Inside This Issue:
Spring 2021
PHELPSToday
• Outpatient joint replacement surgeries becoming increasingly popular • When a physician becomes a patient • Back pain: Common causes and tips for pain prevention • Spring Calendar
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Our Phelps
Heroes nwh_constellation_07
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Letter from the Executive Director Dear Phelps Community, The last year has been quite a year. Lots of challenges, lots of change. Shortly after I was selected as our Executive Director, we admitted the first COVID-19 patient in the entire Northwell Health System. Since then, we have learned a lot about COVID-19, the worldwide pandemic, our staff, and our community. We have all worked under extreme pressure with valor and resilience, and our patients and community have benefited from that strength. We want to thank you for recognizing our expertise and compassion. You have demonstrated your gratitude by charitable giving, donating to the meal train and the fund-a-cause campaign, thank you letters, and simply by following safety precautions like social distancing, hand washing, and wearing your masks.
“We have all worked under extreme pressure with valor and resilience, and our patients and community have benefited from that strength.”
I am also grateful for how our Phelps team members and community members came together to support and care for one another. We really are dependent on each other – we really are in this together. On behalf of our Senior Leadership and Community Board Members, I invite you to join us in looking ahead with hope, especially since vaccinations against COVID-19 have begun. Please stay optimistic and continue your great care of yourselves, your loved ones, and your neighbors.
Eileen Egan, RN, Esq. Executive Director
2 Spring 2021 | Phelps Today
Table of Contents
PHELPS TODAY Editor Elissa Hannon Managing Editor Margaret Plofchan mplofchan@northwell.edu PHELPS TODAY is a publication of Phelps Hospital, a 238-bed, not-for-profit acute care community hospital located in Sleepy Hollow, NY. Phelps, part of Northwell Health, has been providing medical and mental health services to Westchester and surrounding communities since 1955.
Outpatient Joint Replacement Surgeries Becoming Increasingly Popular 4 nwh_constellation_01 When a physician becomes a patient: Dr. Raniolo’s treatment journey
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Back pain: Common causes and tips for pain prevention
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Phelps Hospital Announces the Care Connections Program
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Recipe: Move Over, Stuffed Peppers. Try Stuffed Eggplant Instead!
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Healthy Life Calendar Spring 2021
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Maternal Child Health
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Cirugías ambulatorias de reemplazo de articulaciones se hacen más populares Cuando un médico se convierte en un paciente: La travesía de tratamiento del Dr. Raniolo Phelps Hospital Programs and Services
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Visit us on Facebook: http://www.facebook.com/ PhelpsHospitalNorthwell Visit us on Twitter: https://twitter.com/ phelpshospital Visit us on Instagram: Instagram@PhelpsHospital
Request Your Appointment Online! Appointments for many of Phelps’ outpatient services can be requested on the nwh_constellation_10_live hospital’s website, including: cardiovascular, diabetes, infusion, nutrition counseling, occupational and physical therapy, pain center, pulmonary/respiratory, radiology/ x-ray, senior services, sleep, speech & hearing, voice & swallowing, and wound healing. Just go to www.phelps.northwell.edu and click on “Request an Appointment” – any time of the day or night! nwh_constellation_10_live
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Spring 2021 | Phelps Today 3
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Outpatient Joint Replacement Surgeries Becoming Increasingly Popular By: Jason Hochfelder, MD
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Traditionally, hip and joint replacement therapies are thought to be expansive ordeals requiring extensive hospital stays and lengthy recovery procedures. It’s time to rethink that train of thought.
