FALL 2012

HEALTH NEWS YOU CAN USE FROM BETH ISRAEL MEDICAL CENTER

Reaching Out to the LGBT Community

ts dinner hour at The SAGE Center in the Chelsea neighborhood. Several women call out to another to join them at their table. A man asks a young volunteer about the days vegetable. Another pours over The New York Times, lingering after his afternoon collage class. A few friends discuss the SAGE Singers. SAGE, which stands for Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders, is a national organization that offers supportive services and consumer resources to LGBT older adults and their caregivers, advocates for public policy, and provides training for aging providers and LGBT organizations. This center, which opened in March 2012, provides a comprehensive array of services and programs related to arts and culture, fitness, food and nutrition, health and wellness, and lifelong education to LGBT adults age 60 and over in New York City, says Sarah Savino, manager of the center. Mary Simmons, RN, a community health nurse at Beth Israel, (shown above, far left), spends two afternoons a week at the center, in a partnership between Beth Israel and SAGE. Ive taken time to get to know everyone and provide some counseling on health issues and medical management, says Ms. Simmons. Soon, Ill be doing programming that focuses on topics of importance to the aging LGBT community, she adds. When we opened the center, Beth Israel ran a health fair for us and it was a big success, says Tom Weber, Director of Community

Services at SAGE (shown above, far right). This is the kind of dynamic resource this center wants to be, he added, pointing out that the senior citizen center model that was born in the 1960s hadnt evolved much over the decades. The mayor and the New York City Department for the Aging wanted to make senior citizen centers more impactful and so they funded 10 new ones. We are one of those 10 and the only full-time LGBT senior center in the country, he explains. The city is not the only entity considering how to better serve the needs of targeted populations. Barbara Warren, Director for LGBT Health Services at Beth Israel (shown above, second from left), points out that Beth Israels work with SAGE falls under the broader umbrella of the Destination Diversity Initiative across the entire Continuum Health System, of which Beth Israel is a part. Beth Israel is increasing and improving our LGBT health services in all settings, she says. We believe our partnership with SAGE will be an excellent model for future collaboration with other important organizations, too. l

For more information about Beth Israels commitment to the LGBT community, please call 212.844.6389. For more information about The Sage Center, please call 646.576.8669 or visit www.SageUSA.org/TheSageCenter.

Bloodless Surgery for Joint Replacement

Medical experts say that patients who receive blood transfusions have more complications and infections and an increased length of stay in the hospital. Choosing a bloodless approach to surgery makes good medical sense for nearly everyone, explains Steven F. Harwin, MD, Chief of Total Hip and Knee Replacement at Beth Israel.

Message from the President

With the arrival of fall, so comes the flu season! Please remember to get your annual influenza or flu shot. Now is the perfect time for everyone older than six months to receive this protective vaccine. The flu vaccine is safe. However, individuals who are allergic to eggs, have had a reaction to a flu vaccine in the past that required medical attention, or have had a history of Guillain-Barr syndrome, should consult with their physicians. Beth Israels Karpas Health Information Center will be offering free seasonal flu vaccines at Phillips Ambulatory Care Center, 10 Union Square East, Dr. Gerald J. and Dorothy R. Friedman Conference Center, 2nd floor. Please see Karpas Calendar insert for complete schedule. Call 212.420.4247 to register and for more information. Once you have made that essential appointment, enjoy another issue of Healthy Neighbors! You can see how Beth Israel Medical Center is reaching out to and providing services for members of the LBGT community, patients interested in bloodless surgery, those who seek treatment for hernias, and anyone interested in living a life of wellness and health. Remember, We are always here to help!

More patients are opting for transfusion-free surgery simply to avoid complications like transfusion reactions, allergy and the remote chance of disease transmission. For some patients, like Jehovahs Witnesses, their religious beliefs will not allow accepting blood for any reason. Diana Hector (shown below with Dr. Harwin) is a Jehovahs Witness and Dr. Harwins patient. Dr. Harwin replaced my hip in 2005. I turned to him again a few months ago to replace my knee because I knew he had the expertise and would respect my beliefs, she says.

Harris M. Nagler, MD, FACS President, Beth Israel Medical Center

Visit Beth Israels brand-new blog for health and wellness information from our doctors, nurses and other health care professionals. Topics range from surgery, yoga and high blood pressure to dietary supplements, heart health and how to get your kids to take their medication. Check out Health Bytes at www.HealthBytesNYC.com.

