A Publication of WINTER 2020 CLARA MAASS MEDICAL CENTER healthytogether
HOW TO AVOID WINTER FALLS SAFE CARE FOR COLDS DURING PREGNANCY 4 TIPS FOR TAKING PRESCRIPTIONS
CRITICAL CARE WHEN EVERY MOMENT COUNTS A MESSAGE FROM LEADERSHIP HEALTH NEWS SAVING LIVES IS OUR LIFE’S WORK t RWJBarnabas Health, we take the trust people place in us to heart. It’s the bedrock of our commitment to your care, from preventive services to TOP 5 PERCENT A life-saving emergency treatment. FOR SAFETY For urgent situations, we have two world-class trauma centers, one in Jersey City and one in New Brunswick, as well as the only burn center in the state, located in Clara Maass Medical Center has received the Livingston. In addition, we have expanded our emergency response capabilities and Healthgrades 2019 Patient Safety Excellence Award. This distinction places the medical center have acquired an advanced emergency helicopter, call sign Life Flight, equipped and among the top 5 percent of all short-term acute- staffed to provide critical care while transporting badly injured patients. care hospitals reporting patient safety data as At Clara Maass Medical Center, we’ve recently upgraded our Emergency Department evaluated by Healthgrades, the leading online with the comfort of our patients in mind. We have a new Pediatric Emergency resource for information about physicians and Department that offers observation rooms for our youngest patients as well as 10 new hospitals. During the study period (2015 to 2017), pediatric treatment rooms. We have more than 20 new rooms for adult patients who Healthgrades 2019 Patient Safety Excellence require observation or a brief stay. There are new pediatric and adult waiting areas and Award recipient hospitals demonstrated excellent a new discharge area, where patients awaiting transportation or further instructions can performance in safety provided for patients in the wait comfortably. These are important elements of the thoughtful care available at Clara Medicare population, as measured by objective Maass Medical Center—care that always has the patient at the forefront. outcomes (risk-adjusted patient safety indicator rates) To help people stay healthy and safe, we reach out with education and for 14 patient safety indicators defined by the Agency for Healthcare Research and Quality (AHRQ). prevention programs for people of all ages. We’ve also invested in creating the Healthgrades found that patients treated in new secure and convenient RWJBarnabas Health Connect app, available at your hospitals receiving the Patient Safety Excellence app store. Health Connect lets you access your records, store your insurance Award were, as compared to patients at non- information, search for doctors and make real-time appointments that are recipients hospitals, on average: automatically added to your phone calendar. • 55.9 percent less likely to experience an Health Connect, along with the RWJBarnabas Health TeleMed app, which accidental cut, puncture, perforation or offers online access for a physician visit, are integral parts of efforts to create a hemorrhage during medical care. truly tech-forward healthcare organization. These efforts led to all RWJBarnabas • 50.9 percent less likely to experience a collapsed Health hospitals earning the “Most Wired” designation from the College of lung due to a procedure or surgery in or around Healthcare Information Management Executives this year. the chest. Whether you face an emergency or have an everyday health question, we’re • 64.4 percent less likely to experience pressure committed to providing convenient access to the highest-quality care—whenever and sores or bed sores acquired in the hospital. wherever you need it. • 57 percent less likely to experience catheter-related Yours in good health, bloodstream infections acquired at the hospital.
BARRY H. OSTROWSKY MARY ELLEN CLYNE, PhD PRESIDENT AND CHIEF EXECUTIVE OFFICER PRESIDENT AND CHIEF EXECUTIVE OFFICER RWJBARNABAS HEALTH CLARA MAASS MEDICAL CENTER 1 Clara Maass Drive, Belleville, NJ 07109 973.450.2000 | www.rwjbh.org/claramaass
CONNECT WITH US ON @ClaraMaassMedicalCenter @Clara_Maass RWJBarnabas Health Clara Maass Medical Center clara_maass.medicalcenter
Clara Maass Medical Center complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. For more information, see link on our home page at www.rwjbh.org/claramaass. Clara Maass Medical Center cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: Si usted habla español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted. Llame al 973.450.2000. Clara Maass Medical Center konfòm ak lwa sou dwa sivil federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 973.450.2000.
Healthy Together | 2 | Winter 2020
CMMC_Memo_Winter20_REV1.indd 2 12/16/19 12:51 PM healthytogether contents WINTER 2020
2. WELCOME LETTER. 13. LEARNING TO CRAWL 20. ASK THE DOCTOR: WHAT A community update AGAIN. A baby SHOULD I KNOW ABOUT from our CEOs. rebounds from a COLON CANCER? Learn traumatic brain injury. how to prevent this 4. TAKING YOUR MEDICINE, common disease. THE RIGHT WAY. 14. A STRANGER’S GIFT. Prescriptions can A blood stem cell 21. ‘THE BEST THING I’VE be confusing, but a 9. HOW TO SAVE A LIFE. Is it donation—and a powerful EVER DONE.’ Weight pharmacist can help. a heart attack or cardiac medical partnership— arrest—and what can a loss surgery helps a save the life of a 5. A COLD WHILE PREGNANT? bystander do? Nutley woman conquer WHAT TO DO. How to ease Toms River woman. lifelong obesity. your symptoms while 10. TRAUMA WITHOUT DRAMA. keeping your baby safe. Top RWJBarnabas Health 16. YOU CAN BEAT THE 22. NOTHING BUT THE trauma and burn centers WINTER BLUES. Seasonal BEST. The pursuit of 6. 6 WAYS TO AVOID WINTER stand ready to save severely depression is a struggle, perfection in healthcare FALLS. Smart strategies injured patients. but help is available. delivery never stops. will keep you steady on your feet. 12. MAKING MATERNITY SAFER. 18. A SAFER WAY TO 23. WHAT’S NEW AT CLARA 8. CELEBRATING CLARA. We A strong focus on women’s PREVENT A STROKE. A MAASS MEDICAL paid tribute to 150 years health before, during and new, minimally invasive CENTER. New ways of care and compassion at after pregnancy aims to cardiac surgery carries we serve our diverse our anniversary gala. save lives. less risk. community.
PB | Healthy Together | Fall 2018 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 3
CMMC_TOC_Winter20_final.indd 3 12/11/19 4:25 PM Chris Cilderman, PharmD, on duty at the Barnabas Health Retail Pharmacy at Clara Maass Medical Center 4 TIPS FOR MANAGING YOUR MEDICINE 1. FOLLOW DIRECTIONS EXACTLY. “Carefully read the instructions on the prescription bottle,” says Chris Cilderman, PharmD, Outpatient Pharmacy Manager for Barnabas Health Retail Pharmacy at Clara Maass Medical Center. “Ask your pharmacist if you have any questions about the medication and what it’s used for.” 2. USE AN ORGANIZER. This could be a physical pill organizer with compartments for days of the week, or a cell TAKING YOUR MEDICINE, phone reminder. “We also offer a free calendar so you can mark off each dose as you take it,” THE RIGHT WAY Cilderman says. 3. IF YOU MISS A DOSE, talk to your pharmacist or doctor PRESCRIPTIONS CAN BE CONFUSING, BUT A PHARMACIST CAN HELP. before you consider doubling up. If you can’t remember fter patients are discharged question, rather than trying to figure it because you weren’t using any from the hospital, they are out on your own. of the memory aids, consult your responsible for following doctor or pharmacist. “It’s rare A that we’d say to go ahead and take directions for taking any medications What is medication management? they have been prescribed. But between That’s a big part of our job, which a second one,” Cilderman says. 25 and 50 percent of patients in the U.S. involves helping patients understand why 4. MAKE A LIST of the medications don’t take prescriptions as directed, they’re taking a medicine, and ensuring you are on, and keep it with according to recent research. that they’re taking it as directed. you. Give a copy to a loved Fortunately, patients don’t have to We also look at the bigger picture: one. It will be important to have that information try to understand prescriptions on their Are they on too many medications? Are available in the event of a medical own. Outpatient pharmacies can help there drug interactions that might affect emergency. with the job of medication management. outcomes? Are there side effects that Chris Cilderman, PharmD, Outpatient might cause them to stop taking it? Pharmacy Manager for the Barnabas Our main goal is to help patients take Health Retail Pharmacy at Clara Maass their medications as prescribed so they Sometimes patients don’t understand Medical Center, explains: get better and don’t have to come back to why they’ve been given so many the hospital. medications to take after discharge. Why is a hospital Or there may have been changes to pharmacy important? What are some common the medication they have been taking. We assist patients with their medications medication mistakes? Sometimes, patients get confused when as they transition from a hospital The biggest problem with the use of switching from one product to another. visit to home or another care setting. medications is not following directions— You can call our pharmacist and ask a for example, not taking a pill at the right Is the Barnabas Health Retail question. That’s the simplest way to get time of day, or with food, or for the Pharmacy also open to people high-quality help with any medication entire length of time needed. who aren’t patients of the hospital? Yes, we are a full-service retail pharmacy The arnabas Health etail harmacy is located on the ground loor serving patients who are being of Clara Maass Medical Center at 1 Clara Maass Drive in Belleville. discharged, employees and patients from For more information, call 973.450.2581. the entire community. We offer free delivery within five miles.
