Health Matters September 2019

Health Matters The latest news on the health and wellness issues that matter most • September 2019

NCH von Arx Diabetes and Nutrition Health Center offers Treatment, Education and Nutritional Counseling

In May 2019, the NCH von Arx Diabetes and Nutrition Health Center moved back to the NCH Downtown Baker Hospital campus after a full renovation of the center. It provides treatment, nutrition counseling, planning and education, and is overseen by a staff of medical providers including Victor Luna, MD, and Valeriu Neagu, MD, both NCH endocrinologists, and Janis King, DPN, APRN, endocrinology nurse practitioner. “Dr. Neagu and Janis King, located at the von Arx Center and Dr. Luna, who is based at our Bonita Springs office, see patients who have diabetes and other endocrine concerns such as gland and hormonal imbalances, thyroid and adrenal problems and metabolic disorders,” says Sarah Frye, NCH Physician Group Operations Director. A team of registered and licensed dietitians, registered nurses and certified diabetes educators completes the highly qualified staff. According to Dr. Neagu, diabetes is the main cause of secondary blindness, amputation, chronic kidney disease and end-stage kidney disease for dialysis patients in the US. “Diabetes is known as the silent killer, since patients can be without symptoms,” explains Dr. Neagu. “They can function well with a blood glucose three times above the target and still feel relatively well.” Among the many macrovascular and microvascular complications that can arise from diabetes are retinopathy (affecting vision), neuropathy (affecting nerves) and nephropathy (affecting the kidneys) – all of which are non-reversible. However, if a patient’s diabetes has been uncontrolled for a long time, and then becomes controlled with diagnosis and treatment, the progression of the disease, and its complications, can actually stop. Dr. Neagu says that the incidence of diabetes is increasing exponentially. Once considered a disease of the elderly, diabetes is now routinely diagnosed in teenaged patients – and younger children – many of whom are overweight. “Lifestyle changes like the rate of automatization with the use of cars rather than walking, decreases in

• Individual Nutrition Consultation – Adult and Pediatric • Healthy Plate Weight Management Program (1:1 personalized counseling and meal planning sessions) von Arx Diabetes and Nutrition Health Center programs for Diabetes and Nutrition education programs:

physical activity, changes in dietary patterns and the fact that most foods – even salami – are infused with high fructose ingredients, all contribute to the rise in obesity,” Dr. Neagu explains. However, he adds that he has seen a big improvement in the control and management of Type I diabetes with the use of home based insulin pumps and continuous glucose monitors. “One patient dropped their A1C from 12% to 7% in three months after initiating glucose monitoring,” he says. “While diet is still the cornerstone in treating diabetes, medication is also effective.” Dr. Neagu says that he recommends that his patients practice “mindful eating” to help control their diabetes. “At the table, be aware of what you’re eating,” he suggests. “Never eat anything while you're driving, or watching television, or engrossed in activities. The brain doesn’t register the process of eating; it is just a reflex, and you only end up with NCH Endocrinologist, Dr. Valeriu Neagu, and Sarah Frye, Director of Operations for NCH Physician Group. unneeded extra calories.” The NCH von Arx Center offers a diabetes education self-management program, a gestational diabetes clinic, diabetes prevention, a caregiver workshop and a diabetes and insulin pump support group. Nutritional offerings include individual nutrition consultation and weight management programs and a 12-week supervised weight management group. Audrey McKernan, NCH registered dietitian

• Healthy Weight Management Group (with a 12-week Wellness membership) • Diabetes Self-Management Program (with a 30-day Wellness membership; evening and daytime) • Gestational Diabetes Clinic (individual instruction) • Diabetes Prevention Class • Diabetes Caregiver Workshop • Diabetes & Insulin Pump Support Group

and certified diabetes educator, teaches patients about healthy meal planning, as well as how to shop, and more. Patients who have undergone bariatric procedures such as a gastric bypass, sleeve gastrectomy or the Orbera gastric balloon, or who are enrolled in a medical weight loss program, now have access to a support group that addresses their particular concerns. “It is well-documented that 80 percent of Type II diabetes patients that have a BMI of about 40 and who had various gastric bypass procedures can actually go off insulin in three months. It’s virtually a cure for diabetes,” says Dr. Neagu.

“As they lose weight, they go from having chronic diabetes to remission. They have a struggle every time they take a bite; we have to reinforce the good behavior – and the more we do, the more success we see.” In addition to medications, new technology includes continuous glucose monitoring devices, an external device placed on the arm, and an array of insulin pumps that enable staff members to download information to see the patient’s trends and explain treatment. The NCH von Arx Diabetes and Nutrition Health Center hopes to use its expertise and passion to better serve the southwest Florida community.

Insurance coverage is available fromMedicare and most private insurances for diabetes programs.

