In Good Company - Fall 2017

IN GOOD COMPANY Fall 2017 /// A publication of Providence Little Company of Mary Medical Centers

A NEW AGE IN NEUROSCIENCES Leading-edge care for brain diseases comes to the South Bay

A WORD FROM OUR CHIEF EXECUTIVE ambulatory neurologists, along with nurse practitioners, physician assistants and navigators. State-of-the-art

EDITORIAL STAFF

surgical and interventional equipment was purchased

Chief Executive Mary Kingston

to make sure our clinicians have exactly what they need

Director, Marketing Andrew Werts

plane catheterization lab will open in early 2018 and will

Marketing Manager Ellen Driscoll

In 2018, our objective is to become the first Joint

Development Officer Christopher “Chria” Hazlitt Stroke Program Coordinator Catrice Nakamura, RN

to deliver excellent patient outcomes. Our advanced bi-

be the most up to date in Los Angeles County.

Commission Comprehensive Stroke Center in the South Bay. Currently our hospitals receive the fourth

O

ver the last several years, Providence Little Com-

largest volume of stroke patients in Los Angeles

pany of Mary Medical Center leadership has been

County, via our emergency departments. Both

devoted to advancing clinical excellence in neuroscience

Providence Little Company of Mary Medical

care for the South Bay. More than 40% of people living in

Centers in San Pedro and Torrance are certified

the South Bay have sought neuroscience care outside of

Stroke Centers. Our acute rehabilitation center in

the South Bay, so it was our aim to initially invest more

San Pedro was named in the top 2% in the nation

than $10 million to provide an exemplary Neuroscience

for rehabilitation services and is providing neuro

in the community. If you wish to no

Program in our own community. We wanted to make

rehabilitation, including the exoskeleton robot to

longer receive any communications

sure that only in the rarest of circumstances would

assist patients with spinal cord injury in learning

someone have to leave the South Bay for first-class care.

to walk again. Complementing our care is the first

We are grateful for the charitable support we receive from our friends

from the Foundation, please let us know by calling 310-303-5340, emailing CAFoundation.OptOut@providence.org

It took a comprehensive approach involving experts

telestroke service in the South Bay, guaranteeing 24/7

from their specialized fields to collaborate in the

expert consultation from experienced neurologists as

Providence Little Company of Mary

design and execution of our advanced Neuroscience

back up to our in-house neuro-hospitalists.

Foundation: 4101 Torrance Blvd.,

Program. To that end, a partnership with the Pacific

or writing to Foundation Operations,

Torrance, CA 90503. Please allow four to six weeks to honor this request.

200 N. Sepulveda Blvd., Suite 110 El Segundo, California, 90245 Tel 310-376-7800 Fax 310-376-0200 moontidemedia.com

Along with our investment in the most current

Neuroscience Institute brought to us a team of

technology and clinical expertise, we are committed to

outstanding and experienced fellowship-trained

our core mission of delivering compassionate, whole-

neurosurgeons specializing in brain tumors, stroke

person care in concert with our Promise to all patients:

and aneurysm, pituitary disorders, movement

“Know me, Care for me, Ease my way.” As health care

disorders and adult hydrocephalus. Supporting this

is changing, so is Providence Little Company of Mary…

team are fellowship-trained neuro-interventionalists,

becoming what we need to be in order to best meet your

neuro-hospitalists, neuro critical care intensivists and

evolving health care needs.

Mary Kingston RN, FACHE Chief Executive, Providence Little Company of Mary Medical Centers San Pedro and Torrance

p. 3

TABLE OF

CONTENTS INSIDE 3 | Message from the Chief Executive 11 | Datebook 36 | Out & About

UpFront 6 | Accolades & Designations 7 | Urgent Care Options

8

COMMUNITY OUTREACH 8 | Building the Little Company of Mary Advanced Care Center

10 | Fit Food Fair

Features 12 | Stroke Q&A Laura Jong, MD, on what you need to know about stroke.

14 | Deep Brain Stimulation New treatments are transforming quality of life for people with Parkinson’s, essential tremor and more.

18 | New Brain Tumor Therapies Offer New Hope Providence Little Company of Mary Medical Center Torrance is

24

leading the way in diagnosing and treating brain tumors.

24 | “Take Me to Providence Little Company of Mary” Comprehensive stroke care offers the best chance of a full recovery.

30 | The Patient Who Slept Through A Stroke Angel Atamian was lucky that she was taken to Providence Little Company of Mary Torrance where stroke care is a team effort.

32 | The Rehabcentre at Providence Little Company of Mary Medical Center San Pedro Gets People Walking And one of their newest equipment additions—a robotic exoskeleton—helps.

Donor Profiles

35

34 | Mark Paulin Ed and Alanna Kennedy

35 | Jim and Joanne Hunter p. 5

UPFRONT

Achieving the Highest Honor Possible for Treating Stroke

T

his year marks the seventh year

Magnet Recognition: Why I Chose to Work at Providence Little Company of Mary Medical Center Torrance

A

Jennifer Frisina, BSN

Company of Mary

chieving recognition as a

Medical Center San

Magnet hospital is the highest

Pedro has received

acknowledgement that a medical center

the American Heart

can get for nursing excellence. That

Association/American

journey was undertaken by Providence

Stroke Association’s

Little Company of Mary Torrance and

Get With the Guidelines® Stroke Gold Plus Quality

culminated last year with the medical

Achievement Award. “The Gold Plus award vali-

center receiving Magnet recognition—just

dates the quality and consistent performance we

one of 31 hospitals in California to do so.

have offered in San Pedro for our stroke patients,”

And, while this is a draw for patients who

says Darcie Fitzgerald, stroke and orthopedics pro-

know that with this designation they are

gram manager. “Every year the American Stroke

getting the best nursing care possible, it

Association reviews our data and determines that

is a big bonus for nurses as well.

we have at least 85% adherence to the achieve-

“Four years ago, after I finished

college in Northern California, I came back to the South Bay and didn’t think I would

ment indicators.”

One of the major criteria evaluated for this

be able to get a job at Providence Little Company of Mary Torrance because it is so

award is the quick administration—when applica-

competitive,” says Jennifer Frisina, BSN. “But I was so excited that I did, and I have

ble—of the clot-buster tissue plasminogen activator

been here ever since.” Frisina was raised in the South Bay and born at Providence Little

or tPA. This medication, if given intravenously

Company of Mary Torrance. “The hospital has such a great reputation,” says Frisina.

within the first three hours (or up to 4 1/2 hours

“And the Magnet recognition has enhanced that.”

for some patients) after an ischemic stroke (an

The designation has validated my feelings that everyone I work with is highly trained and values quality.”

obstruction within a blood vessel supplying blood to the brain), can reduce the effects of the stroke and lessen the chance of permanent disability.

“With stroke, it is so important to get to a hospital with a quality program,” says Fitzgerald. “We

“The designation has validated my feelings that everyone I work with is highly

like to say ‘Time is brain.’ San Pedro is, in essence,

trained and values quality. Achieving Magnet recognition increased morale and was

isolated from the rest of Los Angeles. Our hospital

definitely a time for celebration. It filled the hospital with positive energy and empow-

felt it was important for our community to have

ered clinical nurses,” Frisina adds.

access to quality, rapid acute stroke care provided

“Appraisers for the Magnet Recognition Program, developed by the American Nurses

p. 6

that Providence Little

by a certified Primary Stroke Center accredited by

Credentialing Center, told the nurses to celebrate for three months and then get right

the Joint Commission. We were the first Primary

back to the journey,” says Frisina. “We get redesignated every four years, so it is a

Stroke Center in the South Bay because of the need

constant journey. It has definitely changed me for the better. I am a nurse leader on my

here. For a long time, we have had an excellent

floor and every day I get positive comments from patients about their nurses. We have

certified stroke rehabilitation center, and we have

always cared for patients in the absolute best way that we can and the Magnet recogni-

worked hard to gain recognition, as well, for our

tion has pushed us to be even better.”

treatment of the acute phase of stroke.”

UPFRONT 2. URGENT CARE: For injuries or illnesses that are more severe (but don’t necessitate a trip to the ER), urgent care is the next step. Urgent care facilities are walk-in and many are open 24/7. This is the place to go for a churning stomach, burns and broken bones. They treat serious issues that aren’t life-threatening.

There are five Providence urgent care centers in the South Bay: San Pedro, Redondo Beach, Manhattan Beach, Torrance and Del Amo. For more information visit California.Providence.org/urgentcare.org or call 888-432-5464.

3. EXER - MORE THAN URGENT CARE: The newest addition to the urgent care options is Exer, which is an emergency-room alternative staffed with ERtrained doctors. It offers a higher level of care than urgent care, for more serious

Urgent Care Options: When Sick Happens, Providence Little Company of Mary Has Answers

G

conditions that are not life-threatening. “We are hearing extremely positive feedback from our patients who have visited the new Exer location. This is truly

etting sick is never convenient, but it’s a fact of life. Depending on what

a wonderful addition to the South Bay community,” says Werts. They are open

kind of malady you are dealing with, Providence Little Company of Mary

from 9 a.m. to 9 p.m. No appointment is necessary, and there is usually little

Medical Centers Torrance and San Pedro have several different options for care.

or no waiting time. The sites in Redondo Beach and Manhattan Beach (coming

Here they are in order of the level of the illness/injury severity:

soon) are convenient and close to neighborhoods, schools and community hos-

1. EXPRESS CARE VIRTUAL VISIT: This modern option lets you receive care in the comfort of your own home. There is no appointment necessary, and you can get treatment for common issues through the audio and visual

pitals. Exer locations also offer on-site X-ray, IV lab, splinting and diagnostics.

For more information visit ExerUrgentCare.com or call 888-432-5464.

4. PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER

components of your computer or smart phone. Nurse practitioners are avail-

TORRANCE AND SAN PEDRO EMERGENCY ROOMS: If you need

able at any time to treat such illnesses as: fevers, cold, sore throats, rashes,

immediate care for a life-threatening emergency or you call 911, you need

gastrointestinal issues, sprains and even women’s wellness issues such as

an emergency room—the highest level of care. If you are having shortness of

breastfeeding support. “Being able to provide patients the option of a virtual

breath, severe chest or abdominal pain, stroke symptoms such as weakness

visit is redefining how healthcare is delivered. It provides convenience at an

or speech problems, this is where you should head. Additional events that

affordable cost,” says Andrew Werts, director of marketing, Providence Little

require an emergency room visit include accidental poisoning, behavioral

Company of Mary Medical Center Torrance and San Pedro. For more informa-

health and chemical dependency issues. If you are experiencing a life-threatening

tion visit Virtual.Providence.org, or call 888-432-5464.

emergency, please call 911.

Recognizing Excellence in Maintaining Patient Safety

“P

rovidence Little Company of Mary Medical Center Torrance is proud to once again receive the Healthgrades® Patient Safety Excellence Award,” says Mary Kingston, chief executive of the medical center. “The fact that

we have received this award for five years in a row speaks to the dedication and excellence that is evident everywhere in the hospital, from the clinical and medical staffs to our support services and even volunteers.”

