St. Clair Hospital HouseCall_Volume 5 Issue 2
St. Clair Hospital's community newsletter sharing new medical technologies, patient stories and health tips.
VOLUME V ISSUE 2 HouseCall Center of Healthcare Expanded Outpatient Center Debuts in Bethel Park Page 2 The New Restored to South Park resident Tami Mikush was clinically dead for 45 minutes. St. Clair Hospital doctors, advanced technology, and her determination to live brought her back from the brink. Her amazing story begins on Page 10. life inside New Physician Spotlight I Ask The Doctor: Low Testosterone Treatment In The Swing Of Things: Summer Swing Date Announced I In The Community Continued GroWth Outpatient Center at Village Square-Bethel Park St. Clair Hospital The newly expanded St. Clair Hospital Outpatient Center at Village Square is a response to patient desire to access healthcare services in a way that is convenient and efficient. 2 I HouseCall I Volume V Issue 2 outpatient facility triples in size and makes accessing healthcare services simple and convenient. ThE CrEATion oF A onE-STop ouTpATiEnT CEnTEr AllowS pATiEnTS To hAvE TESTS, SEE A phySiCiAn, unDErgo ThErApy, AnD EvEn EnJoy A SpECiAlTy CoFFEE. All unDEr onE rooF. E xtensive renovations at St. Clair Hospital Outpatient Center–Village Square are nearing full completion, but patients are already enjoying a wealth of healthcare services conveniently located on three floors, all Grouping these services allows patients to see a number of physicians and obtain healthcare services in one day, all under the same roof ― a response to patient desire to access healthcare services in a way that is convenient and efficient. Moreover, a new café will soon be added to the Outpatient Center so patients can enjoy a specialty coffee and a bite to eat in a warm, inviting atmosphere. What follows over the next six pages is a floor-by-floor breakout of services at the Outpatient Center-Village Square and corresponding contact information for each. We encourage HouseCall readers to save this handy guide for future reference. Meantime, welcome to the new St. Clair Hospital Outpatient Center–Village Square. We look forward to taking care of you and your family. Continued on page 4 in one accessible, easy-to-navigate building across Fort Couch Road from South Hills Village mall. You'll find easy access to a wide range of healthcare services and physicians, including lab, imaging and other diagnostic services, occupational medicine, physical therapy, breast care, pain management, diabetes care, and cardiac testing, along with physicians in primary care, endocrinology, ear/nose/throat, orthopedics, cardiology and more. And coming soon: an urgent care center that will be open every day of the year, including all major holidays. An artist’s rendering of the soon-to-open South Hills Cardiology Associates’ suite on the Third Floor. Volume V Issue 2 I HouseCall I 3 Continued GroWth Continued from page 3 First Floor A diaGnoStiC Center B Café 4 at villaGe Square Long considered the heart of the overall Outpatient Center, the Diagnostic Center’s easy check-in service and comfortable, spacious waiting area are a gateway to the Center’s many services, such as: • Lab, which includes blood draws and • specimen X-ray collection, and • Imaging, which includes X-ray, CT, MRI, and more. • MRI • CT scan To contact the Diagnostic Center, please call 412.942.7100. CominG Soon! Patients and visitors to the Outpatient Center will be able to sip a cup of specialty coffee and get a bite to eat at the Center’s soon-to-open Café 4 at Village Square. The sit-down café will be offering some of the same popular menu items as its namesake at the Hospital. In addition to its famous coffee, those items will include danish and bagels, baked goods, salads and sandwiches, nuts and dried fruits, and more. A selection of bottled beverages suitable for breakfast and lunch will also be available. C A B D E A diaGnoStiC Center B Café 4 C rehabilitation ServiCeS D urGent Care E valet ServiCe 4 I HouseCall I Volume V Issue 2 C rehabilitation ServiCeS D urGent Care PHYSICAL THERAPY St. Clair Hospital’s Outpatient Physical Therapy Department, or PT, has