1. science
2. medicine
3. surgery

Health Essentials
Your link to a healthier life
TM
Winter 2012
Doing it her way
Like all women, Beyoncé had a pregnancy experience that was unique. What can her habits teach us? PAGE 4
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A message from
the president
A Cleveland Clinic
expert answers
your mammogram
questions
Getting back in the
saddle after knee
surgery
me d i nahos p i tal . org
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1/9/12 3:28 PM
from the president
Happy New Year!
I hope the new year is
going well for you. Many
of us use this time as an
opportunity to set new
goals for health and
wellness. Medina Hospital
would like to help.
As a physician, my goal is to keep people out of the
hospital. You may be surprised to hear this coming
from a hospital president, but it’s true. I have a real
interest in wellness.
Our goal for 2012 is to be your community
wellness partner. While we are already a wellness
partner with the Medina Community Recreation
Center, we would like to expand our reach to all
residents of Medina County.
I want to share with you some of the initiatives we
have under way:
n
n
In December, we partnered with the city of
Medina to bring in Caldwell Esselstyn, MD, who
directs the cardiovascular disease prevention
and reversal program at the Cleveland Clinic
Wellness Institute and is the author of the book
Prevent and Reverse Heart Disease. He gave a
lively presentation that included healthy recipes
from his wife, Ann.
to enjoy a free day at the Rec Center and
participate in screenings and education provided
by the hospital.
n
n
Research has shown that exercise can improve
the overall health and flexibility of older adults. So
to encourage more frequent exercise among our
senior citizens, we’re working with the Recreation
Center to provide them with free access and
transportation to the facility.
Community leaders have come together with our
hospital wellness team to look for ways to better
meet the health and wellness needs of Medina
County. The hospital offers a significant number
of health and wellness events and screenings
throughout the year and together we are working
to reach out to more community members and
encourage them to adopt a healthy lifestyle.
Watch our Community Connections calendar for
upcoming screenings and programs and stay tuned
as we work to make Medina County a healthier
community.
Tom Tulisiak, MD
President, Medina Hospital
M
Medina Hospital
1000 E. Washington St.
Medina OH 44256
330.725.1000
Tom Tulisiak, MD
President, Medina Hospital
Board of Directors
Pamela Miller, Chairman
Ronald H. Paydo, Jr., Secretary
Thomas Steinke, Treasurer
Tom Tulisiak, MD, President
David Bronson, MD
Gail Houk, LPCC-S
Kent Daugherty
Fred M. DeGrandis
Jonathan Funk, MD
Steve Glass
William J. Koran
Josh Miller, DO
Michael Modic, MD
S. Jules Moodley, MD
Elaine Nichols, EdD, RN, CNS
Timothy E. Phillips
Sampath Ramanavarapu, MD
Brad Root
Richard K. Shewbridge, MD
Timothy Spiro, MD
Brian Tucker
Editorial
Robin Louis
Martha Makar
Gary Weiland
This publication is for information
purposes and should not be relied
upon as medical advice. It has
not been designed to replace a
physician’s medical assessment
and medical judgment. Always
consult first with your physician
about anything related to your
personal health.
On Jan. 15, our “New Year, New You” event gave
more than 1,000 area residents the opportunity
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HEALTH ESSENTIALS
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WINTER 2012
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Mammogram
Q&A
Q
What’s involved in breast cancer screening?
There are three parts: a monthly breast self-exam, a clinical
breast exam by a physician and a yearly mammogram.
Q
When should I start breast cancer screenings?
You may have seen different guidelines about when a
woman should start breast cancer screenings. Several
leading physicians and groups, including the American
Cancer Society and Cleveland Clinic, maintain that women
should begin performing monthly breast self-exams by age
20. These should be performed around the same time every
month and seven to 10 days after your menstrual cycle ends.
Women between the ages of 20 and 39 should have a
breast exam performed by a physician at least once every
three years and each year after the age of 40.
Women age 40 and older should have a mammogram
every year. However, certain risk factors, such as family
history, may mean you have to start your screening earlier.
Always check with your physician to find out what is right
for you.
Q
What is a mammogram?
