2015 Fall Newsletter - Phelps Memorial Hospital
Transcription
2015 Fall Newsletter - Phelps Memorial Hospital
phelps News from Phelps Memorial Hospital Center Fall 2015 T o d ay Parkinson’s Disease: A Q&A Oral Appliances Help Sleep Apnea Patients Lung Cancer Screening for High-Risk Individuals New Chef Brings Healthier Choices to Phelps Advanced Treatment for Swallowing Disorders Prestigious organizations Recognize Phelps Plus: Fall Healthy Life Calendar Letter from the President and Chairman Dear Friend, If you have visited the hospital lately, you will know that there are many exciting changes in the making. A new MRI facility that will feature the latest technology is nearing completion, and the opening of our impressive new entrance is expected early next year. Expansions of our Phelps Medical Associates practices are also taking place in Croton-on-Hudson and Dobbs Ferry. These projects represent the hospital’s continuing commitment to provide state-of-the-art medical services in attractive, comfortable environments. We realize that navigating our campus during construction is sometimes difficult, and we truly appreciate everyone’s understanding as we make these significant improvements. Phelps has received a number of recognitions recently from prestigious organizations, including acknowledgement as a Fit-Friendly Worksite by the American Heart Association and designation as a Diagnostic Imaging Center of Excellence by the American College of Radiology – one of only 17 hospitals in the nation to be so designated. U.S. News and World Report ranked Phelps as number 16 out of 250 hospitals in New York State, and in an upcoming Hospital Quality Star Rating by Centers for Medicare & Medicaid Services (CMS), Phelps is the only hospital in our health system to achieve 4 stars. Recent patient satisfaction surveys also tell a positive story: In comparison to peer hospitals in the region, Phelps was at the 99th percentile for inpatient services, the 89th percentile for emergency services and the 91st percentile for care provided at our Phelps Medical Associates practices. The Excellence through Innovation for Patient Experience award was presented to Phelps by HealthStream, an organization that provides hospitals with educational resources to improve patient care. The award acknowledges Phelps’ exceptional performance in driving change and improving patient experience and safety. HealthStream also invited Phelps leaders to participate at its annual conference this September in Denver as Pinnacle Speakers, presenters who are chosen from organizations that have made a commitment to transform their culture and focus on patient-centered care. The Phelps Board of Directors has added several new members this year, including three representatives from the North Shore-LIJ Health System: Anthony Ferreri, Regional Executive Director; Richard Goldstein, immediate past Chairman; and Ralph Nappi, Executive Vice Chairman of North Shore-LIJ’s Board. Our new board members bring valued expertise in law, finance, management and healthcare, and they will be instrumental to our success in setting the course for the hospital’s future. We are proud of our extraordinary staff for providing care of such high caliber that it distinguishes Phelps from other hospitals. To support their efforts, we will continue to enhance services and acquire the latest technology. Mark Twain once said, “If you stand still, you will fall behind.” As you can see, that doesn’t apply to Phelps. Wishing you the best of health as the fall season begins, Richard J. SinniDaniel Blum President & CEO Chair, Board of Directors 2 Phelps Today Table of Contents A Q&A on Parkinson’s Disease phelps today Editor Mary Sernatinger msernatinger@pmhc.us Managing Editor Tina Dorfman Medical Editor Bruce Heckman, MD, MPH Editorial Advisors Daniel Blum Lucy C. Engelhardt, RN Robert R. Lane Mary McDermott, RN PHELPS TODAY is a publication of Phelps Memorial Hospital Center, a 238-bed, not-forprofit acute care community hospital located in Sleepy Hollow, NY. Phelps, part of the North Shore–LIJ Health System, has been providing medical and mental health services to Westchester and surrounding communities since 1955. E EL B R AT I N T N Years EXCELLE 60 P HEL P S G CARE C If you would like to be removed from the Phelps Today mailing list, please call (914) 366-3100 or email tdorfman@pmhc.us. AT T P IEN Visit us on Facebook: http://www.facebook.com/ PhelpsMemorialHospitalCenter Visit us on Twitter: https://twitter.com/ #!/phelpshospital 4 Sleep Apnea: Oral Appliances Make Treatment Easier 8 Phelps Welcomes CIA-Trained Chef Joe Syngjellari 10 Treating Swallowing Disorders with Electrical Stimulation 12 Family Medicine Residency Program Graduates Its First Class 13 Insurance for Low-Dose CT Screening for Lung Cancer 14 Orthopedic Excellence Continues 15 Finding Better Balance 15 It Takes a Committed Community 16 Recognitions 18 Phelps Auxiliary; Medication Smartphone Service 25 Phelps Medical Associates News 26 Healthy Life Calendar 28 Construction on Campus 31 Preguntas y respuestas sobre la enfermedad de Parkinson 32 Seguro médico para CT para detectar cáncer pulmonar 36 Request Your Appointment Online! Appointments for many of Phelps’ outpatient services can be made on the hospital’s website, including: cardiovascular, diabetes, infusion, nutrition counseling, occupational and physical therapy, pain center, pulmonary/respiratory, radiology/x-ray, senior services, sleep, speech & hearing, voice & swallowing, and wound healing. You can even make an appointment to donate blood online. Just go to www.phelpshospital.org and click on “Request an Appointment” – any time of the day or night! Phelps’ Community Service Plan Phelps Memorial Hospital Center is committed to improving the health and well-being of the community. To see our Community Service Plan (2013-14) and learn about our current and planned activities and initiatives, please visit phelpshospital.org/about-phelps and click on “Community Service Plan.” A summary of the hospital’s 2014 community service is described in our “Caring for Our Community” publication, which is also available at the same address (click on “Caring for Our Community”). A printed copy of these publications may be requested by calling 914-366-3115. Phelps Today 3 A Q&A on Parkinson’s Disease By Douglas D. Sankar, MD There are numerous fears and misconceptions associated with a diagnosis of Parkinson’s disease, but many people are not aware that although Parkinson’s is not curable, it is very treatable. A little knowledge can go a long way in allaying some of the fears. 4 Phelps Today What is Parkinson’s Disease? Neurotransmitters, the chemicals that communicate information throughout our brain, play a role in controlling one’s heartbeat, breathing and even digestion. They can affect mood, sleep, concentration and weight, and can cause symptoms when they are not functioning correctly. Simply put, Parkinson’s disease happens when a deep structure in the brain called the substantia nigra or “black substance” starts to die, which causes the amount of the neurotransmitter “dopamine” to become depleted. Much of the treatment for Parkinson’s is aimed at restoring the amounts of dopamine in the brain. Why do people get Parkinson’s disease? There are many theories as to why people get Parkinson’s, which basically means we don’t know why. While there are families in which Parkinson’s disease is common (15% of the cases), the majority (85% of the cases) are “sporadic” or occur without clear reason. Unfortunately, Parkinson’s disease is not rare. From 2-4 percent of people over the age of 60 are expected to get Parkinson’s disease, with a lower percentage in people younger than 60. What are the symptoms? The most noticeable symptom of Parkinson’s disease is the tremor. Not everyone with a tremor has Parkinson’s disease, however. An evaluation by a neurologist will often sort out other causes of tremor, many of which are quite benign. One example is the essential tremor that Katherine Hepburn had, which affected her voice and head movements. What distinguishes the Parkinson’s tremor from essential tremor is that it typically occurs when the individual is at rest, especially when hands are held at the sides or in the lap. Essential tremor also affects the hands, but is more likely to be evident when the hands are being used. Parkinson’s tremors are slower than other types of tremors and usually start in the hands. Essential tremor is more likely to involve the head. Not every patient with Parkinson’s disease has the tremor. The following are some of the other significant Parkinson’s symptoms that should warrant a trip to the doctor. •Bradykinesia, or slowness of movements, is one of the more significant symptoms. Bradykinesia is often evident when an individual has difficulties in everyday activities, from brushing teeth to getting dressed. It is sometimes described by patients as feeling as if there is a pause between when the brain tells the body to do something and the body actually does it. •Gait disturbance, or difficulty with walking. An abnormal gait with short steps, a stooped posture and shuffling movements is very typical of Parkinson’s disease and can interfere greatly with an individual’s ability to function. Parkinson’s patients often fall backwards without much provocation. At times, they feel as though they are walking too quickly, and that they have difficulty stopping after walking. There are many other factors that can suggest Parkinson’s disease, such as changes in handwriting, specifically when handwriting becomes much smaller than it previously was. The voice can become lower in volume, or a person may have difficulty with swallowing. There can be a loss of the normal facial expressiveness, which is sometimes described as being “mask-like.” Additionally, Parkinson’s disease patients may experience conditions that people often do not associate with the disease, including depression, sleep disturbance and memory disturbance. Is there treatment for Parkinson’s disease? In a word, YES! There are many medications available, including some that may slow down the progression of Parkinson’s disease. The treatment of Parkinson’s is greatly influenced by many variables, including the patient’s age and his/her memory. The treatments include medications to: •slow down the breakdown of dopamine in the brain •stimulate the dopamine receptors, or nerves in the brain that would normally be stimulated by dopamine (“dopamine agonists”) •try to increase the amount of dopamine in the brain (levodopa or “L-dopa”) Other medications can be used to try to reduce the tremor. These medications vary greatly from individual to individual, and a Parkinson’s patient typically takes small amounts of multiple medications rather than a large dose of one drug to reduce potential side effects. The management of these medications requires close interaction with a neurologist experienced with Parkinson’s disease. Phelps Today 5 Parkinson’s disease patients who experience depression can be treated with antidepressants, which can significantly improve their quality of life. It is important for anyone with depression to address concerns about it with his or her doctor, but it is especially important for someone with Parkinson’s disease. Being treated for depression can really impact overall well-being. Often, individuals with Parkinson’s disease ask their physicians about whether diet and nutritional supplements can help. These issues are currently under investigation, but a particular diet or supplement has not yet been found to be of benefit. Tremor Stooped posture Mask-like facial expression There are also surgical treatments available for Parkinson’s disease. Largely, these are done in tertiary care centers and are reserved for patients who are not doing well with currently available medical treatments. While there can be complications from these surgeries, for some patients they can improve the quality of life. What else can be done to help symptoms? As it is for many neurologic conditions, physical therapy is quite important in maintaining and improving an individual’s functional abilities and quality of life. Physical therapy geared towards walking can improve balance and endurance. Occupational therapy can improve a patient’s ability to perform fine movements with the hands and daily activities. Speech therapy can improve any issues a patient has with speaking and swallowing. There are specialized programs that are available to Parkinson’s patients, including LSVT BIG and LSVT LOUD (see page 7). Rigidity Arms flexed at elbows and wrists Tremor What should I expect with Parkinson’s disease? Hips and knees slightly flexed Short shuffling steps Symptoms of Parkinson’s disease 6 Phelps Today Parkinson’s disease is a “neurodegenerative” disorder, which means that the disease will progress over time. However, it is hoped that some of the medications now available may slow down this progression. In general, the older one is when symptoms begin, the less rapidly the disease tends to progress, but monitoring and treatment by a neurologist helps predict how the disease will behave in a specific patient. It is important for a person with symptoms to seek medical attention as soon as Parkinson’s is suspected. Neurologist Douglas D. Sankar, MD, is a Phelps Medical Associates physician. He is board certified in neurology and clinical neurophysiology and is a clinical assistant professor at New York Medical College. Dr. Sankar earned his medical degree from Boston University School of Medicine and completed an internship in internal medicine, a residency in neurology and a fellowship in neurophysiology, all at New York University Medical Center. Dr. Sankar sees patients on the Phelps campus in Suite 560 of the 755 Building (914-366-5440). What Are LSVT BIG and LSVT LOUD? Phelps offers two intensive exercise programs that have been shown to slow down the effects that Parkinson’s disease has on voice and mobility and to improve patients’ quality of life. The first, Lee Silverman Voice Treatment (LSVT LOUD), for voice disorders related to Parkinson’s, is offered in the Speech and Hearing Center at Phelps by speech therapists who are certified in LSVT LOUD. The focus of this program is to increase vocal loudness, but it may also result in slowing down a patient’s rate of speech and improving his or her overall speech clarity. One of the reasons the program has such a high rate of success is that patients are able to immediately apply what they have learned during therapy to their conversational speech. The second, called LSVT BIG, is provided in Phelps’ spacious outpatient physical therapy department, where therapists certified in LSVT BIG train patients with Parkinson’s to use bigger movements when performing activities of daily living. The exercises increase the amplitude or “bigness” of limb and body movement and improve trunk rotation, gait and balance. Patients learn strategies to help them more easily get in and out of bed, tie their shoes, button and unbutton their clothing and go up and down stairs. Both of these programs consist of 16 individual one-hour sessions, four days a week over a four-week period and include exercises for patients to do at home. For more information about LSVT BIG, call 914-366-3700. For information about LSVT LOUD, call 914-366-3010. A speech therapist performs voice exercises with patients during an LSVT LOUD session. Physical therapists demonstrate some of the LSVT BIG movement exercises. Phelps Today 7 Sleep Apnea: Oral Appliances Make Treatment Easier More than 18 million Americans have sleep apnea, many of whom have not been diagnosed. Anyone can develop this condition, but it most commonly affects people who are middle aged or older and those who are overweight. If you have any of the following symptoms, speak to your doctor about whether you might have Obstructive Sleep Apnea or another sleep disorder. •Snoring •Waking up choking or gasping for breath •Waking up unrefreshed •Excessive daytime sleepiness •Morning headaches or migraines •Forgetfulness and lack of concentration •Fatigue •Sleepiness while driving •Irritability, depression, mood swings or personality changes •Decrease in sex drive O bstructive Sleep Apnea is a very common and potentially life-threatening medical disorder that occurs when the upper airway becomes blocked by excess tissue, large tonsils or the collapsing of relaxed muscles during sleep. If the blockage prevents adequate air intake, it can cause a reduction of oxygen in the blood. Risk for heart disease, stroke and diabetes is higher among people who have Obstructive Sleep Apnea. In addition, individuals with this condition are more likely to have car accidents due to chronic daytime sleepiness. 8 Phelps Today Diagnosing a Sleep Disorder The standard for diagnosing Obstructive Sleep Apnea and most other sleep disorders is a sleep study. This noninvasive overnight evaluation, conducted in a sleep center, provides information about a person’s sleep patterns, breathing, level of oxygen in the blood, electrical activity of the heart and muscle activity. CPAP Therapy The most common non-surgical treatment for Obstructive Sleep Apnea is Continuous Positive Airway Pressure (or CPAP) therapy, which requires the patient to wear a mask or nose piece that is hooked up to a hose coming from a small machine. Air blows through the hose and into the throat, keeping the airway open. Oral Appliance Airway Opened Oral Appliance Therapy For patients who have been diagnosed with mild to moderate Obstructive Sleep Apnea and have not had success with CPAP therapy, oral appliance therapy is an excellent option. The oral appliance fits in the mouth like an orthodontic retainer and helps prevent the collapse of the tongue and soft tissue in the back of the throat during sleep, keeping the airway open and promoting adequate air intake. An oral appliance is easy to use, comfortable, and small enough to bring along when traveling. Most people become accustomed to wearing their oral appliance in a couple of weeks. This form of therapy is covered by Medicare and most medical insurances. Ensuring a Proper Fit Although oral appliances of various types have been on the market since the 1980s, it was not until 2012 that the FDA approved a product that helps determine the most effective settings for these devices. The Sleep Center at Phelps now offers a new service called an oral The oral appliance fits in the mouth like an orthodontic retainer and helps prevent the collapse of the tongue and soft tissue in the back of the throat during sleep, keeping the airway open and promoting adequate air intake. appliance titration for patients who want to pursue oral appliance therapy. During the study, which is done overnight in the Sleep Center, a sleep technologist uses cutting-edge technology to monitor and remotely adjust the oral appliance (in tenths-of-a-millimeter increments) while the patient sleeps. The results are evaluated by one of the Sleep Center’s board-certified sleep medicine physicians, who determines whether an oral appliance is effective for treating the patient’s sleep apnea. If so, precise settings for the appliance are calculated and given to a dentist to custom make an oral appliance to fit the patient. The oral appliance titration method Phelps uses is less intrusive and more effective than the process used in most other sleep centers, where the technologist wakes up the patient multiple times throughout the night to manually adjust the device inside the patient’s mouth. In addition to disrupting the patient’s sleep, which detracts from the study, it is a much less precise method since the adjustments cannot be finely calibrated. Getting a Good Night’s Sleep Adequate sleep is essential to our health and our ability to function mentally and physically. Treating a sleep disorder can improve quality of life in many ways. The Phelps Sleep Center The Sleep Center at Phelps is fully accredited by the American Academy of Sleep Medicine. It is staffed by physicians who are board certified in sleep medicine and by authorized polysomnographic technologists. Patients are provided with a private bedroom and bathroom, as well as amenities such as in-room television and continental breakfast. In addition to nighttime sleep studies, the center also offers sleep studies during the day for patients who are shift workers or who usually sleep during the day, and daytime PAP-NAP studies, which provide one-on-one time with a sleep technologist to address specific issues a patient may be having with CPAP therapy. If you would like to schedule a sleep study or learn about treatments for sleep disorders, contact the Phelps Sleep Center at 914-366-3626. Phelps Today 9 Phelps Welcomes CIA-Trained Chef Joe Syngjellari I n the spring, the quality of cafeteria food at Phelps stepped up a notch when Executive Chef Joe Syngjellari came on board. Trained at the renowned Culinary Institute of America and with 15 years’ experience in the restaurant industry, Chef Joe has foregone prepared foods, trading them for fresh ingredients that he obtains from local producers. He has created new cafeteria menus that are changed every six weeks. Diners in the cafeteria are enjoying a greater variety of delicious food that is freshly made with the sophisticated techniques of a professionally trained chef. Foods made from scratch include pasta, mashed potatoes, hummus and even the pita bread to accompany it. One item Joe added to the patient menu was a particularly big hit: Joe’s Pot Roast. Presented here is the recipe for the pot roast along with two other favorites. 10 Phelps Today Joe’s Pot Roast with Gravy Turkey Chili Miso Glazed Shrimp Stir-Fry (ten 6-oz. portions) (six 8-oz. portions) (eight 8-oz. portions) Ingredients 4 lbs. beef eye round, 10 sprigs fresh thyme, 1 bunch fresh parsley, 5 bay leaves, 10 garlic cloves, garlic powder, salt & pepper, onion powder, 6 white onions (roughly chopped), 1 head celery (leaves removed, roughly chopped), 3 large carrots (peeled, sliced on bias) Ingredients 4 lbs. lean ground turkey, 2 large white onions (diced small), 1 green bell pepper (diced small), 2 red bell peppers (diced small), 1 cup chili powder, ½ gallon chicken stock, garlic powder to taste, salt & pepper to taste, 10 oz. tomato paste Method Heat a dutch oven on stove over medium high heat. Coat bottom of pan with light olive oil and sear eye round with salt and pepper, onion powder and garlic powder. Remove from pan and reserve. In same dutch over, sweat onions, celery and carrots with parsley, thyme and bay leaves until onions are translucent. Place eye round back into roasting pan after vegetables are cooked and fill pan with water ¾ to the top of the meat. Cover and simmer on low heat for 4-5 hours, until meat is tender, and remove from pan. Method Heat a large skillet over medium high heat. Coat the bottom with light olive oil and cook onions and peppers until translucent, then add tomato paste and ground turkey. When turkey is fully cooked, add chili powder, stir until completely dissolved. Add chicken stock, cover and let simmer for 30 minutes. Season with salt, pepper and garlic. Taste and adjust if necessary. Ingredients 4 lbs. peeled & deveined shrimp, 3 large carrots (julienne), 1 lb. snow peas, 2 large red bell peppers, 16 oz. water chestnuts, ½ lb. sliced shiitake mushrooms, 1 quart miso sauce, ½ cup minced garlic, vegetable oil as needed, salt & pepper to taste. Method Heat a large skillet over medium high heat. Coat the bottom with light olive oil and cook garlic until translucent. Add vegetables and cook until tender, then add shrimp and stir until fully cooked. Add miso sauce, season with salt and pepper, taste and adjust. Serve immediately. Gravy Pour liquid from roasting pan into a large sauce pot, blend it with a stick blender, then strain through a fine mesh colander into another pot. Bring it to a slow simmer and whisk in a cornstarch slurry (2oz. cornstarch/2oz. water mixed together until pasty consistency), season with salt and pepper and serve on top of pot roast. Phelps Today 11 Treating Swallowing Disorders With Neuromuscular Electrical Stimulation NMES has been shown to be an effective addition to the treatment of swallowing disorders for many patients. F or most people, swallowing is an act that requires no special effort. For those with swallowing problems (dysphagia), however, it can be a difficult and arduous task that directly impacts nutrition and hydration. When swallowing foods, liquids or even one’s own saliva is difficult, it can affect physical health and create social and emotional problems. People who are most likely to develop swallowing problems are those with neuromuscular conditions or diseases, including stroke, traumatic brain injury, Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis (Lou Gehrig’s disease), myasthenia gravis, progressive supranuclear palsy and Guillain-Barre syndrome. Patients who have had radiation treatment for head or neck cancer are also prone to dysphagia. 