St. Clair Hospital HouseCall Vol VI Issue 2

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VOLUME VOLUMEVI V ISSUE 2

HouseCall Carpe Noctem HOUSECALL FOLLOWS ST. CLAIR HOSPITAL'S BOARD-CERTIFIED INTENSIVIST YVONNE R. CHAN, M.D. AS SHE AND A TEAM OF FELLOW CLINICIANS CARE FOR PATIENTS ON THE EVENING/OVERNIGHT SHIFT.

inside

Minimally Invasive Parathyroid Surgery I The Heart Of A Hero I Ask The Doctor History Minute I Summer Swing

AROunD-THE-CLOCK CARE

“

There is acTive healThcare managemenT happening 24/7 aT sT. clair.

”

YVONNE R. CHAN, M.D. INTENSIVIST AND HOSPITALIST

Yvonne R. Chan, M.D.

2 I HouseCall I Volume VI Issue 2

EDITOR’S NOTE: THE HIGH QUALITY, COMPREHENSIVE, AND COMPASSIONATE CARE that St. Clair Hospital is well known for doesn’t stop when the sun starts to dip in the western sky and visitors kiss their hospitalized loved ones good night before heading home to their own beds. The Lab continues to do blood work and other tests, Medical Imaging continues to do X-rays and other scans, Emergency Room physicians and specially trained staff continue to treat patients who have been whisked to St. Clair by ambulance or walked in under their own power, pediatric hospitalists continue caring for their young patients, obstetricians continue to deliver babies in the Family Birth Center, nurses continue monitoring and tending to their patients, Hospital pharmacists continue to fill lifesustaining prescriptions, and Nutritional Services continues to prepare healthful meals for hungry patients. Just as importantly, acutely ill patients throughout the Hospital continue to be cared for by experienced, highly trained physicians. One of those elite physicians is Yvonne R. Chan, M.D., a Critical Care Intensivist and Hospitalist who has been caring for patients during the evening/overnight shift since 2005.

HouseCall followed Dr. Chan — who splits evening/overnight duties with fellow Critical Care Intensivist and Hospitalist Maxim V. Bocharov, M.D. — through a recent evening/overnight shift to see what she does in the proverbial still of the night. Her shift started at approximately 5:30 p.m. on a Tuesday and concluded just after 7 a.m. Wednesday.

The following photo essay captures the spirit of one particular overnight shift as Dr. Chan and other clinicians continued caring for patients while most of us were fast asleep.

Meeting patients’ needs around the clock

F

or most of us, working after midnight is exhausting just

‘Seize the night.’ We had a

thinking about it, let alone actually doing it on a regular

t-shirt with this imprinted

basis. But for Dr. Chan, working when most everyone else

in midnight blue on black

is asleep is something she learned and mastered back in the

with the subtitle ‘I do my

early 1990s while she was an undergraduate majoring in biology

best work after 2 a.m.’”

at the Massachusetts Institute of Technology (MIT) in Boston.

Dr. Chan, who went

“Do you remember the Robin Williams movie, ‘Dead Poets

on to earn her medical

Society,’ in which he told his students, ‘Carpe Diem,’ which is Latin

degree at Harvard Medical

for ‘Seize the day’?” asked Dr. Chan as she began her shift on a

School, says that she has

recent weeknight this spring where the weather transitioned

“always been nocturnal” and relishes the extra challenges and

quickly from sunny to gently falling snowflakes to bone cold at

responsibilities she has as one of the Hospital’s Intensivists and

nightfall. “Well, when I was at MIT, the saying was ‘Carpe Noctem,’

Hospitalists after the sun goes down.

Continued on page 4 Volume VI Issue 2 I HouseCall I 3

THE EVENING BEGINS

The transition from day to evening/ overnight shift: Yvonne R. Chan, M.D. is thoroughly briefed on each Intensive Care Unit (ICU) patient

by Co-Director of Critical Care Gregory Fino, M.D.

Critical care: She treats a patient in the ICU.

On the move:

In search of: ICU Nurse Amy Carbonara searches online for relatives of a critically ill patient.

The evening/overnight duties are often fast paced for her and the clinical staff.

Continued from page 3

Sporting blue scrubs, black clogs, and a

healthcare centers.

