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Toning Up for the Future
News Briefs
The Way to One's Heart is through...the Arms and Legs?
Create a Business Plan to Keep Yourself Well
Doctor Q&A
Wellness Runs Deep here
When Breathing Becomes a Super Power
Gardens Help Heal


Toning Up for the Future
Possible merger of St. Mary’s parent and Dean could put YOU in better shape too

 “Obese” may describe the U.S. health care system. At the very least, it’s flabby, thanks to duplication of services, unnecessary tests, high prices.

But here in Dane and surrounding counties, a figurative diet and exercise regimen was started at least 30 years ago.

That’s when Dean Clinic’s physician group founded an insurance company, called Dean Health Plan. A dozen years later, St. Mary’s umbrella hospital network (SSM Health Care) purchased a 47 percent share of the health plan and a 5 percent share of Dean Clinic. By providing clinic services, hospital care AND insurance products, this integrated delivery system has a built-in incentive to innovate in ways that keep results up, costs down and customer service at peak performance.

This year, SSM Health Care and Dean Health Systems signed an agreement whereby the for-profit, doctor-owned Dean and its subsidiaries will become part of SSM Health Care, which will remain not-for-profit. A whopping 97 percent of physician shareholders voted in favor of the deal, which awaits approval by regulatory agencies, and the transaction could close as soon as this summer.

“This is very good news for our patients and entire communities,” says Dr. Frank Byrne, president of St. Mary’s Hospital in Madison. “The closer alignment will allow us to improve the patient experience, from clinic to hospital to clinic to home, keep our communities healthier and do it all at a lower cost,” he says, pointing to consistent efficiencies and greater purchasing power.

Dean Clinic doctors make up the greatest portion of the medical staff at Madison’s St. Mary’s Hospital and St. Mary’s Care Center, St. Mary’s Janesville Hospital, St. Clare Hospital and St. Clare Meadows Care Center in Baraboo, and many regional clinics and four affiliated hospitals in 18 counties. In addition, the potential merger could take the high-quality/low-cost model beyond south-central Wisconsin to three other states served by SSM Health Care.

Try These Tips for NO-COST Health Care:

  • Take walks, ride bikes, swim at public pools, use exercise DVDs instead of joining a gym.
  • Eat at home instead of out. You’ll likely pay less money and avoid calorie overload. If eating out, immediately put aside half of oversized meals to enjoy as leftovers.
  • Strengthen upper bones and muscles by doing pushups on the stairs or lifting a gallon of milk, for example, like exercise weights while waiting in line or walking to your car.
  • Eat food with lots of vitamins, minerals, water. For less money and no pills, you’ll have better natural absorption of nutrients.
  • Stop smoking and save yourself a bundle while improving life for yourself and those around you.



News Briefs

Care for Rural Stroke Patients Improved
People who seek help at rural emergency rooms for their neurological symptoms, especially those related to stroke, will have 24/7 access to neurologists through a new Telehealth service starting this summer. Usually, patients at smaller hospitals must be transported to larger hospitals like St. Mary’s that have neurology specialists on staff. But transporting costs more, often separates patients from their families and sometimes prevents the most effective treatment from being administered, due to lost time.

That’s why Dean & St. Mary’s Stroke Center is offering live video conferencing between a remote neurologist, the local doctor, the patient and any immediately involved family members. The service, to be used for diagnosis and possible treatment at the local hospital, will connect experts in neurological care with patients and staff at St. Clare Hospital in Baraboo, St. Mary’s Janesville Hospital and St. Mary’s Sun Prairie Emergency Center.



President Earns New Title: Champion of Women’s Health
St. Mary’s President Frank Byrne has been recognized as a Champion of Women’s Health by the Wisconsin Women’s Health Foundation. Among his contributions, he turned his family’s personal experience with the emotional and medical challenges of a pre-term baby into a positive service to community by championing Wisconsin’s first hospital-based Ronald McDonald Family Room.










