Date post: | 07-Apr-2016 |
Category: |
Documents |
Upload: | dymun-company |
View: | 217 times |
Download: | 2 times |
VOLUME V ISSUE 2VOLUME VI ISSUE 460YEARSCELEBRAT ING
Bringing an Expert Touch to Delicate Surgery I In Good Hands: For Perri Brothers, Surgery is a Family Affair I Advances in Orthopedic Surgery Technology I Hall of History I Ask The Doctorinside
“HOW WE TREAT YOUR
MEDICAL CONDITION IS
IMPORTANT, BUT SO IS
HOW WE TREAT YOU
AS A PERSON.
”JOAN MASSELLA, R.N., M.ED., MBA,ADMINISTRATIVE VICE PRESIDENT
AND CHIEF NURSING OFFICER,ST. CLAIR HOSPITAL
Healing
St. Clair Hospital Chief Nursing Officer Joan Massella, R.N., M.Ed., MBA, standing at center, confers with RegisteredNurses, from left, Stephen Lamb, Kathy Warznak, and Julia Palumbo, as well as Unit Secretary Linda Mazek on Nursing Unit 6E during a recent walk-through of the highly rated unit.
The
Touch
PATIENT SATISFACTION
2 I HouseCall I Volume VI Issue 4
Continued on page 4
Joan Massella, R.N., M.Ed., MBA,administrative vice president
and chief nursing officer at St. Clair, says the 60-year-old
Hospital’s tradition of excellence has evolved into a hospital-wide
culture, and as a result, patient satisfaction rates have soared.
“Hospitals measure patient satisfaction to assess how well
they are meeting the needs of patients, to acquire insights into the patient
experience, to identify opportunities to improve. Listening to patient
feedback is essential. Patients today are informed and educated, and
they expect a quality outcome. How we treat your medical condition is
important, but so is how we treat you as a person.”
St. Clair measures patient satisfaction through a contract with South
Bend, Indiana-based Press Ganey, an independent research company
that tracks patient satisfaction at the majority of hospitals across the
country, including almost all of Western Pennsylvania. Press Ganey uses
patient satisfaction surveys to quantify the experience of
the patients, and reports this information to the Hospital
in the form of scores and compilations of patient
comments. The reports help the Hospital track its
progress. Patient satisfaction data drive change
within the Hospital, improving outcomes.
According to Joan, there are a number of key initiatives behind St. Clair’s
extraordinary patient satisfaction ratings. “Within nursing, we are always
implementing best practices,” she explains, “including bedside report
at change of shift, where nurses exchange information with each other,
patients, and families. We put white boards in each patient room, with
up-to-the minute information about their medications, tests, and care-
givers. All staff are educated in a program known as AIDET, an acronym
that stands for Acknowledge, Introduce, Duration, Explain and Thank
You. We started it in 2012 and find that it makes a big difference. The
purpose is to decrease anxiety and increase trust.We have very skilled
clinicians at the bedside and AIDET helps them communicate their
passion for helping patients heal in an environment of compassion,
dignity and respect.”
Amy Carbonara, R.N., a charge nurse in the Intensive Care Unit (ICU)
at St. Clair, says nursing care is shaped by the five AIDET principles.
“At St. Clair, patient satisfaction is a priority.
“We get regular reports and take that information to the front line
staff, and ask for their input. We’re all involved in the process; it isn’t
someone sitting at a desk making the decisions. Patient satisfaction
benefits everyone.”
ST. CLAIR HOSPITAL HAS THE HIGHEST PATIENTSATISFACTION IN WESTERN PENNSYLVANIA ANDIS RANKED IN THE TOP 2% NATIONWIDE.
EXCELLEN
T
GOOD
FAIR
POOR
PATIENT SATISFACTION
No one wants to be in the hospital. But when hospitalization is necessary, one hopes, of course,
for the best experience possible. That means top-notch, state-of-the-art care, delivered by
women and men who are highly competent and kind, in an environment of safety, comfort and
healing. Fortunately, that kind of ideal experience can be found close to home, according to
patients who report they are immensely satisfied with the high quality of care and services they
received at St. Clair. In an independent survey of patient satisfaction, these patients have given
St. Clair superlative ratings, catapulting the Hospital into the top 2 percent of hospitals nationwide.
Volume VI Issue 4 I HouseCall I 3
Patient satisfaction is impacted by many things above
and beyond hands-on patient care, says Joan. “It’s the
whole St. Clair experience
— from our valets to our
guest service representa-
tives to our volunteers to
our housekeeping staff —
these services matter a great deal to patients and are
part of their overall Hospital experience. We even have
menu concierges who visit each patient every day. For
many patients, meals are a highlight of the day. I can’t
say enough about our employees and volunteers and the
way they care about the patient experience. They get it.”
Physician leadership also drives high patient
satisfaction. “Our 550 physicians understand the
importance of the patient experience and are engaged
in this effort,” Joan says. St. Clair’s hospitalist program,
she adds, is also a major factor in patient satisfaction.
“We have a team of well-qualified hospitalists who
have a special skill set in managing the problems of
hospitalized patients, from newborns to the elderly.
They are always in-Hospital 24/7. They have a great
relationship with the nurses and provide seamless
continuity of care.”
Jose Christlieb, M.D., who serves as the medical
director of St. Clair’s hospitalists, says, “St. Clair has a
completely different culture from any other hospital in my
experience. It’s a true team, with the focus on the whole
patient. Patient needs are anticipated and the staff is
unfailingly kind and courteous. The interaction of the
nurses with patients is tremendous; I see it every day.
“I believe that patient satisfaction is driven by care
with great outcomes. Engaging the patient is key, and
that means listening and giving the patient your full
attention. When we communicate with empathy and
compassion, in language the patient understands,
patient satisfaction follows.
“Patient satisfaction is not about a score. I understand
that the numbers are necessary, but for me, it’s about
making a difference in someone’s life. Numbers cannot
capture what this is all about.”
PATIENT SATISFACTION:
The sum of the whole
Hospitalist Jose Christlieb, M.D., with patient Steve Kladakis of Paris, Washington County, near Weirton, W.Va.
The food is freshand healthy
PATIENT SATISFACTION:
A wide variety served
Highlight of the day
Enjoyable and contributes to recovery
“ST. CLAIR HAS
A COMPLETELY
DIFFERENT CULTURE
FROM ANY OTHER
HOSPITAL . . .
IT’S A TRUE TEAM,
WITH THE FOCUS
ON THE WHOLE
PATIENT.
”JOSE CHRISTLIEB, M.D.,HOSPITALIST,
ST. CLAIR HOSPITAL
Continued from page 3
PATIENT SATISFACTION
4 I HouseCall I Volume VI Issue 4
Joan agrees that data are not the whole story. “The
Press Ganey scores are important, and have helped us
transform the patient experience, but it’s not the scores
alone. They tell us where we stand. What takes St. Clair
beyond the patient’s expectations is the human element,
plus the amenities and personal touch. Patients value
human relationships and communication.”
Gracious. For Juanita Knouff, that’s the word that best describes the care she received at St. Clair Hospital
during a recent admission for intestinal surgery. “I’ve been
in other hospitals and I’ve never experienced anything like
the care I had at St. Clair,” she says. “It was gracious care,
and it was the best experience I’ve ever had as a patient.”
