The telegenetic services at  Waldo County General Hospital include all cancers that have genetic risks, such as breast, colon, pancreatic, kidney, melanoma (skin), and others.

The Waldo County General Hospital team members include Ann Hooper, the hospital’s Imaging Manager who oversees the program, Kim Lenfestey, the patient navigator, Mary Ann Dyer, RN and Sharon Curtis, RN. The genetic specialists at Maine Medical Center include Amanda Lamb, ScM, a board-certified genetic counselor, and Dr. Susan Miesfeldt, a medical oncologist with 15 years of cancer genetic experience.

If you have been diagnosed with cancer and have a family history of it, talk with your primary care provider about whether genetic counseling might be right for you.

Mary Ann Dyer RN and Sharon Curtis RN are the nurses helping patients through telegenic counseling.

Waldo County General Hospital was selected as one of two sites in the state to pilot telegenetic services videoconferencing with Maine Medical Center’s cancer genetic specialists. The service is funded in part by a Maine Cancer Foundation grant awarded to Maine Health. Now in its third month, four Waldo County residents referred by their primary care providers have received cancer telegenetic services.

The telegenetic services at  Waldo County General Hospital include all cancers that have genetic risks, such as breast, colon, pancreatic, kidney, melanoma (skin), and others.

The Waldo County General Hospital team members include Ann Hooper, the hospital’s Imaging Manager who oversees the program, Kim Lenfestey, the patient navigator, Mary Ann Dyer, RN and Sharon Curtis, RN. The genetic specialists at Maine Medical Center include Amanda Lamb, ScM, a board-certified genetic counselor, and Dr. Susan Miesfeldt, a medical oncologist.

Karen Kelley of Searsport was the first person to take advantage of the new telegenetic services at Waldo County General Hospital. On her birthday last December, an abnormality was detected in one of Karen’s breasts. The Friday before Christmas she had a biopsy. When she received a call the next week asking her to come to the hospital, she expected to be told that she had breast cancer. She was correct. Karen feels lucky that her cancer was found early. She had a lumpectomy in January and then 33 sessions of radiation in Brewer. Now she is taking an oral treatment for five years.

During her treatments, Karen was able to maintain her counseling practice and her normal activities, including skiing. “I had to keep being Karen,” she explains. “My attitude was that I was going to keep moving forward…I am grateful that I didn’t have many side effects.”

Telegenetics was recommended to Karen because of her family history of cancer. Karen’s mother and grandmother both were diagnosed with breast cancer. Karen says it was really interesting to begin genetic counseling. She was asked to fill out a family health history form, including the causes and ages of family members’cancer diagnoses and deaths. “It really opened my eyes about how inclusive cancer can be,” she says. Her grandmother died fighting her second diagnosis; her mother has been cancer-free for seven years.

Six years ago, a close relative with a history of breast cancer underwent BRCA1 and 2 genetic testing.  These genes are known to increase the chances of getting breast cancer and other types of cancer. Her relative’s genetic test was negative. Karen still expected she would be diagnosed with breast cancer during her lifetime, because she is convinced that this disease runs in her family.

Now there’s another BRCA1 and 2 test, BART, that sometimes catches genetic defects that the original test missed; Karen’s relative will have BART. If this test is positive, Karen says she will also have the testing. She knows that this information will allow her to be proactive in her health. It will also direct her generation and the next to make decisions about genetic counseling and testing and preventive care.

If you have been diagnosed with cancer and have a family history of it, talk with your primary care provider about whether genetic counseling might be right for you.

In my mom’s last years of life, she was no longer able to decide what she wanted for dinner, let alone what she wanted for medical treatment. So the decisions fell to me. Another bone marrow biopsy? A spinal tap? Pain treatment? Antibiotics? I was faced with cascading decisions for which I was wholly unprepared…
 

The last thing my mom would have wanted was to force me into such bewildering, painful uncertainty about her life and death. I realized only after her death how much easier it would have all been if I heard her voice in my ear as these decisions had to be made…”

That experience led Goodman to co-found The Conversation Project, which is designed to help people have “the conversation.”  Eighty-two percent of people say it’s important to put their wishes in writing and yet only 23 percent have actually done it.

You may have strong opinions on whether you would want a doctor to hook you up to a breathing machine or insert a feeding tube. Or if your heart stops, you know if you  want to be resuscitated. You know if quality of life is more important to you than the quantity.

These are tough, but important, questions. Having a conversation about what matters most to you and your loved ones and then putting your wishes in writing is important. But far too few people do it before it’s too late and their families have to make the tough decisions on their own.

Sixty percent of people say that making sure their family is not burdened by tough decisions is “extremely important,” and yet, 56 percent admit that they have not communicated their end-of-life wishes.

While it’s important to put your wishes in writing, it’s also critical to designate a health care agent in the event you cannot communicate yourself.

