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Echocardiogram, often referred to cardiac echo or simply an echo is a sonogram of the heart. (It is not abbreviated as ECG, which in medicine usually refers to an electrocardiogram.) Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart. Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic tests in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart (internal chamber size quantification), pumping capacity, and the location and extent of any tissue damage. An Echocardiogram can also give physicians other estimates of heart function such as a calculation of the cardiac output, ejection fraction, and diastolic function (how well the heart relaxes). Echocardiography can help detect cardiomyopathies, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and many others. The use of Stress Echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease. The biggest advantage to echocardiography is that it is noninvasive (doesn't involve breaking the skin or entering body cavities) and has no known risks or side effects. Not only can an echocardiogram create ultrasound images of heart structures, but it can also produce accurate assessment of the blood flowing through the heart, using pulsed or continuous wave Doppler ultrasound. This allows assessment of both normal and abnormal blood flow through the heart.

Wesley Howell provides specialty clinic care at Memorial's Specialty Clinic weekly. His primary practice is the SIH Medical Group of Carbondale, IL. Their urology team offers leading-edge care for urological diseases, including diagnosis and treatment of urological diseases, bladder control problems, erectile dysfunction and male infertility. To learn more about our specialists call Memorial Hospital Specialty Clinic at (618) 826-4581 ext. 1366

Physicians typically refer patients to the Sleep Lab when they display signs & symptoms of possible sleep disorder. Signs and Symptoms of sleep disorders may include; morning headaches, daytime fatigue, daytime sleepiness, snoring, waking up gasping for air, irritability, anxiety, depression, loss of concentration, falling asleep while driving, increased work place accidents, high blood pressure. Other circumstances in our daily lives may cause these signs and systems. Once your physician reviews your signs and symptoms along with a physical exam, he/she may determine a sleep study is right for you. During the sleep study the Sleep Technician will monitor brain waves, eye movements, muscle activity, multiple breathing variables, heart rate/rhythm, position, limb movements, and blood oxygen levels during sleep, using specialized recording equipment. Sleep Problems and Disorders have been linked to a multitude of short and long-term health problems. Studies have shown that some patients with chronic sleep disorders may be at higher risk for Blood pressure and Heart Disease. If you feel that you or someone you know may be suffering from a sleep disorder, there is help. Contact your Family Physician to discuss your symptoms or click on Ask The Expert. Memorial Hospital has been providing Sleep Diagnostic testing since 1998. Memorials Registered Polysmnographist (Sleep Technician) is a member of the American Academy of Sleep Medicine. Memorial Hospital is also a Community Sleep Awareness Partner of the National Sleep Foundation. Memorial Hospital Offers the Home Noxturnal Sleep Study This new service is available to qualifying patients for simplification, increased efficiency in the comfort of their own home. This portable monitor is very easy to use with a full set up and instruction by a sleep specialist from Memorial Hospital. Contact your provider to find out if you are a candidate. To learn more about our sleep center or services we provide, please call 618-826-4581 Sleep Lab ext. 1106 | Cardiopulmonary ext.1283 HOURS: Cardiopulmonary Mondays-Friday 6:00 a.m. to 6:30 p.m. Weekends and Holidays 6:00 a.m. to 2:30 p.m. Sleep Lab Tech Hours: Sundays-Tuesdays 6:30 p.m. to 6:00 a.m. Scoring Tech Hours: Tuesdays-Thursdays 9:00 a.m. to 5:00 p.m. Director’s Sleep Lab Hours: Tuesdays-Thursdays 8:00 a.m. to 4:30 p.m. On call coverage 24 hours a day, 7 days a week: Call our toll free number 833-687-6502

A stress test can be used to test for heart disease. Stress tests are tests performed to determine the amount of stress that your heart can manage before developing either an abnormal rhythm or evidence of ischemia (not enough blood flow to the heart muscle). The most commonly performed stress test is the exercise stress test. What Is an Exercise Stress Test? The exercise stress test -- also called a stress test, exercise electrocardiogram, treadmill test, graded exercise test, or stress ECG—is used to provide information about how the heart responds to exertion. It usually involves walking on a treadmill or pedaling a stationary bike at increasing levels of difficulty, while your electrocardiogram, heart rate, and blood pressure are monitored. Why Do I Need a Stress Test? • Determine if there is adequate blood flow to your heart during increasing levels of activity • Evaluate the effectiveness of your heart medications to control angina and ischemia • Determine the likelihood of having coronary heart disease and the need for further evaluation • Check the effectiveness of procedures done to improve blood flow within the heart vessels in people with coronary heart disease Identify abnormal heart rhythms Help you develop a safe exercise program

