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.

Collaborative Partnerships Lead to National Recognition – Again

Penn State Health St. Joseph Medical Center recently earned national recognition for its commitment to delivering a higher standard of patient care.

The American Heart Association and American Stroke Association approved St. Joseph Medical Center for the Get With The Guidelines® — Stroke Gold Plus with Honor Roll Elite award, which recognizes the hospital’s commitment to ensuring that every stroke patient receives treatment according to nationally accepted recommendations and standards.

“We have been Gold Plus for years, but 2019 was the first year we achieved Target: Stroke Honor Roll Elite,” says Wendy Clayton, clinical program coordinator, quality and performance improvement. “It was the result of great work on the part of our Emergency department, the physicians, the nursing staff and our EMS partners. We improved our processes, but it is really about that collaborative relationship between all key partners.”

St. Joseph Medical Center also earned the American Heart Association’s Get With The Guidelines® — Heart Failure Gold Plus with Honor Roll award. Once again, while the hospital previously has earned the Gold Plus recognition for treating heart failure patients, this is the first year it achieved the Honor Roll award.

The American Heart Association also renewed St. Joseph Medical Center’s Mission Lifeline® Heart Attack Receiving Center Accreditation. The three-year accreditation recognizes centers that meet or exceed quality of care measures for people experiencing the most severe type of heart attack, ST-elevation myocardial infarction (STEMI), in which blood flow is completely blocked to a portion of the heart.

“We are thoroughly committed to providing our patients the highest quality cardiac care centered on current scientific research,” Clayton says. “Having this accreditation renewed highlights our accomplishments, as we strive to improve the overall treatment and care for our heart attack patients.”

A Top Cardiologist Tells Fellow Cardiologists: Vegan Diet is the Way to Go

A noted cardiologist, educator and researcher touted the benefits of a vegan diet, noting that the need for medications to control high blood pressure, high cholesterol and diabetes could decrease dramatically with improved dietary habits among most Americans.

“In many cases, we don’t need drugs. We need lifestyle changes,” said Dr. Kim Williams, Chief of the Division of Cardiology at Rush University in Chicago.

Williams was a featured speaker at the Cardiovascular Symposium held recently at the Crowne Plaza Hotel in Wyomissing. The symposium was sponsored by Penn State Health St. Joseph and the Pennsylvania Chapter of the American College of Cardiology.

Williams, who has adhered to a plant-based diet since 2003 when his LDL cholesterol became elevated, warned that mortality increases in people who eat red meat, excessive salt, sugar, refined carbohydrates and processed meats. Processed meats, he said, are particularly deadly.

“If we could get patients to stop eating hot dogs and ham and get them to eat hamburgers and pork chops, we’d be better off,” said Williams, a former president of the American College of Cardiology.

With heart disease the number one killer of Americans for the past century, he pointed to huge portion sizes, sugary drinks and fast food as major contributors to that trend.

Among the population of Americans who are 20 to 40 years old, nearly half of them eat fast food every day.

Transitioning to a vegan diet – one that does not contain any animal products – can add years to your life, asserted Williams.

Men who consume only plant-based foods typically live nearly a decade longer than those who consume large quantities of meat and few vegetables, he said.

A plant-based diet also is associated with increased emotional well-being and lower rates of depression.

However, Williams warned, a vegan diet that includes donuts, French fries, potato chips, sweet tea, white rice and other refined carbohydrates is worse than a diet containing animal products.

“High carbohydrates increase mortality, as well,” Williams said.

If you are not able or willing to become completely vegan, upping your intake of fruits and vegetables and limiting your intake of meat, particularly processed meat, will still be advantageous to your health.

Choose foods with a high fiber to sugar ratio, advised Williams, for instance, substituting blackberries for grapes, which have a higher sugar content and less fiber than berries.

He also advocated the consumption of peanuts, soy beans and lentils as protein sources, turning over the notion that you can’t get enough protein without eating meat.

“Soy beans and lentils have more protein that beef and pork,” Williams said. “Beef and peanuts have the same amount of protein.”

Nuts, in general, are good sources of nutrients, especially when consumed in place of meat and processed meat.

“If everyone replaced sausage and bacon with almonds and cashews, you’d see about a 24 percent reduction in mortality, he said.”

Dr. Andrew Waxler, a member of Penn State Health Medical Group – Berks Cardiology, https://www.thefutureofhealthcare.org/physician/?id=3868 who organized the Cardiovascular Symposium and has worked with Williams, said Williams’ research and presentations have inspired him to make changes in his diet that have resulted in weight loss and better health.

