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Louisa-Lawrence Co, KY

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MARCH 26, 2015

Louisa, Ky  – Healer. Detective. Adviser. Confidante. Comforter.  These are among the many roles doctors fulfill each day as they care for patients and their families. Whether it is in a hospital, a clinic, or a long-term care facility, doctors work tirelessly to make sure patients get the care they need. 

On March 30, healthcare organizations will celebrate National Doctors’ Day. First observed in Winder, Georgia in 1933, Doctors’ Day honors the contributions physicians make to communities across the country. We, at Three Rivers Medical Center and Paul B. Hall Regional Medical Center, are proud to honor the work of the nearly 270 physicians that represent 29 specialties on our medical staffs. 

Caring for the sick and maintaining good health for those who are well requires teamwork of the highest level, and doctors are at the core of this relationship. We work closely with the physicians on our medical staff to deliver quality, personalized care to each patient. Having physicians who share this commitment and our mission to deliver high-quality care is important to us and we’re fortunate that members of our medical staff share these beliefs.

We’re committed to making sure the community has access to the healthcare services it needs. That’s why recruiting and retaining talented physicians and surgeons to our community is a top priority. Combined, the two hospitals welcomed 33 primary care and specialty physicians to our medical staffs in 2014.  Currently, we are actively recruiting primary care, orthopaedics, pulmonary/critical care and psychiatry.  

And so, as we celebrate Doctors’ Day, we recognize all the doctors in the community for their contributions, and we say a special thank you to the members of our medical staff for their dedication to our patients.

Three Rivers Medical Center has been awarded Joint Commission Top Performer distinction four years in a row.  The Emergency Department is an Accredited Chest Pain Center.  TRMC is a 90-bed, acute care facility.  It is accredited by The Joint Commission.  With over 80 medical staff members, TRMC offers cardiology, general surgery, nephrology, orthopedics, urology, gynecology, ophthalmology, otolaryngology, gastroenterology, podiatry, 24-hour emergency care, diagnostic radiation, rehabilitative services and mental health.   

Paul B. Hall Regional Medical Center is a 72 bed Acute-Care hospital located in Paintsville, KY with certified staff specialists in surgery, neurology, obstetrics, gynecology, internal medicine, ophthalmology, psychiatry, cardiology, radiology, urology, pulmonology, gastroenterology and oncology. Paul B. Hall Regional Medical Center serves more than 45,000 people with a medical service that has not only remained in the top ranking of the Joint Commission on Accreditation of Healthcare Organizations, but has been the recipient of Accreditation with Commendation on three separate occasions in recent years.  Paul B. Hall Regional Medical Center is directly or indirectly owned by a partnership that proudly includes physician owners, including certain members of the hospital's medical staff.

March 18, 2015

Greg Kiser CEO with Dr. Thomas H. Frazier gastroenterologist left and Dr. Aaron Kendrick anesthesiologist right


Louisa, Ky -- When Greg Kiser’s doctor recommended that he get a routine colonoscopy when he turned 50, he didn’t think twice about getting it scheduled.   

“A colonoscopy is the one screening test that can actually prevent cancer,” said Kiser, Three Rivers Medical Center CEO.  “With this one test, I am able to reduce my risk of dying from colon cancer in half, I can’t argue with those figures.” 

Colon cancer starts in the large intestine as a polyp, a benign growth made up of precancerous cells.  During a colonoscopy, most polyps can be removed before they turn cancerous.  Most patients who develop colon cancer experience no symptoms until the disease is advanced and difficult to treat.  That’s why screenings are so important. 

“Studies have proven that colonoscopies save lives,” said Kiser.  “Unfortunately, some people are afraid of them or embarrassed about having the procedure done.  As a result, colorectal cancer is the second leading cause of cancer death in both men and women.  When you turn 50, listen to your doctor and schedule your colonoscopy.  It’s easier than facing a cancer diagnosis.”  

