Winter 2008 - Huron Valley-Sinai Hospital

TO YOUR GOOD HEALTH
Your Report From America’s Best Doctors WINTER 2008
M.O. Bayram, M.D., FACOG
Chief of Obstetrics/Gynecology
DMC Huron Valley-Sinai Hospital
SPOTLIGHT:
OB/GYN
INSIDE — HEAR FROM
THE OB/GYN TEAM
• Q&A with Huron Valley-Sinai
OB/GYNs - page 4
• What is important in choosing a hospital
to deliver my baby
• Is there a certain age that I would be
considered a “high risk” mom
• What can I do to alleviate morning
sickness symptoms
• The Harris Birthing Center at
Huron Valley-Sinai Hospital -
page 5
IN OTHER NEWS...
• Stay hip and active with Birmingham
Hip Resurfacing - page 2
• The new Comprehensive Breast Clinic -
page 2
• The Vascular Clinic for Peripheral
Artery Disease - page 3
• Non-invasive heart-imaging - page 3
• Event listings - page 6
• Frequently called numbers - page 6
• Why immunize - page 7
WWW.HVSH.ORG

news
BIRMINGHAM HIP
RESURFACING
COMPREHENSIVE
BREAST CLINIC
Hip replacement without the
replacement Absolutely!
In people with arthritis, bones
of the hip joint become rough
and worn and they rub together
causing pain, swelling and
stiffness. Birmingham Hip
Resurfacing (BHR) is a surgical
procedure which shields these
worn surfaces in the joint using
a metal cap and socket.
Unlike traditional hip replacement surgery, Birmingham Hip Resurfacing
does not remove as much hip bone. Instead, the process simply buffs
away the rough damaged surface of the hip joint bones and replaces them
with more durable high carbide cobalt chrome.
BHR is significantly less invasive than total hip joint replacement surgery
allowing you to return to your normal routine sooner.
Huron Valley-Sinai Hospital pioneered BHR in Michigan and is now one of
the leading hospitals in the nation for this procedure.
For an appointment with a Huron Valley-Sinai Hospital physician
trained in BHR, please call 1-888-DMC-2500 or visit www.hvsh.org.
The Comprehensive Breast Clinic combines the expertise of radiologists,
surgeons, medical oncologists, radiation oncologists, nurses and
social workers - all in one location - to provide a thorough diagnosis
and treatment plan in a timely manor. The clinic is located in the
beautiful Sinai Center for Women at Huron Valley-Sinai Hospital and
offers the following state-of-the-art comprehensive care:
• Breast MRI
• Breast ultrasound
• Digital mammography
• Stereotactic breast biopsy
As part of the Comprehensive Breast Clinic, a nurse works with patients
to coordinate care and provide access to any medical or support services
needed. These “nurse navigators” are assigned to all patients in need of
ongoing care.
Other services at The Sinai Center for Women include:
• Bone density testing
• Breast cancer support group
• Breast feeding supplies (rental and retail)
• Laser Venous Ablation
• Postpartum depression support group
• Tuesday Tea: a series of educational presentations for women
• Women’s counseling
Physicians who perform Birmingham Hip
Resurfacing at Huron Valley-Sinai Hospital are:
For more information, or to make an appointment at the Comprehensive
Breast Clinic, please call 248-937-3800.
Roland Brandt, D.O.
Mark Kwartowitz, D.O.
Philip Schmitt, D.O.
To watch a video
of this revolutionary procedure,
visit Emery King’s Medical
Video Library at
www.dmc.org/videolibrary.
2

DMC HURON VALLEY-SINAI HOSPITAL
PERIPHERAL ARTERY
DISEASE
CORONARY COMPUTED
TOMOGRAPHY ANGIOGRAM
(CORONARY CTA)
A Coronary CTA is a non-invasive heart-imaging test currently used for
determining whether either fatty deposits or calcium deposits have built
up in the coronary arteries, which supply blood to the heart muscle. If
left untreated, these areas of build-up can cause heart muscle disease
which can lead to a heart attack.
