total knee replacement

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1 SUMMER 2012 On the Cover: Rosa Gets Her Active Lifestyle Back through Knee Replacement Surgery Inside... Awarded Women s Choice Award Stressing the Need to Manage Stress...If it wasn t for them I would have never been able to return to my normal activities or complete the Gate River Run six months after surgery pain-free... Rosa, Total Knee Replacement Patient total knee replacement Offers State-of-the-Art Treatment for Common Men s Health Condition

2 2 The personal touch you want, the outstanding care you need. 3 Awarded Women s Choice Award About Go Red For Women Go Red for Women is the American Heart Association s national campaign to increase awareness of heart disease the No. 1 killer of women and to inspire women to take charge of their whole body health. The grassroots campaign has since grown into a vibrant national movement as more women, men, celebrities, healthcare professionals and politicians embrace and elevate the cause of women and heart disease. Life Saving Kits Given to New Moms in May was pleased to serve as the American Heart Association s Go Red For Women Newborns Go Red advocate in May. Throughout the month, the hospital provided families of children born in the hospital an Infant CPR Anytime kit, red baby bonnet, family nutritional and physical activity guide, baby s first year book, red dress pin and family oriented cardiovascular health educational materials. The Newborn Go Red kits are designed to provide mothers with tools to build a healthy home. Infant CPR, family nutrition and physical activity as well as what to expect during baby s first year combined with women s cardiovascular health materials ensure that new mothers have the materials needed to practice healthy habits in order to establish health values in their families. At, we believe education is a key component to provide a nurturing healthy environment for mothers and newborns to thrive. We are proud to take the step to become a proactive vehicle for the health materials necessary to build a strong community, says Nangela Davidson, Director of Maternity Services. This is one of the many ways we can support our ongoing commitment to provide world class medical care for our community. About is a 335 bed, acute care hospital that has been ranked among the top 5% of all hospitals in the nation for both clinical excellence and patient safety for the past seven consecutive years. The hospital has operated as a not-for-profit healthcare institution in St. Augustine, Florida since its founding in s focus on quality has resulted in numerous national accreditations including, designation as a Chest Pain Center by the Society of Chest Pain Centers, ANCC Magnet Status for Nursing Excellence, the Gold Seal of Approval from The Joint Commission for Primary Stroke Care Centers, National accreditation for its total hip and total knee replacement programs, accreditation of its Cancer Institute by the Commission on Cancer and ASMBS Center of Excellence Designation for its Bariatric Surgery Center. To learn more about all of the hospital s services log on to was recently presented the Women s Choice Award for demonstrating extraordinary service in meeting the needs of women and their families. We are pleased to have been recognized with the Women s Choice Award for patient experience. This distinction affirms our commitment to not only achieving the best possible clinical outcomes, but also to ensuring that we achieve our overarching mission to provide the best patient experience with the best staff. At, we work diligently to ensure every member of our team treats our patients with CARE we are committed to being Compassionate, Always listening, Responsive and Empowered to make a difference for every patient, during every interaction, every time, said Joe Gordy, President and CEO of. And we are particularly proud that through this recognition from WomenCertified, our female patients have affirmed that our patient-centered, icare approach is working. A sincere thank you to who not only made the list but is going above and beyond by partnering with WomenCertified to support and empower women in their community, and globally to support our mission to set higher healthcare standards by appreciating the unique needs and preferences of female patients, added Delia Passi, WomenCertified CEO. Through consumer surveys, consumer behavior research, market intelligence, and years of experience as the leader in building sales and loyalty among women, Women s Certified, Inc. strives to simplify consumer choices and reward businesses that have earned the trust and loyalty of women. The Sunday Knitting Group from the Allegro recently knitted over 150 caps for Flager Hospital newborns

