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Doc Talk

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St. Elizabeth Sports Medicine Director Dr. Michael Miller doesn’t have to look at the calendar to know when it’s mid-July. He can tell practices have started by the sudden surge in young athletes coming into the sports medicine clinic with sports-related injuries.


“Our volume of patients goes way up starting around July 15,” Dr. Miller says. “The increased number of injuries is primarily a function of the increased number of young athletes that begin their fall sports seasons.


“By far and away the most common type of injury is the overuse injury involving bones, muscles and joints. Athletes sometimes do too much, too quickly, too soon and their bodies gradually break down. Examples of overuse injuries include: shin splints, tendonitis, stress fractures and knee cap pain. Proper training and conditioning over the summer may help reduce injuries in the fall.”


Many of those sudden onset injuries, like broken bones and sprains, also end up at Commonwealth Orthopaedics. Commonwealth Sports Medicine specialist, Dr. Matthew DesJardins, said they also see a surge in patient athletes at this time of year. Still, he says, a big concern for young athletes at this time of year doesn’t involve orthopaedics at all.


“We really get concerned at this time about the effects of the heat and dehydration, which can have serious medical complications,” says Dr. DesJardins.


“That is particularly the case for football players, who are wearing equipment which predisposes them to heat illness and dehydration. So we really need to remind everyone about that because most of the interventions for heat-related injuries must happen at the team and coaching level where they need to manage their practices in the heat.”


Concussion: Know the Symptoms


Another serious situation that calls for immediate cessation of play and attention by a physician is a concussion, an injury that statistics indicate happens to athletes as often as 3.8 million times a year. Both doctors stress that it’s essential that athletes, coaches and parents all know and respond early to the signs and symptoms of concussion.


“You do not have to have loss of consciousness to have a concussion,” says Dr. Miller.


“In fact, the majority of sports-related concussions don’t involve loss of consciousness. The symptoms include being dazed and confused initially, as well as blurry vision, dizziness, headache and maybe even a little nausea. They really just may feel they’re in a fog. And the new guidelines now say that if an athlete shows any signs or symptoms of a concussion, they must be taken immediately out of the game or practice and not allowed to return until they’re cleared by a medical doctor.”


A complete evaluation by a medical doctor is also something every student athlete should do before practices start in the first place. In fact, the Kentucky High School Athletic Association requires a yearly pre-participation examination.


The bottom line for safeguarding the health of student athletes then is really that a little awareness and preparation now will go a long way toward ensuring a youngster stays healthy and on the field long after the heat of summer is gone.


“When their athletes are letting them know they have pain and soreness, they need to listen,” said Dr. Miller. “The earlier you can pick up an overuse injury the less likely it will go on and become a chronic problem where they end up missing more in the long run.”


Written by Shelly Whitehead


Editor’s Note: This is a special advertising supplement, paid for by St. Elizabeth Healthcare

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St. Elizabeth Physicians General Surgeon, Dr. Magued Khouzam, is working to rally monetary and medical supply support for two medical missions to Ethiopia and Egypt this year. Dr. Khouzam is working with other volunteering medical professionals from around the world as part of the Coptic Medical Mission trips.


The Coptic Medical Mission is a global endeavor to provide healthcare to the needy, and help spread God’s word, sponsored by the Coptic Medical Association of North America. The missions are an extension of the Coptic Church, the largest Christian church in Egypt and the Middle East.


In its first mission, 20 physicians from the U.S. and Canada traveled to Egypt for a week. In that brief time, the team performed 90 surgeries, including cardiac, obstetrical/gynecological, eye, and ear, nose and throat procedures. The volunteer medical team also participated in clinics, lectured and taught staff physicians.


In November 2011, Dr. Khouzam was again among the team that traveled on a second mission trip to Ethiopia, where poverty is rampant and there is currently only about one or two physicians per 100,000 people. Healthcare in Ethiopia is ranked among the worst in the world, with high maternal and fetal mortality.


The team that traveled there in November included 23 physicians and two OR nurses, who completed 80 surgeries during their stay. Dr. Khouzam said he hopes the next two trips this year will be even more successful, but much depends on the generosity of others.


