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SPRING2013BackintheDriversSeatOneMansStaircaseBigResultsSmallIncisionsAFriendshipGrowsinAbingtonCelebrateGoodTimesComeOnIdeasforHealthierLivingHealthEducationClassesAndMuchMore FocusonLANSDALEHOSPITAL2TheseriesofeventsthatlandedGeorgia63intheNeurovascularLaboratoryatAbingtonsNeurosciencesInstitutebeganinAugust2010.ShedbeentakingAdvilforafewdaystoalleviateafternoonheadachepain.OnemorningGeorgiadidntplaceherdailytelephonecalltohermotherEdith88.By9p.m.aworriedEdithcouldntreachGeorgiaonthephoneandcontactedGeorgiassonMatt.WhenmysoncalledforsomereasonIansweredthephonesaysGeorgia.MatttellsmeIwastalkingbutnotmakinganysensealthoughIdontrememberit.MatttookhismomtoLansdaleHospital.TheretheEmergencyMedicineteamevaluatedGeorgiaanddeterminedshewashemorrhagingontherightsideofthebrain.TheyhadhertransportedimmediatelytoAMHwhereshewouldgetthehighlyspecializedcaresheneeded.AtAMHspecialistsdeterminedthatdiagnosticimagingtechniquesaCTscanandsubsequentCTangiogramsuggestedamalformationofbloodvesselswascausingGeorgiasbrainbleed.BasedoninformationfromthosetestresultsNeurointerventionalistOsmanKozakMDdecidedtoperformacatheterangiogramintheNeurovascularLab.ThistechniqueinvolvestheuseofaspecialdyecontrastagentX-raysandcomputeranalysistogiveadetailedpictureofthebloodvesselsandbloodflowinthebrain.GeorgiasangiogramrevealedaduralarteriovenousfistulaAVFanabnormalconnectionbetweenanarteryandveininthecoveringofherbrain.InGeorgiascasethehighpressurebloodflowfromthearterywasdrainingintoaveinwhichisnotdesignedtohandlethatpressureandflowsotheveinburstandbloodleakedintothesurroundingbraintissueexplainsLaramiMacKenzieMDassociatedirectorNeurocriticalCare.Bloodalsohadaccumulatedintheventriclesspacesinthebrainthatcontaincerebralspinalfluid.GLUEFORBRAINBLEEDSTostopthehemorrhageDr.KozakassociatedirectorNeurointerventionalCareinourNeurosciencesInstituteperformedanendovascularembolization.ThroughasmallincisioninGeorgiasgroinheinsertedamicro-catheteratinytubeandusingX-rayguidancenavigatedtothepreciselocationoftheAVF.WorkingwithspecializedinstrumentsthroughthecatheterDr.Kozakinjectedaslowlytime5to7PMlocationLansdaleHospitalConferenceRoomEandFfee5persessionincludesdinnertoregister215-481-2204orwww.ahlansdale.orgWomenandHeartDiseaseMichaelZakrzewskiDOLansdaleHospitalcardiologistdiscussesthedifferentriskfactorssymptomsandtreatmentoptionsforwomen.Questionandanswersessionfollows.dateWednesdayMarch6HypertensionWhatYouNeedToKnowWhatdothenumbersmeanAreyouatriskforhighbloodpressureLearnhowtoadoptahealthylifestylewithThomasDelGiornoMDandRichardFriedmanMDLansdaleHospital.dateWednesdayApril24StrokeAlertWhenSecondsCountJessicaFeldmanMDneurologistandtheLansdaleHospitalstrokecoordinatordiscusssignsandsymptomsofstrokeandtreatmentforstroke.dateWednesdayMay15BackintheDriversSeatSEMINARSWORKSHOPSGluesavedGeorgiaSlaterslife.OfcoursethehighlyskilledneurointerventionalandneurocriticalcareteamatAbingtonMemorialHospitalAMHplayedasignicantroleaswell.TheyinjectedtheliquidglueinsideGeorgiasbraintostopthebleedingthatcouldhavekilledher.Amazinglytheydidsowithoutperformingsurgery.DinnerwiththeDocsSeriesatLansdaleHospitalAllDinnerwiththeDocseventsareatthesametimeandlocation.SKIPPACKGRANDMOTHERREGAINSCONTROLOFHERLIFEAFTERBRAINBLEED 3polymerizingliquidresinintotheAVFtoblockitandpreventitfrombleedingagain.ThisnewliquidembolicagentiseasiertouseandsaferthanapreviouslyusedagentexplainsDr.MacKenzie.Itislikeaplasticmolasseswhichdribblesveryslowlyandthicklyoutofthecatheterandthenslowlybecomessolidinsidethebloodvessel.OnceGeorgiasAVFwassuccessfullyobliteratedtheneurointerventionalcareteamplacedatemporaryexternalventriculardraintoensurethatGeorgiasspinalfluidcontinuedtodrain.WhenbloodleaksintothebraintissueandventriclesitclotsandcanblockdrainageofspinalfluidsaysDr.MacKenzie.Becausespinalfluidiscontinuouslymadeithastodrainoritaccumulatescausingincreasedpressureonthebrainwhichcanleadtobraindamage.Dr.MacKenziedrilledasmallholeinGeorgiasskullandinsertedanarrowtubeintotheventriclestodrainthespinalfluid.Thetubewasconnectedtoanexternaldrainagebagandmonitor.Aphysicianwouldremovethedrainwhenitwassafetodoso.FOLLOW-UPREHABGeorgiaremainedinthehospitalforacoupleweeks.OnceshewasmedicallystableshewastransferredclosertohometoLansdaleHospitalsAcuteRehabilitationUnit.ForthreehoursadayGeorgiapushedthroughsessionswithphysicaloccupationalandspeechtherapiststoregainskillsandherindependence.UpondischargefromrehabGeorgialivedwithhersonforafewweeksasshecontinuedtohealandbuildstrength.NearlysixmonthsafterherbrainbleedGeorgiaachievedwhatsheconsideredherfinalsteptoindependentliving.Shecompletedbehind-the-wheeltrainingataspecializeddrivingschoolforpeoplewithdisabilities.InNovember2012Georgiajoinedhermotherdaughterandtwograndchildrenforafour-generationtriptoOrlandoFL.ThekidslovedtheamusementparkssaysGeorgia.Therestofussimplylovedbeingtogether.Ihavemydoctorstothankforthat.GeorgiaSlaterToreceiveafreemagnetwithsymptomsofstrokecallourphysicianreferralservice215-481-MEDI6334. 