PREVENTING AMPUTATIONS - COLONOSCOPY: GET THE FACTS NEW HOPE FOR DEPRESSION - Holyoke Medical Center
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A PUBLICATION OF HOLYOKE MEDICAL CENTER SPRING 2022 I HOLYOKEHEALTH.COM
COLONOSCOPY:
GET THE FACTS
NEW HOPE FOR
DEPRESSION
PREVENTING
AMPUTATIONS
CONTENTS
MEET THE VALLEY HEALTH SYSTEMS
EXECUTIVE TEAM
SPIROS HATIRAS
President & Chief
CARL CAMERON
Chief Operating Officer
DEAN VITARISI
Treasurer & Chief Financial
12
Executive Officer Officer
HEALTHY HABITS News and tips for
3 better health, plus hospital events.
SPECIALIZED CARE FOR
4 PARKINSON'S DISEASE Rani Athreya,
MD, is the only movement disorders
specialist in Western Massachusetts.
6 C OLONOSCOPY: KNOW THE FACTS
This screening exam can detect—and even
prevent—colorectal cancer.
SIMON AHTARIDIS, AVADHOOT GOKHALE BEVERLY FEIN
MD, MPH
Chief Medical Officer
Vice President,
Chief Quality Officer
Vice President, Chief
Human Resources Officer 8 B ALANCING ACT Endocrinologists keep
the body in balance by treating hormonal
disorders.
10 BEST FOOT FORWARD How intensive
wound-care treatment can prevent
amputation.
12 NEW HOPE FOR DEPRESSION Ted
Ackerman, MD, answers questions about
transcranial magnet stimulation.
COLLEEN DESAI, RN MARCEL MONIZ, MBA ROSEMARIE ANSEL
14 8 GREAT REASONS TO SEE A
PRIMARY CARE PROVIDER Regular
visits to a big-picture provider can help
Chief Nursing Officer, Vice Vice President of Executive Director of keep you healthier.
President of Patient Care Ambulatory Operations River Valley Counseling
15
Services Center THE FACTS ON FLAX Bursting with
potential health benefits, flax may be just
the seed you need.
A PUBLICATION OF HOLYOKE MEDICAL CENTER SPRING 2022 I HOLYOKEHEALTH.COM
On the Cover:
Rafael Perez alongside COLONOSCOPY:
GET THE FACTS
the hyperbaric oxygen NEW HOPE FOR
therapy equipment DEPRESSION
that helped him avoid
an amputation. ● H
OLYOKE MEDICAL CENTER
575 Beech Street, Holyoke | 413.534.2500
● H
OLYOKE MEDICAL GROUP
15 Hospital Drive, Holyoke | 413.535.4800
● H
OLYOKE VNA HOSPICE LIFE CARE
PREVENTING 575 Beech Street, Holyoke | 413.534.5691
AMPUTATIONS
● R
IVER VALLEY COUNSELING CENTER
2 SPRING 2022 P.O. Box 791, Holyoke | 413.540.1234
HEALTHY HABITS
FOR YOU AND YOUR FAMILY
WELLNESS
EVENTS
MANAGING DIABETES
Managing diabetes is a journey, but
not one you have to make alone.
Sign up today for a virtual, group-
based distance learning experience
and discover what you can do to
better manage your diabetes. Topics
covered will include:
• Your experience with diabetes
• Monitoring your blood sugar
HAY FOR • Healthy eating and activity
• Long-term management
HEART
To sign up or learn more, please
call 413.535.4732.
It appears there’s a good heart
time to hit the hay. Researchers
report that folks who fall asleep
between 10 and 11 p.m. have
7 th Annual
a lower risk of heart disease
compared to people who go to
sleep both earlier and later.
—European Heart Journal
GREENS RVCC GOLF TOURNAMENT
Tee off for a great cause! Please join
FOR MUSCLE us on Friday, September 16, 2022,
Sure, protein aids muscle at East Mountain Country Club in
function, but a recent study Westfield, Mass., for River Valley
found that leafy green veggies—think Counseling Center’s 7th Annual Golf
kale, spinach and arugula—play an Tournament, presented by Action
important role, too. The nitrates found in Ambulance Services.
them boosts strength and mobility.
—The Journal of Nutrition Funds raised will directly benefit
the children, teens and their families
who are in need of the mental health
programs we offer.
The day will include 18 holes,
POUR golf cart, lunch, dinner, gift bag,
contests and prizes, too. To register
ANOTHER as an individual or a foursome, or
to learn more about the various
CUP sponsorship opportunities, please
visit www.rvccinc.org/golf or
Increasing coffee intake from
one to two cups daily makes REASON FOR contact Janet Laroche at
you 8 percent less likely to
lose executive brain function, 20-SEC WASH Laroche_Janet@holyokehealth.com.
according to researchers. You’ve heard it before: Wash your hands
In addition, you’ll enjoy a 5 for 20 seconds to stay healthy. But why?
percent reduction in amyloid A recent study found that bacteria and
protein in the brain, which is viruses can get stuck on the surface of
associated with Alzheimer’s hands. Brisk washing for 20 seconds
disease. detaches them, washing them away.
