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SAINT AGNES Fall 2006 SCENE Soul survivor PAGE 4 A breast cancer patient’s journey

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SAINT AGNES

Fall 2006 SCENE

SAINT AGNES

Fall 2006 SCENE

soul survivor

Page 4

A breast cancer patient’s journey

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FeaturesFrom discovery to recovery. Read about one woman’s experience with breast cancer and the lessons she learned.

Heart health: what’s in the numbers. Confused by all the numbers related to heart health? Find out what they mean and which ones you need to know.

setting new standards in icu care. Saint Agnes participates in an innovative project to dramatically improve patient safety.

lung health. Learn the truth behind the harm of secondhand smoke and what you can do to protect your lungs.

SAINT AGNES HEALTH SCENE is published as a community service for the friends and patrons of:

saint agnes Medical center 1303 E. Herndon Ave. Fresno, CA 93720 (559) 450-3000 www.samc.com

President and Chief Executive Offi cerMathew abraham

Vice President, Planning, Marketing and Business DevelopmentJames vandevelde

Director, Corporate Communicationskelley Babigian sanchez

Manager, Graphics/Publicationsdouglas Hembd

Senior Communications SpecialistJaime Huss

Communications SpecialistPatricia adams

Information in SAINT AGNES HEALTH SCENE comes from a wide range of medical experts. Models may be used in photos and illustra-tions. If you have any concerns or questions about specifi c content that may affect your health, please contact your healthcare provider.

Copyright © 2006Coffey Communications, Inc.HSM19178h

In step with your healthChances are, someone you know has had breast cancer. More than 200,000 women are expected to be diagnosed this year alone. But thanks to advances in early detection and improved treatment, death rates from breast cancer have been on the decline.

In honor of October being Breast Cancer Awareness Month, we’ve given special attention to breast health in this edition of Saint Agnes Health Scene. Inside you’ll read about our new Diagnostic Breast Center – which features the latest technology for breast cancer diagnosis and intervention – and the inspirational story of one local woman who’s proud to call herself a breast cancer survivor. You’ll also learn about Passionately Pink – a unique way to raise awareness and funds for breast cancer research.

This Health Scene also covers a range of other health and wellness topics. You’ll discover how to keep certain numbers – like your cholesterol and blood pressure – in check to maintain a healthy heart. Read on to learn about the importance of avoiding secondhand smoke and the benefi ts of a high-fi ber diet.

As you strive to improve your health, we at Saint Agnes work with you. When it comes to your health, you and your loved ones deserve the best. We are committed to providing nothing less.

Sincerely,

Mathew AbrahamPresident and Chief Executive Offi cer

Fall 2006

Mathew abraham President and ceo

Fashion for a causePage 7

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SHE DISCOvERED the devastating truth by accident. At age 40, veritta L. Holloway wanted a cosmetic breast lift. In-stead, she learned she had breast cancer.

The dark journey into unfamiliar territory eventually led to enlighten-ment – transforming Holloway, with her admittedly “sloppily” performed self-exams and “zip-to-zero” breast care knowledge, into a passionate advocate for early detection and education.

diagnosis and treatMentBreast cancer was the last thing on this healthy woman’s mind in August 2005. “I turned 40 and decided I wanted a physical tune-up – a breast lift, tummy tuck and liposuction,” Holloway says. Her doctor required her to have a preopera-tion mammogram.

On fi ve consecutive nights prior to her mammogram, Holloway had intense dreams about her breasts. She could not remember them clearly but believed they were messages from her mother, who had died of liver cancer fi ve years ear-lier. Around the time of her screening, Holloway also noticed tenderness under her right armpit. ultimately, the Clovis resident canceled the breast lift but kept her mammogram appointment.

After her screening, Holloway received a letter requesting a second mammogram, which was immediately followed by a diagnostic ultrasound. “I doubled over in shock, and I started crying,” the mother of three young children says. The next day she underwent a core biopsy.

Within 24 hours, Holloway was di-agnosed with stage IIB cancer and was informed that it was fast-growing or bad-acting. “It wasn’t a gigantic shock,” she says. “I had already accepted that I had breast cancer. It was almost a relief, because now I could take action. Hope is the most important thing to a cancer patient.”

Holloway’s fi rst treatment was surgery, performed at Saint Agnes by general surgeon Margaret Hadcock, MD. It included a successful lumpectomy and an auxiliary lymph node dissection. (A lumpectomy is the removal of a cancerous

A breast cancer patient’s journey from discovery to recovery

SoulsurvivorEarly detection: The best defense against breast cancerFor 11 years, Saint Agnes Medical Center has been promoting early detec-tion and breast cancer prevention as a proud sponsor of KSEE Channel 24’s BuddyCheck, a program that encourages Central Valley women to perform their breast self-exams every month and to remind their “buddies” to do the same.

