Look good, feel great - Continuum Health Partners

St. Luke’s and
Roosevelt Hospitals
Fall 2008
ehealny®
Look good,
feel great
The upside
of illness
Let’s
hear it for
hospitalists
Fight flu and
pneumonia

wehealny
To our readers
Autumn is here, and
that means winter illness
aren’t far behind.
Older adults in particular
are susceptible
to flu and pneumonia,
but with a healthy
dose of prevention,
you can guard against these conditions.
Read “Defend yourself” on this
page to find out how.
In this issue of We Heal New York,
you’ll also learn about the different
health care providers you may
come in contact with at St. Luke’s and
Roosevelt Hospitals, including nurse
practitioner Eileen Quinlan, GNP, BC,
hospitalist Raj Gurunathan, MD, and
physician assistant Danielle Witman.
Each of these individuals plays a
key role in helping our patients stay
healthy and cared for, both in and out
of the hospital setting.
We’re in your corner
Whether you need a primary care provider,
a specialist or specialty health
services, you’ll find them at St. Luke’s
and Roosevelt Hospitals. Call our physician
referral line at 1 (800) 420-2462.
We want your
feedback!
We Heal New York welcomes
questions, comments and story
suggestions. Write to us at:
We Heal New York
c/o Public Affairs and Marketing
Continuum Health Partners
555 W. 57th St., 18th Floor
New York, NY 10019
e-mail: GFessenden@chpnet.org
View a PDF of this issue online at
www.WeHealNewYork.org/SLR.
2 wehealny
Frank J. Cracolici,
President, St. Luke’s
and Roosevelt
Hospitals
Mark Gorny, MD
Defend
yourself
Your guide to preventing
flu and pneumonia
If you’re one of many Americans
who thinks you’re
immune to infectious
diseases like the flu and
pneumonia, you may be putting
yourself at risk for serious illness.
Older adults often overlook the
complications that can result from
colds and flu, such as bronchitis
and pneumonia, but as you age,
you face a higher risk for developing
these conditions. Your risk for
complications also rises if you:
• have a chronic health condition
such as diabetes, cardio-
vascular disease or lung disease
• have an impaired immune
system
• are being treated for cancer
• live in a nursing home or
other institution
The good news is that with
good care and prevention, you
won’t have to worry about these
conditions. Read on to learn how
to protect yourself from the flu
and pneumonia this season.
Get a shot of
good health!
To find a doctor who can give you
the vaccinations you need, call
1 (800) 420-2462.

