phelps WINTER 2014 T O D A Y News from Phelps Memorial Hospital Center Getting Back in the Game After Hip Replacement Preventing Disability from Rheumatoid and Psoriatic Arthritis When Snoring Is More than an Annoyance Cheryl Slaughter, a personal trainer and an avid boxer who had hip replacement surgery last year, works on her boxing moves in the gym at Sleepy Hollow Country Club. Get better. Here. Dear Friends, Greetings and Happy New Year! During the busy holiday season, much has been going on at Phelps. Construction of our new SurgiCenter began in October. This state-of-the-art surgical facility will be located in the 755 Medical Services Building with a bridge connecting it to the third floor of the main hospital. The project has been planned for a long time and we are excited to be building a suite of operating rooms so modern that it will meet the needs of our patients, surgeons and changing technology for decades to come. The SurgiCenter will be the first inpatient and outpatient surgical facility in New York State to be located in a medical office building. The hospital’s multi-specialty medical group, Phelps Medical Associates, continues to grow with the addition of internal medicine physician Imaan Chowdhury, neurologist Mark Homonoff and nurse midwife Rebecca McCracken. The group now has 34 providers at 12 locations in the surrounding community and on the Phelps campus. Three Phelps physicians were among only seven chosen as Westchester’s first “Doctors of Distinction” and were honored at a recognition ceremony on October 24. Chief of General Surgery Robert Raniolo received the Community Service Award, Chief of Thoracic Surgery Avraham Merav received the Lifetime Achievement Award, and Senior Vice President for Medical Affairs and Chief Medical Officer Lawrence Faltz received the Leadership in Medical Advocacy Award. The event was founded by Citrin Cooperman, Westchester County Medical Society, and Westfair Communications. We are eagerly anticipating the launching of a “Room Service” food delivery system early in 2014. In preparation, the hospital’s entire kitchen has been renovated to accommodate on-demand meal delivery from 7 am to 7 pm. The system is similar to a hotel room service program, and patients can expect to have their meals delivered within 45 minutes. This will surely be appreciated by our patients, who will now have the ability to choose from a varied menu and eat when they are hungry, instead of on a set schedule. Wishing you a happy and healthy 2014! Sincerely, Richard J. Sinni Chair, Board of Directors Keith F. Safian, FACHE President & CEO Preventing Disability from Rheumatoid or Psoriatic Arthritis . . . . . . . . . . . . . . . . . . . . . 8 Three Phelps Physicians Named Westchester “Doctors of Distinction” . . . . . . . . . . . . . . . . 11 Sleep Apnea: When Snoring Is More than an Annoyance . . . . . . . . . . . . . . . . . . . . . 12 Phelps Cardiac Rehab Program Receives Certification . . 14 Robin’s Nest Child Care Center Celebrates Expansion . . . 14 Phelps Breaks Ground on New Surgical Suite . . . . . . . 15 Phelps Medical Associates News . . . . . . . . . . . . . 16 On the Move: Promoting Physical Fitness in the Community . . . . . . . . . . . . . . . . . . . . 18 ¿Cuándo es el momento de realizar una cirugía de reemplazo de cadera? . . . . . . . . . . . . . . . . . . 22 Cómo vivir una vida plena con artritis reumatoide o psoriásica . . . . . . . . . . . . . . . . . . . . . . . 26 Programs and Services at Phelps . . . . . . . . . . . . . 29 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 (2014-16) 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 2012 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. Contents When Is It Time for a Hip Replacement? . . . . . . . . . . 4 PHELPS TODAY Editor Mary Sernatinger msernatinger@pmhc.us Managing Editor Tina Dorfman Medical Editor Bruce Heckman, MD, MPH Editorial Advisors Lucy C. Engelhardt, RN Leonard B. Fogel Kenneth C. Kaplan, MD Mary McDermott, RN Keith F. Safian, FACHE PHELPS TODAY is a publication of Phelps Memorial Hospital Center, a 238-bed, notfor-profit acute care community hospital located in Sleepy Hollow, NY. Phelps has been providing medical and mental health services to Westchester and surrounding communities since 1955. If you would like to be removed from the Phelps Today mailing list, please call (914) 366-3100 or email tdorfman@pmhc.us. Visit us on Facebook: http://www.facebook.com/ PhelpsMemorialHospitalCenter Visit us on Twitter: https://twitter.com/ #!/phelpshospital When Is It Time for a Hip Replacement? It may start out as pain and stiffness in the groin, buttock or thigh when you first wake up in the morning. The pain gets worse when you move around and better when you rest. But after a while, you may find that even resting no longer helps. Chances are you have arthritis of the hip. Those with a family history of arthritis of the hip have an increased chance of developing it, and the risk increases with age, obesity or an injury that puts stress on the hip cartilage. A rthritis is a condition that occurs when the surface of a joint (cartilage) wears out. Your cartilage is covered by tough, slick, 1/4-inchthick tissue that allows your bones to glide over each other without causing painful friction. When cartilage thins or wears out completely, the bone ends rub against each other, resulting in pain and stiffness. According to the Centers for Disease Control, one in four people will develop hip arthritis in their lifetime. Those with a family history of arthritis of the hip have an increased chance of developing it, and the risk increases with age, obesity or an injury that puts stress on the hip cartilage. First-line therapies generally recommended for pain caused by hip arthritis are anti-inflammatory drugs, exercise and physical therapy. For a time, one or more of these therapies may provide relief so that you can sleep, climb stairs and perform the activities of daily living. But when hip pain becomes so severe Pelvis Ball of Femur Socket of Pelvis Femur Normal Hip 4 PHELPS TODAY that these therapies no longer work, and it hurts too much to even go for a walk, it may be time to consider a hip replacement. Types of Hip Replacement The most common type of hip replacement is the posterior approach. During this surgery, the surgeon makes a 6- to 8-inch incision over the side or back of the hip, cutting through the muscles and detaching tendons and ligaments from the back of the hip. The surgeon then removes the diseased bone and cartilage from the hip joint and replaces the ball and socket with an artificial hip. The minimally invasive anterior approach hip replacement surgery requires only a small 3-4 inch incision. Surgical entry to the hip joint is through the area between the lower abdomen and the top of the thigh. The surgeon is able to reach the hip without cutting through muscles or detaching tendons, working by way of the natural space between the muscles. Pelvis Damaged Cartilage Femur Arthritic Hip In addition, the most important muscles for hip function – the gluteal muscles, which attach to the pelvis and femur – are left undisturbed and therefore do not require a healing process. Compared to traditional total hip replacement, the anterior approach has been shown to cause considerably less pain and result in a quicker recovery and lower risk of post-operative hip dislocation, where the hip pops out of the joint, one of the most common complications after surgery. Since no muscles are cut to access the hip joint, the anterior approach, also referred to as “muscle-sparing” surgery, is associated with a quicker return to normal activity. Patients are not required to sleep in a special position, use special instruments to put on their shoes and socks or have an elevated toilet seat. They can return to driving as soon as they are comfortable. Anterior approach hip replacement is performed on a special surgical table called the hana™ Hip & Knee Arthroplasty Table, the only table designed exclusively for hip and knee replacement. The table allows the surgeon to rotate the hip in ways that are not possible with conventional surgical tables. Additionally, because the table allows for continuous image guidance during the surgery, it is possible to adjust the implant if it is not perfectly aligned, before the patient leaves the operating room. Orthopedic surgeon Corey F. Burak, MD, brought the minimally invasive anterior approach hip replacement technique to Phelps in 2006. He was the first surgeon in Westchester County, NY, to perform this surgery and has more experience in anterior approach than any other orthopedic surgeon in the Northeast, having performed more than 2,000 such surgeries to date. Option for a Wider Variety of Patients “The bulk of my patients are between 40 and 60 years old,” says Dr. Burak. “These are people with arthritis or congenital conditions, or athletes who’ve had sports injuries. They have different expectations for the surgery than an older person. They’re eager to get back to their active lifestyles, which often includes sports and playing with their kids.” In addition to these benefits for a younger, on-the-go patient, this surgery is an option for a much wider variety of patients than traditional and other minimally invasive hip replacement surgeries. “I’ve operated on patients from 25 to 98 years old and from 100 to 400 pounds,” says Dr. Burak. “The beauty of this operation is that you don’t have to be selective – almost all patients are candidates.” PHELPS TODAY 5 About five years ago, Cheryl Slaughter, a 45-year-old athlete and personal trainer living in Croton, began having hip pain caused by arthritis and from falling on her hip while skiing. Initially she tried physical therapy to alleviate the pain, which helped for a while, but eventually the bone-on-bone pain became more than she could tolerate. Her pain was seriously restricting her life. Cheryl conducted extensive research before deciding what kind of hip replacement to have and who should perform the surgery. Because of her occupation, she is in contact with many physical therapists, so she asked them for recommendations. Dr. Corey Burak’s name came up again and again. 