2014 Fall Newsletter - Phelps Memorial Hospital

Transcripción

phelps
Fall 2014
News from
Phelps Memorial
Hospital Center
T o d ay
Breast Density:
Why It Matters
Bronchiolitis:
A Respiratory Illness
in the Very Young
The Importance
of Rehabilitation
After Traumatic
Brain Injury
How to Prevent
Prescription
Drug Abuse in Teens
Central Auditory
Processing Disorders:
Helping the Brain
to “Hear”
s
Fall Calendar
Get better. Here.
Pediatric hospitalist Julie Sylvester, DO,
treats a baby for bronchiolitis.
Letter from the
President and Chairman
Dear Friend,
Many changes are under way, both in the healthcare arena at large and here at
Phelps Memorial Hospital Center.
Throughout the nation, hospitals are seeking solutions to meet the federal
Affordable Care Act’s objective to reduce healthcare costs through efficiency while
continuing to provide the highest quality of care. As a result, many hospitals are forming
partnerships with large health systems, which provide expanded resources and
support. Phelps is in discussions with the North Shore-LIJ Health System, the state’s
largest healthcare organization. We look forward to realizing the benefits that partnering with such an outstanding system will bring to our community.
As we anticipate formalizing this relationship, we have already begun addressing
the growing healthcare needs associated with the Affordable Care Act with the
construction of a new surgical facility. The Phelps SurgiCenter, which will open by the
end of the year, will provide inpatient and ambulatory surgical services in spacious
state-of-the-art operating suites and comfortable private rooms. Over the course
of the coming year, the hospital’s main lobby will be relocated to the Atrium
entrance of the 755 building, which will be dramatically expanded to include a new
Admitting Department and a coffee bar. Next year, construction will begin on a new
MRI suite to be located in the current main lobby area.
As the world of healthcare evolves, Phelps remains committed to its role as your
community hospital. Through partnerships, facility improvements, and expanded
services, we are confident that Phelps will continue to meet the healthcare needs of
you and your family today and in the decades to come.
We wish you a healthy and glorious fall.
Sincerely,
Richard Sinni
Keith F. Safian, FACHE
ChairPresident & CEO
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Phelps Today
Table of
Contents
phelps today
Breast Density: Why It Matters
4
Rehabilitation After Mild to Moderate Traumatic Brain Injury
6
Misuse and Abuse of Prescription Drugs Among Teens
9
Ergonomics: Making Your Workstation Work for You
12
Bronchiolitis: A Respiratory Illness in the Very Young
14
Central Auditory Processing Disorders:
Helping the Brain to “Hear”
16
Keith Safian Celebrates 25 Years as
Phelps President and CEO
18
Phelps Medical Associates News
20
PHELPS TODAY is a publication of Phelps
Memorial Hospital Center, a 238-bed, notfor-profit acute care community hospital
located in Sleepy Hollow, NY. Phelps has been
providing medical and mental health services
to Westchester and surrounding communities
since 1955.
Vitality for Seniors and the Community
21
Fall Calendar
22
Mal uso y abuso de medicamentos bajo
receta entra adolescentes
29
If you would like to be removed from
the Phelps Today mailing list, please call
(914) 366-3100 or email [email protected].
Densidad de senos – Por qué es importante
32
Editor
Mary Sernatinger
[email protected]
Managing Editor
Tina Dorfman
Medical Editor
Bruce Heckman, MD, MPH
Editorial Advisors
Lucy C. Engelhardt, RN
Leonard B. Fogel
Mary McDermott, RN
Keith F. Safian, FACHE
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
Visit us on Facebook:
http://www.facebook.com/
PhelpsMemorialHospitalCenter
Visit us on Twitter:
https://twitter.com/
#!/phelpshospital
Phelps Memorial Hospital Center is committed to improving the health
and well-being of the community. To see our Community Service Plan
(2014-16) and learn about our current and planned activities and
initiatives, please visit phelpshospital.org/about-phelps and click on
“Community Service Plan.” A summary of the hospital’s 2012 community
service is described in our “Caring for Our Community” publication,
which is also available at the same address (click on “Caring for Our
Community”). A printed copy of these publications may be requested by
calling 914-366-3115.
Phelps Today
3
Breast Density –
Why it Matters
The following Q&A explains what breast density
means and why mammography alone is not always
enough when screening for breast cancer.
Regardless of size or
shape, women who
have dense breasts
have a greater
risk of developing
breast cancer.
Q. I had a mammography recently
and was told that I have dense breast
tissue. What does that mean?
A. Breasts are made up of fat and nonfatty glandular and connective breast
tissue. Some women have more fat than
breast tissue, while others have more
breast tissue than fat. Breasts that have
higher proportion of the glandular tissue
are described as “dense.”
Q. Is it unusual to have
dense breasts?
A. Every woman’s breasts are different. Some are fatty, some are dense,
and some are a mix. Approximately
46 percent of American women have
dense breasts.
Q. My breasts don’t feel dense,
so I must not have dense breast
tissue, right?
A. Breast density is not evident by feel or
appearance. The only way to determine
whether breasts have dense tissue is by
evaluating a mammogram.
Q. Who determines whether or not
I have dense breasts?
A. The radiologist who looks at your
mammogram classifies breast composition into one of four categories
of increasing density: predominantly
fatty, scattered fibroglandular tissue, heterogeneously dense or extremely dense.
Q. Will I always have dense breasts?
A. Dense breast tissue is a physical attribute like other features of your body. You
cannot actively modify density, but it
can change as a result of age, hormone
levels and menopause. As women age,
their breasts may become less dense.
Extremely dense or heterogeneously
dense tissue is present in more than half
of women under age 50 and in only onethird of women age 50 or older.
Q. Why does it matter if my breasts
are dense?
A. Regardless of size or shape, women
who have dense breasts have a
greater risk of developing breast cancer
than women with fatty breasts. Dense
tissue may also obscure underlying
abnormality, making it harder to detect
early cancer.
Q. How can women be sure
they will be told if they have
dense breasts?
A. Recognizing the importance of early
detection of breast cancer and the fact
that women with dense breasts have
a higher risk for developing it, several states – including New York – have
passed legislation requiring mammography services to inform patients if dense
breast tissue is seen during an exam. The
intent of the law is to empower women
to discuss additional screening options
with their physicians.
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Phelps Today
Q. Will a tumor show up in a
mammogram of a dense breast?
A. Looking for a tumor in mammography of dense breasts is like looking for
a snowball in a snowstorm, because
dense breast tissue looks white on the
mammogram and masses or lumps also
appear white. That’s why a cancer can
easily hide in a background of dense tissue. Conversely, fatty breasts show up
mostly black and grayish on a mammogram, so detection of a suspicious mass
is more sensitive.
Q. Is there another test that can
detect cancer in dense breasts?
A. Ultrasound can help identify masses
that are hard to see on a mammogram.
MRI is a useful tool as well.
The Avon/ACRIN 6666 study showed
that among women who were at risk
for developing breast cancer and had
dense breasts, ultrasound as an adjunct
to a screening mammogram increased
detection by revealing certain cancers
that do not show up in mammography.
Q. What is ultrasound?
A. Ultrasound is a non-invasive method
that uses high-frequency sound waves
to look inside the body and create a
detailed image of an organ or tissue.
Q. Should I skip having a
mammography and just go for an
ultrasound screening?
A. No. Mammograms are still being used
as the primary imaging method of breast
cancer screening. Mammography is the
most sensitive modality to detect calcifications (deposits of calcium that can be
seen on a mammogram) that are sometimes produced by early breast cancers.
Also, comparing a mammogram with
a previous year’s exam allows small
changes to be seen.
If you have dense breasts, having both
a mammography and an ultrasound
screening will provide a more complete evaluation. Screening breast MRI
is another effective supplemental modality for breast cancer detection.
Ultrasound Supervisor Susan Carpenter prepares a patient for a 3-D ultrasound
of the breast with the ABUS.
New 3-D Ultrasound System
Now at Phelps
To provide women with the benefits
of the latest state-of-the-art ultrasound
screening technology, Phelps Memorial
Hospital Center recently became the first
hospital in the Hudson Valley Region to
acquire the G.E. Invenia™ Automated Breast Ultrasound System (ABUS),
which is FDA-approved as a supplemental screening modality for cancer detection in women with dense breast tissue.
Like traditional breast ultrasound, ABUS
also uses ultrasound technology to generate images. The difference is that the
data generated with ABUS is in a 3-D
format, allowing more ways for the radiologist to analyze the images. ABUS
also allows for a more uniform way of
acquiring the images by being less operator-dependent, since the technologist
does not have to manually guide an
ultrasound wand. Studies have shown
that the cancer detection rate is higher among patients with dense mammograms when mammography is combined
with a supplemental screening modality such as ABUS, traditional breast ultrasound or breast MRI.
The Breast Imaging Center at Phelps
Memorial Hospital has been designated
a Breast Imaging Center of Excellence
by the American College of Radiology
(ACR) for many years.
Norman Lee, MD, a board-certified
radiologist with subspecialty
fellowship training in breast imaging,
is the medical director of the Phelps
Breast Imaging program and is on-site
full time at Phelps. The high quality
of care delivered to patients of the
Breast Imaging Center is a result of
Dr. Lee’s passion for his work and
his staff’s dedication to continually
advancing their skills and knowledge.
Phelps Today
5
Rehabilitation After
Mild to Moderate
Traumatic Brain Injury
By Dr. Wei Angela Liu, MD, Judith Christopher, PhD, CCC-SLP,
Anjum Lone, OTR/L, CHT, and Puja Agarwal, PT, DPT
Life is full of pitfalls, literally. The curb of a road, an unseen
step or black ice in a parking lot, can lead to a fall – the most
common cause of traumatic brain injury (TBI). Other causes
include vehicular collisions, sports injuries or violence.
several factors, including the nature of
the accident and the force of impact.
Prompt evaluation and treatment can
help lessen the effects of the injury.
After a TBI, a person may experience
changes in thinking, understanding,
memory, attention, personality and
balance. There may also be emotional or behavioral changes. If you or a
loved one receives a blow to the head
that concerns you or causes behavioral changes, consult a doctor. Even a
mild injury to the brain is serious and
requires prompt attention and an accurate diagnosis.
After a TBI, a person
may experience
changes in thinking,
understanding, memory,
attention, personality
or balance.
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Phelps Today
E
ven a mild TBI can cause physical
or cognitive impairments that may
require rehabilitation to regain
motor, sensory, visual-perceptual, cognitive, balance and behavioral functions.
