St. Clair Hospital_HouseCall Vol VI Issue 4

60

C E L E B R AT I N G

YEARS

VOLUME VOLUMEVI V ISSUE 2 4

inside

Bringing an Expert Touch to Delicate Surgery I In Good Hands: For Perri Brothers, Surgery is a Family Affair I Advances in Orthopedic Surgery Technology I Hall of History I Ask The Doctor

Healing

PATIENT SATISFACTION

The “

HOW WE TREAT YOUR

MEDICAL CONDITION IS

Touch

IMPORTANT, BUT SO IS HOW WE TREAT YOU AS A PERSON.

”

JOAN MASSELLA, R.N., M.ED., MBA, ADMINISTRATIVE VICE PRESIDENT AND CHIEF NURSING OFFICER, ST. CLAIR HOSPITAL

St. Clair Hospital Chief Nursing Officer Joan Massella, R.N., M.Ed., MBA, standing at center, confers with Registered Nurses, from left, Stephen Lamb, Kathy Warznak, and Julia Palumbo, as well as Unit Secretary Linda Mazek on Nursing Unit 6E during a recent walk-through of the highly rated unit.

2 I HouseCall I Volume VI Issue 4

ST. CLAIR HOSPITAL HAS THE HIGHEST PATIENT SATISFACTION IN WESTERN PENNSYLVANIA AND IS RANKED IN THE TOP 2% NATIONWIDE. No one wants to be in the hospital. But when hospitalization is necessary, one hopes, of course, for the best experience possible. That means top-notch, state-of-the-art care, delivered by

J

women and men who are highly competent and kind, in an environment of safety, comfort and healing. Fortunately, that kind of ideal experience can be found close to home, according to patients who report they are immensely satisfied with the high quality of care and services they received at St. Clair. In an independent survey of patient satisfaction, these patients have given St. Clair superlative ratings, catapulting the Hospital into the top 2 percent of hospitals nationwide.

oan Massella, R.N., M.Ed., MBA, administrative vice president

According to Joan, there are a number of key initiatives behind St. Clair’s

and chief nursing officer at St. Clair, says the 60-year-old

extraordinary patient satisfaction ratings. “Within nursing, we are always

Hospital’s tradition of excellence has evolved into a hospital-wide

implementing best practices,” she explains, “including bedside report

culture, and as a result, patient satisfaction rates have soared.

at change of shift, where nurses exchange information with each other,

“Hospitals measure patient satisfaction to assess how well

patients, and families. We put white boards in each patient room, with

they are meeting the needs of patients, to acquire insights into the patient

up-to-the minute information about their medications, tests, and care-

experience, to identify opportunities to improve. Listening to patient

givers. All staff are educated in a program known as AIDET, an acronym

feedback is essential. Patients today are informed and educated, and

that stands for Acknowledge, Introduce, Duration, Explain and Thank

they expect a quality outcome. How we treat your medical condition is

You. We started it in 2012 and find that it makes a big difference. The

important, but so is how we treat you as a person.”

purpose is to decrease anxiety and increase trust. We have very skilled

St. Clair measures patient satisfaction through a contract with South

clinicians at the bedside and AIDET helps them communicate their

Bend, Indiana-based Press Ganey, an independent research company

passion for helping patients heal in an environment of compassion,

that tracks patient satisfaction at the majority of hospitals across the

dignity and respect.”

country, including almost all of Western Pennsylvania. Press Ganey uses

Amy Carbonara, R.N., a charge nurse in the Intensive Care Unit (ICU)

patient satisfaction surveys to quantify the experience of

at St. Clair, says nursing care is shaped by the five AIDET principles.

N CTIO ISFA SAT T N IE PAT NT

ELLE EXC D GOO FAIR R POO

the patients, and reports this information to the Hospital

“At St. Clair, patient satisfaction is a priority.

in the form of scores and compilations of patient

“We get regular reports and take that information to the front line

comments. The reports help the Hospital track its

staff, and ask for their input. We’re all involved in the process; it isn’t

progress. Patient satisfaction data drive change within the Hospital, improving outcomes.

someone sitting at a desk making the decisions. Patient satisfaction benefits everyone.”

Continued on page 4

Volume VI Issue 4 I HouseCall I 3

PATIENT SATISFACTION Continued from page 3

Patient satisfaction is impacted by many things above and beyond hands-on patient care, says Joan. “It’s the

PATIENT SATISFACTION:

The sum of the whole

“

ST. CLAIR HAS

A COMPLETELY DIFFERENT CULTURE FROM ANY OTHER

whole St. Clair experience — from our valets to our guest service representatives to our volunteers to our housekeeping staff —

these services matter a great deal to patients and are part of their overall Hospital experience. We even have menu concierges who visit each patient every day. For many patients, meals are a highlight of the day. I can’t say enough about our employees and volunteers and the way they care about the patient experience. They get it.”

Physician leadership also drives high patient

HOSPITAL ... satisfaction. “Our 550 physicians understand the IT’S A TRUE TEAM, importance of the patient experience and are engaged WITH THE FOCUS ON THE WHOLE PATIENT.

”

JOSE CHRISTLIEB, M.D., HOSPITALIST, ST. CLAIR HOSPITAL

in this effort,” Joan says. St. Clair’s hospitalist program,

Hospitalist Jose Christlieb, M.D., with patient Steve Kladakis of Paris, Washington County, near Weirton, W.Va.

Jose Christlieb, M.D., who serves as the medical

she adds, is also a major factor in patient satisfaction.

director of St. Clair’s hospitalists, says, “St. Clair has a

“We have a team of well-qualified hospitalists who

completely different culture from any other hospital in my

have a special skill set in managing the problems of

experience. It’s a true team, with the focus on the whole

hospitalized patients, from newborns to the elderly.

patient. Patient needs are anticipated and the staff is

They are always in-Hospital 24/7. They have a great

unfailingly kind and courteous. The interaction of the

relationship with the nurses and provide seamless

nurses with patients is tremendous; I see it every day.

“I believe that patient satisfaction is driven by care

continuity of care.”

with great outcomes. Engaging the patient is key, and

PATIENT SATISFACTION:

The food is fresh and healthy

A wide variety served Highlight of the day

Enjoyable and contributes to recovery

4 I HouseCall I Volume VI Issue 4

that means listening and giving the patient your full attention. When we communicate with empathy and compassion, in language the patient understands, patient satisfaction follows.

“Patient satisfaction is not about a score. I understand that the numbers are necessary, but for me, it’s about making a difference in someone’s life. Numbers cannot capture what this is all about.”

Joan agrees that data are not the whole story. “The Press Ganey scores are important, and have helped us

I was shocked to see so many other patients! The nurses took time with me and treated me like I was special.

transform the patient experience, but it’s not the scores

My surgeon, Dr. (Leigh) Nadler, stopped in twice a day.

alone. They tell us where we stand. What takes St. Clair

My husband, Richard, was amazed.” Adds Richard:

beyond the patient’s expectations is the human element,

“The nurses explained everything about my wife’s care

plus the amenities and personal touch. Patients value

to me, too. I always felt included.”

human relationships and communication.”

