RambamISSUE No. 9 | April 2012 on call The Bride’s Slippers Successfully treated for degenerating hip joints, a bride dances on her wedding day Backstory IMS – Innovative treatment for back pain 24HOURS in the Department of Anesthesiology The Sperm Bank Great Returns on Deposits Rambam on call American Friends of Rambam Medical Center 521 Fifth Avenue, Suite 1731 Dear Friends, New York, NY 10175 USA Every patient or caregiver who enters www.aforam.org a hospital’s gates has entered a world [email protected] unto itself. The work of physicians, Tel: 212.292 4499 nurses, and hospital orderlies is highly physical, but one cannot work Canadian Friends of on a stranger’s body, or be the patient Rambam Medical Center whose body is being handled, without 64 Merton Street, 1st Floor having deep channels of experience carved into one’s soul. Toronto Ontario M4S 1A1 Even the youngest physician or nurse, coming into daily contact Canada www.cframbam.com with illness, injury, and healing – and certainly every patient and [email protected] family member – quickly learns the lessons of maturity: being Tel: 416.481 5552 human requires effort, courage, and humility. In this issue of Rambam on Call, we present the profound stories British Friends of and voices of several such individuals: a bride, determined to Rambam Medical Center dance at her own wedding, who undergoes hip-joint replacement 1 Opal Court surgery (p.14); infertile couples and single women determined to 120 Regents Park Road conceive and nurture life, for which purpose they seek donated London N3 3HY sperm (p.6); medical psychologist Dr. Yigal Ben Haim, who offers United Kingdom hope to the severely ill and injured and their families (p.26); and www.rambamuk.co.uk Organ Donation and Transplant Coordinator Esty Katz, who at [email protected] no small emotional cost to herself, turns to bereaved families Tel: 020.8371 1500 with a request that they perform a lifesaving act of utmost selflessness (p.4). Dear Friends of Rambam, you have volunteered to enter Israeli Friends of Rambam’s gates with us. We think that is remarkable. We keep Rambam Medical Center our gates and hearts open all the time! Thank you. POB 9616 Haifa 31096 Israel 1. a PROF.1. b RAFI BEYAR For more information: For more information:[email protected] Tel: 972.4.852 0670 www.rambam.org.il www.rambam.org.il Director and CEO Israel Main Office & Rambam Health Care Campus rambamhospitalAll Other Countries 52 mm rambamhospital 52 mm 50 mm POB 9602 Rambam Health Care Campus - Rambam HealthHaifa Care 31096 Campus - Hospital Hospital Israel www.rambam.org.il i [email protected] Tel: 972.4.854 1612 58 mm 58 mm Rambam on call | APRIL 01 2. a 2. b For more information: For more information: www.rambam.org.il www.rambam.org.il rambamhospital rambamhospital 42 mm Rambam Health Care Campus - Hospital Rambam Health Care Campus - Hospital i i 90 mm 90 mm DEPARTMENTS Contents Issue No. 9 | April 2012 21st Century Medicine GPS technology tracks physicians, patients and CUSTOM-MADE equipment in real time » 22 DAD Human Physiology Who donates sperm? 10 things you didn't know Who seeks it? about the kidney » 24 06 Complementary Medicine A medical psychologist helps patients hospitalized for BACKSTORY physical ailments cope with Rambam gives the emotional distress lowdown on avoiding » 26 back surgery. The Rambam's Way Feline bad? Maybe you’re 10 allergic to the house cat » 27 VOTING WITH Strategically Speaking HER FEET Rambam writes the rulebook for quickly converting a From hyperbaric oxygen chamber to wedding chamber by parking garage into the way of hip replacement surgery. world’s largest hospital bunker » 28 14 International Outreach Our medical ambassadors TIME FOR ASPIRIN reorient themselves » 30 A wonder drug’s roller Friends Help Build coaster history. a Hospital 18 Ports of call » 33 Rambam Health Care Campus, State of Israel – Ministry of Health | Director and CEO: Prof. Rafael Beyar Published by the Department Executive Editor: All written and/or published of International Relations & Dorit Kravchik content in Rambam On Call magazine is for general Resource Development Managing Editor: information purposes only and Neomi Cohen - David is not intended or implied to be Chief Medical Consultant: a substitute for professional Prof. Shimon Pollack Graphic Editor: Michal Herbstman medical advice, diagnosis Photographers: Edward Kaprov, and/or treatment or an Pioter Fliter, Kobi Bossel, Concept Director: endorsement for any medical AFORAM, MUSC Shirley Enbom or pharmaceutical product. All CEO: David Basan advice, diagnosis and treatment Letters to the Editor: should be given in