Eastern Wisconsin

MDCMC’s sleep disorders facility earns a gold star

Expanded space for Sleep Disorders Facility

The Sleep Disorders Facility at Ministry Door County Medical Center (MDCMC) earned accreditation in November from the American Academy of Sleep Medicine (AASM).

The facility has also moved to another area of the hospital building and added services in an expanded space.

Gold star of accreditation

Accreditation means that providers “display and maintain proficiency in areas such as testing procedures and policies, patient safety and follow-up and physician and staff training,” according to AASM.

In 2010, the AASM sent a national sleep expert to the Sturgeon Bay Sleep Disorders Facility for a facility evaluation and meetings with caregivers.

“The surveyor went over everything with a fine-tooth comb and said we are way ahead of the curve in terms of the electronic medical record and the way our lab functions,” said Richard Hogan, MD, the medical director of the MDCMC Sleep Disorders Facility. “We are doing all the things they wanted to see being done. We are happy and proud to earn the accreditation.”

“There are many standards that we met to show we provide the highest quality of care to patients,” added Nancy Ruff, coordinator of the Sleep Disorders Facility.

In preparation for the accreditation in November 2009, Dr. Hogan became board certified by the American Board of Medical Specialties, a part of the American Board of Internal Medicine’s subspecialty of sleep medicine. Dr. Hogan, an internal medicine specialist affiliated with MDCMC’s North Shore Medical Clinic, has been caring for people with sleep problems for more than 18 years.

Expanded space for Sleep Disorders Facility

The review by AASM was done in the Sleep Disorders Facility’s new location at MDCMC. The facility is situated in an area of the hospital that formerly housed the Birthing Center (now a part of the new inpatient services and Emergency Department addition).

Two private rooms allow people stay overnight for sleep studies, also known as polysomnographic tests. Each room has a bathroom, whirlpool tub and is outfitted with organic and allergen-free linens as well as individually controlled heating and air conditioning. Two more private rooms are equipped and available for future use.

The hospital has technology necessary to monitor brain waves, breathing, muscle activity, heart rhythm, and leg and arm movements as people sleep. The new space also has an area where physicians can review sleep test results the morning after patients participate in overnight studies.

“That is a big thing—that our patients meet with the doctors in the morning after their tests and get the results,” Ruff said. “Sometimes they can start treatment the same day,”

The hospital employs three registered polysomnographic technologists. Dr. Hogan and Andrzej Kurek, MD, a family medicine specialist pursuing board certification in sleep medicine, discuss treatments that often lead to cures for patients suffering from obstructive sleep apnea.

Obstructive sleep apnea is a condition characterized by episodes of highly restricted or non-existent breathing during sleep. People are often fitted with a continuous positive airway pressure (CPAP) mask, which is connected to a machine. The portable CPAP provides a continuous stream of air pressure to keep the sleeping patient’s airway open.

“They can use the mask and CPAP machine, and they feel like a different person,” said Dr. Hogan. “A weight is lifted off their shoulders. Often people attribute a slowdown in the functioning to aging, and it’s not aging. It’s sleep apnea.”

Other sleep problems analyzed in the MDCMC facility include periodic limb movement, restless leg syndrome and insomnia.

“There are more than 100 sleep-related disorders,” Ruff said. She also added that people age 13 and older may be studied in the facility.

New services to help troubled sleepers

The team has already added new services and technology including actigraphy, a portable wrist watch type device that records a person’s movement over time. It provides information about sleep patterns for analysis by the doctor.

“We can hone in the problem they have and where to go further,” Dr. Hogan said. “Actigraphy can tell us when people are sleeping and when they are not.”

Other technologies being developed will allow caregivers to conduct sleep studies in people’s homes. MDCMC has already provided the service to select patients. “This will be a change over the next few years, and we will bring people into the hospital when we cannot make a diagnosis with a home study or they have special problems,” Dr. Hogan said.

“It’s an exciting area,” Dr. Hogan said of sleep medicine. “We spend a third of our life asleep, but we’ve just begun to pay greater attention to sleep medicine in the last 30 years.”

For more information or to make an appointment for a study in the Sleep Disorders Facility, call 920.746.3585. A physician referral is not required.

New technology is changing sleep study procedures. Today, some tests can be done in a patient’s home.

Family nurse practitioner joins North Shore Medical Clinic

Barbara Heilman BSN-RN, MSN, FNP-BCBarbara Heilman BSN-RN, MSN, FNP-BC, joined North Shore Medical Clinic located in Washington Island as a family nurse practitioner.

Heilman is originally from the Egg Harbor area. She received both her Bachelor of Science Degree in Nursing and a Masters of Science Degree in Nursing – Family Nurse Practitioner from the University of Wisconsin-Oshkosh. She was a part of Ministry Door County Medical Center in the 1980’s, working as shift supervisor and house supervisor.