4MarkRickersonhatedstairs.Simplystandingatthebottomofastaircasefeltlikeabaddream.Tryingtoreachthetopwasanabsolutenightmare.PeoplewouldtellmetheycouldfeelmypainjustwatchingmestruggleoneachsteprecallsMark.Attheageof54everyactivityMarkconsideredrevolvedaroundhisknees.Theconstantpainofbone-rubbing-on-bonearthritisaffectedeverydecisionImadehesays.Marklivedthatwayforfiveyearsandwhenhecouldnttakethepainanylongerasingledecisiontransformedhislife.ThenheunderwentbilateraltotalkneereplacementatAbingtonHealthsOrthopaedicSpineInstituteOSIatLansdaleHospital.LikemanypeoplewhodeveloposteoarthritisMarkhadafamilyhistoryofthedisease.Hehadalsoplayedhigh-contactsportsinhighschoolandgotknockedaroundaquiteabit.Laterhisoccupationasaconstructionengineerwashardonhisknees.Overtheyearsthetraumatohiskneejointscombinedwithhisgeneticpredispositiontodegenerativearthritiscausedthewearing-awayofcartilageinhiskneesessentiallydestroyingthejoints.Hehadtriedprescriptionmedicationsandinjectionsforkneepainbuteventuallytheystoppedworking.JointReplacementsFAQsAnsweredHereFREEMinimallyinvasiveanteriorquadsparingceramicvs.materials..therearesomanychoices.Comeandlearnyouroptionsandwhatmayworkbestforyou.PresentedbysurgeonsfromAbingtonHealthsOrthopaedicSpineInstitute.dateThursdayApril18time6to8PMlocationAbingtonMemorialHospitalLenfestPavilionFrobeseConferenceCenterAuditoriumtoregister215-481-2204orwww.amh.orgOneMansStaircaseisanotherMansMountainLOCALMANISONHISWAYSEMINARSWORKSHOPSMarkRickersonMarksoldandnewknees. 5UPAFTERBILATERALKNEEREPLACEMENTOnemorningIwokeupandjustcouldnttakeitanymoresaysMark.Ihadhadenough.MarkdiscussedhissurgicaloptionswithAndrewStarMDchiefofOrthopaedicSurgeryAbingtonMemorialHospitalandmedicaldirectorOSIandoptedtohavebothkneesreplacedatthesametime.ForapatientlikeMarkwhoishealthyactiveandyoungabilateralkneereplacementisagoodoptionexplainsDr.Star.Amongtheadvantagesofthesimultaneousprocedureisthatrehabilitationisshorteroverallthepatientisonlyhospitalizedonceandrequiresanesthesiajustonce.Noteveryoneisacandidateforsimultaneouskneereplacementhowever.Thosewithcardiovascularpulmonaryorotherdiseasesmaybeathigherriskforcomplicationsafterbilateralsurgery.HavingsurgeryonbothkneesatoncealsocausesmorephysicalandemotionalstrainsaysDr.Star.ForMarktheminimallyinvasivesimultaneousjointreplacementwasagoodchoice.Dr.Starrecommendedamobilebearingkneeimplantcomprisedofthedurablemetalschromiumandcobaltwithaplasticspacer.Theplasticspacerwhichreplacesthecartilagewasdesignedtoprovideamorenaturalrangeofmotion.Withmorethan150kneereplacementsystemsonthemarkettodaythetypeofimplantthesurgeonchoosesdependsonthepatientsoverallhealthactivitylevelageandweight.Inadditiontoadvancesinimplantdesignandmaterialssurgeonshavedevelopedlessinvasiveapproachestosurgeryoverthepast10years.TodaywecanperformbettermoreaccuratesurgeriesinalessinvasivewaysaysDr.Starwhohashelpeddesigntheminimallyinvasiveinstrumentationusedintheseprocedures.TheoverallexperienceofjointreplacementisbetterforthepatientthankstoacombinationofadvancesincludingsmallersurgicalincisionsrefinedinstrumentationbetterpostsurgicalrehabilitationprotocolsandbetterpainmanagementsaysDr.Star.MarkatteststhathisentireexperienceatLansdaleHospitalmadethepostoperativepainandchallengesofthebilateralkneereplacementworthwhile.Recoverywaspainfulandverydifficulthesaysbuteveryonewhocaredformefromthedoctorsandnursestothepeoplefromfoodserviceandhousekeepingwasupbeat.TheyallshowedconcernaboutmypainandseemedasexcitedasIwasaboutmyprogress.Uponreturninghomeafter10daysinLansdaleHospitalMarksenttheOSIandRehabstaffasingingthank-youcard.HewroteLansdaleHospitalisahappyvillageforhealingwhereacultureofcompleteandcompassionatepatientcareisprofound.MarkandhiswifeLeslieareintheprocessofplanningatriptoItalyin2014whichwillentailagreatdealofwalkingandscalingmorethanastaircaseortwo.JustmonthsagoIcouldnthaveevenconsideredatriplikethis.NowIwouldntmissitforanythinghesays.AbingtonHealthOrthopaedicSpineInstitutejointsspinesportshandstraumarehabWEEKENDWARRIORSORPROATHLETESItmayhavebeenapainfulseasonforEaglesfansbutAbingtonHealthistryingtohelpanyonewhosufferssportsinjuries.DuringthefootballseasonourOrthopaedicSpineInstitutepartneredwithPhiladelphiaEaglesRadioNetworkCBSradio-94WIPtopromoteourexpertiseinsportsmedicine.SurgeonsfromtheOSIofferedinformationtoeducatelistenersaboutavarietyofsports-relatedinjuries.Thesepodcastsfocusingoncommonsportsinjuriescanbeviewedatwww.abingtonhealth.orgsportsmedicinetips.jointsspinesportshandstraumarehabFormoreinformationaboutourminimallyinvasiveproceduresinhipkneeandspinecarevisitwww.abingtonhealth.orgboneorcallusat215-481-BONE2663.Todaywecanperformbettermoreaccuratesurgeriesinalessinvasiveway.AndrewM.StarMDChiefOrthopaedicSurgeryAbingtonMemorialHospitalandmedicaldirectorOSI