For a Coronary CTA, Huron Valley-Sinai Hospital is using the state of the
art Siemens Dual Source, 64-slice CT. This technology allows scans of the
heart at any heart rate at the lowest radiation dose ever achieved in CT.
BEFORE
AFTER
Unlike a coronary angiogram or cardiac catheterization which is invasive
and requires patients to have a catheter threaded into their coronary
arteries, Coronary CTA can rule out significant narrowing of the major
coronary arteries non-invasively. Coronary CTA can detect “soft plaque,”
or fatty matter, in their walls that has not yet hardened but that may lead
to future problems without lifestyle changes or medical treatment.
Clogged artery in leg (image on left). Artery cleared using a
balloon and stent procedure (image on right).
Cardiovascular problems can affect more than just the heart. Blocked
arteries in other parts of the body can also lead to serious health
problems. One condition, known as Peripheral Artery Disease or PAD,
most noticeably occurs in the legs, causing symptoms such as:
• Pain and cramping in the legs or buttocks when walking or climbing
stairs that disappears with rest
• Heaviness, tightness or tiredness in the muscles of the legs or buttocks
• Loss of feeling, tingling or weakness in the legs
• Burning or aching in the feet while resting
• A sore on a leg or foot that will not heal
People who should consider having a Coronary CTA have:
• Intermediate to high-risk profiles for coronary artery disease, but who
do not have typical symptoms (especially chest pain, shortness of
breath, or fatigue during heavy physical activity.)
• Unusual symptoms for coronary artery disease (such as chest pain
unrelated to physical exertion), but low to intermediate risk profiles for
coronary artery disease.
• Unclear or inconclusive stress-test (treadmill test) results.
As some Coronary CTA uses are more appropriate than others it is
important to consult with your physician before making any decisions.
For a physician or cardiologist in your area, please call 1-888-DMC-2500
or visit www.dmc.org.
• Legs or feet that feel cold or change color to pale, bluish or dark reddish
• Loss of hair on the legs
Huron Valley-Sinai Hospital has established a PAD Clinic to diagnose and
treat this serious disease. At the Clinic, health care professionals use the
latest technology to test for PAD.
The PAD Clinic emphasizes the use of the least-invasive treatment
possible. Medications to manage blood pressure, prevent clots and reduce
the pain of walking may be used. Minimally invasive procedures can be
performed to remove blockages or to implant a special device in an artery
to open it. Open surgical procedures may be needed to bypass blood
around a blocked artery.
3-D heart image produced by a Dual Source 64-Slice
Cardiac Calcium CT Scan.
Call for more information or an appointment:
The Vascular Clinic at Huron Valley-Sinai Hospital
Phone number: 248-937-3467
Hours: Wednesday 8:00 a.m. – 12:00 p.m.
Location: Huron Valley-Sinai Hospital Cardiology Department
3

spotlight: OB/GYN
Q&A OB/GYN
Rekha Pramod, M.D.
OB/GYN
Q: Do you have advice about exercise during pregnancy Should I be
concerned about how high I get my heart rate during exercise When
should I stop exercising
A: Regular exercise builds bone and muscles, gives you energy and keeps
you healthy. This is just as important when you are pregnant.
Recommendations for exercise in pregnant women is not that much
different than nonpregnant women. The CDC and ACSM (American College
of Sports Medicine) recommends 30 minutes of moderate exercise per
day on most days of the week. In the absence of medical or obstetrical
complications, this recommendation applies to pregnant women as well.
Exercise during pregnancy can help prepare you for labor and childbirth.
Exercising afterwards can help you get back in shape.
The extra weight you are carrying will make your body work harder.
Exercise increases the flow of oxygen and blood to the muscles being
worked and away from other parts of your body. So it is important not
to overdo it. Try to exercise moderately so you don’t get tired quickly.
If you are able to talk normally while exercising, your heart rate is at an
acceptable level.
Q: Are there certain foods I should be eating or are there certain vitamins
that I should be taking
A: A balanced diet is a basic part of good health at all times in your life.
During pregnancy it is even more important. The best time to begin eating
a healthy diet is before you become pregnant.
Every diet should include proteins, carbohydrates, fats, vitamins and
minerals. To be sure your diet provides you with the right amount of
nutrients, you should know which foods are a good source of each.
