MARCH 2013

VOLUME 2 NO. 1

A Year of Complete Cardiac Care at Lexington Medical Center

SI EE IN DE:

nds a l d i M The s Red Goe LMC with 4

S
PAGE

Its Electric with Electrophysiology

page 7

Heart Surgery Patient Stories

page 11

contents
3 Meet Steven Marra, MD, FACS, Lexington Medical Centers Newest Heart Surgeon The Midlands Goes Red with Lexington Medical Center Ask the Doctor: Q&A with Sumter Cardiology Getting to the Heart of the Matter Tech Talk: I Spy Blood Supply Editorial: Its Electric with Electrophysiology Whats Cookin: Quinoa Salad Knockout Knees Points for Your Joints My Love Affair with the Bicycle by Langston Powell, MD 4 5 6 7 7 8 9

Letter from the Editorial Team

Our hearts are filled with gratitude. Lexington Medical Center is about to celebrate the first anniversary of its open heart surgery program. In the past year, our hospital has performed more than 150 open heart surgical procedures. Were looking forward to expanding our program in its second year, providing the best possible care and the most advanced technology. If youve been shopping lately, you may have noticed Midlands storefronts decorated in red as part of our new partnership with the American Heart Association called The Midlands Goes Red with LMC. The idea is to educate our community about the devastating prevalence of cardiovascular disease in South Carolina. Within these pages, were proud to introduce you to some of our open heart surgery patients. Youll also meet an LMC doctor who rides his bike to work 25 miles each way. We hope you can join us on March 23 for our fourth annual Colon Cancer Challenge, a bike ride and 8K run that raises money to provide colonoscopies for people who are underinsured. And The Doctor is In to show you how to keep your knees in knockout shape and the best way to battle those awful spring allergies. House Call is full of interesting, relevant information about your health and the health of your family. If you have comments or story ideas, drop us a line at housecall@lexhealth.org or call (803) 791-2191. In good health, House Call Editorial Team Lexington Medical Center

10 Feature: The Beat Goes On... A Year of Complete Cardiac Care at Lexington Medical Center 11 Heart Surgery Patient Stories 14 Hospital Spotlight: Meet the O-arm 14 Calendar of Events 15 Editorial: We Can Prevent Colon Cancer by March Seabrook, MD 16 Easy Exercises for Women on the Go 17 Back-2-Back! Lexington Medical Center Wins Pink Glove Dance Competition! 18 Spring Is in the Air... So Is Pollen with Andrew P. Battiata, MD 19 Welcome New LMC Physicians and Practices

In our next issue:

LMCs Honor Flight Weight Loss Success Stories  Organic Eating

Stay Connected!
Visit our website LexMed.com for all the latest news about Lexington Medical Center. You can also stay up-to-date on calendar events and learn more about health topics important to you and your family.

Cant wait?
Visit the Lexington Medical Center blog at blog.lexmed.com or find us on Facebook.
2

House Call March 2013

Meet Steven Marra, MD, FACS

Lexington Medical Centers Newest Heart Surgeon

House Call recently sat down with cardiovascular surgeon Steven Marra, MD, FACS, who has joined Lexington Medical Center as our second heart surgeon. He will practice with Jeffrey Travis, MD, at Lexington Cardiovascular Surgery, an LMC physician practice.
When I was growing up, my father was an administrator at a childrens hospital in Ohio. He would introduce me to doctors and tell me they truly impacted lives. I also always liked science and surgery. And I was fascinated by the way the heart works. As a heart surgeon, you have such a profound impact on the lives of patients and families. Heart surgery is something most people have not had to endure. The patients welcome you into their lives and the lives of their families. It becomes a very personal experience. I like Lexington Medical Centers commitment to patient care, excellence and taking care of the cardiac needs of the community. I look forward to adding support for the excellent program here. My wifes name is Jamie. We have a daughter, Olivia, who is a 17-year-old high school senior, and a son, Bennett, who is a 15-year-old sophomore. Were moving to South Carolina from Virginia, where I helped to develop a cardiothoracic surgery program and was the chief heart surgeon. The latest advances in heart surgery include the development of more minimally invasive procedures and new ways to treat problems with the vascular system. Education about women and heart disease is very important. Symptoms of a heart attack can be different in women and are not always easy to recognize. Also, women may wait longer to get help or discredit their own symptoms because theyre busy taking care of their families. For these reasons, heart disease is sometimes diagnosed later in women, which can be more dangerous. While there are risks with any surgery, statistics show that 99% of open heart surgery patients do exceptionally well and go home within five to seven days. Thousands of people undergo open heart surgery each day in our country. Its a regimented procedure and the most heavily studied surgery in medicine. Dr. Steven Marra

Steven Marra, MD, FACS Lexington Cardiovascular Surgery

Education:
 University of Dayton Dayton, Ohio - Bachelor of Science, Pre-Medicine  Medical College of Ohio Toledo, Ohio - Doctor of Medicine  MetroHealth Saint Lukes Medical Center Cleveland, Ohio  - General Surgery Internship and Residency - General Surgery Chief Resident - Attending General Surgeon

 University of Medicine and Dentistry of New Jersey Newark - Cardiothoracic Surgery Fellowship - Resident and Chief Resident

Experience:
 Cooper University Hospital Camden, New Jersey - Attending Cardiothoracic Surgeon - Interim Division Chief of Cardiothoracic Surgery

 Rockingham Memorial Hospital Harrisonburg, Virginia - Cardiothoracic Surgery Medical Director

Certifications:
 The American Board of Surgery  The American Board of Thoracic Surgery
Dr. Steven Marra and Dr. Jeffrey Travis inside LMCs open heart surgery operating room LexMed.com
3

The Midlands Goes Red

with Lexington medical center

cardiovascular disease is an epidemic in South Carolina.

