FOR YOUR BEST HEALTH SPRING 2022 Finding Her Voice Jeri’s inspiring comeback MEATLESS MEAT Fad or fabulous? PREGNANCY AND HYPERTENSION What you need to know
/KetteringHealth @KetteringHealth /KetteringHealth Connect with us 4 Fad or Fabulous: Is meatless meat worth a try? 5 Meet family medicine physician Jonathan Stofer, MD, MPH 6 Time for a healthy clean sweep 8 Your first choice for emergency care might not be right for you 10 Stay sunburn-free this summer 12 A stroke survivor finds a new voice and purpose 15 A stroke patient’s advice for fellow survivors and caregivers 16 Embarrassed to Ask? The facts on pelvic floor dysfunction 17 Get help for overactive bladder 18 Healthy pregnancy: What to know about preeclampsia 20 Health Hacks: Seize the day 22 At Our Best for the community Spring 2022 12 10 20 STRIVE is published three times a year by Kettering Health, 3535 Southern Blvd., Kettering, OH 45429, to improve the health literacy of the community and connect readers to health information and services. CEO Fred Manchur Managing Editor Carrie Bebris Art Direction Kelly Long Photography AGI Studios, Dayton Business Journal, John Rossi, Lee Ann Yahle, and Kettering Health staff Writing Carrie Bebris, Dale Donovan, Addison Griffin, Erin Laviola, Tom Tumbusch, Cari Zahn, and Kettering Health staff Information in STRIVE comes from a wide range of medical experts. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that might affect your health, please contact your healthcare provider. 2022 © Kettering Health and Coffey Communications, Inc. All rights reserved. 2 ketteringhealth.org
Primary care providers don’t all have the same training. While some specialize in certain age ranges or other patient groups, one type of primary care provider—a family medicine provider—cares for patients from newborns to the elderly. We asked Jerika Ortlieb, MD, a family medicine doctor with Kettering Health, to name five of the many services they offer. 1 One-stop care. Parents can take their children to the same physician they themselves see for vaccinations, minor illnesses and injuries, preventive care, wellness visits, and pre-participation exams for sports, workout regimens, and other activities. 2 Comprehensive care. Family doctors monitor not only physical health and chronic conditions but also your family’s mental wellbeing, dietary needs, and prescriptions. 3 Minor procedures. Many minor procedures such as biopsies or injections that once required a specialist can now be performed in the office. 4 Reproductive healthcare. As family members mature, a family practitioner can guide them through different stages of reproductive health. From HPV vaccinations and birth control through pregnancy and childbirth, your family doctor can serve as the foundation for reproductive care. 5 Convenient technology. Healthcare apps such as MyChart allow patients to send messages to the doctor’s staff, make appointments, and view test results. Too busy to get to the doctor’s office? Ask your provider about telehealth visits. What a family medicine provider can do for you FASTFIVE Does honey help seasonal allergies? Many people suffer from seasonal allergies caused by pollen. Bees collect pollen and turn it into honey. So could consuming local, unprocessed honey help alleviate seasonal allergy symptoms? “That idea sounds logical, but it’s just not true,” says Jerika Ortlieb, MD, a family medicine physician with Kettering Health. Immunotherapy (also known as allergy shots) exposes an allergy sufferer to tiny doses of the allergen to build up the body’s resistance to it. But the principle doesn’t apply here. The pollens that cause most seasonal allergies are airborne and come from weeds, grasses, and trees—which are not where bees gather pollen. They gather it from flowering plants. “Flower pollen isn’t airborne and thus typically doesn’t cause allergy symptoms,” Dr. Ortlieb explains. Therefore, consuming honey made from flower pollen has no effect on allergy symptoms. Moreover, while the processed honey found on supermarket shelves is safe to consume, unprocessed (“raw”) honey can be risky. Dr. Ortlieb warns that “unprocessed honey could contain botulism,” among other potentially dangerous bacteria. Like unpasteurized milk, raw honey is best avoided. So if you suffer from seasonal allergies, skip the honey and seek help from your doctor instead. FACT OR FICTION WELLNESS ALL YEAR-ROUND Having a primary care provider is important for your overall wellness. If you don’t have one, visit ketteringhealth.org/primarycare or call 1-888-726-2372. ketteringhealth.org 3
4 ketteringhealth.org Plant-based meat alternatives are all the rage in the United States. You may have noticed more brand names showing up in the grocery store aisles as producers look to join the trend. But is meatless meat worth the hype? Are these vegetarian or vegan options actually healthier than regular meat? The answer is mixed. Read the nutrition labels carefully Based on nutrition labels, plantbased options from companies like Impossible Foods and Beyond Meat contain higher levels of fiber, calcium, and iron compared to traditional meat. The amount of protein and fat is about equal. However, plant-based alternatives contain a lot more sodium than regular meat. Some are also prepared with coconut oil, which is high in saturated fat. “You have to look at the nutrition label to determine which ones are healthiest for you, because some are highly processed and high in fat,” Is meatless meat worth a try? OR FABULOUS? says Alicia Buterbaugh, registered dietitian and certified diabetes educator with Kettering Health. “If you have high blood pressure or otherwise need to watch out for salt, you might be better off using lean ground meat or ground chicken instead.” Consider cooking your own If your goal is to eat healthier, Alicia recommends preparing your own plant-based “meats” with whole ingredients rather than buying processed alternatives. Foods like cauliflower, tofu, and certain mushrooms are good substitutes. Alicia says she likes to cook burgers in a skillet using canned black beans, rice, and other veggies. She also enjoys using chickpeas instead of meat in a traditional chicken salad recipe. How’s the taste? Do meatless alternatives taste like meat or have a similar texture? It depends on the brand or, if you’re cooking your own, the ingredients you use. “I cooked one baked ‘chicken’ patty for my college-age son, and he loved it,” says Alicia. “But when I bought a different brand of meatless chicken, he thought it was disgusting and that the texture was weird.” As for swapping out regular meat for plant-based alternatives in recipes, Alicia says there are some good options. She recommends using lentils in chili for a tasty change. She also says “hamburger” crumbles resemble the look and feel of ground meat and could be used in traditional recipes. MEATLESS AND DELICIOUS Find vegetarian, low-sodium, and more healthy recipes at healthlibrary.ketteringhealth.org/library
