Healthy You: Spring 2011 - Englewood Hospital and Medical Center

the healthcare magazine for englewood hospital and medical center Spring 2011
Healthy You
Advanced
Techniques in
Pediatrics
&
One Patient’s
Renewed Outlook
on Life
Comprehensive
Cancer
Services
for Patients
englewoodhospital.com

Walter B., post-surgery, with exercise
physiologists Peter Toto (left) and
Anthony Avecilla (right)
What He’s Gained
Outweighs What He’s Lost
Walter B., a 39-year-old resident of West New York, had come to terms with his obesity some time ago.
However, his mother worried about her son. She had already lost her three other sons and did not want to
lose Walter to a battle against obesity.
In July 2009, while visiting a friend, Walter did not recognize
his friend’s aunt. She had undergone bariatric surgery and had lost
a significant amount of weight. Walter was amazed by her success
with the procedure.
The following week, an unmarked envelope arrived in Walter’s
mailbox. Inside was information about bariatric surgery at
Englewood Hospital and Medical Center. He took the delivery as
a sign that he needed to confront his obesity. He decided to learn
more about the surgical options that would change his life and
ultimately improve his health.
Turning to a Specialized Team
On April 13, 2010, Walter was admitted to Englewood Hospital
for bariatric surgery. He weighed 543 pounds.
Under the care of Ibrahim M. Ibrahim, MD, FACS, FASMBS,
BSCOE, Director of Minimally Invasive Surgery and Bariatric
Surgery at Englewood Hospital,
and his associate, Jeffrey
Strain, MD, FACS, FASMBS,
BSCOE, bariatric surgeon,
Walter underwent a weight-loss
procedure called laparoscopic
sleeve gastrectomy. This surgery
removes a portion of the stomach,
restricting the amount of food it
Ibrahim M. Ibrahim, (left) MD, FACS, FASMBS,
BSCOE, Director of Minimally Invasive Surgery
and Bariatric Surgery at Englewood Hospital,
and his associate, Jeffrey Strain, MD, FACS,
FASMBS, BSCOE, bariatric surgeon
can hold. Less than one year later,
Walter weighs 255 pounds. He has
lost four shirt sizes and 22 waist
sizes—and gained self-respect
and confidence.
Walter B., before weight-loss
surgery at 543 pounds
“Successful weight loss and health maintenance are best achieved
with a comprehensive team approach,” says Dr. Ibrahim. “The
surgeons work with the bariatric patient advocate, pre-admission
testing experts, psychiatrists, social workers, dietitians, nurses, and
exercise physiologists. Each plays an integral part in the outcomes for
our patients. But what made Walter’s surgery a success was his desire
to be healthy and fit.”
Walter still exercises regularly at the Bariatric Health and Fitness
Program, located within the Cardiac Rehabilitation Fitness Center
at Englewood Hospital. And, in case you are still wondering who put
the mysterious envelope in Walter’s mailbox… it was his mother’s
best friend.
For information about our free weight-loss surgery seminars,
visit BestBariatricDocs.com. For a referral to a weight-loss
surgeon at Englewood Hospital’s Bariatric Center of Excellence ® ,
call 1-866-980-EHMC (3462).
Overcoming Obstacles
Following Walter B.’s weight-loss surgery, he began rehabilitation at
Englewood Hospital and Medical Center with exercise physiologist
Peter Toto.
“We began with exercise three days a week, but soon Walter was asking
to do more,” says Mr. Toto. “No one could hold Walter back—he truly is
a success story because of his attitude and will to change his life. He
lights up the Center when he is here. He knows everyone’s name and
shows mutual respect for everyone. Walter is ‘hungry to succeed.’”
2 ¦ Healthy You Spring 2011

Uterine Fibroids:
Know Your
Facts and Options
According to the Society of Interventional Radiology, up to 40 percent of women ages 35 and older may develop a
uterine fibroid of a significant size. While these noncancerous tumors are often asymptomatic, they can be the root
of an array of troublesome problems, from abdominal pressure and pelvic pain to heavy bleeding.