Healthy Together | 4 | Winter 2020
CMMC_Medication_Winter20_REV1.indd 4 12/16/19 3:21 PM A COLD WHILE PREGNANT? WHAT TO DO HOW TO EASE YOUR SYMPTOMS WHILE KEEPING YOUR BABY SAFE
ver-the-counter remedies for the (a suppressant), he says, though it’s best to necessarily cause for concern,” he says. “It’s symptoms of a common cold— consult your physician first. the body’s way of removing an infectious Osneezing, coughing, congestion, a Read labels carefully before you take agent. However, if a woman has a stubborn sore throat—are easy to fi nd. But if you’re an any cold medicine, particularly for multi- fever that will not come down with Tylenol expectant mother or a mom who is nursing, symptom products, advises Dr. Straker. and increased uids, as well as signifi cant how do you fi nd relief while being sure your “People often load up on different types physical discomfort, she should contact her medications don’t aff ect your baby of cold medicine because the brand names doctor and possibly be seen right away.” are different, but the ingredients are LESS IS MORE the same,” he says. “You may be taking TAKING CARE OF YOU “If you can limit medications, that’s always too much of a given ingredient without “An expectant or new mom already has a safer and better,” says Michael Straker, MD, knowing it.” Drug labels should also list compromised immune system because so Director of the Department of Obstetrics any appropriate warnings for pregnant much of her body’s energy is being used and Gynecology at Clara Maass Medical women. to support her baby,” Dr. Straker says. Center. For congestion, he su ests the use “To lessen the chances of catching cold, of a saline nasal spray or steam from a WHEN TO CALL THE DOCTOR pregnant and nursing women should neti pot, and plenty of uids. For a Th ere is no one-size-fi ts-all recommendation follow a balanced diet, remain active, sore throat, try gargling with salt water. for when to call a doctor—whether your avoid those who are sick and wash hands Chicken soup and plenty of rest can relieve OB GYN or primary care physician—about frequently with soap and warm water. symptoms as well. cold symptoms, Dr. Straker says. However, “In addition, the flu shot is not only For aches, acetaminophen (for troubling signs include fever and chills, safe for pregnant and nursing moms, example, Tylenol, rather than products shortness of breath or an increased heart it’s recommended,” he says. “It helps to containing aspirin, rate, and symptoms that linger more than protect mom, and mom passes those ibuprofen or 10 days or become more persistent. In those antibodies to baby. naproxen) is situations, a pregnant woman should seek “Any time you’re concerned, talk to safe throughout the care of a doctor. your doctor,” says Dr. Straker. “He or she pregnancy, says “A temperature of 100. or above will walk you through whatever you’re Dr. Straker. The is considered a fever, but a fever isn’t experiencing.” same is true for cough medicines with guaifenesin To nd a rimary care doctor or at Clara Maass Medical (an expectorant) or Center, call 888.724.7123 or visit r bh org claramaass MICHAEL STRAKER, MD dextromethorphan
Healthy Together | PB | Winter 2020 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 5
CMMC_ColdPregnant_Winter20_final.indd 5 12/12/19 9:21 AM 6 WAYS TO AVOID WINTER FALLS THESE EVERYDAY SITUATIONS CAN TRIP YOU UP, BUT SMART STRATEGIES WILL KEEP YOU STEADY.
inter is a high-risk time HAZARD #1: for injuries from slips H . W and falls—but the PREVENTION: When good news is that most falls are it’s cold outside, people preventable. Here, experts from take shortcuts or try Clara Maass Medical Center— to walk more quickly board-certifi ed orthopedic surgeon so that they can get HAZARD #2: Frank Femino, MD, Director of inside where it’s warmer. C D M C A D Orthopedics and John Fontanetta, MD, “Many falls happen because of AC M . Chairman of Emergency Medicine, board- hurrying,” says Dr. Femino. “You don’t PREVENTION: “When your muscles are certifi ed in emergency medicine, internal have time to shovel the steps, so you cold they tend to become more rigid,” medicine and pulmonary medicine— give figure you’ll just hold on to the rail. You’re explains Dr. Femino. “If you go out their best advice on avoiding common rushing to make an appointment, so you without proper outdoor clothing, and falling hazards. don’t pay attention to the things that your legs are cold, they can’t react quickly surround you.” if you slip or lose your balance.” “Give yourself plenty of time to get Don’t run outside—even just to pick where you’re going,” says Dr. Fontanetta. up the newspaper—without proper winter “Walk slowly and carefully, taking slower, clothes, including hat, gloves and coat. smaller steps and keeping your weight At the same time, too much bundling up over your feet. And keep your hands can actually hinder mobility and affect out of your pockets so they’re available balance. Choose clothing that’s both warm to block the fall if necessary. If you’re and light, such as lightweight down coats going to fall, using your arms and hands and vests. Make sure you’re comfortably to lessen the impact will help you avoid warm inside, so your muscles are warmed FRANK FEMINO, MD JOHN FONTANETTA, MD head trauma.” up even before you go out.
Healthy Together | 6 | Winter 2020 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 7
CMMC_WinterFall_Winter2020_final.indd 6 12/12/19 9:27 AM AVOIDING FALLS AS YOU AGE Falls are more likely as people age, due to a combination of factors including a declining sense of balance, reduced muscle strength and vision and hearing issues. To stay safe, Dr. Fontanetta advises: • Practice balance and strength exercises all year. If you do lose your balance, having good muscle strength lets you recover by regaining your footing or grabbing on to a railing to support yourself. (If balance is an ongoing problem, contact the Comprehensive Balance Center at Clara Maass Medical Center.) HAZARD #3: HAZARD #5: • Have your eyes checked. Keep F MAD H M your vision sharp. Go to the eye PP C A A doctor to make sure contacts or eyeglasses prescriptions are H . A D D A . current. PREVENTION: At PREVENTION: You home, get in the habit have to go out onto the • Be mindful about medications. of taking off your shoes or walkway or driveway to get it Everyone reacts differently to medications, so any kind can boots—and asking guests to do the cleared—but before it’s cleared, a potentially impair your balance or same—right inside the entrance. Then, snow-covered driveway is a fall waiting to make you unsteady. Be especially change into indoor shoes or slippers with happen. “Keep a bucket of sand near your cautious when starting a new good treads. “They should be slippers that front or back door and throw a handful medication. hold onto your feet well—not something of sand on your steps before you go out,” you just slip into,” says Dr. Fontanetta. advises Dr. Femino. “You can do the same Slippery floors are particularly thing with salt—even table salt—but if hazardous in offices or stores, where the you’re worried about the effect on the parking lot and step out not knowing wet shoes of many people create slick environment or neighborhood pets, there what the surface is like.” Park in a well- conditions. Be cautious in public places, are pet-friendly ice melts available. You lit area close to your destination, and and make sure your own shoes or boots can also use clean kitty litter for traction.” take extra care when stepping out of your have good traction and ankle support. In most apartment complexes or senior vehicle. buildings, the pathways are shoveled and “Getting out of the car is an awkward HAZARD #4: salted for the residents, Dr. Femino notes. movement—you have to twist and stand C A P “But if you live in your own home, it’s at the same time, which can be especially D A M. better to pay a snow removal service or a difficult for someone with arthritis in PREVENTION: Many neighborhood kid to clear your driveway their knees or hips,” says Dr. Fontanetta. people think it’s and walkways rather than risk “To get out of the car, take your time to important to keep hurting yourself.” swing both legs out and plant them firmly appointments or on the ground before moving. Feel around get their shopping HAZARD #6: and steady yourself on the door frame done even though PA . before you start walking.” conditions are hazardous. PREVENTION: “This is It’s also smart to keep a flashlight, and Stay inside unless your task a huge hazard,” says Dr. even a small container of sand or salt, in is truly an emergency, says Dr. Femino. “You drive into a your car so you can deal with icy patches. Femino. “I tell my patients to cancel their appointment if it’s icy or snowy out. I want them to be safe,” he To learn more about orthopedic services at Clara Maass Medical Center, says. “There are very few things that can’t call 888.724.7123 or visit www.rwjbh.org/ortho. wait until after a snowstorm.”
