Our Passion, Your Health

Our Passion | Your Health features stories on the latest happenings at Penn State Health St. Joseph. Check out our blogs, recipes, patient stories, program highlights, and new services that represent our passion...your health.

Prenatal Care Open House Connects Expectant Moms with Health Care

Emily, an Exeter Township woman who recently learned she was pregnant, found a health care home recently when she visited a Prenatal Care Open House at the Downtown Campus of Penn State Health St. Joseph.

“I just wanted to get some more information, because it’s like, ‘we’re pregnant, now what do we do?’” she said. “I didn’t expect to get all this help when I came here today.”

Hosted by Kimberly Hunter, OB Nurse Navigator with Penn State Health St. Joseph, Emily received a tour of the Downtown Campus OB/GYN facilities and learned about St. Joseph’s innovative Centering Pregnancy program.

She was excited to hear about the program, which employs a group setting. With a group size of about six, women who are due within the same month interact with one another by learning together, sharing information and supporting one another.

While participating in the Centering Pregnancy program, expectant mothers also receive private prenatal care from Penn State Health St. Joseph providers.

“Centering is unique because there’s a self-care aspect,” Hunter explained to Emily. “I’m really proud of this program, and the women who participate in it really love it.”

The small group setting enables women to bond with one another as they share ideas and concerns and keep each other up to date about what’s happening with their pregnancies.

“It becomes a real feeling of community,” Hunter said. “There’s lots of sharing and concern for one another.”

Low-risk patients are given a choice of participating in the Center Pregnancy program or receiving traditional pre-natal care. About 60 percent choose the Centering option, which is managed by midwives.

“Most women enjoy the bonding and fellowship that happens with that group,” Hunter said. “But the more traditional type of care also is available.”

Before she left the open house that day, Emily was signed up for an intake appointment with a nurse, and feeling far more assured than when she’d arrived.

“This is amazing,” said Emily, who with her husband moved to the Reading area from a small town in Massachusetts. “Everyone here is so friendly and helpful. This place feels like a really good fit for my baby and me.”

Emily was only one of about a dozen women who attended the open house, anxious to learn more about their options for pregnancy care.

“Any patient in the community who appreciates and wants the services of a midwife can come here for those services,” explained Kelly Johnson, Clinic Leader of the Downtown OB/GYN department.

The Downtown Campus also is staffed by physicians, nurses, nurse practitioners, medical assistants, community health workers and other staff who assist women throughout their pregnancies.

“Women can get all the care they need here, and then deliver at St. Joseph’s Bern Township hospital,” Hunter explained. “It makes it nice for anyone who lives in the City and might have an issue with transportation. We’ve got a great facility right here, downtown.”

Kim Hunter, MSN, RN, OB Nurse Navigator Planning a pregnancy? Expecting this year? Want to check out our birthing center? Or just have general questions? Call Kim Hunter, MSN, RN, OB Nurse Navigator and let her be your personal guide.
610-378-2569   |   KHunter3@PennStateHealth.psu.edu   |   www.StJoesSpecialDeliveries.org

Parents Receive Perfect Christmas Gift

A baby boy, born two weeks before his due date on Dec. 25, seems like a Christmas miracle for parents Dominic and Tabitha DeLillo and their five-year-old daughter, Annalise.

Photo Credit: Brianna DeLillo

Jaxon Sonny DeLillo was born Christmas afternoon at 4:13 in Penn State Health St. Joseph’s Breidegam Family Birthing Center, and is now at home with his parents and sister in Windsor Township.

“It’s the same day that Jesus was born,” Dominic marveled a week and a half after Jaxon’s birth. “He just seems like a Christmas miracle.”

Tabitha, who after being admitted to Penn State Health St. Joseph early Christmas morning had other things to think about than the date of the birth, was equally pleased that Jaxon arrived when he did.

Tabitha had learned several weeks prior to delivering that doctors did not expect she would carry the baby until its due date, as her cervix had already begun to dilate. Still, she was surprised when, very early on Christmas morning, there were indicators that Jaxon might be on his way.

“She woke me up around 4 o’clock,” Dominic said. “I looked at her and said, ‘you’re kidding, right?’ because I’d just gone to bed two hours before that. I was up getting the gifts ready and making sauce for my lasagna the next day.”

