Working To Get Back On The Field

RED-S Among Those Conditions Treated at Milford Regional’s New Sports Medicine Center Relative Energy Deficiency in Sport (RED-S) – a condition of energy imbalance in athletes in which the body steals fuel from other sources – continues to be diagnosed in a growing number of athletes internationally. It is among the conditions treated at Milford Regional’s recently opened Orthopedics and Sports Medicine Center at 98 Prospect Street in Milford. RED-S was introduced by the International Olympic Committee in 2014, refining the condition referred to as Female Athlete Triad which was coined in 1992. According to Milford Regional Family and Sports Medicine Physician Amy Costa, MD, CAQSM, the diagnoses began to evolve following the passage of Title IX of the Education Amendments in 1972, when the inclusion of women in sport was recognized and then increased dramatically. Prior to the established diagnosis of Female Athlete Triad/RED-S, sports medicine clinicians thought that female athletes losing periods was a normal state with training and competition. “We now know this to be evidence of energy imbalance in female athletes,” said Dr. Costa, who has a special interest in RED-S, and treats patients for this and a number of other sport-induced injuries and conditions at the Orthopedics and Sports Medicine Center. Often unrecognized and undiagnosed, RED-S is common in both male and female athletes, and can include: Low energy; The loss of menstrual periods in girls/women and drop in hormone levels for both boys/men and girls/women; Low bone density; High risk for overuse or other sports injury; and Poor athletic performance. According to Dr. Costa, competition and training will suffer without adequate fueling and recovery. She advises that athletes in training should be deliberate in their nutrient fueling; ensure that their diet includes plentiful and appropriate snacks and meals; and make certain that recovery days are worked into their training regimens. “The body cannot utilize workouts without the building blocks it needs to become better, stronger, faster,” said Dr. Costa, who joined Milford Regional Physician Group following 17 years as a staff physician in the department of Student Health Services and as Assistant Director of Sports Medicine at Boston College. “Body Mass Index shouldn’t be the only consideration when evaluating adolescent and young adult athletes. Nutritional intake and recommendations need to be highly personalized to the individual athlete and his or her activity level and type,” said Dr. Costa, who explains that even nutrient fueling for athletes who play the same sport, but different positions, tends to vary. “I would treat and advise a lacrosse goalie differently than I would a lacrosse midfielder or attacker.” m Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. milfordregionalphysicians.org/getmoving To learn more about this condition and its treatment, visit milfordregionalphysicians.org/getmoving and reference the RED-S video featuring Dr. Costa. COVID Q&A Milford Regional Medical Center Chief of Infectious Diseases Michael Newstein, MD, PhD, provides the answers to the latest issues related to the COVID-19 pandemic Q: What is currently the best “defense” against COVID-19? A: Vaccines remain the best tool in our arsenal to prevent serious illness from COVID. Even with the most recent and highly contagious omicron BA.5 subvariant, vaccines have done their job to lessen the severity of symptoms in infected individuals and to prevent hospitalizations and/or death. For infected individuals, therapeutic treatments – in the form of oral medications and antiviral infusions – have dramatically improved infected patients’ outcomes. Q: With the high percentages of vaccinations, especially in Massachusetts, why is COVID-19 still spreading? A: Over time, viruses mutate and variants and subvariants 3 result that can “escape” antibodies acquired through vaccination or prior infection. Q: Is there still value in wearing masks? A: Especially in healthcare settings, masks assist to mitigate the spread of COVID-19 to patients and coworkers. Although mask mandates have loosened in non-clinical settings given lower rates of the virus overall, immunocompromised and other at-risk individuals are recommended to continue wearing a mask when social distancing is not possible. Q: What can we expect to see in the prevalence of COVID-19 over the next year? A: Since pandemics are fluid and unpredictable, Milford Regional Medical Center continues to monitor local, national and global COVID-19 infection patterns and rates. Although there is no immediate concern for a surge, we should be prepared for another one in the future, as early as this fall. Answers were provided in August 2022, at the time of this publication’s printing. m Good Feelings