John Greely, MD
Fighting flu
Influenza is a viral infection of
the nose, throat, bronchial tubes
and lungs. Symptoms include runny
nose, coughing, sneezing, sore throat,
fever of 101˚ F or higher, chills, body
aches, appetite loss, fatigue and weakness.
“See your doctor right away if
you have flu symptoms,” says John
Greely, MD, a board-certified internal
medicine physician at St. Luke’s
and Roosevelt Hospitals. “A prescription
antiviral medication, taken
within 48 hours of the symptoms’
onset, can help the body fight off the
flu in addition to the body’s natural
defenses.”
Sound nutrition and regular exercise
can strengthen your immune
system to fight infectious diseases,
and regular hand washing can keep
germs at bay. Annual flu shots will
give you added protection and are
recommended for adults ages 50 and
older. Because new strains appear
each year, the vaccine is reformulated
to fight the three strains expected to
be most active. “The best time to get
vaccinated is in October or
November, so you’ll be protected
throughout the winter season,”
advises Dr. Greely.
Nixing pneumonia
Adults ages 65 and older have an
increased risk of pneumonia, a lung
infection and inflammation that
often stems from a cold or the flu.
More than 50 kinds of pneumonia
exist, caused by bacteria, viruses (the
same ones that can cause flu), fungi
and other organisms.
“Pneumonia can be a serious and
potentially fatal illness, especially
in older adults, since their immune
system may not be as robust as a
younger person’s,” says Mark Gorny,
MD, an internal medicine physician
at St. Luke’s and Roosevelt Hospitals.
That’s why it’s important to see your
doctor at the first sign of symptoms
such as chills, fever, sweating, chest
pain, cough and shortness of breath.
Prompt treatment can minimize complications.
Depending on the type of
Be wise—immunize
pneumonia you have, your physician
may prescribe antibiotics or antivirals
and instruct you to rest until you’ve
recovered.
Better yet, getting an annual
flu shot and a pneumonia vaccination
can help prevent pneumonia.
“Immunization against pneumococcal
pneumonia is recommended for
adults ages 65 and older,” Dr. Gorny
says. You only need one pneumonia
vaccination, and you can get it all
year long (not just during flu season).
Aside from having little to no side
effects, Dr. Gorny points out the
vaccine’s benefits far outweigh the
risks of developing pneumonia. “It’s
a lot easier to get the vaccine than
to deal with the illness itself later,”
he says.
You can also keep your immune
system strong with a healthy diet
and regular exercise. Get in the habit
of regular hand washing and if you
smoke, quit, since smoking makes
your lungs more vulnerable to
respiratory infection.
If you’re not adequately immunized, you could be susceptible to preventable
illness. Drs. Greely and Gorny recommend these immunizations for healthy
older adults. (Ask your doctor about your risk factors and specific needs.)
IMMunIzaTIon Frequency
ÑTetanus, diphtheria, pertussis (Td/Tdap) Once every 10 years
ÑInfluenza Every year
ÑPneumococcal polysaccharide (pneumonia) Once at age 65 or older*
ÑZoster (shingles) Once at age 60 or older
* Adults who received this vaccine before age 65 due to a higher individual risk should
receive a one-time revaccination if five years have passed and they’re now 65 or older.
Fall 2008 3

If you’re sick or in need of a
regular checkup and screenings,
you normally make
an appointment to see your
physician. But did you know that a
nurse practitioner can also work with
you to help you stay healthy?
That’s because nurse practitioners
have the expertise to examine and
treat patients who have acute and
chronic medical problems. Just ask
Eileen Quinlan, GNP, BC, a geriatric
nurse practitioner at St. Luke’s
and Roosevelt Hospitals. Quinlan
is a member of University Medical
Practice Associates’ location across
the street from St. Luke’s Hospital.
(UMPA has two additional Upper
West Side locations.) “I’m the primary
care provider for my patients,”
she says. Quinlan cares for patients
similar to the way physicians do.
What is a nurse practitioner?
A nurse practitioner is a registered
nurse who has completed a master’s
4 wehealny
Greta Weinberg
program in a particular specialty, like
geriatrics, and achieved national certification
and state licensure.
“A nurse practitioner brings a
background in nursing to her patient
care and is trained at an advanced
level to diagnose and treat common
chronic and acute problems,” Quinlan
says. Similar to physicians, nurse
practitioners are also authorized to
prescribe medications to patients.
Understanding patients’ needs
Older adults have unique health
care needs, and Quinlan makes a
point of addressing them with her
patients. “We focus on disease prevention,
promoting healthy activities and
maximizing their quality of life,” she
says. To that end, she also collaborates
with other health care providers such
as home health aides and social workers.
“It’s crucial to be a team player,
since older adults often have many
people on their team. That’s one of
my strongest suits,” says Quinlan. “I
eileen quinlan,
GnP, Bc
Focusing on YOU
Nurse practitioners offer quality medical care
keep the entire team working together
and with the patient.”
Quinlan also draws on her experience
as a child of aging adults.
“I’ve been there—I understand my
patients and their families professionally
and personally,” says Quinlan. “I
have an appreciation on a personal
level of some of their issues.”
Strengthening relationships
One of the most satisfying things
about Quinlan’s job is the one-onone
relationship she builds with
each patient. “I enjoy the people
I care for,” she says. “In geriatrics,
you develop a very close bond with
patients, since health care is a big
focus for them. It’s so rewarding.”
Stay healthy!
To find a health care provider who can
care for you, call 1 (800) 420-2462.

