St. Clair Hospital HouseCall Vol VI Issue 1

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C E L E B R AT I N G

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VOLUME VOLUMEVI V ISSUE 1 2

HouseCall A REVOLUTIONARY APPROACH TO KNEE AND HIP REPLACEMENT

Taking the offensive against pain

Plus Urgent Care Opens at Village Square Please see page 18

inside

Broken Heart Syndrome I From Hospital Gown To Wedding Gown Ask The Doctor I History Minute I Focus On Giving Again Ranked Among The 100 Top Hospitals速 In The Nation

Pioneering TreaTmenT

Transforming Orthopaedic Surgery Brett C. Perricelli, M.D. specializes in complex hip and knee joint replacement surgery at St. Clair Hospital, spending his days performing total hip arthroplasty (THA) and total knee arthroplasty (TKA). In recent months, he has become a trailblazer in his specialty, pioneering a revolutionary approach to total joint replacement that holds the promise of a new era in the field. His approach to controlling pain after hip and knee surgery represents a dramatic departure from the conventional approach. His protocol is not just innovative; it may be transformative.

P

ain. It’s a fundamental issue in joint replacement. The pain

of pain and facilitating a faster, gentler and more comfortable post-

and disability of osteoarthritis eventually become unbearable,

operative recovery process and more successful rehabilitation. His

driving people to orthopaedic surgeons in search of relief.

“Peri-operative Pain Protocol,” is a regimen that is centered on multi-

Joint replacement will bring that relief, or at least significant improve-

modal analgesia — “hitting pain from many angles,” he calls it —

ment, but first, there’s the procedure itself — generally considered

and local peri-articular injections, given with exquisite precision into

by surgeons to be among the more painful of all surgeries. Consider

the surgical site. Pain is controlled for up to three days after surgery,

what is involved: to accommodate the implant, the surgeon makes

with effects that can last much longer. The result is less reliance on

multiple cuts in large bones, shaping the ends of the femur and tibia,

narcotics and fewer narcotic-related side effects, which can inhibit

and cutting out the arthritis to replace it with metal implants. “It’s

recovery and create complications that prolong length of stay, increase

literally sawing the bone in multiple places,” Dr. Perricelli explains.

patient discomfort and drive up costs. “Joint replacement surgery, and

“There is also dissection of the soft tissue that has multiple nerve

knee replacement in particular, are difficult for patients,” he explains.

endings.” The resulting post-operative pain can actually be an

“They feel agonizing pain that is traditionally treated with narcotic

impediment to recovery, when it keeps patients from adhering to

painkillers that leave them groggy and nauseated. In the old paradigm,

their physical therapy (PT) regimen.

pain management means narcotics. My goal is to improve pain control

Dr. Perricelli takes the offensive against this pain, aggressively

throughout the peri-operative period — before, during and after

treating it before he even begins the surgery. His comprehensive

surgery — in order to decrease narcotic use and minimize complications

approach to analgesia is all about altering the patient’s experience

associated with narcotics. It gets patients back on their feet faster.”

2 I HouseCall I Volume VI Issue 1

“

My goal is to iMprove pain control ... before, during and after surgery ... it gets patients back on their feet faster.

”

BRETT C. PERRICELLI, M.D. ORTHOPAEDIC SURGEON

Brett C. Perricelli, M.D.

Volume VI Issue 1 I HouseCall I 3

Pioneering TreaTmenT Continued from page 3

it Didn’t Hurt much at all

no Post-op Pain Laverne Lewis, R.N., a former St. Clair Hospital nurse, and a resident

When Liza Minnelli was asked on a talk show about her knee replacement,

of Upper St. Clair, had TKA surgery November 19. “I was out of bed walking

she said the pain was so horrific that it left her eyes permanently crossed.

with a walker that night. I had no pain on my first post-op day until I had

She was joking, of course — about her eyes. But the pain can be so severe

physical therapy. During rehab, I just took an anti-inflammatory and now,

that sometimes, patients who need to have both knees done will choose not

if I have pain, I take Tylenol.” Living in a split level house with three floors,

to return for the second procedure. That was the case for Deb Gossic, 61, a

she has a lot of stairs to climb. Thus, she opted to spend three weeks at

retired physical education teacher. “I had knee replacement surgery eight

a rehab facility before heading home. “Having PT and OT (occupational

years ago. The pain was worse than labor and lasted much longer. I decided

therapy) every day was a big advantage. I also had home PT two or three

that no matter how bad my other knee got, I would not go through that again.”

times a week, and then outpatient PT at St. Clair. They gave me a walker but I don’t use it, and I only use my cane when I go out.”

“

i was waiting for the Medication to wear off and the terrible pain to begin. it never did.

”

DEB GOSSIC KNEE REPLACEMENT PATIENT

Deb Gossic

Her other knee did get worse and she took cortisone shots and endured it, until she heard about Dr. Perricelli. “It was a completely different experience this time,” she raves. “It was like night and day.

The first time, I was on Vicodin and morphine and I could not sleep due to the pain. It took me forever just to get dressed for PT.” Her second TKA took place in October. “I didn’t realize I would have almost no pain.

I woke up in the Recovery Room and I thought that they had not done the surgery. I asked, ‘What happened? Did you do it?’ I was waiting for the medication to wear off and the terrible pain to begin. It never did.”

Gossic recalls that her PT began 15 minutes after she got to her room on the orthopaedic floor. “I had my surgery Tuesday and I was home Friday.

I never took the narcotic pain medication; most of the time, I did well with Tylenol. I put off the second surgery for eight years. This time, the experience was amazing. Dr. Perricelli has perfected this, and I’m grateful to him and to St. Clair for the excellent care.”

4 I HouseCall I Volume VI Issue 1

a multimodal approach The old approach to pain management has

Dr. Perricelli, at far right, injects anesthetics and anti-inflammatory agents directly into the surgical site during knee replacement surgery to reduce or prevent the pain during recovery.

