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VITALITY
A PUBLICATION OF NORTH SHORE UNIVERSITY HOSPITAL AND LONG ISLAND JEWISH MEDICAL CENTER
ranked Among
America’s
100 best Hospitals
for Cardiac Care
New LIJ Tower
transforms
campus and care
Robotic
Techniques for
prostate Surgery
N ORT H S H ORELIJ .COM
SU M M ER 2012
Contents
Summer 2012: In This Issue
20Prostate Treatment
Radical prostatectomy procedures
are performed with the da Vinci
Robotic Surgical System.
22 North Shore-LIJ News
The new LIJ Medical Center tower
transforms campus and care.
LIJ Medical Center and North Shore
University Hospital rank tops for heart
care by the Department of Health.
11 Health Programs
Learning opportunities in childbirth,
parenting and CPR.
12 Neurological Care
3
Cardiac Developments
The new cardiac unit offers a welcoming setting for patients and visitors.
An 84-year-old from Hauppauge is the
first patient on Long Island to receive
the only FDA-approved nonsurgical
heart valve replacement device.
New multifunctional rooms allow
cardiologists and cardiothoracic surgeons to perform minimally invasive
procedures in one operating suite.
A young boy undergoes a six-hour
surgery to relieve pressure on his brain.
Patients benefit from counseling and
education programs at the Stroke
Prevention Clinic.
16 Orthopedic Advances
A 23-year-old man from Franklin
Square defies the laws of recovery after
a head-on car collision last July.
A 30-year-old ovarian cancer survivor
and new mother attended the unveiling ceremony to pay tribute to the care
she received at LIJ Medical Center.
Special Forces medics learn advanced
lifesaving skills at the BioSkills
Education Center.
US News & World Report awards five
stars to the North Shore-LIJ Stern
Center for Rehabilitation.
Patients with acute and chronic pain
conditions find relief at the Procedural
Pain Management Center.
36Giving Back
A 3-year-old patient thanks LIJ
Medical Center for allowing her to
be able to hear.
38 Lighten Up!
Tomatoes are ripe with health benefits.
An orthopedic surgeon becomes a fixer
with a mission: to spare the limbs of
pediatric oncology patients.
39 Health Bytes
Tips for a healthier lifestyle.
2
Vitality + Summer 2012
Cardiac De velopments
Aesthetics, Smarts and Compassion
Built into New LIJ Cardiac Unit by Betty Olt
I
f not for the cutting-edge bedside
technology, you might mistake a patient
room in LIJ Medical Center’s new 30-bed
Cardiovascular and Thoracic Unit for a
sleek hotel room. When planning the new
space, designers focused on delivering care
that is not only state-of-the-art but also
compassionate. Each room is private and
provides ample space for loved ones at the
bedside if they choose to stay overnight.
Amenities of patient rooms within the
29,000-square-foot medical/surgical unit
include a full bathroom and shower, a
42-inch flat-screen TV, mini refrigerator,
Internet access, a desk and a visiting area
with a pull-out loveseat. Rich wood floors,
nature-inspired motifs and artwork provide
a warm, welcoming setting that accommodates patient needs and privacy. Carpeted
corridors are not only visually appealing but
also help reduce noise. Extra-large windows
in patient rooms and family lounges provide
access to natural daylight and views.
The Cardiovascular and Thoracic Unit is
dedicated to patients undergoing cardiothoracic surgery, cardiac catheterization and
electrophysiology procedures. Telemetry
technology equips each patient room,
allowing remote monitoring of vital signs;
bedside computers give clinicians access to
patients’ electronic health records.
The cardiac suite opened to rave reviews
from patients and staff alike, but the new
facility is built on the reputation of LIJ’s
cardiac services. “LIJ has consistently
excelled in performing angioplasty and
cardiac surgery, and has achieved outstanding outcomes for both procedures in New
York State,” said Barry Kaplan, MD, vice
Online Extra
The hospitality industry inspired the design of the Cardiovascular and Thoracic Unit. The inpatient space is
on the eighth floor in the Zuckerberg Pavilion, part of a $300 million 10-story tower that also houses the
Katz Women’s Hospital.
chairman of cardiology for LIJ and North
Shore University Hospital. (See related story
on page 8.) “Now, with the new unit, we
can practice in a world-class facility and
provide the best possible care to patients
in a beautiful and healing environment.”
By decentralizing nursing stations and
locating supply closets adjacent to every
patient room entrance, nurses spend less
time walking the floor — and more time
with patients. A pharmacy on the floor
ensures timely, accurate delivery of medications. And the needs of special patient
populations are addressed via two dedicated
isolation rooms with anterooms for patient
observation and a bariatric room equipped
with overhead lifts for patient and staff safety.
In addition to its beauty and efficiency,
LIJ’s new Cardiovascular and Thoracic Unit is
ecologically kind, too. As part of the North
Shore-LIJ Health System’s commitment to
sustainable and environmentally responsible
healthcare, the unit is registered with the
Green Building Certification Institute and has
been designed to achieve a Silver rating from
LEED, the accepted industry benchmark for
sustainable design, green building materials
and energy efficiency. n
The new patient rooms in the cardiac unit offer a warm, welcoming setting.
To take a virtual tour, use your smartphone to scan this code or visit http://bit.ly/IHmQHB.
nor thshorelij.com
3
LIJ Cardiac Team Performs Aortic Valve
Replacement Without Open-Heart Surgery
by Betty Olt
C
ardiologists and cardiothoracic surgeons at LIJ Medical
Center are the first in Queens
and Long Island to perform a
new nonsurgical heart valve
replacement procedure to treat
patients with failing heart valves.
The device allows patients to
be treated without traditional
open-heart surgery.
Breakthrough
Procedure
Patients with severe aortic
stenosis can now be considered
for the less invasive procedure
with the new device known as
the Sapien transcatheter aortic
valve replacement (TAVR),
manufactured by Edwards
Lifesciences in Irvine, CA. These
patients are generally older, with
multiple medical conditions that
may put them at very high risk in
traditional surgical procedures.
“TAVR is a breakthrough
because it offers some patients
who could not withstand the
conventional surgery due to age
or serious medical conditions a
viable treatment option,” said
Jacob Scheinerman, MD,
associate chair of cardiothoracic
surgery at LIJ Medical Center.
The US Food and Drug Administration approved TAVR last
November; it has been used in
Europe since 2002.
Symptoms of
Aortic Stenosis
Approximately 250,000 Americans suffer from severe aortic
stenosis, often developing
debilitating symptoms that can
affect normal day-to-day
activities, such as walking short
distances or climbing stairs.
Generally, the condition affects
people ages 70 and older. Aortic
stenosis occurs when the aortic
valve does not properly open and
close, usually due to a buildup of
calcium. The calcium buildup
restricts blood flow from the heart
to the rest of the body. This
increases pressure within the
heart, causing heart muscles to
weaken. All these events increase
the risk of heart failure. Symptoms of the disease can include
extreme fatigue, dizziness, chest
pain or pressure, shortness of
breath during activity, rapid or
irregular heartbeat and fainting.
“Patients who do not receive an
aortic valve replacement have no
effective, long-term treatment
option to prevent or delay the
progression of severe aortic
stenosis and eventual death,” said
Dr. Scheinerman, further noting
that approximately 50 percent of
patients who are in their 80’s and
have symptoms of congestive heart
failure with critical aortic stenosis
will die within six months to a
year without treatment. “For
patients who were previously
inoperable, the new TAVR gives
hope for extending their lives with
an improved quality of life.”
New Suite Has Latest
Technology
Ann Pszybylski, 84, is the first patient on Long Island to receive the only FDA-approved nonsurgical heart valve
replacement device. Members of LIJ’s cardiac team wished her well as she prepared to leave the hospital. Ms. Pszybylski
is shown, from left, with Jacob Scheinerman, MD; Dorothy Veron, RN, nurse manager of the catheterization lab;
Rajiv Jauhar, MD; Annmarie Copertino, RN, nurse manager; and Robert Rodriguez, RN.
Earlier this year, Dr. Scheinerman,
along with interventional
cardiologist Barry Kaplan, MD,
vice chairman of cardiology at LIJ
and North Shore University
Hospital; Rajiv Jauhar, MD, chief
of cardiology and director of the
cardiac catheterization laboratory
at LIJ; and cardiothoracic surgeon
Robert Palazzo, MD, joined the
multidisciplinary team of
specialists in performing the
procedure on an elderly woman
who suffered from severe aortic
4
stenosis. They performed the
procedure in LIJ’s new, state-of-theart hybrid operating room. The
$5 million surgical suite combines
the latest surgical and cardiac
catheterization robotic technology
and three-dimensional radiologic
imaging capabilities with real-time
patient monitoring.
“Having all the equipment and
members of the cardiac team in
one OR saves time and eliminates
the need for a patient to be moved
from one room to another,” said
Dr. Kaplan. “Interventional
cardiologists and cardiac surgeons
can collaborate closely during the
procedure. Working in our new
hybrid surgical suite allows us to
be ready for any situation or
potential emergency.”
Similar to a technique to
implant cardiac stents into
clogged arteries, the TAVR
procedure involves the
physician guiding a catheter
attached to the Sapien valve
through the patient’s femoral
artery. The cardiac team uses
transesophageal echo and
fluoroscopic imaging guidance for
proper placement. The Sapien
valve is expanded by a balloon,
about the diameter of a quarter, in
the delivery system, pushing
away the calcium to enlarge the
opening of the valve. Upon
placement at the opening of the
valve, it is anchored inside the
aorta and blood flow is restored.
first patient
to receive the TAVR
Ann Pszybylski, an 84-year-old
grandmother and great-grand-
Online Extra
mother of eight from Hauppauge,
was the first patient at LIJ to
receive the TAVR. Her symptoms increased to the point that
she had shortness of breath
while doing any type of activity
that required movement, even
walking. Due to her Parkinson’s
disease and frail condition, Ms.
Pszybylski was not a candidate
for the conventional heart valve
procedure.
“After the TAVR procedure, Ms.
Pszybylski did remarkably well,”
said Dr. Scheinerman. “Within 24
hours after the procedure, she
was up and walking around the
“I’m thankful I was able to receive this new treatment close to
my home as opposed to getting the procedure in Manhattan.”
Intensive Care Unit, and her
breathing was easier.”
Ms. Pszybylski, who spent
three days in the hospital, said
she used to “huff and puff” to
keep up with her daughters or
residents of the assisted-living
facility where she lives. She
added, “I’d like to travel to see
my nephew in Georgia and
daughter in North Carolina, but
mostly I’m looking forward to
just living longer.”
Elliott Gaberman, 78, of
Oakland Gardens, underwent
the TAVR procedure at LIJ. He
also suffered from severe aortic
stenosis, and TAVR replaced his
Watch a
video featuring the LIJ cardiac team
who performed the first TAVR procedure.
Go to NorthShoreLIJ.com/NSLIJ/
vitality-videos, or use your smartphone
to scan the QR code.
nor thshorelij.com
5
Elliott Gaberman can resume his volunteer work now that he’s recovered from
a procedure to replace his failing heart valve.
failing heart valve. Over the past
year, Mr. Gaberman, a retired
safety quality assurance specialist, struggled with shortness of
breath and extreme fatigue while
walking and climbing stairs. As
his symptoms increased, Mr.
Gaberman sought relief from his
condition. He was not a
candidate for surgical valve
replacement because his triple
heart bypass in 2007 and other
medical conditions closed the
door on surgery. “With the
TAVR, Mr. Gaberman is
breathing easier, is walking more
comfortably and is more
energetic,” said Dr. Kaplan.
Mr. Gaberman is looking
forward to resuming his
volunteer work at the St. Albans
VA Hospital, where he has
transported patients every week
for the past eight years. “I’m
thankful I was able to receive
this new treatment close to my
home as opposed to getting the
procedure in Manhattan. It’s
much easier, especially with
presurgical testing and follow-up
visits,” he said.
At LIJ, interventional cardiologists, cardiothoracic surgeons and
cardiac anesthesiologists evaluate
patients for the TAVR procedure.
Members of the hospital’s heart
team work together to ensure
optimal patient outcomes.
Specialists include cardiac
surgeons, interventional
cardiologists, cardiologists,
anesthesiologists, echocardiographers, physician assistants, nurses,
OR staff and other professionals. n
+
Protect your heart.
For information about
less invasive heart valve
replacement procedures,
call LIJ’s Department
of Cardiac Services at
718-470-7460.
Hybrid OR: Making Many Things Possible
by Betty Marton
T
wo new hybrid operating rooms — the first in Queens and Long
Island — are letting previously inoperable patients benefit from
cutting-edge combination surgical, cardiac and vascular interventions, including a lifesaving heart valve replacement procedure.
Located at LIJ Medical Center and North Shore University
Hospital, these interdisciplinary, multifunctional rooms allow
cardiologists and cardiothoracic surgeons to perform a range of
open, minimally invasive, image-guided and catheter-based
procedures in one operating suite.
No Need to Transfer Patients
“It’s the ideal environment to bring interventional cardiologists and
cardiac surgeons together in a team approach that is relatively
unusual and unprecedented,” explained Barry Kaplan, MD, vice
chairman of cardiology at LIJ and North Shore University Hospital.
“The hybrid operating rooms eliminate the need to transfer patients
from one room to another and allows the surgical team to be ready
for any situation or potential emergency.”
The hybrid OR incorporates robotic technology and 3-D
radiologic imaging capabilities with real-time patient monitoring
that, when not needed, can easily be moved out of the way to
support general surgical procedures. Maximizing room use and
efficiency makes it possible to perform procedures such as the
Sapien transcatheter aortic valve replacement (TAVR) on patients
with severe aortic stenosis. TAVR is performed via the femoral
artery, which is similar to the approach used for a cardiac catheterization. The cardiac team then uses a transesophageal echo and
fluoroscopic imaging guidance for proper placement.
Advanced Surgical Care
“TAVR requires only a two- or three-centimeter incision, which
allows us to treat patients who were previously deemed inoperable
due to age or serious medical conditions,” said Jacob Scheinerman,
MD, associate chairman of cardiothoracic surgery at LIJ.
According to Robert Blenderman, PA, director of cardiothoracic
surgery at North Shore University Hospital and LIJ, the $5 million
hybrid surgical suites, built at a time when healthcare dollars are
stretched thin, exemplify the North Shore-LIJ Health System’s
commitment to providing the highest-quality treatment and care
for its patients.
