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in medicine

S U P P L E M E N T TO B E R G E N H E A LT H & L I F E

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2 advancesin medicine

today’s TREATMENTS: simpler, safer and easierFor both men and women, minimally invasive procedures can now mean fewer complications and a faster recovery

M A N Y C O N D I T I O N S that just a decade or two ago required a hospital stay of several days can now be treated successfully at Holy Name Medical Center in just a few hours or a single day and night. Here are examples:

U T E R I N E F I B R O I D SEach year in the U.S., some 300,000 women undergo hysterectomy—removal of the uterus—because of uterine

JOHN R. SCHEUCH, M.D. JOHN RUNDBACK, M.D.

A D VA N C E S I N M E D I C I N E I S P U B L I S H E D B Y WA I N S COT M E D I A , M O N T VA L E , N . J . © 2010 . A L L R I G H T S R E S E R V E D.

fi broids, benign tumors that begin in the wall of the uterus. But most patients don’t need this major operation, says John Rundback, M.D., medical director of the Interventional Institute at Holy Name Medical Center.

Instead, they could benefi t from a radiologic procedure called uterine fi broid embolization, or UFE, in which X-ray guidance is used to direct small particles to block blood fl ow to the fi broids. Radiologists thread a catheter through a small artery in the groin and guide it through the artery to the fi broids. They then inject specialized material to block blood fl ow to the fi broids, which literally starve and shrink, leading to relief from bloating, pain, excessive menstrual bleeding and urinary problems.

“The embolization procedure takes

30 to 60 minutes, and the patient goes home in a few hours and returns to normal activity within a week,” Dr. Rundback says. “A hysterectomy requires up to fi ve days in the hospital and up to six weeks out of work.”

“Women need to understand their options,” he says. “About 90 percent of women with uterine fi broids are good candidates for UFE. They need to discuss this with their doctor, rather than accept the gospel of hysterectomy.”

P R O S TAT E C A N C E RSurgery, too, has become minimally invasive, and the most dramatic example is surgery performed with robotic technology. These robots aren’t the independent operators you see in sci-fi movies, but special devices manipulated by skillful surgeons that give them a dexterity and range of motion beyond the ability of any human hand. Says John R. Scheuch, M.D., Holy Name’s director of urologic robotic surgery: “When we use the da Vinci® Surgical System to perform urologic procedures, patients recover more quickly and have minimalside effects.”

Using the da Vinci® Surgical System, Dr. Scheuch can treat prostate cancer so effi ciently that patients are discharged within 24 hours. But more important are the quality-of-life concerns of prostate-cancer patients—“these are critical when deciding on surgery,” says the doctor. “Both potency and urinary continence are better maintained with the robotic approach than with open surgery.”

O T H E R C O N D I T I O N SThe robotic surgical system can also be used for surgeries on kidney and bladder tumors, and gynecologists can employ it to treat ovarian and cervical cancer, and to perform hysterectomies when a surgical approach is required.

“We have excellent results with all these procedures,” Dr. Scheuch says.

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www.holyname.org3

B E I N G D I A G N O S E D W I T H breast cancer can make a woman feel alone. “Family and friends are wonderful,” says Bogota resident Judy Flores, 46, who found a lump in her breast in 2009 that turned out to be malignant. “But no one except another woman with breast cancer can understand what you feel.” So Flores took action to fi ght that “alone” feeling. She helped to launch a support group that now meets twice a month at Holy Name Medical Center, giving women with breast cancer a chance to share their concerns and sometimes a laugh or two.

“I was shocked when the test results showed I had Stage II invasive cancer,” says Flores, a vice president with PNC Bank.

After the initial news, she tried to learn as much as she could about the disease. “That’s how I deal with things,” says Flores, who has a son, Gregory, 20. “But I was overwhelmed.”

She underwent a radical mastectomy of her right breast,

fighting breast cancer— together

The physicians who staff Holy Name Medical Center’s Medical Oncology Department pride themselves on their caring, personal approach. “Almost any hospital will give the same medications and follow the same standards of care,” says medical oncologist Yadyra Rivera, M.D. “But we go to great lengths to treat each patient as a person, not a number.”