6 PHELPS TODAY Cheryl had anterior approach hip replacement surgery performed by Dr. Burak at Phelps in December of 2012 and left the hospital three days later. One week after surgery, she was walking 1½ miles, and she returned to work full time after just one month. “If I had a desk job I would have gone back weeks earlier,” she says. In addition to the method used to replace her hip, she attributes her quick recovery to the strengthening exercises she did prior to surgery, and to the fact that she went on an anti-inflammatory diet. Certified as a corrective exercise specialist (a personal trainer for people with injuries), she says she “knows how to rehab.” The married mother of two teenagers speaks about how wonderful it is to go into New York City with them and to be able to go up and down the steps to the subway. She also is back to boxing twice a week, one of her favorite sports, and works out with weights at the gym. “Hip replacement is the best thing I ever did,” she says. “My hip was restricting me a lot. Now I have a renewed ‘baby’ joint with lots of range of motion and a renewed life. I can stand up straighter and move without restriction. It’s great to be able to walk without pain.” Marian Weinberg’s hip had been hurting for years. This 94-year-old Sleepy Hollow resident has led a very active life, and continued playing tennis until age 92, in spite of the pain. Finally she realized she had to do something about it. “When I told my children I was considering getting a new hip, they said that I shouldn’t do it, that I’m too old, that my bones would split, that I would be in a wheelchair for the rest of my life. But I didn’t listen to them, and I’m glad I didn’t!” Mary Wu of Ossining is one of Dr. Corey Burak’s most impressive patients. A twotime kidney transplant recipient with a number of chronic medical conditions including congenital kidney disease, Mary was diagnosed with mild scoliosis and left hip arthritis at the age of 10. She has been in pain and had limited mobility for much of her 30-year life. In April of last year, when her hip pain became too much to handle, Mary underwent anterior approach hip replacement surgery. For more than five years, she had not been able to walk for more than 15 minutes at a clip, but after the surgery and several months of intense physical rehabilitation at Phelps, she is learning to “move and groove again.” In fact, Mary was chosen to be the adult honoree for the first annual 2013 Westchester County Jingle Bell Run/Walk for Arthritis, a national event held by the Arthritis Foundation in 200 cities across the U.S. A dedicated Arthritis Foundation ambassador, Mary has appeared before Congress and local legislators advocating for arthritis issues. “My new normal with my new hip has been invigorating. Life and living have never been more beautiful and extraordinary,” she says. Dr. Burak performed anterior approach hip replacement surgery on Mrs. Weinberg in September of 2011, and she left the hospital three days later for a stay in a skilled nursing facility and two weeks of physical therapy. In four weeks, she was walking without a cane, and without any pain. their treatment locations using empty seats on corporate jets. She hasn’t had any problems with her hip in the last two years and currently swims half a mile twice a week. “Getting my hip replaced is the best thing I ever did,” says Mrs. Weinberg, who was a math teacher at Briarcliff High School and is one of the founders of Corporate Angel Network, a charitable organization that arranges free air travel for cancer patients to and from “Some people think that once you reach a certain age, it’s not worth undergoing such a major operation,” says Dr. Burak. “But if you’re in generally good health and motivated to recover, it can be safely and successfully done.” Corey Burak, MD, is board certified in orthopedic surgery by the American Board of Orthopedic Surgery. He earned his medical degree from the SUNY-HSC at Syracuse College of Medicine in NY. He completed a general surgery internship at Saint Vincent’s Hospital and Medical Center, New York, NY, and an orthopedic surgical residency at Tulane University Hospital and Medical Center in New Orleans, LA, where he completed a research fellowship in adult reconstruction under the renowned Dr. Robert L. Barrack. Dr. Burak also completed a fellowship in hip and knee arthroplasty at the Dorr Arthritis Institute, Los Angeles, CA, and received the Rockwood and Green Award in 2002. PHELPS TODAY 7 Preventing Disability from Rheumatoid or Psoriatic Arthritis W Nearly 1.3 million Americans are afflicted with rheumatoid arthritis, one of the two most common joint diseases. hen Sharon Mitchell went off to college in 1978, the last thing she expected to learn was that she had rheumatoid arthritis. Treatments did little to help, and soon Sharon found it difficult just to walk across campus. That was the beginning of many years of trying new therapies and enduring increasing pain and disability. Sharon is one of nearly 1.3 million Americans who are afflicted with rheumatoid arthritis, which is one of the two most common joint diseases. The other is psoriatic arthritis. By adulthood, most people have encountered the occasional swollen and achy joint resulting from physical injury or infection. Easily resolved through rest, anti-inflammatory medication and, in some cases, antibiotics, the pain is quickly forgotten. But for many people, joint pain is chronic and requires aggressive, long-term medical care. In both rheumatoid arthritis and psoriatic arthritis, the inflammation is caused by abnormal functioning of the autoimmune system – the body’s defensive response against foreign substances mistakenly attacks internal cells and tissues. Rheumatoid Arthritis Rheumatoid arthritis usually occurs between the ages of 30 and 50, although people of any age can develop the disease. Two out of every three cases are in women. Diagnosis of rheumatoid arthritis is based on the presence of more than three of the following criteria: • Morning joint stiffness that lasts for more than an hour before improvement 8 PHELPS TODAY • At least one inflamed joint in the wrist or knuckles, or in the area between the middle and base of the finger • Below-the-surface hard nodules over bony prominences, on the back of the elbows or front of the knees, or near joints • Higher than normal levels of various antibodies in the blood, some of which are specific only to rheumatoid arthritis • An X-ray or CT scan that shows features such as soft-tissue swelling, or narrowing and erosion of space between the joints A person who has rheumatoid arthritis typically experiences fatigue, decreased range of motion, and fever. While the exact causes of rheumatoid arthritis are unknown, medical researchers speculate that the disease may be triggered by a combination of factors such as an abnormal autoimmune response, genetic susceptibility, viral infection, hormonal changes, and long-term exposure to tobacco or cigarette smoke. Psoriatic Arthritis Psoriatic arthritis afflicts men and women at the same rate, with most cases developing between the ages of 30 and 50. Factors that may predispose an individual to the disease are unknown, although up to 30 percent of people who have psoriasis will develop this condition. Individuals with the genetic marker HLA-B27 may also be at greater risk. There are five types of psoriatic arthritis, including: • Three or more joint areas that have simultaneous joint swelling Asymmetric – a stage of psoriatic arthritis characterized by swelling in a few random joints of the extremities. About 30 to 50 percent of psoriatic arthritis patients have this form of the disease. • Simultaneous inflammation of the same joint areas on both sides of the body Symmetric – a common later stage of psoriatic arthritis in which joint pain and swelling occur on both sides of the body. Nancy Carangelo, RN, of the Phelps Infusion Center monitors patient Sharon Mitchell during an infusion treatment for rheumatoid arthritis. Distal interphalangeal predominant (DIP) – an affliction of the joint nearest the tip of the fingers and toes, which produces pitting, splitting, and other degenerative changes in fingernails and toenails. About 25 percent of all psoriatic arthritis patients develop DIP. Arthritis mutilans – a severe form of psoriatic arthritis that causes painful swelling in the ligaments and tendons attached to bone. This condition is rare. Psoriatic spondylitis – produces swelling in the lining around the pelvis and inflammation of vertebrae. It occurs in about 30 to 35 percent of all cases. Other findings that indicate psoriatic arthritis include a negative blood test for rheumatoid factor, imaging studies that show joint changes, dactylitis (swelling in the fingers that produces a sausage-like appearance) and complaints of fatigue or exhaustion. Treatment for Rheumatoid or Psoriatic Arthritis According to rheumatologist Richard Parrino, MD, Medical Director of the Phelps Infusion Center, “Current practice supports aggressive treatment in the early stages of rheumatoid and psoriatic arthritis to prevent long-term disability. There is not a specific drug that can cure either form of arthritis, but there are medications that can minimize progression of the disease, which leads to a reduction in inflammation, prevents damage to bones and ligaments of the joints, and preserves movement.” Treatment is similar for both conditions, relying on antiinflammatory agents, disease-modifying anti-rheumatics (DMARDS) and Biologic response modifiers (Biologic DMARDS). Biologic DMARDs, developed in the 1990s, are drugs made from living cells. Remicade, HUMIRA, and Rituxan are common names for some of the biologics currently available. Biologics, which are usually administered intravenously or by injection every six to eight weeks, target the specific components of the immune system that cause joint inflammation. Possible side effects from biologics are an increase in risk for infections and the possibility that they may cause a dormant condition such as tuberculosis to flare up. DMARDs such as methotrexate, leflunomide, and sulfasalazine work by suppressing the body’s over-reactive immune system. The drawback with these drugs is that they may produce gastrointestinal distress, and they do not immediately alleviate joint discomfort. While waiting for a DMARD to take effect, pain relievers such as aspirin, ibuprofen, naproxen and sometimes prednisone may be given. Factors influencing the selection of a DMARD include the stage and severity of the joint condition, the balance between possible side effects and expected benefits, and a patient’s preference. Vectra, a New Diagnostic Tool for Rheumatoid Arthritis Phelps Infusion Center patients were among the first in New York State to benefit from a new diagnostic tool for rheumatoid arthritis called Vectra. This advanced blood test measures the levels of 12 proteins in the blood that are associated with rheumatoid arthritis, providing clinicians with an understanding of the current activity of the disease. This information helps clinicians determine the success of a patient’s current treatment and can control the expense of PHELPS TODAY 9 biologic medications by enabling physicians to know when to start and stop drug administration, as well as dosage effectiveness. Pursuing an Active Life with Psoriatic Arthritis A positive attitude, willingness to adapt to change, desire for independence, and a supportive social environment help many people with rheumatoid and psoriatic arthritis to lead a full life, despite joint discomfort and the threat of physical impairment. For John Kavanah, maintaining a fulfilling life with psoriatic arthritis has meant “listening to his body and adjusting goals as needed.” Born with club feet, John successively pursued his passion for athletics and professional interest in physical education despite his infirmities. Corrective surgery on his feet enabled John to play his preferred sports through young adulthood. Shortly after obtaining a college degree as a physical education teacher in 1984, John began to notice swelling in his ankles. Diagnosed with psoriatic arthritis, he continued to engage in high-motion sports for the next 10 years through treatment with cortisone