Since its inception in October 1995, more than 30,000 women have registered for BuddyCheck 24. If you aren’t one of them, sign up yourself and a friend today by visiting www.ksee24.com or calling (559) 455-2224.

BuddyCheck 24 is jointly sponsored by KSEE Channel 24, Saint Agnes Medical Center and Longs Drugs.

defense against breast cancer

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New Diagnostic Breast CenterOffering the latest in diagnosis and treatment Fear is a universal emotion felt by women facing a breast cancer diagnosis. Understanding this, Saint Agnes Medical Center has taken steps to make the process from screening and diagnosis to treatment as compassionate and comfortable as possible.

This includes the recent open-ing of our new state-of-the-art Diagnostic Breast Center, housed inside Plaza Surgical Center (1105 E. Spruce Ave.). Here the most advanced technology for physical healing comes together in a beautiful, soothing environ-ment conducive to our patients’ spiritual and emotional needs.

convenient servicesAmong the services offered at the Diagnostic Breast Center are minimally invasive stereotactic and ultrasound procedures that provide a precise diagnosis for breast problems, often without the need for surgery. However, if a surgical biopsy is required, patients are conveniently accom-modated without having to leave the building, thanks to a partner-ship with Plaza Surgical Center.

While still in surgery, an on-site pathologist consults with the surgeon to confirm that the tumor has been successfully removed, and biopsy results are processed within 24 hours.

More >> To learn more about the Saint Agnes Diag-nostic Breast Center, call (559) 450-3833.

A breast cancer patient’s journey from discovery to recovery

Soul

lump from the breast. Auxiliary lymph node dissection is the removal of lymph nodes under the arm.)

After the procedure, she underwent six months of chemotherapy, followed by two months of radiation five times a week. “It wasn’t as bad as people believe,” Holloway says.

The treatments left her cancer-free.

take screenings seriouslyThe ordeal also led to significant lifestyle changes. Previously, Holloway did not think much about mammograms. Now, the breast cancer survivor knows they are vital to living a high-quality life.

“If you had cancer last year but the screening didn’t detect it at that time, you can still survive when it’s detected this year – if you get that mammogram once a year like you should. Skip a year and it could prove fatal,” Holloway says. “If it’s a choice between getting my breasts squeezed or death, squeeze me every week!”

Likewise, this full-time mother now takes self-exams seriously. Previously, she was not entirely familiar with the feeling and characteristics of her breasts. Discouraged by dense tissue and a lumpy feel, she performed the exams “very sloppily.” Today, she does them thoroughly.

Through it all, Holloway’s level of breast care education increased, as she was forced to make quick, informed de-cisions about her own health care. She consulted the Internet. She spoke with doctors, survivors, patients and friends. She read books. “It was horrendous and overwhelming,” Holloway says.

“Knowledge is my way of gaining control,” she says. “Now I can tell you percentages and statistics about breast cancer.” However, she warns that patients and their loved ones should exercise caution when obtaining information because much of it is untrue, incom-plete or wrong. Ensuring that sources are legitimate is key.

lessons learnedThis articulate survivor also learned the

importance of putting herself and her needs first. “When I became a mom, my focus changed,” the gregarious 41-year-old says. “I didn’t take vitamins but I made sure my kids ate right and were healthy.” In the end, “you can’t do much for them if you’re not well.”

Three pieces of advice stem from Holloway’s ordeal. First, “take care of your body and be good to yourself – all the time. I was taking care of my kids and not myself.”

Second, “if you’re in treatment, what-ever you did during pregnancy will probably make you feel good. Soothing baths carried me through chemo.”

Third, “I don’t care if you just have the flu – fight. Always fight. Be your own advocate. Do what you’d do for your child.”

Taking her own advice, she continues fighting for her health.

Throughout all the overwhelming cancer clutter that invaded her life, Hol-loway walked away with one great lesson: “Do what’s being recommended to the masses – as long as you do the mammo-gram and self-exam, you’re OK.”

one year after being diagnosed with breast cancer, veritta Holloway is proud to call herself a survivor. 5

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IN 1983 NANCY BRINKER created the fi rst Susan G. Komen Race for the Cure® in memory of her older sister, Suzy, who died of breast cancer. The race was held in Dallas with 800 participants. Today the Komen Race for the Cure Series is the largest 5K run/fi tness walk in the world, with more than 100 races held throughout the united States annually.

Fresno is proud to host one of them. Join Saint Agnes Medical Center in supporting the Komen Race for the Cure at California State university, Fresno, and be among the more than 1 million people to “step out” this year in the fi ght against breast cancer.

The event will be held Saturday, Oct. 28. Choose from a 5K run and walk or a 1-mile walk, with a special race just for kids. The cost

is $15 for adults and $10 for children 12 and younger. For more infor-mation or to register, call (559) 229-4255 or visit www.komen-fresno.org.

FOR THE SECOND YEAR in a row, Saint Agnes Medical Center has been ranked in the top 5 percent of hospitals nationwide for clini-cal excellence in women’s health services, based on a study issued by HealthGrades, the nation’s leading independent source for healthcare quality information.

