A Publication of WINTER 2019 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NEW BRUNSWICK healthytogether PROGRESS FOR PARKINSON’S EMERGENCY CARE FOR KIDS LIVING ORGAN DONORS

EAT LIKE AN MVP! NJ DEVILS STAR TAYLOR HALL TELLS HOW

RWJUHNB_Cover_Winter19_final.indd 1 12/18/18 2:41 PM A MESSAGE FROM LEADERSHIP HEALTH NEWS

Joint Commission We’re Focused on Community Recognizes RWJUH oretta Scott King once said that the greatness of a community is best measured Surgical Programs by the compassionate actions of its members. At RWJBarnabas Health, we share King’s belief in the power of compassionate action. Each of our hospitals is Robert Wood Johnson University C Hospital New Brunswick has earned actively engaged in making a difference on critical community issues, including housing, the Joint Commission’s Gold Seal of Approval® for employment, food security and economic empowerment. That includes everything from Bariatric Surgery and Hip and Knee Joint Replacement hiring locally to finding ways to make fresh, affordable produce widely available. System- Programs. The certification award recognizes RWJUH wide, we’ve added RWJBarnabas Health TeleMed, a telemedicine service that improves New Brunswick’s dedication to continuous compliance access to care for people with transportation or scheduling challenges. with the Joint Commission’s state-of-the-art standards. To expand our community reach, we partner with other organizations, like the New Jersey Devils, to bring about positive change. One example: Collaborating with the staff of the Barnabas Health Hockey House at Newark’s Prudential Center, our RWJUH Cancer specialty physicians and nutrition experts have developed a youth hockey program Program Earns that promotes optimal performance and good health while building confidence, Prestigious sportsmanship and life skills. It’s now available at ice-hockey rinks throughout the state. The Devils organization and players, including NHL MVP Taylor Hall, also work Accreditation closely with us to bring encouragement and moments of joy to hospitalized children. The Commission on Cancer (CoC), a quality program of the American College of Surgeons, has granted Three- RWJUH New Brunswick’s Community Health Promotions Program (CHPP) Year Accreditation with Commendation to The Cancer offers initiatives specifically designed to meet the needs of populations adversely Program at RWJUH New Brunswick, an RWJBarnabas affected by certain health conditions. Currently, there are education and wellness Health facility, in partnership with Rutgers Cancer programs identifying Latinos who are at risk for or have been diagnosed with Institute of New Jersey, the state’s only National Cancer diabetes, and African-Americans who are impacted by cardiovascular disease and Institute-designated Comprehensive Cancer Center. To earn voluntary CoC accreditation, a cancer program stroke. In addition, RWJUH New Brunswick’s CHPP has taken a leadership role in must meet or exceed the CoC quality care standards. domestic violence prevention and education, and the hospital’s Injury Prevention program seeks to keep children safe from harm through innovative initiatives like the Safety Ambassadors Program. RWJUH New Brunswick also has partnered with Healthier Middlesex, Live Well New Brunswick, St. Peter’s University Hospital Celebrity Chef Carla Hall and other community-based organizations in the New Brunswick Healthy Housing Headlines RWJUH Event on Collaborative to conduct in-home assessments, educate families and remediate February 12 homes with unsafe and unhealthy living conditions. Join us for “Heart Healthy and Delicious!” RWJUH At RWJBarnabas Health, we believe in the greatness of the New Jersey New Brunswick’s annual Matters of the Heart event on community and are glad to help improve quality of life for everyone who, like us, Tuesday, February 12, at the Imperia in Somerset. This calls the Garden State home. year’s event features a presentation by celebrity chef Yours in good health, and former “Chew” co-host Carla Hall (author of “Soul Food: Everyday and Celebration”) and RWJUH heart experts. To register, call 888.MD.RWJUH.

BARRY H. OSTROWSKY JOHN J. GANTNER PRESIDENT AND CHIEF EXECUTIVE OFFICER PRESIDENT AND CHIEF EXECUTIVE OFFICER RWJBARNABAS HEALTH ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NEW BRUNSWICK 1 Robert Wood Johnson Pl., New Brunswick, NJ 08901 888.MD.RWJUH (888.637.9584)

CONNECT WITH US ON @RWJUH @RWJUH RWJBarnabas Health

Robert Wood Johnson University Hospital New Brunswick 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/newbrunswick. RWJUH New Brunswick 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 888.637.9584. RWJUH New Brunswick 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 888.637.9584.

Healthy Together | 2 | Winter 2019

RWJUHNB_Memo_Winter19_REV1.indd 2 12/19/18 2:27 PM healthytogether contents WINTER 2019 8

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2. WELCOME LETTER. 10 12. GOOD FOOD FOR EVERY 17. SUPPORTING THE A community update BODY. The Wellness on NEXT GENERATION. from our CEOs. Wheels van takes healthy One family’s gifts help cooking on the road. both young patients 4. PEDIATRIC TRAUMA and aspiring medical SPECIALISTS. When a 13. GETTING OLDER, GETTING professionals. 10-year-old girl collides BETTER. Geriatric with a bike and needs psychiatry can help 18. 24/7 EMERGENCY CARE emergency brain surgery, adults thrive as they age. FOR KIDS. Experienced her parents are thankful pediatric specialists and for expert care close to 14. LIVING WELL WITH HEART child-focused technology home. FAILURE. It’s possible to make all the difference 9. THE DOCTOR IS feel good and stay active, for children in need of 6. THE GIFT OF LIFE. Live- IN ONLINE. With even with a diagnosis of emergency care. donor organ transplants RWJBarnabas Health heart failure. save lives. Here’s how it TeleMed, a doctor is 20. PARKINSON’S RELIEF. works. available 24/7. 16. WORKING THROUGH THE Deep brain stimulation PAIN. A brave young helps reduce symptoms 8. KEEPING KIDS SAFE. Local 10. ‘HOW I STAY ON TOP OF woman gets her life of Parkinson’s disease. high school students help MY GAME.’ NJ Devils back with the help of teach youngsters how star Taylor Hall reveals Children’s Specialized 22. DON’T MISS A BEAT. to avoid accidents and how to eat and stay fit Hospital. What you need to know injuries. like an MVP. about AFib.

PB | Healthy Together | Fall 2018 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 3

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PEDIATRIC NEUROSURGERY: HELP WHEN YOU NEED IT MOST

A 10-YEAR-OLD GIRL COLLIDES WITH amilies in one Belle Mead, New Jersey, street with a friend. Two other girls were on neighborhood look forward to their bikes behind them.” One of the bike riders A BIKE, LEADING TO EMERGENCY Fend-of-the-summer block party. Streets drew close and shouted, “Watch out!” Elli BRAIN SURGERY—AND HER are closed to traffic for the festivities and instinctively moved to the right as did her children roam the quiet roads without fear bike-riding friend. The two collided and Elli FAMILY’S RENEWED APPRECIATION of cars. For 10-year-old Elli Pizzulli and her fell to the pavement, striking her head. OF LIFE’S MOST IMPORTANT friends, spirits were high this past September Still at home preparing party food, Lynne PLEASURES. as they enjoyed the unaccustomed freedom. received a call about the accident. She grabbed Lynne Pizzulli, Elli’s mother, recalls an ice pack and hurried to Elli’s side. “She the moment that shattered the otherwise had a good-sized bump on her head,” recalls perfect Saturday. “Elli was running down the Lynne, who convinced her daughter to leave

Healthy Together | 4 | Winter 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 5

