Among the many accomplishments of Sandy Hainline Williams is being instrumental in the creation of a Marshallese health-care clinic, which opened last November in Springdale.

For those efforts and others, NWA Media has selected Williams as its Nurse of the Year for 2012.

Co-worker Bill Burton said Williams has devoted the past decade of her life to helping improve the lives of the Marshallese population in Northwest Arkansas.

The Compact of Free Association signed in 1986 allows residents of the Marshall Islands to reside in the United States indefinitely without visas. Springdale offered nearly unlimited job opportunities in the boom years starting around 1990 and continuing until the recent recession, which played a significant role in that city becoming home to the largest population of Marshallese outside of their namesake islands.

“She has taken a lot of time to learn about their unique culture and works closely with their special health issues,” Burton said of Williams. “She has done numerous cultural-awareness seminars around the area to assist the medical community in better understanding this population.”

Burton said Williams has even been known to drive clients to appointments as far away as Little Rock.
“She has paid for patients’ medicine and co-pay fees out of her own pocket.”

Williams said she knew nothing about the Marshallese when she began working with them but has fallen in love with them as a whole.

“They are so nice, laid back and love their families — I am honored to be able to help them,” she said.

As a child in east Oklahoma and later Gravette, Williams grew up watching her father work in the medical field as a physician. At just 6 weeks old, he was taking her on rounds.

“It’s all I ever knew — I really never thought about being anything else but a nurse,” she said.

Williams began her career as an operating room tech but soon realized she was doing the same duties as a licensed practical nurse, although for less pay.

She earned her LPN license from Northwest Technical Institute in Springdale in 1975.

Williams said she later ran into the same issue — she was doing the work of registered nurse but being paid as an LPN. So she again went back to school and earned her associates nursing degree from the University of Arkansas.

Williams has always gravitated toward emergency, critical and intensive care.

“You really get to get to know someone very quickly and have to make a quick association,” she said. “There’s no other field of medicine like that. It’s exciting and challenging.”

A NEW CHALLENGE
After working at several hospitals, Williams in 2001 heeded the urging of a friend and joined the Benton County office of the Arkansas Department of Health.

Nine months later, she was asked to interview for a grant-funded position that focused on identifying and treating tuberculosis in Northwest Arkansas. Williams was selected for the position, which allowed her to hire two outreach workers — one Hispanic and one Marshallese.

The team discovered that the Marshallese in Springdale not only accounted for most of the tuberculosis cases, but they also had other “huge health issues,” Williams said.

The afflictions included diabetes, unusual skin conditions, high blood pressure, dental problems and others. Most of the Marshallese population had not received any sort of preventive health care, and their children were behind on immunizations, Williams said.

Realizing that most of the tuberculosis was in Washington County, the health department moved Williams and her team from Benton County to Washington County.

During the first year of the grant, the team investigated and treated as many cases of tuberculosis as possible. Instead of asking a family to come into a clinic, the team made home visits, which allowed them to test the entire household.

While treating the tuberculosis, the team also helped Marshallese, and some Hispanics, with immunizations and access to basic health care.

When the grant expired, state health officials came from Little Rock to access the work that Williams’ team had done. They were so impressed that they absorbed the team into the Health Department.

In 2011, the department secured a clinic site near the Jones Center for Families in downtown Springdale, which is accessible to most Marshallese.

Williams said because one large family often only has one vehicle, location is very important.

“It’s a big deal to ask them to drive to Fayetteville to be treated, but being in the Jones complex makes us accessible,” she said.

Although the clinic is funded by tax revenue, it saves taxpayers in the long run, Williams said.

“It is much more cost-effective to prevent disease than to wait until someone is sick and needs expensive medical treatment that the public pays for,” she said.

NOT AN EASY ROAD
Williams had to examine the history and culture of the Marshallese to grasp the plethora of medical problems that so many of them face.

She said there are many contributing factors, including little access to medical care in the outer islands, a lack of education, limited access to basic services in the United States and belief that diseases are a result of supernatural causes.
“In the Marshall Islands, health care is run by the government, and a person on the outer islands is lucky to see a doctor once in three months — if that,” Williams said.

