Geisinger Chair of Pediatrics: Rising Theat of Marijuana Edibles Between legalization in many surrounding states and the increased amount of people with medical use cards, the use of tetrahyocannabinol or THC, has increased dramatically in the past decade. The surge in popularity of edible cannabis products has allowed users to be discreet, while eliminating odor and potential harm to the lungs. However, the packaging of these products is appealing to children. Most people don’t know, that THC, the principal psychoactive compound found in cannabis, can be extremely toxic to children. In our communities and at our children’s hospital, there has been an alarming rise of accidental poisonings of children due to synthetic marijuana. It is a growing threat that demands our attention and immediate action. In 2024, we had more than a dozen children brought to our hospital for THC poisoning. We recently admitted two young children to our pediatric intensive care unit (PICU) on the same day with life threatening consequences from cannabis exposure. Young children who unknowingly ingest THC-laced products often present with significant medical emergencies, including profound lethargy, respiratory depression, seizures, and, in severe cases, coma or even near-cardiac arrest. Nearly 10 percent of children suffering from these ingestions require support in a PICU. Recent data from the Centers for Disease Control and Prevention (CDC) reveals a dramatic increase in the rate of overdoses. In 2017, there were 207 reported cases of accidental edible cannabis exposure for kids under the age of 6. By 2021, the number skyrocketed to 3,054, and these numbers continue to increase. Toddlers are disproportionately affected due to their small size and developing metabolism, making even small quantities extremely toxic. In June 2022, the Food and Drug Administration released a consumer alert warning that THC-containing edibles are easily mistaken for products that might appeal to children. By Frank Maffei, Geisinger chair of pediatrics
Geisinger Obsertrician Speaks on HPV Vaccine: GetYour Questions Answered HPV vaccine: Get your questions answered By Benjamin Matthews, MD, Geisinger obstetrician and gynecologist The human papillomavirus (HPV) is the most common sexually transmitted infection, and most people will have exposure at some time in their lives. HPV is the virus that causes genital warts, but some strains can lead to various types of cancer later in life, including cervical, vaginal, vulvar, penile, anal, mouth, and throat cancers. The HPV vaccine is the safest and most effective way to protect against HPV infections — and their potential negative effects — and stop the spread. A misperception is that HPV only causes problems in females. In reality, both women and men can develop genital warts and HPV-related cancers. The vaccine helps the body develop immunity to the virus and prevents spread among people. Immunity is more likely before exposure to HPV, so vaccination in early adolescence is so important to keep preventable cancers from happening. How is HPV spread? HPV is spread through skin-to-skin contact. The strains of HPV that cause cancers in the cervix, penis, throat and anus are usually spread by sexual contact. The problem is, most people infected with HPV will not have symptoms. Even so, the virus is still in their system and could be causing damage. Not to mention, people with HPV can pass the infection to others without knowing it. No treatment for HPV is available. Fortunately, a healthy immune system can detect and suppress HPV in most cases. However, when it doesn’t and the virus remains in the body for long periods, the infected cells can progress into pre-cancer and then cancer. What is the HPV vaccine? Gardasil 9, approved by the U.S. Food and Drug Administration in 2014, is the most often recommended HPV vaccine. This HPV vaccine helps protect against 9 of the highest-risk HPV strains that cause genital warts and cancers. The vaccine works by stimulating the body’s immune system to produce antibodies that can fight off the HPV virus. This response helps the body recognize and destroy the virus if encountered in the future. It’s not a live vaccine. If you’ve already been exposed to a particular strain of HPV, the vaccine doesn’t treat the infection. The vaccine is meant to protect against a new HPV infection, so the vaccine may not be as effective once a person has HPV. Who should get the HPV vaccine series? The CDC recommends the HPV vaccine series for males and females starting at the age of 11 or 12, but it can be safely administered as early as age 9. At this young age, a child’s immune system is especially strong and provides the greatest immune response — and the best protection against HPV infection. Plus, the HPV vaccine series is most effective when given before a child is sexually active and potentially exposed to the virus. Many parents have concerns that giving their child the HPV vaccine might encourage sexual activity