Dr. Rivera and her partners, Beata Pieczara, M.D., and Raimonda Goldman, M.D., give one-on-one care and lead every patient individually through his or her treatment. They treat any type of cancer, aided by a sta� that includes genetic and nutritional counselors, nurse practitioners and oncology nurses. And they o� er participation in clinical trials that test the newest and most promising treatment options. To contact the physicians, call Holy Name’s Regional Cancer Center at 201-227-6008.

CARE+COMPASSION

YADYRA RIVERA, M.D. BEATA PIECZARA, M.D. RAIMONDA GOLDMAN, M.D.

A D VA N C E S I N M E D I C I N E I S P U B L I S H E D B Y WA I N S COT M E D I A , M O N T VA L E , N . J . © 2010 . A L L R I G H T S R E S E R V E D.

Because of one woman’s initiative, patients now meet twice monthly to learn, shareand support each other

BREAST CANCER SUPPORT GROUP | 1-877-HOLYNAME (1-877-465-9626)

followed by a regimen of chemotherapy and radiation, overseen by Yadyra Rivera, M.D., medical oncologist with the Regional Cancer Center at Holy Name Medical Center. During her treatments, Flores looked for support groups to help answer her questions and provide comfort. But the only group she was able to fi nd met just once a month.

“If I had a treatment or other appointment that confl icted with the group meeting, I couldn’t go until a month later,” Flores explains. “That was crazy to me.” Vowing to change that, she worked with administrators at Holy Name and suggested a structure and timeline for a new group she hoped to start. Holy Name staffers quickly lent assistance. “They were excited, because everyone knew it was needed,” she says.

“When she took the lead on this project, we backed her up completely,” says Dr. Rivera. “We now have brochures about the group all over the Medical Center.”

The group meets from 5:30 to 7 p.m. on the fi rst and third Wednesdays of each month on the Lobby Level of Holy Name’s Regional Cancer Center. Meetings last about two hours and often include guest lecturers such as nutritionists, oncologists, psychiatrists and other Holy Name experts. Walk-ins are welcome, but participants may also call to register in advance.

“We talk about everything from how treatments make you feel to how your breasts look,” says Flores. “Soon I’ll have my fi rst mammogram and MRI since my surgery. I can’t wait to go to the group and talk about it.”

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4 advancesin medicine

protect young athletes from

Head injuries are a growing problem, but safety begins with knowledge

Let’s face it—some kids just don’t like to move much. Whether they aren’t athletic or simply prefer to play video games, they need special motivation to keep them active enough to stay healthy and � t. Without it, they’re at risk for the growing epidemic of childhood obesity.

For these kids, Holy Name Medical Center o� ers YouthFit. “The two-step program is designed to get young people active in fun, noncompetitive, nonthreatening ways,” says J. Christopher Mendler, M.D., Holy Name’s medical director of sports medicine.

Step 1 consists of four weeks of twice-weekly classes. In each 45-minute class, both kids and their parents learn about exercise. The children receive baseline assessments: height, weight, body-fat composition, � exibility, strength and resting heart rate. Then they take part in activities that include spinning, kickboxing, yoga and strength training with light weights or resistance bands. They even use the Wii Fit™ video game. “At the end of the four weeks, we test them again and show them how they’ve improved,” says Dr. Mendler.

In Step 2, kids sign up for the activities they most enjoy. The YouthFit sta� sends reports to each child’s doctor on his or her progress and helps set speci� c health goals. YouthFit is held at HNH Fitness, Holy Name’s medically-based � tness center at 514 Kinderkamack Road in Oradell.

YouthFit introduces

young people to the

bene� ts and joys of

exercise

I N T H E P A S T Y E A R , the National Football League and National Hockey League have both looked more carefully into the problem of concussion. But concern about this potentially serious head injury isn’t limited to the pros; it’s shared by those who supervise youth sports. Fortunately, Holy Name Medical Center is taking the lead in educating the community about the causes, prevention and treatment of concussion through its Concussion Evaluation Program.

