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Coon Memorial takes steps to improve women’s health


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Coon Memorial takes steps to improve women’s health

By Bill Kelly

THE DALHART TEXAN

In an effort to make gains in the long-term health outcomes for many of the women in Dalhart and the surrounding counties, the Dallam-Hartley Counties Hospital District (DHCHD) recently purchased two new pieces of radiology equipment and installed them in a small suite of rooms in the radiology section of Coon Memorial Hospital. One is a 3-D mammography machine, which will be used to hopefully detect breast cancer in the earliest stages, and the other is a bone density scanner that can detect the beginning signs of osteoporosis.

3-D mammography is still fairly new, having been approved by the U.S. Food and Drug Administration (FDA) just 10 years ago. It is similar to regular mammography in that it uses x-rays to make images of breast tissue in order to find lumps, tumors or other abnormalities.

What makes 3-D different is that takes multiple images from different angles and then brings those images together to create a 3-D image of the breast. The radiologist who reads the mammogram is then able to review that 3-D reconstruction one “slice” at a time, somewhat like turning pages in a book. That makes it easier for the radiologist to see if there is anything to be concerned about when compared to a regular mammogram, which only produces two images, one from side-to-side and one from top-to-bottom. (3-D mammography does also produce the side-to-side and top-to-bottom images in addition to the 3-D image.)

A study in the Journal of the American Medical Association that evaluated close to a half million mammography exams showed a 41% increase in the detection of invasive breast cancers by 3-D mammography when compared to regular mammography, and a 29% increase in the detection of all breast cancers.

A bone density scanner does exactly what the name implies, it uses x-rays to scan certain parts of the body (mainly the spine and hips) and determine bone density. The patient lies flat on a table, and an arm moves up and down the length of the patient’s body to do the scan.

 The bone density of the person who was scanned is compared to the bone density of an average, healthy adult in the same age range using software. A significant deviation in the bone density of the person being scanned can signify actual osteoporosis or potentially the early stages of osteoporosis, which causes bones to become more brittle and increases the possibility of fractures. While men can develop osteoporosis too, it is much, much more common in women, and women are much more susceptible to it after they have gone through menopause.

Loree Tamayo, the chief executive officer (CEO) of DHCHD, wanted to bring 3-D mammography to the hospital. Joyce Bezner, the Healthcare Foundation Director for the hospital district, said that up until now the mobile mammography bus from the Harrington Cancer Center in Amarillo would come to Dalhart on a monthly basis and could see about 20 patients in a day. Otherwise, women have had to go to Amarillo to have mammograms done, which can be difficult if they have a job and have to take time off to do that since mammograms aren’t offered on weekends.

Once the decision had been made to attempt to obtain a 3-D mammography machine, the money to purchase the machine had to be raised. Bezner wrote a grant and worked with the Dalhart Economic Development Corporation (EDC) to come up with the money. The Amarillo Area Foundation donated $12,000, and Harrington Cancer and Health Foundation provided $88,000. The EDC pitched in $100,000 towards to machine, and then the hospital district paid for the rest, which was also about $100,000 since the machine cost approximately $300,000.

After the money was raised, the decision was made as to exactly which company to buy a machine from, and Tamayo had the idea to set it up as part of a women’s suite of rooms in the radiology section of the hospital along with the bone density scanner. The bone density scanner had actually been acquired the year before with a grant from the Amarillo Area Foundation for $35,000. The women’s suite includes a small waiting room, the room with the 3-D mammography machine, and a room with the bone density scanner.

The hope is that being able to provide mammograms every weekday at the hospital will allow more women in this area to have their yearly mammograms done and detect any signs of breast cancer as early as possible, since they will no longer have to either wait for the monthly bus visit or drive to Amarillo. Nationally, approximately 75% of women between the ages of 40 and 74 will obtain a yearly mammogram, which means 25% are not doing so. It is thought that it may currently be closer to 50-60% of women in the local area who obtain yearly screening mammograms due to the inconvenience of having to drive to Amarillo or wait for the monthly bus visit.

The expectation is that not only will women from Dallam and Hartley counties start having mammograms done at Coon Memorial, but that women from other nearby towns such as Clayton, New Mexico, Boise City, Oklahoma, and Stratford will be able to come to Dalhart instead of having to drive all the way to Amarillo or somewhere else.

After being referred for a mammogram, the hospital will call the patient and set up the actual appointment. The patient will go to admissions first, and will fill out some paperwork that will include questions about whether the patient has detected any lumps or is having any pain or other issues. The patient will then change into a gown, and the mammogram itself should take about 10 minutes or so. The patient will also put her address on an envelope, which will be used to mail the results of the mammogram, which will also be faxed or sent electronically to her doctor. The results are expected to be available in 30 days at most, although it should actually be much sooner than that.

The mammograms will be read by the High Plains Radiology group in Amarillo, which is the same group of radiologists that reads mammograms from Harrington Cancer Center. Any doctor will be able to refer women to the hospital for a mammogram, so even if a woman who lives in Dalhart is seeing a doctor in Amarillo, that doctor can refer her for a mammogram in Dalhart so that she doesn’t have to make a separate trip.

The machine has been installed, but it isn’t actually being used quite yet. Carrie Gilly, the Radiology Director for DHCHD, said that she and her staff will be trained to use the machine at the end of July, and the tentative start date for actually doing 3-D mammograms is August 3.

The hope for the bone density scanner is that it will detect early signs of osteoporosis in women and allow them to halt the advance of that disease in the early stages. The scanner should also be able to allow doctors to see if a treatment program is working or needs to be altered.

In the past, osteoporosis has been debilitating for many older women, making it difficult for them to lift or carry more than a few pounds and causing them to having problems with many aspects of everyday life. According to Bezner, diet, medication and exercise can prevent those problems if early signs of the loss of bone density are detected. Medicare recommends that women have a bone density scan every other year beginning around the age of 40, or around the age of 35 if there is a known family history of osteoporosis.

Medicare and most health insurance companies will pay for yearly screening mammograms and for a bone density scan every other year. Early detection of cancer can ultimately save the insurance companies money, so they would prefer to spend a small amount every year than have to spend large amounts of money on the more expensive cancer treatments that are needed if the cancer is more advanced.

Overall, having these machines in Dalhart, and the advanced technology that they represent, should improve the health outcomes for many women in the area. “It’s going to be wonderful for women in these five rural counties to have improved access and the convenience of getting a mammogram.” Bezner said.

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