best winner - elliot health system and elliot hospital in ... · mri system was developed and...

Treat yourself to a healthier mind & body, see classes on pages 6 to 8

Spring/Summer 2012 • www.elliothospital.org

DIAGNOSTIC IMAGINGPage 2

PELVIC PAIN IN MEN1

INFANT REFLUXPage 13

BENEFITS OF HOSPICEPages 14

Rheumatologists CAN HELP...

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2 Spring/Summer 2012 | www.elliothospital.org | Elliot Direct 603-663-1111

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Introducing the Elliot’s newDiagnostic Imaging Center at

River’s Edge. The Imaging Center isfocused on patient comfort andconvenience, reduced radiationexposure, faster procedure times, andspeedy results! The imagingequipment is completely digital,including digital x-rays, digitalfluoroscopy, MRI, CT Scan,Ultrasound, and Nuclear Medicine.This digital equipment provides thehighest image quality; fast proceduretimes, and connects through ourdigital network to radiologists whointerpret the images using voicerecognition software. All of this addsup to high quality, low dose,imaging procedures that aresimultaneously integrated into theElliot’s electronic medical recordsystem.Digital x-ray machines have

replaced traditional methods andnow utilize wireless digital platescapable of showing your x-ray to thetechnologist within 2 seconds! X-rayexams are faster, allowing patients tocomplete their testing quickly. All ofour digital x-ray units allow easy onand off access to the tables bylowering to within 18 inches fromthe floor. The wireless plates allow usto position patients in wheelchairs oron stretchers more easily.The CT scanner at River’s Edge is

the Siemens HealthcareSOMATOM Definition Flash CTscanner. Our scanner has recentlybeen honored by AuntMinnie.comwith the 2009 “Best New RadiologyDevice” Minnie Award forexcellence in radiology. TheDefinition Flash CT scanner setsnew standards regarding speed and

dose reduction. This system requires only a fraction of the radiation dosethat were previously required to scaneven the tiniest anatomical detailsand it is faster than ever before. TheSOMATOM Definition Flash is adual-source CT from Siemens,featuring two X-ray tubes thatsimultaneously revolve around thepatient’s body. This feature alsoallows for dual energy scanningwhich will improve the diagnosticanalysis of kidney stones, reduce thenumber of scan passes needed fortissue differentiation, remove boneoverlap and calcifications fromvascular exams, and reduce motionin pediatric CT scan images. It willvirtually eliminate the need to sedateyoung children for diagnostic CTscans.

The Siemens S2000 ultrasoundsystems at River’s Edge are state-of-the-art digital ultrasound systemsdesigned to produce high qualityimages, obtain “live” imaging clipsof functioning organs, with thecapability of “live” supervision by aspecialized radiologist through oursophisticated networking solution.These systems are designed for fasterthroughput, have intuitive softwarefeatures which use automaticmeasurements of anatomy usingpattern recognition software.

The 3T Siemens Verlo MRIsystem at River’s Edge features acomfortable 70 cm “open-bore”configuration, accommodating alltypes of patients with reducedsensitivity to claustrophobia. ThisMRI system was developed andintroduced as the world’s first high-strength “open-bore” magnet. It isalso the shortest 3T MRI scanner

DIAGNOSTIC IMAGING SERVICES

Digital X-Ray

Digital X-Ray Plate

SOMATOM Definition Flash CT

Siemens S2000

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Elliot Direct 603-663-1111 | www.elliothospital.org | Spring/Summer 2012 3

ever created. Our new 3T scanner will complement our 1.5T scanners at the ElliotHospital and Elliot Medical Center at Londonderry Imaging. If you have everexperienced an MRI that you found to be uncomfortable and too confined, you willbe happy to hear about this scanner which offers comfort and space. The largeopening and specially designed table can accommodate patients weighing up to 550lbs, offering high-quality MRI exams to everyone needing them. The 3T, high-strength MRI improves the quality and resolution of small anatomical imaging,brain imaging, breast MRI, and is exquisite for imaging of joints and cartilage.Elliot’s MRI services are accredited by the American College of Radiology. To assurethat your MRI is done at an accredited site, follow this link to www.acr.org.SPECT-CT completely integrates the functional imaging sensitivity of Nuclear

Medicine with the rich anatomical detail of diagnostic multi-slice CT. This newimaging modality will increase our ability to detect changes in molecular activityeven before anatomical changes become visible. The molecular “hot-spots” seen onthe nuclear medicine scan can be fused with the CT scan detail, making diagnosticconfidence much better. This technology lowers false positive scans, aids in planningmore effective treatment of disease as well as monitor effectiveness of treatments.

Women’s Imaging EnhancementsThe Women’s Imaging equipment at River’s Edge is located within the Elliot

Breast Health Center for convenient access during a visit. In addition to digitalmammography, breast ultrasound, and breast MRI services, the River’s Edge facilitywill add stereotactic breast biopsy capability, breast ultrasound Elastography, as wellas ABVS (Automated Breast Volume Sonography), all within the center. Key advantages of ABVS include standardized, reproducible bilateral whole

breast imaging with 3D capability. The typical study is an automated 65 secondscan of the breast in multiple positions, then images are reconstructed and reviewedon a specialized workstation by a radiologist. Breast Elastography is a new techniquewhich looks at the mechanical properties of tissues (relative stiffness) as opposed toconventional ultrasound which looks at the back-scatter of transmitted ultrasoundwaves through tissues. The outcome requires calculation of an Elastography ratio todetermine if the lesion is more or less stiff than the surrounding tissues, suggestingeither malignant or benign mass. This technique has the potential of reducingunnecessary biopsies as well as to help select those patients for whom biopsy iswarranted. The GE IDXA Bone Density Scanner represents

the latest state-of-the-art bone density scanningsystem. In addition to traditional bone densityevaluation, this system introduces the capability toperform Vertebral Fracture Assessment. It is capableof taking a full-view measurement of the entirespine. The advantages of this technology are theability to detect vertebral fractures that are oftenunrecognized.For more information or to book an

appointment for your diagnostic imaging needs,please call central booking at 603-663-2180.