Establishing an emotional connection with every patient

Confident in their skills, sensitive to human as well as clinical needs, buoyed by teamwork and fortified by a supportive nursing administration, nurses at St. Clair are empowered to deliver exceptional care.

A shared sense of mission facilitates teamwork at St. Clair, and that translates into better

Gracious. For Juanita Knouff, that’s the word that best

care, says Beau Concillio, R.N., a staff

describes the care she received at St. Clair Hospital

nurse on the Observation Unit, 4B.

during a recent admission for intestinal surgery. “I’ve been

“St. Clair is one giant family,” he says.

in other hospitals and I’ve never experienced anything like

“Everyone’s role is important. At

the care I had at St. Clair,” she says. “It was gracious care,

St. Clair, we keep the patient and

and it was the best experience I’ve ever had as a patient.”

family in the loop. Patients are sick,

Juanita is a 74-year-old Brookline resident who

scared, and away from home; when the

says she got so much attention from the staff that she

doctor comes in to update them on

occasionally wondered if she was the only patient on

their conditions and treatment, they will

the unit. “When I walked in the hall for the first time,

often nod their heads to indicate that they understand, but they aren’t fully hearing everything that is being said. I’ll go over it all with them to make sure they understand exactly what the doctor is saying.”

PATIENT SA TISFACTION :

Patients tru our nurses st Highly skille

Continued on page 6

d

They take ti me to explain pati ent care

Susan Bonelli, R.N., BSN, with patient Ernestine Banycky of Bethel Park.

Volume VI Issue 4 I HouseCall I 5

PATIENT SATISFACTION Continued from page 5

For Jason Graham, R.N., a staff nurse on Unit 5A,

everyone gets. Chief Nursing Officer Joan Massella

the orthopedic unit, his co-workers are a key to his job

forwards notes from patients to us; if my name is

satisfaction. “5A is a busy place; fortunately we have a

mentioned by a patient, she sends an email. It means

We never forget that the person in the bed is somebody’s loved one.

tight group

a lot.” When Susan orients new nurses, she tells them,

of staff who

‘No matter how bad your day is, you’re not the patient

support

in the bed.’” Susan also credits other members of the

each other.

staff. “The dieticians work closely with families and do

St. Clair has a talent for hiring people who are happy and

a lot of patient education. I think our high patient satis-

positive. The staff is caring and warm. We never forget

faction is also due to the contributions of our volunteers,

that the person in the bed is somebody’s loved one.”

who are amazing.”

Kathleen Casey, a Certified Nursing Assistant (CNA), has worked at St. Clair for 18 years. To her, high patient satisfaction is derived not only from the clinicians’ natural empathy for their patients, but from utilizing their continuously improving skill set at bedside. “St. Clair provides constant classes; we never stop learning and that enhances our caregiving. We will do anything for the patients. Sometimes, all they really need is a listener, someone they can talk to.”

According to Susan Bonelli, R.N., BSN, a staff nurse on Unit 6E, a medical-surgical Vincent E. Reyes, Jr., M.D.

unit: “My father was a patient here and received phenomenal care — not because I work here but because that’s the level of care that

Kevin Johnson, at right, a patient transporter in the Physical Therapy Department, and Jason Graham, R.N., with patient Al Borza of South Fayette.

“

I CHOSE TO PRACTICE AT ST. CLAIR BECAUSE OF

THE SHARED SENSE OF MISSION THERE. PEOPLE

HAVE A HIGHER PURPOSE BEYOND A JOB.

VINCENT E. REYES, JR., M.D., ST. CLAIR HOSPITAL

6 I HouseCall I Volume VI Issue 4

”

One of those amazing volunteers is Marcia Cohen, a Mt. Lebanon resident and retired school principal who became a patient at the Hospital when she was diagnosed with ovarian cancer in the fall of 2012. “I was watching a medical show on television,” she explains. “They were doing a show about ovarian cancer and listed the symptoms. I had every single one. Two days later I had an ultrasound; I had massive tumors on both ovaries. I had a total hysterectomy, then chemotherapy at the Hospital’s infusion center, with oncologist Dr. Vincent Reyes overseeing my care.

The nurses were wonderful to me and Dr. Reyes was incredible. He’s warm and caring and treated me like family.” Marcia had such a positive experience at St. Clair that she became a volunteer at the Hospital, where she helps other women fighting cancer.

Marcia’s oncologist, Dr. Reyes, believes that communication is one key to patient satisfaction.“A patient who is kept informed is an empowered patient. She or he is part of the decision-making process and has less fear of the unknown. St. Clair patients are well informed; they are partners with me on this journey.”

Dr. Reyes credits the Hospital’s nurses for St. Clair’s stellar patient satisfaction ratings. “The nurses are responsible for patient care, every hour of every day.

It’s the nurses who execute the plan of care. Patients

PATIENT SATI SFACTION:

Our doctors personalize p atient care Physicians sp end quality time Genuine co patient quesncern for tions and worries Reassuring, ca lming anxieties

never forget good nurses.”

“I chose to practice at St. Clair because of the shared sense of mission there. People have a higher purpose beyond a job. I think patients sense this, and that makes

them feel very comfortable at St. Clair Hospital.” n

JOAN MASSELLA, R.N., M.ED., MBA Joan is Administrative Vice President and Chief Nursing Officer at St. Clair Hospital. She previously served as Nurse Manager of the Psychiatric Unit, Director of Psychiatric and Medical/Surgical Units, and Director of the Family Birth Center. Joan holds a Master of Business Administration from West Virginia University, a Master of Education from Duquesne University, and a Bachelor of Science in Nursing from Edinboro State University.

To contact Joan Massella, please call 412.942.2100.

Volume VI Issue 4 I HouseCall I 7

A HANDS-ON APPROACH

“

I’m young and healthy ...how did this happen?

”

8 I HouseCall I Volume VI Issue 4

Bringing an expert touch to delicate surgery BOARD-CERTIFIED OTOLARYNGOLOGIST SHELLY J. MCQUONE, M.D., FACS OFFERS A HANDS-ON LEVEL OF EXPERTISE TO THE DIAGNOSIS, TREATMENT AND CARE OF PATIENTS AT ST. CLAIR HOSPITAL.

A

s a senior nursing student, Alycia Jones of Brownsville, Fayette County, knows

well the importance of living a healthy lifestyle. She is a 23-year-old woman who, in addition to attending classes and clinicals at California University of

Pennsylvania, works hard to maintain her health and fitness; she runs five days a week, lifts weights, does cross training and follows a healthy, balanced diet. “I’ve always been health conscious and tuned into my body,” Alycia says. “In nursing school, I’m learning how important that is in disease prevention. Many conditions are lifestyle-related, and we have control over that. I have always tried to take good care of myself.” Her training, self-awareness and intuition paid off earlier this year when she recognized that something was not right with her body. “I always know when something is wrong,” she recalls.

Continued on page 10

Dr. Shelly McQuone performs a follow-up exam on patient Alycia Jones.

“

Dr. McQuone made me feel comfortable …

She was always smiling and reassuring. I’ve never known another doctor like her.