Pregnant women need extra iron and folic acid, and these are usually
prescribed in pill form as supplements. Sometimes a prenatal supplement
that contains these two nutrients plus vitamins and minerals is
recommended.
Check with your doctor before taking any vitamins, herbs, or other
supplements that are not prescribed for you, as they might be harmful
during pregnancy. Just because a product is natural does not mean it
is safe to use during pregnancy.
Before beginning with your exercise program, talk with your doctor to
make sure you do not have any obstetric or health condition that would
limit your activity. Your doctor can offer advice about what type of
exercise routine is best for you.
To find an OB/GYN in your area,
please call 1-888-DMC-2500.
Dara Maurant, M.D.
Theodore Jones, M.D.
OB/GYN
Q: What is important in choosing a hospital to deliver my baby
A: It is important to ask your doctor what hospital they deliver at.
There are some practices that deliver out of more than one hospital.
Once you have that figured out, it is important to visit the hospital.
Make sure the hospital is a comfortable environment. This is one of
the most intimate times of our lives and comfort is imperative.
Ask about the ratio of nurses to patients. Knowing how many people
are available in the delivery room is a good question to ask so there
are no surprises. You want a hospital that is dedicated to patient
care and committed to excellence. It is good to know if the hospital
is equipped to deal with infants who need intensive care and if high
risk doctors are available for you if complications arise.
Q: Is there a certain age that I would be considered a “high risk” mom
A: Thirty-five years of age or older is the traditional age used for issues that
relate maternal age and risk. Risks include genetic disorders, such as
Down’s Syndrome (a chromosomal anomaly), increased risk for structural
anomalies (birth defects), medical risks (e.g. gestational diabetes and
preeclampsia), and higher risk for cesarean section for delivery. Also, any
problems for which a woman sees a physician on a regular basis or any
history of a complicated prior delivery would constitute a person that is
at-risk in their next pregnancy.
4

DMC HURON VALLEY-SINAI HOSPITAL
MERLE AND SHIRLEY
HARRIS BIRTHING CENTER
Shiri Gordinier, D.O.
OB/GYN
Q: How does an epidural work Are there other pain management
options
A: An epidural provides relief from the pain of contractions and delivery.
This is performed by an anesthesiologist by injecting a local anesthetic
into the epidural or peridural space. Although one injection may be
used, much more often these are repeated through an indwelling
catheter, or they are given by continuous infusion using a volumetric
pump.
Andrew Markowitz, M.D.
OB/GYN
Q: What can I do to alleviate morning sickness symptoms
A: Small frequent meals help avoid over distension of the stomach. If
prenatal vitamins are contributing to nausea, they may be stopped as
long as folic acid supplements are continued. Avoid noxious odors at
work and obtain adequate sleep. Ginger tablets 250 mg four times
daily have shown some benefit, while other studies reveal acupressure
stimulation by wrist bands may be effective. While limited studies have
been done on the safety of anti-nausea medicines in pregnancy, over
time several regimens have found acceptance with doctors and women
suffering most severely.
Additionally, it is important to consult with your physician to make
sure there are no medical disorders that may be causing similar
symptoms such as thyroid disease. Finally, there are a variety of
prescription medications we use when symptoms are interfering with
family life or work, after discussing the risks vs. benefits in comparison
to the degree of severity of nausea.
More than 32,000 mothers have chosen Huron Valley-Sinai Hospital to
bring their babies into the world.
The Merle and Shirley Harris Birthing Center at Huron Valley-Sinai
Hospital has earned a reputation as one of the area’s best obstetrics
programs. Widely regarded for our highly trained staff and extensive
capabilities, the Harris Birthing Center is also favored by mothers for
our decidedly personal approach.
The complete obstetric care is so exceptional that even many of the
hospital’s obstetricians choose to deliver their babies in the comfort of
Huron Valley-Sinai Hospital.
The Harris Birthing Center is home to a critical care nursery (CCN).
Our first-class facility is equipped to care for babies born prematurely or
requiring other critical care, including full-time neonatology service for
infants with special needs.
