A Good Steward

Dr. Haley Busch

For Haley Busch, PharmD, her first-of-its-kind job combines personal and professional passions with one goal: saving lives.

In June 2019, Dr. Busch made history: She became CHI Saint Joseph Health’s first clinical pharmacist specialist in opioid stewardship and pain management, and the first at a community health system in Kentucky. Her job places her in the thick of the campaign to curb the Commonwealth’s opioid crisis.

“I provide education, consultation and updates to policies and procedures to ensure the health system manages pain appropriately, according to the latest evidence-based literature and guidelines,” Dr. Busch said. “My program seeks to prevent prescribing opioids to patients who have never before been exposed to them, if possible, calls for safe use and monitoring of opioids when indicated, promotes and integrates the use of nondrug and nonopioid methods of pain control, and fosters compassionate and comprehensive care for patients with opioid use disorder.”

How a Project Led to a Career

Dr. Busch traces her passion for opioid stewardship and helping people with addiction to an honor society project during her third year of pharmacy school at the University of Kentucky. As the society’s president, she and other members set up a distribution table for naloxone — a drug that reverses the effects of opioids to prevent overdose — at a local health department. Once a week, they provided the lifesaving drug free of charge, along with patient counseling. Dr. Busch and the other pharmacy students extended similar services to shelters, halfway houses and police departments.

“We worked with media and film students at the university to create two public service announcements that aired at local movie theaters and on radio stations to educate the public about naloxone and destigmatize addiction,” Dr. Busch said. “We also published an academic article about the benefits of pharmacy student-led naloxone counseling.”

Meaningful Moments

Like so many other health care roles, Dr. Busch’s is about people. Certain moments she shares with patients underscore that — and keep her passion for what she does burning bright.

“When speaking with a patient about naloxone use at the health department, the individual said, ‘I have never before been treated like a human by any other health care professional. Thank you for making me feel human today, and for taking the time to show that you care about me,’” Dr. Busch said. “I’m blessed to have the opportunity to help save lives through my work both inside and outside of the hospital.”

“All patients are worth our time, attention and respect, no matter what choices they’ve made.”

A version of this article originally appeared in the Winter 2020 edition of Spirit of Health. For more stories like this one, subscribe to Spirit of Health magazine today.

Overcome Pain and Depression from Fibromyalgia with Treatment

Physician and patient having conversation

Many people are currently suffering from a chronic pain disorder called Fibromyalgia, which causes those affected to feel unnatural pain and an increased sensitivity to pain. Fibromyalgia affects more than 4 million Americans, according to the Centers for Disease Control and Prevention (CDC). Although it is clear that Fibromyalgia is not an inflammatory or autoimmune disease, the cause is still unknown. 

Fibromyalgia causes wide-spread muscle pain and tenderness all over the body. The pain can shift areas or occur in many places at once. The intensity of the pain may change from day to day, or even hour by hour. Those with fibromyalgia may describe the pain as aching, deep, shooting or tingling. In addition to pain, other symptoms of fibromyalgia may include body stiffness, fatigue, trouble thinking or concentrating, and even memory loss.

Although there is no known cause, certain factors can put you at an increased risk for developing fibromyalgia. The disorder is typically diagnosed in middle-aged people, but can sometimes affect children. Women are twice as likely to develop fibromyalgia than men. Repeated injuries can cause or worsen the condition, and there are reported links between developing fibromyalgia and experiencing traumatic events, such as post-traumatic stress disorder, according to the CDC.

The two most common complications of fibromyalgia are depression and poor sleep. The presence of consistent and chronic pain takes a heavy toll on the mental state of those with fibromyalgia. This often coincides with feelings of helplessness and anxiety. Lack of sleep can intensify these feelings, which often go untreated if a patient has not already been diagnosed. This can worsen depression.

If you’re feeling depressed or have thoughts of suicide due to chronic pain, talk to your doctor right away or call the National Suicide Prevention Lifeline at 1.800.273.8255.

If you are experiencing symptoms of fibromyalgia, visit your physician for further testing. A physician, typically a rheumatologist, will diagnose fibromyalgia by excluding similar conditions through a series of physical examinations, blood tests, X-rays, and by reviewing a patient’s medical history.

