Summer 2011 - Lake Forest Hospital

healthreport
L I V I N G B E T T E R E V E R Y D AY
SUMMER 2011
The
picture
of stroke
survival
A veteran comes home to
face his toughest battle
KNOW YOUR
EMERGENCY
DEPARTMENT
Staff experience
matters
GASTROINTESTINAL
CANCER
New expertise for
a growing threat
AGE THREE,
FIVE OR 12?
When and why
to screen your
child’s vision
Your new option for
outpatient surgery is right
around the corner.
SUMMER 2011
healthreport
Features
2
THE PICTURE OF
STROKE SURVIVAL
A veteran faces his
toughest battle
10
KNOW YOUR
EMERGENCY DEPARTMENT
Staff experience matters
2
10
Departments
8
TEST YOUR HEALTH IQ
14
STRAIGHT ANSWERS
16
THE CUTTING EDGE
14
16
18
SUPPORTING NORTHWESTERN
LAKE FOREST HOSPITAL
20
NEW HEALTHCARE
PROFESSIONALS
Outpatient surgery does not have to mean long delays or settling for anything less than
the best care. Northwestern Grayslake’s new outpatient Surgery Center offers the latest in
minimally invasive technology and the expertise of Lake County’s top-ranked* surgeons,
anesthesiologists and nurses. The center is close to home and offers procedures with
shortened wait times. When it comes to healthcare, convenient advanced care matters.
To learn more or find a physician, visit lfh.org/northwesterngrayslake or call 847.535.6171
ON OUR COVER: Northwestern Lake Forest Hospital patient
Daniel DelaPeña.
The Health Report is published by the Northwestern Lake Forest
Hospital Marketing Department. Tel: 847.535.6789.
The information contained in this newsletter is intended to
inform and educate about subjects pertinent to health and
should not be interpreted as a substitute for consultation
with a personal physician.
© 2011 Northwestern Memorial HealthCare
* In 2010, for the sixth year, Northwestern Lake Forest Hospital was named National Research Corporation’s “Consumer Choice” hospital
for best doctors, best nurses, best quality, and best overall image and reputation in Lake and Kenosha counties.
SUMMER 2011
1
THIS IS
WHAT
STROKE
SURVIVAL
CAN LOOK
LIKE
An Iraq War veteran
wins the most important
battle of his life
2
NORTHWESTERN LAKE FOREST HOSPITAL
SUMMER 2011
3
J
AT JUST 48 YEARS OLD, Daniel (Dan) DelaPeña had
already experienced more than his share of danger
and close calls. As a Blackhawk helicopter machine
gunner and mechanic for the U.S. Army, he was
deployed to Kuwait and then Iraq during the Iraq
War in 2003, transporting army personnel, cargo
and troops while “trying not to get shot down.”
Dan did not know then that the biggest threat
to his life wasn’t overseas, but lurking deep within
his body’s vascular system.
A long 18 months later, Dan came home from
training and duty in Iraq without a scratch and
went on to more deployments: El Salvador in 2006
and The Republic of Kosovo in 2007. Back home in
Gurnee, Dan returned to his job in ground support
at the Waukegan Regional Airport. He also served
in the National Guard one weekend a month
providing flight crew training.
A strong and
sudden change
In June of 2010, he was at work when his keys
suddenly dropped out of his hand. He found
himself struggling to pick them up, feeling numb
on his left side and deeply fatigued. He chalked
it up to being on the airport’s third shift, and he
kept on working. A concerned co-worker searched
online and discovered that Dan’s behavior matched
symptoms of a stroke. He urged Dan to go home,
but Dan kept on working.
“My army training tells me to keep going,”
he says. “And I did what a lot of stroke victims
do: I didn’t treat it as an emergency.”
That evening, Dan’s wife Judi took him to
Northwestern Lake Forest Hospital’s Grayslake
Emergency Department. The physicians performed
a computed tomography (CT) scan and gave Dan
the news: a blockage in his neck’s carotid artery
had caused a full stroke. Strokes occur when a
4
NORTHWESTERN LAKE FOREST HOSPITAL
blockage in an artery prevents blood flow to the
brain tissue or when a hemorrhage causes bleeding
in the brain. Without the oxygen carried by the
blood, brain cells begin to die within minutes.
This is why strokes often lead to death or serious
brain damage and paralysis. In fact, strokes are the
number one cause of long-term disability in the
United States.
Stroke center
handles an
unusual case
An ambulance brought Dan to Northwestern
Lake Forest Hospital’s Wood-Prince Family Stroke
Center at the hospital’s main campus in Lake
Forest. Under a new Illinois law, an ambulance may
travel to a certified stroke center like Northwestern
Lake Forest’s stroke center, even if it is not the
closest medical center. The legislation established
a special set of requirements for the certification
intended to save more stroke patients’ lives and
lessen the need for long-term, institutional care.
(See next page.)
“He had an unusual case in that a tear in the lining
of the artery created a blockage,” explains Dan’s
physician Mark Eskandari, MD, a board-certified
vascular surgeon with the Northwestern Memorial
Medical Faculty Foundation, associate professor
of medicine at Northwestern University Feinberg
School of Medicine, and chief of the Division of
Vascular Surgery at Northwestern Memorial.
“The Stroke Center was key to reducing the
severity of Dan’s stroke because it enables
immediate determination of what type of stroke
has occurred and prompt administration of the
right treatment. In his case, we discovered it was
best to start him on blood thinners rather than the
more typical tPA (tissue plasminogen activator),
a clot-dissolving drug.”
