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What You Need To Know About Cervical Cancer

January is Cervical Cancer Awareness Month. Approximately 12,820 women in the United States will be diagnosed with cervical cancer this year, and nearly one-third of those women will die from cervical cancer.

The good news is that there are steps women can take to protect themselves. Cathy McAfee, Certified Registered Nurse Practitioner at Keystone Community Outreach, shares some important information about this disease.

What Is Cervical Cancer?

Cervical cancer is when cells in the cervix (the lower part of the uterus) begin to grow out of control. In most cases, this is caused by a virus called The Human Papilloma Virus (HPV). In the past, cervical cancer was one of the most deadly forms of cancer in women. However, over the last 40 years, survival rates have doubled. This is due in large part to increased use of Pap testing.

What Is Pap Testing?

Pap tests are used to find changes in the cervix, and may also be combined with HPV testing. When changes are discovered before cancer begins to develop, or when the cancer is in an early stage, the disease is much easier to treat. The earlier the cancer or pre-cancer is found, the greater chance the patient has to survive.

Most medical insurance plans cover preventative screenings such as Pap tests. If you don’t have insurance, there are programs such as Keystone Community Outreach which offer screenings at a discounted rate or for free.

Who Should Be Tested?

You should talk to your healthcare provider about whether you need to be screened, and how often. Generally, women ages 21-65 are recommended to get regular screenings. If you are older than 65, ask your provider whether or not screening is necessary for you.

You may be at a higher risk for cervical cancer with certain genetic or lifestyle factors, including if you: have a family history of cervical cancer, are a smoker, have had multiple sexual partners, have a weakened immune system and/or have taken oral birth control for five years or longer.

What Are Some Signs Or Symptoms Of Cervical Cancer?

Women who are in the pre-cancerous or early stages of cervical cancer usually have no symptoms; symptoms usually don’t begin until the cancer cells become invasive and spread into nearby tissue. This is why regular screenings are so important.

When symptoms do occur, they can include: abnormal vaginal bleeding (such as bleeding after sex, after menopause, between periods, etc.), menstrual periods which are longer or heavier than usual, an unusual vaginal discharge, and pain during sex.

These symptoms can sometimes be caused by things other than cervical cancer (such as an infection), but if you experience any of the signs above, it’s important to see a healthcare professional right away. The earlier the cancer is caught, the less time it has to advance and spread.

What Can I Do To Protect Myself?

If you are a woman who is 26 or younger you can get the HPV vaccine, which protects against most strains of the virus that can cause cervical cancer. Both girls and boys can receive this vaccine starting at age 9.

Being alert to signs and symptoms is important, but it’s better yet to take charge of your health. By being proactive, being vaccinated if possible, and having regular screenings, your chances of developing cervical cancer will be dramatically reduced.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Are You Prepared For Flu Season?

The Pennsylvania Department of Health announced on December 19 that the flu activity in the state of Pennsylvania has increased to “regional status.” However, it’s not too late to get a vaccine if you or your child is not already vaccinated.

Dr. Michael Colli, Chief Medical Officer of Keystone Health and Board-Certified Pediatrician and Medical Director of Keystone Pediatrics, shares some important information about the flu, who should get the flu vaccine, and what to do if you suspect you have the flu.

What is the flu, and what are the symptoms?

The flu is a viral infection caused by the influenza virus. It causes fever, cough, sore throat, headaches, body aches, vomiting, nasal congestion, runny nose, and fatigue. Some patients, unfortunately, can get quite ill from the flu and can have serious respiratory issues as a result. Sometimes, these respiratory issues progress to the point where patients require hospitalization for closer monitoring and support. At its worst, patients can die from the influenza virus. Every year in the United States tens of thousands of people, including several hundred children, die from complications related to the flu.

