primary & Senior Health Center · Sevierville
707 Dolly Parton Parkway, Sevierville, TN 37862
3/14/08 11:33:13 AM
(continued from page 7)
Day 20:
DAY 13:
Day 15:
WARM UP
YOUR TOOTSIES
If you’re having trouble sleeping, slip
on some socks. A study published in
Physiology & Behavior found that wearing socks to bed better regulates body
temperature, making it easier to slumber.
WATCH A
FUNNY MOVIE
Whatever your brand
of humor, laughing is
good for your mind,
heart, body (it burns
calories!) and even
your relationships.
Day 16:
READ TO RELAX
Day 14:
DRINK A GLASS
(OR TWO) OF
LOW-FAT MILK
Milk helps build
strong bones, and
may make you stronger. A recent study
showed that elderly
people with high
levels of vitamin D
in their blood were
significantly stronger
during grip-strength
tests than those with
deficient amounts.
Having trouble sleeping? Try reading to
distract you from your
worries, allowing you
to rest easier.
Day 17:
JUST ADD BEANS
To cut some fat from
recipes for brownies
and dropped cookies
that call for butter
or shortening, add
pureed cooked cannelli bean as a substitute. The Journal of
the American Dietetic
Association says they
can replace up to half
the called for fat without sacrificing taste.
Day 18:
READ FOOD
LABELS WITH A
CRITICAL EYE
The package may say
“whole grain,” but
that doesn’t mean
it’s good for you.
Learn to scrutinize
the label by visiting
the U.S. Food and
Drug Administration
website, cfsan.fda.gov/
~dms/foodlab.html.
Day 19:
PLAY MUSIC—
STRATEGICALLY
If you’re feeling
stressed, listen to
classical music, which
can help ease anxiety.
Also, listening to soft
music during a meal
may help you to chew
slowly and eat less,
while exercising to
up-tempo tunes
can help you work
out longer and with
more intensity.
10 | S P R I N G 2 0 0 8
Be a Quitter
If you’re a smoker, the most important thing you can do for your health is quit smoking.
Yes, it’s hard. But it can save your life.
Here are some tips from the U.S. Surgeon General to get you through that critical
first week:
R Drink plenty of liquids, especially water. Try herbal teas and fruit juices, but limit
coffee, soft drinks and alcohol, which can increase your urge to smoke.
R When the urge hits, distract yourself. Do something else immediately, whether it’s
striking up a conversation or going for a walk.
R Reduce your stress. From deep breathing to massage, we offer several tips in our
30-day plan.
R Talk to someone. Lean on family and friends. Or visit mercy.com on the Internet
for tips on how to quit smoking.
FdAHSP0834_06-11_littlethin_lh.i10 10
CHEW SUGARFREE GUM
BETWEEN
MEALS
Chomping on gum
freshens your breath,
but it also can satisfy
your sweet tooth and
can help you eat less.
Day 21:
ROLL UP YOUR
SLEEVE
You can save as
many as three lives
by donating a single
pint of blood. Plus, a
study by Dartmouth
Medical School shows
that having your
blood drawn twice
a year might lower
risk of heart disease
because it removes
excess iron from
the body.
Day 24:
LEARN HOW TO
COUNT FATS
The American Heart
Association makes it
easy to figure out how
much fat you need in
your diet. The My Fats
Translator (myfats
translator.com) calculates your daily
limits and gives tips
for staying within
your range.
Day 22:
FLEX
YOUR
BRAIN
The key to keeping your brain fit is
to keep it stimulated.
At happy-neuron.com,
you’ll find an array
of online activities
scientifically developed to make your
brain sweat.
Day 23:
MUNCH ON
WALNUTS
A study found that
foods such as walnuts that are high in
omega-3 fatty acids
can help maintain
bone health. Allergic
to nuts? Visit the
National Osteoporosis
Foundation’s website
(nof.org) for other
ideas on preventing
bone loss.
Day 25:
EAT A BOWL
OF CEREAL
Starting your day
with a bowl of highfiber cereal—at least
6 grams per serving—
can help reduce your
risk of heart disease,
stroke, diabetes and
even intestinal polyps
and colon cancer.
3/17/08 2:47:01 PM
DAY 26: SAY
“NO, THANKS”
One of life’s biggest stressors is our inability
to say no. Today, when you’re asked to do
something optional, practice “thanking the
person for the opportunity and then turning
him or her down,” Krieger advises.
