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Keystone Foot and Ankle Center

Keystone Foot and Ankle Center is accepting new patients! Click here to learn more.

Don’t Diet – Tips for Making Healthy Eating a Lifestyle

Dr. Rebecca Patterson

In America, healthy eating is not a top priority for most people. The vast majority of Americans are carrying extra weight, and even those who are in a healthy weight range often don’t have the best eating habits. A poor diet can contribute to a variety of health conditions including high blood pressure and cholesterol, heart disease, stroke and even some cancers.

In today’s article, Dr. Rebecca Patterson of Keystone Family Medicine gives some tips for avoiding diets and making healthy eating a part of your everyday lifestyle.

What’s wrong with dieting?

I don’t recommend traditional dieting as there are no quick magic fixes. Most diets promise rapid results by eliminating food groups or having rigid rules that will not be maintainable long-term. Instead, I encourage my patients to make healthy eating part of their lifestyle, and to find a balance they will be able to sustain long-term and feel good about.

One eating plan that I do recommend is the Mediterranean style of eating. It is high in fruits, vegetables, fish, olive oil, nuts and whole grains, and recommends that dairy, red meat and added sugars be consumed only occasionally or in smaller amounts. There is good evidence that following the Mediterranean eating style increases longevity and helps keep inflammation controlled, which is an important part of overall health.  Another eating plan that shows great evidence for longevity and controlled inflammation is a whole-foods, plant-based diet. Studies show that 60% of chronic diseases could be prevented by diet changes that lower inflammation.

Are juices and diet sodas OK to drink?

Juice, even 100% juice, isn’t the healthiest option. Juice has concentrated sugar as the fiber has been removed from the fruit. Many juices have similar amounts of sugar as sodas. Eating a piece of fruit is a much better option than drinking a glass of juice. Diet sodas also aren’t healthy. While they may have no actual sugar, they are loaded with artificial sweeteners which spike insulin. The body has the same reaction to artificial sweeteners as it does to sugar, and the more of it you consume, the more the dopamine centers in your brain will crave it. There are also concerns about how artificial sweeteners affect the body long-term, and studies are currently underway.

No sweetened drinks are healthy, including sweet tea. Instead, opt for water or unsweetened tea. Most people are not drinking enough water. I do not recommend the water flavoring packets or liquids which are available at grocery stores as they contain artificial sweeteners. If you want to add flavor to your water, try a fruit or cucumber slice instead.

Is sugar or salt worse for you?

For most people, lowering their sugar intake is most important. Sugar has been linked to cancer, diabetes, hypertension and more. It is also highly addictive. In research, mice have shown higher levels of addiction to sugar than to cocaine.

Excess salt or sodium intake is not recommended, but unless you have heart conditions, high blood pressure or some other medical concerns it is generally not as big of a problem. However, you should still be mindful about how much salt you are eating. Don’t buy pre-salted foods, limit processed foods (which are often high in sodium) and add salt to meals after cooking instead of before.

What’s the microbiome?

The microbiome, in short, is the bacteria in our guts. This is an exciting area of research showing that proper nutrition may not only be about what we consume, but what our bodies absorb. Everyone’s body absorbs nutrition differently and can be affected by many different factors. In the future, the research that is currently underway may help us better craft eating plans specifically designed for individuals.

What should I keep in mind when trying to change my eating habits?

Healthy eating should focus on what options are available, instead of focusing on restrictions. It’s best to eat fewer foods that are processed and more whole foods that are recognizable without changing their forms. Processed foods do not give our bodies the nutrients we need, and nutrition is the most fundamental part of health and is used for everything our bodies do. Increase your intake of fiber and healthy fats (such as vegetables, fish and nuts), and decrease the amount of sugar, high fructose corn syrup, pre-packaged foods and simple carbs that you eat. (Examples of simple carbohydrates include bagels, donuts, white bread and white pasta). High fructose corn syrup, a type of added sugar, has been linked to the obesity epidemic and like sugar is highly addictive. Foods with preservatives also have a negative effect on many people, and can lead to gastrointestinal issues.

It’s important to keep in mind that it takes a long time to change your eating habits. If you are used to eating a highly-processed or sugar-filled diet, many fruits and vegetables may not taste very good to you at first. It takes a while for your taste buds to adjust, and adding them into your diet gradually may help the transition be easier. Don’t feel like you can never eat your favorite treats again. But keep them as that – an occasional treat – as opposed to eating them every day.