long been recognized for its highly skilled team of licensed physical therapists. The newly renovated and greatly expanded space at the Outpatient Center has allowed the installation of new state-of-the-art equipment and the introduction of enhanced treatment options for patients. Physical therapists use a variety of treatment techniques, such as exercise; gait training; balance activities; heat/cold modalities; electrical stimulation; traction; and tissue mobilization/manual therapy techniques to aid patients. OCCUPATIONAL THERAPY With a personalized plan of care, patients are assisted in resuming activities integral to participation in independent self-care, home and work-related skills, and leisure activities. SPEECH THERAPY Utilizing comprehensive assessments and therapy materials, the department’s team of specialized healthcare professionals identifies and treats a variety of speech conditions and disorders. To contact Rehabilitation Services, please call 412.942.7122. CominG Soon! Today’s urgent care centers are designed to take care of patients who become ill or are injured, but their conditions are not serious enough to warrant a trip to an Emergency Room. St. Clair Hospital’s Urgent Care center will be a brand new addition to the Outpatient Center, and will offer on-demand care for minor injuries, colds and flu, physical exams for after-school sports, and vaccinations. The Urgent Care Center will be open 9 a.m. to 9 p.m., seven days a week, 365 days a year and will be staffed by board-certified physicians. Follow-up care will be coordinated with patients’ personal physicians. Patients visiting the Center do not make appointments. They simply walk in and ask to see a doctor. E free valet ServiCe Free valet parking is available for patients of the Outpatient Center and physician practices. Visitors to other building tenants may also use valet parking for a nominal fee. Volume V Issue 2 I HouseCall I 5 Continued GroWth Continued from page 5 Second Floor A South hillS orthopaediC SurGery aSSoCiateS B preferred primary Care phySiCianS, inC. South Hills Orthopaedic Surgery Associates is home to a leading team of surgeons who specialize in the care of the musculoskeletal system, with emphasis on the spine, neck, shoulder, elbow, wrist, hand, hip, knee, foot and ankle. Whether it is repairing a torn ACL (anterior cruciate ligament) in the knee of an athlete, performing intricate hand or shoulder surgery, or completing a joint replacement of a patient's hip, the surgeons at South Hills Orthopaedic Associates are committed to helping their patients regain motion and be more active without fear of pain or further injury. To contact South Hills Orthopaedic Surgery Associates, please call 412.283.0260 or 888.817.2019. The office of Preferred Primary Care Physicians (PPCP) at Village Square is staffed by board-certified physicians who specialize in family practice. They provide primary care services with an emphasis on wellness and preventative care. To contact PPCP, please call 412.831.1522. (left to right) Damon B. Combs, D.P.M., Brett C. Perricelli, M.D., Eric D. Nabors, M.D., Derrick J. Fluhme, M.D., and Christopher M. Manning, M.D. Kevin G. Kotar, D.O., (l) and John L. Bobby, D.O. B C D1 D2 A E B preferred primary Care phySiCianS, inC. A South hillS orthopaediC SurGery aSSoCiateS C oCCupational mediCine Center D1 Center diabeteS D2 aSSoCiateS in endoCrinoloGy E South hillS ent aSSoCiation 6 I HouseCall I Volume V Issue 2 C oCCupational mediCine Center D1 diabeteS Center The Occupational Medicine Center is under the direction of an experienced certified occupational medicine physician who promotes and maintains the health of workers and provides client companies with personalized, professional and cost-effective healthcare. The Center also offers medical services for individuals traveling overseas, including vaccinations and immunizations. To contact Occupational Medicine, please call 412.942.7115. The Diabetes Center provides comprehensive, personalized diabetes care and management, with diabetes educators and registered dietitians in one convenient location. The Center’s highly trained staff is very