Juanita is a 74-year-old Brookline resident who
says she got so much attention from the staff that she
occasionally wondered if she was the only patient on
the unit. “When I walked in the hall for the first time,
I was shocked to see so many other patients! The nurses
took time with me and treated me like I was special.
My surgeon, Dr. (Leigh) Nadler, stopped in twice a day.
My husband, Richard, was amazed.” Adds Richard:
“The nurses explained everything about my wife’s care
to me, too. I always felt included.”
Confident in their skills, sensitive to human as well
as clinical needs, buoyed by teamwork and fortified by
a supportive nursing administration, nurses at St. Clair
are empowered to deliver exceptional care.
A shared sense of mission facilitates teamwork
at St. Clair, and that translates into better
care, says Beau Concillio, R.N., a staff
nurse on the Observation Unit, 4B.
“St. Clair is one giant family,” he says.
“Everyone’s role is important. At
St. Clair, we keep the patient and
family in the loop. Patients are sick,
scared, and away from home; when the
doctor comes in to update them on
their conditions and treatment, they will
often nod their heads to indicate that they
understand, but they aren’t fully hearing
everything that is being said. I’ll go over it all
with them to make sure they understand exactly
what the doctor is saying.”
Establishing an emotional connection with every patient
Susan Bonelli, R.N., BSN, with patientErnestine Banycky of Bethel Park.
Patients trustour nurses
PATIENT SATISFACTION:
Highly skilled
They take time to explain patient care
Continued on page 6
Volume VI Issue 4 I HouseCall I 5
6 I HouseCall I Volume VI Issue 4
Continued from page 5
PATIENT SATISFACTION
For Jason Graham, R.N., a staff nurse on Unit 5A,
the orthopedic unit, his co-workers are a key to his job
satisfaction. “5A is a busy place; fortunately we have a
tight group
of staff who
support
each other.
St. Clair has a talent for hiring people who are happy and
positive. The staff is caring and warm. We never forget
that the person in the bed is somebody’s loved one.”
Kathleen Casey, a Certified Nursing Assistant (CNA),
has worked at St. Clair for 18 years. To her, high patient
satisfaction is derived not only from the clinicians’ natural
empathy for their patients, but from utilizing their contin-
uously improving skill set at bedside. “St. Clair provides
constant classes; we never stop learning and that
enhances our caregiving. We will do anything
for the patients. Sometimes, all they really
need is a listener, someone they can talk to.”
According to Susan Bonelli, R.N., BSN,
a staff nurse on Unit 6E, a medical-surgical
unit: “My father was a patient here and received
phenomenal care — not because I work here
but because that’s the level of care that
everyone gets. Chief Nursing Officer Joan Massella
forwards notes from patients to us; if my name is
mentioned by a patient, she sends an email. It means
a lot.” When Susan orients new nurses, she tells them,
‘No matter how bad your day is, you’re not the patient
in the bed.’” Susan also credits other members of the
staff. “The dieticians work closely with families and do
a lot of patient education. I think our high patient satis-
faction is also due to the contributions of our volunteers,
who are amazing.”
We never forget that the person in the bed is somebody’s loved one.
Kevin Johnson, at right, a patient transporter in the PhysicalTherapy Department, and Jason Graham, R.N., with patient Al Borza of South Fayette.
“I CHOSE TO PRACTICE AT ST. CLAIR BECAUSE OF
THE SHARED SENSE OF MISSION THERE. PEOPLE
HAVE A HIGHER PURPOSE BEYOND A JOB.”VINCENT E. REYES, JR., M.D.,ST. CLAIR HOSPITAL
Vincent E. Reyes, Jr., M.D.
Volume VI Issue 4 I HouseCall I 7
One of those amazing volunteers is Marcia Cohen,
a Mt. Lebanon resident and retired school principal who
became a patient at the Hospital when she was diagnosed
with ovarian cancer in the fall of 2012. “I was watching a
medical show on television,” she explains. “They were doing
a show about ovarian cancer and listed the symptoms. I had
every single one. Two days later I had an ultrasound; I had
massive tumors on both ovaries. I had a total hysterectomy,
then chemotherapy at the Hospital’s infusion center,
with oncologist Dr. Vincent Reyes overseeing my care.
The nurses were wonderful to me and Dr. Reyes was
incredible. He’s warm and caring and treated me like
family.” Marcia had such a positive experience at St. Clair
that she became a volunteer at the Hospital, where she
helps other women fighting cancer.
Marcia’s oncologist, Dr. Reyes, believes that commu-
nication is one key to patient satisfaction.“A patient who
is kept informed is an empowered patient. She or he is
part of the decision-making process and has less fear of
the unknown. St. Clair patients are well informed; they
are partners with me on this journey.”
Dr. Reyes credits the Hospital’s nurses for St. Clair’s
stellar patient satisfaction ratings. “The nurses are
responsible for patient care, every hour of every day.
It’s the nurses who execute the plan of care. Patients
never forget good nurses.”
“I chose to practice at St. Clair because of the shared
sense of mission there. People have a higher purpose
beyond a job. I think patients sense this, and that makes
them feel very comfortable at St. Clair Hospital.” n
Our doctorspersonalize patientcare
PATIENT SATISFACTION:
Physicians spendquality timeGenuine concern for patient questions and worriesReassuring, calming anxieties
JOAN MASSELLA, R.N., M.ED., MBA
Joan is Administrative Vice President and Chief Nursing Officer atSt. Clair Hospital. She previously served as Nurse Manager of the Psychiatric Unit, Director of Psychiatric and Medical/Surgical Units,and Director of the Family Birth Center. Joan holds a Master ofBusiness Administration from West Virginia University, a Master ofEducation from Duquesne University, and a Bachelor of Science inNursing from Edinboro State University.
To contact Joan Massella, please call 412.942.2100.
8 I HouseCall I Volume VI Issue 4
A HANDS-ON APPROACH
“I’m youngand healthy...how did thishappen?”
As a senior nursing student, Alycia Jones of Brownsville, Fayette County, knows
well the importance of living a healthy lifestyle. She is a 23-year-old woman
who, in addition to attending classes and clinicals at California University of
Pennsylvania, works hard to maintain her health and fitness; she runs five days a week,
lifts weights, does cross training and follows a healthy, balanced diet. “I’ve always been
health conscious and tuned into my body,” Alycia says. “In nursing school, I’m learning
how important that is in disease prevention. Many conditions are lifestyle-related, and
we have control over that. I have always tried to take good care of myself.” Her training,
self-awareness and intuition paid off earlier this year when she recognized that some-
thing was not right with her body. “I always know when something is wrong,” she recalls.
Bringing an expert touchto delicate surgery
“Dr. McQuone made me feel comfortable…She was always smilingand reassuring. I’venever known anotherdoctor like her.
” ALYCIA JONES
Dr. Shelly McQuone performs a follow-up exam on patient Alycia Jones.
Continued on page 10
Volume VI Issue 4 I HouseCall I 9
BOARD-CERTIFIED OTOLARYNGOLOGIST SHELLY J. MCQUONE, M.D., FACS
OFFERS A HANDS-ON LEVEL OF EXPERTISE TO THE DIAGNOSIS,
TREATMENT AND CARE OF PATIENTS AT ST. CLAIR HOSPITAL.
