How Sweet It Is - CentraState Healthcare System

CENTRASTATE.COM 1
President’s Message
Community Voices
President’s Message…
Community Voices…
I’m thing
proudthat
to announce
that
once
again,care
for the
fourth
One
always holds
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in health
is that
year
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CentraState
has
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parents are consistently concerned if their child is as
a Top 100properly.
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DearMr.
Mr. Gribbin,
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As
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know what
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&
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Networks,
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care for your children. Finding the right pediatrician that you connect with canand
be
the College
Healthcare
Information
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more
difficultof
than
you would
think. This is
the person toExecutives.
whom you’re entrusting
your child’s health, so you have to feel comfortable with them and make sure that
The Top 100 Most Wired designation is a testament to the significant strides
they’re going to deliver the care that you expect.
we’ve made in health care technology over the past decade here at Cen-
Whether
expecting
a baby or need
to find a in
new
pediatriciantechnology,
for your child,
traState. you’re
We have
made substantial
investments
information
CentraState’s
many
advanced
health
care
services
for
children—from
team
including electronic medical records, computerized physician orderour
entry,
of esteemed pediatricians to our Pediatric Emergency Department to our on-staff
digital archiving of radiology images, and bar coding to reduce patient medipediatric hospitalists—are available to ensure that your child receives the very
cation errors.
best care.
Achieving
designation
each year
important
to Bhaskar,
us to reinforce
to our
One
of our this
outstanding
pediatricians
onisstaff
is Vatsala
MD, boardcommunity
that
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hospital’s
technology
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par
with,
or
in
many
cases
certified pediatrician, who is featured in this issue discussing pediatric behavior
superior
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larger
medicalexplains,
centers. well
This visits
designation
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for yourdoes
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mean
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andon
ahead
page
10. others in addressing these matters and using information technology
of most
in meaningful
When
mothers ways.
do choose CentraState to deliver their child and select one of our
pediatricians to care for their child’s health, they tend to return for subsequent
In particular, a special thanks to vice president and chief information officer
deliveries. Such is the case with Erika Vargo-Dill, a mother of three who delivered
Neal Ganguly and Information Systems director, Peg Kauth. Also, thank you to
all of her children at CentraState and has had nothing but positive experiences
our information
technology
, nurses,
clinicians,
and
each
time. The story
of Erika’s staff
charming
family
can be pharmacists
found on page
8. physicians in creatively adopting and using technology.
If you’re interested in learning more about CentraState’s maternity and pediatric
CentraState
continue
to embrace
fullSpring
potential
ofFair
health
IT. As25,
changservices,
the will
perfect
opportunity
would the
be our
Baby
on April
to
es held
in theathealth
care landscape
over the
coming years,
CentraState
will
be
CentraState’s
Star and occur
Barry Tobias
Ambulatory
Campus.
More details
about
the Babyto
Fair
can be found
on page 15.
hope better
to see communication
you there, and
be dedicated
updating
our technology
toWe
provide
hope
to see
child ordepartments
children as part
ofpatients
our healthcare
for many
among
our your
physicians,
and
so we system
can provide
the best
years
to care
come.
level of
possible to our community. We are proud of this honor and know
it is a symbol of our organization’s commitment to better serving our patients.
Yours in Good Health,
I just completed 33 radiation treatments for breast
I was recently in your hospital for eight days. I
cancer under the guidance of a superb group of
came to you after five days of being at [another
your staff members. Dr. Soffen [Edward Soffen, MD,
area hospital],radiation
and coming
down with
withPrinceton
MRSA
board-certified
oncologist
and
another
infecRadiation Oncology and chair of the Radiation
tion Department
called Pyoderma
Oncology
at
gangrenosum.
I was so
CentraState
Medical Center]
happy
withmost
the service
was the
kindest,
downto-earth
physician
I have
I received
from
theever
met! He
was Care
knowledgeable
Wound
Center
and experienced,
and made me
and the Emergency
feel empowered
byThe
giving
me
Department.
nursoptions of treatment. He made
es on Medical/Surgical
me feel as though he came to
(3N) were the best I
work just to care for me.
Edward Soffen, MD,
board-certified radiation
oncologist
have ever come across.
Your therapists:
I was in soSusan,
much pain
Nathalie,
Jennifer
andStephanie,
they did everyIryna Shpott, RN
R. and Gloria went above and
thing possible to help
beyond any call of duty to make my treatments a
me through it.
pleasant experience. They always greeted me with
aI smile
words.
worked
together
cried aand
lotkind
when
I wasThey
alone,
but I did
get as a
team
to
make
sure
that
my
treatment
went
perfectly
caught by your angel of a nurse, Iryna Shpott,
smoothly.
I
will
genuinely
miss
seeing
them
RN. She was coming in to let me know her every
shift
morning! They were the sunshine in my day.
was over, and when she saw me crying she
Nurses
Carol,
Jennifer
andI was
Jennifer
B.,because
with their
would not
leave.