We also provide high-risk care for you before and during your delivery.
Our connection with Hutzel Women’s Hospital means experts are
available to you no matter what your needs.
Q: When should prenatal care begin
A: Ideally, prenatal care should begin prior to conception to screen for
any maternal illnesses or risk factors. If that is not possible, then
prenatal care should begin at 6-8 weeks of gestation (2-4 weeks after
a missed menstrual cycle). If the mother experiences any bleeding or
pain prior to her first appointment, she should call her physician
immediately.
Victoria Kean, D.O.
OB/GYN
At first glance, you won’t believe you’re even in a hospital. Our
comfortable all private LDRP (labor delivery recovery postpartum) rooms
include many amenities not available at other hospitals, including a
sleeper chair for dad, an in-room refrigerator, wall-mounted flat screen
television and high-speed Internet access.
We invite expecting mothers and their families to tour our birthing center.
To schedule a tour, please call 248-937-5220.
5

event listings
SUPPORT GROUPS
Family
GROUP
AL-ANON
ALATEEN
AA Meetings
Alzheimer’s Family Support Group
Arthritis Support Group
Breather’s Club
Breast Cancer Support Group
Cardiac Rehab Support Group
Diabetes Support Group
H.U.G.S.
(Help, Understanding and Grief Support)
Journeys Cancer Support Group
Postpartum Depression Support Group
DATE/TIME
Every Sunday, 10 a.m.
Every Sunday, 10 a.m.
Every Sunday, 10 a.m.
Second Monday, 7 p.m.
Fourth Monday, 2 p.m.
Third Thursday, 2 p.m.
Third Wednesday, 12 p.m.
Second & Fourth Thursday, 10 a.m.
Call (248) 937-3606 for dates
and times.
Call (248) 937-3600 for dates, 7 p.m.
Third Thursday, 7 p.m.
First & Third Monday, 7 p.m.
Every Thursday, 7 p.m.
Support groups are free and held at Huron Valley-Sinai Hospital. Registration is not
required unless otherwise indicated. Family members or friends are welcome. Note: some
support groups may vary their schedules around holidays and during the summer.
CPR/FIRST AID CLASSES
& Friends CPR, $25
Covers CPR and choking for adults, children and
infants. This course is intended for persons who wish to
know CPR but do not require training for work purposes.
Heartsaver CPR, $35
Covers CPR and choking for adults, children and infants.
This course is intended for persons who need CPR for
work purposes. Participants receive a completion card.
CPR and First Aid, $60
Covers CPR/Choking/First Aid/AED for adults and
children, and CPR/Choking for infants. This course is
intended for persons who need training for work purposes.
Participants receive a completion card.
For CPR class dates, please go to our website,
www.hvsh.org or call 248-937-3314.
DMC PEOPLE’S MEDICAL COLLEGE
People’s Medical College is a DMC educational series
designed to teach healthcare consumers about various
health topics. Topics can range from cardiovascular
disease to joint replacements to women’s health. Held on
both weeknights and weekends, these short conferences
will help you better understand various conditions and
how to prevent and treat them as well. Registration is
available by going to www.dmc.org/peoplesmedcollege or
by calling 1-888-DMC-2500.
COMMONLY USED NUMBERS
GENERAL INFORMATION
Visiting Hours
& Patient Information (248) 937-3300
Emergency Services (248) 937-3400
Pharmacy (248) 937-5710
DMC Health Access Center/
Physician Referral Services
888-DMC-2500
TUESDAY TEA
The Sinai Center for Women (SCW) at DMC Huron
Valley-Sinai Hospital hosts a series of lectures on Tuesday
evenings. Tuesday Tea provides a gathering place for
women while educating them on health-related concerns
women in our community face every day. These programs
take place in the lobby of the SCW. Please call
248-937-5055 for more information and to register.
Space is limited.