Williams said that because many Marshallese believe an illness or condition is brought on by a curse, they avoid seeking medical attention.

“Some Marshallese see it as admitting weakness to go to the doctor,” she said.

However, with about half of the Marshallese population in Springdale under age 20, the culture is changing.
“As children grow up in the U.S., they are starting to understand how to take better care of themselves,” Williams said.
Because Marshallese not born in the U.S. aren’t required to seek citizenship, many do not qualify for most federal assistance or Medicaid in Arkansas. Pregnant women who meet income guidelines do qualify for SCHIP Medicaid, as do Arkansas-born children, Williams said.

The nonprofit Community Clinic and the state Health Department outreach clinic where Williams works are doing their best to help the Marshallese get proper health care. The outreach clinic doctor holds a skin clinic there once a month. Williams hopes to see a wavier to the Arkansas Medicaid act to include foreign-born Marshallese who meet income guidelines.

Breast cancer is No. 2 among common cancers in United States women and one of the leading causes of female cancer death. About one in eight women will be diagnosed with it during her lifetime.

Early detection remains the best and most effective tool in the battle against breast cancer. According to the American Cancer Society, there are more than 2 million breast cancer survivors nationwide. Understanding your risk factors and making wise lifestyle choices is the first step. Regular check-ups and screenings are important, too — the earlier breast cancer is found, the better your chances for successful treatment and recovery. Mammograms play a key role in monitoring breast health and detecting any changes that warrant further examination.

Northwest Breast Imaging Center at Willow Creek offers advanced breast imaging with digital technology that yields accurate, reliable results. Personalized care is tailored to the patient’s needs in order to provide peace of mind.

A New Ally
Northwest Health System is committed to providing resources to help detect breast cancer at its earliest stages.

Recent advances include:
• New convenient location near Willow Creek Women’s Hospital in Johnson
• A relaxing, spa-like environment
• Spacious, private dressing rooms, exam rooms and bathrooms
• Digital mammography with Soft Touch Mammo pads
• Advanced ultrasound equipment
• Needle biopsy procedures, which can often be scheduled on the same day
• For follow-up diagnostic imaging, an on-site radiologist interprets studies and consults with patients during the appointment
• Digital mammography van, which is the only digital mobile unit in Northwest Arkansas; used to provide annual mammograms for area employers and at community events.

The Women’s Breast Imaging Center offers advanced imaging technology for women’s preventive health. Digital mammography enhances the doctor’s ability to detect changes in breast tissue at an earlier stage. A digital mammogram uses computer technology to capture high-resolution, sharply defined images of the breast tissue. This technique provides more detailed images, which can allow the trained radiologist to detect any potential abnormalities earlier than with traditional mammogram techniques.

For patients, a digital mammogram feels quite similar to a traditional screen-film mammogram. Both techniques use breast compression and X-rays to capture images of the breast tissue.

Computer-based images obtained during a digital mammogram are produced in a matter of minutes and displayed on high-resolution computer monitors. These images can be manipulated for more detailed evaluation and stored electronically, which means health records can be retrieved more easily for future reference.

Image-Guided Biopsy
The new center also offers image-guided breast biopsies, which are simpler, quicker and more comfortable for patients than traditional open surgical biopsies. The biopsy is a minimally invasive, one-step procedure that is performed in an outpatient setting using ultrasound and/or mammographic guidance to examine the breast tissue.

A breast biopsy collects a small sample of breast tissue for further examination, such as after a lump or abnormal tissue is found. Benefits of minimally invasive biopsy include:
• No hospitalization required
• Imaging guidance allows radiologist to more accurately pinpoint the lesion or lump of interest
• Requires only a single small incision with no stitches
• Requires only local anesthesia to minimize discomfort
• Minimal scarring – internally and externally
• Allows immediate return to normal activities