Continued from page 9
A HANDS-ON APPROACH
10 I HouseCall I Volume VI Issue 410 I HouseCall I Volume VI Issue 4
“At first, it was not anything specific. I just sensed that something was off. Then I began developing
strange symptoms: fatigue, heart palpitations, swelling of my lower extremities and weight
fluctuations. I saw my primary care physician, who felt a nodule on my thyroid, on the right side,
and told me that I had hyperthyroidism.”
Hyperthyroidism occurs when the thyroid gland produces an excessive amount of a hormone
called thyroxine, or T4 — the hormone that is responsible for metabolism. The thyroid gland is a
tiny, soft, butterfly-shaped gland that sits in front of the trachea. Its miniscule size belies its signif-
icance to physiologic functioning — the thyroid is a critically important organ that regulates every
aspect of metabolism, the process by which the body takes in calories from food and converts them
to energy. A healthy thyroid regulates the heart rate, breathing, body temperature, digestion and
thousands of other cellular processes. When the thyroid is healthy, it performs with quiet efficiency,
Patient Alycia Jones with Dr. Shelly McQuone.
“She told me to stay positive.I can’t express
what a difference that made for me.
”ALYCIA JONES
Continued on page 12
Volume VI Issue 4 I HouseCall I 11
but an unhealthy thyroid can wreak havoc on the body.
Disorders of the thyroid generally take two forms: abnormal
hormone production and abnormal growths. Abnormally
low production results in hypothyroidism, the most common
disorder, and excessive production leads to hyperthyroidism.
Abnormal growths,or thyroid nodules, are common, but
may mean thyroid cancer.
An ultrasound revealed just such a nodule on the right
side of Alycia’s thyroid gland. A needle biopsy was performed,
and it was negative for cancer. She was referred to an
endocrinologist, who in turn referred her to Shelly J.
McQuone, M.D., FACS, a board-certified otolaryngologist
who recently joined the staff of St. Clair Hospital.
“Alycia’s case was medically interesting and not
entirely typical,” says Dr. McQuone. “She had symptoms
of hyperthyroidism: weight loss, sweating and palpitations,
along with laboratory testing supporting the initial diag-
nosis of Plummer’s Disease, a thyroid condition in which
there is a hyperfunctioning nodule that is secreting
excessive thyroid hormone, resulting in hyperthyroidism.
Her thyroid scan demonstrated a hyperfunctioning area,
or a ‘hot nodule’ — one nodule that is overactive, and the
apparent source of the excess hormone. Alycia’s history,
laboratory and imaging findings were all consistent with
Plummer’s Disease, and the treatment for that is a
hemithyroidectomy, the surgical removal of the affected
half of the thyroid. That usually results in the resumption
of normal functioning.”
Consequently, Dr. McQuone performed a hemithy-
roidectomy on Alycia at St. Clair, and Alycia did well
throughout the procedure and post-operative period.
But there was an unexpected development: although
both the original needle biopsy and the frozen section
biopsy, done during surgery, were negative for cancer,
the final pathology report indicated Stage I follicular
thyroid cancer. “It was a surprise; I was not expecting
that,” says Dr. McQuone. “Thyroid cancer is usually
asymptomatic; it most typically presents as a painless
nodule, or lump in the neck. It is not usually associated
with any abnormalities in blood tests, including thyroid
function studies. Patients say, ‘But I feel fine and my
bloodwork is normal.’ Neither is relevant. Alycia was
unusual in that she had symptoms. But her cancer was
in the earliest stages and that was important.”
Fortunately, most thyroid nodules are benign. A benign
nodule may be removed if it has suspicious features on a
needle biopsy specimen, or an ultrasound, or is associated
with other risk factors such as heredity or history of
radiation. In these instances, a portion of the thyroid is
removed for the purpose of obtaining a definitive diagnosis
on the nodule. If it later proves to be benign, no further
surgery is necessary. If the nodule turns out to be malignant,
often the remaining half of the thyroid gland is removed
at a second surgery.
According to the National Cancer Institute, 60,000
people in the U.S. are diagnosed with thyroid cancer
every year. It is more common in women, especially
women who are 50 or older. There are four kinds of
thyroid cancer: papillary, follicular, medullary and
anaplastic, with papillary being the most common by far.
Follicular thyroid cancer is the second most common
type, and it is the type that Alycia Jones was found to
have. One week after the surgery to remove the right
side of her thyroid, Alycia again placed herself in the
skilled and competent hands of Dr. McQuone, and
underwent the exact same procedure, hemithyroidectomy,
on the remaining left half of her thyroid, to prevent the
cancer from spreading.
Patient Alycia Jones works out daily.
Frank Torok, M.D., explains the effect of the radioactive medication Alycia Joneswill take to help rid her thyroid of any remaining cancer cells, and her needto self-quarantine for five days following ingestion.
Nuclear medicine, a subspecialty of radiology, involves the
administration of radioactive compounds into the body,
orally or by injection, for diagnostic or therapeutic purposes.
This is usually followed by a scan that provides data to further a
diagnosis or treatment plan. Within the field of medical imaging,
nuclear medicine is unique in that it can be used to study not only the
anatomic structures of the body, but the functions as well. Although
it may sound a bit frightening to think of radioactivity being introduced
into the body, nuclear medicine is safe and the procedures are
non-invasive and painless.
Board-certified in radiology and nuclear medicine, Frank S.
Torok, M.D.’s expertise enables St. Clair Hospital to offer advanced
care for thyroid cancer, hyperthyroidism, heart disease, and a wide
range of other diseases and conditions that can be diagnosed and
treated with the special capabilities of nuclear medicine.
Dr. Torok receives referrals from a variety of medical specialists
to diagnose and treat patients with thyroid problems, such as
thyroid cancer.
NUCLEAR MEDICINE:SAFE AND PAINLESS
Alycia then progressed to the next phase of treatment,
which involved the administration of radioactive iodine (RAI) to
complete the eradication of thyroid cancer cells from her body.
Frank S. Torok, M.D., board-certified radiologist and nuclear
medicine specialist, is personally managing her care, as he
does for every thyroid cancer patient at St. Clair. “Six weeks
post-op, the patient receives radioactive iodine to rid the
body of any thyroid tissue,” he says. “Thyroid tissue is avid for
iodine; the radioactive iodine sits in the body and attracts the
thyroid tissue. It is retained in the thyroid tissue, where it
slowly destroys thyroid cells and thyroid cancer cells, but
does not harm the other cells in the body.”
Alycia’s RAI therapy began with a full body scan and two
weeks on a low-iodine diet. That meant avoiding dairy, eggs
and any foods containing iodized salt, which is present in
nearly every processed food in the supermarket. “It isn’t
easy. The purpose of the strict diet is to make the thyroid
tissue crave iodine, so that when it is administered to the
patient, it takes up the iodine ravenously,” Dr. Torok explains.
“In the past, the patient had to go six weeks without thyroid
hormone and they felt awful. Today, we give the patient
injections to raise the level of TSH — thyroid stimulating
hormone — which stimulates the thyroid tissue and cancer
cells to take up the iodine. The RAI is more effective this way.”
After completing the two-week diet, Alycia came to
St. Clair’s Nuclear Medicine department where she received
RAI in pill form. After the administration of the RAI, the body
will emit radiation so precautions are necessary to avoid
exposing others to radiation. The iodine is gradually eliminated
through the urine, sweat and saliva, and the patient has to be in
isolation for five days, avoiding close contact with others. For
Alycia, who resides with her mother, this meant segregating
herself within her own home.
