Construction “Guys and Dolls”

Posted on May 17, 2012 by Guest Blogger

Mother-Baby Unit Construction "guys and dolls."

The construction team is moving along with remodeling the Mother-Baby Unit at Summa Akron City Hospital, except when we ask them to stop and smile!

Exciting news: Phase I of the renovation is scheduled to be complete by mid-June. By then, we will have six remodeled private rooms dedicated to care after delivery plus a new nursery area. Phase II is planned for completion by mid-August and will provide five additional postpartum rooms. Renovation of the entire unit will tentatively be complete by the end of the year. The new unit will include 18 beautiful, private rooms for moms, babies and families. Each room will have new beds, recliners conducive to breastfeeding, and a couch that can easily convert to a comfortable bed for the dads.

If you’re interested in maternity services across Summa Health System or to take a virtual tour, please read on.

Jill Scovern, BSN, MBA, RN, NE-BC
Unit Manager, Mother Baby & Perinatal
Summa Akron City Hospital

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Observing the Life Lessons of Your Children

Posted on May 16, 2012 by Dr. von Gruenigen

Life is full of lessons, and parenting is an ongoing class for me. Recently, one of my children was cut from a sports team. It’s happened before to each of my children, and it will probably happen again. Yet, it is so painful for them and me. Sometimes I feel helpless and frustrated even though I love and support them. Reflecting, I appreciate that my own parents probably felt the same when I was learning life’s lessons.

My graduation from medical school.

My graduation from medical school.

I entered medical school with the intent of being a pediatrician. My childhood pediatrician was a very compassionate man. However, when I rotated on pediatrics as a third year medical student, I didn’t feel as though I had the personality to be a pediatrician. To be direct, I am not “that nice.” The word nice is not the first word people use to describe me, and I’m OK with that.

I recall discussing this with my mom as we sat on the back porch. I shared with my mother that I could not be a pediatrician because I was not “that nice.” She stated, “I know, Dear,” with a smile. I told her I was interested in surgery, and she was enthusiastically supportive of me in that specialty.

My Mother always knew I wasn’t going to be a pediatrician. I didn’t. She wanted me to come to the revelation on my own no matter how painful it was for me to realize my own limitations. Just because I respected my pediatrician didn’t mean I could emulate him.

Who’s in my classroom to help me parent? My family and friends. They are teachers and coaches for me, and I love them for it.

Dr. Viv

Follow me on Twitter @DoctorViv

Posted in Dr. Viv, Parenting | Tagged , , , | 3 Comments

Isn’t My Mother Beautiful?

Posted on May 11, 2012 by Dr. von Gruenigen

It’s that time of year again! Mother’s Day! It’s one of my favorite holidays of the year as I celebrate my mother, and my kids celebrate me.

My mother, Joyce, who is pictured at left, taught me many, many things. It’s interesting how one of her phrases will come into my mind when I least expect it. Her words actually come out of my mouth, and my children think they are my words. There are the usual examples, “Eat with your mouth closed,” “Don’t forget to say please and thank you,” and “Be careful.” Each family has unique phrases; however, remember that my mother is a southern gal. My favorite family quotes include, “Dern dag bern,” “No grungies,” and “No wallerin.” Try finding those words and phrases on Wikipedia.

So, enjoy your day, ladies, and ask for what you want! Take full advantage. By the way, remember the blog on me being a Mommy hoarder? I wanted to take my kids away for Mother’s Day weekend. Well, at the time of this blog posting, they have academic and athletic commitments, which may not be conducive to travel. Plan B? Breakfast in bed for me on Mother’s Day. I better get to the grocery.

Dr. Viv

Follow me on Twitter @DoctorViv

P.S. Isn’t my mother beautiful?

Posted in Dr. Viv, Mom, Parenting | Tagged , , , | 5 Comments

The Intersection of Grandmother & Nurse

Posted on May 10, 2012 by Guest Blogger

Choosing a career was one of the toughest decisions I had to make. I wanted a career that I would truly enjoy for the rest of my life, and to me, nursing is that career. It is a profession dedicated to helping the sick. My dedication not only comes from within, but from my mother who supported and encouraged my career decision. Compassion, warmth and determination to help others have always been part my mother’s character. Nursing allows you to bring these qualities to life in order to help people and make an impact in their lives.

I have been a nurse for 38 years at Summa Health System. When I was 18 years old, I went to Idabelle Firestone School of Nursing at Summa Akron City Hospital to begin my education and work as a student nurse.

