Flourish

Anyone can have mental health issue, but a crisis will be someone who is either in imminent danger to self or others, they're having an acute exacerbation of psychosis. That could be anyone who has a previous history of mental illness, or someone who is having a new onset of symptoms or going through any difficult time in their personal life or someone who needs to be in the hospital immediately. So when the patient is admitted on the unit, we try to give them a break from the outside world, which means they are not going to be able to have access to things that distract them, and they're kept under constant supervision.

They sleep on time, they eat on time, their medications are maintained and managed by the nursing staff. They see the psychiatrist within twenty four hours of admission to the hospital so that we can do a psychiatric assessment. Based on that, we can formulate a treatment plan. And that treatment plan would include not only the medication management, but also for them to be able to receive some therapy, both the individual and therapy groups.

And then we are able to involve their families into treatment decisions as well. The goal of all of that is, you know, we can stabilize them on their mental health as soon as possible so they could be stepped down to the lower level of care. So when a patient is going through an acute mental health crisis, to be able to get the mental health back on track means not only helping these patients, but their families and the community in general. And that is what we find to be most rewarding.

Doctor. Thomas came to us with a really complex problem. He had had heart surgery over fifteen years prior. And where they did his heart surgery, the wall of the aorta or the main blood vessel that comes out of the heart had weakened. And as that aneurysm was getting bigger, the wall was getting weaker and it was really at risk of rupturing.

I talked to Austin Ward and he had an idea that he could do a new procedure.

He was pretty confident that it would work. And I said, Well, how confident are you on a one to ten scale? And he said, I'm confident ten. And I said, Schedule it.

Where this problem was in Doctor. Thomas' aorta is really at a crossroads of where I typically work, which is the ascending aorta, and where Doctor. Bicking typically works, which is the descending aorta. Doctor. Thomas' pseudoaneurysm was really in his aortic arch, is the meeting of those two spots. It's a very demanding procedure.

It takes a lot of expertise, lot of training, a lot of time and planning to do this.

We met with the team multiple times. Doctor.

Ward had written up a whole thing for where we need to be, where things were going be in the room.

This problem is extremely rare and this treatment endovascularly has only been performed a few times. So this highlights our ability to adapt and come up with innovative solutions for complex problems like that here at Baptist Health Paducah.

Sepsis is the body's reaction to infections. Specifically, it's kind of an exaggerated response to infections that we see typically in different sorts of patients. Sepsis does evolve very quickly and there are some steps that if they're taken early can help lessen the body's response to an infection.

As a physician I was very familiar with sepsis but I think physicians are often poor patients. I took some Tylenol, laid in a bath. I started hallucinating, getting confused. I also felt very weak.

My husband had to help me to the restroom, and at that point, he decided it was time to go to the As a reminder, we use the acronym for time when we're discussing sepsis.

The T in time stands for temperature, so a particularly elevated temperature or a lower than expected temperature can be signs of early sepsis. The I stands for infection. That can be any infection, respiratory infection, urinary tract infection, skin infections, etc. And then M is mental change, particularly in the elderly. So, an elderly patient with confusion, we're very concerned about the possibility of sepsis. And then the last one is for extreme illness. Feeling worse than you might expect because of a recent cold or infection, having shortness of breath, having a rapid rate, those are all things that should prompt you to see emergent medical attention.

Research is very important in oncology care. It is the way that we advance our treatments and develop new treatments in cancer care. As you may have seen in recent years, the number of treatments and the quality of treatments has increased significantly from many different forms of cancer.

I was diagnosed with triple negative breast cancer, which means that there are no hormones involved. When they explained it to me, they said it was a more aggressive type. They said that I was going to need a course of chemotherapy, surgery, and radiation. In one of my visits with Doctor. Huber, he said that I would be eligible for a clinical trial that was going on. He said that I would get less harsh drugs if I participated. So I told him I want to do that.

Dana's progress through her clinical trial will be reported out in the aggregate of patients through the clinical trial. And then hopefully that will lead to some improvement in our treatment for breast cancer. And that is the goal of all clinical trials is to eventually improve the quality of our care.

Today, I'm cancer free. It's gone. I'm hoping that that particular clinical trial becomes standard care for people in the future. I'm very passionate about research and very passionate about treatment for people in the future. Clinical trials take a long time and a ton of people. I'm just happy to be one of those people.

A hospitalist is a physician who practices inside of the hospital unlike a traditional primary care physician which has an outpatient office. Hospitalists are responsible for managing care of patients inside of the hospital who spend the night with us. We're the primary point of contact, not only for the patient and the patient's family, but also nursing care, as well as any specialist that may be consulted. So it is the hospitalist's responsibility to coordinate and see the bigger picture in relation to the patient's stay and overall health.

A big part of that management is communicating with the outpatient primary care provider. The benefit of being in a community hospital is we have firsthand experience and we've met these primary care physicians so we can give each other a phone call, a touch base on their patient, and then when the patient is ready to go home and be discharged, it is the responsibility of the hospitalist to write a discharge summary, and it relays all the information, including any medication changes, any imaging findings or pertinent follow ups that get sent directly to their primary care physician. I chose

to become a hospitalist because I love meeting with patients. I love seeing the bigger picture. It's the relationships that you build in a community hospital. We're often seeing the same patients multiple times because they're members of our community, which helps me feel more involved with where I live.

Inflammatory Bowel Disease or IBD is a condition where the body's immune system attacks and damages the digestive tract. There are two main types of IBD, ulcerative colitis and Crohn's disease. Ulcerative only affects the large intestine. Crohn's disease can affect any part of the digestive tract but often involves the end of the small intestine.

IBD can also cause problems outside the digestive tract including pain or swelling in joints, skin problems, and eye inflammation. Ulcerative colitis is diagnosed with colonoscopy. During the procedure, we look for inflammation and ulcers in the lining of the colon. Small tissue samples are then taken to confirm the diagnosis.

Crohn's disease can also be diagnosed with a colonoscopy with inspection of the end of the small intestine with a scope. If Crohn's disease mainly affects the small intestine, additional tests such as capsule endoscopy or other advanced imaging may be needed. Treatment depends on how severe the disease is, which parts of the bowel are affected, and whether it causes problems outside the intestines. Treatments can range from suppositories or enemas to pills, injections, or infusions. Steroids are used initially to induce remission of inflammation but are not good as long term medications for IBD due to their serious side effects. Some people with inflammatory bowel disease may eventually need surgery, however because there are now many more effective medications available, surgery is needed less often than it was in the past. So really, there's a lot more options for patients with IBD than there used to be.

Clinical trials are really ways of improving care going forward. So what we know are things that don't work as well and to find things that work better, the way to do it are clinical trials. So standard of care is what we usually do in a situation that the patient is in. But a clinical trial is something that we can look at if that standard of care is not as effective or if there's no good options going forward.

There's criteria to be met to be in a clinical trial. You have to have the right set of circumstances that allows you to be in that trial, and the patient has to be fairly fit. The patient's safety is the utmost thing we have to be cognizant of. When patients ask me why I should be in a trial, I always say, Well, this is probably a very good option for you, number one.

But cancer care doesn't move forward unless we have patients who volunteer for this care. The reason we have the drugs available today is because we've had so many participants in clinical trials over the years, and those things are coming to fruition now. And now we're seeing the benefits of all those bench research that have gone on for all those years back in the day.

In today's world, cancer care has come a long way and we are helping be part of that solution for patients.