Midstate News for 2010

Below is a history of MidState Medical Center news that occurred during 2010. Click the [+] next to each title to view that story.

December 28, 2010
Wallingford Orthopedic Surgeon Makes Knees, Hips Good as New

Wallingford Orthopedic Surgeon Makes Knees, Hips Good as New

MERIDEN - Four decades of being on her feet as a factory worker took its toll on Rose Coscuna's knees. Around the time she turned 50, the 58-year-old Meriden resident was told she had the knees of an 80year-old. She endured the pain for years, taking medications, but finally decided enough was enough.

"I said I can't take this pain anymore," she said. Though she was advised against it, Coscuna chose to have total knee-replacement surgery on both knees at the same time. This was partly due to her health insurance coverage and her high co-payments, but Coscuna said she also had time to do enough research to find that some people don't go back after having surgery on just one knee, and her prime motivation was getting rid of the pain.

She explored a few options, including visits to surgeons throughout the state, but came back to Dr. Leonard A. Kolstad, an orthopedic surgeon with Comprehensive Orthopaedics and Musculoskeletal Care, in Wallingford.

Kolstad was the featured medical speaker at MidState Medical Center's annual meeting in November.

"I'm so grateful that he's the one I chose to do the surgery," said Coscuna. "He followed through with everything." Because the factory she worked for went out of business, Coscuna is unemployed, but a year following her surgery she feels more than up to the task of returning to work.

"If I had to be on my feet all day I'd be fine," she said. "Now I feel I can almost do a little run, and before I couldn't run at all," she said. "I'm pleased with it, 100 percent. The pain was so severe; I never had pain like that in my life."

Mother Nature gives the knee - for shock absorber purposes - the meniscus, cartilage between the thigh bone, or femur, and the shin bone, or tibia.

Over time, the cartilage can wear away, most commonly from osteoarthritis, though inflammatory arthritis and injury can also cause the erosion.

When that happens, the bones of the joint start rubbing together, and that's where the big-time pain comes in. When nature runs its course, science can step up to the plate. "Basically, you're doing it for pain relief," said Kolstad, of the total replacement.

The major advantage developed over the years is in the material used to replicate nature's intent. That involves highly polished steel attached to the ends of each bone and a dense plastic in between that can take more wear. The aim is to replace a knee once, and have it last for the rest of the person's life. Problems with early knee replacements led to repeat procedures. Those problems included a chipping away of the plastic, which led to microscopic pieces floating around in the joint. Early efforts also did not account so well for the side-to-side or rounded pressures everyday activity can put on the knee joint.

So while early replacements might have lasted seven to eight years, today the hope is replacements will last 20 to 30, or even beyond, said Kolstad.

Similar advances pertain to total hip replacements, which started being performed in the United States in the 1970s. There are both cemented and cement-free approaches, and typically the age and activity of the patient determines which approach is more appropriate. Improvements include the use of titanium, which flexes more like bone.

Again, wearing away of the cartilage is the major culprit, this time in the area where the rounded end of the thigh bone meets the pelvic bone.

The ball grinds in the socket and, again, pain is the major complaint.

The aim of total replacement for people in the range of 40 years old, who are going to need that hip for a while, is to provide something that "will go the distance," said Kolstad.

Replacing the hip involves a prosthesis that is a socket and ball, which is connected to a stem that is inserted into the thigh bone, with the aim of having the bone grow into the component. The component is made of trabecular metal, which is pressed into the bone. The bone will grow into the component, and increase the strength of the implant. The ball area uses dense plastic backed by metal.

Kolstad typically tells patients they can do everything they want except running. There's a 95 percent change of it lasting 25 years, he said.

"I'm putting in steps that stand the test of time," he said. In August, DePuy Orthopedics, a division of Johnson & Johnson, voluntarily recalled hip replacement systems that use metal-onmetal implants, which became available in 2003. The New York Times reported that while the implants were designed to last up to 15 years in some cases they needed to be replaced in only a couple of years. Among the risks of the metalon- metal approach is the possibility of metal pieces being absorbed in the body, leading to infection.

Those recalled implants were not used at MidState, said Kolstad. The dense plastic, which is used in the socket with a metal backing, is now strong enough to withstand wear. "So why go with metal on metal?" he asked.

"Some is luck," said Kolstad. "Some is not jumping on the next thing because it's cutting edge. I want a track record."

Dwain Harry is a 51-year-old Meriden resident who had his right hip replaced in 2000 and his left hip replaced four years later. He's been so trouble free since that if he knew what he knows now he would have had the procedures done sooner.

For seven years, Harry has coached Amateur Athletic Union basketball, first in Middletown and now in the shoreline area.

"I don't play like I used to play," he said. "I still play with the kids."

Harry played football and basketball in high school, and then basketball in the Navy, where he served four and a half years. After earning a degree in international business at Central Connecticut State University, Harry has had a near 30-year career with Sikorsky Aircraft.

It was while he was attending Middlesex Community College, in Middletown, that Harry's hip pain pushed him to action.

"I was sitting in class and I couldn't get up off the chair," he recalled, "and I knew it was time to take care of this."

"Dr. Kolstad did a fantastic job, because if you had known me (before) you wouldn't know I had hip replacements," he said. Now Harry can continue one of his long-time passions: motorcycle riding.

But he said one worry is that because he had his replacements at such a young age, he "might last longer than the hip." Of Kolstad, said Harry, "in my eyes he's the best in the business."

December 13, 2010
Woman to Head Medical Staff at MidState

Woman to Head Medical Staff at MidState

MERIDEN - Dr. Rajani Nadkarni is the new chief of medical staff at MidState Medical Center. Its the first time a woman has held the position in the long history of Meridens hospital, which includes MidState and its predecessor hospitals dating back 125 years. As leader of the medical staff, Nadkarnis responsibilities include resolving issues and representing physicians interests in relations with the hospital administra tion. Dr. Harold Kaplan, Mid States director of medical affairs, compared it to being president of a large volunteer organization.

She essentially is in charge of making sure that the medical staff functions as its designed to function, and is ultimate arbiter, said Kaplan.

While women have achieved parity when it comes to attending and graduating from medical schools, they still lag behind when it comes to taking on leadership positions, noted Lucille A. Janatka, Mid-States president and chief executive.

Shes going to be great, said Janatka.

The chief of staff role is a six-year commitment. Nadkarni was named chief of staffelect two years ago. She took over from Dr. Kenneth R. Kurz (no relation to this reporter) as chief of staff during the medical staffs annual meeting Thursday night. Kurz now becomes immediate past chief of staff, a two-year position.

Nadkarni, a medical oncoloist is in her 14th year at Mid-State. She downplayed the gender significance of her new role.

There are two things Ive never thought about in my career, she said. One is that Im female and the other is that Im Asian. Ive always thought that if youre good at what you do, it doesn't matter.

Nadkarni is from India. She earned her medical degree from the King Edward Memorial Medical College in Mumbai in 1985. The medical school is comparable to Harvard, she said.

Nadkarni, an Orange resident, did her residency at the Hospital of Saint Raphael in New Haven, and her fellowship in medical oncology at the Yale University School of Medicine.

She is taking on her leadership role at a pivotal time for hospitals, as health-care reform is about to increasingly put pressure on medical providers to control costs and show results. Meeting that challenge will require a strong relationship between the medical staff and the hospitals administration.

I think its a great relationship, which is one of the reasons I want to do this, said Nadkarni.

With all of the changes ahead, its very important for the medical staff to take a leadership role in this environment, she said. You want to participate in that change proactively.

Of the changes ahead, she said, Its all outcome-based. Theres going to be a lot of accountability.

MidState now has 400 on the medical staff, having added 47 physicians in the past year, said Janatka.

During the annual medical staff meeting, the hospital also handed out physician awards. It was the third year for the awards, which Kaplan started out of the conviction that if doctors were going to be critiqued with reviews, they also ought to be recognized for outstanding performance.

The four award categories are named in honor of physicians with distinguished service at MidState and its predecessor hospitals. This years winners are: The Matthew P. Campione Community Service Award: Dr. Linda Durhan, a radiologist who in her free time leads a Pilates class for breast cancer patients.

The Daniel Kahn Clinical Quality Award: Dr. Robert Levitz, who since 1984 has taken on the role of educator in passing on his expertise in infectious diseases.

The David W. Parke Leadership Award: Dr. Louis Meyer, general surgeon and member of the medical staff who, since 1975, has taken on a variety of leadership roles.

The Joseph Goodman Collaboration and Teamwork Award: Dr. Brian Timko, a hospitalist at MidState since 2007 who was received several nominations for his collaborative work with nursing, case management, dietary services, pharmacy and other clinical support.

November 24, 2010
MidState Medical Centers Earns Breast MRI Accreditation

MidState Medical Centers Earns Breast MRI Accreditation

MERIDEN - MidState Medical Center has been awarded a three-year term of accreditation in breast magnetic resonance imaging (MRI) as the result of a recent review by the American College of Radiology (ACR). MRI of the breast offers valuable information about many breast conditions that may not be obtained by other imaging modalities, such as mammography or ultrasound.  MidState Medical Center is the third site in Connecticut and the first in the central Connecticut area to have earned this prestigious distinction.

The ACR gold seal of accreditation represents the highest level of image quality and patient safety. It is awarded only to facilities meeting ACR Practice Guidelines and Technical Standards after a peer-review evaluation by board-certified physicians and medical physicists who are experts in the field. The process is completely voluntary.

What does ACR accreditation mean? It means that MidState Radiology Associates has voluntarily gone through a rigorous review process to ensure that nationally-accepted standards of care are meant; that our personnel is well qualified to perform, interpret and administer patient imaging; and that our equipment is state-of-the-art and exceeds quality assurance and safety guidelines.

November 23, 2010
MidState Cancer Center Re-accredited by the Commission on Cancer

MidState Cancer Center Re-accredited by the Commission on Cancer

MERIDEN - The MidState Cancer Center is pleased to announce it has been re-accredited a three-year approval award with commendations in seven areas from the American College of Surgeons Commission on Cancer (CoC). Accreditation from the Commission on Cancer center ensures that patients have access to high-quality comprehensive cancer services delivered by a multidisciplinary team of experts. Accreditation also reinforces that MidState is equipped with the most innovative means to diagnosis and treat cancer, including access to sophisticated technology and ongoing clinical trials.

"We have met the vigorous standards required for a high performing program, with a focus on quality patient care in the areas of prevention, early diagnosis, state-of-the-art treatment, rehabilitation, psychosocial support and end of life care. This designation means that we have not only met all of those standards, but have exceeded them in seven areas," said Abbi Bruce, RN, Director, Cancer Center.

These seven areas of commendation include: producing an annual report that focuses on patient outcomes, achieving 100% compliance with case review, meeting quality criteria for the annual Commission of Cancer's Call for Data submission, obtaining 100% compliance with College of American Pathologist protocols, offering three or more prevention or early detection programs, and implementing two quality improvement projects since the last accreditation.

Accreditation is valid through 2013.

November 22, 2010
Minimally Invasive Aneurysm Repairs

Minimally Invasive Aneurysm Repairs

MERIDEN - An aortic aneurysm led to the deaths of Albert Einstein and Charles DeGaulle.

Francis Keane drove himself home from MidState Medical Center early this month following surgery to repair an aortic aneurysm. All he had to show for it were two Band-Aids.

Keane was able to take advantage of a technique not available in Einstein's time, a minimally invasive endovascular repair that placed a stent graft in the aorta, relining and reinforcing the blood vessel.

The surgery left two incisions, each about a half an inch, on either side of his abdomen.

"I was surprised," said Keane, a Southbury resident who is 71. "I had some mild pain in my stomach and I returned to my usual routine the next day 100 percent."

Keane said the incision areas healed quickly. "It was like having a little cut on my finger," he said.

The minimally invasive approach was thanks to Dr. Jonathan E. Hasson, who has been with MidState since mid-October.

"I think we're up to 50 now," he said of the number of surgeries he's performed in this manner. The operation typically takes from 90 minutes to two hours, he said.

The aorta is the major blood vessel that brings blood to the body from the heart.

Think of it as a garden hose about an inch in diameter in the shape of an upside-down Y. An aneurysm is when the blood vessel expands, either from disease or injury.

A ruptured aorta can cause the victim to bleed to death from the inside in up to 50 percent of cases, so an aortic aneurysm, or weakening wall of the blood vessel, can be a life-threatening condition.

Symptoms are not always obvious, and may include back pain or tenderness in the abdomen or chest. Risk factors include tobacco use and hypertension. It's more prevalent in men and those over 60.

Keane's aortic aneurysm was confirmed by ultrasound after he complained to his family doctor, in Southbury, about pain in his upper shoulder.

Hasson said Keane was fortunate his doctor recognized the threat.

Instead of open surgery, the endovascular repair technique snakes a stent graft to the aorta through blood vessels.

Hasson's innovation is to perform it by making the smallest of incisions, instead of the three to four-inch incisions in the groin area.

"It's really an evolution, and quite frankly, it really is an advance," he said. Up to 90 percent of aneurysms can be treated in this way, he said.

"The difference isn't the stent, but not cutting the patient open," he said.

