St. Clair Hospital HouseCall Vol VI Issue 2

HouseCallVOLUME V ISSUE 2

HouseCallVOLUME VI ISSUE 260

YEARS | 1954 - 2014CELEBRAT ING

Carpe NoctemHOUSECALL FOLLOWS

ST. CLAIR HOSPITAL'S

BOARD-CERTIFIED

INTENSIVIST

YVONNE R. CHAN, M.D.

AS SHE AND A TEAM OF

FELLOW CLINICIANS CARE

FOR PATIENTS ON THE

EVENING/OVERNIGHT SHIFT.

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

2 I HouseCall I Volume VI Issue 22 I HouseCall I Volume VI Issue 2

Yvonne R. Chan, M.D.

“There is acTive

healThcare

managemenT

happening 24/7

aT sT. clair.

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

AROunD-THE-CLOCK CARE

Meeting patients’ needsaround the clock

Volume VI Issue 2 I HouseCall I 3

F or most of us, working after midnight is exhausting just

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

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

is asleep is something she learned and mastered back in the

early 1990s while she was an undergraduate majoring in biology

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

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

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

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

recent weeknight this spring where the weather transitioned

quickly from sunny to gently falling snowflakes to bone cold at

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

‘Seize the night.’ We had a

t-shirt with this imprinted

in midnight blue on black

with the subtitle ‘I do my

best work after 2 a.m.’”

Dr. Chan, who went

on to earn her medical

degree at Harvard Medical

School, says that she has

“always been nocturnal” and relishes the extra challenges and

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

Hospitalists after the sun goes down.

EDITOR’S NOTE: THE HIGH QUALITY, COMPREHENSIVE, AND COMPASSIONATE CARE that St. Clair Hospitalis well known for doesn’t stop when the sun starts to dip in the western sky and visitors kiss their hospitalized

loved ones good night before heading home to their own beds. The Lab continues to do blood work and other tests,

Medical Imaging continues to do X-rays and other scans, Emergency Room physicians and specially trained staff

continue to treat patients who have been whisked to St. Clair by ambulance or walked in under their own power,

pediatric hospitalists continue caring for their young patients, obstetricians continue to deliver babies in the Family

Birth Center, nurses continue monitoring and tending to their patients, Hospital pharmacists continue to fill life-

sustaining prescriptions, and Nutritional Services continues to prepare healthful meals for hungry patients. Just

as importantly, acutely ill patients throughout the Hospital continue to be cared for by experienced, highly trained

physicians. One of those elite physicians is Yvonne R. Chan, M.D., a Critical Care Intensivist and Hospitalist who

has been caring for patients during the evening/overnight shift since 2005.

HouseCall followed Dr. Chan — who splits evening/overnight duties with fellow Critical Care Intensivist and Hospitalist

Maxim V. Bocharov, M.D.— through a recent evening/overnight shift to see what she does in the proverbial still

of the night. Her shift started at approximately 5:30 p.m. on a Tuesday and concluded just after 7 a.m. Wednesday.

The following photo essay captures the spirit of one particular overnight shift as Dr. Chan and other clinicians

continued caring for patients while most of us were fast asleep.

Continued on page 4

4 I HouseCall I Volume VI Issue 2

In search of:ICU Nurse Amy Carbonarasearches online for relativesof a critically ill patient.

The transition from day to evening/overnight shift:Yvonne R. Chan, M.D. is thoroughly briefed on each Intensive Care Unit (ICU) patient by Co-Director of Critical CareGregory Fino, M.D.

Critical care:She treats a patient

in the ICU.

On the move: The evening/overnight duties

are often fast paced forher and the clinical staff.

Sporting blue scrubs, black clogs, and a

white lab coat, the self-described “nocturnist”

bounds from one unit of the Hospital to the

next as she explains that it is important for

families of hospitalized patients to know that

their loved ones are well cared for during the

night. “There is active healthcare manage-

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

adding it is a superior level of care usually

offered at only the country’s best academic

healthcare centers.

Drs. Chan and Bocharov are full-time

nocturnists, a rare breed of physicians who

work exclusive nights. Nocturnists are quickly

becoming high in demand as peer-reviewed

medical journals, including the New England

Journal of Medicine, say that night and week-

end coverage by attending physicians greatly

enhances patient care.

