Preeclampsia is a condition that develops during pregnancy that can be life-threatening for mom and baby. But a mom from Snyder County says she made it through a scary experience with the disorder with the help of a midwife at Geisinger Medical Center.

Bode is a happy, healthy, typical 2-year-old.  He loves cars and trucks and knows all about Thomas the Train.  His mom, Kim Burkhart of Selinsgrove, says she knows how lucky she is to have him.  Despite being 38 when she gave birth to him, considered of “advanced maternal age” at Geisinger, she says her pregnancy was great.

But suddenly at week 35, she was very swollen.  Her midwife called one morning to tell her some test results: she had developed preeclampsia, and doctors wanted to induce labor that day.

“I gasped- and she said, are you ok?  And I said- I was about to go to my baby shower!,” Kim recalls.

Angie Cassel, Kim’s midwife, explained that preeclampsia is a condition that causes vascular constriction, usually sometime after 20 weeks of pregnancy.  It’s marked by high blood pressure and swelling, and can result in seizure for mom.

“If the pregnancy is allowed to continue in light of preeclampsia and the baby isn’t getting adequate blood flow from the placenta, the baby can pass away,” said Cassel.

Kim’s case was severe, and she was already 35 weeks along, which Cassel says made it an easy decision to induce labor.  In more mild cases of preeclampsia, or if the baby isn’t far enough along to survive outside the womb, it becomes a more dangerous situation, since there’s no way to treat it.

“The only cure for preeclampsia is delivery,” Cassel noted.

Kim calls her delivery fast-paced and chaotic, but she says she knew she was in good hands at Geisinger.  Experts there have told her, despite the complications, she is healthy enough to try for another child.

“If I’m fortunate enough for that to happen, my husband and I would love to give him a sibling,” Kim said.

“He’s thriving, doing well, a bright little boy.  That’s what it’s all about,” said Cassel, who notes that it’s unknown exactly what causes preeclampsia, although she says moms who are a little older are at a greater risk.

If a baby isn’t quite fully developed at birth, or needs some extra care, he or she might end up in a hospital’s NICU, or neonatal intensive care unit.  That can be tough on new moms and dads, who don’t get a lot of the same experiences other parents do with their newborns.  But something called “kangarooing” can help them bond with baby, and Geisinger Medical Center just wrapped up an event encouraging the practice.

We found 6-week-old Jacob Luke Grimm snuggling under his mom Betsy’s shirt.  Betsy Grimm, from Sunbury, was admitted to Geisinger Medical Center near Danville when her water broke just 24 weeks into her pregnancy.

“My due date is July 23rd.  I had him May 6th.  He was born at 28 weeks, 6 days,” she says.

Jacob weighed less than three pounds at birth, and ended up in Geisinger Medical Center’s NICU.  We found his mom doing something called kangaroo care, or skin-on-skin contact.

“Strip them down to their diaper and lay them on top of your chest.  It’s relaxing for him, and it’s relaxing for me as well,” said Betsy.

It’s so important, the staff here at Geisinger recently held a marathon of sorts, called a Kangaroo-A-Thon.  Paper cut-outs of kangaroos line the walls here.  For each hour family members “kangarooed,” they got a ticket that went into a drawing for prizes.

Phoebe Beckley, a March of Dimes NICU Family Support Specialist, thought it was a great way to encourage families to do it, considering how beneficial it is to the newborn.

“By holding them skin-to-skin, the mother regulates their temperature, heart rate, and breathing rate.  When all of that can be controlled, the baby can heal,” said Beckley.

Experts say even brain development occurs during the practice.

“I think it’s pretty cool, and I know in third world countries it’s almost standard practice because they maybe don’t have the isolets like we have.  It’s pretty cool,” according to Kayla Farr, a NICU nurse.

Betsy says at this point, she’ll do whatever she can to help little Jacob.  She can already tell he’s a lot less fussy during kangaroo care.

“He’s just calm.  They fall into a deep sleep,” she noted.

There’s a new partnership happening in Pottsville between Schuylkill Health Systems and Geisinger Health Systems that looks to bring better cancer care to the region, and it opened just this week.

We got a look inside a new, 1.8 million dollar oncology clinic in Pottsville.  It’s located at Schuylkill Medical Center’s East Campus, on East Norwegian Street.

