phelps
News from Phelps Memorial Hospital Center
Spring 2015
T O D AY
Daniel Blum
Appointed
President & CEO
Phelps Joins
North Shore-LIJ
Health System
State-of-the-Art
SurgiCenter Opens
The All-Important
Kidneys:
Your Body’s Filter
The Inner Ear
and Balance
Daniel Blum
President & CEO
Chickenpox
Letter from the
President and Chairman
Dear Friend,
A lot has been happening at Phelps over the past several months.
In November, after 25 years at the hospital’s helm, Keith Safian stepped down from
his position as President & CEO. This change occurred shortly before
Phelps joined the North Shore-LIJ Health System, becoming the system’s first
hospital in Westchester County. It is exciting for us to be part of this superb
organization, and we look forward to the benefits that the hospital and our community
will realize from this relationship.
In February, the much-anticipated opening of our new SurgiCenter took place.
The facility has exceeded all expectations in terms of functionality and patient
comfort and satisfaction. The combination of the state-of-the-art facility and our outstanding surgical staff makes the Phelps SurgiCenter one of the top surgery centers
in the region.
We continue to expand Phelps Medical Associates, our primary care and multispecialty medical group, with plans to establish practices at additional locations in
the coming year.
In our roles as Chair of the Board and the new President & CEO, we look forward
to working together to fulfill Phelps’ mission to serve the healthcare needs of our
community. We wish you the best of health in the warm months to come.
Sincerely,
Richard J. Sinni
Chair, Board of Directors
Daniel Blum
President & CEO
2
PHELPS TODAY
Table of Contents
Daniel Blum Appointed Phelps President & CEO
PHELPS TODAY
5
Editor
Mary Sernatinger
[email protected]
Vincent DeSantis Named a 2014 Westchester CFO of the Year
5
Phelps Becomes Part of North Shore-LIJ Health System
6
Managing Editor
Tina Dorfman
The SurgiCenter: A Milestone in Phelps’ History
8
The All-Important Kidneys: Your Body’s Filter
10
Relief from Carpal Tunnel Syndrome
13
Family Medicine Residency Program Thrives in Third Year
15
Don’t Call It a Comeback: Chickenpox Has Been Here for Years
18
Dizziness and the Inner Ear
21
Phelps Medical Associates News
23
Vitality: Why Preventing Falls Is So Important
27
Healthy Life Calendar
30
Los tan importantes rinones: El filtro de su cuerpo
33
No la llame un retorno: La varicella ha estado aquí por años
36
Report from Auxiliary President Mark Frederich
39
Medical Editor
Bruce Heckman, MD, MPH
Editorial Advisors
Daniel Blum
Lucy C. Engelhardt, RN
Robert R. Lane
Mary McDermott, RN
PHELPS TODAY is a publication of Phelps
Memorial Hospital Center, a 238-bed, not-forprofit acute care community hospital located
in Sleepy Hollow, NY. Phelps, part of the North
Shore–LIJ Health System, has been providing
medical and mental health services to Westchester
and surrounding communities since 1955.
E
EL
B R AT I N
T
N
Years
EXCELLE
60
PHELPS
G
CARE C
If you would like to be removed from
the Phelps Today mailing list, please call
(914) 366-3100 or email [email protected].
AT
T P IEN
Visit us on Facebook:
http://www.facebook.com/
PhelpsMemorialHospitalCenter
Visit us on Twitter:
https://twitter.com/
#!/phelpshospital
Request Your Appointment Online!
Appointments for many of Phelps’ outpatient services can be made 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!
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 2013 community service is
described in our “Caring for Our Community” publication, which is also
available at the same address (click on “Caring for Our Community”).
A printed copy of these publications may be requested by calling
914-366-3115.
PHELPS TODAY
3
Exciting Projects to
Begin at Phelps!
Tappan Zee Bridge
James
House
Use “New Main Entrance” to
access Admitting and Hospital
New Main Entrance
Bus Stops
Auditorium
West
Wing
Emergency Dept.
South Parking
Rockefeller State
State
Rockefeller
Park Preserve
West Parking
701
Entrance
Closed
Entrance
Closed
Use 755 North Entrance to access
physicians and services in the 755 Bldg.
755
North
Entrance
Garage
Park here for 755 Bldg.
755
Building
te 9
707 MRI
Pedestrian
Access / Elevators
Ke
nd
al
Wa
y
Road Closed
Phel
ps
La
n
Access to Admitting and the main hospital will be through the West Wing
entrance, shown on the map at right as
“New Main Entrance.”
PHELPS TODAY
Southwest
Parking
Riverview
777
Building
Park here for
Admitting and Hospital
nce
ide
4
Kendal on Hudson
Hudson River
Res
Access to the 755 Building will be through
its back entrance, directly across from
the garage.
we make these major improvements to
our hospital.
e
During construction, it will be necessary to close the road that runs in front
of the hospital and the 755 Building, but
it will still be possible to get from one
side of the campus to the other by driving
behind the hospital.
Signs will be posted, and we will do our
best to minimize any inconvenience.
Thank you for your understanding as
R ou
T
wo major construction
projects will begin at
Phelps this spring. A new
MRI facility featuring the
most advanced technology
will be built in the area of the current
main lobby. The front of the 755 Building
will be expanded to create a magnificent
new main lobby.
The new main lobby will be a grand entrance to Phelps Memorial Hospital.
g
Garage Entrance
din
Buil
To Route
Northeast Parking
Robin’s Nest
Park here for 755 Bldg.
N
Route 9
– North
Broadway
Tim Grajek illustration & design
117
Daniel Blum Appointed
Phelps President and CEO
Daniel Blum
has officially
assumed the
role of President and CEO
of Phelps
Memorial Hospital Center, following
the resignation
of Keith Safian, who led the hospital for
25 years. From 2009 until assuming his
new role, Mr. Blum served as Phelps’
Senior Vice President.
“We believe that Daniel Blum’s
exceptional knowledge and experience will ensure Phelps’ continuing
success as we transition to become a
member of the North Shore-LIJ Health
System,” said Richard J. Sinni, Chair of
the Phelps Board.
While he was Senior Vice President,
Mr. Blum developed Phelps Medical
Associates, the hospital’s multi-specialty medical group, and was responsible for implementing the hospital’s
strategic plans and overseeing its clinical and ancillary services. He serves as
collaborating administrative executive
on Phelps’ Graduate Medical Education
Committee and Chairman of the Board
of Robin’s Nest, the hospital’s child
care center.
Prior to joining Phelps, Mr. Blum was
Senior Vice President of White Plains
Hospital Center, Vice President of
Operations of the Stellaris Health
Vincent DeSantis Named a
2014 Westchester CFO of the Year
Phelps VP of
Finance and
Chief Financial
Officer Vincent
DeSantis was
honored as 2014
Westchester CFO
of the Year in the
“large company”
category. He
accepted his award at a ceremony hosted
by Westfair Communications last fall at the
Wainright House in Rye.
When Mr. DeSantis came to Phelps in
2001, he brought more than 25 years of
experience in accounting and auditing.
Prior to joining Phelps, he was associate
executive director/CFO of Long Island
Jewish Medical Center in New York
City, part of the North Shore-LIJ Health
System. Earlier in his career, he spent
18 years at the accounting firm Deloitte
& Touche, LLP, where he was senior
manager of the healthcare division.
Mr. DeSantis earned his BBA and MBA
at Iona College in New Rochelle, NY,
and is a New York State CPA. He was an
adjunct professor of healthcare finance
in the graduate division at Iona College
and in the bachelor of science general
accounting program at Mercy College
School of Business.
Network, and Operations Manager at
St. Vincent’s Hospital and Medical
Center in New York City. He began his
healthcare career as a paramedic and
paramedic instructor in New York City
and worked at several New York City
hospitals in clinical and administrative
capacities.
Mr. Blum holds a bachelor’s degree
in philosophy and a master’s degree
in healthcare administration, both
from New York University. He is a
member of the American College of
Healthcare Executives and Medical
Group Management Association.
Mr. Blum is also Chairman of the
NYS Department of Health Emergency
Medical Advisory Council.
A Healthcare Association of New
York State (HANYS) report pertaining
to profitability, liquidity and capital
structure has ranked Phelps consistently
among the top 10 percent of all acute care
hospitals in New York State throughout
Mr. DeSantis’s tenure as the hospital’s
CFO.
“Being a CFO is a hard job,” he noted
in his acceptance speech, “but it’s also
an exciting job that allows me to be
creative, generate growth and go beyond
the numbers.” He accepted the award
on behalf of the leadership team and
all of his colleagues in the financial
departments at Phelps. “I work with the
most amazing people in all areas of the
hospital, and I thank them for their trust
and confidence.”
PHELPS TODAY
5
Phelps Becomes Part of the
North Shore-LIJ Health System
Phelps was honored by the
presence of North Shore-LIJ
top executives at the
SurgiCenter Ribbon Cutting.
Pictured left to right:
Daniel Blum, Phelps President
& CEO; Avraham Merav, MD,
Medical Director, Surgical
Services; Mark J. Solazzo,
Executive Vice President and
Chief Operating Officer,
North Shore-LIJ Health System;
Michael J. Dowling, President
and CEO, North Shore-LIJ Health
System; and Richard Sinni,
Chair, Phelps Board of Directors.
6
PHELPS TODAY
A
cross the country,
healthcare organizations are changing,
as hospitals and
physician groups
partner with large health systems. In
Westchester, nearly all of the community
hospitals have made such alliances.
Phelps, which has achieved financial
stability for more than 25 years, recognizes that an ever-changing healthcare
environment creates financial challenges
for all hospitals. Being a member of a
large, stable health system helps hospitals increase efficiency, lower operating
costs and improve quality, enabling them
to continue to serve the people who rely
on them for their healthcare needs.
Formerly Stellaris
Phelps was previously a member of the
Stellaris Health Network, which included three other Westchester community
hospitals. Recognizing the need to connect with larger systems, each of the
Stellaris hospitals decided to explore
opportunities for partnerships with other
health networks in 2013. There were a
number of possible choices for Phelps,
and each was carefully examined. In the
end, one system stood out as the one that
would benefit our hospital and our community the most.
North Shore-LIJ Health System
The North Shore-LIJ Health System
shares the same commitment to
community and quality as Phelps. The
system’s goal, as stated by President and
CEO Michael Dowling, is to “be better
tomorrow than we are today,” a sentiment
that Phelps supports with regard to the
hospital and everyone who comes to us
for care.
North Shore-LIJ considered Phelps a
good partner because our hospital has
long been financially stable and is highly regarded in Westchester. Importantly,
the system will enable Phelps to continue
to serve as our community’s hospital, as
stated by Mr. Dowling: “We are committed to strengthening and expanding the
clinical services that Phelps provides,
ensuring that the hospital will continue
to fulfill its mission as a full-service
community hospital.”
New York State’s largest private employer, the system has 19 hospitals and
about 54,000 employees throughout
Long Island, New York City and, now,
Westchester. North Shore-LIJ will support
Phelps in developing services, enhancing facilities, acquiring the latest technology and expanding our medical staff.
Phelps will have access to high-level
expertise and knowledge and education
and research opportunities.
Phelps’ success has been based on
continued growth, and our partnership
with North Shore-LIJ will accelerate our
rate of growth while ensuring the delivery
of high-quality, patient-centered care.
Being Part of the
North Shore-LIJ Family
Phelps’ relationship with North ShoreLIJ has just begun, but the hospital
has already been embraced as part of
the system’s “family.” When a major
blizzard threatened in January, for example, various North Shore-LIJ departments reached out to their counterparts
at Phelps, offering assistance with preparation and communication. They were
even prepared to bring us an additional generator if the need arose. It is reassuring to know that the system’s experts
are available to support us whenever we
need them.
The Future
Being part of the North Shore-LIJ Health
System will enable Phelps to participate
in new healthcare models such as population health management and accountable care organizations (ACOs), initiatives that a community hospital could not
undertake on its own.
Phelps’ success
has been based on
continued growth,
and our partnership
with North Shore-LIJ
will accelerate our
rate of growth while
ensuring the delivery
of high-quality,
patient-centered care.
The goal of these programs is to
identify the most common health problems among the people we serve, and
provide education and care to prevent
and manage chronic diseases. Through
these programs, we will deepen our
connection to the community and fulfill
our commitment to improving the wellness of all who look to Phelps for their
healthcare needs.
PHELPS TODAY
7
The SurgiCenter –
A Milestone in Phelps’ History
At the SurgiCenter ribbon cutting, left to right: Mary McDermott, Sr. VP, Patient Care Services & CNO;
Richard Sinni, Chair, Board of Directors; Daniel Blum, President & CEO; Kathleen Scherf, Nursing Director,
Surgical Services; Avraham Merav, MD, Medical Director, Surgical Services; Richard Peress, MD, Director,
Department of Surgery; Lawrence Faltz, MD, Chief Medical Officer; and Kerry Pisano, VP, Support Services.
T
he opening of Phelps’
new operating suite – the
“SurgiCenter” – marks a
milestone in the hospital’s history. Designed
by a team of Phelps surgeons, nurses and other clinical staff, the facility’s
spacious operating rooms, state-of-theart technology and unique configuration
provide an optimal environment for both
ambulatory and inpatient surgery. The
20,000-square-foot facility is located on
the third floor of the 755 North Broadway building. A connecting bridge links
the SurgiCenter to the main hospital,
allowing for easy circulation of supplies,
equipment and staff. “It is a safer surgi-
8
PHELPS TODAY
cal environment than freestanding surgery centers, because the bridge ensures
quick access to the full capabilities of
the hospital and teams of medical subspecialists, such as cardiologists, pulmonologists and internists,” notes Richard Peress, MD, Director of Surgery.