THE COMPREHENSIVE HANDOVER OF PATIENT CARE

white lab coat, the self-described “nocturnist”

Drs. Chan and Bocharov are full-time

bounds from one unit of the Hospital to the

nocturnists, a rare breed of physicians who

The 40-year-old Boise, Idaho, native’s

next as she explains that it is important for

work exclusive nights. Nocturnists are quickly

shift begins in the Hospital’s Intensive Care

families of hospitalized patients to know that

becoming high in demand as peer-reviewed

Unit where she is thoroughly briefed on

their loved ones are well cared for during the

medical journals, including the New England

each patient by Co-Director of Critical Care

night. “There is active healthcare manage-

Journal of Medicine, say that night and week-

Gregory Fino, M.D., who, along with specially

ment happening 24/7 at St. Clair,” she says,

end coverage by attending physicians greatly

trained critical care nurses, has been treating

adding it is a superior level of care usually

enhances patient care.

patients there throughout the day.

offered at only the country’s best academic

4 I HouseCall I Volume VI Issue 2

Staying nourished: Mindful of colleagues’ needs too, Dr. Chan orders in food for the ICU staff.

Suiting up: In preparation for placing a central line, she creates a sterile environment.

Administering critical care: Dr. Chan places a central line in a patient in the ICU.

A caring mom checks in: A quick call home to say good night to her two young children.

ALWAYS CLOSELY MONITORING PATIENTS IN RECOVERY

“Each patient in ICU needs to be individually

His breathing assisted by a ventilator, the

discussed because they are so critically ill,”

unconscious patient is suffering multiple-

explains Dr. Chan, as she examines a 38-year-

organ failure. Attempts to locate the patient’s

In a flash, Dr. Chan is down the hall, then

old man who was rushed to St. Clair after

next-of-kin have proven unsuccessful so far,

the stairs, to the Cardiovascular Surgical Unit

being found unresponsive by his roommate.

as all phone calls have gone straight to voice-

(CVSU) on the Third Floor to check on patients

The patient’s initial caregivers first suspected

mail. ICU nurse Amy Carbonara begins

who had undergone open heart surgery

bacterial meningitis, but tests soon ruled out

researching various addresses on her desk-

earlier that day. Like her patients in ICU, the

that potentially fatal disease in which a person

top computer to try and find close relatives of

patients in CVSU are in need of very intensive,

suffers from acute inflammation of the protective

the patient to notify them about his condition.

individualized care following surgery.

membranes covering the brain and spinal cord.

Continued on page 6 Volume VI Issue 2 I HouseCall I 5

Quick change: ER physician Jason Biggs, M.D., and Dr. Chan discuss a patient he is treating in the ER and who is about to be admitted.

St. Clair Hospital’s nationally recognized ER is staffed 24/7 by board-certified physicians.

Cardiology conference: Cardiologist John Girod, D.O., who practices with South Hills Cardiology Associates, part of St. Clair Medical Services, confers with Dr. Chan about a 90-year-old female patient who was transported to the ER after suffering a heart attack and was about to undergo a cardiac catheterization.

Cardiac catheterization team: Left to right, Leah Pence, R.N., and Cardiovascular Technologists Nicole Antle and Rachel Zeh arrive in the ER to prepare a patient for a catheterization in the nearby Cath Lab, just after midnight.

Continued from page 5

A CALL TO THE ER

There, Dr. Chan consults Micromedex, one

door-to-balloon team — interventional cardiol-

Dr. Chan also serves as the Hospital’s admitting

of the many medical knowledge databases the

ogists who respond to heart-related emergencies

physician throughout the evening/night, which

Hospital provides to augment physicians’ practice,

throughout the night. Door-to-balloon refers to

means frequent trips to the Emergency Room to

to determine the toxicology of the medication he

the time between when a suspected heart attack

consult with ER physicians. Together, they will

had ingested in large quantities.

victim arrives in the ER and when a tiny balloon

decide which tests to run before patients are assigned to a unit in the Hospital.

Around midnight, Dr. Chan is back in the ER,

is inflated in his or her heart artery to clear

conferring with Cardiologist John Girod, D.O.,

blockages that led to the attack. Studies have

One of her trips to the ER this evening is to

who was called in from home to perform a heart

shown that shorter door-to-balloon time leads

examine a 39-year-old patient who attempted

catheterization on a 90-year-old female patient

to a better recovery. St. Clair cardiologists have

suicide. Intubated to maintain an open airway,

who had suffered a heart attack and was rushed

long had some of the best door-to-balloon times

he is later transported to the ICU.

to St. Clair. Dr. Girod is a member of St. Clair’s

in the country.