”

ALYCIA JONES

Volume VI Issue 4 I HouseCall I 9

A HANDS-ON APPROACH Continued from page 9

“At first, it was not anything specific. I just sensed that something was off. Then I began developing strange symptoms: fatigue, heart palpitations, swelling of my lower extremities and weight fluctuations. I saw my primary care physician, who felt a nodule on my thyroid, on the right side,

“

She told me to stay positive.

I can’t express what a difference that made for me.

”

ALYCIA JONES

Patient Alycia Jones with Dr. Shelly McQuone.

10 I HouseCall I Volume VI Issue 4

and told me that I had hyperthyroidism.”

Hyperthyroidism occurs when the thyroid gland produces an excessive amount of a hormone called thyroxine, or T4 — the hormone that is responsible for metabolism. The thyroid gland is a tiny, soft, butterfly-shaped gland that sits in front of the trachea. Its miniscule size belies its significance to physiologic functioning — the thyroid is a critically important organ that regulates every aspect of metabolism, the process by which the body takes in calories from food and converts them to energy. A healthy thyroid regulates the heart rate, breathing, body temperature, digestion and thousands of other cellular processes. When the thyroid is healthy, it performs with quiet efficiency,

but an unhealthy thyroid can wreak havoc on the body.

Disorders of the thyroid generally take two forms: abnormal hormone production and abnormal growths. Abnormally low production results in hypothyroidism, the most common disorder, and excessive production leads to hyperthyroidism.

Abnormal growths,or thyroid nodules, are common, but may mean thyroid cancer.

An ultrasound revealed just such a nodule on the right side of Alycia’s thyroid gland. A needle biopsy was performed, and it was negative for cancer. She was referred to an endocrinologist, who in turn referred her to Shelly J. McQuone, M.D., FACS, a board-certified otolaryngologist who recently joined the staff of St. Clair Hospital.

“Alycia’s case was medically interesting and not entirely typical,” says Dr. McQuone. “She had symptoms of hyperthyroidism: weight loss, sweating and palpitations, along with laboratory testing supporting the initial diagnosis of Plummer’s Disease, a thyroid condition in which there is a hyperfunctioning nodule that is secreting excessive thyroid hormone, resulting in hyperthyroidism.

Her thyroid scan demonstrated a hyperfunctioning area, or a ‘hot nodule’ — one nodule that is overactive, and the apparent source of the excess hormone. Alycia’s history,

Patient Alycia Jones works out daily.

laboratory and imaging findings were all consistent with Plummer’s Disease, and the treatment for that is a

needle biopsy specimen, or an ultrasound, or is associated

hemithyroidectomy, the surgical removal of the affected

with other risk factors such as heredity or history of

half of the thyroid. That usually results in the resumption

radiation. In these instances, a portion of the thyroid is

of normal functioning.”

removed for the purpose of obtaining a definitive diagnosis

Consequently, Dr. McQuone performed a hemithy-

on the nodule. If it later proves to be benign, no further

roidectomy on Alycia at St. Clair, and Alycia did well

surgery is necessary. If the nodule turns out to be malignant,

throughout the procedure and post-operative period.

often the remaining half of the thyroid gland is removed

But there was an unexpected development: although

at a second surgery.

both the original needle biopsy and the frozen section

According to the National Cancer Institute, 60,000

biopsy, done during surgery, were negative for cancer,

people in the U.S. are diagnosed with thyroid cancer

the final pathology report indicated Stage I follicular

every year. It is more common in women, especially

thyroid cancer. “It was a surprise; I was not expecting

women who are 50 or older. There are four kinds of

that,” says Dr. McQuone. “Thyroid cancer is usually

thyroid cancer: papillary, follicular, medullary and

asymptomatic; it most typically presents as a painless

anaplastic, with papillary being the most common by far.

nodule, or lump in the neck. It is not usually associated

Follicular thyroid cancer is the second most common

with any abnormalities in blood tests, including thyroid

type, and it is the type that Alycia Jones was found to

function studies. Patients say, ‘But I feel fine and my

have. One week after the surgery to remove the right

bloodwork is normal.’ Neither is relevant. Alycia was

side of her thyroid, Alycia again placed herself in the

unusual in that she had symptoms. But her cancer was

skilled and competent hands of Dr. McQuone, and

in the earliest stages and that was important.”

underwent the exact same procedure, hemithyroidectomy,

Fortunately, most thyroid nodules are benign. A benign nodule may be removed if it has suspicious features on a

on the remaining left half of her thyroid, to prevent the cancer from spreading.

Continued on page 12

Volume VI Issue 4 I HouseCall I 11

A HANDS-ON APPROACH Continued from page 11

NUCLEAR MEDICINE:

SAFE AND PAINLESS

Alycia then progressed to the next phase of treatment, which involved the administration of radioactive iodine (RAI) to complete the eradication of thyroid cancer cells from her body.

Frank S. Torok, M.D., board-certified radiologist and nuclear medicine specialist, is personally managing her care, as he does for every thyroid cancer patient at St. Clair. “Six weeks post-op, the patient receives radioactive iodine to rid the body of any thyroid tissue,” he says. “Thyroid tissue is avid for iodine; the radioactive iodine sits in the body and attracts the thyroid tissue. It is retained in the thyroid tissue, where it slowly destroys thyroid cells and thyroid cancer cells, but does not harm the other cells in the body.”

Alycia’s RAI therapy began with a full body scan and two weeks on a low-iodine diet. That meant avoiding dairy, eggs and any foods containing iodized salt, which is present in nearly every processed food in the supermarket. “It isn’t easy. The purpose of the strict diet is to make the thyroid tissue crave iodine, so that when it is administered to the patient, it takes up the iodine ravenously,” Dr. Torok explains.

“In the past, the patient had to go six weeks without thyroid hormone and they felt awful. Today, we give the patient injections to raise the level of TSH — thyroid stimulating hormone — which stimulates the thyroid tissue and cancer

Frank Torok, M.D., explains the effect of the radioactive medication Alycia Jones will take to help rid her thyroid of any remaining cancer cells, and her need to self-quarantine for five days following ingestion.

cells to take up the iodine. The RAI is more effective this way.”

After completing the two-week diet, Alycia came to St. Clair’s Nuclear Medicine department where she received RAI in pill form. After the administration of the RAI, the body

N

will emit radiation so precautions are necessary to avoid

uclear medicine, a subspecialty of radiology, involves the

exposing others to radiation. The iodine is gradually eliminated

administration of radioactive compounds into the body,

through the urine, sweat and saliva, and the patient has to be in

orally or by injection, for diagnostic or therapeutic purposes.

isolation for five days, avoiding close contact with others. For

This is usually followed by a scan that provides data to further a

Alycia, who resides with her mother, this meant segregating

diagnosis or treatment plan. Within the field of medical imaging,

herself within her own home.

nuclear medicine is unique in that it can be used to study not only the

“Alycia did well and we will recheck her in one year,”

anatomic structures of the body, but the functions as well. Although

Dr. Torok says. “Patients have to return every year for a full

it may sound a bit frightening to think of radioactivity being introduced

body scan. Fortunately, thyroid cancer is one of the most

into the body, nuclear medicine is safe and the procedures are

curable cancers.”

non-invasive and painless.