Recovery times are significantly shortened, from as much as three weeks of recovery and three days in the hospital to experiences like Keane's. Keane, a retired railroad worker, arrived at MidState at 3 p.m. one afternoon and drove himself home at 3 p.m. the following day.

Hasson said Keane will undergo a couple of CT scans in the first year following surgery to make sure the stents mesh is in place and working properly.

"I think it's the way to go," said Hasson.

November 17, 2010
MidState Posts 11th Straight Operating Surplus

MidState Posts 11th Straight Operating Surplus

MERIDEN - MidState Medical Center has posted an operating surplus for the 11th consecutive year, a string of fiscal health that coincides with the years Meriden's hospital has been at Lewis Avenue.

The operating margin for the 2010 fiscal year, ending Sept. 30, was $10.6 million, or 5.3 percent of net revenue. An operating margin of 5 percent is generally recommended nationally as an indication of fiscal fitness. The performance puts MidState on solid footing, said Ralph Becker, the hospital's chief financial officer, and is better than most hospitals in Connecticut.

The hospital's operating margin in 2009 was 3.2 percent.

MidState held its annual meeting Monday at the Wallingford-based Connecticut Hospital Association. Along with the financial report, the hospital also presented its Crystal Obelisk Award, which since 1991 has honored individuals and groups for outstanding contributions to health care.

The 2010 recipient is James J. Ieronimo, the executive director of the United Way of Meriden and Wallingford, who has served on the hospital's board of governors and community advisory council.

Honored for helping the hospital connect with the community, Ieronimo was called "a true ambassador for MidState Medical Center" by Lawrence McGoldrick, chairman of the hospital board of directors.

Ieronimo, in turn, honored past recipients of the award, including Dr. Matthew P. Campione, the 2005 winner, and last year's honoree, Dr. Teofilo Gutierrez Jr., "and all the people who modeled for me what it means to be a community hospital."

"It's kind of overwhelming because I've been on the board of governors for a number of years and watched people get this award," said Ieronimo, following the meeting. "I think of these people and I think these are people who model for the rest of us how you relate to an institution. It's a community resource but it demands something from the community."

"Unless people model behavior like that, you really don't know where you fit," he said.

MidState's favorable financial performance was boosted by an investment the hospital made about 15 years ago in a malpractice captive insurance company, which manages risk and sets premiums for physicians affiliated with the hospital. Claims were less and investments performed better than expected, said Becker.

That added up to $10 million, or a 4.5 percent difference. Even without that boost, MidState would still have performed with an operating surplus.

Recent highlights for MidState include the major expansion of its emergency department and the relocation of the MediQuick walk-in center. The emergency department received about 52,000 visits last year. The expansion, completed in September, now enables the department to handle about 65,000 annual visits.

Now located on Pomeroy Avenue, the MediQuick center has experienced a 23 percent increase in patient activity, from about 18,000 in 2009 to 22,600 visits this year, said Lucille A. Janatka, the hospital's president and chief executive. MidState's complex in Wallingford is also experiencing increases in patient visits, she said.

Janatka said it was all about "getting out into the community and getting people to hear about MidState. MidState isn't a secret any longer."

The annual meeting is typically the time for the election of the hospital's board of directors, but that action has been delayed for a month as MidState and other affiliates of the Hartford Healthcare Corp. prepare to change bylaws to more fully synchronize activities.

The aim is to make the affiliates operate more effectively as a unit, said McGoldrick, who served on an affiliate task force.

"Everybody knows that you can't survive as just a small, local hospital," he said. Local boards will still have responsibilities, focusing on health assessments and quality of care.

"We will get back more, I'm convinced," said McGoldrick.

Eliot Joseph, president and chief executive of Hartford Hospital and Hartford Healthcare, told the gathering that "today, health care is typically a fragmented experience. Our pledge is to do it differently."

"We have to integrate our care, coordinate our care," he said.

November 17, 2010


MERIDEN - Health care professionals and hospital administrators are at the forefront of advocacy for physical fitness. All aspects of Americans' lives benefit, it seems, from being healthy, physically fit and possessing a positive attitude.

Fiscal fitness is a mandate for hospitals, too. In this regard, Meriden's MidState Medical Center gets deserved commendation for exceeding a generally recommended national operating margin of 5 percent. For the 11th consecutive year, MidState has posted an operating surplus - 5.3 percent for fiscal year 2010. In juxtaposition with a troubled, stressed economy, as well as an ocean of economic uncertainty, MidState's leadership continues to demonstrate prudence and vision - something of a model for some of its peers to emulate.

In addition to declaration of a clean bill regarding fiscal health and expanded services (emergency department and MediQuick walk-in center), MidState presented its 11th annual Crystal Obelisk Award to the executive director of the United Way of Meriden and Wallingford, James J. Ieronimo, who has served with distinction on the hospital's board of governors and community advisory council.

In addition to being a highly visible member within our municipalities (including regular United Way-themed columns he authors for this newspaper), Ieronimo's dedication is as obvious as it is sincere. Little wonder, then, the he was appropriately dubbed "a true ambassador for Mid-State" by Lawrence Mc-Goldrick, chairman of the hospital's board of directors.

As 2010 yields to 2011, we offer a tip of the hat both to Mid-State and James Ieronimo, wishing both continued fitness, fiscally and physically.

November 08, 2010
MidState Medical Center's Pink Partini is Fashionably Successful

MidState Medical Center's Pink Partini is Fashionably Successful

MERIDEN - It was a night that surpassed everyone's expectations: nearly 1,000 people gathered in support of the MidState Cancer Center at the 2010 Pink Partini Fashion Show, making the event the largest in MidState history!

Over 75 models walked the runway to the comedic introductions delivered by emcee and Channel 3 television personality, Scot Haney. Members of the Meriden and Wallingford fire departments also enthusiastically showed their support wearing black and hot pink t-shirts, selling raffle tickets, and mixing specialty drinks. The decor for the evening incorporated their spirit, with pink ribbon wellie boots as centerpieces and stuffed animal Dalmatians as favors.

All of the proceeds from last week's event support the MidState Cancer Center. Dr. Gary Tansino, medical director of the Cancer Center, took a few moments to highlight the advanced technology and cutting-edge programs aimed at reducing and treating cancer in our community. He concluded, "Should you, a relative or friend need cancer services, be confident that high quality, comprehensive, state-of-the-art cancer care is available at MidState Medical Center."

MidState wishes to thank the Medical Oncology and Hematology Group, all sponsors, participating boutiques, hair and makeup stylists, and to our long list of models, entertainers, and volunteers who dedicated their time and talent to this show.

View our photos from the Pink Partini Fashion Show.

November 08, 2010
MidState Announces the Blooming Pink Celebration Garden

MidState Announces the Blooming Pink Celebration Garden

MERIDEN - MidState Medical Center is proud to announce the creation of the Blooming Pink Celebration Garden. This special garden, in the shape of a breast cancer awareness ribbon, has been filled with thousands of pink tulips planted to honor, celebrate or memorialize those touched by cancer.

Located on MidState's campus, this garden is not only an inspiration but a symbol representing survivorship. This spring the first annual "Blooming Celebration" will take place.

Bulbs are being sold for $25 and benefit The Cancer Center at MidState. For more information, please contact Tina Fabiani at 203.694.8744 or Tina.Fabiani@hhchealth.org. Your gift will not only bring awareness to breast cancer but will also help MidState continue to meet the needs of patients and families coping with the diagnosis of cancer.

Together we can make a difference in the lives of cancer patients ... one bulb at a time.

November 08, 2010
Patient Satisfaction In The Emergency Room Is On The Rise

Patient Satisfaction In The Emergency Room Is On The Rise

MERIDEN - In the last year, the MidState Emergency Department (ED) has seen significant increases in overall patient satisfaction. This upward trend began in late 2009 after several improvements were made to enhance the patient experience in the ED. This included making discharge phone calls to select patients and increasing rounding on patients by providers.

Patient satisfaction again increased earlier this year, most likely a result of the opening of the new department, which is a much larger, efficient and patient-friendly space. Overall, patient satisfaction between early 2009 and late 2010 has increased by 36%. As a result, MidState's ED is now performing better than 83% of hospitals in the state for patient satisfaction, which ranks the ED number 3. Additionally, the MidState ED is faring better than 81% of hospitals in the nation.

Wait times in the ED have also improved. In early 2010, 32% of patients were being seen by a provider in less than 30 minutes. Results from a September patient satisfaction survey show that 75% of patients are being seen by a provider in less than 30 minutes.

With new space and improved operations, the ED is well positioned to care for its patients in a timely, efficient and compassionate manner.

October 29, 2010
Addressing Sleep Disorders at MidState

Addressing Sleep Disorders at MidState

MERIDEN - Garrett Hazen has known he's had a snoring problem since he was a child. He'd snore so much there'd be complaints among his friends during sleepovers. One morning, he found his 11-year-old friend in a walk-in closet, with a pillow over his head. Hazen is now 29, and works for J&L Medical Services, a Connecticut company specializing in respiratory and home medical equipment. For about the last four years, he's used a CPAP machine for his sleep apnea.

Sleep apnea is one of the more common sleep disorders. In the most common form, obstructive sleep apnea, the airway collapses or becomes blocked during sleep. Starved for air, the sleeper awakens, typically many times during the course of a night's sleep. Because these awakenings can be brief, the person often doesn't recognize that sleep has been so disturbed. Many cases of apnea are first identified by the bed partner.

CPAP stands for continuous positive airway pressure. The approach uses a mask that's connected to a machine controlling a flow of air designed to keep the airway open and sleep uninterrupted during the night.

One of the problems with CPAP machines is that people don't like them, for all sorts of reasons. Those can range from feelings of claustrophobia to just not being thrilled with the idea of wearing a mask to bed at night.

According to the American Sleep Apnea Association, the compliance rate, or the number of CPAP users who manage to stick with the device for more than a few months, is about 60 percent.

Dr. Brett Volpe, the medical director of MidState Medical Center's sleep center on Pomeroy Avenue, says that thanks to initiatives like sleep apnea clinics his center has been able to achieve compliance rates of more than 90 percent.

It's "far different from the national average and I believe it's because of the time we spend with the patient," said Volpe.

Hazen, a Thomaston resident, had been outfitted with a CPAP device about four years ago following a night under study in a sleep laboratory. The results were near immediate; he'd awaken from a night's sleep feeling more refreshed than ever.

But those results began to wear off after a few years, and Hazen said he was no longer feeling the benefits. One reason may have been weight loss. Hazen was able to shed 26 pounds during the time he was using CPAP.

Obesity and sleep apnea risks go both ways; obesity can lead to apnea and apnea can make it more difficult to lose weight.

Untreated, sleep apnea can also lead to diabetes, and is also associated with a number of other health risks, including high blood pressure, heart attack and stroke.

Hazen said he was drawn to MidState's sleep services because the facility, which is in the same complex as the hospital's MediQuick walk-in clinic, is fairly new and the amenities are up-to-date. He was also aware of Volpe's comprehensive approach.

"He's different, there's a follow-up with Dr. Volpe," said Hazen. "He doesn't let you fall through the cracks."

At MidState about a half a year ago, Hazen underwent a titration study, in which the patient's breathing is monitored throughoutthe night and includes monitoring of the use of the CPAP device. It was found that the rate of air flow had to be changed, possibly because of his significant weight loss.

Following those adjustments, Hazen said the benefits of his initial use of the device returned, and he felt as refreshed following a night's sleep as he had the first time he'd used the CPAP.

Volpe's sleep apnea clinic involves follow up visits with respiratory therapists to make sure the CPAP device is being used properly and the patients is receiving the benefits. The devices now come with monitoring features that help physicians determine whether they're being used the right way.

For some patients, the result of wearing the device the first night in the sleep lab is so dramatic "they wake up and hug the technician," Volpe said.

For those who find wearing the device anxiety-inducing, Volpe will recommend that they start using it while watching television at night, for example, just to get accustomed to wearing it.

For patients who can't tolerate exhaling with the CPAP machine, an alternative called BiPAP, which stands for bi-level positive airway pressure, allows for adjusting for the patient in inhaling and exhaling.

"I think there's a lot of behavioral learning that needs to go on," said Volpe, who added that investing the time with patients after they're outfitted with the device is an important part of the sleep therapy.

"It's a prosthetic device for your airway, so in some sense, we're doing physical therapy with them," he said.

Hazen said another complaint associated with the device, the noise it makes, is not an issue for him or his wife.

"Hearing the gentle noise of the machine beats the heck out of hearing me snore," he said.

More information about MidState's sleep care services is available by calling 203.694.5415.

October 27, 2010
Forum Focuses on Health Care Reform

Forum Focuses on Health Care Reform

NORTH HAVEN - Federal health care reform is going to require that hospitals, physicians and other health care providers collaborate like never before as the goal of offering insured health-care coverage for all alters the business model for providing care.

"Accountable care is going to require us to act together in more constructive ways than we've done historically," said Dr. Fabienne Moore on Tuesday night. "We need to build that culture change into the roots of our care."

Moore is senior director with The Advisory Board, a Washington-based research company focusing on healthcare trends. She was a featured speaker at a physician symposium sponsored by Meriden's MidState Medical Center and Quinnipiac University.