3T Siemens Verlo MRI

SPECT CT

ABVS

GE IDXA Bone Density Scanner


RHEU

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heumatology is a rapidlyevolving subspecialty in internal

medicine and pediatrics which includes the pathogenesis, diagnosis, andmanagement of over 100 complex inflammatory andconnective tissue diseases. Rheumatologists care for a widearray of patients – from children to senior citizens, seediseases like Rheumatoid Arthritis, Systemic LupusErythematosus, Psoriatic Arthritis, Ankylosing Spondylitis,Scleroderma, Myositis, Sjogren’s syndrome, Vasculitis,Polymyalgia Rheumatica, and particularly diseases of aging,such as Osteoarthritis, Gout and Osteoporosis. These

diseases affect nearly 50 million Americans andcan cause joint and organ destruction, severe pain,disability and even death. Inflammatoryrheumatic diseases with arthritis cause moredisability in America than heart disease, cancer ordiabetes.

How can a Rheumatologist help?Most rheumatologic conditions previously led tosevere disability and even death in many patients.Evidence-based medical treatment ofrheumatological disorders is currently helpingpatients with rheumatism lead a near-normal life.

Medications such as Methotrexate and Tumornecrosis factor inhibitors have had a significantimpact on patients with Rheumatoid Arthritis(RA), and today patients with RA can lead a painfree and productive life.


WHAT ISRHEUMATOLOGY?

Rheumatology facts by numbers: • Over 7 million American adults suffer frominflammatory rheumatic diseases; 1.3 millionadults have rheumatoid arthritis; and 161,000 to322,000 adults have lupus.

• 8.4 percent of women will develop a rheumaticdisease during their lifetime. Women are 2 to 3times more likely to be diagnosed with RA, and10 times more likely to develop lupus than men.

• 5 percent of men in the U.S. will develop arheumatic disease during their lifetime.

• Osteoporosis and low bone mass are currentlyestimated to be a major public health threat foralmost 44 million U.S. women and men aged 50and older.

• Approximately 1.6 million hip fractures occurworldwide each year; by 2050 this number couldreach between 4.5 million and 6.3 million.

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After 50 years, the FDA approved a new drug, Belimumab, forpatients with Systemic Lupus Erythematosus (SLE). It is usedto treat patients with active SLE who are not controlled on otherconventional therapy.

As mentioned above, Osteoporosis is a growing problemespecially in the aging population, which increases the risks offractures, most common being hip and vertebral fractures.Medications such as bisphosphonates, Teriperatide and

Denosumab can prevent bone loss and improve the quality ofbone leading to reduction in fractures by 50% or more.

Some of the greatest strides in pharmacologic therapy in the pasttwo decades have come in the field of rheumatology, and thenext decade promises even more. At Elliot RheumatologyAssociates we are committed to providing the highest quality care available in this ever-advancing specialty.

Douglas F. Marks, MDEXPERIENCE:RheumatologistDartmouth-Hitchcock Manchester ClinicAssistant Professor of MedicineDivision of RheumatologyDartmouth-Hitchcock Medical Center

EDUCATION:Fellowship in Rheumatology, Dartmouth

Hitchcock Medical CenterInternship and Residency in Internal

Medicine, Dartmouth Hitchcock Medical Center

Medical Doctorate, University ofMassachusetts Medical School

CERTIFICATIONS:American Board of Internal Medicine

subspecialty Rheumatology

Naureen Mirza, MDEXPERIENCE:Assistant Professor of Clinical MedicineDivision of RheumatologyDepartment of MedicineSUNY Stonybrook

EDUCATION:Fellow, Rheumatology, SUNY Upstate

Medical UniversityFellow, Geriatric Medicine, Flushing

Hospital Medical CenterIntern and Resident, Internal Medicine,

Flushing Hospital Medical CenterMBBS, Dow Medical College, University of

Karachi, Pakistan


subspecialty RheumatologyAdded qualifications in Geriatric Medicine

Christopher J. Lynch, MD, FACPEXPERIENCE:Private Rheumatology PracticeManchester, NH, 31 years

EDUCATION:Clinical and Research Fellow in,

Rheumatology and Clinical Immunology,University of Pittsburgh

Senior Resident in Medicine, AlbanyMedical Center Hospital

Assistant Resident in Medicine, AlbanyMedical Center Hospital

Intern in Medicine, Albany Medical CenterHospital

Medical Doctorate, Cornell UniversityMedical College


subspecialty Rheumatology


American Heart Association CPR & Basic First AidThe American Heart Association strongly promotesknowledge and proficiency in BLS, ACLS and PALS andhas developed instructional materials for this purpose.Use of these materials in an educational course does notrepresent course sponsorship by the American HeartAssociation. Any fees charged for such a course, exceptfor a portion of fees needed for AHA course material, donot represent income to the Association.

Heartsaver CPR $38RE: Sat, Mar 3, May 5 or Jul 14, 8 to 11AM.

CPR for New Healthcare Professionalsor those with Expired Certification $63RE: Sat, Apr 14, Jun 2 or Aug 4, 8AM to12:30PM

CPR Renewal for Healthcare Professionals $48RE: Sat, Mar 3, May 5 or Jul 14, 11:30AM to3:30PM

Heartsaver First Aid $38RE: Wed, Apr 11 or Jul 11, 6 to 9PMLearn techniques to give immediate care to aninjured or suddenly ill person or to someoneinvolved in a life-threatening situation; andwhen to alert medical personnel.

Foot Clinic $20LON: Every 4th Mon from 9AM to noonMarie Cole, RN will be in Londonderry, withone patient every 30 minutes to address yourfoot care needs from a clinical perspective.

Medication Management Free!RE: 6 times yearly. Call 663-2767 for dates.A two hour class for patients taking narcoticmedication to relieve pain. Learn the risksand benefits of prescribed opioids.

Women’s Health Pre-operative Patient Education Class Free!EH, King Unit: On-going. Physician referralrequired. To participate, speak with yoursurgeon.For women with scheduled gynecologicalprocedures at Elliot Hospital. Learn how toprepare for surgery, what to expect followingsurgery, pain management and more. Yourquestions will be answered. Patients areencouraged to bring a family member orsupport person.

Understanding & Managing Chronic Pain $35RE: Thur, Apr 12 to June 14, 5:30 to 7:30PM.Call 663-2767 to register.Learn techniques to control pain, improvefunction, restore hope and improve thequality of life. Taught by a Pain ManagementCenter nurse with years of experienceworking with pain patients.

