Discover why Elgin-based Provena Saint Joseph Hospital is working to enhance women’s health through its new clinic.
Located in the heart of the Elgin community, Provena Saint Joseph has always worked hard to provide the finest possible health care to all people, regardless of gender or age. In recent years, Provena has responded to an increased demand for women’s services by opening its Breast Health Center, the Women’s Heart Center and the Bob & Edna Meadows Regional Cancer Center. The two leading causes of death for women remain heart disease and cancer.
The Women’s Heart Center is an encapsulated area within Provena’s cardiovascular services area, which opened last February. Kathleen Mika, Director of Cardiovascular Services, describes it as a center “for women, by women.”
“We had teamed up to focus on awareness and education, including early screening, to evaluate risk factors,” she says. “We feel it’s vital for women to change their lifestyles before heart disease develops. We often discover that some women have issues which need to be worked out with their primary care physicians.”
The center focuses on a wellness perspective, says Mika, in an effort to combat problems before they develop. During a one-hour appointment, risk factors are determined by a series of measurements and tests including cholesterol, blood glucose, weight, height and blood pressure, including in the arms and legs, to screen for peripheral artery disease (PAD).
“An ABI [ankle-brachial index] is a simple test that compares the blood pressure in your ankles with the blood pressure in your arms to determine if you are at risk for PAD,” says Mika. Once the information is gathered, a patient is given a printed evaluation. A nurse with the Women’s Heart Center discusses the results and recommends a preventive plan of action.
“Heart disease is still the No. 1 killer of women,” says Mika. “The odds have gotten better, but heart disease and heart attacks are still perceived as men’s health concerns.”
Provena Saint Joseph Hospital is a sponsor of the American Heart Association’s Go Red program, and it routinely hosts luncheons and educational events to spread the word about improving women’s heart health.
“The center is an area set aside where women can feel comfortable and hopeful,” Mika says. “We want to get the word out to Elgin and the surrounding communities that here is a private, comfortable place where women can get their questions answered, seek personalized advice and learn how to avoid adverse heart problems in the future.”
Dr. Agnieszka Silbert is a cardiologist who specializes in women’s heart disease and preventive medicine. She’s also the medical director of the Women’s Heart Center at Provena Saint Joseph, which opened last February and is housed within the hospital’s Heart & Vascular Institute.
“Women’s heart health is my personal passion,” says Silbert. “I see women in my practice who have been diagnosed with heart disease, and I feel a strong obligation to intercede on their behalf. In the past 10 years, I haven’t seen a clear-cut transition from traditional cardiovascular diagnosis and treatment. Not that we haven’t made progress, but their quality of life after a heart attack has not significantly improved.”
Silbert adds that when she came to Provena Saint Joseph, she felt there was a real opportunity to bring women’s heart health issues to the forefront.
“Our goal was a major initiative involving a whole range of comprehensive approaches,” she says. “Being realistic, we understood that we had to start somewhere and we chose to begin with screening.”
Today, the Women’s Heart Center is a woman-to-woman endeavor which screens for cardiovascular and peripheral vascular disease. Silbert says the program mainly attracts women between the ages of 40 and 70 who don’t necessarily have heart disease but may be experiencing some of the symptoms, or those who are worried they might be at risk because of their family histories, current health status or potential harmful habits.
“This is their first foot in the door, where we encourage women to come and learn,” Silbert says. “We meet women who have not had a heart attack, along with those who need secondary prevention measures because they are suffering the aftermath.”
Screening involves compiling a family history and identifying mothers and grandmothers who have had heart attacks or heart disease; talking about diet, comfort food and habits, such as smoking and excessive drinking; and conducting cholesterol panels and arterial examinations. The center sees two different kinds of patients: those who are curious or concerned about their heart health because of family history, and women who are at risk.
“Women are the gatekeepers for the whole family,” Silbert says. “Women won’t hesitate to bring their husbands to the emergency room if they think the husbands are having heart attacks, but they hesitate when it comes to their own symptoms. We offer education and access to care, plus the tools they need for self-assessment.”
Silbert explains that at-risk women are frequently under-diagnosed, because their warning signs differ from those that men experience. They may not feel enough sense of urgency, and then try to figure their symptoms on their own. The entire medical and sociological community may downplay a woman’s symptoms, by assuming she is depressed, stressed or paranoid. Then everyone is surprised when she has a heart attack.
“We must make sure women don’t feel that their personal health issues are not important,” she says. “We want Provena to become a mecca for women who might feel alone in their concerns and search for answers. We want them to live a good life, which includes rehabilitation afterwards.”