1 3
deaths
in our state is related to cardiovascular disease.

out of every

In February, Lexington Medical Center partnered with the American Heart Association for a new heart disease prevention campaign and asked the Midlands business community to join us. The idea was for the Midlands to Go Red with information about cardiovascular disease, including heart attack and stroke, and promote heart health for every body.

on the back burner because were so concerned about our children. But the best thing we can do for our children is to take care of ourselves, Addy said. Women should not neglect themselves. If you think something is wrong, tell your doctor. We believed business leaders in our community could increase awareness about the high rate of heart high rate of cardiovascular disease. Cardiovascular disease takes a life every 39 seconds mothers, fathers, siblings, spouses and friends. And its not just a mans disease more women than men die of heart disease each year. Risk factors include excessive weight, high blood pressure and smoking. Lexington Medical Center hopes that, with help from our communitys business leaders, we can move away from this dangerous course and steer toward a healthier future.
TERESA ADDY

More than 200 businesses signed up to decorate their storefronts with kits provided by LMC and the AHA that included window decorations, items for employees, giveaways and educational information about heart disease. There was no cost to participate. One of them was Craig Reagin Clothiers on Main Street in Lexington. Members of the Addy family of Lexington own and operate the store, including Teresa Addy, who is a stroke survivor. Addy suffered a stroke in 1995 at the young age of 32. At the time, she and her husband, John, had three young children, ages 5 to 8. Her main risk factor was high blood pressure. She spent more than a week in intensive care and underwent extensive physical and occupational therapy. As women, we put ourselves
4

disease and stroke in the Midlands, and help move our state away from its

House Call March 2013

Q&A with Sumter Cardiology, a Lexington Medical Center Physician Practice

Ask the Doctor

Getting to the Heart of the Matter

Q: What causes heart disease? A: Some people are predisposed to heart disease and stroke, but most develop cardiovascular disease because of a combination of factors, such as poor diet, lack of physical activity and smoking. Q: Which risk factors for heart disease do you see most often? A: Here in the Barbecue Belt, we see obesity and metabolic syndrome as ever-present risk factors accompanied by lipid disorders, hypertension and abnormal glucose metabolism. These problems are a result of diet, lifestyle choices and, to some degree, lack of education. Thats why its important for patients to know and understand their role in risk-factor modification. Q: What is the most common heart condition in the Midlands? A: The most common cardiac condition is congestive heart failure. Its prevalence is directly related to the frequency of risk factors in our community and an aging population. We also see many patients with coronary artery disease. Q: What is cholesterol and why is it so important? A: Cholesterol is a fatlike substance found in all body cells. Extra cholesterol enters your body when you eat foods that come from animals (meat, eggs and dairy products). Although we often blame cholesterol found in foods for raising blood cholesterol, the main culprit is saturated fat.
Low-density lipoprotein (LDL) is often called bad cholesterol. Too much LDL causes plaque to form on artery walls. When plaque builds up in the coronary arteries that supply blood to the heart, you are at greater risk of having a heart attack. High-density lipoprotein (HDL) carries cholesterol from your cells back to your liver, where it can be eliminated from your body. HDL is known as good cholesterol because high levels may lower your risk for heart disease.
C. West Jacocks IV, MD, FACC W. Strat Stavrou, MD, FACC, FAHA Mitchell W. Jacocks, MD

Q: How are high blood pressure and heart disease connected? A: Blood moving through your arteries and pushing against the arterial walls is measured as your blood pressure. High blood pressure (hypertension) occurs when very small arteries tighten. This means that your heart has to work harder to pump blood through a smaller space and pressure grows inside the vessels. The constant excess pressure weakens artery walls, which makes forming plaque inside your arteries more likely. Q: How important is diet in the development of heart disease? A: Diet can play an important role in protecting you from heart disease. Diets high in animal fat, low in fresh vegetables and fruit, and high in alcohol have been shown to increase the risk of heart disease.

Q: What are the most common heart tests? A: Cardiologists use several tests to determine heart disease or abnormalities. An echocardiogram uses sound waves to create a moving picture of the heart. This picture is more detailed than an X-ray and involves no radiation exposure. Cardiac catheterization is used to diagnose and treat coronary artery disease. During this procedure, doctors thread a long, thin tube through an artery or vein in the leg or arm and into the heart. Cardiac catheterization is also used with other tests such as electrophysiology studies. These tests use cardiac catheterization techniques and electrical impulses to study irregular heartbeats known as arrhythmias.

540 Physicians Lane Sumter, SC 29150 (803) 778-1941

A Lexington Medical Center Physician Practice

SumterCardiology.com

For more information on cardiovascular disease, visit the Lexington Medical Center health information library at LexMed.com.

LexMed.com

techtalk

I Spy Blood Supply

In 2011, LifeCell, a biotechnology company that focuses on tissue grafts and blood cell preservation products, developed the SPY Elite System to help surgeons assess tissue perfusion during plastic, reconstructive and microsurgery by using infrared light. The SPY enables surgeons to see a tissues blood supply and decide whether there is enough to use that tissue for reconstruction. If there isnt, the surgeon can determine if a different plan of action is needed, said Todd Lefkowitz, MD, a plastic surgeon at Lexington Plastic Surgery. According to Dr. Lefkowitz, the

Dr. Todd Lefkowitz using the Spy Elite System in the Lexington Medical Center Surgery Department.

Inside Lexington Medical Center, state-of-the-art technology is taking reconstructive surgery to another level.
arrangement and rearrangement of tissue is the heart of plastic surgery. This non-invasive technology takes what we do to the next level. Blood supply is our lifeline to success in reconstructive surgery. The SPY Elite System offers a fast and accurate assessment of blood supply to tissue during surgery, providing real-time information needed to modify surgical plans before the patient leaves the operating room. The system complements clinical judgment and aids surgical decision-making by visualizing tissue perfusion throughout a procedure. The biggest benefit for the SPY Elite System, depending on its use, is the optimization of a patients surgical plan, said Dr. Lefkowitz. And while this technology is new to Lexington Medical Center, it isnt new to Dr. Lefkowitz. He began using the SPY Elite during his training at the University of Louisville Hospital in Kentucky. During my training, we were one of the first institutions in the world to use the SPY Elite and I saw its effectiveness firsthand. The SPY doesnt lie, he said. Lexington Medical Center is the only hospital in the Midlands with this technology.

Dye injected into a patients bloodstream illuminates tissue with strong blood supply.

Tissue with no blood supply remains dark.

Todd S. Lefkowitz, MD
Medical School: Medical University of South Carolina, Charleston, SC
A Lexington Medical Center Physician Practice

For more information, visit the Lexington Medical Center health information library at LexMed.com.