“When you become more aware of your diet, you can make small changes that yield significant results,” said Waxler, who has mostly replaced red meat in his diet with fish and increased his intake of whole grains, fruits and vegetables. “You’ll be more inclined to eat better and then to get more exercise, as well. Those are two very good things that you can do for your health.”

Limiting your diet to plant-based foods and avoiding sugar, salt and refined carbohydrates is not simple, Williams said, but the health benefits can be huge.

According to Williams, myocardial ischemia, a condition in which blood flow to the heart is reduced, can be reversed through lifestyle changes, particularly the adoption of a vegan diet.

“If you eat vegetables, your mortality goes down,” he said. “If you eat animal products, your mortality goes up.”

Above nearly all else, asserted Williams, avoid trans fats, which have been banned in some countries and several states in the U.S.

“Saturated fats are bad, but trans fats are worse,” he said.

Hospital admissions for heart attacks decreased in New York, one of the states that have banned trans fats, after the ban was put in place.

In closing, Williams advised the audience to emphasize in their diets vegetables, fruits, legumes, nuts, whole grains and fish, while reducing processed meats, refined carbs and sweetened drinks. Trans fats should be avoided completely.

That balance of foods can provide benefit, event without being completely plant based.

“The data is very clear,” Williams said. “If you change your diet, you can change your health.”

To learn more about the benefits of a vegan diet you can also contact Penn State Health St. Joseph Nutrition Therapy.

#1 Heart Month Takeaway: Small Changes Make a Big Difference When it Comes to Your Heart

It was a cold morning in late February, but those who got out of the house early to take advantage of a Penn State Health St. Joseph HEALTH4cast event received a bonus – a chance to ask questions and receive advice from cardiologist Andrew Waxler.

Dr. Waxler, a member of Penn State Health Medical Group – Berks Cardiology, was on hand in the lobby of the Bern Township Campus from 7 to 9 a.m., fielding questions and chatting about heart health.

He talked to visitors and staff members about preventing cardiac problems by quitting smoking, maintaining appropriate weigh and body mass index, controlling blood pressure and cholesterol, and exercising regularly.

The opportunity was part of Penn State Health St. Joseph’s February Heart Health recognition.

Dr. Waxler’s advice was encouraging. Even small changes such as adding more fruits and vegetables to your diet and taking a daily walk can make a big difference in your health, he advised.

“You don’t have to do anything too drastic,” he said. “Just go for a walk and watch what you eat. Losing just five or 10 pounds will lower your blood pressure a couple of points.”

Cutting down on processed foods, simple carbs and red meat and replacing them with vegetables and whole grains can help people avoid diabetes, a disease that greatly increases the risk of cardiovascular problems.

In addition to consulting with Dr. Waxler, staff and guests were able to assess their risk for diabetes and cardiovascular diseases such as heart attack and stroke by participating in Penn State Health St. Joseph’s HEALTH4cast screening program.

Using simple tests and procedures, staff is able to provide participants with four critical numbers that aid in predicting future health. Numbers are: body mass index, blood pressure, total cholesterol and blood sugar/glucose.

Together, those numbers indicate a person’s risk factor for developing a major illness that could negatively impact life.

Once the numbers have been collected, HEALTH4cast participants receive recommendations for improving their health with lifestyle changes such as cutting back on sodium intake, losing weight, reducing stress and exercising more.

Brenda Rivera of Wyomissing braved the cold to take advantage of the HEALTH4cast program.

With a family history of high blood pressure and diabetes, Rivera was grateful for the opportunity to have her health assessed.

“I don’t see my primary care provider on a regular basis, but I want to take care of myself,” Rivera said. “So, it’s really nice to have this screening as a resource. It’s a great event, and it’s all free.”

Haley Fidler, who works with cardiac rehab patients at Penn State Health St. Joseph’s Spring Ridge campus, was on hand to tell participants about the hospital’s FIT150 Program.

“It’s basically an initiative we have to encourage people to get 150 minutes of exercise a week,” Fidler said. “Exercising for 30 minutes, five days a week, is an easy way for people to keep track of their fitness.”

If you are ready to kick off the spring with a free health evaluation and take the FIT150 pledge, mark your calendar and join us for our next HEALTH4cast event on Saturday, April 6 from 8am – 11am! HEALTH4cast is proud to be a part of the 2nd Annual BCIU Apple a Day 5k & Family Fun Run/Walk to benefit the United Way of Berks County at Penn State Berks. Attendees will be served on a first come, first served basis. And remember no need to fast!

Heart Attack Victim Credits Quick Action With Saving His Life

It was a Sunday in August, and Robert Clay had just made a putt on the 15th green of the Rich Maiden Golf Course near Fleetwood.