Once fibromyalgia is diagnosed, it can be treated with a combination of medication and self-management strategies. It’s important to note that there is no role for opioids to help manage the pain. Muscle strengthening classes, such as aerobics, can also help to mitigate symptoms. Stress management techniques such as yoga, meditation and massages can improve mental health difficulties associated with fibromyalgia. Symptoms of fibromyalgia may vary. Therefore, patient education and individual pain management programs are crucial to ensure the best possible treatment outcomes.

Living with fibromyalgia is completely manageable with the right treatment plan.

To learn more about fibromyalgia and rheumatology care, contact the CHI Saint Joseph Medical Group or call 859.313.2255 to schedule an appointment or receive assistance with a provider referral.

Travis Sizemore

Travis Sizemore, DO, MPH

Dr. Sizemore is with CHI Saint Joseph Medical Group – Rheumatology.

Critical Care for Chest Pain

If you experience the warning signs of a heart attack, do not delay. Seek help immediately.

When it comes to health, you may be the kind of person to put on a brave face and push through the pain. But if you feel sensations typical of a heart attack, getting timely medical care could mean the difference between life and death.

“The earlier we can intervene, the better your chance of a good outcome,” said Jennifer Chism, MSN, RN, interim vice president of patient care services and chief nursing officer with Saint Joseph Mount Sterling. “In the case of heart attack, time is muscle.”

The most serious type of heart attack is known as an ST-segment elevation myocardial infarction, or a STEMI. This event occurs when a blood clot partially or totally blocks an artery that supplies blood to the heart. As a result, heart muscle begins to die.

Warning signs of a STEMI include:          

  • Chest pain          
  • Dizziness          
  • Nausea          
  • Sweating

Cardiac screenings are an important step to stay in tune with heart health. Learn more about cardiac screenings here.

A version of this article originally appeared in the Winter 2020 edition of Spirit of Health. For more stories like this one, subscribe to Spirit of Health magazine today.

Putting Community Center Stage

Picture of physical therapist holding photo album and smiling

When it comes to serving her community, Vickie Heierman, PT, plays many parts.

Heierman, the longtime rehabilitation director at Saint Joseph Hospital and Saint Joseph Jessamine, caught the theater bug when her son was in the drama club in middle and high school.

“I was a drama club mom,” Heierman said. “I traveled to festivals with my son and chaperoned many of his club’s trips. Those experiences got me interested in theater. Many of the people I met volunteered at the Lexington Opera House.”

Built in 1886, the Lexington Opera House hosts a variety of productions each year, including touring Broadway shows, and is home to the Lexington Theatre Company, which brings together Broadway actors, talented college students and local artists for performances. Heierman doesn’t take the stage at the Opera House, but without her and her fellow volunteers, the show might not go on. About 10 times each year, Heierman volunteers to take tickets, show patrons to their seats or check VIP credentials.

“The Opera House enhances Lexington’s culture,” Heierman said. “Being able to see a Broadway show without having to leave town is incredible. I enjoy seeing the energy of theater when I volunteer.”

Ministry and Motion

Contributing to Lexington’s cultural scene isn’t all Heierman does to better her community. She’s an active member of the city’s First United Methodist Church, where her projects have included leading a 34-week Bible study, participating in a mission trip to Puerto Rico, helping with vacation Bible school and serving as church lay leader. Currently, she teaches Sunday school, serves on the intercessory prayer team and volunteers once per year for Room in the Inn, a church program that gives homeless men meals and a place to sleep.

Heierman combines community service with a favorite pastime: running.

“I enjoy participating in charity races,” she said. “I always try to run the Shamrock Shuffle 3K, which supports Lexington Habitat for Humanity, and the Yes Mamm! 5K, which funds free mammograms at CHI Saint Joseph Health facilities. I also compete in a lot of races that support people dealing with addiction.”

Heierman has no plans to retire — she still loves her work after 40 years with CHI Saint Joseph Health — but when she does, she plans to devote more time to volunteering. It’s the role she was born to play.

“Volunteering builds me up and makes me so grateful for what I have.”

A version of this article originally appeared in the Winter 2020 edition of Spirit of Health. For more stories like this one, subscribe to Spirit of Health magazine today.