I toldS.her
crying
expertise,
made
me
feel
confident
and
reassured
of the pain of taking off the dressing. The next
that
was going
to bein,
fine.
who took
dayIwhen
she came
sheCheryl,
came right
to mycare
of
my
simulator
needs,
put
me
at
ease
with
room and said she was thinking of how sheher
knowledge and care. Cassie at the front desk
could change the dressing without so much pull
greeted me each morning with kind words and
on the sores. I just can’t believe someone was
reassurance.
thinking of her patients after hours. All of the
Having
is a very
scary
experience,
but due
nursescancer
there were
angels.
I am
a breast cancer
to
your
fine
staff,
I
felt
confident
each
day
I was
survivor, and I know good care, and yourthat
hospigetting the best care possible! Thank you!
tal is up there with the best.
Sincerely,
Linda
ThankHoward
you,
New
EgyptBevilaque
Maryann
John T. Gribbin, FACHE
President and CEO
Healthy Directions is produced by
CentraState Healthcare System,
Freehold,
New Jersey.
Healthy
Directions
is produced by
CentraState
Spring 2013Healthcare System,
Freehold, New Jersey.
Editorial Advisors
William J. Setaro, EdD
Chair,Editorial
Board of Trustees
Advisors
J. Setaro,
JohnWilliam
T. Gribbin,
FACHE EdD
President
CEOof Trustees
Chair,and
Board
Daniel J. Messina, PhD, FACHE, LNHA
John
Gribbin, FACHE
Senior
ViceT. President
and
Chief Operating
PresidentOfficer
and CEO
Jack H. Dworkin, MD, FACC
Vice President and Chief Medical Officer
Cape Coral, Fla.
Please note that physicians on staff are private practitioners and not employed by CentraState.
Linda W. Geisler, RN, MNEd, NEA-BC, FACHE
Editor–CentraState
Vice President, Patient Care Services
Brian Johnson
We hope you enjoy this issue of Healthy Directions. Comments about the publication can be directed to
RomantheN.Public
Lucky,
CFRE and Marketing Department, CentraState Healthcare System,Editor
Kim A. Kelly, RN,Daniel
MS, NEA-BC,
FACHE
Managing Editor–True North
Relations
901 West Main Street,
J. Messina,
PhD, FACHE, LNHA
Vice President, Clinical Services
Mike Legault
Vice President,
Development
Freehold,
NJ, 07728. (732) 294-7080.
Senior Vice President and
Brian Johnson
Roman N. Lucky, CFRE Chief Operating Officer Writers
Rich
Mackesy
Healthy
Directions is published by CentraState Healthcare System to provide general
health information.
Vice President, Development
Jane DeTullio
Writers
& Business
Development
It is not intended
to provide
personal medical advice, which should be obtained
directly
from a
Jack H. Dworkin, MD, FACC Stephanie Duncan Vice President, Strategic Planning
Jane
DeTullio
Rich Mackesy
health care provider.
Vice President, Vice
Strategic
Planning
Photographers
President
and Chief Medical Offi
cer
Stephanie Duncan
Jay Solomon,
MPA, LNHA
& Business Development
Peter Chollick
Chris N. Johnson
Vice President, Senior Services
Geisler, RN, MNEd, NEA-BC, David
FACHEKelly Crow
Jay Solomon,Linda
MPA, W.
LNHA
Rich Schaub
Vice President, Senior
Services Patient Care Services
Vice President,
Photographers
Abbey M. Luterick
Designer
Peter Chollick
Abbey M. Luterick
Director, Public Relations and Communications
Kim A. Kelly,
Sherri Thornton
Director, Public Relations
and RN, MS, NEA-BC, FACHE
Rich Schaub
Communications Vice President, Clinical Services
Kevin Birch
CentraState
Medical Center
is a Magnet hospital.
®
2 CENTRASTATE HEALTHY DIRECTIONS | FALL 2013
Meet the Docs
The
S IG NS
of
Kathy Swayne, MD
Medical Specialty: Pediatrics
Medical School: University of Medicine
and Dentistry of New Jersey-New Jersey
Medical School
Residency: Atlantic Health-Morristown
Memorial Hospital/Overlook Hospital
Board Certification: American Board of
Pediatrics
What led you to the medical field? I realized “later in life” that
I wanted to be a physician; after college, I joined a health care
consulting firm and part of my job was to interview physicians by
phone. I had never considered a career in a medical profession
before, but from that experience I realized that I wanted to be a
physician rather than interviewing them!
What interested you in pediatrics in general? I think I relate
very well to children, and as a mother myself, can relate to their
parents! I absolutely love helping children feel better when
they are sick, and to stay well when they are well. A smile and a
high five from a patient is all I need to feel satisfied!
What is the most gratifying part of your job as a pediatrician?
Making long-term relationships with patients and their
families, and being someone that parents “go to” when they
have questions about their children’s health and well-being is
extremely gratifying.