The second, intra-operative part of the

numerous drawbacks that affect recovery and

protocol is more complicated. The patient is

Dr. Perricelli’s Pain

quality of life. Nerve blocks numb the thigh and

given spinal anesthesia, then IV Tylenol for

managemenT Program

knee joint, leading to a decrease in pain but also

pain, IV anti-nausea medication, an anti-bleeding

severe weakness of the quadriceps muscles, the

medication, and steroids to prevent inflammation,

major thigh muscles that rehabilitate the knee.

which is a huge factor in pain. I give the two

resulTs. His THree-sTeP,

Patients have difficulty getting up and walking,

workhorses — the injections — right into the

mulTimoDal aPProacH

and the resultant immobility can produce many

operative site. The drug Exparel is suspended

complications, such as falls, blood clots and

in bubbles of fat, which slowly break down and

urinary retention. There is also risk of injury to

release the medicine over 72 hours. I then inject

the nerve itself. Once the nerve block has worn

other anesthetics, anti-inflammatory agents

inTravenous meDicaTions,

off, usually several hours after surgery, the

and epinephrine into the knee at any point where

Plus mulTiPle injecTions

patient may have severe pain that requires

I think I’m going to cause pain. This is hitting

narcotic medications. These can produce drowsi-

the pain right where it happens. It’s a painstaking

ness, nausea and constipation. The multimodal

process and adds time to the procedure, but

approach employed by Dr. Perricelli relies less

it’s worth it.”

on narcotics and blocks, and instead uses

The third step is the post-operative care

Has sHown remarkable

incluDes Pre- anD PosT-oP oral , PaTcH anD

aT THe oPeraTive siTe.

Joint replacement is not pain-free surgery, Dr. Perricelli emphasizes, but it is far more

multiple short and long lasting pain medications,

of the patient. Once on the patient care floor,

comfortable when done in this manner. “The

given in a site-specific, rather than systemic,

the patient receives intravenous Tylenol, oral

absence of pain and inflammation is the key.

manner, combined with low doses of oral and

Celebrex, Pepcid and Tramadol, a non-narcotic

When you control the immediate pain and

intravenous medications.

pain medication. “If the patient needs opioid pain

inflammation, the effects are longer lasting.

medication, it’s available,” says Dr. Perricelli.

It’s not like it wears off and then the patient is

program. “I begin treating pain and nausea

“Many of my patients don’t need it. They also

miserable. Seeing my patients looking comfort-

before I start the surgery. We know it’s going

don’t need the pain medication pumps for IV

able after surgery is the most amazing experience.

to happen, so why not get a head start on

morphine.” Patients are discharged to home

One was up and making his own bed when I went

treatment? The pre-op protocol consists of

with Celebrex and Tramadol, plus oxycodone

in to his room the day after a hip replacement.

giving the anti-inflammatories and an anti-

if they need it.

I could hardly believe my eyes.”

Dr. Perricelli describes his three-step

nausea skin patch in the pre-op holding area.

Continued on page 6 Volume VI Issue 1 I HouseCall I 5

Pioneering TreaTmenT Continued from page 5

up and walking shortly after Hip replacement That patient was Roger Kurtz, 60, from Bethel Park, a retired auto-

orthopaedic surgeon who just happened to be on-call, she needed a new hip joint. “He’s a great person and a great surgeon; he told me I was his

motive interior repair specialist who spent his workdays outdoors, on his

star patient. I was lucky that he was on call. He gave me a new hip and I

feet and often in contorted positions that led to osteoarthritis in his hips.

was only in the Hospital for a day and a half. I went to rehab for a week

Kurtz had his left hip replaced one year ago, using conventional methods,

and came home on Christmas Day. I had almost no pain and I never took

and he had the right one done in early November; both were done by

anything but Tylenol.” Sasser came home with a walker but used a cane

Dr. Perricelli. “I went in with a list of 25 questions and he answered

instead, for just a few days. She has already finished her physical therapy

every one without ever looking at his watch. After my first operation,

and is eager to get back to her activities.

I came out of the O.R. with a drain in my hip, a catheter, IVs and morphine.

I was in bed all day and in the hospital for four days. I went home on crutches. The surgery in November was nothing like that. I was out of

changing old Procedures Implementation of the multimodal pain protocol was an enormous

bed that evening and walking. I had PT the next day and I never needed

endeavor for Dr. Perricelli, involving more than six months of design,

any morphine. I went home in two days with just a cane; I took oxycodone

development and research. It required not only a change in procedures,

for three days and then switched to Tylenol.

but also a shift in beliefs and attitudes. He conducted several in-service trainings for staff, educating the nurses, aides and physical therapists about the protocol and helping them view pain management in a new

“

way. “We had to change the way people think,” he says. “In the past, pain

i was out of bed that evening and walking, and had physical therapy the next day.

”

management meant major narcotics like opioids and then managing all their adverse effects; what I am doing is counter to everything the nurses and I have been doing for years. I wanted the staff to understand the process and embrace this. The staff grabbed the concept and ran with it.

They’re with the patients 24/7 and they taught me a lot about how to make the entire protocol better.”

ROGER KURTZ HIP REPLACEMENT PATIENT

“It took some getting used to,” says Sandy Stanley, BSN, MS, a charge nurse for St. Clair’s Center of Orthopaedics, “but the nurses like it and think it’s working well. It’s been amazing. We’re used to giving narcotic pain medications, but Dr. Perricelli’s patients don’t even use the word ‘pain.’ Instead they might say that the knee aches,” she says.

Dr. Perricelli’s patients are getting up and walking on the day of surgery, and going home one day earlier, in general, she says. “I give him a lot

Roger Kurtz

of credit for preparing his patients so well, too; when the patient knows what to expect, they experience less stress.”

Cindy Crock, R.N., has been a Recovery Room nurse at St. Clair

In rehab, my PT told me that I was three or four weeks ahead of

Hospital since 2008. She has cared for hundreds of joint replacement

schedule with my walking. I can tie my own shoes again! My advice to

patients and she’s enthusiastic about Dr. Perricelli’s pain regimen.

people who need joint replacement is this: first, don’t be afraid; second,

“It’s wonderful; it solves and prevents problems. Typically, after TKA,

don’t put it off too long; and third, go to Dr. Perricelli. He said to me,

when the spinal anesthesia wears off, the patient needs a femoral nerve

‘Roger, I can take care of you.’ And he did.”

block in the Recovery Room. It takes away some of the pain and lasts a few hours. They also need a pain pump. This can be hard on the patient.”

Tylenol was all she Took Barbara Sasser never planned to have joint replacement surgery.

Dr. Perricelli's patients do not need either and they are stable enough to leave recovery in under an hour, while the norm is 90 minutes.

At 77, with an active social life, she had no known history of arthritis or

David Mayer, CRNP, has worked in orthopaedics for 33 years. As the

osteoporosis. But in the wee hours of a Sunday in December, she found

nurse practitioner with Dr. Perricelli’s practice, South Hills Orthopaedic

herself in the Emergency Department of St. Clair Hospital with a fractured

Surgery Associates, he makes daily post-op rounds on knee and hip

hip. She had fallen during the night and, according to Dr. Perricelli, the

replacement patients. “I’ve never seen anything like this,” he says.

6 I HouseCall I Volume VI Issue 1

“ ”

this pain regiMen solves and prevents probleMs that can be hard on patients.

CINDY CROCK, R.N. RECOVERY ROOM NURSE

Cindy Crock, R.N.

