Daniel Blum Appointed

President & CEO

Phelps Joins North Shore-LIJ

Health System

State-of-the-Art SurgiCenter Opens

The All-Important Kidneys:

Your Body’s Filter

The Inner Ear and Balance

Chickenpox

phelps T O D AY

News from Phelps Memorial Hospital Center Spring 2015

Daniel Blum President & CEO

Letter from thePresident and Chairman

Dear Friend,

A lot has been happening at Phelps over the past several months.

In November, after 25 years at the hospital’s helm, Keith Safian stepped down from his position as President & CEO. This change occurred shortly before Phelps joined the North Shore-LIJ Health System, becoming the system’s first hospital in Westchester County. It is exciting for us to be part of this superb organization, and we look forward to the benefits that the hospital and our community will realize from this relationship.

In February, the much-anticipated opening of our new SurgiCenter took place. The facility has exceeded all expectations in terms of functionality and patient comfort and satisfaction. The combination of the state-of-the-art facility and our out-standing surgical staff makes the Phelps SurgiCenter one of the top surgery centers in the region.

We continue to expand Phelps Medical Associates, our primary care and multi- specialty medical group, with plans to establish practices at additional locations in the coming year.

In our roles as Chair of the Board and the new President & CEO, we look forward to working together to fulfill Phelps’ mission to serve the healthcare needs of our community. We wish you the best of health in the warm months to come.

Sincerely,

Richard J. SinniChair, Board of Directors

Daniel BlumPresident & CEO

2 PHELPS TODAY

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LLENT PATIEN

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ELEBRATING

Table of Contents

PHELPS TODAY 3

Daniel Blum Appointed Phelps President & CEO 5

Vincent DeSantis Named a 2014 Westchester CFO of the Year 5

Phelps Becomes Part of North Shore-LIJ Health System 6

The SurgiCenter: A Milestone in Phelps’ History 8

The All-Important Kidneys: Your Body’s Filter 10

Relief from Carpal Tunnel Syndrome 13

Family Medicine Residency Program Thrives in Third Year 15

Don’t Call It a Comeback: Chickenpox Has Been Here for Years 18

Dizziness and the Inner Ear 21

Phelps Medical Associates News 23

Vitality: Why Preventing Falls Is So Important 27

Healthy Life Calendar 30

Los tan importantes rinones: El filtro de su cuerpo 33

No la llame un retorno: La varicella ha estado aquí por años 36

Report from Auxiliary President Mark Frederich 39

PHELPS TODAY

EditorMary Sernatinger

msernatinger@pmhc.us

Managing EditorTina Dorfman

Medical EditorBruce Heckman, MD, MPH

Editorial AdvisorsDaniel Blum

Lucy C. Engelhardt, RNRobert R. Lane

Mary McDermott, RN

PHELPS TODAY is a publication of Phelps Memorial Hospital Center, a 238-bed, not-for-profit acute care community hospital located in Sleepy Hollow, NY. Phelps, part of the North Shore–LIJ Health System, has been providing medical and mental health services to Westchester and surrounding communities since 1955.

I f you would l ike to be removed from the Phelps Today mailing list, please call (914) 366-3100 or email tdorfman@pmhc.us.

Visit us on Facebook:http://www.facebook.com/PhelpsMemorialHospitalCenter

Visit us on Twitter:https://twitter.com/#!/phelpshospital

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 PlanPhelps Memorial Hospital Center is committed to improving the health and well-being of the community. To see our Community Service Plan (2014-16) and learn about our current and planned activities and initiatives, please visit phelpshospital.org/about-phelps and click on “Community Service Plan.” A summary of the hospital’s 2013 community service is described in our “Caring for Our Community” publication, which is also available at the same address (click on “Caring for Our Community”). A printed copy of these publications may be requested by calling 914-366-3115.

Years

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4 PHELPS TODAY

Exciting Projects to Begin at Phelps!

wo major construction projects will begin at Phelps this spring. A new MRI facility featuring the most advanced technology

will be built in the area of the current main lobby. The front of the 755 Building will be expanded to create a magnificent new main lobby.

During construction, it will be neces-sary to close the road that runs in front of the hospital and the 755 Building, but it will still be possible to get from one side of the campus to the other by driving behind the hospital.

Access to Admitting and the main hos-pital will be through the West Wing entrance, shown on the map at right as “New Main Entrance.”

Access to the 755 Building will be through its back entrance, directly across from the garage.

T Signs will be posted, and we will do our best to minimize any inconvenience. Thank you for your understanding as

The new main lobby will be a grand entrance to Phelps Memorial Hospital.

Kendal Way

Use 755 North Entrance to access physicians and services in the 755 Bldg.

Route 9 – North Broadway

707 MRI

777 Building

Auditorium

755North

Entrance

West Wing

James House

755 Building

Garage Entrance

701

PedestrianAccess / Elevators

N

Residence Building

Robin’s Nest

Kendal on Hudson

To Route 117

West ParkingWest Parking

Southwest Parking

Riverview

Southwest Parking

Riverview

South ParkingSouth Parking

Northeast ParkingNortheast Parking

GarageGarage

Hudson RiverTappan Zee Bridge

Rockefeller State Park Preserve

Rockefeller State Park Preserve

Phelps Lane

Tim Grajek illustration & design

Use “New Main Entrance” to access Admitting and Hospital

Bus StopsEmergency Dept.

Park here for Admitting and Hospital

Park here for 755 Bldg.

Park here for 755 Bldg.

New Main Entrance

EntranceClosed

EntranceClosed

Rout

e 9

Road Closed

we make these major improvements to our hospital.

PHELPS TODAY 5

Vincent DeSantis Named a 2014 Westchester CFO of the Year

Phelps VP of Finance and Chief Financial Officer Vincent DeSantis was honored as 2014 Westchester CFO of the Year in the “large company” category. He

accepted his award at a ceremony hosted by Westfair Communications last fall at the Wainright House in Rye.

When Mr. DeSantis came to Phelps in 2001, he brought more than 25 years of experience in accounting and auditing.

Daniel Blum has officially assumed the role of Presi-dent and CEO o f P h e l p s Memorial Hos-p i t a l C e n -ter, following the resignation

of Keith Safian, who led the hospital for 25 years. From 2009 until assuming his new role, Mr. Blum served as Phelps’ Senior Vice President.

“We believe that Daniel Blum’s exceptional knowledge and experi-ence will ensure Phelps’ continuing success as we transition to become a member of the North Shore-LIJ Health

System,” said Richard J. Sinni, Chair of the Phelps Board.

While he was Senior Vice President, Mr. Blum developed Phelps Medical Associates, the hospital’s multi-spe-cialty medical group, and was respon-sible for implementing the hospital’s strategic plans and overseeing its clini-cal and ancillary services. He serves as collaborating administrative executive on Phelps’ Graduate Medical Education Committee and Chairman of the Board of Robin’s Nest, the hospital’s child care center.

Prior to joining Phelps, Mr. Blum was Senior Vice President of White Plains Hospital Center, Vice President of Operations of the Stellaris Health

Network, and Operations Manager at St. Vincent’s Hospital and Medical Center in New York City. He began his healthcare career as a paramedic and paramedic instructor in New York City and worked at several New York City hospitals in clinical and administrative capacities.

Mr. Blum holds a bachelor’s degree in philosophy and a master’s degree in healthcare administration, both from New York University. He is a member of the American College of Healthcare Executives and Medical Group Management Association. Mr. Blum is also Chairman of the NYS Department of Health Emergency Medical Advisory Council.

Daniel Blum Appointed Phelps President and CEO

Prior to joining Phelps, he was associate executive director/CFO of Long Island Jewish Medical Center in New York City, part of the North Shore-LIJ Health System. Earlier in his career, he spent 18 years at the accounting firm Deloitte & Touche, LLP, where he was senior manager of the healthcare division.

Mr. DeSantis earned his BBA and MBA at Iona College in New Rochelle, NY, and is a New York State CPA. He was an adjunct professor of healthcare finance in the graduate division at Iona College and in the bachelor of science general accounting program at Mercy College School of Business.

A Healthcare Association of New York State (HANYS) report pertaining to profitability, liquidity and capital structure has ranked Phelps consistently among the top 10 percent of all acute care hospitals in New York State throughout Mr. DeSantis’s tenure as the hospital’s CFO.

“Being a CFO is a hard job,” he noted in his acceptance speech, “but it’s also an exciting job that allows me to be creative, generate growth and go beyond the numbers.” He accepted the award on behalf of the leadership team and all of his colleagues in the financial departments at Phelps. “I work with the most amazing people in all areas of the hospital, and I thank them for their trust and confidence.”

6 PHELPS TODAY

Phelps Becomes Part of the North Shore-LIJ Health System

A cross the country, healthcare organiza-tions are changing, as hospi ta ls and physician groups

partner with large health systems. In Westchester, nearly all of the community hospitals have made such alliances. Phelps, which has achieved financial stability for more than 25 years, recog-nizes that an ever-changing healthcare environment creates financial challenges for all hospitals. Being a member of a large, stable health system helps hospi-tals increase efficiency, lower operating costs and improve quality, enabling them to continue to serve the people who rely on them for their healthcare needs.

Formerly StellarisPhelps was previously a member of the Stellaris Health Network, which includ-ed three other Westchester community hospitals. Recognizing the need to con-nect with larger systems, each of the Stellaris hospitals decided to explore opportunities for partnerships with other health networks in 2013. There were a number of possible choices for Phelps, and each was carefully examined. In the end, one system stood out as the one that would benefit our hospital and our com-munity the most.

North Shore-LIJ Health SystemThe North Shore-LIJ Health System shares the same commitment to

Phelps was honored by the presence of North Shore-LIJ top executives at the SurgiCenter Ribbon Cutting. Pictured left to right: Daniel Blum, Phelps President & CEO; Avraham Merav, MD, Medical Director, Surgical Services; Mark J. Solazzo, Executive Vice President and Chief Operating Officer, North Shore-LIJ Health System; Michael J. Dowling, President and CEO, North Shore-LIJ Health System; and Richard Sinni, Chair, Phelps Board of Directors.

PHELPS TODAY 7

community and quality as Phelps. The system’s goal, as stated by President and CEO Michael Dowling, is to “be better tomorrow than we are today,” a sentiment that Phelps supports with regard to the hospital and everyone who comes to us for care.

North Shore-LIJ considered Phelps a good partner because our hospital has long been financially stable and is high-ly regarded in Westchester. Importantly, the system will enable Phelps to continue to serve as our community’s hospital, as stated by Mr. Dowling: “We are commit-ted to strengthening and expanding the clinical services that Phelps provides, ensuring that the hospital will continue to fulfill its mission as a full-service community hospital.”

New York State’s largest private employ-er, the system has 19 hospitals and about 54,000 employees throughout Long Island, New York City and, now, Westchester. North Shore-LIJ will support Phelps in developing services, enhanc-ing facilities, acquiring the latest tech-nology and expanding our medical staff. Phelps will have access to high-level expertise and knowledge and education and research opportunities.

Phelps’ success has been based on continued growth, and our partnership with North Shore-LIJ will accelerate our rate of growth while ensuring the delivery of high-quality, patient-centered care.

Phelps’ success

has been based on

continued growth,

and our partnership

with North Shore-LIJ

will accelerate our

rate of growth while

ensuring the delivery

of high-quality,

patient-centered care.

Being Part of the North Shore-LIJ FamilyPhelps’ relationship with North Shore-LIJ has just begun, but the hospital has already been embraced as part of the system’s “family.” When a major blizzard threatened in January, for exam-ple, various North Shore-LIJ depart-ments reached out to their counterparts at Phelps, offering assistance with prep-aration and communication. They were even prepared to bring us an addition-al generator if the need arose. It is reas-suring to know that the system’s experts are available to support us whenever we need them.

The FutureBeing part of the North Shore-LIJ Health System will enable Phelps to participate in new healthcare models such as popu-lation health management and account-able care organizations (ACOs), initia-tives that a community hospital could not undertake on its own.

The goal of these programs is to identify the most common health prob-lems among the people we serve, and provide education and care to prevent and manage chronic diseases. Through these programs, we will deepen our connection to the community and fulfill our commitment to improving the well-ness of all who look to Phelps for their healthcare needs.

The SurgiCenter –A Milestone in Phelps’ History

he opening of Phelps’ new operating suite – the “SurgiCenter” – marks a milestone in the hospi-tal’s history. Designed

by a team of Phelps surgeons, nurs-es and other clinical staff, the facility’s spacious operating rooms, state-of-the-art technology and unique configuration provide an optimal environment for both ambulatory and inpatient surgery. The 20,000-square-foot facility is located on the third floor of the 755 North Broad-way building. A connecting bridge links the SurgiCenter to the main hospital, allowing for easy circulation of supplies, equipment and staff. “It is a safer surgi-

8 PHELPS TODAY

cal environment than freestanding sur-gery centers, because the bridge ensures quick access to the full capabilities of the hospital and teams of medical sub-specialists, such as cardiologists, pul-monologists and internists,” notes Rich-ard Peress, MD, Director of Surgery. “While patients who are seriously ill or need complex surgery cannot be treated at a freestanding surgery center, they can be safely cared for in the SurgiCenter.”