and, later, methotrexate. In 2007, the initiation of treatment with biologics eliminated most of his foot pain, although he continues to have an irregular way of walking due to stiffness in his legs. Nearly 30 years since his initial diagnosis, John still works as a physical education teacher but no longer plays on high-motion sports teams. New responsibilities have been added to his life, including coaching a girls’ varsity basketball team and serving as a filmmaker for a local football team. He also works out at a gym to maintain his overall fitness. Whatever his role, John is forthcoming to others about his body’s limitations and his great interest in maintaining his physical independence. Living with Rheumatoid Arthritis As a college student in 1978, Sharon Mitchell coped by asking her professors for more time to walk to classes, or 10 PHELPS TODAY scheduling her classes in one building. Initial therapies, which included prednisone, gold injections, and Indocin, alleviated some of her pain, but did not have the ability to prevent the disease from attacking her joints. After Sharon married and had children, the family worked as a team to maintain the home and address personal needs. As Sharon’s health deteriorated, this sometimes meant resetting her priorities. She learned, for example, to not expect her family to immediately take responsibility for household chores she could no longer accomplish. She became more open to the support offered by neighbors to transport her children to school or extracurricular activities. She and her husband also modified their surroundings to maintain her independence. Levers replaced knobs on faucets and doors, and the family avoided placing household goods on high shelves. The introduction of biologics in 2007 changed Sharon’s life dramatically. By the morning after the initial treatment, she was able to get out of bed without discomfort and stiffness for the first time in 30 years. With the reduction in pain, her energy increased and Sharon soon felt well enough to work full-time instead of part-time as a director of finance. Daily tasks, such as driving, became less worrisome because of the decreased pain levels and increased mobility. Her energy level increased as did her ability to engage in physical activities, which helped to bring joy to both her and her family. Although Sharon continues to suffer from permanent joint damage, she considers the improvement in the quality of her life brought by biologics to be “nothing short of a miracle.” For both Sharon and John, the administration of biologics was instrumental in reducing pain and minimizing further joint damage. However, biologics may not be appropriate for all patients with rheumatoid or psoriatic arthritis. Dr. Parrino advises patients to speak with their rheumatologist prior to the start of any treatment to “discuss the benefits and risks of each therapy, including possible side effects and toxicities, dosing schedule, monitoring frequency and expected results.” The Phelps Infusion Center The Phelps Infusion Center was established in 2004 to provide patients with the latest treatments for chronic inflammatory diseases, including rheumatoid and psoriatic arthritis, ulcerative colitis, lupus and Crohn’s Disease. It is one of the largest infusion centers for inflammatory diseases in the New York metropolitan area. The center, located on the Phelps campus in Suite 260 of the 755 Building, features comfortable private rooms where patients can rest, read or work on a laptop while they receive treatments. “In our almost 10 years of providing infusion services on an outpatient basis, we have perfected delivering this service in a way that makes patients and their families feel secure and comfortable. This is a great tribute to the center’s caring and expert staff,” says Dr. Parrino. For more information about the diagnosis and treatment of rheumatoid or psoriatic arthritis, or any other inflammatory conditions, contact the Phelps Infusion Center at 914-366-3523. Richard Parrino, MD, the medical director of the Phelps Infusion Center, has over 40 years of experience in rheumatology. A graduate of the University of Rome Medical School, Dr. Parrino completed his residency in medicine at Queens Hospital and fellowship in rheumatology at New Jersey College of Medicine and Dentistry. Three Phelps Physicians Named Westchester “Doctors of Distinction” cardiothoracic surgery at Albert Einstein College of Medicine. At Phelps, he recently established the Westchester Lung Nodule Center for lung cancer screening in response to new guidelines that recommend low-dose CT scan screening for high-risk individuals. In accepting his award, Dr. Merav said his greatest reward has been helping to save, prolong and improve the quality of thousands of lives over several decades, and he marveled about the profound experience of seeing a heart start beating again following a surgical procedure. He mused about receiving a lifetime achievement award, saying there is so much more for him to do in years to come. Lawrence Faltz, MD, Robert Raniolo, MD, and Avraham Merav, MD T hree Phelps Memorial Hospital Center physicians were among seven honored at the first annual “Doctors of Distinction” awards ceremony, held in October at the Bristal assisted living facility in White Plains. The event was founded by Citrin Cooperman, Westchester County Medical Society and Westfair Communications. “We are particularly proud that three of the seven doctors honored are members of the Phelps medical staff,” said Keith Safian, President and CEO. “Our congratulations go to all the honorees, but particularly to Dr. Larry Faltz, Dr. Robert Raniolo and Dr. Avraham Merav for these well-deserved recognitions.” Robert Raniolo, MD, chief of general surgery, received the Community Service Award. A trauma-trained and board certified general surgeon, Dr. Raniolo has maintained a private surgical practice in Westchester and has been a member of the medical staff at Phelps since 1988. In addition to being a well-respected general surgeon, Raniolo is known in the community as a doctor to whom people can talk about their medical problems, very often having nothing to do with surgery. In accepting his award, Dr. Raniolo spoke about the life experiences that led him to become a surgeon – including his humble beginnings in a tightly knit family, his medical school years in Guadalajara, Mexico, when the care he offered to the indigent was so gratefully received, and his placement in a surgical residency program by a mentor physician who recognized his potential. He closed by thanking his family and many friends and colleagues who supported him on his path to becoming and practicing as a general surgeon. Avraham Merav, MD, chief of thoracic surgery and medical director of surgical services, received the Lifetime Achievement Award. A cardiothoracic surgeon for several decades, Dr. Merav 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 is an associate clinical professor of Lawrence Faltz, MD, senior VP for medical affairs and chief medical office at Phelps since 1994, received the Leadership in Medical Advocacy Award. He was instrumental in founding the family medicine residency program at Phelps, in partnership with New York Medical College and Open Door Family Medical Centers. He was recently appointed as clinical professor of medicine at NYMC. In addition to his activities at Phelps, Dr. Faltz was Chairman of the Northern Metropolitan Hospital Association’s Patient Safety Institute and is a member of the Quality Steering Committee of the Hospital Association of New York State. He is a Master and former Governor of the American College of Physicians, the national internal medicine specialty organization. In 2009, he completed a 6-year term as the American College of Physicians representative to The Joint Commission Hospital Professional Technical Advisory Committee. In accepting the award, Dr. Faltz said that his medical advocacy is not for physicians or hospitals – it is for patients, because ultimately they are the ones who benefit from improvement in the delivery of healthcare. PHELPS TODAY 11 Sleep Apnea When Snoring Is More than an Annoyance L With sleep apnea, there are pauses in breathing during sleep that result in lower levels of oxygen in your blood. oud snoring may be more than a mild annoyance that keeps the person sleeping next to you awake. It may be a signal that you have sleep apnea – a serious condition affecting more than 18 million Americans that causes breathing difficulty during sleep. Sleep apnea occurs because the airway is partially or completely closed. The noise of snoring is caused by air being forced through the narrowed passageway. With sleep apnea, there are pauses in breathing during sleep that result in lower levels of oxygen in your blood. Your body will fight to get the oxygen it needs, so if your airway is constricted, it may wake you up. Waking up repeatedly throughout the night impairs the depth of your sleep, which leads to chronic fatigue. If you experience daytime sleepiness or wake up tired every day, you may have sleep apnea. In addition to chronic f a t i g u e , t h e a dve r s e effects of sleep apnea on a person’s health have been well established. It is associated with an increased incidence of high blood pressure, heart attack, stroke, diabetes, depression and sexual dysfunction. It also raises your risk of having an automobile accident. Although not all people who snore have sleep apnea, proper diagnosis is essential to rule out this condition. If you feel you have a problem, you should first consult with your primary care physician about snoring, fatigue, and other sleep issues. If you and your doctor feel that you would benefit from a sleep evaluation, the staff of the Phelps Sleep Center can provide a complete test and diagnosis. 