HARTFORD ’S WELLNESS MAGAZINE • Fall 2015 ROUNDS Construction Underway On New Bone & Joint Institute

ALSO: Advances in Cardiac Care Neuroscience Center And More Fall 2015 ROUNDS welcome Hartford Hospital’s Wellness Magazine to Rounds Magazine contents Page 3 Thank you for taking the time to read Rounds and New Bone & Joint Institute learn about Hartford Hospital. We are proud to be Page 6 ranked by U.S. News & World Report as the No. 1 hospital Hartford Hospital News in the Hartford metro area and as high performing in Page 8 four specialties: psychiatry, nephrology, urology and Advances in Cardiac Care orthopedics. We could not have earned this distinction without the exceptional physicians, nurses, healthcare professionals Page 11 and other staff members who go above and beyond for every patient, Integrated Excellence: every day. Neuroscience Center Hartford Hospital is the regional destination for innovative and Page 16 complex care. As you will see in Rounds, we also provide a wealth 30 Years Of LIFE STAR of services and educational opportunities for our communities. We Page 18 are both a medical and research center and a community hospital, Research Studies delivering the most-advanced, skilled care with compassion and always working to improve the quality of life of the populations we serve. Page 19 We hope Rounds gives you a feeling for the extraordinary profes- Welcome, New Physicians sionalism and dedication of our institution. Page 20 Calendar Of Events

Sincerely,

Stuart K. Markowitz, MD President, Hartford Hospital & Rounds Advisory Board: Adrienne Bentman, MD Senior Vice President, Hartford HealthCare James Blazar John Greene Jr., MD Stuart Markowitz, MD Andrew Salner, MD Editorial Team Amanda Blaszyk, Helayne Lightstone, Allison Mahon, Rebecca Stewart Designer Karen DeFelice Writers Garret Condon, Debra Durbin, Annie Emanuelli, Karen Hunter, Noreen Kirk, Hilary Waldman Photography Chris Rakoczy Calendar Coordinator 1.855.HHC.HERE Kat Ryan One number. Thousands of acclaimed physicians. ROUNDS is a publication of Hartford Hospital Hartford Hospital. It is not intended to provide medical advice on individual 80 Seymour Street • Hartford, CT 06102-5037 health matters. Please consult your 860.545.5000 • www.harthosp.org physician for any health concerns. CONSTRUCTION UNDERWAY ON NEW Bone &Joint INSTITUTE

he dynamic lines of the new Hartford HealthCare connected TBone & Joint Institute at Hartford Hospital, now by a walkway under construction at Retreat Avenue and Seymour over Seymour Street, will be a stunning addition to the hospital’s Street. The 130,000- campus. More importantly, it will be the ideal setting square-foot inpatient for providing a range of orthopedic services which will care unit will feature 60 private rooms, 10 operating be unique in the region. rooms, a post-anesthesia care unit (PACU), rehabilitation “We’re creating something that doesn’t exist facilities, a radiology suite, a Center for Sports & in this area: a comprehens ive center of Fitness and after-hours orthopedic urgent- excellence with a regional focus,” says care services. Amenities include a spacious orthopedic surgeon Courtland Lewis, The new facility lobby and a café. The ambulatory building MD, the Institute’s physician-in-chief. will be a regional will have three ambulatory surgery Lewis expects the Institute to become rooms and medical offices occupying center of excellence a destination for patients from across 35,000 square feet. Procedures such as the Northeast because “there’s nothing in comprehensive total joint replacement, spine surgery quite like it in New England.” musculoskeletal care. and fracture repair will be performed at The Institute will bring together in the inpatient facility, while hand, foot or one place all the medical, surgical and ankle surgery, as well as minimally invasive rehabilitation services necessary to provide (arthroscopic) knee surgery, will be done at the expert, hi ghly coordinated diagnosis and treatment outpatient center. of orthopedic and musculoskeletal conditions. It Where certain procedures are performed may also will focus on preventive care and education of change over time, says Institute Medical Director Ross patients, families and providers. Benthien, MD. “We have plans to innovate around The project is a collaborative effort between spine and total joint procedures,” he notes, “and these Hartford HealthCare (HHC) and Bone & Joint Institute may eventually be done in the ambula tory center.” Physicians LLC, which includes more than 50 physicians During the project’s planning stages, physicians from multiple disciplines, including orthopedic surgery, and administrators traveled to several of the country’s rheumatology, anesthes iology, pain management, leading musculoskeletal centers to explore best practices radiology and hospital medicine. and how to adapt them to the Hartford project. Two The new complex, designed to suggest a human prominent architectural firms collaborated on the joint in motion, is slated to open in late 2016. It will design. The result is a physical environment with the include a five-story inpatient building and a four-story most advanced features and technologies. ambulatory and medical building. The two will be continued on page 4

Fall 2015 3 Having an entire team dedicated exclusively to The Bone & Joint the Institute is essential to top-quality care, says Institute, slated to Dawn Tranter, RN, inpatient unit manager. “Science open in late 2016. demonstrates that when you have dedicated teams, team members become experts in care, which produces quality, safety, positive outcomes and an exceptional patient and family exp erience.” Plus, talented profes- sionals want to be part of expert teams, which will help the Institute continue to recruit the best people. “Talent is our greatest resource,” says Tranter. The 50-plus physicians on the Institute’s medical staff are all fellowship trained; that is, they have extensive education and experience in their specialties. Benthien, who did his residency in orthopedics at Bone & Joint continued from page 3 Hartfor d Hospital before completing two fellowships, says, “I’m practicing with many of my orthopedic The new buildings will streamline care by having heroes — awesome surgeons who took great care of all clinicians in one place. Additional services will be patients and taught me how to do orthopedics.” added once the new facility is operational. But inno- Hayes points out that the Institute’s nursing staff is vations in the way care is provided already are well expert in the care of musculoskeletal and orthopedic underway. “In essence, the Institute exists today,” says patients. All the nurses are highly educated in the David Santoro, MBA, OTR/L, the Institute’s director of unique needs of this population, and those who work operations. “We have inpatient units at Hartford in t he preoperative and PACU areas are trained in Hospital, dedicated operating rooms and a PACU, and critical care. Still, she says, creating a positive patient teams working together to ready systems and opera- and family experience is everyone’s responsibility. tions in preparation for the move.” “It’s all of us as a team — physicians, nurses, patient Kim Hayes, MS, BSN, director of nursing at the care associates, environmental services — every point Institute, says that teams are establishing effective of encounter the patient has — who are responsible processes right now “so that when the doors of the for the patient’s experience.” new building open, the transition will be seamless.” The team’s exclusive focus on this patient Demand for advanced orthopedics continues to population, Tranter says, gives them “an understanding grow, as baby boomers age and want to maintain an of the impact the injury or surgery has on the patient active lifestyle. and family and ensures empathetic and sensitive care.” Another feature that sets the Institute apart is the Redesigning Care range of patients it is prepared to care for. “We’re a Lewis has practiced in the area for unique system, because we are a Level I more than 25 years. He says the quality of orthopedic [where the area’s most severely injured patients are care is very high in the area, but that the Institute taken for care],” says Benthien. “We have to be sure will take it to a new level. “By starting from scratch, we can care for the high-acuity patient, but also we can redesign the way we take care of people and provide the polished experience that someone having organize the layout of the new hospital to fulfill our an elective procedure would want to see.” vision of doing things better and continuousl-y im proving. For me, living that vision is really important.” Prepared Patients, Better Outcomes Lewis describes the Institute as a “hospital within The Institute has developed an innovative preoperative a hospital” that focuses exclusively on providing a education and evaluation program for patients having complete continuum of care to orthopedic and elective surgery. PREPARE — shorthand for Procedure- musculoskeletal patients. “By creating this team — Related Education and Pre-Anesthesia Risk Evaluation everybody from nurses to anesthetists to the house- — is under the direction of Karen Livingston, APRN. keeping staff — we can manage the whole episode It is designed to ensure that every patient has a safe of care, from when the patient chooses a slurgica and successful surgery. PREPARE helps patients date to when the patient returns to the office for understand what to expect before and after surgery. follow-up,” he says. More importantly, it identifies ahead of time any

