November 2013
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Healthy Message from North Country Pediatrics
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LRH News

New PET Scan Service Now Available at LRH



LRH Volunteer, Zora Kinney demonstrates how comfortable the

new PET Scan is for patients.


Littleton Regional Healthcare and Alliance Imaging have joined forces to offer the innovative combined PET/CT scan, which is quickly on its way to becoming the gold standard in detecting, diagnosing, and staging new and residual cancers. Littleton Regional Hospital began offering PET/CT in late September. PET/CT applications deal basically with cancer and non cancer imaging, which includes Alzheimer's Disease and some cardiac uses.

"Fused PET/CT is becoming the standard for cancer imaging," states Dr. J.C. Biebuyk, a radiologist at LRH. "It is state-of-the-art, and we use one of the most advanced machines available."

The PET scan provides functional imaging based on metabolism in tumor cells. The CT scan provides anatomic imaging such as size, location, and shape. The merged information better pinpoints cancers than either test alone, Biebuyk said. "Both tests have limitations, but together it's the best test to pinpoint cancer growths," he said.

PET technology has been slow to evolve primarily because reimbursement issues govern who receives a PET scan. It is not currently used to diagnose cancer except in the case of a solid pulmonary nodule.  "The majority of patients receiving combined PET/CT studies already have the diagnosis of cancer or something suspicious for cancer," Biebuyck said.  CT scan, on the other hand, provides excellent detailed information on the size, shape and location of a mass, but it cannot distinguish between malignant and benign.  "If you get a PET/CT, I can usually tell you exactly where your tumor is instead of where it might be," Biebuyck said.

For example, if a physician wants to take out lung cancer in the right upper lobe, a PET/CT study could show there is a lymph node that is more accessible. By taking out the more accessible node, which can be biopsied without anesthesia, the patient receives the same diagnosis, staging, most appropriate chemotherapy and radiation treatment with the least number of invasive procedures.

"In this example, if they hadn't had the PET/CT study, they might have gotten a different treatment that wasn't the best for their cancer," Biebuyck said. "I've seen CTs that were read as normal, and a PET study picked up undetected cancers you couldn't see on the CT. It really improves your treatment planning and your monitoring of response to treatment."

The combined scan is also useful in detecting recurrent cancer. For example, if a patient has breast cancer and has finished treatment, a PET/CT can show if there are residual cancer cells. Sometimes on a PET study alone, because there is no anatomic lesion to look at, a physician can't tell if the amount of radioactive glucose on the scan is enough to determine if there are cancer cells still there or not, but with the combined study, a physician can actually see if there is a nodule there and if there is reason to believe there are still cancer cells.

"This kind of detailed information leads the oncologist to start a second course of treatment early to kill remaining cancer cells that would have gone undetected with plain CT or plain PET," Biebuyck said.

At Littleton Regional Healthcare, all scans are interpreted by PET-trained physicians. Some are nuclear medicine board certified physicians, and others are radiologists who are board certified but have special interest and training in PET. There is a core group of three radiologists who work there, which gives reproducible reporting style and allows only the most knowledgeable radiologists to read the studies.

"Combined PET/CT gives the patient the best chance for a good outcome and avoids unnecessary procedures," Biebuyck said. "If we can continue to educate physicians on when and how to use this advanced technology, treatment results for many cancers will continue to improve."


According to Robert Mach, Executive Director of Operations at LRH, "We are very excited to offer this advanced technology at Littleton Regional Healthcare. Our goal is to provide the most advanced imaging technology close to home and with the addition of the new PET/CT, patients no longer have to travel over an hour to receive this advanced imaging technology."


LRH is proud to offer PET/CT imaging every Monday between the hours of 8 am to 4 pm. A physician referral is required, so please have their office call (603) 444-9072 to schedule your PET Scan. 


What Our Patients are Saying!

littleton healthcare 

At LRH we take great pride in caring for patients and their families. We'd like

to share some of the comments we receive, and we think you will agree that LRH is a very special hospital!


Happy to choose LRH for his healthcare...


There have been times in my life when thinking back I wished I had taken the time to say, "Thank you". This note is not just to say thank you, to me, I hope I have conveyed to you just extremely how great and professional I think your hospital is. While I haven't had much experience in hospitals, seeing how things are done at LH, I would think your hospital should be a model, from the way volunteers actually take the time to take patients to the proper place, the way patients are greeted, to the monitors set up for those relatives waiting, to the follow up telephone calls, everything was just incredible!