Every year there are three to four different circulating strains of the influenza virus. These strains change from year to year. This means that we typically have very little natural immunity to the flu and each winter we are susceptible to contracting influenza again. The more the strains change, the more susceptible we are. This is why getting a flu shot is so important. Each year the CDC and the vaccine manufacturers make an educated guess as to which strains of the flu will be circulating that winter, and tailor the vaccines to include these strains. Unfortunately, the four strains present in the vaccine are not always a perfect match to the strains circulating in the community each winter. However, even if all four strains are not a perfect match, two or three of the strains usually are matched well. This means that the flu shot always offers at least partial protection to the circulating strains of flu.

Who should get a flu shot?

Everyone 6 months and older is recommended to get a flu shot.

Why is getting the shot important for children?

Young children are at highest risk of severe complications from the flu. Therefore, they should be the highest priority to receive a flu vaccine. Due to their age, children have little to no natural immunity to the flu. Their immune systems are naturally not as robust as the immune system of an adult. Therefore, when they contract the flu, they can get quite ill. This holds true of any infectious disease, not just the flu. However, because we have a vaccine that can protect our children from the devastating complications of the flu, there should be no reason for us not to take advantage of it.

Why is it important for adults?

In addition to infants and young children, the elderly are the next highest-risk segment of the population for complications from the flu. Like children, the elderly also have relatively weakened immune systems, which can result in severe life-threatening complications from the flu. Although young adults rarely manifest severe complications from the flu, it usually causes enough symptoms to result in time off of work. In addition, many adults have close contact with young children or the elderly. By getting a flu shot, young adults reduce the chance of contracting the flu and therefore protecting their loved ones and close contacts.

What other ways can you reduce your chance of getting the flu?

By far and away the best means of protecting yourself from getting the flu is getting an annual flu shot. Frequent handwashing, including the use of alcohol-based hand sanitizers, and avoidance of people who are showing flulike symptoms can help reduce, but not eliminate, the likelihood of transmission.

If you are experiencing symptoms, when should you or your child see a doctor?

Severe symptoms from the flu, such as difficulty breathing, persistent vomiting, significant lethargy or change in mental status warrant a doctor visit. Because severe complications from the flu can happen, monitoring vital signs, certain labs, and blood oxygen levels, can help determine which patients may require hospitalization.

What are some ways to help someone with the flu feel better?

Measures like running a humidifier, saline nose sprays, over-the-counter pain and fever reducers like acetaminophen or ibuprofen, rest, and fluids can help make people with the flu feel somewhat better. Occasionally, an antiviral medication called Tamiflu can be prescribed that can slightly shorten the duration of symptoms. Most people recover from the flu eventually, without requiring prescription medications. Because the flu treatments are so limited, however, prevention of flu through vaccination is paramount.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.


Could Your Child Benefit From Occupational Therapy?

If you have a young child, it’s important to make sure they are on track with completing proper developmental milestones. If you notice your child has delays, is not able to do things that most children of the same age can, or is having behavioral problems, you should talk to his or her doctor. One option your healthcare provider may recommend is occupational therapy.

Emily Mason, Occupational Therapist at Keystone Pediatric Therapies, shares information parents should know about occupational therapy, and who might benefit.

What is occupational therapy?

Occupational therapy focuses on helping patients with delays, impairments or disabilities develop the skills necessary to lead full and independent lives. This encompasses all of the activities from when they wake up in the morning to when they go to bed at night. Occupational therapy can help patients improve skills such as morning and nightly routines, school, play, and social interactions. Specific skills they can work on include motor, cognitive, social, sensory processing, vision, reflex integration and vocational skills.

Who can benefit from occupational therapy?

Kids and adolescents of all ages and diagnoses can benefit. Any child who is struggling with daily activities, social skills, behavioral issues, birth defects, developmental delays or other difficulties resulting from an injury or illness could benefit. Some common diagnoses which are served by occupational therapists include: Autism, ADD/ADHD, developmental delays and disorders, social skills dysfunction, Asperger Syndrome, Down Syndrome, spina bifida and others.

