View Vitality summer issue 2010

Transcription

VITALITY
A PUBLICATION OF NORTH SHORE UNIVERSITY HOSPITAL AND LONG ISLAND JEWISH MEDICAL CENTER
NEW MOM
OVERCOMES STROKE
SUPPORT AFTER
PREGNANCY LOSS
PARALYZED ATHLETE
WALKS AGAIN
REFRESHING RECIPES
N ORT H S H ORELIJ . COM
S UM M ER 2010
National Quality
Healthcare Award
Winner 2010
CONTEN TS
Summer 2010: In This Issue
A new cancer treatment delivery
system produces faster images with
lower radiation doses.
16 Neuroscience
Transitions® of Long Island helps
patients recover from traumatic brain
injuries through neurorehabilitation.
A professional cricket player receives
life-altering spinal cord surgery at
North Shore University Hospital.
20 Seeing Clearly
Custom LASIK gives patients clearer,
sharper vision than conventional LASIK.
22 Lupus Research
Positive results of a drug study give
hope to lupus patients.
25 Health System News
3
Manhattan Expansion
7
Lenox Hill Hospital joins the North
Shore-LIJ Health System.
4
6
A new program personalizes the
medical services necessary for
senior adults to maintain health and
independence at home.
Stroke Rescue
A new mom from Massapequa Park
receives lifesaving care through the
Stroke Rescue Program at North Shore
University Hospital.
Circle of Care
8
Healing for Pregnancy Loss
The Recurrent Pregnancy Loss Program
supports women who have suffered
multiple pregnancy losses.
Cancer Care
A routine screening saves lives.
LIJ Medical Center gets an Outstanding
Achievement Award for excellent care
of cancer patients.
The Hofstra School of Medicine in
partnership with North Shore-LIJ has
earned accreditation.
Richard Goldstein elected as the
new North Shore-LIJ Health System
chairman.
Clinicians learn new skills without risk at
the Patient Safety Institute.
29 Health Bytes
Tips for a healthier lifestyle.
30 Lighten Up
Refreshing recipes.
Patients at the new Center for Head and
Neck Cancer receive comprehensive
care from a team of specialists.
Medical Update to Enter Season 8
Medical Update will return from its summer break on Saturday, October 9. Watch North Shore-LIJ Health System’s award-winning
TV series on Saturdays at 11 a.m. on WLNY-TV (Channel 10 on Cablevision and Verizon FiOS and Channel 55 on Time Warner Cable in
New York City), plus DirecTV and DishTV. See reruns at 11 a.m. and 2:30 p.m. Monday through Friday on Verizon FiOS Channel 1, and
at 12:30 p.m. Sunday, 8:30 p.m. Tuesday and 3 p.m. Friday on Great Neck Public Access TV (Channel 20 on Cablevision and Channel 37
on Verizon FiOS) and any time at NorthShoreLIJ.com.
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Vitality + Summer 2010
WELCO ME
North Shore-LIJ Expands into Manhattan
L
enox Hill Hospital, a 652-bed facility on
Manhattan’s Upper East Side, recently
joined the North Shore-LIJ Health System.
The new partnership opens an exciting
chapter in Lenox Hill Hospital’s 153-year
history, preserving a rich legacy of providing
exceptional care to more than 325,000
patients annually. For North Shore-LIJ, the
addition of Lenox Hill establishes its first
hospital in Manhattan and its 15th overall,
expanding its reach in the metropolitan
New York area.
“When Lenox Hill Hospital began the
process of seeking a partner, North ShoreLIJ was identified as desirable since both
organizations have similar cultures with
core missions of providing high-quality
clinical care supported by medical education and research,” said William Hiltz,
chairman of the Lenox Hill Hospital Board
of Trustees.
“The decision was also based on North
Shore-LIJ’s reputation as a highly respected
organization that has successfully integrated
independent hospitals into its system,” said
Gladys George, president and chief
executive officer of Lenox Hill Hospital.
“We are confident that our patients will
benefit from North Shore-LIJ’s nationally
recognized quality initiatives, depth of
clinical services and new medical school
being developed with Hofstra University.”
“This is an unprecedented opportunity to
build upon Lenox Hill Hospital’s legacy of
medical excellence,” said Saul Katz, former
chairman of the North Shore-LIJ Health
System’s Board of Trustees. “Utilizing North
Shore-LIJ’s infrastructure and resources will
Lenox Hill Hospital, on Manhattan’s Upper East Side, recently joined the North Shore-LIJ Health System.
further strengthen Lenox Hill Hospital’s
ability to provide its physicians with access
to the full continuum of care for their
patients. The board is confident that this
new partnership will bring great value to
both Lenox Hill and the North Shore-LIJ
Health System.”
“North Shore-LIJ will provide the
necessary support to help Lenox Hill
Hospital enhance its clinical services, which
have a well-deserved reputation for excellence
in cardiac care, digestive disorders, maternal/
child health and orthopedics,” said Michael
Dowling, president and chief executive
officer of the health system. “By making
clinical investments at Lenox Hill and
providing other resources and support that
will enhance quality and reduce expenses,
we’re confident we can build on the
hospital’s unique operating niche as a
physician- and patient-friendly facility that
attracts clinical talent and patients from
throughout the metropolitan area,” he said.
“Among Lenox Hill’s attributes is its large
core of loyal physicians in key clinical areas
who are critical in attracting patients and
expanding programs.”
NORTH SHORE-LIJ GOES MOBILE
A mobile version of the North Shore-LIJ Health System’s Web site is accessible via NorthShoreLIJ.com
on any smartphone, BlackBerry, iPhone or Palm and delivers a greatly improved experience for
mobile Web site visitors. You can quickly retrieve address information, phone numbers, directions
and maps to North Shore-LIJ’s hospitals and facilities.
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3
STROKE RESCU E P ROGRAM
Stroke Rescue Program
Saves Young Mother from Disability
S
hari Stack, 30, is a very
unusual new mom. While
others may find constant
feedings, diaper changes and
late-night wake-ups challenging,
she looks forward to this routine
with her infant, Liam, with great
joy. That’s because six weeks after
Liam was born, a massive stroke
threatened hers.
One Saturday morning in
January, Ms. Stack and her
husband, Christopher, had just
finished playing with their son
in the family room of their
Massapequa Park home. As
Mr. Stack watched television,
Ms. Stack was checking e-mails
Shari and Christopher Stack are all
smiles with Liam, their pride and joy.
by Betty Olt
when the vision in her right eye
blurred. Upon trying to close her
laptop computer, she realized that
she shut her right hand inside it
and couldn’t feel it. Puzzled,
Ms. Stack looked over at her
husband but couldn’t speak.
She lay down on the couch and
realized she couldn’t move her
right leg. Her husband asked if
she was okay — whether she
could breathe and talk. When she
couldn’t respond, Mr. Stack, a
veteran New York City firefighter,
instantly knew his wife was
having a stroke and called 911.
He also immediately called a
neighbor to take care of Liam.
Paramedics rushed Ms. Stack
to a nearby community hospital,
where a computed tomography
(CT) scan revealed total blockage
of her left middle cerebral artery.
To restore blood flow to the left
side of her brain, doctors gave
Ms. Stack the clot-busting drug,
tissue plasminogen activator
(tPA). Administration of the
medication within the first three
hours of the initial appearance of
stroke symptoms increases the
likelihood of complete recovery.
Still unable to speak and
showing other symptoms, such as
right-side paralysis, Ms. Stark was
transferred by ambulance to North
Shore University Hospital (NSUH)
for further treatment. NSUH is a
New York State Department of
Health stroke center and certified
by the Joint Commission as a
stroke center of distinction.
“Our new Stroke Rescue
Program gives patients rapid
transport from other hospitals
for specialized stroke interventions at North Shore University
Hospital,” said Jeffrey Katz, MD,
4
director of stroke and vascular
neurology at NSUH. “The key is
to do it as quickly as possible.”
By the time Ms. Stack got to
North Shore University Hospital,
doctors from both hospitals and
the paramedics had already
conferred via conference call and
the stroke team and Emergency
Department (ED) staff were on
alert. Ms. Stack got rapid
assessment in the ED’s critical
area and evaluation by the stroke
physician on call and by Avi
Setton, MD, chief of interventional neuroradiology and
codirector of the hospital’s Brain
Aneurysm Center.
Ms. Stack was brought to
NSUH’s endovascular suite
to treat her cerebral artery
blockage. Dr. Setton performed
an angiogram, a specialized
X-ray of blood vessels in the
head and neck, then inserted a
catheter in an artery near the
groin and snaked it up to
the blockage in Ms. Stack’s
brain. Dr. Setton administered
additional tPA directly into
the clot to dissolve it. Within
10 minutes, Ms. Stack regained
her ability to speak and move
both her legs.
Dr. Setton attributed part of
Ms. Stack’s positive results to
her relatively young age, good
health history and her husband’s
quick response. “If she came to
the hospital later, there probably
would’ve been more damage,”
said Dr. Setton.
Source: National Stroke Association
When Ms. Stack awoke from
the procedure, she said she felt
“75 percent” recovered. “During
the eight days in the hospital,
more than 20 nurses and doctors
came to see me, ‘the miracle girl.’
I was very overwhelmed at how
many people came to check up
on me. Everyone was so great and
caring, only wanting the best for
me. I appreciated that so much.”
Two months after her stroke,
Ms. Stack felt almost completely
recovered. She underwent
physical, speech and occupational therapy, and although she
occasionally struggled for the
right word, she continued to
improve. “After six weeks, I was
driving,” said Ms. Stack. “Two
months after the stroke, I could
take a walk with my husband in
the neighborhood, with my son
in the stroller. I know I’m lucky.”
Ms. Stack reported no risk
factors for stroke. Before Liam’s
birth, she practiced prenatal
yoga and worked out twice a
week with a trainer at the gym.
Ms. Stack’s physicians are not
sure what caused the stroke; her
genetic testing is normal.
“I’m determined to do
everything I can to make sure I
take the best possible care of
myself for my son and husband,” said Ms. Stack. “Before
this happened, I didn’t know
the warning signs of a stroke,
but I knew about heart attack.
My husband saved my life; he’s
truly my hero.”
LIJ Clinic Helps Prevent Stroke
The Stroke Prevention Clinic at Long Island Jewish (LIJ) Medical
Center can reduce the chance of stroke for those at high risk.
The center educates and counsels high-risk patients, as well as
those who do not know if they are at risk, and can advise
whether surgical intervention is appropriate.