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Far left: Elli Pizzulli and her family are enjoying life’s simpler pleasures, like a game of tennis, PEDIATRIC after Elli’s close call. Left: Elli is all smiles at a recent follow-up visit with NEUROSURGERY: Dr. Narayan. HELP WHEN YOU NEED IT MOST

the party. As Elli lay on the couch at home, she into the front seat of the ambulance as Elli was about her neck brace. Of the trauma and complained of a tingling sensation in her face. intubated and put to sleep. pediatric intensive care unit staff, Lynne says, She started to vomit. “When Elli arrived, we reviewed the CT “Everyone was helpful and supportive.” Lynne bundled Elli into the car and scan, which showed a skull fracture and the As Elli recovered, she visited the headed to nearby Princeton Medical Center large blood clot on the right side, exerting Family Resource Center, where she and with her husband, Tony, and 6-year-old pressure on her brain,” explains Dr. Narayan, her sister, Sami, had manicures. “It raised daughter, Sami. The Pizzullis assumed Elli who met the ambulance at BMSCH’s Pediatric her spirits,” says Lynne. An avid reader, had suffered a concussion and were shocked Trauma Center with Dr. Grayson. “Emergency Elli was excited to discover a sequel to her when the emergency department doctor said surgery was necessary to evacuate the blood favorite book, Good Night Stories for Rebel her CT scan showed a six-centimeter epidural clot and preserve neurological function.” Girls, there. “She was so pleased she could hematoma, a mass of blood between the skull BMSCH is New Jersey’s first pediatric take it home.” and the brain. trauma center certified by the American College of Surgeons. “At a pediatric trauma center, the RIGHT TIME, RIGHT PLACE PEDIATRIC TRAUMA CARE team is specially trained and experienced in One week after discharge, Elli returned “We were told Elli needed a level 1 taking care of children with multiple injuries to to fifth grade, gradually transitioning to trauma center and would be airlifted to different organ systems. Everything is expedited a full-day schedule. She’s restricted from the children’s hospital in Philadelphia and efficient, specifically tailored to the needs her favorite contact sports, basketball and affiliated with Princeton,” says Lynne. of children, which leads to excellent care and lacrosse, but got clearance from Dr. Narayan “I didn’t know a lot about the Philly outcomes,” says Dr. Narayan. to play tennis. “She’s an amazing kid who is hospital, but I did know about Robert strong and very brave,” says Dr. Narayan. He Wood Johnson’s pediatric hospital in New EMERGENCY BRAIN SURGERY sums up the chain of events leading to Elli’s Brunswick.” He and the trauma team assembled quickly in successful surgery: “It was important that She reached out to Jeremy Grayson, MD, the operating room for Elli’s emergency surgery. Elli was transported to a pediatric trauma a friend and anesthesiologist at The Bristol- The team included pediatric trauma surgeon center in a timely manner.” Myers Squibb Children’s Hospital (BMSCH) Shaheen Timmapuri, MD, and Dr. Grayson, The Pizzulli family agrees. “As traumatic at Robert Wood Johnson University Hospital along with emergency medicine doctors and as this experience has been, it forced us to who contacted his colleague, Prithvi Narayan, nurses. In just over an hour, the blood clot was appreciate life and slow down,” says Lynne. MD, the pediatric neurosurgeon with The removed. “We’re not in a million places. We spend Bristol-Myers Squibb Children’s Hospital at “Elli was silly post-surgery,” recalls Lynne, time at home playing lots of backgammon Robert Wood Johnson University Hospital who felt reassured when Elli cracked jokes and Yahtzee! We’re grateful to be together.” and Rutgers Robert Wood Johnson Medical School. “It was like something out of the movies,” recalls Lynne of the controlled chaos that erupted when the transport team from For more information on the Bristol-Myers Squibb Children’s Hospital BMSCH arrived to transfer Elli. Comforted by at Robert Wood Johnson University Hospital, visit BMSCH.org. a hug from the lead physician, Lynne climbed

Healthy Together | 4 | Winter 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 5

RWJUHNB_PedsNeuro_Winter19_final.indd 5 12/18/18 2:47 PM THE GIFT OF LIFE

Healthy Together | 6 | Winter 2019

NB_Kidney_Winter_final.indd 6 12/18/18 2:49 PM access to the most timely clinical trials The transplant team at RWJUH not and research. only guides patients through the process of deciding on a treatment option, but of FIRST STEPS finding donors, as well. A recent initiative After the patient is provided a thorough assists patients who find themselves evaluation, the transplant team considers challenged by the prospect of locating the relevant criteria to determine whether a donor by selecting a “champion.” This kidney transplantation is a viable option. person acts on the recipient’s behalf, If so, the patient is placed on a national publicizing the message that the patient waiting list. Organs are matched based needs a kidney. on blood type, medical suitability, tissue RWJUH NEW BRUNSWICK’S type and the length of time on the list. At KIDNEY TRANSPLANT PROGRAM the same time, patients are encouraged to For more information on the OFFERS A SOPHISTICATED solicit family and friends who might be RWJ Transplant Center, located living donors. at 10 Plum Street in New LEVEL OF CARE AVAILABLE AT If a donor is found but isn’t compatible, Brunswick, call 732.253.3699. ONLY A FEW CENTERS due to blood type or cross-match issues, RWJUH, along with other New Jersey IN THE WORLD. transplant centers and the New Jersey RWJUH also participates in clinical Organ and Tissue Sharing Network, offer drug trials that investigate the most current he idea of donating a living organ a statewide living donor kidney exchange anti-rejection medications available. As can be an unnerving prospect. If program. This paired exchange program a young medical student, Dr. Pelletier T our bodies come equipped with allows the donor to give a kidney to a was particularly interested in this area of two organs, surely, we must need them compatible recipient and another living transplantation. “When a person is receiving both for optimal health. However, kidneys donor to give one to the patient. non-self tissue, the body’s natural response are one of the few paired organs where While transplants from both deceased is to reject it. To prevent this, we have to one is a “spare” that we can live without. and living donors are performed at adroitly manipulate the immune system so A person who donates a kidney can still RWJUH New Brunswick, the backbone of that the organ won’t seem foreign.” enjoy a normal life expectancy with few its program is the live-donor transplant. or no transplant-related health problems, Live-donor organs typically last longer and OVERCOMING THE ODDS according to the National Kidney provide better function than deceased- This challenge was a key part of one of Foundation. donor organs. And there’s another powerful Dr. Pelletier’s most memorable cases. “One Kidney transplants are the most benefit of utilizing an organ from a live of my favorite patients came to me when he common transplant surgeries performed donor: The waiting time is far less than for was in his early 60s. He desperately needed in the U.S., and, along with pancreas one from a deceased donor, which is around a kidney, but he had been what we call transplants, are the specialty of Ronald five-and-a-half years. That’s a long period very sensitized. This means that because Pelletier, MD, Surgical Director, Kidney for a patient to remain on dialysis, which he’d been previously exposed to tissues and Pancreas Transplantation, RWJUH most patients require in order to survive. from others, he’d developed antibodies that and Rutgers Robert Wood Johnson Medical attacked and rejected almost any foreign School. A national leader in transplant PLAYING MATCHMAKER tissue. He also was prone to blood clots. surgery care, the team at RWJ offers As Dr. Pelletier notes, finding a donor Given these two strikes against him, he’d techniques available at only a few of the match for the patient is often a time- been told by every doctor he’d visited that world’s leading transplant centers. consuming and daunting task. Luckily, he could never receive a kidney transplant. Dr. Pelletier, as part of a team of that is changing. “There have been an “When he came to see us, he was at physicians, faculty and staff at RWJUH increased number of educational efforts to the end of the road—facing continual and Rutgers Robert Wood Johnson get the word out and explain the options dialysis and an uncertain future,” explains Medical School, for live donations,” he says. “And the Dr. Pelletier. “We were able to offer him a guides patients methods that patients use now to express procedure of desensitization—a modality through each step their need are only limited by their of treatment that removed antibodies. of the transplant creativity. I’ve transplanted patients who This procedure worked well with him, and experience. used the back of their minivans as mobile subsequently, I was able to successfully This program advertising platforms, with signs that read transplant him with a living donor kidney. is personalized ‘I NEED A KIDNEY.’ Many appeals are He was overjoyed by this gift of new life. to meet the now web-based. I’ve performed several live I kept in touch with him over the years individual needs donor transplants that have resulted from to check on his well-being and his kidney of each patient contacts through social media,” says function, and whenever I saw him I felt a RONALD PELLETIER, MD and includes Dr. Pelletier. great sense of fulfillment.”

