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Idea Transcript


PHELPS SPRING 2011

T O D A Y

News from Phelps Memorial Hospital Center

Coronary Artery Disease Infertility Fever In Children Westchester’s First Baby of 2011

Sarina DiStefano, MD, who delivered Westchester’s first baby of 2011 (second from left) and three other babies on New Year’s Day.

Dear Friends of Phelps, It is our pleasure to report on recent developments and achievements at Phelps. Stellar Joint Commission Survey: In November of 2010, the international accrediting body, The Joint Commission, recognized the high quality of care provided by our nurses, doctors, and staff. Their six-member team of surveyors was truly impressed with Phelps’ staff, commenting on their dedication, enthusiasm, compassion, skill, teamwork, and commitment to The Joint Commission’s goals of quality and safety. They cited 18 specific examples of where Phelps is an exemplary hospital. Recognition: The excellence of our services has also been recognized by several other respected organizations: l

The New York State Department of Health placed Phelps among the top 10 hospitals statewide with the highest percentage of mothers who exclusively breastfeed their newborns.

l

The American Heart Association and American Stroke Association presented Phelps with the “Gold Plus Performance Achievement Award” for excellence in stroke care – achieved in a remarkably short period after the creation of our Stroke Center.

l

The Blue Cross and Blue Shield Association designated Phelps as a “Blue Distinction Center for Knee and Hip Replacement” for demonstrating expertise in delivering quality healthcare in this specialty.

Medical Student Education: Another form of recognition is Phelps’ continuing role in physician education. Two years ago, our hospital became a training site for second-year medical students from New York Medical College. This year, we have had a magnificent opportunity to make a difference by training twelve members of the next generation of physicians. It is a testament to our medical staff to have been selected to teach these students how to examine their first patients. Our relationship with New York Medical College expanded further just recently when, for the first time, third-year medical students rotated to Phelps for “selectives” in geriatrics, hyperbaric medicine, and anesthesiology. Our senior physicians have fully embraced these opportunities to share their skills as outstanding mentors and teachers. We are proud to report on these endorsements of Phelps quality. They should reassure you of the sincere efforts of our staff to provide the very best care to the community. We wish you a healthy and joyful spring. Sincerely,

David W. Coulam

Keith F. Safian, FACHE

Chairman, Board of Directors

President & CEO

Request Your Appointment Online! Appointments for many of Phelps’ outpatient services can now be made on the hospital’s website, including: cardiovascular, diabetes, hyperbaric, infusion, nutrition counseling, occupational and physical therapy, pain center, pulmonary/respiratory, radiology/x-ray, senior services, sleep, speech & hearing, voice & swallowing, and

Contents

Coronary Artery Disease ....................................................................2 Enfermedad coronaria..........................................................................4 Calendar ........................................................................................................6 Phelps Supporter Lisina Hoch Named ADO Philanthropist of the Year ..........................................10 Maternity & Baby Care Classes ................................................11 Infertility: A Q & A with Dr. Rachel Bennett ..................12 Fever in Children ..................................................................................14 La fiebre en los niños ........................................................................16 Breaking News on Vaccination and Autism ....................18 Finding a Path to Smoother Speech ......................................19 Phelps Receives “Gold Plus Award” for Excellence in Stroke Care ................................................20 Teddy Bear Clinic ................................................................................20 Westchester’s First Baby of 2011 Born at Phelps ........21 Phelps Recognized by State Department of Health for High Breastfeeding Rates ........................21 Are You a Knitter? ................................................................................22 Phelps Becomes a Tobacco-Free Campus ........................22 Second Annual James House Mansion Craft Fair ........22 New Pain Center ..................................................................................23

PHELPS TODAY Editor Bruce Heckman, MD, MPH Managing Editor Mary Sernatinger [email protected] Editorial Advisors Lucy C. Engelhardt, RN Kenneth C. Kaplan, MD Keith F. Safian, FACHE PHELPS TODAY is a publication of Phelps Memorial Hospital Center. Phelps is a member of the Stellaris Health Network and the Hudson Valley’s exclusive affiliate of Memorial Sloan-Kettering Cancer Center.

wound healing. You can even make an appointment to donate blood online. Just go to www.phelpshospital.org and click on “Request an Appointment” – any time of the day or night!

Visit www.phelpshospital.org to see our annual reports, videos, physician directory, calendars and more.

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Coronary Artery Disease – A Lifelong Challenge

I

and lipid-modifying

n the past 30 years, great strides have been made in the prevention and treatment of coronary artery disease (CAD), also known as coronary atherosclerosis. Mortality rates from the disease have declined substantially during this period. Nonetheless, CAD remains the leading killer of both men and women in the United States. According to a recent article by Arthur E. Fass, MD, chief of cardiology at Phelps, in the journal Cardiology in Review, new evidence about the nature of chronic coronary artery disease has come to light. However, current treatment often does not yet properly reflect this new knowledge.

therapy will reduce

What is coronary artery disease?

“We now know that a healthy diet, regular exercise, and, when necessary, medications for blood pressure

the prevalence and progression of coronary artery disease.”

2

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The coronary arteries are the major blood vessels that supply your heart with blood, oxygen and nutrients. Coronary artery disease develops when cholesterol-containing deposits (or plaques) build up in the vessels, narrowing them and compromising coronary blood flow. As plaques continue to accumulate in the coronary arteries, they become increasingly narrow, and symptoms such as chest pain, known as

angina, and shortness of breath may develop. Risk factors that contribute to CAD are smoking, high blood pressure, high cholesterol, diabetes, obesity and physical inactivity. The most devastating complications of chronic coronary artery disease are sudden death, which is usually caused by extensive atherosclerosis and strikes approximately 500,000 people a year in the U.S., and acute myocardial infarction (heart attack). The main causes of both of these events are the rupture of coronary plaques and formation of a clot at the rupture site. The primary aim of treatment, therefore, should be the prevention and stabilization of plaque.

When does coronary artery disease begin? Contrary to popular belief, coronary artery disease is not found only in the middle aged and elderly. In fact, CAD is thought to begin as early as childhood. Studies performed in soldiers who died in the Korean and Vietnam Wars revealed a surprisingly high prevalence of CAD in this young population. Another study, of

262 heart donors with an average age of 33, revealed that 52% had at least one atherosclerotic site, and 17% of the donors aged 12-17 already had evidence of atherosclerosis. According to Dr. Fass, the high prevalence of coronary artery disease in the general population calls for aggressive preventive measures in individuals from childhood on.

The current treatment approach The current approach in addressing coronary artery disease emphasizes angioplasty, a procedure in which vessels are opened and dilated, accompanied by stenting, in which a small wire mesh tube is inserted to help prop the artery open. The majority of angioplasty interventions in the U.S. are performed not for acute coronary events but for the management of chronic stable CAD. While these procedures relieve the immediate blockage, they do not prevent the progression of coronary disease, heart attacks or sudden death. In fact, after many of these invasive coronary interventions, symptoms tend to recur as a result of atherosclerosis in other coronary arteries. “The problem is that many people view coronary disease as a plumbing problem, but it’s not so simple,” says Dr. Fass. “It’s a diffuse disease that affects the whole system of coronary arteries, so the treatment should be systemic. The answer is to address CAD at its early stages with diet and lifestyle modifications and pharmacological interventions, when necessary,” says Dr. Fass.

Preventing and Managing CAD Primary prevention – lifestyle modifications for everyone Prevention of coronary artery disease among the general population should include dietary modifications and regular exercise beginning in childhood. Evidence suggests that adopting a Mediterranean-type diet high in fruits and vegetables, olive oil, nuts, fish and chicken and avoidance of trans-fats, refined carbohydrates and processed foods reduces the risk of CAD. Exercise for at least 20 minutes a day should be obtained and could consist of walking, jogging, bicycling, swimming, etc. – activities that are practical and can be done on a daily basis.

Secondary prevention – medical therapy for people with known CAD

We have witnessed

For patients with known coronary artery disease, a modified diet and exercise program must be accompanied by medications to control high blood pressure and treatment with statins. Statins block the body’s production of cholesterol and reduce inflammation, which may be a major cause of plaque destabilization. Statins have become one of the mainstays of primary and secondary coronary prevention. Antiplatelet therapy, including aspirin and clopidogrel (Plavix), are also widely used for primary and secondary prevention of cardiovascular events.

declining morbidity

The COURAGE Trial of 2007, which compared the effectiveness of medical management versus angioplasty for patients with chronic coronary artery disease, concluded that for patients with stable chronic CAD, aggressive pharmacologic treatments proved to be just as effective as aggressive invasive treatments. Other trials have likewise failed to demonstrate an advantage of angioplasty over medical therapy. When invasive interventions are appropriate

and mortality from cardiovascular disease, and application of new research will allow this trend to accelerate. By applying the new preventive and treatment methods, we can now realistically anticipate that the scourge of the 20th century will be eradicated in the 21st.”

Invasive coronary interventions, including angioplasty and bypass surgery, are most appropriate for acute coronary patients who are in the midst of an acute coronary event such a unstable angina or a heart attack. Device therapies such as defibrillators can also help reduce the incidence of sudden death in selected patients who have suffered heart damage.

Eradicating the Scourge of the 20th Century “We now know that a healthy diet, regular exercise, and, when necessary, medications for blood pressure and lipid-modifying therapy will reduce the prevalence and progression of coronary artery disease,” says Dr. Fass. “It is likely that in the future targeted drug therapies will be developed to interrupt the disease process of CAD at several levels. We have witnessed declining morbidity and mortality from cardiovascular disease, and application of new research will allow this trend to accelerate. By applying the new preventive and treatment methods, we can now realistically anticipate that the scourge of the 20th century will be eradicated in the 21st.”

