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Advancing Care - July 2022

colonoscopy

Why you should start colon cancer screenings at age 45

The unexpected death of award-winning actor and playwright Chadwick Boseman at 43 to colon cancer in 2020 put a spotlight on a disease usually associated with older adults. According to experts, while the rates of colon cancer among older adults have dropped significantly over the past two decades thanks to screening protocols like colonoscopy, they are concerned that younger patients are not getting the screenings they need.

“For the last 20 years we’ve seen a steady increase in the number of individuals who develop colorectal cancer before the age of 50,” said Xavier Llor, MD, medical director of the Colorectal Cancer Prevention Program at Smilow Cancer Hospital.

Given the increasing colorectal cancer rates among younger people, the American Cancer Society now recommends people at average risk of colorectal cancer begin regular screening at age 45. Some patients with a family history of colon cancer or inflammatory bowel disease may need to get screened earlier as well.

During a colonoscopy, a doctor uses a colonoscope, a long, flexible tube with a tiny video camera at the tip, to check for abnormal tissue in the large intestine. Sometimes, a small growth, called a polyp, can form on the inner wall of the colon or rectum. Although many polyps are benign (not cancerous), some become cancerous. Polyps can be removed during the colonoscopy to prevent possible progression of cancer.

Doctors often can do more when colorectal problems are diagnosed early, said George Yavorek, MD, medical director of colon and rectal surgery at Lawrence + Memorial Hospital. His message to anyone, whether or not they have a family history of colorectal problems: Never miss a routine colonoscopy screening.

“It's heartbreaking to see someone who is in their late 50s or early 60s, and never had a colonoscopy, show up with advanced colon cancer. Colonoscopy screenings can prevent cancer or at least catch it at an earlier stage when it is much more curable,” he said.

During a colonoscopy, the patient is sedated and feels no pain. Most patients say preparing for the procedure is the hardest part, which includes a clear liquid diet and laxatives the day before. Others may feel uneasy about having a procedure of any kind, but physicians urge people not to let nerves deter them from getting the screening they need.

No matter what your age, it’s important to know common colorectal cancer symptoms. Most people don’t have any symptoms in the cancer’s early stages. The most common symptom is a change in bowel habits. You may notice blood in the stool, weight loss and abdominal pain or develop anemia. If you experience any of these signs, consult a physician.

Care for colorectal cancer has changed dramatically with the use of minimally invasive surgeries, according to Dr. Yavorek. “The outcomes, in terms of cancer survival, are equal to open surgery, but the length of stay and patient satisfaction are better,” he said. Results are also improving as different specialists collaborate on plans of care that may include such treatments as chemotherapy, radiation, and biologic medicines, he adds.

Dr. Llor advises everyone to speak with their doctor about screening for colon cancer. "Colorectal cancer screening saves lives, so please have your cancer screening,” he said.

Studies show that habits related to diet, weight and exercise are strongly linked to colorectal cancer risk. To minimize the risk of colorectal cancers:

  • Eat lots of vegetables, fruits and whole grains. Also, eat less red meat (beef, pork or lamb) and processed meats (hot dogs and luncheon meats), which can increase the risk of colorectal cancer.
  • Stay physically active. People who have a sedentary lifestyle may have a greater chance of developing colorectal cancer.
  • Watch your weight. Being overweight or obese increases the risk of getting and dying from colon or rectal cancer. Control your weight by eating healthier and exercising.
  • Don’t smoke. Longtime smokers are more likely than nonsmokers to develop colorectal cancer. If you are ready to stop smoking, the Smilow Cancer Hospital Tobacco Treatment Program tailors treatment to your situation and tobacco use history. To learn more or to schedule a consultation, call 203-688-1378.
  • Avoid alcohol. Studies show alcohol use is linked to a higher risk of colorectal cancer. The American Cancer Society recommends no more than two drinks a day for men and one drink a day for women.

Learn more about the Gastrointestinal Cancers Program at Smilow Cancer Hospital Care Center in Waterford

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Kidney Stone Program at L+M helps relieve the pain

Women have equated the pain to labor and childbirth. Men have described it as the worst pain of their life. What can cause such a horrible pain? Kidney stones.

Roughly one million Americans develop kidney stones each year. Kidney stones are usually found in the kidneys or in the ureter, the tube that connects the kidneys to your bladder. They are a made up of a concentration of calcium, uric acid and other substances found in urine that form into solid masses. It is these masses that create an obstruction -- causing the blockage of urine in the ureter (tube that goes from kidney to the bladder).

“A kidney stone is essentially what it sounds like: It’s a stone that forms within the kidney,” said Timothy Tran, MD, a urologist with the Kidney Stone Program at Lawrence + Memorial Hospital.

Kidney stones can range in size from a grain of sand to a ping pong ball. Many people pass small kidney stones from their bodies without any symptoms, but larger stones can be very painful as they move through the ureter, into the bladder, and out of the body. These larger stones may also need to be broken up or removed with surgery, according to Dr. Tran.

“If a kidney stone is just sitting there causing a blockage in your kidney, there is a real risk that over time as that kidney is blocked off, it’s almost as if it is being strangled. The kidney can start to lose function and gradually wither away,” he said.

How do you know if you have a kidney stone? Typical symptoms include a burning sensation when you urinate; urinating more frequently than usual; traces of blood in your urine; nausea or vomiting; and pain in the low back, abdomen or groin.

“If you take your hand and put it on your back and go just below your rib cage, that’s usually where your kidney is,” said Dr. Tran. “If you tap yourself in that area when you are having a kidney stone attack, that can be quite painful.”