Healthy Together | 6 | Winter 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 7

NB_Kidney_Winter_final.indd 7 12/18/18 2:49 PM Local high school students teach younger children valuable safety lessons that will last a lifetime.

KEEPING KIDS SAFE LOCAL HIGH SCHOOL STUDENTS HELP TEACH YOUNGSTERS HOW TO BE SAFE AND AVOID INJURIES.

he sooner children learn about elementary schools in their towns. After the Summit and throughout safety, the better. And thanks to This year’s program kicked off in October the fall, the Ambassadors, with guidance T the Safety Ambassador program at when the students, along with advisors from from their advisors, develop lesson plans Robert Wood Johnson University Hospital their high schools, convened at The Imperia for 25-minute presentations on one of the New Brunswick, more than 4,000 first- and Banquet Center in Somerset for the annual topics. After the holiday recess, program second-graders throughout Middlesex, “Safety Summit.” Each year at the Summit, volunteers will review the presentations to Monmouth and Somerset counties will teens hear presentations in four key areas: ensure they’re on target and child-friendly. learn important lessons from “Safety safety in and around cars; pedestrian safety; Then, from February to May, Ambassadors”—270 specially trained wheeled sports and helmet safety; and fall Ambassadors work in pairs to deliver students from 28 area high schools. prevention. “Those are the main reasons we monthly presentations on each of the four Now in its eleventh year, the program see most children and adolescents in our topics to participating elementary schools. uses high school students to teach first- emergency department,” says Diana Starace, As part of the program, the elementary and second-graders how to stay safe while the hospital’s Injury Prevention Coordinator. school teachers survey the children about walking at home, at play and at school. The Ambassadors also learn how to their safety knowledge and habits prior to Participating high schools recruit juniors engage younger children, such as with the first presentation and at the end of the and seniors to create safety presentations puppet shows and games, and how to discuss program to measure knowledge gain and and then share them with students at safety in language a child can understand. change in safety practices. Based on results Each school receives a “prop kit,” complete from previous years, Starace is convinced with puppets, helmets, seat belts, stickers, that children are getting the message. For more information about the reflective tags and other presentation “The data shows us that not only are we Safety Ambassadors Program, materials. The students also receive handouts increasing the children’s understanding,” call 732.418.8026. to give to parents so that they can reinforce says Starace, “but we’re also changing their the safety lessons with their children. safety behaviors.”

Healthy Together | 8 | Winter 2019

RWJUHNB_SaftyAmbassadors_Winter19_final.indd 8 12/18/18 2:50 PM THE DOCTOR IS IN ONLINE WITH RWJBARNABAS HEALTH TELEMED, A DOCTOR CAN BE AVAILABLE 24/7.

ealth needs have a way of Mansue says. “But we also know that people’s her primary care doctor, “we do know that happening at inconvenient times. lives are increasingly time-pressed, and that there are people who don’t have access H You’re on a business trip and we’re in a world of one-click expectations to primary care, or don’t go routinely,” forgot a prescription. It is after hours and when it comes to service. Mansue says. “This is a way to connect your doctor’s office is closed. Your family is “Our job is to find ways to get people them with healthcare.” on vacation and you have a sick child. Or access to the services they need, at the right Older patients may find telemedicine you’re simply too sick to get out of bed. level of care, at the time they need it.” easier to adopt because long-distance For those situations and more, healthcare has become common for chronic RWJBarnabas Health TeleMed now HOW IT WORKS conditions, such as checking pacemakers offers telemedicine—medical care Once enrolled, patients can log in at any or heart monitors over the phone. Younger available through a smartphone, tablet or time of night or day for a videoconference patients, on the other hand, may actually computer—for urgent needs, or for people with one of the on-call, U.S. board-certified prefer telemedicine to the in-person kind. who feel they just don’t have time to visit physicians. There’s a flat fee of $45, payable “One study showed that 70 percent of a doctor. by credit card at the time of service. (Many people under age 35 had accessed medical “At RWJBarnabas Health, we’ve private insurance plans cover telemedicine, care through telemedicine,” Mansue says. been doing telemedicine for a long time and in New Jersey, state-funded health “They do everything through their phones— in specific specialty services,” says Amy insurance plans are required to, as long as create relationships, order pizza—so it feels Mansue, President, Southern Region, certain standards are met.) RWJBarnabas natural to do healthcare that way as well.” RWJBH. “For example, when very fragile Health TeleMed is secure and compliant Ultimately, the goal for RWJBarnabas babies are sent home, telemedicine lets with HIPAA, a federal law that sets Health TeleMed is for physicians to be doctors and nurses see a baby in real time if standards for, among other things, the able to access, with patient permission, a parents have a concern.” privacy of health information. patient’s entire medical record in order to The rollout of the broader RWJBarnabas The doctor at the other end of the help make better diagnoses. Health TeleMed program to the general camera can assess symptoms, look at the “That’s an aspirational goal right now, public follows a area in question and make a judgment as because electronic medical record systems successful pilot to whether follow-up tests are needed. don’t communicate between themselves program with Though telemedicine is not meant to as well as they need to yet,” Mansue says. the system’s replace a patient’s relationship with his or “But the technology improves every year.” 30,000 employees. “We know that telemedicine is not a one- To enroll or learn more about RWJBarnabas Health TeleMed, size-fits-all powered by American Well, visit www.rwjbh.org/telemed, or solution for every download the app at the App Store or Google Play. AMY MANSUE demographic,”

Healthy Together | PB | Fall 2018 RWJBarnabas Health | RWJBH.ORG | 9

System_Telemedicine_Winter19_FINAL.indd 9 12/18/18 11:54 AM ‘HOW I STAY ON TOP OF MY GAME’ NJ DEVILS STAR TAYLOR HALL REVEALS HOW TO EAT AND STAY FIT LIKE AN MVP. PHOTO CREDIT © JERSEY DEVILS/ANDY MARLIN