A mammogram is an X-ray image of the breast used to
detect tumors or other abnormalities. It is used as a cancer
screening tool for the early detection of breast cancer.
Q
What is a digital mammogram?
One of the most recent advances in mammography,
digital (computerized) mammograms create highresolution images that are exceptionally clear and
detailed. The differences are in the way the picture is
made, looked at and stored. Regular mammograms
are printed on X-ray films. Digital mammograms are
recorded and saved as files in a computer, similar to the
way digital cameras take and store pictures.
medinahospital.org
FdHNWI1207_Medina_AMM.indd 3
Immediately after the
exam, the doctor can
look at the pictures on
a computer screen and
adjust the size, brightness
or contrast to see certain
areas of the breast more
clearly. This allows the
radiologist to identify and
diagnose extremely small
masses or lumps. If a
breast specialist needs to look at the pictures, they can be
emailed rather than sent as a hard copy.
Q
Should I always request a digital mammogram?
For the most part, regular and digital mammograms
have similar accuracy. However, some studies have
shown digital mammograms to be more accurate at
finding cancer for some women under age 50 or women
with dense breast tissue. In addition, women who have
questionable areas on their mammograms have to
return less often for extra imaging tests because digital
mammograms allow the image to be magnified and
looked at in different ways. It is important to remember
that even if digital mammography is not available, women
should still get a regular mammogram.
Seema Misbah, MD
Dr. Misbah is a
Cleveland Clinic
medical oncologist
specializing in
breast cancer.
(call)
SCHEDULE YOUR MAMMOGRAM TODAY
Medina Hospital offers digital mammograms. To schedule
your appointment, obtain a referral from your physician
and call 330.721.5350.
HEALTH ESSENTIALS
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E
Risky
Business
A scary statistic: Black
women are three to four
times more likely than
white women to die of
pregnancy-related complications, according to the
U.S. Department of Health
and Human Services Office
on Women’s Health.
th
16
ta
Beyoncé’s
high-profile
pregnancy had
the whole world
watching
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That makes preconception
health and prenatal care
even more important for
black women, says Erin
McKelvey, MD, member
of the Regional Ob/Gyn
at Medina Hospital.
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“For most women, pregnancy is a relatively normal
process that we can optimize with healthy eating
and common-sense care,”
Dr. McKelvey assures. And,
of course, scheduling regular Ob/Gyn visits to track
fetal growth and health.
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Special D
WINTER 2012
1/9/12 3:26 PM
EvER SINCE lAST AuGuST, when Beyoncé Knowles slipped open her sequined tuxedo jacket during
the 2011 MTv video Music Awards to reveal a well-developed baby bump, the world went on pregnancy patrol. The
16-time Grammy winner and her husband, rapper and record producer Jay-Z, are R&B royalty, so it’s no surprise that
tabloids and websites around the globe have reported the first-time mother’s every step.
Most moms-to-be will never have to endure that level of scrutiny,
but many may have marveled at how well Beyoncé weathered
her pregnancé. Can we learn something from her? We asked Erin
McKelvey, MD, member of the Regional Ob/Gyn at Medina
Hospital, for her advice.
She: Worked Nonstop
In the first months of her pregnancy, Beyoncé appeared at a slew
of red-carpet events and concerts. “I have been pregnant through
every event I’ve done, from the Billboard Awards to Glastonbury,”
she told Harper’s Bazaar magazine.
She: Kept Cravings Under Control
Although tabloids had reported cravings for everything from
ketchup to ice cream with hot sauce, the star told ABC’s Katie
Couric that wasn’t true. Plus she was careful about what she ate.
“I’ve been trying my best not to lose control because I’ve met so
many people that say, ‘My second baby, my third baby, I learned
my lesson.’ So I haven’t been going crazy.”
We: Stay Active but Rest
“Women who stay active and walking to the end of their pregnancy
seem to have easier deliveries,” says Dr. McKelvey. “Remember,
labor is called labor for a reason—it’s a lot of work to push out a
baby!—and couch potatoes will tire out faster.” In the meantime,
aim for eight hours of sleep a night.
We: Indulge but Keep Nutrition in Mind
An occasional splurge is OK, Dr. McKelvey says, but remember
that it takes only about 300 extra calories a day to meet the needs
of a developing fetus. “That’s maybe a full-milk latte,” she says.