It’s making an enormous difference for patients.

Thomas K. Fehring, M.D. He serves as a

ecstatic. This approach produces happy patients,

I was at St. Clair when they started doing joint

reviewer of research for the Journal of

good outcomes, shorter stays and lower costs.

replacement in the 70s, so I have seen all the

Arthroplasty and was recently selected by the

It has surpassed my hopes and expectations,

advances over the years. It’s wonderful to see

American Academy of Hip and Knee Surgeons

and it feels awesome to me as a surgeon.

patients who are not writhing in pain or taking

for a national leadership program. Through

Part of being a physician is to keep learning,

narcotics, especially the elderly patients. They

his training and travels, he has encountered

to know and apply the research and stay on top

don’t have a glazed, groggy look. Patients now

orthopaedic surgeon colleagues across the

of things.”

want to go home earlier. Most are discharged

country; they share information about evolving

in one or two days.” Mayer says Dr. Perricelli is

pain control techniques and review the literature,

to be an agent of change, a gentle and caring

an exceptional surgeon. “He has an incredible

and put it all together to create and enhance

revolutionary, who brings in new concepts and

knowledge of the knee. He has great surgical

this multimodal protocol. “It has a cumulative

practices, and illuminates the path toward a

technique and takes his time. He calls every

effect; it’s synergistic,” he says. “I’m stunned

new direction. “The suffering that patients were

patient on the night before surgery to see if

at how well the protocol solves problems

experiencing was unacceptable,” Dr. Perricelli

they feel ready and to answer last minute

associated with conventional pain management.

says. “We needed a new paradigm for joint

questions. Patients appreciate that.”

It’s fun for me because my patients are

replacement surgery.”

Apparently, it sometimes means choosing

Dr. Perricelli is a Pittsburgh native who graduated from the University of Pittsburgh School of Medicine. He completed three years of a general surgery residency at UPMC, followed by a complete orthopaedic surgery residency there, under Freddie Fu, M.D. He served as chief orthopaedic resident in 2009–2010, then completed a fellowship in hip and knee replacement at OrthoCarolina Hip and Knee Center in Charlotte, N.C., under

BRETT C. PERRICELLI, M.D. Dr. Perricelli earned his medical degree at the University of Pittsburgh School of Medicine. He completed his residency in orthopaedic surgery at the University of Pittsburgh Medical Center. Dr. Perricelli then completed a fellowship in hip and knee replacement at OrthoCarolina Hip and Knee Center, Charlotte, N.C. He practices with South Hills Orthopaedic Surgery Associates, P.C. To contact Dr. Perricelli, please call 412. 283 .0260.

Volume VI Issue 1 I HouseCall I 7

sTress carDiomyoPaTHy

Accurate diagnosis is key to

HealingBroken Hearts

THROUGHOUT THE AGES, poets have given metaphorical meaning to the human heart. The heart, they say, holds the essence of a person; a kind person is softhearted, and a brave one, lionhearted. The heart aches when one suffers a loss, and it sings with joy when something wonderful happens. Every human emotion seems to find expression through the heart.

Modern medical science has told us something different. The heart, we have learned, is simply an organ, a muscle composed of soft tissue. It is nevertheless a vital organ, simple in structure but complex, even wondrous, in function. The healthy heart is a workhorse, an engine that never rests, its chambers and valves pumping life-sustaining blood throughout the body in a constant, rhythmic choreography. The heart is so essential that we ascertain the presence of life by the presence of the heartbeat. Encasing it within a bony cage of ribs, vertebrae and sternum, the body protects the heart, in an acknowledgement of this importance, and also vulnerability.

Hearts, cardiologists tell us, do not break. They weaken, they fail, their rhythms go awry and they become damaged when their own blood supply is compromised. But hearts don’t actually break. Or do they?

8 I HouseCall I Volume VI Issue 1

A

ccording to Jeffrey Friedel, M.D., Chief of Cardiology at St. Clair

suffering the loss of a beloved Pet

Hospital, there is in fact a clinical condition known as Broken

Janet Ghise, 70, a resident of Bethel Park, knows all too well that

Heart Syndrome, or Takotsubo Cardiomyopathy. First described

Broken Heart Syndrome is real. She and her husband, Cornell, traveled to

in Japan almost 20 years ago, it is caused by extreme, sudden emotional

Cooperstown, N.Y., last summer to see their grandson play in a baseball

trauma or distress, and it causes damage to the heart, sometimes

tournament, and left their beloved 14-year-old Peekapoo, Maggie, in the

permanently. “In Broken Heart Syndrome, there is a characteristic pattern

care of a kennel. It was tough to leave Maggie behind, Janet recalls.

of damage to the heart muscle,” Dr. Friedel says. “The patients who

“Maggie cried so much when we left her. We weren’t worried, though.

experience this are predominantly women, over age 65, who present

Despite her age, she was healthy and had been to the vet for a check-up

with symptoms similar to those of a heart attack: sudden chest pain,

recently. She was fine.”

shortness of breath, lightheadedness, and sometimes an irregular

At the tournament, they enjoyed seeing their grandson hit three

heartbeat. An EKG will most often be

home runs. As they were leaving the

abnormal, with a pattern that looks

park, both Janet and Cornell found

like a heart attack, and cardiac

messages on their cell phones from

enzymes will be elevated, indicating

the kennel. “As I was reading the

the injury to the muscle. A cardiac

message —‘please call right away’ —

catheterization will show no blockages,

I overheard my husband, on his phone,

but a ventriculogram (a diagnostic test

say, ‘She’s dead?’ Our dear little Maggie

in which the heart is filled with dye

had died suddenly at the kennel. They

so it can be visualized on X-ray as it

didn’t know what happened to her,

contracts) will show that the apex of

but they could not revive her.”

the heart (the bottom front of the

For Janet, the unexpected death of

muscle) is enlarged and ballooned

her precious pet was a profound loss,

out. It doesn’t move, so it cannot

shocking and deeply felt. “Maggie was

pump effectively, but other parts of

special, a good little dog; all the neigh-

the heart move normally.”

bors loved her. It was also a terrible

If detected in time and treated

loss for my husband, but he handled it

appropriately, this damage will most

differently; Maggie went to work with

likely heal, although Dr. Friedel says

him every day and was a constant

that a small percentage of patients will

companion.” Janet had experienced

have permanent damage to their hearts

other losses in her life but this one,

and may require more specialized,

she says, felt different. “I cried all the

ongoing treatment. “We treat this like

time; I couldn’t seem to stop. I just

we treat congestive heart failure,

could not bear it. I couldn’t talk about

with ace inhibitors, beta blockers and

her without crying. I wasn’t myself;

diuretics. The patient will be admitted

Continued on page 10

to the hospital, probably for several days in the ICU or CCU (Coronary Care Unit), until the EKG is normal and symptoms are improved.”