Healthy Together | 10 | Winter 2019 RWJBarnabas Health | RWJBH.ORG 11

System_NJDevils_Winter19_REV1.indd 10 12/19/18 11:13 AM HELPING KIDS GET aylor Hall’s healthy eating habits started young. “I can remember HEALTHIER, TOGETHER being at tournaments with my RWJBarnabas Health (RWJBH) and the T New Jersey Devils have built a robust parents. All the other kids would be having Slurpees and chocolate bars after the game, partnership focused on promoting health but my parents had oranges and granola and good, clean hockey fun. bars ready for me,” the 26-year-old New RWJBH is the official healthcare provider Jersey Devils left wing recalled during a for the Devils and their home base, post-practice interview at RWJBarnabas the Prudential Center, where healthy Health Hockey House in Newark. “Eating snacks are available at all events. With the help of its specialty physicians and well was instilled in me at an early age and experts in nutrition and wellness, RWJBH it’s something I take pride in, for sure.” collaborates with the Devils to benefit pro Those healthy habits—along with hard players, young athletes and children in work and amazing talent—have paid off, need. Some examples: for Hall’s career as well as for his team. • A rink affiliate program brings youth Last year, he scored a career-high 93 points hockey clinics and wellness and and led the Devils to the Stanley Cup nutrition education to players and playoffs for the first time in five years. He coaches at ice hockey rinks statewide. also became the first-ever Devils player to • The two organizations partner each win the Hart Trophy as the league’s most year on the Running With the Devils valuable player. 5K Run and Walk, with proceeds What’s his secret for staying at peak benefiting RWJBH hospitals. fitness? It turns out that Hall’s regimen, • Devils players visit RWJBH hospitals to while serious, is also simple, with principles participate in special events for children. that can be followed by athletes at any level. “That’s a huge part of being a hockey player,” says Devils star Taylor Hall. “We EATING TO WIN have a platform to give back, whether Ask Hall to name a favorite food, and you From top: practicing shots in the Little with a smile or simple encouragement. Devils zone; membership is free for ages won’t hear anything about ice cream or And not only is it great for the patients, 12 and under; healthy snack options for all cake. “I tend to avoid sugar,” he says. “I’m it’s also good for us.” Devils fans. lucky that I don’t often have a craving for it. But with the calories we expend, it’s very important for me to digest healthy carbohydrates and lots of protein. He starts each day with two 500-milliliter to me, I seem to play my best,” he says. “I keep my diet pretty simple. Protein, bottles of water as soon as he wakes up, to get carbohydrates and then as much roughage his metabolism going. “All day, I drink a ton A WORD TO YOUNG ATHLETES as I can—a side dish like asparagus or sweet of water, and during games, as many fluids Perhaps surprisingly, Hall’s advice potatoes, and always a salad with dinner. with electrolytes as possible.” to aspiring young hockey stars is not Gluten-free pasta, rice and quinoa—those necessarily to work harder, but to take a are really good for people like me who BODY AND MIND step back. “Some parents have their kids expend a lot of energy.” During the 82-game season, players expend in hockey year-round,” he says. “You see Hall sticks to snacks that are low in energy where it counts—on the ice. After these kids who are amazing hockey players, carbohydrates and high in fat, like nuts, or the season, Hall takes up to a month off but they just don’t seem to have a passion high in protein, like Greek yogurt. “That from any physical activity, to give his body for it. I would say that you have to try out kind of snack is not going to give you a big a rest. From then on, he works out and different things and have some free time. burst of energy before bedtime, so it will skates three times a day, five days a week. “You have to really love whatever you allow you to rest properly,” he says. His advice for other athletes is to focus do,” he says. “The thing that you have the Less nutritionally worthy foods are their workouts on what their weaknesses most passion for in life is what you’re going limited, but not eliminated. “My cheat are. “Some athletes might already have a to be successful at.” foods are cheeseburgers and pizza,” Hall very strong core, but need to work on their says. “Maybe once a week you have yourself foot speed,” he says. “Overall, don’t worry a night where you have those things. about what you’re good at. Just try and To learn more about the Certainly, you’ve got to live your life.” correct stuff that might be hampering you Getting enough fluid takes on special a little bit.” RWJBarnabas Health/New urgency for professional athletes. “Staying as To prepare mentally, Hall uses meditation Jersey Devils partnership, visit well-hydrated as possible is huge. You don’t and relaxation techniques. “When I have www.rwjbh.org/devils.

PHOTO CREDIT © JERSEY DEVILS/ANDY MARLIN want cramps during the game,” Hall says. a calm brain and everything seems easy

Healthy Together | 10 | Winter 2019 RWJBarnabas Health | RWJBH.ORG 11

System_NJDevils_Winter19_REV1.indd 11 12/19/18 11:46 AM The Wellness on Wheels van is rolling to communities throughout the state.

demonstrated a simple, healthy recipe. Says Mintz, “We partner with local food banks and farmers markets to distribute healthy foods at our events.” Simple, culturally appropriate recipes are also provided to further support the mission of helping good health begin at home. GOOD FOOD FOR EATING WELL CORN AND BLACK BEAN SALSA EVERY BODY We can get protein from plants as WELLNESS ON WHEELS MOBILE EDUCATION VAN PROVIDES A well as animals. Corn and black bean salsa makes a protein-packed HANDS-ON APPROACH TO HEALTHY EATING. after-school snack, or the perfect side dish with dinner. hen the big green van pulls up, hands-on activities is an overarching goal: to the kids say “Wow!”—and that’s help communities get healthier. • 1½ cups frozen corn, thawed just the reaction RWJBarnabas “At RWJBarnabas Health, we embrace and drained W • 1 cup low-sodium black beans, Health healthcare providers and their the concept of bringing health and wellness partners are looking for. to communities by teaching people in drained and rinsed The 35-foot vehicle, decorated with places where they live, work, earn and • 1 tomato, diced bright fruits and vegetables, is the hub of learn,” says Barbara Mintz, Senior Vice • ½ red bell pepper, diced the Wellness on Wheels mobile education President, Healthy Living and Community • ¼ red onion, diced initiative, which launched in the fall of 2018. Engagement. “We want to make sure that • ½ jalapeño pepper, minced Equipped with a hydroponic and earth-box people in underserved communities have a (optional) greenhouse and a full kitchen, the van travels level playing field when it comes to being • 2 tablespoons chopped parsley to places like preschools, senior homes and healthy.” (or 1 tablespoon dried) houses of worship in areas where affordable, • zest and juice of 1 lime healthy food is hard to come by. HELP FOR HUNGER It’s fun to see More than 900,000 New Jersey residents • 1 tablespoon olive oil young kids marvel face hunger every day, according to the • 1/8 teaspoon salt at what an herb’s Community Food Bank of New Jersey. • 1/8 teaspoon black pepper root looks like, Unemployment, low wages and high In a large bowl, combine all the run their fingers housing costs contribute to the problem. So ingredients and stir. Set salsa aside through soil, sort does the prevalence of “food deserts,” areas to allow flavors to come together. plastic fruits and where residents live more than one mile Serve with tortilla chips or on top of vegetables or smile from a supermarket and, without a car, your favorite Latin-inspired dishes. as they taste-test must depend on public transportation to healthy recipes. get there. Too often, those residents resort BARBARA MINTZ Behind those to unhealthy packaged or fast foods. Wellness on Wheels aims to change those patterns and, to increase its impact, partners with local community groups. At a To see a video of the Wellness on recent event at a New Brunswick preschool, Wheels inaugural outing and to hosted in conjunction with the Puerto learn more, visit www.rwjbh.org/ Rican Action Board, a dietitian fluent in WellnessWheels. conversational Spanish showed children how to fill a plate with colorful food and