Rehabilitation can help patients with
TBI return to their previous level of ability for home, school and work life.
What is a traumatic brain injury?
The brain is a mass of soft tissue
that floats in fluid within the skull.
When there is a sudden bump, blow or
jolt to the head, the “floating” brain can
be thrown forward and back, resulting
in a traumatic brain injury. The degree
of damage to the brain depends on
Concussion
A concussion is a mild TBI that most
often is the result of a fall or a blow to
the head. Concussions are also common
among people who participate in contact and collision sports, even in athletes
who wear protective helmets. Most concussions occur without loss of consciousness, and symptoms may not appear for
hours or days following the injury.
Symptoms of Mild to Moderate TBI
Physical symptoms may include
headache, nausea or vomiting, fatigue
or drowsiness, difficulty sleeping or
sleeping more than usual, and dizziness
or loss of balance.
Sensory symptoms may include
blurred vision, ringing in the ears, a bad
taste in the mouth, changes in the ability
to smell, and sensitivity to light or sound.
Occupational therapist
Anjum Lone, left, works
on an exercise with patient
Jan Pierre Chavez to
improve visual memory
and concentration.
Cognitive problems may include
difficulty:
•Concentrating
•Processing and understanding
information
•Remembering
•Prioritizing
•Problem-solving
•Organizing
•Learning new information
Rehabilitation
A medical doctor specializing in
physical medicine and rehabilitation,
called a physiatrist, oversees the entire
rehabilitation process, manages medical rehabilitation problems, and prescribes medication as needed. Physical, occupational and speech therapists
offer rehabilitation services focused on
improving a patient’s ability to perform
activities of daily living. In addition,
the interdisciplinary rehab team may
include neuropsychologists, vocational
counselors and recreational therapists.
Occupational Therapy
An occupational therapist views patients
holistically, evaluating and analyzing all
aspects of their ability to perform activities of daily living. For these patients,
packing a book bag, gathering items
for meal preparation or simply locating
an article in a shopping aisle can cause
frustration and confusion.
The occupational therapist helps patients
re-learn activities such as bathing, dressing and grooming and may recommend
assistive equipment. Structured activities are used to improve a patient’s range
of motion, strength, and gross and fine
motor coordination. To offset disruption
in sleep patterns and decreased energy,
the OT teaches ways to conserve energy and balance periods of work and rest.
For patients with TBI who have problems with higher level functions such
as planning, organizing, abstract reasoning, problem solving, time management and judgment, an occupational
therapist might suggest simple routines
and schedules to help the patient regain
independence. Devices such as electronic technology, memory books or
checklists may be incorporated.
Patients often have trouble with social
interactions and may withdraw from
family and friends. Those around them
may think that they lack motivation or
initiative. Recognizing social unease
early on can help prevent isolation and
serious depression. The therapist may be
able to suggest ways for family members
to cope with such behavior changes and
raise their tolerance for frustration.
Physical Therapy
When a TBI occurs, the neck absorbs
the impact and twists. For six months or
more following a TBI, this trauma to the
neck may cause dizziness and imbalance. A physical therapist assesses the
neck injury and focuses treatment on
reducing pain and restoring mobility
and balance.
Along with neck pain or strain, damage
to the cervical spine (the upper seven
vertebrae that support the neck) can
decrease a person’s ability to turn his
head and may cause a “spacey” feeling. Using gentle muscle energy techniques and stretching, the physical therapist works to normalize mobility and
also provides training to help the patient
reorient awareness of his body in space.
If the function of the vestibular system
(the balance system in the inner ear) is
disrupted, it can cause a change in a
person’s gaze or focus. A physical therapist helps improve vestibular function by having the patient do exercises
in which he gazes at a target while his
head moves.
If the calcium crystals located in the
inner ear are displaced by a TBI, dizziness and/or extreme vertigo may occur
upon movement of the head. The therapist may perform relocation maneuvers
to move the crystals back to their normal position.
A TBI can also affect an individual’s balance when walking. There may be difficulty with turning or stepping on or off
a curb, fear of falling, or a need to hold
onto furniture or a wall while walking.
Balance therapy may include exercises
to decrease sway, weight-shifting activities to reduce the risk of falling, and
dynamic activities to improve safety,
such as walking, turning, reaching overhead and bending over.
Phelps Today
7
Speech Therapy
A speech therapist helps patients with
TBI by breaking down language into
short segments so that understanding is
assured. The patient is taught to ask the
speaker to repeat what he or she is saying, to use different words or to speak
more slowly. A speech therapist may discuss a subject with a patient using an
outline so that the patient can maintain
focus and stay on topic. Lastly, communication aids such as pictures or words
organized by topic (e.g., the weather) help patients respond to questions
when the speed of word retrieval has
been slowed.
How the Pieces Fit Together
Following a consultation with a physiatrist, patients with TBI benefit from
combined occupational, physical and
speech therapies. For example, if a
patient wanted to buy a present at a
department store for his wife’s birthday, the physical therapist would
a d d r e s s t h e i s s u e s o f p hy s i c a l
mobility, balance and strength that
would be needed for the patient to
travel to the store, purchase the gift
and travel home. The occupational
t h e ra p i s t m i g h t a s k t h e p a t i e n t
to map out the route and sequence
the steps involved in purchasing
a gift. The speech pathologist would
help the patient retrieve the words
he would need to ask the clerk in the
store for the desired item.
If you or a loved one
requires rehabilitation
following a mild or
moderate traumatic brain
injury, contact Phelps
Memorial Hospital at
366-3700 or 366-3010.
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Phelps Today
Wei Angela
Liu, MD, has
been Medical
Director of
the Physical
Medicine and
Rehabilitation
Department at
Phelps since
2013. She is
an academic
physician in rehabilitation medicine
and a faculty member at New York
University Medical Center. Dr. Liu
earned her medical degree at NYU
School of Medicine. She subsequently completed an internship in internal
medicine at NYU Medical Center and
a residency in rehabilitation medicine
at the world-renowned Rusk Institute
of Rehabilitation, where she was selected as chief resident. Dr. Liu has expertise in treating patients with back, neck
or joint pain, sports injuries, arthritis,
stroke and neuromuscular disease, as
well as patients in need of cardiac and
pulmonary rehab. She currently has
practices at Phelps Memorial Hospital
and the Rusk Institute. 914-366-3757
or 914-366-3700.
Puja
Agarwal, PT,
DPT, is
Manager of
Physical
Therapy. She
has been a
PT since 1994.
In addition to
having training and experience with concussion and traumatic
brain injury patients, she has certification in early intervention (EI) services
for infants and toddlers, vestibular
rehabilitation and Lee Silverman Voice
Training for patients with Parkinson’s
disease. 914-366-3700.
Judith
Christopher,
PhD,
CCC-SLP,
has been the
Director of the
Donald R. Reed
Speech &
Hearing Center
at Phelps for
21 years. With
more than 40 years of clinical experience, Judith received her doctorate
from the Graduate School of Arts and
Sciences, Columbia University. Her
area of clinical interest is adult voice
and swallowing disorders, and includes
certification in LSVT (Lee Silverman
Voice Training). She is currently
providing clinical swallowing consults
to patients diagnosed with head and
neck cancer. 914-366-3015.
Anjum Lone,
OTR/L, CHT,
Manager of
Occupational
Therapy, has
more than
30 years of
experience as
an occupational
therapist in
a variety of
settings, including inpatient rehab at
the Brain Trauma Center at JFK Medical Institute in Edison, NJ. She has been
employed at Phelps since 1996, specializing in the field of hand therapy.
Anjum trained at the Welsh School of
Occupational Therapy in Wales, Great
Britain. 914-366-3700.
Misuse and Abuse
of Prescription Drugs
Among Teens
By Michael McCormick, MD, and Imaan Chowdhury, MD
Last year, The Partnership at DrugFree.org and the
MetLife Foundation reported that the recreational use
of prescription drugs among teenagers had increased
33 percent in the five years between 2008 and 2013 to a
point where one in four teens has misused or abused
a prescription drug at least once in his or her lifetime.
These vignettes from kidshealth.org
point out several of the reasons for the
upward trend of prescription drug use
among our children:
•The attitudes and misconceptions
of teens
•The attitudes and behaviors of
their parents
•The increasing availability of
these medications
Kids’ Attitudes and Misconceptions
Young people take drugs for many
reasons: They want to be cool. They want
to fit in. They think drugs will help them
lose weight, stay awake or get some
sleep. They feel that the stimulants will
help them get better grades. Sometimes
they are pressured to use drugs by their
peers. Sometimes they have real physical
or emotional pain and don’t know where
to find help.
Why the Increase in Prescription
Drug Abuse?
“Angie overheard her parents talking
about how her brother’s ADHD medicine was making him less hungry.
Because Angie was worried about her
weight, she started sneaking one of her
brother’s pills every few days.”
Teens who are prescribed pain pills
following a sports injury or who innocently take a pill that is passed around
at a party can develop a physical dependency to the pills in a surprisingly short
period of time. No amount of education
or pleading can stop the neurochemical
process of addiction from happening.
“Todd found an old bottle of painkillers that had been left over from his
father’s operation. He decided to try
them. Because a doctor had prescribed
the pills, Todd figured that meant they
were safe.”
Prescription drug abuse has been
normalized in the teen subculture. It’s
talked about as freely and openly (with
peers, not with parents, of course) as
what was on TV last night or who is no
longer dating whom.
Phelps Today
9
Children and teens tend to believe
that prescribed and over-the-counter
medications must be safe. Otherwise,
why would the doctors and pharmacies
dispense them? Why would their parents have them? In studies, interviewed
teens say they are sure that their parents
would be less angry if they were busted using prescription drugs rather than
street drugs.
Fifty percent of
parents admit that
“anyone”can get into
their meds, and nearly
20 percent do not
dispose of expired or
unused medications.
While 80 percent of teens say that
they had a conversation with their
parents about marijuana and alcohol
in the past year, and 30 percent about
crack/cocaine, less than 15 percent say
that they ever had a discussion at home
about the misuse of prescription meds.
Parents’ Attitudes and Behaviors
It appears that some of what kids say
about their parents is true.
Parents too often fail to effectively communicate the dangers of prescription medication misuse to their kids.
Those parents who have talked to their
children have taken an important first
step, but merely telling children not
to misuse prescription medications is
not enough. A parent’s attitudes and
behaviors send a much more powerful
message than lectures and admonitions.