“We’re going to have two physicians that rotate through the facility, two oncologists/hematologists,” said Thomas Graves, Geisinger’s Vice President of Cancer Services.

He and John E. Simodejka, President and CEO of Schuylkill Health Systems, showed Newswatch 16 the renovated center.  Both said the need for an oncology facility in the Pottsville area is great, and continues to grow.  They cited statistics that nearly 1,200 new cancer patients are reported in Pottsville and the surrounding areas each year.  Many of those patients are currently traveling- to Allentown, Philadelphia, or other areas- to be treated.
“There was a single provider in the area, and we felt that we could add specialty care and it would be successful,” said Graves.

Some of the services now offered include chemotherapy and IV treatment for blood disorders.  There are also new exam rooms and a new, specialized pharmacy.  The building is owned by Schuylkill Health Systems but will be run using Geisinger doctors, with full access to Geisinger’s programs and clinical trials.
“The biggest winners of this are the patients in Schuylkill County who now won’t have to travel outside Schuylkill County for advanced cancer care,” said Simodejka.

We know the importance of being safe around fireworks this July Fourth holiday.  Doctors are Geisinger Wyoming Valley Medical Center say not doing so could cause lifelong injuries.

Dr. Ronald Strony expects it to be a busy few days at Geisinger Wyoming Valley Medical Center near Wilkes-Barre.  He’s Director of Emergency Medicine there.

“We all like to see it, we all like to experience it, we all like to celebrate.  But there really isn’t a safe firework in and of itself.  The only safe kind is the one you watch from a distance, that the pros are putting on,” said Dr. Strony.

He notes that even sparklers, often seen as the most harmless of fireworks, burn at a very intense heat.

“We let our kids walk around with them in their hands.  But we wouldn’t let them walk around with torches in their hands!  Let the professionals do the professional job,” he said.

The most common injuries from fireworks are blast and burn injuries, according to Dr. William Krywicki.  He’s an orthopaedic surgeon and Director of Orthopaedics at GWV.

“Even the smallest of firecrackers can create an injury,” he said.

Dr. Krywicki points out that those are injuries that can last a lifetime, from burns to lost fingers to fractures that can cause stiffness or loss of function.

“It’s an explosive.  It’s something that can cause damage, and treating it as such is the best way to prevent injuries from happening,” he said.

Dr. Strony also mentioned that alcohol and fireworks is a bad combination, since alcohol slows reaction time.

Shorts and swimsuit season means that legs are on full display.  It’s a time of year people commonly notice varicose veins.

Frank Galicki, of Dallas, started to notice them a while back.

“I inherited them from my mother and my father.  However I’m an athlete, a referee, I work out on a regular basis, I do a lot of work,” said Galicki.

Varicose veins are swollen, sometimes twisted veins you can see just under the skin.  They can be unsightly, but can also cause the legs to feel painful, heavy, achy, or itchy.

Dr. Melissa Obmann, a vascular surgeon at Geisinger Wyoming Valley Medical Center near Wilkes-Barre, says women are more commonly affected.

“People usually notice them a little later in life, 30′s and 40′s, and sometimes in women earlier if they’ve had children,” she said.

Galicki was referred to Dr. Obmann after he noticed itching and soreness in his calf area.  On June 12th, he had a procedure to remove the varicose veins on his left leg.  On July 24th, he’ll do the same for his right leg.

“it’s caused from people who have jobs where we stand on our feet for long periods of time, where we put pressure on the valves of the veins in our legs,” said Dr. Obmann.  She points out that varicose veins aren’t dangerous, but can have complications, such as bleeding problems and inflammation.

Frank Galicki says getting them taken care of was the right decision.

“It has increased the time I can spend on my feet.  No problems, no difficulties,” he said.

There are varying ways to treat varicose veins.  Talk with your doctor about a referral if you have questions.

It’s no surprise that men and women have different health worries.  But post-menopausal women have specific concerns.

“In the United States, it’s about 51, 52 is about when most women will go through menopause,” said Dr. Jim Bosscher.  He’s a gynecologic oncologist at Geisinger Wyoming Valley Medical Center, who also sees patients in Scranton and Danville.  He met with us to discuss five important things women need to remember as they age.