Michelle Teresh, MD
Medical Specialty: Pediatrics
Medical School: Penn State College of
Medicine
Residency: UMDNJ - Robert Wood
Johnson
Board Certification: Will be taking
boards this October
SINUS ITIS
in
CHILDREN
by Kathy Swayne, MD and
Michelle Teresh, MD
Now that it is almost fall and children are heading back to
school, parents are bracing for cold and cough season to begin.
Many children come to our office complaining of stuffy noses
and pressure in the sinuses. How do you know whether these
children have a sinus infection? It can be difficult to determine
whether these symptoms are due to a sinus infection or the
common cold. In fact, studies show that only 7 percent of people
who have common cold symptoms, including sinus congestion,
actually have a sinus infection. Recently, the American Academy
of Pediatrics released updated guidelines for the diagnosis and
treatment of sinus infections.
The following are signs that your child may have a
sinus infection:
• Nasal congestion and/or cough lasting more than
10 days
• Cold symptoms that initially improve, then
dramatically worsen (this is new to the
updated guidelines)
• Fever of at least 102.2 and thick nasal discharge
lasting at least three days
There are no specific tests, including imaging tests, that make the
diagnosis, and it is not recommended that X-rays or CT scans be
used to diagnose common sinus infections.
What led you to the medical field? I was always interested
in science, especially how it is applied to better people’s lives
in the real world. In medicine, I could work directly with the
people whose lives are improved by the application of science
and technology.
What interested you in pediatrics in general? I’ve always
loved working with children, ever since I was old enough to
babysit. One of my favorite things about working with children
is that preventative health really matters. I think it’s easier to
influence the choices they make and help them pick a healthier
lifestyle.
What is the most gratifying part of your job as a pediatrician?
Watching my patients grow up—just seeing them getting
bigger and learning more with every visit.
Once a sinus infection has been diagnosed, a decision needs
to be made as to whether or not to treat it with an antibiotic.
Studies show that some sinus infections will clear on their own
without antibiotics. Therefore, one strategy is to wait three to
four days to see if the infection starts to get better on its own, as
long as the child is not extremely ill; if there is no improvement,
then antibiotics can be tried. The option to not treat initially with
antibiotics is also new to the updated guidelines. We discuss
the options with each patient and parent, and a decision can be
made together.
Don’t miss our Baby and Children’s Fair on Oct. 22, where
you can meet pediatricians and more. Visit centrastate.com/
livewell for more information.
CENTRASTATE.COM 3
LIFE AF
George Glory describes himself as a
“farm-raised Jackson resident.” George
and his brother are owners of Glory’s
market, a community landmark for
generations.
George recalls the day in May 2007 when he was
sitting in the office at Glory’s Market, working on
the store’s scheduling, and watching over new
granddaughter, Carly, when he had a headache.
The next thing he recalls is falling to the floor
from his desk chair and not being able to move or
speak, his right side paralyzed.
Thankfully, George’s stroke came at work and
staff immediately called 911. Wife Clara told the
ambulance to take him to CentraState Medical
Center. George recalls “I got an injection in the
ambulance on the way to the hospital and even
with everything going on, I realized how crucial it
was to receive such prompt treatment.”
Physical Therapy
The stroke left George with paralysis on his right
side, so after being discharged, the hard work
began. George underwent physical and speech
therapy at CentraState Medical Center. “Within
six months I was talking again and in less than
one month I was walking.” While he describes
the therapy as grueling and admits his emotions
ran the gamut of being frightened, discouraged
and depressed, he adds that, “The people at
CentraState were very nice to me and really
helped me regain my strength.”
His wife, Clara, is also appreciative to the staff
at CentraState. “His primary care doctor, Ken
Faistl, MD [board-certified in family medicine
and geriatrics], and David Frank, MD [boardcertified neurologist], were amazing following
George’s stroke,” she says. “Their compassion and
expertise really exceeded my
expectations; I give them a lot
of credit for George’s successful
recovery.”
CentraState is an advanced Primary Stroke Center with
licensed certification from The Joint Commission and New
Jersey Department of Health and Senior Services. We are
among an elite group of hospitals with a specially trained
stroke alert response team.
4 CENTRASTATE HEALTHY DIRECTIONS | FALL 2013
A year after his stroke he
passed a driving test and with it
regained a lot of independence.
Within about two years
following the stroke, George
was back to fully functioning
again.
Ken Faistl, MD, boardcertified in family medicine
and geriatrics
AFTER A STROKE
Hang In There
His advice to others who are recovering
from a stroke, “Hang in there. The
program that I went through at
CentraState was challenging, but helpful.
The therapists won’t let you rest; they
keep pushing you so that you can regain
your strength and independence.”
Today, George works out at the
CentraState Fitness and Wellness
Center, located in the Star & Barry Tobias
Ambulatory Campus, five times a week.
“Every day I am improving,” he says. He
also admits to learning a valuable life
lesson through his experience. “I was
always a worrier and under a lot of stress,
but now I simply don’t worry about the
big or little things,” George says. “It’s a
lesson I wish I had learned 60 years ago.”
For more words of wisdom from George,
visit him at Glory’s Market—he’s back
working there every day.