Healthy Together | 6 | Winter 2020 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 7
CMMC_WinterFall_Winter2020_final.indd 7 12/12/19 9:27 AM THREE CHEERS FOR CLARA! CELEBRATING 150 YEARS OF CARING FOR OUR COMMUNITY
Clara Maass Medical Center has been providing welcoming care for all types of people, in all kinds of circumstances, since its founding in 1869 as the Newark German Hospital. On November 13, we celebrated the occasion in style at A Very Tasteful Experience at Nanina’s in the Park in Belleville.
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1. Robert Gaccione, Esq., Chairman, 3 5 Clara Maass Medical Center Board of Trustees, with Brent Rudnick, member of Clara Maass Medical Center Board of Trustees 2. Barry H. Ostrowsky, President and Chief Executive Officer, RWJBarnabas Health, with Fran Adubato and Mary Ellen Clyne, PhD, President and Chief Executive Officer, Clara Maass Medical Center 3. Thomas A. Biga, President, Hospital Division, RWJBarnabas Health; Robert V. Gamba, Chairman, Clara Maass Medical Center Foundation Board of Trustees; and Brian Sterling, member, Clara Maass Medical Center Board 4 6 of Trustees and Clara Maass Medical Center Foundation Board of Trustees 4. From The North Ward Center: Galen Johnson, Director of Youth Leadership Development, and Kayla Williams, Director of Community Outreach 5. Robert Brautigan, MD, Medical Staff President, with his wife, Lourdes Brautigan; Good Day New York sportscaster Tina Cervasio and her husband, Kevin McKearney 6. Lourdes and Robert Brautigan, MD; Michael Gentile, MD; and John V. Kelly, Jr., MD, with his wife, Cynthia Kelly
Healthy Together | 8 | Winter 2020
CMMC_Foundation_Winter20_final.indd 8 12/12/19 9:31 AM HOW TO SAVE A LIFE
IS IT A HEART ATTACK OR CARDIAC ARREST—AND WHAT SHOULD A BYSTANDER DO?
eart attack” and “cardiac arrest” may sound like similar HEART ATTACK CARDIAC ARREST (CA) “Hconditions, but they’re not the same—and one is potentially much more life-threatening. “With a heart attack, WHAT IT IS WHAT IT IS an artery is clo ed, and the majority A circulation problem. Blood ow Usually, an electrical problem that of patients have 100 percent closure of stops because of a blockage in an causes the heart to stop pumping. an artery,” explains Jay H. Stone, MD, artery. Th e part of the heart muscle CA can be tri ered by a heart attack Director of the Cardiac Catheterization and that is deprived of oxygen-rich but can have other causes, such as an Interventional Lab at Community Medical blood begins to die. undiagnosed heart abnormality or Center in Toms River and a member of the SYMPTOMS cocaine or amphetamine use. RWJBarnabas Health medical group. “In a Th ese may begin hours, days or SYMPTOMS cardiac arrest, the heart stops completely weeks in advance. • Possibly racing heart or dizziness, and no blood at all is circulating.” Death can • Chest pain or feeling of pressure but CA may occur without warning. be instantaneous. in the chest, possibly spreading to A person suff ering CA will become Th e two things that determine survival, arms, neck, jaw, back or stomach. unconscious and will not breathe Dr. Stone explains, are the underlying Feeling sick, sweaty or short of normally, or breathe at all. pathology and the ow of blood to the brain. breath. WHAT TO DO “If someone passes out in front of you, take Th e person having a heart attack • Immediately call 911, or have action immediately,” will usually remain conscious. he urges. “Th e patient someone else make the call while WHAT TO DO can’t aff ord to lose you perform the steps below. the time that it may If you are having these symptoms, • If an AED (automated external take for professional don’t hesitate to contact your defi brillator) is available, begin use, medical help to doctor or call 911. If someone you following the prompts. arrive.” uick action are with appears to be having a • Do CPR (cardiopulmonary can double or even heart attack, call 911 immediately. resuscitation). If you don’t know triple a cardiac arrest Sit the person down and keep them conventional CPR, do hands-only victim’s chance for calm while you wait for help. CPR (see below). JAY H. STONE, MD survival.
HANDS-ONLY CPR GET IT Hands-only CPR can be done successfully even by someone CHECKED who’s not a professional. The idea is to push hard and fast in the center of the victim’s chest to the beat of a familiar song that has Your heart doesn’t beat just for 100 to 120 beats per minute. Think of the song “Stayin’ Alive” you. Get it checked. To make by the Bee Gees to help keep compressions in a regular rhythm. an appointment with one of New If disco doesn’t do it for you, push along to one of these: Jersey’s top cardiac specialists, • “Crazy in Love” by Beyoncé call 888.724.7123 or visit • “Hips Don’t Lie” by Shakira www.rwjbh.org/heart. • “I Walk the Line” by Johnny Cash
Healthy Together | PB | Winter 2020 RWJBarnabas Health | RWJBH.ORG | 9
System_Cardiac_Winter20_final.indd 9 12/11/19 2:40 PM TRAUMA WITHOUT DRAMA TOP RWJBARNABAS HEALTH TRAUMA AND BURN CENTERS STAND AT THE READY TO DO WHAT’S NEEDED FOR THE MOST SEVERELY INJURED PATIENTS.