The Patient Safety Excellence Award was given to 460 hospitals, which puts them in the top 10% of hospitals in the country for superior performance in safeguarding patients from serious, potentially preventable complications during their hospital stays. The safety award is determined by evaluating the occurrence of observed incidents and expected performance for 13 patient-safety indicators, as defined by the Agency for Health Care Research and Quality. p. 7

COMMUNITY

OUTREACH

Providence Little Company of Mary Medical Center Torrance Expands Care to the Community

T

here is a massive construction project

coordinated cancer care in one convenient place,

will provide key programs including City of

when in the past, they may have had to travel

a sea of change in patient care for residents of

Hope’s Multidisciplinary Cancer Center and

all the way to Duarte to receive City of Hope’s

the South Bay. The former site of the Daily Breeze

Providence Little Company of Mary’s Orthopedic

nationally-recognized services.”

building, located at 5215 Torrance Blvd., is being

and Spine Institute, among others. “This is

transformed into the Little Company of Mary

a real benefit to the community,” says Uriah

was to anticipate the kinds of medical services that

Advanced Care Center (ACC)—which is good news

Melchizedek, director of business development

would be in greater demand in the South Bay in the

for residents who need convenient, local access to

and strategy for Providence Little Company of

future, move them out of the hospital setting going

advanced outpatient care. The ACC, slated to open

Mary Medical Centers San Pedro and Torrance.

forward and house them in one place. “We saw

in the summer of 2018, will house multiple state-

“The partnership with City of Hope means South

the need for more advanced cancer care as well as

of-the-art services, all in one place.

Bay patients can receive local, high-quality,

orthopedic care. We wanted to provide outpatient

p. 8

happening on Torrance Blvd. that represents

The $80 million, 106,000-square-foot facility

Back in the planning stages, the idea for the ACC

COMMUNITY

OUTREACH

An artist’s rendering of the future Providence Little Company of Mary Advanced Care Center, slated to open in 2018.

care for those needs, that is close to home and

Hope | Torrance will offer radiation therapy, medi-

diometabolic program and an advanced imaging

community-oriented,” says Melchizedek, “and this

cal oncology, chemotherapy, surgical oncology and

center. The many advanced diagnostic and treat-

new facility does all of that.”

other cancer-related services within the ACC.

ment modalities that the imaging center will offer include: CT simulation, digital tomosynthesis (3D

CITY OF HOPE PARTNERSHIP

AND MORE

The ACC will also house City of Hope | Torrance,

In addition to cancer treatment, the ACC will

a new comprehensive ambulatory cancer center,

house Providence Little Company of Mary’s

up and running, South Bay residents will be able

allowing local patients in need of treatment to

Orthopedic and Spine Institute, Women’s Breast

to see high-quality specialists, complete imaging

remain under the care of their local physicians

Center, an ambulatory surgery center, restorative

and other tests, have surgery if necessary and

while gaining access to the expertise of City of Hope

therapies (including physical and occupational

avail themselves of restorative therapies, all on

specialists, clinical research and treatments. City of

therapies), genetic testing and counseling, a car-

one campus.”

mammography), digital X-ray and more.

In closing, Melchizedek says, “When the ACC is

p. 9

COMMUNITY

OUTREACH

2 1. Sister Terrance, Ashley Cook, Jim Tehan; 2. L-R Giovanne Dimas, Nikki Robles, Omar Serrano, Ashley Cook (strawberry), Ashley Hernandez, Tom Harney; 3. Sister Terrence as Vanna White with the Wheel of Nutrition

1

3

Fit Food Fair Making good nutrition fun

P

rovidence Little Company of Mary Medical

bring the concept to other communities. “The part of my job that

Centers San Pedro and Torrance have a

really infuses me with energy,” explains Harney, “is doing things

firm commitment to helping build stronger

that help the community—this is part of the Mission of Providence

local communities. One symbol of this endeavor is the Providence Little

Little Company of Mary, as well. The food fair, which will be offered

Company of Mary Community Health Wellness and Activity Center in

each season, has attracted more than 150 people—parents, kids,

Wilmington, a complex that includes a soccer field, basketball court,

grandparents—to each event.”

meeting rooms and more, for use by local community members. This

The Fit Food Fair, which strives to bring nutritional information to

center, which was recently named as a leader in innovative programs that

the whole family, is not a series of lectures. It entails games, hands-

support the “Let’s Get Healthy California” initiative, offers free daily exer-

on cooking and—of course—eating. “We start with a wellness moving

cise classes, art and music programs, after-school programs for kids, and

activity,” says Harney. “And then the group breaks off into sections. The

nutritional classes for families, people with diabetes and elderly people.

kids go outside for a fun activity, such as making smoothies or fruit

The center also sponsors quarterly Fit Food Fairs, thanks to Tom

popsicles with our chefs, and the adults are divided into two groups. One

Harney, director of hospitality services for both Providence Little

group starts out in a room playing nutritional jeopardy and the second

Company of Mary Medical Centers. After visiting the center as part of a

group has a cooking demonstration. We like to show how a traditional

training program, Harney decided to volunteer and offer his expertise

dish can be made healthy. For the fair in May, we made enchiladas with

to improve opportunities for healthy eating in this underserved

vegetables, yogurt and farro.” After lunch, the groups switch.

community—in a fun way!

At the end of the event, each family goes home with a bag full of fruits, vegetables and staple food items—enough for a family of six. “The

THE FESTIVITIES

spirit of Providence was really alive as seen on the smiles of the folks we

So far there have been two Fit Food Fairs, and they have been so

were able to serve and the laughter that we shared together. It really is a

successful that they are now quarterly and growing, with plans to

wonderful event and we are so grateful to be a part of it,” adds Harney.

p. 10

DATE BOOK UPCOMING

ONGOING

SUFFERING FROM TENDONITIS PAIN? SEPTEMBER 12 (TORRANCE) 6:30 to 8:30 p.m.

If you’ve ever had sudden pain when making a repetitive movement during a sport or everyday activity, it could mean tendonitis. Find relief at our free lecture. Learn how to prevent tendonitis and find out how the latest treatments can help you get back in action. Register online at ProvidenceClasses.org or call 888-HEALING (432-5464).

TREATING BRAIN TUMORS AND MOVEMENT DISORDERS OCTOBER 23 (TORRANCE) 6:30 to 8:30 p.m.

Today’s groundbreaking advances in technology offer more treatments than ever to improve your health and quality of life. Join us to learn about the newest treatments for brain tumors and movement disorders. Register online at ProvidenceClasses.org or call 888-HEALING (432-5464).

CELEBRATION GALA* OCTOBER 28 Terranea Resort, Palos Verdes 6 p.m. Cocktail Reception 7:30 p.m. Dinner On October 28, more than 600 people will gather at the Terranea Resort for an evening of dinner, drinks, dancing, and silent and live auctions featuring truly unique and sought-after items.

The annual event sells out quickly.

Tickets are $350, sponsorships, $5000.

For more information, visit California. providence.org/PLCMevents.

TORRANCE AND SAN PEDRO FARMERS MARKET A farmers market is held every Thursday from 10 a.m. to 2 p.m. in the west parking lot at Providence Little Company of Mary Medical Center San Pedro, 1300 W. 7th Street, San Pedro. Another farmers market takes place every Friday, 10 a.m. to 3 p.m. in the Atrium parking lot at Providence Little Company of Mary Medical Center Torrance, 4101 Torrance Boulevard, Torrance.

LOW-COST HEART SCREENINGS KEEP DIABETES IN CHECK NOVEMBER 14 (TORRANCE) NOVEMBER 30 (SAN PEDRO) 5:30 to 6:30 p.m. Blood glucose screening 6:30 to 8:30 p.m. Presentation Your choices can have a big effect on your health. Eating a balanced diet and getting regular exercise are beneficial to your overall well-being and for preventing and managing type 2 diabetes. Get a free, blood glucose screening to help determine if you’re at risk for diabetes, and join us for a lecture on managing prediabetes and diabetes. Register online at ProvidenceClasses.org or call 888-HEALING (432-5464).

Location for lectures in Torrance: Providence Little Company of Mary Medical Center Torrance, Del Webb Center for Health Education

San Pedro: Providence Little Company of Mary Medical Center San Pedro, De Mucci Conference Center

Providence Little Company of Mary is proud to offer valuable, low-cost heart screenings to the community, at three convenient locations: Torrance, San Pedro and Manhattan Beach. Screenings are available during the week as well as on the weekends.

Getting screened today could help avoid problems in the future. Register online at Providence.org/heartscreening or call 888-HEALING (432-5464).

GENETIC SCREENING AND TESTING Providence Little Company of Mary offers genetic testing and genetic screening. Services are available at the Women’s Imaging Center in Torrance, located at 20929 Hawthorne Boulevard.

With good information, you can make informed choices, assess your risk of developing cancer and plan for tomorrow. We provide complete, state-of-the-art care for all members of families who are at increased risk of breast, ovarian, colon, uterine, pancreatic and other cancers due to inherited tendencies. To schedule a consultation, call 310-303-7087.

PRENATAL AND BABY CARE CLASSES If you are expecting your first child or have already had your baby, prenatal or baby care classes are a great way to help you understand pregnancy and parenting. We offer a variety of classes that give insight into what you are experiencing now and help you prepare for the experiences to come. Topics include: preparation for childbirth; breastfeeding; labor, epidural and neonatal care; baby care basics, and CPR techniques for infants, children and adults. Visit ProvidenceClasses.org to learn more. *For more information or to inquire about event sponsorship opportunities, please contact Katie Moe, special events manager, at 310-303-5350 or katherine.moe@providence.org p. 11

Q&A

What is a stroke?

Stroke occurs when blood flow to the brain is cut off. There are two types of strokes: isch-

STROKE 101

emic and hemorrhagic. The most common type of stroke, which occurs nearly 9 out of

Interview by Nancy Brands Ward

10 times, is ischemic stroke. In this type of stroke, there is brain cell death and damage from impaired circulation to the brain (ischemia). Impaired circulation can come from a blood clot in the brain, or it can come from poor circulation in the blood vessels of the brain due to thickening of the artery walls, which is called “atherosclerosis.” The second

Dr. Laura Jong

photographed by Kristin Anderson

type of stroke, a hemorrhagic stroke, occurs when a blood vessel in the brain ruptures and causes hemorrhage.

What are the symptoms of stroke?

Almost any symptom can indicate stroke.

Most commonly we say that sudden numbness on one side of the body, sudden weakness on one side of the body, or sudden speech difficulty can be early signs of a

A

ccording to the American Stroke Association, stroke is the

stroke. To identify stroke quickly, it’s helpful

fifth leading cause of death in the United States. Each year

to remember the mnemonic “FAST,” which

approximately 795,000 people suffer a stroke, and more than 130,000

stands for Facial drooping, Arm weakness,

people die from one. Stroke is also the leading cause of serious, long-

Speech difficulties, Time to call 911.

term disability. Given that stroke is such a threat to the health of our community, In Good Company sought the advice of Laura T. Jong, MD,

Are there other possible signs

about what stroke is, how to deal with it and how to prevent it from

or symptoms of stroke?

occurring. Dr. Jong specializes in neurology and electrodiagnostic

Sometimes people might experience sudden

medicine (a subspecialty of neurology that involves analyzing electrical

onset of dizziness, loss of consciousness,

activity of body parts or measuring their response to external electrical

double vision or walking difficulties. These

stimuli to help in diagnosis). She practices at the Academic Center in

can be additional symptoms that may

Rolling Hills Estates and at Providence Little Company of Mary Medical

represent a stroke. Sudden inability to do

Center Torrance.

something simple like dialing the phone or inability to do things that are typically done without thinking may also suggest stroke.