“North Shore-LIJ has gone above and beyond in supporting this
hybrid OR technology to meet the needs of future procedures,” he
said. “It’s a beautiful thing to have the ability to offer treatment to
those patients who previously had no other options. This is a
groundbreaking development in cardiovascular surgery and shows
our dedication to growing our discipline in a quality way.” n
Mobile Site includes “Find a Physician”
A mobile version of the North Shore-LIJ Health System’s Web site is accessible via NorthShoreLIJ.com on
any smartphone, BlackBerry, iPhone or Palm, and it delivers a greatly improved experience for mobile
Web site visitors. Use the site for quick retrieval of directions and maps to North Shore-LIJ’s hospitals and
facilities or to try our “Find a Physician” feature.
6
Quick, Collaborative Cardiac Care Saves Patient
at Franklin Hospital and LIJ Medical Center
by Kristen Longo
I
“ t felt like there was a dagger in my back,”
said 47-year-old Noel Riley. The Valley
Stream resident had woken up with chest pain
and intermittent searing pain across his back,
and when the pain would not go away, he
headed to Franklin Hospital, where Mollie
Williams, MD, made a diagnosis that would
save his life. Mr. Riley was experiencing an
ascending (type A) aortic dissection which,
without treatment, is fatal for 90 percent of
patients within 48 hours. Mr. Riley required
emergency surgery to prevent rupture and was
transferred to LIJ Medical Center’s specialized
cardiac team for immediate surgery.
Symptoms of Aortic Dissection
Aortic dissection happens when a tear inside
the layered wall of the aorta (the largest artery
of the body) causes bleeding into and along the
wall, forcing the layers apart. Symptoms are
varying and similar to those of other heart
problems — such as a severe ripping or tearing
pain from the shoulder blades or back and
extending to the chest, loss of consciousness,
shortness of breath, sweating or overall
weakness — which can make
proper diagnosis difficult. Mr. Riley
“did not have chronic hypertension, his EKG [electrocardiography] and blood work were
normal, and he looked healthy,”
said Dr. Williams, who treated him
in Franklin’s emergency department.
Considering his symptoms, she
ordered a computed tomography
(CT) scan, a test commonly used
to diagnose aortic dissection,
and discovered the seriousness
of his condition.
Quick Actions
Lead to Survival
The team at Franklin quickly
transferred Mr. Riley to LIJ
Medical Center’s Department of
nor thshorelij.com
7
Cardiothoracic Surgery. There, a team of
clinicians rushed him into surgery, where
Jacob Scheinerman, MD, associate chair of
the department, removed the damaged
segments of the ascending aorta, replaced the
tissue with a graft and, along with Robert
Palazzo, MD, repaired the damaged aortic
valve. “Mr. Riley’s type A dissection, which
involves the root of the aorta, is the most
dangerous type,” said Dr. Scheinerman.
“The key to his survival was how quickly
Franklin’s team made a diagnosis and got
him to our
operating
room. Many people never even make it to
the hospital.”
The risk factors for aortic dissection
include a history of uncontrolled hypertension, aortic aneurysm, a dilated aorta or
congenital connective tissue disorders, such
as Marfan syndrome or Ehlers-Danlos
syndrome, explained Dr. Scheinerman.
Mr. Riley had none of these risk factors.
As an orthotist (a medical field specializing
in the design of orthopedic appliances),
Mr. Riley was familiar with the condition aortic
dissection but was shocked by the diagnosis.
“Dr. Williams’ ability to listen was pivotal to my
survival,” said Mr. Riley. Her quick actions to
explore all causes of his pain are the reason he
made it to surgery in time, and the collaboration of the healthcare teams at Franklin
Hospital and LIJ Medical Center saved his life.
“Mr. Riley’s case highlights the benefits
patients receive from the collaboration of
North Shore-LIJ hospitals,” said John Rohe,
MD, director of emergency medicine at
Franklin. “Our facilities truly work together
to save lives.” Mr. Riley’s survival is
also a testament to the health
system’s cardiac care and each
hospital’s access to that care, well
evidenced by Dr. Williams calling
in the expertise of LIJ Medical
Center’s cardiac
Emergency Medical Services (EMS)
transfer team and Aortic Surgery
Center physicians.
Mr. Riley has nothing but praise
for the care he received at both
Franklin Hospital and LIJ Medical
Center. “It was nothing short of
excellent,” he said. “They saved
my life.” n
+
To find a cardiologist
affiliated with the
North Shore-LIJ Health
System, call 888-321-DOCS.
LIJ, North Shore University Hospital
Rank Tops for Heart Care in New York by Terry Lynam
L
IJ Medical Center and North
Shore University Hospital
provide some of New York State’s
best outcomes for open-heart
surgery and percutaneous
coronary interventions, according
to reports by the state Department
of Health. In fact, LIJ was the only
hospital in the state with significantly better outcomes for both
cardiac surgery and percutaneous
coronary interventions.
According to the Department of
Health’s report on adult cardiac
surgery (covering 2007 to 2009),
LIJ was one of only four hospitals
in New York State — and the only
one on Long Island — whose
risk-adjusted mortality rates were
significantly better than the
statewide average for 676 patients
undergoing surgeries to repair or
replace heart valves and for those
in need of surgeries for both valve
and coronary artery bypass graft
(CABG) surgery. In a separate
category analyzing outcomes for
CABG, valve or valve/CABG,
North Shore University Hospital
and LIJ were among six hospitals
in the state — and the only ones
on Long Island — distinguished
by low, risk-adjusted mortality
rates. Over the three-year period
analyzed by the Department of
Health, the combined volume of
cardiac surgeries at North Shore
University Hospital and LIJ
Medical Center was 2,082 —
the most in the state.
In addition to the hospitals’ top
rankings, LIJ heart surgeons
Robert Palazzo, MD, and Jacob
Scheinerman, MD, and North
Shore University Hospital
surgeons Alan Hartman, MD, and
Robert Kalimi, MD, were among
13 surgeons statewide to earn the
Department of Health’s prestigious double-asterisk for their
extraordinarily low mortality rates
— out of about 190 surgeons at
40 hospitals who performed
open-heart surgeries during that
period. In fact, Dr. Palazzo
performed 225 CABG surgeries
without a single death over the
three-year period covered in the
Department of Health report.
In a separate New York State
Department of Health report on
percutaneous coronary interventions, Lenox Hill Hospital had the
lowest risk-adjusted mortality rate
in the state in 2009 for 2,940
patients undergoing angioplasty
(a procedure that clears blocked
heart arteries to increase blood
flow). Over the three years
covered in the report (2007 to
2009), LIJ was one of six
hospitals statewide with statistically superior outcomes for angioplasty. In addition, North Shore
was one of only three hospitals in
New York — and the only one on
Long Island — with significantly
better outcomes for 935 emergency angioplasty patients.
From an individual standpoint,
LIJ Medical Center’s Barry Kaplan,
MD, and North Shore University
Hospital’s Loukas Boutis, MD,
and Donna Marchant, MD, were
the only cardiologists in New
York State — of more than 300
statewide — who were outliers
for superior outcomes.
Since 2000, the Department of
Health has released eight reports
for angioplasty. LIJ has received
double-star rankings for all cases
in six of those reports, which is
more than any other hospital
in the state, according to
Dr. Kaplan, vice chairman
of cardiology for the North
Shore-LIJ Health System.
In addition to LIJ being the
only hospital in New York to
receive a double-asterisk for both
cardiac surgery and angioplasty
in the current Department of
Health reports, North Shore also
was the only other hospital in
the state to have statistically
superior outcomes in at least one
category for both open-heart
surgery and angioplasty.
“The New York Department of
Health’s analysis of cardiac
outcomes in hospitals across the
state has contributed to continuous improvements in the care
delivered to New Yorkers with
heart disease,” said Stanley Katz,
MD, senior vice president of
cardiovascular services for North
Shore-LIJ and chair of cardiology
at North Shore University Hospital
and LIJ Medical Center. He added
that heart disease is the number
one cause of death in this state and
in this country. “The availability of
these reports provides heart
patients and their families with
valuable information for making
informed decisions about their
cardiac care.”
“Teamwork is at the heart of
everything we do,” said Dr.
Hartman, chairman of cardiothoracic surgery at North Shore-LIJ.
“Fortunately, the same formula for
success that has enabled us to
provide exceptional open-heart
surgery at North Shore University
Hospital and LIJ Medical Center
has been replicated at Southside
Hospital.” Since the launch of
Southside’s cardiothoracic program
in February 2011, Dr. Hartman’s
team has performed 359
surgeries, ensuring that residents
of Suffolk County’s South Shore
get the same access to state-ofthe-art heart care as the tens of
thousands who have entrusted
their lives to LIJ and North Shore
University Hospital. n
8
Nursing Grad Comes Back from the Brink —
And into the Fold by Michelle Pinto
L
evittown resident Joanne Giacalone’s life
changed forever on the afternoon of
December 20, 2011, four days after her
24th birthday. Found slumped between two
cars in a parking lot, the Adelphi University
nursing graduate was rushed by ambulance
to Nassau University Medical Center, where
she suffered several cardiac arrests and had
to be resuscitated with chest compressions
and medication. A computed tomography
(CT) scan of her chest showed that
Ms. Giacalone had significant pulmonary
embolisms (blood clots in the lungs).
An ambulance transported her to LIJ
Medical Center, where she entered the
Intensive Care Unit (ICU) in almost complete
cardiac arrest. Ms. Giacalone was again
resuscitated with chest compressions and
medication, and brought to the operating
room (OR) while a nurse and physician
assistant performed chest compressions to
maintain her blood pressure.
LIJ clinicians were not optimistic she
would survive. The cardiothoracic surgery
team operated on her immediately to
remove clots from her lungs and arteries.
Ms. Giacalone suffered severe organ failure,
internal bleeding, and lung and heart
failure. Clinicians were concerned whether
her brain had received enough oxygen
during her several cardiac arrests.
Severe internal swelling prevented the
surgical team from closing her breastbone
after surgery, so she was brought to the ICU
with her chest open and only a dressing
covering her heart. Over the next 48 hours,
Ms. Giacalone improved dramatically and
was taken back to the OR to have her chest
closed. She spent the next week and a half
recovering from multiple organ injury/
failure and returned home January 3.
Exactly a month after her medical crisis
began, Ms. Giacalone met the surgeon who
saved her life — Michael Graver, MD
— and other caregivers who helped her
survive. Ms. Giacalone, who originally
planned to pursue a nursing career in
nor thshorelij.com
9
Joanne Giacalone met with Michael Graver, MD, who helped save her life after she suffered cardiac arrest
last December.
obstetrics/gynecology, was surprised when
Dr. Graver made a special announcement:
Her application to join LIJ’s Critical Care
Nursing Fellowship Program had been
approved. The six-month program provides
special training for nurses just out of
nursing school who are pursuing a career in
critical care. As Dr. Graver pointed out, “If
she’s half as tough as a nurse as she was as a
patient, she’ll be great.”
To celebrate the one-month anniversary of
her crisis and recovery, Ms. Giacalone
brought along her family — including her
mother, father, grandmother and best friend
— to reunite with the cardiothoracic critical
care team that saved her life. Ms. Giacalone’s
mother said, “My daughter’s survival is a true
miracle. We are all here today to say that
miracles are possible when you believe.”
Ms. Giacalone recently started the Critical
Care Nursing Fellowship Program at LIJ
Medical Center. During her training, she
will attend classroom lectures and work
alongside doctors and nurses who are
treating critical care patients. Upon
completion of the program, Ms. Giacalone
hopes to work as a critical care nurse in LIJ’s
Cardiothoracic Intensive Care Unit — on
the same floor where compassionate doctors
and nurses brought her back to life. n
+
Take care of your heart.
To find a cardiac specialist
affiliated with the North Shore-LIJ
Health System, call 888-321-DOCS.
HealthGrades Ranks LIJ and North Shore University
Hospital Among Best for Cardiovascular Care by Betty Olt
L
IJ Medical Center and North Shore University Hospital (NSUH)
have been named among America’s 100 Best Hospitals for
cardiac care, cardiac surgery and coronary intervention, according
to a report by HealthGrades, an independent group that analyzes
hospital quality outcomes. LIJ was also ranked number one in New
York State for cardiac surgery for two consecutive years (2011 and
2012); and NSUH was ranked number two in the state for overall
cardiac services, cardiology services and coronary interventional
(heart stent) procedures in 2012.
HealthGrades analyzed Medicare patient outcomes data for 5,000
hospitals nationwide from 2008 through 2010, the most recent
years for which data was available. It published performance
outcomes for cardiac services in its HealthGrades 2011 Healthcare
Consumerism and Hospital Quality in America report. Among the
achievements noted in the report, NSUH and LIJ consistently
received five-star ratings, the highest possible hospital rating, in
multiple cardiac service areas, which translates to a 73 percent
lower chance of death compared to one-star hospitals, according to
HealthGrades.
NSUH received five-star ratings for the following clinical
achievements:
<< Overall cardiac services five years in a row (2008-2012)
<< Cardiac surgery five years in a row (2008-2012)
<< Cardiology services two years in a row (2011-2012)
<< Coronary bypass surgery in 2012
<< Valve surgery six years in a row (2007-2012)
<< Coronary interventional procedures 10 years in a row (2003-2012)
<< Treatment of heart attack seven years in a row (2006-2012)
<< Treatment of heart failure in 2012
LIJ received five-star recognition for the following clinical achievements:
<< Overall cardiac services two years in a row (2011-2012)
<< Coronary interventional procedures 10 years in a row (2003-2012)
<< Cardiac surgery three years in a row (2010-2012)
<< Coronary bypass surgery four years in a row (2009-2012)
<< Valve surgery two years in a row (2011-2012)
“The North Shore-LIJ Health System is committed to providing
the highest-quality care to our patients,” said Stanley Katz, MD,
senior vice president of cardiovascular services and chairman of
cardiology at North Shore-LIJ. “Our cardiac physicians and their
teams at LIJ Medical Center and North Shore University Hospital
are making major treatment breakthroughs in the field, improving
the lives of our patients in our community. The HealthGrades
ratings demonstrate our excellent outcomes in cardiac care, which
are accessible to consumers online and are extremely useful for
patients and loved ones making the important decision of choosing
their cardiologists and hospitals.”
LIJ Medical Center was also recognized for the following clinical
achievements:
LIJ Ranked Nationally
LIJ Ranked in New York State
Among the top 5 percent
for coronary interventional
procedures (2008-2012)
Among the top 10 for
coronary interventional
Among the top 5 percent for
cardiac surgery (2011-2012)
for overall cardiac services
(2011-2012)
Among the top 10 for overall
cardiac services (2011-2012)
In addition, North Shore University Hospital was recognized for
the following clinical achievements:
NSUH Ranked Nationally
NSUH Ranked in New York State
for coronary interventional
Among the top five for
coronary interventional
overall cardiac services
(2008-2012)
Among the top five for
cardiology services in 2012
cardiac surgery in 2012
overall cardiac services in 2012
Among the top 10 for overall
cardiac services (2005-2012)
Key findings of the HealthGrades 2011 Healthcare Consumerism
and Hospital Quality in America report include:
On average, patients had a 73 percent lower risk of dying in a
five-star rated hospital compared with a one-star rated hospital, and
a 54 percent lower risk of dying in a five-star rated hospital
compared with the national average.