12 PHELPS TODAY In addition, an otolaryngologist (ENT) can identify any anatomic irregularities in your nose or throat that may be contributing to the condition. Treatment The gold standard for the treatment of sleep apnea is continuous positive airway pressure (CPAP), which increases air pressure in the throat to prevent your airway from collapsing when you breathe in. There are various types of CPAP masks. Some cover the nose and mouth, some cover only the nose, and some have prongs that fit directly into the nose (nasal pillows). If one type of mask seems uncomfortable, you can try another. Other non-surgical treatments for mild to moderate sleep apnea include dental appliances and mouth guards. It may take time to find the treatment that will work for you. Sometimes a deviated septum (the wall between the right and left sides of the nose) contributes to sleep apnea. In people who have a deviated septum, one side of the nose is wider than the other, which alters the pattern of airflow in the nose and sometimes blocks the narrower side. Surgically repairing the deviation has been shown to reduce the number of times a patient stops breathing during sleep. This surgical repair may also make the use of a CPAP mask more comfortable because the level of air pressure being administered can be decreased. Not to be overlooked, weight loss may significantly reduce sleep apnea or at least reduce the CPAP pressure that would be needed to prevent the airway from collapse. If you are diagnosed with sleep apnea, treatment may reinvigorate you by allowing you to enjoy uninterrupted sleep. More importantly, it may improve your overall health and quality of life. The Sleep Center at Phelps The Sleep Center at Phelps is a state-ofthe-art diagnostic facility dedicated to the diagnosis of sleep disorders. The center is accredited by the American Academy of Sleep Medicine, the gold standard by which the medical community and public evaluate sleep disorder programs. The Sleep Center is capable of diagnosing a full spectrum of sleep disorders. Using the latest diagnostic equipment, the center’s credentialed staff can determine if you are experiencing sleep apnea or other less common sleep disorders, such as narcolepsy or chronic fatigue syndrome. Sleep studies are conducted in comfortable, private rooms. Phelps also offers sleep studies for children under the guidance of a board-certified pediatric sleep specialist. Sleep Center staff work closely with patients who choose CPAP therapy to ensure that adjustment to the therapy is successful. In addition to overnight sleep studies, the center will soon be offering daytime studies and studies that can be conducted in the home. The center also offers a sleep support group that meets in the evening or daytime. For information about the Phelps Sleep Center, call 914-366-3755. Michael J. Bergstein, MD, FACS, is surgical director of the Phelps Sleep Center Maternity & Baby Care Classes The Childbirth Experience/ LaMaze Method Wednesday evenings 7:30 – 9:30 pm for 5-6 weeks Start dates: January 8, February 19, April 2, May 14, June 25 OR 2-day weekend sessions, 10 am – 3 pm: January 11-12, February 8-9, March 8-9, April 12-13, May 17-18, June 21-22 $170 per couple Breastfeeding: First Choice for Babies June 12 or 26 7 pm • $65 per couple Big Brother/Big Sister: Sibling Preparation January 18, March 15, May 24, July 19 10:30 am • $20 per child Totsaver Program: American Heart Association CPR for Family and Friends January 4, February 1, March 1, April 5, May 3, June 7 9 am • $55 per person 7 – 9 pm • $45 per couple For up-to-date schedules, visit phelpshospital.org. Call (914) 366-3382 for information or to register. ABCs of Baby Care Prenatal Clinic: Phelps Memorial Hos- January 6, February 3, March 6, March 31, May 1, June 9 January 23, February 10 or 27, March 10 or 27, April 7 or 24, May 8 or 29, pital Center and Open Door Family Medical Center, participants in the Medicaid Prenatal Care Assistance Program, jointly sponsor a and chief of the department of otolaryngology. Dr. Bergstein earned his medical degree at Mount Sinai Medical Center, where he also performed an internship and residency in general surgery and otolaryngology. He completed a fellowship in facial plastic surgery at the University of California, San Francisco Medical Center. Dr. Bergstein is board certified in otolaryngology – head and neck surgery and in facial plastic and reconstructive surgery. He is an assistant clinical professor of otolaryngology – head and neck surgery at Mount Sinai School of Medicine. He has offices in Sleepy Hollow and Yorktown Heights (914-631-3053). 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 basándose 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 13 Cardiac Rehab Program Receives Certification P helps Cardiovascular Services has received certification for its cardiac rehabilitation program from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). AACVPR-certified programs are recognized as leaders in the field of cardiovascular and pulmonary rehabilitation because they offer the most advanced practices available. Certification is valid for three years. Cardiovascular rehabilitation programs are designed to help people with cardiac disease improve their cardiovascular health and their quality of life. The programs include medically supervised exercise, education, counseling and support for patients and their families, with the goal of maximizing a patient’s aerobic capacity through regular exercise. This is the fourth program certification achieved by Phelps Cardiovascular Services in the past year. The other three were for peripheral arterial testing, peripheral venous testing and extracranial cerebrovascular studies (carotid artery studies). Pictured above are two cardiovascular rehab patients during a medically supervised workout. For more information about cardiac rehab at Phelps, call 914-366-3742. Pictured at the Robin’s Nest expansion ribbon-cutting: Keith Safian, Phelps President and CEO; Kenneth Wray, Sleepy Hollow Mayor; Diane Matrafailo, Robin’s Nest director; Lauren McDonald, Robin’s Nest Board member; and Daniel Blum, Phelps Senior VP. A ribbon-cutting for the Robin’s Nest child care center at Phelps Memorial Hospital Center was held in November, marking the official opening of a $1,400,000 expansion. The 3,860-square-foot addition to the facility opens up day care opportunities for 40 more infants, toddlers and preschool age children, ages two months through six years. Taking part in cutting the ribbon, Sleepy Hollow Mayor Ken Wray said, “The expansion of Robin’s Nest is great for everyone in the community, especially for working parents 14 PHELPS TODAY who know that their children are well taken care of here. The Village is growing, the hospital is growing, and it’s important that assets such as this facility grow, too.” Phelps President and CEO Keith F. Safian said, “The Robin’s Nest has a long tradition of providing excellent child care for local families and hospital employees. The need we are meeting for greater capacity is a solid indicator that the community is recovering from the recession, with more and more parents employed. Phelps is delighted to be able to support our Robin’s Nest Child Care Center Celebrates Expansion region’s economic growth by making it possible for a greater number of young children to receive care.” Diane Matrafailo, director of the facility, said, “The Robin’s Nest is one of very few day care facilities in the area that is nationally accredited. Parents know that this is a mark of excellence and it is one of the reasons so many want to bring their children to the Robin’s Nest. With the expansion, we are happy to be able to accommodate more children, cutting down wait times for enrollment.” For information, call 914-366-3232. Phelps Breaks Ground On New Surgical Suite G long x 9-foot-wide enclosed corridor bridge will connect the new surgical area to the surgical wing of the main hospital building. “We expect the planning we have done today to produce a facility so modern that it will meet our needs for decades to come.” “Building this new surgical suite is a huge step forward for Phelps,” said Richard Sinni, chairman of the hospital’s board. “We are very excited to be able to meet the growing needs of the community in this significant way.” “What we’ll have at Phelps is a stateof-the-art surgical facility, designed for tomorrow’s technology,” said Keith Safian, Phelps president and CEO. “The spacious operating rooms will accommodate new, larger equipment and will provide a comfortable environment for our patients and surgical staff.” Dr. Peress noted that a number of surgeons and staff were consulted about the design and capabilities of the new suite, so that the end result will reflect many people’s visions about how to create the best possible environment for patients, providers and changing technology. “We’ll be equipped to accommodate a full range of major surgeries, as well as minor procedures,” he said. “And we’ll be wired to handle robotic surgery when necessary.” round was broken recently on a 20,163-square-foot surgical suite to be built on the Phelps campus on the third floor of the 755 Medical Services Building. The suite, called the SurgiCenter, is unique in New York State in that it will be the first surgical facility to be located in a medical office building. It will function as a self-contained surgical unit for both inpatients and outpatients. A 200-foot- “This is really a bridge to the future,” said Dr. Richard Peress, a specialist in spine surgery and participant with thoracic surgeon Dr. Avraham Merav on the Board’s Facilities Master Planning Task Force. The estimated opening date for the new SurgiCenter is October 2014. Pictured at the SurgiCenter groundbreaking: Mary McDermott, Phelps Chief Nursing Officer; Kathleen Scherf, Nursing Director of Surgical Services; Louis Wachtel, Board member; Keith Safian, Phelps President and CEO; Richard Peress, MD, Director of Surgery; Richard Sinni, Board Chair; Russell Watson, Board member; George Gatullo, Director of Engineering; and Kerry Pisano, Vice President of Facilities. PHELPS TODAY 15 Phelps Medical Associates News Two New Physicians Join Phelps Medical Associates P helps Medical Associates, the hospital’s multi-specialty medical group, continues to expand. The latest additions to the group are internal medicine physician Imaan Chowdhury, MD, and neurologist Mark Homonoff, MD. Phelps Medical Associates now includes 34 clinicians in 12 practice locations in Briarcliff, Croton, Dobbs Ferry, Ossining, Sleepy Hollow and Tarrytown. Imaan Chowdhury, MD Mark Homonoff, MD Rebecca L. McCracken, CNM Dr. Chowdhury received her medical degree from Ross University School of Medicine. She conducted research in the anesthesiology department at Cleveland Clinic and completed a residency in internal medicine at Brookdale University Hospital and Medical Center in Brooklyn. Dr. Homonoff practices general neurology with a special interest in problems of higher cortical function, including Alzheimer’s disease. Before coming to Phelps, he was on the medical staff of Beth Israel Medical Center in Manhattan and held a faculty appointment at Mount Sinai School of Medicine. Dr. Homonoff earned his medical degree at Albert Einstein College of Medicine in the Bronx and completed residency training in neurology at Columbia Presbyterian Medical Center. He was a post-doctoral and research fellow at Rockefeller University and Cold Spring Harbor Laboratory. Both physicians are now accepting new patients on the Phelps campus in Suite 417 of the 755 building. To schedule an appointment with Dr. Homonoff, call 914-366-5330. Dr. Chowdhury can be reached at 914-366-5490 and also sees patients at Phelps’ primary care medical suite in Dobbs Ferry at 18 Ashford Avenue, 914-478-1384. Nurse Midwife Joins Sleepy Hollow Medical Group Rebecca L. McCracken, CNM, RN, BS, MS, a Certified Nurse Midwife, has joined the Sleepy Hollow Medical Group, a Phelps Medical Associates practice located on the hospital campus at 755 North Broadway. She provides prenatal care and delivery for normal pregnancies, routine gynecology and family planning services. Montgomery Douglas, MD 16 PHELPS TODAY McCracken served most recently as a midwife at Nyack Hospital and at Beth Israel Medical Center in New York City. Prior to that, she worked as a registered nurse at Lenox Hill Hospital and New York University Medical Center. McCracken holds a bachelor of science degree in nursing from University of Rochester and a master of science degree in midwifery from New York University. She is certified in Basic Life Support (BLS) and as a Neonatal Resuscitation Provider (NRP). She is a member of the American College of Nurse Midwives, Midwives Alliance of North America and the New York State Association of Licensed Midwives. Appointments may be made by calling 914366-5400. Montgomery Douglas, MD, Elected to American Board of Family Medicine Family physician Montgomery Douglas, MD, who sees patients at the Phelps Medical Associates primary care practice in Dobbs Ferry, was one of three new board members recently elected to the American Board of Family Medicine. The ABFM, the second largest medical specialty board in the United States, administers the exams and maintenance of certification programs taken by board-certified family physicians nationwide. Dr. Douglas is chairman of the Department of Family and Community Medicine at New York Medical College (NYMC) and is immediate past chair of the board of directors of the New York State Academy of Family Physicians. Board certified in family medicine and geriatrics, he played a critical role in the development of the NYMC Phelps Family Medicine Residency Program, the first residency program of its kind established in New York State since 1995. “Monty is a passionate advocate for excellence in medical education and clinical practice,” says Lawrence Faltz, MD, Senior VP of Medical Affairs and Chief Medical Officer at Phelps. “It was his vision and energy that brought the family medicine residency program to Phelps.” The Dobbs Ferry practice of Phelps Medical Associates is at 18 Ashford Avenue, Suite MW (914-478-1384). Phelps Opens Osteoporosis Center Phelps Memorial Hospital Center is pleased to announce the establishment of a new office dedicated to the diagnosis and treatment of osteoporosis. The Phelps Osteoporosis Center, located at 200 South Broadway, Suite 100 in Tarrytown, is headed by endocrinologist James Hellerman, MD. A multidisciplinary team of osteoporosis specialists will develop a treatment plan tailored to each patient’s unique needs. Treatment plans may include: • physical and occupational therapy • exercise programs • pain management • educational forums • a support group For more information or to make an appointment contact the Phelps Osteoporosis Center at 914-269-1888. TOGETHER WE CAN KEEP THE FLU FROM SPREADING At Phelps, our goal is to protect patients, employees and visitors during the flu season. What we do: All hospital employees have gotten the flu shot or will wear surgical masks when near patients during flu season. Please don’t come to the hospital if you have flu-like symptoms, including: • Fever or chills Hospital employees also use standard precautions: • Cough • Hand washing or hand sanitizers • Sore throat • Goggles • Runny nose • Gowns • Body aches • Antiseptic wipes for equipment use • Headaches Employees who have the flu must stay home while sick and may not return to work until 24 hours after flu symptoms end. • Fatigue What you can do to prevent getting the flu: Get a flu shot. It is the best defense against the flu! Also, wash your hands often and avoid people who are sick. If you become ill, stay home so you don’t spread germs to others. • Vomiting/diarrhea Instead, call your doctor, who may want to see you if you are at risk for complications. Taking an anti-viral medication within the first 48 hours of the onset of symptoms can lessen the severity of the flu. PHELPS TODAY 17 On the Move: Promoting Physical Fitness in the Community T he Phelps Vitality initiative was established in an effort to promote healthier lifestyles in the community. One of the ways Phelps does this is by sponsoring local physical fitness events and encouraging participation in these and other fitness events by hospital employees and medical staff. No matter what the season, a dedicated team of race enthusiasts from Phelps can be found actively engaging in walks, runs, marathons and triathlons, along with their families and friends, while supporting worthwhile causes. The Sleepy Hollow Half Marathon, sponsored by Phelps, started the spring season off with an ambitious 13.1-mile run through scenic Sleepy Hollow. Sixteen Phelps participants included staff members and their friends and family. Seven hospital departments were represented: Behavioral Health, Blood Donor Services, the Family Medicine Residency Program, Heritage Medical Group, Patient Accounts, Nursing and Vitality, along with staff from the Pediatric Diabetes & Endocrine Center, a division of Children’s and Women’s Physicians of Westchester, located on Phelps’ campus. As the weather got warmer, Phelps staff prepared for the Sleepy Hollow Sprint Triathlon, which benefits the Leukemia and Lymphoma Society and was also sponsored by Phelps. The June weather makes the 13.5-mile race (half-mile swim, 10-mile bicycle ride and 3-mile run) a natural for the outdoor athlete. The Family Medicine Residency Program formed a team with Dr. Shantie Harkisoon, Dr. Rebecca Collins and Kimberly Andron, LCSW-R, each taking NYC Marathon American Cancer Society’s Making Strides Walk American Heart Association Heart Walk 18 PHELPS TODAY NYC Marathon Planning for Your Future Phelps will be hosting a three-part series on planning for the future for individuals who are already retired as well as those who are just beginning to plan for retirement. 7:30 pm in the Phelps Auditorium on the following dates: The presentations will be held the first Tuesday of the month from 6:00- May 6: Nuts and Bolts: Making Your Money Last Through Retirement a leg of the race. Geriatrician Dr. Cathryn Devons of Senior Health was really ambitious and participated in all three legs of the race on her own. In the fall, there were three events sponsored by Phelps: the American Heart Association’s Heart Walk, the American Cancer Society’s Making Strides Against Breast Cancer Walk and the Rivertown Runners’ Sleepy Hollow 10K Halloween race. April 4: Estate Planning/Elder Law 101: Nuts and Bolts of Estate Planning to Preserve Your Assets Twenty-two people representing Team Phelps participated in the American Heart Association’s Heart Walk by either walking three miles around the Kensico Dam or raising funds for the cause. Through a variety of efforts, the team was able to raise $2,158. A field of more than 1,000 runners followed Phelps Pharmacy Director Fred Perino as his motorcycle led the Sleepy Hollow 10K Halloween race through June 3: How Do I Pay for Long Term Care: Planning With or Without Long Term Care Insurance Registration is required. Please call Ellen Woods at 914-366-3937 to reserve a space at any or all of the programs. Sleepy Hollow. The event became a real family affair with Phelps staff and their families participating together, including children who ran in their own race. Behavioral Health, Health Information Management, Human Resources, Patient Accounts and Radiology all had representatives in the race. The grand finale of events was the New York City Marathon on November 3, 2013. An impressive four people from Phelps participated in the 26.2-mile event: Rosanna Almanzar, Dr. Rebecca Collins, Dr. Cathryn Devons, and Dr. Satish Kapoor. Congratulations to everyone who put in the time and dedication to train and participate in the event. Sleepy Hollow Half Marathon Sleepy Hollow 10K Halloween Race Sleepy Hollow Sprint Triathlon PHELPS TODAY 19 Look Good Feel Better Now Gift Buying for Phelps Patients Is Easier than Ever! Look Good Feel Better® is a free, two-hour workshop held monthly at Phelps that teaches beauty techniques to women undergoing cancer treatment to help them manage the appearance-related aspects of treatment. The program includes a hair consultation with a professional stylist and a makeup consultation with a cosmetologist. Buying a gift for a Phelps patient is now easier than ever! Just call the Phelps Gift Shop at 914-366-3183 to place an order by phone. All phone orders include complimentary gift wrapping and are delivered to the patient along with a small gift card bearing your message. ® Order from Phelps Gift Shop by Phone Attendees can take home a complimentary wig and a makeup kit donated by a cosmetics company. The program is offered in partnership with the American Cancer Society, the National Cosmetology Association, and the Cosmetic, Toiletry and Fragrance Association Foundation. Registration is required. Please call 914-366-3315 or 914-366-3345 to register for an upcoming session. A Note of Thanks from a Look Good Feel Better Participant I’m just getting around to thanking you for the great event you held at Phelps this past Monday evening. I didn’t expect to walk away with so many goodies and a wig! I am so glad that I heard about Look Good Feel Better and that you had space for me to join in. I got rave reviews on my new look thanks to you all. I never would have gone blonde and short, but it works! My husband loves it, and my 12-year-old daughter said wow! Many other compliments include looking young and sexy... so thank you very much! -MaryBeth Schulze 20 PHELPS TODAY The Phelps Gift Shop, located off the main lobby, is a wonderful place to browse for that special gift. Among its treasures are attractive and well-priced gifts for all occasions, including fashion jewelry, ladies’ scarves, baby clothing, handbags and wallets, umbrellas, decorative figurines and pillows, picture frames, stuffed animals and more. Greeting cards, snacks, and a variety of personal items are also available for purchase. The Gift Shop, which is open seven days a week and staffed by volunteers, is a fundraising project of the Phelps Auxiliary. Visa and MasterCard are accepted, and all gift purchases include free gift wrapping. For information, call 914-366-3183. Hours of operation: Monday and Friday: 9 am to 4:45 pm Tuesday, Wednesday and Thursday: 9 am to 8:45 pm Saturday and Sunday, 12 pm to 3:45 pm VENDOR SALES IN MAIN LOBBY The Phelps Auxiliary sponsors dozens of vendor sales throughout the year, held in the main lobby of the hospital. Collections of beautiful jewelry, cosmetics, leather goods, and more are brought into the hospital, where they are sold, often at discounted prices. Sale proceeds benefit Phelps Memorial Hospital. For information, call 914-3663183. For a current list of vendor sales, visit phelpshospital.org/ patient-visitor-info/gift-shop/. Juntos podemos hacer que la gripe no se propague En Phelps, nuestro objetivo es proteger a nuestros pacientes, empleados y visitantes durante la temporada de la gripe. Qué hacemos: Todos los empleados del hospital han recibido una vacuna contra la gripe o usarán máscaras quirúrgicas cuando estén cerca de pacientes durante la temporada de la gripe. Los empleados del hospital también usan precauciones estándares: • Lavado de manos o uso de desinfectantes de manos • Gafas • Batas • Toallitas antisépticas para usar en equipos Los empleados que tienen la gripe deben permanecer en el hogar y no pueden volver al trabajo hasta 24 horas después que finalizaron los síntomas. Qué puede hacer para prevenir contagiarse la gripe: Reciba una vacuna contra la gripe. ¡Es la mejor defensa contra la gripe! Además, lávese las manos con frecuencia y evite personas que estén enfermas. Si se enferma, quédese en su casa para no propagar los gérmenes a otros. Por favor, no venga al hospital si