Colonoscopy is a painless procedure that uses a flexible scope with a camera to examine the lining of the colon for polyps.  To prepare for the procedure, patients have to drink a solution to clear out the colon so the doctor can easily see any polyps and remove them.  Different health conditions require different types of preparations.  

“No one looks forward to this procedure, but we do everything we can to help alleviate people’s fears when they come in for the test,” says Dr. Thomas H. Frazier, gastroenterologist.  “We explain all aspects of procedure. We are very conscious of protecting the patient’s dignity and privacy. “

“It sounds worse than it is.  You are sedated, so it doesn’t hurt,” said Kiser, who had the test performed on March 6th, which was national Dress in Blue Day.  Dress in Blue Day is a day designated to promote colon cancer screenings.  

“Our staff and physician are very professional.  They are committed to do the work they do to prevent cancer and save lives.  I wouldn’t go anywhere else when I can receive exceptional care from people I know and trust. 

About 140,000 Americans are diagnosed with colorectal cancer every year, with nearly 90% of the disease occurring in people 50 and older.  Family history, smoking, obesity and having a sedentary lifestyle increase the risk of developing colon cancer. 

Everyone over the age of 50 should get a colonoscopy, and at-risk groups should start earlier.  For people of average risk, a colonoscopy is recommended every 10 years, if no polyps are found.  

Board certified gastroenterologist, Thomas H.  Frazier performs hundreds of colonoscopies a year at Three Rivers Medical Center to protect patients against cancer.  

Dr. Frazier has experience in treating patients with digestive tract problems, such as swallowing disorders, heartburn, irritable bowel syndrome, ulcers, colon cancer, Crohn’s disease and ulcerative colitis.  He also treats patients with diseases of the liver and pancreas.  

For more information about getting your screening colonoscopy or other services provided by Dr. Thomas H. Frazier, please call 606-638-9495.

March 15, 2015 

Eating the right foods can help keep blood sugar on an even keel. Find out what to put on the menu when you have type 2 diabetes.

By Mikel Theobald

Medically reviewed by Cynthia Haines, MD

Following a type 2 diabetes diet doesn’t mean you have to give up the things you love — you can still enjoy a wide range of foods. The best diabetes diet is one that is well balanced and includes a variety of healthy carbohydrates, fats, and proteins. The trick to this balancing act is choosing the right combination of foods that will help keep blood sugar level in your target range and avoid big swings that can cause diabetes symptoms — from the frequent urination and thirst of high blood sugar to the fatigue, dizziness, headaches, and mood changes of low blood sugar.

The Basics of the Type 2 Diabetes Diet

To follow a healthy diet, you must first understand how different foods affect your blood sugar. Carbohydrates, which are found in grains, bread, pasta, milk, sweets, fruit, and starchy vegetables, are broken down into glucose in the blood faster than other types of food, which raises blood sugar levels. Protein and fats do not directly impact blood sugar, but both should be consumed in moderation.

To hit your blood sugar level target, eat a variety of foods but monitor portions for foods with high carbohydrate content, says Alison Massey, RD, LDN, CDE, director of diabetes education at Mercy Medical Center in Baltimore, Md. “Carbohydrate foods have the most impact on blood sugar levels. This is why some people with diabetes count their carbohydrates at meals and snacks,” she says.

Best and Worst Type 2 Diabetes Choices by Food Group

As you fill your plate at each meal, here’s a helpful guideline to keep in mind: Fill half your plate with non-starchy vegetables. Round out the meal with other healthy choices — whole grains, nuts and seeds, lean protein, low-fat dairy, and small portions of fresh fruits and healthy fats. Sugar should be limited, says Massey.

Here’s what you need to know about choosing the best options from each group.


Best options: The American Diabetes Association (ADA) recommends lean proteins low in saturated fat, like fish or turkey. Aim for two or three servings of seafood each week; some fish, like salmon, have the added benefit of containing heart healthy omega-3 fats. For a vegetarian protein source, experiment with the wide variety of beans. Massey adds that nuts, which are protein and healthy fats powerhouses, are also a great choice — just watch portion sizes as they're very high in calories.