at a younger age. But as a provider caring for women with potentially deadly cervical and vulvar cancers, I encourage parents to focus on the opportunity to prevent their child from developing an avoidable cancer. Also, research shows that receiving the vaccine at a young age isn’t linked to an earlier start of sexual activity. The CDC also recommends the HPV vaccine series for older adolescents who aren’t yet vaccinated. Is there anyone who shouldn’t get the HPV vaccine? A person shouldn’t receive the HPV vaccine: If they’re pregnant If they had an allergic reaction after the first HPV shot or have severe, life-threatening allergies If they’re sick with a mild illness at the time When can you get the HPV vaccine? The HPV vaccine is a series of shots, with the number depending on the age at the first dose, and can be safely given at the same time as other vaccines. The CDC recommends the following HPV vaccine schedule: Kids ages 9 to 14 should receive 2 doses of the vaccine, with the second dose administered 6 to 12 months after the first. Teens and young adults ages 15 to 26 should receive 3 doses, with the second dose given about 2 months after the first and the third dose given 6 months after the initial one. Kids who didn’t start or complete the HPV vaccine series during the recommended age can still catch up on their vaccination up to age 45. However, the HPV vaccine after age 26 should be individualized, as the vaccination provides less benefit because more people in this age group have already been exposed to HPV. But everyone’s situation is different, so talk to your primary care provider or OB-GYN about whether the HPV vaccine is right for you. You might still benefit from the vaccine by protecting you against HPV strains you don’t already have. Is the HPV vaccine effective? Earlier forms of the HPV vaccine were only made available less than 20 years ago, but the impact of vaccination is already clear. A recent study in the Journal of the American Medical Association showed that cervical cancer deaths among young women dropped by more than half in the last decade. Gardasil 9 has been extensively studied and is close to 100 percent effective at preventing precancerous lesions and genital warts that are caused by the strains included in the vaccine for people who are vaccinated before onset of sexual activity. It’s proven to offer long-lasting protection and doesn’t require a booster shot after the initial series. However, the HPV vaccine doesn’t protect against all strains of HPV. So, it’s still important to practice safe sex and get regular screenings for cervical cancer starting at age 21. What are the HPV vaccine side effects and risks? Like any vaccine, the HPV vaccine may have side effects and potential risks, but these are generally mild and temporary. Most people don’t have any trouble with the HPV vaccine. HPV vaccine side effects can include: Pain, redness or swelling at the injection site Fever Dizziness or fainting (remain seated for 15 minutes after the shot to lower the risk) Headache Fatigue Nausea Muscle or joint pain These symptoms usually resolve within a few days and can be managed with over-the-counter pain relievers, if necessary. In rare cases, more serious side effects like an allergic reaction can occur. If you or your child have difficulty breathing, hives or swelling of the face, lips or tongue, seek medical attention immediately. The benefits of the HPV vaccine far outweigh its risks. It’s a proactive step in protecting your family’s health. By getting your kids vaccinated, you can reduce their risk of developing potentially life-threatening conditions as an adult. For more health and wellness topics, visit Geisinger.org/balance.
Geisinger Wyoming Valley delivers 2,000th baby of the year The labor and delivery department at Geisinger Wyoming Valley delivered its 2,000th baby of the year early Sunday morning, Dec. 22. The milestone is the first time a Geisinger hospital labor and delivery unit has delivered more than 2,000 babies in a year. Anna Gitanga, 37, of Corona, N.Y., gave birth to a 7-pound, 13.3-ounce girl, Daniela, at 1:59 a.m. Gitanga was visiting family for the Christmas holiday when she went into labor and was brought Geisinger for the delivery. This was Gitanga’s fourth baby — and the second born at Geisinger during a family visit. The child’s father, Magesa Mwita, planned to pick up mother and baby from the hospital on Monday, Dec. 23. “I am so happy with everything,” Gitanga said. “Everyone here is so kind and caring.” The team had anticipated reaching this milestone for several months and assembled a gift basket for the family, according to Melissa Williams, Geisinger Wyoming Valley nursing operations manager. “We updated the delivery totals daily once we hit 1,900, eagerly awaiting 2,000,” Williams said. “While the unit was very busy, this created excitement to see which nurse and doctor would have the milestone delivery. The team now hopes to end 2024 with 2,024 deliveries.”