“Don’t go overboard, and go for quality, not quantity. If you’re
craving ice cream, buy a small container of the good stuff—not a
half-gallon.” Overall, what’s important is a healthy, balanced style
of eating, with an appropriate amount of fruits, vegetables, whole
grains and lean proteins.
She: Runs the World … in heels
“I still rock my stilettos,” says Beyoncé, who was photographed in
mid-November stepping out in 5-inch platform heels.
We: Lower the expectations
“High heels are one of the worst inventions as far as women staying
on balance,” says Dr. McKelvey. “As pregnant women gain weight
in their bellies, they’ll need to lean backward to maintain balance,
which puts a strain on part of the lower back.” Wearing high heels
can amplify this effect and make back pain worse, Dr. McKelvey
says, which is why she recommends sticking to lower-heeled pumps.
She: had a Pregnancy Plan
“I always said I’d have a baby at 30,” Beyoncé said last June in
an interview on CNN’s Piers Morgan Tonight, and she’s right on
schedule: She turned 30 this past September, and her daughter,
Blue Ivy, was born in early January.
We: Plan for Preconception health
“What you do during pregnancy appears to program your child’s
health,” Dr. McKelvey says, so proper nutrition is important even
before you discover you’re expecting. Talk to your Ob/Gyn provider
if you’re trying to get pregnant—“two to three months ahead of
time is ideal,” Dr. McKelvey says—and begin taking prenatal vitamins and folic acid, which can help prevent certain birth defects.
Get fASt, fRee PReGNANCy ANSWeRS
Cleveland Clinic’s website covers all your pregnancy
concerns, from when to schedule dental visits to your
options for delivery. Go to my.clevelandclinic.org and
under health Information, select the letter P.
lDelivery
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By SAM MITTELSTEADT
heALth eSSeNtIALS
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1/9/12 3:27 PM
Back in the
saddle
Wadsworth woman back to enjoying
the great outdoors after knee surgery
Lisa Kriz loves taking advantage
of the outdoors—nature trails,
horseback riding and walking her
dog. Unfortunately, an accident on
one of those outdoor adventures
threatened to limit her ability to
enjoy her active lifestyle fully.
Joseph Scarcella, MD
Last April, the Wadsworth resident
was planning to go for a ride on her horse. “I was at the
stable loading my horse up the ramp and into the trailer,”
says Kriz, 42. “That’s when he decided he was going to
turn around and come out.” To get out of the way, she
hopped off the trailer. She fell as her right leg slipped on
the muddy ground.
“I heard a pop and felt a lot of pain,” she says. “I thought
I broke my leg.”
Her leg wasn’t broken, but she ruptured the anterior
cruciate ligament (ACL) on her right knee.
Diagnosing an ACL Injury
Kriz went to the Emergency Department at Medina
Hospital, where she works as a patient scheduler. “They
were great,” Kriz says. “They did an X-ray and suspected
an ACL injury.”
To confirm the diagnosis, she needed an MRI and a
consult with an orthopaedic surgeon. Based on the
experiences she and her patient-scheduling colleagues
had, she knew she wanted to see Joseph Scarcella, MD.
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HeALTH eSSenTIALS
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“He has years of experience and knows what he’s doing,”
says Kriz. “I wasn’t taking any chances.”
“I
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WInTer 2012
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1/9/12 3:29 PM
e
”
Dr. Scarcella confirmed the damage to her ACL, which
is the most common ligament injury to be operated
on, especially among athletes. However, instead of
recommending immediate surgery, he prescribed four
weeks of physical therapy to determine if that would
ease the pain.
Physical Therapy Vs. Surgery
“It depends on the patient,” explains Dr. Scarcella.
“Strains can sometimes be fixed through physical
therapy and muscle strengthening alone, though tears
almost always require surgery when it involves the ACL.
“High-level athletes immediately choose to have the
surgery, followed by physical therapy, to get them back
to a competitive level as quickly as possible. For some
patients, however, physical therapy is enough and they
choose not to have the surgery. I wanted to give Lisa the
opportunity to try physical therapy first.”