Total Joint Replacement Pre-operative Patient Education Class Free!EH, King Unit: 1st & 3rd Thur, 1 to 3PMLearn how to prepare for knee or hip replace-ment surgery, what to expect following theprocedure and through the therapy process.

Elliot Center for Tobacco TreatmentRE: By appointment, call 663-2201 for moreinformation. Sessions may be reimbursed byAnthem or other insurance companies.• Four, 1-hour private sessions $125• One, 1-hour private sessions $45• One, hypnosis private session $90Studies show that intense support andcounseling with a trained tobacco treatmentspecialist increase the chances you can quitsmoking for good. Our certified counselorworks with you privately to formulate a quitplan based on current clinical guidelines.

1-Day Surgery Ctr Tour for Children Free!RE, 1-Day Surgery Center: First & Third Wedmonthly, 3PM, registration required.Parents, children ages 12 and younger, andtheir siblings are invited to attend our specialpediatric tours. Meet with staff, review thesurgical process and tour the facility.

Health Coaching $29RE, Welliot: Various appointment times, call663-5757 to schedule.Receive an individual health evaluation toidentify your health goals and establish acomprehensive treatment plan to reduceyour risk for disease or manage yourcondition. Follow-ups available for $15per session.

Women’s Stress and Self Care $60 per session275 Mammoth Rd, Suite 1, Manchester: Tues,Mar 20, 27, & Apr 3, 10, 17 & 24, 4 to 5PM.Do you find it difficult to find time in yourday to take care of yourself? Feel guilty aboutsaying no? Do you have difficulty trying tounwind? Join us for six weeks to learn how totake better care of you. We will talk aboutstress and the toll it takes on your body, andhow you can reduce anxiety, relaxation skillswith hands on practice and much more!Participants will leave relaxed and hopefulabout practicing learned tips at home. Selfcare starts with you!

This session is offered to patients of theElliot Physician Network or Elliot employeesonly. Elliot Behavioral Health Services acceptsmost insurances.

Body Acceptance $60 per session275 Mammoth Rd, Suite 1, Manchester: Mon,Apr 9, 16, 24, 30 & May 7, 14, 6 to 7PM.A women’s group on making peace with yourbody, lumps, bumps, spots and all!Discussions will focus on changing yournegative thoughts, whether it was createdthrough media, illness, family or own ideas.In a safe and nurturing space, explore howthat has affected you and the way you look atyourself. Learn how to have compassion forthe body you have and how to have a morepositive body image.

This session is offered to patients of theElliot Physician Network or Elliot employeesonly. Elliot Behavioral Health Services acceptsmost insurances.

Role Reversal: Caring for Aging Parents Free!EH Conf Rm CDEF: Thur, Apr 19, Jun 21 orJul 19, 5:30 to 7:30PM.EH Conf Rm CDEF: Wed, May 16 or Aug 15,5:30 to 7:30PM.This presentation is provided by the expertsat the VNA of Manchester and SouthernNew Hampshire. Planning for the future isimportant. Come and learn about options forcare that will be available including homehealth, hospice care, nursing home and

LOCATION OF CLASSES ARE DENOTED IN EACH DESCRIPTIONTo register, call Elliot Direct 603-663-1111, unless otherwise noted. For additional program details, visit www.elliothospital.org.

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Community Wellness

Take time for your health

"SOME CLASSES MAY BE JOINED WHILE ALREADY IN PROGRESS."

GENERAL HEALTH EDUCATION

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Register online at www.elliothospital.org or call Elliot Direct 603-663-1111

• EH: Elliot Hospital, One Elliot Way, Manchester• EBHS: Elliot Behavioral Health Services, 445 Cypress Street, #8, Manchester• LON: Elliot Medical Center at Londonderry, 40 Buttrick Road, Londonderry• EWC: Elliot Wellness Center, 1070 Holt Avenue, Manchester• SHC: Senior Health Center, 138 Webster Street, Manchester• RE: The Elliot at River’s Edge, 185 Queen City Avenue, Manchester


COMMUNITY WELLNESS

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rehabilitation care, who pays for it, which level ofcare is appropriate at what time, and how toaccess care. Coping tips as well as informationabout transitional care and advanced directiveswill be provided. Participants will receive a take-home resource kit.

Fit & Feisty $45RE: T/Th, Mar 13 to May 3, May 15 to Jul 5, 10to 11AM.This is a 60-minute low-impact aerobics class tomusic, with easy-to-follow moves, followed bystrength training, floor exercises, chair exercisesand toning work. For individuals 50+.Instructor: Chris Guthro and Cecily Danver.

Total Body Strength and Tone $80RE: Wed/Fri, Mar 14 to May 4, 5:45 to 6:45AM.Start your day right with this total bodyworkout. It offers strength training to all themajor muscle groups and abs using a variety ofexercise equipment. This class is ideal forbeginners to advanced exercisers. Instructor:Ann Suls.

Full Body Fusion $80RE: T/Th, Mar 13 to May 3, May 15 Jul 5, 6 to7PM.A fusion of strength training exercise using bodyweight and hand-weights, cardiovascularintervals, plyometrics, yoga, pilates, core workand stretching. Keeps your body guessing!Instructor: Nicole Hansche.

Yoga Core $80RE: Mon, Mar 12 to Apr 30, May 14 to Jul 2,4:45 to 5:45PM.Yoga core focuses on increasing strength of theabdominals, low back, and core stabilizermuscles while promoting total health and wellbeing through stretching, strengthening, andrelaxing. Yoga core uses breath and movementto feel the release of physical and mental tensionand to increase mind and body awareness. Thisclass is slightly more challenging than GentleYoga. Instructor: Chris Guthro.

Gentle Yoga $80RE: Mon, Mar 12 to Apr 30, May 14 to Jul 2, 6to 7PM.Gentle Yoga is designed to promote total healthand well being through stretching,strengthening, and relaxing. This class usesbreath and movement to feel the release ofphysical and mental tension and to increasemind and body awareness. Good for thebeginner level participant. Instructor: ChrisGuthro.

Pilates $80RE: Wed, Mar 14 to May 2, 6 to 7PM.This class focuses on core (abdominals, obliques,back muscles) and pelvis stabilization, spinalflexibility and stabilization as well asstrengthening and stretching the whole body toattain balance. Appropriate for all levels.Instructor: Pam Godbois.