—Frontiers in Aging Neuroscience —Physics of Fluids
VALLEY HEALTH & LIFE 3
SPECIALIZED CARE FOR
PARKINSON’S
DISEASE
THE ONLY MOVEMENT RANI ATHREYA, MD, was doing Fellowship at UMass Medical School.
her residency in Neurology at State The only Movement Disorders
DISORDERS SPECIALIST University of New York when she specialist in Western Massachusetts,
IN WESTERN became intrigued by patients with Dr. Athreya currently provides care for
MASSACHUSETTS, movement disorders, particularly more than 3,000 patients with PD. “There
RANI ATHREYA, MD, Parkinson’s disease (PD). “Though are about 1 million people living with
not life-threatening, Parkinson’s is a Parkinson’s disease in the United States,
PROVIDES PERSONALIZED life-changing disease for patients and and as the population ages, the number
CARE FOR PEOPLE WITH their families,” says Dr. Athreya, who of people with Parkinson’s is increasing,”
PARKINSON’S DISEASE. then completed a Movement Disorders says Dr. Athreya. PD occurs when nerve
4 SPRING 2022
cells in the brain that control movement Diagnosis is based on a patient’s medical medication directly to the small intestine,
stop working—causing tremors, stiffness, history, a review of signs and symptoms, and INSPIRE, an implantable device that
slowness, and walking and balance and a neurological and physical stimulates the airway for sleep apnea
problems. examination. Lab and imaging tests and patients, have both shown great results.”
genetic testing also may be done. Dr. Athreya says patients with
RECOGNIZING SYMPTOMS “Once we’ve made a diagnosis, we movement disorders receive the same
“During my early years in practice, I educate patients and families so they caliber of care at HMC as they would at
realized sleep disorders were an integral fully understand the disease and can an academic medical center in Boston.
part of Parkinson’s disease and decided plan for the future,” says Dr. Athreya. “We offer every treatment available for
to also specialize in Sleep Medicine,” “We connect patients with local support Parkinson’s disease close to home in a
says Dr. Athreya. In addition to sleep groups to help them better manage the personal community hospital.”
medicine, Dr. Athreya is board-certified physical and mental challenges posed
in psychiatry and neurology and is a by this chronic disease. In addition to PD
member of the American Academy of education, healthy eating and targeted
Neurology, the International Parkinson exercise therapies, various medical MEET THE TEAM
and Movement Disorder Society and the treatments are available, including
Massachusetts Medical Society. She’s medications and Botox injections to help
the Medical Director of Holyoke Medical alleviate symptoms."
Center Neurology and Sleep, formerly At Holyoke Medical Center (HMC),
Pioneer Valley Neurology and Sleep, patients also have access to physical
which she founded in 2012. Along with therapy for balance and stretching,
sleep and movement issues, people speech language pathology to improve
with PD may experience constipation, speech problems and occupational
depression and fatigue, according therapy for daily tasks.
to the American Parkinson’s Disease PD has gained public awareness
Association (APDA). through well-known figures like
“When I started my own practice, actor Michael J. Fox, who created a Rani Athreya, MD
my goal was to provide all management foundation to accelerate treatments.
strategies for Parkinson’s disease and Actor Alan Alda, diagnosed with PD
the other movement disorders,” says more recently, has shown that life can
Dr. Athreya, who also treats ataxia, be lived vibrantly with PD. “Movement
dystonia, essential tremor, Huntington’s helps,” he says. “Walking, biking,
disease and Tourette syndrome. “I’ve treadmills. I move to music. I take
been in the field for 20 years, so I have boxing lessons from a guy trained in
a large following of patients. Because it’s Parkinson’s therapy. I do a full workout
a slowly progressive disease, many of specifically designed for this disease.”
my Parkinson’s patients have been with
me for a long time. I have built strong INNOVATIONS IN TREATMENT
relationships as I’ve helped patients Though there is currently no cure for
navigate the challenging Parkinson’s PD, researchers are working to better Kristie Harrington, FNP
journey.” understand the disease—identifying
genes and biomarkers linked to it and
DIAGNOSING THE DISEASE experimenting with new therapies.