To find a CentraState physician, call
866-CENTRA7 or visit
www.centrastate.com/physicians
Around-the-Clock Coverage
The stroke response team at CentraState Medical Center consists of an Emergency
Department (ED) physician, neurologist, ED RN, and a stroke coordinator, all of whom
have special training in caring for stroke patients.
The team is available around the clock to assess patients immediately upon their arrival
at the Emergency Department and initiate appropriate treatment, which may include
the administration of a clot-busting medication. When a patient is experiencing stroke
symptoms, every second counts in preventing or limiting damage to brain tissue.
SymptomS oF A Stroke iNClude:
• SUDDEN numbness or weakness in the face, arm or leg, especially on
one side of the body.
• SUDDEN confusion, trouble speaking or understanding.
• SUDDEN trouble seeing in one or both eyes.
• SUDDEN difficulty walking, dizziness, loss of balance or coordination.
• SUDDEN severe headache with no known cause.
For more information about CentraState’s Stroke Center, call 866-CENTRA7 (866-236-8727).
CentraState is holding a Neuro Wellness event on oct. 30.
Visit centrastate.com/livewell for details.
Striking Back at Stroke
With Prompt Treatment By David Frank, MD
When someone has a stroke, every
second counts. It’s important to
recognize the signs of stroke so you can
seek medical attention immediately and
call 911. A stroke occurs when blood flow
to the brain is blocked, either by blood
clots or narrowed blood vessels, or when
there is bleeding in the brain. As a result,
brain nerve cells begin to die within
a few minutes. The resulting physical
damage can include paralysis, physical or
mental impairments, difficulty speaking,
or chronic fatigue.
The type of stroke a person experiences
determines the treatment he or she can
receive. The most common type of stroke
is ischemic stroke. This occurs when a
blood clot travels from somewhere in
the body to the brain and either blocks
an artery that supplies the brain with
blood or blocks a vessel inside the brain
(embolic stroke), or when a blockage
forms in an artery leading to or in
the brain (thrombotic stroke). Tissue
plasminogen activator (tPA) is the most
effective first-line treatment, but it must
be administered intravenously within
three hours (in some cases up to fourand-a-half hours). The sooner it is given,
the better the chance of improvement.
Patients who receive tPA during the first
three hours of an acute stroke have an
improved probability of reversing stroke
symptoms and face fewer long-term
complications.
Transient ischemic attack (TIA) is often
an early warning sign of ischemic stroke.
It occurs when blood flow to the brain
is momentarily blocked and inflicts no
lasting damage to the brain. Victims
of TIA should nevertheless seek help
immediately.
Hemorrhagic stroke is less common,
but typically this more deadly type of
stroke occurs when a blood vessel in
the brain ruptures and bleeds into the
brain. Symptoms often include severe
headache, nausea, and vomiting.
Treatment is based on the underlying
cause of the hemorrhage and extent of
damage, but hemorrhagic stroke victims
cannot receive tPA.
loved one is experiencing any signs of
stroke, seek medical help immediately.
Dr. David J.
Frank is a
board-certified
neurologist
on staff at
CentraState
Medical Center
in Freehold.
He may be
reached at
Central Jersey
Neurology
Associates in Freehold at 732-462-7030.
While significant inroads have been
made in the prevention and treatment
of strokes, the effects can still be
debilitating or irreversible. If you or a
CENTRASTATE.COM 5
How
Sweet
It Is:
Beating
Metastatic
Breast Cancer
After beating breast cancer, Emma Reynolds is enjoying every precious moment with her granddaughter, Aislynn.
Emma had met with Bhavesh Balar, MD, board-certified
medical oncologist and hematologist with Regional Cancer
Care Associates and on staff at CentraState, for evaluation and
treatment of a breast mass. When tests confirmed Emma’s breast
cancer, Dr. Balar told her, “We’re in this together, and we’re going
to win the fight,” words that eventually lifted Emma’s sagging
spirits. “Dr. Balar came in to my life for a reason, to hold my hand
through this journey,” Emma says. “He was my savior.”
Finding Strength
Emma’s cancer treatment was difficult. Aggressive rounds of
chemotherapy left Emma so weak that she considered giving
up, but her family impressed upon her how much they still
needed her. Emma started thinking about them rather than
her illness, and this turn of mind helped her rally. Her body’s
response to Dr. Balar’s chemotherapy “cocktail,” a treatment
directed to the genetic makeup of her cancer, was remarkable.
Post-chemotherapy scans showed a complete disappearance
of cancer in the liver, and the tumor in her breast had shrunk
significantly.
Some of the credit goes to the individualized approach of
current cancer treatments, according to Dr. Balar. “You can’t
make assumptions about the stage of a cancer,” Dr. Balar says.
“Not all cancers, all breast cancers, or all stage 4 cancers are the
same. Each person, each case, is unique.”
6 CENTRASTATE HEALTHY DIRECTIONS | FALL 2013
Freehold resident Emma Reynolds
didn’t hear anything Dr. Balar said
after “stage 4 metastatic breast cancer.”