In fact, 20 percent of parents say that
they have given a prescription drug to
a child of theirs even though it was
not prescribed for that child. Almost
one-third of parents feel that stimulant
drugs like Ritalin and Adderall would
help their children’s attention and
performance in school even if they are
not diagnosed with attention deficit
hyperactivity disorder.
One of every two teenagers says it’s easy
to get meds from a parent’s medicine
cabinet. Fifty percent of parents admit
that “anyone” can get into their meds,
and nearly 20 percent do not dispose of
expired or unused medications.
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Phelps Today
Prescription Drugs Most Available
and Most Abused
Stimulants Ritalin or Adderall are
prescribed to treat attention deficit
hyperactivity disorder (ADHD), which
is defined by the American Psychiatric Association as “a persistent pattern
of inattention and/or hyperactivityimpulsivity that interferes with function or development.” The diagnosis is
complex and is generally based on
an array of behaviors, conditions and
symptoms as observed by a trained
professional.Treatment for ADHD is
behavioral and medical.
Nearly 7 million American children
diagnosed with ADHD have been prescribed one of the amphetamine-like
stimulants Ritalin or Adderall. Alarmingly, one in eight teens who has NOT been
diagnosed with ADHD has taken these
medications without a prescription.
Although the United States makes
up only 4 percent of the world’s population, it uses 70 percent of the world’s
supply of Adderall and Ritalin. Even
toddlers are being prescribed these
stimulants for hyperactivity, a disturbing
trend that could lead to addiction, use of
other drugs and health problems.
The rate of stimulant prescriptions
for college students and other adults is
also increasing at a brisk rate, making
them more easily available in households and on college campuses. The
result is an increase in deliberate abuse
of stimulants and accidental overdose.
Side effects of stimulant medications
include increased blood pressure, respiration and heart rate, constriction of
blood vessels, and increased blood glucose levels. Stimulants can be addictive.
Central nervous system (CNS) depressants, including Xanax, Valium and
Ativan, slow normal brain function.
These tranquilizers and sedatives, which
are used to treat anxiety, panic attacks
and sleep disorders, can be addictive. Combining CNS depressants with
prescription pain medications, certain
over-the-counter cold and allergy medications or alcohol can slow breathing
and heart rate, which in some cases can
be fatal.
Opioids, such as Vicodin and OxyContin, also called narcotics, are prescribed to treat pain. Side effects include
drowsiness, constipation, nausea and
itching. Confusion or dizziness may
also occur. High doses of opioids result
in serious respiratory side effects, which
if severe can damage the body’s organs
and lead to a coma.
Warning Signs of Prescription
Drug Use
•Pupils smaller or larger than usual
•Change in sleep habits
•Change in energy level
•Change in personal appearance
or hygiene
•Change in mood/personality
•Social withdrawal from family
and friends
•Change in friends
•Sudden change in grades
•Loss of appetite
•Defensiveness when asked
simple questions (attempt to
hide a drug dependency)
Prevention…What Can We Do
as Parents?
Kids who start abusing drugs when
they are young are more likely to have
an addiction problem as adults. Parents
should do all that they can to help
their children make good decisions
about drugs.
•Realize what a huge influence
you have on your kids and set an
example you’d like them to follow.
•Love your children. Nurture a
relationship in which they feel safe
talking about what’s going on in
their lives and sharing anything
that is bothering them.
•Tell your children about the risks
of drugs, and be clear about how upset
you would be if they abused them.
Kids who are well informed about
the risks are up to 50 percent less
likely to use drugs.
•Set reasonable expectations
and boundaries for your children’s
behavior. If there is a problem, take
a stand and take charge.
•Encourage your children to participate
in sports and/or academic or
social activities.
•Know your teen’s friends and
their parents.
•If narcotic, stimulant or depressant
medications are kept in your home,
make sure that they are stored
securely . . . not in the family medicine
cabinet. Monitor the number of
pills you have.
•Dispose of any medications that are
no longer needed or used.
•Support community and school based drug prevention meetings
and programs.
•Utilize professional help
when needed.
Michael McCormick, MD, practices
family medicine and is a Phelps
Medical Associates physician.
Board certified in family medicine,
he earned his medical degree at
St. George’s University School
of Medicine and completed an
internship and residency in
family medicine at JFK Family
Practice in New Jersey. His practice
is in Ossining (914-373-4948).
Drugfree.org has support, tools, resources and answers.
Dispose of
Unused
Medications
Carefully
Unused medications can
be disposed of at most
local police stations.
Medications should not
be flushed down the toilet
or poured down the drain,
because they can taint
local rivers and streams.
Imaan Chowdhury, MD, practices
internal medicine and is a Phelps
Medical Associates physician.
She received her medical degree
from Ross University School of
Medicine and completed a
residency in medicine at Brookdale
University Hospital and Medical
Center. She sees patients in Dobbs
Ferry (914-478-1384) and in the
Senior Health and Internal
Medicine practice on the Phelps
campus (914-366-3677).
Phelps Today
11
Ergonomics: Making Your
Workstation Work for You
By Shannon Clearwater, OTD, OTR/L, CHT, CEAS II
Ergonomics is a term that is thrown around quite a
bit these days. But what exactly is it? Ergonomics
is the applied science of equipment design intended
to reduce worker fatigue and discomfort.
The top of your
computer screen
should be at or just
below your eye level
and about 18-30 inches
away from your face.
Occupational therapist Shannon Clearwater measures the distance between
a patient’s face and a computer screen.
12
Phelps Today
Workstation Ergonomics:
Ideal Set-Up
Top of monitor at
eye level or just below
I
n simple terms, ergonomics means
fitting your workstation to your
needs, not trying to fit yourself into
a one-size-fits-all workplace. If you
have a poor ergonomic set-up in
your work area – whether you work
at home or in an office outside the
home – it can potentially lead to conditions such as carpal tunnel syndrome,
tennis elbow, tendonitis or neck or
back pain.
How do we improve a workstation so
that by the end of the day our bodies are
not riddled with discomfort and pain?
Let’s start with some basics of why people who work at a desk find themselves
in pain.
One of the biggest causes of injuries at a
computer workstation is poor posture.
Observe other people in your work
area. You probably see slumped shoulders, necks extending forward, bent
wrists and awkward positions. While
you’re working, your shoulders should
be relaxed, and your neck and wrists
should be in a neutral position. For
the neck, this means your head should
be aligned above your shoulders, not
jutting forward. Your wrists should be
fairly horizontal, with your hands resting
on the keyboard, not bent up or down.
Your elbows should rest at your sides at
about a 90 degree angle.
Another risk factor for injury is repetitive motion. How many keystrokes
have you done by the end of the day?
How many times have you reached for
the phone? Repetitive motions, especially if you have poor posture or are sitting
in an awkward position, can be extremely detrimental to your body.
When evaluating your workplace, it’s
easiest to start with the chair. First,
learn how to adjust your chair (height,
seat depth, arm rests, angle of the backrest, etc.). Set the seat height so that your
thighs are nearly parallel with the floor.
A backward lean of the backrest of 10-15
Monitor roughly
arm’s length away
Back
straight
Elbows
close to
body
Backrest
supporting
lower back
90°120°
Minimal
bend
at wrists
Document
holder
90°120°
Adjustable
swivel chair
Front of seat not pressing
on back of knees
Feet flat on ground
or resting on footrest
degrees is acceptable and will take some
of the pressure off of your lower back.
Your feet should rest flat on the floor.
Where your keyboard should be placed
depends on your height. To determine
the ideal location, sit at your desk, relax
your shoulders, and bend your elbows to
90 degrees. Where do your hands fall?
If you are under 6 feet tall, your hands
probably fall below your desk. If so, the
keyboard is too high for you and you
need to adjust the height of your chair
to accommodate for this difference.
If you raise your chair in order to type
correctly and your feet are dangling,
a simple solution is a foot rest. If you
have raised your chair as high as you can
and the keyboard is still too high, you
may need to consider attaching a keyboard tray underneath your desk.
The mouse should be placed directly
next to your keyboard and on the same
level to reduce any excessive reaching.
You should not have your keyboard on
a tray and your mouse up on the desk.
When moving the mouse around, use a
full arm motion. Isolating the motion of
the mouse to the wrist alone can put you
at risk for injury.
The computer monitor is another
adjustable part of the workstation. The
top of your computer screen should
be at or just below your eye level and
about 18-30 inches away from your face
(depending on your vision). If you are
experiencing neck pain or headaches,
be sure to check the height of your monitor. If you find that your eyes are dry
or fatigued at the end of the day, your
screen may be too high. This happens
because when the screen is too high, you
blink about 50% less than you should.
Screen glare can be reduced by placing a filter over the screen or adjusting
the location of the monitor in relation to
windows and lights in your work area.
An occupational therapist can help
you identify problematic areas in
your work area and teach you how
to prevent injuries. If you feel that you
would benefit from such intervention, the first step is to see your doctor
and obtain a prescription for occupational therapy. To reach the occupational
therapy department at Phelps, call
(914) 366-3700.
Shannon Clearwater, OTD, OTR/L,
CHT, CEAS ll, has been an
occupational therapist at Phelps
since 2007. She received her master’s
degree in occupational therapy from
Dominican College and her doctorate
of occupational therapy from the
University of St. Augustine for Health
Sciences. Shannon became a Certified
Ergonomics Assessment Specialist
through the Back School of Atlanta
in 2010 and achieved Level 2 of this
certification in 2013. She became
a Certified Hand Therapist (CHT)
in 2012.
Phelps Today
13
Bronchiolitis: A Respiratory
Illness in the Very Young
By Julie Sylvester, DO
Bronchiolitis is a common respiratory illness
that primarily affects infants and children under
two years of age. It is caused by a virus such as
Respiratory Synctial Virus (RSV), adenovirus,
human metapneumovirus, influenza virus or
parainfluenza virus, and is most common from
October through March.
Pediatric hospitalist
Julie Sylvester, DO,
visits 11-month-old
patient John Knight.
14
Phelps Today
T
he virus causes swelling of
the small airways of the lungs
(bronchioles) and increases the
production of mucous. This blocks
air movement through the lungs and
makes it difficult to breathe.
Bronchiolitis is more common in young
infants and children because their
airways are smaller and more easily
blocked than the airways of older children and adults. If adults have RSV, their
symptoms are mild and similar to the
common cold.
Bronchiolitis typically lasts up to seven
days, with the worst symptoms occurring on day three or four of the illness.
