The Keystone Health Employee Spotlight for May shines on Geetha Potineni, Network Security Administrator in our Information Systems Department!

Geetha started working at Keystone in January 2016 after completing her master’s degree in Computer Science.

“I was in search of a job in the area when an opportunity became available at Keystone,” she said. “My husband was already working for Keystone and I had heard many great things about the organization, so I was naturally excited to become a part of it.”

Geetha’s daily job responsibilities include checking on the servers and making sure they are backed up, monitoring computer systems and servers for potential threats and preventing them from happening, responding to threats when they do happen as part of the IT team, and maintaining logs for compliance. She can also be found helping staff through the Keydesk when they encounter issues with their computers, logins, websites, emails, pagers, etc. and also provides IT security awareness training to new employees and providers.

“I enjoy every aspect of my job,” Geetha said. “As a Network Security Administrator, I am responsible for continuous monitoring of some of the IT systems and servers and it gives me a sense of pride when I find something critical early and can address it in time so patient care is not interrupted.”

She’s also glad to take part in Keystone’s overall goal.

“I’m proud to be part of Keystone Health, which is driven by the mission of providing access to healthcare for everyone, irrespective of one’s ability to pay for the services.”

In her free time, Geetha keeps busy with her family life.

“I live in Greencastle with my husband, Venkat, who is a Pediatrician at Keystone, and our two daughters, Sindhu and Shriya. My daughters keep me busy, but I love to cook and travel, and I run whenever feasible.”

While she and her husband are not Franklin County natives, they are glad they chose this area to raise their family.

“Franklin County is really beautiful, especially during spring,” she said. “Also, neither I nor my husband likes a long commute to work, so we both enjoy shorter commutes and the area’s relatively slow-paced lifestyle. Its proximity to Washington D.C is also another thing that we love.”

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

We hope you will join us on May 28 for an informative discussion on mental wellness and self-care by Dr. Jagdeep Kaur! Light refreshments will also be provided. Don’t forget to RSVP as space is limited.

While most parents are diligent about taking their children to the doctor for routine medical visits, many people don’t treat their children’s teeth with the same importance. Developing a proper oral hygiene routine, including regular visits to the dentist, is one of the most important habits parents can pass on to their children to help them have healthy teeth for life.

Dr. John Palm of Keystone Dental Care shares some information about how to properly care for babies’ and children’s teeth and how to prepare for their first dental office visit.

How and when should parents begin caring for their baby’s teeth?

Begin cleaning your baby’s mouth during the first few days after birth by wiping the gums with a clean, moist gauze pad, teeth wipes or washcloth. Gently wipe his or her gums after each feeding.

For children younger than 3 years, start brushing their teeth as soon as they begin to come into the mouth by using fluoride toothpaste in an amount no more than the size of a grain of rice. Brush teeth thoroughly twice per day with a small, soft-bristled toothbrush or finger brush. Supervise children’s brushing to ensure that they use the appropriate amount of toothpaste and remind them not to swallow the toothpaste. When your child has two adjacent teeth that touch side-by-side, you should begin cleaning between his or her teeth daily with flossers.

Introduce a pea-sized amount of fluoridated toothpaste for children 3 to 6 years of age. Do not do this until the child is old enough to spit out the toothpaste after brushing. Use only the recommended amount of toothpaste and tell your child to spit out—not swallow—the toothpaste.

Until you’re comfortable that your child can brush on his or her own, continue to brush your child’s teeth twice a day with a child-size toothbrush and a pea-sized amount of fluoride toothpaste. Allow the child to watch you brush, and follow the same brushing pattern to minimize missed spots. Typically around age 8, most children are able to brush on their own with minimal supervision.

Prevent baby bottle tooth decay: Don’t give children a bottle of milk, juice or sweetened liquid at bedtime or naptime. Don’t allow children to walk around with a sippy cup filled with sugary beverages all day long. Encourage water between meals, and limit milk and other drinks that may contain sugar to mealtime.

