This article appeared in our Spring 2013 Update publication.
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.
This article appeared in our Spring 2013 Update publication.
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.
This article appeared in our Spring 2013 Update publication.
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.
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.
Lois Flint and Dennis Boardman of Chelsea share a laugh with Gifford respiratory therapist Stephannie Welch.
This article appeared in our Spring 2013 Update publication.
When Lois Flint of Chelsea showed up for pulmonary rehabilitation at Gifford, who did she find one treadmill over? None other than her neighbor, Dennis Boardman. With Lois’ husband behind the wheel, the duo started commuting together for their thrice-weekly appointments, spending the winter working out and laughing hard at Gifford.
Pulmonary rehabilitation is medical therapy for chronic respiratory diseases, typically chronic obstructive pulmonary disease (COPD). While not curative, the 10-week program combines exercise and education to decrease symptoms and hospitalizations, increase exercise tolerance, and improve quality of life.
Dennis has COPD and had a cancerous kidney removed in October at Gifford. When he left the hospital, he was on oxygen. His primary care provider, Dr. Mark Seymour at the Bethel Health Center, suggested he try pulmonary rehabilitation.
He recently completed the program, off of oxygen.
The 62-year-old retired log truck driver credits the program with improving his stamina for walking, getting him off the oxygen and giving him “a lot of freedom to be able to do what I want to do.”
Lois had part of her right lung removed, also from cancer, three years ago. Since, the 74-year-old retired cook has struggled with her diminished lung capacity. Her primary care provider, physician assistant Starr Strong of the Chelsea Health Center, suggested the program.
Overseen by Gifford pulmonologist Dr. Marda Donner and a team of respiratory therapists and nurses who carefully monitor participants as they workout, the now four-year-old program can’t cure lung disease, but aims to help people feel better just the same.
Lois, for example, still has limited lung capacity, but she’s no longer letting it slow her down.
“It motivated me,” says Lois, who is now walking on the treadmill at home. “I think it’s great.”
Learn more about pulmonary rehabilitation by calling Gifford Cardiopulmonary Services at 728-2222 or asking your health care provider for a referral.
RANDOLPH – At some point in life, driving may become more challenging or perhaps too challenging. “Keeping the Keys” is a free workshop by AAA that offers tips for safe driving longer. And Gifford Medical Center is bringing the talk to the Randolph area.
AAA Northern New England traffic safety specialist Rayette Hudson of Maine will offer the free workshop on June 18 in the Gifford Conference Center from 5-6:30 p.m.
Gifford Blueprint Project Manager LaRae Francis helped organize the talk. The talk is being held during Safe Driving Month.
The discussion targets drivers ages 50 and over as well as families of aging drivers. Discussed will be adjusting to natural changes in driving ability, keeping driving skills sharp and safe driving as long as possible.
“Everyone ages differently,” notes Francis. “Just because you hit a certain age, it doesn’t mean it’s time to take away your keys. But what are some signs to look for? How do you prolong safe driving? How do you choose a car for a senior?”
According to data from AAA, older drivers are actually among the safest drivers. They’re less likely to speed, less likely to drive after drinking, more likely to wear their seatbelts and avoid high risk driving situations, such as driving at night or in poor weather conditions.
Increasing age, however, is generally associated with a decline in functional abilities, such as vision and reaction time. An increase in medical conditions and consequently the number of medications taken can also both impact driving abilities.
Statistically, older drivers have lower crash rates per miles driven than young drivers. But because of their fragility, drivers age 85 and older are more likely to be involved in fatal accidents.
While the goal of the talk is to keep drivers on the road as long as possible to maintain quality of life and independence, the talk will open the door to discussions on when it is time for some drivers to relinquish the keys, Francis notes.
To join the discussion, register with Zach Bean at the Kingwood Health Center at 728-7100, ext. 6, by June 14.
Photo provided. Gifford laboratory technician Jennifer Celley plays with a young earthquake survivor at an orphanage in Haiti. Celley visited Haiti as part of a medical mission last year and is now sharing images in the Gifford gallery of her remarkable experience there. The show is a fund-raiser for a return trip to the impoverished country.
Braintree’s Jennifer Celley shares compelling images from medical mission
RANDOLPH – Gifford Medical Center laboratory technician Jennifer Celley traveled to Haiti in June 2012 for a medical mission through the Community Health Initiative, a non-profit co-founded by Gifford Emergency Department physician Dr. Josh White.
The trip was Celley’s first ever to Haiti and she didn’t know what to expect. Would Caribbean island or post-earthquake rubble await? What Celley found was poverty, desperation, warmth and love.
“Before going to Haiti, I was excited yet nervous about what I was going to see,” says Celley of Braintree. “I had an image in my mind of a beautiful Caribbean island covered with rubble from the earthquake two years earlier. I was unsure and as the plane took off. I felt butterflies in my stomach. ‘Have I made a mistake?’ ‘Maybe I should go home’ ran through my head.