“In 2012, we are planning two missions – one to Ethiopia (May 12-19), and another to Egypt (November 2012),” he said. “We are hoping to raise enough funds to be able to sponsor operating room nurses/technicians from St. Elizabeth Healthcare to join the mission and transfer their expertise to local OR nurses and technicians (working at the mission destinations).


“We wish to have extra money to purchase some medical supplies. We also accept donations in the form of medications, medical supplies, children’s clothing, toys and school supplies.”


Monetary donations will be tax exempt upon request and checks should be made payable to the Coptic Medical Association of North America.


Donations of new or gently used clothes, toys or school supplies can be placed in the designated donation box in the operating room holding areas at St. Elizabeth Edgewood, Florence and Fort Thomas.


Editor’s Note: This is a special advertising supplement, written by Shelly Whitehead and paid for by St. Elizabeth Healthcare.

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You leave your doctor’s office, wondering what happened. You had a ton of things to ask her, but somehow you only remembered a few of your less pressing concerns during the visit. Worse still, you forgot to tell her about that new medicine you’re taking.

That frustrating scenario is one that far too many of us experience. St. Elizabeth Physicians Family Practitioner Dr. Esther Saalfeld knows. She sees it all the time. From patients who forget their medication lists to those who can only vaguely describe their symptoms, communication problems in the doctor’s office can really get in the way of an accurate and timely diagnosis. That is particularly true these days, when primary care physicians, like Dr. Saalfeld, are typically seeing about 34 patients in a rushed eight-hour day.
The good news is that there are some simple things you can do to vastly improve communication with your doctor and, as a result, the care you receive. At the top of the list? Preparation.
Elizabeth-InStory.gif Dr. Saalfeld says if all patients would take a few moments to think about their medical issues ahead of their visit, the results would be dramatically improved.
"I recommend that patients actually make a list of the issues they’re having before they come in," says the veteran Taylor Mill doctor.
"Keep it simple and brief, and pick out two or three of the most important things to discuss at that visit. I’ve found if people do this they’re able to be more succinct, they don’t forget anything and the problems are a lot easier to address.

"The other thing they must do is to bring a medication list or the medications themselves. That is huge."

Six Questions to Ask Before Your Visit
The list is a great beginning, but it’s not all you need to think about before your visit. Saalfeld said you should also try to quantify and qualify your symptoms. But, skip the online research and self-diagnosis. Saalfeld said that usually doesn’t help.
Instead, spend the time before your office visit thinking about, and even jotting down answers to the following questions:
•    How, specifically, does the problem I’m having feel?
•    Where, on my body, is it centered?
•    When did it start?
•    What makes it better or worse?
•    How intense is the pain, on a 1-10 scale?
•    What medications am I taking and what are the dosages?

Saalfeld emphasized that the more specific you can be about your symptoms, the better. But, it’s likely you’ll only have time to discuss two or three issues during a typical office visit. Schedule another appointment if you have additional concerns. Finally, take writing materials to your appointment so you can jot down your doctor’s instructions.

What to Do if You Have Questions After Your Visit
Questions remain sometimes, even for those who’ve prepared well for their visits. That’s one reason St. Elizabeth Physicians doctors increasingly recommend that their patients enroll in the new electronic medical record system called MyChart. The online personal health information tool allows patients to send things like follow-up questions and refill requests directly to their doctors at any time, via computer. It also keeps record of all St. Elizabeth test results and physician visits.

If, however, you don’t use this system and must follow-up with your doctor about non-emergency issues by phone, physicians recommend that you:
•    Call early in the day
•    Leave a one-sentence description
•    Provide symptoms and dates
•    Have medication and pharmacy information handy

Physicians are as busy as the rest of us. But, like Dr. Saalfeld, their joy comes from quick and accurate diagnoses that get their patients back on the road to health quickly. By following a few communication pointers, you can help your doctor do just that, well into the future.

"Really, the biggest problem physicians have is when patients are vague about the problems they’re having," Dr. Saalfeld said. "The more information you can give us, the better and more quickly everything goes, and the more we can really get an idea what’s going on and get you feeling better."

AUTHORED BY: Shelly Whitehead with contributions from Dr. Esther Saalfeld

Editor’s Note: This is a special advertising section provided by St. Elizabeth Healthcare.