6 I HouseCall I Volume VI Issue 2

Working the phone: A concerned physician consults Dr. Chan about his patient.

Bedside: As evening/overnight shift rounds continue, she checks the condition of a patient on Unit 5G from head to toe.

Floor by floor: The evening/overnight shift often requires her to hustle between floors, going wherever highly specialized patient care is needed.

SOOTHING THE FEARS AND PAIN OF A MOTHER AND BABY Critical Care Intensivists and Hospitalists,

Code Blue: Dr. Chan checks monitors that have been connected to a patient who suffered a medical emergency in the middle of the night.

round of ear drops for the child who is suffering from infection in both ears and pneumonia in both lungs.

CODE BLUE RESPONSE Dr. Chan is also responsible for responding to all Hospital-wide Code Blue response calls,

the ER physicians, and an in-house anesthesi-

Dr. Chan’s own children, Brendan, 6, and

which are medical emergencies that might

ologist are also ready to assist in emergent

Hana, 2, are at home with dad, Jerry, a software

require resuscitation and advanced life support,

issues in the Pediatric Unit, where there is a

engineer. Earlier that evening Dr. Chan snuck

as well as Rapid Response calls, in which a

pediatrician in house 24/7.

in a quick call to wish them all a good night.

team of healthcare providers attempts to prevent

A quick check of the Pediatric Unit around

She acknowledges that her steady evening/

respiratory or cardiac arrest in patients in non-

1 a.m. finds a mom gently trying to coax her

overnight schedule can be tough with little ones

intensive care units who are showing early signs

eight-month-old son back to sleep. Down the

at home. “Not seeing my family is the hard part,”

of clinical deterioration.

hall, the boy’s nurse is preparing another

she says.

Continued on page 8 Volume VI Issue 2 I HouseCall I 7

COORDInATED InPATIEnT CARE Full team response:

As noted in the main story, Drs. Chan and

A team of clinicians, including Dr. Chan, treat a patient in the Behavioral Health Unit who has suffered a seizure while walking in a hallway. Once stabilized, the patient is placed on a backboard and her neck is secured in a brace, before she is transported to Medical Imaging for a CT scan, the results of which are negative.

Bocharov are Intensivists and Hospitalists who care for patients in critical care units, as well as other units throughout the Hospital during the evening/overnight shift.

During standard daylight hours, patients are cared for in the Intensive Care Unit (ICU) by Co-Directors of Critical Care Gregory Fino, M.D. and Patrick G. Reilly, M.D., as well as by their Intensivist colleagues Laurie A. Kilkenny, M.D., Andrew Perez, IV, M.D., and Zachary T. Young, M.D. St. Clair also uses Hospitalists, i.e., physicians who are trained in internal medicine or family practice and who specialize in the care of acutely ill patients.

Hospitalists work closely with patients’ primary care physicians and specialists so Hospital and

Heading to ICU:

follow-up care are well coordinated.

Following the CT scan, the patient is taken to the ICU for extensive evaluation.

ST. CLAIR’S HOSPITALISTS INCLUDE: Jose I. Christlieb, M.D., Medical Director Meredith C. Broberg, M.D. Daniel C. Jackson, D.O. Christopher Mizzi, D.O.

Continued from page 7

Catherine M. O’Hara, M.D. Danilo O. Policarpio, M.D. Ansal Shah, M.D. Amy Danner, CRNP Moreover, St. Clair offers 24/7 in-Hospital pediatric

INTENSE IS TYPICAL FOR A HOSPITAL INTENSIVIST Although Dr. Chan would later describe this particular shift as relatively “slow,” it was a night of constant activity, as she only sat down

care by a team of board-certified pediatricians led

to record notes on patients and exchange

by Dayle B. Griffin, M.D., and Sheila Clarke, M.D.

patient information with Dr. Fino. n

8 I HouseCall I Volume VI Issue 2

Heading home: Dr. Chan leaves the ICU around 7 a.m. She plans to stop for a workout at a gym before heading home to see her family and get some sleep.

Ensuring continuity of care: Dr. Chan records patient notes to apprise incoming day shift staff of patient status.