4 ROUNDS factors that might put the patient at increased risk the patient on special rehabilitation, balance issues, for complications, so that care can be tailored to the osteoporosis therapy and lifestyle changes to try to patient’s unique needs. prevent future fractures. The PREPARE program begins with a registered The Sports & Fitness Center also will feature a nurse calling the patient about a month before motion-analysis laboratory, exercise equipment and surgery to take a medical history. Then the patient space for classes on health and wellness topics. visits the PREPARE center. Depending on his or her Obesity, which is so prevalent today, contributes health status, the patient may be instructed to see a to many health issues, including osteoarthritis, cardiologist or pulmonologis t (lung specialist) or that eventually can necessitate joint replacement. have certain tests performed. Patients who have The Institute’s Sports & Fitness Center will collaborate risk factors, such as high body mass index or heart with Hartford Hospital’s Integrative Medicine problems, are flagged as possibly needing a higher Department to offer education on healthy eating level of care while hospitalized, a longer period in and lifestyle changes to help people lose that the PACU, or a period in a rehabilitation facility after excess weight. The center will have a demonstration discharge. This knowledge allows the care team to kitchen where people can learn about healthy prepare the patient and make whatever arrangements cooking and eating. are necessary for op timal care. “It’s all done ahead “We’re trying to help people better understand of time,” says Livingston. “The more we know up- the disease process they face and take advantage front, the better the patient’s outcome will be.” of preventive care resources that may help them The Institute offers preoperative educational avoid surgery,” Santoro says. “Surgery should be the classes for patients and their families prior to last option.” elective surgeries, such as total joint replacements. Instructors explain what to expect, including what The Big Picture the course of treatment will be, who the members of The Institute’s leaders envision a continuing the care team will be a nd what the recovery period evolution of services and initiatives. These include will be like. Karen DePasquale, RN, nurse navigator, developing tools to help primary care providers who runs the classes, says “They decrease stress employ evidence-based practices when treating and lead to a better patient experience. Patients patients with musculoskeletal problems and who are educated and understand what to expect conducting research to determine optimal treatments. have better quality outcomes.” All relate to the Institute’s overarching goal. “We’re Hayes points out that during the patient’s hospital all about ‘Life in Motion,’” says Lewis, referring to stay, nurses and physical therapists reinforce the the Institute’s motto. “We’re all about getting people information presented in the class. They also educate back to where they want and need to be.” patients who have had unplanned procedures, such as fracture repairs. When patients are discharged, clinicians review medications, the recommended Hartford Hospital activity level, wound care and any other issues of recently became the First with New Technology concern to the patient. first in the region for Hip and Knee to use a new, high- Procedures Promoting Wellness technology device The opening of the new facilities will allow the Bone for orthopedic surgery. & Joint Institute to expand its services, especially MAKOplasty® for partial those designed to prevent health problems in the knee resurfacing and total hip first place. ® The Institute has partnered with the Hartford replacement uses the RIO Robotic Arm HealthCare Rehabilitation Network to create the Sports Interactive Orthopedic System. RIO is a & Fitness Center that will be located in the inpatient surgeon-controlled robotic arm system that building. The center will provide multispecialty enables surgeons to personalize partial evaluations of individuals’ health risks and recommend knee resurfacing and total hip replacements steps to address them. An example is the planned to achieve excellent results with greater Fragility Fracture Program. If a patient with osteoporosis precision than ever before. has sustained a fracture, the program will work with

Fall 2015 5 HARTFORD HOSPITAL news Kidney exchange benefits patients clot risk in active women. The study team is Hartford Hospital was involved in the longest funded by the NASA CT Space Grant Consortium. kidney transplant chain ever accomplished. Dr. Thompson also presented two lectures as Twenty-six participated in the chain, part of Boston Marathon’s medical events. On in which 34 kidneys were exchanged, ensuring April 18, he lectured at the American Medical that the vital organs reached the most appro- Athletic Association’s Annual Boston meeting priate transplant recipients. The chain, which on premature coronary artery disease in life- was covered by ABC’s “Nightline,” was called long endurance athletes. He also presented the a chain of love and took three months to annual marathon lecture, “Cardiac Problems in be i mplemented. Veteran Endurance Athletes” at Massachusetts In other transplant news, Hartford Hospital’s General Hospital. kidney and heart transplant teams have been accepted into Optum’s Center of Excellence for Awards and Accolades Transplants. Optum’s Clinical Sciences Institute Hartford Hospital’s Stroke Team received the evaluates transplant programs throughout the Get With the Guidelines® Stroke Gold Plus and United States and only includes transplant Target Stroke Elite Honor Roll awards from the programs that meet strict Centers of Excellence American Heart Association and American Stroke criteria. The transplant program also is an Association. The awards recognize hospitals Aetna Institute of Excellence and an Anthem that achieve at least 85 percent compliance in Center of Excellence. each of the seven Get With The Guidelines Stroke Achievement Measures. Hartfo rd Hospital has also earned two Women’s Choice Awards®, including recognition Mr. and Mrs. as one of America’s Best Stroke Centers. This Marvin Mitchell; distinction is the first of its kind in the United donor/recipient; and Dr. Anne Lally States and is awarded to hospitals that carry the certification of an Advanced Primary Stroke Center or Advanced Comprehensive Stroke Center from the Joint Commission and have achieved above-average patient recommendation scores. The award seal, issued to only 250 hospitals nationwide, is the only recognition that integrates clinical excellence and the Advancing cardiac care for athletes patient experience. Hartford Hospital also Dr. Paul Thompson, chief of the Hartford Hospital received the Women’s Choice Award for America’s Department of Cardiology; Beth Taylor, PhD; Best Hospitals, Orthopedics, based on its and Amanda Zaleski, MS, collected data at the comprehensive orthopedic services and Boston Marathon in April performance on Centers for Medicaid & for a study, “Investigating Medicare Services measures. Deep Vein Thrombosis Risk in Women At Flight,” Hospital selected as research site to examine the influence for cardiac clip of estrogen-based oral Hartford Hospital has been chosen as a research contraceptives on blood- site for the COAPT (Clinical Outcomes Assessment of the MitraClip Percutaneous Therapy) Trial, Left-Right: Gregory Panza, Amanda Zaleski, Dr.Paul which will study an investigational device in Thompson, Dr. Beth Taylor, patients who have functional mitral regurgitation Dr. Kevin Ballard and Dr. and are not appropriate candidates for mitral- Antonio Fernandez. valve surgery. The trial will evaluate the safety