What are some achievements that patients can reach through occupational therapy?

Some common goals for patients in occupational therapy include: increased independence, increased participation and engagement in daily activities, improving self-regulation, improving academic success, and gaining the play, cognitive, social, and motor skills needed to engage in daily activities.

What are some types of activities that might be included in a therapy session?

Activities vary based on individual patient goals. Some commonly used activities include: obstacle courses, social games, pretend play (doctor, restaurants, grocery stores, etc.), vocational activities (cooking, laundry, etc.), job readiness skills (practice interviews, etc.), card games, craft projects, STEM (science, technology, engineering, math) activities and social group activities.

What are some signs that your child might benefit from occupational therapy?

Children who have difficulty with any of the following may benefit from occupational therapy services: regulating their emotions, frequent poor behavior or meltdowns, trouble playing and/or interacting with others, struggling with motor skills and coordination (buttons, zippers, etc.) struggling in school (reading, spelling, handwriting, etc.), difficulty adapting to changes or challenges, clumsiness (such as frequent tripping) and struggling with daily living activities (dressing, feeding, tooth brushing, bathing, toileting, etc.).

If you notice any of these behaviors in your child, contact his or her doctor as soon as possible. With proper treatment, occupational therapy services can have a big impact on helping your child reach their full potential.

For more information about Keystone Pediatric Therapies, click here.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Keystone Health Receives Patient Health Medical Home Level 3 Recognition


 NCQA Patient-Centered Medical Home™ standards emphasize enhanced care through patient-clinician partnership

The National Committee for Quality Assurance (NCQA) announced that Keystone Health of Chambersburg has received NCQA Patient-Centered Medical Home (PCMH) Recognition for using evidence-based, patient-centered processes that focus on highly coordinated care and long‐term, participative relationships.  Keystone Pediatrics, Keystone Internal Medicine, Keystone Family Medicine and Keystone HIV/STD Services are all recognized as NCQA Patient-Centered Medical Home sites.

The NCQA Patient-Centered Medical Home is a model of primary care that combines teamwork and information technology to improve care, improve patients’ experience of care and reduce costs. Medical homes foster ongoing partnerships between patients and their personal clinicians, instead of approaching care as the sum of episodic office visits. Each patient’s care is overseen by clinician-led care teams that coordinate treatment across the health care system. Research shows that medical homes can lead to higher quality and lower costs, and can improve patient and provider reported experiences of care.

“NCQA Patient-Centered Medical Home Recognition raises the bar in defining high-quality care by emphasizing access, health information technology and coordinated care focused on patients,” said NCQA President Margaret E. O’Kane. “Recognition shows that Keystone Health has the tools, systems and resources to provide its patients with the right care, at the right time.”

To earn recognition, which is valid for three years, Keystone Health demonstrated the ability to meet the program’s key elements, embodying characteristics of the medical home. NCQA standards aligned with the joint principles of the Patient-Centered Medical Home established with the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics and the American Osteopathic Association.

Dr. Michael Colli, Chief Medical Officer at Keystone Health said, “The process of obtaining NCQA PCMH level 3 certification has been transformative for our organization. In order to achieve this certification, we evaluated and re-engineered all of our organizational standards and processes to ensure that they truly meet the needs of our patients. As a result, we believe that we can offer a patient experience that is second to none. Keystone Health has always provided unbiased, compassionate patient care to this community, regardless of ability to pay. By attaining NCQA PCMH certification, we now have raised our own bar and deliver the highest quality healthcare around and really listen to our patients and how they want healthcare delivered in the 21st  century. As the only NCQA PCMH certified organization in Franklin County, we are well-positioned to be the primary care provider of choice for our community.”

To find clinicians and their practices with NCQA PCMH Recognition, visit

Employee Spotlight — Nancy Hernandez Charlotten

The Keystone Health Employee Spotlight for December shines on Nancy Hernandez Charlotten, of Keystone Internal Medicine!