From what he’s been told, as he reached down to retrieve the ball, he sank down onto one knee and said to his golf partners, “something isn’t right.”

Clay recalls none of that, nor much of what happened to him for the next 12 hours. What he does know, however, if not for the speedy and capable efforts of other golfers, the EMTs who treated him, and Penn State Health St. Joseph’s Emergency Department and Heart Institute staff, he would not be alive after suffering cardiac arrest.

“They told me when I woke up in the hospital that I was really lucky,” Clay said during a recent interview. “They said that most people who have the kind of heart attack I had don’t make it. I hate to think what would have happened if I had been home by myself, or out in the woods hunting.”

After Clay fell onto the golf course, one of his golfing buddies started CPR. No one in the foursome had a cell phone, so a player behind them called 911.

Northern Berks Emergency Medical Services was on the scene in less than 10 minutes, and paramedics treated Clay en route to Penn State Health St. Joseph. On two different occasions, they could detect neither a pulse nor a heartbeat.

“They told me that I flat-lined twice, but the EMTs used the paddles on me and brought me back,” Clay said. “Then, when I got to the hospital, they were all ready for me in the Emergency Department.”

After being treated and stabilized in the ED, Clay was moved to the St. Joseph’s Heart Institute, where a stent was placed to open a blocked artery. He was released three days later, grateful to be going home.

The Spring Township resident, who is 60, had very few symptoms before the cardiac arrest, which he was told was triggered by a blood clot caused by heart arrhythmia.

“I didn’t have any pain, or anything like that,” he explained. “The only thing I can think of is that for about a week before it happened, I felt really sluggish. Like, I’d wake up in the morning and feel still tired.”

Clay, whose father and two brothers died of heart disease, currently is in cardiac rehabilitation at Berks Cardiology, and says he is feeling well.

He is changing his diet to avoid fats and salts, and has stopped smoking cigarettes.

“I sent my son to my house while I was in the hospital to get rid of all the cigarettes,” Clay said. “I’m wearing a patch now. Every now and then I crave a little bit, but then I think about something else and it’s okay. I should have given them up a long time ago.”

Reading food labels is time consuming, said Clay, who lives alone, but he’s doing his best. Changing his eating habits won’t be easy, but he’s determined.

“I’m Pennsylvania Dutch, so I like some shleck,” he said. “And, what I’m really going to miss is my all-time favorite, fresh-cut French fries.”

Clay, however, who is the father of a son and a daughter and the grandfather of five, is determined to improve his health.

“I’ve got my family, and I just retired from Car Tech last year,” Clay said. “I’ve got a lot to live for, and I want to stick around for a while and enjoy it.”

Penn State Health St. Josephs Heart Institute and Emergency Department
have demonstrated expertise and commitment to quality patient care by meeting American Heart Association’s stringent criteria as a Heart Attack Receiving Center. If you’re having chest pain or other heart attack symptoms, call 9-1-1 and seek medical attention immediately. Any other questions, contact The Heart Institute at 610-378-2340.

Berks cardiologists weigh in on keeping your heart healthy

Excerpt from Reading Eagle story by Matthew Nojiri

February is American Heart Month, and it puts the spotlight on an important issue. About 34 percent of American adults have high blood pressure, and heart disease accounts for one in seven deaths, according to the American Heart Association.

Dr. Andrew Waxler, a cardiologist with Berks Cardiologists Ltd., Wyomissing, discussed heart disease and the ways to live a healthy life.

About heart disease

Coronary artery disease is the biggest heart issue, Waxler said.

The buildup of plaque and the hardening of the arteries around the heart can be an insidious problem as artery disease doesn’t always come with symptoms,” said Waxler, who also serves as president of the Berks County Medical Society. “Coronary artery disease is incredibly common.

“We’ve known the process of arteriosclerosis, the hardening of the arteries, starts early. People get to my age, 50, and they have a heart attack, but the process has been going on for years.”

Coronary artery disease makes up about 45 percent of all cardiovascular disease, but some people don’t know it’s an issue until later in life.

“In some people, their first warning is a heart attack,” Waxler said. Others will notice tightness or pressure in the middle of the chest or shortness of breath from doing everyday tasks, Waxler said. “I never ask about chest pain,” he said. “It’s about tightness, pressure and discomfort.”

Preventive steps

Some aspects of health cannot be changed.

Family history and genetics fall into that category. Ethnicity is another. Those factors can make you more likely to suffer from heart disease. Still, there are things that are within your reach. For one, you can decide to quit smoking, Waxler said.