Arthur Fass, MD, is chief of cardiology at Phelps Memorial Hospital. He earned his medical degree at New York Medical College. He completed an internship and residency in internal medicine at Metropolitan Hospital Center in New York and a fellowship in cardiology at Westchester Medical Center. Dr. Fass is board certified in internal medicine and cardiovascular disease. He and fellow cardiologists Franklin Zimmerman, MD, and Dina Katz, MD, have offices in Briarcliff Manor (914-762-5810).

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Enfermedad coronaria: un desafío de por vida

n los últimos 30 años se han logrado importantes avances en la prevención y el tratamiento de la enfermedad coronaria (CAD), también conocida como aterosclerosis coronaria. Los índices de mortandad por la enfermedad han disminuido considerablemente en este período. Sin embargo, la CAD sigue siendo la causa principal de muerte de hombres y mujeres en Estados Unidos. Según un artículo reciente de Arthur E. Fass, MD, jefe de cardiología de Phelps, publicado en la revista Cardiology in Review, se han encontrado nuevas evidencias sobre la índole de la enfermedad coronaria crónica. Sin embargo, el tratamiento actual a menudo no refleja adecuadamente este nuevo conocimiento.

que contribuyen a la CAD son fumar, alta presión sanguínea, colesterol alto, diabetes, obesidad e inactividad física.

necesario, medicamentos

¿Qué es la enfermedad coronaria?

para la presión sanguínea

Las arterias coronarias son los vasos sanguíneos principales que suministran de sangre, oxígeno y nutrientes al corazón. La enfermedad coronaria se desarrolla cuando depósitos que contienen colesterol (o placas) se acumulan en los vasos sanguíneos, haciéndolos más estrechos y afectando el flujo de sangre coronaria. A medida que las placas continúan acumulándose en las arterias coronarias, éstas se hacen cada vez más estrechas y pueden desarrollarse síntomas como dolor en el pecho, conocido como angina y falta de aliento. Los factores de riesgo

Contrario a la creencia popular, la enfermedad coronaria no se encuentra únicamente en las personas de edad madura y en los ancianos. De hecho, se piensa que la CAD empieza en la niñez. Estudios realizados en soldados que murieron en las guerras de Corea y Vietnam revelaron una prevalencia sorprendentemente alta de CAD en esta joven población. Otro estudio, de 262 donadores de corazón con un promedio de edad de 33 años, reveló que el 52% tenía por lo menos un sitio arteriosclerótico y el 17% de los donadores de entre 12 y 17 años de edad ya tenían evidencia de aterosclerosis. Según el Dr. Fass, la alta prevalencia de la enfermedad coronaria en la población general

“Ahora sabemos que una dieta saludable, ejercicio regular, y, cuando sea

y terapia modificadora delípidos, reducirán la prevalencia y progresión de la enfermedad coronaria.” 4

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Las complicaciones más devastadoras de la enfermedad coronaria son la muerte súbita, que usualmente es causada por una aterosclerosis extensiva y afecta a aproximadamente 500,000 personas al año en EE.UU. y el infarto agudo de miocardio (ataque al corazón). Las causas principales de estos dos sucesos son la ruptura de las placas coronarias y la formación de un coágulo en el lugar de la ruptura. Por lo tanto, el principal objetivo del tratamiento debe ser la prevención y estabilización de la placa.

¿Cuando empieza la enfermedad coronaria?

requiere de medidas preventivas agresivas en las personas a partir de la niñez.

El abordaje actual de tratamiento El abordaje actual para tratar la enfermedad coronaria enfatiza la angioplastia, un procedimiento en el que los vasos sanguíneos se abren y dilatan, en conjunción con la colocación de un stent, durante la cual se inserta un tubo de malla metálica para ayudar a mantener abierta la arteria. La mayoría de las intervenciones de angioplastia de EE.UU. son realizadas no por sucesos coronarios agudos, sino para el manejo de una CAD crónica estable. Aunque estos procedimientos alivian el bloqueo inmediato, no previenen la progresión de la enfermedad coronaria, los ataques al corazón o la muerte súbita. De hecho, después de muchas de estas intervenciones coronarias invasivas, los síntomas tienden a recurrir como resultado de la aterosclerosis en otras arterias coronarias. “El problema es que muchas personas ven la enfermedad coronaria como un problema de plomería, pero no es tan simple”, dice el Dr. Fass. “Es una enfermedad difusa que afecta a todo el sistema de arterias coronarias, por lo que el tratamiento debe ser sistémico. La respuesta es abordar la CAD en sus etapas iniciales con modificaciones a la alimentación y al estilo de vida e intervenciones farmacológicas, cuando sea necesario”, dice el Dr. Fass.

Prevención y manejo de CAD Prevención primaria: modificaciones del estilo de vida para todos La prevención de la enfermedad coronaria entre la población general debe incluir modificaciones a la dieta y ejercicio regular a partir de la niñez. La evidencia sugiere que la adopción de una dieta tipo mediterráneo con un alto contenido de frutas y vegetales, aceite de oliva, nueces, pescado y pollo, y que evite las grasas trans, los carbohidratos refinados y los alimentos procesados reduce el riesgo de CAD. Se debe hacer ejercicio por lo menos 20 minutos al día, que puede consistir en caminar, correr, andar en bicicleta, nadar, etc., actividades que son prácticas y se pueden hacer diariamente. Prevención secundaria: terapia médica para personas que ya tienen CAD Para los pacientes que padecen de enfermedad coronaria, una dieta modificada y

un programa de ejercicio deben acompañarse de medicamentos para controlar la hipertensión y de tratamiento con estatinas. Las estatinas bloquean la producción de colesterol del cuerpo y reducen la inflamación, que puede ser una causa importante de desestabilización de las placas. Las estatinas se han convertido en una de las bases de la prevención coronaria primaria y secundaria. La terapia antiplaquetas, incluyendo aspirina y clopidogrel (Plavix), también se usa ampliamente para la prevención primaria y secundaria de eventos cardiovasculares. El estudio COURAGE de 2007, que comparó la eficacia del manejo médico contra la angioplastia en pacientes con enfermedad coronaria crónica, concluyó que en pacientes con CAD crónica estable, los tratamientos farmacológicos agresivos comprobaron ser tan eficaces como los tratamientos invasivos agresivos. Del mismo modo, otros estudios no han podido demostrar una ventaja de la angioplastia sobre la terapia médica.

Hemos sido testigos de una menor morbilidad y mortandad por enfermedades cardiovasculares, y la aplicación de las nuevas investigaciones permitirá que esta tendencia se acelere. Al aplicar los nuevos métodos preventivos y de tratamiento, podemos

Cuando intervenciones invasivas son apropiadas

ahora de modo realista

Las intervenciones coronarias invasivas, incluyendo la angioplastia y cirugía de derivación, son más adecuadas para los pacientes con enfermedad coronaria aguda que están en medio de un evento coronario agudo como una angina inestable o un ataque al corazón. Las terapias de dispositivos como los desfibriladores también pueden ayudar a reducir la incidencia de muerte súbita en ciertos pacientes que han sufrido daños al corazón.

prever que el azote del siglo XX será erradicado en el siglo XXI.”

Erradicar el azote del siglo XX “Ahora sabemos que una dieta saludable, ejercicio regular, y, cuando sea necesario, medicamentos para la presión sanguínea y terapia modificadora de lípidos, reducirán la prevalencia y progresión de la enfermedad coronaria”, dice el Dr. Fass. “Es probable que en el futuro se desarrollen terapias farmacológicas para interrumpir el proceso de enfermedad de CAD en varios niveles. Hemos sido testigos de una menor morbilidad y mortandad por enfermedades cardiovasculares, y la aplicación de las nuevas investigaciones permitirá que esta tendencia se acelere. Al aplicar los nuevos métodos preventivos y de tratamiento, podemos ahora de modo realista prever que el azote del siglo XX será erradicado en el siglo XXI”.

Arthur Fass, MD, es el jefe de cardiología de Phelps Memorial Hospital. Obtuvo su título en el New York Medical College. Completó un internado y residencia en medicina interna en el Metropolitan Hospital Center de Nueva York y una beca en cardiología en el Westchester Medical Center. El Dr. Fass está certificado por el consejo en medicina interna y enfermedades cardiovasculares. Él y sus compañeros cardiólogos Franklin Zimmerman, MD y Dina Katz, MD, tienen sus consultorios en Briarcliff Manor (914-762-5810). phelps today

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PHELPS AT

C A L E N D A R L I F E H E A L T H Y 6

phelps today

MARCH

donated by cosmetic companies are given to each participant to take home. The program is offered in partnership with the American Cancer Society, The National Cosmetology Association, and the Cosmetic, Toiletry and Fragrance Association (CTFA) Foundation. Sheri Silver, cosmetologist 7 – 9 pm Walkway Conference Room Advance registration is required. Call (800) 227-2345.

Bereavement Support Groups Support groups for adults struggling with the loss of a loved one. 8-week support group Tuesday evenings from 6:30 – 8 pm, beginning in April. Please call (914) 3663325 for starting date. Ongoing support group Thursday afternoons from 2 – 3:30 pm on the following dates: March 10 and 24, April 14 and 28, May 12 and 26, and June 9 and 23 Bess Steiger, CSW Bereavement Coordinator

Tuesday, March 8, 2011

Better Breathers Club Opening meeting for the spring season of the Better Breathers Club for individuals with lung disease. Gala celebration will include refreshments and gifts from the American Lung Association.