Patients Can Live a Full and Healthy Life After Heart Valve Surgery

Picture of a heart with a stethoscope

Each year in the United States, more than five million Americans are diagnosed with heart valve disease, which occurs when one or more heart valves are not opening or closing properly.

A person’s heart has four valves: aortic, mitral, pulmonary and tricuspid. These valves help direct the blood flow through the chambers of the heart and into the rest of the body. The valves are prone to various medical problems that can affect the way they function – resulting in narrowing or leaking – which disturbs normal blood flow patterns.

This results in various symptoms such as progressive shortness of breath, swelling of legs, chest pain, lightheadedness or blackouts, leading to the patient not being able to perform daily activities, recurrent hospitalizations, and potential death from heart failure and associated complications.

The most common valve problems are those of the aortic and mitral valves, which are also the two most commonly repaired or replaced valves. Narrowing of these valves – referred to as stenosis – is a challenging and potentially life-threatening condition.

A patient experiencing aortic stenosis will eventually need an aortic valve replacement, which is currently done with open heart surgery in patients who are deemed at low risk for such surgery. It can also be performed during a minimally invasive procedure known as the TAVR procedure, where a catheter is inserted through a small incision in the groin.

The TAVR procedure is done like a heart catheterization and most patients are able to go home in 24 hours following the procedure. Leakage in the aortic valve – known as aortic valve regurgitation – is currently treated through surgical valve replacement.

Mitral stenosis – usually the result of rheumatic heart disease – is usually repaired through a minimally invasive procedure known as a balloon valvuloplasty, where a balloon on the tip of a catheter is inflated to widen the valve and improve blood flow.

Mitral valve regurgitation – or leakage – is a more common condition and typically requires surgery to repair or replace the valve. Patients deemed high risk for open heart surgery may instead undergo a catheter-based procedure, the Mitraclip, performed through a small incision in the groin.

The Mitraclip procedure uses innovative technology to repair the mitral valve without the need for open heart surgery. Following this procedure, most patients leaving the hospital within 24 hours. This procedure is helping reduce hospitalization time and symptoms of heart failure, such as shortness of breath and leg swelling. Saint Joseph Hospital has been performing the Mitraclip procedure since 2013.

If you are suffering from heart valve disease or are experiencing symptoms of this disease, it is important to talk to your physician immediately to help determine the source of the problem.

Watch the video below to learn more about the minimally invasive Transcatheter Aortic Valve Replacement (TAVR) procedure to correct a narrowed aortic valve:

To learn more about heart valve replacements, contact the CHI Saint Joseph Medical Group. The practice is located at 1401 Harrodsburg Road, Suite A-300 in Lexington, and can be reached by calling 859.276.4429.

Nezar Falluji, MD

Nezar Falluji, MD, MPH

Dr. Falluji is with the CHI Saint Joseph Medical Group – Cardiology.

A Partner in Care: Cleveland Clinic Cancer Center

Scott T. Pierce, MD, medical oncology, hematology, at CHI Saint Joseph Health – Cancer Care Center in Lexington

CHI Saint Joseph Health can now offer expert second opinions, specialized treatment options and clinical trials to our patients, thanks to an affiliation with Cleveland Clinic Cancer Center.

We strive to continually improve our cancer services and bring new care options to patients at CHI Saint Joseph Health. In fact, we have been recognized for our quality cancer program by organizations such as the National Cancer Institute and the American College of Surgeons Commission on Cancer. Now, we are pleased to announce a further enhancement of our program with this new affiliation.

CHI Saint Joseph Health In affiliation with Cleveland Clinic Cancer Center

“It’s difficult for patients to travel long distances for second opinions, to see a rare cancer specialist or undergo procedures that aren’t found in a community hospital,” said Jessica Croley, MD, medical director for CHI Saint Joseph Health – Cancer Care in Lexington.

We decided that finding the right health care affiliate could help us enhance and expand our capabilities in meaningful ways while providing an extra level of convenience and comfort for the communities we serve.

After months of discussions, preparations and review, CHI Saint Joseph Health is proud to announce that we have entered into an affiliation with Cleveland Clinic Cancer Center.

Expert Care Locally

Cleveland Clinic is a national leader in cancer care — it has one of the top 10 cancer programs in the country and is considered one of the nation’s best hospitals by U.S. News and World Report.