12 Phelps Today Treatment for dysphagia traditionally involves teaching patients strategies to aid in the swallowing process. For example, it may help to change the consistency of food and liquids, position the head in a certain way when eating or drinking, control the amount of food or liquid taken in each bite or sip, eat slowly, and drink additional liquid after each swallow to clear out any residue. There are also exercises that increase the strength and coordination of muscles in the throat to reduce delays in triggering the swallow, direct food and liquid to the right pathway, protect the airway during the swallow, and open the muscle at the top of the esophagus to allow food to pass to the stomach. The most advanced treatment for dysphagia is neuromuscular electrical stimulation (NMES). Utilizing the VitalStim® program, external electrical stimulation is delivered to muscles of the neck through electrodes placed on the skin at specific points. This stimulation elicits contractions and “reeducates” muscle function. Patients also practice eating and drinking and perform other exercises with the electrodes in place. The therapy program is intense, usually scheduled three times a week for 18 sessions. Although improvement is not guaranteed, NMES has been shown to be an effective addition to the treatment of swallowing disorders for many patients. VitalStim® therapy has been cleared by the FDA since 2001. All staff in the Speech & Hearing Center at Phelps have completed this specialty program for dysphagia therapy, which is now accredited by the Institute for Credentialing Excellence. Before a patient can be assessed as to whether he or she is a candidate for NMES therapy, a radiology test called a Modified Barium Swallow study is required. For more information about NMES, call the Speech & Hearing Center at Phelps at 914-366-3010. Family Medicine Residency Program Graduates Its First Class I n June, the NYMC Phelps Family Medicine Residency Program held graduation ceremonies for its inaugural class of six doctors who had completed their training as family medicine physicians – primary care doctors who take care of patients from birth through their senior years. “Three years ago, this select group arrived at Phelps from medical school to begin residency, sharing in our vision of a brand new program dedicated to training the best and brightest family medicine physicians,” says Program Director Shantie Harkisoon, MD. The hope has always been that graduates would choose to stay in the area after they completed their residency, benefiting the region with excellent family physicians. “It is bittersweet to see them leave the program as they embark on a new journey, but it is truly a gift that all six have planned to continue practicing medicine in Westchester County and New York,” says Dr. Harkisoon. Anesh Badiwala, MD, will become a member of Phelps Medical Associates, the hospital’s primary and specialty care medical group; Jorge M. Espana, MD, has joined the staff of Open Door Family Medical Centers in Port Chester; and London Muse, MD, has accepted a teaching position on the faculty of the NYMC Phelps Family Medicine Residency Program. Sara Marie Paul, MD, will complete fellowship training in obstetrics at Lincoln Medical and Mental Health Center in the Bronx. Batel Isenstein, MD, and George Elkomos, MD, have not finalized their plans but intend to remain in the Westchester area. The NYMC Phelps Family Medicine Residency Program is a collaboration developed by three major Westchester health institutions: New York Medical College in Valhalla is the sponsoring academic institution for the program; Phelps and its physicians provide residents with the broad range of clinical training that is required for board certification in family medicine; and residents see outpatients at Open Door Family Medical Centers’ Sleepy Hollow location. The residency program received national accreditation in 2011 and was recently reaccredited for a period of 10 years. Further information on the NYMC Phelps Family Medicine Residency Program is available at www.nymcphelpsresidency.org or by calling 914-366-5350. “It is bittersweet to see them leave the program as they embark on a new journey, but it is truly a gift that all six have planned to continue practicing medicine in Westchester County and New York.” The inaugural class: (back row) Anesh Badiwala, MD; George Elkomos, MD; Jorge M. Espana, MD; (front row) Sara Marie Paul, MD; Batel Isenstein, MD; London Muse, MD Phelps Today 13 Low-Dose CT Screening for Lung Cancer By Avraham Merav, MD To Be Covered by Insurance U p until now, many lung cancer survivors owed their good fortune to luck – an incidental discovery of a lung nodule on an X-ray or a CT scan that was done for a totally unrelated reason. In the past, screening for lung cancer was usually performed with chest X-rays and sputum analysis. A better way to screen for lung cancer was revealed in 2011 by a study called the National Lung Screening Trial, involving 53,454 active or former cigarette smokers ages 55 to 75 years, which showed that low-dose CT scans detected more lung cancers than standard chest X-rays. Participants who received CT screening had a 20 percent lower risk of dying from lung cancer than those who received plain X-rays. Cost should no longer be a deterrent for access to this more effective type of screening, because the study results prompted an Affordable Care Act 14 Phelps Today requirement for medical insurance companies to cover low-dose CT screenings for individuals at high risk. Risk for developing lung cancer is considered high among current or former cigarette smokers age 55 to 75 with a history of more than “30 pack years” (one pack a day for 30 years or 2 packs a day for 15 years, etc.). Lung cancer kills more people each year than colorectal cancer, breast cancer, pancreatic cancer and prostate cancer combined. If detected early, before symptoms begin, lung cancer is often curable. With the cost of screening covered by insurance, including Medicare, more people will be able to be screened, diagnosed and treated early. Phelps Memorial Hospital established the Westchester Lung Nodule Center to offer screenings for individuals who are at risk of developing lung cancer. Information about the Westchester Lung Nodule Center’s screening program is available online at lungnodulecenter. org or by calling 914-366-2333. Dr. Avraham Merav is director of the Westchester Lung Nodule Center and chief of thoracic surgery at Phelps. A cardiothoracic surgeon for several decades, he has performed thousands of open heart and thoracic surgical procedures. He did pioneering work on lung transplantation while at Montefiore Medical Center, where he was chief of thoracic surgery. He was also chief of thoracic surgery at Englewood (NJ) Hospital. Dr. Merav earned his medical degree at the University of Basel and completed a residency in general surgery and a fellowship in cardiothoracic surgery at Montefiore Hospital and Medical Center. He is board certified in general surgery and thoracic surgery and was an associate clinical professor of cardiothoracic surgery at Albert Einstein College of Medicine. Dr. Merav speaks six languages (Hebrew, French, German, Hungarian, Yiddish, and English). His office is in Suite 535 in the 755 North Broadway building on the Phelps campus (914-366-2333). Orthopedic Excellence Continues P helps is known for being at the leading edge in orthopedics. Its surgeons excel at performing advanced, complex procedures, from sports injury surgeries to joint replacements. The hospital was the first to offer anterior approach hip replacement, which was brought to the region by Dr. Corey Burak. Patients have access to nonsurgical options as well, such as a specialized injectionand-exercise protocol to control arthritic knee pain, which was developed by Dr. J. Robert Seebacher. The breadth of orthopedics continues to expand with the addition of orthopedic surgeon Dr. Jason Hochfelder to the Phelps medical staff. Dr. Hochfelder brings expertise in hip and knee replacement and hip arthroscopy. He is also experienced in a procedure previously unavailable at Phelps called ACI (Autologous Chondrocyte Implantation), a treatment for cartilage damage that is an option for people who are too young for knee replacement. All Phelps surgeons and their patients are benefiting from the hospital’s brand new SurgiCenter, which opened in February. It provides the latest technology and an optimal environment for the performance of all types of surgeries. Patients enjoy exceptional comfort, with private rooms – some with a Hudson River view. Phelps’ excellence in performing joint replacements was recognized in July in the annual hospital rankings published Orthopedic surgeon Jason Hochfelder, MD, recently joined the Phelps medical staff by U.S. News & World Report, which rated Phelps as High Performing for hip and knee replacement. The same report ranked Phelps #16 overall in New York State out of 250 hospitals. To learn more about Phelps orthopedic services or physicians, visit phelpshospital.org, or call Physician Referral at 914-366-3367. Finding Better Balance L oss of balance is an unwelcome condition experienced by many people as they age. Sometimes dizziness comes on suddenly, and sometimes people feel a gradual loss of balance over time. It may result from an illness, but often the cause is not obvious. No matter why it happens, dizziness can have a devastating effect on a person’s quality of life. The focus of testing conducted at the Phelps Balance Center is the evaluation of various aspects of the inner ear balance (vestibular) system. The results of these tests are used to diagnose many of the most common forms of dizziness. Quick and precise diagnosis of a balance disorder is an extremely important first step toward helping patients deal with their symptoms. For more information about the Balance Center or to schedule an appointment, call 914-366-1700. The Phelps Balance Center continues to expand and offers the latest diagnostic techniques and treatments for patients experiencing dizziness and imbalance. Phelps Today 15 It Takes a Committed Exceptional healthcare doesn’t occur in a vacuum. At Phelps, it is the result of many people supporting our programs and services, ensuring our ability to continue delivering the quality healthcare for which the hospital is known. Following are some examples of the impact our supporters have had on the quality of care at Phelps and in the community. Breast MRI Technology for Advanced Diagnosis of Breast Cancer When Phelps opens its new MRI suite in late 2015, there will be a significant enhancement to the MRI services offered, thanks to the generosity of an anonymous donor who provided funding for the purchase of breast MRI coil technology. This new technology transforms the magnet used during an MRI scan into a system for dedicated breast imaging. The shape of the coil enables radiologists and technolo- Emergency Training and Skill Development The Hoch Center for Emergency Education, established through the generosity of Lisina and the late Frank Hoch, is located on the Phelps campus and provides a full range of emergency training and education programs to physicians, nurses, paramedics, EMTs, and other emergency healthcare professionals. To enrich the center’s pediatric training capabilities, 16 Phelps Today the Children’s Dream Foundation, a long-time supporter of Phelps, funded the purchase of “SimNewB” and “SimJunior,” two human simulation manikins, one representing a newborn and the other a six-yearold boy. These manikins simulate a full range of age-appropriate pediatric responses, from healthy patients who are crying or talking to unresponsive patients in critical condition. They are excellent resources for the training of medical staff in patient assessment, airway management skills, cardiac rhythm recognition, team dynamics, rapid response and emergency interventions. gists to customize the equipment to accommodate different breast sizes, which not only makes the MRI experience more comfortable for patients but also results in higher-quality images. Phelps is designated as a Breast Imaging Center of Excellence by the American College of Radiology’s Commission on Quality and Safety, and this new resource expands the diagnostic and treatment capabilities of our Breast Center team. Community... Baby-Friendly Hospital Initiative As part of its commitment to the World Health Organization’s Baby-Friendly Hospital Initiative (BFHI) – a global effort to implement practices that promote and support breastfeeding – Phelps is redesigning the