THE HEART BEAT - Atlantic Health · Leonardo Liberman, MD-EP Consultant Nurses Wanda Kaminski, RN...
-
Upload
vuongkhanh -
Category
Documents
-
view
214 -
download
0
Transcript of THE HEART BEAT - Atlantic Health · Leonardo Liberman, MD-EP Consultant Nurses Wanda Kaminski, RN...
Heart History: The Invention of
the Stethoscope: Rene Laen-
nec and his “Le Cylindre”
N o two symbols have come
to represent the medical
profession more than the ca-
duceus and the stethoscope.
Apollo, the Greek god of medi-
cine and music, gave the ca-
duceus to Mercury in ex-
change for the lyre which Mer-
cury had invented. Laennec,
perhaps as skilled in music as
he was in medicine, gave us
the stethoscope and, in ex-
Volume 3, I ssue 1
TH E D IR ECTO R ’S C U T C H R I S T I N E D O N N E L L Y , M D
Winter 2011 -12
THE HEART BEAT
Children’s Heart Center
Goryeb Children’s Hospital
Morristown Medical Center
100 Madison Ave.
Morristown, NJ 07960
Goryeb Children’s Center
Overlook Medical Center
99 Beauvoir Ave.
Summit, NJ 07901
Newton Medical Center
175 High Street
Newton, NJ 07860
Physicians
Christine Donnelly, MD-Director
Stuart Kaufman, MD
Donna M. Timchak, MD
Suzanne Mone, MD
Lauren Rosenthal, MD, MPH
Leonardo Liberman, MD-EP Consultant
Nurses
Wanda Kaminski, RN
Maria Lawton, RN
Elena Cobleigh, RN
Technologists
Colleen Henderson, RCS, RDCS-Lead tech
Alexis Harrison, RCS, RDCS
Bhavisha Pandya
Alla Greenberg
Ashley DeRosa
Kelli Vranch, RDCS
Medical Assistant
Joanne Spiropoulos
Social Worker
Margaret Micchelli, LCSW
Administrative Staff
Lynn Vanderyajt
Jessica Darcy
Diann Vivar
Sandy Segreto
Crystal Hernandez
Phone: (973) 971-5996
Fax: (973) 290-7979
Visit the Children's Heart Center Web Site
Edited by:
Margaret Micchelli and Stuart Kaufman
change, achieved “immortal”
fame.
B efore Rene Laennec,
medical diagnoses were
made on the basis of informa-
tion obtained from a patient’s
history, observation and lim-
ited examination, including
palpation, percussion of the
body and “immediate” auscul-
tation, or the direct application
of the ear to the patient’s
chest. Laennec, chief of the
l’Hopital Necker in Paris which
specialized in the care of pa-
tients with chest afflictions,
found this last method of diag-
nosis inadequate in certain
situations and “as uncomfort-
able for the doctor as it was
for the patient” and sought a
better means of examination.
And so he did:
“I was consulted, in 1816, for
a young person who presented
with generalized symptoms of
heart disease and in whom
palpation and percussion gave
few results because of plump-
ness. The age and sex of the
patient prevented me from
conducting the type of exami-
nation I have just described
(immediate auscultation); I
recalled a well-known acoustic
phenomenon: if the ear is
placed at one end of a log, the
tap of a pin can be heard very
distinctly at the other end. I
imagined that this property of
bodies could be applied to the
case at hand. I took a paper
notebook, made it into a tight
roll, one end of which I applied
to the region of the heart, and
putting my ear on the other
(Continued on page 3)
H A L L E T O T H E C H I E F !
T here aren’t many 6-1/2 year olds who can say they had a chat with the president of the United
States. But Halle Major and her family were treated to a VIP tour of the White House that included
time with President Barak Obama in the Oval Office.
H alle is one of Dr. Donna Timchak’s long-time pediatric cardiology patients. Many children, when
given the chance for any wish in the world, think of trips to faraway places or some of their favor-
ite past times. But Halle’s fondest wish was to meet the president. So,
she patiently remained on a waiting list until the fateful call came at the
end of March 2011. Can the family be ready in a week to go to Washing-
ton to meet President Obama?
T he Make-A-Wish Foundation © of NJ is part of a national non-profit
organization that grants wishes to children whose health conditions
meet the organization’s criteria. They arranged for a deluxe 4-day stay in
the capital for Halle, her parents, her sister Nya and her grandmother.