Physical Rehabilitation (248) 360-8700
PATIENT MEDICAL SERVICES
Cardio-Pulmonary
Rehabilitation (248) 937-3606
Cardiology Services (EKG) (248) 937-3467
Medical Records (248) 937-3360
Obstetrics/Gynecology (248) 937-5220
Occupational Rehabilitation (248) 360-8700
Radiology/x-ray (248) 937-3440
Respiratory Care (248) 937-3468
Sinai Center for Women (248) 937-3800
Social Work/
Discharge Planning (248) 937-3383
ADMINISTRATIVE SERVICES
WELCOME NEW PHYSICIANS
• Colon/Rectal Surgery
Khatchadour
Kamamdjian, M.D.
• Emergency Medicine
Pamela Eaton, D.O.
• Neurological Surgery
Lawrence Rapp, M.D.
• Obstetrics/Gynecology
Dara Maurant, M.D.
Julie Mladic, D.O.
6
Oncology Services (248) 937-5077
Orthopaedic Services (248) 937-4947
Outpatient Laboratory (248) 937-3427
Patient Representative/
Relations (248) 937-3344
Admitting (248) 937-3461
Billing Information (313) 578-2700
Community Health Education (248) 937-3314
Human Resources (248) 937-4040
Volunteer Services (248) 937-3505
• Family Medicine
Hussein Ajrouche, M.D.
Nathan Bloch, D.O.
Richard Mark, D.O.
• Internal Medicine
Howard Blank, M.D.
Mary Lazar, M.D.
Bijan Movafegh-
Jooryabi, D.O.
• Orthopaedic Surgery
Robert Travis, M.D.
• Pediatrics
Glenn Bauer, M.D.
• Plastic Surgery
Milena Lambie, D.O.

DMC HURON VALLEY-SINAI HOSPITAL
Expecting
Someone
Expect the Best
WHY IMMUNIZE
James Gordon, M.D..FIDSA
Infectious Disease Physician
I have people ask me; with certain diseases on the decline is it really
worthwhile to keep vaccinating our children
The best way to answer that question is to think of the following scenario.
Pretend you are bailing out a boat with a slow leak. The faster and harder
you bail the quicker the boat empties. Now, you could say, “Good. The boat
is dry now, so I can throw away the bucket and relax.” But the leak hasn’t
stopped. Before long you would notice a little water seeping in, and soon it
might be back up to the same level as when you started.
T he Merle and Shirley harriS BirT hing CenT er
a T dMC h uron Valley-Sinai hoSpiT al
Unless we can “stop the leak” (eliminate the disease), it is important to
keep immunizing - even if there are only a few cases of disease today. If
we take away the protection given by vaccinations, more and more people
will be infected and will spread disease to others. Essentially undoing the
progress we have made over the years.
To schedule a tour of the Merle
and Shirley Harris Birthing Center
at Huron Valley-Sinai Hospital,
call (248) 937-5120. To schedule
an appointment with one of our
physicians, call (888) DMC-2500.
• Beautiful, all private birthing suites, for labor,
delivery, recovery and postpartum (LDRP) care
• Anesthesiologists available 24 hours a day
• Critical-care nursery including full-time
neonatology service for infants with special needs
• High-risk pregnancy, infertility and genetics
services along with the experts, including Dr.
Theodore Jones, a specialist in maternal and fetal
medicine, at DMC Hutzel Women’s Hospital
Children who are not immunized can transmit vaccine-preventable
diseases throughout the community. Unvaccinated people can pass
diseases on to babies who are too young to be fully immunized, people who
can’t be immunized for medical reasons, people with compromised immune
systems, or in children whose immunizations did not “take”.
In the U.S., vaccines have reduced or eliminated many infectious diseases
that once routinely killed or harmed many infants, children, and adults.
However, the viruses and bacteria that cause vaccine-preventable disease
and death still exist and can be passed on to people who are not protected
by vaccines. During disease outbreaks, unimmunized children may be
excluded from school or child care until the outbreak is over, both for their
own protection and for the protection of others.
It is important to discuss any concerns you have with a trusted healthcare
provider or call the immunization coordinator at your local or state health
department. Remember, your final decision affects not only the health of
your child, but also the rest of your family, the health of your child’s friends
and their families, classmates, neighbors, and community.
To find a healthcare provider in your neighborhood, please call 1-888-DMC-2500
or visit us on the web at www.dmc.org.