Dan stayed in the Northwestern Lake Forest
Intensive Care Unit (ICU) before being released
to continue therapy through the hospital’s
comprehensive Stroke Support Services. Unlike
many stroke patients whose lives are irreparably
“My army training tells
me to keep going. And I
did what a lot of stroke
victims do: I didn’t treat it
as an emergency.”
changed due to paralysis and brain damage,
Dan left the ICU on his own two feet. But it
would take some time before his fine motor
control, speech and emotional state would be
fully restored.
“The first thing I asked was, ‘will this affect my
military flying?’ I wanted to fight my way out of
this thing. I just had a stroke, but I still thought
I was Superman.”
A rough road,
with more bad news
The road to full recovery would test Dan’s can-do
attitude. He began exercising with his physical
therapist in the hospital and feeling great. But
then, things went wrong again.
“I felt as if my whole body died; everything just
gave way. My left side went dead, and my speech
nearly disappeared. I was confused, frustrated and
trying not to get down on myself. “
“A few days after the initial stroke, and after he
began therapy, the severity of weakness increased
significantly,” explains Charu Nagar, MD, a
Northwestern Lake Forest board-certified
neurologist who treated Dan. “This can occur
about 3 – 5 days after the stroke, signifying that
swelling has set in. It’s part of the natural evolution
of a stroke and not a true setback. Thanks to Laura
Meller, our valuable stroke services coordinator, and
the entire team, ultimately Dan experienced a full
and smooth recovery.“
SUMMER 2011
5
“Our stroke center was
key to reducing the
severity of Daniel’s stroke
because it enables
immediate determination
of what type of stroke
has occurred and prompt
administration of the
right treatment.”
But this after effect meant that it was back to
square one for Dan, and in December he received
more difficult news: the airport he had worked at
for 15 years had to let him go. His wife worked at
the same company, and she was laid off as well.
Meanwhile, the possibility of a medical discharge
from the U.S. Army loomed over him.
But support from his family helped him maintain
his positive attitude and push through. His wife
and his mother, Eva DelaPeña, both helped him,
and even sons Tim, 14, and Sammy, 11, tried to
help while Dan worked on rebuilding his motor
control by bouncing and catching a ball.
“They’ve been helpful—they’ve tried, anyway,”
he recalls. “While I was doing the ball exercises
my son tossed his hacky sack at me, and it hit me
in the head because I couldn’t reach my arm up
to catch. We had a good laugh over that.”
Coordinated,
compassionate
expertise
Dan also credits his medical team and the Stroke
Support Services at Northwestern Lake Forest for
helping him to recover and avoid long-term disability.
6
NORTHWESTERN LAKE FOREST HOSPITAL
“My physicians, nurses and therapists were
all fantastic—positive, encouraging, and
knowledgeable,” he says. “They were always
communicating with each other; when I mentioned
something that I did with my therapist, Dr. Nagar
would say, ‘yes, I heard about that.’ And, I could
see Northwestern experts right here. There’s no
way I would get that kind of care otherwise—
my 75-year-old mother was driving me to
appointments, and she couldn’t travel far.”
Based at Northwestern Memorial Hospital in
Chicago, Dr. Eskandari also has office hours in
Lake Forest for precisely that reason.
“The whole idea of spending time here is to
provide expertise on site. A highly skilled clinician
administering treatment and monitoring the
patient makes all the difference for a stroke
patient’s successful recovery.”
A new
attitude
Some of the stroke support services available
to Dan, like a clinical psychologist and support
groups, were not required as part of his
treatment—and at first he resisted.
“I was completely against going. I thought,
‘why should I go to a clinical psychologist—I’m
not crazy. And why would I want to sit and talk
about this with other people?’ It was already a
humbling experience.”
But after his wife and his medical team convinced
him, Dan found that these services not only
boosted his recovery, they made him a source
of encouragement for others.
“The Life After Stroke group helped me realize I
wasn’t the only one and seeing stroke survivors in
wheelchairs made me appreciate my own health
and good fortune,” he says. “At one seminar I met
a woman whose husband was struggling with his
therapy. We talked for a long time, and I told her
what kinds of things I did, and how I knew it was
up to me to do this. I was used to training people
on technical things, and here I was talking about
neurological medicine—I never thought I’d be in
that kind of role.”
A HEALTHIER LIFESTYLE
IS JUST A CLICK AWAY
Dan is having a follow-up ultrasound over the
summer to check on the status of his arteries.
To hear him talk you would never know that
he was once close to having his voice silenced
forever. He is still looking for full-time work,
but has fully regained his motor skills. And
after refusing many of Dan’s earlier requests,
Dr. Eskandari has finally said he can return to
flying. Thanks to his family and the excellent
care he received, he is the same soldier he was
before the stroke—only stronger.
WHAT IS A CERTIFIED
STROKE CENTER?
The Joint Commission, an independent,
non-profit accreditation and standards
organization for nearly 20,000 U.S. healthcare
facilities, has certified Northwestern Lake
Forest Hospital’s Wood-Prince Family Stroke
Center as a Primary Stroke Center. The
certification recognizes centers that make
exceptional efforts to foster better outcomes
for stroke care.
The Wood-Prince Family Stroke Center
provides comprehensive care to help stroke
survivors recover to the best possible level
of function:
• Advanced cardiovascular and
neurological expertise
STROKES
ARE MEDICAL
EMERGENCIES
“Stroke symptoms are
well defined, and they
include sudden and
profound difficulty
with speech, motor
skills and vision,” says
Northwestern Memorial
Hospital vascular surgeon
Mark Eskandari, MD.