Anything unusual that happens suddenly could be a symptom of stroke, especially in people who have risk factors such as smoking,

p. 12

diabetes, hypertension [high blood

a new procedure can literally pull

teams on standby around the

pressure] or high cholesterol.

blood clots out of brain vessels

clock, ready to immediately treat

to restore the brain’s circulation

any stroke patient who comes

If someone is experiencing

and prevent brain cell death. This

through our doors. We treat some

any of these symptoms,

procedure, called thrombectomy,

700 patients with strokes each year.

what should they do?

can only be performed at Primary

They should IMMEDIATELY call

Stroke Center hospitals such as

What are the chances

911, take an aspirin and wait

Providence Little Company of

of having a good

for help to arrive. If the person

Mary Torrance. Providence Little

recovery from stroke?

experiencing symptoms is unable

Company of Mary Torrance offers

Chances are very good if a patient

to call 911, they should try to seek

these emergency services 24 hours

can be treated as soon as symptoms

help from a loved one, neighbor or

a day, 365 days a year.

begin. The often-repeated phrase in

other nearby person.

stroke care, “Time is Brain,” refers to

Why is Providence Little

the fact that human nervous tissue

Why is it critical to

Company of Mary Torrance

is rapidly lost as a stroke progresses

get help ASAP?

a good place to go if

and that the sooner treatment is

In the past, there wasn’t much

stroke is suspected?

started, the smaller the area of

that could be done to help

Our medical center has earned

damage to the brain will be.

stroke victims. But now we have

recognition from the Joint

treatments that can make a huge

Commission as an Advanced

Who’s at risk for stroke?

difference, and the faster stroke

Primary Stroke Center. The Joint

In general, people most at risk for

can be diagnosed and treatment

Commission is an independent,

stroke are older, smoke, have high

begun, the better the chances

not-for-profit organization

blood pressure, high cholesterol

are of preventing the spread of

that accredits and certifies

and diabetes. People who have

damage to the brain that can cause

nearly 21,000 U.S. health care

atrial fibrillation or heart valve

loss of normal functioning and

organizations yearly. This

vegetation, in which growth of

even death. For every minute of

designation means it has passed

bacteria on one of the heart valves

ischemia, 1.9 million brain cells

a rigorous set of standards to

leads to an infected mass, are also

are destroyed. This is why it is

qualify as a designated Primary

at increased risk for stroke. (See

imperative to get to a Primary

Stroke Center and follows national

sidebar for more specifics on who

Stroke Center hospital without

standards and guidelines that can

is at risk.)

delay. One possible treatment is a

significantly improve outcomes for

“clot-buster” medication, called

stroke patients. It acknowledges

Can stroke be prevented?

tissue plasminogen activator or

that we use proven best practices

Yes, strokes can be prevented by

tPA, which helps dissolve clots

for stroke patients, including

exercising, eating well—a Med-

and return the flow of blood to the

around-the-clock care, excellence

iterranean diet is recommend-

brain in 1 of 3 people experiencing

in staff education and training,

ed—taking prescribed medication,

ischemic stroke. If patients receive

comprehensive patient education

controlling blood pressure, quit-

this drug treatment within 4½

and an award-winning stroke

ting smoking and having regular

hours of the onset of symptoms,

rehabilitation program. We have

preventive visits with your primary

it can be lifesaving! Additionally,

highly skilled and dedicated stroke

care physician.

!

Are You at Risk?

According to the American Stroke Association, the following people have a higher risk of experiencing a stroke: • THOSE WITH HEALTH RISK FACTORS People who are obese, have high blood pressure, diabetes or high cholesterol.

• LIFESTYLE RISK FACTORS People who are sedentary, smoke tobacco, abuse alcohol or other drugs.

• OLDER PEOPLE Risk approximately doubles for each decade after 55.

• FAMILY HISTORY A person has a greater risk if a grandparent, parent or sibling has had a stroke.

• RACE African-Americans are at increased risk for stroke as compared to Caucasians, partially because they have higher incidences of high blood pressure, diabetes and obesity.

• GENDER Women have more strokes than men. Possible reasons include: preeclampsia, eclampsia or gestational diabetes during pregnancy, use of birth control bills and use of hormone replacement after menopause.

• PRIOR HISTORY Persons who have had a prior stroke or “mini-stroke” (TIA, transient ischemic attack) are more likely to have a stroke. A person who has had one or more TIAs is almost 10 times more likely to have a stroke than someone of the same age and sex who hasn’t.

p. 13

DEEP BRAIN STIMULATION Transforming quality of life for people with Parkinson’s, essential tremor and more Written by Kristin Reynolds Photographed by Kristin Anderson

p. 14

A

gentleman with Parkinson’s disease sent

suffering and then have undergone DBS. It’s like

his physician a video of himself gliding

having a huge part of their life unlocked. For me,

down a ski slope, thrilled he could

it’s an amazing feeling to witness that.”

rekindle a lifelong passion. Another Parkinson’s patient was back on his surfboard again.

WHAT HAPPENS DURING DBS

A drone engineer suffering from essential

DBS uses technology to alter brain activity in

tremor—an involuntary trembling unrelated to

a nondestructive, reversible and minimally

Parkinson’s—returned to work, his now-steady

invasive way.

hands able to control drones again.

These scenarios represent outcomes of Deep

“The idea is to find the ‘sweet spot’ in each patient’s brain and then to stimulate that highly

Brain Stimulation (DBS), a surgical procedure

targeted area,” Dr. Langevin says. “In the past,

used to treat a variety of disabling neurological

surgeons used to make lesions in specific regions of

symptoms caused by Parkinson’s disease,

the brain to treat movement disorders. With DBS,

essential tremor and dystonia, a movement

we are targeting small regions with a tiny electric

disorder that causes muscle spasms. DBS

current. Unlike lesioning, DBS is reversible.”

is part of a family of treatments known as

DBS surgery is done in stages, usually

neuromodulation—the practice of altering nerve

about two weeks apart. During the first stage,

activity by delivering electrical currents to highly

two small openings (each about the size of a

targeted, personalized areas in the brain.

dime) are made in the skull and electrodes

I’ve treated patients who had resigned themselves to a life of suffering and then have undergone DBS. It’s like having a huge part of their life unlocked.”

Each patient mentioned above underwent

Dr. Jean-Phillipe Langevin and Dr. Melita Petrossian offer new hope to patients with Parkinson’s disease and other movement disorders with the use of deep brain stimulation.

are placed deep in the brain. The first surgery

DBS under the care of Jean-Phillipe Langevin,

can take up to five hours, and the patient stays

MD, director of restorative neurosurgery and

in the hospital overnight for observation. In

deep brain stimulation surgery at the Pacific

the second stage of the procedure, a small

Neuroscience Institute, which is affiliated with

cardiac pacemaker-type device is implanted

Providence Little Company of Mary Medical

near the collarbone, and a connecting wire

Center Torrance.

from the electrodes is tunneled under the

Though DBS is not a cure for movement

scalp and behind the ear, leading to the “brain

disorders like Parkinson’s disease, Dr. Langevin

pacemaker.” Physicians can, using a remote-

says it can significantly lessen symptoms so

control device, then adjust the electrical

people can return to normal activities and feel

current depending on the ailment. From there,

like themselves again.

a constant current is delivered to the brain to

“It’s like seeing somebody rediscovering life,”

reduce or eliminate the patient’s symptoms.

he says of post-DBS treatment. “I’ve treated

Stage two is an outpatient procedure that takes

patients who had resigned themselves to a life of

about an hour. p. 15

Dr. Langevin sees patients for a follow-up visit

Providence Little Company of Mary Torrance

one month after their implant. The stimulator is

also offers frameless DBS, which makes the

then progressively adjusted over time.

procedure more comfortable for the patient.

The surgery can be done under local

in athletics without the fear of, ‘Is my medication going to wear off?’”

While DBS is not a last resort for Parkinson’s

With traditional DBS, the patient’s head is

patients, it is also not considered a first-line

anesthesia while the patient is awake or under

attached to a frame via pins in the skull, and then

treatment. DBS candidates are typically at least

general anesthesia. The benefit of being awake

the frame is connected to the table. But this can

five years out since diagnosis.

is that the patient can respond right away as

be uncomfortable and require pain medication.

the doctor is adjusting the electric current. The

With frameless DBS, a lightweight platform is

there are fewer advances in medical treatment,

benefits and the side effects are then known

customized for each patient and constructed

making DBS that much more life changing.

right at the time of the surgery and the electrode

using the patient’s CT and MRI scans to identify

can be moved slightly if needed.

the exact areas in the brain that need surgical

jeweler,” she says. “Patients can walk and get

intervention. It’s also a shorter procedure,

dressed, but when they want to eat, they are

shaving off a couple of hours—which is a big

embarrassed to go out in public. Handwriting

benefit when it comes to patient recovery.

is affected, so writing a check is challenging.

Patients with tremor are known to watch their hands stop trembling on the spot.

If all this sounds like futuristic science fiction, it’s not.

With essential tremor, Dr. Petrossian explains,

“Essential tremor can disable a dentist or a

They can’t do things online because they can’t

DBS doesn’t reverse or halt disease progression, but it can mean that a patient gains five good hours in a day. They can meet friends for lunch, go to work or participate in athletics without the fear of, ‘Is my medication going to wear off?’”

type well due to loss of motor control. DBS can be transformative for these patients. It has been shown to reduce tremor by about 70% and can mean the difference between being isolated and embarrassed, and living a fulfilling life.”

The reaction time is also very fast, according to Dr. Petrossian. “Within seconds of turning on the current, their tremor is gone.”

DBS was pioneered in France in the late 1980s.

DETERMINING ELIGIBILITY

DBS is FDA-approved to treat obsessive-

It was FDA-approved in the United States in 1997

As many as 1 million Americans have Parkinson’s

compulsive disorder, as well, and is under

for patients with essential tremor and in 2002

disease, according to the Parkinson’s Disease

investigation as a treatment for depression,

for patients with Parkinson’s. Since then, it is

Foundation, and about 60,000 new cases are

bipolar disorder and other psychiatric conditions.

reported that more than 150,000 Parkinson’s

reported annually. Those numbers are expected

patients worldwide have received the treatment.

to increase as the average age of the population

WHY IT WORKS

increases. Essential tremor is eight times more

Researchers and specialists don’t completely

essential tremor, Parkinson’s disease, dystonia

common than Parkinson’s, according to the

understand exactly why DBS works, but they

and more, is part of a multidisciplinary

National Organization for Rare Disorders.

believe the electrical activity regulates abnormal

Melita Petrossian, MD, who specializes in

care team at Providence Little Company

“Patients with Parkinson’s typically have a good

electrical signaling patterns in the brain.

of Mary Torrance that includes movement

initial response to medication,” Dr. Petrossian

disorder neurology, neurosurgery, speech

says. “But over time, they may find that it isn’t

each other, controlling movement and other

therapy and support groups—all comprising

as reliable, wears off more quickly and that side

functions, using electrical signals,” Dr. Langevin

a comprehensive, well-rounded treatment

effects appear. These patients are good candidates

says. “Neurological disorders occur when one

program for patients with movement disorders.

for DBS, since the procedure can prolong the

part is disruptive and sending abnormal signals.

effects of medication and increase the number of

We think the DBS current acts as a static signal,

hours in the day when they feel good.”

rendering meaningless the area of the brain

“People are skeptical of the idea of brain surgery and electrical stimulation,” Dr. Petrossian says.