“The whole world knows smoking can cause emphysema and lung cancer,” he said. “I don’t think the American public knows how detrimental it is to the heart. It causes injury to the lining of heart arteries, which promotes more blockages. It also causes constriction of blood vessels, which can lead to a heart attack.”

Penn State Health St. Josephs Heart Institute and Emergency Department
have demonstrated expertise and commitment to quality patient care by meeting American Heart Association’s stringent criteria as a Heart Attack Receiving Center. If you’re having chest pain or other heart attack symptoms, call 9-1-1 and seek medical attention immediately. Any other questions, contact The Heart Institute at 610-378-2340.

The Watchman is a Device That Can Help Certain Patients with Atrial Fibrillation

Charlotte Moyer had no fears about getting a new heart procedure at Penn State Health St. Joseph.
The 71-year-old St. Lawrence resident had bigger fears about having a stroke. “I decided to have it done just to be cautious,” Moyer said. “I don’t want to worry about having a blood clot in the head. It was nothing to have it done.”


Moyer was one of the first patients in Berks County to have a new procedure to insert a device called the Watchman. The device from Boston Scientific Corp. was approved by the Food and Drug Administration in 2015.

The Watchman has been approved for certain patients with atrial fibrillation who are at a higher risk for a stroke and do not want to be on a blood thinner for the long term due to concerns about bleeding and other side effects.

Cardiologists at St. Joe’s say the new procedure fills an important niche. Many patients with an abnormal heartbeat are at a higher risk of stroke, but can’t take a blood-thinning medicine, such as Coumadin.

The Watchman could be emerging as an alternative for those patients, said Dr. Christopher Rogers, a cardiologist with Berks Cardiologists. “It kind of technically eliminates the part of the heart where clots form to eliminate the risk of having a stroke,” Rogers said.

Abnormal heartbeat

At St. Joe’s, Rogers and his colleague Dr. Troy Trayer have been performing the procedure since August, and it’s taken a bit of legwork to get ready.

The two doctors have been watching for nearly a decade as the device moved through the process of clinical trials and regulation. They said there has always been a need for such a device.

Patients who have an irregular heartbeat can be at higher risk for blood clots and strokes.

Most of those blood clots develop in the left atrial appendage in the heart and then travel through the bloodstream. That can ultimately lead to a stroke in the brain.

Blood thinners have been the gold standard for stroke prevention, but some patients have problems with bleeding while on those drugs. “There’s a population of patients who need to be protected from having stroke that are not good candidates to be on blood thinners,” Rogers said. “This is the only FDA-approved device that’s approved and available that shows it’s at least as protective as being on blood thinners.”

How it works

The device is implanted through a catheter that runs all the way up from a leg vein to the left side of the heart.
Rogers and Trayer work with a team of caregivers during the procedure, which can last between 45 minutes and three hours.

The device is pushed through the catheter and opens up like a flower once it reaches its destination in the heart. It’s made of a self-expanding, nickel-titanium frame with an attached woven plastic cap.

The key is to position the device in just the right spot, making sure it’s secure and there are no leakages, the doctors said. “It’s like putting an umbrella in this pouch, and that umbrella is catching and preventing blood from coming out there where that clot could form,” Trayer said.


Patients are put under general anesthetic and only have to stay at the hospital for a day before being released. Moyer said the whole process could not have been simpler. She was a perfect candidate for the procedure because she has atrial fibrillation but couldn’t be on blood thinners for the long term due to the bleeding problems in her stomach.

“I feel fine, and I have no problems,” she said of her recovery. “I’m just glad I had it done. It’s one less worry I have.”
Moyer was on Coumadin for 45 days and now takes Plavix, but eventually she’ll just need to take a daily aspirin.

Rogers said it’s possible the device could be expanded to help more people one day, but that is likely years down the line.
For now, the doctors are happy to offer the service to the patients who need it in Berks County.

“They have an alternative to blood thinners if they have high risk of stroke and high risk of bleeding,” Trayer said. “They don’t have to go on living their life crossing their fingers and hoping they don’t have a stroke.”

About the Watchman

What: The device is implanted via a catheter into the left atrial appendage of the heart. It prevents blood clots from entering the bloodstream and causing a stroke.

How it works: The device is implanted through a catheter through a vein in the leg. The physician makes a small hole through the wall between the two upper chambers of the heart. The device is pushed in the left atrial appendage and then opens up like an umbrella.

When it’s used: The device is an option for patients who have atrial fibrillation not related to heart valve disease. Those abnormal heart beat patients should also be at increased risk for stroke, recommended for blood thinners and have appropriate reason to seek an alternative to those blood thinners.