Morning debriefing: As her evening/overnight shift comes to an end, she updates Dr. Fino on ICU patients he transferred to her care at the end of his daylight shift, as well as new patients she admitted during the night.

THE OVERNIGHT SHIFT ENDS

YVONNE R. CHAN, M.D.

MAXIM V. BOCHAROV, M.D.

Dr. Chan earned her medical degree from Harvard, where she completed

Dr. Bocharov earned his medical degree in

a joint program in Health Sciences and Technology with the Massachusetts

Saint Petersburg, Russia, his native country.

Institute of Technology (MIT). She completed a residency in internal

He then completed a residency in internal

medicine at Mount Auburn Hospital in Cambridge, Massachusetts (part of

medicine at Mercy Hospital in Pittsburgh,

the Harvard network of teaching hospitals), and a fellowship in pulmonology

and a fellowship in critical care medicine at

and critical care medicine at UPMC. She is board-certified in critical

UPMC. He is board-certified in critical care

care, pulmonology, and internal medicine. She practices with St. Clair

and internal medicine. Dr. Bocharov practices

Medical Services.

with St. Clair Medical Services.

Volume VI Issue 2 I HouseCall I 9

MInIMALLy InVASIVE SuRGERy

WHAT IS PARATHyROIDISM? The parathyroid glands are tiny marvels. They are four organs, each no bigger than a grain of rice, which are attached to the back of the thyroid.

The parathyroids perform a vitally important function in the human body: regulating calcium metabolism, along with phosphorus and Vitamin D levels.

Calcium is essential to every cell; it builds bones and teeth, helps regulate the pumping of the heart and plays a key role in muscle contraction. It helps the nervous system transmit messages and it is a component of the body’s blood clotting process. When the parathyroid glands are healthy, they do their job quietly and efficiently, manufacturing parathyroid hormone and maintaining the body’s delicate balance of calcium in the bloodstream.

When things go awry, it is generally because the parathyroid is making too much hormone (hyperparathyroidism) or too little (hypothyroidism).

Hyperparathyroidism is more common. It can be primary — meaning that one of the four glands is too large or is overactive, secreting an excess of the hormone; or it may be secondary, resulting from dialysis or illness.

Hyperparathyroidism produces hypercalcemia, elevated calcium levels in the blood. While symptoms such as fatigue and weakness sometimes occur, they are vague and common to many conditions. According to St. Clair Hospital thoracic surgeon Richard H. Maley, Jr., M.D., “The body controls calcium in a very tight range. Slight elevations may not be symptomatic, but any elevation is abnormal and the cause has to be determined and treated.” Left untreated, hypercalcemia may lead to kidney stones, bone pain, fractures and heart disease.

10 I HouseCall I Volume VI Issue 2

ROBOTIC-ASSISTED PARATHYROID SURGERY Accessing hard-to-reach places with minimal trace rista Woodard, a 22-year-old hairstylist from

K

Bethel Park, had no idea that elevated calcium

levels were the source of an illness that

began bothering her in the fall of 2013. “I was experiencing nausea and stomach pain, and I

thought that maybe I had an ulcer. I saw my primary care doctor and he ordered blood work, which showed that my calcium level was abnormally high. He referred me to Wayne Evron, M.D., an endocrinologist at St. Clair. On my scan, they found that one of my parathyroid glands was down in my chest, in my thymus gland, instead of in my neck. Dr. Evron sent me to Dr. (Richard H.) Maley, (Jr.) a chest surgeon at St. Clair, to see about removing it.”

Generally, parathyroid surgery is performed by an otolaryngologist, or ENT surgeon. But Krista’s condition was an ectopic parathyroid — a gland that had migrated to the wrong location, underneath the sternum in her chest. Thus, a thoracic surgeon was needed. In addition to being lodged in the thymus, the gland was enlarged.

Dr. Maley recognized right away that Krista was an ideal candidate for robotic-assisted surgery, utilizing the da Vinci Surgical System. “For Krista’s condition, robotics is the gold standard. For places that are difficult to access, it’s quite helpful and has many benefits.”