Dr. Athreya says she and her staff, which Dr. Athreya is enthusiastic about the
includes Kristie Harrington, FNP, and many promising treatments available for
Jooyun Shin, FNP, use a family-centered her patients.
approach. “Parkinson’s is a difficult “Some innovations I'm particularly
disease that changes how the entire excited about include deep brain
family lives as a person gets less mobile,” stimulation (DBS), in which electrodes
she says. While a general neurologist are surgically implanted in the brain to
may be skilled at identifying PD, the regulate abnormal activity, and focused
APDA recommends consultation with ultrasound treatment for tremors and
Jooyun Shin, FNP
a movement disorder specialist such Parkinson’s,” she says. “The Duopa
as Dr. Athreya to avoid misdiagnosis. Dopamine pump, which dispenses
✱ Holyoke Medical Center Sleep and Neurology has two locations: 100 Wason Ave, Suite 360, Springfield, and
10 Hospital Drive, Suite 103, Holyoke. For more information or to make an appointment, call 413.736.1500.
VALLEY HEALTH & LIFE 5
COLONOSCOPY:
KNOW THE FACTS
COLONOSCOPY SCREENINGS DETECT—
AND CAN EVEN PREVENT—COLORECTAL CANCER.
HAVING A COLONOSCOPY may not men and women in the United States. that, most patients can be screened
be pleasant, but it could save your life. “Unlike other cancers, colorectal cancer every 10 years.”
Colorectal cancer almost always develops is highly preventable if we find polyps More frequent screenings may be
from precancerous polyps in the colon early and remove them,” says Tuyyab recommended for those at higher risk,
or rectum. Screening tests—including Hassan, MD, of Holyoke Medical Center including African Americans, people with
colonoscopy—help locate these polyps so Gastroenterology. a family history of colorectal polyps or
they can be removed before they become Although the overall death rate from colorectal cancer, and those who have
cancer. Screening tests, now recommended colorectal cancer has dropped, thanks inflammatory bowel syndrome, a genetic
beginning at age 45, can also find colorectal to screenings and healthier lifestyles, syndrome or a related cancer, such as
cancer early, when it’s most treatable. deaths among people younger than uterine or pancreatic cancer.
50 have increased. “This encouraged
A PREVENTABLE DISEASE medical organizations to lower the WHICH TEST IS BEST
Colorectal cancer is the third most recommended screening guideline to Medical experts agree that colonoscopy
common cancer diagnosed in both start at age 45,” says Dr. Hassan. “After is the most effective colorectal cancer
6 SPRING 2022
screening test. Another option, the stool- DURING A COLONOSCOPY
based test, looks for microscopic blood During a colonoscopy, which takes 6 STEPS TO
in the stool and is done yearly for people 30 to 60 minutes, a gastroenterologist LOWER YOUR COLON
of average risk. But if a stool test result is inserts a colonoscope, a long, thin
CANCER RISK
abnormal, a colonoscopy is still needed flexible instrument, into the rectum to
to complete the screening process. obtain magnified views of the rectum The American Society of Colon
Colonoscopy is also a diagnostic tool, and colon. Special tools can be passed and Rectal Surgeons advises
helping doctors find out why symptoms, through the scope to take a sample taking these steps to lower your
chance of colorectal cancer.
such as abdominal pain, rectal bleeding (biopsy) or to remove suspicious polyps.
or weight loss, are present. Any detected polyps are sent to a lab 1. B
eginning at age 45, get
Dr. Hassan talks with patients to for testing. regular colorectal cancer
determine which screening test is right screenings. Talk to your
for them, dispelling fears about the AFTER A COLONOSCOPY doctor about earlier
colonoscopy procedure. “Sometimes,” he Following a colonoscopy, patients must screening if you have a
says, “patients are afraid they’ll feel pain have a ride home because the sedative personal or family history
during the procedure or remain awake. I may impair judgment and coordination. of colorectal cancer or
colorectal polyps, or a
explain that we use intravenous sedation, Patients usually can resume their
personal history of another
so they’ll sleep comfortably and won’t regular diet that day and normal activity
cancer or inflammatory bowel
feel a thing. Once the procedure is the next. Results of the colonoscopy will
disease.
over, many who were initially fearful be reviewed by the doctor and shared
are surprised at how easy it was. with the patient. If no abnormalities 2. E
at 20 to 35 grams of
Colonoscopy is a very safe procedure are found, the doctor will recommend fiber each day from fruits,
with few complications, occurring in less when to repeat the test based on each vegetables, whole grains,
nuts and beans.
than 1percent of patients.” individual’s personal risk.