Suggested donation: $10 per session

Serena Arrabito, Esq., American Lung Association, New York

Conference Room 225 755 North Broadway on Phelps’ Campus

6-7 pm Pulmonary Lab

Call (914) 366-3325 or email [email protected] for information.

Call (914) 366-3712 to register.

Stroke Support Group A support group for stroke survivors, their families, friends and caregivers, providing education, friendship and support. Held the first Wednesday of every month. 3:30 – 4:30 pm Walkway Conference Room For more information, call (914) 366-3221.

Monday, March 7, 2011

Look Good . . . Feel Better® This free program is for women who are going through treatment for all types of cancer. Look Good...Feel Better® teaches women beauty techniques to help manage the appearance-related side effects of cancer treatment. Makeup kits

Saturday, March 26, 2011

Half-Marathon Running Event Phelps is sponsoring a half-marathon (13.1 mile) running event with the Village of Sleepy Hollow and the Rivertown Runners Club of Sleepy Hollow. More than 500 runners are expected to participate.

9:30 am Begins at Town Hall in Sleepy Hollow

Monday and Tuesday, April 11 and 12, 2011

To register, call (914) 631-3632 or register online at rivertownrunners.org.

Defensive Driving

APRIL

Two-evening certification program. Lowers insurance premiums, reduces violation points, and sharpens driving skills.

Monday, April 4, 2011

Robert Fogel

Look Good . . . Feel Better®

5:30 – 8:30 pm Auditorium

This free program is for women who are going through treatment for all types of cancer. Look Good...Feel Better® teaches women beauty techniques to help manage the appearance-related side effects of cancer treatment. Makeup kits donated by cosmetic companies are given to each participant to take home. The program is offered in partnership with the American Cancer Society, The National Cosmetology Association, and the Cosmetic, Toiletry and Fragrance Association (CTFA) Foundation.

Fee: $45 Call (914) 366-3220 to register.

Learn about how acupuncture can be used as a therapy for individuals with lung disease. The session will include a demonstration by a licensed acupuncturist.

Michael Bergstein, MD, otolaryngologist, Surgical Director of the Phelps Sleep Center and Assistant Clinical Professor of Otolaryngology at Mt. Sinai School of Medicine

Sheri Silver, cosmetologist

Jillian C. Schwartz, L.Ac., Dipl.O.M., acupuncturist

7 pm Auditorium

12-1 pm Pulmonary Lab

Call (914) 366-3220 to register.

Call (914) 366-3712 to register.

Monday, April 25, 2011

7 – 9 pm Walkway Conference Room Advance registration is required. Call (800) 227-2345 to register.

Tuesday, April 12, 2011

Better Breathers Club Acupuncture and Its Benefits for Lung Disease

Wednesday, April 6

Wednesday, April 13, 2011

Stroke Support Group

An Update on In-Vitro Fertilization (IVF)

A support group for stroke survivors, their families, friends and caregivers, providing education, friendship and support. Held the first Wednesday of every month. 3:30 – 4:30 pm Walkway Conference Room For more information, call (914) 366-3221.

Are you having trouble conceiving? Do you think or have you been told that you might need in-vitro fertilization? Learn about IVF from a board-certified reproductive endocrinologist — when it might be indicated, how it is performed and the newest technologies associated with it. Rachel A. Bennett, MD, OB/GYN, Reproductive Endocrinology and Infertility 6:30 pm Board Room Call (914) 366-3220 to register.

Thursday, April 14, 2011

Chronic Cough Clinic People often have a chronic cough despite numerous doctor visits, medications, and diagnostic tests. Coughing associated with throat clearing, voice changes, trouble swallowing, nighttime cough, and vocal spasms can often be caused by chronic laryngopharyngeal reflux disease. Alternatively, some people often feel a tickle in the throat that precedes a cough, a dry spot or dryness in the throat, which may be caused by an irritation of a nerve. Screenings for these types of coughs will be offered. Craig H. Zalvan, MD, laryngologist, Medical Director, Phelps Institute for Voice and Swallowing Disorders 8:30 – 10 am Prompt Care

Snoring and Sleep Apnea

Call (914) 366-3220 to register.

Sleep apnea is a condition that causes pauses in breathing during sleep and results in lower levels of oxygen in the blood. The most common symptom of sleep apnea is snoring. Learn about the latest diagnostic methods and therapies for this condition and how treatment can improve your quality of life.

MAY Annual Bereavement Memorial Service Call Bereavement Coordinator Bess Steiger at 366-3325 for details.

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Monday, May 2, 2011

Wednesday, May 4, 2011

Look Good . . . Feel Better®

Stroke Support Group

This free program is for women who are going through treatment for all types of cancer. Look Good...Feel Better® teaches women beauty techniques to help manage the appearance-related side effects of cancer treatment. Makeup kits donated by cosmetic companies are given to each participant to take home. The program is offered in partnership with the American Cancer Society, The National Cosmetology Association, and the Cosmetic, Toiletry and Fragrance Association (CTFA) Foundation.

A support group for stroke survivors, their families, friends and caregivers, providing education, friendship and support. Held the first Wednesday of every month.

Sheri Silver, cosmetologist

Changes in voice, throat clearing, mucus in the throat with discomfort, chronic cough not responding to medications, and swallowing problems are all symptoms of Laryngopharyngeal Reflux (LPR). In addition, chronic asthma, recurrent sinusitis, dental disease and even cancer can all be caused or exacerbated by LPR. LPR is not GERD.

7-9 pm Walkway Conference Room Advance registration is required. Call (800) 227-2345 to register.

3:30 – 4:30 pm Walkway Conference Room For more information, call (914) 366-3221.

Monday, May 9, 2011

Larygopharyngeal Reflux (LPR) – Silent Reflux Screening

Craig H. Zalvan, MD, laryngologist, Medical Director of Phelps Institute for Voice and Swallowing Disorders 8:30 – 10 am Prompt Care Call (914) 366-3220 to register.

Tuesday, May 10, 2011

Better Breathers Club This workshop will focus on stress management for patients with lung disease. Come learn or refresh stress management techniques.

Tuesday, May 3, 2011

Swallow Screening Do you sometimes feel food or liquid go down the “wrong pipe”? Does food get stuck? Do you have pain when you swallow? Do you experience food or liquid coming back up? If you answered yes to any of these questions, then you should attend this free swallow screening clinic. Erin Baker, MS-CCC/SLP Andrea Bracciante-Ely, MSP-CCC/SLP Paula Dinu, MS-CCC/SLP 9:30 – 11 am Walkway Conference Room Call (914) 366-3220 to register.

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Pat Duquette, LCSWR, CASAC, Phelps Counseling, Behavioral Health Unit 6 – 7 pm Pulmonary Lab Call (914) 366-3712 to register.

Wednesday, May 11, 2011

Polycystic Ovarian Syndrome (PCOS): Do You Have It? Do you or someone you know have irregular periods or trouble with excess body hair? Have you been told you have PCOS? Come hear about PCOS from a board-certified reproductive endocrinologist — what causes it, how to treat it.

Rachel Bennett, MD, OB/GYN, Reproductive Endocrinology and Infertility 6:30 pm Board Room Call (914) 366-3220 to register.

Monday and Tuesday, May 23 and 24, 2011

Defensive Driving Two-evening certification program. Lowers insurance premiums, reduces violation points, and sharpens driving skills. Robert Fogel 5:30 – 8:30 pm Auditorium Fee: $45 Call (914) 366-3220 to register.

JUNE Monday, June 6, 2011

Look Good . . . Feel Better® This free program is for women who are going through treatment for all types of cancer. Look Good...Feel Better® teaches beauty techniques to help manage the appearance-related side effects of cancer treatment. Makeup kits donated by cosmetic companies are given to each participant to take home. The program is offered in partnership with the American Cancer Society, The National Cosmetology Association, and the Cosmetic, Toiletry and Fragrance Association (CTFA) Foundation. Sheri Silver, cosmetologist 7 – 9 pm Walkway Conference Room Advance registration is required. Call (800) 227-2345 to register.

6:30 pm Board Room Call (914) 366-3220 to register.

Thursday, June 16, 2011

Balloon Sinuplasty

Saturday, June 11, 2011

Annual James House Mansion Craft Fair Join us at the second annual James House Mansion Craft Fair featuring more than 30 vendors selling jewelry, handbags, pottery and more. Refreshments will be sold. 10 am – 5 pm James House Mansion on the Phelps Campus

For five years, people with sinus pain have been helped by a revolutionary procedure called balloon sinuplasty. Learn about this alternative to traditional sinus surgery that enables most patients to resume normal activities within two days. Dr. Bergstein is the most experienced surgeon in Westchester in performing balloon sinuplasty, having accomplished more than 200 procedures. Michael Bergstein, MD, otolaryngologist, Senior Attending at Phelps and Assistant Clinical Professor of Otolaryngology at Mt. Sinai School of Medicine 7 pm Auditorium

Rain date is Sunday, June 12.

Call (914) 366-3220 to register.

Wednesday, June 15, 2011

Monday, June 20, 2011

Infertility 101

Strong Bones for Life

Are you trying to conceive? Does it feel like everyone is getting pregnant but you? Come to this informative lecture by reproductive endocrinologist Dr. Rachel Bennett, who will discuss the causes of infertility, diagnostic testing, and treatments available to help you conceive including artificial insemination and in-vitro fertilization.

Learn about the prevention, diagnosis and treatment of osteoporosis. Identify your risk factors, understand your bone density test results, learn how to optimize your nutrition and discuss other steps you can take to reduce risk factors for bone loss and/or osteoporosis. You will be empowered with the knowledge to promote stronger bones for life!