Everything went quiet that day in 2010
for Emma, then 53. She had an aggressive breast cancer that had spread to her
liver, and recovery appeared uncertain.
Emma then underwent a mastectomy, as
research indicates an increased survival
rate for patients who respond well to
chemotherapy and have subsequent surgery.
Michael Menack, MD, board-certified general
and advanced laparoscopic surgeon with
Advanced Surgical Associates of Central
Jersey and on staff at CentraState, performed
Emma’s surgery, noting that “we, as her
Michael Menack, MD,
board-certified general
physicians and surgeons did our part, but her
and advanced laparoscopic
overwhelming courage and will to survive is
surgeon
the real story here.” Emma’s internist, Frederic
Heitzer, MD, board-certified internal medicine
physician and on staff at CentraState, agrees in his assessment
of Emma as “a responsible, dedicated person
who is dealing with this medical issue in an
impressive manner.”
New Lease on Life
Post-surgical results showed all invasive
cancer eliminated, lymph nodes clear and
only pre-cancerous changes still evident.
Subsequent radiation therapy targeted any
remaining areas of concern.
Despite all of the kudos, Emma credits her
Frederic Heitzer, MD, boardcertified internal medicine
physician
support system for her survival and
complete remission. “I had my family
and a great team of doctors,” Emma says.
“You don’t need to go to another state
for treatment. If you find a good team of
doctors locally, you will have your family
members there to give you strength. I
thought that the doctors I had were there
for me. The whole team was excellent.”
Three years later, Emma sparkles with life
and delights in her full remission. She has
regained all of her energy, works every
day, walks regularly with a neighbor, and
eats a much healthier diet than before her
illness. This is a fight they all won.
For more information about CentraState’s cancer
services, call 855-411-CANCER (855-411-2262) or
visit www.centrastatecancercenter.com
Visit our Women’s Health event
on oct. 1 for information on
breast health and other women’s
health topics, including nutrition,
managing your weight, reducing
your cardiovascular risks and more.
Visit centrastate.com/livewell or call
(732) 308-0570 to learn more.
Emma Reynolds has leaned on the strength of her family and her team of physicians at CentraState to overcome metastatic breast cancer.
“There’s no doubt that Emma’s positive attitude
actually helped her. You can’t give up. If you
admit defeat with stage 4 cancer, you’re not
leaving yourself a good enough chance to beat
the disease.” —Bhavesh Balar, MD
Bhavesh Balar, MD, boardcertified medical oncologist
and hematologist
BRCA 1 and 2: Genetic Markers for Cancer
by John Pellegrino, MD
2 mutations is the significant increase in a woman’s
lifetime risk of developing hereditary breast or ovarian
cancer. Where 12 percent of women in the general
population will develop breast cancer in their lifetimes,
more than half of women with a harmful mutation in
their BRCA 1 or 2 genes will do so. Ovarian cancer rates
jump from 1.4 percent in the general population to
an average lifetime risk of approximately one in four
women with harmful BRCA 1 or 2 genes.
BRCA 1 and 2 (pronounced brak-uh) are human genes
that under normal conditions act as tumor suppressors.
Healthy BRCA 1 and 2 genes help maintain the stability
of cells’ genetic material through preventing cells from
growing or dividing too rapidly and through repairing
damaged DNA. Research shows, however, that there are
more than 1,000 possible mutations of the BRCA 1 gene,
and, although some of these mutations are beneficial,
many are harmful.
Most notable among the effects of harmful BRCA 1 and
As BRCA 1 and 2 genes with harmful mutations are
no longer suppressing tumors, the incidence of other
cancers also rises, although to a lesser extent. Evidence
also shows that men with harmful mutations in the
BRCA 2 gene will have a higher incidence of specific
cancers, including breast and prostate cancer, than the
general population.
Individual risk of having a harmful BRCA 1 or 2 gene is
highest in families with multiple cases of breast cancer,
cases of both breast and ovarian cancer, member(s) suffering two primary cancers (original tumors developing
at different sites in the body), or an Ashkenazi (Central
and Eastern Europe) Jewish background.
the presence of harmful BRCA 1 or 2 mutations. A
positive test result would indicate an increased risk of
developing certain cancers but would not predict that
the individual will develop cancer. Not all individuals
who inherit harmful BRCA 1 or 2 genes will develop
breast or ovarian cancer. However, a positive test result
would provide the opportunity to consider important
health and social implications for the individual,
the individual’s family and for future generations.
Individuals with relatives bearing a BRCA 1 or 2 genes
with harmful mutations, as well as those women at
increased risk of breast and ovarian cancer because of
family history, should consider genetic counseling with
qualified professionals to determine if the BRCA test is
recommended.
Dr. John Pellegrino is a boardcertified breast surgeon with
Breast Surgery & Breast Oncology
Associates and on staff at
CentraState. He may be reached
at 732-458-4600.
A simple sputum test (saliva sample) will determine
CENTRASTATE.COM 7
Finally Finding Answers at
CentraState
During the past three years, 33-year-old state trooper
Jeff Heimbach of Denville has been hospitalized more
than 80 times for gastrointestinal problems. His medical
journey has taken him from community hospitals near his
Morris County home to a major university medical center
in Philadelphia.