What if I don’t have the time or money to cook healthy meals?

We live in a culture of convenience, and finding the time to eat healthy can feel overwhelming. In today’s society, many people work long hours at multiple jobs, are busy with kids and often have little support. Most people feel they do not have enough time or energy left to prepare healthy meals. However, making small changes can make a big difference. Limiting junk food at home and replacing it with healthier options is a great place to start. Drink water instead of juice or soda and eat real fruit instead of fruit snacks. Instead of sugary breakfast cereals, try yogurt with granola and fruit (make sure you are buying low-sugar products – many yogurts and granolas have added sugars). Swap white pasta for whole-grain pasta. Instead of reaching for cookies, try veggies with hummus or an apple with peanut butter. When you buy fruits or vegetables, it’s helpful to cut them into bite-sized pieces that same day so they are easy to take on-the-go.

As a working mom myself, I find it helpful to plan my meals for the week ahead of time, and to set aside a specific time each week to cook. Those meals can then easily be reheated for a quick, healthy dinner. Allowing your children to be part of this process may encourage them in your new habits. Let them pick which vegetable you’ll have, or assist with simple cooking tasks.

If money is tight, it can be extra tempting to opt for a cheap drive-through meal instead of one with fresh ingredients. However, you don’t have to spend a lot of money to eat healthy foods. Watch for good deals at the store and stock up on foods that you can freeze or can. When you have a day off, cook a large amount of food in advance. Dinner leftovers make great lunches! Frozen fruits and vegetables are often more affordable for produce that is not in-season. For produce that is in-season, farmers markets offer good prices and allow you to support the local economy. Chambersburg has a great outdoor farmers market on Saturday mornings – North Square Farmers Market – which even offers kids tokens to exchange for free produce each week! There are other great markets in Chambersburg and our surrounding towns well, some of which offer weekday and evening hours.

Making the adjustment to healthier eating is crucial to your and your family’s wellbeing. Children often carry their childhood habits into adulthood and eat the same foods they ate growing up. Make time to enjoy your meals together (never in front of the TV), and focus on which healthy foods you really enjoy instead of those which you should limit. If you are looking for some support on your journey to eating healthier, check out a local program called Healthy Eating Adventure (www.healthyeatingadventure.org), a 28-day program which helps people transition to making better nutrition choices.

By gradually changing your eating habits and making a few good choices each day, you can have a healthier and happier tomorrow.


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.


111 Chambers Hill Drive

You may have noticed ongoing construction over the past year for Keystone Health’s newest facility. In just over a month, construction will be complete and our newest building will be open!

The 68,000 square foot building is located at 111 Chambers Hill Drive, on the corner of Norland and Fifth avenues in Chambersburg. Several of our current practices will relocate to the new site to allow for expansion so we can better serve the community.

The sites planned for relocation are:

  • Keystone Urgent Care
  • Keystone Pediatric Dental
  • Keystone Pediatric Therapies including Audiology and Speech (which will be renamed Keystone Pediatric Developmental Center)
  • Keystone Infectious Diseases, HIV/STD Services, and Keystone Community Outreach (These practices will be combined into one office named Keystone Community Health Services)
  • Keystone Administration and Billing

All offices will be open for operation on September 23, with the exception of Keystone Administration and Billing which will be in the new building on September 30.

Keep an eye out  for information about an upcoming community open house!

111 Chambers Hill Drive

Meet The Provider – Dr. David Pagnanelli Jr.

Dr. David Pagnanelli Jr. recently moved to Franklin County to join one of Keystone’s newest practices, Keystone Foot and Ankle Center. What’s not new, however, is his love of the medical field.

Dr. David Pagnanelli Jr.

As the son of a neurosurgeon and an ophthalmologist, Dr. Pagnanelli knew a career in medicine was right for him from an early age.

“I was surrounded by medicine growing up,” he said. “I’ve been spending time in an operating room regularly since I was 12 years old. My father worked pretty much around the clock. To be able to spend time with him I started to go to work with him after hours or on weekends when he got called in. I sat in on my first brain surgery when I was 12 and many after that.”

Dr. Pagnanelli chose the field of podiatry so he could be a physician with the ability to perform complex surgeries while still being able to maintain a healthy family life. He loves that this career allows him to impact the quality of life for so many patients.

“It feels great to be able to do what I consider something good every day, something that heals people, something that makes them feel better and makes a difference in their lives,” he said. “I feel very confident in my abilities. When I was in school, I could never imagine myself to be the person I am today. It truly feels surreal. Though this is just the beginning of what will hopefully be a very long and rewarding career.”