“Identifying narrowing of the carotid artery, checking for
atrial fibrillation and risk factor modification can make a
dramatic difference in a patient’s future risk of stroke.
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5
We want to identify these conditions early so we can intervene
if necessary,” said Richard Libman, MD, chief of vascular
neurology and the director of the center.
Don’t wait until it is too late. For an evaluation by a stroke
physician, please call 718-470-7260 or e-mail neuro@nshs.edu
and mention the Stroke Prevention Clinic.
CENTER FOR H UMA N REPRODUCTION
Somewhere to Turn After
Recurrent Pregnancy Loss
T
he loss of a pregnancy in the first or second
trimester, also known as miscarriage, is one
of the most devastating and emotionally
draining experiences a woman and her family
can endure. When a woman suffers from two
or more miscarriages in a row, it is nothing
short of a life crisis, fraught with sorrow, anger
and grief. The Recurrent Pregnancy Loss
Program at North Shore-LIJ’s Center for
Human Reproduction provides patients with
tools to handle the trauma and treatment to
help prevent future miscarriages.
“When I see patients who have had a
second or third miscarriage, they are just
destroyed,” said Eileen Mitchell, a psychotherapist who counsels couples in the
Recurrent Pregnancy Loss Program. “With
each subsequent loss, it becomes more and
more difficult.”
The recently established program provides
comprehensive support, evaluation and
treatment to those who have suffered from
multiple pregnancy losses. It helps pinpoint
why the miscarriages occurred and determine
treatment options to improve the likelihood of
a viable, successful pregnancy.
A LONELY TRAUMA
Although approximately 25 percent of all
recognized pregnancies result in miscarriage,
less than five percent of women experience
two consecutive miscarriages and only one
percent experience three or more, according
to the American Society of Reproductive
Medicine.
“Women who suffer from multiple
miscarriages experience feelings of inadequacy
and isolation. It is extremely difficult to be
around family, friends or neighbors who are
pregnant and/or have children. Holidays can
be heartbreaking because family gatherings are
painful reminders of the children they don’t
have,” said Ms. Mitchell. “Friends and family
often don’t fully understand or appreciate the
severity of this ordeal.”
“Patients in this emotionally trying
situation often don’t know where to turn
after suffering repetitive pregnancy losses,”
said David Rosenfeld, MD, chief of human
reproduction for North Shore-LIJ Health
System. “This program helps our patients
navigate through this complex and baffling
medical trauma, offering comprehensive
and clinically proven testing and treatment
in a compassionate and encouraging
environment.”
FINDING SOLUTIONS
Recurrent Pregnancy Loss Program participants are guided through examinations that
help determine the causes for their miscarriages, which can be anatomic, genetic,
hormonal or immunologic in nature.
Developmentally or genetically flawed
embryos or fetuses account for the vast
majority of miscarriages. While most
miscarriages result from a random chromosomal abnormality, some inherited chromosomal abnormalities can be identified by
analyzing the parents’ blood. The most
common of these disorders is translocation.
“Each embryo has a certain number of
chromosomes, and while it might have the
right number, the chromosomes may not be
paired up properly,” explained reproductive
endocrinologist Micheline Chu, MD, director
of the Recurrent Pregnancy Loss Program.
“The genetic material that biological parents
pass on to a fetus can split unevenly in
translocation, which can cause miscarriage.
Pre-implantation genetic diagnosis, a
procedure that checks the genes of embryos
created through in vitro fertilization, can help
parents carrying translocations or other
chromosome defects.”
Deformation of the uterine cavity affects
approximately 10 to 15 percent of women
with multiple miscarriages, according to
Dr. Chu. “Outpatient surgery can address any
uterine abnormalities,” she said.
Specialists evaluate hormone levels and
metabolic abnormalities to determine if
a related condition is the culprit. Antiphospholipid syndrome, a blood vessel disorder,
causes between three and 15 percent of
recurrent miscarriages.
A BEAM OF HOPE
“Once we identify the origin of the problem,
we methodically try to treat it,” said
Dr. Rosenfeld. “But sometimes there is no
identifiable reason for miscarriages. Even in
these instances, the likelihood of conceiving
and carrying a child to term is still good.”
Studies show that a woman with no
identifiable cause for recurrent miscarriages
has a very good chance of having a
successful pregnancy when standard treatments are used. “If we follow women very
closely through early pregnancy, we can help
improve the outcome,” added Dr. Chu.
+
The Recurrent Pregnancy Loss
Program provides comprehensive support, evaluation and treatment
to those who have suffered from
multiple pregnancy losses. For more
information or to make an appointment, please call 516-562-2229.
6
HO ME CARE SERVI CES
Older Patients Maintain Independence
with Personalized Program
A
s we age and the risk of developing health problems that
require complex care increases, it can be confusing knowing
how to get the services and assistance we need. This is especially
true for elderly people who live on their own. Coordinating
appointments with multiple doctors, wading through insurance
questions or even driving to appointments can be difficult. That’s
why the North Shore-LIJ Health System created Circle of Care, a
new geriatric care management program.
“Circle of Care helps senior adults navigate the healthcare system,
offering a complete array of home care services,” explained Merryl
Siegel, executive director of the North Shore-LIJ Home Care
Network. “Our program is unique because most of the services are
available in our own healthcare system [North Shore-LIJ], providing
patients integrated, seamless care.” COORDINATING IN-HOME CARE SERVICES
Circle of Care is supported by a broad spectrum of home care
services offered through the North Shore-LIJ Home Care Network.
These services can address short-term health issues, such as
recovery from surgery, to longer-term, chronic care management
of such conditions as congestive heart failure, stroke or diabetes.
The many in-home clinical services available include: geriatric care management;
nursing care;
physician house calls;
wound and skin care;
physical therapy;
occupational therapy;
speech/language pathology;
social work; and
infusion services.
Through the array of home health services available, the Circle of
Care program helps seniors access the combination of clinical
services they may need. A geriatric care manager, who is a licensed
social worker, works with clients to personalize the medical and
care services necessary to maintain their health and independence
at home. The geriatric care manager then coordinates and schedules
the services for each patient.
“This program helps fill the gap in caring for the geriatric
population,” said Ms. Siegel. “Services are often available for people
with chronic health needs, but it can be difficult knowing what
services you’re entitled to and how to access them. Circle of Care
takes the confusion out of the process.”
GOING THE EXTRA MILE
Care for each individual is personalized, and often extends beyond
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the scope of the medical programs typically offered by home care
providers. For example, if a patient needs home bathroom renovation to accommodate a wheelchair, the geriatric care manager can
help get the process started. Furthermore, geriatric care managers
often facilitate finding an eldercare attorney or financial planner.
They can also travel with clients to doctor appointments when
necessary — not only providing transportation, but also taking
notes and asking questions as the patient’s advocate.
“Anything a patient needs, we can provide,” explained Ms. Siegel.
“We do all we can to support a patient’s choice to live at home by
providing access to care and services.”
PARTNERING WITH FAMILY MEMBERS
If desired, the Circle of Care program also closely coordinates with
patients’ family members. This can be especially helpful for loved
ones who don’t live nearby. Geriatric care managers keep concerned
family members informed of services, care and progress through
regular e-mails and phone calls.
“Many patients do best in their home environment,” said Ms. Siegel.
“We offer patients the help they need to stay there.”
+
Circle of Care offers a complete array of home care
services. For a free assessment or more information,
call 866-651-4200.
ONCOLOGY
Colorectal Cancer Screening:
An Ordinary Miracle
J
une Kim, a 60-year-old man from
Syosset, is vigilant about taking care of
his health, and it shows. Most days, Mr.
Kim rises at 5 a.m. and begins his daily
routine. The owner of a plumbing and
heating supply business, Mr. Kim heads to
work early, so that by 2 or 3 in the after-
noon, he can enjoy a round of golf, go for
a long walk outside or hop on the treadmill
in his basement. He was understandably
stunned when his routine colonoscopy
revealed that not only did he have a large
polyp in his colon, but also that it was
cancerous.
“This was a shock. I consider myself a very
healthy man and never had any serious health
problems in the past,” explained Mr. Kim. “My
screening was a miracle. I would never have
known I had cancer if I hadn’t checked it.”
“When I met Mr. Kim, I was surprised by
his age because he looks no older than 40.
June Kim is back to
work at his plumbing
and heating supply
company after being
treated for Stage II
colon cancer.
8
He is that visibly fit,” said Marc Greenwald,
MD, chief of colorectal clinical services at
North Shore University Hospital (NSUH).
“But Mr. Kim is also typical of many
colorectal cancer patients because he had no
symptoms of being sick, let alone having
Stage II colon cancer.”
Virtually all colorectal cancer cases start
as a polyp, an abnormal growth of tissue
found on the wall of the colon or rectum.
Most often, these polyps are asymptomatic
and therefore don’t cause pain or bleeding,
and often go undetected on blood tests. For
this reason, people who have no identified
risk factors — other than age — should
begin regular colorectal cancer screening at
age 50, when the incidence of polyps
substantially increases.
“I like to explain to my patients that a
polyp is like a little seed,” said James
Sullivan, MD, associate chairman of surgery
in the Division of Surgical Oncology at
NSUH. “We know that not every seed grows
up to become a tree. But every tree was
once a seed. Every case of colorectal cancer
was at one time a polyp. This is why when
polyps are detected, they should be
removed at the pre-malignant state to
prevent the development of colon cancer.”
CASES ON THE RISE
There are nearly 150,000 new cases of
colorectal cancer in the United States each
year, making it the third most common
cancer diagnosed in both men and women
excluding skin cancers, according to
American Cancer Society estimates. More
concerning, colorectal cancer is the second
leading cause of cancer-related deaths in the
United States when both sexes are combined and was estimated to cause nearly
50,000 deaths during 2009. Last year in
New York State, more women died of
colorectal cancer than of breast cancer.
“It is widely known that mammograms
detect cancer at an early stage. But as crucial
as it is for women to get mammograms,
they actually don’t prevent breast cancer,”
said Dr. Sullivan. He added that colorectal
cancer is preventable through regular
screening. A colonoscopy can either find
benign polyps before they develop into
cancers or find the cancer in its earlier
stages when the disease is easier to cure.
The colonoscopy procedure allows the
physician to view the entire length of the
large intestine by inserting a colonoscope
(a long, flexible, lighted tube) through the
rectum up into the colon. The physician
examines the lining of the colon to identify
and remove any abnormal growths, such as
polyps, for further examination.
John Procaccino, MD, is chief of colon
and rectal surgery at NSUH and director
of the Center for Colon and Rectal
Diseases, a state-of-the-art facility that
administers colonoscopies in a convenient
ambulatory setting.