ketteringhealth.org 5 ACCEPTING NEW PATIENTS Need a checkup? Call 1-888-796-9704 for an appointment with a Kettering Health primary care provider. To find a provider, visit ketteringhealth.org/primarycare One of our newer physicians, Jonathan Stofer, MD, MPH, has already distinguished himself for his commitment to providing care to underserved communities. Q: What inspired you to become a physician? A: Serving the less fortunate has always been close to my heart. As a teenager, I watched my grandfather lose his battle with cancer. All I wanted to do was help him. My goal as a physician is to bring hope even if it seems options are running out. I also get to celebrate with people during some of the most joyous times of their lives. Q: Why family medicine? A: I love that the scope of care is broad—from delivering babies to performing surgical procedures. Plus, I find family medicine allows for a deeper connection with patients. Q: What are your areas of expertise? A: Preventive health, chronic disease management, pediatric care, reproductive health, contraception management, and HIV prevention (PrEP). I’m also skilled in global health and travel medicine. Q: Why should a patient choose you as their doctor? A: My patients would describe me as personable, comprehensive, and caring. I treat all my patients like family. I want my patients to see me as a partner. I love it when they take control of their healthcare, and it’s my job to provide them with the necessary tools. Q: You were named “Resident of the Year” for the Soin Family Medicine Residency program in 2021. How did you earn that? A: I received the award because of my dedication and contributions to outpatient family medicine. It was also based on positive interactions with both patients and colleagues. Q: Tell us about the Rural Amazonian Health Initiative you started. A: I went on my first medical trip to Peru in 2008 and fell in love with it. I launched the nonprofit organization to help provide holistic care for rural Peruvians who have Bringing hope and caring for the underserved little access to quality healthcare. Caring for underserved and hard-to-reach populations has given me a wider understanding of what it means to be a doctor. Before COVID-19, I traveled to Peru every year. I’d like to resume those trips and bring more medical students with me. Q: What do you like to do outside of work? A: Running, hiking, reading, watching movies, and spending time with family and friends. I also spend a lot of time with my black Lab puppy, Charlie. Physician profile Jonathan Stofer, MD, MPH, is a primary care provider who specializes in family medicine at Kettering Health.
6 ketteringhealth.org Wellness SWEEP It’s time for spring cleaning! A long list of chores may seem daunting, but the health benefits—both physical and mental—of this annual tradition make it well worth the effort. Air out the allergens Thoroughly cleaning your home will help keep you and your family healthier. Dirt, dust, mold, pet dander, and other allergens can build up during the winter months, when keeping windows and doors closed reduces air circulation. Spring cleaning is the perfect opportunity to air it all out. Jonathan Stofer, MD, MPH, a primary care provider with Kettering Health, recommends cleaning often-forgotten areas, like baseboards, behind the refrigerator and furniture, and underneath sinks. “The goal is to get rid of organisms that could spread illness,” he says. Dr. Stofer suggests washing or replacing bedding, especially if you have pets: “Fabric surfaces hold allergens that can cause acne and other skin conditions.” Burn some calories Spring cleaning is a healthy way to get moving. Activities like scrubbing floors, moving boxes, and doing yard work are all forms of low-intensity exercise. THE HEALTH BENEFITS OF SPRING CLEANING
ketteringhealth.org 7 TIME FOR A CHECKUP Spring is also a good time to schedule an annual wellness visit with your primary care provider. If you don’t have a provider, visit ketteringhealth.org/primarycare or call 1-888-981-3524. “Pop in those headphones and turn cleaning into a workout,” Dr. Stofer says. “Anything that gets us up and moving around is good for your cardiovascular health and can improve your physical fitness.” Be sure to stay hydrated and alternate between tasks to avoid straining specific muscles. When lifting heavy objects, remember to lift with your legs and carry them close to your body to prevent injuries. Remove the junk Organizing and removing clutter can prevent falls or other injuries. This is especially important if you live with young children or elderly family members. Also, bugs and other pests gravitate toward messy areas. Removing junk can prevent these unwanted visitors from showing up. Decluttering your bedroom can improve sleep, says Julie Manuel, MSEd, clinical program manager of Kettering Health Behavioral Medical Center. “A bedside table stacked with junk could cause a sense of anxiety before bed, as you are seeing projects that are undone and unkempt,” Julie explains. “Creating a peaceful environment will help you sleep better and allow you to wake feeling rested and ready to be productive.” Release stress Spring cleaning can be a tonic for your mental health. “When we feel symptoms of depression or anxiety, we battle with feelings that are often out of control,” says Julie. “Cleaning, organizing, and uncluttering is a way for many people to take control and begin refocusing on the present.” Julie says following through on a plan to clean your house is also beneficial in other ways. “Achieving those small goals can release endorphins, because we have a sense of accomplishment and success.” Dr. Stofer adds that one’s spirit can also benefit. “When we clean out the physical aspects of our lives, it can inspire us to remove other things in our lives that don’t serve us, like unhealthy relationships or dependence on technology.” Refresh your medicine cabinet Get rid of expired prescription and overthe-counter medicines by dropping them off at a community “take back” day or bringing them to an approved collection disposal site. Visit takebackday.dea.gov to find locations near you. Keep pain and fever-reducing medications like Tylenol and ibuprofen on hand. Restock other over-the-counter medicines such as an antihistamine, a decongestant, cough medicine, cough drops, and antacids. Restock first-aid basics like antibiotic ointment, hydrocortisone cream, and bandages. For urinary tract infections, Dr. Stofer recommends having phenazopyridine available. Make sure you have a digital thermometer. Mercury thermometers can release poison into the air if broken. If you still have ipecac syrup around, remove it. The National Institutes of Health no longer recommends it as a remedy for accidental poisoning.