But it wasn’t until he arrived at CentraState Medical Center in
February 2013 that doctors finally pinpointed and corrected the
cause of his relentless heartburn, nausea and vomiting. He was
unable to eat solid food and was rapidly losing weight.
Jeff traces his medical problems to 2008 when he was involved in a
high-speed pursuit resulting in a crash while chasing after a stolen
car. The accident “should have killed me,” he says. He felt lucky to
walk away with a back injury and broken ribs.
It was years later that he learned the accident had actually done
much more internal damage.
An Expert In Our Area
Prior to the accident, Jeff twice underwent surgery to fix a hiatal
hernia, a condition in which the stomach bulges up into the chest,
causing symptoms such as severe heartburn. When his symptoms
flared up again in 2010, he had corrective surgery for a third time.
Yet, his problems keeping down food grew worse. He was frequently
hospitalized for dehydration and vomiting and reached a point
where he needed a feeding tube. He was eventually diagnosed with
gastroparesis—his stomach muscles were, in essence, paralyzed and
no longer correctly moving food through the digestive tract.
In November 2011, Jeff went to Philadelphia to have a pacemaker
implanted in his abdomen. Similar to a cardiac pacemaker, which
provides electrical stimulation to the heart, a gastric pacemaker
stimulates movement of the stomach muscles.
The unusual procedure is prescribed by only a few dozen doctors in
the country including—as Jeff learned after his procedure—Brian
Weiner, MD, board-certified gastroenterologist with Marlboro
Gastroenterology and on staff at CentraState. To stay somewhat
closer to home, Jeff transferred his follow-up
care to Dr. Weiner, a leading gastroparesis
expert in New Jersey.
“Gastroparesis is a rare and difficult disease
to treat,” Dr. Weiner says. “Food just sits
in the stomach, causing abdominal pain,
nausea and vomiting. People can become
devastatingly ill.”
A Medical Journey To CentraState
While the pacemaker temporarily improved
Jeff ’s symptoms, he was still having trouble
eating solid food and keeping on weight.
He worried his weakened condition made it
unsafe to be out on patrol as a trooper.
Jeff credits the support of his wife, Christine, the expertise of Brian
Weiner, MD, (far left) and the efforts of the ICU/CCU staff, including
Donna Betar, RN, (far right) for his amazing recovery.
8 CENTRASTATE HEALTHY DIRECTIONS | FALL 2013
On Feb. 25, 2013, Dr. Weiner admitted Jeff to
CentraState for dehydration. He performed
an endoscopy and ordered a CT scan and
other tests to reassess Jeff ’s condition. He also
consulted Vince Moss, MD, a board-certified
thoracic surgeon, and his brother Vance Moss,
MD, a board-certified urologist and transplant
surgeon, with Mid-Atlantic Multi-Specialty
Surgical Group and on staff at CentraState, as
well as lieutenant colonels in the U.S. Army
Reserves Medical Corps.
Together, the doctors decided reconstructive abdominal
surgery, while risky, was Jeff ’s best chance at a normal life.
“They could have said, ‘Oh, it’s just the
gastroparesis, let’s give him some fluids and
send him home again,’” Jeff says. “But they
went the extra mile. They really believed in me,
and they stepped up.”
Dr. Vance Moss, along with
his brother, Dr. Vince Moss,
performed an extremely
complex surgery that greatly
improved Jeff Heimbach’s
quality of life.
A Complex Surgery at a Community Hospital
Drs. Vince and Vance Moss determined that Jeff ’s condition
was likely due to previously undiagnosed trauma from the
2008 crash. Among Jeff ’s problems: His stomach had moved
up into his chest; he had a severely injured diaphragm; and
the nerve that sends signals from the brain to the stomach was
compressed.
“We basically reconstructed his gastrointestinal
system from his esophagus down to his stomach,”
Dr. Vince Moss says. “This was, by far, one of the most
complex procedures that I have ever performed.”
Jeff was in surgery for nearly seven hours. He
then spent 13 days in the Critical Care Unit (CCU)
at CentraState, where he fought off infection
and required a ventilator for serious breathing
problems, says Nirav N. Shah, DO, director of the
CCU.
Nirav N. Shah, DO, boardcertified pulmonologist
“He was among the sickest of the patients
we see in the CCU,” Dr. Shah says. “With a
multidisciplinary team approach, we were able
to achieve a very good outcome considering
how sick he was.”
Back On The Beat
Jeff ’s post-operative care made all the difference in his recovery,
Drs. Vince and Vance Moss say, adding that it’s the reason why they
recommend CentraState for surgical care.
“We always explain to our patients the importance of the minuteby-minute care they receive after surgery,” Dr. Vance Moss says. “We
give all the credit for where Jeff is today to the nurses and staff at
CentraState.”