3. Eat a low-fat diet.
COLONOSCOPY PREPARATION STREAMLINING THE EXAM 4. E
at folate-rich foods such as
Preparing for a colonoscopy involves To make scheduling a colonoscopy leafy green vegetables.
emptying out the colon with a laxative more convenient for patients, Holyoke
before the procedure. “Some people don’t Medical Center Gastroenterology 5. A
void excessive alcohol or
tobacco use. Together, they’re
like drinking the prep or following the is now offering Open Access to
linked to colorectal cancer
low-fiber diet the week of the procedure colonoscopy screenings. This eliminates
and other gastrointestinal
and the clear liquid diet the day before the need for a pre-op appointment
cancers.
the test,” says Dr. Hassan. “But there’s with a gastroenterologist for low-risk
no way around it, as leftover residue can patients, enabling them to go straight 6. E
xercise at least 20 minutes
obscure the view of the colon and rectum to the procedure. three to four days per week.
during the exam.” Dr. Hassan’s office or Moderate exercise, like
the primary care provider will supply a walking, gardening or climbing
detailed set of instructions and helpful tips ✱ T
o learn more or to schedule a steps, may reduce risk.
to make the preparation easier. colonoscopy, call 413.540.5048.
MEET THE TEAM
Tuyyab Hassan, MD Ruby Malik, MD Jeanne McCarthy, PA-C April Bowers, NP Lucy Nigro, NP
VALLEY HEALTH & LIFE 7
Balancing
ACT
ENDOCRINOLOGISTS KEEP THE BODY IN BALANCE
BY TREATING HORMONAL DISORDERS.
HORMONES ARE CHEMICAL answers common questions about • Osteoporosis
messengers that play important roles his specialty. • Calcium disorders
in the body. Examples include cortisol, • Thyroid disease
which triggers stress reactions; insulin, WHAT IS AN • FNA for thyroid nodules
which helps the body absorb glucose ENDOCRINOLOGIST? • Adrenal and pituitary conditions
(sugar); and estrogen and testosterone, Endocrinologists are medical specialists • Polycystic ovary syndrome
female and male sex hormones that trained in the endocrine system, which • Male hypogonadism
influence everything from physical controls hormones. Hormones travel • Female hyperandrogenism
development to mood. through the bloodstream to tissues
Hormones are made by a network and organs, where they help regulate WHY CHOOSE AN
of glands called the endocrine system. metabolism, reproduction, movement, ENDOCRINOLOGIST?
When there’s a problem with the body’s sexual development and more. When Although most primary care providers
ability to produce or use hormones, the glands producing hormones don’t can address basic hormonal conditions,
the impact can be serious. The medical function correctly, diseases can develop. a referral to an endocrinologist is often
specialty that manages diseases of needed for more complex cases. Having
the endocrine system is known as WHAT CONDITIONS DOES AN completed advanced training, they're
endocrinology. Here, Robert Cooper, ENDOCRINOLOGIST TREAT? experts at identifying and treating
MD, FACE, FACP, who recently joined the Common conditions include: endocrine problems. Some of these
HMC Endocrinology & Diabetes Center, • Diabetes specialists treat a range of disorders,
8 SPRING 2022
while others focus in one area.
MEET THE TEAM
ARE THERE FACTORS THAT
INCREASE RISK?
Yes. Factors that increase a person’s
risk of developing an endocrine
disorder include:
• Elevated cholesterol levels
• Family history of endocrine disorder
• Inactivity
• Personal history of autoimmune
disorders
• Poor diet
• Pregnancy Robert Cooper, MD, Pam Ohri Zizzamia, DO Ana Ronderos, ANP
FACE, FACP
• Recent surgery, trauma or infection
WHAT ARE SOME COMMON
SYMPTOMS?
Endocrine disorders can produce an array AN EXPERIENCED ENDOCRINOLOGIST
of symptoms, including:
• Severe exhaustion or weakness
RETURNS TO HMC
• Extreme thirst or hunger Robert Cooper, MD, FACE, FACP, who worked at Holyoke Medical Center (HMC)
• Unexplained weight loss or gain from 2003 to 2012 and was chief of medicine from 2005 to 2009, is happy to be back
• Mood changes seeing patients at the HMC Endocrinology & Diabetes Center. An endocrinologist for
• Blood glucose level fluctuations 25 years, Dr. Cooper brings vast expertise to the HMC community.
• Frequent urination “My focus has always been on providing academic-type medicine to smaller
• Joint and muscle pain communities,” says Dr. Cooper. His experience includes temporary positions in
• Nausea or stomach pain underserved locations in South Dakota and Pennsylvania. “Those were fascinating
experiences,” he says. “I taught primary care providers more about endocrinology
HOW ARE ENDOCRINE so they could better care for their patients locally.”
