Endoscopic ultrasound is easier on patients, offers physicians best diagnostic tool, all closer to home

The recent advent of endoscopic ultrasound procedures at Franciscan Alliance Northern Indiana Region hospitals offers another example of why patients need not travel outside of the area to receive the best available treatment.

The outpatient procedure, which provides for more efficient diagnoses and is less invasive and relatively pain-free, recently became available at Franciscan St. Margaret Health – Dyer and Hammond and at Franciscan Point, which is under the auspices of Franciscan St. Anthony Health – Crown Point.

A scope attached to the end of a probe photographs areas using sound waves and “can take pictures in parts of the body that can’t be done with regular ultrasound and get samples of the area being examined through a needle that passes through the scope,” said Julia LeBlanc, MD - gastroenterology, who does the procedure at Franciscan Point.

It provides a real-time view to study the upper and lower digestive and respiratory tracts to stage lung, esophageal, pancreatic, bile duct, rectal and gastric cancer, as well as to check tumors of the upper gastrointestinal tract and to locate gall stone disease. The device also allows physicians to take biopsies (with a needle) without having to perform surgery, as was the case in the past. It also can be used to destroy certain pancreatic cysts and prevent possible cancer growth, through the injection of alcohol and other medicine.

“We are able to see how thick and deep a tumor is and if it has spread, which allows the specialist to know how to best treat it. It is the standard of care for esophageal and rectal cancer and is being used routinely in pancreatic cancer care,” Dr. LeBlanc said.

Praveen Nallapareddy, MD – gastroenterology at Franciscan St. Margaret Health, said the tool adds “more specific imaging to structures being examined than a CAT scan and is done without incisions.”

“The results determine whether a patient needs surgery, or what the next treatment step should be. It is a follow-up procedure to regular endoscopes, colonoscopies and ultrasounds. It allows for faster treatment time and can be managed on an outpatient basis,” he said.

Before endoscopic ultrasound was available locally, patients had to travel to Chicago or Indianapolis, Dr. Nallapareddy pointed out, adding, “We’re able to provide the highest quality of care, right here.” Dr. LeBlanc agreed.

“This tool changes how we practice medicine – it shows how we can use technology to make for a positive impact on patients and improve their overall health.”

She said it also makes physicians’ jobs easier because, “the more information we have going in, the more we can help the patient – and everyone is happier in the end.”

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New technology at Franciscan St. Margaret Health can provide world of relief for asthma sufferers

Bronchial thermoplasty, a new procedure being offered at Franciscan St. Margaret Health – Hammond, can be a life-changer for patients who suffer from severe asthma.

2014-SMH-bronchial-therapy

Shown with the bronchial thermoplasty equipment at Franciscan St. Margaret Health – Hammond are (from left), Leonard Buccellato, MD; Bassel Ericsoussi, MD; Jason Tackett, NP; and Tapan Desai, MD

“A lot of people say they have gotten their life back (following the treatment),” said Leonard Buccellato, MD, who offers the procedure along with Bassel Ericsoussi, MD, and Tapan Desai, MD, all of whom are pulmonologists associated with Franciscan Medical Specialists in Munster.

The technology, which was approved by the Food and Drug Administration in 2010 and is available from the Boston Scientific company, is “a brand-new, novel treatment,” Dr. Buccellato said. Franciscan Alliance is the only hospital group in Northwest Indiana to offer it, according to Mike Pisco, a company territory manager, who said, “Between Chicago and Indianapolis, no one else has it.”

Three treatments, delivered in three-week intervals on an outpatient basis, send therapeutic radiofrequency energy to airway walls through a catheter from a bronchoscope, which is introduced through the nose or mouth, into the lungs. The catheter provides a series of 10-second, temperature-controlled energy bursts that heat the lungs to 65 degrees Celsius and destroy some of the muscle tissue that constricts during an asthma attack. In turn, the frequency and severity of exacerbations is decreased.

Video: How It Works

Boston Scientific, which calls bronchial thermoplasty the “first and only nondrug therapy for severe asthma,” said proven benefits have a five-year duration, which likely will last much longer, said that period of time essentially is how long the treatment has been available.

Clinical trials demonstrated after one year of treatment:

  • A 32 percent decrease in asthma attacks.
  • An 84 percent reduction in emergency room visits for patients having respiratory symptoms.
  • A 66 percent decline in asthma-related days lost from work, school and other activities.
  • A 73 percent drop in hospitalizations for respiratory symptoms.
  • A significant improvement in quality of life for 79 percent of patients.

An extension trial of patients treated over five years yielded similar findings.

Medication still is required to treat such cases as inflammatory asthma, Dr. Ericsoussi said.

According to Boston Scientific, “With any procedure, there are risks and individual results vary. The most common adverse effect of BT is a temporary worsening of respiratory-related symptoms, which usually occurs within one day of the procedure and usually resolves within a week, with proper care. There is a small risk (3.4 percent per procedure) that symptoms may require hospitalization.”

Dr. Buccellato added, “The goal of using bronchial thermoplasty is to reduce the need for steroids, the need for hospitalization, to reduce costs and to improve quality of life.”