Hospitalists:
Inpatient specialists
If you or a loved one have been
an inpatient at St. Luke’s and
Roosevelt Hospitals lately, you
may have noticed the presence
of senior-level physicians who
coordinate all aspects of your care
while you’re in the hospital. They
admit you, work with your surgeon
if you need surgery, communicate
with your primary care physician and
quickly coordinate emergency care
if needed.
These are just some of the
responsibilities of someone called a
hospitalist. “A hospitalist is a physician
whose sole focus is on inpatient
care,” says Raj Gurunathan, MD,
one of 28 such physicians on staff at
St. Luke’s and Roosevelt Hospitals
and director of its hospitalist
program.
raj Gurunathan, MD
Coordinating your care
Adult hospitalists are typically
internal medicine physicians—like
Dr. Gurunathan—or sometimes
family practitioners or medical
sub-specialists who are based in the
hospital. “We’re on-site full-time,
allowing us more direct interaction
with the patients and their families,
more time to supervise and educate
medical trainees, and more time to
partner with surgeons and other specialists
to provide a complete scope
of care for patients during their hospital
stay,” Dr. Gurunathan says.
Traditionally, physicians have had
to split their time between making
rounds at the hospital and seeing
patients in their office. For a busy
physician and a sick patient, this
schedule isn’t always practical. That’s
where hospitalists come in.
From admission to discharge, a
hospitalist is responsible for developing
a treatment plan, which includes
consulting with any necessary specialists
and social service staff. They help
you navigate the hospital services
system, answer questions about tests
and procedures, arrange for any necessary
emergency care and communicate
with your primary care physician
when you’re discharged to ensure
proper follow-up care. (For patients
who don’t have a primary care physician,
follow-up appointments and
referrals can be provided.)
“Patients like that they have one
point person to go to,” Dr. Gurunathan
says. Physicians appreciate
having a skilled colleague to care
for their hospitalized patients while
they’re busy in their offices.
Still, some patients are apprehensive
about seeing someone other than
their regular physician. Their fears
are quickly calmed.
“We make it pretty clear to
patients that we’re not replacing anybody,”
Dr. Gurunathan says. “We’re
part of the spectrum of care—allies
of patients and their primary care
doctors—and champions of better
hospital care for everyone.”
Need a great
doctor?
For help finding a physician, call
1 (800) 420-2462.
Fall 2008 5

Seizing
the day
How having
an illness can
change your
life—for the
better
not about how to
achieve your dreams,”
Randy Pausch told a
“It’s
captivated audience in
the packed Carnegie-Mellon University
lecture hall. “It’s about how
you live your life. If you lead your
life the right way, the karma will
take care of itself. The dreams will
come to you.”
Stay healthy today
For a referral to someone who can
help you cope with these and other
mental health issues, call 1 (212)
523-8080.
Watch Dr. Gilbert discuss “The
Wisdom of Illness” at www.slrpsych.org.
6 wehealny
Joel Podgor
The words of the celebrated 46year-old
computer sciences professor,
who died on July 25, 2008, and the
standing ovation that followed were
captured on video and posted to the
popular Web site YouTube.com.
While his words are moving, what’s
really an inspiration to the millions
who’ve heard them is that Pausch’s
zest for life wasn’t diminished by the
fact that he was dying. His pancreatic
cancer had spread, but he was still
ready to embrace every last second of
his life.
It may seem strange that some
people who face life-threatening
illnesses can be so upbeat. But ask
those who’ve faced such adversity
and they’ll tell you an illness can
indeed be a gift.
Lemons, lemonade and life
Joel Podgor is a 59-year-old
accountant from Queens who faced
two life-threatening illnesses. He
was diagnosed with embryonal cancer
when he was 23 and end-stage
heart failure at age 53. He beat them
both—but not before undergoing
grueling regimens of chemotherapy
and waiting for doctors to fix the
damage to his heart. At one point, he