Janet Ghise

Broken Heart Syndrome is believed to be the result of a sudden surge of the stress hormones adrenaline, epinephrine and norepinephrine.

“These cause spasms of the arterial blood vessels of the heart, which cause the damage to the heart muscle,” Dr. Friedel explains. “Any sudden and intense emotional upset or shock can cause this surge of stress hormones. The classic event is the sudden death of a spouse, but it can also be triggered by the death of any loved one.” It can be brought on by extreme rage or fear as well. A heated argument, domestic abuse, a home invasion, a car accident — even a surprise party — can be the triggering event. But most often, it is brought on by the sudden, unbearable loss of a loved one.

“

now i know that a broken heart is real . . . broken hearts can also be healed.

”

JANET GHISE BROKEN HEART SYNDROME PATIENT

Volume VI Issue 1 I HouseCall I 9

sTress carDiomyoPaTHy Continued from page 9

“

broken heart syndroMe is a legitiMate clinical diagnosis widely accepted aMong physicians . . . the heart actually changes shape.

”

JEFFREY FRIEDEL, M.D.

I was worried that people would think I was crazy to grieve like this over a pet, but now I know that lots of people do. I decided to tell my story because it might help someone else and even save another life. People need to know about this.”

Broken heart syndrome is a legitimate clinical diagnosis, Dr. Friedel says. “This is not junk science. It’s well described in the literature and Cardiologist Jeffrey Friedel shows what a broken heart looks like.

widely accepted among physicians. Doctors are more aware of the condition, but it’s probably underdiagnosed. You have to know what you are looking for and once you see it, there is no mistaking it. The heart

I felt very tired.” It happened that Janet already had an appointment

actually changes shape.” That characteristic change in the heart — the

scheduled with Dr. Friedel. She had had a stent placed in her artery

apical ballooning — is the source of the name Takotsubo, which means

following a heart attack in the past, and he was her regular cardiologist.

“octopus trap” in Japanese. The affected heart closely resembles the

“I had missed my July appointment and rescheduled for August, and

trap that Japanese fishermen use to catch octopuses.

that turned out to be a good thing. If I had gone to the July appointment,

Broken heart syndrome should be taken seriously and treated as

before Maggie died, I may not have been diagnosed and I could have died.”

an emergency. People who have the classic symptoms — chest pain,

Dr. Friedel did an EKG in the office, but he knew as soon as he saw

shortness of breath, weakness — should call 911. Although Broken

her that Janet was in trouble. “She is normally energetic and smiling,

Heart Syndrome is not a heart attack, the symptoms are similar and

but she was ashen and sweating. I sent her directly to the Emergency

the condition can lead to sudden cardiac arrest.

Room at St. Clair. A cardiac catheterization showed that her stent looked fine and there was no blockage. But the bottom of her heart muscle was destroyed, in a classic Takotsubo presentation.”

Janet is receiving close follow-up care from Dr. Friedel and her heart

an emotional malady Broken heart syndrome is so similar in presentation to a heart attack that it’s often initially misdiagnosed. That was the case for Rose Corrado,

is almost back to normal. “Dr. Friedel told me that my heart was healing

72, of Mt. Washington, a semi-retired electrologist whose symptoms

itself, but I know that he is healing me, too. I told him about Maggie,

developed after an intense emotional upset. “I was in the shower afterwards

and he understood; he said I lost a family member when I lost Maggie.

and I felt a twinge in my chest that hit me really hard. I wasn’t afraid; I thought I had the world’s worst case of indigestion. But I cancelled my

NORMAL HEART

clients and drove myself to an urgent care center, where they immediately called an ambulance and sent me right to St. Clair Hospital. I was taken

LEFT VENTRICLE

Tako-tsubo Tako tsubo [noun, Japanese] fishing pot for trapping octopus.

“BROKEN” HEART

OCTOPUS TRAP

either get a stent or have open heart surgery.”

As it turned out, Rose did not have a heart attack, and did not need a

In Takotsubo cardiomyopathy, also known as Broken Heart

stent or surgery. Instead, she learned that she had Broken Heart Syndrome.

Syndrome, the heart, affected by acute or sudden distress

“Dr. Friedel told me that my heart was only working at 30 percent capacity,

or loss, results in apical ballooning. The shape closely

(TAKO TSUBO)

to the Cath Lab and they told me that if there was a blockage I would

as though it was frozen, nearly standing still. He gave me medication to strengthen my heart and encouraged me to quit working. But I felt okay

resembles the trap that Japanese fishermen use to catch

and wanted to go back to work; I like to be around people. I have clients

octopuses. Broken Heart Syndrome should be taken

who depend on me.”

seriously and treated as an emergency.

Rose says that she has learned an important life lesson from her experience. “It wasn’t like me to get that upset and now I know that it is not worth it. Nothing is worth dying over. I’m trying to stay mellow, because if it happens again, I could die. I like to stay busy with my husband

10 I HouseCall I Volume VI Issue 1

Anthony, my four kids and seven grandkids, but I have less energy now.

I have to stop to sit and rest. I am working part-time and I make jewelry.”

Dr. Friedel says that Rose is recovering well. Like Janet Ghise, she was already his patient, being treated for an aortic valve problem.

“Rose’s underlying heart disease made it easy to assume at first that she was having a heart attack,” Dr. Friedel says. “Her enzymes were elevated and she had EKG changes, but it was from extreme stress and not a blockage.

“Stress is a direct trigger of a lot of serious problems. We know now that severe physical or emotional stress, even in the absence of significant plaque, can cause a heart attack through this same mechanism. That surge of catecholamines (adrenaline hormones) raises the blood pressure and

JEFFREY FRIEDEL, M.D. Dr. Friedel earned his medical degree at the Pennsylvania State University College of Medicine and completed his residency at Allegheny General Hospital in Pittsburgh.

He also completed fellowships in cardiology and interventional cardiology at Allegheny General Hospital. He is board-certified and practices with South Hills Cardiology Associates, a division of St. Clair Medical Services.

To contact Dr. Friedel, please call 412.942.7900.

can cause plaque to rupture and act like a blood clot. We’ve changed our thinking about heart attacks over the past 10 years. It is not that the plaque grows and becomes an obstruction, but that it ruptures.”

This has implications for diagnosing heart disease, Dr. Friedel says.

A stress test will not reveal the presence of plaque build-up, so cardiologists are not relying on them as in the past. Instead, they prefer a cardiac CT scan

don’t hesitate to come to the Emergency Room so we can make a diagnosis and begin treatment.”