They enjoyed the National Zoo, the National Aquarium and the Smith-
sonian National Air and Space Museum, but the highlight was definitely
the White House.
P resident Obama gave his undivided attention to Halle, asking about
her school work and encouraging her to dream big dreams. She also
got to play with the presidential pooch, Bo, and to meet the president’s personal chef. Halle and her
sister had fun bowling in the White House bowling alley and they saw the White House movie theater
where Halle sat in the president’s favorite seat. After it was all over, Halle presented Dr. Timchak with a
framed picture of herself with the president. Now how many first graders can say that?
Save The Date: Valentine’s Day Family Event, February 12, 2012
Why did you want to be a
pediatric cardiologist?
M y father suffered his
first heart attack when I
was in the 2nd grade. He went
on to have a second heart
attack and cardiac bypass
surgery when I was a fresh-
man in high school. The im-
print that these events left on
my life is clear in my choice of
careers. It influenced not only
my decision to pursue a ca-
reer in medicine, but also
initially sparked my interest in
cardiology.
W hile completing my pedi-
atric residency and
fellowship in cardiology at the
Children’s Hospital of New
York Columbia Presbyterian
Hospital, I was trained by
pioneers in the field of pediat-
ric cardiology. I was inspired
by the idea of offering mean-
ingful therapeutic interven-
tions to children with cardiac
disease. The field has
evolved to change the way we
view conditions that were
once, at best, chronic ill-
nesses into treatable prob-
lems. I’m fortunate to be in a
position to guide my patients
through treatments that will
significantly improve their
quality of life.
P ediatric cardiologists have
a unique opportunity to
care for patients in a broad
range of clinical settings and
from a wide range of age
groups. When I establish a
relationship with a family it’s
often one that will span many
years and clinical scenarios. I
consider it a privilege to get to
know a patient and his or her
family on this intimate level.
The opportunity to begin to
form this bond even before
birth is but one of the many
reasons I’m interested in fetal
echocardiography.
A nother one of the reasons
I chose to become a phy-
sician was to have the oppor-
tunity to make a community-
based impact. After college
graduation, I spent several
months in Costa Rica where I
worked in a rural public
health clinic. During my time
there, I developed an under-
standing of the dramatic con-
tribution that a grass-roots
initiative can make to the
welfare of a population. This
experience motivated me to
obtain a Master’s Degree in
Public Health at Columbia
University’s Mailman School
of Public Health and it contin-
ues to shape the way in which
I practice medicine.
W hen my father was
acutely ill I used to hope
that he would live to see me
graduate from high school.
He lived not only to witness
that moment, but he also
shared many of my other im-
portant milestones. He ulti-
mately saw me graduate from
medical school, walked me
down the aisle at my wedding
and got to hold both of his
grandchildren. So, finally, as
a pediatric cardiologist, I hope
to have the chance to help
give families the priceless
time with a loved one that my
father’s physicians gave to my
family and me.
The Heart Beat Vo lume 3, Issue 1
HEA LTH Y HEA RT S U Z A N N E M O N E , M D
STAFF H I GH L I GH T L A U R E N R O S E N T H A L , M D , M P H
Take the stairs whenever
you can instead of the
elevator or escalator.
Choose a restroom that
is the furthest way, if you
have an option.
Grab a friend and go for
a 30 minute brisk walk
on the weekends. You
can catch up on every-
thing and exercise while
doing so.
Go for a walk while talk-
ing on your cell phone,
but be careful of traffic.
If you find yourself in
front of the TV, jump rope
or do calisthenics during
the commercial breaks.
Exercise first thing in the
morning. Get up 20–30
(Continued on page 3)
steps between your car
and the store.
Take a “walk break”
whenever you can find
time during the day.
Taking short 10 minute
walks a few times a day
will do wonders for your
metabolism!
Use your lunch break as
time for exercise. Spend
half the time eating and
half the time walking.
Play with your children!
This is great attention for
them and a great activity
for everyone.
A way to spend time as a
family is to take a walk
together around the
neighborhood after din-
ner.
Importance of Exercise
W e all know exercise is
good for us. Exercise
controls weight, combats
health conditions and dis-
eases, promotes better sleep,
improves mood, boosts en-
ergy and is fun! All of us
should strive for at least 30
minutes of physical activity
each day.
H ere are ways to incorpo-
rate more exercise into
your daily life. It’s good for
you and it sets a great exam-
ple for your children of “heart
healthy” living.