A grateful oncology patient...


For everything you've done...for being the special people that you are...thank you so very much.


To all the young ladies in Oncology...Thanks for all you have done for me and for putting up with me every day for over a month. You made my daily trips here for my infusion worthwhile.


Comments from a long time RN...


As an RN of over 40 years myself, I am all too aware of what is and isn't good care, and you are lucky to have an exceptional staff. If I was looking for a job in NH, I would certainly consider working with your staff! I can't say enough about all who were involved in my mother's care. My thanks to all of you.


Healthy Message from North Country Pediatrics

Dr Traci Wagner
This article is provided by Dr. Traci Wagner, Pediatrician with LRH's North Country Pediatrics

Children, the Flu, and the Flu Vaccine


Children should be vaccinated every flu season for the best protection against Influenza ("the flu"). For children who will need two doses of flu vaccine, the first dose should be given as early in the season as possible. For other children, it is good practice to get them vaccinated soon after flu vaccine becomes available, ideally by October. However, getting vaccinated even later can be protective, as long as flu viruses are circulating. While seasonal influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against influenza virus infection, it is best that people get vaccinated so they are protected before influenza begins spreading in their community.


Influenza is dangerous for children


Influenza ("the flu") is more dangerous than the common cold for children. 

Severe influenza complications are most common in children younger than 2 years old.  Children with chronic health problems like asthma, diabetes and disorders of the brain or nervous system are at especially high risk of developing serious flu complications. Each year an average of 20,000 children under the age of 5 are hospitalized because of influenza complications.


Flu seasons vary in severity, however some children die from flu each year. During the 2012-2013 influenza season, more than 150 flu-related pediatric deaths were reported.  The single best way to protect your children from the flu is to get them vaccinated each year. The seasonal flu vaccine protects against the influenza viruses that research indicates will be most common during the upcoming season. Traditional flu vaccines (called trivalent vaccines) are made to protect against three flu viruses; an influenza A (H1N1) virus, an influenza A (H3N2) virus, and an influenza B virus. In addition, this season, there are flu vaccines made to protect against four flu viruses (called "quadrivalent" vaccines). These vaccines protect against the same three viruses as the trivalent vaccine and an additional B virus. They come in a shot for children as young as 6 months old and a nasal spray approved for healthy* non-pregnant people 2 through 49 years of age.


The CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine. Vaccination is especially important for certain people who are high risk or who are in close contact with high risk persons, including the following groups:

Children younger than 5 years of age, and children of any age with a long-term health condition like asthma, diabetes, heart disease, kidney disease, blood disorders, immune disorders, cancer, chronic aspirin therapy or disorders of the brain or nervous system, and American Indian and Alaskan Native children are at a higher risk of serious flu complications (like pheumonia) if they get the flu.


In addition to the children listed above, the following people and groups are among those who are at a higher risk of serious flu complications (like pheumonia) if they get the flu:


  • Are close contacts of children younger than 5 years old (people who live with them).
  • Are out-of-home caregivers (nannies, daycare providers, etc.) of children younger than 5 years old.
  • Live with or have other close contact with a child or children of any age with a chronic health problem (asthma, diabetes, etc.).
  • Are health care workers.

Can the flu vaccine give me the flu?


No, a flu vaccine cannot cause flu illness. Flu vaccines that are administered with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been 'inactivated' and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The nasal spray flu vaccine does contain live viruses. However, the viruses are attenuated (weakened), and therefore cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other areas where warmer temperatures exist.


There are special vaccination instructions for children aged 6 months through 8 years of age. Some of them require two doses of influenza vaccine. Children in this age group who are getting vaccinated for the first time, as well as some who have been vaccinated previously, will need two doses. Your child's health care provider can tell you whether two doses are recommended for your child.


The first dose should be given as soon as vaccine becomes available.


The second dose should be given at least 28 days after the first dose. The first dose "primes" the immune system; the second dose provides immune protection. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine.   If your child needs the two doses, begin the process early. This will ensure that your child is protected before influenza starts circulating in your community.


In addition to vaccination you can take everyday preventive steps like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading influenza to others.


Visit for more information about the 2013-2014 flu vaccine! 