experienced in diabetes care and management, and assists patients in managing their condition and understanding how it impacts their lives. As part of its Empowerment Program, Center staff works with patients and their primary care physicians to provide the comprehensive education and support patients need to stay healthy and reduce the risk of complications. Patients receive a personalized plan on blood glucose monitoring, insulin administration, diabetes medications, exercise strategies, meal planning, sick-day management, and more. To contact the Diabetes Center, please call 412.942.2151. D2 aSSoCiateS in endoCrinoloGy Associates in Endocrinology specializes in the care of diabetes, thyroid disease, osteoporosis, hormonal disorders and metabolism. To contact Associates in Endocrinology, please call 412.942.2140. Christopher G. Maropis, M.D. (r) Bridget Beier, D.O., (l) and Camille Buonocore, M.D. E South hillS ent aSSoCiation throat care. The physicians and audiologists at South Hills ENT Association combine compassion, expertise and integrity in the care of every patient. Services there include: • Head and neck surgical oncology and reconstructive surgery • Thyroid surgery • Facial plastics • Allergy • Sinus surgery • Sleep apnea • Snoring • Otologic surgery • Vestibular disorders • Audiology • Hearing aid dispensing The branch of medicine and surgery that specializes in the diagnosis and treatment of disorders of the head and neck is called Otolaryngology, but most people refer to it simply as ear, nose and To contact South Hills ENT Association, please call 412.831. 7570. (left to right) David P. DeMarino, M.D., Stephen F. Wawrose, M.D., Brian R. Elford, M.D., and Paul Scolieri, M.D. Volume V Issue 2 I HouseCall I 7 Continued GroWth Continued from page 7 Third Floor A CardiaC diaGnoStiCS B evron endoCrinoloGy aSSoCiateS/ robert t. JohnSton, m.d. The new Cardiac Diagnostics Center offers patients a full range of diagnostic testing, including EKG, holter monitoring, echocardiology, stress testing, and nuclear cardiology. To contact Cardiac Diagnostics, please call 412.942.7900. Endocrinologist Wayne A. Evron, M.D., and Internal Medicine Physician Robert T. Johnston, M.D., share this suite. Dr. Evron specializes in the care of diabetes, thyroid disease, hormonal disorders, hypertension and osteoporosis. Dr. Johnston offers a full range of internal medicine and primary care services. Dr. Evron Dr. Johnston To contact Dr. Evron, please call 412.942.7295. To contact Dr. Johnston, please call 412.4 71.3061. B A D F C E D South hillS CardioloGy aSSoCiateS A CardiaC diaGnoStiCS B evron endoCrinoloGy aSSoCiateS/robert t. JohnSton, m.d. C KeyStone pain ConSultantS, ltd. E breaSt Care Center F ConferenCe room 8 I HouseCall I Volume V Issue 2 C KeyStone pain ConSultantS, ltd. E breaSt Care Center Staffed by Jorge N. Rivero, M.D., who specializes in pharmacologic and interventional management of pain, Keystone offers a host of acute and chronic pain services designed to support and speed healing and relieve suffering. Chronic back pain sufferers, for example, may benefit from epidural steroid injections, facet joint injections, neurolytic blocks, spinal cord stimulators and intrathecal Dr. Rivero St. Clair Hospital launched a new era in women’s healthcare with the October 2012 opening of its new, state-of-the-art Breast Care Center at Village Square. Designed with a spa-like ambience, the Center offers the most advanced diagnostic imaging technology in an environment of comfort, convenience and beauty. The Center also features a new technology called 3D breast tomosynthesis, which has been credited in a recent study with a significant increase in cancer detection rates, particularly for invasive cancers, and a simultaneous decrease in falsepositive rates, when used with traditional mammography. Patients also have access to stereotactic biopsy, a procedure that uses a computer and imaging to localize a tumor, or small calcifications, which can be an early sign of breast cancer, and guide the removal of tissue for examination by a pathologist. drug delivery system implants. All patients must be referred by their primary