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Colorectal cancer is very
curable if it is diagnosed
at an early stage.
“One of the reasons I wanted to build
a center for colon and rectal diseases
was to make it patient friendly,” said
Dr. Procaccino. “We have a certified
colonoscopy suite in our center that meets
very stringent criteria set by the New York
State Department of Health so patients can
undergo the procedure outside the hospital.
A colonoscopy takes between 15 and 30
minutes. If no polyps are found, the patient
doesn’t need another screening for another
five to 10 years. If polyps are found, they
can be removed then and sent
to our lab for analysis.”
THE EARLIER, THE BETTER
Colorectal cancer is very curable if it is
diagnosed at an early stage. The treatment
of colon and rectal cancer almost always
necessitates surgery, which entails removing
the diseased tissue and then resecting, or
splicing, the healthy sections together.
Chemotherapy and radiation therapy
may also be used depending on the case
and stage.
“Removing the segment of the colon that
has cancer does not have long-term effects
on patients’ bowel patterns, eating habits
or physical activities. There is so much
redundancy to the colon, which is actually
five feet long. If you take one foot out,
the remaining four feet will more than
compensate for what was removed,” said
Dr. Procaccino.
There have been many surgical advances
in the treatment of colorectal cancer within
the last 10 years, including minimally
invasive, laparoscopic-assisted colorectal
surgery, which is done extensively at NSUH.
Laparoscopy requires very small incisions
on the abdomen, and reduces how long
patients stay in the hospital and the severity
of pain during recovery. Dr. Sullivan uses a
robot in surgery for some cases.
continued on page 10
ONCOLOGY
Colorectal Cancer Screening
“Robotic surgery gives us a minimally
invasive approach with the best articulation,” explained Dr. Sullivan. “The instrumentation is so advanced, we can do things
with the robot that we couldn’t do before.”
For rectal cancer, many patients receive
radiation therapy or chemotherapy to shrink
the cancerous tumor before surgery. This
course of treatment prevents the need for
colostomies, which are rarely necessary today.
The treatments of Stage III and IV
colorectal cancer also have undergone major
breakthroughs. More advanced and
aggressive treatments of liver metastasis, the
most advanced stage of colorectal cancer,
including new surgeries and radiofrequency
ablation, have increased survival rates in
these further advanced stages.
continued from page 9
Ivy Algazy is enjoying
her summer plans after
recently completing
treatment for Stage III
colon cancer.
WORK BECOMES PERSONAL
For Ivy Algazy, her June 12, 2009, colonoscopy
marked the day her professional and personal
lives collided. She has been the director of
communications for women’s health services
for North Shore-LIJ Health System for nearly
two years. In February, Ms. Algazy completed
her last course of chemotherapy treatment
for Stage III colon cancer.
“My job for the health system is to
promote the message of prevention and
wellness and taking care of ourselves, for
women. If we don’t take care of ourselves,
we won’t be able to take care of our families,”
said Ms. Algazy. “These words could not
have become truer for me than on the day
of my colonoscopy. If I did not take charge
of my health and get my colonoscopy, I
would never have caught the cancer early
enough to get treatment and save my life.
Moreover, one of the best things that came
out of this ordeal is that my three children
will begin to get their screenings at age
35 to ensure early detection.”
+
Colorectal cancer is a very
curable disease if it is diagnosed
at an early stage. To find a colorectal
surgeon, call 888-321-DOCS or go
to NorthShoreLIJ.com and click on
“Find a Physician.”
10
LIJ Cancer Care Is “Outstanding”
by Elaine Wohl
T
he Commission on Cancer (CoC) recently
honored Long Island Jewish (LIJ) Medical
Center with an Outstanding Achievement
Award for the hospital’s excellent programmatic care of cancer patients.
“This exceptional designation is reserved
for only a few programs,” said Richard Gralla,
MD, vice president of cancer services for
North Shore-LIJ Health System and chief of
hematology/oncology at the Monter Cancer
Center in Lake Success. “Based on the daily
dedication and expertise of our physicians
and staff, we are very pleased that a prestigious group such as the American College of
Surgeons, which established the CoC, has
recognized our achievement.”
Eligibility and accreditation for the CoC’s
Outstanding Achievement Award are reserved
for facilities that commit to providing the best
cancer care and comply with CoC standards.
Each program undergoes a rigorous evaluation and review of its performance and
compliance with CoC standards and on-site
evaluation every three years.
“To be among the few institutions chosen
from around the country to receive the
Outstanding Achievement Award shows our
deep commitment to providing the highest
quality of care to our cancer patients,” said
Kanti Rai, MD, chief of hematology/
oncology at LIJ Medical Center. “Our
Cancer Registry staff members maintain
excellence in each aspect of their work,
while Cancer Committee colleagues pursue
new areas in cancer research as well as
community outreach. This is an occasion to
take pride in our work and rededicate
ourselves to maintaining our high level of
care,” he added.
To receive the CoC’s Outstanding Achievement Award, a facility must demonstrate a
commendation level of compliance with six
standards that represent the full scope of the
cancer program within activities that encompass cancer committee leadership, cancer data
management, research, community outreach
and quality improvement. The commendation
follows an on-site evaluation by a physician
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Standing from left: Adrienne Thomas, tumor registry supervisor; Kanti Rai, MD, LIJ’s chief of hematology/
oncology; Mary Paul, RN, nurse manager, ambulatory chemotherapy and treatment (ACT); and Meg
McCormick, RN, ACT, with patient Mel Ilberman, seated.
surveyor. Furthermore, each facility receives a
compliance rating for an additional 30
standards. Only 82 programs received the
award following the 2009 surveys — 18
percent of the 432 participating programs.
There are more than 1,480 CoC accredited cancer programs across the country.
These accredited hospitals and treatment
centers diagnose and treat 80 percent of
newly diagnosed cancer patients annually.
Participating programs focus on continuum
of cancer care, prevention and early
detection, pretreatment evaluation, staging,
optimal treatment, rehabilitation, surveillance for recurrent disease, support services,
end-of-life and lifelong follow-up care.
ONCOLOGY
New Multidisciplinary Head and Neck Cancer Center
Gives Patients Coordinated, Comprehensive and Convenient Care
H
ead and neck cancers are challenging to
diagnose and treat. Determining the
location and extent of each patient’s cancer
can be difficult, and greatly affects the
approach to treatment. Preservation of
day-to-day abilities such as eating and
speaking as well as physical appearance
must also be factored into the course of
care. To accomplish this best, head and
neck cancers must be treated by a team of
specialists — head and neck surgeons,
radiation oncologists, medical oncologists,
diagnostic radiologists, plastic and reconstructive surgeons, dentists, oral and
maxillofacial surgeons, and speech and
swallowing therapists — who collaborate to
develop the best plan and improve the
patient’s quality of life.
The Head and Neck Cancer Center,
located in the Naymark Hearing and Speech
Building on Long Island Jewish (LIJ) Medical
Center’s campus in New Hyde Park, gives
patients one convenient place for evaluation
and treatment by a team of dedicated
specialists. After initial screening, patients
return within a week for a highly coordinated evaluation by all specialists involved in
their care.
“In other settings, developing a course of
treatment can often drag out over several
weeks because it takes that long for patients
to see each specialist involved in their care
individually,” said Douglas Frank, MD, the
hospital’s chief of head and neck surgery,
Department of Otolaryngology, and codirector of the center. “In our center, patients see a
head and neck surgeon, a radiation oncologist and possibly a medical oncologist all in
the same location. In most cases, a speech
pathologist performs a swallowing evaluation. After these examinations are completed,
the team comes to a consensus on the stage
of the cancer and tumor volume, and works
out a tentative treatment plan — all in one
visit. We are truly coordinating patients’ care
at the time of examination. This reduces
treatment delays — ultimately enhancing
patient safety.”
William Nardella says “Everything is great” after undergoing complex treatment at the Head and Neck
Cancer Center.
William Nardella of Islip Terrace was
diagnosed with tongue cancer in October
2008. The following January, Dr. Frank
removed one-third of Mr. Nardella’s tongue
to eradicate the cancerous tumor, as well as
Mr. Nardella’s wisdom teeth, and then
12
reconstructed his tongue using an artery
and vein taken from Mr. Nardella’s left arm
during a 12-hour surgery at LIJ Medical
Center. After recovery from surgery, Mr.
Nardella received courses of radiation
therapy and chemotherapy.
“I was very surprised by the complexity of
my treatment and the number of physicians
who were involved in my care,” said Mr.
Nardella, who completed his treatment
nearly a year ago. “But now the rest is history.
I am able to eat, my speech has improved
through speech therapy and I have full use of
my arm. Everything is great.”
“The Center offers patients one of the
most cohesive and sophisticated treatment
experiences for head and neck cancer in the
country,” said David Schwartz, MD, vice
chairman of radiation medicine at North
Shore-LIJ Health System, and codirector of
the center. “Patients facing the stress and
anxiety of their diagnosis can meet with
experts and quickly receive a plan for their
treatment from their team. Patients will
know right away if they are eligible for one
or more of our clinical trials or specialized
techniques. The idea is to make the
process understandable and reassuring,
and to make treatment as individualized
and effective as possible.”
+
The new Center for Head and
Neck Cancer gives patients one
convenient place for evaluation and
treatment by a team of specialists
dedicated to treating head and neck
cancer. To make an appointment,
please call 866-690-2008.
Charitable Gift Rates Are Up
North Shore-LIJ Health System charitable gift
annuity rates are increasing. If you are age 55 or
older, you can receive a fixed income for the rest
of your life by making a gift of $10,000 or more.
SAMPLE RATES as of July 1, 2010*
One-Life Rates Two-Life Rates
Age Rate Ages Rate
55 60 65 70 75 80 90 5.5 percent 5.7 percent 6.0 percent 6.3 percent
6.9 percent
7.7 percent 10 percent 55/55 5.1 percent
60/60 5.4 percent
65/65 5.6 percent
70/70 5.9 percent
75/75 6.2 percent
80/80 6.8 percent
90/90 8 percent
*Rates may change.
You will receive a steady income, part of which
is tax-free. The amount of the gift that remains
is used to benefit North Shore-LIJ. For example,
if you are 72 years old and donate $10,000
cash, you can lock into a fixed rate of 6.5
percent and receive $650 of guaranteed annual
income, $440 of which is tax-free for about 14
years. You would also be eligible to claim a
charitable income tax deduction about $3,560.
+
For more information and
a no-obligation personalized
illustration of benefits, contact
Alexandra Brovey, senior director
of gift planning, at 516-465-2610
or abrovey@nshs.edu.