Silbert describes Provena’s Women’s Heart Center as sort of a “mom-and-pop” operation, carried out on a smaller, more intimate level than found in most major heart health centers.
“We quickly establish a first-name basis in an environment where privacy is respected,” she says. “Kathy Berger, our center nurse, is a warm, down-to-earth person who does our assessments and discusses risks. She listens closely to patients, not only for family history, but also for personal problems. It’s a woman-to-woman talk. If she finds something of concern, she refers the patient to the appropriate physicians. Just like a big sister, we strive to guide women through the steps from prevention to recovery.”
Women’s cancers are another major health concern. Two years ago, Provena Saint Joseph opened its Bob & Edna Meadows Cancer Care Center, consolidating infusion, radiation and other cancer treatment programs into a 25,000-square-foot, two-floor addition. The Breast Program, an integral part of the cancer center, officially started on Oct. 4. With its natural light and soft, soothing colors, the center is dedicated to providing the latest in diagnostic, radiation and infusion technologies.
“When a person is diagnosed with cancer, it’s easy to say ‘don’t worry,’ but the news is never easy to live with,” says Andi Duval, cancer center director. “Our new virtual Breast Center offers everything from screening and detection all the way through treatment. The cancer center’s main floor houses our radiation department, while, on the second floor, we have all of the infusion procedures including chemotherapy, blood treatments, intravenous antibiotics and hydration therapy. ”
Provena Saint Joseph also has introduced a new radiation procedure that significantly speeds the treatment and healing process for breast cancer patients.
“It’s not applicable for every woman,” Duval explains. “Normally, radiation takes daily treatments for six to eight weeks. This new procedure places a radiation pellet directly into the cancerous site for a timed exposure twice a day, for five days. It reduces radiation and its side effects substantially.”
Beyond diagnosis and treatment, the center stresses survivorship and continued care.
“We answer women’s questions about what they should do after treatment ends, and how to take care of themselves,” Duval says. “We started a program last year, called ‘Take Care of You,’ that we plan to repeat in October, that helps post-cancer patients to find resources and learn how to live life to the fullest. We don’t just turn them loose.”
Duval says that in 2009, Provena Saint Joseph received a Susan G. Komen grant, which it applied to an outreach program for senior women, encouraging them to continue annual mammograms. More than 300 women participated.
“In any hospital, space is at a premium,” Duval notes. “In our Breast Center, we have what we feel is a ‘virtual’ breast cancer center, that pools all the necessary components needed for breast health and cancer treatment. We work closely together, and we can move things along quickly, because we are sharply focused on breast cancer. Everything is just feet away.”
One of those services involves recently-upgraded mammography capability. Director of Medical Imaging Laurie Schachtner, MBA, CRA, FACHE, RT (R) (M), says Provena invested $1 million for two Hologic digital mammography imaging machines about one year ago, which are enhanced with computer-aided detection capabilities that mark areas of concern. Provena radiologists can now magnify, darken and lighten images to enhance anomalies.
“The quality is just incredible, featuring five-megapixel resolution,” she adds. “Mammography is one of the most governmentally regimented technologies, which ensures a high standard of quality. It’s hard to quantify resolution, but you could liken it to a film camera versus a digital camera. The principle is the same, but now we can see the images as we take them, without having to develop plates. Patients no longer have to stand around and wonder or worry. And the radiation dose is lowered by 22 percent, because we get it right the first time.”
Provena Saint Joseph conducts an average of 520 mammograms each month, offering expanded hours on evenings and Saturdays, so that “there are no excuses,” as Schachtner puts it.
“On Oct. 4, we initiated real-time reading,” she says. “From 8 a.m. to 2 p.m. Monday and Wednesday, women can wait for their screening results, at no extra cost. That way, women will know right away, instead of waiting for a phone call or a letter with an all-clear message. It saves them worry or anxiety.”
Schachtner says everyone is proud of the Breast Health Center, with its new bed tower and expanded footprint.
“We worked with the architects to position the mammography and breast ultrasound rooms to be proximal to one another, and to design it so that nuclear medicine is within the cardiac stress testing region,” she explains. “This way, we have everything for the patient, right where the patient is.”