The Latest Technology and SystemsConsiderable resources were allocated toward acquiring the latest technology-to make the SurgiCenter among West-chester’s most advanced operating facilities. The five large operating rooms were designed to house the

Tmost modern and technologically advanced equipment and facilitate delivery of the highest quality surgical care. Suspension of equipment from ceiling booms enables exact position- ing of technology and operating lights and keeps floor space clear.

Video monitors positioned around the operating table project images from laparoscopic cameras as well as CAT scan, MRI, fluoroscopic and X-ray images, which are transmitted from a central computer. Anesthesiologists use an advanced computerized medication dispensing system.

Phelps is one of only a few hospitals in New York State to install the STERIS RealView Visual Workflow

At the SurgiCenter ribbon cutting, left to right: Mary McDermott, Sr. VP, Patient Care Services & CNO; Richard Sinni, Chair, Board of Directors; Daniel Blum, President & CEO; Kathleen Scherf, Nursing Director, Surgical Services; Avraham Merav, MD, Medical Director, Surgical Services; Richard Peress, MD, Director, Department of Surgery; Lawrence Faltz, MD, Chief Medical Officer; and Kerry Pisano, VP, Support Services.

PHELPS TODAY 9

Management System, which pro-vides real-time, instant updates on patient locations and perioperative sta-tus (admission, anesthesia, surgery and recovery). The system has two types of digital display screens – one for families to keep them informed about the patient’s status; the other for the surgical team that displays schedules, patient location and alerts regarding any special circum-stances about the patient. Families can also request updates via text messages, which can be sent anywhere in the world.

The SurgiCenter has an advanced, envi-ronmentally friendly waste disposal system that fully cleanses surgical waste water and utilizes reusable plastic con-tainers. This significantly reduces the hospital’s contribution to landfill and eliminates the need for removing the waste with diesel trucks.

Unprecedented Beauty and ComfortThe décor in the SurgiCenter is a com-bination of contemporary and tradi-tional, creating an overall timeless, elegant look. The space was designed to be very welcoming, comforting and warm. It includes a stone accent wall in the reception area, wall coverings in natural tones, and dark wood doors and trim throughout.

Unlike the patient admission and recovery rooms at freestanding surgery centers, which are usually separated simply by curtain partitions, the Surgi-Center features rooms with solid walls and sliding glass doors, providing ample space, comfort and privacy. Soft, low lighting illuminates the patient’s bed,

with brighter spot lighting above the chairs to allow visitors to read or use electronic devices.

The combination of the new facility and the dedicated Phelps staff will enhance the hospital’s attractiveness to patients and surgeons, according to Dr. Peress. “We expect our SurgiCenter, which reflects the many ideas of surgeons and staff about how to create the best possi-ble environment for patients, providers and changing technology, will meet our needs for decades to come.”

Nursing station

Considerable

resources were

allocated toward

acquiring the latest

technology to make

the SurgiCenter

among Westchester’s

most advanced

operating facilities.

Admission and recovery rooms RealView display to keep visitors apprised of patient status

Spacious, technologically advanced operating rooms

The All-Important Kidneys: Your Body’s Filter

ust below the rib cage on either side of the spine are two fist-sized organs that are vital to our sur-vival – our kidneys. They

each have about a million microscopic filters called nephrons, which process all of the blood in our bodies several times each day. This process filters toxins from about 150 quarts of blood, creating up to two quarts of urine that contains wastes and excess bodily fluid. The urine drains down tubes called ureters to the bladder and is emptied from the bladder through a tube called the urethra.

The kidneys are important to our health for many reasons. They prevent the buildup of wastes and fluid in the body. They stabilize electrolytes such as sodium, potassium and phosphate, which are essential for the normal functioning of our cells and organs. And they generate hormones that help produce red blood cells, regulate blood pressure and maintain bone strength.

Kidney DiseaseSometimes the kidneys slowly stop functioning. Without treatment, this decline can progress to chronic kidney disease, also called chronic renal insufficiency or chronic kidney failure. The cause of chronic kidney d i sease i s no t a lways known , but any condition that damages blood vessels can negatively affect the kidneys. One common cause is diabetes, because elevated blood sugar levels over a long period of time damage the kidneys’ blood vessels.

10 PHELPS TODAY

There is also a relationship between kidney disease and high blood pressure (hypertension). High blood pressure can damage blood vessels, and if that causes kidney disease, the failing kidneys, in turn, can cause even higher blood pressure.

Preventing Kidney FailureWhen kidney function falls below a certain point, it is called kidney failure. As with any condition, the earlier kidney disease is detected, the sooner treatment can begin to slow down its progression and prevent kidney failure. The first step is to determine and treat the underlying cause. Since diabetes and high blood pressure account for 66 percent of chron-ic kidney disease, preventing or manag-ing those conditions through diet, exer-cise and appropriate medication is vitally important in protecting the kidneys.

It is possible to survive with only a part of one kidney if it is still functioning.

JIf neither kidney works, however, a machine has to be used to clean the blood (dialysis) or a new kidney has to be transplanted.

Leading-Edge TreatmentPhelps offers patients a higher level of care for the prevention of renal diseases and disorders than is typical-ly available at community hospitals. “My colleagues and I are experienced in performing the most advanced laparo-scopic and minimally invasive recon-structive procedures through small access sites without large incisions,” says urologist Michael Grasso, MD. “As a result, our patients heal more quickly and are able to return to normal activities much sooner. There is also less pain than with open surgery.”

Dr. Grasso adds, “In general, urologists who have broad surgical experience with the latest technology and who follow a surgical team approach are able to

The two images above are of the same kidney, which is filled with stones. The left image is an X-ray used for diagnosis. On the right is the image that the urologist obtained from an endoscope – a narrow tube with a camera at the end that is inserted into the body. The urologist viewed the endoscopic image while removing the kidney stones.

PHELPS TODAY 11

The yellow line outlines a polypoidtumor – so called because it has the appearance of a polyp. The urologist removed the tumor endoscopically, saving the kidney.

In this 3D CT image, the white arrow points to a blockage in the kidney where accessory vessels crossed. The urologist reconstruct-ed the drainage portion of the kidney and moved the extra vessels away from the blockage, restoring kidney function.

In this image, the area outlined in blue is cancerous, the area outlined in yellow is a cyst. The red outline indicates the portion of the kidney that was removed. The rest of the kidney was saved.

provide improved treatments and better patient outcomes for conditions such as kidney stones, ureteral obstruction and kidney cancer.”

Kidney StonesKidney stones are formed from the crystallization of certain substances in urine, such as calcium, oxalate, or uric acid. The stones can affect any part of the urinary tract – from the kidneys to the bladder. Kidney stones are more common among men.

Symptoms of kidney stones include severe pain in the side and back below the ribs, which may spread to the lower abdomen and groin. Pain may be in waves and fluctuate in intensity. Urine is usually red, brown, pink or cloudy and may be foul smelling. Fever and chills occur if there is an infection.

Small kidney stones often pass out of the body in the urine and may go com-pletely unnoticed. But in the ureter, larger stones can block the flow of urine and be excruciatingly painful as they move toward the bladder. Painful or not, kidney stones usually do not cause any permanent damage.

While drinking large quantities of water is sometimes all that is necessary to pass a kidney stone, if the stone is large, a procedure by a urologist may be the only solution.

The good news is that kidney stones can often be eliminated without any surgical incisions, usually in an out-patient setting. In a procedure called ureteroscopy, a small viewing instru-ment called a ureteroscope is insert-ed into the urethra, through the bladder

Phelps offers

patients a higher

level of care

for the prevention

of renal disease

and disorders

than is typically

available at a

community hospital.

and the ureter to where the kidney stone is located. Once the stone is in view, the urologist can capture it with forceps or a basket. Another non-surgical technique, Extracorporeal Shock Wave Lithotripsy (ESWL), uses shock waves to break larger stones into pieces small enough to pass in the urine. The best method for eliminat-ing very large, complex kidney stones is Percutaneous Nephrolithotomy (PCNL), which involves a small incision and placement of a tube into the kidney through which instruments can be intro-duced to break up and remove the stone.

Ureteral ObstructionUrine travels from the kidneys to the bladder through thin, muscular tubes called ureters. There is one ureter for each kidney, and each is 8 to 10 inch-es long. Sometimes the ureters become blocked and the flow of urine to the bladder is impeded.

The most common cause of ureteral obstruction is ureteral or kidney stones. Other causes include congenital condi-tions, scarring or injury from previous abdominal or pelvic surgery, blood clots, tumors, ureter wall swelling, inflamma-tion of organs around the ureters, a tiny swelling in the ureter called a uretero-cele, endometriosis, severe constipation and pregnancy.

Symptoms include pain in the lower back or lower belly toward the sides, painful urination, increased urinary frequency or urgency, reduced urine output, blood in the urine, swollen legs or fever.

To diagnose ureteral obstruction, a urologist will conduct a physical exam, measure blood pressure and check for blood or infection in the urine. An abdominal ultrasound or CT scan may also be done.

The goal of treatment is to reduce or eliminate the blockage. Severe cases usually require surgery to repair the underlying cause of the obstruction.

Kidney CancerThe incidence of kidney cancer is growing in the United States. Fortunately, most kidney cancers are detected before they metastasize (spread) to other organs.

Historically, a diagnosis of kidney can-cer led to removal of the entire kidney in an operation called a nephrectomy. Today, the majority of kidney tumors are removed in a partial nephrectomy, in which advanced laparoscopic techniques and special imaging are used to remove the tumor and some tissue around it with-out a large incision. The healthy part of the kidney is saved, and good kidney function is maintained.

Additionally, techniques using tiny endoscopes (lighted, flexible instruments for visualizing inside the body) and powerful, precise lasers are used to treat tumors on the lining of the kidneys, ure-ters, and bladder, removing malignancies while saving the remaining organ.

In fact, with these new techniques for treating kidney cancer, the entire organ is rarely removed.

Michael Grasso, MD, is Professor and Vice Chairman of the Department of Urology at New York Medical College, as well as Regional Director of Urology for the North Shore-LIJ Health System. He annually teaches instructional courses in advanced urological procedures at the American Urologic Association meeting and the European Urologic Association meeting. Dr. Grasso and his colleagues, Andrew I. Fishman, MD, and Christopher Dixon, MD, specialize in leading-edge, minimally invasive procedures for the treatment of kidney disease. Dr. Fishman is an Assistant Professor and Dr. Dixon is Director of Reconstructive Urology at New York Medical College. Their Westchester office is on the Phelps campus in the 755 North Broadway building, Suite 510. The urologists perform outpatient and inpatient surgical procedures in the new SurgiCenter at Phelps. To contact Dr. Grasso, Dr. Fishman or Dr. Dixon, call 914-302-0100.

12 PHELPS TODAY

PHELPS TODAY 13

Relief from Carpal Tunnel Syndrome

ay the words “carpal tunnel syndrome,” and most people think of wrist pain resulting from too much time spent at a

computer keyboard. Interestingly, stud-ies looking at the connection between excessive computer use and carpal tun-nel syndrome have not found enough evi-dence to support a link.

In fact, although a number of factors have been associated with carpal tunnel syndrome – including anatomy (a smaller carpal tunnel), gender (it’s more common in women), nerve damaging conditions, inflammation and thyroid disorders – none of these factors has been estab-lished as a direct cause of carpal tun-nel syndrome.

What Is Carpal Tunnel Syndrome?The carpal tunnel is a narrow passage-way located inside the palm side of the wrist that is surrounded by bones, ten-dons and a wide band called the trans-verse carpal ligament. The tunnel pro-tects the median nerve – a main nerve running from the forearm into the palm of the hand that controls sensations to the palm side of the thumb and fingers, except for the little finger. The nerve also controls impulses to some small muscles in the hand that allow the fingers and thumb to move. Carpal tunnel syndrome results when a thickening from irritated tendons or other inflammation narrows the tunnel and causes the median nerve to be compressed.

SSymptoms of carpal tunnel syndrome include:•painornumbnessinthehand, wrist or forearm•numbnessorpaininthefingers that causes waking at night•lossofthumbfunctionand hand dexterity•reducedstrengthandgripin the fingers, thumb and hand

Patients with carpal tunnel syndrome typically complain of numbness or pain at night, which frequently wakes them from sleep. “Many patients come in with bags under their eyes due to months or even years of poor sleep,” says Phelps hand surgeon Jeffrey Jacobson, MD.

DiagnosisThere are other conditions that cause symptoms similar to those of carpal tun-nel syndrome, including injury to the muscles, ligaments, tendons or bones; nerve problems in the fingers, elbow or neck; and arthritis in the thumb joint or wrist.

To diagnose whether you have carpal tunnel syndrome, your doctor will:•Reviewyoursymptoms,making note of when symptoms occur•Conductaphysicalexamination, testing the feeling in your fingers and the muscle strength in your hand

Your doctor may also conduct a nerve conduction study or an electromyogram, which is a test that measures the electri-cal activity of your muscles and can rule out muscle damage and other conditions. “A recent nerve conduction study is very helpful when discussing how much nerve damage has already taken place. It is not uncommon for patients to already have had nerve tests performed at the direc-tion of their primary care physicians before they arrive in my office for a con-sultation,” says Dr. Jacobson.