THE COMPREHENSIVE HANDOVEROF PATIENT CARE

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

shift begins in the Hospital’s Intensive Care

Unit where she is thoroughly briefed on

each patient by Co-Director of Critical Care

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

trained critical care nurses, has been treating

patients there throughout the day.

Continued from page 3

T H E E V E N I N G B E G I N S


Administering critical care:Dr. Chan places

a central line in a patient in the ICU.

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

“Each patient in ICU needs to be individually

discussed because they are so critically ill,”

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

old man who was rushed to St. Clair after

being found unresponsive by his roommate.

The patient’s initial caregivers first suspected

bacterial meningitis, but tests soon ruled out

that potentially fatal disease in which a person

suffers from acute inflammation of the protective

membranes covering the brain and spinal cord.

His breathing assisted by a ventilator, the

unconscious patient is suffering multiple-

organ failure. Attempts to locate the patient’s

next-of-kin have proven unsuccessful so far,

as all phone calls have gone straight to voice-

mail. ICU nurse Amy Carbonara begins

researching various addresses on her desk-

top computer to try and find close relatives of

the patient to notify them about his condition.

ALWAYS CLOSELY MONITORING PATIENTS IN RECOVERY

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

the stairs, to the Cardiovascular Surgical Unit

(CVSU) on the Third Floor to check on patients

who had undergone open heart surgery

earlier that day. Like her patients in ICU, the

patients in CVSU are in need of very intensive,

individualized care following surgery.

Suiting up:In preparation forplacing a centralline, she creates asterile environment.

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

Continued on page 6

Cardiology conference:Cardiologist John Girod, D.O., who practices withSouth Hills Cardiology Associates, part of St. ClairMedical Services, confers with Dr. Chan about a90-year-old female patient who was transportedto the ER after suffering a heart attack and wasabout to undergo a cardiac catheterization.

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


A CALL TO THE ER Dr. Chan also serves as the Hospital’s admitting

physician throughout the evening/night, which

means frequent trips to the Emergency Room to

consult with ER physicians. Together, they will

decide which tests to run before patients are

assigned to a unit in the Hospital.

One of her trips to the ER this evening is to

examine a 39-year-old patient who attempted

suicide. Intubated to maintain an open airway,

he is later transported to the ICU.

There, Dr. Chan consults Micromedex, one

of the many medical knowledge databases the

Hospital provides to augment physicians’ practice,

to determine the toxicology of the medication he

had ingested in large quantities.

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

conferring with Cardiologist John Girod, D.O.,

who was called in from home to perform a heart

catheterization on a 90-year-old female patient

who had suffered a heart attack and was rushed

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

door-to-balloon team — interventional cardiol-

ogists who respond to heart-related emergencies

throughout the night. Door-to-balloon refers to

the time between when a suspected heart attack

victim arrives in the ER and when a tiny balloon

is inflated in his or her heart artery to clear

blockages that led to the attack. Studies have

shown that shorter door-to-balloon time leads

to a better recovery. St. Clair cardiologists have

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

in the country.

Quick change:ER physician Jason Biggs, M.D.,and Dr. Chan discuss a patienthe is treating in the ER and who is about to be admitted. St. Clair Hospital’s nationallyrecognized ER is staffed 24/7 by board-certified physicians.


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


SOOTHING THE FEARS AND PAIN OF A MOTHER AND BABY

Critical Care Intensivists and Hospitalists,

the ER physicians, and an in-house anesthesi-

ologist are also ready to assist in emergent

issues in the Pediatric Unit, where there is a

pediatrician in house 24/7.

A quick check of the Pediatric Unit around

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

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

hall, the boy’s nurse is preparing another

round of ear drops for the child who is suffering

from infection in both ears and pneumonia in

both lungs.

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

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

engineer. Earlier that evening Dr. Chan snuck

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

She acknowledges that her steady evening/

overnight schedule can be tough with little ones

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

she says.

CODE BLUE RESPONSEDr. Chan is also responsible for responding

to all Hospital-wide Code Blue response calls,

which are medical emergencies that might

require resuscitation and advanced life support,

as well as Rapid Response calls, in which a

team of healthcare providers attempts to prevent

respiratory or cardiac arrest in patients in non-

intensive care units who are showing early signs

of clinical deterioration.