“The biggest question I get is, do I still need to get a pap smear?  The recommendation is that they get them yearly starting at 21 until they’re 65,” he said.

After 65, Dr. Bosscher thinks pap smears aren’t as necessary as long as a patient has had three normal results in ten years, particularly if those normal results came in the last five years, but it is important to continue with regular pelvic exams, which is the first of the five.

Number two is colonoscopies.  Colon cancer becomes more common as women age.  The recommendation is a colonoscopy every ten years unless otherwise directed.  Number three is being up to date on general health vaccines, including flu and shingles.

“They have all been shown to be very successful in incidence of preventing these diseases.”

Number four is mammograms.
“They should be basically obtained after age 50, between 40-49 a good time to get mammogram on every year or every other yearly basis,” said Dr. Bosscher.  He recommends yearly mammograms up to age 70, or older if directed.

Number five is keeping up with your health in general: quit smoking, exercise, and watch your diet more than ever.

“I think as you get older, your immune system is less successful at fighting infection.  You need to do what you can to prevent infection,” Dr. Bosscher noted.

This is certainly not an exhaustive list, but he says it addresses some of his patients top concerns.

Geisinger Wyoming Valley Medical Center has put its 100th kidney transplant in the books.

Jennifer Jennings, from Madison Township, is 30-years-old and the mother of two girls.  She’s had kidney problems since she was 12.  For the last 6 years, dialysis has been a way of life.

“My worst day was not being able to do anything.  It does take a toll on you,” Jennifer admitted.

She was on a national transplant list, but wouldn’t get her hopes up.  She’d been a “back-up” recipient for kidneys in the past, and didn’t receive the organ in the end.  But a few weeks ago- a bit out of the blue- came the phone call she wanted.

“I got out of dialysis Friday June 7th, and 5 minutes later, they called and said something had happened with the patient (ahead of me on the list).  It was my turn.  I was freaking out!  Crying, screaming, I’m like, I can’t believe this,” she remembers.

Dr. Manish Gupta has been with Geisinger WV’s kidney transplant program from its inception, along with the program’s creator, Dr. Chintalapati Varma.  Dr. Gupta says Jennifer was a back-up recipient this time too, but the patients ahead of her happened to be not the best matches.  Just one hour after that phone call, her transplant surgery was ready to begin.  Dr. Gupta says the hospital’s proximity to people living in Northeastern Pennsylvania makes a big difference.

“She’s a young healthy woman, mother of 2.  dialysis is just not the way.  For someone like this, a transplant is the best way to take care of them,” said Dr. Gupta.

Only later did she realize she was Geisinger Wyoming Valley’s lucky 100th kidney transplant.  Lucky is exactly what she feels.

“I’m so psyched and happy that I can be home with the girls, so I don’t have to worry about where they’ll be when I’m at dialysis,” said Jennifer.

Nobody ever plans to break bones.  But if you do find yourself in an emergency room, needing care for a fracture, you’ll be in much better shape to heal if you’re a non-smoker.

We hear all the time how harmful smoking is to our health.  It’s highly addictive, linked to heart disease, stroke, and chronic lung diseases, and can increase your risk for cancer of the bladder, throat and mouth, kidneys, cervix and pancreas.  Now, there’s something new to add to the list, something doctors have suspected for a long time.

“Nicotine use prevents fracture healing,” said Dr. Gregory Thomas, an orthopaedic traumatologist at Geisinger CMC in Scranton.  He adds that bones heal much quicker in patients who are non-smokers.

“Normally it takes a fracture approximately 24 weeks to heal.  Studies show that nicotine use extends that by 6 weeks, so approximately 2 extra months of healing time for someone who uses tobacco products,” Dr. Thomas noted.

He says if there’s elective surgery in your future, quitting the habit even 6 to 8 weeks beforehand can greatly help your healing time.

That’s where Tony Delonti comes in.

“Because of the way smoking constricts blood vessels in the body, it doesn’t supply full blood flow to that area,” explains Delonti, a program specialist at the American Lung Association in Pennsylvania.  He has long been involved in teaching smoking cessation programs.

Delonti says he’s surprised at how little people know about what happens to your body when you smoke, and he’s quick to point out it’s not just cigarettes that are cause for concern, but nicotine in general.