8 ketteringhealth.org According to the National Center for Health Statistics, emergency departments in the U.S. receive about 130 million visitors annually. Pre-pandemic, nearly a quarter of U.S. adults went to an emergency department at least once a year. But how many of those trips could have been avoided? Nancy Pook, MD, emergency medicine physician and medical director of the Kettering Health Operations Command Center, says there are plenty of cases when going elsewhere could result in better health outcomes for patients. Chronic but less severe symptoms If you’re ill or experiencing pain, consider how severe the symptoms feel. If it’s not a life- or limbthreatening situation, then your primary care physician is your best resource. Emergency care NEEDCARENOW? Kettering Health’s On-Demand Care clinics are also a resource if your primary care doctor is unavailable or if you don’t have a primary care doctor. “If a chronic or minor problem seems to be getting worse, the On-Demand Care clinics may be the best destination,” Dr. Pook says. Providers at the clinics commonly treat things like bladder infections, bronchitis, and bug bites. Urgent care or the emergency department? Urgent care facilities and emergency departments provide different services. Head to urgent care if you need services such as a physical exam, a strep test, or a “return to work” note. If you have only one issue or a relatively minor symptom, then urgent care should suffice. Urgent care providers can also handle simple cuts and lacerations. However, wounds with a lot of pus are more serious and should be treated at the emergency department. Relying on the emergency department for immediate care is not always the right choice “Before immediately going to the ED, check in with your primary care doctor first,” Dr. Pook says. “If you’re experiencing lingering symptoms, they’ll be able to figure out your healthcare options.” For example, the emergency department isn’t the most helpful resource for chronic headaches. Your primary doctor may refer you to a neurologist to develop a more long-term plan for curing those headaches. Respiratory infections are among the most common emergency department cases. For a minor cough or cold that doesn’t include other debilitating symptoms, most people will recover on their own at home. “However, if a patient is at higher risk from COVID-19 or the flu, then they should touch base with their primary care doctor and get tested,” Dr. Pook recommends. KNOW WHERE TO GO When you need care now, it’s important to know where to go. Visit ketteringhealth.org/find-care to determine ahead of time the location of your nearest emergency department, urgent care, and On-Demand Care clinic. Know your best option
ketteringhealth.org 9 When emergency care is the best option Chest pain and abdominal conditions are some of the most common reasons people come to an emergency department. Severe pain should never be ignored, especially if accompanied by associated symptoms. It’s a good idea to know the location of the closest emergency department and have a plan in place for how to get there. “If you’re hit with chest pain, you can’t breathe, and you’re sweaty, call 911 immediately,” says Dr. Pook. “Light-headedness, high fever, and shortness of breath are all signs of something more serious.” Dr. Pook explains this is where the expertise of the emergency department becomes a crucial factor. “Physicians in the ED can take chest X-rays to look for pneumonia, start IV lines, and provide fluids. An urgent care typically isn’t equipped for this kind of treatment.” Dr. Pook also recommends emergency care for patients suffering from severe sprains. “If you can’t move the limb, or if there’s a significant deformity, then we’d want to take X-rays immediately.” She also says patients with hand or face injuries are generally sent to the emergency department. “We have years of experience in treating those types of wounds.” “If you’re hit with chest pain, you can’t breathe, and you’re sweaty, call 911 immediately.” —Nancy Pook, MD
10 ketteringhealth.org With the arrival of spring, you might be anxious to head outside. But as the weather warms up, don’t neglect to protect your skin against its greatest danger from the sun: skin cancer. Rebecca Tuttle, MD, surgical oncologist with Kettering Health Cancer Care, warns against braving the sun without proper skin protection. “Sun exposure is definitively linked to the development of skin cancer,” says Dr. Tuttle. “You need to protect yourself when you’re out in the sun.” Developing skin cancer—such as melanoma—is associated with lifelong sun exposure. Sunburns (particularly severe burns when you’re young) increase your risk, as do your family history and complexion. Those with fair skin, light hair, and light eyes are especially at risk for skin cancer. Dr. Tuttle recommends practicing sun safety by • Wearing sunscreen • Choosing protective clothing • Staying in the shade while outside The power of sunscreen Sunscreen is easily the most popular form of sun protection. But with so many options, it’s difficult to know which is best. Dr. Tuttle says the key is not the SPF (sun protection factor) number but rather applying sunscreen generously and often. Wear sunscreen whenever you’re out in the sun, no matter the activity. Stick to SPF 30 since it provides 97% protection from the sun’s rays. And use an ounce of sunscreen—roughly the same amount as a travel-sized hand sanitizer bottle. Reapply every one to two hours and whenever you sweat or swim. Dr. Tuttle adds that for full protection, sunscreen needs to be applied 15 to Sun safety STAYsunburn-free Sunburn prevention is skin-cancer protection. EXTRA CARE If you or your child gets sunburned, you can use aloe, cooling gel, and/or Tylenol. Do not peel or pop your blisters— they are your body’s bandage. If you have a severe sunburn that continues to blister or needs to be examined, see your primary care provider or visit ketteringhealth.org/find-care to locate your closest Kettering Health On-Demand Care.