Leadership Team Solidifies

Three new vice presidents and another serving on an interim basis have joined the leadership team of St. Mary’s Hospital. Dr. Greg Burnett (VP/medical affairs and chief medical officer) comes from Marshfield Clinic, though he was based in Eau Claire; Craig Sommers (VP/cardiac services and operations) served most recently at Genesis Heart Institute in Davenport, Iowa; Jon Lewis (VP/operations) comes from St. Mary’s Dean Ventures in Madison; and Barb Campfield (interim VP/patient care services), who is president and principal for her nationwide firm, Partners for Clinical Success, is serving as a consultant until a permanent leader is hired to oversee the nursing organization.

St. Mary’s is part of a four-state system based in St. Louis, Missouri, called SSM Health Care. At the regional level, SSM Health Care of Wisconsin also has a new vice president: Todd Burchill, who oversees strategic development. Previously, he worked at Dean, though his most recent position was with Advocate Medical Group in Chicago.


St. Mary’s Gets National Kudos for Safety, Quality
St. Mary’s was the only Madison hospital to earn an “A” grade recently for hospital safety from the national Leapfrog Group, a nonprofit founded by businesses to improve the safety and quality of health care. In addition, St. Mary’s is among a small number of organizations nationwide named as top performers in multiple quality areas determined by Premier Healthcare Alliance. For three years in a row, St. Mary’s met the criteria to reduce mortality; reduce the average cost of care; reliably deliver evidence-based care measures to patients in the areas of heart attack, heart failure, pneumonia and surgical care; improve the hospital experience; reduce preventable harm events; and reduce readmissions. Five hospitals owned by SSM Health Care, including St. Mary’s in Madison and St. Clare in Baraboo, have met those high standards this year.


Stage 7 is Heaven for Electronic Records
St. Mary’s Hospital and Dean Clinic are ahead of more than 98 percent of the country’s health care facilities in the use of the electronic medical record. They are the first combined clinic/hospital organization to receive the Stage 7 Award from the Healthcare Information and Management Systems Society. Stage 7 is the highest level of use, meaning that all records are electronic and all systems are in place for reducing the number of preventable errors that can be made using traditional manual systems. In addition, Stage 7 providers are able to share patient information with other health care providers as needed, further improving patient care and safety.

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The Way to One’s Heart is through … the Arms and Legs?
Elmer Ambrose could see the humor of his slow “old man shuffle,” but the pace at which his legs tired was not funny at all.

“I had to stop four or five times just to walk 500 feet,” he says, recounting the daily effort to visit his wife at the nursing home where she lives. “My legs got so tired, I felt like I was about to collapse.”

Doctors then noticed a problem with his blood supply. The valve that sends fresh blood from the heart to the rest of the body wasn’t working properly. The most solid solution is open heart surgery to remove the diseased valve, but at 86 and already scarred from similar surgery, Ambrose was not a good candidate. Instead, Dr. Russ Reiss and other Dean & St. Mary’s heart doctors now offer a less-invasive option called the Transcatheter Aortic Valve Replacement, or TAVR.

TAVR – Through the Leg

Seek Medical Advice if you experience any of the following:
  • shortness of breath
  • unexplained fatigue
  • dizziness
  • chest pain
  • clamminess or sweating
  • intolerance to exercise that get progressively worse

During the procedure, a catheter starting at an artery near the groin carries a tiny replacement value up to the heart. A balloon on the end of the catheter pushes the old valve tissue aside and expands the new valve to fit inside. The catheter is removed and the patient begins a fast recovery.

“The only pain I felt was when they tore off the tape,” says Ambrose, who now walks faster, stops less often and feels better. His quality of life continues to improve with strengthened leg muscles that keep him on the move.

Transradial Angioplasty – Through the Arm
Doctors at Dean & St. Mary’s Cardiac Center are at the forefront of other breakthroughs as well, offering new treatment for narrowed heart vessels: balloon angioplasty through the wrist. Traditional angioplasty threads a catheter through an artery near the groin and then places a stent in a clogged artery to improve blood flow.

Wrist entry provides a shorter route to the heart and reduces the risk of bleeding complications. It’s more comfortable for the patient, and recovery is almost immediate. Patients usually go home within 15 hours, compared with one or two days for patients whose stent is placed through an artery in the leg.

“It’s so much easier on patients,” says Dean & St. Mary’s cardiologist Dr. John Phelan, adding that many factors help determine the approach that’s best for each patient.

Chest Pain Center – Through Watchful Eyes
The Emergency Room sees a lot of patients with potential heart troubles, and St. Mary’s nationally accredited Chest Pain Center assures that they will neither be sent home too early nor needlessly admitted for a hospital stay. The center’s specialized processes allow doctors to treat patients faster during the critical early stages of a heart attack and to better monitor patients when it is not clear whether their symptoms are heart-related. Their watchful eyes help save lives, even before doctors perform life-saving surgeries.




Create a Business Plan to Keep Yourself Well
Think of your health as your business—because it is. Arguably, it is your life’s most serious business.

What is your mission? Your vision? What are your strengths and weaknesses? Your opportunities and threats? And what strategies and tactics will you employ to manage your health to live as well as you can … all for the purpose of carrying out other important aspects of your life?

As health goes, many people live day to day without much thought given to how current actions (or inactions) affect their outcomes down the road. Here are some basic “must haves” in your plan:

Time for Sleep
While some people who burn the midnight oil may think that sleep is a luxury, it most certainly is not. It is a necessity. There would be no oil to burn without sleep.

According to Lori Zobel, a sleep technician at St. Mary’s Sleep Center in Madison, insufficient sleep can be at the root of chronic conditions such as obesity, diabetes, heart issues and depression. Adults should get seven to nine hours of sleep each night, she says. Of course, some night owls operate surprisingly well on fewer hours, but they usually fuel up on caffeine to help them feel more alert. Caffeinated drinks may be more trouble than they’re worth, Zobel cautions. Caffeine can interfere with sleep and also cause anxiety and tremors, among other health concerns. The best medicine for not enough sleep is simple: get more sleep.

A Burning Desire
Everyone knows if you consume more calories than you burn, you’ll gain weight. So let’s use that as a starting point for the importance of exercise. If you decide to indulge in a heavy meal or a sinful treat, you can make up for it by burning more calories through exercise.

The benefits of exercise, however, go way beyond weight control. “Using your muscles and improving your heart and lung capacity will strengthen your body overall,” says Michelle Pertzborn, a St. Mary’s Hospital exercise physiologist who helps patients develop long-term strategies to reclaim their health. “Exercise lowers your risk for heart disease and many other health problems.” In fact, recent studies also show that exercise helps prevent and treat conditions of the brain and central nervous system, such as Alzheimer’s and Parkinson’s diseases.

In addition, exercise improves attitude and makes you more energetic, Pertzborn says. “Maybe not the first time you attempt it, but after it becomes part of your daily or weekly routine, you’ll find that you are happier and can accomplish more”—something many of us have on our personal business plan.

Food for Thought
You’ve heard it before: Fad diets and pills don’t work in the long run. Sure, you might get a jump start on your weight-loss goal, but at what expense? Some diets could have serious consequences for your health and the drop in weight usually doesn’t last. It’s best to talk with your doctor before embarking on such a diet, making sure your vital organs will not be at risk for damage and that your nutritional needs will be met.

If you go the route of a get-skinny-quick diet, it’s important to then shift gears to a medically sound routine that becomes your lifestyle. “Good nutrition and controlled portions, coupled with exercise, are a proven way to manage your weight over time,” says Dr. Susan Isensee, a Dean Clinic Family Medicine physician specializing in weight management.

For proper nutrition, diet supplements such as vitamins and mineral pills may be useful, but the amount that is absorbed by the body is usually far less than the dosage. In addition, some supplements may increase your risk for serious health problems. The bottom line, says Dr. Isensee, is that nothing can replace the value of naturally beneficial foods.

Room for Revision
Perhaps the biggest threats to achieving the health we envision for ourselves are age (yes, even the tender ages of 30 and 40) and menopause. Neither “threat” should come as a surprise – you know before they arrive that they’re on the way. So start planning now, and review and revise regularly. For anyone past those markers, it’s never too late to develop a business plan for your health.

Many health risk assessments for lifestyle and medical conditions are online at stmarysmadison.com  > Health Info.

