We don’t like to talk about it.  And that’s the problem.  Conversations about mental health are uncomfortable and we can always find a reason to wait, or tell ourselves that we are ok, or that our loved one is ok.  But what if they are not?  What if we are not?  What if this is our one opportunity to prevent a tragedy?  A few moments of discomfort are trivial compared to a lifetime of grief for those left behind.  National Suicide Prevention Month is the perfect time to learn how to respond to a mental health crisis.

We are living through a time of extraordinary stress.  The pandemic and the economic and social upheaval that have occurred in its wake have taken a toll on our collective mental health.  According to the American Foundation for Suicide Prevention, there were 1.2 million suicide attempts in 2020 in the U.S.  Mental health professionals report disturbing spikes in patient reports of depression, anxiety, and suicidal thoughts.  At the same time, we face a shortage of behavioral health resources.  The closure of Brandywine Hospital and cutbacks at Crozer Health have made locating mental health services more difficult than ever for people living in the communities we serve.

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To learn more, or locate training resources check out these sites:

https://www.chesco.org/4191/TrainingsWorkshops

https://www.preventsuicidepa.org/task-force-county-init/delaware/

ChesPenn celebrated National Health Center Week from August 7 – 13.  We were honored to host federal, state and local elected officials and their representatives, including Representative Mary Gay Scanlon, Pennsylvania Senators John Kane and Tim Kearney, Pennsylvania Representative Gina Curry,  staff from Senator Kearney and Representative Scanlon’s offices, and Upper Darby Mayor Barbarann Keffer’s office.  The officials and their teams toured our health centers and shared in dialogue about our community impact and hopes for the future.  We were grateful for their enthusiastic support for our work and look forward to partnering with them in the future.  We were also joined by the League of Women Voters of Chester and Delaware Counties and Delta Sigma Theta Sorority, who assisted patients with voter registration.

National Health Center Week (August 7 – 13) is an annual celebration with the goal of raising awareness about the mission and accomplishments of America’s health centers over the past five decades.  This National Health Center Week honors those front-line providers, staff, and beloved patients who lost their lives during the (ongoing) COVID-19 pandemic. From the very beginning of the crisis, Community Health Centers began finding innovative ways to provide preventative and primary care to their patients.

Over the course of the week ChesPenn provided lunch for our staff and cupcakes from Dia Doce Cupcakes in West Chester.  Each employee received a gift bag with goodies as a small thank you for the extraordinary work they do each day to care for residents of the communities we serve.

When Lashira Council was growing up, her father was convinced that she would grow up to be an attorney.  She would advocate for other people, always seeking justice. She was voted “most outspoken” in middle school because she stood up for what was right. But Lashira had other ideas.  As she explains it, “I’ve always been interested in the connection between thought and behavior.”  And that gave her the direction for her passion to help others – behavioral health.

Immediately after graduation from college, Lashira began her career in behavioral health as a residential worker at Devereaux, a behavioral health organization with multiple residential facilities in Pennsylvania and around the country. Later, she became a mental health case manager at Crozer Health.  Here, she found her true vocation.  She obtained a master’s degree and completed an internship in drug and alcohol counseling.  In 2017 Lashira became Service Coordinator and Youth Prevention Supervisor, for Crozer-Keystone Recovery Center, developing policies and procedures for the center and supervising staff while continuing to counsel patients directly.  She has also served as a group facilitator for Healing and Strength, a program offered by the Chester Community Coalition that provides trauma-informed group settings where children, youth, and adults can process trauma and grief and learn skills to move toward healing.  Lashira joined ChesPenn in August as our Behavioral Health Manager.  She will supervise ChesPenn’s other Behavioral Health Consultants and also provide direct care to patients at our Eastside location.

Lashira continues to have an interest in working with patients with substance use disorder (SUD) and has been certified in EMDR (Eye Movement Desensitization and Reprocessing) therapy.  This is an approach developed to alleviate the distress associated with traumatic memories.  She hopes to be able to offer this treatment to patients at ChesPenn.  Lashira shared that she is learning the Behavioral Health Consultant model and is excited about building mental health services at ChesPenn.