Geisinger Cancer Institute Attains National Reaccreditation Geisinger Cancer Institute has received reaccreditation under the American College of Surgeons (ACS) Commission on Cancer (CoC) Accreditation Program at Geisinger Community Medical Center in Scranton. The ACS CoC is a consortium of professional organizations dedicated to improving survival and quality of life for patients with cancer by setting and raising standards. “As the population in the northeast continues to age, with that comes the need for high-quality cancer care close to home,” said Erin Miller, D.O., a Geisinger general surgeon and ACS CoC committee chair. “Our recognition by the ACS CoC signifies that we meet the rigorous standards required to deliver exceptional care to our patients and validates our efforts while enabling us to further elevate the standards of cancer care in our region.” CoC accreditation is granted to institutions committed to providing high-quality cancer care by demonstrating compliance with the CoC standards. Each program must undergo a rigorous evaluation and review of its performance and compliance with the CoC standards. To maintain accreditation, cancer programs must undergo a site visit every three years. The CoC accreditation standards supply the structure for providing all patients with a full range of diagnostic, treatment and supportive services either on site or by referral, including community-based resources. As a CoC-accredited institution, Geisinger also becomes an ACS Surgical Quality Partner, which means it is dedicated to consistently improving procedures and approaches, while maintaining a critical eye on process at every step. “ACS Quality programs are grounded in more than a century of experience and participation is an important measure of a hospital’s surgical quality. As an ACS Surgical Quality Partner, Geisinger has shown a commitment to providing the best possible patient care, evaluating that care in a rigorous fashion and dedicating themselves to continuous self-improvement,” said Patricia L. Turner, M.D., executive director and chief executive officer of ACS.
Geisinger Expands Community Medicine in Lackawanna County Geisinger is adding to its community medicine offerings for patients and members in Lackawanna County. Geisinger Montage, located at 5 Lakeview Commons in Moosic, will provide primary care, ConvenientCare walk-in services, lab, and diagnostic imaging in one newly renovated facility. The primary care clinic and diagnostic services are scheduled to welcome their first patients Monday, Dec. 16, with ConvenientCare slated to open in the first quarter of 2025. Geisinger will hold an open house from 11 a.m. to 1 p.m. Thursday, Dec. 12, when members of the community and local media are welcome to tour. Geisinger Montage features 28 primary care exam rooms and six ConvenientCare exam rooms in a 25,000-square-foot space that also serves as a training center for nurses and emergency medical services personnel in Geisinger’s northeast region. “As programs mature, Geisinger Montage will be staffed by eight primary care physicians and four advanced practitioners, making primary care more available to our patients in northeastern Pennsylvania,” said Roger Scott, D.O., internal medicine specialist and director of community medicine in Geisinger’s northeast region. Four more advanced practitioners will staff the ConvenientCare clinic when it opens. Joining Dr. Scott, who is moving his practice to Geisinger Montage, for opening day will be internal medicine specialist Joseph Leo, D.O.; family medicine specialist Saima Mukta, D.O.; internal medicine specialist Michael Jalowiec, D.O., who is a new addition to the Geisinger team; certified physician assistants Thomas Nawrocki and Ripal Patel, and certified registered nurse practitioner Kelly Haikes.
Geisinger Serves Meals at Drive-Through Veteran Appreciation Dinners DANVILLE, Pa. – To thank local veterans for their service, Geisinger served approximately 2,500 meals during drive-through veteran appreciation dinners at 11 locations across its service area on Thursday, Nov. 7. The dinners were provided at no cost to U.S. military veterans and their guests. Meals were provided in Bloomsburg, Danville, Jersey Shore, Lewistown, Mifflintown, Muncy, Pittston, Scranton, Shamokin, State College and Wilkes-Barre. Members of Geisinger’s executive leadership team, regional leaders and volunteers attended the event to hand out meals to veterans. Members of leadership, along with staff and volunteers, distributed the meals with a smile and expression of gratitude for the veterans’ selflessness and sacrifice. At some locations, veterans also received homemade cards and notes from local students.