Day 28:
TAKE A HIKE
Day 27:
CLEAN YOUR
CAR WITH
ANTIBACTERIAL
WIPES
Dashboards, seats,
cup holders and steering wheels are covered
with germs. And this
breeding ground
magnifies as temperatures climb.
Walking is good
for you, but hiking
makes exercise
feel more like
an adventure.
Visit trails.com to
find hiking trails in
your area.
Day 29:
GET A MASSAGE
More than an indulgence, massage
eases stress as well
as pain. Research also
suggests that massage
boosts the immune
systems in women
with breast cancer.
Day 30:
MAKE A
GROCERY LIST
FdAHSP0834_06-11_littlethin_lh.i11 11
One easy way to maintain your health is to
stay up to date on
your medical history.
Visit mercy.com and
click on “My Health
Manager” for dozens of
tools to help manage
your health. With “My
Health Manager” you
can store your healthcare information in a
secure environment,
learn more about your
medications, manage
the healthcare of your
entire family, and so
much more.
S P R I N G 2 0 0 8 | 11
A study in the Journal
of Consumer Research
found that people
who took this step
before shopping made
the healthiest food
choices and avoided
impulse buys.
30 SECONDS
TO BETTER
HEALTH
3/17/08 2:47:43 PM
Not
YOUR GRANDFATHER’S
Better training, tools and
techniques have transformed
emergency care
ER
I L L U S T R AT I O N B Y L U C L AT U L I P P E
Emergency medicine is a relatively new medical specialty. The American
Medical Association officially began to recognize specialties in 1934, but
it wasn’t until 1979 that emergency medicine was added to the list.
“Now, whether you’re a young child or 99 years old, there is somebody
in the emergency department who knows exactly how to manage you,”
says Roger A. Brooksbank, M.D., an emergency physician and regional
medical director of emergency services in East Tennessee for Team
Health. Team Health physicians staff St. Mary’s Health System emergency departments in Knoxville, Powell, Jefferson City and LaFollette.
Emergency rooms—or now more commonly called emergency
departments (EDs)—have changed in five key areas over the years.
1
SPECIALIZED CARE
2
MORE TREATMENT OPTIONS
Emergency medicine residency programs emerged in the
1970s, as pioneering physicians pushed for formal training
in emergency care. Over the past few decades, emergency medicine has
grown into a well-established specialty, with a solid infrastructure of
academic programs and clinical training.
Subspecialties such as trauma and pediatric emergency medicine
have created focused areas of research and teaching.
12 | S P R I N G 2 0 0 8
These days, more people are headed to fewer emergency
departments. From 1993 to 2003, visits to emergency departments increased by 27 percent, but 425 emergency departments closed
during the same period, according to the Institute of Medicine.
FdAHSP0834_12-13_ED_lh.indd 12
3/17/08 2:45:04 PM
To deliver efficient care for minor emergencies, many EDs have added
fast-track areas, “where patients can be seen and discharged more
quickly,” Dr. Brooksbank explains.
For patients who need monitoring but don’t need to be
admitted to the hospital, some EDs now have observation
areas, or clinical decision units. These areas allow patients to
stay eight to 12 hours and receive some of the same tests they would
receive if they were admitted.
3
IMPROVED TECHNOLOGY
“EDs today are more than a stopgap until patients can see
their primary care providers,” says Heath A. Parker, M.D., an
emergency medicine physician with Team Health. Dr. Parker is an emergency department physician at St. Mary’s Medical Center North in Powell.
“Emergency physicians now do a lot more diagnosing and treating. This
shift is largely in part to better imaging tools.”
For example, computed tomography (CT) scans provide a detailed look
at structures in the body. They often make exploratory surgery unnecessary for ED patients. But they also “give physicians the ability to make more
accurate diagnoses beyond trauma,” Dr. Parker says. “Both CT scans and
portable ultrasounds offer quick, noninvasive means to diagnose a range of
conditions, from gallstones to aneurysms.”
ED patients often need to be moved from place to place for tests. Older
monitoring equipment required a lot of unhooking and rehooking. “Newer
monitors are smaller and more portable,” Dr. Brooksbank says, “allowing
for easier, continuous monitoring.”
Another monitoring tool, pulse oximetry, has emerged in the past
decade. A pulse oximeter noninvasively clips on to the fingertip to measure
how well a patient is oxygenated. “Pulse oximetry has become the fifth vital
sign,” Dr. Brooksbank explains, in addition to the traditional four: body
temperature, heart rate, blood pressure and breathing rate.