aramedics are running through care surgeon Rajan Gupta, MD, Director center’s job is to bring all these aspects the Emergency Department (ED) of the Level I Trauma Center and Pediatric together to help prioritize decisions and get Pentrance. Blood is all over. Doctors Trauma Center at Robert Wood Johnson the best possible long-term outcome for the are shouting, “Get me a clamp—stat!” University Hospital (RWJUH) in New patient.” And cut! End scene. Th at chaotic Brunswick. “Th e more we mitigate chaos, Together, experts at the Trauma Center scenario, a staple of medical shows, happens the safer the environment, and the better at RWJUH, the Level II Trauma Center at on TV show sets but not in real life, trauma the patient will do.” Jersey City Medical Center (JCMC) and experts say. Another common misconception, says Th e Burn Center at Saint Barnabas Medical “In a true trauma situation, we have Dr. Gupta, is that trauma treatment ends Center (SBMC) in Livingston—each an quiet, controlled conditions,” says critical aft er the critical fi rst 30 to 0 minutes of RWJBarnabas Health facility—provide a care. “In fact, our critical safety net for thousands of New system spans the Jersey residents. entire gamut of care—emergency TRAUMA OR ED? services, acute Hospital EDs take care of emergencies, of care centers, rehab course, like heart attacks and breathing facilities, radiology, problems. EDs also deal with a broad range blood banks, clinical of noncritical conditions, such as the u or labs, data registry broken bones. and more,” explains A trauma center, however, has a larger RAJAN GUPTA, MD MICHAEL MARANO, MD BRUNO MOLINO, MD Dr. Gupta. “A trauma scope than an ED. First responders or ED
Healthy Together | 10 | Winter 2020 RWJBarnabas Health | RWJBH.ORG | 11
System_Trauma_Winter20_final.indd 10 12/11/19 2:50 PM From left, fl ight paramedic Michael Brown, FP–C; fl ight nurse Robert Maiullo, CFRN; and situations: falls by elderly people, blunt- THE NEED lead pilot Joe Gilbert with the RWJBarnabas force assault or penetrating wounds (such FOR SPEED Health Airbus 135 helicopter. as gunshots), and motor-vehicle crashes, “In trauma care, timing is says Dr. Gupta. “Our cars are getting much everything,” says Jim Smith, Vice safer, so traumatic injuries from crashes are President, Mobile Health Services and decreasing,” he explains. “Meanwhile, for Patient Transport at RWJBarnabas Health the elderly, even a minor fall can result in (RWJBH). “The gold standard is to have devastating injuries. As the population ages, no more than 60 minutes from the time a this has become an ever-growing issue for patient has a traumatic emergency to the health systems.” time he or she is in the OR.” Trauma centers also routinely drill to Depending on location and time of day, a be prepared for mass casualties in a disaster trip that takes 45 minutes by road could be situation. Th is training includes close done by helicopter in 20 minutes. That’s coordination with other trauma centers in why RWJBH has partnered with Med-Trans aviation to provide a state-of-the-art Airbus case backup is needed. Th ere are 10 state- 135 helicopter and two dispatch centers for certifi ed trauma centers in New Jersey. live satellite tracking. Known as LifeFlight, the service includes on-scene and in-air HELP FOR SEVERE BURNS emergency treatment and transportation Trauma centers across the state coordinate to the closest appropriate state-certifi ed closely with Th e Burn Center at SBMC, trauma center. The crew includes RWJBH New Jersey’s only state-certifi ed burn- Emergency Medical Services fl ight nurses treatment facility. In addition to burns and paramedics who have had extensive from home accidents, industrial incidents training in emergency, air medical and and motor-vehicle crashes, one of the most trauma protocols. common injuries the center sees—up to 30 In addition to providing time-critical percent of cases—is scalding in children transportation from emergency events, under age 2 who have been splashed the LifeFlight system transports patients accidentally by a hot liquid. as needed among RWJBH’s 11 hospitals Specialists including burn technicians, (and other health systems as appropriate). “The service assists with continuity of care nurses and respiratory therapists, as well as within the same network,” Smith says. the most advanced technology, are available “And although it can seem dramatic and at the center at all times. “If someone scary for patients to hear they are being comes in with a surface burn, for example, transported by helicopter, sometimes the we’re able to immediately treat them with issue is not so much medical acuity as it is hydrotherapy—water piped through special timing and traffi c.” spigots that removes dead skin and bacteria In either case, he says, “It’s important for to minimize the chance of infection,” New Jersey residents to know that, barring physicians make the decision as to whether a explains Michael Marano, MD, Medical any weather issues, air medical services in patient needs the services of a trauma center. Director of Th e Burn Center. the state are robust and coordinate closely “A trauma center is designed to Th e center has 12 intensive care beds with ground providers. Very few states have immediately treat critically injured patients for the most critically injured patients and the availability of resources and capabilities who have life- or limb-threatening injuries,” an 1 -bed recovery unit. It also runs Th e that we do.” explains acute care surgeon Bruno Molino, Outpatient Center for Wound and Burn MD, Trauma Director at JCMC and a Healing, which works with more than 4, 00 member of RWJBarnabas Health medical patients each year. bicycle safety, sports safety, yard-work group. “When seconds count to make the safety and distracted driving education. “I diff erence between life and death, a whole AN OUNCE OF PREVENTION tell my Injury Prevention Coordinator that team is waiting around a stretcher even In the hope of minimizing the need for it’s her job to put me out of business,” says before the patient arrives. their services, the trauma and burn centers Dr. Gupta. “To be certifi ed as a trauma center, put considerable resources into community Inevitably, accidents will happen. a facility must have extensive resources education, covering the age spectrum When they do, New Jersey residents are in available to care for severely injured patients from infants and car seats to geriatric fall the fortunate position of having a nearby at all times,” says Dr. Molino. “Neurosurgery, prevention, as well as pedestrian safety, trauma center ready and able to serve. maxillofacial surgery, orthopedic surgery, cardiac surgery—all these specialties and more have to be there at our disposal.” To learn more about safety education and training at Th e most common types of injuries arnabas Health hos itals, visit r bh org c r seen in trauma centers come from three
Healthy Together | 10 | Winter 2020 RWJBarnabas Health | RWJBH.ORG | 11
System_Trauma_Winter20_final.indd 11 12/11/19 2:50 PM ALERT IN THE ED MAKING RWJBH Emergency Departments (EDs) have created a system to ensure that any woman coming to an ED who has given birth within the previous 42 days is identifi ed, and a MATERNITY note made in her electronic health record. “Care management for certain conditions for RWJBarnabas Health (RWJBH). can be quite diff erent for a woman who “We’re collectively looking at the entire has recently given birth compared to a SAFER continuum of healthcare to see what woman in the general population,” Spernal women want and need to be healthy says. “Th is alert system quickly identifi es A FOCUS ON WOMEN’S HEALTH before, during and aft er pregnancy.” postpartum women and when minutes BEFORE, DURING AND AFTER matter it can save lives.” PREGNANCY AIMS TO SAVE LIVES. EMPOWERING WOMEN Other aspects of RWJBH’s Providing education is a priority. “Th e comprehensive approach to maternal majority of maternal adverse events don’t health include: don’t feel well,” said Tara Hansen, happen on the day a woman gives birth,” Promoting equality in healthcare 29, of Wanamassa, shortly aft er Spernal says. “Th ey occur in the days and to improve pregnancy outcomes. “Our “I giving birth to her son in 2011. But weeks that follow the birth, when mom is hospitals are exploring the specifi c needs her healthcare providers considered her back at home and the warning signs of a and challenges of women in their unique a healthy postpartum patient, and sent serious complication may not be immediately communities,” Spernal says. her home. Six days later, she died from an recognized.” Providing reproductive planning so infection that occurred during the birth. To increase awareness, Tara’s husband, women, particularly those with medical Pregnancy-related deaths are Ryan, partnered with Rutgers Robert conditions, can plan safer pregnancies. relatively rare—about 700 occur each Wood Johnson Medical School and Robert Co-designing initiatives with year in the U.S.—but are on the rise. So Wood Johnson University Hospital, an community groups that address issues such is the rate of delivery-related “severe RWJBH facility, to create the Tara Hansen as housing, domestic violence, obesity, maternal morbidity,” which is defined as Foundation’s “Stop. Look. Listen!” program. diabetes and substance abuse, all of which significant short- or long-term effects to Th is initiative empowers women to voice can negatively aff ect pregnancy outcomes. a woman’s health. any concerns they have and reminds Focusing on maternal mental health. “In New Jersey, healthcare systems, providers to pay close attention, rather than Monmouth Medical Center, an RWJBH community-based organizations and assuming a symptom is a typical complaint facility, has the state’s only perinatal mood government agencies are tackling this of pregnancy or the postpartum period. Th e and anxiety disorder program. issue head-on,” says Suzanne Spernal, program has been embraced by facilities Participating in Maternal Health Vice President of Women’s Services throughout RWJBH. Awareness Day, this year on January 23. “This is new attention to maternity care that is so long overdue,” Spernal says. “Healthcare providers, policy advocates, women’s advocates—together, we’re really going to change the landscape over the next few years.”