Working the phone:A concernedphysician consultsDr. Chan about his patient.

Bedside:As evening/overnightshift rounds continue,

she checks the condition of a

patient on Unit 5G from head to toe.

Floor by floor:The evening/overnight shiftoften requires her to hustlebetween floors, going whereverhighly specialized patient care is needed.

Continued on page 8

INTENSE IS TYPICAL FOR A HOSPITAL INTENSIVIST

Although Dr. Chan would later describe

this particular shift as relatively “slow,” it was a

night of constant activity, as she only sat down

to record notes on patients and exchange

patient information with Dr. Fino.n

Full team response:A team of clinicians, including Dr. Chan, treat a patient in the Behavioral Health Unit who hassuffered a seizure while walking in a hallway. Once stabilized, thepatient is placed on a backboardand her neck is secured in abrace, before she is transported to Medical Imaging for a CT scan,the results of which are negative.

Heading to ICU:Following the CT scan,the patient is taken to the ICU for extensiveevaluation.

As noted in the main story, Drs. Chan and

Bocharov are Intensivists and Hospitalists who

care for patients in critical care units, as well as

other units throughout the Hospital during the

evening/overnight shift.

During standard daylight hours, patients are

cared for in the Intensive Care Unit (ICU) by

Co-Directors of Critical Care Gregory Fino, M.D.

and Patrick G. Reilly, M.D., as well as by their

Intensivist colleagues Laurie A. Kilkenny, M.D.,

Andrew Perez, IV, M.D., and Zachary T. Young, M.D.

St. Clair also uses Hospitalists, i.e., physicians who

are trained in internal medicine or family practice

and who specialize in the care of acutely ill patients.

Hospitalists work closely with patients’ primary

care physicians and specialists so Hospital and

follow-up care are well coordinated.

ST. CLAIR’S HOSPITALISTS INCLUDE:

Jose I. Christlieb, M.D., Medical Director

Meredith C. Broberg, M.D.

Daniel C. Jackson, D.O.

Christopher Mizzi, D.O.

Catherine M. O’Hara, M.D.

Danilo O. Policarpio, M.D.

Ansal Shah, M.D.

Amy Danner, CRNP

Moreover, St. Clair offers 24/7 in-Hospital pediatric

care by a team of board-certified pediatricians led

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

COORDInATED InPATIEnT CARE




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

YVONNE R. CHAN, M.D.

Dr. Chan earned her medical degree from Harvard, where she completeda joint program in Health Sciences and Technology with the MassachusettsInstitute of Technology (MIT). She completed a residency in internalmedicine at Mount Auburn Hospital in Cambridge, Massachusetts (part ofthe Harvard network of teaching hospitals), and a fellowship in pulmonologyand critical care medicine at UPMC. She is board-certified in criticalcare, pulmonology, and internal medicine. She practices with St. ClairMedical Services.

MAXIM V. BOCHAROV, M.D.

Dr. Bocharov earned his medical degree inSaint Petersburg, Russia, his native country.He then completed a residency in internalmedicine at Mercy Hospital in Pittsburgh,and a fellowship in critical care medicine atUPMC. He is board-certified in critical careand internal medicine. Dr. Bocharov practiceswith St. Clair Medical Services.

Heading home:Dr. Chan leaves the ICU around7 a.m. She plans to stop for aworkout at a gym before headinghome to see her family and getsome sleep.

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

T H E O V E R N I G H T S H I F T E N D S


ROBOTIC-ASSISTEDPARATHYROID SURGERY

Accessing hard-to-reach places with minimal trace

The parathyroid glands are tinymarvels. They are four organs, each nobigger than a grain of rice, which areattached to the back of the thyroid.The parathyroids perform a vitallyimportant function in the human body:regulating calcium metabolism, alongwith phosphorus and Vitamin D levels.Calcium is essential to every cell; itbuilds bones and teeth, helps regulatethe pumping of the heart and plays akey role in muscle contraction. It helpsthe nervous system transmit messagesand it is a component of the body’sblood clotting process. When theparathyroid glands are healthy, theydo their job quietly and efficiently,manufacturing parathyroid hormoneand maintaining the body’s delicatebalance of calcium in the bloodstream. When things go awry, it is generally because the parathyroid is making toomuch hormone (hyperparathyroidism)or too little (hypothyroidism).