Nonsurgical therapy Carpal tunnel syndrome should be treated as early as possible after symptoms begin. If the condition is diagnosed early, nonsurgical methods may help improve

Flexor tendons

Transverse carpal ligament

Synovium

Median nerve

14 PHELPS TODAY

carpal tunnel syndrome. Methods may include wrist splinting, non-steroidal anti-inflammatory drugs, or corticoste-roids. Splinting and other conservative treatments are more likely to help some-one with mild to moderate symptoms that have been present for less than six months.

SurgeryIf symptoms are severe or persist for more than six months, despite trying nonsurgical therapy, surgery may be the most appropriate option. Carpal tunnel release is one of the most common sur-gical procedures performed in the U.S.

Traditional SurgeryIn performing standard open surgery, which is done under local anesthesia or with sedation from an anesthesiologist, the surgeon makes a two-inch incision in the palm of the hand above the carpal tunnel and cuts through the ligament. This enlarges the carpal tunnel and frees the nerve. Following surgery, soreness or weakness may persist for several weeks to a few months. Patients generally return to work in two to six weeks, depending on their occupation.

Endoscopic Carpal Tunnel Release (ECTR)During the minimally invasive procedure known as an Endoscopic Carpal Tunnel Release or ECTR, the surgeon makes a tiny incision (1/2 inch) in the wrist and inserts an endoscope (a telescope-like device with a tiny camera attached to it) to see inside the carpal tunnel. He then divides the ligament, relieving the pressure. The procedure takes approximately 10-15 minutes and can be comfortably performed under local

anesthesia with the patient fully awake or with light sedation from an anesthe-siologist. The incision site needs no bandage and patients can shower imme-diately after surgery.

ECTR is a very specialized procedure and should be performed only by a surgeon who has performed it many times. Dr. Jacobson, who has performed hundreds of these procedures, recently brought the technique to Phelps, one of the few Westchester facilities where it is offered. Surgery brings permanent relief to almost all patients, says Dr. Jacobson. Compared to traditional open carpal tunnel release surgery, patients typical-ly have significantly less pain afterwards and return to work and leisure activities more quickly. Office workers are usually back at work within two to four days, and those who perform physical labor can return to work as soon as they feel up to it, often in less than two weeks. There is some soreness in the palm for a few days, but no bandage is required and there are no restrictions regarding showering.

The change in his patients’ physical appearance after surgery is remarkable, says Dr. Jacobson. “When they no longer have numbness and pain, patients stop waking up at night. This often results in

their looking refreshed and healthier, even by their first follow-up visit two weeks later. Often their only complaint is having to come in for the follow-up appointment at all, since they’re feeling so good!”

Jeffrey Jacobson, MD, received his medical degree from SUNY-Stony Brook and completed a residency in plastic surgery at Georgetown University Hospital. Board certified in plastic surgery, Dr. Jacobson is fellowship trained in orthopedic hand and wrist surgery with a specialty in microvascular and peripheral nerve surgery at University of Pittsburgh Medical Center. In addition to hand surgery, he performs the full breadth of plastic surgery. Dr. Jacobson has offices in Harrison and Katonah (914-421-0123).

Cross-section of the carpal tunnel Carpal tunnel release, decompressing the median nerve

PHELPS TODAY 15

Family Medicine Residency Program Thrives in Its Third Year, Inaugural Class Prepares to Enter the Field

little over three years ago, Phelps welcomed six newly graduated MDs into a brand new residency program.

Today, the NYMC Phelps Family Med-icine Residency Program, established by Phelps in partnership with New York Medical College and Open Door Family Medical Centers, is a well-established and highly respected program.

The three-year program was originally designed for 18 residents (six per year). Last year, the Accreditation Council for Graduate Medical Education granted a program expansion that allowed eight residents in the third-year residency class, so that there are currently 20 residents in training at Phelps.

A What Are Family Medicine Physicians?Family medicine physicians are primary care providers who treat the whole person in every stage of life, focusing on the prevention and treat- ment of disease. They are trained to take care of the entire family, dealing with medical issues that may affect more than one family member and creating long-term, personal relationships with their patients.

“A family medicine doctor can provide continuity of care for patients in virtually every medical setting,” says Co-Chief Resident London Muse, MD. “We see infants, children, adolescents, pregnant women, adults and geriatric patients on a daily basis. Having one provider

for everything is something I think is really important, so that even when we refer patients to specialists, they feel confident that someone who knows them very well is overseeing their care.”

Residency Program A residency is a period of advanced medical training that follows medical school and involves supervised practice in a hospital and outpatient settings. During family medicine residency training, doctors complete clinical “rotations” in areas includ-ing adult inpatient and outpatient medicine, obstetrics and gynecology, cardiology, geriatrics, orthopedics and adult and pediatric emergency medicine.

“Developing the NYMC Phelps Family Medicine Residency Program has been a phenomenal experience,” says Dr. Shantie Harkisoon, a family physician and director of the residency program. “As a family doctor, I never expected to wear so many different hats – from designer of the residency head-quarters to trainer of physicians. My guiding principle has been for us to do whatever it takes to create an extraordi-nary training program, and I think we’ve done that. I could not have wished for better resources or greater support from

Second-year residents Julia Krim, DO, and Carmen Tamayo, MD, review an EKG.

Photo by Leslie Fass

16 PHELPS TODAY

the community and the wonderful, inspiring people with whom I work. We have an extraordinary group of residents as a result.”

Much of the success of the program stems from the involvement of Phelps physicians and other clinicians and staff. “The thing I like most about our program is the people we work with – from faculty, specialists and other residents to nurses, medical assistants, hospital volunteers and, most importantly, our patients and their families. The bond, consideration and care we have for one another really cannot be matched.” says second-year resident Molly Kilpatrick, MD.

In addition to providing training that is founded on evidence-based medi-cal care, the program focuses on giving residents skills that enable them to listen and relate to their patients. Residents receive specialized behav-ioral medicine training to help them maintain their own wellbeing, enabling them to better protect the wellbeing of their patients.

Integrative TrainingBecause of the evolving nature of health-care, family medicine training is more integrative than ever before. Residents in the NYMC Phelps program receive their clinical training at Phelps and at Open Door Family Medical Center in Sleepy Hollow. The program also has a special relationship with Westchester Medical Center and Maria Fareri Children’s Hospital, where residents learn to care for pediatric patients who have more serious medical conditions. Training at these various locations enables the residents to refine their medical skills

under varying circumstances and pro-vides them with experience in working with diverse groups of patients.

According to Hira Qureshi, MD, Pediatric Chief Resident at Westchester Medical Center, “Phelps residents bring to the Department of Pediatrics a sense of dedication to all patients, a willing-ness to learn about the pediatric patient, and a zeal that is needed to fuel their drive while on this short but momentous residency journey. Though they are ini-tially faced with daunting tasks that might scare first-year residents, by the end of the rotation, they seem to over-come most if not all that is daunting and are able to accomplish such tasks with grace. We appreciate their unique per-spective and enjoy learning from them as much as we hope they enjoy learn-ing from us.”

In addition to

providing training

that is founded on

evidence-based

medical care, the

program focuses

on giving residents

skills that enable

them to listen and

relate to their patients.

Third-year resident Anesh Badiwala, MD, reviews a patient’s X-rays in the Emergency Department

Photo by Leslie Fass

PHELPS TODAY 17

Community“It’s great working at a community hospital because it’s small, you know everyone in the hospital, you build relationships with patients and learn about differ-ent cultures,” says Farah Ansari, MD, first-year resident. The residents have created a bond with the community by volunteering at local events and getting to know the people in the towns where they live. Recent events include managing a teddy bear clinic for chil-dren at the Sleepy Hollow Street Fair or volunteering in the Phelps medical tent during a triathlon.

With the increased demand for primary healthcare comes a need for more inter-nal medicine and family medicine doc-tors. Many Westchester physician practices have been recruiting the soon-to-be-graduates.

“It has been so exciting watching the program evolve and reach its full complement,” says Kimberly Andron, LCSW-R, MSW, Director of Behavioral Medicine for the residency. “The suc-cess of all of our efforts is becoming apparent as our inaugural class makes plans to enter the field.” Dr. Harkisoon agrees: “Thanks to the involvement and enthusiasm from faculty and staff, we have developed a superb program that is creating outstanding family physicians.”

Dental Residency Program Completes Third Year2014 also marked the third year for the general dental practice residency program at Phelps, sponsored by the New York Medical College Department of Dental Medicine. This one-year program, with a two-year option, was recently granted approval to expand from four to eight resident positions by the American Dental Association Commission on Dental Accreditation.

The dental residents complete their rotations in anesthesia and emergency medicine at Phelps. Throughout the year, they provide on-call emergency dental/oral surgery coverage for the Emergency Department 24/7 and perform comprehensive dental services in the operating room for patients with special needs who require general anesthesia.

As for outpatient assignments, in addition to treating patients at the Open Door Family Medical Center site in Port Chester, all incoming residents will also treat outpatients at Open Door’s Brewster location.

Andrea Lochan, DMD Scott Levitz, DDS

Cindi Bane, DDS Zachary Logozio, DDS

Don’t Call It a Comeback: Chickenpox Has Been Here for Years

18 PHELPS TODAY

rimary care physicians seldom receive the accolades of other spe-cialties. TV shows are about neurosurgeons or

cardiologists, not primary care doctors. But what we may miss out on in glam-our, we more than make up for with the satisfaction of having the opportunity to prevent so many illnesses from occurring or worsening.

I have been asked more times than I can remember, “Did you become a doc-tor to help sick people?” My answer to that is always: “Yes, but the main reason I became a doctor is so that I can help

P people before they get sick.” Preven-tion of disease is the main goal of prima-ry care medicine, and keeping patients healthy and free of major illnesses is my primary objective as a physician. One of the main ways to accomplish this goal is with vaccinations.

The Varicella VaccineThe varicella vaccine is given to prevent chickenpox – a highly contagious viral infection caused by the varicella- zoster virus. The vaccine has been invaluable in decreasing the incidence of childhood chickenpox. As of 2007, childhood deaths from chickenpox had been cut by 97%. Prior to the introduc-

tion of the vaccine in 1995, 50 children in the U.S. died each year and thousands more were hospitalized.

Knowing that the vaccine is made up of “live-attenuated virus” sometimes causes people to worry that they could catch chickenpox from being vaccinated. A varicella-like rash may develop in 1-6 percent of people following vaccination, but the more common reaction is fever and pain, redness or swelling at the site of injection. Except for individuals who have some sort of immune deficiency or are allergic to the vaccine, its benefits far outweigh the risks for the overwhelming majority of people.

By Jillian Elliott, MD

PHELPS TODAY 19

While most people know that it is important to vaccinate children, many do not realize that it is also important for adults to get the vaccine and boost-er. This is especially true for people who had chickenpox in childhood but show no immunity to it in adulthood. For older people and those with weak-ened immune systems, shingles is also a concern. Caused by the reactivation of the chickenpox virus, shingles manifests as a painful rash. There are vaccines available to reduce the risk of shingles.

Chickenpox Transmission and Course of the DiseaseChickenpox can be transmitted either by directly touching the fluid in a lesion on someone’s skin or by breathing in the secretions from an infected person’s nose. After exposure to the virus, it takes approximately 10-21 days before the initial signs of infection, which include fever, fatigue, sore throat and loss of appetite. The rash develops approxi-mately 24 hours after these symptoms appear and presents itself in “crops,” typically on the face, trunk, arms and legs. Because new lesions develop each day for approximately four days, both flu-id-filled lesions and scabbed lesions may be present at the same time. Approxi-mately six days after the initial signs and symptoms, all the lesions will scab over and will no longer be infectious.

As benign as all of this may sound, chickenpox can unfortunately become more serious for some patients. Severe complications from the virus include secondary bacterial skin infections, pneumonia and encephalitis, which is a swelling of the brain. The primary method for preventing the most serious

aspects of chickenpox is through vacci-nation. While it is reported to be 44% effective in preventing chickenpox, the vaccine is 86% effective in preventing severe complications.

ImmunityI recall having chickenpox when I was five years old and being covered from head to toe in lesions that caused such a severe itch. Luckily, I did not develop any complications. When my parents were children, they were brought to visit friends who had chickenpox so they could get the virus and later overcome it. There was no vaccine at that time, and this was simply the only way to build immunity.

Prior to the implementation of the varicella vaccine in 1995, the natu-ral course of chickenpox immunity was this: You got chickenpox as a child and developed immunity. Then, in adulthood, you were exposed to young children with chickenpox, and that provided your immunity with a boost. Through this process, you developed a lifelong immunity to chickenpox. However, now that children are being vaccinated, adults are no longer being re-exposed to chickenpox, so the boost does not occur.

While most people know that it is important to

vaccinate children, many do not realize that it is also

important for adults to get the vaccine and booster.