2728 Sunset Boulevard, Suite 105 West Columbia, SC 29169 (803) 936-7045 LexPlasticSurgery.com

Residency: St. Vincents Hospital and Medical Center, General Surgery; University of Louisville Hospital, Plastic and Reconstructive Surgery Fellowship: Lenox Hill Hospital, Aesthetic Plastic Surgery

House Call March 2013

[ Editorial ]

Its Electric
If there is a problem with your hearts electrical system, blood flow can be disrupted and lead to health problems such as arrhythmias, palpitations and even stroke. As an electrophysiologist at Lexington Cardiology, William W. Brabham, MD, specializes in the diagnosis and treatment of arrhythmias, or abnormal heart rhythms. Patients with symptoms of arrhythmias, such as irregular heart beat, palpitations, light-headedness or passing out, are candidates for electrophysiology testing. While not all patients with arrhythmias require invasive therapy, we can review available options to determine the best strategy for each patient, said Dr. Brabham. Electrophysiology (EP) studies are new to Lexington Medical Centers complete cardiac care program. During an EP study, an electrophysiologist positions catheters in

with Electrophysiology
with William W. Brabham, MD, of Lexington Cardiology, an lmc physician practice

Did you know that your heart has an electrical system? It does! Your hearts electrical system creates the signals that tell it when to beat. And your heartbeat is what pumps blood throughout your body, bringing oxygen and other nutrients to help it function properly.
the heart to diagnose arrhythmias. Cardiac arrhythmias are very common, especially in the aging population of South Carolina. But these illnesses are treatable and can be curable when using newer techniques and technology. Atrial fibrillation, the most common arrhythmia in adults, is now potentially curable with catheter ablation, said Dr. Brabham. Ablation utilizes a catheter to deliver radiofrequency or an alternative energy source to burn cardiac tissue that causes arrhythmias. If a patient needs to have this procedure, it is performed in conjunction with an EP study. EP may also involve the treatment of heart problems including insertion of pacemakers or other device-based therapies to help your heart run properly. Electrophysiology is an essential component of complete cardiovascular care that enables Lexington Medical Center to provide a new dimension of arrhythmia management for patients in Lexington and our surrounding communities, he said. According to Dr. Brabham, electrophysiology has grown as a specialty due to advances in understanding cardiac arrhythmias and improvements in techniques and technology. As a result, outcomes following these procedures are better than ever before.

Willam W. Brabham, MD

2601 Laurel Street, Suite 260 Columbia, SC 29204 (803) 744-4900 131 Sunset Court West Columbia, SC 29169 (803) 744-4940

A Lexington Medical Center Physician Practice

lmcLexingtonCardiology.com

1 The Commons Lugoff, SC 29078 (803) 729-4610

From pasta and potato salads to signature green salads, House Call wanted to know what Lexington Medical Center employees have been tossing together.

Whats Cookin

Our favorite healthy salad recipe came from Dr. E. Jayne Moffatt, a pathologist at the hospital. Her salad uses quinoa, a nutritious grain thats easy to prepare and adds texture. Vegetarians or vegans can substitute eggs or tofu for chicken.

Quinoa Salad Serves 2

4 cups mixed romaine and baby greens 1 red onion, finely chopped 1 cup broccoli florets, broken into bite-sized pieces 1 cup cooked quinoa* 1 fresh tomato, cut into small wedges 1 cup cooked chicken breast or 1 cup firm silken tofu or 2 hard-boiled eggs Dressing: Olive oil and white wine or balsamic vinegar, to taste Salt and pepper, to taste

*To prepare quinoa: Add 1 cup uncooked red or brown quinoa to 2 cups boiling water. Reduce heat to simmer and cover until water has evaporated and quinoa is soft (about 15 minutes). Stir gently with fork. LexMed.com
7

 Points for Your Joints

The knee is one of the most important joints in the body. Knee problems can be painful and debilitating. Lexington Medical Center orthopaedic surgeons understand knee problems and know how to make your knees better.
What is the anatomy of the knee?
Dr. David Kingery: The knee is made up of an upper bone (femur), a lower bone (tibia), the knee cap (patella), four ligaments and two cartilages known as meniscus. Dr. Kevin Nahigian: Both surfaces of the knee are covered with articular cartilage. That cartilage is like tread on a tire. Just like on your car, the tread will wear down over time. surfaces with artificial ones also known as total knee replacement.

Knockout Knees

david kingery, MD

A Lexington Medical Center Physician Practice

146 North Hospital Dr., Suite 140 West Columbia, SC 29169 (803) 936-7230 811 West Main St., Suite 101 Lexington, SC 29072 (803) 936-7230 7033 St. Andrews Rd., Suite 104 Columbia, SC 29212 (803) 936-7230 Lex-Ortho.com

What occurs during knee replacement surgery?

Dr. David Kingery: A knee replacement to a knee is much like a crown to a tooth. We resurface the upper and lower bones, and the patella. Plastic is placed between the resurfaced bones and attached to metal on the lower bone or tibia.

david LEE, MD

What are some initial treatment options for knee pain?

Dr. David Lee: Depending on the extent of the wear or arthritis, a treatment plan may start with an anti-inflammatory medication or cortisone injection. Physical therapy may help strengthen the muscles around the knee. Hyaluronic acid injections may help lubricate the knee joint. Dr. Kevin Nahigian: In addition to injectable options, there is technology that allows us to harvest cartilage cells from the knee, culture them and inject them beneath a patch to allow the body to grow back a cartilage which is similar to the original cartilage. Dr. David Kingery: Knee replacement is considered when a knee becomes painful with daily activities due to complications from arthritis or a traumatic injury. Dr. Kevin Nahigian: If the cartilage has become worn and bare bone is exposed, the knee becomes increasingly more painful and dysfunctional. When symptoms become refractory, we begin talking about replacing the knee

How can we take care of our knees?

Dr. David Lee: Sometimes knee problems are genetic and may be inevitable. But maintaining a healthy weight and good muscle strength around the knee will maximize function and possibly reduce the risk of needing medical intervention. Dr. David Kingery: Weight reduction and regular exercise are the most effective ways to prevent knee problems. Dr. Kevin Nahigian: Take care of your knees, stay strong, watch your weight and get moving!
A Lexington Medical Center Physician Practice

110 East Medical Lane, Suite 140 West Columbia, SC 29169 (803) 936-7966 seOrthopaedic.com

When do doctors begin to consider surgery for a patients knee?