Illness can be empowering. It allows some people
to recognize what matters most to them and how to
achieve their goals. —Melvin Gilbert, MD
was put on the heart transplant list.
His health improved after a year and
his name was taken off of it.
These days, “I don’t care as much
about looking ahead 20 years,”
Podgor says about his revamped
outlook. “I care about what happens
tomorrow.”
He recalls how people reacted
when they first heard his diagnoses:
“ ‘How awful,’ they said.” But Joel’s
view is just the opposite.
“As awful as these things are, I’d
go through the heart failure and the
cancer again,” he says. “If it makes
a difference in how you view your
Melvin Gilbert, MD
life and how you live it, it’s worth it.
Sometimes it takes going through a
traumatic event to put things in
perspective.”
Melvin Gilbert, MD, has seen
this before. Dr. Gilbert is a boardcertified
psychiatrist specializing in
patients with medical and psychiatric
problems at St. Luke’s and Roosevelt
Hospitals; he’s also an assistant
professor of clinical psychiatry at
Columbia University. In the late
1980s and early 1990s, he worked
with AIDS patients—young people
dying before they had a chance to
fully live. “I had a patient who had
aspirations to be a playwright,” he
says. “In the last year of his life, he
fulfilled that dream and put together
an off-off-Broadway production.
“Illness can be empowering. And
as unfortunate as these diagnoses are,
it allows some people to recognize
what matters most to them and how
to achieve their goals.”
A new attitude
For Podgor, that meant a gradual
attitude change. During this time, he
learned not to sweat the small stuff.
“Every day, people make decisions
that make them unhappy,” he says.
He’s not one of them.
Finding your silver
lining
eople tend to deal with
“P illness the way they deal
with other challenges in life,”
says Dr. Gilbert. People who are
best equipped to deal with illness
usually:
• aren’t overwhelmed by life’s
challenges
• have some degree of
resiliency
• see possibilities other than
hopelessness
• are willing to ask for help
• can adapt easily to change
• aren’t bitter
• aren’t depressed
While it’s normal to feel that life
didn’t give you a fair shake, don’t
let it consume you. Think about
what you want to accomplish in
the time remaining, Dr. Gilbert
says. Medications to curb depression
or dull pain can do wonders
for enjoying the rest of your life.
“Illness can be depressing, it’s
true,” he says, “but you still have
time left.”
And that’s time worth living.
He takes his own zest for life to
work, throwing his energy into solving
the problems of the hundreds of
clients who come to his accounting
firm. He helps put clients’ financial
situations into perspective. “I ask
them, ‘How’s your health? How’s
your wife’s health?’ Good? OK, now
let’s get to the small stuff,’ ” he says.
Fall 2008 7

Ready for a
NEW LOOK?
Consider facial rejuvenation
Aging comes with many
changes, including the
ones you can see on the
outside. Many wear their
wrinkles with pride—the signs of a
life well lived. Others, however, may
feel that their appearance isn’t a true
reflection of how they feel inside.
“Most of my patients tell me,
“Doctor, I want to look as young as I
feel, and that’s not what I see in the
mirror,’ ” says Maurice Khosh, MD,
a facial plastic and reconstructive
surgeon at St. Luke’s and Roosevelt
Hospitals. For these patients, facial
rejuvenation—more commonly
called a face-lift—can help match the
outside with the inside.
Thanks to medical advances,
patients now have several facial rejuvenation
options. “There used to be
one way to do it: Make one type of
incision and pull the skin back,”
Dr. Khosh says. “Now we can alter
the placement of the incision and
the direction of elevation. The
results can look more natural, and
the recovery is faster.”
8 wehealny
There are also new procedures
to avoid what Dr. Khosh calls “that
windswept look,” in which the skin
is pulled so tight it looks fake. “We
don’t just tighten the skin, we also
tighten the muscle layers underneath,”
he says. “We don’t have to
make the skin tight because the muscles
hold the skin in place better.”
Other enhancements
Plastic surgeons can also enhance
the face-lift by performing some of
these procedures:
• Nose and mouth. Surgeons can
transfer fat from other parts of the
body, usually the abdomen, to fill
the hollows that can be seen in the
nasal-labial fold (the line from the
nose to the corner of the mouth).
“Instead of pulling skin so tight that
the nasal-labial fold becomes flat,
we can add a little bit of fat to the
groove to make it look more natural,”
says Dr. Khosh.
• Chin. Some patients also benefit
from chin implants. “The chin
tends to droop with age; an implant
restores the natural, youthful position
of the chin,” Dr. Khosh says.
• Brows. Brow lifting can reverse
age-related sagging in the forehead.
“We use an endoscope and three
small incisions to expose and elevate
the brow,” explains Dr. Khosh.
It’s a great feeling to look in a mirror and see that you
look as young as you feel. —Maurice Khosh, MD