Worst options: Processed deli meats and hot dogs have high amounts of fat along with lots of sodium, which can increase the risk of high blood pressure. Heart attack and stroke are two common complications of diabetes, so keeping blood pressure in check is important.


Best options: When choosing grains, make sure they’re whole. Whole grains such as wild rice, quinoa, and whole grain breads and cereals contain fiber, which is beneficial for digestive health. Whole grains also contain healthy vitamins, minerals, and phytochemicals.

Worst options: Refined white flour doesn’t contain the same health benefits as whole grains. Processed foods made with white flour include breakfast cereals, white bread, and pastries, so avoid these options. Also try to steer clear of white rice and pasta.


Best options: With only 6 to 8 grams of carbohydrates in a serving, plain nonfat Greek yogurt is a healthy and versatile dairy option. You can add berries and enjoy it for dessert or breakfast; you can use it in recipes as a replacement for sour cream, which is high in saturated fat.

Worst options: Avoid all full-fat dairy products and especially packaged chocolate milk, says Massey, as it also has added sugar.


Best options: Non-starchy vegetables such as leafy greens, broccoli, cauliflower, asparagus, and carrots are low in carbohydrates and high in fiber and other nutrients, Massey says. You can eat non-starchy vegetables in abundance — half of your plate should be filled with these veggies. If you’re craving mashed potatoes, give mashed cauliflower a try, she adds.

Worst options: Stick to small portions of starchy vegetables such as corn, potatoes, and peas. These items are nutritious, but should be eaten in moderation. The ADA groups them with grains because of their high carb content.


Best options: Fresh fruit can conquer your craving for sweets while providing antioxidants and fiber. Berries are a great option because recommended portion sizes are typically generous, which may leave you feeling more satisfied, Massey says.

Worst options: Avoid added sugar by limiting fruits canned in syrup, and be aware that dried fruits have a very high sugar concentration. Also, fruit juices should be consumed in moderation as they’re high in sugar and don’t contain the same nutrients as whole fruit.


Best options: Some types of fat actually help protect your heart. Choose the monounsaturated fats found in avocados, almonds, and pecans or the polyunsaturated fats found in walnuts and sunflower oil, which can help to lower bad cholesterol.

Worst options: Saturated fats increase bad cholesterol, so limit butter, cheese, gravy, and fried foods. Keep calories from saturated fat to less than 10 percent of your total daily intake. Trans fats are even worse than saturated fats, so avoid them as much as possible. Look for the term “hydrogenated” on labels of processed foods such as packaged snacks, baked goods, and crackers. “I always tell my clients to double-check the ingredient list to make sure they don’t see any partially hydrogenated oil in their food products,” Massey says.

March 16, 2015

From CDC, Tips from Former Smokers body


What Is Diabetes?

Diabetes is a group of diseases in which blood sugar levels are higher than normal. Most of the food a person eats is turned into glucose (a kind of sugar) for the body’s cells to use for energy. The pancreas, an organ near the stomach, makes a hormone called insulin that helps glucose get into the body’s cells. When you have diabetes, your body either doesn't make enough insulin or can't use the insulin very well. Less glucose gets into the cells and instead builds up in the blood.

There are different types of diabetes. Type 2 is the most common in adults and accounts for more than 90% of all diabetes cases. Fewer people have type 1 diabetes, which most often develops in children, adolescents, or young adults.

How Is Smoking Related to Diabetes?

We now know that smoking causes type 2 diabetes. In fact, smokers are 30–40% more likely to develop type 2 diabetes than nonsmokers. And people with diabetes who smoke are more likely than nonsmokers to have trouble with insulin dosing and with controlling their disease.

The more cigarettes you smoke, the higher your risk for type 2 diabetes. No matter what type of diabetes you have, smoking makes your diabetes harder to control.

