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Hospital MemorialWar Memorial

Hospitalwarmemorialhospital.org JANUARY 2019

Across the MilesLearn how telemedicine

is connecting patients with specialists. - see page 4

For YourConsideration

A message from President and CEO David Jahn

A message from President and CEO David Jahn

As I reflect on 2018 at WMH, I see some major accomplish-

ments but our organization also went through a very stressful time last year.

We implemented a new Electronic Health Record that will provide us with better access to patient infor-mation in the future, but there were

also a lot of growing pains with this process. We are currently in the optimization phase of the project, which means fixing the issues that we have found with the new system and this could continue for some time.

We appreciate any questions or concerns that the general public has regarding our new system. This is the only way that we know if the system is functioning as planned and providing accurate information to patients regarding their bills and services provided.

Last year was also not a very good year financially for WMH. Volumes were down in most areas which caused us to lose money and forced us to reduce the number of em-ployees. We are hopeful that 2019 will be a better year from a volume

perspective which would translate into a better financial picture.

The good news is that our journey to becoming a high reliability orga-nization continues to show success and we were able to reduce the number of safety events by another 50% during 2018. We also continue to see solid results from our patient satisfactions surveys regarding the care that is provided at WMH. Both of those areas are key to us remaining an independent hospital for the future.

I would like to thank all of our care team for their commitment to providing high quality, safe patient care for those that we serve. Without the dedication of the more than 950 healthcare professionals at WMH, we would not be able to provide these services to our community.

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Art for HopeBy Teresa Armstrong, Director of Community Relations and Development Fund

Cancer brings physical and emo-tional challenges that begin at diagnosis and continue throughout treatment. A diagnosis of cancer can be devastating for patients and their families. The mission of Art for Hope is to transform clinical areas into warm, hopeful and healing spaces for patients, their families and health-care providers

Research has shown that the physical environment can have an impact on patients. Patients spend long hours in chemotherapy/infusion treatments. Clinical areas that are soothing and comfortable help to alleviate some of the stress of treatment and have even shown

to positively impact patient health outcomes.

As a community hospital, WMH is partnering with community artists

and businesses to make this a reality for the patients we serve.

Great things happen in Chippewa County when groups collaborate!

Clip and mail this form and your donation toWMH Development Fund, 500 Osborn Blvd, Sault Ste. Marie MI 49783

To make a donation by credit card, please visit warmemorialhospital.org and click on “Give a Gift”. For more information, please call 906-635-4351 or email contactus@wmhos.org

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WMH HEALTHBEAT 3 JANUARY 2019

Bert Menominee remembers exactly when he found out his kidneys were going to be a major health factor in his future. It was 1978 and he was attending the police academy when he was told there was a high amount of protein in his urine.

“They told me back then that in 20 years I would need a kidney transplant,” he said. It was 1994 when doctors started Menominee, a Brimley resident, on peritoneal dialysis. That approach meant the patient could continue his active life as a tribal police officer who enjoyed a game of softball and liked to hunt and fish.

Peritoneal dialysis uses the lining of the belly to filter blood inside the body. Menominee had a catheter placed near his belly button, which was used to transfer a dialysis solu-tion into his abdomen. The solution absorbs waste and is then drained out of the body. One benefit of this approach is that the patient can maintain normal activities.

That approach worked for four years until he received a kidney transplant in 1998. Menominee’s new kidney came from a cadaver, which typi-cally means it will be effective for a shorter period than one donated by a living donor.

“At the time, they told me it would last 10 years and, sure enough, in 2008 I had to start dialysis again,” he explained. Only this time, the deci-sion was made to use hemodialysis. In this process, a dialysis machine and a special filter called a dialyzer are used to clean the blood. The blood passes from the body through the dialyzer and back to the body.

Dialysis patient awaits his second kidney transplant

“I was scared when I first started. Really scared. But over time, I real-ized I can do this,” Menominee said.

Hemodialysis required a much more rigid schedule. Menominee visits the WMH Dialysis Center every Monday, Wednesday and Friday morning for a four-hour session, something he now looks at like his job.