“Bone, muschles, tendons, all need oxygen to heal.  Decreased oxygen means decreased healing, and therefore prolonged healing.”

If you need help quitting nicotine, contact the American Lung Association.

It is World Breastfeeding Week, a time meant to educate people about the benefits of breastfeeding.  But what happens in cases where new moms can’t provide milk for their babies?  They can turn to donated breast milk.

Kelly Rilk, from Tipton in the Altoona area, was as surprised as anybody when little Parker came along ten weeks early.

“He’s feisty, he’s fussy.  he loves to be the center of attention, wants to be involved in whatever mom and dad are doing,” Kelly said, smiling, telling us about her baby.

Parker is now four and a half months old, and doctors say he is thriving, in part, because of something Kelly didn’t even know existed: donated breast milk.

Dr. Connie Andrejko is a neonatologist at Geisinger Medical Center near Danville.  She says for newborns, mom’s milk is always best.

“But there’s definitely situations where moms can’t provide that milk, or there’s a period where mom’s milk isn’t in at first.  The next best thing would be donated breast milk,” said Dr. Andrejko.

She, along with registered nurse and lactation consultant Ronna Aucker, explained that there are donor human milk banks across the country.  Breast milk is donated by moms who, for a variety of reasons, have an extra supply.  Parker was a recipient of donated milk when he was first born.

“It was something that was really important to me.  Early here I had problems getting my milk supply up, so for the first few days of life, he recieved donor milk, before my milk came in,” Kelly told us.

Lactation experts say there’s a long list of breastfeeding benefits.  For baby, that includes fewer and shorter episodes of illness, and a decreased risk of a host of ailments, from allergies and ear infections to diabetes and asthma.  Breastfeeding moms enjoy a lower risk of breast, ovarian, and cervical cancers.

Ronna Aucker says there’s a team at Geisinger dedicated to educating new and prospective moms.

“We support moms the whole time they are breastfeeding, whether it be after you get discharged, the day you go home- all the way up to the mom still breastfeeding at 18 months and needs help weaning,” she said.

There is a cost associated with getting donated breast milk.  The Children’s Miracle Network funds that program at Geisinger.

The Little League World Series starts today.  Kids from all over the world will be battling it out on the diamond in South Williamsport.   It’s America’s pasttime- and no doubt a lot of fun for the players- but for pitchers especially, the sport of baseball can take a big toll on a little body.

Dr. Dan Feldmann will be watching.

He works in sports medicine and orthopaedics at Geisinger Woodbine Lane in Montour County, and he’s been a coach for his sons’ baseball teams for years.   What he sees might be different than what other fans notice.

“A lot of shoulder pain, a lot of elbow pain, all related to throwing,” said Dr. Feldmann.

Kids playing in the Little League program are between 9-12 years of age, several years before the time boys usually stop growing.  His worry is the tremendous amount of force on elbows and shoulders from throwing, particularly for pitchers.

“Bruises, contusions an sprains get better without us intervening at all. But these repetitive overuse injuries, over weeks months and seasons, don’t get better,” said Dr. Feldmann.

Technique is important, but even with good form, Dr. Feldmann points out that it’s the repetition that’s most damaging.  He also says it’s important for coaches and parents to be watching out for injury or overuse.

“Everybody figures, well, if I give a kid a couple of weeks off for rest, he’ll be back next season, troubles will go away.  And typically they don’t,” he noted.

Geisinger Medical Center’s Sports Medicine Department has doctors and trainers who work specifically with young athletes to prevent injury as much as possible.  If players, coaches or parents have questions now- or in advance of next year’s season- they’re available for a consultation.

Back-to-school means back-to-fall-sports.  Lots of athletes are getting ready to take to the fields for the season, and in some cases, athletic trainers are too.

We stopped by the Solomon Plains school complex in Plains Township this week, just as the Coughlin High School football team started its second week of practice for the upcoming season.  Adam Tomassacci was watching the Crusaders closely.

“All summer you run around without pads or helmets and the first day of practice you’re in full gear.  (Getting used to the heat) is an excellent idea,” he said.

Tomassacci is a licensed athletic trainer in Geisinger’s Orthopaedic Sports Medicine Department.  It’s his fourth year at Coughlin.  He says in the early stages of the season, it’s all about getting acclimated to the heat, proper hydration and nutrition, and lots of stretching to prevent injury.

