Year in Review – Part 1

Our 2012 Annual Report included a month-by-month “Year in Review” section. Here is the first quarter excerpt.

JANUARY

pediatrics' open houseUrologist Dr. Richard Graham and menopause practitioner Dr. Ellamarie Russo-DeMara of the Twin River Health Center offer a free talk at the Montshire Museum on urinary incontinence.

Gifford is once again awarded a grant from the Avon Breast Health Outreach Program. For the 11th year, Gifford is the only entity in Vermont to receive the $35,000 grant for breast cancer awareness education and outreach.

Pediatrics and adolescent medicine moves from the main medical center building to Dr. Chris Soares’ former space at the corner of South Main and Maple streets. Joining the practice on the first floor of the renovated, spacious Victorian home is pediatric physical, occupational, and speech therapies.

A free three-week series on heart health includes talks from cardiologist Dr. Bruce Andrus and registered dietitian Stacy Pelletier as well as a heart-healthy cooking demonstration from Gifford’s chefs.

FEBRUARY

As part of Gifford’s expanded efforts under the Vermont Blueprint for Health, a chronic illness support group – Chronic HealthShare Consortium – is launched and begins meeting monthly.

Dr. Ovleto Ciccarelli strives to bring colon health to the forefront with a free health talk, “Everyone’s Got One: A Discussion on the Colon and How to Keep It Healthy”.

Pacemaker surgeries return to Gifford after a quarter century hiatus.

The Menig Extended Care Facility is named among nation’s top 39 nursing homes by U.S. News and World Report, which released a list of “2012 Honor Roll” nursing homes. Menig was the only nursing home chosen in Vermont and neighboring New Hampshire.

MARCH

The 106th Annual Corporators Meeting is held at the medical center and features Steve Kimbell, commissioner of what was then the Vermont Department of Banking, Insurance, Securities and Health Care Administration. Leo Connolly, Fred Newhall, and Peter Nowlan are elected to the Board of Trustees.

A Vermont House of Representatives resolution recognizes “the outstanding health care services provided by Gifford Medical Center”. The resolution is in honor of Gifford’s more than 100 years of service to the Randolph area and for its many recent awards.

The Diabetes Education Expo focuses on teeth and feet and how diabetes can keep both healthy. It is the 7th annual exposition organized by the Diabetes Clinic especially for the growing diabetes population.

An open house is held for pediatrics’ new space at 40 South Main Street. Children attending enjoy face painting, balloons, snacks, tours of their new doctor’s office, bike helmet fittings, and painting tiles that have become part of the clinic’s permanent decor.

In Your Words…A Patient’s Story

This article appeared in our Spring 2013 Update publication.

patient feedbackThe following is excerpted from a letter sent to Gifford by patient Emily Betts Newman of Chelsea. With her permission, we share her words with you.

I underwent surgery at Gifford Medical Center, which was performed by Dr. Dina Levin. The short of it is that Dr. Levin treated me with kindness, compassion, and stellar professionalism – with some humor thrown in. I arrived at 8:30 a.m. and was escorted to a room where the business of prepping me for surgery commenced immediately. The nurse  was outgoing, friendly, and knew exactly what she was doing, pleasantly professional.

Very shortly in came Dr. Levin. She spoke to me and then to my husband. Then in came the anesthesiologist. He too was most approachable, but at the same time remained professional. Just when I thought it couldn’t get any better, along comes a young man and a young woman, dressed in surgical scrubs, to walk me to the OR. They were both most
solicitous toward me and made the walk to the OR quite entertaining.

But wait, it still gets even better. Upon entering the OR, I was instructed to get up on the  bed and stretch my arms out. As I did I felt many hands stroking my arms and touching my legs in very soothing manner, sending waves of reassurance through me. Dr. Levin came in, looked at me, smiled and said, “Emily, we are going to take such good care of you.” At that very moment I was relaxed, felt like all was well with me and the world. Dr. Levin was the last smiling face that I saw before I went into the dreamless world of anesthesia.

Soon I was back in the room where it all began. I was actually sorry to go when they decided to boot me out. The quality of care at Gifford is sterling and exceptional in every  way. I even got a call from a gentleman at Gifford asking how I was doing since my procedure. I now tell my friends that it certainly paid off to have the surgery and there is only one person on the planet who can do it with compassion, humor, and professionalism. That person is Dr. Dina Levin.