To nd orld class maternity care near you, call 888.724.7123 or visit r bh org maternity
Healthy Together | 12 | Winter 2020
System_Maternal_Winter20_final.indd 12 12/11/19 2:51 PM From left to right, LJ Lopes in the playroom at Children’s Specialized Hospital; snuggling with his cousin Auggie; getting a boost from visiting Rutgers LEARNING TO University football players. SKILLS REGAINED LJ returned to CSH on February 11 to CRAWL AGAIN continue his rehabilitation journey. He quickly bonded with his inpatient team, A BABY REBOUNDS FROM A particularly enjoying aquatic therapy. “Once TRAUMATIC BRAIN INJURY they got LJ into the pool, there was no stopping him,” says Olivia. “He loved it, and WITH THE HELP OF CHILDREN’S the resistance of the water forced him to SPECIALIZED HOSPITAL. start using his right arm more.” LJ spent another two months at n the afternoon of January , 2019, An RWJBarnabas Health facility Children’s Specialized working with Olivia Lopes got a frightening physical, occupational, speech-language O phone call: Her mother, nephew and recreational therapists. “The progress and 7-month-old son had been in an accident. (CSH) in New Brunswick. There, a team he made at Children’s Specialized was While the three were walking home from her of specialists developed a customized amazing,” says Olivia. “After the accident, nephew’s school, a vehicle had jumped the rehabilitation program to address he lost all of his muscle memory. The team curb and struck them from behind. his medical, physical, cognitive and worked with him day in and day out, Olivia’s mother and nephew suffered psychosocial needs. helping him to learn how to roll, crawl, multiple fractures. Infant LJ, who had Within a week, however, his family stand and walk.” LJ went home on April . been in his car seat in a wagon being and team realized something wasn’t He is now attending outpatient therapy pulled by his grandmother, suffered the right with LJ. He was transferred to the sessions three days a week at the CSH most extensive injuries as the car seat Emergency Department at Robert Wood location in Hamilton, working hard to became dislodged and soared 70 feet Johnson University Hospital in New build strength in his right arm and learn away. “When we finally got in to see LJ, Brunswick, where a CAT scan led to a how to suck and swallow properly. he was on life support,” Olivia recalls. diagnosis of hydrocephalus. With this “We still keep in touch with the “He had multiple skull fractures, orbital condition, excess cerebrospinal fluid remarkable therapists and care team at fractures, severe brain trauma and a builds up in the ventricles (cavities) of Children’s Specialized, updating them on broken leg, and was having difficulty the brain and increases pressure within LJ’s progress,” Olivia says. “We’re forever moving his right arm.” the head, causing head enlargement, grateful for the care that Children’s LJ spent 21 days in a Pediatric headaches, impaired vision, cognitive Specialized provided to our son.” Intensive Care Unit before being difficulties and loss of coordination. To learn more about Children’s transferred to the Brain Injury Program A shunt was surgically inserted into a Specialized Hospital, call 888.244.5373 or at Children’s Specialized Hospital ventricle to drain the excess fluid. visit www.childrens-specialized.org.
At Children’s Specialized Hospital, we provide world-class care for children and young adults who face special health challenges across the state of New Jersey and beyond. Our locations in Bayonne, Clifton, East Brunswick, Egg Harbor Township, Hamilton, Jersey City, Mountainside, New Brunswick, Newark, Toms River and Warren treat everything from chronic illnesses and complex physical disabilities like brain and spinal cord injuries, to developmental and behavioral issues like autism and mental health.
Healthy Together | PB | Winter 2020 RWJBarnabas Health | RWJBH.ORG | 13
System_CSH_Winter2020_final.indd 13 12/11/19 2:52 PM A STRANGER’S A BLOOD STEM CELL DONATION— AND A POWERFUL MEDICAL PARTNERSHIP—SAVE THE LIFE OF GIFT A TOMS RIVER WOMAN. t’s a gorgeous day on the boardwalk “To have a donor and patient together made an appointment with an infectious in Bradley Beach and to look at like this is truly remarkable,” says Vimal disease specialist, and his phlebotomist I the two smiling women, you would Patel, MD, a hematologist/oncologist took blood samples,” she recalls. never guess that they had met in person in the Blood and Marrow Transplant Within 24 hours, the doctor called for the very first time just three days Program at Rutgers Cancer Institute of back to explain that he had sent the before. They exhibit a strong physical New Jersey and Robert Wood Johnson blood test results to a hematologist who and emotional connection—a bond worth University Hospital (RWJUH) New wanted her in his office that day. “I think life itself. Brunswick. “This is the reason I went you have leukemia,” the hematologist “I feel as if I’m with my daughter or into my field: to see moments like this.” told her. “And I think you need to go to my niece,” Lael McGrath, 68, admits. Rutgers Cancer Institute of New Jersey She owes her life to Wiebke Rudolph, a AN UNEXPECTED DIAGNOSIS in New Brunswick. Today.” 21-year-old recent college graduate from In August 2016, Lael was not well. She Lael’s immune system was so Kassel, Germany. Wiebke donated her had been a runner for more than 40 suppressed that she was in a life- stem cells anonymously to Lael after years, but that summer she couldn’t threatening situation. Within three days the retired second-grade teacher from run more than a block without having she would be admitted to RWJUH, where Toms River was diagnosed with life- to stop to walk. She had fevers, night she would spend the next seven weeks threatening acute myeloid leukemia in sweats and a rash on her back. “A friend undergoing chemotherapy. Dr. Patel has 2016. Both had looked forward to this was diagnosed with Lyme disease and been by her side since then, along with meeting for more than two years. her symptoms sounded like mine, so I a vast team of specialists from both
Healthy Together | 14 | Winter 2020 RWJBarnabas Health | RWJBH.ORG | 15
System_BMTPatient_Winter20_final.indd 14 12/11/19 2:53 PM Opposite page, top, Lael and Wiebke with Vimal Patel, MD; this page, with members of the Blood and Marrow Transplant Program at Rutgers Cancer Institute and Robert Wood Johnson University Hospital.
NOT ALL DONORS AND PATIENTS MEET. BUT THERE WAS NEVER ANY DOUBT FOR EITHER OF THESE TWO WOMEN. IN FACT, THE PAIR STARTED EMAILING, RWJUH and Rutgers Cancer Institute. Four thousand In the hospital, Lael’s treatment miles away in TEXTING AND involved the use of combination Germany, Wiebke THEN TALKING chemotherapy designed to get her was notified that she into remission. “However, the specific matched a patient in dire TO EACH OTHER ON mutations that we identified in her need. “Not that many people FACETIME RIGHT AFTER leukemia were high-risk in nature, so we in Germany do this and certainly no knew that chemotherapy alone would one in my family or among my friends,” BEING GIVEN EACH OTHER’S not keep her in remission,” says Dr. Patel. she says. “But when I first heard about CONTACT INFORMATION. “We needed immune therapy in the form this, I said yes, I’m going to do it. I was of an allogeneic stem cell transplant.” determined.” Wiebke underwent peripheral blood SEARCHING FOR A DONOR stem cell donation, a procedure called was female and 19 years old.” In a bone marrow transplant, cells can be apheresis, in which blood is removed Lael did so well post-transplant that used from your own body, known as an through a needle in one arm and passed she was able to go home on New Year’s autologous transplant. When cells are taken through a machine that collects only Day 2017. Over in Germany, Wiebke was from a donor, the transplant is called blood-forming cells. (The remaining blood told that the transplant had gone well. allogeneic. “In this procedure, the patient’s is returned to the donor through a needle Protocol and confidentiality policies diseased marrow is replaced with a donor’s in the other arm.) The procedure took don’t permit donors and patients to have blood stem cells,” says Dr. Patel. “It allows six hours. All the logistics of harvesting direct contact with each other until at for normal blood formation and provides Wiebke’s stem cells and then transporting least one year has passed. In this case, the a new immune system to help eliminate them to the U.S. were handled by wait lasted more than two years, until the leukemia. It also has the potential for NMDP. Meanwhile, Lael’s repeat blood test results showed that Lael’s blood cells a cure.” transfusions were made possible by the were 100 percent “donor.” At RWJUH, bone marrow transplant RWJUH Blood Services team. Not all donors and patients meet. coordinator Mary Kate McGrath, MSN, Lael spent weeks in the hospital But there was never any doubt for RN, APN, BMTCN, OCN (no relation during the fall and winter of 2016, waiting either of these two women. In fact, the to Lael), ran the results of Lael’s DNA for the transplant and being closely pair started emailing, texting and then testing through the National monitored by her healthcare team. talking to each other on FaceTime right Marrow Donor Program Finally, in December 2016, after being given each other’s contact (NMDP) registry. she was notified that her information. “Within two months RWJBarnabas Health and transplant was imminent. Recently, at a celebration hosted by of Lael’s diagnosis, Robert Wood Johnson University “On December 16th, it RWJUH, both women held bouquets of we identified three Hospital, in partnership with Rutgers happened,” she recalls. owers and stood happily alongside one Cancer Institute of New Jersey— potential matches “A team walked in another. “If it weren’t for Wiebke, I don’t the state’s only NCI-Designated on the registry— Comprehensive Cancer Center— carrying a small know what would have happened,” Lael says. but Wiebke turned provide close-to-home access to the cooler and within an With the breeze blowing off the out to be the most advanced treatment options. Call hour, the transfusion Atlantic Ocean, these two women look perfect match,” she 844.CANCERNJ or visit was over. All I actually knowingly at one another, smile and explains. www.rwjbh.org/beatcancer. knew was that the donor agree, “It was a miracle.”