“They immediately think of electroshock therapy

“DBS doesn’t reverse or halt disease

“Parts of the brain communicate with

that is sending disruptive messages. The brain

or lobotomy. But DBS is not experimental, and it’s

progression, but it can mean that a patient gains

discounts bad messaging and hears white noise

not weird science fiction. DBS is well established as

five good hours in a day,” she says. “They can

instead. From there, better communication in

a treatment for movement disorders.”

meet friends for lunch, go to work or participate

the brain leads to lessened symptoms.”

p. 16

“Though DBS doesn’t stop the disease

5 THINGS TO KNOW ABOUT DEEP BRAIN STIMULATION

from advancing, it can greatly reduce disability resulting from Parkinson’s disease,” Dr. Petrossian says. “And there is mounting evidence that undergoing the procedure earlier, which helps patients get back to their routine activities, is

Melita Petrossian, MD, part of the multidisciplinary care team at Providence Little Company of Mary Torrance, says there’s much in the way of quality of life that Deep Brain Stimulation (DBS) can improve. Here are five things to know if you think you or someone you know may be a good candidate for DBS:

better for the body—especially since

1

2

3

RISK VS. REWARD

Parkinson’s disease,

DBS to treat

Not everyone is

As with any surgery, there are risks

essential tremor and

Parkinson’s,

a DBS candidate.

dystonia patients

essential tremor,

Patients who

should see a

dystonia and

are newly

movement disorder

obsessive-

diagnosed with

specialist for a

compulsive

Parkinson’s are

consultation before

disorder is

not candidates for

making treatment

covered by

DBS, nor are the

decisions.

insurance.

medically frail.

patients with Parkinson’s, in particular, greatly benefit from physical activity.”

associated with DBS. However they are rare: Infection occurs in about 4% of cases, and there is a 1% chance of stroke as a result of insertion of electrodes into the brain.

And while short-term side effects can occur—tingling and muscle contraction among them—the rewards outweigh the risk, both doctors say.

“If there is a problem, DBS can be reversed,” Dr. Langevin says. “If there is misplacement of electrodes, the device can easily be shut off. DBS does not damage the brain tissue.”

There are, however, significant strides being made in the short and long term with regard to improved treatment options for patients.

4

5

DBS is not a last-

DBS will not reverse or cure Parkinson’s

resort treatment.

disease or essential tremor, but it can

Patients shouldn’t wait

lessen symptoms and in turn, significantly

until all other options

improve quality of life by helping patients

are off the table before

return to the normal, everyday activities

considering DBS.

they enjoy.

“We are in an age of information in medicine,” Dr. Langevin explains. “Just as the information gained through precision

“We are on the cusp of something even greater

too. It’s gratifying to be able to impart realistic

medicine is revolutionizing cancer treatment—in

than DBS, and I think we’ll see profound changes

hope—to tell people, ‘There is a lot we can do to

our field, we’re getting breakthrough informa-

in the treatment of Parkinson’s, essential tremor

help you now, and there’s even more to come.’” 

tion from DBS.”

and other neurological conditions in the next

“In the future,” he adds, “the “brain pacemaker”—as opposed to the neurologist or

five to 10 years,” Dr. Langevin says.

Even at this moment, according to Dr.

patient—will be able to automatically adjust the

Petrossian, there is a new DBS device on the

electrical current based on information gathered

horizon that improves the way electric stimulation

from the brain.” Further, he believes this technology will be merged with our consumer technology wearables—the iWatch, for example.

is being delivered and is more user-friendly.

“It’s a very exciting time to be in this field,” she says. “You can see the excitement in patients,

Call To Action + For more information about Deep Brain Stimulation, visit Pacificneuroscienceinstitute.org/ movement-disorders p. 17

INNOVATIVE

BRAIN TUMOR THERAPIES OFFER NEW HOPE Providence Little Company of Mary Medical Center Torrance is leading the way in diagnosing and treating brain tumors.

Written by Kristin Reynolds Photographed by Kristin Anderson

L

ate last year, Gene Juckett kept falling. He also noticed he was losing strength on his left side, and soon he was unable to lift his left leg. Before long, he was wheelchair-bound.

“It must be my back,” he remembers thinking. He had undergone three back surgeries in previous

years, so it was a reasonable self-diagnosis.

But after seeing neurologist Laura Jong, MD, at Providence Little Company of Mary Medical Center Torrance and having an MRI, the 77-year-old Hawthorne resident got a different diagnosis: a large brain tumor was compressing his motor cortex. Since this is the area of the brain that controls movement, the weakness, falling and inability to walk unaided made sense.

Within two weeks, Juckett was in the operating room undergoing microsurgical resection of his tumor.

It was a meningioma, the most common benign brain tumor in adults 65 and older. (See sidebar, page 23 for more information about tumor types.)

Neurosurgeon Achal Singh Achrol, MD, performed Juckett’s surgery using a minimally invasive, MRIguided technique that allowed him to precisely and successfully access and remove the tumor.

Dr. Achrol specializes in the minimally invasive treatment of brain tumors, aneurysms and vascular malformations, as director of neurovascular surgery and chief of the Glioma Surgery Program at Pacific Neuroscience Institute (PNI), which is newly affiliated with Providence Little Company of Mary Torrance.

Its multidisciplinary team of specialists in neurosurgery, interventional neuro-radiology and neurooncology are now offering inpatient care and emergency stroke center services here, and an outpatient brain tumor clinic is in the works.

“We are thrilled to bring highly complex microsurgical care for brain tumor patients to the South Bay,” Dr. Achrol says. “This is care that would typically only be available at academic centers. Our patients often travel nationally and internationally to be treated here at PNI.” “Gene is a prime example of how the new neuroscience services at Providence Little Company of Mary Torrance will continue to make a significant difference for brain tumor patients in the South Bay.” And for many patients, they are indeed seeing a difference—not only in the types of innovative therapies that are available to them, but also in life expectancy after diagnosis.

p. 18

Gene Juckett, with his wife, Beverly, has a new lease on life after his successful brain tumor treatment.

p. 19

According to the National Cancer Institute, the five-year survival rate

Neurosurgeon Daniel F. Kelly, MD, director of the PNI Brain Tumor and

for all brain tumors—including benign tumors—is about 33%, though this

Pituitary Disorders Centers, says, “This is one of the major challenges in

number drops for the highly malignant glioblastoma tumor type.

brain surgery—getting out all of the tumor while making sure not to remove

In general, however, brain tumor patients are living longer, thanks in

any parts of the normal brain that control critically important functions.”

large part to the prevalence of molecular profiling and subsequent targeted

The optimal approach to tumor removal is different for every patient

therapies designed especially for specific tumor types.

“The overall direction of the oncology field is moving away from a onesize-fits-all approach as it was for many years, but rather, it is now person-

and is determined by the location of the tumor, as well as the surrounding anatomy. The goal is to remove as much of the tumor as possible, while minimizing manipulation of healthy areas of the brain.

alized for each individual patient’s tumor,” Dr. Achrol says. ”As we better understand the molecular and genetic underpinnings of a tumor, we are learning how critical it is to individually tailor each treatment approach.”

Also the marriage of state-of-the-art technology and leading-edge research is offering patients the most promising array of removal techniques and treatments yet.

The overall direction of

Neurosurgeon Dr. Achal Singh Achrol, is the director of neurovascular surgery and chief of the Glioma Surgery Program at Pacific Neuroscience Institute (PNI).

the oncology field is moving away from a one-size-fits-all approach as it was for many years, but rather, it is now personalized for each individual patient’s tumor.”

INNOVATION IN TUMOR REMOVAL Among the innovative tumor removal surgeries in which Dr. Achrol specializes, is the computer-assisted, minimally invasive keyhole technique: Using advanced imaging and MRI-guided navigation, he and other neurosurgeons at Providence Little Company of Mary Torrance can precisely target specific areas of the brain through a small opening in the patient’s skull or through their nostrils.

The keyhole technique maximizes tumor removal and minimizes the chance of damaging normal areas of the brain in the process. It can also mean a quicker recovery time for the patient—on average, patients are out of the hospital in a few days and back to their normal activities within three weeks.

High-definition endoscopy, ultrasound and refined instrumentation are making the keyhole technique, as well as other innovative procedures, possible.

Advanced imaging techniques are also increasingly prevalent in tumor removal. These include enhanced visualization of the tumor during surgery, in which florescent dye is injected into the veins to allow surgeons to more easily see where tumor-infiltrated brain tissue begins and ends.

p. 20

Neurosurgeon Dr. Daniel F. Kelly, director of the PNI Brain Tumor and Pituitary Disorders Centers and neurologist and neuro-oncologist Santosh Kesari, MD, PhD, who leads the Pacific Neuroscience Research Center at PNI.

Surgeons are accessing tumors in a variety of minimally invasive ways: • Endonasal endoscopic route, through the nostrils for skull base tumors • Supraorbital route, through a small eyebrow incision • Retromastoid route, through an incision behind the ear • Gravity-assisted approaches, which use patient positioning and gravity to allow normal brain to fall away, creating a surgical pathway to the tumor.

To reach tumors located deep in the brain, a small tube is guided to the tumor using MRI fiber-mapping to minimize damage to healthy brain. The tumor is removed through the tube.

On the oncology front, physicians and researchers are learning more every day about how to use new developments in the lab to help more patients. Though brain tumors are notoriously difficult to treat due to their accessibility and ability to spread quickly, new key learnings in the lab are making their way to the bedside with promising results.

“We are increasingly finding other ways to attack cancer cells besides the traditional chemotherapy and radiation method, because the old way is nonspecific to cancer cells and comes with tough side effects. It’s much better to be able to target the tumor directly,” Dr. Achrol says.

NOVEL WAYS OF DELIVERING NEW THERAPIES Precision medicine, a hot topic in cancer treatment across the board, is about identifying what mutations drive each individual patient’s cancer, identifying drugs that provide the best match for it and then using combination therapy, such as immunotherapy, targeted therapy and chemotherapy, to treat it.

“There is so much progress in oncology. It is a great time to be in the field,” says neurologist and neuro-oncologist Santosh Kesari, MD, PhD, who leads the Pacific Neuroscience Research Center at PNI.

Dr. Achrol as principal investigator for the trial, in collaboration with

“We are continuing to improve on utilizing all the new developments—

Dr. Kesari in neuro-oncology. This technique is especially promising for

and optimizing them—so that we can better help our patients and also help

treating a recurrence or progression of glioblastoma, the most aggressive

more patients.”

malignant brain cancer (see sidebar, page 23). With this drug delivery

“A big part of this,” Dr. Kesari agrees, “is understanding each patient’s tumor.

Then we can work to identify off-label drugs that may help patients while we’re

technique, medication is infused directly into the tumor.

“The therapeutic agent is a bioengineered fusion protein that acts as a

waiting for new drugs to be approved.” Clinical trials are the pathway to new

Trojan horse,” Dr. Achrol explains. “The protein is engineered to specifically

drug development—the key to improving quality of life and patient outcomes.

target tumor cells that unknowingly take in the toxin, a process that selectively

Dr. Achrol, who leads a translational research team at PNI and works closely with Dr. Kesari, says, “For today’s patient and their loved ones, wait-

kills these tumor cells without affecting the surrounding normal brain.”

Average survival for glioblastoma has traditionally hovered at just more than

ing for future treatments aren’t going to save their life. They’re looking for

a year, but now it’s closer to 16 months with aggressive surgical resection, radi-

something today that can help them. To be a part of a clinical trial is to be

ation and chemotherapy. This tumor type is particularly challenging—it tends

part of something innovative right now, at this very moment.”

to come back again and again, even after surgery and rounds of treatment. It

Among the promising clinical trials that PNI offers is one using targeted,

grows rapidly and is often referred to as having tentacles that extend from the

MRI-guided Convection Enhanced Delivery (CED) of drugs to a tumor, using

mass into normal brain tissue. Efficient drug delivery to the tumor can be chal-

a small catheter inserted into small openings in the skull. The study is led by

lenging, which is why techniques like CED show considerable promise.

p. 21

Dr. Achrol and Dr. Kesari are also testing, via clinical trials, certain types

BE LIKE MAGIC

of viral therapy, in which a virus that has been specially modified is deliv-

Despite the complexities around tumor removal and treatment, it’s

ered to the area of the tumor to infect and kill cancer cells while preserving

important for brain tumor patients to remember to keep the faith, all three

normal and healthy cells. The viruses can also stimulate the body’s own

doctors say, because the treatment landscape will only continue to broaden.

immune system to recognize and attack cancer cells, which makes them a kind of immunotherapy.