4
QUICK INTERVENTION
Emergency care has become more focused on rapid diagnosis and
intervention. EDs now can administer time-sensitive treatments,
such as clot-dissolving medication or stents to open blocked arteries.
In years past, Dr. Parker explains, the ED might admit a patient suspected of having a heart attack, who would then see a cardiologist the next day.
Now rapid-response systems can bring cardiologists to the catheterization
lab for immediate intervention.
“We intervene dramatically faster,” Dr. Parker says. “People who
10 or 20 years ago would have died or been crippled from a weakened
TO WAIT OR
NOT TO WAIT
Sometimes it’s not easy to decide whether to seek emergency care.
Here are some warning signs that indicate a medical emergency:
◗ Difficulty breathing or shortness of breath
◗ Chest or upper abdominal pain or pressure
◗ Fainting, sudden dizziness, weakness
◗ Changes in vision
◗ Difficulty speaking, confusion or changes in mental status
◗ Any sudden or severe pain
◗ Uncontrolled bleeding
◗ Severe or persistent vomiting or diarrhea
◗ Coughing or vomiting blood
◗ Suicidal feelings
Your primary care physician’s office can help you decide whether you
need emergency medical attention. But when in doubt, go to the ED.
Source: American College of Emergency Physicians
heart can now have a
normal life.”
From strokes to pneumonia, faster treatment is now
recognized to bring about
better outcomes.
5
MORE COMFORTABLE
CARE
Left to right: Roger A. Brooksbank, M.D., Emergency
Physician, Regional Medical Director of Emergency
Services in East Tennessee, Team Health; and
Heath A. Parker, M.D., Emergency Physician,
Team Health
It’s a kinder, gentler ED
these days—thanks to more
and better medications to
treat pain, nausea and anxiety. “Patients are suffering dramatically less,” Dr. Brooksbank says.
Conscious sedation is now commonly used for painful procedures, such
as setting broken bones. Also, when patients need to be intubated and put on
a breathing machine, they are now given anesthesia and medication to relax
their muscles.
Other treatment advances also make emergency care less painful,
Dr. Brooksbank explains. For asthma patients, inhaled treatments have all
but replaced injections. For treating some lacerations, surgical adhesives
can close the wound instead of stitches.
Our experienced emergency medicine physicians are ready
to treat illnesses and injuries at any time of the day or night. Our
goal is to get you in, get you treated, and get you home as soon as
possible. To learn more, visit mercy.com.
FdAHSP0834_12-13_ED_lh.indd 13
S P R I N G 2 0 0 8 | 13
24/7 EMERGENCY CARE
3/17/08 2:45:20 PM
A Student for
Cardiac rehabilitation
teaches you the skills
you need to live a
heart-healthy life after
a heart attack
It was the answer your teacher gave you
in school when you asked why you
had to learn history. And it’s the
answer your doctor may give
you when you ask why you
need cardiac rehabilitation: “Those who cannot
remember the past are condemned to repeat it.”
Philosopher George Santayana
wasn’t writing about life after a heart
attack, but he sure could have been. If
you’ve just had a heart attack, you may
be eager to get back on your feet, back
to your job and back to that burger joint
you love. But if you don’t want to have
another heart attack, you’ll need to
Life
study the lessons of your heart attack
and learn some new skills to avoid
repeating history.
And cardiac rehabilitation can
help you do just that. In fact, successful
participation can reduce your risk of a
non-fatal recurrent heart attack by
20 percent, says Richard M. Briggs,
M.D., a board-certified cardiovascular and thoracic surgeon with East
Tennessee Cardiovascular Surgery
Group in Knoxville.
Here’s a primer on what you can
expect from cardiac rehabilitation.
VALUABLE EDUCATION
“We use the term rehabilitation, but it
may not be the
proper term,”
Dr. Briggs says.
“It’s really risk
reduction.”
According to
Remember what your teachers used to say: There are no
Dr. Briggs, the
stupid questions. If you’ve had a heart attack or heart
goals of cardiac
surgery, the number of questions whizzing through your
rehabilitation
mind can be overwhelming.
are to help you:
Here are a few questions to spark conversation with
ƒ Feel better
your physician:
ƒ Increase
ABOUT RECOVERY IN THE HOSPITAL
strength
◗ What happens after surgery?
ƒ Reduce stress
◗ What can be done to help my recovery?