“While patients who are seriously ill or
need complex surgery cannot be treated
at a freestanding surgery center, they can
be safely cared for in the SurgiCenter.”
The Latest Technology
and Systems
Considerable resources were allocated
toward acquiring the latest technologyto make the SurgiCenter among Westchester’s most advanced operating
facilities. The five large operating
rooms were designed to house the
most modern and technologically
advanced equipment and facilitate
delivery of the highest quality surgical
care. Suspension of equipment from
ceiling booms enables exact positioning of technology and operating lights
and keeps floor space clear.
Video monitors positioned around the
operating table project images from
laparoscopic cameras as well as CAT
scan, MRI, fluoroscopic and X-ray
images, which are transmitted from a
central computer. Anesthesiologists use
an advanced computerized medication
dispensing system.
Phelps is one of only a few hospitals
in New York State to install the
STERIS RealView Visual Workflow
Management System, which provides real-time, instant updates on
patient locations and perioperative status (admission, anesthesia, surgery and
recovery). The system has two types of
digital display screens – one for families
to keep them informed about the patient’s
status; the other for the surgical team that
displays schedules, patient location and
alerts regarding any special circumstances about the patient. Families can
also request updates via text messages,
which can be sent anywhere in the world.
Admission and recovery rooms
RealView display to keep visitors
apprised of patient status
Nursing station
Spacious, technologically
advanced operating rooms
with brighter spot lighting above the
chairs to allow visitors to read or use
electronic devices.
Considerable
resources were
allocated toward
acquiring the latest
technology to make
the SurgiCenter
among Westchester’s
most advanced
operating facilities.
The SurgiCenter has an advanced, environmentally friendly waste disposal
system that fully cleanses surgical waste
water and utilizes reusable plastic containers. This significantly reduces the
hospital’s contribution to landfill and
eliminates the need for removing the
waste with diesel trucks.
Unprecedented Beauty
and Comfort
The décor in the SurgiCenter is a combination of contemporary and traditional, creating an overall timeless,
elegant look. The space was designed
to be very welcoming, comforting and
warm. It includes a stone accent wall
in the reception area, wall coverings in
natural tones, and dark wood doors and
trim throughout.
Unlike the patient admission and
recovery rooms at freestanding surgery
centers, which are usually separated
simply by curtain partitions, the SurgiCenter features rooms with solid walls
and sliding glass doors, providing ample
space, comfort and privacy. Soft, low
lighting illuminates the patient’s bed,
The combination of the new facility and
the dedicated Phelps staff will enhance
the hospital’s attractiveness to patients
and surgeons, according to Dr. Peress.
“We expect our SurgiCenter, which
reflects the many ideas of surgeons and
staff about how to create the best possible environment for patients, providers
and changing technology, will meet our
needs for decades to come.”
PHELPS TODAY
9
The All-Important Kidneys:
Your Body’s Filter
J
ust below the rib cage on
either side of the spine
are two fist-sized organs
that are vital to our survival – our kidneys. They
each have about a million microscopic
filters called nephrons, which process all
of the blood in our bodies several times
each day. This process filters toxins from
about 150 quarts of blood, creating up to
two quarts of urine that contains wastes
and excess bodily fluid. The urine drains
down tubes called ureters to the bladder
and is emptied from the bladder through
a tube called the urethra.
The kidneys are important to our health
for many reasons. They prevent the
buildup of wastes and fluid in the body.
They stabilize electrolytes such as
sodium, potassium and phosphate, which
are essential for the normal functioning
of our cells and organs. And they
generate hormones that help produce red
blood cells, regulate blood pressure and
maintain bone strength.
Kidney Disease
Sometimes the kidneys slowly stop
functioning. Without treatment,
this decline can progress to chronic
kidney disease, also called chronic
renal insufficiency or chronic kidney
failure. The cause of chronic kidney
disease is not always known,
but any condition that damages
blood vessels can negatively affect
the kidneys. One common cause is
diabetes, because elevated blood
sugar levels over a long period of time
damage the kidneys’ blood vessels.
10
PHELPS TODAY
The two images above are of the same kidney, which is filled with stones.
The left image is an X-ray used for diagnosis. On the right is the image
that the urologist obtained from an endoscope – a narrow tube with a
camera at the end that is inserted into the body. The urologist viewed the
endoscopic image while removing the kidney stones.
There is also a relationship between
kidney disease and high blood pressure
(hypertension). High blood pressure
can damage blood vessels, and if that
causes kidney disease, the failing
kidneys, in turn, can cause even higher
blood pressure.
Preventing Kidney Failure
When kidney function falls below a
certain point, it is called kidney failure.
As with any condition, the earlier kidney
disease is detected, the sooner treatment
can begin to slow down its progression
and prevent kidney failure. The first step
is to determine and treat the underlying
cause. Since diabetes and high blood
pressure account for 66 percent of chronic kidney disease, preventing or managing those conditions through diet, exercise and appropriate medication is vitally
important in protecting the kidneys.
It is possible to survive with only a part
of one kidney if it is still functioning.
If neither kidney works, however, a
machine has to be used to clean the
blood (dialysis) or a new kidney has to
be transplanted.
Leading-Edge Treatment
Phelps offers patients a higher level
of care for the prevention of renal
diseases and disorders than is typically available at community hospitals.
“My colleagues and I are experienced in
performing the most advanced laparoscopic and minimally invasive reconstructive procedures through small
access sites without large incisions,”
says urologist Michael Grasso, MD.
“As a result, our patients heal more
quickly and are able to return to normal
activities much sooner. There is also less
pain than with open surgery.”
Dr. Grasso adds, “In general, urologists
who have broad surgical experience with
the latest technology and who follow
a surgical team approach are able to
provide improved treatments and better
patient outcomes for conditions such as
kidney stones, ureteral obstruction and
kidney cancer.”
Kidney Stones
Kidney stones are formed from the
crystallization of certain substances in
urine, such as calcium, oxalate, or uric
acid. The stones can affect any part of the
urinary tract – from the kidneys to the
bladder. Kidney stones are more common
among men.
Phelps offers
patients a higher
level of care
for the prevention
of renal disease
and disorders
than is typically
available at a
community hospital.
Symptoms of kidney stones include
severe pain in the side and back below
the ribs, which may spread to the lower
abdomen and groin. Pain may be in
waves and fluctuate in intensity. Urine
is usually red, brown, pink or cloudy and
may be foul smelling. Fever and chills
occur if there is an infection.
The yellow line outlines a polypoid
tumor – so called because it
has the appearance of a polyp.
The urologist removed the tumor
endoscopically, saving the kidney.
Small kidney stones often pass out of
the body in the urine and may go completely unnoticed. But in the ureter,
larger stones can block the flow of urine
and be excruciatingly painful as they
move toward the bladder. Painful or not,
kidney stones usually do not cause any
permanent damage.
While drinking large quantities of water
is sometimes all that is necessary to
pass a kidney stone, if the stone is large,
a procedure by a urologist may be the
only solution.
The good news is that kidney stones
can often be eliminated without any
surgical incisions, usually in an outpatient setting. In a procedure called
ureteroscopy, a small viewing instrument called a ureteroscope is inserted into the urethra, through the bladder
In this 3D CT image, the white
arrow points to a blockage in the
kidney where accessory vessels
crossed. The urologist reconstructed the drainage portion of the
kidney and moved the extra vessels
away from the blockage, restoring
kidney function.
In this image, the area outlined
in blue is cancerous, the area
outlined in yellow is a cyst.
The red outline indicates the
portion of the kidney that was
removed. The rest of the kidney
was saved.
PHELPS TODAY
11
and the ureter to where the kidney stone
is located. Once the stone is in view,
the urologist can capture it with forceps
or a basket. Another non-surgical
technique, Extracorporeal Shock Wave
Lithotripsy (ESWL), uses shock
waves to break larger stones into
pieces small enough to pass in the
urine. The best method for eliminating very large, complex kidney stones
is Percutaneous Nephrolithotomy
(PCNL), which involves a small incision
and placement of a tube into the kidney
through which instruments can be introduced to break up and remove the stone.
Ureteral Obstruction
Urine travels from the kidneys to
the bladder through thin, muscular
tubes called ureters. There is one ureter
for each kidney, and each is 8 to 10 inches long. Sometimes the ureters become
blocked and the flow of urine to the
bladder is impeded.
The most common cause of ureteral
obstruction is ureteral or kidney stones.
Other causes include congenital conditions, scarring or injury from previous
abdominal or pelvic surgery, blood clots,
tumors, ureter wall swelling, inflammation of organs around the ureters, a tiny
swelling in the ureter called a ureterocele, endometriosis, severe constipation
and pregnancy.
Symptoms include pain in the lower back
or lower belly toward the sides, painful
urination, increased urinary frequency or
urgency, reduced urine output, blood in
the urine, swollen legs or fever.
12
PHELPS TODAY
To diagnose ureteral obstruction, a
urologist will conduct a physical exam,
measure blood pressure and check
for blood or infection in the urine. An
abdominal ultrasound or CT scan may
also be done.
The goal of treatment is to reduce or
eliminate the blockage. Severe cases
usually require surgery to repair the
underlying cause of the obstruction.
Kidney Cancer
The incidence of kidney cancer is growing
in the United States. Fortunately, most
kidney cancers are detected before they
metastasize (spread) to other organs.
Historically, a diagnosis of kidney cancer led to removal of the entire kidney
in an operation called a nephrectomy.
Today, the majority of kidney tumors are
removed in a partial nephrectomy, in
which advanced laparoscopic techniques
and special imaging are used to remove
the tumor and some tissue around it without a large incision. The healthy part of
the kidney is saved, and good kidney
function is maintained.
Additionally, techniques using tiny
endoscopes (lighted, flexible instruments
for visualizing inside the body) and
powerful, precise lasers are used to treat
tumors on the lining of the kidneys, ureters, and bladder, removing malignancies
while saving the remaining organ.
In fact, with these new techniques for
treating kidney cancer, the entire organ
is rarely removed.
Michael Grasso, MD, is Professor
and Vice Chairman of the Department
of Urology at New York Medical
College, as well as Regional Director
of Urology for the North Shore-LIJ
Health System. He annually teaches
instructional courses in advanced
urological procedures at the American
Urologic Association meeting and
the European Urologic Association
meeting. Dr. Grasso and his colleagues,
Andrew I. Fishman, MD, and
Christopher Dixon, MD, specialize in
leading-edge, minimally invasive
procedures for the treatment of kidney
disease. Dr. Fishman is an Assistant
Professor and Dr. Dixon is Director of
Reconstructive Urology at New York
Medical College. Their Westchester
office is on the Phelps campus in the
755 North Broadway building, Suite
510. The urologists perform outpatient
and inpatient surgical procedures in the
new SurgiCenter at Phelps. To contact
Dr. Grasso, Dr. Fishman or Dr. Dixon,
call 914-302-0100.
Relief from
Carpal Tunnel Syndrome
S
ay the words “carpal
tunnel syndrome,” and
most people think of
wrist pain resulting from
too much time spent at a
computer keyboard. Interestingly, studies looking at the connection between
excessive computer use and carpal tunnel syndrome have not found enough evidence to support a link.
In fact, although a number of factors
have been associated with carpal tunnel
syndrome – including anatomy (a smaller
carpal tunnel), gender (it’s more common
in women), nerve damaging conditions,
inflammation and thyroid disorders –
none of these factors has been established as a direct cause of carpal tunnel syndrome.
What Is Carpal Tunnel
Syndrome?
The carpal tunnel is a narrow passageway located inside the palm side of the
wrist that is surrounded by bones, tendons and a wide band called the transverse carpal ligament. The tunnel protects the median nerve – a main nerve
running from the forearm into the palm
of the hand that controls sensations to
the palm side of the thumb and fingers,
except for the little finger. The nerve also
controls impulses to some small muscles
in the hand that allow the fingers and
thumb to move. Carpal tunnel syndrome
results when a thickening from irritated
tendons or other inflammation narrows
the tunnel and causes the median nerve
to be compressed.
Flexor tendons
Median nerve
Synovium
Symptoms of carpal tunnel
syndrome include:
•pain or numbness in the hand,
wrist or forearm
•numbness or pain in the fingers
that causes waking at night
•loss of thumb function and
hand dexterity
•reduced strength and grip in
the fingers, thumb and hand
Patients with carpal tunnel syndrome
typically complain of numbness or pain
at night, which frequently wakes them
from sleep. “Many patients come in with
bags under their eyes due to months or
even years of poor sleep,” says Phelps
hand surgeon Jeffrey Jacobson, MD.
Diagnosis
There are other conditions that cause
symptoms similar to those of carpal tunnel syndrome, including injury to the
muscles, ligaments, tendons or bones;
nerve problems in the fingers, elbow or
neck; and arthritis in the thumb joint
or wrist.
Transverse carpal
ligament
To diagnose whether you have carpal
tunnel syndrome, your doctor will:
•Review your symptoms, making
note of when symptoms occur
•Conduct a physical examination,
testing the feeling in your fingers
and the muscle strength in your hand
Your doctor may also conduct a nerve
conduction study or an electromyogram,
which is a test that measures the electrical activity of your muscles and can rule
out muscle damage and other conditions.
“A recent nerve conduction study is very
helpful when discussing how much nerve
damage has already taken place. It is not
uncommon for patients to already have
had nerve tests performed at the direction of their primary care physicians
before they arrive in my office for a consultation,” says Dr. Jacobson.