“This time, it was too much for me to work. I took myself off the road and worked in the school system be-fore I ended up retiring. Now I look at dialysis like I’m going to work for four hours per day. I have a part-time job on Monday, Wednesday and Friday. I’m going to work to keep myself going,” he said.

With a 10-year stint at WMH Dialysis, he says the staff is like one big family to him now and jokes that “sometimes I see those people more than I see my wife.”

In recent years, the hospital opened up a new dialysis unit, which was a hit with Menominee and other patients who enjoy more privacy, a little extra space and a place to stow coats and belongings. He passes the time with a portable tablet and a ros-ter of movies to watch on Netflix. “I start the day by watching the news and then I watch a movie. I’m out of there at 10:30 in the morning so I still have lots of time to do stuff.”

Dialysis hasn’t slowed Menominee down much. He still enjoys ice fishing and deer hunting, bagging himself a 9-point buck in November. He credits his wife, Marcia, for keep-ing him moving. “She doesn’t want me to turn into a couch potato and that’s good.”

Menominee is a candidate for another transplant, but was waylaid in 2017 when he underwent open heart surgery. “That delayed me for another six or seven months but I’ve had all kinds of tests since my bypass and everything has checked out.”

He anticipates getting a new kidney at any time, but until then will con-tinue his dialysis at WMH.

“It’s a nice unit. One of the nicest I’ve been in and I’ve been in some big ones by Detroit when I visit my daughter. I’ve dialyzed in probably a dozen different units and the Soo’s is the nicest one I’ve been in,” he remarked.

As a veteran of dialysis, Menominee’s advice to newcomers is to take it one day at a time. He found his love of family is what keeps him pushing forward.

“I’m going to keep myself going. I’ve got a granddaughter, Madison, who lives in St. Ignace. We’re pretty close and I want to stick around and watch her graduate.”

Even while undergoing dialysis, Bert is able to enjoy the hobbies he loves.

It’s as simple as turning on the television, but in this instance, the person looking back at you will ask how you’re feeling and wait for your response. Welcome to the world of telemedicine, the technology through which some WMH practices are now able to provide specialist care using physicians who are lo-cated outside the region.

The WMH Sleep Center is a prime example of a department success-fully using telemedicine. Dr. Farrukh Siddiqui specializes in helping patients with sleep apnea and other sleep-related disorders. Patients will often undergo sleep studies at the hospital and then have follow-up visits with the physician, who is located in Texas.

“Telemedicine has helped me grow my practice and has helped my patients gain access to improve their sleep health, which they may have otherwise not been able to get,” the doctor explained. “There is less travel time involved for most pa-tients who would have to otherwise travel to larger metropolitan areas to get similar care. Patients come to their local healthcare facility where the drive time is often shorter and they are seen in a timely manner.”

Carl Stutzner was one of those patients. The Sault Ste. Marie man admits that his first reaction to meet-ing with Siddiqui via telemedicine was “you’ve got to be kidding me.”

Seeing the doctor for sleep apnea for more than a year now, Stutzner has gotten used to the system and says it works fine.

“Once we got into it, we were just talking back and forth. I like face to face, but what I needed was to talk with the doctor,” he said, also noting

that an on-site staff person still takes his blood pressure, weight and other vitals and conveys them to the doctor.

Debra Howie has visited with Siddiqui only once via telemedicine but agreed that system worked just fine.

“I was rather surprised at how relaxing and easy it was,” she re-marked. “I really didn’t know what to expect but it wasn’t much differ-ent than a traditional appointment. Once Dr. Siddiqui began speaking with me it seemed as though he was right there in the same room.”

That’s a pretty common response, according to the doctor.

“Our experience tells us that tele-medicine is very well received, even with older patients who sometimes may arrive skeptical, but leave contented and well satisfied with the care they receive,” the sleep specialist explained. “Patients find

the experience fascinating and are appreciative of having the access to sleep services,” he added.

For Stutzner, the ability to schedule follow-up visits meant he was able to resolve a nagging problem with-out traveling out of town.