The forum was held at the university's new School of Health Sciences in North Haven. Among the school's goals is promoting primary care practice among students, said Edward R. O'Connor, the school's dean. "Because that's the biggest identified need across the country,".

About 100 local physicians and medical office managers signed up for the symposium, which included a tour of Quinnipiac's $50 million health science complex, which features four buildings on 104 acres.

About half that number listened to talks about the challenges health care reform will present to providers. Speakers included Moore and Jon Zimmerman, senior vice president for Allscripts Care Management, a provider of electronic medical records used by Hartford Healthcare. Hartford Healthcare includes Mid-State and Hartford Hospital.

Electronic medical records are viewed as a fundamental precursor to significant health-care reform because they can help save costs by eliminating the need for repeated testing and duplication of services. But not all electronic medical record systems can talk to one another. Some hospitals have different systems that can communicate between them only rudimentary information. There's also the challenge of bringing the capability to primary care practices, which can be hard-pressed to finance the high-tech initiative.

Dr. Robert Golub, a Wallingford cardiologist, said following the symposium that integrating systems is something for the future, but not ready for the present.

"We have a ways to go before we can do electronic medical records," he said.

During his talk, Zimmerman used the analogy of automatic teller machines in banking. At the onset, their use was limited to an individual bank, but now their use is near universal. The same can be accomplished when it comes to linking the languages of electronic medical records.

"There's a lot of technology out there," he said. "The question is now are you going to make it work in a system?"

The goal, he said, was to pull data from different systems "so that it comes to you in your native language."

During her wide-ranging talk, which included an examination of the universal health-care initiative in Massachusetts, Moore said reform will shift risk from patients to providers.

"There's little or nothing in this legislation that sets patients up for accountability for their behaviors," she said.

She said the reforms will also "definitely expand the bureaucracy."

Some of the physicians attending were not pleased with the legislation and the changes in store for providers.

"I think it's letting the insurance companies off the hook and the paper pushers, the bureaucrats, off the hook," said Dr. Michael Ackley, a Cheshire podiatrist, followingthe symposium.

October 13, 2010
Friends and Family Remember Dr. C. Robert Biondino

Friends and Family Remember Dr. C. Robert Biondino

WALLINGFORD - Friends and family were remembering Dr. C. Robert Biondino Tuesday as an extremely popular local physician who possessed a keen intellect and a sense of humor.

"It all comes down to being that he was the most intelligent man I have ever known in my life - and he was so kind," said Biondino's daughter, Alysha Biondino Havrilla.

Biondino died suddenly Saturday. He was 67. "He died with dignity," said his daughter.

A practicing orthopedic surgeon for 30 years, Biondino was a partner in the Meriden Orthopedic Group for 21 years and a founder of Comprehensive Orthopedics, where he worked for nine years.

"He'll leave a void," said William Woods, a retired physical therapist in Meriden, who was a friend. Biondino was noted among his patients for his compassion, said Woods.

"They liked him because of his down-to-earthiness and his forthrightness," said Woods. "He always gave an honest opinion, good or bad."

Woods said Biondino was also able to relate to all people. "He was never on a pedestal," he said. "You wouldn't know he was a physician if you spoke to him. He was just an average Joe if you didn't know who he was."

As well as enjoying a working relationship, Woods and Biondino shared an enthusiasm for sports, particularly UConn basketball. They also had a friendly, Ivy League rivalry. Biondino was a proud Princeton man. Woods graduated from the University of Pennsylvania.

Biondino was born Aug. 7, 1943, in Bridgeport, the son of Charles and Isabelle Dortensio Biondino, longtime residents of Wallingford. He graduated from the Choate School in 1961, then Princeton, followed by the New Jersey College of Medicine in 1969. His internship was at the Medical College of Virginia. Biondino also served as an officer in the Navy.

Biondino and his wife, Sharon, were married for 46 years. Along with daughter, Alysha, a bilingual educator, they also have a son, C. Robert Biondino Jr., a Colorado lawyer. It was at Choate that Biondino became long-time friends with Ron Stempien, a Meriden attorney and a director of the Stempien Funeral Home.

On Friday night, Biondino was at the Lyman Hall High School football game, Stempien said. He was the team physician.

"Bob lived a life where he worked hard but he also played very hard," noted Stempien, who said the poem by Dylan Thomas, which begins "do not go gentle into that good night" was an apt description of his friend.

"He brought the best out in all of us," said Stempien. "He was the type of guy that got you to do things."

That included travel, to farflung locations like Alaska and Poland. Biondino's sense of humor, Stempien noted, was often more about the presentation than the punch line. Biondino got a vigorous round of applause from an elderly group on a tour bus in Poland with a rendition of a joke involving an Italian doctor and a young nun, recalled Stempien. "He's a man who deserves a lot of respect," said Stempien. "He did a lot for his friends and family and we are indebted to him." Biondino also possessed what Stempien called "terrific analytical skills," that served his life as a doctor but also included business acumen.

"Obviously as a surgeon you need the ability to focus and concentrate," said Stempien, "and that applied across the board."

Biondino's life will be celebrated today from 3 p.m. to 8 p.m. at the Choate Chapel in Wallingford. A Mass at St. Stanislaus Church, in Meriden, Thursday will be followed by burial at In Memoriam cemetery. Biondino's family has set up a scholarship fund to help Wallingford students attend Choate or for a Lyman Hall graduate to go on to college.

"I was pleased to see that they're establishing a scholarship in his name," said Woods.

October 13, 2010
Mission Trips to Haiti Continue Months After Earthquake

Mission Trips to Haiti Continue Months After Earthquake

Abbi Bruce, a MidState Medical Center nurse, had only planned one visit to Haiti to help treat people living in villages who may only see a doctor or nurse once or twice a year.

But once Bruce, 53, saw the need for medical care in the four southern Haiti villages she visited last month, she knew she needed to find a way to get back. And she is not alone, as at least two more trips are planned this year by area groups to visit the earthquake-ravaged nation.

"It's heartbreaking, and they need so much help," said Bruce, of Cheshire.

She was one of five nurses - three from MidState in Meriden - who set up clinics in Les Cayes, an area south of the capital, Port-au-Prince, during a weeklong mission trip in September. The region was severely affected by the earthquake that hit the country in January.

The nurses saw 700 patients in four days and distributed bags filled with rice, beans and spaghetti to about 500 families.

Bruce said the group brought nine 50-pound duffle bags of supplies that included medications ranging from Tums to Tylenol, along with antibiotics and multi-vitamins. She said the supplies were mostly donated by hospital employees and a medical supply drive held by the Kol Ami Jewish congregation in Cheshire.

The nurses provided basic medical care in Les Cayes and diagnosed issues from high blood pressure to stomach ailments to ear infections. Bruce said almost everyone they saw suffered from dehydration issues and many people had skin diseases and rashes.

The medical trip was organized by Bethesda Evangelical Mission, a nonprofit interdenominational organization based in Wallingford that organizes four-to-six mission trips to Haiti every year.

Las Cayes native Jean-Lubin Beaucejour of Meriden is U.S. director for the trips. He said the number of visits per year to Haiti is increasing and a long-term goal of building a hospital is in the works.

Beaucejour, 45, is pastor of the International Center of Deliverance in Wallingford. Bethesda Evangelical Mission is affiliated with 35 churches, 12 schools and an orphanage in Les Cayes.

Beaucejour's brother, Jean-Phares, is director of the program in Haiti, and people who travel on the missions stay at their family home in Les Cayes.

The group would need to raise about $40,000 to buy the land for the hospital and another roughly $150,000 to $200,000 for supplies, Jean-Lubin Beaucejour estimated.

He said they could save money on labor costs because volunteers would be building the site, which he hopes will also include a food distribution center, a garage and a place for residents to use the Internet or call relatives in the U.S.

In December, Beaucejour is organizing the last mission trip of the year to Haiti - a Christmas trip on which he hopes to feed more than 2,000 orphans during the holiday season and lift the children's spirits.

Instead of buying food in New England and bringing it down to the Caribbean, the group is raising money to buy the food in Les Cayes to help pump up the economy.

The group also plans to bring at least 2,000 toys to distribute to kids, and estimates that an $8 donation will provide one child a holiday meal and gift.

Ruth Palmer, of Wallingford, is one of 10 volunteers going on the December trip. She is organizing a toy drive at Wallingford's First Baptist Church, 114 N. Main St., on Friday from 4:30 to 7:30 p.m. to collect toys and dolls.

Outside of Beaucejour's missions, other churches and nonprofits from the region are actively visiting Haiti to lend a hand.

Members of First Assembly of God, on Paddock Avenue in Meriden, have traveled to Haiti four times this year to volunteer at Christian Haitian Orphanage in Mariani, outside Carrefour.

The orphanage is roughly 10 miles west of Port-au-Prince, just miles from the epicenter of the devastating earthquake earlier this year.

In November, five volunteers from the church plan to spend six days in Haiti to distribute food and vitamins and volunteer at the orphanage.

Members of the church are also actively raising money to buy a new truck for the doctor at the orphanage so he can help treat patients nearby. All table rental proceeds from the church-run Craft Fair and Holiday Bazaar on Dec. 4 will go toward purchasing the truck for the doctor.

October 11, 2010
MidState Medical Center Launches New Website

MidState Medical Center Launches New Website

MERIDEN - The MidState Medical Center website has a new look! The hospital's new website features an enhanced, user-friendly design with fast and easy access to information you need to know, including directions to hospital facilities, contact information, online bill pay and more.

MidState's revamped website also offers more videos, patient testimonials, and "The Doctor's In" section, which features special health columns written personally by MidState physicians. Our Health Library is another resource for finding important information on various health conditions and treatments.

October 07, 2010
MidState Appreciates its Physician Assistants

MidState Appreciates its Physician Assistants

MERIDEN - It's hard to imagine a work day at MidState Medical Center without the helping hands of physician assistants.

It was just two years and nine months ago, in January 2008, that the surgical PA program was formed at MidState, but the positive effect has rippled to every department at the medical center.

To show their appreciation for the PA's work, the staff at MidState celebrated PA Day with plenty of thank yous, cakes and coffees for the PA team of Carleen Blois, Henry Vladyka, Peter Lopez, Nisha Rana, Michelle Trinidad, Ashley Allitan, Scott Crowley, Eileen Tobin, Brian Major, and Leslie Maska, led by Surgical Physician Assistants Program Director Joseph Kaplowe.

"Everyone really went out of their way on PA day; they did a bunch of little things," Kaplowe said. "There were only a handful of programs when the first class graduated and now there are 120."

Physician assistants act as professional partners to doctors, practicing medicine as an extension to them. They may perform a number of the same tasks as MDs, including ordering tests, conducting physical exams, diagnosing and treating patients, writing prescriptions and performing invasive procedures while being supervised, not always directly, by an MD.

"Our job is different every day," physician assistant Scott Crowley said. "There are so many facets to our job. We do rounds on patients and adjust treatments."

As the PAs make rounds and treat patients, the work load on MDs and surgeons is greatly decreased, leaving more time for other ventures and at times, relaxation.

"Before we did everything ourselves, but now the PAs give us 24-hour on-site expertise," Division of Surgery Director Aziz Benbrahim said. "They help us in the surgery room, where before I would have to have my surgical partner there. They cut the workload and make it more bearable."

Benbrahim also pointed out that having a smaller work load has given surgeons the time needed to research and introduce new technologies to the hospital, including the addition of robotic surgery.

The benefits of PAs are felt similarly by patients. PAs see about 80 percent of the patient population on their first visit, on average almost double that of a MD.

"It is always an advantage to get more patients into the health care system earlier and more efficiently," Kaplowe said, noting a push by the FDA for a minimum two-to-one Pas-to-doctors ratio.

The 28-month education required for a PA is extensive, but shorter by 14 months to that of an MD. Being just 14 months shy from earning a Dr. in front of their name doesn't bother the members of the PA team or Kaplowe, though his mother jokingly asks him all the time why he didn't just become a doctor.

"Becoming a PA was a better fit for my life circumstances," Kaplowe said. "I was just getting out of the military and I was married and wanted to start a family. I got to be a part of the healing process much quicker."We get all the perks without the hassles," Major said.

"We can care for patients and still have a life outside of medicine."

See a video version of this article.

October 07, 2010
Firefighters Help Cancer Survivors and MidState get People Thinking Pink

Meriden, Wallingford Firefighters Help Cancer Survivors and MidState get People Thinking Pink

MERIDEN - Firefighters share a common mission, camaraderie and an enthusiasm for sticking up for one another. In those respects, they have a lot in common with cancer survivors.

For the first time, members of the Wallingford and Meriden fire departments are volunteering to help out at Mid-State Medical Center's Pink Partini Fashion Show, which will take place the evening of Oct. 14 at the Aqua Turf in Plantsville. Gov. M. Jodi Rell, a breast cancer survivor, is once again the event's honorary chairwoman.

The event, which raises money for the hospital's cancer center, is already sold out, with 900 people set to attend. Of the 75 runway models, seven are cancer survivors.

About 20 firefighters from the Meriden and Wallingford departments will greet guests, serve drinks and dinner, and sell raffle tickets.

"I think we're going to be doing just about everything," said Meriden Fire Lt. John Galdenzi. Meriden has lost members of its fire department to cancer, he said. "I think cancer touches everybody's life in one way or another."