If you have diabetes and you smoke, you are more likely to have serious health problems from diabetes. Smokers with diabetes have higher risks for serious complications, including:

  • Heart and kidney disease
  • Poor blood flow in the legs and feet that can lead to infections, ulcers, and possible amputation (removal of a body part by surgery, such as toes or feet)
  • Retinopathy (an eye disease that can cause blindness)
  • Peripheral neuropathy (damaged nerves to the arms and legs that causes numbness, pain, weakness, and poor coordination)

If you are a smoker with diabetes, quitting smoking will benefit your health right away. People with diabetes who quit have better control of their blood sugar levels.

For free help to quit, call 1-800-QUIT NOW (1-800-784-8669) or visit   

How Can Diabetes Be Prevented?

Don’t smoke. Smoking increases your chance of having type 2 diabetes.4

Lose weight if you are overweight or obese.6

Date: 03-14-2015

Kentucky Press News Service

FRANKFORT – More Kentuckians have health insurance, are covered by smoke-free policy, can access physical activity resources, seek care for heart disease and cancer prevention, and get dental services since the launch of kyhealthnow last year, according to the program’s preliminary inaugural annual report previewed Thursday by the Cabinet for Health and Family Services (CHFS).

The draft report, which was discussed during the kyhealthnow quarterly oversight team meeting, shows Kentucky is moving in the right direction in meeting the ambitious and wide-ranging goals laid out in the initiative, which was launched in February 2014 by Gov. Steve Beshear.

“To truly reverse or significantly reduce the major indicators of poor health in the state, we must continue to monitor our progress and programs through initiatives like kyhealthnow,” Beshear said in a statement. “This latest report is another important tool for us in our continuing efforts to create a healthier Kentucky.” 

Kyhealthnow, chaired by Lt. Gov. Crit Luallen, includes individuals from various areas of state government to develop innovative strategies for addressing the state’s health woes, while challenging local governments, businesses, schools, nonprofits and individuals to take meaningful steps toward improving health in their communities.

“We’ve heard statistic after statistic illustrating how profoundly unhealthy our state is, but until recently we didn’t have a comprehensive plan to address it,” Luallen said. “Kyhealthnow not only identifies the major issues affecting the health of Kentuckians, it provides achievable strategies that will help Kentucky become a healthier state. This report illustrates that while we still have a long road ahead of us, we are making progress.”

The program is designed to build on Kentucky’s successful implementation of the Affordable Care Act, which paved the way for the state-based health benefit exchange – kynect – and expansion of the Medicaid program. Over the past 18 months, hundreds of thousands of Kentuckians have purchased a qualified health plan through kynect or enrolled in Medicaid, many of whom were previously uninsured and unable to afford health coverage, a state news release said.

Kentucky Public Health Commissioner Dr. Stephanie Mayfield, vice chair of the kyhealthnow oversight committee, noted the importance of reducing tobacco use in Kentucky, which, in 2013, had the second highest rate of adult smoking in the country at 26.5 percent of the population.

“It is encouraging that we have made considerable gains addressing tobacco smoking, which is the number one preventable cause of death in Kentucky and the nation,” Mayfield said. “Both kyhealthnow’s policies addressing tobacco use and expanded health care coverage have given us the tools we need to truly start reducing tobacco use in Kentucky – and the numerous health problems and diseases associated with it.”

About kyhealthnow

Kyhealthnow targets seven major health goals to be met by 2019, focusing on increasing health insurance coverage; reducing the smoking rate and tobacco use; lowering the prevalence of obesity; lowering cancer deaths; reducing cardiovascular disease; treating and reducing dental decay; and reducing drug overdoses and mental health issues in Kentucky.

Among numerous other achievements, the kyhealthnow annual report shows much success in recent years, indicating progress toward meeting the goals of the program. Some of the findings include:

More access to health care coverage:

· The number of uninsured Kentuckians has been significantly reduced. According to a Gallup Poll released in February 2015, Kentucky’s uninsured rate dropped from 20.4 percent in 2013 to 9.8 percent in 2015 following the launch of kynect and Medicaid expansion. This was the second largest decline in the nation, moving Kentucky from the 10th highest number of uninsured to the 11th lowest.