Dr. Jim Stevenson talks about a case he had in which a middle-aged man with advanced lung cancer was brought into the emergency room following an accident. The man was unresponsive, but clearly in pain, and it took three or four days to identify a decision maker to determine what the patient would want for life-sustaining treatment.

Increasing the number of Advance Directives (a document in which you put your wishes in writing and designate a health care agent) executed by individuals 65 years and older is a stated goal for Waldo County General Hospital during 2013. The plan is to accomplish this through the hospital’s employed primary care doctors’ offices and at the five health centers.

To help with this goal, the hospital is offering a number of presentations to hospital personnel, Hospital Aid and Hospice volunteers, and the community through a presentation on the local cable station, access at Health Fairs and community classes, and placing Advanced Directive packets at nursing homes, Spectrum Generations, the local Agency on Aging and on the hospital’s website.

Dr. David Giansiracusa, who specializes in Hospice Care and palliative medicine, talks to WCGH staff about Advance Directives.

On April 23, Dr. David Giansiracusa, a physician in Portland, who specializes in Hospice Care and Palliative Medicine, did a presentation on Advance Directives for medical staff and other interested parties at the hospital. He said Advance Directives are important so doctors know what to do when a patient is unable to express his or her wishes. And based on the incident at the Boston Marathon, “everyone is vulnerable to being unable suddenly to express his or her wishes,” he added.

Giansiracusa said Advance Directives “prevent a huge amount of suffering,” adding, “It is difficult to care for a patient whose wishes are not known and it creates conflicts within the medical staff and within the family. The family has to live with uncertainty.”

He said advance care planning helps the health care agent understand the values and beliefs of the patient, which provides a foundation for making decisions. Advance care planning is “preparing for the in-the-moment medical decisions” that often need to be made, he said.

“If you don’t want to do it for yourself, do it for your loved ones,” Giansiracusa said. He said visiting The Conversation Project website is a good way to get the conversation started. And the decisions that are made should be shared with all involved “to decrease confusion and conflict and to provide peace of mind to the patient and his or her family.”

He said advance care planning should be a routine part of medical care for a primary care provider. “I think it is equally important as allergies and medications list,” he said, adding he thinks primary care providers should be asking their patients “what type of life would be intolerable.” And there should be notes in the patient’s medical record about the discussion.

So no matter what your age, if you are interested in making your wishes known and having them carried out, ask your primary care provider about completing an Advance Directive packet and providing a copy to your doctor, the hospital, with your health care agent, and at your home.

Sandra Weagle RN won the 2013 Nurse Excellence Award. Making the presentation was Director of Nursing Teri Young-Hise RN.

   Weagle, who works in the Emergency Department, has been with the hospital for 22 years, while Garcelon is in her third year and works on the patient floor.

The 2013 CNA Excellence Award winner was Taylor Garcelon CNA, shown here with Director Nursing Teri Young-Hise RN.

   In announcing the 2013 Nurse Excellence Award winner, Director of Nursing Teri Young-Hise RN, said of Weagle: “(She) was nominated by a peer who recognizes her as setting high standards for patient care and professionalism. She is seen as a valued colleague who serves as a good resource for others and as a leader who helps keep the patient flow moving smoothly and calmly…

   “She consistently puts the patient’s safety and comfort at the top of her list of priorities. She quickly responds to special needs for equipment or services, such as requesting social work assistance, to meet the patient’s requirements beyond the obvious medical needs…

   “She is a steady force in a fast-paced area providing everyone with calm, competent direction,” Young-Hise concluded.

   On the nomination form, Weagle’s colleague also wrote: “She not only performs the mandatory year-to-year training within the department of education and skills, but maintains the Advanced Care Certificate recommended. She has obtained and maintained her certification as a CEN (Certified Emergency Nurse) and exceeds even that goal by serving as president of the ENA (Emergency Nurses Association) in a nationwide capacity.”

   In making the announcement of the CNA Excellence Award winner, Young-Hise said of Garcelon: “(She) is described as a natural leader with a warm and intuitive approach that immediately puts her patients at ease. She is noted for her strong teamwork and for her collaboration with the nursing staff, consistently keeping them apprised of any changes in vital signs or in the patient’s condition…

   “Patient safety and comfort is her mission. She consistently discusses her patients with the nursing team to be sure that their safety and care needs are met,” said Young-Hise.

   The nurse, who nominated Garcelon for the award, wrote, “(She) brings her ‘A game’ regardless of what may be happening in her life. I have stood outside a patient’s door donning isolation garb and can hear Taylor inside the room calming a patient, laughing with a patient or settling down a patient…”

   Garcelon also serves in various committees at the hospital. She is described as eager to implement new ideas and remains upbeat with change.

