Download the September/October 2012 Issue - Bayshore ...

In February 2012, Bernard “Bernie”
Rudnicky finally took his loved
ones’ advice and made an
appointment with his doctor. The
68-year-old Keansburg school bus
driver had been feeling ill for months.
He’d lost 25 pounds, felt run-down,
and was having intestinal problems.
As part of his exam, Bernie’s primary
care physician, Vinutha Raj, M.D., an
internal medicine physician on staff
at Bayshore Community Hospital,
recommended he have a colonoscopy.
Bernie then saw Bonnie Robinson-
Gallaro, M.D., a gastroenterologist
on staff at Bayshore and Riverview
Medical Center.
In addition to the colonoscopy,
Dr. Robinson-Gallaro ordered a CT
scan of Bernie’s abdomen. The scan
revealed an aneurysm — a bulge in
the wall of an artery that can grow
and rupture, causing life-threatening
bleeding — in an unusual location: an
artery leading to his left kidney.
This serious problem required the
care of a vascular surgeon. A neighbor
recommended James Brock, M.D.,
on staff at Riverview and part of
Meridian CardioVascular Network.
After reviewing the CT scan, Dr. Brock
told Bernie he needed surgery.
“I was very upset about the
aneurysm,” Bernie recalls. “But
Dr. Brock talked to me straight about
what needed to be done, and his
manner was so reassuring. He really
calmed me down.”
Notable Treatment
Dr. Brock hoped to spare Bernie from
open surgery and the large incision
it would require. But because of the
anatomy of his aneurysm, Bernie
wasn’t a candidate for a less invasive
procedure called endovascular
stent grafting.
So Dr. Brock decided on a hybrid
approach. By first using laparoscopic
techniques to expose the aneurysm,
he was then able to remove the
aneurysm and stitch the artery
back together through a much
smaller incision. He was assisted in
the operating room by his partner,
vascular surgeon Joseph Cauda, M.D.,
also on staff at Riverview.
The procedure was notable for a
few reasons. In the medical literature,
Dr. Brock found only about 12 cases
in which a renal artery aneurysm was
repaired with laparoscopic surgery.
In addition, Dr. Brock cooled
Bernie’s left kidney during surgery
by infusing it with a chilled saline
solution to help prevent organ
damage. He says he hasn’t found any
published accounts of this therapy
being used during laparoscopy to
repair a renal artery aneurysm.
“When reconstructing the artery
after removing the aneurysm, the
surgeon needs to clamp the artery
to temporarily stop blood flow,”
Dr. Brock explains. “Typically, the
kidneys can handle a loss of blood
flow for about 45 minutes without
suffering irreversible damage.
“But during surgery, you can never
predict if things will go according
to plan. Cooling the kidney reduces
Tour Our New Healing Spaces — From Your Home!
Our new Surgical Day Stay, described below, offers a wide
range of traditional and minimally invasive treatments,
without the hospital stay, in a serene space. Take a virtual tour
at www.RiverviewMedicalCenter.com/surgicaldaystay.
Surgical Day Stay: Designed for Comfort and Privacy
James S. Brock, M.D.
Board certified in General
Surgery and Vascular Surgery
Shrewsbury • 732-747-4744
its need for oxygen and decreases
its demand for blood flow — and it
buys time if you need to clamp the
artery longer than anticipated.”
Back on Track
Dr. Brock’s approach was a winning
one for Bernie. He was walking the
day after his surgery and spent just
four nights at Riverview.
He still raves about the care he
received from Dr. Brock. “He’s a great
doctor,” Bernie says. “I can’t say it
enough.”
Interestingly, Bernie learned from
Dr. Brock that the fatigue and diarrhea
he’d been experiencing weren’t related
to his aneurysm. The colonoscopy Dr.
Robinson-Gallaro ordered before his
surgery showed Bernie had mild colitis,
an inflammation of the colon. Bernie
is taking medication for it and feels
terrific, he says. He has a clean bill of
health and returned to work on May 1.
“I’m eating like a horse and have
gained about 5 pounds,” Bernie says.
“I’m feeling great. There was a whole
group of people who helped to save
my life by being so thorough and
good at what they do.” •
Regardless of the type of procedure you’re having, surgery can be stressful. Riverview Medical Center
wants every patient to have the best possible experience in an optimal healing environment.
Riverview’s new Surgical Day Stay — the outpatient service for surgical patients who go home in less
than 24 hours — lets you enjoy many relaxing amenities in a homelike atmosphere.
The spacious waiting area has comfortable chairs, a flat-screen TV, and a fish tank. Inside the unit, each
healing area is equipped with a 26-inch TV, seating for visitors, and a personal storage locker. Patients
have the ability to adjust their lighting, and there’s a private consultation area for those needing to speak
with their doctor after their procedure.
Meridian HealthViews • September/October 2012
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