The Blood Management and Bloodless Medicine and Surgery Program at Beth Israel coordinates bloodless health care throughout the institution, encouraging pharmaceuticals, procedures and technologies to avoid the use of transfused blood and its components. Experts estimate that 40 percent of transfusions nationwide are unnecessary, says Sandra Gilmore, Director of the program. Dr. Harwin uses a number of techniques to conserve blood, including boosting iron in the patients blood before surgery, using anesthetics that help lower blood pressure, and meticulous operative techniques. Dr. Harwin doesnt rely on arbitrary trigger levels for postoperative transfusions. If a patients hemoglobin level drops and there are no symptoms, we dont automatically transfuse, he explains. Orthopedics at Beth Israel is one of several specialties that engages in bloodless options. Our international reputation for excellence attracts people from all over the world who have an interest in blood management, says Ms. Gilmore. With six kids, 13 grandchildren and 14 great-grandchildren, Ms. Hector is happy to be among the thousands of Dr. Harwins patients who have had successfuland bloodlesstotal hip and knee replacements. l For more The Blood Management and Bloodless l Medicineinformation onProgram, please call 212.420.2430 or visit and Surgery http://www.chpnyc.org/services/BI_BloodlessMedicine.

Help for Hernia Sufferers

ernias are one of the most common operations in America, says I. Michael Leitman, MD, FACS, Director of Beth Israels Hernia Center. Hernias occur when part of an internal organ bulges through a weak area of muscle. Patients should know that we can almost always treat hernias on an outpatient basis with minimally invasive techniques, minimal discomfort and a quick return to normal life activities. If your hernias are more complicated or you have a case of a recurrent hernia, we can help. Our team of surgeons is expert in diagnosing and treating all types of hernias, from the most common to the most complex. The small subsets of hernias that do require more extensive surgeries are rare, but we have the ability to treat them and have great results, adds Dr. Leitman. The centers surgeons use a comprehensive range of surgical procedures (including robotic surgery and complex repairs done simultaneously with plastic and reconstructive surgeons). The experts also stay up-to-date on the latest materials for repair, including the latest synthetic mesh products. The goal

of mesh repair surgery is to close the hole in the muscle, with the mesh placed between the layers of muscle to decrease the likelihood that the hernia will come back over time. The mesh acts as a scaffold to allow the body to produce natural scar tissue in and around it to keep the hole closed. The centers surgeons also work closely with other specialists, such as those who care

for the digestive system or those who provide sophisticated imaging tests, to provide you the best and most successful treatment plan for your hernia type. l

To make an appointment with one of the surgeons at the Beth Israel Hernia Center, please call 212.844.1555.

WEST SIDERS, TAKE NOTE!

Beth Israel has just opened or will soon open the following new primary and specialty care locations in your neighborhood: Beth Israel Medical Center, along with other members of Continuum Hospitals of New York, has teamed up with The New York Daily News and NBC-New York to provide valuable health information to the New York metropolitan community via a multimedia platform. Visit www.LiveWellNY.com for excellent health tips and advice, as well as more information on the program.
NOW OPEN! BETH ISRAEL MEDICAL GROUPWEST 14TH STREET 222 West 14th Street, New York, NY 10011 212.604.1800 NOW OPEN! BETH ISRAEL MEDICAL GROUPWEST 23RD STREET 309 West 23rd Street, New York, NY 10011 212.352.2600

Please call the location nearest you for more information on hours, services and insurances accepted. l

Caution! Food-Drug Interactions

ou may be rightly careful about drinking alcohol while on medication, but did you know that you should also consider what you eat? Sally S. Wong, PhD, RD, CDN, Clinical Nutrition Manager at Beth Israel, outlines common unhealthy or dangerous food-drug interactions you should know about. For instance, if you take: Statins (Lipitor), avoid grapefruit, which can dangerously multiply the drugs effect. Blood thinners (Wafarin), be careful how often you eat Vitamin K-rich foods like green, leafy vegetables. You dont have to avoid these foods entirely, but you should eat a steady amount so your doctor can fine-tune the medications dosage according to your normal diet. You should, however, avoid cranberry products, which interfere with the drug. Antibiotics, avoid grapefruit, which can block the effect. For some classes of antibiotics (Cipro, Avelox, tetracycline), calcium also blocks the drug, so dont eat dairy products within two hours of taking these antibiotics. Blood pressure-lowering drugs (ACE inhibitors), be careful how you eat potassium-rich foods like bananas, oranges and green, leafy vegetables. You may not have to avoid these foods entirely, but because the drugs increase potassium in your body, your doctor may want to guide you on whats a safe amount. Anti-depressants (MAOI class), avoid foods rich in tyramine, often pickled, smoked, aged or preserved foods, such as aged cheeses, sausages, wines, soy sauce, sauerkraut, caviar and organ meat like liver. This interaction can cause a very dangerous hypertensive crisis.

Bronchodilators (Ventolin, Albuterol), avoid caffeine. The combination can cause excitability, nervousness and racing heartbeat. HIV medications (saquinavir, ritonavir), avoid garlicky dishes and garlic supplements, which render the drug ineffective. Always ask your physician about what information you should know regarding your medications. For instance, some medications should be eaten with foods and some taken on an empty stomach. If you dont have a regular doctor, call 877.886.9334 for a physician referral.

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Inside: LGBT health, treating hernias and bloodless surgery.

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