In the HealthGrades Third Annual Report on Women’s Health Outcomes in U.S. Hospitals, Saint Agnes was recognized as a recipient of the 2006-2007 HealthGrades Wom-en’s Health Excellence AwardTM

and received a fi ve-star rating for women’s health services, which in-cludes cardiac and stroke outcomes for women, as well as maternity care. The hospital is the only 2006-2007 Women’s Health Excellence Award recipient in the Central val-ley area.

“We are extremely proud of this designation,” says Mathew Abra-ham, Saint Agnes Medical Center president and chief executive offi cer. “It demonstrates the shared commit-ment of our physicians and staff to providing our patients with clini-cal excellence for the best possible outcomes.”

Saint Agnes earns top women’s health ranking

Go pink in the name of breast cancer

Walk, run or wear pink

More >> The complete mater-nity care and women’s health services ratings are available on the HealthGrades Web site, www.healthgrades.com.

saint agnes Foundation gets pretty in pink for the cause. From left, teri amerine, kathy carlino, denee conner, Marti simpson, Juliana Pizura and gina anderson show their passion for pink.

YOu DON'T HAvE to wear walking shoes to help raise breast cancer aware-ness. Wear anything, as long as it’s pink.

To coincide with National Breast Cancer Awareness Month in October, the Komen Foundation is kicking off a new fundraising and education program, Pas-sionately Pink for the CureTM. The program encourages companies, schools and organizations to help fi nd a cure for breast cancer by raising money to support breast cancer research, education, screening and treatment.

Saint Agnes Medical Center is pleased to participate in this creative new program. Interested employees should contribute $5 or more to the Komen Foundation and wear pink to show their commitment to fi nding a cure.

If you’d like to join Saint Agnes on Friday, Oct. 20, and show your passion for pink fashion, sign up today by calling (559) 450-2090.

Or you can register your group or business for another day in October by visiting www.komen.org.

Passionately Pink for the Cure

Step out in the fi ght against breast cancer

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“The Power of Fashion”Saint Agnes Associates Fashion and Entertainment Event

10:30 a.m., saturday, nov. 4, the spa at Fig garden village

WHETHER YOu’RE A FASHION guru or a novice, you won’t want to miss the Saint Agnes Associates Fashion and Entertainment Event – “The Power of Fashion.” Join us Saturday, Nov. 4, in front of The Spa at Fig Garden village.

See the latest from stores throughout the village, such as B.B. Pepper Collec-tions, Banana Republic, Coach, Coldwater Creek, J. Jill and many others. Presenting sponsors include Fresno Lexus and Fig Garden village.

Event proceeds will benefi t Saint Agnes Holy Cross Center for Women, a daytime respite for underserved women and children in downtown Fresno. Last year’s event raised more than $70,000 for the center.

The high-style day begins with a no-host social hour at 10:30 a.m., followed by the program at noon. Ticket prices start at $50 per person.

More >> For more information or to make reservations, call Saint Agnes Foundation, (559) 450-2040.

Fashion for a

cause

Name

Address

City State ZIP

Phone

E-mail

Win tickets to “The Power of Fashion” and $100 to dress yourself!

(please print)

See the latest in fashion and enjoy a little extra spending money. One lucky winner will receive two tickets to “The Power of Fashion” (valued at $50 each) plus a $100 gift card to Fig Garden Village – compliments of Saint Agnes Medical Center. Fill out this form for a chance to win!

To enter, fax this form to Saint Agnes Health Scene, (559) 450-2122, or mail it by nov. 1 to: Saint Agnes Health Scene, Saint Agnes Medical Center Communications Department, 1303 E. Herndon Ave., MS 915, Fresno, CA 93720.

congratulations to rosie lares, winner of a $100

Pottery Barn gift card.

last issue’s winner:

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numbers, numbers, too many numbers – phones,

social security, Pin. if you have trouble remem-

bering these, then focus on five that really matter,

for the sake of your health.

Numbers to learn – and learn to control – for a healthier, longer life are these: blood pressure, cholesterol, blood sugar, body mass index (BMI) and waist measurement.

“Being aware of these numbers, what range you should be within and then reaching them are important starts to beating heart disease,” Fresno cardiologist Lakhjit Sandhu, MD, says.

Let’s look at each one.

Blood PressureBlood pressure is the force blood places on artery walls when the heart beats (systolic pressure, the first number) and when it rests (diastolic pressure, the second number).

“It’s clear that the risks of heart at-tack and stroke are tied to high blood pressure,” Dr. Sandhu says.

High blood pressure often has no symptoms, making regular blood pres-sure checks crucial.

Dr. Sandhu says people in their 20s and 30s should have their blood pressure checked at each doctor’s visit – or at least every five years. Since high blood pressure becomes more common as people age, he suggests more frequent checks as people get older.