orseveralyearsVincentLiddle79hadbeenlivingwithanabnormalballooningofhisabdominalaortathemainarterythatsuppliesbloodtothelowerpartofthebody.Doctorshadbeenkeepingacloseeyeontheweakenedbloodvesselwithperiodicultrasoundscans.Hehadnosymptomsandnorestrictions.Hehadbeenspendinghisdaysinsemi-retirementservingparttimeasanEpiscopalpriestatSt.MatthewsChurchinMapleGlen.InOctober2012aroutineultrasoundshowedthatVincentsabdominalaorticaneurysmAAAhadgrown.At5.3centimetersthebulgingbloodvesselcouldeasilyburstwhichcouldresultinmassiveinternalbleeding.WithanabdominalaorticaneurysmwewaittointerveneuntiltheriskofruptureoutweighstheriskofsurgerysaysTheodoreSullivanMDdirectorVascularSurgicalServices.Vincentsarteryhadreachedthatpoint.RemarkablyDr.SullivanwouldnotneedtomakealargeincisioninVincentsabdomentofixtheaneurysm.InsteadhedrepairitbytravelinginsideVincentsaortaguidedbyadvancedimagingtechnology.AdecadeagotheonlysurgicaloptionforVincentwouldhavebeenanopenoperationrequiringasizeableincisionintheabdomen.Thankstoadvancesinmedicaltechniquesandtechnologywecannowofferaminimallyinvasiveproceduretonearly80percentofthosewhorequireAAArepairsaysDr.Sullivan.Theseproceduresresultinlessphysicalstressandpostoperativepainandhaveasignificantlyshorterrecoveryperiodthantraditionalopensurgery.VincentwasthefirstpatientatAbingtonMemorialHospitaltobenefitfromsurgeryinthehospitalsnew3.5millionhybridoperatingroom.LargerthanatraditionaloperatingroomthehybridO.R.isequippedwithhighlydevelopedfluoroscopycontinuousreal-timeX-rayequipmentusedincombinationwith3-Dhigh-definitionvideotechnology.TheimagequalityinthehybridO.R.isabsolutelystellarsaysDr.Sullivan.AlthoughX-ray-guidedproceduresrequireminimalexposuretoradiationthesophisticatedequipmentinthehybridO.R.resultsinevenlessexposureduringproceduresanadvantageforboththepatientandthemedicalteam.ThehybridO.R.combinestreatmentstraditionallyofferedonlyintheinterventionalradiologysuiteorcardiaccatheterizationlaboratorywiththosetraditionallyofferedonlyintheoperatingroom.AMHshybridO.R.oneofonlyahandfulintheregionenablesspecialiststoperformcatheter-basedminimallyinvasiveworkwiththecapacitytoperformfullsurgicalinterventionsifnecessaryinonesetting.Vascularsurgeonscardiothoracicsurgeonsinterventionalcardiologistsinterventionalradiologistsneurosurgeonsandorneurointerventionalistscanworkcollaborativelyinoneroom.PriortotheestablishmentofAbingtonshybridO.R.manyprocedureshadtobestagedfirstinthecardiaccatheterizationorneurovascularlaboratorieswithsurgery6Rev.VincentLiddleBIGRESULTSSMALLINCISIONSthrough scheduledatalaterdate.ThehybridO.R.combinesthebestofbothworldsallowingforasinglehospitalstayandrecoveryforthepatient.TorepairVincentsAAADr.Sullivanperformedanendovascularaorticstentgraft.ThroughsmallincisionsoneachsideofthegroinheusedliveX-raytechnologytoguidecathetersthintubesthroughbloodvesselstothesiteoftheaneurysm.Throughthecatheterhethreadedastentatubecomprisedoffabricreinforcedbymetalmeshandattachedittothehealthypartsofthearteryaboveandbelowtheaneurysm.Oncethegraftwasinplacebloodflowedthroughitremovingpressurefromthesurroundinganeurysm.VincentscasewasalmosttextbookasfarasendovascularAAArepairgoessaysDr.Sullivan.Itwasaplannedprocedurewithagreatoutcome.AlthoughVincentswasarelativelyuncomplicatedsituationthehybridO.R.enablesexpertsatAMHtotreatthehighlycomplexcasestheypreviouslywouldhavehadtorefertoanothercenter.Frequentlysuchcasesarelife-threatening.Vincentwasthrilledwiththeresultsofhissurgery.Ihadverylittlepainafterwardhesays.Ispentjustonenightinthehospitalandaboutaweektakingiteasyathome.HehasresumedhisretirementlifestyleassistingatSt.MatthewsChurch.InadditionheintendstospendsometimeputteringinthegardenvisitingwithgrandchildrenandtakingwalkswithwifeRosemaryandtheirtwodogswhorulethehousehold.ThePillaHeartCenterAbingtonMemorialHospital7amedinmemoryofV.PaulAddonizioMDwhowasChiefofCardiothoracicSurgeryatAMHthehybridoperatingroomisoneofonlyahandfulintheregion.Specialistscanperformcatheter-basedminimallyinvasiveproceduresandhavethecapacitytoperformfullsurgicalinterventionsinonesetting.Vascularsurgeonscardiothoracicsurgeonsinterventionalcardiologistsneurosurgeonsandneuro-interventionalistscantakeadvantageofthenewtechnologywhichservespatientsclinicalneedsandenhancespatientsafety.LargerthanastandardoperatingroomthehybridO.R.accommodatesuoroscopyequipmentfromthecatheterizationlaboratorywithhighdenitionvideotechnologyoftheoperatingroom.Theadditionof3DimagingmonitorsenablesoverlayingtechnologyofMRIandCTscanimaging.ByplacingmultiplemonitorsaroundthehybridO.R.physicianstechnologistsandnursesviewpatientsprogressandvitals.ProceduresperformedinthehybridO.R.includeIEndovascularabdominalaorticrepairIEndovascularthoracicaorticrepairITranscatheteraorticvalvereplacementIMinimallyinvasivevalverepairorreplacementBeforetheadventofthehybridO.R.procedureshadtorstbestagedininterventionalradiologyorcardiaccatheterizationlabswithsurgeryfollowingatalaterdate.ThehybridO.R.allowsforcombinedproceduretechnologyonestayandrecoveryforthepatientamoreefcientandsaferprocess.AdvancementsinTreatingHeartConditionsFREEPleasejoinAbingtonMemorialHospitalsChiefofCardiothoracicSurgeryRohintonMorrisMDforthisinformativeprogram.Hewilldiscussnewtechniquesincardiacsurgeryincludingcoronaryarterybypassgraftingvalvularsurgeryandanewprocedureforcongestiveheartfailure.dateWednesdayAugust28time130PMlocationRydalPark1515TheFairwayRydalLightrefreshmentswillbeserved.toregister215-481-2204orwww.amh.orgSEMINARSWORKSHOPSPATIENTTREATEDINNEWHYBRIDO.R.ToviewavideowithsurgeonsdiscussingthehybridO.R.atAMHvisitourwebsiteatwww.amh.orghybridor.FormoreinformationaboutsurgeonsonstaffatAbingtonpleasecallourphysicianreferralserviceat215-481-MEDIorvisitwww.amh.orgsurgeryorwww.amh.orgphysicians.OPERATINGROOMCOMBINESANGIOGRAPHYANDINTERVENTIONALCAPABILITIESWITHSURGICALTECHNIQUESIThankstoadvancesinmedicaltechniquesandtechnologywecannowofferaminimallyinvasiveproceduretonearly80percentofthosewhorequireabdominalaneurysmrepair.IRETIREDEPISCOPALPRIESTIS 8ItallbeganoverasteaksandwichinDecember2005.JackLawlorhusbandofaveryillAbingtonpatientwasinlineatthecafeteriaandorderedasandwichfromthemostimpressiveshort-ordercookhedeverseenMarkHarris.LunchtimecanbethebusiesttimeofdayforMarkwhotypicallyworksthroughdinnertimeandisoftenjugglingseveralcustomerordersatatime.ButMarksfriendlydispositionandseeinghistalentsinactionactuallyhelpedJacktakehismindoffhiswifesconditionforabit.HiswifeElainehadjustsufferedasecondstrokeinayearandwasingravecondition.EachdayhespentwithhiswifeJackwentdownforlunchandorderedasteaksandwichfromMark.ThenonedayonhiswayoutMarksawJackbytheelevators.HeapproachedJackandsaidWhatareyoudoinghereeverydayItsChristmastime.JacktoldhimofhiswifessituationandMarkwelledupwithtearsrelatingveryclosely.JusttwomonthspriorMarklosthismomandwasstillrawwithemotion.Thetwomentalkedforawhile.STEAKSANDWICHANDAHUGFromthatdayonatlunchtimeMarkwouldcomeoutfrombehindthegrillwhenhesawJackinlineandgavehimabigbearhugaccordingtoJackandaskhowthingsweregoing.IfMarkdidntseehimhedcomeuptotheroomtovisitwithJackandhisfamily.HedaskiftherewasanythingIneededorwantedtoeat.HebroughtupicecreamcandybarsandevenballoonsandcardsfromtimetotimesaysJackwhoaddsthatElainewasinthehospitalfor22days.JackandhisfamilywereatthehospitaloverChristmasandNewYearsEve.AndsadlyhiswifepassedonJanuary112006.MarkwasthereeventhedayshepassedJackadds.ALASTINGBONDButthefriendshipdidntendonceJackandhisfamilyleftthehospital.InfactMarkcalledJackregularlytocheckonhiminthemonthsfollowinghiswifesdeath.HesaverycaringpersonsaysJack.Morethanpeopleknow.Thatbuddingfriendshiphasblossomedintoasteadysupportsystemforeachofthemen.WhenJackcametothehospitaltobetreatedfordehydrationinApril2011Markwastheretocheckonhim.HedsayHeyPopcanIgetyousomethingJackexplains.ItwasthenthatJackrealizedthathewasnttheonlyonewhoknewhowspecialMarkis.EveryonewhoknewMarkwouldsayOhMarkhesthegreatest.Hestouchedalotoflivesatthehospitalinhis13yearsofservicesaysJack.POPANDMARKOvertheyearsMarklosthisbelovedfostermomhissisterandhisfatherandJackwasthereforhimthroughitall.Itslikeafather-and-sontypeofthing.IcallhimPopsaysMark.Wealwayskeepintouch.InfacttheycalleachotherregularlyespeciallyontheirbirthdaysandholidaysaswellasmeetupintheAbingtoncafeteriaforlunch.WhenaskedwhatMarkappreciatesmostaboutJackhesaysHispersonalityHessoftspokenandhecares.Hesareallygoodguy.Theirfriendshiphasbeeninvaluabletoeachofthemtheysay.SomuchsothatattheendofeachconversationtheyhaveneitheroneofthemisafraidtoexpressthemselvesbysayingIloveyouAFriendshipGrowsinAbingtonMarkHarrisandJackLawlorAPATIENTSHUSBANDANDATALENTEDCOOKDISCOVERACOMMONENDURINGCONNECTION 