News

 WEEMS AMBULANCE DRIVERS SAVE A LIFE

     Steve Kirschenbaum considers himself a very lucky man, and he has Weems ambulance staffers to thank.  In the middle of last month, nine days after major abdominal surgery at Tallahassee Memorial Hospital, Kirschenbaum’s wife, Deb, was recovering well, recuperating in their St. George Island home.  The only medical emergency she faced at that time was not hers, but that of her dog Baby, a 17-year-old Lhasa Apso, who was entering its final days.  On January 17, the couple realized the time had come to end Baby’s suffering, so they took their beloved pet that afternoon to Eastpoint veterinarian, Hobson Fulmer’s office, to have it euthanized. Deb couldn’t bear to come inside, so she waited in the car to mourn alone, while her husband handled the sad duty.  Her crying in the car turned into wrenching sobs, and that’s where the trouble started.

     “She had been told to take it easy, no physical activity, but the trauma of her crying was like doing sit-ups,” said Steve. “From all the crying she ingested air into her stomach, and it blew up to the size of a football. She must have torn something that caused internal bleeding.” 

     When Steve returned to the car, he was shocked. “She was doubled over in excruciating pain, her face was white as a ghost and she was still crying,” he said. “I knew something was wrong.”  Steve dialed 911, and as he was speaking to the operator, he drove to the Weems ambulance station at Sellers Plaza next door. He summoned the EMTs and paramedics, Kenny Gilbert, Jason Sphiller and Blake Tolley, who sprang into action to triage her. 

     “Her vitals were dropping incredibly fast. She needed a trauma team,” Steve said. “Her blood pressure was down at 60 or 70, incredibly low. At that point they didn’t want to scare me but they were losing her. They were afraid every minute.”

     Mike Murphy, who heads Weems emergency services, then made some quick decisions. An air ambulance was summoned out of Tallahassee, and it was agreed to meet the Weems ambulance rushing eastward at St. James Bay Golf Resort, an arrangement that would shave at least seven minutes off the total travel time from Eastpoint to TMH.

     In addition to an advanced clotting drug, Deb received a unit of blood while en route. All told, she would receive four units of blood prior to surgical intervention; the result of which drained 1000 cc of blood from inside her.

     “That drug brought her vitals back initially; and long term stopped the bleeding,” said Steve.  “If it weren’t for the coordination between Weems, the ShandsCair people, and TMH, she wouldn’t be here.”

     “One of the paramedics made a point to come up and see me,” Steve said, “I gave him a big hug, and thanked him.  I said ‘You saved somebody’s life yesterday’.  They knew they had a limited time to make this happen and they made it happen. That’s the amazing thing.”

TOBACCO CESSATION CLASSES

The Tools to Quit program is a FREE two-hour tobacco cessation program held to assist those using any form of tobacco products (cigarettes, cigars, snuff, dip, etc.) with quitting. Nicotine replacement therapy (nicotine patches, gum, etc.) are FREE and are provided to active participants. Please contact Emily Kohler at 850-224-1177 and/or at ekohler@bigbendahec.org for more information.


OVEREATERS ANONYMOUS

Thursday from 5:30pm to 6:30pm at Weems Hospital's Cafeteria

For more information on Thursday meetings, call Daphne at 850-899-3715

Sunday from 5:30pm to 6:30pm at the Trinity Episcopal Church Annex in Apalachicola 

For more information on Sunday meetings, call Sarah at 850-385-8421

Anyone from the community is welcomed to attend this meeting.  There is no registration required.  The only requirement for becoming a member of OA is a desire to stop eating compulsively or other compulsive food behaviors. 


ATTENTION CAPITAL HEALTH PLAN MEMBERS

Weems Memorial Hospital is a network provider of emergency, swingbed, and radiology services for Capital Health Plan members.


 Weems To Begin $10 Million Renovation

Weems Memorial Hospital received the green recently to begin a $10 million renovation to replace aging infrastructure in the Apalachicola facility’s emergency, radiology and inpatient nursing departments. The Franklin County Commission approved the hospital board’s plans to  move forward with the major hospital renovation during its October 5 meeting. Now, hospital officials say they are ready to proceed with the details of the major overhaul of the 56-year old facility.