This is especially true for people who had chickenpox in

childhood but show no immunity to it in adulthood.

Who Should Get the VaccineVaccination is recommended for all children between the ages of 12-15 months who have no evidence of immunity, and a second dose is given between the ages of four and six years old. Experience has taught us that with just one dose, children can still become infected with chickenpox, which is why the second dose is needed.

All adults should be tested by their doctor to see if they have immunity to the virus, even if they had chickenpox as a child. If immunity is not detect-ed, a varicella booster is recommended. Adults should receive two doses of the vaccine four to eight weeks apart. Pro-tection against chickenpox is especially important for adults who work in health-care or daycare or who are exposed to people with weakened immune systems. In addition, women of childbearing age who show no immunity should be vacci-nated; however, they should not get preg-nant for at least four weeks after receiv-ing the vaccine.

Herd ImmunityWith my patients, I stress the impor-tance of getting the varicella vaccine, not only to protect themselves but also those around them. In fact, outbreaks can

be prevented by something called “herd immunity,” whereby a critical portion of a community is immunized against a disease, and any cases that crop up cannot spread among the people who have been vaccinated. A tragic example of what can happen when large numbers of people fail to be vaccinated occurred in 2012, when a four-year-old girl with

Jillian Elliott, MD, is an internal medicine physician and a member of Phelps Medical Associates. Board certified in internal medicine, Dr. Elliott received her medical degree from New York Medical College and completed a residency in internal medicine at Montefiore Medical Center. She sees patients on the Phelps campus in suite 417 of the 755 North Broadway Building (914-366-5490).

leukemia died after being exposed to a cousin with a rash that turned out to be chickenpox. She could not get the varicella vaccine because she was under-going chemotherapy and her immune system was too weak. Sadly, she could have been protected if herd immunity had prevented her cousin from becom-ing sick.

20 PHELPS TODAY

While we have nearly eliminated chick-enpox with vaccination, recent news shows us how viruses can re-emerge. Vaccinations can become a victim of their own success – by being so effective, people undervalue their benefit and fail to get vaccinated. The truth is that the vaccine is vital, not only to keep you safe, but to keep your loved ones safe as well.

I became a primary care physician to prevent illness, and vaccines allow me to do that – for chickenpox and many other diseases. I believe my most impor-tant role is to educate my patients about vaccines and the many other steps they can take to protect their health.

Dizziness and the Inner Ear

By Cameron Budenz, MD

DEven though the

sensation of dizziness

is quite common,

it can be associated

with many different

disorders, and

determining the cause of

dizzy symptoms can be

complicated and often

frustrating for the patient.

izziness is a common problem experienced by most people at some point dur ing their l i fetime. It can be

described as lightheadedness, a feeling of imbalance or a false sensation of movement (vertigo). While most people suffer from dizziness occasionally, others have continuous symptoms of imbalance. Most people find their dizzy symptoms to be quite distressing and even anxiety provoking. It impacts their daily life, even if they do not experience symp-toms every day, because it affects their confidence in their ability to maintain their balance and avoid injury to them-selves or others.

Even though the sensation of dizziness is quite common, it can be associated with many different disorders, and deter-mining the cause of dizzy symptoms can be complicated and often frustrating for the patient. The sensation of dizziness can arise from problems in the vestib-ular system (in the inner ear), sensory abilities in the feet and spine, or vision, or when the brain is unable to correctly interpret the information it receives from the ear, sensory system or vision.

Inner Ear Disorders There are many different disorders of the inner ear that can cause dizziness The most common one is benign parox-ysmal positional vertigo, or BPPV. This disorder occurs when small crys-tals called otoconia, which are normally found in the inner ear, become displaced from their normal location. Individuals with BPPV have episodes of intense spinning vertigo, often accompanied by nausea and vomiting, that lasts for a number of seconds and occurs whenever the patient moves a certain way. Move-ments that commonly cause dizziness are lying down or rolling over in bed, looking up to get an object off of a high shelf, or lying back when having one’s hair washed at the hairdresser. BPPV most often resolves on its own over a period of weeks. However, it can be treated more quickly using positioning maneuvers performed by a physician or occupational or physical therapist who is trained in vestibular therapy.

Labyrinthitis is an infection or inflam-mation of the inner ear that leads to severe spinning vertigo lasting from a few hours to a few days. This condition is accompanied by hearing loss in one

PHELPS TODAY 21

ear that is often permanent. Vestibular neuritis, which is similar to labyrinthi-tis, is related to infection or inflammation of the balance (vestibular) nerve. It also causes severe spinning vertigo lasting hours to a few days; however, there is no associated hearing loss. Initial treatment for both of these conditions may include steroids and/or medications taken short-term to reduce the sensation of vertigo. Once the severe vertigo subsides, many people continue to have a general sense of imbalance, and may even experience brief episodes of vertigo when turning their head quickly. These milder symp-toms are almost always successfully treated with vestibular therapy.

Meniere’s disease is a rare disorder affecting the inner ear. The cause of Meniere’s disease is not known, but is thought to be related to an imbalance of the fluids in the inner ear. Meniere’s is characterized by episodes of vertigo that last at least 20 minutes and less than one day. The vertigo occurs in combination with fluctuating hearing loss, tinnitus (a roaring or buzzing sound in the ear), and a sense of fullness in one ear. There are many different treatment options for Meniere’s disease, ranging from lifestyle changes to medications to – in extreme cases – surgery.

Other Causes of DizzinessTwo other common causes of dizziness that are not disorders of the inner ear are anxiety and vestibular migraine, which may involve dizziness without a headache. With both, symptoms can vary considerably in terms of severity, dura-tion and character of the dizziness. There is no diagnostic test for either anxiety or migraine. Typically, the evaluation

includes a hearing test and a balance test to rule out an inner ear disorder. Management of these disorders often includes the care of one or more of the following: a neurologist, an otolaryngol-ogist with specialty training in balance disorders, a psychiatrist and a physical or occupational therapist trained in ves-tibular therapy.

Evaluation and Management of DizzinessComprehensive evaluation and manage-ment of a patient with dizziness often includes:•oneormorevisitswithaphysician specializing in balance disorders•ahearingevaluation•testingofbalancefunction•vestibulartherapyPhysicians involved in the care of dizzy patients are most frequently neurolo-gists or otolaryngologists who have sub-specialty training in vestibular disor-ders. Many patients have improvement or resolution of their symptoms with a combination of vestibular therapy and medical management. Surgery is rarely recommended, but when neces-sary typically leads to significant relief of symptoms.

Cameron Budenz, MD, is Medical Director of the Balance Center at Phelps, which is staffed by audiologists and physical and occupational therapists who have expertise in the testing and treatment of patients with dizziness or imbalance. Dr. Budenz is an otologist/neurotologist (an ear, nose and throat physician who specializes in disorders of the ear) and a skull base surgeon. She has expertise in the treatment and management of imbalance and dizziness, acute and chronic ear disease, hearing loss and facial nerve disorders. As a skull base surgeon, she is also able to remove growths or abnormalities at the interface between the ear and the brain.

Dr. Budenz is an assistant professor in the department of otolaryngology at New York Medical College and has served as an instructor for courses attended by surgeons from around the world. She received her medical degree from the University of Michigan Medical School, followed by a surgical internship and otolaryngology residency at New York University. After residency training, she completed both a National Institutes of Health-funded research fellowship and a clinical fellow-ship in otology, neurotology and skull base surgery at the University of Michigan.

To schedule an appointment at the Phelps Balance Center, call 914-366-1170.

22 PHELPS TODAY

Phelps Medical Associates News

Comprehensive Primary Care Initiative to Improve Health of High-Risk PatientsPatients with chronic medical conditions often don’t receive adequate education or support to help them manage their conditions. As a result, many of them fail to recognize symptoms that should prompt them to call their primary care physician. Instead, they tend to wait until their condition gets much worse and end up going directly to the Emergency Department, which frequently leads to hospitalization.

Now, thanks to an initiative launched by the Centers for Medicare and Medicaid Services and other healthcare insurers to help primary care practices deliver enhanced and better coordinated medical care to high-risk patients, some patients are becoming adept at disease self-management and enjoy-ing a better quality of life. In addition, they require fewer visits to the Emergency Department and are less likely to be hospitalized.

The Comprehensive Primary Care (CPC) initiative, which was launched in October 2012, is a four-year program designed to achieve the Institute for Healthcare Improvement’s “triple aim” of better health and better care at lower costs. Phelps Medical Associates prac-tices are among 481 primary care prac-tice sites in seven states participating in this initiative. The practices, which were selected through a competitive applica-tion process, receive financial support on behalf of their Medicare beneficiaries. The goals of the program are for primary care physicians to:1. Manage care of patients with serious or multiple medical conditions2. Ensure that patients have 24/7 access to care by phone or patient portal3. Deliver preventive care, including medication management and review4. Engage patients and their caregivers5. Coordinate a patient’s care with his/her other healthcare providers

“This is the direction healthcare is heading in,” says Judith Sapione, RN, Clinical Quality Manager, who oversees the CPC initiative for Phelps Medical Associates. “The goal is for people to learn self-management skills and be engaged so they can participate in their care. For example, if patients with congestive heart failure begin to gain weight, which is usually caused by fluid retention, they know to call their primary

care physician instead of waiting for the condition to get worse and going straight to the Emergency Department.”

When Phelps Medical Associates patients are identified as having high-risk needs, their physicians can refer them to one or more of the program staff, which includes: •a patient care navigator, a social worker who can make referrals for diabetes education, medication management, wound care, or drug or alcohol counseling, and can help with assisted living or nursing home placement, set up a home health aide, or help a patient access community services or transportation;•a clinical pharmacist, who works with patients to help them manage their medications;•an RN case manager, who provides education about disease management information and follows up with patients after they are discharged from the hospital; •an RN care coordinator, who follows up with patients who are discharged from the Emergency Department and provides assistance with less complex cases.

“Having the comprehensive care provided by this system keeps the patient at an appropriate level of care, therefore avoiding frequent ER visits and multiple hospital readmissions,” says Ms. Sapione.

Having the comprehensive

care provided by this

system keeps the

patient at an appropriate

level of care, therefore

avoiding frequent ER

visits and multiple

hospital readmissions.

PHELPS TODAY 23

24 PHELPS TODAY

Gastroenterology Practice Re-AccreditedPhelps Medical Associates-Gastroenter-ology was recently re-accredited by the Accreditation Association for Ambula-tory Health Care (AAAHC) following a rigorous survey. Status as an AAAHC-accredited organization, required every three years, means the practice has met nationally recognized standards for the provision of quality healthcare. Approx-imately 5,000 ambulatory healthcare organizations across the United States are accredited by AAAHC. The gas-troenterology practice is located on the Phelps campus in Suite 305 of the 777 Building (914-366-5420).

More Endocrinology and Neurology on the Phelps CampusEndocrinologist Delia Stefan, MD, is board certified in both internal medicine and endocrinology, diabetes and metabolism. Dr. Stefan attended

medical school at the Carol Davila University of Med-icine and Phar-macy in Bucha-rest, Romania. She completed two res-idencies in inter-nal medicine at

Danbury Hospital and University of Arkansas Medical Center in Little Rock, followed by fellowship training in endo-crinology, diabetes and metabolism, also at University of Arkansas Medical Center. Dr. Stefan sees patients on the Phelps campus at the Diabetes, Osteo-porosis and Metabolism Center, in Suite 300 of the 777 building (914-366-2270) and in Croton (914-269-1700).

Neurologist Douglas D. Sankar, MD, board certified in neurology and clinical neurophysiology, sees patients on the Phelps campus in Suite 560 of the 7 5 5 B u i l d i n g . Dr. Sankar earned his medical degree from Boston Uni-versity School of Medicine. He com-pleted an intern-ship in internal medicine, a resi-dency in neurology and a fellowship in neurophysiology, all at New York Uni-versity Medical Center. Prior to joining Phelps, Dr. Sankar was in private prac-tice in Cortlandt Manor. He is a clinical assistant professor at New York Medical College (914-366-5440).

Cardiology in Dobbs FerryRajat Sanyal, MD, is Chief of Cardiol-ogy at Phelps. Board certified in cardio-vascular disease, Dr. Sanyal is certified to read vascular ultrasound stud-ies by the Amer-ican Registry for Diagnostic Med-ical Sonography. Dr. Sanyal attend-ed medical school and completed a residency in internal medicine at Cal-cutta Medical College, followed by a fel-lowship in cardiology at the Institute of Postgraduate Medical Education and Research at the University of Calcutta. In 1994, he completed a residency in internal medicine at the Medical College

of Virginia in Richmond, followed by a fellowship in cardiology at New York Medical College. He sees patients at 88 Ashford Avenue in Dobbs Ferry (914-478-0641).

More Primary Care in Sleepy HollowInternal medicine physician Andres Espinoza, MD, sees patients at 362 N. Broadway in Sleepy Hollow. Dr. Espinoza attended medical school at the Univer-sidad Autonoma de Guadalajara, Mex-ico. He completed a pre-internship at New York Medi-cal College and an internal medicine residency at Dan-bury Hospital. His training includes a Patient Centered Med ica l Home ( P C M H ) t e a m -based model in a private practice and the development of a PCMH at the Seif-ert and Ford Community Health Center in Danbury, CT. In addition to speaking English, Dr. Espinoza is fluent in Span-ish and conversational in Portuguese (914-631-2070).