Gym Membership $35 monthlyWelliot at River’s Edge: Mon to Fri ongoing,6:30AM to 4PM. Call 663-4200 to get started.The Welliot at River’s Edge fitness centerconsists of a variety of cardiovascular equipment,Nautilus strength training equipment, and a freeweight area. Our fitness specialists will design aprogram specific to your needs and limitations.We offer one-on-one orientations and a safe,non-competitive environment to help you reachyour fitness goals, whether you are just startingout or have been exercising for years. Membersmay join at any time.

Diet for Health $150EH: Call 663-4LBI for dates, times and to registeror for more information.This 10-week lifestyle change program will helpyou reduce cardiovascular risk factors, promotefat loss, and support healthy insulin and bloodsugar.

Comprehensive Weight Management Program Free! EH: Call 663-4LBI for dates, times and to registeror for more information. This free introductory session outlines the 10-week comprehensive weight managementprogram focusing on total health, not justpounds on a scale.

LBI Support Group $25 per 4 sessionsEH: Call 663-4LBI for dates, times, to register orfor more information.Includes weigh-in and group session with aprofessional. Supports people who would like tomaintain their weight loss.

Do you know your Numbers? (Cholesterol Tests)RE: Third Thur monthly, 8 to 10AM. By appt.Fasting Lipid Profile with Glucose $25Non-Fasting Total/HDL $21Find out if you have an increased risk of heartdisease.

Breast & Cervical Cancer Screenings Free!FREE breast and cervical cancer screening teststo eligible women. For more info, call 668-3067.

Are You at Risk for Osteoporosis? $22RE: Third Thur monthly, 8AM to 10AMSafe, quick and painless test using ultrasoundtechnology to assess risk of osteoporosis.Recommended for both women and men.Confidential results provided to participants.

Postpartum Emotional Support Group Free!EH, Elliot Childcare Center Activity Rm, ElliotHospital campus, 450 Massabesic St., Manchester:Mon, 10:30AM to noon. Call Alison Palmer, RNC,MS, at 663-3052 for more information.This group is intended to help support womenexperiencing mood, anxiety, and thoughtdisorders during pregnancy and the first yearafter the birth of their baby. We discuss issuesand coping strategies related to the adjustmentperiod and challenges of new motherhood.

NICU Parent Support Group Free!EH, NICU Family Rm, 5th Floor: Tue, noon. Formore info, Contact [email protected] call 663-4360.

S.H.A.R.E. Free!Third Wed monthly, 7 to 9PM. Call 663-3396 formore information.For parents who have experienced a miscarriage,stillbirth or neonatal death.

Chronic Pain Support Group Free!RE: Second & Fourth Tue monthly, 5 to 6:30PM.Call 663-2767 to register. Peer support group focused on education;bringing new thinking to what chronic painpatients can do to more fully engage inlife. Guest speakers.

Stupid Cancer!!! Free!Concord: Mar. 30, Apr. 6 &13, 3 to 4:30 pm.Call Nicole at 663-1833 to register.A social and supportive gathering for teens witha loved one who has experienced cancer.

Thriving with Yoga Free!LON, Elliot Regional Cancer Ctr: Mon, 4:30 to5:30PMEH, Elliot Regional Cancer Ctr: Tue, 6 to 7:30PM.Registration is required, call 670-0302 [email protected] partnership with YogaCaps, Inc., free yogaclasses are offered for cancer survivors andcaregivers. Register online at www.elliothospital.org

or call Elliot Direct 603-663-1111

NUTRITION

SCREENINGS and CLINICS

GENERAL FITNESS

SUPPORT GROUPS


Breast Cancer Basics Free! RE, Breast Health Center: Third Tue monthly,3:30 to 5PM.A monthly educational presentation for womenrecently diagnosed or in active treatment forbreast cancer.

Living with Cancer Free! EH, Elliot Regional Cancer Ctr: Third Wedmonthly, 5:30 to 7PM. Call 663-1804 for moreinformation.A support group for people living with cancer,including family and caregivers.

Living Beyond Breast Cancer Free! LON, Elliot Regional Cancer Ctr: Third Thurmonthly, 5:30 to 7PM. EH, ERCC: Second Wed monthly, 6 to 7:30PM.Call 663-1804 for more information.An ongoing group that provides support andsharing for any woman who have experiencedbreast cancer.

Look Good, Feel Better Free!EH, Radiation Therapy Waiting Rm: Mar 13, 5 to7PM, Apr 13, 9 to 11AM, May 19, 9-11 and June12, 5-7PM. Call 663-1804 for more information.In conjunction with the American CancerSociety. Cosmetology help is provided to thosereceiving cancer treatment.

Prostate Cancer Free!EH, Radiation Therapy Waiting Rm: Fourth Monmonthly, 6 to 7:30PM. Call 663-4170 for moreinformation.Support and education for men with prostatecancer, their families and/or support person.

Women’s Pelvic Pain Support Group Free! RE: First Fri monthly, 6 to 8PM. Call 663-2767 toregister.For women with diagnosis of chronic pelvic painsuch as pudendal neuralgia or interstitial cystis.

Caregiver Support Group Free!SHC: First & Third Tue monthly, 10AM. CallBarbara MacPhee, MSW at 663-7051 for moreinformation.Learn strategies for caring for yourself, identifyways to build a support system, and learn newcoping strategies. Confidential.

A Time for Caregivers Free!EH, Radiation Oncology Waiting Rm: Mar 10,Jun 9, 9 to 11AM.A program for caregivers of cancer patients/survivors to find support and share resources.AICD (Automatic Internal

Cardiac Defibrillator) Free!First Fri monthly, 11AM to noon. Call 663-2959for more information.The only AICD support group in the tri-statearea. Designed to help patients with internalcardioverter defibrillators and their families dealwith unique issues.

Parkinson’s Free!SHC: Third Wed monthly, 3 to 4:30PM. Call 663-7063 for more information.For people with Parkinson’s, family members,friends, or anyone who has an interest inlearning more about this disease.

All classes require registration.Elder Law Education Free!SHC: Fourth Wed Monthly, 4 to 5PM

Attorney Judith Jones of Butenhof & Bomster,PC will be presenting select topics in Elder Law.Sessions will provide useful information aboutlegal issues commonly faced by seniors.Attendees are encouraged to come withquestions.