Tabitha, however, was not kidding, and, in a light snow, they arrived at the hospital at about 6 a.m.

Once Tabitha was settled and comfortable, Dominic returned home to open some presents with Annalise and to prepare two pans of lasagna. One was for his father, and the other was for doctors and nurses on duty at Penn State Health St. Joseph.

“Tabitha worked in the nursing field and had to work on holidays, so she knew what it would be like being at the hospital on Christmas,” Dominic explained. “So I put together a full tray, and I think that everybody appreciated it.”

Dominic returned to the birthing center with plenty of time to spare, and waited with Tabitha until the baby was born.

“At one point we weren’t sure he was going to be born that day,” Tabitha recalled. “The midwife wasn’t sure if my water had broken, and the contractions I was having weren’t that strong.”

Once the contraction started in earnest, however, it was a very short time until Jaxon was born.

“It went really fast at the end,” Tabitha said. “Once I really started dilating, it was only about 20 minutes until he was born.”

In addition to the timing of Jaxon’s birth, his parents discovered some other bits of information that made them smile. When they got home and compared the information cards staff members had recorded for Annalise and Jaxon, they realized that both babies had been born at nearly the exact same time in the same room.

And, during the earliest hours of each child’s lives, they received care from the same physician, Dr. Mary Ann Mancano, a pediatric hospitalist.
“That was really neat to find out,” Dominic said. “It seemed a little bit like we had come full circle.”

10 Reasons to Deliver With Us

Want to know what sets our Birthing Center apart from others? How about 10 things that set us apart?

10 Reasons to Deliver With Us

Penn State Health St. Joseph Working to Raise Awareness of Sexual Abuse

A case of sexual assault occurs every 98 seconds in America, according to Rape, Abuse & Incest National Network (RAINN), the nation’s largest anti-sexual violence organization.

Tina Roman-Rios, a community health worker in the OB/GYN Department at Penn State Health St. Joseph’s downtown campus, is working to change that.
“My mother raised me to know that I’m important enough to not be in an abusive relationship,” Roman-Rios said. “And I want to let others know that they are that important, too.”

Working toward that end, Roman-Rios created a display at Penn State Health St. Joseph’s Family and Women’s Center at the Downtown Campus. A large bulletin board provides information and facts in English and Spanish, urging people to recognize and take action against domestic violence and sexual assault.

“I designed it so it’s eye-friendly and easy to read,” Roman-Rios said. “You don’t need to understand big words or medical terms to understand what it means.”

The board, along with an information table that Roman-Rios tends to, will remain in place throughout April and into May. April is Sexual Assault Awareness and Prevention Month.

Safe Berks donated items and information packets that Roman-Rios distributes to people who visit the Downtown Campus.

“I think it’s important to keep this issue in the public eye,” she said. “Sexual violence isn’t something that we can keep quiet about. We get a lot of people coming into this clinic who can learn if we provide information for them.”

In addition to educating patients and their families about sexual assault and prevention, Roman-Rios and others in the OB/GYN and Women’s Care group encourage women to seek help, when necessary.

“We see patients who, for various reasons, are reluctant to call the police in cases of domestic violence or abuse,” she said. “And, that is a problem.” However, she explained, there are other sources of help. “If someone is afraid to call the police, they should call the Safe Berks hotline,” Roman-Rios said. “And, if they can’t call, they can text. The important thing is to seek help. Someone who is abused needs counsel.”

Victims need to remember that sexual abuse happens among every socio-economic group, ethnic group and religion, and that they are not to blame.
“Abuse is never the victim’s fault,” said Roman-Rios, who is studying to be a nurse. “That’s something that everyone needs to remember.”

Roman-Rios admitted that, as a teenager, she did not understand the mentality and circumstances that cause some people to remain within abusive situations.

“I was little judgmental,” she said. “But people should never judge. Abuse very easily can be mistaken for love.”

The OB/GYN and Women’s Care clinic is a safe place where patients who are experiencing difficulty can talk to someone who cares about them, Roman-Rios noted.

“We understand the perils that some of our patients face and we do whatever we can to help them,” she said.

Roman-Rios, who has lived in Reading her entire life, is committed to bringing positive change to the city and her patients that live there.

“I care about this city, and I’m working to make a difference,” she said. “And, I’ll teach my children to work to make a difference, too. I think that we can change things for the better, even if that change starts with a simple board in a downtown clinic.”