Healthy Together | 14 | Winter 2020 RWJBarnabas Health | RWJBH.ORG | 15
System_BMTPatient_Winter20_final.indd 15 12/11/19 2:53 PM sunlight tends to boost serotonin. A lack of light causes the brain to release less serotonin, which can lead to depression. “We’re not sure what makes some people vulnerable to SAD while others aren’t greatly affected by less exposure to sunlight,” says Dr. Kaplan. “The theory is that people with SAD may have some form of imbalance in the regulation of these two hormones. Genetic factors may play a role in this.”
WHAT TO DO “If you think you may have SAD, consult with a professional to determine whether your condition relates to that or to something else,” advises Dr. Kaplan. “Depression can be due to many different things, so it’s better not to self- diagnose and possibly waste time on the wrong treatments.” YOU CAN BEAT THE Having a healthy diet and regular exercise have been shown to improve symptoms of depression. Other possible treatments for SAD include: WINTER BLUES Light therapy. The patient sits or works near a device called a light therapy box, SEASONAL DEPRESSION IS A STRUGGLE, BUT HELP IS AVAILABLE. which gives off a bright light that mimics natural outdoor light. “For some people, n winter, the short hours of daylight as feelings of hopelessness, anxiety and this treatment is very effective, but it’s best can lead to dark moods. It’s a problems with appetite. “A couple of to consult your physician about the type of Icommon syndrome—thought to affect symptoms seem to be more common with device to use,” says Dr. Kaplan. up to 10 million people in the U.S—known SAD, however,” says Dr. Kaplan. “People Cognitive behavioral therapy. This as Seasonal Affective Disorder, or SAD. with SAD often crave sweets more, and kind of psychotherapy, or “talk therapy,” “SAD is a kind of depression that happens are more tired and sleep more.” focuses on changing inaccurate or negative at a specific time of year, usually in the As with regular depression, there is thinking in order to create new behaviors. winter,” explains help for those who suffer from SAD. Antidepressant medication. “Generally psychiatrist Gabriel speaking, antidepressants don’t start Kaplan, MD, Chief WHY WINTER? working for four to six weeks,” says Dr. Medical Officer of While the exact cause of SAD is unknown, Kaplan. “If your depression is seasonal, the RWJBarnabas two hormones are implicated: melatonin, you may choose to take them for several Health Behavioral the hormone that regulates sleep, and months and then go off them when Health Network. serotonin, a key hormone for mood winter is over, or continue to take them Symptoms of stabilization. “Melatonin tends to be for the rest of the year to prevent the SAD are similar produced when there’s no sunlight,” reappearance of depression. It’s the to those of clinical explains Dr. Kaplan. “More melatonin combined job of the doctor and patient to GABRIEL KAPLAN, MD depression, such means people feel sleepier.” Conversely, decide the best course.”
To learn about o tions or getting hel or de ression, call the arnabas Health ehavioral Health et or ccess line at 800.300.0628.
Healthy Together | 16 | Winter 2020
System_SAD_Winter20_final.indd 16 12/11/19 2:54 PM Your heart doesn’t beat just for you.
Get it checked. It beats for your husband or wife, your children and grandchildren. It beats for your brothers and sisters, your friends and lovers. It beats for everyone who cares deeply about you. So please, get your heart checked. For them. For you. For more information and to make an appointment with one of New Jersey’s top cardiologists, visit rwjbh.org/heart
CMMC_AD_Winter20_final.indd 5 12/11/19 4:29 PM A SAFER WAY TO
groundbreaking new treatment is now available to help some PREVENT A patients with carotid artery disease, a leading cause of stroke. TransCarotid Artery Revascularization (TCAR) has fewer risks than other A STROKE options, reduces scarring and gets patients out of the hospital and back on A NEW TYPE OF SURGERY CARRIES LESS RISK WHEN their feet sooner. “TCAR is specifically designed to CLEARING PLAQUE FROM THE CAROTID ARTERIES. treat high-risk patients with carotid
Healthy Together | 18 | Winter 2020 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 19
CMMC_TCAR_Winter20_final.indd 18 12/12/19 9:32 AM artery disease in the safest way possible,” HOW TCAR WORKS WHAT IS says Daniel Fremed, MD, a board- TCAR helps reduce risk in CAROTID certified vascular surgeon at Clara Maass two ways. First, it requires ARTERY Medical Center (CMMC). a smaller cut, less than an About a third of all strokes are caused inch long, just above the DISEASE? by carotid artery disease. Fatty deposits collarbone, rather than up WHAT IT IS: A waxy (known as plaque) clog arteries and to several inches along the substance called reduce or block blood flow to the brain. length of the neck, as CEA does. plaque builds up in “Strokes can be life-altering and “This smaller incision can lead to one or both of the carotid debilitating,” says Dr. Fremed. “Stroke less postoperative pain and a quicker arteries, the vessels in the neck that carry oxygen-rich blood to the survivors can be left physically and recovery,” Dr. Fremed explains. brain. Blood flow to the brain may cognitively impaired.” The TCAR Through this minimally invasive be interrupted, causing a stroke. procedure is a new way to prevent strokes opening, surgeons can reach the carotid from occurring. artery and insert a slender tube. Then WHAT CAUSES IT: Factors that damage the inner layers of the they put a stent inside the artery to open carotid arteries, such as smoking, it up so blood flows freely to the brain. TRADITIONAL TREATMENTS high levels of cholesterol, high The most common treatment for carotid The other key factor with TCAR is blood pressure and high levels of artery disease is carotid endarterectomy that, incredibly, it temporarily reverses sugar in the blood. (CEA). To do this, a surgeon makes an the blood flow to the brain. Surgeons TREATMENT: Lifestyle changes, such incision on the patient’s neck. Then the clamp the carotid artery feeding blood as heart-healthy eating, maintaining surgeon opens the carotid artery and to the brain. Then they redirect the a healthy weight and being as removes the plaque. blood back from the brain through a tube physically active as you can reduce Another option, called angioplasty, leading to a vein in the thigh. the risk. If those measures aren’t inflates a tiny balloon in the artery to During the procedure, blood flowing enough, your doctor may prescribe open it up. A surgeon may also put a away from the brain goes through a filter medicines to help control risk stent (a tiny tube) in the artery to keep before it reenters the body. In this way, if factors. it open. To reach the carotid artery, the pieces of plaque break off, they won’t get WARNING SIGNS: For some people surgeon must feed a catheter up to the to the brain and cause a stroke, as is the a “mini-stroke”—a transient neck from a puncture in the femoral risk with more traditional interventions ischemic attack, or TIA—is a artery in the groin. for carotid artery disease. This reversal warning sign. Symptoms include These two treatments carry certain of blood flow takes about 10 minutes and sudden trouble seeing or speaking, risks. CEA is open surgery, which doesn’t harm the brain because other dizziness, a severe sudden requires a large incision. It is commonly arteries continue to supply blood to the headache or sudden weakness performed under general anesthesia and brain during this time. in the face or limbs—similar to symptoms of an actual stroke, carries a risk of nerve injury. although these usually go away With angioplasty, the danger is that HOME SOONER within 24 hours. If you or a loved pieces of plaque could break loose and Along with greatly reduced risk of stroke one have these symptoms, call 911 move into the brain. That in itself can and nerve damage, patients recover faster as soon as possible. cause a stroke. and with less scarring. Often, they are For some patients, including those able to return home and get back to their with diabetes and heart or lung disease, normal activities the next day. surgery already carries greater risks. “Most patients undergoing TCAR can says Dr. Fremed. For these patients in particular, TCAR be discharged on post-op day one,” Dr. In the future, other hospitals seem is a great benefit. “TCAR eliminates Fremed says. “It is an overnight hospital certain to follow this lead. Dr. Fremed the riskiest parts stay to monitor their blood pressure and says that TCAR is so safe that it may of traditional the incision.” even eventually be used with low-risk carotid surgery Surgeons at CMMC have been patients. and stenting performing TCAR for about a year. Says Dr. Fremed, “TCAR turns and delivers an “There are only a handful of hospitals in treating high-risk carotid artery disease extraordinarily New Jersey performing this procedure,” into a very safe procedure.” safe procedure, especially for high-risk For a referral to a Clara Maass Medical Center patients,” says vascular surgeon, call 888.724.7123. DANIEL FREMED, MD Dr. Fremed.