Jeff left the hospital on March 26. The 6-foot-6-inch man gained
back 24 pounds in less than two months. By May, he was eating
normal foods, even steak and hamburgers—the thought of which
would have previously made him nauseous. At the end of June,
his health had improved so much he had his gastric pacemaker
removed.
Jeff spent the summer enjoying time with his daughters Grace, 3,
and Kylie, 5, and wife Christine, while awaiting medical clearance to
resume his 9-year career as a state trooper.
“I worked my whole
life to be a trooper, I
wasn’t going to throw it
away,” Jeff says. “At other
hospitals, I felt like a
project. At CentraState, I
was a patient.”
For more information about CentraState’s surgical services, visit
www.centrastate.com/surgical-services or call 866-CENTRA7
(866-236-8727).
CENTRASTATE.COM 9
Fall Baby
and
Children’s Fair
WhEN: October 22
5:30-8 p.m.
WhErE: The Star and
Barry Tobias Ambulatory
Campus, 901 West Main
Street, Freehold
Whether you’re thinking about having a baby, are already expecting or have a little
one, CentraState’s Baby and Children’s Fair will have something for you! Meet with
ob-gyns and pediatricians; tour CentraState’s First Impressions Maternity Center;
attend a physician lecture on preparing for pregnancy or what do if your child has
an emergency; visit vendors offering a range of child-related products, services and
free giveaways; learn about our childbirth and parenting classes; win door prizes and
more!
Physician Lectures
Preparing For Pregnancy & Trying to Conceive
• Ob-gyn visits, prenatal vitamins, exercise, what to eat or
not to eat
• Predicting ovulation—learn when you’re most fertile,
find out if ovulation kits really work and discover the symptoms
of ovulation
• Pregnancy testing—common symptoms of pregnancy
during the two-week wait and when to start testing
• Identifying and managing risk factors
What to Expect During Pregnancy
• Stages of pregnancy
• Weight gain, nutrition, and exercise tips to keep you and your
baby healthy
• How to cope with the occasional morning sickness
• What’s safe and what’s not - medications, caffeine, hair dye
and more
What to Expect During Labor & Delivery
• Signs of early labor and when to go to the hospital
• Stages of labor
• Learn how to manage pain
• Delivery room tips for your support person
Additional lecture topics include:
• Breastfeeding
• Pediatric emergencies
• And more!
To join us, please call 866-CENTRA7 (866-236-8727) or visit
centrastate.com/livewell to register.
10 CENTRASTATE HEALTHY DIRECTIONS | FALL 2013
Settle Into Fall
with Healthy Slow-Cooker Recipes
As the weather begins to turn cooler outside, it’s a good time to
warm your slow-cooker up and enjoy some hearty and healthy
meals.
Vegetable and Chickpea Curry
Ingredients
1 tablespoon olive oil
1 1/2 cups chopped onion
1 cup (1/4-inch-thick) sliced carrot
1 tablespoon curry powder
1 teaspoon brown sugar
1 teaspoon grated, peeled fresh ginger
2 garlic cloves, minced
1 serrano chile, seeded and minced
3 cups cooked chickpeas (garbanzo beans)
1 1/2 cups cubed peeled baking potato
1 cup diced green bell pepper
1 cup (1-inch) cut green beans
1/2 teaspoon salt
1/4 teaspoon black pepper
1/8 teaspoon ground red pepper
1 (14.5-ounce) can diced tomatoes, undrained
1 (14-ounce) can vegetable broth
3 cups fresh baby spinach
1 cup light coconut milk
6 lemon wedges
Preparation
Heat oil in a large nonstick skillet over medium heat. Add onion and
carrot; cover and cook 5 minutes or until tender. Add curry powder,
sugar, ginger, garlic, and chile; cook 1 minute, stirring constantly.
Place onion mixture in a 5-quart electric slow cooker. Stir in chickpeas
and next 8 ingredients (through broth). Cover and cook on HIGH for 6
hours or until vegetables are tender. Add spinach and coconut milk;
stir until spinach wilts. Serve with lemon wedges.
Slow-Cooker Meat Loaf with Shiitake Mushrooms
Ingredients
2 (1-ounce) slices whole wheat bread
3/4 pound ground round
3/4 pound ground turkey
1 1/2 cups sliced shiitake mushrooms
1/2 cup grated fresh onion
1 teaspoon dried Italian seasoning
3/4 teaspoon salt
2 large eggs, lightly beaten
1 garlic clove, minced
2 tablespoons ketchup
1 1/2 teaspoons Dijon mustard
1/8 teaspoon ground red pepper
Preparation
Place bread in a food processor, and pulse 10 times or until crumbs
measure 1 1/3 cups. Combine the crumbs, beef, and next 7 ingredients
(beef through garlic) in a large bowl, and shape meat mixture into a 9
x 6-inch loaf. Place loaf in an electric slow cooker.
Combine ketchup, mustard, and pepper in a small bowl, stirring with
a fork. Spread ketchup mixture evenly over top of loaf. Cover with lid;
cook on LOW for 5 hours.
For more healthy recipes, visit centrastate.com/recipes.