DISEASES DIAGNOSED? Dr. Cooper feels strongly that a good physician is a good listener and a good
Because symptoms often mimic those of teacher. “Interviewing skills are important when making a diagnosis,” he says.
other conditions, endocrine diseases can Dr. Cooper has found that, once he determines the cause of a patient’s
be challenging to diagnose. In addition to symptoms, how he communicates is critical. “It’s not just having knowledge
in-depth discussion with patients, doctors about a disease,” he says, “it’s being able to bring that expertise to a level that
use urine tests, imaging studies, genetic patients truly understand.”
testing and hormone testing to make an
accurate diagnosis. CUTTING-EDGE CARE
A graduate of Albert Einstein College of Medicine, Dr. Cooper completed a
ARE THERE TREATMENT residency at Long Island Jewish Medical Center. Subsequently, he completed
OPTIONS? a two-year endocrinology fellowship at Long Island Jewish Medical Center
Yes! Treatment depends on the specific and Winthrop University Hospital. Dr. Cooper holds a teaching position at Tufts
disorder, but is focused on relieving University School of Medicine and is a Fellow of both the American College
symptoms and adjusting hormones of Endocrinology and the American College of Physicians. “I attend a lot of
with medications. If surgery is indicated, conferences to keep up with cutting-edge medical treatments,” says Dr. Cooper.
a referral will be made to a surgical “I love bringing what I’ve learned back to my colleagues and patients.”
endocrinologist. Some issues, such Dr. Cooper enjoys treating all types of endocrine diseases, including osteoporosis
as thyroid nodules, are monitored with and thyroid, adrenal and pituitary disorders. He has a unique niche treating male
regular testing. hypogonadism, a condition in which a man’s body doesn’t produce enough of the
hormone testosterone.
Dedicated to a multidisciplinary approach, Dr. Cooper collaborates with kidney and
cardiac specialists for heart disease and cholesterol management. He’s excited to
✱ work with endocrinology specialists Pam Ohri Zizzamia, DO, and Anna Ronderos,
The HMC Endocrinology & ANP, as well as the rest of the team at the HMC Endocrinology & Diabetes Center.
Diabetes Center is located at
Dr. Cooper welcomes both former and new patients. “Medicine allows me to make
10 Hospital Drive, Suite 104.
a positive difference in people’s lives, and that brings great meaning to my own.”
To make an appointment,
please call 413.534.2820.
VALLEY HEALTH & LIFE 9
Rafael Perez talks with Ryanne
Whalen, LPN, HBO Technician,
while he is undergoing hyperbaric
oxygen therapy at HMC's Wound
Care Center.
BEST FOOT
FORWARD
HOW INTENSIVE WOUND-CARE TREATMENT CAN PREVENT AMPUTATION.
APRIL IS FOOT HEALTH MONTH, making it the perfect cuts, blisters or sores that go unnoticed and become serious.
time to remind everyone to be sure they’re taking good care “One of four people with diabetes develops a foot ulcer,
of their feet. For people with diabetes, however, foot health and 40 percent of those with healed diabetic foot ulcers will
should be top of mind daily. Diabetes can damage nerves in develop a new one within a year,” says Ann Johnson, Program
any part of the body, but most often impacts nerves in the Director of Holyoke Medical Center’s Wound Care Center.
feet and legs. Sometimes this damage causes symptoms, but “Daily self-foot exams and getting treatment early are key to
other times it doesn’t, leaving affected people vulnerable to healing challenging wounds. The longer a wound is open, the
10 SPRING 2022longer it takes to heal and the lower the likelihood of healing.”
patients,” says Johnson. “We’re the only wound care center
SLOW TO HEAL in our area to consistently achieve this award.”
Last summer, Rafael Perez experienced this firsthand following a The HMC Wound Care Center has two state-of-the-art
swim at the Daughters of the American Revolution State Forest hyperbaric oxygen chambers. HBOT surrounds the body with
lake in Goshen with his fiancée and her young daughter. “We 100 percent oxygen at a pressure 1.5 times greater than normal
had a great time,” recalls Rafael. “But a few days later, I became air pressure—equivalent to diving down 50 feet in seawater.
sick—shaking uncontrollably and spiking a fever.” A diabetic This treatment helps heal chronic conditions, including diabetic
since his 20s, Rafael says he’s careful to protect his feet and was foot ulcers and circulation ulcers, chronic bone infections,
wearing water shoes. trauma and damage from radiation. HBOT accelerates the
Despite his precaution, an irritated area on Rafael’s right toe body’s healing process by increasing the amount of oxygen in
had become infected after exposure to the marshy lake. Rafael the blood.
went to the Emergency Department at Holyoke Medical Center Rafael participated in 60 “dives,” receiving one 90-minute
(HMC) and was admitted for antibiotic treatment. He remained treatment daily for 60 days. He continued antibiotics and had
there for one week. Francis Martinez, MD, used surgical dead tissue debrided by Fuller at the clinic.
debridement to remove the infected skin tissue and hasten “After the initiation of HBOT, we began to see signs of
healing. “Dr. Martinez was concerned that my toe wasn’t healing,” improvement,” Fuller says. “More and more healthy tissue began
recalls Rafael. “We were worried I might need an amputation.” to grow in the wound, which eventually led to complete healing.”