“Brain cells start dying
within minutes. So
remember that time
equals brain, and don’t
ignore stroke symptoms.”
ACT F.A.S.T.
AND CALL 911
IMMEDIATELY
F
A
At lfh.org, you can
learn about the free
or low-cost health
classes and screenings
Northwestern Lake
Forest Hospital offers
every month.
Disease and injury
prevention
Face - Ask the person
to smile – does the face
droop on one side?
Maternity and parenting
Arms - Can the person
raise both arms?
Does one arm drift
downward?
Adolescent health
Speech - Is the speech
slurred or strange? Ask
the person to repeat a
simple phrase
CPR training
S
T
Time - If you observe
any of these signs, call
9-1-1 immediately.
Wellness for seniors
Men’s and women’s unique
health issues
Immunizations
Health screenings
Fitness
• Physical and occupational therapy
• Speech therapy
• Clinical psychology
• Life After Stroke support group
for patients and families
• Stroke seminars and educational
programs
Learn more at lfh.org/stroke.
ty
Communi nts
ve
Wellness/evEents for a
rg
Visit lfh.o
ellness
mmunity W
o
C
r
detailed
ven registe
you can e
r—
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d
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ca
online.
for classes
SUMMER 2011
7
TEST YOUR HEALTH IQ
WHEN
IN THIS ARTICLE BRADLEY RUFF, MD, SHARES THE FACTS ABOUT PROTECTING CHILDREN’S VISION. DR. RUFF
IS A NORTHWESTERN LAKE FOREST HOSPITAL BOARD-CERTIFIED OPHTHALMOLOGIST WITH OVER 25 YEARS
OF EXPERIENCE TREATING CHILDREN AND ADULTS. HE WAS ONE OF THE FIRST SURGEONS IN CHICAGO
TO PERFORM LASIK EYE SURGERY, AND HE WAS THE CHICAGO BEARS’ SURGICAL EYE CONSULTANT FOR
16 YEARS. CASTLE CONNELLY MEDICAL LTD. NAMED DR. RUFF ONE OF CHICAGO’S “TOP DOCTORS.”
IS THE RIGHT TIME TO
SCREEN CHILDREN’S VISION?
The number one cause of sportsrelated eye injuries among children
ages five to 14 is
1
A
B
C
D
E
A U G U S T I S N AT I O N A L C H I L D R E N ’ S E Y E H E A LT H A N D S A F E T Y M O N T H , A N D S E P T E M B E R I S
S P O R T S E Y E I N J U R Y M O N T H . O N LY 2 0 % O F P R E S C H O O L C H I L D R E N H AV E V I S I O N S C R E E N E D
A N D E V E N F E W E R C H I L D R E N H AV E A V I S I O N E X A M B E F O R E E N T E R I N G S C H O O L . C H E C K
YOUR KNOWLEDGE ABOUT THE BASICS OF PROTECTING CHILDREN’S VISION.
2
Often children won’t complain
about vision. Some indications
of a problem include:
5
Hockey
Baseball
Bicycling
Soccer
Air, BB, or spring-loaded guns
A Redness, blinking, rubbing, squinting
B Closes or covers one eye
C Complaints of blurriness, dizziness
or “itchiness”
D Crankiness with close work, trouble
keeping up in school
E All of the above
Number of school-age children
with a vision problem:
A
B
C
D
One in four
One in 10
Two out of five
One in 30
6
A True – Small fireworks and sparklers
do not cause a significant number of
eye injuries; toys or household objects
cause far more
B False – Nearly half of serious fireworksrelated eye injuries happen to children
15 and under; sparklers harm many
children 4 and under
The leading cause of blindness
in children is a preventable
condition called
3
A
B
C
D
Nearsightedness (myopia)
Crossed eyes (strabismus)
Lazy eye (amblyopia)
Congenital cataracts
For vision exams, The American
Optometric Association and
The American Academy of Pediatrics
recommend:
4
A Examination after birth, in the
hospital nursery
B General eye health screening by a
pediatrician, annually at ages three
through ten
C Comprehensive, professional eye exam
at six months, three years and five years
D All of the above
8
NORTHWESTERN LAKE FOREST HOSPITAL
Answers: 1-b, 2-a, 3-c, 4-d, 5-e, 6-b, 7-d
Certain types of fireworks are
safe around children’s eyes.
Eye surgery is performed at
Northwestern Lake Forest for
which of the following:
7
A
B
C
D
Crossed eyes (strabismus)
Tear duct blockage
Cataracts
All of the above
Find a board-certified ophthalmologist and make
an appointment online at lfh.org/find_a_physician.
A SCARY STORY:
HALLOWEEN AND
CHILDREN’S EYES
Halloween is right around
the corner, and every year
emergency department
physicians treat hundreds of
serious eye injuries related to
costumes. In addition, over
500 pedestrian deaths occur
due to limited visibility from
masks. Prevent Blindness
America® advises parents to:
– Make sure masks, wigs,
scarves, floppy hats and eye
patches do not block vision
– Be aware that “cat’s eyes”
and cosmetic contact lenses
can cause eye infection,
swelling, corneal scratches
and sensitivity to light
– Avoid long, pointed props
such as spears, swords
or wands
– Trick-or-treat in daylight,
or bring a flashlight to
improve visibility
– Avoid long costumes that
drag on the ground to
prevent tripping
– Do not let young children
keep lollipops or candy
with long sticks
SUMMER 2011
9
DO YOU KNOW
YOUR LOCAL
EMERGENCY
DEPARTMENT?