Memorial Hospital’s team of ultrasound technologists, respiratory therapists, certified registered nurses, and cardiologists work together to provide stress echocardiography testing for patients. Stress Echocardiography or stress echo, is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body. This test is most often used to detect a decrease in blood flow to the heart due to narrowing in the coronary arteries. A doctor orders this test if the patient has chest pain that is believed to be related to coronary artery disease or a myocardial infarction or heart attack. The stress echo can also be used to tell how well treatments such as bypass grafting, angioplasty, and anti-anginal or antiarrhythmic medications are working. During the stress echo, the doctor is able to observe your heart at a resting state and peak rate to compare blood flood to the heart. The healthcare team begins the test by applying electrodes to the chest of the patient to measure the heart’s electrical activity and regularity of heartbeats. The patient’s blood pressure is also manually monitored throughout the test. During the resting state, the patient will be placed on their side while the ultrasound technologist takes images of the heart muscle. Once the resting images are taken, the patient will then be asked to walk on a treadmill to help increase their heart rate. Depending on the patient’s physical condition, the care team may increase the intensity of the exercise. If a patient is unable to physically exert themselves to reach their target heart rate, medications will be used to help simulate exercise to the heart. Once the peak rate has been reached, the patent is then asked to lay on their side once more to take more images of the heart to determine if their heart muscles are getting enough blood and oxygen during exercise. As the person cools down and their heart rate returns to normal, they are continually monitored.

The Department of Transportation (DOT) requires commercial motor vehicle operators to have the DOT physical exam to maintain their driver certification. Drivers must provide periodic physical examination reports to maintain compliance and continue working. Memorial Hospital's Rural Clinic providers are certified to perform your DOT physical to ensure that you are in satisfactory health and able to work safely. Don't loose time on the road, schedule your DOT physical today at the Chester Clinic 618-826-2388 or Steeleville Family Practice 618-965-3382. Wat the DOT Physical Covers 1. Vision 2. Hearing 3. Blood Pressure/Pulse Rate 4. Urinalysis 5. Physical Examination Be Prepared for Your Physical • Take all medications as scheduled at all times, since taking your medication irregularly may cause inaccurate readings during the physical exam. • Do not run out of your prescribed medications as you lead up to your physical exam. Suddenly withdrawing from a medication can significantly impact your test. • If you use contact lenses or glasses to see, make sure your prescription is up to date and bring your corrective lenses with you tot he physical. What You Need for the DOT Physical • Bring medical records from your primary care doctor if your primary care doctor is not the one performing your exam. • If you have any health conditions, bring the name and contact information for the doctor who treats you for each condition. Conditions like high blood pressure, diabetes, or sleep apnea typically require additional paperwork, such as sleep test results or stress test results. • Bring a complete medication list. The list should include every medication you take, its strength, its dosage, and the prescribing doctor.

An electrocardiogram, also called an EKG or ECG, is a simple test that detects and records the electrical activity of the heart. It is used to detect and locate the source of heart problems. An EKG shows how fast the heart is beating. It shows the heart’s rhythm (steady or irregular) and where in the body the heartbeat is being recorded. It also records the strength and timing of the electrical signals as they pass through each part of the heart. EKGs are used to evaluate signs and symptoms that could indicate heart problems. Many heart problems change the electrical “signature” of the heart in distinct ways. EKG recordings of this electrical signature can help reveal these heart problems. During an EKG, electrical signals in the heart are detected by electrodes placed on the skin. A machine records them on graph paper or displays them on a screen. An EKG is painless and harmless, and usually takes about 10 minutes to complete. Special EKG tests are done to detect certain kinds of heart symptoms, such as those that are present for only a few minutes out of the day, or that happen only while a person is exercising.

Cryosurgery is a technique for removing skin lesions that primarily involve the surface of the skin, such as warts, seborrheic keratosis (noncancerous skin growth), or actinic keratosis (A rough, scaly patch on the skin caused by years of sun exposure.). Liquid nitrogen needs to be applied long enough to freeze the affected skin. By freezing the skin, a blister is created underneath the lesion. Ideally, as the new skin forms underneath the blister, the abnormal skin on the roof of the blister peels off. Occasionally, if the lesion is very thick (such as a large wart), only the surface is blistered off. The base or residual lesion may need to be frozen at another visit. Talk to your physician about it. To schedule an evaluation with a Memorial Hospital Provider contact one of our Rural Health Clinic Locations.