Planned Gifts Leave a Lasting Legacy

planned givingThis information appeared in our Spring 2013 Update publication.

From the Birthing Center to the Menig Extended Care Facility, we rely on donors to help us to continue improving upon the care we are so privileged to provide.

Together, we are working toward a strong future for Gifford and our community. When you extend your support through your estate or long-term financial plans, your dedication to Gifford will continue as a part of your legacy for years to come. You are truly making a difference when you include Gifford in your will.

For more information about including Gifford in your planned giving, please contact: Ashley Lincoln in the Development Department at 728-2380 or visit www.giffordmed.org.

New Providers

This information appeared in our Spring 2013 Update publication.

Dr. Barbara Lazar

Dr. Barbara Lazar

Dr. Barbara Lazar

Family physician Dr. Barbara Lazar has joined Gifford in Randolph, providing care to all  ages, especially older Vermonters.

A graduate of the University of Pennsylvania School of Medicine, Dr. Lazar did her internship and residency at Thomas Jefferson University Hospital in Philadelphia. She is board certified by the American Board of Family Practice.

She began her career in 1996 at the Indian Health Service at Northern Navajo Medical Center in New Mexico. Moving to Vermont in 2003, she worked as medical director at Genesis Elder Care in Lebanon, N.H., and as part of the family medicine department at Dartmouth-Hitchcock Medical Center. She has also worked at Brookside Nursing Home in
White River Junction and most recently at the Program for All-inclusive Care of the Elderly (PACE) in Rutland.

A Sharon resident, wife and mother, Dr. Lazar joined Gifford for the opportunity to work close to home and at a small medical center committed to family care.

Call her at Gifford Family Medicine at 728-2445.

Tara Meyer, APRN

Tara Meyer, APRN

Tara Meyer, APRN

Family nurse practitioner Tara Meyer is the newest member of the family medicine team at the Gifford Health Center at Berlin.

Board-certified by the American Nurses Credentialing Center and a graduate of the  University of Vermont, Tara has both nursing and family nurse practitioner experience. She worked as an inpatient nurse at Fletcher Allen Health Care, as a nurse practitioner to children and adults with traumatic brain and spinal cord injuries at Dartmouth-Hitchcock Medical Center, and most recently as a primary care nurse practitioner for the Program
for All-inclusive Care of the Elderly (PACE) in Colchester.

A Montpelier resident and wife, she calls her position at Gifford her “dream job.” “I’m very happy. I just love Gifford. A lot of my friends come to Gifford. A lot of my friends have had babies at Gifford,” Tara says. “It feels really great to work in a place where I’m proud of, that’s really invested in the community and has a great reputation.”

Tara provides care to all ages and also works in area nursing homes on Gifford’s
behalf. Call her at the Berlin Health Center at 229-2325.

Brad Salzmann, PA-C

Brad Salzmann, PA-C

Brad Salzmann, PA-C

Experienced orthopedics physician assistant Bradford “Brad” Salzmann has
joined Gifford’s orthopedics team in Randolph, providing office care and assisting
in surgery.

A graduate of Springfield College in Massachusetts, Brad is certified by the National
Commission on Certification of Physician Assistants. He’s worked since 1996 in
orthopedics at Saint Vincent Hospital in Worcester, Mass., and Wing Memorial
Hospital in Palmer, Mass. He also worked in hospitalist medicine at IPC Hospitalist
of New England.

In addition, he has a master’s degree in disaster medicine and management and serves as part of a disaster medical assistance team that responds to national crises.

Now a Royalton resident, this outdoor enthusiast has joined Gifford for the opportunity to work in Vermont and in a small hospital setting. “I’m really excited to be at Gifford. It’s personable. You get to know people and make more of a difference,” he says.

Call Brad in Gifford’s Randolph orthopedics practice at 728-2455. Orthopedics is also offered at the Gifford Health Center at Berlin.

Hilda Gray: A Mammogram Found Her Breast Cancer

Now she encourages others to have their annual exams

This article appeared in our Spring 2013 Update publication.

radiologist Dr. Scott Smith

Radiologist Dr. Scott Smith performed Hilda’s biopsy and shared her diagnosis with her extended family.