I then began my career as a cancer nurse working the night shift, which allowed me to give comfort the terminally ill and experience life and death through others. My next career path led me to women’s health, where I began on a gynecology floor, followed by maternity services. I then spent 17 years in the Special Care Nursery where I grew to love nurturing and caring for new moms and their babies.

All three of my daughters were born at Summa Health System, and I fortunately had wonderful deliveries with no problems. As a nurse, however, you come to experience many different situations. I found myself in one of these situations when my first granddaughter was born premature with three Ventricular septal defects (VSD) and one Atrial septal defect (ASD) in her heart.

Karen and her daughter, Andrea McKinney, with her two granddaughters Ella (age 5) and Brenna (age 2).

Coping with having a premature baby can be difficult, especially when your baby has a heart defect. Your expectations immediately shift, and the birth, the first days, going home, and newborn parenting all become overshadowed by worry and grief. When your baby is premature, it is natural to feel complex emotions, and being a grandmother and a nurse, I was also feeling those emotions for my daughter and granddaughter. My granddaughter spent one week in the Special Care Nursery, and we were told she would need open heart surgery once she tripled her birth weight. After nine months and to our delight, we were informed that the defects had closed and she would not have to undergo surgery. My granddaughter is a very healthy five year old now, and looking back, I believe this experience led me to develop a deeper understanding of how important nurses are in the healing process.

Today, I am the case manager for Summa Women’s Health Services, where I act as a discharge planner, educator and researcher. Some of my most complex patients are mothers who are addicted to opiates. This addiction is a major concern because their infants are usually born with Neonatal Abstinence Syndrome (NAS), or problems of being exposed to addictive illegal or prescription drugs. It is very important that opiate-addicted women who get pregnant do the right thing and get prenatal care. I find it very gratifying that I am able to help these women and protect the health of their unborn child.

Nurses are needed in every field, and I am glad to be able to do my part. During Nursing Recognition Week from May 5 to 11, we recognize these extraordinary, compassionate, dedicated and hardworking people that help care for our patients and their families every day. If you’ve had excellent care from a Summa nurse, please comment below.

Karen Frantz, BSN, RNC
Case Manager, Women’s Health Services
Summa Health System

Posted in Nursing, Parenting, Pregnancy | Tagged , , , , | Leave a comment

A Million Times a Year

Posted on May 9, 2012 by Guest Blogger

It’s National Nurses Week! I’d like to recognize Summa nurses for the compassion and clinical excellence they provide our patients every single day. Indeed, they “care beyond.”

I would also like to take a moment to share with you the impact our nurses have made on our community this past year. In 2011 alone, our 2,443 Summa nurses cared for 1 million patients including:

  • 227,239 ER visits
  • 47, 101 surgeries through our eight 24/7 hospitals
  • 114,687 home care visits
current Summa Health System “Cameos of Caring” nursing award recipients

Current Summa Health System “Cameos of Caring” nursing award recipients

Our nurses are truly invested in their profession and are helping to improve the health of our community – through research, clinical care and active partnering with physicians and other healthcare professionals. The photo at left shows our current Summa Health System “Cameos of Caring” nursing award recipients. Overall, Summa nurses have achieved a “gold standard” of nursing care after receiving Magnet status at Summa Akron City Hospital and Summa St. Thomas Hospital, and re-designating Magnet status at Robinson Memorial Hospital, an affiliate of Summa Health System. Only 7 percent of hospitals nationwide achieve this status, so we are especially proud of and inspired by our nurses as they continue to provide the very best care for each of our patients.

Has a Summa nurse made a difference in your life? Visit us on Facebook, and post a note on our wall about a nurse special to you. We’ll pass along your appreciation. Tomorrow, you will want to read a blog post from one of our outstanding, committed nurses as she talks about her 38-year nursing career in Women’s Health Services.

Please join me in thanking our nurses this week for everything they do for our patients and their families in the communities we serve.

Lanie Ward, RN, MBA, NEA-BC
System Vice President, Patient Care Services/CNO
Summa Health System

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Fifty Shades of Feminism

Posted on May 8, 2012 by Dr. von Gruenigen

Fifty Shades of Gray by E.L. James has been on the New York Times best sellers list for weeks. This week, the trilogy held the top three spots. Depending on who’s classifying, it’s a romance or erotic novel. The trilogy is set largely in Seattle and involves an interesting relationship between a young couple. The book has been controversial because of the dominant and submissive aspects of their relationship. Oh, how life is fascinating.

The reviews have been interesting especially those done by men.  Some women reviewers have chastised the male reviewers, as they didn’t believe they could critique from a women’s perspective.  However, I think it’s a good thing men are reading the book.  Gentlemen, please put down The Hunger Games and read this book instead – you may learn a thing or two about women.