Wallingford firefighter Bill Fabiani and Joanne Struble, who survived breast cancer, are involved in the Pink Partini Fashion Show fundraiser. The event is sold out, with 900 people set to come to the Aqua Turf Club in Southington on Thursday.

The idea of enlisting the support of firefighters came from the Pink Heals Tour, in which firefighters from across the country drive pink fire engines to raise support for the fight against cancer, said Tina Fabiani, a MidState development coordinator, who is coordinating the fashion show.

The hospital wanted to get firefighters involved because there's a close tie among firefighters, Fabiani said.

"They'll do anything for each other and cancer survivors have the same bond," she said.

Wallingford Fire Lt. William Fabiani, Tina Fabiani's father, said firefighters were happy to lend their services, "especially in these economic times and it can help raise money for a worthy cause."

"We can relate to this," he said. "Everybody knows somebody who has cancer."

Rick Garrison, a veteran Wallingford firefighter, has been recovering from colorectal cancer and will be among the survivors who will model during the fashion show.

The others include: Susan Claflin, a Cheshire resident and breast cancer survivor whose daughters participated in a MidState art therapy program for children of those diagnosed with cancer. She will be escorted by her daughter, Jesse Claflin, who donated her art supplies to the program.

Dr. Martha Bertz, a primary care physician with the MidState Medical Group in Wallingford.

Joanne Struble, a breast cancer survivor who is wife of Wallingford's Fire Chief Peter J. Struble. Joanne is a registered nurse in MidState's digestive health department.

"I think it's a great combination," she said of the partnering of firefighters with survivors. Her husband will be in the audience.

Denise Eldridge, of Meriden, and Nancy Stevens, of Cheshire, are also breast cancer survivors who will model for the fashion show.

Eleanor Bober, mother of Dr. Kathleen Bober-Sorcinelli, a MidState oncologist, is a cancer survivor who will also model. She'll walk the runway with her daughter.

The participating Wallingford firefighters are members of the International Association of Fire Fighters union Local 1326. Meriden firefighters are from Local 1148.

Galdenzi said firefighters are "really a brotherhood - we're always looking to help each other out."

They're also, he said, "always looking for ways to help out in the community."

The fashion show is held every other year, alternating with MidState's gala dinner, a fundraising event held by the hospital's auxiliary.

September 03, 2010
MidState Medical Center Expansion Completed

MidState Medical Center Expansion Completed

The old Emergency Department was plagued with long waits, crowding, lack of privacy - but now, after a $45 million expansion, MidState is 'well prepared for the future'

MidState Medical Center expands again...

MERIDEN - Patient beds in the hallway are now in the rearview mirror at MidState Medical Center's emergency department. The hospital has completed a $45 million expansion, nearly doubling the capacity of emergency services.

"It does feel great," said Dr. Fred Tilden, emergency department medical director. "It does feel like we're in a position to do the right thing for our patient community."

Emergency services are now operating in 33,000 square feet of space at the hospital's south end. The expansion increases the emergency department from 28 to 53 beds.

The second and final phase of the project was completed this week, and the department started running at its new, full capacity on Wednesday. That first day turned out to b e among its busiest, with 169 patient visits in a 24hour period. In the last month, there have been about a dozen days as busy, said Susan Mc-Gaughan, emergency department director.

The upswing Wednesday was not because of heat-related illnesses, said Tilden, but part of the typical, unpredictable ebb and flow of patients that emergency services must deal with routinely.

"It was swamped," said Tilden.

MidState's emergency department has experienced higher-than-anticipated demand nearly since Meriden's new hospital opened on Lewis Avenue in 1998. Built to handle 26,000 annual visits, the department was faced with handling more than 50,000. For the hospital's 2009 fiscal year, which ran to last September, there were about 50,800 annual patient visits. This year will likely be up from that by as much as 5 percent, said McGaughan.

The number might have grown higher had word not spread about the difficulties the department was having with wait times and other inconveniences. MidState responded to the demand by setting up patient stations in hallways, but that effort to treat patients as quickly as possible often elicited negative responses because the beds were in hallways.

"We think people were voting with their feet," said Tilden. "It just became too well known that we were at capacity."

Those negatives - long wait times, crowding, no privacy - have been reversed, thanks to the expansion.

"Now we've swung the other way," said McGaughan.

"One of the hospital's mantras is to treat patients like customers, and you can't do that if you don't have the space to do it in," said Tilden. "So now we have that."

The state's March 2008 approval of the expansion also included adding 14 inpatient beds, bringing MidState to 144 beds. The addition of new inpatient beds was also significant to the emergency department, said Tilden. In the past, the emergency department could not move patients to inpatient beds if the hospital was at capacity, which added to crowded conditions within the department.

In September 2008, Mid-State embarked on the expansion, which included a four story pavilion between the emergency department and Pavilion D. The new emergency department space was completed in March of this year, and emergency services moved to that area, operating there while the old department space was rebuilt. That second phase was completed this week.

The result is a seamless emergency department, a network of hallways with patient bays that include rooms for behavioral health patients. Centrally located radiology services include two X-ray machines. Radiology services, including CT scan equipment, are located next to the emergency department.

There's definitely a roomy feel, said Patty Pomposi, a registered nurse who's worked in the emergency department for 14 years.

"It is way nicer than before," she said. "It was very different space - it was sardine-like."

"This is a very good thing," she said. "If I was a patient I would definitely want to come to this area."

The new department also includes a lounge for staff and an area for emergency medical technicians.

"There is a lot of room," said Michelle LaVoie, an EMT with Hunter's Ambulance.

"It's nice when you don't have to put a patient in the hallway and you can put them in these new rooms," she said.

Along with the new space, the emergency department has been adding staff, about 12 positions in nursing and support. Tilden said three physicians will also come on board. The department has also been working to set up electronic medical records, which should be fully operational by early December.

"Now that we have the space, we need the ability to track people more closely," Tilden said.

The department is now set to handle from 50,000 to 55,000 annual patient visits. "We're well prepared for the future," Tilden said.

In setting up the new department, "We tried to address things we heard from in the community that they were frustrated with," said Mc-Gaughan. "It's not just the physical space, it's the people working in the space."

In that effort, the hospital has altered the way of initially evaluating patients, getting them out of the waiting area and into assessment rooms as quickly as possible.

Overall, patient satisfaction with emergency services is growing ever more positive, said McGaughan.

"What's gratifying is the reports we're getting now," she said.

August 28, 2010
Professionals To Discuss Pelvic Pain, Incontinence In Women

Professionals To Discuss Pelvic Pain, Incontinence In Women

WALLINGFORD - Not many people are comfortable sitting on a cold, metal table dressed in a paper gown at their doctor's office.

Many of us want to get doctor's appointments over with as quickly as possible, without asking important questions or obtaining materials pertinent to our health and well being.

MidState Medical Center is hoping their latest program will offer a more casual and comfortable atmosphere than the office, thus enhancing question asking and answer giving.

"Dinner with a Doc" is a two hour session with medical professionals who will discuss predetermined health issues. The next dinner, at Brother's Restaurant, 33 N. Cherry St., on Sept. 16, focuses on treatment for pelvic pain and incontinence in women. Featured speakers will be gynecologist Michelle Taylor, resident nurse Lisa Oliviera and physical therapist Stacey Head.

"Any women should come to this whether they have symptoms or not because women talk," Head said. "They probably talk to each other more than they talk to their physicians. It is a good way to get the word out."

According to MidState, an estimated 25 to 45 percent of women suffer from urinary incontinence, an involuntary leakage of urine that is not life-threatening but can have a profound impact on one's quality of life. It is highly treatable once diagnosed and the proper medical approach is taken.

"I try to educate my patients that if they are in pain that's not normal," Head said. "I have some patients that say 'I laugh and I leak sometimes' and that is not normal. I want to tell them that it shouldn't be happening and that it's not normal."

The two-hour discussion will focus on treatment for both pelvic pain and incontinence. Head, who has been working with ERN for almost four years and in practice for nine, notes there are a number of treatment options, which all start with diagnosis.

"It takes an average of nine years before women complain about urinary incontinence," Head said.

"That's a long time to be leaking. If you have a doctor you have been seeing for a while you should have a rapport with them that you can talk about this kind of stuff. It takes nine years just to mention it, forget about starting to deal with it."

While medicines can help, certain exercise can be done at home to help ease the pain and stop leaking.

"I try to teach patients to relax pelvic muscles and strengthen those muscles," Head said. "If you are 80 years old and leak a little bit it is not necessarily your biggest issue but when you are young it shouldn't be happening. It's not normal to have pelvic pain or leakage."

August 12, 2010
MidState Medical Center Announces September "Dinner With A Doc" Program

MidState Medical Center Announces September "Dinner With A Doc" Program

MERIDEN - MidState is pleased to announce the return of its women's health "Dinner with a Doc" program on Thursday, September 16th. The program will be held from 5:30 PM to 7:30 PM at Brothers Restaurant on 33 North Cherry Street in Wallingford.

The topics featured for this fall's program are treatment for pelvic pain and incontinence, with a focus on physical therapy for the treatment of incontinence. It is estimated that approximately 25% - 45% of women suffer from urinary incontinence.

This program will provide a comfortable and supportive environment to discuss these prevalent women's health issues. Our featured speakers are gynecologist Michelle Taylor, MD; Lisa Oliviera, APRN and Stacey Head, PT.

If you are interested in signing up for this program, please call 203.694.8733 by September 9th.
Cost is $25.

August 08, 2010
Breastfeeding Class Raises Awareness Of Its Benefits

Breastfeeding Class Raises Awareness Of Its Benefits

MERIDEN - Dawn Flohr used to be met with "funny" looks from mothers attending her intro to breastfeeding class at MidState Medical Center's Birthing Center when she spoke of the Academy of Pediatrics' recommendation that breastfeeding continue beyond six months into the first year of life and even further if desired by both mom and child.

These days, news of the one-year mark has spread, she said and the looks aren't quite as common in the monthly classes she teachers as the center's lactation care coordinator.

The new moment of wow comes when she mentions the World Health Organization recommends exclusive breastfeeding for six months and a combination of breast milk and complementary foods for up to or beyond two years of age.

On average, six months is still the amount of time most of her students plan to breastfeed, though the tide could be changing slightly as awareness increases through agencies and occasions such as World Breastfeeding Week work to spread the word about the benefits of breast milk for both mother and baby.

"We have just about 75 percent of our population that is choosing to breastfeed. It has definitely increased over the years," said Flohr, a registered nurse. "I hear more now from the patients that they're breastfeeding longer."

Babies need milk from somewhere be it formula or nutrients from their mother's blood stream and research boasts benefits such as decreased viral infections, childhood cancers and diarrhea in infants. It can also help mothers lose weight after birth and is shown to reduce incidents of breast and ovarian cancer and diseases such as diabetes.

Scientific studies and international agencies may agree on the benefits, but many Americans still frown on breastfeeding into toddler years.

In year 20 of World Breastfeeding week, this week, a mother was asked - against Connecticut statutes - to leave a public beach in East Hampton Monday when she began breastfeeding her 2-year-old son. If the goal is to encourage American mothers to feed for longer periods of time, it might take some time before it catches on.

"Americans, as a culture, we're not used to seeing toddlers breastfeed," said Flohr. "But in many cultures it's the norm."

Parents Mayra and Wilfredo Galicia wouldn't have it any other way. Minutes after their first child, Joniel, was born at the center Monday he was able to latch on for a feeding. And the Galicias aren't setting a timeline for stopping just yet.

"It's very exciting to see him breastfeed for the first time," said Mayra Galicia, 30. "It's like an instinct. They know what to do."

"I think it's more personal and it creates that bond between mom and baby and it's healthier."
Breastfeeding isn't necessarily the easiest route. Some mothers have a hard time getting babies to latch on. Breastfeeding is also painful for some women, but Flohr likes to get mothers to try techniques like placing the infant on the chest and allowing the child to find the breast itself or encouraging them to pump their milk after six months rather than give up entirely. "It's almost like it's survival of the species. They have that innate capability," Flohr said of newborns.

The Galicias waited a long time for their first child, they said. Sweethearts since their days at Maloney High School together, their plan was to purchase a home and settle down first. Now that he's here, if breastfeeding is the best thing, it won't be rushed.

"As long as I can breastfeed, he's going to get it." Mayra Galicia said.

July 26, 2010
MidState Medical Center Announces 2010 Cancer Survivors' Day

MidState Medical Center Announces 2010 Cancer Survivors' Day

The Cancer Center at MidState Medical Center announces its annual Cancer Survivors' Day to be held on Sunday, September 12, 2010, from 2 p.m. to 4 p.m. at Meriden's own Hubbard Park. This day is dedicated to honoring the lives of our cancer survivors, especially those treated at MidState Medical Center. The theme of this year's event is "The Magic of Survivorship."

Cancer survivors are encouraged to bring their family and friends to share in the day. Activities for children include face painting, balloon animals, and caricature drawings. Survivors can treat themselves to a relaxing chair massage; and of course, musical entertainment and refreshments can be enjoyed by all. Featured musicians this year are Kelley and Sean Moore. Both survivors and caregivers will share how cancer has changed their lives and offer inspirational messages and words of wisdom to others.