A normal blood pressure reading is 119 mm Hg systolic

H e a l t H y H e a r t

What’sin the

Blood pressure, cholesterol, blood sugar, body

mass index and waist measurement are all

important clues to heart health.

or lower and 79 mm Hg diastolic or lower. High blood pressure, or hypertension, is defined as 140/90 mm Hg or higher. Numbers between normal and high are considered prehypertension.

To manage elevated blood pressure, focus on eating fruits, vegetables and nonfat or low-fat dairy products. Moderate your consumption of total fats, and limit saturated fats and cholesterol. Limit sodium intake to no more than the equiva-lent of about a teaspoon per day. Maintain a healthy weight, and lose weight if you need to. At the same time, work up to at least 30 minutes of brisk exercise each day.

cHolesterolCholesterol is a fatlike substance in the blood that’s involved in several important functions, such as building cell walls, aiding digestion and producing hormones.

“The data is clear-cut: High cholesterol values are as-sociated with an elevated risk of heart attack and stroke,” Dr. Sandhu says.

The two main types of cholesterol – low-density lipo-protein (LDL) and high-density lipoprotein (HDL) – play different roles.

LDL, or bad cholesterol, can form fatty deposits inside arteries that nourish the heart or brain. Blocked heart or brain arteries can cause a heart attack or stroke.

numbers

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i t ’ s y o u r M o v e

Activity benefits the heartIf exercise were a pill, nearly everyone would want to take it.

Exercise is one of the best things you can do for your heart. It helps reduce total cholesterol, lower blood pressure and cut the risk of diabetes, and it helps you maintain a healthy weight.

Experts offer these ideas for getting started:n Start slowly, especially if you haven’t been active

for a while. Don’t try to make up for your previous inactivity all at once.

n Schedule exercise at the same time each day so that it becomes a habit.

n Work up to whatever amount of activity your doctor recommends. The American Heart Association says most people should get at least 30 minutes of exercise most or all days of the week.

n Keep things interesting by trying different activi-ties. Walking, biking or swimming can be fun, but so can working in the garden.

n Exercise with a friend or a family member, or take an exercise class.

n Stop exercising if you have severe pain or swelling, but expect a little muscle soreness at first.

n If you have to stop exercising for a while, don’t get discouraged. Just start over again and work up to your previous level.

keeping active is one of the best things you can do for your heart. exercise can help you maintain a healthy weight, reduce total cholesterol and lower blood pressure, among other benefits.

HDL, or good cholesterol, helps clear arteries of these deposits.

Generally, the lower the LDL number, the better. The American Heart Association says an LDL of less than 100 milligrams per deciliter (mg/dL) of blood is optimal, 130 to 159 mg/dL is borderline high and anything above that is high. For those with established coronary artery disease, LDL levels should be below 70.

Since HDL helps protect against heart disease, higher numbers are better. Men have an average HDL of 40 to 50 mg/dL, while women average between 50 and 60 mg/dL. Levels below 40 mg/dL are considered low for both men and women and increase the risk of heart disease.

If you need to lower your LDL, eat a diet low in saturated fats and cholesterol, manage your weight and exercise. If these changes alone aren’t enough, medications may help.

If you need to raise your HDL, focus on exercising for at least 30 to 60 minutes a day on most or all days of the week. Losing weight if you’re overweight and not smoking can also help.

Blood sugarAfter a meal, food is broken down into a sugar called glucose, which is carried by the blood to nourish the body’s cells.

get regular health screenings so you’ll know how your numbers measure up for a healthy heart. your doctor can tell you how often you need to be screened.Continued on page 10 9

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Too much glucose in the blood damages nerves and blood vessels, which can lead to heart disease. A person with high glucose levels has diabetes.

“Findings show that higher blood sugar readings are con-nected with hardening of the arteries and an added risk for heart attack or stroke,” Dr. Sandhu says.

Two common tests can determine blood sugar levels: the fasting plasma glucose (FPG) test and the oral glucose tolerance test (OGTT.)

Both tests measure blood sugar after an eight-hour fast. With OGTT, however, a second measurement is taken two hours after you swallow a special glucose beverage. FPG is more convenient; OGTT is more sensitive.

A normal FPG is 99 mg/dL or below. Anything above 107 mg/dL is considered diabetes.

A normal OGTT reading is 139 mg/dL and below. Any-thing above 199 mg/dL is diabetes. Readings of 140 mg/dL to 199 mg/dL are considered pre-diabetes.

Lifestyle changes that help control blood sugar are similar to those that help manage high blood pressure and cholesterol – namely, weight loss if you’re over-weight; a low-fat, low-calorie diet; and regular exercise. If these measures fall short, your doctor may prescribe medications.

BMi and waist MeasureMentBMI is a calculation that evaluates weight relative to height to determine whether you’re of normal weight, overweight or obese. Likewise, a larger waist circumference usually means more body fat.