Early detection is key

The American Cancer Society recommends that all women over 40 have a screening mammogram annually.
Factors that may increase the risk of breast cancer:
• Age 55 and up. About two-thirds of women with invasive breast cancer are 55 or older when the cancer is found.
• Genetic changes. About 5-10 percent of breast cancers are thought to be linked to inherited changes in certain genes, primarily BRCA1 and BRCA2.
• Family history. Breast cancer risk is higher among women whose close blood relatives (mother’s or father’s side) have the disease.
• Ethnicity. Caucasian women are slightly more likely to get breast cancer than are African-American women. Asian, Hispanic and American Indian women have a lower risk.
• Dense breast tissue. Dense breast tissue means there is more glandular tissue and less fatty tissue. Women with denser breast tissue have a higher risk of breast cancer.
• Menstrual history. Women who began having periods before age 12 or who went through menopause after the age of 55 have a slightly increased risk.
• A baby after age 30. Women who have not had children or who had their first child after age 30 have a slightly higher risk.
• Use of birth control pills. Studies have found that women who are using birth control pills are at a slightly greater risk than women who have never used them.
• Postmenopausal hormone therapy (PHT). PHT is also known as hormone replacement therapy. Long-term use of PHT may increase the risk.

More information about the services at the Breast Imaging Center is available online at northwesthealth.com or by calling (479) 750-6660.

Appointments can be scheduled by calling  (479) 757-4135. The Breast imaging Center is located at 5501 Willow Creek Drive, Suite 103 in Springdale.

The field of nursing is seemingly recession-proof. According to the U.S. Bureau of Labor Statistics, there are about 2.6 million nurses nationwide. No other career choice within the field of health care can claim such strength in numbers, both in the United States and Canada.

There are many advantages to becoming a nurse, including growing employment opportunities. Over the next 20 years, the bureau predicts 800,000 vacancies in the field of nursing in the United States alone. Financial gain is to be had as well.

Depending on the type of nurse, he or she has the potential to make between $43,000 and $115,000 a year, according to the bureau’s Occupational Employment Statistics Program. Furthermore, because of the wide breadth of nursing services, there is plenty of room for specialty application and advancement.

Here are the common types of nurses and education requirements.

• Nursing aide/orderly: Nursing aides and orderlies help nurses care for patients and perform routine tasks. They spend most of their time with patients — serving meals, keeping patients comfortable, answering call lights, making beds and giving baths. Most nursing aides work in a hospital setting or long-term facilities for the elderly. A high school diploma may be all that’s needed to become a nursing aide.
• Licensed Practical Nurse (LPN): A licensed practical nurse studies for a year after earning a high school diploma and must be licensed in the state in which he or she will work. LPNs typically record medical histories, weigh and measure patients, record symptoms and administer injections.
• Registered Nurse (RN): An registered nurse typically pursues a two-year associate’s degree in nursing or may receive a bachelor’s degree in the field. RNs must pass a national exam to become licensed. Duties of an RN are generally more varied and in-depth than those of an LPN and can include helping patients manage treatment plans.
• Nurse Practitioner (NP): Nurse practitioners are among the most educated hospital employees. In addition to their RN study, they earn a master’s degree and may specialize in one area. Also, NPs may be able to work outside of the authority of a physician. In such instances, an NP can run a medical practice, diagnose illnesses and prescribe medication, just as a doctor would.

Although doctors often are thought of as the primary care providers in most health-care settings, nurses are growing in numbers and have taken on many of the roles once reserved exclusively for doctors.

SPECIAL TO NWA MEDIA Enola Bunton, R.N., is a breast health navigator at the Washington Regional Cancer Support Home. Her position is funded by the Susan G. Komen Foundation.

Enola Bunton, R.N., has joined Washington Regional Cancer Support Home as breast health navigator. In this role, she provides personal assistance to patients and families by guiding them through all phases of the cancer experience.

Bunton provides information, literature and support, and may even accompany patients to doctor visits, surgery and treatment.
“The breast health navigator follows women throughout every aspect of treatment, aiding in dispelling fear, linking to financial and quality-of-life support resources and being a comfort and friend to patients and their families,” said Susan Neyman, manager of the Cancer Support Home.