J. Christopher Mendler, M.D., medical director of sports medicine at

Holy Name, says the concussions he’s seen in children and adolescents have grown more frequent and more severe in recent years. “Kids are bigger and stronger

today, and they’re hitting harder,” Dr. Mendler explains. “And young people tend to be more vulnerable to head injuries than adults.”

The program reaches out to area youth, high school and college teams to educate athletes and coaches on what a concussion is. For example, says Dr. Mendler, “You don’t have to be hit in the head to have a concussion—a hard blow to the chest can cause a whiplash effect that makes the brain bounce against the skull. Nor must you be ‘knocked out’ to have a concussion.”

Dr. Mendler also teaches about concussion’s common symptoms, which can include not only headache, nausea

and sensitivity to light and sound, but also more subtle symptoms such as sleep problems

and behavioral or emotional changes.Perhaps most important, the

program offers neurocognitive testing of all area athletes through a computer-based tool called ImPACT (for Immediate Post-

concussion Assessment and Cognitive Testing). “This 20-minute test is used in the NFL, NHL, NCAA and many high schools,” Dr. Mendler says. “It provides us with a baseline reading for each young athlete, so if they take a hard hit, we can test them again and see how they compare.”

ImPACT is just “one tool in our toolbox,” he says. “We use it along with interview assessments of the athlete and his or her parents and coaches to determine whether or not the child has suffered a concussion.”

Most concussions respond simply to rest and time. “Along with careful observation, we let the body heal itself,” says Dr. Mendler. “The main goal is to protect the brain from further injury, because a second injury often causes more serious complications.”

CONCUSSION EVALUATION PROGRAM | 1-201-833-3909YOUTH FIT PROGRAM | 1-888-236-4236

J. CHRISTOPHER MENDLER, M.D.

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www.holyname.org5

Total joint replacement now features better materials, better surgical techniques and better pain control

N O O N E C H O O S E S joint replacement lightly. But for people whose mobility has been seriously impaired by pain from arthritis or overuse injuries, surgical advances in joint replacement are good news.

“Total joint replacement of the hip and knee has improved in three major ways,” says Ari Seidenstein, M.D., an orthopedic surgeon on staff at Holy Name Medical Center. They are:

1 B E T T E R R E P L A C E M E N T C O M P O N E N T S . “Both the

quality of the materials and the geometric design of the implants are far superior, so they last longer and offer greater range of motion,” Dr. Seidenstein says. “Plus, we now have gender-specifi c implants that address the differing geometry of male and female

joints.” And now there are even partial knee implants that can replace only the damaged portion of the knee, leaving the still-healthy part and the patella (kneecap) in place.

2 B E T T E R S U R G I C A L T E C H N I Q U E S . “With new

minimally invasive methods we cut through much less skin and muscle,” says Dr. Seidenstein. “Incisions for knee replacements once covered half the thigh and lower leg. Now we make cuts of just 10 to 12 centimeters.” That means quicker recovery, less pain and lower risk of complications, such as infection.

3 B E T T E R P A I N C O N T R O L . Not only are new pain

medications available, but new methods of delivering them have also been developed. “We’ve learned that giving narcotics a couple of hours before surgery has been shown to reduce pain afterward,” he says. “This increases mobility after surgery, which helps patients get home and to rehab earlier.”

Thanks to these improvements, more people are candidates for joint- replacement surgery. “The implants

themselves have a much longer life, so now people in their 50s can have the surgery,” Dr. Seidenstein says. His patients are often back on the tennis courts or ski slopes within a few months of surgery. “One Hartzband Center patient even competes in triathlons,” he says. “Joint replacement makes patients’ lives better right away. They can return to doing things they haven’t been able to do in years.”

