betterhealth

Remember those old television shows that depicted emergency rooms as places of interminable waits, impersonal care, and a crisis-to-crisis mentality? Step intosome emergency departments today, and you’ll find a dramatically different

scenario. Immediate triage is the goal, with fast track services and specialty care teamsproviding care. Step into Stony Brook University Medical Center’s new EmergencyDepartment (ED) today, and you’ll see how it is being transformed by an ongoing majormodernization project that is helping to raise the standard of care in emergency medicineto an even more patient-centered level.

“Our goal is to treat people efficiently, to be considerate of their time, and care for them inspecially designated areas appropriate to theirneeds, or in the case of children, appropriate to their age,” says Mark Henry, MD, Chair ofEmergency Medicine at Stony Brook University Medical Center. “And we’ve designed our newED to reflect the way we now deliver care.”

This includes an emphasis on:

• Patient privacy. Every opportunity is taken to preserve patient privacy. When possible, patients will have their physicals and initial histories taken in private rooms—hard-walled rooms with doors, not curtained cubicles—as well as receive the majority of their treatment there. There are times, however, when certain procedures takepatients out of these rooms and into more open facilities, but ensuring patient privacy is one of our primary goals.

• Appropriate care setting. The ED has built separate treatment areas according topatient needs. There is a trauma area for the most critical cases; an Intermediate CareArea for patients with non life-threatening conditions; and a Critical Decision Unit,where patients can be observed for six to eight hours, which may result in them not being admitted to the Hospital. A separate pediatric emergency room is being constructed to help keep children from being exposed to potentially scary traumas

Spring 2009

BetterHealthBetterLiving

Health information for the community

EMERGENCY MEDICINE’S NEW PARADIGM:PATIENT-CENTERED CARE IN A PATIENT-FRIENDLY SETTING

IN THIS ISSUELeadership Message 2

Division of Gastroenterology 3

Pediatric Cystic FibrosisCenter 6

The 10 Things You Needto Know About Research 8

Smallest Heart Pump 9

Ask the Expert 10

1,000th Kidney Transplant 11

Classes and Programs 12

Research Studies 14

Cody Center Recreation/Respite Program 15

Auxiliary Shows Heart 16

continued on page 4

4

9

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The Emergency Department at StonyBrook University Medical Center has built separate treatmentareas according topatient needs.

There is a certain excitement tothe onset of spring. It’s a timeof promise and renewal. A

time to make plans, sometimes vow-ing to make changes for the better inyour life. It’s a time to dream big. It’s atime of hope. A time when you feel theimpossible may just be possible.

For Stony Brook University MedicalCenter, we welcome spring 2009 withthe realization that, in many ways, theseemingly impossible dreams fromyears gone by, when we first envi-sioned our major modernization project, have become reality. As aHospital known for the best ideas inmedicine, we have recently seenmany of those “best ideas” come intobeing. With Phase I complete andPhase II underway, we now have afacility that reflects the way we prac-tice medicine in the 21st century—with design that promotes efficientworkflow and state-of-the-art monitor-ing, telecommunications, and diagnos-tic capabilities; patient rooms thatfacilitate family involvement; andoperating rooms that are configuredto accommodate new equipment andadvanced techniques.

In these pages, for example, you canread about how the new EmergencyDepartment ultimately improves careto the community and what thatmeans for you. We also feature arti-

cles about many of our other new ini-tiatives—from new procedures beingperformed in the Division of Gas-troenterology to a new heart pumpthat is transforming cardiac surgeryto comprehensive treatment of cysticfibrosis. We also have a host of newworld-class physicians who are bring-ing best ideas of their own to StonyBrook University Medical Center.

And speaking of best ideas, ourresearchers eat, drink, live, andbreathe them every day. Read abouthow they study, test, and track theirideas—some of which are setting thenew standard of care in medicine.

As always, Better Health, Better Livingis devoted to exactly that—better

health for the community, and better living for you. Check out our newhealth tips that appear throughout the publication. They may give yousome ideas of your own about how toto kick off spring.

2 www.StonyBrookMedicalCenter.org

MESSAGE FROM STONY BROOK UNIVERSITY MEDICAL CENTER LEADERSHIP

RICHARD N. FINE, MD STEVEN L. STRONGWATER, MDDean Chief Executive OfficerSchool of Medicine Stony Brook University Hospital

We Are Smoke Free!Everyone who sets foot on the campus of Stony Brook University Medical Centerwill now find a healthier environment. Effective January 1, 2009, a new policyprohibits smoking not only inside and near buildings but also on the grounds of theMedical Center, Health Sciences Center (HSC), and the Long Island State VeteransHome (LISVH). In addition to the HSC and LISVH, this includes the Hospital,Ambulatory Surgery Center, Cancer and Imaging Centers, the Hospital and HSCparking garages, and all open space around these areas.

We have a commitment to improve lives through advanced medical treatments andthrough prevention of disease and promotion of good health. The health ramifica-tions of smoking and second-hand smoke are well documented. We believe thateveryone who spends time on our campus deserves to breathe fresh, healthy air. It is our job as a healthcare leader to take proactive steps. This is one of many.

To learn about smoking cessation, call HealthConnect®, (631) 444-4000.

Sharing the best ideas in medicine.

From stopping strokes to minimiz-ing the side effects of cancer treatment, Stony Brook UniversityMedical Center is home to the bestideas in medicine. To learn more,visit BestIdeasinMedicine.com. Ifyou would like to receive usefulhealthcare information via e-mail,send your e-mail address to [email protected].

In many ways, having an academicmedical center in the communityis like having a giant safety net

wrapped around the health of eachperson living in it. That’s because academic medical centers do not justdeliver one-to-one healthcare. Theysupport the community’s primarycare physicians by making a widerange of subspecialists available topartner with them on complex diag-noses. They complement communityhospitals by investing in state-of-the-art technology and services thatsmaller facilities cannot offer. Theyeducate the doctors of tomorrow,many of whom choose to remain inthe community and have a strongfocus on research, which means themost advanced treatments, includingnational clinical trials, are available for patients with serious or rare condi-tions. In short, an academic medicalcenter both raises and sets the standard of care in the community.