Be Part of the Conversation
Follow North Shore-LIJ on Facebook and Twitter
Get up-to-the-minute healthcare information when you follow the North Shore-LIJ Health
System on Facebook and Twitter. You’ll get the latest health news, press releases, free health
screening information and community education events, plus a host of wellness and other
important information. In addition, you’ll be able to lend your voice to the healthcare
conversation by asking questions and offering insights. On Facebook, search for North Shore-LIJ
Health System. And find us on Twitter.com/NorthShoreLIJ. Be part of the conversation!
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13
ONCOLOGY
New Cancer-Fighting Technology
Delivers Faster Treatment
I
n a promising development for cancer patients in the New York
metropolitan area, Long Island Jewish (LIJ) Medical Center’s
Department of Radiation Medicine has acquired an innovative new
system called TrueBeam that offers a radically different approach to
treating cancer with image-guided radiotherapy.
The TrueBeam system, produced by Varian Medical Systems, was
engineered to deliver more powerful cancer treatments with pinpoint
accuracy and precision. It uniquely integrates new imaging and motion
management technologies within a sophisticated new architecture that
makes it possible to deliver treatments more quickly while monitoring
and compensating for tumor motion. The technology opens the door
to new possibilities for the treatment of lung, breast, prostate, head,
neck and other cancers that are treatable with radiotherapy.
“TrueBeam is a real game changer that will enable us to treat even
the most challenging cases with unprecedented speed and precision,”
said Louis Potters, MD, chairman of radiation medicine at LIJ Medical
Center and North Shore University Hospital. “With a broad spectrum
of new capabilities, TrueBeam breaks the mold in just about every
dimension, making it possible for us to offer faster, more targeted
treatments to tumors even as they move and change over time.”
TREATMENT TIME REDUCED
With dose delivery rates that are 40 to 140 percent higher than earlier
generations of linear accelerator technology, the TrueBeam system can
complete a treatment commensurately faster. This makes it possible to offer
greater patient comfort by shortening treatments and to improve precision
by leaving less time for tumor motion during dose delivery. “Intelligent”
automation further speeds treatments with an up to fivefold reduction in
the number of steps needed for image guidance and dose delivery.
Simple treatments that once took 15 minutes or more can be
completed in less than two minutes, once the patient is in position.
“These are significant reductions in treatment time,” said Dr.
Potters. “Patients will spend a whole lot less time lying still,
immobilized on a hard surface.”
The TrueBeam’s precision is
measured in increments of
less than a millimeter. The
system measures more than
100,000 data points every 10
seconds as a treatment
progresses.
ENHANCED QUALITY AND PRECISION
Being an early adopter of this technology requires rigorous monitoring and quality assurance testing. The North Shore-LIJ Department
of Radiation Medicine is putting this machine through its paces to
ensure a smooth integration of treatment planning and delivery
with the greatest of accuracy, Dr. Potters said. “This tool offers us
capabilities never before considered,” he explained, “but along with
that potential comes the responsibility to prove the clinical benefits
of this technology.”
The precision of the TrueBeam system is measured in increments
of less than a millimeter. This accuracy is made possible by the
system’s sophisticated architecture, which synchronizes imaging,
patient positioning, motion management, beam shaping and dose
delivery, performing accuracy checks every 10 milliseconds
throughout the entire treatment. More than 100,000 data points are
measured every 10 seconds as a treatment progresses, ensuring that
the system maintains a true isocenter, or focal point, of treatment.
For lung and other tumors subject to respiratory motion,
TrueBeam offers gated RapidArc radiotherapy, which makes it
possible to monitor patient breathing and compensate for tumor
motion, while quickly delivering the appropriate dose during a
continuous rotation around the patient. “During the past decade,
lung cancer became the leading cause of cancer death for both
men and women in the United States,” said Dr. Potters. “With
TrueBeam, we can treat a moving lung tumor as if it were standing
still. We expect this to make a meaningful difference for lung cancer
patients in the area.”
FASTER IMAGING AT LOWER DOSES
TrueBeam imaging technology can produce the 3-D images used to
fine-tune tumor targeting in 60 percent less time. Additional
functionality makes it possible to create images using 25 percent
fewer X-ray doses. “Imaging is an essential part of modern-day
targeted radiotherapy,” explained Dr. Potters. “This unit allows us to
choose an imaging mode that minimizes the number of X-rays
needed to generate an image — and that’s good for our patients.”
TrueBeam can be used for radiotherapy treatments, including
image-guided radiotherapy and radiosurgery, intensity-modulated
radiotherapy, RapidArc radiotherapy and gated RapidArc.
“With TrueBeam, we can select the optimal treatment for every
type of cancer,” said Dr. Potters. “This is a breakthrough that lets us
bring a wider spectrum of advanced radiotherapy treatment options
to many more patients. It represents a quantum leap in our ability
to help people fight cancer.”
+
Get quicker results fighting cancer. To learn
more, call 866-690-2008.
14
HEPAT I TIS C TRIAL
Hepatitis C: A Light at the End of the Tunnel
by Elaine Wohl
F
or more than 20 years, Andrew Mongiardo lived with the sometimes fatal disease called hepatitis C, which affects over 3.9
million Americans and 170 million people worldwide. Over the
past two decades he participated in many clinical trials, not
knowing what the outcome would be, always trying to maintain a
positive attitude. Recently, he was offered an opportunity to take
part in yet another new clinical trial — and it changed his life.
“This was the most difficult clinical trial by far, as it took a toll on
me physically, mentally and emotionally,” said Mr. Mongiardo, a Long
Island resident. “It was a very rough trial therapy, with many side
effects lasting for a year. After waiting six months for the results, it
was worth all of the pain and suffering, as I was told that my viral
count was so low that it was undetected and I was virtually cured, a
word I thought I would never hear. I am now hepatitis C-free.”
North Shore University Hospital was one of only 53 hospitals
worldwide invited to take part in a clinical trial study designed to
treat patients with hepatitis C, genotype 1 (the type of hepatitis most
prevalent in the United States) who had failed previous treatments.
“These two studies of triple drug therapies, recently published
in the New England Journal of Medicine, have recently been shown
to be more effective in obtaining a sustained viral response. These
medications were pegylated interferon, ribavirin and a new agent
called a protease inhibitor,” said David Bernstein, MD, chief of the
Digestive Disease Institute at North Shore University Hospital and
LIJ Medical Center, and principal investigator of the study.
The currently accepted two-drug (dual) therapy, a combination
of weekly alpha interferon injections and twice-daily oral ribavirin,
has so many difficult side effects that many people drop out of the
therapy that lasts from 24 to 48 weeks, depending upon the
patient’s type of hepatitis C. The overall sustained viral response
rates for people who failed initial treatments and are retreated with
the same regimen are less than 15 percent and the side effects are
considerable, including flu-like symptoms, anemia and depression.
“The new three-drug regimen was well-tolerated by patients,” said
Dr. Bernstein. “This combination led to a greater than 50 percent
sustained viral response rate in previous nonresponders like Mr.
Mongiardo — a dramatic improvement over the previous response
rates of around 10 to 15 percent with the previous therapies.”
Many patients show no obvious symptoms or warning signs of
“I was virtually cured, a word I thought
I would never hear. I am now hepatitis
C-free.”
nor thshorelij.com
15
Illustration of the hepatitis C virus in the bloodstream.
the disease. Hepatitis C, one of five known hepatitis viruses that
affect humans, and the one with the highest rates of progression to
chronic disease, can cause scarring of the liver, cirrhosis and liver
cancer. It is transmitted by blood and patients may have contracted
the disease from blood or blood product transfusions they received
prior to 1992 when there was no reliable, standard prescreening of
blood, or from injected or intranasal recreational drug use.
The new therapies are targeted for approval in the United States by the
end of 2011. Dr. Bernstein emphasizes that the use of these products,
when approved by the Federal Drug Administration, will require
significant experience by physicians and their staffs. Until then, he
recommends that patients practice a liver-safe way of life by avoiding
alcohol and marijuana, maintaining a healthy diet and exercising. Patients
with cirrhosis need to be screened every six months for liver cancer.
Mr. Mongiardo credits North Shore’s Liver Support Group, Dr.
Bernstein, the department’s nurses and staff, and the American Liver
Foundation for helping him and others get through their ordeal.
“Without their constant encouragement and care, I may not have
had the perseverance to continue with the trial which proved to be
so critically important to my life. I still go to my support group,
hoping to encourage others,” said Mr. Mongiardo.
+
Participate in the promise. To enroll in the study,
call 516-562-4281.
NEUROLOGY
People with Traumatic Brain Injuries
Transition to a Better Life
by Michelle Pinto
I
n 1995, a two-ton truck traveling 50 miles
per hour rear-ended Deborah Schneider’s
station wagon. Unknown to her then, she
sustained a traumatic brain injury (TBI) so
severe that it reduced her level of functioning to that of a 5-year-old. A wife and
mother of two young children, Ms.
Schneider recalls headaches so painful that
she could not get out of bed. She suffered
from vertigo, memory loss, sensitivity to
light, inability to form sentences or recall
words and chronic pain that made her life
feel burdensome.
A few months later, Ms. Schneider visited
a neuropsychologist whose tests were
“frustrating” because she was unable to
complete them. “I couldn’t understand why
he was asking me to do things I couldn’t
do,” she said. The neuropsychologist
recognized that she needed full-time
rehabilitation, so in January 1996, Ms.
Schneider began her journey at Transitions®
of Long Island, a neurorehabilitation
program tailored for the complex needs of
people with acquired brain injuries.
Part of North Shore-LIJ Health System,
Transitions has provided specialized services
since 1988. Its therapies primarily focus on
giving clients practical strategies that will
provide new, lifelong coping mechanisms,
said Jean Elbaum, PhD, director of clinical
services. “Learning and using new strategies
— which could be as simple as making lists,
highlighting written material to help with
memory or keeping a journal — are
invaluable to our clients, who struggle
constantly to reclaim their place at home, at
work and in their community.
“Our greatest achievement is to help
people reinvent themselves after sustaining
life-altering trauma and returning a sense of
meaning and purpose to their lives,” added
Deborah Benson, PhD, chief of rehabilitation psychology at Transitions.
BEGINNING THE JOURNEY
For her first few months of neurorehabilitation, Ms. Schneider attended the program
five days a week, then scaled back to four
days. Her neurocognitive team worked
with her in such key areas as speech and
occupational therapy. “For example,” said
Ms. Schneider, “the injury left me unable
to concentrate. My therapists helped me
learn new strategies for paying attention,
such as filtering out unwanted background
noise. I also learned new ways to solve
problems since so much had to be
relearned. And a big focus was on learning
to remember things.