Avoid foods and treats that increase tooth decay: hard or sticky candies, gummy fruit snacks, multi-vitamins that are high in sugar and sweetened drinks and juice. Offer fruit rather than juice; the fiber in fruit tends to scrape the teeth clean, whereas juice just exposes the teeth to sugar.

When should the first dental appointment be scheduled?

The American Dental Association, American Academy of Pediatric Dentistry, and American Academy of Pediatrics all recommend that the first dental visit should occur within six months after the baby’s first tooth appears, but no later than the child’s first birthday. Baby teeth are vulnerable to tooth decay from their very first appearance, on average between six months and one year of age. Being proactive about your child’s dental health today can help keep his or her smile healthy for life. It is important to have his or her teeth screened by a dental professional at medical well-child visits. This service is offered at both Keystone Dental and Keystone Pediatrics Chambersburg.

What will be done at the first dental appointment?

Most initial office visits are to help acquaint the child with the dental professional. The first visit usually lasts 30-45 minutes. During the visit, you will be seated in the dental chair with your child on your lap if your child isn’t able to — or doesn’t want to — sit in the chair alone. The dentist will check the teeth, jaws, bite, gums and oral tissues to monitor growth and development. Once the exam is over, the dental professional will gently clean the teeth, which includes polishing teeth and removing any plaque, tartar and stains. The dentist will give you tips for good oral hygiene practices for your child’s teeth and gums. At this time, the dentist can provide or recommend information on baby bottle tooth decay, infant feeding practices, teething, pacifier habits, and finger-sucking habits.

If you have dental anxieties, be careful not to relate those fears or dislikes to the child. If your child cries a little or wiggles during the exam, don’t worry. It’s normal, and your dental team understands this is a new experience for your child.

How can parents prepare their child for their first dental visit?

Start early! To get your child ready for the visit, talk to him or her about what’s going to happen and be positive. Have your child practice opening his or her mouth to get them ready for when the dentist counts and checks their teeth. Reading books or watching videos about first dental visits may help your child be less fearful and more confident. Explain why it is important to go to the dentist. Build excitement and understanding.

Moms and dads can prepare, too. When making the appointment, it can’t hurt to ask for any necessary patient forms ahead of time. It may be quicker and easier for you to fill them out at home instead of at the office on the day of your visit.

Make a list of questions as well. If your child is teething, sucking his or her thumb or using a pacifier too much, your dentist can offer some advice.

Tips for a great visit

Be sure to schedule all dentist appointments for times when your child will be comfortable and in a good mood. Don’t schedule an appointment during naptime. Instead, pick a time your child is usually well-rested and cooperative. Make sure your child has had a light meal and brushes their teeth before their appointment so they won’t be hungry during their visit.

Think of the appointment as a happy and fun experience. If your child becomes upset during the visit, work with your dentist to calm your child. You’re on the same team!

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.

Monica with her sons Jaxson and Abel.

The Keystone Health Employee Spotlight for April shines on Monica Heinbaugh, Lead Licensed Practical Nurse at Keystone Pediatrics Chambersburg!

Monica began working at Keystone in 2001. She had previously worked as a night-shift nurse for a year and was looking for a change that would allow her to have daytime hours without working weekends and holidays.

Almost 18 years later, Monica still enjoys her role at Keystone. She works in dual positions – part-time as Dr. Michael Colli’s nurse, and part-time fulfilling administrative duties.

“I get to work with the best family I could ask for,” she said. “And I love watching the families we see grow up. I have met some life-changing people here and I am so grateful!”

Monica’s job involves a variety of duties each day. When she’s not with Dr. Colli taking care of patients, she keeps busy with other responsibilities, including giving vaccines, doing the nursing schedule, doing vaccine inventory and management, charting, and attending meetings.

When asked about what makes her proud to work at Keystone, helping patients is at the top of Monica’s list.

“Seeing some patients who I remember as babies now graduating and becoming adults, and some becoming parents themselves makes me proud,” she said. “I like being able to help patients, especially kids who can’t help themselves and offering services, medical care, and education to those in need and knowing they are leaving with more than they came with.”