“Cleveland Clinic has experts who each deal exclusively with one type of cancer,” Dr. Croley said. “When they collaborate on patient cases, they refer to specialists in that exact field of expertise to find the best treatment options.”

This thorough review is something our patients now have access to. When patients see an oncologist at CHI Saint Joseph Health, we consult with the team at Cleveland Clinic on their case. Specialists in breast cancer, brain tumors, sarcomas and other cancers respond to us with advice regarding care and treatment plans.

“This partnership gives us a way to consult with Cleveland Clinic without making patients travel out of the community,” Dr. Croley said. “Patients are still treated in our facilities, so the convenience is there even as they receive expert second opinions.”

Rapid Referrals

Sometimes, patients may require a form of treatment that cannot be provided at CHI Saint Joseph Health, such as targeted radiation treatments, minimally invasive surgical options and experimental treatment through clinical trials. In those cases, we can easily refer patients to Cleveland Clinic for the care they need.

Monty Metcalfe, MD, is part of the medical oncology – hematology team in Lexington

“Typically, when we refer patients outside of our system, it can take weeks to get them in to see a provider,” Dr. Croley said. “This partnership gives us a seamless referral process that allows for quick appointments at Cleveland Clinic.”

Access to clinical trials is especially important for patients whose cancer has not responded to standard treatment options. Instead of traveling to Cleveland Clinic to determine if they’re eligible for trials, patients can do their prescreenings at CHI Saint Joseph Health.

Enhancing Our Program

Though we are excited to give our patients access to services from Cleveland Clinic, we also saw this affiliation as an opportunity to improve our existing cancer program. Before we agreed to a formal affiliation, the Taussig Cancer Center at Cleveland Clinic performed a thorough review of our cancer program and gave us recommendations to enhance our services.

The cancer care team in Lexington celebrated the affiliation announcement between CHI Saint Joseph Health – Cancer Care Centers and Cleveland Clinic Cancer Care in October.

“Cleveland Clinic assessed our pharmacy, nursing, radiation, infusion, research and support services to see how our processes work,” Dr. Croley said. “They were most impressed by our patient education and support offerings. That includes the work done by our dietitians, genetic counselors, financial counselors, licensed social workers, psychosocial professionals, physical therapists and others.”

Based on advice from Cleveland Clinic, we will create short- and long-term goals for the enhancement of our cancer program to ensure patients continue to receive high standards of care.

“Cleveland Clinic is homed in on best practices and safety standards that we’re able to apply in our day-to-day patient care,” Dr. Croley explained. “Our hope is that our patients’ experiences are the same as they would be if they walked into Cleveland Clinic.”

Multiple Specialists, one Contact

Though we offer an expanded set of cancer services through our partnership with Cleveland Clinic, we want to keep things simple for patients and their loved ones. Thankfully, our new referral coordinators are available to help patients navigate their cancer care without additional hassle.

Watch the video below to see the CHI Saint Joseph Health – Cancer Care affiliation with Cleveland Clinic Cancer Center announcement.

“Instead of contacting multiple offices and specialists for their appointments, patients can rely on referral coordinators as their main point of contact,” said Dr. Croley. “Referral coordinators determine which providers patients need to see and how we can best help them. They can gather records and test results and submit them to Cleveland Clinic for a second opinion.”

To learn more about this important affiliation with Cleveland Clinic Cancer Center, call 859.313.4673.

Healthy New Year

2020 Healthy New Year's Resolutions

Schedule your preventive screenings – make 2020 your healthiest year yet!

“Health screenings are a way for patients to get a head start on health issues that could become something more serious,” said Teresa Lucas, BSN, RN, population health coach at CHI Saint Joseph Health Partners. “They are a simple but effective way to be proactive about your health.”

Based on your age, here are the screenings you should receive.

In your 20s and 30s

Women should receive Pap tests every three years to screen for cervical cancer until age 30, and then they should be screened every five years with the addition of HPV screening. Everyone should have their blood pressure and cholesterol checked annually to monitor their heart health, as well as undergo a yearly skin cancer screening.

In your 40s

Both men and women should be screened for diabetes and colorectal cancer starting at age 45, and women should begin receiving mammograms by age 40.

In your 50s

Men should begin screening for prostate cancer by age 50. If you are between the ages of 55 and 74 and currently smoke or have recently quit, ask your provider if you qualify for a lung cancer screening.