And that is exactly what is happeningwith Stony Brook’s Division of Gastroenterology (GI). The newlyappointed Chief, Basil Rigas, MD, isleading the division toward servingthe community in an even more comprehensive way. This includes:• Recruiting the “best and the

brightest.” “We have been able torecruit outstanding physicians fromsome of the finest medical institu-tions in North America, includingHarvard, Johns Hopkins, NYU, andthe University of Toronto,” says Dr. Rigas. One of the best knownamong the new doctors is JonathanBuscaglia, MD, an advanced interventional endoscopist who also serves as the Director ofEndoscopy at Stony Brook.

• Creating seven centers of excel-lence. This will include centers forbiliary; liver disease and transplant;women’s gastroenterology;esophageal and swallowing disor-ders; screening for gastrointestinalcancers; inflammatory bowel diseases (Crohn’s and colitis); andweight control and nutrition.

• Developing the first NanomedicineCenter in the country. Workingwith the School of Engineering andApplied Sciences, the Gastroen-terology Division is developing nanotechnology-based methods to identify tumor markers within afraction of a second, as well as totreat GI cancers. These efforts will hopefully culminate into aNanomedicine Center, which couldbe the first of its kind in the nation.

• Investing in equipment and tech-nology. This includes state-of-the-art endoscopy and ultrasoundequipment such as the SpyglassTM,which is an ultra-thin endoscopeused in advanced procedures.

• Reaching out into the community.“Although we offer advanced medi-cine for complex and rare condi-tions, we address all GI disorders.In fact, that is the foundation of ourdivision,” says Dr. Rigas. Thisincludes prevention, education,screening, and treatment for common GI complaints such asheartburn, abdominal pain, consti-pation, and changes in bowel habits.

• Offering state-of-the-art and pioneering procedures. Many ofthese are minimally invasive or incisionless procedures that resultin less infection and faster recovery.In addition, because of the limitedstress they place on the body theseprocedures can be performed on

patients who would otherwise notbe candidates for surgery. Dr.Buscaglia, for example, performsseveral advanced procedures thatare minimally invasive, such asendoscopic mucosal resection for removing diseased portions of the GI tract without surgery,among others.

Call (631) 444-4000 3

Gastroenterology Offers Advanced Medicine and Pioneering Techniques

To Get a ColonoscopyOf course, not many of us lookforward to a colonoscopy, but fordetecting colorectal cancers andother gastroenterologic disorders,it remains the gold standard. Hereare three good reasons to schedule a colonoscopy.

1. Age. If you are at average risk and recently turned 50, it is time to get a baseline screening. If theexam is normal and there are noother risk factors, you will only needto have future exams at 10-yearintervals, unless your physicianrecommends otherwise.

2. New Technology. Colonoscopiesare less invasive and more comfort-able than ever before. The averageprocedure takes less than an hour.Plus, Stony Brook is pioneeringpromising virtual colonoscopytechnology, which may make colono-scopies even easier in the future.

3. Success. Colon cancer has one of the highest cure rates if detectedearly. Colonoscopies can uncover and remove benign polyps that if leftin the colon can grow into canceroustumors. Because colon cancer hasno discernible early symptoms,screenings are particularly important.

THREE REASONS


EMERGENCY MEDICINE’S NEW PARADIGMcontinued from cover

occurring in the adult ED, and toprovide specialty care and equip-ment tailored to pediatric patients.In the interim, a separate area in theED is currently reserved for treat-ing pediatric patients.

• Efficiency and speed. A built-in StatLab offers a 30-minute turnaroundon many tests. The ED has the mostmodern radiographic digital imag-ing equipment available, providing aremarkable three-second timeframefrom imaging to interpretation. And, the ED’s new entrance allowspatients to drive directly to thedoors and have their cars parked by valet service—a way of gettingtreatment as quickly as possible.

• Faster communication. Severalmonths ago, a sophisticated patienttracking system was installed sothat doctors can monitor the statusof patients in real time. Via a 52-inchmonitor set up in clinical areas andRadiology, the patient’s progressthrough the ED can be tracked(via a coded system) so that doctorscan immediately see, for example,which tests have been completedand which medications have beenadministered and when. “This pushes the information out to thedoctors, rather than the old way,which pulled the doctors toward the computer,” says Eric Niegelberg,Administrative Director for Emergency Services. “They save valuable time in an environmentwhere every minute counts.”

• Precautions against airborne

infections. The new ED is equipped

with negative pressure rooms in all

clinical areas, allowing the ability to

quarantine patients who may have

airborne infections such as tubercu-

losis, chicken pox, and meningitis

from other patients.

• Diagnosis-specific teams. This

includes the Code H Team for rapid

response to acute myocardial

infarctions (heart attack) that can

mobilize a cardiology and cardiac

catheterization team to the patient’s

bedside. This team has been so suc-

cessful in administering appropriate

treatment in such a short timeframe

that the team has presented their

results at national conferences.

Other teams include a Stroke Code

Team and a Trauma Code Team,

among others.

• Continuity of care. Every morning,

seven days a week, each case is

reviewed by the follow-up office

(consisting of two full-time nurses

and two clerks). This is possible

because of a new secure digital

scanning system that allows each

patient’s chart to be scanned daily.

The chart, including the latest test

results and interventions, is then

sent out to the patient’s primary

care physician to ensure continuity

of care. The office also does follow-

up calls days after the patient has

been discharged.

WHEN IS IT AN EMERGENCY?

Unsure of when to go to theEmergency Department? Asa Viccellio, MD, ViceChair, Department of Emer-gency Medicine, describesthe classic, general symptomssignaling an emergency. He notes that there may beother more specific signs aswell, so if you are not sure,call your doctor. If the symp-toms seem life-threatening or are rapidly worsening, call 911.

• Difficulty breathing/Shortness of breath

• Chest or upper abdominalpain or pressure

• Fainting, sudden dizziness,weakness

• Changes in vision

• Difficulty speaking

• Confusion or changes inmental status

• Suicidal feelings

• Any sudden or severe pain

• Uncontrolled bleeding

• Severe or persistent vomiting or diarrhea

• Coughing or vomiting blood

• Unusual abdominal pain

Call (631) 444-4000 5

WHAT MAKES STONY BROOK’S EMERGENCYDEPARTMENT STATE-OF-THE-ART?

As Suffolk County’s only Level I trauma center, Stony Brook’s Emergency Department offers:

• Expert care for the most severe traumas, 24/7. Patients often are flown inby helicopter from accident sites or transported by paramedics from com-munity hospitals in order to receive the advanced level of care offered atStony Brook.