Hyperparathyroidism is morecommon. It can be primary — meaningthat one of the four glands is too largeor is overactive, secreting an excess ofthe hormone; or it may be secondary, resulting from dialysis or illness.

Hyperparathyroidism produces hyper-calcemia, elevated calcium levels in theblood. While symptoms such as fatigueand weakness sometimes occur, theyare vague and common to many condi-tions. According to St. Clair Hospitalthoracic surgeon Richard H. Maley, Jr.,M.D., “The body controls calcium in avery tight range. Slight elevations maynot be symptomatic, but any elevationis abnormal and the cause has to bedetermined and treated.” Left untreated,hypercalcemia may lead to kidneystones, bone pain, fractures and heart disease.

WHAT ISPARATHyROIDISM?

Krista Woodard, a 22-year-old hairstylist from

Bethel Park, had no idea that elevated calcium

levels were the source of an illness that

began bothering her in the fall of 2013. “I was

experiencing nausea and stomach pain, and I

thought that maybe I had an ulcer. I saw my

primary care doctor and he ordered blood work,

which showed that my calcium level was abnor-

mally high. He referred me to Wayne Evron, M.D.,

an endocrinologist at St. Clair. On my scan, they

found that one of my parathyroid glands was down

in my chest, in my thymus gland, instead of in my

neck. Dr. Evron sent me to Dr. (Richard H.) Maley, (Jr.)

a chest surgeon at St. Clair, to see about removing it.”

Generally, parathyroid surgery is performed by

an otolaryngologist, or ENT surgeon. But

Krista’s condition was an ectopic

parathyroid — a gland that had

migrated to the wrong location,

underneath the sternum in her

chest. Thus, a thoracic surgeon was

needed. In addition to being lodged in

the thymus, the gland was enlarged.

Dr. Maley recognized right away that

Krista was an ideal candidate for

robotic-assisted surgery, utilizing

the da Vinci Surgical System. “For

Krista’s condition, robotics is the

gold standard. For places that are

difficult to access, it’s quite helpful

and has many benefits.”

MInIMALLy InVASIVE SuRGERy

Krista Woodard


The da Vinci Robotic Surgical System is

an advanced surgical technology that uses a

high-powered endoscopic camera and robotics

to translate the movements of a surgeon's

hands into precise movements of surgical

instruments. The surgeon sits at

a console in the operating

room, positioned several

feet away from the patient,

and works through tiny

incisions, as in minimally

invasive laparoscopic

surgery. Using hand and

foot controls, he manipu-

lates a machine with four

robotic arms, which is

poised over the patient.

Three of the arms hold miniaturized surgical

instruments and the fourth holds the camera.

At the console, the surgeon looks through

lenses that give him a three-dimensional

image and magnification up to ten times

beyond normal. The da Vinci system enables

surgeons to perform intricate surgical proce-

dures in the least invasive way possible, without

large incisions, making recovery faster and

easier. The Hospital uses a special robotics

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

room that is utilized by many surgical specialties.

“I’ve been using the da Vinci system for

several years. Everything

is visual with the da Vinci

Surgical System,”

Dr. Maley says, adding

the da Vinci is perfectly

suited to the anterior

mediastinal surgery that

he often performs.

To Krista, robotic-

assisted surgery sounded

“kind of cool.” Dr. Maley

explained to her that with the da Vinci, he

would be able enter her chest from the side,

between the ribs and behind the sternum, in

order to avoid cutting through the sternum.

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

was with robotic-assisted surgery. I had never

heard about that, but he explained everything

in detail, even how the thymus and parathyroids

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

the surgery, and had it done on December 4.

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

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

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

cutting hair at Sport Clips, by December 31.

I just have four little holes instead of a scar.

Best of all, my calcium and parathyroid levels

are normal now and the stomach pain and

nausea are gone. I feel great.”

“For KrisTa’s condiTion,

roboTics is The gold

sTandard. For places

ThaT are diFFiculT To

access, iT’s quiTe helpFul

and has many beneFiTs.

