Geisinger Hospitals Recognized for Maternal Healthcare Five Geisinger hospitals were recipients of the Pennsylvania Perinatal Quality Collaborative (PA PQC) inaugural Designations Awards. The awards, presented May 22 at a ceremony in Harrisburg, recognize hospitals for establishing multidisciplinary teams that have demonstrated improvements in maternal and newborn care by sharing best practices in their hospital and community. Hospitals could earn a designation for each 2023-24 PA PQC initiative in which they actively participated, including: the availaibility of immediate postpartum long-acting reversible contraception (IPLARC); maternal substance use disorders (SUD) identification and treatment; and standardizing the treatment of the substance exposed newborn (SEN) to reduce the need for drug therapy. The awards are based on meeting quality improvement milestone criteria from April 2023 through March 2024. “These recognitions are a reflection of the focus that our Obstetric and Pediatric teams place on high quality and equitable care across the Geisinger system,” said Sandra Culbertson, M.D, chair of Geisinger’s Women and Children’s Institute. “Responding to the opioid crisis and providing easy access to effective contraception are priorities that reflect the needs of families in our communities.” Geisinger Medical Center earned a silver designation to recognize its work in the issue areas of SUD focusing on health equity and a bronze designation in IPLARC. Geisinger Bloomsburg Hospital earned a gold designation in SEN, a silver designation in SUD with a health equity focus, and a bronze designation in IPLARC. Geisinger Wyoming Valley Medical Center earned a gold designation to recognize its work in the issue areas of SUD and a bronze designation in IPLARC. Geisinger Lewistown Hospital earned a silver designation in SEN with a patient voice focus, a silver designation in SUD with a health equity focus, and a bronze IPLARC designation. Geisinger Community Medical Center in Scranton earned a silver designation to recognize its work in the issue areas of SUD focusing on health equity and a bronze designation in IPLARC. A gold designation signifies a hospital’s proven commitment to health equity and patient voice in their quality improvement work. A silver designation signifies the hospital’s proven commitment to incorporating health equity OR patient voice into its quality improvement work. A bronze designation signifies the hospital met the required quality improvement submission criteria for at least two of the four quarters. In Pennsylvania, perinatal health issues persist, including racial and ethnic disparities in maternal and neonatal outcomes, higher than average maternal sepsis rates, and drug overdose deaths during pregnancy and postpartum. The PA PQC addresses these challenges through various initiatives, including Maternal Opioid Use Disorder, Neonatal Abstinence Syndrome, Maternal Sepsis, and Safe Sleep. Through collaborative efforts, the PA PQC aims to improve maternal and neonatal health outcomes across the state. “All Geisinger delivery hospitals have taken an active role in the PA PQC since its inception in 2019. The work is conducted by hospital staff (nurses, care managers and providers) who have shown tremendous dedication to improving care for mothers and babies,” said James Cook, M.D., Geisinger director of newborn services and co-chair on the PA PQC for pediatrics. “This work has been rewarded by the PA PQC with funds to purchase equipment and provide further education to our staff. “Future PA PQC initiatives for 2024-25 will include a focus on reducing the incidence of both maternal sepsis and sudden unexpected infant death across the region,” Dr. Cook added. The PA PQC is administered by the Jewish Healthcare Foundation and WHAMglobal, and it is affiliated with the Northeastern PA PQC (NEPaPQC).