• Stellar faculty members who have won awards for outstanding leadershipin the field from the American College of Emergency Physicians and othernational groups.

• The latest technology, including a 64-slice CT scanner that can quickly andaccurately help diagnose such major events as stroke, cardiac problems,and traumatic brain injuries. As an added benefit, since the new CT scan-ners are so much faster, fewer children need to be sedated for procedures.They also produce significantly less radiation, which means children willhave reduced exposure during key developmental years.

• A residency in Emergency Medicine, as well as teaching programs for medical students.

• Ongoing basic and clinical research on burns and wounds as part of amajor Department of Defense grant.

New Pediatric Emergency RoomDelivering Kid-FriendlyCare

There’s a saying in children’s medicinecircles that pediatric care is not simplyadult care downsized. Pediatric medi-cine recognizes that children have very specific medical needs and require avastly different approach to care.

That’s why Stony Brook University Medical Center’s major moderniza-tion project calls for the creation of aseparate pediatric emergency depart-ment. “A visit to the emergency department can be a very scary thingfor children,” says Alison Rowe, RN,CEN, Interim Emergency DepartmentNurse Manager. “Children don’t needto be exposed to the noise and the trau-ma of the major events typical to mostemergency rooms. At Stony Brook,we’ve designed the new pediatric ED tobe friendly and comfortable, and tohelp take the scariness away.” Thisstarts with a separate ED entrance andcontinues throughout the entire facilitywith private rooms, kid-sized equip-ment and gowns, and a child-friendlyenvironment.

But that’s just one piece. The other isexpert care. The pediatric ED staffincludes pediatric specialists and nurs-es trained in pediatric care. Andbecause of Stony Brook UniversityMedical Center’s Level I trauma desig-nation, our medical specialists areeither at the Hospital or on call 24/7.Visiting is also 24/7, even duringalmost every test and procedure—something parents seem to appreciatethe most.

Dr. Catherine Kier, Director ofthe Cystic Fibrosis (CF) Cen-ter at Stony Brook believes in

treating this genetic disease aggres-sively, and treating patients and theirparents like family. “We tell them to,‘call us any time,’” says Dr. Kier.“There’s no question that can’t beasked and won’t be answered. We’rehere to hold their hands 24/7, even ifit is a holiday.”

That philosophy has helped to winover patients and their parents. LauriSantaniello’s daughter, Christina, wasborn at Stony Brook and diagnosed at birth. She’s been a patient thereever since. “Dr. Kier and the entire CF team, including the nurse practi-tioner, social worker, CF nutritionist,and respiratory therapist are alwaysavailable,” says Mrs. Santaniello. “Nomatter what time of day or night,there is always someone on call toanswer questions, reassure, and tohelp problem solve.”

Dr. Kier has been treating Christinasince 2001, the same year she becamedirector of the CF Center. StonyBrook’s CF Center is one of only 115in the U.S. accredited by the CysticFibrosis Foundation, meaning that theCenter follows strict guidelines setforth by the Foundation and is subjectto annual reviews. According to Dr.Kier, studies have shown that CFpatients who receive care at anaccredited center actually have betteroverall clinical status. “The quality ofcare impacts survival,” says Dr. Kier.

And at Stony Brook, this quality ofcare is elevated further by the MedicalCenter’s status as an academic institu-tion and research center. “We’re up to

date on the latest treatment break-throughs,” says Dr. Kier, “and we areinvolved in multicenter clinical trials,which give certain patients earlyaccess to new medications.”

Moving ForwardIn 2008, Stony Brook implementedprocedures and protocols to furtherimprove patients’ pulmonary function.In less than a year, the CF Center’s initiative resulted in a 10 percent improvement in patient pulmonaryfunction. “We’re now above the nation-al average,” says Dr. Kier.

CF is a complex disease that requiresa multipronged treatment approach.To make it easier for patients and parents to keep on top of medicationsand nutrition, the Center now providesparents with a CF Action Plan. “It’s awritten plan the team gives to the par-ents after every visit,” says Dr. Kier.“It’s a very useful way to communicatewith the parents.” This simple step has

already had positive results. “We seean improvement in our patients’ adher-ence to their regimens,” she adds.

While respiratory therapy, medica-tion, and good nutrition remain the cornerstones of CF treatment, theCenter’s comprehensive team approach also focuses on the psycho-social aspects of coping with a chronicillness and reducing stress on parentsand patients. “Our social worker is atevery clinic visit to make sure that werecognize problems early and inter-cede in whatever way needed,” saysDr. Kier. At times, that means nudgingparents to monitor the child’s nutri-tion and sometimes that means nudg-ing the patient. “Christina takes a lotof medications,” says Mrs. Santaniel-lo. “Sometimes she slacks a little. Dr.Kier talks to her and helps figure outthe root of the problem.” And Christi-na listens: “Dr. Kier always explainsthings to me and that helps me feelmore in control,” says Christina.


Family-Centered Approach to TreatingPediatric Cystic Fibrosis

Christina Santaniello meets with Dr. Kier, as her mother, Lauri, looks on.

Call (631) 444-4000 7

Q & A WITH DR. KIER

What is Cystic Fibrosis?Cystic fibrosis (CF) is an inherited, chronic disease caused by a defective gene that affects the lungs and digestive system. The defective gene causesthe body to produce thick, sticky mucus that clogs the lungs, which causesinfection and respiratory ailments and obstructs the pancreas, blocking theproduction of important digestive enzymes that help the body break down and absorb food.

How is CF diagnosed?New York State has mandatory CF testing for newborns. Babies are tested forelevated blood levels of a specific pancreatic enzyme (IRT). If there is an ele-vated finding, the baby is then tested for the CF gene mutation. If the baby hasone mutation, he or she is a carrier; two mutations means the child has the dis-ease. If a CF-related mutation is found, the child’s siblings should be tested.

Is the newborn test definitive?CF is a complicated disease with a variety of manifestations. Not all cases arecaught at birth. Clinical symptoms, which include chronic cough, wheezing,and recurring persistent respiratory infections typically appear during the firstfew years of life but may not appear until later. It’s important that if a physiciansees clinical manifestations, even in a state with mandatory testing, the doctorshould order a sweat test.

What happens when a child is diagnosed with CF at Stony Brook?We immediately call the parents and the primary physician. We then set up aformal family meeting with the entire CF team to determine the course oftreatment.

What’s the advantage of being close to a Cystic FibrosisCenter?Some parents feel they need to seek treatment at large city hospitals. WithinNew York State, there is a consortium of hospitals that share information andideas. It’s a wrong notion that one center is better than another. However,coping with a chronic illness is stressful and demanding. A long commute forrequired regular checkups adds to the stress, which affects both the parentsand the child.

Call (631) 444-4000 7

BEST IDEA

Healthy Eating on a BudgetEating healthy can be achallenge during difficulteconomic times. Here aresome tips from the AmericanDietetic Association for eatinghealthy on a budget.

Buy store brands instead of their name brandcounterparts; they arenutritionally equivalent and will save you money.

Purchase whole chickensand cut them up yourself. You can then portion them into batches to cook andfreeze for future meals.

Buy fruits and vegetables that are in season and locallygrown.

Buying frozen foods in bulkcan save you money, especiallyif you portion out into smallercontainers for individual use.

Purchase healthy snacksin bulk and divide into smallplastic bags for children’slunches.

Note: At grocery stores, lesshealthful foods such as bakerygoods, snack foods, and sodascan be more expensive thanhealthier foods.

CYSTIC FIBROSIS: THE FACTS


What many people may not realize is that what distinguishes an academic

medical center from other facilities—medical centers, community hospitals,hospitals with schools of medicine,and medical schools—is one keything: research. Having a researcharm means that patients are treatedby doctors who have access to the latest information and treatment fortheir particular illness. That clinicaltrials of innovative drugs, procedures,and devices may be available topatients with rare or complicated dis-eases. That the next generation ofdoctors are being trained at all levels,not just the clinical level. And thatsome of the best and brightest medical minds in the country will be attracted.

As an active research facility, StonyBrook University spends in excess of$185 million annually on research, $90million of which is in biomedicalresearch at the Medical Center. It isonly one of 70 medical centers in theU.S. designated as a National Insti-tutes of Health (NIH) clinical researchcenter. Here’s what else you may notknow about Stony Brook UniversityMedical Center research.

1. Six World-Class ResearchFacilities These include a proteomics center foranalyzing protein/peptide/small mole-cule samples via mass spectrometry; aDivision of Laboratory AnimalResources facility for humane animalresearch; a bioinformatics facility thatprovides bioinformatics and IT sup-port; a genomics core facility, whichprovides access to cutting-edge technologies; a Central Microscopy

Imaging Core facility providing confo-cal light microscopy and transmissionelectron microscopy services; and abiostatistical consulting core to providedata analysis of research endeavors.

2. On the Leading Edge ofMedical Treatment With funding from the State of NewYork Institute on Stem Cell Research,Stony Brook has two investigatorswho are looking into treatment complications and clinical relevance of life-saving stem cell treatments—research that could have long-rangeimplications on the treatment of awide range of diseases.

3. Collaborative Efforts As a partner in the Center of Excel-lence in Wireless and InformationTechnology, Stony Brook collabor-ates with government and privateindustry to conduct world-class inter-disciplinary research in emerging critical technologies including wire-less and IT. Recently, medicalresearchers and engineers have collaborated to develop wireless tech-nology to monitor human illness. Thefirst building of the Center’s newresearch park recently opened.

4. Unique Equipment Stony Brook has the only spectrome-ter on Long Island. Located at theStructural Biology Center, this high-intensity optical instrument iscurrently being used to image pro-teins involved in Alzheimer’s disease.

5. Development of New Drugs Ten years ago, Stony Brook researcherPaul Bingham, PhD, identified a newdrug therapy for breast cancer. Now inthe clinical testing phase, it may reach

FDA approval status as early as 2012.Another Stony Brook investigatorrecently received a large grant to inves-tigate drug-resistant tuberculosis.

6. Epidemiological Studies Ongoing epidemiological studiesinvestigate specific diseases in specific populations such as the envi-ronmental and genetic risk factors for prostate and breast cancers in theAfrican-Caribbean population of Bar-bados. Last year, the National CancerInstitute awarded a $4 million grant to continue for an additional five years the prostate study of genetic and obesity-related factors for dispropor-tionately high rates of prostate cancerin men of African descent.

7. Development of NewSurgical Techniques Nationally known cerebrovascularneurosurgeon Henry Woo, MD,Director of the Cerebrovascular Center, has perfected cutting-edgetechniques for treating cerebralaneurysms. He was the first neuro-surgeon on Long Island to use theWingspan® stent for intracranial atherosclerosis and the Cordis EnterpriseTM stent for aneurysms.

8. Development of NovelMedical Devices Two Stony Brook researchers arepart of a team leading the search for abiological pacemaker that could revo-lutionize care and holds the promiseof curing conditions that require theuse of traditional pacemakers.

9. New Technologies forExisting ProceduresThis includes pumpless open heartsurgery, laparoscopic valve replace-

THE 10 THINGS YOU NEED TO KNOW ABOUT RESEARCH AT STONY BROOK UNIVERSITY MEDICAL CENTER

The Best Ideas in Medicine Start with Innovative Technology

INTRODUCING THE WORLD’SSMALLEST HEART PUMP

Imagine a heart pump so small that it can be inserted through anartery in the leg and guided up to the left ventricle of the heart inorder to support heart functionduring life-saving interventions.Fewer than 100 hospitals in theUnited States—including the Mayo Clinic and Johns Hopkins—have access to this life-saving innovation. Stony Brook UniversityMedical Center is one of them.

The Impella® 2.5, which wasrecently FDA approved, representsa major breakthrough for criticallyill patients who may be experienc-ing advanced cardiac failure orwho may be in shock during recovery from a major heart traumasuch as heart attack. How does it work? Doctors say it is easy touse and can be inserted within a few minutes in the CardiacCatheterization Lab. It then temporarily takes over the heart pumping function, pumping as much as 2.5 liters of blood perminute, while the interventional cardiologist tries to open criticalblockages in the arteries of the heart.

“The support provided by this tiny pump is five times faster thanthe current industry devices and provides three to five times moreblood flow than the present standard of care,” says Luis Gruberg,MD, Director of the Cardiac Catheterization Lab at Stony Brook’sHeart Center. To date, Dr. Gruberg has completed two proceduresusing this pump.

“Not only is this cutting-edge technology,” he says, “but it alsooffers enormous benefits. Because it is minimally invasive, it cutsdown risk of complications with already very sick patients. It offersus a safety net during high-risk procedures, along with very goodoutcomes.”