“Alycia did well and we will recheck her in one year,”
Dr. Torok says. “Patients have to return every year for a full
body scan. Fortunately, thyroid cancer is one of the most
curable cancers.”
Thyroid surgery is a significant portion of Dr. McQuone’s
practice, although, as an otolaryngologist and ear, nose and
throat specialist, she has expertise in treating a broad range
of conditions of the head and neck. Her patients include those
with head and neck cancers, including cancer of the thyroid,
parathyroid, larynx, esophagus, tongue and lymph nodes.
Dr. McQuone also treats thyroid disease, vocal cord disorders,
sinus problems, allergies, airway obstructions, cleft palate,
ear disorders, hearing loss, balance problems, sleep apnea
and facial trauma. The busy surgeon typically performs eight
to 10 surgical procedures each week, from insertion of ear
tubes to complex cancer surgeries.12 I HouseCall I Volume VI Issue 4
Continued from page 11
A HANDS-ON APPROACH
“I was drawn to head and necksurgery in medical school. It’s a combination field in many ways, both medical and surgical. The specialty
is a good fit for me.
”SHELLY J. MCQUONE, M.D., FACS
Thyroid and parathyroid surgery is delicate and highly
specialized, due to the proximity of the glands to the airway and to the
nerves that control the vocal cords. “Thyroid surgery is less invasive
today and we are able to make smaller incisions,” Dr. McQuone says.
“Most thyroid and parathyroid surgery can be done on an outpatient
basis, unless there is a large tumor that requires removal of the entire
gland. Patients have very little pain and usually recover quickly. They
can generally resume regular diet and normal activity right away.”
Alycia Jones is immensely grateful to Dr. McQuone and describes
her as a superb surgeon. “As a surgeon, Dr. McQuone is incredibly
skilled. I had two surgeries in the exact same spot, one week apart,
but the scar in the front of my neck is barely visible.” Alycia also regards
Dr. McQuone as a role model who demonstrated to the future nurse
that compassion and caring are as essential as clinical expertise for
healthcare professionals. Dr. McQuone, says Alycia, addressed not only
the unexpected diagnosis of cancer but also the fear and confusion
that left her reeling for a while. “This was very hard for me,” Alycia says.
“I’m young and healthy. I kept wondering, how did this happen? When
they first gave me the cancer diagnosis, it took a few days for it to really
hit me, to sink in. Dr. McQuone was great. She was so positive with me,
and she told me to stay positive. I can’t express what a difference that
made for me. I decided that I could face it, come to terms with it and
accept it. Dr. McQuone made me feel comfortable. She was kind and
caring in the way that she told me it was cancer, and that I would need
another operation. She was always smiling and reassuring. I’ve never
known another doctor like her.”
Dr. McQuone says that for Alycia, the overall prognosis is excellent.
“Alycia has received radioactive iodine, but no chemotherapy or radiation
will be necessary. Thyroid cancers do not respond well to radiation
therapy or chemotherapy and therefore these treatments are not
generally employed. The radioactive iodine is a one-time treatment, and
was undertaken approximately four to six weeks after surgery in
conjunction with a full body scan. The scan is used to determine if there
are any thyroid cells left in the body after surgery. Frequently, they
microscopically adhere to the trachea or may have spread to the cervical
lymph system. So we need to determine if any thyroid tissue remains,
and, if so, whether or not it has spread. The most common area of
spread would be the lymph nodes of the neck, but metastasis in very
rare circumstances can occur in the lungs, bones or brain, among other
organs. It helps that Alycia is young and in great health. She will need
to be monitored for cancer, although the rate of recurrence is low.
She will be on lifelong thyroid replacement, and her care will be
co-managed with endocrinology. She should have a normal life and
normal life expectancy.”
Continued on page 14
Volume VI Issue 4 I HouseCall I 13
Continued from page 13
A HANDS-ON APPROACH
As the head of the department of nursing and a professor of nursing at
Robert Morris University School of Nursing and Health Sciences in Moon
Township, Nadine Englert, Ph.D., R.N. teaches her students the art and
science of nursing. Now she has something new to offer her students:
the perspective of the patient, an experience she gained recently while
having sinus surgery at St. Clair Hospital. Dr. Englert, 48, of Mt. Lebanon,
had never had surgery or been an in-patient at a hospital before, except
during the births of her three children. Normally, she’s a healthy, vibrant,
high-energy powerhouse who juggles a demanding job with a home and
family, but a severe and stubborn sinus infection was taking a toll on her
health and well-being.
“It started on July 4. I developed a congested cough and raspy voice
and nothing seemed to help. For the next four months, my primary care
physicians at Mt. Lebanon Internal Medicine and my pulmonologist
treated me with medication, including four different courses of antibiotics
and two courses of steroids. I was told that I had a chronic, drug-resistant
infection that my doctor thought was stemming from my sinuses. The
chronic coughing resulted from sinus drainage and my body’s attempt
to get rid of the infection. Despite no previous history of sinus problems,
my doctor felt that the most appropriate course of action was to consult
an otolaryngologist and he referred me to Shelly J. McQuone, M.D.”
Dr. McQuone ordered a CT scan of Dr. Englert’s sinuses and
performed a nasal endoscopy in the office; these two diagnostic
measures confirmed that she had a severe sinus infection and revealed
a surprise: Dr. Englert had a structural defect in her nasal septum.
Dr. McQuone suggested surgery to eradicate the infection and repair
the deviated septum. “Dr. McQuone explained things to me in great
detail,” Dr. Englert says. “At heart, she is a teacher and she really
cares that you understand what she is going to do and what you will
experience. She pulled up a stool and sat with me, drawing diagrams
and pictures and answering every question. I felt well prepared.”
Dr. Englert underwent surgery at St. Clair under general anesthesia.
Dr. McQuone describes the procedures: “I performed bilateral endoscopic
sinus surgery using a CT image-guided technique, balloon sinoplasty
on the frontal sinuses, as well as septoplasty, establishing adequate
ventilation to the previously occluded sinus passages. I also used
powered instrumentation to vacuum the infected tissue. The balloon
procedure can be used to safely access such areas as the frontal sinus,
which is under the forehead, and enlarge the natural openings into
these sinuses also.” Dr. Englert was discharged by late afternoon,
with little pain other than a headache, and that was manageable with
over-the-counter medication. Post-operatively, there was some nasal
swelling and a bit of bleeding, but no bruising at all, which Dr. Englert
attributes to the extraordinary skill of her surgeon. Dr. Englert returned
to Dr. McQuone’s office two days later to have stents removed; the
sutures in her left sinuses will be absorbed by her body.
“I received fabulous care from Dr. McQuone and from St. Clair Hospital.
Believe me, as a nurse educator, I was paying attention! St. Clair is a
“Dr. McQuone always sat atmy eye level to talk with me. She never stands over the patientand never talks at you. She hasthe best bedside demeanorI have ever seen.
”NADINE ENGLERT, PH.D., R.N.
Nadine Englert, Ph.D., R.N.
Valuable lessons learned from being a patient
14 I HouseCall I Volume VI Issue 4
Volume VI Issue 4 I HouseCall I 15
FRANK S. TOROK, M.D.