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Substantial improvements in medical technology have led to minimally invasive surgical techniques for hip and knee replacement surgery. These procedures now have such positive outcomes that many orthopedic surgeons, including Dr. Jason Hochfelder of Phelps Hospital, Northwell Health, are offering outpatient surgery that allows patients to go home the day-of surgery, as opposed to spending unneeded time in a hospital setting. 4 Spring 2021 | Phelps Today
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“You can recover in the comfort of your own home and bed,” Dr. Hochfelder said. “No overnight stay is needed, and studies show no increased risk. Plus, you sleep better in your own home vs the hospital, which leads to greater patient satisfaction, less pain, and a faster recovery.” Due to less invasive techniques, joint replacement procedures are considerably less painful, and patients recover faster
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“You can recover in the comfort of your own home and bed.” than ever before. Additionally, due to Phelps’ relationship with Northwell Health, doctors are able to monitor patients remotely following surgery. Most of the time, at-home physical therapy even starts the day following surgery. The concept of recovering from what seems like a major joint replacement while entirely at home could seem daunting to many. Many patients have some simple, but understandable questions: Is this safe? What are the risks? How is the recovery different for this procedure? Studies have shown that there is no increased risk of complications for patients who go home on the same day as the procedure – it’s a totally safe way of recovery. Actually, some studies have shown that patients will actually recover faster if they go home on the day of the surgery. “People used to think that they had to stay overnight,” Dr. Hochfelder said. “But hip and knee replacements are so common now that we have so much data and information that shows there’s no increased risk of the patients going home. Whether patients stay overnight or whether they go home, the risks are low to begin with and they’re not increased by going home. The way we do that is by identifying which patients are appropriate candidates to go home.” Of course, like Dr. Hochfelder said, this outpatient procedure isn’t for everyone. In general, this is an option for more motivated patients and those that are active in their everyday lives. Those with other outstanding medical issues will need to be monitored within the facilities following a procedure. “The last thing we want is to send anybody home and then have them back in the emergency room or the hospital the next day,” Dr. Hochfelder said. “And that’s
something we haven’t seen because we are so strict with our criteria and we make sure patients are actually safe to go home before we send them home.” It simply takes breaking a mental barrier for many to see the benefits of this type of surgery. There’s a traditional, old way of thinking where many think they must stay overnight in a hospital after surgery. There’s no real evidence that supports that line of thinking. The COVID-19 pandemic has opened the eyes of many patients regarding the benefits of day-of, outpatient surgery. According to Dr. Hochfelder, the standard patient is more open than ever before to these new sorts of procedures. “So many people are suffering from hip and knee pain, but some are reluctant to stay in hospital,” Dr. Hochfelder said. “So this option is becoming more and more appealing.” By now, Dr. Hochfelder has been doing this procedure enough that he has many satisfied patients in the outpatient realm. One recent patient, who needed a knee replacement surgery when physical therapy for a prior injury wasn’t enough, was a bit hesitant to be in the hospital with the ongoing pandemic throughout the country.
“With the COVID risks in the hospitals it felt so good to just head home after,” one patient said. “The presurgical staff was wonderful. Dr. Hochfelder even called me the night before to make sure were on same page and showed he really cared for me… after surgery, I was able to walk fine and was able to be discharged the same day.” Even while offering outpatient surgery as an option, Dr. Hochfelder sees about an eight-to-one ratio of patients who will stay overnight vs. those who will go home the day of surgery. However, the large difference has been slowly decreasing as more patients have begun to see the advantages of returning home more quickly. If you or a loved one needs to undergo any sort of joint replacement therapy in the future, be sure to ask your surgeon about potential outpatient options. In particular, Dr. Hochfelder at Phelps Hospital, Northwell Health, would love to serve you. Besides, wouldn’t we all prefer to wake up in our own beds as opposed to the hospital? phelps.northwell.edu/orthopedics.
The option to stay at home for most of the process put them at ease. By Jason Hochfelder, MD Orthopedic Surgeon Hip & Knee Replacement
For a consultation with Dr. Hochfelder, call (914) 298-2620 or visit us online at https://phelps.northwell.edu/orthopedics.
Spring 2021 | Phelps Today 5
When a physician becomes a patient Dr. Raniolo’s treatment journey
A doctor first As a dedicated surgeon, Dr. Robert Raniolo takes pride in always being available for his patients. For the past 30 years, he has rarely needed to take a sick day. But, as he was recently reminded, “No one is immune to illness.” A few months ago, after a long weekend ride to Vermont on his motorcycle, Dr. Raniolo noticed an unusual soreness in his groin. On inspection, he found a small lump, which while unexpected, did not cause him much alarm. Perhaps the nodule came from riding on rough roads, he thought. The following Monday, after a conversation with his colleagues, Dr. Raniolo decided to have the lump removed, even before getting the tissue results from the lab. He already suspected that the outcome might not be good. Days later, Dr. Raniolo learned he had an aggressive form of nonHodgkin’s lymphoma that affects the lymph system and may invade other organs, particularly the central nervous system and brain.
Early detection is key After the diagnosis, a series of tests—MRI, PET-Scan, CAT-Scan, and lumbar puncture (spinal tap)—revealed that the disease had not yet spread. The remission rate for the diagnosis of early-stage lymphoma is better than 80%. The standard treatment for this aggressive form of non-Hodgkin’s lymphoma involves infusion with the cancer-fighting drug methotrexate as an inpatient and six courses of R-CHOP (an infusion of an immunotherapy drug along with three other cancer-fighting drugs and prednisone), administered every three weeks as an outpatient. 6 Spring 2021 | Phelps Today
“Only at Phelps can I be surrounded by staff who know and care about me, and professionals that I fully trust. Only at Phelps can I be close to my family and home during treatment. When all factors are considered, Phelps is clearly the only choice for me.”