I view this book as an updated version of Lady Chatterley’s Lover by D.H. Lawrence published in the 1920’s. Initially, it was published in Italy as it could not be published in the United Kingdom.  The “lady,” is now modern, confident and she asks for what she wants in an adult relationship with hard limits. I say, you go girl.

As a gynecologist, I talk to women daily behind closed doors, essentially about anything they want.  I learned nothing new in this book, but other readers may learn a few fun facts. However, some of the scenes become a bit redundant over the course of the three books (Yes, I had to read all three for research, you know). Finally, if you think you may be offended, then don’t read it.

Ladies, feel empowered and ask for what you want in a healthy relationship. We all have an “inner goddess” within us.

Dr. Viv

Follow me on Twitter @DoctorViv

Posted in Dr. Viv, Sexual health | Tagged , , | 2 Comments

Long Term, Reversible Birth Control

Posted on May 3, 2012 by Guest Blogger

I was recently talking with a college friend about her birth control options now that she is newly married and focusing on her career. She has grown tired of oral contraceptive pills and forgets to take them at the same time every day. I suggested a variety of options including an intrauterine device (IUD) and was surprised to hear that she knew very little about it. I’ve noticed a similar trend in my patients, so here is a bit of information for you or someone you know who is not quite ready for a bundle of joy.

What is an IUD? It is a T-shaped device that is inserted into the uterus through the opening in the cervix. It can be placed in the office. Before inserting an IUD, your health care provider may wish to check for sexually transmitted infections. Your physician may also recommend taking Ibuprofen before the IUD insertion to help with the discomfort.

The procedure takes approximately five to 10 minutes and involves using a speculum, slightly dilating the cervix and inserting the device. After five to seven days after insertion, the IUD is considered effective birth control. A back-up birth control method, such as a condom, is recommended for five to seven days after insertion.

It is important to note that an IUD does not protect from sexually transmitted infections, so condom use is still recommended. There is also a small risk of infection up to 20 days after insertion that can be easily treated with antibiotics. After that point, the infection risk is the same as for a woman without an IUD.

There are two different types of IUDs. The first is made of copper (copper T380A IUD). The failure rate after one year is 0.8% for this type. Common complaints from women with copper IUDs are abnormal vaginal bleeding or pain with menstruation. The copper IUD can remain in place for 10 years. The second type of IUD contains progesterone (levonorgestrol intrauterine system) and has a 0.2% failure rate in the first year of use. Common concerns from users for the levonogestrol IUD include no menstrual period or irregular vaginal spotting. The progesterone IUD can remain in place for five years.

IUDs are an excellent option for birth control because they require no day-to-day work. They can also save you money in the long run. When comparing the price for five years worth of birth control, IUDs were the least expensive form of reversible birth control. The downside is that they require a high initial cost. Many insurance companies will cover the devices, but if not, they run between $750 and $850. If you are unsatisfied with your current method of birth control, talk to your health care provider about other options, such as IUDs, that are available.

Shannon Armbruster, M.D.
Obstetrics and Gynecology Resident PGY-1
Request an appointment with Summa Women’s Health Services

Posted in Gynecology, Our bodies | Tagged , , , | Leave a comment

Being Mrs. Bagnoli

Posted on May 2, 2012 by Dr. von Gruenigen

Last week, I traveled with my husband for his work and left the kids at home. This is a rare event. Only one other time have I joined him for an entire work trip, and even then, I took the kids. So why wouldn’t I want to regularly be the Mrs. and travel? I pondered this question and have derived three reasons.

1. I am a busy physician. As you know from following me on Twitter, I’m all over the place. Most of my days start at 5 a.m. with multitasking between clinical office, surgery and meetings. I also travel once or twice a month either for national board responsibilities or for giving talks to professionals and the public.

2. We are an active family. What can I say? I like being with my kids. The best part of my day is family dinner. Each family member goes over his or her day, and we update the family calendar. We review school project deadlines, talk about after school activities or we just talk. For fun, we sometimes watch reality TV like Survivor and American Idol. I just miss their chaos while I’m away.

3. Being the Mrs. isn’t always my priority. And I’m realizing I need to be better at this. I am my own evolution and am now more comfortable with simply being the Mrs. I no longer feel the need to define myself. In the past, I favored being introduced as Dr. von Gruenigen. In social settings, I now favor the Mrs.

I am not the same woman I was a few years ago. My priorities and life are in constant change and that’s OK. I am enough.