“Statistics show that people with greater waist circumfer-ence are more likely to develop heart disease and diabetes,” Dr. Sandhu says. “A higher BMI reading is also connected with an increased risk of heart attack and stroke.”

Continued from page 9

More >> To learn more about heart health, go to the American Heart Association Web site at www.amhrt.org.

Tips for preventing a supersized waistline You might remember how many pints are in a quart or how many ounces are in a pound. But how many servings are in a portion?

When it comes to restaurant food, packaged food and even food served at home, portion sizes seem to be growing. Not surprisingly, so are our waistlines.

In fact, food portions served in the United States have never been bigger, according to the American Institute for Cancer Research. And the more food we’re served, the more we eat, which leads to weight gain and an increased risk of heart disease, diabetes and some cancers.

Portions vs. servingsA portion is the amount of food you eat. A serving is a standard amount set by the U.S. government. Here are some ways to visualize a serving of:n Meat (3 ounces) – a deck of cardsn Salad greens (1 cup) – a baseballn Fresh fruit (half cup) – half a baseballn Peanut butter (2 tablespoons) – a pingpong ball

eat out wiselyResearchers say that restaurant portion sizes have grown substantially over the years. To cut those restaurant portions down to size:n Eat an appetizer as your meal. n Split your meal with a friend or order a half

portion.n Ask for half the meal to be boxed before you begin

eating.n Eat slowly, savor the food, and stop eating when

you feel full.

Need help knowing your numbers?Saint Agnes Medical Center is pleased to offer the following profiles to help you stay in touch with your health.

For more information or to sign up, please call (559) 450-2010.

Fitness ProFile laB PanelLearn your blood lipid profile, including total choles-terol, HDL, LDL and triglycerides. The cost is $60.

Personal wellness ProFileGet a personalized report of your health risks, based on your height and weight, blood pressure, total cholesterol, a body fat analysis, and a self-report questionnaire. The cost is $45.

A BMI of 18.5 to 24.9 is considered healthy. Between 25 and 29.9 is overweight, while 30 and above is obese. Waist circumference becomes a health concern when it exceeds 40 inches for a man or 35 inches for a woman. To calculate your BMI, visit www.samc.com and click on “Cool Tools.”

Like controlling high blood pressure, cholesterol and blood sugar, bringing your BMI and waist measurement down involves proper diet and exercise.

Putting it all togetHerWhile medications may also be needed – especially if you have diabetes or have had a heart attack – making lifestyle changes is always the first option if you want to enjoy the perks of a long life, Dr. Sandhu says.

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in ICU care

NEW STANDARDS STANDARDSSTANDARDSSetting

SSHE’S BEEN CALLED a walking miracle. Experiencing complications from cancer and other illnesses, Betty Furr, of Squaw valley, was admitted to Saint Agnes Medical Center’s Intensive Care unit (ICu) in October 2005. There she was in a coma for eight weeks, fi ght-ing organ failures and health issues. But thanks to an innovative project that the Saint Agnes ICu is part of, Furr is alive and making tremendous strides.

tHe keystone ProJectThe Saint Agnes ICu is among 127 ICus nationwide, and the only facility west of Iowa, to participate in the Keystone In-tensive Care unit Project. The Michigan Hospital Association and safety experts from Johns Hopkins university launched Keystone in 2003 to reduce medical er-rors and improve patient safety.

Participating hospitals use telephone conference calls and Web-based edu-cational tools to learn about and share evidence-based interventions to improve the quality of care.

“It’s essentially a huge medical chat room where we can cross-reference, share material and ask questions,” says Joyce Eden, RN, MHA, director of Critical Care Services, Respiratory Care and the Transitional Care unit at Saint Agnes.

The project has proven to be an over-whelming success, with nearly 1,600

lives saved at participating ICus between March 2004 and June 2005.

Saint Agnes’ involvement in the Keystone Project began in spring 2004. Along with other participating ICus, the Medical Center implemented a number of interventions to create a culture of safety – such as elevating the heads of patients who need mechanical ventilators to breathe, providing frequent oral care and preventing stress-induced ulcers.

draMatic iMProveMents“Because patients coming into an ICu are so sick, it’s natural that a percentage of patients will end up with additional infections,” Eden says. “But institutions participating in Keystone have been able to drop infections well below national averages.”

Thanks to the collaboration of many individuals involved in a patient’s stay – including physicians, nurses, respiratory therapists, social workers and house-keepers – the Keystone Project has re-sulted in dramatic improvements at Saint Agnes. For example, the Medical Center’s ventilator-associated pneumonia rate fell

more than 80 percent in four years.In Furr’s case, ICu staff were able

to identify potential risks early on, implement practices learned through the Keystone Project, and ultimately prevent infections. That stood out to Furr’s husband, Bill, who was at Betty’s bedside every day. “I was overwhelmed by the staff members – their care and professionalism,” he says. “She couldn’t have been in better hands.”