How to Find Help

If you, or someone you know, is a victim of domestic abuse or sexual violence, there is help available.

Safe Berks offers a 24-hour, toll-free hotline at 844-789-SAFE (7233). You also can text SAFE BERKS to 20121 for help, or contact by email at peace@safeberks.org.

Rape, Abuse & Incest National Network (RAINN) also offers a 24-hour, toll-free hotline at 800-656-HOPE (4673). Or, you can live chat online in English or Spanish on RAINN’s website at rainn.org.

Breidegam Family Birthing Center: Our All Deliveries Are Special Deliveries.

The Breidegam Family Birthing Center opened in 2006 and offers state-of-the-art care to expectant mothers and newborns. The Center includes 15 private maternity suites (six of them dedicated to cesarean section patients) in which mothers and babies are cared for together. Our 6 bed, Level IIIA state-licensed neonatal intensive care nursery is located nearby for infants who have special health needs following birth.

Once you enter our home-inspired birthing suites you will feel at ease; this will be your room for the duration of your stay with us. Also known as LDRP, you will labor, deliver, recover and stay in one private room. Each room is equipped with a whirlpool tub that can be used for relaxation during labor, or for pampering after delivery.

There is a sofa bed in your suite for your support person to stay with you. Your suite also includes free Wi-Fi and a flat screen TV. When you leave us, we have lovely parting gifts in a tote bag designed specifically by your baby!

Our caring, well-trained staff is there to assist you through each stage of labor, delivery, and post-delivery care so that you feel confident in bringing your baby home. Our Lactation Consultant and staff promote skin-to-skin care to help your newborn transition into the world. Mothers who choose breastfeeding are supported throughout their stay to reach their personal goals. Mothers are comforted to know that their baby is asleep beside the bed, being able to respond quickly if the little one needs attention.

Whether this is your first baby or the next expansion of your family, we invite you to see why we make all births special!

Kim Hunter, MSN, RN, OB Nurse Navigator Planning a pregnancy? Expecting this year? Want to check out our birthing center? Or just have general questions? Call Kim Hunter, MSN, RN, OB Nurse Navigator and let her be your personal guide.
610-378-2569   |   KHunter3@PennStateHealth.psu.edu   |   www.StJoesSpecialDeliveries.org

Thermal Totes Donated to NICU Provide Safe Transport for Mothers’ Breast Milk

Former Fleetwood resident Alycia Cardona has a heart for service and reaching out to others.

It’s evident in her work as a counselor in the mental health/addictions field, and it extends into her position as an independent director with Thirty-One Gifts, a direct selling company that offers purses, accessories, totes and other items.

Thirty-One Gifts, which was founded in 2003 with a mission of giving women business opportunities that could support and strengthen them, also has a strong charitable program and encourages its consultants to make a difference within their communities.

It was that urging that prompted Cardona to reach out to her former neighbor, Bobbi Jo Martin, a NICU nurse at Penn State Health St. Joseph.
“I was looking for a way to help, and I reached out to Bobbi Jo,” Cardona explained. “I was motivated by the mission of Thirty-One Gifts and wanted to do something beneficial in my community.”

baby

It did not take Martin long to identify a way that Cardona could help.

The staff of St. Joseph’s NICU is adamant about the benefits of breastfeeding, and encourages all mothers to breastfeed, or at least pump breast milk for their babies’ use. While staff is able to help moms secure breast pumps and other items, they were lacking in one regard.

“We didn’t have a safe way for our moms to transport their milk so they can bring it from home to their babies in the hospital,” Martin explained. “That was the piece we were missing.”

When Martin explained that need to Cardona, the Thirty-One Gifts director had a ready answer.

“Thirty-One Gifts has these thermal bags that I knew would be just perfect for this,” Cardona said. “I was so excited to think I could do something that might make a difference to women who were going through a difficult time.”

Cardona used social media and employed the old-fashioned method of posting flyers in area grocery stores and meeting places, asking people to donate money that would be used to buy a thermal tote in which breast milk could be safely transported.

The response was memorable.
“I was able to collect donations to purchase 35 thermals, and then I used the commissions I made on the sales to buy items to put inside of the bags,” Cardona said. “I am so proud of our community for getting behind this project and helping these moms.”
Several of the bags were donated by women whose babies are former patients of St. Joseph’s NICU.

