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AperiodicpublicationabouthealthierlivingnoexcusesTruthandmythaboutcolonoscopyinittogetherHANfertilitycentersnewshared-riskprogramwake-upcallsIdentifyingsleepproblemsinchildrenandadultsredefiningorthopediccarethetotaljointcenteratspringfieldhospitalputspatientsandfamiliesfrontandcenterFeaTuresToryalsoinTHisissue Decidingtohavesurgeryisjustthebeginningjointreplacementcanbealongandchallengingjourney.ThatswhyanewprogramatSpringeldHospitaltheTotalJointCenterwasexpresslydesignedtomaketheexperienceapleasantoneforpatientsandtheirfamilies.Wewanttheprocesstobeasuser-friendlyaspossibleandwevedevelopedthiswholestandardizedroutinewiththataiminmindsaysFrankGiammatteiM.D.chiefofOrthopedicSurgeryatCrozer-ChesterMedicalCenter.Fromtheoutsetpatientsareencouragedtothinkofthemselvesasanactivememberofacomprehensivecareteamalongwiththesurgeonanesthesiologistnursesandphysicalandoccupationaltherapists.Oncethesurgeryisscheduledthepatientisassignedanavigatorasinglepointofcontactwhowillanswerquestionsandsmooththewayforaseamlessprocedureandrecovery.Thenavigatorcallstosetupapreparatoryvisittotakecareofbusinessmattersbeforethedayofthesurgery.Thisvisitmightincludediscussionofpaymentissuespre-admissiontestsandatourofthefacilityalongwithmeetingswiththesocialworkertherapistsnursesdoctorsandotherstaff.Continuedonnextpage.REDEFININGORThOPEDIccARE Crozer-KeystoneMedicineSpringSummer2013Akeyfactorinthenewprogramiseducationpreparingboththepatientandfamilymembersfortheentireexperiencefrompre-operativetestingallthewaythroughrehabilitation.Makingsuretheirexpectationsarealignedwiththerealityofwhatliesaheadcanmakeamajordifferenceinthepatientssuccessandsatisfaction.Athoroughlyeducatedpatientisonewhocanparticipatemoreactivelyintheprocessofrecoveryandthisisparticularlytrueofjointsurgery.IftheyhaveanyquestionsalongthewayweareheretoanswerthemallsaysGwendolynSmithpresidentofSpringeldHospital.Thefacilitiestoohavebeendevelopedwiththepatientinmind.TheAcuteCareCenterfeaturessixnewlyrenovatedprivateroomsdecoratedwithhomeyhardwoodoorsandsoftlighting.Includedinalloftheroomsareat-screenTVsWi-Fiaccesspulloutbedsforguestsrobesandslippersandpersonalcaretoiletriessuchassoapshampooandlotion.Patientscanalsotakeadvantageofroomservicewithaspecialmenuofmade-to-ordermeals.Thesearehotel-styleamenities.WeknowthatmostpatientshavebeenwaitingtohavethissurgeryforsometimesowewanttomakeitascomfortableaspossiblesaysSmith.Fromhelpingndcareforpetsathometospecialparkingspotsthestaffhasthoughtofeverythingthatapatientmightneed.WethinkofitalmostasaboutiquehospitalwherealloftheresourcesaredevotedtotakingcareofjointreplacementpatientsDr.Giammatteisays.Sofartheresponsehasbeenexcellent.WeveonlyjuststartedtoofferthisprogramforthepastseveralmonthsbutpatientsthathavegonethroughithavebeenextremelyhappyandimpressedsaysJeffreyMalumedM.D.presidentofPremierOrthopaedicsandSportsMedicine.Initiallytheymightbefocusedonjustgettingagoodresultbutoncetheyreheretheyrealizethatallofthesethingsfromtherobestothenursenavigatoradduptomaketheexperienceapositiveoneforthem.HeatherKoelleisonesuchpatient.TheveryrsttotakeadvantageofSpringeldsprogramsheunderwenttotaljointreplacementsurgeryforherrighthiplastDecember.Everythingwasexplainedtomereallywellinadvance.TheroomwasverycomfortablethenursingcarewasexcellentandthetherapistsdidagreatjobaswellKoellesays.Sincehavingthesurgerysheisbackathomewalkingandclimbingstairsandlookingforwardtogettingbacktofavoriteactivitieslikeyogaswimminganddance.Withitspatient-centeredfocusandemphasisonmoderncomforttheTotalJointCentersprogrammaywellbethewaveofthefutureDr.Giammatteisays.Wearecertainlyaheadoftheeightballhere.Ithinkwewillcontinuetoseemorehospitalsmovetothismodelintime.Andatleastinourareawecansaythatwediditrst.Formoreinformationortosheduleanappointmentvisitjointenter.rozerkeystone.orgorall1-855-cK-JT1-855-255-6468.PicturedaboveonfarrightHeatherKoelleleftworkswithTonyaMerrillWellnessdirectorattheHealthplexSportsClub. OntheoldshowInLivingColorDamonWayanscharacterisapprehensiveabouthisupcomingcolonoscopythatisuntilhisdoctorsoulsingerLouRawlsshowsuparmedwithascopeadiscoballandasmoothballadtoeasehispatientsanxieties.Therealityisthatthereareanumberofreasonswhypatientsavoidcolonoscopy.Thefearofanesthesia.Thefearofndingsomethingworrisome.Andthentheresthefearofahemthepreparation.Wealwaysremindpeoplethatthisisaveryroutineprocedure.WecanaddressanyfearapatientmighthavebecauseweveheardthemallbeforesaysJohnW.SeedorM.D.chiefofGastroenterologyatTaylorHospital.Thereareavarietyofdifferentpreparationsavailable.PeoplehaveheardstoriesaboutwhatoxusesFormoreinformationortosetupadiret-aessappointmentforaolonosopyvisiti.rozerkeystone.ororall1-877-cKH-g11-877-254-7441.Iandwhenwedofndaproblemwewillimmediatelycomeupwithagameplantoaddressit.Butthatjourneyhastostartwiththefrststepwhichisfndingout.preparationtheymighthavetotakeandareconcernedtheycantdoit.Wecanworkwiththepatienttondtherighttforthem.Theprocedureitselfispainlessitsagoodnapandwhenyouwakeupitsover.Mostimportantofallcolonoscopyistherstlineofdefenseagainstcoloncanceranall-toocommonillnessthatcanbeverycurableiftreatedearly.AllAmericanshaveasixpercentriskofdevelopingthisdiseaseoverthecourseoftheirlifetimesoourjobistomakesureourcommunityisawareofthatsaysImmanuelHoM.D.chiefofGastroenterologyatCrozer-ChesterMedicalCenter.MaryBethDavishadherrstcolonoscopyattheageof38.Mymotherdiedofcoloncancerwhenshewas56soIstartedtogetscreenedatabouttenyearsbeforetheagewhensheprobablyrstgotsick.ItturnedoutthatIhadacancerouspolypinmycolon.IhadnosymptomsandtheresnootherwayIwouldhaveknownifIhadnthadthetest.AtthetimeIwasdevastatedandangrybutwhenItoldmyprimarydoctorhehadanexcellentpointHesaidmymotherhadessentiallysavedmylife.IndeedndingoutaboutthepolypatsuchanearlystagemeantthatDaviscouldhaveittreatedbeforeshebecamesymptomaticorthecancerspread.Dr.HoremovedthepolypandDavishasntlookedbacksince.IhadacolonoscopyeverysixmonthsafterthatandabouttwoyearsagoIstartedgoingannually.Mychildrenwillstartgettingtheirscreeningsintheirtwenties.Colonoscopynotonlydetectstheearlieststagesofcancerbutitcanalsobeusedtoanalyzecausesofdiarrheainfectionsandproblemswithbloodsupplytothecolon.Formostofthepopulationthoughearlycancerdetectionisthemostcompellingreasonfortheprocedure.Insomesituationsthedoctorcanremovetheproblemduringthescreeningitselfsavingpatientsthetroubleofhavinganadditionalprocedure.JusttodayIfoundalargepolyponathinareaofapatientscolon.TenyearsagothatwouldhaverequiredsurgerybutIwasabletoremoveitthereandthensaysMarkJacobsM.D.chiefofGastroenterologyatDelawareCountyMemorialHospital.Jacobssayshehasdoneatleast39000colonoscopiesoverthecourseofhiscareer.Thisisnotrarestuffthisisadiseaseweseeeveryday.Forpatientswithnofamilyhistoryofcoloncanceroranysymptomsregularscreeningsshouldstartatage50.Ifapatienthasarst-degreerelativewithahistoryofcoloncancerthentheyareadvisedlikeMaryBethDavistostarthavingcolonoscopiestenyearsbeforetherelativewasdiagnosed.AsforthefearofndingsomethingDr.Seedorsaysitsavalidonebutpatientsshouldrememberthatitswhattheydontknowthatcanliterallykillthemnotwhattheyknow.Ifandwhenwedondaproblemwewillimmediatelycomeupwithagameplantoaddressit.Butthatjourneyhastostartwiththerststepwhichisndingout.saysDr.Seedor.ForherpartDavishasbecomeanadvocateforroutinecolonoscopyscreenings.WheneverIhavetheopportunityItellpeopletogogetscreened.Itdoesntmakeanysensenottodoit.WHyiTSWoRTHGETTiNGPASTTHEFEARoFAColoNoSCoPyJohnW.SeedorM.D. Itseasyenoughtoidentifywhetheryouoralovedonehasgottenagoodnightsrest.Whatmostpeopledontrealizeisthatmajorsleepproblemscannotonlyaffectchildrenbuttheycantakedifferentformsinchildrenandadults.Thenumber-onesleepproblemaffectingbothchildrenandadultsissleepapnea.WhileadultswithsleepapneatendtofallasleepduringthedaychildrenwiththeconditioncanoftenappearirritableandwiredandsometimesappearasthoughtheyhaveattentiondecithyperactivitydisorderADHD.TherealityisthattheyaretwodifferentsleepapneassaysCalvinStaffordM.D.medicaldirectoroftheCrozer-KeystoneSleepCenteratTaylorHospital.InadultsthereareclassicsignssuchasirregularbreathingsnoringandinterruptedsleepbutforchildrenapneacanmoreeasilygoundetectedbecauseitlookslikeabehavioraldisordersaysMichaelWeinsteinM.D.medicaldirectoroftheCrozer-KeystoneSleepCenteratDelawareCountyMemorialHospital.BobRaffertyswifenoticedhewasbreathingsporadicallyandsnoringatnight.WhenhewenttotheCrozer-KeystoneSleepCenteratBrintonLakeforaroutinesleepstudybeforegastricbypasssurgeryhediscoveredthatheindeedhadsleepapnea.BeforethatIhadntrealizeditwasaproblemexceptwhenIdwakemyselfupatnightsnoring.hesays.RaffertywasadvisedtouseaCPAPmachineatnightandhefoundthatithelpedhimsleepsoundly.WhileadultsareprescribedtheCPAPmachinetherecommendedtreatmentisdifferentforchildren.ForchildrenwecanusuallytreatsleepapneawithsurgeryontheadenoidssaysAsadKahnM.D.medicaldirectoroftheCrozer-KeystoneSleepCenteratBrintonLake.Circadianrhythmdisturbancesimpactbothchildrenandadultsbutinverydifferentways.Adolescentsareoftentroubledbydelayedonsetsleeppatternswheretheygotobedlateatnightandwakeuplaterintheday.Whetheritsadiseaseorapatternofbehaviorisamatterofdisputebutweseekidswhoarealmostimpossibletoarouse.ThisisatroublingpatternforhighschoolstudentswhocanhaveacademicdifcultiesasaresultDr.Staffordsays.OlderadultsmeanwhilehavetheirownversionofcircadianissuesTheytendtogotosleepandwakeupmuchearlier.AthirdconditionthatimpactsbothadultsandchildrenisperiodiclimbmovementsaysVatsalaRamprasadM.D.medicaldirectoroftheCrozer-KeystonePediatricSleepCenteratCrozer-ChesterMedicalCenter.RestlessLegsSyndromeaffectsmanychildrenbutitisoftenseenasgrowingpains.Inadultsitsalotofnonspeciclimbmovementssometimesassociatedwithapnea.ItcanbehardertoproveinapediatricpatientbutitssomethingIhavebeguntoscreenpatientsforroutinely.InbothcasesthesyndromeisCrozer-KeystoneMedicineSpringSummer2013Wake-upcallsFormoreinformationortomakeanappointmentatoneofthecrozer-Keystoneleepcentersvisitsleepenters.rozerkeystone.orgorall1-888--031-888-753-3703.commonlyassociatedwithlackofironsowewillincreasethatasatreatment.Crozer-Keystonebeganprovidingcustomizedtreatmentsforpediatricsleepdisordersin2011whenthehealthsystemopenedDelawareCountysrstpediatricsleepcenteratCrozer-ChesterMedicalCenterinUpland.Renownedcarethattodayyoullndtobejustasconvenientasitiscomprehensive.ThatsbecauseforthersttimeallCrozer-KeystoneSleepCenterlocationsBrintonLakeCrozerDCMHandTaylorarenowofferingappointmentsforchildrenandyoungadults.Patientsshouldbeatleast6monthsold.ForyoungandoldalikethebottomlineisthatallsleepdisordersneedtobetakenseriouslysaysDr.Weinstein.Itsimportanttobeevaluatedforanyproblemsatanyagebecausesleepingwellisoneofthebestthingswecandoforourlong-termhealth.ThesedaysBobRaffertynolongerneedshisCPAPmachinebecauseweightlosshaseliminatedhissleepapnea.ButhewouldrecommendasleepstudyataCrozer-KeystoneSleepCentertoanyonewhothinkstheymighthaveaproblem.Theymakeyoufeelverycomfortableandtheyexplaineverythingitwasverynicetherelikesleepinginahotel.SlEEPPRoblEMSCANHAPPENATANyAGE AttheSportConcussionManagementCenteratSpringeldHospitalconcussionsaretreatedwithacollectiveapproachtocare.Thecenterprovidesmedicaltreatmentforsports-relatedconcussionsandworkswithschoolsandteamsforsafereturntobothacademicandathleticneedssothatpatientscangetbacktoschoolandperformwellintheclassroomaswellasontheeld.Wearereallyawrap-aroundserviceforthemedicalmanagementofconcussionsaysCarlaDeWaldadministrativedirectorofRehabilitationServicesatSpringeldHospital.PatientsbegintheirassessmentwithaphysicalexaminationandcomputerizedImmediatePost-ConcussionAssessmentandCognitiveTestingImPACTbeforemovingontomedicalmanagementorthopediccareandphysicaltherapywhichmayincludevestibularorbalancetherapyspeechtherapyandorcognitivetherapyasneeded.Aneuropsychologistisalsoavailableforadditionalconsultation.IngeneralthereismoreawarenessaboutconcussionsincludingnewerstatelawsinPennsylvaniaNewJerseyandDelawarethatmandatethatyoungpatientsbeseenbyphysicianstrainedinconcussionbeforetheyreturntoplaysaysStevenCollinaM.D.chiefofSportsMedicineatCrozer-KeystoneHealthSystem.Currentsciencehasshownusthatconcussionsaremorecommonandlastlongerthanweoncethoughtbutbeingevaluatedgettingdiagnosedandreturningforcarewhenappropriateisourbestdefenseandpatientscangeteverythingtheyneedrighthere.ForadultswhohavesufferedfromafallorimpacttotheheadthemultidisciplinaryteamatthePost-ConcussionClinicatCrozer-ChesterMedicalCenteroffersacompleteevaluationtoassesstheinjuryandpatientneeds.CrozersConcussionClinicwillalsoworkwithpatientsages18andunder.ConcussionscanresultinamyriadofsymptomsandwereanintegratedservicethatoffersacoordinatedplanofcareforalloftheaspectsapatientmightneedsaysDeborahLoveadministrativedirectorofNursingServicesatCrozer.Theteamincludesexpertsinoccupationaltherapyspeechtherapyandphysicaltherapyalongwithaneuropsychologistphysiatristneurologistandtraumasurgeons.BecauseconcussionsymptomsmaynotrevealthemselvesforuptofourweeksafteranincidentsomepatientsmaynotbeawareoftheextentoftheirownmedicalneedssaysColleenReynoldsassistantadministrativedirectorforPhysicalMedicineandRehabilitationatCrozer.Theproblemcanshowupinseeminglyunrelatedwayssuchasmemorylossspeechissuesheadachemoodswingsorevendepression.BecauseofthenatureofconcussionthisisanunderservedpopulationReynoldssays.WeareheretohelppeoplegetbacktoschoolandworkandallofthethingstheyliketodoReynoldssays.TaklingconussionswithcoordinatedcareConcussionscanhappentoanyonenotjuststudentathletes. Crozer-KeystoneHealthSystemsHANFertilityCenterDelawareCountysleadingfertilitycenterrecentlyintroducedaShared-RiskProgramaswellasofcehoursinNewtownSquareandDelawareCountyMemorialHospitaltobetterservepotentialpatients.ThenewShared-RiskProgramisdesignedtogivepatientsthecondenceofknowingthattheirinvestmentwillresultinapregnancyortheywillgettheirmoneyback.Foraatfeecouplesareentitledtofourfreshcyclesofin-vitrofertilizationandunlimitedfrozenembryocyclestoachieveapregnancywithina24-monthperiod.Couplesmustmeetcertainqualications.OurnewShared-RiskProgramallowspatientstorelaxandfocusonwhatmattersmostachievingahealthypregnancy.AlbertEl-RoeiyM.D.medicaldirectorInadditiontocurrentofcesatCrozer-ChesterMedicalCenterandtheCrozerMedicalPlazaatBrintonLaketheHANFertilityCenterhasalsoopenedtwonewDelawareCountyofces.Locatedat3475W.ChesterPikeinNewtownSquarewithSaturdayhoursfrom9a.m.tonoonandSuite705intheMedicalOfceBuildingatDelawareCountyMemorialHospitalinDrexelHillthenewlocationspromisetomakepatientcareasconvenientaspossible.DelawarecountyseadingFertilitycenterffersewprogramsewoationsCrozer-KeystoneMedicineSpringSummer2013 NON-PROFIT.U.S.POSTAGEPAIDUPPERDARBYPAPERMITNO.134TDcT.HgHTDD.Since1990Crozer-KeystoneHealthSystemhasprovidedtheregionwithsuperiorserviceacrossabroadrangeofhealthcaremodalities.Adedicatedandcompassionatecommitmenttohealthandwellnessexempliedbythe90CKHSphysiciansnamedbyMainLineTodaymagazineas2013TopDoctors.RepresentingclinicalexcellenceinahostofspecialtiesincludingorthopedicsneurologydiagnosticradiologygastroenterologyandreproductiveendocrinologytherecognitionsafrmCrozer-Keystoneslongstandingreputationforprovidingexceptionalmedicalcare.FordoctorslikeAlbertEl-RoeiyM.D.beingnamedaTopDoctorisatestamenttoCrozer-Keystonesunwaveringcommitmenttomeetingtheneedsofourpatientstodayaswellasanticipatingthoseofthefuture.AsthemedicaldirectoroftheHANFertilityCenterDr.El-Roeiyhasmaintainedasteadfastrecordofsuccesssincejoiningthehealthsystemin1992.Crozer-KeystonecongratulatesDr.El-RoeiyforbeingfeaturedonthecoveroftheTopDoctorseditionofMainLineTodaymagazine.OnApril82013theSurgeryCenterofPennsylvanialocatedinSuite212oftheMedicalOfceBuildingWellnessCenterII2010WestChesterPikeinHavertownbecamepartoftheCrozer-KeystoneHealthSystem.LicensedbythePennsylvaniaDepartmentofHealthandaccreditedbytheAccreditationAssociationforAmbulatoryHealthCareInc.thefacilitywhichwasrenamedtheCrozer-KeystoneSurgeryCenteratHaverfordisaserviceofDelawareCountyMemorialHospital.WelookforwardtoworkingwithournewCrozer-KeystonecolleaguesandtoprovidingexcellentcaretopatientsinthesurroundingareassaysWilliamS.IsaacsonM.D.ananesthesiologistandmedicaldirectoroftheCenter.TheCenterhasanunsurpassedreputationinthecommunityforexcellentcareandpatientservice.WeareproudtoaddtheCrozer-KeystoneSurgeryCenteratHaverfordtothearrayofservicesthatDelawareCountyMemorialHospitalofferstopatientsinourcommunitysaysWilliamMcCunepresidentofDelawareCountyMemorialHospital.Featuringcentralizedpre-operativeoperatingandpost-operativeareasthefacilitypromisesenhancedoperationalefciencyandconvenienceforpatientsseekingearnoseandthroatsurgerygastroenterologysurgerypluscolonoscopiesgeneralsurgeryinterventionalpainmanagementophthalmicsurgeryoralsurgeryorthopedicsurgerypodiatricsurgeryandplasticcosmeticsurgery.crozer-KeystonexpandswithdditionofurerycenterFacilitynowknownastheCrozer-KeystoneSurgeryCenteratHaverfordFormoreinformationvisitrozerkeystone.ororall610853-7700.052013