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DOCTOR Q & A

I’m afraid of losing my mobility as I age. What can I do?
No matter you’re age, it’s never too early – or too late – to take action to help yourself age well. Proper nutrition, with a focus on adequate calcium and Vitamin D intake will improve bone density and give your body the solid base it needs. Then, an emphasis on maintaining strength is imperative through weight-bearing exercises such as walking, weight lifting or other forms of frequent exercise. It’s important to know that adults who don’t exercise enough lose about four to six pounds of muscle each decade.

Having muscle mass as you age is critically important to maintaining your mobility through strength, balance and bones. In addition, yoga and T’ai Chi are great ways to optimize your sense of balance while also strengthening muscle. Finally, a screening for decreased bone density – especially for women over 65 – may lead to an effective course of treatment that will keep you from breaking bones easily – a major barrier to mobility.

Dr. David Gronski
Dean Clinic Sports Medicine

My diet is almost exclusively low-fat foods, yet I’m gaining weight. What’s the problem?
Since the early 1980s, low-fat processed food products have been marketed as healthy and are now a regular part of the American diet. These food products, however, are full of quickly digested processed sugars and carbohydrates that cause blood sugar and insulin levels to go up, which in turn leads to hunger, overeating and weight gain. 

The standard American diet—large portions of processed grains and sugars, processed meats and red meat, and too few fruits and vegetables—is making us sick and often overweight. Instead, try the following tactics:
  • Avoid foods advertised on TV that make health claims and those that have more than five ingredients.
  • Treat meat as a flavoring or “special occasion” food.
  • Eat real food by adding more veggies and fruit to your meals, limit portion sizes and avoid eating when you’re not hungry.
For overall health, well-being and weight management, it is important to eat real foods—not processed food products—from each nutrient category. 

Dr. Janet Droessler
Dean Comprehensive Weight Management Program



I’m having trouble getting to sleep each night. What do you recommend I do?
Let’s start with a look at how well you slept as a 10-year-old child – before work and family stressors, financial concerns or physical ailments. Most parents enforced “down time” before bedtime, and we got up at a regular time for school. We  weren’t  exposed  to caffeine, alcohol or many medications. We can apply some of the same principles to our adult lives to improve our ability to sleep. Avoid  caffeine after lunch, alcohol after dinner and exposure to computers or smart phones within two hours of bedtime. Keep the TV out of the bedroom.  Keep your room dark, cool and quiet. Keep naps short and only in the mid-afternoon. Try to avoid unpleasant phone calls and discussions close to bedtime. If these suggestions don’t help, by all means, talk to your primary physician to explore other related health-related sleep issues. 

Dr. Kathryn Middleton
St. Mary’s Sleep Center




Wellness Runs Deep Here
Angie’s trip to the ER with symptoms of extreme thirst, frequent urination and blurry vision ended with hospitalization and diagnosis of Type II diabetes. After thousands of dollars in medical bills, she’s making lifestyle changes to keep her condition under control, and she’ll likely be forever dependent on the health care system for prescriptions, lab work and continual follow-up visits with her doctor.

Things could’ve been different. And now St. Mary’s is taking steps to see that things are not only different, but better. Of course, doctors and nurses stand ready to provide hospital care when it’s needed, but they are also assessing the health concerns of each community and tapping into partnerships for prevention of disease.

“Essentially, we want what patients want: better health that keeps people out of the hospital,” says Stephanie Johnson, St. Mary’s community relations coordinator.

St. Mary’s teamed up with the other three hospitals in Dane County (Meriter, UW Health and Stoughton Hospital) as well as with Public Health Madison & Dane County. The collaborative, known as Healthy Dane (healthydane.org), uses public health and hospital data to provide a deeper look at hundreds of community health issues and how the county’s population fares.

The focus on wellness complements the 2010 Patient Protection and Affordable Care Act that’s now being implemented, and it’s a way to rein in costs for the entire health care system, including costs paid by each patient. But the best outcome, Johnson says, is a healthier quality of life.

5 Ways to Reduce Your Risk for Diabetes
St. Mary’s Focus:
  • Type II Diabetes
  • Poor Birth Outcomes
  • Asthma/COPD
Visit stmarysmadison.com to read the CHNA report.