Geisinger Discusses Isometric Exercise By: Geisinger, interventional cardiologist, Sandy Green, MD Exercises to combat high blood pressureNew evidence points to wall sits, planks and other isometric exercises as the most effective at lowering high blood pressure. Movement is the key to combating hypertension, right? Not so fast. It’s long been thought that aerobic exercise — think brisk walking, running and cycling — strengthens your heart and reduces blood pressure. And that’s true. But new evidence shows wall sits, planks and other isometric or static exercises are more effective at lowering high blood pressure. While research shows all forms of exercise are good for your heart, isometric training is a promising exercise mode for people with high blood pressure. The good news is isometric exercises also bolster joint stability, promote better posture and can be beneficial for preventing injuries and aiding in rehabilitation. What is isometric exercise? Isometric exercise is a low-intensity form of strength training where you contract or tighten a muscle group and then hold still — without any joint movement. While holding in a static position, the exercise relies on your body’s weight to help maintain strength and stabilize your joints and core. Isometric exercise is convenient, can be done in just a few minutes and doesn’t require any equipment and you can perform it easily at home or in the office during breaks. Why are isometric holds the best exercise to lower blood pressure? A study published in the fall of 2023 in the British Journal of Sports Medicine revealed that while most types of exercise helped lower blood pressure, isometric training was the most effective at lowering both systolic and diastolic blood pressure — especially in people with high blood pressure. When doing a plank or other isometric hold, your muscles contract and generate tension. That makes your blood vessels constrict, causing more demand for oxygen and nutrients. Decreased blood flow stimulates the production of nitric oxide, which dilates blood vessels to improve blood flow and supply these required resources. As a result, more blood can flow through the blood vessels and blood pressure is reduced. Strength training also engages the muscles and constricts blood vessels, but not for an extended time. When you do a bicep curl, you don’t hold it for several minutes. You lift it quickly and go back down, so you’re not getting the decreased blood flow to the area and increased production of nitric oxide from holding the position. An isometric hold also increases your heart rate and cardiac output to supply more oxygen to your muscles. Over time, this strengthens and conditions your heart to pump blood more efficiently and reduces stress on blood vessels, leading to lower blood pressure. What are isometric exercise examples? While all isometric exercises can contribute to lowering blood pressure, some are more effective than others. In the study, researchers studied three isometric exercise examples in particular: squeezing a handgrip, leg extensions and wall sits, also called wall squats. The wall sits were found to be the most effective isometric exercise of them all. To do a wall sit, position yourself with your back against a wall and slide down until your knees are bent at a 90-degree angle. Hold this position for 20 seconds or more. The wall sit primarily focuses on your quadriceps and glutes. The optimal isometric exercises for lowering blood pressure are those that engage multiple muscle groups and increase your heart rate. The study found doing four sets of two minutes each with a rest period in between, three to four days a week, yields maximum benefits. Other isometric exercise examples include: Plank, side plank and reverse plank Glute bridge Dead hang from a pull-up bar Static lunge V-sit Standing wall push-ups Calf raise and hold Tricep dip and hold Bicep curl and hold Overhead hold Kettle ball hold in front of you When doing any isometric hold, breathe slowly and regularly to make sure your muscles get plenty of oxygen. You can start by holding the position for 20 seconds and slowly working your way up to holding it for two minutes. Just be sure to talk with your doctor before starting any new exercise routine. Adding isometric holds as “exercise snacks” There is increasing evidence that points to the health benefits of “exercise snacks,” short bursts of vigorous activity spread throughout the day. If you struggle to find 30 minutes to work out each day, these two-minute or so “snacks” can quickly add up to help you meet your daily fitness goals. Incorporating exercise snacks into your daily routine is a great way to vary your workouts. For office workers, this is an easy way to get in exercise snacks throughout the day and positively impact blood pressure. So do wall sits between phone calls, hold a plank if you’ve been sitting too long or grip a stress ball before heading to a meeting. It breaks up your day at the office and can get you up and out of your chair even if you do it three or four times a week, that’s enough to lower blood pressure. Small changes can make a big difference. Adding isometric exercises doesn’t mean you should stop doing all other types of exercise, like strength training and cardiovascular workouts. It’s important to include all forms of exercise for your overall health and heart health. The American Heart Association recommends 150 minutes of moderate-intensity exercise (hiking, biking, water aerobics) or 75 minutes of vigorous aerobic activity (running, swimming laps) each week. Research is well established that aerobic training is just as important as strength training, which is just as important as stretching and isometric exercise for longevity. Each type of exercise plays a vital role in building the body’s strength, endurance, coordination, flexibility and functionality. For the latest health and wellness tips and advice, visit geisinger.org/balance.