Progress continuesNow back at home, Furr continues to recuperate and relearn how to walk on her own, and she is eager to return to gardening all five acres of their home.

At Saint Agnes, staff members contin-ue to work diligently with the Keystone Project. “We have access to evidence-based protocols that have become so signifi cant, patients who get admitted today to the ICu at Saint Agnes have better outcome opportunities than those admitted to many other ICus,” Eden says. “And ultimately, the biggest win-ners are the patients.”

The Keystone Intensive Care Unit Project has

saved nearly 1,600 lives at participating ICUs

between March 2004 and June 2005.

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l u n g H e a l t H

Y

l u n g H e a l t HAvoid smokesecondhand

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Is it asthma or allergies? Testing can help tellYou’re coughing, your chest feels tight, and you’re having trouble breathing. It could be just a cold. But these also could be signs of asthma or allergies.

If you’re unsure what is causing your symptoms, seeing your doctor is a good idea. He or she can use various tests to determine if you have asthma or allergies.

asthma is a condition that causes your airways to swell and narrow. It can cause you to wheeze, cough and feel short of breath. Attacks may be triggered by exercise, dust, viral infections and other conditions, such as allergies. The attacks can vary in length, frequency and severity.

To diagnose asthma, your doctor will likely ask about your symptoms and listen to your breathing. You also may be given spirometry – a test that mea-sures airflow in your lungs.

Your doctor may also recommend:n A test that uses a handheld peak-flow meter to

check your breathing over a period of one to two weeks.

n Allergy testing to find out what allergens might affect you.

n A test to see how your airways react to exercise.n Tests to see if you have gastroesophageal reflux

disease (GERD) or sinus disease – both of which can produce symptoms similar to asthma.

n Chest X-rays or an electrocardiogram to find out if other lung diseases or heart disease could be causing asthma symptoms.allergies are triggered by substances called al-

lergens, which include dust mites, pollen, smoke and other airborne particles. Certain foods can also trigger allergies.

To treat allergies effectively, your doctor will have to determine what triggers your allergic reactions. Most allergy tests involve exposing your skin or blood to tiny amounts of different allergens and looking for reactions, such as skin swelling or redness.

Some common allergy tests include:n A prick test. An allergen is placed in the skin by

making a small puncture.n An intradermal test. An allergen is injected under

the skin with a syringe.n A scratch test. An allergen is dropped onto a

scratch on the skin.n Challenge testing. An allergen is eaten or inhaled.n A radioallergosorbent test (RAST). Blood is drawn

and exposed to allergens.For more information about asthma and allergy

testing, visit the American Academy of Allergy, Asthma and Immunology Web site at www.aaaai.org.

Sources: American Academy of Allergy, Asthma and Immunology; National Heart, Lung, and Blood Institute

YYOu’vE NEvER SMOKED in your life. That’s good. But it doesn’t necessarily mean you’re immune to the many health problems linked to smoking, such as heart disease and lung cancer. All you have to do is be around someone else’s smoke, and you put your health at risk.

“Secondhand smoke is actually much dirtier than what smokers directly inhale,” says Saint Agnes respiratory therapist Jodi McEdward, RRT-NPS, RPFT, AE-C.

Secondhand smoke is especially harmful to children who are still developing physically and have higher breathing rates than adults.

wHat is it?Secondhand smoke is a mixture of the smoke from the burn-ing end of a cigarette, pipe or cigar, and the smoke exhaled by smokers. When you’re exposed to it, your body absorbs nicotine and other harmful chemicals.

“Someone exposed to secondhand smoke doesn’t have the benefit of a filter, like the smoker finds in a cigarette,” McEd-ward says. “And if you’re a nonsmoker inhaling secondhand smoke, your body hasn’t adapted to chronic exposure of these toxins, making your body more sensitive to the bad effects.”

Along with increasing your risk for lung cancer, second-hand smoke is associated with:  Chronic and severe heart disease  Irritation of the eyes, nose and throat  Respiratory problems such as coughing, excessive phlegm, chest discomfort and reduced lung function.

Children exposed to secondhand smoke are at an increased risk of getting asthma, ear infections and respiratory infections, such as bronchitis or pneumonia. Secondhand smoke has also been linked to sudden infant death syndrome (SIDS).

How can i avoid it?While smoking is now banned in many public places, it’s still not easy to avoid secondhand smoke. But these steps from the American Lung Association (ALA) can help:  Ask people to go outside when they smoke.  Tell family, friends and co-workers that you do not want them to smoke around you. Prohibit smoking in your vehicle. Make sure your child’s day care, school and after-school programs are smoke-free.

“If you’re smoking, the best gift you can give your loved ones is to quit,” McEdward says. “And as you work on quit-ting, be sure not to smoke around children or other family members.”

want to quit sMoking? The ALA, in conjunction with Saint Agnes Medical Center’s Respiratory Care Department, holds a regular smoking cessation program called Freedom From Smoking®. This eight-week program includes:  Group support  Techniques to handle stress management and relaxation  Tips for dealing with weight control and social issues surrounding smoking.