Dr. Torok specializes in radiology and nuclear medicine. He earned his medical degree at The Pennsylvania State University School of Medicine andcompleted residencies at The Washington Hospital and the University ofPittsburgh Medical Center. He also completed a fellowship at UPMC. Dr. Torokis board-certified in radiology, nuclear medicine, nuclear cardiology, familypractice and geriatrics. He practices with South Hills Radiology Associates.
To contact Dr. Torok, please call 412.942.3101.
SHELLY J. MCQUONE, M.D., FACS
Dr. McQuone specializes in head and neck surgery. She earned her medicaldegree at The University of Virginia School of Medicine, and completed herresidency in head and neck surgery at The Johns Hopkins University Schoolof Medicine, where she also did an internship in general surgery.Dr. McQuone was a Head and Neck Surgical Oncology Fellow at The JohnsHopkins University School of Medicine, where she served as Assistant Chiefof Service in the Department of Otolaryngology-Head and Neck Surgery.She is board-certified by the American Board of Otolaryngology. Shepractices with Straka & McQuone, Inc.
To contact Dr. McQuone, please call 412.668.3395.
Robert Morris University Nursing Professor Nadine Englert, Ph.D., R.N., uses a full-size skeleton at RMU’s School of Nursingto explain the sinus procedure she underwent at St. Clair Hospital. The RMU Nursing students are, left to right, Molly Delaney,Victoria Morando, Nicholas Plansinis, and Jessica Blodgett.
“I will take back to the classroom the lessons I learned from Dr. McQuone and the St. Clair Hospital staff.
”NADINE ENGLERT, PH.D., R.N.
well-oiled machine, extremely organized, but the
staff does not sacrifice personal care for the sake
of efficiency. The nurses were delightful; in every
single interaction I had with a nurse, she told me
what she was doing and why. They were extremely
attentive and constantly cognizant of patient
safety. I was touched that Diane Puchetti, Director
of Peri-Operative Services, stopped by to say hello
and see how I was doing.”
At two weeks post-op, Dr. Englert was back to
work and feeling great. “Having outpatient surgery
was a new experience,” she says. “I will take
back to the classroom the lessons I learned from
Dr. McQuone and the St. Clair Hospital nursing
staff. One of the strongest impressions that remains
with me is the way Dr. McQuone always sat at my
eye level to talk with me. She never stands over
the patient and never talks AT you. She has the
best bedside demeanor I have ever seen. The
nurses showed me the importance of keeping
the patient informed. That takes away fear and
anxiety. I knew I was in good hands and I could
trust their care.” n
PERRI FAMILY LEGACY
16 I HouseCall I Volume VI Issue 4
All inthe FamilyDrs. Bill and Jeff Perri flank their sister, Mary Anne Perri, CRNA, before the three of them scrub in before a surgery at St. Clair Hospital.
Volume VI Issue 4 I HouseCall I 17
W hen Dr. Francis Perri retired in 1998 at
age 73 after an exemplary career as a
surgeon, he left his practice to a worthy
successor: his son, Jeff. Jeff attended medical school
at Georgetown University, as his father had. The senior
Dr. Perri trusted that his thriving surgical practice
was in excellent hands. Their three years in practice
together are deeply meaningful to both.
“I know that my Dad waited for me,” says Dr. Jeff
Perri, who is now chairman of the Department of
Surgery at St. Clair. “He could have retired sooner.
I began practicing with him in 1996 and we had a
unique situation. Although three of my brothers
are also surgeons, I was the first in the family to
become a surgeon. My sisters are both nurses.
Mary Anne is a nurse anesthetist at St. Clair,
and Kathy works in Philadelphia.”
Dr. Jeff Perri has clear memories of child-
hood experiences that inspired his professional
aspirations. “I knew when I was 10 that I was
going to be a surgeon. My earliest recollections
are of running into people in Mt. Lebanon and
hearing them say things like, ‘Your Dad saved
my life,’ and ‘Your Dad operated on me and helped
me so much.’ It happened a lot and it made an
impression.”
After his father retired, Dr. Jeff Perri had a solo
practice for nine years, until his younger brother Bill
joined Perri Surgical Associates in 2007. Bill had
initially planned to become an attorney, but changed
direction after a pivotal experience with his father
and Jeff. “I was at a restaurant with Dad and Jeff,
Continued on page 18
Dr. Francis Perri, fourth from left, is surrounded by family/fellow clinicians following his last surgical procedure
at St. Clair Hospital. He retired in 1998.
THE PERRI FAMILY CONTINUES THEIR LEGACY OF CARE.
Jeffrey A. Perri, M.D., FACS and William M. Perri, D.O., FACS are brothers and surgeons whose
education began at home, well before they took their first pre-med classes. They are two of the 12
children of Francis R. Perri, M.D., who performed general surgery for decades at St. Clair Hospital.
Dr. Francis Perri is a physician and surgeon, a World War II veteran, a leader, and a teacher who
trained hundreds of surgeons. But his most cherished role is that of husband and father. To his
family, he is a revered figure, a gentle and humble man who set high standards and taught his
children, simply by being himself.
Continued from page 17
PERRI FAMILY LEGACY
18 I HouseCall I Volume VI Issue 4
and they were discussing an operation that another
surgeon had performed. Dad was drawing pictures on
a napkin, explaining how it should have been done. I was
fascinated and thought, ‘This is what I should be doing.’
I knew then that I was going to go to medical school.”
Bill graduated from Duke University and LECOM. Both
brothers perform a wide variety of surgical procedures.
“In my practice with Bill, we do general surgery, such as
hernia repairs, appendectomies, thyroid and parathyroid
surgery, and gall bladder removals; we also do oncologic
surgery and a good deal of emergency surgery,” Dr. Jeff
Perri says. “We also perform colorectal surgery and
minimally invasive colon resections.” Dr. Jeff Perri
also performs mastectomies, and both brothers are
trained in robotic-assisted surgery using the da Vinci
robotic system.
The Perri brothers appreciate the fact that their
situation is exceptional. According to Dr. Bill Perri,
“It’s fun to work with my brother Jeff, but also with
my sister Mary Anne. She’s excellent; I have complete
confidence in her skills as a nurse anesthetist. It’s
great when we’re all in the OR together. Adds Dr. Jeff
Perri, “In the OR, Bill and I are surgeons first and
brothers second. We can say anything to each other
and there will be no hard feelings. We know that the
patient’s best interest comes first.”
“IN THE OR, WE ARE
SURGEONS FIRST AND
BROTHERS SECOND …
THE PATIENT’S BEST
INTEREST ALWAYS
COMES FIRST.
”JEFFREY A. PERRI, M.D.,ST. CLAIR HOSPITAL
Continued on page 20
WILLIAM M. PERRI, D.O.
Dr. Perri earned his medical degree at LECOM, Erie, Pa. He completed his internship at ConemaughMemorial Medical Center and his residency at Pinnacle Health System, Harrisburg. Dr. Perri isboard-certified by the American Board of Surgery. He practices with Perri Surgical Associates, LLC.
To contact Dr. William Perri, please call 412.942.5660.
The past year has been unexpectedly challenging for
38-year-old Krista Fahnestock. Around Labor Day last
year, she developed abdominal pain and was given a
diagnosis of diverticulitis, an inflammation of pouches
that form in the intestine. She was doing well until
the following March, when a high fever landed her in
St. Clair Hospital. “I had a horrible infection with an
abscess in my left side; I was referred to Dr. Jeff Perri.