Healthy Together | 18 | Winter 2020 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 19
CMMC_TCAR_Winter20_final.indd 19 12/12/19 9:32 AM Why do some people put off getting a colonoscopy? The night before a colonoscopy, you have to drink a certain amount of uids with medications that cause diarrhea in order to cleanse your colon thoroughly. Many people are fearful of this. In an older person, the process may be harder because they may get dehydrated. Certain medical problems may also make colonoscopy preparation more di cult. For those cases, there are other screening options to try first, including tests of stools (fecal matter) to look for signs of colon cancer, and what’s known as a “virtual colonoscopy,” which is like having an -ray. If any of these tests are su estive of colon cancer, then a colonoscopy will be necessary. A colonoscopy is the gold standard for WHAT SHOULD I KNOW screening for colon cancer. What happens if colon cancer ABOUT COLON CANCER? is found? Today, treatments for colon cancer offer PREVENTION, NEW TREATMENTS AND EVEN POTENTIAL CURES ARE AVAILABLE. a chance for significantly prolonging a patient’s life, or even a cure. In fact, 0 olon cancer, often called colorectal especially in your immediate family, and percent of individuals who undergo surgery cancer, is the third most common people with a history of IBD (irritable by a specialist—an oncological cancer C cancer detected in both men and bowel disease). Talk with your doctor to surgeon—are cured. women in the U.S., and the third leading determine if you are in a high-risk group. Surgery is often followed by systemic cause of cancer-related deaths. Yet colon chemotherapy. In a small percentage of cancer, unlike other cancers, can actually How can colon cancer patients with colon cancer, innovative be prevented through regular screening. be prevented? therapies, such as immune therapy, have “Awareness is the key,” says James Orsini, Lifestyle factors may contribute to an been considered when patients relapse. MD, Director of Medical Oncology at Clara increased risk, but they can be modified. We can actually target these therapies by Maass Medical Center. He explains: These factors include lack of regular testing for specific markers that enable us physical activity a diet low in fruits and to establish which treatment is best suited Who needs to be screened for vegetables and high in processed meats for that individual. We’re seeing some colon cancer? and fat alcohol consumption and tobacco remarkable responses to advanced colon The recommendation from the American use. For prevention, a colonoscopy—a cancer with combined immune therapies. So Society of Clinical Oncology is that type of screening that allows the doctor we’re extremely optimistic about the future everyone should to use a lighted tube to view treatment of colon cancer. begin colorectal the rectum and colon cancer screening at while the patient is What message do you want age 0. However, sedated—can detect people to get about colon RWJBarnabas Health and Clara people at higher lumps of cells cancer? Maass Medical Center, in partnership risk should be called polyps that with Rutgers Cancer Institute It all starts with awareness. screened earlier. may turn into of New Jersey—the state’s only Anyone can develop colon Higher-risk groups cancer. These National Cancer Institute-Designated cancer. Unexplained weight include people with polyps can be Comprehensive Cancer Center— loss or stomach pain that a family history removed during provide close-to-home access to the doesn’t go away could be JAMES ORSINI, MD of colon cancer, the colonoscopy. most advanced treatment signs. If you have rectal options. Call 844.CANCERNJ or visit bleeding, don’t ignore it www.rwjbh.org/beatcancer. or assume it’s a hemorrhoid. To learn about colon cancer screening at Clara Maass Medical Reach out to your primary care Center, call 888.724.7123 or visit www.rwjbh.org/claramaass. physician and find out the next best steps to protect yourself.
Healthy Together | 20 | Winter 2020
CMMC_ColonCancer_Winter20_final.indd 20 12/12/19 9:34 AM Lisa DeFabbi is less food than they’re used to eating and thriving after weight have a much smaller appetite. “The surgery loss surgery at Clara Maass Medical Center. has come a long way in the last couple of decades,” says Dr. Rainville, who performed Lisa’s surgery. “The newer procedures are minimally invasive. We make smaller incisions, and there is quicker recovery time: The patient spends less than 24 hours in the hospital and often, there is full recovery within a few days of surgery.”