6 ROUNDS and effectiveness of the MitraClip System for the s ervices to financially challenged adults in Greater treatment of moderate-to-severe or severe functional Hartford. Care is provided at a mobile clinic by mitral regurgitation in symptomatic heart failure volunteer physicians and nurses. patients who are treated per standard of care and Dr. Subramani Seetharama, director who have been determined by the site’s local heart of Hartford Hospital’s Spinal Cord team as high risk for mitral-valve surgery. The COAPT Injury Program, received the 2014 Trial will study up to 430 patients at as many as 85 YMCA Healthy Living Award, which medical centers in the U.S and Canada. is given to individuals who quietly In May, the hospital’s Structural Heart Program at and tirelessly work for a cause outside Hartford Hospital marked a milestone in cardiac the spotlight. Seetharama care by completing their 200th trans-catheter aortic Dr. Robert Brautigam, critical care valve replacement (TAVR). surgeon at Hartford Hospital, was named a ”Hometown Hero“ by the Unique prostate procedure eliminates Hartford Courant. He was nominated need for oral medications by a fellow Hartford Hospital employee In June, Hartford Hospital physicians performed for the dedicated and compassionate their first prostate embolization for benign prostatic care he gave her son, who was critically Brautigam hypertrophy (BPH). This may be the first time this injured in a motorcycle accident. procedure for enlarged prostate glands has been Dr. Lenworth Jacobs, Hartford Hospital vice performed in New England. Hartford Hospital has a president of Academic Affairs, presented the unique technology — not available at nearby hospi- most-recent work of the Hartford Consensus at the tals — that enables the procedure, which has been White House. The Consensus, a group of national shown to be very effective for long-term treatment professionals, met in Hartford in April to create the of BPH, eliminating the need for oral medications. Hartford Consensus III Document, a national policy to enhance survivability from intentional mass- Hospital staff recognized casualty and active-shooter events. The meeting Dr. Godfrey Pearlson, founding was sponsored by the American College of Surgeons director of the Institute of Living’s (ACS). Participants Olin Neuropsychiatry Res earch included the president Center at Hartford Hospital, of the ACS and senior received the 2015 Stanley Dean leadership from the ACS Award for Research in Schizophrenia Pearlson Committee on Trauma. from the American College of Psychiatrists (ACP). In addition, there was The award recognized his lifetime achievements in represe ntation from the schizophrenia research, which the ACP said constitutes White House, the National a “major contribution to the understanding and Security Council, the treatment of schizophrenic disorders.” Dr. Pearlson U.S. military, Homeland has studied the intricacies of the brain to deteremin Security, FEMA, the FBI, U.S. Vice President Joseph Biden and Dr. Lenworth Jacobs whether or not there are biological differences emergency medicine, and between schizophrenia and bipolar disorder. other medical professionals. Doug Elliot, president Yvette Melendez, Hartford Hospital’s of The Hartford and chair of the board of directors vice president of Government and of Hartford Hospital, represented the private sector. Community Alliances, was The thrust of the document is to empower the public selected by the Malta House of to become involved as immediate responders to Care as one of their six Wonder stop bleeding in these catastrophic events. It Women for 2015. Recipients are also underlines the importance of full integration recognized for their public service of professional first-responding groups to rapidly and philanthropy. Malta House provides Melendez and efficiently transport patients to appropriate free primary and preventive medical hospitals for definitive care.

Fall 2015 7 Advances In CARDIAC CARE

Hartford Hospital is improving — and saving — heart patients’ lives through leading-edge technology and therapies

here’s good news for people with some isn’t possible once the artery is totally occluded. Tcommon heart ailments. Today’s new treatments The only alternative was open heart surgery, a major can relieve symptoms and offer a better, often longer, operation with substantial risks. Today, there’s a quality of life, and they’re provided by expert teams better solution, says Hartford Hospital interventional at Hartford Hospital. cardiologist Daniel Fra m, MD, co-director of the CTO program. “In the last few years, a number of new HELP FOR CHRONIC TOTAL OCCLUSION devices have been developed that help physicians Hartford Hospital is one of only 50 centers in the open up arteries that are totally occluded,” Fram country using advanced equipment and minimally says. These new devices allow physicians to treat invasive techniques to treat a once nearly untreatable the blockage endoscopically, that is, from within the condition called chronic coronary total occlusion. blood vessel. One device can be rotated like a corkscrew Over time, major arteries of the heart can become so it passes through or around the blockage. Used completely blocked or “occluded” by a buildup of with a second devi ce, it can be passed between the plaque and cholesterol. “Many times, coronary inner and middle layers of the artery wall and then arteries will become 100 percent closed, and patients be guided back into the “lumen,” or center of the don’t even know it,” says Jeffrey Hirst, MD, an inter- artery, on the other side of the blockage. “You ventional cardiologist and co-director of the virtually make a new artery,” Hirst says. Still Chronic Total Occlusion (CTO) program at Hartford another possibility is passing the wire through a Hospital. “It can be a silent event.” collateral vessel and coming at the blockage from The heart tries to compensate. Other arteries may the other side. The procedure is done in the cardiac form “collaterals,” smaller blood vessels that carry catheterization lab under X-ray guidance. blood — and critical oxygen — to the blocked artery. “With these catheter-based endovascular But with a major blood vessel totally occluded, the techniques, we can open arteries without subjecting heart can’t get the oxygen it needs. Patients develop patients to open heart surgery,” says Hirst. Fram chest pain and pressure, called angina, and suffer notes that with the new devices and techniques, incapacitating shortness of breath. “Success rates have gone from 40 to 85 percent. Until recently, little could be done for these Some patients weren’t candidates for surgery, so patients. Medications are only modestly effective. they were stuck with their symptoms. Patients have Angioplasty, in which a catheter is used to insert a had relief from angina and a better quality of life balloon or stent to open a partially blocked artery, because of these techniques.”

8 ROUNDS Hartford Hospital performs more CTO procedures patients deemed “high” risk. Hartford Hospital is than any other program in New England. Fram and Hirst participating in a trial examining use of TAVR in collaborate on the procedures, which are complicated patients at “intermediate” risk, as well. and can take from two to five hours. “All 160 cases Another change is that new catheters are much we’ve done, we’ve done together,” Hirst says. “Four smaller. The smaller catheters allow more procedures experienced hands are better than two.” to be done through the femoral artery in the groin. Using the femoral artery creates less risk than the TAVR OFFERS HOPE two alternative approaches: using the subclavian Aortic valve stenosis, a narrowing of the heart’s aortic artery, which is within the chest, or going through valve, affects approximately 1.5 million people in the the chest wall. United States. About a quarter-million of them have The often unsung heroes of the sophisticated severe symptoms that restrict activities and reduce procedure are the members of the hospital’s multi- the quality and length of their lives. Many are elderly disciplinary TAVR Team. Patients being considered for or ill, so they can’t undergo open heart surgery to TAVR undergo a rigorous screening process by clinicians replace the valve. Hartford Hospital made history in from echocardiography, cardiac catheterization, cardiac 2012 when it became the first in the region to use surgery, radiology, pulmonology, anesthesiology, palliative the Edwards SAPIEN transcatheter heart valve to care, discharge planning and more. The entire team replace patients’ aortic valves without surgery. The reviews findings. Taking part in the procedure itself device enabled physicians to replace aortic valves are approximately 20 professionals from those areas, via a catheter inserted into an artery and guided to as well as interventional cardiologists, catheterization the heart. Transcatheter aortic valve replacement, or lab nurses, technicians and surgical assistants. TAVR, gave new hope to people with stenosis who Raymond McKay, MD, director of interventional were not candidates for surgery. cardiology research at Hartford Hospital, says that Since then, Hartford Hospital’s multidisciplinary the skill of the TAVR team, the robust screening process TAVR team has performed more than 220 TAVR and the superior technology combine to produce the procedures, with excellent results. There have been hospital’s excellent patient outcomes. He adds that some changes along the way. The Food and Drug the number of people undergoing TAVR is expected Administration, which originally approved TAVR only to quadruple in the next 10 years. “This is a lifesaving for patients categorized as being at “extreme” risk procedu re,” McKay says, “and only a fraction of the of dying after open heart surgery, has extended it to people who need it have been treated to date.” continued on page 10

Fall 2015 9 Cardiac Care continued from page 9 “allows us to individualize appropriate and necessary treatments for our patients.” THE BEAT GOES ON SCA occurs when the heart’s electrical activity Hartford Hospital electrophysiologists — heart becomes chaotic. Until recently, patients at risk for rhythm specialists — recently became the first in SCA had to have a defibrillator implanted using the region to implant two innovative devices: one to insulated wires, called leads, placed in the heart, monitor patients’ heart rhythms and the other to ready to provide a “shock” if necessary to restore prevent sudden cardiac arrest (SCA). normal rhythm. A new device, Boston Scientific’s The Medtronic Reveal LINQ loop recorder is an subcutaneous implantable defibrillator (S-ICD), implantable cardiac monitor that is injected just however, offers the same protection, but sits just under the patient’s skin to detect abnormal heart beneath the skin and leaves the heart and blood rhythms that can cause palpitations, fainting and vessels untouched. Edmond Cronin, MD, the first to even stroke. The recorder transmits information implant the S-ICD system, says; “With more people wirelessly to the patient’s physician almost at risk for sudden cardiac arrest, we must be at the immediately. Steven Zweibel, MD, director of forefront with leading-edge treatment protocols to electrophysiology at Hartford Hospital, says that provide patients with the best possible protection.” by revealing abnormalities as they occur, the device