Yet another promising therapy is radiosurgery, in which high levels of radiation are delivered to precisely selected areas of tumor tissue.

All three doctors emphasize the importance of a team-based approach

“I remind my patients about Magic Johnson,” Dr. Achrol says. “Many of us remember when he announced his devastating HIV diagnosis in 1991. Not much was known on how to treat it at the time, and frankly he wasn’t expected to live. But he went after cutting-edge treatments year after year, and he climbed the mountain one step at a time—he didn’t try to tackle it all at

when it comes to any kind of treatment. “We are not working as individual

once. It would be five years before the life-saving triple-therapeutic protocol

clinicians, but rather as a team that includes specialists in neurology,

for HIV was even invented, but he made it there. It’s the same with brain

oncology, genetics, radiation oncology, head and neck surgery, and neuro-

tumor treatment. Every year the clinical trial landscape is different; what’s

radiology,” Dr. Achrol says.

happening now in brain cancer treatment wasn’t happening last year.

“While there is no cure yet, if we can get a patient to next year, then we’ll have a whole new set of options to offer them.

I say to my patients: ‘You can be like Magic—living well—20 to 30 years later, ‘” adds Dr. Achrol.

Speaking of living well, meningioma patient Gene Juckett is feeling back to normal these days, though he isn’t ready just yet to get back out on the field with his senior softball league.

But it’s not because he can’t.

“Sure, I miss the game,” he says, “but my new hobby is garage sale hunting with my wife. I enjoy adding to all my collections. That’s keeping me busy these days.”

And on the brain tumor front?

His most recent MRI revealed a clean scan. “In Gene’s case, I believe he has a very good chance of a cure from this surgery alone without requiring any further treatment,” says Dr. Achrol. 

Despite the complexities around tumor removal and treatment, it’s important for brain tumor patients to remember to keep the faith, all three doctors say, because the treatment landscape will only continue to broaden.”

p. 22

Call To Action + For more information about the latest in brain tumor therapies offered at Providence Little Company of Mary Torrance, visit Providence.org/torrance or call 888-HEALING (432-5464).

TYPES OF BRAIN TUMORS THERE ARE MORE THAN 120 TYPES OF BRAIN TUMORS, ACCORDING TO THE NATIONAL BRAIN TUMOR SOCIETY, AND THE EXACT CAUSES ARE NOT KNOWN. HERE ARE SOME OF THE MOST COMMON TYPES:

1

3

MENINGIOMA

A primary brain tumor, meaning it begins in the brain. Meningioma accounts for 37% of primary brain tumors in the United States, according to the American Society of Clinical Oncology. Most meningioma tumors are not malignant. They are most common in adults 65 and older.

2

4

GLIOBLA STOMA

A primary brain tumor that arises from the cells that make up the gluey, supportive tissue of the brain. These tumors are usually highly malignant because the cells reproduce quickly and are supported by a large network of blood vessels.

Glioblastoma represents about 15% of all primary brain tumors, according to the American Brain Tumor Association, and it is the most aggressive form of glioma (a tumor that begins in the brain or spine). This is the tumor type with which Sen. John McCain was diagnosed.

META STATIC

A tumor that starts somewhere else in the body and spreads to the brain. This is the most common type of brain tumor in adults. The incidence of brain metastasis is estimated to be 10 times higher than that of all primary brain tumors combined.

PITUITARY

A tumor arising from the pituitary gland. This tumor type is usually a benign, slow-growing mass that represents about 10% of primary brain tumors.

Women are more affected than men, particularly during their childbearing years.

5

MEDULLOBLA STOMA

A fast-growing tumor located in the cerebellum, the lower, rear portion of the brain. It accounts for 18% of all pediatric brain tumors. Nearly 70% of all pediatric medulloblastoma are diagnosed in children under age 10. This tumor type is less common in adults.

COMMON BRAIN TUMOR SIGNS AND SYMPTOMS HERE ARE SOME OF THE MOST COMMON SIGNS AND SYMPTOMS ASSOCIATED WITH BRAIN TUMORS. HOWEVER THESE SYMPTOMS CAN ALSO RESULT FROM OTHER CONDITIONS. ALWAYS SPEAK WITH YOUR DOCTOR IF YOU EXPERIENCE ANY OF THE BELOW:

Headaches, which may be severe and worsen with activity or in the early morning

Personality or memory changes; changes in speech; problems understanding or finding words; or altered emotional state, such as exhibiting aggressiveness

Altered perception of touch or pressure, arm or leg weakness on one side of the body or confusion with left and right sides of the body

Seizures

Changes in ability to walk or perform daily activities; loss of balance and difficulty with fine motor skills

Vision changes, including loss of part of the vision or double vision

p. 23

Comprehensive stroke care gives patients the best chance of a full recovery.

Written by Shari Roan Photographed by Michael Neveux

p. 24

W

hen the “possible stroke� call comes into the emergency department at Providence Little Company of Mary Medical Center Torrance, no fewer than a dozen people spring into action before the ambulance has even reached the hospital doors.

While stroke is a sudden, unexpected and overwhelming event to the person having it, it can be reassuring for patients to know that a health care team is poised and waiting for them. Over the last few years, the hospital has held countless hours of training and planning to establish a comprehensive stroke services unit.

That means that from the time patients are wheeled out of the ambulance, a multidisciplinary team is standing by, and an emergency protocol is activated to deliver state-of-the-art diagnostic, treatment and rehabilitative care.

Dr. Willliam Conrad, Carolina Diaz, RN and paramedics wheel a patient into the emergency departmennt to be evaluated for a possible stroke.

p. 25

“We have changed the way we offer stroke care. The

Providence Little Company of Mary Torrance has a

entire culture of the hospital has changed,” says William

designated stroke program coordinator who oversees

Conrad, MD, an emergency department physician

care within the program protocol. Stroke program

and an architect of the hospital’s stroke program. “The

coordinator Catrice Nakamura, RN, moves to the ED the

program involves everyone from registration, laboratory,

minute she hears the code. She often meets the patient in

pharmacy, imaging, cardiac catheterization lab,

ED ambulance bay and begins to assist the team in rapid

radiology, nursing, neurology and more. Stroke care has

delivery of stroke care by coordinating the patient’s care and

the most moving parts of anything we do in the hospital.”

communicating with multiple members of the stroke team.

Such care is needed because stroke is a complex medical crisis where minutes count. During a stroke, blood flow to

Within 29 minutes, on average,

the brain is impaired, causing brain cells to die at a rate of about 1.9 million per minute. Stroke is a leading cause

the patient has had blood work, the CT,

of death and disability in the United States, and stroke

a clinical exam from a board-certified

symptoms should always be considered an emergency.

Remember the acronym FAST: Face drooping, Arm

neurologist, and they’ve gotten treatment.”

weakness, Speech difficulty and Time to call 911. Other symptoms that warrant emergency response are sudden

“I see our stroke patients in the ED and follow them

numbness or weakness on one side the body; mental

through their hospital stay,” Nakamura says. “I oversee that

confusion; visual disturbances; impaired balance or

our stroke quality measures are completed and that care

coordination; dizziness or a severe, sudden headache.

is individualized to the needs of the patient and his or her

About 87% of strokes are ischemic, which means a

family by rounding with our multiprofessional stroke team.”

clot is blocking blood flow—and oxygen—to the brain.

While the patient is in the ambulance bay, a nurse will

A TIA, transient ischemic attack or “mini-stroke,” is a

draw blood for tests. The patient is then sent directly to

temporary blockage of blood flow to the brain and can

the imaging department for a CT scan. The test results

be relatively benign compared to other types. About 13%

are imeediately reviewed by a stoke specialist.

are hemorrhagic, meaning that a blood vessel carrying blood and oxygen to the brain ruptures. Subarachnoid

“It’s incredibly efficient,” Dr. Conrad says. “The patient doesn’t even stop in the ED treatment area.”

hemorrhagic stroke is a type of hemorrhagic stroke in which a weakened part of an artery enlarges and bursts.

TREATMENT

Doctors at Providence Little Company of Mary Torrance

After the CT scan is completed the patient is returned to

are ready to deal with any type of stroke or level of severity

the emergency room and the patient’s history is gathered.

as a Primary Stroke Center (see box, page 28).

“The stroke neurologist performs his or her assessment, and makes a treatment decision,” Nakamura says.

ARRIVAL AND ASSESSMENT

For an ischemic stroke, two highly effective treatment

Stroke care begins when the emergency department (ED)

options can make a huge difference in outcomes. One is

receives a radio transmission that a patient is en route.

a medication called tissue plasminogen activator (tPA),

Information is gleaned from the paramedics regarding

which is designed to break apart smaller blood clots.

the patient’s age, medical history, symptoms and when

Patients who have clots blocking larger blood vessels,

the symptoms began. If the signs point to a possible

called large vessel occlusions, may receive tPA and may

stroke, the ED charge nurse—or anyone on the health care

also be candidates for a revolutionary new procedure to

team—can call a “code stroke.” This is an order to alert the

physically remove the clot.

team and start the protocol. “We want to empower the

In many cases where tPA is indicated, the pharmacist

staff to make the determination. Once the code is called,

is also ready in the emergency room and is preparing

the whole team descends,” says Dr. Conrad.

the dose. “We used to wait to notify the pharmacy. Now

p. 26

Dr. J. Diego Lozano looks at CT scans to determine the type and severity of a stroke in a newly-admitted parient.

when a patient comes in with stroke, the clinical

first symptoms of a stroke. A National Institute

pharmacist is standing there, and he or she

of Neurological Disorders and Stroke (NINDS)

understands stroke as well as any community ED

study suggests that 8 out of 18 stroke patients who

is taken to a procedure room called a cardiac

doctor,” Dr. Conrad explains. “Within about 29

receive tPA according to the proper protocol will

catheterization lab. The interventional

minutes, on average, the patient has had blood

recover without significant disability.

radiologist, using an X-ray machine for guidance,

work, a CT, a clinical exam from a board-certified neurologist, and they’ve gotten treatment.”

Time is also critical for patients with large

appropriate patients.

To perform a thrombectomy, the patient

threads a catheter through the groin into a blood

vessel occlusions, according to J. Diego Lozano,

vessel. A device called a stent retriever is then

MD, a neuro-interventional radiologist at

inserted and snaked through the catheter to the

to save precious time, such as having paramedics

Providence Little Company of Mary Torrance.

clot. The doctor snares the clot and pulls it out to

draw blood en route and having a pharmacist

These large clots block major blood vessels and

reestablish blood flow to the brain. The procedure

deliver tPA in the CT room. The goal is to treat all

can cause devastating brain injury if not removed

is fairly low-risk, and studies published earlier

patients within 60 minutes of entering the hospi-

quickly. Two years ago, a series of landmark

this year show mechanical thrombectomy may be

tal and over half of all patients within 45 minutes,

scientific papers was published demonstrating

suitable for even more patients.

according to Dr. Conrad. To be effective, tPA

that a procedure called thrombectomy is

must be administered within 4 1/2 hours of the

safe and effective for removing these clots in

The team is considering other actions designed

“Within the last few months, we’ve seen tremendous progress in mechanical p. 27

thrombectomy regarding which patients might benefit,” says George Teitelbaum, MD, a neuro-interventionalist on medical staff at the hospital. “We used to think that the procedure had to

the emergency room.”