In 2017, Rafael had a diabetic foot ulcer that was treated Patients receiving HBOT lie in a chamber on a stretcher with
successfully with hyperbaric oxygen therapy (HBOT) at HMC’s a television mounted on top to pass the time and help them
Wound Care Center. Determined not to undergo an amputation relax. An HBO technician is nearby throughout the treatment.
this time, either, Rafael was eager to try HBOT again. Rafael says the staff at the HMC Wound Care Center made his
“When Rafael came to us in August, he was suffering from experience a comfortable one. “I’d watch TV or fall sleep,” Rafael
toe pain and was unable to walk,” says Maureen Pendergast says of his time in the chamber. He was surprised at the quick
Fuller, PA, of the HMC Wound Care Center. Fuller works results. “You could see my toe healing.”
alongside Savitri Rambissoon, MD, a general surgeon, certified
wound care specialist and Medical Director of HMC Wound SUCCESS STORY
Care. “Rafael’s MRI showed gas gangrene associated with the Fuller describes Rafael as an HBOT success story. “He escaped
wound, which carries a particularly high risk of nonhealing,” says toe amputation after a very serious infection associated with a
Dr. Rambissoon. He had what’s classified as a grade 4 Wagner diabetic foot ulcer. He participated in all aspects of our care plan,
diabetic foot ulcer with exposed muscle and tendon, making followed our instructions and had the best outcome we could
HBOT appropriate for him. hope for.”
Remarking that HBOT is not for everyone, Fuller says: “It
AWARD-WINNING CARE carries some risk, which is weighed carefully and individually for
The HMC Wound Care Center has been recognized five each patient. We follow Medicare guidelines and obtain insurance
times as a Center of Distinction by Healogics, the company approval for patients to receive advanced therapies. In addition to
partnering with HMC to manage the Center. “We have quality diabetic foot ulcers, we have had success treating osteonecrosis
outcomes that include healing 82 percent of wounds for of the jaw and cystitis associated with radiation exposure for
cancer patients.”
After being off his
feet for so many months,
Rafael has returned
to work as a driver for
Autopart International.
He says he’s happy to
get back to life again
and looks forward to a
summer of swimming
and fishing for bass and
Maureen Pendergast trout. “I’ll be careful!”
Francis Martinez, MD Savitri Rambissoon, MD Ann Johnson, Program
Director Fuller, PA Rafael promises.
✱ or more information about hyperbaric oxygen therapy (HBOT) or other advanced wound care
F
treatments, call the HMC Wound Care Center at 413.535.4740.
VALLEY HEALTH & LIFE 11Tedd Ackerman, MD,
Medical Director of
Behavioral Health
at HMC, and Lori
Goshea, TMS
Coordinator, with
transcranial magnet
stimulation (TMS)
equipment.
NEW HOPE FOR
DEPRESSION TEDD ACKERMAN, MD, ANSWERS QUESTIONS ABOUT
TRANSCRANIAL MAGNETIC STIMULATION (TMS), A NONINVASIVE,
DRUG-FREE WAY TO TREAT DEPRESSION
12 SPRING 2022FOR MANY PEOPLE living with periods of rest in between for a total of relapse. If treatment with TMS was effective
depression, medication and 3,000 pulses. Treatment is administered by the first time, it likely will be again. We also
psychotherapy may not be enough to an experienced TMS technician under the have found that medications that were not
alleviate debilitating symptoms. Some supervision of the TMS physician or by the previously effective may be more helpful
can’t tolerate the side effects of drugs, TMS physician. after TMS treatment.
and others find they don’t help. Tedd
Ackerman, MD, Medical Director of IS TMS SAFE? WILL MY INSURANCE COVER
Behavioral Health at Holyoke Medical FDA-cleared to treat depression since TMS TREATMENT?
Center, was excited when a new 2008, TMS has a proven track record for Massachusetts insurance plans cover TMS
development in psychiatry offered hope providing a safe, effective way for patients when criteria are met. You may have a co-
for major depressive disorder. He began to achieve relief from depression. TMS pay for each treatment.
offering transcranial magnetic stimulation does not require surgery or implantation of
(TMS) to patients in 2017. Since then, electrodes. And, unlike electroconvulsive IS THERE ANYONE WHO
Dr. Ackerman has treated hundreds therapy (ECT), TMS doesn’t cause seizures SHOULD NOT HAVE TMS?
of people with TMS. Sixty-six percent or require sedation with anesthesia. People with implanted metallic hardware
reported an improved quality of life, TMS doesn’t have any of the side effects in the brain, such as aneurysm clips, or
and 33% said symptoms were gone associated with traditional antidepressant implanted electrical devices, such as
completely. Here, Dr. Ackerman answers medications. pacemakers or cochlear implants, are not
common questions about the treatment. candidates for TMS.
