Care Through The Good Times & The Bad Times

A primary care provider’s thorough approach to health care leads a grateful patient to recommend her to family and friends.

Judy Binek has been coming to St. Clair Health for nearly all of her health care needs for 50 years. The former Mt. Lebanon resident has visited St. Clair Health providers for everything from routine checkups and inpatient treatment to the birth of her three children and emergency care. Out of all the providers she has seen over the years, she sings the praises of one in particular these days. It’s Amanda Hercules-Smith, MD, of St. Clair Medical Group Internal Medicine, as Judy credits her for keeping her healthy during her golden years.

Judy had previously seen Joseph P. Endrich, MD, also of St. Clair Medical Group Internal Medicine, for her primary care needs. When he announced his retirement, Judy immediately knew she wanted to transition to another provider in the same practice. She says, “When I asked Dr. Endrich who he would recommend, he said Dr. Hercules-Smith. I thought, good, because I saw her once before. I liked her and got along with her.”

Dr. Hercules-Smith was easily able to familiarize herself with Judy’s medical history prior to their first appointment. She explains, “For some patients, it requires a quick review of the charts to get a better understanding of their past medical history and any ongoing medical problems. All of our physicians do pretty comprehensive chart updates which makes transition of care seamless.”

But this first appointment wasn’t just a routine checkup. Judy needed to discuss a rash and other concerning symptoms she was experiencing. She explains, “I thought the rash may have been caused by the fabric softener my daughter-in-law used while on vacation in Ocean City. But there were other symptoms, too.”

“Judy was exhibiting stroke-like symptoms, so I said to her, ‘Why didn’t you go to the emergency room?’ She said she thought she’d see me first,” says Dr. Hercules-Smith. “After examining her, I realized this wasn’t a stroke but rather Bell’s palsy.”

Bell’s palsy is a condition that causes sudden weakness of the muscles on one side of the face. As many as one in four cases of the condition are caused by Lyme disease, a bacterial infection spread to humans by infected ticks that can lead to serious longterm side effects if left untreated.

“When Dr. Hercules-Smith sent my blood to be tested, we learned it was Lyme disease. Nobody knew what was wrong with me, but she figured it out,” says Judy. After making the diagnosis, Dr. Hercules-Smith worked with an infectious disease physician at St. Clair Health to create a personalized care plan for Judy and begin treating her right away.

“I headed right to the hospital, where I was admitted so I could start an antibiotic treatment as an inpatient,” shares Judy. “Obviously they couldn’t keep me as an inpatient for a whole month, so I had to travel back and forth using St. Clair Health courtesy vans to continue to get the antibiotic treatment as an outpatient.”

Judy currently resides at the Hillcrest Residences, a newly-constructed senior community in Carrick. Despite the added distance and a lack of personal transportation, Judy did not have to worry about getting to and from this series of follow-up appointments thanks to St. Clair Health’s signature blue and white vans. She was able to access the care she needed, when she needed it, to treat both conditions.

Though the antibiotics cured her Lyme disease, the Bell’s palsy is considered a chronic condition. Dr. Hercules-Smith explains, “It can totally resolve in some patients, but Judy still has some persistent symptoms of the facial paralysis. She’s one of about 20 percent of people who are left with unilateral facial paralysis.”

Judy began seeing Dr. Hercules-Smith for more regular checkups following this episode because she didn’t just have the Bell’s palsy to monitor. She shares, “I kept up with my appointments. I also have high cholesterol, high blood pressure, and a history of aneurysms. I think it’s hereditary because my uncle had one, too.”

An aneurysm is an abnormal swelling or bulge in the wall of a blood vessel that can occur anywhere throughout the circulatory system. If left untreated, an aneurysm can rupture and may result in internal bleeding, stroke, or sometimes even death.

Having previously experienced two aneurysms, Judy didn’t hesitate to mention a lump in her groin area when seeing Dr. Hercules-Smith for a routine checkup. Dr. Hercules-Smith emphasizes, “It was not just a lump. It was very big and quite pulsatile, so we got her to the ER right away. The aneurysm was eight centimeters at diagnosis, and had very a high risk of rupture.”

While the vascular surgeon who treated Judy’s earlier aneurysms was called in to repair this femoral artery aneurysm, Dr. Hercules-Smith stayed involved to ensure Judy was well taken care of. Judy says, “Dr. Hercules-Smith called me in the ER. She went above and beyond to keep an eye on me and said she would keep in touch—which she did. She’s good that way.”

Dr. Hercules-Smith not only cares for Judy. She also cares about her. This approach to health care is why Judy has referred several patients—including her daughter, son, grandson, and sister—to Dr. Hercules-Smith for care. Judy says, “I can’t even describe in words how I feel about her. Dr. Hercules-Smith makes me feel like I’m number one on the list. It’s why I have family going to her now and try to encourage people from my apartment building to see her, too.”

Judy and Dr. Hercules-Smith now like to joke that every time she has an appointment, there is a chance they’ll find a new health issue given her track record. Fortunately, Judy is feeling good, so there has been more talk of lifestyle changes and preventive care recently—rather than emergency treatments—to ensure she maintains a good quality of life while managing her chronic conditions.

“I certainly discuss physical health ailments and lab results with patients, but more importantly, I focus on improving their quality of life and what’s most valuable to them when it comes to their health,” shares Dr. Hercules-Smith. “For patients I see regularly, we talk about a lot more than just medicine. I talk to them about what’s going on socially.”

She continues, “I ask about what they do in a day if they’re retired. I also find out who they live with, if they have good social support. I learn where their children live and if they see their grandchildren. All of that makes a difference for their health.”

What also makes a difference for patients like Judy is getting the highest level of evidencebased care in a personalized environment that is close to home. Dr. Hercules-Smith explains, “We’re constantly striving to have the most comprehensive model of care so patients can get all their health care needs met in one location.”

Spending less time in health care facilities means Judy has more time do the things she loves. Boating at nearby lakes with her children and grandchildren. Cooking German food. Baking for special occasions. Vacationing at the beach with family. Playing cards with her friends at Hillcrest Residences.

It means a lot that she can do all this at her age, since Judy maintains she is lucky to be alive given her medical history. And should another health issue arise, Judy is confident that Dr. Hercules-Smith will once again see her through every step so she can continue enjoying a quality life for years to come.

Amanda Hercules-Smith, MD
Dr. Hercules-Smith serves as the Medical Director of St. Clair Health Urgent Care. She is board-certified by the American Board of Internal Medicine. Dr. Hercules-Smith earned her medical degree from St. George’s University School of Medicine and completed her residency in Internal Medicine at AHN’s Allegheny General Hospital. She also earned a master’s degree in Medical Management from Carnegie Mellon University. Dr. Hercules-Smith practices with St. Clair Medical Group. To contact Dr. Hercules-Smith, please call 412.835.4886.