According to her physical therapist, Philip Toal PT,
DPT, Kriz’s four weeks of therapy at the Cleveland
Clinic Rehabilitation and Sports Therapy Unit at
Medina Hospital were quite successful. “She built up a
lot of strength and range of motion,” he says.
Deciding on Surgery
“I was told I may not need the surgery,” says Kriz, “but
I wanted to develop more stability in my knee for horse
riding and other activities. I’m very active, so I decided to
have the surgery.”
t
Kriz’s outpatient surgery was performed on June 23.
Dr. Scarcella used arthroscopy, a minimally invasive
procedure, to reconstruct the ACL using a cadaver tendon.
The outpatient surgery took about one hour, and Kriz
returned home the same day. She was immediately
allowed to put weight on the leg and begin bending it.
Her twice-a-week physical therapy regimen with Toal
began just four days later.
The Benefits of Therapy
“Physical therapy was the last thing I wanted to do so soon
after surgery,” says Kriz, but it was highly recommended
by her medical team.
”
“It’s a great benefit to see patients as soon as possible after
surgery,” says Toal. “We can immediately begin to restore
muscle strength and resolve soreness.”
2
medinahospital.org
FdHNWI1207_Medina_AMM.indd 7
After rupturing the anterior
cruciate ligament (ACL) in her
right knee, Lisa Kriz underwent
outpatient surgery followed
by physical therapy. She is
pictured at left with physical
therapist Philip Toal PT, DPT.
Physical therapy first consisted of range of motion
exercises to regain flexibility of the ligament, prevent
breakdown of scar tissue and reduce loss of muscle tone.
After the first month, Kriz saw Toal just once a week while
continuing therapy exercises on her own time.
“She’s a great patient,” says Toal. “She’s very active and
we had to pull her back a bit. She was very motivated and
wanted to do more.”
At press time, Kriz was seeing Toal every three weeks
and was working on dynamic hopping and light jogging.
For the time being, she still wears a protective brace
when doing her outside activities. “I am back to walking
the nature trails, doing my barn activities and riding the
horse,” she says. “I am not yet doing competitive trails yet,
but that’s my goal.”
(call)
KNEE
INJURY?
For an
appointment
with a Cleveland
Clinic expert, call
330.721.5700
(Orthopaedics) or
330.721.5009
(Physical Therapy).
And she has no regrets about having the surgery. “I
am feeling really well,” she says. “I would recommend
Dr. Scarcella and Phil to anyone.
“It’s not the greatest time in your life after an injury,”
notes Kriz. “But I want others to know they should not be
apprehensive about having this surgery. I was very confident
in my medical team, and I want people to know that.”
HEALTH ESSENTIALS
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1/9/12 3:29 PM
Medina General Hospital
1000 E. Washington Street
Medina, OH 44256
NON-PROFIT ORG
US Postage
PAID
HEALTH ESSENTIALS
Girl Talk
EvErything you Want to KnoW
But arE afraid to asK
Thursday, February 16, 2012
Diamond Event Center
1480 Pearl Road, Brunswick, OH 44212
5:45 p.m. – Visit informational tables, health
screenings, giveaways, raffle and more.
6:30 p.m. – Complimentary dinner
7 – 8 p.m. – Physician panel discussion
speakingofwomenshealth.com
Did you ever have a gynecological question that you were too
embarrassed to ask your doctor?
Join this lively Q & A session in which you’ll have the opportunity to
ask your questions live, or submit questions anonymously in writing.
Don’t be shy – this friendly atmosphere will help you relax and find out
what you need to know.
Topics will include:
•Yourbodyafterbabies–what to expect when you’re done expecting.
•Bladdercontrol–when to “hang in there” and when to do something about it.
•Straighttalkaboutyourperiod– there’s something almost everyone doesn’t know
about the monthly event every woman experiences.
•Sex,sexandmoresex– everything you wanted to know about the highs and
lows of libido.
FdHNWI1207_Medina_AMM.indd 8
There is no charge for this event
but reservations are required.
Register online at
www. medinahospital.org (click
on Calendar of Events) or call
330.721.5992. Deadline for
registration is February 9, 2012
1/9/12 3:29 PM