DO TMS TREATMENTS HURT?
HOW DOES TMS WORK? TMS is generally well-tolerated, and IS TMS RIGHT FOR ME?
During a TMS treatment, an electromagnet very few patients drop out of treatment. TMS may be a good choice if you
delivers targeted magnetic pulses that At Holyoke Medical Center, we do suffer from depression that has not
stimulate cortical regions in the left pre- everything we can to ensure our patients responded to traditional treatments, or
frontal cortex of the brain, an area of the are comfortable during treatment. This if you can’t tolerate the side effects of
brain involved in regulation of mood and may include changing the parameters antidepressant medications. My typical
depression. This area is known to be of treatment or alternating where the patients have failed a minimum of two to
underactive in people who suffer from magnetic coil is placed. four medications. They’re frustrated, trying
depression. Research studies with PET medications endlessly with diminishing
scans show that there are changes in brain WHAT ARE THE SIDE EFFECTS? returns. I’m pleased that Holyoke Medical
activity not only in the left prefrontal cortex Side effects are generally mild and may Center offers another treatment option.
but in other connected areas of the brain include superficial scalp pain at the site of Our staff will work with each patient’s
not being directly stimulated. treatment and occasional headache. Both medical provider to see if TMS is an
side effects are temporary and can be appropriate and safe choice.
WHAT DOES A TMS TREATMENT alleviated with Tylenol or ibuprofen.
INVOLVE?
TMS therapy is a noninvasive treatment WHAT HAPPENS AFTER A
requiring 36 sessions of 20 to 30 TREATMENT SESSION? SCAN BELOW
minutes, five days a week for six weeks. After a treatment session, patients can
To learn whether TMS might be
During treatment, the patient reclines immediately return to their normal routine,
right for you, take our quiz by
in a comfortable chair, and a small including driving. scanning this QR code.
electromagnetic coil is placed against the
scalp near the HOW SOON WILL I SEE
forehead. The RESULTS?
electromagnet Some patients experience positive mood
delivers a pulse changes within a few sessions, with many
that stimulates seeing changes after 20 treatments. To get
nerve cells in the full effect, patients should complete the
the region of entire treatment plan.
the brain that
controls mood. CAN I HAVE TMS AGAIN?
Patients feel a Some patients who undergo TMS have
mild tapping long-lasting results and remain free of
Tedd Ackerman, MD sensation with symptoms. However, some patients do
✱ o learn more about transcranial magnet stimulation (TMS) or to make an appointment for a consultation
T
with our board-certified psychiatrists, call 413.535.4930. To learn more, visit www.holyokehealth.com/TMS.
VALLEY HEALTH & LIFE 13to specific illnesses, your primary care
8
provider can suggest lifestyle changes to
reduce your risks and regular screenings
to detect any problems that do develop at
an early stage.
4 Remote consults may be readily
available. Baseline health information
GREAT
your primary care provider has may make
him or her comfortable treating certain
problems over the phone, knowing you
REASONS
can always schedule a follow-up if your
symptoms don’t improve. Without a
primary care provider, you’ll more likely
TO SEE A
need to take time out of your schedule to
visit a medical office.
5
PRIMARY
You’ll have an easier time finding
specialists. When you need the care
of an expert in a certain specialty, your
primary care provider can help you find
CARE
the right person—not only someone
with the proper qualifications, but a
doctor who will mesh well with your
PROVIDER
personality and care preferences. If you're
comfortable with aggressive treatments,
for instance, you can tell your primary
care provider, who can recommend
specialists who align with your approach.
REGULAR VISITS TO A BIG-PICTURE PROVIDER
CAN HELP KEEP YOU HEALTHIER.
WHEN WAS THE last time you saw— than one, sometimes prescribed by
6 You’ll get help navigating the
Emergency Department. Wondering
if you should head to the emergency
or maybe even had—a primary care different doctors. Many take vitamins room? If you have a relationship with a
provider? Research suggests the number and supplements as well. A primary care primary care provider, you can touch base
of Americans who regularly see one is provider can monitor and track all your with the practice for guidance, potentially
dropping. But regularly seeing a primary medications, helping to protect you from sparing you a trip. If you do need to seek
care provider can improve your health for drug interactions. He or she can also keep emergency care, in some circumstances
many reasons, including these. records of any changes in dosages that your provider might be able to call ahead
might cause unwanted side effects and and offer pertinent medical details that
1 You’ll be better off if you get ill. After
just one meeting, your primary care
speak with your other providers to help
fine-tune your regimen.
could shorten your wait time.