care physician, oncologist, or another medical doctor. To contact Keystone Pain Consultants, LTD., please call 412.942.5786. D South hillS CardioloGy aSSoCiateS D This seven-physician practice offers a wealth of services that focus on the diagnosis and treatment of conditions and diseases involving the heart and vascular system at large. In addition to providing an array of diagnostic testing, the cardiologists are available 24 hours a day, seven days a week to provide scheduled and emergency cardiac care. The highly trained cardiologists also offer patients undergoing heart catheterizations the option of having a “cath” performed through the radial artery in the wrist instead of the traditional femoral artery in the groin, a procedure that offers several advantages, including less bleeding and faster recovery time. To contact South Hills Cardiology Associates, please call 412.851.0279. To contact the Breast Care Center, please call 412.942.3177. Sherri H. Chafin, M.D., and Raye J. Budway, M.D. additional St. Clair hoSpital phySiCianS at villaGe Square are: Family Practice: John E. Popovich, M.D. To contact Dr. Popovich, please call 412.854.5491. Hematology/Oncology: Louis Pietragallo, M.D.; Robert Volkin, M.D.; Ronald Fierro, M.D.; Vincent Reyes, M.D.; Robert Vanderweele, M.D. To contact any of the above physicians, please call 412.831.1320. Internal Medicine: Joel D. Warshaw, M.D. To contact Dr. Warshaw, please call 412.833.2233. (left to right) Mark K. Greathouse, M.D., John P. Girod, D.O., Robert N. Shogry, M.D., James H. MacDougall, M.D., Harshad R. Mehta, M.D., and Jeffrey M. Friedel, M.D. Not pictured, Jeffrey C. Liu, M.D. Rheumatology: David J. Helfrich, M.D. To contact Dr. Helfrich, please call 412.854.3491. Volume V Issue 2 I HouseCall I 9 patient profile FROM DEATH TO life Tami Mikush is given a second chance at life after a heart attack throws her heart out of normal rhythm. 10 I HouseCall I Volume V Issue 2 T go numb. amara “Tami” Mikush (pronounced Mick-ish) remembers that fateful Friday night in late October 2012 like it was yesterday. But only the first part of the night. Because later that night … she was clinically dead. For 45 minutes. “I was getting ready for bed around 11 p.m. As soon as I got into bed, I felt something was wrong; something wasn’t right. It was almost like a panic attack. I felt sweaty and I could feel my heart beating.” Tami, 53, says she got out of bed and sipped on a glass of water in an attempt to calm herself down. When that failed, she woke her husband. “I think we need to call an ambulance,” she told him. Seconds later, she felt her left arm Paramedics arrived and told her she was having a heart attack. The ambulance crew rushed her to the Emergency Room (ER) at St. Clair Hospital. inTervenTional cardiologisT James w. marcucci, m.d., remembers Tami crying ouT, “please don’T leT me die,” JusT as she began To lapse in and ouT of consciousness. As she was being transferred from the ambulance stretcher to a bed in the ER, Tami says, “My heart stopped.” Her doctors told her later that her heart had stopped its normal rhythm and instead was in “ventricular fibrillation” (V-fib) in which it was quivering and no longer sending oxygen-rich blood to her heart, brain and other vital organs. ER staff quickly used an electrical device known as a defibrillator to restore her trembling heart to its normal rhythm. They then transported Tami to the adjoining Catheterization Lab where Interventional Cardiologist James W. Marcucci, M.D., was preparing to insert shock to her heart did not restore it to its natural rhythm. Dr. Marcucci and Cath Lab staff declared a Code Blue and immediately began Cardio Pulmonary Resuscitation (CPR) to manually provide oxygen to the heart, brain and other vital organs until normal heart and pulmonary function could be restored. Within seconds, some 10 to 12 people were in the room, all part of St. Clair Hospital’s CPR team. In between chest compressions, the team shocked Tami’s heart. Again and again. They worked feverishly on Tami for more than 20 minutes, alternating between electrical shocks and CPR. Still, her heart would not return to a normal