A note of thanks that we would like to share

After a recent Free vascular screening fair at Oshkosh Senior Center, a member of the community had this to say about our practicing professional volunteer team….


Good Morning, We just wanted to let you know we are thankful for the senior center. Thank you for providing needed services to our community. We recently attended the vascular screening. We would like to thank all the professionals involved for giving of their time. They provided a much appreciated service


Please follow Living Well Foundation for the next scheduled FREE vascular screening fair in the Fox Cities.

The screening is coordinated and led by a Physician/Ultrasound team. Not only is this event free it can detect medical problems that could save your life.

Again, The Living Well Foundation promotes and is thoroughly committed to health and wellness and vascular disease prevention in the communities throughout the Fox Valley. We would like everyone to have the opportunity to have preventive screening for vascular disease.

We are excited to be part of the community and your healthcare.

Additional details of future events to follow, stay connected.


The Living Well Foundation’s Vascular Screening Program

The Living Well Foundation’s vascular screening program is a no cost community focused service. The Foundation promotes and is thoroughly committed to health wellness and vascular disease prevention for the communities throughout the Fox Valley. The committed passion and purpose of the screening is a preventative measure for individuals asymptomatic of possible unknown vascular disease. This dedicated screening should be considered an important supplement to ones regimented healthcare plan.

The contributing risk factors regarding vascular disease may include:

  1. Previous or current tobacco use
  2. Family history
  3. High blood pressure
  4. Diabetes
  5. Age ( 55+)
  6. Diet
  7. Environment

Who we are:

The Living Well vascular screening program is staffed with practicing professional volunteers. The Physician team overseeing and reporting your results are professional practicing board registered Medical Doctors with years of specialized training in various radiology modalities including Ultrasound-X-ray-MRI-C.T.-Interventional procedures-Neuro-imaging-and specific vascular disciplines.

The Ultrasound team are practicing sonographers multi-registered, by the highest standards, through the American Registry of Diagnostic Medical Sonographers or ARDMS. Both the physicians and sonographers are hospital based imaging professionals with decades of imaging and healthcare experience working on a volunteer basis.


What you will experience:

The screening process will require you to make an appointment at the determined location, sign consent and release forms. No written report will be issued. A verbal result will be given by the attending physician upon completion of screening exams. If there are concerns with any of the screening exams the physician will guide and refer you back to your primary physician for needed follow-up.

Your appointment time is here: The technologist will call in and explain the screening process and exams.


1. The Carotid Screening:

The sonographer will assist you to the exam table and have you lie down. Ultrasound gel will be applied to your neck area and the technologist will move a transducer (our camera so to speak) over both the RT and Lt Carotid arteries. This will allow the physician to visualize real-time the structure and integrity of the neck arteries to observing for plaque or arterial narrowing. Approximately 5-10 minutes.

2. Abdominal Aorta Screening:

The sonographer will ask you to lift your shirt up to expose your abdomen. Ultrasound gel will be applied and the transducer moved up and down your abdomen over your aortic vessel. This portion of the test checks for enlargement of the abdominal aorta. The physician will report the results of the Carotid and Aortic exam as this portion is completed.

3. Ankle-Brachial Indices Exam:

The ABI exam will assess for peripheral arterial disease (PAD). The technologist will assist you in removing your socks, shoes and rolling up your shirt sleeves. (Please attempt to wear short sleeves or loose fitting long sleeves the pressure cuff wraps around your upper arm). The sonographer will wrap inflatable cuffs to your upper arm and around both ankles. Each pressure cuff will be inflated while the technologist listens with a small transducer for arterial sounds post inflation. The physician will evaluate the acquired data from the ABI unit and verbal results of the test given. The technologist will assist you putting your socks and shoes back on. This will complete the vascular screening. Questions you might have will be answered by the physician.

Treatment Options for Low Back Pain

Many individuals will experience low back pain at some point in their lives. Most who

seek treatment will begin with a conservative treatment plan that typically includes rest, ice,

anti-inflammatories (NSAIDs), muscle relaxants, as well as physical therapy or chiropractic care.