Stony Brook is one of 37 sites participating in a national study ofthese outcomes. And although Dr. Gruberg was the first StonyBrook physician trained in using this new device, the entire teamhas subsequently been trained, and the Impella 2.5 is now a part ofthe overall standard of care at Stony Brook.

Call (631) 444-4000 9

ment surgery, and laparoscopic colonsurgery—all of which are safer, lessinvasive, and promote dramaticallyfaster patient recovery times, in manycases. Stony Brook is the only hospitalin Suffolk County where these proce-dures are available.

10. Nobel Prize Recognition In 2003, Paul C. Lauterbur, PhD, wasawarded the Nobel Prize for Medicinefor his pioneering research while afaculty member at Stony Brook University. Dr. Lauterbur’s work in the1970s led to his development of mag-netic resonance imaging (MRI),which helped transform medicine.

BEST IDEA

Exercising in Spring“Spring!” A time when mosteveryone looks forward togetting outdoors and gettingsome exercise. But whatexercise is right for you?Whether you’re a regularexerciser or just starting out,it’s important to ask, “Why am Idoing this? What are mygoals?” When you can answerthose questions, you can besure that you will choose theexercise that is right for you.

Steven Jonas, MD, MPH, Professor

of Preventive Medicine at SBUMC

and senior author for the American

College of Sports Medicine’s

Exercise is MedicineTM, A Clinician’s

Guide to Exercise Prescription, due

to be published this spring.

Dr. Gruberg holding the Impella device.

Lynn Hallarman, MD, one of the firstphysicians in the country to be boardcertified in palliative medicine, talksabout what palliative care is and why itis a priority at Stony Brook UniversityMedical Center.

What is palliative care?

Palliative care is patient- and family-centered care that optimizes quality of life by anticipating, preventing, andtreating suffering. The goal is to pro-vide support to patients undergoingtreatment for life-limiting illness suchas cancer, congestive heart failure,chronic obstructive pulmonary disease(COPD), heart disease, devastatingstroke, or dementia. Support can be physical, emotional, or spiritual. It may involve practical measures, and often involves helping familiesdeal with stress or difficult decisions. Palliative care is not prognosisdependent and can be provided at the same time as life-prolonging treatment such as chemotherapy.

How is it different fromhospice care?

It is important to note that hospicemay be just one component of the full spectrum of palliative care.

Hospice deals with the last three tosix months of a patient’s life. Hospice

is a structured program of care oncedisease directed treatments are losingtheir benefit. Care can be provided inmany settings, including nursinghomes, inpatient facilities, and “hospice house” locations. Hospicealso helps families take care of theirloved ones at home.

How is palliative medicinedelivered at Stony Brook?

At Stony Brook University MedicalCenter, specialized palliative care services are available by consultationwith the Survivorship and SupportiveCare (SOS) Team. Our team consistsof two nurse practitioners, one physi-cian, one social worker, and one pastoral care counselor. An exampleof SOS services is the care providedto a young, college-age woman study-ing to be a doctor who had metastaticmelanoma. Care was provided overthe course of a year and through several hospitalizations. The Survivor-ship and Supportive Care Teamworked with the patient’s oncologiststo alleviate the pain and fatigue shewas experiencing. In addition, thepatient, a single mom, needed helpwith child care and custody issues,which we helped her sort out. Later,when she needed surgery, we sup-ported her and her family through her hospitalization.

Another example involves a patientwith advanced emphysema who couldno longer live at home. We collaborat-ed with the primary care team to findthe appropriate care setting, assistedwith a symptom management plan,facilitated communication with thefamily, and helped the patient desig-nate a healthcare proxy. Both exam-ples point to the multidisciplinarynature of our work. We are connectedto a vast network of communityresources and to the different treat-ment teams in the Hospital, so we canoffer a full spectrum of assistance nomatter what the patient’s needs are.

It sounds like working with families is a big part

of what you do.In our jobs we do a lot of listening—itis probably the biggest part of whatwe do—and we especially listen tofamily concerns. We truly take timewith them. We then, in turn, makefamilies part of the therapeuticapproach, and bring them into thesolution. This can range from address-ing their fears and helping them askthe right questions to making themactive members of the care team.

Do you do the same level of‘listening’ with patients?

Absolutely. It is the cornerstone of ourapproach. With patients we recognize


Q.

Q.

Q.

ASK THE EXPERTBy Lynn Hallarman, MDAssistant Professor in the Department of Medicine, Division of Hematology/Oncology Director of Palliative Medicine

Compassionate Physicians and Palliative Care

Q.

Q.

1,000TH KIDNEYTRANSPLANTCELEBRATION

An invitation-only crowd of morethan 300 people, ranging frominfants to octogenarians, gatheredon November 12 at the Charles B.Wang Center to celebrate a life-affirming milestone: the 1,000thkidney transplant performedthrough the Stony BrookUniversity Medical Center KidneyTransplant Program. All those whodonated a kidney in 2007 receiveda Gift of Life “Medal of Honor”from the program, issued by NewYork State. Joseph Celli, 72, the1,000th recipient, who received akidney from his daughter onMarch 18, 2008, also receivedspecial recognition.

Since reaching this milestone, thenumber of transplants performed atStony Brook increased to morethan 1,079, making it the fifthhighest kidney transplant medicalcenter in New York and placing it inthe top 20 percent by volume in theU.S. Begun in 1981, the program isheaded by transplant surgeonsWayne Waltzer, MD, Chair of theDepartment of Urology, and FrankDarras, MD. Today, the programservices more than 30 dialysis unitsthroughout Suffolk and Nassaucounties and averages close to 80transplants per year—with morethan a third of the organs comingfrom living donors.

Call (631) 444-4000 11

that symptoms are complex—thereare no quick fixes—so we really takeour time to listen to concerns andneeds. Based on what we hear, we can develop targeted interventions tohelp the person feel better and getback into his or her normal life asmuch as possible.

How would you describe theblend of compassionate,

relationship-based care withadvanced medical treatmentsoffered by your team?In a word, comprehensive. Palliativecare at Stony Brook is extremely comprehensive. We focus on thewhole person, the big picture, andoften share this with the patient, family, and primary care team. Wework to relieve patient suffering andenhance quality of life—whatever itinvolves. On some days, we may sitand talk with the patient, on other

days we might develop an aggressivepain management plan. It reallydepends on what the patient needs.