rhythm. Dr. Marcucci was bound and determined to not let Tami die, so he and the staff continued CPR and shocking her heart for another 25 minutes. They also administered intravenous amiodarone and lidocane, both powerful anti-rhythm drugs, and vasopressin, which stimulates contraction of muscles of capillaries and arteries. It was the 25th shock, and what was probably going to be the final shock that Tami would receive, that restarted her heart and returned it to a normal rhythm. Continued on page 12 The docTors and The enTire sTaff aT The hospiTal were wonderful To me and my family. i feel blessed for everyThing each and every one of Them did in making sure i had a greaT recovery. “ ” a thin wire through her femoral artery into her heart to clear the suspected blockage that caused the heart attack and the V-fib. “When I got to the Cath Lab, apparently my heart stopped again,” Tami relates in a calm, strong voice while relaxing in the living room of her South Park home. Dr. Marcucci remembers Tami crying out, “Please don’t let me die,” just as she began to lose consciousness. As in the ER, Tami’s heart had gone into V-fib. But unlike the first time, an electrical TAMI MIKUSH Volume V Issue 2 I HouseCall I 11 patient profile Continued from page 11 dr. marcucci acknowledges … ThaT in 30 years of pracTicing cardiology, he has never seen a paTienT be clinically dead for 45 minuTes and noT suffer any ill effecTs. James W. Marcucci, M.D. In fact, Tami believes she remembers feeling the sensation of that last shock to her heart. Dr. Marcucci then proceeded with the emergency catheterization, which revealed that Tami’s dominant right artery was 100 percent blocked. Dr. Marcucci performed a balloon angioplasty to restore blood flow through the artery. Tami’s chest was black and blue and what she would later describe as very sore, but, amazingly, she did not suffer any broken ribs, despite 45 minutes of continuous CPR, a nod to the skill and dexterity of the CPR team. Following her catheterization, Tami was taken to the Hospital’s Cardiovascular Surgical Unit (CVSU), where, still critically ill, she was placed on a ventilator and had a temporary pacemaker and intra-aortic balloon pump inserted to support her blood pressure. She also was placed in a medically induced coma. CVSU doctors pumped refrigerated intravenous fluids through her veins and also placed cooling blankets underneath and on top of her to keep her body temperature at approximately 92 degrees for 24 hours. (Normal body temperature is 98.6). The cooling blankets are body-sized plastic coverings filled with extremely cold water that is supplied by a portable pump. The chilling effect of the cold fluids and the cooling blankets is designed to lower a patient’s body temperature, reducing brain swelling and the formation of dangerous chemicals that result from inflammation. It also preserves other vital organs. iT was The 25Th shock, and whaT was probably going To be The final shock ThaT Tami would receive, ThaT resTarTed her hearT and reTurned iT To a normal rhyThm. As her husband and family, which includes two adult daughters, gathered at Tami’s bedside, staff in the CVSU prepared them for the worst. Given her heart attack and the fact she was “clinically dead” for 45 minutes in the Cath Lab, it was possible Tami would die, or, she would be severely impaired mentally and physically because of the suspected lack of oxygenated blood to her brain. 12 I HouseCall I Volume V Issue 2 But 12 days later, Tami was discharged from the Hospital with no neurological or other impairment. She recognized everyone and could talk, walk, and eat without assistance. She believes it is a miracle that she survived and did so in full possession of all her faculties. “I’m still here because there is a purpose for me in this world,” Tami says. “It wasn’t my time.” And, she adds, “I was lucky Dr. Marcucci shocked me one more time.” Dr. Marcucci largely credits Tami’s miraculous recovery to the efforts of the CPR team, who kept precious blood coursing through her arteries, and the organpreserving cooling blanket. He acknowledges, though, that in 30 years of practicing cardiology, he