”RICHARD H. MALEY, JR., M.D.

Continued on page 12

Krista with her pet bunny.

Da Vinci surgery is highly regarded as a minimally invasive option,

with surgeons only making a few small incisions. The da Vinci Surgical

System features a magnified 3D high-definition vision system and tiny

wristed instruments that bend and rotate far greater than the human wrist.

These features enable surgeons to operate with enhanced vision, precision,

dexterity and control. St. Clair Hospital surgeons offer da Vinci robotic-

assisted procedures for patients in need of thoracic, urologic, gynecologic,

colorectal and general surgeries. The potential benefits of da Vinci surgery

for all robotic-assisted procedures at St. Clair Hospital include:

• Lower rate of complications

• Less blood loss

• Shorter hospital stay

• Less pain

• Minimal scarring

• Improved quality of lifesoon after surgery

The Benefits ofRobotic-Assisted Surgery

The da Vinci Surgical System console.



MInIMALLy InVASIVE SuRGERy

Too Much of a Good Thing

Laureen Cramer also had a parathyroid

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

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

gland, but of an extra one. With five parathyroids

functioning normally, she had an elevated

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

and was diagnosed when routine screening

blood work revealed hyperkalemia. “My doctor

told me to stop taking my calcium supplements.

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

St. Clair to have scans and my parathyroids lit

up when they injected iodine; they could see

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

surgeon, but he said the site was too low for

him; he operates in the neck and head. He

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

perfect for robotic surgery. I was surprised.

I’ve had previous surgeries and didn’t know

what it would be like.

“It turned out to be much less painful this

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

but that’s because it’s your chest.”

During the surgery, Dr. Maley deliberately

leaves the right lung unventilated so that it is

reduced in size and can be secured out of the

way. Post-operatively, the patient then requires

a chest tube for a day or two to drain blood

and re-inflate the lung. “We check parathyroid

levels immediately after the procedure, about

20 minutes after the gland is removed. They

should be decreased; it happens that fast.

We also have to watch that the calcium does

not drop too low; the normal parathyroids

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

and may have gotten lazy. Now with the extra

or enlarged one gone, they have to step up and

do all the work. We monitor to watch that the

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

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

there’s no further follow-up needed.”

Laureen says that her calcium levels are

perfect now. “They were normal by discharge,

and are still normal. I had a very positive

experience at St. Clair.” Laureen is enjoying

an active retirement at her 100-acre farm in

Taylorstown. Formerly of Upper St. Clair, she

says that she and her husband Fred moved to

the country for the sake of their dogs and cats.

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

but it keeps us healthy. I believe in living a

healthy lifestyle and I encourage everyone to

get the recommended health screenings.

If I had not had routine blood tests, my high

“i believe in living

a healThy liFesTyle and

i encourage everyone To

geT The recommended

healTh screenings.

”LAUREEN CRAMER

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


St. Clair Endocrinologists

Who Diagnose and Treat

Glandular Diseases

Diagnosing problems with patients’ parathyroid glands is just one

of many skills of endocrinologists, specially trained physicians

who diagnose and treat diseases related to the glands.

In addition to hyperparathyroidism, hypothyroidism and other thyroid-

related diseases, endocrinologists also treat patients suffering from:

• Diabetes

• Metabolic disorders

• Menopause-related issues

• Osteoporosis

• Hypertension

• Cancers of the endocrine glands

• Cholesterol disorders

• Infertility

• Over- or under-production of hormones

• Lack of growth

St. Clair Hospital Endocrinologists include:

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

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

To contact Dr. Maley, please call 412.942.5710.

calcium would have gone undetected and might

have done some damage.”

To his patients Krista Woodard and Laureen

Cramer, Dr. Maley is a great surgeon whose skill

cured their hyperparathyroidism. “I really liked

Dr. Maley,” enthuses Laureen. “He’s not only a great

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

and never rushes, and I appreciated that.”n

WAYNE A. EVRON, M.D.

Dr. Evron earned his medical degree at University ofPennsylvania. He completed his internship at Universityof Florida, his residency at Presbyterian Hospital, and afellowship at University of Pittsburgh. Dr. Evron is board-certified by the American Board of Internal Medicine. He practices with Evron Endocrinology Associates, adivision of St. Clair Medical Servies.