When the job opportunity arose at Keystone, Dr. Pagnanelli knew it was the right fit for him.

“I was working in private practice and spending less and less time with each patient which is what drew me to healthcare in the first place,” he said. “I began looking for a position where I could spend as much time as I needed on each individual patient. After meeting with Ms. Cochran (Keystone’s CEO) and the rest of the management team, I knew we held similar values when it came to patient care and I knew this was the right place for me and my family.”

Though new to the area, he is enjoying the change of pace that Franklin County offers.

“I like the small town feel here,” Dr. Pagnanelli said. “There are good local restaurants and I like spending time at Norlo Park. Oh, and I can’t forget the $5 hotdogs with beer cheese and bacon at Roy Pitz!”

In his free time Dr. Pagnanelli enjoys tennis, bike riding, fishing, barbecuing, and spending time with his family – his wife, Katie, their 19-month-old daughter, Rosalie, and their dog Jack.

Welcome to Keystone Health, Dr. Pagnanelli!

Dr. Pagnanelli is accepting new patients. To find out more about Keystone Foot and Ankle Center, click here.

Keystone Health Receives Joint Commission Accreditation

Keystone Health has earned The Joint Commission’s Gold Seal of Approval ® for Ambulatory Health Care Accreditation by demonstrating continuous compliance with its performance standards. The Gold Seal is a symbol of quality that reflects a health care organization’s commitment to providing safe and quality patient care.

Keystone Health underwent a rigorous, unannounced onsite review in June. During the visit, a team of Joint Commission reviewers evaluated compliance with Ambulatory Health Care Accreditation standards spanning several areas including emergency management, environment of care, infection prevention and control, leadership, medication management, and rights and responsibilities of the individual. The Joint Commission’s standards are developed in consultation with health care experts and providers, measurement experts and patients. They are informed by scientific literature and expert consensus to help health care organizations measure, assess and improve performance. The surveyors also conducted onsite observations and interviews.

“As a private accreditor, The Joint Commission surveys health care organizations to protect the public by identifying deficiencies in care and working with those organizations to correct them as quickly and sustainably as possible,” says Mark Pelletier, RN, MS, chief operating officer, Accreditation and Certification Operations, and chief nursing executive, The Joint Commission. “We commend Keystone Health for its continuous quality improvement efforts in patient safety and quality of care.”

“Keystone Health is pleased to receive accreditation from The Joint Commission, the premier health care quality improvement and accrediting body in the nation,” added Joanne Cochran, President and CEO, Keystone Health. “Staff from across the organization continue to work together to develop and implement approaches that have the potential to improve care for all the residents of our community.”

Sun and Water Safety

Dr. Erin Hannagan

With summer in full swing, this is a great time of year for families to get active and enjoy time outdoors. However, the warmer weather months do pose some potential dangers.

Dr. Erin Hannagan of Keystone Pediatrics Chambersburg shares some summer safety tips about what everyone, and especially parents, should keep in mind this time of year.

Why is sun safety important?

Sunburns are unpleasant and can be damaging to the health of the skin. Skin cancers are some of the most common cancers in the US. Most sun damage occurs in childhood, so protecting your children today will help to prevent skin cancer in the future.

What can you do to avoid sunburn?

The best way to minimize exposure to the harmful ultraviolet radiation from the sun is to stay in the shade whenever possible and wear protective clothing. Cotton clothing with a tight weave, sunglasses and hats can help protect your children from the sun. Use a sunscreen with a minimum of SPF 15 (the higher the better), even on cloudy days. Apply sunscreen 15-30 minutes before going outside. Remember to reapply every two hours or after swimming or sweating. Babies under 6 months of age should be kept out of direct sunlight.

How can sunburn be treated?

The signs of sunburn typically appear 6-12 hours after exposure, with the greatest discomfort during the first 24 hours. If your child’s burn is just red, warm and painful treat it with cool compresses and cool baths. You can also give acetaminophen or ibuprofen. If the sunburn causes blisters, fever, chills, headache or other feelings of illness your child should be seen and evaluated by his or her healthcare provider. Severe sunburn should be treated like any other serious burn.

What is heatstroke?

Heatstroke is a condition that includes fever and often decreased level of consciousness. It is caused by failure of the body’s temperature regulating mechanism when exposed to excessively high temperatures. Sometimes extensive or severe sunburn can also lead to dehydration and in some cases heatstroke. If your child faints and has a decreased level of consciousness they need to be seen immediately by their pediatrician or in the Emergency Department.