Nancy began her career at Keystone in August 2008 when she was hired as a temporary staff member through Aerotek. By the end of the year, she was asked to remain at Keystone as a permanent employee. Since then, she has been named the Lead Medical Records Technician/Translator.

Nancy, who used to live in Puerto Rico, brought a lot of experience to Keystone.

“I worked at a hospital in Puerto Rico for 14 years, and I wanted to stay in the medical field,” she said. “It makes me proud to be able to help people and encourage them to stay healthy. I also love translating and learning from the doctors and patients.”

On a typical day, Nancy oversees the Medical Records process, translates for patients, and assists in any other ways she can.

“I like to come to work with a smiling face to bring cheer to my co-workers,” she said. “I do my work and am available to anyone who needs help in the office. I’m proud to be part of the Keystone family.”

People who know Nancy may be surprised to find out that she wasn’t always as friendly and outgoing as she is now.

“I grew up between New York, New Jersey, and Puerto Rico,” she said. “I used to be so shy and quiet that I didn’t have any friends until I entered high school. I found true friends there, and we are still best friends today!”

When she’s not at work, Nancy enjoys keeping busy and healthy with activities like walking and Zumba. She says she also enjoys sleeping, vacationing, and going to the movie theater.

Thank you, Nancy, for all that you do for Keystone and our patients!

How To Protect Yourself From Antibiotic Resistance

While antibiotics save lives every day, antibiotic resistance is one of the most urgent threats to the public’s health. Dr. Raghavendra Tirupathi, Medical Director of Keystone Infectious Diseases, shares important information about antibiotic resistance and what you can do to protect yourself.

Why is antibiotic resistance an important topic?

When you take an antibiotic, some of the bacteria in your body can build an immunity to the drug. These bacteria can then multiply, and cause your body to no longer respond to the antibiotic. This leads to 23,000 deaths annually in the United States alone. When a patient needs antibiotics, the benefits outweigh the risks. However, it’s important to make sure you use them correctly.

When it is OK to take antibiotics?

Antibiotics aren’t always the answer. They are only used for treating certain illnesses caused by bacteria. If you have an ailment caused by a virus, antibiotics are not useful and will not help you feel better. Some of these illnesses include colds and the flu – even if your mucus is thick, yellow or green. Bronchitis, sinus infections and ear infections sometimes require antibiotics, but a prescription is not always necessary. Your healthcare provider can assess whether you need antibiotics, and if you don’t, give you advice about how to feel better while your body fights off the virus naturally. When antibiotics aren’t needed, they won’t help you but can hurt you.

What are some ways to feel better when I don’t need antibiotics?

Getting rest and drinking plenty of fluids is always important when you’re sick. For upper respiratory infections (including sinus infections, ear infections, colds and bronchitis), tips include: using saline nasal spray or drops, avoiding smoking and secondhand smoke, breathing in steam from a hot bowl of water or shower, taking an over-the-counter pain reliever or decongestant (make sure to follow directions carefully) and a warm, moist cloth over aching sinuses or ears.

For sore throats, you can drink warm beverages, gargle with salt water, use sore throat spray, and suck on ice chips, popsicles or lozenges (for those not at risk of choking). For coughs, humidifiers or vaporizers, breathing in steam, lozenges and honey may provide some relief. (Never give honey to a child under 1 year of age.)

What can I do to protect myself from antibiotic resistance?

If your illness does require antibiotics, make sure you take them exactly as prescribed. This includes finishing the entire dosage, even if you are feeling better. Your healthcare provider should prescribe you the shortest duration of antibiotics necessary. You should talk to your doctor if you have any questions or develop side effects to your antibiotics, including diarrhea, as it could be a sign of infection.

It’s important to never share antibiotics, to keep yourself and others healthy by practicing good hygiene (washing your hands frequently, covering coughs, staying home when sick, etc.), and getting recommended vaccinations, including the flu vaccine.