Krista Woodard

The da Vinci Robotic Surgical System is

dures in the least invasive way possible, without

in detail, even how the thymus and parathyroids

an advanced surgical technology that uses a

large incisions, making recovery faster and

work. He told me what to expect. I agreed to

high-powered endoscopic camera and robotics

easier. The Hospital uses a special robotics

the surgery, and had it done on December 4.

to translate the movements of a surgeon's

surgical team in a state-of-the-art operating

I was in St. Clair for three days. Post-op, I was

hands into precise movements of surgical

room that is utilized by many surgical specialties.

pretty sore at first and it hurt to breathe, but I

instruments. The surgeon sits at

“I’ve been using the da Vinci system for

a console in the operating

“

room, positioned several feet away from the patient, and works through tiny incisions, as in minimally invasive laparoscopic surgery. Using hand and foot controls, he manipu-

For KrisTa’s condiTion, roboTics is The gold sTandard. For places ThaT are diFFiculT To access, iT’s quiTe helpFul and has many beneFiTs.

lates a machine with four robotic arms, which is poised over the patient.

”

felt a lot better in seven days. I was back at work,

several years. Everything

cutting hair at Sport Clips, by December 31.

is visual with the da Vinci

I just have four little holes instead of a scar.

Surgical System,”

Best of all, my calcium and parathyroid levels

Dr. Maley says, adding

are normal now and the stomach pain and

the da Vinci is perfectly

nausea are gone. I feel great.”

suited to the anterior

Continued on page 12

mediastinal surgery that he often performs.

To Krista, robotic-

RICHARD H. MALEY, JR., M.D.

assisted surgery sounded “kind of cool.” Dr. Maley

Three of the arms hold miniaturized surgical

explained to her that with the da Vinci, he

instruments and the fourth holds the camera.

would be able enter her chest from the side,

At the console, the surgeon looks through

between the ribs and behind the sternum, in

lenses that give him a three-dimensional

order to avoid cutting through the sternum.

image and magnification up to ten times

“Dr. Maley told me that the best way to do it

beyond normal. The da Vinci system enables

was with robotic-assisted surgery. I had never

surgeons to perform intricate surgical proce-

heard about that, but he explained everything Krista with her pet bunny.

The Benefits of Robotic-Assisted Surgery

D

a Vinci surgery is highly regarded as a minimally invasive option, with surgeons only making a few small incisions. The da Vinci Surgical

System features a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human wrist.

These features enable surgeons to operate with enhanced vision, precision, dexterity and control. St. Clair Hospital surgeons offer da Vinci roboticassisted procedures for patients in need of thoracic, urologic, gynecologic, colorectal and general surgeries. The potential benefits of da Vinci surgery for all robotic-assisted procedures at St. Clair Hospital include: • Lower rate of complications

• Less pain

• Less blood loss

• Minimal scarring

• Shorter hospital stay

• Improved quality of life soon after surgery

The da Vinci Surgical System console.

Volume VI Issue 2 I HouseCall I 11

MInIMALLy InVASIVE SuRGERy Continued from page 11

Too Much of a Good Thing Laureen Cramer also had a parathyroid

I’ve had previous surgeries and didn’t know

or enlarged one gone, they have to step up and

what it would be like.

do all the work. We monitor to watch that the

gland in the wrong place — in her chest. In her

“It turned out to be much less painful this

case, though, it was not a matter of a migrating

way. I had to stay in the hospital for four days,

one month and six months; if they’re normal,

gland, but of an extra one. With five parathyroids

but that’s because it’s your chest.”

there’s no further follow-up needed.”

functioning normally, she had an elevated

calcium doesn’t fall too low. We check levels at

During the surgery, Dr. Maley deliberately

Laureen says that her calcium levels are

calcium level. The 64-year-old had no symptoms,

leaves the right lung unventilated so that it is

perfect now. “They were normal by discharge,

and was diagnosed when routine screening

reduced in size and can be secured out of the

and are still normal. I had a very positive

blood work revealed hyperkalemia. “My doctor

way. Post-operatively, the patient then requires

experience at St. Clair.” Laureen is enjoying

told me to stop taking my calcium supplements.

a chest tube for a day or two to drain blood

an active retirement at her 100-acre farm in

I did, but the level remained high. I went to

and re-inflate the lung. “We check parathyroid

Taylorstown. Formerly of Upper St. Clair, she

St. Clair to have scans and my parathyroids lit

levels immediately after the procedure, about

says that she and her husband Fred moved to

up when they injected iodine; they could see

20 minutes after the gland is removed. They

the country for the sake of their dogs and cats.

that there was one in my chest. I saw an ENT

should be decreased; it happens that fast.