“I truly believe that these new strategies
are what got me back to real life,” she
concluded. “Even years later, what I learned
at Transitions continues to help me keep it
all together.”
FULL SPECTRUM OF CARE
Along with physical and occupational therapy,
Transitions offers speech/language therapy,
neuropsychological evaluations, individual
and group counseling, family education and
support and prevocational training.
Transitions remains pivotal for clients
because treatment continues even after
discharge, said Dr. Elbaum. “We welcome
our clients to remain connected to us,” she
said. Both Dr. Elbaum and Dr. Benson
maintain regular contact with Ms. Schneider
and many other Transitions alumni. “We
encourage our clients to take advantage of
our Post-Rehab Extension Program [PREP],
Harnessing the Power of Genetics
Community members over age 18 can
get involved in genetic research
through the Genotype and Phenotype
(GaP) Registry. Thanks to a $2.2 million
federal grant, the GaP Registry is now
expanding to become a national
resource to scientists.
The program is enrolling healthy
volunteers who provide a DNA
sample in addition to a limited health
history. Collection of a DNA sample
and health history allows for the
selection of control subjects on the
basis of genotype, as well as demographic information or health history.
Scientists can extract DNA from a
saliva sample and use it anonymously
in research.
More than 3,600 volunteers have
already enrolled; the long-term goal
is to attract 10,000. Those in the
Long Island/metro New York area
community are encouraged to
participate. Volunteers may be
contacted about voluntary
participation in additional studies.
For more information, visit
GaPRegistry.org or call 516-562-1175
and ask about the GaP Registry.
16
which reinforces the skills learned in therapy
sessions and provides continued structure
and stimulation. Also, we have an active
alumni group, where our clients can come
back to visit and socialize every month.”
THE NEXT CHAPTER
When Ms. Schneider began treatment, she
had one thought: “I can remember being
here almost 15 years ago and vowing that
one day I would write a book about all
this,” she said. “I decided that I wanted to
help people understand TBI’s and how to
deal with the reality of their new life. Most
of all, I wanted to let people know that
there is life after a serious brain injury. My
motto is, ‘The sky’s the limit. I did it — it
can be done.’”
Today, Ms. Schneider is the coordinator for
the Family Advocacy, Counseling, Training
and Services Program of the Brain Injury
Association of New York State, where she
advocates for TBI survivors and their families;
she was even the keynote speaker at North
Shore University Hospital’s 2010 Brain Injury
Symposium. She also published her memoir,
Wind Dancing: The Gift of Healing Traumatic
Brain Injury. Along with her devout faith and
spirituality, Ms. Schneider credits the staff at
Transitions for her miraculous recovery.
“When I come here, I know I’m not alone.
These are people who care,” she said.
+
Along with physical and
occupational therapy, Transitions
offers speech/language therapy,
neuropsychological evaluations,
individual and group counseling,
family education and support and
prevocational training. To learn more,
call 866-690-2008.
Deborah Schneider recently visited Transitions to
showcase her continuing progress to Dr. Elbaum.
Caring for Today, Planning for Tomorrow
The North Shore-LIJ Health System
Foundation’s Web site features
an attractive, user-friendly design.
NorthShoreLIJ.com/foundation
offers:
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17
a variety of opportunities to support
building projects or individual hospitals,
or to make a gift in honor of a loved one
and more;
campaign pages with news about exciting
changes throughout the health system;
expanded coverage of foundation and
health system events, including the
opportunity to purchase event and raffle
tickets online; and
photo albums featuring our supporters.
NEUROLOGY
Paralyzed Athlete Walks Again,
Takes New Path in Life by Betty Olt
R
oopnarine Ramlall, 25, a professional cricket player, was
paralyzed from the chest down in a car crash last December
in his native country of Guyana. When his car was rear-ended,
Mr. Ramlall was thrown from the vehicle, leaving him unconscious
and with a fractured spine.
At Guyana Hospital, he was evaluated for a spinal cord injury;
however, there are no neurosurgeons in the country. Mr. Ramlall
remained unconscious in the hospital for 15 days. When his doctors
predicted that he had a 50 percent chance of survival, his uncle in
Queens arranged to have him transported to North Shore University
Hospital (NSUH).
To prepare Mr. Ramlall for the seven-hour flight to New York City,
Guyana doctors immobilized his head, neck and chest in a cast. The
athlete’s family brought him to the Emergency Department at NSUH,
where orthopedic surgeons cut away his cast and trauma surgeons
and neurosurgeons evaluated him.
A specialist in spinal cord injury medicine, Adam Stein, MD,
assessed Mr. Ramlall’s neurological function. “Although Mr. Ramlall was
partially paralyzed in his hands and completely paralyzed in his trunk
and legs, he could correctly discriminate between sharp and dull
sensation in his lower body,” said Dr. Stein, chairman of physical
medicine and rehabilitation for the North Shore-LIJ Health System.
“This indicated a good prognosis because the nerve fibers that carry
sharp/dull sensations are adjacent to nerves that control movement.”
Soon after Dr. Stein’s evaluation, Peter Hollis, MD, a specialist in
neurosurgery and the spine, performed spinal fusion surgery on
Mr. Ramlall at NSUH. Dr. Hollis stabilized the C-6 and C-7
vertebrae in Mr. Ramlall’s lower cervical spine. “If he did not have
this surgery, he wouldn’t have been able to recover,” said Dr. Hollis.
“Mr. Ramlall is a young, accomplished athlete and that’s in his favor,
but his situation is unique in that his family went to extraordinary
lengths to bring him to us.”
After surgery, Mr. Ramlall could move his feet and toes and had
sensation in his hands. “These new abilities gave me confidence that I
would improve and eventually learn to walk again,” he said.
Upon discharge from NSUH, Mr. Ramlall was transferred to
Glen Cove Hospital’s Wunsch Center for Rehabilitative Therapies
for intensive rehabilitation. Mr. Ramlall had worked out at a gym
regularly, lifting weights and performing cardiovascular exercise.
“At first, therapists were surprised to see how well I did, given my
injury. I couldn’t wait to get to rehab; every minute, every second,
I was working for improvement,” said Mr. Ramlall.
After 28 days in rehab at Glen Cove Hospital, Mr. Ramlall used a
walker at his time of discharge. Three months after the car accident,
he no longer needed a walker at home and aimed to take a two-block
walk every afternoon with his wife, Padmini. “I hope my husband
will soon be chasing after our little girl, Mia,” said Ms. Ramlall.
In addition to rehab at Glen Cove, Mr. Ramlall received physical
therapy at home and is now an outpatient at Transitions® of Long
Island in Manhasset. “For now, the main thing is to keep doing
exercise, keep my body and muscles moving and stay focused on
my recovery,” said Mr. Ramlall. Looking forward to starting a
position as a computer technician, he added, “I can’t thank the
doctors and nurses at North Shore and the therapists at Glen Cove
enough for helping me start my new life.”
+
Get expert care with one of the specialists at
the Harvey Cushing Institutes of Neuroscience.
For information, call 866-562-3822.
ONLINE COST ESTIMATOR
A new online service from North Shore-LIJ Health System can
help estimate medical costs. Accessible via the Financial Help
section on NorthShoreLIJ.com/FinancialHelp, the Cost Estimator
also helps consumers understand hospital bills; determine their
eligibility for financial assistance; establish affordable, interestfree payment plans; and arrange for convenient online payments. For concerns with an existing account, contact a payment
specialist with our online contact form in the “Understand Your
Bill” section or by calling 888-214-4065.
18
Could Your
Aching Neck
Signal Something Serious?
Mr. Ramlall, right, stays active and looks forward to a new computer career. His physical therapist, Daniel Madrazo, left,
worked with him for a month to help restore mobility.
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19
“What a pain in the neck!” For
many people, that’s more than
just a cliché — it’s a bonecrunching daily misery. Neck
pain is one of the most common
reasons to visit a doctor.
Unfortunately, one of its
common causes is something
you can’t do much about: aging.
Degeneration of the spine is
a normal consequence of
growing older. Aging is a risk
factor for many of the
degenerative disorders that
can cause neck pain, including
osteoarthritis, spinal stenosis
and cervical spondylosis.
Those are big words to
describe small changes in the
spine that get worse over
time. All of these conditions
can put pressure on the spinal
cord. The result: Chronic pain
which, left untreated, can
severely impact daily life.
Symptoms that may signal a
degenerative spinal disorder
include:
neck pain that worsens
when you bend or turn your
neck or when you cough,
sneeze or laugh;
pain, weakness, numbness
or tingling in shoulders, arms,
hands or legs;
difficulty in using fingers for
precise tasks such as writing,
fastening buttons or opening
cans;
legs that feel stiff, weak
or jerky, making walking
difficult; and
bowel or bladder control
problems.
If you have any of these
symptoms, see your doctor.
VISION CARE
Laser Vision Correction Evolves
with Custom LASIK by Maria Conforti
W
hile conventional LASIK revolutionized vision correction — obviating the
need for corrective lenses for millions of
patients — the newest generation of vision
correction, Custom LASIK, advances the
innovation further. Custom LASIK gives
patients clearer, sharper vision than
available from conventional LASIK.
“Studies show that Custom LASIK may
improve not only what you see but also how
well you see it,” said Carolyn Shih, MD, codirector of the North Shore-LIJ LASIK Center
in Great Neck. “In fact, clinical studies have
shown that Custom LASIK treatments help
reduce possible higher-order aberrations that
create glare and halos during night driving.”
SOLVING MORE PROBLEMS
Previously, conventional LASIK could
measure and treat only such eye imperfections as nearsightedness, farsightedness and
astigmatism, said Jodi Luchs, MD, a
community-based ophthalmologist with
privileges at North Shore University
Hospital and Long Island Jewish (LIJ)
Medical Center, adding that other vision
flaws, like glare and halos, went unaddressed. “Now, Custom LASIK can customize treatment of such problems that
previously couldn’t be treated adequately
with glasses, contacts or conventional
LASIK,” he added.
With Custom LASIK, a wavefront
analyzer measures how light travels through
patients’ individual eyes. This state-of-theart tool creates customized 3-D maps that
detail the unique characteristics of each eye,
providing additional, crucial data about the
patient’s vision that allows further customization of vision correction.
Like most LASIK patients, Ms. Feaser recovered fully
in a couple of days. She said her biggest thrill is not
needing to wear glasses to see her alarm clock in
the morning.