Dr. Viv

Follow me on Twitter @DoctorViv

Posted in Dr. Viv | Tagged , , , , | 4 Comments

I am a Mommy Hoarder

Posted on April 26, 2012 by Dr. von Gruenigen

My parenting style has changed over the last couple of years. When I was a young surgeon and mother, I remember moments of just trying to survive. Don’t get me wrong, I love “doing it all.” However, there have been challenges. This includes the lack of reflection to stop, pause and enjoy.

Now that I am middle aged, I stop and pause more often. I give myself certain liberties that I would not do several years ago. An area of motherhood that has recently changed is the time I spend with my children. This includes quality and quantity time.

My daughter is in the eighth grade, and my son is a high school sophomore. My family dynamics will change in less than three years when my son goes to college. I have mixed feelings about the evolution and growth of my family. Despite being a physician, I’m still just a mom.

My coping mechanism for this inevitable change has become hoarding my children. Because my kids are teenagers, they want to spend time with their friends, which means time away from me. My strategy is now to take them away so they are forced to be with our nuclear family. Believe me, they are not suffering.

I’ve taken them for the traditional travels of spring break and summer vacation. However, I’ve taken it a step further with Martin Luther King, Jr. Day and even Presidents’ Day weekends. If there is a weekend with a title, it is an excuse for me to pack the car.

The highlight of our family trips thus far was this winter when we rented a ski shack in New York for a few days. The term “shack” does not do the place justice. We sheltered not only our family but also critters like mice and a bat. In addition, this past season was not known for heavy snowfall. Despite the lack of snow and the critters running around, our family time was precious. I’m sure my children will tell the tales years from now to their children.

Next family hoarding adventure? Mother’s Day weekend.

Dr. Viv

Follow me on Twitter @DoctorViv

Posted in Dr. Viv, Parenting | 2 Comments

“Hot Mess”

Posted on April 19, 2012 by Guest Blogger

“Girl help me, please!” she said as I sat down to introduce myself to my new patient. “If you don’t help me, I am going to end up in an orange jumpsuit.”

“What’s wrong?” I asked. She then proceeded to tell me her story about debilitating hot flashes and how they were ruining her life. She said she they were driving her so crazy she thought she might go mad and commit a crime. She was actually fanning herself in the office while complaining that she could not sleep at night, that she was tired all the time, and that intercourse had become painful. These issues were beginning to interfere with her job performance and her marriage. She literally was a “hot mess.”

She had previously approached her primary care doctor and had discussed hormone replacement therapy (HRT). With “all the new evidence regarding HRT” this physician said he did not feel like it was a good idea. And so she ended up seeing me, and I am happy to report that she is crime-free and not wearing an orange prison jumpsuit today.

Unfortunately, this scenario is not uncommon. Hot flashes are the most common menopausal symptom, affecting as many as 60 to 80 percent of women. Prior to the last decade, HRT was given to women fairly liberally with the false expectation that it would protect them from getting heart disease. Then, in 2002, the results from the Women’s Health Initiative trial were released, and everything changed. The results, which are still being dissected and reanalyzed today, demonstrated that HRT does not protect women from getting cardiovascular disease. In fact, there is an attributable excess risk per 10,000 person-years of 7 more cardiovascular events, 8 more strokes, 8 more pulmonary emboli, and 8 more invasive breast cancers (JAMA. 2002 Jul 17;288(3):321-33). As a result, the FDA requires that all estrogen-containing prescription therapies carry an added warning of the new associated risks. These risks have made doctors and patients fearful of HRT, and this has resulted in a backlash: women are being denied access to a treatment that they could benefit from.

Yes there are risks associated with HRT; however, these risks do not mean that there is no role for these medicines. Scientific evidence proves that HRT effectively helps such conditions as hot flashes, vaginal dryness, night sweats and bone loss. A recent review determined a 75 percent reduction in the frequency and an 87 percent reduction in severity of hot flashes. Benefits can lead to improved sleep, sexual relations and quality of life.

Many factors will be part of a woman’s decision to use HRT. A clinician should consider a women’s age, her risks, her preferences, all available treatment options and cost when determining if HRT is appropriate. HRT is not an option if the patient has a personal history of blood clots in the legs or lungs, breast cancer or a high risk of stroke or heart disease. In this case, other non-hormonal remedies to treat the symptoms should be offered.

So talk to your doctor! Only after examining and understanding your own situation, and after a thorough consultation with your clinician discussing the risks, benefits and alternatives, can you make the best treatment choice.

Priya Maseelall, M.D., Chief of Reproductive Endocrinology
Women’s Health Services, Summa Health System

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