Often discovered during routine pelvic exams, uterine fibroids
can vary in size—ranging from pea-sized to the circumference of a
melon. Their cause remains largely unknown despite being studied
by scientists and clinicians.
“The origin of uterine fibroids is not understood, but medical
research has associated the condition with genetic predisposition
and high hormone levels, specifically estrogen,” says Phillip
Bahramipour, MD, Director of Interventional Radiology at
Englewood Hospital and Medical Center.
Expert Care When You Need It
While fibroids are a very common condition, the good news is
that only about 25 percent of women have fibroids that can cause
symptoms. But those who suffer can take comfort in the fact that a
variety of medical and surgical treatments abound.
Over-the-counter drugs, such as ibuprofen, may ease occasional or
mild pelvic pain. However, women who experience frequent or more
severe symptoms may require prescription medication and close
physician monitoring.
Hormone therapy may help shrink fibroids by preventing the
pituitary gland from overproducing estrogen. Birth control pills are
also often prescribed for women with uterine fibroids, to control
blood flow and relieve pelvic pain.
In cases of severe symptoms or advanced tumor size, surgery
may be necessary to treat uterine fibroids. Surgical options
include uterine fibroid embolization (see inset below) in addition
to the following:
• Myomectomy—This is the best surgery for patients who want
to have children. The doctor removes the fibroids without
removing healthy tissue in the uterus.
• Endometrial ablation—To manage heavy bleeding, the uterine
lining is destroyed or removed.
• Hysterectomy—This surgical procedure removes the uterus
and is generally performed when a woman experiences excessive
bleeding or has very large uterine fibroids.
Could You Have Uterine Fibroids
The most common symptoms of uterine fibroids include:
• A need for frequent urination
• Full feeling in the lower abdomen
• Heavy periods
• Increase in waist size
• Irregular bleeding between periods
• Pain during intercourse
Only a physician can diagnose uterine fibroids. For a referral to an
Englewood Hospital gynecologist, call 1-866-980-EHMC (3462) or visit
EnglewoodHospital.com.
Phillip Bahramipour, MD,
Director of Interventional Radiology
Minimally Invasive Fibroid Treatment
Uterine fibroid embolization is a surgical option that deprives the fibroids of
blood, causing them to shrink. Englewood Hospital and Medical Center offers
this advanced procedure. The minimally invasive surgery typically produces no
side effects and alleviates symptoms in 90 percent of patients.
“This procedure is designed to preserve the uterus,” says Phillip
Bahramipour, MD, Director of Interventional Radiology at Englewood Hospital.
“Over time, the fibroids shrink, and patients’ symptoms are relieved.”
To learn more about uterine fibroid embolization, call Englewood
Hospital’s Department of Interventional Radiology at (201) 894-3480.
Spring 2011 Healthy You ¦ 3

Treating Tough Cancers with an
Expert Team Approach
Cancers of the bile ducts,
liver, and pancreas
have been historically
difficult to treat because
of their location in the
human body and lack
of symptoms until the
disease is advanced.
Experienced physicians
at the new Pancreas,
Biliary, and Liver Center
at Englewood Hospital
and Medical Center
combine their expertise
to maximize treatment of
these rare cancers.
4 ¦ Healthy You Spring 2011
Cancers of the pancreas, liver, and bile
ducts—also known as hepatopancreaticobiliary
cancer—are in the top 10 leading causes of
cancer deaths in the United States. Because
symptoms are vague or nonexistent in the early
stages of the disease, these cancers are most
often found too late for curative surgery.
Herbert Dardik, MD,
Chief of Surgery and Vascular Surgery
Michael Schleider, MD,
Chief of Hematology and Oncology
“Nationally recognized surgeons have
joined Englewood Hospital’s large number
of experienced physicians to provide leadingedge,
compassionate care through the
Pancreas, Biliary, and Liver Center,” says
Herbert Dardik, MD, Chief of Surgery and
Vascular Surgery at Englewood Hospital.