To contact Dr. Evron, please call 412.942.7295

CAMILLE M. BUONOCORE, M.D.

Dr. Buonocore earned her medical degree at State University of New York. She completed her internship andresidency, and a fellowship, at University of Pittsburgh.She is board-certified by the American Board of InternalMedicine. Dr. Buonocore practices with Associates inEndocrinology, P.C.

To contact Dr. Buonocore, please call 412.942.2140.

JANN M. JOHNSTON, M.D.

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

To contact Dr. Johnston, please call 412.942.2140.

BRIDGET K. BEIER, D.O.

Dr. Beier earned her medical degree at Lake Erie Collegeof Osteopathic Medicine. She completed her internshipand residency at University of Connecticut, and a fellow-ship at Virginia Commonwealth University. She is board-certified in Internal Medicine and Endocrinology. Dr. Beier practices with Associates in Endocrinology, P.C.

To contact Dr. Beier, please call 412.942.2140.

DOUHA SAFAR, M.D.

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

To contact Dr. Safar, please call 412.942.2140.

PATIEnT PROFILE

Joe Zimbicki has a remarkable heart, and over the course of his

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

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

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

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

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

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

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

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

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

His generous, heroic

heart remains strong,

due in large part to a

healthful lifestyle and

regular sessions at

St. Clair Hospital’s Cardiac/

Pulmonary Rehabilitation

Center. Since 2000, when

he underwent quadruple

bypass surgery at St. Clair,

Joe has been a fixture at

Cardiac/Pulmonary Rehab,

never missing his Monday,

Wednesday and Friday workouts. To David DeCarlucci, MS, CES, a

clinical exercise specialist and the Supervisor of Cardiac/Pulmonary

Rehabilitation at St. Clair, Joe is an inspiration, not only to the

other patients, but also to the staff. “Joe has a robust spirit

and is a natural leader. He has a quiet strength and leads

by example. He’s a thoughtful listener who remembers

what people tell him. He’s been through a lot in his life,

but he’s always focused on others.”

David says that when new patients begin Cardiac/

Pulmonary Rehab following a heart attack, stent placement,

or heart surgery to bypass blocked arteries or repair a valve,

they’re understandably anxious. “Then they see Joe. They

hear his story and learn that he developed heart disease

in his 80s, had bypass surgery, and learned to make

adjustments in his life. They see him exercising three

times a week and hear that he’s been faithfully

doing it for 14 years. It makes an impression.”

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

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

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

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

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

aspect, David explains, that becomes part of recovery.

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

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

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

breakfast. I eat a breakfast of oatmeal, a banana, bagel and tea, and then

I go to St. Clair. I work out on the treadmill, recumbent bike, regular bike

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

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

of him, “The Many Hats of Joe Zimbicki.” She believes that the Cardiac/

Pulmonary Rehab program is a major factor in her beloved grandfather’s

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

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

going there.”n

At 96, Joe Zimbicki is an inspiration

THE HEART OF A HERO

96-year-old Joe Zimbicki pumps some iron.

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


ASK THE DOCTOR

JOHN P. BROSIOUS, M.D.

Ask the Doctor Q

A

People often equate plastic surgery with cosmetic surgery.

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

Plastic surgery is actually one of the broadest fields in

medicine. We are the only surgeons who operate on

every body part from head to toe. We operate on

every type of tissue: skin, bone, muscle, nerves, blood

vessels and fat; and we operate on every age group,

from newborns to the very elderly. The perception

that cosmetic surgery is our primary focus is a

mistaken one; it’s rooted in television shows like

“Nip and Tuck” and “Extreme Makeover,” and in all

the advertising for cosmetic surgery. These things

have given the public a somewhat skewed view of

plastic surgery. The fact is, cosmetic surgery is just a

fraction of what plastic surgeons do. It’s one of many

subspecialties within plastic surgery.

Plastic surgery encompasses a wide range of

subspecialties. Craniofacial surgery is the treatment

of facial trauma, usually due to accidents and injuries,

but also including the correction of congenital facial

deformities such as cleft lip and palate. Treatment of

burns is a major aspect of plastic surgery; we perform

burn reconstructions, both acute and delayed, when

there is a need for scar revision. Plastic surgeons

perform many kinds of hand surgery; this is a very

specialized field in which we strengthen and restore

function in hands that have lost functionality due to

fractures, tendon tears, carpal tunnel syndrome,

arthritis, and other conditions of the hand.