way care is provided to mother and infant in the Maternal Child Health Unit, where more than 1,000 babies are welcomed each year. Instead of keeping newborns in a large central nursery, most babies will stay in patient rooms with their mothers (“room in”), and nurses and medical staff will visit the room to support mom and baby together. To help staff serve our maternity patients more effectively, the friends and family of Diane Lane, RN, NP, and the The Annual Fund Annual Fund giving is the lifeblood of a community hospital. The monies raised through the Annual Fund provide unrestricted support, giving Phelps the flexibility to use these resources wherever they are needed most. Annual Fund gifts have been used to purchase equipment, fund programs and support the people who bring our exceptional healthcare to our patients. Phelps remains committed to its mission to offer the community the very best healthcare, and through the support of our donors, we have the resources to make this mission a reality. We are especially grateful to individuals like Mr. Howard Dean, who understand the important role of the Annual Fund and support this program in a significant way. O’Neill family, honoring Dr. Harry Lubell for a lifetime of service to our community, each underwrote the purchase of a Nursery on Wheels (NOW), a wheeled cart that stores supplies and a laptop. The NOWs will provide key support for nurses as they move from room to room caring for mother and baby. Pulmonary Rehabilitation Pulmonary Rehabilitation offers those with lung disorders the ability to improve their quality of life through an exercise program tailored to their individual needs. Wanting to provide pulmonary patients with advanced resourc- es to help them return to a more active lifestyle, the van Hengel family funded the purchase of a Monark rehab trainer and table. The trainer is an important piece of equipment for upper-body conditioning of the accessory muscles used for breathing. It is also an effective lowerbody ergometer, which measures the amount of work performed during muscular activity and is useful to patients who are working to get back into shape after a knee or leg injury. Phelps Today 17 Recognition Phelps Radiology: A Diagnostic Imaging Center of Excellence T he radiology department at Phelps has been designated a Diagnostic Imaging Center of Excellence™ by the American College of Radiology (ACR), one of only 17 hospital radiology departments in the U.S. to have achieved this designation and the only one in the region. “We are extremely proud that our radiology department has received this designation. It validates our commitment to superb patient care and quality and our focus on the highest level of patient safety. Phelps earned this designation ahead of approximately 99.8% of all U.S. hospitals.” In announcing the designation, Michael Glennon, Senior Administrative Director of Ancillary Services at Phelps, said, “We are extremely proud that our radiology department has received this designation. It validates our commitment to superb patient care and quality and our focus on the highest level of patient safety. Phelps earned this designation ahead of approximately 99.8% of all U.S. hospitals.” To become a Diagnostic Imaging Center of Excellence – an elite distinction recognizing the highest level of medical imaging care – a facility must first have accreditation for all of the ACR-rated imaging services it provides. The ACR then undertakes a comprehensive assessment of the entire medical imaging enterprise, including its structure, patient outcomes, credentials of professional staff, technology, and policies and procedures the organization follows. Excellence in all of these aspects contributes to superior patient care. To maintain this designation, a center must submit monthly data to the ACR and undergo an onsite survey every three years. It must also participate in several national data registries, disclosing information such as radiation dosages administered and turnaround times for test results. The Phelps radiology department performs a full spectrum of services for early detection and diagnosis of medical conditions, including bone densitometry, breast imaging ultrasound, MRI, CT scan, nuclear medicine, angiography and diagnostic radiology (914-366-3430). The new MRI facility will soon be opening on the hospital campus. Radiology services are also available in the Phelps location in the ShopRite Plaza in Croton-on-Hudson (914-269-1701). RECOGN Phelps Today ION 18 IT (l to r): Phelps President & CEO Daniel Blum, Sr. Administrative Director of Ancillary Services Michael Glennon, Radiology Manager Biagio Siniscalchi, and Director of the Department of Radiology Robert Perelman, MD. Recognition Craig Zalvan, MD, Named a 2015 Westchester Magazine “Healthcare Hero” Dr. Zalvan is known throughout the region as the go-to person for chronic cough and voice and swallowing disorders. He has given hope to patients who have been frustrated by the lack of progress or treatment for their medical conditions. He was instrumental in creating the Institute for Voice and Swallowing Disorders at Phelps, which has helped thousands of singers, public speakers, teachers and others regain and improve their voices. His team has also restored and improved swallowing function to many patients, preventing pneumonia and restoring their ability to eat. Dr. Zalvan has led the region in educational outreach concerning these disorders by sponsoring a yearly World Voice Day event to increase public awareness of voice disorders. He leads quarterly meetings with local voice professionals to elevate the quality of care and knowledge of voice problems and lectures locally, nationally and internationally on these topics. Dr. Zalvan is an associate professor at New York Medical College, a faculty member of the NYMC Phelps Family Medicine Residency Program, and an adjunct professor at Mercy College, where he teaches graduate-level speech pathology students. Dr. Zalvan has also donated his time and expertise internationally, performing medical outreach in South America. Through Healing the Children, Northeast, he has traveled to Peru and Ecuador, providing surgery for cleft lips and palates and vocal disorders. In April, he traveled to Lima, Peru, where he led a voluntary team on a surgical mission and a conference focused on teaching laryngology techniques used in the United States to local ENT doctors, enabling them to provide care to people in their country. To learn more about the Institute for Voice and Swallowing Disorders, call 914-366-3636. Dr. Zalvan has led the region in educational outreach concerning these disorders by sponsoring a yearly World Voice Day event to increase public awareness of voice disorders. Craig Zalvan, MD, with Judith Christopher, director of the Donald R. Reed Speech & Hearing Center, who nominated Dr. Zalvan for this honor. O R E C G NI C raig Zalvan, MD, a laryngologist and medical director of the Institute for Voice and Swallowing Disorders at Phelps, was selected as one of 10 individuals worthy of Westchester Magazine’s 2015 “Healthcare Heroes” award who were honored at a luncheon held in May at the Royal Regency Hotel in Yonkers. This honor is bestowed upon health professionals who have demonstrated leadership in the local healthcare field, commitment to community service and excellence in patient care. O I T N Phelps Today 19 Recognition Phelps Nurses: Experts in Geriatric Care H ospitalized seniors have needs that are not common among younger patients. The elderly have a greater propensity for developing pressure ulcers, dehydration or malnutrition, and they are at greater risk for falls. Geriatric patients may suffer from sleep deprivation or delirium, and they may be incontinent. With a desire to meet the unique needs of geriatric patients, in 2012 Phelps nurses became part of a program called NICHE (Nurses Improving Care for Healthsystem Elders), a leading nurse-driven program designed to help hospitals and healthcare organizations improve the care of older adults. Based at New York University College of Nursing, NICHE is now part of the philosophy and practice at more than 600 healthcare facilities across the U.S. At this point, Phelps has achieved Level III NICHE status (out of four levels) based on various initiatives and achievements. At present, Phelps has approximately 70 RNs who have become Geriatric Resource Nurses and 60 technicians who have become Geriatric Patient Care Associates. Along with an interdisciplinary Phelps nurses provide specialized care for geriatric patients. team of board-certified physicians, they work with patients and their families to develop individualized treatment plans that take into account the patient’s medical, social and psychological needs. “We’ve seen a number of significant improvements as a result of NICHE training,” says Cheryl Burke, RN, NICHE Coordinator. “To address risk for RE ITION Phelps Today GN 20 C O Based at New York University College of Nursing, NICHE is now part of the philosophy and practice at more than 600 healthcare facilities across the U.S. At this point, Phelps has achieved Level III NICHE status (out of four levels) based on various initiatives and achievements. falling, for example, we instituted 15-minute safety rounds – where staff check in on elderly patients every 15 minutes in addition to performing hourly rounds – and that has resulted in a decrease in patient falls. NICHE training has also made our staff better able to recognize early delirium, which can often be related to dehydration, urinary infections, an electrolyte imbalance or pain. Educating staff about how elderly patients differ from younger ones, including how they metabolize medications, how their pain presents itself, and their different nutrition and fluid needs helps us prevent ‘geriatric syndromes’ such as falls, pressure ulcers, delirium, malnutrition and inadequate pain management.” Recognition Dr. Emil Nigro: Recognized by Children’s Dream Foundation Dr. Nigro led the design of a brand new, state-of-the-art emergency department that opened at the end of 2008, providing a level of comfort and privacy unique among community hospitals in Westchester. The facility was so extraordinary that other hospitals in the region used it as a model for their own emergency department upgrades. In the Children’s Dream Foundation gala journal, Dr. Nigro is described as “an individual who has devoted his entire professional life to improving emergency medical care for everyone in our community.” In recognition of all he has accomplished at Phelps and his dedication to providing quality emergency care to the community, Dr. Nigro will be honored at Phelps’ annual Champagne Ball in November. G Dr. Nigro has been an emergency medicine physician and administrator at Phelps since 1984. During his early years as Medical Director of the Emergency Department, he updated and enhanced the department’s systems, oversaw the renovation of the original facility, implemented a formal triage system, and instituted a mandate that all department physicians be board certified in emergency medicine. An innovator in emergency medicine training programs throughout his career, Dr. Nigro was instrumental in the development of the emergency life support education programs offered by Phelps to the community’s first responders. He was instrumental in initiating the practice of providing life-saving interventions in the field, before patients arrived at the hospital. The education programs expanded and formally became the Hoch Center for Emergency Education in 2008, a high-tech facility where approximately 3,000 first responders from throughout the Hudson Valley are trained every year. Dr. Nigro continues to be very involved with the local Ambulance Corps, as well as fire and police departments and other community organizations. TION I N RECO L ast May, Emil Nigro, MD, FACEP, Director of Emergency Medicine at Phelps, received the 2015 Medical Service Award from the Children’s Dream Foundation, an organization dedicated to improving children’s healthcare in the Hudson Valley. The award was presented at the foundation’s annual gala. An innovator in emergency medicine training programs throughout his career, Dr. Nigro was instrumental in the development of the emergency life support education programs offered by Phelps to the community’s first responders. Phelps Today 21 Recognition Cheryl Burke Named Top Nurse at Hudson Valley Magazine’s Excellence in Nursing Awards Event C heryl Burke, MS, MBA, RN-BC, WCC, a nurse educator at