In young children, bronchiolitis often
starts with cold symptoms, such as
a runny nose, mild cough, nasal congestion and fever. After a few days, the
cough may get worse and the child may
begin to breathe faster, have difficulty
breathing and begin to wheeze. These
symptoms can be scary both for parents
and children.
When to Seek Medical Attention
If you see any of the following signs, you
should seek medical attention. Promptly bring your child to your pediatrician
or the Emergency Room:
In young children,
bronchiolitis often
starts with cold
symptoms, such as
a runny nose, mild
cough, nasal
congestion and fever.
•Flaring or widening of the nostrils
and pulling in of the abdomen under
the rib cage
•Grunting and tightening of the
stomach muscles while breathing
•Making a high-pitched whistling
sound, called a wheeze, with
each breath
•Difficulty drinking and eating
•A bluish tint around the lips
and fingertips
Bronchiolitis may cause more severe
illness in children who also have a
chronic illness such as congenital heart
disease. If you think your child has bronchiolitis and he or she has a chronic illness, call your pediatrician immediately
or go to the Emergency Room.
Know the Signs of Dehydration
While your child has bronchiolitis, it is
very important to prevent dehydration,
which may occur if your child cannot
comfortably drink fluids. Call your pediatrician if your child develops any of the
following signs of dehydration:
•Drinking less than normal
•Dry mouth
•Crying without tears
•Urinating less often than normal
RSV and many other respiratory viruses are spread by direct contact with
an infected person’s mucous or saliva,
such as during coughing and sneezing.
It is easily passed among family members
and children in daycare centers. To prevent the spread of illness, it is very important to wash your and your child’s hands
frequently, especially after coughing
or sneezing.
Julie Sylvester, DO, is a full-time
pediatric hospitalist at Phelps.
She is board certified in pediatrics
and a Fellow of the American Academy
of Pediatrics. Dr. Sylvester cares for
children who are admitted to the
pediatric inpatient unit and is available
for consultations on pediatric patients
in the Emergency Department.
Dr. Sylvester received her medical
degree and completed an undergraduate fellowship in osteopathic manipulative medicine from the New York
College of Osteopathic Medicine. She
completed her residency in pediatrics
at Schneider Children’s Hospital of
the North Shore-Long Island Jewish
Health System, where she was also
chief resident. Following her residency,
Dr. Sylvester remained at Long Island
Jewish Medical Center, working in
the pediatric urgent care center and
outpatient pediatric division. Prior to
joining Phelps, Dr. Sylvester was a
hospitalist in the newborn nursery at
the Wakefield Division of Montefiore
Medical Center.
Dr. Sylvester, who speaks Spanish,
was born at Phelps and grew up in
Ossining, NY. She recently returned
to Westchester with her husband and
three children.
Phelps Today
15
Central Auditory
Processing Disorders
Helping the Brain to “Hear”
Perry is a 10-year-old boy who was struggling
academically in school, despite having received
years of school-based interventional services.
In addition, Perry’s difficulty with
following directions, poor recall of
auditory information, and reading and
writing weaknesses suggested that he
might have a central auditory processing disorder. He was referred to one of
the center’s audiologists for evaluation.
The results indicated that the auditory centers in his brain had not matured
appropriately for his age. He had difficulty integrating auditory information (such
as recognizing that the written letter “b”
makes the sound “buh”) and separating
competing auditory information (such as
being able to hear the teacher’s spoken
instructions over the hustle and bustle of
a busy classroom).
H
e’d been to a neurologist, a
developmental pediatrician, a
psychologist, and an ophthalmologist, but none was able to determine the nature of his problem. He was
diagnosed with mild Attention Deficit
Disorder and short-term memory issues,
but neither of these could account for the
severity of his academic problems.
16
Phelps Today
Th e n Pe r r y wa s r e f e r r e d t o t h e
Donald R. Reed Speech and Hearing
Center at Phelps for a comprehensive language evaluation by a speechlanguage pathologist. The results indicated that he had significant language
delays, which had not been previously
identified. Intensive speech-language
therapy was recommended.
The audiologist made recommendations to improve Perry’s access to
auditory information in the classroom.
Whenever possible he is seated in
the front of the room. He uses an FM
system: Perry wears wireless headphones
and his teachers wear a microphone,
so their speech is delivered directly to
him. His teachers also check with him
periodically to ensure comprehension
and use visual cues such as hand gestures while speaking.
Today, Perry receives speech-language
therapy services in school and benefits
from these listening modifications in the
classroom. He has made great strides in
reading and writing, and his teachers and
parents are thrilled with his progress.
What Is a Central Auditory
Processing Disorder (CAPD)?
Central auditory processing refers to
how a person’s central nervous system
receives and processes sounds. Incoming
sounds must be analyzed by the brain in
order for them to be understood.
Disorders that
may be confused
with or coexist with
auditory processing
disorders include
attention deficit
hyperactivity disorder
(ADHD), autism,
dyslexia, and learning
or language disorders.
There is no specific cause for a central
auditory processing disorder (CAPD), but
some of the possible causes are a trauma,
a viral infection or a neurological condition. Auditory processing problems in
children resulting from delayed development of the auditory centers in the brain
may resolve as the child matures. Disorders that may be confused with or coexist with auditory processing disorders
include attention deficit hyperactivity
disorder (ADHD), autism, dyslexia, and
learning or language disorders.
The diagnostic process begins with
a complete audiological evaluation
to rule out hearing loss. If no hearing loss
is detected, the audiologist will administer a number of behavioral tests.
A child with a central auditory processing disorder may have normal hearing
but may:
1.Changing the child’s learning environment to improve his or her access
to auditory information. Examples of
this approach include:
•Have poor listening skills
•Be easily distracted by surrounding
or irrelevant stimuli and background
noise
•Have difficulty following verbal
directions
•Have a short attention span
•Have poor short-term and
long-term auditory memory
•Be unable to pay close attention
to detail
•Have difficulty processing, sequencing
and integrating units of information
•Have difficulty telling the
difference between similar
sounding words (bat/cat)
Diagnosis of CAPD
To diagnose CAPD, a multidisciplinary
team approach – including audiologists, teachers, psychologists, speechlanguage pathologists, and parents – is
crucial. A thorough case history, academic profile, and descriptions of school
and home behaviors provide important
information regarding a child’s strengths
and weaknesses.
Specialized testing is typically administered by an audiologist to children
who are at least seven years old.
Treatment
Once a child has been diagnosed with
CAPD and the nature of the deficit has
been identified, individualized management and treatment activities will be recommended. One or more of the following three measures may be implemented:
•Having the teacher speak clearly
and rephrase what has been said
•Seating the child closer to
the teacher
•Having the child use an assistive
listening device that enhances
relevant auditory information over
surrounding noise
•Reducing classroom noise
•Providing visual aids to supplement
auditory information
2. L anguage therapy provided by
a speech-language pathologist to
strengthen a child’s cognitive-linguistic skills needed for problem-solving,
memory and attention.
3.Auditory training provided by an
audiologist to improve a child’s ability to identify the origin of a sound,
differentiate spoken words and focus
listening when in a noisy environment.
Testing and treatment for central
auditory processing disorders are offered
at the Donald R. Reed Speech & Hearing
Center. A physician referral is required.
For information or to schedule an
appointment, call 914-366-3010.
Phelps Today
17
18
Phelps Today
Keith Safian Celebrates 25 Years
as Phelps President and CEO
Phelps marked a significant milestone this summer,
when Keith Safian celebrated his 25th year as
President and CEO. Under his leadership, Phelps
has grown to become a leading healthcare provider
and major economic force in Westchester County.
P
helps is one of very few profitable
hospitals in New York State, operating in the black in all but one of
the past 25 years. Since 1989, when Mr.
Safian was hired, the operating budget
has increased from $40 million to $245
million in 2014.
Over the same time period, the hospital
staff has grown from 800 employees
to more than 1,700, making Phelps the
7th largest employer in Westchester
County, up from 50th. Since 1989,
the number of physicians on staff at the
hospital has grown from 189 to 503.
The campus facilities have doubled in
size, with the addition of two medical
services buildings, a parking garage,
and a new emergency department that
is triple the size of the previous one.
The emergency department, which
integrates the latest technology with a
design that enhances patient comfort
and privacy, has served as a model for
emergency department improvements
at other community hospitals in Westchester and beyond.
A new surgical operating suite called
the SurgiCenter is nearly complete and
scheduled to open this fall. It will occupy an entire floor of the newer medical
services building and be connected to
the main hospital by an enclosed bridge.
The SurgiCenter will be the first operating suite in New York State for both inpatients and outpatients to be located in a
building of this kind.
Plans have been developed for a new
main lobby and MRI suite as well as a
patient tower that will feature private
patient rooms that can be adapted to the
severity of a patient’s illness.
During Mr. Safian’s tenure, Phelps
became a teaching hospital with the
establishment of residency training
programs for family medicine and
dental residents, both in partnership
with New York Medical College and
Open Door Family Medical Centers.
The programs provide an extraordinary
training environment for 24 residents.
Mr. Safian has made several key business
decisions that continue to benefit the
hospital and the community. In 1995, an
unprecedented affiliation with Memorial Sloan-Kettering Cancer Center
(MSKCC) made Phelps the first nonManhattan location for MSKCC radiation
therapy and medical oncology. Several
years later, the hospital leased 21 acres of
its 69-acre campus for the building
of Kendal on Hudson, a not-for-profit
continuing care retirement community
that is home to 300 residents.
Under Mr. Safian’s direction, Phelps
has been at the forefront of information technology. He supported early
implementation of electronic medical
records, and Phelps has achieved Stage 6
designation by the Healthcare Information and Management Systems Society
(HIMSS), which recognizes the highest degree of clinical automation to
support patient safety and quality
outcomes. Less than 3% of U.S. hospitals
have achieved this designation. The staff
of Phelps Medical Associates, the hospital’s multi-specialty medical group,
also use electronic medical records
in their offices.
With a focus on patient satisfaction,
the hospital adopted its “culture of
kindness” over a decade ago. Phelps has
differentiated itself from other hospitals in
New York with its “Hospitality” program
and on-demand “room service” dining.
The Child Care Council of Westchester
recently recognized Mr. Safian as a
“Champion for Children” for his support of Phelps’ onsite childcare center,
Robin’s Nest, which was established in
1988 as the first “corporate” childcare
center in Westchester. A $1.4 million
expansion last year increased the center’s capacity to help accommodate the
additional childcare needs that Westchester’s economic growth will create.