person by On the Cover: [email protected] Production: CONCEPT- a physician and under his/her Image of low back Content Solutions supervision. pain. iStockphoto Tel- 972-3-6893358 e-mail: [email protected] APRIL 01 | Rambam on call Team Work Erela Tarlev Ben-Shahar Departmental Rounds Medical Transplantation Unit Esty Katz, RN, MA, Transplant Coordinator, widow (with a partner) + 4 children and grandchildren How did you choose your profession? How do you speak with a bereaved I had always dreamed of being a nurse, but family about organ donation? With my late husband was not enthusiastic about extreme sensitivity. First of all, I inform them of the the idea so I studied accounting management possibility and afterwards tell them about families instead. At the age of 31, already a mother of that have donated. I'm helped by the knowledge three, I went to nursing school. I worked as a that organ donation helps people to cope, short- community health nurse on a kibbutz for two term and long-term, with loss and grief. years and then came to the Cardiac Intensive Has turning to bereaved families Care Unit at Rambam. Later on, I was asked to become easier with the years? No. become the hospital's Transplant Coordinator. There's no immunization for it. The pain is I gave it a lot of thought, but Dr. Tamar Ashkenazi, great and accompanies me home. the Director of the National Organ Transplant Center, called me in for an interview, and what What gives you satisfaction? she said interested and challenged me. I have The knowledge that I am involved in a worked in this field ever since. process that contributes to saving lives, and the fact that I have seen significant change in public What does your work entail? awareness about the importance of organ I have a variety of responsibilities – as well donation. This year at Rambam we had 26 as turning to bereaved families with a donation cadaver donations, each of which made it request, I work at advancing public awareness possible to harvest on average 5 organs. of organ donation by identifying potential donors and helping to medically supervise the transplant Are you in touch with the transplant process. recipients? No, but I stay informed about their condition and feel that I am the thread linking What are your difficult moments? them and the donating family. It is most difficult for me when I must turn to people at the most agonizing time of their How do you combine work and family lives. Death is a terrible tragedy for a family, life? This kind of work requires complete and because brain death is death that happens recruitment of the family. I am available for work suddenly, grief is compounded by shock. To 365 days a year. Every plan I make is liable to be approach grieving family members precisely at interrupted by a telephone call putting me into this moment and ask them to donate their loved action. This happened while I was at a restaurant one's organs isn't easy. celebrating my son's 30th birthday and also while I was at a spa with friends celebrating my birthday. My Day after I have been notified of a potential organ donation 05:30 I rise early, drink coffee, skim 08:30 A test is done to determine if 14:00 I raise the possibility of organ details: arranging a psychologist for the newspaper and solve crossword there is cerebral blood flow. donation with the family. the children, making connections with puzzles and Sudoku. 09:45 If there is no blood flow, I meet 15:00 The family agrees to the family members abroad. 06:15 I leave for the hospital. with the patient’s family and inform donation. In the case of a lack of 20:00-24:00 I part from the family, 06:50 I go through e-mails and deal them of his condition and of the need agreement, I would hold additional continue making administrative with the urgent matters. to convene a committee authorized to conversations with the family in an arrangements and follow up on the establish brain death. effort to change their minds. donor. 07:30 I go to the department where the potential donor is hospitalized 13:00 If brain death is determined, then 16:00-20:00 I inform the National 24:00 The donor is brought into and meet with the team of physicians together with the treating physician and Transplant and Organ Donation surgery. and nurses. We go over the patient’s the committee, I hold a conversation Center of the family's agreement and 06:00 I fill out forms and reports. with the family about their loved one’s coordinate a number of additional lab tests and consult with the treating 07:30 I head for home, and on the way death. tests. I continue to accompany the physician regarding the next step.