If these are not sufficient, it is likely a radiographic image, CT or MRI study will be viewed by a

radiologist to determine if abnormalities in the lumbar spine may be present.

In the case of radiculopathy, image-guided injections or lumbar decompression spine

surgery are viable options to reduce pressure off a nerve and improve feeling in the legs in

these patients. [1] Osteoarthritis is a condition that may result in spinal stenosis. This occurs in

older patients more commonly than younger individuals and can also be treated with lumbar

decompression. [1] Total disc replacement or artificial disc surgery may be an appropriate

procedure for those with degenerative discs that may be causing debilitating symptoms. 1

In case of painful compression fractures refractory to conservative management, a

procedure called vertebroplasty or vertebral augmentation is a safe and effective treatment to

achieve pain relief, reduce disability and improve quality of life. In the case of spinal cancer

surgery will likely be performed with emphasis placed on removing the tumor, controlling or

reducing pain, and fixing or maintaining neurological function and spinal stability. [2]

With the ability and skills to read multiple types of diagnostic images and offer

image-guided treatments for pain relief, radiologists offer a critical service to help patients get

the necessary treatment to improve their quality of life, and in some cases, save a patient’s life.


Author 1: Braden Stoeger UWSP Biology Major

Author 2: Kunal Patel, MD



Ullrich Jr, P.F, MD, Orthopedic Surgeon. (2004, May 10). “When to See a Surgeon for Low Back

Pain.” Retrieved January 21, 2017, from


Schneider, J. H., MD. (2010, April 1). “Types of Spinal Tumors.” Retrieved January 21, 2017,

from http://www.spine-health.com/conditions/spinal-tumor/types-spinal-tumors

Importance of Imaging in Low Back Pain

Radiologists utilize imaging studies to accurately diagnose a variety of causes of low

back pain. In primary care, the most commonly used imaging modalities are X-ray, MRI, CT, and

nuclear medicine bone scan. Sometimes, more advanced imaging techniques are used in

anticipation for surgery and that includes CT myelography and PET scans.

By having specialized training with these techniques radiologists are able to provide

assistance to surgeons and other medical practitioners. X-rays are helpful for evaluation of

fracture, bony deformity including degenerative changes, sacroiliitis, disk and vertebral body

height, and assessment of bony density and architecture. MRI or CT is recommended in

patients with severe or progressive neurologic deficits or with serious underlying conditions,

such as vertebral infection, cauda equine syndrome, or cancer with spinal cord compression.

MRI does not require radiation exposure and provides better visualization of soft tissue and

spinal canal, and thus preferred over CT. Computed tomography (CT) has superior depiction of

cortical bone than MRI. It may be better in visualizing fractures and detecting facet

degenerative changes. Bone scans are used mainly to detect occult fractures, stress fractures,

infections, or bony metastases and to differentiate them from degenerative changes.

Radiologists can take patient findings and correlate them with the appropriate imaging

studies to provide diagnoses, further diagnostic studies if needed, and possibly a treatment


Author 1: Braden Stoeger UWSP Biology Major

Author 2: Kunal Patel, MD


Harwood MI, Smith BJ. Low back pain: a primary care approach. Clin Fam Pract.

2005;7(2):279–303. doi: 10.1016/j.cfp.2005.02.010.

Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK, Clinical Efficacy

Assessment Subcommittee of the American College of Physicians., American College of

Physicians., American Pain Society Low Back Pain Guidelines Panel.

Ann Intern Med. 2007 Oct 2; 147(7):478-91.

Jarvik JG, Deyo RA. Ann Intern Med. 2002 Oct 1; 137(7):586-97.