It may well be that the poets who have found love, courage and character

or calcium scoring, which looks at plaque within the coronary arteries.

in the heart were not wrong after all. We are complex beings, and research

Broken Heart Syndrome can be treated and is usually reversible.

into the mind-body connection, a new frontier in medicine, is fascinating

Heart disease in general is far easier to prevent than to treat, says

in its possibilities and implications. Before her appointment with Dr. Friedel,

Dr. Friedel. He encourages everyone to live a healthful lifestyle, learn

Janet Ghise told her husband Cornell that she hoped her cardiologist

to manage stress, and become aware of the symptoms of heart disease.

could fix her broken heart. It was, she thought then, just an expression.

And, if you have an experience of extreme emotional distress and you

“Now I know that a broken heart is real, and it was actually a relief to

don’t feel right afterwards, seek medical attention. “At St. Clair, we have

know that. It’s real, and it can be life threatening. But broken hearts

all the most advanced tools to treat heart disease. If you have symptoms,

can also be healed.”

“

My heart was only working at 30 percent . . . as though it was frozen, nearly standing still.

ROSE CORRADO BROKEN HEART SYNDROME PATIENT

”

Rose Corrado

Volume VI Issue 1 I HouseCall I 11

minimally invasive surgery

From Hospital Gown

toWedding Gown in 48 hours

Jacki Fury Hennon was a beautiful, beaming bride on October 2, 2010. Escorted by her parents, and preceded by a procession of seven bridesmaids, Jacki walked slowly down the aisle toward her waiting fiancÊ, Christopher Hennon. It was a remarkable sight — not just because Jacki was a beautiful bride, but because just 48 hours before, she was wearing a very different kind of gown: a hospital gown, as she lay intubated and under general anesthesia on the operating table of a St. Clair Hospital surgical suite, in the capable hands of St. Clair Hospital Obstetrician/Gynecologist Douglas H. MacKay, M.D.

12 I HouseCall I Volume VI Issue 1

J

acki’s fantasy wedding almost

obstetrician/gynecologist who practices in

attack, in that the blood supply to the organ

didn’t happen. A project

Mt. Lebanon and Peters Township with

is cut off, causing the tissue to die. In Jacki’s

Advanced Women’s Care of Pittsburgh, P.C.

case, the ovary and tube could not be saved.”

administrator/financial analyst for

On Thursday evening, while her guests

Bayer Corporation in Robinson Township,

“Dr. MacKay was on-call, and was called in

with a side business as a floral designer, Jacki

for consultation,” Jacki recalls, “and every-

enjoyed the rehearsal dinner, sans the bride,

was a detail-oriented young woman who knew

thing changed for the better when he arrived.

Jacki recovered at St. Clair. “I woke up in the

how to make things happen. She spent 18

He reviewed all my tests and labs and told

recovery room to a different world,” she says.

months meticulously planning every detail of

me I needed surgery; he warned me that I

“Despite pain from the surgery, my four days

the wedding of her dreams. The reception was

might lose my left ovary. But I felt hopeful;

of agony were over.” Her mother and Chris

planned for Jacki’s favorite Pittsburgh place:

I knew I was in good hands. I had immediate

went to the dinner, but Jacki was not alone;

PNC Park. She did not overlook a single

confidence in Dr. MacKay. He told me that

bridesmaid Marlene Hedberg sent her own

detail, and as the wedding date approached,

he would do the procedure using minimally

mother, Cheryl Rieland, to St. Clair to sit

she felt confident, excited and very happy.

invasive techniques and I would still have my

with Jacki. “I was so grateful. Afterwards,

Things were going perfectly.

beautiful wedding.”

Chris, my sister, bridal party members and

Until wedding week. On the Saturday before the wedding, as Jacki was running last

Jacki went into surgery almost immediately.

The procedure that Dr. MacKay performed

my cousins all came to see me.”

Cancelling the wedding was not an option

minute errands with her mother, Maribeth

was a “salpingo-oopherectomy” — the removal

for Jacki. “I was going forward with my wedding,

Fury, she began to feel sick, with nausea and

of the ovary and fallopian tube. Unfortunately,

even if it meant being pushed down the aisle

stomach pain. She stayed home all weekend,

Jacki’s ovarian cyst had twisted tightly around

in a wheelchair with an IV. My gown was

hoping to feel better with rest. No such luck

the ovary. “Sometimes, we’re able to twist

strapless; an IV would be no problem! I spent

— her condition grew worse, and on Sunday

the vessels back and then observe to see if

18 months planning my wedding and I had 200

night, a worried Chris took her to the

there is perfusion (blood flow) to the ovary,”

people coming. Dr. MacKay told me I could

Emergency Room at St. Clair Hospital. By

Dr. MacKay explains. “It’s similar to a heart

do it, and I had no doubts. I was a bride.”

then, Jacki had a fever and her abdominal pain was severe. “The pain was agonizing, beyond anything in my experience,” Jacki recalls.

An ultrasound showed that Jacki had an ovarian cyst and was advised to see her gynecologist about the cyst as soon as possible.

Jacki felt increasingly anxious; the wedding was now just days away, and her rehearsal dinner was scheduled for Thursday — a choice she made so that she could spend Friday creating bouquets of flowers.

On Wednesday, she and her mother

“

Continued on page 14

i always try to do this laparoscopically, for the sake of the patient. recovery is faster and there’s less post-op pain.

”

DOUGLAS H. MACKAY, M.D. OBSTETRICIAN/GYNECOLOGIST

returned to the ER. Doctors there ordered a CT scan and another ultrasound. These tests showed that the ovarian cyst was so large within Jacki’s pelvis that it had created a rare, extremely painful and potentially lifethreatening condition known as ovarian torsion. Ovarian torsion occurs when the ovary and the fallopian tube become twisted, cutting off blood flow to the ovary itself.

It can be a surgical emergency.

And so, early Thursday morning, with less than 72 hours to go until the wedding, Jacki and Chris met Dr. MacKay, a board-certified Douglas H. MacKay, M.D.

Volume VI Issue 1 I HouseCall I 13

minimally invasive surgery Continued from page 13

She got through it, she says, with adrenaline, teamwork, strength

Jacki and Chris definitely wanted a family, and she became pregnant

and a lot of love. “I left the hospital on Friday and went immediately

the following May. “It was reassuring to us that I became pregnant

to have a pedicure. I spent that afternoon on my patio, surrounded by

so easily. We were thrilled. But then I miscarried in July, and we kept

relatives and hundreds of flowers and ribbons. I pointed to the flowers

trying, but had no luck for over a year. We had testing done and we

I needed, and they handed them to me. I made all my bouquets, just

were preparing for me to start Clomid (a prescription medication that

as planned.”

stimulates ovulation). We had an appointment with Dr. MacKay to discuss that, and when he walked into the room, he greeted us by

in sickness anD in HealTH On wedding day,

us for deciding to go on Clomid? But then he said, ‘You’re pregnant!’”