Everyone can help improve antibiotic prescribing and use. Improving the way healthcare providers prescribe antibiotics, and the way we take antibiotics, is imperative. Proper usage will help us keep healthy now, help fight antibiotic resistance, and help make sure that these life-saving antibiotics will be available for future generations.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

What You Should Know About Antibiotic Safety

This is Antibiotic Awareness Week. While antibiotics save countless lives every year, using them improperly can have serious consequences. Dr. Raghavendra Tirupathi, Medical Director of Keystone Infectious Diseases, shares some important information everyone should know about antibiotic safety.

What is an antibiotic?

Antibiotics are medicines that help to stop infections caused by bacteria. They do this by killing the bacteria, or by keeping them from reproducing. Penicillin, one of the most widely-used antibiotics, was discovered by Alexander Fleming in 1928. This event revolutionized the treatment of many life-threatening infections. Subsequent discoveries of antibiotics have made organ transplants and cancer treatment possible and have made surgeries less risky. However, antibiotics only treat bacterial infections – they cannot treat infections caused by viruses.

What is antibiotic resistance?

Antibiotic resistance is usually due to excessive use of antibiotics. When antibiotics are used incorrectly, bacteria can change or adapt in a way that makes the antibiotics ineffective.

Why should I care about antibiotic resistance?

The ever-growing problem of antibiotic resistance leaves us with fewer effective antibiotics to treat deadly infections. Many of the modern medicines we use today may eventually become obsolete. This has the potential to turn even minor infections deadly. In the United States, antibiotic resistant bacterial infections lead to 23,000 deaths and more than 2 million illnesses annually.

What are the causes of antibiotic resistance?

Some of the main causes of antibiotic resistance are: the overprescribing of antibiotics, patients not taking antibiotics as prescribed, patients not completing their antibiotic course, poor infection control in hospitals and clinics, unnecessary antibiotic use in agriculture and poor hygiene and sanitation practices.

How do I know if I need an antibiotic?

Your doctor will be able to decide whether an antibiotic is necessary to treat your condition. Some common illnesses are caused by viruses, and antibiotics will not be helpful.

Some common conditions that are caused by bacteria and do require antibiotics are: strep throat, urinary tract infections and whooping cough.

Some common conditions that may require antibiotics are: sinus infections and middle ear infections.

Some common conditions that are caused by viruses and do not require antibiotics are: common colds, runny noses, bronchitis or chest colds in otherwise healthy children or adults, the flu and sore throats (that are not strep).

In the next article, I will discuss steps you can take to help prevent antibiotic resistance.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.

Give Thanks

This holiday season, we’re on a mission to say thank you to our employees for making a difference in people’s lives every day!

Maybe you have a story you could share with us: Has one of our doctors, nurses, or another staff member made a difference in your life? Do you want to say thank you to a receptionist who always has a great attitude? Has one of our employees gone above and beyond their job requirements to help you? Maybe an entire office always gives you a great experience.

We want to hear from you!

Please send your thank you story to, and we will pass it along.

If you prefer to mail a thank you note, you can send it to:

Keystone Executive Office
22 St. Paul Drive
Suite 200
Chambersburg, PA 17201

If we use your story in future advertising efforts, we will remove identifying information, such as your last name.

Thank you for your help!

Employee Spotlight — Erin Potteiger

The Keystone Health Employee Spotlight for November shines on Erin Potteiger, Certified Occupational Therapy Assistant at Keystone Pediatric Therapies!

Erin began working at Edlantis Achievement Center in October 2015. In April of 2016, when Keystone acquired Edlantis and renamed the office Keystone Pediatric Therapies, Erin became part of the Keystone family.

“There is such a friendly atmosphere working at Keystone, and everyone in the office is like family,” Erin said.