Healthy Together | 12 | Winter 2019

System_WellnessWheels_Winter19_REV2.indd 12 12/19/18 10:43 AM GETTING OLDER, GETTING BETTER GERIATRIC PSYCHIATRY CAN HELP ADULTS NAVIGATE ALL THE TRANSITIONS THAT COME WITH AGING.

mproving with Age” is the title of a presentation that “I Lina Shihabuddin, MD, Chief Medical Officer, Behavioral Health Network at RWJBarnabas Health Dr. Shihabuddin says. “One, they may be “Medications have more side effects for (RWJBH), likes to give. dealing with very normal life adjustments geriatric patients, and take longer to get “A lot of things do get better with that come with aging, which may include out of the system. In treating geriatric age,” says Dr. Shihabuddin, who is board- retirement, loss of a partner or distance patients, you have to start at very low certified in adult and geriatric psychiatry from family. dosages and slowly increase the dose if as well as hospice and palliative “A second level of the issue is the start needed.” medicine. “Growing older should not of memory problems, erratic behavior, be thought of as a bad thing, but as a possibly unsafe driving,” Dr. Shihabuddin TAKING THE FIRST STEP transition to a different phase of life.” says. “Is this the beginning of dementia, or Dr. Shihabuddin urges older adults (or That’s a call not just to think positive, a reversible medical problem? That’s where their loved ones) to speak with their but also to think about aging and health the intersection of primary care, neurology primary care provider as soon as signs of in a new way. It’s the approach healthcare and geriatric psychiatry really comes depression or anxiety appear. “The earlier practitioners like those in the RWJBH into play.” Anxiety, depression and other you detect and treat a disorder, the Behavioral Health Network are taking issues can be triggered by a wide range of better off you are,” she says. when they proactively screen for depression conditions, such as thyroid dysfunction, Getting older gets a bad rap, Dr. and anxiety in primary care settings. vascular problems, obesity or untreated Shihabuddin believes. “Yes, as the body “It’s no longer ‘I have a disease, so I diabetes. ages, the neurons in the brain cells get need to see a doctor,’” Dr. Shihabuddin Once the problem is diagnosed, less flexible, so it may be harder to learn explains. “It’s ‘I need to be well.’ Screening healthcare providers can come up with new things,” she says. “On the other and early intervention helps patients of a treatment plan, which may include hand, the mind is more mature, giving every age stay ahead of the game.” anything from treating a disease, to older people the ability to look more creating a safer environment at home, to analytically at situations and take them ISSUES OF AGING finding ways to be sure the patient has in stride. That’s what we call wisdom. Geriatric activity during the day, to teaching family “People think about aging and they psychiatry, members how to minimize conflict. tend to think about things falling apart,” also known as “The last resort, for us, is to offer Dr. Shihabuddin says. “If we do enough geropsychiatry, medications,” such as antidepressants early detection and prevention, it does refers to mental or sleep aids, Dr. Shihabuddin says. not have to be like that.” health care of a person 65 years or older. “People seek out geriatric To learn more about geriatric psychiatry services in the psychiatry for RWJBarnabas Health system, visit www.rwjbh.org/geriatricpsych. LINA SHIHABUDDIN, MD two reasons,”

Healthy Together | PB | Fall 2018 RWJBarnabas Health | RWJBH.ORG | 13

System_Geropsychiatry_Winter19_REV1.indd 13 12/19/18 10:54 AM EVALUATING HEART FAILURE Determining the degree of a patient’s heart failure allows doctors to make the best recommendations for preventing, delaying or treating the condition. Cardiologists put heart failure into one of four classes, starting with symptoms. Here is the New York Heart Association Classification: • CLASS I: Ordinary physical activity does not cause undue fatigue or shortness of breath • CLASS II: Comfortable at rest, excessive physical activity results in fatigue and shortness of breath • CLASS III: Symptoms with non- excessive physical activity • CLASS IV: Symptoms at rest The cardiologist will then do an objective assessment of the degree of heart failure based on observations as well as tests such as a blood test, X-ray, electrocardiogram, stress test and echocardiogram. LIVING WELL WITH HEART FAILURE

Healthy Together | 14 | Winter 2019

System_Heart_Winter19_final.indd 14 12/18/18 12:01 PM IT’S POSSIBLE TO FEEL GOOD AND STAY ACTIVE, EVEN WITH A DIAGNOSIS OF HEART FAILURE.

he term “heart failure” means sometimes get confused when they hear that this vital organ is damaged ‘heart failure,’ and ask, ‘Am I going to T in some way. Despite the dire- have a heart attack?’” Dr. Rogal says. “The sounding nature of the term, however, reality is that they’re two different types a diagnosis of heart failure is far from a of pathologies.” death sentence. Heart failure does not lead to a heart “Care for heart failure patients has attack, he explains. Also, heart failure improved so dramatically that, although develops gradually, but a heart attack this is a chronic problem, patients who happens suddenly, when blood flow to an have it can live long and productive lives,” artery leading to the heart is blocked. says Gary Rogal, MD, Chief of Cardiology In either case, patients will receive for RWJBarnabas Health and a member of similar advice for a heart-healthy lifestyle. TWO SIDES OF Barnabas Health Medical Group. HEART FAILURE The key to this positive outcome is GETTING TO GOOD HABITS WITH LEFT-SIDED HEART FAILURE, simple—but not necessarily easy. The Those recommendations likely come as the muscle in the left side of heart failure patient must take medicine no surprise: Take medication as directed. the heart weakens so that the as directed and make the recommended Exercise. Eat a healthy, low-salt diet. Stop heart can’t pump enough blood lifestyle changes. smoking. Get enough sleep. Manage stress. properly (systolic dysfunction), “The patient who listens to the things Still, many patients don’t follow doctors’ or stiffens (diastolic dysfunction) their doctor recommends they do will do orders, Dr. Rogal says. “People’s lives are so that the pressure in the heart better in the long term,” Dr. Rogal says. “I so busy, and this tends to be a problem goes up. Either case can result in fluid in the lungs and reduced always tell my patients, ‘50 percent of your that’s not an immediate issue staring them heart output, resulting in marked outcome is based on what I do, and 50 in the face,” he says. “They think they can reduction in exercise capacity, percent is based on what you do.’” pay attention to it tomorrow.” breathing difficulty and fatigue. At the first sign of weakening or IN RIGHT-SIDED, OR RIGHT UNDERSTANDING THE TERMS abnormality of the heart muscle, “I tell VENTRICULAR (RV) HEART About 5.7 million U.S. adults have heart patients they need to start medications FAILURE, the right side of the failure, according to the Centers for to help their heart muscle and begin to heart loses pumping power, Disease Control and Prevention. exercise,” Dr. Rogal says. “Walking is the leading to a backup of blood in “‘Heart failure’ is a generic, umbrella easiest way to begin. And over the years, the veins that results in swelling term that covers many different disease the pharmacology for heart failure has and congestion. entities,” Dr. Rogal says. “In the simplest dramatically improved, so that we have a terms, the heart is a pump, and it is failing broad spectrum of medicines we can use.” as a pump.” The Dr. Rogal also recommends that failure can fall patients with heart failure stop drinking. can remain sexually active,” Dr. Rogal into two different “Alcohol is a direct toxin to the heart says. “But be sure to discuss this with your categories that muscle,” he says. “It can also lead to other doctor to ensure there are no limitations.” often exist issues, such as excessive sodium intake Heart failure patients will find that together: left- and dietary indiscretion. In my view, once the benefits of a heart-healthy lifestyle sided and right- you’ve started to develop any sign of heart far outweigh the effort required to create sided dysfunction. muscle impairment, it’s time to hang up new habits. Says Dr. Rogal, “You can live (See sidebar at the alcohol.” a very productive and positive life with right.) The same caution does not hold true heart failure—as long as you follow the “People for sexual activity. “In most cases, patients guidelines shared by your doctor.” GARY ROGAL, MD

YOUR HEART DOESN’T BEAT JUST FOR YOU. GET IT CHECKED. The cardiac specialists at RWJBarnabas Health care for approximately 20,000 heart failure patients in New Jersey each year. RWJBH provides cardiac care for patients of every age and every condition, from wellness programs to heart transplants. To schedule a checkup or to learn more about world-class heart care near you, visit www.rwjbh.org/heart.