3 4 The personal touch you want, the outstanding care you need. 5 Stressing the Need to Manage Volunteer of the Year by Joseph Mark, LMHC, NCC These are marvelous times we live in with so many modern conveniences and opportunities to make our lives better. There are also many amazing advancements in medical science that improve our health. We have great technical wonders to increase the quality of life, and with these improved standards we often find it easier to cope with the challenges of our lives. Of course the pace may speed up, but we keep on going and even find it possible to get more done in less time. Then we begin to notice that our expectations of life begin to subtly increase. Our schedules fill up, but some how we still continue to accomplish everything we set out to do. Life is good. It is predictable that as we progress through adulthood we naturally take on more responsibilities, and as we pursue our careers and establish relationships we become the ones upon whom others rely. We are the parents, the teachers, the caregivers, employees, and the professionals. We are considered the responsible adults. We are the ones who have to get things done. And for the most part we do just that. And we do this very well, more often than not. You might say, That s just, what we do, and very often we do it without question or complaint. There is though, a toll as we hurry down this highway of life at ever increasing speeds. Moving along, faster and faster, trying always to keep it between the white lines, and of course right at the speed limit. Honest, officer, I was just doing... That toll can sometimes be a traffic ticket, but then sometimes it may be worse. And something worse isn t always a catastrophic accident, though that is a possibility. It may only be an increase in blood pressure, or a head ache, or nothing more than fatigue. These more subtle effects may be moments of moderate anxiety, or even mild depression. But those things begin to add up over time, and just like the eroding forces of wind and rain the fast pace of our lives can also wear us down to nothing. As I said before, the occurrence of a traumatic accident is always possible, and when those catastrophes do strike, it is amazing how we are able to get through them. But during those events we initially suppress vital emotions so that we are able to deal with emergencies and salvage our reality. The emotional stress though may still lie quietly beneath the surface. We are after all, only human and we will eventually have to deal appropriately with the stress. cont d on next pg Stress is a vital part of us, and the response we feel to stressful events, whether good or bad, is a very important part of our functioning. A little bit of stress can helpful, like when we start to cross a street, and the stress of traffic dangers makes us look both ways before we walk. It is more than just a mental functioning though. Many amazing things take place when we experience what is referred to as the Stress Response, sometimes called the Flight or Fight Response. When our senses detect danger a series of neurological and biological events take place inside our bodies that prepare us to survive the imminent peril we perceive. Our systems release a surge of hormones, including adrenaline and cortisol, and we are then able to more effectively fight the danger or flee. This system being self-regulating returns our bodies to normal once the danger has passed and as the hormone levels decrease our heart rate, blood pressure and other systems return to normal. But if we remain in a constant state of alarm we begin to feel stressed, tense, and always on edge. This can then put us at a greater risk for other health problems such as heart disease, digestive problems, depression and sleep disruption. This is exactly why it is so important to learn how to manage the stress in our lives. It must start with a healthy diet, and plenty of exercise. Adequate rest is also necessary. Adequate sleep is very important for our good physical health, but also for our good emotional health. I recommend practicing relaxation exercises that include focused breathing techniques. And don t overlook friendships. These need to be nurtured and even cherished. Try to see the humor in life and find what makes you smile. And finally if necessary seek professional counseling to help you sort through the challenges of your life. Most of all don t forget yourself as you take care of all your responsibilities. You can t help anyone else if you can t take care of yourself. It is quite reasonable and highly recommended to establish healthy boundaries and then care for your own self by meeting your needs and pleasures of life. The Auxiliary recently named Chuck Holmes as the Volunteer of the Year! Chuck began his career as a volunteer in August He is one of the hardest working, most dedicated volunteers in our organization. Chuck is always willing to work extra days or substitute when necessary. He is highly respected by his coworkers and is always willing to serve. Chuck works and chairs the Patient Transport Service, and as of the second quarter of this year, he has accumulated a total of 6,223 hours of volunteer service.