T’ai Chi Level 1 $55SHC: Tues, Mar 6 to Apr 24 or May 8 to Jun 26,9:30 to 10:30AM

This is an exclusive trademark program calledSenior Friendly Tai Chi™. It is based on the YangStyle, the most popular in the world today, butmodified just for seniors. It incorporates Qigongwarm-up and then a form of slow, continuousand graceful movements to increase strength,range of motion, balance and relaxation. It alsorefers to Tai Chi’s history as an art of self defense.Instructor: Oriental Healing Arts Association.

T’ai Chi Level 2 $55SHC: Tue, Mar 6 to Apr 24, May 8 to Jun 26,8:15 to 9:15AM

This program builds on the level 1 fundamentalsand adds more linear motion. It usually requiresthe completion of three of four level 1 sessionsbefore moving to level 2. T’ai Chi improvesbalance and body movements as well as overallhealth and well-being. Instructor: OrientalHealing Arts Association.

Chair Aerobics Plus! $55SHC: M/W, Mar 5 to Apr 25 or May 7 to Jun 27,11:30AM to 12:15PM

This class consists of cardiovascular exercisesand strength training that begins in the chairand progress to standing exercises while

utilizing the chair for balance. Applying cardioand strength training for endurance and endingwith gentle flow movements to improve rangeof motion and mobility; a great beginnersprogram designed for seniors.

Body Balance $45SHC: M/W, Mar 5 to Apr 25 or May 7 to Jun 27,7:30 to 8AM.This class is a combination of low-impactaerobics, strength training and stretching. It is aperfect combination to improve muscular andcardio endurance, along with gentle stretchingto enhance overall well-being. Participants willincrease their balance, as well as flexibility, whileworking out in a senior friendly environment.

A Matter of Balance $20SHC: T/Th, May 1 to May 24, 1 to 3PM. This award winning 4-week program is designedto reduce the fear of falling and increase theactivity levels of older adults who have concernsabout falls. Designed for the community-dwelling older adult who is ambulatory (with orwithout assistive devices) and able to problemsolve.

Fit and 50 $55SHC: Mon/Wed, Mar 5 to Apr 25 or May 7 toJun 27, 5:15 to 6PM. A more advanced cardio and resistance exerciseprogram using light to moderate weights withfrequent repetitions to increase muscular as wellas cardio endurance. This class will test yourcore stability as well as improve muscularbalance with the use of free weights and floormat exercises.

Cardio Sculpt $55SHC: Mon/Wed, May 7 to Jun 27, 9 to 10AM. A well balanced mix of cardio movements,strength training, balance and stretching. It is aperfect combination to improve muscular andcardio endurance, along with gentle stretching,to enhance overall well-being. Participants willincrease their balance, as well as flexibility, whileworking out in a senior friendly environment.

Fusion $55SHC: T/Th, May 7 to Jun 27, 5:15 to 6:15PM.This program is a dynamic mix of exercises allin one program, beginning with cardiomovements to increase cardiovascular health,followed with strength training from head totoe to improve muscular endurance and endingwith basic Pilates and yoga moves to improvecore strength and balance.

Gym Membership $25 per month

COMMUNITY WELLNESS


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SENIOR HEALTH and FITNESS


COMMUNITY WELLNESS

9

SHC: Mon to Fri, ongoing, 6:30AM to 6:30PM.Call 663-7016 to get started.The Elliot Senior Fitness Center is designedspecifically for those 50 and older. The centerconsists of a variety of cardiovascularequipment and a full body strength trainingcircuit. Our team of exercise specialists are hereto help integrate physical activity safely intoyour life, offering one-on-one orientations andexercise programs to fit individual needs. Freegroup exercise classes are also offered to ourmembers. A large variety of additional paidgroup exercise classes are also available. Comework out in a safe, supervised, fun, non-competitive environment. Membership ison-going and members may join at any time.Labor Series $125 per couple

EH, Elliot Childcare Ctr Activity Rm: On-goingThis class prepares the expectant mother andher partner for aspects of labor and birth. Class includes knowledge of the natural laborprocess, as well as a variety of coping measures,ranging from relaxation and breathing, toavailable medical options. Includes a tour ofthe Maternity Center.

Breastfeeding $50 per coupleEH: On-goingCertified Lactation Consultants introduceexpectant Mothers and their partners to theadvantages of breastfeeding, proper techniques,

and what to expect in the first few weeks athome. Further discussion includes choosing abreast pump, and collection and storage ofbreast milk.

Mom’s Group Free!EH, Elliot Childcare Center Activity Rm: Wed.Call for times.Offered to mothers and their babies as anopportunity to share and network. Weeklytopics include: feeding, crying, sleep, caring foryourself, growth and development, dealingwith relationships, nutrition, managing andpreventing illness and more.

Ongoing ClassesBoot Camp for New DadsBreastfeedingInfant/Child CPR & SafetyIntroduction to Underwater BirthLabor SeriesMaternity TourMom’s GroupParenting Your NewbornPre-Natal YogaSafe SitterSibling Class


CHILDBIRTH and FAMILY EDUCATION

Elliot Health System is going green!Help us decrease paper use by signingup for the email version of YourWellness Matters. You’ll receive fourinformation-packed issues a year, plususeful health alerts when needed.

If you would like to participate, visitwww.elliothospital.org and click on thelink for Your Wellness Matters. Or emailus at [email protected] your current mailing address so wecan remove it from our mailing list.

Elliot does not share it’s email list withanyone.

Thomas J. Antisdel MD

E D U C AT I O N

University of Wisconsin Medical School

Doctor of Medicine

Madison, Wisconsin

I N T E R N S H I P S

Saint Joseph’s Hospital-Milwaukee

Milwaukee, Wisconsin

R E S I D E N C Y


Milwaukee , Wisconsin

C E R T I F I C AT I O N

American Board of

Obstetrics & Gynecology

Thomas J. Barrett MD

E D U C AT I O N

Royal College of Surgeons

Doctor of Medicine

Dublin Ireland

I N T E R N S H I P S


Milwaukee, Wisconsin

R E S I D E N C Y


Milwaukee , Wisconsin

C E R T I F I C AT I O N

American Board of

Obstetrics & Gynecology

Memories of Mothers Tea and LuncheonA Wellness and Spiritual Care DaySaturday, May 12, 20129 a.m. to 2 p.m.Visiting Nurse Association of Manchester &Southern New Hampshire, Inc.1070 Holt Ave., Manchester, NH

Join us for a wellness and spiritual careday and an occasion to share memoriesof mothers who are no longer with us.Attendees will enjoy a sumptuous lunchand a relaxing day of speakers with achance to make a special item honoringyour mother. Guests are invited to sharephotos and stories so others have theopportunity to learn about these special

women. For moreinformation and toregister please call(603) 663-4008 oremail

[email protected]



ELLI

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Greg Baxter, MDnamed Medical

Director for GraniteHealthcare Network.