NOT ALL EMERGENCY
CAREGIVERS ARE THE SAME,
SO CHOOSE WISELY
The quality of care in your local
emergency department (ED) can make
all the difference when you or a family
member has a sudden illness or serious
injury. But not all EDs are the same. Staff
expertise and wait times can vary, and not
all hospitals have dedicated, permanently
employed physicians and nurses to ensure
quality care and continuity with your
personal physician.
Northwestern Lake Forest Hospital’s Emergency
Department and Northwestern Grayslake’s
Emergency Department are preferred by a
majority of Lake County residents (see sidebar).
But what exactly makes for an excellent
emergency department?
FOLLOW-UP AND FEEDBACK
When he finds a few extra minutes, Jack Franaszek,
MD, medical director of the Northwestern Lake
Forest Hospital Emergency Department and
Northwestern Grayslake Emergency Department,
likes to walk around the emergency units, ducking
his head into patient rooms or maybe talking with
a nervous parent.
“I walk through the department on a daily basis,
gathering feedback that helps us understand what
we’re doing right and where we can improve,” he
says. “We aim for an atmosphere of excellence and
caring, and we need to talk to people to make sure
that happens for every patient.”
Meanwhile, Michael Peters, MD, chairman of
emergency medicine, is setting aside an hour to
make follow-up calls to the emergency patients
he recently treated. The follow-ups are part of a
new program based on research showing that this
practice improves care outcomes.
10
NORTHWESTERN LAKE FOREST HOSPITAL
“People are pretty surprised to hear from me,”
says Dr. Peters. “They expect just brief patientdoctor encounters in the emergency department,
but I hand out my business card and want them to
know I’m available. That means a lot to a parent
going home with a croupy baby, or any of our
patients—they can call if they have a question
or more problems.”
BOARD-CERTIFIED STAFF,
LOW TURNOVER
Perhaps the most important consideration when
choosing an emergency provider is the training
and experience of emergency staff members.
At Northwestern Lake Forest, the entire staff
of physicians is board-certified in emergency
medicine and nurses have special certification
in emergency care. Some of the physicians have
multiple board certifications, and most have been
with the hospital for over 15 years—steadiness and
experience that can make a difference in urgent,
often complex emergency cases.
Dr. Peters trained at Northwestern Memorial
Hospital and is board certified in emergency
medicine and certified in travel medicine as
well. He also worked at Cook County Hospital’s
renowned trauma center (now John G. Stroger,
Jr. Hospital of Cook County) before joining the
hospital’s emergency team, a position he has
had for 13 years.
“Our staff has trained at the top institutions,
and they’re a very stable group of long-time
employees,” he says. “That kind of continuity is
great for patients, especially those with chronic
conditions who visit the ED frequently. We get to
know them, their family and their physicians.”
But the quantity of staff members can be just as
important as the quality.
“When choosing an ED, consider how long it takes
for you to have contact with a nurse or doctor,”
says Dr. Franaszek, who has practiced emergency
SUMMER 2011
11
Sharon Moise, MD, one
of the members of the
Northwestern Lake Forest
emergency medicine staff.
NORTHWESTERN
29
%
LAKE FOREST HOSPITAL
SPECIALIZED PEDIATRIC EXPERTISE
AND RESOURCES
LAKE COUNTY –
WHICH EMERGENCY CENTER
DO YOU PREFER?
“MANY OF US IN THE ED ARE INVOLVED WITH
Northwestern Lake Forest Hospital
29%
LOCAL SCHOOLS AND CHARITIES. WE’RE
Advocate Condell Medical Center
16.8%
North Shore Univ. Healthcare/Highland Park Hospital 13.9%
Vista Health System
3.7%
TRULY INVESTED IN THE LOCAL COMMUNITIES
AND WE FEEL A STRONG RESPONSIBILITY
Northwestern Lake Forest Hospital has ranked higher than all Lake County
hospital emergency departments for six consecutive years, according to
a survey of Lake County residents conducted by the National Research
Corporation. Results shown from June 2011.
“WHEN CHOOSING AN ED,
CONSIDER HOW LONG IT
TAKES FOR YOU TO HAVE
TOWARD THE HOSPITAL AND ITS PATIENTS.”
LOW EMERGENCY DEPARTMENT
WAIT TIMES*
Northwestern Lake Forest Hospital
10 minutes
(contact with an emergency professional)
National waiting time
55 minutes
CONTACT WITH A NURSE
OR DOCTOR.”
NORTHWESTERN LAKE FOREST HOSPITAL
10
12
NORTHWESTERN LAKE FOREST HOSPITAL
minutes
*Northwestern Lake Forest Hospital average wait times based on internal electronic medical records of 30,000
ED visits in 2010. National waiting time is a mean, reported in “National Hospital Ambulatory Medical Care
Survey.” Stephen Pitts, MD, MPH, FACEP, et al. National Health Statistics Reports. No. 7, August 6, 2008.
Centers for Disease Control.
medicine for 35 years. “We’ve always had a good
staff-to-patient ratio at both Northwestern Lake
Forest and Northwestern Grayslake, and that’s one
reason our wait times are often lower than the
national average.”