Barry M. Zingler, MD,
Chief of Gastroenterology

“Our entire team works together to maximize the long-term
survival of our patients, from accurate diagnosis using the latest
technology available, through the acute phase, and into the
chronic phase of the disease.”
Diagnosing the Problem
Hepatopancreaticobiliary cancer can be found at earlier stages
when physicians are screening for other concerns. A diagnosis
of pancreatic cancer begins with a thorough medical history and
physical examination. A computed tomography scan can show
the presence, location, and extent of cancerous cells.
An endoscopic ultrasound (EUS) is a recent innovation in
diagnostics that allows the gastroenterologist to see the pancreas
up close and stage any cancer cells found.
“One advantage of EUS is that it is a more sensitive technology,
so it can find smaller tumors,” says Barry M. Zingler, MD, Chief
of Gastroenterology at Englewood Hospital. “When a pancreatic
lesion is found, we can take a biopsy of the tissue and nearby
lymph nodes in one procedure instead of calling the patient back
for a needle aspiration at a follow-up visit.”
A Surgical Focus
Surgery is the primary treatment for hepatopancreaticobiliary
cancers when found at early and advanced stages. Patients with
liver cancer who are healthy enough for surgery may have entire
lobes of the liver removed. Depending on a patient’s health,
surgery for stage 0, I, and II bile duct cancer offers the best
prospect for recovery.
While surgery to remove affected cells is often undertaken to
limit the spread of cancer, surgery can also relieve pain or improve
a patient’s quality of life. A block in the bile duct is a common
cause of most symptoms of hepatopancreaticobiliary cancers,
which include itching, jaundice, and pain.
A conventional surgical approach to remove bile duct blockages
is surgical bypass. For example, a tumor squeezing the bile duct
can be bypassed by connecting the intestine to the gallbladder
directly or to the bile duct above the tumor. At Englewood
Hospital, a gastroenterologist can use a minimally invasive
approach, pushing back the blockage with a balloon and stenting
the bioduct in much the same way an interventional cardiologist
clears blockages in the heart.
Removing Pancreatic Tumors
Three surgical procedures are used to remove tumors of the
pancreas—a fish-shaped gland with a head, body, and tail—
depending on the tumor’s location:
• Whipple procedure—the most common approach, removes
the head and possibly a portion of the body of the pancreas.
• Distal pancreatectomy—removes the tail and part of the
body of the pancreas as well as the spleen.
• Total pancreatectomy—removes the spleen and the entire
pancreas, which renders the patient insulin dependent.
Due to the complexity of the Whipple procedure, this
surgery carries a high risk for complications. However, when the
procedure is performed by an experienced surgeon, it reduces
the risk of complications from more than 15 percent to less than
5 percent, according to the American Cancer Society.
Combined Expertise
Oncologists are part of the team at the Center and most
often treat patients with chemotherapy after surgery to reduce
the likelihood of cancer returning. For patients whose cancers
are initially too advanced for surgery, the Pancreas, Biliary, and
Liver Center offers chemotherapy to shrink the tumor to an
operable size.
Current success with this approach at Englewood Hospital
is building the data needed to show its impact on long-term
survival. Patients at the Pancreas, Biliary, and Liver Center may
also benefit from genetic and molecular testing, which helps
oncologists predict the success of tumor therapy to maximize a
patient’s recovery.
“Our multidisciplinary approach brings together expertise
and experience to conditions that previously have been very
frustrating to treat,” says Michael Schleider, MD, Chief of
Hematology and Oncology at Englewood Hospital. “In our usual
style of prioritizing patient needs, members of the Pancreas,
Liver, and Biliary Center work in a collegial manner, consulting
on each case to determine optimal treatment plans, which sets
Englewood Hospital apart from other institutions.”
To learn more or make an appointment at the Pancreas, Biliary,
and Liver Center at Englewood Hospital, call (201) 894-3331.