9JudyConnelly56criedthefirsttimeshemountedabikeinheradultyearsandthetiresdidntgoflat.IcriedfortheentirerideIwassoproudandhappysherecalls.IthadbeennearlyayearsinceJudyhadundergoneasurgicalweightlossprocedureatAbingtonMemorialHospitalsInstituteforMetabolicandBariatricSurgeryIMBS.Weighing120poundslessthanshehadtheprevioussummershewasabletoparticipatejoyouslyandconfidentlyinactivitiesthatforyearshadcausedshameandinsecurity.JudysnewleaseonlifebeganinJanuary2010astheresultofhardworkmedicalcomplianceandRoux-en-YgastricbypassRGBthemostcommonsurgicaltreatmentformorbidobesityintheU.S.today.JudywholivesinHollandPAattendedaninformationsessionaboutthesurgicaloptionsofferedatIMBSandeventuallymetwithBariatricSurgeonGintasAntanaviciusDr.G.MD.Basedonherparticularcircumstancesandafteracomprehensivepre-surgicalexamandtestingDr.G.recommendedalaparoscopicRGB.DuringthisprocedurehewouldalsoremoveJudysdiseasedgallbladder.Dr.G.performedJudyssurgerylaparoscopicallyusingspecializedinstrumentstooperatethroughseveraltinyincisionsintheabdomen.Nexthecreatedasmallgastricpouchatthetopofthestomachandseparateditfromthemainstomach.Dr.G.thencreatedanewdigestivepathbypassingtherestofthestomachandthepartofthesmallintestine.Withhersmallegg-sizedstomachJudyfeelsfullfastersosheeatslessfoodandconsumesfewercalorieswhichleadstoweightloss.Inadditiontoimprovingqualityoflifethroughweightlossgastricbypassproceduresreduceoreliminateobesity-relatedmetabolicproblemssuchashighcholesterolhighbloodpressuresleepapneajointpainandmostimportantlydiabetesexplainsDr.G.TakeJudyforexample.Sincesurgeryhersleepapneahasimprovedshenolongertakesprescriptionpillsforhighbloodpressureandhasgreatlyreducedthefrequencyofcortisoneinjectionsforherkneeandlowerbackpain.FurthermoreIdontsweatlikeIdidpriortosurgeryIglownowshesays.NomoreseatbeltextenderwhenIfly.Icanfitintheseatontheboardwalkpirateshipride.Imnolongerconfinedtolifeinachair.Judyssuccessisnosecret.IfollowedeverypartoftheInstitutesextensiveprogramtoaTshestressesfrompre-surgicaltestingtopreparationfortheprocedureandthevitaminandnutritionalrequirementsaftersurgery.JudynotestoohowvaluableithasbeenforthetreatmentteamatIMBStokeepherprimarycarephysicianinformedeverystepoftheway.ShehasbeensopleasedwithherresultsJudynowvolunteersasanangelwiththeprogramsbariatricsurgerysupportgroup.Imaliferhereshesayscommittedtothemonthlymeetings.Istruggledwithmyweightmyentirelife.IcouldnotdothisonmyownandIdonthaveto.Iwantotherstoknowtheyarenotalone.AFTERSUCCESSFULGASTRICBYPASSSURGERYSEMINARSWORKSHOPSWomanStepsofftheRollercoasterRideofWeightManagementJudyConnelly2009JudyConnelly2010InstituteforMetabolicandBariatricSurgeryInformationSessionsFREEBariatricsurgeryistheonlyprovenprescriptionforlong-termweightlossforthosestrugglingwithobesity.Pleasejoinusforaninformationalseminarwellexplainyouroptionsanswerquestionsandshowyouhowourprogramcanliterallysaveyourlife.datesfirstTuesdayofthemonthtime630to830PMlocationAbingtonMemorialHospitaldatesthirdThursdayofthemonthtime630to830PMlocationLansdaleHospitaldatessecondThursdayandfourthTuesdayofthemonthtime10AMto12NOONlocationAHCWarminstertoregister215-481-2204orwww.amh.orgIstruggledwithmyweightmyentirelife.ICOULDNOTDOTHISONMYOWNANDIDONTHAVETO.IWANTOTHERSTOKNOWTHEYARENOTALONE. 10LastMayJoannePottshadapersistentcoughshecouldntkick.UponhersecondofficevisitherdoctororderedachestX-rayandreferredJoannetoaspecialist.Joannewasstunnedtolearnthatwhatshethoughtwasacoldwasactuallylungcancer.Furthermoreithadspreadtoalymphnodeinthecenterofherchest.WhenthedoctortoldmeIhadcancerIwassoshockedIdidntutterawordrecallsJoanne.InthemidstofmydistressmyhusbandThomasbravelyremindedmethatallsicknessisntdeath.Hiswordshelpedmeinmyresolvetotakeonedayatatime.AseriesoftestsatAbingtonMemorialHospitalshowedthelemon-sizedmassinJoannesrightlungwasnon-smallcelllungcancer.KeytoeffectivetreatmentwouldbedeterminingthestageofJoannesdisease.WithoutmakingasingleincisionseesidebarPulmonologistRajPatelMDusedaminimallyinvasivetechniquetocollectatissuesampleoftheaffectedlymphnodeinthecenterofJoanneschest.ApathologistwouldstudyitunderamicroscopetostageJoannescancer.ForpatientsnewlydiagnosedwithlungcancerAMHholdsaPulmonaryCancerEvaluationConferenceatTheRosenfeldCancerCentereverytwoweeks.AllphysiciansinvolvedinthepatientscaresurgeonspulmonologistsradiologistspathologistsandradiationandmedicaloncologistsmeetspecificallytodiscusseachcaseexplainsJohnRedmondMDchiefMedicalOncologyandmedicaldirectorRosenfeldCancerCenterAMH.TogetherthismultidisciplinaryteamofexpertsreviewedJoannescaseincludingtheresultsofallherdiagnostictests.BasedonthestageofJoannescancertheCentersexpertsdevelopedanindividualizedtreatmentplanforJoannederivedfromrecommendationsoftheNationalComprehensiveCancerNetworkNCCN.Thisallianceof21oftheworldsleadingcancercentersdevelopsandpublishesguidelinesforoncologycare.Theguidelinesarebasedonscientificevidencefromsignificanttrialsandstudiesandincludetreatmentrecommendationsfor97percentofcancers.ForJoanneAMHspecialistsproposedsurgicalremovalofthetumor.Tomakeitoperabletheywouldneedtoreduceitssizefirstusingacombinationofradiationtreatmentsandchemotherapy.ItrustedthatthesemedicalexpertscoulderadicatemycancersaysJoanne.Myjobwastostayhealthycontinuewiththerapiesandcontinueinmyfaithinorderforthemasstoshrinkenoughforsurgicalremoval.OverthecourseoffiveweeksJoannecompleted15radiationtreatmentsandfivesessionsofchemotherapy.ThroughouttheprocessJoanneprayedandkeptajournal.ShejoinedasupportgroupatAMHandparticipatedinchairyogaguidedmeditationandhealingtouchtherapy.Theregimenworked.Thetumorshrank.InOctoberaportionofJoannesrightlungwasremovedinaminimallyinvasiveprocedure.Thetraditionalopensurgeryrequiresalongincisionfromfronttobackononesideofthebody.Insteadthesurgeonoperatedthroughseveralsmallincisionsusingspecializedinstrumentsandatinycameraendoscopetomagnifyhisviewonalargevideoscreen.Forpatientstheendoscopicproceduremeansfarlesspost-operativepainlessscarringandamorerapidrecovery.WhenDr.RedmonddeliverednewsofJoannespost-operativetestresultsheannouncedthatsheandherfamilyshouldthrowavictoryparty.Joannewasincompleteremission.Therewasnosignofcancer.Joannehasspentthemonthsfollowingsurgeryregainingherstrengthandcaringforherfamily.Shealsowroteanarticleaboutherexperienceforherchurchbulletin.Sheiseagertoresumehervolunteerworkatanelementaryschoolandisespeciallyexcitedaboutrejoiningherbowlingteam.WhenIreflectonmyjourneyImsogratefultomyfamilythemedicalteamatAbingtonMemorialHospitalandmyfamilydoctorwhogottheballrollingsaysJoanne.Ialsorealizemyspiritualfoundationprovedtobethepathtomyemotionalandphysicalwell-being.Thisexperiencewillenablemetosharemystorywithothersfacingthesechallenges.Idliketogivethemthehopetheywillneedtosurviveandlivefullandmeaningfullives.LUNGCANCERISINCOMPLETEREMISSIONAFTERPERSONALIZEDTREATMENTCelebrateGoodTimesComeOnFormoreinformationaboutTheRosenfeldCancerCenterandourservicesvisitwww.amh.orgcancerorcall1-800-405-HELP.WhenIreflectonmyjourneyIMSOGRATEFULTOMYFAMILYTHEMEDICALTEAMATABINGTONMEMORIALHOSPITALANDMYFAMILYDOCTORWHOGOTTHEBALLROLLING. 11NEWTECHNIQUEREACHESDEEPLUNGTISSUEWITHGREATPRECISIONSpecialistsatAMHarenowusingGPS-likenavigationbronchoscopytotravelintotinylungnodulestomoreaccuratelylocatediagnoseandplanforthetreatmentoflungcancerdeepinsidethelungs.Usinganadvancedbronchoscopysystempulmonologistscanaccesssmalllungnodulesthatwerepreviouslybeyondthereachofaconventionalbronchoscopeathinexibletubewithalightedtipwhichispassedthroughthewindpipetoinspectthelungs.Aspecializedprobetsthroughthebronchoscopetoreachtinylungnodulesusingthree-dimensionalchestcomputedtomographyCTtoreconstructavirtualimage.NotonlycanwebiopsythesetinynodulesbutiftheyarecancerouswecanplacemarkersattheirpreciselocationssotheyareeasilytraceableforsurgeryorradiationtreatmentexplainedAMHpulmonologistRajeshkumarPatelMD.ThisisthemostrecentadditiontotheadvancedproceduresAMHpulmonologistsusetodiagnoseandstagelungcancer.Inadditiontoconventionalbronchoscopytheyalsoperformendobronchialultrasound-guidedbiopsyoflymphnodes.Dr.PatelandhiscolleagueWilliamL.WardDOhaveperformedmorethan100oftheseproceduresinthetwoyearssincethemethodwasintroducedatAMH.Formoreinformationaboutourlungnoduletestingprogramandthelungscreeningprogramrecommendedforlongtimesmokersvisitourwebsiteatwww.amh.orgcancerorcall215-481-LUNG.LungcancerisaleadingcauseofdeathintheUnitedStates.Arecentnationalstudyshowedthatcurrentorformerheavysmokerswhoreceivelow-dosescreeningCTscanshavea20percentdecreaseinmortalitycomparedtoroutinechestx-rayfromlungcancer.WiththatinmindAbingtonMemorialHospitalhaslaunchedthisnewprogram.criteriaICurrentorformersmokers55to74yearsoldhavingquitwithinthepast15yearsISmokinghistoryofatleastonepackadayfor30yearsortwopacksperdayfor15yearsINohistoryoflungcancerfeeMostinsurancecompaniesdonotcurrentlycoverthecostsofthisscreeningthefeeisforthisserviceis350.information215-481-LUNGPROGRAMSCREENINGJoannePottsLungScreeningProgram 12SutiefirstbecameawareofherconstanttwitchesticsandvocalizationsatageeightalthoughshewasntdiagnosedwithTourettessyndromeTSuntilshewas13.TSisaninheritedneurologicaldisordercharacterizedbyrepetitiveinvoluntarymovementsandvocalizations.ThereisaverycomplexgeneticbasisforTourettesexplainsSutiesAbingtonMemorialHospitalNeurologistJamesCookMD.Expertssuspectthedisorderiscausedbyabnormalitiesincertainareasofthebrainthecircuitsthatconnectthemandtheneurotransmittersbrainchemicalsthattransmitmessagesamongbraincells.Tourettessyndromeismuchmorecommonthanmostpeoplerealize.Studiesshowthatnearly1percentofthepopulationexhibitsTourettesinsomeformwiththeprevalencebeinghigherinschool-agechildrenandlowerinadults.Thesyndromesonsetoccursmostcommonlybetweentheagesofsevenand15.Inmanychildrenticsdisappearduringadolescence.Butinnearlyone-thirdofthosewithTourettesticscontinuethroughoutadulthood.AdiagnosisofTourettesisbasedontheexpressionofavocalticandmultiplemotortics.SimplemotorticsassociatedwithTSmayincludeeyeblinkingshouldershruggingslappingorhead-tossing.Complexmotorticsincludepatternsofmovementsuchasaheadtosscombinedwithajumportwist.Ticscanbedangeroustoo.Someareself-injuringsuchashittingoneself.NobodyhasidenticalticssaysDr.Cook.Theticscanwaxandwanesometimesgoingawayforperiodsoftime.Theycanalsochangeinnatureovertime.ManywithTourettessimultaneouslyexperienceotherneurologicaldisorderssuchasattentiondeficitdisorderandobsessivecompulsivedisorderOCD.FewpeopleunderstandtheintensepsychologicalcomponentofTS.Sutiedescribesherticsasmoderatebutburdensome.Theyareall-consumingandcanbepainfulphysicallytaxingandexhaustingshesays.ToexplaintheconnectionbetweenTourettesandOCDSutiesaysthatwhileshecansometimessuppressaticitisimpossibletosuppresstheurgetotic.IstarttofeellikeImgoingtojumpTourettesADancingDisorderExploreTourettessyndromethroughdanceandmusicwithBandofArtistsdanceteamandmusicianStephenDiJoseph.LearnthehistorycausesdiagnosisandtreatmentsofTourettessyndromepresentedbyJamesCookMDneurologist.ThisentertainingperformanceandinformativelecturewillunveilTourettessyndromeandrevealitscreativeintelligence.Co-sponsoredbyTheNeurosciencesInstituteatAbingtonMemorialHospitalandPennStateAbington.PERFORMANCELECTUREGIVINGVOICETOTHEMOVEMENTMUSICBEAUTYSUTIEMADISON32MOVESALOT.ASANARTISTDIRECTORANDCHOREOGRAPHERITSPARTOFHERWORK.ASAWOMANLIVINGWITHTOURETTESSYNDROMEITSPARTOFHERLIFE.SutieMadison NeurosciencesInstituteAbingtonMemorialHospital13GettingtothenearestemergencycenterandthenaccessingtheadvancedcareattheAMHNeurosciencesInstituteviatelemedicinemeantthatDawnHaldemanofMalvernreturnedhomewithnolastingeffectsaftersufferingtwoseverestrokes.SEPTEMBER182012timesshownaremilitarytime1100AMDawnHaldemanhaddysarthriaslurredspeechringinginherearsweaknessandlossofsensationonherrightside.ShewastakentoPhoenixvilleHospitalbyalocalEMSteamwhereshewasdiagnosedwithastroke.1208PMJamesM.BurkeJr.MDAMHneurologistmadethetelemedicineconnectionfromAbingtonMemorialHospital.1247PMClot-bustingdrugrT-PAadministeredintravenouslyatPhoenixvilleHospitalwithcompleteresolutionofhersymptoms.1510PMMs.HaldemanarrivedatAMHandwasadmittedtotheNeuroIntensiveCareUnitformonitoring.1615PMSheexperiencedrecurrentright-sideweaknessslurredspeechandbecamecomatoseasecondstroke.1630PMOsmanKozakMDatbedsideelectstotakeheremergentlytotheNeurovascularLaboratory.1647PMSeverestenosisinleftvertebralarteryandcompleteocclusionofthebasilararteryaddressedbyangioplastystentingandmechanicalthrombectomy.SEPTEMBER191030AMExtubatedremovedbreathingtubeSEPTEMBER200810AMMs.Haldemanclearedbyphysicaltherapytogohome.Thenshealsopassedaswallowtest.SEPTEMBER211030AMShewasclearedbyoccupationaltherapytogohome.1500PMMs.Haldemanwasdischargedtoherhomeafterhavingsufferedtwoseverestrokes.SheisbackhomewithherdogSambacktoworkandhasnoimpairments.IToreadthefullstoryaboutMs.Haldemanscarevisitourwebsiteatwww.amh.orgbrainandclickonpatientstories.IdateFridayApril12time730to9PMlocationPennStateAbingtonSutherlandAuditoriumfee15perperson.NofeeforPennStateAbingtonstudents.toregister215-481-2204orwww.amh.orgoutofmyskinifIdontticshesays.Mybrainisconstantlycommandingmybodytomoveortic.Inawaythesemovementsareaphysicalmanifestationofmycompulsivenature.TreatmentforTSmayincludemedicationsuchasminorandmajortranquilizersamongothersbutmanyofthesedrugscausedrowsinessorsedation.Cognitive-behavioraltherapymayalsobehelpful.Forexamplethepatientisencouragedtocountertheurgetoticbyengaginginanotheractivity.TreatmentmustbetailoredtotheindividualstressesDr.Cook.TURNINGTOURETTESINTOARTSutiebeganexperimentingartisticallywithherticsaftergraduatingfromArcadiaUniversitywhereshestudiedpainting.ArcadiaassociateprofessorAlanPowellarenownedvisualartistencouragedSutietouseherticsindevelopingvideoperformancepieces.DuringthistimeIrealizedthatmyticsservemeasapersonallanguagesystemshesays.Becausetheyarekineticinnaturetheybecomeakindofdance.AwakeningtoherinherentgiftsmotivatedtheAmblerresidenttoeducateothersaboutTourettessyndromeandpromotetolerance.In2011SutiefoundedBandofArtistsBOAagroupofeducatorsperformerspresentersandscientistswhostrivetocreateawarenessaboutneurologicaldisorders.BOAsproductionsincludeperformingartselementssuchasmoderndanceandlivemusicaswellasascientificcomponent.AsdirectorandchoreographerSutieusesphysicalandvocalticsbothherownaswellasothersasafoundationforchoreography.ThescientificpartoftheshowfeaturesalecturebyDr.Cookfollowedbyanopendiscussionwiththeaudience.Dr.Cookalsoservesontheorganizationsboard.Sutieisproudofherteammembersandpassionateabouttheirmission.Ultimatelymygoalistodrawfromothersthroughdevelopingcollaboratinganddirectingdifferentmediapiecesscientificlecturesandperformingartseventsshesays.Eachwillhighlightbothsocialandselfawarenessinthelivesofpeoplewhohavethecouragetoembracetheirchallengesbyfindingauniquewayofexpressingthem.FormoreinformationaboutTourettessyndromeandBandofArtistsortogetinvolvedvisitwww.bandofartists.org.ANDSCIENCEOFTOURETTESSYNDROMETIMELINETOCAREFORSEVERESTROKEPATIENT......