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VIDEO: Donate Life Month – Donor/Recipient Stories of Heroism & Hope

Colorful and emotional stories of people who have given of themselves so that others might live were told on April 14, 2014, during an annual Franciscan St. Anthony Health – Crown Point observance of National Donate Life Month.

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National Healthcare Decisions Day – Understanding Advance Directives

There may come a time when you or a family member is seriously injured or gravely ill. In the midst of shock and grief, you may be asked to make hard medical decisions. It is important for you to learn about Advance Directives, types and intensity of medical care, and to discuss the kind of treatment you feel comfortable with before you make those difficult decisions.

April 16 is National Healthcare Decisions Day…a time to bring awareness to the importance of advance care planning and communicating and documenting your healthcare decisions.

Understanding Advance Directives

Advance care directives allow patients to provide instructions about their preferences regarding the care they would like to receive if they develop an illness or a life-threatening injury and are unable to express their preferences. Advance care directives can also designate someone the patient trusts to make decisions about medical care if the patient becomes unable to make (or communicate) these decisions. This is called designating “power of attorney (for health care).”

Advance care directives can reduce:

  • Personal worry
  • Feelings of helplessness and guilt by family members
  • Futile, costly, specialized interventions that a patient may not want
  • Overall health care costs
  • Legal concerns for everyone involved

Example of Advance Directives

  • Verbal instructions. These are any decisions regarding care that are communicated verbally by an individual to health care providers or family members.
  • Organ donation. This may be accomplished by completing an organ donation card and carrying it in your wallet. A second card may be placed with important papers (such as a living will, insurance papers, and so on).
  • Living will. This is a written, legal document that conveys the wishes of a person in the event of serious illness. This document can speak for a patient who is unable to communicate. A living will may indicate specific care or treatment the person does or does not want performed under specific circumstances. A living will is not to be confused with a last will and testament that distributes assets after a person’s death.
  • Special medical power of attorney. A legal document that allows an individual to appoint someone else (proxy) to make medical or health care decisions, in the event the individual becomes unable to make or communicate such decisions personally.
  • DNR (do not resuscitate) order. This states that CPR is not to be performed if your breathing stops or your heart stops beating. The order may be written by the person’s doctor after discussing the issue with the person (if possible), the proxy, or family.

Recommendations

  • In the event you choose to create a living will or special medical power of attorney, know specific state laws that may apply. Write the document to be consistent with your state’s laws.
  • If you have a living will or special medical power of attorney, provide copies for your family members and health care providers. Carry a copy with you in a wallet, glove compartment of a car, or similar location. If you have a planned admission to a hospital, take copies for the hospital to include in your medical chart and tell all medical personnel involved with your case about the documents.
  • Consider the possibilities of the future, and plan ahead. Studies have shown that although the majority of people believe having some form of advance directive is a good idea, most people have not actually developed advance directives for themselves. Many people state that they want their families to make health care decisions. However, less than half of these people have ever discussed the issue and their specific desires with family members.
  • These decisions can be changed at any time. However, if a living will is changed, everyone involved — including family or proxies and all healthcare providers — must be informed and new copies of instructions made and distributed.

The process of creating advance care directives may be difficult. It requires you to think about your priorities regarding quality of life and your death. Treatment options, and their possible influence on your quality of life, need to be fully understood and considered. Know the potential implications of choosing or refusing specific forms of care.

Discuss your wishes regarding advance care directives with your health care providers, family members, and friends. Review your wishes from time to time to remind everyone.

To learn more about Advance Directives, including downloadable forms to get you started, please choose the community nearest you:

Article Source: A.D.A.M. Health Library

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Franciscan St. Anthony Health – Michigan City receives rave reviews for gastrointestinal services

asge-quality-logoRecent recognition by an internationally renowned program assures patients at Franciscan St. Anthony Health – Michigan City and its Woodland Health Center the area’s best possible care from the most qualified physicians, said Eugene Lyubashevsky, MD, medical director of gastrointestinal endoscopy for the two facilities.

The Endoscopy Unit Recognition came several months ago from the American Society of Gastrointestinal Endoscopy (ASGE), following a stringent, year-long evaluation process that involved quality measures, policies, innovations, excellence in patient care and outcomes and other areas. Franciscan St. Anthony Health and Woodland have the only such designation in Porter and LaPorte counties, according to the ASGE website.

Dr. Lyubashevsky, who made the proposal and supervised the evaluation process, said the recognition was “tough to get,” but well worth the effort.

“Each of our four surgeons was scrutinized for five or six quality measures they have to obtain,” he said, adding, “We all are board-certified, are ASGE members, and have to have a certain level of expertise. Quality measures for surgeries were tracked and reported and based on those factors and others, we received the recognition award.”

Dr. Lyubashevsky, who has been with Franciscan St. Anthony Health for 10 of his 17 years in practice, added, “When patients come here, they know they are getting the best care, as conferred on us by a major international society. There is no higher award for quality of care for gastroenterologists. The bottom line is, patients can trust in the care they get from us.”