Smoking and tobacco use:

· Numerous steps have been taken to address smoking and tobacco use, including an executive order signed by Gov. Beshear last year to expand the prohibition of all tobacco products and e-cigarettes in executive branch buildings. The action makes Kentucky one of only five states in the country to enact such a policy. Furthermore, there are now 24 smoke-free ordinances in communities across the state; 37 school districts are smoke-free and 51 individual college and university campuses have tobacco-free policies. In addition, Senate Bill 109, which was passed during the 2014 General Assembly, prohibits the sale of all types of e-cigarettes to minors. 

Increasing Physical Activity/Obesity Prevention:

· Two “trail towns,” located in Morehead and Olive Hill, were recently certified by the Kentucky Office of Adventure Tourism and eight more are expected to be completed by the end of 2015. In addition, Dawkins Trail, a rail-to-trail project in eastern Kentucky, continues to grow. As of June 2013, 18 miles had been completed.

· Over the past eight years, 224 bicycle and pedestrian projects funded by federal grant dollars have been awarded, increasing the opportunity for cycling or walking in neighborhoods.

· Kentuckians now have increased access to the nationally recognized Diabetes Prevention Program (DPP). Available to state employees via the state health plan and now offered via 23 CDC recognized organizations around the state, DPP helps people who are at risk of developing diabetes reverse the onset of the disease.

· School districts are showing an increase in the amount of time devoted to physical activity. According to the Kentucky Department for Public Health (DPH) and the Department of Education, there is an increase in Comprehensive School Physical Activity Program (CSPAP) implementation at proficient or distinguished levels at all grade levels (515 of the 746 elementary schools, 186 of the 329 middle schools and 109 of the 228 high schools). Also, more schools report they are using BMI data to inform school wellness policy. DPH is also working to implement physical activity and obesity prevention curriculum in early child care centers. DPH received CDC grant funding to assist child care centers as they incorporate physical activity and healthy eating standards for preschool age children. The goal is to develop healthy habits in children before the age of 5 and prevent obesity.

Cancer Screening and Prevention:

· Last year, $1 million was awarded to the Kentucky Colon Cancer Screening Program to provide screenings for the uninsured population. In addition, DPH is working to increase rates for HPV vaccination, which would help prevent the spread of the HPV virus linked to cervical and other forms of cancer. Gov. Beshear and DPH have also have supported legislation that would prohibit the use of tanning beds by minors.

Heart Disease:

· The report shows that more adults have been screened and identified as having high blood pressure and are able to control their hypertension.

· More adults have had their cholesterol checked.

· Diabetes management has improved among adults. One study of Medicaid patients showed an overall decrease in those with poor diabetes control measures.

Dental Care: 

· Pediatric dental visits among Medicaid patients have significantly increased in the last year. In addition, in 2014, DPH announced grant awards to five health departments to implement public health dental hygiene programs. These programs broaden access to hygiene services, such as cleanings, screening and referrals, by providing staff and resources to supply mobile units to deliver care in schools. Five more grants will be awarded this year.

· The report also states there has been an increase in the number of children enrolled in Medicaid receiving two fluoride dental varnishes per year.

Substance Abuse: 

· In 2014, more than 13,000 individuals in the Medicaid program received substance use treatment services.

· In addition, a naloxone pilot program launched, which will fund the purchase of naloxone rescue kits for participating hospitals. The kits will be provided free of charge to every treated and discharged overdose victim.

“The findings of the first annual report of the kyhealthnow initiative demonstrate important progress in achieving our key goals, but there is much work still to be done,” said Lt. Gov. Luallen. “And while we should celebrate our successes, like the considerable gains Kentucky has made in addressing tobacco use, it’s important that we not become complacent in our efforts. We must remain focused on our goal of improving the health of Kentuckians and the long-term educational and economic benefits our improved health status will provide for generations to come.”