Healthy
Connections
w w w. r r m c . o r g
S U MM E R 2 0 1 2
Patient focus group provides
valuable insight
A
n important part of
Rutland Regional’s role as
a healthcare organization is
to advocate for current and future needs
of its community. The Rutland Heart
Center was formed to improve the
accessibility of quality heart healthcare
throughout the region. In September
2011, cardiology patients from the
Rutland area participated in focus
groups comprised of patients with one
of four distinct heart conditions, plus
family members.
Complex critical patients: A
condition that requires immediate
hospitalization and is life threatening.
Elective patients: A condition
posing no significant risk of loss
of life or substantial reduction in
functional ability if treatment is
delayed or postponed.
Perpetual patients: A disease
that extends over a multiyear period,
requiring ongoing medical therapy.
Occasional patients: A condition
that can be resolved within a short
period of time with no substantial
ongoing medical therapy required.
Each participant was asked to recall
their cardiac treatment experience by
describing how well his or her needs
were met. The focus group sessions
revealed common concerns: stressful
situations, need for emotional support
and counseling and understanding family
expectations during a patient’s critical
care. As a result, several needs surfaced
and are being addressed to better serve
patients and their families.
•
4RMC
Cooking
cleanly
Keep it clean
Be sure to wash your hands frequently with soap and
warm water and thoroughly clean or disinfect all kitchen
surfaces, including appliances and the sink, as you work.
Reusable towels and washcloths should be washed daily in
hot water, and a 30-second stint in the microwave can kill
germs in the kitchen sponge. Areas such as the microwave
and refrigerator also need to be sanitized regularly, and
throw reusable grocery bags into the laundry periodically
on the hot cycle. Last, wash all produce—even those you
peel—before eating.
Curb cross-contamination
Cross-contamination occurs when juices from raw
meats or other contaminants come in contact with cooked
or ready-to-eat foods. To avoid it, use separate, clean cutting boards for raw meat, poultry, fish and seafood, as well
as ready-to-eat foods. Wash cooking utensils after working
with each food, and never use the same plate for raw and
cooked foods. Discard marinades, or heat them to boiling
before re-using them.
At the store, put meat products and produce into plastic bags and keep them separated from other food in your
2 Summer 2012
cart. When unloading your groceries, place meat below
ready-to-eat foods in the refrigerator.
Find a safe temperature
When cooking, use a food thermometer to ensure
meat, poultry, eggs, fish and seafood reach a high enough
temperature to kill any potentially harmful bacteria. Place
the thermometer in the thickest part of the food, away
from fat, bone or gristle. (See “Is it hot enough?”)
Cold temperatures slow the growth of harmful bacteria, so it’s important to refrigerate cooked foods within two
hours. Check that your refrigerator is set to 40 F or lower
and your freezer to 0 F or lower. Use shallow, airtight containers, bags or wrap to store leftovers, and toss them after
three days.
•
> Is it hot enough?
Type ofUSDA-recommended
food internal temperature
> Steaks and roasts
145 F
> Fish
145 F
> Pork
145 F
> Ground beef
160 F
> Egg dishes
160 F
> Chicken
165 F
Images on any of these pages may be from one or more of these sources:
© 2012 Thinkstock and © 2012 istockphoto.com
F
ood poisoning can debilitate even the healthiest
person with a range of unpleasant symptoms. For
some individuals—including pregnant women,
newborns, older adults and those with compromised
immune systems or chronic diseases—foodborne illnesses
can be downright dangerous. Because more than half of
foodborne illnesses in the United States are contracted in
the home, a few simple steps in the kitchen can help you
avoid getting or making others sick.
I
Setting healthy living goals
f you find yourself living a less than healthy lifestyle,
yet keep telling yourself that you’ll do something
about it tomorrow, it’s time for a heart to heart.
Lifestyle changes that are too ambitious, too vague or not
backed up by a plan rarely succeed. Yet by starting with
simple steps and working your way up to longer-range
goals, you'll find yourself on a path to healthier living.
Within Reach
Small steps lead to sustainable results. The key to lifestyle changes is to identify healthy goals that are attainable
because they’re specific and measurable. Don’t try to take
on too much at one time. Be clear about what you want to
accomplish, write it down and visualize yourself reaching
that goal.
> Rather than: I will exercise more.
I will start walking three times a week for 30 minutes
at a time.
Pick an aerobic exercise/physical activity you enjoy. Start
with a reasonable weekly goal for one to three months.