Rheumatology in Croton, Sleepy Hollow and TarrytownRheumatologist Farrah Gutwein, DO, attended medical school at the New York College of Osteopathic Medicine, where she was inducted into the National Honor Society. She completed her inter-nal medicine residency and rheumatol-ogy fellowship at Westchester Medical Center. After her fellowship, she was in

Phelps Medical Associates News

PHELPS TODAY 25

private practice in New Rochelle and served as assis-tant director of the Rheumatology Clinic at Montefio-re New Rochelle Hospital and as the hospital’s physician educator. She sees patients in Croton at 440 South River-side Avenue (914-269-1700), in Tar-rytown at 200 S. Broadway (914-631-8826) and in Sleepy Hollow at 362 N. Broadway (914-631-2170).

Rheumatologist G. Richard Parrino, MD , the medi-cal director of the Phelps Infusion Center, has more than 40 years of experience in rheu-matology. He earned his medical degree from the University of Rome Medical School and completed a residency in medicine at Queens General Hospital

followed by a fellowship in rheumatol-ogy at New Jersey College of Medicine and Dentistry. Dr. Parrino sees patients at 200 S. Broadway in Tarrytown (914-631-8826).

Podiatry in ElmsfordPodiatrist Frank Lattarulo, DPM, who has been on the Phelps medical staff since 1993, joined Phelps Medical Associates in February. In addition to his practice, he provides podiatric services to patients of Phelps’ Wound Healing Institute, Hyperbaric Medicine Center, and Diabe-tes, Osteoporosis and Metabolism Center. Dr. Latta-rulo received his DPM degree from the New York Col-lege of Podiat-ric Medicine and completed a residency in podiatry at St. Barnabas Hospital in the Bronx. His office is at 160 South Central Avenue in Elmsford (914-345-3400).

About Phelps Medical AssociatesPhelps Medical Associates, Phelps’ multi-specialty medical group, provides high-quality, personalized medical care at its many practices located on the hospital campus and in the surrounding communities. In addition to offering primary care, services include obstetrics/ gynecology, gastroenterology, rheumatology, neurology, cardiology endocrinology and podiatry. Phelps Medical Associates also offers in-person or phone consultations with a dedicated pharmacist to patients who are having difficulty managing their medications. To find a Phelps Medical Associates provider near you, call the Physician Referral Line at 914-366-3367 or visit phelpsmedicalassociates.org.

Congratulations to

our Medical Editor,

Dr. Bruce Heckman, on

publishing his first book –

“Parthenope,” a children’s

book telling the myth

of one of the Sirens,

featuring beautiful water-

color illustrations by

Randy Gallegos.

The book was inspired

by Dr. Heckman’s five

grandchildren and the

creation of pastiera, a

traditional Italian Easter

dessert. Dr. Heckman

has been a Phelps

physician for many years

and is medical director

of Phelps Hospice.

26 PHELPS TODAY

Phelps recently introduced another initiative to improve care and quality of life for high-risk patients. In February, Phelps launched a telehealth pilot proj-ect in collaboration with the Visiting Nurse Association (VNA) of Hudson Valley to extend the continuum of care into the home setting. Using equip-ment installed in the home, a patient’s blood pressure, pulse, oxygen levels and weight are captured and wire- lessly transmitted to a monitoring sta-tion, where the data is reviewed and changes in the patient’s health status are noted. If an abnormal result is found, a telehealth nurse will contact the patient to determine the cause and will follow up with his or her primary care provider as necessary. Phelps is the first hos-pital in Westchester to offer this type of program.

“Telehealth” Technology Comes to Phelps

Studies show that up to 20 percent of hospital inpatients are re-admitted within 30 days of discharge due to exac-erbations of congestive heart failure, chronic obstructive pulmonary disease or diabetes. The goals of the telehealth

Phelps Medical Associates News

program are to prevent avoidable re- hospitalizations, enhance patient and caregiver satisfaction, guide patients toward more disease self-manage-ment, and support their ability to age-in-place safely, responsibly and inde-pendently. Evidence-based research shows that telehealth can be instrumen-tal in achieving these goals by tracking a patient’s health status and providing prompt intervention by medical practi-tioners as needed.

Patients of Phelps Medical Associ-ates providers are being selected for participation in the program based upon their need for chronic disease manage-ment and risk for repeated hospital-izations. During the pilot project, tele-health services are being offered free of charge to participants, thanks to a generous donation from the William Olson Memorial Fund.

For more information on the program, please contact the Vitality program at 914-366-3937.

PHELPS TODAY 27

Vitality for SeniorsWhy Preventing Falls Is So Important

F alls are the leading cause of both fatal and non-fatal injuries in people over the age of 65. Every year, one in three people in this age

group falls, and the probability that a fall will result in serious injury increas-es with age. According to the Centers for Disease Control and Prevention (CDC), more than 2.4 million older adults were treated in emergency departments for falls in 2012, with more than 30 percent of them requiring hospitalization.

After experiencing a fall, people may become less mobile and consequent-ly lose their independence. Many older adults develop a fear of falling and often limit their activities and social interac-tions. The resulting isolation can lead to further physical decline, depression and feelings of helplessness, significant-ly impacting quality of life.

Nine out of ten hip fractures in older adults are caused by falls. On average, a patient with a hip fracture is hospitalized for one week, and 25 percent of those patients need extended care in a nurs-ing home for at least one year. The CDC reports that up to 20 percent of patients with a hip fracture will die from result-ing complications.

How Exercise Helps Prevent FallsAs people age, muscle mass is lost, resulting in decreased strength, elasticity and joint mobility. At the same time, balance may be compromised as well, and the combination of dizziness and

weakness increases the likelihood of falling. To offset these changes, it is important for older adults to engage in some form of exercise.

A particularly good form of exercise for people with limited mobility is Tai Chi. This ancient Chinese discipline involving a continuous series of con-trolled, usually gentle, flowing move-ments has been shown to improve strength, flexibility, balance and coor-dination. A 2001 study conducted by the Oregon Research Institute in Eugene reported that seniors who took Tai Chi classes for an hour twice a week report-ed having an easier time with activities like walking, climbing, bending, lifting, eating, and dressing than those who did not participate in the classes.

According to the

Centers for Disease

Control and Prevention

(CDC), more than

2.4 million older adults

were treated in emergency

departments for falls in

2012, with more than

30 percent of them

requiring hospitalization.

28 PHELPS TODAY

In recognition of National Fall Prevention Awareness Day, Phelps sponsored a full day of activities last September at the James House Mansion on the hospital campus. The fall prevention event started with balance screenings conduct-ed by the physical medicine depart-ment and blood pressure screenings performed by the nursing depart-ment. Cheryl Burke, RN, CNS, offered safety tips for fall-proofing the home to reduce the risk of falls. She also talked about the NICHE program – Nurses Improving Care for Healthsystem Elders – which focuses on the care of hospitalized older adults, including how to rec-ognize patients at risk for falling and ways to prevent falls from occurring.

Because there is a connection between fall-induced fractures and osteoporo-sis, Dr. Farrah Gutwein, a Phelps Medical Associates physician special-izing in rheumatology, spoke about risk factors for osteoporosis. Main risk fac-tors are: cigarette smoking, long-term use of steroids, low body weight (less than 127 lbs.), rheumatoid arthritis, a personal or parental history of a non-traumatic or low-trauma bone frac-ture (e.g., breaking a bone after falling from standing height or less), excessive alcohol consumption (three or more drinks a day), and having an osteopo-rosis-related disorder such as diabetes, untreated hyperthyroidism, hyperpara-thyroidism, early menopause, chron-ic malnutrition or malabsorption, or chronic liver disease.

Dr. Gutwein talked about ways to prevent osteoporosis. She recom-mended eating foods that provide calcium (milk, yogurt, and green leafy vegetables) and vitamin D (milk and fish), taking calcium and vitamin D supplements if diet sourc-es are inadequate, exercising for at least 30 minutes most days, avoiding smoking, limiting the use of medi-cations that can cause osteoporosis, and limiting alcohol consumption, which is associated with poor nutri-tion and increased risk for falling.

Dr. Gutwein also suggested ways to prevent falls in the home: ensure rugs have a no-slip backing to keep them in place; keep electrical cords tucked away; install adequate light-ing on walkways; use caution when walking on slippery floors; wear sturdy, comfortable shoes with rub-ber soles; have eyes checked rou-tinely; and find out whether pre-scribed medications cause dizziness or increase the risk of falling.

Fred Perino, Phelps Pharma-cy director, was on hand to pres-ent a more in-depth discussion of medications and their link to falls. Participants learned which types of drugs put them at a higher risk for falls and why. Some medica-tions that are associated with falling are those for cardiovascular condi-tions, pain, anxiety, sleep problems, depression, psychosis and nasal congestion (especially over-the-counter antihistamines).

Vitality for SeniorsFall Prevention Awareness Day at Phelps

PHELPS TODAY 29

Phelps Donates Two Vehicles to Support Local Emergency Medical Services

L ast summer, members of the Tri-Community Advanced Life Sup-por t Sys tem, wh ich includes Croton Emer-

gency Medical Services, the Briar-cliff Manor Fire Department, and the Ossining Volunteer Ambulance Corps, stopped by Phelps Memorial Hospital Center to thank Phelps for the two new “fly cars” the hospital donated to the system at a cost of $83,703.

A fly car is a rapid response Emergency Medical Services vehicle featuring advanced life support equipment that usually arrives at the scene of a medi-cal emergency before the ambulance.

According to Emil Nigro, MD, Director of Emergency Medicine at Phelps, the fly car, which is staffed with a paramed-ic and sometimes an EMT, “brings the ER to the patient.” A paramedic can pro-vide lifesaving modalities on the scene of a medical emergency, including IV fluids, cardiac interventions and medica-tion, and advanced airways (intubations). The speed of a fly car can significantly impact outcomes in life-threatening emergencies. “Many lives have been helped and quite a few saved because of fly cars,” says Dr. Nigro.

Years ago Phelps formed a partner-ship with the villages of Croton-On- Hudson and Briarcliff Manor and the Ossining Volunteer Ambulance Corps, which staffs and manages the Tri-Community ALS system. Phelps has donated a total of six fly cars since 1995. The money donated for the vehi-cles comes from a special fund created to support ambulance services.

“The partnership that the Tri-Community ALS system has with Phelps contin-ues to allow the residents of Croton-on- Hudson, Briarcliff Manor and Ossining to have high-quality advanced life support at a reasonable cost,” says Nick Franzoso, captain of the Ossining Volunteer Ambulance Corps.

Many lives

have been helped

and quite a few

saved because

of fly cars.

AprilWednesday, April 8, 2015

LSVT “Big” for People with Parkinson’s DiseaseLearn about this research-based exercise program for people with Parkinson’s disease that helps improve smoothness of movement and increase strength, balance and range of motion in the arms and legs. Presented by LSVT-certified speakers.

Jennifer Teyfel-Freestone, PT, DPT, CLT-LANA, CSCS, Senior Physical Therapist

Leslie Sims, PT, Physical Therapist

Ronald Lynch, PT, Physical Therapist

11 am – 12 pm; Auditorium Registration is required. Call 914-366-3758 to register.

Friday, April 10, 2015

Balance TherapyIf you are having balance issues, learn balance exercises and strategies to use at home from certified vestibular therapists.

Sheetal Shenoy, OT/ OTR/L

Puja Agarwal, PT/DPT

9 – 10:30 am; Boardroom Registration is required. Call 914-366-3758 to register.

Monday, April 13, 2015

Speech Therapy for Parkinson’s Patients: Think LOUD, Speak LOUDJoin graduates of LSVT LOUD and learn about this intensive speech therapy program for individuals with Parkinson’s disease.

phelps Healthy Life Calendar Spring 2015

Andrea Bracciante-Ely, MS Sp, CCC-SLP, Senior Speech-Language Pathologist

10:30 – 11:30 am; Walkway Conference Room Registration is required. Call 914-366-3220 to register.

Tuesday, April 14, 2015

Better Breathers Club: Build Your Pulmonary ToolboxAdd life to your years by learning proper breathing techniques for when you are at rest or participating in activities.

Susan DiFabio, RRT/CPFT, Education Coordinator for Pulmonary Rehabilitation Program

12 – 1 pm; Pulmonary Lab Registration is required. Call 914-366-3712 to register.

Monday, April 20, 2015

Balance ScreeningsIf you are having trouble with dizziness or imbalance, this is an opportunity to speak with a specialist about your balance problems and receive guidance regarding the next steps for evaluation.

Cameron Budenz, MD, otolaryngologist with subspecialty training in evaluation and management of vestibular (balance) disorders, Medical Director of the Phelps Balance Center

8:45 – 10 am Registration is required. Call 914-366-3220 to register.

