DIVINE SAVIOR NEWS

Divine Savior Emergency Department Combats Ongoing Opioid Epidemic

Wisconsin is at the forefront of the nation’s opioid epidemic with the highest increase in emergency room visits for opioid overdose in the US (107% increase in 2017). Wisconsin's hospitals, particularly the emergency departments (EDs), are in a strong position to integrate new and more effective pain management treatments that are tailored to each patient’s unique pain experience.

As such, Divine Savior Healthcare is following principles put forward by the Midwest ALTO Project (alternatives to opioids) to reduce the administration of opioids in hospital EDs. Divine Savior's goal is to improve pain management for its patients and return them to a maximum quality of life, while also recognizing and controlling the inherent risks of prescribing highly addictive medications like opioids. 

Vice President of Physician Services, Dr. Michael Walters states, “Divine Savior's emergency clinicians are dedicated to understanding and responding appropriately to their patients’ physical and emotional symptoms of pain, while also taking steps to help the community combat the ongoing opioid epidemic”.

This project implements components from the Wisconsin ACEP 2018 Opioid Prescribing & Treatment Guidelines developed by the Wisconsin chapter of the American College of Emergency Physicians (ACEP) in Divine Savior's ED. These guidelines include using alternatives to opioids (ALTOs) as a first line of defense in treating patients with painful conditions before resorting to opioids.

In January 2018, the Colorado Hospital Association announced the results of a similar program that was implemented in ten EDs across the state in 2017. During the six-month pilot, the participating facilities reduced the administration of opioids by an average of 36 percent and increased the usage of ALTOs by 31 percent.

Divine Savior is very pleased to be joining this effort to reduce the opioid epidemic in Wisconsin. Emergency physician Bobby Redwood MD, MPH is working as a physician coordinator on the project.

He reminds us that, "Opioid medications have a very serious side effect profile that includes confusion, constipation, respiratory depression, and addiction. We are very proud to be combatting the opioid epidemic in the Divine Savior ED by working with our patients to find alternative therapies to this potentially dangerous class of medication".

Divine Savior is passionate about reducing opioid dependency. If you have questions about opioids or are suffering from chronic pain, talk to your primary care provider about alternatives to opioids.  Call (608) 745-4598 or visit www.dshealthcare.com for more information.

 

 

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Experiencing a dull pain in the pit of your stomach

Stomach PainGastroesophageal reflux disease, or GERD, and gallbladder disease are two very common disorders. Knowing which one you have may be trickier than you think. Symptoms may be vague, such as a “dull pain in the pit of your stomach”, making it hard for you to explain to your doctor what’s exactly going on.

At Divine Savior Healthcare, General Surgeons, Dr. Eric Anderson and Dr. Joshua Pogorelec, have seen many patients with these symptoms and after further examination are able to help  diagnose and treat both diseases.

What is GERD?
Gastroesophageal reflux disease GERD refers to stomach contents moving into the esophagus causing a burning sensation commonly referred to as heartburn. Other symptoms may occur as well, such as pain in the upper abdomen, bloating, nausea and an acid taste in your mouth.  If this continue, prolonged exposure of the esophagus to stomach contents can result in damage to the lining of the esophagus.  This in turn can result in difficulty swallowing, pain with swallowing or permanent damage to the esophagus.

Although not all reflux results in symptoms or damage to the esophagus, common symptoms include:
• Heartburn
• Acid regurgitation
• Belching
• Difficulty or pain when swallowing
• Waterbrash sudden excess of saliva
• Dysphagia the sensation of food sticking in the esophagus
• Chronic sore throat
• Laryngitis
• Inflammation of the gums
• Erosion of the enamel of the teeth
• Chronic irritation in the throat
• Hoarseness in the morning
• A sour taste
• Bad breath
• Coughing at night

What is gallbladder disease?
The gallbladder is located below the liver on the upper right side of the abdomen. The main function of the gallbladder is to store bile, which is made in the liver and allows fat-soluble vitamins and nutrients to be easily absorbed into the bloodstream. Any condition that affects the gallbladder is considered a disease, and there are many different scenarios that fall under gallbladder disease:
• Inflammation
• Gallstones
• Common bile duct stones
• Biliary Dyskinesia
• Infection
• Perforated gallbladder
• Gallbladder polyps
• Porcelain gallbladders
• Gallbladder cancer

Dr. Anderson and Dr. Pogorelec share "the most common disease of the gallbladder is gallstones. Most people with gallstones do not even know they have them.  Once they cause problems, the gallbladder may need to be removed. Symptoms include pain below the right rib cage or in the “pit” of the stomach. This pain may radiate to the right upper back, chest, or shoulder. Other symptoms may include, bloating, nausea or vomiting, fever or chills, chronic diarrhea, jaundice yellow-tinted skin, or unusual lighter-colored stools or dark urine.”

After taking a closer look at GERD and gallbladder disease, Dr. Anderson and Dr. Pogorelec are able to provide helpful insight on common distinguishing factors between the two diseases.

Common distinguishing factors:
• Location: Although both may feel like a “pit in your stomach”, if you experience symptoms located closer to your throat or in your chest it is more likely to be GERD related. Symptoms located near your right lower rib radiating into your right upper back, chest and shoulder are more likely to be associated to your gallbladder.
• Pain: Unlike GERD, gallbladder pain usually begins suddenly, and changing positions, belching, passing gas or taking medications rarely helps pain symptoms go away.
• Timing: With heartburn being the most common symptom of GERD, symptoms of reflux are likely to occur shortly after eating, where symptoms of gallbladder disease usually occurs several hours after eating and have more consistent patterns of reoccurrence the same time each day.

What does treatment look like?
The symptoms of GERD are commonly and effectively treated with over-the-counter medications such as anti-acids and proton pump inhibitors. However, if relief does not go away from these medications your provider may recommend you be evaluated by one of our surgeons at Divine Savior.

After a thorough history and physical, our surgeons may recommend further evaluation of the esophagus and stomach with endoscopy.  Similar to colonoscopy, but without the need for prep, upper endoscopy allows the surgeon to visualize the esophagus, stomach and intestine to evaluate for damage to the esophagus, infection and a hiatal hernia.  Depending on the findings, further testing may be indicated to evaluate the function of the esophagus. 

Patients with severe GERD benefit from surgery to prevent reflux from occurring.  This procedure is commonly performed by both Dr. Anderson and Dr. Pogorelec, is minimally invasive, and very effective at treating GERD.  In fact, most patients no longer require any antacid medications after the procedure.

If you are found to have stones in the gallbladder causing symptoms, the best course of action is to have the gallbladder removed.  Leaving the stones in place will continue to cause pain and may result in serious infection of the gallbladder and bile ducts, jaundice or pancreatitis. 

Both Dr. Anderson and Dr. Pogorelec routinely perform minimally invasive removal of the gallbladder.  This is most often an outpatient procedure and very successful.  After a short recovery, most patients will find their symptoms are gone and they are able to live a normal life. 

If you experience symptoms related to GERD or gallbladder disease, or have concerns about either, it is best to consult your provider for further examination. Treatment for either disease varies person to person, but taking action immediately and being properly treated can help you prevent problems from worsening.

To schedule an appointment with Divine Savior Healthcare General Surgeons, Dr. Anderson or Dr. Pogorelec, call 608-745-5176.

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