Recognize
The Warning Signs
Of Alzheimer’s
As we grow older, it’s natural to become more forgetful. However, there is a distinction
between routine forgetfulness and signs of a serious medical condition, such as
Alzheimer’s disease. According to the Centers for Disease Control, approximately 5 million
Americans suffer from Alzheimer’s.
Even after years of research, the exact cause or causes of Alzheimer’s are unknown. Two
risk-factors that are commonly associated with Alzheimer’s are age and family history of
the disease.
“The most important thing to understand is that some or even all of
these things happen to everyone as they get older, so just forgetting
where you put your television remote once isn’t necessarily indicative
of a sign of Alzheimer’s,” says Robert Chen, MD, board-certified
family medicine physician specializing in geriatrics and on staff at
CentraState. “It’s when several of these things happen with increasing
frequency that point to a potentially serious condition.”
As the Alzheimer’s Association points out, there is a difference
between missing a monthly bill payment and being completely
incapable of managing your finances. If you do find yourself in such
a situation, be sure to share your concerns with your physician. He or
she will give you proper testing to determine whether or not you’re
showing true symptoms of Alzheimer’s disease.
Robert Chen, MD, boardcertified family medicine
physician
“As with any disease, early detection is important,” Dr. Chen says. “There is currently no
cure for Alzheimer’s, but diagnosing it in the beginning stages can help with symptoms
through proper medication and with planning care and support.”
CentraState’s senior communities, Applewood Estates, Monmouth Crossing and The
Manor Health and Rehabilitation Center now offer on-site geriatric physician services,
as part of the system-wide expansion of CentraState’s senior care services. For more
information, visit www.centrastate.com/senior-services.
The Alzheimer’s Association lists
10 major Alzheimer’s
warning signs:
Memory loss
that disrupts
daily life
Difficulty
completing
familiar tasks at
home, at work or
at leisure
Trouble
understanding
visual images
and spatial
relationships
Decreased
or poor
judgment
Withdrawal
from work
or social
activities
Challenges
in planning
or solving
problems
Confusion
with time or
place
New problems
with words in
speaking or
writing
Misplacing
things and
losing the ability
to retrace
steps
Changes in
mood and
personality
Walk to End Alzheimer’s
Each year, Monmouth Crossing and CentraState
Healthcare System sponsor and participate in the
Southern Regional “Walk to End Alzheimer’s”
(formerly known as the Alzheimer’s Memory
Walk). The 2013 “Walk to End Alzheimer’s” will
be held on Saturday, Sept. 28, in Point Pleasant.
For more information or to sign up to participate
or donate, visit the Alzheimer’s Association
website at www.act.alz.org.
CENTRASTATE.COM 11
NONPROFIT
ORGANIZATION
U.S. POSTAGE PAID
CENTRASTATE
HEALTHCARE SYSTEM
CentraState Medical Center
901 W Main St
Freehold, NJ 07728
CentraState Briefs
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Congratulations to all of the physicians, employees and
volunteers at CentraState who deserve this well-earned
recognition!
Wine Tasting Event
An evening in the Vineyards
To benefit the Linda E. Cardinale Multiple Sclerosis Center
A sampling of over 100 fine wines, craft beers, and
spirits,
and hors d’oeuvres
to complement
them.
CentraState
Honors
Nursing
Excellence
Award Winners
Friday, Sept. 20, 2013 • 6–9 p.m.
CentraState
honored
seven RNsCampus
with its 11th annual
CentraState’s
Starrecently
and Barry
Tobias Ambulatory
Nursing
Excellence
Awards
for
demonstrating
exceptional
901 W. Main Street, Freehold
clinical skill and leadership in the hospital and in the
Thecommunity.
proceeds of this event are dedicated to the Linda E. Cardinale
Army football head coach Rich Ellerson (left) and members of the coaching staff present Dr. Mark
McLaughlin with an autographed team football after their hands-on portion of the precision workshop.
The 2013 award winners are (from left to right): Karen Goglia, RN, AD, Critical Care/
Emergency Services Award; Eileen Ammon, RN, BSN, CNOR, and Helen Bueti, RN, BSN,
ReadCGRN,
Healthy
Directions
online
www.centrastate.com/publications
Perioperative
Services
Award;at
Renie
Ebreo, RN-BC, BSN, MSN, Mental Health
Services Award; Mary Foster, RNC, Maternal/Child Health Services Award; Vickie Moon,
Subscribe
to ourSurgical
free health
visiting
RN-BC, Medical
Servicese-newsletter
Award; and (not by
pictured)
Judy Howley, RN, BSN, CDP,
www.centrastate.com/enews
Long-Term Care Services Award.
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and audiology center, a cognitive training program, and space
for clinical research and is now the largest such center in New Jersey
serving over 700 patients annually.
Read Healthy Directions online at
www.centrastate.com/publications.
Register online at:
Subscribe to our free health
www.centrastatefoundation.org/An-Evening-in-the-Vineyards/
e-newsletter by scanning the QR
code with your smartphone or
visiting www.centrastate.com/enews.