Adds Dr. Lozano: “We’ve come a long, long way. Twenty years ago, all we had to offer these patients was an aspirin.”

be performed within six hours of the onset of symptoms. But we may be able to extend that out to 24 hours.”

In order to have growth and

Recent research shows the neuro-interventionalist can perform a test called a CT perfusion scan to look at what area of the

change, you need a team effort—which

brain may be impacted by the stroke. While some brain tissue has

exemplifies the environment at Providence.”

likely already died, the scan may show an area that is threatened by the blood clot but that can be salvaged with rapid treatment.

“If this area, called the penumbra, is larger than the area that

RECOVERY

has already died, mechanical thrombectomy is warranted,” Dr.

The acute stroke patient may spend a few days recovering in

Teitelbaum says. “One of every three of these patients will have

the intensive care unit or one of our specialized stroke units.

an excellent result, recovering with little or no disability three

Throughout the stay, the patient is typically followed by both the

months following the stroke.”

stroke program coordinator and a neuro-hospitalist, a physician

“That’s a remarkable outcome,” he adds. “We’re sitting on one

who has training in handling inpatient neurology cases. At

of the greatest medical procedures in modern history. It could

Providence Little Company of Mary Torrance, neuro-hospitalists

potentially save billions of dollars in long-term medical costs.”

include doctors such as Allison Arch, MD, who also has specialty

Mechanical thrombectomy is still considered an emergency, and

training in stroke and vascular care.

doctors aim to complete the

“A neuro-hospitalist is adept

procedure within one hour.

at handling what goes on inside

outcomes for many stroke

PRIMARY STROKE CENTER ON THE WAY TO COMPREHENSIVE STROKE CENTER

patients today according

In 2010 Providence Little Company of Mary

The ability to offer tPA and thrombectomy has dramatically changed the

to Laura Jong, MD, the hospital’s stroke program director.

“In the past, this therapy

Medical Center Torrance was designated as a Primary Stroke Center by The Joint

a hospital,” she says. “That is a different type of experience compared to neurologists who typically see mostly outpatients.”

The neuro-hospitalist usually sees a stroke patient in the ED or

Commission, a national, not-for-profit group

shortly after admission and follows

that administers voluntary accreditation

the patient to coordinate care.

programs for hospitals and other health

“We see the patient every day,”

was only available at certain

care organizations. That means the hospital

she says. “If the primary team has

facilities that were not

has the resources and protocols to provide

a question, we help them. We talk

geographically convenient.

excellent outcomes for stroke care.

to families. We order tests. The

And as the clock was ticking, more brain cells were

Soon the hospital is hoping to receive the highest level of accreditation and become

neuro-hospitalist is the doctor

a Comprehensive Stroke Center by the

who is there from the beginning

lost while the patient’s

end of 2018. “All of our efforts stem from

of care to discharge. While it

ambulance was stuck in

the goal of becoming a Comprehensive

can seem that a lot of people

traffic,” she explains. “Now

Stroke Center,” says William Conrad, MD,

are involved in one person’s

Providence Little Company

an emergency department physician

care—emergency room doctor,

of Mary Torrance has the

who helped design the hospital’s stroke

neuro-hospitalist, interventional

ability to perform these life-saving therapies day or night, seven days a week, as soon as patients arrive to p. 28

program. “All the pieces are in place to achieve that. It’s so exciting.” Less than 1%

radiologist, neurosurgeon,

of hospitals nationwide are Comprehensive

neuro-intensivist—the team is

Stroke Centers.

highly coordinated and united,” Dr. Arch says.

possible as quickly as possible,” Dr. Long explains.

“We believe the more functional activities that the patient does while using their affected arms and legs, the faster the recovery will be.”

The center has state-of-the-art equipment to support those goals, such as the robotic exoskeleton, a type of robotic leg brace that helps a patient relearn the ability to walk. (See exoskeleton story, page 32.) Studies show that Caring for patients who have had a stroke is a group effort. Here are members of the team who care for patients from intake to rehab.

stroke patients can regain function with the

Left to right: Dr. Anh Long, Dr. George Teitelmaum, Dr. Allison Arch, Dr. Laura Jong, Catrice Nakamura, RN.

limb, the faster you recover. You stimulate

appropriate rehabilitative therapy.

“In the last 10 to 20 years, there is a lot of research that shows the more you use the weak

another part of the brain to take over the part of the brain you’ve lost,” she says. “All of the new equipment in stroke rehab is focused on developing new pathways in the brain to take over the part of the brain the patient lost.”

“It’s a pretty intimate setting among the

such as speech impairment or partial paralysis.

The rehab team also assists the patient and

physicians on the comprehensive stroke team,”

But patients who require rehabilitation don’t have

family members with the coping skills they will

she adds. “We talk every day and update each

to go far to find rehabilitative care that’s among the

need and with the transition from hospital to

other. One of the best parts of being a stroke

best in the nation. The Rehabcentre at Providence

rehabilitation to home.

neurologist is the multidisciplinary aspect of

Little Company of Mary Medical Center San Pedro

care. It’s one of the reasons I went into this. We

is accredited by the Commission on Accreditation

here because all of our patients come to us

have a really great team.”

of Rehabilitation Facilities (CARF) and is a Stroke

in crisis,” Dr. Long says. “The whole family

Specialty Program. The Rehabcentre ranked in the

is in crisis. The team is working to support

ters the hospital. However various members of the

top 1% in the nation in 2015 for patient outcomes

the patients so they can focus and improve

medical team also update the patient and family

and ranked in the top 2% in 2016.

in therapy. Our rehab team is talented,

Things happen fast when a stroke patient en-

members at every step, according to Nakamura.

“I get an opportunity to meet the patient or their

The Rehabcentre offers both inpatient and

“We have very strong psychological support

compassionate, innovative and loves what they

outpatient services. The 20-bed inpatient

do. From the time the ambulance doors swing

loved ones when the patient is in the ICU, and then

program features daily physician supervision,

open to a patient’s discharge from inpatient

I follow up every day,” she says. “I’m a familiar face.

24-hour nursing supervision and an intensive

or rehabilitative care, the Providence Little

Even if it’s just a quick peek in the stroke unit or

rehabilitation program of at least three hours a

Company of Mary team is dedicated to obtaining

ICU to say, ‘How are you?’”

day. A multidisciplinary team focuses on treating

the best possible outcomes,” says Dr. Jong, the

the entire patient according to Anh Long, MD,

stroke program director.

Toward the end of the patient’s stay, the neurohospitalist, physical therapist, social worker, chaplain and acute rehab team member meet

who directs the program.

Patients undergo a range of therapies

“I am most proud of how every staff member has given more than 100% of their time and

with the patient and family to discuss discharge

designed to help them recover their skills as fully

efforts to collaborate and work together to

additional medical services, if needed.

and quickly as possible. “There are not a whole

care for patients with stroke as if the patient

lot of centers that focus on the neurological-

were a personal loved one,” she says. “In order

REHAB

deficit patient [as we do],” she says. “It’s a totally

to have growth and change, you need a team

Despite aggressive care by stroke specialists some

different set of skills.”

effort—which exemplifies the environment at

stroke patients are left with neurological damage,

“We focus on getting the patient as functional as

Providence.”  p. 29

THE PATIENT WHO

SLEPT THROUGH A STROKE Angel Atamian was lucky she was taken to Providence Little Company of Mary Medical Center Torrance, where stroke care is a team effort.

Written by Nancy Brands Ward

W

hen Angel Atamian awoke in her Redondo Beach home on

the enormous bond and love that I could sense from Mrs. Atamian’s

the morning of April 4, the naturally loquacious 85-year-

husband as well as from her daughter and how much they wanted

old wasn’t talking. Neither was she responsive. She gazed

her to be helped.”

to the left and was weak on her right side.

I have to say, what struck me the

Worried, her 90-year-old husband of nearly 60 years, Albert, phoned their daughter, Sylvia. She dialed 911.

most was the enormous bond and

Paramedics rushed Angel to Providence Little Company of Mary Medical Center Torrance, where her family learned she was experiencing a massive ischemic stroke. J. Diego Lozano, MD, an interventional neuroradiologist, was notified as he was riding his bicycle to work at the medical center. He arrived a few minutes later to the

love that I could sense from Mrs. Atamian’s husband as well as from her daughter and how much they wanted her to be helped.”

emergency department.

Because Angel’s stroke began in her sleep, no one knew how

“When I first saw him, I thought Dr. Lozano was too young to be a

much time had elapsed since its onset. That meant she wasn’t

doctor. He was incredible,” Sylvia recalls. “He explained everything

eligible for clot-busting drugs that are often successful in restor-

clearly, including the fact that he didn’t know if her speech would

ing blood flow to the brain when administered shortly after stroke

come back.” Sylvia, who takes after her strong-willed mother who

symptoms begin.

survived civil wars in Lebanon and doesn’t take ‘No’ for an answer,

Dr. Lozano suggested a relatively new procedure called a mechanical thrombectomy (see page 29) whereby, under imaging

told Dr. Lozano, “You have to bring her back. My mom has to speak.

Dad needs her.”

guidance using a special x-ray machine, a catheter is threaded into an artery in the groin and up through the neck until it reaches the

THE PROCEDURE

blood clot in the head causing the stroke.

Angel was rushed to a angiography suite where Dr. Lozano and

“With the family’s understanding of the dire situation, the risks

p. 30

a team comprised of an anesethesiologist, and specially trained

and benefits of mechanical thrombectomy, both the patient’s

nurses and technicians awaited her. “Within a few minutes we were

husband and daughter agreed to the proposed endovascular treat-

able to partially extract a clot from her blocked left brain vessel and

ment,” says Dr. Lozano. “I have to say, what struck me the most was

establish some flow,” Dr. Lozano says. “After about 45 minutes, we

Angel Atamian with her husband, Albert. They have been married for almost 60 years.

were able to completely extract the clot and completely open the left middle cerebral artery using stent retrievers.

Blood flow supplied by this major brain artery was reestablished and we were able to save a significant amount of brain tissue.”

Angel’s recovery was remarkable.

The next day she moved her right side well enough to attempt to remove the IVs and get out of bed. Most of her speech came back initially in her native Armenian, and although she speaks four languages, her very first word was in English, and it was “No.” “After I heard the ‘No,’ I knew everything was going to be OK, ”Sylvia says.

Dr. J. Diego Lozano, the interventional neuroradioloist, who treated Angel Atamian.

Angel’s treatment and care was a team effort, from the paramedics, to the emergency department doctors and staff, the

“Today you can’t even tell she’s had a stroke. She was in the right place with the right doctor and they responded very quickly. My family is so grateful.”

Dr. Lozano insists Angel’s treatment and care was a team effort, from the paramedics, to the emergency department doctors and staff, the catheterization lab team, the ICU team, and the rehabilitation team.

Sylvia understands that. Neverthe-

catheterization lab

less, she can’t thank Dr. Lozano enough.

team, the ICU team, and

“I want to hug him. I want to kiss him.

the rehabilitation team.”

From our standpoint, what he did was a miracle.” 

p. 31

Call To Action + To learn more about the exoskeleton and acute rehab services, call 310-514-5370.

Physical therapy aide Justin Rodriquez and physical therapist Julia Mathews with Orfa Nitkiewicz and Dr. Anh Long.