Neyman said the navigator role is designed to:
• Specialize in educational information about benign and malignant breast diseases, treatments and side effects of treatment
• Provide facts about breast cancer — not opinions and no treatment advice — and support the decisions of the physician and patient
• Provide a link to language translation when necessary
• Provide emotional support to breast cancer patients and their families
• Conduct continual assessment of the educational, physical, psychological and social needs of the patient and family members
• Make appropriate referrals for additional assessment when needed
• Serve as a support group facilitator for a variety of breast cancer support groups
• Coordinate Washington Regional’s weekly multidisciplinary breast conference
• Provide financial and support services resources to patients and their families
• Serve as an advocate for breast cancer patients
• Become a knowledgeable friend to each patient

Prior to joining Washington Regional, Bunton was a patient advocate and navigator at Hope Cancer Resources. Her background also includes home health nursing, case management and medical auditing. She earned a bachelor of science degree in nursing from the University of Arkansas. Bunton’s credentials also include certification from the Harold P. Freeman Patient Navigation Institute and in health-care management systems coding.

More information about the breast health navigator program is available by contacting Bunton at (479) 521-8024. The breast health navigator position at the Cancer Support Home is funded by the Ozark Affiliate of Susan G. Komen for the Cure.

Established in 1995, the home serves the Northwest Arkansas community with locations in Bentonville and Fayetteville. Services include free overnight lodging, support groups, various cancer screenings, resource library and mastectomy supplies. The home is supported in part by grants from Cancer Challenge, Ozark Affiliate of Susan G. Komen for the Cure, Walmart, SAM’S Club Foundation, Winthrop P. Rockefeller Cancer Institute Auxiliary and Bank of America Foundation, as well as by corporate and individual contributions.

Natasha Maier, who formerly worked with Nay at a women’s clinic, said “bubbly” and “outgoing” are come to mind when she thinks of Nay. Maier said that in addition to knowing her job, Nay excels at customer service.

“She is one of few nurses that takes the time to find and answer to a question and will actually call you back,” Maier said. “She is very personable, and it seems like she enjoys her job no matter what hurdles may come.”

Nay said she always knew she wanted to work in a profession where helping people is the main priority. The self-described “people person” said nursing was a good fit for her because she could help people on a daily basis.

“If I have eased someone’s concerns or fears regarding their current health issues, it was a very successful day,” Nay said.
She said nurses not only have physical duties, but also the responsibility of providing emotional support to patients and their families.

“It truly is a powerful dynamic between the two,” she said.

While rewarding, the profession is very demanding and can be emotionally draining, Nay said.
“The absolute most difficult portion of my job is caring for patients who have just been given bad news or a poor prognosis,” she said. “My heart truly aches for people who are going to be given upsetting news, but I try to remain strong and very supportive for their sake.”

In addition to being a full-time nurse, Nay also is a mother and wife. Because nurses are needed around the clock, Nay said she is lucky to have a “normal” schedule, which is easier on her family.

When she’s not at work, she and her family are “always on the go,” she said. They love spending time outdoors, traveling, going to sporting events, taking in movies and trying new restaurants.

Among those on hand at the Pinnacle Hills Promenade will be Aimee Johnson of Fayetteville, a 26-year-old survivor of breast cancer who is extremely grateful for the financial help she received from the foundation.

Six years ago, when Johnson was just 20, she felt a lump in her breast as she showered. Her primary-care doctor told her it was probably nothing to worry about, but six months later the lump was so large that Johnson requested a needle biopsy, which revealed she had stage 2 ductal carcinoma.

Too old to be on her mother’s insurance and without a job that provided that benefit, Johnson had to rely on Medicaid to pay her medical bills. Her doctors wanted to have her genetically tested to determine whether or not she would have a double mastectomy or a much simpler lumpectomy. While Medicaid did not cover the test commonly known as a BRAC analysis, Johnson was able to secure the a Komen grant to cover the $3,200 cost. The test showed that she did not carry the gene mutation, which helped her doctors decide her course of treatment.

“Because I do not have the breast cancer gene, I was able to have a minor surgery in comparison to the double mastectomy that they would have done,” Johnson said. “Thanks to the Komen grant, I have my breasts still.”

Before the lumpectomy, Johnson received chemotherapy and lost all of her hair, including her eyebrows and eyelashes. The chemotherapy cleared all traces of cancer, but she still received radiation and oral medicine.