<< If all Medicare patients from 2008 through 2010 had been
treated at five-star hospitals, 240,040 lives might potentially have
been saved.
<< If all Medicare patients from 2008 through 2010 had gone to
five-star hospitals for their procedures, 164,472 in-hospital
complications might potentially have been avoided. n
+
Find a quality comparison of doctors and hospitals
in the New York area online at HealthGrades.com.
10
Health Programs
Prepare Yourself with
Parenting, Baby Care and CPR Classes
Stay safe and healthy with the help of
programs offered by North Shore-LIJ’s
Office of Community and Public Health.
To learn more, go to NorthShoreLIJ.com/
community. Click on the “Events
Calendar” and search for “parenting”
or “CPR,” or call 516-465-2500 for a
brochure. Sorry, no phone registrations.
The Katz Women’s Hospital in New
Hyde Park offers childbirth preparation
classes, breast-feeding education,
baby care programs and orientation
tours of the Maternity Unit. For more
information, call the Parents’
Education Office at 718-470-5134.
Lamaze Childbirth
For expectant mothers and their partners.
Instruction in stages of labor, role of labor
partner, relaxation and pushing techniques,
hospital admission procedures, anesthesia/
analgesic options, cesarean and vaginal
birth after cesarean, and postpartum
expectations.
Class includes a tour of postpartum and
nursery units. Lamaze instruction must be
completed two weeks prior to expected
delivery date. $175 per couple
Breast-Feeding I: The Basics
Expectant mothers and their partners can
learn about breast-feeding techniques,
facts and myths. Bring a baby doll or
stuffed animal.
7 to 9:30 p.m.; $40 per person/$65 per couple
Baby Safe
Topics include creating a safe home environment for baby, home emergencies
and basic first aid for bleeding, burns,
fractures, shock and poisoning.
7 to 9 p.m.; $20 per person/$35 per couple
Breast-Feeding II: Beyond the Basics
For expectant and new mothers and their
partners. Covers bottle use, returning to
work and breast pumping.
Cardiopulmonary Resuscitation (CPR)
The Department of Professional and Public
Health Education offers cardiopulmonary
resuscitation (CPR) courses tailored for
babies, children and adults.
Weekends: Saturday or Sunday
(one session)
9 a.m. to 5 p.m.
Baby Care Basics
Expectant parents, grandparents and
childcare providers can learn about characteristics of the newborn, feeding, bathing, diapering, cord and circumcision
care, temperature taking, baby equipment, safety, sleep and immunization.
Bring a baby doll.
Infant CPR
CPR for newborn to 1-year-old children.
$45 per person/$75 per couple
Weekends: Saturday and Sunday
(two sessions)
9:30 a.m. to 2:30 p.m.
Weekdays (three sessions)
7 to 10 p.m.
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11
Infant/Child CPR
CPR for newborn to 8-year-old children.
$45 per person/$75 per couple
Adult CPR
Adult course includes a take-home kit
with inflatable mannequin, practice DVD,
American Heart Association booklet and
accessories. $55 per person
Neurological care
Successful Surgery Gives
10-Year-Old His Swing Back
by Michelle Pipia-Stiles
U
Caring for Today,
Planning for
Tomorrow
The North Shore-LIJ Health
System Foundation’s Web site
features an attractive, userfriendly design. NorthShoreLIJ.
com/foundation offers:
campaign pages with news
about exciting changes
throughout the health system;
expanded coverage of
Foundation and health
system events, including the
opportunity to purchase event
and raffle tickets online;
photo albums featuring
our supporters; and
a variety of opportunities to
support building projects or
individual hospitals, to make a
gift in honor of a loved one
and more.
ntil Zachary Howell was 10, he lived
a normal life in his hometown of
Clemmons, NC. Like many 10-year-old
boys, Zachary was busy with school and
active in sports, including baseball and
football. But all that changed after one
football practice in September 2010,
when Zachary experienced a severe
headache and nausea that got progressively
worse for months.
That December, clinicians in North
Carolina diagnosed Zachary with Chiari
malformation, which is characterized by
herniation of the cerebellum through the
large opening in the base of the skull into the
spinal canal. Over the next several months,
he underwent two surgeries to relieve
pressure on his brain and three spinal taps to
relieve intracranial pressure. But the pressure
remained high, with a reading of 20 (normal
is between five and 10).
Surgery to Relieve Pressure
Like any parent seeing a child in pain and
helpless, Ms. Howell continued to look for
other options that could help Zachary live a
normal life again. That is when his neurosurgeon at Wake Forest Baptist Medical
Center recommended a consultation with
Harold Rekate, MD, director of the Chiari
Institute at North Shore University Hospital.
Dr. Rekate confirmed that the top of
Zachary’s spine (called the odontoid
process) was malformed, putting pressure
on his brain and causing severe headaches.
As his head moved to and fro, this bone
pushed into the front of his brain. To
correct it, Zachary needed an occipitocervical fusion, which properly aligns and
stabilizes the skull and spine to prevent the
pressure. Last December, Dr. Rekate, along
with neurosurgeon Salvatore Insinga, DO,
performed the six-hour surgery.
No More Headaches

“The top of Zachary’s spine
was malformed, putting
pressure on his brain and
causing severe headaches.”
“Despite the surgeries, Zachary was always
a driven child with a high tolerance for pain,
so he never complained,” recalled Suzy
Howell, his mother. Though Zachary’s
headaches were less intense after the surgeries,
the pain still interfered with his quality of life.
Zachary had to be picked up early from
school every day and brought home to rest.
He would then return to school to catch the
last few hours of the day. By May 2011, Ms.
Howell saw her son changing — becoming
more withdrawn and isolated from the family.
That evening, Zachary’s first words were, “I
don’t have a headache!” His mother recalled,
“There was not a dry eye in the room. I
prayed for so many days that he would wake
up and say he didn’t have a headache, and
this was the first time he woke up and said
those words. I knew we had Zachary back,
especially when he let his grandfather take a
picture of him, with the thumbs-up sign.”
Zachary went from having severe
headaches every day to an occasional
headache that is easily treated with overthe-counter medication. While he cannot
resume football, he enjoys Little League
baseball and living the life he once had. n
+
Get advanced neurological
care with one of the specialists
at the Cushing Neuroscience Institute.
Call 516-562-3822, email neuro@nshs.
edu or visit NorthShoreLIJ.com/
neurosciences.
12
Zachary Howell plays ball for his
hometown team.
nor thshorelij.com
13
Neurological Care
Stroke Prevention Clinic Helps
Keep Stroke at Bay
P
eople at high risk for stroke can improve
their chance of staying healthy at the
Stroke Prevention Clinic at LIJ Medical
Center. The clinic — the only one of its
kind in Queens or Nassau — educates and
counsels high-risk patients, as well as those
who do not know if they are at risk, and can
advise whether a surgical technique to clean
out the arteries is appropriate.
A stroke, or brain attack, occurs when
circulation to the brain fails. When brain
tissue cannot get the blood and oxygen it
needs, it starts to die and can cause paralysis,
speech impairment, loss of memory and
reasoning ability, and death. Stroke is the
third-leading killer in the United States and
the leading cause of long-term disability.
The Stroke Prevention Clinic can help
patients with stroke risk factors, including
diabetes, high cholesterol and blood
pressure, increasing age, tobacco use,
obesity and previous heart attack. Frequently,
risk for stroke goes undiscovered until a
routine medical exam reveals a symptom.
“I routinely see many patients at risk for
stroke, but I can reach only a small number of
patients,” said Richard Libman, MD, vice
chairman and chief of vascular neurology at
LIJ Medical Center. “There has to be something that brings patients to my attention,
such as a narrowed carotid artery. If patients
have no symptoms, it’s much more difficult to
get them in for preventive treatment.”
Identifying High-Risk Patients
The clinic’s staff evaluates those who may be
at risk for stroke in a just few steps:
<< detailed physical examination and history;
<< ultrasound of carotid arteries (evaluation
of the major arteries in the neck that supply
blood to the brain); and
<< risk factor analysis.
By age 75, at least 8 percent of the
population has atrial fibrillation, said Dr.
Libman. Treatment includes blood thinners.
Many patients with risk factors for stroke
can benefit from the clinic’s counseling and
education. Some people need help to stop
smoking or lose weight, and others need to
find out whether they are taking the right
blood pressure or cholesterol medication.
“Identifying narrowing of the carotid
artery, checking for atrial fibrillation and
risk factor modification can make a
dramatic difference in a patient’s future risk
for stroke,” said Dr. Libman. “We want to
identify these conditions early so we can
intervene if necessary.”
A Surgical Method for
Stroke Prevention
Two large studies have shown the effectiveness of carotid endarterectomy — an
operation to remove arterial plaque — in
patients with narrowing of a carotid artery
but no symptoms. Both studies showed that
this procedure can help prevent stroke
compared with medical therapy alone.
Medical therapy includes treating high blood
pressure and cholesterol, taking aspirin,
smoking cessation, exercise and weight loss.
“You have to choose the appropriate
treatment,” said Dr. Libman. Before
recommending surgery, he and his team
consider patients’ other risk factors, the type
of carotid narrowing they have and their
risk for surgery. n
Time Lost
Is Brain Lost
Time is of the essence when having
a stroke. Remember to call 911
immediately if you notice any of
the following:
numbness and weakness of
face and/or limbs on one side of
the body;
slurred or inappropriate word
usage or inability to speak;
problems with vision, such as
dimness or loss;
dizziness or loss of balance
and coordination;
problems with movement
or walking;
confusion; or
severe headaches with no other
known cause.
+
For more information or
to make an appointment
at the Stroke Prevention Clinic, call
516-325-7000, email [email protected]
or visit NeuroCNI.com.
Dr. Libman listens to a patient’s heart and
checks the pulse to detect atrial fibrillation.
This irregular heart rhythm is another risk
factor for stroke that increases with age.
14
Rare Tumor Changes Executive’s Direction
F
or Sharon Scrima, a 43-year-old from
Lynbrook, what was supposed to be a
relaxing Caribbean cruise turned out to be
quite the opposite. During the trip, sudden
nausea struck — and didn’t go away even
after she returned home. She also began to
experience frequent headaches. A former
human resources executive at an investment
banking firm, Ms. Scrima hardly ever
missed work due to illness, so she was at a
loss as to what was happening.
She found the answer at North Shore
University Hospital, where a computed
tomography (CT) scan revealed a mass,
called an acoustic neuroma, about the size of
a golf ball. Located at the base of her skull,
the tumor put pressure on Ms. Scrima’s brain
stem and had the potential to cause seizures.
“An acoustic neuroma, also known as a
Online Extra
Hear about lifesaving treatment
for a young woman with an acoustic neuroma. Go to
http://bit.ly/LbeF18 or use your smartphone to scan this code.
vestibular schwannoma, is a slow-growing
tumor of the nerve that connects the ear to
the brain,” explained Michael Schulder, MD,
director of the Brain Tumor Center at North
Shore-LIJ’s Cushing Neuroscience Institute.
“The treatment plan for acoustic neuromas
varies depending on the patient’s age, as
well as the size and location of the tumor.”
In Ms. Scrima’s case, 80 percent of the
acoustic neuroma was removed through
resection surgery and the remaining 20 percent
was treated with stereotactic radiation therapy.
“This combined treatment approach allowed us
to preserve hearing and facial function as much
as possible,” Dr. Schulder said.
After such a life-changing experience, Ms.
Scrima said, “I have such a greater appreciation for the people in my life, and I am so
grateful for the outstanding medical care I
received from Dr. Schulder and his staff at
North Shore University Hospital.” She looks
forward to her next phase and has begun
working with a career coach to embark on
her journey of self-exploration. n
New Center Takes on Rare Brain Tumors
E
valuation and treatment for a rare birth
defect that affects the brain are available
right in your own backyard at the Hypothalamic Hamartoma Center (HHC), part of
North Shore-LIJ’s Cushing Neuroscience
Institute (CNI).
A hypothalamic hamartoma is a benign
brain lesion found in the hypothalamus, a
small but critical area located deep within
the brain that is responsible for many
automatic functions, including hunger,
thirst, body temperature and hormone
regulation. A hypothalamic hamartoma can
cause seizures, premature puberty and
progressive deterioration of behavioral and
cognitive function.
“Hypothalamic hamartomas are debilitating, but the good news is that surgical
removal of this birth defect can result in the
patient having a normal or much-improved
nor thshorelij.com
15
life,” said neurosurgeon Harold Rekate, MD,
director of CNI’s Hypothalamic Hamartoma
Center. “Although several treatment options
are available, the plan of clinical care must
be strategically individualized because what
may be appropriate for one patient, may be
different for another depending on the
anatomy of the lesion.”
In addition to Dr. Rekate, the HHC is
staffed with a multidisciplinary team of
experts. “Since our physicians and specialists are involved in all treatment plans and
therapies, the Hypothalamic Hamartoma
Center is a prime destination for those
suffering from this rare condition,” said
Dr. Rekate.
Surgical removal of hypothalamic
hamartoma involves working within the
center of the brain, while protecting vital
structures that surround the mass. The
surrounding structures include all the arteries
that supply the brain — regions that are
responsible for memory, thirst, hunger,
passion, rage and all the body’s hormone
control. Avoiding these vital structures
requires the ability to use different approaches
in different patients. In most cases, the
hamartoma can be removed using an
endoscope through a small hole in the skull.
But some patients require more than one
approach to completely remove the mass. n
+
Learn more about expert
neurological care at the
Cushing Neuroscience Institute’s
Hypothalamic Hamartoma Center.
Call 516-570-4400 or visit NeuroCNI.com.
Orthopedic Advances
Patient Defies the Laws of Recovery
After Head-On Auto Accident by Mara Mazza
A
ll mid-July mornings last year started
the same way for Domenico Vecchie.
Shortly after waking in the Surgical
Intensive Care Unit at North Shore University
Hospital (NSUH), the 23-year-old from
Franklin Square would welcome a kind and
friendly face into his room. This was the
only constant in his life, and he waited with
anticipation for the daily visit from his
surgeon, Ariel Goldman, MD, an attending
orthopedic surgeon at NSUH and LIJ
Medical Center, and a specialist in the care
of severe fractures and trauma.