Nonsurgical therapy
Carpal tunnel syndrome should be treated
as early as possible after symptoms
begin. If the condition is diagnosed early,
nonsurgical methods may help improve
PHELPS TODAY
13
carpal tunnel syndrome. Methods may
include wrist splinting, non-steroidal
anti-inflammatory drugs, or corticosteroids. Splinting and other conservative
treatments are more likely to help someone with mild to moderate symptoms
that have been present for less than six
months.
Cross-section of the carpal tunnel
Carpal tunnel release,
decompressing the median nerve
anesthesia with the patient fully awake
or with light sedation from an anesthesiologist. The incision site needs no
bandage and patients can shower immediately after surgery.
their looking refreshed and healthier,
even by their first follow-up visit two
weeks later. Often their only complaint
is having to come in for the follow-up
appointment at all, since they’re feeling
so good!”
Surgery
If symptoms are severe or persist for
more than six months, despite trying
nonsurgical therapy, surgery may be the
most appropriate option. Carpal tunnel
release is one of the most common surgical procedures performed in the U.S.
Traditional Surgery
In performing standard open surgery,
which is done under local anesthesia or
with sedation from an anesthesiologist,
the surgeon makes a two-inch incision
in the palm of the hand above the carpal
tunnel and cuts through the ligament.
This enlarges the carpal tunnel and
frees the nerve. Following surgery,
soreness or weakness may persist for
several weeks to a few months. Patients
generally return to work in two to six
weeks, depending on their occupation.
Endoscopic Carpal Tunnel
Release (ECTR)
During the minimally invasive procedure
known as an Endoscopic Carpal Tunnel
Release or ECTR, the surgeon makes
a tiny incision (1/2 inch) in the wrist
and inserts an endoscope (a telescopelike device with a tiny camera attached
to it) to see inside the carpal tunnel.
He then divides the ligament, relieving
the pressure. The procedure takes
approximately 10-15 minutes and can
be comfortably performed under local
14
PHELPS TODAY
ECTR is a very specialized procedure
and should be performed only by a
surgeon who has performed it many
times. Dr. Jacobson, who has performed
hundreds of these procedures, recently
brought the technique to Phelps, one of
the few Westchester facilities where it is
offered. Surgery brings permanent relief
to almost all patients, says Dr. Jacobson.
Compared to traditional open carpal
tunnel release surgery, patients typically have significantly less pain afterwards
and return to work and leisure activities
more quickly. Office workers are usually
back at work within two to four days, and
those who perform physical labor can
return to work as soon as they feel up to
it, often in less than two weeks. There is
some soreness in the palm for a few days,
but no bandage is required and there are
no restrictions regarding showering.
The change in his patients’ physical
appearance after surgery is remarkable,
says Dr. Jacobson. “When they no longer
have numbness and pain, patients stop
waking up at night. This often results in
Jeffrey Jacobson, MD, received
his medical degree from SUNY-Stony
Brook and completed a residency
in plastic surgery at Georgetown
University Hospital. Board certified
in plastic surgery, Dr. Jacobson is
fellowship trained in orthopedic hand
and wrist surgery with a specialty in
microvascular and peripheral nerve
surgery at University of Pittsburgh
Medical Center. In addition to hand
surgery, he performs the full breadth
of plastic surgery. Dr. Jacobson has
offices in Harrison and Katonah
(914-421-0123).
Family Medicine
Residency
Program Thrives in Its Third Year,
Inaugural Class Prepares to Enter the Field
Second-year residents
Julia Krim, DO, and
Carmen Tamayo, MD,
review an EKG.
for everything is something I think is
really important, so that even when we
refer patients to specialists, they feel
confident that someone who knows them
very well is overseeing their care.”
Residency Program
A
little over three years
ago, Phelps welcomed
six newly graduated
MDs into a brand new
residency program.
Today, the NYMC Phelps Family Medicine Residency Program, established
by Phelps in partnership with New York
Medical College and Open Door Family
Medical Centers, is a well-established
and highly respected program.
The three-year program was originally
designed for 18 residents (six per year).
Last year, the Accreditation Council for
Graduate Medical Education granted a
program expansion that allowed eight
residents in the third-year residency
class, so that there are currently 20
residents in training at Phelps.
Photo by Leslie Fass
What Are Family
Medicine Physicians?
Family medicine physicians are
primary care providers who treat the
whole person in every stage of life,
focusing on the prevention and treatment of disease. They are trained to take
care of the entire family, dealing with
medical issues that may affect more
than one family member and creating
long-term, personal relationships with
their patients.
“A family medicine doctor can provide
continuity of care for patients in virtually
every medical setting,” says Co-Chief
Resident London Muse, MD. “We see
infants, children, adolescents, pregnant
women, adults and geriatric patients
on a daily basis. Having one provider
A residency is a period of advanced
medical training that follows medical
school and involves supervised
practice in a hospital and outpatient
settings. During family medicine
residency training, doctors complete
clinical “rotations” in areas including adult inpatient and outpatient
medicine, obstetrics and gynecology,
cardiology, geriatrics, orthopedics and
adult and pediatric emergency medicine.
“Developing the NYMC Phelps Family
Medicine Residency Program has
been a phenomenal experience,”
says Dr. Shantie Harkisoon, a family
physician and director of the residency
program. “As a family doctor, I never
expected to wear so many different hats
– from designer of the residency headquarters to trainer of physicians. My
guiding principle has been for us to do
whatever it takes to create an extraordinary training program, and I think we’ve
done that. I could not have wished for
better resources or greater support from
PHELPS TODAY
15
the community and the wonderful,
inspiring people with whom I work. We
have an extraordinary group of residents
as a result.”
Much of the success of the program
stems from the involvement of Phelps
physicians and other clinicians and staff.
“The thing I like most about our program
is the people we work with – from faculty,
specialists and other residents to nurses,
medical assistants, hospital volunteers
and, most importantly, our patients and
their families. The bond, consideration
and care we have for one another really
cannot be matched.” says second-year
resident Molly Kilpatrick, MD.
In addition to providing training that
is founded on evidence-based medical care, the program focuses on giving
residents skills that enable them
to listen and relate to their patients.
Residents receive specialized behavioral medicine training to help them
maintain their own wellbeing, enabling
them to better protect the wellbeing of
their patients.
Integrative Training
Because of the evolving nature of healthcare, family medicine training is more
integrative than ever before. Residents in
the NYMC Phelps program receive their
clinical training at Phelps and at Open
Door Family Medical Center in Sleepy
Hollow. The program also has a special
relationship with Westchester Medical
Center and Maria Fareri Children’s
Hospital, where residents learn to care
for pediatric patients who have more
serious medical conditions. Training
at these various locations enables the
residents to refine their medical skills
16
PHELPS TODAY
Third-year resident Anesh Badiwala,
MD, reviews a patient’s X-rays
in the Emergency Department
under varying circumstances and provides them with experience in working
with diverse groups of patients.
According to Hira Qureshi, MD, Pediatric
Chief Resident at Westchester Medical
Center, “Phelps residents bring to the
Department of Pediatrics a sense of
dedication to all patients, a willingness to learn about the pediatric patient,
and a zeal that is needed to fuel their
drive while on this short but momentous
residency journey. Though they are initially faced with daunting tasks that
might scare first-year residents, by the
end of the rotation, they seem to overcome most if not all that is daunting and
are able to accomplish such tasks with
grace. We appreciate their unique perspective and enjoy learning from them
as much as we hope they enjoy learning from us.”
Photo by Leslie Fass
In addition to
providing training
that is founded on
evidence-based
medical care, the
program focuses
on giving residents
skills that enable
them to listen and
relate to their patients.
Community
“It’s great working at a community hospital
because it’s small, you know everyone
in the hospital, you build relationships
with patients and learn about different cultures,” says Farah Ansari, MD,
first-year resident. The residents have
created a bond with the community
by volunteering at local events and
getting to know the people in the towns
where they live. Recent events include
managing a teddy bear clinic for children at the Sleepy Hollow Street Fair or
volunteering in the Phelps medical tent
during a triathlon.
With the increased demand for primary
healthcare comes a need for more internal medicine and family medicine doctors. Many Westchester physician
practices have been recruiting the soonto-be-graduates.
“It has been so exciting watching
the program evolve and reach its
full complement,” says Kimberly Andron,
LCSW-R, MSW, Director of Behavioral
Medicine for the residency. “The success of all of our efforts is becoming
apparent as our inaugural class makes
plans to enter the field.” Dr. Harkisoon
agrees: “Thanks to the involvement and
enthusiasm from faculty and staff, we
have developed a superb program that is
creating outstanding family physicians.”
Dental Residency Program
Completes Third Year
2014 also marked the third year for the general dental practice
residency program at Phelps, sponsored by the New York Medical
College Department of Dental Medicine. This one-year program,
with a two-year option, was recently granted approval to expand from
four to eight resident positions by the American Dental Association
Commission on Dental Accreditation.
The dental residents complete their rotations in anesthesia and
emergency medicine at Phelps. Throughout the year, they provide on-call
emergency dental/oral surgery coverage for the Emergency Department
24/7 and perform comprehensive dental services in the operating room for
patients with special needs who require general anesthesia.
As for outpatient assignments, in addition to treating patients at the
Open Door Family Medical Center site in Port Chester, all incoming
residents will also treat outpatients at Open Door’s Brewster location.
Andrea Lochan, DMD
Scott Levitz, DDS
Cindi Bane, DDS
Zachary Logozio, DDS
PHELPS TODAY
17
Don’t Call It a Comeback: Chickenpox
By Jillian Elliott, MD
Has Been Here for Years
P
rimary care physicians
seldom receive the
accolades of other specialties. TV shows are
about neurosurgeons or
cardiologists, not primary care doctors.
But what we may miss out on in glamour, we more than make up for with the
satisfaction of having the opportunity to
prevent so many illnesses from occurring
or worsening.
I have been asked more times than
I can remember, “Did you become a doctor to help sick people?” My answer to
that is always: “Yes, but the main reason
I became a doctor is so that I can help
18
PHELPS TODAY
people before they get sick.” Prevention of disease is the main goal of primary care medicine, and keeping patients
healthy and free of major illnesses is my
primary objective as a physician. One of
the main ways to accomplish this goal
is with vaccinations.
The Varicella Vaccine
The varicella vaccine is given to prevent
chickenpox – a highly contagious
viral infection caused by the varicellazoster virus. The vaccine has been
invaluable in decreasing the incidence
of childhood chickenpox. As of 2007,
childhood deaths from chickenpox had
been cut by 97%. Prior to the introduc-
tion of the vaccine in 1995, 50 children
in the U.S. died each year and thousands
more were hospitalized.
Knowing that the vaccine is made up
of “live-attenuated virus” sometimes
causes people to worry that they could
catch chickenpox from being vaccinated.
A varicella-like rash may develop in 1-6
percent of people following vaccination,
but the more common reaction is fever
and pain, redness or swelling at the site
of injection. Except for individuals who
have some sort of immune deficiency or
are allergic to the vaccine, its benefits far
outweigh the risks for the overwhelming
majority of people.
While most people know that it is
important to vaccinate children, many
do not realize that it is also important
for adults to get the vaccine and booster. This is especially true for people
who had chickenpox in childhood but
show no immunity to it in adulthood.
For older people and those with weakened immune systems, shingles is also
a concern. Caused by the reactivation of
the chickenpox virus, shingles manifests
as a painful rash. There are vaccines
available to reduce the risk of shingles.
Chickenpox Transmission and
Course of the Disease
Chickenpox can be transmitted either
by directly touching the fluid in a lesion
on someone’s skin or by breathing in
the secretions from an infected person’s
nose. After exposure to the virus, it takes
approximately 10-21 days before the
initial signs of infection, which include
fever, fatigue, sore throat and loss of
appetite. The rash develops approximately 24 hours after these symptoms
appear and presents itself in “crops,”
typically on the face, trunk, arms and
legs. Because new lesions develop each
day for approximately four days, both fluid-filled lesions and scabbed lesions may
be present at the same time. Approximately six days after the initial signs and
symptoms, all the lesions will scab over
and will no longer be infectious.
As benign as all of this may sound,
chickenpox can unfortunately become
more serious for some patients. Severe
complications from the virus include
secondary bacterial skin infections,
pneumonia and encephalitis, which
is a swelling of the brain. The primary
method for preventing the most serious
While most people know that it is important to
vaccinate children, many do not realize that it is also
important for adults to get the vaccine and booster.
This is especially true for people who had chickenpox in
childhood but show no immunity to it in adulthood.
aspects of chickenpox is through vaccination. While it is reported to be 44%
effective in preventing chickenpox, the
vaccine is 86% effective in preventing
severe complications.
Immunity
I recall having chickenpox when I
was five years old and being covered
from head to toe in lesions that caused
such a severe itch. Luckily, I did not
develop any complications. When my
parents were children, they were brought
to visit friends who had chickenpox
so they could get the virus and later
overcome it. There was no vaccine at that
time, and this was simply the only way to
build immunity.
Prior to the implementation of the
varicella vaccine in 1995, the natural course of chickenpox immunity
was this: You got chickenpox as a child
and developed immunity. Then, in
adulthood, you were exposed to young
children with chickenpox, and that
provided your immunity with a boost.
Through this process, you developed
a lifelong immunity to chickenpox.
However, now that children are being
vaccinated, adults are no longer being
re-exposed to chickenpox, so the boost
does not occur.
Who Should Get the Vaccine
Vaccination is recommended for all
children between the ages of 12-15
months who have no evidence of
immunity, and a second dose is given
between the ages of four and six years
old. Experience has taught us that with
just one dose, children can still become
infected with chickenpox, which is why
the second dose is needed.
All adults should be tested by their
doctor to see if they have immunity to
the virus, even if they had chickenpox
as a child. If immunity is not detected, a varicella booster is recommended.