Geisinger Doctor Discusses Headache Pain By Geisinger neurologist Abigail Chua, DO How to stop waking up with a headache: Ever realized your head is pounding before you even get out of bed in the morning? Waking up with a headache is — well, a pain. Here’s why they happen and how you can find relief. Like other common symptoms, headaches vary in cause and strength. Some intense headaches can last for hours. Others might be a minute or two of dull but manageable discomfort. Most headaches are grouped into primary and secondary categories. Primary headaches are usually caused by pain sensors in your head that aren’t working right. These headaches may run in your family. Or you might get them from foods you eat (or don’t eat enough of), alcoholic drinks or changes in sleep patterns. Primary headaches are what most people have. The good news is, these types of headaches are preventable and treatable. The two most common kinds: Tension headaches – This type causes mild pain around the head, face or neck. Migraine headaches – This neurological disease can cause sharp pain on one side of the head and may last for hours or even days. Secondary headaches are typically caused by underlying medical conditions, including: Dehydration – Not drinking enough fluids on a regular basis contributes to headaches. Medication overuse – Taking too much of a variety of medications — like Tylenol or forms of ibuprofen, ironically — can make your head hurt. For most people, morning headaches result from lifestyle factors. The good news: You can adjust those to ease your pain. Lack of sleep, whether due to insomnia or just an occasional restless night, often leads to waking with an aching head. Others include: Dehydration Poor sleep quality Medication side effects Sleep apnea Jaw clenching or teeth grinding If poor sleep quality is causing your headaches, your doctor may recommend some changes to your sleep routine. Besides getting a better night’s sleep, minor adjustments to your daily routine to reduce the frequency of morning headaches. Simple changes you can make include everything from skipping that extra glass of red wine after dinner to drinking more water before bed. Luckily, there are a number of things you can do to make your morning headache go away. Hydrate: Drink lots of water to start the day. Dehydration can bring on a headache or make an existing one worse. Dim the lights: Many people are sensitive to bright light, especially early in the morning. Give your eyes and head time to adjust. Use a cold compress: Grab a bag of frozen veggies or a cold pack and put it on your forehead or the back of your neck. The cold eases pressure and can soothe a morning headache. Try light massage: It’s simple — but effective. Use your fingers to apply gentle pressure on the part of your head or neck where you’re having pain. This trick can help relieve a tension headache. Get plenty of sleep: Some headaches are related to sleep apnea or other factors causing a lack of quality rest. Try going to bed a little earlier to give your body more time to rest. Digging out the root cause is the first step in treating your early morning headaches. If you’ve tried to troubleshoot on your own with no success, it’s time to talk to your doctor — especially if you have frequent or daily morning headaches. Once you and your doctor determine the right treatment plan, you can wake up refreshed, rested and ready to take on your day. For more health and wellness tops, visit Geisinger.org/balance.
Geisinger Doctor Discusses Remission By: Geisinger Doctor Sorab Gupta, MD, hematologist-oncologist What does it mean to be in remission?It doesn’t mean “cured,” but remission marks a major turning point in cancer treatment — because your body shows little or no sign of the disease. If you’ve been diagnosed with cancer, no doubt you’re looking forward to the day your doctor uses the word remission. Getting to remission is the goal of any cancer treatment. But what does it mean? Remission is a period when tumors or cancer cells in your body have diminished, symptoms have lessened (or disappeared entirely) and you may even get negative results for cancer on medical tests. Once you’re in remission, you can reduce or even stop treatment, because it’s been successful. Remission can last for months, years or even the rest of your life. Decreasing signs or the absence of cancer that lasts for at least a month indicate that a person is in remission. Remission does not mean, though, that you are cured of cancer. Types of cancer remission You can achieve cancer remission through an effective treatment plan. Depending on the type and stage of cancer you have, treatment may include radiation therapy, surgery, chemotherapy, targeted therapy, immunotherapy, hormone therapy or a combination. It’s more likely for a person to achieve remission with early-stage cancer that remains local than with advanced stages that have spread throughout the body. There are two types of cancer remission: partial and complete. While the goal is to reach complete remission, many people live healthy lives in partial remission. Partial remission