a ketteringhealth.org 11 Protect your young ones Children under six months old should avoid sun exposure. If it’s unavoidable, babies should not wear sunscreen. Instead, dress them in hats and rash guards (swim shirts) for protection, and consider using protective clothing throughout their childhood. “For my children, I really like the rash guards,” says Rebecca Tuttle, MD. “I don’t know if you have ever tried to put sunscreen on a two-year-old, but it is really like trying to apply sunscreen to a water weenie.” Dr. Tuttle also recommends nosting sunscreen. “If you put it on and it burns their eyes, you’re going to find it hard to get it on them again,” she says. When children are older, any type of sunscreen is effective if used correctly. Dr. Tuttle recommends using sticks for the face to avoid sunscreen running into your child’s eyes, and cream for the body to know your child is getting full coverage. Cover all exposed skin, including often-missed areas such as ears, tops of feet, and back of the neck. Teaching your children to wear sunscreen at an early age will benefit them the rest of their lives. “It is important to build healthy habits,” Dr. Tuttle says. “My kids know if they go outside, they’re going to wear sunscreen. It’s a habit. Children learn what they live.” 20 minutes before sun exposure. So apply sunscreen before leaving the house, not when you arrive at the park or beach. Many sunscreen options are available, so try different types to find what you need, such as formulas that leave no residue or are free of chemicals your body might react to. Sunscreens are also available specifically for children, who are at high risk for sunburns that could increase their skin-cancer risk later in life. Finally, make sure everyone in your group is wearing sunscreen, regardless of skin tone. Despite popular misconceptions, people of color are still susceptible to sunburn and are at higher risk for different types of melanoma. this summer
12 ketteringhealth.org Patient story Stroke survivor and advocate Jeri Ward SPEAK with intent
ketteringhealth.org 13 A stroke survivor finds a new voice and purpose Knowing that people go to the hospital because of the education that I’ve shared makes me feel like all this terrible time and struggle and heartache and depression and anxiety was worth it.” —Stroke survivor and advocate Jeri Ward Jeri Ward heard a pop, then a fizzle in the back of her head. She stopped typing as her laptop screen blurred. But the sudden dizziness didn’t worry her; she knew it was getting late. She just needed to send these documents before the next day’s court hearing. But when she heard a firework go off in the back of her head, she did worry a bit. As she tried to turn toward her husband, Dean, on the other end of the couch, she realized she couldn’t move or speak. And worry evolved into full-blown panic. She managed to toss her computer from her lap. It slid to the floor, getting Dean’s attention. The nonsensical words that escaped Jeri’s lips were so shocking, she giggled. But the fear in her eyes told her husband this was serious. Finally, she forced out the right word: “hospital.” A humanitarian at heart At 30 years old, Jeri had already crafted her life around advocacy. Her career as a social worker and crisis therapist meant she held legal guardianship of 42 children who were physically, mentally, or sexually abused. But the care she showed for others extended beyond her office door. During nights and weekends, Jeri volunteered at homeless shelters and worked with adults who had never learned how to read, teaching them English as a second language. In the midst of it all, she went to school fulltime to earn her graduate degree. A plate this full led to stress, lack of sleep, and the morethan-occasional headache. But Jeri was never one to put herself first. Even as a child growing up in Virginia, Jeri missed only one day of school for illness. So, when she had to leave work that day in 2018 because her head pain had become unbearable, her supervisor knew she must be suffering. When Jeri arrived at the Emergency Department of Kettering Health Miamisburg, she was asked to enter her Social Security number. “When I went to type it in, I realized not only did I not remember my number anymore, but I also did not remember what numbers were,” Jeri says. “It was really terrifying because I was cognizant but not intelligent.” The emergency staff immediately ordered a CT scan that confirmed their fears: Jeri was having a stroke. “I thought, ‘OK, let’s fix that. Whatever we gotta do. Is there medicine we can do?’ Just totally naïve to the situation as a whole,” Jeri recalls. Jeri needed to be transferred to Kettering Health Main Campus for emergency surgery to save her life. At first, she tried to convince the hospital staff her husband could drive her in lieu of an ambulance. After her third attempt, a nurse leveled with her: “Ma’am, you have to understand—you may die.” From powerful to powerless The complexities of the blood clots in Jeri’s brain required a three-hour thrombectomy—a procedure that typically takes an hour. Jeri was awake the whole time. “Here I am, just 30 years old, lying on a surgery table, and I can see my brain on the screen in front of me,” Jeri says. Akil Patel, MD, the neurological surgeon who performed the surgery, reassured her throughout. Unable to speak or move, Jeri the advocate, the humanitarian, the voice for others, had to be Jeri the patient. Her body gave her no choice. As Jeri cried, unable to communicate, her nurse anesthetist held her hand through the entire procedure. “It made me feel a bit more calm,” Jeri says. “I stopped crying at that point because I felt that human connection.” She didn’t know it at the time, but this moment when she felt the most powerless would determine the trajectory of the rest of her life. —Continued on page 14
14 ketteringhealth.org Patient story “Just a body” Jeri made it through the surgery, but she had a long road ahead. She couldn’t move, speak, read, or write. She could move only her eyes, but she was cognizant the entire time. “I was lying there in the ICU, and I realized that I was really just a body,” Jeri says. “It’s really hard to watch the world go on without you.” The next 10 months held challenges for Jeri that most people expect to face only once in life—learning again how to speak, write, and even eat. Jeri forced her way through recovery, determined to reclaim the life she led before. In sickness and in health The first time Jeri could eat real food, she chose pasta— her favorite. She bit her cheek with the first bite and threw her tray in frustration. The tears that followed weren’t so much from the pain in her mouth but the brutal reminder of how far she had to go. Dean reassured her they would get through it. He would be next to her every step of the way—but there would be no more throwing trays. The Wards didn’t expect their first couple years of marriage to be filled with appointments, scans, and therapy, but Dean worked with Jeri on her words and walking every day. “I know he said, ‘In sickness and in health,’ but I don’t think he realized that was going to be just a year after our wedding,” Jeri says. A new voice Jeri never heard her original voice again. Her strong Southern accent faded into a blended new sound while learning how to talk again in the Midwest and practicing with her husband, a native of England. “A lot of people thought I was foreign, which is really funny, because I’m from a town with one red light,” Jeri says. “But it was really sweet because it was just a testimony to how hard my husband worked with me to be able to speak again.” Jeri’s stroke took a lot from her. But there is one thing it gave her: a new voice. It sounds a bit different. But she’s using it in the same way—to advocate for others. From survivor to advocate In the large physical therapy room of Kettering Health’s NeuroRehab and Balance Center, inspirational quotes are stenciled on the walls in bold script. But in the small speech therapy room, it was a humble, laminated paper sign, taped to the wall and bearing only three words, that inspired Jeri with new purpose: “Speak with intent.” A message heard far and wide “I remember sitting down in that chair for the first time and seeing that sign and thinking, this can be something amazing—it can be very much what I make it,” Jeri says. “So I really had to make sure that I was intentional about what I wanted to do after my stroke to make an impact— to learn how to speak with intent, but also use my life and purpose with intention. I promised myself that I would make my message wide and large and give back to as many people as possible.” And she has. While Jeri still hasn’t fully recovered, she worked so hard at therapy that she was able to enter— and win—the 2021 Mrs. Ohio International pageant. She now uses her platform to educate people about stroke prevention and symptoms and to lobby for laws that would increase funding for post-stroke healthcare—not only in Ohio and the United States but also worldwide. She has spoken to people in 38 countries and will address the United Nations in June. All worth it “I firmly believe this was supposed to happen,” Jeri says. “People always think I’m nuts when I say that. But honestly, it was one of the best things that ever happened to me in the most confusing kind of way, because I feel like I’m more myself—who I was supposed to be and who I’m supposed to grow into post-stroke. “Knowing that people go to the hospital because of the education that I’ve shared makes me feel like all this terrible time and struggle and heartache and depression and anxiety was worth it,” Jeri continues. “Without this experience, I wouldn’t have been able to save as many lives as I have.” —Continued from page 13 Jeri Ward, pictured with Gov. Mike DeWine, won the 2021 Mrs. Ohio International pageant after her stroke.