“As the plane descended I looked out the window and saw a lush, beautiful Caribbean island and felt relief. But as the plane continued descending, I saw an island so barren you could see tires burning on the ground, and thousands and thousands of rusty tin roofs staring up at you. It was at this moment that my heart sank. It sank for these people, and I knew then that I was supposed to be on this plane. I was destined to love Haiti.”
At first blush, Haiti assaults the senses. “The heat slaps you across the face,” Celley recalls. “It takes your lungs a minute to breathe in the hot, humid air. It takes your nose by surprise when you smell the rotting garbage and the raw sewage.”
But then there are the people – the thousands and thousands of desolate, smiling, joyful people.
“The amount of suffering that these loving, caring, happy people have to live with every day is heartbreaking, but the surprising part is how they cope with it and move forward. I did not hear anyone complain. I did not see anyone frown. I did not see one tear,” Celley says.
It is these people and these experiences that Celley documented through photographs, and it is these experiences that she is now sharing with the community in hopes of making an even greater difference.
Celley’s photos of her time in Haiti are in her employer, Gifford Medical Center’s, art gallery from the afternoon of May 29-July 31.
Created with the help of Dr. Lou DiNicola and Shari Voghell at the Corner Frame Shop in Randolph, the pieces are for sale. All profits from the sale support Celley’s effort to return to Haiti for another mission with the Community Health Initiative and directly support the organization.
To learn more about this organization with Randolph roots, visit www.chihaiti.org. To see Celley’s show, visit Gifford’s art gallery, located just inside the main lobby (marked “Registration”) and to the left.
Learn more about Gifford and get directions on the Web at www.giffordmed.org.
RANDOLPH – Gifford Medical Center will hold its second annual Randolph Antique and Artisan’s Fair on Saturday, July 20.
The fair is from 9 a.m. to 2 p.m. in the Randolph hospital’s Route 12 park space, and the hospital is looking for vendors to participate.
“We already have great interest from vendors and crafters,” said organizer Amanda Wheeler, “and are excited to welcome more to this successful event.”
Individuals and businesses selling antiques, architectural salvage, collectibles, crafts, unique items, vintage clothing and more are invited. Up to five food vendors will also be welcomed.
Lot sizes are 15-feet by 15-feet with up to three lots available per person/business. Lots are $20 each.
Not accepted are animals, cars, junk or merchandise from distributors such as Pampered Chef, Avon, Snap-on tools, etc.
The event will be held rain or shine. Vendors must supply their own tents, should they want them. Tables are available for a nominal fee on a first-come basis.
Space is limited. Call Wheeler at 728-2238 or e-mail awheeler@giffordmed.org by June 28 to reserve a space while they last.
Gifford Administrator Joe Woodin wrote the following as an introduction to the 2012 Annual Report, segments of which we’ll be featuring on our blog:
It’s interesting to be working in an industry that continues to be under the microscope of the political process, with people wanting more control over the cost of health care. Frankly it can be a bit exhausting, but I can understand and agree with their concerns.
“What can we afford?” is becoming an uncomfortable theme both locally and nationally; although we can all relate to this in our daily lives when we go shopping for food or services. There are now so many involved in helping to “fix” the health care system that it becomes a daunting task just to stay focused on the basics: providing quality patient care with compassion and kindness.
This report highlights a few of our providers who have remained focused and undistracted by all of the changes in health care. As the years have ticked by, they have not lost their love of the profession, nor have they been dissuaded by all of the changes, paperwork, and new requirements. Their work has become a calling, and they have touched many of our lives when we have been in need of medical help.
The more we try to understand and solve the complicated aspects of health care, the more I am reminded that at the end of the day, there are still patients in beds or in clinic exam rooms awaiting care. They are usually anxious, at times scared or upset, and always hopeful that someone can give them answers and help them through the next step. Our role is to ensure that we have a provider willing to enter into patients’ lives, helping to answer questions and even hold their hand when the news is “not good”.
So regardless of where we end up with “health care reform”, hopefully Gifford will always be there with physicians and staff members who reflect the values of the professionals highlighted in this report. Many things will change moving forward, but unchanged will be our commitment to you and our communities.
Gifford is fortunate to have many long-time Medical Staff members. Some have worked in our community for 30 years or more. Most got their start as private practice physicians recruited to the area by the hospital and then became medical center employees.
Many came from outside the area. They could have chosen to work anywhere, but they chose to dedicate their careers and lives to the people of central Vermont and to bettering health care on a statewide level.
For patients, that means remarkable continuity of care, relationships embedded throughout generations, and access to some of the best and most experienced health care providers – anywhere.
With so much history and know-how behind them, we asked them to share some of their experiences with us. Our 2012 Annual Report is the result of their efforts to share what we’re calling brief “memoirs” or essays. Some talk about the amazing privilege of being entrusted with patients’ care and health. Others share stories of unique times with a patient.
We’ll begin featuring some of these memoirs as future blog posts. We hope you enjoy these reminiscences and are reminded, as we were, how very fortunate we are that these incredibly gifted individuals have given so much of themselves professionally, and personally, to our friends and neighbors.
As you’ll read, these long-time providers have also set the stage for our next generation of caregivers, who – like those who came before – are dedicating themselves to their communities and high-quality care for our region.