Why Phelps? We’re a family Dr. Raniolo consulted two of the most prestigious cancer centers who offered to treat him in their facilities, but when he compared their recommendations and therapies to Phelps, he realized that there weren’t any differences. But he knew he would feel more comfortable surrounded by friends and family at Phelps.
Patient first, doctor second Dr. Raniolo has already started to experience some of the side-effects of his treatments, including hair loss, mouth sores, periods of “super-highs,” and sleeplessness. His white blood cell count is sometimes very low, which makes him more susceptible to infections. Although there is no guarantee of remission, Dr. Raniolo understands that without the treatment and his physicians, the disease will only progress. These side effects were not as difficult for him as his struggle with anxiety, although it has lessened since being treated here at Phelps, surrounded by family and friends. After 30 years of taking care of others, Dr. Raniolo is now the patient. He has always been a very energetic and giving soul but now must adjust to being in his wife’s care. Like many others in these trying times, Dr. Raniolo had no choice but to seek medical care during the peak of the worldwide COVID-19 pandemic. As serious as this virus can be, it’s important to remember that COVID-19 is far from the only thing that one may need to seek medical care for, and should not deter anyone from seeking medical care – Dr. Raniolo knows that firsthand.
“None of us are immune to cancer, but fortunately we have great treatment here at Phelps and great caregivers. Lastly, I want you all to know how reassured, comfortable, and confident I am with all of you amidst my illness. I know I wouldn’t receive better healthcare or more love and care than has been offered me here at Phelps. I wouldn’t want to be anywhere else. Hopefully, I will be well again and return to caring for all of you, which has been very fulfilling for me in my life. I am strong and all of you are too.”
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At Phelps, we understand how difficult a cancer diagnosis can be;
that’s why we offer various support groups and services alongside oncological treatment. For more information, please call (914) 366-1600.
Dr. Raniolo is thankful to the staff at Phelps and his family for their ongoing support, whether through kind words, encouragement, or accommodation to the changes in his life. “I would especially like to thank all of the world-class physicians and staff here in our community hospital who are involved in my care.” Spring 2021 | Phelps Today 7
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The Cancer Institute at Phelps Hospital, Northwell Health is dedicated to providing exceptional care for every step of your cancer care journey. To learn more or schedule an appointment, please call (914) 366-1600. Our mission at Phelps has always been to provide the highest quality, comprehensive care in a safe environment. Cancer screening and treatment are still happening at Phelps, with strict COVID-19 safety measures in place. Don’t put off testing or
treatment; we’ve worked hard to ensure Phelps is a safe place for you to get screened as early as possible. To learn more about the safety precautions we’ve implemented, visit phelps.northwell.edu.
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Early detection is key in prevention and treatment therapy effectiveness for lymphoma Know the signs and symptoms: Swelling in the lymph nodes in the • Neck • Groin • Stomach
And/Or • Feeling very tired • Fever for no known reason • Pain in the chest, abdomen or bones
• Recurring night sweats • Skin rash or itchy skin nwh_constellation_04 • Weight loss
When fever, night sweats, and weight loss occur together, this group of symptoms is called B symptoms. Other signs and symptoms of adult non-Hodgkin's lymphoma may occur and depend on the following: • How fast the tumor grows • The size of the tumor • Where the cancer forms in the body
These symptoms can also come from other conditions, so it’s important to screen early. 8 Spring 2021 | Phelps Today
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BACK PAIN: COMMON CAUSES AND TIPS FOR PAIN PREVENTION
Meet some members of our Spine Institute team:
nwh_constellation_02 Joseph Lee, MD Orthopedic Spine Surgery Rothman Institute
Danilo Silva, MD Neurosurgery
Q: Why does my back hurt? A: There are many different reasons for someone to have back pain. The key is figuring out why your back hurts. It may be related to the spine itself, disc herniation, facet joint pain, muscular pain, or even pain from the sacroiliac joint. Often, it is a combination of these. Ultimately, discovering the underlying cause of your pain is the first step for successful treatment. —Stephen Thorp, MD
Q: What non-surgical treatment options exist for back pain? A: There are many causes of back pain, and Phelps offers multiple treatment options. We take a holistic approach and initially aim to make dietary and lifestyle changes that will improve your pain and overall health. Physical therapy is a key component of our treatment. When nwh_constellation_05 more conservative management is not enough, we offer a variety of procedures, from epidural steroid injections and nerve blocks, to state of the art radiofrequency ablation and spinal cord stimulation. The ultimate goal is to improve not only your pain but your quality of life. —Stephen Thorp, MD
Q: When should I see a surgeon for my neck or back pain? A: About 90% of neck and back pain will resolve with conservative treatment. However, there are certain redflag symptoms that should prompt a consultation with a spine surgeon. Severe pain, progressive weakness in an extremity, and loss of bowel and bladder function require an urgent consultation. Progressive hand numbness, difficulty with balance, and loss of hand dexterity should also prompt a consultation. —Joseph Lee, MD
nwh_constellation_03 Stephen Thorp, MD Pain Management
Nivin Thundiyil, DPT Physical Therapy
Q: What role do physical therapists (PTs) play in the treatment and management of back pain? A: PTs are movement experts that help you understand how your body behaves with pain. Not all hurt means harm. PTs can guide you to overcome the fear of movement and teach you to perform daily activities without aggravating your back. PTs prescribe exercises and give you hands-on care that can alleviate or help better control your symptoms. Improving posture and modifying how you sit or stand can often help alleviate your back pain. PTs also teach you activities and exercises that help strengthen your back in a way that reinforces and supports it. —Nivin Thundiyil, DPT
Q: What is the Spine Institute’s approach to treating and managing back pain?