Lashira shared the story of a patient with SUD who had been mandated by the court to receive therapy and was very resistant to working with her.  They worked through the patient’s trauma history and the patient learned new, healthier ways to process his trauma and communicate with others.  During their time together she was able to witness the transition from an external requirement for her patient to seek change to a true internal motivation to change his life.    At the end of their time together, the patient gave her a plaque that reads “With God all things are possible.  Thank you, Lashira for being an inspiration in my life.”

Lashira’s prescription for responding to the stress of our times:  “Practice empathy and grace for yourself and others.  Acknowledge progress and change.  Ask for help.  Stay hopeful.”

Every year when August comes around, parents begin preparing their children for the coming school year.  September and school are just around the corner and it’s time to stock up on school supplies, think about new shoes and clothes, and most important, make sure kids are ready for a healthy start to the school year.  Families are scheduling dental and medical check-ups and making sure children are up to date on their vaccines.  Most schools will require documentation that students are current on essential vaccines before they can return to the classroom.

Over the past few years, some parents have been reluctant to vaccinate their children as a result of now-discredited reports that circulated at one time linking vaccines to negative health outcomes.  There is no valid evidence that vaccines are harmful to children.  More important, we need to remember that vaccines have saved millions of lives.  Vaccines for diseases like polio, whooping cough, tetanus, and measles have been around for so long it’s hard for most of us to remember how terrible epidemics of these diseases were. As an example, polio was once one of America’s most feared diseases, killing and paralyzing children and adults at an alarming rate.

Today, polio has essentially been eradicated. Here’s another example – the DTaP and Tdap vaccines for tetanus, diphtheria and pertussis or whooping cough are a standard part of the immunization schedule for children (adults should also get regular boosters).  DTaP is administered to infants and young children while Tdap is for older children and adults.  Few of us have witnessed outbreaks of diphtheria or whooping cough, but our grandparents can tell us how frightening these outbreaks were or about losing friends and family members to these diseases, which are beginning to break out once again in regions around the world where vaccines aren’t readily available.  A great article in National Geographic describes the history of disease before vaccines:  https://www.nationalgeographic.com/culture/article/cannot-forget-world-before-vaccines .

This is the perfect time of year to focus on updating children’s vaccines.   Your child’s pediatrician will recommend the vaccines appropriate for their age.
You can also check this table available from the CDC: https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html.  Make your appointment now to ensure your children are protected and ready for school or day care.  And you may also want to check with your own primary care provider to be sure you are up to date on vaccines as well!

ChesPenn’s Upper Darby site is tucked into a tiny building on State Road ust south of West Chester Pike.  It’s easy to miss unless you’re looking for it, but extraordinary things happen there every day.  Upper Darby is unique among ChesPenn’s locations.  Its medical providers are all Family Medicine Residents and Preceptors in Crozer Health’s Family Medicine Residency Program.  ChesPenn and Crozer have partnered since 2005 to provide training in family medicine while simultaneously caring for residents of the diverse community in Southeast Pennsylvania.  Today, over 70 Family Medicine Residents have graduated from the program and almost 4,000 adults and children call ChesPenn’s Upper Darby office their healthcare home.

The small, tight-knit team of four Medical Assistants, two Patient Service Representatives, Social Services Coordinator Fariha Trisha, and Behavioral Health Consultant (BHC) Michelle Quigley are led by Yvonda Romeo, Upper Darby’s Office Manager.  Nurses from Eastside serve the site on a rotating basis and ChesPenn’s Community Health Educator, Tina Beahm, is there two days a week to coach patients on smoking cessation, nutrition, and other healthy lifestyle choices.  On a given day, three residents and a preceptor are on hand to see patients.

Sue Ramberg is one of two registered nurses who work at Upper Darby shared that “The reason this office works is that we work as a team.  I’ve had days that should have been really hard, but the MAs, the front desk staff, Michelle, and Tina all pitched in to help. The MAs are incredible and there is such an atmosphere of gratitude.  Yvonda is an amazing Office Manager.  She is so compassionate.  She enforces the rules but in a loving, caring way.”

Yvonda herself has had an inspiring journey with ChesPenn.  She began in 2017 as a temporary worker at the front desk.  She loved the spirit she encountered and in turn impressed her supervisor and was hired full time.  In 2021 she was appointed Office Manager.  Yvonda said about the Upper Darby team, “In spite everyone’s differences, we come together for our patients.  We call them our neighbors; we see their kids grow up.  We’re really involved in the community here.”