Meanwhile, the latest technology is enhancing Franciscan St. Anthony Health – Michigan City’s ability to more accurately diagnose esophageal-reflux issues and helping to better differentiate patients who may need surgery from those who instead can be treated with medication.

“Upgraded technology helps us better measure esophageal motility and helps us identify reflux events more clearly,” said David Fumo, MD, a 25-year gastroenterology specialist, who practices with Dr. Lyubashevsky.

Dr. Fumo said the new equipment has two components: the first of which provides high-definition esophageal motility measurements.

“We currently have 20-year-old motility equipment. The new device gives us more information and allows us to much more accurately diagnose disorders,” he said, adding such patients typically present with difficulty in swallowing or unexplained chest pain.

“The procedure is done with the patient awake and there is very little discomfort. It takes about 15 to 20 minutes,” Dr. Fumo said.

The second component is an impedance measurement for esophageal reflux. Dr. Fumo said many patients have mild acid reflux that responds well to medications. Some, however, continue to have heartburn or regurgitation, despite medical therapy. Some have a hiatal hernia.

After the procedure, the patient goes home and does normal activities, including eating and drinking. The device measures reflux episodes continually during a 24-hour period. The patient returns to the GI lab and has the catheter removed, again with little to no discomfort.

“We are then provided with a detailed account of the patient’s reflux through a much-improved process,” Dr. Fumo said.

The procedures are performed at Woodland Health Center, 8865 W. 400 N., Michigan City. Call (219) 872-6566 for gastroenterology services.

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Stay on track this Easter!

Submitted by Kelly Devine Rickert, MS, RD, CSSD, LDN, Registered Dietitian/Health Coach, Franciscan WELLCARE

With Easter just a few days away, here are some tips on how you can stay on track and not overdo it this Easter holiday!

1. Plan ahead! Eat something small first thing if you are heading out the door for mass or to go to a brunch. Some examples: slice of whole grain toast with peanut butter or a hard boiled egg, Greek yogurt with fresh fruit.

2. Incorporate more fruits and vegetables in your plate. Scope out what is being served and load up on the fresh produce. It will help fill you up so you have less room for the calorie laden dishes.

3. Moderation is key! Indulge in one or two of your favorite Easter treats. Eating half the basket of chocolate? No, not so much!

4. Get moving! IF it’s a nice day out, go for a walk or bike ride or try and get in a good workout the day before.

5. Most important tip… Enjoy your time with family!

Happy Easter!

 

Posted in Franciscan Healthcare - Munster, Franciscan St. Anthony Health - Crown Point, Franciscan St. Anthony Health - Michigan City, Franciscan St. Margaret Health | Tagged , , , , , , , | Leave a comment

Physicians honored for service to patients and staff members

Two Franciscan St. Margaret Health physicians recently received St. Luke awards, which annually are given on behalf of nurses from both the Dyer and Hammond campuses to honor excellence in service to patients and staff.

Deepak Kadiyala, MD (pictured on the left), a nephrologist who has been with Franciscan St. Margaret Health for about a year since he started practicing 1.5 years ago, received the award for the Hammond campus; while Kirti Ramnivas, MD, a child/adolescent psychiatrist who has been with Franciscan Alliance since 2006, received the honor for the Dyer campus, where she has so far spent her career.

2014-SMH-StLuke-Winners

Also known as doctor of the year honor, the St. Luke Award has been presented at Franciscan St. Margaret Health since 2008, “in recognition of extraordinary efforts in maintaining excellent rapport with nurses, providing educational mentoring and leadership and exhibiting a collaborative approach to patient care, which shows respect for the nursing profession and to the mission of the Sisters of St. Francis,” according Kathy O’Donnell, physician liaison.

Luke is the patron saint of physicians. The awards were presented to the physicians by Tom Gryzbek, hospital president, during ceremonies packed with applauding nursing staff members and hospital officials at each campus. Gryzbek lauded their contributions to the hospitals and their patients, adding he feels blessed to have him in the system.

Among nomination comments, nurses called Kadiyala an exceptional physician, who exhibits compassion to his patients.

“He continually goes above and beyond and his bedside manner is excellent. He takes time to listen and explain things to the patient and family and gives them informed options. He is extremely thorough and comes back to check on his patients throughout the day. He maintains a good rapport with staff and returns calls in a timely fashion.”

After receiving his award, Kadiyala said he was humbled, adding, “I just love coming to this hospital.”

He said nursing staff members deserve the honor more, adding he could not perform his duties as effectively without them.

“They are the best I’ve ever worked with; they do a wonderful job,” he said.

Nurses likewise complimented Ramnivas in their nominations, adding she demonstrates respect, kindness and concern for patients, is dedicated and exudes a positive attitude.

“She always takes time to explain the patient’s needs and plan of care. She goes out of her way to accommodate her patients, as well as the parents. The doctor gives exceptional care and is an excellent physician, leader and mentor. Every day, she sets a high standard for all of the staff to follow. She is always the first one in and the last one to leave.”

After receiving her award, Ramnivas said she likewise was humbled and that the honor should have gone to the nursing staff for being a pleasure with whom to work.

“They are wonderful – they make my job so easy. I survive because of them,” she said.

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