What are some water safety tips for parents?

After birth defects, drowning is the number one cause of death for children ages 1-4. To lower the risk of drowning and other water-related injuries to children, the American Academy of Pediatrics (AAP) recommends “layers of protection.” Parents should start swim lessons as soon as your child is ready. When children are not expected to be around water, barriers can help prevent tragedies during inevitable, brief lapses in supervision. Close and constant supervision is essential when children are playing in and around water (put down your phone!). Especially during parties or picnics near water, when it is easy to get distracted, assign a “water watcher” to keep eyes on children constantly.

Children should always wear life jackets when in, on or near natural bodies of water. Children who are not strong swimmers should also wear life jackets at pools. Also, be aware of water dangers other than pools. Children can drown in as little as 2-3 inches of water. Use safety gates, door locks or doorknob covers to prevent small children from going outside unnoticed. Also be ready to respond when there is trouble. Everyone should learn CPR and safe rescue techniques to respond to a drowning incident.


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.

Free Fluoride Treatments for Kids

Fluoride treatments help keep teeth healthy and strong. Keystone Health is providing them to children for free in honor of National Health Center Week!

When: Wednesday, August 7, 10 am – 2 pm

Where: Keystone Community Outreach, located at 51 South Main Street, Chambersburg, PA 17201

If you have any questions, call (717) 709-7959 or send an email to email@keystonehealth.org.

Choosing A Healthcare Provider For Your Child

After finding out a baby is on the way, or when moving to a new town, one of your top priorities may be finding a healthcare provider for your child. Having a doctor or provider that you trust and can go to with any questions or concerns is an important step in keeping your little one healthy. But where do you start?

Dr. Michael Colli, Chief Medical Officer of Keystone Health and Medical Director and Pediatrician at Keystone Pediatrics, shares tips on selecting the provider that’s right for you, and why it’s important for kids to get regular care during the first years of life.

Healthcare Provider Options

There are two types of primary care physicians who treat children. Family doctors and other medical providers at family medicine offices (such as physician assistants and certified registered nurse practitioners) provide care to people of all ages, including babies. After attending medical school, family care physicians do residency training in a variety of specialties where they learn to provide care for all ages. Some people find it convenient to have every member of the family go to the same healthcare location and/or see the same healthcare provider.

Other people prefer to have a pediatrician manage their child’s care. Pediatricians and other providers in a pediatric office specialize in treating babies, kids and teens and only see patients from birth to 18 years old. To become a pediatrician, doctors attend medical school and then complete three additional years of specialized residency training in treating children. This also includes advanced training in the care of critically ill and hospitalized children.

Regular Care Is Important

Even when your child is not sick, it is important that they see their healthcare provider regularly. Well child checks are important, and allow providers to make sure your child is growing and developing properly. Children should be seen at birth, and at ages 1 month, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years, 2 and a half years, 3 years, and then yearly after that. The earlier growth and developmental issues are identified, the earlier testing and treatment can be done which can lead to significant improvements.

Types of Visits

There are three types of appointments—well child checks, acute illness visits and behavioral evaluations. Medical providers can identify and treat many common physical illnesses and complaints, and order testing when needed. They can also evaluate your child for behavioral issues and developmental disorders such as autism spectrum disorder or attention deficit disorders. If your child needs further care from a specialist, your healthcare provider will refer you to the appropriate place.

Finding the Right Provider

If you are expecting a baby, a good way to find great care is to ask your family and friends for their recommendations. You may also consider asking your obstetrician or midwife to recommend a provider. If you are new to the area, there are many options available in Franklin County and the surrounding regions. A simple online search will yield plenty of choices. Decide whether you prefer a family doctor or pediatrician, and what offerings are important to you. Some offices provide evening or weekend hours, or an option to walk in without an appointment.

By finding a healthcare provider that is right for your child and by visiting them regularly, you will be on the right track to helping your child grow up to be a healthy adult.


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.


For more information about Keystone Pediatrics and the Chambersburg Pediatrics Walk-In Program, click here.

For more information about Keystone Family Medicine, click here.