Tuesday, April 21, 2015

I Need Hearing Aids?!What consumers need to know before purchasing hearing aids. Where do I go? Who do I see? How do I decide what to get? What are my legal rights as a consumer? Bring your questions – knowledge is power!

Susan D. Reilly, MS, CCC-A, Coordinator of Audiology Services

10 – 11:30 am; Auditorium Registration is required. Call 914-366-3220 to register.

Thursday, April 23, 2015

Bladder HealthLearn about how to keep your bladder healthy and how to minimize problems if you have incontinence.

Huan Sue Zhou, MD, urogynecologist

10 am; Boardroom Registration is required. Call 914-366-3220 to register.

Thursday, April 23, 2015

Swallow ScreeningDo you sometimes feel food or liquid going down the “wrong pipe” or coming back up? Does food get stuck? Do you have pain when you swallow? If you answered yes to any of these questions, you should attend this free swallow screening.

Lynne Marie Gagne-LeBlanc, MS, CCC-SLP

Andrea Bracciante-Ely, MS Sp, CCC-SLP

Paula Dinu, MS, CCC-SLP

9:30 – 12 am; Walkway Conference Room Registration is required. Call 914-366-3220 to register.

Monday, April 27, 2015

Yoga for Professional Voice UsersFor teachers, singers, lawyers and clergy. Use yoga to control nerves, improve posture, use your voice with confidence and connect with your audience. Please bring a large towel and yoga mat. Space is limited.

30 PHELPS TODAY

Leah Ross-Kugler, MS, CCC-SLP, voice rehabilitation specialist and former opera singer

7 – 8 pm; C Level Classroom Registration is required. Call 914-366-3220 to register.

Tuesday, April 28, 2015

Controlling the Pain of Arthritic Knees Without SurgeryOrthopedic surgeon J. Robert Seebacher, MD, will discuss a non- surgical therapy that often helps people with arthritic knees maintain active life-styles while postponing – or eliminating – the need for surgery. Learn how injections and exercise can enable reconditioning and reduce inflammation and pain.

J. Robert Seebacher, MD Medical Director of the Phelps Joint Replacement Service

6:30 pm; Auditorium (light refreshments at 6 pm) Call 914-366-3100 to register.

MayThursday, May 7 and Friday, May 15, 2015

Speech-Language Screenings for Preschool ChildrenAre you concerned about your child’s speech and language development? If so, schedule a free speech-language screening with an experienced pediatric speech-language pathologist.

Kim M. Ventimiglia, MS, CCC-SLP, pediatric speech-language pathologist

Thursday, May 7: 10:30 am – 12 pm Friday, May 15: 1 – 2:30 pm

Donald R. Reed Speech & Hearing Center at Phelps 777 North Broadway, Suite 303

Registration is required. Call 914-366-3220 to register.

Monday, May 11 and Tuesday, May 12, 2015

Defensive Driving ProgramThis two-evening certification program lowers insurance premiums, reduces viola-tion points and sharpens driving skills.

Robert Fogel

5:30 – 8:30 pm; Auditorium Fee: $45 Registration is required. Call 914-366-3220 to register.

Monday, May 11, 2015

Screenings for Chronic Cough and Laryngopharyngeal Reflux Do you have a chronic cough that won’t go away? Screenings will be offered for people with chronic cough despite numerous doc-tor 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, night-time cough and vocal spasms. Symptoms of an irritated nerve include dryness in the throat or a tickle prior to a cough.

Craig H. Zalvan, MD, laryngologist, Medical Director of the Institute for Voice and Swallowing Disorders at Phelps

8:45 – 10 am Registration is required. Call 914-366-3220 to register.

Tuesday, May 12, 2015

Better Breathers Club: Build Your Pulmonary ToolboxLearn about the anatomy and physiology on the normal and diseased lung.

Susan DiFabio, RRT/CPFT, Education Coordinator for Pulmonary Rehabilitation Program

12 – 1 pm; Pulmonary Lab Registration is required. Call 914-366-3712 to register.

JuneThursday, June 4, 2015

Fall Prevention at HomeLearn about how to prevent falls at home from therapists who are certified in vestibular therapy.

Sheetal Shenoy, OT, OTR/L Puja Agarwal, PT, DPT

10:30 am – 12 noon; Boardroom Registration is required. Call 914-366-3758 to register.

Thursday, June 4 and Tuesday, June 16, 2015

Skin Cancer ScreeningsA dermatologist will visually examine your skin for the presence of abnormal tissue and let you know if further testing is advisable.

Thursday, June 4, 2015 9 – 11:15 am Jeffrey Sturza, MD

Tuesday, June 16, 2015 1 – 3 pm Alison Stallings, MD

Appointments are required. Call 914-366-3220.

Tuesday, June 9, 2015

Better Breathers Club: Build Your Pulmonary ToolboxAdd life to your years by learning to exercise safely at home, wearing comfortable clothes and non-slip shoes.

Susan DiFabio, RRT/CPFT, Education Coordinator for Pulmonary Rehabilitation Program

12 – 1 pm; Pulmonary Lab Registration is required. Call 914-366-3712 to register.

PHELPS TODAY 31

Wednesday, June 10, 2015

LSVT “Big” for People with Parkinson’s DiseaseLearn about this research-based exercise program for people with Parkinson’s disease that helps improve smoothness of movement and increase strength, balance and range of motion in the arms and legs. Presented by LSVT-certified therapists.

Jennifer Teyfel-Freestone, PT, DPT, CLT-LANA, CSCS, Senior Physical Therapist

Leslie Sims, PT, Physical Therapist

Ronald Lynch, PT, Physical Therapist

11 am – 12 pm; Auditorium Registration is required. Call 914-366-3758 to register.

OngoingBereavement Support GroupThis ongoing support group for adults struggling with the loss of a loved one meets two Thursdays a month on the following dates: March 12 and 26, April 9 and 23, May 7 and 21

Bess Steiger, LCSW, Bereavement Coordinator

2 – 3:30 pm; Hospice Office in the James House Suggested donation: $10 per session. Registration is required. Call 914-366-3325 or email bsteiger@pmhc.us.

Look Good . . . Feel Better® This free, 2-hour workshop teaches beauty techniques to women under- going cancer treatment. The program, held monthly at Phelps, includes a hair consultation with a professional stylist and a makeup consultation with a cosmetologist. Attendees can take home a complimentary wig and a 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 914-366-3421 to register for an upcoming session on March 2, April 6, May 4 or June 1.

Osteoporosis Support and Education A free monthly group program for individuals with osteoporosis, providing education on nutrition, exercise (weight-bearing, strengthening and balance) and activities of daily living. The sessions are held from 11 am to 12:30 pm the second Thursday of the month in the Phelps Boardroom (C Level).

Call 914-366-2270 to register for an upcoming session on April 19, May 13 and June 11.

Vitality for SeniorsApril 9, May 13, June 11 and July 9

Breakfast ClubMeets monthly and includes a free breakfast, a presentation on a healthy life-style topic and a light exercise program.

8:30 – 10:30 am; Cafeteria To register, call 914-366-3937.

Tuesdays, March 17, April 21, May 19, June 16, July 21, August 18 and September 15, 2015

Senior StepsA program offering health screenings for seniors, held once a month in various locations throughout the hospital.

Appointments are required. Call 914-366-3937.

Wednesdays, April 1, May 6, June 3, July 1, August 5 and September 2, 2015

Mind GamesMind Games is a fun way to help seniors stimulate their minds and develop cognitive functioning skills, including memory, visual recall, problem solving, focus and speed, and spatial reasoning.

2 – 3:30pm; Boardroom (C Level) To register, call 914-366-3937.

Fridays, April 3, 10 and 17 and May 1, 8 and 15

Tai Chi ClassesTai chi is a graceful form of exercise that reduces stress and improves a variety of health conditions, such as osteoporosis, through gentle, flowing movements. It involves a series of motions performed in a slow, focused manner and accompanied by deep breathing.

9:30 – 10:30 am in the Board Room To register, call 914-366-3937.

Tuesdays, April 7, 14, 21 and 28 and May 5 and 12

Health for Life Program (HeLP)The Health for Life Program empowers participants to better manage chronic conditions such as diabetes and high blood pressure; communicate effectively with healthcare professionals and family; realize healthcare savings by avoiding trips to doctors and hospitals; and enjoy an enhanced quality of life.

10 am – 12:30 pm; 755 Building, Room 235 To register, call 914-366-3937.

Wednesday, April 29

Spirituality ProgramElders on Parade: How Society Sees Us and How We See Ourselves Most seniors feel younger than their age, but our culture often treats them as if they are older than they are. Using William Thomas’s book What Are Old People For? How Elders Will Save the World and other research as a basis for discussion, this program will investigate how ageism affects seniors and how they can respond.

9 – 10:30 am; Auditorium To register, call 914-366-3937.

32 PHELPS TODAY

Los tan importantes riñones: El filtro de su cuerpo

usto debajo de la caja torácica a ambos lados de la columna vertebral hay dos órganos del tamaño de un puño que

son vitales para nuestra supervivencia: nuestros riñones. Cada uno tiene aproximadamente un millón de filtros microscópicos llamados nefrones, que procesan toda la sangre de nuestro cuerpo varias veces cada día. Este proceso filtra las toxinas de aproximadamente 150 cuartos de galón de sangre, creando hasta dos cuartos de galón de orina que contiene desechos y fluido corporal en exceso. La orina se drena por conductos llamados uréteres hacia la vejiga y se vacía desde la vejiga mediante un conducto llamado uretra.

Los riñones son importantes para nuestra salud por muchas razones. Evitan la acumulación de desechos y fluido del cuerpo. Estabilizan los electrolitos como el sodio, potasio y fosfato, que son esenciales para el funcionamiento normal de nuestras células y órganos. Y generan hormonas que ayudan a producir glóbulos rojos, a regular la presión arterial y a mantener la fortaleza de los huesos.

Enfermedad renalA veces los riñones lentamente dejan de funcionar. Sin tratamiento, este deterioro puede progresar hasta la enfermedad renal crónica, también l lamada insuficiencia renal o falla crónica del riñón. La causa de la enfermedad renal crónica no siempre es conocida, pero cualquier afección que dañe los vasos

sanguíneos puede afectar negativamente a los riñones. Una causa común es la diabetes, porque los niveles elevados de azúcar en la sangre en un largo período de tiempo dañan a los vasos sanguíneos de los riñones. También hay relación entre la enfermedad renal y la alta presión arterial (hipertensión). La alta presión arterial puede dañar a los vasos sanguíneos, y si eso causa la enfermedad renal, los riñones dañados pueden, a su vez, causar presión arterial más alta.

Prevención de la insuficiencia renalCuando la función renal cae debajo de cierto punto, se llama insuficiencia renal. Al igual que con cualquier otra afección, mientras más pronto se detecte la enfermedad renal, más pronto podrá el tratamiento desacelerar su progreso y prevenir la insuficiencia renal. El primer paso es determinar y tratar la causa subyacente. Como la diabetes y la alta presión arterial representan el 66 por ciento de la enfermedad renal crónica, prevenir o manejar estas afecciones mediante un régimen alimenticio, ejercicio y medicamentos adecuados es

Jde vital importancia para proteger los riñones.

Es posible sobrevivir con solo una parte de un riñón si este aún funciona. Sin embargo, si ninguno de los riñones funciona, se debe usar una máquina para limpiar la sangre (diálisis) o se debe trasplantar un nuevo riñón.

Tratamiento de vanguardiaPhelps ofrece a los pacientes un nivel más alto de atención para la prevención de las enfermedades y trastornos renales que típicamente están disponibles en los hospitales comunitarios. “Mis colegas y yo tenemos experiencia en la realización de los procedimientos más avanzados en laparoscopía y en los procedimientos reconstructivos mínimamente invasivos mediante pequeños sitios de acceso y sin incisiones grandes”, dice el urólogo Dr. Michael Grasso. “Como resultado, nuestros pacientes sanan más rápidamente y pueden volver a sus actividades normales más pronto. Además, hay menos dolor que con una cirugía abierta”.

Las dos imágenes de arriba son del mismo riñón, el cual está lleno de cálculos. La imagen de la izquierda es una radiografía usada para el diagnóstico. A la derecha está la imagen que el urólogo obtuvo de un endoscopio, un tubo angosto con un cámara en un extremo que se inserta en el cuerpo. El urólogo miraba la imagen endoscópica mientras retiraba los cálculos renales.

PHELPS TODAY 33

La línea amarilla delinea un tumor polipoide, llamado así porque tiene la apariencia de un pólipo. El urólogo lo retiró endoscópicamente, salvando el riñón.

En esta imagen tomográfica 3D, la flecha blanca señala un bloqueo en el riñón donde vasos auxiliares estaban cruzados. El urólogo reconstruyó la porción de drenaje del riñón y movió los vasos adicionales lejos del bloqueo, restaurando la función renal.

En esta imagen, el área delineada en azul es cancerígena, el área delineada en amarillo es un quiste. La delineación roja indica la porción de riñón que se removió. El resto del riñón fue salvado.