20
Tailor Your Vision
Clinical studies show Custom LASIK can provide: a
greater chance of having 20/20 vision; the potential
for better vision than possible with contacts or
glasses; less glare and halos; and better overall vision
— even at night.
SHE CAN SEE CLEARLY NOW
Laura Feaser, MSW, a senior social worker at the Orzac Center for
Extended Care and Rehabilitation, recently underwent Custom
LASIK performed by Dr. Shih. She utilized IntraLase blade-free
technology to create an optimal corneal surface for Ms. Feaser’s
outpatient procedure. Like most LASIK patients, Ms. Feaser
recovered fully in a couple of days.
IntraLase performs the initial step of the LASIK procedure — creating a corneal flap — with a laser (previously, doctors performed this
step with a handheld oscillating blade). Clinical analysis reveals that the
IntraLase laser prepares an optimal corneal surface below the flap,
providing for superior visual outcomes, especially among Custom
LASIK patients.
“I cannot believe how simple the Custom LASIK procedure was
and how well I did afterward,” Ms. Feaser said. “Dr. Shih is professional and delightful. I appreciate the conscientious follow up, and I
wake up each morning surprised that I can see without glasses.”
+
See the world more clearly. Select physicians with
privileges at North Shore University Hospital and
Long Island Jewish Medical Center offer Custom LASIK
expertise. Ask your primary care physician for a referral. To
make an appointment for a free evaluation at the North
Shore-LIJ LASIK Center, call 866-690-2008.
Computer Users: Give Your Eyes a Break
Using computers won’t harm your eyes, according to the American Academy of Ophthalmology. But it can cause temporary discomfort. Your eyes may feel heavy or tired. Or
your vision may seem less sharp after you’ve been surfing the Internet for some time.
Here’s how to prevent these problems:
Place your computer’s monitor so that it is about 20 to 25 inches from you. If you can,
raise or lower the chair or monitor so the screen is just below your eye level.
Get rid of glare. Try closing blinds or lowering the light in the room. Putting a
glare filter on your screen also can help.
Take frequent rest breaks. Do something else and blink your eyes several times. If
your eyes feel dry, try using artificial tears.
While computers may not be a threat to your eyesight, other things can pose
problems as you get older. Remember to get your eyes checked every one to two
years. An ophthalmologist or optometrist can check for early signs of eye diseases.
See an eye professional sooner if: your vision gets worse; you have eye pain, redness
or swelling; you see flashes of light; or you have fluid leaking from your eye.
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21
LEADING RESEARCH
Scientists Collaborate to Unravel Lupus
by Jamie Talan
K
athleen Nolan, RN, was diagnosed with systemic lupus
erythematosus (SLE) when she was 26. Two years ago, her
rheumatologist handed her the bad news: There was nothing else
they could do for her. She took 12 pills in the morning and two
at night, and an injection of another medicine once a week. Her
symptoms — joint pain, ulcers, fatigue and constant fever —
were unrelenting despite her medication regimen. The doctor’s
proverbial black bag was empty.
A colleague gave Ms. Nolan a copy of Focus on Research,
published by The Feinstein Institute for Medical Research, which
detailed an extensive lupus research program and a number of
experimental drug studies at the institute. There hasn’t been a
new lupus drug in more than 50 years. Most of the medicines
now used were designed for other conditions.
Ms. Nolan enrolled in a Phase III study of Benlysta, which
showed promise in laboratory models of lupus and in early studies
in humans. Last summer, after spending a year in the trial not
knowing whether she got the real drug or a placebo dose, Ms.
Nolan — and the rest of the lupus world — learned about the
results of a similar multicentered study of Benlysta being conducted
outside the United States. It seemed to be working. Patients on the
drug fared better than those in the placebo group. After one year,
patients were all put on one of two doses of the study drug.
PROGRESS FOR PATIENTS
“This is a major step forward,” said Cynthia Aranow, MD, a
rheumatologist at the Feinstein who was an investigator in the
study. Dr. Aranow said there are about 10 other lupus clinical drug
trials under way in the Feinstein’s Center for Autoimmune and
Musculoskeletal Disorders and a number of other studies to figure
out why the disease starts and progresses. Benlysta, which is the
brand name for belimumab, is a monoclonal antibody against BAFF,
which is a B lymphocyte stimulator. BAFF is an immune system
cytokine that is important for B cell activation and B cell survival.
Lupus patients make too much BAFF and this drug blocks BAFF.
“This is the first time in decades that a lupus drug study had
positive results,” added Meggan Mackay, MD, codirector with
Dr. Aranow of the center’s Clinical Research Unit. The unit works
through the General Clinical Research Center.
The Feinstein Institute for Medical Research is one of the leading
centers in the world exploring SLE. Led by Betty Diamond, MD,
director of the Center for Autoimmune and Musculoskeletal
Disorders, Feinstein scientists are committed to unraveling the
puzzle of this abnormal immune response to identify pathways to
stop this rogue process. Lupus is an autoimmune disease.
To understand autoimmune disease, scientists turn to the inner
workings of the B cell repertoire. In producing antibodies against
things that are foreign to itself, the body on more than a rare
A trial of a medication for systemic lupus erythematosus is giving study participant
Kathleen Nolan, RN — and others like her — new hope.
occasion wages war against its own tissues. About eight percent of
the population has an autoimmune disease.
The body produces millions of antibodies that protect against
infection. In general, it is an efficient system. But every once in a
while, the immune system sees the self as foreign and wages an
attack. This process is the underlying problem at work in scores of
autoimmune diseases, including common ones like diabetes,
rheumatoid arthritis, lupus and multiple sclerosis.
GENETIC AND ENVIRONMENTAL TRIGGERS
Lupus is characterized by a high serum of auto-antibodies — specifically antibodies to double-stranded DNA. Lupus is unusual (and
therefore a good model) in that it can affect so many different
22
Scientists at The Feinstein Institute for Medical Research
work to discover how B cells alter the response of the
immune system.
organs of the body. Dr. Diamond’s interest in
understanding the induction of anti-DNA
antibodies and how these antibodies
become toxic to that environment is at the
heart of the research. In demystifying this
process, the Diamond team has discovered
that the condition has both genetic roots
and environmental triggers. For instance,
scientists on Dr. Diamond’s team are
fascinated by a finding that sex hormones
can trigger SLE. Lupus is far more common
in women, which is why they are now
focusing on estrogen. They are exposing
B cells to sex hormones to see how the
hormones change B cell receptor signaling
and B cell maturation. They are also
studying whether genes regulated by
hormones alter the response of the
immune system.
Dr. Diamond’s team has identified foreign
antigens (microbes from the environment)
that cross-react with the anti-DNA antibodies that they believe play a major role in
lupus. What is the normal way to regulate
or prevent this cross-reactive system?
How does the immune system make this
mistake? These are some of the questions
the team is answering.
Her team is also working to discover
how this cross-reactivity alters a very
important population of glutamate
receptors called NMDA receptors. These
receptors are all over the brain and
regulate a lot of excitatory synaptic activity.
Dr. Diamond has shown that a subset of
anti-DNA antibodies cross-react with
NMDA receptors and contribute to
neuropsychiatric lupus. It has become
clear in recent years that many lupus
patients have a long list of cognitive and
mood complaints that until now were
ignored or not linked to the underlying
pathological lupus process. As part of the
effort, Dr. Diamond’s colleagues, Drs.
Mackay and Aranow, are working cross-
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23
institute with David Eidelberg, MD, head
of the Susan and Leonard Feinstein Center
for Neurosciences, to image the brains of
lupus patients to figure out whether there
are observable brain changes and whether
more changes occur with advancing
illness. They are using magnetic resonance
imaging and positron emission tomography
scans to identify the functional and
structural problems that underlie these
brain symptoms.
+
To learn more about ongoing
lupus studies, call 866-690-2008.
THESE TELLTALE SIGNS
MAY SIGNAL LUPUS
Lupus is a disorder that causes the
immune system to attack the body’s
own organs and tissues. And if you’re
a woman of childbearing age, you’re
in the biggest risk group for lupus.
One symptom of lupus is a distinctive “butterfly rash,” in which the skin
across your nose and cheeks turns red.
Other possible signs include the
following:
painful, swollen joints — most
often in the knees, wrists and hands;
extreme tiredness;
achy muscles;
low-grade fever; and
sensitivity to the sun.
If you have any of these symptoms,
talk with your doctor. Left unchecked,
lupus can damage the kidneys, brain
and other organs. But treatment can
help control symptoms and manage
the disease.
Sisters Helping
Sisters
Scientists at The Feinstein
Institute for Medical Research
have embarked on a national
search for sisters. The SisSLE
(Sisters of Women with Systemic
Lupus Erythematosus) research
study is looking for sisters: one
with a diagnosis of lupus, an
autoimmune disease, and one
(or more) who does not have
lupus. Betty Diamond, MD, and
Peter Gregersen, MD, designed
the study to understand how
individuals may progress to
lupus. By following a sister or
sisters of a lupus patient, the
scientists hope to identify the
disease in its earliest, presymptomatic stage and track its
progression over time.
The Feinstein will enroll 400
sisters over a two-year period.
Scientists will be able to
identify auto-antibodies that
play a role in lupus and study
other changes in blood serum
that may help predict disease.
Studies show that 15 to 20
percent of sisters with these
auto-antibodies will not get
lupus. Figuring out who those
people are and why they are
protected will help design
treatment options for those
who do go on to develop
lupus. Women who were
diagnosed with lupus between
the ages of 10 and 35 are
welcome to join the study if
they have a sister or sisters
(also between the ages of 10
and 35) with no signs of illness.
Half-sisters are welcome to
joint the SisSLE study as well.
For more information about
the study, call a research
nurse at 877-698-9467, e-mail
SisSLE@nshs.edu or visit
SisSLE.org.
HEALTH SYSTEM NEWS
New School to Change Medicine on
Long Island and Beyond
H
ofstra University’s and North Shore-LIJ Health System’s School
of Medicine is officially open for business. It is the first new
allopathic medical school to open in New York State since 1963.
The medical school has received preliminary accreditation from
the Liaison Committee on Medical Education (LCME), as well as
final approval of its education program from the New York State
Education Department’s Professional Education Division. The
approvals have allowed the medical school to begin to recruit its
first class of 40 students, who will begin studies next summer.
“Having our own medical school will transform both North
Shore-LIJ and Hofstra University, elevating us to an unprecedented
level of prominence,” said Michael Dowling, the health system’s
president and CEO. “It will put the health system on par with some
of the nation’s most prestigious healthcare organizations.”