“Tiny absorbable implants keep the
brow in its new position as it heals.”
• Eyes. To make eyes look younger
and match the rest of the face, surgeons
remove skin from the upper
eyelids. Surgery to repair bags under
the eyes is undergoing “a revolution
right now,” says Dr. Khosh. “The
new idea is not to take out fat, but
to add fat below the baggy bulge in
the lower eyelid. This fills the valley
below it. The fat injections make the
face and lower eye area look plumper
and more youthful. This technique
has become widely accepted in the
last five years and works very well.”
“Patients love it”
Facial rejuvenation procedures are
usually performed in an outpatient
setting. “I prefer using the outpatient
Maurice Khosh, MD
What about the “weekend face-lift”?
In traditional face-lift surgery, surgeons make an incision that starts above the
ear and continues toward the hairline behind the ear.
Today, however, a modified technique allows surgeons to stop the incision
at the ear without continuing to the neck. This can be done without general
anesthesia, and it makes the procedure quicker and recovery faster—what
Dr. Khosh calls “the weekend face-lift.”
However, this technique isn’t recommended for older patients. “Traditional
surgery allows us to tighten both the face and neck, and that’s better for older
adults because they have excess skin in their neck,” explains Dr. Khosh.
“Someone younger, on the other hand, who doesn’t have excess neck skin
would be a good candidate for this procedure.”
facility at Roosevelt Hospital—it’s convenient,
well run and very safe for surgery
under general anesthesia,” notes
Dr. Khosh. “I recommend patients
hire an overnight nurse to watch them
carefully the first night after surgery.”
Stitches are removed about a week
after surgery, and most patients go
back to daily activities after stitches
are out. Patients can expect about 10
days of bruising. There’s some pain
and swelling, but “most people are
surprised at how little discomfort
they feel,” says Dr. Khosh. He typically
prescribes Tylenol with codeine
to help relieve pain.
Facial rejuvenation surgery comes
with some risks, but it’s generally
very successful, Dr. Khosh says.
“Patients love it. It’s a good feeling
to look in a mirror and see that you
look as young as you feel.”
Learn more
Few facial rejuvenation procedures
are covered by insurance.
For a referral to see Dr. Khosh or
another plastic surgeon, please call
1 (800) 420-2462.
Fall 2008 9