Lucky to Have the BEST CARE But Fram and his colleague, Dr. Jeffrey Hirst, proposed using a sophisticated new angioplasty Mark Brien describes himself as “a very lucky technique known as a “retrograde” procedure. guy, both professionally and medically.” The Since the usual, frontal approach would not work retired Coventry resident had a career he was in Brien’s case, they would thread a tiny wire passionate about: piloting Gulfstream jets for through thin “collateral” blood vessels and use a major corporations. He was also one of the first balloon and stent to clear the blockage from its Hartford Hospital patients to undergo an innovative, back side. “It had only been done for about four minimally invasive angioplasty procedure to open years at that time, and only a handful of hospitals a totally occluded coronary artery. in the country had experience with it,” says Fram. Brien w as apparently healthy in 1995 when “It was an unusual, much more complex and higher- he had a heart attack that caused his heart to end technique that required a team approach.” abruptly stop beating, a condition known as Brien agreed, and Drs. Fram and Hirst, working sudden cardiac arrest. His wife, Theresa, a Hartford as a team, did the procedure in January 2011. Hospital nurse, called 911 and kept Brien alive by “I came home the next day,” Brien recalls. Was performing CPR until emergency responders arrived. he nervous? “No, I was fine with it, because I At Hartford Hospital, interventional cardiologist thought, ‘This is Hartford Hospital and this is Daniel Fram, MD, performed a balloon angioplasty Fram and Hirst.’ I never thought the outcome to clear the blockage that had caused the attack would be anything except good.” and inserted a stent to keep the artery open. The procedure was successful. With the artery Back in good health, Brien was able to return to open, Brien could once again take to the skies, flying. Like all pilots, he was required by the Federal doing the work he loved for s everal more years Aviation Administration to have regular stress until his retirement. tests to monitor his coronary health. In late 2010, “I’ve been fine since then,” Brien says. He takes Brien got bad news. An angiogram showed his ar- his medication faithfully and tries to stay active tery was occluded again, this time completely and and in good physical condition, walking, working for longer than three months, a condition know n outside and fishing — especially fishing. “It’s nice as “chronic total occlusion.” Standard angioplasty and quiet,” he says. “I listen to the birds. I pay procedures had never worked well for these types attention to the sky. I know how lucky I am.” of blockages. Unless he underwent major open- heart surgery, Brien’s days as a pilot were over.

106 ROUNDSROUNDS Hartford Hospital’s Neuroscience Center brings together all the expertise needed to prov ide advanced treatment for even the most complex diseases of the brain and spine. INtEGRAtED EXCELLENCE

he most sophisticated technology that exists When a person’s central nervous system is Tcan’t compare to the human body’s amazing disrupted, whether by stroke, disease or injury, he central nervous system. Made up of the brain or she requires expert, highly coordinated care and spinal cord, and connected to billions of from specialists in a variety of related fields. nerve cells throughout the body, the central That’s why Hartford Hospital has established a nervous system is what enables us to interact comprehensive Neuroscience Center. with the world around us — to see, speak, hear, The Neuroscience Center brings together move and touch. It is how we are able to feel specialists with expertise in diagnosing and emotions, have ideas, learn new things and re- treating disorders of the nervous system, from call memories. It literally keeps us alive, telling the common to the most complex. It includes our hearts to beat, our lungs to inflate, our me- experts in neurology, neurosurgery, physical tabolism to break down that salad we just had medicine, neuropsychology, behavioral health for lunch. continued on page 12

Fall 2015 11 of neurological and neurosurgical conditions. Integrated Excellence continued from page 11 Components of the center include those focused on psychology, rehabilitation and other fields, who col- general neurology, neurosurgery, neuromuscular, laborate with each other and additional specialists to stroke, neuro-oncology (cancer of the brain or spine) ensure each patient receives integrated, optimal care. hearing and balance, and epilepsy. Together, they “The Neuroscience Center gives us the ability to provide the most advanced care for patients with provide coordinated care to all patients who suffer from many neuroscience-related conditions. neurosurgical, neurological or psychiatric conditions Several recent innovations are expanding the that can be treated medically or surgically,” says Inam Neuroscience Center’s range of expertise. These include Kureshi, MD, chairman of Hartford Hospital’s Department a Headache Cen ter, a Movement Disorders Center of Neurosurgery. A key feature of the center, Kureshi and an Epilepsy Surgery Program. The new programs says, is that it is “patient-centered,” that is, it brings complement the center’s well-established ones. together specialists able to provide comprehensive care for each patient’s disease or condition. “If a Relief from Headache Pain patient goes to our Stroke Center, for example, they The Neuroscience Center recently established an will have access to a team of providers who specialize outpatient Headache Center. The Headache Center’s in various aspects of their care,” Kureshi s ays. “The medical director is Brian Grosberg, MD, a board- philosophy is to bring specialists to the patient, certified neurologist and headache specialist and the rather than the patient having to struggle to find former director of the world-renowned Montefiore the specialist who fits their needs.” He adache Center in New York City. According to The Advisory Board Company, a Grosberg says he chose to lead the new center global research firm that studies healthcare trends, because he and Hartford HealthCare share the same the number of patients needing neuroscience care is “vision of excellence.” growing. The firm projects a 43 percent increase in “We are creating and growing a state and nation- outpatient neuroscience services over the next 10 ally recognized, comprehensive, multidisciplinary years in areas such as spine surgery, neurodiagnostics headache program that provides individualized care,” (electroencephalograms to record electrical activity of Grosberg says. “We’re all about the patients and the brain and nerve-conduction tests), sleep issues making sure they get what they need.” and pain management. The center will diagnose and treat headache in all its forms, but Grosberg says the most common type A Complete Range of Services that people seek treatment for is migraine. About 36 Hartford Hospital’s Neuroscience Center is made up million people in the United States, the vast majority of numerous centers and programs that focus on of them women, suffer from migraines. Grosberg research, diagnosis and tailors his approach to each individual patient, using treatment related both medical and nonmedical therapies. For those to the full range with headaches that are particularly debilitating, relentless or nausea-producing, the center offers intravenous infusion therapy. “Very few places in the country have the capability or skill to do this,” says Grosberg. The center is work- ing with Hartford Hospital’s Maternal-Fetal Medicine team to provide other services that are hard to find: safe, effective injections of anesthetic at pain sites and outpatient intravenous therapy for pregnant women suffering from headaches. Looking ahead, Grosberg says the center will train nurse practitioners and fellows, form partnerships with various headache organizations and collaborate with colleagues on both research and patient care. He also envisions a “telemedicine” component that

12 ROUNDS would be one of the first in the country. It would “We are creating and allow patients at distant locations to have initial and growing a state and nationally follow-up visits remotely. Grosberg’s approach at Montefiore helped recognized, comprehensive, patients so much that many travel long distances to multidisciplinary headache see him. He expects that, in a similar way, patients program that provides will seek care from the Hartford HealthCare individualized care.” Headache Center. “ will be a destination site for headache care for patients in the state and beyond,” Grosberg says.

