New Bone and Joint Hospital Opens in Ruby Memorial

A new 22-bed orthopaedic hospital is opening on a floor of Ruby Memorial as part of an effort to meet growing demand for complex orthopaedic care in the region. Existing outpatient orthopaedic clinics will continue to provide services.

The new WVU Medicine facility will provide hip or knee replacement, and orthopaedic procedures for traumatic injuries, metabolic bone disorders, musculoskeletal oncology, spine, joint degeneration, cartilage regeneration, sports injuries, ankle arthroplasty, and hand and shoulder disorders among other things, according to a press release.

The hope is that the new hospital will also allow WVU Medicine to recruit new faculty, expand research and educate nationally recognized surgeons. 

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

W.Va. Has High Rate of Cervical Cancer Despite Preventive Vaccines

Human Papillomavirus – more commonly known as HPV — is the most common sexually transmitted infection in the United States. It is so common that almost all sexually active individuals will get it at some point, which puts them at risk for developing various cancers. The good news: HPV is preventable. The bad news: vaccination rates are low nationwide, with particularly troubling statistics coming out of West Virginia.

Shelly Dusic found out she had cervical cancer two weeks after she got married. She was 22.

“And I was probably the most grateful person to find out I had cancer you’ve ever seen,” says Dusic. “Because for the six years prior to that, I’d been told by four doctors that I’d never live to see 30, that they didn’t know what was wrong with me. [I had] been through seven diagnostic surgeries and we didn’t know what was wrong.”

Her first symptoms of having HPV – irregular, heavy periods, debilitating pain in her right side – started when she was about 16. She had a hysterectomy to address the cancer when she was 23.

Dusic was quick to point out that her case was not “normal.” The average age of cervical cancer diagnosis in the United States is 48.  

“But being exposed to the virus that causes cervical cancer in your teens or early 20s is very common,” she says.

HPV viruses (there are more than 100 related strains) cause almost all cases of cervical and anal cancers, according to the National Cancer Institute. HPV can also cause other cancers, including cancer of the mid-throat. Once someone is infected with HPV, they will carry it until the virus leaves their system – or doesn’t; there is no cure.

“We need to get the word out that we have a vaccine that can prevent cancer,” says Kathryn Moffett, head of the pediatric infectious diseases at West Virginia University School of Medicine.

“Giving the HPV vaccine is not about giving your child permission to be sexually active,” says Moffett. “Those are very important conversations to talk to your kid about making good choices, and waiting on things and being monogamous – those are all really important things. It’s about prevention – give it before anyone is even remotely considering doing anything. Give it at 11 and 12 when they get a really brisk response and they get a response to all the serotypes in the vaccine – then you are protected.”

Moffett says millions of doses of the vaccine have been given in the ten years since the vaccine was approved, but that West Virginia continues to experience low vaccination rates. There are no known serious side effects to the vaccine.

“Unfortunately, we are number one in HPV-related cervical cancer deaths and number four in HPV-related infections in the United States,” says Moffett. “That’s bad.”

Part of West Virginia’s high cervical cancer rates may be due to other risk factors. Smoking, for instance, increases the risk of cervical cancer, as does poverty and being overweight, according to the American Cancer Society.

Shelly Dusic was diagnosed with cervical cancer in 2002 – four years before the first vaccine came out.

“The day the FDA approved the vaccine for HPV, I bawled like a baby,” says Dusic. “Because for the first time there was hope that no other woman had to go through what I went through, and no one should.”

According to the CDC, about 79 million Americans are infected with HPV. About 14 million people become newly infected each year, with no cure yet in sight.

Dusic is now 36 and hasn’t been sick since her surgery. She loves being well. But she says she still has trouble walking through the aisles of Walmart and passing the baby section.

“And I think about the things that that vaccine could have saved,” she says. “It would be worth it.”

Dusic is now a Health Information Specialist for the WV Breast and Cervical Cancer Screening Program, which has been partnering with the WV Immunization Network to try and increase HPV vaccination rates in Appalachia.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

Terminally Ill and Want to Die at Home? Fill Out This Form

People who have a terminal illness often prefer to spend their last days at home, rather than a hospital. WVU published research this month showing there’s a way to make it easier for those people to do so. In reality, it all comes down to paperwork.  

Janet Black looks up from her bed. She is terminally ill with end-stage lung disease and is due to be discharged into hospice care any day.

Credit www.POLST.org
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www.POLST.org
West Virginia POST Form

“I can’t stay in a hospital forever so we had to look at alternatives to get me out of the hospital and to get me to where I could get the help I needed,” she says.

Janet Black is 73 and has known she was sick since September. Doctors give her about six months to live, although she matter-of-factly stated she thinks she has less time left than that. Her daughter Tammy was in the hospital with her.

“Coming home, that’s her decision,” says Tammy. “That’s what she wants and that’s what we’re going to do.”

Janet stresses she wants to be comfortable when she passes from this world, and that she doesn’t want emergency medical personnel to try and save her.

“I don’t want no CPR or resuscitation when it comes down to that point where there is nothing they can do – just let nature and God take its course and do what is supposed to be done,” she says.

So under her physician (Doctor Alvin Moss’) direction, she filled out a POST form. This form makes Black’s end-of-life wishes absolutely clear and, most importantly, the POST form is registered online where caregivers can easily locate it.Moss is coauthor of a study published this month in the Journal of Pain and Symptom Management, which found that 92 percent of West Virginians prefer to die outside the hospital, yet only about 60 percent are able to do so.

“You just want to be home where you can get the care and the love you need, so you can give care and love to them as well.”

Janet also has an Advanced Directive in place. That lets medical personnel know who she wants to manage her care. Signed forms are important. Moss’ study also found that 57 percent of patients who have signed an Advanced Directive, but no POST form, die at home, while the figure jumps to 76 to 88 percent for those who signed both of those forms.

The POST form has been available in West Virginia since 2002 – one of six states to pioneer the idea. Now 43 states either have a POST form or are in the process of developing one.

West Virginia is also one of the only states in the country with an electronic registry.

“We are the most comprehensive registry in the country,” says Moss. “Thirty-seven forms a day, 1,000 forms a month ­– up almost 200 percent since we started doing this three years ago.”

Moss says that prior to the forms being accessible online, about 25 percent of all forms – both Advanced Directives and POST forms – were lost, meaning that patients like Black often received end-of-life care, such as CPR or a tube down their throat, that they didn’t want.

“We actually even know that 550 times a month, physicians go online and find the form on a patient they want, so it’s working.”

Moss said that in the end, most Americans say they want to live as long and as well as possible and to die gently. The idea behind the form is to help people die with dignity.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

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