The Effect of Low Back Pain

      Lower back pain is a serious issue faced by many individuals in the United States. Low back pain is the fifth most common reason for all physician visits, and is the second most common symptomatic reason (upper respiratory symptoms are first). As these patients are attempting to find a solution for their low back pain they are likely to have to pay medical bills and have decreased productivity at work.  The estimated annual national bill for the care of low back problems is $38 to $50 billion. Low back pain can be a symptom of a wide array of mechanical and nonmechanical conditions. The mechanical conditions typically include muscular or ligament strains/sprains as well as degenerative disk disease, spondylolysis, spondylolisthesis, or osteoporosis. Radiculopathy is another large contributor to low back pain and is often identifiable as a sciatica, herniated intervertebral disk, as well as fractures, tumors, infection, or a vascular compromise. Nonmechanical spine disorders are less common but include neoplasia, infection of the low back, and inflammatory arthritis. Low back pain is located, managed, and treated by family practice providers, internists, neurologists, rheumatologists, radiologists, emergency physicians, and orthopedic and neurological surgeons. Nonallopathic providers of back care include osteopathic physicians, chiropractors, physical therapists, acupuncturists, and massage therapists.

Author 1: Braden Stoeger ,UWSP Biology Major

Author 2: Kunal Patel, MD


Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain. Frequency, clinical
evaluation, and treatment patterns from a U.S. national survey. Spine. 1995; 20:11–9.
Frymoyer JW, Durett CL. The economics of spinal disorders. In: Frymoyer JW, Ducker TB, Hadler NM, Kostuik JP, Weinstein JN, Whitecloud TS, editors. The Adult Spine: Principles and Practice.Philadelphia, PA: Lippincott-Raven; 1997. pp. 143–50.
Frymoyer JW. Back pain and sciatica. N Engl J Med. 1988; 318:291–300.
Atlas, S. J., & Deyo, R. A. Evaluating and Managing Acute Low Back Pain in the Primary Care Setting. N Engl J Med 2001; 120-131


Breast Cancer – Current Issues and Promising Techniques

Currently, thirty-five states have either put laws into effect or are in the process of passing laws that require breast density information be given to patients with their mammogram results. Wisconsin is not one of those states.[1] Additionally, research has shown that women with dense breasts may be up to six times more likely to develop breast cancer,[2] so it is important there are adequate means of screening these patients and ways of being proactive regarding breast cancer. Fortunately, a new technology, SoftVue, is being investigated locally. Led by Delphinus and in joint collaboration with Radiology Associates of the Fox Valley, St. Elizabeth Hospital, and the LivingWell Foundation, SoftVue is a new style of breast imaging that incorporates the attenuation of conventional mammography with the acoustic properties of ultrasound scans.[3] It is seeking FDA approval in hopes of proving its capability of finding more cancers and reducing false-positives and -negatives, particularly in women with dense breasts.[4]


1st Author: Tessa Miller

2nd Author: Rudy Lin, MD


[1] Durning, M. (2016, May 26). Breast Density Notification Laws by State – Interactive Map. Retrieved January 01, 2017, from http://www.diagnosticimaging.com/breast-imaging/breast-density-notification-laws-state-interactive-map
[2] Adding 3-D Mammography or Ultrasound to Regular Screening Finds More Cancers in Dense Breasts. (2016, March 18). Retrieved January 01, 2017, from http://www.breastcancer.org/research-news/add-3d-mammo-or-ultrasound-to-dense-breast-screening
[3] Delphinus. (2016). SoftvueTM System. Retrieved January 01, 2017, from http://www.delphinusmt.com/technology/
[4] Ibid.

Breast Cancer – How do we Detect it?

     Owing to the fact that mammograms are not always fully reliable when it comes to detecting breast cancers, many alternative screenings in addition to regular mammographies have been researched. The most popular researched studies are breast MRI and Ultrasounds. Also, although Ultrasounds finds a couple more cancers than mammography alone when used together, the PPV is only like 10%- very poor. Hopefully with the additional impedance data, Ultrasounds will become more specific.[1] When administered in conjunction with mammography, breast ultrasounds detect more cancers in dense breasts than in mammography alone.[2] Ultrasound sends high frequency sound waves through the tissue which produces an image of the tissue, and it does not use radiation, making adverse effects virtually none.[3] Rather than using attenuation like x-rays, ultrasounds use acoustic properties of tissue to detect abnormalities. Since mammograms and ultrasound use different methods of detection, they can pick up different types of masses. Therefore, they are best paired together, particularly in women with dense breasts. 