El Dr. Grasso añade, “En general, los urólogos que tienen amplia experiencia quirúrgica con la más reciente tecnología y que siguen un abordaje de equipo de cirugía pueden ofrecer mejores tratamientos y mejores resultados para los pacientes con afecciones como cálculos renales, obstrucción del uréter y cáncer en los riñones”.

Cálculos renalesLos cálculos se forman por la cristalización de ciertas sustancias en la orina, como calcio, oxalato o ácido úrico. Los cálculos pueden afectar a cualquier parte de las vías urinarias desde los riñones hasta la vejiga. Los cálculos renales son más comunes en los varones. Los síntomas de los cálculos renales incluyen dolor agudo en el costado y la espalda debajo de las costillas, que puede difundirse al abdomen bajo y a la entrepierna. El dolor puede sentirse en oleadas y fluctuar en intensidad. La orina usualmente es roja, marrón, rosada o turbia y puede tener mal olor. Hay fiebre y escalofríos si hay una infección.

Aunque tomar grandes cantidades de agua es a veces todo lo que se necesita para expulsar un cálculo renal, si este es muy grande, la única solución puede ser un procedimiento realizado por un urólogo.

La buena noticia es que los cálculos renales a menudo se pueden eliminar sin incisiones quirúrgicas, usualmente en un entorno ambulatorio. En un procedimiento llamado ureteroscopía se inserta un pequeño instrumento de visualización, llamado ureteroscopio, en la uretra a través de la vejiga y el uréter hacia donde se localiza el cálculo renal. Una vez que el cálculo está a la vista, el urólogo puede capturarlo con fórceps o una canastilla. Otra técnica no quirúrgica, la litotripsia extracorpórea (ESWL), usa ondas de choque para desbaratar los cálculos más grandes y hacerlos lo suficientemente pequeños para expulsarlos en la orina. El mejor método para eliminar los cálculos renales muy grandes y complejos es la nefrolitotomía percutánea (PCNL),

Phelps ofrece a

los pacientes un nivel

más alto de atención

para la prevención

de las enfermedades

y trastornos renales

que típicamente están

disponibles en los

hospitales comunitarios.

Los cálculos renales pequeños a veces salen del cuerpo en la orina y pueden pasar completamente desapercibidos. Pero en el uréter, los cálculos más grandes pueden bloquear el flujo de la orina y ser extremadamente doloroso a medida que se mueven hacia la vejiga. Dolorosos o no, los cálculos renales usualmente no ocasionan ningún daño permanente.

34 PHELPS TODAY

PHELPS TODAY 35

Michael Grasso MD, es profesor y Vicepresidente del Departamento de Urología del New York Medical College, así como Director Regional de Urología del North Shore-LIJ Health System. Anualmente enseña cursos en procedimientos urológicos avanzados en la asamblea de la Asociación Urológica Americana y en la asamblea de la Asociación Urológica Europea. El Dr. Grasso y sus colegas, el Dr. Andrew I. Fishman y el Dr. Christopher Dixon, se especializan en procedimientos de vanguardia, mínimamente invasivos para el tratamiento de la enfermedad renal. El Dr. Fishman es Profesor Asistente y el Dr. Dixon es Director de Urología Reconstructiva en el New York Medical College. Su consultorio de Westchester está en el campus Phelps en el edificio de 755 North Broadway, Suite 510. Los urólogos realizan procedimientos quirúrgicos en pacientes ambulatorios y pacientes hospitalizados en el nuevo SurgiCenter de Phelps. Para comunicarse con el Dr. Grasso, el Dr. Fishman o el Dr. Dixon, llame al 914-302-0100.

que implica una pequeña incisión y la colocación de un tubo en el riñón a través del cual se pueden introducir instrumentos para desbaratar y retirar el cálculo.

Obstrucción del uréterLa orina viaja desde los riñones hasta la vejiga mediante unos conductos delgados y musculares llamados uréteres. Hay un uréter en cada riñón, y cada uno mide de 8 a 10 pulgadas de longitud. A veces los uréteres se obstruyen y se impide el flujo de la orina hacia la vejiga.

La causa más común de la obstrucción ureteral son los cálculos ureterales o renales. Otras causas incluyen afecciones congénitas, cicatrización o lesión por una cirugía abdominal o pélvica previa, coágulos sanguíneos, tumores, inflamación de la pared del uréter, inflamación de los órganos de alrededor de los uréteres, una pequeña inflamación en el uréter llamada ureterocele, endometriosis, estreñimiento severo y embarazo.

Los síntomas incluyen dolor en la espalda baja o en el vientre bajo hacia los lados, micción dolorosa, aumento en la frecuencia o urgencia en la micción, reducción en la producción de orina, sangre en la orina, piernas inflamadas o fiebre.

Para diagnosticar una obstrucción ureteral, un urólogo realizará una exploración física, medirá su presión arterial y revisará si hay sangre o infección en la orina. También se puede realizar un ultrasonido o una tomografía abdominal.

El objetivo del tratamiento es reducir o eliminar la obstrucción. Los casos graves usualmente requieren cirugía para reparar la causa subyacente de la obstrucción.

Cáncer en los riñonesLa incidencia de cáncer en los riñones está creciendo en Estados Unidos. Afortunadamente, la mayoría de los cánceres se detectan antes de que se propaguen (metatasticen) a otros órganos. Históricamente, el diagnóstico del cáncer de riñón conducía a la extirpación de todo el riñón en una operación llamada nefrectomía. En la actualidad, la mayoría de los tumores del riñón se extirpan en una nefrectomía parcial, en la que se usan técnicas avanzadas de laparoscopía e imagenología especial para extirpar el tumor y parte del tejido que está a su alrededor sin hacer una incisión grande. La parte saludable del riñón se salva, y se mantiene la buena función renal.

Adicionalmente, hay técnicas que usan endoscopios (instrumentos iluminados y flexibles para visualizar dentro del cuerpo) y rayos láser poderosos y precisos para tratar tumores en el revestimiento de los riñones, uréteres y vejiga, extirpando malignidades mientras que salvan el resto del órgano.

De hecho, con estas nuevas técnicas para tratar el cáncer de riñón, raras veces se extirpa el órgano entero.

No lo llame un retorno: La varicela ha estado aquí por años

36 PHELPS TODAY

os médicos de atención pr imaria con poca frecuencia reciben los elogios de otras e s p e c i a l i d a d e s .

Los programas de TV son sobre neurocirujanos o cardiólogos, no médicos de atención primaria. Sin embargo, lo que perdemos en glamur, lo compensamos con la satisfacción de tener la oportunidad de prevenir que muchas enfermedades ocurran o empeoren.

Me han preguntado muchas veces más de las que puedo recordar: “¿Se convirtió en médico para ayudar a personas enfermas?” Mi respuesta

La eso es siempre: “Sí, pero la razón principal de convertirme en doctor es para ayudar a las personas antes de que se enfermen”. La prevención de enfermedades es el objetivo principal de la medicina de atención primaria, y mantener a los pacientes saludables y libres de enfermedades graves es mi objetivo principal como médico. Una de las mejores maneras de lograr este objetivo son las vacunas.

La vacuna contra la varicelaLa vacuna contra la varicela se aplica para prevenir la varicela (chickenpox en inglés), una infección viral altamente contagiosa causada por el virus varicela-zoster. La vacuna ha sido muy valiosa en la disminución de la incidencia de varicela infantil. Al 2007, las muertes infantiles por varicela se han cortado en

un 97%. Antes de la presentación de la vacuna en 1995, 50 niños en EE.UU. morían cada año y miles más eran hospitalizados.

Sabiendo que la vacuna está hecha de “virus atenuados vivos” a veces causa que las personas se preocupen sobre contagiarse la varicela al ser vacunados. Un sarpullido parecido a la varicela podría desarrollarse en 1 a 6 por ciento de las personas después de la vacunación, pero la reacción más común es fiebre y dolor, enrojecimiento e inflamación en el sitio de la inyección. A excepción de personas que tienen algún tipo de deficiencia inmunitaria o son alérgicas a la vacuna, sus beneficios superan los riesgos para la mayoría de las personas.

Por Jillian Elliott, MD

PHELPS TODAY 37

Mientras que la mayoría de las personas saben que es importante vacunar a sus hijos, muchas no se dan cuenta que es también importante para los adultos vacunarse y recibir refuerzos. Esto es especialmente verdad para personas que padecieron varicela en la niñez pero no muestran inmunidad a esta de adultos. Para personas mayores con sistemas inmunitarios débiles, el herpes zóster (también conocido comúnmente como la culebrilla) es también una inquietud. Causado por la reactivación del virus de la varicela, el herpes zoster se manifiesta como un sarpullido doloroso. Hay vacunas disponibles para reducir el riesgo de herpes zóster.

Transmisión de la varicela y curso de la enfermedadLa varicela puede transmitirse tocando directamente el líquido en una lesión en la piel de alguien o respirando las secreciones de la nariz de una persona infectada. Después de la exposición al virus, lleva aproximadamente entre 10 y 21 días antes de los primeros síntomas de infección, que incluyen fiebre, fatiga, dolor de garganta y pérdida del apetito. El sarpullido se desarrolla aproximadamente 24 horas después que estos síntomas aparecen y se presenta en “grupo”, típicamente en la cara, torso, brazos y piernas. Debido a que se desarrollan nuevas lesiones cada día durante alrededor de cuatro días, lesiones llenas de líquido o lesiones en costra podrían presentarse al mismo tiempo. Aproximadamente seis días después de las señales y síntomas iniciales, todas las lesiones formarán una costra y ya no serán contagiosas.

A pesar de que todo esto puede sonar benigno, la varicela puede desa fo r tunadamente ag rava r se para ciertos pacientes. Severas complicaciones del virus incluyen infecciones dérmicas bacterianas secundarias, neumonía y encefalitis, que es la inflamación del cerebro. El método principal de prevenir los aspectos más serios de la varicela es por medio de la vacunación. Mientras que se reporta que es 44% efectiva en prevenir la varicela, la vacuna es 86% efectiva en prevenir complicaciones graves.

InmunidadRecuerdo haber tenido varicela cuando tenía cinco años y estar cubierta desde la cabeza hasta los pies de lesiones que causaban gran picazón. Afortunadamente, no desarrollé ninguna complicación. Cuando mis padres eran niños, los llevaban a visitar amigos que tuvieron varicela para contagiarse el virus y más tarde superarlo. No había una vacuna en ese momento, y esto era simplemente la única manera de aumentar la inmunidad.

Antes de la implementación de la vacuna contra la varicela en 1995, el curso natural de la inmunidad contra la varicela era este: Usted se contagiaba la varicela de niño y desarrollaba inmunidad. Luego, de adulto, usted se exponía a niños con varicela y eso proveía a su inmunidad un refuerzo. A través de este proceso, usted desarrollaba inmunidad para toda la vida contra la varicela. Sin embargo, ahora que los niños son vacunados, los adultos ya no son expuestos nuevamente a la varicela, por lo tanto el refuerzo no ocurre.

Quién debería recibir la vacunaSe recomienda la vacuna a todos los niños de 12 a 15 meses de edad que no tengan evidencia de inmunidad, y una segunda dosis entre las edades de cuatro a seis años. La experiencia nos ha enseñado que solo con una dosis los niños aún pueden infectarse con varicela, y por eso necesitan la segunda dosis.

Los adultos deberían someterse a una prueba con su doctor para ver si tienen inmunidad contra el virus. Si no se detecta inmunidad, se recomienda un refuerzo. Los adultos deberían recibir dos dosis de la vacuna con cuatro a ocho semanas de separación. La protección contra la varicela es especialmente importante para adultos que trabajan en la atención médica o cuidado de niños o que están expuestos a personas con sistemas inmunitarios debilitados. Además, las mujeres en edad de concebir que muestran no inmunidad deberían vacunarse; sin embargo, no deberían quedar embarazadas por lo menos por cuatro semanas después de vacunarse. Inmunidad de las masasCon mis pacientes , enfat izo la importancia de recibir la vacuna de la varicela, no solo para protegerse a sí mismos pero también a aquellos que los rodean. De hecho, los brotes pueden prevenirse con algo llamado “inmunidad de las masas”, donde una porción crítica de la comunidad es inmunizada contra la enfermedad, y cualquier caso que se presente no puede propagarse entre las personas que han sido vacunadas. Un ejemplo trágico de lo que puede suceder cuando una cantidad numerosa

38 PHELPS TODAY

Jillian Elliott, MD, es una doctora de medicina interna y miembro de Phelps Medical Associates. Certificada por la Junta Médica en medicina interna, la Dra. Elliott recibió su título de medicina en New York Medical College y completó su residencia en medicina interna en Montefiore Medical Center. Atiende pacientes en el campus de Phelps en la suite 417 del Edificio 755 North Broadway (914-366-5490).

de personas no se vacuna ocurrió en 2012, cuando una niña de cuatro años con leucemia murió después de ser expuesta a un primo con un sarpullido que terminó siendo varicela. Ella no podía recibir la vacuna de la varicela

porque estaba recibiendo quimioterapia y su sistema inmune estaba muy débil. Lamentablemente, podría haber estado protegida si la inmunidad de las masas hubiese prevenido el contagio de su primo.