Craig Parker, a long-time patient at Upper Darby, has experienced the benefits of this outlook firsthand.  Several years ago, Craig was in a motorcycle accident.  He still experiences hand tremors and the effects of damage to his knee.  Over the years, he has used alcohol and nicotine to help manage the lingering effects of his accident.  At Upper Darby, he sees a physician regularly and has worked both with Michelle and with Tina and has dramatically decreased his alcohol and nicotine consumption.  He shared that he’s grateful for the care he’s received and has a great relationship with the staff.

Dr. Thomas Yuen has been a preceptor with the program since 2012.  He distilled the Upper Darby experience to his essence with his reflection:  “I have been working at UD since I joined Crozer in 2012.  There have been many ups and downs- including staff changes, the constant search for a new location, and a little thing called COVID-19.  But despite these challenges- what keeps me working here is everyone’s complete dedication to serving the most vulnerable and disenfranchised among our community. The work here is hard and often our rewards from our patients are limited to a sincere thanks, a plate of home cooked food, or a card at Christmas.  But despite the difficulties and occasional frustrations, I cannot see myself working anywhere else.  In a single day, I will see a Spanish-speaking family who has just arrived from Ecuador.  A young Liberian woman struggling with PTSD from childhood trauma.  A patient of mine that I’ve known for 10 years, who was born and plans to die in her family home in West Philadelphia.    We still have many challenges ahead of us, but I have no doubt that the staff, residents, and physicians here will continue to persevere to provide the best care possible to our patients.”

National Health Center Week is coming!

Click the link for more information:  https://chespenn.org/health-center-week-flyer-7-28-22a/ 

In 2005 Dr. Erica Turner was looking for a new part-time position as a pediatrician.  A friend told her that ChesPenn Health Services had just opened a new health center in Coatesville.  Soon after, she accepted a position that divided her time between Coatesville and ChesPenn’s Chester locations.  One of her earliest experiences was of testing ChesPenn’s first electronic medical record before its use was expanded to the larger organization.   This was in the days before the Pennsylvania Statewide Immunization Information System was created and she remembers having to enter each child’s entire vaccination record into the system.

After 17 years caring for families in the same community, Dr. Turner enjoys seeing children grow and change.  She also likes a puzzle –  doing the detective work to solve a mystery when a patient’s illness is difficult to diagnose.  Her love of puzzles made studying science in college seem like a good choice.  She jokes that the decision to become a pediatrician after she started medical school came because she saw that pediatrics was the only specialty where she could sit on the floor with her patients.

One of her biggest sources of satisfaction comes from helping children feel safe during their visits.  Often children bring a doll or stuffed toy with them, so she first “examines” the toy with the child’s help, which makes the exam less scary when it’s the child’s turn.  One child had no toy with him but had a bear on his shirt.  Dr. Turner and the child took turns listening to the bear’s heart and checking his ears, and then she did the same for the child.
This approach gets children excited about being active participants in their visits, making them more fun and less scary.

Having also worked in a private practice, Dr. Turner appreciates the opportunity to help parents who often struggle with so many life challenges that focusing on their children’s health needs can seem overwhelming.  She shared that “It feels like a win when I can convince parents to take the next step to improve their child’s health.  Sometimes people need an extra minute of listening and compassion.”

Summer is here and it’s picnic time! Sadly, some of our favorite picnic foods are not our friends when it comes to healthy eating.   We have some great ideas for healthy versions of picnic favorites that don’t sacrifice great flavor for good nutrition.

Here’s a healthy alternative to the infamous bucket of fried chicken with a side of fried potato wedges.  This recipe from the American Heart Association brings all the flavor with almost no fat:  https://bit.ly/3bo5inv.

Or for a great finger food option, try oven baked chicken taquitos from the American Diabetes Association’s  Diabetes Food Hub:  https://bit.ly/39JRAux

And if you can’t imagine a picnic without potato salad, try this one from the Diabetes Food Hub: https://bit.ly/3zQKSxA.

Another perfect summer salad choice is black bean and corn salad.  It’s full of flavor, fiber, and protein!  https://bit.ly/3OgmIke

After all that healthy eating, you can indulge in a treat or two.  July is National Hot Dog Month.  But far more important for some of us, it’s also National Ice Cream Month!  So indulge a little, whether your favorite is chocolate, vanilla, or pineapple coconut.