COMMUNITY TIES THE DOCTOR NEXT DOOR
Dr. Peters does not just treat the residents of
Lake County—he is an active member of the
community. He lives in his native Lake Bluff, where
he served as a volunteer firefighter and engineer
for seven years. He knows that the people he sees
around town may turn up in the Northwestern
Lake Forest or Grayslake Emergency Departments
at some point.
“We want to provide the very best care because
these are our neighbors and friends,” says
Dr. Peters. “Many of us in the ED are involved
with local schools and charities. We’re truly
invested in the local communities and we feel
a strong responsibility toward the hospital and
its patients.”
The Northwestern Lake Forest and Northwestern
Grayslake emergency departments see a high
volume of pediatric patients—about 30 percent.
These cases, along with an array of other
emergency cases, translate into a depth and
breadth of experience for treating children in
emergencies.
“The more you work with a particular type of
person or case, the better you perform your role,”
says Dr. Peters. “Our emergency physicians have
strong capabilities in pediatric emergency medicine.
We also have pediatric certification awarded
by Emergency Medical Services for Children in
conjunction with the Illinois Department of Public
Health. And, all of our nurses are certified in
pediatric advanced life support.”
Both Dr. Franaszek and Dr. Peters believe this
pediatric expertise should be a comfort to parents.
But parents should also know that this experience
is complemented by the 24/7 presence of
Children’s Memorial Hospital pediatric hospitalists.
These board-certified pediatricians specialize in
the care of hospitalized infants and children, assist
with high-risk deliveries, and consult on pediatric
emergency cases. In fact, Northwestern Lake Forest
is the only emergency department in Lake County
with these experts on site all day, every day.
“They are immediately available if we need their
support,” says Dr. Peters. “For parents, there’s
nothing scarier than a sick child, and you should
expect—and receive—only the very best at
that moment when you choose an emergency
department for your child.”
SUMMER 2011
13
STRAIGHT ANSWERS
Q&A
Stanley Dee, MD, loves kids. HE HAS FOUR OF HIS OWN (ROBERT, MARTHA, AND
TWINS VICTORIA AND TOMMY), AND HE HAS HELPED HUNDREDS OF CHILDREN “GO TO
SLEEP” AS ONE OF THE AREA’S FEW BOARD-CERTIFIED PEDIATRIC ANESTHESIOLOGISTS.
FOR OVER 20 YEARS, HE HAS WORKED AT NORTHWESTERN LAKE FOREST HOSPITAL
AND WAS RECENTLY NAMED MEDICAL DIRECTOR OF THE NORTHWESTERN GRAYSLAKE
SURGERY CENTER. HERE HE EXPLAINS WHAT PARENTS SHOULD KNOW.
WHAT IS THE BIGGEST RISK FOR A CHILD
HAVING SURGERY?
Most complications have to do with respiratory and
breathing issues, which is why the anesthesiologist’s
skill is so important. The particular surgery might
be general or common, but anesthesiology is
always a complex process. The challenge for us
is to maintain the airways and make sure kids
emerge from the anesthesia breathing well.
HAVING WORKED WITH MANY SURGEONS AND
PARENTS, WHAT IS YOUR BEST ADVICE?
When a
Child Needs
Surgery
A PEDIATRIC
ANESTHESIOLOGIST
EXPLAINS WHAT
YOU SHOULD KNOW
Always let the surgeon or your primary care
physician know if your child is not feeling well.
A cold during surgery, when breathing is critical,
increases the risks. Parents are reluctant to
re-schedule the surgery or change a planned
day off from work, but safety is the priority.
Also, take seriously any orders to withhold food.
Many parents cheat a little, but gastric contents
can enter the lungs during surgery and that’s
dangerous. Finally, stay calm and be honest with
your child. We had a wonderful dad here recently
who was relaxed and treated it as no big deal—his
son wasn’t afraid and went to sleep beautifully.
HOW DOES A SPECIALIZATION IN PEDIATRICS MAKE
A DIFFERENCE; I.E. HOW DO YOU HELP CHILDREN?
Kids are not small adults; their systems are
entirely different. It is about knowing these
physiological differences but also being gentle,
calm and quickly establishing trust. We talk,
and I use toys and flavored masks to establish
a playful mood. I also maintain physical contact
with the child throughout the surgery—I’m not
just monitoring equipment.
A common complaint from parents during
children’s surgery is that the anesthesiologist
talked to the parents, but never even looked
14
NORTHWESTERN LAKE FOREST HOSPITAL
at the child—it shouldn’t be that way. The
anesthesiologist’s personality and orientation to
children is very important. I love kids, and I think
being a father has made me a better pediatric
anesthesiologist.
Parents should also know that pediatric specialty
training is important for the surgeon to have as
well. At Northwestern Lake Forest, we have a full
staff of pediatric specialists who perform surgery,
as well as pediatric general surgeons.
WHAT ARE THE RULES REGARDING PARENTS
IN THE OPERATING SUITE BEFORE AND
AFTER SURGERY?
For children over one year old, parents are
allowed to come in during the beginning of the
anesthesia process, and we try to explain what
they will see and hear. It doesn’t interfere, and it
makes the parents feel better. Bringing a parent in
toward the end of surgery is prohibited because
of the careful process we undergo to make sure
the child emerges from the anesthesia safely. We
can’t promise, but often by the time the child is
fully awake the parent is already there.
WHAT SHOULD PARENTS LOOK FOR IN AN
OUTPATIENT SURGERY CENTER?
Proximity, facilities and technology are important.