Although the process was traumatizing, Johnson said some good has come out of having cancer.

“It has made me want to be a better version of me, and it has also made me realize that I don’t need to do things that I don’t like because you only get one life to live.”

Drew Eisele enjoys making patients happy on the medical/surgical floor of Mercy Medical Center in Rogers.
“The best part of being a nurse is hearing patients tell me the great experience they have had at Mercy,” said the 29-year-old registered nurse upon being named among the best in his profession by NWA Media. “That keeps us going.”

Annette Boling of Bella Vista has stayed at Mercy several times under Eisele’s watch.

“Drew is always professional, kind, pleasant and has an excellent bedside manner,” Boling said. “What a wonderful person Drew is — too bad there aren’t more people like him in the nursing profession.”

Suzanne Kent, also of Bella Vista, said she is grateful for the care he provided her sister while at Mercy.
“Drew helped my sister above and beyond the call of duty,” she said. “I am so grateful for his care.”

Eisele decided to enter nursing after realizing he was unhappy at a desk job sitting still all day. He wanted a profession that he could feel good about and would keep him moving when a friend told him about the flexibility of becoming a nurse.
“I looked into becoming a nurse and felt it would be a really good fit for me,” he said. “I cannot put into words how much of a growing experience it has provided me.”

Eisele has worked at Mercy since October 2010 and believes it is the best hospital in Northwest Arkansas.

“Mercy attracts staff that not only sees their time at the hospital as a job, but people who really want to make a difference in others’ lives,” he said. “I do not believe it is was just chance this opportunity was placed in my path — this is where I am supposed to be right now.”

Tonja Seusy, clinical director of medical/surgical and Eisele’s supervisor, said he understands what “giving of self” means as a nurse.

“When I think of Drew, this quote from Mother Theresa comes to mind — ‘It is not how much you do, but how much love you put in the doing.’”

Seusy said her wish is for all Mercy’s patients and families to have the opportunity to have a nurse like Eisele.
Originally from Mena, Eisele has lived in Fayetteville for six years. When he is not at the hospital, he enjoys bicycling and spending time with wife Alisha and 18-month-old daughter Lila.

“The cold and flu season brings on body aches, sore throats, chapped lips, headaches and fevers,” said Dr. Charles Zugerman, clinical associate professor of dermatology at the Feinberg School of Medicine, Northwestern University, Chicago. “When suffering from these ailments, it is important to stay home and not risk spreading germs to others.”

Zugerman said it is critical to have the necessary items on hand to combat symptoms before the season starts to ensure a restful recovery. Here are a few medicine cabinet basics:

• Sanitizer. Stave off germs by keeping disinfectant wipes and a hand sanitizer that contains 60 percent ethanol or isopropanol nearby. These will help kill germs and prevent them from being transmitted.
• Nasal decongestant. A stuffy nose is one of the most common and irritating symptoms of allergies, a cold and the flu. Decongestants relieve congestion and help shrink the tissues and blood vessels in the eyes and nose that swell in response to a cold or contact with an allergen.
• Lip balm. Mouth breathing due to congestion and other side effects of a cold, allergies and the flu create severe dryness and irritation that leave lips susceptible to further infection. By relieving annoying symptoms like lip discomfort, cold and allergy sufferers feel better, which in turn helps them rest and recuperate.

But a lesser-known condition — food sensitivities — can affect a person’s health to varying degrees.

Food sensitivity is often linked to chronic disease but is not life-threatening, said Dr. Jason Collins of Northwest Health & Lifestyles Centre in Bentonville. Collins is a chiropractor who also works in nutritional counseling and food sensitivity testing.

A person with a food sensitivity cannot properly digest that food, which is especially common in processed foods like grains, milk and sugars.

Collins said patients often expect the traditional skin scratch test associated with allergy testing, but food sensitivity is determined through blood tests.

“I explain the difference between food sensitivity testing so the patient understands that the immune pathways, timing of symptoms and testing methodology are different,” he said.

The blood tests measure the levels of antibodies to specific foods.  “The greater the concentration of antibodies, the more likely it is that the food triggers an inflammatory reaction that results in symptoms,” Collins said. “The two panels we use most often test for 96 and 184 foods.”