The school’s curriculum will change the face of medical education
in this country by putting students in patient care settings from Day
One, including the ambulances operated by North Shore-LIJ’s
Center for Emergency Medical Services. The health system’s Patient
Safety Institute, Feinstein Institute for Medical Research and
hospitals will all serve as training sites, ensuring students will
graduate as highly prepared young doctors five years from now.
+
Learn about the region’s most exciting development
in higher education. Visit http://medicine.hofstra.edu,
call 516-463-7516 or e-mail medicine@hofstra.edu.
Richard Goldstein Elected Chairman of North Shore-LIJ Health System
T
he North Shore-LIJ Health System
Board of Trustees has elected Richard
Goldstein as chairman. Mr. Goldstein
was formally named to the post at the
board’s annual meeting.
He succeeds Saul Katz, who concluded four years as chairman after previously serving as the North Shore-LIJ
Health System’s first chairman from
1997 to 2000.
Mr. Goldstein, an attorney, joined the
Board of Trustees in 1995, after serving
for three years as an associate trustee.
nor thshorelij.com
25
He has served as the board’s vice
chairman for the past four years.
“I am honored to serve as the North
Shore-LIJ Health System’s fourth chairman,” said Mr. Goldstein. “It’s an
enormous challenge that brings with it
enormous responsibilities, but I have
the benefit of being able to rely on
the knowledge and experience of my
predecessors, most notably Saul Katz,
who leaves an incredible legacy of
unparalleled leadership, energy, dedication and devotion to our health system.”
Mr. Goldstein is
chairman and chief
executive officer of
AEP Capital LLC, a
specialized investment/merchant
banking firm
located in New
York. He is also a
senior managing
director of Alpine
Equity Partners LP.
Richard Goldstein
HEALTH SYSTE M NEWS
Diagnostic Imaging Center
Renamed to Honor
Mitchell A. Goldman, MD
N
At a ceremony to dedicate the Mitchell A. Goldman, MD, Diagnostic Imaging
Center, from left: Dennis Dowling, North Shore-LIJ’s regional executive
director for physician and ambulatory network services; Barbara Goldman,
Dr. Goldman’s wife; Michael Dowling, president and CEO of North Shore-LIJ;
Laura Chasin, Dr. Goldman’s sister, and his father, Leo Goldman.
Sen. Gillibrand Tours Simulation Center
US Senator Kirsten Gillibrand recently toured North Shore-LIJ’s
Patient Safety Institute to learn about the health system’s work
in providing simulation training to medical residents, nurses and
other clinicians from throughout the region. North Shore-LIJ’s
Chief Learning Officer Kathy Gallo, RN, PhD, right, showed
Senator Gillibrand plans for expanding the health system’s
Patient Safety Institute and Center for Learning and Innovation
— the nation’s largest corporate university.
orth Shore-LIJ Health System has renamed its Diagnostic
Imaging Center in Lake Success as a tribute to the late Mitchell
A. Goldman, MD, former chairman of radiology at North Shore
University Hospital and Long Island Jewish Medical Center. The
facility was recently dedicated as the Mitchell A. Goldman, MD,
Diagnostic Imaging Center in appreciation of his many contributions
to the health system over the past 34 years.
Dr. Goldman, who passed away February 16 after a long illness,
served as chairman of radiology for the past 12 years. He was a
gifted radiologist, specializing in ultrasound, and a beloved
physician and clinical leader known for his engaging personality
and kind nature. His career at North Shore-LIJ dates back to 1976,
when he joined the North Shore University Hospital Radiology
Department.
Health and Wellness
Meet the Mets
Next time you attend a
Mets home game at Citi
Field, check out the
Health and Wellness
Information Center,
located on the field level
in the right field corner.
The first of its kind in
major league baseball,
the 400-square-foot
center, called the Health
Information Team, or HIT,
is staffed by a team of
healthcare professionals who can answer questions on such
health-related topics as sports safety, exercise, heart health
and nutrition.
HIT is the brainchild of Mets co-owner Saul Katz, chairman
of the board of North Shore-LIJ Health System from 2006 until
this summer and previously from 1997 to 2000.
For more information about the Health and Wellness
Information Center at Citi Field, visit NorthShoreLIJ.com/HIT.
26 Vitality + Summer 2010
COMING THIS FALL: 3 New Outpatient Locations
by Brian Mulligan
The North Shore-LIJ Health System will
open three multispecialty locations this
fall, providing high-quality outpatient care
and specialized services to residents of
Queens and Nassau counties.
Healthcare practitioners in a variety of
disciplines will staff the new facilities to
provide community-based care, said Donna
Moravick, NP, North Shore-LIJ’s vice president for cardiovascular services. “Each
location — two in Queens and one in Nassau
— will offer expert specialized care,
educational programs and state-of-the-art
imaging services to help diagnose and treat
disease,” she said. “The new locations
represent a significant investment by North
Shore-LIJ and are a continuation of our
commitment to the communities we serve.
“These new locations provide convenience and quality under one roof,
complementing our inpatient programs
and services in Queens and Nassau,” Ms.
Moravick said. “Responsiveness to patient
needs will be paramount and supported
by our ambulatory care management
team.”
The locations and services are:
1001 Franklin Avenue, Garden City
— internal medicine, cardiology;
150-55 14th Avenue, Whitestone
— internal medicine, cardiology,
pulmonary medicine; and
Queens Crossing, 136-20 38th Avenue,
Flushing — internal medicine, cardiology,
thoracic surgery, urology.
MAKING STRIDES FOR WOMEN’S HEALTHCARE
by Marisa Fedele
F
our thousand community members
donned sneakers and traversed the
Jones Beach boardwalk recently as participants in Every Woman Matters: A Walk
for Women and Their Families. The event
benefited the North Shore-LIJ Health
System’s new Katz Institute for Women’s
Health and Katz Women’s Hospital.
One of the most rousing sights was the
sea of white hats bearing the Prudential
Douglas Elliman Real Estate logo. Inspired
by the President and CEO Dottie Herman,
hundreds of New York-area Prudential
Douglas Elliman employees formed an
impressive three dozen walk teams and
raised significant funds in a variety of
creative ways.
“Several years ago, I was contacted by
Saul Katz, who shared his vision for the first
women’s hospital in New York State,” said
Ms. Herman. “I feel this is one of the most
important things I can do in my lifetime.”
After learning of the health system’s plans
to hold a walk for this cause so close to her
heart, Ms. Herman made a generous gift for
Prudential Douglas Elliman Real Estate to
become the event’s title sponsor.
The walk raised more than $500,000 for
the Katz Institute for Women’s Health and
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27
Staff members from the event’s corporate sponsor, Prudential Douglas Elliman Real Estate, formed 36 walk
teams, contributing significantly toward the more than half a million dollars raised for the Katz Institute for
Women’s Health and Katz Women’s Hospital.
Katz Women’s Hospital, thanks to dozens of
corporate and individual sponsors, thousands of people who walked or supported
other walkers, and the dedication of the
Commerce and Industry Council (CIC), a
group of professionals and philanthropists
who cohosted the walk with North
Shore-LIJ.
“CIC got involved with this walk to
celebrate women’s health and wellness
and to support a cause that promises to
transform women’s healthcare,” said Arthur
Sanders, who cochaired the walk with
fellow CIC members Teresa Breen and
Cheryl Vanek. “It was incredibly rewarding
to be on the boardwalk and see so many
families bonding as they walked in honor
or memory of the women they love.”
+
To learn more or make a
gift to the Katz Institute
for Women’s Health and
Katz Women’s Hospital, visit
support.northshorelij.com/women.
HEALTH SYSTE M NEWS
Clinicians Enhance Patient Safety
Via Simulation Training by Betty Olt
T
“The Patient Safety Institute is a major asset and we must
continually invest in the development of our physicians and nurses
to practice life-saving skills for real-life situations,” said Michael
Dowling, president and chief executive officer of the North
Shore-LIJ Health System. “The expanded facility greatly expands
our ability to train clinicians in a state-of-the-art learning environment and improve quality and safety for our patients.”
Medical simulations will train approximately 7,000 clinicians at PSI
this year. The North Shore-LIJ Patient Safety Institute’s comprehensive
and innovative programs align with the health system’s goal of zero
tolerance for medical errors and hospital-acquired infections. Borrowing lessons learned from the aviation industry, where pilots learn with
simulator technology to improve performance, North Shore-LIJ is
helping its nurses and doctors improve clinical and decision-making
skills — and avoid serious medical errors in the hospital.
“Healthcare is a team sport,” said Kathleen Gallo, PhD, the health
system’s chief learning officer. “At the Patient Safety Institute, we
emphasize that those who work in teams,
train in teams so communication and skills
are learned in realistic, fast-paced hospital
simulations, and responding to rare medical
events becomes second nature.”
PSI will also be used as a key clinical
training site for medical students at the
Hofstra University School of Medicine in
partnership with the North Shore-LIJ
Health System.
“Medical simulation lets us put new
doctors into critical situations that you
would never allow them to get involved in
with real patients,” said Lawrence Smith,
MD, North Shore-LIJ’s chief medical officer
and dean of the medical school. “Learning
doesn’t happen without being emotionally
engaged, and the life-like mannequins
replicate stressful medical scenarios, so the
simulated setting is as real as it gets.”
The debriefing sessions are equally
important because that is when healthcare
teams can critique their own performance,
Dr. Smith said. “The power of simulation
is to recreate rare medical events that
you’d never be proficient in, in real
practice,” he added. “The litmus test of a
medical student is whether you can put
Pediatric critical care nurses Jacqueline Colombraro, RN, left, and Ronit Schwartz, NP, of the Cohen Children’s
knowledge into action in real time under
Medical Center of New York, insert a breathing tube and check airways on a computerized infant mannequin
the most stressful situations.”
during a simulated medical emergency at North Shore-LIJ’s newly expanded Patient Safety Institute.
he North Shore-LIJ Center for Learning and Innovation recently
tripled its size to 45,000 square feet — and nearly half of the space is
dedicated to patient safety. The newly expanded Patient Safety Institute
(PSI), a major hub for high-tech medical simulation training, allows
clinicians to sharpen their skills without risk to patients.
PSI features cutting-edge simulated hospital settings such as an
operating room, a procedure room, a labor and delivery suite, and
eight critical care rooms where physicians and nurses hone their
clinical and communication skills. The facility includes computerized patient mannequins that mimic high-risk medical scenarios
like respiratory failure and cardiac arrest in a variety of clinical
settings. All training simulations are video-recorded and reviewed
during post-scenario debriefings.