When should you seek immediate medical attention for a kidney stone? "It becomes a dangerous problem if you have a fever over 100 degrees,” said Dr. Tran. “Even if you don’t have a fever but you find yourself shaking like you’re having chills, that’s another worrisome sign that there might be a significant infection going on. Similarly, if you find your pain or nausea to be unbearable, notify your doctor or seek urgent medical attention.

Diagnosis is through a urine test, blood test, X-ray, ultrasound or low-dose CT scan. If tests show a stone is small, pain medicine and drinking plenty of fluids may be enough to flush it out through the urinary tract. Should surgical intervention be necessary, the urology team at L+M offers a full range of treatment options are generally minimally invasive.

Once someone has had a kidney stone attack, their chance of recurrence is high – estimates are as high as 75 percent. And the younger you are when you suffer your first attack, the more likely you will suffer again. According to Dr, Tran, recurrence is 25 percent within the first three years after having a kidney stone and up to 50 percent after five years. The Kidney Stone Program at L + M Hospital offers comprehensive care that includes nutritional counseling to reduce the risk of developing new ones and behavior change designed to prevent recurrence.

“We provide personalized treatment that begins with sending a stone to the lab for analysis to begin to understand the cause and best treatment,” said Dr. Tran, because there are many types of stones and every patient’s situation is unique.

“Our clinic covers the whole process for a patient suffering from kidney stones,” said Dr. Tran, pointing out that ultrasound, nutritional counseling and medical treatments are provided in his office at the hospital. “In our region, we offer the only comprehensive kidney stone program in one location.”

Depending on the individual and type of stones, preventive treatment may include cutting down on red meat, organ meats and shellfish, and following a diet rich in certain vegetables, fruits and whole grains. Dr. Tran recommends limiting sugar-sweetened foods and drinks. Drinking water infused with fresh-squeezed lemon or lime juice or eating oranges will help decrease urine acidity and reduce the chance for stone formation.

“The best way to treat kidney stones is to avoid getting them,” said Dr. Tran. “The easiest way to do that is to drink plenty of water.”


BE FAST at first signs of stroke

Stroke is the fifth-leading cause of death and a major cause of disability in the United States. Thanks to the acronym BE FAST, more people are aware of some of the classic signs of stroke, including face drooping, balance problems, speech difficulty and arm weakness.

What people might not know is that a person having a stroke doesn’t have to display all of the symptoms. Any one, or a combination, can indicate a life-threatening emergency.

A stroke occurs when blood flow to the brain is reduced or interrupted. Deprived of adequate nutrients, brain cells can begin to die within minutes. Timely treatment is vital because it can help preserve brain function and potentially save a life.

Remember: BE FAST

  • B: Balance – Is the person having sudden trouble with balance or coordination?
  • E: Eyes – Does the person have sudden blurred or double vision, or loss of vision in one or both eyes without pain?
  • F: Face drooping and/or numbness on one side. Ask the person to smile.
  • A: Arm weakness – Is one arm weak or numb? Ask the person to raise both arms – does one arm drift downward?
  • S: Speech difficulty – Is the person’s speech slurred? Ask them to repeat a simple sentence.
  • T: Time to call 911

Lawrence +Memorial Hospital is certified as an Advanced Primary Stroke Center by The Joint Commission, a designation which recognizes that we provide some of the fastest and most effective treatments for stroke, including clot-busting drugs that can save patients from brain loss. The L+M Stroke Center works in collaboration with Yale New Haven Hospital’s TeleStroke program, which provides an on-staff stroke-trained neurologist 24/7 who can diagnose and administer treatment within minutes to preserve brain function in the critical early onset of stroke.


Our wayfinding app gets you where you need to go

You arrive for your medical appointment and park in a garage. But how you can you find the office? At Yale New Haven Health, there’s an app for that.

Trying to navigate a healthcare facility with multiple buildings and offices can be overwhelming. With YM-YNH Go, you can find the care you need, when and where you need it. The free wayfinding app provides a map of the hospital to your smartphone and allows you to navigate in real time.

 

Download YM-YNH Go before your next appointment to:
  • Get turn-by-turn directions from your home to dozens of Yale New Haven Health locations, including hospitals, walk-ins, emergency departments and outpatient locations
  • Drop a reminder pin at your parking space
  • Find amenities inside hospitals and ambulatory locations like dining, restrooms and ATMs
  • Search for a doctor near you
  • Find the nearest emergency departments and urgent care centers
  • Connect with your Yale New Haven Health MyChart account for video visits, online bill pay and more

The app is also available for download from Apple or Google Play.


MyChart: Your medical information in one place

MyChart gives Yale New Haven Health patients secure, online, 24/7 access to portions of your electronic medical record (EMR). There, you can see your medical history, most laboratory and test results, appointment information, medications, allergies, immunizations and other health information. You can schedule appointments with your doctor, request or renew prescriptions, pay your bill, and send and receive secure, confidential electronic messages with your doctor’s office. Sign up by using the activation code on the after-visit summary from your doctor, request a MyChart Activation Code at your next appointment or visit https://mychart.ynhhs.org and click “New User?”


Find a Doc at L+M or WH

Are you looking for a physician? Call 888-700-6543 or visit our website’s Find a Doctor feature for information on physician specialties, office hours and locations as well as insurance plans accepted. Many of our physician practices offer telehealth video visits for your convenience.


Billing questions?

Yale New Haven Health offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.