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Partners. That’s how Amy Gastright has always viewed the midwives at St. Elizabeth Physicians Women’s Health.


Like many women, Mrs. Gastright first began seeing them for gynecological care when she was still a teenager. The 33-year-old Taylor Mill woman says she started forming strong bonds with them at her very first visit with veteran midwife, Shauna Zerhusen.


"I was just 18 or 19, and I remember she took me into her office first and she really talked to me like I was an adult," Mrs. Gastright recalls.


"Since that point, I’ve never felt uncomfortable. You never feel rushed … because they really take time with you. It’s just kind of special."


That relaxed partnership is what the physicians and midwives at the practice – with offices in Florence and Cold Spring – say many of their patients are seeking when they choose midwives for gynecologic and obstetric care. It’s a partnership that’s always been a perfect fit for Mrs. Gastright, who naturally went to see one of the midwives when she and her husband, Doug, wanted to have a child.


Unfortunately the Gastrights faced complications that forced them to spend years seeing fertility specialists for treatments, which all ultimately proved unsuccessful.


"I’ll Never Forget That Day…"
At wit’s end, and frustrated with all the complex medical treatments, the couple decided to try a more holistic approach to their problem. That’s when Amy Gastright went back to Shauna Zerhusen and received a referral to an acupuncturist. Within two months, the Gastrights were expecting their first child.


"I’ll never forget that day when I found out I was pregnant – I was absolutely hysterical I was so happy," Amy recalls.


Fortunately, there were no complications with Amy’s pregnancy, so she could receive all her care from the midwives at St. Elizabeth Physicians Women’s Health. Complicated pregnancies are always referred to the care of the physicians at the practice, while the midwives there specialize in normal pregnancies.


"All our midwives are advanced practice registered nurses, with master’s degrees in nursing. We’re all also nationally certified by the American College of Nurse Midwives … and we all can prescribe drugs, as well," Ms. Zerhusen said.


Partners with Physicians, Too
All five midwives work in partnership with the three obstetricians and one gynecologist at St. Elizabeth Physicians Women’s Health to ensure every woman gets the care she needs, even if problems develop. In fact, Dr. Robert Flick, Assistant Medical Director at the St. Elizabeth Obstetrics and Gynecology Outpatient Center in Florence, said at least one physician is at the hospital when every patient gives birth.


"We’re still in-house 24 hours a day … so if a woman should suddenly need a C-section, for instance, we move in," Dr. Flick said.


"Otherwise, the midwife is right there laboring with them, hour after hour, tapping into their expertise to try to lessen their discomfort."


The birth of Amy and Doug Gastright’s first son, Brycen, two years ago was a blessedly normal one, so they were able to take complete advantage of their midwife’s full attention. In fact, the birth was such a good experience that this May the Gastrights delivered a second boy the same way. It’s the kind of repeat business that this group of midwives just can’t get enough of.


For more information, contact St. Elizabeth Physicians Women’s Health:
Florence: (859) 212-5125
Cold Spring: (859) 912-6500


Editor’s Note: This is a special advertising section provided by St. Elizabeth Healthcare.

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Women’s healthcare took a giant leap forward when St. Elizabeth Fort Thomas opened its new multi-million-dollar Women’s Wellness Center last week.


At approximately 8,000 square feet, it is one of the largest such centers in Northern Kentucky. But it’s much more than size that makes this state-of-the-art facility unique. It’s also the posh surroundings, seamless delivery of care, and up-to-the-second technology that you’ve come to expect from all things St. Elizabeth.


“This center for women’s wellness is both technologically advanced and beautiful to behold,” said St. Elizabeth Fort Thomas Chief Operating Officer Thomas Saalfeld.


“It’s the perfect setting for our skilled medical professionals to deliver a large spectrum of wellness services to women from all over the area.” Full Spectrum of Services in One Convenient Location


The center offers women a broad array of services in a soothing, spa-like setting on the hospital’s second floor. St. Elizabeth System Director for Women and Children Laurie Conkright said that when administrators asked Northern Kentucky women what type of center they wanted at their Fort Thomas hospital, the overwhelming majority of women pointed to centers already open at St. Elizabeth Covington and Edgewood as prime examples.