BEFORE A BIG COMMITMENT “I knew going in that the surgery would change the way I would be able to eat for the rest of my life,” Lisa says. “When they take out more than half your stomach, it can be nerve-wracking, because you know this is an irreversible procedure.” Before the procedure, Lisa was on a two-week diet after the operation, she was given a diet protocol that was explained to her by the team of dietitians in the bariatric program. This postoperative diet lasts for a duration of six weeks and gradually ‘THE BEST THING progresses from primarily liquids to normal solid foods. A little over a year post-surgery, Lisa I’VE EVER DONE’ has lost of her 2 2 pounds, and says she has never felt better. “I eat smaller amounts WEIGHT LOSS SURGERY HELPS A NUTLEY WOMAN now, and a mostly healthy diet: fruits, vegetables, lean proteins. But I do allow CONQUER LIFELONG OBESITY. myself things like pizza and wine on the weekends and some chocolate—just smaller isa DeFabbi, 53, has been heavy for the best possible chance for long-term amounts.” And the end result? most of her life. “From the time weight loss. “This is absolutely the best thing I have L I was a child, weight issues were ever done,” she says. “I want to be that always with me,” says the Nutley resident. WHO IS A CANDIDATE? 1-year-old that is running marathons! And “I had tried the lap band an in atable To be a candidate for bariatric surgery, a this will help me get there.” band placed around the upper part of the person needs to have a body mass index, stomach that decreases stomach size to or BMI—a calculation measured using the limit food intake . That didn’t work. Jenny patient’s height and weight—of greater than Craig, Weight Watchers: Nothing kept the 40. Alternatively, the person can have a weight off.” BMI of 35 or higher, along with one or more Last year, she made a decision. obesity-related conditions. “I’m a grandmother with a 3-year-old “Often, patients at that number suffer CLARA MAASS granddaughter, and I felt, enough was with a number of medical conditions: MEDICAL CENTER enough. I decided I wanted to go in for diabetes, high blood pressure, high weight loss surgery.” cholesterol, sleep apnea, re ux disease, CAN HELP Lisa got to work osteoarthritis,” explains Harvey Rainville, To learn more about bariatric with the bariatric MD, Medical Director of Robotic Surgery surgery at Clara Maass Medical team at Clara Maass at CMMC. “In addition to helping a patient Center, attend one of the monthly Medical Center lose weight, bariatric surgery allows the “Surgical Options for Weight (CMMC), which has majority of patients to get off many of the Loss” seminars (which are also a comprehensive medications they are taking for obesity- offered in Spanish) led by one of program to support related conditions.” CMMC’s bariatric surgeons. To patients before, Bariatric surgery, in the simplest terms, register, call 888.724.7123 or during and after involves surgically reducing the size of a visit www.rwjbh.org/weightloss. HARVEY RAINVILLE, MD surgery to provide person’s stomach so that they consume
Healthy Together | PB | Winter 2020 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 21
CMMC_Bariatrics_Winter20_final.indd 21 12/12/19 9:35 AM SAFETY FIRST— AND ALWAYS In addition to numerous awards for clinical excellence, Clara Maass Medical Center has received national recognition for its safety measures, including: • 2019 Patient Safety Excellence Award from Healthgrades • 12 Grade A scores in quality and patient safety from The NOTHING BUT Leapfrog Group
“We use a lot of checklists, much as THE BEST pilots do before a flight,” Dr. Ballem says. “For example, we do something we call a THE PURSUIT OF PERFECTION IN HEALTHCARE DELIVERY NEVER STOPS. ‘time-out’ in the operating room, where we go through a checklist to confirm and great hospital has great reliable manner,” he says. “Th e healthcare reconfirm the patient’s name and the healthcare providers—doctors, landscape is constantly changing, from type of surgery to be done, that we have “A nurses, physical therapists and new technologies to new evidence-based all the equipment ready, and so on. Once so on—and great processes,” says bariatric guidelines, and it is imperative that we not everyone on the team confirms that all surgeon Naveen Ballem, MD, who holds only keep up but strive to stay a step ahead.” the components are in place, then we can the newly created position of Chief perform the surgery.” Clinical Effectiveness Officer at Clara DATA MATTERS Equally important, the Chief Clinical Maass Medical Center (CMMC). Like other RWJBarnabas Health facilities, Effectiveness Officer must make sure “It’s the role of the hospital CMMC is on a mission to become a the medical center is up to speed with administration to make sure a hospital has High Reliability Organization (HRO), the constantly changing guidelines and those great processes, and to ensure that a concept that originated in the field of evaluation metrics used by insurers and all steps are beautifully orchestrated in a aviation and is now being widely adopted other outside organizations. patient-centric treatment plan,” he says. in healthcare. “HRO is not an award. It’s Delivering quality care is not, of As Chief Clinical Eff ectiveness O cer, the pursuit of perfection,” says Dr. Ballem. course, a new concept. “From a smaller Dr. Ballem oversees the areas of uality This high-level goal takes shape in perspective, every medical practice Improvement, Performance Excellence, many ways. One is the relentless collection strives for the same kind of excellence Regulatory and evaluation of data of all kinds. For and effectiveness,” Dr. Ballem explains. Compliance, example, all patient infections—wound, “In my bariatric practice, we focus on Patient Safety and bloodstream, urinary and more—are every patient as if they are the only Infection Control. analyzed for cause, treatment and means one as we guide them through the pre- “When you think of preventing future occurrences. op process to surgery and ensure their about quality, it’s Processes, too, are continually success and excellent surgical outcomes. not about achieving evaluated. What is the best process for But it becomes more complex in a large it once, but rather diagnosis if someone comes to the hospital organization, because there are so many about maintaining with chest pain? What are the best moving parts.” it long-term in a practices and technology for preventing Still, he and the medical team at NAVEEN BALLEM, MD highly reproducible, bed sores? CMMC are up for the challenge. Dr. Ballem says, “Every day at Clara Maass, we strive for the pursuit of perfection with To learn about treatments and services off ered by Clara Maass Medical a highly reliable team and consistently Center, call 888.724.7123 or visit www.rwjbh.org/claramaass. reproducible high-quality outcomes for every single patient we serve.”
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CMMC_HRO_Winter20_final.indd 22 12/12/19 9:36 AM WHAT’S NEW AT CLARA MAASS MEDICAL CENTER HERE ARE JUST A FEW OF THE WAYS WE’RE SERVING OUR DIVERSE COMMUNITY.
SMILE! AWARDS CELEBRATE ORAL HEALTH First Lady of the State of New Jersey Tammy Snyder Murphy was the keynote speaker at the inaugural SMILE! Awards, held at Clara Maass Medical Center. The SMILE! Awards are given by the KinderSmile Foundation, a nonprofit pediatric dental community outreach center based in Bloomfield, serving the oral health needs of uninsured and underserved children up to age 17. The awards honored 20 pregnant and postpartum moms from Essex County, primarily Bloomfield, Belleville, Newark, East Orange, Nutley and Montclair, who have graduated from KinderSmile Foundation’s Perinatal Health and Wellness Program. “Giving birth is an exciting time, especially for the graduates of the perinatal and wellness program. LATINO HEALTH Thanks to the KinderSmile Foundation, new and expecting mothers are empowered to improve their ADVISORY BOARD health, including their oral health for themselves, their new babies and their entire families, and we are GETS NEW CHAIR grateful to have such a meaningful and rewarding partnership with the foundation,” says Mary Ellen Margarita Mu iz, Executive Clyne, PhD, President and Chief Executive O cer of Clara Maass Medical Center. Director of Family and Community Engagement for Above, left to right: Frank Mazzarella, MD, Chief Medical Officer, Clara Maass Medical Center; Mary Ellen Clyne, Newark Public Schools, was PhD, President and Chief Executive Officer, Clara Maass Medical Center; New Jersey First Lady Tammy Snyder recently appointed as the Murphy; Nicole McGrath-Barnes, DDS, Founder and CEO, KinderSmile Foundation; Annette Cozzarelli-Franklin, MD, Director, Women’s Health Services, Clara Maass Medical Center; and Darwin K. Hayes, DDS, MHA, FAGD, new Chair of the Advisory State of New Jersey Dental Director. Board for the Center of Excellence for Latino Health at Clara Maass Medical Center (CMMC). As Chair, Margarita NEW BEHAVIORAL UNIT IS OPEN will lead the Advisory Clara Maass Medical Center (CMMC) recently Board in providing strategic opened a new, state-of-the-art Behavioral Health Unit guidance, assistance and specifically designed for patients in need of evaluation advice to the medical center’s by the medical center’s Psychiatric Emergency leadership as it continues Screening Service (PESS) team. The new unit has to identify ways to provide six private patient rooms, a secure area for patient enhanced healthcare to the belongings and a private consultation room for the Latino community, which healthcare team and patient families. represents more than The PESS Unit is one of only 2 state-designated 40 percent of the CMMC Psychiatric Emergency Screening Services located in Emergency Departments around New Jersey. Among patient population. the list of services provided through the unit are: crisis intervention, stabilization and treatment mobile outreach to local residents experiencing acute psychiatric distress and crisis hotline services. The hotline, at 973. 44.43 7, is available 24 hours a day, 7 days a week. CMMC provides mobile crisis outreach for the To learn more about following municipalities in Essex County: Belleville, Bloomfield, Caldwell, Cedar Grove, East Orange, events at Clara Maass Essex Fells, Fairfield, Glen Ridge, Livingston, Maplewood, Millburn, Montclair, North Caldwell, Nutley, Orange, Roseland, South Orange, Verona, West Caldwell and West Orange. Medical Center, visit www.rwjbh.org/events. Above, the new Behavioral Health Unit with six private patient rooms.
Healthy Together | PB | Winter 2020 Clara Maass Medical Center | RWJBH.ORG/CLARAMAASS | 23
CMMC_CommunityEvents_Winter20_final.indd 23 12/12/19 9:38 AM NONPROFIT U.S. POSTAGE PAID Lebanon Junction, KY PERMIT #799 1 Clara Maass Drive, Belleville, NJ 07109
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CMMC_BackCover_Winter20_final.inddRWJ-17 CMMC Bariatric SPANISH 8.375x7.29_redshirtfemale_apnea_m1.indd 24 1 12/11/1911/1/19 4:25 PM11:04 AM