Dr. David Lee: When other conservative measures arent helpful, we start talking about surgery. Surgical options range from arthroscopic surgery to total knee replacement.

kevin nahigian, MD

A Lexington Medical Center Physician Practice

810 Mallet Hill Road Columbia, SC 29223 (803) 419-6646 LMCCarolinaShoulder.com

House Call March 2013

My Love Affair with the Bicycle

on-again, off-again
By Langston Powell, MD

Dr. Langston Powell, an LMC urgent care physician, rides his bike 25 miles to work.
remember my first green Schwinn with its banana seat and tall handlebars. By age 12, I was riding that bike all over Columbia. The bike meant freedom, fun and adventure. In my neighborhood, riding our bicycles was our main leisure activity. For my peers, the infatuation with two wheels ended around age 16, when most of us started to think about girls and cars. While I eventually found a nice girlfriend, my car was old and always broken down. So the bicycle was my frequent transportation. Even in medical school, I depended on my bike to get around. By the time I entered my medical residency, I could afford a decent car that wasnt always in the shop. I began to ride my bicycle less. Over time, I gained 20 pounds. In 2001, the bicycle bug bit me again. I was going on weekend rides of 20, 40 and eventually 60, 80 and sometimes a full 100 miles. I also began racing again winning and placing in South Carolina biking championships. In 2010, I started working for Lexington Medical Center. I thought it would be neat to ride to work in Lexington County from my house in Columbias Shandon neighborhood.

Riding the 16 miles from my house to Urgent Care in Lexington took me about 30 minutes by car and about an hour by bicycle. I was getting two hours of exercise every day with an hour of it being free meaning that I would have spent an hour of that time driving anyway. The only drawback was that the ride was mostly over really busy roads. I spent much of the time riding in the median or on the sidewalk. There must be a better route, but I have not yet discovered it. I was also working at Urgent Care in Swansea. Thats almost 25 miles from my house. I traveled through Shandon, down the bike lanes of West Columbia, onto the12th Street Extension, to Old Wire

Dr. Langston Powell competes in the 2008 Vista Grand Prix.

Road, to Highway 321 for a few miles and I was there! It took about 75 minutes. I used this ride to prepare for the 40K state time trial championships. I won my age group in 2011 and was 2nd in 2012 with a personal best time of 59:29 for 25 miles. Unfortunately, there were drawbacks such as bad weather. I once rode down Highway 321 in a blinding rain. It was a struggle to stay upright as the wind blew me sideways. I felt lucky to make it through that ride unscathed. The other hazard was the ride at night its no fun being buzzed by an 18-wheeler in the dark. The bicycle is an amazing machine efficient transportation and an excellent method of exercise. Ive lost 20 pounds since I began riding my bicycle and have reduced my body fat to 10%. I think its important to make the most of your exercise time. I use a heart rate monitor while on the bike, with portions of the ride at 80 to 95% of my maximum heart rate. Though we have made great strides in the treatment of heart disease and cancer, we are losing the war on obesity. Reducing obesity would have a tremendous impact on health care costs and the wellbeing of our citizens. For some, the bicycle might lead to health and happiness.

The bicycle is an amazing machine efficient transportation and an excellent method of exercise.
Dr. Langston Powell
LexMed.com
9

[ Feature ]

The Beat Goes On

On March 28, 2012, Dr. Jeffrey Travis and his team made history when they performed the first open heart surgery at Lexington Medical Center.
Between that day and the end of 2012, there were 146 open heart surgeries at Lexington Medical Center. The most common procedures were coronary artery bypass grafting and valve repairs or replacements. In addition to Dr. Travis, the hospitals heart surgery team includes physician assistant Victor Gomez; cardiovascular anesthesiologists Dr. Virgil Kenneda and Dr. Patrick Sipe; certified registered nurse anesthetists Christa Collins, Judy Wolfe, Amanda Baker and Kelly Metts; perfusionists led by Ty Walker; registered nurses Carol Antley, Richard OConnor, Melanie Parilla and Mona Smith; surgical technologists Michelle McCarthy and Kristie Taylor; and Cardiovascular Operating Room Nurse Manager Meri Kinney.

A Year of Complete Cardiac Care at Lexington Medical Center

March 2013 marks an important milestone for cardiovascular care in the Midlands. Its the one-year anniversary of Lexington Medical Centers first open heart surgery.

Open heart surgery inside Lexington Medical Center

I enjoyed seeing a group of professionals come together to work toward a common goal, Dr. Travis said. And Im so proud of how well they have done. Many of Lexington Medical Centers heart surgery patients participated in cardiac rehabilitation. Patients work with staff members to develop a personalized wellness plan that helps them rebuild strength, endurance, emotional well-being and confidence. Cardiac rehab changes lives and saves lives, said John Leech, cardiac rehab manager at Lexington Medical Center. This year, Lexington Medical Center will add a second heart surgeon. Dr. Steven Marra comes to Lexington Medical Center after five years as medical director of Cardiothoracic Surgery at Rockingham Memorial Hospital in Harrisonburg, VA (read more about Dr. Marra on page 3). In addition, Lexington Medical Center will focus on growing the programs technology and services. The hospital is now expanding electrophysiology, a sub-specialty of cardiology that focuses on the treatment of abnormal heart rhythms. That includes catheter ablations for the treatment of atrial fibrillation. And the hospital is looking into providing minimally invasive aortic valve replacement in the future. We want to make sure were providing the best care with the latest techniques and state-of-the-art equipment, said Lang Spotts, assistant vice president for Cardiovascular Administration at Lexington Medical Center. That work extends into the community, with a robust heart education program and strong resources for people who want to be involved in heart health. The goal is to deliver comprehensive cardiovascular care focused on unparalleled efficiency and excellent outcomes.

Physician Assistant Victor Gomez of Lexington Cardiovascular Surgery during open heart surgery at LMC 10

House Call March 2013

Patient Story

Les Snipes, 60
Coronary Artery Bypass on November 16, 2012
The last thing Les Snipes remembers from Friday, November 16, 2012 is pulling into the parking lot of the Lexington Medical Center Emergency Department in the back of an ambulance with paramedics talking on a radio about his racing pulse. Then he passed out.
Twenty minutes later, he would be in Lexington Medical Centers cardiac surgery suite undergoing open heart surgery that would save his life. It all started earlier that day. Sixtyyear-old Snipes was driving his truck in the Pond Branch area of Lexington County when he started to feel dizzy. He pulled over to the side of the road. Soon, he was sweating and vomiting. He knew he needed help, but he was about 10 miles away from anyone. He managed to drive to a friends house nearby. The friend called 911 and an ambulance rushed Snipes to Lexington Medical Center. Snipes was having a major heart attack. It was a significant cardiac emergency. Snipes had two blocked arteries. His particular kind of heart attack is nicknamed the widow maker because of its often fatal outcome. Doctors said Snipes needed open heart surgery right away in order to survive. They sent him immediately to Lexington Medical Centers cardiac surgery suite where he underwent a coronary artery bypass. but I was smoking a pack of cigarettes a day, he said. I stopped five years ago, but it made me edgy, so I started smoking again. Since his surgery, hes quit smoking. Today, he says he feels just about 100 percent better.