Monica was born and raised in Chambersburg and is now raising a family of her own here. She has two boys with her husband Brad – Jaxson, 7, and Abel, 2. Outside of work she keeps busy with trying new DIY projects, enjoys spending time with friends and family, and with her sons.

“These boys keep me on my toes,” she said. “We have soccer and baseball and love being outside!”

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

March is Colorectal Cancer Awareness Month. Also known as colon cancer, this disease is one of the most commonly diagnosed cancers and is the second leading cause of cancer-related deaths in Pennsylvania and the United States.

The good news is, many of these deaths can be prevented by being proactive. Gregory Gibson, Certified Registered Nurse Practitioner at Keystone Internal Medicine, shares information about the disease, including what signs to look for and what testing options are available, in today’s Take Care article.

What is colorectal cancer?

Colorectal cancer (CRC) is a common and potentially fatal disease. Cancers are cells that overgrow and begin to invade other parts of the body, and this is a cancer that affects the lower part of the digestive tract. There are nearly 150,000 new cases reported each year with approximately 51,000 deaths yearly from this disease. This cancer can affect both sexes but it does affect men more than women. Environmental and hereditary factors are both contributors to a person’s risk for colorectal cancer.

What are some warning signs and symptoms?

Signs of colon cancer include changes in bowel habits such as diarrhea or constipation or other changes that last for more than a month. Bleeding from your rectum or blood in your stool is another possible sign of CRC. Other symptoms can include persistent abdominal pain or a feeling that you cannot completely empty your bowels when you go. Weakness, fatigue, unexplained anemia and unexplained weight loss may also occur but are less specific signs.

Who should be tested, and what testing methods are available?

The United States Preventive Services Task Force recommends that everybody over the age of 50 should be tested for colorectal cancer, and screening should continue until at least age 75. The US Cancer Society has suggested that screening should begin at age 45. People with a family history of colorectal cancer, inflammatory bowel disease (ulcerative colitis or Crohn’s disease), history of radiation treatments to the abdomen or pelvis, Lynch syndrome or familial adenomatous polyposis should consult with their primary care provider to see if screening should begin sooner.

There are several different options for screening of colorectal cancer. There are multiple stool-based tests that may be performed in the privacy of your own home such as FIT, FIT-DNA, and gFOBT. These tests need to be performed every year except for the FIT-DNA which may be performed every one to three years. These methods offer the advantage of not having to have any anesthesia and not requiring bowel preparation before being performed. Patients may also have a sigmoidoscopy performed every five years or colonoscopy performed every 10 years. Advantages of these tests are that they have to be performed less often, and during the screening some issues can be addressed without additional procedures. The disadvantages of these tests are that they require anesthesia and bowel prep before the procedure.

Why is it important to not put off screening?

The reason to not put off screening is because colorectal cancer does not always have signs and symptoms in the earlier stages or when it is just a precancerous polyp. Screening tests allow providers to find these abnormalities earlier and treat them before they have a chance to spread to other parts of the body. It is a missed opportunity to not screen for this cancer because we cannot screen like this for every disease. Screening has proven to be very effective over the past few decades at decreasing mortality rates from colorectal cancer.

Even if the screening may seem unpleasant to you, I assure you it is a much better alternative of finding you have colorectal cancer because you have not had any screening. Some of my own family and friends are still here with us today because of early detection. This allowed them to begin treatment early and they have overcome this diagnosis. They are still with us 20 years later.

What are the benefits of early detection?

If colorectal cancer is detected before it spreads to other parts of the body, the survival rate over a 5-year period is 90%. The mortality rate of this disease has decreased steadily since the 1980s partly because of the early detection of cancer through screening. Colonoscopies in particular are very useful. Not only do they detect colorectal cancer but they can see and remove growths, and biopsy them before they cause problems. The mortality rate for colorectal cancer is much lower when detected early.

We do preventative maintenance and screening on our cars, so why would we not do it for ourselves? Prevention is always preferable treatment. People need to play an active role in their healthcare. Your provider can make suggestions but unless you are an active participant in your healthcare and participate in screenings, disease can only be reacted to instead of prevented.