Effective Blood
Management
Englewood Hospital and Medical Center offers blood management
during surgery to eliminate or reduce the need for blood
transfusions. Blood management has been shown to improve
immune function of cancer patients following surgery and reduce
their risk for cancer recurrence.
Patients who elect blood management are tested for anemia and
receive medication to improve the quality and volume of blood prior to
the procedure. Cell-saving technology and the expertise of surgeons
limit blood loss and the need for blood transfusions during surgery.
Spring 2011 Healthy You ¦ 5

Advanced
Technology
for Tiny Patients
In the hands of our expert pediatric surgical
team, robotic surgical techniques offer superior
results and faster healing for pediatric patients.
Children who present with a need for intricate urologic
procedures can rely on the highly skilled specialists at Englewood
Hospital and Medical Center who use the da Vinci ® Surgical
System for pediatric patients. A superior tool that assists surgeons
with complex surgeries, the
da Vinci is controlled by the
Enhancing
Our Expertise
The da Vinci ® Surgical
System enhances the way
surgeons perform intricate
operations while also
providing a wide variety of
patient benefits, including:
• Faster recovery
• Less scarring
• Lower risk of infection
• Minimal blood loss
• Significantly reduced pain
• Shorter hospital stay
operating physician.
“When you see a small child
and know that you can help
him and his family feel better
faster, it is a wonderful and
rewarding feeling,” says Richard
Schlussel, MD, pediatric
urologist at Englewood
Hospital. “Our team at
Englewood Hospital is top
notch. To be able to provide a
young child with less pain, less
blood loss, and a fast recovery is
phenomenal. We all know that
when a child is feeling better,
the parents also feel better, and
everyone can more easily and
more quickly return to their normal, everyday activities.”
Some of the pediatric urologic procedures amenable to
robotic surgery include pyleoplasty, nephrectomy and partial
nephrectomy, and bladder and ureteral surgery.
for precision. The da Vinci’s small tools and expert design allow
surgeons to operate with an unprecedented degree of accuracy.
“Englewood Hospital has the technological capabilities and
proficiently trained specialists to provide pediatric patients with
state-of-the-art treatment options,” says Gregg Lobel, MD, FAAP,
pediatric anesthesiologist at Englewood Hospital. “Our goal has
always been and will always be to offer great care to patients and
their families.”
Under Richard Lee, MD, Director of Robotic Surgery at
Englewood Hospital, the physicians, nurses, and technicians of the
robotic surgical team have performed minimally invasive urologic
procedures for pediatric patients throughout our region with optimal
results, helping children get back to their active lives more quickly
and with the least amount of pain possible.
For more information about robotic surgery at Englewood Hospital,
visit EnglewoodHospital.com. For a referral to an Englewood Hospital
physician, call 1-866-980-EHMC (3462).
Providing Better Outcomes
The delicate nature of performing complicated surgeries on
children—whose small bodies and organs can make it difficult for
adult hands to maneuver during a procedure—increases the need
Gregg Lobel, MD, FAAP,
pediatric anesthesiologist
Richard Schlussel, MD,
pediatric urologist
6 ¦ Healthy You Spring 2011

Say Goodbye
to Joint Pain
Joint replacement surgery can provide a lifechanging
solution to chronic, debilitating pain.
The expert team at Englewood Hospital and Medical
Center’s Joint Replacement Center offers a variety
of techniques to help those who suffer from knee or
hip pain regain their mobility and their quality of life.
At Englewood Hospital, board-certified orthopedic surgeons
specializing in joint replacement offer advanced surgical options,
including complex revision surgery, gender-specific knee
implants, partial knee replacement, hip resurfacing, and twoincision
hip replacement.
“We use minimally invasive, bloodless surgical techniques. This
means our patients typically experience less pain and blood loss and
return to normal life more quickly compared to traditional surgery,”
says Richard Salzer, MD, orthopedic surgeon
at Englewood Hospital. “We transfuse only
1 percent of our knee replacement patients
and 3 percent of our hip replacement
patients. This often results in a quicker
healing process, shorter hospital stay,
and a reduced risk of infection and blood
transfusion-related complications.”