I should have died that day, he said. But I received great care.
The next thing Snipes remembers is waking up Saturday morning in Lexington Medical Centers Surgical Intensive Care Unit. He spent a week in the hospital recovering from surgery and beginning cardiac rehabilitation. I couldnt have asked for better care. Im glad to still be here. On the day Snipes came home, the first thing he wanted to do was build a fire pit in his backyard and spend time with his beloved dog, Scooter. And he had some thinking to do. I never thought I was a bad eater,

Dont smoke Maintain a healthy weight Exercise regularly Eat healthy foods Manage your blood pressure Take charge of cholesterol Keep blood sugar in check

To keep your heart healthy

LexMed.com

11

Patient Story

Jim Guilfoyle, 67
Aortic Valve Replacement and Aorta Repair on September 17, 2012
Jim Guilfoyle is the picture of good health. He canoes on Lake Murray. He rides his bike to work in Irmo two miles each way. He was a competitive gymnast in high school.
And he enjoys flying his Piper Cherokee 140. The married father of three grown sons has had a pilots license since 1966. He even flew his plane to South Carolina from his home state of Minnesota when he and his wife moved here 16 years ago. But one day about seven years ago at a required Federal Aviation Administration physical, the doctor heard a heart murmur. Guilfoyle was diagnosed with a bicuspid aortic valve, a congenital heart defect in which the aortic valve has two leaflets instead of three. That can mean the heart has to work harder to pump blood. The extra pressure was causing Guilfoyles heart to enlarge. Doctors told Guilfoyle that one day hed likely need his aortic valve replaced. He wasnt nervous, but when doctors started shortening the time between his heart appointments, he knew the time was getting closer. In 2012, he started to experience shortness of breath. The time had come. Guilfoyle had aortic valve replacement at Lexington Medical Center on September 17, 2012. During the surgery, doctors also noticed that his aorta, the main artery from the heart to the rest of the body, was dilating as a result of the faulty valve. They repaired that, too. Everyone who took care of me at the hospital was unbelievable, he said. And they prepared my wife for what would happen when we came home. Guilfoyle spent two days in the Surgical Intensive Care Unit and another two days as an inpatient. He was walking around just one day after surgery. Since coming home, hes attended Lexington Medical Centers Cardiac Rehabilitation program. He returned to work after eight weeks and is now back to canoeing on Lake Murray and biking to work. He hopes to start flying again, soon. Doctors say his fast recovery was due, in part, to his excellent level of fitness and health before surgery.

each year in South Carolina

9,000
people die from cardiovascular disease

2,000
people die from stroke

50,000
people are hospitalized because of heart disease

14,000
people are treated for stroke in hospitals

7 YEARS
Life expectancy in the United States would rise by if all forms of major cardiovascular disease were eliminated
Source: American Heart Association

12

House Call March 2013

Patient Story

know your numbers

Blood Pressure:

Total Cholesterol:
less than

120/80 180

less than

Linda Burdick, 60
Aortic Valve Replacement on October 16, 2012
Looking back, life as a 5-year-old was no fun for Linda Burdick. She was sick with bad fevers almost the whole year. Doctors took her tonsils out and she got better but the fevers had done irreversible damage to one of her heart valves.
Ever since, the Northeast Columbia woman had a heart murmur. Doctors monitored it throughout her childhood and into adulthood. I always had a heart murmur it was part of me, she said. A few years ago, her primary care physician began performing echocardiograms, which are ultrasounds of the heart, and told her he would keep an eye on the valve. Last year, her doctor thought the results of her latest echocardiogram were severe enough for Burdick, now age 65, to have a consultation with Dr. Jeffrey Travis at Lexington Cardiovascular Surgery. Dr. Travis told Burdick that her aortic valve had become too narrow to let the correct amount of blood through the heart and that she needed open heart surgery to fix it. He told me, The time is now. I had to process that, because it was a hard thing to hear, she said. The thought of surgery was somewhat a surprise. I started having some shortness of breath and heart palpitations last year, she said. And if I laughed or coughed, Id see spots in front of my eyes. But I thought I was just getting old and I didnt give my valve issue much thought. So the thought of open heart surgery was overwhelming. The morning of surgery, Burdick said Dr. Travis prayed LexMed.com with her. He prayed for me to come through the surgery and he prayed that God would guide his hands. I really appreciated that and it calmed me down. Burdick understands the power of prayer. She works on the prayer line at Northeast Presbyterian Church in Columbia, taking prayer requests from the voice mail system and praying for members of the congregation and their families. Burdick woke up after successful surgery with a breathing tube and some pain at the site of the incision. But the hospital was great. In a session I had a few days before surgery, they told me exactly what was going to happen so I was prepared. She returned home after five days in the hospital. One of the biggest challenges in Burdicks recovery was using her walker. Burdick also has arthritis and needs the help of a walker to get around. So she used a wheelchair for the first four weeks. Today, she can tell that her heart surgery made a positive difference. She says she can take deeper breaths and when she laughs or coughs, there are no more spots in her eyes.

LDL Cholesterol:

130 or
less than

less than

if you have other risk factors

100

HDL Cholesterol:
more than

Optimal
less than

60 50 40

is a risk for women

less than

is a risk for men

Learn more about our cardiovascular surgery program at LexMed.com.