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A: The team approaches easing back pain in a three-step process. First, we seek to understand why your back hurts. This is different for everyone, so finding the underlying cause is key to treatment. Second, we determine how we can both decrease your pain and increase your quality of life. The third and most important step is we seek to prevent this pain from reoccurring. —Stephen Thorp, MD
Q: Why should I seek treatment at Phelps? A: At the Spine Institute, patients with back pain have the opportunity to see a specialist within 48 hours of requesting an evaluation. Our comprehensive group of specialists includes physical therapists, neurologists, pain management physicians, and orthopedic and neurosurgeons. Phelps also has advanced technology for minimally invasive image-guided spine surgery. —Danilo Silva, MD
Spine Institute 701 North Broadway, Sleepy Hollow, NY 10591, (844)-94-SPINE
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Spring 2021 | Phelps Today 9 nwh_constellation_09
Being honored for giving excellent patient care is the best recognition a hospital can get.
The American Heart and American Stroke Associations awarded Phelps Hospital • “GOLD PLUS” for the 10th year in a row • Honor Roll Elite for providing the latest evidence-based treatment for best patient care and outcomes. phelps.northwell.edu (914) 366-3000
Phelps Hospital Announces the
Care Connections Program
Caregiving is the ultimate act of love. It requires strength, commitment, and sound judgment. Caregivers bear a tremendous responsibility. The stress associated with caring for a chronically ill family member is a heavy burden. The physical, emotional, and financial consequences for the family caregiver can be overwhelming, particularly for those providing care to a loved one with dementia. During the COVID-19 public health emergency, demands on caregivers have been heightened. Phelps Hospital’s newly created Care Connections Program has partnered with the Westchester Public/ Private Partnership for Aging Services to offer caregivers unique services during this difficult time. Caregivers can connect with a navigator who is available to offer guidance and counseling. The caregiver navigator develops trusting and supportive relationships with caregivers through open communication, an understanding of their needs, and by instilling confidence in their ability to competently address the needs of their loved ones. They also 10 Spring 2021 | Phelps Today
assist in identifying and addressing health system barriers, particularly as they relate to COVID-19; help to solve problems and supporting caregivers while they learn to self-navigate their caregiving responsibilities; ensure caregivers are kept well informed of available support services and resources not only for their loved one, but also for themselves — particularly to mitigate loneliness and isolation during this public health emergency; and provide linkage to collaborative partners for services such as counseling, support groups, and in-home assistance. Care Connections offers six-week educational workshops on Your Caregiver Relationship Contract given from a caregivers’ perspective. Participants learn
how to prepare to become caregivers, new ways to communicate, how relationships change and how to set boundaries. The Building Better Caregivers workshop teaches caregivers how to better manage the difficulties of caregiving without sacrificing their well-being by focusing on coping strategies, delegating stress, and developing support systems. COVID-19 has placed new demands on caregivers. Because respite services are difficult to find at this time, the Care Connections Program offers alternative relaxation amenities to caregivers. If you can benefit from the services of the Care Connections Program, please contact us at 914-366-1199 or caregiver@northwell.edu.
Move Over, Stuffed Peppers. Try Stuffed Eggplant Instead!