Rachel Bennett, MD, OB/GYN, Reproductive Endocrinology and Infertility

Shari Silverstein, RN, MS and Michelle Mosner, RD, CDN, Co-Coordinators of the NY State Osteoporosis Prevention and Education Program

Calendar on the web We were disappointed to learn that the previous issue of Phelps Today was not delivered to some people until after the calendar events and screenings had begun. To be sure that you do not miss any programs in the future, please regularly visit www.phelpshospital.org and click on “calendar of events” to learn about the latest offerings.

Receive Email News If you would like to receive announcements and health information via e-mail, please e-mail msernatinger@ pmhc.us.

7 pm Board Room Call (914) 366-3220 to register.

Appointments are required. Schedules for all programs are subject to change.

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Phelps Supporter Lisina Hoch Named ADO Philanthropist of the Year

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isina Hoch, a long-time Irvington resident and a generous supporter of Phelps, was named 2010 Philanthropist of the Year by the Association of Development Officers (ADO), a nonprofit organization dedicated to the advancement of fundraising and philanthropy in the Hudson Valley. For more than 50 years, Mrs. Hoch, along with her late husband, Frank, has been a major benefactor to a wide array of local and international socially responsible organizations. Her long record of philanthropy as a leader, volunteer and donor spans the globe. Mrs. Hoch’s affiliation with Phelps began in 1955, when she worked as a volunteer shortly after the hospital opened. Over the years, she has served on numerous hospital committees, and she is currently a member of the Development Committee.

For more than 50 years, Mrs. Hoch, along with her late husband, Frank, has been a major benefactor to a wide array of local and international socially responsible organizations. Her long record of philanthropy as a leader, volunteer and donor spans the globe. Pictured at one of the Bhutanese training sessions is Lisina Hoch (right), vice president of the Bhutan Foundation, with Tashi Tenzin, MD, director of the emergency department at Bhutan’s National Referral Hospital, and orthopedic surgeon Ugyen Thinley, MD.

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The Hochs funded numerous projects at Phelps, including the Hoch Center for Emergency Education, which serves communities in the Hudson Valley and throughout the Northeast. The Hoch Center provides life support programs and emergency preparedness training for emergency medical service providers, medical and nursing staff, businesses, organizations and community members. “We are so proud that Lisina was named ADO’s Philanthropist of the Year,” said Keith Safian, President and CEO of Phelps. “We are pleased that her extraordinary efforts on behalf of Phelps and so many other non-profit organizations have been recognized in such a fitting way.”

Mrs. Hoch has a special ability to weave her philanthropic activities together. She is vice president of The Bhutan Foundation, and in 2009, sponsored a group of six medical personnel from the Himalayan region to come to the Hoch Center. The doctors and nurses received training on how to create Bhutan’s first emergency medical services system – no easy task for a remote, mountainous country of 700,000 citizens. In just one year, those six healthcare professionals trained hundreds of Bhutanese citizens – including taxi drivers, teachers and nuns – to serve as medical first responders. Lisina and her family also purchased the first fully equipped ambulance for Bhutan. In 2010, a second group of Bhutanese medical professionals came to Phelps for training. In addition to her work with Phelps, Lisina Hoch has also generously donated her time and resources to The Asia Society; the Woods Hole Oceanographic Institute; Scenic Hudson, the largest environmental organization in the Hudson Valley; and Exodus Transitional Community, Inc., an organization that helps released prisoners begin the difficult work of reentry into society. Described as the “quintessential philanthropist,” Lisina Hoch personifies the concept of responsible and unselfish generosity. Her leadership has inspired many to be philanthropic, and her children are continuing in her footsteps. Mrs. Hoch’s philanthropic work has without a doubt made Phelps, the Hudson Valley and the world a better place.

Maternity & Baby Care Classes The Childbirth Experience/ LaMaze Method Weeknights 7:30 – 9:30 pm for 5-6 weeks

Start dates: April 6, April 26, May 18, June 7, June 29 or Weekend sessions, 10 am – 3 pm:

April 9-10, May 14-15, June 11-12, July 16-17 Cost: $170 per couple

Breastfeeding: First Choice for Babies April 7, May 2, June 2, July 7 7 – 9 pm Cost: $45 per couple

ABCs of Baby Care April 4, 21, 28; May 5, 19; June 6, 20 or 30 6 pm Cost: $65 per couple

care early in their pregnancy. Care is provided at Open Door during the first 36 weeks of pregnancy and at Phelps Memorial Hospital during the remainder of the pregnancy and for delivery. For information, call (914) 941-1263. Atención Prenatal: Phelps Memorial Hospital Center en Sleepy Hollow y Open Door Family Medical Centers, participantes en el Programa de Asistencia de Atención Prenatal de Medicaid, auspician conjuntamente un Programa Prenatal. La atención de mujeres embarazadas es provista por un personal bilingüe y solidario, altamente capacitado. No se rechaza a nadie basándose en sus ingresos económicos o seguro. Se alienta a las mujeres a recibir atención prenatal lo más temprano posible durante su embarazo. La atención es provista en Open Door durante las primeras 36 semanas del embarazo y en Phelps Memorial Hospital durante el resto del embarazo y el parto. Para mayor información, sírvase llamar al (914) 941-1263.

Big Brother/Big Sister: Sibling Preparation April 16, May 21, June 18, July 23 10:30 am Cost: $20 per child

Totsaver Program: American Heart Association CPR for Family and Friends April 2, May 7, June 4, July 9 9 am $55 per person For up-to-date schedule, visit www.phelps hospital.org or call (914) 366-3382 for information or to register. Prenatal Clinic: Phelps Memorial Hospital Center and Open Door Family Medical Centers, participants in the Medicaid Prenatal Care Assistance Program, jointly sponsor a Prenatal Program. Care for expectant mothers is provided by a highly trained, caring, bilingual staff. No one is turned away based on income or health insurance. Women are encouraged to seek prenatal

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Infertility

A Q & A with Dr. Rachel Bennett My husband and I want to have a baby, but I can’t get pregnant. Should I see a specialist?

If you are under 35 and have been attempting conception for at least one year, it’s appropriate to see a fertility specialist. If you are over 35, a visit to a specialist is recommended after six months of trying.

It depends on your age and how long you’ve been trying to have a baby. If you are under 35 and have been attempting conception for at least one year, it’s appropriate to see a fertility specialist. If you are over 35, a visit to a specialist is recommended after six months of trying. In some cases, it’s a good idea to seek advice from a fertility specialist before attempting to get pregnant or shortly after. For females and males, this applies to anyone with a history of infertility or a history of cancer and/or radiation or chemotherapy. Females with a history of sexually transmitted disease, pelvic inflammatory disease (PID) or previous abdominal or gynecological surgery should consider seeing a specialist, as should males who have a history of testicular infection, inflammation, trauma or surgery. If we aren’t ready to see a specialist yet, are there lifestyle changes my husband and I can make that might help us get pregnant? Yes, you should avoid tobacco and marijuana, which reduce sperm counts. Avoid excessive alcohol use, which may damage eggs or sperm, and avoid harmful chemicals. Maintain a body weight that is

recommended for your height to help prevent hormone imbalances. In general, eat a healthy diet with adequate servings of fruits and vegetables, and whenever possible choose whole grains rather than refined carbohydrates. Try to be as relaxed as possible, as stress may have an effect on fertility. What testing and treatments will be done to help me conceive? First, your hormone levels will be checked. If your thyroid is underactive or overactive, you will be given medication. Likewise, if your level of the hormone prolactin, which is produced by the brain, is elevated, medication can help. If you’re ovulating irregularly or aren’t ovulating at all, fertility medications can be prescribed to induce ovulation. If you have polycystic ovarian syndrome, it can be treated by exercise, diet and/or medication as well as ovulation induction with fertility medications. A procedure called hysterosalpingography (HSG) can determine if there are anatomical causes for infertility. HSG is an x-ray examination of a woman’s uterus and fallopian tubes that uses a special form of xray called fluoroscopy and a contrast material. If the HSG demonstrates intrauterine fibroids or polyps, these can be surgically removed in a procedure called a hysteroscopy. If fallopian tubes are blocked, surgery (laparoscopy) can be considered to unblock them, or in vitro fertilization (IVF) can be performed. Another condition that sometimes causes infertility is endometriosis, in which the tissue that lines the inside of the uterus also grows outside of the uterus. Endometriosis can cause painful periods, painful sexual intercourse, irregular bleeding and generalized chronic pelvic pain. Endometriosis can be diagnosed surgically during a laparoscopy, at which time it can be surgically removed to enhance fertility. What tests will be done to determine my husband’s fertility? Male infertility is a result of low sperm production, misshapen or immobile sperm, or blockages or other problems that prevent sperm from being delivered.

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with in vitro fertilization to improve the chances of the embryo implanting successfully in the uterine wall. Pre-implantation genetic diagnosis involves testing of embryos for the most common chromosome abnormalities and using only normal embryos to attempt a pregnancy. Each in vitro fertilization cycle, therefore, has a better potential outcome, since embryos screened in this way have been shown to have a higher rate of implantation in the uterus, lower spontaneous loss rate, and a reduced risk of Down syndrome.

Your husband’s semen will be analyzed to determine how much is produced as well as the number and quality of sperm in the semen. If the results show any abnormality, the test may be repeated or he may be referred to a urologist. Enlarged testicular veins called varicoceles are a common cause of low sperm production and decreased sperm quality. Varicoceles are easily diagnosed and can be repaired surgically by a urologist. Your husband’s hormone levels may be checked. If there is a hormone imbalance, particularly in the thyroid or pituitary glands, it can be treated with medication.