Last year Cancer Survivors' Day attracted nearly 300 people. For more information or to register for Cancer Survivors' Day, please contact the Cancer Center at MidState at 203-694-8353. Registration is preferred.

July 16, 2010
Getting Wired

Getting Wired

MERIDEN - For the past five years, MidState Medical Center has participated in a Hospitals and Health Networks survey to gauge the hospital's development of information technology systems.

Significant changes have occurred during that time, including federal health-care reform and the emphasis on electronic medical records as the framework for significant reform. The federal legislation includes Medicare and Medicaid incentives for developing such systems.

During the past few years, the survey has been revamped to include, among other considerations, an emphasis on the usefulness of information systems. Called "meaningful use," it's one of the goals of the Health Information Technology for Economic and Clinical Health Act.

Meaningful use basically means tying the development of information technology to patient outcomes and improvements in care. An example would be maintaining active lists of patients' medications.

With that revamped 2010 survey in place, MidState was recently named one of the nation's "Most Wired" hospitals. Meriden's hospital is one of 99 across the country lauded in this month's issue of Hospitals & Health Networks magazine. The recognition shows MidState is well positioned when it comes to tying information technology to patient results. The hospital was "on track to meet meaningful use even before it was defined," said Jennifer Comerford, the hospital's director of informational services. During the past decade, the hospital has been developing its information technology, implementing improvements, such as physician order entry, incrementally.

"The focus has been what's best for the patient," Comerford said.

Device integration was among the recent projects, and involved keeping track of vital signs in the hospital's critical care unit. There, instead of having to repeatedly take routine measurements of vital signs like blood pressure and pulse, nurses can monitor and approve the automated measuring of vital signs.

Medical device integration was among the survey questions, which are designed to examine "how robust your implementation of health-care technology" is, Comerford said.

One goal behind the push toward electronic medical records is avoiding the expense of unnecessarily repeating tests and procedures.

But there's a hurdle: most patient records are in the offices of family doctors, who can be ill-equipped and lack the funding to keep their own electronic records. MidState is preparing to embark on a $1.5 million initiative over the next two years to help doctors, starting with physicians in the MidState Medical Group.

"It's such a huge initiative," Comerford said. "It changes everything that happens in a practice. We anticipate being able to offer to our affiliated physicians - it's just timing."

"We've been preparing for this for a long time," said Claudette Genova, MidState's director of clinical information. "The patients should understand that wherever they go and an emergency happens they'd have access to your health records."

Comerford said that the "Most Wired" recognition shows MidState has been moving in the right direction in using information technology in ways government considers meaningful.

July 07, 2010
MidState Named One of the Nation's "Most Wired" Hospitals for Excellence

MidState Named One of the Nation's "Most Wired" Hospitals for Excellence

MidState Medical Center is pleased to announce it has been named one of the nation's "Most Wired" hospitals for excellence in information technology.

MidState has been participating in the "Most Wired" survey for over 5 years, a survey administered in cooperation with the American Hospital Association, McKesson Corp., and the College of Healthcare Information Management Executives

The survey recognizes hospitals for achievements in four focus areas including: infrastructure, business and administrative management, clinical quality and safety and the care continuum. Some areas MidState excelled in include information transfers through data systems, our wireless and enterprise-wide networks, medical imaging, and independent physician-office electronic medical records, to name just a few.

This accomplishment will be featured in the July issue of Hospitals & Health Networks magazine.

"Advanced information technology has been at the forefront of our operations for many years. We are so proud to be recognized for all of our efforts," said Jennifer Comerford, Director, Information Services.

July 02, 2010
Flesh-Eating Disease "Becoming Increasingly Common"

Flesh-Eating Disease "Becoming Increasingly Common"

MERIDEN - A pimple on his leg turned into a ghastly wound the size of a baseball for Middletown resident Randy Travis. He was lucky not to have lost his leg.

Cheshire resident Raymond Mik woke up one morning with a callus on his foot. The next day, the foot was swollen and full of blisters. It reached the point where it looked as though his foot was on fire. He spent months, which included two extended hospital stays, not quite knowing what was going on.

"I was just rolling with the punches," he said.

For Travis, who also had a similar development on his stomach, from pimple to boil to wound, the progression was startling, or, as he put it, "blew my mind."

"It looked like something out of a horror film," he said.

Mik and Travis were both afflicted with an extremely rare condition that over the past few years has been growing in frequency. It's known as necrotizing fasciitis, but because that's such a mouthful, it's more commonly referred to simply as the "flesh-eating" disease.

The flesh eaters are bacteria.

"It's rare, but becoming increasingly common, because the bacteria have become more aggressive and resilient," said Dr. Zeb A. Ali, a physician with MidState Medical Center's wound care center, on Pomeroy Avenue.

Ali said that while a decade ago, the condition would afflict about one in a million, today it's closer to one in 10,000. A 1996 report by the Centers for Disease Control estimated 500 to 1,500 cases each year, with 20 percent dying from the condition. The National Necrotizing Fasciitis Foundation has subsequently estimated the number of cases to be higher.

MidState's wound care center has seen four cases involving the flesh-eating bacteria, including Travis and Mik, since the center opened in 2004. The center moved to Pomeroy Avenue, next to MediQuick urgent care, about a year ago.

Necrotizing fasciitis is an infection caused by A Strep bacteria, the same that causes Strep throat that is usually handled readily by antibiotics. But it's a very strong variety.

The flesh-eating bacteria destroy tissue and the condition is often accompanied by extreme flulike symptoms. In the past, the disease typically involved those generally frail or experiencing other diseases, said Ali, but now can be "community acquired."

"You want to know if you have the bacteria," Ali said. "It doesn't have to be a big open wound. All it takes is a break in the skin."

Because symptoms look like other, often minor, conditions, the flesh-eating bacteria can evade initial diagnosis. One of the keys is that it's rapidly aggressive, Ali said. That rapid progression can be a matter of hours. "It's that dramatic," Ali said. "That's the hallmark."

"You'll know something is wrong, big time," he said. "You will start to feel very ill, like the worst flu of your life."

The 35-year-old Travis installs 12-volt electronics and was training in mixed martial arts until he ran afoul of the flesh-eating bacteria. He'd "never had a boil in my life," he said, until the one on his stomach led him to a walk-in clinic in Middletown about two months ago. The boil was lanced and he was put on antibiotics.

A little short of two weeks later, the boil developed on his leg. "It was quite painful," he said, but when it grew to four inches in diameter the pain was extreme, and he'd developed a high-grade fever. He went back to the clinic, where a doctor discovered the dead tissue.

That's when he was referred to MidState's wound center, where he learned that had he waited another week or so there was a good possibility he would have lost his leg.

Mik, 57, retired a couple of years ago after a 36-year career as a highway maintenance crew leader with the state Department of Transportation. His wife, Donna, is principal of Platt High School.

Mik woke up with his foot problem in late January. On the third day, his wife insisted that he go to the hospital. He spent 10 days at the Bradley Memorial campus of the Hospital of Central Connecticut, in Southington, receiving antibiotics. It was considered an A Strep infection. "They didn't really mention the necrotizing at that point," he said.

After release from the hospital, he received visiting nurse care, but this is when his foot developed that on-fire appearance. After a physician examined him at the wound care center, Mik was sent back to the hospital, this time MidState.

"I could tell by his face that it was pretty serious," Mik said.

He underwent surgery to remove the dead tissue.

"All along I kept hearing the words, you're lucky," he said. "After, I found out I was lucky because they saved my leg."

Both Travis and Mik have undergone hyperbaric oxygen therapy. The high levels of oxygen help accelerate the wound healing. The treatment involves up to 14 times the normal oxygen level, Ali said. "So it's a major dose."

Travis had 10 treatments, once each day. Mik underwent 40 treatments, spending two hours in the chamber each time.

"I was lucky I had a lot of caring friends," said Mik, whose wound repair has also included skin grafting. Now, each visits the wound care center once a week to monitor progress.

"A very small percentage of carriers will get this," Ali said. "But the key point is that it's increasing in frequency."

July 01, 2010
Switch From VNA To MidState Begins Today

Switch From VNA To MidState Begins Today

WALLINGFORD - Residents will see very little difference other than a new office when MidState Medical Center begins providing health services to the town on Thursday.

Town health services such as the well child clinics and the Community Mental Health Services will be administered at 185 Center St., office space rented by MidState.

Health Director Eloise Hazelwood said the town specified in the bid for health services that everything the Visiting Nurse Association of Wallingford had provided will also be provided by MidState Medical Center.

"That's all in there," she said. "That was one of our criteria... ultimately it's making sure the residents are served."

Hazelwood said information on the switch was sent to health service recipients in town. Only the location and providers for some services are changing, according to MidState spokeswoman Pam Cretella.

"The services we are offering are no different than before," she said.

Well child clinics and mental health services were administered at the VNA's North Plains Industrial Road location.

Town Council Chairman Robert Parisi said town officials will be monitoring how health services are administered under MidState. Parisi said the fewer changes for the public during the transition the better. "That was one of the concerns that the Town Council had, that it would be a tumultuous situation for the public," he said. "If there aren't a great number of changes, that seems like a good thing."

Parisi said the price was the main factor in switching from the VNA to MidState.

"Hopefully it'll be a good thing for the town," he said.

Hazelwood said MidState was a stable institution on which the town could depend. She said she hasn't heard any concerns from residents about the switch.

"MidState is not a new provider," Hazelwood said.

For years, the town had contracted with the VNA to provide health and mental health services that municipalities are mandated to make available. But the town re-evaluated that association this year and subjected those services to a public bidding process, which MidState Medical Center won.

While the VNA's services had cost the town more than $500,000, about $170,000 is budgeted for MidState's programs in the upcoming fiscal year. Town health services include tuberculosis screenings, childhood dental services and nursing services. State and federal health programs are unaffected by the switch from the VNA to MidState, according to Hazelwood.

Childhood dental services will still be provided at the VNA, 135 North Plains Industrial Road.

June 18, 2010
More Time to Feel Fine ~ MediQuick Center Will Expand Hours in July

More Time to Feel Fine ~ MediQuick Center Will Expand Hours in July

MERIDEN - When the doors of the MediQuick urgent care center on Pomeroy Avenue open at 8 a.m., invariably there are patients outside waiting to come in. So beginning July 5, MediQuick will expand hours, to 6 a.m. to 11:30 p.m. weekdays and 8 a.m. to 7:30 p.m. on weekends and holidays.

"It was a no-brainer," said Brad Stevenson, a registered nurse who with Dr. Walt Kupson is a MediQuick team leader. "We're excited that the public is supporting us."

MediQuick's hours are changing from 8 a.m. to 7:30 p.m. each day. The center has also been closed on holidays. That will change next month.

"We're seeing so many patients and we wanted to expand our hours to see people before and a fter work," said Kupson.

A year ago, MidState Medical Center moved MediQuick from Paddock Avenue, the site of the former World War II Veterans Memorial Hospital, to the former movie theater site near East Main Street. The center is now easily visible from the Interstate 691 and 91 interchange.

MediQuick is set up to handle all but the most dire emergencies, such as heart attacks or other afflictions that prompt 911 calls.

Since the center opened on Pomeroy Avenue, there has been about a 20-percent increase in the number of patient visits. Activity varies, the way it does in an emergency department, but the average has been 50 to 80 patient visits a day, said Kupson, a doctor of osteopathic medicine. One of the busiest times came during the flu season last November, when there were 118 patient visits in a day.

"There's no predictability to flow here," said Kupson. On one day this week there were 48 patients before 2 p.m. The previous day there had been 22 patients during that time.

A number of factors are at play behind the increase in activity. More people are getting the word about services like MediQuick, which is at least in part set up to relieve the pressure faced by Mid-State's emergency department. In an emergency department, patients with the most critical, often life-threatening conditions are treated first, leaving longer waiting times for others with less serious conditions.

At MediQuick, "we don't want time to be an issue," said Stevenson.

"I'd also like to think that it's because we can provide quality care with a smile," said Kupson.

Along with expanded hours will come an expansion in staffing, including moving from one doctor during a 12-hour shift to two providers, which could be a physician and physician assistant.

Another factor behind increased MediQuick activity is the busy schedules of primarycare physicians, as well as patients without family practice doctors.

"Primary care doctors are at their max and because of that we're seeing overflow," said Stevenson. "Primary care is sending patients to us after five o'clock."

On a recent weekday after- noon, Waleska Hiraldo came to MediQuick with a bad case of poison ivy. There are some aspects of urgent care that can at least be generally forecast: poison ivy during the gardening months, flu during the winter season, fish hook gashes during the opening of the fishing season.

Over the weekend, which included work in the back yard, Hiraldo, a Meriden resident, had started experiencing the tell-tale itching, "and it just go t worse and worse. It was very hard not to scratch." She tried over-the-counter treatments, but they were not doing the trick.

"I called my doctor's office today and they didn't have any opening until tomorrow," Hiraldo said, "and I thought, you know what, I'm going to MediQuick."

"We've got a very special place and people are finding out about it," said Stevenson.

jkurz@record-journal.com 203.317.2213


June 17, 2010
Students' "Funky Flowers" Cheer Up Cancer Patients

Students' "Funky Flowers" Cheer Up Cancer Patients

MERIDEN - For Sue Murphy, arts and crafts are more than just a hobby.