He was fantastic.
“I’m young to have diverticulitis. He recognized my
fear and explained everything to me.” He was honest,
but I knew he was trying not to scare me.” Although
Dr. Jeff Perri was Krista’s primary surgeon, brother Bill
was also in the operating room for her case. “It was a
minimally invasive procedure,” she says.
Krista is married with one child and lives in Hickory,
Washington County. As an X-ray technician, she’s familiar
with hospitals and doctors. “I felt like the Perri brothers
were in tune with me. This was a big surgery, but I knew
I was in good hands. When I told Dr. Jeff that, he put
his hands out to me and I held them. On my last day
in the Hospital, he hugged me. I expected a handshake,
so that was nice.” n
JEFFREY A. PERRI, M.D.
Dr. Perri earned his medical degree at Georgetown University Medical School, Washington, D.C.He completed his internship and residency at Mercy Hospital, Pittsburgh. Dr. Perri is board-certifiedby the American Board of Surgery. He practices with Perri Surgical Associates, LLC.
To contact Dr. Jeffrey Perri, please call 412.942.5660.
KristaFahnestockis one of the
many patients ofthe Perri
brothers whobenefitedfrom theirdiligence.
“I FELT LIKE THE
PERRI BROTHERS WERE
IN TUNE WITH ME.
THIS WAS A BIG SURGERY,
BUT I KNEW I WAS
IN GOOD HANDS.
”KRISTA FAHNESTOCK,PATIENT
LIKE THEIR FATHER BEFORE THEM, THE PERRI BROTHERSCONTINUE A TRADITION OF PATIENT-FOCUSED CARE
Volume VI Issue 4 I HouseCall I 19
PATIENT PROFILE
Dr. Francis Perri is 88 now and has been
retired for 16 years. He is a modest, soft-
spoken gentleman who speaks with pleasure
about his life’s work and his family. The Perris
have 10 sons and two daughters, 24 grand-
children, and two great-grandchildren. Looking
back on his years as a surgeon, he cherishes
the gratitude of his patients and finds great
meaning in the opportunities he had to teach
and train other physicians. His daughter
Mary Anne Perri explains: “My Dad inspired
a lot of us to go into healthcare. Being a nurse
anesthetist is perfect for me and I love it.
Working with my brothers is fun. We’re often
on call at the same time, so we sometimes
do the same cases.”
The son of a physician and a nurse,
Dr. Francis Perri grew up in Monaca, Beaver
County, and attended high school and college
at St. Vincent Seminary and College in Latrobe,
where he excelled in academics and sports. He
later served in World War II as a radio operator.
Wanting to emulate his father, Francis Perri
applied to Georgetown University Medical
School, where he met Prudence Boutin, a
medical technologist from Minneapolis who
shared his love of biology. In 1954 he married
Prudie and the couple moved to Pittsburgh.
Following a residency in general surgery at
Mercy Hospital, he went to New York for a
fellowship at Memorial Sloan-Kettering Cancer
Center where he acquired expertise in cancer
surgery. By then, several of their children had
been born, with more to come.
In 1960, the family moved back to Pittsburgh;
Dr. Perri opened a solo practice and joined the
staff at Mercy, eventually becoming chair of
the department of surgery. He performed a
broad range of procedures, including many
cancer surgeries. “I got all the bad cancer
cases,” he recalls, “because I had trained at
Sloan-Kettering.” They moved to their present
home in Mt. Lebanon in the early 1960s and
before long, found themselves adding two bed-
rooms to accommodate their expanding family.
Dr. Perri knew the surgeons at the brand new
St. Clair Hospital, not far from his home. When
they asked him if he would like to moonlight
at the Hospital, working one night per week in
the Emergency Room, he accepted. Before
long, he had joined the staff.
Seven of the Perri children followed their
parents into healthcare. As there are hints of
interest in medicine among some of the
grandchildren, an expansion of Perri Surgical
Associates may be on the horizon. n
20 I HouseCall I Volume VI Issue 4
Continued from page 18
PERRI FAMILY LEGACY
THE FAMILY PATRIARCH
The Perri family has been providing three generations
of healthcare.
(At left) Dr. Francis Perri and his wife, Prudie, recently stopped for a quick breakfast with theirsons, Drs. Jeff and Bill Perri, in the brothers’ officesin St. Clair Hospital Professional Office Building.
A picture from the family scrapbook shows newly minted physician
Francis Perri, M.D. performing a procedure.
Most surgical procedures are elective
and are therefore scheduled to
take place on weekdays, with
ample opportunity for the surgeon to know
his or her patient and the patient’s condition.
But, of course, surgical emergencies happen,
too, often in off-hours. At St. Clair Hospital,
general surgeons are available 24/7/365,
ready to respond when a patient’s life or
health is jeopardized by a condition that
requires immediate surgical intervention.
“During the off-hours, meaning
nights and weekends, we may get a
call from the Emergency Room
telling us that there is a suspected
surgical emergency,” Dr. Jeff Perri
explains. “Typically, this might be a
perforated gastric ulcer, a perforated
intestine from diverticulitis, or a bleeding
ulcer. Appendicitis was once considered
a surgical emergency, but studies indicate
that if there is no perforation and the patient
is stable, they can be admitted and given
antibiotics and then have surgery the
following morning.”
Performing emergency surgery in the
middle of the night is no simple matter —
it requires considerable logistics, including
the assembly of a surgical team and prepa-
ration of the Operating Room. Dr. Jeff Perri
credits St. Clair’s Emergency Department
for streamlining the process. “St. Clair has
an excellent, highly efficient emergency
department, and that makes a difference.
They stabilize the patient and initiate the
diagnostic tests, and get things rolling right
away, in terms of notifying the on-call surgeon
and getting the OR ready. We notify the nursing
supervisor, who calls in the OR staff and
anesthesia, and we open up the room and go
to work.”
A surgical team includes a surgeon or
surgeons, an anesthesiologist or anesthetist,
surgical nurses, OR technicians and other
clinicians, all of whom are highly trained for
this scenario. Supportive services, including
laboratory, blood bank and pharmacy, are
available if needed. Provision must be made
for the post-anesthesia and post-operative
nursing care of the patient as well, whether in
the Intensive Care Unit or other nursing unit.
Dr. Jeff Perri says that St. Clair’s Surgery
Department has an on-call system with a
rotating schedule of surgeons. “Our emergency
department is one of the busiest in south-
western Pennsylvania, so we get called quite
a bit, at least for a surgical consult, if not for
a surgical procedure. The emergency room
physician assesses the patient and calls the
surgeon on-call, and we determine if the
patient needs surgery, and if it needs to be
done immediately.”
Dr. Jeff Perri says that surgeons get used
to performing surgery whenever they are
needed. “Residency prepares us for that.
Emergency operations are interesting
and exciting and you always have a little
adrenalin flowing.”
For Drs. Jeff and Bill Perri, and their
surgical colleagues at St. Clair, being on-call
for emergencies is part of the job. For them,
interrupted sleep is offset by the satisfaction
of knowing that they were able to help
someone in critical need, someone who
also did not expect to be in the OR in
the middle of the night. n
SURGEONS INCLUDING THE PERRI BROTHERS ARE AVAILABLEIN CASE OF EMERGENCY AROUND-THE-CLOCK
At St. Clair Hospital, general surgeons are available 24/7/365,
ready to respond when a patient’s life or health is jeopardized
by a condition that requires immediate surgical intervention.