Phelps, received Hudson Valley Magazine’s “Top Nurse Award” at its 8th annual “Excellence in Nursing” event in May. The annual event during National Nurses Week celebrates the region’s finest nurses, and Cheryl Burke was selected for the highest honor from among 45 nominated nurses from regional hospitals and healthcare facilities. “In addition to being innovative, Cheryl is nurturing, enthusiastic and above all, patient, in her position as a clinical educator,” said Mary McDermott, Chief Nursing Officer at Phelps. “She is a true role model in pursuit of excellence in patient care and she encourages staff to participate in scholarly activities, which demonstrates her commitment to lift up those around her. Cheryl truly deserves this recognition.” A Registered Professional Nurse, Burke has significantly impacted the lives of thousands of patients and their families over the course of her 35-year nursing career. She has increased Cheryl Burke (right) with Jack Driscoll, Associate Publisher of Hudson Valley Magazine. the knowledge of countless RNs and has been a valuable asset to Phelps by bringing numerous patient care programs to life. She helped develop the hospital’s Rapid Response Team (a medical team that arrives within five minutes anywhere on the hospital campus to help patients or visitors who require urgent medical intervention) and the palliative care and stroke programs, all of which have contributed to better care for hospitalized patients. A Registered Professional Nurse, Burke has significantly impacted the lives of thousands of patients and their families over the course of her 35-year nursing career. Her most recent display of commitment to Phelps and the community is the implementation of the NICHE program (Nurses Improving Care of Healthsystem Elders) to meet the needs of geriatric patients, which has achieved Level III status (out of 4 levels). In her 10 years at Phelps as a clinical educator, she has successfully oriented more that 100 new staff members to the professional role of the RN. She also is a resource to several local colleges, working with senior students on their projects. Burke holds two masters degrees and two National Board certifications. In addition, she maintains her competency in chemotherapy administration. RECOGN IT Phelps Today ION 22 Recognition U.S. News & World Report Ranks Phelps #16 in New York replacement. This performance recognizes Phelps’ track record of maintaining high quality standards in delivering healthcare. Recognition Phelps Recognized as a Fit-Friendly Worksite P helps Memorial Hospital Center has been named a “Platinum-Level FitFriendly Worksite” by the American Heart Association for helping its employees eat better and move more. “Physical activity and employee wellness are important priorities at Phelps. We are honored and excited to be recognized by the American Heart Association as a Platinum-Level Fit-Friendly Worksite,” said Daniel Blum, President and CEO of Phelps. “We’re committed to providing the best workplace environment possible. This program benefits our employees’ health and produces positive results for our hospital as a whole and ultimately our patients.” To achieve AHA Platinum-Level status, Phelps reported its accomplishments in the areas of healthy eating and fitness. The healthy eating initiatives include taking a proactive approach to food preparation and distribution in the cafeteria by linking portion size to cost to encourage staff (and the public) to purchase and consume smaller portions. The hospital also has vending machines stocked with healthy choices and a device that provides the nutritional content of the various vending machine offerings. For Phelps, the 2015-16 regional rankings took into account care performance in hip and knee replacement surgery, heart failure and chronic lung disease. G For more than 25 years, U.S. News & World Report has published its annual list to help patients make well-informed choices about their healthcare. These reports and the quality data from which they’re derived highlight hospitals that perform best in specific areas of care. TION I N RECO U . S. News & World Report released its annual hospital rankings on July 21, and Phelps Memorial Hospital was ranked #16 in New York State, out of 250 hospitals. In the New York metro area, which includes New York City, Long Island, Westchester County and Northern New Jersey, Phelps was ranked #18. In addition, Phelps was rated as “High Performing” for hip replacement and knee Phelps’ Employee Wellness programs include free annual health screenings, on-site physical activities, walking competitions, free monthly smoking cessation classes, a gym reimbursement program and a series of Lunch and Learn educational programs on a variety of topics such as healthy eating and stress management. Phelps Today 23 Recognition Phelps Stroke Center Receives “Gold Plus” Award from American Heart/American Stroke Associations for 6th Consecutive Year A ccording to the American Heart/American Stroke Associations, stroke is the number five cause of death and a leading cause of adult disability in the U.S., where 795,000 people suffer a new or recurrent stroke every year. On average, someone has a stroke every 40 seconds and someone dies of a stroke every four minutes. Get With the Guidelines-Stroke helps hospital teams provide the most up-todate, research-based treatments with the goal of speeding recovery and reducing death and disability for stroke patients. To earn the award, Phelps is required to meet specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include the aggressive use of medications and risk-reduction therapies. “Phelps is dedicated to improving the quality of stroke care, and Get With the Guidelines helps us achieve that goal,” said Elaine Gardner, BSN, RN, CCRN, Stroke Coordinator. “With this award, our hospital demonstrates its commitment to ensuring that our patients receive care based on internationally-respected clinical guidelines.” To contact the Stroke Center at Phelps, call 914-366-3397. RE For the sixth year in a row, Phelps Memorial Hospital Center has received the Get With the Guidelines-Stroke “Gold Plus” Achievement Award for implementing specific quality improvement measures outlined by the American Heart Association/American Stroke Association for the treatment of stroke patients. C NITIO G O N Stroke Team members (back l-r): Candace Huggins, RN, Asst. Nursing Director, ED; Cheryl Burke, MS, RN-BC, Nurse Educator, Med/Surg; Emil Nigro, MD , Medical Director, ED; Sanda Carniciu, MD, Director of Neurology and Stroke Center; Daniel Blum, President & CEO; Elaine Gardner, RN, BSN, CCRN, Stroke Coordinator; Jeffrey Gindi, MD, Hospitalist; Ben Siniscalchi, Manager, Radiology; Andrew Lu, Stroke Center Analyst; (front l-r): Arlene Kritzer, RN, Nurse Coordinator, Telemetry; Veronica DeLaRosa, RN, NP, Nurse Manager, ED; Carol Daley, RN, BSN, Nurse Manager, ICU/PACU; Suzanne Mateo, RN, MSN, Nursing Director, Critical Care/ED. Not pictured: Margaret Cotter-Santos, MS, RN, ACNS-BC, CCRN, CNS, Critical Care; Lora Murphy, RN, MS, Nurse Educator, ED; Nancy Fox, MS, NEA, RN-BC, Director, Organizational Development; Puja Agarwal, PT, DPT, Manager, Physical Therapy and Rehab; Paula Dinu, MS, CCC-SLP, Assistant Director, Institute for Voice & Swallowing Disorders; and neurologists Paul Lleva, MD, and Douglas Sankar, MD. 24 Phelps Today The Phelps Auxiliary – 60 Years of Support T he Phelps Hospital Auxiliary, established in 1955, is a network of dedicated men and women who provide volunteer services and participate in fundraising activities to support the hospital. most important projects – the hospital gift shop and the Cherry Door thrift shop in Tarrytown. Their works have strengthened the hospital’s connection with the community and provided significant resources for Phelps. From the time the hospital opened its doors 60 years ago, the Phelps Auxiliary has been an important resource, and its volunteers continue to enhance a vast range of services. Auxilians have demonstrated creativity in developing and successfully implementing many fundraising endeavors and have voluntarily taken responsibility for the ongoing oversight of the organization’s two It is rewarding for Auxilians to know that the financial support provided through their efforts ultimately helps to save lives. The Auxiliary is committed to continuing its efforts to help ensure that the community continues to receive the very best in healthcare. Being an Auxilian does not require a major time commitment. There are Rose Marie Parise, Phelps Auxiliary President many tasks to be done and positions to be filled. In some cases, the time commitment is only a few days a year, while ongoing projects can give regular purpose in the lives of people who have the time and inclination. For more information about the Auxiliary and how to join, please call Eve Urban at 914-366-3170. Phelps Community Pharmacy Offers New Smartphone Service P atients who fill their prescriptions at the Phelps Community Pharmacy now have an opportunity to learn about their medications and how to use them safely with a new smartphone service called Meds on Cue. Scanning the QR code (barcode) on the receipt with a smartphone provides access to an educational video about the medication in English or Spanish. It also allows the patient to call the pharmacy automatically and request email or text reminders to take a medication or refill a prescription. “We are pleased to be among the first pharmacies to offer this innovative service to make prescription management easier,” says Joseph Paternoster, supervising pharmacist. “The pharmacy staff will be happy to assist our customers with downloading a QR code reader.” The Phelps Community Pharmacy is a full-service pharmacy located on the hospital campus at the ground floor entrance to the 777 building. Hours are 9 am – 6 pm, Monday through Friday. For information call 914-366-1400. Phelps Today 25 Phelps Medical Associates News Phelps Medical Associates, the hospital’s primary and specialty care medical group, provides high-quality, personalized medical care at practices conveniently located on the hospital campus and in the surrounding communities. In addition to offering primary care, the group has specialists in cardiology, endocrinology, gastroenterology, geriatrics, neurology, obstetrics/gynecology, podiatry, rheumatology, thoracic surgery and wound healing. For patients who are having difficulty managing their medications, Phelps Medical Associates has a dedicated pharmacist who offers in-person or phone consultations. A number of physicians have recently joined Phelps Medical Associates: Anjali Ankolekar, MD, who has been on the Phelps medical staff since 2003, is board certified in obstetrics/ gynecology. She attended medical school at Lokmanya Tilak Municipal Medical College in India and completed an internship and residency in obstetrics/gynecology at Mount Vernon Hospital. She sees patients on the Phelps campus in Suite 308 of the 777 Building (914-631-0908). William Boxer, MD, is board certified in internal medicine and has 15 years of primary care experience as the Director of Internal Medicine and Osteoporosis for the Joint Pain Center of New York. Dr. Boxer attended medical school at the State University of New York Health Science Center at Syracuse and completed his internship and residency at Boston University Medical Center. He sees patients on the Phelps campus in Suite 417 of the 755 Building (914366-5490). 