“Women told us they really liked the kind of one-stop shopping experience offered at those Women’s Wellness Centers,” Conkright said.


“So we really wanted to provide that same kind of feeling and experience for the people of Fort Thomas with a very comfortable environment offering state-of-the-art medicine with all the latest diagnostic equipment.”


The center’s dedicated group of physicians, cancer surgeons, nurses and technicians are all skilled in the most advanced medicine and the use of the latest diagnostic technology to obtain the clearest picture of each woman’s health. The center features a pair of digital mammography machines, a stereotactic room, ultrasound technology, bone density scanners and a women’s boutique, as well as educational, exam and consultation rooms.


“Aside from mammography and bone density testing services, we offer breast biopsy, ultrasound, genetic counseling and the services of our nurse navigators, all in one easy-to-reach space at St. Elizabeth Fort Thomas,” said Women’s Wellness Nurse Manager Toni Carle.


“Before, all these services were spread out across the facility. Now, by bringing them all together in this beautiful space, it really helps streamline everything from diagnosis to treatment.”

A Calming, Comfortable Environment


When planning the center, St. Elizabeth leaders remained ever-mindful of the fact that medical tests and procedures can often be unsettling. That’s why so much time and thought was invested to create a calming environment at the new Fort Thomas center.


By working with a team of veteran healthcare architects and interior designers, St. Elizabeth has succeeded in creating a welcoming and peaceful place for the area’s premier women’s healthcare services.


“The colors used in the center are very feminine, but still very bold, including large-patterned carpeting and rich, darker-colored accent walls that give you a different feel and perception of things,” said St. Elizabeth Assistant Facilities Management Director Patrick Wilgenbusch.


We used a lot of different materials, too, like art glass and ceramic tile with lush colors, like browns and golds and rich reds. I think when it’s all said and done, it comes together very nicely to portray a new concept at St. Elizabeth Fort Thomas that I think women will really like.”


Editor’s Note: This is a special advertising section provided by St. Elizabeth Healthcare.

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When it comes to weight management, Dr. Troy Schumann can safely say he really knows what he’s talking about. The St. Elizabeth Weight Management Center physician has not only undergone specialty training in bariatric medicine, but he was once clinically obese himself. In fact, he’s so interested in the field that today he’s in the process of becoming a certified bariatrician.


In other words, Troy Schumann understands the problem his patients face on both a personal and professional level. But it’s his personal experience – perhaps more than any other – that has given him special insight into both the frustration of being overweight and the very real health risks of do-it-yourself dieting.


"Before I received specialty training in bariatrics – when I was just out of my medical residency – my weight was in the obese range. And even though I was a physician, I was still looking for that magical answer," he recalls.


"So I just picked up the biggest fad diet going and I lost a lot of weight. But I also got kidney stones five times and had to have surgery for them. That really opened my eyes about the serious risks dieting can pose if you go about it the wrong way."


Today, Schumann puts his considerable professional and personal experience to work daily to help patients at the Florence center trim down and get healthy safely and successfully. But, he knows many considering such a program have lots of concerns. Dr. Schumann has answered some of the most common questions many people ask when considering whether St. Elizabeth’s program is right for them.


Q: Why should someone choose to seek your help through the program at St. Elizabeth to achieve their weight loss goals?
We are dedicated solely to treating conditions of overweight and obesity, and their related illnesses. To accomplish that, we have a full array of medical professionals who specialize in weight management, including registered dietitians, nurses, exercise specialists, and specialists in behavioral health.


We spend considerable time working with our patients individually to educate and change behaviors that they can develop into permanent lifestyle changes. We’re not just looking at the number on the scale.


Q: What do you mean when you say you "don’t just look at the number on the scale"?
It means successful weight management requires that we look at everything going on in each patient’s life. So, we perform blood work and other necessary tests to obtain critical information about things like your body fat percentage and lean muscle mass. But, we also work to determine whether you have any eating disorders or stressors that might trigger your dietary intake, or medical conditions that might inhibit weight loss.


We look at your situation from many different angles to achieve the best results for overall health. We really focus on long-term success through weight maintenance after weight loss.