In partial remission, many signs and symptoms of cancer have significantly improved, but not all have disappeared. In this phase, the disease is under control and it’s a positive step forward in recovery. Complete remission If you’ve achieved complete remission, all symptoms of cancer have disappeared. Medical tests, such as body scans, biopsies, physical exams or blood tests, show no detectable evidence of cancer. Complete remission could mean that all of your cancer cells have been destroyed, or that cancer cells are still in your body, but they aren’t showing up on tests. That’s why complete remission doesn’t mean you’re cured — there is no way for doctors to know for sure that all cancer cells in your body are gone. Remission vs. cure While the terms are often used interchangeably, being in remission is different from being cured of cancer. Remission means the cancer has become inactive, while a cure is total eradication of the disease, with no cancer remaining in the body. Doctors consider patients to be cured of cancer if they have no signs or symptoms for at least five years after completing treatment. A recurrence can occur during remission — even complete remission — because cancer cells may still be present in your body. The cancer can become active again in the same area it was first diagnosed or elsewhere in your body. Cancer doesn’t always recur, but it’s more likely to if the cancer is fast-growing, more advanced, or initially widespread. Maintaining cancer remission Staying in cancer remission means having regular checkups with your care team, along with routine screenings, such as physical exams, blood and imaging tests specific to your type of cancer. Cultivating healthy lifestyle habits can also lower your risk of recurrence. Regular checkups, especially in the first few years following remission, are crucial to monitor symptoms and detect any signs the cancer has become active again. Your doctor may recommend maintenance therapy, such as taking lower doses of cancer drugs or hormones, to help you stay in remission for as long as possible. Tips for adopting healthy lifestyle habits: Eating a healthy diet full of fruits, veggies, whole grains and lean meats. A nutritionist can help you create a food plan tailored to your needs. Exercising regularly. Aim for at least 150 minutes of moderate-intensity exercise (hiking, biking, water aerobics) or 75 minutes of vigorous aerobic activity (running, swimming laps) each week. Maintaining a healthy weight. Getting at least seven to nine hours of sleep each night. Limiting alcohol consumption. Men should consume no more than two drinks per day and women no more than one per day. Quitting smoking. Managing stress through techniques such as breathing exercises, yoga or meditation. Whether you’re going through treatment or on the other side, reaching remission is great news for anyone diagnosed with cancer. It may not be a cure, but it signifies a substantial advancement in the quest for one, and it’s a time to celebrate an important turning point in your cancer journey. For the latest health and wellness tips and advice, visit geisinger.org/balance.
Geisinger-led Study on Weight Loss and Diabetes Drugs A recent Geisinger-led study has determined that GLP-1s, a popular class of weight loss and diabetes drugs, may make it unsafe for patients to undergo a common gastroenterology procedure. Researchers from Geisinger Medical Center and Geisinger Commonwealth School of Medicine collected data from 2019 to 2023 on 35,183 patients who had esophagogastroduodenoscopy (EGD) procedures. An EGD, or upper endoscopy, is one of the most common diagnostic procedures to examine the lining of the esophagus, stomach and first part of the small intestine. Among 756 patients with diabetes who took GLP-1s and had an EGD, those patients were: Four times more likely to have retained food in their stomach during the procedure About three times more likely to have aborted procedures Twice as likely to need a repeat EGD Among 166 patients without diabetes who took GLP-1s and had an EGD, those patients were: About five times more likely to have retained food in their stomach Five times more likely to have aborted procedures As likely as nonusers to need another EGD GLP-1s, such as the popular Ozempic medication, decreases how fast the stomach empties, regardless of a patient’s diabetes status, the study found. “Having food in the stomach during one of these procedures can increase the risk as well as decrease the ability of your doctor to perform a complete examination,” said Amitpal S. Johal, M.D., Geisinger chair of gastroenterology and one of the co-authors of the study. The researchers cautioned that clinicians responsible for scheduling and performing EGDs on patients taking GLP-1s, should carefully assess the impact of the medication on the procedure’s safe completion, stating “healthcare providers must consider the implications of delayed gastric emptying when planning an EGD for GLP-1 patients.” “If you are taking a medication for weight loss, please let you doctor know before scheduling a procedure,” Dr. Johal said.