More >> For more information about upcoming classes, call the ALA, (559) 222-4800.

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Y

Well-fitting shoes can help you prevent foot problems. Keep in mind these tips when you buy new shoes: n Shop late in the day; feet can swell as the day passes.n Have your feet measured each time you buy shoes.n Shoes should fit in width and length. Make sure

you can wiggle your toes. n Avoid pointed toes, high heels and materials such as

plastic or vinyl that don’t “breathe.” Leather or canvas uppers are better choices.

n Choose cushioned shoes over ones with stiff leather

soles. Opt for lace-up, not slip-on styles. n If you wear shoe inserts, take them with you when you

try on new shoes. n Walk around the store before buying. New shoes

should feel comfortable right away – you don’t want to buy shoes that need to be broken in. Once you buy new shoes, check for foot redness or

irritation after wearing the shoes for at least an hour.

Sources: American Diabetes Association; American Podiatric Medical Association; National Diabetes Education Program

d i a B e t e s

How to

YOuR FEET DESERvE MORE than a little kindness. After all, when you need to go somewhere, they’re always there for you. So if you have diabetes, return the favor: Give your feet some extra care and help them stay healthy.

“Foot care is probably the easiest part of managing your diabetes, but it’s no less important than other parts of your diabetes treatment plan,” says Susan Hopper, RN, BSN, CDE, Diabetes Program Coordinator of the Saint Agnes Diabetes Treatment & Resource Center.

Diabetes can raise your risk for serious foot problems. For example, if you have nerve damage from diabetes, you might not feel an injury – or even a blister – on your foot. Poor circulation and high blood sugar can then hamper healing of the wound, which can lead to infection and deep sores. Severe cases may even require amputation, notes the American Academy of Family Physicians.

Work with your doctor to keep your blood sugar under control, and practice healthy habits, such as exercising, con-trolling cholesterol and not smoking. Also, consider these tips from the American Diabetes Association (ADA) and other experts:

Check your feet daily, and tell your doctor if you notice problems such as redness, cuts, swelling and blisters, pain that doesn’t go away, numbness or tingling. If you have trouble seeing the bottoms of your feet, ask someone to look at them for you or use a mirror.

Wash your feet daily with mild soap and lukewarm water. Dry them well, especially between the toes. To help your feet stay dry, dust them with nonmedicated powder. Apply lotion only on your feet – not between your toes.

Check with your doctor before treating calluses, corns or bunions.

Cut your toenails straight across, not into the corners. Tell your doctor if you have ingrown toenails.

Don’t go barefoot. Wear shoes that fit well, and check inside each time you wear them for torn linings or objects, such as gravel, that could harm your feet.

Have your feet checked at least once a year by your doctor – or at every visit if you have problems with them.

“Making foot care a daily priority can lead to healthy, functioning feet for a lifetime,” Hopper says. “After all, we only get one pair of feet.”

To learn more about diabetes services or to speak with a diabetes educator at Saint Agnes, call (559) 450-2002.

protect your feet

Put your feet first when shopping for shoes

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food choiceYOu’vE PROBABLY HEARD that eating fiber keeps you “regular.”

That’s a euphemism, of course. The fiber your digestive system takes in as food is pretty much the fiber your diges-tive system moves out as waste.

And that’s how fiber keeps you “regular” – by regularly moving waste out of your body.

But the benefits of fiber aren’t limited to your digestive system.

tHe role oF FiBerYou get fiber by eating plants such as fruits, vegetables and grains, notes the American Dietetic Association (ADA).

Bran, whole wheat, and the skins of fruits and vegetables are insoluble fibers. Insoluble fibers, also called roughage, mostly benefit your digestive system, according to the ADA. They promote bowel regularity and help prevent, or ease the symptoms of, diseases such as diverticulosis, diverticulitis and irritable bowel syndrome.

“Soluble fibers come in the form of oats, barley, dried beans, peas, and the flesh of fruits and vegetables,” says Saint Agnes dietitian Andrea Grim, MS, RD, CNSD. “They don’t pass through your system as quickly as insoluble fibers.”

By slowing the absorption of food, soluble fibers help stabilize blood sugar and insulin levels in the body, reports the American Institute for Cancer Research (AICR). They also reduce blood levels of bad cholesterol or fats, which in turn can help reduce the risk of heart disease.

Both insoluble and soluble fiber also

c H e w o n t H i s

Make fiber an everyday

appear to lower your risk for colon cancer, according to the AICR.

good sources“Depending on age and gender, the average healthy adult should strive to get 21-38 grams of fiber daily,” Grim says. It’s best to get your fiber through foods rather than supplements, which don’t offer all the health benefits of natural fiber.