Healthy Together | 14 | Winter 2019 RWJBarnabas Health | RWJBH.ORG 15

System_Heart_Winter19_REV1.indd 15 12/19/18 11:16 AM Harley (third from right) came back to Children’s Specialized Hospital for a visit with friends and fellow alumni of the Chronic Pain Management Program.

WORKING THROUGH HOW A BRAVE YOUNG WOMAN GOT HER THE PAIN LIFE BACK, WITH THE HELP OF CHILDREN’S SPECIALIZED HOSPITAL

hen Katherine Bentley, MD, meet her, and she had to know what she weaned off her pain meds, and had hours Director of the Pain Program at would be getting into if she came back for of therapy every day, six days a week,” Dr. W Children’s Specialized Hospital, the program,” Dr. Bentley says. “It’s a huge Bentley says. The goal of therapy is to re- first met Harley Bourgeois, the 20-year-old commitment. But she was ready for it.” train the brain to decrease sensitivity to had been confined to a wheelchair for more pain. Patients can take advantage of aqua than a year. UNEXPLAINED ACHES therapy in the hospital’s pool, as well as Harley had traveled with her mother Harley’s problem started when, as a healthy cutting-edge technology like the ZeroG, a from their North Carolina home to New middle-schooler, she had an X-ray for dynamic support harness that helps people Brunswick so that the young woman a minor injury that caught a suspicious walk without using their full body weight. could be evaluated for the hospital’s abnormality on her right femur. An The program also emphasizes mental Chronic Pain Management Program. It oncologist removed the lump, and all preparation for reentering the normal life had been six years since Harley had been seemed well—but the aching in Harley’s that so many have lost. A typical day would diagnosed with complex regional pain right leg never went away. include meditation, individual and group syndrome (CRPS), a chronic condition One day, the horse she was riding bucked, psychology sessions, peer mentoring and that is thought shooting her into the air. She landed on evening recreation. to be caused by the same aching femur. For many months Over the course of eight demanding an injury to the thereafter, she and her parents traveled from weeks, Harley made progress: mastering the nervous system, doctor to doctor as the pain escalated. By parallel bars, walking up a stair, walking and that grows the time Harley got to Children’s Specialized with a walker and the ZeroG harness. more excruciating Hospital, the slightest touch—even a breeze— Finally, one day when her mother visited, over time. sent pain shooting through her body. Harley surprised her by walking to her “It was a long “CRPS is a hard diagnosis because it’s a without assistance, and giving her a big hug. way to come just diagnosis of exclusion. You rule out everything That was in March 2018. Harley is to be evaluated, else, test by test,” Dr. Bentley says. “While now a student at North Carolina State KATHERINE BENTLEY, MD but we had to we don’t know everything about why a University, fulfilling her dream of studying youngster might be experiencing this chronic livestock and poultry management. She still pain, we know that intensive therapies and makes time to visit her friends and former To learn more about the Chronic multidisciplinary treatment plans can help therapists at Children’s Specialized. them.” Harley worked with a dedicated team “The takeaway of this story is, ‘never Pain Management Program of physical therapists, occupational therapists, give up hope,’” Dr. Bentley says. “Harley had and other services at Children’s psychologists, child life specialists and been in such pain and dysfunction for a long Specialized Hospital, visit physician/advanced practice nurses. time, but she kept looking for a way to get www.childrens-specialized.org. The Chronic Pain Management Program better. And thanks to her perseverance and is not for the faint of heart. “Harley was commitment, she did.”

Healthy Together | 16 | Winter 2019

System_ChildrensSpecialized_Winter19_REV1.indd 16 12/19/18 10:46 AM Celebrating the grand opening of Kate’s Place.

Brunswick Health Sciences Technology High School follow their dreams of earning a college SUPPORTING THE degree. HPSP introduces high school students to careers in healthcare, providing hands-on exposure at the hospital through internships and career-shadowing opportunities in a NEXT GENERATION variety of healthcare roles. “We thought there was no better way to honor Kate’s memory HOW ONE FAMILY’S GIFTS HELP YOUNG PEOPLE ON BOTH THE than to give other bright, young people an RECEIVING AND PROVIDING SIDES OF HEALTHCARE. opportunity to fulfill their educational and professional dreams,” says Tom. Tom and Meg have also contributed or 30 years, Dr. Thomas (Tom) and has wonderful views of the lobby and the to the hospital and its various fundraising Margaret (Meg) Gorrie have been street. Kate was almost 18 when she was lost campaigns over the years and plan to Fmaking thoughtful and generous in a car accident in 1997. “We were excited at continue their support. donations to Robert Wood Johnson University the idea of doing something for the hospital Tom has also given generously of his time. Hospital (RWJUH) New Brunswick. This that would help teenage patients,” says Meg, He is a former Johnson & Johnson executive summer, they attended the ribbon-cutting “and the new location and furnishings make and has served on several of the health ceremony for the newly redesigned and the lounge a more welcoming, supportive system’s boards, including the Robert Wood relocated teen lounge at The Bristol-Myers and accessible place for teens to gather.” Johnson University Hospital Foundation Squibb Children’s Hospital at RWJUH, which In addition to the teen lounge, the Gorries Board. He was also Chair of the health system they funded. The new lounge gives young have been instrumental in helping to support during that time. “The Gorries’ efforts and people at the hospital a sleek, modern space to the next generation of healthcare professionals. donations have made a difference to the lives socialize, play games, use technology and join In 1999, they established the Katherine Wright of hundreds of young people over the years,” in activities with other teens their age. Gorrie Scholarships, also in honor of their says John J. Gantner, President and CEO of The new Kate’s Place, in honor of their late daughter, to help students in the Health RWJUH. “We’re honored and grateful for daughter, Katherine, is cheerful, bright and Professions Scholars Program (HPSP) at New their continued support.”

To support the Health Professions Scholars and other programs at RWJUH New Brunswick and The Bristol- Myers Squibb Children’s Hospital, visit rwjuhgiving.org or call 732.937.8750.

Healthy Together | PB | Fall 2018 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 17

RWJUHNB_Foundation_Winter19_final.indd 17 12/18/18 2:51 PM EXPERIENCED PEDIATRIC SPECIALISTS, CHILD-FOCUSED TECHNOLOGY AND A COMFORTING 24/7 ENVIRONMENT HIGHLIGHT THE PEDIATRIC EMERGENCY DEPARTMENT.