Comprehensive Care for Movement Disorders Hartford HealthCare’s Movement Disorders Center, part of the Neuroscience Center, focuses on the for Parkinson’s patients, and de Marcaida hopes to wide-ranging needs of patients whose ability to make those options more available to patients. The move is impaired because of abnormalities in the center also will focus on educating staff in skilled- brain and nervous system. Several diseases, such as nursing facilities about the unique needs of patients dystonia (involuntary muscle contractions) and with Parkinson’s. Tourette syndrome (which causes involuntary move- De Marcaida has been drawn to caring for ments and sounds) are categorized as movement those with Parkinson’s since she was a resident, disorders. But the disease that leads most people and she has great affection for her patients. “They to seek a neurologist’s care is Parkinson’s disease, are wonderful people,” she says, “and they have a says J. Antonelle de Marcaida, MD, medical director disease that’s unforgiving.” of the Movement Disorders Center, located in Vernon, Connecticut. Surgical Treatment for Epilepsy Parkinson’s disease is a progressive disorder of the Hartford Hospital’s Epilepsy Center has a well-deserved nervous system. It typically causes tremors, difficulty reputation for excellence, says Medical Director moving and muscle stiffness. As the disease progresses, Lawrence Hudson, MD, and its capabilities are expanding. patients develop many other physical, mental and “When people come here, they soon will be able emotional symptoms. While medication can help to obtain the full range of diagnostic and treatment control symptoms, there is no cure. services they would find in the best comprehensive De Marcaida, who has been in practice for many epilepsy centers in the country,” Hudson says. He years, says the nature of Parkinson’s disease requires notes that the center’s attributes include five fellow- intensive, multidisciplinary care. ship-trained neurologists who specialize in epilepsy “This is a challenging field because there are so care, a full-time clinical psychologist, a superb many aspects of the disease you have to pay attention technical staff, and state-of-the-art technology for to,” she says. “Besides the mobility issues, there video EEG (electroencephalogram) monitoring for the are blood pressure issues, sleep disorders, urinary diagnostic evaluation of seizure disorders. difficulties and gastrointestinal issues. There are also Recently, the center developed an Epilepsy Surgery cognitive issues and comorbidities such as depression Program to treat the roughly one-third of patients and anxiety.” whose epilepsy isn’t controlled by medication. Sur- As the Movement Disorders Center evolves, it will gery has long been effective in eliminating seizures seek to address this full range of needs. De Marcaida caused by brain abnormalities such as tumors. The envisions involving neuropsychologists; patient and new program makes it possible to operate on patients fa mily counselors; physical, occupational and speech whose structural abnormalities are more complex, or therapists; dieticians; gastroenterologists and, whose brains are structurally normal, in order to eventually, neurosurgeons trained in deep brain relieve their epilepsy. stimulation, a procedure in which electrodes are The process begins with placing intracranial elec- placed on the brain and then activated to reduce trodes on the surface of the brain to locate electrical symptoms. Exercise, especially dancing, is helpful abnormalities that can’t be detected from the scalp. continued on page 14

Fall 2015 13 Integrated Excellence continued from page 13 a stroke occurs through to treatment, recovery, complication management, rehabilitation, second- Placement of these electrodes makes it possible to ary-stroke prevention and reintegratio n to daily life. do functional mapping studies to locate areas of the “With a team that includes subspecialists in brain that are important to brain functions such as vascular neurology, vascular neurosurgery, speech and voluntary movement. endovascular neurosurgery, neurocritical care Ultimately, two maps are created: one that shows medicine and neuroscience nursing, we have the the distribution of electrically irritable, seizure- capability to care for the sickest stroke patients,” generating tissue within the brain, and another says Silverman. “We offer the access they need at that shows functional areas. With this knowledge, both the emergent, acute stages of their disease surgeons c an remove brain tissue that generates and during long-term outpatient clinical decision- seizures without removing or damaging functionally making for their future.” important areas of the brain. The time between When the stroke is caused by a clot blocking a placing the electrodes and performing surgery blood vessel in the brain, the stroke team is ready may be one to three weeks. with medication to dissolve the clot or interventional “We are in an era when brain surgery no longer procedures that physically retrieve the clot. The requires removing a large part of the skull and ex- patient is then closely monitored in the neuro posing unnecessary brain,” says Brendan Killory, MD, intensive care unit. But the story doesn’t end once director of Epilepsy and Functional Neurosurge ry. the emergency is over and the patient is sent home. As with most neuroscience initiatives, epilepsy The Outpatient Stroke Center provides ongoing treatment requires a team approach. aftercare, helping patients with complications “The treatment of epilepsy in general — and that may include cognitive impairment, physical epilepsy surgery in particular — is a very cooperative, disability, swallowing problems, depression, multidisciplinary process,” Hudson says. He stresses headache and more. Clinic staff link patients to all that everyone — he; his colleagues in neurosurgery, specialized services needed, coordinate their care, neuropsychology and neuroradiology; and the technical monitor progress and manage medications. They staff — are critical to the success of a procedure. “It also work to prevent future strokes. in volves a team of as many as a dozen people who “Once someone’s had one stroke, they’re at are engaged in various tasks to ensure the process increased risk of having another one,” Nouh says. will be both effective and safe,” Hudson says. “Up to one in every four strokes in the United States occurs in a patient who’s had a previous stroke.” Complete Care for Stroke Nouh and his team work with patients to address The Stroke Center is an example of the comprehensive, risk factors such as high blood pressure, high “patient-centered” care the Neuroscience Center cholesterol and heart problems that may contribute provides. It was the first center in New England cer- to stroke. They advise patients about lifestyle tified by the Joint Commission as a Comprehensive modifications that can reduce risk. “Patient education Stroke Center, and the program is still the only one is a strong component of what we do regarding of its kind in Connecticut. “This certification means these conditions,” Nouh says. we are part of an elite group of hospitals that have a Hartford Hospital's Telehealth Network brings team of specialized providers who are dedicated to world-class emergency stroke and critical neurology complex stroke care,” says Isaac Silverman, MD, care to hospitals that may lack around-the-clock medical director of the Stroke Center. on-call neurologists or that want to strengthen their Hartford Hospital is the largest stroke center in primary stroke care services. The network provides New England, treating more than 800 patients a year. stroke and neurology consultative services using Every one of those patients can expect what Outpatient advanced telemedicine technology on a 24/7 basis, Stroke Center Medical Director Amre Nouh, MD, calls 365 days a year. With this technology, Nouh says, a “360-degree experience.” Hartford Hospital, Nouh “The vascular neurologist can consult with the says, is “taking the definition of a comprehensive outlying hospital’s team, see stroke center to the next level” by providing a the patient, look at the scan and then guide care.” complete continuum of expert care, from the moment

14 ROUNDS Ongoing Evolution of Neurosciences, says, will attract additional medical The Neuroscience Center is expected to continue to and surgical experts, talented individuals who want evolve into a full-fledged Neuroscience Institute, to work collaboratively as members of a team. The with all Hartford HealthCare partners playing result, she says, will be to “ensure that all Hartford active roles. HealthCare patients continue to receive personal- The institute model, Wendy Elberth, vice president ized and coordinated neuroscience care.”

Helping Others Spot Stroke

Bruce Bissonnette is on a mission to help The surgery was successful, and two days people recognize the signs and symptoms of later, Bissonnette was transferred to a rehabili- stroke. Bissonnette, 73, of Manchester, suffered tation facility with orders for speech, physical a stroke in November 2014 while he and his and occupational therapy. Once at home, he wife, Elizabeth, were at a gathering in Haddam. began seeing Nouh regularly in the Outpatient Like most strokes, his was sudden and painless. Stroke Center. Nouh adjusts his medications: He was unable to speak or move the right side evaluates his reflexes, vision and range of mo- of his body, and his vision was impaired. Several tion; and works with him on stroke prevention. minutes passed before he realized whats wa “Mr. Bissonnette has recovered very well,” happening to him and alerted friends to call Nouh says. “His speech is much improved, his 911. “With stroke,” he says, “you don’t have any arm strength is great, and he has a new lease pain, so you don’t think it’s anything serious.” on life. He’s lost 35 pounds following the He continued to have strokes while at the local Mediterranean diet we recommended, and he’s hospital having a CT scan. exercising regularly. He looks great, and he Emergency Department physicians arranged feels great.” for Bissonnette to be rushed to Hartford Hospital’s Bissonnette agrees that he’s feeling good, Stroke Center, where the multidisciplinary given all he’s been through. He has joined the Stroke Center team was waiting for him. hospital’s Stroke Patient Advisory Board. It’s his “Before I knew it, I had seven doctors at my way of giving back and raising awareness of bed, evaluating me,” Bissonnette recalls. stroke, because he now realizes “how easy it is The team determined that Bissonnette had to have a stroke and not know you’re having it.” had a “left middle cerebral artery ischemic stroke.” It’s changed him in other ways, too. A piece of the plaque that had accumulated in “I have a new appreciation for life,” Bisson- Bissonnette’s carotid artery had broken off and nette says. “I take life a day at a time. And I traveled to a blood vessel in his brain, cutting make sure I’m well aware of my wife, who’s off blood flow. The team worked to stabilize him, been by my side through this whole thing. I administering blood thinners, regulating his make sure I tell her I love her every day.” blood pressure and monitoring him closely, be- cause he was at high risk of having another stroke. Bissonnette needed surgery to remove the Recognize and respond to remaining plaque from his carotid artery, but it symptoms of stroke FAST wasn’t until his 11th day of hospitalization that Face: ask the person to smile; the stroke team, which included stroke neurol- does one side of face drop? ogist Amre Nouh, MD, and vascular surgeons Arms: ask the person to raise both Thomas Divinigracia, MD, and James Gallagher arms; does one drift downward? III, MD, determined he was stable enough to Speech: are words slurred? undergo the procedure. “The plaque had to be Time: if person shows any of these removed, because it could have caused another symptoms, time is important! stroke,” Nouh says. Call 911.