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................DawnHaldeman AMHTurns100Joinusforayear-longpartyInMay2013werelaunchingtheAMHat100websiteourCentennialhubawaytoexplorethepastandsharestoriesplusfunideasforkids.AdailyFacebookpost365AMHFactswillfeatureinterestingfunhistoricalfactsandphotos.AHFWomensBoardCelebratesLongbeforeAMHs1914openingourWomensBoardwasbusyplanningandraisingfunds.ThisyeartheymarkoveracenturyofsupporttoAMHwithcommunityfunandfundraising.CelebrateattheJuneFetesmemorabilia-lledhistorytentdancethenightawayattheGalaenjoytheHolidayHouseTourandmuchmore.LearnMoreVisitwww.amh.orgfordetailsandLiketheAMHFacebookpage.WHATDOCHICKENSWHISKEYANDFLYSWATTERSHAVEINCOMMONAllarelistedasin-kinddonationsinAMHannualreportsfromthe1920s. ConcussionProgramforYoungAthletesInSeptemberourNeurosciencesInstituteannouncedaconcussionprogramtoeducatecoachesparentsandathletesaboutsignssymptomsandtreatmentofconcussion.Gearedparticularlyforschoolandcommunityathleticprogramsourneuroandsportsmedicinespecialistsinconjunctionwithtraumaspecialistshelpdiagnoseandtreatathleteswhohavesufferedheadinjuries.InadditiontodiagnosisandtreatmentofconcussiontheprogramcanprovideIInformationaboutrecognizingsignsandsymptomsofconcussion.IGuidanceonwhentoseekemergencycare.IEducationalprogramsforschoolsathletesandorcoaches.Arrangeforapresentationbyourprogramsnurseeducatorandorphysiciansatyourschool.Formoreinformationvisitourwebsiteatwww.amh.orgbrainorcall215-481-HEAD4323.AllAROUNDABINGTONHEALTHNewSleepDisordersCenterLocationOpensAbingtonHealthssleepspecialistsannuallyevaluatediagnoseandtreatmorethan3000patientswhoareexperiencingsleepdisorders.AMHscenterincludesastaffofspecialistswhoareboard-certifiedinsleepmedicineplusmulti-disciplinaryphysicianexpertsinneurologyotolaryngologypediatricspulmonologyandoralmedicine.OurnewestcenterisconvenientlylocatedinBlueBellatSuite201686DeKalbPike.SleepDisordersCentersarealsolocatedatAbingtonMemorialHospitalLansdaleHospitalAbingtonHealthCenterSchillinginWillowGroveAbingtonHealthCenterWarminsterandinSellersville.Allourlocationsfeatureupdatedcomfortableroomsandthelatesttechnologyinsleepmonitoring.Studiesfocusoneachindividualpatientandasappropriatehomemonitoringisalsoavailable.Foranappointmentatanyofourlocationscall215-481-EXAM3926.FortheSellersvillelocationpleasecall215-453-8106.Moreinformationaboutthecentersisavailableonourwebsiteatwww.amh.orgbrainorwww.AHLansdale.org.HeartFailureExpertJoinsPillaHeartCenterDonaldC.HaasMDhasjoinedAbingtonMemorialHospitalsComprehensiveHeartFailureProgram.HeisboardcertifiedinAdvancedHeartFailureandCardiacTransplantationCardiovascularDiseaseandInternalMedicineandisdesignatedasaclinicalspecialistinHypertensionbytheAmericanSocietyofHypertension.Heservesasco-directoroftheHeartFailureProgramandmedicaldirectoroftheVentricularAssistDeviceProgram.Dr.Haashasextensiveexperienceinheartfailuremanagementatanumberofmedicalcenters.AgraduateofNewYorkUniversitySchoolofMedicineDr.HaascompletedhisresidencyinInternalMedicineatHarvardMedicalSchoolMassachusettsGeneralHospital.HecompletedhisfellowshipsinCardiovascularDiseaseandAdvancedHeartFailureattheMountSinaiSchoolofMedicineinNewYork.From1996-2000Dr.HaasservedintheUnitedStatesNavyultimatelyachievingtherankoflieutenantcommander.Formoreinformationvisitourwebsitewww.amh.orgphysiciansortomakeanappointmentwithDr.Haaspleasecall215-481-4100.AbingtonHealthNamedMostWiredAbingtonHealthhasbeenrecognizedasoneofthenationsMOSTWIREDaccordingtotheresultsofthe2012MostWiredSurveyintheJulyissueofHospitalsHealthNetworksmagazine.ThenationsMostWiredhospitalsareimprovingperformanceinanumberofareasthroughtheadoptionanduseofhealthinformationtechnologyaccordingtotheMostWired2012SurveywhichisconductedincooperationwithMcKessonCorporationtheCollegeofHealthcareInformationManagementExecutivesCHIMEandtheAmericanHospitalAssociation.AbingtonHealthisanonprofitorganizationandwelcomesthesupportofourcommunityforallofourservicesandprograms.IfyouwouldlikeinformationabouthowyoucanmakeagiftofcashstockorabequestinyourwillpleasecontacttheOfficeofPhilanthropyat215-481-4438.YoucanalsovisittheWaysofGivingsectionofourwebsiteatwww.abingtonhealth.orgorusethepostage-paidenvelopeinthisissue.15 SPRING2013PublishedbythePublicRelationsandMarketingDepartmentatAbingtonHealth.Tocontactuspublicrelationsamh.orgor215-481-2300.1200OldYorkRoadAbingtonPA19001www.abingtonhealth.orgTHEPOWERTOHEALScanthisQRCodeandvisitournewmobilesite.OpeninginSummer2013ANEXCITINGNEWOUTPATIENTCENTERWITHIprimarycareIobstetricsgynecologyIneurologyIradiologyIlaboratoryIotherspecialties721ARBORWAYBLUEBELL