26 Phelps Today Lourdes Castano, MD, is board certified in obstetrics/gynecology and has been on Phelps’ medical staff since 2003. She attended medical school at New York Medical College and completed an internship and residency in obstetrics/gynecology at North Shore University Hospital-Manhasset. Fluent in English and Spanish, Dr. Castano sees patients on the Phelps campus in Suite 308 of the 777 Building (914-631-0908). Frank Foto, MD, longtime Phelps rheumatologist, has had a private practice in the community since 1994. He is board certified in internal medicine and rheumatology. Dr. Foto attended medical school at Universidad Autonoma De Guadalajara and completed a residency in internal medicine at Nassau County Medical Center, followed by a fellowship in rheumatology at University of Iowa Hospitals and Clinics. Dr. Foto’s practice is at 310 North Highland Avenue in Ossining (914-762-5555). Syna Kandarappallil, DO, geriatrician, is board certified in internal medicine. She received her doctor of osteopathic medicine degree from New York College of Osteopathic Medicine and completed a residency in internal medicine at St. Francis Medical Center (New Jersey) and a fellowship in geriatric medicine at New York Presbyterian Hospital-Cornell Campus. She sees patients on the Phelps campus in Suite 100 of the 755 Building (914-366-3677). Michael Marchese, MD, endocrinologist, is board certified in internal medicine. He attended medical school at the Ross University School of Medicine and completed a residency in internal medicine at Stamford Hospital, followed by a fellowship in endocrinology, diabetes and metabolism at Albany Medical Center. He sees patients on the Phelps campus at the Diabetes, Osteoporosis and Metabolism Center in Suite 300 of the 777 Building (914-366-2270). In Memoriam Janice Teixeira, DO, MS, is board certified in obstetrics/gynecology and is a Fellow of the American College of Obstetricians and Gynecologists. She attended the New York College of Osteopathic Medicine and completed her residency in Ob/Gyn at St. Luke’s Roosevelt Hospital Center. Dr. Teixeira is an Assistant Professor in the Department of Obstetrics & Gynecology at the Mount Sinai School of Medicine. She sees patients on the Phelps campus in the 777 Building, Suite 308 (914631-0908) and in the 755 Building, Suite 560 (914-366-5400). G a r y Wi l l a r d , MD, a wound care specialist and medical director of Phelps’ Hyperbaric Medicine Center, is board certified in family medicine and has certification in undersea and hyperbaric medicine. He received his medical degree from Universidad Autonoma De Guadalajara and completed an internship and residency in family medicine at University of Southern California Medical Center. He sees patients on the Phelps campus at the Phelps Wound Healing Institute, 755 Building, Suite 230 (914-366-3040). Diana Winston, MD, gastroenterologist, is board certified in internal medicine. She received her medical degree from Indiana University School of Medicine and completed a residency in internal medicine, followed by a fellowship in gastroenterology, both at Tufts University/New England Medical Center. Dr. Winston sees patients on the Phelps campus in the 777 Building, Suite 305 (914-366-5420). John Curran The Phelps family mourns the loss of John Curran, a dear friend whose generous support over many years demonstrated how much he and his wife, Connie, valued their community hospital. Described as one of Phelps’ most gracious supporters, John served on the Phelps Board of Directors for 12 years. In recognition of their extraordinary dedication to Phelps, the hospital honored John and Connie in 2006 at the annual Champagne Ball. John’s wonderful sense of humor and kind, giving spirit will long be remembered. For more information about Phelps Medical Associates providers or to make an appointment, call 914-269-1900 or visit phelpsmedicalassociates.org. Coming Soon! G. Richard Parrino, MD Expansions in Croton and Dobbs Ferry This fall, the Croton-on-Hudson location will be expanded to provide patients with convenient access to more specialty care, including cardiology, endocrinology, gastroenterology, obstetrics/gynecology and rheumatology, as well as internal medicine. The Phelps Radiology facility at the Croton location will offer mammography, bone densitometry, ultrasound and diagnostic X-rays. In Dobbs Ferry, the Phelps Medical Associates office will be moved to larger space in the shopping center on Ashford Avenue, above Walgreens. In addition to primary care, there will be specialists in cardiology, endocrinology, gastroenterology and obstetrics/ gynecology. Phelps will also establish a radiology facility in the new Dobbs Ferry facility. The many Phelps friends and colleagues of Dr. G. Richard Parrino are deeply saddened by his passing. A well respected rheumatologist, Dr. Parrino had a practice in Tarrytown and was a member of the Phelps medical staff for over 40 years. He was instrumental in establishing the Phelps Infusion Center, where he provided advanced treatments that improved the quality of life for countless patients. He will be missed by all who knew him. Phelps Today 27 phelps September Friday, September 18, 2015 Healthy Life Calendar Fall 2015 ensure a clear line of sight over the steering wheel, proper seat belt use and fit, and safe positioning of mirrors to minimize blind spots. National Fall Prevention Awareness Day Taking a few simple steps to prevent falls can help you stay active and remain independent. Attend this informative session and learn what you can do to reduce your risk of falls. 9:00 am –12:00 pm (rain or shine) Phelps parking garage 9:00 am –12:00 pm; Auditorium Call 914-366-3937 to register. Speech Therapy for Parkinson’s Patients: Think LOUD, Speak LOUD Join graduates of LSVT LOUD and learn about this intensive speech therapy program for Parkinson’s disease. Monday, September 28, 2015 Silent Reflux and Cough Screening If you have had a chronic cough for more than six weeks, have excessive throat clearing, feel a lump or burning in the throat, have voice problems, trouble swallowing, or taste acid, attend this screening for evaluation by a throat specialist. Appointments are required. Call 914-366-3705 to schedule. Thursday, October 8, 2015 Andrea Bracciante-Ely, MS.Sp, CCC-SLP, Senior Speech-Language Pathologist 10:30 – 11:30 am Walkway Conference Room Call 914-366-3010 to register. Craig Zalvan, MD, Laryngologist (voice, swallow and cough specialist) Thursday, October 8 and Friday, October 16, 2015 8:30 am – 10:00 am Registration is required. Call 914-366-3010 to register. October Speech-Language Screenings for Preschool Children Are you concerned about your child’s speech and language development? If so, schedule a free speech-language screening with an experienced pediatric speech-language pathologist. Saturday, October 3, 2015 Kim M. Ventimiglia, MS, CCC-SLP, Pediatric Speech-Language Pathologist CarFit for Older Driver Safety An individualized 20-minute educational session for older drivers designed to improve the “fit” of their cars for safety and comfort, promote conversations about safe driving, and link drivers with local resources to enable them to continue driving for as long as safely possible. The trained CarFit team, Phelps’ Occupational Therapy Department, will work with participants to help 28 Phelps Today Thursday, October 8: 1:00 – 2:30 pm Friday, October 16: 10:30 am – 12:00 pm Donald R. Reed Speech & Hearing Center at Phelps 777 North Broadway, Suite 303 Registration is required. Call 914-366-3010 to register. Tuesday, October 13, 2015 Better Breathers Club Learn about how playing the harmonica can help you to breathe better. Harmonicas will be provided. Judy Burns, Director, Phelps Behavioral Health Services 12:00 – 1:00 pm; Pulmonary Lab Registration is required. Call 914-366-3712 to register. Tuesday, October 13, 2015 Controlling the Pain of Arthritic Knees Without Surgery Orthopedic surgeon J. Robert Seebacher, MD, will discuss a non-surgical therapy that often helps people with arthritic knees maintain active lifestyles while postponing – or eliminating – the need for surgery. Learn how injections and exercise can enable reconditioning and reduce inflammation and pain. J. Robert Seebacher, MD, Medical Director of the Phelps Joint Replacement Service 6:30 pm; Auditorium (light refreshments at 6 pm) Call 914-366-3100 to register. Thursday, October 15, 2015 Lung Cancer Screening for High-Risk Individuals Learn about how low-dose CT lung cancer screening for individuals who are at high-risk can save lives. Avraham Merav, MD, Chief of Thoracic Surgery and Director of the Westchester Lung Nodule Center 6:30 – 7:30 pm, Auditorium A light supper will be served at 6:00 pm in the Boardroom. Registration is required. Call 914-366-2333 to register. Monday, October 19, 2015 Swallow Screening Do you sometimes feel food or liquid going down the “wrong pipe” or coming back up? Does food get stuck? Do you have pain when you swallow? If so, you should attend this free swallow screening. Lynne Marie Gagne-LeBlanc, MS, CCC-SLP Andrea Bracciante-Ely, MS Sp, CCC-SLP Paula Dinu, MS, CCC-SLP 9:30 am – 12:00 pm; Walkway Conference Room Registration is required. Call 914-366-3010 to register. aware of that may indicate the need for a counselor, clergy or support group. Phelps Hospice is hosting this community event. The evening will include a film about the ways that grief affects us physically, emotionally and physically and a panel discussion. 6:30 – 8:00 pm Briarcliff Public Library One Library Road, Briarcliff Manor Call 914-366-3325 to register. Monday, November 2, 2015 5:30 – 8:30 pm; Auditorium Free: $45 Registration is required. Call 914-366-3220 to register. Grief: What Helps When It Hurts? While each of us grieves differently, there are things we can do to help ourselves and those around us cope with loss. Learn about the signs to be 11:00 am; Auditorium Registration is required. Call 914-358-5552 to register. Defensive Driving Program This two-evening certification program lowers insurance premiums, reduces violation points and sharpens driving skills. Essential Vocal Warm-ups for the Professional Voice User By performing these systematic exercises, you’ll be able to speak and sing with more freedom. Goals are to release muscle tension, increase range and expressiveness and have fewer vocal problems during a presentation or performance. Thursday, October 22, 2015 Huan Sue Zhou, MD, Urogynecologist November Robert Fogel 6:00 – 7:00 pm; C-Level Classroom Registration is required. Call 914-366-3010 to register. Bladder Health Learn about the anatomy of the bladder and the urinary tract to understand urinary incontinence. Monday, October 26 and Tuesday, October 27, 2015 Tuesday, October 20, 2015 Leah Ross-Kugler, MS, CCC-SLP, Vocal Rehabilitation Specialist Thursday, October 29, 2015 Tuesday, October 27, 2015 How to Choose Hearing Aids Should you trust a “big box” retailer when purchasing a medical device? Purchasing hearing aids is an expensive and sometimes stressful endeavor, but it doesn’t have to be. Learn how an audiologist navigates the hearing aid industry to provide appropriate and comfortable amplification for her patients. Susan D. Reilly, MS, CCC-A, Coordinator of Audiology Services 10:00 – 11:30 am; Auditorium Registration is required. Call 914-366-3010 to register. Balance Screening If you are having trouble with dizziness or imbalance, this is an opportunity to meet with a specialist about your balance problems and receive guidance for next steps for evaluation. Cameron Budenz, MD, Medical Director of the Phelps Balance Center 8:45 – 10:00 am Registration is required. Call 914-366-3010 to register. Tuesday, November 10, 2015 Better Breathers Club Do you experience shortness of breath or have a lung disease? Come learn about what the American Lung Association can do to help. Serena Arrabito, Esq., American Lung Association 12:00 – 1:00 pm; Pulmonary Lab Registration is required. Call 914-366-3712 to register. Phelps Today 29 December Tuesday, December 8, 2015 Better Breathers Club Feeling stressed with the holidays approaching? Learn how stress affects your breathing and how to control it. Susan DiFabio, RRT, CPFT, Coordinator of the Pulmonary Lab 12:00 – 1:00 pm; Pulmonary Lab Registration is required. Call 914-366-3712 to register. Ongoing Bereavement Support Group Spouse/Partner Loss 8 Thursday afternoons from 2:30 – 4:00 pm starting October 1, 2015 755 North Broadway, Suite 545 Bess Steiger, LCSW, Facilitator Parent/Sibling Loss 8 Wednesday evenings from 6:30-8:00 pm starting October 14, 2015 755 North Broadway, Suite 225 Jody Monkovic, LMSW, Facilitator Suggested donation of $10 per meeting. Pre-registration is required. Contact Bess Steiger at 914-366-3957 or bsteiger@pmhc.us. Look Good . . . Feel Better® This free, 2-hour workshop teaches beauty techniques to women undergoing cancer treatment. The program, held monthly at Phelps, includes a hair and makeup consultation. Attendees can take home a complimentary wig and a makeup kit donated by cosmetic companies. The program is offered in partnership with the American Cancer Society, the National Cosmetology Association and the Cosmetic, Toiletry and Fragrance Association Foundation. Call 914-366-3315 or 914-366-3421 to register for an upcoming session, 6:00 – 8:00 pm on Monday, September 14, October 5, November 2 or December 7. 