“I was having difficulty using the sleep apnea machine so he referred me to someone who helped me with a dental device that means I don’t need the machine. Basically I put it in my mouth at night and I’m able to sleep longer and I don’t have tubes connected to me, which would wake me up when I would move around,” he explained.

For Howie, she was able to talk to the doctor about a sleep study that was performed to see if sleep irreg-ularities were causing her to have headaches.

“It was nice to not have to travel somewhere, especially in the win-tertime, to be seen by a specialist,” she noted.

Carl Stutzner (left) consults with Dr. Siddiqui and Sleep Tech Cristina Oglesby

To schedule an appointment at the WMH Sleep Center, call (906) 253-2788.

Telemedicine brings sleep specialist to patients

For the first time in its history, War Memorial Hospital now has a full-time endocrinologist and for patients with diabetes or thyroid disease, that’s welcome news. In fact, when Kelli Virgin, D.O., joined the staff in November, she became the only endocrinologist in the entire Upper Peninsula. Endocrinology is the study of diseases related to glands and hormones, which play the role of regulator in the body. Having first studied internal medicine, Virgin saw the impact of hormones and decided to specialize even further. “I picked endocrinology because it afforded me the ability to work with more than one system. Hormones play a role in every system in your body. It challenged me to think about how they interact with systems and that allowed me to impact a lot of different things in one patient’s life,” she explained. The most pervasive condition im-pacted by hormones is diabetes. The condition occurs when the pancreas does not produce enough of the hor-mone insulin, or the body can’t use insulin properly. In her residency at St. John Providence Health System in south-eastern Michigan, Virgin realized just how drawn she was to treating patients with diabetes. “When I was in residency, I worked with patients to get on the right treat-ment protocols and make the right lifestyle modifications to get their diabetes under control,” she recalled. “I saw patients go from requiring multiple drugs and insulin to just one drug. When that’s something you can do to make somebody’s quality of life that much better and reduce their risk of cardiovascular disease and death,

Endocrinologist joins hospital staffit made an impact on me and made me say this is what I want to do.” While Virgin will see many patients with diabetes in her practice, she will also treat folks with adrenal gland problems, osteoporosis, hypothyroid and hyperthyroid diseases, and thy-roid cancer. In actuality, any ailment that relates to hormones is in her wheelhouse.

patients can book appointments Monday through Friday with Virgin via telemedicine. With the assistance of her nurse, pa-tients will sit before a computer-like device that allows them to see and talk to the physician and allows her to hear their heart, lung and stomach sounds via connected stethoscope. She can even utilize a close-up cam-era if there is something in particular she needs to examine. “We started this in early November and it’s going well. It’s just like a nor-mal visit, except that I’m on a screen,” Virgin explained. Every few months, the doctor will be on-site in Sault Ste. Marie to see patients in person. “Telemedicine allows people to have access to an endocrinologist that they wouldn’t have otherwise. They would have to deal with travel and take time off from work or make time to go out of town. This makes it so much more convenient for the patient. It really is a perk,” she noted. Whether a patient has a hormone-re-lated disease or not, there’s one piece of advice that Virgin shares with everyone. “Avoid a sedentary lifestyle. I try to talk about weight and diet with everybody. For me, a diet is super important but I don’t think of it as limiting what you eat, but rather feeding yourself nutritious food in the right quantity. No matter what, your heath is going to improve be-cause if you’re overweight, you will lose weight and if you’re malnour-ished, you’ll be nourished,” she said, adding “I’m passionate about what people eat.”

Patients who have been accustomed to seeing their primary care physician to manage issues like diabetes will find the endocrinologist to be a help-ful addition to their medical team. “The number of medications to manage diabetes has skyrocketed in the past five years. When a patient can see an endocrinologist who is familiar with these massive changes in the control of diabetes and the new procedures that can be done, they have more resources at their disposal. While the family doctor manages multiple aspects of a person’s health, I can focus on just that one thing and reduce the risk that comes from uncontrolled glucose,” Virgin said. The physician, who is a Michigan na-tive, currently resides in Mississippi. Through the beauty of technology,

Kelli Virgin, DO

To make an appointment to see Dr. Virgin, call (906) 253-0113

WMH HEALTHBEAT 5 JANUARY 2019

Healthbeat is a publication of Chippewa County

War Memorial Hospital, Inc. Stories by Angela Nebel, Summit Public Relations Strategies, LLCDesign and printing by Paul Ignatowski and Sault Printing Co.Cover photo by Picture This Photography & Design.