Cardona began collecting the thermal bags in July, and delivered them to the NICU in September, which was designated as NICU Month. The response from mothers who have received the bags has been extremely positive.

“They are thrilled,” Martin said. “We’ve all been surprised at how excited the moms are to get the bags. They’ve certainly been using them, and that was the whole idea.”

Packed inside each bag are items including a reusable ice pack, dish soap, antibacterial wipes, nail file, pen, notebook and tissues.

Cardona recently moved to San Diego, CA, but maintains close ties with the Berks County community. She stays in touch with Martin, who keeps her up to date on the use of the thermal bags.

“I am over the moon excited that the bags have been so received by the hospital and the mothers,” Cardona said. “It’s very rewarding to be in a position to help others, especially those going through a difficult time. There’s no greater joy than knowing you had a positive impact on someone’s life.”

Kim Hunter, MSN, RN, OB Nurse Navigator Planning a pregnancy? Expecting this year? Want to check out our birthing center? Or just have general questions? Call Kim Hunter, MSN, RN, OB Nurse Navigator and let her be your personal guide.
610-378-2569   |   KHunter3@PennStateHealth.psu.edu   |   www.StJoesSpecialDeliveries.org

Penn State Health St. Joseph working to advance the cause for breastfeeding

Breastfeeding is good for mothers and babies.

With that in mind, Penn State Health St. Joseph is participating in several initiatives to advance the cause for breastfeeding among patients and employees, with one woman leading the charge.

Cindy Griffis, a lactation specialist at St. Joseph’s and an International Board-Certified Lactation Consultant, said the hospital is working to become a Baby-Friendly facility, as specified by the Baby-Friendly Hospital Initiative of the World Health Organization and the United Nations Children’s Fund.
breastfeeding-lg
St. Joseph’s also is participating in the Pennsylvania Department of Health’s Keystone 10 Initiative, aimed at increasing the rate of breastfeeding and ultimately improving the health of mothers and babies.

The hospital is working toward these goals, Griffis said, because it’s the right thing. “This is my mission,” she said. “It’s the right thing to do.”

St. Joe’s already has in place a corporate lactation program for employees, which includes a free class and consultation, and other services for employees who are pregnant or breast feeding.

In March the hospital, which offers employees a designated Lactation Room, was named a 2015 Berks County Breastfeeding-Friendly Employer by the Berks County Breastfeeding Coalition.

Offering opportunities for women to breastfeed their babies at work or express milk for them during the work day is good for both employers and employees, Griffis said.

“It’s all about return on investment,” she said. “Family-friendly workplaces have lower levels of absenteeism and greater employee satisfaction. Most companies do understand this.”

The federal Break Time for Nursing Mothers law, enacted in 2010, requires some employers to provide basic breastfeeding accommodations for some nursing mothers at work.

“Basically, the new laws say that any place with more than 50 employees must provide break time and a private place for moms that is not a bathroom,” Griffis explained.

While the topic of breastfeeding can be controversial, the benefits to both mothers and babies are clear. “The whole thing with breastfeeding is that the health benefits are so significant,” Griffis said.

Studies show that babies who are breast fed have lower incidence of:

  • Asthma
  • Sudden infant death syndrome
  • Ear infections
  • Dermatitis
  • Childhood leukemia
  • Childhood obesity
  • Gastrointestinal infections
  • Type I and Type II diabetes

Mothers who breastfeed their babies have lower incidences of breast and ovarian cancer and diabetes. And, studies suggest that breastfeeding reduces the risk of osteoporosis later in life and may help to avoid post-partum depression. Breastfeeding also contains economic benefits. The U.S. Department of Agriculture reports that infant formula on average costs a family in the United States between $1,200 and $1,500 a year. And, statistics show that, if 50 percent of babies were breastfed exclusively for the first six months of life, as recommended by the American Academy of Pediatrics, a minimum of $3.6 billion could be saved in medical expenses.

Expressing milk and continuing to breastfeed upon returning to work can seem daunting, Griffis acknowledged. However, she said, mothers who plan ahead, become well informed and make arrangements with their employers before returning to work can fare well.

Employees of St. Joseph can get a free consultation before returning to work on how to successfully transition while breastfeeding.
Some tips include:

  • Practice pumping your milk and freezing 1-2 ounces at a time before returning to work.
  • Talk to your supervisor about your intention to pump breast milk during the workday.