Tell us more.

In fact, we recently were one of ninefirst-ever recipients of the Quality inPalliative Care Leadership Awardfrom the National Consensus Project—and the only academic medical center to win. It is remarkablebecause our program only started inJanuary 2007. I was brought in todevelop the program because it is partof Stony Brook’s mission to have palliative care available on an expertlevel. I saw it as an opportunity to putmy years of experience—whichincluded implementing the palliativecare program at the Baltimore VA—into practice as well as a chance to putinnovative programming into place.Today, I also do a lot of teaching withmedical students and trainees to helpthem integrate palliative care into theday-to-day approach to patient care.

What do patients need toknow about getting referred

into palliative care?Generally, the attending team will pre-scribe it for patients with a life-limitingillness, but patients need to know thatthey can ask for it at any time duringtheir treatment. It is available to helpthem through a long and difficulttreatment process, not just when theyare dying. We have many, manyresources available and we wantpatients of use them. We want them toknow we are there for them, 24/7.

“We recently were one of nine first-everrecipients of the Qualityin Palliative Care Leadership Award from the National Consensus Project—and the only academicmedical center to win.”Dr. Lynn Hallarman

Q.

Q.

Q.

Some of the donors and recipients atthe celebration.

Classes and Programs

www.StonyBrookMedicalCenter.org12

Amyotrophic LateralSclerosis (ALS)

ALS SUPPORT GROUPA monthly support group forpatients with ALS and theirfamily members.

Tuesdays, 6-8 pmApril 7, May 5, June 2

Stony Brook NeurologyEast SetauketFree

Cancer Care

LOOK GOOD, FEEL BETTEROffered in conjunction withthe American Cancer Society.This program is for womenundergoing treatment forcancer. The beauty program,facilitated by a licensedcosmetologist, includes tipson skin and hair care, make-up instructions, anddemonstrations of wig,turban, and scarf use. Registration is required.

Mondays, 6-8 pmApril 6, May 4, June 1

Stony Brook University Cancer CenterFree

COPING WITH LUNGCANCER SUPPORT GROUPA diagnosis of lung cancercan lead to physical,emotional, and spiritualupheaval. SBUMC providespatients and caregivers aplace to discuss these issuesat a monthly support group.

Tuesdays, 7-8 pmApril 21, May 19, June 16

Stony Brook University Cancer CenterFree

ORAL CANCER SCREENINGNo appointment is requiredfor the screening. For a free dental exam also,call (631) 632-8989 for anappointment.

Thursday, April 2310 am-7 pm

Stony Brook University Dental CenterSouth Drive, Stony Brook Free

Cystic Fibrosis

CYSTIC FIBROSIS SUPPORT GROUPParents and caregivers ofchildren with cystic fibrosiscan join this support group.

Mondays, 7-8 pmApril 20, May 18, June 15

Middle Country Library101 Eastwood Blvd.CentereachFree

Diabetes

DIABETES SELF-MANAGEMENT EDUCATIONCLASSESA comprehensive three-dayeducational program forpeople with type 1, type 2, andgestational diabetes, whichcovers meal planning, bloodglucose monitoring, exercise,

use of medications, acute andchronic complications, stress,travel, vacationing, andcommunity resources.Registration is required.

April 20, 21, 22, 6-9 pmMay 4, 5, 6, 9 am-noonJune 1, 2, 3, 6-9 pm

Stony Brook Technology ParkCall (631) 444-4000 for location.Fee: Insurance acceptedwhere applicable

Diet and Nutrition

TARGET FITNESS WEIGHTMANAGEMENT PROGRAMA 12-week interactiveprogram that uses research-based strategies to lose weight, for good!

Tuesdays, 5:45-6:45 pmApril 7, 14, 21, 28 May 5, 12, 19, 26 June 2, 9, 16, 23

Family Practice Center181 Belle Mead RoadEast SetauketFee: $225

Heart Health

MENDED HEARTSOffering support for patientswith heart disease and theirfamilies.

Sundays, 1:30-3:30 pmApril 19, May 17, June 21

Heart Center Conference RoomStony Brook UniversityMedical CenterFree

For information on classes, programs, and eventsvisit www.StonyBrookMedicalCenter.org, go to “In The Community,” and click on “Calendar ofEvents.” For questions, call (631) 444-4000.

LIVE WELL AND GIVE BACK AT THE SAME TIMEIn these uncertain times, charitable gift annuities are anattractive alternative for someone looking for a stable sourceof retirement income. With CDs paying less than 3%, forexample, a gift annuity donor who is 80 can enjoy a paymentrate of 7.1%, more than double today’s CD rates. And thesepayment rates are guaranteed for life. They will never changeno matter what happens in the stock market or in theeconomy. Your gift today will give back to Stony BrookUniversity Medical Center for a lifetime.

ONE-LIFE RATESAGE RATE55 4.8% 60 5.0% 65 5.3% 70 5.7% 75 6.3% 80 7.1% 85 8.1% 90+ 9.5%

TWO-LIFE RATESAGE RATE55/55 4.1% 60/60 4.6% 65/65 4.9% 70/70 5.2% 75/75 5.6% 80/80 6.1% 85/85 7.0% 90/90 8.3%

For more information or to obtain a no-obligation illustration, contactEric Doepel, Senior Associate Vice President for Advancement, at (631) 632-4371, [email protected] or visit us online atwww.stonybrook.edu/sb/giving. Valid 2/1/09

Call (631) 444-4000 13

April - June 2009

SPECIAL EVENTSSTARS OF STONY BROOK GALACreated in 2000 for the solepurpose of increasingscholarship funding, thisannual event has raised morethan $12 million. This year’sgala will honor Stony BrookUniversity President ShirleyStrum Kenny. Individual ticketsand tables of ten are availablefor purchase. Donations arealso accepted. Please call forpricing and sponsorshipopportunities.

Wednesday, April 15 6:30-10:30 pm

Pier SixtyNew York City

RETURN MEDICATIONSKeep medicines out of LongIsland waters. Don’t flushunwanted medicines, bringthem to this event for proper,free disposal. Expired and

Mall Walkers

SMITH HAVEN MALLWALKERSCo-sponsored by SBUMC andthe Smith Haven Mall, MallWalkers meet the lastWednesday of the month.Blood pressure screeningsbegin at 8 am, followed by alecture at 9 am. Registrationis required. For topics visitStonyBrookMedicalCenter.orggo to tab, “In the Community,”and click “Programs.”