The only way to keep weight off is by incorporating behavior and lifestyle changes into your everyday life, including regular exercise as a key element. And, we continue to work with our patients during maintenance, reinforcing what they learned during their weight loss program and offering needed support to keep them on track.


Q: Do you only help people with very large amounts of weight to lose?
We can help anyone, from individuals who may need only to lose 10 pounds, to those who are severely obese. We offer a lot of different options. Most of the people who come to see us have already been on every diet known to man, but when they come here we’re going to build a program that is specially suited for their needs and situation.


Q: What types of concerns and questions do people ask initially?
The No. 1 thing people ask me is, "Do you prescribe medications?" Everybody’s looking for the magic pill, but there just isn’t one. Though some medications can help, we really want to find the underlying problems you’re having and then correct them.


One other big question is, "Why am I overweight anyway?" Some people want to know why they’re working so hard and eating all the right things, but they’re still overweight. They’re very frustrated.


So we look to see if they have certain health, medication or other issues that might be contributing to weight gain. Then we work with their physicians to figure out how to target the problems to optimize their efforts for the best results, but always with safety in mind.


Q: Obviously, it takes a lot of effort from the patient to succeed, but you’ve seen a lot of people do just that. Tell me about the pay-offs.
Oh, the pay-offs are tremendous. You see them in the numbers when their cholesterol, blood pressure and blood glucose levels drop and they can reduce or even eliminate their medications. And sometimes people need to lose 200-300 pounds and they’ve been wheelchair-bound for years – they may never think they’re going to progress out of that chair, much less exercise. But they do, and you see them feeling better and better, both physically and emotionally about themselves. Their lives are tremendously improved. I know. I’ve been there, too.


Editor’s Note: This is a special advertising section provided by St. Elizabeth Healthcare.

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•    Approximately 160,000 Americans sustain spinal column injuries annually
•    85 percent of us will experience at least one disabling low back pain injury
•    About 10 percent of that group will suffer chronic problems

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As most of us already know, back problems are ever-present in this country. In fact, right at this moment about 250,000 of us are living with spinal cord injuries, according to the National Institutes of Health. And it’s estimated that a whopping 85 percent of us will end up suffering some sort of disabling low back pain injury during our lives.

"I am seeing all aspects of spinal problems … and these are very common problems. In fact, 80-90 percent of people will have this type of problem in their lives," Dr. Raj Kakarlapudi, Medical Director and spine surgeon at St. Elizabeth says.

The prevalence of the problem is one reason why Kakarlapudi is working with St. Elizabeth Healthcare toward the creation of a spine center in Northern Kentucky in the near future, which will bring together all the best technology and brightest professionals in the field of spine health.

Kakarlapudi says his practice is the foundation of that effort. He says he hopes to serve as a valuable local resource for people with all types of spinal ailments. Kakarlapudi says he also hopes to work closely with local primary care doctors to direct patients with spinal problems to the best source of treatment. "My goal is to educate primary care physicians about spinal conditions," Kakarlapudi says.
"I think it’s important for them to know how I can help them figure who can be helped surgically and who might be better served with a non-operative course of treatment. … I’ll be evaluating all those cases in that way."

When to Talk to Your Doctor About Seeing a Spine Surgeon
Kakarlapudi says people should talk to their doctors about seeing a spine surgeon for ongoing complaints involving any part of the spine and neck, as well as pain that extends down the arms and legs, or tingling in the fingers. He will then work with these individuals and their physicians to determine whether surgery is the answer, or if another type of treatment might be more appropriate. 031411DOCTALK.jpg

Typically, Kakarlapudi says surgery is only considered when an individual is unable to live with his or her pain or condition, or a problem exists that endangers their health, like compressed nerves, or degenerative or unstable discs. Often too, Kakarlapudi is called on to monitor individuals as they are treated non-surgically to determine when and if it would be best to intervene surgically.
And when it comes to surgery, Kakarlapudi performs a complete array of procedures, but he specializes in minimally invasive measures. When appropriate, these less traumatic operations can offer patients the same benefits as open surgery with fewer risks.

"I’ve really concentrated on minimally invasive spinal surgery and also percutaneous procedures," he says, referring to surgical procedures where access is gained to the spine through small skin punctures, rather than larger openings with a scalpel.