Adults should receive two doses of the
vaccine four to eight weeks apart. Protection against chickenpox is especially
important for adults who work in healthcare or daycare or who are exposed to
people with weakened immune systems.
In addition, women of childbearing age
who show no immunity should be vaccinated; however, they should not get pregnant for at least four weeks after receiving the vaccine.
Herd Immunity
With my patients, I stress the importance of getting the varicella vaccine,
not only to protect themselves but also
those around them. In fact, outbreaks can
PHELPS TODAY
19
be prevented by something called “herd
immunity,” whereby a critical portion
of a community is immunized against
a disease, and any cases that crop up
cannot spread among the people who
have been vaccinated. A tragic example
of what can happen when large numbers
of people fail to be vaccinated occurred
in 2012, when a four-year-old girl with
leukemia died after being exposed to
a cousin with a rash that turned out to
be chickenpox. She could not get the
varicella vaccine because she was undergoing chemotherapy and her immune
system was too weak. Sadly, she could
have been protected if herd immunity
had prevented her cousin from becoming sick.
While we have nearly eliminated chickenpox with vaccination, recent news
shows us how viruses can re-emerge.
Vaccinations can become a victim of
their own success – by being so effective,
people undervalue their benefit and fail
to get vaccinated. The truth is that the
vaccine is vital, not only to keep you safe,
but to keep your loved ones safe as well.
I became a primary care physician to
prevent illness, and vaccines allow me
to do that – for chickenpox and many
other diseases. I believe my most important role is to educate my patients about
vaccines and the many other steps they
can take to protect their health.
Jillian Elliott, MD, is an internal
medicine physician and a member
of Phelps Medical Associates.
Board certified in internal medicine,
Dr. Elliott received her medical
degree from New York Medical
College and completed a residency
in internal medicine at Montefiore
Medical Center. She sees patients
on the Phelps campus in suite 417
of the 755 North Broadway Building
(914-366-5490).
20
PHELPS TODAY
Dizziness and the
Inner Ear
D
izziness is a common
problem experienced
by most people at some
point during their
lifetime. It can be
described as lightheadedness, a feeling
of imbalance or a false sensation of
movement (vertigo). While most people
suffer from dizziness occasionally,
others have continuous symptoms of
imbalance. Most people find their dizzy
symptoms to be quite distressing and even
anxiety provoking. It impacts their daily
life, even if they do not experience symptoms every day, because it affects their
confidence in their ability to maintain
their balance and avoid injury to themselves or others.
Even though the sensation of dizziness
is quite common, it can be associated
with many different disorders, and determining the cause of dizzy symptoms can
be complicated and often frustrating for
the patient. The sensation of dizziness
can arise from problems in the vestibular system (in the inner ear), sensory
abilities in the feet and spine, or vision,
or when the brain is unable to correctly
interpret the information it receives from
the ear, sensory system or vision.
By Cameron Budenz, MD
Inner Ear Disorders
Even though the
sensation of dizziness
is quite common,
it can be associated
with many different
disorders, and
determining the cause of
dizzy symptoms can be
complicated and often
frustrating for the patient.
There are many different disorders
of the inner ear that can cause dizziness
The most common one is benign paroxysmal positional vertigo, or BPPV.
This disorder occurs when small crystals called otoconia, which are normally
found in the inner ear, become displaced
from their normal location. Individuals
with BPPV have episodes of intense
spinning vertigo, often accompanied
by nausea and vomiting, that lasts for a
number of seconds and occurs whenever
the patient moves a certain way. Movements that commonly cause dizziness
are lying down or rolling over in bed,
looking up to get an object off of a high
shelf, or lying back when having one’s
hair washed at the hairdresser. BPPV
most often resolves on its own over a
period of weeks. However, it can be
treated more quickly using positioning
maneuvers performed by a physician or
occupational or physical therapist who is
trained in vestibular therapy.
Labyrinthitis is an infection or inflammation of the inner ear that leads to
severe spinning vertigo lasting from a
few hours to a few days. This condition
is accompanied by hearing loss in one
PHELPS TODAY
21
ear that is often permanent. Vestibular
neuritis, which is similar to labyrinthitis, is related to infection or inflammation
of the balance (vestibular) nerve. It also
causes severe spinning vertigo lasting
hours to a few days; however, there is no
associated hearing loss. Initial treatment
for both of these conditions may include
steroids and/or medications taken shortterm to reduce the sensation of vertigo.
Once the severe vertigo subsides, many
people continue to have a general sense
of imbalance, and may even experience
brief episodes of vertigo when turning
their head quickly. These milder symptoms are almost always successfully
treated with vestibular therapy.
Meniere’s disease is a rare disorder
affecting the inner ear. The cause of
Meniere’s disease is not known, but is
thought to be related to an imbalance of
the fluids in the inner ear. Meniere’s is
characterized by episodes of vertigo that
last at least 20 minutes and less than one
day. The vertigo occurs in combination
with fluctuating hearing loss, tinnitus
(a roaring or buzzing sound in the ear),
and a sense of fullness in one ear. There
are many different treatment options for
Meniere’s disease, ranging from lifestyle
changes to medications to – in extreme
cases – surgery.
Other Causes of Dizziness
Two other common causes of dizziness
that are not disorders of the inner ear
are anxiety and vestibular migraine,
which may involve dizziness without a
headache. With both, symptoms can vary
considerably in terms of severity, duration and character of the dizziness. There
is no diagnostic test for either anxiety
or migraine. Typically, the evaluation
22
PHELPS TODAY
includes a hearing test and a balance
test to rule out an inner ear disorder.
Management of these disorders often
includes the care of one or more of the
following: a neurologist, an otolaryngologist with specialty training in balance
disorders, a psychiatrist and a physical
or occupational therapist trained in vestibular therapy.
Evaluation and Management
of Dizziness
Comprehensive evaluation and management of a patient with dizziness often
includes:
•one or more visits with a physician specializing in balance disorders
•a hearing evaluation
•testing of balance function
•vestibular therapy
Physicians involved in the care of dizzy
patients are most frequently neurologists or otolaryngologists who have subspecialty training in vestibular disorders. Many patients have improvement
or resolution of their symptoms with
a combination of vestibular therapy
and medical management. Surgery is
rarely recommended, but when necessary typically leads to significant relief
of symptoms.
Cameron Budenz, MD, is Medical
Director of the Balance Center at Phelps,
which is staffed by audiologists and
physical and occupational therapists
who have expertise in the testing and
treatment of patients with dizziness or
imbalance. Dr. Budenz is an otologist/
neurotologist (an ear, nose and throat
physician who specializes in disorders
of the ear) and a skull base surgeon.
She has expertise in the treatment and
management of imbalance and dizziness,
acute and chronic ear disease, hearing
loss and facial nerve disorders. As a skull
base surgeon, she is also able to remove
growths or abnormalities at the interface
between the ear and the brain.
Dr. Budenz is an assistant professor
in the department of otolaryngology
at New York Medical College and has
served as an instructor for courses
attended by surgeons from around
the world. She received her medical
degree from the University of Michigan
Medical School, followed by a surgical
internship and otolaryngology
residency at New York University. After
residency training, she completed both
a National Institutes of Health-funded
research fellowship and a clinical fellowship in otology, neurotology and skull base
surgery at the University of Michigan.
To schedule an appointment at the Phelps
Balance Center, call 914-366-1170.
Phelps Medical Associates News
Comprehensive Primary Care Initiative to Improve
Health of High-Risk Patients
Patients with chronic medical conditions
often don’t receive adequate education
or support to help them manage their
conditions. As a result, many of them
fail to recognize symptoms that should
prompt them to call their primary care
physician. Instead, they tend to wait
until their condition gets much worse and
end up going directly to the Emergency
Department, which frequently leads
to hospitalization.
Now, thanks to an initiative launched
by the Centers for Medicare and
Medicaid Services and other healthcare
insurers to help primary care practices
deliver enhanced and better coordinated
medical care to high-risk patients,
some patients are becoming adept at
disease self-management and enjoying a better quality of life. In addition,
they require fewer visits to the Emergency
Department and are less likely to
be hospitalized.
Having the comprehensive
care provided by this
system keeps the
patient at an appropriate
level of care, therefore
avoiding frequent ER
visits and multiple
hospital readmissions.
The Comprehensive Primary Care
(CPC) initiative, which was launched in
October 2012, is a four-year program
designed to achieve the Institute for
Healthcare Improvement’s “triple aim”
of better health and better care at lower
costs. Phelps Medical Associates practices are among 481 primary care practice sites in seven states participating in
this initiative. The practices, which were
selected through a competitive application process, receive financial support on
behalf of their Medicare beneficiaries.
The goals of the program are for primary
care physicians to:
1.Manage care of patients with serious
or multiple medical conditions
2.Ensure that patients have 24/7
access to care by phone or
patient portal
3.Deliver preventive care,
including medication management
and review
4.Engage patients and their caregivers
5.Coordinate a patient’s care with
his/her other healthcare providers
“This is the direction healthcare is
heading in,” says Judith Sapione, RN,
Clinical Quality Manager, who oversees
the CPC initiative for Phelps Medical
Associates. “The goal is for people
to learn self-management skills and
be engaged so they can participate in
their care. For example, if patients with
congestive heart failure begin to gain
weight, which is usually caused by fluid
retention, they know to call their primary
care physician instead of waiting for the
condition to get worse and going straight
to the Emergency Department.”
When Phelps Medical Associates
patients are identified as having highrisk needs, their physicians can refer
them to one or more of the program staff,
which includes:
•a patient care navigator, a social worker who can make referrals for diabetes education, medication
management, wound care, or drug
or alcohol counseling, and can help with assisted living or nursing
home placement, set up a home
health aide, or help a patient
access community services
or transportation;
•a clinical pharmacist, who works
with patients to help them manage
their medications;
•an RN case manager, who
provides education about disease management information and
follows up with patients after they
are discharged from the hospital;
•an RN care coordinator, who
follows up with patients who are
discharged from the Emergency Department and provides assistance with less complex cases.
“Having the comprehensive care
provided by this system keeps the
patient at an appropriate level of care,
therefore avoiding frequent ER visits and
multiple hospital readmissions,” says
Ms. Sapione.
PHELPS TODAY
23
Phelps Medical Associates News
Gastroenterology Practice ReAccredited
Phelps Medical Associates-Gastroenterology was recently re-accredited by the
Accreditation Association for Ambulatory Health Care (AAAHC) following a
rigorous survey. Status as an AAAHCaccredited organization, required every
three years, means the practice has met
nationally recognized standards for the
provision of quality healthcare. Approximately 5,000 ambulatory healthcare
organizations across the United States
are accredited by AAAHC. The gastroenterology practice is located on the
Phelps campus in Suite 305 of the 777
Building (914-366-5420).
More Endocrinology
and Neurology on the
Phelps Campus
Endocrinologist Delia Stefan, MD,
is board certified in both internal
medicine and endocrinology, diabetes
and metabolism. Dr. Stefan attended
medical school at
the Carol Davila
University of Medicine and Pharmacy in Bucharest, Romania. She
completed two residencies in internal medicine at
Danbury Hospital and University of
Arkansas Medical Center in Little Rock,
followed by fellowship training in endocrinology, diabetes and metabolism,
also at University of Arkansas Medical
Center. Dr. Stefan sees patients on the
Phelps campus at the Diabetes, Osteoporosis and Metabolism Center, in Suite
300 of the 777 building (914-366-2270)
and in Croton (914-269-1700).
24
PHELPS TODAY
Neurologist Douglas D. Sankar, MD,
board certified in neurology and clinical
neurophysiology, sees patients on the
Phelps campus in Suite 560 of the
755 Building.
Dr. Sankar earned
his medical degree
from Boston University School of
Medicine. He completed an internship in internal
medicine, a residency in neurology and a fellowship in
neurophysiology, all at New York University Medical Center. Prior to joining
Phelps, Dr. Sankar was in private practice in Cortlandt Manor. He is a clinical
assistant professor at New York Medical
College (914-366-5440).
Cardiology in Dobbs Ferry
Rajat Sanyal, MD, is Chief of Cardiology at Phelps. Board certified in cardiovascular disease, Dr. Sanyal is certified
to read vascular
ultrasound studies by the American Registry for
Diagnostic Medical Sonography.
Dr. Sanyal attended medical school
and completed a
residency in internal medicine at Calcutta Medical College, followed by a fellowship in cardiology at the Institute of
Postgraduate Medical Education and
Research at the University of Calcutta.
In 1994, he completed a residency in
internal medicine at the Medical College
of Virginia in Richmond, followed by a
fellowship in cardiology at New York
Medical College. He sees patients at 88
Ashford Avenue in Dobbs Ferry (914478-0641).
More Primary Care in
Sleepy Hollow
Internal medicine physician Andres
Espinoza, MD, sees patients at 362 N.
Broadway in Sleepy Hollow. Dr. Espinoza
attended medical school at the Universidad Autonoma de Guadalajara, Mexico. He completed a pre-internship at
New York Medical College and an
internal medicine
residency at Danbury Hospital. His
training includes a
Patient Centered
Medical Home
(PCMH) teambased model in a private practice and
the development of a PCMH at the Seifert and Ford Community Health Center
in Danbury, CT. In addition to speaking
English, Dr. Espinoza is fluent in Spanish and conversational in Portuguese
(914-631-2070).
Rheumatology in Croton,
Sleepy Hollow and Tarrytown
Rheumatologist Farrah Gutwein, DO,
attended medical school at the New York
College of Osteopathic Medicine, where
she was inducted into the National
Honor Society. She completed her internal medicine residency and rheumatology fellowship at Westchester Medical
Center. After her fellowship, she was in
private practice in
New Rochelle and
served as assistant director of
the Rheumatology
Clinic at Montefiore New Rochelle
Hospital and as the
hospital’s physician educator. She sees
patients in Croton at 440 South Riverside Avenue (914-269-1700), in Tarrytown at 200 S. Broadway (914-6318826) and in Sleepy Hollow at 362 N.