“That’s kinda the goal at Geisinger.  We want to get them back in as soon as possible, but make sure they’re safe and functional,” Tomassacci said.

Roxanna Larsen agreed.  She’s the program manager of the Sports Medicine Department at Geisinger.

“Sports medicine for us isn’t just the scholastic setting, but it’s also reaching into the community, into the active population.”

Larsen says Geisinger has 17 athletic trainers affiliated with high schools in Northeastern and Central Pennsylvania, three on the collegiate level, and two who are clinically based.

“When they happen to see as they go through practice, see aches and pains or notice a weakness- they’ll put them on a preventative program for strength and agility and conditioning to prevent further injury,” she said.

Coughlin head coach Cirro Cinti thinks having an athletic trainer’s expertise so handy is a great idea, both for the good of the team, and for the health of the players.

“Used to be we had 70-80 kids on a team, now it’s 30-40.  So those kids are out there the entire time, doing both offense and defense, special teams- we really have to be congnizant of what we see,” said Cinti.

Geisinger officials point out there’s always someone available to answer questions at the Sports Medicine Department.  They also hold clinics on Saturday mornings, specifically for scholastic athletes to deal with injuries that may have happened during the week.

A new study done by the University of Pittsburgh touches on concussions during youth football.  It was done on eight-to-12 year olds, but doctors say the findings can apply to high schoolers as well.

Researchers studied 468 players from 18 different youth football teams in suburban Pittsburgh and Central Pennsylvania.

We spoke with Dr. Jason Scotti, a sports medicine physician at Geisinger Medical Center’s Lake Scranton facility, about the study.

“Concussion is a traumatic brain injury where the brain at the cellular level actually swells,” explained Dr. Scotti.

According to the study, players are 26 times more likely to suffer concussion in a game than in a practice.   Players 8-12 were about three times less likely to suffer concussions than older players.  Also, quarterbacks, running backs and linebackers suffered 95% of all concussions during practices and games.

“The younger the kid, or athlete, the more susceptible for a concussion because the brain is still growing,” said Dr. Scotti.

Some signs of a concussion are nausea and vomiting, blurred vision or slurred speech, confusion or lack of concentration, ringing in the ears, and feeling suddenly or overly tired.

Dr. Scotti says ideally coaches, trainers and parents need to be looking out for the symptoms.
“You can’t really count on players.  At a lower age they won’t know what a concussion is, and at a higher age nobody wants to come out,” he said.

The effects of a concussion can last three to seven days, depending on how hard a hit.  But it could be a week to 10 days before a student athlete is ready to get back into the game.

If someone’s heart stopped right in front of you, would you know what to do?  A college student is alive today because lots of people did.

Each year, hundreds of runners take to the streets of Berwick for the Run for the Diamonds, a race held on Thanksgiving day.   Last year, 22-year-old Colin Parker of West Scranton was one of them.

“I packed up all my stuff, had some water, and told my mom I’d see her at dinner after the race,” he remembers.

Colin was young and healthy, a student at Penn State Worthington Scranton and member of the cross country team.  He says he felt fine the morning of the race, but that’s the last thing he can recall until he woke up in a hospital bed.

“I remember saying, Mom, is this a dream?  Did I finish the race?  I felt wet, and there were IVs in me, and I’m thinking, why am I in a hospital?”

His mom Deborah, getting ready for Thanksgiving dinner, remembers what she was told in a frantic phone call.

“He is critical.  He’s on life support.  Get here as soon as possible,” she says.

Colin had collapsed on the course, after going into cardiac arrest, and was in a coma.  Deborah remembers arriving at his room, only to be greeted by a priest.  She was eventually shown a picture of her son’s heart rate as paramedics worked on him: a flat line.

“They were going to call it at 3.  This one gentlemen said, he’s too young.  He gave him that last defibrillator shock,” she says.

Colin was flown to Geisinger Medical Center near Danville, to an area in the trauma unit.

“The vast majority of people who have that happen outside of the hospital don’t survive,” said Dr. Douglas Kupas.  He’s an emergency physician and director of the medical system’s Arctic Program.

In certain cases, he explains, patients’ body temperatures are lowered to decrease the chance of brain cells dying.  Colin was one such case.