Seek out the parking
spot that’s furthest away
and get in a few extra
N U R S E S ’ N O T E S
Cold and Flu
Season Tips by Elena Cobleigh, RN
The CDC recommends a
yearly flu vaccine as the
most important step in
protecting against flu
viruses.
If there’s a child in the
home with cyanotic heart
disease (blue at birth), all
family members should
get the flu vaccine.
The flu shot cannot
cause you to get the
flu. Any side effects
are mild and last about
24-48 hours.
Children under the age
of 2 years with certain
heart diseases should
also receive monthly
Synagis injections (Oct.
to April) to minimize the
effects of the RSV virus.
See your pediatrician
for more information.
During cold and flu
season, wash your
hands often with soap
and water. Handwash-
ing is the single most
effective way to prevent
the spread of infection.
Please keep your child
home if sick with a cold
or the flu. If you have a
cardiology appoint-
ment, speak with one
of the nurses to see if
you should reschedule
the appointment.
Page 2
The Heart Beat Volume 3 , Issue 1 Page 3
F A M I L Y C O N N E C T I O N
D I R E C T O R ’ S C U T ( C O N T ’ D )
past fall was our 2nd annual family picnic at
Lewis Morris Park. Families enjoyed the petting
zoo, live music, a climbing wall, a martial arts
demonstration, face painting and crafts.
O ur 3rd annual Valentine’s Day family event
in honor of National Congenital Cardiac
Defect Awareness Day is on Sunday, 2/12/12
from 1pm to 3 pm in the hospital auditorium.
The whole family is invited to an afternoon of fun
and sharing. Please mark your calendar be-
cause we hope to see you there!
T hese smil-
ing boys
have something
very special in
common. Their
parents met at
our pediatric
cardiology fam-
ily events and found out they share many similar
experiences. Now these boys are buddies and
the families have become friends.
I n addition to the monthly parent group, we
hold two large family events every year. This
Did you know??
There is a difference between a
serving size and a portion size.
A portion size is what you
choose to eat, while a serving
size is the recommended
amount.
ONE SERVING SIZE EQUALS…
½ cup cooked rice equals a
filled cupcake wrapper
½ cup cooked pasta equals an
ice cream scoop
1 medium piece of fruit is the
size of a tennis ball
¼ cup raisins or nuts is about
the size of a large egg
1 ounce of cheese equals about
2 dice
1 cup of yogurt is the size of a
baseball
3 ounces lean meat, chicken or
fish is about the size of a deck
of cards
1 teaspoon of salad dressing is
the size of a postage stamp
2 tablespoons of peanut butter
equal a golf ball
1 baked potato is about the size
of a computer mouse
1 slice of bread is the size of a
cassette tape
What is the serving size of one
pancake?
end, I was just as surprised as I was satisfied to
hear the beating of the heart in a manner that
was clearer and more distinct than I had heard it
by the direct application of the ear.”
A lthough Laennec preferred to call his inven-
tion “le cylindre” and indeed the first instru-
ments were wooden cylinders, he eventually
gave into peer pressure and named it the
stethoscope from the Greek “stethos”-chest and
“scope”-to see. Incredible as it may seem to-
day, the stethoscope was not universally ac-
cepted and as late as 1834, a commentary in
the London Times stated:
“That it will ever come into general use…is
extremely doubtful because its beneficial
application requires much time and gives a
good bit of trouble…There is something even
ludicrous in the picture of a gray physician
proudly listening through a long tube applied
to the patient’s thorax.”
Answer: The size of a CD.
O ver time, the stethoscope has evolved from
the monaural cylinder Laennec invented to
today’s familiar binaural instrument. Indeed the
variety of stethoscopes developed since Laen-
nec’s time continues to increase with 318 pat-
ents related to stethoscopes between 1976-
2000 alone. But despite the varieties, colors
and accessories of modern day stethoscopes, it
is still clear, as Dr. Tsung Cheng tells us…“It is
not these fancy accessories that make the dif-
ference. It is what lies between the two ear-
pieces that counts”.
minutes earlier and get in your workout first
thing.
Try to choose a physical activity immedi-
ately following work. A walk, gardening or
even housework is better than sitting on the
couch.
If you are torn between reading at home
and jogging in the park, get an audio ver-
sion of the book of your choice from the
library. You can listen to the book while you
walk or jog.
Walk, jog, or stretch while you’re waiting for
dinner to cook, the laundry to finish up, or
for your child to be finished with an activity.