ƒ Reduce risk
◗ When do I start rehabilitation?
of a subseABOUT RECOVERY AT HOME
quent heart
◗ What type of diet should I eat?
event
◗ How can I prevent another attack?
ƒ Increase life
◗ What changes should I make in my lifestyle?
expectancy
ABOUT REHABILITATION
◗ What is involved in cardiac rehabilitation?
Cardiac
◗ Is it covered by my health insurance?
rehabilitation
◗ What happens when my rehab program stops?
has four phases.
Think of them as
14 | S P R I N G 2 0 0 8
RAISE YOUR HAND
FdAHSP0834_14-15_heartsma_lh.ind14 14
classes or grade levels. As you advance,
you’ll gain more skills and knowledge
about your heart and how to take care of
it. And though there isn’t a graduation
ceremony, the benefits of a long life and
a healthy heart are more valuable than
any diploma could be.
PHASE 1: INPATIENT
If you’ve had or are suspected to have
had a heart attack, or if you’ve had
open-heart surgery, you likely will
recover in the cardiac care unit or
intensive care unit. Your heart rate,
blood pressure, breathing and other
vital signs will be monitored around
the clock. This is truly your first phase
of cardiac rehabilitation.
In the days following your heart
attack or surgery, your condition will be
stabilized, and you and your family will
be educated by a physician or a cardiac
rehabilitation nurse about what happened and what you can expect to happen. Upon discharge from the hospital,
ask your doctor questions until you are
comfortable with your treatment plan.
PHASE 2: TRANSITION
The second phase begins after you’ve
gone home, explains John A. Ternay,
M.D., a board-certified cardiologist with
East Tennessee Heart Consultants in
Knoxville. This is a period of monitored
activity during which you’ll visit a rehabilitation facility three times a week. At
each visit, you’ll exercise using a treadmill, bike, rowing machine or walking/
jogging track. A nurse or other professional will supervise your activity and
monitor you for any change in symptoms.
3/17/08 2:42:20 PM
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“If you are overweight, you
will be counseled on how to lose
weight,” Dr. Ternay says. “You
also will be educated on nutrition and other lifestyle changes,
such as smoking cessation.”
Other phases of cardiac rehabilitation vary in length depending
on the patient’s needs, but the standard
for this phase is 36 sessions over 12 weeks.
PHASE 3: SUPERVISED ACTIVITY
During the third phase, you’ll continue to go to
the rehabilitation facility to increase your physical
activity under supervision. “You’ll increase the
length and intensity of your workouts, and your
heart will continue to be monitored regularly. You
will receive further assistance with weight management and maintaining a healthy lifestyle,”
Dr. Ternay says.
This phase can last one to six months, depending on your needs and dedication. According
to Dr. Ternay, many patients enjoy the sense of
camaraderie they build with other cardiac rehab
patients. “It’s a social thing,” he says. “People
really enjoy it. And they appreciate the security
they feel in exercising in a medical facility.”
Richard M. Briggs,
M.D., Board-Certified
Cardiovascular and
Thoracic Surgeon,
East Tennessee
Cardiovascular Group,
Knoxville
John A. Ternay, M.D.,
Board-Certified
Cardiologist, East
Tennessee Heart
Consultants, Knoxville
%
10 20
TO
Statistics show that only 10 to 20 percent of people
who need cardiac rehabilitation actually do it.
PHASE 4: MAINTENANCE
S P R I N G 2 0 0 8 | 15
The fourth phase has no endpoint. Patients in this phase are “believers,” Dr. Briggs says. “They realize that they’ve had a problem, but they
can avoid having another one.”
During this phase, you’ll continue to live a tobacco-free life that
includes regular exercise, proper nutrition and weight management.
With your physician’s approval, you may exercise at home, a health club
or a community center—or you may opt to continue to work out at the
cardiac rehab facility.
“The majority of people who’ve gotten this far do quite well,”
Dr. Briggs says. The most crucial part of this phase, he says, is regular stress testing under your physician’s supervision. In the best-case
scenario, this phase lasts many years, as you’ve successfully averted a
second heart attack and improved your longevity.
If cardiac rehab can be likened to a school, you might feel like a student for life. The upside? It’s a long, healthy life.
PHOTOGRAPH BY JEFF NEWTON
FdAHSP0834_14-15_heartsma_lh.ind15 15
3/14/08 11:38:51 AM
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ABOUT HEALTH
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3/17/08 2:38:05 PM