But it comes down to the experience of the
surgical team—the surgeon, the anesthesiologist,
the nurses. The clinical staff at our new
Northwestern Grayslake Surgery Center is made
up of veteran nurses and anesthesiologists whose
average years of experience is high, some of
them over 20 years. I often hear from surgeons
that our anesthesiologists are highly regarded in
the county—and our external patient satisfaction
scores [PressGaney™] back that up.
NORTHWESTERN
GRAYSLAKE
SURGERY CENTER
• Four operating suites
equipped with the
latest, state-of-the-art
technology
• A veteran team of
nurses, surgeons and
anesthesiologists,
most with pediatric
subspecialty expertise
• Easy, free parking and
curbside drop-off,
private patient exit
area
• One-stop check in
with receptionist
• Private consultation
rooms and pre/postoperative patient
rooms with private
toilets
• Patient rooms
equipped with
flat-screen TVs
• Beautifully furnished
waiting room with
indoor garden and
décor inspired by
surrounding prairie
landscape
SUMMER 2011
15
THE CUTTING EDGE
New expertise
for a growing
cancer threat
“A common scenario is that a CT scan
reveals an abnormality in an organ like the
pancreas, where there’s no easy access,”
explains Dr. Keswani. “These procedures
let us biopsy outside the intestinal tract.
We can place our camera in the stomach
and evaluate and biopsy the pancreas
that way. Radiology or surgery are
options, but treating endoscopically is
the preferred approach.”
According to Dr. Komanduri, “Endoscopic
procedures like EUS are critical in effective
change management of GI cancer, because
they add more information based on the
particular stage of the tumors.”
RESEARCH-DRIVEN EXPERTISE
Both Dr. Keswani and Dr. Komanduri are
board-certified physicians in interventional
gastroenterology (which requires additional
training following subspecialty training in
gastroenterology) and affiliated with the
Robert H. Lurie Comprehensive Cancer
Center of Northwestern University.
New endoscopic interventions
offer more options in Lake Forest
ACCORDING TO A MARCH 2011 REPORT
from the National Cancer Institute, the
incidence rate of pancreatic cancer has
increased in both men and women. At
the same time, the rate of esophageal
(throat) cancer is rising more rapidly than
any other type of cancer. The increase
may be due to lifestyle factors like
smoking or rising obesity.
In any case, cancers that attack the
esophagus, stomach, colon, pancreas
and other difficult-to-reach organs of the
gastrointestinal system claim far too many
lives—more than 250,000 annually.
INTERVENTIONAL ENDOSCOPY
NOW IN LAKE FOREST
The good news is that the relatively new
field of interventional endoscopy offers
16
NORTHWESTERN LAKE FOREST HOSPITAL
less invasive, non-surgical options to
access, diagnose and treat gastrointestinal
diseases. This kind of care is usually only
available at academic medical centers.
But now, select procedures are available
for the local community. Northwestern
Lake Forest has invested in new
technology and two physicians from the
renowned interventional endoscopy team
of Northwestern Memorial Hospital in
Chicago, Rajesh N. Keswani, MD, and
Sri Komanduri, MD, MS, will join the
gastroenterologists here to provide this
advanced care onsite in Lake Forest.
AVOIDING SURGERY WITH ERCP, EUS
Two types of these interventional
procedures will be offered onsite in
Lake Forest: EUS (endoscopic ultrasound)
and ERCP (endoscopic retrograde
cholangio-pancreatography). EUS and
ERCP diagnose and treat diseases of the
difficult-to-reach gastrointestinal organs
in a less invasive manner, treatments
that Dr. Keswani says “were previously
under the domain of surgery.”
ERCP
Using a long, flexible instrument equipped
with a camera at its tip, ERCP enables
diagnosis and treatment for gallstones,
blockages, cancer tumors and numerous
other conditions.
EUS
EUS enables earlier, more effective staging
of gastrointestinal cancers and other
abnormalities by combining endoscopy and
ultrasound imaging to identify, biopsy and
treat tumors in or near the intestinal tract.
They are also on faculty at Northwestern
University Feinberg School of Medicine
and serve as panel members on the
National Comprehensive Cancer Network,
the organization that publishes national
guidelines for management of tumors.
Both physicians are also active in research
that is helping to shape the field of
gastrointestinal oncology.
MEETING LOCAL NEEDS,
IMPROVING CANCER OUTCOMES
“Better outcomes in advanced GI
procedures are linked with experience,”
says Dr. Keswani, whose research interests
include clinical outcomes for ECRP and
EUS and new endoscopic approaches
for complex or difficult colonoscopies.
“A generalist may receive some training,
SRI KOMANDURI, MD, MS
RAJESH N. KESWANI, MD
but the national organizations that issue
guidelines recommend that endoscopic
interventions be reserved for physicians
who perform them frequently—high
volume is key to good outcomes.”
do not experience heartburn at all—there
aren’t great screening tools available yet.”
Northwestern Memorial has one of the
largest interventional endoscopy programs
in the Chicago area, performing nearly
2,000 interventional procedures per year.
That means that Dr. Keswani and Dr.
Komanduri have the recommended level
of experience to perform these procedures
safely and effectively.
“For example, a pre-cancerous polyp
may be too large to remove during the
colonoscopy in which it was discovered,”
explains Dr. Keswani. “A local
gastroenterologist can now refer the
case to us for more complex but safe
treatment, and the patient avoids surgery
and traveling far from home.”