By Susan Shelly

Cindy Griffis, RN, BSN, IBCLC is a Lactation Consultant at Penn State Health St. Joseph Hospital. For more information call 610-378-2068

Boston Agency Awards Centering Pregnancy Program

Reading, Pa., March 28, 2016
The centering pregnancy program at Penn State Health St. Joseph got another big endorsement this week when the Boston-based Centering Healthcare Institute gave official site approval to the Bern campus location following an extensive review. It is the only program in Berks County to be officially recognized as an approved centering site.

Kimberly Hunter, MSN, RN, OB Nurse Navigator, said that site approval is “national recognition that the Penn State Health St. Joseph centering program exhibits all the essential elements that define the Centering model of care, has solid plans for model sustainability, and has a positive impact on healthy birth outcomes.”

“By being a part of this national elite group,” she continues. “We have a wide network and resources available to help our program to continue to be successful. In the 4 years we have been doing Centering, our program has proven to decrease the incidence of premature and low birth weight babies, which ultimately leads to healthy moms, healthy babies and, overall, a healthier community.”

While the traditional model of prenatal care is given one-on-one by a provider in a private examination room in an office or clinic setting, Centering Pregnancy is an innovative model in a group setting that includes self-monitoring and extended time with the provider. It integrates three major components of care: health assessment, education, and support. Expecting moms are placed in a group of 8-12 other women due within the same month, and they attend group sessions until it is time to deliver. They are seen by a prenatal provider as they would be in a traditional appointment, and their exams take place in a private section of the Centering room during their group sessions. After all the women have been examined, they gather in a circle for group discussions about pregnancy related topics led by expert facilitators.

“This is not just for first-time moms,” adds Hunter. “Experienced moms enjoy sharing their pregnancy and parenting knowledge to add to the group discussion.”

Studies have shown that knowledge about pregnancy is greater in Centering groups when compared to traditional prenatal care.

Tanya Munroe, Regional Director for the Centering Healthcare Institute, said the centering program “demonstrated fidelity to the Centering model of care” noting that “it is unusual for any site to receive full approval with their initial application.”
Munroe noted that the Institute’s site surveyor found “profound institutional support for the growth of Centering and (the) attention to quality was obvious in all aspects.” She offered congratulations on the program’s one percent pre-term birth rate and 100 percent patient satisfaction rate further noting “St. Joseph is an exemplary Centering site and one of the most well-poised for continued success” of the 200 approved sites nationally.

St. Joseph’s program – with offerings in both English and Spanish at our Downtown Reading Campus and forming the first group at the Bern Campus – includes educational sessions that consist of: prenatal nutrition, dental health, healthy relationships, labor preparation, pain management during labor, breastfeeding, post-partum depression, bonding with your baby, preventing SIDS and Shaken Baby Syndrome, and newborn care.

In 2015, Penn State Health St. Joseph’s Centering Pregnancy program received the Community Champions Achievement Award from The Hospital and Health System Association System of Pennsylvania (HAP).

Leap Year Baby is New Addition to Her Siblings Also Born on Significant Dates

Jackie Brown just seems to have a knack for having her babies arrive on significant dates. Jackie and her husband, Ryson, welcomed their third baby, Aaliyah, at 1:40 p.m. on Feb. 29 in the Breidegam Family Birth Center at Penn State Health St. Joseph. Aaliyah was one of two Leap Year babies born in the hospital that day.

The couple’s four-year-old daughter, Layla, was born at St. Joseph on April Fool’s Day in 2011, while their son, Vion, entered the world in a Maryland hospital just before the dawn of Halloween in 2014.kids

The timing of the births, Jackie said, is purely coincidental. “We did not plan this at all,” she said with a laugh. “It just happened.”

While participating in a Centering group at the Downtown Reading Campus during her pregnancy, Jackie mentioned to OB Nurse Navigator Kim Hunter that her other two children had been born at holidays. The two joked that perhaps Jackie’s third child would be born on Valentine’s Day, which was approaching.

“I thought I might have her on Valentine’s Day, but she was a little late,” Jackie said. “Valentine’s Day would have been a little early, and she waited. I guess she just wanted to be a Leap Year baby.”