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.

Join us on Thursday, March 28, to get some FREE fruits and veggies!

For pregnant women, by the time the third trimester arrives many changes have already taken place. As the body grows and prepares to give birth, more changes are on the way – both physically and mentally.

Dr. Radha Rani Padhy of Keystone Women’s Care shares information about what women can expect during the last trimester of pregnancy, and when they should seek medical advice.

What kind of physical changes start to happen during this trimester?

During this trimester, the uterus gradually expands from the pelvis up to the rib cage. This can cause tremendous physical pressure and discomfort. In addition to lower back pain, there may be pressure on the sciatic nerves causing pain, tingling or numbness down the legs. Finding a comfortable position to sleep may become challenging. The best position is lying on the side, preferably the left side to allow for maximum blood flow. Body pillows may be helpful in maximizing comfort.

Hemorrhoids may develop, which are varicose veins in your rectum, and swelling of the fingers, face and ankles may become more evident. The skin across the abdomen may become dry and itchy from the stretching. Pink, reddish or purplish indented streaks may become visible reflecting stretch marks.

False contractions, known as Braxton Hicks contractions, may become more frequent. These are irregular and sporadic contractions. As unpleasant as the physical symptoms become, the highlight will be consistent movement of the baby. Get to know your baby’s patterns of movements, including the frequency and intensity. There may be a slight decrease in activity in the last few days before birth as the baby descends further down in the pelvis in preparation for delivery.

What kind of emotional changes may be taking place?

By this point, the fatigue of pregnancy may be overwhelming, leading to growing eagerness towards the estimated due date. Many women also experience feelings of apprehension about the birthing process. A good way of overcoming this is to talk with others who have had positive birth experiences. If you’re frightened and anxious during labor, your birthing experience may be more difficult. Educating yourself and asking questions about the process can greatly ease your qualms.

What are common tests that will be run during this time?

Prenatal visits become more frequent during this trimester. After 28 weeks of pregnancy, visits occur every two weeks and visits will be scheduled weekly after 36 weeks. These appointments are important as they include checking the position of the baby to see whether the head or the buttocks is facing the down towards the mother’s pelvis.

A group B strep test is performed, which is a swab of the vagina and rectum. Group B strep is a bacteria that is normally found in the vagina or rectum, but it can cause a serious infection for the baby if there is exposure during birth. If you test positive for group B strep, you will require antibiotics during labor.

If you pass your due date, the baby’s heartbeat may be monitored with an electronic fetal monitor. An ultrasound may also be performed to assess the baby’s breathing, movement, muscle tone and the amount of amniotic fluid. You may also be offered an induction of labor, which involves the stimulation of uterine contractions before labor begins in order to achieve a vaginal birth. Your provider will explain in detail all the modalities of induction available and individualize a plan appropriate for you.

What do healthcare providers generally recommend when it comes to over the counter medications and physical activity during this trimester?

As stressed throughout your pregnancy, always ask your provider before starting any medications. This includes prescription and over-the-counter medications. Daily exercise is still recommended (30 minutes at moderate intensity) if there are no medical or obstetric complications. However, avoid lifting heavy weights (greater than 20 pounds) and any exercises that involve lying on your back.

What warning signs should the expectant mother be concerned about? When should she call her doctor or midwife?

Babies establish movement and sleep patterns as the pregnancy progresses. It is important to be aware of and account for these movements. If you perceive decreased fetal movement, sit down in a quiet place and count your baby’s kicks. You should count at least 10 movements within two hours. If there are less than 10 kicks or you don’t feel any movement at all, call your provider immediately.

Toward the end of the trimester, it may be difficult to tell the difference between false contractions and true contractions. False contractions usually are irregular, don’t get consistently closer together, vary in length and intensity and dissipate with walking, changing positions or resting. They are mainly centered in the lower abdomen and pelvis. True contractions have a regular pattern that grow closer together, last at least 30 seconds, become longer and stronger and strengthen despite walking, changing positions or resting. They most often radiate throughout the abdomen and lower back. If you start experiencing contractions every two to three minutes lasting for one or more hours, or painful contractions with heavy vaginal discharge, call your provider immediately.