1 William Carls Drive • Commerce, Michigan
248-937-3300 • www.hvsh.org
At Commerce & Commerce in Commerce
99th Percentile
Satisfaction
in national Survey
Family Life Education
Whether you’re expectant parents for the first time or the fifth, Huron Valley-Sinai
Hospital has an array of Family Life Education classes to help you prepare for life with
a baby.
Questions regarding any of our classes and associated fees can be directed to
(248) 937-3619. You can register online at www.hvsh.org. Register early as our classes
fill up quickly.
• Big Kids Class
• Birth Awareness
• Birth Review
• Breastfeeding
• Bringing Baby Home
• Gestational Diabetes
• Siblings at Birth
7

DECKER
PONTIAC LAKE RD.
WALTON BLVD.
HICKORY RIDGE RD.
COMMERCE RD.
MILFORD RD.
LIVINGSTON RD.
PETTIBONE LK. RD.
DUCK LK. RD.
Brighton
25 minutes
DUCK LK.
COOLEY LAKE RD.
BOGIE LK. RD.
E. COMMERCE RD.
ELIZABETH
BOGIE LK. RD.
White Lake
5-10 minutes
CARROLL LK. RD.
LAKE RD.
WISE RD.
COMMERCE RD.
WILLIAMS LAKE RD.
UNION LK RD.
HOSPITAL RD.
AIRPORT RD.
COOLEY LAKE RD.
WILLOW RD.
HILLER RD.
CRESCENT LAKE
ELIZABETH LAKE RD.
West
Bloomfield
15 minutes
TELEGRAPH RD.
ORCHARD LK. RD.
BUNO RD.
GENERAL MOTORS RD.
KENT LAKE RD.
MILFORD RD.
SOUTH HILL
WIXOM RD.
BUNO RD.
WIXOM RD.
DUCK LK. RD.
SLEETH RD.
BASS LAKE RD.
WIXOM RD. GLENGARY RD.
N. COMMERCE RD.
BENSTEIN RD.
S. COMMERCE RD.
NEWTON RD.
S. COMMERCE
RICHARDSON RD.
MARTIN RD.
OAKLEY PARK RD.
WELCH RD.
PONTIAC TRAIL
HAGGERTY RD.
HALSTEAD
GREEN LAKE RD.
PONTIAC TRAIL
WALNUT LAKE RD.
ORCHARD LK RD.
LONG LAKE RD.
LONE PINE RD.
WIXOM RD.
W. MAPLE
POTTER RD.
S. COMMERCE RD.
MAPLE RD.
W. MAPLE
PONTIAC TRAIL
14 MILE RD.
OLD PLANK
WIXOM RD.
WEST RD.
BECK RD.
WEST PARK DR.
S. LAKE DR.
NOVI RD.
13 MILE RD.
HALSTEAD RD.
MIDDLEBELT RD.
DRAKE RD.
FARMINGTON RD.
11 MILE RD.
Novi
15 minutes
11 MILE RD.
BECK RD.
12 MILE RD.
TAFT RD.
GRAND RIVER
NOVI RD.
MEADOWBROOK RD.
9 MILE RD.
HAGGERTY RD.
10 MILE RD.
To
U.S. 10
downtown
DMC
Campus
For assistance with directions, please call 248-937-3300.
For a physician referral, call 1-888-DMC-2500.
1 William Carls Drive
Commerce, MI 48382-2201
248-937-3300
www.hvsh.org
board members
DMC Huron
Valley-Sinai Hospital
Board Chair
Merle Harris
David Aronow
Mehmet Bayram, M.D.
Jack Belen, D.O.
Marc Bocknek, D.O.
Karol Breen
Barbara Dobb
Brian A. Derisley
Jim Doyle, Ph.D.
James R. Geisler, Ph.D.
Christina Hamill
Christopher Heberer, M.D.
Jacqueline Johnston
Jay Kozlowski, M.D.
Lila Lazarus
Kim Margolis, M.D.
Robert McGee
Michael J. Moore
George M. Nyman
Paul Oster
Mark Steinberg
Lyle B. Tyler
Lynn M. Torossian
Your link to top docs in Oakland County
www.hvsh.org