30 Phelps Today Osteoporosis Support and Education A free monthly group program for individuals with osteoporosis, providing education on nutrition, exercise (weight-bearing, strengthening and balance) and activities of daily living. The sessions are held from 11 am to 12:30 pm the second Thursday of the month in the Phelps Boardroom (C Level). Call 914-366-2270 to register for an upcoming session on September 10, October 8, November 12 or December 10. Vitality for Seniors Fridays, September 25, October 2, 16, 23 and November 6, 13 Tai Chi Classes Tai Chi is a graceful form of exercise that reduces stress and improves a variety of health conditions, including arthritis and osteoporosis, through gentle, flowing movements. It involves a series of motions performed in a slow, focused manner and accompanied by deep breathing. 9:30 and 10:30 am; James House To register, call 914-366-3937. Wednesday, September 30, 2015 Spirituality Program: “This Is Your Life: The Critical Place of Life Review in Our Later Years” As we age, we are compelled to tell our life story. This workshop will focus on how to tell your life story both chronologically and spiritually. 9:00 – 10:30 am in the Auditorium To register, call 914-366-3937. Friday, October 2, 2015 Demystifying Medicare The program will present the different Medicare plans. You will receive information on the costs and benefits of each plan to allow you to make informed decisions on your coverage. Topics will include Original Medicare, Medicare Advantage Plans, prescription drug plans, Medigaps (supplemental plans), and cost-saving programs like EPIC that can help seniors with limited resources. The program will help people currently enrolled in Medicare, as well as those soon to be 65, planning their retirement, or assisting relatives and friends with their medical decisions. 9:00 – 12:30 pm in the Auditorium To register call 914-366-3937. Alzheimer’s Caregivers Support Group Alzheimer’s disease is life changing for both those who are diagnosed and those close to them. The Alzheimer’s Caregivers Support Group provides a safe place for caregivers, family and friends of persons with dementia to meet and develop a mutual support system. This group, new at Phelps, meets the second Friday of every month starting September 11. 10:00 – 11:30 am; 755 Building, Room 545 To register call the Alzheimer’s Association at 800-272-3900 or 914-366-3937. Ongoing Vitality Programs Mind Games 1st Wednesday of the Month Breakfast Club 2nd Thursday of the Month Senior Steps 3rd Tuesday of the Month For information, call 914-366-3937. Construction on Campus A new MRI facility being built in the vicinity of the former main lobby will feature a state-of-the-art Siemens 1.5 Tesla Magnatom MRI. With highdensity resolution, the new MRI will provide comprehensive advanced applications, including the ability to screen for breast cancer and tools for evaluating other oncological conditions. The system has a wide diameter that will give patients a feeling of spaciousness, and it is also short enough in length to allow a person’s head to remain outside of the magnet during an exam. Patients will appreciate faster exam times and greater comfort in the new MRI, which will be quieter than traditional MRI scanners and will have special lighting to foster relaxation. Entrances from outside and inside the hospital will create easier access. The MRI building is expected to be completed by the end of November. A new main entrance for the hospital is also under construction. When completed early next year, the more than 1,600 people who come to Phelps every day will enter through the centrally located 7,000-square-foot space, which will feature a welcoming lobby, comfortable seating, a coffee bar and an efficient new admitting area. Phelps Today 31 Preguntas y respuestas sobre la enfermedad de Parkinson Por Douglas D. Sankar, MD Existe una gran cantidad de temores e ideas erróneas asociadas con el diagnóstico de la enfermedad de Parkinson, pero muchas personas no saben que aunque la enfermedad es incurable, es muy tratable. Un poco de conocimiento puede ser de gran beneficio para calmar esos temores. 32 Phelps Today ¿Qué es la enfermedad de Parkinson? Los neurotransmisores, los químicos que comunican la información por todo nuestro cerebro, desempeñan un papel en el control del latido del corazón, la respiración y hasta la digestión. Pueden afectar el estado de ánimo, el sueño, la concentración y el peso, y pueden causar síntomas cuando no funcionan correctamente. En pocas palabras, la enfermedad de Parkinson ocurre cuando una estructura profunda del cerebro llamada Substantia Nigra o “sustancia negra” empieza a morir, lo que ocasiona que se agote la cantidad del neurotransmisor “dopamina.” Gran parte del tratamiento de la enfermedad de Parkinson está dirigida a restablecer las cantidades de dopamina del cerebro. ¿Por qué padecen las personas la enfermedad de Parkinson? Existen muchas teorías de por qué las personas padecen la enfermedad de Parkinson, lo cual básicamente significa que no sabemos por qué. Aunque hay familias en las que la enfermedad de Parkinson es común (15% de los casos), la mayoría (85% de los casos) son “esporádicos” u ocurren sin un motivo claro. Desafortunadamente, la enfermedad de Parkinson no es poco común. De 2 a 4 por ciento de las personas mayores de 60 años tienen probabilidad de tener la enfermedad de Parkinson, con un porcentaje menor en personas menores de 60 años. ¿Cuáles son los síntomas? El síntoma más notable de la enfermedad de Parkinson es el temblor. Sin embargo, no todas las personas con temblores tienen la enfermedad de Parkinson. Una evaluación de un neurólogo a menudo determinará otras causas del temblor, muchas de las cuales son benignas. Un ejemplo es el temblor esencial que tenía Katherine Hepburn, que afectaba a su voz y a sus movimientos de cabeza. Lo que distingue al temblor de Parkinson de un temblor esencial es que típicamente ocurre cuando la persona está en descanso, especialmente cuando las manos están a los lados o en el regazo. El temblor esencial también afecta a las manos, pero es más probable que sea evidente cuando se usan las manos. Los temblores de Parkinson son más lentos que otros tipos de temblores y usualmente empiezan en las manos. Es más probable que el temblor esencial incluya a la cabeza. No todos los pacientes con enfermedad de Parkinson tienen el temblor. Los siguientes son algunos de los otros síntomas importantes de la enfermedad de Parkinson que ameritan una visita al médico. •Br adiquinesia , o lentitud de movimientos, es uno de los síntomas más significativos. La bradiquinesia a menudo es evidente cuando una persona tiene dificultad en las actividades diarias, desde cepillarse los dientes hasta vestirse. A veces es descrita por los pacientes como una sensación de pausa entre cuando el cerebro le dice al cuerpo qué hacer y el cuerpo hace lo que el cerebro le dice. •Trastornos en el andar, o dificultad para caminar. Un andar anormal con pasos cortos, una postura encorvada y los movimientos de arrastre son muy típicos de la enfermedad de Parkinson y pueden interferir enormemente con la capacidad de funcionar de una persona. Los pacientes de la enfermedad de Parkinson a menudo se caen hacia atrás sin mucha provocación. A veces, sienten como si estuvieran caminando muy rápido, y tienen dificultad para detenerse después de caminar. Hay muchos otros factores que pueden sugerir la enfermedad de Parkinson, como cambios en la escritura, específicamente cuando la escritura se vuelve mucho más pequeña de lo que era antes. La voz puede bajar de volumen, o la persona puede tener dificultad para tragar. Puede haber una pérdida de la expresión facial normal, lo que a menudo se describe como “apariencia de máscara.” Además, los pacientes con la enfermedad de Parkinson pueden experimentar afecciones que las personas a menudo no asocian con la enfermedad, incluyendo depresión, trastornos del sueño y trastornos de la memoria. ¿Hay un tratamiento para la enfermedad de Parkinson? En una palabra, ¡SÍ! Hay muchos medicamentos disponibles, incluyendo algunos que podrían desacelerar el avance de la enfermedad de Parkinson. El tratamiento de la enfermedad de Parkinson está enormemente influenciado por muchas variables, incluyendo la edad y la memoria del paciente. Los tratamientos incluyen medicamentos para: •desacelerar la degradación de la dopamina que está en el cerebro •estimular a los receptores de la dopamina, o nervios del cerebro que normalmente se estimularían con la dopamina (“agonistas de dopamina”) •tratar de aumentar la cantidad de dopamina en el cerebro (levodopa o “L-dopa”) Phelps Today 33 Se pueden usar otros medicamentos para tratar de reducir el temblor. Estos medicamentos varían enormemente de persona a persona, y un paciente con la enfermedad de Parkinson típicamente toma pequeñas cantidades de múltiples medicamentos en lugar de una dosis grande de un medicamento para reducir los efectos secundarios potenciales. El manejo de estos medicamentos requiere una interacción muy cercana con un neurólogo con experiencia en la enfermedad de Parkinson. A los pacientes que padecen la enfermedad de Parkinson y experimentan depresión se les puede tratar con antidepresivos, lo que puede mejorar significativamente su calidad de vida. Es importante que cualquier persona que tenga depresión plantee sus inquietudes sobre esta con su médico, pero es especialmente importante para una persona con Temblor Postura encorvada Expresión facial tipo máscara Rigidez Brazos flexionados en los codos y muñecas Temblor Caderas y rodillas ligeramente flexionadas Pasos arrastrados cortos Síntomas de enfermedad de Parkinson 34 Phelps Today la enfermedad de Parkinson. Recibir tratamiento para la depresión puede realmente impactar el bienestar general. A menudo, las personas con la enfermedad de Parkinson preguntan a sus médicos sobre si la dieta o suplementos alimenticios pueden ayudar. Estas cuestiones están actualmente en investigación, pero no se ha descubierto una dieta o suplemento en particular que tenga beneficios. También hay tratamientos quirúrgicos disponibles para la enfermedad de Parkinson. En gran medida, se hacen en centros de atención terciaria y se reservan para los pacientes que no están reaccionando bien con los tratamientos médicos actualmente disponibles. Aunque puede haber complicaciones por estas cirugías, en algunos pacientes pueden mejorar su calidad de vida. ¿Qué debo esperar de la enfermedad de Parkinson? La enfermedad de Parkinson es un trastorno “neurodegenerativo”, lo que significa que la enfermedad avanzará con el transcurso del tiempo. Sin embargo, se espera que algunos de los medicamentos ahora disponibles puedan desacelerar este avance. En general, mientras más grande es uno cuando empiezan los síntomas, la enfermedad tiende a avanzar menos rápido, pero el monitoreo y tratamiento de un neurólogo ayudan a predecir cómo se comportará la enfermedad en un paciente específico. Es importante que una persona con síntomas busque atención médica tan pronto como se sospeche de la enfermedad de Parkinson. ¿Qué más se puede hacer para aliviar los síntomas? Al igual que con muchas afecciones neurológicas, la terapia física es muy importante para mantener y mejorar las capacidades de funcionamiento y la calidad de vida de una persona. La terapia física dirigida a la ayuda a caminar puede mejorar el equilibrio y la resistencia. La terapia ocupacional puede mejorar la capacidad del paciente de realizar movimientos finos con las manos y con las actividades diarias. La terapia de lenguaje puede mejorar cualquier problema que el paciente tenga para hablar y tragar. Hay programas especializados en terapia física que están disponibles para los pacientes de la enfermedad de Parkinson, incluyendo LSVT BIG y LSVT LOUD (vea la página 35). El neurólogo, Dr. Douglas D. Sankar, MD, es un médico de Phelps Medical Associates. Está certificado por la junta médica en neurología y neurofisiología clínica y es profesor adjunto clínico en el New York Medical College. El Dr. Sankar obtuvo su título en medicina en la Boston University School of Medicine y completó un internado en medicina interna, una residencia en neurología y una subespecialidad en neurofisiología en el New York Medical Center. El Dr. Sankar atiende a sus pacientes en el campus de Phelps en la Suite 560 del edificio 755 (914-366-5440). ¿Qué son LSVT BIG y LSVT LOUD? Phelps ofrece dos programas de ejercicios intensivos que han demostrado desacelerar los efectos que la enfermedad de Parkinson tiene en la movilidad y la voz y mejorar la calidad de vida de los pacientes. El primero, Lee Silverman Voice Treatment (LSVT LOUD), para trastornos de la voz relacionados con la enfermedad de Parkinson, se ofrece en el Centro de Habla y