THE REHABCENTRE AT PROVIDENCE LITTLE COMPANY MEDICAL CENTER SAN PEDRO

GETS PEOPLE WALKING

And one of their newest equipment additions—a robotic exoskeleton—helps.

Written by Mary Jane Horton Photographed by Kristin Anderson

W

hen Orfa Nitkiewicz, a 63-year-old designer and seamstress who lives in Hawthorne, saw a partially paralyzed man walking with the help of an exoskeleton walking device in a parade on televi-

sion, she had no idea how important that image would be for her future.

Last October, Orfa went to work as usual in Costa Mesa. “I started feeling dizzy and nauseous throughout the day,” she remembers. “And in the afternoon, I told my manager I had to leave early because I didn’t feel well. I didn’t think anything of it. I didn’t know anything about stroke.”

Orfa says other symptoms were developing—her shoe wouldn’t stay on, it was a little hard to move the steering wheel, and her face started getting numb—but she was able to drive home.

“In the driveway, I just sat for a moment and prayed,” says Orfa. “Then I banged on the front door, called my husband, and he called the ambulance.”

A HOSPITAL STAY AND THEN REHAB Orfa was lucky that she was taken to Providence Little Company of Mary Medical Center Torrance, with its designation as a Primary Stroke Center.

She learned she had had a stroke. After four days in the hospital, she was transferred to the Acute Rehabcentre at Providence Little Company of Mary Medical Center San Pedro, where she spent a month on improving her p. 32

Who Should Not Use the Exoskeleton Just as important as knowing who is a good candidate for the exoskeleton is knowing who isn’t, according to Anh Long, MD, medical director of the Rehabcentre. “When we first got it, people chose to come to our program just for the

facility] and at home. And she is recovering with

device,” she says. “But it isn’t appropriate for everyone. We have to evaluate each patient carefully to be sure they can

more normal movement. The quality of her

use it safely.” Careful screening and evaluation ensures the safe and effective use of this device as one of many tools

walking is improving each week, she is using her

used during the rehab process. However there are many contraindications. Some of the most common are:

affected side, and she is getting away from the

Osteoporosis: “If this is present, there is a possibility of breaking bones,” says Dr. Long.

Skin lesions: “There can’t be any where the robot has to go,” she says.

Anxiety: Dr. Long adds, “If a person’s heart rate or blood pressure is elevated, we will wait until it’s under control.”

compensations that she used to have to rely on.”

HOW IT IS USED The device can be utilized both during inpatient

functional mobility, activities of daily living and

THE EKSO GT EXOSKELETON

rehab and, as in Orfa’s case, in outpatient physical

her speech. The Rehabcentre is accredited by the

From the start of rehab, Orfa was motivated to get

therapy sessions. It is adjusted to custom fit each

Commission on Accreditation of Rehabilitation

better. “I had my family to think about,” she says.

individual and operated by one of the four trained

Facilities (CARF). It ranked in the top 2% for

“My 12-year-old grandson, Clayton, said to me,

therapists at Providence Little Company of Mary

patient outcomes in 2016. It offers an inpatient

‘Grandma, don’t look at this as a sickness. Look at it

San Pedro who have been certified for its use.

program with round-the-clock nursing super-

as a long-term vacation without pay.’” And in that

At first the robot can provide up to 100% of the

vision and intensive rehabilitation including

spirit, Orfa was willing to do anything to improve.

power needed for standing and walking, During

Her main physical therapist, Julia Mathews,

the course of several sessions, it is adjusted to put

physical, occupational and speech therapy. Once Orfa was ready to transition home, she went to

says, “At the start of her outpatient physical ther-

in less work as the patient learns to move on his

the outpatient program.

apy, Orfa was walking short distances on level

or her own power. The device has proven to be a

ground and had gait impairments. She had to

valuable tool in facilitating normal weight shift-

cits from her stroke—“I remember everything,”

move her bedroom downstairs and couldn’t walk

ing and movement during the walking process.

she says—the right side of her face drooped and

in the community or go to the grocery store.”

The device can also record the effort and quality

While she was lucky she had no cognitive defi-

her right arm and leg were affected. She started rehab slowly and then came the exoskeleton.

“The Ekso GT robotic exoskeleton allows us to get

When her team of therapists brought up the idea

of movement, giving the therapist valuable

of the exoskeleton, Orfa says she was leery at first.

feedback on how to further tailor the walking

“Julia told me I had to sign a liability waiver, which

program both in and out of the device.

a patient who is very weak to start putting weight

was scary, but then I remembered seeing that man

on her legs and start walking again,” says Anh Long,

in the parade. I really trust her, so I said, ‘Okay.’”

Orfa, who can now negotiate stairs, walk in the community and complete tasks such as shopping

MD, medical director of the acute rehabilitation

When she started with the ekso (which it is

for groceries, says, “I feel much more steady on my

program. “Research shows the more you use the

fondly called), Orfa says she was nervous. But

feet and my balance is improved. I am so grateful

weak limb, the faster you recover. We get patients

her leg was wiggly and she was determined to

for all of the help I have gotten at Providence

on their feet as soon as possible while the neuro-

walk better. “Orfa is an ideal patient,” says Julia

Little Company of Mary San Pedro. Everyone is so

plasticity in the brain can help stimulate other parts

“She does all of her exercises here [at the rehab

experienced and compassionate.” 

of the brain to take over for injured areas.

“The exoskeleton is part of stroke therapy, along with parallel bars and other therapy modalities. It allows patients to be able to walk normally, without a limp,” says Dr. Long. Besides stroke rehab, the Ekso GT device is also instrumental in rehabilitation after partial spinal cord injury, brain injury and immobility due to other illnesses.

“For someone who hasn’t walked in a while,

How The Ekso GT Device Came to Providence Little Company of Mary San Pedro “About a year and a half ago, I started researching bionics, along with Dr. Long and Julia Mathews,” explains David Bauer, director of rehabilitative services for both Providence Little Company of Mary Medical Centers in San Pedro and Torrance. “And we made it a mission to get this device for our community. Our focus has always been to embrace new technology.”

Bauer says that after they found the device they wanted, they had to wait about a year until it received

just being able to stand and look at people eye to

FDA approval for use with stroke patients. “Sixty percent of people are in acute rehab due to having a

eye is very important psychologically,” says Dr.

stroke,” he says. “So that was very important. The hospital has had the Ekso GT device for about a year.

Long . “They get really excited.”

“Now we are hoping to buy another one as well. We really have a need for a second.” p. 33

PROFILES

STEPPING UP

Mark Paullin is a strong ally for Providence Little Company of Mary, offering leadership and philanthropic support.

M

ark Paullin sees Providence Little Company

When Mark considered entities to support

of Mary Medical Center Torrance as a friend

financially, Providence Little Company of Mary

who has come through many times over the years.

Torrance and San Pedro were a natural fit. He and

His wife, Barbara, delivered all four of the couple’s

Barbara have given more than 30 gifts to benefit the

children at the medical center, and more recently

two hospitals. They have generously supported the

the couple’s three grandchildren (ages 7, 3 and 1)

Torrance Women and Children’s Services and the

were born there as well. The family has relied on

San Pedro Emergency Room campaigns, and Mark

the hospital for various emergency room visits and

sits on the committees of both.

medical procedures.

Regarding the San Pedro Emergency Room, he

the Foundation’s endowment. He also expects that

“We appreciate having a top-notch medical cen-

says, “I think there’s a great opportunity to help

funding of the Cardiovascular Center of Excel-

ter close by,” he says. “The Mission of the hospital to

[those in need] and I feel a great affinity for that

lence, Women & Children’s Services and San Pedro

help the poor and vulnerable reflects a compassion

mission.”

Emergency Room campaigns will all be completed

that’s shown in all their caregiving. Over the years,

Currently vice chair of the Board of Trustees,

I’ve consistently seen the genuine sense of compas-

Mark will become chair in 2018. During his term,

Mark’s professional experience will benefit his

sion and caring among the medical staff, nurses,

he looks forward to strengthening and expanding

role as chair. For more than three decades, he has

doctors and medical technicians.”

the Board with new members as well as growing

served as CEO and owner of Capstan, Inc.

A PASSION FOR HELPING

A

Alanna and Ed Kennedy’s decades of giving are inspired by the Mission of Providence Little Company of Mary Medical Center Torrance.

lanna Kennnedy and her husband, Ed, have

ship are embodied in everyone including the

directed their passion for giving towards

staff, administration, doctors and nurses. When

Providence Little Company of Mary Medical Center

I volunteer, I see the deep caring that is exhibited

Torrance since the early 1990s. The couple has given

for every patient, relative and loved one. They are

regularly to further the medical center’s Mission of

treated with dignity and compassion, and their

revealing God’s love for all, especially the poor and

needs are always listened to intently,” says Alanna.

vulnerable, through compassionate service.

Their contributions extend beyond generous fi-

Three of the Kennedy’s five grandchildren were born at the hospital, so the couple have seen the

nancial support. Ed served on the medical center’s

caliber of care firsthand. “What stands out about

finance committee. Alanna joined Mary Potter &

the hospital is that it has a community feeling,

Company, a volunteer support arm of the Prov-

everyone knows each other, and they really care

idence Little Company of Mary Foundation. She

about their patients,” Alanna adds.

also served as a member of the medical center’s

during his tenure.

Ed works daily at Long Beach-based ACOM

“Company Calls” program that made daily calls

Solutions, a software company he founded in 1983.

to check on elderly community members. Today

Alanna works actively with her philanthropic orga-

she volunteers as a Eucharistic Minister, bringing

nizations: the Peninsula Committee for Children’s

grandsons who live nearby and a son and two grand-

communion to patients who request it and serves

Hospital Los Angeles, the Peninsula Committee for

sons who live in Burlingame. Family time is import-

on the Foundation Board of Trustees.

the Los Angles Philharmonic, Little Sisters of the

ant to them: “Our family has gathered traditionally

Poor and Las Simpaticas, a subcommittee of the

in Lake Tahoe since 1971, and there are a lot of great

National Charity League.

family memories there,” adds Alanna.

“We support this hospital because its core values of compassion, justice, excellence and stewardp. 34

Alanna and Ed have two daughters and three

PROFILES

HEALING AND HELPING When life dealt Jim and Joanne Hunter two unbearable blows, they decided to help others.

created in 2016 to expand access to leading-edge, high-quality cancer care and services), we really have a first-class hospital right here in the South Bay. There is absolutely no reason to get on a highway and travel elsewhere,” adds Jim. Jim is as excited about the medical center’s cardiology services as he is about their expanding cancer care. “Hands down, they (Providence Little Company of Mary Torrance) are becoming the foremost cardiology center in Southern California,” exclaims Jim. Jim and Joanne’s desire to support cardiovascular and cancer research grew from the pain of losing their children, but the couple has a long legacy of giving back to the community and to those less fortunate. For instance, the Bloomfield Family Foundation founded Alliance Margaret

A

ripple effect of healing begins when one turns tragedy into a catalyst for

M. Bloomfield High School and Alliance Kory Hunter Middle

helping others. Just ask Jim and Joanne Hunter. The loss of a child is

School, independent public charter schools in Huntington

unbearable. Losing two is unthinkable. The Hunters of Manhattan Beach decided

Park, designed to help less affluent families garner access to

long ago to turn their pain into a positive force—through generously supporting

high-quality education.

and expanding medical research and education, while also creating opportunities for California families to have access to better health care and education.