tiene síntomas parecidos a los de la gripe, incluyendo: • Fiebre o escalofríos • Tos • Dolor de garganta • Goteo nasal • Dolores corporales • Dolores de cabeza • Fatiga • Vómitos/diarrea En su lugar, llame al médico, quien puede desear verlo si corre riesgo de complicaciones. Tomar un medicamento antiviral dentro de las primeras 48 horas de la aparición de síntomas puede disminuir la severidad de la gripe. Request Your Appointment Online! ¡Solicite su cita en línea! Appointments for many of Phelps’ outpatient services can be requested on the hospital’s website, including: cardiovascular, diabetes, hyperbaric, 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! Citas para muchos de los servicios de pacientes ambulatorios de Phelps pueden solicitarse en el sitio web del hospital, incluyendo: cardiovascular, diabetes, hiperbárico, infusión, terapia ocupacional y física, Centro del Dolor, radiología/radiografías, servicios para adultos mayores, sueño, habla y audición, voz y deglución y curación de heridas. Visite www.phelpshospital.org y haga clic en “Request an Appointment” (Solicite una cita) – ¡en cualquier momento del día o de la noche! PHELPS TODAY 21 ¿Cuándo es el momento de realizar una cirugía de reemplazo de cadera? P uede empezar como dolor y rigidez en la entrepierna, los glúteos o muslos en cuanto se levanta por la mañana. El dolor empeora cuando se mueve y mejora cuando descansa. Pero después de un tiempo, puede descubrir que ni siquiera el reposo alivia el dolor. Es probable que padezca de artritis de la cadera. Según los Centros de Control de Enfermedades, una de cada cuatro personas desarrollará artritis de la cadera en su vida. Aquellos con historial familiar de artritis de la cadera tienen mayores probabilidades de desarrollarla y el riesgo aumenta con la edad, la obesidad o una lesión que aplique tensión sobre el cartílago de la cadera. La artritis es una afección que ocurre cuando se desgasta la superficie (cartílago) de una articulación. Su cartílago está cubierto de un tejido duro y liso de 1/4 de pulgada de grosor que permite a los huesos deslizarse unos sobre otros sin provocar una fricción dolorosa. Cuando el cartílago se adelgaza o desgasta por completo, los extremos de los huesos rozan entre sí, lo que provoca dolor y rigidez. Las terapias de primera línea generalmente recomendadas para el dolor causado por artritis de la cadera son fármacos antiinflamatorios, ejercicio y fisioterapia. Por un tiempo, una o más de estas terapias podría proporcionar alivio para que usted pueda dormir, subir escaleras y desempeñar las actividades de la vida diaria. Sin embargo, cuando el dolor de la cadera se vuelve tan intenso que estas terapias ya no funcionan, e incluso salir a caminar provoca 22 PHELPS TODAY demasiado dolor, puede ser el momento de considerar un reemplazo de cadera. Tipos de reemplazo de cadera El tipo más común de reemplazo de cadera es el abordaje posterior. Durante esta cirugía, el cirujano realiza una incisión de 6 a 8 pulgadas en la parte lateral o posterior de la cadera, cortando los músculos y separando los tendones y ligamentos de la parte posterior de la cadera. Después el cirujano retira el hueso y el cartílago enfermos de la articulación de la cadera y reemplaza la bola y el receptáculo con una cadera artificial. La cirugía de reemplazo de cadera con abordaje anterior y de invasión mínima requiere tan solo una pequeña incisión de 3 a 4 pulgadas. La entrada quirúrgica a la articulación de la cadera se realiza a través del área entre el abdomen inferior y la parte superior del muslo. El cirujano puede llegar a la cadera sin cortar músculos ni separar tendones, trabajando con el espacio natural que existe entre los músculos. Además, se dejan intactos los músculos más importantes para la función de la cadera, los glúteos, que se insertan en la pelvis y el fémur, por lo que no requieren un proceso de cicatrización. En comparación con el reemplazo de cadera total tradicional, el abordaje anterior ha demostrado causar bastante menos dolor, con una recuperación más rápida y menor riesgo de luxación de cadera posoperatoria, donde la cadera se sale de la articulación, una de las complicaciones más comunes después de la cirugía. Debido a que no se corta ningún músculo para acceder a la articulación de la cadera, el abordaje anterior, también llamado cirugía “preservadora de músculo”, está asociado con un retorno más rápido a las actividades normales. Los pacientes no requieren dormir en una posición especial, usar instrumentos especiales para ponerse los zapatos y calcetines, ni tener un asiento elevado para el inodoro. Pueden regresar a conducir tan pronto como se sientan cómodos para hacerlo. El reemplazo de cadera con abordaje anterior se realiza en una mesa quirúrgica especial llamada Mesa para artroplastia de cadera y rodilla hana™, la única mesa diseñada exclusivamente para el reemplazo de cadera y rodilla. La mesa permite al cirujano girar la cadera de maneras que no son posibles con una mesa quirúrgica convencional. Además, Pelvis Cabeza del fémur Cavidad de la pelvis Fémur Cadera normal debido a que la mesa permite el uso continuo de imágenes como guía durante la cirugía, es posible ajustar el implante si no está perfectamente alineado, antes de que el paciente salga del quirófano. El cirujano ortopédico Dr. Corey F. Burak, introdujo en Phelps la técnica para reemplazo de cadera con abordaje anterior de invasión mínima en 2006. Él fue el primer cirujano en el Condado Westchester, Nueva York, en realizar esta cirugía y tiene más experiencia en el abordaje anterior que cualquier otro cirujano ortopédico en la zona noreste, habiendo realizado más de 2,000 cirugías de este tipo hasta la fecha. Opción para una variedad más amplia de pacientes “La mayoría de mis pacientes tienen entre 40 y 60 años de edad”, dice el Dr. Burak. “Son personas con artritis o afecciones congénitas, o atletas que han sufrido lesiones relacionadas con el deporte. Tienen diferentes expectativas de la cirugía que una persona mayor, están ansiosos por regresar a sus estilos de vida activos, lo que a menudo incluye deportes y jugar con sus hijos”. Además de estos beneficios para un paciente más joven y activo, esta cirugía es una opción para una variedad mucho más amplia de pacientes que las cirugías tradicionales u otras cirugías para el reemplazo de cadera de invasión mínima. “He operado a pacientes de 25 a 98 años de edad y de 100 a 400 libras”, dice el Dr. Burak. “Lo maravilloso de esta operación es que no es necesario ser selectivo, porque casi todos los pacientes son candidatos para ella”. Aquellos con historial familiar de artritis de la cadera tienen mayores probabilidades de desarrollarla y el riesgo aumenta con la edad, la obesidad o una lesión que aplique tensión sobre el cartílago de la cadera. Pelvis Cartílago dañado Fémur Cadera artrítica PHELPS TODAY 23 Hace aproximadamente cinco años, Cheryl Slaughter, atleta y entrenadora personal de 45 años de edad con residencia en Croton, empezó a tener dolor en la cadera causado por artritis y por caer sobre su cadera al practicar esquí. Inicialmente probó la fisioterapia para aliviar el dolor, lo cual ayudó por un tiempo, pero eventualmente el dolor por la fricción de hueso contra hueso se volvió más de lo que podía tolerar. Su dolor restringía gravemente su vida. Cheryl realizó una investigación a fondo antes de decidir qué tipo de reemplazo de cadera hacerse y quién realizaría la cirugía. Debido a su ocupación, ella está en contacto con muchos fisioterapeutas, de modo que les pidió recomendaciones. El nombre del Dr. Corey Burak se mencionaba una y otra vez. 24 PHELPS TODAY Cheryl tuvo una cirugía para reemplazo de cadera con abordaje anterior realizada por el Dr. Burak en Phelps en diciembre de 2012 y salió del hospital tres días después. Una semana después de la cirugía, ella ya estaba caminando una milla y media, y regresó a trabajar a tiempo completo solo un mes después. “Si tuviera un trabajo de escritorio hubiera regresado al trabajo semanas antes,” dice. Además del método utilizado para reemplazar su cadera, ella atribuye su rápida recuperación a los ejercicios de fortalecimiento que realizó antes de la cirugía y al hecho de que se sometió a una dieta antiinflamatoria. Certificada como especialista en ejercicio correctivo (un entrenador personal para personas con lesiones), ella dice que “sabe cómo hacer la rehabilitación”. La madre casada de dos adolescentes habla sobre lo maravilloso que es ir a la ciudad con ellos y poder subir y bajar las escaleras del metro. Además regresó a practicar boxeo dos veces a la semana, uno de sus deportes favoritos, y hace ejercicio con pesas en el gimnasio. “Mi reemplazo de cadera es lo mejor que he hecho”, dice. “Mi cadera me restringía mucho. Ahora tengo una nueva articulación con mucho rango de movimiento y una vida renovada. Puedo pararme sin encorvarme y moverme sin restricciones. Es grandioso poder caminar sin dolor”. Marian Weinberg había tenido dolor en la cadera durante años. Esta residente de Sleepy Hollow de 94 años ha llevado una vida muy activa y continuó jugando tenis hasta la edad de 92 años a pesar del dolor. Finalmente reconoció que tenía que hacer algo al respecto. Mary Wu de Ossining es una de las pacientes más impresionantes del Dr. Corey Burak. A Mary, una receptora de trasplante de riñón en dos ocasiones con varias afecciones médicas crónicas que incluyen trastorno renal congénito, se le diagnosticó escoliosis leve y artritis de cadera a los 10 años de edad. Ella ha sufrido dolores y ha padecido de movilidad limitada durante la mayor parte de sus 30 años de vida. En abril del año pasado, cuando el dolor de su cadera se volvió insoportable, Mary se sometió a una cirugía de reemplazo de cadera con abordaje anterior. Por más de cinco años, no había podido caminar más de 15 minutos seguidos, pero después de la cirugía y varios meses de rehabilitación física intensa en Phelps, está aprendiendo a “moverse y bailar de nuevo”. De hecho, Mary fue elegida para recibir el premio para adultos en la primera Carrera/Caminata anual por la Artritis Jingle Bell del Condado de Westchester de 2013, un evento nacional llevado a cabo por la Fundación de Artritis en 200 ciudades de todo Estados Unidos. Una dedicada embajadora de la Fundación de Artritis, Mary ha comparecido ante el Congreso y legisladores locales abogando por cuestiones relacionadas con la artritis. “Mi nueva situación normal con mi nueva cadera ha sido estimulante. La vida nunca han sido tan hermosa y extraordinaria”, dice. “Cuando les dije a mis hijos que estaba considerando una cirugía de reemplazo de cadera, ellos me dijeron que no debería hacerlo, que soy demasiado vieja, que mis huesos se quebrarían y que pasaría el resto de mi vida en una silla de ruedas. Pero no les hice caso, y me alegra no haberlo hecho”. El Dr. Burak realizó una cirugía de reemplazo de cadera con abordaje anterior a la Sra. Weinberg en septiembre de 2011; ella salió del hospital tres días después para quedarse en un centro de enfermería especializado y recibir dos semanas de fisioterapia. En cuatro semanas, estaba caminando sin bastón y sin dolor. “Reemplazar mi cadera fue lo mejor que he hecho”, dice la Sra. Weinberg, quien fue maestra de matemáticas en la