Volume VI Issue 4 I HouseCall I 21
Patients benefit from technologicaladvances in orthopedic surgery
Nearly 30 million Americans live with the pain and
disability of knee osteoarthritis, and chances are
good that most of those people have been led
to believe that knee replacement surgery, or total
knee replacement, is inevitable. Not necessarily, says
Jon B. Tucker, M.D., a board-certified St. Clair Hospital
orthopedic surgeon who focuses on knee and shoulder
disorders. Many patients who have been told they need
total knee replacement may not need it after all, he says,
thanks to advances in orthopedic surgical technology that
are designed to preserve and restore diseased joints,
rather than replace them.
“My focus is joint preservation,” Dr. Tucker says.
“There are new, advanced options to restore cartilage
and preserve all or part of the joint; these are
wonderful developments in orthopedic
surgery. They are alternatives that can
keep you going until you clearly need
total knee replacement, or they can keep
you going without having to undergo a
replacement at all.”
Dr. Tucker describes his typical
knee replacement patient as a middle-
aged person with a knee problem
that causes pain and instability that
eventually impair quality of life.
The patient is told to take anti-inflammatories, get cortisone
shots, modify their lifestyle, lose weight, use a cane and
be prepared to have a total knee replacement. “About
half of the people I see who think they need a total knee
replacement have a condition that is treatable with less
invasive procedures and techniques. Many of these
people will actually do better with a less invasive
surgery than a total knee replacement. It’s a highly
individual matter; every person’s knee, their demands
and their expectations are unique.” Dr. Tucker is not
opposed to total knee replacements; he frequently performs
the procedure. “Total knee replacement is a great
procedure. St. Clair’s surgeons use multimodal
pain management, so it isn’t the ordeal it
once was. But a total knee replace-
ment is no simple matter.”
In his practice, Dr. Tucker
uses Magnetic Resonance
Imaging, or MRI, for short.
An MRI, he says, is like
a piece of fine art —
detailed and rich with
information. “Images
provide the nuance
that makes the
difference,” he says.
ORTHOPEDIC ADVANCES
JOINT REPLACEMENT SURGERY IS UNQUESTIONABLY ONE OF THE MIRACLES
OF MODERN MEDICINE. BUT IT’S NOT THE ONLY ALTERNATIVE FOR PATIENTS
WITH OSTEOARTHRITIS.
22 I HouseCall I Volume VI Issue 4
Jon B. Tucker, M.D.
Volume VI Issue 4 I HouseCall I 23
“ABOUT HALF OF THE PEOPLE I SEE WHO THINK
THEY NEED A TOTAL
KNEE REPLACEMENT
HAVE A CONDITION THAT
IS TREATABLE WITH LESS
INVASIVE PROCEDURES
AND TECHNIQUES.
”JON B. TUCKER, M.D.,ORTHOPEDIC SURGEON,ST. CLAIR HOSPITAL
Continued on page 24
“For instance, you can see bone marrow lesions (BML) on an MRI. BMLs are little micro-
fractures — insufficiency fractures — in the bony tissue in the joint just beneath the cartilage.
The bone starts to crumble. An MRI helps me plan exactly what surgery you need, according
to your personal anatomy.”
To Dr. Tucker, these advancements reflect the evolution taking place in orthopedics.
“It represents a coming together of advancements in medical science and technology.
We’re learning more about osteoarthritis all the time: what makes it hurt? What can be done
about it? What is actually causing the disability and pain? When we know, we can match the
problem with the right tools. These days, a versatile surgeon has many tools in the toolbox
— it’s no longer just total knee replacement. These advances bridge the gap between non-
surgical treatment of osteoarthritis, which remains very important, and total knee replacement.
An experienced surgeon can expertly match the right minimally invasive techniques with the
right patient and achieve a great outcome. This can significantly delay and even eliminate the
need for total knee replacement. It’s a matter of what can be done versus what should be done.”
Dr. Tucker believes that the newer technologies bring customized treatment for each
patient. “My goal is always to choose what is best for each patient, and to consider all
procedures after listening to each patient’s needs and collaborating with them on a treat-
ment plan.”
Orthopedic surgeon Jon B. Tucker, M.D. prepares for a recent knee procedure in an operating room at St. Clair Hospital. Dr. Tucker says newer technologies bring customized treatment for each patient.
R ICHARD JUST ICE :
Back to work, pain-freeRichard Justice, 52, of Oakdale, was a veteran of four knee
operations, before meeting Dr. Tucker. He lived with constant
severe pain for 18 years, due to kneecap misalignment
problems and osteoarthritis.
Previous surgeries were all
attempts to realign his cracked,
chipped kneecap and debride
the joint; the procedures provided short-term relief at best.
As a contractor, his work is physically demanding and
he found ways to cope with the pain, remarkably never
missing a day of work, but it’s been a struggle. “I knew
I was heading toward a total knee replacement,” he says.
“Nothing helped — including cortisone shots or physical
therapy. I was always on and off crutches. Chronic pain
wears on you.”
Dr. Tucker performed a partial knee replacement
on Richard’s brother-in-law and he, in turn, suggested
Richard see Dr. Tucker. “Dr. Tucker is straightforward
with you. He told me I needed a procedure called
arthrosurface patellar femoral resurfacing. In my
situation, a total knee replacement would be overkill,
he told me.”
“Total knee arthoplasty, when the problem is
confined to the kneecap, is a big step to take for a
small problem,” says Dr. Tucker. “Richard had an
unstable knee, beyond joint preservation but not bad
enough for a total knee. His problem, kneecap arthritis
and instability, is clinically very different from garden-
variety osteoarthritis. I gave him a prosthetic partial
knee joint replacement; it’s an implant that is similar
to getting a tooth filled. Only the damaged area is
restored; the healthy part of the knee is not disturbed,
so much of the joint is preserved.”
Richard says his surgery was life changing. “Being
pain-free is amazing. This surgery bought me time.
I spent one day in the Hospital and was back at work
in a week. I have occasional swelling and stiffness,
but no major pain. I’m able to accomplish much more.
But the biggest difference is that I can enjoy my life
again with my wife, Stacie, and our kids, and our
first grandchild.” n
ARTHROSURFACEPATELLAR FEMORALRESURFACING
“BEING PAIN-FREE IS AMAZING... . I CAN ENJOY MY LIFE AGAIN.
”RICHARD JUSTICE,PATIENT
FOLLOWING ARE TWO REAL-LIFE EXAMPLES OF ALTERNATIVES TO TOTAL KNEE REPLACEMENT
Knee patient Richard Justice is back at work, pain free.
24 I HouseCall I Volume VI Issue 4
Continued from page 23
ORTHOPEDIC ADVANCES
JON B. TUCKER, M.D.
Dr. Tucker earned his medical degree at the Universityof Pennsylvania. He completed his internship ingeneral surgery, residency in Orthopedic Surgery,and a fellowship in Sports Medicine at the Hospitalof the University of Pennsylvania. He is board-certifiedby the American Board of Orthopedic Surgery. Hepractices with St. Clair Medical Services TuckerOrthopedic Group.
To contact Dr. Tucker, please call 412.276.0267.