When you or someone you love suffers a stroke, the journey toward recovery can feel overwhelming. Stroke survivor and advocate Jeri Ward offers this advice to stroke patients and those who care for them. Practice self-care First, caregivers should “make sure that they take care of themselves, because a stroke is really frustrating for everyone involved,” Jeri says. “It is very hard—no two days look the same. It feels like there’s a new issue every day. Crucial to a stroke survivor’s success is a caregiver being fully whole and healthy.” Ask for and accept help “Navigating healthcare when you don’t know anything about healthcare involves a lot of learning,” Jeri says. “Make sure to lean in to friends and family, because it takes a village to help a stroke survivor.” She recommends joining a stroke survivor caregiver group, which not only offers a safe place to vent fears and frustrations but also an opportunity to hear and learn about what works for other survivors. “Sharing things like that is one of the most important things,” she says. Celebrate small victories “I remember the first time that I could chew and swallow on my own,” Jeri says. “And when I could brush my teeth on my own again for the first time, that was a really big deal as well. Appreciate and celebrate the small things—the small things are big things when you’re a stroke survivor.” Connect with other survivors “In some way, try to reach out to other stroke survivors— whether they are ahead of you in their journey or behind you—because we learn a lot from each other,” Jeri says. “We also feel less alone.” Seek supportive technology Jeri recommends two technological aids that she continues to use in recovery. • Sensory processing headphones allow the wearer to focus on someone talking to them by screening out background noise in crowds or other noisy environments. ketteringhealth.org 15 YOU’RE NOT ALONE Visit ketteringhealth.org/stroke to learn more about our stroke care, treatments, services, and support group. Caring for yourself or a loved one after a stroke • Flux is a computer and phone app that changes the color, texture, and tone of screens so that visual processing is easier for survivors who get headaches triggered by light. Make the most of your therapy “Really invest and integrate yourself into therapy as much as possible,” Jeri says. “Because when you’re looking at neuroplasticity in the brain—which is the rejuvenation of all your neurons in your neuro pathways to get you learning— you have to do things to regenerate those pathways.” Jeri Ward’s new voice has some of her husband Dean’s English accent—a testament to his help in her recovery.
16 ketteringhealth.org Sometimes when I’m in a workout class, I accidentally pee— or worse yet, I suddenly need to go and can’t make it to the bathroom on time. Why is this happening, and what can I do about it? Sound familiar? The concern we’re talking about is urinary incontinence, or the loss of bladder control. Stress urinary incontinence occurs when there’s increased pressure on the pelvic floor, leading to leaks. You may have urinary leaks when you cough, sneeze, jump, or exercise. Urge urinary incontinence occurs when you’re unable to control a urinary urge. Both are happening in the scenario above, so we call this mixed urinary incontinence. If you’re having bladder control problems, it’s likely that you’re dealing with pelvic floor dysfunction. Common symptoms The pelvic floor is a group of muscles that start at your pubic bone and stretch back to your SEEK RELIEF Visit ketteringhealth.org/pelviccontrol to learn more about pelvic floor therapy with Kettering Health. tailbone. They have many functions, including contracting so that you don’t urinate or have a bowel movement at the wrong time. Pelvic floor dysfunction is the inability to correctly contract, relax, stretch, or coordinate your pelvic floor muscles. Besides trouble with bladder control, pelvic floor dysfunction can lead to • A weak or slow urine stream • Difficulty emptying your bladder • Frequent urination • Pain during sex • Pelvic organ prolapse (a feeling of pressure or out-of-place tampon) Speak up and get help Pelvic floor dysfunction affects men, too. The anatomy of the pelvic floor muscles doesn’t vary that much between males and females. Men may also deal with urinary incontinence, fecal incontinence, and pelvic pain. Whether you’re male or female, no one should feel embarrassed to seek treatment for pelvic floor health. At Kettering Health, we offer pelvic floor therapy, which is a specialized type of physical therapy designed to help you use your pelvic floor muscles and your entire core properly. You might need to strengthen your pelvic floor, or you might need to learn to relax your pelvic floor. Most people see significant improvement in their symptoms after only three months. Our goal is to arm you with the knowledge that you need to improve and maintain your pelvic health on your own. As therapists, we are the guides to teach you what to do—you are the one healing your own body. Fixing your floor Understanding pelvic floor dysfunction EMBARRASSED TO ASK? Alicia Baker, PT, DPT, CLT, is a pelvic floor therapist with Kettering Health.
“How can I get my bladder under control?” ASK A DOC If you’re concerned that you might have an overactive bladder, you’re not alone. Jorge Arzola, MD, a urologist with Kettering Health, explains this common condition. Q: What is overactive bladder? A: Overactive bladder (OAB) is a syndrome that causes sudden, strong urges to urinate and frequent urination during the day or night. You may also have urine leaks, a condition known as urge urinary incontinence, that occur because of miscommunication between the bladder and the brain. Q: How common is OAB? A: Overactive bladder is extremely common, affecting approximately 37 million adults in the United States. That’s 1 in 6 adults, making OAB even more common than vision problems or diabetes. Q: What treatment options are available? A: The first line of therapy is behavior modification. You may learn lifestyle changes, including diet modifications, fluid restrictions, or using the bathroom only at certain times. Pelvic floor physical therapists can also help with pelvic floor strengthening and bladder training. Once conservative OAB treatment options have failed, medications that calm the bladder muscles are typically tried. Although these medicines do often help, they can be associated with side effects of dry mouth, constipation, confusion, memory loss, or hypertension, among others. If these treatments don’t work, we may consider advanced therapies such as botulinum toxin injections to calm the bladder muscles or neuromodulation to calm the nerves going to the bladder. Q: How does neuromodulation treat OAB? A: Neuromodulation corrects the communication pathway between your bladder and your brain by stimulating the nerves that control your bladder. • Peripheral tibial nerve modulation (PTNM) indirectly stimulates the nerves going to your bladder by stimulating the tibial nerve, located just above your ankle. The stimulation travels up the leg to a bundle of nerves at your sacrum, the bone at the bottom of your spine above your tailbone. We perform this stimulation in the office during weekly 30-minute sessions. After 12 weeks, you can move on to monthly maintenance sessions. • Sacrum neuromodulation directly stimulates the nerve going to your bladder (sacral nerve). We place a thin wire directly onto your third sacral nerve. This treatment involves two sessions. The first session is a test where we measure whether your symptoms improve. If you have at least 50% symptom improvement, we place a battery underneath your skin during a second session. Sacral neuromodulation is safe and effective, with a greater than 84% patient satisfaction rate. Have a question you’d like to Ask a Doc? Email it to strive@ketteringhealth.org IT’S COMMON AND TREATABLE If you think you might have overactive bladder, visit ketteringhealth.org/ urology to find a urologist. Jorge Arzola, MD, is a urologist with Kettering Health. ketteringhealth.org 17 Overactive bladder affects approximately 37 MILLION ADULTS in the United States.