Board-certified in radiology and nuclear medicine, Frank S.

Thyroid surgery is a significant portion of Dr. McQuone’s practice, although, as an otolaryngologist and ear, nose and

Torok, M.D.’s expertise enables St. Clair Hospital to offer advanced

throat specialist, she has expertise in treating a broad range

care for thyroid cancer, hyperthyroidism, heart disease, and a wide

of conditions of the head and neck. Her patients include those

range of other diseases and conditions that can be diagnosed and

with head and neck cancers, including cancer of the thyroid,

treated with the special capabilities of nuclear medicine.

Dr. Torok receives referrals from a variety of medical specialists to diagnose and treat patients with thyroid problems, such as thyroid cancer.

parathyroid, larynx, esophagus, tongue and lymph nodes.

Dr. McQuone also treats thyroid disease, vocal cord disorders, sinus problems, allergies, airway obstructions, cleft palate, ear disorders, hearing loss, balance problems, sleep apnea and facial trauma. The busy surgeon typically performs eight to 10 surgical procedures each week, from insertion of ear

12 I HouseCall I Volume VI Issue 4

tubes to complex cancer surgeries.

Thyroid and parathyroid surgery is delicate and highly

caring in the way that she told me it was cancer, and that I would need

specialized, due to the proximity of the glands to the airway and to the

another operation. She was always smiling and reassuring. I’ve never

nerves that control the vocal cords. “Thyroid surgery is less invasive

known another doctor like her.”

today and we are able to make smaller incisions,” Dr. McQuone says.

Dr. McQuone says that for Alycia, the overall prognosis is excellent.

“Most thyroid and parathyroid surgery can be done on an outpatient

“Alycia has received radioactive iodine, but no chemotherapy or radiation

basis, unless there is a large tumor that requires removal of the entire

will be necessary. Thyroid cancers do not respond well to radiation

gland. Patients have very little pain and usually recover quickly. They

therapy or chemotherapy and therefore these treatments are not

can generally resume regular diet and normal activity right away.”

generally employed. The radioactive iodine is a one-time treatment, and

Alycia Jones is immensely grateful to Dr. McQuone and describes

was undertaken approximately four to six weeks after surgery in

her as a superb surgeon. “As a surgeon, Dr. McQuone is incredibly

conjunction with a full body scan. The scan is used to determine if there

skilled. I had two surgeries in the exact same spot, one week apart,

are any thyroid cells left in the body after surgery. Frequently, they

but the scar in the front of my neck is barely visible.” Alycia also regards

microscopically adhere to the trachea or may have spread to the cervical

Dr. McQuone as a role model who demonstrated to the future nurse

lymph system. So we need to determine if any thyroid tissue remains,

that compassion and caring are as essential as clinical expertise for

and, if so, whether or not it has spread. The most common area of

healthcare professionals. Dr. McQuone, says Alycia, addressed not only

spread would be the lymph nodes of the neck, but metastasis in very

the unexpected diagnosis of cancer but also the fear and confusion

rare circumstances can occur in the lungs, bones or brain, among other

that left her reeling for a while. “This was very hard for me,” Alycia says.

organs. It helps that Alycia is young and in great health. She will need

“I’m young and healthy. I kept wondering, how did this happen? When

to be monitored for cancer, although the rate of recurrence is low.

they first gave me the cancer diagnosis, it took a few days for it to really

She will be on lifelong thyroid replacement, and her care will be

hit me, to sink in. Dr. McQuone was great. She was so positive with me,

co-managed with endocrinology. She should have a normal life and

and she told me to stay positive. I can’t express what a difference that

normal life expectancy.”

made for me. I decided that I could face it, come to terms with it and accept it. Dr. McQuone made me feel comfortable. She was kind and

Continued on page 14

“

I was drawn to head and neck surgery in medical school.

It’s a combination field in many ways, both medical and surgical. The specialty is a good fit for me.

”

SHELLY J. MCQUONE, M.D., FACS

Volume VI Issue 4 I HouseCall I 13

A HANDS-ON APPROACH Continued from page 13

Valuable lessons learned from being a patient As the head of the department of nursing and a professor of nursing at

to get rid of the infection. Despite no previous history of sinus problems,

Robert Morris University School of Nursing and Health Sciences in Moon

my doctor felt that the most appropriate course of action was to consult

Township, Nadine Englert, Ph.D., R.N. teaches her students the art and

an otolaryngologist and he referred me to Shelly J. McQuone, M.D.”

science of nursing. Now she has something new to offer her students:

Dr. McQuone ordered a CT scan of Dr. Englert’s sinuses and

the perspective of the patient, an experience she gained recently while

performed a nasal endoscopy in the office; these two diagnostic

having sinus surgery at St. Clair Hospital. Dr. Englert, 48, of Mt. Lebanon,

measures confirmed that she had a severe sinus infection and revealed

had never had surgery or been an in-patient at a hospital before, except

a surprise: Dr. Englert had a structural defect in her nasal septum.

during the births of her three children. Normally, she’s a healthy, vibrant,

Dr. McQuone suggested surgery to eradicate the infection and repair

high-energy powerhouse who juggles a demanding job with a home and

the deviated septum. “Dr. McQuone explained things to me in great

family, but a severe and stubborn sinus infection was taking a toll on her

detail,” Dr. Englert says. “At heart, she is a teacher and she really

health and well-being.

cares that you understand what she is going to do and what you will

“It started on July 4. I developed a congested cough and raspy voice and nothing seemed to help. For the next four months, my primary care physicians at Mt. Lebanon Internal Medicine and my pulmonologist

experience. She pulled up a stool and sat with me, drawing diagrams and pictures and answering every question. I felt well prepared.”

Dr. Englert underwent surgery at St. Clair under general anesthesia.

treated me with medication, including four different courses of antibiotics

Dr. McQuone describes the procedures: “I performed bilateral endoscopic

and two courses of steroids. I was told that I had a chronic, drug-resistant

sinus surgery using a CT image-guided technique, balloon sinoplasty

infection that my doctor thought was stemming from my sinuses. The

on the frontal sinuses, as well as septoplasty, establishing adequate

chronic coughing resulted from sinus drainage and my body’s attempt

ventilation to the previously occluded sinus passages. I also used powered instrumentation to vacuum the infected tissue. The balloon procedure can be used to safely access such areas as the frontal sinus, which is under the forehead, and enlarge the natural openings into these sinuses also.” Dr. Englert was discharged by late afternoon, with little pain other than a headache, and that was manageable with over-the-counter medication. Post-operatively, there was some nasal swelling and a bit of bleeding, but no bruising at all, which Dr. Englert attributes to the extraordinary skill of her surgeon. Dr. Englert returned to Dr. McQuone’s office two days later to have stents removed; the

Nadine Englert, Ph.D., R.N.

sutures in her left sinuses will be absorbed by her body.

“I received fabulous care from Dr. McQuone and from St. Clair Hospital.

Believe me, as a nurse educator, I was paying attention! St. Clair is a

“

Dr. McQuone always sat at my eye level to talk with me.