Broadway (914-631-2170).
Rheumatologist G.
Richard Parrino,
M D , the medical director of the
Phelps Infusion
Center, has more
than 40 years of
experience in rheumatology. He earned his medical degree
from the University of Rome Medical
School and completed a residency in
medicine at Queens General Hospital
followed by a fellowship in rheumatology at New Jersey College of Medicine
and Dentistry. Dr. Parrino sees patients
at 200 S. Broadway in Tarrytown (914631-8826).
Podiatry in Elmsford
Podiatrist Frank Lattarulo, DPM,
who has been on the Phelps medical
staff since 1993, joined Phelps Medical
Associates in February. In addition
to his practice, he provides podiatric
services to patients of Phelps’ Wound
Healing Institute, Hyperbaric Medicine
Center, and Diabetes, Osteoporosis
and Metabolism
Center. Dr. Lattarulo received his
DPM degree from
the New York College of Podiat ric Medicine and
completed a residency in podiatry at
St. Barnabas Hospital in the Bronx. His
office is at 160 South Central Avenue in
Elmsford (914-345-3400).
Congratulations to
our Medical Editor,
Dr. Bruce Heckman, on
publishing his first book –
“Parthenope,” a children’s
book telling the myth
of one of the Sirens,
featuring beautiful watercolor illustrations by
Randy Gallegos.
The book was inspired
by Dr. Heckman’s five
About Phelps Medical Associates
Phelps Medical Associates, Phelps’ multi-specialty medical group,
provides high-quality, personalized medical care at its many practices
located on the hospital campus and in the surrounding communities.
In addition to offering primary care, services include obstetrics/
gynecology, gastroenterology, rheumatology, neurology, cardiology
endocrinology and podiatry. Phelps Medical Associates also offers
in-person or phone consultations with a dedicated pharmacist to patients
who are having difficulty managing their medications. To find a Phelps
Medical Associates provider near you, call the Physician Referral Line
at 914-366-3367 or visit phelpsmedicalassociates.org.
grandchildren and the
creation of pastiera, a
traditional Italian Easter
dessert. Dr. Heckman
has been a Phelps
physician for many years
and is medical director
of Phelps Hospice.
PHELPS TODAY
25
Phelps Medical Associates News
“Telehealth” Technology Comes to Phelps
Phelps recently introduced another
initiative to improve care and quality of
life for high-risk patients. In February,
Phelps launched a telehealth pilot project in collaboration with the Visiting
Nurse Association (VNA) of Hudson
Valley to extend the continuum of care
into the home setting. Using equipment installed in the home, a patient’s
blood pressure, pulse, oxygen levels
and weight are captured and wirelessly transmitted to a monitoring station, where the data is reviewed and
changes in the patient’s health status are
noted. If an abnormal result is found, a
telehealth nurse will contact the patient
to determine the cause and will follow
up with his or her primary care provider
as necessary. Phelps is the first hospital in Westchester to offer this type
of program.
26
PHELPS TODAY
Studies show that up to 20 percent
of hospital inpatients are re-admitted
within 30 days of discharge due to exacerbations of congestive heart failure,
chronic obstructive pulmonary disease
or diabetes. The goals of the telehealth
program are to prevent avoidable rehospitalizations, enhance patient and
caregiver satisfaction, guide patients
toward more disease self-management, and support their ability to agein-place safely, responsibly and independently. Evidence-based research
shows that telehealth can be instrumental in achieving these goals by tracking
a patient’s health status and providing
prompt intervention by medical practitioners as needed.
Patients of Phelps Medical Associates providers are being selected for
participation in the program based upon
their need for chronic disease management and risk for repeated hospitalizations. During the pilot project, telehealth services are being offered free
of charge to participants, thanks to a
generous donation from the William
Olson Memorial Fund.
For more information on the program,
please contact the Vitality program at
914-366-3937.
Vitality for Seniors
Why Preventing Falls Is So Important
F
alls are the leading cause
of both fatal and non-fatal
injuries in people over the
age of 65. Every year, one
in three people in this age
group falls, and the probability that a
fall will result in serious injury increases with age. According to the Centers for
Disease Control and Prevention (CDC),
more than 2.4 million older adults were
treated in emergency departments for
falls in 2012, with more than 30 percent
of them requiring hospitalization.
After experiencing a fall, people may
become less mobile and consequently lose their independence. Many older
adults develop a fear of falling and often
limit their activities and social interactions. The resulting isolation can lead
to further physical decline, depression
and feelings of helplessness, significantly impacting quality of life.
weakness increases the likelihood of
falling. To offset these changes, it is
important for older adults to engage in
some form of exercise.
A particularly good form of exercise
for people with limited mobility is Tai
Chi. This ancient Chinese discipline
involving a continuous series of controlled, usually gentle, flowing movements has been shown to improve
strength, flexibility, balance and coordination. A 2001 study conducted by
the Oregon Research Institute in Eugene
reported that seniors who took Tai Chi
classes for an hour twice a week reported having an easier time with activities
like walking, climbing, bending, lifting,
eating, and dressing than those who did
not participate in the classes.
According to the
Centers for Disease
Control and Prevention
(CDC), more than
2.4 million older adults
were treated in emergency
departments for falls in
2012, with more than
30 percent of them
requiring hospitalization.
Nine out of ten hip fractures in older
adults are caused by falls. On average, a
patient with a hip fracture is hospitalized
for one week, and 25 percent of those
patients need extended care in a nursing home for at least one year. The CDC
reports that up to 20 percent of patients
with a hip fracture will die from resulting complications.
How Exercise Helps
Prevent Falls
As people age, muscle mass is lost,
resulting in decreased strength, elasticity
and joint mobility. At the same time,
balance may be compromised as well,
and the combination of dizziness and
PHELPS TODAY
27
Vitality for Seniors
Fall Prevention Awareness Day at Phelps
Dr. Gutwein talked about ways to
prevent osteoporosis. She recommended eating foods that provide
calcium (milk, yogurt, and green
leafy vegetables) and vitamin D
(milk and fish), taking calcium and
vitamin D supplements if diet sources are inadequate, exercising for at
least 30 minutes most days, avoiding
smoking, limiting the use of medications that can cause osteoporosis,
and limiting alcohol consumption,
which is associated with poor nutrition and increased risk for falling.
In recognition of National Fall
Prevention Awareness Day, Phelps
sponsored a full day of activities
last September at the James House
Mansion on the hospital campus.
The fall prevention event started
with balance screenings conducted by the physical medicine department and blood pressure screenings
performed by the nursing department. Cheryl Burke, RN, CNS,
offered safety tips for fall-proofing
the home to reduce the risk of falls.
She also talked about the NICHE
program – Nurses Improving Care
for Healthsystem Elders – which
focuses on the care of hospitalized
older adults, including how to recognize patients at risk for falling and
ways to prevent falls from occurring.
28
PHELPS TODAY
Because there is a connection between
fall-induced fractures and osteoporosis, Dr. Farrah Gutwein, a Phelps
Medical Associates physician specializing in rheumatology, spoke about risk
factors for osteoporosis. Main risk factors are: cigarette smoking, long-term
use of steroids, low body weight (less
than 127 lbs.), rheumatoid arthritis, a
personal or parental history of a nontraumatic or low-trauma bone fracture (e.g., breaking a bone after falling
from standing height or less), excessive
alcohol consumption (three or more
drinks a day), and having an osteoporosis-related disorder such as diabetes,
untreated hyperthyroidism, hyperparathyroidism, early menopause, chronic malnutrition or malabsorption, or
chronic liver disease.
Dr. Gutwein also suggested ways to
prevent falls in the home: ensure
rugs have a no-slip backing to keep
them in place; keep electrical cords
tucked away; install adequate lighting on walkways; use caution when
walking on slippery floors; wear
sturdy, comfortable shoes with rubber soles; have eyes checked routinely; and find out whether prescribed medications cause dizziness
or increase the risk of falling.
Fred Perino, Phelps Pharmacy director, was on hand to present a more in-depth discussion of
medications and their link to falls.
Participants learned which types
of drugs put them at a higher risk
for falls and why. Some medications that are associated with falling
are those for cardiovascular conditions, pain, anxiety, sleep problems,
depression, psychosis and nasal
congestion (especially over-thecounter antihistamines).
Phelps Donates Two Vehicles to Support
Local Emergency Medical Services
According to Emil Nigro, MD, Director
of Emergency Medicine at Phelps, the
fly car, which is staffed with a paramedic and sometimes an EMT, “brings the
ER to the patient.” A paramedic can provide lifesaving modalities on the scene
of a medical emergency, including IV
fluids, cardiac interventions and medication, and advanced airways (intubations).
The speed of a fly car can significantly
impact outcomes in life-threatening
emergencies. “Many lives have been
helped and quite a few saved because of
fly cars,” says Dr. Nigro.
Many lives
have been helped
and quite a few
saved because
of fly cars.
L
ast summer, members
of the Tri-Community
Advanced Life Support System, which
includes Croton Emergency Medical Services, the Briarcliff Manor Fire Department, and
the Ossining Volunteer Ambulance
Corps, stopped by Phelps Memorial
Hospital Center to thank Phelps for the
two new “fly cars” the hospital donated
to the system at a cost of $83,703.
A fly car is a rapid response Emergency
Medical Services vehicle featuring
advanced life support equipment that
usually arrives at the scene of a medical emergency before the ambulance.
Years ago Phelps formed a partnership with the villages of Croton-OnHudson and Briarcliff Manor and
the Ossining Volunteer Ambulance
Corps, which staffs and manages the
Tri-Community ALS system. Phelps
has donated a total of six fly cars since
1995. The money donated for the vehicles comes from a special fund created
to support ambulance services.
“The partnership that the Tri-Community
ALS system has with Phelps continues to allow the residents of Croton-onHudson, Briarcliff Manor and Ossining
to have high-quality advanced life
support at a reasonable cost,” says
Nick Franzoso, captain of the Ossining
Volunteer Ambulance Corps.
PHELPS TODAY
29
phelps
April
Wednesday, April 8, 2015
LSVT “Big” for People with
Parkinson’s Disease
Learn about this research-based exercise
program for people with Parkinson’s
disease that helps improve smoothness of
movement and increase strength, balance
and range of motion in the arms and legs.
Presented by LSVT-certified speakers.
Jennifer Teyfel-Freestone,
PT, DPT, CLT-LANA, CSCS,
Senior Physical Therapist
Healthy Life Calendar
Spring 2015
Andrea Bracciante-Ely,
MS Sp, CCC-SLP, Senior
Speech-Language Pathologist
10:30 – 11:30 am; Walkway
Conference Room
Registration is required.
Call 914-366-3220 to register.
Tuesday, April 14, 2015
Better Breathers Club: Build
Your Pulmonary Toolbox
Add life to your years by learning proper
breathing techniques for when you are at
rest or participating in activities.
Ronald Lynch, PT, Physical Therapist
Susan DiFabio, RRT/CPFT,
Education Coordinator for Pulmonary
Rehabilitation Program
11 am – 12 pm; Auditorium
Registration is required.
Call 914-366-3758 to register.
12 – 1 pm; Pulmonary Lab
Registration is required.
Call 914-366-3712 to register.
Friday, April 10, 2015
Monday, April 20, 2015
Leslie Sims, PT, Physical Therapist
Balance Therapy
If you are having balance issues,
learn balance exercises and strategies
to use at home from certified
vestibular therapists.
Sheetal Shenoy, OT/ OTR/L
Puja Agarwal, PT/DPT
Balance Screenings
If you are having trouble with dizziness
or imbalance, this is an opportunity to
speak with a specialist about your balance
problems and receive guidance regarding
the next steps for evaluation.
9 – 10:30 am; Boardroom
Registration is required.
Call 914-366-3758 to register.
Cameron Budenz, MD, otolaryngologist
with subspecialty training in evaluation
and management of vestibular (balance)
disorders, Medical Director of the Phelps
Balance Center
Monday, April 13, 2015
8:45 – 10 am
Registration is required.
Call 914-366-3220 to register.
Speech Therapy for
Parkinson’s Patients: Think
LOUD, Speak LOUD
Join graduates of LSVT LOUD and
learn about this intensive speech
therapy program for individuals with
Parkinson’s disease.
30
PHELPS TODAY
Tuesday, April 21, 2015
I Need Hearing Aids?!
What consumers need to know before
purchasing hearing aids. Where do
I go? Who do I see? How do I decide
what to get? What are my legal rights
as a consumer? Bring your questions –
knowledge is power!
Susan D. Reilly, MS, CCC-A,
Coordinator of Audiology Services
10 – 11:30 am; Auditorium
Registration is required.
Call 914-366-3220 to register.
Thursday, April 23, 2015
Bladder Health
Learn about how to keep your bladder
healthy and how to minimize problems
if you have incontinence.
Huan Sue Zhou, MD, urogynecologist
10 am; Boardroom
Registration is required.
Call 914-366-3220 to register.
Thursday, April 23, 2015
Swallow Screening
Do you sometimes feel food or liquid going
down the “wrong pipe” or coming back
up? Does food get stuck? Do you have pain
when you swallow? If you answered yes to
any of these questions, you should attend
this free swallow screening.
Lynne Marie Gagne-LeBlanc,
MS, CCC-SLP
Andrea Bracciante-Ely,
MS Sp, CCC-SLP
Paula Dinu, MS, CCC-SLP
9:30 – 12 am; Walkway Conference Room
Registration is required.