Geisinger Performs First Ever Lifetime Guaranteed Shoulder Replacement Geisinger, Medacta announce first shoulder replacement with lifetime guarantee. Program builds on the success of the health system’s ProvenCare® surgeries on hips, knees and spines Geisinger and the Medacta Group SA, a Swiss company specializing in innovative and sustainable solutions for joint replacement, sports medicine and spine surgeries, announced the first lifetime guarantee for a recent reverse shoulder replacement surgery. Geisinger and Medacta will stand behind the full cost of care throughout the patient’s lifetime. Mark Pallis, D.O., Geisinger regional director of orthopaedic surgery, performed the first guaranteed reverse shoulder surgery at Geisinger South Wilkes-Barre. “This is the first reverse shoulder arthroplasty with a lifetime guarantee in the world,” Dr. Pallis said. “We used state-of-the art intra-operative navigation to more accurately place the implants, using sensors to guide pin placement, reaming depth and screw length and position. The postoperative results were nearly identical to the preoperative plan based on 3D modeling from a CT scan of the shoulder.” A reverse shoulder replacement is a specific type of total shoulder replacement commonly performed in patients who have arthritis as well as a torn or non-functioning rotator cuff. It is called a “reverse” because the ball portion of the shoulder is placed where the socket was, and the socket implant is placed where the head of the humerus was. Medacta and Geisinger previously partnered on groundbreaking guarantees for qualified patients for hip and knee replacement surgeries and spinal fusion surgery as part of Geisinger’s ProvenCare® program, which covers inpatient and follow-up care for patients, including visits due to complications up to 90 days after the procedure. “This new guarantee allows us to expand our ProvenCare® commitment to include patients who qualify for total shoulder replacement, offering those patients a sense of security when making the decision to have the procedure,” said Michael Suk, M.D., J.D., chair of the Department of Orthopaedic Surgery. “Standing behind our world-class joint replacement and spinal surgeries demonstrates Geisinger’s commitment to making better health easier for our patients and communities.” A global leader in orthopaedic medical devices, Medacta provides unique resources to train surgeons — including those at Geisinger — in surgical techniques and the use of their specially designed hip, knee, shoulder and spinal implants for minimally invasive surgeries. Medacta’s innovative technologies are designed to enable a healthy and active lifestyle for every patient, reducing postoperative pain and shortening rehabilitation time. “The addition of the world’s first guarantee for reverse shoulder arthroplasty completes our robust offering of patient-focused guarantees for those undergoing hip, knee or spine procedures at Geisinger,” said Francesco Siccardi, CEO of Medacta International. “Through this initiative, we remain dedicated to improving outcomes for patients throughout their lifetimes.”
Geisinger Recognized as WellBeing First Champion Geisinger recently announced its recognition as a WellBeing First Champion for 2024 by ALL IN: WellBeing First for Healthcare. As a WellBeing First Champion, Geisinger has demonstrated that licensure and credentialing applications for physicians and advanced practice providers are free from intrusive and stigmatizing language around mental health care and treatment. This means health workers at Geisingercan seek needed care without fear of losing their license or job. Geisinger is currently the only hospital system in its service area to be recognized. “This recognition is a testament to our deep commitment to supporting the well-being of our workforce,” said Susan Parisi, M.D., chief wellness officer at Geisinger. “Our profession is demanding and impactful, and all too often comes at a very personal cost to us, our families and friends. We often talk about the importance of taking care of ourselves so that we can best care for our patients, and with these credentialing changes, we’re putting our words into action. We hope our employees feel confident seeking any health care services they need, free from shame or barriers.” Verification that all invasive or stigmatizing language around mental health has been removed from applications is confirmed annually by ALL IN: WellBeing First for Healthcare, a coalition of leading health care organizations that works to eliminate barriers for health workers to obtain needed mental health care. “Across the country, health workers are at an increased risk for burnout and mental health conditions,” said Corey Feist, co-founder of ALL IN: WellBeing First for Healthcare and CEO of the Dr. Lorna Breen Heroes’ Foundation. “Many health workers feel they cannot speak up about their mental health without being criticized by colleagues or losing their jobs. Today, physicians and nurses die by suicide at two times the rate of the general population. We as a nation must better protect these lives, and I applaud our WellBeing First Champions for their leadership to support the well-being of health workers.”