Fall 2015 15 When it comes to saving lives the SKy IS NO LIMIt

16 ROUNDS hirty years ago, LIFE STAR took its first life-saving flight and launched a service that has made Hartford THealthCare a regional leader in trauma and critical care. LIFE STAR now has two helicopters — and three homes: Hartford Hospital, MidState Medical Center in Meriden, and in Norwich. Having multiple bases ensures short response times to locations throughout Connecticut and beyond. Over the years, LIFE STAR’s airborne intensive care units have treated and transported more than 30,000 patients, often saving their lives. When speed and skill count, people rely on LIFE STAR and its skilled and dedicated crews to be there quickly.

Living Proof of the Lifesaving Prowess of LIFE STAR

At Hartford Hospital’s bones and was bleeding pr ofusely. Time was the Black and Red Gala enemy. His only chance was getting to the trauma last winter, a hand- center at Hartford Hospital — fast. some young man, his Within seven minutes of receiving the call, LIFE blonde hair parted STAR took off from the at Hartford Hospital, just so,his tux crisper with a pilot, a flight nurse and a flight respiratory than James Bond’s, therapist aboard. circ ulated among the Carrying the same state-of-the-art equipment cocktail-party crowd and expertise found in any ICU, the crew was able to and paused for an start treating O’Brien even bef ore they lifted off for interview with re- the return flight. Today, William is completely recovered from his injuries. He is porters broadcasting About one-third of LIFE STAR’s calls are for grateful that LIFE STAR was there live from the event. trauma patients such as O’Brien, often the victims to save his life. He could have been of horrible accidents. The rest are for sick patients an entertainer or a celebrity guest. But he wasn’t. such as cardiac, stroke or pediatric patients who William O’Brien Jr. was Exhibit A for the lifesaving must be transported from one hospital ICU to prowess of LIFE STAR and the trauma team at another to ensure the best care. Hartford Hospital. “We deliver critical care when and where it is In May 2010, O’Brien became one of the 32,000 needed most,’’ said Dr. Kenneth Robins on, director desperately injured or ill patients whom LIFE STAR of LIFE STAR. “Every day, we have the honor and has tra nsported to Hartford Hospital in the 30 years privilege of saving lives.’’ since its first flight in 1985. O’Brien, now 24, has relearned how to walk, talk Although not everybody survives, O’Brien became and play guitar and piano, activities he took for one of the many who has lived to say “thank you.” granted before he was injured. His parents, Lisa and O’Brien was 19 and had just finished his freshman William Sr., have gotten their son back. And they year at UConn. He was driving home from his summer could not be more grateful. job when he crashed into a highway retaining wall, crushing the cab of his truck. He had multiple broken

Fall 2015 17 Research Studies Generous Spirit Lives on in Groundbreaking Cancer Research Fund

The condolences describe a vibrant woman: devoted HealthCare and loving, kind and generous, compassionate and Cancer caring. “She made our hearts smile!” Institute is Dedicated to her husband and three children, working to Mary Thomson Russell touched the lives of her family bring cancer and friends in meaningful ways. “She was generous patients in with her time, she was generous with an encouraging Connecticut word, she was generous when someone was in need,” unprecedented access says her husband, Douglas Russell, who is a senior to breakthrough research and innovative treatment vice president at MassMutual Financial Group. “She options. An important focus of the research relationship was also the most selfless person I knew — thinking will be active participation in molecular oncology of the other person first and always. And it did not tailored research studies. matter whether you were a family member, a great “Many of our new clinical trials will look for friend or merely an acquaintance.” unique molecular fingerprints in cancer cells that can Mary Thomson Russell was just 47 when she was be matched to a new targeted therapy,” Salner says. diagnosed with thymoma, a rare cancer affecting the “These trials will focus on identifying these particular thymus that can be a challenge to cure. “When local- patients and developing a personalized treatment for ized, it frequently can be treated successfully with them. They are not based on cancer type — i.e., breast surgery and radiation therapy,” says Andrew Salner, or lung cancer — as we have traditionally based our MD, medical director of the Hartford HealthCare clinical trials, but rather, on unique molecular signatures. Cancer Institute at Hartford Hospital. “When more “We are just beginning to open MSK trials here,” advanced, the treatment options are not as effective.” Dr. Salner says. “We hope that the molecular trials For six years, Mary Thomson Russell “fought a will be open later this year. While we have various graceful battle” against the disease, Russell says. “She funds that support the cancer center and research, lived successfully with her cancer because of physicians the [Mary Thomson Russell Endowed Cancer Research like Dr. Salner, Dr. Robert Lowe, Dr. Robert Siegel and Fund] is clearly the beginning of our effort to support Dr. Jack Foster, and the quality of care they provided.” this unique and exciting research.” That quality of care was one of the factors Russell The Russell family’s relationship with Hartford considered when he decided to establish the Mary Hospital is longstanding. “All our children were born at Thomson Russell Endowed Cancer Research Fund Hartford Hospital,” Russell says. “Over time it became at Hartford Hospital. The permanent endowed fund an organization that we gave to. As time went on, we will provide support for critical molecular oncology started to give a little more. We give because of our research to identify new targeted therapies for commitment to care and our involvement in the patients diagnosed with more common cancers, community. Both of Mary’s parents had cancer. The such as breast, colon, lung and prostate, as well as for Helen & Harry Gray Cancer Center-Avon gave them patients with unique cancers like Mary’s. great care. ... And when Mary was diagnosed, she “What makes funding this research appealing is was treated in the room that had our name on it. the personal way it connects to Mary, the type of “It is important for our community to understand cancer that she had, and where the research is just how talented and capable the doctors we have going,” Russell says. “We’re moving into a world in our own backyard are,” says Russell, who has been where targeted types of treatment will grow. This a Hartford Hospital corporator since 2002. “With fund will be able to make a difference.” Memorial Sloan Kettering, Hartford Hospital has an As the charter member of the Memorial Sloan opportunity to become even more pre-eminent.” Kettering Cancer (MSK) Alliance, the Hartford

18 ROUNDS WELCOME, NEW PHYSICIANS

We welcome some of the newest members of our Hartfo rd Hospital Medical Staff. For more information on these and other physicians, visit our website at www.harthosp.org or call the Health Referral Service at 860.545.1888.