Geisinger Recognized for Diversity Practices Geisinger has earned designation as an “LGBTQ+ Healthcare Equality High Performer” from the Human Rights Campaign Foundation (HRC). The designation was awarded in the HRC’s Healthcare Equality Index (HEI), released in May. Of 1,065 healthcare facilities that participated in the HEI 2024 survey and scoring process, Geisinger is just one of 462 organizations to receive this designation. The recognition speaks to Geisinger’s ongoing commitment to diversity, equity and inclusion (DEI) practices and creating a welcoming, inclusive environment for patients, members and employees. Among several categories, Geisinger scored high for its DEI practices listed below: Bias elimination and welcoming interactions: Geisinger recently established a systemwide policy to address issues related to patient and visitor misconduct. Geisinger’s Office of DEI hosts a monthly education and training session for all staff focused on SAFER, a model that helps guide employees when responding to verbal or physical harassment and discriminatory behavior. Electronic Health Records (EHR) sexual orientation and gender identity (SOGI) data: In 2019, Geisinger clinicians started gathering SOGI information in its EHR platform, Epic. This effort has been ongoing to better understand patients’ healthcare needs, address health disparities and provide high-quality care to everyone. Pronouns in EHR: In 2019, Geisinger also started collecting patients’ pronouns in Epic, along with veteran status and other demographic information, which helps clinicians better meet patients’ individual needs. Comprehensive benefits for domestic partners: Geisinger provides medical coverage and other health benefits to domestic partners of benefits-eligible employees, as long as shared residence is proven. Employee resource groups: Geisinger’s officially recognized LGBTQ+ employee resource group Geisinger — People Ready for Inclusion, Diversity and Equality (G-PRIDE) exists to foster a welcoming, caring and inclusive environment for employees of all sexual orientations, gender identities and expressions. Community engagement and support: Each year, Geisinger supports, participates in and sponsors several LGBTQ+-related events and initiatives in communities across its service area. “We’re honored to be acknowledged by the HRC’s HEI for our ongoing commitment to promote inclusivity and equity at Geisinger,” said Kim Drumgo, chief diversity, equity and inclusion officer. “This achievement reminds us of the positive impact we can make together by being champions of humanity and making a difference in the lives of others.” This year’s HEI comes as LGBTQ+ adults are twice as likely as non-LGBTQ+ adults to be “treated unfairly or with disrespect by a doctor or healthcare provider” in the last three years, according to the Kaiser Family Foundation. The impact of anti-LGBTQ+ legislation combined with a history of discrimination in healthcare settings has the potential to cause even more LGBTQ+ people to delay or avoid seeking healthcare, which makes the HEI even more salient for those looking to find LGBTQ+-inclusive care.
Geisinger Neurologist Explains When a Headache is More Than Just a Pain Geisinger Neurologist, Abigail Chua, explains that if you have headaches, you know how debilitating and intense they can be. Sometimes, an over-the-counter pain reliever is enough to dull the pain. But what if you need more? There are actually hundreds of different types of headaches, all with different causes and treatments. It’s also important to remember that headaches can occur in children as well, not just adults. When you understand the type of headache you have, you can treat it more effectively. Here are some of the common headache types and what treatments may work for each one. Tension headache A tension or stress headache is the most common type of headache. These headaches cause noticeable pressure and tightness on both sides of your head, can occasionally be caused by stress and the pain comes and goes. Tension headaches are typically treated with an over-the-counter pain reliever. Some people also find relief by exercising, taking a hot shower or taking a short nap. Migraine A migraine is a neurologic disease that causes painful headaches as well as other symptoms. Migraine symptoms can include: Pounding, throbbing pain Visual changes, like blurred vision or bright flashing lights Pressure in your face that feels like a sinus infection Sensitivity to light or sound Nausea or vomiting Some migraine attacks are associated with triggers, including: Changes in the weather Lack of sleep Fatigue Emotional stress Loud noises Strong smells Missing a meal A change in caffeine, alcohol or chocolate consumption If a migraine is caught early, it can sometimes be treated with over-the-counter pain relievers. However, some people with migraine headaches may also require treatment with prescription medications. Cluster headache Cluster headaches are considered the most severe type of headache, and people typically have piercing or stabbing pain behind one eye when they have an attack. People with cluster headaches usually feel restless during their attacks and can’t sit still. Treatment for cluster headaches can include injected medications, inhaled oxygen or steroids. Preventive medications can help in some cases. Rebound headache Rebound headaches, also called medication-overuse, or medication adaptation, headaches, can develop because of regular, long-term use of medications that treat headaches, including migraine. Taking pain relievers to treat headaches on a regular basis for a longer period, usually three months or more, can actually trigger daily rebound headaches. The good news? Once you stop taking the medication causing your headaches, the rebound headaches usually subside. However, people with a rebound headache can also have a migraine, so the migraine attacks may continue to occur. When to worry about headache pain While most headaches are treated with over-the-counter pain relievers, there are some symptoms and warning signs that may need more attention. Call your doctor or seek emergency medical attention if you notice: A sudden or significant change in the pattern of your headaches. Headaches that are accompanied by weight loss, slurred speech, vision change, weakness, numbness, seizures or cognitive dysfunction. A headache along with a stiff neck, fever, nausea, vomiting, confusion or decreased alertness. Headaches following a blow to the head. Always seek medical attention immediately if you experience this. Exceptionally bad pain that you haven’t felt before. Headaches when you wake up that get worse when you move, cough or lift weights. While it’s rare to have any of these symptoms, don’t ignore them if you feel your headache isn’t normal. They could indicate medical emergencies that need immediate care. It’s always better to be safe than sorry. A doctor will conduct the appropriate tests to confirm whether your headache is just a headache or something more. For more health and wellness tops, visit Geisinger.org/balance.