The Wallingford resident and her entourage of students paint, glue, cut and paste to raise money for cancer research and provide comfort to the sick.

Murphy and four of her art students arrived at MidState Medical Center's cancer treatment unit Tuesday with a donation of 56 "funky flowers" for the patients. Painted in vivid neon hues, the flowers consist of plastic strips taken from old soda bottles.

"They're just so much fun," Murphy said.

MidState Cancer Center Director Abbi Bruce said gifts such as these lift the spirits of cancer patients. She noted that the plastic flowers are especially beneficial in a cancer treatment setting, where patients with low immunity cannot keep fresh flowers due to the potential for infection.

"It brightens our patients' day," Bruce said. "Some of our patients can't have fresh flowers in their rooms, so this is a good substitute."

Three students of Murphy's private art school in Wallingford, The Artist's Loft, presented the flowers: Maddie Severson, 11; Camryn Christensen, 11; and Amy O'Keefe, 13. Also presenting the gifts was 11-year-old Cauley Comerford, who goes to Holy Trinity School, where Murphy teaches art.

Murphy's students also participated in the Relay for Life team for her charitable arts and crafts organization, Create to Donate, for which she is trying to get nonprofit status.

Christensen said it "felt really good" to walk around the track and sell crafts to raise funding for cancer research.

Murphy said she began crafting for a good cause, in memory of her son Brandon, who died nearly 25 years ago at 5½ months. A mong the first items she created were baby hats made out of socks to be provided to sick infants.

Under the banner of Create to Donate, Murphy has been traveling to senior centers and other gathering places to hold crafting workshops for a good cause. Items produced at the workshops are either sold for fundraising purposes or donated to the sick.

Murphy said her next goal is to provide therapeutic arts and crafts classes at hospitals.

More information about Create to Donate is available on Facebook under that name, and her art school website is www.theartistsloft.net.

gmoore@record-journal.com 203.317.2275

May 21, 2010
MidState Medical Center Nurse Named a Breast Patient Navigator

MidState Medical Center Nurse Named a Breast Patient Navigator

MidState Medical Center is pleased to announce that Katherine Clements, RN, OCN, CBPN-C, CBCN, hailing from Cheshire, has received the designation of Certified Breast Patient Navigator through her completion of The National Consortium of Breast Center's Breast Patient Navigator Certification Program.

This certification program validates Clement's knowledge and skills in navigating a breast cancer patient through the continuum of care, a process that is highly complex and individualized. This complexity is significantly reduced with the assistance of an individual like Clements who is trained to help the patient work through, reduce, or eliminate barriers to appropriate breast health.

During the breast imaging stage, the Breast Patient Navigator ensures the patient receives timely exam results and is scheduled for appropriate follow-up care. In the case of breast cancer, the navigator guides the patient through the experience to ensure timely diagnosis and treatment, and movement through the care delivery system.

Clements has been the Breast Care Coordinator at MidState Medical Center for 7 years. She provides patient navigation, education and support to women with breast health issues. She also coordinates the MidState Cancer Risk Assessment Clinic. She graduated from Mattatuck Community College with an Associate of Science Degree in Nursing. She received a Bachelor of Science Degree in Community Services from the University of Massachusetts and a Master of Science in Education from Southern Connecticut State University. She has been employed at MidState for 23 years holding a variety of positions including staff nurse, nurse manager and nursing supervisor. In 2008, she was named a Healthcare Hero by the Connecticut Hospital Association.

April 23, 2010
New Entertainment System Helps With Cancer Treatments

New Entertainment System Helps With Cancer Treatments

MERIDEN - The other day, John Pirie had the 17th of 37 scheduled radiation treatments for prostate cancer. The 63-year-old Wallingford resident underwent surgery to remove the prostate in 2008, but subsequent prostate-specific antigen testing showed elevated levels, which called for radiation.

"Initially, the treatment scared me," said Pirie. But now his treatment is accompanied by music and video, and it's made a significant difference.

"It distracts you," he said, "almost to the point where you forget you're being treated."

The entertainment system, which includes speakers and three 32-inch flat panel screens, is now part of the radiation therapy at the Cancer Center of MidState Medical Center. MidState recently started using volumetric modulated arc therapy, an advanced system that employs three-dimensional imaging and more accurate targeting of tumors.

The entertainment is thanks to a $27,000 donation from the hospital's Auxiliary, and it's not as much a luxury as it might seem. While the advantage of soothing patients as they undergo a serious procedure may be hard to measure, it's certainly significant, said Tracy Bielert, radiation oncology manager.

"Sometimes people have a lot of anxiety in this room - they're here for cancer treatments," she said. "We're trying to help them relax and not think of why they're here." Geraldine Meoni, the Auxiliary president, said she was gratified to hear that the new system was being so well received by patients, and that some were making arrangements for their music ahead of their appointments.

"I don't view it as any kind of extravagance," said Meoni. "We all know people who have cancer and are dealing with it. If it can help them for a few minutes to feel better, I think it's fabulous."

Radiation treatments typically last from seven to 10 minutes, so there's not likely to be many requests for full-length motion pictures, though titles like "A Beautiful Mind" and "The 40-year-old Virgin" are available. Pirie, who plays guitar, enjoys Animusic, in which computer-animated virtual instruments dance and perform music.

One of the video screens is located on the ceiling above the patient platform.

The other two are on opposite walls. The screens are situated to accommodate positioning of the patient, said Bielert.

The Kaleidescape System allows for a simple way to organize collections. Patients can select from an ambient collection, which includes titles like "Ocean Tranquility" and "Alpine Elements," or bring their own CDs or DVDs. Song titles in a growing list include music by Elton John, Celine Dion and Jimmy Buffett.

MidState's Auxiliary, of which there are about 200 members, supports the hospital and its patients in various ways, and holds fundraising events throughout the year, including a golf tournament in June.

The Auxiliary holds its annual open meeting Tuesday, beginning at 2 p.m. in the hospital's Medical Services building on Pomeroy Avenue.

April 20, 2010
MidState Honors Veteran Nurse ~ Hospital Also Recognizes Staff of Pavilion C

MidState Honors Veteran Nurse ~ Hospital Also Recognizes Staff of Pavilion C

MERIDEN - For 50 years, Rita Rowley has worn the traditional outfit of the registered nurse, even if that means, these days, that she has to starch her own white cap.

She now has another crown to wear, at least figuratively.

Rowley was named Mid-State Medical Center's 2010 Employee of the Year Monday evening. She was hailed as a role model by Lucille A. Janatka, the hospital's president and chief executive, who also noted that Rowley is "affectionately recognized to be the last real nurse," because of her white uniform and nurse's cap.

"I know I still have a few years left," Rowley told the gathering of about 100 employees. "I still get a great satisfaction from working."

This is the 16th year Meriden's hospital has honored employees with annual awards. Along with an individual employee, MidState also recognizes a team. This year's team winner is the staff of Pavilion C, the hospital's critical care and progressive care unit. The nurses and supporting staff of the pavilion receive consistently high rankings in patient satisfaction, said Lynn M. Amarante, the pavilion's director of cardiology services.

The pavilion treats patients with the most serious conditions.

"Not only do you see patients who are as sick as they can be, but you get families that are extremely anxious and very worried about their loved ones," Amarante said. "You always have to be at the top of your game."

Teams and individual employees are nominated by their peers, and judging is done by an independent panel.

"Out of the many events I do this is my favorite, because it's all about you," Janatka told the gathering. The ceremony in the Horwitz Conference Center was followed by a reception in the hospital cafeteria.

Rowley was selected from 15 nominees.

Born and raised in Meriden, the 1956 Meriden High School graduate started working for what was then Meriden Hospital after graduating from the Meriden Hospital School of Nursing in 1959. She took some time off to raise her three children, but has worked at the hospital for the last 43 years. She and husband, Jim, also have seven grandsons.

Her daughter, Ann Lonczak, is a registered nurse on Pavilion D.

"I started candy striping when I was a teenager and saw what enjoyment she got out of the nursing profession, and I decided to join her," Lonczak said.

"You have to get personal satisfaction to stay in it," Riley said.

"Sometimes it's just a thank you from a patient after a long day's work," Lonczak said.

Rowley said she was surprised by the recognition. "I didn't even know I was nominated until my daughter told me," she said.

March 26, 2010
Advanced Tumor Treatment Improves Accuracy, Efficiency

Advanced Tumor Treatment Improves Accuracy, Efficiency

MERIDEN - You don't usually think of what's inside you as a moving target, but such movement is one of the major challenges when it comes attacking cancerous tumors with radiation.

The goal is to deliver as much of the dose as possible at the intended target, the cancer, and avoid as much as possible the surrounding tissues and organs. The challenge isn't limited to patients squirming on the treatment table, but involves the movements within the body, often caused by breathing.

Evolving technology is giving physicians and support staff greater tools to help accomplish the mission of more precise targeting.

For the past few months, staff at the Cancer Center of MidState Medical Center have been setting up and preparing to use a sophisticated radiation treatment system that employs volumetric modulated arc therapy and three-dimensional imaging via a computer. The approach also makes use of the fourth dimension, time, by targeting problem areas before, during and after treatments. The hospital has just started treating patients with the new system.

"We're doing so much at such a high level for a community hospital," said Dr. Allan S. Kratzer, radiation oncology medical director.

For patients, more accurate positioning of radiation and improved control of radiation levels makes for treatment times reduced by as much as a third, to five minutes or less.

Volumetric modulated arc therapy is an enhanced form of intensity modulated radiation therapy, which allows for greater control of the intensity and accuracy of radiation doses.

The patient reclines on the table while lasers are used to make sure the patient is in the right position. The hardware, or gantry, moves around the patient, controlled by digital imaging, delivering the radiation treatment. Three-dimensional imaging allows technicians to more accurately identify the tumor and its shape. The movement of the gantry sweeps around the patient, delivering a continual radiation treatment.

The image guided control is "what's really cutting edge about it," said Kratzer. The availability of real-time imaging "opens up a whole range of possibilities," he said.

"Now we can dynamically manipulate the intensity of the beam while the machine is rotating," he said.

The linear accelerator, the device that delivers the radiation doses, can also be used for stereotactic radiosurgery.

More rapid treatment also reduces the risk of patient movement, said Letty Morrissey, a medical physicist.

The sophisticated nature of the equipment, manufactured by Elekta Infinity, of Stockholm, Sweden, presented a learning curve, said Morrissey.

"It's not plug-and-play," she said. What took some getting used to was using the digital imaging, said Tracy Bielert, radiology oncology manager.

The equipment, which involved a redesigned and rebuilt treatment room, is about a $2.3 million investment for MidState.

"The hospital has been very, very supportive," said Kratzer. "Cancer is something that everybody deals with."

"This is really the best accelerator out there," he said. "As a community we're very well-positioned for the next five to 10 years."

Along with the Elekta Infinity system, MidState's recent commitments to technology include robotic assisted surgery for certain types of cancer.

"We can't let these opportunities go by," said Lucille A. Janatka, MidState's president and chief executive, who noted that both techologies include a less invasive approach to treatment.

"When you think about cancer and general surgery, these are the kinds of things that, unfortunately, most of us are going to experience," she said. "When I think of these two large items I think about how, at your local community hospital, you should be able to get that great level of care," she said.

March 10, 2010
An Extension of Medical Skill - Robotic System Becoming Popular Option for Surgeries

An Extension of Medical Skill - Robotic System Becoming Popular Option for Surgeries

MERIDEN - At the moment, the biggest hurdle is that when you mention robots people think of Data or C3 PO.

But innovation under way in the operating room has nothing to do with the android from Star Trek or the droid from Star Wars. It's not robot surgery, but robotic-assisted surgery. Not artificial intelligence, but an extension of medical skill.

In other words, though it's a significant difference, the surgeon is still in control of the operation.

"The fundamentals of the surgery haven't changed," said Dr. Andrew Metzger, a gynecological surgeon who recently performed the first robotic-assisted surgery at MidState Medical Center, a hysterectomy.

"You just have an advance in technology that's allowing us to do more and have greater control," said Metzger.

Descended from military technology, robotic-assisted surgery has become an increasingly popular option for prostate and gynecologic surgeries, and holds promise for other procedures as well. The robot now employed by MidState is the da Vinci Surgical System. Made by Intuitive Surgical, of Sunnyvale, Calif., the system was approved by the Food and Drug Administration in 2000. MidState operating room personnel received training at Hartford Hospital, which has used robotic- assisted surgery for the past six years. Hartford Hospital and MidState are both part of Hartford Healthcare.

The technology "requires that we focus on team activity and team communication," said Joe Kaplowe, a MidState physician assistant. Kaplowe compared the role of the surgeon in such operations to that of a maestro.

The robotic-assisted approach extends the advantages of laparoscopic surgery. While open surgery involves a large incision, laparoscopy requires just a few quarter-inch incisions, through which instruments, including a tiny camera, are inserted. The doctor manipulates the tools as he watches the images from the camera.