About a week after surviving a head-on
car collision on Old Country Road, Mr.
Vecchie finally wanted to understand what
he had endured in the wee hours of July 10,
2011. Staring at the computer screen in his
room with Dr. Goldman by his side, Mr.
Vecchie viewed the X-rays of his shattered
left hip socket, broken left tibia and broken
left elbow before his operations, and it was
a heart-stopping sight to see so much of his
body in pieces.
“That morning, I wanted to know what
really happened,” said Mr. Vecchie, a
banquet manager at a catering hall in Carle
Place. “I still didn’t understand what I had
broken, since so much of my body was in a
cast. Dr. Goldman came by every morning
to see how I was healing, and I appreciated
that he kept me informed of what was going
on and what he had done.”
What Dr. Goldman and the multidisciplinary
team who cared for Mr. Vecchie did was
nothing short of extraordinary. It is a prime
example of how a collaborative and coordinated approach to urgent patient care can yield
not only lifesaving results but also the best
chance of returning to life as it was for patients
with life-threatening trauma injuries.
Teamwork at Its Best
Dr. Goldman led a 12-hour marathon
surgery in which he inserted a titanium
metal rod through the middle of Mr.
Vecchie’s tibia to stabilize bone that was
Domenico Vecchie has fully recovered from the multiple injuries he received during a head-on
car collision last July.
broken in several pieces; repaired his elbow
with three screws and a metal plate; and
fixated his shattered hip socket, an extremely
complicated and time-consuming procedure
that very few orthopedic surgeons have the
training to perform.
Unlike the knee or elbow, which can be felt
externally, the hip joint lies deep behind
muscle and is surrounded by vital arteries and
nerves. To reach down and expose the entire
16
hip joint, Dr. Goldman had to maneuver
carefully through muscle and safely move
major blood vessels, arteries and the sciatic
nerve. “Managing this delicate anatomy
carefully was imperative because we were
dealing with a hip fracture that had very
sharp spikes of bone that could potentially
puncture them,” said Dr. Goldman.
As if the long and complicated
orthopedic surgery was not difficult
enough, Dr. Goldman and his team
members had to factor in the vascular
surgery Mr. Vecchie had undergone days
before to repair his aorta, which had
been torn down to a hairline.
“Mr. Vecchie just had vascular surgery
on a major heart vessel, causing significant
blood loss. As a result, we looked for the
earliest possible window, when he was
stable enough to undergo an even longer
surgery to repair his injuries,” said Dr.
Goldman. “Mr. Vecchie’s trauma surgery
required a comprehensive group effort
from the surgery and anesthesiology teams
to ensure that the appropriate amount of
fluids and blood transfusions were
administered during the procedures. It was
a risky surgery, but we all worked together
to make sure he came through it OK and
experienced the best long-term outcome.”
The Come-Back Kid
Mr. Vecchie’s recovery was miraculous to
say the least. A little more than two weeks
after the accident, the next phase in his
continuum of care began at Glen Cove
Hospital’s Acute Inpatient Rehabilitation
Unit, where he benefited from its
extensive treatment services.
“Dr. Goldman gave me so much
encouragement, assuring me that I was
recovering faster than he expected,” said
Mr. Vecchie. “I also remember the two men
who moved me from North Shore
University Hospital to Glen Cove Hospital.
They read over my chart and wanted to
make sure it was correct because they
couldn’t understand why I was leaving so
soon. After 14 days and multiple injuries,
they couldn’t believe that I was ready to
start rehab. They thought I shouldn’t be
going in for another month. But I am
young, I didn’t give up and I kept a good
attitude. I just wanted to get home, get
nor thshorelij.com
17
back to work and start enjoying life again.”
His rehabilitation therapists at Glen
Cove Hospital were equally baffled. They
would have happily kept him as an
inpatient longer, but there was nothing
more Mr. Vecchie needed to accomplish;
he could easily work on the rest at home
with a physical therapist. After completing
his inpatient rehab in only 16 days, Mr.
Vecchie returned home in mid-August. He
continued to practice his physical therapy
at home and through Sports Therapy and
Rehabilitation Services (STARS) in
Manhasset. By Thanksgiving, Mr. Vecchie
happily returned to work.
“I don’t know why, but meeting Dr.
Goldman was the first thing I recalled after
my accident,” said Mr. Vecchie. “His
constant presence and guidance during the
days leading to my surgery are so clear in
my memory.” Mr. Vecchie attributes his
survival and quick recovery to his positive
attitude, the support he received from his
family and friends, and the skill, knowledge, attentiveness and encouragement of
Dr. Goldman, who has left a lasting
impression on him. n
+
We’ll help you get moving
again. The North Shore-LIJ
Orthopaedic Institute specializes in
multidisciplinary care for the entire
spectrum of musculoskeletal
disorders to help patients regain
mobility and return to active,
independent lives. For a referral to
one of our orthopedic specialists,
please call 516-465-8663.
The Rehabilitation Network
provides inpatient and outpatient
treatment for orthopedics, neurology, pulmonary medicine, cardiology
and generalized debilitation due to
chronic illness. STARS’ convenient
locations are in Manhasset, Roslyn
Heights, East Meadow and Forest
Hills. Call 888-REHAB-03 (734-2203)
to learn more.
Prevent Falls,
Stay Independent
by Nancy Copperman, RD
Falling is a genuine concern for older adults,
but it’s easy to reduce the risk of falling and
injury with simple lifestyle changes.
Fortunately, falls are largely preventable.
The North Shore-LIJ Health System has
created Stepping On, a free falls-prevention
program that encourages independence at
home and in the community for anyone 60
and older. This new seven-week program
arms senior adults with the knowledge and
tools to reduce or eliminate falls and the
fear of falling — and to build confidence.
Healthcare professionals, such as nurses,
physical and occupational therapists,
health educators, pharmacists and vision
specialists, demonstrate how to prevent
falls with strength and balancing exercises,
medication management, home safety,
footwear, vision and mobility.
How to Reduce Your Fall Risk
Get regular exercise. Walking and doing
balance exercises, such as tai chi, can
increase strength and improve balance.
Review medications with your
doctors and pharmacist. This can reduce
medication side effects and interactions
that increase the risk of falls.
Get an eye exam at least once a year.
Regular vision and eyeglass checkups will
detect vision problems that can cause falls.
Improve home safety. Remove tripping
hazards; add grab bars to showers/tubs/
toilets; install railings next to steps; and
improve lighting in and around your
home. Making these changes can greatly
reduce the chance of injury from falling.
Take steps to avoid a fall.
Call 515-465-2500 to learn more about the
falls-prevention program. For more about
how to avoid falls and stay independent,
visit preventfalls.NorthShoreLIJ.com.
Orthopedic Care
Connecting with Orthopedic Oncology
Patients to Save Lives and Limbs
S
amuel Kenan, MD, was always interested
in fixing things, so it was no surprise that
by his last year of medical school, he decided
to take a residency in orthopedics. But the
chairman of the department at Hadassah
University Medical Center, Mayer Makin,
MD, had other things in mind for the young
man. Dr. Makin recommended that he train in
orthopedic oncology and spend a year working
in bone pathology to understand everything he
could about bone cancer.
That was back in 1977, when fixing bone
tumors meant amputation. But the chairman
had hopes that Dr. Kenan would move the field
into new directions that included limb-sparing,
lifesaving surgeries. His mentor was right.
Creating Joint Prosthetics
Dr. Kenan finished his yearlong stint at
Hadassah’s pathology laboratory and completed
six years of residency in orthopedic surgery at
the Israeli health system before coming to New
York for a fellowship with Michael Lewis, MD,
at the Hospital for Joint Diseases. Dr. Lewis was
doing precisely what the Hadassah chairman of
orthopedics had envisioned: He was creating
joint prosthetics made of metal and bone, and
enabling pediatric cancer patients to walk out
of surgery with their legs intact.
The bone prosthetics were a major
advance, but the pediatric population
brought new problems. Children’s bones
grow, so they had to figure out how to get
both legs to match. They developed bone
prosthetics that could be expanded as their
patients grew. It changed the field, and Dr.
Kenan became a fixer with a mission. “It’s
hard enough that children have bone cancer,
but then to tell them that they might lose a
leg was just too much,” Dr. Kenan said.
Online Extra
“It’s hard enough that children have bone cancer, but then
to tell them that they might lose a leg was just too much.”
Dr. Kenan began working on sparing the
growth plate, even when tumors were
precariously close to the plate. Saving the
growth plate meant that the limb would
grow naturally to match the other leg.
He has been following some of his
patients for more than two decades.
Dr. Kenan went on to head several orthopedic oncology programs, from the Hospital for
Joint Diseases to Mount Sinai Medical Center
and Hadassah. He was recently recruited by the
North Shore-LIJ Health System to head an
initiative in orthopedic oncology that offers
young patients access to a team of health
professionals, starting from the initial suspicion
that there may be something wrong to
chemotherapy surgery and lifelong care.
Connecting with Patients
In addition to his technical skill in the
surgical suite cutting out diseased bone,
crafting an implant and setting the stage for
healing, Dr. Kenan connects with his young
patients in indelible ways. When 18-year-old
Mariela Calderon of Port Washington
showed up last October with osteosarcoma,
Dr. Kenan called Nicole Lubin of Hempstead,
a teenager who recently underwent surgery
for bone cancer, and brought the girls
together. Nicole came to visit Mariela at
Cohen Children’s Medical Center (CCMC) of
New York. Watching Nicole walk effortlessly
Hear about Mariela and Nicole’s
experience with joint prosthetics. Go to http://bit.ly/Lqg4nk
or use your smartphone to scan the QR code.
gave Mariela hope that someday soon her
crutches would be a thing of the past. And
her leg, like Mariela’s, would be spared.
“Dr. Kenan is technically exceptional, and it
is the whole package of what he brings to the
surgical table,” said Jeffrey Lipton, MD, PhD,
chief of pediatric hematology/oncology and
stem cell transplantation at CCMC. “These
patients are complex and we have teams of
professionals working with patients.”
Dr. Kenan has performed nearly 250 of
these surgical cases during his career. He
keeps in touch with many of the children,
some of whom are now grown. He saves
videos and photos of his young patients
during all stages of the process. He pulls up a
digital picture of John Browndorf, who is
now 28 and taller than his doctor. Mr.
Browndorf was 6 years old when he was
diagnosed with Ewing’s sarcoma, located in
the proximal tibia. The first thought was that
there would be no way to spare the growth
plate; the tumor was too close. But his father,
a golfer, wanted his son to walk — with both
feet planted on the green — in his footsteps.
“Do what you can to save the growth
plate,” his father said. Dr. Kenan listened,
carrying off the complicated surgery. Now,
more than two decades later, Mr. Browndorf
stands tall. And plays golf.
Mariela said that she wants to be a medical
assistant when she grows up. And she looks
forward to the day when she can replace her
crutches with a fancy pair of high heels. n
+
Get expert orthopedic care.
To find out more about the
orthopedic services offered by
Dr. Kenan, call 516-280-3733.
18
Samuel Kenan, MD, removed cancerous
bone and replaced it with a limb-sparing
device that will enable Mariela Calderon,
left, to walk normally without fear of losing
a leg to cancer. Dr. Kenan introduced Mariela
to Nicole Lubin, right, who underwent
surgery for bone cancer a few years ago.
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19
Prostate treatment
Robotic Prostate Surgery
Turns Three Men into Believers
P
atrick Chierichella slowly opened his eyes
to find himself in a bustling recovery room
at North Shore University Hospital (NSUH).
The 66-year-old awoke after his prostate
surgery to a flurry of activity around him;
nurses and doctors attentively conversed,
working on what seemed like hundreds
of different tasks. The last thing he could
remember was walking through a set of giant
stainless steel doors that led to a large
operating room with a space-age machine.
“The entire moment was like something
out of science fiction,” said Mr. Chierichella,
a retired science teacher for the Sachem
School District in Suffolk County. He had
heard in passing and read about robots being
used in surgeries. But here he was, approaching the enormous machine that was going to
perform his radical prostatectomy.
Radical prostatectomy is a treatment option
for prostate cancer when it is localized to the
prostate gland, with the prime goal of removing
the cancer completely before it has a chance
to spread to other parts of the body. The
procedure entails removal of the entire
prostate gland, the attached seminal vesicles
(a pair of glands that produce part of the
semen) and the vas deferens (the muscular
cord that pumps sperm from the testicles to
the urethra).
Cancer Control Is the Goal
“The robotic approach to radical prostatectomy is my favored approach and the gold
standard for prostate cancer cure,” said Lee
Richstone, MD, chief of urology at NSUH,
and vice chairman of the Arthur Smith
Institute for Urology at the Monter Cancer
Center. “Depending on the grade or stage of
the cancer, most of my patients have a 90 to
95 percent chance of total cure. I firmly
believe that this procedure offers the best
option for cancer control.”
Using the da Vinci Robotic Surgical
System, the surgeon sits at a computer
console and operates by manipulating
master controls to four robotic arms, which
are connected to a variety of surgical
instruments. The system’s state-of-the-art
technology allows the surgeon’s hand
movements to be scaled, filtered and
translated in real time, while the surgeon
views the operation through 3-D cameras
that transmit magnified images of the
organs to a video monitor.
When David Roberts, 65, felt nervous
before his upcoming surgery, he and his
wife, Dianne, sat with Dr. Richstone, who
walked them through the procedure, step
by step, while they watched a video of him
performing the robotic prostatectomy. “I felt
very good that everything was so magnified.
What normally looks small, looks gigantic
on his monitor,” said Mr. Roberts, a former
Shirley resident who recently retired to
North Carolina. “Watching how the
machine’s arms actually moved like real
hands made me feel more comfortable.”
by Mara Mazza
Tough Decisions
Diagnosed with prostate cancer when he
was only 45, Paul Riley of Wantagh was
married with two sons starting high school
and middle school. “I was shocked when I
got my diagnosis. In my head, I thought,
‘I’m young, I’m active, I’m thin. I am doing
everything right. Why is this happening?’”
In addition to robot-assisted surgery, Mr.
Riley was given the option of radiation
therapy using radioactive seed implants. “I
researched the radioactive seeds, but it did
not seem to be a viable treatment option for
me because of my age,” said Mr. Riley, who
works at the trading desk of a brokerage
firm in Manhattan. “The seeds would be
inside me permanently, and I didn’t want to
walk around with them for the remainder of
my life. I preferred the robotic surgery
option because it was more modern and
“I preferred the robotic surgery option because it was
more modern and seemed more precise and controlled.”