“We’re happy that the commission has allowed us to move forward,” said Weems CEO Mike Cooper. “We know there’s alot of work to do but we look forward to creating the best healthcare situation for Frankln County.”

Franklin County Commissioners originally lent their support to building a new hospital during June when Weems Memorial officials and representatives from the U.S. Department of Agriculture (USDA) announced to Franklin County Commissioners that the county’s $10 million loan application was approved thus clearing the way to renovate the county’s existing 56-year old facility. The board was reluctant to pull the trigger on the loan in June because of worries over the financial viability of the hospital. Those concerns were allayed however with positive financial reports from the hospital CEO Cooper and approval was granted at the October 5 meeting to move forward on the project which is estimated to take 18-24 months.

“The hospital board is 100% committed to the success of the hospital,” said hospital board chairman Jim Bachrach. “We’re excited to begin working with the commission to make this project a reality.”        The hospital renovation project consists of construction, and furnishing of 15,375 square feet of new construction and 11,250 square feet of renovations to the existing facility located two blocks north of US Highway 98 in Apalachicola.

The proposed plan calls for the replacement of the emergency department, radiology suite and inpatient nursing unit. The new facility will be constructed on the eastern side of the Hospital and include 10-12 private inpatient rooms with individual shower and restrooms, an emergency department with triage, four exam rooms and a radiology suite with CT and radiology/fluoroscopy rooms.. Procedure services will remain in the existing location with some cosmetic upgrades.  Also remaining in the existing facility will be pharmacy, laboratory, respiratory, physical therapy and dietary services. An expansion of physical therapy to include outpatient physical therapy is planned in the existing space.

Weems officials say renovations to the existing facility will be primarily cosmetic with the upgrade of flooring and painting of walls. A new replacement roof will be provided. With the movement of the emergency department, radiology suite and nursing unit to the new facility, minor renovations will be made to those areas to meet business occupancy needs. The current business office trailer is expected to be eliminate as those functions move into vacated space inside the existing building. The heliport will not be affected by the project and will remain in its current location.
 The existing facility will be connected to the new building and will include hospital administration, dietary and dining services, loading dock and building services, sterile processing, on-call suite and additional outpatient service capability. Once groundbreaking is approved, the project construction/renovation is estimated to take between 18-24 months to complete.    

Weems Memorial Hospital opened on June 21, 1959 in its current location. But it was not Apalachicola’s first hospital. According to longtime Apalachicola physician Dr. Photis Nichols, Apalachicola’s first hospital was actually a renovated Army barracks building at the airport with 13 beds, a small obstetrical wing and operative suite. The hospital served the needs of the community from the time of its opening in 1948 until the completion of the new hospital with 25 beds at the present site in 1959.