“Make annual wellness visits a priority,” Lucas said. “They are an opportunity for you to touch base with your providers and alert them of any health changes or concerns.”

A provider can help you develop a screening schedule that is right for you. If you need a provider, visit our online Provider Directory or call 859.313.2255 to speak with a member of our provider referral team.

A version of this article originally appeared in the Winter 2020 edition of Spirit of Health. For more stories like this one, subscribe to Spirit of Health magazine today.

Comprehensive Wound Care Can Help Minimize Pain and Improve Recovery

Wound care and recovery

Wounds can hurt in more ways than one, especially when they limit your ability to perform everyday activities. While minor cuts and scrapes can often be treated at home, chronic wounds may require medical attention. It’s important to recognize when a wound warrants a doctor’s visit, as comprehensive wound care can minimize pain and shorten recovery time.

Nearly everyone will experience a wound at some point in their life. Acute wounds generally occur as a result of trauma, and typically heal within a few weeks with proper care. Falls, injuries from sharp objects and car accidents are some of the most common causes of acute wounds. Acute wounds include all types of cuts, scrapes, tearing of the skin and punctures.

Acute wounds can sometimes be treated at home by simply cleaning the wound and applying a bandage. Applying ice can minimize bruising and swelling, and taking the recommended dose of acetaminophen, like Tylenol, will relieve pain. You should see your doctor if an acute wound is deeper than a half inch, if bleeding doesn’t stop with direct pressure, or if bleeding lasts longer than 20 minutes. In the case of a serious accident, seek immediate medical care.

To treat a more serious acute wound, a doctor will first clean and possibly numb the area. Then, they may close the wound using glue, sutures or stitches. In some cases, surgery might be required. Depending on the location of the wound and potential for infection, it may be able to heal naturally, while covered with gauze or a bandage. Antibiotics may be prescribed to protect the wound from infection.

If a wound has not healed within 30 days, it may be classified as chronic or non-healing, and will require further medical attention. Chronic wounds may take a long time to heal, never heal or recur. These wounds are common and reduce the quality of life for those affected. 

Chronic wounds include ulcers, which are often associated with diabetes, arterial or venous disease, which is poor blood circulation. Other types of chronic wounds are pressure ulcers, post-radiation therapy ulcers, and ulcers caused by chronic bone infection, such as osteomyelitis.

These wounds sometimes require debridement. Chronic wounds are often so large that they cannot close on their own, and require surgery with skin grafts. These wounds are even less likely to heal if they become infected with bacteria, so depending on how severe the infection is, antibiotics may be considered.

Another characteristic of chronic wounds is that they are hypoxic, or have low oxygen levels in the tissue. Studies have shown that Hyperbaric Oxygen Therapy improves the chance of healing for chronic wounds. If you have a chronic wound, talk to your doctor to see if this treatment is right for you.

Comprehensive wound care is a critical part of the recovery process for many patients. If you’ve experienced a wound or serious accident, talk to a physician about the benefits of wound care.

Jean-Maurice Page

Jean-Maurice Page, MD

Dr. Page is with CHI Saint Joseph Medical Group – Orthopedics.

Unexplained Symptoms Could Be Signs of a Thyroid Problem

Unexplained Symptoms Could Be Signs of a Thyroid Problem

If you are experiencing unexplained symptoms, including issues with weight gain or loss, anxiety, perspiration, restlessness or fatigue, you may have a problem with a small gland in your neck.

Issues with the thyroid gland, one of the nine major endocrine glands in the body, can be the underlying cause of a wide variety of health problems. It’s important to understand what the thyroid affects and to seek medical care if your thyroid may not be functioning properly.

What is the Thyroid Gland?

The thyroid gland is a butterfly-shaped endocrine gland located in the front of the neck. Endocrine glands produce and regulate chemicals called hormones. Specifically, the thyroid gland produces hormones that help the body regulate metabolic speed, or the rate at which your metabolism works. If hormone levels become too low or too high, you can experience a wide variety of strange and unwanted symptoms.

Common Thyroid Disorders

Thyroid disorders are typically classified as either hypothyroidism or hyperthyroidism. However, hypothyroidism occurs more frequently than hyperthyroidism.