13

hospitalspotlight

calendar of events
march 2013
Your Special Touch Infant Massage: 4, 11, 18 Your Special Delivery (Tuesday Series): 5, 12, 19, 26 Caring for You and Your Baby: 5, 28 Total Joint Replacement: 7 Infant and Child CPR: 7, 26 Your Special Delivery (Saturday Series): 9, 23 Super Sibling: 12, 21 Breastfeeding: 14 Hysterectomy: 14 Colon Cancer Challenge: 23 Physician Lecture Series: 25 Mammography Van Schedule: LMC BatesburgLeesville 4 LMC Swansea 11 LFP Northeast 13, 26 Wagener 21

may 2013
Total Joint Replacement: 2 Infant and Child CPR: 2, 21 Your Special Delivery (Saturday Series): 4, 18 Your Special Touch Infant Massage: 6, 13, 20 Your Special Delivery (Tuesday Series): 7, 14, 21, 28 Caring For You and Your Baby: 7, 23 Breastfeeding: 9 Hysterectomy: 9 Super Sibling: 16, 28 Physician Lecture Series: 27 Mammography Van Schedule: LMC Swansea 23 LFP Northeast 28

The O-Arm at work inside LMCs surgery department

Imagine a machine that can take real-time, 3-D, HD images of the inside of your body during surgery.
screen at a view station next to Doctors can see exactly whats going the operating table. on inside of you and make sure every Before O-arm technology, step is correct throughout the surgical patients would have an MRI or procedure. You probably wouldnt CT scan before surgery and want to have surgery without it. And doctors would use one- or now you dont have to. two-dimensional images to Lexington Medical Center is the guide them. They would place first hospital in the Midlands with instruments and implants by using the technologically advanced O-arm, their best educated guess based a new imaging system for spinal on standard anatomy. But in back surgery. surgery, doctors are working The O-arm is a machine placed An O-arm image of through a small opening and it around a patient on the operating instrumentation placed during back surgery at can be difficult to know where you table. Before surgery, doctors use Lexington Medical Center are in the spine. Margins of error the O-arm to capture images of the patient that help them develop a precise surgical are millimeters and implants must be placed with a great deal of accuracy. guide. During surgery, the O-arm images allow The O-arm improves safety for surgeons and neurosurgeons to confirm proper placement staff members, lowers the chance of revision of instrumentation. After implants are placed, surgeries and can enhance patient outcomes. neurosurgeons use the O-arm again to confirm Spinal problems can be chronic and debilitating. correct placement of instruments in the spine The O-arm gives patients a great opportunity for and address anything further that needs to be done. Images are displayed on a large, digital flat excellent results.

Meet the O-arm

june 2013
Your Special Touch Infant Massage: 3, 10, 17 Your Special Delivery (Tuesday Series): 4, 11, 18, 25 Caring for You and Your Baby: 4, 20 Total Joint Replacement: 6 Infant and Child CPR: 6, 13, 25 Your Special Delivery (Saturday Series): 8, 22 Super Sibling: 11, 27 Breastfeeding: 13 Hysterectomy: 13 Physician Lecture Series: 24 Mammography Van Schedule: LMC BatesburgLeesville 3 LFP West Columbia 4 Peterson & Plante Internal Medicine Associates 6 LMC Swansea 10 LFP White Knoll 11 LFP Northeast 12, 25 Sandhills Womens Care 13 Wagener 20 LFP Ballentine 21 LMC Gilbert 24 Spring Valley Family Practice 27 LFP Lake Murray 28

april 2013
Your Special Touch Infant Massage: 1, 8, 15 Your Special Delivery (Tuesday Series): 2, 9, 16, 23 Caring For You and Your Baby: 2, 25 Total Joint Replacement: 4 Your Special Delivery (Saturday Series): 13, 20 Breastfeeding: 11 Hysterectomy: 11 Super Sibling: 11, 23 Infant and Child CPR: 18, 30 Physician Lecture Series: 22 Mammography Van Schedule: LMC BatesburgLeesville 1, 29 LFP West Columbia 2 Peterson & Plante Internal Medicine Associates 4 LMC Swansea 8 LFP Northeast 10, 23 Sandhills Womens Care 11 LFP Lexington 12 LMC Gilbert 15 LFP White Knoll 16 LFP Ballentine 19 Spring Valley Family Practice 25 LFP Lake Murray 26

Now, with the O-arm, we are able to do procedures that previously were considered too risky expanding the scope of what we can treat, especially minimally invasive procedures. It gives patients a great opportunity for excellent results, said Scott Boyd, MD, a surgeon who uses the O-arm at Lexington Medical Center.
Scott Boyd, MD 14

Lexington Medical Center began using the O-arm this summer. For more information, visit LexMed.com/O-arm.

Visit LexMed.com and select Calendar for details on classes and times.

House Call March 2013

the doctor is in

[ Editorial ]

We Can Prevent Colon Cancer

An editorial by March Seabrook, MD, Gastroenterologist

awareness plus action

March is Colorectal Cancer Awareness Month and a good time to talk about the disease thats expected to cause 2,350 new cancer diagnoses in South Carolina this year. Colon cancer remains the second-leading cause of cancer deaths in both men and women, behind lung cancer.
Early detection is important. But with colorectal cancer, the goal is not only awareness, but action. Thats because timely screening can actually prevent you and your loved ones from developing the disease. And screening is especially important for African Americans, who are disproportionately affected by the disease and likely to die earlier. Colorectal cancer develops from small growths called polyps that form on the inside lining of the colon, or large intestine. We dont know exactly why some people are more likely to develop polyps. But they are more common as people get older. Its recommended that everyone be screened for colorectal cancer at age 50. Some organizations recommend that African-Americans be screened at age 45. Also, be aware of your family history. If someone in your family has had colorectal cancer or even polyps you are at increased risk and should be screened at an earlier age. This is where the great potential for prevention comes in. Screenings that detect and remove precancerous polyps can prevent colorectal cancer. And when the disease is found and treated early, people have a much better chance for survival. Survival rates are much lower when colorectal cancer has spread to other organs. Symptoms of colorectal cancer may include unexplained blood in the stool, change in bowel behavior, weight loss or abdominal pain. But its important to know that early-stage colorectal cancer typically has no symptoms at all. About 25 to 30 percent of people who are screened will turn out to have precancerous polyps. The best test to detect and remove polyps is a colonoscopy. Youll need to clean out your colon the night before, which most people say is the worst part of the procedure. You are sedated during the colonoscopy, and most patients dont even remember the process afterward. If there are no polyps found and no colon cancer in your family, you might not need another colonoscopy for 10 years. If your doctor finds polyps, the size, type and number will determine when you need another screening. As with many other diseases, a healthy lifestyle may help to reduce your risk of developing colon cancer. According to the American Cancer Society, exercising and eating more fruits, vegetables and whole grains may lower your risk. A diet high in red meats, processed meats and fried meats may increase your risk. Many South Carolinians are realizing the importance of colorectal cancer prevention and screenings. If its time for you to have a screening, please do. And talk to your friends and family members about screening, too. We can prevent colorectal cancer!