What is the success rate for artificial insemination and in vitro fertilization? Typically, artificial insemination yields a 10-20% success rate per cycle.

What if my husband and I undergo testing but no problems are discovered?

Pregnancy rates per cycle for in vitro fertilization are as high as 60-70% for women under 35, with lower rates for older women.

Sometimes, the reasons for infertility cannot be explained. In such cases, ovulation enhancement with fertility medications combined with artificial insemination (IUI) or in vitro fertilization (IVF) may be used with or without intracytoplasmic sperm injection (ICSI). Can you describe some of these treatments? Ovulation induction or enhancement can be achieved by: l

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Taking a pill – most commonly clomiphene citrate (Clomid) for five days at the beginning of the menstrual cycle. Ovulation often occurs five to nine days after the last pill is taken. Administration of Follicle Stimulating Hormone (FSH) injections for an average of 10 consecutive days at the start of the menstrual cycle. During the injection period, frequent visits to the doctor take place so that estrogen levels can be checked, and ultrasounds are done to observe growth of the follicles that contain the eggs. Dosage adjustments can be made if necessary.

Artificial Insemination (IUI) Artificial insemination is usually performed in the doctor’s office. A semen sample is obtained and processed using a method that separates healthy sperm from weak or abnormally shaped sperm. The sperm is then inserted into the uterus with a soft catheter. The procedure takes less than half an hour and is usually painless. The hope is that the sperm will swim into the fallopian tubes and fertilize a waiting egg, resulting in pregnancy.

In Vitro Fertilization (IVF) or In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF/ICSI)

Please refer to the calendar of events in this issue of Phelps Today for information about presentations by Dr. Bennett on April 13, May 11 and June 15.

The first phase of in vitro fertilization involves the injection of Follicle Stimulating Hormone with the goal of producing multiple mature eggs. The eggs are “retrieved” during a 15-minute procedure called follicular aspiration, which is usually done under anesthesia. With “standard IVF,” a semen sample is taken and the good sperm are processed and placed in the dish with the eggs. Alternatively, the sperm can be injected directly into the eggs, during the process called intracytoplasmic sperm injection (ICSI). In both cases, the eggs are kept in the dish in an incubator for two to five days, where they grow and develop. When the embryos are ready, they are placed into the uterus in a painless procedure using a soft catheter. The extra embryos can be frozen for future use through a process called embryo cryopreservation, so that they will be available if the cycle does not work or if a couple wants to have another baby in the future. Other ancillary procedures such as assisted hatching or pre-implantation genetic diagnosis (PGD) may be used in some cases. Assisted hatching is used frequently

Rachel Bennett, MD, earned her medical degree at Mount Sinai Medical Center. She completed a residency in obstetrics/ gynecology at New York-Presbyterian Hospital/Weill Cornell Medical Center and a fellowship in reproductive endocrinology at Harvard’s Brigham and Women’s Hospital in Boston. Dr. Bennett is board certified in obstetrics and gynecology and reproductive endocrinology. Her fertility practice, Westchester Reproductive Medicine, is located in Mount Kisco (914) 218-8955; www.WestchesterReproductiveMedicine. com.

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I understand that parents become concerned when a fever develops,” says Dr. Stillman, “but fever is only part of the picture. It is a sign that your body’s immune

Fever in Children

system is fighting an infection. Our job as pediatricians is to determine if your child

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erhaps one of the most common distress calls that parents make to their pediatrician is “My child has a fever!” When pediatrician Margaret Stillman answers such a call, her first question is “What other symptoms are there?”

or if it is a bacterial

Pediatricians evaluate fevers every day. “I understand that parents become concerned when a fever develops,” says Dr. Stillman, “but fever is only part of the picture. It is a sign that your body’s immune system is fighting an infection. Our job as pediatricians is to determine if your child has a viral infection, such as a common cold, and can fight the infection himself, or if it is a bacterial infection that will need an antibiotic.”

infection that will

Signs and Symptoms

need an antibiotic.”

Pediatricians try to help parents identify the signs and symptoms that should raise concern by asking some key questions:

has a viral infection, such as a common cold, and can fight the infection himself,

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Are there signs of a typical early viral illness with runny nose and cough? Is your child alert? Is there any pain? If so, where does it hurt? Is he able to swallow and drink fluids?

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Is there vomiting or diarrhea? If so, can your child keep fluids down? Are the only symptoms a fever and a sore throat? This could point to strep throat, which is a bacterial infection. If your child had a cold and a cough without any fever, did a fever suddenly develop? This could signal that a secondary bacterial infection has developed. Did your child have a slight cough that turned into coughing non-stop all night long? This could be a sign of pneumonia, which can be either viral or bacterial.

If your baby is less than 3 months old, any temperature over 100.4 should prompt a call to your pediatrician to be safe.

Definition of Fever It is generally accepted that a rectal temperature over 100.4 or an oral temperature over 99.5 is a fever. Parents ask at what temperature they should be concerned. It is really not the precise temperature as much as how the child is acting. If the child’s behavior improves after the temperature is brought down by a fever reducer, that is reassuring. It is also helpful to know

that fevers often go up in the late afternoon and evening (as does the normal body temperature). It would not be surprising for a child who has a temperature of 100 at 8 in the morning to have a temperature of 102 by the evening. That should not be alarming.

Measuring the Temperature The most accurate temperature is a rectal temperature using a digital thermometer. An oral digital thermometer can be used in a child over 4 or 5. Ear thermometers are less accurate, but often used by parents because they are easy to use. They are not reliable in infants less than 6 months old.

Effects of Fever There was a time when some pediatricians did not recommend giving medication to reduce a high temperature, because it was believed that fever was important in helping a child get well faster. While there has not been any scientific data to prove the benefits of fever, it is generally agreed that fever itself is not harmful. Contrary to common misconceptions, fever does not cause brain damage and it does not cause epilepsy. The decision to give medication to reduce fever should be based on how your child is feeling. If your child seems comfortable and is playing and eating, there is no need to treat the fever. However, if your child is sleepy, irritable or not taking anything to drink or eat, it would be a good idea to treat the fever. Please be aware that if you decide not to treat a fever, your child will need to drink more liquids to prevent becoming dehydrated.

Controlling Fever Either acetaminophen or ibuprofen can be used to reduce a fever. Aspirin is not recommended for children under 18 years of age because of its association with Reye’s syndrome, a rare but serious condition that causes swelling in the liver and brain. Determining how much medicine to give your child depends on his weight. The dosage amounts for acetaminophen and ibuprofen are different, so it is very important to read the instructions. Acetaminophen and ibuprofen preparations are also different for infants and children. If you have any

doubt about what the correct and effective dose is for your child, call your pediatrician with the medication in your hand so you can tell her which preparation you have at home. You’ll also need to tell the doctor how much your child weighs. Check the ingredients on the bottle to make sure nothing has been added to the acetaminophen or ibuprofen, as some preparations may include a decongestant, antihistamine or some other ingredient.

The decision to give

Teething

playing and eating, there

Teething does not cause a high fever. If your teething child’s temperature is more than 100.8 degrees, it is not just from teething – something else is going on and you should call your pediatrician.

Immunizations When your child receives an immunization, he may react with a slight fever. The benefits of immunizations far outweigh such mild effects, however. Consider the fact that in the 1950s, many children were crippled by polio, a disease conquered by the polio vaccine.

medication to reduce fever should be based on how your child is feeling. If your child seems comfortable and is

is no need to treat the fever. However, if your child is sleepy, irritable or not taking anything to drink or eat, it would be a good idea to treat the fever.

Thanks to the haemophilus (Hib) vaccine and the pneumococcus vaccine, the incidence of meningitis, pneumonia, and other serious infections associated with high fevers has decreased dramatically over the past 10-20 years.

Visiting the Emergency Department If your child with a high fever looks very ill, has a severe cough or experiences a first-time seizure and you are unable to see your pediatrician, you should take him to the Emergency Department. If you come to Phelps, a pediatric hospitalist, who specializes in taking care of children in the hospital, will be available to evaluate and treat your child. She is just one of the many specialists from Maria Fareri Children’s Hospital who care for pediatric patients at Phelps. Some of the specialists have offices right on the Phelps campus.

Margaret Stillman, MD, earned her medical degree at Columbia University College of Physicians and Surgeons. She completed an internship and residency in pediatrics at Babies Hospital in New York and a fellowship in behavioral pediatrics at the University of Maryland Medical System in Baltimore. Dr. Stillman is board certified in pediatrics and is the Director of the Department of Pediatrics at Phelps. She and her colleagues, Drs. Harry Lubell, Caroline Cho and Emily Koelsch, see their young patients at 245 North Broadway in Sleepy Hollow (914) 332-4141. phelps today

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Yo entiendo que los padres se preocupen cuando la temperatura sube,” dice la Dra. Stillman, “pero la fiebre es solo parte del cuadro

La fiebre en los niños

general. Es un signo de que el sistema inmunitario del cuerpo está uchando contra una infección. Nuestro trabajo como pediatras es determinar si su niño tiene una infección viral, por ejemplo un resfrío, y si él mismo podría luchar contra la infección, o si es una infección bacteriana que necesita un antibiótico.”

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al vez una de las llamadas más comunes en situación de angustia que los padres hacen a su pediatra es: “¡Mi niño tiene fiebre!”

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Cuando la pediatra Margaret Stillman responde a una llamada tal, su primera pregunta es: “¿Qué otros síntomas tiene?”