Heilman will join Holly Ullman-Herlache, family nurse practitioner, who has been practicing on the Island for the past year. They will share a schedule and see patients of all ages for well exams, general physicals and sports physicals.

North Shore Medical Clinic in Washington Island has its own laboratory for patients’ tests and is open Monday, Tuesday, Thursday and Friday from 8 a.m. to 4 p.m. Wednesday hours are 8 a.m. to noon. The clinic is closed on Saturdays and Sundays.

To make an appointment with Barbara Heilman or Holly Ullman-Herlache, call the clinic at 920.847.2424.

Well-child check catches a larger problem

Amy FogartyScoliosis causes the spine to curve abnormally.

When Stephanie Reinhardt took five-year-old Emma to see Amy Fogarty, MD, a pediatrician at Ministry Door County Medical Center’s Women and Children’s Center in Sturgeon Bay, she was expecting for an update on Emma’s height and weight. However, more was discovered during the routine exam.

Well-child visits allow physicians to assess children physically, behaviorally, developmentally, and emotionally, as children grow. These are critical times for challenges to be detected and treated early in a child’s life.

As Dr. Fogarty did a scoliosis screening test on 5-year-old Emma, something did not appear right. A standard screening test for scoliosis is performed by having the child bend forward while the doctor examines the back for a difference in the shape of the ribs on each side. “Dr. Fogarty noticed that something was a little off,” Reinhardt said. The pediatrician referred Emma to the Diagnostic Imaging Department at MDCMC for an X-ray.

“You always assume you are going to hear the results from the nurse,” Reinhardt said. So when Dr. Fogarty called me back later that day, I had a feeling it was something more.”

The images of the spine revealed Emma was born with congenital scoliosis—a curvature of the spine that is caused by a defect present at birth. In Emma’s case, part of a vertebra did not form completely. The abnormality, called a hemivertebra, produces a sharp angle in the spine, according to the American Association of Orthopedic Surgeons (AAOS).

“One of Emma’s vertebrae is only half there, and she is missing a rib,” Reinhardt said. “There was a significant curve in her back.” The Reinhardts were advised to see a specialist in pediatric orthopedics at Children’s Hospital of Wisconsin in Milwaukee. There, they learned that a period of observation is appropriate since Emma has not yet experienced a growth spurt. Reinhardt went on to say, “the medical staff at Children’s explained to us that growth spurts typically happen in the teenage years, and congenital scoliosis is usually treated with surgery.”

Further testing will determine whether treatment or more observation is necessary. In the meantime, the Reinhardts are grateful that Dr. Fogarty was able to diagnosis Emma’s condition at such an early stage. “Because Dr. Fogarty is very good at what she does, she caught this (the congenital scoliosis) at the well-child visit,” Reinhardt said. “Even the (Milwaukee-based) doctor who deals with the condition on a regular basis commented on how great a visual catch it was by Dr. Fogarty. The key is to find it early, to know what we are dealing with, and to fix it early. Dr. Fogarty did that for us,” she continued.

Reinhardt also recognized the staff in the hospital’s Diagnostic Imaging Department for their care and communication. “Emma is a little 33-pound, five-year-old, and the technologists were very good with her,” Reinhardt said. “They told her, ‘this is the picture we took of you and what you look like inside.’”

Emma is an active kindergartner enthusiastic about playing. Congenital scoliosis is not slowing her down. “She can do gym class,” said Reinhardt. “She can run. She can play. She can jump. She does hopscotch. She does everything every other kindergartner can do.”

Emma will continue to see Dr. Fogarty for her well-child visits every year. Reinhardt encourages other parents to make certain that they take their children in for the check-ups as well. “Dr. Fogarty is trained to help these little people in the best possible way,” Reinhardt added. “She was able to look at something and immediately know there might be an issue. Dr. Fogarty is a mom herself. She treated my kids as if they were her own. She’s great!”

For more information or to schedule an appointment with Dr. Fogarty or any of the pediatricians at MDCMC, call 920.746.3666. You can also get more information online by visiting www.ministryhealth.org and clicking on the Women & Children’s Health Center webpage.



Safe & Sound with featured author Beth Finke

Tuesday, March 22, 7 p.m. at the Southern Door Community Auditorium

Wednesday, March 23, 7 p.m. at the Door Community Auditorium in Fish Creek

Beth became blind at the age of 26 from type 1 diabetes.

Her talks focus on all that she has been able to do and still does in her life, not her disability. Come and listen to her inspiring and heartwarming story of struggles and triumph!

For reservations or information, please contact 920.493.5979.

All tickets $5, payable at the ticket windows.

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