 LRH Events


LRH Education

A Message from LRH Education Department

Learning CPR and AED skills can improve your ability to take action in an emergency.  Patients have the best chance for full recovery from a cardiac arrest when cardiopulmonary and defibrillation are administered appropriately and effectively. The Education and Staff Development Department at Littleton Regional Healthcare is now offering American Heart Association (AHA) classes for Cardio-Pulmonary Resuscitation and Automated External Defibrillator (AED) use.  The Heartsaver® CPR AED course uses interactive lessons and videos to teach CPR, AED and choking knowledge. Students will learn how to react in a cardiovascular emergency and activate the emergency response system.  This program is for individuals with limited or no medical training who want or need an AHA course completion card. You will learn:


  • Adult CPR and AED use
  • Adult choking
  • Child CPR and AED use (optional)
  • Infant CPR (optional)
  • Child choking (optional)
  • Infant choking (optional)

CPR instruction includes high-quality compressions, airway management, breathing, and how to use a mask. The courses are offered to non-clinical employees and volunteers at LRH as well as members of the community.  To find out more information about how to register for this and other courses offered by the Education and Staff Development Department, visit our web pages at


LRH Auxiliary Corner



Books are Fun Book Fair - Littleton Regional Hospital Auxiliary will host its Holiday - Books-Are-Fun - Book Fair on Monday, December 2nd from 11:00 am until 6:30 pm and Tuesay, December 3rd from 7:00 am until 1:00 pm.  It will be located in H. Taylor Caswell, Jr. Physicians' Office Building in the lower atrium by the cafeteria at Littleton Regional Healthcarel.


Community members are welcome to stop by to purchase a wide variety of books and gift items.  Items to occupy and educate children of all ages can be found at the Books Are Fun Book Fair at LRH.  Proceeds from the event benefit the LRH Auxiliary whose mission is, "to support Littleton Regional Hospital and help educate the community it serves." 



LRH Auxiliary Cookie Sale - This is one of the Auxiliary's favorite events!  On Friday, December 13th there will be trays of cookies available to purchase, and all of the cookies are homemade by members of the Auxiliary.  Anyone wishing to bake and donate cookies, please call Marian Edmunds at 823-8558.


For more information about the Books are Fun - Book Fair and Cookie Sale hosted by the LRH Auxiliary, please contact, Amy LaSalle, Volunteer Director at LRH at (603) 444-9207.


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LRH Staff Recognition

Case Management& Social Services Department Manager Receives Certification


Jody Brusseau, Mrg. Case Mangaement at LRH

Littleton Regional Healthcare is pleased to announce that Manager of Case Management, Social Services and Utilization Review Department, Jody Brusseau, BHCA, RAC,has earned her CPHM (Certified Professional in Healthcare Management). This certification recognizes Jody's knowledge and understanding of the U.S. health care system, health economics and strategies, both legal and ethical issues in the field, national health care policies, leadership and management in health care and the growing responsibilities of care managers in the healthcare industry from both the payer and provider viewpoints.


By achieving this certification, Jody has shown her commitment to Littleton Regional Healthcare and its patients. Her continuing education demonstrates her determination to ensure a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes and patient satisfaction.


"Littleton Regional Healthcare is proud to have such a valued and skilled Staff member. Jody's commitments to high quality patient care, and ensuring an exemplary patient care experience, are clear in the approach she takes every day." states Chief Nursing Officer/Chief Administrative Officer, Linda Gilmore.

Your Gift Makes a Difference



It's not news a woman wants to hear... "There's a questionable spot on your mammography. We want you to come back for further studies." Her mind races to the worst imaginable outcome. Could it be cancer?


Here at Littleton Regional Healthcare, we know that early detection of breast cancer can make all the difference in providing greater treatment options and greater chances of survival. That's why we are so pleased to have digital mammography and ultrasound as non-invasive tools to find breast cancer EARLY. LRH is very pleased to now offer PET (positron emission tomography) scans, which can be useful once cancer has been diagnosed to determine if cancer has spread to lymph nodes or other parts of the body.


Recently the Littleton Regional Healthcare Charitable Foundation helped two women who needed mammography, but either did not have insurance or whose insurance denied the test. Staff of the Diagnostic Imaging Department advocated for their patients by asking the Foundation for help on their behalf. Making a difference in the lives of those two women by making the right care available when needed is what the LRH Charitable Foundation is all about.


Later this fall when you see the LRH Charitable Foundation appeal, please consider how your gift may make the difference. Thank you in advance for your support!


Susan Durgy, MBA, CFRE

Director of Development



Make your gift today in support of our Campaign for Hope and make this wish come true! 



600 St. Johnsbury Road

Littleton, NH  03561

(603) 259-7785



600 St. Johnsbury Road - Littleton, NH 03561 - (603) 444-9000 -