April 29: Anna Rosenthal, RNTopic: What To Do To FeelGood. Part 2

May 27: Topic: StrokeAwareness and Screening

June 24 Topic to beannounced

Smith Haven Mall, Food CourtLake GroveFree

Multiple Sclerosis(MS)

MS PATIENT EDUCATION SERIESAn informative evening ofconversation with MSspecialists and other experts.Each presentation will befollowed by a question andanswer session. Coffee andtreats will be served.Registration is required.

Thursdays, 7-8:30 pm

April 16: Patricia Melville, NP-C,MS Comprehensive CareCenter, Topic: Staying Healthy With Vitamins and OralSupplements

April 23: Jane Elson, LCSW,Topic: Taming Stress in MS

April 30: Anne Klassert, NP,Department of Urology,Topic: Bladder Issues in MS

May 7: Karen E. Giles, MAc,Lac, Five ElementAcupuncture, Topic:Complementary Therapies

Stony Brook Neurology179 Belle Mead RoadEast SetauketFree

Pregnancy andChildbirth

MEET THE MIDWIVESFor women seeking prenataland gynecology care andhealthcare professionalswanting to learn more aboutmidwifery. Includes question

and answer period, and tourof labor and delivery, nursery,and postpartum units.

Thursday, 7-8 pmApril 2

Health Sciences CenterLevel 2, Lecture Hall 2Free

PREGNANCY EDUCATION CLASSESFor women delivering at StonyBrook University Hospital.Classes promote optimalmaternal, fetal, and newbornhealth. Topics include“Breastfeeding and InfantFeeding Choices,” “StayingHealthy During Pregnancy,”and “Taking Care of Yourselfand Baby at Home.”Registration required.

Thursdays, 11 am-noonApril 2, 9, 16May 7, 14, 21June 4, 11, 18

Stony Brook UniversityHospitalFree

PRENATAL BREASTFEEDING CLASSLearn about breastfeeding to help you and your baby getoff to a good start and avoidcommon problems.Registration required.

Wednesdays, 7-9 pmApril 1May 6

Stony Brook UniversityHospital Free

unwanted prescriptions andover-the-counter medicationswill be collected, includingcontrolled and non-controlledsubstances. Bring them intheir original containers, ifpossible.

Saturday, April 1810 am-4 pm

Setauket Fire DepartmentNicolls Road, Setauket

JUDY’S RUN FOR NATIONALSTROKE AWARENESS5K run/mile fun walk to raiseawareness of stroke symp-toms and treatment. A portionof the proceeds benefitSBUMC’s Stroke Program.Fee: $20 prior to April 24For information visitwww.judysrun.com.

Saturday, May 99 am-noon (7:30-8:30 am check-in)

Sunken Meadow State ParkKings Park

CODY COMEDY FESTIVALThis annual event benefits theMatt and Debra Cody Centerfor Autism and DevelopmentalDisabilities, and will featurecomedians Kevin Meaney,Tina Georgi, and MelvinGeorge. Call to purchasetickets or for sponsorshippackage information.

Wednesday, May 13

6:30 pm Funny Bone CocktailReception at the Charles B. Wang Center(tickets are $150 per personwith other sponsorshippackages available)

8:00 pm Comedy Show at the Staller Center(tickets are $25 per person)

For more information or to enroll in studies, call(631) 444-4000.

ARE YOU CURRENTLYDEPRESSED OR WERE YOUDEPRESSED IN THE PAST? Seeking volunteers, ages 18to 65, for a research study ondepression and brainfunctioning. Participants willbe paid up to $110 forcompleting the study.

TREATMENT STUDY FORCHILDREN’S BEHAVIORALCONTROL PROBLEMS The Division of Child andAdolescent Psychiatry isconducting a study supportedby the National Institutes ofHealth of treatment steps for children, ages 6 to 12,who have attention deficithyperactivity disorder and otherbehavioral control problemssuch as aggressiveness,

explosiveness, and lowfrustration tolerance. Eligiblechildren receive free evaluationand study treatment, includingmedication and help withbehavioral support strategies.

STUDY OF HIV+/AIDS ANDCHROMIUM PICOLINATEThe General Clinical ResearchCenter (GCRC) at Stony Brookis seeking volunteers 18years of age and older with adiagnosis of HIV+ or AIDS toresearch the effectiveness ofchromium picolinate treatingcomplications of current HIVtherapy including insulinresistance (leading todiabetes) and possibly bodyfat distribution (HIV lipodys-trophy). Volunteers arecompensated up to $2,050plus transportation expenses.

SEEKING VOLUNTEERS FORDIABETES STUDYLooking for children andadolescents, ages 6 to 18,with a recent diagnosis of type1 diabetes to participate in asix-month study to see ifpioglitazone can reduce insulinrequirements. This study isbeing conducted at the GCRC.

SEEKING VOLUNTEERSWITH CYSTIC FIBROSIS Volunteers, 18 years and older,will participate in a 28-weekresearch study, conducted bythe GCRC, to examine theefficacy of IGF-1 treatment tomaintain or improve bodyweight and composition.

OSTEOARTHRITIS STUDY Do you have osteoarthritis ofthe joint at the base of thethumb? We are seekingvolunteers to participate in aclinical study to treat thispainful problem.

ARE YOU OBESE? LEARNMORE ABOUT HOW YOURMETABOLISM MAY PUT YOUAT RISK FOR DIABETES.We are seeking obese menand women, ages 25 to 45, toparticipate in a research studyinvestigating fat and sugarmetabolism. You may becompensated up to $1,800for participating. This study isbeing conducted at the GCRC.

DO YOU HAVE HEARTFAILURE? The Heart Failure andCardiomyopathy Center atStony Brook is seekingvolunteers with heart failurefor its research studies.

DICE: This study seeks toprove if a simple device thatrecords heart function can beused to predict how one’shealth will continue.

PROBE: Do you have heartfailure and has yourcardiologist recommended that you have a biventricularpacemaker implanted?Investigators are attempting to predict how well patientsbenefit from this biventricularpacemaker (“extra wire” orCRT/resynchronization device).

OPTIMAL: This study offers ano-cost consultation with aheart failure specialist toreview the medical therapyyou receive for your heartfailure and to provide writtenrecommendations fordiscussion with your regularphysician.