4 6 The personal touch you want, the outstanding care you need. 7 Here s some terrific news: What s good for your heart is great for your taste buds. As the recipes that follow show, you don t have to lose flavor to gain health. Heart healthy cooking simply means making dishes that are low in saturated fat, trans fat, cholesterol, and moderate in total fat. As an added bonus, these dishes have fewer calories than those higher in fat. The recipes that follow will even tempt children. That s important, because good eating habits need to start early. So, cook up some Classic Macaroni and Cheese and Peach Cobbler and teach your kids or grandkids how delicious good health can taste. Chances are, they ll want another lesson. These recipes were specially developed by the National Heart, Lung, and Blood Institute (NHLBI). If this collection whets your appetite for more information on healthy eating or other heart health topics, visit the NHLBI online at www. nhlbi.nih.gov. Enjoy! Barbecued Chicken Fall under the spell of this Southern-style, sweet barbecue sauce. 5 Tbsp (3 oz) tomato paste 1 tsp ketchup 2 tsp honey 1 tsp molasses 1 tsp Worcestershire sauce 4 tsp white vinegar 3/4 tsp cayenne pepper 1/8 tsp black pepper 1/4 tsp onion powder 2 cloves garlic, minced 1/8 tsp ginger, grated 1 1/2 lbs chicken (breasts, drumsticks), skinless Yield: 6 servings Serving size: 1/2 breast or 2 small drumsticks Each serving provides: Calories: 176 Total fat: 4 g Saturated fat: less than 1 g Cholesterol: 81 mg Sodium: 199 mg Total fiber: 1 g Protein: 27 g Carbohydrates: 7 g 1. Combine all ingredients except chicken in saucepan. Simmer for 15 minutes. 2. Wash chicken and pat dry. Place on large platter and brush with 1/2 of sauce mixture. 3. Cover with plastic wrap and marinate in refrigerator for 1 hour. 4. Place chicken on baking sheet lined with aluminum foil and broil for 10 minutes on each side to seal in juices. 5. Turn down oven to 350º F and add remaining sauce to chicken. Cover chicken with aluminum foil and continue baking for 30 minutes. RECIPES FOR HEART HEALTH Classic Macaroni and Cheese 2 c macaroni 1/2 c onions, chopped 1/2 c evaporated skim milk 1 medium egg, beaten 1/4 tsp black pepper 1 1/4 c (4 oz) lowfat sharp cheddar cheese, finely shredded As needed, nonstick cooking spray Yield: 8 servings Serving size: 1/2 cup Each serving provides: Calories: 200 Total fat: 4 g Saturated fat: 2 g Cholesterol: 34 mg Sodium: 120 mg Total fiber: 1 g Protein: 11 g Carbohydrates: 29 g Here s a scrumptious, lower-fat version of a favorite dish. 1. Cook macaroni according to directions, but do not add salt to the cooking water. Drain and set aside. 2. Spray casserole dish with nonstick cooking spray. Preheat oven to 350º F. 3. Lightly spray saucepan with nonstick cooking spray. Add onions and sauté for about 3 minutes. 4. In another bowl, combine macaroni, onions, and rest of ingredients and mix. 5. Transfer mixture into casserole dish. 6. Bake for 25 minutes, or until bubbly. Let stand for 10 minutes before serving Peach Cobbler Try this healthier, mouth-watering take on a classic favorite. 1/2 tsp ground cinnamon 1 Tbsp vanilla extract 2 Tbsp cornstarch 1 c peach nectar 1/4 c pineapple or peach juice (can use juice from canned peaches) 2 cans (16 oz each) peaches, packed in juice, drained, (or 1 3/4 lb fresh), sliced 1 Tbsp tub margarine 1 c dry pancake mix 2/3 c all-purpose flour 1/2 c sugar 2/3 c evaporated skim milk As needed, nonstick cooking spray 1/2 tsp nutmeg 1 Tbsp brown sugar Yield: 8 servings Serving size: 1 square Each serving provides: Calories: 271 Total fat: 4 g Saturated fat: less than 1 g Cholesterol: less than 1 mg Sodium: 263 mg Total fiber: 2 g Protein: 4 g Carbohydrates: 54 g 1. Combine cinnamon, vanilla, cornstarch, peach nectar, and pineapple or peach juice in saucepan over medium heat. Stir constantly until mixture thickens and bubbles. 2. Add sliced peaches to mixture. Reduce heat and simmer for 5-10 minutes. 3. In another saucepan, melt margarine and set aside. 4. Lightly spray 8-inch square glass dish with cooking spray. Pour in peach mixture. 5. In another bowl, combine pancake mix, flour, sugar, and melted margarine. Stir in milk. Quickly spoon this mixture over peach mixture. 6. Combine nutmeg and brown sugar. Sprinkle mixture on top of batter. 7. Bake at 400º F for minutes, or until golden brown. Cool and cut into 8 squares. KEEPING THE HEART IN YOUR FAVORITE RECIPES With a few changes, you can keep the heart in family favorites and add the health. Here s how: Dairy Products Cook with lowfat, fat free, nonfat dry, or evaporated fat free milk. Bake or cook with 3 egg whites and 1 egg yolk, instead of 2 whole eggs. Or use 2 egg whites or 1/4 cup of egg substitute, instead of 1 whole egg. Spices and Flavorings Use a variety of herbs and spices in place of salt, and choose low-sodium bouillon and broths. Oils and Butter Use cooking oil spray to lower fat and calories. Use a small amount of vegetable oil, instead of lard, butter, or other fats that are hard at room temperature. Meats and Poultry Choose lean cuts of meat and remove any visible fat. Remove skin from chicken and other poultry before cooking. Sandwiches and Salads Use fat free or lowfat dressing, yogurt, or mayonnaise. For salad dressing, use equal parts water and vinegar, and half the oil. Soups and Stews Remove fat from homemade broths, soups, and stews by preparing them ahead and chilling them. Before reheating, lift the hardened fat off the surface. Breads Make muffins, quick breads, and biscuits by using no more than 1-2 Tbsp of fat for each cup of flour. For muffins or quick breads, use 3 ripe, wellmashed bananas, instead of 1/2 cup butter or oil. Or, substitute a cup of applesauce for a cup of butter, margarine, oil, or shortening. Desserts Make a pie crust with only 1/2 cup margarine for every 2 cups flour. Use soft margarines (liquid or tub types). For chocolate desserts, use 3 Tbsp of cocoa for every ounce of baking chocolate. If you need to replace the fat in chocolate, add up to 1 Tbsp of vegetable oil. Make cakes and soft-drop cookies by using no more than 2 Tbsp of fat for each cup of flour.