“We induce hypothermia.  That decreases the body temperature to a target of 90-93 degrees, much lower than the normal temperature.  That slows down metabolic processes, and slows the death of brain cells,” Dr. Kupas notes.

Later, Colin underwent surgery to correct an arrythmia, or an irregular heart beat, something with which he was likely born.  Doctors installed a pacemaker and now say that Colin’s prognosis is very good.  He can still run, and since the race last year has earned his third degree black belt in karate.

“Feeling fine.  I feel good, safe with this in me.  In case it happens again, I’ll be protected,” Colin says.

According to Dr. Kupas, the patients who fare best in cardiac emergencies get care right from the start.  In this case, several Geisinger employees happened to be running the race.  A bystander did chest compressions immediately, and an ambulance was seconds away.  He says that illustrates the importance of doing CPR right away until medical help can arrive.

Al Russomano, 58, from Scranton, has had about a year to think about one of the scariest days of his life.

For a week or so early last fall, Al was tired and had some heartburn.  He suspected he’d pulled a muscle in his chest, something he’d done before as a fitness trainer and head wrestling coach at University of Scranton.

“I said to my girlfriend, ‘I’m going to take care of this client then come right home.  I don’t feel good.’  And she said, ‘go to the hospital.’  And I said, ‘I’ll only be an hour,’” he remembers.

He had been driving for just a few blocks when intense pain came over him, and he decided to drive to Geisinger-CMC in Scranton.  He recalls now that he didn’t even park near the emergency room.

“I walked from across the street by the museum, clutching my chest, step by step,” he says, admitting he was in denial.  “I still had bad pain, but just being in that care, I sort of  relaxed, I knew I was in the right place and it was up to them now.  They saved my life,” he says.

Al was having a massive heart attack, according to Dr. Stephen Voyce.  He’s an interventional cardiologist, and Chief of Cardiology at Geisinger-CMC.  He explains that a heart attack, simply put, is when blood clots form in a blood vessel to the heart.

“They may partially block off the artery.  I suspect that’s what he was experiencing the first few days,” says Dr. Voyce.

Al says it was just 42 minutes from the time he made it to the door to the time he was in the operating room, getting stents inserted.  Dr. Voyce notes that Al was lucky to be so close to the hospital at the time of the heart attack, but says calling for an ambulance is still recommended.

“Sometimes heart-related problems can develop bad rhythms quickly and patients die suddenly.  You’re driving?  You endanger yourself and everyone else on the roads.”

Also, Dr. Voyce points out that emergency medical technicians are critically important in the fight to save a heart attack patient, because they can take the proper heart scans en route and allow the hospital to review the information, and get a specific team on standby.

Al says no matter how it happened, he’s grateful he’s here to talk about it.

“I feel great.  Better than my old self,” Al says.

Geisinger-CMC just won an award from the American College of Cardiology Foundation- one of only 4% of hospitals nationwide to win the award- for meeting aggressive goals when it comes to how quickly and effectively heart attack patients are treated.

 Infant hip dysplasia is fairly common, and treatable, but getting it diagnosed early is important.

“She’s like any other baby- she gets into everything.  She’s getting so big,” said Stephanie Landmesser of Jenkins Township, about her 8-month old daughter Caitlyn.  The little girl is crawling and standing, milestones that are normal for her age.  But all wasn’t exactly normal when Caitlyn was born.
 
 ”They told me it was very common, a lot of babies have it, but I never heard of it before,” Stephanie said.

She couldn’t tell by looking at her, but an ultrasound found that Caitlyn had infant hip dysplasia, when the hip joint doesn’t form normally.

Dr. Stacy Frye works in pediatric orthopaedics at Geisinger Wyoming Valley Medical Center.  She explains that Caitlyn’s left hip wasn’t completely out of socket- or dislocated- it just wasn’t well enough in the socket.   
 
“Loose hips are very common, actually.  In the majority of these babies, that will tighten up after the first 6 weeks of life.  If it’s loose after that point, we need to evaluate for hip dysplasia,” said Dr. Frye.
 
Infant hip dysplasia is more common in a firstborn, in a female baby, if mom had low fluid levels during pregnancy, or in a bigger than usual baby.
   