She never stands over the patient and never talks at you. She has the best bedside demeanor I have ever seen.

”

NADINE ENGLERT, PH.D., R.N.

14 I HouseCall I Volume VI Issue 4

“

I will take back to the classroom the lessons I learned from Dr. McQuone and the St. Clair Hospital staff.

”

NADINE ENGLERT, PH.D., R.N.

Robert Morris University Nursing Professor Nadine Englert, Ph.D., R.N., uses a full-size skeleton at RMU’s School of Nursing to explain the sinus procedure she underwent at St. Clair Hospital. The RMU Nursing students are, left to right, Molly Delaney, Victoria Morando, Nicholas Plansinis, and Jessica Blodgett.

well-oiled machine, extremely organized, but the staff does not sacrifice personal care for the sake of efficiency. The nurses were delightful; in every single interaction I had with a nurse, she told me what she was doing and why. They were extremely attentive and constantly cognizant of patient safety. I was touched that Diane Puchetti, Director of Peri-Operative Services, stopped by to say hello and see how I was doing.”

At two weeks post-op, Dr. Englert was back to

SHELLY J. MCQUONE, M.D., FACS Dr. McQuone specializes in head and neck surgery. She earned her medical degree at The University of Virginia School of Medicine, and completed her residency in head and neck surgery at The Johns Hopkins University School of Medicine, where she also did an internship in general surgery.

Dr. McQuone was a Head and Neck Surgical Oncology Fellow at The Johns Hopkins University School of Medicine, where she served as Assistant Chief of Service in the Department of Otolaryngology-Head and Neck Surgery.

She is board-certified by the American Board of Otolaryngology. She practices with Straka & McQuone, Inc. To contact Dr. McQuone, please call 412.668.3395.

work and feeling great. “Having outpatient surgery was a new experience,” she says. “I will take back to the classroom the lessons I learned from Dr. McQuone and the St. Clair Hospital nursing staff. One of the strongest impressions that remains with me is the way Dr. McQuone always sat at my eye level to talk with me. She never stands over the patient and never talks AT you. She has the best bedside demeanor I have ever seen. The nurses showed me the importance of keeping the patient informed. That takes away fear and

FRANK S. TOROK, M.D. Dr. Torok specializes in radiology and nuclear medicine. He earned his medical degree at The Pennsylvania State University School of Medicine and completed residencies at The Washington Hospital and the University of Pittsburgh Medical Center. He also completed a fellowship at UPMC. Dr. Torok is board-certified in radiology, nuclear medicine, nuclear cardiology, family practice and geriatrics. He practices with South Hills Radiology Associates.

To contact Dr. Torok, please call 412.942.3101.

anxiety. I knew I was in good hands and I could

trust their care.” n

Volume VI Issue 4 I HouseCall I 15

PERRI FAMILY LEGACY

All in the

Family Drs. Bill and Jeff Perri flank their sister, Mary Anne Perri, CRNA, before the three of them scrub in before a surgery at St. Clair Hospital.

16 I HouseCall I Volume VI Issue 4

THE PERRI FAMILY CONTINUES THEIR LEGACY OF CARE. Jeffrey A. Perri, M.D., FACS and William M. Perri, D.O., FACS are brothers and surgeons whose education began at home, well before they took their first pre-med classes. They are two of the 12 children of Francis R. Perri, M.D., who performed general surgery for decades at St. Clair Hospital.

Dr. Francis Perri is a physician and surgeon, a World War II veteran, a leader, and a teacher who trained hundreds of surgeons. But his most cherished role is that of husband and father. To his family, he is a revered figure, a gentle and humble man who set high standards and taught his children, simply by being himself.

W

hen Dr. Francis Perri retired in 1998 at

my life,’ and ‘Your Dad operated on me and helped

age 73 after an exemplary career as a

me so much.’ It happened a lot and it made an

surgeon, he left his practice to a worthy

impression.”

successor: his son, Jeff. Jeff attended medical school

After his father retired, Dr. Jeff Perri had a solo

at Georgetown University, as his father had. The senior

practice for nine years, until his younger brother Bill

Dr. Perri trusted that his thriving surgical practice

joined Perri Surgical Associates in 2007. Bill had

was in excellent hands. Their three years in practice

initially planned to become an attorney, but changed

together are deeply meaningful to both.

direction after a pivotal experience with his father

“I know that my Dad waited for me,” says Dr. Jeff Perri, who is now chairman of the Department of Surgery at St. Clair. “He could have retired sooner.

and Jeff. “I was at a restaurant with Dad and Jeff, Continued on page 18

I began practicing with him in 1996 and we had a unique situation. Although three of my brothers are also surgeons, I was the first in the family to become a surgeon. My sisters are both nurses.

Mary Anne is a nurse anesthetist at St. Clair, and Kathy works in Philadelphia.”

Dr. Jeff Perri has clear memories of childhood experiences that inspired his professional aspirations. “I knew when I was 10 that I was going to be a surgeon. My earliest recollections are of running into people in Mt. Lebanon and hearing them say things like, ‘Your Dad saved

Dr. Francis Perri, fourth from left, is surrounded by family/fellow clinicians following his last surgical procedure at St. Clair Hospital. He retired in 1998.

Volume VI Issue 4 I HouseCall I 17

PERRI FAMILY LEGACY Continued from page 17

“

IN THE OR, WE ARE SURGEONS FIRST AND BROTHERS SECOND …

THE PATIENT’S BEST INTEREST ALWAYS COMES FIRST.

”

JEFFREY A. PERRI, M.D., ST. CLAIR HOSPITAL

and they were discussing an operation that another

also performs mastectomies, and both brothers are

surgeon had performed. Dad was drawing pictures on

trained in robotic-assisted surgery using the da Vinci

a napkin, explaining how it should have been done. I was

robotic system.

fascinated and thought, ‘This is what I should be doing.’

The Perri brothers appreciate the fact that their

I knew then that I was going to go to medical school.”

situation is exceptional. According to Dr. Bill Perri,

Bill graduated from Duke University and LECOM. Both

“It’s fun to work with my brother Jeff, but also with

brothers perform a wide variety of surgical procedures.

my sister Mary Anne. She’s excellent; I have complete

“In my practice with Bill, we do general surgery, such as

confidence in her skills as a nurse anesthetist. It’s

hernia repairs, appendectomies, thyroid and parathyroid

great when we’re all in the OR together. Adds Dr. Jeff

surgery, and gall bladder removals; we also do oncologic

Perri, “In the OR, Bill and I are surgeons first and

surgery and a good deal of emergency surgery,” Dr. Jeff

brothers second. We can say anything to each other

Perri says. “We also perform colorectal surgery and

and there will be no hard feelings. We know that the

minimally invasive colon resections.” Dr. Jeff Perri

patient’s best interest comes first.”

Continued on page 20

18 I HouseCall I Volume VI Issue 4

PATIENT PROFILE

LIKE THEIR FATHER BEFORE THEM, THE PERRI BROTHERS CONTINUE A TRADITION OF PATIENT-FOCUSED CARE Krista Fahnestock is one of the many patients of the Perri brothers who benefited from their diligence.