has never seen a patient be clinically dead for 45 minutes and not suffer any ill effects. Before she left the Hospital, Tami was fitted with a Zoll LifeVest, a wearable defibrillator that is designed to detect any abnormal heart rhythms and then deliver a treatment shock if necessary. She had to wear the LifeVest 24 hours a day. The only time she could take it off was for showering or bathing, and then, she had to have a family member nearby in the event of another heart-related emergency. The LifeVest, which was featured in a previous issue of HouseCall, is often used by patients until they are fitted with an implantable cardioverter defibrillator by an electrophysiologist. (Editor’s note: Tami’s cardioverter defibrillator was implanted by St. Clair Hospital Electrophysiologist/Cardiologist Puvalai M. Vijaykumar, M.D., in March.) About four weeks following the October heart attack, Tami began to experience chest pains and returned to St. Clair’s Cath Lab, where Dr. Marcucci cleared two more blockages in her heart and placed stents in two arteries to prop them open and ensure good blood flow. Twelve days laTer, Tami was discharged from The hospiTal wiTh no neurological or oTher impairmenT. she recognized everyone and could walk, Talk, and eaT wiThouT assisTance. Tami’s heart attack in October was actually her second. She suffered her first attack in 1990, an event that resulted in a 14-day hospital stay. She readily admits that years of smoking about a pack of cigarettes a day likely contributed to both heart attacks. She had smoked for about 10 years until her first heart attack in 1990. She then stopped smoking for 11 years, before resuming the habit about 12 years ago, smoking right up until the night of the second attack. She had no serious health problems between the two attacks. “I have not started to smoke again,” says Tami, “and very desperately am hoping that I never do again.” Tami says she is very grateful for the care she received at St. Clair Hospital. “The doctors and the entire staff at the Hospital were wonderful to me and my family. I feel blessed for everything each and every one of them did in making sure I had a great recovery.” Feeling better each day, Tami has returned to work, part-time for now, in the office of a South Hills podiatrist. One of the requirements for her job as a medical receptionist there: being certified in CPR. As she heads to the kitchen to prepare lunch for her husband and one of her daughters, Tami smiles when she offers, “I definitely feel everyone should be trained in CPR.” n JAMES W. MARCUCCI, M.D. Dr. Marcucci specializes in interventional cardiology at St. Clair Hospital. He earned his medical degree at the University of Pittsburgh School of Medicine and completed an internship at Temple University Hospital, an internal medicine residency at UPMC Mercy Hospital of Pittsburgh, and a cardiology fellowship at George Washington University Hospital. Dr. Marcucci is board-certified in interventional cardiology and cardiovascular disease by the American Board of Internal Medicine. He practices with US Heart and Vascular, P.C. To contact Dr. Marcucci, please call 412.429.8840. PUVALAI M. VIJAYKUMAR, M.D. Dr. Vijaykumar specializes in electrophysiology and cardiology at St. Clair Hospital. He earned his medical degree at Stanley Medical College and completed his medical training at Madras Medical College, both in India. He completed an internship at Cabrini Medical Center in Manhattan, and fellowships at Coney Island Hospital in Brooklyn and Deborah Heart and Lung Center in Browns Mills, New Jersey. Dr. Vijaykumar is board-certified in cardiology and electrophysiology. He practices with Pittsburgh Cardiac Electrophysiology Associates, P.C. To contact Dr. Vijaykumar, please call 412.687.8838. Volume V Issue 2 I HouseCall I 13 aSK the doCtor Ask the Doctor ArnoLDj.SHoLDEr,M.D. CAMiLLEM.BUonoCorE,M.D. Q A i keep hearing the term “low T” being bandied about. what is it and should i be concerned? Thephrase“LowT’hasbecomepartofthe Americanlexicon,thankstoawealthofTVand printadvertisementsformedicationstotreatlow testosteroneinmen.HavingLowTissomething thatcanbeasigniﬁcantproblemformen.Low testosteronecouldplaceamanatahigherriskfor developingillnessessuchasdiabetes,osteoporosis andheart disease,aswellascausinglackofenergy andlowlibido. Testosteroneisthehormonecreated bymen’stesticlesthatgivethemmale characteristics,bothphysicaland emotional.Atthelowendofnormal, men’stotaltestosteronecount isabout300,whilethehighend isaround900. “Menintheir20s through40smayhave anormalrangeof around500,” notesArnold J. Sholder, M.D.,aurologicalsurgeonat St.ClairHospitalwhopracticeswithSholder&Bordeau UrologicAssociates.