Once you’ve reached that level, set a new bar to achieve—
such as five times a week for 45 minutes each time for the
next three months. Vary your routine with different exercises
if that helps keep you motivated or do it with a friend. You’ll
soon find yourself up to one hour of physical activity every
day—what many fitness experts currently recommend.
TRY
> Rather than: I need to eat better.
I will start each day by eating a healthy
breakfast.
Breakfast is the most important meal of the day so if
you find yourself grabbing unhealthy snacks throughout
the day, it may be because you started the day with an
empty tank. Perhaps you drink too much soda or rarely
get enough fruits and vegetables in your diet. Once you
have identified the eating habit you want to change, take
steps to correct it. Choose low-fat or nonfat milk or water
instead of sugary drinks. Aim for eating five servings of
fruits and vegetables daily.
TRY
> Rather than: I need to lose some weight.
I will lose 1 to 2 pounds per month, until I reach my
recommended weight.
Being active on a daily basis and eating more nutritiously
are great steps toward losing weight. Consider limiting
your television time and substituting an activity instead
such as dancing to your favorite music, moving to an exercise DVD or fitting in some strength training. Eat less at
meal time—without feeling denied—by using a smaller
plate. Drink a glass of water before each meal so you won’t
feel so hungry.
TRY
> Rather than: I probably should see my doctor.
I will call today to schedule a physical with my
physician to discuss my health concerns.
Before starting an exercise or weight-loss program, especially if you’ve been inactive, it’s smart to have a complete
physical. Your physician can help identify lifestyle goals
that are pertinent to your health condition and make sure
it’s safe for you to start.
TRY
•
Summer 2012 3
A new approach to
hip replacement
by Eric J. Marsh, MD, Vermont Orthopaedic Clinic
A
t Rutland Regional Medical Center we have
long been proud of our Joint Replacement
Program. We’ve been designated as a Blue
Distinction Center for Knee and Hip Replacement by
BlueCross BlueShield of Vermont and in 2011 were
the only hospital in Vermont to receive a Five-Star
rating in joint replacement, hip replacement and knee
replacement by HealthGrades, a nationwide healthcare
ratings company. For years we’ve been
on the leading edge of joint replacement
surgery, performing minimally invasive
surgery, computer-navigated knee
replacement surgery and complex
revision joint replacement surgery. We’re
Eric J. Marsh, MD
proud to announce that we continue to
remain on the forefront of orthopaedic surgical
technology by offering anterior approach total hip
replacement (AATHR).
AATHR surgery is made easier with the use of
a specialized operating table called the Hana™ table.
This table positions the patient in a way that allows
the hip to be exposed through a single small incision
on the front (anterior) of the hip. AATHR is a true
tissue-sparing approach to the hip. Unlike more
traditional approaches from the back (posterior)
or side (lateral), AATHR doesn’t require muscle
detachment from the hip or thigh bone during surgery.
The decreased trauma to the muscles and tissues allows
for a quicker recovery and eliminates precautions
to avoid postsurgical hip dislocation. In addition,
positioning on the Hana table permits the use of X-ray
imaging during surgery to ensure accurate implant
placement and allows for the possibility to have both
hips replaced during one surgery.
•
Relief for joint pain
Anterior approach total hip replacement (AATHR)
surgery is a wonderful option for some patients.
Call the Vermont Orthopaedic Clinic and make an
appointment with Eric Marsh, MD, to see if AATHR
surgery at Rutland Regional Medical Center is the right
choice for you. Visit www.vermontorthoclinic.org
or call 800.625.2937.
4 Summer 2012
4RMC
Reducing asthma triggers
in the home
by Sarah Cosgrove, BA, RCP, VT TTS, AE-C, Health Coach, Rutland Regional Medical Center
I
n the United States, asthma affects approximately
22 million people — and 6 million of those are
children. Asthma is a chronic lifelong disease caused
by swelling and inflammation in the airways. When an
asthma attack occurs, the muscles surrounding the airways
become tight and the lining of the air passages swells,
reducing airflow and making it difficult to breathe.
Poorly controlled asthma may lead to missed school,
problems playing sports, missed work for parents and
multiple visits to the doctor’s office and emergency room.
Learning how to control asthma and knowing your
child’s asthma “triggers” are important. Because a variety
of triggers can lead to asthma symptoms or an attack,
avoiding them is best.