Mientras que casi hemos eliminado la varicela con la vacunación, noticias recientes nos muestran cómo los virus pueden reemerger. Las vacunaciones pueden ser víctimas de su propio éxito; al ser efectivas, las personas desestiman su beneficio y no se vacunan. La verdad es que la vacunación es vital, no solo para mantenerlo seguro a usted, pero para mantener a sus seres queridos también seguros.

Me convertí en una doctora de atención primaria para prevenir enfermedades, y las vacunas me ayudan a hacerlo, contra la varicela y muchas otras enfermedades. Creo que mi papel más importante es educar a mis pacientes sobre las vacunas y los muchos otros pasos que pueden tomar para proteger su salud.

La mayoría de la población

es inmunizada.

La propagación de la enfermedad

contagiosa es contenida.

No inmunizado pero aún saludable

No inmunizado pero aún saludable

No inmunizado, enfermo y contagioso

Nadie está inmunizado.

La enfermedad contagiosa se propaga en la

población.

Una parte de la población es

inmunizada.

La enfermedad contagiosa se

propaga a través de una parte de

la población.

PHELPS TODAY 39

A Report from Phelps Auxiliary President Mark Frederich

he Phelps Hospi ta l A u x i l i a r y , e s t a b -lished in 1955, is a network of dedicat-

ed men and women who provide volunteer services and participate in fundraising activities to support the hospital. Over the past year, Auxilians volunteered their time, energy and exper-tise to manage the Cherry Door (our thrift shop in Tarrytown) and the hospital’s Gift Shop with superb results. Our bake sales were also remarkably and deliciously successful. These and other Auxiliary projects enabled the organiza-tion to donate $150,000 to the hospital, which contributed to the purchase of the state-of-the-art GreenLight XPS laser technology for treating benign prostatic hyperplasia. The Auxiliary has pledged half a million dollars over the next few years to help fund important capi-tal projects, such as the extraordinary SurgiCenter that opened in February.

Phelps Memorial Hospital and the healthcare industry in general face huge challenges in the future, making this the most exciting time in decades to be involved with Phelps as an Auxil-ian. Muhammad Ali once said, “It isn’t the mountains ahead that wear you out; it’s the pebble in your shoe.” It is the Auxilians’ tireless work on a daily basis (the little things) that helps us to scale our mountains.

T...there is a need to

broaden our membership

with participants who can

bring in new ideas and

enthusiasm for ongoing and

future projects.

Auxilian volunteers working in the hospital Gift Shop.

The Auxiliary’s fundraising efforts are vital to Phelps. Its projects have enabled significant donations to the hospital every year. To continue the good work of the Auxiliary, there is a need to broaden our membership with participants who can bring in new ideas and enthusiasm for ongoing and future projects.

Being an Auxilian does not require a major time commitment. There are many tasks and positions to be filled. Some require only a few days a year, while ongoing projects can give regular purpose in the lives of people who have the time and inclination.

For more information about the Auxiliary and how to join, please call Eve Urban at 914-366-3170.

40 PHELPS TODAY

Maternity and Baby Care ClassesThe Childbirth Experience/LaMaze MethodWednesday evenings 7:30 – 9:30 pm for 5-6 weeks

Start dates: March 18, April 22 and May 27

OR

2-day weekend sessions, 10 am – 3 pm:

March 14-15, April 11-12, May 9-10 and June 13-14Cost: $170 per couple

Breastfeeding: First Choice for BabiesApril 16, May 4 and June 47 – 9 pmCost: $45 per couple

ABCs of Baby CareApril 13, May 14, June 11 7 pm Cost: $65 per couple

Totsaver Program: American Heart Association CPR for Family and FriendsApril 4, May 2, June 6 9 am – 2 pm $55 per personFor up-to-date schedule, visit www.phelpshospital.org or call (914) 366-3382 forinformation or to register.

Prenatal Clinic: Phelps Memorial Hospital Center and Open Door Family Medical Center, participants in the Medicaid Prenatal Care Assistance Program, jointly sponsor a Prenatal Program. Care for expectant mothers is provided by a highly trained, caring, bilingual staff. No one is turned away based on income or health insurance. Women are encouraged to seek prenatal care early in their pregnancy. Care is provided at Open Door during the first 36 weeks of pregnancy and at Phelps Memorial Hospital during the remainder of the pregnancy and for delivery. For information, call: (914) 941-1263

Atención Prenatal: Phelps Memorial Hospital Center en Sleepy Hollow y OpenDoor Family Medical Center, participantes en el Programa de Asistencia de Atención Prenatal de Medicaid, auspician conjuntamente un Programa Prenatal. La atención de mujeres embarazadas es provista por un personal bilingüe y solidario, altamente capacitado. No se rechaza a nadie basándose en sus ingresos económicos o seguro. Sealienta a las mujeres a recibir atención prenatal lo más temprano posible durante su embarazo. La atención es provista en Open Door durante las primeras 36 semanas del embarazo y en Phelps Memorial Hospital durante el resto del embarazo y el parto. Para mayor información, sírvase llamar al: (914) 941-1263.

Save The Dates!

12th Annual Phelps Classic

Monday, June 8, 2015 Sleepy Hollow Country Club,

Scarborough, NY

For information contact Marissa Coratti, Special Events Manager914-366-3104, mcoratti@pmhc.us or register online at phelpshospital.org

28th Annual Champagne Ball

Saturday, November 7, 2015 Trump National Golf Club,

Briarcliff Manor, NY

PHELPS TODAY 41

Save The Dates!

Proceeds will benefit Phelps Memorial Hospital Center

&2 0 1 5 P H E L P S

FOODWINE

FESTTRUMP NATIONAL GOLF CLUB339 Pine Road, Briarcliff Manor, NYSUNDAY AFTERNOON12:00 – 4:00MARCH 22, 2015$90 Per Ticket

JOIN US FOR OUR FIRST-EVER

Celebrity chef: Waldy Malouf

Gourmet Sponsor

Restaurant Participants (As of 2/18/15)

105 Ten Bar & GrillCoffee Lab RoastersCoopers MillCrabtree’s Kittle HouseElia TavernaGreat American BBQIron Horse GrillJean-Jacques’ Culinary CreationsMambo 64Memphis Mae’sProvisionsRiver Market Kitchen and BarSam’s of Gedney WayTarry TavernTavern at Croton LandingTrump National Golf Club

International Beer GardenSponsored by: Half Time World’s largest beer retailer

WineGrape Expectations

Thank you to our sponsors: BBL Construction Services, Gordon & Silber, PC, Robert Lane and Janine Guercio, M&T Bank, Michael and Judith Sullivan

To purchase tickets go to phelpshospital.org/food-wine-fest or contact Marissa Coratti, Special Events Manager, at (914) 366-3104 or mcoratti@pmhc.us

Bank

A 1

B 2

C3

D

E

PHELPS PRACTICES ON THE HOSPITAL CAMPUS• Advanced Endoscopy & Gastroenterology: 914-366-1190• Diabetes, Osteoporosis & Metabolism Center: 914-366-2270• Gastroenterology: 914-366-5420• Primary Care: 914-366-5490• Neurology: 914-366-5330 & 5440• OB/GYN: 914-366-5400• Senior Health & Internal Medicine: 914-366-3677• Thoracic Center: 914-366-2333• Westchester Lung Nodule Center: 914-366-2333

H

4

BEHAVIORAL HEALTH SERVICESAddiction Treatment Services (ATS)Ossining: 914-944-5220

Ossining Counseling ServiceOssining: 914-944-5250

Continuing Day Treatment Briarcliff Manor: 914-923-5700

Supportive Case ManagementBriarcliff Manor: 914-923-5740

Rt. 119Rt. 117

sleepy hollow

briarcliff manor

dobbs ferry

tarrytown

irvington

croton-on-hudson

A

B

1 2

C

3 4

D

E

G

H

Felmsford

F

G

PHELPS MEDICAL ASSOCIATES IN THE COMMUNITY Croton Primary Care, Cardiology, Endocrinology, & Rheumatology: 914-269-1700 Phelps Radiology: 914-269-1701OssiningFamily Medicine: 914-373-4948Internal Medicine: 914-941-1277

BriarcliffCardiology: 914-762-5810

Sleepy Hollow Primary Care, Cardiology and Rheumatology: 914-631-2070

ElmsfordPodiatry: 914-345-3400Tarrytown Endocrinology: 914-366-7862Rheumatology: 914-631-8826 Dobbs FerryPrimary Care: 914-478-1384Cardiology: 914-478-0641

Phelps Memorial Hospital Locations in the Community

42 PHELPS TODAY

PHELPS TODAY 43

Donate Blood at PhelpsGive the gift of life and receive a discount from a local business!

Briarcliff Manor 105 Ten Bar & GrillBella Maiya Day SpaBriars RestaurantDom & Vinnie’sGood FoodManor Wine & SpiritsOrfino’sPaese Pasta & PizzaSquire’s Steak & SeafoodTerra Rustica

Chappaqua Kittle House

Croton-on-Hudson Anton RestaurantBackstage SalonBaked by SusanThe Black CowCroton Colonial DinerDePrez Wines & SpiritsFeed the Birds!Giovanni’s Deli & PastriesHolistic Physical TherapyHop Scotch Market & RestaurantJustin Thyme Café BarMemphis Mae’s Bistro BBQNew York Sports ClubsPronto Brick Oven PizzaTavern at Croton LandingVan Wyck Wines & LiquorsVogue Nails & Spa

Elmsford Fairview Golf CenterWestchester Broadway Theatre

Hawthorne Gordo’sGreen Valley NurseryTramonto Restaurant-Bar-Café

Irvington Geordane’sIl Sorriso Red Hat on the RiverRiver City Grille

Mt. Kisco Basilico Pizza, Pasta Tijuana Mexican Grill

Ossining Art Barn Atria Senior Living The Boathouse Capri Pizza & Pasta Carpet Giant Corsi Tire Doca’s Portuguese Goldfish King Shell Service Center Landmark Diner Mandee Melita’s South of the Border Ultra Clean Car Wash VaZa Salon & Spa Wobble Café

Pleasantville A’MangiareBest Wine PurveyorsThe Black CowThe Flower BasketFoley’s Club LoungeIron Horse GrilleJacob Burns Film CenterManhattan Chili Co.Martha’s Pleasantville DeliMediterraneoPhysical Fitness XpertsPleasantville Colonial DinerPony Express Good FoodSinapi’s Bakery & CaféSir Speedy Printing & MarketingSparx Hair & Makeup SalonTech Connect ComputerTrattoria 160

Sleepy Hollow Bridge View TavernDominick’s LimousineJ. P. Doyle’s RestaurantThe HorsemanThe HuddleKendal on HudsonThe River Grill Restaurant & BarTijuana Mexican Grill

Tarrytown Bark & Meow Pet ProductsBella’s BoutiqueCastle Hotel & SpaCoffee Labs RoastersElite Hair DesignFamily YMCAGrape ExpectationsTGI Friday’sHeritage FrameHudson River EyecareHorsefeathersKing Shell Service CenterLubins and LinksMain Street SweetsMr. Nick’s Brick Oven PizzaNY School of EstheticsOn Track Sport CenterPHR ElectrolysisPure Mountain Olive OilRiver View Wines & SpiritsSunset CoveTaco ProjectThe Tapp Tarry TavernTaste of ChinaWarner Libraryw@tercooler

Thornwood Casa Rina

White Plains The Cabin

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.

P H E L P SPhelps Memorial Hospital Center701 North BroadwaySleepy Hollow, NY 10591-1096www.phelpshospital.org

Nonprofit OrganizationU.S. Postage

PAID White Plains, CTPermit No. 105

Ongoing Health Programs and Support GroupsAlzheimer’s Support Group For information, call Curtis Au (914) 253-6860

Outpatient Behavioral Health Alcohol/chemical dependency, counseling, continuing day treatment, supportive case management (914) 366-3027

Bereavement Support Groups (914) 366-3325

Better Breathers Club (914) 366-3712

Blood Donations (914) 366-3916

Blood Pressure Screenings Generally the 1st & 3rd Wednesday of the month, 9:30 - 11:30 am Appointments necessary (914) 366-3220

Cardiovascular Rehab (914) 366-3740

Cardiovascular Wellness Center Exercise under RN supervision (914) 366-3752

Celiac Sprue Support Group Sue Goldstein: (914) 428-1389

CPR Classes (914) 366-3166

Diabetes Education Classes for Adults (914) 366-2270

Group Counseling Help with issues such as: separation & divorce, losses, relationships, family issues, parenting, coping skills (914) 366-3600

Hospice (914) 366-3325

Look Good Feel Better® for women undergoing cancer treatment (914) 366-3315 or (914) 366-3421

Mammography (914) 366-3440

Maternity & Baby Classes (914) 366-3382

My Sister’s Place (800) 298-SAFE (7233)

Osteoporosis Support Group (914) 336-2270

Ostomy Support Group 3rd Sunday of every month (914) 366-3395 (Call 366-3000 for cancellation information)

Physician Referral (914) 366-3367

Pulmonary Rehabilitation (914) 366-3712

Sleep Well Support Group (914) 366-3755