Caitlyn was treated using what’s called a Pavlik harness, something she wore 23 hours a day for 18 weeks.
      
“I remember crying the first day I brought her home with it- didn’t know what to do- it was difficult to change diapers,” recalls Stephanie.

But she- and Caitlyn- got used to the treatment, and today the little girl’s hip is fixed for good.
 

“She’s doing great.  Her last exam is normal, and you can tell she’s busy!  Her hip looks fantastic,” said Dr. Frye.

If infant hip dysplasia isn’t treated, a variety of problems could develop in childhood, such as a limp, early arthritis, or general joint pain.
  
 

Measles is back in the headlines.  The number of cases used to be in the hundreds of thousands nationwide, before the vaccine was invented.  Officially it was eradicated as of the year 2000.  But now the number of cases is creeping up, and there have been outbreaks very close to our viewing area.

According to the Centers for Disease Control and Prevention, this year could be the worst for measles in more than a decade.

“We’re now seeing more measles cases in this year so far than in 10 or 15 years, at least.  Maybe 25,” said Dr. Michael Ryan, Chief of Pediatrics at Geisinger Health System.

He explains that measles is a highly-contagious respiratory disease caused by a virus.
Although the disease is still considered rare, it is geographically close to us right now.

“We actually have no active measles cases in Pennsylvania right now, but we do in New York City, and right on our New York State border.  I think they’re reporting 65 cases of measles in New York,” said Dr. Ryan.

Measles starts with a fever, which can get quite high.  Then comes the cough, runny nose, and red burning eyes.  A rash of red spots then appears, starting at the head and working its way down the body.  The rash can last up to a week.  The coughing can last up to 10 days.

There’s no way to treat measles other than to quarantine the patient and let it run its course.  But it’s easily prevented with proper vaccination.  And don’t think it’s just a kids disease.  Dr. Ryan says adults who get measles are some of the sickest he has ever seen.

“One of the last cases of measles I saw here at Geisinger was an Amish woman who was pregnant.  She was on a ventilator and in intensive care.  She was a very sick woman.”

In that case, both she and the baby were ok in the end.  Dr. Ryan says these most recent outbreaks have been traced to global travelers.  Measles is not under control worldwide, and he suspects people who have been overseas brought it back to communities where immunization levels aren’t high.   He notes that our area does have a high immunization rate.

For people who are in need of a knee replacement, surgery can mean a whole new world of less pain and a better quality of life.  Whether to have the surgery is always a case-by-case basis, medically.  But for the first time, a group of economists has calculated the costs of not doing the procedure.

In 2009, more than 600,000 people had knee replacement surgeries in the United States.  By the year 2030, that number is expected to be more than 3 million.  That’s why the American Academy of Orthopaedic Surgeons wanted an economic group to study just how much it costs when people undergo the procedure, or when they don’t.

“This paper covers the direct and indirect cost of replacement surgeries, which was never really covered before,” said Dr. David Kolessar, Chief of Hip Arthroplasty Services at Geisinger Health System.

He met us to talk about knee replacements, specifically the study that just found that for the average patient undergoing the surgery, the expense of it is offset by indirect savings of nearly $40,000 in a lifetime.

He’s involved with the American Academy of Orthopaedic Surgeons, which wanted the study to be done.  He points out that a typical knee replacement surgery can cost in the ballpark of $20,000.

“What (people) don’t really see is the long-term benefit.  How do we measure this economically?  Does it benefit us as a society to fix the knee and return to a productive life?”

According to the findings, the answer is yes, taking into account time lost at work and needed disability benefits, not to mention pain alleviation.  It’s something Dr. Kolessar says doctors will have to pay more attention to as the population ages.

It’s estimated that 1 in 4 Americans has bone or joint problems, making them the greatest cause of lost work days in the United States.       
       

When you hear “gastric bypass” surgery, you probably think of weight loss, and it’s true that it’s an available tool for some people to lose weight.  But in some cases it’s also effective in the battle against diabetes.   Some doctors at Geisinger are getting recognition for a scoring system they’ve invented to predict whether a patient’s diabetes would be helped by the surgery.  It’s called the DiaRem score.

It’s estimated that 2/3 of the adult US population is overweight, and 1/2 of those people are obese.  The prevalence of diabetes has also increased in recent decades not only in adults, but in children too.