BARRETT’S ESOPHAGUS AND CANCER
“Heartburn is the number one symptom
of acid reflux disease, and 20 to
25 percent of the population with
longstanding heartburn can develop
Barrett’s Esophagus, a precancerous
condition,” says Dr. Komanduri, a pioneer
in the use of radiofrequency ablation
(RFA), an intervention that removes
precancerous cells in patients with
Barrett’s. “But many people with Barrett’s
However, he explains, there are general
guidelines for patients to keep in mind:
overweight, Caucasian males over the
age of 60 are at high risk for esophageal
cancer, even if they don’t experience
heartburn. Any person age 40 and older
who has sudden onset of heartburn, and
is taking over-the-counter or prescribed
medication without effect may be at
risk. Other symptoms can include sudden
weight loss, difficulty swallowing, nausea,
and vomiting. But keep in mind that
esophageal cancer is not limited to
older men.
In a recent profile in the Chicago
Sun-Times about his pioneering work
with RFA for Barrett’s, Dr. Komanduri
pointed out that “while the ratio of
males to females continues to be 2 to 1,
we’re identifying more and more patients
in their 30s, and we’re even seeing it
younger women and children.”
Both physicians recommend seeing your
primary care physician or gastroenterologist
if you have questions about the advanced
procedures now available in Lake Forest.
SUMMER 2011
17
SUPPORTING NORTHWESTERN LAKE FOREST HOSPITAL
THE WOMEN’S BOARD of Northwestern Lake Forest
A
“FIELD OF HEARTS”
IN LAKE FOREST
THE WOMEN’S BOARD CREATES A
CARDIOLOGY CAMPAIGN FOR
LOCAL RESIDENTS
Hospital is spearheading an effort to bring hearts
from Northwestern Memorial Hospital’s “Hearts
a Bluhm” campaign to Lake Forest. “Hearts a
Bluhm” was a heart awareness and public art
campaign made up of 100 unique, five-foot acrylic
hearts designed by local artists to reflect personal
experiences with and important messages about
heart health.
“Each of these hearts is so unique, so original,
we thought it would be a wonderful way to raise
awareness about heart disease and the extension
of Northwestern’s Bluhm Cardiovascular Institute
here in Lake Forest,” says Jennifer Bianchi,
president of the Women’s Board. “We are so
blessed to have these cardiology services right
in our backyard.“
SUPPORTING ADVANCED CARDIOLOGY
IN LAKE FOREST
Twenty of the original hearts, what the Women’s
Board is calling a “Field of Hearts,” will arrive at the
hospital’s Lake Forest campus in early September
and will later appear in Market Square. They
remain on display until October 1, the day of
“A Night in the Forest,” the Women’s Board
Annual Benefit. The Annual Benefit has been a
Lake Forest tradition for more than 50 years, and
this year’s Annual Benefit is dedicated to raising
funds for Northwestern Lake Forest’s lifesaving
cardiology services.
“Thanks to the can-do spirit and energy of
the Women’s Board, this initiative will help
us build upon the excellent care the hospital
already provides to the community,” says Ian
Cohen, MD, medical director of cardiology at
Northwestern Lake Forest. “There are tremendous
changes happening in cardiology, including
new preventative and diagnostic services and
sophisticated technology for interventional
cardiology, vascular radiology, electrophysiology
and heart failure—additional support could be
used in all of these areas.”
HEARTS FIRST “BLOOMED” ON MICHIGAN AVENUE
Northwestern’s Bluhm Cardiovascular Institute
launched the original Hearts a Bluhm promotion
this past February on Michigan Avenue in Chicago
to raise awareness of heart disease—the number
18
NORTHWESTERN LAKE FOREST HOSPITAL
one cause of death in the United States. February
is a dreary time of year in the city, but during the
campaign the Magnificent Mile “bloomed” with
the one-of-a-kind heart sculptures. The Bluhm
Cardiovascular Institute partnered with students,
faculty, staff and alumni artists from Columbia
College of Chicago to design and paint the
hearts. For example, Bill Coon painted text from
his book “Swim,” which details his experience
receiving a successful heart and kidney transplant
at Bluhm. Another student, Alison Shiman,
painstakingly recreated a replica of her father’s
electrocardiogram.
A UNIQUE SPONSORSHIP AND GIVING OPPORTUNITY
As part of the Lake Forest campaign, the Annual
Benefit has been successful with a growing group
of individual and corporate sponsors that includes
the Northwestern Lake Forest medical staff, Lake
Forest Bank and Trust, Baxter Laboratories, Energy
BBDO, Stericycle, and Knauz Automotive Group.
“We’re thrilled by the strong response,” Bianchi
says. “I think people appreciate that the proceeds
are going directly to Northwestern Lake Forest’s
cardiac care. Our community is seeing that the
connection with Northwestern Memorial is growing
stronger. There is this fabulous ‘Field of Hearts’ on
display, and we’ve been able to get The Beach Boys
to play at our benefit. It’s great timing and makes
for a great combination.”
Kathy Walgreen, long-time Lake Forest resident and
sustaining member of the Women’s Board, was
instrumental in securing the Beach Boys for the
benefit. The Mr. and Mrs. Charles R. Walgreen III
Foundation is sponsoring the event.
Help fight
America’s
number
one killer
Businesses and
individuals may
contribute to the
Bluhm Cardiovascular
Institute expansion
in Lake Forest. Gifts of
all sizes are welcome
and appreciated.
Contact the Office
of Philanthropy at
847.535.6111.