Turn your house chores into exercise.
When vacuuming, try to use your arm, back
and abdominal muscles to push the vac-
uum. When loading the dishwasher, main-
tain good posture as you are bending and
straightening while keeping your abdominal
muscles tight. Washing the car, weeding,
and mowing the lawn are great ways to
burn extra calories.
It is perfectly fine to break up your intense
workouts. If you split your 30 minutes of
aerobic activity each day into three 10 min-
ute sessions, you may find this more man-
ageable...JUST DO IT!
H E A LT H Y H E A R T ( C O N T ’ D )
Family Picnic 9/18/11
Parent Support Group:
Get Acquainted After the Holidays!!
C ongenital heart problems are the most common birth defect
in the country and throughout the world. Do you know any-
one else who shares your experience? This is a monthly group for
mothers and fathers whose children are under age 5. It’s an op-
portunity to share information and support as different develop-
mental issues arise in the course of family life. The group meets
on the first Monday evening of the month at 7 pm on the second
floor of Goryeb. Upcoming meeting dates are: January 9, Febru-
ary 6, March 5, April 2, May 7, June 4, 2012. Please drop in
whenever it’s convenient for you.
For more information please contact (973) 971-8689.
The Heart Beat Vo lume 3, Issue 1 Page 4
Living With Pediatric Chronic Illness: Empowering
Families to Help and Heal
T he dept. of pediatrics presents a panel of Goryeb experts to
address the impact of any chronic illness on families.
Christopher Lynch, PhD Impact of chronic illness on the
family
Tara Gleason, MSN, CPNP Practical tips for parents when
dealing with school issues
Ann Stocknoff, LCSW Caring for the caregiver: strategies
to reduce stress
When: Sunday, March 25, 2012 from 1 pm to 3 pm
Where: Malcolm Forbes Amphitheatre
Registration is requested. Please call (800) 247-9580.
SO C IAL WOR K COR N ER M A R G A R E T M I C C H E L L I , L C S W
P E D I AT R I C EP N OW O N B OA R D
W e are very pleased to announce
that Dr. Leonardo Liberman, a
pediatric electrophysiologist, has
joined our team. First, an answer to
the question: What exactly is an elec-
trophysiologist? Within the specialty
of pediatric cardiology, an electro-
physiologist focuses on problems with
the heart’s rhythm and electrical im-
pulses. In other words, he’s an electri-
cian for the heart!
D r. Liberman graduated from the
medical school at the University
of Buenos Aires and completed fellow-
ships in pediatric cardiology and pedi-
atric electrophysiology at CHONY-
Columbia University where he is an
Associate Clinical Professor of Pediat-
rics. He also publishes and lectures
extensively in the field.
D r. Liberman now sees patients
here at Goryeb every 3rd Monday
of the month, so families no longer
have to travel to NY for an appoint-
ment. They can receive this expert
specialized care much closer to home.
N U R S E A B O U T T OW N
W anda Kaminski, RN, was at Hill-
crest School in Morristown on
May 27, 2011 to speak with the Mor-
ristown and Morris Township school
nurses who cover grades K through
12. Wanda is committed to commu-
nity outreach to educate others about
pediatric congenital and acquired
heart problems. Also, such a meeting
serves to improve communication
among pediatric cardiologists, schools
and families.
T he nurses discussed various con-
genital heart defects and condi-
tions, such as syncope and postural
orthostatic tachycardia. Also, Wanda
was able to respond to specific stu-
dent scenarios that the school nurses
presented. Issues related to exercise
tolerance and sports activity are espe-
cially important in a school setting.
Overall, this was a wonderful opportu-
nity to answer questions and address
concerns about the daily school life of
children with cardiac conditions.
E M P L OY E E O F T H E M O N T H
C ongratulations to Bhavisha
Pandya, cardiovascular technolo-
gist, who was designated employee of
the month (March/April) in the depart-
ment of pediatrics. She has been with
the Children’s Heart Center for seven
years, after coming from Florida where
she obtained her CVT education. In
addition to
her regular
work in pedi-
atric cardiol-
ogy, she
also does
studies in
both the
NICU and
PICU, when
n e e d e d .
Bhavisha’s
calm man-
ner is a real
help in doing echocardiograms on the
youngest of patients. She also was
commended for her awareness of cost
effective measures in her role of or-
dering clinical supplies for the division.
Bhavisha is a team player and we are
very fortunate to have her as part of
our team.