Joni Spring, RN named Chief NurseOfficer at Elliot.

Dianne Mercierawarded OutstandingWomen in Business by

New HampshireBusiness Review.

Anne Marie Hafemannamed 40 Under 40 by New Hampshire

Union Leader.

John Hessionrecipient of the WilliamS. Green Award for

Excellence.

Elliot Hospital Associates awarded the Robert & Lucille Davison Award for Philanthropy.

From our Board Members toour Physicians, Staff, and

Volunteers, Elliot is proud torecognize individuals being

honored for their leadership,benevolence and tireless

dedication to the community.


Elliot Direct 603-663-1111 | www.elliothospital.org | Spring 2012 11

Dan is a 42 year-old male, an avid cyclist, who has beentraining daily for a bike race. He spends up to 4 hours eachday on his bike.John is a 55 year-old computer analyst who spends much

of his day at his desk, sitting in his chair. He gets up rarely;only to use the restroom or to go to lunch. While Daniel and John seem to spend their days in

dramatically different ways, they have one thing incommon: they have both been experiencing ongoing painin their groin, scrotum and rectal area. Both men suffer from a condition known as pudendal

neuralgia. This condition involves irritation of the pudendalnerves which supply sensation to the pelvic region.Pudendal neuralgia is common in people who sit forextended periods of time including cyclists, office workers,truck drivers, and pilots, among others. The pain is oftenexperienced when sitting, and is relieved when a personstands or lies down.A person with pudendal neuralgia will often notice a

painful or tender sensation in their buttocks, scrotum ortesticles, penis and perineum. This may be accompanied bysexual dysfunction, painful ejaculation, or persistent sexualarousal. Additionally, they may find urinating or movingtheir bowels to be increasingly painful.

Pudendal Neuralgia is a highly treatable condition,especially if symptoms are caught early on. The sooner oneseeks treatment, the better the chances are for a successfuloutcome. Treatments include adjusting a patient’s work

environment to avoid pressure on the buttocks, wearingbriefs instead of boxers, avoiding heavy, strenuous exercise

and limiting sitting. Perineal suspension pads can be helpful.Physical therapy or an exercise program consisting ofstretching can be very helpful. Medications can sometimesbe beneficial, particularly anti-seizure medications that havebeen shown to be highly effective in treating nerve pain.These include pregablin (Lyrica) and gabapentin(Neurontin), tricylic antidepressants – amitriptyline ornortriptyline, and creams or ointments which contain localanesthetics. Many patients also benefit from psychologicalsupport, including stress reduction techniques.Some patients benefit greatly from a series of injections to

the pudendal nerve. These are done at the PainManagement Center with fluoroscopic guidance (x-ray).Other injections called trigger points are also done if themuscles surrounding the nerves are very tight. If pain persists despite these treatment options, some

patients may be a candidate for surgery which may helprelieve the nerve from any compression. If you believe you are experiencing symptoms of

pudendal neuralgia, it is very important that you consultwith your primary care physician as soon as possible. Yourphysician will evaluate you and if appropriate, refer you tothe Pain Management Center so that one of our painspecialists can develop a treatment plan to ease yourdiscomfort. If treatment is prolonged for a long period oftime, there is a risk of damage to the pudendal nerve whichcould greatly diminish the extent of symptom relief.For more information on the Elliot Pain Management

Center at River’s Edge, please call 663-6730 or visit us atwww.elliothospital.org.

Dr. Dainesi founded the Pain ManagementCenter in 1991 after completing his residencyin Anesthesia and Pain Management atDuke University, Durham, NC. He receivedhis undergraduate degree from ColumbiaUniversity, NYC and graduated from Mount

Sinai Medical School in NYC. He completed his Internship inInternal Medicine at Dartmouth Hitchcock Medical Center inHanover, NH. Dr Dainesi is board certified in Anesthesia andhas added qualifications in Pain Management by the AmericanBoard of Anesthesiology and is a Diplomate of the AmericanBoard of Pain Medicine.

SYMPTOMS OF PUDENDAL NEURALGIA:� A painful sensation in on one or both sides of thebuttocks, scrotum/testicles, penis and perineum.

� Sexual dysfunction� Pain with ejaculation� Persistent sexual arousal� Painful urination or bowel movements or irritablebladder symptoms

� Numbness or tenderness in the buttocks or perineum � Symptoms are relieved by standing or lying down;worse when sitting

PELVIC PAIN...NOT JUST A WOMEN’S ISSUE

By Stephen Dainesi, MD, Pain Management Center

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The Mary & John Elliot Charitable Foundation ispleased to announce that this year’s annualcampaign has surpassed all expectations! Elliotemployees made gifts of approximately $100,000and the community matched the generosity of ourstaff with more than $130,000 in donations. Ourtotal is now over $230,000 we are very grateful foreveryone who participated! P

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Bean Foundation GrantProvidesCritiCal traininG

he Mary & John Elliot Charitable Foundation has been awarded a grant in the amountof $27,095 from the Bean Foundation to assist with purchasing a Laerdal Sim-JuniorManikin. This manikin will support critical training to New Hampshire’s Hospital forChildren (NHHC) staff (and others within our community – EMT’s and rescue workers,for example) on treatment interventions related specifically to pediatric trauma. The Sim-Junior Manikin will allow NHHC to deliver simulated training on a child-size

manikin maximizing the knowledge and skills of our nurses and physicians who deliver services withinthe Pediatric Intensive Care Unit. New Hampshire’s Hospital for Children is also planning on providingoutreach services to community hospitals and local educational institutions for training purposes.

“Sim Junior will enable us to continue to lead the way in improving the care of critically ill childrenacross Southern New Hampshire,” said Michael Miller, MD, Pediatric Critical Care physician at NewHampshire’s Hospital for Children. “We are very grateful to the Bean Foundation for their generosityin providing this grant.”