provider will know at least some of your
medical history and possibly baseline
results from a number of routine screening 3 You’ll receive disease-prevention
advice. Seeking out a primary care
7 You’ll receive better care overall.
People with primary care providers
tend to receive significantly more high-
tests. When something goes wrong, your provider regularly, even when you’re feeling value healthcare, such as flu shots and
provider will know what “normal” looks like fine, can help prevent you from becoming cancer screenings. They often have better
for you, which will help in addressing both seriously ill down the road. From your patient experiences and better overall
your acute and chronic medical problems health profile, your provider will be able to access to healthcare as well.
more effectively. recommend tests that can assess your
2 Medications will be managed
more effectively. People who use
chances of developing heart disease,
diabetes, cancer and other serious-
but-common problems. If your medical
8 You might live longer. Research
suggests that, on average, people who
live in areas where primary care providers
prescription drugs often take more history and tests indicate that you’re prone are readily available have longer life spans.
✱ With Adult Primary Care offices in Holyoke and Chicopee, as well as a Family Medicine office in Westfield,
Holyoke Medical Group is accepting new patients. To make an appointment, please call 413.535.4800.
14 SPRING 2022{ POWER FOOD }
THE FACTS ON FLAX
BURSTING WITH POTENTIAL HEALTH BENEFITS, FLAX MAY BE JUST THE SEED YOU NEED.
DID YOU KNOW? Egyptian mummies were wrapped in linen appears to reduce blood pressure and progression of
made from flaxseeds, and the use of flaxseed for nutritional atherosclerosis (plaques in the arteries) by decreasing cholesterol
benefits is almost as old as civilization itself. Cultivation of the seed, in the blood,” says Reardon. “We also have some research
which comes from a plant with a stunning blue-violet flower, can to suggest that those omega-3 fatty acids can play a role in
be traced back to 3000 B.C., and records show it was used for improving brain function.”
medicinal purposes in the time of Hippocrates and among the
ancient Egyptians. A few centuries later, Charlemagne passed laws BUY/STORE/SERVE
requiring its consumption. Today, nutritionists laud its heart-health For culinary purposes, flaxseed is available whole, ground or
benefits as well as its potential ability to help ward off certain types pressed into oil, otherwise known as linseed oil. It’s also sold in
of cancer. As an added plus, it’s tasty. capsule form to take as a supplement. The seeds can be eaten
whole—they add a pleasant texture to soups and salads. “But I’d
POWER UP recommend ground flaxseed,” says Reardon. “It can be difficult for
For a food with a composition that’s almost one-half oil, flaxseed the body to extract the nutrition in whole flaxseed.”
is relatively low in calories. One serving (a tablespoon of ground The downside is that the ground seeds perish faster. As a
flaxseeds) has only 37 calories. With that come 1.3 grams of protein solution, buy the seeds whole and grind them yourself in a coffee
(3 percent of the recommended daily value, or DV) and 2 grams of or spice grinder—they last up to a year in a cabinet whole and only
fiber (8 percent DV). about a month ground. The oil should be kept in the refrigerator,
But flaxseed’s greatest claim to fame is its high content of and the expiration date should be heeded—a bitter taste indicates
omega-3 fatty acids. The seed is a top provider of these heart- that the oil has gone bad.
healthy polyunsaturated fats, offering more in a tablespoon than an One of the additional benefits of this power food is its versatility.
entire serving of salmon. Flaxseed also Flaxseeds’ noticeably nutty flavor is mild, so they can be added
contains fiber, which can help control to most dishes without altering their taste. Bake them into bread
blood sugar, manage cholesterol levels or muffins; sprinkle them in smoothies, on rice and on salads; or
and improve digestion. Additionally, use them as a breading for vegetables or protein. You also can use
flaxseed contains a small amount flax as a vegan egg substitute while baking. Mix one tablespoon
of protein. “Protein, fiber and healthy ground with three tablespoons water to replace one egg in a
fat can all help you stay fuller longer, recipe. Flaxseed oil can take the place of butter on vegetables,
and these seeds have all three, says and when mixed with an acid, like lemon or vinegar, it makes for a
Christina Reardon, a dietitian at Holyoke nutritious salad dressing.
Medical Center. “Flaxseed has great health benefits,” says Reardon, “but so do
“We have seen in human and animal thousands of other foods, so it’s really important to eat a general
Christina Reardon studies that flaxseed consumption healthy diet and include all food groups.”
VALLEY HEALTH & LIFE 15NON PROFIT
U.S. POSTAGE
PAID
Harrisburg, PA
575 Beech Street Permit #324
Holyoke, MA 01040
Lose Weight. Live Better.
Call the Weight Management Program at (413) 535-4757.
With our medical help, you can reach,
and maintain, your healthiest body weight.
Our team of experts has the experience and technology to help you achieve your weight loss
goals. Equally important, we are committed to helping you keep the weight off — for life.
Call the Weight Management Program at (413) 535-4757.
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