Good sources of fiber include arti-chokes, beans, berries, whole-wheat bread, broccoli, starfruit (carambola), carrots, dates, figs, lentils, nuts, oranges, papayas, pears, peas and potatoes with skin.

The ADA and American Academy of Family Physicians offer these tips for adding more fiber to your diet:n Read cereal labels. Some cereals offer

5 grams of fiber or more per serving.n Eat brown rice rather than white.n Having a muffin? Choose bran.n Eat cooked beans at least once a

week.n Have minestrone or pea soup rather

than chicken noodle.To prevent gas and bloating – possible

side effects if you increase your con-sumption of fiber too quickly – gradually add about 5 grams of fiber per week to your overall diet. And drink plenty of fluids to avoid constipation.

More >> To learn more about fiber, check out the ADA Web site at www.eatright.org, or you can go to the AICR Web site at www.aicr.org.

Lentils with garlic and tomatoesHere’s a simple way to add extra fiber to your diet. Try this healthy recipe from our Saint Agnes Medical Center dietitians.

ingredients4 teaspoons olive oil5 cloves garlic½ pound tomatoes, peeled and

minced1 cup dry lentils1½ teaspoon salt11/5 teaspoon lemon juice

1. Heat oil in a 2-quart pot over medium heat.

2. Add garlic and cook until just turning golden.

3. Add tomatoes and cook down until thick, around 8 minutes.

4. Add lentils and 2½ cups water. 5. Bring to a boil, cover and reduce

heat. 6. Simmer 30 minutes. 7. Add salt and lemon juice. 8. Mix well.

nutrition inForMationMakes 4 servingsCalories 225 Fat 5gCarbohydrates 32g Fiber 15gProtein 13g

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Health resource education Programs and referral serviceweekdays, 8 a.m.-4 p.m.FreeReferrals to physicians and other health-related education programs and support services. Call (559) 450-2000.

Heart Health for Heart FailureMonthlyFreeControl congestive heart failure. Call (559) 450-3762.

licensed Massage therapy$55 for 60 minutes, $45 for 45 minutes or $30 for 30 min-utes. Call (559) 450-3595.

Maternity educationInformation about maternity education, stork tours, lactation and postpartum. Call (559) 450-BaBy (2229).

Personal wellness ProfileA personalized report of your health status, including height and weight, blood pressure, body fat, total cholesterol and a self-report questionnaire. $45. Call (559) 450-2010.

sickle cell Program (adult)Call (559) 450-5121.

supermarket tourFreeTour the supermarket with a registered dietitian and learn guidelines for healthy foods and how to read food labels. Call (559) 450-2000.

F o r s e n i o r s

club 55 PlusPrograms and services that enrich the lives of Central Valley residents 55 and older. Call (559) 450-5555.

P a t i e n t a n d F a M i l y s u P P o r t g r o u P s

amputee support groupCall (559) 450-2000.

Bariatric surgery Postoperative support groupFor Saint Agnes postop gastric bypass patients and their families. Call (559) 450-5166.

Brain tumor support groupCall (559) 450-3452.

Breast cancer support groupCall (559) 450-2000.

caregiver support group (adult)Call (559) 450-3626.

c l a s s e s a n d P r o g r a M s

Body composition analysis$25. Call (559) 450-2010.

california eye institute at saint agnesEye disorders information and eye physician referrals. Call (559) 449-5000.

cancer informationCall (559) 450-5528.

cPrn Healthcare Provider course n HeartSaver CPR Call (559) 450-2010.

diabetes self-Management skillsPhysician referral required for all diabetes classes. Call (559) 450-2002.

Fitness Profile lab Panel weekdaysBlood lipid profile, including total cholesterol, HDL, LDL and triglycerides. $60. Call (559) 450-2010.

crohn’s and colitis support groupCall (559) 450-2000.

FootstepsGrief support program for children and teens, and their parents and caregivers who have experienced a loss through death, divorce or separation. Call (559) 450-5600.

grief support groupFor adults who have recently experienced the death of a friend or loved one. Call (559) 450-3858.

life after loss support groupSupport and education about the grief process. Call (559) 450-5600.

Moms support groupMothers bring their babies and share concerns. Call (559) 450-2000.

ostomy support groupCall (559) 450-5121.

Prostate cancer support groupCall (559) 450-2000.

registration required for most classes. dates and times are subject to change. For more information or to register for these classes or support groups, call the numbers listed or call saint agnes Health source connection, (559) 450-2000 or 1-800-ST-AGNES (1-800-782-4637). visit us at www.samc.com.

YOUR HEALTH SOURCE

connection

r e a c H u s numbers to know

General Information (559) 450-3000Business Office (559) 450-3154Centralized Scheduling (559) 450-5656Emergency Department (559) 450-3205Foundation (559) 450-2040Home Health (559) 450-5112Physician Referral (559) 450-2000Volunteer Services (559) 450-3521

check out our web site www.samc.com

1303 E. Herndon Ave.Fresno, CA 93720

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