2015 Fall Newsletter - Phelps Memorial Hospital

Transcription

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

2015 Fall Newsletter - Phelps Memorial Hospital

Transcription

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