ABOUT CARDIOLOGY SERVICES AT
NORTHWESTERN LAKE FOREST
Northwestern Memorial’s cardiology services
are delivered by the experts of the Bluhm
Cardiovascular Institute, the number one heart
care provider in metropolitan Chicago.*
Local patients can receive a wide range of
specialized cardiac care in Lake Forest, including
comprehensive diagnostic cardiac testing and
advanced treatment and interventions for coronary
artery diseases, cardiomyopathy and congenital
heart defects.
*Since 2004, the National Research
Corporation’s annual survey has rated
Northwestern Memorial Hospital as
metropolitan Chicago’s most preferred
provider for heart care. In 2011, the
Heart and Surgery program at the
Bluhm Cardiovascular Institute was
ranked 16th in the nation according
to U.S. News & World Report.
SUMMER 2011
19
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lfh.org
847 535 6171
nmh.org
main telephone
patient scheduling
health resources
847 234 5600
847 535 8000
312 926 2000
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Northwestern Lake
Forest Hospital has
expanded its network
of physicians. We
welcome these new
members on our staff.
Cardiac Surgery
A
S. CHRIS MALAISRIE, MD
Chicago, 312.695.2517
A
PATRICK McCARTHY, MD
Chicago, 312.695.4965
A
EDWIN McGEE, JR., MD
Chicago, 312.695.0454
Dermatology
B
GINA DILLIG, MD
Lake Forest, 847.234.6121
C
DIVYA SINGH-BEHL, MD
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A
SRINADH KOMANDURI, MD, MS
Chicago, 312.695.5620
Internal Medicine
D
DIPESHKUMAR SHAH, MD
Northbrook, 847.498.1515
Internal Medicine Hospitalist
A
ROBERT GERBER, MD
Chicago, 847.535.8490
Neonatology
A
ANTRANIK POLADIAN, MD
Nephrology
RAMONA GUPTA, MD
ROBERT LEWANDOWSKI, MD
SCOTT RESNICK, MD
ROBERT RYU, MD
RIAD SALEM, MD
KENT SATO, MD
ROBERT VOGELZANG, MD
Gastroenterology
A
RAJESH KESWANI, MD
Chicago, 312.695.5620
E
F
JAWAD MUNIR, MD, FACP
Libertyville, 847.549.7222
G
NORTHWESTERN LAKE FOREST HOSPITAL
Pediatric Dentistry
E
CAMERON WAGNER, DMD
GRAYSLAKE CAMPUS
LIBERTYVILLE – USG DRIVE
BANNOCKBURN
LINDENHURST
GLENVIEW
VERNON HILLS
GURNEE – BROOKSIDE
GURNEE – TOWER COURT
Pediatric Hospitalist
A
SHEPHALI KATIRA, MD
Chicago, 847.535.5600
Pediatric Neurology
A
CHICAGO
MELISSA CIRILLO, MD
Chicago, 773.880.4352
Physical Medicine and
Rehabilitation
D
SUSAN KEESHIN, MD
Northbrook, 312.238.3812
Thoracic Surgery
A
RICHARD LEE, MD
Chicago, 312.695.3662
LESLIE SCHMITZ, DO
Urology
Orthopedic Hand/Upper
Extremity Surgery
Lake Forest, 847.295.0010
B
RONALD KIM, MD
Northwestern Lake Forest Hospital is an affirmative action/equal opportunity employer that welcomes, respects, and serves with dignity all
people and does not discriminate, including in hiring, or employment, or admission, or access to, or treatment in its programs or activities on the
basis of any status protected by relevant law. Questions relating to Northwestern Lake Forest Hospital’s non-discrimination policies in admission,
programs, and treatment should be directed to the Patient Relations department at 847-535-8282 (TDD/TTY 800-526-0844), and questions
relating to non-discrimination in recruitment and employment should be directed to the Department of Human Resources at 847-535-6163.
Copyright©2011 Northwestern Lake Forest Hospital.
GARY KRONEN, MD
Libertyville, 847.247.0547
Pediatrics
H
LIBERTYVILLE – HOLLISTER DRIVE
Vernon Hills, 847.367.6055
Highland Park, 847.432.7222
F
LAKE FOREST CAMPUS
JULIA KOVAL, MD
Vernon Hills, 847.968.2351
SARAH BREEN, DO
Gurnee, 847.367.5400
20
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Diagnostic Imaging
HOWARD CHRISMAN, MD
Northwestern Memorial HealthCare, a nonprofit organization, is the corporate parent
of Northwestern Memorial Hospital and Northwestern Lake Forest Hospital.
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Chicago, 773.880.6318
JAMES CARR, MD
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Deerfield, 847.480.0004
Staff supporting seven imaging locations.
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Complete profiles on all physicians
are available at lfh.org.
We are proud to do our part to help the environment.
The FSC trademark identifies products that contain fiber from
well-managed forests certified by SmartWood in accordance with
the rules of the Forest Stewardship Council.
Non-Profit Org.
U.S. Postage
PAID
Northwestern
Lake Forest Hospital
660 North Westmoreland Road
Lake Forest, Illinois 60045
847.234.5600
to learn
lfh.org
to give
lfh.org/philanthropy
to volunteer
lfh.org/volunteer
to register
lfh.org/events
The Women’s Board of
Northwestern Lake Forest Hospital Auxiliary
Annual Benefit
Saturday, October 1, 2011
FEATURING THE MUSIC OF
The Beach Boys
Proceeds from this year’s event benefit the extension of
Northwestern’s Bluhm Cardiovascular Institute at
Northwestern Lake Forest Hospital. For more information,
visit lfh.org/womensboard or call the Office of Philanthropy
at 847.535.6111.