GRETCHEN GR IMES :
Her shoes were made for walkingGretchen Grimes loves to go for evening walks in her Rennerdale
neighborhood, and now she has some fancy new shoes for those
walks — a pair of black, white and pink running
shoes with purple laces. The shoes were a gift from
her daughter, to celebrate the return to her cherished
walks, following two partial knee replacements.
Gretchen has had two partial knee replacement surgeries in
recent months, both performed by Dr. Tucker. She was suffering with
osteoarthritis and bone deterioration, with considerable pain that was
limiting her life. “I saw Dr. Tucker and he explained his findings to me.
He told me about partial knee replacement, which I had never heard
of. I was excited about it.”
Dr. Tucker says that partial knee replacement is for severe
osteoarthritis that is limited, usually, to just the medial half of the
joint. It resurfaces only the damaged cartilage, while a total knee
replacement replaces the entire joint. “This procedure uses a special
device to replace the worn out half of the knee. About one third of
patients with knee osteoarthritis can have this done instead of total
knee replacement, and it will produce results that last as long, with
less risk, and a lower complication rate. It’s a smaller operation,
with a shorter recovery time, and it results in a more natural feeling
knee, with better range of motion.”
St. Clair’s physical therapists had Gretchen out of bed and walking
the very evening of her surgery. “I used a walker and just went a
short distance, but I was amazed to be walking so quickly.” Gretchen
is back to work after being off for eight weeks from her job as a
payroll supervisor for a multi-national corporation headquartered
in Downtown Pittsburgh.
“I feel great. Dr. Tucker takes his time with you and explains
things until he is sure that you understand. The staff on the Orthopedic
Unit of St. Clair Hospital is outstanding, and Dr. Tucker’s office staff
is excellent. I’m so glad that I had the procedures and have now
returned to my evening walks.” n
“I FEEL GREAT… I’M SO GLAD THAT IHAD THE PROCEDURES AND HAVE NOW
RETURNED TO MY EVENING WALKS.
” GRETCHEN GRIMES, PATIENT
PARTIAL KNEEREPLACEMENT
A partial knee replacement allowedpatient Gretchen Grimes to return toher daily walks near the RennerdaleDuck Pond, just outside Carnegie.
Volume VI Issue 4 I HouseCall I 25
60 YEARS OF CARE
26 I HouseCall I Volume VI Issue 4
This architect’s rendering offers a sneak preview of thesoon-to-be erected Hall of History on the Fourth Floor at St. Clair Hospital.
Hall of History Brings St. Clair Hospital’s 60 Years of Service to Life
To commemorate 60 years of serving the
community, St. Clair Hospital is erecting a
Hall of History that will run approximately half
the length of the hallway adjacent to the Fourth Floor
Lobby and include St. Clair’s greatest achievements
throughout the past decades. When completed,
the Hall’s photographs and exhibits will serve as a
testament to the spirit of the thousands of men,
women, and, yes, children of the area who united in a
tenacious effort to build a hospital they could call their
own, close to home. If you are interested in making a
financial donation to the Hall of History and continuing
St. Clair’s long-running history of grassroots support,
please contact the St. Clair Hospital Foundation at
412.942.2465 or [email protected]. n
Jay A. Lutins, M.D.
Volume VI Issue 4 I HouseCall I 27
ASK THE DOCTOR
JAY A. LUTINS, M.D.
Ask the Doctor
Q
A
I have trouble controlling my bladder. I need to urinate often during
the day and night, and I get hardly any warning before I have to make
a dash for the bathroom. Is there anything that can be done for me?
Yes, there are a lot of things that can be done for you.
These problems affect men and women of all ages,
although mainly people over the age of 35. We refer
to these symptoms as Overactive Bladder (OAB). It is
important at the initial office visit to perform a few routine
tests, which include a physical exam, an assessment of a
urine sample for infection or blood, and measuring how
much urine is left in the bladder after the patient thinks
he or she might have completely emptied.
OAB is an enormously common, yet NOT a normal
part of aging. More than 33 million people in the U.S.
suffer from some sort of bladder problem. These issues
are embarrassing to the patient which explains why, on
average, patients delay bringing up these problems to
their doctor. OAB can alter one’s life in dramatic ways
by causing sufferers to avoid travel, parties, interacting
with family, and basically avoiding many social activities.
Many patients will improve with simple steps, such
as restricting certain fluids and foods which are bladder
irritants, trying to keep their bladders empty, exercising
certain pelvic floor muscles, and taking medications.
Newer medications have been developed which have
minimal, if any, side effects.
For those patients who do not respond to these simple
measures, we offer another proven treatment as an option
for improving bladder control, and it has also been shown
to help those suffering from bowel accidents, as well. Up
to one third of patients who suffer from bladder problems
also experience bowel problems, called fecal incontinence
(FI). The treatment is referred to as Sacral Neuromodulation,
and it has helped greater than 150,000 patients worldwide.
In the office setting, we are able to test the patient
to see if he or she would benefit from this approach.
The office test takes 7 to 10 minutes. Patients usually
know within 2 to 3 days if the office test was successful.
If successful, then we have the patient come to St. Clair
Hospital where we place a silver dollar-sized disc under
the skin above the buttock. Placing the disc takes 20 to
30 minutes and patients can comfortably go home
shortly thereafter.
Sacral Neuromodulation was FDA approved in 1997
as a safe, minimally invasive
procedure that can dramati-
cally improve one’s quality
of life. It has proven
effectiveness in
selected patients for
up to 5 years. Risks
are minimal, and we
change the device
battery when it runs
low. Sacral Neuro-
modulation is a very
viable treatment for
patients suffering
from FI. n
JAY A. LUTINS, M.D.
Dr. Lutins earned his medical degree at the Medical College of Virginiaand completed his residency training in urology at the University of PittsburghMedical Center. He is board-certified by the American Board of Urology.He practices with The Center for Urologic Care.
To contact Dr. Lutins, please call 412.833.3000.
The results are in!
Our staff iskind and courteous
PATIENT SATISFACTION:
Staff is friendly and helpful
to patients and families
Volunteers and drivers
offer special care
St. Clair Hospital is ranked among the top2% nationwidein patient satisfaction.Independent surveys of patients hospitalized at St. Clair show soaring satisfaction levels from discerning men and womenwhose high expectation levels are being met on every front. Please turn to Page 2 to read how the Hospital’s ‘Healing Touch’ is exemplified in an environment of compassion, dignity and respect.
Patients trustour physicians
PATIENT SATISFACTION:
Kept patient informed
Respected patient concerns and views
Answered all questions about condition and care
Our nurses deliver
genuine careand compassion
PATIENT SATISFACTION:
Responsive to
patient requests
Attentive with special
care needs
Understanding
St.Clair Hospital1000 Bower Hill RoadPittsburgh, PA 15243www.stclair.org
General & Patient Information: 412.942.4000
is a publication of St. Clair Hospital. Articles are for informational purposes and arenot intended to serve as medical advice. Please consult your personal physician.
Follow us on twitter at: www.twitter.com/stclairhospitalHouseCall
Outpatient Center–Village Square: 412.942.7100Physician Referral Service: 412.942.6560
Urgent Care–Village Square: 412.942.8800Medical Imaging Scheduling: 412.942.8150
Outpatient Center–Peters Township: 412.942.8400