Kwame Asante, MD Hartford and University of Connecticut and earned Kwame Asante, MD, has joined his doctorate of medicine at the American University Hartford Hospital’s Physical of the Caribbean. He completed a residency program Medicine and Rehabilitation through the University of Connecticut School of Department. Dr. Asante is a Medicine and fellowship training in endocrinology, graduate of Brandeis University. He diabetes and metabolism at Baystate Medical Center. completed his residency training at Moss He is board-certified in Internal Medicine and Rehabilitation and Temple University Hospital and is Endocrinology, Diabetes and Metabolism. board-eligible in Physical Medicine and Rehabilitation. Lisa Mack, MD Phyllis G. Grable-Esposito, MD Lisa Mack, MD, has joined Hartford Phyllis G. Grable-Esposito, MD, Hospital’s Obstetrics and Gynecology has joined the D epartment of Department. Her special interests Neurology at Hartford Hospital. include minimally invasive gynecologic She is a graduate of Harvard surgery including laparoscopic and University and Tufts University robotic surgery. She is a graduate of Boston School of Medicine. She completed a University and received her doctorate of medicine at fellowship and her residency at Brigham and Virginia Commonwealth University. Women’s Hospital and Massachusetts General Hos- pital. She is board-certified in Neurology, Neuromus- Jaime P. Moskowitz, MD cular Medicine and Electrodiagnostic Medicine. Jaime P. Moskowitz, MD, has joined Hartford HealthCare Medical Group John J. Huang, MD and Hartford Hospital’s Department John J. Huang, MD, has joined of Internal Medicine. She is a graduate Hartford Hospital’s Ophthalmology of Manhattan College and Ross Department. Dr. Huang earned University School of Medicine. She completed her his medical degree from Johns residency at St. Mary’s Hospital in Waterbury, CT Hopkins University School of and is board-certified in Internal Medicine. Medicine. He completed his residency training at the Manhattan Eye, Ear and Throat Jozsef Piri, MD Hospital/New York University Medical Center and Jozsef Piri, MD, has joined the fellowship training at Johns Hopkins Hospital Department of Internal Medicine at Wilmer Eye Institute in vitreo-retina disease and Hartford Hospital. He is a graduate at the Massachusetts Eye, Ear Infirmary/Harvard of San Francisco State University and Medical School in uveitis and is board-certified the University of Debrecen School of in Opthalmology. Medicine. He completed his residency training at the University of Connecticut and is board-certified Michael LeMay, MD in Internal Medicine. Michael LeMay, MD, has joined Hartford HealthCare Medical Group and Hartford Hospital’s Department of Medicine. Dr. LeMay is a graduate of the University of

Fall 2015 19 calendarTo see a complete listing of classes, or for more details, please visit www.harthosp.org/calendar.

Cancer Support, Integrative Medicine Smoking Cessation and Exercise Offered at multiple locations. Contact Carol Barrett, www.harthosp.org/Cancer/Classes 860.972.5776

Cancer Education and Support Yoga for Cancer Survivors • Bladder Cancer, Kidney Cancer: held quarterly at This free program meets weekly at West Hartford rotating locations. Contact Amy Reynolds, Yoga. Contact Nina Fox, 860.953.9642 860.696.4021. • Brain Tumor: held monthly at rotating locations. Healthy Hearts Contact Erin Mangan, 860.972.5808. Individual Cessation Counseling • Lung Cancer: held monthly at rotating locations. Recommended for individuals who would benefit Contact Barbara Gaughan, 860.972.5807 or Noa from a personalized, one-on-one treatment approach Mench er, 860.696.4814. to learn about behavior al strategies, medication • Prostate Cancer: held monthly at rotating options and counseling support. Sessions are locations. Contact Amy Reynolds, 860.696.4021. offered in West Hartford. Call 860.972.5864 for more information. Look Good, Feel Better For women undergoing cancer treatment, offered in Mended Hearts Support Group English and Spanish. Learn supportive techniques For people who have had open-heart surgery or on skin, makeup, and hair care from a licensed heart disease and their partners. Hartford. Call cosmetologist. Free, non-medical, product-neutral 860-688.5489. FREE. program offered in partnership with the American Cancer Society. Contact M ary Ann Vanderjagt, Surgical Weight Loss Programs 860.972.4184. www.harthosp.org/obesitysurgery/Classes

Healthy Steps Lebed Method Surgical Weight Loss: General Education Session An effective therapeutic program of exercise and An information session for individuals who are movement to music for women who have experienced ready to start the program or want to learn more breast cancer or other cancers. Meets weekly at mul- about surgical weight loss. You will meet the tiple locations. Contact Sharon Mucahy, 860.324.8143. bariatric surgeons and other members of the team. Several locations are available. Registration is Integrative Medicine required. To register, call 860-246-2071, option #2 or Integrative Medicine offers massage therapy, see schedule online at www.harthosp.org/obesity- acupuncture and Reiki on-site at multiple locations surgery. Parking will be validated. FREE. throughout Hartford Healt hcare Cancer Institute. Contact 860. 972.4444. Surgical Weight Loss: Support Gro up Education and support for those who have had or are thinking of having bariatric weight loss surgery.

20 ROUNDS Facilitated by members of the surgical weight loss recovery while caring for a newborn. Includes a program. Offered in Hartford and Enfield. Registra- maternity tour at Hartford Hospital. FEE: $50. tion is not required. Schedule is available online at • Expectant Grandparents Class www.harthosp.org/obesitysurgery. Provides grandparents with an opportunity to talk with trained professionals about birthing changes, Surgical Weight Loss: Nutrition Workshop baby care, infant feeding and safety. FEE: $5/person. A nutrition class for individuals who have already had bariatric surgery. Run by registered dieticians • Pups And Babies from the surgical weight loss program. Registration Get tips on preparing your pet for baby’s arrival, required. For information and to register call Hart- introducing baby to your pet and helping your pet ford Hospital Food and Nutrition Services at understand his new place in the expanded pack. 860.972.2604. FEE: $25/couple.

Women’s Health Issues • Baby Signing: An Intro duction www.harthosp.org/women/Classes Led by a pediatric nurse practitioner, this class focuses on how your child develops language and The Strong Women Program speech, and how sign language can enhance family Working with weights increases strength, muscle communication. For babies 6 to 24 months. FEE: $25. mass and bone density while reducing the risk of numerous chronic diseases. Twelve-week sessions • Maternity Tours meet twice a week for “no-impact” workouts. A guided tour to acquaint you with our facility and Schedule and registration available online at maternity services. Tours available in English and www.harthosp.org/classes. FEE: $160. Spanish. For schedule and to register, visit www.harthosp.org/ParentEd. FREE.

Parent Education Classes • Neonatal Intensive Care Unit Tours www.harthosp.org/ParentEd Private tours for those expecting twins, triplets, etc. Registration is required for all classes. Some classes By appointment only. Please call 860.545.8987. FREE. may close registration 48 hours prior to the begin- ning of class so please register early. • eLearning Childbirth Education When traditional childbirth education classes are • Twin Preparation Class not a possibility due to bed rest or time constraints, This three-part series will cover the unique needs of our interactive web-based program provides a parents delivering and caring for multiples. Expectant solution. Call 860-545-1888. FEE: $100. parents may invite extended fam ily members to attend any of the classes. FEE: $125/3 sessions (may • Preparation For Childbirth be prorated). Topics include: stages of labor, relaxation, breathing techniques, pain management options and coping • Baby Care skills. Learn to be an active participant in the birth Understand the needs of your newborn and learn of your baby. Go to www.harthosp.org/ParentEd for great tips on diapering, bathing and general care. schedule and to register. FEE: $100. FEE: $25/couple. • The Happiest Baby • Breastfeeding With Success Learn approaches to keeping babies happy by Before the baby arrives, learn about the basics and helping them sleep better and soothing even the benefits of breastfeeding. FEE: $25. fussiest baby in minutes. FEE: $65/couple includes • Breastfeeding And Returning To Work class, Pa rent Kit, choice of Dr. Karp’s DVD (or VHS) We’ll help you by covering such topics as choosing and Soothing Sounds CD. the right breast pump, collecting and storing milk • Epidural Anesthesia For Labor and setting a routine. Babies are welcome. FEE: $25. Led by a board-certified anesthesiologist, this class • Cesarean Birth covers what an epidural is, the risks involved and This class prepares you for the experience from pre- what to expect for pain relief. FREE. admission through recovery at home. Learn what to • Comfort Measures For Labor expect during surgery and throughout your hospital Led by a certified labor doula/licensed massage stay, how your partner can help, and tips for a smooth therapist, this interactive class will help expectant