“Our daughter Meredith had transposition of the great arteries, a heart defect,

“Giving runs in our families. Jim and I have both had such good lives and want to give back,” Joanne says. She feels lucky to live in beautiful Manhattan Beach and knows how fortu-

which took her life at six months old. Our son Kory passed away four years ago, at

nate most in this vibrant community are. From appreciating

the age of 43, from brain cancer. Nothing is as important as good health. We have

her life, she finds inspiration to help others who struggle with

always volunteered and given back,” shares Joanne, who is co-trustee with her

poverty or access to quality health care and education.

brother of the Margaret M. Bloomfield Family Foundation. Since Kory’s death, their

They are major supporters of the education foundations

daughter, Mandy, and son-in-law, Heath Gregory, founded the Uncle Kory Founda-

of Manhattan Beach and Palos Verdes schools. Joanne raises

tion, a private foundation focused on raising money for brain cancer research. The

funds for Sandpipers’ endowment (a women’s volunteer orga-

efforts of both Foundations are passions for Joanne and Jim.

nization). Jim chairs the Foundation for the Manhattan Beach

The philanthropists have supported Providence Little Company of Mary Medical

Rotary and is a Board member of Cancer Support Community

Center Torrance for over a decade, with Jim serving on the Foundation Board of

in Redondo Beach. They are also on the Board of Overseers for

Trustees and Joanne as a member of the Executive Committee of the Community

the Los Angeles Music Center.

Ministry Board. The hospital recently received a significant gift from the Hunters, which will make a major impact on its cardiovascular services.

When not volunteering, the longtime South Bay residents enjoy traveling and spending time with their family, including: daughter, Mandy, and son-in-law, Heath Gregory,

CARDIOLOGY, CANCER AND EDUCATION ARE A FOCUS FOR GIVING

and grandchildren Hunter, Griffin and Emery of Manhattan

“Providence Little Company of Mary Torrance has the highest quality of care. From

Beach; and their daughter-in-law, Rory Hunter, and

state-of-the-art technology to their new venture with City of Hope (a partnership

grandchildren Ethan, Dylan and Kailey of Palos Verdes. p. 35

OUT & ABOUT

39th Annual Golf Classic

1

2

3

4

5 p. 36

More than 130 golfers teed it up on May 22 to support Providence Little Company of Mary Foundation’s 38th Annual Golf Classic, presented by American Honda Motor Co., Inc. The tournament raised more than $260,000 to benefit the Providence Little Company of Mary Medical Centers in San Pedro and Torrance.

Clinical caregivers were thrilled to learn that the event also funded the purchase of cutting-edge phototherapy equipment used to treat newborns with jaundice.

We are extremely grateful to all of our generous sponsors, including lead sponsors the Scriba family, Mrs. Jacqueline Glass and family, Tom and Mary Ann Jankovich, Emergency Physicians of Providence Little Company of Mary Torrance and The Thermal Club. Thanks also to Ed Fountain and Rich Severa for their leadership as co-chairs and to all of the golfers and volunteers for another fantastic tournament.

1. Presenting sponsor, American Honda Motor Co., Inc., with the Scriba family and Mrs. Jacqueline Glass and family, made it a very successful tournament.

2. Bill Moller, major sponsor Tom Jankovich, Cheryl Gage and Chuck O’Malley enjoyed golf and dinner.

3. The “Welcome Team” consisted of Sister Terrence Landini and Providence Little Company of Mary Foundation staff Marlene Young, Chria Hazlitt and Kurt Hinrichsen.

4. Co-chair Rich Severa presents the women’s division prize to Twanna Rogers, Karen Mabli, Mafi George and Marilyn Perona.

5. Dr. Tom Schmalzried participated in the $98,000 shoot-out at the beautiful Palos Verdes Golf Club.

6. Providence Little Company of Mary chief executive, Mary Kingston, updated the golfers on the hospital’s accomplishments.

7. The Thermal Group sent two teams including Nick Battaglia, Mark Casey, Tim Rogers and Dr. Tom Schmalzried.

8. Emergency Specialist Physicians of Providence Little Company of Mary Torrance enjoyed a great day on the links: L-R Dr. John Wallace, Dr. Leon Artzner, Dr. Mark Rhee, Dr. Michael Tarnay, Dr. Will Conrad, Dr. Jo Vournas, E.J. Kahn and Dr. Fred Carr.

9. Lead sponsor, the Scriba family, was represented by Roy Omotto, Daniel Scriba, Jim Scriba and Jerry Soldner.

10. Multi-year major sponsor, the Jacqueline Glass family, was represented by Mike Freedman, Mike Joyce, Dave Jones and Randy Born.

6

7

8

9

10

OUT & NICU Graduate Reunion On Sunday, June 4, we hosted an annual event, inviting the families who had children in the Providence Little Company of Mary Torrance NICU from 2010 to 2016, for a reunion. It was a full house with over 200 people. There were crafts, games and toys to occupy the children, while the adults were able to reconnect with the caregivers and other parents who shared similar experiences.

1. NICU RN, Lori, with an adorable, grateful patient and happy mother 2. NICU medical director, Dr. Jon Yamamoto along with the family of a more recent NICU patient and occupational therapist, Camille 3. Providence Little Company of Mary Torrance volunteer Marie, reminiscing with former patients

On Sunday, March 12, Dr. Phyllis Monroe and Dr. David Cannom hosted a Donor Salon cocktail reception at their Rolling Hills home, to share details surrounding the emergency department expansion project at Providence Little Company of Mary Medical Center San Pedro. Dr. Miles Shaw, chief of staff and emergency department medical director, spoke about the wonderful impact this will have on the community.

1. Dr. Miles Shaw and Dr. Phyllis Monroe 2. Michael Neals, Providence Little Compny of Mary Foundation Development Officer with his wife, Mary Tabata, and Dr. David Cannom 3. L-R Providence Little Company of Mary Foundation Board Member Mark Paullin, Bobbie and George Farinsky, and LaRae Mardesic Bechmann, senior development officer for the Expansion Campaign.

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ABOUT

Providence Little Compamy of Mary San Pedro Emergency Excellence Campaign Salon

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Congresswoman Barragรกn Gathering

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Nancy Pelosi asked all Democratic congresspeople to tour health care facilities on the morning of February 18, 2017 and talk about the potential impact of the repeal of the Affordable Care Act. LaRae Mardesich Bechmann helped to facilitate a local health care provider roundtable with Congresswoman Nannette Barragรกn (D-CA).

1 1. L-R Anne Lemaire, Providence Little Company of Mary San Pedro chief administrator, Irene Mendoza, Congresswoman Nannette Barragรกn, Rachel Viramontes and LaRae Mardesich Bechmann

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2. Group shot including community health care leaders and two members of the Campaign for Emergency Excellence, Irene Mendoza and Rachel Viramontes p. 37

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OUT & ABOUT Ripley Donor Salon On November 6, Lucille and Fred Ripley hosted a Sunday brunch at their Rolling Hills home to share the impressive expansion plans for Providence Little Company of Mary Medical Center San Pedro’s emergency department. Anne Lemaire, the hospital’s administrator and Dr. Miles Shaw, chief of staff and medical director of the emergency department, spoke about the positive impact the new expansion will have on the Harbor and Peninsula communities. LaRae Mardesic Bechmann, senior director of development, spoke about how event attendees can support the Campaign for Emergency Excellence by being community advocates and donors.

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1. L-R LaRae Mardesic Bechmann with Campaign Council Members Lucille Ripley, Rachel Viramontes, Glenn D. Thompson, Irene Mendoza and Dr. Phyllis Monroe 2. Event hosts and Providence Little Company of Mary San Pedro supporters, Lucille and Fred Ripley

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3. Anne Lemaire and Dr. Miles Shaw

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Electrophysiology Lab Dedication and Blessing A signature element of Providence Little Company of Mary Medical Center Torrance’s $35 million Cardiovascular Center of Excellence Heart to Heart campaign is the $4.8 million, state-ofthe-art Electrophysiology Laboratory (EP Lab). A dedication was held on April 3 in the hospital’s Center for Health Education, followed by a tour and demonstration of the new lab, which has been named in honor of donors Stanley and Maureen Moore.

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1. Donors Stan and Maureen Moore flank Providence Little Company of Mary chief executive, Mary Kingston.

2. Paula and Mike Del Vicario in the new Electrophysiology lab with donors Maureen and Stanley Moore 3. L-R Longtime donors and board members Paula Del Vicario, Suzie Gulcher, Jan Brandmeyer, Kathie Eckert and Alanna Kennedy

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OUT & ABOUT

Go Red for Women Providence Little Company of Mary Medical Centers San Pedro and Torrance were major sponsors of the Go Red For Women Luncheon on May 5. It was an honor to help lead the fight against heart disease, and our very own Dr. Nazanin Azadi, a board-certified cardiologist, shared valuable information during the event.

A Western Celebration Providence Little Company of Mary Medical Center Torrance and the Cancer Support Community– Redondo Beach joined in celebrating National Cancer Survivors Day with a fun “Western” themed evening.

More than 140 cancer survivors, their families and friends enjoyed a buffet dinner, photo booth and a night of dancing that was lots of fun for all!

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E E M G O C TO

R E TH

CELEBRATION GALA BENEFITING PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTERS

HONORING DONALD AND PRISCILLA HUNT FOR THEIR EXTRAORDINARY PHILANTHROPY

SATURDAY, OCTOBER 28, 2017

6:00pm Cocktail Reception, 7:30pm Dinner

TERRANEA RESORT

100 Terranea Way Rancho Palos Verdes, CA 90275 TICKETS $350 SPONSORSHIPS $5,000+ THANK YOU TO OUR GENEROUS SPONSORS

Scriba Family The Centofante Family • Driftwood Healthcare Center • Kathie Eckert Emergency Physicians of Providence Little Company of Mary Medical Center Torrance Mrs. Jacqueline Glass and Family • Advanced Imaging of the South Bay, Inc. Rosalind Farmans Halikis & Family • Jim and Joanne Hunter • Ginny and Kent Shoji, MD Affiliated Pathologists Medical Group • American Province of Little Company of Mary Sisters • Joan Caras and Family • Philomina and Raju Chhabria John and Janine Colich • Del Amo Gardens Care Center • Gardena Convalescent Center • Tom and Mary Ann Jankovich • Chuck and Betsy Miller Providence Little Company of Mary Medical Center • Providence Little Company of Mary Medical Center San Pedro Medical Staff Rosecrans Care Center • South Bay Anesthesia Medical Group Sean F. Armstrong • Richard Brombach • COR Healthcare Medical Associates • Cuningham Group Architecture, Inc. • Emergency Physicians, San Pedro Integrated Anesthesia Medical Group/Pacific HealthWorks • Kei-Ai Southbay Healthcare Center • Dr. William Liu and Yvonne Liu • Mark C. Paullin Providence Little Company of Mary Medical Center Torrance Medical Staff • The Prindle Family • U.S. Bank Healthcare Division • Vermont Healthcare Center Special Thanks: Daily Breeze • Easy Reader News • TravelStore

For more information, please contact Katie Moe at (310) 303-5350, Katherine.Moe@providence.org or California.Providence.org/PLCMevents.

Sponsors as of 8.10.17

NONPROFIT ORGANIZATION U.S. POSTAGE

PAID Torrance, CA Permit No. 89

Providence Health & Services Administrative Offices 20555 Earl Street Torrance, CA 90503 888-HEALING providence.org/torrance providence.org/sanpedro

p. 32 Dr. Anh Long confers with Orfa Nitkiewicz during a rehabilation session.

p. 14 Drs. JeanPhillipe Langevin and Melita Petrossian offer innovative treatments for movement disorders.

p. 34 Donor Mark Paullin appreciates his ability to help Little Company of Mary Medical Centers in their Mission.