Mix it up with our unique vegetarian dish. By: Amanda Marzullo, Producer; Katrina Doell, Community Manager; Lauren Urban, Writer/Editor
If you or a family member is vegetarian, you know it can be tough to find a variety of tasty, nwh_constellation_02 nutritious meals that keep you full – and keep you from getting bored. Shake things up withnwh_constellation_0 our delicious vegetarian stuffed eggplant! It’s filled with quinoa (a protein-rich food that contains almost twice as much fiber as most other grains) and a healthy mix of vegetables. Follow our recipe or make it your own by substituting your favorite fresh veggies. A delicious meal isn’t far away: Prep Time: 30 mins
Cook Time: 20 mins
What you’ll need: (makes 2 servings) • 1 medium eggplant • ¼ cup dry quinoa • ½ cup chopped onion • 1-2 garlic cloves, minced • ½ cup chopped zucchini • ½ cup chopped bell pepper • ¾ cup seeded chopped tomatoes • ¼ cup ground flax seed • ½ tablespoon dried parsley • ½ teaspoon dried thyme • ¼ teaspoon salt • ¼ teaspoon pepper • ¼ teaspoon crushed red pepper flakes • 1 tablespoon grated parmesan cheese • Paprika, to taste • Coconut oil cooking spray
Total Time: 50 mins
Preparation: 1. Rinse and cook quinoa on stove top according to directions, then set aside. 2. Cut eggplant in half. Remove pulp, leaving a ¼” thick shell. Cube pulp; set shells and pulp aside. 3. Coat a large nonstick skillet with coconut oil cooking spray; sauté onion and minced garlic until tender. 4. Add zucchini, bell pepper and eggplant pulp; sauté for 4-6 minutes or until vegetables are crisp-tender. 5. Stir in the tomatoes, ground flax seed, parsley, thyme, salt, pepper and red pepper flakes; cook for 1 minute. Remove from heat and stir in cooked quinoa. 6. Divide mixture evenly between the eggplant shells; sprinkle with parmesan cheese and paprika. 7. Place on baking sheet and bake at 400°F for 20 minutes or until shells are tender.
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Nutrition by the numbers:* • 270 calories • 12g protein • 46g carbohydrates • 7g fat • 18g fiber • 310mg sodium * per serving
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Feeding a family? Double the recipe for double the servings!
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Healthy Life Calendar Spring 2021 Phelps Hospital offers the community a wide range of programs on health-related subjects as well as numerous health screenings and support groups. All events are free and will be virtual for the time being.
Lectures and Seminars
Cancer Institute nwh_constellation_01 Support Groups
Support Groups and nwh_constellation_02 Programs
Virtual Lecture Series
These support group sessions are open to anyone with cancer as well as family, friends, caregivers and anyone else interested in attending. You do not have to be a Phelps Hospital cancer patient to join, all are welcome.
For support group questions and registration, please reach out to Ellen at (914) 366-3937 or vitality@northwell.edu for information on joining.
To stay up to date on our monthly virtual lectures and other community programs, scan here:
Cancer Survivorship Support Group or visit this site: https://lp.constantcontactpages. com/su/duZPBfj/newsletter
Wednesdays: April 7, April 21, May 5, May 19, June 2, June 16 11:00am – 12:00pm For more information, and to register nwh_constellation_04 for the e-mail list to receive the information to join the meeting, please reach out to Jane Hearty at jhearty@northwell.edu or 914-366-7520.
Cancer Patient & Family Support Group Mondays: March 22, April 5, April 19, May 10, May 24, June 14, June 28
1:30pm – 3:00pm For more information, exact dates, and to register for the e-mail list to receive the information to join the meeting, please reach out to Carol Greiner, LMSW at cgreiner2@northwell.edu or 914-366-1661.
Breast Cancer Support Group Thursdays: March 25, April 8, April 22, Maynwh_constellation_07 13, May 27, June 10, June 24
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6:00pm – 7:00pm For more information, and to register for the e-mail list to receive the information to join the meeting, please reach out to Carol Greiner, LMSW at cgreiner2@northwell.edu or 914-366-1661.
Bereavement Support Group Handled on an individual basis
Alzheimer’s Caregivers Support Group 2nd and 4th Friday of each month 10:00am – 12:00pm
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Parkinson’s Support Group 4th Tuesday of each month 2:30pm – 3:30pm
Laughter Yoga Thursdays: April 1, April 15, May 6, and June 3 6:00pm – 7:00pm
Thursdays: March 18, May 20, and June 17 11am – 12:00 pm For more information, and to register for the e-mail list to receive the information to join this fun event, please reach out to Carol Greiner, LMSW at cgreiner2@northwell.edu or 914-366-1661.
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Maternal Child Health
Vitality for Seniors Vitality is hosting a variety of virtual presentations. In addition to the programs below, additional presentations will be scheduled. If you are interested in being added to the email list that will inform and remind you of presentation dates and times, please reach out to Ellen Woods at vitality@northwell.edu, or call (914) 366-3937. Keeping Memory Alive First Monday of each month 10:00am – 11:00am
Breakfast Club 2nd Thursday of each month 9:00am – 10:00am
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For more information on our Maternal Child Health classes and groups, please reach out (914) 366-3559. While these classes are offered virtually, they will be free of charge.