T

WELCOME

Meghan Durkeejoins the Mary

& John Elliot CharitableFoundation as the newDevelopment Specialist.Spending the past three years inPortsmouth at The Music Hall

as the Corporate and Special Events Manager, she oversaw andcoordinated benefit events such as the annual Kitchen Tour,the largest fundraiser for The Music Hall, and the CorporatePartnership Program. Prior to The Music Hall Meghanworked as the Marketing and Special Events Coordinator forthe nonprofit performing arts organization Prescott Park ArtsFestival (also in Portsmouth), managing multiple food andmusic festivals. Upon graduating from Endicott College with aBachelor’s Degree in Visual Communications and aconcentration in Photography, she worked as the MarketingCoordinator for the architectural firm Olson Lewis Dioli &Doktor in Manchester-by-the Sea, MA. Meghan is honored to join the team at The Elliot and is excited to expand herfundraising career into the field of healthcare.


Three month old Adam is brought by his mother to thepediatric clinic. Adam spits up often. Mother is concernedthe spit ups are frequent and large, almost every time he isfed. This has been worsening. Is it possible that he has acidor gastroesophageal reflux? Does he require any testing?At least half the infants spit up in the first 6 months of life

and the majority of these do not experience complicationsfrom reflux. Troublesome or complicated reflux is calledGastroEsophageal Reflux Disease or GERD. How do wedistinguish uncomplicated reflux from GERD? Shouldevery infant who spits up undergo testing? Infants such as Adam will not typically require

medications. The spit up may appear large enough to causeparental anxiety, however, weight gain is rarely affected.These “happy spitters” benefit from simple measures thatinclude keeping the baby in upright posture after feeds andthickening feeds with rice cereal. Some infants with acid reflux may have difficulty with

feeds and fussiness. This is likely related to acid irritation,the equivalent of heartburn in the adult with acid reflux.This may in some instances be associated with esophagitis(inflammation of the esophagus). Not all fussiness in infantsis related to reflux. Other reasons could include infant colic,formula intolerance or painful bowel movements. Infants with esophagitis or heartburn may exhibit arching

of back, or choking with feeds. This can lead to feedingdifficulties or refusal to feed. Reflux of acid contents maycause breath holding spells with the infant appearing pale orblue with struggling to breathe. Other considerations forthese symptoms may include inadequate or poorcoordination of sucking, swallowing and breathing. This maybe related to neurological immaturity, a learning curveespecially for premature babies or those with low birthweight. Fussy infants or those with feeding difficulties may becandidates for further medical evaluation. Occurrence ofbreath holding or apneic spells as well as a concern foraspiration may also require a more thorough evaluationincluding observation in the hospital. Episodes of aspiration,choking, recurrent wheezing or pneumonia demand more

detailed investigation or more involved therapy.Presence of bile (green or yellow fluid) or blood in the

vomit or vomit which leads to dehydration in an infant mayrequire further tests to rule out a bowel obstruction.Inadequate weight gain demands a careful evaluation forother causes. Onset of vomiting after six months of ageusually is not attributable to acid reflux. Prematurity or low birth weight infants may be more

prone to feeding difficulties and aspiration from acid reflux.Infants with neuromuscular conditions, such as cerebral palsy,may have a more severe form of acid reflux includingesophagitis, or aspiration. Infants who have undergone surgeryon the esophagus or upper airway are likely to experiencemore severe reflux. In summary, infant spit ups are common and usually do

not result in any serious consequences. When growing welland thriving, these infants do not benefit from further testsor medications. Infants who experience feeding difficulty orrefusal to feed, aspiration episodes or blue spells demandprompt attention. It is prudent to remember that vomitingwith bile or blood and leading to dehydration are unlikely tobe gastroesophageal reflux. Certain groups of infants aremore prone to severe or prolonged acid reflux and moreoften need testing or treatment.

Exciting News: In addition to the conventional therapiesmost often offered to infants with reflux and fussiness it isnow clear that integrating complementary alternativetherapies can play an beneficial role. For example, the useof probiotics has been shown to be effective for infantilecolic. Supplements such as camomile or other interventionssuch as infant massage have also proven effectiveness ininfants with fussiness. We are fortunate at Elliot Pediatric Gastroenterology to

work closely with Dr. Matthew Hand who is the divisiondirector of pediatric integrative medicine. Thiscollaboration has allowed us to offer many differentapproaches to the care of our children. Please call our officeat 663-3222 for more information.

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ICS INFANT SPIT UP and ACID REFLUX: TEST, TREAT or WAIT?

by Dr. Mark Integlia and Dr. Harohalli Shashidhar


Dr. Mark Integlia

Dr. HarohalliShashidhar



This past November, my elderlymother required two

extended hospitalizations due toCOPD flare-ups and intestinalbleeding. Her discharge ordersspecified rehabilitation in amedical nursing facility so shecould receive oxygen andtreatments for her breathing.

“But I don’t want to go tosome strange place,” my mompleaded. “Please let me go back tomy own home.”

I, too, wanted her back in her ownplace. My mom raised seven children,worked and volunteered, and valuedindependence her whole life. She belonged at home.But how was that possible when she suffered from asevere illness and needed continuous medical care?

On a bleak, rainy night, I did comply with doctor’sorders and brought Mom to a nearby nursing facility.I placed her favorite stuffed puppy dog next to her andheld her hand until she fell asleep. Her mouth droppedopen. Dried teardrops creased her pale, sunken cheeks.

Leaving my mother there that night was the hardestthing I’ve ever done. After struggling with a tearfulnight myself, I awoke and realized that Mom couldindeed come back to her home where memories andfriends brought her joy and comfort. Under the care ofher own hospice team, she could remain in her homeand let the medical hospitality come to her!

Sadly, few doctors today, including my mom’sphysicians, suggest hospice care unless a patient has aterminal illness like cancer with few days left to live. Asa trained hospice volunteer, though, I knew otherwise.A person doesn’t have to have terminal cancer or be onher deathbed in order to receive the many healingservices hospice offers.