There are three surgical approaches to radical
prostatectomy, including the open technique
that involves a six- to eight-centimeter incision
between the belly button and pubic bone, and
the laparoscopic method, a minimally invasive
procedure that begins by inflating the abdomen
with carbon dioxide gas to create a working
space. The surgeon then inserts thin instruments into the body through several small
incisions to perform the operation.
The third technique, the robotic approach, begins the same as laparoscopic
surgery, but the surgeon makes several
one-centimeter incisions in the abdomen, in
which the surgical instruments are inserted
into the patient’s body and maneuvered
remotely from the console.
seemed more precise and controlled. I think
Dr. Richstone explained that it’s ‘a better
pair of scissors’ and I liked that.”
The robot’s instrumentation provides
greater mobility, range of motion and
movement precision, which is an important
advantage in prostate surgery, where fine
motions are needed to protect neurovascular bundles and reconstruct the urinary tract
to ensure continence.
“In addition to complete removal and
eradication of the cancer, my focus during surgery is on preserving urinary continence and
erectile function,” said Dr. Richstone.
“Ninety-five percent of my patients become
totally continent, without the need for
long-term use of pads. The majority of my
patients also return to normal sexual function.
20
For most men, robotic prostatectomy gives
them some of the best outcomes with
respect to their quality of life.”
Like It Never Happened
The robotic prostatectomy is a minimally
invasive procedure that is performed in
approximately four hours. Blood transfusions are almost never needed, and a vast
majority of patients go home the next day.
When family and friends visited Mr.
Chierichella in the recovery room shortly
after his surgery, they were dumbfounded
because he looked like he just woke up from
a nap.
“I know I had major surgery; I know these
mechanical arms were in my body, but for the
fact that I never felt anything, it is amazing,”
said Mr. Chierichella. “From the time I awoke
in recovery to the time I was in my car to go
home, it was 48 hours. The idea that I was
David Roberts felt at ease after watching a video
of the robotic surgery procedure.
nor thshorelij.com
21
“For most men, robotic
prostatectomy gives some
of the best outcomes with
respect to quality of life.”
mobile and walking around so quickly after
the procedure, that I was still in control of my
own life, for this I am so grateful. I was out
playing golf within a month of the surgery. I
could not have been happier.”
Dr. Richstone currently performs all radical
prostatectomy procedures using the da Vinci
Robotic Surgical System. And he is one of a
few people in the world to perform single-site
prostatectomy, the removal of the entire
prostate through the belly button. He believes
this procedure may soon take on a greater role
in prostate cancer surgery. In addition, Dr.
Richstone and others at the Smith Institute are
investigating a novel surgical approach called
the NOTES (natural orifice transluminal
endoscopic surgery) radical prostatectomy, in
which the prostate is completely removed by
going through the opening of the penis, and is
therefore a scar-free procedure without a
single external incision. n
+
Learn about your options.
To schedule a consultation,
call the Arthur Smith Institute for
Urology at 516-734-8500 or visit
smithinstituteforurology.com.
NOrth Shore-LIJ News
$300M 10-Story
LIJ Tower Transforms
Campus and Care
T
he North Shore-LIJ Health System
recently completed the single largest
expansion project in its history — a
10-story glass tower at LIJ Medical Center
featuring 162 single-bed rooms with
hotel-like accommodations.
The $300 million project — featuring the
Zuckerberg Pavilion and Katz Women’s Hospital — opened to the public this winter after
more than three years of construction. With
its glass facade and hallways the length of a
football field, the 300,000-square-foot tower
fully transforms the 1950’s appearance of the
hospital. Among the many new enhancements
are a meditation center, women’s garden,
reflecting pool, wellness boutique, education
room, and patient and family resource center.
“This is truly a transformational time in
the history of this hospital and the entire LIJ
Medical Center campus,” said North
Shore-LIJ President and CEO Michael
Dowling. Designed to accommodate both
patients and family members in an elegant
setting, each room includes a private
refrigerator, bath, flat-screen TV and safe,
and all patients have their own designated
“food ambassadors” so that they can
customize their meal orders. To add to the
patient- and family-friendly atmosphere,
each floor has at least two family waiting
areas, nearly all floors are carpeted to
reduce noise and all include special
nighttime lighting to make it easier for
patients to sleep undisturbed.
New Medical Technology
To improve medical care, all units have
decentralized nursing stations so that staff
can closely monitor patients, using telemetry
technology in each room that allows for the
From left, board members Saul and Iris Katz and
Roy Zuckerberg; Michael Dowling, president and
CEO; Richard Goldstein, board chairman; and
Chantal Weinhold, LIJ executive director.
measurement of patients’ heart and breathing
rates, blood pressure, blood-oxygen levels
and other vital information. All rooms also
have kidney dialysis hookups available. In
addition, 75 new staff members have been
hired to staff the new facility.
“Clearly, we’ve entered a new era in healthcare delivery, allowing us to begin writing a new
chapter in the history of LIJ Medical Center,”
said hospital Executive Director Chantal
Weinhold. Richard Goldstein, North Shore-LIJ
board chairman, said the unveiling represented
the “culmination of a vision” made possible by
two of his predecessors as board chairmen,
trustees Roy Zuckerberg and Saul Katz, as well
22
as associate trustee Iris Katz. “There are
many people whose generosity made this
day a reality, but certainly none more than
the people whose names adorn this
magnificent building,” Mr. Goldstein said.
Mr. Zuckerberg, a Manhattan resident, has
been a supporter of LIJ Medical Center and
the health system for more than 20 years,
while Mr. Katz’s involvement with North
Shore-LIJ dates back to 1982. Residents of
Glen Cove, Mr. and Ms. Katz have worked
tirelessly to support women’s health.
The 57,000-square-foot Zuckerberg
Pavilion will serve as the new entrance for
all LIJ services. It includes a two-story
lobby and 60 new single-bed surgical
rooms on the eighth and ninth floors for
orthopedic, urological and cardiovascular
patients, as well as a physical therapy gym.
Realizing a Dream of Motherhood
Among the celebrants on hand at the opening of the medical center’s new facility was
30-year-old Cheryl Lampasona, a long-time patient at LIJ Medical Center. About 10
years ago, the Mineola resident was diagnosed with a rare Wolffian tumor near her
ovaries (one of only 12 such reported cases worldwide). A plan of care needed to be
created for Ms. Lampasona to help fulfill her desire to have children.
After following the course of treatment planned by Diana Contreras, MD, chief of
gynecologic oncology, which involved laparoscopic surgery every six months for three
years to evaluate and manage the level of the disease, Ms. Lampasona became pregnant in 2005 and now has two healthy boys. Michael and Ryan, both delivered at LIJ,
joined their mother as she paid tribute to the care she received at the hospital.
“It had always been my goal to become a mother and have a family,” Ms. Lampasona said,
“so you can imagine my shock when I was diagnosed with this potentially life-threatening
and virtually unknown illness. Words can’t express how grateful I am to Dr. Contreras and the
teams of people who treated me when I was sick. They treated my cancer without taking
away my ability to bear children. Thanks to them, and their knowledge and compassion,
I was able to realize my dream. I have two beautiful boys and my health. What else is there?”
Private Rooms
With its own separate entrance, the Katz
Women’s Hospital features a range of
maternity and gynecological surgery
services on four floors. Housing one of the
busiest maternity programs in New York
State, with more than 5,000 babies
delivered annually, it includes 88 private
patient rooms and 14 labor and delivery
rooms, as well as newborn nurseries, four
operating rooms and other specialty
services. Last May, North Shore University
Hospital opened the first phase of the Katz
Women’s Hospital on its Manhasset campus.
That $50 million expansion and modernization project features 73 private rooms. n
+
To find out more
about women’s health
services at North Shore-LIJ,
visit NorthShoreLIJ.com/obgyn.
The Lampasonas joined the
celebration at the unveiling
of the 10-story facility.
Be Part of the Conversation
Follow North Shore-LIJ on Facebook and Twitter
Get up-to-the-minute healthcare information when you follow the North Shore-LIJ Health System on
Facebook and Twitter. You’ll get the latest health news, press releases, free health screening information
and community education events, plus a host of wellness and other important information.
Find us on Facebook.com/NorthShoreLIJ or Twitter.com/NorthShoreLIJ.
nor thshorelij.com
23
Special Forces Medics Get Special Training,
Courtesy of North Shore-LIJ by Marc Greene
N
ormally, when you hear the word PJs
you think of a garment that you wear to
bed. But on a recent Friday afternoon, PJs
took on an entirely different meaning. On
this particular afternoon, a group of
Pararescue Jumpers, aka PJs, from the
103rd Rescue Squadron of the New York
Air National Guard/US Air Force from
Westhampton Beach, came to the North
Shore-LIJ BioSkills Education Center in
Lake Success for a special workshop on
combat medical care.
The Pararescuers, some of whom deployed
to the Mideast within a week of their visit to the
BioSkills Education Center, are an elite combat
force specifically organized, trained and
equipped to conduct both conventional and
unconventional combat and noncombat rescue
operations. They are the most highly trained
and versatile personnel recovery specialists in
the world. Because of their training, the
pararescuers are called on to execute the most
perilous, demanding and extreme rescue
missions anytime, anywhere across the globe.
In light of the pararescuers’ critical
mission, the workshop — directed by Lt.
Col. Stephen Rush, MD, a pararescue flight
surgeon, and Jason D’Amore, MD, director
of the North Shore-LIJ Advanced Airway
Jason D’Amore, MD, center, trains pararescuers from the 103rd Rescue Squadron of the New York Air
National Guard/US Air Force during a recent visit to the North Shore-LIJ BioSkills Education Center.
Training Center — focused on the advanced
lifesaving skills that are necessary when
performing in severe environments where
hospitals and physicians are not readily
available. The operating room for pararescuers is frequently in the back of a helicopter.
Necessity Spurs Innovation
Jason D’Amore, MD, director of the North Shore-LIJ Advanced Airway Training Center,
conducts workshops on combat medical care with the Air National Guard pararescuers. When he first presented these medical workshops, he was surprised at the surgical
medical kits for cricothyrotomy, commonly called a cric kit, used by the military in the
field. “The kit was clearly designed by people who never went into the field to use it.
There were basic surgical tools that should’ve been included but weren’t, and some of
the tools were just too big to fit in the standard-issue kit.” Necessity being the mother
of invention and innovation, Dr. D’Amore teamed with medical device manufacturer
Cook Medical to create a new cric kit that would not only have the appropriate
surgical tools, but would also fit in a pararescuer’s fanny pack. “One of the pararescuemen showed me his own kit, which he had literally taped together with surgical tools
from an assortment of scavenged kits. I knew that we had a serious need that had to
be addressed, but I also knew that we could put something together that would fit
the bill — and the fanny pack.”
While training at the BioSkills Education
Center, part of North Shore-LIJ’s corporate
university known as the Center for Learning
and Innovation (CLI), pararescuers learned
critical techniques that previously could
be practiced only in a very basic way on
computerized simulators, such as those
available at the CLI’s Patient Safety Institute,
also in Lake Success. The state-of-the-art
training facilities at BioSkills offer a unique
opportunity for military personnel to practice
medical skills in areas such as advanced
airway intubations, chest tube placement and
deep-wound packing, along with multiple
suturing techniques for skin closure.
“I can say without equivocation that the
care that we are able to render to members
of our armed services in critical rescue
situations is truly enhanced by our experience at the BioSkills Center,” said Lt. Col.
Rush. “We have been fortunate to have
Dr. D’Amore as an enthusiastic and expert
teacher, and the gratitude of the pararescuers
cannot be underestimated.”
continued on next page
24
What It Means to Be a Patriotic Employer
by Michelle Pinto
S
ince Operation Iraqi Freedom began in
2003, much has been written about the
plight of returning military personnel. One
member of the US Army Reserves, Michael
Kentner, platoon sergeant, 773rd Transportation
Company, Fort Totten, who is also a New York
City firefighter and a maintenance worker at the
North Shore-LIJ Stern Center for Rehabilitation,
knows how important it is for reservists to have
a supportive work environment.
Last year, Mr. Kentner found a Web site
maintained by Employer Support of the Guard
and Reserve, a Department of Defense agency
that seeks Patriot Award nominations for
employers that support military-reservist
obligations. He wrote a letter extolling his
immediate supervisor, Walter Oberman, the
Stern Center’s assistant director of engineering,
who “continues to support what I’m doing with
a special sincerity that gives you chills. This guy
embodies a certain intangible patriotism that
simply cannot be articulated in words on paper.”
At the recent ceremony to accept the
Patriot Award, Mr. Oberman was surrounded
by colleagues, veterans, and active duty and
reserve military personnel. He said he was
both humbled and honored to work with
his good friend who, he added, “is clearly
an American hero. How can you not want
to help someone whose only thought is to
help his country and his city?”
Andrew Roberts, director of North
Shore-LIJ’s Office of Military and Veterans
Liaison Services, led the ceremony. Also an
Iraq war veteran, Mr. Roberts noted that the
North Shore-LIJ Health System has recruited
100 veterans for various staff positions
throughout health system facilities. He
praised the health system’s practice of paying
employees on military leave the difference
between military pay and their regular
salaries, ensuring that their service to our
country does not create economic hardship.
Also on hand to present the award was
Sgt. Major Vincent Mannion, 301st Information Operations Battalion, Fort Totten. “There
are so many people who talk the talk but
wind up complaining about the reservists’
military obligations,” he said, congratulating
Maureen McClusky, executive director of the
Stern Center, and staff members for providing true support and concern. n
From left: Andrew Roberts, Sgt. Major Vincent Mannion,
Maureen McClusky, Walter Oberman, First Sgt. Kilsi
Ciprian, and Michael Kentner, platoon sergeant and
Stern Center staff member accept the Patriot Award.
continued from previous page
Lt. Col. Rush thanked the North Shore-LIJ
Health System for opening its doors to the
military and BioSkills Education Center
Director Joseph Colaccico for his logistical
help and support. “The staff at the center
has been incredibly helpful to enable us to
have an efficient experience and, more
important, a valuable experience,” he said.
Lt. Col. Rush said the 103rd Rescue Squadron
currently has three airmen deployed in the
theater of operation. “I can truly say that not
only were two lives saved because of techniques
nor thshorelij.com
25
that we practiced and honed in the BioSkills labs,
but also the patients were kept more comfortable as a result of the treatments and techniques
that the pararescuemen learned,” he said.
North Shore-LIJ’s BioSkills Education
Center brings the latest operative techniques
Online Extra
to physicians, medical students, nurses and
surgical technologists. Coupled with the
most advanced technologies in video and
endoscopic surgical equipment, the center
supports surgical training, continuing
medical education and research. n
Watch the Pararescue Jumpers
team train for action at the BioSkills Education Center.
Go to http://bit.ly/zbMwNS or use your smartphone to scan
the QR code.