 Weems Chronic Pain Treatment Policy

An Open Letter from Weems Emergency Department Director Dr. Patrick Conrad
    For several years questions from the community and local elected officials have continued regarding the ability of the Weems clinics to treat chronic pain with controlled prescriptions.  These are valid concerns that deserve some update and clarification as we work to improve our regional care.  
    Chronic pain is real, it is distressing to patients and their families, and also to the physicians who care for them.  In the classic tradition, treatment decisions would be left up to the attending physician and the patient, both of whom would rely on the clinical presentation and the doctor’s best judgment.  
    Candidly, those days are gone in a tangle of lawyers and legislation that cannot be ignored.  It is also true that there is a nationally a serious epidemic of prescription medication abuse from which we are not immune.
    The examination of chronic narcotic usage has both ethical and legal components.  Ethically, the physician is obligated to provide the best possible care, including the alleviation of pain and suffering; that does not include the unnecessary (!) physical or psychological habituation of a patient to addictive medications and their deleterious side effects.  Competent practicing physicians will confirm that the best medical care often requires denying what a patient requests in order to protect that patient’s best interests.
    The legal side is more complex, and in some instances trumps the ethical obligations.
    We are obliged to start with a common definition of chronic pain, as given by Florida Statute 459.0137:  “Chronic nonmalignant pain” means pain unrelated to cancer which persists beyond the usual course of disease or the injury that is the cause of the pain or more than 90 days after surgery.” This does not prohibit short-term, small amounts of prescription narcotics for acute injuries, or pain control in terminal cancer patients.  The restrictions described below apply to the ongoing prescribing of addictive medications for non-cancer patients.  And yes, many compassionate primary care doctors had for years prescribed daily narcotics to the elderly for chronic arthritis and other degenerative conditions.  
    Bluntly, those days are gone.  According to the definition above, any physician so prescribing will be regarded by the state as a “controlled substance prescribing practitioner pursuant to Florida Statute 456.4 (“Controlled substance prescribing”), and must so designate himself with the state.  Such a designation requires “...ensuring compliance with the following data collection and reporting requirements” which include “ ... in writing, on a quarterly basis, all new and repeat patients seen and treated at the clinic who are prescribed controlled substance medications for the treatment of chronic, nonmalignant pain”; those discharged due to drug abuse or diversion; and those “patients treated at the pain clinic whose domicile is located somewhere other than in this state.”  Additionally, each patient receiving chronic narcotics must have a written treatment plan with objectives; a signed controlled substance agreement with the patient; documentation of having discussed abuse and addiction risks with patient. The state is also monitoring to see that the patient is seen “at no more than 3 month intervals” (source Hall Render Killian Heath & Lyman, PC), and that “unless the physician is board-certified or -eligible in pain management, patients with drug abuse symptoms must be immediately referred to a board-certified pain management physician or an addiction medicine specialist.”
    But surely a physician who means well can convincingly argue his case?  Not according to Florida Statute 458.331, Grounds for disciplinary action:  “...it shall be legally presumed that prescribing ... all controlled substances, inappropriately or in excessive or inappropriate quantities is not in the best interest of the patient and is not in the course of the physician’s professional practice, without regard to his or her intent” (emphasis added).  Penalties for being found in violation of this regulation may result in substantial fines and license suspension of 6 months, 1 year, or complete revocation.
    Is the state really being so hard-nosed in their prosecution of these violations?  Florida Attorney General Pam Bondi said on 9/26/14:  “In 2010, 98 of the top 100 oxycodone pill dispensing physicians nationally resided in Florida.  In 2011, after the passage of HB 7095, only 13 of the top 100 resided in Florida, and by the end of 2012, not one Florida doctor appeared on the top 100 list.”  This statement had been previously confirmed by the DEA on 4/5/13.
 The DEA also noted that from 2011 to 2013, “42 physicians lost their DEA registrations through the issuance of Immediate Suspension Orders (ISO).  The ISO suspended the DEA registrant’s ability to handle controlled substances in Schedules II – V.  Also approximately 61 more DEA registrations were voluntarily surrendered by physicians following an official visit from the DEA (and)... 38 pain clinics were closed due to the investigative efforts of the Tactical Diversion Squad”, according to the DEA’s official website.
    Where therefore do the Weems clinics and their clinicians stand?  Several years ago Franklin County had a large, very serious prescription drug addiction and diversion problem, to which I can personally attest from working in our emergency department.  Today that problem is significantly smaller, if no less harmful for those still affected.  Ethically, we dare not open the gates to a resurgence of a larger scale affliction that will be harmful to patients.  
    Legally and professionally, our physicians and clinics so urgently needed by our local patients cannot be put at very real risk by running afoul of the state’s initiatives to curb this problem.  While it may be difficult to educate the public, it is imperative that we honestly explain the delivery of their best, compassionate care while protecting our ability to actually deliver it.
    Please contact me at any time if I may be of assistance in this matter.