Robotic surgery puts the tools in the hands of the multi-armed robot. The surgeon sits at a console, peering through binocular lenses that provide a three-dimensional view inside the patient's body. From the console, the doctor moves the robot arms and minisurgical tools, about the size of a pencil eraser, using pincer-like controls between the thumb and forefinger. Foot pedals offer additional control. The robot acts as an extension of the surgeon's hands. Metzger said it's like operating with three hands instead of two. MidState's system also feature a second console, so another surgeon can watch the procedure. The doctor is no longer required to be at the side of the patient, though support staff are, and in theory the surgery could be performed from just about anywhere.

A concession is the loss of the tactile, or hands-on, feeling, but Metzger said that is greatly outweighed by the advantages of the three-dimensional visual perspective.

"You're still doing the surgery you've been trained to do, but you've been given tools," he said.

And the machine, he said, is fairly intuitive.

"If anything this is more of an art," said Metzger. "I love doing what I do. I love the skill of operating. This is allowing us to do much more complicated procedures with much less recovery time for many patients."

A nurse for 14 years, Marcy Di Pasquale said she was drawn to the technology because she feels it's the wave of the future and she still has plenty of nursing years ahead of her. Di-Pasquale is operating room coordinator and head of the robot team.

"It's the future of surgery and I wanted to get involved because that's where it's going," she said.

MidState is promoting the system, both to its wider staff and to the general public, partly to counter any misperception that robots are now performing surgeries at the hospital.

Metzger said so far he's had just one patient who didn't want to have anything to do with robotic surgery.

An open house is set for Monday for hospital staff, to be followed by one for doctors.

Hospital staff will be asked to give the robot a name. Plans also include wheeling the system out into the hospital lobby, so the public can see what it's all about.

March 09, 2010
MidState Cancer Center Adds New Technology to Improve Radiation Therapy

MidState Cancer Center Adds New Technology to Improve Radiation Therapy

The MidState Medical Center Cancer Center is pleased to announce the addition of a new, advanced radiation therapy system that will allow clinicians the ability to better treat and target tumors more aggressively than ever before.

The Elekta Infinity radiation therapy system incorporates a sophisticated feature, known as Volumetric Modulated Arc Therapy (VMAT), which reduces the time it takes to administer radiotherapy treatment sessions to patients to nearly five minutes or less. Shorter treatment times mean patients are more comfortable, making it easier for them to remain still during treatment and increasing the likelihood of delivering radiation more accurately and safely.

Additionally, the new equipment features a suite of imaging tools that enable high quality, 3D imaging at the time of treatment, significantly minimizing damage to surrounding healthy tissues. The Elekta Infinity is the most advanced technology of its kind. The Cancer Center anticipates treating patients on the new system beginning in March.

March 05, 2010
MidState Medical Center Earns Blue Distinction® as a Center for Knee and Hip Replacement by Anthem Blue Cross and Blue Shield

MidState Medical Center Earns Blue Distinction ® as a Center for Knee and Hip Replacement by Anthem Blue Cross and Blue Shield

MERIDEN - MidState Medical Center is proud to announce it has been designated a Blue Distinction ® Center for Knee and Hip Replacement by Anthem Blue Cross and Blue Shield.

This distinction signifies that MidState has met objective, evidence-based criteria that demonstrate reliability in delivering knee and hip replacement, with better overall outcomes for patients.

The Blue Distinction® helps consumers find quality specialty care and encourage healthcare professionals to improve the delivery of care. "We are very pleased to have been awarded this distinction by Anthem Blue Cross and Blue Shield. This mark of excellence would not be possible without the commitment and skill of our specialty physicians and staff," said Cindy Russo, FACHE, Vice President, Patient Care Services.

MidState will be listed on the Anthem website as a distinguished center as well as on the Blue National Doctor and Hospital Finder.

March 01, 2010
MidState's ER Doubles Its Size Next Week

MidState's ER Doubles Its Size Next Week

MERIDEN - The first phase of MidState Medical Center's $45 million expansion is complete. On Tuesday morning, the hospital's emergency department will transfer operations from the 10,200 square-foot space it has used for the past decade into a new 23,300square-foot complex. The old space will then be rebuilt, and when that's done in September the size of the hospital's emergency department will have tripled.

Emergency department personnel have long waited for this moment. Emergency services have operated at or near capacity almost from the time MidState opened as a new hospital on Lewis Avenue in 1998. The department was set up at that time to handle 26,000 patients a year, but for the past few years it has had twice that number of annual visits.

The new emergency department contains many amenities hospitals across the state would find enviable, but perhaps the most significant change is in the way MidState has chosen to handle the influx of patients. Gone is the traditional approach of signup followed by triage and waiting areas. MidState wants to get patients into the hospital and under care as quickly as possible.

Gone also is the circuitous path patients have had to take to the emergency department during construction of the new four-story hospital wing, which also includes a new inpatient pavilion. While construction was underway, walk-in entry to the department was next to the ambulance entry. Now, entry to the emergency department is at the southwest corner of the hospital, the part closest to Interstate 691, near the hospital's new main entrance. The main entrance is now under an overhang, another amenity the hospital has long wanted in order to accommodate patients during bad weather.

Patients are not likely to miss the emergency department hallway beds, makeshift treatment spaces the hospital set up to handle the outstripping demand for its services. They're likely to be pleased with a new approach that eschews triage bays for an 11-bed assessment area, one of four treatment zones in the new emergency department.

"The idea is to not hold anyone up in the registration process," said Dr. Fred Tilden, emergency department medical director.

The first step now uses three registration areas to identify patients and get them added to electronic medical records, said Susan McGaughan, MidState's director of emergency services. "It's us coming to patients instead of them coming to us," she said.

"This is rapid screening and assessment of patients to determine what kind of care you need," she said.

Those with relatively minor injuries or conditions are likely to receive their treatment in the assessment area and then be released from the hospital. About a third of emergency department visitors are such fast-track patients, Tilden said. The new department is set up for more efficient patient focus, and derived from discussions following an emergency department conference held in Hartford about four years ago. "We talked about fluid processes and built the design around that," said McGaughan. The new rooms have televisions and telephones, and clinical equipment such as blood pressure and temperature monitors. The single bedrooms share the same design, set up so doctors and nurses can treat patients to their right, a kind of traditional approach. The department includes radiology services and each of the four zones includes its own medication center.

The other zones include a center for patients with more serious conditions, where each room has a hard-wired cardiology monitor, and a sequestered acute behavioral health unit. MidState's emergency department sees five to eight psychiatric patients a day, Tilden said.

That area is secured space, with badge-controlled entry, that features four stripped down rooms, with file-drawer type lockers inside benches.

"It's designed differently," said McGaughan. "It's designed for the psychiatric population. It will be very therapeutic because there's not a lot of activity going on."

The fourth zone will be the rebuilt second phase, scheduled for completion in September.

"You're basically taking out everything," said Robert Palumberi, MidState's director of facilities management. The old space is being rebuilt to blend in with the new, he said.

The first phase increases the number of treatment beds from 28 to 36. Add the 13 beds once the second phase is finished, and the four acute behavioral health beds, and by September MidState's emergency services will be a 53-bed operation.

MidState is adding staff, both clinical and non-clinical jobs, for both phases of the expansion, McGaughan said.

The expansion also for the first time gives Meriden's hospital a clearly defined main entrance. The main entrance hall, leading to the hospital's expansive galleria, features a flowing water wall, next to which will be etched a poem by Jason W. Janatka, the late son of MidState's president and chief executive, Lucille A. Janatka.

Two floors of the new wing are shell space, to accommodate future expansion needs. On the third floor is Pavilion E. On Tuesday, patients in the 22-bed Pavilion A will be transferred to the new 28-bed pavilion, which also features a new conference room. Pavilion A will now be used as a swing unit, said Lori A. Nohilly, director of inpatient services.

"Our goal is not to have patients waiting in the emergency department anymore," she said. MidState, which has a license for 144 inpatient beds, was operating at inpatient capacity Friday and has been operating at 90 percent inpatient capacity or higher for the past three months, Nohilly said.

The emergency department typically has 25 to 30 patients at any given time. Patients will be transferred to the new rooms early Tuesday, and new patients will be admitted to the new wing.

"The move is the easy part," said Tilden.

February 19, 2010
Ins And Outs Of Congestive Heart Failure

Ins And Outs Of Congestive Heart Failure

MERIDEN - In 1966, while pregnant with her daughter, Carol Sinon underwent open heart surgery. Just six years ago, Sinon went back under the knife to have a pacemaker put it.

Sinon suffers from congestive heart failure or CHF, which comes along with a handful of other diseases and symptoms.

Sinon, along with 20 others, took part in the MidState Medical Center "Living with Congestive Heart Failure" seminar on Thursday at The Village at Kensington Place.

"I have congestive heart failure," Sinon said. "I know most things there are to know about it, but you can always learn more. I have learned that it is so important to watch for symptoms every day."

The hour-long discussion, delivered by registered nurse Donna Jones, covered the ins and outs of CHF from causes to management.

"I have worked with so many patients who suffer from congestive heart failure and other chronic diseases," Jones said. "In all cases, education for the patient is most important."

CHF is a condition in which the heart can no longer pump enough blood to the rest of the body. With the decrease in pumping, the body no longer receives enough oxygen-carrying blood, causing a number of symptoms.

"Congestive heart failure has a slow progression," Jones said. "It isn't something that happens overnight. It is a result of another illness."

CHF is almost always a chronic, long-term condition, which occurs when another problem, or disease, has affected the body.

Heart failure can affect the right, left or both sides of the heart.

Coronary artery disease, a narrowing of the small vessels that supply oxygen and blood to the heart, is the leading cause of CHF.

CHF can also occur when a toxin or illness weakens the heart muscles, preventing full strength pumping. These toxins, or cardiomyopathies, are a mixture of self created problems and unpreventable issues.

"Drug and alcohol abuse can really weaken the heart," Jones said. "An improper diet, not managing problems like diabetes and obesity correctly and taking medicine incorrectly can lead to CHF."

Recognizing CHF, according to Jones, is the first step in treatment. Symptoms include shortness of breath, wheezing, coughing, moments of weakness and tiredness, trouble breathing when lying down, frequently awakening at night, swollen feet and ankles and sudden weight gain.

"You really need to be honest with your doctor and tell them everything that is happening with you and every medication that you are taking," Jones said.

Treatment of CHF changes in accordance with each patient. Some patients require up to five medications, while others need just one. ACE inhibitors, diuretics and beta-blockers have been found particularly useful in treatment of CHF.

Outside of medication, there are many things the patient can do to help treat CHF. Keeping blood pressure, heart rate, and cholesterol under control with exercise and diet, resting during the day and omitting smoking and drinking can keep CHF symptoms under control.

"The most important thing to remember is that you can live successfully with congestive heart failure," Jones said. "You just really need to be aware of everything. Before, it was always 'because the doctor said so' and now we are asking more questions and it is becoming 'because I know.' "


January 22, 2010
Forum Focuses On Technological Advances In Cancer Screening

Forum Focuses On Technological Advances In Cancer Screening

MERIDEN - Last fall was a controversial time for breast cancer screening, following a government task force recommendation that counteracted long-standing practices. Recognizing that confusion likely remains among many women, MidState Medical Center has put the subject of mammography among the topics in an upcoming forum focusing on women's health issues.

On Thursday, in the conference room of the hospital's still relatively new complex on Pomeroy Avenue, Dr. Holly Dey, a MidState radiologist will discuss the latest advances in breast imaging as well as guidelines covering more advanced procedures, including magnetic resonance imaging.

In November, the U.S. Preventative Services Task force, a panel made up of doctors and scientists, recommended breast cancer screening every other year for women beginning at age 50.

Part of the recommendation was based on the conclusion that screenings at an earlier age led to too many false positives, unnecessary anxiety for patients and unnecessary follow-up procedures.

The panel's recommendations caused a stir. Instead of changing course, most hospitals, including MidState, continue to follow the guidelines of the American Cancer Society, which recommends annual mammograms for most women beginning at age 40.

"We do have a long history of doing mammograms for women at 40 and above," said Dey. "The decision to have a mammogram is a decision made by a woman with her physician based on risk factors."

One advantage of starting mammograms at age 40 is that it establishes a baseline from which future tests can be measured, said Dey.

Mammograms also measure the tissue density of the breast, an import ant consideration when determining whether to pursue additional procedures. Routine self examinations, which Dey says are still a good idea, can't tell breast tissue density.

Digital mammography enables enhanced and magnified images, but dense tissue still makes it more difficult for mammogram testing to find suspicious lumps. Further testing includes ultrasound and MRI. Those tests are more sensitive and can reveal more false positives, but the risk of false positive results may be considered worth it in cases where breast tissue is dense.

Breast tissue density is considered so significant a factor Connecticut passed legislation last October requiring that mammography results given to patients include information about breast density. Patients with dense breast tissue must be told that it can hide small abnormalities and that they may benefit from further screening tests.

The legislation caused "a bit of havoc," said Dr. Gary Dee, a MidState radiologist.

"The intent of the law is great," he said, but it's led to some confusion among patients and put pressure on physicians. MidState affiliated radiologists are working with local doctors to track patients "so they don't get lost in the system," Dee said.