Ancillary services are an equally important part of Provena Saint Joseph’s expanded focus on women’s health. Linda Roherty provides one of these, for women who have had lymph nodes removed as part of breast cancer treatment. A physical therapist, Roherty is also a certified lymphedema specialist who, for the past 12 years, has provided rehabilitation for the swelling and pain that sometimes accompanies lymph node surgery and radiation therapy. She explains that lymphedema occurs because removal of lymph nodes reduces the pathways for fluid to move through the body, which in turn can cause painful swelling. While some people are born with lymphedema and others develop it later, cancer treatment is its No. 1 cause in the United States.
“One advantage at Provena is that we are all experienced physical therapists,” says Roherty. “We aren’t newly graduated. We see the patient as a whole person, not just as parts. Swelling can stem from blood clots, wounds, infections, surgery or adverse reactions to treatment. I do a pre-operation assessment as part of a breast cancer work-up, and then see the patient post-op.”
Roherty says women shouldn’t have blood drawn or blood pressure tests performed on the arm where lymph nodes were removed. Of 100 women who had blood drawn from the same arm, every one ended with lymphedema.
“We educate our women cancer patients, which empowers them to understand the risks and have the tools to make good decisions,” Roherty adds. “Life goes on after cancer treatment, but not everyone realizes how having lymph nodes removed can affect them,” Roherty says. “I can’t prevent lymphedema, but I can help women to reduce the risk.”
Jane Cosentino is a nurse navigator who guides patients through the frightening and often-confusing processes involved in cancer treatment.
“To be honest, I believe my job is the most exciting one, because it’s good to start with patients at the very beginning of their diagnosis and see them all the way through treatment and follow-up care,” she says.
Cosentino’s background in oncology reaches back to the 1980s. She has a unique perspective on what patients go through, after being diagnosed, because of the diverse settings in which she has worked.
“I used to administer chemotherapy,” Cosentino says. “My role now is to cut through all the red tape and help make the treatment process as seamless as possible for patients. I can’t change the course of the disease for patients, but I can help them with issues such as transportation, contacting oncologists and surgeons, and making sure they get to the right door for tests, which leaves them with fewer things to worry about.”
Cosentino talks about a patient, newly diagnosed with cancer, who called her in tears. “No one had told her what to do next,” she says. “I said ‘no problem.’ We have a great team here, all under one roof, and we work together to find solutions for every patient’s needs.”
Contacting doctors’ offices, getting orders faxed and working with both surgeons and central admitting are all among routine tasks for Cosentino, who calls herself a “shmoozer” who maintains positive give-and-take relationships around the hospital and surrounding medical practices.
“I take my job very seriously,” she says. “At Saint Joseph, we are blessed that all the women’s cancer services are not only under one roof, but also just steps apart, including dietitians, social workers and pastoral services, as well as radiation and chemotherapy units. That’s the beauty of our system here.”
Laurie Cox, an art therapist and oncology counselor for the cancer center, provides another ancillary service for patients. She says that creating art can help to reduce heart rate and blood pressure, promote relaxation and refocus the patient’s attention away from the pain and anxiety that naturally occur during treatment.
“We look at art therapy in two different ways,” Cox explains. “We have a relaxed, fluid art program in an open studio environment for women of all ages and their families. We also have art psychotherapy, a more structured approach to art therapy.”
Cox’s therapeutic interventions include two- and three-dimensional arts, such as drawing, painting and mask-making. She brings art materials into the chemotherapy areas, where women seated in lounge chairs can work on projects, not only as a way to pass the time, but also as a distraction.
“Art encourages them to express their emotions in a tangible way,” Cox says. “Some of my patients haven’t done much artwork since they were in middle school. Art helps them to be more open about their worries. We also have special groups in which patients and their families participate together in creating artwork.”
Verbal therapy is another way in which Cox helps cancer patients to cope. She says that talking through anxieties and fears about their diagnosis, treatment, finances and relationships helps them to adjust more readily to the whole process, which, after all, impacts many people who are close to the patient.
“Many try to put their emotions on hold through the treatment process, with the intention of dealing with them later,” Cox explains. “It’s not uncommon for a patient to want to talk to someone outside the immediate family.”
The rapport which develops between therapists and patients may be the bridge which guides them from diagnosis and treatment to a better tomorrow.
“When they complete their treatment, many tell us they’ll really miss us,” Cox says. “They become very attached, because of the support and understanding they receive from our staff members.”
Provena Saint Joseph is doing its part to improve the quality and longevity of women’s lives throughout the Elgin community. And as more women become aware of the newly sharpened focus of its services, the hospital will advance its mission to create a wholesome, positive place in which women not only live, but thrive. ❚