The family plans to celebrate Aaliyah’s birthday on March 1 until Leap Year rolls around again, when they’ll celebrate on Feb. 29. “We want to keep her moving ahead, not move her back a day,” Jackie explained.

A stay-at-home mom, Jackie doesn’t rule out the possibility of another baby in the future.

“We’re not planning any more right now, but you never know,” she said. “We’ll just have to wait and see.

If there is another baby and he or she arrives at a holiday, Jackie will not be too surprised. “That just seems to be the way it happens with us,” she said. “It’s really funny, when you think about it.”

Kim Hunter, MSN, RN, OB Nurse Navigator Planning a pregnancy? Expecting this year? Want to check out our birthing center? Or just have general questions? Call Kim Hunter, MSN, RN, OB Nurse Navigator and let her be your personal guide.
610-378-2569   |   KHunter3@PennStateHealth.psu.edu   |   www.StJoesSpecialDeliveries.org

Lots of benefits to Kangaroo Care, especially for preemies

Reading, Pa., February 12, 2016 – The simple act of a mother holding her newborn baby against her bare chest produces remarkably positive outcomes.

Skin-to-skin contact, also known as kangaroo care, warms the infant and relaxes both mother and child. Vital signs stabilize and, typically, deep sleep comes. Babies who experience kangaroo care cry less than those who don’t, and experience increased weight gain.
kangaroo care
The contact also promotes milk production, making it easier for the baby to breastfeed.

While nearly all mothers – and fathers – can engage in skin-to-skin contact with their babies, it is particularly important for babies born prematurely and housed in the Neonatal Intensive Care Unit (NICU).

“When babies are in the NICU the moms typically can’t do too much for them,” explained Karen Sponagle, manager of the Family Birth Center at Penn State Health St. Joseph. “But when they do kangaroo care, it makes such as difference. It’s good for both moms and babies.”

Developed in South America as a means of keeping premature infants warm, kangaroo care has become mainstream in many NICUs and birthing centers across the United States. Its benefits have been widely recognized and clinically supported.

The simple procedure involves nestling a diaper-clad baby between her mother’s breasts or against a father’s bare chest. A cloth is placed over the baby’s back for warmth, and the parent and child merely sit or lie together.

At St. Joseph, it is expected that all medically able infants will be placed skin to skin with their mothers immediately following birth, and permitted to remain there, uninterrupted, for at least one hour.

The use of kangaroo care is considered so important that tasks such as weighing a baby and administering eye drops and a Vitamin K shot are being put on hold so that a mother can immediately hold her baby.

That, Sponagle said, has been a little difficult for some nurses to accept.

“Nurses tend to be so focused on tasks that it’s sometimes hard for them to delay them,” she said. “But, our goal is to get that mom and baby skin to skin as soon as possible.”
Christine Oram, a staff nurse in St. Joseph’s NICU, is a certified kangaroo care specialist, and has observed the positive effects of skin-to-skin contact many times.

“It’s amazing to see,” Oram said. “In just about five minutes their (the babies) heart rates have slowed. Their breathing has slowed, and they need less oxygen. And then they sleep, and they can begin to heal.”

While it used to be thought that babies in the NICU slept best in isolettes, sleep studies have showed that more sound sleep occurs while being held against a parent’s bare chest.

Kangaroo care is even promoted for babies born by cesarean delivery, and can occur when a baby is on a ventilator.

“It’s a powerful therapy for both babies and parents,” Oram said.

Promoting kangaroo care is part of St. Joseph’s larger mission of becoming a Baby-Friendly facility, as specified by the Baby-Friendly Hospital Initiative of the World Health Organization and the United Nations Children’s Fund.

That effort began in 2013, with the goal of achieving optimal mother/baby bonding, increasing the rate of breastfeeding and ultimately improving the health of mothers and babies.

“Skin to skin is a piece of the larger picture,” explained Sponagle. “There are lots of things we’re doing to promote family-centered care and assure that we provide the best care possible for all family members.”

Kim Hunter, MSN, RN, OB Nurse Navigator Planning a pregnancy? Expecting this year? Want to check out our birthing center? Or just have general questions? Call Kim Hunter, MSN, RN, OB Nurse Navigator and let her be your personal guide.
610-378-2569   |   KHunter3@PennStateHealth.psu.edu   |   www.StJoesSpecialDeliveries.org