In fact, according to the New England Journal ofMedicine (2010), when severely ill patients (with

chronic conditions like heart disease,COPD, and dementia) receivehospice care early on, theyexperience less depression, andthey improve mentally,emotionally, and physically. Infact, patients under early hospicecare live 25% longer due tobetter management ofsymptoms by a team of doctors,nurses, aides, volunteers, social

workers, and spiritual directorsunited around one special person.My mother, who is now home with

hospice care, is living proof of that. Twomonths ago, she could barely get out of her

bed. She was caught in a depression so deep thatstories of her precious great-grandchildren couldn’tmake her smile. She even stopped listening to herbooks on tape.

Now, though, after six weeks of undivided attentionfrom her hospice team, Mom’s transformation isremarkable. Miraculous, you could say. She is up andwalking again, often without oxygen. She can cook herown favorite meals. Best of all, Mom is smiling again.Whenever we call or visit, she can’t wait to tell us aboutthe daily adventures from her “wonderful new family”– her hospice team.

I realize my mom is still dying. But now, it isn’t thepresence of death that shrouds the room. It’s theblessing of life. So I urge you: If you have a loved onesuffering from a chronic, severe illness, please don’twait. They deserve the compassion, care, and comfortthat hospice offers – and so do you.

Remember how I mentioned that my mom smilesnow? Well, thanks to my mom’s amazing hospiceteam, I’m smiling again, too!

For more information on the VNA of Manchesterand Southern New Hampshire, call 622-3781 or visitour website: http://www.manchestervna.org.

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What Are You Waiting For? The PROVEN BENEFITS of EARLY HOSPICE INTERVENTION

By Lorraine C. Lordi, VNA Hospice Volunteer


ou might have heard the term“care transitions” and wondered

what it means. A care transitionrefers to the movement of patientsfrom one healthcare provider or

setting to another (Healthcare.gov, 2011). Caretransitions can occur all along the healthcarecontinuum and could include a patient movingfrom a primary care to a specialty physician; inthe hospital it would be patients moving from theemergency room to other departments; or whenpatients are discharged from the hospital and gohome or to a nursing home or assisted livingfacility. During these transitions, patients withcomplex healthcare needs are vulnerable anderrors can occur. Good communication andcoordination among healthcare professionalsbetween settings are factors that can improvepatient outcomes (Craig C, Eby D, WhittingtonJ., 2011).Transitional care is defined as a set of actions

designed to ensure the coordination and

continuity of health care as patients transferbetween different locations or different levelsof care within the same location (CareTransition Program, 2011). The UnitedStates Department of Health and HumanServices is working together with otheragencies to help healthcare providers develop

effective programs to improve care transitions(USDHHS, 2011). The focus of these programsincludes decreasing re-hospitalization rates forpatients with complex medical problems;medication reconciliation, or making sure thepatients medication list is up to date and accurate;and improving communication among healthcareprofessionals between care settings. The VNA of Manchester and Southern NH

has a team of Registered Nurses who are expert atproviding transitional care for patients who aredischarged home from different healthcaresettings. Once a referral has been made for homehealth services, they meet with patients andfamilies in the hospital or nursing home settingand coordinate and communicate patients’ careneeds between the transferring and receivingprovider. The VNA transition nurses work closelywith the social workers and case managers inhospitals and nursing homes in the greaterManchester and southern New Hampshire areaand their role is vital to ensuring successful caretransitions for patients. If you or your loved onesneed home health services, be sure to ask yourprovider about making arrangements to have theVNA of Manchester and Southern NewHampshire take care of you. The VNA transitionnurse can come and meet with you to discussyour care if needed. It can make the all thedifference for a successful transition home.


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Care Transitions

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Barbara Feloney, MSN, RN


One Elliot WayManchester, NH 03103

Nonprofit Org.U.S. PostagePAID

Manchester, NHPermit No. 6147

YOUR WELLNESS MATTERS is published as a community service for the friends and

patrons of Elliot Hospital, One Elliot Way, Manchester, NH 03103, 603-669-5300,

www.elliothospital.org.

Doug Dean President and CEO

Scott Bacon Chair, Board of Directors

Susanna Whitcher Vice President, Public Affairs & Marketing

Melissa Ballard Sullivan Marketing & Communications Specialist

Anne Marie Hafeman Marketing & Communications Specialist

Information in YOUR WELLNESS MATTERS comes from a wide range of medical

experts. If you have any concerns or questions about specific content that may affect

your health, please contact your healthcare provider. Models may be used in photos

and illustrations.

ELLIOT CARES ABOUT

PATIENT SAFETYIf you have a concern regarding the safety orquality of care given to our patients, we wantto hear from you! We encourage you tocontact our Patient Relations/Safety line at

603-663-2666, or contact the JointCommission at 1-800-994-6610 or the Stateof New Hampshire at 1-800-852-3345.

Elliot Health System is a non-profit organization serving your healthcare needs since 1890.

Our DOCTORS are in!

OUR DOCTORS AREACCEPTING NEW PATIENTS.

Craig Widness, MDElliot Pediatrics & Primary

Care at Riverside20 Chambers Drive | Suite 2200

Hooksett | 641-5386www.elliotdocriverside.com

Dr. Widness received his medical doctorate at the

University of Rochester School of Medicine and

Dentistry where he also completed his fellowship

training. He then completed his residency in

Pediatrics and Internal Medicine at the University of

Rochester Strong Memorial Hospital. Dr. Widness

has a special interest in preventative care and wellness.

He enjoys working with the full age spectrum and

establishing relationships with families.

Andrea Palumbo, MDElliot Pediatrics at Bedford

Pine Tree Place | Unit 8 | 360 Route 101Bedford | 472-5860www.elliothospital.org

Dr. Palumbo attended the University of

Massachusetts Medical School where she received

her medical doctorate. She completed her residency

training at the University of Connecticut School of

Medicine, Connecticut Children’s Medical Center

in Hartford, CT. She recently joined The Elliot

from her practice at Derry Pediatrics in Derry, NH.

Melissa Borthwick, MDElliot Family Medicine at Manchester

4 Elliot Way | Suite 100Manchester | 626-5113www.elliothospital.org

Dr. Borthwick attended the East Tennessee State

University College of Medicine in Johnson City,

TN where she earned her doctoral degree. She then

completed her residency at Dartmouth Family

medicine in Concord, NH before joining the

Elliot. Dr. Borthwick has an interest in pediatrics,

GI disorders, and preventative care across the

lifespan with a focus on women’s health.


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