Geisinger to Host Men’s Health Talk To celebrate men’s health month, Geisinger urologists Ryan Mori, MD, and John Ramey, MD, will host a free PA Health Talk about erectile dysfunction, bladder cancer and prostate conditions. The live discussion will be held at the Wilkes-Barre Penguins Practice Pavilion on June 12 from 6 p.m. – 7:30 p.m. and will include a light dinner. Everyone is welcome at this relaxed, casual event, including women who have questions about a loved one’s health. It’s predicted that by 2025 over 300 million men will have erectile dysfunction, and 30 million men will be diagnosed this year. Treatment options can include medication and surgery. Men are also at risk of being diagnosed with prostate cancer during their lifetime. 1 in 8 men will be diagnosed with an individual’s risk of prostate cancer varying by age, race/ethnicity, and other factors. Drs. Mori and Ramey will discuss multiple urological conditions, their causes and treatment options, followed by a question-and-answer session. Questions can be submitted ahead of time and will be asked anonymously. Attendees interested in a tour of the practice facility should arrive by 5:10 p.m. The tour will start at 5:15 p.m. Boston Scientific will also be there to showcase products used to help treat erectile dysfunction. To register, visit events.geisinger.org. Space is limited. The practice facility is located at 40 Coal St., Wilkes-Barre.
Geisinger Hosting PA Health Talk on Fertility Prospective parents and community members are invited to join fertility specialists Jennifer Gell, M.D., and Lydia Shively, PA-C, for a virtual PA Health Talk from 6 to 7 p.m. on Tuesday, June 18. Infertility is more common than most people think, and risk for infertility increases with age. Participants looking to grow their family can learn about: When to see a fertility specialist Conditions that affect fertility Testing options Fertility medications Fertility treatments and more The live event will be hosted via Microsoft Teams. To register, visit geisinger.org/fertilitytalk. During registration, participants may submit questions for the fertility experts to answer during the talk. For more information on fertility treatments, visit Geisinger’s fertility website.
Geisinger Commonwealth School of Medicine’s Gala Raises More Than $100,000 for Student Scholarships Geisinger Commonwealth School of Medicine celebrated a monumental success with its annual Black Ties for White Coats Gala, raising more than $100,000 in support of student scholarships. Held at Mohegan Pennsylvania on Saturday, April 20, the event brought together esteemed guests, faculty, students, and community members for an evening of philanthropy and celebration. Geisinger Commonwealth would like to thank the Diamond Sponsor of this year’s event, Mericle Commercial Real Estate Service/Discover NEPA and the Gold Sponsor, Whiting-Turner Contracting Company. The annual gala serves as a cornerstone fundraising event for the school and is aimed at supporting the next generation of healthcare leaders. “We are thrilled by the overwhelming generosity and support shown at this year’s Gala”, said School President and Dean Julie Byerley, MD, MPH. “The funds raised will directly impact our students by enabling them to pursue their dreams of becoming a healthcare provider who will make a difference in the communities they serve.” The success of the Black Ties for White Coats event underscores Geisinger Commonwealth’s commitment to fostering a diverse and inclusive learning environment where students from all backgrounds can thrive. By providing scholarships, the school aims to alleviate the financial burden of medical education and empower students to focus on their studies and clinical training. Each year Geisinger Commonwealth selects a Founders, Wel-lbeing and Community honoree. This year’s honorees include: Founders: Tom Churilla, MD Well-being: Shubhra Shetty, MD Community: The Scranton School for Deaf & Hard of Hearing Children