NASA Seeks Neuro Expertise from North Shore
University Hospital Specialist by Michelle Pipia-Stiles
W
hen the National Aeronautics and Space Administration (NASA)
sought medical insight on how to protect astronauts’ vision, they
knew where to turn: Harold Rekate, MD, director of the Chiari Institute
at North Shore University Hospital. Dr. Rekate is world renowned for
his research over the past 30 years relating to the causes and treatment
of raised intracranial pressure. He recently joined the agency’s advisory
board for the Visual Impairment Intracranial Pressure (VIIP) Program.
The program analyzes the physiological and anatomical changes in
astronauts who participate in long-duration space missions, where
intracranial pressure may cause long-term visual impairment. A study
sponsored by NASA found that space flights lasting six months or
more can cause a spectrum of changes in astronauts’ visual systems,
including blurry vision and excess fluid around the optic nerve.
“Before astronauts embark on space missions, we need to determine who is at risk of developing intracranial hypertension. When
they return, we need to determine who has suffered visual impairment as a result of intracranial pressure and decide how to best treat
them to prevent these problems,” said Dr. Rekate. “Intracranial
hypertension can be measured with a spinal tap, wherein a needle
inserted into the spinal canal in the lower back measures cerebrospinal fluid surrounding the brain and spinal cord. The VIIP advisory
board is investigating other kinds of treatment that are less invasive,
such as ultrasound. The advisory board will first need to determine if
the raised intracranial pressure is a result of an eye or brain problem.”
This year, the VIIP advisory board will meet to enact protocols so
Harold Rekate, MD, egresses the Space Shuttle astronaut training facility at
NASA’s Johnson Space Center.
that astronauts can be screened before a space mission; to determine what astronauts can do to relieve intracranial pressure while
in space; and upon their return, measure intracranial pressure
immediately and treat those with elevated levels. n
New Corneal Treatments Restore Vision
Most people never give the covering surfaces of the eye much
thought, but diseases of these layers can be terribly debilitating, causing chronic pain and even blindness.
The care of these layers calls for a unique combination of
specialized training, diagnostic equipment and surgical techniques. Most of all, this care requires the formation of a team
to build lasting relationships with the patients who suffer from
these often chronic problems.
Physicians at the North Shore-LIJ Health System treating these
diseases have created a unique Ocular Surface Center. Anne
Steiner, MD, directs the center and spends much of her day
evaluating and treating patients with complex corneal diseases.
Led by Ira Udell, MD, chairman of the Department of
Ophthalmology at the North Shore-LIJ Health System, this center offers novel approaches and distinctive therapies for a
broad range of corneal, conjunctival and tear-film conditions.
Among these treatments is a device developed by the Boston
Foundation for Sight called prosthetic replacement of the ocular
surface ecosystem (PROSE). About the size of a nickel, the transparent dome sits on the ocular surface, and a sterile saline keeps the
eye moist and free of environmental contaminants.
“We now have a powerful new tool to restore vision to these
patients without surgery,” said Dr. Steiner. She added that a
growing number of military men and women whose lids have
been severely injured in combat are being successfully helped by
the PROSE device at the Brooke Army Medical Center Burn Unit.
North Shore-LIJ ophthalmologists have screened 50 people
for the device since August and have fit a dozen of them. The
cost is $5,500 for one and $8,000 for the pair. The center also
offers ocular stem cell transplants, in which stem cells are harvested from a healthy eye or from a donor and implanted to
regrow cells on the surface of the injured eye.
26
US News Awards Five Stars
to Stern Center
T
he North Shore-LIJ Stern Center for
Rehabilitation recently earned the top
five-star overall quality ranking in US
News & World Report’s annual Best
Nursing Homes edition. The report
recognizes top-rated facilities in all 50
states and offers important guidance to
families and healthcare providers.
US News & World Report’s evaluation of
nursing homes is based on data from Nursing
Home Compare, a consumer Web site run by
the US Centers for Medicare and Medicaid
Services. Facilities earn an overall rating of
one to five stars, as well as up to five stars in
each of the categories of health inspections,
nurse staffing and quality of care.
Of more than 15,500 nursing homes rated
and profiled on the US News Web site, the
North Shore-LIJ Stern Center for Rehabilitation was among the fewer than one in eight
that received a five-star overall quality rating
in all four quarters of 2011. According to
US News, more than three million
Americans will spend part of this year in a
nursing home. “Nursing homes in New
York and across the country vary in
quality of care and the healthcare services
they provide to residents,” said Maureen
McClusky, executive director of the Stern
Center. “Earning US News’ five-star
quality ranking is a top honor, thanks to
the dedication of our clinical teams and
our entire staff. The report also gives
concrete quality measures consumers can
access on the Internet to help them select
the best nursing home for family members or loved ones.”
Located on North Shore University
Hospital’s Manhasset campus, the 256-bed
Stern Center for Rehabilitation specializes
in short-term rehabilitation, skilled nursing
and extended care services. n
+
Learn more about services
at the Stern Center for
Rehabilitation at 516-562-8000 or
visit NorthShoreLIJ.com. For more
information on the ratings, visit
USNews.com/nursinghomes.
Free Program Gives
Strength Back to
Cancer Patients
Cancer patients and survivors can regain
their strength at free weekly group
exercise classes, courtesy of Sports
Therapy and Rehabilitation Services
(STARS) and Strength for Life.
The Strength for Life Program includes:
individualized exercise plans based
on your needs;
instruction by certified cancer
exercise specialists;
take-home exercise equipment; and
education on the benefits of exercise.
No equipment is needed — just bring
yourself, water and a towel.
Classes take place at STARS, 801 Merrick
Avenue in East Meadow every Friday, from
2 to 3 p.m. or 3 to 4 p.m. Medical clearance and preregistration are necessary.
To register or learn more, call 631-6756513 or visit StrengthForLifeNY.org.
nor thshorelij.com
27
Healthcare Reform Glossary
by Mary Elizabeth Dallas
Navigating healthcare reform can be tricky if you’re unfamiliar with the terminology.
Here is a glossary of commonly used terms and topics.
Accountable Care Organization
Groups of doctors, hospitals and other
healthcare providers that work together to
administer coordinated care for Medicare
patients to streamline services and avoid
medical errors. These organizations are
eligible to receive a share of the savings they
achieve for Medicare.
Affordable Care Act of 2010
A comprehensive healthcare reform bill
signed into law by President Obama in
March 2010. This legislation was passed with
the aim of lowering healthcare costs,
improving the quality of healthcare and
expanding coverage to 32 million Americans.
Association Health Plan
These plans allow groups, such as trade and
professional associations, to offer health
benefits to their members. By grouping
these individuals together, the plans have
the buying power of a larger organization,
allowing them to offer better rates and
comprehensive benefits.
Basic Health Program
Federally subsidized state-run coverage
program for low-income individuals who
are not eligible for Medicaid and do not
have access to an employer-sponsored plan.
Going Abroad?
Protect your health
when you travel
overseas. Contact the
North Shore-LIJ Travel
Immunization Center
before your getaway.
Call 516-562-4280
to learn more.
States have the option to create and offer a
basic health program under the Affordable
Care Act of 2010.
Cost Containment
Efforts to lower increases in healthcare costs.
Insurance Exchanges
Bundled Payments
A payment structure that motivates healthcare
providers to offer high-quality care. With
bundled payments, two or more healthcare
providers treating the same patient over a certain
period of time are paid a collective lump sum
instead of individual payments for specific tests
and procedures. There are multiple models for
bundled payments.
The Affordable Care Act of 2010 calls for
every state to establish an insurance
exchange by 2014. These exchanges will
serve as a marketplace where individuals and
small businesses can review their healthcare
options and buy plans at competitive rates.
Plans that participate in the exchanges must
be accredited for quality and will use a single
enrollment form.
Capitation
Medicare Payment Incentives
A method used by health insurance plans to
reimburse healthcare providers. Doctors receive
a fixed amount of money for each patient for a
set period of time. This money is paid to
doctors in advance. The amount is based on
local costs and average use of services.
Medicare providers have the opportunity to
receive incentive payments for participating
in certain Medicare initiatives, including the
Physician Quality Reporting System, the
Electronic Prescribing Incentive Program
and the Electronic Health Record Incentive
Program.
Consumer Operated and
Oriented Plans (CO-OPs)
A type of nonprofit health insurer operated
by a board of directors that is elected by its
customers. By using profits to lower
premiums and improve benefits, these plans
are intended to provide consumer-friendly,
affordable health insurance options for
individuals and small businesses.
Pay for Performance
Financial incentives that reward healthcare
providers for meeting certain standards for
quality, improved healthcare results and
efficiency.
Uncompensated Care
Healthcare services provided by hospitals
for which no payment is received from the
patient or insurer. Patients may be unwilling
or unable to pay their hospital bills.
Universal Coverage
Universal healthcare guarantees affordable
coverage for all citizens. n
28
Patients Find Relief at Pain Management Center
by Betty Olt
N
orth Shore University Hospital (NSUH),
collaborating with LIJ Medical Center,
recently opened the Procedural Pain
Management Center, an outpatient facility
that specializes in treating adults of all ages
with acute and chronic pain conditions.
The Power of Injection
The expert healthcare team at the NSUH
Procedural Pain Management Center
provides several different injection treatments to reduce and alleviate pain, with the
goal of preventing pain before it becomes
chronic. The center is staffed by fellowshiptrained physicians credentialed in pain
management, nurses with experience in
ambulatory surgery or critical care,
radiology technicians and support staff.
Patients must be referred to the center by
a physician, usually an internist or neurologist, prior to treatment. During the procedure, the patient receives local anesthesia to
numb the area of the body being treated,
and remains awake. No sedation or major
anesthesia is necessary, reducing risks and
shortening recovery time.
Acute and chronic pain (defined as pain
that lasts for six months or more) affects at
least 116 million Americans, according to a
report by the Institute of Medicine. The causes
for longstanding pain are many, from cancer
and shingles to low back and head and neck
pain to arthritis. Acute pain can stem from an
injury or can be experienced after surgery.
“With such a large number of people
coping with different pain conditions, we
saw a need to create a convenient, patientfriendly center that offers highly specialized
treatment for pain management,” said John
DiCapua, chairman and vice president of
anesthesiology at NSUH and LIJ Medical
Center, and a pain management expert who
helped launch the center.
While a variety of modalities exist to treat
and manage pain, in many cases, people
with chronic, debilitating pain or severe
acute pain may get relief only from injection
therapy. “The power of injections is that
nor thshorelij.com
29
medication is delivered to a targeted
location in the body where the pain is, and
there are fewer side effects compared with
pain medications, which treat the whole
body,” said Dr. DiCapua.
Among the procedures the center offers are
an epidural steroid injection, a safe and
low-risk procedure used to treat the low
back, neck and other areas of the spine; a
sacroiliac joint injection that delivers
numbing medication to the lower back and
spine area to reduce inflammation and pain;
and a nerve block, used to treat painful nerve
damage. Physicians employ X-ray guidance
to pinpoint locations for injections.
Making Patients Comfortable
The nurses and staff at the Procedural Pain
Management Center understand that patients
living with chronic pain, which is considered
a disease in itself, have unique needs and
often have mobility issues. “We know that
pain takes a toll on our patients’ daily lives
and we are sensitive to their needs,” said
Stacey Tarnow, RN. “We do whatever we can
to put patients at ease and help them
through the entire treatment process.”
Nurses at the center provide compassionate care for patients every step of the way,
said Ms. Tarnow, beginning with a phone call
the day before the procedure. On the day of
the appointment, RNs perform brief health
assessments, educate patients and family
members about the treatment and stay with
patients during the procedure and while they
are in the recovery area. They also follow up
with patients the next day by phone.
“At the Procedural Pain Management
Center, our goal is to deliver high-quality,
patient-centered care in a healing outpatient
setting for people who need procedural
interventions to help them cope with their
pain conditions and get them to their
highest level of functioning,” said Daphnie
Pilgrim, senior administrative director of
anesthesiology services at NSUH and LIJ
Medical Center. n
New Tracking Tool Helps Triage Patients
Before They Arrive at ED by Betty Olt
North Shore-LIJ’s Center for
Emergency Medical Services
(CEMS) has installed a new
wireless tracking system to
better predict ambulance
arrivals and collect critical
health data in real time before
patients arrive at the Emergency
Department (ED). The new
technology was recently
launched at LIJ Medical Center,
the first hospital on Long Island
and Queens to use the software.
Responding to 911 calls,
paramedics and emergency
medical technicians (EMT)
begin their assessment and
gather critical patient information. Using a laptop computer,
emergency medical workers
transmit patients’ age, gender,
vital signs and brief comments
about their conditions — for
example, “dizziness, seizure,
fainting.” Information is
displayed on a 40-inch monitor
facing the entrance of LIJ’s
ambulance bay (names are not
used to protect patient privacy). Triage nurses or physicians can get a quick visual
picture about the number of
ambulances en route to the
hospital and the severity
of patients’ conditions, which
allow staff to better prepare for
patients and manage care.
Physicians and nurses can also
access patient information on
computers in the ED.
“The Emergency Department is
an unpredictable place,” said
Salvatore Pardo, MD, associate
chairman of emergency medicine
at LIJ. “The technology is a great
tool because it gives the ED team
information at a glance to better
LIJ’s new tracking software informs emergency medicine clinicians about incoming ambulances and gives critical patient information in advance for
better care coordination. ED nurse Debbie Sutton-Williams, RN, discusses a
patient’s case with North Shore-LIJ paramedics.
plan for incoming patients.” From
several yards away, staff can see
incoming cases on the monitor,
with trauma cases in black and
cardiac arrests in orange, for
example. “The tracking system
eliminates paperwork and gets
patients registered before they
arrive, making treatment and
the entire process more effective,”
he added.
The new tracking system,
known as XChangER, was
developed by Sansio. Currently,
North Shore-LIJ EMS and
the SeniorCare EMS are using
the system at LIJ. North
Shore-LIJ’s CEMS, the largest
hospital-based ambulance
service in the New York
metropolitan area and one of
the largest in the country, plans
to introduce the technology at
other health system hospitals in
the coming months.
“The tracking technology
provides a continuum of care
for patients, integrating
information taken at the
emergency site and in the
ambulance prior to arrival at
the hospital for treatment,”
said Alan Schwalberg, vice
president of the health system’s
CEMS. “Combining the
technology of electronic medical
records and this new tracking
software, we are providing
accurate, up-to-the-minute
health information about
patients so ED staff can prepare
and coordinate the best possible
medical care.”