Put the brakes on
cardiovascular disease
One of the main risk
factors for cardiovascular
disease (CVD)
is simply growing
older. Women in particular are at
much greater risk for the condition
after menopause. That’s why the
Cardiovascular Disease Prevention
Network (CDPN) at St. Luke’s
and Roosevelt Hospitals offers an
aggressive approach to treating CVD
risk factors to prevent heart attack,
stroke and peripheral vascular disease
from ever happening.
“One of the program’s missions is
to reach out to women,” says Merle
Myerson, MD, EdD, a cardiologist
and director of the program. “Women
are under-served in prevention, even
though CVD is their No. 1 killer.”
Complete cardiovascular care
The CDPN, which Dr. Myerson
developed three years ago, is a comprehensive,
multidisciplinary program
whose goal is to make it easy
for women to keep track of their
cardiovascular care. “Women have
one person overseeing the preven-
Don’t leave your
heart health to chance
For more information about the
cardiovascular Disease Prevention
network, call 1 (800) 420-2462 or visit
www.WeHealnewyork.com/SLr.
10 wehealny
Your cardiovascular disease prevention team
• Merle Myerson, MD, EdD, cardiologist and director, Cardiovascular
Disease Prevention Network
• Donna Mendes, MD, peripheral disease services
• Jaqueline Tamis-Holland, MD, interventional cardiologist
• Carolyn Brockington, MD, stroke prevention services
• Malcolm Reid, MD, rehabilitation services (not pictured)
tion aspect of their CV care,” she
says. Patients in the program first see
Dr. Myerson for an initial examination;
they’re then referred to the
appropriate specialist. “We all work
together to find patients the proper
help,” says Dr. Myerson.
Many avenues of prevention
The CDPN can tap the expertise
of other specialists to help women
learn about every aspect of CVD
prevention, including:
• nutrition
• exercise
• smoking cessation
• weight control
• blood pressure and cholesterol
management
• menopause and hormone
management
• peripheral vascular disease
evaluation and management
• mini-stroke and stroke risk
evaluation and management
Another important mission of
the CDPN is community outreach
and education. “We provide services
at health fairs, offer free screenings
and provide lecturers who will talk
to groups throughout the community,”
says Dr. Myerson.
“A well-organized CVD prevention
program is greatly needed in
New York City, and we’re pleased to
offer it,” she adds.

Mable Lee
A perfect fit
Being a PA has professional
and personal rewards
Danielle Witman,
RPA-C, has been
interested in medicine
for as long as she can
remember. Growing up in Stony
Brook, N.Y., “I got excited whenever
the ambulance drove by,” she
says. “I was always intrigued by doctors
and hospitals, and I always had
a million questions.”
Though she knew she wanted a
career in medicine, she wasn’t sure
exactly which path to take. While
working in an OB/GYN office during
high school, she met a physician
assistant, also known as a PA.
“I liked that PAs treated patients
as a whole person and not just as a
disease,” she says. With an outgoing
personality and a love of people, she
knew “this was the best path for me.”
“I love it all”
Witman has been a PA for about
nine years now. Ask her what she
loves most about her job and she
says without hesitation, “I love it
all.” Her favorite part, though, is
simply sitting with patients and talking
to them. “The medical part is
great, but the best part is meeting
people,” says Witman. “Everyone in
New York has a story. I love hearing
their stories.”
A soft spot for older adults
Witman says older patients are “by
far my favorite group. With older peo-
Danielle Witman,
rPa-c
What is a physician
assistant?
physician assistant, or PA, is
A prepared to provide health
care services under the direction
and supervision of a doctor of
medicine (MD) or osteopathy (DO).
Working in collaboration with these
physicians, PAs are licensed to:
• conduct physical exams
• diagnose and treat illnesses
• write prescriptions
• order and interpret medical
tests
• advise patients on screenings
and other preventive health
measures
ple, you’re not just treating one problem
or issue, you’re treating the entire
person. Older patients need a gentle
hand. You have to be more thorough,
which I love. And they love it, too.”
And that’s just what makes her a
successful PA. “This is the perfect fit
for me,” she says.
The care you need
is right here
call 1 (800) 420-2462 to find a primary
care provider or specialist who’s
right for you.
Fall 2008 11

A helping hand from
those who care
If you or someone you love needs
end-of-life care, call us.
We’re here to help you manage your
illness, minimize pain and help your
family get the support they need.
Most of all, we’re here to help you
make the most of every day.
wehealny
Call today
(212) 420-3370
Roosevelt Hospital
1000 Tenth Ave. at W. 59th Street
New York, NY 10019
need a physician referral?
a second opinion?
We can help.
Our experienced nurses and
health information specialists can
help you find a doctor near you
who accepts your insurance.
Call Monday through Friday,
9 am to 5 pm
1 (800) 420-2462
Nonprofit Org
U.S. Postage
PAID
New York, NY
Permit No. 8048