“

The past year has been unexpectedly challenging for 38-year-old Krista Fahnestock. Around Labor Day last

I FELT LIKE THE

year, she developed abdominal pain and was given a diagnosis of diverticulitis, an inflammation of pouches

PERRI BROTHERS WERE

that form in the intestine. She was doing well until the following March, when a high fever landed her in St. Clair Hospital. “I had a horrible infection with an

IN TUNE WITH ME. THIS WAS A BIG SURGERY, BUT I KNEW I WAS

abscess in my left side; I was referred to Dr. Jeff Perri.

IN GOOD HANDS.

He was fantastic.

”

“I’m young to have diverticulitis. He recognized my fear and explained everything to me.” He was honest,

KRISTA FAHNESTOCK, PATIENT

but I knew he was trying not to scare me.” Although Dr. Jeff Perri was Krista’s primary surgeon, brother Bill was also in the operating room for her case. “It was a minimally invasive procedure,” she says.

Krista is married with one child and lives in Hickory,

I was in good hands. When I told Dr. Jeff that, he put

Washington County. As an X-ray technician, she’s familiar

his hands out to me and I held them. On my last day

with hospitals and doctors. “I felt like the Perri brothers

in the Hospital, he hugged me. I expected a handshake,

were in tune with me. This was a big surgery, but I knew

so that was nice.” n

JEFFREY A. PERRI, M.D. Dr. Perri earned his medical degree at Georgetown University Medical School, Washington, D.C. He completed his internship and residency at Mercy Hospital, Pittsburgh. Dr. Perri is board-certified by the American Board of Surgery. He practices with Perri Surgical Associates, LLC. To contact Dr. Jeffrey Perri, please call 412.942.5660.

WILLIAM M. PERRI, D.O. Dr. Perri earned his medical degree at LECOM, Erie, Pa. He completed his internship at Conemaugh Memorial Medical Center and his residency at Pinnacle Health System, Harrisburg. Dr. Perri is board-certified by the American Board of Surgery. He practices with Perri Surgical Associates, LLC. To contact Dr. William Perri, please call 412.942.5660.

Volume VI Issue 4 I HouseCall I 19

PERRI FAMILY LEGACY Continued from page 18

THE FAMILY PATRIARCH Dr. Francis Perri is 88 now and has been

at St. Vincent Seminary and College in Latrobe,

spoken gentleman who speaks with pleasure

where he excelled in academics and sports. He

about his life’s work and his family. The Perris

later served in World War II as a radio operator.

have 10 sons and two daughters, 24 grand-

A picture from the family scrapbook shows newly minted physician Francis Perri, M.D. performing a procedure.

The Perri family has been providing three generations of healthcare.

County, and attended high school and college

retired for 16 years. He is a modest, soft-

Wanting to emulate his father, Francis Perri

children, and two great-grandchildren. Looking

applied to Georgetown University Medical

back on his years as a surgeon, he cherishes

School, where he met Prudence Boutin, a

the gratitude of his patients and finds great

medical technologist from Minneapolis who

meaning in the opportunities he had to teach

shared his love of biology. In 1954 he married

and train other physicians. His daughter

Prudie and the couple moved to Pittsburgh.

Mary Anne Perri explains: “My Dad inspired

Following a residency in general surgery at

a lot of us to go into healthcare. Being a nurse

Mercy Hospital, he went to New York for a

anesthetist is perfect for me and I love it.

fellowship at Memorial Sloan-Kettering Cancer

Working with my brothers is fun. We’re often

Center where he acquired expertise in cancer

on call at the same time, so we sometimes

surgery. By then, several of their children had

do the same cases.”

been born, with more to come.

The son of a physician and a nurse, Dr. Francis Perri grew up in Monaca, Beaver

In 1960, the family moved back to Pittsburgh; Dr. Perri opened a solo practice and joined the staff at Mercy, eventually becoming chair of the department of surgery. He performed a broad range of procedures, including many cancer surgeries. “I got all the bad cancer cases,” he recalls, “because I had trained at Sloan-Kettering.” They moved to their present home in Mt. Lebanon in the early 1960s and before long, found themselves adding two bedrooms to accommodate their expanding family.

Dr. Perri knew the surgeons at the brand new St. Clair Hospital, not far from his home. When they asked him if he would like to moonlight at the Hospital, working one night per week in the Emergency Room, he accepted. Before long, he had joined the staff.

Seven of the Perri children followed their parents into healthcare. As there are hints of interest in medicine among some of the grandchildren, an expansion of Perri Surgical Associates may be on the horizon. n

(At left) Dr. Francis Perri and his wife, Prudie, recently stopped for a quick breakfast with their sons, Drs. Jeff and Bill Perri, in the brothers’ offices in St. Clair Hospital Professional Office Building.

20 I HouseCall I Volume VI Issue 4

SURGEONS INCLUDING THE PERRI BROTHERS ARE AVAILABLE IN CASE OF EMERGENCY AROUND-THE-CLOCK

M

ost surgical procedures are elective and are therefore scheduled to take place on weekdays, with

ample opportunity for the surgeon to know

his or her patient and the patient’s condition.

But, of course, surgical emergencies happen, too, often in off-hours. At St. Clair Hospital, general surgeons are available 24/7/365, ready to respond when a patient’s life or health is jeopardized by a condition that requires immediate surgical intervention.

“During the off-hours, meaning nights and weekends, we may get a call from the Emergency Room telling us that there is a suspected At St. Clair Hospital, general surgeons are available 24/7/365,

surgical emergency,” Dr. Jeff Perri

ready to respond when a patient’s life or health is jeopardized

explains. “Typically, this might be a

by a condition that requires immediate surgical intervention.

perforated gastric ulcer, a perforated intestine from diverticulitis, or a bleeding ulcer. Appendicitis was once considered a surgical emergency, but studies indicate

anesthesia, and we open up the room and go

physician assesses the patient and calls the

that if there is no perforation and the patient

to work.”

surgeon on-call, and we determine if the

is stable, they can be admitted and given

A surgical team includes a surgeon or

antibiotics and then have surgery the

surgeons, an anesthesiologist or anesthetist,

following morning.”

surgical nurses, OR technicians and other

patient needs surgery, and if it needs to be done immediately.”

Dr. Jeff Perri says that surgeons get used

Performing emergency surgery in the

clinicians, all of whom are highly trained for

to performing surgery whenever they are

middle of the night is no simple matter —

this scenario. Supportive services, including

needed. “Residency prepares us for that.

it requires considerable logistics, including

laboratory, blood bank and pharmacy, are

Emergency operations are interesting

the assembly of a surgical team and prepa-

available if needed. Provision must be made

and exciting and you always have a little

ration of the Operating Room. Dr. Jeff Perri

for the post-anesthesia and post-operative

adrenalin flowing.”

credits St. Clair’s Emergency Department

nursing care of the patient as well, whether in

For Drs. Jeff and Bill Perri, and their

for streamlining the process. “St. Clair has

the Intensive Care Unit or other nursing unit.

surgical colleagues at St. Clair, being on-call

an excellent, highly efficient emergency

Dr. Jeff Perri says that St. Clair’s Surgery

for emergencies is part of the job. For them,

department, and that makes a difference.