Hilda Gray is a strong proponent of mammograms. The South Royalton resident has had one every year at her community hospital, Gifford Medical Center.

Last year was the first time this active grandmother got some unsettling news, however.

A small lesion in her left breast was found and merited further study. Gifford Patient Care Navigator Brittany Kelton scheduled all of Hilda’s follow-up care and was at her side during each appointment.

A diagnostic mammogram and ultrasound were performed and then an ultrasound-guided biopsy was done right in the Radiology Department.

At first, Hilda didn’t want the biopsy. “I wasn’t too thrilled about that,” she says. Her family, however, was insistent. “‘Momma, you’re going to have the biopsy and that is all there is to it,’” Hilda recalls one of her daughters saying.

On the day radiologist Dr. Scott Smith delivered the news that the small mass was indeed breast cancer, three of Hilda’s children and her husband, Robert Gray Sr., were at her side.

General surgeon Dr. Maury Smith

General surgeon Dr. Maury Smith removed Hilda’s cancer.

Dr. Smith “took the whole family in the office and explained to everybody. He didn’t try to hurry you out. He wanted to make sure all of our questions were answered,” Robert recalls.

A lumpectomy, surgery to remove the mass, was the next step. This time, Hilda was fearless. “If its something that’s got to be done, it’s got to be done,” she recalls saying at the time.

She also had every confidence in the general surgeon who would operate – Dr. Maury Smith. “To Dr. Smith, you are a person, not just a patient,” says Robert.

This time with Robert, all four of her children and their spouses with her, Hilda returned to Gifford last fall for surgery to remove the cancer. A follow-up mammogram earlier this year found no additional lesions, says a happy, cancer-free Hilda.

“I feel like the hospital did wonderful by me,” she says, encouraging others to have their annual mammograms.

“Just do it,” she says. “If I hadn’t gone, I would never have known it was there. I really think it’s something women should do every year.”

New Option Available for Incontinence, Overactive Bladder

This article appeared in our Spring 2013 Update publication.

Dr. Richard Graham

Dr. Richard Graham

For men and women who have exhausted all other options for the treatment of overactive  bladder or urinary incontinence, Gifford’s Urology Department is offering a new alternative – Medtronic InterStim Therapy, or sacral nerve stimulation.

The therapy involves surgery to place a small, thin device that looks and works much like a pacemaker under the skin in the upper buttock. The device is connected to leads, or soft wires, that are placed near the sacral nerves, sending mild stimulation to the nerves.

“It’s stimulates the nerves that affect the bladder. It turns off the sensory input to some degree and increases motor function,” urologist Dr. Richard Graham explains.

“This is an option for the patient who has tried everything and nothing has worked,” he says.

For patients who have tried other options without success, one major plus of this procedure is that patients can try the device in advance of undergoing surgery.

Right in the office, at either Gifford’s Randolph urology practice or the Twin River Health Center in White River Junction, Dr. Graham or physician assistant Nancy Blessing can insert the leads under the skin near the tailbone and test for a reaction. Patients then go home with an external device for a few days to see if it helps.

Usually the goal is to decrease one’s number of trips to the bathroom by at least half, notes Vice President of Surgery Rebecca O’Berry. Ultimately, it’s up to the patient to decide if, based on the results, he or she wants to have the surgery.

People who are interested in learning more about this option or who have untreated incontinence or overactive bladder, should call Gifford’s urology team in Randolph at 728-2470 or White River Junction at 296-7370 to set up an appointment to discuss this and the many other treatment options available.

Bill Brainard Avoided Surgery, Thanks to an Interventional Radiology Procedure

This article appeared in our Spring 2013 Update publication.

Bill Brainard of Bethel

Bill Brainard of Bethel poses with his skidder. Thanks to interventional radiology at Gifford, he is back to logging.

A year ago Bill Brainard of Bethel was in so much back pain he visited his doctor, Milt Fowler at Gifford in Randolph, for help.

“I’ve got a high tolerance for pain, but the day I was at this office, it was so bad it would almost bring tears to your eyes,” says Bill, who worked in excavation and trucking. “It hurt like heck.”