“It’s a lot of work to take care of this property,

surgeon, but he said the site was too low for

We also have to watch that the calcium does

but it keeps us healthy. I believe in living a

him; he operates in the neck and head. He

not drop too low; the normal parathyroids

healthy lifestyle and I encourage everyone to

referred me to Dr. Maley, who told me this was

have had this ‘big kid on the block’ for years

get the recommended health screenings.

perfect for robotic surgery. I was surprised.

and may have gotten lazy. Now with the extra

If I had not had routine blood tests, my high

“

i believe in living a healThy liFesTyle and i encourage everyone To geT The recommended healTh screenings.

”

LAUREEN CRAMER

Laureen Cramer selects some spring flowers at Pete Donati and Sons Inc. Florist-Greenhouse in Bethel Park.

12 I HouseCall I Volume VI Issue 2

St. Clair Endocrinologists Who Diagnose and Treat Glandular Diseases

D

CAMILLE M. BUONOCORE, M.D.

iagnosing problems with patients’ parathyroid glands is just one of many skills of endocrinologists, specially trained physicians

Dr. Buonocore earned her medical degree at State University of New York. She completed her internship and residency, and a fellowship, at University of Pittsburgh.

She is board-certified by the American Board of Internal Medicine. Dr. Buonocore practices with Associates in Endocrinology, P.C. To contact Dr. Buonocore, please call 412.942.2140.

who diagnose and treat diseases related to the glands.

In addition to hyperparathyroidism, hypothyroidism and other thyroidrelated diseases, endocrinologists also treat patients suffering from: • Diabetes • Metabolic disorders • Menopause-related issues • Osteoporosis

WAYNE A. EVRON, M.D. Dr. Evron earned his medical degree at University of Pennsylvania. He completed his internship at University of Florida, his residency at Presbyterian Hospital, and a fellowship at University of Pittsburgh. Dr. Evron is boardcertified by the American Board of Internal Medicine.

He practices with Evron Endocrinology Associates, a division of St. Clair Medical Servies.

To contact Dr. Evron, please call 412.942.7295

• Hypertension • Cancers of the endocrine glands • Cholesterol disorders • Infertility • Over- or under-production of hormones • Lack of growth

St. Clair Hospital Endocrinologists include:

JANN M. JOHNSTON, M.D. Dr. Johnston earned her medical degree at Pennsylvania State University. She completed her internship, residency, and a fellowship at University of Pittsburgh. She is boardcertified by the American Board of Internal Medicine.

Dr. Johnston practices with Associates in Endocrinology, P.C. To contact Dr. Johnston, please call 412.942.2140.

BRIDGET K. BEIER, D.O.

DOUHA SAFAR, M.D.

Dr. Beier earned her medical degree at Lake Erie College of Osteopathic Medicine. She completed her internship and residency at University of Connecticut, and a fellowship at Virginia Commonwealth University. She is boardcertified in Internal Medicine and Endocrinology.

Dr. Beier practices with Associates in Endocrinology, P.C.

Dr. Safar earned her medical degree at University of Aleppo, Aleppo, Syria. She completed her internship at Pennsylvania State University and a fellowship at University of Pittsburgh. She is board-certified by the American Board of Internal Medicine. Dr. Safar practices with Associates in Endocrinology, P.C.

To contact Dr. Beier, please call 412.942.2140.

To contact Dr. Safar, please call 412.942.2140.

calcium would have gone undetected and might

RICHARD H. MALEY, JR., M.D.

have done some damage.”

surgeon but also a very good doctor. He’s caring

Dr. Maley earned his medical degree at Hahnemann University in Philadelphia, now affiliated with Drexel University, and completed his residency in general surgery at the University of Kentucky. He also completed a fellowship in trauma/ critical care at the University of Kentucky. Dr. Maley also completed a residency in cardiothoracic surgery at the University of Pittsburgh, and a fellowship in thoracic surgery at Memorial Sloan-Kettering Cancer Center, New York City. He is boardcertified in thoracic surgery. Dr. Maley practices with St. Clair Medical Services.

and never rushes, and I appreciated that.” n

To contact Dr. Maley, please call 412.942.5710.