Audición de Phelps por terapeutas de lenguaje certificados en LSVT LOUD. El enfoque de este programa es aumentar el volumen vocal, pero también puede resultar en la desaceleración del índice de habla del paciente y en la mejora de su claridad en el habla en general. Uno de los motivos por los que el programa tiene un alto índice de éxito es que los pacientes pueden aplicar inmediatamente lo que aprendieron en la terapia a su lenguaje conversacional. El segundo, llamado LSVT BIG, se ofrece en el espacioso departamento de terapia física ambulatoria, en donde los terapeutas certificados en LSVT BIG capacitan a los pacientes con la enfermedad de Parkinson en el uso de movimientos más grandes al realizar actividades de la vida diaria. Los ejercicios aumentan la amplitud o “grandeza” del movimiento de las extremidades y del cuerpo y mejoran la rotación del tronco, el andar y el equilibrio. Los pacientes aprenden estrategias para ayudarlos a subir y bajar de la cama con más facilidad, a atarse los cordones de los zapatos, a abotonarsey desabotonarse la ropa y a subir y bajar escaleras. Para obtener más información sobre LSVT BIG, llame al 366-3700. Ambos programas consisten en 16 sesiones individuales de una hora cuatro días a la semana en el transcurso de un período de cuatro semanas e incluyen ejercicios para que el paciente haga en casa. Para obtener más información sobre LSVT LOUD, llame al 366-3010. Un terapista del habla hace ejercicios de voz con pacientes durante una sesión LSVT LOUD. Terapistas del habla demuestran algunos de los ejercicios de LSVT BIG. Phelps Today 35 La prueba de tomografía de pecho de baja dosis para detectar cáncer pulmonar será cubierta por el seguro médico H asta ahora, muchos sobrevivientes de cáncer pulmonar le deben su buena fortuna a la suerte – un descubrimiento accidental de un nódulo pulmonar en una radiografía o tomografía que se hizo por algún motivo totalmente diferente. En el pasado, la detección del cáncer pulmonar se hacía usualmente con radiografías de pecho y análisis de esputo. Una mejor manera de detectar el cáncer pulmonar fue revelada en un estudio llamado el Ensayo de prueba de detección pulmonar nacional, que incluía a 53,454 fumadores activos o ex-fumadores de 55 a 75 años, el cual demostró que las tomografías de baja dosis detectaban más cánceres de pulmón que las radiografías de pecho estándar. Los participantes que recibieron detección por tomografía tuvieron un 20 por ciento menos de riesgo de muerte por cáncer pulmonar que quienes recibieron una radiografía común. El costo no será un freno para acceder a este tipo de detección más efectiva, porque los resultados de estudio motivaron un requisito en la Ley de Cuidado de la Salud a Bajo 36 Phelps Today Precio para que las compañías de seguros médicos cubrieran las pruebas de detección en tomografía de baja dosis para personas con alto riesgo. El riesgo se considera alto entre quienes fuman en la actualidad o fumaban anteriormente con un historial de más de “30 años de cajetilla” (una cajetilla diaria durante 30 años o 2 cajetillas diarias durante 15 años, etc.). El cáncer pulmonar mata a más personas cada año que el cáncer colorrectal, cáncer de senos, cáncer de páncreas y cáncer de próstata juntos. Si se detecta a tiempo, antes de que comiencen los síntomas, el cáncer pulmonar es a menudocurable. Con el costo de la prueba de detección cubierto por el seguro, incluyendo Medicare, más personas podrán ser examinadas, diagnosticadas y tratadas oportunamente. Phelps Memorial Hospital estableció el Westchester Lung Nodule Center para ofrecer pruebas de detección a personas que corren riesgo de desarrollar cáncer pulmonar. Hay información disponible sobre el programa de detección del Westchester Lung Nodule Center en línea en lungnodulecenter.org o llamando al 914-366-2333. Por Avraham Merav, MD El Dr. Avraham Merav es director del Westchester Lung Nodule Center y jefe de cirugía torácica de Phelps. Cirujano cardiotorácico durante varias décadas, ha realizado miles de procedimientos quirúrgicos torácicos y a corazón abierto. Realizó un trabajo innovador en el trasplante de pulmón en el Montefiore Medical Center, donde fue jefe de cirugía torácica. También fue jefe de cirugía torácica en Englewood (NJ) Hospital. El Dr. Merav obtuvo su título en medicina en la Universidad de Basilea y completó una residencia en cirugía general y una subespecialidad en cirugía cardiotorácica en el Montefiore Hospital and Medical Center. Está certificado por la junta médica en cirugía general y cirugía torácica y fue profesor adjunto clínico de cirugía cardiotorácica en el Albert Einstein College of Medicine. El Dr. Merav habla seis idiomas (hebreo, francés, alemán, húngaro, yidis e inglés). Su consultorio está en la Suite 535 en el edificio 755 North Broadway del campus de Phelps. (914-366-2333). NEW DATE and Exciting NEW VENUE Phelps Memorial Hospital Center’s 28th Annual Champagne Ball Sleepy Hollow Country Club Briarcliff Manor Friday, November 6, 2015 6:00 pm For more information please visit: phelpsevents.org Maternity and Baby Care Classes The Childbirth Experience/ LaMaze Method Wednesday evenings 7:30 – 9:30 pm for 5-6 weeks Start dates: September 9, October 14 and November 18 OR September 12-13, October 17-18, November 14-15 and December 12-13 Cost: $170 per couple Breastfeeding: First Choice for Babies September 8, October 8, November 2 and December 1 7 – 9 pm Cost: $45 per couple ABCs of Baby Care September 7, October 15, November 19, December 17 7 pm Cost: $65 per couple Totsaver Program: American Heart Association CPR for Family and Friends September 5, October 3, November 7 and December 5 9 am – 2 pm $55 per person For up-to-date schedule, visit www.phelpshospital.org or call (914) 366-3382 for information or to register. Cancellation policy: Registrants are entitled to a full refund if cancellation is requested up to 1 week prior to start of class, and a 50% refund after that date. Prenatal Clinic: Phelps Memorial Hospital Center and Open Door Family Medical Center, participants in the Medicaid Prenatal Care Assistance Program, jointly sponsor a Prenatal Program. Care for expectant mothers is provided by a highly trained, caring, bilingual staff. No one is turned away based on income or health insurance. Women are encouraged to seek prenatal care early in their pregnancy. Care is provided at Open Door during the first 36 weeks of pregnancy and at Phelps Memorial Hospital during the remainder of the pregnancy and for delivery. For information, call: (914) 941-1263. Atención Prenatal: Phelps Memorial Hospital Center en Sleepy Hollow y Open Door Family Medical Center, participantes en el Programa de Asistencia de Atención Prenatal de Medicaid, auspician conjuntamente un Programa Prenatal. La atención de mujeres embarazadas es provista por un personal bilingüe y solidario, altamente capacitado. No se rechaza a nadie basándos en sus ingresos económicos o seguro. Se alienta a las mujeres a recibir atención prenatal lo más temprano posible durante su embarazo. La atención es provista en Open Door durante las primeras 36 semanas del embarazo y en Phelps Memorial Hospital durante el resto del embarazo y el parto. Para mayor información, sírvase llamar al: (914) 941-1263. Phelps Today 37 Donate Blood at Phelps Give the gift of life and receive a discount from a local business! Did you know that every time you donate a unit of blood you can help save up to three lives? Also, each time you donate at Phelps, you’ll receive a $15 voucher for a free meal in the Phelps cafeteria and will be invited to choose a discount offer from one of the many generous area businesses listed below that support Phelps’ Blood Donor program. To donate, you must be between 16 and 75 years old and weigh at least 110 pounds. Blood Donor Services is located in suite 265 of the 755 building. To make an appointment, call 914-366-3916. Walk-ins are welcome. Briarcliff Manor 105 Ten Bar & Grill Bella Maiya Day Spa Briars Restaurant Dom & Vinnie’s Good Food Manor Wine & Spirits Orfino’s Paese Pasta & Pizza Squire’s Steak & Seafood Terra Rustica Chappaqua Kittle House Croton-on-Hudson Anton Restaurant Backstage Salon Baked by Susan The Black Cow Croton Colonial Diner DePrez Wines & Spirits Feed the Birds! Giovanni’s Deli & Pastries Holistic Physical Therapy Hop Scotch Market & Restaurant Justin Thyme Café Bar Memphis Mae’s Bistro BBQ New York Sports Clubs Pronto Brick Oven Pizza Tavern at Croton Landing Van Wyck Wines & Liquors Vogue Nails & Spa Elmsford Westchester Broadway Theatre Hawthorne Gordo’s Green Valley Nursery Tramonto Restaurant-Bar-Café 38 Phelps Today Irvington Geordane’s Il Sorriso Red Hat on the River River City Grille Mt. Kisco Basilico Pizza, Pasta Tijuana Mexican Grill Ossining Art Barn Atria Senior Living The Boathouse Capri Pizza & Pasta Carpet Giant Corsi Tire Doca’s Portuguese Goldfish King Shell Service Center Landmark Diner Mandee Melita’s Ultra Clean Car Wash VaZa Salon & Spa Wobble Café Pleasantville A’Mangiare Best Wine Purveyors The Black Cow The Flower Basket Foley’s Club Lounge Iron Horse Grille Jacob Burns Film Center Manhattan Chili Co. Martha’s Pleasantville Deli Mediterraneo Physical Fitness Xperts Pleasantville Colonia Diner Pony Express Good Food Sinapi’s Bakery & Café Sir Speedy Printing & Marketing Sparx Hair & Makeup Salon Tech Connect Computer Trattoria 160 Sleepy Hollow Bridge View Tavern Dominick’s Limousine J. P. Doyle’s Restaurant The Horseman The Huddle Kendal on Hudson The River Grill Restaurant & Bar Tijuana Mexican Grill Tarrytown Bark & Meow Pet Products Bella’s Boutique Castle Hotel & Spa Coffee Labs Roasters Elite Hair Design Family YMCA Grape Expectations Heritage Frame Hudson River Eyecare Horsefeathers King Shell Service Center Lubins and Links Main Street Sweets Mr. Nick’s Brick Oven Pizza NY School of Esthetics On Track Sport Center PHR Electrolysis Pure Mountain Olive Oil River View Wines & Spirits Sunset Cove Taco Project The Tapp Tarry Tavern Tarrytown Copy Center Taste of China Warner Library w@tercooler Thornwood Casa Rina White Plains The Cabin Bob Davidson enjoys the peace and quiet of sitting at the end of his dock and spending time with his son. He also enjoys the peace of mind he gets from his doctors at Phelps Medical Associates. “My doctor keeps my cholesterol in check, my blood pressure in range and my fishing line in the water” Not just because his doctors keep him healthy and active, it’s the entire Phelps Medical Associates experience — from the ease of making an appointment, to the compassionate care from doctors who really listen. Our patients say, “It’s doctors the way you wish they could be.” Your Family of Exceptional Doctors Experience the Phelps Medical Associates difference. Call 914-269-1900 or visit us at phelpsmedicalassociates.org Internal Medicine • Family Medicine • Cardiology • Endocrinology • Gastroenterology Neurology • Obstetrics/Gynecology • Podiatry • Rheumatology • Thoracic Surgery Briarcliff • Croton-on-Hudson • Dobbs Ferry • Elmsford • Ossining • Sleepy Hollow • Tarrytown Phelps Today 39 P HEL P S Nonprofit Organization U.S. Postage PAID White Plains, CT Permit No. 105 Phelps Memorial Hospital Center 701 North Broadway Sleepy Hollow, NY 10591-1096 www.phelpshospital.org Ongoing Health Programs, Classes and Support Groups Alzheimer’s Caregivers Support Group (800) 272-3900 or (914) 366-3937 Outpatient Behavioral Health Alcohol/chemical dependency, counseling, continuing day treatment, supportive case management (914) 366-3027 Bereavement Support Groups (914) 366-3325 Better Breathers Club (914) 366-3712 Blood Donation (914) 366-3916 Cardiovascular Rehab (914) 366-3740 Cardiovascular Wellness Center Exercise under RN supervision (914) 366-3752 Celiac Sprue Support Group Sue Goldstein: (914) 428-1389 My Sister’s Place (800) 298-SAFE (7233) CPR Classes (914) 366-3166 Osteoporosis Support Group (914) 366-2270 Diabetes Education Classes for Adults (914) 366-2270 Ostomy Support Group 3rd Sunday of month (914) 366-3395 (Call 366-3000 for cancellation info) Group Counseling Help with issues such as: separation & divorce, loss, relationships, family issues, parenting, coping skills (914) 366-3600 Hospice (914) 366-3325 Look Good Feel Better® For women undergoing cancer treatment (914) 366-3315 or (914) 366- 3421 Mammography (914) 366-3440 Maternity & Baby Classes (914) 366-3382 Physician Referral (914) 366-3367 Pulmonary Programs • Better Breathers Club • Pulmonary Fibrosis Support • Pulmonary Rehabilitation Reservations required (914) 366-3712 Sleep Well Support Group (914) 366-3755