“I absolutely love working with kids and helping them work towards their goals for their daily, functional tasks through various games and activities. It’s so rewarding to see the kids accomplish and meet goals and is often amazing to see how far each of the kids has come. I’ve built a rapport and a bond with each of the kids that I treat and their families, and I always try my best to do everything I can to help them achieve their goals.”

Erin begins her workday at 8 a.m. and clocks out at 6:30 p.m. In the hours between, she provides treatment sessions for between seven and 11 patients.

“After each treatment session, I take time with the child’s parent to discuss how their child worked during the session as well as skills that were addressed,” she said. “Many of the skills that are addressed during treatment sessions include problem solving, following directions, self-regulation, planning and organization, as well as various motor skills such as fine, gross, visual motor and motor planning. Currently, I am supervising an Occupational Therapy Assistant student from Penn State Mont Alto and will be working with her until the beginning of December.”

When she’s not at work, Erin enjoys camping with her family at Raystown, backyard campfires, and traveling. Some places she has traveled to include Wyoming, Colorado, Montana, several Hawaiian islands, Niagara Falls, and Gatlinburg and Pigeon Forge in Tennessee.

“I really enjoy living in the Chambersburg/Franklin County area because I like how small each surrounding town is and I truly enjoy the country side,” she said. “I live in Shippensburg, PA with my husband, Brandon and our Yorkie Poo, Gracie. I have been married for two years and we are currently expecting our first baby, which we are very excited about!”

Thank you, Erin, for all that you do for Keystone and our patients!

What To Do When Your Child Has A Cold

As children return to school, an unwelcome guest visits many families – the common cold. Dr. Arnauld Oreste of Keystone Pediatrics Waynesboro shares what you need to know about helping your children treat and prevent the common cold.

What are the usual symptoms?

Sneezing, nasal congestion, a runny nose, sore throat, cough, low grade fever and headache often accompany a cold.

How can I help my child feel better while recovering from a cold?

Make sure they drink plenty of liquids as hydration helps fight off the cold. If your child is old enough to drink warm liquids such as tea and soup broth, these may soothe sore throats and help loosen nasal congestion. Using a humidifier may also help.

Topical saline may provide nasal relief. In infants, topical saline is applied with saline nose drops and a bulb syringe. In older children, a saline nasal spray or saline nasal irrigation (such as a squeeze bottle or neti pot) may be used. It’s important that saline irrigation be prepared from sterile or bottled water; it’s possible for serious infections to occur from using tap water.

If your child is twelve or older, over the counter decongestants may be helpful. These products should not be used on younger children, as their bodies may not be able to properly process the medication.

Low-grade fevers may occur during the first few days of the illness. If the fever is causing your child discomfort, acetaminophen may be helpful for children older than three months, or ibuprofen for children older than six months.

How can I help them stop coughing?

While coughing can be irritating, it plays an important role of clearing secretions from the respiratory tract. I suggest coughs be relieved with hydration and warm fluids, honey (in children older than one year), or cough lozenges or hard candy in children whom are not at risk for choking on them.

How long does a cold last?

In infants and young children, symptoms are usually worse on the second or third day of illness, and then gradually improve over 10 to 14 days. The cough may linger, but should steadily resolve over three to four weeks. In older children and adolescents, symptoms usually clear in five to seven days, though it may take longer in those with lung disease or who smoke cigarettes.

When should my child see a doctor?

If symptoms worsen or last longer than noted above, your child has difficulty breathing or swallowing, and/or has a high fever or a cough that doesn’t go away, you should seek medical attention. These could be signs that the cold has developed into something more serious, such as pneumonia or pertussis.

How can colds be prevented?

The best ways to prevent spreading or catching a cold are frequent handwashing and avoiding touching one’s mouth, nose and eyes. Disinfecting surfaces with products such as Lysol may help decrease the transmission of viruses.

There is not an immunization to prevent the common cold, but there are immunizations to prevent some of the viruses that can cause similar effects. Yearly flu vaccines are recommended for all people older than six months.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.