War Memorial Hospital is an equal opportunity provider and employer.

Pursuant to the authority granted to Det Norske Veritas Healthcare, Inc. by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, this organiza-tion is deemed in compliance with the Medicare Conditions of Participation for Hospitals (42 C.F.R. §482). This certificate is valid for a period of three (3) years from the Effective Date of Accreditation. Effective Date of Accreditation: October 26, 2017.

There are old wives’ tales told about nearly every area of healthcare and dermatology is no exception. Have you heard that eating too many sweets leads to acne? How about the theory that tanning in a tanning bed will protect you from sun damage? Anastasios Pappas, M.D., dispels these myths and more while provid-ing basic dermatological care at War Memorial Hospital. Since July, Pappas sees patients for one week each month in the Sault Ste. Marie facility. The doctor makes the trek from the St. Paul, MN area, where he has resided for more than 10 years. The Midwest native earned his medical degree from the University of South Dakota School of Medicine, performed an intern-ship at Mayo Clinic in Rochester, MN, and completed his residency at the University of Iowa hospitals and clinics. He was a partner in a South Dakota dermatology practice until 2006, when he moved to Minnesota. While Pappas doesn’t perform any surgical interventions at WMH, he does address a long list of basic

skin conditions that benefit from the expertise of a dermatologist. Patients might see him for acne, eczema, fungus, moles and warts, pediatric conditions, poison ivy and other plant rashes, psoriasis, rosacea, skin cancer, and infections.

safer than lying in the sun, which the doctor discourages. What he is a fan of, however, is sun screen. “SPF 30, applied every two hours if you are spending time on a beach is what is recommended. On a typical day, you might only apply it in the morning and again in the afternoon, but reapplying is good maintenance,” Pappas said. There are other ways that patients can care for their skin. “Smoking damages your collagen and leads to wrinkles but it also increases your risk of squamous cell carcinoma,” the doctor said, outlining two good reasons to quit smoking. He also encourages patients to cover their head from the sun. “Good maintenance means apply sunscreen, don’t smoke, and wear a hat,” he said simply. While patients need to focus on following those principles of good skin care, scientists in the field of dermatology are making all sorts of new discoveries. With more than 5,000 diseases and 3,000 plus rashes, study of the body’s largest organ is vigorous and fruitful. “There have been a lot of new op-tions in the last five years for people with psoriasis,” Pappas said, noting “it has really expanded the therapeu-tic options available to the patient.” The variety of conditions is part of what attracted Pappas to the world of dermatology. “It’s also nice because you see and treat all age groups, from babies to 100. Our patients are usually healthy but need to improve their quality of life,” he said.

Dr. Pappas

To schedule an appointment to see the dermatologist, call (906) 253-0113

New WMH dermatologist shares do’s and don’ts

So far, the doctor has witnessed a trend of seeing patients for skin cancers and pre-cancers here as com-pared to other parts of the U.S. “That’s likely because of the outdoor nature of the population, the number of outdoor activities, with people fishing and enjoying the water,” he explained. And what about those myths? Pappas said that diet doesn’t really play a major role in acne. Instead, things like plugged oil glands and bacteria can cause inflammation. There are over-the-counter and prescription medicines that can best address those problems. Tanning before a vacation, he explains, doesn’t provide any pro-tection. Your skin can still burn just as easily and, considering booths use the same kind of ultraviolet light that we get outdoors, it isn’t any

It is the diagnosis that everyone fears. A word that some hate to utter, preferring instead to say “the c-word” and yet many of us aren’t doing enough to avoid it. Cancer kills people all over the world and one local doctor believes there is something we can do about it.