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Los pediatras evalúan fiebres todos los días. “Yo entiendo que los padres se preocupen cuando la temperatura sube,” dice la Dra. Stillman, “pero la fiebre es solo parte del cuadro general. Es un signo de que el sistema inmunitario del cuerpo está luchando contra una infección. Nuestro trabajo como pediatras es determinar si su niño tiene una infección viral, por ejemplo un resfrío, y si él mismo podría luchar contra la infección, o si es una infección bacteriana que necesita un antibiótico.”

Signos y síntomas Los pediatras tratan de ayudar a que los padres identifiquen los signos y síntomas que deberían ser preocupantes haciéndoles algunas preguntas clave: l

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¿Hay signos del comienzo típico de una enfermedad viral con corredera nasal y tos? ¿Su niño está alerta? ¿Hay algún dolor? Si es así, ¿dónde le duele? ¿Su niño puede tragar y beber líquidos? ¿Tiene vómitos o diarrea? Si es así, ¿su niño puede retener los líquidos?

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¿Solo hay un fiebre y un dolor de garganta? Estos son síntomas que podrían indicar un estreptococo en la garganta, que es una infección bacteriana. Si su niño tuvo un resfrío y un tos sin fiebre, ¿aparecióó fiebre repentinamente? Esto podría indicar que desarrolló una segunda infección bacteriana. ¿Tuvo su niño un poco de tos y luego pasó a toser sin parar durante toda la noche? Esto podría ser un signo de neumonía, que puede ser viral o bacteriana.

Si su bebé tiene menos de 3 meses, cualquier temperatura superior a los 100.4 es motivo para llamar a su pediatra, por seguridad.

Definición de fiebre Por lo general se acepta que una temperatura rectal superior a los 100.4 o una temperatura oral superior a los 99.5 es fiebre. Los padres preguntan a qué temperatura deberían preocuparse. En realidad no es la temperatura exacta, sino cómo el niño está actuando. Si la conducta del niño mejora después que la temperatura baja con una medicación para bajar la fiebre es un buen signo. También ayuda saber que la fiebre a menudo sube al final de la tarde y comienzo de la noche (como pasa con la temperatura corporal normal). No sorprendería que un niño con una temperatura de 100 a las 8 a.m. tenga una temperatura de 102 al comenzar la noche. Eso no debería alarmar.

Medición de la temperatura La temperatura más exacta es la temperatura rectal medida con un termómetro digital. Un termómetro digital oral puede usarse en un niño mayor de 4 o 5 años. Los termómetros de oído son menos precisos, pero los padres a menudo los prefieren porque son fáciles de usar. Estos termómetros no son fiables en bebés de menos de 6 meses.

Efectos de la fiebre En una época, algunos pediatras no recomendaban dar medicación para bajar una temperatura alta, porque se creía que la fiebre era importante para ayudar al niño a sanar más rápido. Si bien no ha habido una base científica que compruebe los beneficios de la fiebre, generalmente el consenso es que la fiebre en sí misma no es dañina. Contrariamente a falsos conceptos comunes, la fiebre no causa daño cerebral y no causa epilepsia. La decisión de dar medicación para bajar la fiebre debe basarse en cómo su niño se siente. Si su niño se ve cómodo, está jugando y se alimenta, no hay necesidad de tratar la fiebre. Sin embargo, si su niño está somnoliento, irritable o no quiere comer ni beber nada, tratar la fiebre sería una buena idea. Por favor, sea consciente que si usted decide no tratar la fiebre, su niño necesitará beber más líquidos para prevenir una deshidratación.

Control de la fiebre El acetaminofeno o el ibuprofeno pueden usarse para bajar la fiebre. La aspirina no está recomendada para niños menores de 18 años por su asociación con el síndrome de Reye, una condición rara pero grave que causa inflamación en el hígado y el cerebro. Determinar la cantidad de medicina para dar a su niño depende del peso del niño. Las cantidades en las dosis de acetaminofeno e ibuprofeno son diferentes, así que es muy importante leer las instrucciones. Las preparaciones de acetaminofeno e ibuprofeno también son diferentes para bebés y para niños. Si tiene cualquier duda acerca de qué dosis es correcta y efectiva para su niño, llame a su pediatra con la medicación en su mano y así podrá decirle qué preparación usted tiene en su casa. Usted también necesitará decirle al

médico cuánto pesa su niño. Controle los ingredientes en el frasco para asegurarse que nada se añadió al acetaminofeno o ibuprofeno, porque algunas preparaciones pueden incluir un descongestivo, un antihistamínico o algún otro ingrediente.

La dentición La dentición no causa una fiebre alta. Si la temperatura de su niño, al que le está creciendo un diente, es más de 100.8 grados, eso no es simplemente por la dentición, algo más está pasando y usted debe llamar a su pediatra.

Inmunizaciones (vacunas)

La decisión de dar medicación para bajar la fiebre debe basarse en cómo su niño se siente. Si su niño se ve cómodo, está jugando y se alimenta, no hay necesidad de tratar la

Cuando su niño recibe una vacuna, él o ella puede reaccionar con una fiebre leve. Pero los beneficios de las vacunas superan ampliamente esos efectos leves. Considere que a fines de la década de 1950, muchos niños quedaban inválidos por la polio, una enfermedad vencida por la vacuna contra la polio.

fiebre. Sin embargo, si

Gracias a la vacuna contra el hemófilo (Hib) y la vacuna contra el neumococo, la incidencia de meningitis, neumonía y otras infecciones graves asociadas con fiebres altas ha descendido drásticamente a lo largo de los últimos 10 a 20 años.

tratar la fiebre sería una

su niño está somnoliento, irritable o no quiere comer ni beber nada,

buena idea.

Visita al Departamento de Emergencias Si su niño que tiene una fiebre alta se ve muy enfermo, tiene una tos muy fuerte o sufre por primera vez una convulsión y usted no puede ver a su pediatra, debe llevarlo al Departamento de Emergencias. Si usted viene a Phelps, un médico hospitalista pediátrico, que se especializa en la atención de niños en el hospital, estará disponible para evaluar y tratar a su niño. Este profesional es sólo uno de los muchos especialistas de Maria Fareri Children’s Hospital que atiende pacientes pediátricos en Phelps. Algunos de estos especialistas tienen sus consultorios en el mismo campus de Phelps.

Margaret Stillman, MD, obtuvo su título de médica en la Facultad de Medicina y Cirugía de la Universidad de Columbia. Ella completó una pasantía y residencia en pediatría en Babies Hospital en New York y un postgrado en pediatría conductual en el Sistema Médico de la Universidad de Maryland en Baltimore. La Dra. Stillman es médica certificada en pediatría y es la Directora del Departamento de Pediatría en Phelps. Ella y sus colegas, los doctores Harry Lubell, Caroline Cho y Emily Koelsch, ven a sus pacientes pediátricos en 245 North Broadway en Sleepy Hollow (914) 332-4141. phelps today

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Breaking News on Vaccination and Autism Ronald I. Jacobson, MD Chief of Pediatric Neurology at Maria Fareri Children’s Hospital Associate Clinical Professor of Neurology and Pediatrics at New York Medical College

O In the ongoing research for autism causes, the newest area of great interest is the discovery of small changes in the DNA of children with autism.

n Wednesday, January 5, 2011, ABC-TV’s “Breaking News” of the day was yet another piece in the long debate about whether vaccines such as those protecting us from measles, mumps, and rubella might cause autism and/or autism-related gastrointestinal problems. Early that evening I was interviewed by Jim Dolan of Channel 7 News, who asked me the all-too-familiar question, “How has the news about vaccination fears affected your patients?” This is a daily question for me in my pediatric neurology practice, and I am sure an even more frequent concern of parents in their quest for information from their pediatricians. The study that originally gained so much notice was published in The Lancet in 1998 by the British physician Dr. Andrew Wakefield. However, The Lancet later retracted the published article due to concerns about inaccuracies. Eventually many coauthors also rejected the article and its claims. Now the British Medical

Journal has published an investigative article and an editorial stating that the original Lancet article was more than misleading, it contained misrepresentations of the medical histories of the children in the study. Claims of dishonesty, misconduct, and now fraud have circulated through the scientific and lay press. By January 13, 2011, a week after the ABC report, more information was revealed in the British Medical Journal, claiming financial gain was a possible motivation for the unsubstantiated research originally published in The Lancet. When I was interviewed by Jim Dolan, my final comment was that the controversy has diverted attention from the real concern – what is, or are, the cause or causes of autism, whether environmental or genetic? It is a shame that the focus on this misinformation distracted the scientific community from pursuing real opportunities to serve our patients and to search for the truth. In the ongoing research for autism causes, the newest area of great interest is the discovery of small changes in the DNA of children with autism. Recent studies have shown that about 18-20% of children with autism have small DNA changes called Copy-Number Variations (CNVs). These are alterations of DNA that can be caused by deletions, duplications, inversions, and/or translocations, which jumble the proper reading of the genetic code contained in the genome (the biological information needed to build and maintain a living organism). Commercial labs are now able to do genetic evaluations for CNVs; however, doing routine tests on all children with autism may be premature. This area of research is rapidly evolving, with better tests being developed every few months. Understanding the changes in brain function caused by the CNVs associated with autism or similar disorders may help us gain insight into proper diagnosis, and eventually lead us to treatments designed to improve the resultant brain dysfunction. That is my dream and hope for breaking news stories in the future.