That was December 14, 2012. Eight months later, Madelyn Hennon

Jacki had some anxious

was born, on August 16, at St. Clair Hospital. She was delivered by

moments as she donned

Dr. MacKay, and she is a happy, healthy baby.

her gown. Would it

Christopher and Jacki Hennon with daughter Madelyn.

saying, ‘Congratulations.’ We were confused — he’s congratulating

“For the past three years, Dr. MacKay has just happened to be

still fit over her three

on call every time I needed him, even though there are six doctors in

incisions and sore,

his practice,” says Jacki. “He’s an excellent surgeon, and he has a kind,

swollen belly? “There

warm bedside manner. He’s been there for me through every step

was a moment of panic,

of this journey. I’m so grateful to him, and my family loves him.

as the dress was tight,

Dr. MacKay is my hero.”

but it fit. My hair and makeup were done at

the house and everyone helped me. When I walked down the aisle, my parents were pretty much holding me up. During the ceremony, there was a lighthearted moment when we got to the words ‘… in sickness and in health.’ Everybody in the church laughed.” Fortuitously, Jacki and Chris, an asset integration technician at Crown Castle International in Southpointe, had planned a delayed honeymoon. “I could not have gotten on a plane, so it worked out. And yes, I danced at my wedding!

Just not much!”

Jacki’s experience illustrates the beauty of minimally invasive surgery, says Dr. MacKay. “The cyst was so large that I might have done a large abdominal incision, but I always try to do this laparoscopically, for the sake of the patient. Recovery is faster and there’s less post-op pain. Pain is related to the length of the incision. With a large, open incision, Jacki could not have had her wedding.

This was a challenging diagnosis because often, with ovarian torsion, the torsion is intermittent. It comes and goes, twisting and untwisting, and the ultrasound may actually have been normal when they looked. It’s best to be conservative with a young woman and not rush to operate, because she is in her child-bearing years.”

14 I HouseCall I Volume VI Issue 1

DOUGLAS H. MACKAY, M.D. Dr. MacKay earned his medical degree at the Ohio State University School of Medicine and completed his residency in obstetrics and gynecology at West Penn Hospital, Pittsburgh. Dr. MacKay is board-certified by the American Board of Obstetrics and Gynecology. He practices with Advanced Women’s Care of Pittsburgh, P.C. To contact Dr. MacKay, please call 724 .941.1866 or 412 . 561.5666.

ask THe DocTor

Ask the Doctor Q A

SCoTT A. HolEkAMP, M.D.

Is it a sign of something serious if I notice blood while using the bathroom?

Bleeding is a common reason why patients visit a colorectal surgeon’s office. Patients may experience significant blood in the toilet bowl; it may be mixed in their stool, they may pass blood clots, or they may notice it on toilet paper. Some have bleeding that is not obvious, otherwise known as occult. In these cases, a primary care physician discovers it with simple blood or stool tests. Bleeding may accompany constipation, diarrhea, or be spread throughout the day; and it may or may not be associated with pain.

Although common causes of rectal bleeding include benign conditions such as hemorrhoids and fissures, we must always be vigilant for risk factors of colon polyps or cancer, which can also cause bleeding. The gold standard for examining the entire colon is the colonoscopy. Although the American Cancer Society recommends a screening colonoscopy starting at age 50 for the general population, the risk of having a polyp or cancer is influenced by age, medical history, and family history.

We consider these

factors when determining at what age patients should undergo their first and subsequent colonoscopies.

After ruling out more serious causes, a simple history and physical will diagnose the majority of rectal bleeding. Internal hemorrhoids tend to bleed painlessly and have bright red blood. Anal fissures can also have bright red bleeding, but are generally accompanied by excruciating pain with bowel movements. External hemorrhoids generally present with pain instead of bleeding.

Dietary and bowel habits significantly affect the incidence of hemorrhoids and fissures. Making sure that the patient’s stools are soft and regular is key to successful symptom management. In addition, medical therapies can help reduce the inflammation and muscle spasm that exacerbate symptoms. For internal hemorrhoids, painless office procedures such as banding or infrared coagulation can act as an adjunct to medical and dietary therapy. Finally, surgical therapy is an option for patients who have continued symptoms despite dietary, medical and office treatment. By looking for and addressing the underlying cause of a patient’s symptoms, we are able to offer a more durable solution.

As with any medical condition, it is important to talk to your doctor if you are having any of these symptoms, including bleeding or changes in bowel habits.

SCOTT A. HOLEKAMP, M.D. Dr. Holekamp specializes in colorectal surgery. He earned his medical degree at the University of Cincinnati College of Medicine. He completed his residency in general surgery at the Beth Israel Medical Center, New York City, and a fellowship in colon and rectal surgery at the University of Miami/Jackson Memorial Hospital.

Dr. Holekamp practices with Colorectal Surgical Associates, a division of St. Clair Medical Services.

To contact Dr. Holekamp, please call 412 .572. 6192.

Scott A. Holekamp, M.D. Volume VI Issue 1 I HouseCall I 15

CELEBRATING

HisTory Focus onminuTe giving YEARS 1954-2014

jack boguT: THe making oF an icon

F

or decades, Jack Bogut has graced the radio airwaves of southwestern Pennsylvania with humor, creativity and an

exceptional talent for storytelling. Highly honored, Jack

Hospital logo. Bogut explains how this came about.

“I was invited to join the board of directors at St. Clair in 1976, during the period when the size of the Hospital was being doubled.

is a Pittsburgh institution, familiar and beloved to legions of fans.

I was chairman of the Public Relations Committee, and we were

Raconteur, interviewer, host, speaker and author, the versatile

seeking a strong, clear identity for the Hospital within the community.

radio man is the recipient of numerous

The board was concerned that doubling the size of the Hospital could

prestigious awards: he was inducted

compromise the quality of care, especially as the construction took

in 2011 to the Broadcasters Hall of

place and created inconvenience for staff, patients and visitors. I felt

Fame; he was given the Pittsburgh

that we needed to send a message of a caring hospital. I thought about

Radio and Television Club’s Lifetime

how medicine is the “laying on of hands” and that patients come to

Achievement Award; and he was honored

St. Clair and place themselves in the hands of the staff. So the image

by the March of Dimes with their AIR

of a pair of hands came to me.”

(Achievement in Radio) Lifetime

Photo courtesy of John Altdorfer/Mt. Lebanon Magazine.