Once the results have come back from a Alletess Medical Laboratory, Collins works with the patient to formulate a personalized diet plan. The patient receives a card that lists all their food sensitivities.

Collins said many healthy people have sensitivities to certain foods. Because the symptoms can be subtle and may not appear until well after eating, they often don’t suspect that a food is to blame, he said.

“The antibodies involved in this reaction stay elevated for up to 72 hours, so by the time the antibodies would normally drop, we have often eaten the same food again,” Collins said.

Because signs and symptoms of food sensitivity can vary greatly, testing is the best way to know if there is a problem food, he said.

Ranging from vague to debilitating, common symptoms include digestive issues such as acid reflux, bloating, constipation and diarrhea; headaches; fatigue; upper respiratory problems such as sinusitis or asthma; skin conditions; itching; and joint pain.

“Chronic food sensitivities may be associated with autoimmune problems such as Crohn’s disease, irritable bowel syndrome, rheumatoid arthritis, eczema, psoriasis and lupus,” Collins said.

Danette Thompson of Fayetteville had lived with chronic joint pain and “terrible stomach pains” for years before eliminating gluten from her diet. She discovered that after her morning bowl of shredded-wheat cereal, her symptoms would worsen.

“Within five days of cutting out the cereal I felt better than I had in years, and as a pleasant surprise my arthritis went away, too,” Thompson said.

Collins said that this type of relief is not uncommon, especially among people with autoimmune diseases such as rheumatoid arthritis and lupus.

“The most dramatic improvements I see are with people who have autoimmune disorders,” he said. “Patients with rheumatoid arthritis often find relief from small-joint pain and patients with lupus have seen a reversal of their symptoms which reflected in follow-up lab tests.”

Last year, Collins had a patient who suffered from migraine headaches about 20 times a month. She had these migraines for several years, and also had significant digestive problems. Collins said after identifying her food sensitivities, she had 10 migraines over the next three months.

“When we last spoke, she hadn’t had a migraine for about six months,” he said. Nutritional counseling and food
sensitivity testing can be scheduled by calling (479) 254-9355

While the two afflictions have similar symptoms, they are very different.

“Common colds are caused by viruses, while seasonal allergies are triggered by immune-system responses to an allergen,” said Dr. Tom Crosby, a family-practice doctor at Washington Regional Family Clinic–Fayetteville.

Hay fever, or pollen allergy, is one of the most common kinds of allergies, according to Crosby, but people can be allergic to many different things, such as dust mites, animal dander, mold or even certain foods and medications.

“When you encounter something that you are allergic to, your body reacts with sneezing, runny nose and itchy eyes — symptoms similar to those of the common cold.”

About 35 million Americans suffer from hay fever, according to the U.S. Department of Health and Human Services. Pollen is produced by trees, grasses and weeds, so the risk of exposure is all around us.

“During the spring, summer and fall months, many plants release pollen into the air,” Crosby said. “When you breathe, you breathe in the pollen. It’s hard to avoid.”

Hay fever symptoms also can include stuffy nose and coughing, along with itchy nose and throat. Some patients also report red, swollen or watery eyes.

“Your symptoms might be different at different times of the year,”  Crosby pointed out. “It depends on the kinds of plants that grow where you live and what kinds of things you are allergic to.”

To determine whether a patient has allergies instead of a cold, doctors often turn to diagnostic testing. In one type of allergy test, doctors use a needle to put a small amount of allergen into the patient’s skin. After a few minutes, the reaction tells the doctor if the patient has an allergy. Doctors can also use a blood test to look for a protein in the patient’s blood called IgE, or immunoglobulin E, which is produced by people with allergies and hay fever.

Treatment of seasonal allergies may include over-the-counter or prescription antihistamines, nasal steroid sprays and decongestants, and avoiding allergens when possible. Some patients may require injections. Symptoms may last as long as the patient is exposed to the allergen.

To treat a common cold, Crosby recommends rest, pain relievers and over-the-counter cold remedies such as decongestants.

“Typically, cold symptoms will clear up within a week or so,” he said.