Mr. Safian earned BS degrees in electrical and industrial engineering
from the University at Buffalo (SUNY),
followed by an MBA from the Wharton
School of the University of Pennsylvania.
He has been a healthcare administrator
throughout his career and is a fellow
of the American College of Healthcare
Administrators.
Phelps Today
19
Phelps Medical Associates News
Patient Advisory Council Formed
Thirteen patients of Phelps Medical
Associates primary care physicians have
joined the group’s new Patient Advisory
Council to help identify ways to optimize
the overall experience of visiting a doctor.
The council, chaired by practice managers
Julissa Vargas and Dominic Paruta, met
for the first time on June 6. The patient
members who were nominated by their
primary care physicians, offered feedback about their own experiences
and brainstormed with the managers
to develop solutions for improvements.
At their first meeting, the group talked
about customer service, patient access
to providers and even the state of healthcare today. Meetings will take place
quarterly. In the meantime, Phelps Medical
Associates staff and council members will
be working further on the solutions that
were discussed.
The formation of a patient advisory council
is one of the goals of the governmentfunded program Comprehensive Primary
Care Initiative (CPCI), in which the Phelps
Medical Associates primary care practices
have participated since 2013.
Patients to Be Surveyed
In its continuing efforts to meet the needs
of its patients, Phelps Medical Associates
will soon be surveying patients through
Press Ganey, the national healthcare performance improvement organization.
What patients report on their surveys will
help our practices provide ever better care.
Pharmacist Provides Medication
Management
Services
Pa t i e n t s o f
Phelps Medical Associates
physicians are
n ow a b l e t o
have in-person
or phone consultations with Dara Becker, RPh
a dedicated
pharmacist to discuss their medications.
This medication management service,
provided by pharmacist Dara Becker,
RPh, PharmD, is appropriate for
p a t i e n t s wh o a r e t a k i n g m u l t i ple medications, have several medical conditions, are seeing more than
one healthcare provider, or are having
difficulty taking their medications as
instructed. The pharmacist will review
a patient’s medications and explain
their function, provide advice on
ways to reduce cost, and develop a medication action plan of recommendations for patients to
self-manage their medications at home.
To set up an appointment with the
pharmacist, contact the office of your
Phelps Medical Associates physician.
New Physicians
Neurologist
Paul Lleva,
MD, is board
certified in internal medicine
and neurology.
He received his
medical degree
from the University of Santo Paul Lleva, MD
Tomas in the
Philippines. He then completed an internship in internal medicine, a residency in
neurology, and a fellowship in vascular
neurology, all at New York Medical
College. He is seeing patients in Suite 417
of the 755 Building on the Phelps campus
(914-366-5330).
Cardiologist Jay Doshi, MD, is board
certified in internal medicine. He
received his medical degree from New
York University School of Medicine. He then completed a residency in internal medicine at North
Shore University Hospital-Manhassat.
He was fellowship trained in both
cardiovascular disease at New York
Medical College and cardiac
electrophysiology at Montefiore Hospital and
Medical Center. He is seeing
patients at the
cardiology practice in Briarcliff
(914-762-5810). Jay Doshi, MD
Wellness Minute on WXPK
Phelps is currently sponsoring a health series called the “Wellness Minute” on
WXPK “The Peak” radio (107.1 FM), providing listeners with health information from
Phelps medical experts. If you have a medical question that you would like answered,
go to phelpshospital.org and click on “The Wellness Minute” in the left-hand column.
20
Phelps Today
Vitality for Seniors and the Community
Participation is increasing in Phelps “Vitality,” which
promotes health and wellness in the community and
offers programs and services that focus on the physical,
social and intellectual aspects of aging. Vitality also
aims to increase the quality and efficiency of healthcare
for older adults and supports aging-in-place initiatives.
I
n May, Phelps recognized National
Older Americans Month with
Vitality Day. Seniors enjoyed a full
day of activities, starting with Tai Chi
led by well-known Tai Chi instructor
and author Dr. Robert Chuckrow.
Rose T. Ellis, a well-being consultant, demonstrated some easy-toprepare recipes, including massaged
kale salad and healthy banana bread.
Phelps Hospitality Manager Andrea
Hodges talked about how patients
appreciate amenities and services offered
by the Hospitality Department – a fact
confirmed by several attendees who had
experienced Hospitality’s TLC first-hand.
The award-winning PBS documentary
Age of Champions, which follows five
competitors, ages 88 to 100, sprinting,
leaping and swimming for gold at the
National Senior Olympics, was an inspiration to all.
doubled in size since it first opened three
years ago. In addition to fresh fruits and
vegetables, customers are happy to
find fresh cheeses, yogurt and international prepared foods like samosas and
falafel. There is a wide array of choices
for all different tastes. The market will
be open Thursdays from 11 am to 3 pm
through October.
Hudson Valley is home to the historic
Sleepy Hollow Cemetery, which is listed
on the National Register of Historic
Places and is the final resting place of
noted author Washington Irving. On
Thursday, October 2 at 10:30 am in the
Phelps auditorium, the cemetery historian will give a special presentation on
the history of this famous burial ground.
A gourmet lunch prepared by Phelps
Executive Chef Jennifer Angel and
scrumptious desserts from Hospitality
topped off a wonderful day.
Seniors learn healthy recipes at Phelps Vitality Day.
In recognition of National Fall Prevention Awareness Day on September 23,
Phelps will host a series of events focusing on balance, equilibrium, fall prevention and osteoporosis. For more
information, contact Ellen Woods at
914-366-3937 or [email protected].
This year finds the Phelps Farmers Market
in a new location – on the hospital
campus in the parking lot opposite the
755 building. The market has more than
Phelps Farmers Market
Phelps Today
21
e a lt h y l i f e c a l e n d a r
PHELPS
Healthy Life Calendar
Fall 2014
September
Tuesday, September 9, 2014
Better Breathers Club –
Pulmonary Fibrosis
Support Group
The Pulmonary Fibrosis Support
Group welcomes those with pulmonary
fibrosis to learn and share with others.
A light lunch will be served.
Susan DiFabio, RT
Education Coordinator for Phelps’
Pulmonary Rehabilitation Program
12 – 1 pm; Pulmonary Lab (B Level)
Registration is required.
Call (914) 366-3712 to register.
Thursday, September 18
and Mondays, September 22
and 29
Prostate Cancer Screenings
Jack Hershman, MD
September 18, 22 and 29
9 am – 12 pm
Arno Housman, MD
September 22 and 29
5 – 8 pm
Appointments are required;
no walk-ins. For an appointment
call (914) 366-3220.
Tuesday, September 23, 2014
National Fall Prevention
Awareness Day
A day of activities promoting fall
prevention that is geared toward
seniors. The day will include balance
screenings, osteoporosis education
and home safety tips.
For more information,
call (914) 366-3937.
Thursday, September 25, 2014
Sleep Well Support Group
Do you or a loved one have a problem
sleeping at night? Are you having difficulty with the treatment for your sleep
disorder? The Sleep Well Support group
provides an opportunity for people with
sleep disorders and their family members to come together to share experiences and learn about sleep disorders
and treatment options. The group meets
every other month and is free to attend.
7 - 8:30 pm
Family Medicine Residency Conference
Room, 755 Building, 4th floor
Call (914) 366-3755 for questions
or to attend.
October
Saturday, October 4, 2014
CarFit for Older Driver Safety
An individualized 20-minute educational session for older drivers,
designed to improve the “fit” of their
22
Phelps Today
cars for safety and comfort, promote
conversations about safe driving, and
link drivers with local resources to
enable them to continue driving for
as long as safely possible. The trained
CarFit team, Phelps’ Occupational
Therapy Department, will work with
participants to help ensure a clear line
of sight over the steering wheel, proper
seat belt use and fit, and safe positioning of mirrors to minimize blind spots.
9 am until noon (rain or shine)
Phelps parking garage.
Appointments are required.
Call (914) 366-3705 to schedule.
Monday, October 6, 2014
Yoga for Singers
If you’re a singer, learn how yoga can
help you release tension, stay “in the
moment,” and breathe with ease and
control so you can have a freer voice.
Bring a yoga mat. Space is limited.
Leah Ross-Kugler, MS, CCC-SLP
6:30 – 9 pm
C Level Classroom
Thursday, October 9, 2014
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.
Andrea Bracciante-Ely, MS Sp,
CCC-SLP
Senior Speech-Language Pathologist
10:30 – 11:30 am
Walkway Conference Room
Tuesday, October 14, 2014
Better Breathers Club
Learn about the American Lung
Association’s new nationwide
campaign for individuals with lung
disease. A light lunch will be served.
Serena Arrabito-Joo
Development Director,
American Lung Association
If so, call for a free speech-language
screening with an experienced pediatric speech-language pathologist.
12 – 1 pm; Pulmonary Lab (B-Level)
Kim M. Ventimiglia, MS, CCC-SLP
Pediatric speech-language pathologist
Tuesday, October 14, 2014
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)
Lung Cancer After 70
Dr. Avraham Merav, Director of the
Westchester Lung Nodule Center,
will discuss lung cancer screening
and treatment recommendations for
individuals 70 and older – a population
at high risk for the disease.
Avraham Merav, MD
Chief of Thoracic Surgery and Director
of the Westchester Lung Nodule Center
6:30 – 7:30 pm; Auditorium
A light dinner will be served at
6 pm in the Boardroom.
Friday, October 17 and
Speech-Language Screenings
for Preschool Children
Are you concerned about your child’s
speech and language development?
October 17: 10:30 am – 12 pm
October 23: 1 – 2:30 pm
Donald R. Reed Speech & Hearing
Center at Phelps
777 North Broadway, Suite 303
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 – 11 am
Walkway Conference Room
Monday and Tuesday,
October 27 and 28, 2014
Defensive Driving
This two-evening certification
program lowers insurance premiums,
reduces violation points and sharpens
driving skills.
Robert Fogel
5:30 – 8:30 pm; Auditorium
Fee: $45
Monday, October 27, 2014
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 the cough.
Craig H. Zalvan, MD
Laryngologist, Medical Director of
the Institute for Voice and Swallowing
Disorders at Phelps
8:45 – 10 am
Treatment and Management
of Snoring and Sleep Apnea
Dr. Michael Bergstein, Surgical
Director of the Phelps Sleep Center,
will discuss the causes and diagnosis
of sleep apnea and how snoring and
sleep apnea can be managed.