EMERGENCY hen children have urgent or emergency medical needs, they W require specialized skills and compassionate care. That’s what they’ll find in the Pediatric Emergency Department CARE (ED) at the Bristol-Myers Squibb Children’s Hospital (BMSCH) at Robert Wood Johnson University Hospital New Brunswick—every hour of every day. FOR KIDS “Children are different than adults,” Healthy Together | 18 | Winter 2019

NB_PedsED_Winter19_final.indd 18 12/18/18 2:52 PM says pediatric Knowing when a child’s condition emergency requires an ED visit as opposed to a trip medicine physician to the pediatrician can be tricky. Parents Richard Brodsky, are advised to trust their instincts. If a MD, Director child displays any of these symptoms, a of Pediatric trip to the ED may be in order: abnormal Telemedicine behavior; shortness of breath; fever and WINTER SAFETY TIPS at BMSCH and rash; uncontrollable vomiting or diarrhea; Winter is a busy time full of outdoor Assistant Professor orthopedic injury or medication overdose. activities and holiday celebrations. RICHARD BRODSKY, MD of Pediatrics, BMSCH collaborates with pediatricians Emergency medicine physician Rutgers Robert in the community, providing after-hours Richard Brodsky, MD, shares his Wood Johnson care. When a family arrives at the ED, tips to help families enjoy the season Medical School. “A child who comes to a triage nurse evaluates their child and safely, without a trip to the ED. the ED complaining of chest pain likely determines the level of care needed. If the What outdoor activities bring won’t have the same problem facing an concern is less serious, such as a cough kids to the ED? adult with that symptom. Our doctors, or minor injury, the child is brought to nurses and techs are specially trained in Express Care, where pediatric medical In winter, we see injuries caused pediatric emergency care. They understand professionals provide efficient care seven by snow activities like skiing, snowboarding and sledding. Close pediatric concerns and know how to help days a week. monitoring by an adult is always immediately.” recommended and, whenever a TOPS IN TRAUMA TREATMENT child is doing an activity at high CARE AND COMFORT For critically injured children, BMSCH speed, a helmet is a must. The ED was designed to be as child-friendly offers New Jersey’s first American College as possible. “Our child life specialists make of Surgeons-designated Pediatric Trauma Are there weather-related scary situations less scary,” says Dr. Brodsky. Center. Pediatric surgery specialists are concerns? “They explain what’s happening in words available at a moment’s notice to perform Children need to wear appropriate kids understand.” emergency surgery. winter weather gear that insulates The child focus extends to care delivery. Children at neighboring hospitals who their bodies from wet and cold. Staff know how to place IVs as painlessly require trauma care are transferred to This helps them avoid frostbite and as possible. A moderate sedation service BMSCH in a state-of-the-art ambulance by hypothermia, a dangerous condition enables painful procedures to be done a pediatric emergency medicine team. The brought on by cold exposure. right in the ED. A new ultrasound allows ED is also equipped to receive patients by Jumping in the snow can cause an procedures and diagnoses to be performed helicopter on its hospital-based helipad. injury if there’s something hidden at bedside. under the snow such as a wall or “Our doctors are excellent at PROVIDING EXPERTISE shovel. Always make sure children determining the severity of head injuries,” REMOTELY play in safe areas. says Dr. Brodsky about head trauma, a Thanks to telemedicine, pediatric patients When it’s cold, families resort to leading cause of ED visits. “They’re skilled at Robert Wood Johnson University creative ways to heat their homes. at deciding who needs a CT scan and who Hospital Somerset in Somerville now Curious kids can suffer burns from can be monitored at home. It’s a balance receive care virtually from pediatric ED hot surfaces or carbon monoxide poisoning from unvented space as we don’t want to give unnecessary physicians at BMSCH. Through real- heaters. radiation.” time video consultations, specialized ED doctors evaluate, diagnose and offer second Do emergencies increase FEVER TO FRACTURE opinions. “Telemedicine expedites the during the holidays? The Pediatric ED at BMSCH sees more diagnosis process, helping children receive New decorations are introduced into than 22,000 young patients each year for the emergency care they need when and homes that are tempting to kids and reasons ranging from common illnesses where they need it,” says Dr. Brodsky, who pose potential danger. Christmas like respiratory infections and influenza hopes to expand the service so children trees and menorahs are electrical to broken bones to poisoning to life- throughout the region can benefit from risks. Garland can get wrapped threatening injuries. BMSCH’s Pediatric ED expertise. around small necks, and toys with small parts can be choking hazards. Though most winter-related ED visits can be avoided, accidents happen. For more information on The Bristol-Myers Squibb Children’s Hospital In a serious situation, always go to the nearest Emergency Department at Robert Wood Johnson University Hospital, visit BMSCH.org. or call 9-1-1.

Healthy Together | 18 | Winter 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 19

NB_PedsED_Winter19_final.indd 19 12/18/18 2:52 PM QUALITY OF LIFE, RESTORED A TRANSFORMATIVE PROCEDURE BRINGS SYMPTOMATIC RELIEF FOR PARKINSON’S PATIENTS.

Healthy Together | 20 | Winter 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 21

RWJUHNB_Parkinsons_Winter19_final.indd 20 12/18/18 2:53 PM hen we talk about stimulating out of options. Her Anne and Denis Hruza were the brain, most of us think of life had grown so at a crossroads until they discovered the Deep Wstudying a new language or diminished that Brain Stimulation performing a difficult crossword puzzle. she and her treatment program. But in the realm of medicine, there’s a husband, Denis, procedure called Deep Brain Stimulation were considering (DBS) that’s utilized to ease the devastating placing her in a the body tries to symptoms of Parkinson’s disease. In fact, nursing home. reject what the it’s the most common surgical treatment “I fell often. I battery is telling it for this disorder. had no balance to do, sensing that For the right candidate, this treatment and suffered from it’s a foreign object has been proven to be an effective long- freezing, where my and trying to override term therapy for the most disabling feet wouldn’t move,” the signal. But I had the symptoms of Parkinson’s, including tremor, says Anne. “It was difficult procedure done in 2016 and rigidity and muscle contractions. Luckily for me to write. My speech was it’s still 90 percent effective.” for Anne Hruza, a 76-year-old Parkinson’s very slurred and I cut off the ends of my Dr. Danish believes that not enough sufferer, the only hospital that performs words. Although I’m a chemist by trade, I Parkinson’s patients are aware of this this procedure in New Jersey—Robert also like to paint watercolors, but I could transformative surgery. “Patients don’t Wood Johnson University Hospital no longer handle the brushes. In general, I receive the information they need, or they (RWJUH) New Brunswick—is not too far had little or no control of my body around get sucked into the black hole of Google,” from her home. 80 percent of the time.” he says. He and the team at RWJUH New Brunswick are dedicated to getting the A (MULTIDISCIPLINARY) BACK IN CONTROL word out. Apart from patient outreach, TEAM EFFORT Dr. Danish performed DBS surgery the team also is committed to innovation. While DBS is brain surgery and not without on Anne on Sept 6, 2016, a date she Recently, it performed the first fully risks, the advanced training and extensive has no difficulty remembering as it’s robotic DBS procedure in New Jersey. experience of the DBS team at RWJUH New her wedding anniversary. Electrodes Brunswick greatly increases the probability were implanted into specific areas of PAYING IT FORWARD of successful outcomes. Anne was treated Anne’s brain. These electrodes produce As a testament to her gratitude for her by one of the preeminent neurosurgeons electrical impulses that either regulate life-changing surgery, Anne decided in the field, Shabbar Danish, MD, Chief abnormal impulses or affect certain cells that she wanted to make a dramatic of Neurosurgery, Rutgers Cancer Institute and chemicals within the brain. The gesture. “I changed my will to donate to of New Jersey; Director, Stereotactic and amount of stimulation is controlled by a Dr. Danish and his colleagues’ work. I have Functional Neurosurgery and Director, pacemaker-like device placed under the no children, and in my will have donated RWJUH Gamma Knife Center; Associate skin of her chest. A wire under the skin to further his research into Parkinson’s and Professor, Rutgers Robert Wood Johnson connects this device to the electrodes in support his work training new doctors.” Medical School. Dr. Danish is part of the brain and delivers electrical signals As for Dr. Danish, DBS is one of his the hospital’s unique multidisciplinary to it. These electrical pulses help control most rewarding surgeries. “It really is a team, which includes neurologists, symptoms of Parkinson’s, including tremor, procedure that can transform a life,” he neurophysiologists, psychiatrists, rehab slowed movement and stiffness. “I was says. “It can allow patients to get out of physicians and speech therapists. partially awake during the surgery,” Anne wheelchairs, stretchers or nursing home Dr. Danish is well known for the recalls, “but I remembered nothing upon beds. As with Anne, the personal impact excellence and humanity of his care. He awakening. All I knew was that I felt as if can be remarkable. She has even resumed has been the recipient of two five-year Dr. Danish had given me my life back. I had painting again.” anniversary awards in the Patient’s Choice been so debilitated by Parkinson’s, but now In fact, her new paintings are and the Compassionate Doctor category, I can walk, write and talk again.” showcased throughout Dr. Danish’s honoring the Anne uses her remote device to control office—a reminder of the power and mastery of his the voltage that stimulates her brain. “When potential of this procedure to change care and his the voltage is adjusted correctly for my lives. “You would never believe that these bedside manner. body, I feel nothing. If it’s too high or low, I beautiful paintings were done by someone When Anne met might have minor side effects. Each month, suffering from Parkinson’s,” Dr. Danish says with Dr. Danish, I return and receive a tune-up. Sometimes with pride. she had already suffered from Parkinson’s for For more information on RWJUH New Brunswick’s DBS treatment more than 15 years program for Parkinson’s disease, call 732.235.7733. SHABBAR DANISH, MD and felt she was