Call 914-366-3220 to register.
Monday, April 27, 2015
Yoga for Professional
Voice Users
For teachers, singers, lawyers and
clergy. Use yoga to control nerves,
improve posture, use your voice
with confidence and connect with your
audience. Please bring a large towel
and yoga mat. Space is limited.
Leah Ross-Kugler, MS, CCC-SLP,
voice rehabilitation specialist and former
opera singer
7 – 8 pm; C Level Classroom
Registration is required.
Call 914-366-3220 to register.
Monday, May 11 and
Tuesday, May 12, 2015
June
Defensive Driving Program
This two-evening certification program
lowers insurance premiums, reduces violation points and sharpens driving skills.
Thursday, June 4, 2015
Robert Fogel
Tuesday, April 28, 2015
Controlling the Pain of Arthritic
Knees Without Surgery
Orthopedic surgeon J. Robert
Seebacher, MD, will discuss a nonsurgical therapy that often helps people
with arthritic knees maintain active lifestyles while postponing – or eliminating –
the need for surgery. Learn how injections
and exercise can enable reconditioning
and reduce inflammation and pain.
J. Robert Seebacher, MD
Medical Director of the Phelps Joint
Replacement Service
6:30 pm; Auditorium
(light refreshments at 6 pm)
Call 914-366-3100 to register.
May
Thursday, May 7 and
Friday, May 15, 2015
Speech-Language Screenings
for Preschool Children
Are you concerned about your child’s
speech and language development?
If so, schedule a free speech-language
screening with an experienced pediatric
speech-language pathologist.
Kim M. Ventimiglia, MS, CCC-SLP,
pediatric speech-language pathologist
Thursday, May 7: 10:30 am – 12 pm
Friday, May 15: 1 – 2:30 pm
Donald R. Reed Speech &
Hearing Center at Phelps
777 North Broadway, Suite 303
Registration is required.
Call 914-366-3220 to register.
5:30 – 8:30 pm; Auditorium
Fee: $45
Registration is required.
Call 914-366-3220 to register.
Fall Prevention at Home
Learn about how to prevent falls at
home from therapists who are certified
in vestibular therapy.
Sheetal Shenoy, OT, OTR/L
Puja Agarwal, PT, DPT
10:30 am – 12 noon; Boardroom
Registration is required.
Call 914-366-3758 to register.
Monday, May 11, 2015
Screenings for Chronic Cough
and Laryngopharyngeal Reflux
Do you have a chronic cough that won’t go
away? Screenings will be offered for people
with chronic cough despite numerous doctor visits, diagnostic tests and medications.
Your cough may be caused by silent reflux
(laryngopharyngeal reflux disease or LPR)
or the irritation of a nerve. Symptoms of
silent reflux are excessive throat clearing,
voice changes, difficulty swallowing, nighttime cough and vocal spasms. Symptoms
of an irritated nerve include dryness in the
throat or a tickle prior to a cough.
Thursday, June 4 and
Tuesday, June 16, 2015
Skin Cancer Screenings
A dermatologist will visually examine
your skin for the presence of abnormal
tissue and let you know if further testing
is advisable.
Thursday, June 4, 2015
9 – 11:15 am
Jeffrey Sturza, MD
Tuesday, June 16, 2015
1 – 3 pm
Alison Stallings, MD
Craig H. Zalvan, MD, laryngologist,
Medical Director of the Institute for
Voice and Swallowing Disorders at Phelps
Appointments are required.
Call 914-366-3220.
8:45 – 10 am
Registration is required.
Call 914-366-3220 to register.
Tuesday, June 9, 2015
Tuesday, May 12, 2015
Better Breathers Club: Build
Your Pulmonary Toolbox
Learn about the anatomy and physiology
on the normal and diseased lung.
Susan DiFabio, RRT/CPFT,
Education Coordinator for Pulmonary
Rehabilitation Program
Better Breathers Club: Build
Your Pulmonary Toolbox
Add life to your years by learning to
exercise safely at home, wearing
comfortable clothes and non-slip shoes.
Susan DiFabio, RRT/CPFT,
Education Coordinator for Pulmonary
Rehabilitation Program
12 – 1 pm; Pulmonary Lab
Registration is required.
Call 914-366-3712 to register.
12 – 1 pm; Pulmonary Lab
Registration is required.
Call 914-366-3712 to register.
PHELPS TODAY
31
Wednesday, June 10, 2015
LSVT “Big” for People with
Parkinson’s Disease
Learn about this research-based exercise
program for people with Parkinson’s
disease that helps improve smoothness of
movement and increase strength, balance
and range of motion in the arms and legs.
Presented by LSVT-certified therapists.
Jennifer Teyfel-Freestone,
PT, DPT, CLT-LANA, CSCS,
Senior Physical Therapist
Leslie Sims, PT, Physical Therapist
Ronald Lynch, PT, Physical Therapist
11 am – 12 pm; Auditorium
Registration is required.
Call 914-366-3758 to register.
Ongoing
Bereavement Support Group
This ongoing support group for
adults struggling with the loss of a
loved one meets two Thursdays a
month on the following dates:
March 12 and 26, April 9 and 23,
May 7 and 21
Bess Steiger, LCSW,
Bereavement Coordinator
2 – 3:30 pm; Hospice
Office in the James House
Suggested donation: $10 per session.
Registration is required.
Call 914-366-3325 or
email [email protected].
Look Good . . . Feel Better®
This free, 2-hour workshop teaches
beauty techniques to women undergoing cancer treatment. The program,
held monthly at Phelps, includes a
hair consultation with a professional
stylist and a makeup consultation with
a cosmetologist. Attendees can take
home a complimentary wig and a makeup kit donated by cosmetic companies.
The program is offered in partnership
with the American Cancer Society,
The National Cosmetology Association,
and the Cosmetic, Toiletry and Fragrance
Association (CTFA) Foundation.
32
PHELPS TODAY
Call 914-366-3315 or 914-366-3421
to register for an upcoming session on
March 2, April 6, May 4 or June 1.
Osteoporosis Support
and Education
A free monthly group program for
individuals with osteoporosis, providing
education on nutrition, exercise
(weight-bearing, strengthening and
balance) and activities of daily living.
The sessions are held from 11 am to 12:30
pm the second Thursday of the month in
the Phelps Boardroom (C Level).
Call 914-366-2270 to register for an
upcoming session on April 19, May 13
and June 11.
Vitality
for Seniors
April 9, May 13, June 11 and
July 9
Breakfast Club
Meets monthly and includes a free
breakfast, a presentation on a healthy lifestyle topic and a light exercise program.
8:30 – 10:30 am; Cafeteria
To register, call 914-366-3937.
Tuesdays, March 17,
April 21, May 19, June 16,
July 21, August 18 and
September 15, 2015
Senior Steps
A program offering health screenings
for seniors, held once a month in various
locations throughout the hospital.
Appointments are required.
Call 914-366-3937.
Wednesdays, April 1, May 6,
June 3, July 1, August 5 and
September 2, 2015
Mind Games
Mind Games is a fun way to help seniors
stimulate their minds and develop
cognitive functioning skills, including
memory, visual recall, problem solving,
focus and speed, and spatial reasoning.
2 – 3:30pm; Boardroom (C Level)
To register, call 914-366-3937.
Fridays, April 3, 10 and 17 and
May 1, 8 and 15
Tai Chi Classes
Tai chi is a graceful form of exercise that
reduces stress and improves a variety of
health conditions, such as osteoporosis,
through gentle, flowing movements.
It involves a series of motions performed in
a slow, focused manner and accompanied
by deep breathing.
9:30 – 10:30 am in the Board Room
To register, call 914-366-3937.
Tuesdays, April 7, 14, 21 and 28
and May 5 and 12
Health for Life Program (HeLP)
The Health for Life Program empowers
participants to better manage chronic
conditions such as diabetes and high
blood pressure; communicate effectively
with healthcare professionals and
family; realize healthcare savings by
avoiding trips to doctors and hospitals;
and enjoy an enhanced quality of life.
10 am – 12:30 pm;
755 Building, Room 235
To register, call 914-366-3937.
Wednesday, April 29
Spirituality Program
Elders on Parade: How Society
Sees Us and How We See Ourselves
Most seniors feel younger than their age,
but our culture often treats them as if they
are older than they are. Using William
Thomas’s book What Are Old People For?
How Elders Will Save the World and
other research as a basis for discussion,
this program will investigate how ageism
affects seniors and how they can respond.
9 – 10:30 am; Auditorium
To register, call 914-366-3937.
Los tan importantes riñones:
El filtro de su cuerpo
J
usto debajo de la caja
torácica a ambos lados
de la columna vertebral
hay dos órganos del
tamaño de un puño que
son vitales para nuestra supervivencia:
nuestros riñones. Cada uno tiene
aproximadamente un millón de filtros
microscópicos llamados nefrones, que
procesan toda la sangre de nuestro cuerpo
varias veces cada día. Este proceso filtra
las toxinas de aproximadamente 150
cuartos de galón de sangre, creando
hasta dos cuartos de galón de orina que
contiene desechos y fluido corporal en
exceso. La orina se drena por conductos
llamados uréteres hacia la vejiga y
se vacía desde la vejiga mediante un
conducto llamado uretra.
Los riñones son importantes para nuestra
salud por muchas razones. Evitan la
acumulación de desechos y fluido del
cuerpo. Estabilizan los electrolitos
como el sodio, potasio y fosfato, que
son esenciales para el funcionamiento
normal de nuestras células y órganos. Y
generan hormonas que ayudan a producir
glóbulos rojos, a regular la presión
arterial y a mantener la fortaleza de los
huesos.
Enfermedad renal
A veces los riñones lentamente dejan de
funcionar. Sin tratamiento, este deterioro
puede progresar hasta la enfermedad
renal crónica, también llamada
insuficiencia renal o falla crónica del
riñón. La causa de la enfermedad renal
crónica no siempre es conocida, pero
cualquier afección que dañe los vasos
Las dos imágenes de arriba son del mismo riñón, el cual está lleno de cálculos.
La imagen de la izquierda es una radiografía usada para el diagnóstico. A la
derecha está la imagen que el urólogo obtuvo de un endoscopio, un tubo angosto
con un cámara en un extremo que se inserta en el cuerpo. El urólogo miraba la
imagen endoscópica mientras retiraba los cálculos renales.
sanguíneos puede afectar negativamente
a los riñones. Una causa común es la
diabetes, porque los niveles elevados de
azúcar en la sangre en un largo período
de tiempo dañan a los vasos sanguíneos
de los riñones. También hay relación
entre la enfermedad renal y la alta
presión arterial (hipertensión). La alta
presión arterial puede dañar a los vasos
sanguíneos, y si eso causa la enfermedad
renal, los riñones dañados pueden, a su
vez, causar presión arterial más alta.
Prevención de la
insuficiencia renal
Cuando la función renal cae debajo
de cierto punto, se llama insuficiencia
renal. Al igual que con cualquier otra
afección, mientras más pronto se detecte
la enfermedad renal, más pronto podrá
el tratamiento desacelerar su progreso y
prevenir la insuficiencia renal. El primer
paso es determinar y tratar la causa
subyacente. Como la diabetes y la alta
presión arterial representan el 66 por
ciento de la enfermedad renal crónica,
prevenir o manejar estas afecciones
mediante un régimen alimenticio,
ejercicio y medicamentos adecuados es
de vital importancia para proteger los
riñones.
Es posible sobrevivir con solo una
parte de un riñón si este aún funciona.
Sin embargo, si ninguno de los riñones
funciona, se debe usar una máquina
para limpiar la sangre (diálisis) o se debe
trasplantar un nuevo riñón.
Tratamiento de vanguardia
Phelps ofrece a los pacientes un nivel
más alto de atención para la prevención
de las enfermedades y trastornos renales
que típicamente están disponibles en los
hospitales comunitarios. “Mis colegas y
yo tenemos experiencia en la realización
de los procedimientos más avanzados
en laparoscopía y en los procedimientos
reconstructivos mínimamente invasivos
mediante pequeños sitios de acceso
y sin incisiones grandes”, dice el
urólogo Dr. Michael Grasso. “Como
resultado, nuestros pacientes sanan
más rápidamente y pueden volver a
sus actividades normales más pronto.
Además, hay menos dolor que con una
cirugía abierta”.
PHELPS TODAY
33
El Dr. Grasso añade, “En general, los
urólogos que tienen amplia experiencia
quirúrgica con la más reciente tecnología
y que siguen un abordaje de equipo
de cirugía pueden ofrecer mejores
tratamientos y mejores resultados para
los pacientes con afecciones como
cálculos renales, obstrucción del uréter
y cáncer en los riñones”.
Cálculos renales
Los cálculos se forman por la
cristalización de ciertas sustancias en la
orina, como calcio, oxalato o ácido úrico.
Los cálculos pueden afectar a cualquier
parte de las vías urinarias desde los
riñones hasta la vejiga. Los cálculos
renales son más comunes en los varones.
Los síntomas de los cálculos renales
incluyen dolor agudo en el costado y
la espalda debajo de las costillas, que
puede difundirse al abdomen bajo y a la
entrepierna. El dolor puede sentirse en
oleadas y fluctuar en intensidad. La orina
usualmente es roja, marrón, rosada o
turbia y puede tener mal olor. Hay fiebre
y escalofríos si hay una infección.
La línea amarilla delinea un
tumor polipoide, llamado así
porque tiene la apariencia de
un pólipo. El urólogo lo retiró
endoscópicamente, salvando
el riñón.
34
PHELPS TODAY
Phelps ofrece a
los pacientes un nivel
más alto de atención
para la prevención
de las enfermedades
y trastornos renales
que típicamente están
disponibles en los
hospitales comunitarios.