“I see a good percentage of people smoking. Everywhere in the coun-try, obesity is an epidemic. Alcohol consumption is everywhere,” said Dr. Ahmed Maksoud, the oncologist at WMH’s Cancer Care Center. Reeling off the list, the phy-sician put it plainly: “People are dying from reasons we can avoid.”

Referencing infor-mation from the American Society of Clinical Oncology, Maksoud gave more detail about each of the three biggest risk factors.

Smoking, he noted, relates to almost every cancer. Lung, oral, larynx, esopha-geal, bladder, kidney, pancreatic, small bowel and colon cancer all have smoking attributed as a risk factor.

“The risk isn’t limited only to the person who smokes, but also the people who surround them, includ-ing children, spouse, neighbors and co-workers. It is also important to note that all types of tobacco bring cancer risk. People think if they chew tobacco, it is better but the risk of oral cancer goes up dramatically. Smoking cigars, even without in-haling, is still a risk,” the oncologist explained.

CANCER PREVENTIONYour 3 biggest risk factors

The National Cancer Institute points to research that shows that “people who use both alcohol and tobacco have much greater risks of developing cancers of the oral cavity, pharynx (throat), larynx, and esoph-agus than people who use either alcohol or tobacco alone.”

The final of the “big three” risks for cancer is obesity. The risk for breast, colon, endometrial and prostate cancer all increases when the patient is obese. For most, obese is defined as a body mass index (BMI) of 30 or higher.

“Less red meat, more vegetables and fruits, more nuts and whole grains. It’s all about calories in and out,” the doctor remarked.

Ranking the risk factors is pretty straightforward and may provide some guidance to those who want to move the needle in the right direction.

If you are a smoker, that’s the num-ber one risk factor. Quitting smoking should be priority number one. The second greatest risk comes from obe-sity. Working to control weight and address caloric intake is key. Finally, alcohol consumption is the third big-gest risk. Reducing consumption or even taking the route of a teetotaler is the recommendation for those trying to significantly reduce cancer risk.

In addition to treating patients, Maksoud hopes to become active with area schools to help future gen-erations avoid the aforementioned risks.

“I see people come in suffering from cancer pain and emotional stress and financial distress and when you see that situation, you think about how we can prevent this.”

pancreatic, small bowel and colon pancreatic, small bowel and colon

Maksoud is hopeful that education about the risk of smoking starts early and is part of what they teach in schools. “If we can explain the damage to the generations at the elementary, middle and high school and make that part of their regular curriculum, it will help achieve our goal,” he said.

The good news is that quitting smoking is linked to a longer lifespan. “If you quit smoking for 10 years, you get 15 more years of life,”

Maksoud explained.

Alcohol consump-tion is another risk

factor that can be avoided. Asked about the line between safe consumption and abuse, Maksoud pointed to the “Million Women Study” that took place in 2009 and stated that “low to moderate alcohol

consumption among women is associated with a statistically significant increase in cancer risk.”

In fact, the study points out that for every 1,000 women who consumed one drink of alcohol per day, 15 incidences of cancer occurred.

What is perhaps even more trou-bling is the combination of the two risk factors of smoking and alcohol. Maksoud referred to the combina-tion as “synergistic.”

Your local health care providers

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EMERGENCY SERVICES *K. Lufkin, MD *J.M. Neri, DO *M. Panetta, MD *K. Raycraft, MD *A. Seidner, MD GENERAL SURGERY K.L. Mc Cullough, MD (906) 635-1048WMH General Surgery *J. Adair, MD *P. Rechner, MD (906) 253-9770HOSPITALIST *R. Farha, MD *A. Luka, MD *C. Murphy, MD *B. Samuel, MDINFECTIOUS DISEASEWMH Infectious Disease *A. Luka, MD (906) 253-0113NEPHROLOGYWMH Nephrology *M. Haider, MD (906) 632-5824OB/GYNECOLOGY WMH Women’s Health *S. Amo, MD *N. Cristof, MD *A. Donmyer RN, CNM *M. Guevara, DO (906) 635-3002ONCOLOGY WMH Oncology *A. Maksoud (906) 253-2685OPHTHALMOLOGY Grand Traverse Ophthalmology M. Madion, MD D. Thuente, MD P. vonKulajta, MD J. Wentzlo�, MD (906) 635-9802