Preeclampsia occurs in up to 3.5% of pregnancies in the United States. Most women with the condition have healthy babies. But without treatment, preeclampsia can lead to complications for you or your baby. What is preeclampsia? Preeclampsia is high blood pressure during pregnancy. Often, women also have protein in their urine, a condition called proteinuria that can point to problems with kidney function. A single high blood pressure reading during pregnancy doesn’t necessarily mean you have preeclampsia. Your doctor will take multiple readings, as well as run blood and urine tests, to diagnose preeclampsia. Though sometimes preeclampsia shows no symptoms, you may experience • Headaches • Nausea or vomiting • Pain in your abdomen, especially directly below your right ribs • Shortness of breath • Vision changes, including blurred vision, sensitivity to light, or temporary vision loss 18 ketteringhealth.org Women’s health Healthy habits can help protect you and your baby WHAT YOU
Effects on mom and baby According to David Stultz, MD, a cardiologist with Kettering Health, experts believe preeclampsia occurs because of a spasm in the inner lining of the mother’s blood vessels. “This causes high blood pressure in the mother as well as decreased blood flow to multiple organs in the mother and possibly the fetus,” Dr. Stultz explains. The fetus may receive less blood flow, which can lead to impaired growth, preterm birth, and even stillbirth. “Preeclampsia is one of the major causes of maternal mortality and can lead to significant maternal complications, such as stroke,” says Dr. Stultz. Although there’s no foolproof method to prevent preeclampsia, practicing good health habits before and during pregnancy can help. How to lower your risk “Being aware of the risk is the first place to start,” Dr. Stultz says. Certain factors can increase your risk of preeclampsia, including • Advanced maternal age • Autoimmune diseases, such as lupus or multiple sclerosis • Carrying multiple fetuses • Chronic high blood pressure • Diabetes • History of preeclampsia • Kidney disease If you have a high risk of preeclampsia, your healthcare provider may prescribe low-dose aspirin to lower your risk. But even women without any risk factors can develop preeclampsia. Before and during pregnancy, it’s important to eat a nutritious diet and exercise regularly. Follow all your healthcare provider’s instructions throughout your prenatal care to increase your chances of having a healthy pregnancy. Effects on long-term heart health Long-term, women who experience preeclampsia have an increased risk of developing high blood pressure, heart disease, stroke, and diabetes. “It’s not clear if preeclampsia itself causes these conditions later in life,” Dr. Stultz states. “Pregnancy may place a stress on patients who already have risk factors for developing these conditions.” Is preeclampsia linked to gestational diabetes? Yes. As Dr. Stultz explains, “Women who have gestational diabetes are about twice as likely to also have preeclampsia. The link between the two is not entirely clear, but both conditions have similar risk factors: advanced maternal age, first pregnancy, obesity, and carrying multiple fetuses.” If you have gestational diabetes or preeclampsia, your healthcare provider will guide you on a treatment plan and monitor you closely to ensure both you and your baby stay safe. How to protect yourself and your baby Throughout your pregnancy, the most important strategy for staying healthy is to see your healthcare provider regularly for prenatal care. These visits increase the chances of detecting preeclampsia early, so you can get timely treatment. ketteringhealth.org 19 NEED TO KNOW ABOUT HERE FOR YOU Talk to your OB-GYN or midwife about your risk of preeclampsia. If you don’t yet have a provider, visit ketteringhealth.org/ women to schedule an appointment with a women’s health provider.