Postpartum Support Group
nwh_constellation_10_live 1st and 3rd Monday of each month
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11:00am – 12:00pm Register here to receive information to join the meeting: https://phelpspostpartumsupport.eventbrite.com
Breastfeeding Class
Saturdays: April 3, May 1, June 5 10:00am – 12:30pm
Osteoporosis Program 2nd Thursday of each month 10:30am – 11:30am
Register here to receive information to join the meeting: https://breastfeeding-class.eventbrite.com
ABC’s of Baby Care
Holistic Pain Support
Thursdays: March 25, April 22, May 20, June 24
3rd Wednesday of each month
7:00pm – 9:00pm
9:00am – 10:00am
Register here to receive information to join the meeting: https://abcbabycare.eventbrite.com/
Childbirth Experience
nwh_constellation_10_outline Saturdays: April 10, May 15, June 12
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10:00am – 12:30pm Register here to receive information to join the meeting: https://childbirthexperience.eventbrite.com/
Spring 2021 | Phelps Today 13
Cirugías ambulatorias de reemplazo de articulaciones se hacen más populares By: Jason Hochfelder, MD
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Tradicionalmente, las cirugías de reemplazo de cadera o rodilla se pensaban que eran un calvario que requerían estadías extensas en el hospital y una recuperación larga. Es hora de reconsiderar este tren de pensamiento.
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nwh_constellation_05 Los mejoramientos sustanciales en la tecnología médica han llevado a técnicas de invasión mínima para la cirugía de reemplazo de cadera o rodilla. Estos procedimientos ahora tienen un resultado tan positivo que muchos cirujanos ortopédicos, incluyendo el Dr. Jason Hochfelder del Hospital Phelps, Northwell Health, están ofreciendo cirugías ambulatorias que permiten a los pacientes irse a la casa el día de la cirugía, en oposición a pasar tiempo innecesario en un ambiente hospitalario. 14 Spring 2021 | Phelps Today
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“Usted puede recuperarse en la comodidad de su propio hogar y cama”, dijo el Dr. Hochfelder. “No necesita quedarse a la noche, y los estudios no muestran que exista un más riesgo. Además, usted puede dormir mejor en su propio hogar que en el hospital, lo cual lleva a más satisfacción del paciente, menos dolor y una recuperación más rápida”. Debido a las técnicas menos invasivas, los procedimientos de reemplazo de articulaciones se consideran menos
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“Usted puede recuperarse en la comodidad de su propio hogar y cama.” dolorosos y los pacientes se recuperan mucho más rápido que antes. Además, debido a la relación de Phelps con Northwell Health, los doctores pueden monitorear a los pacientes remotamente después de la cirugía. En la mayoría de los casos, la terapia física en la casa empieza el día después de la cirugía. El concepto de recuperarse de lo que aparenta ser un reemplazo de articulación mayor mientras se está completamente en la casa podría parecer abrumador para algunos. Muchos pacientes tienen preguntas sencillas pero comprensibles: ¿Es seguro? ¿Cuáles son los riesgos? ¿Cómo se diferencia la recuperación para este procedimiento? Los estudios han mostrado que no existe un mayor riesgo de complicaciones para los pacientes que regresan a sus casas el mismo día del procedimiento; es una manera totalmente segura de recuperación. De hecho, algunos estudios han mostrado que los pacientes se recuperarán realmente más rápido si regresan a sus casas el mismo día de la cirugía. “Las personas solían pensar que tenían que quedarse durante la noche”, dijo el Dr. Hochfelder. “Pero los reemplazos de cadera y rodilla son tan comunes ahora que tenemos muchísimos datos e información que muestran que no hay más riesgo para los pacientes que regresan a sus casas. Sea que los pacientes se queden durante la noche o regresen a sus casas, los riesgos son bajos en primer lugar y no aumentan si regresan a sus hogares. La manera en que hacemos esto es identificando qué pacientes son los candidatos adecuados para ir a casa”. Por supuesto, como dijo el Dr. Hochfelder, este procedimiento ambulatorio no es para todos. En general, esta es una opción para pacientes más motivados y aquellos que son activos en sus vidas diarias. Aquellos con otros asuntos médicos presentes necesitarán ser monitoreados en los centros médicos después del procedimiento.
“Lo último que deseamos es enviar a alguien a casa y que tenga que volver a la sala de emergencias o el hospital el día siguiente”, dijo el Dr. Hochfelder. “Y esto es algo que no hemos visto debido a que somos muy estrictos en nuestro criterio y nos aseguramos de que los pacientes estén realmente seguros para ir a casa antes de enviarlos a sus hogares”. Para muchos, simplemente toma derrumbar una barrera mental para ver los beneficios de este tipo de cirugía. Existe una manera tradicional y antigua de pensar que uno debe permanecer durante la noche en un hospital después de una cirugía. No hay evidencia real que apoya ese tipo de pensamiento. La pandemia de COVID-19 ha abierto los ojos de muchos pacientes sobre los beneficios de la cirugía ambulatoria en un día. Según el Dr. Hochfelder, el paciente estándar está mucho más abierto que antes a estos tipos de procedimientos. “Mucha gente está sufriendo de dolor de caderas o rodillas, pero algunos son reacios a permanecer en el hospital”, dijo el Dr. Hochfelder. “Por lo tanto, esta opción se está haciendo mucho más atractiva”.