Preparatoria Briarcliff y es una de las fundadoras de Corporate Angel Network, una organización de beneficencia que organiza viajes gratuitos en avión para pacientes con cáncer hacia y desde sus lugares de tratamiento usando asientos vacíos en jets corporativos. Ella no ha tenido ningún problema con su cadera en los últimos dos años y actualmente nada media milla dos veces a la semana. “Algunas personas creen que una vez que se llega a cierta edad, ya no vale la pena someterse a una cirugía mayor”, dice el Dr. Burak. “Pero si cuenta con una buena salud general y está motivado a recuperarse, puede realizarse de manera segura y con éxito”. Corey Burak, MD, es médico certificado en cirugía ortopédica por el Consejo Americano de Cirugía Ortopédica. Obtuvo su título de medicina de SUNY-HSC en la Escuela de Medicina de Syracuse en Nueva York. Terminó un internado en cirugía general en el Hospital y Centro Médico Saint Vincent, Nueva York, NY, y una residencia en cirugía ortopédica en el Hospital y Centro Médico Universitario de Tulane en New Orleans, LA, donde terminó una investigación postdoctoral en reconstrucción en pacientes adultos con el renombrado Dr. Robert L. Barrack. El Dr. Burak también realizó una subespecialidad en artroplastia de cadera y rodilla en Dorr Arthritis Institute, Los Angeles, CA, además recibió el Premio Rockwood and Green en 2002. PHELPS TODAY 25 Cómo vivir una vida plena con artritis reumatoide o psoriásica C Casi 1.3 millones de estadounidenses afectados con artritis reumatoide, la cual es una de las dos enfermedades articulares más comunes. uando Sharon Mitchell fue a la universidad en 1978, lo último que esperaba era descubrir que tenía Artritis Reumatoide. Los tratamientos ayudaron poco y pronto para Sharon era muy dificultoso caminar a través del campus. Ese fue el comienzo de muchos años de probar nuevas terapias y sufrir el aumento de dolor y discapacidad. Sharon es uno de casi 1.3 millones de estadounidenses afectados con artritis reumatoide, la cual es una de las dos enfermedades articulares más comunes. La otra es la artritis psoriásica. En la edad adulta, la mayoría de las personas ha sufrido la ocasional inflamación o dolor de articulación como resultado de una lesión o infección. Fácil de resolver por medio de descanso, medicamentos antiinflamatorios y, en algunos casos, antibióticos, el dolor es rápidamente olvidado. Sin embargo, para muchas personas, el dolor articular es crónico y requiere una atención médica agresiva y a largo plazo. En ambas artritis reumatoide y psoriásica, la inflamación es causada por un funcionamiento anormal del sistema inmunitario: la respuesta defensiva del cuerpo contra sustancias extrañas que atacan erróneamente células y tejidos internos. Artritis reumatoide La artritis reumatoide ocurre por lo general entre los 30 y 50 años de edad, aunque personas de cualquier edad pueden desarrollar la enfermedad. Dos de cada tres casos son mujeres. El diagnóstico de artritis reumatoide se basa en la presencia de más de tres de los siguientes criterios: • Rigidez articular en la mañana que dura más de una hora antes de mejorar 26 PHELPS TODAY • Tres o más áreas articulares que tienen inflamación articular a la vez • Inflamación simultánea de las mis- mas áreas articulares en ambos ladôs del cuerpo • Por lo menos una articulación infla- mada en la muñeca o nudillos o ên el área entre el medio y la base del dedo • Nódulos duros bajo la superficie sobre prominencias óseas, en la parte posterior de los codos o parte frontal de la rodilla o cerca de articulaciones • Niveles más altos que los normales de varios anticuerpos en la sangre, algunos de los cuales son específicos solo a la artritis reumatoide • Una radiografía o tomografía que muestre características como inflamación de los tejidos blandos o estrechamiento o erosión del espacio entre las articulaciones Una persona que tiene artritis reumatoide típicamente experimenta fatiga, disminución del rango de movimiento y fiebre. Mientras que las causas exactas de la artritis reumatoide son desconocidas, los investigadores médicos especulan que la enfermedad puede desencadenarse por una combinación de factores como una respuesta autoinmune anormal, susceptibilidad genética, infección viral, cambios hormonales y larga exposición al tabaco o humo de cigarrillo. Artritis psoriásica La artritis psoriásica afecta a hombres y mujeres por igual, y la mayoría de los casos se desarrollan entre los 30 y 50 años. Se desconocen los factores que podrían predisponer a una persona a la enfermedad, aunque hasta el 30 % de personas que tienen psoriasis desarro- llarán esta condición. Las personas con el marcador genético HLA-B27 podrían también correr mayor riesgo. Hay cinco tipos de artritis psoriásica, incluyendo: Asimétrica – una etapa de artritis psoriásica caracterizada por la inflamación de algunas articulaciones de las extremidades. Alrededor del 30 a 50 por ciento de los pacientes de artritis psoriásica tienen este tipo de la enfermedad. Simétrica – una etapa común más tardía de la artritis psoriásica en la cual el dolor articular e inflamación ocurren en ambos lados del cuerpo. Interfalángica distal predominante (DIP) – una aflicción en la articulación más cercana a la punta de los dedos o dedos de los pies, la cual produce marcas, separación y otros cambios degenerativos en uñas de manos y pies. Alrededor del 25 por ciento de los pacientes de artritis psoriásica desarrolla DIP. Artritis mutilante – una forma severa de artritis psoriásica que causa inflamación dolorosa en los ligamentos y tendones que se conectan al hueso. Esta condición es rara. Espondilitis psoriásica – produce inflamación en el revestimiento alrededor de la pelvis e inflamación de las vértebras. Ocurre en alrededor del 30 a 35 por ciento de todos los casos. Otros hallazgos que indican artritis psoriásica incluyen una prueba sanguínea negativa para el factor reumatoide, estudios de imágenes que muestran cambios articulares, dactilitis (inflamación en los dedos que produce una apariencia parecida a una salchicha) y quejas de fatiga y agotamiento. Tratamiento para la artritis reumatoide o psoriásica Según el reumatólogo Richard Parrino, MD, Director Médico del Centro de Infusión de Phelps, “La práctica actual apoya el tratamiento agresivo en las etapas tempranas de la artritis reumatoide y la sporiásica para prevenir la discapacidad a largo plazo. No hay una droga específica que pueda curar cualquier forma de artritis, pero hay medicamentos que pueden disminuir la progresión de la enfermedad, lo cual lleva a una reducción de la inflamación, previene daño a los huesos y los liga- La enfermera Nancy Carangelo del Centro de Infusión de Phelps asiste a la paciente Sharon Mitchell durante un tratamiento de infusión para la artritis reumatoide. mentos de las articulaciones y preserva el movimiento”. El tratamiento es similar para ambas condiciones, confiando en agentes antiinflamatorios, antirreumáticos modificadores de la enfermedad (DMARDS) y los modificadores de respuesta biológica (DMARDS biológicos). Los DMARD como el metotrexato, leflunomida, y sulfasalazina, trabajan al suprimir el sistema inmunitario sobrerreactivo del cuerpo. La desventaja de estos medicamentos es que pueden producir malestar gastrointestinal y pueden no aliviar inmediatamente el dolor articular. Mientras se espera que los DMARD hagan efecto, pueden recetarse analgésicos como la aspirina, el ibuprofeno, naproxeno y algunas veces la prednisona. Los factores que influencian la selección de un DMARD incluyen la etapa y severidad de la condición de la articulación, el balance entre los posibles efectos colaterales y beneficios esperados y la preferencia del paciente. Los DMARD biológicos, desarrollados en la década de 1990, son drogas fabricadas de células vivas. Remicade, HUMIRA y Rituxan son nombres comunes de algunos de los medicamentos biológicos disponibles. Los medicamentos biológicos, los cuales son generalmente administra- dos intravenosamente o por inyección cada seis a ocho semanas, trabajan sobre los componentes del sistema inmunitario que causan la inflamación de la articulación. Los efectos colaterales posibles de los medicamentos biológicos son un aumento en el riesgo de infecciones y la posibilidad de que causen que una condición latente como la tuberculosis vuelva a aparecer. Vectra, una nueva herramienta de diagnóstico para la artritis reumatoide Los pacientes del Centro de Infusión de Phelps están entre los primeros en el Estado de Nueva York en beneficiarse con una nueva herramienta de diagnóstico para la artritis reumatoide llamada Vectra. Esta prueba de sangre avanzada mide los niveles de las 12 proteínas en la sangre que están asociadas con la artritis reumatoide, la cual provee a los clínicos una comprensión de la actividad actual de la enfermedad. Esta información ayuda a los clínicos a determinar el éxito del tratamiento actual del paciente y puede controlar el gasto de los medicamentos biológicos permitiendo a los médicos saber cuándo empezar y detener la administración de la droga, PHELPS TODAY 27 además de la efectividad de la dosis. Cómo seguir una vida activa con artritis psoriásica Una actitud positiva, la voluntad de adaptarse al cambio y un ambiente social de apoyo ayudan a muchas personas con artritis reumatoide y psoriásica a vivir una vida plena, a pesar del malestar de las articulaciones y la amenaza de impedimentos físicos. Para John Kavanah, mantener una vida plena con artritis psoriásica ha significado “escuchar a su cuerpo y ajustar objetivos según se necesite”. Nacido con pies zambos, John siguió exitosamente su pasión por el atletismo y su interés profesional en la educación física a pesar de sus dolencias. La cirugía correctiva en sus pies permitió a John jugar sus deportes preferidos a lo largo de su juventud. Poco después de obtener un título universitario de maestro de educación física en 1984, John empezó a notar inflamación en sus tobillos. Diagnosticado con artritis psoriásica, continuó participando en deportes de alto movimiento durante los 10 años siguientes por medio de tratamiento con cortisona y, más adelante, metotrexato. En 2007, la iniciación de tratamiento con medicamentos biológicos eliminó la mayoría del dolor en sus pies, aunque continuó teniendo una manera de caminar irregular debido a la rigidez en sus piernas. Casi 30 años desde su diagnóstico inicial, John aún trabaja como maestro de educación física pero ya no practica deportes de alto movimiento. Se han sumado nuevas responsabilidades a su vida, como entrenar a un equipo varsity de básquetbol de niñas y como filmador de un equipo de fútbol americano local. Además, él entrena en un gimnasio para obtener un bienestar general. Cualquier sea su rol, John comunica a otros sus limitaciones corporales y su gran interés en mantener su independencia física. Cómo vivir con artritis reumatoide Como estudiante universitaria en 1978, Sharon Mitchell se adaptó pidiendo a sus profesores más tiempo para llegar caminando a sus clases, o programando sus clases en un edificio. Las terapias iniciales, que incluyeron prednisona, inyecc- 28 PHELPS TODAY iones de oro e Indocin, aliviaron un poco su dolor, pero no le dieron la habilidad de prevenir que la enfermedad atacara sus articulaciones. Después