ORTHOPEDIC SURGERYWMH Orthopedics *Jaimee Brow, NP *S.M. Woolever, DO (906) 632-4740PAIN MANAGEMENTWMH Pain Management - Kinross *A. Alshab, MD 906-632-5849WMH Pain Management - Sault *A. Daha, MD 906-253-0113PATHOLOGY C. Liu, MD (906) 635-4434PEDIATRICS *P. Newhouse, MD (906) 635-4401WMH Pediatrics *R. Beckman, DO (906) 253-2605PODIATRIC SURGERY *R. Sehgal, DPM (248) 553-4040PULMONARY/CRITICAL CAREWMH Pulmonology *E. Al-Ghandour, MD (906) 253-2652RADIOLOGYCedar Straits Medical Assoc., PC G. Bowman, MD R.J. Duman, MD M. Jacoby, MD B. VanAssche, MD (906) 635-4438SLEEP MEDICINEWMH Sleep Medicine *J. Sand, DO *F. Siddiqui, MD (906) 253-2788UROLOGYWMH Urology *B. Gier, PA (906) 632-5808

PRIMARY CARE (cont.)Drummond Island Family Health Care, PC C. Cordray, CFNP, MSN (906) 493-6644Drummond Island Medical Center *C. Richwine, NP (906) 493-5221 ALLERGIST/ASTHMA Great Lakes Allergy & Asthma Center, PC P. Ranta, MD (906) 253-0400ANESTHESIOLOGY *Joe Beccario, CRNA *J. Carlson, CRNA *A. Daha, MD *D. Marjomaki, CRNA *N. Newhouse, CRNA *J. Slade, MD *F. Winkler, MD (906) 635-4589BARIATRIC (WEIGHT LOSS)Advanced Surgical Care *J. Adair, MD (906) 253-9770BEHAVIORAL HEALTH SERVICESWMH Outpatient Psychiatry *L. Armstrong, NP *E. Hansen, PA *Z. Masood, MD *D. Wilson, NP *D. Tetzla�, JD, PsyD (906) 253-0108CARDIOLOGY Michigan Heart & Vascular K. Bobish, DO D. Miranda, MD N. Overton, MD J. Ricci, MD (906) 253-0668DERMATOLOGYWMH Dermatology *A. Pappas, MD (906) 253-0113EAR, NOSE & THROATSault Otolaryngology M. Wallace, DO (906) 259-0244

WALK-IN SERVICESCommunity Care Clinic (906) 635-4401WMH Community Care - Kinross *C. Harris, MD *D. Russo, NP (906) 495-1344WMH FastCare at Meijer (906) 253-0137PRIMARY CARE P.W. Niemi, DO (906) 632-1100Bay Mills Health Center D. Furr, NP D. Maloney, MD A. Rivard, NP (906) 248-5527Bridgeview Family Medicine T.E. O’Connor, MD J. Peterman, MD (906) 253-9374Lakeview Internal Medicine T. Chander, MD (906) 635-9090 LSSU Health Care Center S. Bartz, PA-C E. Meehan-Amo, PA (906) 635-2110E.J. Ranta, MD (906) 632-6823Riverside Medical Associates M. Hanna, NP R.H. Mackie, MD T. Malloy, FNP-BC P. Nichols, CFNP J.P. Ockenfels, DO T.N. Tetzla�, DO (906) 632-1800 Sault Tribe Health Center C. Behling, CFNP J. Garlinghouse, MD E. Javellana, MD G. Maloney, MD V. Sherman, MD L. Styer, MD (906)632-5200Superior Family Medical J.M. Pahn, MD (906) 632-0370 VA Community BasedOutpatient Clinic Colleen Burton, NP (906) 253-9383WMH Family Care – Cedarville *A. Steele, PA (906) 484-2295WMH Primary Care – Sault *L. Land, NP *K. Sawruk, NP (906) 253-2665

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PERMIT NO. 22

* Services provided by War Memorial Hospital