“Con los riesgos de COVID en los hospitales me sentí muy aliviado de regresar a casa después de la cirugía”, dijo un paciente. “El personal prequirúrgico fue maravilloso. El Dr. Hochfelder hasta me llamó la noche anterior para asegurarse que estábamos de acuerdo y mostrarme que realmente se preocupaba por mi bienestar... después de la cirugía, podía caminar bien y me dieron el alta el mismo día”. Hasta con la oferta de cirugía ambulatoria como una opción, el Dr. Hochfelder ve una proporción de ocho a uno de pacientes que permanecerán durante la noche versus aquellos que se irán a casa el día de la cirugía. Sin embargo, la gran diferencia ha disminuido lentamente mientras más pacientes han empezado a ver las ventajas de volver a casa más rápidamente. Si usted o un ser querido necesita recibir cualquier tipo de terapia de reemplazo de articulaciones en el futuro, asegúrese de preguntar a su cirujano sobre las opciones potenciales de paciente ambulatorio. En particular, el Dr. Hochfelder en el Hospital Phelps, Northwell Health, quien estará encantado de ayudarlo. Además, ¿no preferiríamos todos despertar en nuestras propias camas en vez de en el hospital?
Por ahora, el Dr. Hochfelder ha realizado este procedimiento lo suficiente para tener muchos pacientes satisfechos en el campo ambulatorio. Un paciente reciente, quien necesitaba un reemplazo de rodilla cuando la terapia física para una lesión previa no fue suficiente, estaba indeciso de permanecer en el hospital con la pandemia continua en todo el país. La opción de permanecer en casa por la mayoría del proceso lo hizo sentir cómodo.
By Jason Hochfelder, MD Orthopedic Surgeon Hip & Knee Replacement
Para una consulta con el Dr. Hochfelder, llame al (914) 298-2620 o visítenos en línea en https://phelps.northwell.edu/orthopedics. Spring 2021 | Phelps Today 15
Cuando un médico se convierte en un paciente La travesía de tratamiento del Dr. Raniolo
Primero un doctor Como un cirujano dedicado, el Dr. Robert Raniolo se enorgullece de estar siempre disponible para sus pacientes. Durante los últimos 30 años, raramente se ha tomado un día por enfermedad. Pero, como se le recordó recientemente, “nadie es inmune a la enfermedad”. Hace unos pocos meses, después de un viaje de fin de semana largo a Vermont en su motocicleta, el Dr. Raniolo notó un dolor inusual en su ingle. Al inspeccionar el área, encontró un bulto pequeño, el cual, aunque inesperado, no le causó mucha alarma. Quizás el nódulo se formó por viajar sobre carreteras irregulares, pensó. El lunes siguiente, después de una conversación con sus colegas, el Dr. Raniolo decidió extirpar el bulto, incluso antes de recibir del laboratorio los resultados del tejido. Él ya sospechada que el resultado podría no ser bueno. Días después, el Dr. Raniolo se enteró que tenía una forma agresiva de linfoma no Hodgkin, el cual afecta el sistema linfático y puede invadir otros órganos, particularmente el sistema nervioso central y el cerebro.
La detección temprana es clave Después de la diagnosis, una serie de pruebas (MRI, escaneo PET, escaneo CAT) y una punción lumbar, revelaron que la enfermedad aún no se había propagado. La tasa de remisión para la diagnosis de linfoma en etapa temprana es más del 80%.
16 Spring 2021 | Phelps Today
El tratamiento estándar para esta forma agresiva de linfoma no Hodgkin involucra la infusión con la droga metotrexato anticanceroso como paciente internado y seis cursos de R-CHOP (una infusión de una droga de inmunoterapia junto con otras tres drogas anticancerosas y prednisona), administrados cada tres semanas como paciente ambulatorio.
“Solo en Phelps puedo estar rodeado de un personal que conozco y se preocupa por mí, y por profesionales en los que confío completamente. Solo en Phelps puedo estar cerca de mi familia y hogar durante el tratamiento. Cuando considero todos estos factores, Phelps es claramente la única opción para mí”.