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Finding a Path to Smoother Speech

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he recent hit movie “The King’s Speech” has focused public attention on a speech disorder that is widely acknowledged but poorly understood. George VI became the king of England in 1936. He was a lifelong stutterer and was terrified of the responsibility he would have to address the public and make important speeches. The film hints that the causes of King George’s stammer were psychological and emotional: humiliation by his father leading to poor self-esteem and the impatience of listeners. The fear of public speaking exacerbated his stammer. Strategies depicted in the movie for improving his fluency include smoking (to relax), swearing (!), singing, repeating tongue twisters, improving breath control, and using loud music to mask his own awareness of his voice while reading out loud. Psychological factors related to his self-image and a strained relationship with his father are cited as reasons for his stuttering continuing throughout his life. King George sought treatment for his speech disorder from various sources, including one doctor who recommended talking while having marbles in his mouth in order to gain control of his tongue. Finally, he met Lionel Logue, a self-proclaimed speech therapist with whom he formed a trusting and supportive relationship. The bond between them enabled King George to speak with only minor hesitations for the rest of his life. Current thinking about the causes of stuttering continues to include a number of possibilities. Although there are psychological components, there is no evidence that emotional trauma causes stuttering. Recent research suggests that the nervous system plays a part in the timing of speech production. Genetics may account for this disruption in fluency – approximately 60% of those who stutter have a family member who does also. Stuttering is four times more common in males than females.

A developmental disorder that typically begins in early childhood, stuttering is often variable, with periods of fluency followed by periods of stuttering. Stuttering can worsen when the speaker is nervous or fearful. At times, a particular situation or person will elicit an anxious response and stuttering will become more severe. On the other hand, conditions can be created which are conducive to increased fluency such as singing, talking in unison, or – as in the case of King George – reading out loud while wearing earphones and listening to music. Approximately 5 percent of all children will experience a period of dysfluency that lasts six months or more, but by late childhood the majority of children will have outgrown the condition. Those who continue stuttering will likely stutter throughout their lives. Stuttering can also be an acquired disorder that results from head injury, stroke or tumor. Total elimination of stuttering may not be a realistic goal for most adult stutterers, but therapy can help. Most therapy techniques focus on reducing the severity of the repetitions, prolongations or blocks, thus enabling speech that is less strenuous while increasing the person’s confidence to communicate thoughts and feelings. There are many treatment techniques, including electronic pacing devices and even medication, which claim instant success. What works are programs that change speech patterns by gradually modifying the stuttered words, especially when the speaker accepts his stuttering and his listeners provide positive support. King George found all these elements in his therapy program with Lionel Logue, which helped him to be an effective ruler. The Donald R. Reed Speech & Hearing Center provides clinical services to children and adults who stutter, as well as those with speech, hearing, language, voice, and swallowing problems. Please call (914) 366-3010 for further information.

Stuttering can worsen when the speaker is nervous or fearful. At times, a particular situation or person will elicit an anxious response and stuttering will become more severe.

Judith Christopher, Ph.D., CCC-SLP, has been the Director of the Donald R. Reed Speech & Hearing Center for 17 years. With more than 40 years of clinical experience, Judith received her doctorate from The Graduate School of Arts and Sciences, Columbia University. Her area of clinical interest is adult voice and swallowing disorders, and includes certification in LSVT (Lee Silverman Voice Training). She implemented a training protocol for Flexible Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) studies in 2001 after completing a mentoring program at ColumbiaPresbyterian Hospital, New York. Currently, she provides direct service to patients with head and neck cancer.

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Phelps Receives “Gold Plus” Award for Excellence in Stroke Care

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helps Hospital continues to garner awards for outstanding stroke care. In 2010 the Hospital was awarded the Gold Plus Achievement Award for its high level of compliance with the American Heart Association/American Stroke Association’s “Get with the Guidelines” program, a hospitalbased quality-improvement program. “This award demonstrates our commitment to being one of the top hospitals in the country for providing aggressive, proven stroke care,” said Dr. Sanda Carniciu, Physician Director of the Stroke Center at Phelps.

At the 2010 Stroke Award Ceremony are (l-r) Sandra Rocha, Stroke Coordinator; Margaret Santos, CNS, Critical Care Educator; Keith F. Safian, Phelps President and CEO; Sanda Carniciu, MD, Stroke Team Director; Christine Rutan, Senior Director of Quality Improvement, American Heart Association; Cheryl Burke, CNS, Stroke Educator; Candace Huggins, CNS, Clinical Educator, Emergency Department; and Carolynn Young, CNS, Clinical Educator.

Teddy Bear Clinic

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he Phelps Emergency Department recently hosted a Teddy Bear Clinic to reach out to kindergarten children in the community. The object of the Clinic was to familiarize the children with the treatment process in an emergency room in order to reduce their anxiety if and when they need to visit one. The children were each given a teddy bear to escort through the treatment process, which included being examined by a doctor, treated by a nurse, receiving pretend xrays and being discharged. The children also received wellness information and were trained in proper handwashing. The event was a huge success.

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Kim Filauro, RN, (above) and Donna Alvado, RN, (below) take care of the teddy bear patients.

Westchester’s First Baby of 2011 Born at Phelps

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estchester County’s first baby of 2011 was born one minute after midnight on New Year’s Day at Phelps Memorial Hospital Center. Waverly Ross Beckwith was greeted by her proud parents, Linnea and David Beckwith of Irvington. Delivered by Dr. Sarina DiStefano of the Sleepy Hollow Medical Group at Phelps, Waverly weighed in at 7 pounds, 10 ounces at 12:01 a.m. Dr. DiStefano had an unusually busy New Year’s Day. She delivered a second baby at 6 a.m. and twins later that morning, with the help of midwives who practice regularly at Phelps. “Women who deliver at Phelps appreciate having the birthing experience they want,” says Dr. DiStefano. “Our obstetricians and midwives strive to avoid interventions such as Cesarean sections, unless they are necessary.” Phelps has among the lowest C-section rates in Westchester County. Phelps offers a family-centered approach

David and Linnea Beckwith marvel at their newborn baby girl, Waverly Ross Beckwith – their first child and Westchester’s first baby of 2011.

to childbirth, both during pregnancy and after birth. Laboring mothers are offered an array of options for relaxation and labor pain management, including acupuncture. The hospital also offers a wide selection of educational programs for the childbirth years and lactation support services, which were recently recognized as being

among the top 10 in the state. In addition to Dr. DiStefano, Sleepy Hollow Medical Group’s physicians include Lawrence Mendelowitz, MD, Vanessa Dinnall, MD, and Zarina Zhuravleva, MD. Sleepy Hollow Medical Group is located at 755 North Broadway on the Phelps campus. (914) 631-0337

Phelps Recognized by State Department of Health for High Breastfeeding Rates

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ew mothers at Phelps receive lots of encouragement and support for breastfeeding – from the nurses who train them to the four certified lactation consultants on staff who are available to assist them with breastfeeding problems they might have after they are discharged. The hospital’s efforts have paid off: Phelps has been recognized by the New York State Department of Health as one of the top 10 hospitals statewide with the highest percentage of mothers who exclusively breastfeed their newborns. According to the DOH, hospital policies and procedures, staff training, and quality of support provided to new mothers all play a powerful role in affecting breastfeeding rates in the hospital and after discharge. Virginia Moore, RN, lactation consultant, helps new mom learn techniques for breastfeeding twins.

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Second Annual

James House Mansion Craft Fair

Are You a Knitter?

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helps Volunteer Services is looking for knitters who are willing to spend a little time making a “comfort shawl” for patients who might need emotional or physical warmth over their shoulders. This project can be done in your own home. Phelps will supply the pattern — all you have to do is get those knitting needles going! In times of stress, bereavement, illness or recovery, a handmade shawl is a wonderful source of comfort, especially when the patient knows that someone cared enough to cre-

ate it for them. And you will derive immeasurable fulfillment from knowing that your creativity will be enjoyed by someone in need of caring compassion. You don’t have to be a volunteer at Phelps to participate. All you have to do is be willing to knit! Please call the Volunteer Department at 3663170 if you are interested in participating in this wonderful project. If you don’t knit but would like to provide a donation for this program, please call Pam Cardozo, Director of Volunteers, at (914) 366-3170.

Phelps Becomes A Tobacco-Free Campus

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n February 14, 2011, Phelps Memorial Hospital Center officially became a tobacco-free campus. Phelps is a member of the Stellaris Health Network, whose hospitals have all established tobacco-free and smoke-free campuses to comply with Blue Cross Blue Shield’s quality standards. Phelps’ no-smoking zones have been expanded to include the entire hospital campus, including all buildings, parking lots, garages, staff residences, the James House Mansion, Robin’s Nest Childcare Center and all off-campus sites. Phelps has joined many workplaces across the country where it has been proven that having a smoke-free environment is an effective way of reducing employee smoking rates. The Hospital takes pride in this important initiative, which will help ensure that all who come to Phelps will enter a healthy, tobacco-free environment, free of the health risks associated with smoking.

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Calling All Vendors!

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he second annual James House Mansion Craft Fair, a Phelps Auxiliary project, will be held from 10 am to 5 pm on Saturday, June 11, 2011 (rain date Sunday, June 12) at the James House Mansion, located on the river side of Phelps’ campus in Sleepy Hollow. If your crafts are hand-made and you wish to participate, please email jameshousecraftfair@gmail .com or call (914) 366-3170.