“Asmenage,thereisagradual declineintestosterone,somanymenintheir70s and80swillhavealevelatthelowrangeofnormal orslightlybelow.” Aprimaryreasonthatmen’stestosteronelevels declineastheyageisbecausetheirtesticlesarenot asactiveinproducingtestosterone.Accordingto Dr.Sholder,95percentofthetestosteronecomes fromthetesticlesandabout5percentcomesfrom theadrenalglands,whicharelocatedabovethe kidneys.Dr.Sholderstressesthatit’snormalfor men’stestosteronetodeclineastheygetolderand, forthemostpart,itisnothingtobetoo concernedabout—aslongasaman’s testosteronelevelremainsintherange forhisagegroup. Dr.SholderandSt.ClairHospital EndocrinologistCamille M. Buonocore, M.D., saytheyareseeingagrowing numberofpatientsseekinganswers aboutLowT,manyofthemprompted tocallafterseeingtheubiquitous advertisements. Thedoctorssayasimplebloodtest isused todeterminetestosteronelevels. Typically,thebesttimetohaveblood drawnfortestosterone levelsisearly morning. Themostcommonsymptoms oflowtestosteronearealack ofenergyandalackofinterest insex. Whenayoungermanis displayingthesesymptoms, atestosteronelevel shouldbedone,says 14 I HouseCall I Volume V Issue 2 Arnold J. Sholder, M.D., with Robin Pavlik, Medical Assistant Dr.Sholder,sincethiscouldbeasignoflowtestosterone. Forapatientinhis80s,it’sjustanormalpartofaging. Sometimes,thesymptomsoflowtestosteronecan be confusedwithsufferingfromstressatworkorhome, being overworked,orjustnotgettingenoughrest. Dr.Buonocore,whoseLowTpatientsrangeinagefrom 30to70,saysshebelievestestosteronelevelsaredeclining earlierinmenduetotherisingincidenceofobesity.She notesthattestosteronelevelsinobesepatientsoften improvewithweightloss. TesTosTerone supplemenTaTion can be of greaT benefiT for men wiTh low T and significanT sympToms. reTurning The TesTosTerone level To The normal range can resulT in a noTiceable increase in energy and resToraTion of normal libido. iT can also pose hazards for older men wiTh low normal TesTosTerone levels who have minimal chance of benefiTing from a higher TesTosTerone level. replacementinoldermenwithlownormalserumtestosterone remainsunclear,”saysDr.Sholder.“TheCommitteeofthe instituteofMedicineofthenationalAcademyofSciences reviewedavailablestudiesandconcludedthatnobeneﬁcial effectsofadministeringtestosteronehavebeenwell establishedinthisagegroup.” However,menwhohavesigniﬁcantlylowlevelsof testosteronedefinitelydobenefitfromtestosterone supplementation. “iseeelderlymenwhoareusingtestosterone supplementationwhohaveborderlinelowlevels,whichis normalfortheiragegroup,”saysDr.Sholder.“Theproblem withsupplementationintheseelderlymenisthattherearea hostofotherproblemsthatcouldarise.Forexample,ifyou havesleepapnea,itcanmakeitworse.Menwithanenlarged prostatecanhaveprostaticgrowthandanincreasein urinarysymptoms.ifamanhasundiagnosedprostate cancer,thereisariskthattheycouldbefeedingtestosterone tothecancer,whichmakesprostatecancergrow.” Forpatientsundergoingtestosteronesupplementation, Drs.SholderandBuonocoresaytheytesttheirpatients’ testosteronelevels,liverfunctionandbloodcount,and monitorthemforanyurinaryproblems.n Drs.BuonocoreandSholdersaytherearemanytreatments availableformensufferingfromLowT.Followingaprostate examandPSAleveltoruleoutanyotherproblems,some urologistsandendocrinologistswillrecommendan inter-muscularshoteverytwoweeks.Thereisalsoa pelletthatisimplantedundertheskinandslowly releasestestosterone. Drs.SholderandBuonocoreoftenoptforoneoffour topicalgelsthatareappliedtotheskinonadailybasisand canbequiteeffective. “Thegelsworksowellthattobegivenashotoraninjection reallydoesn’tmakealotofsensewhenyoucanjustapplya