Los cálculos renales pequeños a veces
salen del cuerpo en la orina y pueden
pasar completamente desapercibidos.
Pero en el uréter, los cálculos más
grandes pueden bloquear el flujo de la
orina y ser extremadamente doloroso a
medida que se mueven hacia la vejiga.
Dolorosos o no, los cálculos renales
usualmente no ocasionan ningún daño
permanente.
En esta imagen tomográfica
3D, la flecha blanca señala un
bloqueo en el riñón donde vasos
auxiliares estaban cruzados.
El urólogo reconstruyó la
porción de drenaje del riñón y
movió los vasos adicionales lejos
del bloqueo, restaurando la
función renal.
Aunque tomar grandes cantidades de
agua es a veces todo lo que se necesita
para expulsar un cálculo renal, si este
es muy grande, la única solución puede
ser un procedimiento realizado por un
urólogo.
La buena noticia es que los cálculos
renales a menudo se pueden eliminar
sin incisiones quirúrgicas, usualmente
en un entorno ambulatorio. En un
procedimiento llamado ureteroscopía
se inserta un pequeño instrumento de
visualización, llamado ureteroscopio,
en la uretra a través de la vejiga y el
uréter hacia donde se localiza el cálculo
renal. Una vez que el cálculo está a la
vista, el urólogo puede capturarlo con
fórceps o una canastilla. Otra técnica no
quirúrgica, la litotripsia extracorpórea
(ESWL), usa ondas de choque para
desbaratar los cálculos más grandes y
hacerlos lo suficientemente pequeños
para expulsarlos en la orina. El mejor
método para eliminar los cálculos
renales muy grandes y complejos es
la nefrolitotomía percutánea (PCNL),
En esta imagen, el área delineada
en azul es cancerígena, el área
delineada en amarillo es un quiste.
La delineación roja indica la
porción de riñón que se removió.
El resto del riñón fue salvado.
que implica una pequeña incisión y
la colocación de un tubo en el riñón a
través del cual se pueden introducir
instrumentos para desbaratar y retirar el
cálculo.
El objetivo del tratamiento es reducir
o eliminar la obstrucción. Los casos
graves usualmente requieren cirugía
para reparar la causa subyacente de la
obstrucción.
Obstrucción del uréter
Cáncer en los riñones
La orina viaja desde los riñones hasta la
vejiga mediante unos conductos delgados
y musculares llamados uréteres. Hay un
uréter en cada riñón, y cada uno mide de
8 a 10 pulgadas de longitud. A veces los
uréteres se obstruyen y se impide el flujo
de la orina hacia la vejiga.
La incidencia de cáncer en los riñones
está creciendo en Estados Unidos.
Afortunadamente, la mayoría de los
cánceres se detectan antes de que se
propaguen (metatasticen) a otros órganos.
Históricamente, el diagnóstico del cáncer
de riñón conducía a la extirpación de
todo el riñón en una operación llamada
nefrectomía. En la actualidad, la mayoría
de los tumores del riñón se extirpan en
una nefrectomía parcial, en la que se
usan técnicas avanzadas de laparoscopía
e imagenología especial para extirpar el
tumor y parte del tejido que está a su
alrededor sin hacer una incisión grande.
La parte saludable del riñón se salva, y se
mantiene la buena función renal.
La causa más común de la obstrucción
ureteral son los cálculos ureterales o
renales. Otras causas incluyen afecciones
congénitas, cicatrización o lesión
por una cirugía abdominal o pélvica
previa, coágulos sanguíneos, tumores,
inflamación de la pared del uréter,
inflamación de los órganos de alrededor
de los uréteres, una pequeña inflamación
en el uréter llamada ureterocele,
endometriosis, estreñimiento severo y
embarazo.
Los síntomas incluyen dolor en la
espalda baja o en el vientre bajo hacia
los lados, micción dolorosa, aumento en
la frecuencia o urgencia en la micción,
reducción en la producción de orina,
sangre en la orina, piernas inflamadas o
fiebre.
Para diagnosticar una obstrucción
ureteral, un urólogo realizará una
exploración física, medirá su presión
arterial y revisará si hay sangre o
infección en la orina. También se puede
realizar un ultrasonido o una tomografía
abdominal.
Adicionalmente, hay técnicas que usan
endoscopios (instrumentos iluminados
y flexibles para visualizar dentro del
cuerpo) y rayos láser poderosos y precisos
para tratar tumores en el revestimiento de
los riñones, uréteres y vejiga, extirpando
malignidades mientras que salvan el
resto del órgano.
De hecho, con estas nuevas técnicas para
tratar el cáncer de riñón, raras veces se
extirpa el órgano entero.
Michael Grasso MD, es profesor
y Vicepresidente del Departamento
de Urología del New York Medical
College, así como Director Regional de
Urología del North Shore-LIJ Health
System. Anualmente enseña cursos en
procedimientos urológicos avanzados en
la asamblea de la Asociación Urológica
Americana y en la asamblea de la
Asociación Urológica Europea. El Dr.
Grasso y sus colegas, el Dr. Andrew I.
Fishman y el Dr. Christopher Dixon,
se especializan en procedimientos de
vanguardia, mínimamente invasivos
para el tratamiento de la enfermedad
renal. El Dr. Fishman es Profesor
Asistente y el Dr. Dixon es Director de
Urología Reconstructiva en el New York
Medical College. Su consultorio de
Westchester está en el campus Phelps
en el edificio de 755 North Broadway,
Suite 510. Los urólogos realizan
procedimientos quirúrgicos en pacientes
ambulatorios y pacientes hospitalizados
en el nuevo SurgiCenter de Phelps.
Para comunicarse con el Dr. Grasso, el
Dr. Fishman o el Dr. Dixon, llame al
914-302-0100.
PHELPS TODAY
35
No lo llame un retorno: La varicela
Por Jillian Elliott, MD
ha estado aquí por años
L
os médicos de atención
primaria con poca
frecuencia reciben
los elogios de otras
especialidades.
Los programas de TV son sobre
neurocirujanos o cardiólogos, no
médicos de atención primaria. Sin
embargo, lo que perdemos en glamur,
lo compensamos con la satisfacción
de tener la oportunidad de prevenir
que muchas enfermedades ocurran o
empeoren.
Me han preguntado muchas veces
más de las que puedo recordar: “¿Se
convirtió en médico para ayudar a
personas enfermas?” Mi respuesta
36
PHELPS TODAY
a eso es siempre: “Sí, pero la razón
principal de convertirme en doctor es
para ayudar a las personas antes de
que se enfermen”. La prevención de
enfermedades es el objetivo principal
de la medicina de atención primaria,
y mantener a los pacientes saludables
y libres de enfermedades graves es mi
objetivo principal como médico. Una
de las mejores maneras de lograr este
objetivo son las vacunas.
La vacuna contra la varicela
La vacuna contra la varicela se aplica
para prevenir la varicela (chickenpox
en inglés), una infección viral altamente
contagiosa causada por el virus varicelazoster. La vacuna ha sido muy valiosa
en la disminución de la incidencia de
varicela infantil. Al 2007, las muertes
infantiles por varicela se han cortado en
un 97%. Antes de la presentación de la
vacuna en 1995, 50 niños en EE.UU.
morían cada año y miles más eran
hospitalizados.
Sabiendo que la vacuna está hecha
de “virus atenuados vivos” a veces
causa que las personas se preocupen
sobre contagiarse la varicela al ser
vacunados. Un sarpullido parecido a
la varicela podría desarrollarse en 1 a
6 por ciento de las personas después
de la vacunación, pero la reacción más
común es fiebre y dolor, enrojecimiento
e inflamación en el sitio de la inyección.
A excepción de personas que tienen
algún tipo de deficiencia inmunitaria o
son alérgicas a la vacuna, sus beneficios
superan los riesgos para la mayoría de
las personas.
Mientras que la mayoría de las personas
saben que es importante vacunar a sus
hijos, muchas no se dan cuenta que es
también importante para los adultos
vacunarse y recibir refuerzos. Esto es
especialmente verdad para personas que
padecieron varicela en la niñez pero no
muestran inmunidad a esta de adultos.
Para personas mayores con sistemas
inmunitarios débiles, el herpes zóster
(también conocido comúnmente como
la culebrilla) es también una inquietud.
Causado por la reactivación del virus
de la varicela, el herpes zoster se
manifiesta como un sarpullido doloroso.
Hay vacunas disponibles para reducir el
riesgo de herpes zóster.
Transmisión de la varicela y
curso de la enfermedad
La varicela puede transmitirse tocando
directamente el líquido en una lesión
en la piel de alguien o respirando las
secreciones de la nariz de una persona
infectada. Después de la exposición al
virus, lleva aproximadamente entre 10
y 21 días antes de los primeros síntomas
de infección, que incluyen fiebre,
fatiga, dolor de garganta y pérdida del
apetito. El sarpullido se desarrolla
aproximadamente 24 horas después que
estos síntomas aparecen y se presenta
en “grupo”, típicamente en la cara,
torso, brazos y piernas. Debido a que
se desarrollan nuevas lesiones cada
día durante alrededor de cuatro días,
lesiones llenas de líquido o lesiones
en costra podrían presentarse al mismo
tiempo. Aproximadamente seis días
después de las señales y síntomas
iniciales, todas las lesiones formarán una
costra y ya no serán contagiosas.
A pesar de que todo esto puede
sonar benigno, la varicela puede
desafortunadamente agravarse
para ciertos pacientes. Severas
complicaciones del virus incluyen
infecciones dérmicas bacterianas
secundarias, neumonía y encefalitis, que
es la inflamación del cerebro. El método
principal de prevenir los aspectos más
serios de la varicela es por medio de la
vacunación. Mientras que se reporta que
es 44% efectiva en prevenir la varicela,
la vacuna es 86% efectiva en prevenir
complicaciones graves.
Inmunidad
Recuerdo haber tenido varicela cuando
tenía cinco años y estar cubierta
desde la cabeza hasta los pies de
lesiones que causaban gran picazón.
Afortunadamente, no desarrollé ninguna
complicación. Cuando mis padres eran
niños, los llevaban a visitar amigos que
tuvieron varicela para contagiarse el
virus y más tarde superarlo. No había
una vacuna en ese momento, y esto
era simplemente la única manera de
aumentar la inmunidad.
Antes de la implementación de la
vacuna contra la varicela en 1995, el
curso natural de la inmunidad contra la
varicela era este: Usted se contagiaba
la varicela de niño y desarrollaba
inmunidad. Luego, de adulto, usted
se exponía a niños con varicela y eso
proveía a su inmunidad un refuerzo. A
través de este proceso, usted desarrollaba
inmunidad para toda la vida contra la
varicela. Sin embargo, ahora que los
niños son vacunados, los adultos ya no
son expuestos nuevamente a la varicela,
por lo tanto el refuerzo no ocurre.
Quién debería recibir la vacuna
Se recomienda la vacuna a todos los
niños de 12 a 15 meses de edad que
no tengan evidencia de inmunidad, y
una segunda dosis entre las edades de
cuatro a seis años. La experiencia nos
ha enseñado que solo con una dosis
los niños aún pueden infectarse con
varicela, y por eso necesitan la segunda
dosis.
Los adultos deberían someterse a una
prueba con su doctor para ver si tienen
inmunidad contra el virus. Si no se
detecta inmunidad, se recomienda un
refuerzo. Los adultos deberían recibir
dos dosis de la vacuna con cuatro a ocho
semanas de separación. La protección
contra la varicela es especialmente
importante para adultos que trabajan
en la atención médica o cuidado de
niños o que están expuestos a personas
con sistemas inmunitarios debilitados.
Además, las mujeres en edad de concebir
que muestran no inmunidad deberían
vacunarse; sin embargo, no deberían
quedar embarazadas por lo menos por
cuatro semanas después de vacunarse.
Inmunidad de las masas
Con mis pacientes, enfatizo la
importancia de recibir la vacuna de la
varicela, no solo para protegerse a sí
mismos pero también a aquellos que
los rodean. De hecho, los brotes pueden
prevenirse con algo llamado “inmunidad
de las masas”, donde una porción crítica
de la comunidad es inmunizada contra
la enfermedad, y cualquier caso que
se presente no puede propagarse entre
las personas que han sido vacunadas.
Un ejemplo trágico de lo que puede
suceder cuando una cantidad numerosa
PHELPS TODAY
37
de personas no se vacuna ocurrió en
2012, cuando una niña de cuatro años
con leucemia murió después de ser
expuesta a un primo con un sarpullido
que terminó siendo varicela. Ella no
podía recibir la vacuna de la varicela
No inmunizado pero
aún saludable
porque estaba recibiendo quimioterapia
y su sistema inmune estaba muy débil.
Lamentablemente, podría haber estado
protegida si la inmunidad de las masas
hubiese prevenido el contagio de su
primo.
No inmunizado pero
aún saludable
Nadie está
inmunizado.
La enfermedad
contagiosa se
propaga en la
población.
No inmunizado,
enfermo y contagioso
Mientras que casi hemos eliminado la
varicela con la vacunación, noticias
recientes nos muestran cómo los virus
pueden reemerger. Las vacunaciones
pueden ser víctimas de su propio éxito; al
ser efectivas, las personas desestiman su
beneficio y no se vacunan. La verdad es
que la vacunación es vital, no solo para
mantenerlo seguro a usted, pero para
mantener a sus seres queridos también
seguros.
Me convertí en una doctora de atención
primaria para prevenir enfermedades, y
las vacunas me ayudan a hacerlo, contra
la varicela y muchas otras enfermedades.
Creo que mi papel más importante es
educar a mis pacientes sobre las vacunas
y los muchos otros pasos que pueden
tomar para proteger su salud.