In 14 new patient-room settings, actors test physicians’ diagnostic
skills by portraying patients with various illnesses. The institute also
houses an endovascular simulation lab where physicians practice
cardiac, vascular and neurosurgical procedures.
28
HEALTH BYTES
An Exercise-Free Diet
Could Rob Your Bones
Losing weight is more complicated than “calories
in and energy out.” How you lose matters to your
bones. People who simply dieted for one year lost
bone density in the lower spine and hip. In contrast,
dieters who exercised maintained their bone density.
Girls ages 8 to 13 who ate three or more daily servings of fruits and vegetables
had stronger bones than girls who ate fewer servings. Other studies have
shown that adult bones benefit from eating lots of produce, too.
Food & Fitness
Vitamin C is found in citrus fruits
and juices and green peppers.
Vitamins C and E, zinc and beta-carotene may cut
the risk for age-related macular degeneration.
High-zinc foods
include poultry, fish
and dairy products.
Carrots, kale
and spinach are
good sources of
beta-carotene.
Whole grains and nuts
are high in vitamin E.
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29
Watch Out for
High Triglycerides
A high triglyceride level is a risk
factor for heart disease. To find
out how common the condition
is, researchers looked at data
from a health survey of 5,600 US
adults ages 20 and older. Based on
blood test results, 33 percent had
borderline high (150 to 199 mg/
dL) or higher (200+ mg/dL) levels.
But only one percent used medicine for the condition. This may be
because experts suggest adopting
a healthy lifestyle as the first step in
treatment. If lifestyle changes don’t
work out, however, medicine may
be an option for those with high
triglyceride levels.
LIGHTE N UP!
Chill out with these refreshing summer dishes.
Make Your Own Yogurt
1 gallon skim milk
4 cups nonfat instant dry milk
Up to ¾ cup sugar to taste
1 cup plain yogurt with live cultures
Food thermometer
1. Mix the dry milk and sugar and blend
into skim milk. Heat in a saucepan to
just near boiling (185 degrees). Remove
from heat and let cool to 110 degrees.
2. Warm to 110 degrees. Slowly stir the
warm yogurt into milk mixture.
3. Put liquid in the oven and keep at
110 degrees until a custardlike texture
develops — about three to six hours.
4. Pour yogurt into containers that have
been sterilized with boiling water.
Refrigerate and keep for two to three
weeks at most. If desired, add fresh or
drained canned fruit before eating.
Chillin’ Out Pasta Salad
Fruity Freeze
1 15-oz. can of tropical fruit salad
in fruit juices, no sugar added (or
about 1 ¾ cups of your favorite
chopped fresh fruit)
1 cup low-fat vanilla ice cream or
frozen yogurt, softened but not
melted
Strainer
Small mixing bowl
Measuring cup
Large spoon
2 containers
1. Open the can of fruit and drain the juices
in the strainer over a small bowl. You can
save the drained juices for drinking later
if you want.
2. Pour the drained fruit into a small mixing
bowl. Spoon in the softened ice cream.
3. Mix the fruit and ice cream together with
a large spoon.
4. Divide the Fruity Freeze into two
containers, cover and freeze for at least
two hours. When ready, serve and enjoy!
2 cups
1 cup
2 tbsp.
2 tbsp.
1 cup
1 cup
1 lb
3 cups
(8 oz.) spiral or shell pasta
(8 oz.) plain nonfat yogurt
spicy brown mustard
salt-free herb seasoning
chopped celery
sliced green onion
cooked small shrimp
(about 3 large) coarsely
chopped tomatoes
1. Cook pasta according to directions —
but do not add salt to water. Drain
and cool.
2. In large bowl, stir together yogurt,
mustard and herb seasoning.
3. Add pasta, celery and green onion.
Mix well.
4. Chill for at least two hours.
5. Just before serving, carefully stir in
shrimp and tomatoes.
30 Vitality + Summer 2010
Salt: Friend or Foe?
S
alt, or sodium chloride, is a staple of the
diet. Derived in crystalline form from the
sea or from salt deposits on land, it is added
to food as a flavor enhancer and preservative
and sprinkled on at the dining table. Ten
percent of salt is found naturally in our food
supply, taken up from the soil as crops grow
or as part of the diet of livestock and fish.
Believe it or not, it’s mostly a very good thing.
Besides being tasty, salt is critical in maintaining
the body’s balance of fluids, regulating blood
pressure and blood volume and contributing to
the functioning of muscles and nerves through
the activities of electrolytes (dissolved sodium)
that regulate cell activity.
But in large quantities, salt becomes
dangerous. It contributes to high blood
pressure in people who are sensitive to sodium,
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31
and it can also lead to a serious buildup of fluid
for those with congestive heart failure, liver
cirrhosis or kidney disease. People diagnosed
with these conditions are directed to limit salt
intake to 1,500 mg or less daily. For the rest of
us, the current FDA recommendation is 2,300
mg of sodium daily — less than a teaspoon of
table salt. But nearly all Americans consume
well above that without realizing it. The typical
male ages 20 to 39 takes in close to 4,500 mg,
most of it consumed in processed food, like
canned goods, cold cuts, frozen entrées, sauces,
condiments, chips, cereal — and soft drinks.
Even healthy food can add to the salt load:
An eight-ounce cup of low-fat milk has about
107 mg of sodium!
What’s the solution? Be a savvy consumer.
Read labels carefully, being sure to take the
number of servings into account. Choose
food that has less than five percent of daily
sodium values. Cut back on canned, frozen
and otherwise processed and preserved food
in favor of fresh produce and meat. Steer
clear of bottled salad dressings and condiments. Enhance food with herbs, spices,
lemon juice, garlic, onions and other
natural flavors instead. And select salt
substitutes wisely. Many contain potassium
chloride, which can interfere with medication, or have so little flavor that you end up
doubling the amount and use as much table
salt as you set out to avoid.
+
For an excellent guide to
lowering salt intake and healthy
eating, see dashdiet.org.
VITALITY
NORTH SHORE-LONG ISLAND
JEWISH HEALTH SYSTEM, INC.
300 Community Drive
Manhasset, NY 11030
Michael Dowling
President and CEO, North Shore-LIJ Health System
Dennis Dowling
Regional Executive Director
Non-Profit Org
U.S. Postage
PAID
NSLIJHS
Susan Somerville
Executive Director, North Shore University Hospital
Chantal Weinhold
Executive Director, Long Island Jewish Medical Center
Terry Lynam
Vice President, Public Relations
Maria Conforti
Managing Editor
Vitality is published by the Public Relations Department
of the North Shore-LIJ Health System (516-465-2600).
The information within this publication is intended
to educate readers about subjects pertinent to their
health and is not meant to be a substitute for consultation with a
personal physician. Produced by StayWell Custom Communications,
Evanston, IL. © 2010. Printed in USA
Hope lives here.SM
northshorelij.com
Need to find a doctor?
Call 888-321-DOCS
NEED TO FIND A DOCTOR? 888-321-DOCS • NORTH SHORE-LIJ HEALTH SYSTEM
North Shore and LIJ Physicians Among New York’s “Best”
New York magazine recently published its 2010 list of top doctors in the metropolitan New York
area. Physicians from Long Island Jewish (LIJ) Medical Center (which incorporates LIJ Hospital, the
Cohen Children’s Medical Center (CCMC) of New York and The Zucker Hillside Hospital) and North
Shore University Hospital were among the honorees.
North Shore
University Hospital
Allergy & Immunology
Sharon Markovics, MD
Marc Sicklick, MD
Gynecologic
Oncology
John Lovecchio, MD
Hematology
Steven Allen, MD
Maternal & Fetal
Medicine
Victor Klein, MD
Neurology
Roger Kula, MD
Obstetrics &
Gynecology
Michael Nimaroff, MD
Otolaryngology
Michael Setzen, MD
Plastic Surgery
Lyle Leipziger, MD
Rheumatology
Richard Furie, MD
LIJ Hospital
CCMC
Gastroenterology
Maurice Cerulli, MD
Adolescent Medicine
Martha Arden, MD
Martin Fisher, MD
Ophthalmology
Ira Udell, MD
Orthopaedic Surgery
David Dines, MD
Pathology
Leonard Kahn, MD
Plastic Surgery
Alex Keller, MD
Pulmonary Disease
Harly Greenberg, MD
Mark Rosen, MD
Thoracic Surgery
L. Michael Graver, MD
Urology
Louis Kavoussi, MD
Michael Ziegelbaum, MD
Child and Adolescent
Psychiatry
Carmel Foley, MD
Neurology
Joseph Maytal, MD
Clinical Genetics
Martin Bialer, MD, PhD
Pediatrics
Andrew Adesman, MD
Eric Gould, MD
Allergy and
Immunology
Vincent Bonagura, MD
Cardiology
Fredrick Bierman, MD
Rubin Cooper, MD
Gastroenterology
Jeremiah Levine, MD
James Markowitz, MD
Hematology/
Oncology
Jeffrey Lipton, MD, PhD
Infectious Disease
Lorry Rubin, MD
Nephrology
Howard Trachtman, MD
Rheumatology
Beth Gottlieb, MD
Surgery
Stephen Dolgin, MD
Caregivers’
Conference
Caring for children?
Your parents? Both?
Equip yourself at The
Many Faces of Caregiving:
Practical Strategies and
Solutions. Francine Russo,
author of They’re Your
Parents, Too, will keynote
the conference.
Tuesday, October 26,
8 a.m. to 3 p.m.
Immaculate Conception
Center, 7200 Douglaston
Parkway, Douglaston
For information and
reservations, call North
Shore-LIJ Health System’s
Department of Public
Health Education at
516-465-2500.
The Zucker Hillside
Hospital
Child and Adolescent
Psychiatry
Victor Fornari, MD
Endocrinology
Dennis Carey, MD
Phyllis Speiser, MD
Please recycle this magazine.
NORTH SHORE-LIJ HEALTH SYSTEM HOSPITALS: NORTH SHORE UNIVERSITY HOSPITAL • LONG ISLAND JEWISH MEDICAL CENTER •
COHEN CHILDREN’S MEDICAL CENTER OF NEW YORK • ZUCKER HILLSIDE • FRANKLIN • GLEN COVE • SYOSSET • PLAINVIEW • SOUTHSIDE • HUNTINGTON •
FOREST HILLS • STATEN ISLAND UNIVERSITY HOSPITAL • LENOX HILL HOSPITAL • AFFILIATE: NASSAU UNIVERSITY MEDICAL CENTER
940M

View Vitality summer issue 2010

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