Milford Regional Physician Offering Breakthrough Treatment to Ease Chronic Pain and Injury Platelet-rich Plasma Injections Provided at New Orthopedics & Sports Medicine Practice A revolutionary therapy using a patient’s own blood plasma to treat chronic injuries and pain is now being offered at Milford Regional Orthopedics & Sports Medicine Center, which recently opened at 98 Prospect Street in Milford. Primary care and sports medicine specialist Kevin Jillson, MD, offers this unique treatment called platelet-rich plasma injections, or PRP, to patients who have not received relief from traditional treatments such as physical therapy or cortisone injections. PRP has shown to be effective Kevin Jillson, MD in treating tennis elbow, arthritis (particularly arthritis of the knee), plantar fasciitis and rotator cuff tears, as well as other degenerative muscle, tendon and ligament issues. “PRP uses a patient’s own blood, so there is no risk of significant side effects or reaction,” says Dr. Jillson. “It is a really well-tolerated treatment and can provide potential prolonged relief from pain or stiffness.” For this in-office procedure, a sample of blood is drawn from the patient and placed in a centrifuge which isolates the plasma from the blood. Plasma contains a higher concentration of platelets than is found in normal blood, and research has shown that platelets may stimulate tissue regeneration and promote healing. Using an ultrasound as a guide, the plasma is injected back into the patient, targeting the area of damaged tissue. According to Dr. Jillson, treatment takes less than one hour and is performed under a local anesthetic. “Patients can return to their normal activities within a few days of the treatment,” says Dr. Jillson. PRP injections are currently not covered by insurance, and payment is the patient’s responsibility. m Women’s Health and Pelvic Floor Therapy Up to one third of all women experience a problem with their pelvic floor muscles at some point in their lives. Available at Milford Regional’s Rehabilitation and Sports Medicine (Northbridge and Milford locations), a non-surgical approach is offered to rehabilitate dysfunctions in the pelvis/ groin that contribute to bowel, bladder, sexual health and pain complaints. Common conditions treated include: Pelvic floor weakness Pregnancy – sacroiliac joint pain, sciatica, pubic symphysis separation, incontinence, low back pain, pelvic pain Post-partum incontinence Diastasis recti abdominus Endometriosis Pudendal neuralgia Prolapse Pelvic pain, vulvodynia Urge/stress/mixed incontinence Interstitial cystitis/painful bladder syndrome Post-surgical pain – bladder slings/lifts, hysterectomy, laparoscopy, colporrhaphy, endometrial ablation Sexual dysfunction/dyspareunia/vaginismus Sexual trauma Chronic pain Treatment approaches include: Behavioral strategies (voiding re-training, bladder diaries, splinting strategies) Biofeedback training, surface EMG training Manual therapies like visceral and internal/ external soft tissue mobilizations Therapeutic exercises for pelvic floor Posture re-training Functional re-training Self-management techniques Lifestyle education Thorough home exercise program To learn more, visit milfordregional.org and reference the “The Facts about Urinary Incontinence” video on the bottom of the homepage. The video features Milford Regional urogynecologist Diego Illanes, MD. A portion of the video includes Milford Regional Rehabilitation and Sports Medicine physical therapists Amada Lehman, DPT, CSCS, and Erin Mannion, DPT, CLT, who explain how physical therapy can help manage urinary incontinence. m milfordregionalphysicians.org/getmoving To learn more about this breakthrough treatment option, visit milfordregionalphysicians.org/getmoving and click on the PRP injections video featuring Dr. Jillson. Fall 2022 4

HOSPITAL NEWS Milford Regional is Nationally Recognized for Patient Safety Milford Regional Medical Center received an “A” Leapfrog Hospital Safety Grade for spring 2022. This national distinction recognizes Milford Regional’s achievements in protecting patients from preventable harm and error in the hospital. This marks the eighth consecutive period that Milford Regional has received this top grade from the Leapfrog Group. “Patient safety is our highest priority,” said Milford Regional’s President and CEO Edward J. Kelly. “Our ability to maintain exemplary performance on this front is only possible due to a commitment by many throughout our inpatient and outpatient settings. We take great pride in our comprehensive safety efforts.” Visit hospitalsafetygrade.org to learn more. Milford Regional Medical Center Lauded for Response/Treatment for Stroke Patients Milford Regional Medical Center was awarded the 2022 American Heart Association/American Stroke Association’s “Get With The Guidelines-Stroke” Gold Plus Award, marking the ninth consecutive year MRMC has received a Gold/Gold Plus award. This year’s award is based on 2021 data and comes after the medical center’s multidisciplinary Stroke Committee – co-led by Neurologist Eliezer Sternberg, MD, and Emergency Medicine Physician Karen DeFazio, MD, FACEP – implemented several new strategies to improve stroke care at MRMC. “This award highlights the collective efforts not only of our Stroke Committee, but of our wonderful colleagues in the Emergency Department, nursing, hospital medicine, critical care, and neurology,” said Dr. Sternberg. “Excellence in stroke management arises from the collaboration of all these departments, coming