Department has an on-call system with a

interrupted sleep is offset by the satisfaction

They stabilize the patient and initiate the

rotating schedule of surgeons. “Our emergency

of knowing that they were able to help

diagnostic tests, and get things rolling right

department is one of the busiest in south-

someone in critical need, someone who

away, in terms of notifying the on-call surgeon

western Pennsylvania, so we get called quite

also did not expect to be in the OR in

and getting the OR ready. We notify the nursing

a bit, at least for a surgical consult, if not for

supervisor, who calls in the OR staff and

a surgical procedure. The emergency room

the middle of the night. n

Volume VI Issue 4 I HouseCall I 21

ORTHOPEDIC ADVANCES

Patients benefit from technological advances in orthopedic surgery JOINT REPLACEMENT SURGERY IS UNQUESTIONABLY ONE OF THE MIRACLES OF MODERN MEDICINE. BUT IT’S NOT THE ONLY ALTERNATIVE FOR PATIENTS WITH OSTEOARTHRITIS.

N

early 30 million Americans live with the pain and

The patient is told to take anti-inflammatories, get cortisone

disability of knee osteoarthritis, and chances are

shots, modify their lifestyle, lose weight, use a cane and

good that most of those people have been led

be prepared to have a total knee replacement. “About

to believe that knee replacement surgery, or total

half of the people I see who think they need a total knee

knee replacement, is inevitable. Not necessarily, says

replacement have a condition that is treatable with less

Jon B. Tucker, M.D., a board-certified St. Clair Hospital

invasive procedures and techniques. Many of these

orthopedic surgeon who focuses on knee and shoulder

people will actually do better with a less invasive

disorders. Many patients who have been told they need

surgery than a total knee replacement. It’s a highly

total knee replacement may not need it after all, he says, thanks to advances in orthopedic surgical technology that are designed to preserve and restore diseased joints, rather than replace them.

“My focus is joint preservation,” Dr. Tucker says.

“There are new, advanced options to restore cartilage and preserve all or part of the joint; these are wonderful developments in orthopedic surgery. They are alternatives that can keep you going until you clearly need total knee replacement, or they can keep you going without having to undergo a replacement at all.”

individual matter; every person’s knee, their demands and their expectations are unique.” Dr. Tucker is not opposed to total knee replacements; he frequently performs the procedure. “Total knee replacement is a great procedure. St. Clair’s surgeons use multimodal pain management, so it isn’t the ordeal it once was. But a total knee replacement is no simple matter.”

In his practice, Dr. Tucker uses Magnetic Resonance Imaging, or MRI, for short.

An MRI, he says, is like a piece of fine art —

Dr. Tucker describes his typical

detailed and rich with

knee replacement patient as a middle-

information. “Images

aged person with a knee problem

provide the nuance

that causes pain and instability that

that makes the

eventually impair quality of life.

difference,” he says.

Jon B. Tucker, M.D.

22 I HouseCall I Volume VI Issue 4

Orthopedic surgeon Jon B. Tucker, M.D. prepares for a recent knee procedure in an operating room at St. Clair Hospital. Dr. Tucker says newer technologies bring customized treatment for each patient.

“For instance, you can see bone marrow lesions (BML) on an MRI. BMLs are little microfractures — insufficiency fractures — in the bony tissue in the joint just beneath the cartilage.

The bone starts to crumble. An MRI helps me plan exactly what surgery you need, according

“

ABOUT HALF OF THE

to your personal anatomy.”

To Dr. Tucker, these advancements reflect the evolution taking place in orthopedics.

“It represents a coming together of advancements in medical science and technology.

We’re learning more about osteoarthritis all the time: what makes it hurt? What can be done about it? What is actually causing the disability and pain? When we know, we can match the problem with the right tools. These days, a versatile surgeon has many tools in the toolbox

PEOPLE I SEE WHO THINK THEY NEED A TOTAL KNEE REPLACEMENT HAVE A CONDITION THAT

— it’s no longer just total knee replacement. These advances bridge the gap between non-

IS TREATABLE WITH LESS

surgical treatment of osteoarthritis, which remains very important, and total knee replacement.

INVASIVE PROCEDURES

An experienced surgeon can expertly match the right minimally invasive techniques with the

AND TECHNIQUES.

right patient and achieve a great outcome. This can significantly delay and even eliminate the need for total knee replacement. It’s a matter of what can be done versus what should be done.”

Dr. Tucker believes that the newer technologies bring customized treatment for each patient. “My goal is always to choose what is best for each patient, and to consider all procedures after listening to each patient’s needs and collaborating with them on a treat-

”

JON B. TUCKER, M.D., ORTHOPEDIC SURGEON, ST. CLAIR HOSPITAL

ment plan.”

Continued on page 24

Volume VI Issue 4 I HouseCall I 23

ORTHOPEDIC ADVANCES Continued from page 23

FOLLOWING ARE TWO REAL-LIFE EXAMPLES OF ALTERNATIVES TO TOTAL KNEE REPLACEMENT RICHARD JUSTICE:

Back to work, pain-free Richard Justice, 52, of Oakdale, was a veteran of four knee

missing a day of work, but it’s been a struggle. “I knew

operations, before meeting Dr. Tucker. He lived with constant

I was heading toward a total knee replacement,” he says.

severe pain for 18 years, due to kneecap misalignment

“Nothing helped — including cortisone shots or physical

ARTHROSURFACE PATELLAR FEMORAL RESURFACING

problems and osteoarthritis.

therapy. I was always on and off crutches. Chronic pain

Previous surgeries were all

wears on you.”

attempts to realign his cracked, chipped kneecap and debride

Dr. Tucker performed a partial knee replacement on Richard’s brother-in-law and he, in turn, suggested

the joint; the procedures provided short-term relief at best.

Richard see Dr. Tucker. “Dr. Tucker is straightforward

As a contractor, his work is physically demanding and

with you. He told me I needed a procedure called

he found ways to cope with the pain, remarkably never

arthrosurface patellar femoral resurfacing. In my situation, a total knee replacement would be overkill, he told me.”

Knee patient Richard Justice is back at work, pain free.

“Total knee arthoplasty, when the problem is confined to the kneecap, is a big step to take for a small problem,” says Dr. Tucker. “Richard had an unstable knee, beyond joint preservation but not bad enough for a total knee. His problem, kneecap arthritis and instability, is clinically very different from gardenvariety osteoarthritis. I gave him a prosthetic partial knee joint replacement; it’s an implant that is similar to getting a tooth filled. Only the damaged area is restored; the healthy part of the knee is not disturbed, so much of the joint is preserved.”

Richard says his surgery was life changing. “Being pain-free is amazing. This surgery bought me time.

I spent one day in the Hospital and was back at work in a week. I have occasional swelling and stiffness, but no major pain. I’m able to accomplish much more.

But the biggest difference is that I can enjoy my life again with my wife, Stacie, and our kids, and our first grandchild.” n

“ ”

BEING PAIN-FREE IS AMAZING.

. . . I CAN ENJOY MY LIFE AGAIN.