In the past year, LIJ’s ED saw
a 36 percent increase in patient
visits, partially attributable to
recent hospital closures in
Queens, according to Patricia
Farrell, RN, senior administrative director of patient care
services at LIJ. Each month,
the ED receives about 1,400
ambulances via 911 calls and
approximately 80,000 patient
visits annually.
“We know that seconds count
in a 911 call for a medical
emergency,” said Ms. Farrell.
“The tracking system jumpstarts care, and we are able to
triage patients before they come
through the door.”
Ms. Farrell explained that the
pre-hospital electronic records
technology also helps the ED
staff to better manage incoming
ambulance traffic. Through
CEMS, the staff has the ability to
divert an ambulance to a nearby
hospital, if necessary, improving
“hospital throughput.”
“If we see an increased
volume of patients in the ED
and we know their conditions,
we can notify the operating
room or other hospital departments, such as a need for more
beds,” she said. “This way, we
have a game plan that not only
enhances patient care and
service, but makes the work
flow more efficient. n
Online Extra
To see a video of this story, go to
http://bit.ly/KlvgkO, or use your
smartphone to scan the QR code.
30
North Shore University Hospital Recognized
for Gynecological Surgery Expertise by Elaine Wohl
North Shore University Hospital was recently
designated as an Academic Center of
Excellence for minimally invasive surgery in
gynecologic oncology and gynecology by the
American Institute of Minimally Invasive
Surgery (AIMIS). North Shore University
Hospital joins LIJ Medical Center as one of
only 28 Centers of Excellence in the country
to achieve this designation — and only one
of four centers in New York State.
“For North Shore University Hospital to
receive this prestigious accreditation from AIMIS
shows that we have a deep commitment to
providing only the highest quality of care to all
our female patients, with state-of-the-art,
minimally invasive and robotic surgical
gynecologic expertise,” said Susan Somerville,
executive director of North Shore University
Hospital. “This is an occasion to take pride in our
work and to rededicate ourselves to continue at
this same high level in the future,” she added.
AIMIS is the nation’s pre-eminent educator
of advanced surgical techniques for women’s
health specialists and recognizes hospitals and
clinics that excel and provide leadership in
leading-edge surgical techniques. A hospital or
surgical center can be recognized as a Center
for Excellence once it has combined efforts
with an accredited AIMIS surgeon and meets
AIMIS standards. Recognized institutions have
made minimally invasive surgery a priority,
which helps minimize recovery times and
provide better patient outcomes. At North Shore University Hospital, we have
always taken great pride in our ability to
provide our patients with the latest that
technology offers in a safe, caring, professional
environment,” said Michael Nimaroff, MD, vice
chair and chief of gynecology at North Shore
University Hospital. “We are fully committed to
offering our patients the full range of minimally
invasive and robotic surgical options that
successfully treat a wide range of both benign
conditions and gynecological cancers.”
In 2011, North Shore University Hospital’s
division of gynecology performed more
procedures than any other hospital in New
York State — a total of 3,935 cases. “It is
because of our team of highly trained
gynecologists, urogynecologists, reproductive
surgeons and gynecological oncologists that
we have established a proven track record of
positive surgical outcomes for women. We
thank AIMIS for recognizing North Shore
University Hospital with this highly soughtafter accreditation,” said Dr. Nimaroff.
Minimally invasive surgery, whether
laparoscopic or robotically assisted, is advancing healthcare for women by providing doctors
new tools to accomplish the same goals as they
would with traditional open surgery. Most
patients undergoing minimally invasive
procedures experience less pain and blood loss,
decreased scarring, fewer complications, faster
recovery and a decreased length of hospital stay.
AIMIS teaches and supports minimally
invasive gynecological and urogynecological
surgical methods while improving patient
outcomes through advanced surgical
techniques. The organization brings together
hospitals, surgeons, clinics, medical technology companies, the insurance industry and
patients by providing a platform to deliver
advanced surgical procedures that improve
healthcare for women of all ages. n
+
To learn more about North
Shore-LIJ’s minimally invasive
and robotic surgery capabilities,
visit http://bit.ly/LgzSwk.
North Shore University Hospital’s (NSUH) minimally
invasive and robotic surgery team represents
gynecologic surgeons from gynecologic oncology,
urogynecology, reproductive endocrinology and
infertility, and benign gynecology. From left are: Kelly
Cifu, RN, associate executive director, peri-op services at
NSUH; Chris Ciampa, quality management; Pat Moleski,
RN, director peri-op services; Adiel Fleischer, MD, North
Shore-LIJ’s chair of obstetrics and gynecology; Emily
Kao, RPh, associate executive director, NSUH; Robert
Barnett, MD, AIMIS representative; Michael Nimaroff,
MD, vice chair of obstetrics and gynecology, and chief of
gynecology at NSUH; Cindy Girdusky, RN, nurse
manager, peri-op services; and Andrea Restifo, RN,
associate executive director, quality management.
nor thshorelij.com
31
Gastroenterology Care
A Chance Encounter Saves Young Mom
T
hese days, Kandice Gray eats as much as she can. And that is no
small feat considering the petite young woman, barely five feet
tall, spent months in and out of hospitals unable to keep food
down. In a span of six months, she lost 50 pounds.
The question was why. The 23-year-old was diagnosed with
diabetes four years ago. At 19, Ms. Gray was pregnant, and routine
checkups revealed abnormal blood glucose levels. Her doctor said
it was gestational diabetes. But even after she gave birth to her
daughter, here blood glucose levels fluctuated. Ms. Gray was told
that she probably had diabetes, unchecked, since she was a child.
She was resigned to giving herself insulin injections for life.
Mysterious Symptoms
Last year, Ms. Gray started feeling nauseated and could not keep
food in her stomach. The weight melted away. She grew weak.
She went to other hospitals, but doctors couldn’t figure out
what was wrong.
Then Ms. Gray had a chance meeting with gastrointestinal
surgeon Jerzy Macura, MD, who was visiting one of his patients
in the hospital bed next to her at LIJ Medical Center. Ms. Gray
provided him with a brief description of her mysterious gastro
intestinal symptoms. Dr. Macura promised that he would come
back the next day to check on Ms. Gray. He had an idea what
might be the trouble.
One common problem in diabetes is gastroparesis, which is
delayed gastric emptying. Food doesn’t move from the stomach
into the digestive tract, which causes nausea and the urge to vomit.
People generally feel uncomfortably full after a few bites of food.
Gastroparesis can make controlling blood glucose difficult, which
compounded Ms. Gray’s problems.
high risk for aspiration pneumonia, which is a significant problem
for patients with gastroparesis. Ms. Gray now weighed 75 pounds
and could hardly move herself from one side of the bed to the
other. Dr. Macura had heard about a relatively new gastric pacemaker being used to treat gastroparesis. He explained the device to
Ms. Gray but said that she must gain weight before any type of
surgical treatment could be considered. “I would have done
anything,” Ms. Gray said. “I was really sick.”
One month and 10 pounds later — the day before Thanksgiving
2010 — Dr. Macura brought Ms. Gray into the operating room and
threaded electrodes into the wall of her stomach and the oval
pacemaker device into her abdomen. The pacemaker releases mild
electrical pulses to help control nausea and vomiting.
Ms. Gray is now a much healthier mother, weighing in at 105
pounds. She eats several meals a day without worrying that she
will get sick. She is still managing her fluctuating blood glucose
levels, but her energy is back. Most important, she is no longer in
and out of the hospital.
“Dr. Macura told me that many people who have the gastric
pacemaker are living normal lives,” the young mother said.
“I took a chance. I had no choice. I had to get better to take care
of my daughter.”
Ms. Gray touches the skin that hides the pacemaker just below
its surface. “I eat a lot now. As much as I can eat.” n
+
To find a gastroenterologist affiliated with the
North Shore-LIJ Health System, call 888-321-DOCS.
Pacemaker Controlled Nausea
While Dr. Macura ordered tests to confirm his suspicions, he
arranged for a tube to be inserted into Ms. Gray’s stomach to drain
fluid and to help her gain weight. Dr. Macura worried about the
“Many people who have the gastric pacemaker are living normal lives. I took a chance.
I had to get better to take care of my daughter.”
32
CUSHING NEUROSCIENCE INSTITUTE
brain and spine specialists
serving our patients
with expertise and compassion
State-of-the-art diagnosis and treatment is available for all brain and
spine disorders including:
�
Spinal disorders resulting in
back and neck pain
�
Alzheimer’s disease,
dementia and other
memory disorders
�
Brain tumors
Brain aneurysms and AVMs
�
�
Headaches and migraine
�
�
�
Chronic pain
�
Nerve disorders
�
Epilepsy and seizure disorders
�
Hyperhidrosis
�
Multiple sclerosis
�
Parkinson’s disease and
other movement disorders
Traumatic brain injury
Normal pressure
hydrocephalus
Sleep disorders
�
�
Chiari malformation
Neuromuscular conditions
�
�
Moyamoya disease
Stroke and other
neurovascular conditions
�
Hypothalamic hamartoma
�
For more information or to see one of our specialists,
call the Cushing Neuroscience Institute
at (516) 562-3822,
email us at [email protected] or visit us
on the web at neurocni.com.
Hope lives here.
SM
nor thshorelij.com
29
LEADING RESEARCH
New Program Will Sequence
Alzheimer’s Patients’ Whole Genomes
T
he Feinstein Institute for
Medical Research has entered a
partnership with the New York
Genome Center (NYGC), in
collaboration with Illumina, a
bioscience manufacturer, to initiate
a large-scale whole genome
sequencing project.
The goal of this project is to
understand the genetic basis of
susceptibility to Alzheimer’s
disease. Knowledge of genetic
susceptibility will help assess an
individual’s lifetime risk of
developing the disease and
better define the molecular
pathways responsible for
neuronal degeneration.
Understanding the molecular
basis of neuronal degeneration
will allow scientists to develop
effective strategies for early
detection and targeted treatment.
Whole genome sequencing
efforts will begin with 130
Alzheimer’s patient samples, for
whom there is detailed clinical
data and brain pathology
available. Over a four-year period,
the genomes of as many as 1,000
patients with Alzheimer’s disease
will be sequenced and compared
with the genomes of a control
group of elderly individuals.
All data will be available to the
scientific community.
The genome sequencing,
bioinformatics and data storage
services being made available to
sequences to normal individuals,”
said Peter Davies, PhD, scientific
director of the Feinstein’s
Litwin-Zucker Center for
Research in Alzheimer’s Disease
and Memory Disorders. “NYGC
provides us with the sequencing
expertise and data analysis
“Alzheimer’s research will allow scientists
to develop strategies for early detection
and targeted treatment.”
NYGC will enable the Feinstein
Institute and other NYGC
member institutions to complete large-scale genomic
research projects using the latest
technology and most advanced
analytical expertise.
“This project is a massive
undertaking that involves
sequencing 30 billion bases per
person for 1,000 patient samples
and then comparing these
capability that are required for
such a large-scale endeavor.”
“The Feinstein’s commitment
to sharing the data resulting
from these efforts with the
greater research community
could significantly accelerate the
speed of translational research
in Alzheimer’s disease, with a
profound impact on patient care
and clinical outcomes,” said
Nancy Kelley, NYGC’s founding
executive director.
This project is funded through a
grant by private philanthropists
Frank and Mildred Feinberg of
Locust Valley, NY, and their family,
in memory of Mrs. Feinberg’s
mother, Esther Corman, who
succumbed to Alzheimer’s disease.
Dr. Davies, who has been involved
in research on Alzheimer’s disease
for more than 35 years, will direct
the Feinberg Initiative to sequence
the genomes of the targeted 1,000
Alzheimer’s patients.
“The launch of this initiative
with NYGC and the Feinstein will
enable a deeper understanding of
the clinical application of genetics
along the path of improving
human health,” said Jay Flatley,
Illumina’s president and CEO.
“Illumina’s collaboration with
NYGC will aid the Feinstein’s
researchers to understand the
genetic basis of susceptibility to
Alzheimer’s disease.” n
+
Discover what’s
new in research at the
Feinstein. Learn more at
feinsteininstitute.org.
Harnessing the Power of Genetics
Community members older than age18 can get involved in
genetic research through the Genotype and Phenotype
(GaP) Registry. Thanks to a $2.2 million federal grant, the
GaP Registry is now expanding to become a national
resource for scientists.
The program is enrolling healthy volunteers who provide
a DNA sample in addition to a limited health history.
Collection of a DNA sample and healthy history allows for
the selection of control subjects based on genotype, as well
as demographic information or health history. Scientists
extract DNA and cells from a blood sample and use these
in research.
More than 4,000 volunteers have already enrolled; the
long-term goal is to attract 20,000. Those in the Long
Island/metro New York area community are encouraged to
participate. Volunteers may be contacted about voluntary
participation in additional studies.
For more information, visit GaPRegistry.org or call
516-562-1175 and ask about the GaP Registry.
34
Discovery Helps
Assess Best Treatment
for Ovarian Cancer
Patients by Emily Ng
O
varian cancer patients’ blood samples can help determine their
best treatment plan, according to a new discovery by researchers
and physicians from the North Shore-LIJ Health System and The
Feinstein Institute for Medical Research. More specifically, a genetic
marker embedded in deoxyribonucleic acid (DNA), called microRNA,
indicates whether an ovarian cancer patient’s tumor is benign or
malignant, and whether she will benefit from chemotherapy after
surgical removal of the tumor.
There will be approximately 22,280 new cases and 15,500 deaths
from ovarian cancer in the United States this year. Due to lack of
adequate screening, the majority of patients with ovarian cancer are
diagnosed at stage III (the second-to-last and most devastating stage
of cancer); 70 percent of stage III patients will die within five years.
“The discovery that microRNAs can help assess the best treatment
plan for women with ovarian cancer — who are most likely at stage III
of the disease — offers them enormous hope,” said Iuliana Shapira,
MD, director of the Cancer Genetics Program at the Monter Cancer
Center. “We can now inform stage III patients if they will have success
with chemotherapy following surgery, similar to patients who are at
stage I. This information gives them hope that the disease is curable,
despite being diagnosed at an advanced stage. It also gives them the
strength necessary to undergo chemotherapy.”
Several microRNAs have been found to have links with various
types of cancer. Researchers at the North Shore-LIJ Health System
and the Feinstein found that microRNA-195 increased 40-fold
during chemotherapy and microRNA-16 increased 80-fold during
chemotherapy. These changes may explain why some women
experience side effects from ovarian cancer chemotherapy, others
are cured by chemotherapy and others need ongoing chemotherapy
to continue living with the cancer.
“Understanding the changes in microRNA throughout chemotherapy helps us better understand ovarian cancer and how best to
treat patients with this disease,” said Annette Lee, PhD, associate
investigator at the Feinstein. “The genetic markers we identified
allow patients to individualize their therapy in order to get maximum benefit and minimal side effects. In addition, this knowledge
will help researchers develop new ovarian cancer treatments.”