While the new state law and the national task force recommendations have made breast cancer screening a more confusing issue for many women, "it's starting to make people aware that there are different tests for different situations," said Dee.

Factors that increase the risk for developing breast cancer include a genetic predisposition and family history, particularly if a close relative has had the disease.

Breast cancer is the most common cancer among American women and the second leading cause of cancer death.

MidState's health program for women runs from 5:30 pm. to 8 p.m. on Thursday, and includes dinner. The charge is $10.

Along with Dey, speakers include Dr. Aziz Benbrahim, a MidState surgeon, who will talk about how obesity affects health, and Dr. Joseph Peccerillo, an obstetrician/gynecologist, who will discuss recommendations about how often women should get pap smear tests.

Registration is available by calling 203.694.8733.

MidState's symposiums on women's health are designed to offer a variety of topics and are the result, in part, of a recognition that women tend to be the ones making health-care decisions for their families.

"We want to make sure that the women in our community are aware of the services we have to offer them," said Donna Sassi, the hospital's director of women's health services.

January 08, 2010
Informatics Streamlines Information For Patient Care

Informatics Streamlines Information For Patient Care

Until about a year ago, a nursing assistant at MidState Medical Center measured an insulin dose for an inpatient with diabetes by taking a blood sample, reading the glucose level, recording it on a paper chart, and using a scale to calculate the correct dose.

These days, everything but taking the finger-prick blood sample is done electronically, with a computerized system that calculates the dose for the nurse. The information is then readily available for anyone involved in the care of the patient.

The system was set up by Jeff Kayser, a clinical information systems analyst at the hospital.

"Jeff did a great job with how he did this; he really eliminated any medical error," said Kathleen Wietrak, an advanced practice nurse with MidState's diabetes center. It was Wietrak who suggested that technology could provide a more streamlined method.

"Everything's behind the scenes and the nurses love it, because there's no calculating for them to do," Wietrak said.

Not too long ago, Kayser worked the floor of the hospital's Pavilion D as a registered nurse. Today, his work is in informatics, a nursing specialty that has emerged prominently as hospitals across the nation make the move toward putting into bits and bytes everything that was once put on paper.

The Obama administration has made electronic medical records an essential element in health-care reform. Going digital is seen as a way of reducing expense, medical errors and unnecessary repetition of procedures.

Kayser's work on behalf of treating diabetes patients is just one example of the ways he's helped Mid- State in making the transition.

"It's allowed the computer to do the calculations to give us the best practice doses," Wietrak said. "In five years, every hospital will be doing this."

"Awesome forward we will see more and more capabilities," Kayser said.

For MidState, the transition toward electronic systems has been through a series of implementations. In recent years, Meriden's hospital has introduced physician order entry, replacing handwritten doctor's orders with those entered into a computer network, and it has replaced charts that nurses keep by the bedside with a software program that maintains detailed patient information.

Such efforts have led to the establishment of a new department within the hospital, made up of those tasked with becoming experts in the new systems so they can train and support the staff using them. At MidState, the department is called clinical informatics. Investing money and technology is worthless unless those on the user end know how to make the most of it, said Jen Comerford, MidState's director of information technology.

"Our hospital administration has been so committed to funding technology, and the reason we've been able to be successful on the clinical side is because we have the nurses that can do that work," she said.

"The ultimate goal is making it more efficient for the patient at the bedside," said Claudette Genova, the clinical informatics department director. Genova said MidState is about 70 percent of the way toward complete implementation of electronic medical records. Initially, the department was made up of Genova and Kayser. Kayser's nursing background was in medical-surgical and Genova's was in intensive care. The department has since grown to nine members. The most recent addition is pharmacist Sharon Mann, who worked in the hospital pharmacy for five years until last July. Mann said she liked the challenge of linking the pharmacy to the move toward electronic medical records.

Informatics combines the skills of nursing, computer science and information technology. Staffing an informatics department with those who have worked at the hospital for many years and been trained for the new job is not unusual, though there are outside informatics education programs.

Informatics programs are "generally homegrown, because each hospital has its own processes," Genova said. "You like to take people who have been with the organization for a while that understand the processes."

Kayser worked as a nurse for six years, and said he'd had only a mild interest in computers. When MidState began making a major move toward technology, he volunteered to become involved because he thought it would be interesting and because he saw it as "the up-and-coming future of health care."

At 39, Kayser is four classes away from earning his bachelor's degree in nursing at Central Connecticut State University, and he has plans to pursue a master's degree. He trains all the new registered nurses and advanced practice nurses. Also part of his job, he said, is making sure all the upgrades to MidState's systems are being used "to their fullest ability."

Kayser said he'd wanted to become a registered nurse since he got out of the Air Force, which he joined after high school.

"I very much enjoyed treating the patients, making their stay in the hospital as comfortable and as good as possible," he said. "I see this role as an opportunity for me to expand on that in an entirely different way, but still make a difference in their lives."

The most challenging part of his job, he said, "is getting end users to accept inevitable change. We're all creatures of habit, and to relearn something and do it well can be a bit challenging."

January 02, 2010
Meriden Couple Welcomes MidState's First Baby of '10

Meriden Couple Welcomes MidState's First Baby of '10

MERIDEN - On the final day of 2009, a rarity occurred. The second full moon of the month, a blue moon graced the skies, and one nurse in MidState Medical Center's Birthing Center said it was to blame for the "wild day" that ensued on New Year's Day.

Even those who disregard astrological beliefs altogether cannot dispute how busy Friday became for hospital staff who delivered four babies by the late afternoon. However, the day was particularly special for city residents Margarita Leon and Juan Cortes Cortes, proud parents of the center's first baby of 2010.

A standard bouquet of long stem red roses were delivered to Leon's room as a sign of congratulations, and the women's auxiliary donated a hand-knitted pink outfit for baby Yamilka Cortes Leon, born just four minutes shy of 9 a.m. Friday morning. "The most important thing is that she's healthy," said 34-year-old Leon, of her 20-inch tall, 7-pound, 4-ounce baby girl. "(The delivery) was fast."

Cortes assumed the baby would be born in the middle of the night, when he rushed Leon to the hospital at 1 a.m. But after being sent away, the couple then returned again around 6:30 a.m. for a quick and healthy delivery.

"We were actually full when she came in, and didn't have a room," said Kristiana Gregg, labor and delivery nurse.

Doctor Marlene Waradzin delivered the baby in the operating room, as all 14 birthing rooms were filled with new and expecting mothers.

The first delivery then set off a momentum for the day that kept nurses and doctors busy all day long.

A second baby was delivered shortly after the first, and several more trailed, making it one of the busiest holidays, staff members said.

"There were several people in labor," said Karen Edwards, a registered nurse who assisted with the delivery. "It was just a matter of time."

First born babies across the country, however, didn't wait until normal business hours to come into the world.

In Chicago a 29-year-old woman gave birth to a baby girl at exactly midnight on the city's north side, while a baby boy was born 30 seconds into the new year in a different part of the city. Another baby girl was born in the state of Nebraska one minute into 2010.

Leon, who was assigned a due date of Jan. 15, said she wasn't entirely shocked that her baby girl arrived earlier than expected, nor that it was on a holiday.

"I'm just very happy," said the mother of three girls and two boys.

Cortes shared similar thoughts, noting that this Jan. 1, his New Year's wish is for his baby girl.

"I hope that God grants me the privilege of seeing her grow up happy and healthy," he said.

January 01, 2010
Goal: Prevent Diabetes Onset

Goal: Prevent Diabetes Onset

MERIDEN - The onset of the New Year, under way today, is a time when millions of Americans make resolutions to get fit and lose weight. For those at risk of developing Type 2 diabetes, it's the perfect time of year to make a serious commitment.

With a plethora of available weight-loss programs and diets, it's often difficult to determine a common-sense approach, and for that reason MidState Medical Center is launching a new initiative designed to help people remain committed to risk-reducing strategies.

Losing weight and increasing fitness is generally a good idea for anyone, but for those at risk, taking steps to avoid diabetes also means reducing the risk of other serious illnesses. Diabetes increases the risk of heart disease, nerve damage, kidney damage, osteoporosis and foot and eye damage. Diabetes is also linked to increased risk of developing Alzheimer's disease. About 21 million Americans have Type 2 diabetes, and about 90 percent of them developed diabetes as a result of lifestyle, said Kathleen Wietrak, an advanced practicing nurse with MidState's diabetes center, which is now located at the hospital's complex on Pomeroy Avenue, on Meriden's east side.

MidState's program, called "Stepping it Up," is not for those with diabetes but for those with pre-diabetes or those at risk for the disease. Pre-diabetes is defined as having fasting blood sugar levels ranging from 100 to 125 milligrams per deciliter. Those with diabetes have fasting blood sugar levels at 126 mg/dl or greater.

Risks for developing Type 2 diabetes include being overweight, having a history of hypertension, high cholesterol levels and lack of exercise. The body's shape is also a risk factor. Women with waistline measurements of 35 inches or greater are considered at increased risk. For men, it's waistlines of 40 inches or more.

Research indicates that you can delay or prevent the onset of diabetes by reducing weight by 5 percent to 7 percent and by taking on 30 minutes or more of physical activity each day, Wietrak said.

Her program is designed to help participants make lifestyle changes they can maintain. The strategies can also be used for those not facing the threat of diabetes.

At the second of the six-session, every-other week program, for example, participants learn to cut 100 calories a day, either from adjusting diet or adding exercise. Each subsequent session trims an additional 100 calories, so by the time the program is complete 500 calories have been reduced each day. Since, 3,500 calories add up to a pound, at the end of the week participants should have shed that much in weight.

"That's nice, healthy, safe weight reduction that has a higher chance of staying off," Wietrak said.

Other sessions will focus on portion sizes and reading food labels.

"I want to take what people do and show them a few ways to make it better," Wietrak said.

That includes helping people deal with the transition time when they return from work to the home. That's when many begin taking in calories that can get out of control, she said. Ideally, one should have a meal or a snack every three to four hours, to maintain blood sugar levels, she said.

Two "Stepping it Up" programs are slated for 2010, the first starting Jan. 12, the second April 13. Wietrak said she's hoping for 20 to 25 participants in each. She prefers group sessions because participants can offer one another encouragement and support, she said.

Along with advice from a dietitian, Catherine Rich will talk about the risk factors for high cholesterol and hypertension. Rich is Mid-State's cardiac rehabilitation and wellness coordinator. For most in the cardiac program, lifestyle has caused their troubles, she said.

"Some is ignorance and some is hard to do," she said.

After the completion of each program, follow- up meetings will be held monthly for the following three months to help participant's measure progress.

Wietrak said the aim is to show people some behavioral changes "that don't take a lot of time and really aren't so painful - not in a week or two, but six months down the road. If they stick with these changes they'll be healthier."

Depending on the success of this year's programs, MidState could make them ongoing, offering three each year, Wietrak said.

The program is for adults, 18 and older. Wietrak said fliers will be sent to physician's offices so local doctors can help identify potential participants. The cost is $10 a person or $15 a couple.

MidState First to Partner with EMS Crews

MidState Medical Center is the First Community Hospital in Area to Partner with EMS Crews To Enhance Treatment of Heart Attack Patients

MERIDEN - MidState Medical Center is one of the first community hospitals in the area to partner with EMS crews to enhance the treatment of heart attack patients, particularly what is known as an ST Segment Elevation Myocardial Infarction (often called STEMI). A STEMI "is the most dramatic, full blown heart attack a person can have," according to Dr. George Spivack, the Medical Director of MidState Medical Center's Acute Coronary Syndrome Program. "This is where one of the arteries of the heart becomes completely blocked. Research has shown that getting these arteries unclogged can decrease the chance of dying from a STEMI and improve the quality of life in heart attack survivors."

There is a nationwide focus in the field of cardiology with initiatives through the American Heart Association geared towards optimizing treatment for heart attacks and in particular, STEMIs. That optimum treatment involves unclogging the blocked artery as quickly as possible because patients are at increased risk of dying or having more severe heart damage the longer the artery stays clogged. "The mantra is 'time is muscle'," says Dr. Spivack.

A physician makes the diagnosis of a STEMI by reviewing an Electrocardiogram (ECG). In the past, STEMIs were not diagnosed until the patient suffering a heart attack arrived at the hospital. Now, MidState Medical Center is collaborating with local EMS providers to become the first community hospital in Connecticut to employ state-of-the-art technology that allows STEMI patients to be identified before they even reach the hospital. This technology allows ambulance crews to perform ECG's in the field and transmit them electronically to MidState where one of our emergency physicians can review the tracing and immediately make the diagnosis. These ECG's can also be sent along to MidState Medical Center cardiologists to confirm the diagnosis and initiate treatment even before the ambulance arrives at the hospital.

When treating a STEMI, minutes count. Making this particular diagnosis earlier will save crucial time getting patients life saving treatments. The Emergency Department staff can mobilize even before the patient arrives to administer specialized medications designed to dissolve blood clots that occlude arteries or arrange transfer to local tertiary centers such as Hartford Hospital where they can undergo an emergency cardiac catheterization and angioplasty to open up the clogged artery.

Bill Barker, a paramedic for Wallingford Fire, says he, along with other paramedics are looking forward to using this new technology. "This is tremendously good for the patient population who may be experiencing a heart attack."