To his patients Krista Woodard and Laureen Cramer, Dr. Maley is a great surgeon whose skill cured their hyperparathyroidism. “I really liked Dr. Maley,” enthuses Laureen. “He’s not only a great

Volume VI Issue 2 I HouseCall I 13

PATIEnT PROFILE

At 96, Joe Zimbicki is an inspiration

THE HEART OF A HERO oe Zimbicki has a remarkable heart, and over the course of his

J

Adult patients of all ages and fitness levels, from self-admitted

long, full, good life, he has always put that heart to excellent use.

“couch potatoes” to triathletes, come to Cardiac/Pulmonary Rehab on the

It is the heart of a hero who understood and accepted duty,

Hospital’s First Floor, where as many as 300 patients are enrolled at any

whether that meant helping raise his nine younger siblings or going off

time. New patients participate in a 12-week early rehab program, followed

to World War II, where he landed at Utah Beach in Normandy in June 1944

by a maintenance program. The rehab environment definitely has a social

and was twice wounded. He came home to marry a beautiful bride, Alma,

aspect, David explains, that becomes part of recovery.

and together they had two daughters, Beverly and Becky. He has lost

To Joe, Cardiac/Pulmonary Rehab is a warm, friendly place. He still

both Alma and Beverly, but he has a loving family and a very active life.

drives short distances and gets himself to St. Clair on his own. “Exercise

He gardens, cooks, volunteers, shops, attends church, and takes part

does me a lot of good,” he says. “I exercise at home for 40 minutes before

in races and walks for good causes. And he is 96 years old.

His generous, heroic heart remains strong, due in large part to a

Julie Senchak, Joe’s granddaughter, recently penned a biography

healthful lifestyle and

of him, “The Many Hats of Joe Zimbicki.” She believes that the Cardiac/ Pulmonary Rehab program is a major factor in her beloved grandfather’s

St. Clair Hospital’s Cardiac/

longevity. “It keeps him going. The people there are like a second family;

Pulmonary Rehabilitation

they even gave him a surprise party for his 96th birthday. He loves

Center. Since 2000, when

going there.” n

bypass surgery at St. Clair, Joe has been a fixture at Cardiac/Pulmonary Rehab, never missing his Monday, Wednesday and Friday workouts. To David DeCarlucci, MS, CES, a clinical exercise specialist and the Supervisor of Cardiac/Pulmonary Rehabilitation at St. Clair, Joe is an inspiration, not only to the other patients, but also to the staff. “Joe has a robust spirit and is a natural leader. He has a quiet strength and leads by example. He’s a thoughtful listener who remembers what people tell him. He’s been through a lot in his life, but he’s always focused on others.”

David says that when new patients begin Cardiac/ Pulmonary Rehab following a heart attack, stent placement, or heart surgery to bypass blocked arteries or repair a valve, they’re understandably anxious. “Then they see Joe. They hear his story and learn that he developed heart disease in his 80s, had bypass surgery, and learned to make adjustments in his life. They see him exercising three times a week and hear that he’s been faithfully doing it for 14 years. It makes an impression.”

Paula Wagner, R.N., a staff nurse in Cardiac/Pulmonary Rehab, does a blood pressure check on Joe Zimbicki as he exercises.

14 I HouseCall I Volume VI Issue 2

and stair climber, and I lift weights. The staff is wonderful.”

regular sessions at

he underwent quadruple

96-year-old Joe Zimbicki pumps some iron.

breakfast. I eat a breakfast of oatmeal, a banana, bagel and tea, and then I go to St. Clair. I work out on the treadmill, recumbent bike, regular bike

ASK THE DOCTOR

Ask the Doctor Q A

JOHN P. BROSIOUS, M.D.

People often equate plastic surgery with cosmetic surgery.

But aren’t there many clinical uses for plastic surgery, as well?

Plastic surgery is actually one of the broadest fields in medicine. We are the only surgeons who operate on every body part from head to toe. We operate on every type of tissue: skin, bone, muscle, nerves, blood vessels and fat; and we operate on every age group, from newborns to the very elderly. The perception that cosmetic surgery is our primary focus is a mistaken one; it’s rooted in television shows like “Nip and Tuck” and “Extreme Makeover,” and in all the advertising for cosmetic surgery. These things have given the public a somewhat skewed view of plastic surgery. The fact is, cosmetic surgery is just a fraction of what plastic surgeons do. It’s one of many subspecialties within plastic surgery.