Two Keystone Physicians Receive Honor

Two of Keystone Health’s doctors have been honored with a statewide award! Each year The Pennsylvania Medical Society selects a panel of Top Physicians under 40, and Dr. Jagdeep Kaur of Keystone Behavioral Health and Dr. Raghavendra Tirupathi of Keystone Infectious Diseases have been selected among this year’s honorees! Winners were nominated by colleagues and ultimately selected by a statewide committee of Pennsylvania Medical Society members. They will be presented with their awards during a ceremony in October. Congratulations Dr. Kaur and Dr. Tirupathi!


Dr. Jagdeep Kaur

Dr. Jagdeep Kaur, a psychiatrist with Keystone Health, is fellowship trained in addiction psychiatry. She serves as Medical Director for medication-assisted treatment of opioid use disorder at Keystone Health. Dr. Kaur is actively involved with her community, including by participating in the Franklin County Drug Taskforce. Her colleagues note her compassionate patient care for mental health and substance use disorder.

Dr. Raghavendra Tirupathi

Dr. Raghavendra Tirupathi, a practicing doctor and Medical Director at Keystone Infectious Diseases, is a fellowship-trained infectious disease physician. He has brought infectious disease care, including HIV and hepatitis management, to the community. Dr. Tirupathi plays vital a role in quality improvement projects, such as working with local hospitals to implement the meaningful use of antibiotics through antimicrobial stewardship. He is a member of the Chambersburg Borough Board of Health.

HIV – Free Testing Event & FAQs

Dr. Raghavendra Tirupathi

National HIV Testing Day is on June 27. According to the Centers for Disease Control, more than a million people in the United States are living with HIV, and one out of five HIV-positive Americans are unaware of their infection. Dr. Raghavendra Tirupathi, medical director of Keystone Infectious Diseases and the Keystone Health HIV program, says learning about HIV and how it’s acquired is the best prevention.

What’s the difference between HIV and AIDS?

HIV, or Human Immunodeficiency Virus, damages a person’s body by destroying specific blood cells which are crucial to help the body fight disease. If left untreated, HIV can develop into AIDS (Acquired Immune Deficiency Syndrome). This stage of HIV leaves person’s immune system is severely damaged and those affected have difficulty fighting disease and certain cancers.

What are some myths about HIV?

There is a lot of misinformation about this virus. People need to know that HIV is not spread by saliva, kissing, shaking hands or sharing utensils. It is not spread through insect bites, air or water. It is completely safe to have close contact with people who are HIV-positive, as long as you are not having unprotected sex or sharing IV drug needles.

How can I protect myself from HIV?

It is important to make sure you practice safe sex. HIV is transmitted through sex with either a man or woman without the use of condoms. Never share needles as HIV can also be spread through using IV drugs or having a partner who uses IV drugs. Pregnant women can pass HIV to their baby by pregnancy or through breastfeeding, so HIV-positive women need to receive extra medical care during pregnancy. When getting tattoos or body piercing, make sure you are getting them from a licensed facility as there is a potential risk for HIV if procedures are done in an unsterile way.

Do I need to be tested?

Everyone between the ages of 13 and 64 should be tested at least once in their lifetime, even if you don’t think you are at risk. For those who have had more than one sexual partner in the last six months, have a history of sexually transmitted disease in the last year or have a history of IV drug use, you should be tested at least once every year. For those who have high risk-sexual behaviors, multiple partners, have sex in exchange for money or use injection drugs, testing is recommended every three to six months.

Where can I go to get tested?

In Franklin County, free and confidential HIV testing is provided on a walk-in basis at the following places and times. No appointment is needed; you can simply walk in during business hours:

Keystone Internal Medicine at 830 Fifth Avenue Suite 201, Chambersburg from Monday – Friday 9 am – 4:30 pm

Keystone Community Outreach 455 Lincoln Way East, Chambersburg from Monday through Friday 9 am – 4:30 pm, and on Tuesdays from 9 am – 5:30 pm

The testing is very quick—it only takes a few minutes and results are ready in less than half an hour. This non-invasive test is done by simply swabbing the gums—no blood is involved. No appointment is needed; you can simply walk in during business hours.

Free Testing Event

In honor of National HIV Testing day, a free event will be held at Chambersburg Walgreen’s (949 Lincoln Way East) on Thursday June 27 from 10 am – 7 pm. In addition to free testing, counselors will also be in attendance to answer questions about HIV awareness and prevention.

Getting tested is the only way to know your status. There is help available in our community for those who are HIV positive. The Keystone Health HIV Program provides medical and support services to HIV positive individuals. If HIV is detected early and treated, you can expect a higher quality of life and a longer life


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.