Bariatric surgery can be effective for weight loss, but Dr. Christopher Still points out, it’s also can be effective in resolving diabetes, even if the patient isn’t morbidly obese.   There just wasn’t a way to determine which patients had the greatest likelihood of success until now.

“It really is a personalized, patient-centric decision making tool,” said Dr. Still, the Director for Nutrition and Weight Management at Geisinger Medical Center near Danville.  He’s also one of three Geisinger employees to come up with a simple scoring system called DiaRem.

“This is really the first pre-operative equation where you can put in the data before surgery and give a percentage of resolving diabetes after gastric bypass,” said Dr. Still.

The scoring system takes a patient’s age and blood sugar measurement and factors in whether they’re on medication and/or insulin to control diabetes.  The resulting score is a predictor of who will resolve their diabetes within five years of gastric bypass surgery.

Details on the DiaRem scoring system were just published in a national medical journal.  Dr. Still hopes it’ll be used by doctors to help their patients make the best decision.

As we get closer to Halloween, we enter prime time for pumpkin carving.  It’s a tradition for many families, but it can be dangerous.  One doctor at Geisinger Medical Center has already seen cases of hand injuries from pumpkin carving.

“As you finally get through there may be a sudden release, where the knife goes much further than anticipated.  So as you’re cutting, it’s possible the knife slips and cuts your dominant hand,” said Dr. Steven Goldberg, a hand surgeon with Geisinger Health System.

Dr. Goldberg says the number of hand injuries soars this time of year.  He points out there are a number of tendons, nerves and arteries in the palm and the fingers.

“When a tendon is cut completely, you’ll lose ability to move that part of the finger.  A partial tendon injury would mean pain, but may not eliminate movement, so they’re hard to diagnose,” noted Dr. Goldberg.

Cutting a nerve can mean a lot of pain and numbness, even for a small cut.  Injury to an artery can be an emergency situation because it affects blood supply.

Dr. Goldberg instead recommends using plastic knives and tools sold at lots of stores this time of year, which don’t penetrate the skin with light pressure.

“It’s very inexpensive.  If you think about the difference between 1.50 to get these versus missing work for 3 months, it’s a good thing to purchase,” he said.

Another suggestion would be to cut the bottom of the pumpkin instead of at the top, which can help keep your jack-o-lantern more stable both while you’re carving it and when it’s on display.

A woman in Susquehanna County has a lot of good things to say about her doctors at Geisinger Medical Center.  After a lot of pain, and many months in a wheelchair, she is finally able to live her life again.

The fact that Patsy Dmytryszyn is standing upright, walking around in her kitchen making coffee, may not look like an accomplishment.  But it certainly is to her.

“My whole world turned around.   I was given a 20% chance of ever walking again.”

67-year-old Patsy met us at her home in Hallstead to talk about what happened one night last February, when she lived in her native New York.  She’d been perfectly healthy one day, no pain and no idea what was about to hit her the next.

“I got up about 11 o clock at night to go to the bathroom and all of a sudden I collapsed,” Patsy remembered.

She was rushed to a hospital and underwent a 6 hour operation on her back.

“I had an abcess the size of a pineapple that burst in my back,” she explained.

But she says the surgery only made it worse, and the problem kept coming back.  One of her daughters, who lives in nearby Hop Bottom, moved her to Pennsylvania and started getting her treated at Geisinger.

Dr. Brett Schlifka is a neurosurgeon at Geisinger Wyoming Valley Medical Center who diagnosed Patsy as having a very serious infection in her back.  By this point she was in a wheelchair and in severe pain, unable to walk or take care of herself.

“We put a VAC dressing, a sponge-type dressing, to heal from the inside out, and we had our infectious disease colleagues assist us with the antibiotic regimen and treat her with that,” explained Dr. Schlifka.

VAC dressing is vacuum-assisted closure, used to promote  healing in chronic wounds.  It pulls wounds closed from the inside.  It was a long recovery, with lots of physical and occupational therapy, but it worked.

Today Patsy lives on her own, makes her own bed, cooks for herself, and is able to walk without a walker.  She thanks the staff at Geisinger for all of it.

“I can do all the things I used to do.  Just maybe not as quick!”