Una parte de
la población es
inmunizada.
La enfermedad
contagiosa se
propaga a través
de una parte de
la población.
La mayoría de
la población
es inmunizada.
La propagación
de la enfermedad
contagiosa es
contenida.
38
PHELPS TODAY
Jillian Elliott, MD, es una doctora de
medicina interna y miembro de Phelps
Medical Associates. Certificada por la
Junta Médica en medicina interna, la
Dra. Elliott recibió su título de medicina
en New York Medical College y completó
su residencia en medicina interna en
Montefiore Medical Center. Atiende
pacientes en el campus de Phelps en
la suite 417 del Edificio 755 North
Broadway (914-366-5490).
A Report from Phelps Auxiliary
President Mark Frederich
T
...there is a need to
broaden our membership
with participants who can
bring in new ideas and
enthusiasm for ongoing and
future projects.
he Phelps Hospital
A u x i l i a r y, e s t a b lished in 1955, is a
network of dedicated men and women who provide
volunteer services and participate in
fundraising activities to support the
hospital. Over the past year, Auxilians
volunteered their time, energy and expertise to manage the Cherry Door (our thrift
shop in Tarrytown) and the hospital’s
Gift Shop with superb results. Our
bake sales were also remarkably and
deliciously successful. These and other
Auxiliary projects enabled the organization to donate $150,000 to the hospital,
which contributed to the purchase of the
state-of-the-art GreenLight XPS laser
technology for treating benign prostatic
hyperplasia. The Auxiliary has pledged
half a million dollars over the next
few years to help fund important capital projects, such as the extraordinary
SurgiCenter that opened in February.
Phelps Memorial Hospital and the
healthcare industry in general face
huge challenges in the future, making
this the most exciting time in decades
to be involved with Phelps as an Auxilian. Muhammad Ali once said, “It isn’t
the mountains ahead that wear you out;
it’s the pebble in your shoe.” It is the
Auxilians’ tireless work on a daily basis
(the little things) that helps us to scale
our mountains.
The Auxiliary’s fundraising efforts are
vital to Phelps. Its projects have enabled
significant donations to the hospital
every year. To continue the good work of
the Auxiliary, there is a need to broaden
our membership with participants who
can bring in new ideas and enthusiasm
for ongoing and future projects.
Being an Auxilian does not require
a major time commitment. There are
many tasks and positions to be filled.
Some require only a few days a year,
while ongoing projects can give regular
purpose in the lives of people who have
the time and inclination.
For more information about the Auxiliary
and how to join, please call Eve Urban at
914-366-3170.
Auxilian volunteers working in the
hospital Gift Shop.
PHELPS TODAY
39
Save The Dates!
12th Annual
Phelps Classic
Monday, June 8, 2015
Sleepy Hollow Country Club,
Scarborough, NY
28th Annual
Champagne Ball
Saturday, November 7, 2015
Trump National Golf Club,
Briarcliff Manor, NY
For information contact Marissa Coratti, Special Events Manager
914-366-3104, [email protected] or register online at phelpshospital.org
Maternity and Baby Care Classes
The Childbirth Experience/
LaMaze Method
Wednesday evenings 7:30 – 9:30 pm
for 5-6 weeks
Start dates:
March 18, April 22 and May 27
OR
2-day weekend sessions,
10 am – 3 pm:
March 14-15, April 11-12,
May 9-10 and June 13-14
Cost: $170 per couple
Breastfeeding: First Choice
for Babies
April 16, May 4 and June 4
7 – 9 pm
Cost: $45 per couple
40
PHELPS TODAY
ABCs of Baby Care
April 13, May 14, June 11
7 pm
Cost: $65 per couple
Totsaver Program: American
Heart Association CPR for
Family and Friends
April 4, May 2, June 6
9 am – 2 pm
$55 per person
For up-to-date schedule,
visit www.phelpshospital.org or
call (914) 366-3382 for
information or to register.
Prenatal Clinic:
Phelps Memorial Hospital Center and Open Door
Family Medical Center, participants in the
Medicaid Prenatal Care Assistance Program,
jointly sponsor a Prenatal Program. Care for
expectant mothers is provided by a highly trained,
caring, bilingual staff. No one is turned away
based on income or health insurance. Women are
encouraged to seek prenatal care early in their
pregnancy. Care is provided at Open Door during
the first 36 weeks of pregnancy and at Phelps
Memorial Hospital during the remainder of the
pregnancy and for delivery.
For information, call: (914) 941-1263
Atención Prenatal:
Phelps Memorial Hospital Center en Sleepy Hollow
y OpenDoor 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.
Sealienta 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.
JOIN US FOR OUR FIRST-EVER
2015
PHELPS
FOOD
&WINE
FEST
TRUMP NATIONAL GOLF CLUB
339 Pine Road, Briarcliff Manor, NY
SUNDAY AFTERNOON
12:00 – 4:00
MARCH 22, 2015
$90 Per Ticket
Celebrity chef:
Waldy Malouf
Gourmet Sponsor
Bank
Thank you to our sponsors:
BBL Construction Services, Gordon & Silber, PC,
Robert Lane and Janine Guercio, M&T Bank,
Michael and Judith Sullivan
Restaurant Participants
(As of 2/18/15)
105 Ten Bar & Grill
Coffee Lab Roasters
Coopers Mill
Crabtree’s Kittle House
Elia Taverna
Great American BBQ
Iron Horse Grill
Jean-Jacques’ Culinary Creations
Mambo 64
Memphis Mae’s
Provisions
River Market Kitchen and Bar
Sam’s of Gedney Way
Tarry Tavern
Tavern at Croton Landing
Trump National Golf Club
International Beer Garden
Sponsored by:
Half Time
World’s largest beer retailer
Wine
Grape Expectations
Proceeds will benefit Phelps Memorial Hospital Center
To purchase tickets go to phelpshospital.org/food-wine-fest or
contact Marissa Coratti, Special Events Manager, at (914) 366-3104 or [email protected]
PHELPS TODAY
41
Phelps Memorial Hospital
Locations in the Community
A
croton-on-hudson
3
4
1
2
B
C
briarcliff manor
sleepy
hollow
H
D
tarrytown
Rt. 1
Rt. 1
17
19 elmsford
E
F
irvington
dobbs ferry
G
A
B
PHELPS MEDICAL ASSOCIATES
IN THE COMMUNITY
Croton
Primary Care, Cardiology, Endocrinology,
& Rheumatology: 914-269-1700
Phelps Radiology: 914-269-1701
Ossining
Family Medicine: 914-373-4948
Internal Medicine: 914-941-1277
C
Briarcliff
Cardiology: 914-762-5810
D
Sleepy Hollow
Primary Care, Cardiology
and Rheumatology: 914-631-2070
Elmsford
Podiatry: 914-345-3400
Tarrytown
Endocrinology: 914-366-7862
Rheumatology: 914-631-8826
Dobbs Ferry
Primary Care: 914-478-1384
Cardiology: 914-478-0641
E
F
G
42
PHELPS TODAY
PHELPS PRACTICES ON THE
1
BEHAVIORAL HEALTH
SERVICES
Addiction Treatment Services (ATS)
Ossining: 914-944-5220
2
Ossining Counseling Service
Ossining: 914-944-5250
3
Continuing Day Treatment
Briarcliff Manor: 914-923-5700
4
Supportive Case Management
Briarcliff Manor: 914-923-5740
H HOSPITAL CAMPUS
• Advanced Endoscopy &
Gastroenterology: 914-366-1190
•Diabetes, Osteoporosis &
Metabolism Center: 914-366-2270
• Gastroenterology: 914-366-5420
• Primary Care: 914-366-5490
• Neurology: 914-366-5330 & 5440
• OB/GYN: 914-366-5400
• Senior Health & Internal Medicine:
914-366-3677
• Thoracic Center: 914-366-2333
• Westchester Lung Nodule Center:
914-366-2333
Donate Blood at Phelps
Give the gift of life and receive a discount from a local business!
Did you know that every time you donate a unit of blood you can help save
up to three lives? Also, each time you donate at Phelps, you’ll receive a
$15 voucher for a free meal in the Phelps cafeteria and will be invited to
choose a discount offer from one of the many generous area businesses
listed below that support Phelps’ Blood Donor program. To donate,
you must be between 16 and 75 years old and weigh at least 110 pounds.
To make an appointment, call 914-366-3916. Walk-ins are welcome.
Briarcliff Manor
105 Ten Bar & Grill
Bella Maiya Day Spa
Briars Restaurant
Dom & Vinnie’s
Good Food
Manor Wine & Spirits
Orfino’s
Paese Pasta & Pizza
Squire’s Steak & Seafood
Terra Rustica
Chappaqua
Kittle House
Croton-on-Hudson
Anton Restaurant
Backstage Salon
Baked by Susan
The Black Cow
Croton Colonial Diner
DePrez Wines & Spirits
Feed the Birds!
Giovanni’s Deli & Pastries
Holistic Physical Therapy
Hop Scotch Market & Restaurant
Justin Thyme Café Bar
Memphis Mae’s Bistro BBQ
New York Sports Clubs
Pronto Brick Oven Pizza
Tavern at Croton Landing
Van Wyck Wines & Liquors
Vogue Nails & Spa
Elmsford
Fairview Golf Center
Westchester Broadway Theatre
Hawthorne
Gordo’s
Green Valley Nursery
Tramonto Restaurant-Bar-Café
Irvington
Geordane’s
Il Sorriso
Red Hat on the River
River City Grille
Mt. Kisco
Basilico Pizza, Pasta
Tijuana Mexican Grill
Ossining
Art Barn
Atria Senior Living
The Boathouse
Capri Pizza & Pasta
Carpet Giant
Corsi Tire
Doca’s Portuguese
Goldfish
King Shell Service Center
Landmark Diner
Mandee
Melita’s
South of the Border
Ultra Clean Car Wash
VaZa Salon & Spa
Wobble Café
Pleasantville
A’Mangiare
Best Wine Purveyors
The Black Cow
The Flower Basket
Foley’s Club Lounge
Iron Horse Grille
Jacob Burns Film Center
Manhattan Chili Co.
Martha’s Pleasantville Deli
Mediterraneo
Physical Fitness Xperts
Pleasantville Colonial Diner
Pony Express Good Food
Sinapi’s Bakery & Café
Sir Speedy Printing & Marketing
Sparx Hair & Makeup Salon
Tech Connect Computer
Trattoria 160
Sleepy Hollow
Bridge View Tavern
Dominick’s Limousine
J. P. Doyle’s Restaurant
The Horseman
The Huddle
Kendal on Hudson
The River Grill Restaurant & Bar
Tijuana Mexican Grill
Tarrytown
Bark & Meow Pet Products
Bella’s Boutique
Castle Hotel & Spa
Coffee Labs Roasters
Elite Hair Design
Family YMCA
Grape Expectations
TGI Friday’s
Heritage Frame
Hudson River Eyecare
Horsefeathers
King Shell Service Center
Lubins and Links
Main Street Sweets
Mr. Nick’s Brick Oven Pizza
NY School of Esthetics
On Track Sport Center
PHR Electrolysis
Pure Mountain Olive Oil
River View Wines & Spirits
Sunset Cove
Taco Project
The Tapp
Tarry Tavern
Taste of China
Warner Library
w@tercooler
Thornwood
Casa Rina
White Plains
The Cabin
PHELPS TODAY
43
PHELPS
Nonprofit
Organization
U.S. Postage
PAID
White Plains, CT
Permit No. 105
Phelps Memorial Hospital Center
701 North Broadway
Sleepy Hollow, NY 10591-1096
www.phelpshospital.org
Ongoing Health Programs and Support Groups
Alzheimer’s Support Group
For information, call Curtis Au
(914) 253-6860
Cardiovascular Wellness Center
Exercise under RN supervision
(914) 366-3752
Outpatient Behavioral Health
Alcohol/chemical dependency,
counseling, continuing day treatment,
supportive case management
(914) 366-3027
Celiac Sprue Support Group
Sue Goldstein: (914) 428-1389
Bereavement Support Groups
(914) 366-3325
Better Breathers Club
(914) 366-3712
Blood Donations
(914) 366-3916
Blood Pressure Screenings
Generally the 1st & 3rd Wednesday
of the month, 9:30 - 11:30 am
Appointments necessary
(914) 366-3220
Cardiovascular Rehab
(914) 366-3740
CPR Classes
(914) 366-3166
Diabetes Education Classes for Adults
(914) 366-2270
Group Counseling
Help with issues such as: separation
& divorce, losses, relationships,
family issues, parenting, coping skills
(914) 366-3600
Hospice
(914) 366-3325
Look Good Feel Better®
for women undergoing
cancer treatment
(914) 366-3315 or (914) 366-3421
Mammography
(914) 366-3440
Maternity & Baby Classes
(914) 366-3382
My Sister’s Place
(800) 298-SAFE (7233)
Osteoporosis Support Group
(914) 336-2270
Ostomy Support Group
3rd Sunday of every month
(914) 366-3395
(Call 366-3000 for
cancellation information)
Physician Referral
(914) 366-3367
Pulmonary Rehabilitation
(914) 366-3712
Sleep Well Support Group
(914) 366-3755

March 19, 2014 Meeting

WIFI AVAILABLE - Phelps Mill Festival

BIO Marcos Roel President Petrabax 37-18 Northern

Please RSVP to me If you have any questions please feel free to

May 1st - pgfl.org.uk

read current newsletter - Piedmont Adult Living Services

231850 - 3rd Sunday of Easter

USE OF FORCE - Sorenson Unity Center

Pachappa Elementary School

Bajar en formato PDF - University of Illinois Extension