Other reasons to call your provider immediately during any trimester include: heavy bleeding or bleeding that lasts longer than a day, severe abdominal or pelvic pain (especially if accompanied by a fever or bleeding), a fever greater than 102 degrees Fahrenheit, a severe and persistent headache (especially with dizziness, faintness or visual disturbances), severe shortness of breath or chest pain, inability to urinate or painful urination, leg pain with redness or swelling, worsening swelling of the hands or feet, heavy or foul-smelling vaginal discharge and a low mood, loss of pleasure and thoughts of harming yourself or others.

What are common concerns that expectant parents have during this time?

Concerns about breastfeeding, scheduling difficulties with maternity and/or paternity leave and anxiety over becoming parents are common worries. The best way to overcome this anxiety is to be organized before the baby is born. Find a pediatrician or provider with whom you are confident and stock up on baby supplies that you will need immediately once you arrive home with your baby for the first time.

Buy a car seat as it is one of the most important pieces of equipment in the care of your baby, starting with the first ride home from the hospital. Car seats are required by law in every state. Correct and consistent use of them is one of the best ways to protect your child. You should also buy a crib as the newborn baby will spend more than half their time sleeping. When purchasing or borrowing a crib, make sure that it meets specific safety guidelines.

Fears about the birthing process are also normal. As you anticipate the day of your baby’s arrival, it becomes exciting but can also be very stressful. Knowing what to expect can help you have the most positive birth experience. Acknowledge that childbirth can be painful, so inquire about all the pain management options that are available. Address all your fears with your provider and ask as many questions as you need to be prepared. Remember that you are not alone. Childbirth can be a scary experience, but we are here to guide you through it every step of the way. As your provider, we take the utmost pride and pleasure in having a healthy mom and healthy baby.

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 expectant mothers, pregnancy is usually accompanied by many questions. While patients should always feel comfortable asking their healthcare provider about any concerns that arise, knowing what to expect can be extremely helpful in easing fears and concerns for moms-to-be.

In today’s article, Dr. Radha Rani Padhy of Keystone Women’s Care answers some frequently asked questions related to the second trimester of pregnancy.

What kind of physical changes start to happen during the second trimester?

Major physical changes occur during this trimester, and by the twentieth week the uterus grows to be behind the mother’s navel and a small protruding belly is noticeable. The expanding uterus may cause some aches and pains, lower back pain and leg cramps. It’s common to have sharp pain on one side, usually provoked by sudden movement.  This pain results from the stretching of the round ligament that attaches the uterus to the abdominal wall.

Mild contractions, a feeling of slight tightness in the abdomen, may occur with physical activity or after sex, and vaginal discharge may increase due to hormonal changes. The highlight, however, is the beginning sensations of fetal movement as “butterflies in your tummy” between 16 to 20 weeks.

What are common concerns that mothers have during this time?

Naturally, many mothers have concerns about the baby’s development. Other common concerns include fears about the labor and delivery process, adjusting to their evolving body image and rapid physical transformation and childcare both at home and when parents return to work.

What kind of emotional changes are or will be taking place?

The unpleasant symptoms of the first trimester generally have resolved by this time, thereby causing a burst of energy and an improved mood. Use this to your advantage! Be productive and tackle your “to-do” list for the baby. Now is a great time to enroll in childbirth classes, to familiarize yourself with your employer’s maternity and paternity leave policies, to shop for maternity clothes, and to research breast feeding and how to best incorporate it into your lifestyle. Breast feeding is a wonderful way to bond with your baby and has been scientifically proven to enhance your baby’s emotional well-being.

Many patients also experience forgetfulness and difficulty concentrating. There is no such thing as a “pregnancy brain” or “baby brain,” but these symptoms are normal, no matter how attentive and organized you were before pregnancy. Simply focus on the positive aspects of the pregnancy and accept all the nuances.

What are common tests that will be run during this time?