Holy Name’s orthopedic program is more than just surgery, says Jeffrey Steuer, M.D., the Medical Center’s chief of orthopedics. “We take a total team approach to patient care that includes pain management, pre- and postoperative care and physical therapy,” he says. “Our team includes the operating room staff, the nursing staff, orthopedic anesthesiologists and a dedicated physical therapy unit right on the orthopedic fl oor—all of which are essential for good outcomes. We’re proud that this department provides state-of-the-art care that is at the technological forefront of orthopedics.”

when it’s time for a new KNEE or HIP

ARI SEIDENSTEIN, M.D. JEFFREY STEUER, M.D.

HOLY NAME PHYSICIAN REFERRAL | 1-877-HOLYNAME (1-877-465-9626)

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advancesin medicine

6

S U R E , P A R E N T S - T O - B E want the fi nest facilities and top clinical expertise when it’s time to give birth. But they also hope for something more: a place that will be worthy of the special memories their growing family will

create there. That’s Holy Name Medical Center.

Two prestigious benchmarking organizations have recently awarded the Medical Center top grades

a great place to give birth

in caring for maternity patients and their new babies. A study issued in June 2010 by HealthGrades ranked Holy Name among the top 5 percent in the nation for maternity care. The study used state government data to compare hospitals’ complication rates for vaginal and C-section deliveries, as well as neonatal mortality. As a result, the Medical Center received the 2010–2011 HealthGrades Maternity Care Excellence Award.

Holy Name has also been recognized for service excellence under the J.D. Power and Associates

Distinguished Hospital Program. This distinction is determined by querying recently discharged patients about their hospital visits and comparing the results with the national benchmarks established in the annual J.D. Power and Associates National Hospital Service Performance Study. It acknowledges Holy Name’s strong commitment to provide “An Outstanding Maternity Experience.” The Medical Center also won overall honors for “Outstanding Inpatient Experience” and “Outstanding Emergency Experience.”

“Many women come here not knowing much about Holy Name, but once they leave, their satisfaction is tremendous,” says Lev Kandinov, M.D., an obstetrician/gynecologist on staff at HNMC. “They love it here.”

“Holy Name has all the techno-logical advances and medical expertise of a major university medical center,” adds Dr. Kandinov. “But because we’re committed to personalized patient care—with a staff that is truly dedicated—we can provide the one-on-one attention that makes for a truly satisfying birth experience.”

When it’s time for the special event,When it’s time for the special event,you want leading-edge care andyou want leading-edge care anda nurturing approach

HOLY NAME OB/GYN REFERRAL | 1-877-HOLYNAME (1-877-465-9626)

LEV KANDINOV, M.D.

Superior MEDICAL CARE with a FAMILY-CENTERED focus

� 24/7 in-house coverage by board-certi£ ed obstetricians and pediatricians

� 24/7 in-house coverage by board-certi£ ed anesthesiologists speci£ cally dedicated to obstetrics

� 24/7 coverage by board-certi£ ed neonatologists

� Maternal-fetal medicine program and perinatal high-risk services

� Central fetal monitoring

� Maternal monitoring

� Dedicated sta� in labor and delivery, postpartum and the special care nursery

� Comprehensive prenatal and postpartum education and support programs

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www.holyname.org7

Why a smart cardiovascular program is sensitive to the special needs of women

H E A R T D I S E A S E , still the nation’s number-one killer, has been declining in recent years—but only in men. “Statistics show that the incidence of heart conditions in women under 50 has actually been rising,” says Nellie Lee, M.D., a cardiologist at Holy Name Medical Center. Fortunately, HNMC’s comprehensive cardiovascular program is particularly attuned to the special dangers and symptoms of heart disease in females.

The disease’s major risk factors—high blood pressure, high cholesterol, smoking, diabetes, obesity, family history and aging—are the same for both sexes. But there are important differences in conditions, symptoms and responses. For one, women tend to develop heart

disease about 10 years later than men. Recently, studies have also shown that women are more likely than men to have disease that affects the heart’s smallest

arteries. This condition is called coronary microvascular disease, or MVD. Women also are more apt to develop a condition called “broken heart” syndrome. In this recently recognized heart problem, extreme emotional stress can lead to reversible heart-muscle failure. Other factors, such as birth control pills and menopause, may affect women’s heart-disease risk as well, though the precise relationship between hormones and heart health is less clear.