Iconic radio personality Jack Bogut, host of the “Bogut in The Morning Show,” heard on WJAS 1320 AM. Jack is the designer of the original St. Clair Hospital logo.

“

Medicine is the ‘laying on of hands’ . . . patients coMe to st. clair and place theMselves in the hands of the staff. so the iMage of a pair of hands caMe to Me.

Achievement Award. And in 2014, he

hands, upright and open, facing each other like parentheses — conveys

has received yet another honor, this one

much. The hands represent the caregivers who lay their skilled hands

from the hospital that he fondly calls

upon the ill, the suffering and the vulnerable, offering sublime care

“St. Care Hospital.” Jack is serving as

and compassion. They are the hands of surgeons, nurses, therapists

a member of St. Clair Hospital’s 60th

and many others. The logo color (originally a subtle shade of brown),

Anniversary Honorary Committee, and

has come to be known as “St. Clair blue,” suggesting the hope and

he is delighted to do so.

optimism of a sunny, cloudless sky.

There is a story about this renowned

Distinctive and memorable, the logo has endured, and is readily

storyteller, this very public man, which

recognizable throughout the community. It greets visitors who enter

may come as a surprise to Pittsburghers.

the Hospital through the front doors, where the door handles are

Jack has had a long and happy relation-

shaped like the two sides of the logo. “Every time the door closes

ship with St. Clair Hospital — almost as

behind someone, the hands come back together,” Jack says.

long as his radio career, which, of course, included his long-running morning

His love for St. Clair is personal. “My mother was a nurse, so I was always around medical people growing up, and I love nurses, who are

drive-time show on KDKA-Radio. He

the heart and soul of the Hospital. My wife Joanie and I have been

has had a lasting impact on the Hospital,

patients at St. Clair, and we received excellent care. There’s very little

as a longtime member of the board of

waiting at the Emergency Department, and the people are warm

directors, donor, vocal cheerleader for

and friendly. St. Clair’s growth has been amazing, and people in the

the Hospital, and, perhaps unexpectedly,

South Hills choose to go to St. Clair Hospital, with good reason —

as the designer of the iconic St. Clair

it’s the best.”

Jack’s original logotype has evolved over the years into a major brand icon.

”

JACK BOGUT

Original St. Clair Hospital logo created

by Pittsburgh radio personality Jack Bogut in the 1970s.

16 I HouseCall I Volume VI Issue 1

It was a stroke of genius. The simplicity of the image — those caring

wHy i give

making a Personal connection

C

onrad Rossetti is a Washington County

improvement store and donation center that sells

resident and an avid fly fisherman for whom

new and gently used furniture, accessories, building

the sport is restorative and relaxing. So, while

materials and appliances to the public at a fraction

at St. Clair Hospital’s Outpatient Center in Peters

of the retail cost. When St. Clair began demolition on

Township, he saw the framed photograph of fishermen

the site of the Peters Outpatient Center they donated

on Canonsburg Lake hanging behind the reception

the salvage and recyclable items from the previous

desk, it resonated with him. “I was inspired when I

structure to the Habitat for Humanity store. As some-

saw that photograph,” he explains. “I’m passionate

one who spent so much time on that site, overseeing

about fly fishing. My wife Gerrie and I love the outdoors

the salvage operation and literally watching the

and anything to do with water and boats. I saw myself

Hospital’s vision for the Outpatient Center come to

in the picture.”

life, I wanted to ‘pay it forward’ by sponsoring the

The Rossettis decided to make a donation to

Canonsburg Lake photograph.”

sponsor the colorful photograph, one of a collection

CREATE YOUR OWN LEGACY Support the continued growth of St. Clair Hospital by sponsoring one of 13 picturesque scenes of our local community displayed in the St. Clair Hospital Outpatient Center-Peters Township.

Sponsors will be recognized with a plaque placed near the selected artwork.

For information about sponsoring artwork, please contact the St. Clair Hospital Foundation at 412.942.2465 or at schfoundation@stclair.org.

Family is important to the Rossettis, whose

of 13 created by regional artist Leroy G. Pettis and

children and grandchildren all live within five miles

hanging in prominent locations throughout the Center.

of their home. Sponsoring artwork at the Outpatient

The photographs feature 12 Washington County sites,

Center creates a legacy for the close family and, for

plus a picture of St. Clair Hospital that adorns the

Conrad, is a way of honoring his marriage to Gerrie.

Center’s Community Room. They are all available

“This is a special year — we’ve planned a year-long

for sponsorship through the St. Clair Hospital

series of trips and activities to celebrate our 50th

Foundation. Small plaques bearing the donor’s name

wedding anniversary. Sponsoring the photograph is

will be placed beside each photograph. The Rossettis

part of that; it’s a nice feeling to know that something

were moved to donate by the quality of the photograph

lasting exists to honor my marriage and family.”

Washington Courthouse

and their high regard for St. Clair Hospital.

“Gerrie and I were impressed by the Outpatient Center,” Rossetti says. “It exceeded our expectations: the advanced technology, the convenience and location of all the departments, and the addition of the

Henry Covered Bridge

café. It’s well thought-out and beautiful.”

Conrad Rossetti’s relationship with St. Clair Hospital grew out of his volunteer involvement with the Washington affiliate of Habitat for Humanity. Following a 44-year career in industrial sales and marketing, Rossetti retired to his Nottingham County home in 2005 and was eager to find a new

Bednar’s Farm & Greenhouse

purpose. “I wanted to remain active and give back. I’ve been blessed with good health, a good life and good family. I read a story about Habitat for Humanity seeking to establish a “ReStore” for Washington County. A ReStore is a non-profit home Conrad Rossetti

Volume VI Issue 1 I HouseCall I 17

conTinueD growTH

Continuity of Care DISTINGUISHES ST. CLAIR URGENT CARE

“S

t. Clair Hospital is bringing the same innovative processes that helped make its Emergency

the care provided at urgent care is designed to integrate with our priMary care and specialty networks.

”

DAVID KISH, R.N. DIRECTOR OF EMERGENCY SERVICES AND PATIENT LOGISTICS

Department number one in the nation to

urgent care. The new St. Clair Urgent Care, located on the ground floor of the St. Clair Hospital Outpatient Center–Village Square in Bethel Park, is providing care to people in need of immediate but not emergency care, says Rachel L. Schroer, D.O., Medical Director at Urgent Care. “In urgent care, we treat people who come in with a focused problem that we are able to fix. The most common problems that we treat are upper respiratory infections, flu and sore throats; cuts requiring sutures; sprains and uncomplicated fractures; and skin infections. We can do X-rays and point-of-care lab testing on-site for blood sugar, strep throat, mononucleosis and urinary tract

Staffed by board-certified physicians, registered nurses and radiology technologists, St. Clair Urgent Care at Village Square welcomes patients seven days a week, 365 days a year.

infections. Urgent care is not a mini-emergency department; we take care of urgent illnesses and

great work setting; we have top-of-the-line technology

injuries. If a patient is more critically ill or needs

and beautiful aesthetics. All the physicians who work

higher level testing or monitoring, such as with chest

here are board-certified. Patients love the facility, the

pain or abdominal pain, they need to be evaluated

excellent care and the convenience.”

in our Emergency Room.”