Happy Summer Picnicking from all of us at ChesPenn!

Dr. Raquibul Islam (Dr. I to his patients and coworkers) has been a ChesPenn physician for 22 years.  In that time, he has provided care for two generations of patients.  Many of the adult patients at our Center for Family Health at Eastside rely on him for their care – in fact, several of our own staff have been his patients for years.  Administrative Manager Mary McCullough, who has been his patient for almost 20 years, indicated that “he’s very thorough and he explains everything.  He calls me to remind me to go to my specialist and diagnostic appointments.”

Dr. Islam’s choice of healthcare as a profession was a family decision.  His grandfather and father both encouraged him to study medicine.  He completed his medical degree at Dhaka Medical College in 1983 his residency in internal medicine at Fitzgerald Mercy Hospital in Philadelphia in 1997.  In 2020 he learned from a former intern whom he’d supervised that ChesPenn was looking for a primary care physician.  Our Welsh Street health center was near his home and after interviewing with founding Medical Director Dr. Rekha Yagnik, he decided it would be a good fit.

Over the years, Dr. Islam has seen ChesPenn grow and change.  He witnessed the opening of Eastside and has participated in a variety of initiatives to improve quality of care and workflow.  His most satisfying experiences, though, have been all about his patients.  For example, 10 years ago a 75-year-old woman came to him because a friend referred her.  She was suspicious of health professionals but Dr. I worked to build her trust.  She had a vague complaint about stomach pain that at first was difficult to diagnose.  Tests showed she had kidney cancer, but she insisted that she did not want surgery.  Dr. Islam was ultimately able to persuade her to have the surgery.  Ten years later, she is still his patient and is in excellent health.  When she visits, she tells him “I come to ChesPenn because you’re here.”

Dr Letitia O’Kicki, ChesPenn’s Chief Medical Officer, had this to say about Dr. Islam, “As a long time physician in the Chester Community, Dr Islam is well respected by his patients and colleagues. His attention to detail, at listening to the patient, along with his extensive medical knowledge makes him an excellent diagnostician. Dr Islam passionately cares about his patients, their families, and community he serves. He is also a wonderful mentor and teacher. His dedication to high quality care serves as a great role model.

Dr. Islam said as we ended our interview, “I know all my patients well and ChesPenn has been good to me.  It’s been a blessing.  I have no plans to retire.  I’ll be here.”

Sarah Johnson is a strong woman who is deeply tuned in to her body’s signals.  Several months ago, she began to feel that something was off.  She noticed tingling in her hands.  During a visit with her OB/GYN at ChesPenn’s Center for Family Health at Eastside she requested a urine glucose test and the results were shocking.  Her glucose level was over 600 – so high that her physician sent her to the hospital.  After she was released, we enrolled her in our Catalyst Program for patients with uncontrolled diabetes.  Funded and facilitated by United Healthcare, the program is offered in partnership with Manna of Philadelphia.  Manna’s mission is “to use nutrition to improve health for people with serious illnesses who need nourishment to heal.”   They provide clients with meals that are nutritionally tailored to their specific health challenges along with nutrition education.

A nutritionist from Manna met with Sarah virtually to provide nutrition counselling, ChesPenn’s Community Health Educator, Tina Beahm, followed up with regular coaching meetings, helping Sarah understand how to keep track of the sugars, fats, and calories in the foods she ate, and offering encouragement along the way.  Manna volunteers delivered 21 meals to her weekly.  At the end of the
3 month program, Sarah’s glucose level had fallen to 187.

Tina sat in on our interview with Sarah.  The rapport between the two was clear as they described how they worked together. Sarah shared that Tina had really helped her think differently about her food.  She encouraged Sarah to read food labels carefully and Sarah was shocked at the amount of sugar in many products.  She began selecting foods that recreated her favorite meals from the Manna menu and learned to drink her coffee without sugar.  According to Sarah, the program “absolutely changed my life.  I feel better, look better, my life is better.”

To date, 61 ChesPenn patients have participated in the program, with such outstanding results that we have received a second round of funding from United Health Care.  The synergy created by healthy meals and nutrition counseling courtesy of Manna
combined with healthcare and coaching offered by ChesPenn’s physiciansand Patient Education Coordinator
have proven to be powerful tools to help
patients manage their diabetes.