Asthma Triggers
The most important step a family can take is to
eliminate tobacco smoke from the home. Family and
friends who smoke carry smoke residue in and on their
clothes and hair, which can trigger asthma symptoms.
Keep pets outdoors or at least away from your child’s
bedroom. Remove shaggy rugs and make an effort to
vacuum four times a week. Limit the amount of stuffed
animals on your child’s bed. Instead of blinds, which
collect dust, hang curtains or pull shades. Pillows and
mattresses can be covered with “allergy proof ” casings to
reduce exposure to dust mites.
4RMC
Breathe easy
For more information or to determine if you qualify for
the In-Home Pediatric Asthma Intervention Program,
contact Rutland Regional Medical Center’s Community
Education at 802.772.2400.
Store food in containers and out of bedrooms to
minimize the possibility of cockroaches, which can trigger
asthma attacks. Use detergents and cleaning agents that
are unscented. Keep humidity levels low, and fix leaks to
prevent growth of organisms such as mold.
All of these efforts can make a significant difference to
a child with asthma, in both the short and long term.
Asthma Intervention of the Rutland Region
(AIRR) facilitates education and intervention to advance
asthma prevention, control and care. The In-Home
Pediatric Asthma Intervention Program is a free pilot
program available to children and adolescents up to
25 years old with an asthma diagnosis.
This program features home visits by an asthma
educated nurse and an environmental home specialist to
ultimately decrease hospital stays, emergency room visits,
unplanned doctor visits and missed days of school, as well
as increase quality of life.
•
Summer 2012 5
Stay in the game
A
Avoiding sports injuries
ching backs, golfer’s elbow, runner’s knee,
muscle pulls … ouch! For springtime weekend
warriors hitting the pavement, golf courses or
trails after an inactive winter, anything can happen. And it
usually does—unless you stay in shape during the off season,
stretch appropriately and increase the level of your participation gradually in the first few weeks. A sudden burst of
activity can—and will—take a toll on an unprepared body.
Play it safe
Stay safe with these helpful tips for preventing sports
injuries:
> Start with a green light. Get a physical to make sure
you’re healthy before starting a new sport.
> Always wear proper protective equipment, clothing
and well-fitting shoes designed for the sport you’re doing.
Protective eyewear is important for impact sports. Helmets
are a must for bicyclists.
> Know and follow the rules of the sport to avoid
accidents.
> Warm up slowly and stretch out before and after exercising. Warming up gradually increases the heart rate and
can prevent muscle strain and joint injury.
> Stay hydrated by drinking lots of water before, during
and after your activity.
> Avoid playing when you’re tired or in pain.
Treat it right
If you get hurt, act quickly for the best outcome.
Treatment at home should begin with RICE: Resting
6 Summer 2012
the injured area, applying Ice and a Compressive wrap,
Elevating it and giving it time to heal.
Diagnosing and treating overuse injuries can help
ensure they don’t turn into larger chronic problems. The
solution may be as simple as taking a break from the activity or modifying a technique. For a serious injury, seek
emergency care immediately.
If you have questions about preventing or treating
sports injuries, talk to a fitness expert or your doctor.
•
> What’s my sport?
Can you identify the spring sporting activity by its
leading potential injury?
1. Walking
2. Running 3. Hiking
4. Biking
5. Golfing/tennis 6. Softball/baseball
a. Elbow pain
b. Shin splints
c. Shoulder pain
d. Ankle sprains
e. Achilles tendinitis
f. Head injuries
Answers
1. b. Shin splints. Shin splints are an irritation to the
tendons where they connect to the tibia bone.
2. e. Achilles tendinitis. This painful overuse injury
occurs when the large tendon in the back of the ankle
becomes irritated and inflamed.
3. d. Ankle sprains. This accidental injury is often
caused during activities over uneven ground or by
obstacles on a walking path.
4. f. Head injuries. These are the main cause of
disabling injuries in bicyclists, so be sure to wear a
helmet!
5. a. Elbow pain. Golfers and tennis players suffer
elbow injuries primarily due to incorrect technique,
gripping the club or racquet too hard or hitting the
ground frequently.
6. c. Shoulder pain. Frequently seen in throwing
sports, rotator cuff tendinitis is a common cause of
shoulder pain.
High-tech
fitness
N
eed to add a little motivation to your exercise
routine these days? Or maybe just want to
make sure you’re getting the most out of your
regimen? The market is filled with great (and inexpensive!)
gadgets that can help you accomplish your goals.