There is also a subspecialty known as extremity

salvage. This refers to the repair of arms and legs that

have sustained severe trauma, such as open fractures

and crushing injuries that damage soft tissue. We perform

microsurgery or free tissue transfer; this means taking

tissue from one body part and using it to repair and

restore another. Plastic surgeons do a great deal of

cancer reconstruction surgery; the most common is

breast reconstruction after mastectomy, but we also do

a lot of reconstructive surgery for head and neck cancer.

Some plastic surgeons specialize in wound care.

This involves the treatment of difficult wounds such

as pressure sores, which are common in paraplegics,

quadriplegics, and the bedridden elderly. Wound care

represents about one-fourth of my practice. And

finally, there is the treatment of skin cancer, which

often requires the skill and experience of a plastic

surgeon. We remove skin cancer and other skin lesions,

and we repair lacerations and scars, in a way that

minimizes scarring.

It’s a great field. I love plastic surgery

and I embrace all of it. Working

with the different age

groups and all the parts of

the body is challenging

and satisfying. What

we do provides both a

functional and visible

difference for our

patients, and as surgeons

we experience instant

gratification in the operating

room. There is no single

solution in plastic surgery,

no cookie-cutter approach.

Each case is unique, so my

approach is highly individualized

toeach patient’s situation

and needs. n


JOHN P. BROSIOUS, M.D.

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

To contact Dr. Brosious, please call 412.572.6164.

John P. Brosious, M.D.

To help mark its 60th Anniversary and celebrate its legacy, St. Clair

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

related photographs and artifacts to possibly include in the future display,

which will be located on the Fourth Floor.

Do you, or someone you know, have photographs taken during the

planning/fundraising process or construction of the Hospital? Or perhaps

have a St. Clair Hospital nurse’s uniform from the mid to late 1950s? Maybe

a patch that adorned an old uniform? What about a doctor’s little black bag?

Or old Hospital signage? Any photos of, or artifacts from, St. Clair Hospital

through the years is of interest and we would love to hear from you.

Please let us know about your St. Clair Hospital treasure

by calling Matt Hiser at 412.942.2611 or 412.942.2465,

or emailing [email protected].

HISTORy MInuTE

APPEAL FOR ST. CLAIR HOSPITAL MEMORABILIA

St.Clair Hospital1000 Bower Hill RoadPittsburgh, PA 15243www.stclair.org

General & Patient Information: 412.942.4000

is a publication of St. Clair Hospital. Articles are for informational purposes and arenot intended to serve as medical advice. Please consult your personal physician.

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

Outpatient Center–Village Square: 412.942.7100Physician Referral Service: 412.942.6560

Urgent Care–Village Square: 412.942.8800Medical Imaging Scheduling: 412.942.8150

Outpatient Center–Peters Township: 412.942.8400

St. Clair Hospital continues celebrating its 60th Anniversary

in July with a specially themed Summer Swing.

Summer Swing — the Hospital’s biggest fundraiser of the year —

will be conducted Friday, July 18 at the prestigious St. Clair

Country Club with a decidedly early-’50s theme to recognize

the Hospital’s opening in February 1954. Guests will groove

to the sounds of a band dressed for the period and crooning

yesterday’s and today’s hits into vintage mics. The benefit dinner

will feature high-end food stations, live entertainment, and a

silent auction with electronic bidding.

Then on Monday, July 21, the 2014 version of Summer Swing

will wrap up with the Donald J. Hastings Golf Classic at St. Clair

Country Club.

Both the dinner and the golf classic are open to the public with

advance purchases. For tickets or sponsorship opportunities,

please contact the St. Clair Hospital Foundation at 412.942.2465.

St. Clair Hospital’s 60th Anniversary

July 18 & 21, 2014

A 1950s newspaper clipping from Mt. Lebanon News.

St. Clair Hospital HouseCall Vol VI Issue 2

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Transcript of St. Clair Hospital HouseCall Vol VI Issue 2