¿Por qué Phelps? Somos una familia El Dr. Raniolo consultó dos de los más prestigiosos centros de cáncer que ofrecían tratarlo en sus centros, pero cuando comparó sus recomendaciones y terapias con las de Phelps, se dio cuenta que no había diferencias. Pero él sabía que se sentiría más cómodo rodeado de amigos y su familia en Phelps.
Paciente primero, doctor segundo El Dr. Raniolo ya ha empezado a experimentar algunos de los efectos colaterales de sus tratamientos, incluyendo la pérdida de cabello, úlceras bucales, periodos de “estado de euforia” y falta de sueño. Su número de glóbulos blancos es a veces muy bajo, lo cual lo hace susceptible a infecciones. Aunque no hay una garantía de remisión, el Dr. Raniolo comprende que, sin el tratamiento y sus médicos, la enfermedad únicamente avanzará. Estos efectos colaterales no fueron tan difíciles para él como su lucha contra la ansiedad, aunque ha disminuido debido a que es tratado aquí en Phelps, rodeado de familia y amigos. Después de 30 años de atender a otros, el Dr. Raniolo es ahora el paciente. Siempre ha sido una alma bondadosa y vivaz pero ahora debe ajustarse a estar bajo el cuidado de su esposa. Como muchas otras personas en este momento difícil, el Dr. Raniolo no tuvo otra opción que buscar atención médica durante el pico de la pandemia mundial de COVID-19. A pesar de lo serio que este virus puede ser, es importante recordar que COVID-19 no es la única cosa por la que uno tiene que buscar atención médica, y no debería detener a nadie para hacer precisamente esto; el Dr. Raniolo lo sabe de primera mano.
“Nadie es inmune al cáncer, pero afortunadamente tenemos un tratamiento y cuidadores excelentes aquí en Phelps. Por último, quiero que todos sepan lo reasegurado, cómodo y confiado que me siento con todos ustedes en medio de mi enfermedad. Sé que no recibiría una mejor atención médica o más amor y cuidados que los se me han ofrecido en Phelps. No deseo estar en ningún otro lugar. Con esperanza, estaré bien nuevamente para volver a cuidar de todos ustedes, lo cual ha sido muy gratificante para mí toda mi vida. Soy fuerte y todos ustedes también lo son”.
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Continúa en la página 18
En Phelps, comprendemos lo difícil que es un diagnóstico de cáncer; es por esto que ofrecemos varios grupos de apoyo y servicios junto a un tratamiento oncológico. Para más información, por favor llame al (914) 366-1600.
El Dr. Raniolo agradece al personal de Phelps y su familia por su apoyo continuo, sea a través de sus palabras bondadosas, su aliento o por acomodarse a los cambios en su vida. “Deseo especialmente agradecer a todos los médicos y personal de primera categoría aquí en nuestro hospital comunitario involucrados en mi atención”. Spring 2021 | Phelps Today 17
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El Instituto del Cáncer en el Hospital Phelps, Northwell Health está dedicado a proveer un cuidado excepcional en cada paso de su travesía de tratamiento del cáncer. Para aprender más o para hacer una cita, por favor llame al (914) 366-1600. Nuestra misión en Phelps ha sido siempre proveer una atención médica integral de la más alta calidad en un ambiente seguro. Las pruebas y tratamiento de cáncer aún continúan en Phelps, con medidas estrictas de seguridad contra COVID-19. No postergue
sus pruebas ni tratamiento; hemos trabajado arduamente para asegurar que Phelps es un lugar seguro para que usted reciba las pruebas de detección lo antes posible. Para aprender más sobre las precauciones de seguridad que implementamos, visite phelps.northwell.edu.
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La detección temprana es clave en la prevención y efectividad de la terapia de tratamiento para el linfoma Conozca las señales y síntomas: Inflamación de los nódulos linfáticos en • Cuello • Ingle • Estómago
y/o • Sentirse muy cansado • Fiebre por una razón desconocida • Dolor en el pecho, abdomen o huesos
• Sudores nocturnos recurrentes • Sarpullido o picazón de piel nwh_constellation_04 • Pérdida de peso
Cuando la fiebre, sudores nocturnos y pérdida de peso ocurren juntos, este grupo de síntomas se llama síntomas B. Otras señales y síntomas de linfoma no Hodgkin de adultos pueden ocurrir y dependen de lo siguiente: • Lo rápido que el tumor crece • El tamaño del tumor • Donde se forma el cáncer en el cuerpo
Estos síntomas también pueden venir de otras condiciones, por lo que es importante recibir una prueba de detección temprano. 18 Spring 2021 | Phelps Today
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For more information about Phelps services, visit phelps.northwell.edu and click on “Find care.” You may request an appointment for many services on the Phelps website. Just go to phelps.northwell.edu and click on “Request an Appointment.”
Springnwh_constellation_09 2021 | Phelps Today 19
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