Dr. Shapira added, “We applied for a government grant and hope
to receive the funds needed to validate these markers that result in
women receiving therapies that are more personalized and match
their genetic makeup.” n
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35
Ovarian Cancer:
What Is Your Risk?
The causes of most ovarian cancers are not known,
but hormones may be partly to blame. Studies
suggest that the fewer times a woman ovulates,
the less likely she is to get this cancer.
A woman may be at higher risk for the disease
if she:
is older than age 50;
has a personal history of breast or colon cancer;
has a close female relative who had breast or
colon cancer;
has never given birth; and
has taken hormone replacement therapy after
menopause.
Some research suggests that a high-fat diet may
also increase risk.
Ovarian cancer’s symptoms often don’t show up
until the late stages of the disease. They include
the following:
bloating;
nausea;
diarrhea or constipation;
frequent urination;
loss of appetite;
unexplained weight gain or loss; and
abnormal vaginal bleeding.
Based on a woman’s risk factors, her doctor can
recommend screening tests that may be appropriate.
Pelvic exams, ultrasound exams and other tests can
help detect ovarian cancer.
Unfortunately, they do not guarantee early
detection. About 80 percent of women with ovarian
cancer are diagnosed in advanced stages of the
disease — when the long-term survival rate is lowest.
If she is at high risk, a woman and her doctor may
consider surgery to remove the ovaries before cancer
is present. The surgery usually protects against the
cancer. But there are risks and side effects of the
surgery, as well.
GIVING BACK
Apelian Center Celebrates
10 Years of Making Life Beautiful
O
ne morning about eight years ago,
Modesto Rivera, 51, of Mineola, woke
up unable to hear. After trying various
medications and hearing aids, Mr. Rivera
received a cochlear implant a little more than
a year ago at LIJ Medical Center, thanks to a
fund created by the Hagedorn Foundation.
by Michelle Pinto
Maddie thanks LIJ for allowing
her to hear again.
Cochlear Implant
Restores Hearing
During a news conference to celebrate the
10th anniversary of LIJ’s Apelian Cochlear
Implant Center, Mr. Rivera spoke emotionally
about how the loss of his hearing affected his
relationships at home and at work. “Now,” he
said, “the best sound for me is my daughter’s
voice. Everything is beautiful again.”
Those sentiments were echoed by Paul
Kim, of Bayside, who spoke on behalf of
his 3-year-old daughter, Madeline. Maddie
was born at LIJ on Christmas Eve 2007.
Thanks to the North Shore-LIJ Health System’s
policy of screening all newborns for hearing
proficiency, Maddie’s parents learned that their
baby daughter was hearing impaired. Hearing
aids only amplified sound and offered no real
solution. So in August 2009, when Maddie
was 18 months old, she received a cochlear
implant. Now attending a specialized school
for the deaf, Maddie is an energetic child,
as she proved by holding up a hand-drawn
sign during a news conference that read
“I can hear … thank you, LIJ.”
Severe-to-profound hearing impairments
affect more than three million Americans. To
date, the Apelian Cochlear Implant Center
has performed more than 250 implant surgeries, according to Andrea Vambutas, MD, the
center’s medical director.
Online Extra
Cochlear implants are surgically placed
within the inner ear, directly stimulating
the ending of the auditory nerve. The
design of an implant includes an external
microphone, processor and transmitter, as
well as an internal receiver/stimulator and
electrode array.
Following the operation, patients return
to the center within four weeks to have the
implant stimulated. Additional follow-up
care includes periodic evaluations to assist
in gauging efficacy and progress and
Watch the compelling stories
of patients whose hearing was restored at the Apelian
Cochlear Implant Center. Visit http://bit.ly/JzR4fH or use
your smartphone to scan the QR code.
determining rehabilitation, as well as
occasional visits to make other adjustments
to the implant.
Hagedorn Foundation
Funds Surgery
To help cover the cost of cochlear implant
surgery for hearing-impaired individuals,
like Mr. Rivera, who cannot afford it, the
Hagedorn Foundation partnered with
LIJ Medical Center to establish a grants
program. “Mr. Rivera’s outcome was made
possible through the generosity of the
Hagedorns,” Dr. Vambutas said.
Speaking of the life-altering impact
of cochlear impacts, Mr. Kim said,
“The best part of all this is that I can tell
my daughter that I love her — and she
can hear me.” n
36
Miracle Foundation Palliative
Care Center: It’s All About
Quality of Life
P
atients living with a serious illness can
find pain relief and address symptom
management at home, in the company of
their loved ones, courtesy of the Miracle
Foundation Palliative Care Center.
“The Miracle Foundation Palliative Care
Center talks with patients and families
living with advanced illnesses about
treatment options, offers emotional
support and makes them as comfortable as
possible,” said Maureen Hinkelman, CEO
of the Hospice Care Network (HCN).
Palliative care is comprehensive,
individualized medical treatment that
complements curative therapies for patients
with life-threatening illness. In February
and April 2011, Governor Cuomo passed
two important pieces of legislation to
address it. The Palliative Care Information
Act requires that attending physicians and
nurse practitioners offer terminally ill
patients information and counseling
concerning palliative care and appropriate
end-of-life options. According to the New
York State Department of Health, the law
helps to ensure that patients are fully
by Mara Mazza
informed of their options when they face a
terminal illness or condition, empowering
them to make choices consistent with their
goals for care and their wishes and beliefs,
and to optimize their quality of life.
The second law, the Palliative Care Access
Act, requires hospitals, nursing homes,
home care agencies and assisted living
residences to provide access to information
and counseling about palliative care to
patients with advanced, life-limiting
conditions and illnesses. These providers
must also facilitate access to palliative care
consultation and services that are consistent
with the patient’s needs and preferences.
“We are always looking for better ways to
serve the patients and families in our
community. Many families have told us that
they wished they had known sooner about
palliative care and hospice service options.
The Miracle Foundation Palliative Care
Center addresses this concern by providing a
useful venue to help physicians attend to the
new requirements,” said Ms. Hinkelman.
Serving Nassau, Suffolk and Queens
since 1988, HCN is a member of the North
Shore-LIJ Health System. Caring for families
and patients in their own homes and in
nursing home and hospital settings, HCN
provides a compassionate environment for
the final stages of life with palliative care
and hospice services for seriously ill patients
and their families.
The center is generously funded by a
$500,000 grant from the Miracle Foundation, an organization founded by Patti and
Michael Tenaglia and dedicated to improving
the lives of those diagnosed with cancer and
other life-threatening diseases. n
+
Comfortable, Compassionate
Care. Learn more about the
Miracle Foundation Palliative Care
Center by calling 516-224-6563.
nor thshorelij.com
37
Make a Gift Now
and Receive
Payments for Life!
North Shore-LIJ Health System Foundation offers a program that enables you to
make a gift and receive income for life.
A charitable gift annuity enables
you (or you and a spouse) to make a
gift of $10,000 and up and gain a
fixed income stream for life. Any
remaining amount will be used by
North Shore-LIJ to fulfill our mission
of caring for our community.
For example: Anna, age 78, donates
$10,000. She will receive $690/year
($566 tax-free for 10.5 years) and may
be eligible to claim a $4,052 income
tax deduction.
Anna and her husband, George,
both age 78, donate $10,000. They
will receive $590/year ($483 tax-free
for 14 years) and may be eligible to
claim a $3,186 income tax deduction.
Here are some representative
one-life rates:
Sample Rates
Age
Rate
60
4.9%
65
5.2%
70
5.6%
75
6.3%
80
7.3%
85
8.3%
Rates are subject to change.
Contact us to discuss your rate, tax-free
income and charitable deduction.
+
For more information and
a no-obligation personalized
illustration of benefits, contact
Alexandra Brovey, senior director
of gift planning, at 516-465-2610
or [email protected].
Lighten Up!
Tomatoes Are Ripe with Health Benefits
Juicy tomatoes not only taste wonderful, but also offer a range of health benefits:
an excellent source of vitamin C, plus vitamin A, potassium and fiber.
Black Beans with Corn Grilled Tomatoes
and Tomatoes
4 ripe tomatoes
1 15-oz. can low-sodium,
no-fat-added black beans,
drained and rinsed
1 cup cut tomatoes, fresh or canned
1 cup frozen corn, thawed
1 garlic clove, pureed or roasted
1 tsp. chopped fresh parsley
1
⁄ 8 tsp. cayenne pepper or more
to taste
1/2 tsp. chili powder
In a bowl, combine beans, tomatoes, corn
and garlic. Add parsley, pepper and chili
powder. Combine and serve.
Yield: four servings
Each serving contains approximately 110 calories,
1 g fat, 0 mg cholesterol, 220 mg sodium, 25 g
carbohydrate, 7 g fiber, 3 g sugars and 6 g protein.
1 tbsp. fresh oregano or 1 tsp. dried
1 tsp. lemon pepper
Slice tomatoes in half, lengthwise. Prepare
coals. Cover grill grid with foil. Place tomatoes on foil and sprinkle with oregano
and lemon pepper. Grill tomatoes with
cut side down over hot coals for about
four to five minutes.
Yield: four servings
0 g fat, 0 mg cholesterol, 40 mg sodium,
6 g carbohydrate, 2 g fiber, 4 g sugars and
1 g protein.
Sun-Dried Tomato
Hummus
2 15-oz. cans chickpeas, drained
and rinsed
1
⁄ 3 cup fat-free yogurt
1/4 cup tahini (sesame seed paste)
3 garlic cloves
1/2 cup chopped sun-dried tomatoes
1 tsp. dried oregano leaves
2 tsp. lemon juice
Process chickpeas, yogurt, tahini and garlic
in a food processor until smooth. Stir in
sun-dried tomato bits and oregano; season
to taste with lemon juice. Refrigerate two
hours. Spoon hummus into serving bowl
and serve with toasted pita wedges.
Yield: eight servings
5 g fat, 0 mg cholesterol, 400 mg sodium,
29 g carbohydrate, 6 g fiber, 2 g sugars and
8 g protein.
38 Vitality + Summer 2012
he alth bytes
Omega-3 May Be a Natural Alternative to Psychiatric Medications
Can fish oil help teens at risk for serious mental
illness? Researchers at The Zucker Hillside Hospital’s
Recognition and Prevention (RAP) Program are
finding out in a new study funded by the National
Institute of Mental Health. The study is investigating
whether Omega-3 fatty acids, which are abundant
in fish oil, can improve clinical symptoms and help
adolescents and young adults (ages 12 to 25) at
elevated risk for severe psychiatric disorders function better in school, work and social environments.
“Of the 300 adolescents who have participated
in the RAP Program, most have shown substantial
improvement,” said Barbara Cornblatt, PhD, the
director of the RAP Program and an investigator at
The Feinstein Institute for Medical Research. “If
this study continues to show success, Omega-3
could offer a natural alternative to the range of
medications and therapies now offered to RAP
by Emily Ng
participants. Ultimately, the goal of the RAP
Program is to intervene and prevent illness before
symptoms get worse.”
Omega-3 fatty acids are critical for normal
brain function. These acids have been increasingly studied as potential treatments for medical
and psychiatric disorders. The RAP Program study
randomly assigns participants to either Omega-3
supplementation or a placebo, and will compare
the groups on key measures of symptoms and
functioning after six months. Participants in both
groups will be monitored closely on a monthly
basis. Participants receive free supplements and
are compensated for their time.
For more information on the RAP Program
research and clinical studies, including the
Omega-3 study, call 718-470-8115 or visit
RAPProgram.org.
TIP
Dress Up Your Salad with This Surprising Ingredient
So you’re eating a salad, loaded with fresh spinach, carrots, tomatoes and other veggies, and lightly coated
with fat-free dressing. What’s missing?
Surprisingly, it’s fat. Research shows that your body can’t absorb the cancer-fighting beta-carotene and lycopene
in those veggies unless you eat them with fat. So add just two ounces of full-fat — not even low-fat — dressing.
Key Foods May
Save Eyesight
In case you need another good reason to
eat healthy, focus on this fact: A good
diet could help stave off blindness
in old age. A new study involving
more than 4,000 people concluded
that participants with diets rich
in vitamins C and E, zinc, the
antioxidants lutein and zeaxanthin,
and omega-3 fatty acids were less
likely to develop age-related macular
degeneration (AMD). AMD is an eye
disease that destroys sharp, central eyesight; it’s the leading cause of vision loss
in those older than 60. Eating foods high in
those nutrients may help protect against the
disease. You can easily enrich your diet with
such nutrients by eating citrus fruits, olive
and canola oils, nuts, green leafy vegetables
and cold-water fish.
nor thshorelij.com
39
Big Benefits in Tiny Flaxseeds
Sometimes, it’s true that big things come in small
packages. Take the petite flaxseed. This nuttytasting seed can help with constipation. Some
research also suggests that flaxseeds may help
fight high cholesterol, heart disease, rheumatoid
arthritis, kidney disease and some cancers.
Three things seem to make flaxseed special.
One is fiber. The second is alpha-linolenic acid, an
Omega-3 fatty acid. Fatty acids are also what
make fish so healthy to eat. And the third is lignans,
a kind of antioxidant. Lignans are also phytoestrogens, which may help prevent breast cancer.
How much do you need? One study found that
consuming 10 grams of ground flaxseed a day may
offer breast cancer protection in younger women.
Try adding ground flaxseeds to cereal or salads. Or when baking, mix flaxseeds
into bread, cake or muffin batter.
VITALITY
NORTH SHORE-LONG ISLAND
JEWISH HEALTH SYSTEM, INC.
300 Community Drive
Manhasset, NY 11030
Michael Dowling
President and CEO, North Shore-LIJ Health System
Gene Tangney
Central Regional Executive Director
Non-Profit Org
U.S. Postage
PAID
NSLIJHS
Susan Somerville
Executive Director, North Shore University Hospital
Chantal Weinhold
Executive Director, LIJ Medical Center
Terry Lynam
Vice President, Public Relations
Maria Conforti
Director of Editorial Services
Vitality is published by the Public Relations Department
of the North Shore-LIJ Health System (516-465-2600).
The information within this publication is intended to
educate readers about subjects pertinent to their health
and is not meant to be a substitute for consultation with a personal
physician. Produced by Krames StayWell, Evanston, IL. © 2012.
Printed in USA
Hope lives here.SM
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Call 888-321-DOCS
Need to find a doctor? 888-321-DOCS • North Shore-LIJ Health System
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LET US HELP YOU GET MOVING AGAIN!
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Most insurances accepted
For more information visit:
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