St. Clair Hospital HouseCall Vol VI Issue 2
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Transcript of 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
Volume VI Issue 2 I HouseCall I 5
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.
6 I HouseCall I Volume VI Issue 2
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.
Continued from page 5
Code Blue:Dr. Chan checks monitors that have been connected to a patient who suffered a medical emergency in the middle of the night.
Volume VI Issue 2 I HouseCall I 7
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
8 I HouseCall I Volume VI Issue 2
Continued from page 7
Volume VI Issue 2 I HouseCall I 9
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
10 I HouseCall I Volume VI Issue 2
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
Volume VI Issue 2 I HouseCall I 11
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.
12 I HouseCall I Volume VI Issue 2
Continued from page 11
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.
Volume VI Issue 2 I HouseCall I 13
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.
14 I HouseCall I Volume VI Issue 2
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
Volume VI Issue 2 I HouseCall I 15
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.