Finalists for the Nurse Excellence Award were, back row from left, Sandra Weagle RN, Krystal Brouty RN, and Cate Bryant RN. In front are Director of Nursing Teri Young-Hise and finalist Patty Trask RN.

   The other nominees for the 2013 Nurse Excellence Award were Krystal Brouty RN, who works in the Women and Infant Health Care Unit; Cate Bryant RN, who works in the Intensive Care Unit: and Patty Trask RN, who works on the patient floor.

Nominated for the CNA Excellence Award were, back row from left, Jennifer Larrabee CNA, Taylor Garcelon CNA, Pam Ripley CNA, and Stella Littlefield CNA. In the front row, are Director of Nursing Teri Young-Hise RN, and nominees Diana Hills CNA, and Janice Boetsch CNA.

Nominated for the 2013 CNA Excellence Award were Janice Boetsch CNA, and Pam Ripley CNA, who both work on the patient floor; Diana Hills CNA in the procedure room; Jennifer Larrabee CNA in cardiac rehab; and Stella Littlefield CNA in the emergency department.

   The criteria for the awards are:

   •  demonstration of leadership at the bedside;

   •  commitment to professional development; and

   •  dedication to high quality, safe patient and family-centered care.

   This is the second year that Waldo County General Hospital has made the Nurse and CNA Excellence Awards. The winners last year were Carol Knight, LPN, and Cheryl Lucas, CNA.

Shown with their awards are, front row from left, Page Dilts, Chris Harrington, Roxie Whitney, Wanda Moody, Erika Young, Brenda Smith and Perley Martin, RSU 20 Food Service Director. In the second row, from left, are EBS and Nickerson principal Abbie Hartford, CASS principal Jody Henderson, Debbie Mitchell, Cindy Boguen, Rhonda Bishop Wood and Sue Black. In the back row from left are Angela Wight of Maine Child Nutrition department, Linda Hartkopf, Ames principal Laura Miller, Northport principal Sandy Flacke, Rhonda Kinney, and Thierry Bonneville of the RSU 20 Health Kids parents’ group.

Five elementary schools in RSU 20 have been awarded national recognition for their efforts to improve school meals and overall wellness among their students and staff. Only 5 percent of schools in the United States have achieved this award.

Receiving a bronze award from HealthierUS School Challenge were the Ames School in Searsmont, Belfast Area High School, Captain Albert Stevens School in Belfast, East Belfast School, and Drinkwater Elementary School in Northport.

To earn this award, a school must serve healthy meals, teach nutrition education taught in all grade levels and encourage physical activity. Physical education has to include at least 45 minutes a week. There must also be a wellness policy, which states that physical activity is neither denied nor required as a means of punishment, and use of food as a reward is prohibited.

Honored June 3 were the principals, wellness champions and food service personnel from the five schools, along with Linda Hartkopf, the school health coordinator, a position funded by Waldo County General Hospital; Perley Martin, RSU Food Service Director; Healthy Waldo County, Let’s Go! Waldo 5210 and the RSU 20 Healthy Kids parents’ group. With the bronze award, each of the schools received $500 for their nutrition program.

Hartkopf said the goal for next year will be to have the entire district earn a silver or bronze award.

The HealthierUS School Challenge (HUSSC) is designed to improve the health of the nation’s children by promoting healthier school environments.

You can find out more about the weekly hikes by signing up for the Journey to Health email list and newsletter at www.wcgh.org or by calling Sumer Higgins at 338-9359.

According to WebMD, weight loss is only one benefit of a walking program. Regular walking helps lower cholesterol, reduces the risk of type 2 diabetes, increases bone strength, and improves circulation.

The scheduled walks are:

Jun. 1           Passy Greenway City of Belfast Trail

Jun. 8          Stover Preserve, Belfast

Jun. 15         Fernald’s Neck, Lincolnville

Jun. 22        Jetty Road, Sears Island

Jun. 29        Little River Trail, Belfast (from water district)

Jul. 13          Haystack Mountain, Liberty

Jul. 20         Northern Pond, Monroe

Jul. 27         River Trail Tanglewood, Lincolnville

Aug. 3          Little River Trail, Belfast (from Walsh Field)

Aug. 10        Laffin Road, Mt. Waldo, Frankfort

Aug. 17        Bog Brook Trail, Montville

Aug. 24       Purple Trail, Mt. Waldo, Frankfort

Sept. 14       Northern Headwaters Trail, Montville

Sept. 21       Conner Mill Trail, Unity

Sept. 28      Tanglewood Trail, Lincolnville

Oct. 5          Unity Park Loop, Unity

A beautiful quilted coverlet, made by Barbara Biscone, will be raffled off at the walk. Tickets will also be sold in the gift shop.

Jean Dube gets her blood pressure checked that WCGH Family Health Fair held in April.

The presentation is free but space is limited. To register, call Hester Kohl, health educator, at 930-2514 or email her at hkohl@wcgh.org.