For more information or to make an appointment, call the NCH von Arx Diabetes and Nutrition Health Center , located in the Briggs Health Pavilion at 399 9th St N, in Naples, at (239) 624-3450 or visit www.NCHmd.org/Nutrition

The NCH Acute & Stroke Rehabilitation Program is Unmatched in Collier County

Welcome to the Brookdale Center for Healthy Aging

M ore than 750,000 Americans will suffer the debilitating effects of stroke this year. Nearly 140,000 will die. That is why it is very important to know the signs of stroke – and the importance of seeking immediate emergency treatment. The NCH Stroke Center is a patient’s first stop in the NCH acute stroke care and rehabilitation program. Stroke care starts in the ambulance and continues in the ER where time is of the essence. An evaluation of the patient’s condition is conducted immediately – and a neurologist can be consulted quickly in real-time using teleneurology. Interventional radiology identifies and addresses blood clots, administers medication, and performs other testing. Patients remain in acute care until their condition is stabilized. Then, when they are medically ready, they are transitioned to the stroke rehabilitation program at The NCH Brookdale Center for Healthy Aging & Rehabilitation. The stroke rehabilitation services staff includes physical (PT), occupational (OT), and speech (ST) therapists, nurses, a hospitalist, a physiatrist (physical medicine and rehabilitation physician) and a neuropsychologist. Six of the PT and OT staff members are specially certified in neuro-developmental treatment (NDT). To date, NCH Brookdale physical therapists have earned patient satisfaction scores of 98 percent. “While the requirement for rehab is three hours of therapy daily, because many patients are getting PT, OT and ST with our various programs, they actually receive four to five hours of therapy a day,” explains NCH Stroke Inpatient Rehab Manager, Jennifer Shover. “We work on strengthening their ability to perform activities of daily living, getting them to be able to move in bed, to sit up, stand, improve cognition, walk, talk and improve balance.” Because swallowing can be an issue for a number of stroke victims, speech therapists work with these patients to address swallowing difficulties, working in conjunction with the dining program to teach patients how to swallow again. Electrical stimulation is also utilized by OTs on arm or leg muscles to help improve

strength, and by STs to improve facial weakness. Shover says that staff members try to discover the things patients most enjoy and develop customized therapies based on these activities to achieve better results. “Because it’s something valuable to their life, they will be more engaged and interested in working hard,” says Shover. Inpatient rehabilitation rooms are assigned to stroke patients based on their impairments. Specialty rooms are equipped with video monitoring, allowing staff members to communicate interactively with patients, for patients’ safety. Bed alarms will quickly alert staff whenever a patient attempts to leave their bed without assistance. “We are truly set apart from skilled nursing facilities,” says Shover, pointing out that when medical issues arise, patients can be quickly treated due to the hospital setting. “There is no need to call for outside services to transport them to a hospital, and we have two physicians with eyes on each patient,” she adds. Rounding out the stroke rehab program is a case management staff that oversees patient progress from admission in the acute phase, to discharge and after. In addition to comprehensive discharge planning, staff members follow up with patients and their families concerning appointments with specialists, special equipment needs and anything else required to ensure full recovery. “Our Acute & Stroke Rehab program is light years ahead of all others,” says Shover. “When we see stroke patients come in on a stretcher and can’t move – then a month later, we see them walk out – it’s very satisfying.” Why NCH Acute & Stroke Rehab Program is Collier County’s superior stroke recovery and rehabilitation center: ● Most effective facility when comprehensive medical and medication management is required ● Patients are monitored by two physicians: a hospitalist and a physiatrist (physical medicine and rehab doctor) ● Specially trained nursing staff ● Highly trained physical, occupational and speech therapy team (six of whom have neuro disability training, NDT) ● Imaging tests , lab draws and other testing can be performed quickly on-site ● Special rooms designated depending on patient’s impairments, with video monitoring and interactive communication, and bed alarms for safety ● If needed , additional hospital services are located on the NCH property – no need for outside ambulance services as in skilled nursing facilities ● Yearly , on average, 80 percent of patients return home with an average length of stay of 11 days ● The program offers home evaluations to make recommendations for home modifications for optimummobility ● Unrivaled patient satisfaction scores of 98 percent for 2019

NCH Acute & Stroke Rehab offers:

• A fully equipped gym for strength training, with specialized equipment such as LiteGait

• High-tech, cognitive re-training tools and cutting- edge evaluation equipment; iPad applications for cognitive re-training • Dining room programs for motor skills and swallow functioning • Arts in healing program to train fine motor skills and cognition • Full kitchen and laundry, where patients practice home and daily living skills • Outdoor Mobility Garden available for daily as well as leisure activity training (uneven surfaces, a mailbox,

chip and putting green, fishing station) • Certified Peer Support Visitor program (many of whom are former stroke patients) • Horticulture program for planting in raised beds • Availability of a van for community outings • Stroke education and monthly support groups

The NCH Brookdale Center for Healthy Aging & Rehabilitation is located at the NCH North Naples Hospital, 11190 Health Park Blvd. in Naples. For more information about the Acute & Stroke Program call (239) 624-5700

The Top 10 Things Your Mammo Tech Wants You To Know

1. Bring your prior mammograms, it increases accuracy. The CD is available to pick up at most facilities. This will save you time and possibly money! 2. We care about your breast health and want you to be comfortable. The breast is only compressed for a short time and assists in separating the breast tissue to reveal any abnormalities. It does not cause breast cancer to spread. 3. What kind of mammogram do I need? a. Screening Mammography is done for patients with no breast complaints. b. Diagnostic Mammography is done for patients needing evaluation of a breast complaint or an abnormality detected by physical exam or the screening mammography. 4. Annual mammograms should begin at age 40, earlier if there is history. Regardless of advanced age, as long as you are in good health, continue with annual mammograms.