RICHARD JUSTICE, PATIENT

24 I HouseCall I Volume VI Issue 4

GRETCHEN GRIMES:

Her shoes were made for walking Gretchen Grimes loves to go for evening walks in her Rennerdale neighborhood, and now she has some fancy new shoes for those walks — a pair of black, white and pink running

PARTIAL KNEE REPLACEMENT

shoes with purple laces. The shoes were a gift from her daughter, to celebrate the return to her cherished walks, following two partial knee replacements.

Gretchen has had two partial knee replacement surgeries in

“

I FEEL GREAT… I’M SO GLAD THAT I HAD THE PROCEDURES AND HAVE NOW RETURNED TO MY EVENING WALKS.

”

GRETCHEN GRIMES, PATIENT

recent months, both performed by Dr. Tucker. She was suffering with osteoarthritis and bone deterioration, with considerable pain that was limiting her life. “I saw Dr. Tucker and he explained his findings to me.

He told me about partial knee replacement, which I had never heard of. I was excited about it.”

Dr. Tucker says that partial knee replacement is for severe osteoarthritis that is limited, usually, to just the medial half of the joint. It resurfaces only the damaged cartilage, while a total knee replacement replaces the entire joint. “This procedure uses a special device to replace the worn out half of the knee. About one third of patients with knee osteoarthritis can have this done instead of total knee replacement, and it will produce results that last as long, with less risk, and a lower complication rate. It’s a smaller operation, with a shorter recovery time, and it results in a more natural feeling knee, with better range of motion.”

St. Clair’s physical therapists had Gretchen out of bed and walking the very evening of her surgery. “I used a walker and just went a short distance, but I was amazed to be walking so quickly.” Gretchen is back to work after being off for eight weeks from her job as a payroll supervisor for a multi-national corporation headquartered in Downtown Pittsburgh.

“I feel great. Dr. Tucker takes his time with you and explains things until he is sure that you understand. The staff on the Orthopedic

A partial knee replacement allowed patient Gretchen Grimes to return to her daily walks near the Rennerdale Duck Pond, just outside Carnegie.

Unit of St. Clair Hospital is outstanding, and Dr. Tucker’s office staff is excellent. I’m so glad that I had the procedures and have now returned to my evening walks.” n

JON B. TUCKER, M.D. Dr. Tucker earned his medical degree at the University of Pennsylvania. He completed his internship in general surgery, residency in Orthopedic Surgery, and a fellowship in Sports Medicine at the Hospital of the University of Pennsylvania. He is board-certified by the American Board of Orthopedic Surgery. He practices with St. Clair Medical Services Tucker Orthopedic Group.

To contact Dr. Tucker, please call 412.276.0267.

Volume VI Issue 4 I HouseCall I 25

60 YEARS OF CARE

Hall of History Brings St. Clair Hospital’s 60 Years of Service to Life

T

o commemorate 60 years of serving the

women, and, yes, children of the area who united in a

community, St. Clair Hospital is erecting a

tenacious effort to build a hospital they could call their

Hall of History that will run approximately half

own, close to home. If you are interested in making a

the length of the hallway adjacent to the Fourth Floor

financial donation to the Hall of History and continuing

Lobby and include St. Clair’s greatest achievements

St. Clair’s long-running history of grassroots support,

throughout the past decades. When completed,

please contact the St. Clair Hospital Foundation at

the Hall’s photographs and exhibits will serve as a

412.942.2465 or schfoundation@stclair.org. n

testament to the spirit of the thousands of men,

This architect’s rendering offers a sneak preview of the soon-to-be erected Hall of History on the Fourth Floor at St. Clair Hospital.

26 I HouseCall I Volume VI Issue 4

ASK THE DOCTOR

Ask the Doctor JAY A. LUTINS, M.D.

Q

I have trouble controlling my bladder. I need to urinate often during

A

Yes, there are a lot of things that can be done for you.

These problems affect men and women of all ages, although mainly people over the age of 35. We refer to these symptoms as Overactive Bladder (OAB). It is important at the initial office visit to perform a few routine tests, which include a physical exam, an assessment of a urine sample for infection or blood, and measuring how much urine is left in the bladder after the patient thinks he or she might have completely emptied.

OAB is an enormously common, yet NOT a normal part of aging. More than 33 million people in the U.S. suffer from some sort of bladder problem. These issues are embarrassing to the patient which explains why, on average, patients delay bringing up these problems to their doctor. OAB can alter one’s life in dramatic ways by causing sufferers to avoid travel, parties, interacting with family, and basically avoiding many social activities.

Many patients will improve with simple steps, such as restricting certain fluids and foods which are bladder irritants, trying to keep their bladders empty, exercising certain pelvic floor muscles, and taking medications.

Newer medications have been developed which have minimal, if any, side effects.

For those patients who do not respond to these simple measures, we offer another proven treatment as an option for improving bladder control, and it has also been shown to help those suffering from bowel accidents, as well. Up to one third of patients who suffer from bladder problems also experience bowel problems, called fecal incontinence (FI). The treatment is referred to as Sacral Neuromodulation, and it has helped greater than 150,000 patients worldwide.

In the office setting, we are able to test the patient to see if he or she would benefit from this approach.

The office test takes 7 to 10 minutes. Patients usually know within 2 to 3 days if the office test was successful.

the day and night, and I get hardly any warning before I have to make a dash for the bathroom. Is there anything that can be done for me?

If successful, then we have the patient come to St. Clair Hospital where we place a silver dollar-sized disc under the skin above the buttock. Placing the disc takes 20 to 30 minutes and patients can comfortably go home shortly thereafter.

Sacral Neuromodulation was FDA approved in 1997 as a safe, minimally invasive procedure that can dramatically improve one’s quality of life. It has proven effectiveness in selected patients for up to 5 years. Risks are minimal, and we change the device battery when it runs low. Sacral Neuromodulation is a very viable treatment for patients suffering from FI. n Jay A. Lutins, M.D.

JAY A. LUTINS, M.D. Dr. Lutins earned his medical degree at the Medical College of Virginia and completed his residency training in urology at the University of Pittsburgh Medical Center. He is board-certified by the American Board of Urology.

He practices with The Center for Urologic Care.

To contact Dr. Lutins, please call 412.833.3000.

Volume VI Issue 4 I HouseCall I 27

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.

Follow us on twitter at: www.twitter.com/stclairhospital

The results are in!

St. Clair Hospital is ranked among the top2% nationwide in patient satisfaction.

Independent surveys of patients hospitalized at St. Clair show soaring satisfaction levels from discerning men and women whose high expectation levels are being met on every front. Please turn to Page 2 to read how the Hospital’s ‘Healing Touch’ is exemplified in an environment of compassion, dignity and respect.

PATIENT SATISFACTION:

Patients trust our physicians

Kept patient informed

TION: PATIENT SATISFAC

Our staff is us kind and courteo

d helpful Staff is friendly an ilies m fa d an s to patient

Respected patient concerns and views

ivers Volunteers and dr offer special care

Answered all questions about condition and care

TION: PATIENT SATISFAC

Our nurses deliver genuine care and compassion Responsive to patient requests

ial Attentive with spec care needs Understanding