together with the common goal of delivering the best neurological care to our patients.” Community Conversation Milford Regional Medical Center hosted a virtual Community Conversation event in March. Joined by more than 100 guests, Board of Trustees Chair and Vice Chair Laura Mann, Esq. and Anthony Consigli, Milford Regional President and Chief Executive Officer Edward J. Kelly and other leaders 5 shared an informative update and addressed important topics through a series of pre-submitted questions. Topics covered included the impact of COVID-19, effectiveness of vaccines, financial challenges, access to healthcare throughout our community, and improvements made in patient care despite the challenging times, to name a few. Visit milfordregional.org for announcements on future Community Conversation events. President and CEO Ed Kelly Recognized Among WBJ’s 2022 “Power 50” Milford Regional Medical Center President and Chief Executive Officer Edward J. Kelly was selected as one of Central Massachusetts’ “Power 50” by the Worcester Business Journal. The list reflects the editorial team’s determinations of the most influential professionals to Central Massachusetts’ economy in the last 12 months. The 2022 “Power 50” list was published on May 2, 2022. “The entire Milford Regional community is proud of Ed’s selection to this influential list,” said Milford Regional Board of Trustees Chair Laura A. Mann, Esq. “We are grateful for Ed’s many years of leadership at Milford Regional, and his talents have particularly shown during the past two years of COVID-19 challenges. Ed is a thoughtful and compassionate leader, who has successfully leveraged his steady business acumen to lead our community to new and innovative growth.” Kelly has served as a senior administrator at Milford Regional since 1993. He was appointed to his current role as president and CEO in 2016. Emergency Chief Runs Marathon to Raise Money, Honor Colleagues Thanks to the generosity of Milford Regional Medical Center supporters and friends, Chair of Emergency Medicine Jeffrey Hopkins, MD, raised more than 19,000 for his Boston Marathon run on behalf of the Milford Regional Healthcare Foundation. Dr. Hopkins ran the 126th Boston Marathon in April 2022 to raise funds for the medical center and in honor of his colleagues who have had their own physical and emotional endurance tested amid the COVID-19 pandemic. “Every day we come in and see people basically running a marathon of their own. Seems like it’s never-ending and there’s never going to be that finish line with COVID,” said Dr. Hopkins. Good Feelings

New Faces on Hospital and Foundation Boards Milford Regional Medical Center welcomes six new members At the Annual Meeting of the Corporation in January 2022, the additions of Christopher D. Foley, Mary J. O’Neill, MD, and John V. Fernandes to the Milford Regional Medical Center Board of Trustees were announced. In addition, Dr. Diana Caragacianu joined the board, mid-term 2021. Foley is currently the president of Unibank and has served in executive roles in banking for more than 20 years. He holds a Masters of Business Administration from Suffolk University and a Bachelors of Science in Finance from Bentley University. Dr. O’Neill has worked for Milford Regional Medical Center since 2001 and currently serves as the Associate Director of the Emergency Department. She is board certified in pediatric and emergency medicine, holds a Masters Certificate in Clinical Informatics and is board eligible for clinical informatics. Dr. O’Neill received her medical degree from the UMass Chan Medical School, where she currently serves as a clinical assistant professor. She completed her internship and residencies in both pediatrics and emergency medicine at UMass Medical Center. Fernandes is currently an attorney and a government relations policy advisor who served as a Massachusetts State Representative from 2007 to 2016, representing the Tenth Worcester District, including Hopedale, Mendon, Milford and Medway. He is also a past member of the Town of Milford’s Board of Selectmen and has served on local school committees. He received his law degree from Suffolk University Law School and his bachelor’s degree from the University of Massachusetts Amherst. Diana Caragacianu, MD John V. Fernandes Dr. Diana Caragacianu is the medical director of the Breast Center at Milford Regional. Dr. Caragacianu received her medical degree from Wayne State University School of Medicine, completed her internship at the Baylor College of Medicine and her residency at the Brown University School of Medicine. She also completed two fellowships – one in surgical oncology at the National Cancer Institute and one in breast surgery at Dana-Farber Cancer Institute/Harvard Medical School. Prior to her appointment at Milford Regional Medical Center in 2019, she served as a breast and endocrine surgeon at Georgetown University Hospital. Also at the Annual Meeting of the Corporation in January, the addition of Karen Savage to the board for the Milford Regional Healthcare Foundation was announced. Then at the Foundation’s June board meeting, Julie Kehoe was named vice chair. Savage is the former vice