Fall 2015 21 couples practice and master hands-on techniques to Exercise for Expectant and New Moms address the discomforts of labor, including relaxation, positioning, movement and touch. FEE: $35. • Prenatal Yoga Improve your strength and muscle tone, ease • Sibling Preparation tension and relieve discomforts of pregnancy. A class to help children prepare for the arrival of a FEE: $50/4-week session. new baby brother or sister. FEE: $15 per child; $25 for 2 or more children. Safety Education

Nurturing Connections Car Seat Safety (Provided by the Nurturing Families Network) Four out of five car seats are installed incorrectly. That’s why we offer a free Car Seat Safety class for • Telephone Support For New Parents expectant parents, hosted by a Community Safety Volunteers provide education and support when the officer. Space is limited and registration is required. mother is pregnant or while mother and baby are West Hartford. FREE. still in the hospital. Contact Leslie Escobales at 860.972.3201. CPR For Family And Friends: Infants And Children Recommended for new parents, babysitters and • Home Support For New Parents anyone who cares for infants and children who Starting prenatally until the baby is 5 years of age, want basic first aid and CPR information but who home visitors act as teachers, supporters and advocates do not need a course completion card. This is a and help families obtain community services. non-certification informational class intended for Contact Leslie Escobales at 860.972.3201. home use only. Hartford. FEE: $45. • Lactation Feeding Consultant The goal is to offer mothers the information, Mental Health www.harthosp.org/InstituteOfLiving/Events confidence and skills needed to successfully initiate The following free programs are conducted by staff and continue breastfeeding their babies or feeding from the Family Resource Center at the Institute of formula safely. Contact Mary A. Marshall-Crim at Living. Meetings take place at 200 Retreat Avenue on 860.972.1313. the first floor of the Center Building unless indicated • Prenatal Groups otherwise. Registration is not required unless noted. Offered in both English and Spanish depending on For additional information, directions or dates, visit the number of participants. Meet once per week for www.harthosp.org/InstituteOfLiving/Events. ten weeks. Contact Damaris Rodriguez at 860.972.3131. Myths, Minds And Medicine Exhibit Parent–Baby Series A permanent exhibition on the Institute of Living’s history and the treatment of psychiatric illnesses. • Enjoying Infants Together Self-guided tours Monday thro ugh Friday, 9:00 a.m. Led by a pediatric nurse practitioner, this six-week to 5:00 p.m. FREE. By appointment only; contact series is for parents and infants younger than 12 Gina, 860.972.4500 months. Learn fun, developmental activities for Anxiety Disorders Group infants, participate in discussions and make new Group cognitive behavioral therapy for children and friends. FEE: $50 for 6-week series. adolescents with anxiety concerns such as panic • Time For Toddlers attacks, social anxiety and excessive worrying. Led by a pediatric nurse practitioner, this series is Facilitated by licensed psychologists with expertise for parents and toddlers, 12 to 24 months. Learn fun, in anxiety treatment. Call 860.545.7685, option #3 developmental activities for toddlers and participate for schedule. Registration is required. Billabl e to in discussions. FEE: $50 for 6-week series. insurance and co-pay.

• Time For Infants & Toddlers — Saturdays Bipolar Disorder — An Introduction This series is for parents and children under 24 months. This program is for family members and friends of Learn fun, developmental activities, participate in individuals who have bipolar or a related disorder. discussions and make new friends. FEE: $15/class. Registration not required. FREE.

22 ROUNDS To see a complete listing of classes, or for more details, please visit www.harthosp.org/calendar. Schizophrenia — Introduction To The Disorder Support Groups Learn about schizophrenia and its treatment, Visit www.harthosp.org/supportgroups for a full listing with specific suggestions to help family and friends of support groups with dates, times and locations. cope. FREE.

Introduction To Mental Health Benefits Volunteers www.harthosp.org/Careers/Volunteer And Services For Severe Mental Illness If you are interested in giving your time and talent, Overview of benefit programs available for we offer a wide variety of opportunities to serve our individuals with mental health disabilities. FREE. patients, families, visitors and staff. Applications Depression: An Introduction To The Disorder are available online. Training and free parking are This program is for family members and friends of provided. For more information, call Volunteer Services individuals who suffer from depression. Contact at 860.972.2198 or online at www.harthospl.org/volsvc. Mary Cameron at 860.545.7665 for more information and dates. FREE. Bone & Joint Institute Volunteers are needed to make follow-up calls to Managing Schizophrenia discharged patients and for assistance in the busy This presentation will discuss the impact that outpatient office. Bilingual a plus. Call Volunteer symptoms of schizophrenia have on everyday activities Services at 860.972.2198. and how to make things better at home. FREE.

Dementia Support/Educational Group Meeting Reiki Volunteers Please join us as we bring together experts and Hartford Hospital’s Integrative Medicine Reiki those who want guidance, direction and support Volunteer Program is looking for additional through this journey. Let’s work together, help Reiki volunteers. In this volunteer role, you will each other and exchange ideas. Space is limited — assist patients, families, and staff with a gentle, reservations are required, 860.545.7665. hands-on relaxation technique that can reduce stress and pain and help promote a greater sense Mental Health Peer Support Group of well-being. A six-month commitment of one Provides support, encouragement and positive four-hour shift per week is required. I f interested, momentum for people in recovery from mental email [email protected]. health issues and substance use. Call 860.545.7202 for more information. FREE. Pet Therapy Volunteers Certified Pet Therapy teams are needed as visitors Support Group For Families Dealing With on Hartford Hospital’s inpatient units, in the lobbies Major Mental Illness as greeters and at the behavioral health campus — Share your successes and struggles in loving and Institute of Living and Grace Webb School. living with someone who has schizophrenia. FREE.

Peer Support Group: TM Schizophrenia Anonymous (S.A.) MAKOplasty Knee and Hip This is a peer-run, open forum group meeting Replacement providing support to people with a diagnosis of schizophrenia. FREE. Hartford Hospital now offers MAKOplastyTM, a robotic-assisted surgery for partial knee Social Support Group — LGBTQ Issues and total hip replacement. This surgery is so (Lesbian/Gay/Bisexual/Transgender/Questioning) precise that people recover faster with fewer Support group for 16-23 year-olds who identify side effects, and can rapidly return to a more LGBTQ issues as being prominent in their lives. The active lifestyle. Information sessions are goal is to discuss support strategies to manage life scheduled regularly. For more information, challenges. FREE. call 866.633.2229.

To see a complete listing of classes, or for more details, please visit www.harthosp.org/calendar. Fall 2015 23 Non Profit Organization U.S. Postage PAID Hartford, Ct Permit No. 4361

80 Seymour Street Hartford, Ct 06102-5037 Address Service Requested

Fish Tacos

Ingredients Crema • 1 ½ lbs. halibut • 3 tbsp. mayonnaise • 1 tsp. ground cumin • 3 tbsp. plain yogurt • ½ tsp. smoked paprika • ¼ cup finely sliced scallions • ¼ tsp. cayenne pepper • ¼ cup chopped fresh cilantro • ¼ tsp. garlic powder • 1 tsp. grated lime rind • ½ tbsp. canola oil • 1 ½ tsp. lime juice • 8 6-inch corn soft taco shells • 1 minced garlic clove • 2 cups shredded green and purple cbageab Optional garnishes: sliced avocado, lime wedges and more fresh cilantro

Directions • Combine the spices together in a bowl with the oil. Rub gently into the fish on all sides and let stand for 15 minutes in the ref rigerator while preparing the crema. • Combine all the crema ingredients together and refrigerate. • Grill the fish (you can use foil) on both sides to mark it and cook it through. • Heat the corn tacos according to package directions or grill briefly on both sides. 1 serving (2 tacos) provides the following: • Divide the fish among the 8 tacos and add ¼ cup of shredded 527 Calories 4 g Saturated fat cabbage to each. Top with a tablespoon of the crema. Garnish 42 g Carbohydrate 5 g Polyunsaturated fat 29 g Protein 15 g Monounsaturated fat with lime wedges, avocado slices and fresh cilantro. 27 g Fat 1864 I.U. Vitamin D 7 g Fiber Serves 4. 2 tacos each serving.