Nine Effects of Stress on your Body Chronic stress can affect your whole body — from your head to your heart. By Allison Bailey, MD, Geisinger psychiatrist Stress is a powerful thing. In small doses, it can motivate you to ace that presentation at work or land your dream job. However, if left unchecked for a long time, stress is anything but motivating.So what’s really going on when you’re stressed? And how can paying attention to your stress improve your health? Whether you’ve narrowly avoided a car accident or are worried about losing your job, stressful situations trigger a release of hormones that cause a stress reaction, also called a fight-or-flight response. This reaction starts in a part of your brain called the amygdala, which processes emotions like fear. When the amygdala senses danger, it sends a distress signal to your hypothalamus, which communicates to the rest of your body via the nervous system. When the hypothalamus gives the signal, your brain releases hormones like epinephrine (also called adrenaline) and the stress hormone cortisol into your bloodstream. The fight-or-flight response is a survival mechanism that lets us react quickly to dangerous situations by preparing to either fight or run from the stressor. Some physical signs your fight-or-flight response has kicked in include: Rapid breathing and heart rate Heightened senses and awareness Tense muscles Pale or flushed skin Cold or clammy hands Dilated pupils Dizziness Nausea In a truly dangerous situation, this response can be lifesaving. But when stress is chronic and this system is activated too often, it takes a toll on your body. Left unmanaged, stress impacts you physically, mentally and emotionally. Research shows that chronic stress can have effects on almost every system in the body — from the heart to the digestive system to the immune system. Here are 9 effects of stress on your body: 1. Elevated blood pressure It’s normal for your blood pressure to temporarily spike when your fight-or-flight response is activated. But when stress becomes chronic, it could lead to long-term high blood pressure, which increases your risk of heart disease. 2. Weakened immune system Do you feel like you always catch a cold after finishing a stressful project? It’s probably because of cortisol’s effect on your immune system. When you’re stressed, your body releases this hormone. Cortisol temporarily inhibits your ability to fight off infections because it decreases your body’s supply of white blood cells. This can make you more prone to catching illnesses like a cold or the flu. 3. Chronic inflammation Too much cortisol over a long period can also cause your immune system to overreact in the form of inflammation. Inflammation is a critical part of the healing process as your body responds to intruders like viruses and bacteria. But when no intruders are present and your body is still sending out inflammatory signals, it can lead to chronic inflammation. Chronic inflammation has been linked to several health conditions including: Arthritis Diabetes Heart disease Crohn’s disease, ulcerative colitis and irritable bowel syndrome (IBS) Alzheimer’s disease and dementia Cancer Going through periods of high stress doesn’t automatically mean you’ll develop one of these conditions, but it can put you at increased risk — or make symptoms worse if you already have something like arthritis or IBS. 4. Headaches Why does it always seem like a pounding headache strikes right when your frustration reaches its peak? Because your muscles tense up during the fight-or-flight response, chronic stress can cause tension headaches or trigger migraines in people prone to them. 5. Anxiety, depression or mood changes Beyond its physical effects, stress can also take a toll on your mental health.Studies have shown that chronic unmanaged stress can trigger anxiety, depression, fatigue, difficulty concentrating and irritability. 6. Weight gain There’s a reason you reach for mac and cheese or cake whenever you’re stressed — and once again, the culprit is cortisol.Cortisol can cause cravings for foods rich in fat, sugar and salt. This is because our bodies are looking for quick doses of energy to prepare for whatever perceived threat we’re facing. Over time, elevated cortisol levels can affect metabolism and your body’s ability to regulate insulin. Continuing to reach for comfort foods during stressful situations could become an unhealthy habit that leads to weight gain. 7. Difficulty sleeping You’re too stressed to sleep, so you stay up late. The next night, you’re so tired that you worry about falling asleep and end up staying up late again. Sound familiar? Stress and sleep can be a slippery slope. Increased adrenaline and cortisol can make you feel too on edge to fall asleep and sleep deprivation can make you more likely to get stressed out. 8. Decreased sex drive Wondering where your libido went? First consider how stressed you’ve been. When we’re going through periods of high stress, it’s perfectly normal for sex to be the last thing on our minds. This is typically only temporary and should resolve as you cope with the stress. 9. Changes to your menstrual cycle If you’ve noticed your period is later, heavier or shorter than usual, it could be due to stress.Because of chronic stress’ effect on hormones, you may have irregular menstrual cycles. Always talk with your doctor about any changes in your period and be sure to mention if you’ve had any long-term stress lately. Ways to relieve stress So, how do you reduce stress once you have it? t might be tempting to overeat, drink alcohol or use tobacco, but those things provide temporary relief at best, and only add to health problems in the long run. Some healthier ways to relieve stress include: Exercise Deep breathing Yoga Meditation Getting enough sleep Eating a healthy diet Exercise is an especially great way to reduce or eliminate stress, boost your energy levels and improve your mood, not to mention your overall health. And you don’t have to run miles to get the benefits for your mind and body. You can start small by taking a daily walk. But if walking isn’t your jam, try a short-guided meditation instead. It’s not always clear what’s causing your stress — or maybe the effects aren’t going away. Your doctor can work with you to identify causes and discuss coping techniques. They might also refer you to a licensed therapist or a professional counselor who can help you pinpoint and possibly eliminate sources of stress. And if constant stress leaves you with sudden chest pain and shortness of breath, get help immediately. Listen to your body. When it tells you it’s under stress or you need help coping, pay attention to that message, so you can enjoy a long, healthy, high-quality life. For more health and wellness topics, visit Geisinger.org/balance.