Michael Bergstein, MD
Otolaryngologist, Surgical Director of
the Phelps Sleep Center
7 pm; Auditorium
November
Wednesday, November 5, 2014
You Say “tinn-I-tis” and
I Say “TINN-i-tis”
Grandma says that buzzing in your ear
means someone is talking about you,
but what does it really mean? Where do
those sounds in your head come from?
Should you be worried? Learn about
the various causes of tinnitus and some
techniques to reduce the stress often
associated with head noises.
Meryl Epstein, MA
Professional Training Audiologist,
Widex USA
Phelps Today
23
Susan D. Reilly, MS, CCC-A
Coordinator of Phelps
Audiology Services
10 am – 11:30 am; Auditorium
Tuesday, November 11, 2014
Screening for Snoring and
Sleep Apnea
Do you snore? Attend this screening
to learn if you are at risk for obstructive sleep apnea. The exam will include
a complete history evaluation and an
examination of the ear, nose and throat.
Michael Bergstein, MD
Otolaryngologist and Surgical Director
of the Phelps Sleep Center
9 – 11 am
Tuesday, November 18, 2014
Does shortness of breath run in your
family? Were you diagnosed with
emphysema at an early age? Join the
Better Breathers Club for a discussion
of alpha-1 antitripsin deficiency.
Nicole Incanno, MS,
Alpha-1 antitripsin specialist,
Grifols Biotherapeutics
12 – 1 pm; Pulmonary Lab (B Level)
Thursday, November 20, 2014
Urinary Incontinence
in Females
December
Wednesdays, October 1, 8, 15,
22, 29 and November 5, 2014
Tuesday, December 16, 2014
Living Well Program
The Director of Pharmacy Services will
discuss medications for lung disease,
including when and how to take them.
Fred Perino, RPh, MS
Director of Phelps Pharmacy Services
12 – 1 pm, Pulmonary Lab (B Level)
Vitality for
Seniors
Thursdays, September 11,
October 9 and
November 13, 2014
The Breakfast Club
A series of free breakfast meetings
for seniors. Each session includes free
breakfast, a presentation on a healthy
lifestyle topic and a light exercise
program. The group meets monthly,
except in August and December.
8:30 – 10:30 am; Cafeteria (G Level)
Wednesdays, October 1,
November 5 and December 3
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.
Learn about the current treatments for
women with urinary incontinence.
2 – 3 pm; Boardroom (C Level)
Sue Zhou, MD, FACOG
Urogynecologist
Tuesdays, September 16,
October 21, November 18 and
December 16
10:30 am – 12:30 pm; Auditorium
Senior Steps
A program offering health screenings
for seniors, held once a month.
24
Phelps Today
Appointments are required.
A 6-week workshop for individuals 65+
teaches skills needed to self-manage
health, live with chronic conditions,
make better nutrition and exercise
choices, deal with pain and fatigue,
and talk to doctors and family about
health. Co-sponsored by the Westchester County Department of Senior Programs and Services, Northwest Livable
Communities and Westchester Community College.
10 – 12:30 pm; 755 Building,
Room 235
To register, call (914) 366-3937.
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: October 9 and 23, November 6 and 20, December 4 and 18.
Bess Steiger, LCSW
Bereavement Coordinator
2 – 3:30 pm
Hospice Office in the James House
Suggested donation: $10 per session.
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 includes professional hair
and makeup consultations. Attendees
can take home a complimentary
wig and a make-up 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.
Call (914) 366-3315 or (914) 366-3345
to register for an upcoming session on
September 8, October 6, November
3 or December 1.
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.
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
Briarcliff Manor
Bella Maiya Day Spa
Briars Restaurant
Good Food
Manor Wine & Spirits
March Boutique
Paese Pasta & Pizza
Squire’s Steak & Seafood
Terra Rustica
Three Dogs GF Bakery
Tarrytown
Bark & Meow Pet Products
Bella’s Boutique
Coffee Labs Roasters
Elite Hair Design
Family YMCA
Grape Expectations
TGI Friday’s
Heritage Frame
Hudson River Eyecare
Horsefeathers
King Shell Service Center
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
Santa Fe Restaurant
Sunset Cove
The Tapp
Tarry Tavern
Taste of China
Warner Library
w@tercooler
Chappaqua
Kittle House
Croton-on-Hudson
Anton Restaurant
Backstage Salon
Baked by Susan
The Black Cow
Capriccio II
Croton Colonial Diner
DePrez Wines & Spirits
Feed the Birds!
Friends Bar & Restaurant
Giovanni’s Deli & Pastries
Holistic Physical Therapy
Hop Scotch Market & Restaurant
Justin Thyme Café Bar
Memphis Mae’s Bistro BBQ
Pronto Brick Oven Pizza
Red Hot Karaoke
Tavern at Croton Landing
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
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
Okinawa Hibachi
South of the Border
Ultra Clean Car Wash
Wobble Café
Pleasantville
A’Mangiare
The Black Cow
The Flower Basket
Foley’s Club Lounge
Jacob Burns Film Center
Martha’s Pleasantville Deli
Mediterraneo
Physical Fitness Xperts
Pleasantville Dawg house
Pony Express Good Food
Sinapi’s Bakery & Café
Sir Speedy Printing & Marketing
Sparx Hair & Makeup Salon
Tech Connect Computer
Trattoria 160
Thornwood
Casa Rina
Thornwood Ale House
White Plains
The Cabin
Yonkers
UNO Chicago Grill
Phelps Today
25
Stroke Program Earns AHA’s Highest-Level
Quality Achievement Award 5 Years in a Row,
Also Receives Target: Stroke Honor Roll Award
F
or the fifth consecutive year,
the Phelps Stroke Center has
received the Get With the Guidelines – Stroke Gold Plus Quality Achievement Award from the American Heart/
American Stroke Associations. Gold Plus
is the AHA/ASA’s highest-level award
for stroke care and recognizes Phelps’
success in implementing a higher standard of care by ensuring that stroke
patients receive treatment according to
nationally accepted guidelines.
This year, for the
first time, Phelps
also received the
association’s Target: Stroke Honor
Roll for meeting
stroke quality measures that reduce the
time between hospital arrival and treatment with the clotbuster tPA, the only
drug approved by
the U.S. Food and
Drug Administration to treat ischemic stroke (when a blood vessel that
supplies blood to the brain is blocked
by a blood clot). People who suffer a
stroke and receive tPA within three hours
of the onset of symptoms may recover more quickly and are less likely to
suffer severe disability.
The Get With the Guidelines Stroke
program helps hospital teams provide
the most up-to-date, research-based
guidelines with the goal of speeding
recovery and reducing death and disability for stroke patients. The program
also helps hospital staff implement prevention measures, including educating
stroke patients to manage their risk factors, be aware of stroke warning signs
and take their medications properly.
Hyperbaric Medicine Center News
T
he Undersea & Hyperbaric
Medical Society (UHMS) recently granted Level Two Clinical
Hyperbaric Facility Accreditation to
the Phelps Department of Hyperbaric
Medicine. The accreditation followed
a comprehensive survey by a team
of experts who visited the hospital’s
Hyperbaric Medicine Center, home to the
largest (12-person) hyperbaric chamber
in the Northeast. UHMS grants accreditation to hyperbaric centers that demonstrate commitment to patient care and
facility safety.
During hyperbaric treatment, patients
breathe pure oxygen while sitting inside
a pressurized chamber. It is used to
treat a number of conditions, including
tissue damage from radiation therapy,
wounds that are difficult to heal and carbon monoxide poisoning. Hyperbaric
medicine is also used as a secondary
26
Phelps Today
therapy for treatment of
crush injuries, gangrene
and bone or soft-tissue
infections. In many cases,
hyperbaric therapy speeds
up recovery time, decreases the need for hospitalization and reduces the need
for surgery.
“What really sets our staff
apart is our extensive experience, training and dedica- Dr. Owen O’Neill with UHMS Executive Director
tion, which ensures that our Peter Bennett, PhD, and President John Feldmeier, DO
patients receive optimal
treatment in a safe and well-managed
national meeting held in St. Louis, MO.
environment,” says Dr. Owen O’Neill,
FUHM recognition is an acknowledgethe department’s medical director.
ment of achievement and high standards
of expertise, practice and contribution
Dr. O’Neill was recently inducted as
to the field of undersea and hyperbaric
a Fellow of Undersea and Hyperbaric
medicine. There are currently only 63
Medicine by the Undersea & Hyperbaric
Fellows internationally.
Medical Society at the society’s inter-
Save The Date
27th Annual Champagne Ball
BENEFITING Phelps Memorial Hospital Center
Saturday, November 8, 2014 at 6:00 pm
Trump National Golf Club
Braircliff Manor, New York
Honoring
Dr. Lawrence Faltz
Maternity and Baby Care Classes
The Childbirth Experience/
LaMaze Method
Wednesday evenings 7:30 – 9:30 pm
for 5-6 weeks
Start dates: September 17, October 29
OR
2-day weekend sessions,
10 am – 3 pm:
September 13-14, October 11-12,
November 8-9, December 13-14
Cost: $170 per couple
Breastfeeding: First Choice
for Babies
September 4, October 2,
November 6, December 1
7 – 9 pm
ABCs of Baby Care
7 pm
Big Brother/Big Sister:
Sibling Preparation
September 20, November 15
10:30 am
$20 per child
Totsaver Program: American
HeartAssociation CPR for Family
and Friends
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 Open Door Family Medical Center,
participantes en el Programa de Asistencia
de AtenciónPrenatal de Medicaid, auspician
conjuntamente un Programa Prenatal. La atención de mujeres embarazadas es provista por
un personal bilingüe y solidario, altamente
capacitado. No se rechaza a nadie basándose
en sus ingresos económicos o seguro. Se alienta
a las mujeres a recibir atención prenatal lo
más temprano posible durante su embarazo.
La atención es provista en Open Door durante
las primeras 36 semanas del embarazo y en
Phelps Memorial Hospital durante el resto del
embarazo y el parto. Para mayor información,
sírvase llamar al: (914) 941-1263.
Phelps Today
27
Touchscreen Kiosks Help Visitors
Find Their Way
P
helps is continually searching
for new ways to enhance the hospital experience for patients and
visitors. Last year, the hospital created campus maps to help visitors understand the layout of the campus so they
can find their way from one building to
another. In late spring, Phelps installed
three touchscreen informational kiosks
at the entrances to the main hospital’s
701 building, the 755 building and
the ground floor of the 777 building.