5 8 The personal touch you want, the outstanding care you need. Flagler Nurses Earn Specialized Pain Management Certification As anyone who has ever been hospitalized knows, effective pain management is key to the recovery process. In fact, studies show that pain management not only affects a person s mindset, but also plays a factor in achieving the best possible clinical outcomes. And pain is complicated. It can present itself in many ways, for varying reasons, and respond to a wide array of treatments very differently. In recognition of this, the Flagler Life Institute Flagler Hospital s education arm - designed a specialized course to advance optimal nursing care for people affected by pain through evidence-based, best practices and prepare nurses for a national certification exam. congratulates Denise Cata, RN and Bettie Tune, RN for earning national pain management certification. Pain Management Certified Nurses possess sufficient knowledge of pain physiology, pathophysiology and how to apply the nursing process to produce effective outcomes for pain management as judged by experts from the ANCC and ASPMN, including knowledge of the physical, social, cultural, psychological, and spiritual dimensions of the pain experience. Prior to sitting for the examination, both nurses participated in a vigorous, 6 week education program to validate and extend their knowledge of this important topic. Pain is one of the most universal and pervasive sources of human distress, and as such, pain management is a primary challenge for healthcare providers. Bettie and Denise have shown themselves to be dedicated to meeting that challenge through continued education and certification. The American Society for Pain Management Nursing s mission is to advance and promote optimal nursing care for people affected by pain by promoting best nursing practice. This is accomplished through education, standards, advocacy and research. 9 Offers State-of-the-Art Treatment for Common Men s Health Condition More than half of all men over the age of 60 are suffering the effects of an enlarged prostate - also known as benign prostatic hyperplasia (BPH). Today, an innovative treatment available at is providing relief for area residents. GreenLight Laser Therapy uses laser energy to remove enlarged prostate tissue. It is proven to be a quick, minimally invasive outpatient procedure that delivers immediate and dramatic symptom relief without the side effects or expense of medication or the risks associated with invasive surgery. More than 250,000 men worldwide have benefited from GreenLight Laser Therapy. After the procedure, patients have expressed that they have a whole new lease on life, and can once again enjoy things many take for granted; such as going out to eat, or to the movies, or playing golf. If you are suffering from BPH, ask your doctor if GreenLight Laser Therapy might be right for you. At, we re bringing you world-class care, close to home.