One Size Does Not Fit All
The use of appropriately sized implants
and superior surgical tools is crucial to a
successful joint replacement experience.
“Our implant inventory is extensive,
enabling us to provide patients with the
best fitting implant the first time,” says Asit
Shah, MD, orthopedic surgeon at Englewood
Hospital. “This helps prevent repeat or
revision surgeries in the future, which can be
a great inconvenience for patients.”
Deluxe Patient Accommodations
Joint replacement patients at
Englewood Hospital recover in a
new, state-of-the-art acute care unit.
The well-appointed unit, which
features 22 private rooms, offers
an ideal setting for postoperative
care, including special amenities
suited for orthopedic patients.
The patients are cared for by our
Magnet -designated nursing staff
that includes certified orthopedic
nurses and a dedicated orthopedic
nurse practitioner.
Richard Salzer, MD,
orthopedic surgeon
Highest Quality
Standards and
Patient Satisfaction
The Joint Replacement Center at
Englewood Hospital and Medical
Center has been designated once
again a Center of Excellence by
The Joint Commission—a national
organization honoring quality
achievement. The Center earned
recertification by demonstrating
stringent standards and practices
in joint replacement treatments and
procedures that reflect Englewood
Hospital’s ongoing commitment to
providing the best care for patients.
Asit Shah, MD,
orthopedic surgeon
For the patient’s family and loved ones,
comfortable accommodations allow for
extended visits and overnight stays. Ample
parking and valet services facilitate easy access.
Patient satisfaction surveys have shown this
Joint Replacement Center to be the
best of its kind in Bergen County.
“The patient and family
experience on this unit is second to
none,” says Dr. Shah. “The caring
staff provides excellent clinical care
that involves the patient and his or
her family.”
The Joint Replacement Center at
Englewood Hospital holds FREE
monthly seminars. To learn more,
see the pull-out calendar or visit
BestBoneDocs.com.
Spring 2011 Healthy You ¦ 7

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Healthy You is a publication of the Marketing and Communications Department of Englewood Hospital.
Nurses: Our Everyday Heroes
In a role that requires extensive medical knowledge, a caring disposition,
and unshakeable fortitude, nurses are key members of our healthcare
team. Each year during National Nurses Week, Englewood Hospital and
Medical Center honors its own nursing team through a series of celebratory,
educational, and humanitarian activities.
Nurses Week is observed across the nation from May 6 to 12—a week that celebrates
the birthday of Florence Nightingale, the founder of modern nursing. At Englewood
Hospital, the week includes educational programs and an awards ceremony that recognizes
nurses from across the facility for their professional, educational, community, and cultural
contributions to nursing. A fundraiser to benefit the Haitian Nursing Society—a tradition
started by Englewood Hospital nurses to support fellow nurses as they continue to face
challenges following the earthquake—is also held.
“Nurses provide a majority of the direct care a patient receives while in the hospital,” says
Maddy Pearson, MA, RN, NEA-BC, Senior Vice President of Patient Care Services and
Chief Nursing Officer at Englewood Hospital. “Our patients not only expect our nurses to
be technically competent, but also to be caring and supportive. Our nurses carry out this role
exceptionally well.”
For more information about nursing at Englewood Hospital, visit EnglewoodHospital.com.
Congratulations!
In January 2011 Englewood Hospital and Medical Center
once again received the American Nurses Credentialing
Center’s (ANCC) Magnet designation—the highest
recognition of nursing excellence granted to only 6 percent
of hospitals nationwide. Englewood Hospital has held Magnet status for the
past eight years and is recognized as “A Leader Among Leaders” by the ANCC.
“With a family-centered approach to
care and a collaborative relationship
with physicians and other members
of the healthcare team, our nurses
provide excellent care to our patients
and their families.”
—Maddy Pearson, MA, RN, NEA-BC, Senior Vice President
of Patient Care Services and Chief Nursing Officer at
Englewood Hospital and Medical Center