Your healthcare provider will do a complete blood count to check for anemia or low platelets and a glucose test to check for gestational diabetes. Your ultrasound will check on your baby’s development including the heart, heart rate, kidneys, bladder, stomach, brain, spine and sex organs. This ultrasound will also check the placenta, amniotic fluid levels and any markers that may indicate an increased risk of a chromosomal abnormality (Down syndrome, Trisomy 13 and Trisomy 18). You may choose to find out the baby’s gender at this time.

Fundal height (the top of the uterus to the pubic bone) is measured starting at 24 weeks, and genetic screening will be offered to assess the risk of any chromosomal abnormalities. Remember, any abnormal result on a screening test will need to be confirmed on a diagnostic test to detect if a genetic abnormality truly exists.

A Tdap vaccine will be offered to protect the newborn from pertussis, also known as whooping cough, which can be life-threatening. It is also recommended that everyone 11 years of age and older who has not previously received a Tdap vaccination be vaccinated two weeks before coming into close contact with the newborn baby. This creates a circle of protection around the baby known as “cocooning.”

What do doctors generally recommend when it comes to over the counter medications, diet and physical activity during this trimester?

Expectant mothers should continue prenatal vitamins (ensure there is at least 400mcg of folic acid), and continue with 30 minutes of moderate exercise per day as long as there are no medical or obstetric complications. Always ask your provider before starting any medications, whether they are obtained over the counter or through a prescription. Quitting smoking can be an ongoing struggle. Always ask for help as it is readily available.

Sexual intercourse is okay at any time during pregnancy as long as you do not have the following conditions: are at risk for preterm labor, have unexplained vaginal bleeding, are leaking amniotic fluid, the cervix begins to open prematurely or the placenta partly or entirely covers the cervical opening.

What warning signs should cause concern?

As the uterus expands, it starts exercising its muscle mass which may result in occasional irregular and painless contractions that feel like tightening sensations of the abdomen. However, if you start experiencing more than six contractions per hour, contractions that last two or more hours or painful contractions with heavy vaginal discharge, call your provider immediately as these may be signs of preterm labor.

Other reasons to call your provider immediately during any trimester include: heavy bleeding or bleeding that lasts longer than a day, severe abdominal or pelvic pain (especially if accompanied by a fever or bleeding), a fever greater than 102 degrees Fahrenheit , a severe and persistent headache (especially with dizziness, faintness or visual disturbances), severe shortness of breath or chest pain, inability to urinate or painful urination, leg pain with redness or swelling, heavy or foul-smelling vaginal discharge and a low mood, loss of pleasure and thoughts of harming yourself or others.

What else should expectant parents know about this trimester?

This trimester is known to be the “honeymoon” phase of the pregnancy because of the heightened energy and optimism. Enjoy this phase before the queasiness and discomforts of the final trimester begin.

Now is a good time to take a vacation and spend precious time with family and friends. Go out and experience activities that you may not be able to do once the baby comes. Above all, enjoy your sleep as it will soon be in short supply.

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.

Colorectal cancer (also known as colon cancer) is the second leading cause of cancer related deaths in Pennsylvania and the United States. If detected early, those diagnosed have a 90% survival rate. Early detection can mean the difference between life and death, and most colon cancer related deaths can be prevented.

At Keystone Health, we care about our patients and the community. That’s why, during the month of March, we are holding a Colorectal Cancer Awareness campaign to encourage those who are ages 50 -75 to get screened (in some cases people younger or older should also be screened – talk to your healthcare provider).

While colonoscopies are a very effective way to screen for colon cancer, there are other screening methods available. In many cases, colorectal cancer can be screened by using a simple at-home kit that can be completed in the privacy of your home and mailed to the lab in a self-addressed stamped envelope.

For more information on screening or to schedule an appointment to be screened (including take-home kits) please call Keystone Family Medicine at (717) 709-7999, or Keystone Internal Medicine at (717) 709-7970.

To read an article about colorectal cancer by Keystone Internal Medicine’s Dr. Kerry Whitelock, including what signs and symptoms to look for, click here.