 Heart rate monitors. Knowing your optimal heart
rate can keep you burning optimal amounts of fat and
calories—and keep the pounds coming off. Working out
in your target zone helps you avoid exercising at too low
of an intensity or overdoing it and risking injury. Some
models are available in a less bulky wristwatch form and
offer additional measurements, such as steps taken, pace
and distance traveled. Want to monitor your heart rate
without an extra device? Try Modula d.o.o.’s free Instant
Heart Rate app www.instantheartrate.com, which monitors your rate right through your fingertip.
> Hot exercise trends
Some of the newest fitness trends are so hot,
they’re scorching!
Bikram yoga: Also called “hot yoga,” Bikram combines Hatha yoga with extreme temps: It’s practiced in
rooms often heated to 100 F or more. The result? An
extra-sweaty workout session.
Zumba®: This fitness craze combines Latin beats
with relatively easy-to-follow dance moves. Fans love it
because it makes working out fun, but it still packs a
big cardio punch and provides resistance and interval
training. You’ll work up a sweat and have fun at the
same time.
TRX® suspension training: This unique full-body
workout focuses on improving balance, flexibility, total
body strength and range of motion using your body
weight and a special suspension system. Used by
athletes and Navy SEALs, this super-intense workout
system has major fat-blasting potential.
Digital trainers are systems worn as
you work out and offer information
such as heart rate, speed, distance
and calories burned.
 Smartphone apps can also help you access
virtual exercise equipment, yoga trainers and step-bystep exercise instructions. Most only cost a few dollars,
and free apps abound, too. Try the American Heart
Association’s Walking Paths app www.startwalkingnow.
org/WalkingPathApp.jsp, a GPS tracking app for your
walking, hiking or running regimen.
 Tracking systems are small, clip-on devices that
can track how many calories you burn, how many steps
you take, how far you’ve walked, what time you go to bed,
how long it takes you to fall asleep and how long you
slumber—24 hours a day, seven days a week—for a more
complete health picture.
 Digital trainers are systems worn as you work out
and offer information such as heart rate, speed, distance and
calories burned as well as audio coaching and personalized
exercise routines. Some can tell you if you’re going too fast
or too slow as you run and sync with your MP3 player.
•
Summer 2012 7
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Rutland, VT 05701
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Breastfeeding — A great start
by Mary Beerworth, MD, FACOG, Rutland Women’s Healthcare
B
reast milk is the perfect food for your baby. Rutland
Regional Medical Center strongly encourages all
new mothers to breastfeed their newborn babies.
Breast milk provides immune globulins, or antibodies that cross
from mother to baby, helping to protect your baby’s health.
Breastfeeding is good for the mother too, helping to shrink
the uterus and reduce bleeding after delivery. It can also reduce
a woman’s incidence of developing breast cancer and ovarian
cancer later on in life.
Rutland Regional has an abundance of support for
breastfeeding mothers from before birth with expert guidance
by our caring, well-trained nursing staff. Free breastfeeding
classes taught by Sarah Bache, RN, CLC;
Carol Ghent, RN, CLC; and Cathy
Toda, RN, CLC, are held the
second Thursday of every
month from 6 to 8 pm at
the Medical Center in
Conference Room 3.
Mothers are encouraged
to bring their support
person to these classes. For
questions and to register, call
802.747.3695.
Assisting patients
Rutland Regional provides a
room exclusively used for breastfeeding
and breastfeeding counseling. This room
has a private, comfortable feel and is located just
outside the Women’s Healthcare Unit at Rutland
Regional. The breastfeeding room can be used to
assist our patients with any breastfeeding issues
they have, even after they go home. We want you
to be successful and strive to help you in any way
Mary Beerworth,
we can! Our goal is to have 100 percent of our
MD, FACOG
patients try to breastfeed.
Educational materials and breastfeeding
support are provided to all patients. In addition to our staff
at Rutland Regional, patients may also contact the following
for breastfeeding support:
Members of the LaLeche League of Rutland County
Diane Dressler
802.747.8665
Liz Swift
802.483.6296
Lisa Velasquez, IBCLC
802.325.2566
Promise Lactation Consulting
Lisa Velasquez, IBCLC
802.325.2566
Vermont Department of Health and WIC Peer Counselors
Jill Corey, MA, RD
802.786.5811
Rutland Area Visiting Nurse Association & Hospice
Kathy Pemrick, RN,
Heidi Wilhelm, BSN, or
Ardith Wolynec, MS, BC
802.775.0568