March Seabrook, MD Gastroenterologist

Saturday
March 23, 2013

Join Lexington Medical Center for the Annual

Colon Cancer Challenge

Dutch Fork High School ~ 1400 Old Tamah Road, Irmo

65-mile Ride ~ $35* 50-mile Ride ~ $35* 26-mile Ride ~ $35* 8K Boxer Runway ~ $25* NEW!
Turn your boxers into outerwear! Decorate boxer shorts to wear in the race.
*Fees will increase after March 11, 2013.

Please visit LMCColonCancerChallenge.com for more information.

All proceeds will go to fund colon cancer screenings for underinsured and uninsured patients.

LexMed.com

15

Easy Exercises for Women on the Go

Finding time to exercise in the midst of balancing work and family is one of the most challenging tasks in our lives; however, any amount of exercise is beneficial and those benefits are cumulative.
Judy Rubinson, a certified personal trainer at Health Directions, recommends a few minutes of activity while playing with your children or sitting at your desk as a way to reach the recommended 30 minutes of moderate activity per day. Always park the farthest distance from your destination to work toward 10,000 steps per day, and take the stairs. If you want a challenge, try taking two steps at a time, said Rubinson. And there are many opportunities to exercise with your children. The easiest? Play with them. Run around your backyard, jump on a trampoline or use hula hoops. You can also take a family walk around the neighborhood after dinner or before bed. Judy also suggests pushing your child on a swing and, after each push, doing a squat. Here are a few activities to help you meet your daily exercise goal. cardio: Low-impact jumping jacks

C a r d i o
Low-impact jumping jack: Raise right arm and tap left toe to the side while keeping right foot on the floor. Alternate sides. Chubby Checker Twist: Stand with feet hip-width apart. Twist hips from side to side, moving one foot out to help with the motion.

S t r e n g t h
Wall Sit: With back against the wall, bend knees and slide your back down the wall until thighs are parallel to the floor. Sit and hold 30 to 60 seconds. Repeat 10 to 15 times and work up to 3 to 5 sets. Stationary Lunges: Place one foot 2 to 3 feet behind you with heel lifted off the floor. Bending that knee, lower yourself toward the floor. Keep shoulders aligned over hips. Pushing down through your front heel, raise back to the start position while squeezing your buttocks and tightening your abs. Straight Leg Raises: Sitting on the edge of a chair, extend knee and lift your leg to hip level. Hold a few seconds and tighten quadriceps. Lower your leg to a few inches above the floor and repeat. tricep Dips: Sitting with hands shoulder-width apart on the edge of a chair, slide buttocks off the chair and lower your body by bending knees. Keep your back close to the chair until elbows are at a 90-degree angle. Press yourself back up until elbows are fully extended. flexibility: lats

F l e x i b i l i t y
Lats: While sitting, place your hands on the edge of a desk or table and slide the chair back until your elbows are fully extended. Let your chest sink toward the floor. Next, round your spine toward the ceiling while tucking in your chin and pelvis. Release. Hamstrings: Sitting tall on the edge of your chair, extend your legs out straight, heels on floor, toes up. Flex forward from the hips with good posture until you feel the back of your legs stretch and hold for 20 seconds. Shoulders: Roll shoulders forward 10 times, then backward 10 times. Shrug your shoulders up and down 10 times.

strength: stationary lunges

Fitness classes Personal training Wellness programs 3239 Sunset Boulevard, West Columbia lmcHealthDirections.com

Check out Health Directions at its new facility! Come by for a free one-week trial.

strength: dips

16

House Call March 2013

Back-to-Back! Lexington Medical Center Wins Pink Glove Dance Competition!

With nearly 15,000 votes and 63,000 YouTube views from around the world, Lexington Medical Center has won back-to-back National Pink Glove Dance video competitions.
The Pink Glove Dance video competition gave us an incredible opportunity to showcase the level of passion that our employees have for breast cancer awareness, our community and each other, said Barbara Willm, vice president of Community Relations. The Pink Glove Dance contest culminated on November 9 when Medline announced LMC as the 2012 winner live on FOX & Friends on the FOX News network and presented LMC with a $10,000 first-place prize. LMC then donated the prize to the Vera Bradley Foundation for Breast Cancer. To date, there have been more than 3.2 million views of the 2012 Pink Glove Dance video competition entries, including more than 63,000 for Lexington Medical Centers video.

This was truly a team effort and we could not be more proud of our staff for their commitment.
Sponsored by Medline Industries, Inc., more than 260 hospitals, nursing homes, schools and other organizations across the United States and Canada entered a video in this contest, which raises awareness about breast cancer and shows support for cancer survivors. Lexington Medical Center is honored to be selected as the Pink Glove Dance winner for 2012, said Mark Shelley, vice president of Marketing and Communications. Its our privilege and responsibility to raise awareness about a devastating disease that millions of women are diagnosed with each year. In the 2012 video, approximately 1,000 hospital employees danced to the Katy Perry song Part of Me while wearing pink gloves. The video featured LMC nurse Amy Kinard, who was diagnosed with breast cancer five years ago at the young age of 34. Importantly, the dance included several LMC employees who are breast cancer survivors and centered around the theme Survivor from Day 1, which represents the overall message of LMC Cancer Services and its clinicians and notes the courage, strength and fighting spirit of all cancer patients.

Its more than a video contest, said Shelley. Its a show of support for everyone in our communityFor who more information, visit www.lexmed.com. View Lexington Medical Centers 2012 Pink Glove Dance on the hospitals YouTube channel: youtube.com/lexingtonmedical. has cancer.
LexMed.com
17