6 10 The personal touch you want, the outstanding care you need. Is Weight Loss Surgery a Cure for Type 2 Diabetes? Two independent studies have confirmed what many local residents already know - weight loss surgery can eliminate the symptoms of type 2 diabetes. The studies, published in the New England Journal of Medicine and presented at the annual meeting of the American College of Cardiology, noted that many patients got better within weeks, days, sometimes even hours after the surgery -- long before they lost any weight. Patients of the Bariatric Surgery Center are well aware of this. I had surgery on a Wednesday. By Saturday, my blood sugar was in the normal range at 98. On Sunday, it was 92. I have not taken any medication for diabetes since that day, commented gastric bypass patient, Bill. My blood sugar is completely normal. You could say I am no longer diabetic - and I feel great. At the beginning of the first study, conducted on 150 patients by Dr. Phil Schauer of the Cleveland Clinic, most of the patients were taking three or more medications to control their diabetes. But after a year almost none of the gastric-bypass patients needed medication. Forty-four percent required daily insulin injections before surgery and none did after. The second study from the Catholic University of Rome and Weill Cornell Medical College followed 60 patients for two years and produced even stronger results. In that experiment onethird of the volunteers got drug therapy, one third bypass surgery, and the last group underwent bilopancreatic diversion, a procedure where surgeons block part of the small intestine. After two years, 75 percent of those who underwent bypass reached normal blood sugar levels and 95 percent of those undergoing the bilopancreatic diversion were normal. None of the patients on just drug therapy reached the goal of normal blood sugar levels. The authors of the study say the vast majority of surgery patients have achieved complete diabetes remission. Though the doctors have followed them for only two years, there is no indication that the diabetes is returning in any of them. The medical director of Flagler Hospital s Bariatric Surgery Center, Dr. Robert Marema, is one of the nation s leading experts on weight loss surgery and offers free education sessions about this topic and others to the public. For more information, log on to FlaglerHospitalWeightLoss.com. A group of patients celebrate their new, healthier lifestyle on the dance floor! from the cover... total knee replacement Before having my total knee replacement last year, I had never undergone anything that required a hospital stay. Needless to say, I was nervous; however the entire staff at made me feel comfortable, starting with my pre-surgery appointment. They provided answers, encouragement, and conversation to make me feel right at home. If there was anything that I needed, I was urged to call. The personalized care that I received was exceptional and completely beyond my expectations. I am thankful to Dr. Grimes, his team and the staff at for everything that they did to help me get my life back to normal. Every word of encouragement and every minute of physical therapy that went into making sure my total knee replacement recovery was a success is very much appreciated. If it wasn t for them I would have never been able to return to my normal activities or complete the Gate River Run six months after surgery pain-free. I never hesitate to refer as the place to go for medical needs, especially orthopaedic care. After the care I received I understand why they were rewarded the Joint Commission s Gold Seal of Approval for their total knee and hip joint replacement programs. They are Outstanding! --Rosa, Total Knee Replacement Patient March for Babies Features Marchers of All Ages It was a feel-good moment in St. Augustine when approximately 400 residents joined together in support of the smallest citizens of St. Johns County babies by participating in March for Babies to benefit the March of Dimes. Downtown St. Augustine was packed with strollers, families and teams to celebrate raising more than $78,000 to help babies be born healthy. Special guests at the day s events included Dr. Van Lilly, a Neonatologist at Flagler Hospital s neonatal intensive care unit and the Cokeley Family, the 2012 St. Johns County Ambassador Family. First Coast News Joy Purdy emceed the event and area restaurants provided food and drinks to the walkers. We ve seen today how important it is to help ensure babies are born healthy, said Flagler Hospital s Dr. Van Lilly. This has been an incredible event, and I m so proud to work in a community where people can come together for such a great cause. Helping our babies should be a top priority, and we should all be excited about what we ve accomplished here today. It was a memorable and rewarding day for all of us, said Kristen Cokeley, who along with husband Sean and daughter Riley served as the 2012 St. Johns County Ambassador Family. When we lost our first child William, we decided to do everything we could to make sure that other families don t go through what we did, and we were honored to be able to support the March of Dimes today in return for all the support they ve given us. St. Johns County March for Babies was presented by the Neonatal Intensive Care Unit, with additional sponsorship provided by Wells Fargo and Florida Power and Light. Publix Super Markets, Inc. is the Top Corporate Partner for March for Babies for the Florida Chapter. The March for Babies is sponsored nationally by the March of Dimes number one corporate supporter Kmart, Farmers Insurance Group, Bayer HealthCare, CIGNA, Famous Footwear, FedEx, Sanofi Pasteur, United Airlines, First Response, and Mission Pharmacal. To join an event near you, visit marchforbabies.org. The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide and its premier event, March for Babies the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com or nacersano.org. Find us on Facebook and follow us on Twitter earned awards for most creative t-shirt, team with the most walkers and top team second place From Left: Nangy Davidson, RN, CEO Joe Gordy, Vanessa Lenoir, RN, Carla Lovelace, RN, Cynthia Washington, RN, Angela Haynes-Harris, RN, Alaina West-Underwood, RN, Marie Riley, RN, Dr. Van Lilly, Linda Machado,

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