Clinical results: The device was evaluated in four studies, comparing how it compared against blood-thinning medicines to prevent strokes caused by a blood clot in the brain. In two of the studies, the blood thinners were better than the Watchman in preventing strokes caused by a blocked blood vessel in the brain. However, the number of strokes caused by bleeding in the brain was lower in the device patients compared to the blood thinner patients. The rate of serious bleeding was similar in the device and blood-thinner patients.

In one study, 99 percent of patients were able to stop taking the blood thinner Coumadin after a year.

Approved: March 2015

Source: Food and Drug Administration

By Matthew Nojiri, Reading Eagle
Bern Township, PA

Troy Trayer, DO and Christopher Rogers, DO are cardiologists with Berks Cardiologists, Ltd. who perform the Watchman procedure. If you have any questions or would like more information, contact our Heart Institute at 610-378-2340 or email LShober@PennStateHealth.psu.edu

Penn State Health St. Joseph patient’s gain access to leading clinical trials

Cardiologists leading the way in various trials leading to innovative treatments

Cardiologists at Penn State Health St. Joseph are always looking for better and more effective methods of treating patients who have coronary disease. To that end, St. Joseph is participating in a cutting- edge clinical trial designed to compare the performance of a dissolvable heart stent with that of a non-dissolvable stent currently in use.

Depending on trial outcomes, the dissolvable stent could soon be approved by the U.S. Food and Drug Administration (FDA) for use in the United States. And that, said Dr. Guy N. Piegari, Jr., a cardiologist with Berks Cardiologists, Ltd. and Medical Director of the Cardiac Catheterization Laboratory at Penn State Health St. Joseph, could be significant.

“We’re always moving toward something better,” Piegari said. “The stents that we have are really very good, but we’re always in a continual state of improvement for our patients.”

St. Joseph and Berks Cardiologists have been participating as a team in the randomized control trial, sponsored by Abbot Vascular, a division of Abbott Laboratories, since 2013. The Abbot trial is designed to compare the performance of the company’s new dissolvable stent, Absorb™ Bioresorbable Vascular Scaffold (BVS), with its non-dissolvable stent, XIENCE.

A dissolvable stent could provide significant benefits to patients, Piegari said, because it enables an artery to return to its natural state once it has healed. Currently, some patients whose arteries have narrowed due to buildup of plaque are treated with metal stents containing a medicine that, when released into the artery, prevents the plaque from reforming.

The stent holds the artery open, which enables blood flow. Because it remains in the body, however, it prevents the artery from working as it naturally would. A dissolvable stent is designed to remain in place until the medicine to prevent the rebuild-up of plaque has been dispensed over time, and then gradually disappear. “Arteries are designed to dilate and constrict according to the needs of the body, but they can’t do that well when you’ve got a metal stent in,” Piegari explained. “If the stent dissolves, then there’s nothing left in the artery to interfere with its normal function.”

The clinical trial is required by the FDA before the Absorb stent can be approved in the United States. Absorbable stents are already in use in Europe. The Abbott trial is one of two in which the hospital is currently involved.

St. Joseph and Berks Cardiologists also are involved in a trial sponsored by Swiss-based Biosensors Europe, testing a drug coated, non-absorbable stent known as BioFreedom™. More patients were enrolled in that clinical trial at St. Joe’s than at any other trial site in the country – a significant achievement for the hospital.

“We are the leading contributor in that study,” Piegari said. “If it gets approved, it’s definitely due to our participation.”
These clinical trials involving heart stents are just two of many in which Penn State Health St. Joseph has participated during that past 16 years. “We’ve been conducting clinical research since 1999,” said Lori Shober, Director of Cardiovascular Services. “We’ve been involved in some very cutting-edge research.” Most of the clinical trials have occurred within the Heart Institute and Cancer Center, and have involved hundreds of patients.

Some trials conducted within the Heart Institute have directly contributed to approval by the FDA of devices used in angioplasty and stenting of the carotid, coronary, renal and leg arteries. Participating in clinical trials is time consuming and complex, but the effort that the hospital undertakes is well worth it, Shober said. Trial participation not only increases the profile of St. Joseph, it also helps with advances in the medical field. “It’s just awesome to be involved in research that results in life-saving medical advances,” Shober said. “It’s what we’re about.”

Guy N. Piegari Jr., MD, FACC, FSCAI, is a cardiologist with Berks Cardiologists, Ltd.
He is a Board Certified in Cardiovascular Diseases, Internal Medicine, Interventional Cardiology, and Critical Care Medicine. He can be reached at 610-685-8500.