Healthy Together | 20 | Winter 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 21

RWJUHNB_Parkinsons_Winter19_final.indd 21 12/19/18 2:52 PM DON’T MISS A BEAT

WHY IT’S CRUCIAL TO TREAT ATRIAL FIBRILLATION, THE MOST COMMON TYPE OF IRREGULAR HEARTBEAT.

Healthy Together | 22 | FallWinter 2018 2019

RWJUHNB_Afib_Winter19_final.indd 22 12/18/18 2:55 PM hat feeling when your heart flutters, for clues: When do symptoms occur? Are WHEN TO SEE misses a beat, speeds up or slows they associated with specific activities? down can be alarming. Though Do lifestyle factors contribute? Will YOUR DOCTOR T The symptoms below have many these palpitations are often harmless, they weight loss help? For instance, sleep can signal serious malfunctions in the heart’s apnea, associated with obesity, can cause possible causes—atrial fibrillation muscles and nerves. arrhythmia, including AFib. Stress and (AFib) is just one of them. Consult The most common type of irregular medications also can play roles. your physician if you experience: heartbeat, or arrhythmia, is atrial Several tests are used to diagnose AFib. • Fluttering or thumping in the fibrillation—AFib for short. At least An electrocardiogram (ECG) records chest 2.7 million Americans are living with electrical signals as they move through • Heart palpitations—periods of AFib, and that number is expected to the heart and can show irregularities. To especially rapid, intense heartbeat grow as the average age of the population further evaluate how the heart is working, • Confusion rises. Untreated AFib significantly patients may be asked to wear a portable • Dizziness, lightheadedness increases both risk of heart-related death ECG device called a Holter monitor for and risk of stroke. “This is why early 24 hours or longer. An event recorder is a • Fainting diagnosis and treatment is key,” says portable device that monitors heart activity • Fatigue Kataneh Maleki, MD, cardiologist at over longer periods—a few weeks to a few • Weakness Robert Wood Johnson University Hospital. months. Patients activate the device when they experience symptoms and doctors are • Loss of ability to exercise WHAT IS AFIB? able to review the heart’s rhythm at the time • Shortness of breath When the heart beats, it squeezes and that symptoms occurred. pushes blood through each of the heart’s four chambers. With AFib, the top two RESETTING RHYTHM chambers of the heart quiver instead of Treatment for AFib aims to regulate depends on risk factors such as diabetes, beating regularly. This means the heart the heartbeat and prevent clots from high blood pressure and weight,” explains can’t pump well so some blood is left forming. If the AFib is caused by an Dr. Maleki. “A better success rate is sitting. And when blood is stationary, clots underlying condition, that will be treated anticipated with fewer or well-controlled form. Blood flowing through the heart can first. The heart’s regular rhythm (called risk factors.” sweep clots out into the circulatory system, sinus rhythm) can be reestablished Blood thinners are prescribed to help where they can cause blockages that lead using medication, an electrical shock prevent blood clots. Because AFib can to complications (cardioversion) or a combination of the occur without symptoms, many patients such as stroke. two. Before cardioversion is performed, continue these medications even after a blood-thinning medication is normal heart rhythm is reestablished. ANALYZING recommended for several weeks to reduce With active monitoring, patients SYMPTOMS the risk of blood clots and stroke. who have AFib can reduce their risk of The first step If those treatments don’t work, a complications. It’s important to keep in assessing procedure can be performed to ablate, follow-up appointments with a primary an arrhythmia or destroy, the tissues that trigger or care provider, who will watch for and help is a thorough maintain the disruptive rhythms. This manage additional stroke risk factors, patient history. stops the arrhythmia at its source. “The including high blood pressure, diabetes, KATANEH MALEKI, MD Doctors look success rate of atrial fibrillation ablation high cholesterol, smoking and obesity.

WHO IS • Alcohol use (especially binge drinking) AT RISK? • Coronary artery disease GET • Heart failure or an enlarged heart CHECKED! If you have • Family history of AFib one or more of • Overactive thyroid gland (hyperthyroidism) the following • High blood pressure Your heart doesn’t beat just for you. Get conditions, you it checked. To learn more about the • Valvular heart disease may be at higher full range of cardiac services at Robert • Lung disease risk for atrial Wood Johnson University Hospital or fibrillation, • Sleep apnea to schedule an appointment with one or AFib: • Advanced age of New Jersey’s top cardiac specialists, • High-performance or endurance athlete visit rwjbh.org/heart.

Healthy Together | 22 | FallWinter 2018 2019 Robert Wood Johnson University Hospital New Brunswick | RWJBH.ORG/NEWBRUNSWICK | 23

RWJUHNB_Afib_Winter19_final.indd 23 12/18/18 2:55 PM NONPROFIT U.S. POSTAGE PAID Lebanon Junction, KY 1 Robert Wood Johnson Pl., New Brunswick, NJ 08901 PERMIT #799

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Available at Robert Wood Johnson University Hospital’s Laurie Proton Therapy Center, proton therapy is pinpoint accurate, allowing physicians to isolate problems in children and adults for fewer side effects and better results. That’s why RWJBarnabas Health has partnered with national experts from the Rutgers Cancer Institute of New Jersey to create the only center in New York or New Jersey that’s part of an entire campus devoted to bridging the gap between cancer and a cure. Learn more at rwjbh.org/proton

Let’s beat cancer together.

RWJUHNB_BackCover_Winter19_final.indd 24 12/18/18 2:56 PM