Bill had an MRI to determine the cause of his back pain. The MRI revealed a cyst in the spinal canal, which was pushing on the nerve roots that serve the legs. Surgery was an option, but is fairly invasive. A non-surgical interventional radiology procedure at Gifford – a
percutaneous rupture of the synovial cyst – seemed like a better option.

Using CT image guidance, radiologist Dr. John McIntyre accessed the cyst through the facet joint – the joint causing the cyst – and injected sterile saline, causing the cyst to fill and burst. Bill was awake for the procedure, which he called fairly painless.

When the cyst ruptured, he felt immediate relief.

“I don’t think I was in there a total of two hours,” Bill recalls. “I went right back to doing everything. It was amazing.”

Bill, 69, is now retired from the excavation business, but keeps busy logging. A year later, he is still pain-free.

Wound Care Now Available at All Gifford Clinics

This article appeared in our Spring 2013 Update publication.

wound care available at Gifford clinics

Wound care nurse Jan Giles cares for patient Lisa Sayman of Barre.

With an increase in conditions such as diabetes, obesity, and peripheral artery disease, more and more people are suffering from wounds that don’t heal well.

Gifford podiatrists and general surgery staff already offer help with wound care, but now Gifford is launching a special mobile wound care clinic for the convenience of patients.

Registered nurse Jan Giles is leading the effort. She is specially certified in both wound care and diabetic wound care. Jan is now seeing patients in Gifford’s general surgery office and at all Gifford health centers for the convenience of patients.

Jan’s wound care help includes monitoring wounds, applying dressings, utilizing compression as appropriate, referring patients to a health care provider for additional care, and working with home health care agencies to coordinate proper wound care at home.

“This is what I’ve wanted to do for years,” says Jan. “I think it’s an art and a science, and I really enjoy the challenge of it.”

Diabetic foot ulcers and venous stasis ulcers are the most common chronic wounds. Wounds can also occur following an injury or surgery.

A key to wound healing success is seeking treatment early, Jan notes.

To schedule an appointment with Jan in the wound care clinic, call 728-2777.

BRCA Test Can Help Determine Risk for Breast, Ovarian Cancer

By Dr. Ellamarie Russo-DeMara, Gynecologist

Angelina Jolie’s courageous decision to undergo a double mastectomy to reduce her risk of developing hereditary breast cancer has brought to light an important test done regularly, and promoted, at Gifford.

The reason behind Jolie’s decision was a positive BRCA test. BRCA is a test for hereditary breast and ovarian cancers. It is as pain-free as a test gets; all you have to do is spit in a test tube.

In more scientific terms, the test is of your saliva or, buccal DNA, and is done right in the doctor’s office to check for an inherited mutation or alteration in the BRCA 1 or BRCA 2 gene.

While hereditary breast and ovarian cancer account for only 5 percent of these cancers, knowing your BRCA status can help you and your family make informed decisions and choices.

A woman with BRCA 1 or 2 mutations has a markedly elevated risk of developing breast and ovarian cancer, including:

  • Up to a 50 percent risk of developing breast cancer by age 50 (compared to 2 percent in the general population)
  • Up to an 87 percent risk of developing breast cancer by age 70 (compared to 8 percent in the general population)
  • Up to a 64 percent risk of developing a second breast cancer
  • Up to a 44 percent chance of developing ovarian cancer by age 70 (compared to less than 1 percent in the general population)

Knowing whether you have this mutation will enable you to have increased surveillance and/or treatment, which can potentially save your life and help your family members make informed decisions. Management strategies may include earlier breast cancer screening with mammography or MRI, risk reducing surgery such as ovary removal after childbearing is completed, and chemoprevention, such as tamoxifen or birth control pills.

Red flags for hereditary breast and ovarian cancers, include:

  • Breast cancer before age 50
  • Ovarian cancer at any age
  • Male breast cancer at any age
  • Ashkenazi Jewish heritage
  • Relatives of a BRCA carrier

If you or a loved one falls into one of these categories, contact your primary care or gynecologist’s office to inquire about testing.

Dr. Ellamarie Russo-DeMara is a gynecologist at Gifford’s Bethel Health Center and Twin River Health Center in White River Junction. She provides BRCA advice and testing. She is also a breast cancer survivor.