president and Milford Site Head at Rentschler Biopharma and has more than 20 years of experience in the biopharmaceutical manufacturing industry in Massachusetts. Savage is also an active member of the Tri-County Regional Chamber Board of Directors. Kehoe first engaged with the Foundation as a corporator in 2019 and joined its board in 2021. She is a realtor for Berkshire Hathaway HomeServices Commonwealth Real Estate, working out of the Milford branch office. Kehoe is a Maximum Impact Group board member of the Tri-County Regional Chamber, a parishioner and minister at St. Mary Church in Uxbridge, and volunteers for a number of area local non-profit organizations. m Christopher D. Foley Julie Kehoe Mary J. O’Neill, MD Karen Savage Non Discrimination and Accessibility Practices Notice is published as a community service Milford Regional Medical Center does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Tricia Oliver Donna Boynton Tim Jones Glenn Perry VP of PR, Marketing Marketing/Website Social/Digital Photography & Communications; Manager Media Manager Editor ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-508-422-2148. Good Feelings is published by Milford Regional, 14 Prospect St., Milford, MA 01757. Nonprofit postage paid. Issue date: Fall 2022. Material contained here is intended for informational purposes only. If you have medical concerns, consult a physician or other healthcare professional. Fall 2022 ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-508-422-2148. 6

MEET THE PHYSICIANS Introducing Debra Cohn, DO, and Melissa Palma, MD I n late 2021, Milford Regional welcomed obstetricians/gynecologists Debra Cohn, DO, and Melissa Palma, MD, to the Milford Regional Women’s Health practice located at 169 West Main Street in Hopkinton. Dr. Cohn specializes in both routine and atypical gynecologic and obstetrical care, minimally invasive surgical procedures, contraception and family planning. She has additional training in osteopathic manipulative medicine. Dr. Cohn completed her residency at Jersey Shore University Medial Center and is a member of the American College of Osteopathic Association, the American College of Obstetrics and Gynecology, and the American Association of Gynecologic Laparoscopists. What drove your decision to specialize in Obstetrics and Gynecology? Dr. Cohn: I chose obstetrics and gynecology as my specialty because it allows me to perform a good amount of surgery, but I also get to take care of patients from adolescence to menopause and form great relationships along the way. Dr. Palma: I had always pictured myself as a pediatrician. However, my Obstetrics and Gynecology rotation in medical school convinced me that this specialty was my calling. I love teaching young women about their bodies and how to plan for (or prevent) pregnancy, and then helping to bring that life into the world. Why did you decide to practice in Massachusetts? Dr. Cohn: I grew up in Westborough and wanted to be close to my family. I chose Milford Regional Medical Center specifically because it is a small community hospital that is affiliated with the academic medical centers in Boston and Worcester. Dr. Palma: I was born and raised in Massachusetts, and went to college and medical school here. After spending some time in the Midwest, I knew Massachusetts was where I wanted to raise my own family and begin my career. I began my career in Framingham in 2006 but made the transition to Milford Regional Medical Center more recently as I saw the growth and development of the medical center and knew the patient care opportunities here would only continue to expand. How do you establish a connection with your patients? Dr. Cohn: I think the most important way to establish trust and a connection with a patient is to listen to what they have to say. When you truly listen to someone, you can learn a lot and then find the best options to be able to help them or solve whatever problem they may be having. Dr. Palma: I think one of the best ways to connect with 7 Dr. Palma provides general gynecologic care for women of all ages, and both general and high-risk obstetrics care. She also specializes in minimally invasive surgical procedures. Dr. Palma received her medical degree from Tufts University School of Medicine and completed her residency at Saint Joseph Hospital in Chicago. She holds teaching appointments at Tufts and Boston University School of Medicine. patients is to share a little about myself as we progress through the visit. I think patients really appreciate hearing that they are not alone in some situations and it helps them see that their physician is human too. What advances in your field are you excited about? Dr. Cohn: Like with most specialties, advancements and improvements in care are steady. It is quite exciting to implement the most up-to-date care for my patient

He received his medical degree from the Georgetown University School of Medicine; a Master of Science in Physiology and Biophysics from Georgetown University; and a Bachelor of Science in Biology and Chemistry from Fordham University. Following his time at Fordham, he worked for a year in organized international humanitarian efforts