Watch the video to learn more about the difference between hypothyroidism and hyperthyroidism.

Hypothyroidism occurs when the thyroid is not producing enough hormones. The most common symptom is unexplained weight gain. Individuals with hypothyroidism often feel tired, sluggish and depressed. Other common symptoms of hypothyroidism include:

  • Dry skin
  • Brittle nails
  • Numbness or tingling in the hands
  • Constipation
  • Irregular menstrual periods

Slowed heartbeat and low blood pressure often occur in those with hypothyroidism.

Conversely, unexplained weight loss could be a sign of hyperthyroidism, which occurs when the thyroid is producing more hormones than the body requires. Hyperthyroidism can cause anxiety, trouble sleeping, fast heartbeat, high blood pressure, irritability and restlessness. Additional symptoms of hyperthyroidism include muscle weakness, trembling hands, vision problems, diarrhea and irregular menstrual periods.

Those with thyroid disorders may develop a goiter, or swelling in the neck. This can occur in conjunction with either hypothyroidism or hyperthyroidism, as well as with normal thyroid hormone levels.

If you are suffering from symptoms that may be due to a thyroid disorder, talk to your doctor to determine if you should be tested. A blood test for thyroid stimulating hormone (TSH) can help diagnose the true cause of your symptoms.

Treating Thyroid Disorders

Once diagnosed, treatments are available for those suffering from a thyroid disorder. Hypothyroidism can be treated with medication that increases hormone levels. Patients diagnosed with hyperthyroidism are normally prescribed medication to lower their hormone levels. Once medication is administered, patients typically experience noticeable improvements within a few weeks. If a thyroid problem is severe, a physician may recommend surgery to remove the thyroid gland, paired with medication.

Left untreated, thyroid disorders can decrease your quality of life and increase your risk for stroke or heart attack. CHI Saint Joseph Health – Ear, Nose and Throat Care can help if you have questions about thyroid disorders. To learn more, call 859.629.7140.

Jessica Lange, MD

Jessica Lange, MD

Dr. Lange is with CHI Saint Joseph Health – Ear, Nose and Throat Care. The office is located at 120 North Eagle Creek Drive, Suite 102 in Lexington. For more information, call 859.629.7140.

A Community Advocate

Richard Reiter

Growing up in a family of nurses, Ricky Reiter, BSN, RN, CAPA, outpatient surgery charge nurse with Flaget Memorial Hospital, part of CHI Saint Joseph Health, has always been drawn to the idea of improving the lives of those around him.

“In school, I always liked biology and anatomy, and nursing clicked with me,” said Reiter, a graduate of the University of Louisville. “The thought of seeing people when they are at their worst and helping them get better seemed rewarding.”

Upon graduation from his nursing program, Reiter pursued his love for helping others by working in the telemetry unit at Flaget.

“When I started there, it was a small community hospital,” Reiter said. “Everyone knew everyone. If they didn’t know me, they knew my family.”

Nearly two decades later, Reiter has enjoyed being part of the hospital’s evolution, working in a variety of roles in the intensive care unit, infection control, education, employee health and outpatient surgery. But his dedication to service extends well beyond the hospital walls.

Selflessness in Action

When you step onto the elevator at Flaget, you will notice a photo of Reiter gracing the doors and celebrating his love for service to the hospital and the community at large.

At Flaget, Reiter helps organize food drives as part of the Spirit Team. He is the chairperson of the hospital’s Green Team, which oversees the hospital’s recycling program, and he sits on the Nursing Professional Development Program Board to help his colleagues take their careers to the next level.

Reiter is also on the board for the Rolling Fork Iron Horse Festival, serves on the local fire department’s support team and is a former member of the New Haven City Council.

“I always enjoy seeing the community advance,” said Reiter, who is also a father of two children, Emily and Eric. “I am proud to send my kids to the local faith-based school, St. Catherine Academy, and I enjoy bringing them to community meetings with me, as well. They are learning that service is important.”

When It’s Time to Unwind

When he is not helping patients, Reiter enjoys camping and boating with his kids and extended family.

“There are about 60 of us when we all get together,” Reiter said. “We have a good time.”

A version of this article originally appeared in the Fall 2019 edition of Spirit of Health. For more stories like this one, subscribe to Spirit of Health magazine today.