“Many patients think they have to live with pain because it’s a normal part of aging, but that’s not necessarily true. There are so Medical staff gather in the Pain Center’s state-of-the-art treatment room. Pictured are (l-r): Phat Tran, MD; Martha Maresco, RN; Richard Peress, MD; Sathish Modugu, MD; Nancy Pitzel, RN; Linda Neary, RN; and Judy Klein, RN

New Center for Pain Treatment Opens at Phelps

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fter moving from place to place throughout the hospital for the past 20 years, the pain management staff at Phelps longed for a place to call their own. They finally got their wish. In May the hospital’s Engineering Department began tearing down the walls of the former emergency department, and in October Phelps celebrated the opening of a spacious new facility for the diagnosis and treatment of acute and chronic pain disorders. “What began over 20 years ago as the individual practices of a few physicians, and was more of a concept than a place, has grown into a reality,” said orthopedic spine surgeon and Director of Surgery Richard Peress, MD, at the opening celebration. “This permanent facility is specifically designed and dedicated to inpatient and outpatient interventional pain management.” Therapeutic treatments offered at the Pain Center include epidural steroid injections for spine pain, trigger point injections for muscle pain, nerve blocks, joint injections, spinal cord stimulator implantation for pain that is unresponsive to other treatment, and radiofrequency denervation, which is the de-activation of nerves to painful joints of the back or neck so that they no longer transmit pain messages to the brain. A diagnostic test called discography helps to pinpoint sources of

pain in the back and neck that cannot be detected using MRI scans.

many more things that can be done now to relieve pain and allow people to return to their activities of daily living.”

Phelps’ comprehensive approach to treating patients who have chronic or acute pain is based on successful teamwork. Medical specialists from many disciplines, including pain management, physical medicine, anesthesia, neurosurgery and orthopedic spine surgery, and nurses experienced in pain management work together with the patient’s primary care physician to diagnose and manage the cause of the pain. In addition to Dr. Peress, the panel of Pain Center physicians includes Jozef Debiec, MD; Thomas Lee, MD; Sathish Modugu, MD; Neil Patel, MD; John Robbins, MD; Saran Rosner, MD; and Phat Tran, MD. “Many patients think they have to live with pain because it’s a normal part of aging, but that’s not necessarily true,” says Martha Maresco, RN, who is board certified in pain management nursing. “There are so many more things that can be done now to relieve pain and allow people to return to their activities of daily living.” As an added convenience for patients, the Center features designated parking near its entrance. For more information about the Pain Center at Phelps Memorial Hospital, call 914-366-3794.

Pain management specialist Jozef Debiec, MD, stands next to the C-arm in the treatment room of the new Pain Center. The C-arm shows and intensifies a spinal image to guide the needle to the correct location, where medication is injected for pain management or diagnostic purposes.

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Programs and Services at Phelps Bereavement Support (914) 366-3325 Blood Donor Services* (914) 366-3916 Cardiovascular Diagnostic Lab (914) 366-3740 Cardiac Rehabilitation (914) 366-3742 Child Care – Robin’s Nest (914) 366-3232 Diabetes & Metabolism Center** (914) 366-2270 Diabetes & Endocrine Center for Children & Young Adults* (914) 366-3400 Educational Programs and Free Screenings (914) 366-3220 Emergency Department (914) 366-3590 Emergency Department’s PromptCare (914) 366-3660 Emergency Education Center* (914) 366-3676 Gastroenterology & Advanced Endoscopy* (914) 366-1190 Hospice (914) 366-3325 Hyperbaric Medicine Center (914) 366-3690 Infusion Center* (914) 366-3523 Laboratory (Clinical) (914) 366-3910 Maternal Child Center (914) 366-3359 Memorial Sloan-Kettering Cancer Center** (914) 366-0664 Mental Health – Outpatient Counseling* (914) 366-3600 Mental Health – Outpatient Chemical Dependency (914) 944-5220 Mental Health – Inpatient Substance Abuse – Co-occurring Disorders (914) 366-3027 Mental Health – Inpatient Psychiatry (914) 366-3513 Nutrition Counseling (914) 366-2264 Pain Center (914) 366-3794 Pastoral Care (914) 366-3090 Pharmacy for the Community** (914) 366-1400 Physical Medicine & Rehab (PT, OT, Aquatherapy) - Outpatient* (914) 366-3700 Physical Medicine & Rehab - Inpatient (914) 366-3702 Physician Referral Service (914) 366-3367 Prenatal Care Assistance Program (PCAP) (914) 941-1263 Pulmonary Physiology Lab and Pulmonary Rehabilitation (914) 366-3712 Radiology/X-Ray (914) 366-3430 Respite Care (914) 366-3356 Senior Services and Memory Loss Evaluation* (914) 366-3669 or 3677 Sleep Center (914) 366-3626 Speech & Hearing – The Donald R. Reed Center** (914) 366-3010 Surgery – Call Physician Referral (914) 366-3367 Thoracic Center for Chest Diseases* (914) 366-2333 Vascular Institute (914) 366-3008 Voice & Swallowing Institute** (914) 366-3636 Volunteer Services (914) 366-3170 Wound Healing Institute* (914) 366-3040 *Located in the Phelps Medical Services Building (755 North Broadway). ** Located in the Phelps Professional Building (777 North Broadway). For more information about Phelps services, visit phelpshospital.org and click on “Programs & Services.” It is now possible to request an appointment for many services on the Phelps website. Just go to phelpshospital.org and click on “Request an Appointment Online.”

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Save the Date Monday June 13, 2011

Phelps Golf Classic & Tennis Tournament Sleepy Hollow Country Club For information, contact Ruth Burton, [email protected] or (914) 366-3115

Other Dates to Save Craft Fair at The James House Mansion Saturday, June 11, 2011 Rain date Sunday, June 12

24th Annual Champagne Ball Saturday, October 15, 2011

Jazz Concert to Benefit Phelps Hospice Sunday, October 23, 2011 Maternity Open House Coming this Spring. Call 914-366-3389 for details.

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P H E L P S

NON-PROFIT ORGANIZATION

Phelps Memorial Hospital Center 701 North Broadway Sleepy Hollow, NY 10591-1096

U.S. POSTAGE PAID PERMIT NO. 7701 WHITE PLAINS, NY

www.phelpshospital.org

Ongoing Health Promotion and Support Groups

Blood Donor Corner

Alzheimer’s Support Group For information, call Ellen Imbiano (914) 253-6860

The number-one reason donors say they give blood is because they want to help others. If you would like to learn about donating blood, call 914-366-3916. For every 2nd donation, you may choose from a variety of gifts provided by:

Outpatient Behavioral Health Alcohol/chemical dependency, counseling, continuing day treatment, supportive case management (914) 366-3027 Bereavement Support Groups (914) 366-3325

[email protected] for information. Group Counseling Help with issues such as: separation & divorce, losses, relationships, family issues, parenting, coping skills (914) 366-3600

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Hospice (914) 366-3325

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Better Breathers Club (914) 366-3712

Look Good Feel Better® for women undergoing cancer treatment (800) ACS-2345

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Blood Donations (914) 366-3916

Mammography (914) 366-3440

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Blood Pressure Screenings Generally the 1st & 3rd Wednesday of the month, 9:30 - 11:30 am Appointments necessary: (914) 366-3220

Maternity & Baby Classes (914) 366-3382

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Cardiovascular Rehab (914) 366-3740 Cardiovascular Wellness Center Exercise under RN supervision (914) 366-3752 Celiac Sprue Support Group Sue Goldstein: (914) 428-1389

My Sister’s Place 1-800-298-SAFE (7233) Ostomy Support Group 3rd Sunday of every month (914) 366-3395 (Call 366-3000 for cancellation information) Parkinson’s Support Group at Kendal on Hudsaon (914) 922-1749

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Physician Referral (914) 366-3367

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CPR Classes (914) 366-3166 Diabetes Education Classes for Adults (914) 366-2270

Pulmonary Rehabilitation (914) 366-3712

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Essential Tremor Group Meets in Somers. Contact

Stroke Support Group (914) 366-3221

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AJ’s Burgers & America’s Favorite Foods, New Rochelle At the Reef Restaurant & Caterers, Peekskill Auto Clean Clinic, Inc., Ossining Basilico Pizza, Pasta & Gourmet, Mt. Kisco Bistro Z at the Doubletree Hotel, Tarrytown Brasserie Swiss, Ossining The Cabin, White Plains Canfin Gallery, Tarrytown Caravela, Tarrytown Casa Rina, Thornwood Castle on the Hudson, Tarrytown Coffee Labs Roasters, Tarrytown Crabtree’s Kittle House, Chappaqua Creative Flooring, Mt. Kisco Doubletree Hotel, Tarrytown Eldorado West Restaurant Diner, Tarrytown Eyebuzz Fine Art, Tarrytown Executive Diner, Hawthorne Fairview Golf Center, Elmsford Geordane’s Deli & Catering, Irvington Goldfish Oyster Bar & Restaurant, Ossining Gordo’s Restaurant, Hawthorne Hair on the Hudson, Tarrytown Heritage Frame & Picture, Tarrytown Horsefeathers, Tarrytown

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The Horseman Restaurant & Pizza, Sleepy Hollow Il Sorriso Ristorante Italiano, Irvington Isabella Italian Bistro, Tarrytown Kendal on Hudson, Sleepy Hollow Lago di Como Italian Restaurant, Tarrytown Landmark Diner, Ossining Main Street Sweets, Tarrytown Marriott Westchester, Tarrytown Mediterraneo, Pleasantville New York School of Esthetics, Tarrytown PHR Center for Electrolysis, Tarrytown Pinnacle at Heritage Hills Country Club, Somers Pleasantville Colonial Diner, Pleasantville The Red Hat Bistro & Bar, Irvington Sheraton Tarrytown Hotel, Tarrytown Sparx Hair & Makeup Center, Pleasantville Striped Bass, Tarrytown Sunset Cove, Tarrytown Tarrytown Woodworks Taste of China, Tarrytown Terra Rustica, Briarcliff Manor T.G.I. Friday’s, Tarrytown Tramonto Restaurant-Bar-Cafe, Hawthorne Trapp Optical, Irvington

Please patronize these businesses. Let them know you appreciate their community-minded support.

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