Type II diabetes can strike anyone, and the older you get the greater your risk. Likewise, the heavier you get, storing fats and unused carbs that become fat, the greater your risk for developing a dependency on daily insulin shots. Lighten your worries by lightening up:
  • Lose excess weight to help the body’s natural ability to break down sugars and carbohydrates.
  • Go light on bad carbs such as white breads.
  • Cut back on junk foods, which have little or no nutritional value.
  • Put a maximum of four on daily alcoholic drinks, which contains large amounts of sugar.
  • Exercise to burn off food that is capable of being stored as fat.
Community Health Needs Assessments
St. Mary’s and affiliated hospitals in Dane, Columbia, Iowa, Rock and Sauk counties all have their own priorities and action plans to meet community health needs. Their  assessments may be useful to clubs, organizations and individuals as they set goals and plan programs. 
St. Mary's Hospital 
St. Clare Hospital
St. Mary's Janesville Hospital
Stoughton Hospital
 

Custom Health Resource Online
St. Mary’s Health Resource Center offers online and in-person assistance locating health and medical information. Visit the website for more information.




When Breathing Becomes a Super Power
Doctors make splash of heroism with first-in-Wisconsin breathing implant

The whole world knows Superman. All of America knows baseball great Lou Gehrig. And Evansville, Wisconsin, knows high school teacher Joe Amato.

All three are men of steel in their own right, but Joe Amato takes the cake. With his own humble greatness as a beloved history teacher for 35 years and girls basketball coach for 12, he also borrows a bit of tragic thunder from the stories of the other heroes.

Like Gehrig, Amato has a disease that steals his muscle function. While Lou Gehrig’s disease was ALS, Amato’s is the more rare PLS – Primary Lateral Sclerosis. Thankfully, PLS progresses more slowly and is less severe than ALS, but it nevertheless threatens the very basic ability to breathe.

And that’s where Superman flies into this story, courtesy of a Cleveland surgeon with ties to both the late Superman actor Christopher Reeve and Evansville teacher Joe Amato. Dr. Raymond Onders gained fame in 2003 when he implanted a diaphragm pacing device into Reeve’s abdomen to help the paralyzed actor breathe without the use of a ventilator. And last year, he helped Dean & St. Mary’s surgeon Dr. Greg Matzke implant the same type of device into Amato, marking a “first” for Wisconsin.

“This treatment is new for ALS and PLS patients and is available only at major medical centers in the United States,” says Dr. Michael Snyder, the Dean Clinic neurologist who, along with Dr. Oliver Ni, lobbied to begin the breakthrough treatment in Wisconsin. The device helps slow the progression of the disease, improve sleep and avoid the need for an artificial ventilator.

The pacer has improved Amato’s quality of life even though his arms and legs have become useless over the decade since he first noticed subtle symptoms. “He remains awake and alert most of the day and is able to enjoy watching our 4-year-old grandson grow,” says Amato’s wife, Beth. “Our focus is on making the most of each day because we know the time is limited.”

Live Each Day Fully!
No one knows what causes ALS or PLS, how they can be prevented or how to cure them. The most important thing you can do is to live healthfully, according to Dean Clinic neurologist Dr. Michael Snyder. Among his tips:

  • Be active; use your body the way it was intended
  • Avoid or quit smoking
  • Live fully to avoid regrets later on
  • Follow common sense and your doctor’s advice for optimal health
  • Be aware of changes in your body and let your doctor know; early detection may yield better treatment
  • Help find answers by donating to the ALS Association or Muscular Dystrophy Association


Gardens Help Heal
By offering a retreat from the often harsh reality of a hospital, The Gardens of St. Mary’s provide many benefits for patients, visitors and health professionals.
  • Clinical: Gardens can help lower blood pressure, reduce pain and shorten hospital stays.  Even with just a view of nature, patients often heal faster and need fewer medications.
  • Emotional: Healing gardens can lower stress levels for family and caregivers.
  • Safety: Health care workers emerge from garden visits less anxious and are able to fully concentrate on their important jobs.
  • Economic: Healing gardens can reduce health care costs, for all the reasons above.

The Gardens of St. Mary’s were built and maintained through community support. To make a donation or order an engraved brick, please contact St. Mary’s Foundation:  stmarysfoundation.org or 608-258-5600.

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