Respectfully,
Patrick Conrad, MD
Weems Emergency
Department Director

 


 Weems Awarded the 2014 Jean Byers Award for Excellence

Weems Hospital is once again a recipient of the Jean Byers Award for Excellence in Cancer Registration! The Jean Byers Award is the highest national Cancer Registry award from the statewide population-based cancer surveillance system - Florida Cancer Data System (FCDS). The Jean Byers Memorial Award for Excellence in Cancer Registration honors Florida cancer registries that exhibit outstanding leadership and dedication to the field of cancer registration.  


 Weems Recognized for Medication Safety

FMQAI, the Medicare Quality Improvement Organization for Florida, has recognized Weems Memorial Hospital and staff with its 2012 Patient Safety award for their commitment to medication safety. Weems Memorial participates in FMQAI’s Critical Access Hospital Patient Safety Initiative in collaboration with Shands Jacksonville and University of Florida (Jacksonville, FL).

The award is the result of a site visit in January 2013 by a team of Pharmacy Specialists working with Paula Applebee, RN, and Joel Rapack, Weems Consultant Pharmacist, conducting a standardized medication safety and quality assessment. The results of the audits are then used to improve pharmacy and medication processes.

"The objective of the collaboration between Weems and FMQAI is to significantly improve health outcomes and patient safety through the integration of clinical pharmacy services" according to Julie Shiver, Weems Consultant Pharmacist. "We are proud of the progress being made at Weems to provide for patient safety through the use of evidence-based clinical services."


STROKE AWARENESS

 ARE YOU AT RISK OF A STROKE?

"Time is crucial in the treatment of stroke, as on average, every 40 seconds someone in the United States has a stroke and roughly every four minutes someone dies from a stroke," said Weems ER Physician, Pat Conrad, M.D. "The earlier a stroke is recognized and the patient receives medical attention, the greater chance of recovery."

Strokes occur when a blood vessel carrying oxygen and vital nutrients to the brain is either blocked by a clot or ruptures. When this occurs, part of the brain is deprived of blood and oxygen, destroying millions of valuable nerve cells within minutes.

"If you suspect a stroke, remember the word FAST or F-A-S-T," said Dr. Conrad.

  • F is for face - is your face drooping?
  • A is for arms - can you lift both arms?
  • S is for speech - are you slurring your words? 
  • T is for time, call 911 immediately because with stroke, time is brain.

The primary stroke symptoms include:

Sudden numbness or weakness on one side of the face or facial drooping

Sudden numbness or weakness in an arm or leg, especially on one side of the body

Sudden confusion, trouble speaking or understanding speech

Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss of balance or coordination

Sudden severe headache with no known cause

About Stroke

Stroke is a leading cause of death and serious, long-term disability in the United States.' According to the American Stroke Association, approximately 795,000 people experience a new or recurrent stroke each year, and 87 percent of these are ischemic strokes.  An acute ischemic stroke occurs when an obstruction, such as a blood clot, blocks blood flow to the brain. The obstruction deprives the brain of blood and oxygen, destroying valuable nerve cells in the affected area within minutes. The resulting damage can lead to significant disability including paralysis, speech problems and emotional difficulties.

Treatment may be available if you get to the emergency room immediately upon recognition of stroke symptoms. Leading a healthy lifestyle, including lowering risk factors like high blood pressure and weight, can also help reduce your stroke risk.

For more information about stroke, visit www.strokeawareness.com or Becky Gibson, Weems Memorial Hospital, (850) 653-8853 ext. 108.

Heart Disease and Stroke Statistics - 2013 update: a report from the American Heart Association. Circulation 2013; l 27:el 33-242; Epub Dec 12, 2012. American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231


 GET SCREENED: KILLER COLON CANCER IS PREVENTABLE

JAMES STOCKWELL, M.D. AND WEEMS MEMORIAL HOSPITAL

Tragedy strikes when a family member, friend or anyone suffers and dies from a preventable cause. It could even happen to you or ones you love. Then comes the grief and question of, “what could have been done differently to prevent this tragic loss”. The sting and pain are even deeper with the realization that the loss could have been prevented. The answer is colon cancer screening which often prevents tragic loss.