gelafteryourshowereverymorning,”saysDr.Sholder. “Menwhotrulyhavelowtestosteronelevelsaretheones whocantrulybeneﬁtfromtestosteronesupplementation.” Followingsupplementation,withrestorationofnormal testosteronelevels,menusuallyhavemoreenergy,more interestinsex,gainmoremusclemass,andevenlosebody fat,accordingtoresearchbytheAmericanEndocrineSociety. Acontroversyabouttestosteronesupplementation occursinmenwithborderlinelowlevelsoftestosteroneand inelderlymenwhohavephysiologicallowtestosterone basedontheirage. “Althoughthedeclineintestosteronewithagemayhave severaladverseconsequences,theimpactoftestosterone ARNOLD J. SHOLDER, M.D. Dr. Sholder specializes in urological surgery. He earned his medical degree at the University of Illinois College of Medicine and completed his internship, residency and fellowship at Northwestern University-affiliated hospitals in Chicago. Dr. Sholder is board-certified by the American Board of Urology. He practices with Sholder & Bordeau Urologic Associates. To contact Dr. Sholder, please call 412.572.6194. CAMILLE M. BUONOCORE, M.D. Dr. Buonocore specializes in endocrinology. She earned her medical degree at State University of New York College of Medicine and completed her internship, residency and a fellowship at the University of Pittsburgh. Dr. Buonocore is boardcertified in endocrinology, diabetes and metabolism by the American Board of Internal Medicine. She practices with Associates in Endocrinology, P.C. To contact Dr. Buonocore, please call 412.942.2140. Volume V Issue 2 I HouseCall I 15 St.Clair Hospital 1000 Bower Hill Road Pittsburgh, PA 15243 www.stclair.org General & Patient Information 412.942.4000 Physician Referral Service 412.942.6560 Outpatient Center–Village Square 412.942.7100 Medical Imaging Scheduling 412.942.8150 HouseCall is a publication of St. Clair Hospital. Articles are for informational purposes and are not intended to serve as medical advice. Please consult your personal physician. Follow us on twitter at: www.twitter.com/stclairhospital Save the date for t h e 16t h annual SummerSwing to benefit St. Clair hoSpital Friday, July 19 – Beneﬁt Dinner – St. Clair Country Club Food Station Dining l Cocktails l Silent Auction l Entertainment For more information regarding reservations, sponsorships, or underwriting opportunities, please contact St. Clair Hospital Foundation at 412.942.2465 or email@example.com, or visit us online at www.stclair.org/82/foundation. Thank you! New Physician SPOTLIGHT ENDOCRINOLOGIST WAYNE A. EVRON, M.D. WAYNE A. EVRON, M.D., a 10-time Pittsburgh Magazine “Top Doctor” who has been elected by his peers for inclusion in “Best Doctors in America” for 14 years, specializes in the care of diabetes, thyroid disease, hormonal disorders, hypertension and osteoporosis. He earned his medical degree at the University of Pennsylvania School of Medicine, completed an internal medicine internship at the University of Florida-Shands Hospital, and an internal medicine residency, and endocrine and metabolism fellowship at UPMC-Presbyterian Hospital. Dr. Evron is board-certified in internal medicine and endocrinology by the American Board of Medicine. Previously, he served as Medical Director of the Joslin Diabetes Center at The Western Pennsylvania Hospital, and as Clinical Assistant Professor for the Temple University School of Medicine. To contact Dr. Evron, please call 412.942.7295. In the Community s part of its commitment to the community, St. Clair Hospital is supporting area community organizations. The Hospital highlights the good works of these non-profit partners in HouseCall. In this issue, we feature Pittsburgh Action Against Rape. The Pittsburgh Action Against Rape (PAAR) mission is to respond, advocate and educate to end sexual violence through counseling victims and their families and supporting them through the medical and legal systems. PAAR is one of the oldest, and largest rape crisis centers in the country. Additionally, PAAR remains the only organization in Allegheny County dedicated exclusively to victims of sexual violence. PAAR has a 24-hour free and confidential hotline for anyone who needs help: 1.866.END.RAPE. To learn more about PAAR, please visit http://paar.net.