5. Mammograms are still the #1 way of detecting breast cancer and when found early, it is most treatable. 6. Do not wear deodorant or lotions under the arms or on the breasts. These can interfere with the quality of x-ray images. 7. Let us know if you have any physical limitations, we will work with you. 8. An abnormal mammogram is not always cancer. 9. A normal mammogram does not mean there isn’t cancer. 10. 75% of women diagnosed with breast cancer have no family history of breast cancer.

TO MAKE AN APPOINTMENT FOR YOUR MAMMOGRAM CALL NCH IMAGING AT 239-624-4443

Naples-Immokalee-Marco Island Tops U.S. in Well-Being for Fourth Time

For the fourth straight year, the Naples-Immokalee- Marco Island, Florida, metro area had the highest well-being across 156 U.S. communities. Gallup, the world leading analytics and advice firm, reported the findings this spring in their annual community rankings as part of the Gallup National Health and Well-Being Index. This marks the first time in 11 years of annual Well-Being Index reporting that the same city has topped the rankings four times in a row. In 2015, NCH brought the Blue Zones Project to southwest Florida to help promote well-being within the environment in which people live, play, learn,

work, pray, shop and eat. These efforts along with the many dedicated organizations collaborating to help people live healthier and happier in southwest Florida contribute to this stellar ranking. Just 8 years ago, the community’s well-being ranked at 73rd in the nation. “The continued strong well-being measured in the Naples metro area is impressive and illustrates that well-being can remain high amid declines nationally,” said Deb Logan, executive director of Blue Zones Project Southwest Florida.

1 – Naples-Immokalee-Marco Island, FL 2 – Salinas, CA 3 – Boulder, CO 10 Highest Well-Being Communities, 2018-2019

The Gallup National Health and Well-Being Index is calculated on a scale of 0 to 100, and is based on scores within each of the five essential elements of wellbeing: • Career: liking what you do each day and being motivated to achieve your goals • Social: having supportive relationships and love in your life • Financial: managing your economic life to reduce stress and increase security • Community: liking where you live, feeling safe and having pride in your community • Physical: having good health and enough energy to get things done daily

4 – Santa Rosa, CA 5 – Ann Arbor, MI 6 – Cape Coral-Fort Myers, FL

7 – Fort Collins, CO 8 – Lancaster, PA 9 – North Port-Sarasota-Bradenton, FL 10 – Asheville, NC

Electronic Implant Offers Hope to Patients Suffering From Chronic Nausea, Pain and Vomiting

If you or a loved one suffers from the chronic nausea and vomiting that are indicative of gastroparesis, you know just how debilitating the condition can be – and how any relief can be considered a miracle. The groundbreaking Enterra II neurostimulator has proven itself to be a miracle treatment for some gastroparesis patients when other treatment options have failed. In gastroparesis, which affects a number of Type 1 and Type 2 Diabetes patients, the stomach is unable to empty itself of food normally, causing abdominal pain and vomiting. The condition can also be attributed to idiopathic (unknown) origins or can develop in some patients after abdominal surgeries.

Medtronic Enterra II Neurostimulator

“Normally the stomach is a very dynamic organ that moves continuously to help propel food into the intestines,” explains NCH General Surgeon Robert Grossman, MD, who specializes in general, minimally invasive, laparoscopic and robotic surgery. “With gastroparesis, the stomach just sits there as an empty sack. When the stomach doesn’t move properly, patients can have severe pain after eating; patients usually have nausea and vomiting of undigested food.” According to Dr. Grossman, episodes can occur once or twice a week in mild cases, and up to 15 to 20 times a week in severe cases. “It can be very debilitating,” he says. “The few FDA- approved medications aren’t very effective, and the Enterra device is an excellent option that can help to restore a normal quality of life.” Gastroparesis patients ages 18 to 70 are candidates for the one to two-hour procedure, where a small device is implanted laparoscopically in the belly wall underneath the ribs. Two small electronic leads go into the stomach wall. “It is well-tolerated and patients don’t feel the device,” says Dr. Grossman. “They return home the same day, or stay overnight.” The implant’s settings can be adjusted by a handheld external device kept by the physician. When patients visit the office every six to twelve months for a check-up, the handheld device is placed over the implantation site and reads out >Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8

Made with FlippingBook - professional solution for displaying marketing and sales documents online