With newer, minimally invasive procedures, we can use image guidance to see where we have to go, requiring a smaller incision instead of taking muscle out. With these procedures there’s a lot less blood loss and a quicker recovery for the patient, who can go home sooner."

St. Elizabeth Healthcare is partnering with its medical staff to develop a fully integrated, multi-disciplinary spine program at its Florence campus, including the services of physical therapists, interventional radiologists and pain management specialists, providing a full continuum of care to patients with spinal ailments.

Editor’s Note: This is a special advertising section provided by St. Elizabeth.

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Often stroke, heart attack and ruptured aneurysms seem to strike without warning. But in reality, there usually are advance signs that these catastrophic health events may occur. Recognizing those signs, as well as potential risk factors for major cardiovascular events, may be keys to preventing them from ever happening.

Late last year St. Elizabeth Healthcare rolled out a powerful new tool uniquely suited to seek out the warning signs of cardiovascular disease. And the great news is that this state-of-the-art medical technology comes directly to you in your own backyard. 
St. Elizabeth’s CardioVascular Mobile Health Unit delivers an array of potentially lifesaving health screenings to you where you live, work and play. It’s a quick, easy, painless and affordable way to help identify those at increased risk and potentially prevent major cardiovascular events, like strokes or ruptured abdominal aortic aneurysms. And there’s never been anything else like it in the Tristate.
"The mobile unit travels to locations across Greater Cincinnati to offer on-site screenings for cardiovascular conditions like blockages in the carotid artery (which places you at increased stroke risk) and abdominal aortic aneurysm through painless, non-invasive techniques using state-of-the-art ultrasound equipment," says St. Elizabeth Coordinator for the CardioVascular Mobile Health Unit Rhonda Wassom.

"We also screen for peripheral arterial disease – PAD – through a test called an ankle brachial index and we offer cholesterol, blood sugar and blood pressure screenings. Within the year, we will also start offering EKGs and echocardiograms, as well."

"We care about the health and well-being of those in our community, and therefore we provide a holistic approach to prevention. We offer services ranging from education prior to screenings all the way through to follow-up care."

  The CardioVascular Mobile Health Unit also offers classes to help educate the public about the screenings, cardiovascular disease warning signs and prevention activities. Elizabeth-InStory.gif

Are You at Risk?
The mobile unit is equipped with the latest medical technology and staffed by an array of cardiovascular professionals and technicians. Upon request, the unit travels to Greater Cincinnati businesses, churches and other organizations, primarily offering three completely painless, non-invasive cardiovascular screenings that take about 20 minutes total to complete.

In the most recent reporting year, the American Heart Association estimates that more than 81 million Americans had one or more forms of cardiovascular disease, including everything from high blood pressure to stroke and heart failure.

Fortunately, the number of deaths from cardiovascular disease is declining, a fact partially attributable to better early detection and treatment of such conditions. St. Elizabeth Vascular Institute Director Vera Hall says certain individuals may benefit from screening appointments at one of the CardioVascular Mobile Health Unit’s stops in the coming months.

"Individuals should consider undergoing these screenings particularly if they have family histories of cardiac or carotid artery disease or abdominal aortic aneurysm. Likewise, those who smoke, have high blood pressure, high cholesterol or diabetes, might also consider the screenings," she advises.

The Results that Can Save Lives
Hall and Wassom say that all screening results are reported to the individual and his or her doctor. Those with abnormal results are phoned within two days of the screening by the Vascular Institute nurse practitioner, who’ll discuss the results with them and answer any questions.

Although it might be scary to receive word of abnormal results, the good news is that with early detection there may be treatment options that would not be possible if the condition had worsened or resulted in a major cardiovascular event.

Normal screening results are sent to each individual and his or her requested physician so they can be discussed at the next office visit, if desired. The St. Elizabeth CardioVascular Mobile Unit staff are also always available to answer any questions individuals have regarding their screenings.

To find out when the St. Elizabeth CardioVascular Mobile Health Unit might be in your neighborhood, go online to and check the calendar page. You can also call (859)301-WELL for information about the van’s scheduled stops or to obtain details about booking the mobile unit at your workplace, church or organization.

Editor’s Note: This is a special advertising section provided by St. Elizabeth Healthcare.