Symptoms of a heart attack can differ too. “Only about 30 percent of women get the typical crushing chest pain,” Dr. Lee says. “The rest show a combination of other symptoms—shortness of breath, nausea and vomiting, dizziness, jaw or arm or back pain, weakness or sweating. In some cases these signs may precede the actual heart attack by days or weeks. So it’s important for a woman to be aware of her own body, and if any out-of-the-ordinary symptoms appear, she should seek medical attention.”

Unfortunately, women don’t always get help at the fi rst signs of trouble—

especially those who still think of heart disease as a mostly male problem. “Also, women are usually the family’s caretakers, and they may feel they cannot afford to be sick,” says Dr. Lee. “Not only do women either ignore or minimize symptoms, they also may not come in for regular check-ups or be compliant with treatment.”

That’s beginning to change, with growing recognition that heart disease is a danger to both genders. To prevent heart disease, men and women alike need to embrace a healthy lifestyle—one that includes a sensible diet with lots of fruits, vegetables and whole grains; regular exercise, plenty of sleep and the avoidance of smoking and excessive drinking. And both sexes can benefi t from the array of treatments available today, including medications, medical and surgical procedures, and cardiac rehabilitation.

“Women need to be aware of their risk factors, take preventive measures and work with their physicians to reduce their chances of developing a heart condition,” Dr. Lee adds. “After all, they need and deserve to be healthy.”

HEART DISEASE: not for men only

NELLIE LEE, M.D.

HOLY NAME OB/GYN REFERRAL | 1-877-HOLYNAME (1-877-465-9626) CARDIOVASCULAR SERVICES | 1-877-HOLYNAME (1-877-465-9626)

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HEART ATTACKS CLAIM the lives of nearly 500,000 Americans each year. Luckily, being well-informed about your heart’s health can help you reduce your chances of becoming one of them. Take the quiz below, based on information from the American Heart Association, and see how much you know about heart health.

Quiz answers appear upside-down at the bottom of this page.

1. Which of these is a cause of heart disease?A. strokeB. arthritisC. thickening of the arteriesD. none of the above

2. Coronary heart disease develops gradually over many years and can easily go undetected.TrueFalse

3. Some risk factors for heart disease can’t be changed.TrueFalse

4. What is considered “high blood pressure”?A. 90/70B. 100/80C. 140/90D. 160/100E. Both C and D

5. Drinking a moderate amount of alcohol is considered safe for your heart. What can happen if you drink more?A. Too much alcohol can raise blood

pressure.B. Too much alcohol can raise

triglyceride levels.C. Too much alcohol lowers LDL

(“bad”) cholesterol.D. both A and B

6. Your risk for heart disease rises if your body mass index (BMI) is more than 24.9. Why?A. It can increase blood pressure.B. It can increase triglycerides and

lower HDL cholesterol levels.C. It can increase the risk for diabetes.D. all of the above

7. High total cholesterol is a risk factor for heart disease.TrueFalse

8. Which of these is a classic symptom of a heart attack?A. crushing pain in the chest

accompanied by sweatingB. pain that spreads from the

chest to the shoulders, neck, jaw or arms

C. indigestion or heartburn, nausea and vomiting

D. di ̄ culty breathingE. all of the above

9. Someone who has had a heart attack is at increased risk of having another.TrueFalse

10. You can’t exercise if you have heart disease.TrueFalse

ANSWERS: 1. C; 2. TRUE; 3. TRUE; 4. E; 5. D; 6. D; 7. TRUE; 8. E; 9. TRUE; 10. FALSE.

If you scored . . . 10 correct answers: Congratulations! You’re a heart-health whiz!8 to 9 correct answers: You have a good understanding of heart health—just look over that missed answer or two to brush up.7 or fewer correct answers: Your heart’s in the right place, but you could use a refresher. Check the websites of the American Heart Association (www.heart.org) and Holy Name Medical Center (www.holyname.org; click on “Conditions and Treatments”).

are you heart-smart?

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