BREAK-DHF: If you’ve beendiagnosed with diastolic heartfailure, high blood pressure,or diabetes, you may beeligible for a clinical researchtrial of a drug that may “un-stiffen” the heart.

www.StonyBrookMedicalCenter.org14

THE BEST IDEAS IN PEDIATRIC DIABETES

Currently, researchers at Stony Brook University MedicalCenter are taking on one of the country’s most challengingpediatric diseases: Type 1 diabetes, formerly known as juvenile diabetes, which affects five to 10 percent of the 23.6 million people in the U.S. with diagnosed diabetes.

According to Thomas A. Wilson, MD, Professor of Pedi-atrics, there are two areas of study which have been ongo-ing for the past four to five years. One involves unravelingthe sudden 10 to 15 percent weight gain in children thatoccurs after initial diagnosis and start of insulin treatments.Dr. Wilson, along with Margaret McNurlan, PhD, in theDepartment of Surgery, is focusing on the effect of insulinon protein balance, in particular, the balance between syn-thesis and degradation. Along a similar line, Andrew Lane,MD, Division of Pediatric Endocrinology, is focusing on documenting the changes in body composition that occuronce insulin is started in patients newly diagnosed with type 1 diabetes.

The other area of study involves finding a way to preservethe beta cells of the pancreas so that they can continue tosecrete insulin. The researchers have identified a drugcalled pioglitazone (Actose®) that is effective at improvingblood sugar control in adults with type 2 diabetes. Approxi-mately 10 children from the community have been enrolledin the double-blind placebo controlled study. If results provepromising, this drug could potentially change the standardof care for children with diabetes. “I take off my hat in grati-tude to those children, and to the parents who have allowedtheir children to participate in this study. It is the only wayscience can move forward,” says Dr. Wilson.

Research Studies

15

Almost every parent would agree that school vacations can be relaxing breaks, offering opportunities to travel or spendtime with friends and family. For children with autism and related disorders, however, these breaks can potentiallycause a regression in behavior, social skills, and speech.

Here’s where the Cody Center Recreation/Respite Program steps in. It offers recreational opportunities during school vaca-tions for children, ages 5 through 9, with autism spectrum disorders. The program provides children with a safe, structured,and stimulating environment, and gives parents or caregivers a break that allows them to attend to their other children or otherneeds during school breaks.

John Tsunis, Medical Center Development Council member and owner of the Holiday Inn Express in Stony Brook, recognizedthe need for this type of program—and then did something about it. Mr. Tsunis was instrumental in obtaining a $30,000 donationfor the Recreation/Respite Program from Long Island Charities, where he is also aboard member. “Having a child with special needs can be difficult,” he says. “Thesefamilies need a place for their children to grow and learn—and a break for themselves.The Cody Center helps so many children. It’s something I’m proud to be part of.”

For Lisa Neske, the program has been “a Godsend,” and kept her son Joey from re-gressing during school breaks. “Joey did so well in the program that he actually read a book to the class. It makes me happy to see Joey excited to go play with his friends in the group, and it allows me do what I need to for him and the rest of the family.”

Joey is just one of many children and families helped through this program. Becauseof the tremendous demand for its services, the Cody Center has set a goal to offerRecreation/Respite programs to more children and families after raising additionalfunding.

If you are interested in supporting the Cody Center or the Recreation/Respite Program, please call (631) 632-2899. For more information about the Cody Center,visit www.codycenter.org.

DONATION SUPPORTS RECREATIONAL PROGRAM FOR CHILDREN WITH AUTISM

BEST IDEA

SurvivingFlu Season“The single best thing you cando is to get a flu shot. If you getit now, it can help protect you,since flu season lasts untilMay, and even later in someyears. An easy but importantprevention measure is to washyour hands often. Washing yourhands will protect you andothers, since most influenza istransmitted by hand-to-mouth,hand-to-nose, or by hand-to-eyecontact. Soap and water is justas good as alcohol-basedcleaners. Other simple thingsyou can do include coveringyour mouth and nose when yousneeze and cough (with atissue or your sleeve, not yourhand), staying rested, and ifyou do get sick, staying homefrom work or school so youdon’t get others sick.”

William Wertheim, MD, FACP, ViceChair for Clinical Affairs, ResidencyProgram Director, Department ofInternal Medicine.

Call (631) 444-4000

Lisa Niski and her son, Joey, 7, at the Cody Center.

15

AUXILIARY ONCE AGAIN SHOWS HEART

The Stony Brook University Hospital Auxiliary held its annual Gala this past Septemberat The Inn at East Wind in Wading River to honor and benefit the Stony Brook Univer-sity Heart Center. The event raised $135,000 for the Heart Center. Also honored at

the gala were Richard N. Fine, MD, Dean, School of Medicine, who underwent emergencysurgery at the Heart Center, and local resident Dale Carman, who was treated successfullyafter a nail penetrated his heart while mowing the lawn. Through its extraordinary fundraisingefforts, the Auxiliary has raised nearly $6 million for the Medical Center to enhance patientcare, purchase medical and imaging equipment, and to support a variety of employee activi-ties. If you would like to become a member of the Stony Brook University Hospital Auxiliary,please call (631) 444-2699.

14 Technology Drive, Suite 15East Setauket, NY 11733

NonprofitOrganizationU.S. Postage

PAIDStony BrookUniversity

Better Health Better Living

Produced by the Office of Communications. ©2009

Assistant Vice PresidentYvette St. Jacques

Senior Director, Medical CenterCommunicationsRachel Velocci

Director of Medical Center PublicationsMichele Vallone

Associate Director of Medical Center PublicationsJo-Ann Oakes

Copy EditorTherese Xeller

Contributing WritersMargaret JaworskiMary Ellen Sullivan

Art DirectorKaren Leibowitz

DesignerPanarama Design

Photo CreditsSam Levitan, John Griffin, Media Services

This information is intended to educate

people about subjects pertinent to their

health, not as a substitute for consultation

with a personal physician.

This publication can be made available in

an alternate format upon request. If you

require a disability-related accommodation,

please call (631) 444-4000. Stony Brook

University/SUNY is an equal opportunity,

affirmative action educator and employer.

0812043H

Then Auxiliary President Barbara Delfyett presents check to Heart Center Co-Directors, Todd K. Rosengart, MD, left, and David L. Brown, MD, right.

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