Plastic surgery encompasses a wide range of subspecialties. Craniofacial surgery is the treatment of facial trauma, usually due to accidents and injuries, but also including the correction of congenital facial deformities such as cleft lip and palate. Treatment of burns is a major aspect of plastic surgery; we perform burn reconstructions, both acute and delayed, when there is a need for scar revision. Plastic surgeons perform many kinds of hand surgery; this is a very specialized field in which we strengthen and restore function in hands that have lost functionality due to fractures, tendon tears, carpal tunnel syndrome, arthritis, and other conditions of the hand.

There is also a subspecialty known as extremity salvage. This refers to the repair of arms and legs that have sustained severe trauma, such as open fractures and crushing injuries that damage soft tissue. We perform microsurgery or free tissue transfer; this means taking tissue from one body part and using it to repair and

restore another. Plastic surgeons do a great deal of cancer reconstruction surgery; the most common is breast reconstruction after mastectomy, but we also do a lot of reconstructive surgery for head and neck cancer.

Some plastic surgeons specialize in wound care.

This involves the treatment of difficult wounds such as pressure sores, which are common in paraplegics, quadriplegics, and the bedridden elderly. Wound care represents about one-fourth of my practice. And finally, there is the treatment of skin cancer, which often requires the skill and experience of a plastic surgeon. We remove skin cancer and other skin lesions, and we repair lacerations and scars, in a way that minimizes scarring.

It’s a great field. I love plastic surgery and I embrace all of it. Working with the different age groups and all the parts of the body is challenging and satisfying. What we do provides both a functional and visible difference for our patients, and as surgeons we experience instant gratification in the operating room. There is no single solution in plastic surgery, no cookie-cutter approach.

Each case is unique, so my approach is highly individualized to each patient’s situation and needs. n

JOHN P. BROSIOUS, M.D. Dr. Brosious earned his medical degree at Indiana University School of Medicine, Indianapolis, Indiana. He completed an integrated residency in plastic surgery at University of Nevada, Las Vegas. He practices with Bragdon-Stofman Plastic Surgery Group, P.C. To contact Dr. Brosious, please call 412.572.6164.

John P. Brosious, M.D.

Volume VI 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 Outpatient Center–Village Square: 412.942.7100

HouseCall

Physician Referral Service: 412.942.6560 Urgent Care–Village Square: 412.942.8800

Medical Imaging Scheduling: 412.942.8150 Outpatient Center–Peters Township: 412.942.8400

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.

HISTORy MInuTE

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St. Clair Hospital’s 60th Anniversary

July 18 & 21, 2014

S

t. Clair Hospital continues celebrating its 60th Anniversary

in July with a specially themed Summer Swing.

Summer Swing — the Hospital’s biggest fundraiser of the year — will be conducted Friday, July 18 at the prestigious St. Clair Country Club with a decidedly early-’50s theme to recognize the Hospital’s opening in February 1954. Guests will groove to the sounds of a band dressed for the period and crooning yesterday’s and today’s hits into vintage mics. The benefit dinner will feature high-end food stations, live entertainment, and a silent auction with electronic bidding.

Then on Monday, July 21, the 2014 version of Summer Swing will wrap up with the Donald J. Hastings Golf Classic at St. Clair Country Club.

Both the dinner and the golf classic are open to the public with advance purchases. For tickets or sponsorship opportunities,

A 1950s newspaper clipping from Mt. Lebanon News.

APPEAL FOR ST. CLAIR HOSPITAL MEMORABILIA o help mark its 60th Anniversary and celebrate its legacy, St. Clair

T

Hospital is preparing a Wall of History and is looking for Hospital-

related photographs and artifacts to possibly include in the future display, which will be located on the Fourth Floor.

Do you, or someone you know, have photographs taken during the planning/fundraising process or construction of the Hospital? Or perhaps have a St. Clair Hospital nurse’s uniform from the mid to late 1950s? Maybe a patch that adorned an old uniform? What about a doctor’s little black bag?

Or old Hospital signage? Any photos of, or artifacts from, St. Clair Hospital through the years is of interest and we would love to hear from you.

Please let us know about your St. Clair Hospital treasure by calling Matt Hiser at 412.942.2611 or 412.942.2465, or emailing matt.hiser@stclair.org.

please contact the St. Clair Hospital Foundation at 412.942.2465.