Specialized Care throughout your life span - helping you return to work, play, and life! Our physical therapists develop comprehensive plans of care that may include: • Exercises to restore motion, strength, and a greater degree of independence • Joint and soft tissue mobilization • Pain management • Orthotic/prosthetic training • Education & information specific to the injury or illness Specialized Equipment • Therapy Pool • Biodex Balance System • Mechanical Traction • Therapeutic Ultrasound • Electrical Stimulation • Vital Stim • Bariatric Treadmill • Fluidotherapy • Iontophoresis Progressive Clinical Programming Our outpatient program utilizes the latest techniques and equipment and provides specialized services for individuals with various injuries or disorders. Common Diagnoses include: • Amputation • Arthritis • Back and neck injuries • Brain injury • Developmental delay • Dysphagia • Hand injuries • Joint replacement • Multiple trauma • Neurological disorders, including Parkinson’s • Orthopedic injuries • Pain management • Post-surgical conditions • Spinal dysfunction • Sports-related injuries • Stroke • Urinary incontinence • Vestibular/ balance disorders • Work injuries Accepted Insurance Payment Methods We accept payment from most insurance plans including Medicare. Please call us if you have questions on whether your health insurance is accepted at our facility. Referral Services Patients may contact the outpatient center directly; however, a physician’s prescription is necessary to initiate treatment. Clinical Excellence Our state of the art facility houses professional certified staff of physical, occupational, and speech therapists. They are dedicated to applying innovative clinical pathways that ensure each patient receives the utmost in care, on a personalized level. Aftercare Program After graduating from therapy, patients may opt to continue using the facility through our Aftercare program. This program allows patients to continue their exercises on an independent basis so they can maintain or further their progress.

Ultrasound imaging, also called ultrasound scanning or sonography, is a method of obtaining images from inside the human body through the use of high-frequency sound waves. The reflected sound wave echoes are recorded and displayed as a real-time visual image. Ultrasound is a useful way of examining many of the body's internal organs, including but not limited to the heart, liver, gallbladder, spleen, pancreas, kidneys and bladder. Because ultrasound images are captured in real time, they can show movement of internal tissues and organs and enable physicians to see blood flow and heart valve functions. This can help in diagnosing a variety of heart conditions and assessing damage after a heart attack or other illness. Ultrasound remains the procedure of choice for expectant mothers. Using ultrasound during pregnancy: During ultrasound, high-frequency sound waves pass through the mother’s body and her baby’s. You can’t hear the sound waves, but the ultrasound equipment can. It converts them to a visual image on a monitor, allowing expectant parents and the physician to “see” the baby inside the uterus. Ultrasounds can screen for an abdominal aortic aneurysm. An Abdominal Aortic Aneurysm (AAA), is a condition in which the lining of the blood vessel called the aorta is enlarged within the abdomen. Abdominal aortic aneurysms pose a threat because they are usually silent until a medical emergency occurs. During abdominal ultrasound If you are having an abdominal ultrasound during pregnancy or to diagnose an abdominal condition, you will lie down on the exam- nation table and a layer of gel or oil will be applied to your abdomen so the sound waves more easily reach your baby. Then the transducer, a device that produces and receives the sound waves and sends them to a computer, is slowly moved back and forth over your abdomen. The sound waves are used to create a picture called a sonogram, which can be viewed on a TV monitor. The procedure is painless and takes less than half an hour.

HOURS Monday-Friday 8:00am-5:00pm Saturday 8:00am-1:00pm ​ HOW DOES CONVENIENT CARE WORK? Memorial Hospital’s Walk-In Clinic is open to everyone Monday-Saturday. No appointment is needed. A clinical assistant will perform an initial assessment. The clinical assistant and/or Medical Provider shall have final authority in determining whether the patient’s medical condition qualifies them for treatment in Convenient Care. If the patient does not qualify, they will be offered Emergency Care. If the patient does qualify, they will be charged for this service at a reduced rate. Any lab tests or medications given are at an additional cost. Additional lab work or imaging may be necessary and will be charged separately. These services can be done at Memorial Hospital, located right next to Convenient Care. If the patient becomes worse and needs to be treated in the Emergency Department, charges will be billed at the regular Emergency Department rate. In order to do Convenient Care at a reasonable cost, the patient is always asked for the Convenient Care co-pay the day of treatment. WHY CHOOSE CONVENIENT CARE? 1. Emergency Room claims can be denied because the insurance company determines them to be “non-emergent”, which leaves the patient responsible for the bill. 2. Convenient Care is billed at a lower rate to your insurance provider or to you. 3. You can be seen quickly for illnesses or injuries that do not require emergency care. 4. You can even be seen on Saturdays. WHAT CAN I BE SEEN FOR? • Bruises • Sprains or pulled muscles in arms or legs • Colds or Flu-like symptoms • Fever • Earaches • Sore Throats • Small cuts that may need 4 stitches or staples or fewer • Minor burns • Low back pain from lifting, or ongoing back discomfort • Headaches (for patients who have already been evaluated for them) • Scrapes, scratches, or minor skin injuries • Mild rashes that do not affect breathing or blood pressure • Insect stings or spider bites with mild, local reactions • Urinary tract infections without fever or vomiting • Scratched eye • Something stuck in the eye • Something stuck in the nose or ears • Sinus infection • School or sports physicals (Payment due prior to exam.) • Employment physicals