Dr. Schroer transitioned into urgent care after

Urgent Care provides quick, convenient, quality care close to home.

18 I HouseCall I Volume VI Issue 1

David Kish, R.N., Director of Emergency Services and Patient Logistics for St. Clair Hospital, manages

five years in private practice. She finds urgent care

St. Clair Urgent Care. To Dave, urgent care has many

challenging and satisfying. “It’s wonderful to be able

benefits. “St. Clair has a great network of primary

to see a patient quickly and resolve the problem right

care physicians. But if patients need to be seen after

away. There is always a lot of variety. This facility is a

hours, urgent care is here to fulfill that need.

“St. Clair Urgent Care is open seven days a week and is staffed by a physician,

URGENT CARE STAFF AND SERVICES

registered nurse, X-ray technologist and

St. Clair Urgent Care, which opened January 13 in the

patient registrars. The staff is cross-trained

St. Clair Hospital Outpatient Center–Village Square in

to provide support to each other. Urgent

Bethel Park, is staffed by board-certified physicians,

Care’s goal is to examine and treat each

registered nurses, radiology technologists, and patient

patient in less than an hour. Our current

registrars. It is open 9 a.m. to 9 p.m. (9 a.m. to 5 p.m. on

average is 56 minutes.”

major holidays) seven days a week, 365 days a year,

St. Clair Urgent Care also facilitates

no appointment necessary.

continuity of care, Dave explains. “The

There are six examination rooms, two procedure rooms,

care provided at Urgent Care is designed

and an X-ray room. St. Clair Urgent Care also has a lab

to be seamless. For example, St. Clair Urgent Care has treated patients with

offering, among other things, urine analysis and rapid

orthopedic injuries who were referred and seen immediately by orthopedic

strep testing. St. Clair Urgent Care treats minor injuries

surgeons whose practices are in the same building. In a similar fashion, several

and illnesses. Below is a list of some of the common

patients who did not have a primary care physician were able to be connected

ailments and conditions treated there:

with PCPs and seen very quickly. Urgent Care’s location inside the Outpatient Center is ideal, since patients using our lab and diagnostic imaging center can

• Allergies and asthma

also benefit from Urgent Care services.”

• Colds, pneumonia and flu

• Fractures and minor broken bones

• Coughs and sore throats

• Skin rashes/infections

communication, via the electronic health record, or EHR. “A summary of a

• Cuts requiring stitches

• Stomach ailments

patient’s visit to St. Clair Urgent Care is easily accessed electronically by physicians

• Dehydration

• Urinary tract infections

and facilitates communication between the primary care physician and the staff

• Earaches

Also available:

at Urgent Care.”

• Eye infections

• Flu shots

• Fever

• Sports physicals

Both Dr. Schroer and Dave say the key to a smooth continuum of care is

St. Clair Hospital has a commitment to serve the community, says Dr. Schroer, and St. Clair Urgent Care exemplifies that commitment. “Patients appreciate the quality and immediacy of the services. People in the St. Clair communities are

St. Clair Urgent Care accepts most major health insurances

accustomed to top-notch care; they expect a high quality of care. St. Clair Urgent

and can fill selected prescriptions on-site.

Care is unique because it's integrated. We offer streamlined care, excellent communication with your own physician, and a convenient, comfortable location.”

CONVENIENTLY LOCATED FO RT

ON GT IN

.

RD

South Hills Village Mall

Giant Eagle Market District

.

DR

RD .

St. Clair Urgent Care

RD UCH T CO FOR

H AS W

RD FO OX

CO UC H

RACHEL L. SCHROER, D.O., MEDICAL DIRECTOR Dr. Schroer earned her medical degree from Lake Erie College of Osteopathic Medicine (LECOM).

She completed her residency at UPMC–St. Margaret.

Dr. Schroer is board-certified by the American Board of Family Medicine.

D RD. HIGHLAN

Norman Center

Home Depot

RD FO OX

T-line

.

DR

.

MATTHEW S. COOPER, D.O.

T-line

Eat’n Park

St. Thomas More Church

EL TH E B

Dr. Cooper earned his medical degree from Lake Erie College of Osteopathic Medicine (LECOM).

He completed his residency at UPMC-Shadyside.

Dr. Cooper is board-certified by the American Board of Family Medicine.

CH UR H C

.

RD

EDIRI A. MONTOYA, M.D. Dr. Montoya earned her medical degree from the University of Pittsburgh School of Medicine. She completed her residency at Washington Hospital.

Dr. Montoya is board-certified by the American Board of Family Medicine.

VILLAGE SQUARE 2000 OXFORD DRIVE BETHEL PARK, PA 15102 412.942.8800

• 365 DAYS A YEAR • 9 A.M. TO 9 P.M. (9 A.M. TO 5 P.M. ON MAJOR HOLIDAYS)

• NO APPOINTMENT NECESSARY

Volume VI Issue 1 I HouseCall I 19

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

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.

Medical Imaging Scheduling: 412.942.8150 Outpatient Center–Peters Township: 412.942.8400 Follow us on twitter at: www.twitter.com/stclairhospital

n i a g A ^ RANKED AMONG THE 100 TOP

®

OSPITALS IN THE NATION.

St. Clair Hospital has again been named one of the nation’s 100 Top Hospitals®. The annual award — now in its 21st year — is given

by Truven Health Analytics (formerly a division of Thomson Reuters) based on an objective analysis of patient safety, clinical outcomes, patient satisfaction, and value. Hospitals do not apply, nor do they pay, for this honor.

Jean Chenowith, senior vice president of Truven, noted that the winners are “hospitals that deliver higher quality, higher satisfaction, and lower cost.” Among the other notable honorees in 2014 are Duke University Hospital (Durham, NC) and Vanderbilt University Medical Center (Nashville, TN).

Truven calculates that if all Medicare inpatients had received the same level of care as those treated in the award-winning hospitals: • More than 165,000 additional lives could be saved; • Nearly 90,000 additional patients could have avoided medical complications; • And $5.4 billion could have been saved.

St. Clair salutes its outstanding physicians and employees for this prestigious achievement. To learn more about this honor, visit our website at www.stclair.org.