que Sharon se casara y tuviera hijos, la familia trabajó en equipo para mantener el hogar y responder a sus necesidades personales. Al deteriorase la salud de Sharon, esto significó algunas veces restablecer sus prioridades. Ella aprendió, por ejemplo, a no esperar que su familia tomara responsabilidad inmediata por las tareas del hogar que ella ya no podía realizar. Aceptó más abiertamente la ayuda ofrecida por vecinos para llevar a sus hijos a la escuela o a actividades extracurriculares. Ella y su esposo modificaron también sus entornos para mantener su independencia. Palancas reemplazaron llaves en grifos y picaportes en puertas, y la familia evitó colocar artículos del hogar en estante altos. La introducción de medicamentos biológicos en 2007 cambió la vida de Sharon dramáticamente. La mañana después de su tratamiento inicial, ella pudo levantarse de la cama sin dolor y rigidez por primera vez en 30 años. Al disminuir el dolor, su energía aumentó y Sharon pronto se sintió bien como para trabajar tiempo completo en vez de tiempo parcial como directora de finanzas. Las tareas diarias, como conducir, se hicieron menos preocupantes debido a la disminución de los niveles de dolor y aumento de la movilidad. Su nivel de energía aumentó además de su habilidad de participar en actividades físicas, las cuales ayudaron a traer alegría tanto a ella como a su familia. A pesar de que Sharon continúa sufriendo de daño articular permanente, considera su mejoramiento en la calidad de su vida ofrecido por los medicamentos biológicos “casi un milagro”. Para Sharon y John, la administración de medicamentos biológicos fue instrumental en reducir el dolor y minimizar más daño articular. Sin embargo, los medicamentos biológicos pueden que no sean apropiados para todos los pacientes con artritis reumatoide o psoriásica. El Dr. Parrino aconseja hablar con su reumatólogo antes de comenzar cualquier tratamiento para “discutir los beneficios y riesgos de cada terapia, incluyendo los posibles efectos colaterales y toxicidades, programación de la dosis, monitoreo de la frecuencia y resultados esperados”. El Centro de Infusión de Phelps El Centro de Infusión de Phelps se estableció en 2004 para proveer a pacientes con los últimos tratamientos para enfermedades inflamatorias crónicas, incluyendo artritis reumatoide y psoriásica, colitis ulcerativa, lupus y Enfermedad de Crohn. Es uno de los centros de infusión más grande para enfermedades inflamatorias en el área metropolitana de Nueva York. El centro, ubicado en el campus de Phelps en la Suite 260 del Edificio 755, ofrece habitaciones privadas cómodas donde pacientes pueden descansar, leer o trabajar en una laptop mientras reciben tratamientos. “En nuestros casi 10 años de proveer servicios de infusión ambulatorios, hemos perfeccionado la administración de este servicio de una manera que hace que los pacientes y sus familias se sientan seguros y cómodos. Es un gran tributo al personal amable y experto del centro”, dijo el Dr. Parrino. Para más información sobre el diagnóstico y tratamientos de artritis reumatoide o psoriásica o cualquier otra enfermedad inflamatoria, contacte al Centro de Infusión de Phelps al 914-366-3523 Richard Parrino, MD, Director Médico del Centro de Infusión de Phelps, tiene más de 40 años de experiencia en reumatología. Graduado de la Facultad de Medicina de la Universidad de Roma, el Dr. Parrino completó su residencia en medicina en el Hospital Queens y su fellowship en reumatología en Colegio de Medicina y Odontología de Nueva Jersey. Programs and Services at Phelps Bereavement Support(914) 366-3325 Blood Donor Services*(914) 366-3916 Cardiovascular Diagnostic Lab(914) 366-3740 Cardiac Rehabilitation(914) 366-3742 Child Care – Robin’s Nest(914) 366-3232 Diabetes & Metabolism Center**(914) 366-2270 Diabetes & Endocrine Center for Children & Young Adults* (914) 366-3400 Educational Programs and Free Screenings (914) 366-3220 Emergency Department(914) 366-3590 Emergency Department’s PromptCare(914) 366-3660 Emergency Education Center*(914) 366-3577 Gastroenterology & Advanced Endoscopy* (914) 366-1190 Hernia Center (888) 888-2311 Hospice(914) 366-3325 Hyperbaric Medicine Center(914) 366-3690 Infusion Center*(914) 366-3523 Laboratory (Outpatient)(914) 366-3917 Lung Nodule Center(914) 366-2333 Maternal Child Center(914) 366-3382 Memorial Sloan-Kettering Cancer Center** (914) 366-0664 Mental Health – Outpatient Counseling* (914) 366-3600 Mental Health – Outpatient Chemical Dependency (914) 944-5220 Mental Health – Inpatient Substance Abuse – Co-occurring Disorders (914) 366-3027 Mental Health – Inpatient Psychiatry (914) 366-3513 Nutrition Counseling(914) 366-2264 Osteoporosis Center(914) 269-1888 Pain Center(914) 366-3794 Pastoral Care(914) 366-3090 Pharmacy for the Community**(914) 366-1400 Physical Medicine & Rehab (PT, OT, Aquatherapy) - Outpatient* (914) 366-3700 Physical Medicine & Rehab - Inpatient (914) 366-3702 Physician Referral Service(914) 366-3367 Prenatal Care Assistance Program (PCAP) (914) 941-1263 Pulmonary Physiology Lab and Pulmonary Rehabilitation (914) 366-3712 Radiology/X-Ray(914) 366-3430 Respite Care(914) 366-3356 Senior Services and Memory Loss Evaluation* (914) 366-3677 Sleep Center(914) 366-3626 Speech & Hearing – The Donald R. Reed Center** (914) 366-3010 Surgery – Call Physician Referral (914) 366-3367 Thoracic Center for Chest Diseases* (914) 366-2333 Vascular Institute(914) 366-3008 Voice & Swallowing Institute**(914) 366-3636 Volunteer Services(914) 366-3170 Wound Healing Institute* (914) 366-3040 *Located in the Phelps Medical Services Building (755 North Broadway). ** Located in the Phelps Professional Building (777 North Broadway). For more information about Phelps services, visit phelpshospital.org and click on “Clinical Services.” It is now possible to request an appointment for many services on the Phelps website. Just go to phelpshospital.org and click on “Request an Appointment.” PHELPS TODAY 29 Phelps Memorial Hospital Locations in the Community A croton-on-hudson 3 B C briarcliff manor 2 sleepy hollow D tarrytown Rt. 1 Rt. 1 17 19 E 1 irvington dobbs ferry F MEDICAL PRACTICES A B Phelps in Croton Primary & Specialty Care: 914-269-1700; Radiology: 914-269-1701 Phelps in Ossining Family & Internal Medicine: 914-373-4948 & 914-941-1277 PRACTICES ON THE • Advanced Endoscopy & Gastroenterology: 914-366-1190 • Westchester Gastroenterology: 914-366-5420 • Multi-Specialty Medical Group at Phelps (Primary Care & Neurology): 914-366-5490 C Phelps Cardiology in Briarcliff 914-762-5810 D Phelps in Sleepy Hollow – Heritage Medical Group Primary Care: 914-631-2070 • OB/GYN – Sleepy Hollow Medical Group: 914-366-5400 E Phelps in Tarrytown Endocrinology: 914-631-9300 Osteoporosis Center: 914-269-1888 • Senior Health & Internal Medicine: 914-366-3677 F Phelps in Dobbs Ferry Primary Care: 914-478-1384 30 PHELPS TODAY BEHAVIORAL HEALTH SERVICES PHELPS CAMPUS: • Rheumatology at Phelps: 914-366-1005 • Thoracic Center: 914-366-2333 Threshold – Alcohol/Chemical 1 2 3 Dependency Services Tarrytown: 914-631-3133 Addiction Treatment Services (ATS) And Ossining Counseling Service Ossining: 914-944-5220; 914-944-5250 Continuing Day Treatment; Supportive Case Management Briarcliff Manor: 914-923-5700; 914-923-5740 SAVE THE DATES: An Evening of Food, Wine, Martinis & Fine Friends Showcasing wines from South America Friday, April 11, 2014 Trump National Golf Club Briarcliff Manor, New York Spirit of Jazz Concert Saturday, April 26, 2014 Irvington Town Hall Theater Irvington, New York 11th Annual Phelps Classic Monday, June 9, 2014 Sleepy Hollow Country Club Scarborough, New York 27th Annual Champagne Ball Saturday, November 8, 2014 Trump National Golf Club Briarcliff Manor, New York PHELPS TODAY 31 PHELPS Nonprofit Organization Phelps Memorial Hospital Center 701 North Broadway Sleepy Hollow, NY 10591-1096 U.S. Postage PAID Permit #63 Mechanicsburg, PA www.phelpshospital.org 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. To donate, you must be between 16 and 75 years old and weigh at least 110 pounds. Please give the gift of life. To make an appointment, call 914-366-3916. A NU Toy Store, Tarrytown Geordane’s, Irvington The Art Barn, Ossining Goldfish, Ossining Atria Senior Living, Ossining Good Food, Briarcliff Manor Bark & Meow Pet Products, Gordo’s, Hawthorne Tarrytown Green Valley Nursery, Hawthorne Basilico Pizza, Pasta, Mount Kisco Hair on the Hudson, Tarrytown Bella’s Boutique, Tarrytown Heritage Frame, Tarrytown Brasserie Swiss, Ossining Highland Cleaners, Ossining Bridge View Tavern, Sleepy Hollow Hobston Jewelry, Tarrytown Canfin Gallery, Tarrytown Hollywood North Pizza, Capri Pizza & Pasta, Ossining Sleepy Hollow Caravela, Tarrytown Horsefeathers, Tarrytown Carpet Giant, Ossining Il Sorriso, Irvington Casa Rina, Thornwood Images Art Gallery, Briarcliff Manor Chiboust, Tarrytown Isabella Bistro, Tarrytown Choice Pets, Ossining J. P. Doyle’s Restaurant, Coffee Labs Roasters, Tarrytown Sleepy Hollow Connections with Elena, Tarrytown Jacob Burns Film Center, Corsi Tire, Ossining Pleasantville Courtyard by Marriott, Tarrytown Josephine’s Hair Salon, Ossining Doca’s Portuguese, Ossining Kendal on Hudson, Sleepy Hollow Dominick’s Limousine, King Shell Service Center, Ossining Sleepy Hollow King Shell Service Center, Tarrytown Doubletree Hotel, Tarrytown Kittle House, Chappaqua Eldorado West Diner, Tarrytown L3 Couture, Briarcliff Manor Elite Hair Design, Tarrytown Landmark Diner, Ossining Elmsford Chiropractic, Elmsford Main Street Sweets, Tarrytown Fairview Golf Center, Elmsford Mandee, Ossining Family YMCA, Tarrytown Manor Wine & Spirits, Fantastic Finds Boutique, Tarrytown Briarcliff Manor Mediterraneo, Pleasantville Tarrytown Floral Designs, Tarrytown Melita’s, Ossining Tarrytown Woodworks, Tarrytown Moon River River Grill, Taste of China, Tarrytown Sleepy Hollow Tasty Port Wine, Ossining Mr. Nick’s Brick Oven Pizza, Terra Rustica, Briarcliff Manor Tarrytown TGI Friday’s, Tarrytown mysherry&more, Briarcliff Manor The Boathouse, Ossining NY School of Esthetics, Tarrytown The Cabin, White Plains Okinawa, Ossining The Huddle, Sleepy Hollow Old Stone Trattoria, Chappaqua The Red Hat, Irvington OnTrack, Tarrytown The Tapp, Tarrytown Paese Pasta & Pizza, The Tuscan Grille, Briarcliff Manor Briarcliff Manor The Village Soccer Shop, Tarrytown PHR Electrolysis, Tarrytown W@tercooler, Tarrytown Pleasantville Colonial Diner, Thornwood Ale House, Thornwood Pleasantville Threads of Life, Tarrytown Pure Mountain Olive Oil, Tarrytown Trapp Optical, Tarrytown Quirky Consignments, Tarrytown Ultra Clean Car Wash, Ossining River City Grille, Irvington UNO Chicago Grill, Yonkers River View Wine, Tarrytown Warner Library, Tarrytown Rock Island Sound, Tarrytown Westchester Broadway Theatre, Santa Fe Restaurant, Tarrytown Elmsford Sheraton Hotel, Tarrytown Westchester Marriott, Tarrytown South of the Border, Ossining Wobble Café, Ossining Sparx Hair Salon, Pleasantville SpringHill Suites by Marriott Please patronize these businesses Squire’s, Briarcliff Manor and let them know you appreciate Studio A Gallery, Tarrytown their community-minded support. Sunset Cove, TarrytownTo learn about donating blood, call Tarry Tavern, Tarrytown (914) 366-3916.