Colon cancer is a preventable disease of the large intestine. It is preventable in at least 60% of cases. Also, in those in whom cancer is discovered early, it is 90% curable. Yet colon cancer continues to be the third leading cause of cancer in men and woman with over 150, 000 new cases and 50,000 deaths per year in the United States. Quite simply, this occurs because individuals ignore screening recommendations and warning symptoms. I must emphasize the waiting for symptoms is a dangerous gamble since symptoms often occur late when the disease is advanced with less chances of cure. Screening is the key to lowering the death rate from colon cancer.

With screening, colon cancer is often preventable because it begins in a noncancerous growth called a polyp which takes time to develop into a cancer. During this time the polyp can easily be removed during a colonoscopy and then no cancer will develop.

There are many reasons that individuals avoid screening for the prevention of colon cancer. One reason is that some do not know that colon cancer is preventable. Of course that is one of the reasons I am providing this information. Women may erroneously feel it is a “mans disease”. Men have a strong tendency to avoid medical care and, often, a real fear of such care. Seeking care can even be perceived as a weakness.

Many fears can be another reason for not undergoing screening. None of us wants to undergo perceived unpleasant tests. Many individuals are “private” and become uncomfortable in a medical setting or have personal taboos in regard to their bodies. Some fear that a painful experience will occur. Many have heard that the preparation is unpleasant. Others worry about something serious being found and would rather not know. Potential complications of any medical treatment are also a concern. In this time of a poor economy, financial concerns and realities can interfere with undergoing preventative tests or having worrisome symptoms investigated. Last, is the “YUK’ factor. The colon just does not seem to be a pleasant part of the body to discuss or address.

Fear is no reason not to address life saving preventative tests. The fears are often much worse than the reality experienced. I would therefore like to address the fears I have cited in the above paragraph. First, the procedure itself has little discomfort associated with it. The patient is safely sedated and has little or no memory of the procedure. The preparation for the procedure is quite tolerable and can even be motified, if requested. The team that interacts with the patient is professional, caring and is dedicated to preserving the patient’s dignity and privacy.

Fear that something might be found is misguided. Most of the time the exam is normal or small noncancerous polyps are found. It is actually wonderful that the benign polyps are found and removed so they do not evolve into cancer. Again, if a cancer is found it will be in an earlier and more curable stage.

Fear of complications is always a concern for any patient. Complications are extremely rare and all measures are taken to make sure each patient has a safe experience. The safety of each patient is the most important concern of the team.

Financial concerns and barriers are not to be ignored. The hospital, physician and all involved are aware of financial adversities and stresses. All will make every effort to work with patients to make sure they can undergo preventative measures.

The two most common and recommended tests that are utilized for the prevention of colon cancer are chemically testing the stool for small amounts of blood that cannot be seen (stool occult blood testing) and a colonoscopy. The testing of stool for occult blood  is important but not adequate, alone, for the early detection or prevention of colon cancer.

Screening colonoscopies must be done. This involves inserting a lighted tube through the anus into the colon under sedation. The procedure takes about 30 minutes during which time the whole inside of the colon is visualized and benign polyps are removed. Following the procedure there is little or no discomfort and patient is able to promptly resume a normal diet.

A summary of the current SCREENING RECOMMENDATIONS is as follows:

  • Starting at age 50 yearly testing of the stool for occult blood and a colonoscopy every 10 years.  Screening is recommended starting at age 45 in African Americans who have an earlier onset and more advanced disease.
  • An earlier screening age is recommended in those who have relatives with colon cancer or polyps. Also, it may be appropriate, earlier in patient with other cancers such as uterine, ovarian, urinary tract, other digestive tract tumors and brain tumors. I will be happy to answer questions regarding the need for early screening.
  • Since symptoms of colon cancer are often late, patients with rectal bleeding, change in bowel habit, unexplained abdominal pain and fatigue from anemia should promptly seek medical attention.

I have seen too many tragic, needless deaths during my medical career from colon cancer.

PLEASE UNDERGO COLON CANCER SCREENING AND ENCOURAGE THOSE WHO YOU CARE ABOUT TO DO THE SAME.