The kiosks, which are approximately
6 feet tall, provide visitors with maps of
the campus, a calendar of events, directories of staff and medical staff, and basic
information about hospital services and
amenities. Users can also visualize
where they are in relation to their destination. Of course, the kiosks will never
take the place of the wonderful volunteers who staff the information desks!
Looking for a Meaningful Volunteer Experience?
J
oin the Phelps volunteers, a wonderfully diverse group of professionals,
retirees, empty-nesters and students,
whose generosity of spirit makes a real
difference in the lives of our patients and
their families.
Phelps offers a wide range of volunteer
opportunities, from greeting visitors at
the Information Desk to transporting
patients throughout the hospital to providing administrative support in one of
the many hospital departments.
Other opportunities include:
•Auxiliary Newsletter
•Gift Shop
•Cherry Door Thrift Shop (Tarrytown)
•Newborn hearing screening
28
Phelps Today
•Silver Spoons patient feeding program
•Operating Room/Family Liaison
•Patient library
•Prenatal clinic registration
To learn more about volunteering
at Phelps, call 914-366-3170 or visit
phelpshospital.org and click on the
Volunteer link at the bottom of the page.
Mal uso y abuso de
medicamentos bajo receta
entre adolescentes
By Michael McCormick, MD, and Imaan Chowdhury, MD
El año pasado, la asociación The Partnership at DrugFree.org
y la fundación MetLife Foundation reportaron que el uso
recreacional de los medicamentos bajo receta entre adolescentes había aumentado 33 por ciento en el quinquenio
entre 2008 y 2013, y había llegado a un punto donde uno de
cada cuatro adolescentes había hecho mal uso o abuso de un
medicamento bajo receta por lo menos una vez en su vida.
Estas anécdotas, extraídas de kidshealth.
org, señalan varias de las razones para la
tendencia creciente del uso de medicamentos bajo receta entre nuestros niños:
•Las actitudes y los conceptos erróneos de los adolescentes
•Las actitudes y conductas de los
padres
•La disponibilidad creciente de estos
medicamentos
¿Por qué el aumento en el abuso de
medicamentos bajo receta?
“Angie escuchó que sus padres hablaban
de que el medicamento para el ADHD
que le recetaban a su hermano le reducía
el apetito. Angie estaba preocupada por
su peso, así que empezó a sustraer uno
de los comprimidos de su hermano cada
pocos días.”
“Todd encontró un antiguo frasco de
analgésicos que habían quedado de la
operación de su padre. Decidió probarlos. Como un médico había recetado los
comprimidos, Todd consideró que obviamente era un medicamento seguro.”
Las actitudes y los conceptos
erróneos de los adolescentes
Los jóvenes toman medicamentos por
muchas razones: Quieren ser geniales y modernos. Quieren congeniar en
el grupo. Piensan que los fármacos los
ayudarán a perder peso, a permanecer
despiertos o a dormir. Sienten que los
estimulantes los ayudarán a obtener
mejores grados en la escuela. A veces
son presionados a usar fármacos por sus
pares. A veces tienen dolor verdadero,
físico o emocional, y no saben dónde
buscar ayuda.
Los adolescentes a quienes les recetan
analgésicos después de una lesión
deportiva, o los que inocentemente
toman un comprimido que les pasan
en una fiesta, pueden desarrollar una
dependencia física a esos comprimidos
en un período de tiempo sorprendentemente corto. No hay dimensión de educación ni de súplica que pueda detener
el establecimiento del proceso neuroquímico de adicción.
Phelps Today
29
El abuso de los medicamentos bajo receta se ha hecho casi una norma en la subcultura adolescente. Es algo de lo que se
habla tan abiertamente (con los pares,
no con los padres, por supuesto) y con
la misma libertad que del programa de
TV de la noche anterior o de quién ya no
sale con quién.
Cincuenta por ciento
de los padres admiten
que “cualquiera”
puede acceder a
sus medicamentos y
casi el 20 por ciento
nodesecha los
medicamentos
vencidos o que no
se usaron.
Los niños y los adolescentes tienden a
creer que los medicamentos bajo receta
y de venta libre tienen que ser seguros.
Si no fuera así, ¿por qué los médicos los
recetan y las farmacias los dispensan?
¿Por qué sus padres los toman? En estudios que entrevistaron a adolescentes,
algunos afirman que sus padres se enojarían menos si los descubrieran usando medicamentos bajo receta en vez de
las drogas que se consiguen en la calle.
Si bien el 80 por ciento de los adolescentes dicen que han tenido una conversación con sus padres acerca de la
marihuana y el alcohol durante el último año, y 30 por ciento sobre crack/
cocaína, menos del 15 por ciento dicen
que alguna vez tuvieron un intercambio
familiar sobre el abuso de los medicamentos bajo receta.
Las actitudes y conductas de
los padres
Aparentemente, algunas cosas que los
jovencitos dicen sobre sus padres es
verdad.
Con demasiada frecuencia, los padres
no logran comunicar efectivamente a
sus hijos los riesgos del abuso de medicamentos bajo receta. Los padres que
han hablado con sus hijos han dado un
primer paso importante, pero solo decir a
los niños que no hagan mal uso de medicamentos bajo receta no es suficiente.
Las actitudes y conductas de los padres
envían un mensaje mucho más fuerte
que discursos y arengas.
30
Phelps Today
De hecho, 20 por ciento de los padres
dicen que le han dado un medicamento bajo receta a un niño, hijo o hija
de ellos, a pesar de que no fue recetado para ese niño. Casi un tercio de
los padres sienten que algunos fármacos estimulantes como Ritalin y Adderall ayudarían a mejorar la atención y el
desempeño de sus niños en la escuela,
aunque no les hayan diagnosticado un
trastorno de hiperactividad con déficit
de atención.
Uno de cada dos adolescentes dice que
es fácil conseguir medicamentos del
armario de uno de sus padres. Cincuenta por ciento de los padres admiten que
“cualquiera” puede acceder a sus medicamentos y casi el 20 por ciento no desecha los medicamentos vencidos o que
no se usaron.
Los medicamentos bajo receta que
están más disponibles y de los que
más se abusa
Los estimulantes Ritalin o Adderall se recetan para tratar el trastorno de
hiperactividad con déficit de atención
(ADHD), que la Asociación de Psiquiatras Americanos define como “un patrón
persistente de desatención y/o hiperactividad-impulsividad que interfiere con
la función o el desarrollo”. El diagnóstico es complejo y generalmente se basa
en una variedad de conductas, condiciones y síntomas, todo ello evaluado por
un profesional entrenado. El tratamiento
para el ADHD es conductual y médico.
A casi 7 millones de niños estadounidenses diagnosticados con ADHD les
han recetado uno de los estimulantes de
tipo anfetaminas, como Ritalin o Adderall. Resulta alarmante que uno en ocho
adolescentes que NO fue diagnosticado con ADHD ha tomado estos medicamentos sin una receta.
Aunque Estados Unidos tiene solo el 4
por ciento de la población mundial, usa
el 70 por ciento del suministro mundial de Adderall o Ritalin. Incluso a niños
pequeños les recetan estos estimulantes
por hiperactividad, una tendencia inquietante que podría llevar a adicción, uso
de otros fármacos y problemas médicos.
El índice de recetas de estimulantes para
estudiantes universitarios y otros adultos
también está aumentando a gran velocidad, y así esos medicamentos están
más fácilmente disponibles en casas
de familias y en campus de universidades. El resultado es un aumento en el
abuso deliberado de estimulantes y la
sobredosis accidental.
Los efectos secundarios de los medicamentos estimulantes incluyen aumento
de la presión arterial, aumento del ritmo
respiratorio y cardíaco, constricción de
los vasos sanguíneos y aumento de los
niveles de glucosa en sangre. Los estimulantes pueden ser adictivos.
Los depresores del sistema nervioso central (CNS), incluyendo Xanax,
Valium y Ativan, enlentecen la función
cerebral normal. Estos tranquilizantes y
sedantes, que se usan para tratar la ansiedad, ataques de pánico y trastornos del
sueño, pueden ser adictivos. La combinación de los depresores del CNS con
medicamentos analgésicos bajo receta, algunos medicamentos para la alergia y resfríos de venta libre o el alcohol puede enlentecer la respiración y el
ritmo cardíaco, lo que en algunos casos
puede ser fatal.
Los opioides, como Vicodin y OxyContin, también llamados narcóticos,
son recetados para tratar el dolor. Los
efectos secundarios incluyen somnolencia, constipación, náusea y picazón.
También pueden ocurrir confusión o
mareos. Las dosis altas de opioides resultan en efectos secundarios respiratorios
serios, que si son severos pueden dañar
órganos del cuerpo y llevar a un coma.
Signos que advierten del uso de medicamentos bajo receta
•Pupilas más pequeñas o más grandes
que lo común
•Cambios en los hábitos de sueño
•Cambios en el nivel de energía
•Cambios en el aspecto o la higiene
personal
•Cambios en el humor/ la personalidad
•Retraimiento social de la familia y los
amigos
•Cambio de amigos
•Cambio súbito en los grados escolares
•Pérdida del apetito
•Actitud defensiva cuando le hacen
preguntas simples (intento de esconder una dependencia a las drogas)
Prevención… ¿Qué podemos hacer
como padres?
Quienes comienzan a abusar de los fármacos cuando son jovencitos tienen más
probabilidad de tener un problema de
adicción en la edad adulta. Los padres
deben hacer todo lo que puedan para
ayudar a sus niños a tomar buenas decisiones en cuanto a los fármacos/medicamentos.
•Comprenda la enorme influencia que
usted tiene en sus niños y establezca
un ejemplo que le gustaría que ellos
sigan.
•Ame a sus niños. Promueva una relación en la que ellos se sientan seguros
hablando de lo que les pasa en la vida
y compartiendo cualquier cosa que les
inquiete.
•Háblele a sus niños sobre los riesgos
de los fármacos/medicamentos, y diga
claramente cuánto lo lastimaría si ellos
hicieran abuso de estos. Los niños que
están bien informados sobre los riesgos
tienen 50 por ciento menos probabilidad de usar drogas.
•Establezca expectativas razonables y
límites para la conducta de sus niños.
Si hay un problema, sea firme en sus
opiniones y asuma el rol orientador.
•Estimule a sus niños a participar en
deportes y/o actividades sociales o
académicas.