[1] Adding 3-D Mammography or Ultrasound to Regular Screening Finds More Cancers in Dense Breasts. (2016, March 18). Retrieved January 01,2017, from http://www.breastcancer.org/research-news/add-3d-mammo-or-ultrasound-to-dense-breast-screening
[2] Ibid.
[3] Johns Hopkins. (2016).Breast Ultrasound. Retrieved January 01,2017,from http://www.hopkinsmedicine.org/healthlibrary/test_procedures/gynecology/breast_ultrasound_92,p077641/
[4} Ibid.


Author 1: Tessa Miller

Author 2: Rudy Lin, MD





Breast Cancer – Basic Background

The second most common cancer in the United States is breast cancer with 249,000 diagnoses projected for 2016.[1] Of these patients, there will be an estimated 45,000 deaths.[2] Although breast cancer can appear in both sexes, it is 100 times more likely to occur in women as opposed to men.[3] Risk factors include a family history of breast cancer, genetic predisposition, and environmental factors such as obesity and frequent alcohol use.[4] In total, breast cancer is the most expensive cancer to treat in the United States with an expected price tag of $20.5 billion by 2020.[5] Individually, an insured breast cancer patient will have to pay anywhere from $5,000 to $10,000 out of pocket for their care.[6] Currently, the most popular way to screen for breast cancer is mammography, which involves taking an x-ray of the breast.[7] Unfortunately, mammograms can miss up to 20% of any cancerous masses present at the time of imaging.[8] Furthermore, the number of false-negatives increases with the presence of high breast density- a higher amount of connective tissue than fatty tissue.[9] Because connective tissue and tumors appear similarly to the radiologist on a mammogram, tumors can be difficult to detect amongst dense tissue.[10]In addition, the amount of fatty tissue usually increases with age, so older women are less likely to experience these false-negatives as opposed to younger women;[11] however, 43% of women between the ages of 40 to 74 are classified as having dense breasts, as determined by their radiologists.[12]

  1. NIH. (2016, October 12). Breast Cancer Treatment. Retrieved January 01, 2017, from https://www.cancer.gov/types/breast/patient/breast-treatment-pdq
  2. Ibid.
  3. Ibid.
  4. Ibid.
  5. Ryan, S. (2016, November 16). The Costs of Breast Cancer in the U.S. Retrieved January 01, 2017, from http://costsofcare.org/the-costs-of-breast-cancer-in-the-u-s/

6.NIH. (2016, October 16). Cost of Breast Cancer Chemo Varies Widely in U.S. Retrieved January 01, 2017, from https://medlineplus.gov/news/fullstory_161396.html

  1. NIH. (2014, March 25). Mammograms. Retrieved January 01, 2017, from https://www.cancer.gov/types/breast/mammograms-fact-sheet


  1. Ibid.
  2. Ibid.
  3. Ibid.
  4. Adding 3-D Mammography or Ultrasound to Regular Screening Finds More Cancers in Dense Breasts. (2016, March 18). Retrieved January 01, 2017, from http://www.breastcancer.org/research-news/add-3d-mammo-or-ultrasound-to-dense-breast-screening

Author 1: Tessa Miller

Author 2: Rudy Lin, MD

Welcome to the Living Well Foundation


Welcome to our website and blog section.  Over time, you will periodic entries with topics such as:

  • History of our foundation
  • Our team
  • Our partnerships and fundraisers
  • Medical topics such as:
    • Breast cancer
    • Vascular disease
    • Brain tumors
  • Importance of early disease screening
  • Information on our FREE screening fairs
  • Advanced medical imaging technologies
  • Image-guided treatment options


Consider joining our team. Contact us for more information.