Spring Is in the Air So Is Pollen

with Andrew P. Battiata, MD, of Lexington ENT and Allergy

Sneezing, wheezing, hives, nasal congestion and itchy, watery eyes more than 67 million Americans suffer from these and other seasonal allergy symptoms.
According to Andrew Battiata, MD, a physician at Lexington ENT & Allergy, the severity of an allergic reaction can vary from mild discomfort to life-threatening situations. An allergy is characterized by an over-reaction of the immune system to a foreign substance (called an allergen) that is eaten, inhaled, injected or touched. This over-reaction can result in symptoms such as coughing, sneezing, itchy eyes, runny nose and scratchy throat. In severe cases, it can also result in rashes, hives, lower blood pressure, difficulty breathing, asthma attacks and even death, said Dr. Battiata. For people with allergies, their immune systems work too hard and react even when relatively harmless substances, such as pollen, are present. And left untreated, allergies can lead to chronic health problems. By far, the most common side effect from an untreated allergy is frequent sinus infections that require steroids and/or antibiotics, or even sinus surgery. People with untreated allergies also miss time from school or work and have decreased quality of life, said Dr. Battiata. In the spring, the most common allergen is tree pollen, which begins to release between January and April, depending on the climate and location. The trees include elm, pine, birch, ash, hickory, poplar and cypress just to name a few. Grass pollen takes over in summertime, and weed pollen appears in the fall. And allergies can be both environmental and genetic. If one parent has allergies of any type, chances are one in three that each child will have an allergy. If both parents have allergies, it is much more likely (seven in 10) that their children will have allergies, he said. So testing is important, too. Dr. Battiata recommends skin testing as the most accurate way to determine allergies. Blood testing, known as radioallergosorbent (RAST) testing, is also available. Allergies and their symptoms can be a big problem, but there are ways to find relief. There are three types of treatments that can be used in combination: avoidance of the allergen, use of antihistamines, steroids or other medications, and immunotherapy (allergy shots) to desensitize the allergic response, said Dr. Battiata. Although avoiding all airborne allergens is virtually impossible, knowing the peak pollen season and tracking daily pollen counts can help minimize exposure. You can also use allergy devices in your home, such as an air cleaner and air conditioner, which will help remove pollen and mold spores from the air. Be sure to keep the filters clean!

Pollen Peaks
Hot, dry, windy days
usually mean more pollens and molds are in the air.

Rain showers tend

to wash pollens out of the air.

ground level, the pollen

count is highest between 8:00 a.m. and 12:00 p.m. and between 5:00 and 9:00 p.m. Pollen counts fall during times of higher and rise during low humidity.

Generally, at

humidity

The the temperature, the greater the pollen count.

warmer

A Lexington Medical Center

Physician Practice

Lexington Medical Park 1 2728 Sunset Boulevard Suite 307 West Columbia, SC 29169 (803) 936-7530 Lexington-ent.com

For more information, visit LexMed.com.

18

House Call March 2013

Lexington Medical Center proudly welcomes the following physicians and practices to our network of care.

Lexington ENT & Allergy is excited to welcome Edward A. Woody, MD.

Lexington Rheumatology welcomes Bryan J. Wolf, MD.

Chapin Womens Care welcomes George W. Watt, MD, FACOG.

Vista Womens Healthcare has opened a second location in the Irmo area and added the care of Abigail Scheuer Smith, MD, and Eva A. Imperial, MD.

A Lexington Medical Center Physician Practice

A Lexington Medical Center Physician Practice

A Lexington Medical Center Physician Practice

A Lexington Medical Center Physician Practice

Lexington Medical Park 1 2728 Sunset Blvd., Suite 307 West Columbia, SC 29169 (803) 936-7530 Lexington-ent.com

110 East Medical Lane Suite 235 West Columbia, SC 29169 (803) 936-7410 LexingtonRheumatology.com

557 Columbia Avenue Suite D Chapin, SC 29036 (803) 345-7546 ChapinWomensCare.com

700 Gervais Street, Suite 300 Columbia, SC 29201 (803) 254-3230 1 Wellness Boulevard, Suite 203 Irmo, SC 29063 (803) 732-4608 VistaWomens.com

A Lexington Medical Center Physician Practice

Lexington Cardiology welcomes electrophysiologist William W. Brabham, MD.

Lexington Cardiovascular Surgery welcomes cardiovascular surgeon Steven W. Marra, MD, FACS.

Sandhills Womens Care has relocated its Northeast location to a new facility in The Summit.
90 Summit Centre Drive Columbia, SC 29229 (803) 788-0268 Lexington Medical Park 1 2728 Sunset Blvd., Suite 202 West Columbia, SC 29169 (803) 936-7099 SandhillsWomensCare.com

Sumter Cardiology specializes in the diagnosis and treatment of cardiac disease. Located in the heart of Sumter, SC, the practice consists of C. West Jacocks IV, MD, FACC, W. Strat Stavrou, MD, FACC, FAHA and Mitchell W. Jacocks, MD.
540 Physicians Lane Sumter, SC 29150 (803) 778-1941 SumterCardiology.com

A Lexington Medical Center Physician Practice

A Lexington Medical Center Physician Practice

2601 Laurel Street, Suite 260 Columbia, SC 29204 (803) 744-4900 131 Sunset Court West Columbia, SC 29169 (803) 744-4940 1 The Commons Lugoff, SC 29078 (803) 729-4610 lmcLexingtonCardiology.com

Lexington Medical Park 1 2728 Sunset Blvd., Suite 101 West Columbia, SC 29169 (803) 936-7095 LexingtonCardiovascular.com

A Lexington Medical Center Physician Practice

View Lexington Medical Centers latest heart commercial, I Am A Heart Attack, on our YouTube channel: youtube.com/lexingtonmedical.
19

LexMed.com

Postmaster: Please deliver between March 1115. Lexington Medical Center 2720 Sunset Blvd. W. Columbia, SC 29169

Prsrt Std U.S. Postage

PAID

Lexington Medical Center

This magazine is intended for general understanding and education about Lexington Medical Center and health issues. Nothing in the magazine should be considered or used as a substitute for medical advice, diagnosis or treatment. Readers with personal health or medical questions should consult their health care provider.

LMC photo finish

October 16, 2012 Organized by the Carolina Marathon Association, the Lexington Medical Center Governors Cup Road Race included a half marathon, an 8K run, a four-mile walk and a Kids Cup Run.
More than 2,000 people participated in the race, which is one of the oldest, most well-established running events in the region. Sanctioned by USA Track & Field and part of the Palmetto Grand Prix and Tour de Columbia, the course began in front of the South Carolina State House in Columbia and ended at the historic Horseshoe of the University of South Carolina.

More than 900 people attended Womens Night Out 2012, which featured a health and wellness fair, a silent auction, a fashion show featuring cancer survivors and dinner.
Dee Dee Ricks, a cancer survivor and motivational speaker, shared her story of surviving breast cancer and focusing her efforts toward helping uninsured and underinsured cancer patients in her community. Proceeds from the event benefited the Crystal Smith Breast Cancer Fund, which provides wigs, lymphedema garments, mastectomy kits and prostheses for women who are undergoing cancer treatment and cannot afford these items.

20

House Call March 2013