Do you often wish there were more hours in the day? If you’re tired of sacrificing your much-needed sleep or personal time to get everything done, using the limited time you have available in more productive ways can help you accomplish your to-do list more efficiently. Get organized To be successful in our day-to-day activities, we need to be aware of what needs to be accomplished. 20 ketteringhealth.org WHAT MATTERS How we spend our days is, of course, how we spend our lives. —Annie Dillard Free up time for HEALTHHACKS
“Prioritize the most important tasks, determine the best way to keep track of everything you need to achieve, and stay on top of your deadlines,” recommends Dena Mason-Zied, DO, a primary care physician with Kettering Health. “Some people prefer to keep a written list of tasks. Others find it easier to track them on a smart device. Setting alarms as deadline reminders can also be tremendously helpful.” Plan ahead Look at your upcoming day, week, or even month. Strategize what needs to be accomplished by what time. “Delegate tasks to others that may be unnecessary for you to complete or better conducted by someone else,” Dr. Mason-Zied says. “Figure out how to divide up your tasks in a time frame that will allow you to complete them on time.” Know your limits People tend to be less productive and make more errors when they’re impaired in some way. Sleep deprivation and fatigue are just as distracting as being under the influence of substances such as alcohol. Stick to a routine to ensure you’re getting adequate rest and sleep so that you’ll be as efficient and productive as possible when it counts. “It’s also important to limit excess stress by not taking on additional responsibilities when possible,” Dr. Mason-Zied advises. “You don’t need to say yes to everyone all the time.” ketteringhealth.org 21 PUT YOUR HEALTH FIRST Talk to your primary care provider about other self-care tips to help keep you at your best. Don’t have a primary care provider? Visit ketteringhealth.org/ primarycare or call 1-888-981-9456 to schedule an appointment. Use conveniences and technology Look for ways that inexpensive services or technology can help you save time, especially on tasks you need to do regularly. For example, you can do food prep for the week on the weekend and store prepared meal items in the refrigerator or freezer. There are even cookbooks and websites designed to help you do an entire month of cooking in advance. Shopping for groceries online gives you the option to pick them up at a certain time or have them delivered to your front door. Dr. Mason-Zied encourages people to use devices such as slow cookers to prepare meals while you work or perform other essential duties. Another option is to combine tasks that require concentration with others that don’t. “For example, you might read documents for work while walking on a treadmill,” she suggests. Take care of yourself Adequate rest is vital to productivity. In addition, proper nutrition and routine physical exercise are just as important. What’s more, your body needs fuel to function. “Proper nutrition, hydration, and circulation enable your organs to do their jobs so you can do yours,” Dr. MasonZied says. “Paying attention to these self-care tools will allow you to perform to the best of your abilities.”
22 ketteringhealth.org Kettering Health is committed to providing the best care to our community. AT OUR BEST SNACK THERAPY CAFÉ After recognizing there were no vending machines at the NeuroRehab and Balance Center (located on the campus of Kettering Health Washington Township), a few staff members decided to organize a snack café themselves. Purchasing a few supplies out of their own pockets, they set up a table in the staff area and named it the Snack Therapy Café. Profits from the Snack Therapy Café are minimal, but all go toward philanthropic efforts. In the last three and a half years, profits have helped fund • Toiletries and personal items for residents in the Grafton Oaks Nursing Home during Christmas 2020, when no outside visitors were allowed • A driving evaluation for one of the Oregon District mass shooting victims to return to usual activity levels • Cab and bus fares for patients with income limitations who struggled to find ways home after therapy appointments Kudos to Belinda Isaac, Kathy Kingseed, and the staff who keep the Snack Therapy Café running. They are proof that even our small efforts add up to major positive impacts! HEALTHCARE HERO Each year, the Dayton Business Journal recognizes Health Care Heroes. The award honors those who go above and beyond in healthcare innovation, management, and patient care. Lena Jackson, manager of education and training at Kettering Health Medical Group, was among the 2021 honorees. Lena has been crucial in coordinating and implementing our COVID-19 vaccination clinics. She has also served as the site coordinator for the clinic at Grace United Methodist Church. In just six months, the clinics provided almost 100,000 vaccinations—11,000 of those occurring at Grace United alone, where many of the recipients didn’t have health insurance. Lena Jackson (center)
ketteringhealth.org 23 NEW AT KETTERING HEALTH DAYTON In November, we opened a new hybrid operating room (OR) and catheter laboratory (cath lab) at Kettering Health Dayton. This new unit includes a 17-bed area for cath lab patients to prepare for procedures and recover afterward. The hybrid OR allows Kettering Health to offer state-of-the-art imaging with lower radiation doses and quicker procedure times. The expansion increases care continuity while keeping us at the leading edge of treatment. 50 TOP CARDIOVASCULAR HOSPITALS Kettering Health’s main campus has achieved national recognition with IBM Watson Health as one of the 50 Top Cardiovascular Hospitals in the country— making it one of only three hospitals in Ohio and the only one in the Dayton area to earn this designation for 2021. It’s the fifth time the Kettering Health main campus has earned this recognition. To achieve this award, hospitals must have excellent cardiovascular outcomes while operating more efficiently. Nearly 1,000 hospitals across the U.S. were evaluated for the 2021 ranking.
Kettering Health 3535 Southern Blvd. Kettering, OH 45429 Update or remove address by emailing strive@ketteringhealth.org. Nonprofit Org. U.S. Postage PAID Walla Walla, WA Permit No. 44 Health Benefits of Spring Cleaning See page 6 Lifesaving Goal One Emergency Centers, 13 When you need care the most, Kettering Health is at its best. We’re there for you 24/7 to treat heart attacks, strokes, critical injuries, illnesses, and everyday emergencies. So rest assured, our best in emergency care is always nearby. Scan the code to find your nearest location and check current wait times.
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