•Conozca a los amigos y a los padres de
los amigos de sus hijos adolescentes.
•Si en su casa se guardan medicamentos
narcóticos, estimulantes o depresores,
asegúrese que se almacenen de manera segura... no en el armario de medicamentos de la familia. Lleve la cuenta
del número de comprimidos que tiene.
•Deseche cualquier medicamento que
ya no se necesita o no se usa.
•Apoye las reuniones y los programas
de prevención de drogas en la escuela
y la comunidad.
•Utilice ayuda profesional cuando la
necesite.
Drugfree.org ofrece apoyo, herramientas, recursos y respuestas.
Michael McCormick, MD, ejerce la
especialidad de medicina familiar y es
médico de Phelps Medical Associates.
Está certificado en medicina familiar,
obtuvo su título de médico en la
Facultad de Medicina de la Universidad
St. George y completó una pasantía y
residencia en medicina familiar en la
Práctica de Medicina Familiar JFK de
New Jersey. Su consultorio se encuentra
en Ossining (914-373-4948).
Deseche los
medicamentos
sin usar
con cuidado.
Los medicamentos sin
usar pueden ser desechados en la mayoría de las
estaciones locales de
policía. Los medicamentos
no deben ser desechados
en el inodoro o en los
lavabos o fregaderos ya
que pueden contaminar
los ríos y arroyos locales.
Imaan Chowdhury, MD, ejerce la
especialidad de medicina interna y es
médica de Phelps Medical Associates.
Obtuvo su título de médica en la
Facultad de Medicina de la Universidad Ross y completó una residencia en
medicina en la Universidad y Centro
Médico Brookdale. Ella atiende pacientes en Dobbs Ferry (914-478-1384)
y en el consultorio Senior Health and
Internal Medicine en el campus de
Phelps (914-366-3677).
Phelps Today
31
Densidad de senos –
Por qué es importante
El Centro de
Imagenología de
Senos en Phelps
Memorial Hospital
ha sido designado
un Centro de
Imagenología de Senos
de Excelencia por el
Colegio Americano
de Radiología (ACR)
durante muchos años.
Las siguientes Preguntas y Respuestas (P&R) explican
qué significa la densidad de los senos y por qué solo la
mamografía no es siempre suficiente en la detección
de cáncer de senos.
P. Tuve una mamografía recientemente y se me informó que
tengo tejido mamario denso.
¿Qué significa?
R. Los senos están formados por tejido mamario glandular y conectivo graso
y no graso. Algunas mujeres tienen
más grasa que tejido mamario, mientras que otras tienen más tejido mamario que grasa. Los senos que tienen una
mayor proporción de tejido glandular se
describen como “densos”.
P. ¿Es inusual tener senos densos?
R. Los senos de cada mujer son diferentes. Algunos son grasos, otros son densos y algunos son una mezcla. Aproximadamente 46 por ciento de mujeres
estadounidenses tienen senos densos.
P. Mis senos no se sienten densos,
por lo tanto no debo tener un tejido
mamario denso, ¿correcto?
R. La densidad mamaria no es evidente por sensación o apariencia. La única
manera de determinar si los senos tienen
tejido denso es al evaluar una mamografía.
P. ¿Quién determina si tengo o no
senos densos?
R. El radiólogo que mira su mamografía
clasifica la composición de sus senos en
una de cuatro categorías de densidad
en aumento: predominantemente graso,
tejido fibroglandular disperso, denso heterogéneo o denso en extremo.
P. ¿Tendré siempre senos densos?
R. El tejido mamario denso es un atributo físico como otras características de
su cuerpo. Usted no puede activamente
modificar la densidad, pero puede cambiar como resultado de la edad, niveles
hormonales y menopausia. Al envejecer la mujer, sus senos podrían tornarse
menos densos. Tejido extremadamente
denso o heterogéneo está presente en
más de la mitad de mujeres menores de
50 años y solo en un tercio de mujeres
de 50 años o más.
P. ¿Por qué es importante si mis
senos son densos?
R. Sin importar el tamaño o forma, las
mujeres con tejido mamario denso corren mayor riesgo de desarrollar cáncer
de senos que mujeres con senos grasos.
El tejido denso también puede oscurecer
anormalidades subyacentes, dificultando
más la detección temprana del cáncer.
P. ¿Cómo pueden asegurarse las
mujeres de que se les informará si
tienen senos densos?
R. El reconocimiento de la importancia
de la detección temprana de cáncer de
senos y el hecho que mujeres con senos
densos corren mayor riesgo de desarrollarlo, varios estados, incluyendo Nueva
York, han aprobado una ley que requiere que los proveedores de servicios de
mamografías informen a pacientes si se
ve tejido mamario denso durante la prueba. La intención de la ley es empoderar a
32
Phelps Today
mujeres para discutir opciones adicionales de detección con sus médicos.
P. ¿Se verá un tumor en una mamografía de un seno denso?
R. Buscar un tumor en una mamografía
de senos densos es como buscar una
bola de nieve en una tormenta de nieve,
porque el tejido mamario denso aparece blanco en la mamografía y masas
o bultos también aparecen blancos. Es
por esto que el cáncer puede esconderse fácilmente en un fondo blanco de tejido denso. Al contrario, los senos grasos
aparecen mayormente de color negro y
grisáceo en una mamografía, por lo que
detectar una masa sospechosa es más
sensitivo.
P. ¿Hay otra prueba que puede
detectar cáncer en senos densos?
R. El ultrasonido puede ayudar a identificar masas que son difíciles de ver en una
mamografía. MRI es también otra herramienta útil.
El ensayo Avon/ACRIN 6666 mostró
que entre las mujeres que corrían riesgo
de desarrollar cáncer de senos y tenían
senos densos, el ultrasonido como auxiliar de una mamografía aumentó la detección revelando ciertos cánceres que no
aparecen en una mamografía.
P. ¿Qué es ultrasonido?
R. El ultrasonido es un método no invasivo que usa ondas de sonido de alta frecuencia para mirar dentro del cuerpo y
crear una imagen detallada de un órgano o tejido.
P. ¿Debería no hacerme una mamografía y solo hacerme una prueba de
ultrasonido?
R. No. Las mamografías aún están siendo
usadas como el método primario detección de cáncer de senos. La mamografía
es la modalidad más sensitiva para detectar calcificaciones que son producidas a
veces por cánceres tempranos de senos.
Además, la comparación de una mamografía con un examen del año anterior
permite ver cambios pequeños.
Si usted tiene senos densos, tener una
mamografía y una prueba de ultrasonido
proveerá una evaluación más completa.
La Supervisora de Ultrasonido Susan Carpenter prepara a una paciente para un
examen de ultrasonido 3-D de seno con el equipo ABUS.
El MRI de detección para senos es otra
modalidad suplementaria efectiva para
la detección de cáncer de senos.
modalidad de detección suplementaria
como ABUS, ultrasonido tradicional de
senos o MRI de senos.
Nuevo Sistema de Ultrasonido
3-D Ahora en Phelps
Para proveer a las mujeres con los beneficios de la tecnología de ultrasonido
más avanzada, Phelps Memorial Hospital Center se convirtió recientemente
en el primer hospital en la Región del
Valle del Hudson en adquirir el Sistema
de GE de Ultrasonido para Senos Invenia™ Automated Breast Ultrasound System (ABUS), que es aprobado por la
FDA como modalidad suplementaria de
detección de cáncer de senos en mujeres
con senos con tejido denso.
El Centro de Imagenología de Senos
en Phelps Memorial Hospital ha sido
designado un Centro de Imagenología
de Senos de Excelencia por el Colegio
Americano de Radiología (ACR) durante muchos años.
Al igual que el ultrasonido tradicional
de senos, ABUS también usa tecnología
de ultrasonido para generar imágenes.
La diferencia es que los datos generados
con ABUS se ven en formato 3D, permitiendo más maneras para que el radiólogo analice las imágenes. ABUS también permite una manera más uniforme
de adquirir las imágenes al ser menos
dependiente del operador, ya que el técnico no tiene que guiar manualmente un
detector manual de ultrasonido. Los estudios han demostrado que el índice de
detección de cáncer es más alto en pacientes con mamogramas densos cuando
la mamografía es combinada con una
Norman Lee, MD, un radiólogo
certificado por la junta médica
con capacitación fellowship en la
subespecialidad de imagenología
de senos, es el director médico del
programa de Imagenología de Senos
de Phelps y se encuentra en Phelps
a tiempo completo. Su pasión por
proveer la atención a pacientes de la
más alta calidad, es realizada a través
de un abordaje práctico y educación
continua de su personal.
Phelps Today
33
Phelps Memorial Hospital
Hospital Locations in the Community
LocationsPhelps
in Memorial
the Community
A
croton-on-hudson
3
4
1
2
B
C
briarcliff manor
H
sleepy
hollow
D
tarrytown
Rt. 1
Rt. 1
17
19
E
irvington
dobbs ferry
F
A
34
PHELPS MEDICAL ASSOCIATES
IN THE COMMUNITY
Croton
Primary & Specialty Care: 914-269-1700
Radiology: 914-269-1701
B
Ossining
Family Medicine: 914-373-4948
Internal Medicine: 914-941-1277
C
Briarcliff
Cardiology: 914-762-5810
D
Sleepy Hollow
Primary Care: 914-631-2070
E
Tarrytown
Endocrinology: 914-366-7862
F
Dobbs Ferry
Primary Care: 914-478-1384
PRACTICES ON THE
H PHELPS
HOSPITAL CAMPUS
• Advanced Endoscopy &
Gastroenterology: 914-366-1190
• Gastroenterology: 914-366-5420
• Primary Care: 914-366-5490
• Neurology: 914-366-5330
• OB/GYN: 914-366-5400
• Senior Health & Internal Medicine:
914-366-3677
• Thoracic Center: 914-366-2333
• Westchester Lung Nodule Center:
914-366-2333
BEHAVIORAL HEALTH
SERVICES
1Addiction 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
Phelps Today
Map-w-behav-PC-version.indd 1
8/7/2014 12:07:24 PM
P HEL P S
Nonprofit
Organization
U.S. Postage
PAID
Permit #102
Stamford, CT
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
(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) 366-3345
Mammography
(914) 366-3440
Maternity & Baby Classes
(914) 366-3382
My Sister’s Place
(800) 298-SAFE (7233)
Osteoporosis Support Group
(914) 269-1888
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

2014 Fall Newsletter - Phelps Memorial Hospital

Transcripción

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